LETTERS

Patients requesting letters for gym’s, social welfare etc or completion of various forms take up a considerable amount of time, whether medical or not. Please give us at least 48 hours notice for completion of same. Please note that all patients may be charged for this facility as this is not covered under the Medical Card Scheme.


SCREENING CHECKS

Blood Cholesterol, Diabetes, Anaemia, Asthma, Blood pressure, Sexually Transmitted Diseases & HIV, Mammography (arranged), Bone Density Test (arranged), PSA for prostate gland.


MEDICAL EXAMINATIONS

Pre-employment medicals, Insurance Medicals Drivers Licence, Eyesight for driving, General check-up male and female.  These medical examinations would incur a charge, as they would not be covered under the Medical Card Scheme.

24 HOUR BLOOD PRESSURE MONITOR

If you suffer from high blood pressure, we can arrange for you to come into the surgery to have a 24 hour blood pressure monitor reading done. The nurse attaches the cuff to your arm and the monitor is put around your shoulder or waist. We advise you to telephone either Doctor at their dedicated telephone times, where they will give you your results. This gives us time to import the results to your medical file and time for the doctor to read the result. If need be, we can then refer you to a consultant or prescribe medication if necessary. It is important that you make an appointment for this as the monitor is only given on an appointment basis only.

ECG

New guidelines suggest that everyone above the age of 65 years of age should be screened for Atrial Fibrillation, which is an irregular heart beat/pulse, annually.  Atrial Fibrillation is a leading cause of stroke.

This records the electrical activity of the heart. The heart produces tiny electrical impulses which spread through the heart muscle to make it beat. These impulses are detected by the ECG machine, that can be done here at, Carrig Medical Centre. The Nurse attaches the electrodes to parts of your body which in turn will take the reading of your heart beats and you will be given your result at your consultation. It is important you let the reception team know that you want an ECG at your consultation as we need time to set the machine up and input your details.

Spirometry

This is a machine that assesses your lung function by measuring the volume of air entering and leaving your lungs. We also now provide this service at Carrig Medical Centre. It is important you let the reception team know that you want to have a spirometry reading done, at your consultation, as we need time to set the machine up and input your details.

Glucose Tolerance Test (GTT)

This is a blood test performed to diagnose diabetes, or gestational diabetes. A blood test is taken early in the morning, after fasting from the night before. You would then drink a glucose drink, that we will give you, in the surgery, and you would have a further blood test performed 1 hour after the initial blood test, and a further blood test an hour after that, if you are pregnant. Test results are usually back within 5 working days. Please inform the reception staff that you require this blood test as we need to allocate two/three appointment slots for you.

Venesection

Venesection is a simple procedure in which our Practice Nurse, Aisling,  removes blood from you, via a vein in your arm. Venesection is usually a regular treatment performed at varying intervals, depending on your blood results and diagnosis. It is most likely that you have been recommended venesection for one or two reasons:

Polycythaemia – This is when your blood has a raised Red Cell Count which results in a thickening of your blood. In this case, venesection is necessary to remove blood on a regular basis to maintain a normal concentration of red cells.

Haemochromatosis – This is when your body absorbs too much iron from your diet, which is then deposited in various organs around the body, i.e. the liver and heart. Too much iron can cause problems or damage to these organs. Every pint of blood taken during venesection contains ¼ of a gram of iron.

If you have private healthcare with VHI, LAYA, Irish Life this procedure would be covered.  This procedure is not covered by the Medical Card Scheme, or if you do not have private health care, there is a charge for this procedure.

If you require this procedure, please let the reception staff know, so that we can allocate enough time for this to be performed.

Shingles vaccine – Cost €200.00

Shingles is caused by the varicella zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus stays in the body in a dormant (inactive) state Shingles (herpes zoster) is a painful skin rash that develops on one side of the face or body. Shingles vaccine reduces the risk of developing shingles and the long-term pain that can follow. Your risk of shingles and long-term pain from the disease increases as you age.

People 60 years old and older should get shingles vaccine to prevent the disease, regardless of whether they recall having had chickenpox. This is a one-time vaccination. There is no maximum age for getting the shingles vaccine.

Even if you have had shingles, you can still receive the shingles vaccine to help prevent future occurrences of the disease. There is no specific time that you must wait after having shingles before receiving the shingles vaccine.

