RSS

Tag Archives: health benefits

Blogs relating to ways of improving health or concerning health prevention eg immunisation

LIVING WELL – SELF MANAGEMENT PROGRAMME – A PATIENT’S FEEDBACK

image

Dear GP,

I usually write to you to request a prescription. When I have an appointment, I usually talk to you about my ailments – about what is not good. Nowadays that relates to chronic illness.

Today I write to share positive: the privilege of participating in LIVING WELL – the self management programme that aims to help live with long term health conditions – group engagement with individuals who combine together a broad age group with a broad range of illness. I gained from it; I enjoyed it! I use the word enjoy because we shared the experience of illness in the context of our everyday living and although suffering was there, morbidity was nowhere!

Upon first encounter I was amazed to learn that regardless of age and condition, we all shared a similar experience which presents itself in what we have identified as the ‘symptom cycle’, such as the never ending loop of pain, difficult thoughts and emotions, poor sleep, physical limitations …. I gained tools to help manage and ‘break the cycle, to gain more better moments than moments that feel unmanageable. This was nice. Some of the tools are familiar, ones we put to use in our everyday – at work or at home, such as problem solving, decision making, communication (with doctors, for example), however, it became evident to me that we don’t always identify this so we don’t necessarily put our management tools to use in an effective way in the course of an illness in the everyday.

Hey, one doesn’t train to be a patient!

LIVING WELL encapsulates this and in an intense 6 session period, equips us with a toolbox that we can dig into at any given moment. Practice starts together; the work, we each have to continue to apply later. LIVING WELL is a lesson in responsibility and ownership of one’s condition. True, everything is good in ‘class’ and like learning to swim, you might get the moves when you’re in the pool having a lesson but next time you step into the water on your own, you might still feel you are going to drown. I do know it takes time to master tools but I also know that I have been equipped with a framework. I also now know that there is a strength from experiencing a group face to face.

LIVING WELL has enabled me to form a sense of community thanks to caring instructors who themselves experience long term health conditions and have participated in a course prior to becoming the guide. This is also thanks to an amazing group of people who, like me, may have had a sleepless night last night and not because we were out clubbing but because the challenges to go out to ‘a club’ can be immense. ‘Club’ here merely symbolises engaging with life in the everyday. I have learned new strategies that others use on how they may cope with a sleepless night, I hope they have learned something from me. So, we have gained and you do too. As we have learned about responsibility and ownership of how we engage with our long term health conditions,

LIVING WELL demonstrates how we can better engage with our doctors. You have come to know me overtime through my condition. You can understand the importance of this course for me. I strongly hope there will be future opportunities for existing groups to meet again in session for further learning.

But,without patients wanting to participate in the first place there will be no LIVING WELL. I am apprehensive that the course has now ended; someone else might be apprehensive about starting. Can you please continue to promote the LIVING WELL programme in your surgery to your patients, and amongst your colleagues so their patients can ‘LIVE WELL’ too? It has been a privilege,

Sincerely,

Grateful patient

image

 

Advertisements
 
Leave a comment

Posted by on October 20, 2015 in Training and Advice

 

Tags: , , , , ,

MINDFULNESS FOR EVERYONE

Last year I blogged about mindfulness and recommending this has become an integral part of our practice as we constantly see patients faced with the stress of modern living. For those that are not aware of mindfulness, which involves meditation, is defined as:-

 “the intentional, accepting and non-judgemental focus of one’s attention on the emotions, thoughts and sensations occurring in the present moment”.

image

I was asked to proofread an  article written by Charlie Morgan, yogi and yoga teacher who promotes the slogan:-

                               ‘ Your health is your wealth, the rest is a bonus’

The article was to be published in the section on health and happiness on the blog of deliciouslyella the blogger, foodie, yogi, best-selling author, nut butter addict, Telegraph columnist, app creator & avocado enthusiast.

I was delighted to see it appear on her blog for many  people to view and subsequently read the positive comments.

Click on the link below to read the article:-

image                                     Mindfulness

Thank you Ella and Charlie for collaborating to promote mindfulness and help many people understand it’s value in today’s world.

http://www.charliemorganyoga.com

image

 
2 Comments

Posted by on June 12, 2015 in Training and Advice

 

Tags: , , , , , , , ,

OFF TO MARKET – ASPARAGUS AND IT’S VALUE……

Last month I had my usual trip to the Friday market at Brantôme, a small picturesque town in the Perigord , a chance to pick up on the local gossip and see what’s in season.

image

The gossip first; Olivier from Café Co’Thé on ‘Rue Victor Hugo’ was on the French version of Mastermind and he did very well but didn’t get through to the third round. Needless to say his questions were on coffee! There have been a few major changes in that the pharmacist has moved over the bridge and their old shop has been taken over by the cafe owners next to the newsagent on Puy Joli and as they have createneated a large terrace( and who gave permission for that!)  the stall selling greengrocerie has had to move opposite the new cafe as the pitch has been taken over by the terrace. Moreover, the fishmonger’s van has had to relocate up the road on the main bridge! Then a few progress reports of new illnesses and deaths in the past month, what events are coming up such as ‘ the Charente Weavers festival’ in Varaignes, the home of the slipper ( Pantoufle) and what concerts or Art exhibitions are coming up at the Abbey or nearby and not forgetting the progress of the garden and the weather almost all in the same breath! This is what markets are about and happen the World over – it could even  be Saturday morning in West Ealing or chatting on Pitshanger Lane.

