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Blogs relating to lifestyle to improve health

ARE YOU TOO OLD TO START BALLET ?

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Have you ever yearned after being a ballet dancer – that is often the case in growing up and mothers often dutifully take their children to ballet classes as I did for my three children until the tummy aches occur before lessons or with competing interests they can’t fit it into their busy schedules.

But there are some children who feel they have missed out  Or feel they want to rekindle that yearning and as adults they find a studio to reconnect or even start as a beginner.  Moreover, there are significant number of middle – aged adults who decide to join ballet classes and reap the physical and mental benefits of this challenging dance form.

I remember my daughter and friends who dance at any opportunity  often attended a well known studio ‘Pineapple’ in Convent Garden. They have classes for a wide variety of different types of dance classes.

women who do ballet over 50

L to R These women are all keen ballet dancers, or use ballet movements to stay fit and active –-these ladies are aged 50-68yrs

Subsequently  I came across an ex-ballerina from Sadlers Wells Ballet company in an acupuncture class as she wanted to learn to treat common injuries. She was teaching middle – aged pupils at Pineapple and was proud of the fact that she had a pupil of 76yrs!

Isabel McMeekan was principal dance at the Royal Ballet now runs classes for adults including Assoluta class for the over 60’s.  This is a unique class specifically created for 60 year olds and over, involving gentle stretching, core work, barre work and centre practice.

 www.everybodyballet.com

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Hence, I was not shocked when a professional colleague told me she had just enrolled for regular ballet classes. As we talked I could appreciate the positive health benefits of maintaining flexibility and bone density well into your later years to stall the onset of osteoporosis and could also ward off dementia. That’s as well as improving your figure, looks and confidence, relieving stress — and maybe even helping your love life.

We know that about 9 percent of adults age 65 and older report having problems with balance. Poor balance can be a contributing factor to falling, which can result in broken bones and hospital admissions.

Hence, because it is well recognised that:-

The single most serious threat that older people face is falling

Good balance is essential to being able to control and maintain your body’s position while moving and remaining still. Good balance helps you:

• Walk without staggering
• Arise from chairs without falling
• Climb stairs without tripping

You need good balance to help you stay independent and carry out daily chores and activities. Problems with sense of balance are experienced by many people as they age.

Inevitably practising ballet is going to be invaluable in addressing maintaining good balance.

My story of joining an adult ballet class

I did ballet as a child until about the age of 12 when transitioning to secondary school and puberty meant focussing on other things in life. It wasn’t until 9 years ago, in my late 30s, when I joined an adult ballet class, that my love of ballet was reignited! The combination of dance to classical music is unique to ballet, and though I have tried and have enjoyed many other activities (yoga, ballroom, Zumba and flamenco amongst many other things), ballet is what I have stuck at with a passion for the last 9 years! Certainly the movements and positions we get into remind me of my childhood, and the music makes me feel nostalgic and emotional. Perhaps it is all this emotion combined with the fact that I’ve had a seriously good work out keeps me so addicted to ballet!
Music is an essential part of ballet, and through ballet I have learnt to love the piano again too. I found I was enjoying the music so much at the class, I would go home to bang out the tune immediately on the piano! Memories of my old piano teacher came flooding back…and I have since made contact with her through email. These two pastimes have brought me much joy and satisfaction in recent years, I feel my childhood has returned to me in middle age!

Elizabeth

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You may feel this is something you thought was too late to start but there is a chance out there and with the added bonus of physical and mental health benefits.

 

 

 

 

 

 

 

 

 

 
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Posted by on February 9, 2017 in Training and Advice

 

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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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But I feel well I don’t need any medication!

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During my time as a GP I have heard this on countless occasions after taking someone’s blood pressure for the third time and telling them they will need to be treated.

Indeed when I first started on my career blood pressure medication was certainly not free of side effects and many caused severe postural hypotension resulting in profound dizziness,  lightheadedness, unsteadiness, or feeling of loss of balance to the point of fainting when simply getting out of a chair. Many patients who felt well when they presented after being given medication then developed blurred vision, confusion, general weakness and nausea. It was not surprising that many people refused to continue or simply avoided having their blood pressure taken! However, enough patients took medication for doctors to discover how lowering people’s blood pressure could prolong life and prevent heart and circulatory disease particularly strokes.
Pharmaceutical companies have gradually produced medication with fewer side effects and now we can offer treatment with minimal side effects.

