How long have you been working with safe patient handling products?

I have been working on the safe patient handling programme for over 15 years now. Both the Forth Valley Health Board hospital and community teams use equipment and products to support patient care across the Falkirk health and social care partnership. Currently, the Loan Store Works and Services provides over three hundred hoists and over nine hundred slings to help improve patient outcomes across the area. As an equipment service, we made the move from various competitor products to using Hillrom exclusively around 10 years ago.

What factors do you take into consideration when choosing a supplier of has safe patient handling equipment?

We felt as a Health Board that it would be effective to keep the transition of equipment between hospitals and the community the same. This meant that families and carers could be trained to use specific hoists and slings making discharge from hospitals easier and more straightforward for the patient, their families and the care staff involved.

All slings, in a care or home setting, need to be used multiple times, washed and then reused again – you need to be able to achieve longevity and life with equipment.

From the point of view of movement, mobility and handling, it’s always important to choose a supplier that provides top quality products, which are also easy to use and fit all situations across care settings. We need to work with an organisation that provides a wide range of options to help fit the equipment to the needs of the patient rather than trying to fit the patient to the equipment. It was also important to select an organisation we know we can rely on for their support and backup to help us sort out any problems.

How important is product build quality and durability to you and your clients?

The quality and durability of equipment is really important for us. We use over 900 slings across the Forth Valley Health Board area and over the last 10 years, we haven’t had any issues in terms of quality. Slings need to be long-lasting and suppliers need to have good supply, together with excellent customer service, training and support.

How do you and your team maintain your safe patient handling equipment?

I have worked with the Joint Loan Equipment Service for over 15 years. Some of the maintenance we can do ourselves, as we have a service team made up of three technicians who are very knowledgeable about our equipment in terms of the parts’ diagrams, building equipment and ability to access any spare/replacement parts.  But we also rely on a dedicated support team via a rep who we have a good working relationship with.   It’s important to work with a company who are easy to get hold of, and help you to get to the bottom of any problems and/or issues that may arise. Any faults we tend to have with products and equipment, generally come from user misuse rather than any equipment or product issues to be honest.

How important is support to the wider Forth Valley Health Board community?

Having a dedicated rep is a huge time saver for us, meaning communication times are much shorter, I know I can go directly to our rep with anything, as we have established a very productive relationship. Everyone in the Forth Valley Health Board community, from those who work in the hospitals to members of the council, know who our Hillrom rep is and this just saves so much contact time, as they all have established a strong working relationship with them as well. It is a much more time-efficient and a seamless way of working.

Breastfeeding your new baby can be difficult, and with side effects like sore nipples, engorgement and thrush, sometimes it can be hard to keep going. To help you on your breastfeeding journey, Lactation Consultant, Kitty Hackel offers her best tips and advice on some common breastfeeding problems and how you can overcome them.

1. Sore nipples

Many women who breastfeed may experience nipple discomfort or tenderness in the first few weeks of feeding. This transient soreness usually peaks between day 3-5 due to changing hormone levels as your milk transitions from colostrum to more mature milk. The frequent feeds, getting used to baby’s suction and making sure baby is latched properly can all contribute to sore nipples, to help with this try some of my top tips.

• Ensure that your baby is latched properly during feeds, if you’re unsure of whether or not the latch is right then reach out to your midwife or ask your health visitor.
• Try putting breast shells or silver cups over the sore area when wearing a bra to reduce chaffing and irritation.
• Breastfeed on the least sore breast first as baby tends to feed most vigorously at the beginning.
• Use Multi-Mam Breastfeeding Compresses which are formulated to help treat sore, dry and swollen nipples. The compresses contain a cooling gel with patented bio-active polysaccharides, the so called “2 QR-complex” which can prevent harmful bacteria from attaching to the tissue. The cooling pads can be applied at least twice a day for 30-60minutes – pro tip: store in the fridge for added cooling effect.