Before meeting up for coffee a view around the many stalls containing foodstuffs, mostly locally resourced, homemade wooden items, soaps and jewellry aswell as random Morrocan , Peruvian stalls that find their way to Brantôme. The seasonal item that is most noticeable are  local strawberries including ‘Fraises de Bois’,  strawberries diligently gathered in the wild. Also, as always is the Asparagus which always appears at this time and has a very short season. Their are the familiar green asparagus but more popular in this region is the white or purple Charentais asparagus. Fresh asparagus is usually only available in French markets in May and June and stalls sell out very quickly.  White asparagus is derived from the same varieties as green asparagus, however its growing method separates it from other varieties; while being cultivated, it has never seen the light of day: soil is mounded over the asparagus plants to prevent the sun’s rays from producing chlorophyll as they grow. Hence,it matures without colour, making it the albino version of asparagus. When the slightest sight of a tip protrudes from the earth, the plant is picked.
Ideal White asparagus spears are pearly white, thick and rounded, about 6 to 8 inches in length with Christmas tree shaped crowns. Their flavor is mild, slightly herbaceous, earthy and nutty with notes of artichoke and fresh White corn. I have to say I prefer the green variety.
As it hasn’t received the nutritional elements of light, white asparagus is more brittle than green asparagus and must be used soon after harvest or the spears quickly turn fibrous and bitter, rendering them inedible. White salad asparagus are tender and sweet, and can be eaten raw or cooked. Sauté chopped white asparagus with shrimp or scallops, or cook quickly in brown butter and serve as a side.

An easy way to cook green asparagus is first break the stems where it breaks naturally to get rid of the less tender part then lie them in a pan or tray covered with water, bring the water to the boil and then turn the heat off and leave for 5 mins. Serve with butter or Hollandaise sauce on their own or an accompaniment with poached salmon.

image

The same evening we went to the local restaurant for supper and we were interested to note that our amuse-bouche ( pre-meal taster) was garnished with wild asparagus which was foraged in the local vicinity. I managed to discover the source in the next village and imagined Primitive Man ( a known resident of the Dronne valley) probably fed on this delicacy.

image

The Egyptians, Greeks and Romans valued asparagus for its medicinal value in addition to enjoying it as a food. The second century physician Galen attributed cleansing and healing properties to asparagus.

Asparagus can neutralize ammonia, protect small blood vessels, act as a diuretic… plus its fiber is a natural laxative.

Modern studies show the ancients were right to place high value on asparagus. By eating only a few calories you benefit from many nutrients.

It’s loaded with nutrients: Asparagus is a very good source of  fibre, folate, vitamins A, C, E and K, as well as chromium, a trace mineral that enhances the ability of insulin to transport glucose from the bloodstream into cells.
This herbaceous plant—along with avocado, kale and Brussels sprouts is a particularly rich source of glutathione, a detoxifying compound that helps break down carcinogens and other harmful compounds like free radicals.

This is why eating asparagus may help protect against and fight certain forms of cancer, such as bone, breast, colon, larynx and lung cancers.
Asparagus is packed with antioxidants, ranking among the top fruits and vegetables for its ability to neutralize cell-damaging free radicals. This, according to preliminary research, may help slow the aging process.

The asparagus tuber is used in Chinese medicine, known as Tian Men Dong and tonifies the Yin especially the lung and kidney Yin which are affected in debilitating illnesses such as cancer.

This is an an important ingredient of the formula Káng Ái Fāng (C82) which when I have noticed when  administered with Western medicine: the patients seem to respond better and become less debilitated and recover from the ill effects quicker. Most oncologists are not averse to supporting the use of this medication.

image     image

Lung Yin deficiency manifests itself by  a dry cough, loss of voice, thirst, dry throat, dry skin, sometimes spitting up thick sputum.  When advanced, can become Lung Consumption: chronic cough, low-grade afternoon fever, nightsweat, hemoptysis, thin, rapid pulse.

The kidney Yin deficiency occurs in most debilitating chronic illnesses and in Chinese medicine is considered part of the ageing process. It is manifest by symptoms such as dizziness, tinnitus, weak lower back and legs, warm palms and soles, afternoon low-grade fever, diminished sexual function, scanty and dark urine, red-dry tongue, thin pulse without strength.  Kidney yin fails to nourish Liver yin, which can lead to Kidney+Liver yin Deficiency.

In Chinese Medicine the relationship between the Liver and the Kidneys is of considerable clinical significance as it is based on the mutual exchange between blood and essence and is particularly important in gynaecology. Essence ( oversimplified) is a term in Chinese medicine to describe vital substances which are inherited and acquired and determines our basic constitutional strength and resistance to exterior pathogens. When the Essence is deficient it affects growth, development,  fertility and our ability to fight disease of body and mind.

I find that TCM for me gives some explanation to the mysteries of medicine, chronic illnesses and ageing and why we eat certain foods and understanding more about asparagus is a good example of that!

 
 

Tags: , , , , , , ,

GARDENS OPEN/ JARDINS OUVERTS AND DISTRICT NURSESf

I have made it quite apparent that not only do I enjoy gardening but I am advocating it as an important health benefit both physically and mentally. Many people are not fortunate to have a garden and don’t even have a balcony or chance to grow plants. However, during these summer months there is a chance to be able to not only visit public gardens but also private gardens which open for public viewing and at the same time raise money for a selection of important charities.

I have been aware of The National Gardens Scheme in Britain for many years and enjoyed visiting many private gardens with the  help of ‘The Yellow Book’ which has made its appearance in my home from time to time and contains when and where these gardens are open and is available to purchase from ‘Smiths’ bookshop of you can refer to the website

http://www.ngs.org.uk/gardens/county-pages/London-County-Profile.aspx)

image

You may be wondering what this all has to do with District nurses now often named community nurses. Before I reveal that, I must digress to declare my admiration for these nurses who have to be resourceful, broadminded, diplomatic and adaptable to any situation.  They have certainly made a significant  impact on my career as a GP.  It was district nurses in my early career as a GP who enlightened me into the necessity  of holistic care of an ill person at home.