One of the most popular blogs I have written was last years blog on hypertension
https://102theavenue.wordpress.com/2013/05/17/hypertension-t…pertension-day/ ‎which focused on healthy heart – healthy blood pressure.

As a campaign to reduce the incidence of heart and circulatory disease last year the government proposed that everyone over the age of 40 years should have their blood pressure checked and this was one of every GP’s targets to make sure that was done and will remain an ongoing target. There was an increase of 9.5% of people having their blood pressure recorded in 2013/14. However, it is everyone’s responsibility to know your blood pressure!

Infact, World Hypertension Day 2014 the theme is KNOW YOUR BLOOD PRESSURE
WHD

High blood pressure is just one of the risk factors for developing heart and circulatory disease, along with high cholesterol, diabetes and other lifestyle factors. As many as 5 million people in the UK are walking around, undiagnosed, with high blood pressure.

The only way to know whether you have high blood pressure is to have it measured.
Your blood pressure can be measured at most pharmacies, in the work place or gym and many people have machines in their homes.(for home machines make sure they are approved by consulting a list of currently validated machines on British Hypertension Society  http://www.bhsoc.org//index.php?cID=246)
British hypertension
Blood pressure UK
has campaigned for people to take their blood pressure
You can have your blood pressure checked for free anywhere in the UK by simply logging in to the following website and putting in your postcode to find the nearest blood pressure station.
KNOW YOUR NUMBERS
http://www.bloodpressureuk.org/microsites/kyn/Home/Freebpchecks/Findfreecheck

High blood pressure – or hypertension

This means that your blood pressure is constantly higher than the recommended level. High blood pressure is not usually something that you can feel or notice, but over time if it is not treated, your heart may become enlarged making your heart pump less effectively, which could lead to heart failure.

Having high blood pressure increases your chance of having a heart attack or stroke.

Are you too old to be treated?
The benefits of treatment of hypertension in older patients (ie over the age of 80years is evident, reducing BP to a level of 150/80 is associated with large reductions in stroke, mortality and heart failure risk. Different regimens with equal BP reductions have similar effects on outcomes, so should be individually tailored. Systolic blood pressure (elevated top reading) rather than Diastolic blood pressure (elevated bottom reading) reduction is significantly related to lower Cardiovascular risk in older people.

There isn’t always an explanation for the cause of high blood pressure, but these can play a part:

  • not doing enough physical activity
  • being overweight or obese
  • having too much salt in your diet
  • regularly drinking too much alcohol
  • having a family history of high blood pressure.

Even if you don’t have high blood pressure, making simple lifestyle changes may help prevent you having it in the future.

What can you do to reduce your blood pressure?
If your doctor or nurse says you have high blood pressure, he/she is likely to encourage you to make some lifestyle changes to help reduce it. This may include increasing your physical activity, losing weight, reducing the salt in your diet, cutting down on alcohol and eating a balanced, healthy diet.

Salt’s effects on your body
Salt
Salt works on your kidneys to make your body hold on to more water.

This extra stored water raises your blood pressure and puts strain on your kidneys, arteries, heart and brain.

 Reducing salt by 3g/day might prevent approx 10,000 deaths and 10,000 Cardiovascular events each year
 This would exceed the benefits of smoking cessation programmes, weight loss interventions and statins
 Reducing salt intake by as little as 1g/day may be more cost effective than BP lowering drugs

High sodium effervescent drugs should be avoided in patients with or at risk of hypertension or Cardiovascular events.
It is advised not to take soluble Over The Counter(OTC) medication such as painkillers, vitamin C etc. (NB this does NOT apply to 75mg dispersible aspirin which is fine. See what is the sodium content of medicines? )

The Consensus Action on Salt and Health (CASH) has looked at examples of the most popular foods eaten by several different age groups based on the National Diet and Nutrition Survey (NDNS), and has compiled ‘typical shopping baskets’, which have revealed some alarming results. For example, based on types of foods eaten by a student (18-22 year old), a shopping basket of higher salt products can contain up to 58g of salt, while that of a mother (30-39 year old woman) can contain up to 64g of salt – the equivalent of 128 bags of crisps. However, if they were to make some simple switches to lower salt options, the shopping basket of the student could be reduced to 22g of salt and that of the mothers’ could be reduced to 18g of salt, the equivalent of just 36 bags of crisps – cutting their salt intake by a staggering 62% and 72% per week respectively. This shows us that by making more informed choices we could all improve our long term health and reach the 6g a day maximum recommended intake for salt.

