Manor Field Surgery Blog Number 15 – Sick Day Rules

Whenever I heard this phrase, sick day rules, it makes me think that someone is celebrating sick days, as in, ‘Rod Rules!’ it isn’t meant to mean that, although I can’t think of an alternative.

So, what are these rules?

They are in effect advice for people taking different medicines (or who have specific health conditions) as to what they should do if they aren’t feeling well.

I appreciate not feeling well is a little vague; more specifically, if there is a risk you might become dehydrated.

Common causes of dehydration?

Vomiting – perhaps you have gastroenteritis or food poisoning

Diarrhoea – as above

Fever and you are struggling to drink enough liquid

Extreme heat and you have limited access to water

Or, a combination of the above –

If you are older (and, we know what that means), have an illness that results in diarrhoea and vomiting, and you also have a fever; these rules apply to you.

The common theme to these states is risk of dehydration.

As an aside; I remember in the 1970’s (in Scotland) my mum telling me to, ‘Drink or you will dehydrate,’ funnily, I always associated dehydration with raisins (don’t know why) and never understood how I could suddenly flip from being active seven year-old boy to a raisin.

 

My mum knew.

Funnily, my children nowadays are so indoctrinated in the ways of hydration that they very often become in desperate need of a drink the moment we aren’t near a tap (and are near a shop).

Anyway.

Dehydration is not good – here are some of the consequences (again, this is mostly older people although anyone can be affected).

Falls – dehydration can lower blood pressure

Confusion and disorientation

Kidney failure

Coma, death.

I hope I haven’t scared anyone.

Really, the risks and the focus of this blog are on people who are perhaps not in the best of health and in particular those taking the following medicines –

Anti-inflammatories (NSAID’s)

Ibuprofen

Naproxen

Blood Pressure treatments

            Lisinopril

            Ramipril

Diuretics

            Furosemide

            Bendromefluthiazide

Diabetic medicines

            Metformin

There are others although is this probably 80% of the relevant medicines.

If you combine dehydration (because of sick days) with these medicines, all of which have a direct or indirect effect on the kidneys, you can become very unwell very quickly.

For example, if you have diarrhoea and vomiting and are struggling to drink and you continue taking the water tablets (diuretics) prescribed which work by making you more dehydrated, you can make a bad situation worse.

Hence, Sick Day Rules.

What to do if you are sick and taking these medicines.

The usual guidance is to leave them off until you are back to normal (we call this a medicine holiday) – it is not always that straightforward as many people don’t know what their medicines are and, well-meaning pharmacists and doctors put their tablets into a ‘nomad’ – a generic blister pack that makes working out what is what difficult.

I will write a separate blog about nomads; for now, the message is probably, know your medicines! Read the details in the box and discuss concerns with your pharmacist.

The Scottish, as with most things, are ahead of the game on this and have produced their own Sick Day Rules cards, which you can get by following this link.

Enjoy the sunshine.