To give just one example, I remember not long after I started at the practice in Ealing being called to see a patient, Tom who was a middle aged man, formerly a ballet dancer. When I arrived the door was ajar and as I tentatively opened the door I was greeted by a swarm of flies and an intense stench of faeces. I called out to give me an idea of where I was to go and Tom summoned me to a large room at the end of the hallway. He was lying semi-naked propped up in a bed covered in newspapers  to absorb his double incontinence and was struggling to eat his meals on wheels accompanied by a can of Lager and joined by a couple of friends . He was in good spirits, somewhat confused as he was suffering Korsakov Syndrome an infliction secondary to long term alcohol abuse and although he did not warrant an acute hospital  admission, clearly he needed sorting out. Following my visit I contacted the district nurses and within 24hrs when I revisited Tom, I arrived at a flat now smelling sweet and a clean,tidy, almost unrecognisable patient sitting in a chair by the bed eating his dinner, listening to some music. The ‘fairies’ had visited and had transformed the scene in a most remarkable way – the district nurses had managed the situation.

It was the National Garden Scheme, which was founded  in 1927 in order to raise money for a national voluntary organisation which would recruit, train, and support  ‘District’ nurses, who would nurse patients in their  homes in deprived areas throughout the country.

The idea of District  nurses had originated in 1859 when William Rathbone, a Liverpool merchant, employed a nurse to care for his wife at home. After his wife’s death, Rathbone kept the nurse on to help poor people in the neighbourhood. Later, Rathbone raised funds for the recruitment, training and employment of nurses to go into the deprived areas of the city. Based on this idea in the latter half of the 19th century ‘District’ nursing spread throughout the country and became  a national voluntary organisation supported by Queen Victoria and Florence Nightingale.

In 1926 the organisation decided to raise a special fund in memory of their patron, Queen Alexandra, who had recently died. For much of the 20th Century, district nurses were usually unmarried women who lived in nurses’ homes provided by local nursing associations all over the country.The fund would pay for training and would also support nurses who were retiring. The Institute became known as ‘The Queen’s Institute of District Nursing and  trained district nurses until the 1960s, in a model that was copied across the world. This model of care was instrumental in developing a comprehensive, highly-skilled service in the UK that meets the needs of millions of people every year.

image

In 1926 a council member, Miss Elsie Wagg, came up with the idea of raising money for charity through the nation’s obsession with gardening, by asking people to open their gardens to visitors and charging a modest entry fee that would be donated. The following year The National Gardens Scheme was founded. Individuals were asked to open up their gardens for ‘a shilling a head’. In the first year 609 gardens raised over £8,000. A year later, the district nursing organisation became officially named  The Queen’s Nursing Institute.

Subsequently, a few years later Countrylife produced the ‘ Yellow Book’ and there were 1,000 gardens listed.

After the Second World War, the National Health Service took on the District Nursing Service, but money was still needed to care for retired nurses and invest in training. The National Gardens Scheme offered to donate funding to the National Trust to restore and preserve important gardens. In return, the National Trust opened many of its most prestigious gardens for the NGS.

The NGS , although it no longer funds District Nurses per se it now acts as a beneficiary for Macmillan Cancer Support, Marie Curie Cancer Care, Help the Hospices and (now Carers Trust) and also benefits a different annual ‘guest’ charity chosen from recommendations from NGS volunteers.

Since its foundation, the National Gardens Scheme has donated over £45 million to its beneficiary charities, of which nearly £23 million has been donated within the last ten years. The National Gardens Scheme’s commitment to nursing and caring remains constant, and the charity continues to grow and flourish.

Jardins Ouverts 

When I arrived this year in France I was intrigued to hear that the scheme had arrived in this Country starting with 4 gardens in one Departement 3 years ago and is expanding fast by 100 gardens each year. Some enterprising English migrants had decided to start the Jardins Ouverts scheme along similar lines to the NGS. An ex-nurse friend and another friend as well as other people in the area had decided to open their gardens this year and introduce the French in the Perigord to the idea of opening your own garden to raise money for charity.

The chosen charity for Jardins Ouverts for 2015 is:-

À Chacun son Everest is a French charity, founded by Dr Christine Janin, the first French woman to summit Everest.

image

  • It recognises the similarity between the supreme test of climbing the world’s highest mountain and the challenge facing young people with cancer or leukaemia:
  • the sense of achievement when the goal has been reached;
  • the confidence that this brings;
  • the opportunity to share their hopes and fears with children in a similar situation
  • the realisation of innate personal qualities such as courage, will-power, hope and determination.

They decided to support A Chacun son Everest for several reasons: there can be few things worse for a child and his/her family than to be told that s/he has cancer or leukaemia. They were also impressed by their very personal responses to their enquiries and ware now building a very positive relationship with this organisation.

We set off on one of those days which looked totally unpredictable – the sort of day that you wear a sun hat with a raincoat . I used to be amused by one of my patients who would come to surgery dressed like this – I now understand why. The blue sky made a  perfect back cloth  to the  soft white fluffy cotton wool clouds creeping high above with the occasional ones showing a tinge grey potentially threatening to open up to rain. In good determined British style,  whatever the weather we were to proceed not to let our friends down and with grim resolve to enjoy the day. We drove through the beautiful Dordogne countryside past woodland glades causing  the sunlight to dazzle and dance and fields bursting with seedlings teasing the eye  by not revealing whether they would become sunflowers or maize; the fields frequently punctuated with majestic walnut trees either in rows or alone registering their supremecy in this countryside. Moreover, along the roadside there was a plethora of wild flowers, Queen Ann’s lace, wild sage, Ox-eye daisies,  greater and lesser stitch work, campions and  outcrops of wild orchids just to name a few. We didn’t need to go to a Jardins Ouverts we were admiring the country garden just by venturing into this wide open space.

We arrived at the entrance of the first garden labelled accordingly by a sign showing the way and drove up a track for almost 1 km through a wooded area until the house and garden were revealed. The man at the desk took our money 5€ for both gardens  and a plant stall selling donated plants and then pointed us in the right direction. By now the sun was shining brilliantly enough to make us feel happy enough to leave our wet weather attire in the car. We strolled around the garden admiring the clematis concealing old sheds and aged trees, hostas, roses, foxgloves, violas, budding peonies and countless familiar shrubs and perennials all had been tended carefully and prepared for this event.

image
image

It would not be complete without the inevitable chat with fellow visitors over a cup of tea and cake served by the fascinated French children, who had come along to witness this interesting event.

