We asked Dr Simrat Marwah all about her work as a Private General Practitioner in Chelsea.
- Why did you decide to become a Doctor, and what aspects of your job particularly interest you?
It started when I was four years old; I used to follow my father around the house with my toy stethoscope and doctors bag. I wanted to be 'just like him' when I grew up! I did work experience with everyone from accountants to journalists, but only medicine appealed to me. During my training I did eight months working in the trauma and orthopaedics department and became particularly interesting in musculoskeletal medicine. I didn't expect to take such an interest in this side of medicine, but the exposure inspired me to write several publications on musculoskeletal topics. I am also extremely passionate about women's health - I have seen too many women struggle uncesessarily with heavy, painful or irregular bleeding. A number of women with early symptoms of menopause put off seeing a doctor, or don't receive optimal treatment. It can be the fault of both the patient, or the doctor if the patient isn't fully investigated for some reason. These symptoms can be easily controlled if managed properly, which is a great feeling for both the patient and practitioner. The best part of being a General Practitioner is knowing that everyday I can make someone else's day better.
- Is prevention really better than cure?
I don't think either is per se. If we can prevent then that's the aim, but very often those who appear to take all the right measures end up falling ill too, so in those cases I'd go with cure.
- What do low energy levels mean?
If you are coming down with something or recovering from an illness you will naturally feel low in energy. If this feeling persists for 1 - 2 weeks after you start recovering speak to a Doctor. Adjusting your eating habits and taking regular exercise can have a significant effect on energy levels - even a small change such as a 30 minute walk every day will make a difference. If you are feeling tired for no apparent reason make sure you seek medical advice; Low energy levels might be due to a vast number of medical conditions. A medical case history will be taken by your GP to screen for low mood due to depression etc and then routine bloods will be taken to identify other conditions or vitamin deficiencies.
- What is the real deal with fasting?
Fasting is totally safe. Many people fast for dietary and religious reasons and come to no known physical harm. Fasting is not necessarily the best way to detox or lose weight - this very much depends upon individual body types. Moderation, moderation, moderation. Don't cut foods out without good reason. We all do it, myself included, because society has shaped what we should and shouldn't be eating. There are certainly 'trendy foods' and 'fad foods'. The best advice is to eat everything in moderation and if you want personalised guidance seek medical advice from a well trained nutritionist.
- What birth control options are available, and is there a way to avoid taking hormones?
There are many types of contraceptive pill available on the UK market. Some have two hormones (oestrogen and progesterone), and some have one (progesterone only). All have different levels of these hormones in them, but your GP will be able to advise which is most appropriate for you based on your medical and family history. Contraception is also available in other forms such as implants, coils and vaginal rings. If you want to avoid taking any hormones completely then I would advise a barrier method. Condoms are always a viable option, and will reduce the risk of infection. Some people with very regular menstrual cycles won't use birth control or condoms at all. This does not assure you won't get pregnant as hormone cycles vary so much, but some people will use cycle dates as a means of 'natural birth control precautions'.
- What are the common problems people are embarrassed to talk about?
Patients are often embarrassed to talk about disorders or abnormalities of the female and male reproductive system. For example, vaginal discharge, vaginal structural abnormalities, problems getting and maintaining an erection or sexual drive. We see this all the time, so please don't ever feel embarrassed to talk to your GP about any concerns you have.
- How does stress really affect the body?
Stress affects the body from head to toe in a number of ways, inside out. It can affect the way your bowels move, and the way your skin and hair look. Stress affects every part of the body and causes a multitude of physical symptoms including headaches, muscle pains, visual blurring, palpitations, shortness of breath and chest pain. The best way to reduce stress is to learn how you can manage your own stress as an individual. It is important to see your medical practitioner early if you have any of the symptoms I have mentioned because a number of them might also be due to underlying medical conditions. It is my job as a Doctor to screen for these conditions by taking a medical history and doing some preliminary investigations. Blood tests may also be carried out to rule out problems such as anaemia, vitamin D deficiency or thyroid problems.
- The best and worst health trends in your opinion are...
The best are Cognitive-Behavioural Therapy (CBT), mindfulness and any form of exercise including the gym, swimming, or walking more regularly. The worst are 'fad' diets!
Dr Marwah works from Chelsea Pharmacy Medical Clinic on Wednesday's and Saturdays 4 - 8pm (other availability upon request).