At the risk of being accused of having an obsession with weather, I have to comment on how our exceptionally good summer has made an impact on our practice.

As many readers may know, I am both a sailor and a cyclist; these activities may be very pleasurable or extremely unpleasant depending on local meteorological conditions. Both modes of transport, two wheels or one keel, are very dependent on wind speed and direction, as anyone who has ridden a bike in the teeth of a south westerly gale with sheets of driving rain will testify. 

It seems to me that consulting patterns and both the quantity and the content of our clinical interactions are affected by local weather conditions, and not just wind force and direction. For much of June and July we had a very stable high pressure system (the Azores High) which resulted in almost continuous sunshine, high temperatures, very little wind and extremely high pollen counts.

It was wonderful summer weather unless you have hay fever and, though I have yet to audit, anecdotally there were many presentations of allergic rhinitis and conjunctivitis, more than I can ever remember in previous years. Antihistamines, cromoglycate eye drops and nasal sprays were prescribed in a very uninhibited fashion. 

I saw adults with itchy eyes, watery eyes and runny noses, stuffed nostrils, ticklish coughs and puffy faces. There were children with sneezing, exacerbations of asthma, night-time snuffles and blepharitis. Whole families have presented with snorting, sniffling, loss of taste and smell, and in some cases fatigue. Some people are experienced hay fever sufferers, others are newcomers to the condition, surprised and in some cases annoyed that the symptoms were not due to viruses or bacteria. In each case we blamed and, yet nevertheless, applauded the fine weather.

A few days ago a patient with severe COPD presented with mild cough, a little sputum and very modest shortness of breath. She had not been seen for many months and, although she has an infective exacerbation, it is much milder than the norm. She and I reminisced about previous summers when she would have required prolonged antibiotics and oral steroids several times a summer. We assumed that her ability to get out in the fresh air this year and to take more exercise had improved her pulmonary function and increased her resistance to infection. It has been very noticeable that even our most severely affected patients with COPD have remained well this summer.

Presentations of childhood upper respiratory infections have also been much reduced this summer and, apart from a couple of cases of chickenpox and gastroenteritis, children have been neither seen nor heard in the practice. I have noticed that many families have availed of holiday destinations in Ireland this year… mobile homes in Wexford, apartments in Tramore and the seaside of north Co Dublin. Children and adults have been walking more, swimming more and generally reporting enjoyment on beaches and in parks around the country.

I am delighted to report that cases of sunburn have been absent (except for one woman who fell asleep) and the old scourge of multiple sunburned babies at the start of summer is now a thing of the past. Discussions about sunblock and factor 50 are now the norm.

This is in great contrast to the street drinkers and rough sleepers who, while having greater comfort and warmth during the summer months, display skins burned almost black by the prolonged hours of ultraviolet radiation. Their respiratory health is generally better over the past two months as they avoid the challenge of cold air and freezing outdoor sleeping. Many of my homeless patients confess to enjoying the outdoor life at present and much prefer it to the confinement and restriction of night shelters and hostels… long may the warm nights continue.

It seems evident to me that all of us – patients, admin staff, GPs and nurses – are all happier now than we were in February, March and April. And I feel sure, although I have no audit yet, that depression has not presented in such numbers or severity as in previous months.

Nevertheless, we must prepare ourselves for change and, while I have not consulted any long range forecasts, we may expect strong winds and rain around September 23, the so called equinoxial gales. In the meantime, let us metaphorically, and the farmers in reality, make hay!