George Practice

3 Trefoil Square, Gloucester Ln, George Central, 6529

Opening Hours

Mon - Thu: 8am - 5pm
Friday: 8am - 3pm
Sat - Sun: CLOSED
24 Dec - 2 Jan: CLOSED


Fax : 044 874 6299


Feel free to contact us

Organ Donation

August is organ donation month and we would like to take this opportunity to highlight the importance of this decision.

What is organ donation?

Organ donation is the process when a person allows an organ of their own to be removed and transplanted to another person, legally, either by consent while the donor is alive or dead with the assent of the next of kin.

Why should you consider organ donation?

By donating your organsand tissue after you die, you can save or improve as many as 75 lives. Many families say that knowing their loved one helped save or improve other lives helped them cope with their loss. It’s especially important to consider becomingan organ donorif you belong to an ethnic minority.

As an organ donor, you can save the life of someone who is suffering from a life-threatening disease or someone who was in a serious accident.

Approximately 4300 people are waiting for a life-saving organ or cornea transplant in South Africa, but only 0,2% of our population are registered organ donors.

Organ and tissue donation is a simple choice that will cost you nothing but a few minutes of your time to register. Organ transplants are undertaken in both government and private hospitals in the Western Cape, and currently heart, kidney, cornea and liver transplants are carried out at the following government hospitals:

  • Groote Schuur Hospital
  • Red Cross Children’s Hospital
  • Tygerberg Hospital

Here are some FAQ and answers from the Organ Donor Foundation of South Africa.

Who can be an organ / tissue donor?
Any person, who is in good health, and is clear of defined chronic diseases that might adversely affect the recipient, will be considered as a possible donor.

Can I be a donor if I have an existing medical condition?
Having a medical condition does not necessarily prevent a person from becoming an organ donor. The decision about what organs will be transplanted will be established at your time of death.

Which organs can be transplanted?

Your heart, liver and pancreas can save 3 lives and your kidneys and lungs can help up to 4 people.

Which tissues can be transplanted?

You can help up to 50 people by donating your corneas, skin, bone and heart valves.

Can I agree to donate only some organs or tissue and not others?
Yes.Please inform your family which organs/tissue you do not wish to donate.

How long after death do the organs / tissue have to be removed?
It is essential that organs / tissue are removed as soon as possible after brain death in order to ensure successful transplantation. Brain death has to be certified by two independent doctors.

Is there any cost involved in signing up as an organ / tissue donor?
No,it costs nothing to sign up as an organ donor.

Does my family pay for the cost of donation?
No,The hospital or state will cover all
medical expenses from the moment of
diagnosis of brain death and when your family has given consent for the removal of organs/tissue.

Can I donate an organ / tissue while I am alive?
Yes,in some cases. Live donations, such as a kidney are often done between family
members, because the blood groups and
tissue types are more compatible to ensure a high success rate.

How do doctors know I am really dead?
Two doctors, who are completely independent of the transplant team, have to perform detailed Electronic Packs before a person can be declared brain dead. The criteria for brain death are very strictly adhered to and
accepted medically, legally and ethically in South Africa and internationally.

Can doctors keep me alive on support systems?
All potential organ donors are patients on support systems. They are submitted to Electronic Packs to certify brain death and become organ donors once brain death is certified and permission is obtained for organ donation. Death of the organ donor is defined by the time of certification of brain death, not by the withdrawal of support.

Does being a donor delay the funeral?
No.As soon as the donated organs / tissue has been removed, the body is returned to the family to bury or cremate.

Does organ / tissue donation leave my body disfigured?
No.The utmost respect and dignity is given to the donor at all times. The recovery of organs and tissue are carried out with great care by surgeons and trained staff and the process does not change the way the body looks.

Please consider organ donation.  Your death can mean life to another person.

Registering as a donor

You can register as an organ donor by:

Once you’ve been successfully registered, the Organ Donor Foundation will send you an organ donor card to carry in your wallet as well as stickers to stick on your ID book and driver’s licence to make your intentions known in case of an emergency.

Obstructive Sleep Apnea

OSA is the most common sleep-related breathing disorder, but not a lot of people know about it.

What is obstructive sleep apnea?

Let’s firstly start by defining the word “apnea”. Apnea, simply put, is when someone stops breathing. So, what is obstructive sleep apnea? Someone has obstructive sleep apnea (OSA) when this person’s breathing repeatedly stops and starts during sleep.