2. Engorgement

By definition, engorgement is when the milk volume exceeds the alveoli’s capacity. This generally peaks between 2 and 5 days as your milk comes in, your breasts may feel full, heavy and hard at times. To ease this discomfort while your milk production settles down try the following:

• Offer both breasts at every feed to avoid long periods between feeds and try to feed your little one frequently by observing their feeding cues rather than watching the clock.
• Apply a warm compress to your breast before feeds and then use a cool one after feeds to sooth the area.
• Using cool, fresh green cabbage leaves in your bra between feeds is a fantastic for breast engorgement. Wash and apply them to the engorged area to reduce discomfort – be careful not to use them for more than 20 minutes daily as it can reduce your supply.

3. Thrush

Breast and nipple thrush is a yeast infection of the nipple and breast caused by a fungal organism known as Candida albicans, a common cause of all thrush infections. It occurs most commonly in breastfeeding mothers and the infection may lead to severe nipple and breast pain. Diagnosis can be tricky as it can be mistaken for many other breastfeeding issues and so is often the most over diagnosed breastfeeding issue.

If you have or are experiencing breast/nipple thrush, try not to worry, it is entirely treatable. Some of the advice I give to my patients who experience thrush is:

• Good hygiene is so important. To help this try washing your breasts with warm water and soap twice per day. Good hand hygiene, regularly changing breast pads and washing of bras separately in a high heat wash can also all help.
• Observe your diet, the particular fungus that causes thrush thrives off of simple carbohydrates, eliminating these from your diet could help ease your symptoms.
• If none of these seem to work for you, contact your GP to help kick the infection by using the appropriate medication, this should start clearing up the infection in 2-3 days.

4. Mastitis

Mastitis is an inflammation of breast tissue that sometimes involves an infection. The inflammation results in breast pain, swelling, warmth and redness. You might also experience a fever and chills.

Mastitis can be caused by a whole host of reasons from improper drainage, pressure on your breasts, tight bras, stress or even sleeping on your front. Mastitis is often very uncomfortable, so it is important to get to the bottom of why you are experiencing this. My motto for Mastitis and abscess prevention is heat – massage – rest – empty breast. To help combat Mastitis try the following:

• Avoid tight or restrictive clothing that could constrict the milk duct – this includes bras, seatbelts and even your handbag.
• Rest is really important, try and get your friends or family to help out a home while you rest and recover.
• Anti-inflammatories like ibuprofen can help bring down the swelling while also helping with pain management until things become a little easier.

If you have tried all the above tips and you don’t begin to feel better after 24 hours contact your GP as they may offer an appropriate course of antibiotics.

5. Vasospasm

Nipple vasospasm is a constriction of the blood vessels with resultant colour changes to the face of the nipple, the constriction can cause shooting pain or cramping in the nipple. Treatment of vasospasm generally depends on the cause of the vasoconstriction, but some options are:

• Try to optimise baby’s latch to reduce the compression on the nipple.
• Use a warm compress on the affected area to soothe some of the discomfort, you can also try compressing the nipple towards the chest wall as this can do wonders to relieve the immediate discomfort.
• For some women, the use of high dose calcium and magnesium mineral supplementation could be helpful where appropriate.

As with lots of ‘new-baby’ experiences, breastfeeding isn’t always easy and there are often some bumps in the road, if you’re worried about any of these issues be sure to contact your GP or qualified Lactation Consultant for more advice and information.

• Top Priory psychiatrist talks about coping with financial stress, emotional stress and the stress of uncertainty during a pandemic
• Sets out the steps to take to cope with stress
• Explains the ‘catch it, check it and change it’ way of dealing with stress
• Explains the difference between anxiety and stress

The stress of the pandemic has affected everyone, and many have struggled.

Stress at work has been difficult to separate from stress at home; stress about jobs, job losses and finances have become intermingled with stress about physical and mental health, and fear about what the future might look like. Social isolation and anxiety have also taken a huge toll: enquiries to Priory’s private healthcare services about depression were 42% higher in January 2021 than in January 2020, with a 21% increase in enquiries about anxiety disorders over the same period.

Dr Ian Nnatu, a consultant psychiatrist at Priory’s North London Hospital and its Wellbeing Centre in Harley Street, says rising stress levels have been an emerging consequence of the pandemic: “I have seen a significant increase in patients with anxiety and stress over the last year, and I sense the pandemic, lockdown, and uncertainty about the future have all played a part.”

