Hey Doc

The goal of our online services is to make things easier, faster and more convenient for you.

Through our online portal www.health365.co.nz, you have secure access to your personal information and can easily complete a variety of tasks, including:

• Review your health record
• Book appointments
• Renew medications
• Secure communication with our health team
• Email our health team
• Text message us
• Check on the progress of your results and scheduled tasks

In order to access your portal, please visit www.health365.co.nz

To set up your portal, talk to any of our staff who will set you up with this convenient access point that you can access 24 hours, 7 days a week, from anywhere in the world. You can see your medical notes, results, measurements, and tasks. Organise your own appointments and prescription repeats with an accurate service, personalised to you.

In New Zealand almost 70,000 new skin cancer cases are confirmed annually. Basal Cell Carcinoma (BCC) is the most common of these skin cancers making up to 80% of this group, followed by Squamous Cell Carcinoma (SCC) making up to 20% and deadly Malignant Melanoma (MM) killing 300+ New Zealanders annually according to the Cancer Society of NZ.

Like most cancers, it is best to diagnose these early for the best outcome.

Prevention and avoidance of the Sun’s deadly ultraviolet rays in prevention of skin cancer. However, if recreation takes you outside, then barrier protection is best, like hats, clothing and other external shade. However in situations like swimming, ensure that the exposed skin is covered with the highest Sun Protection Factor (SPF) rating possible (at least SPF 50) and ensure that it is broad spectrum, covering both ultraviolet A (UVA) and ultraviolet B (UVB) radiation. This causes damage to the skin which is cumulative and is known to be a direct cause of skin cancer and aging.

An annual skin cancer check is the best way to look for any cancers. You can do this with the help of another person looking at every part of the body for new or unusual spots of any colour for example, red, black, brown, bluish/grey.

If there is any doubt, Health-i-care can provide a skin cancer check for you.

Sleep is important and usually makes up 1/3 of our lives.
Babies sleep the longest as they are developing at a phenomenal rate, physically and mentally. As we get older our sleep time reduces and some people survive on 5 hours sleep. Everyone is different but most healing and mental processing takes place when sleeping. Disturbance may be due to stress when the brain is thinking too much (usually in an endless loop, ruminating) which means you can not settle enough to sleep.

Sleep apnoea is another problem, which is due to breathing obstruction in deep sleep, which causes the body to wake as much as 30 times an hour which prevents restful sleep. If you believe sleep apnoea is an issue for you, please see your doctor. In other cases, difficulty falling asleep can be due to too much mental and physical stimulation. Try eliminating any stimulation prior to bedtime - don't exercise directly before bed, reduce or eliminate caffeine in the afternoon and evening, try to spend some time prior to going to bed relaxing in low light levels (ie not in front of a computer game or television) and give your body time to wind down before getting into bed (try a warm bath or shower).

If you're still having problems, come in and see us to talk it over.

Easy peesy book an appointment online or chat directly to your doctor from your portal, www.health365.co.nz
If you haven't used a portal before, head to our Online Services page to find out more! If online isn't your thing, give us a call on 09 4448682 and come see us at Health-I Care, 575 Glenfield Road, Glenfield, North Shore, Auckland.

Poor skin quality could be something you are born with (like icthyosis neonatorum where the skin dries out due to lack of certain factors), or it could be allergy driven (causing skin to irritate and get red and go scaly). An allergic reaction can be settled with moisturising and avoiding the causing irritant or allergen.

If it does not get better then see your doctor for a review of all the things which might be causing the condition. Families may have this problem, and some people have a triad of medical problems which seem linked like hayfever, eczema and asthma - this can suggest a genetic issue. Fortunately all can be treated. If your skin issue can not be treated by your doctor then a referral can be made to a specialist dermatologist, for review and further treatment options.

If you've had the headache for longer than 72 hours and you have other symptoms (ie a fever, sore eyes, stiff neck etc) please seek urgent medical attention.
If you just have a headache, it could be due to dehydration from not drinking enough fluids or being out in the sun all day. Another common cause is muscle strain, especially around shoulder muscles, which can lead to referred pain in the head. Try drinking a good amount of fluid, taking simple analgesia like paracetamol or ibuprofen. Have a rest and enjoy quiet music in dim light and no heavy lifting.

Other common headache causes include migraines, virus infections like common cold or influenza. Brain tumours are rare and along with meningitis are usually the first things most patients want to exclude. The only way to almost conclusively exclude brain tumours is CT (xray) or MRI (magnetic) scanning. If you have a family history of brain tumours it's worth checking for, though most cases occur randomly.

