Friday 28 November 2008

Living to be a hundred...and fifteen

At the age of 115, Edna Parker passed away, as the oldest lady in the world. She was an American and born in 1893, outliving both her sons according to the BBC.

She had been a widow for nearly 70 years and lived on her own in a farmhouse for most of her life until she moved to an Indiana nursing home when she was 100 years old.

Secrets as to her lengthy life can only be found to be a healthy lifestyle, not smoking or drinking alcohol and keeping active.

When Mrs. Parker was born in the 1890s, when sport became more acceptable for women to take part in. However this was an era where women wore long dresses with full length puffed sleeves to play tennis and bloomers were worn for cycling. 

1893 also saw a serious economic depression in the United States, which led to many people abandoning their homes and travelling West. 

The economy did begin to recover in 1896, which was followed by 10 years of rapid growth. Something of which we might like to be able to relate to today.

Mrs. Parker would have been familiar with a great deal more since then. It is difficult to imagine what 115 years of life could ever feel like.

Monday 24 November 2008

Organ ownership

Last week, scientists advised Gordon Brown that a "presumed consent" system, where all people are organ donors unless they opt out, or a family member refuses their organs to be harvested, was a bad idea. This is not compatible with Mr. Brown's desire to change the "opt-in" system we have at the moment.

The scientists of the Organ Donation Taskforce, which was set up by the government in 2006 think that a change would cause practical problems for the NHS and would risk a potential backlash among the public. 

The Taskforce imply that, despite an increase in organ donors, the number of skilled staff in the transplantation area and better facilities are still needed to improve transplant rates.

The Sunday Times magazine quotes a former heart transplant surgeon with, "Twenty years ago, if you did a transplant it made the news. Now they are done at night, when operating theatres are empty. It's hard, demanding work, and you're still expected to turn up for 8am".

Hearts are one of the least transplanted organs in Britain. That there are not enough hearts available does not appear to be the only reason for this. There simply aren't that many heart transplant surgeons and the operation is risky.

Lives to save
However, there are plenty of stories where people have been waiting for kidneys or livers and there just are never enough. I cannot completely understand the Taskforces view when it would be steps closer to more lives being saved. 

Nobody likes thinking about death and as much as many say they're not superstitious people worry about tempting fate by signing away their organs. An "opt-out" system would be more truthful of whether people actually want to become donors or not, as there is always that people "never get round becoming one" when they have always meant to be.

There is always the risk it could always work the other way round. That the person always meant to opt-out of the system due to beliefs or religion, but never got round to it.

A change could create a stir and a need for further change in staffing. But if it saves lives then is it not worth it? 

Sunday 23 November 2008

Pain is not always beauty


I remember when my housemate returned from her Summer holiday completely terrified of going bald. A few weeks previously she had had her long straight jet black hair chemically curled.

However, it turned out not quite how she had expected so immediately returned to the hairdresser to have it chemically straightened. Her distress rose exponentially when the hairdresser apologised that they had accidentally used too strong a concentration of the chemical.

Her hair began to melt and frizz with a large clump falling out on the top of her scalp and drying out the skin. One and a half years later the patch still has not grown back to its full potential.

But this isn't a one off scenario.

In the Observer newspaper today, there is a health warning about poorly trained beauticians. Health officials have revealed women suffering from paralysis of the face, burnt scalps and lost fingernails. 

It poses the biggest risk when managers encourage cost-cutting techniques amongst poorly trained staff, which can lead to infection. Examples include waxing and body piercings not being carried out properly. 

Hairdressing staff also suffer from dermatitis because of the shampoos and hair chemicals they handle on a day to day basis. 

Chemical warning
Concerns were raised after a drugs watchdog about a tanning agent that you inject called Melanotan. It is illegal to sell as it has not undergone safety checks and has been linked to increased blood pressure. 

Despite this it has been sold in tanning salons, body-building gyms and over the internet. 