So how can people best handle stress, especially amid fears of a third wave of the pandemic? Here, Dr Nnatu answers six common questions people have about stress:

What is the difference between stress and anxiety?

“Stress occurs when the demands placed on us exceed our ability to cope. Stress is very common, leading to cognitive, emotional, behavioural, and physical symptoms. Cognitive symptoms include feeling overwhelmed, inadequate and unable to cope. People can have poor concentration and memory. Emotional symptoms can include feelings of anxiety, worry, apprehension, low mood, irritability, feeling overwhelmed. Some behavioural responses to stress include becoming more withdrawn from others, avoidance of tasks and people, procrastination. Stress can leave people feeling physically unwell, prone to colds and infections, having aches and pains, headaches, feeling physically exhausted.”

What’s the best way to handle financial stress, or stress around job loss?

“We know that poor mental health can make it harder to manage your finances or might lead to you taking time off to manage your mental health. The first thing to do is stay calm. Adopt a calm and positive mindset and do not beat yourself up. Talk to someone; it does not have to be an Independent Financial Adviser, a close friend could suffice.

“Adopt a pragmatic stance and ask yourself if you can meet the expense. If you are unable to, could you consider a payment plan? The key thing is to do something about this. Get a strategy to pay this off and stick to it. Avoid the temptation to bury your head in the sand and put this off, as this often compounds the problem. Track your progress on a regular basis and make adjustments, as necessary. I would suggest forward planning to guard against this happening in future.

“With a job loss, this can be rude shock to the system especially when you have not seen this coming. Be compassionate to yourself and avoid self-blame. Reflecting on what happened is a sensible thing to do, but avoid dwelling on this. Take what you can from this exercise and move on. Focus on the future and avoid dwelling on things that are not within your control. Look after your mental health and self-care. Regular exercise helps to build resilience and boost our immunity. Develop other interests and try not to be defined by your job. Stay connected with positive people.”

During the pandemic, uncertainty about the future is a common source of stress. What’s the best way to deal with this?

“Keep calm and try to stay in the present moment. Mindfulness and breathing exercises can help with this. Keep a routine and structure. Exercise, to boost mood, can be a useful source of distraction. Restrict your news consumption and try not to ‘Google’ your symptoms. Seek professional help instead. Notice your ‘faulty’ thinking styles; cognitive behavioural therapy can help to identify and change faulty thinking styles.”

If you have a higher intolerance for uncertainty, making you prone to negative feelings, and anxiety, what strategies can you put in place?

“The first step is ‘noticing’ and being aware of this problem and then you can take steps to try and address this. Learn to accept the things you cannot change. If you cannot change your circumstances, then change your attitudes towards these. There are several things that you can do on your own to help with low mood and anxiety. Exercise can often be a quick and effective way of boosting mood and reducing anxiety. Thirty minutes of brisk walking every day is sufficient especially if you can do this when the sun is out.

“Make sure you have a healthy diet with wholesome foods; the link between nutrition and our mental health is very powerful. Ensure good sleep and stay connected with close friends and family. Drink alcohol only in moderation and avoid smoking. Seek professional help if your symptoms do not improve.”

No one can avoid the unexpected, but are there simple steps that can help you face life’s uncertainties?

“Try to stay in the present moment and avoid the temptation to dwell excessively on past events, or to try and predict the future. Breathing exercises, mindfulness and meditation can help with this. Focus on things that are within your immediate control. Keeping a routine and structure can help to boost your wellbeing. Accept that the future is uncertain and allow yourself to feel confident that you can cope with whatever comes up or know how to get help. Notice when you are becoming preoccupied with negative thinking and on a downward spiral. Use simple techniques to reframe your thinking by recognising these negative thoughts, challenging them and then replacing them with more adaptive thoughts. Some refer to this as ‘catch it, check it and change it’. Avoid social media feeds that can cause you to feel destabilised. Stay connected to friends and family. Try and find something pleasurable to do; giving, volunteering, and helping others is a great way of boosting your mood and sense of wellbeing.

How do you stop ruminating on negative events or making stress your ‘default’ emotional state?