We then left and after a short drive appeared at our next destination, an old presbytery where the garden had been revived including the nurturing of a herb garden,

image

There was an aged Medlar tree, which bears the fruit that is eaten just before it  becomes rotten, bletted and is frequently mentioned by Shakespeare and Chaucer when they write about unfaithful women.
The house was in the shadow of the Church and there was an ancient well which was adorned by roses and irises in full bloom.

image

Moreover,  hidden away an array of various chickens and bantams all individually named strutting around there territory clearly dominated by the new arrival ‘Lady Gaga’

In the ponds, more recently created goldfish  darted” under the Lily pads and the perfect water lily flowers were resplendent as the water sparkled  in the sun as the water glistened as the surrounding shrubs and flowers swayed gently in the soft warm breeze.

image

image

My friend had jested the night before that she had sent her husband around with a pair of scissors to deadhead some of the flowers and trim any unwanted buttercups which were found peeping amongst the perennials – he had certainly done a good job. Chelsea Flower Show had arrived in the Dordogne! After another chat with visitors French and English, a cup of tea  under the lime tree and a purchase at the pop up jams and chutney stall  we drove back with a clearer blue sky along twisting country roads past the tapestry of the glorious Dordogne countryside.

We arrived home refreshed, inspired with fresh eggs and homemade spicy mango chutney and having had a delightful day out . These gardens had been revived and  nurtured by people who had seen adversity in their lives but had pluckily exercised their energies into something,  which not only can they be proud of but have shown the generosity of spirit to share with others and raise money for a worthy cause.

I wanted to share this experience  As may be someone reading this might be inspired to share their garden and raise money for these worthwhile caring charities  as well as share their garden or allotment  with others who don’t have one of their own.

If you are in France this summer there may be a ‘Jardins Ouverts’ near where you are going : to find out view

The website  http://www.opengardens.eu

When I referred to the NGS website( http://www.ngs.org.uk/gardens/county-pages/London-County-Profile.aspx) there is a garden open in Hanwell this weekend so perhaps you can visit this newly joined garden to be inspired and support Tony and Eddy. Details below:-

image

 
2 Comments

Posted by on May 18, 2015 in Training and Advice

 

Tags: , , , , , , ,

SING – A – LONG TO IMPROVE YOUR LUNG CAPACITY AND PARKINSON’S DISEASE

image

We have all been introduced to singing since we were born and most parents we will be delighted when they hear their child sing a familiar song for the first time and leap to record the moment. It is just as delightful when you hear your grandchild sing and singing to your grandchild even if your singing voice is limited is always appreciated and met with the  words ‘again, again’ !

As a schoolgirl  I associated  singing with warbling, middle aged women with blue rinses and clearly remember having learn to sing ‘Blow the wind Southerly’ by Kathleen Ferrier as an 8 year old !  I was in the school choir because I liked singing not because I had any musical talent!  Then there was the evolution of pop music And musical shows and then the doors opened wide and  singing for pleasure in the home took on a new light. After all I followed the generation where families used to sing around the piano at home but now it was singing with the radio or TV.

My children have known pop music since an early age and sing-a-longs with the radio on the school run were an important start to the day,  amusing many a commuter as they sidled up alongside us on the Great West Road. Now there are an overwhelming number of genres of music,  which has led to a wider range of choirs than ever before – gospel, rock, church, barbershop, beatbox  to name a few. You can find choirs who do popular chart hits arranged for choir, songs from the shows, or traditional folk music so that singing in choirs has become more popular.

In previous blogs I have alluded to the benefits of singing for patients with dementia and  the feel-good effects of singing in helping in depression. However, experts now believe that joining a choir could improve the symptoms of a range of health problems including Parkinson’s, depression and lung disease.

At a conference of the Royal Society for Public Health, Grenville Hancox, professor of music at The Sidney De Haan Research Centre for Arts and Health, Canterbury, described the changes that can take place through singing together as “extraordinary”.
He told how he and colleagues have witnessed people with respiratory problems learning to breathe more easily, those with depression beating the blues and patients with Parkinson’s disease standing tall and singing loudly.
Prof Hancox is the founder of Skylarks, a new choir for people with Parkinson’s. This disorder of the central nervous system makes normal movements difficult and weakens the voice as the muscles in the face and vocal chords deteriorate. Prof Hancox and his colleague Stephen Clift, the centre’s professor of health education, are undertaking research to find out if choral singing can help with Parkinson’s symptoms, especially those affecting the voice, with choir members undergoing computer-assisted acoustical voice analysis at the start and finish of the study.

image

Ian MacDonald, voice specialist with the British Association for Performing Arts Medicine, reported to have said that it is logical that singing can help in this way. “The vocal cords are muscles,” he says. “By exercising them, you increase tone and restrict tremor, and the voice is less jittery. Singing warms the muscles up – just as athletes warm up theirs.” Being required to stand tall when performing may also improve core strength and benefit these patients.

As Professor Hancox and his colleagues have claimed they have witnessed people with COPD , a debilitating respiratory disease  learn to breathe more easily.  Around the world an estimated 64 million people are struggling to breathe on a daily basis.  The World Health Organization expects COPD to be the third leading cause  could potentially help so many people 

Sonia Page, the specialist respiratory nurse who is leading the current Singing for Breathing choir at the Royal Brompton Hospital, London says it has helped people with COPD “gain greater control of their breathlessness instead of being at the mercy of it.”

Patients have also reported improved respiratory stamina, reduced impact of chest infections and improvements in sleep apnoea (a condition that causes interrupted breathing during sleep). Dr Nicholas Hopkinson, a consultant chest physician at the Royal Brompton Hospital in London, notes that singing cannot reverse the lung damage caused by COPD, but it can still be of benefit.
COPD patients have difficulty emptying the air from their lungs (known as gas trapping), he says, which is why they suffer from shortness of breath – a problem made worse if they panic and start to hyperventilate.
“Singing may help these patients to improve their posture and learn techniques to help control their breathing. In particular, by breathing out more slowly they give their lungs more time to empty, reducing gas trapping,” says Dr Hopkinson.

image
The free weekly singing classes held at both Royal Brompton and Harefield hospitals are open to all respiratory  at Royal Brompton & Harefield NHS Foundation Trust to help them relax and learn new breathing techniques.

