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General health

Heart attacks, alongside other cardiovascular diseases, are sadly one of the leading causes of death globally. But by addressing the risk factors and learning to recognise the early and immediate signs of a heart attack, you can improve the chances for early detection and treatment.  

## What is a heart attack?

‘A heart attack (or myocardial infarction) occurs when the flow of blood to the heart muscle is interrupted, usually by a blood clot,’ says Dr Rhianna McClymont, Lead GP at Kry. ‘This means the heart muscle isn’t supplied with enough oxygen, which causes damage and stops it functioning.’

## Who is more likely to have a heart attack?

There are several factors that put you at greater risk: 

- Smoking
- Being overweight
- Having high blood pressure or high cholesterol

There are also some uncontrollable risk factors, like family history of early heart disease. The risk of a heart attack also increases for men after age 45 and for women after menopause. 

## What does a heart attack feel like?

‘A heart attack is described as a feeling of tightness, squeezing or pressure across the centre or left side of the chest,’ says Dr McClymont. This pain or tightness may radiate into the left arm, neck or back and is often accompanied by other symptoms such as:

- Shortness of breath
- Nausea
- Dizziness
- Sweating
- A feeling of intense anxiety

There are other symptoms of a heart attack as well – some that are less common and many that are less obvious. Some people experience unexplained fatigue or feel faint.  People with diabetes may have few or very mild symptoms. On rare occasions, people experience no symptoms at all and are surprised when they find out they’ve had a heart attack. 

## What is a ‘silent’ heart attack?

‘A silent heart attack is one that happens without the characteristic tight chest pain, or with other more unusual symptoms such as indigestion. This is more common in women, older adults and those with diabetes, and it makes it more difficult to recognise a heart attack when it’s occurring,’ says Dr McClymont.

## Are the symptoms and outcomes of a heart attack different for men and women?

‘Both men and women experience the typical symptoms of a heart attack like a tightness of the chest, but the signs of a heart attack in women may be slightly less recognisable – like dizziness, nausea or indigestion,’ Dr McClymont explains. ‘A heart attack presenting in an atypical way can be more difficult to diagnose.’

More research is needed to map out just how big the differences are between the symptoms women and men experience while having a heart attack.  But it’s clear that women with chronic heart disease have worse outcomes than men, likely as a result of presenting without chest pain and instead experiencing symptoms like stomach pain, breathlessness, nausea and fatigue.  

While around one-third of both male and female patients are initially misdiagnosed when presenting with a heart attack, women are twice as likely to be misdiagnosed.  

This might, in part, be a result of women sometimes having lower levels of troponin. This is a protein released into the bloodstream during a heart attack, which helps to establish a diagnosis. 

## Is there anything I can do to prevent a heart attack?

While you can’t do anything about ageing or your family history, there’s a lot you can do to lower your risk of having a heart attack. Lifestyle factors that can help to significantly reduce your risk of cardiovascular disease include:

- Stopping smoking
- Cutting down on alcohol consumption
- Exercising regularly
- Maintaining a healthy weight
- Eating a healthy diet rich in fruit, vegetables and fibre and low in saturated fat, trans fat, salt and sugar 

[‘Monitoring your blood pressure](/your-health/are-my-blood-pressure-levels-healthy-a-doctors-guide/) every now and then is also a good idea, as many people have high blood pressure without realising it,’ adds Dr McClymont.

## What’s the difference between the symptoms of a heart attack and angina?

Angina is chest pain that can feel tight, dull or heavy. ‘Angina symptoms happen when blood flow to the heart is reduced – typically at times when the heart muscle requires more oxygen than normal, such as while exercising – while a heart attack occurs when blood flow to the heart is blocked,’ says Dr McClymont. 

‘Angina symptoms tend to be temporary and occur mainly when the heart is experiencing increased demand or activity, and symptoms tend to be relieved when resting.’

## What is sudden cardiac arrest?

‘A cardiac arrest is when the heart suddenly stops beating,’ says Dr McClymont. ‘Among other causes, this could be because of a large blood clot or an interruption to the electric impulses causing the heart to beat.’

## Why is it important to know the signs of a heart attack?

‘The earlier a heart attack is diagnosed and treated, the less damage is done to the heart muscle and so the better the prognosis for the future,’ says Dr McClymont. ‘It’s very important to get symptoms assessed as quickly as possible.’

## What should I do if I think someone’s having a heart attack or sudden cardiac arrest?

If you think someone is having a heart attack, you should:

- Call 999 for immediate medical help
- Perform CPR, if you know how to do it ([read our guide on how to do CPR here](/your-health/learn-how-to-do-cpr-a-step-by-step-guide/))
- 999 operators will guide you and help you with CPR until emergency help arrives

__This article has been medically approved by Dr Rhianna McClymont, Lead GP at Kry__


See a GP about risk of heart attack

kry.co.uk > Your health > How to spot the signs of a heart attack

How to spot the signs of a heart attack

Dr Rhianna McClymont explains the risk factors and how to spot the immediate signs of a heart attack.

How to spot the signs of a heart attack | Kry UK

General health and seasonal

## Quick facts 

-  The average adult breaks wind 12-25 times a day
-  Sweeteners ending with ‘-tol’ are hard-to-digest sugar alcohols which can cause flatulence
-  Wind problems might be down to an underlying condition

It’s normal to pass wind every now and then, but when it happens frequently it can undermine your confidence. And while it varies between individuals, on average we emit gas from our mouth or bottom between 12 and 25 times a day.

## Why wind happens

Gas builds up in the digestive tract in two ways: by swallowing air or as a by-product of gut bacteria breaking down foods. Having some gas is inevitable and perfectly normal, but having a lot of wind problems could be a sign of an underlying health issue.

During digestion, chemicals called enzymes break down foods so they can be absorbed in the small intestine. During this process, some undigested sugars, starches and fibres reach the large intestine. There, they ferment as bacteria in the gut try to break them down. This produces gases, including carbon dioxide and hydrogen sulphide, which are released as flatulence.