Heart and saltHow to reduce salt intake

(6g of salt a day is the maximum you should eat, and the less you eat the better.)
NB 6g of salt = 2400mg sodium

Sodium: reduce intake to
o 80% of salt is hidden in processed foods, and only 20% added
 Bread, breakfast cereals, table sauces tend to be high in salt
o To avoid hidden salt, start label looking and look for
 Low salt (1.5g per 100g food) avoid!
o Confusingly, some labels cite sodium rather than salt content
 1g sodium = 2.5g salt, so 0.6g per 100g food is high Potassium: potassium rich foods include:
 Fruit (not just bananas!), pulses, beans, vegetables (esp spinach), oily fish, chicken

10 practical tips

  • Eat out less
  • Remove the salt shaker from the dinner table
  • Add other flavours (herbs and spices) when you’re cooking
  • Remove the salt cellar from the dinner table
  • Eat less processed foods
  • Use fresh or frozen vegetables
  • Use shop-bought sauces and marinades sparingly
  • Limit processed and cured meats
  • Use lower salt cheeses
  • Pay attention to sweet foods
  • Use the FREE SaltSwitch App is a new feature of the popular health app, FoodSwitch, which was developed by CASH. The app allows users to scan the barcode of nearly 90,000 packaged foods sold across major UK supermarkets using their smartphone camera to receive immediate, easy to understand colour-coded nutritional information along with suggested similar, less salty products by 100g.

Salt reduction programme results released on 15/4/2014 showed has led to a fall in population blood pressure. From the fall in blood pressure that was due to salt reduction, there has been a saving of approximately 18,000 stroke and heart attack events a year, 9,000 of which would have been fatal

Another way of reducing salt is increasing potassium but if you are taking medication for blood pressure discuss this with your doctor.

Why potassium helps to lower blood pressure
potassium is a chemical which helps to lower blood pressure by balancing out the negative effects of salt. I heard potasquoted as”Potassium could be called the great detergent of arteries.

Your kidneys help to control your blood pressure by controlling the amount of fluid stored in your body. The more fluid, the higher your blood pressure.

Your kidneys do this by filtering your blood and sucking out any extra fluid, which is then stores in your bladder as urine. This process uses a delicate balance of sodium and potassium to pull the water across a wall of cells from the bloodstream into a collecting channel that leads to the bladder.

Eating salt raises the amount of sodium in your bloodstream and wrecks the delicate balance, reducing the ability of your kidneys to remove the water. By eating more fruit and vegetables, you will increase your potassium levels and help to restore the delicate balance. This will help your kidneys to work more efficiently – and help to lower your blood pressure to a healthy level.

However, it is possible to have too much of a good thing. To make sure that you don’t overdose on potassium, it is best to get your daily potassium from natural sources (fruit, vegetables and other foods) and avoid taking supplements.
To reap the benefit of more potassium in your life, try to eat at least five portions of fruit and vegetables every day. (A portion is about the same size as your closed fist). Not only will this help to lower your blood pressure, it will also help you to avoid certain cancers, bowel problems and even heart attacks or strokes.

Good sources of potassium include: potatoes, sweet potatoes, bananas, tomato sauce (without added salt or sugar), orange juice, tuna (fresh, frozen or tinned, but avoid tuna packed in brine), yoghurt and fat-free milk.
Potassium

If you have kidney disease, or are taking certain blood pressure medications, a large increase in potassium could be harmful. In this case, avoid taking potassium supplements and check with your doctor before dramatically increasing your potassium intake.

If your blood pressure is very high or these lifestyle changes do not reduce it enough, your doctor is likely to prescribe you medication to control it and to reduce your risk of having a heart attack or stroke.