The sessions are organised by the arts team at the hospital and are funded by charitable donations. The course leaders hope to enhance existing support for respiratory patients with an enjoyable, informal exercise, that teaches a better understanding of breath control through the use of the voice.
Two of the longest-standing members of the singing groups are Harold Dearing, who has asthma and has had several operations on his heart, and John Turner who has COPD. John has been coming once a week to the Brompton Hospital since 2010 and is passionate about the benefits of singing.
“It helps us feel much, much better. Although singing therapy can’t cure the lung damage caused by acute respiratory conditions such as COPD, the combination of breathing exercises and song can help people with breathing difficulties cope better with their disability.”
“Doing everyday ordinary activities becomes increasingly difficult for people with lung problems,” says John. “I find singing gets your lungs working better, you get out of the house, you meet people and you become a social animal again.”
“Way back in 2002 when I was diagnosed with emphysema, it was suggested I would soon need oxygen. Well I haven’t yet needed it and I think this is very largely due to singing.”
Singing to build confidence
Harold Dearing has been with a singing group for three years. As a teenager, he’d sung in a choir, so when he saw the Harefield course advertised he decided to give it a go.
“Every time I go it’s beneficial. I enjoy the exercises, but it’s especially nice to be together singing. It’s confidence-building. The teachers make it fun and make sure you’re in your comfort zone.”

Angela Reith, a music therapist who runs the sessions at the Harefield hospital says she sees several benefits.
“Some find that by the end of the session they breathe more easily. Others benefit especially on a social level. They have a good time and if you’re happy with yourself you can cope better with your condition,” says Angela.
Singing’s feel-good factor
Joanna Foster who runs the sessions at Royal Brompton agrees about the feel-good factor of singing in a group. “Singing together is not just exercises. It’s fun and it releases endorphins.”
Each of the sessions involves breathing exercises and singing. Starting with gentle upper body stretches, the group then practice making different sounds as they exhale such as sighs and fake laughter.
“It’s the same techniques that actors and professional singers use to warm up their voices and overcome nerves,” says Joanna.
This then leads into singing whole songs, learning them in chunks and eventually – depending on the size of the group – singing rounds and harmonies.
A survey of 500 patients taking part in the singing workshops at Royal Brompton and Harefield found that 70% felt markedly physically better after the workshops.

Joining a choir is by no means a conventional solution for such a serious illness.

The research team from Canterbury Christ Church University in Kent felt they had good reason to investigate the effects  on COPD and singing and showed that the benefits are real. Dr Ian Morrison, a senior research fellow and one of the project’s authors, said: “Lung function improved dramatically, particularly after about five months, once people had got used to what they were doing and changed their breathing habits.

It has been observed that people with breathing problems tend to develop a lot of anxiety about the very process of inhaling.  The tendency is to do ‘gaspy’ breathing so they’re taking short little breaths. This actually fills up the lungs without clearing them, making it even more difficult to breathe. Due to their obstructed airways, many people with COPD already find emptying their lungs a challenge.Gasping makes the problem worse and can, in the most serious cases, lead to a build-up of carbon dioxide in the blood, which can result in respiratory failure.

In contrast, the techniques used in singing encourage people to breathe in a much deeper, more controlled manner.The whole musculature around the lungs, throat and the upper chest improve with time,” says Dr Morrison. They use what they have much better and you really see a difference in the skill of actually breathing.”

To test its effects, Morrison and his colleagues asked over 100 COPD patients – ranging from mild to severely affected – to attend weekly singing sessions over a 12-month period.They measured their lung capacity with a device known as a spirometer – which looks a bit like a giant breathalyser – and asked participants to fill in a questionnaire to find out on a qualitative level how they were feeling. One of the tests involved measuring how much air a person could force out in a rapid puff. ( Peak Flow Meter)

image

On average the people in our study had 50% of expected lung function,” said Prof Stephen Clift, the study’s lead author. “That means about 1.5 litres of air in a one second puff. For healthy lungs, we would expect something more like 3 litres.” Without treatment, people with COPD can expect to see the size of their puff decrease by around 40ml a year.The very best the team had hoped for was that after singing regularly for one year, the size of that puff would stay the same.

Instead we got an increase of 30ml,” says Prof Clift.

“Although the changes are small, the progressive nature of COPD means that any loss of function year-on-year is going to be more significant for them.

“In our study, we not only appeared to halt the decline but people showed a small improvement.”

Dr Morrison added: “There’s also the social and psychological side, because any long term condition is isolating.

A recent Swedish study published in the journal Integrative Physiological and Behavioural Science suggested that it not only increases oxygen levels in the blood but triggers the release of “happy” hormones such as oxytocin, which is thought to help lower stress levels and blood pressure.

Singing has all the benefits mentioned so far and can also be very helpful in improving speech which has become slurred and unclear as a result of Parkinson’s. These same breathing exercises can prevent decline and marginally improve lung function in serious lung disease.

Breathing exercises and vocal techniques used when singing can help with:

  • sustaining the voice
  • increasing and controlling volume
  • varying pitch and expression
  • improving diction
  • controlling vocal speed
  • increasing the fluidity of diction
  • improving Posture

Not surprisingly there are a growing number of informal singing groups for people with Parkinson’s or other illnesses, such as Alzheimer’s. The opportunity to work on vocal and breathing techniques in an informal setting with people who share similar difficulties can be a valuable social activity and can help with self-confidence and overcoming Depression. And you don’t generally need to be able to sing to participate because such groups are not usually choirs and most do not give performances.

