Transcript of Ask the Doctor (part 1) We've generated a transcript of the conversation between Neil McClements (HUK CEO) and Dr Susan Hancock (FRCGP), suitable for screen readers and other assistive technologies. Please note that this was auto-generated and some typos may be present. Enjoy! Neil McClements: [00:00:16] Right. Okay. Let's start, uh, welcome everybody, uh, to our inaugural hemochromatosis UK. Ask the doctor the session. Uh, obviously we are living in very interesting times at the moment and we aren't delighted. So you'd be joined today, bye to Susan Hancock. Uh, Susan is one of the charities, uh, clinical advisors and is also a fellow of the Royal college of GPS. And, uh, Susan's going to help us with a few of the questions which we've had come in from members over the last 24 hours. So welcome to Susan. Dr Susan Hancock (FRCGP): [00:00:53] Thank you very much. Yes. Neil McClements: [00:00:55] Susan, do you want to tell everyone a little bit about your background because you're not simply a GP? Oh, [00:01:00] you do quite a few things. Dr Susan Hancock (FRCGP): [00:01:02] I'm actually a retired from general practice clinically. Um, but, um, I not recently, I must say, but I actually help, um, with medical students. I teach medical students at the university of central lecture. Two days a week, and I'm also a GP appraiser, so I do do a little out of work, um, in a sort of semi retirement situation. I have, however, been asked to rejoin the NHS, which is an interesting thing. After a period of time, uh, by the GMC, and I'm waiting to see what's going to happen about that in this crisis. Neil McClements: [00:01:38] Right. So Dr Susan Hancock (FRCGP): [00:01:39] I hope to be able to answer your questions. Neil McClements: [00:01:42] We've got loads of questions. We, we put a call out to our members. Uh, and we said, please, can you send us your questions within 24 hours? And in fact, we've had over a hundred questions. Um, but what we've tried to do is to sort of select some that are kind of representative. Of the sorts of things that people are asking. [00:02:00] Um, so apologies if one the, if you're a member and your question has not, um, been used on the, uh, the webinar, but we have tried to include as many as we can. So without further ado, let's, let's turn to our first, um, since our first. A question which came from Rosanna in London. Mmm. Does having genetic hemochromatosis increase, uh, risks from covid 19. Dr Susan Hancock (FRCGP): [00:02:27] Oh, hi, Rosanna. That's a very good question. And I'm sure a lot of people are asking the same thing. Have no organ damage, either your heart, your liver, your kidneys, or diabetes or any of the things that put you in an at risk category. Um, then the answer is simply, no, you are the same as everybody else. Uh, in terms of your risks from over at 19. Neil McClements: [00:02:56] that's a bit reassuring for quite a few people. So, so really the key message [00:03:00] there is genetic hemochromatosis in and of itself doesn't put you at increased risk, but obviously we all need to be taken care, staying at home, staying safe, um, following in the government advice. Dr Susan Hancock (FRCGP): [00:03:11] Absolutely. I'm mean, because you're as the same as everybody else does not mean that you shouldn't be taking the advice that we've all been given about this social distancing, washing our hands frequently. Um, that's the everybody. Neil McClements: [00:03:26] Right. Okay. Well that was, um, that was off to a good start. Let's see, our next question. So this one's come from Jerry and working. Uh, what effect, if any, will coronavirus have on people such as myself with hemochromatosis? Dr Susan Hancock (FRCGP): [00:03:40] He's nice. He follows on from the previous question and does depend on whether or not you have. Any other, any damage to your vital organs in your body, or if you're over 70, I, you're in the at most risk group. Um, if you are in the at risk group, I'm afraid there's a slightly increased chance that the, um, [00:04:00] the virus will, uh, affect you more severely. Um, I'm sorry to say that, but if you're not, and everything is good and you're well in control with your hemochromatosis, then it's, it's exactly the same as everybody else. And the effect, if you do get it, and let's hope you don't, Mmm. Can actually go from really hardly knowing you've got it. Uh, many people are walking around, uh, who actually are carrying this virus and have no symptoms, um, to possibly getting some sort of fatty, severe respiratory symptoms where you have difficulty breathing, and that's including a high temperature, a muscle pain headache. Uh, and as I said before, difficulty breathing, usually a dry cough. Occasionally, some people do produce some mucus, but that's normally if they have underlying it, chest condition. I hope that's of help, Jerry. Neil McClements: [00:04:55] Yeah. Wonderful. Wonderful. And, and