Affirmations!

Here’s some welcome advice from my good friend Marnetta Viegas of Relax Kids…

It is so important that children wake up feeling great inside and grow up knowing that they are special. Children with a deep sense of worth and self esteem will find life easier and grow up enjoying each moment and challenge.

Affirmations are a powerful tools to help boost a child’s self-esteem. Getting children to repeat a positive quality or statement about themselves is key to developing their feeling of self worth and value.

Repeating positive affirmations brings calmness, positivity as well as power and inner strength.

Here are some positive qualities that you can use and encourage children to talk about, think about, feel, draw, repeat, practice, affirm, write and act out.

I am special
I am great
I am unique
I am confident
I am loved
I am powerful
I am courageous
I am peaceful
I am happy
I am determined
I am lucky
I am calm
I am bright
I am talented
I am clever

The more children (and adults, actually) think and feel these qualities, the more the qualities will be a natural part of their life.

This is something that we could all learn from – related to my earlier postings on the gratitude dance.

Take a moment to look at the Relax Kids CDs available from my site.

I have found these CDs and products AMAZING in helping my own kids and those of my patients with sleeping and behavioural disturbance, low mood, aggression, self esteem, bullying, or just plain feeling out of sorts!

Love & light,

Alison x


Dr Alison Grimston's Blog

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Holistic Doctor on Line is the blog of Dr Alison Grimston, a United Kingdom GP and spiritual healer who works with animals and people. Here she offers insights and information on integrating the best of complementary and scientific medicine in human and animal care.

Holistic approaches to depression

Fernworthy_small Hi there, naturally healthy people!

I was recently approached for advice about managing depression, alongside medication.

I see many people with depression every week. It is so common in the current stressful circumstances that we live in. For many, it is not until they truly find themselves that they find the resources to get better -permanently.

I recommend https://www.livinglifetothefull.com/ , or its Australian equivalent, https://www.moodgym.anu.edu.au/   These are computerised CBT (Cognitive Behavioural Therapy) which is brilliant, given that the NHS can’t afford face to face CBT for everyone who would benefit.


Dr Alison Grimston's Blog

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The fantastic patient leaflets that I use every day are on www.patient.co.uk – search under depression & you will pick up self help guides as well as specific leaflets on medications (most used are SSRIs these days, like fluoxetine & citalopram) and even on St John’s Wort. There are also excellent self help guides on stress & anxiety; although I am not always certain how many of my patients actually fill them in, if you do so they help you to think through your problem & introduce CBT.

There are many other approaches to depression & I would recommend finding a coach to help you find ways of addressing your mind/body/spirit and home/work life balance. 

Reflexology can be excellent at helping the energy to flow again, and Spiritual healing and Reiki can help you to heal yourself.

EFT (Emotional Freedom Technique)is very powerful, especially if maintained. Ann (see Tap to the Top –  EFT Workshops and Training) is absolutely fantastic, so if you are able to work with her it would be working with a guru. EFT is great, as part as a multidirectional self management plan.  The main thing is to gradually change your way of thinking about yourself, your internal conversation – NLP can also help here.

Don’t forget relaxation and meditation – my website www.TheNaturallyHealthyPet.com has the best CDs I have ever found on it, including an introduction to meditation through the chakras called Journey Through the Chakras.  But the healing CDs by Nigel Shaw (also on my site) are amazing; I only have to hear the first chords now to relax. Deep breathing is essential. Yoga can help to teach you this.

Nutrition – essential – tip out all junk foods, coke, crisps etc. Try to eat as close to natural as possible, raw foods are good (see the Raw Food Coach ), organic is better than non organic & farmed well better than factory – the food holds the energy of the animal  – I found this info amazing. Drink plenty of water – I drink filtered now.

You can guess how difficult I find it to work in the NHS, trying to give all this information out in 10 minutes as well as take a history!