## Can trapped wind be painful?

Yes, trapped wind can cause pain and discomfort. If you do experience painful trapped wind, you‘ll likely feel it in your stomach and lower abdomen. 

## What are the symptoms of trapped wind?

Common symptoms of trapped wind include a bloated stomach or abdomen, flatulence or burping, stomach cramps, a rumbling or gurgling sound, nausea, and pain when you bend or exercise.

## Causes of trapped wind, excess wind and flatulence

Everyone passes wind and many factors, from your genes to an underlying condition, can lead to increased gas and flatulence. But you can reduce unwanted wind problems — the first step is to identify the source of the problem. Here are some of the likely reasons:

__Eating or drinking too quickly__ makes us swallow air, which is then released as burps and belches. Swallowing air, or aerophagia as doctors call it, can also be caused by chewing gum, smoking, having a blocked nose and wearing dentures that don’t fit properly. It‘s common to experience trapped wind after eating.

__Foods that cause trapped wind and flatulence__ include cabbage, cauliflower, Brussels sprouts, broccoli, dried fruit and beans because they tend to contain a lot of hard-to-digest fibres and sugars. But these are incredibly important in the diet, particularly for detoxification of the liver.

If you suspect these foods, before you cut them out, keep a diary of your trapped wind after eating different foods. It could be that only particular vegetables or bean types cause problems. Raw vegetables such as cabbage might be problematic for you, but lightly steamed may not — so note down how you react in relation to the cooking method of the food you’re consuming too.

__Sweeteners__ such as xylitol and sorbitol — which are commonly used in reduced-calorie drinks, chewing gums, sweets, cakes and biscuits — cause flatulence because we lack the enzymes needed to digest them. Any sweetener ending with ‘-tol’ can cause problems.

__Fructose__ is a fruit sugar found in table sugar, sweeteners and syrups, dried fruits, juices and other processed foods and drinks. Our bodies can’t digest too much fructose at one time, and it can add up quickly in our bodies. An apple, or a 200ml glass of orange juice, both have around 6g of fructose and some carbonated drinks have up to 50g for a single can or bottle. For many of us, undigested fructose reaches the large intestine — where it ferments and produces gas.

__Gut bacteria__ play a key role in digestion. Around 500 different bacteria species are found in the large intestine and everyone’s microbiome — as this mix of bacteria is known — is unique.

As bacteria interact with undigested carbohydrates in the gut, they produce a range of different gases and these can lead to excessive wind and flatulence.

Our microbiome is influenced by our diet, lifestyle and use of antibiotics can lead to significant changes in the gases we produce. That’s why antibiotics can sometimes cause flatulence, and why probiotics — which contain so-called friendly bacteria — can improve the balance of beneficial bacteria and reduce flatulence and other gastric symptoms. Probiotic drinks and yogurts are readily available, and fermented foods such as sauerkraut and kimchi also provide probiotics.

__Medicines__ including ibuprofen, statins and antifungals can sometimes cause flatulence. Speak to your doctor if you suspect a medicine you take regularly is causing wind problems.

__[Irritable bowel syndrome (IBS)](/medical-advice/digestive-problems/irritable-bowel-syndrome-ibs/)__ affects as many as 1 in 5 people and can arise from food passing through the gut too quickly or slowly, overly sensitive nerves in the gut, food intolerances and stress. It can also cause stomach cramps, bloating, diarrhoea and constipation. These tend to come and go over time, and episodes can last for days, weeks or months. Talk to your doctor, who can suggest a management plan. This may include adherence to an eating plan known as the FODMAPs diet, which has been clinically shown to help with IBS symptoms, however it must be followed with the supervision of a dietitian.

__Lactose intolerance__ occurs when we don’t make enough lactase, the enzyme needed to break down and digest milk sugars. Warning signs include excessive flatulence as well as diarrhoea, bloating, stomach pain or feeling sick after consuming lactose-containing dairy foods such as milk and cheese. Talk to your doctor if you suspect you might have it.

__Coeliac disease__ occurs when your immune system reacts to gluten found in many foods. It can cause symptoms such as flatulence, bloating, constipation, diarrhoea, weight loss and skin problems. It affects around 1 in 100 people and often runs in the family. A doctor can diagnose coeliac disease with a simple blood test.

## 6 simple steps to help reduce excessive wind and flatulence

1. __Keep a food diary__ to identify foods that cause wind — and avoid them.
2. __Eat smaller meals, more often__ — and chew food slowly. This gives the amylase in saliva more time to start breaking down carbohydrates which can help prevent excess wind.
3. __Drink plenty of water__ — this reduces the risk of constipation and keeps things moving.
4. __Drink peppermint tea__ — it contains essential oils which have been shown to reduce flatulence and bloating.
5. __Exercise to improve digestion__ — studies confirm light exercise, such as walking or a gentle bike ride, will reduce symptoms. It’s believed exercise helps matter move through the intestine so it may aid constipation too.
6. __Check your fibre intake__ — most of us don’t eat enough fibre. Around 30g a day is recommended. Fruits, vegetables and wholegrains such as wholemeal bread, oats and quinoa are good sources.

Speak to a doctor if you have other symptoms such as bloating, pain, diarrhoea, [constipation](/medical-advice/digestive-problems/constipation/), chronic belching or there’s [blood in your poo](/your-health/10-things-your-poo-can-tell-you-about-your-health/) – these could be a sign of something more serious.

__This article has been medically approved by Dr Rhianna McClymont, Lead GP__


Kry.co.uk > Your health > What’s causing your gas and flatulence?

See a GP for trapped wind and flatulence

sew41

Trapped wind can be embarrassing and painful. It can also have many causes — from food to underlying conditions. Here’s a guide to dealing with flatulence.

What’s causing your gas & flatulence? What causes trapped wind?

What’s causing your gas and flatulence? 

For many parents, having ‘the talk’ with their children can seem like an awkward and uncomfortable moment. But the conversation should be about more than just sex – it’s a chance to talk about bodies, relationships and consent. Having these chats early helps parents empower their children with the knowledge and confidence to make healthy life choices. 