actually, I don't know if this is going to be any help to people, but [00:05:00] I've been self isolating for a week because I've had the symptoms and uh, um, I'm in my late forties. I've got hemochromatosis and it's been very much like, Mmm, let the flu, but with an extra sore throat. Um, so I haven't been tested. We don't know for sure there. There's actually covid 19. They've have many of the symptoms which people have been talking about. And so I am sequestered here in my, uh, home away from everybody else, just to be on the safe side. So I don't spray that around if I do have it. Yeah. So, but many people, as you say, Susan, the, uh, the symptoms and the impact is actually quite mild. Even the people with hemochromatosis. Okay, let's move on. Um, so this is someone in Bristol. This is Jeremy. Uh, I have liver fibrosis as a result of genetic hemochromatosis. Would that be considered as a high risk if I can try to, Dr Susan Hancock (FRCGP): [00:05:55] yeah. Um, it's a good question, Jeremy, and thank you for bringing up, I'm sorry to hear that you have [00:06:00] some damage to your liver, which is what fibrosis means. Um, and that is a consequence of, uh, of the hemochromatosis. I'm afraid that does put you in a, in an at risk group. Um, you should be getting a message on Sunday from NHS via text. Um, the 29th. Basically putting you in that high risk category. Mmm. I hope that's going to happen. If not, I would consider him emailing your practice and reminding them that you have this problem so that you can be categorized as being in the high risk category. Um, just keep safe, um, be extra vigilant about your distance. And in fact, I'd suggest you don't really go out unless absolutely necessary. If you can get people to do all your, all your chores, uh, be lazy and do that. Neil McClements: [00:06:57] Okay. And for anybody who's watching this, [00:07:00] if you are concerned about getting help with getting your groceries in and things like that, if you go to a Corona virus updates page on the hemochromatosis or UK website, we have actually got a link in there. To the UK government service where they're actually asking people if they feel that they might need some extra help with things like groceries to actually put their names down, and they will then be contacted directly by the new volunteer help force, which was set up earlier this week by the UK government. So if you do live on your own or it's just not going to be practical for people to get out and get groceries, particularly these sorts of circumstances do go to our website, find the link, sign up, and the government will give you some extra assistance. Dr Susan Hancock (FRCGP): [00:07:46] Yeah. Neil McClements: [00:07:48] Okay. Moving on. So, um, Andy's impact with Everardo, which, um, I think is in Cambridge, uh, not a million miles away from our offices. Uh, he says I'm 57 and have [00:08:00] hemochromatosis and also have a fatty liver. Is there any evidence to suggest that I would have any increased risk of complications if I was to contract covert 19? Dr Susan Hancock (FRCGP): [00:08:10] This is a difficult question for me to answer. I'm completely Andy. So do forgive me if, if there's a little bit of this and that. Um, first of all, you're not in the age group, uh, to be worried about. Um, the hemochromatosis by itself, if it's under control is fine, but the fatty liver has a question Mark over it. Now, if there is no other damage to any other organs in your body, um, and you don't have diabetes or any breathing problems, um, the diagnosis of fatty liver. absolutely definite. Then you should be okay. However, there's a lot of ifs and buts there, and I'm aware of that. Um, I would suggest that you probably try and contact your general [00:09:00] practitioner. Who will have all your records to ask this question. I would do this by email. Don't try ringing the surgery. Most of the GPS are working remotely, um, and are quite happy to answer emails. And I think the GP, your GP will have all the details and we'll be in a much better position to own. So that question, um. Regardless of that, Andy, all the other things that we have been talking about, social distancing, hand-washing, not going out unless you absolutely have to still apply. Neil McClements: [00:09:37] Fantastic. So Andy, hopefully that will give you some, some pointers. Get in touch with your GP by email in the first instance. Great. Okay, let's move on. Okay, so Clara in Chesterfield, um, am I close as vulnerable as I'm a carrier? Dr Susan Hancock (FRCGP): [00:09:56] Yeah. This is an easy one. And the answer is [00:10:00] no. Unless you have some other problem that puts you in the vulnerable group. Just being a carrier would not do that. Neil McClements: [00:10:09] Yeah. Well that was a nice, quick and easy one. So carriers, uh, I'm not in the vulnerable groups, so be reassured about that. Fantastic. Okay, let's move on. Mmm. Dean in London, and