Protection from the shingles vaccine lasts about 5 years. In adults vaccinated at age 60 years or older, protection from the vaccine decreases within the first 5 years after vaccination.

People with weakened immune systems have an increased risk of developing shingles. For example, people with certain cancers, including leukemia and lymphoma, and human immunodeficiency virus (HIV), and people who have undergone a bone marrow or organ transplantation, or who take immunosuppressive drugs.

People who develop shingles typically have only one episode in their lifetime. In rare cases, however, a person can have a second or even a third episode.

Chicken Pox Vaccine   Cost per dose €90.00

We now offer chickenpox (Varicella) vaccination to children aged 14 months or older. Many parents now like their children to be vaccinated against this infection, to help prevent the considerable misery to the child.

HSE recommendations are for 2 doses at least 1 month apart.

It is a routine vaccine in many countries but not on the childhood vaccine schedule in Ireland yet.

It must be given at least a month after other vaccines, so we recommend giving it a month after your baby has the 12-month and 13-month vaccines, i.e. at 14 months, but can be given any time after this too.

The cost is €90 per vaccine, which is a lot less hassle than the 2 unexpected and possibly unpaid weeks off work you’ll have to take when the creche tell you that they won’t take your child until the infection has passed.

Please contact Joan or Marie to organise an appointment with the Doctor to administer this vaccine.  Please let us know when you are making the appointment that this vaccine is required as we don’t keep it in stock.

What is Chickenpox?

Chickenpox is a common disease of childhood and is caused by exposure to the Varicella Zoster virus (VZV) which is transmitted by direct personal contact or by airborne means. Incubation period is usually 14 to 16 days (range 10-21).

The illness itself is usually mild but it can be associated with more severe complications. VZV remains dormant after chickenpox but can reactivate later resulting in shingles. The risk of this increases with age.

Why vaccinate?

A vaccine is available and is licensed for use in Ireland in children over 1 year and adults. However, vaccination against VZV does not form part of the National Childhood Immunisation Programme (for cost reasons mainly). Many other countries routinely fund vaccination of children against VZV. The cost of vaccination in Carrig Medical Centre is €90 per dose. The three main reasons why parents get their child vaccinated are:

1. To help reduce the chance of you needing 2-3 weeks off work if their creche won’t take them when infected

2. To reduce unnecessary suffering of the child. Complications can include pneumonia, secondary bacterial skin infections and viral meningitis and encephalitis. Fatality Rate: 1/100,000 in children and 25/100,000 in adults

3. To help reduce the chance of shingles in later life which has it’s own complications (e.g. post- herpetic neuralgia)

Vaccination Schedule:

 Children can receive the vaccine from 12-14 months of age. It should not be given within one month of any other live vaccines (e.g. MMR, yellow fever).

 Children aged from 1 year to less than 13 years  – 2 Doses are recommended, 4 to 8 weeks apart (we recommend your child gets the 12-month and 13-month vaccines as per Irish schedule, then get this one any time after 14 months)

Effectiveness:

Vaccine efficacy is estimated to be 70-90% against infection, and 90-100% against moderate or severe disease. Vaccine efficacy is lower (~75%) in those aged >13 years. Immunity in most appears to be long lasting, probably life long. However, approximately 1% of vaccinees per year have developed mild breakthrough infections.

Side effects:

Common: Mild injection site soreness;

Uncommon: Fever and varicella rash (approx. 5 lesions), allergy

Whooping Cough (Pertussis) Vaccine

Whooping cough, also known as Pertussis is a very contagious disease which is very easily spread by personal contact.
It is caused by a bacteria known as Bordetella Pertussis which live in the mouth, nose and throat.

The disease causes long bouts of coughing and choking making it hard to breathe. The child may turn blue from lack of air, or vomit after a coughing spell. Between these coughing spells a child gasps for air causing the characteristic ‘whoop’ sound. Not all children get the ‘whoop’. A child with whooping cough can have difficulty eating, drinking or even breathing. The disease can last up to three months. Whooping cough is most serious in babies under 12 months of age, often requiring admission to hospital and may be fatal.

Younger children usually come in contact with this bacteria in the home through older children and adults.