## Why do we need to have these conversations? 

Children are naturally curious about relationships and their bodies. Surveys suggest children as young as 11 might experiment with kissing,  while teenagers may have access to pornography and begin experimenting with sex.  

But according to a US study, 37% of teen boys and 56% of teen girls have never spoken to their parents about contraception.  

There’s no doubt it can feel daunting, but research shows that parent-child communication about sex is vital. In one study, open, supportive conversations were found to reduce the chance of children engaging in sexual behaviours.  Studies have also shown that children whose parents spoke to them about sex and consent were more likely to use safer sex practices, including contraception. 

‘While many young people find these conversations embarrassing, most of them do report that they’re helpful,’ says Beatrice Lindéh, a Kry psychologist specialising in sex. 

## When is the right time to talk to children about sex and consent?

‘By starting these conversations early, you can help to promote that sense of integrity and your child’s respect for themselves as well as others,’ says Lindéh. 

Here’s some advice for approaching each age group:

### 1. Very small children
‘You can start talking about relationships as early as when children are just starting to talk,’ says Lindéh. ‘Listen when they say “no” or “stop” to certain actions – and avoid forcing intimacy like hugs if they show signs of not wanting to.’ 

### 2. Preschool and primary school years
‘Help your child understand social rules and expectations, like if you hit someone, they won’t want to be your friend,’ says Lindéh. ‘This age is also about teaching them to talk to a trusted adult when something feels wrong. You could explain that if they’re asked to keep secrets they have a bad feeling about, they should tell an adult.’ 

### 3. Pre-teens and teenagers
When it comes to pre-teens and teenagers, open communication is key. ‘Building a good foundation for having these conversations is important, as sexual health becomes more important for teenagers,’ says Lindéh.

‘Having the ability to talk openly and honestly about sex makes it easier for them to ask for help if something feels wrong or somebody is crossing boundaries.

## So, what should I say?

‘You might find it challenging, but as a parent or guardian, it’s your responsibility to have these conversations,’ says Lindéh. Here are a few suggestions for getting the conversation started:

### 1. Use everyday situations
With smaller children, use real-life examples to teach them about consent and boundaries. ‘When you see your child behave in an undesirable way towards a sibling or friend, flag it right away. You can ask, “What happened there?” and explain what’s OK and what’s not,’ says Lindéh. 

‘As your child gets older, you can say, “I heard that your friend was upset over something that happened at the party. Can we talk about that?” 

‘When they start having sex education at school, chat about it: “I heard you spoke about this at school today. What are your thoughts?”’

### 2. Respect their boundaries
Show them you’re paying attention to their feelings. ‘If a child is hiding when their aunt wants a hug, say, “I can tell you don’t want to hug right now, and that’s OK – do you want to wave instead?”’ suggests Lindéh.

### 3. Ask if they feel safe
‘Once children are old enough to go on a date or start a relationship, ask if they feel safe with that person,’ says Lindéh. ‘Check if they feel able to say “yes” or “no” when it comes to sex and intimacy.’

### 4. Make conversations positive
‘Conversations about boundaries, consent and learning to say “no” can sometimes tend towards the negative, but it’s good to highlight the positive aspects of sex and relationships too,” says Lindéh. 

‘Having open and supportive conversations has the most positive impact. Avoid stern lectures, as they tend to have the opposite effect. It’s best not to try to fit everything into one big chat but to have smaller, regular conversations. That way, it will also be more natural for the child to raise questions.’

## How can I help with peer pressure?

‘You can talk to your child about learning to listen to their inner compass. If something feels wrong, it usually is,’ says Lindéh.

But be conscious not to blame and shame your child, even if they do fall for peer pressure. ‘Peer pressure is all about wanting to belong, which is only human. Talk to them about what’s happened from their perspective,’ Lindéh advises.

## When and how should I talk to my children about contraception?

‘Most schools don’t cover the subjects of safe sex and sexually transmitted infections until nearer the end of secondary school. If your child is curious, it’s a good idea to broach the subject sooner – possibly as early as when they start asking questions about how children are made.

‘You could always open up the conversation by buying a packet of condoms and letting your teenager know they’re there if they need them,’ Lindéh suggests. 

## How do I deal with the issue of porn?

Most children come across porn at some point during secondary school and, for many, it can be the only source of information about sex they have. However, it can be reassuring to know that most young people understand that it’s exaggerated and unrealistic. 

‘Make your child feel that it’s OK to ask questions,’ says Lindéh. ‘Try to explain that porn may feel frightening, exciting and arousing all at once, and ask how your child feels about that.’

‘Try to emphasise to your child that you should only ever do what feels good for you.’

## Should I talk to my child about self-pleasure and masturbation?

‘A lot of children masturbate – many of them from an early age – and it’s something that isn’t talked about enough,’ says Lindéh. 

Children can feel shame around pleasure if that’s what they’re taught. ‘It’s important to point out that pleasure is good and healthy, based on your child’s level of maturity. Explain that masturbation can feel good. Some children touch themselves in a soothing way, for instance at bedtime, and you can validate their experience by pointing out that they can do this if they want to when you’ve said goodnight and they’re alone.’

‘All forms of sex are about pleasure, whether it’s self-sex or sex with someone else, so try to get this across when you’re talking about sex and consent.’

__This article has been medically reviewed by Beatrice Lindéh, a Kry psychologist specialising in sex.__


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Speak to a GP about children’s health

Kry.co.uk > Your health > How to talk to young people about sex and consent – a therapist’s tips

How to talk to young people about sex and consent – a therapist’s tips

When and how should we talk to children and teenagers about sex? Get expert advice from Beatrice Lindéh, a Kry psychologist specialising in sex.

How to talk to young people about sex and consent | Kry UK

There’s no medical guidance to define a normal amount of sweating, but if you’re worried that you’re sweating a lot more than you should, and it’s started to interfere with your daily life, it’s a good idea to speak to a GP.

In the meantime, here are some key questions answered. 