What are the signs and symptoms of OSA?

Signs and symptoms of obstructive sleep apnea include:

  • Excessive daytime sleepiness
  • Loud snoring
  • Observed episodes of stopped breathing during sleep
  • Abrupt awakenings accompanied by gasping or choking
  • Awakening with a dry mouth or sore throat

Individuals with OSA are rarely aware of difficulty breathing, even upon awakening. It is often recognized as a problem by others who observe the individual during episodes or is suspected because of its effects on the body. OSA is commonly accompanied by snoring. Symptoms may be present for years or even decades without identification, during which time the individual may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance. Individuals who generally sleep alone are often unaware of the condition, without a regular bed-partner to notice and make them aware of the signs.

Risk factors

Anyone can develop obstructive sleep apnea. However, certain factors put you at increased risk, including:

Excess weight. Most but not all people with obstructive sleep apnea are overweight. Fat deposits around the upper airway may obstruct breathing. However, not everyone with obstructive sleep apnea is overweight and vice versa. Thin people can develop the disorder, too.

Narrowed airway. You may inherit naturally narrow airways. Or your tonsils or adenoids may become enlarged, which can block your airway.

Chronic nasal congestion. Obstructive sleep apnea occurs twice as often in those who have consistent nasal congestion at night, regardless of the cause. This may be due to narrowed airways.

Smoking. People who smoke are more likely to have obstructive sleep apnea.

A family history of sleep apnea. If you have family members with obstructive sleep apnea, you may be at increased risk.

Older age

Male gender. OSA is approximately two to three times more common in males than females, although the risk appears to be similar once women are postmenopausal



Obstructive sleep apnea is considered a serious medical condition. Complications may include:

  • Daytime fatigue and sleepiness. The repeated awakenings associated with obstructive sleep apnea make normal, restorative sleep impossible.

People with obstructive sleep apnea often experience severe daytime drowsiness, fatigue, and irritability. They may have difficulty concentrating and find themselves falling asleep at work while watching TV or even when driving. They may also be at higher risk of work-related accidents.

Children and young people with obstructive sleep apnea may do poorly in school and commonly have attention or behavior problems.


  • Cardiovascular problems.Sudden drops in blood oxygen levels that occur during obstructive sleep apnea increase blood pressure and strain the cardiovascular system. Many people with obstructive sleep apnea develop high blood pressure (hypertension), which can increase the risk of heart disease.

The more severe the obstructive sleep apnea, the greater the risk of coronary artery disease, heart attack, heart failure, and stroke.

Obstructive sleep apnea increases the risk of abnormal heart rhythms (arrhythmias). These abnormal rhythms can lower blood pressure. If there’s underlying heart disease, these repeated multiple episodes of arrhythmias could lead to sudden death.


  • Metabolic syndrome and type 2 diabetes. Patients with OSA have an increased prevalence of insulin resistance as well as type 2 diabetes and diabetes complications
  • Nonalcoholic fatty liver disease (NAFLD). Patients with OSA, particularly those with severe OSA, have a two- to threefold increased prevalence of NAFLD
  • Miscellaneous. Patients with OSA may have an increased risk of developing gout compared with patients who do not have gout (4.9 versus 2.5 percent)



Numerous treatment options are used in obstructive sleep apnea. Avoiding alcohol and smoking is recommended, as is avoiding medications that relax the central nervous system (for example, sedatives and muscle relaxants). Weight lossis recommended in those who are overweight. Continuous positive airway pressure(CPAP) and mandibular advancement devices are often used and found to be equally effective. Physical training, even without weight loss, improves sleep apnea. There is insufficient evidence to support widespread use of medications or surgery.


If you suspect that you or your partner may have OSA, speak to your doctor who will assist in the diagnosis and offer treatment options.







Mammograms – the why, when and how often’s

Breast cancer is the most frequent type of non-skin cancer and the most frequent cause of cancer death in women worldwide

The majority of breast cancers are diagnosed as a result of an abnormal screening study, although a significant number are first brought to attention by a patient. Findings suggest that screening mammography both reduces the odds of dying of breast cancer and facilitates the use of early treatment

What is a mammogram?

Mammography is the process of using low-energy X-rays(usually around 30 kVp) to examine the human breast for diagnosis and screening. The goal of mammography is the early detection of breast cancer, typically through the detection of characteristic masses or microcalcifications.

