If you are in a new or unfamiliar area, finding a doctor can be a daunting task. iTriage is an app that uses your phone’s GPS to locate nearby doctors, hospitals, clinics, and pharmacies. it provides phone numbers, addresses, and options to call or get directions. you can even search for medical providers based on specialty or the physician’s name.

You can also look up information on disease symptoms and do research on diseases, treatments, and procedures. Search results narrow as you type your query, which saves time.

iTriage features an “Emergency” button that calls 911. I’m not convinced it’s all that much more useful than just pressing 9-1-1 yourself, but it’s there if you want it.

Voice-enabled search is also an option. But in my tests, the accuracy of voice transcriptions varied a lot, and I finally gave up on it when I realized that typing a search query leads to quicker and more consistent results.

iTriage contains a wealth of information about many medical conditions and treatments, and it provides Web links to even more sources of information. In that sense, it’s a very educational app. however, many different medical conditions have very similar symptoms, and this app should not be considered a substitute for professional medical attention. It’s more appropriate as a way to learn more about a condition once it has been diagnosed, instead of for self-diagnosis.

Also available is a glossary of medical terms, which could help you to decipher the jargon of the medical establishment.

iTriage is most useful as a way to locate and contact medical service providers. it provides the important information–phone number, location, distance, and directions–with a minimum of difficulty. for that reason alone, iTriage is well worth installing–it could come in handy just when you need it.

Note: you might also want to check out the free pharmaceutical reference app Epocrates.

I recently took 10 days worth of antibiotics for a urinary problem I am having. I did not see any change in my symptoms through the course of antibiotics. I am wondering if I have prostatitis. If I do have prostatitis would I see any change my symptoms through the first 10 days of antibiotics? I know the treatment for prostatitis is 6 to 12 weeks.

You might look into Chronic Pelvic Pain Syndrome, CPPS. there is a book called Headache in the Pelvis, and a group of guys with similar symptoms at:

chronicprostatitis.com

I went to several GPs over a period of several years for what turned out to be prostatitis. They gave me antibiotics, but nothing seemed to help. then I went to a urologist who took x-rays. Seeing that several courses of antibiotics had not touched the problem, he had to go in there with a rod and stir things up a bit. It didn't hurt when he did it as he did a local anesthetic, but he told me to sit down to pee for several days, else I would probably fall down from the pain. that procedure and more antibiotics did the trick and I am pain free for many years and
never had the problem again. I am not saying you will need anything like this, but my advice is to go see a urologist if your GP hasn't been able to help you.

Six weeks ago, I realised I had got myself addicted to Boots own paracetamol and codeine tablets – 6/8 a day taken regular as clockwork for at least eight years. I stopped immediately and went cold turkey. I suffered all of the classic opiate withdrawal symptoms: muscle ache, tiredness and exhaustion, sneezing, itching, yawning and anxiety, but I think the worst is over (NB my GP said he would not have recommended cold turkey but said now I had started I should carry on). I still get very tired and exhausted and yawn a lot, and I am sick of it. Can anyone tell me when I reasonably expect to be back to normal and withdrawal symptom free?

I am afraid the potential for addiction of both over the counter co-codamol and the prescribed tablets, some of which have even more codeine, is grossly underestimated by the medical profession. You have my sympathy. I fought a pretty thankless battle to get prescribing locally reduced, even with the help of the local pharmacy prescribing advisor, for 15 years, before I retired.

They are often started in hospital when patients are in patients, and then continued by the GPs indefinitely!

There are no easy pharmacological alternatives to aid the withdrawal process, and fo this particular drug, I usually advised gradual withdrawal. cold turkey is unpleasant but often useful. unfortunately doctors have been taught that it is not a PC method of dealing with addiction.

However when I worked for the Scottish Prison Service as a PMO, it was the method preferred by many opiate addicts!

Sorry I almost forgot to answer your question! I would have thought physical withdrawal should not take more than a week, unfortunately psychological withdrawal has no real measurable timescale.