Typical singing activities which can help with improving posture, breath work and diction include:

  • taking your voice ‘for a walk’ up and down in pitch
  • lifting the tongue to the roof of the mouth
  • practicing trills (rapid alternation between two adjacent notes of a scale) with lip and tongue
  • making different types of sighs
  • humming
  • echoing tunes
  • singing in rounds (one voice starts and others join in one after another until all are singing different parts of the same song at the same time)
  • experimenting with a variety of pitch, pace and mood in songs.

Singing techniques have also been used to aid fluidity of speech and combat stuttering: Melodic Intonation Therapy (MIT) uses song phrases to retrieve speech when this has been lost or weakened. Group singing can give a social outlet and boost self-confidence in people who tend to withdraw socially due to slurred speech and weakening articulation

Prof Clift and Prof Hancox believe the health benefits of belonging to a choir, for some chronic conditions will become indisputable. “There are examples of arts on prescription and gym on prescription,” argues Prof Hancox. “How about singing on prescription, too?”

If after reading this you want to have singing lessons or join a choir try your local church, community centre or school. I have listed some ideas below of various choirs in and around Ealing.

image

Ealing Choral Society,

This is one of London’s best choirs: they are an amateur choir, performing with world-class orchestras and soloists in Ealing, as well as Central London and occasionally abroad.

http://ealingchoralsociety.org

image

Questors Theatre Choir

imageAnd for more information about joining, read the Why not sing with us? section.

Contact us here or phone 020 8816 7734 / 07802 720333

We are a 60-strong mixed voice choir based in West London, England, and affiliated to Questors Theatre.

http://www.questorschoir.org.uk

image

Ealing Common Choir

imageThis was formerly Ealing Common Choir. Singers are welcome and ideally  can read music and sight-read a simple line. You’ve probably sung on and off all your life. Contact us or just come along to a rehearsal on a Thursdays at St Matthews Church, Ealing Common. Further details:-

http://www.smce.org.uk

image

Gospel choir/Singology

image

Singology is a vocal coaching company setup by Mark De-Lisser in 2000 to provide singing opportunities and tuition to people of all ages. With a strong tradition of choral singing, Singology has now launched ‘Singology Choirs’ to encourage more and more people to get involved in community singing, which has been proven to increase confidence, social cohesion and can also be used as a diversionary activity for young people in the community.

Monday Ealing 7:30pm – 9:30pm Ealing Town Hall, W5 2BY 12th Jan – 23rd Mar

http://www.gumtree.com/p/classes/new-intake-of-singers-for-singology-pop-gospel-choir-in-ealing/1007900384

http://www.singology.com

Singology choirs throughout London are joining together to sing at the Royal Festival Hall.

image

The Ealing Rock Choir

image             Grange Primary School,
Church Gardens, Ealing, London, W5 4HN

The Ealing Rock Choir is led by singer/pianist Christina Clark. We have a great year lined up and we would like to invite you to join our choir and take part in the local Ealing and wider London community. We are the Ealing rehearsal of the trailblazing Rock Choir. We often team up with the other local London choirs to perform in much bigger choral groups. These inspirational moments are unique to the Rock Choir experience. It’s unbelievable and you can still join the choir. Just like a gym class or amateur dramatic society, your Rock Choir rehearsal provides an escape from everyday life. One evening a week during term time, your time is completely your own, to do nothing but sing your heart out with friends whilst enjoying our trailblazing formula of fun, friendship and feel-good music. Book a FREE singing taster session at the Ealing Rock Choir and see for yourself!

There’s no pressure to perform if you don’t want to – it’s all about having fun and enjoying some well-deserved ‘me time’. – See more at: http://www.rockchoir.com

The Ealing Rock Choir singing at the Minack theatre, Cornwall. This is a fascinating outdoor theatre with an intriguing story.

http://www.minack.mobi

image

Addison Singers

imageThe Addison Singers comprises two classical choirs – an auditioned Chamber Choir and larger non-auditioned Oratorio Choir; and two jazz choirs – an auditioned Jazz Ensemble and a larger non-auditioned all-female Jazz Choir. It also offers three different singing classes to meet the needs of beginners, intermediate and the more competent, experienced singer.

http://www.addison-singers.org.uk/about-us/who-are-the-addison-singers

image

Or if or if all else fails try some Kareoke or sing- a – long with the TV or radio

image

 
Leave a comment

Posted by on February 8, 2015 in Training and Advice

 

Tags: , , , , , , , , , , , , , , , , , ,

WATCH OUT – PATIENTS BEING FINED FOR OUT OF DATE EXEMPTION CERTIFICATES!

Watch outDuring the last week I have been aware of 4 patients who have been sent fines for out of date prescription exemption certificates

If you suffer from one of the specified medical conditions you are eligible to hold a valid medical exemption certificate.

image

Medical exemption certificates are issued on application to people who have:

  • a permanent fistula (for example caecostomy, colostomy, laryngostomy or ileostomy) requiring continuous surgical dressing or requiring an appliance

  • a form of hypoadrenalism (for example Addison’s disease) for which specific substitution therapy is essential

  • diabetes insipidus or other forms of hypopituitarism

  • diabetes mellitus, except where treatment is by diet alone

  • hypoparathyroidism

  • myasthenia gravis

  • myxoedema (that is, hypothyroidism requiring thyroid hormone replacement)

  • epilepsy requiring continuous anticonvulsive therapy

  • a continuing physical disability which means the person cannot go out without the help of another person.

    (Temporary disabilities do not count even if they last for several months)

  • Or are undergoing treatment for cancer:
    including the effects of cancer, 
    or the effects of current or previous cancer treatment.

    Prescription

    When you visit the pharmacist it is important you show the certificate   when handing in the prescription. The pharmacist wil then indicate in the appropriate place that they have seen the certificate. If this box is not completed there is strong possibility that the business prescribing authorities will check their records and if the certificate is out of date you will be issued a fine.

    The letters I have seen show the fine is £50 for not possessing an up to date certificate.