LOL
Alison
www.holisticdoctoronline.com


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Seven Steps to Going Raw

Words of Wisdom

Willow_in_bracken_small_2 Hi there, naturally healthy people;

I am eager to tell you about some words of wisdom that I receive regularly into my in-box.

From all my experience in life, medicine and healing, I know that only I can change my perception of myself and those around me. We all get stressed – indeed, challenges are needed to keep interest and excitement in our lives. At times the stress seems unbearable, and we feel that it is natural to blame those around us.

In general practice, I am privileged to peek into people’s lives, and at times I am amazed at the degree of human resilience that I see. Some people cope with the most terrible life events – indeed, when we are sent such challenges, we can do nothing but get on with it, take each day as it comes, and live on – rise to the challenge.

It helps us to count our blessings if we simply take a look around the world and see what otheres are going through – years of homelessness and living in makeshift slums; starvation and infant death from preventable infectious diseases where there is no clean water supply; the monks in Burma………the list goes on. So I am grateful for water coming out of the tap, for having paid work, for having a fantastic family.

However, it is difficult to always think positively, even when you know that the decision to be positive comes from within you.  So I find these two free resources really helpful in cheering me up each day.

Take a look! I have posted today’s wonderful examples below, as well as links to their websites…

Bob Procter’s Insights of the Day

Variable in length, these anecdotes and stories can encourage us to change the way we relate to those around us – in many ways.

Mike Dooley’s Totally Unique Thoughts

Brief and easy to read, these "Notes from the Universe" prove thought provoking and stimulate the positive thinking that makes the Law of Attraction work for any of us!

TUT

Couldn’t you just pretend with the job or occupation you now have, whether or not it even pays or is recognized by others as a job, that you’re receiving a salary of millions each year for doing it? That everyday your peers, partners, or supervisors are left in awe by how you deftly handle each challenge and setback? That there are backroom discussions going on (sh-h-h-h-h….) even as you nonchalantly read this email, about retaining you no matter how high the cost? That shareholders are beginning to whisper among themselves about your legacy, and board members are each hoping to bump into you at the water cooler? That the competition has just hired a management consultancy firm just to keep up with your innovative style?

I think you could, even if you work in your pajamas, and I’d highly recommend it. Especially the "millions each year" part.

Insights of the Day

Power of Words 
"Sticks and stones may break my bones but words will never hurt me!"

We all heard that saying when we were children, and, like so many other childlike chants, it was a great myth. Words do have power, immense power, and they can cause much pain, because when they are repeated in negative fashion, people, especially children, may end up believing them. "You’re a bad boy," "You’ll never amount to anything." "You’re a loser," "Does your face hurt? It’s killing me." These are only slight examples of the negative language we often hear. We have all heard them, and unfortunately have been guilty of dishing them out as well.

During the 1980’s there was a big push for building self-esteem, and workshops were available everywhere teaching us how to make people ‘feel good about themselves.’ This 180 degree turn seemed valid in theory, but what happened in many cases was positive feedback became the new mantra, and yet the effect didn’t always achieve the desired results. Why? Because recipients only benefited from the praise if they believed it was genuine. This brings us to an important point. Self-talk and self-belief are the keys. No one can ruin our day without our permission, and always feeling good about ourselves is impossible. I hold this to be true – that self-esteem and self-worth are not synonymous. Self-esteem is having pride in oneself and generally feeling good about who we are. I don’t know about you, but I certainly have had moments in my life when I wasn’t too proud of my actions, and without question I have had times when I didn’t feel good about me. This moment of "lack of self-esteem" would indicate that something is terribly wrong. Contrary to the education of self-esteem, nothing is wrong – we are simply human. Self-worth, on the other hand, is acceptance of who we are – all of our strengths and weaknesses, all of our abilities (or lack thereof), all of our joyful moments as well as those times of sorrow; our contributions and our refusals, etc. See a pattern? We are worthy simply because we are His creation, and we are loved for every part of us. Whether we are in a good place or a bad one, whether we are contributing or contaminating, whether we have done something to be proud of or something to be embarrassed or ashamed of, nothing diminishes our worthiness. The negative actions and the ensuing consequences may affect our self-esteem, but it has no impact on our self-worth!