This has led to the inspection of other chemicals used for the love of beauty. In nail bars methyl methacrate is a chemical sometimes used to bind false nails to a real nail. Worryingly it has been associated to lung, kidney and liver problems, asthma and allergic reactions. 

It is the cheaper option to chose, but there have been incidents where women have also pulled off their real nail after getting their false nail caught in clothing as it was glued on so strongly.

My housemate has refused to have her hair dyed, straightened or curled since the incident at the hairdressers. 

But perhaps we should be staying clear of a lot more. Experiments show that your hair even washes itself after  3 weeks of non shampooing. It would certainly be a great deal cheaper to be more "o'natural" during these difficult "credit crunch" times. 

Thursday 20 November 2008

Secret drinkers

Almost 2 in 5 people who drink above recommended limits of alcohol lie to doctors about their excesses according to a survey. 

According to a BBC source, in poll of 2000 people, men were more likely to downplay their drinking habits than women. 

Those who drank sensibly tended to be honest, where as 39% of those risking their health with drink, lied.

This doesn't surprise me. I remember a psychiatrist giving us medical students advice on questioning patient's drinking habits. 

He said you should always casually overestimate how much they drink, for example with, "how much do you drink a night? 40 beers?" 
The reply could be anything from shock, to an honest, "Oh no not that much, probably 30".

Tell tale signs
When I was 17 years old and thinking about applying for medical school, I had a work experience placement at a GP surgery. I saw a lady perhaps in her 60s, who was suffering from early signs of dementia. She was becoming forgetful and was unable to complete a test which involved filling in the numbers of a clock face. 

When the doctor asked about her alcohol intake, the patient said she enjoyed a couple of beers a night. The doctor was quick to assume that it was a great deal more than that. Her forgetfulness was likely to be a case of alcohol dementia.

It is not unusual for someone to feel ashamed about over drinking when it becomes a problem. It might often be the case that patients don't want to admit to themselves that they have a problem. Sometimes the units just creep up without the person even realising.

It is a shame because there is often help (such as alcoholics anonymous) out there, but by the time they've admitted their problem, their physical health has irreversibly deteriorated. 

It is always hoped social support will reach them before medical care is needed.

Tuesday 18 November 2008

Base it on evidence

Politics is shifting towards science and evidence-based theories. Tory MPs will have to have basic science lessons so that they can grasp concepts of global warming, stem-cell research, pandemic flu and GM crops, I read in the Times newspaper yesterday. 

As these issues are poking their noses more and more into political shadows, MPs need scientific knowledge to support their opinions and decisions.

I think this is a good idea as politicians should then be able to base their arguments on fact rather than which argument they think subjectively sounds the best. 

As there has been almost an evidence based revolution in science, I think that any leaders of the country should be able to understand how to think in this way.

Evidence-based fits all?

The evidence-based theory is not only to be applied to medicine and science, but has also been discussed for its application to social policy and criminal sentencing. 

However for these areas I disagree that they should be used. Evidence based theory often looks at what works best in the majority of cases. 

In criminal sentencing however, every case is different. Therefore I am sceptical as to how sentencing can be readjusted based on previous facts. 

Judging how people should be punished is not a science. It is a humanity. I do not think that, whether or not a person should be forgiven, is just a matter for statistics.

Saturday 15 November 2008

Pseudo-world

The internet and our computers have certainly proved to be a commodity in the modern world. It has been an asset in business, for the health service and for education. 

But sometimes it rather feels that there is no need to live away from our computer screens. We can talk to friends and loved ones online, shop online, write a diary (blog) online, work online, listen to music and watch DVDs all on the one computer.

So when do we know when to stop?

Virtual Relationships
Yesterday it was revealed on the BBC news, that a couple divorced after finding out her husband was having a virtual affair on an internet computer game, Second Life.

The "real" couple met in an internet chat room in  2003 and marriage followed. They shared interests including the virtual reality game which allows one to create their character or avatar and interact with other pretend characters.

Amy Taylor found her husband's avatar with a prostitute on the screen. David Pollard's marriage had ended. 