What are the benefits and potential harms of screening mammograms?

Early detection of breast cancer with screening mammography means that treatment can be started earlier in the course of the disease, possibly before it has spread. Results from randomized clinical trials and other studies show that screening mammography can help reduce the number of deaths from breast cancer among women ages 40 to 74, especially for those over age 50. However, studies to date have not shown a benefit from regular screening mammography in women under age 40 or from baseline screening mammograms (mammograms used for comparison) taken before age 40.

The benefits of screening mammography need to be balanced against its harms, which include:

False-positive results. False-positive results occur when radiologists see an abnormality (that is, a potential “positive”) on a mammogram but no cancer is actually present.

False-positive mammogram results can lead to anxiety and other forms of psychological distress in affected women. The additional testing required to rule out cancer can also be costly and time-consuming and can cause physical discomfort.

False-positive results are more common for younger women, women with dense breasts, women who have had previous breast biopsies, women with a family history of breast cancer, and women who are taking estrogen (for example, menopausal hormone therapy


Overdiagnosis and overtreatment. Screening mammograms can find cancers and cases of ductal carcinoma in situ(DCIS, a noninvasive tumor in which abnormal cells that may become cancerous build up in the lining of breast ducts) that need to be treated. However, they can also find cases of DCIS and small cancers that would never cause symptoms or threaten a woman’s life. This phenomenon is called “overdiagnosis.” Treatment of overdiagnosed cancers and overdiagnosed cases of DCIS is not needed and results in “overtreatment.”

Because doctors cannot easily distinguish cancers and cases of DCIS that need to be treated from those that do not, they are all treated.

False-negative results. In cancer screening, a negative result means no abnormality is present. False-negative results occur when mammograms appear normal even though breast cancer is present. Overall, screening mammograms miss about 20% of breast cancers that are present at the time of screening. False-negative results can lead to delays in treatment and a false sense of security for affected women.

One cause of false-negative results is high breast density. Breasts contain both dense tissue (i.e., glandular tissue and connective tissue, together known as fibroglandular tissue) and fatty tissue.

False-negative results occur more often among younger women than among older women because younger women are more likely to have dense breasts. As a woman ages, her breasts usually become fattier, and false-negative results become less likely.

Some breast cancers grow so quickly that they appear within months of a normal (negative) screening mammogram. This situation does not represent a false-negative result, because the negative result of the screening was correct. But it means that a negative result can give a false sense of security. Some of the cancers missed by screening mammograms can be detected by clinical breast exams (physical exams of the breast done by a health care provider).

Finding breast cancer early may not reduce a woman’s chance of dying from the disease. Even though mammograms can detect malignant tumors that cannot be felt, treating a small tumor does not always mean that the woman will not die from cancer. A fast-growing or aggressive cancer may have already spread to other parts of the body before it is detected. Instead, women with such tumors live a longer period of time knowing that they likely have a potentially fatal disease.

In addition, finding breast cancer early may not help prolong the life of a woman who is suffering from other, more life-threatening health conditions.

Radiation exposure. Mammograms require very small doses of radiation. The risk of harm from this radiation exposure is low, but repeated x-rays have the potential to cause cancer. Although the potential benefits of mammography nearly always outweigh the potential harm from radiation exposure, women should talk with their health care providers about the need for each x-ray. In addition, they should always let their health care provider and the x-ray technologist know if there is any possibility that they are pregnant because radiation can harm a growing fetus.


When and how often should I have a mammogram?

Current screening protocols for an average-risk woman are similar worldwide. No programs begin screening women before age 50 and few have shorter than 12–18-month screening intervals. Most advocate screening from age 50 and longer screening intervals (24–36 months). The American College of Radiology (ACR) has the longest recommended age range for screening and is the only one recommending annual screening. The UK has the longest recommended screening interval at three years.

The World Health Organization (WHO) recommends two-yearly screening in large, national-based screening programs.

South African recommendations have historically been based on American guidelines, some of which changed in 2009, again in 2016 and most recently April 2019.