“Distraction can be useful to help break the cycle of ruminative thinking. Calling a friend or going for a walk helps. Reading a book or listening to music can also be effective. Try to identify what you are worrying about, and ask yourself if you can do anything to solve this. If you can, then use a problem-solving approach instead to try and address the problem. Use brain storming techniques to help come up with a strategy and work on problem solving. Use mindfulness to help you stay in the present moment. Find a comfortable spot in a quiet space and focus on your breathing. Identify your negative thinking styles and try and reframe these.”

About Priory Group

The Priory Group is the leading provider of behavioural care in the UK, caring for around 30,000 people a year for conditions including depression, anxiety, drugs and alcohol addiction, eating disorders and self-harming. The Group is organised into four divisions – healthcare, education and children’s services, adult care and the Middle East

Our lips require TLC all year round to keep them looking good and feeling healthy. From using SPF protection (minimum SPF30) in the summer or lip balm and cold sore remedies in the winter. Dry, cracked lips and cold sores can really knock peoples’ confidence, especially ahead of major events such as holidays, first dates or job interviews! Cold sores in particular have a stigma associated with them – they are considered unsightly and can often cause feelings of shame and embarrassment. In this day and age social media can make this even more difficult especially for young people who may be even more self-conscious when taking ‘selfies’ to post on social medial. It’s so important that we educate young people and help to de-stigmatise the condition so that they may seek help when needed.

Coming into the cold weather now, some people will find that their lips (and skin!) are particularly affected, especially when going from heated houses to the cold air outside. It can cause lips to feel dry and chapped, thus creating the perfect conditions for the cold sore virus.

Cold sores (herpes labiallis) are a common viral infection caused by herpes simplex virus type 1 (HSV-1) and less commonly herpes simplex virus type 2(HSV-2). Usually the first attack occurs during childhood and symptoms can include painful blisters on the lips, mouth or nose; mouth and throat pain; swelling in the neck and fever or body aches. You might not actually have any cold sores at that time. The herpes virus then becomes dormant within the nerve cells of the body and can re-activate at a later date to cause a cold sore. Most of the population will have been infected with HSV-1 (up to 90%) but only 10% of people will develop cold sores from the virus.

When they come back, symptoms tend to last around 12-14 days or less. Some people can tell when their cold sores are going to come back. They feel pain, burning, tingling or itching on their lips about a day before the blisters form. Small fluid filled blisters will appear on the lips or anywhere on the face. They will eventually burst and crust over into a scab. They should start to heal within 12-14 days but it’s important to be aware that they are contagious and may be irritating or painful while they heal.

While everyone is different some people find that certain things trigger a cold sore, such as illness, stress, tiredness, pregnancy, strong sunlight (even sunburn) or menstrual periods (perhaps suggesting there is a hormonal component to reactivation). It’s important to look after yourself, rest and try and avoid triggers if at all possible. If you are feeling stressed try and reduce it through exercise or using relaxation techniques (mindfulness, yoga etc.) Keep your immune system topped up by eating a healthy diet and getting enough sleep. Avoid dangerous sun exposure and protect your skin and lips by using an SPF 30+ minimum.

If you wish to use lip balms or lipstick when you have an active lesion, use your fingers to apply them rather than the tube and make sure you don’t share them with anyone else. Wash your hands thoroughly afterwards and try not to touch the cold sore as much as possible! Make applying lipstick or gloss easy by using HERPOtherm®! HERPOtherm® uses concentrated heat therapy to treat cold sores and can also stop cold sores developing if applied early enough!

The best time to treat a cold sore is before it happens so using a treatment such as HERPOtherm® as soon as you feel the tingling sensation can be helpful and may stop cold sores occurring. Thankfully, due to advances in heat technology, the pocket-sized medical device HERPOtherm® can give you the confidence to combat cold sores in a discreet and effective way. The HERPOtherm® device can be used to apply a brief, concentrated temperature of about 51°C to the affected area of skin, which can reduce symptoms such as tingling, pain, swelling, itching and tightness. It is chemical-free and suitable for those who are pregnant or have allergies so they can use the product without worry. It is recommended that you leave at least 2 minutes between each application of HERPOtherm®, but do not exceed the maximum of 5 applications on the same skin area within one hour, HERPOtherm® should also not be used on open blisters!

