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Exercise related to lifestyle and health benefits with local news

FREE NHS HEALTH CHECKS

Ealing Borough has one of the highest uptakes of free NHS Health Checks in the country. That means residents are reducing their risk of developing heart disease, stroke, diabetes and kidney disease.

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If you are aged between 40 – 74years old , have not had a health check in the last five years and have not already been diagnosed with certain conditions you will  be invited for a Free NHS  Health Check. The checks only take 20 minutes and hopefully will give  you peace of mind and good advice on staying well.

Even if you feel perfectly well and lead a healthy life style it is worth having it. Some conditions do not have early symptoms. It is estimated that 850,000 people are unaware that they have type 2 diabetes. I remember when I first joined the practise on simple urine screening I picked up 19 asymptomatic diabetics in 6 months including a 19 year old young man.

We as GP’s are increasingly aware that people need to be educated as to what is a healthy weight, the safe levels of alcohol aswell as the importance or regular exercise. If after discussing your results you are found to be at risk of getting one of these diseases your healthcare professional can offer support to help lower the risks.

For more information visit   www.nhs.uk/nhshealthcheck

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CAN YOU LIVE A NORMAL LIFE WITH DIABETES ?

imageWhen I first stated at 102 The Avenue I tested every single person’s urine for glucose and after 6 months I had picked up 19 new diabetics.

Those of you who have read one of my previous blogs may remember Sam, an 18yr old boy who came in nervously with his sister as he had been complaining of genital irritation which turned out to be thrush, which is a known presentation of diabetes especially in men.
https://102theavenue.wordpress.com/2013/08/13/how-to-prevent-or-delay-the-onset-of-diabetes/

He had no other symptoms but his urine contained glucose. When I told Sam he had diabetes his reply was, ” Am I going to die?” My reply was “I hope not as that means I am not a very good doctor. However, I suggest that you must not smoke and night’s out with the lads heavy drinking is not for you!” He replied,”Oh that’s good I don’t smoke and I am not fond of drinking I only drink an occasional lager”

I arranged for him to attend the diabetic clinic to be initiated on insulin as he was clearly a Type 1 diabetic.
Sam remains well still in the same job, although thinking of joining the fire service, married with 2 children, fit as a fiddle. Diabetes does not dominate his life, he has never been in hospital,continues taking insulin and sees his doctor every 6 months for regular check ups. That how the majority of diabetics live – they can have a lager or a bar of chocolate occasionally and can become organ donors and he will be assessed on his ability to be a firefighter and will not be turned down because he has diabetes.
Type 1 diabetes develops when the insulin-producing cells in the body have been destroyed and the body is unable to produce any insulin.

Who typically gets Type 1 diabetes?
Type 1 diabetes accounts for about 10 per cent of all adults with diabetes and is treated by daily insulin injections, a healthy diet and regular physical activity. Type 1 diabetes can develop at any age but usually appears before the age of 40, and especially y in childhood. It is the most common type of diabetes found in childhood. Type 1 diabetes can’t be prevented. The body’s immune system destroys the insulin-producing cells, and nobody quite understands why.
The vast majority of children with diabetes have Type 1 diabetes, but an increasing number are now developing Type 2 diabetes.

Notwithstanding, there are those for one reason or another develop complications but for the most part the majority of people like Sam lead a normal life.

 

Diabetes

The rest of those patients who I picked up with glucose in the urine were older.
I particularly remember Diane, who was a 55yr old teacher very overweight, and admitted she did very little exercise. She had come to surgery feeling tired and stressed but a routine urine showed glucose. I tried to suggest that she lost weight and even suggested Bariatric surgery but she was very negative, claiming she had tried every diet and didn’t have time for exercise. As time went by she was treated for hypertension and needed to have several types of diabetic medication and the diabetes was still not satisfactorily controlled and she was not only was her weight increasing but she was developing angina. Probably dreading hearing the same old advice – diet and exercise and the suggestion of insulin she started not turning up for her appointments. At the beginning or each year we audit our patients to review those that have not been checked and her name appeared and we then ask the receptionists or nurse to phone them to make an appointment. She did make an appointment and her blood tests showed her blood glucose was running very high. When I saw her she said that her job was now becoming so stressful that she was considering early retirement and that she was now prepared to have Bariatric surgery and look seriously at her health. I was thrilled it was worth waiting for that moment. She went on to have surgery and with the support of the multidisciplinary team of dietitian, psychologist and surgeon she became motivated to eat a healthier diet, exercise and gradually as the weeks went by she stopped one medication after another. She was transformed she looked more attractive, she was happier, free from both her diabetic and blood pressure medication and the angina settled. She was now retired and set to enjoy life outside London and as she came to say goodbye she said, “Why hadn’t I done this earlier?”
Diabetes
Who typically gets Type 2 diabetes?
Type 2 diabetes usually appears in people over the age of 40, though in South Asian people, who are at greater risk, it often appears from the age of 25. It is also increasingly becoming more common in children, adolescents and young people of all ethnicities. Type 2 diabetes accounts for between 85 and 95 per cent of all people with diabetes and is treated with a healthy diet and increased physical activity. In addition to this, medication and/or insulin are often required.
In Type 2 diabetes there is not enough insulin (or the insulin isn’t working properly), so the cells are only partially unlocked and glucose builds up in the blood.
In today’s press:-
More than one in three adults in England are on the cusp of developing type-2 diabetes, new research suggests.
If nothing is done to stop the trend, there will be a steep surge in this form of diabetes within the next few years, the authors of a report published in the British Medical Journal Open said.
People are classed as having borderline diabetes, also known as pre-diabetes, when they have blood glucose levels at the very high end of the ‘normal’ range. Those with the condition are at high risk of developing diabetes and its associated complications.
Their study found that in 2011, the number of people diagnosed with pre-diabetes tripled from 11.6 per cent in 2003 to 35.3 per cent.
We now regularly screen patients not just for urine glucose but for blood glucose in an attempt to prevent the onset of diabetes.