actually we've had a lot of queries about this actually. Uh, should I keep attending my venesection appointments? Dr Susan Hancock (FRCGP): [00:10:29] Hello Dean. And I'm quite surprised that you are being asked to come because over most of the country then venesection has been sort of terminated for a period of at least four months until July. Um, I, again, this is a, is a sort of. Of the situation, if they are calling you up to come up, I'm suggesting that they've done a risk assessment on you attending, how much you need your venesection and thought [00:11:00] about it. Um, however you need to think about how you're going to get to your appointment. Um, can you get that safely? Um, do you. You know, I wouldn't suggest that you start jumping on tubes that are full of people going to other work situations. So you need to seriously think about, can I get to my vendor section appointment safely with distancing? And if you can and they're calling you, then I would seriously consider going. Neil McClements: [00:11:31] Fantastic. Okay, great. Thanks for that Susan. Dean. Hopefully that gives you small points. Is there, um, I think we have another one which is maybe similar. Um, so this is Jill in London. If I miss venesections, which she normally attends every eight weeks, what is a safe maintenance level to let her ferritin rise too? Normally she's aiming for around . Dave. Um, so Susan, what, what advice do we have to gel. Dr Susan Hancock (FRCGP): [00:11:57] Yeah, I had to think about this quite a lot. Jail. [00:12:00] Um, and I do understand your predicament. There'll be quite a lot of people in the situation. Mmm. You eat normal ferritin for a woman is below 160. So if you're normally capped around 50, you've quite a way to go before you hit 160. I do appreciate that. If the control is 50 but exceptional circumstances. Now damage two organs at the moment. The evidence would suggest that if you can keep your ferritin below. 1000 that there will be minimal damage. So we're way, way, way off that. So I think that for the sake of four months keeping safe. Mmm. You all going to be fine. Um, if however you are concerned and you want to have a ferritin check a bit later on, maybe if you contacted your general practitioner. Um, by email again and requested it just to make [00:13:00] sure it's not going crazy. But I think it's very unlikely, Jill. So relax it back. Don't worry too much about it. There we go. Neil McClements: [00:13:10] Excellent advice. Very reassuring. Thank you, Susan. Okay, let's move on. So this is from Joanne. Um, my Venesection has been postponed for six months. I've been going twice weekly for 16 weeks, and my levels have dropped from over 4,000 to just below 800. How much of a backwards step good. Yes. if she doesn't get fitness sections for six months. Dr Susan Hancock (FRCGP): [00:13:33] Joanne a very good question and well done for getting your, um, your ferritin's down from 4,000 to 800. That's quite an effort. Uh, remember that it has taken years and years and years to gets up to 4,000. That's not something that happens overnight. Mmm. Mmm. I, I appreciate that you haven't hit your target to 800. But during the period of time that we have been asked [00:14:00] to keep away, it's will increase. I can't say that it won't, but it shouldn't, uh, send you anywhere near the levels that you started out. They'll just have to restart the, uh, twice weekly sections when the hospital are open. So there will be a backward step. I can't say they won't, but it shouldn't be massive. And I'm quite sure things will be able to get back in control in the summer when we're through the other end of this virus. So please try not to worry too much. Joanne. Neil McClements: [00:14:32] and Susan, uh, w we get asked a lot by members what things they might be able to do in terms of diet. So are there any. Kind of key things. I mean, we have a, a healthy eating and living, well guy published on the website. So if people haven't, I already downloaded that. Some read it. It's certainly worth a look, but are there one or two things that people might use Lee, do themselves in terms of diet or, or is that really not going to make a lot of difference at this stage? Dr Susan Hancock (FRCGP): [00:14:59] I think you [00:15:00] have to be very careful with the diet because if you start cutting out, you know, vitamin C, things like vitamin C, high iron stuff as all increases iron absorption, then you can reduce your immune sand a little bit. I would suggest, however that may be, if you avoid red meat, um, it's probably not a bad idea. And have a little look at the hemochromatosis, um, uh, advice about which foods are very high in, in iron. And maybe just crop, try to keep them to a minimal, but don't cut anything right out because you're in danger of making yourself deficient of something along the way. Uh, but yes, you can, you can to a certain extent, um, reduce the rise of the iron in your body if you're a little bit careful. take some advice from the website, from the dietary advice on the websites. Okay, Neil McClements: [00:15:53] great. Okay, let's move on. And this is from Angela Northern Ireland. And actually this [00:16:00] is very common, um, question which we're being asked on our helplines at the moment. Um, and if people do feel the need to talk to someone about a genetic hemochromatosis or covert 19, um, do you go to our website, have a look at the help lines link? Um, we're open weekdays. 