Chris Snook with Chet Snook
From Wealth Matters

Chris and Chet Snook are leading experts in personal investments, entrepreneurship, personal development, and money management. Let them show you how to unleash your inner genius and develop your wealth mindset with their new book Wealth Matters.

Love and Light

Alison

How this site is funded:

Three types of contacts are listed. The first help to fund HolisticDoctoronLine.com, as they’re ‘affiliated links’ which invisibly take you usually via affiliate linkage or commercial money sites, which then pay this site. The second type are adverts such as Google Adsense, which are not vetted in any way and are not recommendations on my part. The third are links, often from charities, that do not help with the funding of the site.

You shouldn’t notice any difference, the links don’t impact the product at all and the editorial line (the things I write) is NEVER impacted by the revenue. If it isn’t possible to get an affiliate link for the best product, it is still recommended and still included in exactly the same way. For more details read how this site is financed.

Some of the links I provide may help to fund this site, but I promise that the editorial line is never impacted by the revenue, and I would have recommended them whether or not they contribute.

ADHD and Iron

Iron Hi, naturally healthy people!

I have been aware for some time of the link between ADHD  and food additives. Another potential contributing factor to ADHD (attention deficit and hyperactivity disorder) appears to be iron deficiency. My colleague John Briffa, who keeps his ear to the ground for nutritional – related evidence, has pointed out a recent study, supporting the use of iron supplementation in children with ADHD who have reduced ferritin (iron stores) in the blood.

Previous evidence has suggested that iron deficinency is common in ADHD, and that iron supplementation may help this, but the newer study has a placebo arm and so gives us better evidence of the effect above placebo.

1. Konofal E, et al. Effects of Iron Supplementation on Attention Deficit Hyperactivity Disorder in Children. Pediatr Neurol, 2007;38(1): 20-26

So – it is worth adding iron for a three month period in ADHD, although if you want your GP to prescirbe he or she will wish to do a full blood count and ferritin blood test.

I have also received information about a local event in Eastbourne for those interested in making a helathy lifestyle plan for the new year – see the continuation link for more information!

Meanwhile, have a great week in the run-up to Christmas!

Love & light,

Alison Grimston, Holistic Doctor and Healer

A Warm Welcome …to Eastbourne

• Have you recently moved to Eastbourne?

• Would you like a healthy New Year 2008 lifestyle plan?

• Would you like to meet new people?

We are delighted once again to extend a warm welcome to those new (and of course not so new) to the area. In our state of the art Culinary Arts Studio at the University of Brighton Darley Road, Eastbourne, we invite you to join us for an “Eastbourne Newcomers” nutritious and tasty welcome!

In association with Lucy Ann-Prideaux from Simply Nutrition (www.simplynutritiononline.com) Lucy-Ann with her great passion for food and nutrition, coupled with an expansive knowledge of nutritional science, will talk about her… TOP 7 LIFESTYLE CHANGES for YOU for 2008 …together with key food and dietary tips and advice, to help you get the very most out of the year ahead! This evening will provide a perfect opportunity to meet some like-minded new people, make new friends, or contacts over a glass of wine, or fresh juice, as well as enjoy delicious complimentary canapés from VegOut Sussex. We guarantee you a fun, informative, friendly and healthy evening!

This evening will take place on Monday February 4th from 7:00 pm – 9:30 pm at the Culinary Arts Studio, University of Brighton, Darley Road, Eastbourne BN20 7UR To book your ticket please contact Gilly Nicol on 01323 649127/ 07957 604386 Tickets £15:00 each

GPs offering complementary therapies

Orchid_small Hi there,

My recent blog on HolisticDoctorOnLine has created quite an uproar of comment, especially on Ecadamy, a business networking forum, where it was entitled "Critics of complementary medicine are arrogant and close-minded".