It is now reported that 80% of Type 2 diabetes can be prevented by diet and exercise alone

As I reflected it made me realise the enormous strides that have been made in medicine since I have been qualified regarding diabetes, firstly being able to diagnose it so easily with a simple dipstick and more accurate blood tests to recognise pre-diabetes as well as having the proven knowledge that leading a healthy lifestyle can prevent the onset. However, sadly many people don’t take heed of this and don’t eat healthily and live a life of a couch potato running a great risk of developing Type 2 diabetes.

 

I remember my first job as a surgical house officer there were always some patients on the ward with chronic leg ulcers, and those who had poor lower limb circulation both as a result of diabetes and who were on the surgical ward and inevitably ended up having an amputation. Many of these patients also had poor eyesight due to cataracts or diabetic retinal damage, others had had heart attacks or strokes and it was a concern whether they would able to cope with anaesthetic and had to have the surgery with a spinal block. Most of these diabetics went on to develop kidney failure but were considered unsuitable candidates for renal dialysis because of there array of other complications. They had to have peritoneal dialysis – a cumbersome way of ridding the body of liquid waste. It involved pouring large volumes of fluid into the abdomen and then flushing the fluid out. When I was a GP visiting these patients, who were discharged home for it to be carried out by the District nurse on a regular basis, sometimes daily, I remember having to squeeze past these piled up boxes in the hallway. There prognosis was poor and they often developed severe infections or went into end-stage kidney failure and died at in there 50’s. Hence, it is not surprising that many people fear this condition and feel it will alter their life.
Diets at that time consisted of large amounts of fat and sugar: the day started with a greasy cooked breakfast, puddings were a must and afternoon tea was accompanied by a selection of home-made cakes. Although exercise was part of a daily routine the television began to limit how much people did and more people bought cars, public transport improved but everyone continued with the same diet.
Diet and exercise
In 2001 Diabetes Prevention Program (DPP),a large trial was carried which was scheduled to last 4years comparing a group of people who were supervised strictly to adhere to exercise and a healthy diet and a group who were not educated but the trial had to be abandoned after 3 years because it was so clear that a highly significant number were developing diabetes in the non-educated group and it was considered non-ethical not to educate everybody.
Participants randomly assigned to intensive lifestyle intervention reduced their risk of getting type 2 diabetes by 58 percent. On average, this group maintained their physical activity at 30 minutes per day, usually with walking or other moderate intensity exercise, and lost 5-7 percent of their body weight.

It is reported that 80% of Type 2 diabetes can be prevented by diet and exercise alone

You can check your risk of developing diabetes by clicking on the link below:-
http://riskscore.diabetes.org.uk/type2risk/

It is possible to delay the onset of Type 2 diabetes by lifestyle intervention.
Before you develop symptoms:-
Diabetes

 
 

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Video

CHEERS! GIVE ME A BREAK

2014

Many people will have had an enjoyable festive break but others it will have been a stressful time. For many a festive drink of alcohol and eating rich food will have made the occasion more enjoyable for others it will have caused an aftermath of misery.

The great thing about the start of a New Year it’s a chance to reflect of the what’s good and what’s bad about your life and stick with what’s good and try to change what’s bad.
A chance to improve our lifestyle, our living conditions, our friendships and our relationships as well as our sense of purpose.

Banksy put up four new pieces in London two years ago. One on the side of National Gallery, one in Bell Lane near Liverpool St. Station, one on Wapping High Street – all which were buffed/removed very quickly indeed, but give the message….

Banksy lifestyle

Perhaps one answer to many of your problems could be to
LOOK AFTER YOUR LIVER

What does the liver do?
Your liver is the biggest organ inside your body and does hundreds of essential jobs.

  • Fighting infection and disease
  • Destroying poisons and drugs (including alcohol)
  • Cleaning the blood
  • Controlling the amount of cholesterol
  • Processing food once it has been digested

watch this video found on the website
http://www.britishlivertrust.org.uk/liver-information/looking-after-your-liver/
Liver factory

Liver Health from TCM Perspective
Liver Chinese Since I have studied Traditional Chinese Medicine I have been fascinated how this completes the effects of disease and how the major organs effect the rest of the body and the mind.

The Liver(Chinese: 肝; pinyin: gān)
The Liver in Traditional Chinese Medicine (TCM) is a very important organ. The Liver in TCM has very different functions than the liver in western medicine. In western medicine, some of the functions are to produce certain proteins for blood plasma, regulate blood clotting and resist infections by producing immune factors and removing bacteria from the blood stream. In Chinese medicine, the liver has 6 main functions and they are as follows:
• Regulate Qi (energy)
• Open in eyes
• Stores blood
• Controls tendons and sinews
• Manifests in nails
• Houses ethereal soul
This prime aspect of the liver can have great affect on three aspects of the body: the emotions, digestion, and the free flow of blood.
1) Strongly effects emotions
If Liver function is normal, people will have smooth flowing emotional states favoring happiness. If the flow of Qi is stagnated or stuck, they will experience frustration, depression, irritability or anger. Various pre-menstrual syndrome symptoms will also arise such as irregular or painful periods, mood swings and breast tenderness.
The Liver is the organ system most affected by suppressed emotions. Therefore not dealing with your triggers and emotions for a long time can lead to “Liver Qi Stagnation” and eventually pathologies of other body organs.
2) Affects the digestion of food
If the Qi is not flowing smoothly (i.e. from emotions), the digestion system will have trouble performing their functions. If the Liver Qi is stagnated it can affect the Stomach causing nausea, vomiting and belching. It can also affect the Spleen and cause diarrhea.
3) Blood Flow
The relationship between blood and qi (energy) is very close and they always move together. The blood cannot go where the qi does not. If the free flow of the qi is stagnated by the liver, the blood will stagnate as well. The stagnation of liver qi will still cause stagnation of blood, which will lead to the gynecological symptoms.
I remember a patient coming to the surgery with very sore eyes which she was causing her great distress. On examination there was no obvious problem and as a Western doctor I could offer no treatment. I decided to take a TCM history and as her eyes were the problem I focused on symptoms and examination accordingly. When I asked her about her menstruation she claimed she was late but definitely not pregnant, she had no appetite and had a dull ache in her upper abdomen and chest. Then I asked her about her emotions and she changed from a softly spoken, refined young women and started to cry and become very angry. Eventually she related the story of how she worked in a small boutique and there had been a robbery and she had been held a gunpoint and although she was not hurt she was extremely angry that her boss was not installing a panic alarm and safety catch on the door.