## Am I sweating too much?

It's completely normal for us to sweat if we feel particularly hot or are doing strenuous exercise. If you notice yourself sweating a lot even when your body doesn’t need to cool down, this could be a sign that you’re sweating too much. 

‘Excessive sweating usually happens to help our body cool down, but it can also happen for no apparent reason. It could be linked to a medication you’re taking or a medical condition called hyperhidrosis,’ says Dr Rhianna McClymont.  

## What is hyperhidrosis?

[Hyperhidrosis](https://hyperhidrosisuk.org/what-is-hyperhidrosis/) is the medical term for excessive sweating – and because everyone’s level of sweating is different, it can often be hard to diagnose. Primary hyperhidrosis is more difficult to spot as there is no specific cause, whereas secondary hyperhidrosis has several different triggers – usually an underlying medical condition or side effect of medication.

According to the charity Hyperhidrosis UK, the condition affects around [2 in every 100 people in the UK](https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/hyperhidrosis), which means hundreds of thousands of people are having to deal with the discomfort and stress it can cause. 
Hyperhidrosis usually develops during childhood (or soon after puberty), but can come on at any age.

If you think you have hyperhidrosis, here are some of the daily challenges you might find difficult, or even avoid:

- Making physical contact like shaking hands, because you feel embarrassed about having sweaty palms
- Attending social gatherings that might make you feel even more self-conscious about sweating a lot
- Taking part in activities like group exercise or dancing, as you’re worried it will make your excessive sweating more noticeable
- Doing normal day-to-day activities like driving or using public transport
- Carrying out tasks for work – from typing on a keyboard to holding tools or products
- Spending lots of time trying to manage and cope with excessive sweating, by regularly showering, using deodorant and changing clothes

## What actually causes excessive sweating?

For primary hyperhidrosis, there’s often no particular cause other than the nervous system, which controls how much we sweat. People with this type of excessive sweating usually don’t sweat in their sleep.

Secondary hyperhidrosis has a number of causes which are much easier to spot and manage. Some of the most common triggers include:

- certain medications
- [anxiety](/medical-advice/mental-health/anxiety/)
- low blood sugar (hypoglycaemia)
- overactive thyroid (hyperthyroidism)
- pregnancy
- [menopause](/your-health/10-womens-health-symptoms-you-should-always-talk-to-a-doctor-about/)
- infections

‘If excessive sweating is affecting you on a daily basis, it’s definitely worth talking to a doctor to help you manage. Sometimes there’s no cause found for hyperhidrosis, but there are some medical treatments you could try which may help,’ explains Dr Rhianna McClymont, Lead GP at Kry.

A GP can help you understand the causes of hyperhidrosis, and after discussing your symptoms, they should be able to advise whether any treatment will help.

## Is there a treatment for hyperhidrosis?

Depending on the level of your excessive sweating, it’s not always the easiest to treat quickly. But there are several options that may be effective in helping you sweat less.

‘The most simple, and least invasive option, is to try a strong commercial antiperspirant. Patients may also find that avoiding tight clothing and man-made fabrics is best, and wearing white or black clothing can minimise the signs of sweating,’ says Dr McClymont. 

‘Topical aluminium salt preparations can also be applied to the skin to reduce excessive sweating. These preparations can be bought over-the-counter without the need for a prescription, and a pharmacist could direct you to the best choice.’ 

There are also lots of simple lifestyle changes that can make a big difference. You could try wearing much lighter clothing, and avoiding spicy foods or alcohol as these can be common triggers. 

If these simple measures are not helpful and your symptoms are adversely affecting your life, a GP may suggest a referral to a dermatologist for specialist advice. [Treatment options](https://hyperhidrosisuk.org/treatment-options/iontophoresis/) a dermatologist may consider include iontophoresis, which involves an electric current targeting the affected area, and other treatments involve botox injections or local surgery for more serious cases.

## When should I speak to a GP?

Asking a GP for advice about excessive sweating can feel daunting. One of the great things about speaking to a Kry GP is that you can do so from the comfort of your own home which lots of patients find more reassuring.

The GP may ask about your family history of hyperhidrosis. They may also refer you for further tests or treatment if they think another medical condition may be causing your sweating.

But knowing when to ask for help can be the hardest part. So if you’ve answered yes to one or more of the below questions, book a GP appointment to find out more.

1.	Have your symptoms lasted longer than 6 months?
2.	Are you sweating a lot – at least once a week?
3.	Do you experience regular night sweats?
4.	Have you found that lifestyle changes don’t seem to be helping?
5.	Does sweating a lot make your day-to-day activities difficult?
6.	Have you started a new medication since you’ve been sweating a lot?


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See a GP about excessive sweating

Kry.co.uk > Your health > What causes excessive sweating? Doctor’s guide to hyperhidrosis 

What causes excessive sweating? Doctor’s guide to hyperhidrosis 

Guidance from Lead GP at Kry about managing excessive sweating

Why do I sweat so much? How to deal with excessive sweating | Kry UK

## Quick facts 

- Ticks are most common in grassy, shady areas
- Wearing long-sleeved shorts and long trousers tucked into your boots can help prevent tick bites
- Quick spotting and removal of ticks can help protect you and your family from tick-borne illnesses such as Lyme disease

As the autumn approaches and leaves start to change colour, there’s nothing better than exploring the great outdoors. But if you're going hiking through dense forest or grassy areas — or anywhere else where it’s shady — be sure to keep an eye out for ticks.

## What are ticks?

These small parasites are members of the spider family that attach to skin, causing bites that can lead to tick-borne illnesses such as Lyme disease (see below). Not all ticks cause this bacterial infection – it’s carried by around 12% of ticks. 

As tick bites are usually painless, you may not even notice you’ve been bitten (which is why regularly checking for them is important – see below).

Ticks are found throughout the year, but they're most active in spring and autumn. They’re common in woodland and forests, but ticks can be found anywhere that it’s damp and shady. They can’t jump or fly, but it’s easy to pick one up if you are walking through long grass or greenery. They can be tiny — as small as 0.5mm, which is around the size of a poppy seed — and grow no bigger than 1.5cm (though their bodies balloon out when they feed).