12 to three. And we also provide an email helpline service, which is getting pretty close to 24 by seven. Uh, we have an , a small army of very dedicated volunteers, most of whom have genetic hemochromatosis, who've received. Specialist training and some of the advice which they able to provide over email is particularly useful at the moment if you're not able to get through on the phone. But anyway, so asks, I was just to have an venesection two weeks ago, but the hospital cancelled due to Corona virus. When or how will I get this done now? Dr Susan Hancock (FRCGP): [00:16:54] Okay. Um, you don't say whether you are in a treatment or maintenance [00:17:00] phase. Um, Angela, nice to hear from you, but I'm assuming from the tone of the question that you are actually in maintenance phase. Um, I'm going to suggest. That, uh, there is a possibility that you could have your vendor section done, uh, through the blood and, um, transplant organization. Um, but you will need to have a referral made from your consultant. I'm sorry. I'm sorry about that. That's my husband guys. I'm sorry. He's actually a doctor as well, so apologies for that. Neil McClements: [00:17:39] So you might grab him later. Dr Susan Hancock (FRCGP): [00:17:42] Oh, retired obstetrician. So if any pregnant, that would be quite useful. Neil McClements: [00:17:47] Um, so Dr Susan Hancock (FRCGP): [00:17:49] I would suggest if you can get hold of your hospital consultant and he could maybe send a letter over to, um, they a blood and transplant [00:18:00] organization, this could be expedited and it is a good way because your blood would be useful. Then. Neil McClements: [00:18:06] And just on that note, actually, um, if I hold this up, you may be able to see that. But the Northern Ireland, Mmm. Blood, uh, transfusion service actually have information leaflets, but donors in Northern Ireland. You have hemochromatosis. Um, this is something that we've been working on for the last year or so, and these are available. Um, so to give the a blood transfusion service, a ring, a friend of mine in Northern Ireland, if you, if you know the way the telephone number is, it's zero two, nine. Nine zero three two one four one four. So just to give that to you again, if you're in Northern Ireland, please, if you're not in ordinance, don't bring this number because I won't be able to help you. But yeah, if you live in Northern Ireland and new concerns, you want to get registered as a donor. If these guys are running, it's zero to nine. Nine zero three, two one four one four and that information is also available on our website. [00:19:00] So if you have a look at the, can I donate page? Uh, we have all the information for Northern Ireland, the Scotland, or Wales and England. So please do take advantage of that. We put a lot of work into trying to get ourselves recognized by the donation services. Uh, do give them a ring if you're concerned and you want to see if you can help. Dr Susan Hancock (FRCGP): [00:19:18] Yeah. Cause that's the same for anybody who is, um, has no reason why they can't donate the blood to the, and it chests, the use. Um, this is a good time to push for that. Really. Neil McClements: [00:19:33] Yeah. Well, let's, let's see. I think our next question may be in a similar vein. So this is Joe and Blackheath. So we're a little bit further out from London now, not that far, but all Venesections have be cancelled. And my local hospital, would it be possible to get them done by blood donation unit? Great question, Joe. Yeah, Dr Susan Hancock (FRCGP): [00:19:49] very good question, Joe. And, and dry up to the, to the Mark. Um, yes, it, it, it's not impossible. Um, however you will need a referral letter. Mmm. Mmm. [00:20:00] Hopefully your consultant will have a sort of standard letter that he can send for you to the blood transfusion service and it can be organized. Um, I really don't see why not. And your blood is useful. They're desperate at the moment for blood. So this would be a good st Joe. So Neil McClements: [00:20:18] again, um, this leaflet, well, Oh, can I say by leaflets? I'm just sitting here with a membership pack. I'm just gonna pull some of these things out. But actually we have been working again very closely with NHS blood and transplant in England and Wales, and this leaflet explains the process for becoming a donor. If you have genetic hemochromatosis, it is available for