Especially if you are 40 years or older get your blood pressure checked and
KNOW YOUR NUMBERS

 
 

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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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HEADACHES IN CHILDREN – WHEN TO WORRY……

How common are headaches in children?
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I remember as a child having headaches but adults always said ” you are too young to have headaches!” I ythink ig was because people assume that they are are associated with worry and in those days adults assumed children had nothing to worry about.
We recently had a Newsletter from the Paediatric Integrated Care Team at St Mary’s hospital and I thought I would share their comments.

Up to 90% of school children report headaches.

Migraines are reportedly present in up to 3% of 3-7 year-olds; up to 11% of 7-11 year olds; and up to 23% of 11-15 year olds
Migraines are more common in boys than girls before puberty, with a female preponderance in adolescence.

Management of childhood headaches

  • avoid skipping breakfast
  • drink plenty of fluids to avoid dehydration
  • consider stresses at home or school (exams or bullying)
  • is the child having adequate sleep – is there a routine?

These are important factors to eliminate or address if appropriate in order to treat headaches satisfactorily.

Headache self help tips for children

Often, simple steps will be enough to help your child through a headache or migraine attack.

  • Lie them down in a quiet, dark room.
  • Put a cool, moist cloth across their forehead or eyes.
  • Get them to breathe easily and deeply.
  • Encourage them to sleep as this speeds recovery.
  • Encourage them to eat or drink something (but not drinks containing caffeine).

If you think your child needs painkillers, start the medicine as soon as possible after the headache has begun. Paracetamol and ibuprofen are both safe and work well for children with headaches. The syrups are easier for children to take than tablets. Alternatively, try Migraleve, a pharmacy remedy that treats migraine and is suitable for children aged over 10.

A headache diary is useful especially for highlighting triggers.

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It is also useful to make a note of the severity of the headache using a pain scale.

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However, every parents concern is when do I need to worry, what do I need to look out for in case it is a brain tumour?

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        • persistent headache (continuous or recurrent, present for more than 4 weeks)
        • nausea and vomiting , behavioural change- lethargy/strong>
        • altered consciousnessPlease then see your GP to consider referral to a specialist Paediatrician
          A referral may be considered if the headaches are not responding to lifestyle changes or simple pain relief and the child or young adult is having frequent school absenteeism.
 
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Posted by on October 26, 2013 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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EALING HALF MARATHON – 29th September 2013

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Come and cheer on the ECIL All Stars, who are running to raise funds for disabled people and carers in Ealing. The Half Marathon starts in in Lammas Park from 9.15am. If you’d like to sponsor us, contact Wendy on 020 8840 1566 or wendy.starkie@ecil.org.

Ealing Centre for Independent Living. ECIL is an organisation of disabled people working to eliminate the barriers preventing disabled people from living full and independent lives.
Come to ECIL for everything you want to know about Disability, but were too afraid to ask. We offer advice, information and we can help you get what you need to live an independent life. It’s FREE to join, so why not become a member.
http://www.ecil.org/

The 2nd Ealing Half Marathon will take place on Sunday 29th September 2013 in Ealing, West London
One of only three fully road closed half marathon events in London the race will start and finish in Lammas Park, one of West London’s most picturesque parks and take in parts of Central Ealing, Montpelier, Pitshanger, West Ealing, Hanwell and St Stephen’s before returning to Lammas Park.
http://www.ealinghalfmarathon.com/
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Ealing Mini Mile
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Ealing Half Marathon are pleased to announce the Ealing Mini Mile for 2013. It’s our new race open to children aged 6 – 11 years of age with the route taking place in and around Lammas Park.

The children’s race is run over a course of approximately 1 mile and starts at 9:30am (after the runners have left Lammas Park at the start of the Half Marathon). Entry is £5 with prizes up for grabs for different age categories plus a medal and t-shirt for all finishers.

The race is well supported and will become a popular feature of the day with many children from local schools competing as will the offspring of the Ealing Half Marathon runners and junior members of local athletics clubs.

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Free workshops for carers return!

Supporting carers is something that we as a practise, part of a network and the ECCG want to strongly support. Many people of all ages act as carers without payment, unconditionally giving all-round help and support to a friend, neighbour, relative or another person.