The pertussis vaccine is given to children as part of the 6 in 1 vaccine at 2, 4 and 6 months of age with a booster vaccine given at 4-5 years of age (as part of the 4 in 1 vaccine) and again between 11-14 years of age (Tdap vaccine).

The National Immunisation Office in advice to GPs issued in September 2013 recommend vaccination for the following cohorts:

  • Pregnant women between 27-36 weeks gestation IN EACH PREGNANCY
  • Unvaccinated women in the week after delivery (may be less effective)
  • Close family contacts of infants born before 32 weeks gestation as they may not have received protection via maternal immunisation. Close family should be vaccinated 2 weeks before any close contact with the newborn and should include siblings in the household and unvaccinated adults.

This vaccination is covered by the Mother and Child Scheme, when you are pregnant.

Non-Invasive Pre-Natal Testing – Harmony Test – €500.00/€550.00 (non patients)

We are delighted to be able to offer this cutting-edge DNA test to all expectant Mums.

Non-invasive Prenatal Testing (NIPT) analyses cell-free DNA circulating in the pregnant mother’s blood.

It is a new option in prenatal screening for Down syndrome (trisomy 21) and other common chromosomal conditions (trisomies 18 and 13), X and Y chromosome conditions.

This test can be requested for any singleton pregnancy, including in vitro fertilization (IVF) pregnancies with egg donors.

It can now also be requested for ALL twin pregnancies (without X or Y) conceived naturally or by IVF using the patient’s own egg or a donor egg.

About the Ariosa Harmony™ Prenatal Test

DNA from the fetus circulates in the mother’s blood. Cell-free DNA (cfDNA) results from the natural breakdown of fetal cells (presumed to be mostly placental) and clears from the maternal system within hours of giving birth.
During a pregnancy, cfDNA can be tested to give the most accurate screening approach in estimating the risk of a fetus having a common chromosome condition sometimes called a trisomy. This occurs when there are three copies of a particular chromosome instead of the expected two. The test looks to detect the following trisomies:

  • Trisomy 21 is the most common trisomy at the time of birth. Also called Down syndrome, it is associated with moderate to severe intellectual disabilities and may also lead to digestive disease, congenital heart defects and other malformations.
  • Trisomy 18 (Edwards syndrome) and Trisomy 13 (Patau syndrome) are associated with a high rate of miscarriage. These babies are born with severe brain abnormalities and often have congenital heart defects as well as other birth defects. Most affected individuals die before or soon after birth, and very few survive beyond the first year of life.
  • Sex chromosome conditions. The sex chromosomes (X and Y) determine whether we are male or female. X and Y chromosome conditions occur when there is a missing, extra, or incomplete copy of one of the sex chromosomes. The Harmony with X, Y test can assess risk for XXX, XYY, XXYY, XXY (Klinefelter syndrome), and a missing X chromosome in a girl (Turner syndrome). There is significant variability in the severity of these conditions, but most individuals have mild, if any, physical or behavioural features. If the mother is interested in having this optional testing, she should talk with her healthcare provider to determine if it is right for her. This option is not available for twin pregnancies.

Risk

This test is non-invasive as it involves taking a blood sample from the mother only.

The pregnancy is not put at risk of miscarriage or any other adverse outcomes that are associated with invasive testing procedures such as amniocentesis.

Accuracy

Clinical studies have shown that the Ariosa HarmonyTM Prenatal Test has up to 99% accuracy for assessing fetal trisomy risk.

Who can have the test?

The Ariosa Harmony –  Prenatal Test can be done by the GP for women with pregnancies of at least 10 weeks’ gestational age. The test can also be done for all IVF singleton pregnancies, including those with egg donors. Samples from pregnant women with twins naturally conceived, or those conceived using the patient’s own egg, are also accepted.

How much does it cost?

The cost of the test including doctor consult, blood test and delivery of results is €500.00/€550.00

How long will I have to wait for results?

The test is sent to London for processing. At the moment we are advised that the turnaround time is 7 – 10 working days.

Where can I find out more information?.