TongueI examined her tongue and pulse (important features of a TCM examination) and diagnosed Liver Qi stagnation with fire due to the symptoms she presented and her red tip and sides of tongue as well as a wiry pulse.
The treatment for her eyes was to deal with her anger by getting her work situation sorted out as this from a TCM perspective was causing her medical problems.

If you imagine someone having over indulged alcohol with their red eyes, emotionally labile, irritability, altered appetite and aching joints, staggering gait and poor sexual function – TCM will account for these features.

Liver disease is the fifth biggest – and fastest-growing – killer in the UK but a lack of obvious symptoms means it can be diagnosed at a late stage.
It works hard and can take a lot of abuse, but it is like an elastic band – it can only stretch so far before it breaks.


There are 3 main threats to the Liver

    • Alcohol
    • Fatty diet
    • viral Hepatitis

ALCOHOL

Andrew Langford, chief executive of the British Liver Trust, said: “Overindulging in fatty food too frequently, having an alcoholic drink every night and not making time for regular exercise are major contributing factors for liver disease.

“To repair the liver and keep it healthy, people need to take at least two to three imageconsecutive days off alcohol every week, and drink within the recommended limits at other times, affecting a permanent lifestyle change.”
Only you know yourself if you can limit your drinking and it well established that some people are unable to do and need to abstain completely.

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A long established organisation who can help called Alcoholics Anonymous is a group of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism.

The only requirement for membership is a desire to stop drinking. There are no dues or fees for AA membership; they are self-supporting through their own contributions.
More information can be obtained on their website including the helpline and email address:-
http://www.alcoholics-anonymous.org.uk

If you are effected by someone else, a friend or relative who are drinking and need to share this with others in a similar situation the following website may be helpful:-
http://www.al-anonuk.org.uk

The daily papers have been focussing on alcohol and the fact that it has become as great a problem amongst women as men and all of its terrible effects and there is even an App to track your drinking and give you feedback. The NHS choices website will give you all this information as well as how to cope with a hangover and how many units are safe to drink each week.

http://www.nhs.uk/livewell/alcohol/Pages/Alcoholhome.aspx

There are two Charities that are promoting a dry January in an attempt to encourage those people, who feel that their drinking has got out of hand, to stop and think about the effects of their drinking and by taking on the challenge, lose a few pounds while saving money. Moreover, with no hangovers you can find time and energy you never knew you had, and discover how your skin will look nicer too. Get some support and encouragement from the following websites:-

Dryjanhttp://www.dryjanuary.org.uk
By giving it a get thinking about your drinking and prove to yourself that you can say no to a tipple or two. Thousands of people took up the challenge last year and most decided to cut down for good as a result. Take a look at the website it gives recipes for mocktails and what to do when you fancy a drink!

Cancer researchhttp://www.cancerresearchuk.org/support-us/find-anevent/charity-challenges/dryathlon
DRYATHLON

Become a Dryathlete™ and give up alcohol for January. Clear your head, feel fitter, save money and raise funds to help beat cancer sooner.

BUT WATCH OUT!
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Many people don’t appreciate that unhealthy eating leading to Obesity and diabetes which leads to fatty liver disease.
Figures from the charity show that a third of people in the UK with liver disease have obesity-related non alcoholic fatty liver disease.
The condition is behind a growing number of liver transplants and the problem is expected to get worse as obesity continues to rise.
Every time doctors get together to discuss Type 2 Diabetic who not well controlled and needing to start insulin the same advise from the diabetologists a is always:-
LOOSE WEIGHT
Diet lifestyle

AND EXERCISE
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I have seen first hand on many occasions how a diabetic that follows this advise can come off ALL medical treatment……

Finally
VIRAL HEPATITIS
I blogged about this several months ago
http://wp.me/p3wyoO-aQ
Hepatitis

There are several viruses that cause hepatitis. The common ones are hepatitis A, B and C. Most people recover from hepatitis A with no lasting liver damage, but hepatitis B and C can cause long term liver disease and even liver cancer.

Hepatitis A is passed out in the bowel motions of an infected person, and is passed from person to person by eating food or drinking water contaminated with the virus due to poor hygiene standards . Most people feel better within a few weeks. The illness can be more severe in those who are old or who have other underlying conditions.
How to look after your liver.
There are vaccines available to protect against hepatitis A. Vaccination is recommended if you are travelling abroad outside Europe and the US, but you should also speak to your GP if you think you might be at risk because of your job or your lifestyle.

Both hepatitis B and C are easy to catch through blood to blood contact and very hard to get rid of. Even a tiny amount of dried blood – too small to be visible to the naked eye – is enough to pass on the infection if it gets into your blood stream.

This could be from sharing contaminated:

  • equipment for injecting drugs (including steroids)
  • tattoo, accupuncture or body piercing equipment
  • medical or dental equipment
  • razors, clippers, or toothbrushes
  • through an open cut or wound.

Sex and passing the virus from mother to baby at birth, are also high risk factors for hepatitis B.

There are few symptoms of hepatitis B and C and people can be infected for many years without knowing, during which time liver damage can occur. An estimated five out of every six people with chronic hepatitis C are unaware of their infection.

imageYou only have one liver, it’s important to know how to look after it!

 
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Posted by on January 1, 2014 in Training and Advice

 

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ARE YOU IN THE MOOD?

WORLD OBESITY DAY – 26th OCTOBER 2013

ARE  YOU OBESE?

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If you come into the category of being obese it is today you must consider doing something about it. Rarely is there a medical reason. I am afraid I had to accept for the most part it is due to eating the wrong foods and not exercising enough.
Until you feel mentally motivated to embark on losing weight no diet will help.

But the joys of losing weight will soon be apparent when you get going

  • Feeling generally better in yourself
  • Being able to exercise more easily and enjoy it
  • Improved self esteem
  • wearing more flattering clothes or discovering old clothes you never thought you would wear again
  • Instead of peolpe saying”oh you look well!” Which really means “you have put on more weight!” Let their them say “WOW how did you do it.? And you can confidently say “I know I was fat but eating the right food and exercising has done the trick and I feel great!”
  • and you can dance again!!