## Symptoms of Lyme disease

If you get bitten by a tick, you may get symptoms of Lyme disease. These symptoms appear after 1-4 weeks (or anywhere from 3 days to 3 months), often in the form of a redness or rash around the bite (see below).  Lyme disease may cause flu-like symptoms such as:

- Fever
- Headache
- Fatigue
- Joint or muscle pain

If left untreated, Lyme disease can progress to more serious symptoms including persistent fatigue, neurological symptoms and inflammatory arthritis.

## What to do if you get bitten by a tick

If you get bitten by a tick, or see a tick bite on your skin, you should remove it. You can do this with a pair of tweezers. Follow these steps:

- Pinch the tick as close as you can to the surface of your skin
- Grab the tick and pull it straight up away from the skin
- Check the bite site to see if any parts of the tick are still there – like the head or mouth parts. Remove them if so
- Use soap and water to clean the bite site

Once removed, you can see a GP to talk about your risks and any complications to look out for.

## What does a tick bite rash look like?

In Europe, around three out of five people who are bitten by a tick will develop a rash.

The most common type of tick rash occurs at the bite site. It's quite distinctive, and looks like a bull’s-eye, with a red circle around the immediate area, then a circle of clear skin, and then another ring of redness. These changing stages can appear gradually. However, sometimes this all merges into one large rash with a darker central circle. The edges of the rash might feel slightly raised.

The rash probably won’t be itchy but might feel warm to the touch. Most rashes will appear within the first four weeks but can emerge any time between three days and three months after being bitten.

## Symptoms to look out for after a tick bite

Wondering what happens when a tick bites you? Thankfully, most people won't see any symptoms after being bitten by a tick. But you may be allergic to tick bites, and in that case, you should look out for pain and swelling where the bite is, a burning sensation, blisters, a rash and difficulty breathing.

## What can I do to prevent tick bites?

The simplest way to avoid being bitten when you’re in tick-infested habitats — such as forest, woodland, or long grass — is to wear long-sleeved shirts and long trousers, tucked into your socks.

Other preventative steps include:

- Using an insect-repellent for ticks which contains 20-30% DEET or 20% Picaridin
- Applying this repellant to any exposed skin and reapplying it regularly as you would with a sunscreen
- Treating boots, clothing and camping gear with 0.5% permethrin (an insecticide) spray or solution (you can get wash-in formulas effective through several washes)
- Keeping to the centre of paths and trails and trying not to brush up against greenery
- Carrying tweezers in your first-aid kit to remove ticks as quickly as possible (see below)

## Where and when should I check for ticks?

Check for ticks regularly if you are in a high-risk area. The sooner they are removed, the lower the risk of developing tick-borne diseases such as Lyme disease. Generally, in order for you to become infected, it’s required that the tick be stuck to the skin for at least 24 hours.

Adults are most likely to be bitten on the lower legs. With children, the most commonly bitten areas are the head, neck and around the armpits. 

## How can I remove a tick safely?

 The safest way to remove ticks from the bite site is to:

- Use tweezers or a specially designed tick-removal tool
- Grasp the tick as closely as possible to the skin
- Pull upwards, with a steady even pressure
- Never twist or jerk the tick as this can risk leaving the mouthparts behind
- Clean the bite with antiseptic or soapy water

## Should I see a doctor?

If you develop any symptoms of Lyme disease, speak to your doctor straight away and let them know if you have been bitten, or think you might have been. Do this even if the symptoms disappear as this doesn’t necessarily mean the disease has gone away too.

You will probably be given a two-to-three-week course of antibiotics if you have suspected or confirmed Lyme disease to kill the bacteria which transmit the disease. And remember, it’s important to finish the course, even if your symptoms subside.


See a GP about a tick bite

kry.co.uk > Your health > Tick bites – what you need to know

Tick bites – what you need to know

As the summer approaches, so does tick season. Although they are very rare, tick-borne illnesses can be serious. But there is plenty you can do to prevent tick bites or deal with them quickly if they occur


Tick bites – Symptoms, What to do, Treatment & more

Hemal Shah, Lead GP, Kry

01939 - KRY U.K. WHITE BACKGROUND

Hemal Shah

Lead GP

To meet the demand for blood donations, the UK needs 5,000 people to give blood every day. 

There are lots of reasons why someone might need a blood transfusion, and one of these is blood cancer. Blood cancer is the fifth most common cancer in the UK, with over 40,000 people being diagnosed in the UK every year. It’s also the most common childhood cancer, with over 500 children (under 15) diagnosed with blood cancer every year. The most common blood cancers are leukaemia and lymphoma.

‘As September is National Blood Cancer Awareness Month, we want to help raise awareness of how important it is to give blood if you can,’ says Dr Rhianna McClymont, Lead GP at Kry.

‘We’ve tried to list everything you need to know about giving blood if you’re perhaps considering it for the first time.’
In the UK, there’s currently a greater need for male donors to give blood (and men can actually donate more often than women), black donors and O negative donors.

## Why might I need a blood donation?
Blood donations are crucial to treat patients who have suffered a significant loss of blood – either from having a serious accident, surgery, childbirth or if they have a medical condition like anaemia, cancer or blood disorders such as haemophilia.

O negative is the blood type used most in emergencies and across hospitals in the UK. Because it can be given to anyone, it’s seen as the most 'prized' blood type. Other blood types have to be a much closer match – so someone with blood type A positive would need to be given to an A positive type recipient. 

There’s also a higher demand for blood donations from black donors to treat black patients with sickle cell disease. It’s crucial for their treatment to have blood transfusions from black donors as a closest match to their blood.

## Can I give blood?
‘Most people are able to give blood, but it’s worth speaking to a GP or checking the restrictions online if you’re not sure. These cover any issues with your health, medication you take, and whether you've been abroad recently,’ says Dr McClymont.

To find out if you’re eligible to give blood, you can visit the UK’s blood donation website and search the Health and Eligibility sections.

It will take you through some interactive questions – based on the most common reasons people are unable to give blood, and advise you on whether you can give blood in the future.   