    This can be appealed and may be waived if you are receiving income support. 

    How to apply for a medical exemption certificate

To apply for a medical exemption certificate ask your doctor for an FP92A form. Your GP, hospital or service doctor will sign the form to confirm that your statement is correct. You will also be given a pre-paid envelope. At your GP’s discretion, a member of the practice who has access to your medical records can also sign the form.

Your certificate will be valid from one month before the date that the NHS Business Authrority receives the application form.

The MedEx lasts for five years and then needs to be renewed. You may receive a reminder that your certificate needs to be renewed. If you don’t receive a reminder, it is your responsibility to ensure that it is renewed.

The certificate covers all prescription charges. Further details can be obtained from the following website:-

http://www.nhsbsa.nhs.uk/HealthCosts/1126.aspx

if you want more information about prescription costs including pre-payment certificates if is available on the following website:-

http://www.nhs.uk/nhsengland/healthcosts/pages/prescriptioncosts.aspx

 
Leave a comment

Posted by on February 7, 2015 in Training and Advice

 

Tags: , , , , , , , ,

WHAT MEDICAL STUDENTS CAN TEACH US – HAND HYGEINE

This week I had an email from one of 3rd year medical students requesting topics that her student and her partner would like to concentrate on during the next teaching session. I was a bit surprised when she requested this but apparently she had failed this in a previous examination.

Handwashing
The main medical purpose of washing hands is to cleanse the hands of pathogens (including bacteria or viruses) and chemicals which can cause personal harm or disease. As a general rule, handwashing protects people ill or not at all from droplet and airborne diseases, such as measles, chickenpox, influenza, and tuberculosis. It protects best against diseases transmitted through fecal-oral routes (such as many forms of diarrhoea and vomiting) and direct physical contact (such as impetigo). When visiting hospitals there is also the need to wash hands is to prevent the spread of the ‘super bug’ MRSA and Clostridium Difficile a bacteria responsible for severe diarrhoea which is life threatening particularly in the elderly.

“It is well documented that one of the most important measures for preventing the spread of infectious disease is effective hand washing.”

Handwashing
With the students I then went through the procedure very carefully as it has been established that doctors are probably culpable for the spread of infection in hospitals. We certainly were not taught hand washing formally let alone as part of our examinations and it is only in recent years probably since the swine flu epidemic has there been the stress on prevention of the spread of infection and emphasis of handwashing and using hand rub.

Hand-washing:
• Use warm running water
• Wet the hands before applying soap
• Ensure you create a good lather
• Follow the correct hand washing technique to ensure all areas are covered as shown below.
• Hand washing should take at least 15 seconds, but no longer than 3 minutesAll hand basins in surgeries and hospitals have instructions of how to wash hands correctly as below.
• Rinse well with the hands uppermost so that the water runs off the elbow
• Use a ‘hands-free’ (e.g. elbows) technique to turn off taps. Where ‘hands free’ tap
systems are not in place, dry the hands first with paper towels and use these to turn off
the taps
• Dry each part of the hands properly and dispose of paper towels in the appropriate waste
bin without re-contaminating your hands (e.g. use the foot pedal). Do not touch the bin lids

Drying
Effective drying of the hands is an essential part of the hand hygiene process, but there is some debate over the most effective form of drying in washrooms. A growing volume of research suggests paper towels are much more hygienic than the electric hand dryers found in many washrooms.

hand washing

Removal of microorganisms from skin is enhanced by the addition of soaps or detergents to water.The main action of soaps and detergents is to reduce barriers to solution, and increase solubility. Water is an inefficient skin cleanser because fats and proteins, which are components of organic soil, are not readily dissolved in water. Cleansing is, however, aided by a reasonable flow of water.

Water temperature
Hot water that is comfortable for washing hands is not hot enough to kill bacteria. Bacteria grows much faster at body temperature (37 C). However, warm, soapy water is more effective than cold, soapy water at removing the natural oils on your hands which hold soils and bacteria. Contrary to popular belief however, scientific studies have shown that using warm water has no effect on reducing the microbial load on hands.

Solid soap
Solid soap, because of its reusable nature, may hold bacteria acquired from previous uses. Yet, it is unlikely that any bacteria are transferred to users of the soap, as the bacteria are rinsed off with the foam.

Antibacterial soap
Antibacterial soaps have been heavily promoted to a health-conscious public. To date, there is no evidence that using recommended antiseptics or disinfectants selects for antibiotic-resistant organisms in nature. However, antibacterial soaps contain common antibacterial agents such as Triclosan, which has an extensive list of resistant strains of organisms. So, even if antibiotic resistant strains aren’t selected for by antibacterial soaps, they might not be as effective as they are marketed to be.

Besides this on entering a hospital and individual wards and now in GP surgeries there are facilities to use hand antiseptic and this also must be carried out on entry.

Hand antiseptic
A hand sanitizer or hand antiseptic is a non-water-based hand hygiene agent. In the late 1990s and early part of the 21st century, alcohol rub non-water-based hand hygiene agents (also known as alcohol-based hand rubs, antiseptic hand rubs, or hand sanitizers) began to gain popularity.
Handwashing

Most are based on isopropyl alcohol or ethanol formulated together with a thickening agent such as Carbomer into a gel, or a humectant such as glycerin into a liquid, or foam for ease of use and to decrease the drying effect of the alcohol.

