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Long Covid



What is it?


Much like Chick V, the virus which causes COVID 19, SARS -CoV-2- can leave longer lasting symptoms in about 10% of people. We say these “post acute” Covid symptoms are symptoms going on longer than three weeks after the start of symptoms. The symptoms can last for months, up to 12 weeks. (Then known as “Chronic Covid” ) People suffering with Long Covid are not necessarily still infectious.


Common symptoms include Fatigue, breathlessness, cough, low grade fever, muscle pain and headaches as well as depression. These can come and go.


We are not entirely sure what causes the prolonged symptoms but it is likely to be multifactorial. Long lasting symptoms after an infection are not unique to COVID 19.. ,Many viruses can cause chronic fatigue, for example and many can cause a post infectious  Immune or inflammatory response which can affect many organs including the lungs, brain, muscles/joints or nerves. There is also likely to be  a Psychological component also.


What should you do if you have ongoing symptoms? 


See your doctor for an examination and if appropriate some baseline Investigations to rule out secondary causes for your symptoms/complications of COVID 19. For example your doctor may need to rule out: Anaemia, secondary pneumonia/chest infections requiring antibiotics.; inflammation of the heart or also even heart failure in severe cases. If you were hospitalized and are breathless they may also want to rule out a clot in the lung for example.


Once these have been excluded, rest, limitation of caffeine, monitoring of oxygen levels where appropriate, and possibly graded exercise therapy, and psychological support can help people feel better.


For fatigue, once your doctor has said it is ok, then 4-6 weeks of self paced light exercise such as walking can help.


When is it generally safe to return to exercise?


If you were reasonably active before COVID 19, then after mild illness – try one one week of stretching before attempting light cardiovascular exercise such as walking. Increase your rest periods if you get tired in between.


If anyone has been hospitalized, or required oxygen they should see their one doctor for an individualized assessment.


Patients who had heart  involvement need a cardiac assessment with Blood pressure, pulse, ECG pulse oximetry and review with doctor before resuming exercise.


If you are allowed to exercise, then usually light graded exercises, over 4-6 weeks helps people to recover from the fatigue, brain fog and depression that can follow COVID 19.


Psychological Support can help especially if you are suffering with depression, the death of a loved one or the loss of a job or income.


Peer-peer support groups have been known to be helpful. Perhaps consider starting one on Facebook?


Fever usually responds to paracetamol, although as I mentioned above see doctor to r/o secondary infection.

The good news is that if you are kind to yourself, and allow rest and positive thoughts, most people recover slowly with the above measures…hopefully by 12 weeks or so!

Here are some helpful links:

How to conserve your energy – RCOT

Long Covid Support Group | Facebook






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Minor Surgery Available at Ames Medical Services


Did you know that we do minor surgery?  


If you have a lump or bump that you want removed, we can do a minor procedure under local anaesthetic, right here in our new treatment room. 


We also remove ingrown toenailsabscesses and do cyst and comedone extractions too! 


Have a pesky wart or verruca or skin tag that won’t go? We can freeze it off with Liquid Nitrogen, in a procedure called Cryosurgery that involves no cutting! If you are interested, you can watch a video of it being done by Dr Ames here:

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When is a Duck not a Duck? The Pitfalls of COVID-19 Testing

So, you had a cough and cold and you were worried about COVID….but you went and got a rapid test and its negative so all is good right? Wrong! 

No test is perfect and this is to help you understand some pitfalls of Covid testing.  

Let’s start with the rapid “blood” test. This is looking for antibodies to the virus, and not directly for the virus itself.  

When we get the virus for the first time, it may take a while for our immune system to mount a response and produce antibodies.  

If the test is done too soon, for example before symptoms start, or even in the first 2 weeks after getting it when you may even have symptoms, it may read negative when you are in facet positive, a so called “False negative”! Then you might be falsely reassured and unwittingly go round infecting others.  


So, an antibody test MAY be useful after your symptoms have passed, and if you never managed to get the proper “throat swab” PCR test and you are wondering if in fact it was COVID you had! 


What if you wait, do the antibody test more than two weeks after your symptoms started and you have antibodies Does that mean you are now “immune” to COVID? 


Er, we are still not so sure. It seems that antibody levels wane after 3 months or so, so we are not sure how long that immunity may last…. this is also complicated by the fact that there are different strains of COVID and it may be that the virus mutates very so often, just like the Flu, so your immunity may be short lived! 


On top of this, some people can fight of the virus with a different part of the immune system that doesn’t use antibodies. So you might actually have fought off the virus successfullyand may even have immunity that we can’t measure on the test, but then have no antibodies.  


Confusing right?  


What about the “swab” or fancy RT-PCR  test? 


The swab tests for actual virus particles in the nose/throat.  It is not 100% either!  No test is I am afraid.  The swab is most accurate if done days 3-5 of symptoms.  If done in asymptomatic people right after exposure, it may be too early to get a positive result. Similarly, if taken very late in the illness like day 10, the chance of picking up the virus starts to fall.  