Easy peesy lemon squeezy!
Select what you need online, no more waiting on hold or getting the wrong thing. Visit your portal www.health365.co.nz if you haven't used the portal before, head to our Online Services page to find out more!

This is a very common problem.
Possible causes can include exhaustion, depression, low hormones (usually testosterone, thyroid or cortisol). Life today is often fast paced and packed full of things to do. Modern conveniences like dish washers, clothes washers, car washes mean that we can pack a little more in doing other things like computer work or watching TV (which in itself is bright lights and flashing objects which means the brain needs to keep track of every single dot on the screen) mean that we squeeze more in to the day than previously, and we don't like to rest or sleep! This causes the brain to get tired - it doesn't have time to recharge nor does the physical body. Depression occurs from time to time in many people. Some age groups are more susceptible (like teens where the frontal lobe is less developed and judgement is impaired, especially in boys where the testosterone levels are high).

Another common time is around "midlife crisis" time. Some people have a family history of mental illness, which might make them more susceptible as well. A lack of rest can cause the brain not to cope or recharge and therefore less able to deal with emotions. Hormone levels are also important as these act as messengers to the body. If you are worried then see your doctor and they might give you some tests to do including questionnaires and blood tests for starters and they can then work with you to help improve how you are feeling.

Phone our number if you are a patient (09 4448682) 24 hours and speak to a registered nurse who will guide you to a safe decision.

With asthma, the airways are hyper reactive due to a genetic process (usually developing in childhood).
Some people can grow out of it or not notice the deteriorations as they get older. Asthma triggers the muscles in your lung airways to constrict, narrowing them literally like breathing through a narrow straw. The issue is not getting air in but actually getting air out. Some children don't wheeze as their airways are too narrow and small to allow enough air to pass to make the wheeze sound. Instead they often cough, as the body senses a build up and tries to expel the air by coughing. Asthma can be life threatening. Although some people can overcome the symptoms by techniques such as Buteyko which is popular, it does not get rid of the cause nor stop the condition being life threatening.

Triggers to avoid include cold air, dusty environments, irritating chemicals like chlorine or sulphur. Other airborne substances like cat or dog hair, grasses and can also make asthma feel worse. The only proven way to prevent an attack is using a series of oral inhalers through a spacer regularly and as required. If you are not getting better ask your doctor for a check up and you might get some breathing tests, skin prick tests, and trial of medication inhalers that should be reviewed regularly.

Go online to your portal www.health365.co.nz and see for yourself.
Go online to your portal www.health365.co.nz and see for yourself. You can also read more information about the tests. Then, ask questions about them if you need to, all online via your portal! If you haven't used the portal before, head to www.health365.co.nz or read about how to set up your portal on our Online Services page.

This is very common, and can occur between the legs, around the scrotum in men or labia in women.
It can be called lots of things like jock itch, thrush or candida. Symptoms are: itchiness, can be red and possibly raw looking. This is very treatable. Firstly, wear loose fitting underwear like boxer shorts (it's important to prevent a warm/moist environment that will make the condition worse). If spending a lot of time seated, try to sit with legs apart.

Various preparations might help to sooth or dry out or stop a fungal infection. These include: tea tree oil (to act like a drying agent), paw paw ointment for soothing, miconazole cream or other anti thrush cream from the chemist. If these options do not help then see your doctor for a swab and either some more cream or oral tablets. Probiotic intake has been known to help. You should also consider reviewing the amount of sugar in your diet to reduce it.

Book an appointment online using your portal, www.health365.co.nz. 
If online isn't your thing, give us a call on 09 4448682 and come see us at Health-I Care, 575 Glenfield Road, Glenfield, North Shore, Auckland.

Acne can be disfiguring and can also be socially isolating.
Acne is an angry reaction in the skin, usually around the glands in the skin which get blocked and build up sebum which can get infected by skin bacteria, called propionum bacteria. This commonly occurs on the face and back. Acne treatment usually involves a concerted effort involving diet, exercise, skin care (like cleaning with water and non-soap low allergy preparations like cetaphil from the chemist) this might help unblock pores.

Topical benzyl benzoic acid and oral anti bacterials like doxycycline might also help by not letting the sebum get infected in the first place and lessening the swelling and redness effects of acne. Sometimes seeing the doctor might help as they can prescribe other treatment like isotretinoin, a very strong vitamin A, which encourages the skin to grow faster than the growth of the acne, growing the skin nice and smooth.

Medications are usually the last line of defence, as they can cause some toxicity. Girls have to be extremely careful not to get pregnant while on some skin medications, as it can cause birth defects and so we counsel any female of reproductive age to take an oral contraceptive. Boys do not have to worry but are excluded from donating blood for 1 month, in case it is given to a pregnant woman. Usually the effects last 6m after treatment. Blood tests need to be done regularly as some people can develop liver toxicity.