Herpes virus spreads easily from person to person – you can pick it up from sharing a fork or kissing someone, or any other form of close contact. It’s important also to remember that when you have a cold sore it is possible to spread herpes to others from the moment you first feel tingling to when the cold sore has completely healed. Understandably, many mums worry about newborn babies being around cold sores. Kissing a baby while you have a cold sore can lead to neonatal herpes, which is very dangerous to newborn babies.

With the current global pandemic and mask usage, this will be an extra burden for people suffering with cold sores. They will need to ensure they don’t pass the virus from the mask to others; therefore, it is very important to wash re-usable masks regularly and make sure you don’t use disposable ones more than once. The masks may also make the symptoms of the cold-sore worse potentially exacerbating the tingling and pain or causing the blister to bleed.

What can you do to help?

• Eat cool, soft foods such as yoghurt or ice cream
• Wash your hands with soap and water regularly and especially after contact with your lips
• If possible, try and avoid anything that triggers your cold sores (may not be possible)
• You can use paracetamol or ibuprofen to ease the pain associated with cold sores
• Drink plenty of fluids to avoid dehydration
• Your local pharmacy should be able to help with treatment options and you should only need to see your GP if you have any other worrying symptoms (such as fever, malaise)

With many parents juggling WFH, childcare and home schooling, it’s fair to say that the lockdown had been intense at times for families with babies and young children! However, it’s also been a time to reconnect with our family, be more creative about play and learning and enjoy simple forms of exercise together such as family walks and bike rides, where possible.

With educational and childcare settings such as nurseries and primary schools due to open their doors again, parents may well be sighing a breath of relief and looking forward to getting some much-needed structure back to their lives. Parents will also have concerns about how children will settle back into their old routines, and naturally, about the effect socialising with others might have on their health. While coronavirus will be top of the list of worries, this new Back to School time will also see a resurgence of other common conditions and infectious diseases such as colds, tummy bugs and chickenpox.

Here GP and mum to two toddlers and a newborn ,Dr Laura Lenihan @drlauragp gives you her top tips on how to keep your kids as healthy and happy as possible when they do return to nursery or school:

1. Hands up for hygiene: continuing to hammer home the hand washing message to your child will be vital! Schools can be a common breeding ground for germs and bugs and washing your hands is one of the easiest ways to protect against illnesses such as food poisoning and flu. Make it fun by getting them to sing “Happy Birthday” twice (around 20 seconds) whilst rubbing their hands under running water with a mild soap. It’s instinctive for young children to be curious about touch, but try to explain gently without scaring them, that they need to try not to touch their own or their classmates faces – and to wash their hands regularly throughout the day and when they get home.
2. School fuel: making sure your child eats balanced, healthy meals and snacks will help keep their immunity in check. The occasional treat is fine, but try to keep sugary snacks or processed foods to a minimum. Experiment with brightly coloured snacks such as slices of peppers, oranges, avocadoes, strawberries, blueberries, carrots and apples.  Kids love the colours and fruit and veg is a great source of vitamins A & C. Protein also plays a role in the immune system, so try to incorporate sources such as chicken, fish, eggs, beans and chickpeas. Also, when school’s reopen, pack a water bottle for your child so they can sip it throughout the day and stay hydrated.
3. Sleep on it: for many families, the lockdown has played havoc with sleep routines.  Don’t be hard on yourself if bedtime rules have gone out of the window recently, but do try to get your kids back into a good routine so they’re well rested and ready for the day ahead. There’s no hard and fast rules but as a general guide, toddlers need around 12 hours of sleep a night; children aged three to six – 10-12 hour. ; Sticking to some bedtime rituals can really help: try following some simple “wind down” techniques before bed each night e.g. a warm bath and then story time with their favourite story or poem.
4. Spot on: there’s no doubt that there will be a rise in infectious diseases such as chickenpox when school’s return. Chickenpox is a common, but extremely contagious airborne virus which spreads through the air by coughing or sneezing or by touching an infected person. Chickenpox should be easy to “spot”! Look out for small, roundish red patches which develop into blisters. The rash usually starts from the torso and spreads. The risk of infection lasts until all the blisters have scabbed over. In addition to the obvious blisters, typical symptoms are fever, headache and pain in the limbs and very severe itching. Thankfully chickenpox is easy to treat. Try PoxClin CoolMousse – it promotes the skin’s natural healing process and reduces the risk of skin infection and scarring. If you child does have chickenpox, you’ll probably be advised to keep them off school or nursery. Usually it takes seven to 10 days until all of the blisters have crusted over and they’re no longer contagious. So, you might be back to square one again with ‘quarantine’, but you’re a pro now –  you’ve got this!
5. Ask for help if you need it: it’s natural for parents of young children to feel anxious about their child’s health during these difficult times. We’re all adapting to a new normal. While social distancing is changing the way that we “see” patients, don’t forget that healthcare professionals are still there for you. If you have any concerns at all about your child’s health, check with a pharmacist or book an online or ‘phone appointment with your GP

