Ask the Medic with Dr Niall Breen

0:00Lunchtime Live with Andrea Gilligan on News Talk. Dr. Nile Brain from the Port Marnec GP clinic is with me in studio to answer all of your health questions queries today and I'll host things. Things are very good, thank you. I feel like the whole country must be dozed at this stage. Yeah, and it's doggling. Yeah, absolutely. It's beginning to come through now. Is it? Yeah. Yeah, and there is a bit of COVID around as well. But it's just that time of year. We've fully expected, probably hasn't fully hit just yet. So we're just in the kind of the beginning of it, yeah. Oh, wait, 7, 1400, 106 get your health questions in for Nile. This listener is 35. Says that they've been hearing COVID and the rise again. Advice, what's the advice for people who do test positive for COVID, even if you're healthy, like we do need to be in the office. But is there changes to the current protocol or what is protocol? Yeah, so I looked at the protocol about two months ago. So it's not absolutely fresh in my head, but I think if you test positive, I think that

1:03you do have to isolate still for at least two or three days. To be fair, the HSE have a really excellent resource because it depends on your age and it depends on a few other things as to what exactly you should do. And if you go to that, it'll tell you, I mean, yeah, if you think you have COVID, then you probably should test really. And if you test positive, then look up the guidance and you really do need to isolate for a couple of days. This year, essentially, anybody who feels having spoken to their GP or pharmacist, if they feel that they should get a COVID vaccine, that they're at risk, they are entitled to get it. So it's definitely worth considering. Yeah, I thought the advice was you didn't have to stay home, but obviously there's been some changes. Yeah, I would have last look at it. It's continually changing and it depends on your personal circumstances and it depends on your age. So if that person is worried that they're positive or they're worried that they've been exposed, get along to the HSE website, the rules are definitely way less stringent than they

2:04were. Okay. So yeah, but it is worth checking out HSE.ai. Okay. Lister says they've a twinge in their knee, currently marathon training, but don't know whether I should power through or not. I've done the whole rest and ice thing. The pain is still quite severe. Feel I don't have time now not to train and still get my PB. So no pressure then. Look, I suppose it's like this. It depends what a twinge, like a twinge could be to some people that their knees fall enough. Describe in the pain is quite severe. Yeah, I mean, I think if the pain is quite severe, I would absolutely rest it for a few days. Absolutely. And if they've been doing all the rest and ice and so on and the pain is quite severe, it's probably worth considering going along to your own doctor and considering getting an MRI scan or something along those lines. I mean, I think the marathon is only about two weeks away now. So it's pretty close. The thing about it is if you have a significant cartilage tear or you have a tear to your ACL or something very significant going on, then the bottom line is you probably wouldn't

3:07be able to do the marathon and I'm a bit wary of powering through if you're interested in severe pain. Yeah. Well, maybe a few days rest. They said the person. Yeah, the person said that they had rested. So I think you'd be absolutely within your right to rest completely for at least three or four days and see how you are. But we're in the territory of long runs and that kind of thing for people now in the lead up. So I would be very cautious if I was that person. Yeah, you sound like a man with experience there. I'm not. Listener says, I'm a vegetarian and sometimes I get worried that I'm not getting all of the nutrients and vitamins I need. Should I take supplements and if so, what should I take? It's a really good question. And if somebody's a vegetarian and they're otherwise eating a fairly standard Western diet, they're probably getting most of what they need. Most of the vitamins and nutrients that were advised to take for the vast majority of us with a reasonably balanced Western diet probably don't need most of them. A general multivitamin that you can buy over the counter in your pharmacy is probably plenty if that's what that person wants.

4:09But again, as GPs, there are only two vitamins that we really test for. Vitamin B12 and some and vitamin D, although some laboratories won't test for vitamin D because they're the most important. The majority of them, again, if you're having a fairly standard Western diet, you're getting most of them. Okay. 087, 1400, 106, the WhatsApp number for your health questions for Dr. Nile Brain. Lister says, my nails are actually very damaged after multiple manicures, suggestions and how I might strengthen them. For something like that, we occasionally do see people and I don't know much about nails, but who would have had kind of nails, shell acts and different things. I would just probably leave them be for a good period of time. I wouldn't be putting any product on them. If they're very damaged or very cracked or there's evidence that there's something fungal, then you can get that treated. But if it's just that they feel damaged, then I probably would give a complete rest from all those treatments and just give it a little bit of time, give them a chance to recover. Okay. Lister says, I've recently started a new job and my commute has started eating into my

5:12sleep schedule. How much sleep do I actually need as a minimum and how can I ensure that I'm getting the most restful sleep? Yeah. Well, getting sleep, they usually say between seven to eight hours is the ideal. I don't know how much of us actually achieve that. To get a more restful sleep, I suppose the talkbook doing a decent sleep wind down about an hour before you go to bed. This is all advice I probably should take myself, but I don't. So they say that you probably should avoid alcohol late into the night, not drinking excessive amounts of fluids after five, six o'clock, because that will get you up to the loo. Sorry, as early as five and six need. Yeah, for some people, yeah, absolutely. If they're up in the middle of the night, once or twice to urinate, then definitely reducing your fluids after five or six o'clock quite significantly. And maybe the hour before you go to bed, making sure you go to the toilet at least twice for men that at that visit, that not only do they stand in your net, but they also sit

6:13in your net, because it puts the bladder into two different sort of, I suppose, directions. So making sure the bladder is empty, not having a TV in your room, not watching TV screens, tablets in your room. If there's ambient noise, trying to do something about that. If somebody sleeps beside a snorer, that can be a hard thing to control. But that wind down about an hour before you go to sleep, I'm going to bed and trying to get a good night's sleep, again, reducing things like tea, coffee, any stimulants throughout the day. Unfortunately, it's all the real boring stuff, but it does work. Listeners, I'm quitting alcohol after nine months of drinking 350 milliliters of vodka every evening. I've started to taper off over the last seven. I have started to taper off it over a seven day window. I'm wondering is this safe or do I need medication to help with withdrawals? Yeah, so nine years, 360 milliliters of vodka. Nine months of 360 milliliters of vodka. That poor person has obviously made a really big step, but I definitely would be linking

7:18in with my doctor about that one. So when you go into an alcohol withdrawal, even though this person is talking about reducing it gradually, there's a very significant risk that you can have side effects. And the most serious of those would be a seizure or a seizure like episode. So to be fair to the person, they're trying to make a positive step, but as GPs, we would often prescribe medication that helps that person to detox safely from alcohol. Also it's worth, I suppose, somebody like that who's been drinking very large amounts of alcohol. One of the other benefits of going along to your own GP is they'll ask other questions. So that person might be focusing on the vodka, but they might be drinking other things as well, or they might be taking other things like certain coding, containing medications that you can buy over the counter. So when somebody comes into me like that who's been taking large amounts of alcohol, we do a kind of a risk assessment of all the substance that they may have been taking, and then we calculate medication that can help them to detox if I safely. So they should really get some GP support there? Yeah, I think that it would.

8:18And you know, some people might be able to manage without it, but the, you know, nine months of daily drinking of 350 milliliters. I think a half a bottle. That's an awful lot. Yeah, that person has made a really positive step already. The next one would be to link in a healthcare person to help them. Yeah. Okay. All right, Dr. Nile Brin from the Port Marnec GP clinic. Nile, thanks a million for joining us here on Ask the GP this afternoon. Lunchtime live with Andrea Gilligan, weekdays at midday on News Talk. Conversation that counts.