download off our websites. So if you'd go to the, can I donate age. Which hopefully you can find if you just search for donates, uh, using the search bar, you'll find this. It actually sets out the process and actually it's relatively straightforward now. It used to be, up until about a year ago, there was a lot of faffing about a lot of paperwork, a lot of nonsense involved. It's [00:21:00] now been streamlined and we as a charity have been working very closely with NHS Latin transplants. Try and make this as easy a process as possible because as Susan says, they are keen to receive the blood at the moment. So yeah, get onto the website. Have a look for this leaflet. This particular leaflet is specific to England and Wales, but as I said earlier, we do have telephone numbers, contact details for the other. Uh, nations and regions, uh, services. So do give them a ring or ping them an email if you're interested in donating. Okay. Um, now I think we've got another questions. So this is, um, uh, this is Roland's in candidly, I normally donate blood too, and it's just blood and transplant from, I've been a section. So here is someone who is already well versed in this process of going to the blood donor center. Will they still want my blood? I'm currently . Well. Yeah. Dr Susan Hancock (FRCGP): [00:21:55] Roland, this is an easy answer. Yes, yes, yes. It's the three [00:22:00] stage answer. Yes, of course. They will want your blood. They, uh, I w I went on the website to check out and they're taking precaution, um, at their ranch to avoid, um, yeah, admitting Corona virus into that, into the clinical atmosphere and the donation. You just have to get the essays. That's the only thing I would say. Make sure that you can actually get to the unit safely. Uh, you don't have to get on a crowded bus or a tube or a train. You can drive there and you can walk in. They have distancing there and obviously they have a hand washing it and personal hygiene and cleanliness. That's old. Caught that. So yes, please go. Excellent. Neil McClements: [00:22:41] Okay. Well that's very encouraging. Um, I think we have one more question about, uh, donations. This is from Ghouta in Livingston in Scotland. I've been a sections had been counseled for six months, and I'm not in maintenance yet. Why can't the blood donor service accept blood in the higher normal ranges now. [00:23:00] Uh, we might actually have a little updates on this early next week, but let me, let me just, let me give you the charity view on this. So for anyone who's watching this on catchup, it's actually Thursday, the 26th of March. Okay. And I'm saying that because actually the situation is changing so rapidly that actually by next week it may be totally different. Mmm. But as of Thursday, the 26th of March, we are working very closely with NHS blood and transplant to the senior level. To discuss them, relaxing the criteria or donors and, and really what's driving that to some of these points which are coming from our members. So we feel very frustrated as a community that we receive therapeutic benefit from donating or giving out blood. Yeah. But none of us wants to sit going into a hospital incinerator or being pulled down the drain. And so the conversations which are going on literally later on today are with senior people at NHSBT. To [00:24:00] see whether it is practical for them to flex and relax the criteria. So if you are in maintenance at the moment in England and Wales, you can definitely go and donate, as we've been saying, go to our website, go and find the leaflets. Um, that's England and Wales, that's Northern Ireland. Um, but for people who are just outside the normal range, it is extremely frustrating. And the discussion that we're having with NHSBT at the moment is really around. Are we able to help or would it actually cause them more difficulties, more pressure at this very, very difficult time. So we don't have a final decision on that at the moment. And we may not for maybe a week or two. But what we would say to people is, if you are in maintenance and you can safely travel to a donor center, then please consider registering as a donor. And if you're outside of maintenance and you're very, very close and you'd like to think about being a donor on our website, email newsletters, [00:25:00] we will be reaching out to people. If the advice and the guidance from NHS BT changes, we will let you know immediately because there is a national crisis on, we think as a community we can do something to help. So, uh, at the moment, I think you'd say you're in that situation where you're very, very close to being in maintenance, but not quite close enough. So anyway, let me hand it over to Susan cause I'm not a doctor. Okay. I just, I've just run this charity, so yeah. Susan, what are your thoughts? Dr Susan Hancock (FRCGP): [00:25:27] There's not much more I can add. Thank you. Um, you, so it's a very good question and