Simply start by not eating bread, potatoes, pasta, fizzy drinks, cakes, pastries.
You will not die if you miss a meal you may be better for it!
Star walking 5 minutes a day and build up slowly, tummy tucks 10/ day and build up slowly, bend 5 times daily and build up slowly stand instead of sit as much as possible.

GET STARTED TODAY OR JUST SIMPLY GET IN THE MOOD AND START WHEN YOU ARE READY

 
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Posted by on October 26, 2013 in Training and Advice

 

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BE INSPIRED TO EXERCISE

When I noticed that I knew two of the young runners had done so well in completing the Mini-Marathon and raised money for such a good cause I asked if they were let me publish their photo and comments and was delighted to receive the following:-

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Words from the boys 

I decided to run the Ealing mini mile because running is one of my favourite sports. I trained in Pitshanger Park with my mum. I came 3rd out of 177 runners so I was pleased. Together with my brother Roko I raised £185 for the Winnicott Foundation which provides money for neo-natal intensive care units for premature babies. We chose the charity because our baby brother Arlo was born prematurely and was looked after in intensive care.

Milo Choudhry, age 10.

I wanted to run in the Ealing mini mile because last year I watched my mum running in the Ealing Half Marathon and thought it would be good fun to join in. I’ve never run in a race before so I was a bit nervous but it was really good fun on the day running with all the other children. Before the event there was a competition in my school to design a t shirt to be given to all the children along with their medal. I was really excited because I won and I saw everyone wearing my t shirt design at the end of the race.
Roko Choudhry, age 7.

Well done, boys. I am sure this will encourage other children and adults to make the effort. Start training now!!

 

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CONGRATULATIONS !

imageWell done all those runners who completed the half marathon and the mini marathon yesterday! I recognised at least 3 names amongst those who were amongst the runners. Congratulations on raising money for so many worthy charities. Training for this event has meant a lot of training and if you want to consider next years event and keep fit at the same time you may need to start now! The planning and preparation of the Ealing Half Marathon on race day was supported by Ealing Eagles Running Club image which is a friendly and social running club in Ealing, founded in 2009 for runners and joggers of all standards, from beginners and novices to expert racers, in the Ealing, Perivale, Greenford, Hanwell, Northfields, Brentford & Acton area. If you live, work or are just passing through the Ealing area,you can join one of the Ealing Eagles training sessions. http://www.ealingeagles.com Charities supported It was interesting to learn about those charities, most of which support local causes, that benefitted from runners who raised money by being sponsored. I am afraid I was not aware of several of these charities and felt it was an opportunity to promote their work in our community and beyond. The headline charity of the race supported was:- image Epilepsy Action exists to improve the lives of everyone affected by epilepsy. As well as campaigning to improve epilepsy services and raise awareness of the condition, Epilepsy Action offers assistance to people in a number of ways including a national network of branches, accredited volunteers, regular regional conferences and freephone and email helplines.

