A large number of issues
As I was unable to quote my old EHIC (20 digit) number, I was advised to visit their office with my passport, plus a paper utility bill. My Public Services Card was not acceptable.
I now have six 'unique' ID numbers supplied by the State, plus hospital patient, post code and ESB meter numbers.
Surely, within a huge 20 character ID it must be possible to incorporate all of the above (with space for War and Peace)? – Yours, etc,
READ MORE
LIAM PLUCK,
Co Wicklow.
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Irish Times
an hour ago
- Irish Times
Woman who suffered sustained bleeding after giving birth fails in High Court action
A woman suffering from bleeding and who collapsed at home 2½weeks after giving birth has failed in a High Court claim for damages against the Coombe hospital , Dublin, and the HSE . Virginia Gimenez Perez alleged, among other matters, that the hospital failed to properly diagnose and treat the cause of her bleeding after she gave birth to her second child in October 2019. She also alleged that the Midland Regional Hospital, Portlaoise, failed to make a timely diagnosis of what was causing her bleeding when she was brought there by ambulance in November having collapsed at home. She eventually received surgery to stop the bleeding in December. Ms Justice Emily Egan found in favour of the HSE and the hospital in a recently-published decision. READ MORE She found that the staff involved in the care of Ms Perez in both hospitals acted in ways that ordinary competent professionals might have acted and took decisions that were open to such professionals exercising reasonable care. Ms Perez complained that the Coombe failed to properly diagnose and treat her post-partum haemorrhage (PPH) caused by the incomplete delivery of the placenta, preventing her uterus from contracting and stemming bleeding from the uterine wall. The condition is known as retained products of conception (RPOC) and it was common cause that the PPH suffered by Ms Perez was due to RPOC. In the Coombe at the time of the birth, the placenta was checked by a nurse who noted that it 'appears complete'. 'It is common case that it is very difficult to out-rule the possibility that a small piece of placenta is missing,' the judge noted. 'It is not per se negligent to conclude that a placenta 'appears complete' even if this transpires not to be the case.' Ms Perez also criticised other aspects of her care while at the Coombe, including the hospital's response to her blood loss. However, the judge found the treatment given was 'effective and reasonable' given the scenario presenting. The care given after Ms Perez attended hospital in Portlaoise was also criticised by her and her expert witnesses, with consultant obstetrician Dr Robin Ashe saying the hospital should have performed surgery on her to remove the RPOC when she was brought there by ambulance on November 4th, 2019. However, Ms Justice Egan found that the more conservative management decided upon by the staff was 'within the band of reasonable management'. Consultant Dr Niamh Maher, who decided on the more conservative approach after having made a differential diagnosis, was 'emphatic' that surgery involved a risk of uterine perforation that could have been 'catastrophic' in circumstances where the patient had given birth only two weeks earlier. Surgery was eventually carried out on Ms Perez when she presented at the hospital on December 4th, 2019. By this time the risk of uterine perforation was reduced. The material removed, only part of which was RPOC, had moved from the uterus to the cervix with the aid of prescribed medicines and Ms Perez was 'somewhat unlucky' the procedure was required, the court was told. Ms Perez said she was weak, fatigued and introverted for some time after the surgery, did not return to normal for nearly two years, and was prescribed antidepressants. However, the judge found her 'adjustment disorder' was caused by the stress of having to undergo surgery under general anaesthetic, something that was 'virtually unavoidable'. 'Fortunately [Ms Perez] states that she is now doing really well; she has a good life and feels very happy,' the judge said, as she dismissed the case.