absolutely no real clinical reason because your blood is good and it's good for somebody else. If that helps a little bit extra Island that's not in any way detrimental. The problem is more of an administrative one. If I'm perfectly honest. Um, the problem is. Arranging maintenance, checking bloods, who's going to, okay. Uh, and the blood donor service do not have a [00:26:00] doctor the room when you go. Uh, they have a nurse and the rest of the people that are health health care assistance, um, so they don't have the facility to monitor you a task. It was, so a lot of coordination will need to be done. And I think that's what Neil is alluding to between 'em. Your results and how it, how you controlled. Once you're in maintenance, everything is acceptable because you've gone through the main bit and that's not a very good answer, but that's actually why it's not happening. Okay. Neil McClements: [00:26:37] Yeah, it's, it's not because you're not loved. It's just the administrative side of it is just that bit more challenging at the moment when there's lots of other things going on. So, thank you. It's a feel question. Let's, uh, let's move on. Um, we have Craig and Atherton. Um, my liver is in the national stage of disease. And for anyone watching who doesn't know what Nash is, it's, um. [00:27:00] It's a, it's a form of liver disease. I, let me get, let me just put it like that. Maybe Susan can explain it better than me, but what Craig's asking is if he has Nash, does this class him as a vulnerable person during the outbreak? Dr Susan Hancock (FRCGP): [00:27:12] Yeah, I'm Craig. Yes. Again, I have to think quite clearly about this. Um, when you're in non-alcoholic related staff at hepatitis, it means there is some inflammation to the basic liver cells. Um, so your liver is affected and this w can results, um, and often does in fibrosis, which we mentioned earlier, wrong. Um, so as far as I am concerned, um, and I am willing for this to be discussed. I think this puts you in the vulnerable person range. Um, so you have to be extra vigilant, um, because you live liver is not working 100% normally. [00:28:00] Yeah. That means, Craig, that, uh, you may get a telephone, um, text message on Sunday. You may not. If not, I would check with your surgery because they may not be completely up to date with your records and double double check with your GP, not by phone. Send them an email. And uncheck that. This is the case. Um, and you'll have a little bit better idea cause it is quite a big undertaking if you have to put yourself in a vulnerable person. Cast agree in terms of isolation. Ah, they are requesting quite a long period of time. Um, I'm sorry about that Craig. But, uh, I think it's better to be safe than sorry. Neil McClements: [00:28:45] Great. Thanks Susan. And just for anyone watching, if you, I'm not sure about. He's different sorts of liver conditions, liver diseases. The British Lyford trust, which is a, a charity based here in the UK, has some fantastic resources on [00:29:00] their website. Um, hopefully you can see at the bottom of the screen that we've got a link through to this particular condition. Um, and they also run a helpline, uh, on weekdays, and that helpline is staffed from about 10 o'clock in the morning through till about three o'clock in the afternoon. Um, go to the British liver trust website. Mmm. On the details. They give them a ring. The super, super helpful. Uh, their helpline is staffed by qualified delivery nurses. So if you have a known liver condition or liver disease, and you will know about this because you will have been told by your doctor, um, and you want to talk that through with somebody, a British liver trust, actually qualified Lebanon assist on their helpline, who may be able to help you better. Then perhaps we can, but some good luck with that, Craig. Okay, let's move on. Um, David and Willenhall, am I safe from coronavirus? Walston weekly for intersections. So David's managed to get to the hospital, still wants to see him. Mmm. But is it safe for [00:30:00] him to Dr Susan Hancock (FRCGP): [00:30:00] go. David, I think it's probably safe when you get into the room for the venue section, um, through the door. I would just reiterate what I said before. It's, you've got to make sure that you get to the hospital safely. Um, uh, and that's an important bit and it needs a little bit of thinking about, we are, again, talking about. And not touching and distance social distance saying, um, and maybe in your case, if it's difficult to get that and be reassured by that, maybe you want to consider a face mask. I know it's not recommended for everybody, but in this situation where you have to get there, um, if it's still happening, I would consider that. Neil McClements: [00:30:43] Great, thanks. So he's in, um, our next question is actually a little bit, um, it's quite, quite a sad question, but let's, let's just see what we can, we can