The Ariosa Harmony web site has further information:  www.ariosadx.com

MENINGITIS B VACCINE – Cost per dose €150.00 (2 doses required)

We are now offering the Men B vaccine (Bexsero) at  Carrig Medical Centre.   It helps protect against the leading cause of bacterial and septicaemia meningitis.  Meningitis can strike in an instance, but its impact can last a lifetime. Ireland has the highest incidence of meningococcal disease in Europe and with men B accounting for the majority of these cases.

This vaccine is included through the routine immunisation program since the 1st of October 2016,  any child born before the 1st of October can have the vaccine administered privately at Carrig Medical Centre for €150.00 per vaccine.

The vaccine is available to all children from 2 months of age, and is usually given in two doses, and a booster at 12 months depending on the age of your child when it has first been administered

Anti Wrinkle Treatment

Cost: 1 Area €190, 2 Area’s €250, 3 Area’s €300

Cost : Hyperhydrosis (excessive under arm sweating) € 500.00

We are now offering anti wrinkle treatment at Carrig Medical Centre. Botulinum toxin is often known as the brand name botox, dysport or xeomin. This is the single most effective and by far the most popular of the anti wrinkle treatments in the world. It is considered to be the finest advancement in recent cosmetic medicine in the last two decades.

Anti-Wrinkle Injections can erase lines and wrinkles, improve facial contour and improve eye shape in a matter of days, effectively turning back the clock without the need for surgery.

Does it hurt?

The treatment itself can only takes 15-20 minutes. Numbing cream can be applied to your skin before treatment, but the needles are so tiny that there is normally no need.

How long do the effects last?

The results of the treatment become visible after 2-7 days, and the effects should last about 3-6 months. When you return for regular follow-up treatments, the muscles become accustomed to the treatment and the effects can last much longer.

What areas can be effectively treated?

Botulinum toxin can be used to

  • relax frown lines
  • give the eyebrows a lift
  • soften the appearance of ‘crows’ feet’
  • reduce excessive underarm sweating

Is it safe?

Botulinum toxin has been used for many years to treat muscular spasticity. The doses required to treat spasticity are far higher than the tiny amounts used for cosmetic treatment of the face. At this point in time, MILLIONS of botulinum toxin doses have been administered, safely, with no complications.

The most important thing to remember is that this treatment is non-permanent and very safe. The botulinum toxin is metabolized at the injection site and it does not spread to any other parts of the body. If you decide to stop having the treatment, your appearance will revert to its original state.

Are there any side effects?

Side effects are not very common with botulinum toxin treatments, and very importantly even if they occur there are no long-term side effects whatsoever. For about one hour after the treatment you may have small red bumps at the site of the injections, but these typically fade within 1 hour. Headaches, slight bruising, tightness and heaviness are rare side-effects but all of these usually resolve within a matter of days.

An appointment is essential for this treatment, and this can be done out of surgery hours.

STI Screening – €80.00

We offer a full screening service for sexually transmitted infections. Unfortunately there are a large number of such infections in circulation, many of which can be picked up easily by men or women. They include

  • Chlamydia
  • Gonorrhoea
  • Genital warts
  • Trichomonas
  • Hepatitis B
  • HIV
  • Syphilis
  • Herpes

In many cases you may not even know you are infected so therefore can pass on an infection to a partner without realising it. All of our clinical staff have specific further training in this area so can do all of the necessary swabs and blood tests. A morning appointment is preferable so samples reach the lab in good time. This service is beneficial whether you have symptoms of infection (these include discharge, pain, lumps, sores, burning in urine), or if you and your partner simply want to know you are both free of infection. We realize this is a sensitive subject so we provide the service with discretion and confidentiality.

You may find it easier to come for such testing in the privacy of a GP surgery rather than a busy public STI clinic in a hospital.

Breath Test (H. Pylori) – Bacterial Overgrowth in your stomach

Common symptoms of bacterial overgrowth include bloating, abdominal pain, diarrhoea, constipation (or both), heartburn and nausea. It is also associated with food sensitivities, headache, anaemia, joint pain, and respiratory, skin, brain and mood symptoms.

The Breath Test is a simple breath test, done at the surgery.   Following a 12 hour fast and an initial breath sample, a drink containing lactulose is taken. A second  breath sample is taken after 10 minutes to check the hydrogen & methane levels.  The samples are sent to the lab and we usually have a result with 5-10 working days.

Once the results are back at the surgery your Doctor can discuss your clinical options.