Irish Times
an hour ago
- Irish Times
What to do when you've had a poor night's sleep
Ah, sleep – 'nature's soft nurse' to Shakespeare, 'the foundation of our mental and physical health' to the less poetically minded neuroscientist and podcaster Andrew Huberman. By now, you hopefully know that getting a consistent seven to eight hours of shut-eye is crucial for everything from your short-term decision-making to your long-term health, and you're familiar with all the usual advice on getting it (have a consistent bedtime, make your bedroom really dark, no double espressos at 9pm). But one question that's considered less is -what if you have one restless night? How do you best get through the day – and what can you do to avoid a single interrupted slumber snowballing into several? Let's take it one hour at a time. READ MORE When you first drag yourself out of bed, it's tempting to click the kettle straight on – but should you hold off your first hot drink of the day until you're a bit less bleary-eyed? Increasingly, influencers advise delaying your first hit of tea or coffee for anywhere between 30 and 90 minutes after you wake up – the rationale being that caffeine mostly works by blocking the brain's receptors for a molecule called adenosine, which ordinarily promotes relaxation by slowing down neural activity. Adenosine levels are at their lowest when you wake up, and so in theory, you might be 'wasting' your first brew of the day by glugging it when there's nothing for the caffeine to block. This seems plausible, but it's also worth noting that caffeine's effects take about 10 minutes to kick in, and it's about 45 minutes before levels peak in the bloodstream. Caffeine's also not just good for getting you going: if you're planning a workout or a morning walk, it can help things along by producing feelgood endorphins and increasing the amount of fat you're able to burn. Some people suggest that waiting a while before your first cup helps to avoid afternoon drowsiness, but according to an evaluation of the scientific literature published last year: 'There is no evidence that caffeine ingestion upon waking is somehow responsible for an afternoon 'crash'.' 'Keep your caffeine intake limited to your usual amount – or one cup of coffee or tea if you don't normally rely on caffeine – and make sure it's before noon to avoid damaging your sleep the next night,' says longevity specialist Dr Brittany Busse. 'But drink a decent amount of water alongside your morning brew to make sure you're adequately hydrated.' Stick to the one-water-per-caffeinated drink rule throughout the day to keep your energy levels up – and if you happen to have any on hand, consider a scoop or two of the workout supplement creatine, which a 2024 study suggests is 'a suitable candidate for reducing the negative effects of sleep deprivation'. Most commonly used by bodybuilders, creatine works by 'buffering' the body's energy stores, and it now turns out that this process occurs in the brain as well as the muscles, which might help you focus after a fitful night. Your next job is to get out in the sun as soon as possible. Exposure to morning sunlight signals the brain to reduce melatonin production (the sleep hormone) and increase cortisol, making you feel more alert. 'When you see sunlight, either by walking outside or sitting next to a sunlit window for about 10 minutes, this helps to keep your body's sleep cycle online,' says Shawna Robins, author of, Powerful Sleep. 'It's like setting a sleep-wake timer inside your brain.' Sunlight also stimulates the production of serotonin, a neurotransmitter linked to mood, alertness and a sense of calm and focus. Some of these effects might be more noticeable if you go outside – window glass blocks some of the wavelengths of light that help to produce vitamin D, for instance – but research continues. In general, popping outside is probably a better bet, but if all you can do is see a bit of sun while you're doing the washing up, it's better than nothing. Do cold showers help to wake you up? It could depend on how you feel about them. A short, sharp blast of cold water can give you a boost of endorphins and adrenaline, and up your oxygen intake and levels of alertness. On the other hand, if it's already cold in your house or you can't stand cold water, the cure might be worse than the problem. If you're looking for the best of both worlds, consider a contrast shower, or alternating between hot and cold for intervals of 15-60 seconds – it's a lot more psychologically manageable to sluice yourself with chilly water when you know that relief is on the way. The toaster is probably your next temptation, but don't over-rely on carbs to energise you through the day. 'What you eat and drink can really influence recovery after a bad night's sleep,' says Dr Rostislav Ignatov, chief medical officer at The Haven Detox in Massachusetts, US. 'I recommend you focus on foods that provide steady energy and support your brain, like fruits or leafy greens. Lean proteins such as eggs, chicken or yoghurt help maintain your energy without the crashes you get from sugary snacks.' One five-minute option: scramble a couple of eggs in a pan, and pour half a boiled kettle over a colander of spinach to wilt it. Supplements can help too, but choose wisely. 'Magnesium is a great option if you're feeling tired or wired,' says Dr Ignatov. 