I've been there although mine was only a 6 month usage. I weaned myself down over 2 weeks and I guess it to OK a good 2-3 months after stopping completely before I started feeling like I had the same energy levels. it might be longer for you as you were on them so long but ask your Dr if its ok to use an energy drink mid day to pep you up although I guess this could be swapping one fix for another. it could also be that youre 8 years older and would have been finding yourself more tired even without having become addicted…you just wouldnt have noticed it creeping up on you over 8 years.

I think there needs to be a much bigger warning on these paracetamol/codeine tablets to alert people. my brand were a chemists own brand and carried no warning but I bought them from Lloyd's the one day and I noticed a warning, that's when I realised I was probably a little dependant on them.

Best of luck

LONDON, January 18, 2011 /PRNewswire/ — the National Institute for Health and Clinical Excellence (NICE) today published its final appraisal determination containing final recommendations on the use of specific treatments for Alzheimer´s disease. the new ruling means Alzheimer´s patients will now have access to treatment from the earliest stage of the disease.[1]*

A survey conducted among general practitioners across the UK has suggested that the new recommendations will give Doctors[2] a strong reason to diagnose and treat this devastating disease early. it highlighted that nearly two thirds (64.1%) of GPs believe that their detection and diagnosis of mild Alzheimer´s disease patients will improve as a result of the NICE guidance. Until now diagnosing the condition early has been difficult for GPs, as the guidelines previously recommended treatment only for patients with moderate or severe Alzheimer´s disease. 70.2% of GPs surveyed believe that their management of Alzheimer´s disease will change as a result of the new guidance with over half (57.9%) of GPs stating that they would be likely to recall patients with mild Alzheimer´s previously denied treatment for reassessment. This should help more people with early disease get access to specialist care by being referred to a memory service for assessment. A total of 40.7% of doctors also thought that their prescribing of AChEIs would change as a result of the NICE recommendations.

“This is great news for people with Alzheimer´s disease and their families because we will now be able to offer effective drug treatment in mild, moderate and severe Alzheimer´s disease. for example, patients with mild disease will at last be able to get access to early, cost-effective treatment at the point of diagnosis – treatment that can potentially help to relieve the symptoms in these patients”, says Professor Roy Jones from the Research Institute for the Care of Older People (RICE), Royal United Hospital, Bath, UK. “Previously it was difficult to see patients with mild disease and ask them to come back when their condition worsened before we were able to prescribe drugs that could improve their symptoms. This new ruling will help keep patients as independent as possible for as long as possible.”

the new survey data also revealed that, unfortunately 29.6 % of GPs surveyed were unaware of the preliminary recommendations published by NICE on the use of AChEIs in patients with Alzheimer´s disease and 55.5% believe that there are inadequate protocols / materials in place to effectively help them diagnose people showing early signs of disease. In addition, the survey revealed that 86.7% of GPs believe that families and carers of patients with Alzheimer´s disease do not have adequate support to recognise and manage the early signs of the disease. it is vital that Alzheimer´s disease is diagnosed as early as possible, as having an early diagnosis, starting treatment and putting lifestyle modifications in place in the early stages of the disease can help individuals prepare for the future.[3] Greater awareness is needed amongst patients, carers and GPs of the early treatment options now available to them which could lead to better outcomes for the patient and carers.

*Additional information on the NICE guidance1

1.1 the three acetylcholinesterase (AChE) inhibitors (donepezil, galantamine and rivastigmine) are recommended as options for managing mild to moderate Alzheimer´s disease under all of the conditions specified in 1.3 and 1.4.

1.2 Memantine is recommended as an option for managing Alzheimer´s disease for people with: moderate Alzheimer´s disease who are intolerant of or have a contraindication to AChE inhibitors or severe Alzheimer´s disease.

1.3 Treatment should be under the conditions specified in 1.3.

– Only specialists in the care of patients with dementia (that is, psychiatrists including those specialising in learning disability, neurologists, and physicians specialising in the care of older people) should initiate treatment. Carers´ views on the patient´s condition at baseline should be sought. – Treatment should be continued only when it is considered to be having a worthwhile effect on cognitive, global, functional or behavioural symptoms. – Patients who continue on treatment should be reviewed regularly using cognitive, global, functional and behavioural assessment. Treatment should be reviewed by an appropriate specialist team, unless there are locally agreed protocols for shared care. Carers´ views on the patient´s condition at follow-up should be sought.