© 2019 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

Society and expert recommendations for routine mammographic screening in women at average risk

Group (date) Frequency of screening (years) Initiation of screening for women at average risk
40 to 49 years of age 50 to 69 years of age ≥70 years of age
Government-sponsored groups
US Preventive Services Task Force (2016)[1] Two Individualize* Yes Yes, to age 74
Medical societies
American College of Obstetricians and Gynecologists (2017) One to two* Individualize* Yes Yes, to at least age 75
American College of Physicians (2019) Two Individualize* Yes Yes, to age 74
American Academy of Family Physicians (2019) Two Individualize* Yes Yes, to age 74
American Cancer Society (2015) One year age 45 to 54 Individualize* through age 44

Yes, start age 45

Yes Yes
One to two years age ≥55
American College of Radiology (2017) One Yes Yes Yes


No matter who you are or what your risk factors are, the best option is to have an open discussion with your family doctor about any questions or concerns you might have.

Sore Throat

Your throat aches and burns. It’s painful to swallow. You know something is wrong, but how bad is it? Will it get better without antibiotics? Or will you need to visit the doctor?

Pain in the throat is one of the most common symptoms seen in healthcare. It accounts for more than 13 million visits to doctor’s offices each year worldwide.

Causes include:

  1. Colds, the flu, and other viral infections

Viruses cause about 90 percent of sore throats

  1. Strep throat and other bacterial infections

Bacterial infections can also cause sore throats. The most common one is strep throat, an infection of the throat and tonsils caused by group A Streptococcus bacteria.

  1. Allergies

When the immune system reacts to allergy triggers like pollen, grass, and pet dander, it releases chemicals that cause symptoms like nasal congestion, watery eyes, sneezing, and throat irritation.

Excess mucus in the nose can drip down the back of the throat. This is called a postnasal drip and can irritate the throat.

  1. Dry air

Dry air can suck moisture from the mouth and throat, and leave them feeling dry and scratchy. The air is most likely dry in the winter months when the heater is running.

  1. Smoke, chemicals, and other irritants

Many different chemicals and other substances in the environment irritate the throat, including:

  • cigarette and other tobacco smoke
  • air pollution
  • cleaning products and other chemicals
  1. Injury

Any injury, such as a hit or cut to the neck, can cause pain in the throat. Getting a piece of food stuck in your throat can also irritate it.

  1. Gastroesophageal reflux disease (GERD)

Gastroesophageal reflux disease (GERD)is a condition in which acid from the stomach backs up into the esophagus — the tube that carries food from the mouth to the stomach.

The acid burns the esophagus and throat, causing symptoms like heartburn and acid reflux — the regurgitation of acid into your throat.

How can I tell if it is a viral or bacterial infection?

It is hard to tell the difference. But there are some clues to look for.

People who have a sore throat caused by a virus usually have other symptoms, such as:

  • A runny nose
  • A stuffed-up chest
  • Itchy or red eyes
  • Cough

People who have a sore throat caused by strep throat do not usually have a cough, runny nose, or itchy or red eyes. They might have been in close contact with another person who has strep throat. They might also have:

  • Severe throat pain
  • Fever (temperature higher than 100.4°F or 38°C)
  • Swollen glands in the neck
  • A rash

Do I need antibiotics?

If you have an infection caused by a virus, you do not need antibiotics. But if you have strep throat, you should get antibiotics. Most people with strep throat get better without antibiotics, but doctors often prescribe them anyway. That’s because antibiotics can prevent problems sometimes caused by strep throat. Plus, antibiotics can reduce the symptoms of strep throat and prevent its spread to other people.

What can I do to feel better?

If you want some relief from the pain of the sore throat, you can take pain medicine that you can get without a prescription like ibuprofen or paracetamol.  Throat sprays are no better at soothing pain than sucking on cough drops. Some people feel relief if they gargle with salt water.

When can I go back to school/work?

If you have strep throat, wait 1 day after starting antibiotics. By then you will be a lot less likely to spread the infection. If you do not have strep throat, you can go back as soon as you feel well.

How can I prevent getting a sore throat?

Wash your hands often with soap and water. It is one of the best ways to prevent the spread of infection. You can use an alcohol rub instead, but make sure the hand rub gets everywhere on your hands.

The bottom line

Viral and bacterial infections, as well as irritants and injuries, cause the majority of sore throats. Most sore throats get better in a few days without treatment.

Rest, warm liquids, saltwater gargles, and over-the-counter pain relievers can help soothe the pain of a sore throat at home.