'It promotes relaxation and can help improve the quality of your next sleep cycle. A small dose of vitamin B12 can also fight off fatigue and support energy production without overstimulating your system like caffeine might – the key is to keep your body's natural rhythms intact so you don't disrupt your sleep later at night.' If caffeine makes you jittery, there's some evidence that taking L-theanine, a supplement that commonly comes in capsule form, alongside it can mitigate its negative effects on your attention, and make you better at cognitively demanding tasks. Should you work out? If you're already running on fumes, this is probably not the best day to shoot for a personal best in the 5k, but there's a simpler option. 'When people are feeling very tired, I recommend 'exercise snacks' – short bursts of physical movement throughout the day,' says wellness expert Dr Megan Lyons. 'That could mean one to two minutes of activity, like standing up to do 20 jumping jacks, 20 bodyweight squats, or walking around the office for two minutes. Even better is getting outside.' If you're in the mood for something more sedate, something as simple as a short burst of yoga might help – one small study suggests that a guided sun salutation can reduce stress and get your parasympathetic nervous system (which favours relaxation) online for the rest of the day. Once you've made it to the office – or through the school run – try to avoid the lure of almond croissants and easy energy. 'What people tend to do after a bad night is turn to a lot of caffeine and sugar, because our brains crave quick energy when we feel low on it,' says Dr Lyons. 'While these things may work in the moment, they're setting you back in the long run – caffeine lets us borrow energy rather than create it. And sugar can set us on a blood sugar rollercoaster, which leads to crashes and cravings for more. 'Focus on stabilising blood sugar by getting adequate protein and fibre throughout the day – these nutrients don't provide that immediate burst of energy, but many of the things that provide them, such as vegetables and fruits, also provide phytonutrients that give us sustained energy. Protein also keeps us satisfied throughout the day, reducing cravings for sugary or processed foods.' If you're really struggling (and you've got the option) a power nap can be just what you need to get through the afternoon. Just don't make it too long. 'Limit naps to 15-30 minutes a day, ideally before 3pm,' says Dr Marissa Alert, a psychologist and sleep expert. 'Longer or late-afternoon naps could make it harder to fall asleep at night.' Set an alarm and use box breathing to get yourself in a good state for sleep – picture a square, and visualise yourself travelling along the sides of it as you take a deep breath in for a count of four, hold it for the same count, breathe out, and hold again. Alternatively, if setting up pillows on your desk isn't an option, just trying this without letting yourself nod off can leave you refocused and ready for any unfortunate last-minute meetings. Once you've made it through the work day, your next priority should be setting yourself up for a restful evening – though that doesn't necessarily mean going to bed extra-early. 'You should be looking to stick to your normal bedtime,' says Dr Alert. 'As tempting as it may be to crash early, it's best to tough it out – going to bed too early can leave you tossing and turning since your body isn't used to being asleep at that time. It's also important to remember that sleep can't be forced, so try to avoid worrying about whether you'll get enough rest, especially close to bedtime. Fixating on how well you'll sleep or how much you'll sleep right before bedtime can trigger physical arousal and heighten anxiety, making it even harder to fall asleep.' There is another way to think about it: when your brain thinks that something might be wrong, its priority shifts to protecting you. In this heightened state of alertness, sleep takes a back seat because your brain is focused on keeping you safe, not relaxing. That's why it's better to signal to your brain that it's time to relax, with a calming bedtime routine that puts your brain into rest mode. Don't start doom scrolling; reading fiction, even on an e-reader, is a great option – one study suggests that a 30-minute bout has similar stress-reducing effects to a half-hour yoga session. Doing it on the highest brightness setting for four hours might delay your sleep by a few minutes, but that's about it. When it's time for some shuteye, do a bit more box breathing, make your bedroom as dark as you can, and let yourself drift off. Tomorrow's another day. – Guardian
Irish Independent
2 hours ago
- Irish Independent
The Dublin area with a growing population of 11,335 … but little or no access to a GP
The third edition of the Health Assets and Needs Assessment (HANA) Project, from Trinity College Dublin, was presented at a recent meeting of South Dublin County Council. The findings highlight how healthcare has changed in Tallaght over the last 30 years, and in areas perceived to suffer more from 'deprivation', the symptoms associated with ageing are worse. Nowhere is this more evident than in Fettercairn, where a growing population of 11,335 (according to census 2022) complain that they have little or no access to a local GP. Elizabeth Ruane (76) moved to Fettercairn from Ballymun 44 years ago, and is a member of the senior women's club organised by the Tallaght Community Health Project. 'We've always had to travel for a GP. We used to have one years and years ago but now we have to go to Killinarden,' she said. 'I'd have to get the bus down to the end of the road, which takes about 25 to 30 minutes and walk for 20 minutes from there. 'We were promised a GP when Fettercairn got its first Community Centre – the people of this community raised money to build it. We were told there would be a GP upstairs, but it just never happened. 