As the subject of evidence-based medicine is relevant to animal health also, I have copied it in full here:

At last! some rare signs that I am not alone!

I have found two posts on the PULSE website that make my heart sing.

A recent survey of 200 GPs shows that 56% either provide or recommend (like me) complementary therapies.

I insist on calling them complementary therapies rather than "alternative" as is used on the site – it is essential that science and therapies work hand in hand to help people through illness to wellness and a degree of self-healing.

Acupuncture was recommended by 40%, homeopathy by 11%. The summary does not discuss osteopathy, which I feel is also more commonly recommended (as those GPs with a  purely left-brained mindset can see how it "could" work so more likely to recommend it than, say, homeopathy).

The comments on the page are, unfortunately, back to the traditional arrogant scientific view of "it’s just the placebo effect" and "poor deluded patients, imagining an effect".

Then, amongst the links to the debate to ban all complementary therapies on the basis of lack of evidence-base (you mean, like appendicectomy and paracetamol?), I found the most wonderful article by Dr Michael Dixon from Devon – a fellow – thinker, he has put into words exactly my thoughts.

What a man; like myself he thinks that, maybe, "Critics of complementary medicine are arrogant and close-minded". I had noticed this myself; my patients are so relieved when they find they can talk openly with me about their use of herbal and homeopathic medicine. If at least 60% of the general population use or have used complementary therapies, it suggests to me that the scientists are in the wrong for ignoring and trivialising this.

I would like to point out here that I have spent 4 years in pure scientific research in physiology and pharmacology, and have been trained in the "art" of pulling apart scientific papers, as well as having been on the receiving end. With that experience behind me I feel that a.) evidence based medicine is an appropriate way to distinguish between two drugs to be used for the same problem. b.) No amount of large trials will convince the sceptical scientists that complementary therapies work (as I have already seen that they/ we can pull apart any research anyway). c.) As complementary therapies work at least partly at a holistic level involving the individual in self-healing, randomising patients will not demonstrate an effect anyway – this does not mean the placebo effect (as scientists devalue anything with that term) but the self-healing effect, which should be made use of by each of us in health care (patients and therapists alike).

Dr Dixon’s post is so close to my feelings, I copy it in full below (and wish there was a facility on Pulse for me to register my support for him).

Critics of Complementary medicine are arrogant and closed-minded:

07 Jun 07

Pressure groups such as Sense about Science are too quick to condemn complementary approaches to treatment, argues Dr Michael Dixon

Is it bad medicine to treat some NHS patients using complementary treatments? ‘Yes!’ says the powerful pressure group Sense about Science. But is science – or indeed sense – on its side?

Many complementary approaches do have a good evidence base. St John’s wort for moderate depression or acupuncture for osteoarthritis of the knee are just two examples. In fact, there is better evidence for these than for many conventional treatments in daily use.

It has been estimated that at least 75% of conventional primary care lacks the support of double-blind placebo-controlled trials. For symptoms such as tiredness, back pain or irritable bowel syndrome, there is often no good evidence-based treatment. So why discriminate between the conventional and the complementary, providing both are safe, when neither has the evidence base that Sense about Science demands?

That question is particularly relevant in long-term disease – by definition incurable – where patient perception of improved well-being and function is the desired outcome. Why should we accept Sense about Science’s restricted, even arrogant, interpretation of science and healing? It is the science of ‘scientists’ and technicians, of a regimented world far from frontline general practice where a symptom may be a metaphor for the real problem and where beliefs, background and culture are major factors in the treatment’s success.