It is very specific and moderately sensitive. So, what does that mean? Well, it means that if you get a positive result it is likely to be a true positive, but a negative result is less reliable. So, we tend to believe the positive results, but if a person has a negative test, that doesn’t automatically mean they are truly negative and that they don’t have COVID 19 and are not infectious. 


That’s why in very suspicious cases you will see us asking for 2 negative tests. ..That’s because if it looks like a duck, and quacks like a duck and flies like a duck it is probably a duck…especially if it comes from an area where there is known to be a flock of ducks living. (Like say, you shot it in the middle of a swamp) So, if someone plucks a feather from that duck and analyses it and tells you it is not a duck then would you believe them?   


Similarly, if a person has been exposed to someone with COVID 19, and they then develop the classic fever cough, anosmia etc, OR we know that we are in the middle of a Pandemic or local spike and someone gets a cough and cold, we have a high suspicion of COVID and just one negative test is not going to reassure us.  


To complicate things, we will shortly be going into the “Flu Season” and it’s hard to tell the difference clinically between the Influenza virus and COVID 19! But that’s for a whole other discussion.  


In short, please don’t just take yourself off for a test without consulting a health professional who is up to date with testing and timing and symptoms. The test may not mean what you think it does, and you may even need a completely different test! 





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Finally Some Good News: A COVID -19 Update TT


Good News! We can isolate at home if we have COVID -19! No need to go into hospital if we are well enough to stay home. 

I know this is a huge relief to all of you right? Everyone wants to be in their own bed if they are feeling under the weather!

So what do you do if you think you have COVID 19?


First of all don’t panic! The main symptoms are:


  • Fever more than 38


  • Dry cough


  • Runny nose


  • Sore throat




  • Body aches


  • Diarrhea


Sneezing is not normally a major feature but can be present.


If you have any of these


1.Do not go out


2.Isolate yourself from your family and household (see our Instagram page for a leaflet on how to do this


3.Seek Medical advice via Telehealth, or a hotline rather than coming in, so you do not infected others. If you are extremely unwell with shortness of breath, for example, and you believe you need emergency help then proceed directly to your nearest public health facility. You can call me to find out where to go if you are unsure.

If I think you need testing I can either refer you privately for accredited PCR testing or send you to be tested via the Public health.

I can also arrange a sick note or quarantine note.

If you are well enough to stay home, you can stay home with Pandol, Fluids etc. People with underlying illnesses like Diabetes, Lung, Heart or Kidney disease should have individualized advice

You will need to stay at home from 14 days from the start of your symptoms.

4.Make a list of all those you have had CLOSE contact with. A CLOSE contact is defined as less than 6ft for 10 minutes or more. It is not someone you passed casually in the corridor at work.


What to do if you have been exposed to someone with known or suspected COVID 19:  Remember exposure is defined as less than 6ft for 10 minutes or more, as above…


  1. Don’t panic
  2. Stay home and quarantine for 14 days unless you are told otherwise by a qualified doctor. Monitor for any of the above symptoms. Seek medical advice if they develop.
  3. Seek medical advice as to whether you need to be tested.


Any questions or suggestions for further leaflets let me know!


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Sleep in the time of COVID: Part 1: Struggling to Sleep

My Prescription for Sleep during the lockdown:


It can be tempting to relax our regular sleep routine while in lockdown…especially since we are not going to work, or working from home. .But this lack of, or change in routine can sometimes exacerbate insomnia. Many of us barely know what day it is far less the time! We need to try to maintain our normal sleep rhythms.

Many of us are also not able to exercise as we usually would, and our body is missing those endorphins. This coupled with increased anxiety over this crazy situation we are in, can really affect our sleep…and lets face it, when we can’t sleep…we feel even more anxious and crazy! Think about it: The Japanese used to use sleep deprivation as a form of torture!



As much as possible try to stick to a regular bed time, and still set an alarm for waking up, as well as one for going to sleep


Resist the temptation to nap during the day

Exercise in the morning at home and not after 5pm. Exercising too late in the day can make some people feel “reved up”

Watch out for “workout ” drinks and supplements. Many of them contain Caffeine or taurine or “Green tea extract” or “Coffee bean extract” These all are basically stimulants and can keep you up at night!

Avoid Cigarettes especially before bed.  Nicotine is a stimulant.

Try to limit yourself to caffeinated beverages in the morning only, and certainly not after 3pm.

Avoid an alcohol night cap if you are struggling to sleep…alcohol can interrupt our normal sleep patterns

Dinner time is important. Try to eat at least 2-3 hours before bedtime. Going to be too full can increase heartburn which can wake you up at night with pain or a cough. Remember: Breakfast like a King, Lunch like a Prince, and Dinner like a Pauper.

What you eat is also important. Foods high in Tryptophans like Turkey and chicken can help promote good sleep.


Practice good sleep hygiene: Ideally the bedroom should be for sleep and sex only….but if you are forced to stay there because you are in isolation then keep a window open, and leave the curtains open during the day to let natural light in.


If you are in isolation Try to have a desk and comfortable lounge chair in the bedroom so you resist the temptation to spend all day in bed. 


