Figures from Cancer Research UK suggest thousands of cancers are being missed every week because people with symptoms are not going to their GP.
But many routine tests and treatments are also being postponed as vulnerable people self-isolate and the NHS focuses on the Covid-19 pandemic and the most seriously ill. Here, RACHEL ELLIS looks at treatments you may be missing out on — and what you can take to help yourself.
INJECTIONS OF B12
More than five million Britons who rely on regular vitamin B12 injections have been told by the NHS their treatment may be suspended for at least six months to minimise contact in the pandemic.
A B12 deficiency can cause symptoms including depression, fatigue and breathlessness. Although it can be caused by diet (it is found mostly in fish, meat, eggs and milk), it is often linked to the autoimmune disorder pernicious anaemia, where the immune system attacks cells in the stomach, affecting the body’s ability to absorb B12.
While patients with diet-related B12 deficiency may be advised to take a daily 1,000 mcg B12 tablet, available on prescription or over the counter from pharmacies, those with pernicious anaemia normally have an injection every two to three months at their GP surgery.
Figures from Cancer Research UK suggest thousands of cancers are being missed every week because people with symptoms are not going to their GP (file image)
In these patients, the tablets will have little effect as the stomach cannot absorb them, according to the Pernicious Anaemia Society. Some patients may instead be taught how to self-administer the injections by their GP practice.
TOENAILS AND CORNS
Routine podiatry appointments for toenail-cutting, corns and checks for patients with diabetes (who may have nerve damage, so they don’t feel foot problems developing) have been cancelled.
Emma McConnachie, a spokeswoman for the College of Podiatry, suggests those with foot problems should check their feet daily ‘using a mirror if you can’t see all parts of them yourself. Watch out for cuts or marks you don’t remember getting, or new blisters. If you spot anything, you can still call your podiatrist for advice. Some podiatry clinics also offer video consultations.’
She adds: ‘The ideal way to trim your own toenails is to use a long file and file them in one direction (not back and forth) every two days. This helps reduce the risk of damage to surrounding skin. Don’t try to use anything sharp to remove skin or corns, as you can cause a lot of damage.
‘A foot file or pumice stone is the safest way to keep on top of dead skin, but it may be best just to leave it and simply moisturise your feet.’
EAR SYRINGING
Hearing aids, ear plugs, age and narrow ear canals can all lead to a build-up of earwax, which blocks the ear, causing an ache, difficulty in hearing, and sometimes infection and dizziness.
Ear syringing — where the ear is rinsed with low-pressure warm water to remove wax — is often done by GPs. It can also be performed by microsuction using a vacuum device (without water).
But new guidance from the Royal College of GPs recommends that the procedure should be postponed. Instead, it suggests patients treat blocked ears at home with olive oil, which softens the wax so it naturally comes out of the ear.
The British Tinnitus Association advises putting two or three drops into the affected ear twice a day, for one to two weeks. The olive oil need not be warmed and the wax will often come out by itself. Don’t use fingers or cotton buds to remove it.
Women with implantable contraceptive devices such as the Mirena coil and under-the-skin implants will not be able to have their devices checked or changed during the coronavirus crisis
CONTRACEPTION
Women with implantable contraceptive devices such as the Mirena coil and under-the-skin implants will not be able to have their devices checked or changed during the coronavirus crisis.
‘The expiry date of implantable contraceptive devices tends to be very conservative and they will probably offer protection from pregnancy for some time after,’ says Dr Jonathan Leach, of the Royal College of GPs.
‘Patients can use other contraceptive methods such as condoms, or consider starting on a progesterone pill as an interim measure.
‘There is no risk in keeping these devices in past their expiry date.’
Doctors may extend prescriptions of the Pill for low-risk patients without carrying out the normal review for changes in blood pressure.
BLOOD PRESSURE
People with high blood pressure (above 140/90 mmHg) usually have their blood pressure checked every few months by their GP or practice nurse, but many appointments have been postponed or cancelled.
Katharine Jenner, of the charity Blood Pressure UK, says that unless advised otherwise, people should take their blood pressure at home. She adds: ‘This can give more accurate results because people tend to be more relaxed, and multiple readings can be taken to get an average (a one-off high reading doesn’t necessarily mean you have high blood pressure).
‘These can then be sent in to your GP practice by phone or email.
‘You can buy home monitors for about £25 from pharmacies or online. Choose one with an arm cuff because wrist monitors and smartphone apps aren’t yet clinically validated.’
DENTAL CHECKS
Dental practices in England have been closed since March 20.
While NHS England has said it is providing 165 pop-up centres to treat patients with urgent problems, the British Dental Association says many are not open yet.
Those with minor problems such as lost fillings, dull toothache and small chips will have to wait.
Dr Richard Marques, a London dentist, recommends rinsing the mouth with salt water for 60 seconds several times a day to help remove bacteria and clear infection, dabbing a little clove oil on the affected area to help reduce pain, or taking painkillers.
To help prevent new problems arising, Professor Damien Walmsley, scientific adviser to the British Dental Association, says that as well as brushing twice a day with a fluoride toothpaste, people should use interdental brushes to clean between their teeth.