## What is my blood type?
There are 8 main blood types, with some more common than others. These percentages give you an idea of which blood types are the most common, and which are the most rare (UK data collected in 2018).
O positive: 35%
A positive: 30%
O negative: 13%
A negative: 8%
B positive: 8%
B negative: 2%
AB positive: 2%
AB negative: 1%

If you’re not sure of your blood type, you’ll find out after your first blood donation.

You can find out more about different blood types, and why some are more in demand than others.

## Which blood types are in demand?
Sometimes there will be a shortage of certain blood types – this is why regular donors will be contacted about giving blood if they have the particular blood type.

Certain blood types can also be more widely used which creates a much higher demand. Even though 8% of people in the UK have type O negative blood, this type of blood makes up 13% of blood donation requests from hospitals because anyone in need of a blood transfusion can receive the red cells from O negative donors. 

If a person’s blood type is unknown in an emergency, O negative red cells will be used.

## How do I give blood?
Thousands of people are already signed up to give blood – and you can too. To join the growing community of blood donors, you firstly need to register your details on the blood donation database. 

Once you’ve answered a few questions to check whether you’re eligible, you’ll be asked to fill in some personal details and set up an account. The process is super quick and easy. 

Through your account you can then find out where you can give blood, book an appointment, change any future appointments, update your details and view your blood donation history over the last 5 years. 

Don’t worry if you can’t book an appointment straight away, as some centres get busier than others!

## Are there side effects after you give blood?
Most people don’t feel any different after giving blood. It’s possible you may have some mild bruising on your arm (around the needle site). Some people can feel a bit tired or lightheaded afterwards.

‘Light bruising is completely normal and will disappear very quickly. To make sure you don’t feel dizzy after giving blood, you’ll be encouraged to have at least two drinks and a snack afterwards, and rest for at least 15 minutes before you leave,’ advises Dr Rhianna McClymont. ‘If you feel unwell, stay sitting down and let a member of staff know as soon as you can.’

Once you’re home, if you start to feel poorly in the following 2 weeks (other than a cold or cold sore) or if you believe there’s a reason your blood should not be given to a patient, call the donor helpline on 0300 123 23 23.

## How to feel less anxious about giving blood
It’s completely normal to feel anxious about giving blood, especially if it’s your first time. There will be lots of helpful staff around to put you at ease as soon as you arrive at the blood donation centre – and it’s a good idea to let them know you’re feeling a bit nervous so they can offer reassurance.

One of the best ways to help your anxiety is to distract yourself. Some people bring music to listen to or a book to read. 

During your blood donation, you’ll also be asked to do a simple technique called ‘applied muscle tension’. This helps to regulate your blood pressure and stop you feeling faint or unwell. It’s also another great way to distract you during your blood donation. The technique involves tensing and relaxing your muscles during the giving blood process – including clenching and unclenching your buttock muscles.

More information will be available at the blood donation centre. Ask a member of staff if you have any questions.

## What to eat and drink when you give blood
Eating regularly before giving blood will help to keep your blood sugar levels stable. This is important so that you don’t feel lightheaded or dizzy afterwards. 

‘It’s a good idea to have a snack before you give blood and try to eat foods rich in iron afterwards, like red meat, fish, leafy vegetables, nuts and seeds. This will help to keep you feeling fit and well during and after giving blood,’ Dr McClymont explains.

Almost half of the blood you will donate is made up of water, and so any fluids you lose during the process can lead to your blood pressure falling. To prevent this and stop you feeling faint, it’s recommended you drink lots of fluids in the days leading up to your blood donation, as well as 500ml of water right before you give blood. 

Drinking lots of water after you give blood is just as important – try and bring a refillable bottle if you can to help cut down plastic waste!

Make sure you avoid any alcohol before and after the blood donation. Drinking after giving blood may affect your hydration levels and delay your blood volume returning to normal.

## What to do after giving blood
Dr McClymont has shared a few things you can do to make sure you feel well immediately after giving blood, as well as for the rest of the day. They include:

- Sit down for 15 minutes after you give blood and rest as much as you can – don’t drive if you feel faint or lightheaded

- Keep the pressure dressing on your arm for at least half an hour after you’ve given blood, and the plaster on for at least 6 hours

- Stay hydrated – make sure you have at least 2 drinks straight after giving blood, and avoid drinking alcohol as this can dehydrate you more

- Eat regularly – make sure you eat a snack afterwards and eat your regular meals throughout the day to prevent you feeling dizzy

- Avoid strenuous exercise or using the arm you gave blood from to carry anything heavy, for the rest of the day

For more advice, or if you notice any unusual side effects from your blood donation, call the helpline on 0300 123 23 23.

## Can you exercise after giving blood?
‘Try to avoid exercising or lifting anything heavy on the day you give blood, especially afterwards,’ says Dr McClymont.

‘Resting your body means that you have a chance to properly recover and build up fluids that are lost during your blood donor session. It’s fine to do some light exercise like walking, as long as you stay hydrated throughout the day.’

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Dr Rhianna McClymont

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Everything you need to know about giving blood

Whether your method of protection failed or you didn’t use anything, don’t panic – unprotected sex happens. 

‘If you’ve had unprotected sex, there’s always the possibility of pregnancy and sexually transmitted infections (STIs). Although this can be a scary situation, there are help and options available,’ says Dr Samuel Menon, Lead GP at Kry.

Here are some steps you can take to avoid unwanted pregnancy and look after your sexual health. 

## First of all, what exactly counts as unprotected sex? 

When they’re used the right way, condoms and other barrier methods play a key role in protecting you against pregnancy and STIs. Unprotected sex usually means sex without any form of contraception or condom, but sometimes a condom may break or come off during sex, or it might not have been used correctly or forgotten altogether. 

## What to do straight after unprotected sex

### Empty your bladder

Though it won’t protect you from contracting an STI, peeing after sex can help to reduce your risk of getting a urinary tract infection (UTI). Although UTIs can occur in both sexes, women are 30 times more likely to get a UTI than men. 