'When you're younger, you think it's okay and you can just get the bus. But when you're older, even something that seems simple can make your life so difficult.' Ms Ruane currently visits a GP service a few miles away from her home in Fettercairn. 'I've a new doctor now who's very helpful. I had a spot on my leg that was worrying me. He thought it might have been cancerous and fixed it; then referred me to Tallaght hospital for further care. That was in April, I've never heard back. ADVERTISEMENT 'I'm afraid to get sick, because I know I won't be able to see the doctor. I've figured out that when you get to a certain age, they're not interested. They let you stay at the end of the list because they don't care about us,' she added. Professor Catherine Darker, who authored the Trinity College study, has observed that chronic illnesses, including heart issues, diabetes and neurological diseases, are high among the people of Tallaght. 'We already have data to show that the way different diseases burden ageing groups, differs depending on the community you live in. The most rapidly growing age group in Tallaght is over-65,' Ms Darker said. 'Health is not equally distributed here, so you could have more affluent parts of the city where an age group is doing well globally, but the same groups in social and economically deprived areas will age differently. 'For people who are poor, the poverty automatically means that you have worse health,' she added. A spokesperson for the HSE said it has 39 GPs in the wider Dublin 24 area working from 20 different practices, including within the Fettercairn area. 'The HSE can confirm it does not limit the number of GPs who wish to take on a General Medical Services contract with the HSE in a specific location. 'GPs are self-employed and have the ability to set up a practice in any area they choose, depending on various factors.' Brookfield Health Centre in Jobstown is the clinic located closest to Fettercairn, but multiple calls to check on appointment availability last week went unanswered. Kay Hoban (74), another member of the women's group, says what's harder than the lack of access, is the time it takes to make it through a waiting list. 'It takes at least two weeks to hear back from the GP if you call them. They never answer – people over 60 have to walk to the GP's office to even make an appointment,' she said. 'I always wonder what would happen if you're really sick. At our age that's a real worry. 'If you go to the emergency [department], you're left waiting over 36 hours, and they wouldn't have my history anyway. If you don't have private insurance, you have no chance of finding help.' Independent councillor for Tallaght-Central, Mick Duff, wonders why a part of Dublin with a growing population is struggling to attract a GP. 'It's reprehensible in 2025 that we don't have a GP physically present in Fettercairn,' he said. 'I know there are services in the surrounding area like the Mary Mercer Health Centre and there are doctors and GPs in nearby Springfield. 'The people of Fettercairn deserve a GP in their own area and I don't know what it's going to take to attract a GP. It's quite an established estate, it has an older generation and now a very vibrant young generation. 'There's a great healthcare committee in the community centre, an addiction centre with a GP attending, but there isn't one for general medical issues. 'I hope the county council can support and encourage some young GPs to come in and open their services in the area. 'Fettercairn is not a million miles from Tallaght Hospital, but people should not be reliant on outpatient or emergency care. 'There are older people and people with disabilities who cannot get out of the area as easily as others,' he added. Mary Kelly (77), who has lived in Fettercairn for 45 years, remembers being a young mother in the area struggling for medical care. 'Not much has changed. Having no GPs nearby is a big problem. It was definitely worse when my children were younger,' she said. 'We've been fighting for a GP in Fettercairn for years, but nothing's changed. I have to go to Brookfield to get to mine. It's just 10 minutes for me by car, but not everyone has that luxury.' The HANA report has also found that older people in Tallaght struggle with loneliness. The Tallaght Community Health Project has worked with older people to support them through it. Project coordinator, Samantha Griffin, works closely with locals to encourage arts and crafts, field trips and theatre shows to help build a sense of community. 'For some of the people that engage in the women's club or our other initiatives, this might be the only time in the week that they even see other people,' she said. 'Covid made people feel more isolated than ever before. But initiatives like this can make a world of difference.' Mary Malone (75), who has lived in Fettercairn her entire life, has found the club to be the best way to stay in touch with friends. 'I knew a lot of these women before I joined, some of us are neighbours,' she said. 'I love doing the arts and crafts, you can talk and work away at the same time. It's a way of taking care of our health on our own.' Kay Hoban said having a sense of community has helped her take care of herself. 'I've been coming here for the last two years. I was recommended by a doctor to do exercises because of my arthritis. I heard about the Monday evening group and joined. I've now found a family,' she said. 'I've been a widow for 51 years. The club has helped older people in the area a lot. We're not seeing people during the week. 'If you don't come up here, I go days without seeing anyone. So for me, spending time with these women is a great outlet.'