Its science excludes feelings and suffering. It ignores the patient as an individual. It dismisses empathy, hope and our ability as self-organising beings to heal through the mind. It is a dehumanised vision designed to turn GPs into evidence-based robots.More than 50% of GPs now refer patients to complementary practitioners or practise it themselves, and 75% of patients want to receive complementary medicine on the NHS. Real science should explain that, not condemn it. What we need is a science that goes deeper, using a more pragmatic and applied research methodology, and taking in the entirety of a patient’s treatment rather than dissecting it – a science that gives practitioners and commissioners a better idea of what works and what does not. Otherwise science and patients will go in opposite directions and both will suffer.

Self-appointed experts

The trouble with Sense about Science is that its science is inhuman and its sense fails to resonate with the common sense of ordinary patients. Its self-appointed experts are dominated by emotion. They use personal invective – I have the scars to prove it. Sometimes this emotion is fear – that complementary medicine will take away money from specialist treatments. The reality is the opposite. Complementary medicine used wisely for long-term diseases should enable the right patients to be looked after cost-effectively in primary care, reducing secondary care referrals, drugs and other costs and leaving more money for conventional but costly treatments where they are needed.

I discovered complementary medicine because conventional medicine held insufficient answers. Last week I had failures and successes – a patient whose arthritis had been quiescent for a year on a herbal medicine, another whose frozen shoulder had been helped by self-administered acupressure, a third who had avoided a diagnostic laparotomy by using a complementary diet and a fourth with cancer who felt that creative visualisation and a diet had helped. All these treatments were sustained by the patients themselves and cost the NHS very little.

Fortunately we live in a primary care-led NHS, which respects patient choice. Long may that remain the case.

Dr Michael Dixon is a GP in Cullompton, Devon, visiting professor at the University of Westminster and a trustee of the Prince of Wales Foundation for Integrated Health

Give yourself some time!

Surgery_couch_small Hi there!

It is difficult, isn’t it? We are just not brought up to make time for ourselves! And we have to lead by example – goodness knows what messages I am giving my kids at the moment, what with setting up my animal healing website as well as being a GP – but it has been so exciting!

There are some amazing things, though.  I arrive at work at 8am, having dropped the kids off at their school bus at 0730 – it doesnt seem worth it to return home. So I start on the paperwork – blood test results, hospital letters, telephone messages from patients, changes to medication, writing prescriptions, medication reviews.

And do you know what makes a world of difference to my day? If I can just make time before morning surgery to lie down on my couch with my eyes closed for 5 minutes, with my healing music on (Nigel Shaw – see the CDs for sale on the left of my website), then I know that I love myself enough to give myself that time. It only takes 5 minutes – or even less if pushed – yet my day goes so much better, and I can easily release all those resentful feelings that we all feel at times; I am no longer a martyr!

So go on! What can YOU do to make time for yourself? Let us know, share the tips….

Love & light
[b][i]Alison[/i][/b]

Leg Cramps- The Holistic Way

LegsLeg cramps are extremely common – most of us will experience them at some time in our life. I am going to discuss some ways of helping with leg cramps, illness both medical and holistic. As a GP, patients come to me with distressing leg cramps every week. Fortunately there is something we can do to help, in most cases.

What are Leg cramps?
Leg cramps are pains due to muscle spasm in the muscles of the leg, usually the calf. They can occur especially if the muscle is already partly contracted, and you move in bed to contract them further. They are commoner at night.

Leg cramps are commoner as you get older, in people with an under-active thyroid gland, and in those with peripheral vascular disease, when the arteries of the legs are partially blocked.

Most cases do not have a detectable cause. Occasionally they may be caused by medication, such as diuretics, lithium, cimetidine and asthma medication.

Other causes of leg cramps include excess muscle use during the day, dehydration, low sodium levels, pregnancy, and renal dialysis. They are commonly found after long runs such as marathons.

As leg cramps tend to settle within 10 minutes, pain killers are often not needed, although they can be effective. The most effective medicine to prevent leg cramps is quinine, which should be taken every night for at least 4 weeks to observe the effect. It should be avoided in high doses in pregnancy (unless being used to treat malaria, when the benefits outweigh the risks).