do to help polar and King Sutton. Um, so Paula's husband's seriously ill with COBIT 19. Um, is there any [00:31:00] additional aspects that she should pass on to his doctors? They know he has hemochromatosis. I'm Dr Susan Hancock (FRCGP): [00:31:05] really sorry, Paula, to hear that your husband is seriously out. Um, I, I hope by the time we're talking that maybe he's not so seriously ill and is beginning to pull through. Um, no, I think as long as the doctors are aware of this hemochromatosis, um, and you probably need to keep repeating it, um, on several occasions. Um, they should be accommodating, um, around that. Obviously, if he has any. Organ damage from his hemochromatosis. Um, they will have found that out by now. Um, but we wish you all the best. Um, obviously if your husband is a, you need to take the necessary isolating precautions as well. And I, I understand that's very difficult because I suspect he's in the hospital. Um, and you're going to have to isolate. So it's hard times and I wish you luck. [00:32:00] Neil McClements: [00:32:01] Yeah. All our best wishes, uh, Paula to you and your husband's and the wider family. And, uh, we hope that he's feeling better soon. Dr Susan Hancock (FRCGP): [00:32:14] Okay. Neil McClements: [00:32:14] So we have a, we have a question from Irene who's in the village. Somewhere, maybe this village, maybe she's right around the corner from us. Um, but wherever you are, Irene, thank you very much for your question. It's lovely to hear from you and Irene, as she says, I have symptoms of coronavirus. What should I do. Okay, Dr Susan Hancock (FRCGP): [00:32:34] Irene? Um, good morning. Um, there is a website, one, one, one, a coronavirus service. I suggest that you go on there. There's a lot of detail you put your symptoms in at it is absolutely quite clear. Um, when you've entered your symptoms, what you should do. Um, it may result in you calling for help, or it may result in you just taking some simple procedures at home, depending on your [00:33:00] severity, which obviously we can't tell from your question. So that would be my advice. Get your computer fired up and go on your website. One more mom, Corona virus. It is, it's an NHS website. Um, and have a look about the advice. Neil McClements: [00:33:16] Fantastic. Okay, well, good luck with that, Irene. Um, and I think we now have a final question. So, uh, thank you very much, Susan, for bearing with us. We've really rattled through these, which hopefully has been of some help, see other people, but yeah, here's a final question for today from Rebecca and cut and Lindsey and actually cut. Lindsey, if you don't know, is actually very close to our office in Spalding. So we're almost neighbors. Um, but anyway, Rebecca, thank you very much for your question. Rebecca says, I've had 19 symptoms and I've been taking paracetamol. Could this have been contributing to my breathing difficulties? Dr Susan Hancock (FRCGP): [00:33:53] Good morning, Rebecca. Thank you for your question. 19 or Corona [00:34:00] virus, um, actually affects the lining of the lungs. Um, and so your breathing difficulties are very likely to be due to the virus itself affecting, um, the way the oxygen gets into your body by inflaming the inside of your lungs. Paracetamol does not do this. So you are quite safe to take paracetamol for your symptoms. It will not make you short of breath. It's the actual virus that's doing that. Um, but probably if you, if you are breathless, you ought to be going again on two one, one, one Corona virus, a website, popping your details in and getting some advice online as to why you need to go with this. Um, you don't say how many days you're into it or anything else. So that would be my best advice is pop in there and see what the suggestions are down the algorithm as to what you need to do a good luck. Rebecca. Neil McClements: [00:34:59] That's [00:35:00] great. Thanks, Susan. I know earlier this week there was a little bit of a controversy about ibuprofen versus paracetamol. Do you have any thoughts about that? Dr Susan Hancock (FRCGP): [00:35:10] Yeah, it's to do with the receptors on the, um, on the surface of cells and how the Corona virus attaches and it detaches through a thing called the AC. receptor. This is affected by ibuprofen. Um, in theory. Mmm. So I would suggest that probably you're safer to use paracetamol. I'm on the hall, although I did hear recently that, um, ibuprofen has been cleared and you can use it. But my feeling is why you something that has a question Mark over it. If you can use something that doesn't, so I'd stick with paracetamol. If you can't drink plenty of fluids. Keep out of the way of everybody else, [00:36:00] obviously symptomatic and just rest. If you, if you're having difficulty breathing, don't move around too much. Just just keep nice and still and, and maybe even take to your bed for a couple of days. I don't know what you did nail, but