Many people who are caring for someone do not necessarily see themselves as a ‘carer’. Rather they are mothers, fathers, daughters, sons, partners, husbands, wives or neighbours. However, being identified as a carer by the council can help you get the right support you need to look after the person whom you care.
The Carers’ Centre is a resource and support centre for all unpaid carers, of any age, in the borough. The centre is managed, in partnership with Ealing Council, by Carers Connect, a consortium led by the Ealing Centre for Independent Living and including Ealing Mencap, Dementia Concern Ealing and Crossroads Care West London.
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Following the success of the pilot course for carers earlier this year, Ealing Carers’ Centre is once again running a series of FREE workshops at the Carers’ Centre in November.

The aim of the course is to improve the skills and confidence of people who are caring for a family member or friend at home, and to help them find ways of making more time for themselves.  It is NOT designed to train people to become paid care workers. Twelve places are available and the aim is for participants to attend all the workshops. The workshops are open to all carers who live in Ealing and/or care for someone who lives in Ealing.  The closing date for reserving a place is 7th October.

For more information, please contact Cecilia Coleshawat cecilia.coleshaw@ecil.org or on 020 8840 1566.

If anyone reading this blog has taken part in the half marathon or wants to make a comment about any of the organisations for which money has been raised please make a comment or email
admin.theavenue@nhs.net

 

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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).
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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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HAS YOUR SKIN SURVIVED THE SUMMER?

image“And so with the sunshine and the great bursts of leaves growing on the trees, just as things grow in fast movies, I had that familiar conviction that life was beginning over again with the summer.”
― F. Scott Fitzgerald, The Great Gatsby
After a glorious summer where motivation has increased, our Vitamin D has been topped up and we have managed to get out and go to places we haven’t been to in years, sadly, there are some ill effects of summer.
Besides the passing tummy bugs or heat exhaustion the one thing we must be vigilant about is our skin.
Melanoma is the 6th most common cancer overall in the UK (if non melanoma skin cancer is excluded). More women than men get melanoma.

Every month it is worth doing a self-examination of the skin especially if you are at greater risk such as:-

Moles – the more moles you have, the higher your
risk
• Being very fair skinned – especially with fair or red
hair, or having lots of freckles (although people
with darker skins can still get melanoma)
• Sunburn – getting badly sunburned increases your
risk of melanoma, particularly in childhood
• Where you were born – fair skinned people born
in a hot country, such as Australia or Israel, have a
higher risk of melanoma throughout their life
• Sun exposure – on holiday, as well as sitting in the
sun or sunbathing at home
• Sunbeds – using sunbeds, particularly before the
age of 35.
• Sunscreen – using sunscreens may protect you, as
long as you don’t spend too long in the sun.
There are other less common risk factors such as Family History involving more than 2 close relatives – these other less common risk factors can be found on the website link later in this blog.

How to perform a self-examination of the skin

Firstly find a bright room and use a large mirror where appropriate.
Look at the whole body front and back
imageWhen you have isolated a skin lesion that looks different or you think has changed using the acronym ABCDE to confirm your suspicions.
A Asymmetry – the mole halves don’t match
B Borders – they are uneven
C Colour – this is not uniform
D Diameter – this is larger than 4mm
E Evolution – the mole grows and may become inflamed and itchy

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Where to look

Bend the elbows and look at the forearms, underarms and the palms. Your palms, bottom of the feet nails and nail beds – these are places where it is more likely to acquire acral lentiginous melanoma (ALM) which is more common in women especially with dark skin.
Check the back of the legs and feet including in between the toes and the soles of the feet and toenails. New and unusual bands on the nails could be a sign of sign of cancer.
Examine the back of your neck and scalp with a hand mirror. Ideally, it is better if you can get a friend or partner to help by using a blow dryer as this will allow a closer loo
If you find a mole that fits the above criteria it is important you are seen by your GP.

If you are not sure it is worth taking a photograph of the mole alongside a ruler and storing it on your PC to observe changes when you repeat the photograph a month later.

NICE guidelines for urgent referral follow the 7 point scale

The NICE guidelines say that all GPs should use the 7 point scale for assessing changes in moles. The scale has 3 major features and 4 minor ones.