*************************** image Ealing Mencap provides a wide range of services and support to people with learning disabilities in west London, as well as their families and carers. http://www.ealingmencap.org.uk *********************** imageC-A-P-E is an established registered charity offering a dynamic and flexible outreach and day service for people who experience severe and enduring mental health difficulties living in the London Borough of Ealing. Cape aims to improve the quality of life of the people who use the service by; * Enabling clients to access meaningful activity. * Facilitate clients to build relationships with others who may be isolated. * Offering support – emotionally, practically and socially. * Helping clients to access a range of health and social care provisions. * Helping clients make informed choices about their lives. * Promoting the principles of recovery. Visit their website for more information http://www.c-a-p-e.co.uk *********************** image Shooting Star CHASE is your local children’s hospice service, a charity caring for local families with a child or teenager with a life-limiting condition. We currently help over 600 families living in western London, Surrey and West Sussex. Our aim is to make every day count for these families. We are here for every step of their journey, sharing the good times and helping them through the tough times with practical, nursing and emotional support. ********************** image We work through local churches to unlock people’s potential, helping them to discover that the answer to poverty is within themselves. When disasters strike, we respond quickly. We won’t stop until poverty stops. At Tearfund, what drives us is a belief that the local church is a powerful force for transformation in communities living in every kind of poverty. Inspired by the example and teaching of Jesus, we recognise that people have deeply interconnected material and spiritual needs, and we seek to meet those needs by working through our local church partners. Churches are at the heart of their communities – full of dedicated, resourceful people who want to make a long-term difference. We work particularly in Africa, Asia and South America – and also across Eastern Europe and the UK. Right now, we’re focussing on some of the biggest challenges facing the world today. Find out more about what we do and where on our website.http://www.tearfund.org ************************ image Imperial College Healthcare Charity is an independent charity that raises and manages charitable funds for all five hospitals within Imperial College Healthcare NHS Trust: Charing Cross, Hammersmith, Queen Charlotte’s & Chelsea, St Mary’s and Western Eye hospitals. We work with Imperial College Healthcare NHS Trust to pursue three key objectives: Great Science – enabling clinical research and advances in healthcare. By supporting staff to deliver advancements in medical science, we can make improvements to the treatment patients receive. Clinical advancements can help reduce the time patients spend in hospital, reduce their discomfort and make improvements to their rehabilitation and recovery. Excellent patient care – making a measureable difference to the patient experience and delivery of care. Excellent staff are key to ensuring excellent patient care. We therefore provide grants to staff for training and personal development. We also support the Trust to recognise excellent staff through a range of recognition awards. The use of art has long been recognised as an effective way to improve the healing environment. We manage an art collection of more than 1,600 pieces that are displayed across all five Trust sites. A healthier community – supporting projects that tackle health inequalities in the communities served by the Trust There are huge disparities in the health of the communities where the Trust’s hospitals are based. By funding local community organisations and initiatives, the Charity is able to support the Trust, in accessing some of the hardest to reach communities, where health problems prevail. ************************ image In 2010 22 year-old Holly Bantleman set off on a soul-searching round-the-world trip, hoping to have that ‘life changing’ experience and during this trip she visited Kenya. Raise the Roof Kenya’ began after she visited a village on a dump site called ‘London’ in the town of Nakuru. The area had sprung up after the 2007/2009 electoral violence in which so many people were displaced. Over 250 people, many children, set up camp on the landfill and found themselves with no means of escape, relying on the rubbish truck for their food, with children playing in rags, barefoot and literally starving. Initially the the idea was to raise the money to buy tin roofing for the people living on the landfill without food or shelter and to eventually provide a long term solution for their plight. With that mission accomplished after raising money through UK donations, several more visits to Kenya, and many more eye opening experiences, Holly decided that RTRK would become a long term project. From school fees and medical bills, to housing and small businesses, RTRK have managed to support children and families in destitute situations. Now spending a third of her year in Kenya, Holly has noticed a lack of opportunity for the bigger teenage kids, (she was one herself not so long ago!) so has found another directions in which to take RTRK – the ‘Think Big’ Project is the Barut Development Centre build. The idea is for us to provide the community (the poorest in the area) with a sports ground, community centre and vocational school so people can gain education and training to go on and live sustainably in the future. ************************** image St Mungo’s opens doors for homeless people. Mainly based in London and the South, we provide over 100 accommodation and support projects day in, day out. We run emergency homeless services – including street outreach teams, and accommodation for rough sleepers and hostels. We support homeless people in their recovery – opening the door to safe housing, drug and alcohol support and physical and mental health care. We provide more help for homeless people in gaining life skills than any other charity – from job training to independent living skills in our ‘semi-independent’ houses. Preventing homelessness is very important to us. Our ‘complex needs’ housing provides safe and supportive homes for nearly 400 vulnerable people. Our community support teams work with thousands of people at risk – including former rough sleepers. By opening our doors, and by opening the doors to services within St Mungo’s and in the broader community, we are able to help thousands of homeless people change their lives for good every year. ************************* image http://www.samaritans.org/branches/samaritans-ealing-branch TALKING GOT ME THROUGH Talk to us any time you like, in your own way, and off the record – about whatever’s getting to you. You don’t have to be suicidal. WELCOME TO THE SAMARITANS EALING BRANCH If something’s troubling you, get in touch: Telephone our branch: 020 8560 2345 Email Samaritans: jo@samaritans.org Visit our branch: Samaritans London 26 Junction Road Ealing London W5 4XL Usual hours open to receive callers at the door: Phone for details Facilities for visitors with disabilities: Phone for details ************************ image ECIL is a membership organisation representing and supporting disabled people and carers, of all types and of any age, who live and work in the borough of Ealing and surrounding boroughs. We are proud to be part of the Independent Living movement and are one of a growing number of Centres for Independent Living (CILs) around the country. The government strategy paper Improving the Life Chances of Disabled People published 2005 recommends that there should be a CIL in every local authority area. ECIL was formed as an independent organisation in 2002. We gained our charitable status in that year. We are now funded by Ealing Council and the Ealing Primary Care Trust. ************************ image The Gabrielle Gray Foundation is a charity founded in the memory of my sister Gabrielle Emilie Gray Giam (Gaby) who passed away on the 16th of August 2012 at the age of 31. The Gabrielle Gray Foundation was inspired by the compassion that Gaby showed towards others throughout the 31 years of her life. Some of her last advice to us was to not be bitter, to be grateful for everything and no matter how bad things seem they can always be worse. These wise words remind us of how fortunate most of us are. The Gabrielle Gray Foundation will be helping young vulnerable adults between the ages of 18-24 in West London. Help us to help others who are less fortunate and continue her legacy. If anyone reading this may have benefitted from one of these charities or who ran the half marathon for another worthy cause it would be great to publish your story on this site, which aims to talk about health and related issues especially of local interest.

 
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Posted by on September 30, 2013 in Training and Advice

 

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RECHARGING THE BATTERIES

We all know that feeling of arriving at the station as the barrier goes down and watch your train slide away from you.image
It leaves you feeling irritated and perhaps distressed at the prospect of a long wait for the next train and the hassle of arranging an alternative pick up at your destination.
The last time this occurred was earlier this month when the Eurostar arrived late and I didn’t have enough time to cross Paris to catch the connecting TGV at Montparnasse. I arrived with 4 minutes to go before the departure time but the awaiting station uniformed official mercilessly blocked mine and several others entrance to the platform claiming we should be there at least 2 minutes before departure and indeed by the time she had completed her declaration it was just just less than 2 minutes!

I walked away crest fallen, luckily with a semi-flexible ticket and started to make my way towards the Salle d’Attente ready for more than one hour’s wait. On my way I noticed, out of the corner of my eye a cycling machine for charging batteries.
image I put down my luggage and plugged in my iPad and it wasn’t long before a young French girl from a small village near Nantes joined me also having missed her train connection. We both began pedaling as if in a road cyclists heaven cycling the French Pyrénées on a challenging climb. (Echoed by passing French young men) then she said that there was no need to pedal so hard, the devices did not charge any faster and we slowed down to a casual pace.
She then started to tell me how she had worked as an ‘au pair’ for a councillor’s family in Rochdale near Sheffield. Whilst living there she had worked as a volunteer at a youth club and it was whilst working there that she had gone back to the flat of 2 of the young girls from the youth club. She had been discouraged but felt she had something in common with them as they claimed that they were bored at home and she empathasisec as she been brought up in I small out of the way village in France. When she arrived at the flat she was not unduly surprised to see the disheveled outer appearance after all the outside of her parents farmhouse was not exactly pristine.
As she entered the flat she was shocked and surprised to see that it was totally empty except for some bedding strewn on the bare floorboards, no doors, no electricity and only cold running water. Her look of surprise prompted the girls to admit that both parents were drug addicts and they had sold every possession and use the doors as firewood to make an open fire to cook and keep warm. What do you do to occupy yourself the French girl asked and they told her how they played cards by candle-light and listened to the radio when they acquired batteries.
Following this experience she went back to France and studied Political Sciences and now involved in French Politics.

We the talked about social deprivation and poverty and she felt is was because in Britain we had not had a Revolution and didn’t appreciate the concept of Liberté,Egalité & Fraternité and tended to concentrate our efforts on Liberty(freedom).
image
More importantly after this experience she had phoned her mother to apologise for complaining about being brought up in a boring simple village on an ordinary farm!
It was not long before we noticed that 45 minutes had passed and we parted with devices charged and in separate directions to try to make some difference in society.