sir, that would be my advice. But get, um, get some help. Use this website to plug in with your symptoms and see why you are and you'll have a little bit more information. Then. And good luck with that, Rebecca. Neil McClements: [00:36:28] Fantastic. So, um, that was our final question. Um, before we wrap up, I just wondered if it might be helpful to, Mmm, just highlight some of the resources that we have online. Mmm. Now, hopefully, Susan, you can see our website. Excellent. Okay. The technology's working. That's fantastic. Um, so w we have, uh, very recently actually upgraded our website, which is lucky because, um, I think our old one with a run out of steam, it's, it's been on the very, very intensive use by people, which [00:37:00] is great, but sh as people will be able to see, we have our coronavirus updates here, uh, and we are trying to keep this up to date. Um, every day or two, we're not doing it necessarily every day because sometimes nothing much happens. Um, but what we are trying to do is to bring together some of the resources that we are, um, finding which are reputable resources on the internet from the NHS and from other reputable sources of information. But we have quite a lot of material now building up here, uh, with specific, yeah. Answers to specific questions, which are related to genetics. Hemochromatosis. Um, so do, if you haven't already had a look at this, do have a look through. There's lots and lots of links in here. Um, and also what we're trying to do as well is wherever there is UK government nice. It's often not particularly well signposted online. Um, so we do try and actually give people a little bit of a heads up about where to be looking for certain things. So some [00:38:00] of these, um, links, which Susan's been referring to are available on . Uh, this page. So do have a browse through of that. Um, if you feel that there's a question, which, um, we haven't managed to answer, um, do you get in touch with this? You can do that very simply by coming to the contact us section of the website and just to highlight a couple of other resources, which may be useful at this slightly. Mmm. With and also difficult time. Um, if you are interested in becoming a blood donor, um, here we are. Can I donate blood? We've collated all the current advice. Uh, from NHSBT and the regional transfusion blood services here, Mmm. To have a read of this because if you have intersection has we can cancel, but perhaps for six months and you're concerned, you may be able to become a donor. Um, and we have all the information about the criteria that you need to correspond with, uh, there, the other thing which I'll just draw attention to is. [00:39:00] Actually this whole thing about living well with genetic hemochromatosis and diet. So we have put all of our, uh, leaflets and materials available online. You can download them. You don't need us to post them out. Just go to the website, download them. Uh, and so your boots with all of those sorts of things. Um, but please do take care of everybody. Um, it's a very challenging time for the NHS. It's very challenging for us as citizens. Um, but together we will get through this. We will come out stronger, I'm sure. So do take care and stay safe. Um, and Susan, um, I don't actually have any closing remarks. Um, it's obviously a very, very unusual time. Mmm. You qualify. I think back in 1980 if I'm allowed to say that, uh, this may be, I don't know if you've seen the global pandemic before. Dr Susan Hancock (FRCGP): [00:39:50] Yeah. I haven't, no, this is the first, um, time that it's been, um, a global pandemic. I mean, I've seen pandemics because it's just above a [00:40:00] certain level of infections, but not to this extent. unprecedented in my magical Korea. Um, I think when you understand a little bit about this virus. And how it moves from a to B and how it infects it does help. Um, and there's a lot of stuff online about that if you want to look it up. Um, but that's why the government brought out these rules and regulations, because if we socially distance and we wash our hands, it comes actually spread in anything like the way that it has been doing. Um, it's called because it's not actually live outside any book is Paul Jay. It's just a little bit of RNA. Okay. Capsule around it, which is causing devastation. Yeah. Would like to everybody please, please, [00:41:00] please be careful. Uh, don't worry too much. I say, I say to people, take it seriously, but don't panic. That's my message. and be very careful about what you do. Thank you. Neil McClements: [00:41:14] Thank you very much, Susan. I think that's a really constructive point too, to end on. Thank you ever so much for taking the time today and, uh, I just want to work through your thoughts. Do take care, be safe. Yes, Dr Susan Hancock (FRCGP): [00:41:29] yes. Okay. Neil McClements: [00:41:32] Thank you very much everybody. Take care. Bye. Bye.