1.4 if prescribing an AChE inhibitor (donepezil, galantamine or rivastigmine), treatment should normally be started with the drug with the lowest acquisition cost (taking into account required daily dose and the price per dose once shared care has started). however, an alternative AChE inhibitor could be prescribed if it is considered appropriate when taking into account adverse event profile, expectations about adherence, medical comorbidity, possibility of drug interactions and dosing profiles.

for the full guidance, please visit: guidance.nice.org.uk/

currently, there are around 820,000 people living with Alzheimer´s and other dementias in the UK, [4] including an estimated 575,000 sufferers in England and 37,000 in Wales.[5] Alzheimer´s disease is the most common form of dementia, affecting 62% of dementia patients in the UK.[5] This irreversible, progressive brain disorder gradually destroys memory, reasoning and thinking skills, and may eventually leave patients unable to carry out even the simplest tasks.[6] Alzheimer´s disease has impacts in many ways including physical, mental, nursing, medical and social impacts.[1] despite its burden, Alzheimer´s remains a relatively overlooked disease. Just 2.5% of the government´s medical research budget is devoted to dementia; in contrast a quarter is allocated to cancer research.[7]

Eisai is one of the worlds leading research-based pharmaceutical companies that has defined its corporate mission as “giving first thought to patients and their families and to increasing the benefits health care provides, ” which we call human health care (hhc).

Eisai concentrates its research activities in three key areas:

– Integrative Neuroscience, including: Alzheimer´s disease, multiple sclerosis, neuropathic pain, epilepsy, depression – Integrative Oncology including: anticancer therapies; tumour regression, tumour suppression, antibodies, etc and supportive cancer therapies; pain relief, nausea – Vascular/Immunological reaction including: acute coronary syndrome, atherothrombotic disease, sepsis, rheumatoid arthritis, psoriasis, Crohn´s disease

With operations in the U.S., Asia, Europe and its domestic home market of Japan, we employ more than 11,000 people worldwide.

About Pfizer: Working Together for a Healthier World(TM)

at Pfizer, we apply science and our global resources to improve health and well-being at every stage of life. We strive to set the standard for quality, safety and value in the discovery, development and manufacturing of medicines for people and animals. our diversified global health care portfolio includes human and animal biologic and small molecule medicines and vaccines, as well as nutritional products and many of the world´s best-known consumer products. every day, Pfizer colleagues work to advance wellness, prevention, treatments and cures that challenge the most feared diseases of our time. Consistent with our responsibility as the world´s leading biopharmaceutical company, we also collaborate with health care providers, governments and local communities to support and expand access to reliable, affordable health care around the world. for more than 150 years, Pfizer has worked to make a difference for all who rely on us.

In the UK, Pfizer has its European R&D headquarters at Sandwich and its UK business headquarters in Surrey, and is the major supplier of medicines to the NHS. To learn more about our commitments, please visit us at pfizer.co.uk.

[1] National Institute for Health and Clinical Excellence, Final Appraisal Determination – Donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer´s disease (review of NICE technology appraisal guidance 111)

[2] Opinion Health survey data. Total sample size was 200 GPs in the UK. Online internet-based survey fieldwork undertaken between 13th – 16th December 2010. Eisai Europe and Pfizer Ltd. Data on File

[3] Doraiswamy PM, Steffens DC, Pitchumoni S, Tabrizi S. Early Recognition of Alzheimer´s disease: what is consensual? what is controversial? what is practical? J Clin Psychiatry. 1998;59 (suppl. 13):6-18.

[4] Alzheimer´s Research Trust -Dementia 2010. Available at: dementia2010.org/reports/Dementia2010Full.pdf. Last accessed Jan 2011

[5] Alzheimer Society. Available at: alzheimers.org.uk Last accessed Jan 2011

[6] National Institute on Aging (NIA). Alzheimer´s Disease Factsheet. NIH Publication no 08-6423. Reprinted February 2010

[7] Alzheimer´s Research Trust. Available at: alzheimers-research.org.uk/info/statistics/ Last accessed Jan 2011

Eisai Europe Limited and Pfizer Limited