‘Peeing helps flush out bacteria before it’s able to get into the urethra and other parts of the urinary system,’ says Dr Menon. ‘This is particularly important for women who are more susceptible to UTIs after sex.’ 

## What to do the next day 

### Consider emergency contraception 

If you’re not using any form of hormonal contraception and an unplanned pregnancy is a concern, you can take emergency contraception. There are 2 types of emergency contraception: 

The emergency contraceptive pill, often known as the morning-after pill
The copper intrauterine device (also called the IUD or coil) 

There are 2 kinds of the morning-after pill, which work by stopping or delaying the release of an egg (ovulation). Levonelle should be taken within 72 hours (3 days) of sex, and ellaOne should be taken within 120 hours (5 days) of sex to prevent pregnancy. ‘The effectiveness of the emergency pill depends on how soon after unprotected sex you take it,’ says Dr Menon.

‘The IUD is the most effective way to prevent pregnancy, and it’s also the most effective form of long-term contraception,’ advises Dr Menon. ‘It must be inserted by a health professional within 5 days of unprotected sex, and like all emergency contraceptives, it is more effective the sooner you have it.’ 

Right now, only the copper IUD is available for emergency contraception. But when it comes to long-term contraception, you can choose either the copper or hormonal IUD.

You can get emergency contraceptives free from some doctor’s surgeries and sexual health clinics. The emergency contraceptive pill is also available from some pharmacies. 

### Speak to your doctor about HIV exposure

‘If you’re concerned that you may have been exposed to HIV, contact a doctor or sexual health clinic as soon as possible because you may be suitable for post-exposure prophylaxis (PEP), a short course of medicine that can dramatically reduce the chance of HIV infecting your body after you’ve been exposed to it,’ says Dr Menon.

For PEP to work, it must be started within 72 hours – and it works best if taken within 24 hours. It’s estimated to  reduce the chance of HIV infection by at least 80%.

### Take stock of how you’re feeling mentally

Make time to check in with yourself, because it’s normal to experience a wide range of emotions after unprotected sex. Share how you’re feeling with a trusted friend or member of the family. They can listen to you, offer support and help you think your options through. Or arrange an [appointment with a doctor](/gp-appointments-online/), who’ll be able to offer advice on counselling or recommendations for organisations that can help. 

## What to do 2 weeks to 1 month later 

### Take a pregnancy test

The only way to know if you’re pregnant is to take a pregnancy test. The earliest sign of pregnancy is often a missed period. You may also experience tender, swollen breasts, feel sick and experience mood swings.

‘Taking a test at least 3 weeks (21 days) from the last time you had unprotected sex or on the first day of your missed period will give you the most accurate result,’ says Dr Menon.

You can buy a reliable home pregnancy test from a pharmacy and most supermarkets, or get a free test and confidential advice from a doctor or sexual health clinic. 

### Get tested for STIs 

Look out for signs of an STI ‘If you develop symptoms of an STI, get yourself tested immediately,’ says Dr Menon. Symptoms and signs of an STI include: 

- Unusual discharge from the vagina, penis or anus
- Pain during sex 
- Pain when ejaculating or peeing
- Lower tummy pain 
- Unusual vaginal bleeding 
- Blisters, sores or warts around your vagina, penis or anus

Whether you’ve experienced symptoms or not, it’s best to get tested after unprotected sex because some STIs produce no symptoms at all. 

Waiting 2 weeks after unprotected sex to take an STI test will provide more accurate results. This is because all STIs have a window period. 

The most common STIs with a window period of 2 weeks include:

#### Chlamydia
Look out for an unusual discharge from the vagina or penis, and vaginal bleeding after sex and between periods, pain when peeing and pelvic pain in women. If left untreated, chlamydia can lead to pelvic inflammatory disease (PID), which can cause infertility. Screening is done through a urine or swab test.

#### Gonorrhoea
Symptoms include pain when peeing and green or yellow discharge from the vagina or penis. Less commonly, it can affect the eyes and throat. Testing is done through a urine or swab test. 

‘Virtually all STIs are treatable,’ says Dr Menon. If you’re feeling nervous about getting tested, ask a friend to go with you. Free STI testing is available at sexual health clinics. 

## What to do 2 to 6 months later

### Get another STI test 

‘There are some STIs that take longer to detect. During this period, it’s important not to have unprotected sex with anyone,’ says Dr Menon. 

Common STIs that are tested for at a later stage include:

#### Syphilis
You can be tested for syphilis after 3 months. Symptoms may include painless sores or ulcers on the vagina, penis, anus or mouth, followed by a rash and flu-like symptoms. If left untreated, syphilis can cause long-term health problems. A blood test can diagnose syphilis.

#### HIV
You can be tested for HIV after 45 days. Although there are often no or minimal symptoms in the first few years, the infection weakens the immune system and can lead to more serious conditions, including tuberculosis and cancers such as lymphomas. Testing is done by taking a blood or saliva sample.

## How can I protect myself next time? 

If you’re sexually active, there are some steps you can take to protect your sexual health and prevent pregnancy: 

- Always have a supply of condoms or barrier methods available 
- Check the expiration date on the condom wrapper or box 
- Take good care of your condoms: keep them away from heat and light, and don't open them with anything sharp, such as scissors or teeth
- Choose condom-friendly lubricants – oil-based lubricants can damage the latex of the condom, causing it to rip 
- Consider the right size of condom to avoid slippage or breakage. If you’re not sure about the size, try a variety pack 
- Clean sex toys after every use. If you’re sharing toys with different partners, cover them with a new condom each time because they can pass on STIs and infections 
- Think about regular STI testing 

## What should I do if I’ve been sexually assaulted?

If you’ve been sexually assaulted, it’s important to remember that it isn’t your fault. If you’re in immediate danger, you should call the police. 

Sexual assault includes being physically forced or emotionally manipulated into any sexual act without your consent. This includes a partner deliberately removing or damaging a condom during sex without telling you. 