 
 

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Race for life update

016276From the gallant Warriers

THANK YOU SO MUCH to the those who sponsored us so generously for the Race for Life! We completed the 10k run on Saturday morning in just over an hour running through the finish line all holding hands! It was such a great feeling to take part in such a wonderful event, for such an amazing cause!
image
Anna who last year had cancer and made a fantastic recovery teamed with friends to run a half marathon in Richmond Park. They raised £1500 for this worthy cause and put Cancer Research on the map. They finished the race holding hands with smiles from ear to ear. Well done!

Anyone else out there got some good healthy news!!

 
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Posted by on June 16, 2013 in Patient news

 

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Exercise…Part 2…the alternative

FOR THOSE WHO CAN’T OR DON’T WANT TO EXERCISE

After reading the first blog did you feel that you haven’t the time or exercise is not for you or it is not a thing in your family?

Have you joined a gym attended twice and not returned?

Discussing this with colleagues I was reminded of this programme which was shown in January 2013

Horizon programme BBC 2 The Truth About Exercise
http://www.bbc.co.uk/programmes/b01cywtq

Also on YouTube.

Like many, Michael Mosley wants to get fitter and healthier but can’t face hours on the treadmill or trips to the gym. Help may be at hand.

He uncovers the surprising new research which suggests many of us could benefit from just three minutes of high intensity exercise a week.

He discovers the hidden power of simple activities like walking and fidgeting, and finds out why some of us don’t respond to exercise at all.

Using himself as a guinea pig, Michael uncovers the revealing new research about exercise, that has the power to make us all live longer and healthier lives.
After seeing the programme, there are several suggestions as well as other ideas such as:-

Walking around or even standing when you are using the phone
Using the stairs instead of the lift
(As suggested by my son when I proudly told him I manage 40 tummy tucks and 40 gluteal tucks when using the lift . He was not impressed and replied ‘Why don’t you just use the stairs mum?’

Getting off at a earlier bus stop or tube station and walking home or to work
Using stairs instead of escalator

Parking the car further from the shop entrance rather than driving around to find the nearest space to the door

Dancing with gusto to your teenagers pop music be it Reggae, House or Garage whilst preparing supper.
I once turned up at the local Nursing home for a ward round and as I arrived at the front door heard loud Reggae music ( Oh no I thought there must be a new carer not appreciating this is a home for the elderly) When I entered I witnessed the mobile residents dancing with the carers and those seated looking on with great interest. It turned out that one of the resident’s daughter is a well known Reggae musician and they were playing her music. This lovely gentleman 2 years later died peacefully at the home listening to the music!!

Did you know that you can buy a gadget that can be fitted to a exercise bike that charges your mobile phone? I saw these being used at Lille Europe train station.

3 minute maximum capacity exercise with rest intervals of 20 seconds done regularly
( you must watch the clip from the above programme
to appreciate what this entails )

Other variable ideas of alternative exercise
http://www.nhs.uk/LiveWell/Fitness/Pages/Fitnesshome.aspx

Written by Dr Jacqueline Bayer

 
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Posted by on May 20, 2013 in Training and Advice

 

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HYPERTENSION…..today is WHD – world hypertension day!

Periodically we have to check to ascertain that all patients on our hypertension register have had a blood pressure reading in the last 6-9 months and usually we have to chase up more than half the patients and 10% do not respond after 3 requests; many are found to be uncontrolled due to poor compliance of medication putting their cardiovascular disease risk at stake.

High blood pressure (hypertension) is the major risk factor for cardiovascular disease. Hence, in 2002, it was named ‘the number one killer’ by the World Health Organization (WHO) in The World Health Report.

Every year, 17 May is dedicated to World Hypertension Day (WHD).

WHD

The theme for 2013 is Healthy Heart Beat-Healthy Blood Pressure.

This was inaugurated in May 2005 and has become an annual event: the purpose of the WHD is to promote public awareness of hypertension and to encourage citizens of all countries to prevent and control this silent killer, the modern epidemic.

In the UK the incidence is more than 12 million in adults aged 16- 75years.

In the Department of Health’s 2010 ‘Health Survey for England’ the prevalence of hypertension in adults of 16 years or older was 31.5% in men and 29.0% in women. After the age of 70 years 40-50% are affected.

The full data are available on their website http://www.dh.gov.uk/ or directly at: http://www.ic.nhs.uk/webfiles/publications/003_Health_Lifestyles/HSE2010_REPORT/HSE2010_Trends_commentary.pdf

Prevalence of hypertension is also collected by General Practices nationally and published via the Quality and Outcomes Framework: http://www.qof.ic.nhs.uk/

In our practice we have 300 patients with high blood pressure and we participate in Quality Outcomes Framework (QOF) where we are committed to recording a blood pressure at a minimum of 9 month intervals and then treating to control the blood pressure at the recommended level by medical treatment and lifestyle advice.
You can view how well the practice is doing on the website http://www.qof.ic.nhs.uk/ and we are shown to be above the expected targets thanks to our hard-working staff and co-operation of patients.
Moreover, this achievement will significantly reduce the incidence of stroke and heart attack.

If you are over 40 yrs of age or have a family history and have not had your blood pressure taken in the past 5 years please call in to have this done.

1) What is Hypertension (high blood pressure)

Blood pressure is simply the physical pressure of blood in the blood vessels. It is similar to the concept of air pressure in a car tyre.

The pressure in the arteries depends on how hard the heart pumps, and how much resistance there is in the arteries.
It is thought that slight narrowing of the arteries increases the resistance to blood flow, which increases the blood pressure.
The cause of the slight narrowing of the arteries is not clear. Various factors probably contribute.

2) How is it measured?

A common blood pressure might be 120/80 (said as ‘120 over 80’). These values are quoted in units known as millimeters of mercury (mmHg).

There are 2 numbers because the blood pressure varies with the heartbeat. The higher pressure (120) represents the pressure in the arteries when the heart beats, pumping blood into the arteries.
This pressure is called systolic pressure.