Two addiction experts share how social media and ‘influencers’ can make the festive period challenging for those with alcohol addiction – and anyone trying to go ‘no or low alcohol’ – and what to do about it.

At Christmas and New Year, a surge in the number of alcohol-related endorsements on social media is difficult to avoid. Although advertising regulations are clear; “Marketing communications must be socially responsible and contain nothing that is likely to lead people to adopt styles of drinking that are unwise”, the implicit messages are obvious: drinking freely is part and parcel of the festive season.

For those concerned about the ubiquitous presence of alcohol at work events, end-of-year awards, friendly gatherings, family reunions and on social media, Pamela Roberts, addictions programme manager at the Priory’s Hospital in Woking, says; “Constant exposure to advertisements, pictures or social media posts glamorising alcohol can be wearing, emotionally and physically, especially for those struggling with addiction, for whom it can require a concerted effort to keep in touch with the support networks that help them maintain their recovery.”

Many people will inevitably find themselves at events where alcohol cannot be avoided. Pamela says; “It is impossible to escape every advert, post or picture that involves alcohol during the festive season. This means that recovering addicts may need to invest more time in pursuing their recovery. This can be in the form of talking with peers, if feeling triggered, or attending support groups.”

To help with this, The Priory Hospital Woking’s Addiction Treatment Programme (ATP) offers its patients aftercare support sessions on Christmas Eve and New Year’s Eve to allow those recovering from addictions a time and place to talk about the tensions or temptations experienced at this time of year.

Whilst not underestimating how hard it is, Pamela emphasises that abstinence from alcohol during the Christmas period should not always be thought of as a negative or an ‘impossible dream’. Instead, she suggests continually reminding yourself of the positive impact of abstaining, such as how it reduces harm to yourself and others in the long-term.

“For an alcoholic in recovery, abstinence is essential, and the risks of relapse are ever present. When committed to a ’recovery lifestyle’, increased exposure to temptation, say from engagement with social media, can be extremely tough and can feel very negative. But, social media can also be a positive, helpful, and convenient way of keeping in contact with peers who are in a similar situation, especially during days spent with family or if you’re away from home.

“There is a growing sobriety movement, on platforms such as Instagram, that can be encouraging and engaging. By following the ‘right’ people, you will quickly realise you are not alone and that many others are facing the same struggles as you. In fact, others will have overcome those struggles and learned to love Christmas again, maybe exploring the extensive range of so-called ‘no and low’ drinks that are now a popular feature on the party scene.”

She adds; “Increasingly, my patients are becoming part of online community groups where they can access instant responses, advice and support if they experience cravings or temptation. Thanks to the immediacy of social media, a ‘recovery’ friend can help you talk things through together, whenever or wherever you need it.”

Jeff van Reenen, addiction treatment programme manager at the Priory’s Hospital in Chelmsford, agrees that Christmas can make it much harder for recovering alcoholics to stay on track.

“Prolific marketing and promotions which glamorise and normalise copious drinking, as well as the price cutting of products, are huge triggers – especially for those in early recovery from alcoholism. I’m also concerned by the images and ‘perfect’ lifestyles portrayed on social media. It is often impossible to overlook these posts if one is using digital technologies – and especially if using social media prolifically.