Strep throat and other bacterial infections are treated with antibiotics. Your doctor can use a swab test to find out if you have strep.

See a doctor for more severe symptoms, like trouble breathing or swallowing, a high fever, or a stiff neck.




Without warning and, for some reason, in the middle of the night, gout strikes — an intense pain in a joint, most often the big toe, but sometimes other joints, including knees, ankles, elbows, thumbs, or fingers.

Ask any person who has had an attack of gout and they will confirm that it is excruciatingly painful.

What is gout really?

Gout is actually a form of arthritis. It is the body’s reaction to irritating crystal deposits in the joints. It happens in people who have too much uric acid in the blood. Uric acid can form sharp needle-like crystals that build up in the joints and cause pain

The most common factor that increases your chance of gout and gout attacks is excess consumption of alcohol, especially beer. It used to be known as “the disease of kings” since it was mainly seen in wealthy men who drank and ate too much.

Is there a test for gout?

Yes. To test you for gout, your doctor can take a sample of fluid from the joint that is in pain. If he or she finds typical gout crystals in the fluid, then you have gout. Even without checking the fluid from a joint, the doctor might still strongly suspect gout if:

  • You have had pain and swelling in one joint, especially the joint at the base of the big toe
  • Your symptoms completely go away between flares, at least when you first start having them
  • Your blood tests show high levels of uric acid

How is gout treated?

There are a few medicines that can reduce the pain and swelling caused by gout. When you find one that works for you, make sure to keep it on hand all the time. That way you can take it as soon you feel a flare starting. Gout medicines work best if you take them as soon as symptoms start.

The medicines used to treat gout flares include:

  • NSAIDs– This is a large group of medicines that includes ibuprofen and indomethacinNSAIDs might not be safe for people with kidney or liver disease, or for people who have bleeding problems.
  • Colchicine– This medicine helps with gout but it can also cause diarrhea, nausea, vomiting, and stomach pain.
  • Steroids– Steroids can reduce swelling and pain. These steroids are not the kind that athletes take to build up muscle


What can I do to prevent gout

Uric acid is formed when proteins in the food we eat, called purines, are broken down. Therefore, there has been a great deal of interest in the dietary management of gout by avoiding purine-rich foods. However, a diet very low in purines is extremely difficult to follow, because purines are a natural part of many healthy foods. Even when a diet very low in purines is followed strictly, the uric acid level in the bloodstream is only slightly lowered.

The following dietary principles are important in the management of gout:

  • Gout is associated with obesity, and significant weight loss can dramatically improve the management of gout. A calorie-reduced diet is helpful for weight loss.
  • A diet low in saturated fat, with increased protein and replacement of refined carbohydrates (for example, sugar, white bread, potatoes) with complex carbohydrates (such as vegetables and whole grains) reduces the serum uric acid.
  • Decreased consumption of seafood and red meat.
  • The consumption of low-fat dairy products decreases the risk of gout.
  • Drinking beer and liquor increases the risk of gout. However, drinking wine does not appear to increase the risk of gout.
  • In one study, consumption of fresh cherries was associated with a 35% decreased risk of gout. Some people believe that black cherry juice or dried cherries have the same effect, but this has not been proven.
  • Drinking beverages sweetened with sugar or high fructose corn syrup increases the risk of gout.

With repetitive episodes of gout, there are options to take medication daily to prevent attacks.



Urinary Incontinence Overview

Urinary incontinence — the loss of bladder control — is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that’s so sudden and strong you don’t get to a toilet in time.

Up to 50 percent of women experience urinary leakage during their lifetime, and 10 to 20 percent suffer from bothersome leakage. It is important to understand that leakage is not a normal part of aging and that treatments are available to reduce or eliminate the problem

Urinary incontinence isn’t a disease, it’s a symptom. It can be caused by everyday habits, underlying medical conditions or physical problems. A thorough evaluation by your doctor can help determine what’s behind your incontinence.

Incontinence can be divided up in 4 main groups:

The two most common types of urine leakage in women are stress incontinence and urgency incontinence

Stress incontinence — Stress incontinence occurs when the muscles and tissues around the urethra (where urine exits) do not stay closed properly when there is increased pressure (“stress”) in the abdomen, leading to urine leakage As an example, coughing, sneezing, laughing, or running can cause stress incontinence. Stress incontinence is a common reason for incontinence in women, especially those who are obese or have given birth by vaginal delivery.