The lower pressure (80) represents the pressure in the arteries when the heart is relaxed between beats.
This pressure is called diastolic pressure.

3) Does it vary in an individual ?

Blood pressure can be quite variable, even in the same person.

4) what makes the blood pressure vary?

Blood pressure goes up and down with different normal daily activities. For example, exercise, changes in posture and even talking changes blood pressure.

Blood pressure tends to be higher during the day than at night and higher in the winter than in the summer.

Blood pressure also rises when we grow older, particularly systolic blood pressure. Before adulthood, blood pressure rises in parallel with height.

In adult years, weight and blood pressure are closely related. When weight goes up, blood pressure tends to go up and we can lower blood pressure by losing weight.

5) Does it vary in individuals?

Blood pressures differ between individuals. Some people have low, some average and some high blood pressure levels.

6) What is the definition of high blood pressure?

There are various definitions of high blood pressure, which is also known as hypertension, but most doctors consider blood pressures of 140/90 and greater to be high.

The precise values that doctors might interpret as high blood pressure depend to an extent on individual circumstances. For example, in patients with diabetes, the definition of hypertension is considered by some to be pressures greater than 130/80.

The definition of hypertension is used by doctors to help decide which patients would benefit from medical (lifestyle and drug) treatment to lower pressure.

The definitions depend on the balance of risk of not lowering blood pressure (heart attack and stroke, etc) versus the risks of treatment (drug side effects, etc).

This explains why hypertension is defined at lower blood pressure levels in diabetic subjects. For the same blood pressure, cardiovascular complications (that is damage to the heart, blood vessels and brain) are more likely in diabetics and blood pressure reduction offers benefit even when a diabetic’s blood pressure is not as high as regular definitions of hypertension.

7) Why is blood pressure important?

Blood pressure is important because it is the driving force for blood to travel around the body to deliver fresh blood with oxygen and nutrients to the organs of the body.

However, high blood pressure is important because it leads to increased risk of serious cardiovascular disease, with complications such as heart attack, heart failure, stroke, kidney failure and blindness.

8) What is the cause of high blood pressure ?

For the vast majority of people with high blood pressure no precise explanation is ever found. For this reason, such cases are said to have ‘essential’ hypertension.

These cases are likely to result from a range of factors that could be broadly grouped into genetic and environmental (lifestyle) factors that work together to raise blood pressure.

Because genes and environmental are shared within families, it is not uncommon for people with high blood pressure to know of relatives with the same condition.

In a minority of cases of hypertension (less than about 5%) a precise cause can be identified. These include hormonal imbalances and kidney diseases that can result from genetic problems, occasionally tumors (usually benign) and blood vessel narrowing. Doctors are trained to look for signs of these specific conditions, as they are often curable.

High blood pressure is more common is older age groups and in people with a family history of hypertension. It is also more frequent in those who are overweight. However, high blood pressure can affect young thin people with no family history, so no one should consider himself or herself immune from high blood pressure.

9) Why is it important to control blood pressure ?

It is the goal of good clinical practice to reduce high levels of pressure wherever possible in order to reduce the risk of complications such as heart attack and stroke.

10) How is high blood pressure controlled?

Changes to lifestyle such as weight loss, reduced salt intake, reduced alcohol consumption or exercise are often the first line of treatment. If these approaches don’t return blood pressure to acceptable levels then drug treatment is usually required.

11) How do you know if you have high blood pressure?

The truth is you cannot know your blood pressure unless you have it measured and every adult should know his or her blood pressure.

Although headaches and nose bleeds can be the result of very high blood pressure, there are many more innocent causes for these common ailments.

12) How can you help to control blood pressure?

A healthy lifestyle and a sensible diet are important. One of the most important things is to keep weight under control. Less weight means lower blood pressure, and it also means less diabetes, less stress on muscles and joints and less stress on the heart.

13) Can high blood pressure be cured?

Commonly we hear ‘can I stop taking my tablets now’ or ‘I have finished the course’

It is rare for hypertension to disappear by itself. The general rule is that blood pressure gets higher with time and the risk of complications goes up also.

Although not ‘cured’ as such, modern therapeutic approaches to blood pressure are very effective and generally very safe. However, if treatment is stopped the high blood pressure usually returns reasonably quickly.

14) What are the effects of high blood pressure?

Any degree of high blood pressure is associated with increased risk of stroke and heart attack, but the higher the pressure, the higher the risks.

15) How is high blood pressure treated?

If blood pressure is persistently 140/90 and greater, then some form of treatment is required, although in the first instance this might be adjustments to lifestyle, such as diet and exercise.

However, if the blood pressure is repeatedly greater than 160/110, then there is usually a need to begin drug treatment immediately, rather than relying on lifestyle changes alone.

Sustained blood pressures of over 200/120 are considered potentially dangerous and if associated with for example visual trouble or heart failure they require emergency treatment.

16) Will hypertension cause any damage to my body?

Left unchecked, high blood pressure will over the years cause damage to the blood vessels of the heart and brain that leads to heart attacks and strokes. It also places extra strain on the heart, causing thickening of the heart muscle and heart failure and it damages the kidneys and can lead to kidney failure.

17)Are there any side effects to medication?

These days drugs are safe and generally free of major side effects, but no drug is completely free of side effects in all patients.

As blood pressure drugs work by reducing blood pressure, sometimes too great a fall in blood pressure can cause dizziness on standing. This can be a problem in the summer months and especially when rising quickly from squatting. Dizziness on standing also can be worse in older patients.

There are a variety of other symptoms that can result from blood pressure medications and if these appear in the days or weeks after treatment has begun you should consult your doctor. However, do not stop medications yourself without medical advice, as sometimes the blood pressure will rebound to very high levels that can be dangerous.

18) Can I measure my own blood pressure?

Yes but it is advisable to use a machine recommended by the British Hypertension Society(BHS).
Seek advise from GP,nurse or pharmacist.
The machines should be calibrated annually.
The following Machines are validated by BHS

Lloyds Pharmacy LBP 1 *(D) £30.00 International Protocol
Lloyds Pharmacy LBPK 1 *(D) £30.00 International Protocol

19) Can your risk of stroke or heart attack be calculated?

During a consultation when recording blood pressure and other details this can be calculated.