Hand sanitizers containing a minimum of 60 to 95% alcohol are efficient germ killers. Alcohol rub sanitizers kill bacteria, multi-drug resistant bacteria (MRSA and VRE), tuberculosis, and some viruses (including HIV, herpes, RSV, rhinovirus, vaccinia, influenza,and hepatitis) and fungus. Alcohol rub sanitizers containing 70% alcohol kill 99.97% of the bacteria on hands 30 seconds after application and 99.99% to 99.999% of the bacteria on hands 1 minute after application.
Handwashing

Hand sanitizers are most effective against bacteria and less effective against some viruses. Alcohol-based hand sanitizers are almost entirely ineffective against norovirus or Norwalk type viruses, the most common cause of contagious gastroenteritis.
Handwashing

 
 

Tags: , , , , , , ,

FINDING PEACE WITH YOGA

This week my attention was drawn to an article on bbc.com about the increase of Yoga in Sierra Leone. I had been aware of this country with long, atrocious civil war between 1991 and 2002 and a country with one of the worst records of human rights this was not the place I thought this would be happening.
Yoga
I recalled years ago one of the patient’s, a Head-teacher coming into surgery having had a difficult Ofsted inspection – not an unusual when trying to manage a multicultural, challenging school in London. She certainly wasn’t the first and won’t be the last. I particularly remember her talking about a group of new children that had entered the school: they were children that had come from Sierra Leone and had been used as child soldiers. For her it finding a way to integrate them into the school was in itself a challenge as for these 8-9 year olds who had had no childhood all they knew was war and fighting. They had been deprived of a childhood and found it difficult to just play and have fun in a childlike way.
Despite peace the aftermath of this wretched war has left indelible scars and the World Health Organisation estimate that about one sixth of the almost 6 million population have mental disorders. Albeit, they only have one psychiatrist and care of these people is poor.

Tamba Fayia taking a yoga class

Tamba Fayia taking a yoga class

Tamba Fayia, once a child soldier in Sierra Leone’s civil war, who in 2012 became the country’s first qualified yoga teacher says yoga transformed his life. He set up Yoga Strength which focuses on taking yoga to the people that need it. “I work on the streets, in the slums, in the schools” says Mr Fayia. He has even held a class on a remote river island in the jungle.
He teaches at Sierra Leone’s only mental hospital in the east of Freetown, and therapists say the classes have led to clear psychological improvements in some patients. “It makes me feel light,” one patient said
He teaches at Sierra Leone’s only mental hospital in the east of Freetown, and therapists say the classes have led to clear psychological improvements in some patients. “It makes me feel light,” said one patient.
http://www.bbc.com/news/world-africa-27704543

 
 

Tags: , , , ,

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

 
 

Tags: , , , , , , , , ,

COULD CAMELLIA BE YOUR CUP OF TEA?

It took me many years to appreciate the connection between Camellias and tea.

Tea

When my children were small an ideal afternoon trip was to the Isabella Plantation in Richmond Park. It also impressed my mother-in-law even if she considered me an irresponsible mother as three,explorative dear little children ran up the tiny streams in their Wellington boots, played hide and seek under bushes, climbed precariously on cut down trees and expended enough energy to be awarded with an ice-cream that I think grandma was more grateful for than them. Visits can be all the year around in fact as soon as the snowdrops appear, a welcome assurance that the brighter days of spring are on their way. Camellias, magnolias, as well as daffodils and bluebells are soon to follow.
Bluebells

From late April, the mind blowing beautiful display azaleas and rhododendrons storm into flower reaching their peak in May.
Azaleas
– See more at: http://www.royalparks.org.uk/parks/richmond-park/richmond-park-attractions/isabella-plantation#sthash.XSIa3H8A.dpuf

Strangely it was the dramatic colourful splendour of azaleas and rhododendrons that drew my attention to the Camellias as they heralded the onset of this display.
I was soon to learn that the first recorded camellia in this country was grown by Lord Petre at Thorndon Hall in Essex in the 1730s, and we know it was thriving and flowering by 1745.
The first named varieties to attract public interest were C. japonica ‘Alba Plena’ and ‘Variegata’, both of which were brought to England in 1792 on an East India Company ship.
Although many gardens planted Camellias it was probably not until the 1990’s that they were planted in Richmond Park.

Many years later I was fortunate enough to take a Medical trip to Kerala,South India not only to have lectures in Western Medicine but also Ayurvedic medicine (also called Ayurveda) which is one of the world’s oldest medical systems. It originated in India more than 3,000 years ago and remains one of the country’s traditional health care systems. Its concepts about health and disease promote the use of herbal compounds, special diets, and other unique health practices.
TeaDuring this trip I visited the TaTa tea plantation and the picture on the packet of PG tips came alive. These acres of plants were Camellia senensis Tearelated to those plants I had admired in The Isabella Plantation and the Asian lady on the packet represented a workforce of women who delicately plucked those tender leaves to be dried and fermented to make tea.
Tea
As doctors because they assumed we could be trusted not to touch the exposed machinery we were privileged to be shown around the factory. I certainly hope health and safety standards have now improved. During this visit I was made aware of the chemical contents of tea
which contains xanthine derivatives such as caffeine, theophylline, and theobromine, and the glutamide derivative theanine. These substances have well-known stimulant properties, and have also been reported to have beneficial effects on memory and on the immune system. Tea also contains many nutritional components, such as vitamin E, vitamin C, fluoride, and potassium.
This made me appreciate why tea breaks were introduced in factories in order to calm the workers with theanine at the same time stimulating them with caffeine. Tea is thought to differ from coffee in that coffee simply stimulates without the calming effect and it was found that workers drinking tea carried on for long rather than in a short, sharp spurt. It also made sense of something I have heard on countless occasions when breaking bad news or after a sad or significant event, “shall I make a cup of tea?”
Before soldiers departed on a mission they would often have “a mug of tea” no doubt to calm them before setting off.
Tea
In another context when I worked with miners who had chronic chest problems they often told me how they couldn’t get going in the morning before they had their first cup of tea ” I like it strong, doctor so that the spoon stands up in it!” What they were really saying was they wanted a good dose of theophylline ( a bronchodilator) to improve their breathing. Nowadays, there is appropriate medication in the form of inhalers but these were not available.

Caffeine has been the most popular medical subject for people to read about in 2014 especially with regards to anti-ageing.
Now, new research suggests that a dose of caffeine after a learning session may help to boost long-term memory. This is according to a study published in the journal Nature Neuroscience.
This is my introduction to the fascination subject of tea!

 
 

Tags: , , , , , , , , , , , ,