The major features are
*Change in size
*Change in colour, such as getting darker, becoming patchy or multi shaded
*Change in shape

The 4 minor features are
*7mm or more across in any direction
*Inflammation
*Oozing or bleeding
*Change in sensation, such as itching or pain

The doctor counts 2 points for any of the major features. Any of the minor features scores 1 point. If your mole scores 3 points you need urgent referral to a specialist. But the guidelines say that if there are strong concerns about any one feature, urgent referral is also reasonable.
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If you are not sure it is worth taking a photograph of the mole alongside a ruler and storing it on your PC to observe changes when you repeat the photograph a month later.

More information can be obtained from:-
UK website http://www.cancerresearchuk.org/cancer-help/type/melanoma

PS
If you have had a melanoma always be vigilant.

David’s story

I remember a patient many years ago called David
He never went to the doctor and made it his business to keep well away under all circumstances. I knew his wife well and she attended very regularly and in passing had often remarked about her husbands dislike of doctors. Infact, the only notes on his record were a record of his childhood immunisations.
One day, on a Friday evening she appeared very anxious and said her husband had taken to his bed upstairs, because if he even attempted to move he was very short of breath and he had refused to call a doctor. Understanding her predicament and always enjoying the challenge of sorting out a difficult patient I decided to visit him. When I entered the house climbed the stairs, there was David in bed, sitting up with at least 5 pillows and so breathless he was unable to voice his disapproval of my presence. When I examined him more closely he was extremely swollen with fluid to the level of his waist- totally waterlogged!
I gently suggested a hospital admission and needless to say he summoned up enough breath to refuse outright. In situations like this negotiations are on a par with making a peace treaty between warring countries. After a while we negotiated a plan helped with the knowledge that his first grandchild was due – he would take the medicines I prescribed and if they worked he would attend the surgery on Monday morning before the doors ‘opened’, I would take blood and he would go to the hospital for a chest X-ray. If he was no better he would have the option of deciding the next move. We shook hands on this and I arrived Monday morning wondering if he was alive or dead and whether he would appear. I was not long in the surgery when the bell went and in walked David with his wife and I have say hardly breathless and a look of submission on his face.
I had the X-ray form prepared and proceeded to take blood. As he rolled up his sleeve there before me on his forearm a classical, fulfilling all criteria malignant melanoma. I remained calm as one must with a patient like this as they are likely just to get up and leave precipitantly.
After his remark of “is that it,doctor?” I retorted with ,”not quite, you did say you would go and have a chest X-ray and perhaps Hammersmith would be a better hospital for you and by the way could you just pop in to this clinic whilst you are there!” I quickly scribbled a note for the Walk-in skin clinic hoping that I was right in thinking I had him in my hand and that he would arrive at the clinic and not have to wait.
Later that day his wife phoned to tell me that he had done everything I had suggested and he had been admitted but was wanting to take his own discharge. The hospital doctors had made the diagnosis of malignant melanoma with spread to the lungs and heart failure. He had refused all treatment except what I had prescribed.
He soon came home and was told he was terminal. I visited him and even after lengthy discussion he was adamant that he was not going to have any treatment for this cancer. The Macmillan nurse arrived and he dismissed them as he could manage his own death and he had a lot of things to sort out and he didn’t have enough time to talk to nurses and doctors. The first most important thing to do was to phone the council and have the large tree removed from the family grave as the grave would be needed very soon – he felt it was disgusting how graves were looked after.
This was done by the council in record time.

David never appeared at the surgery again, failed to attend hospital follow ups but continued to take the medicines I originally prescribed. I kept in touch when his wife attended and she collected his medication. I only ever saw him across the road when he was on his way to the graveyard with his trowel and bucket to carefully maintain the grave. He would always wave and shout over , “How are you, doctor?” to which I would reply,”Fine , how are you?” and he would retort,”Fine” and continue about his business. He not only enjoyed the birth of his grandson for 4 other grandchildren and lived for almost 5 years of a good quality life but finally quite suddenly he died to go to the grave he had so lovingly tended.

The point of this story is that for some reason this tumour can become inexplicably dormant but then recur at a later stage even years later.

 

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