Urgency incontinence — In people with urgency incontinence (also called overactive bladder), there is a sudden, uncontrollable urge to urinate. You may leak urine on the way to the toilet. Common triggers of urgency incontinence include unlocking the door when returning home, going out in the cold, turning on the faucet, or washing your hands.

Many people with urgency incontinence also have to go to the bathroom more frequently than most people during the day and/or night. “Normal” frequency is considered to be eight times per day and once at night, but this depends on how much you drink and may increase if you drink fluid in a day.

Mixed incontinence — Women with symptoms of both stress and urgency incontinence are said to have mixed incontinence.

Overflow incontinence — Overflow incontinence occurs when the bladder does not empty completely, causing leakage when the bladder becomes overly full. It may result in symptoms of either stress or urgency incontinence or both.

There are a number of causes of persistent urinary incontinence. They include:

  • Changes with age. Aging of the bladder muscle can decrease the bladder’s capacity to store urine. Also, involuntary bladder contractions become more frequent as you get older.
  • Pregnancy and childbirth
  • After menopause women produce less estrogen, a hormone that helps keep the lining of the bladder and urethra healthy. Deterioration of these tissues can aggravate incontinence.
  • In women, the bladder and uterus are supported by many of the same muscles and ligaments. Any surgery that involves a woman’s reproductive system, including removal of the uterus, may damage the supporting pelvic floor muscles, which can lead to incontinence.
  • Enlarged prostate. Especially in older men, incontinence often stems from enlargement of the prostate gland, a condition known as benign prostatic hyperplasia.
  • Prostate cancer. In men, stress incontinence or urge incontinence can be associated with untreated prostate cancer. But more often, incontinence is a side effect of treatments for prostate cancer.
  • A tumor anywhere along your urinary tract can block the normal flow of urine, leading to overflow incontinence. Urinary stones — hard, stone-like masses that form in the bladder — sometimes cause urine leakage.
  • Neurological disorders. Multiple sclerosis, Parkinson’s disease, a stroke, a brain tumor or a spinal injury can interfere with nerve signals involved in bladder control, causing urinary incontinence.

Although leaking urine can be difficult to talk about, it is often treatable with weight management for women who are obese, pelvic floor muscle exercises, and/or medications. Talking about it with your health care provider is the first step in getting help for this problem that is affecting your life.

Important questions to discuss include:

  • When do you leak? (When you get a sudden urge, with coughing/sneezing, or does it occur without warning?)
  • When did your leakage begin? Has it worsened or improved over time?
  • Have you tried any treatments to reduce leakage?
  • Are there any medications that you are taking that might be worsening the problem (diuretic medicine for high blood pressure or high doses of pain medications)?
  • Have you seen blood in your urine or had fevers with bladder pain or other pelvic symptoms such as bulge or pressure? These symptoms should not be ignored and you should be evaluated by a clinician.

Bladder diary — A bladder diary is a record of how much urine you make and how frequently you go generally during a 24-hour period. You should write down how much fluid you drink and how much urine you make and record any leakage and the activities that caused leakage. This diary may provide useful information about the cause(s) and potential treatment of your leakage.

Tests — Simple tests may be done during an office visit to determine the type of leakage you are experiencing.

A urine test (urinalysis and sometimes a urine culture to test for bacteria) is usually done to look for signs of infection or blood in the urine. Blood tests may be ordered to measure the kidney function.

A test to see how well you empty your bladder when urinating may be done. This can involve inserting a small catheter in the bladder or a simple ultrasound.


If you’re embarrassed about a bladder control problem, you may try to cope on your own by wearing absorbent pads, carrying extra clothes or even avoiding going out.

But effective treatments are available for urinary incontinence. It’s important to ask your doctor about treatment. You’ll be on your way to regaining an active and confident life.


Antibiotic Resistance

Antibiotics are medicines used to prevent and treat bacterial infections. Antibiotics will not work for viral infections including colds and flu.

Antibiotic resistance occurs when bacteria change in response to the use of these medicines.

Bacteria, not humans or animals, become antibiotic-resistant. These bacteria may infect humans and animals, and the infections they cause are harder to treat than those caused by non-resistant bacteria.