Other methods include exercises to stretch the muscles at the back of the leg (by bringing your toes up towards the knees, or leaning forward  towards a wall). This can be done during an attack as well as regularly to reduce the likelihood of an attack. It may help to eat sugary or salty foods before activity, or to raise the bed head slightly.

Quinine is present in bitter lemon and tonic water, and I have had cases (e.g. in pregnancy) where drinking some of this every night was sufficient to hold the cramps at bay.

Massage during an episode can help. Sweet marjoram oil in a carrier oil may help with the massage. Having a bath with lavender oil or nutmeg may help, while a compress of common thyme or purslane may ease the pain. The scientific evidence for these approaches is poor.

I hope that this helps with this common problem. Quinine tablets are, however, useful and effective, and are safe except in overdose, so if you have ongoing problems do see your doctor!

Please see the excellent patient.co.uk leaflet website for a good leaflet:

https://www.patient.co.uk/showdoc/23068794/

Disclaimer:
The content of our website is not a substitute for professional medical advice or treatment. Always seek the advice of your doctor relating to any medical condition.

Tea Tree Oil

Teatreekent Hello, Naturally Healthy People!

A recent useful posting by an American doctor, Astrid Pujari, M.D., on the use of tee tree oil in the management of fungal toenail infections has inspired me to write more on this very useful plant oil.

Tee tree oil is an essential oil derived from the leaves and branches of the tea tree of Australasia.  While toxic when taken orally, as Dr Pujari points out, it has a multitude of uses when used topically.

The natural oil has a varied composition of terpene hydrocarbons, cineol and other alcohols.  In fact more than 100 different compounds have been found in tea tree oil.

It has antibacterial and antifungal action in vitro (ie in labroratory conditions, rather than in live animals). It may even be effective against MRSA (methicillin-resistance staphylococcus aureus).

It is used mainly as an antiseptic, and was used traditionally by Australian aboriginals for athletes foot, bites, cuts and stings. There is some evidence for its effectiveness in skin problems such as acne, eczema, head lice, psoriasis and bacterial infections of the skin.

Adverse reactions include local rashes and allergy, and one source says drowsiness and other CNS effects, diarrhoea, irritation of the oral mucosa, and vomiting, but these are presumably on oral intake only. Effects in pregnancy and breast feeding are unknown.

In animals, tea tree can be used topically, even undiluted, for wounds, thrush in horses (a bacterial infection of the frog of the foot, quite different to the fungal infection in humans), ringworm, and fungal, viral and bacterial infections generally. It can also be used in aloe vera gel or seaweed gel for topical applications. 

For urine infections, it can be applied topically to the skin in between the back legs of dogs and horses, but there have been occasional reports of adverse effects such as severe inflammation and even temporary paralysis. 

A few drops can be added to a bucket or bowl of drinking water for urine infections and as an immune stimulant, but the animal should also have access to plain drinking water so that it can make a choice.

Tea tree oil is an invaluable adjunct to any family medicine cabinet!

Have a great week, naturally healthy people!

Alison

Freedom From Stress

Field_barcombe  What makes you feel free from stress? Just for a moment?

For me it is the Sussex countryside, preferably armed with trees. This photo shows the view on one of the walks along our lane. Every day I am grateful for the place where I live – it is fundamental to my holistic well-being. Of course there are other routes to reducing my stress levels that I have learnt – meditation, deep and relaxing breathing, and hugging the dog to name but three.

For my friend Judith, it is the view from her London apartment that keeps her ticking. She just loves being in London, with all it represents (see below for her fantastic view).

London_docklands_small Two weekends ago I made a trip up to London for 2 days to do a course that Judith was coordinating with EFT master practitioner, Ann Ross.