At night, limit noise and increase darkness by using black out curtains or an eye mask and ear plugs if you need to.


DO NOT look at any screens like TV, Computer,  phone or tablet an hour before bed. The bright light breaks down our natural melatonin.


Have a wind down ritual: A warm shower, doing a crossword or planning what you are going to do/wear  the next day can help your brain understand it’s time for bed.


Sometimes medical conditions like depression, anxiety, pain, hot flushes and night sweats and restless leg syndrome can interfere with our ability to fall asleep. If you think you may be experiencing any of these, talk to your Doctor. Further updates will give more information on medical conditions which can affect your sleep.

Certain medications like Steroids and Diuretics are best taken in the morning to avoid interfering with sleep. Another common problem is Migraine tablets or “Multi symptom day tablets” – These sometimes contain caffeine. If they do, try to use these only during the day or use some without caffeine if this affects you. The common decongestant “Phenylephedrine” can also make children and some adults feel “hyper”



If you are still struggling try two Camomile tea bags in hot water and allow to draw for six minutes. You can add honey to this if you are not Diabetic. Camomile actually works on the same receptors int he brain as sleeping tablets!



You can also try 5mg of Melatonin, available over the counter, an hour before bed. This has been shown to be even more effective if you are over the age of 55.

Look out for my next update which will be on how to deal with waking up at night.

Night Night and Sleep Tight!

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Sexual Health and Importance of STD and STI Testing

Sexual health is often neglected. Usually people are very shy to discuss their sexual health and talk about STDs and STIs. There is a social stigma toward the subject. But since there are 340 million cases around the world the awareness needs to increase.

Sexually transmitted diseases (STDs) are transmitted through sexual intercourse between two people and are also known as sexually transmitted infections (STIs) or venereal diseases. More than 1 million infections are reported daily. There is a thin line between STDs and STIs. STI stands for sexually transmitted infection and may not develop into a disease. You can think of STI’s as the initial stage of an STD.

If left unchecked, STI and STD can have serious repercussions. For example, mother-to-child transmission of STIs can result in stillbirth, neonatal death, low-birth-weight and prematurity, sepsis, pneumonia, neonatal conjunctivitis, and congenital deformities.

If left unchecked, STI and STD can have serious repercussions. For example, mother-to-child transmission of STIs can result in stillbirth, neonatal death, low-birth-weight and premature birth, sepsis, pneumonia, neonatal conjunctivitis, and congenital deformities.

The various symptoms of STIs and STDs:

  • Rashes near the genital area
  • Warts and sores near anus, mouth and genitals
  • Swelling and redness, bleeding and painful urination.
  • Fever, sweating, chills and itchiness
  • Painful sex and discharge of fluids from the genitals

If any of the following symptoms are found in a person, then the said person needs to immediately contact a medical doctor. The doctor may suggest various tests and treatments. It is extremely necessary to cure STDs and STIs as they have a risk of transmission and dissemination to another person in case of any sexual activity.

Ways to control STDs are:

  • Providing necessary sexual health education and awareness
  • Using Condoms
  • Practice monogamy and restricting the number of sexual partners
  • Regular STD and STI checkups.

The major types of STDs and STD tests:

Chlamydia: Chlamydia is caused by Chlamydia Trachomatis. It only affects humans and is an extremely common cause of genital and eye diseases. But women often don’t show symptoms of these diseases. Painful intercourse, bleeding between periods, rectal infections and discharge of fluids are the most common symptoms of Chlamydia. A urine test or a swab of discharge from the cervix for culture or antigen testing which is called a Pap test is used to determine chlamydia.

Chancroid: Also, known as soft chancre and ulcus molle, is caused by bacteria called streptobacillushaemophilusducreyi. This causes sores in genitals and is very common among sex workers. As soon as a person is infected, they start developing bumps which turn into ulcers. It may bleed as well.  Diagnosis is usually done by identifying bacteria Hemophilus ducreyi in a culture from a genital ulcer. A Gram stain test might be misleading.

Genital herpes: Herpes is a recurring condition in human beings. They are of two types which are Type 1 and Type 2. Type 1 is acquired through straws, utensils and surfaces. The most common symptoms may include: 

  • Blisters or ulcers
  • Pain while urination
  • Fever, cold sores

PCR test and cell culture can be used to identify herpes. The PCR test identifies the existence of the virus’s DNA by examining fluids from the genitals.

Hepatitis B: Hepatitis B can be caused by unsafe sex, unsterilized syringes, drinking infected breast milk, getting pricked by sharp objects etc. It results in liver failure which can eventually lead to cancer. Though it can be prevented using vaccinations. A simple blood test, liver ultrasound or liver biopsy can identify Hepatitis B.

HIV/ AIDS: Human immuno deficiency syndrome intervenes with the immune system leaving the host to fall prey to infections and diseases. HIV is transmitted through:

  • Sexual intercourse
  • Blood to blood contact
  • Breast feeding
  • Needles and syringes

If you are looking for STD STI Testing center in Trinidad, the book an appointment with the medical professionals at Ames Medical Service.


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