You can report sexual assault to the police by dialling 999 or 101 or by visiting your local police station. You can also report it online. Alternatively, confidential medical and emotional support is available at sexual assault referral centres (SARCs). 

__This article has been medically reviewed by Dr Samuel Menon, Lead GP at Kry.__


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If you’ve had unprotected sex, taking action now can protect your health today and in the future.

Unprotected sex

If you’ve had unprotected sex, taking action now can protect your health today and in the future. Get expert advice from a Kry Lead GP.

I had unprotected sex – what should I do? | Kry UK

I had unprotected sex – what should I do? 

Research shows that [nearly half of people aged 50+ have had knee pain in the previous year](https://cks.nice.org.uk/topics/knee-pain-assessment/background-information/prevalence-of-knee-pain/), and out of these, a third had spoken to a GP about their symptoms in the same 12 months. Knee pain is very common in people of all ages.

Knee pain can be commonly caused from an injury like a ruptured ligament, torn cartilage or bleeding in the joint – especially if you play lots of high-impact sports like tennis or football. There are several different underlying causes of knee pain too, which can be harder to diagnose.

‘As you get older, you’re more likely to experience mild knee pain symptoms from daily wear and tear,’ says Dr Rhianna McClymont, Lead GP at Kry. 
‘Usually this is nothing to worry about – but if you notice the pain is getting worse, affecting your daily activities or you have other persistent symptoms, speak to a doctor.’

## What knee pain symptoms should I look out for?

On top of injuries and age-related conditions, there are many causes of knee pain and knee inflammation. The symptoms you experience will vary depending on the cause.

Here are some common symptoms to look out for, and reasons most people speak to a doctor about getting knee pain treatment.

- Stiffness
- Swelling
- Redness or warm to touch
- Knee clicking or popping
- Unable to straighten your knee
- Knee feeling unstable or giving way
- Locking of the knee joint

## What are the common causes of knee pain?

Sustaining an injury is by far the most common and often unavoidable reason for experiencing knee pain and swelling. 

A meniscus tear is a typical knee injury, particularly for athletes or people who play contact sports. The meniscus is a piece of cartilage that cushions your femur (thighbone) and tibia (shinbone). There are two in each knee joint.

‘Whether your injury is a sprain, torn ligament or menisci, dislocation or broken bone, you’ll usually get some fairly instant knee pain, swelling and tenderness. And the knee pain will be more intense depending on how badly you’re injured,’ explains Dr Rhianna McClymont.

Underlying conditions usually cause knee pain to come on more gradually instead. While this list is by no means exhaustive, GPs tend to see the following conditions causing chronic knee pain.

### 1. Osteoarthritis
This is the most common form of arthritis, and one that usually develops with old age or overuse of joints. It causes damage to the articular cartilage, which you need to protect your knees. Osteoarthritis of the knee can cause swelling of the tissues around your joints too. Although there’s no cure, a doctor can recommend ways to reduce the strain on your knees which may improve your symptoms.

### 2. Rheumatoid arthritis
Rheumatoid arthritis can develop at any age and can affect almost every joint in your body. The autoimmune condition can cause knee pain and swelling over a long period of time. There may not always be an obvious trigger for this type of knee pain and you may experience flare ups even after resting.

### 3. Gout
Symptoms of gout include very sudden and severe pain in your joints, commonly affecting the big toe as well as the knee joint. On top of getting sharp pain, the affected area usually becomes swollen, red and tender to touch.

### 4. Infection (septic arthritis)
A common infection of the knee joint is septic arthritis. If you’re not sure what’s causing your knee pain, and your knee is very swollen and hot, it could be an infection.

Other symptoms of an infection include having a fever and feeling generally unwell. It’s important to go straight to A&E if you think this might be the case.

### 5. Tendonitis
Tendonitis in the knee happens when the tendons around your knee become inflamed. This kind of knee inflammation can be brought on by lots of intense exercise, especially jumping and squatting (common in sports like basketball and tennis). As with other conditions, symptoms may include a swollen knee that’s warm and tender to touch.

### 6. Bursitis
If you have particular knee pain on bending (that gets worse when you kneel or bend down), it could be bursitis. This knee inflammation is caused by repetitive movement in your knee, or kneeling for a long period of time and is sometimes referred to as ‘housemaid’s knee’. Bursitis can lead to fluid building up over the knee joint which causes further swelling.

### 7. Osgood-Schlatter’s disease
Unlike many knee conditions, this one is much more common in teenagers and young adults who play a lot of sports. The disease causes swelling and tenderness just underneath the knee (in the bony part).

## Self help for knee pain

‘When knee pain is severe, limiting your activities or has persisted for a long time it’s best to speak to your own doctor for a diagnosis and for advice on the best knee pain treatment for your condition,’ says Dr Rhianna McClymont.

‘In the meantime, there’s a few simple ways you can look after your knees, prevent any further damage and help manage your symptoms.’

- Rest your knee to reduce any repetitive strain and give yourself time to heal – a really important one if you’re getting knee pain from exercise, or knee pain from walking      

- Ice your knee to minimise swelling, which works well for acute and chronic knee conditions

- Protect your knee from further trauma with knee padding or a splint, to help keep your knee straight and avoid knee pain when walking up stairs (if you can’t use a lift instead!)

- Elevate your knee as much as you can to help reduce swelling and minimise knee pain from sitting

- Compress your knee with a brace or wrap to reduce knee inflammation - speak to a doctor if you’re not sure how to apply correctly or whether this is suitable for your knee  

## When to speak to a doctor

For most people, minor knee problems should begin to settle within 6 weeks. 

But it’s always best to speak to a GP if your knee pain gets worse, or your knee starts to lock or give way, and hurts when you’re not moving it. 
If you’re not able to extend or bend your knee at all, it needs to be checked out as soon as possible. Look out for any deformities or lumps around the knee joint too.

A GP can make a referral for you to see a specialist for further investigation or treatment.

Phone 111 if you have difficulty putting any weight on your sore leg or your knee becomes immediately swollen after an injury.

__This article has been medically reviewed by Dr Rhianna McClymont, Lead GP at Kry.__


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