Antibiotic resistance is one of the biggest public health challenges of our time. Each year in the U.S., at least 2 million people get an antibiotic-resistant infection, and at least 23,000 people die

The world urgently needs to change the way it prescribes and uses antibiotics. Even if new medicines are developed, without behavior change, antibiotic resistance will remain a major threat.

What can I do to prevent resistance?

  • Only use antibiotics when prescribed by a certified health professional.
  • Never demand antibiotics if your health worker says you don’t need them.
  • Always follow your health worker’s advice when using antibiotics.
  • Never share or use leftover antibiotics.
  • Prevent infections by regularly washing hands, preparing food hygienically, avoiding close contact with sick people, practising safer sex, and keeping vaccinations up to date.





Does cold weather cause cold? Medical myth debunked

I was speaking to a family member this week who was convinced that she picked up a cold after getting drenched in the rain this weekend.

So, does cold weather really make you sick? For centuries, this myth has led grandmothers to insist that kids sit away from drafts, keep a hat on in cold weather, and avoid going outside with wet hair.

But if this is a myth, why do colds and the flu peak in the winter? The answers are complex and fascinating.

In terms of infectious illnesses, germs make you sick, not cold weather itself. You have to come in contact with rhinoviruses to catch a cold. And you need to be infected with influenza viruses to contract the flu.

Rhinoviruses peak in spring and autumn, and influenza viruses peak in winter.

Studies have shown we may feel more cold symptoms — real or imaginary — when we are chilled (after all, cold is called a “cold” for a reason), but the temperature itself does not make us more susceptible to viruses. This has been known since at least 1968 when a study in The New England Journal of Medicine showed what happened when researchers exposed chilly people to the rhinovirus (one cause of the common cold).

It turned out that whether they were shivering in a frigid room or in an icy bath, people were no more likely to get sick after sniffing cold germs than they were at more comfortable temperatures.

Some scientists speculate that colds are more common in cooler months because people stay indoors more, interacting more closely with one another and giving germs more opportunities to spread.





Anxiety is a normal and often healthy emotion. However, when a person regularly feels disproportionate levels of anxiety, it might become a medical disorder.

Generalized anxiety disorder (GAD) is characterized by excessive and persistent worrying that is hard to control, causes significant distress or impairment, and occurs on more days than not for at least six months. Other features include psychological symptoms of anxiety, such as apprehensiveness and irritability, and physical (or somatic) symptoms of anxiety, such as increased fatigue and muscular tension.


Not all anxiety needs treatment

When an individual faces potentially harmful or worrying triggers, feelings of anxiety are not only normal but necessary for survival.

Since the earliest days of humanity, the approach of predators and incoming danger sets off alarms in the body and allows evasive action. These alarms become noticeable in the form of a raised heartbeat, sweating, and increased sensitivity to surroundings.

The danger causes a rush of adrenalin, a hormone and chemical messenger in the brain, which in turn triggers these anxious reactions in a process called the “fight-or-flight’ response. This prepares humans to physically confront or flee any potential threats to safety.

For many people, running from larger animals and imminent danger is a less pressing concern than it would have been for early humans. Anxieties now revolve around work, money, family life, health, and other crucial issues that demand a person’s attention without necessarily requiring the ‘fight-or-flight’ reaction.

The nervous feeling before an important life event or during a difficult situation is a natural echo of the original ‘fight-or-flight’ reaction. It can still be essential to survival – anxiety about being hit by a car when crossing the street, for example, means that a person will instinctively look both ways to avoid danger.


Anxiety disorders

The duration or severity of an anxious feeling can sometimes be out of proportion to the original trigger, or stressor. Physical symptoms, such as increased blood pressure and nausea, may also develop. These responses move beyond anxiety into an anxiety disorder.

A person with anxiety disorder is described as “having recurring intrusive thoughts or concerns.” Once anxiety reaches the stage of a disorder, it can interfere with daily function.



While a number of different diagnoses constitute anxiety disorders, the symptoms of generalized anxiety disorder (GAD) will often include the following:

  • restlessness, and a feeling of being “on-edge”
  • uncontrollable feelings of worry
  • increased irritability
  • concentration difficulties
  • sleep difficulties, such as problems in falling or staying asleep

While these symptoms might be normal to experience in daily life, people with GAD will experience them to persistent or extreme levels. GAD may present as vague, unsettling worry or a more severe anxiety that disrupts day-to-day living.


Should I see a doctor?