“At the Priory’s Hospital in Chelmsford we incorporate a complete digital detox programme into our programme of recovery in order to allow our patients ‘time out’ from the all-consuming nature of social and online media – especially if they have tendencies to be addicted to this, or cross addicted, that is, replacing the one addiction, alcohol. with another, such as social media.”

To help those struggling to avoid alcohol during the festive season, Priory suggests practical tips:

• Recognise your triggers
  Whether your triggers are stress, frustration, fear, anxiety, depression or ‘environmental’ triggers like people and places, stay mindful. Ensure that you prioritise your self-care.
• Use your support network
  If you are an addict, your family, friends and fellowship peers all want you to get through this holiday season without alcohol, so let them help you. When attending events, take a buddy who will help you stay away from alcohol. Make a list of people you can call, including your ‘sponsor’; keep your list with you at all times, and call at least one person a day.
• Be realistic
  It’s important to have a realistic attitude about the potential for anxiety or conflict during the holiday season. The tension between the reality of situations and our idealised images of holiday harmony can lead to anxiety – so be realistic about how the season could increase your anxiety and stress and how you’re going to access support, should you need it.
• Don’t follow the crowd – ‘follow’ wisely
  If you find you’re following friends or influencers who taunt you with temptation, then simply, unfollow. Explore other accounts and threads which will encourage and inspire you and reaffirm the many positives of living without alcohol – not just for Christmas but for life. Be #sobercurious
• Live one day at a time and learn to embrace your sobriety
  Stay in the moment and live one day at a time. Don’t worry about what’s happened in the past or what could happen on your journey of recovery. Enjoy today. Live for today. Celebrate your sobriety.

For working parents, juggling the school run, office schedule and book bags can be a struggle – and that’s before you throw an unexpected sick day into the mix!  Emergency childcare can be difficult to find. So much so that, according to a recent survey conducted by PoxClin CoolMousse, 78% of parents admit they have sent their children to school or nursery knowing that they might be unwell.

Some childhood illnesses, such as chicken pox, can cause particular problems for parents. The NHS recommends keeping a child off school or nursery for around five days as they only stop being contagious once all their spots have crusted over. With so many parents of young children now in full or part time employment, working out who takes the lead on childcare can also a dilemma for parents juggling work priorities. Taking time off work for parents or costly outsourced childcare isn’t always an option. In fact, almost half of parents (43%) saying they have to rely on friends and family for support if their child needs to take a “sick day”.

Given the pressures on working parents, using emergency childcare is becoming increasingly common. Parents in London are more likely to use this an option, with 44% of parents relying on agencies when their children are sick at home. Contrastingly, 60% of parents in the North East would rely on friends and family in this scenario.

Being a parent can be challenging when your child is fit and well, let alone when they’re sick! If you’re a parent or carer struggling to entertain a sick child, check out our top tips for looking after a poorly little one…

1. Chicken pox is highly contagious, so your little ones won’t be able to play with other children and might be stuck inside causing “cabin fever”. Get them to call, or even better, Facetime someone familiar like a grandparent for a chat so they don’t feel too cooped-up.
2. Use the time away from school to practice doing some reading with your little one, if they’re well enough. Or you could always read to them and make it a more interactive experience by coming up with funny voices or acting out the stories to get your child involved.
3. Don’t feel guilty about allowing more screen time when the kids are sick, they might not be in the mood for lots of activity, so let them snuggle up and rest. There are also plenty of educational programmes out there that they can get involved with, though sometimes it’s okay to just let them watch one of their favourite shows to cheer them up. If you’re concerned about too much time watching a screen you could always try downloading some podcasts or audiobooks for your little one to listen to instead.
4. Seeing as you’re stuck inside, why not simulate being outdoors by having an indoor picnic! Lay out a picnic rug and have lunch on the floor – everything tastes better at a picnic. Make sure you include some healthy snacks to keep your little one hydrated and boost their immune system and get them to help with preparing the food to keep them distracted.
5. Make sure you open some windows and get some fresh air into the house; this will ensure your little one stays cool and might help relieve some of the itching as being too warm might irritate their rash.