Some babies develop allergies to food products which may present with facial rash, coughing or lots of regurgitation or vomiting, resulting in crying. Breast milk is the best form of nutrition for the baby as it is natural and is clean and available day or night. The mother's body usually filters out any impurities and allergens, but sometimes these can still cause rashes.

Formula fed babies seem to present with some rashes which may be related to the dairy component but could be any number of additives from vitamins to pre and probiotics or anything else used to stabilise the powder. If there are any signs that this might be happening (like poor growth or bloody or greeny bowel motions or lots of reflux) check with your health provider (midwife, plunket nurse or your doctor).

There are scheduled visits to the doctor in NZ at 6w, 3m, 5m, 15m, 4y and 11y. The doctor may send for some tests or make some suggestions to try alternative methods of feeding or finally see an allergy specialist. Unfortunately at this young age the babies' immune system is immature and any testing may be inconclusive. Testing only after 1y is recommended, and in the meantime consult with your doctor for further advice.

Come in and we can check you out for FREE* (if you are a regular patient).

Make an appointment with us by calling on 09 4448682 or book an appointment online via your portal on www.health365.co.nz.

Smoking is a combination of addiction to nicotine and habit.
In terms of smoking as a habit, situations and associated events like drinking alcohol trigger a need to smoke. The pleasure centre of the brain fires up and this reinforces the habit and addiction. In order to quit smoking, the person or brain needs to want to stop. Ways to stop include: cold turkey (without assistance), non medicated options like hypnosis and acupuncture or medicated options to try and dampen the withdrawal desires.

Usually the symptoms and signs of withdrawal are strongest in the first 2 weeks, and then begin to reduce. Withdrawal signs can include agitation, anxiety, cough (with or without production of phlegm). Once a person passes 6 months without smoking, they revert to a non-smoking state. However the reality is that it could take an average of 13 times for some people to actually quit. See your doctor for advice and options suitable for you, so they can support you.

Head over to shorecare.co.nz, or visit them at Smales Farm Takapuna.

The ear is an amazing transducer of sound to chemical energy to perception of sound in the brain.
It requires sound to travel down the ear canal and hit the ear drum. This vibrates the series of 3 tiny bones called the malleus, stapes and incus. These in turn push on the oval window and generates a pressure wave which is magnified about 3 times the original sound in a snail like organ called the cochlear. On the cochlear, like the keys on a piano, different sounds stimulate different keys and so the message is passed onto the brain as sound and interpreted.

Issues can arise when sound is not getting in, for example when ear wax is blocking the outside ear canal. This can be easily removed. Another issue can be when the ear drum is damaged (eg has a hole in it or has something pushing against like fluid or wax so it can not transmit the sound waves). Fluid can be due to accidents or colds. This is treatable but may take time to get right (at least 2 weeks).

Loud noise is probably the most common cause of hearing issues (eg loud headphones or loud concerts or jet engines or guns firing). These loud noises can be like someone breaking some of the piano keys, so no sounds play or only louder sounds are able to be heard. This can be irreversible. Another issue is that occasionally there is a problem with the nerve or brain which causes deafness. All this can be determined by seeing your doctor and having other referrals like to see an audiologist. In old age, parts of your hearing can get worn out, and this is called presbycusis.

The eye is a simple design - it works like a camera.
A small hole lets light in the front and the back of the eye has sensors on it which transduce the light to electrical energy to go the brain for interpretation. The first layer of the eye is the cornea, a clear window which has magnifying ability. The eye has a way of protecting this sensitive part - eye lids, which react in a fraction of a second as required. The middle of the eye ball has a gel like substance in it which keeps the lining at the back of the eye stuck on, and keeps the eyeball in its shape without stopping light from getting through. There is a lens which finely focuses the light on to the fovea in the back of the eye, to give clarity.

In the case of myopia or short sightedness (which affects Chinese disproportionately) the light is not able to focus. Long-sightedness is also common, and typically starts to affects adults in the early 40s. These two conditions can happen at any age, regardless of race or gender.

In general these conditions are correctable by external lenses like glasses or contact lenses. Some people get laser surgery to alter the shape of the cornea to allow perfect focus again. People need to weigh up the cost of this (usually in the thousands) and glasses (in the hundreds) and their lifestyle. Usually an optometrist can sort this out and can also screen for other causes like glaucoma pressure build up in eye casing damage to fovea, retinal detachment (the gel not keeping back of eye attached so that it pulls away from blood vessels and nerves) and cataracts (dirty lenses essentially, which are not cleanable). If in doubt, see your doctor to exclude things like strokes from causes of eye problems.