See your doctor if you:

  • Are more anxious than you think is normal
  • Get overly anxious about things that other people handle more easily


Is there anything I can do on my own to feel better?

Yes. Exercise can help many people feel less anxious. It’s also a good idea to cut down on or stop drinking coffee and other sources of caffeine. Caffeine can make anxiety worse.


How is anxiety treated?

Treatments include:

  • Psychotherapy– Psychotherapy involves meeting with a mental health counsellor to talk about your feelings, relationships, and worries. Therapy can help you find new ways of thinking about your situation so that you feel less anxious. In therapy, you might also learn new skills to reduce anxiety.
  • Medicines– Medicines used to treat depression can relieve anxiety, too, even in people who are not depressed. Your doctor will decide which medicines are best for your situation.

Some people have psychotherapy and take medicines at the same time.

There is no reason to feel embarrassed about getting treatment for anxiety. Anxiety is a common problem. It affects all kinds of people.

Keep in mind that it might take a little while to find the right treatment. People respond in different ways to medicines and therapy, so you might need to try a few approaches before you find the one that helps you most. The key is to not give up and to let your doctor know how you feel along the way.


What will my life be like?

People with anxiety disorders often have to deal with some anxiety for the rest of their life. For some, anxiety comes and goes, but gets bad during times of stress. The good news is, many people find effective treatments or ways to deal with their anxiety.



Alcohol – How much is too much?

Many adults enjoy drinking a few alcoholic beverages, but how much is too much? It’s a common question, especially when you’re trying to determine if your own drinking habits are worrisome. The threshold for harmful drinking is much lower than you might imagine.

Millions of people drink beer, wine, and spirits on a regular basis. They can do so without ever developing a drinking problem. However, you can drink at levels that could put your health and well-being in jeopardy without drinking becoming an alcohol abuser, alcohol dependent, or an alcoholic.

An estimated 4 to 40 percent of medical and surgical patients experience problems related to alcohol. Roughly 1 in 10 deaths among working age adults results from excessive drinking.

How much alcohol can you drink at a safe level and still be considered a low-risk drinker? How much will place you in the high-risk group?


Men: Four or Fewer Drinks Per Day

For men, low-risk alcohol consumption is considered drinking 4 or fewer standard drinkson any single day and less than 14 drinks during in a given week To remain low-risk, both the daily and weekly guidelines must be met.

In other words, if you are a man and you drink only four standard drinksper day, but you drink four everyday, you are drinking 28 drinks per week. That is twice the recommended level for low-risk alcohol consumption. Likewise, drinking four drinks a day four times a week would also exceed the guidelines.


Women: Three or Fewer Drinks Per Day

Research has shown that women develop alcohol problems at lower levels of consumption than men. Therefore, the guidelines for low-risk drinking are lower for women. The guidelines are 3 or fewer standard drinksa day and no more than 7 drinks per week.

Again, both the daily and weekly standards must be met to remain in the low-risk category. If you drink only two drinks a day but drink them every day, that is 14 drinks a week, or twice the recommended amount for low-risk consumption.


What is a “standard drink”? Amounts are based on a standard drink,” which is defined as 14 grams of ethanol, as found in 140ml of wine, 340ml of beer, or 40ml spirits (vodka, whiskey, gin etc).


Keep in mind that all of these guidelines are for the “average” person. Since the thresholds vary greatly and there are many factors involved, it’s best to take a personalized approach to find a safe level of drinking.

Harvard Men’s Health Watch suggests that you speak to your doctor to determine how much alcohol is too much for you. Only they know your entire medical history and, with that, you can get a more accurate recommendation. It may also need to lower as you age or if you need to keep certain health conditions, like your blood pressure, in check. What is healthy for you may not be the same for everyone else.

If you regularly exceed the above guidelines for low-risk drinking, you might be a good idea to cut down your alcohol consumption or quit entirely and seek help if you believe it would help you do so.

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Welcome! We are two dedicated doctors offering a full-service family practice situated in the centre of George on the beautiful Garden Route. We are eager to optimize the health of patients in and around George, as well as the surrounding area. Our doctors collaborate in order to meet the health needs of the whole family, from baby-care to care of the elderly, in a friendly relaxed atmosphere. We regard our role as being family doctors, concerned with care and support to each member of the family. Being familiar with the personal and family history of each patient, ensures that we will be able to give high quality care and service.

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