In one sense I can understand Amy Taylor's fury. With so much of their lives entwined by computer scenery, how can you really differentiate the physical world from the virtual? And perhaps it also reveals an unappealing side to one's character. That is, if they enjoy going having sex with a prostitute in a game, then who knows, they might do it in real life if they had the chance.

Computer goodness
However the big increase in the number of households owning a computer and having access to internet has helped bring about a revolution in some areas of healthcare. 

For example, the launch of websites allowing patients to share their experiences of illness. Patient and health sites which are widely known and trusted allow people to research diseases that would otherwise take a great deal more time and effort to find out about.

And whether you think games such as Second Life and Grand Theft Auto are good for you or not, is for you to decide, but personally I think they are a little too far beyond imagination.

Tuesday 11 November 2008

Healthy towns

Government Ministers have invested in a “healthy towns” scheme by pouring £30m into nine UK areas to improve the health of the public.

Tower Hamlets, a borough of London involved in the scheme, is one of the nine areas taking part. 

Obesity is prevalent in the London borough and has poor health compared to the rest of London and UK, according to the Tower Hamlets Local Area Agreement 2008-2011. It rates 349th out of 408 authority districts for life expectancy in Britain.

One of the ideas about to be tried at the borough, is an awards scheme. Food businesses will be encouraged to sell healthier options to customers for which they will gain points to buy sportswear and equipment.

Health Secretary Alan Johnson said it is the way “to create a healthy England”.

Is government money the answer?

A Health Councillor and Deputy Manager at Tower Hamlet feels there is more to the health problems within the area than the government is aware of.

He told me: “You can’t come in as an outsider and impose something on a community you don’t know anything about.”

The councillor has worked for the Tower Hamlet council since 1993 and is familiar with the area’s cultural diversity. He thinks that the range of cultures means it is difficult to impose a one-rule fits all approach.

An example he gave of ethnic health diversities was that of the Bengali community. Generally they tended to suffer from mouth cancer because it is in their culture to chew tobacco.

And diets of the Chinese, Somali and Bangladeshi communities all vary. Therefore he said it would be unfair to impose what was healthy and what was not from someone of a white middle class background.

Other ways

Tower Hamlets has organised yearly Summer health fairs for the past 10 years, with 1500 people attending the last two day event last June.

They gave talks on smoking, healthy eating, diabetes and epilepsy with one to one sessions with trained staff. They had bicycle stand competitions and did cholesterol checks. They also introduced alternative therapies to residents such as homeopathy, massage and reflexology.

He said his ideal solution to improving public health is to have, “influential members of the community who is familiar with the neighbourhood and can help the public understand what health means.

“You’re not going to make health fashionable overnight.”

Time will tell whether the scheme improves community health. According to the BBC, Tam Fry, of the National Obesity Forum, said the schemes were:

 “Very sensible. In many ways this is too little, too late. The government should have acted years ago. However, you have to start somewhere and these are certainly the right kind of schemes."

Wednesday 5 November 2008

Slimming pill - not a patent drug?

A medicine has now thought to have been found, by French scientists, to combat fat, according to the BBC. It tricks the body into hitching the metabolism rate up a notch. 

This means that the body is programmed to work at a faster metabolism which would usually only occur when energy levels are low.

The drug contains a substance which is a chemical cousin to that found in red wine.

When used in mice at high doses it not only completely prevented weight gain but also improved blood sugar tolerance and insulin sensitivity.

Is it the answer?

Could this be the drug to prevent 1000 deaths a week caused by obesity? Is medicating obesity really the answer, when being fat isn't really a disease? There's always concern that once a solution in the form of a pill arises, there will be  abandonment of exercise and healthy eating as people feel it is no longer necessary.

Perhaps I am being sceptical. I am sure it would say on the packet that it is a supplement to healthy eating and exercise. And even if being fat isn't a disease, there are many diseases that creep along side it, such as cardiovascular problems.