Judith is an acclaimed business coach, who left her business as an accountant to pursue what she was really passionate about, running multiple businesses to love, creating passive income through property, and coaching entrepreneurs with small to medium businesses to success. Having worked with her over the last year through the Moneygym, I would trust her judgement on most things (thought we agree to differ on the ideal place to live…). Take a look at this site for her Elite Entrepreneur’s Club

Ann led 20 of us through an amazing experience of releasing some of our emotional fears and ties through the Emotional Freedom Technique. Although the title of the weekend was "Creating a Millionaire Mindset", and the pair tend to work together to produce courses for entrepreneurs at present, Ann’s vision is to introduce EFT in a more widespread way across the NHS.

I could feel the powerful effect of the group’s energy working to release each person’s fears and beliefs around money – phrases, often stemming from childhood experiences, such as "There is never enough" and "Money doesn’t grow on trees" were linked first to the emotions that they created within us, such as despair and stifling despondency. Gradually, through tapping certain points on the face and body, we were able to reduce the power these beliefs held for us, and even release them.

I could feel how this would work equally well with beliefs about health and wellness, and stress in general. Most of the patients I see in general practice -and indeed it seems most people these days – are suffering deeply from stress, including emotional and financial stress. This is a fundamental cause of so many of their health problems, and also of the way they perceive symptoms such as pain.

Here are some examples of their courses in London:

EFT Workshops and Training

EFT 1 & 2 Practitioner Training will be on February 16th, 17th and 18th and our remaining workshops (themes to be announced) will be:

15th and 16th March – Exterminate Your Inner Saboteur

10th and 11th May – Design Your Destiny

13th and 14th September – Success Unlimited

8th and 9th November – Millionaire Mindset

Wishing you peace and wellbeing!

Alison

Antibiotic Resistance

Steth_small_2Reading the September 1st British Medical Journal on my return from holiday I was pleased to see both an editorial and a research paper focussing on prescribing antibiotics in primary care. 

A study in Australian children showed that, 2 months after being prescribed antibiotics for a respiratory infection, they were twice as likely to have antibiotic resistant bacteria in their throats than a control group.

The editorial cautions the use of antibiotics in upper respiratory infections that will often get better without, and urges us to use antibiotics as carefully as we should oil – as a non- sustainable resource. The bacteria will always evolve ways of getting over whatever antibiotics we come up with, which is why the drug companies are working faster and faster to come up with new drugs more rapidly.

My own approach, as ever in general practice, is to look at each case individually. However, I know that I would hesitate to use antiobitcs in my own children if they had a sore throat or otitis media, unless it looked very purulent and they were very unwell. I usually give the parent an opportunity to return if the child is not improving, or a prescription to get made up in 24-48 hrs if symptoms are worsening.  If there are no signs of a chest infection (as opposed to bronchitis, which is an upper airway infection that does not need antibiotics), then antibiotics are not needed for a chesty cough, either.

Experience is key, along with education of patients and their families. One particularly useful aid to this is the patient leaflets that I give out in surgery, which come from the https://www.patient.co.uk site – do look! There is excellent information about the use of antibiotics.

Sore throats can be a bit different of course. If there is strong evidence of tonsillitis (although a study previously showed that a clinician cannot distinguish this accurately from glandular fever, a viral infection that does NOT need antibiotics), with pain, pyrexia, a pusy discharge on enlarged red tonsils, and tender enlarged cervical lymph nodes, then antibiotics are useful. However, if antibiotics are used, a further study showed that a full 10 day course of penicillin V is needed to eradicate Streptococcus from the throat. This goes against our trend in other infections to shorten the duration of a course of antibiotics. Now if only I can find those two references…

So you can see how complicated evidence based medicine is, how it is a full time job keeping up with it, and how we have to do our best to come up with a workable way forward with these things.

I am convinced of one thing since I started my healing journey – it is vitally important to let the body’s own immune system work wherever possible, and not step in with antibiotics until and unless necessary. And I was amazed when a homeopathic doctor friend of mine told me that he managed all of his own children’s otitis media with homeopathic remedies! It had never entered my head before that this would be possible. There is so much to learn in medical school that the complementary therapies fall by the wayside.