This risk calculator uses the Framingham risk equation[1] and the adjustments as suggested by the Joint British Societies’ (JBS2) paper[2] and the JBS Cardiovascular Risk Assessor.[3]
More details are obtainable on http://www.patient.co.uk or ask one of the clinicians when you attend the surgery. Those patients who have a high risk are seen more often and offered support regarding their lifestyle ie. diet, exercise,weight loss,smoking cessation

It is not the only risk calculator in use. In 2010 the National Institute for Health and Clinical Excellence (NICE) decided it could no longer recommend that the Framingham risk equation be used, as it tends to over-estimate risk by approximately 5% in UK men.[4] The decision also coincides with the emergence of the QRISK® calculator which has been shown to predict risk more accurately. The QRISK® calculator is available at http://www.qrisk.org. For further information on QRISK® see our cardiovascular risk assessment article.

20) What is the Government doing to prevent cardiovascular disease at population level?

The Government has addressed and continues to address the risk at both the population and individual level. The Department of Health asked the National Institute for Health and Clinical Excellence (NICE) to produce public health guidance at population level. This involves multiple agencies and is outlined in the public health guidance PH25 publication.
publications.nice.org.uk/prevention-of-cardiovascular-disease-ph25

In summary

Recommendation include the following:-

A) Salt
The Food Standard Agency has made considerable progress in reducing salt in everyday foods and this continues.

B) Saturated fat

The Food Standard Agency, consumers and industry have reduced the population’s intake (halving the average intake from 14% to 6-7% might prevent 30,000 CVD deaths and prevent a corresponding number of new cases of CVD annually. Eg promoting semi-skimmed milk for children aged over 2 years.

C) Trans fat
Industrially-produced Trans fatty acids (IPTFA) constitute a significant health hazard. Those who regularly eat fried fast-food may be consuming a substantially higher amount of IPTFA . In some countries e.g Denmark ,Austria and New York have successfully banned IPTFA.

D) Marketing and promotions aimed at children and young people.
Current advertising restrictions have reduced the number of advertisements for foods high in fat,salt or sugar during TV programmes made for children and young people. This policy will be extended.

E) Commercial interests
Ensure dealings between government , government agencies and the commercial sector are conducted in a transparent manner that supports public health interests and is in line with best practice. ( including full disclosure of interests)

F) Product labeling
Clear labeling describing content of food and drink products helping consumers make an informed choice. Evidence shows that simple traffic light labeling works well.

G) Health impact assessment
Where relevant government departments should assess the impact of policies on the health of the population.

H) Common agricultural policy
Negotiate at EU and national level to ensure CAP takes account of public health issues.

I) Physically active travel
Ensure government funding supports physically active modes of travel (such as walking and cycling)

J) Public sector catering guidelines
To reduce CVD would be to improve nutritional quality of food provided by public sector organisations.

K) Take-always and other food outlets
Empower local planning authorities to restrict planning permission for these (e.g within walking distance of schools)

L) Monitoring
Independent monitoring using a full range of available data is vital when assessing the need for additional measures to address health inequalities. CVD is responsible for around 33% of the observed gap in life expectancy among people living in areas with the worst health and deprivation indicators compared with those living in other parts of England .

Recommendations 13-18 provide for a comprehensive regional and local CVD prevention programme. The aim is to plan, develop and maintain effective programmes.

Recommendations 19-24 expand further on implementing the above and extending it into all public sectors.

SUMMARY

THERE ARE USUALLY NO SYMPTOMS FOR HIGH BP

The risk of stroke is four times greater and the risk of myocardial infarction (a heart attack) two times greater if you have high compared with normal blood pressure. This risk increases the higher the level of a person’s blood pressure.

THE ONLY WAY OF REDUCE THE RISK OF DEATH OR SERIOUS CARDIOVASCULAR DISEASE IS BY FOLLOWING LIFESTYLE ADVISE AND TAKING APPROPRIATE MEDICATION

Hypertension is very common indeed and hence a major public health issue.
The prevalence is expected to increase considerably in the coming years.
In 2000, the estimated number of adults living with high blood pressure globally was 972 million.
This is expected to increase to 1.56 billion by 2025!

Lifestyle factors, such as physical inactivity, a salt-rich diet with high processed and fatty foods, and alcohol and tobacco use, are reasons for this increased disease burden, which is spreading at an alarming rate from developed countries to emerging economies, such as India, China and African countries.

Adequate treatment of high blood pressure lowers this cardiovascular risk towards normal levels.

THE GREATEST PROBLEM FOR CONTROLLING BLOOD PRESSURE IS COMPLIANCE WITH TREATMENT .

Despite very effective and cost-effective treatments, target blood pressure levels are very rarely reached, even in countries where cost of medication is not an issue.

Sadly, many patients still believe that hypertension is a disease that can be ‘cured’, and they stop or reduce medication when their blood pressure levels fall to normal levels.

Despite the availability of effective and safe anti-hypertensive drugs, hypertension and its related risk factors (obesity, high blood lipids, and diabetes mellitus) remain uncontrolled in many patients.

THE RULE OF THE HALVES

Only one half of the patients with high blood pressure in a population have been diagnosed, only half of those detected have been treated, and only half of those treated have been adequately treated to a normal blood pressure.

WHAT CAN YOU DO TO CONTROL BLOOD PRESSURE?
Stop smoking (if applies)
Alcohol & caffeine reduction (if applies)
Low fat diet high in fruit and vegetables nuts whole grains DASH diet
Low salt diet
Lose weight (if applies)
Regular exercise ( at least 20 mins 3 days/week)
Check blood pressure at least every 6 months ( or 5yearly if no problem at present)

WHAT CAN WE DO TO CONTROL BLOOD PRESSURE?
Offer smoking cessation support
Alcohol reduction support
Advise you to attend weight reducing classes or seek advise from nurse
Exercise prescription or discuss with nurse
Check your BP regularly and prescribe medication accordingly.
Check cholesterol, blood sugar and kidney function tests regularly.
Prescribe statins – cholesterol lowering medication .

hypertension 1

Written by Dr Jacqueline Bayer

 
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Posted by on May 17, 2013 in Training and Advice

 

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