In one sense it is a matter of who gets their hands on it. If it's to save lives, then it serves it has a worthwhile purpose. If it ends up as a replacement for the "Atkins" diet because it went out of fashion a few years ago, then perhaps not so much. 

I think it is important to differentiate slimming from surviving. This drug would not just be a remedy for removing love handles.

Monday 3 November 2008

Sandwiches

I bought a Brie sandwich. On the front it was named "Brie My Baby". It was tasty and the salad in it was fresh. Perhaps the the bread was a little bit too crusty, but really how wrong can you go with a sandwich?

It can go very wrong according to a figure in the Metro newspaper today, which said 400 people have become ill in a year from listeria, a bug found in prepared food. This is double the numbers of 2001. 

400 people is not a large proportion of the population, however the fact is the numbers appear to be increasing and an Food Standards Agency spokeswoman said: "Although 400 cases each year is still quite small, a lot of them get hospitalised and there is a high proportion of deaths." 

Listeria can infest salads, cooked meat, soft cheese and pate. All the types of foods you can get in sandwiches. "Brie my Baby" could have made a good breeding ground. 

According to the website of the Food Standards Agency: "Symptoms of listeria infection can take up to 90 days after exposure and may start with a fever, "flu-like" illness and/or diarrhoea." And it can be treated effectively with antibiotics.

For preventative measures, the key is to make sure the sandwich is eaten before the date and that it has been stored below 5 degrees celcius.

Caffeine and the Unborn Baby

Cutting the caffeine is being advised by the Food Standards Agency for pregnant women after it has been linked to low birth weight in a study.

This means no more than 2 cups of coffee or 4 cups of tea a day. Caffeine is also found in cola, chocolate and some drugs. However the majority of caffeine an average adult consumes will come from coffee. Coffee is the most popular drink worldwide and around 400 billion cups are drunk each year, according to the Roast and Post Coffee Company.

Don't Panic
However for those who have been drinking more than the 2 cups a day, if the caffeine hasn't prevented it already, this is not something to lose sleep over. Andrew Wadge, chief scientist at the FSA said:

"We would like to emphasise that the risks are likely to be very small and believe our new advice, which is based on new research and has been considered by leading independent scientists, is sensible and proportionate."

The BBC says the study was carried out at Leicester and Leeds universities and the study has been published on the online British Medical Journal

Saturday 1 November 2008

Does Alcohol do Good to the Unborn Baby?

Yesterday it was said, that mothers who drink alcohol modestly during pregnancy are more likely to have better behaved children than those who do not drink at all. 

The study has followed confusion in the past month about whether or not it was safe during pregnancy to drink at all. The government does not recommend complete abstinence, where as the National Institute for Healthcare and Clinical Excellence (NICE) gives opposite advice.

The study at University College of London were looking to see if there was a link between light drinking during pregnancy and cognitive or behavioural problems in the children at the age of three.

Better Behaved
Not only did researchers find toddlers did not suffer cognitively and behaviourally, but also that a significant proportion of the toddlers of mothers who drank during pregnancy seemed to be doing better than those who abstained.

Boys were 40% less likely to have conduct problems and 30% less likely to be hyperactive. Girls were 30% less likely to have emotional and peer problems.

Therefore it is possible that advice not to abstain may be favourable. Light drinking however, means light ie. 1-2 units per week or per occasion. When mothers drank heavily during pregnancy their children were more likely to have problems than abstainers.

Whose Advice is Best?
There is always the risk of women drinking too much if told it is a good idea to drink alcohol during pregnancy, that could lead to more serious effects than abstaining. Pat ''O Brien, a consultant at UCL, said about the Department of Health's views to abstain from drinking that: "They took that stance because they felt that in population terms it was the best way of deterring women from drinking too much in pregnancy." 

Light drinking may advantage children cognitively but it may cause other health problems. Dr. Kelly who carried out the study said: "There is inconsistency in policy around this issue and studies such as this one are vital in light of the wider debate around drinking and pregnancy."