Category Archives: Coffee Time

Questionnaire

QuestionnaireMany thanks to those patients who contributed to our patient questionnaire both in its production and helping to compile and analyse the results.

The survey has highlighted a few areas we need to focus on and this newsletter covers those areas.

If you would like to contribute to helping the practice improve the services we provide then why not register your support for the patient group on the Denmark Doctor website.

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Olfactomeopathy

SmellsThe celebrated polymath Prof Aillo, whose pioneering work has previously been reported in the Denmark Doctor has once again broken new ground in the realms of medical research.

After years of experimenting with the effects of odours on the human body he has developed the new science of olfactomeopathy.

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DNA

DNADNAs are bureaucrats biggest bug bear with running an efficient health service.

Now I know some of you are scratching your heads about what have genes got to do with running the health service – but to a health service manager DNA does not represent Deoxyribonucleic Acid, nor any Do Not Accept, or Do Not Attempt, or Do Not Ask, but Did Not Attend (their appointment/operation/etc).

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Deaf Doctor Strikes Again

Fawlty Towers - BBCMy increasing deafness and over active imagination has been playing up again.

Years ago I misheard a charming supportive daughter ask whether genital warts would help her mother to lose weight.

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New Years Resolutions, METs and Micromorts

2014Let’s face facts the New Year is famous for its resolutions – its widely seen as the opportunity to start off some positive changes, although why this is the case eludes me.

Surely every day is a fresh start and as such an opportunity to change.

Why we should choose one particular day in the year to go OTT about change is very strange – unless you’re into sales and advertising – because over the last week or so I’ve noticed that the numbers of sports related goods in the shops has increased dramatically. I presume January is the month when gyms maximise their profits.

So who am I to question the collective wisdom of marketing and advertising gurus and I’m going to give you some tips for positive change which could add years to your life and come absolutely free!!!

Experts

Actually psychologically I’ve made a mistake, because subconsciously we perceive things which are free to be of no value. There is some excellent work at looking how wine connoisseurs rate a bottle of vintage plonk to a bottle from Tesco’s bargain basement – the experts, not surprisingly rate the vintage wine as superior in all aspects – taste, aroma, richness and all those wonderful words that Oz Clarke uses.

And when these experts have their brains scanned at the same time, the expensive wines fire up lots of their brain whereas the cheap stuff has a very muted response. So we know that there is a very real difference between their appreciation of expensive wine and the cheap wine – although as I’m sure you’ve already guessed, the researchers had been a little deceptive and merely slapped 2 completely different labels on the same middle of the range wine!

In other words their brains perceived the wine differently because of their expectations. So our perceptions are affected by our preconceived ideas.

Think PositiveNumber 1 – Which all leads me onto my first Resolution recommendation – to think more positively.

If you approach something positively you are more likely to get a positive outcome – you will filter out positive factors, be more focussed on solutions and be more tenacious. Think of life as a vintage Champagne rather than a cheap Asti.

Number 2 – Which brings me nicely onto my second resolution drink less alcohol and preferably don’t drink any alcohol.

Drink LessNow I realise I’m being a boring old fart and real killjoy because having a fun time and going out for a drink go together like fish and chips or bread and butter. A little bit of alcohol releases those inhibitions and really allows us to enjoy ourselves.

Being a teetotaller is less of a party pooper than it used to be but you’re still viewed with a bit of suspicion by the majority of the population. Its bizarre that the fine line between being good fun, offensive and dangerous is not often recognised by society. But the bottom lines is that although alcohol raises vast funds for the chancellor (about £10 billion) it costs the NHS £4 billion per year and another £3 billion in hidden costs such as absenteeism.

Confusing

Coupled with the fact that a lot of people are employed through the industry, alcohol is always likely to be socially acceptable until someone crosses that invisible line from being charming to becoming offensive. Alas the medical profession has blurred the advice as well – we talk of people benefiting from drinking a moderate amount of alcohol and recommend a confusing mix of safe amounts to drink.

I almost feel as though we’re back in the early 1960s when drug representatives used to offer their doctors a cigarette brand and even used doctors in their advertising. When the evidence of harm from cigarettes was overwhelming the tobacco barons became the masters of positive spin. We doctors need to give an uncompromising message with alcohol, but we are still a long way away.

The evidence is becoming clearer that no alcohol is probably better than drinking a small amount of alcohol, but we continue to say the opposite. There is still an old definition of an alcoholic which is not far off the truth – ‘someone who drinks more than their doctor!!’ – and when you see the presents which patients bring us at Christmas time it does seem a bit rich that I’m now extolling the virtues of not drinking any alcohol – but it all comes down to being able to give a simple clear message and that is no alcohol is best.

Stop SmokingNumber 3 – My third resolution I’ve already covered – if you smoke then stop.

You can do everything else to improve and extend your life but it will hardly matter a jot if you still smoke. It may be that only alcoholics drink more than their doctors, but actually only 5% of doctors smoke – the lowest rate of any group in society.

The average smoker will extend their life by 7 years if they stop and these are good quality, disease free years.

Number 4 should really be number one for non-smokers and that is to exercise more.

Exercise moreThe benefits of exercise are almost unbelievable, if you could take a pill which halved your risk of diabetes, hypertension, heart disease, stroke, all cancers and made you feel less stressed, anxious and depressed, you wouldn’t hesitate to pop one everyday. In fact we would pass a law to put it into drinking water.

That pill is exercise.

Ideally you need to take it 4 or more times a week for 40 minutes or more at a time and either aim for a pulse rate which is 85% of your maximum predicted (220 minus your age) or of sufficient METs (Metabolic EuivalenTs).

METs

One MET respresents sitting and doing nothing, 23 METs are generated by Usain Bolt in 9 ½ seconds. Most mere mortals are doing well if they can manage 5 or more METs. Whatever METs making activity you’re up to make sure you enjoy it.

The gyms which are full in mid January are half empty a month later. If you can do sufficient exercise to ensure that your heart and lungs get a good work out you’ll add 7 years to your life. I’ve already suggested that although doctors don’t smoke they do drink like fishes, but they also exercise a lot.

Although I run about 40 miles every week I suspect this is still less exercise that most of my colleagues.

And you’ll have no need to achieve resolution Number 5 – to lose weight.

Once again there is a lot of nonsense about the population being overweight and the fact that we’re facing an obesity crisis, for the simple reason that we define being overweight incorrectly.

At present a BMI of 25.1 and over is considered to be overweight and a BMI of over 30 is obese. My preferred definition of being overweight is that weight at which losing weight does more good than harm.

Check your BMI

I realise this is a curious way to define obesity but it transpires that being a little overweight is a good thing. The extra weight you carry increases your METs for simple activities generating all those exercise related benefits, which outweigh the risks of being overweight – diabetes and high blood pressure.

Its only when your BMI goes over 30 that you’re hit with a double whammy, at this weight taking the stairs is simply too much effort so you head for the lift instead, in other words your obesity forces you to reduce your exercise levels. So you need to lose sufficient weight to be able to walk up the stairs.

If you’re already walking up the stairs then you need to commit to resolution 4 as well or you’ll shorten your life!!

If you’re struggling to lose weight, try the 5:2 Diet — it works.

 

Eat HealthilyNumber 6 – Eat healthily.

I find this really hard to say but it looks as though a vegetarian diet is best. But there is also a lot of nonsense talked about diet – this time we need to talk about micromorts.

A micromort is a one in a million chance of death or, conveniently, the risk of taking one ecstacy tablet. We each expend a micromort every 40 minutes just by existing!!

Changing from butter to margarine will save you a whole micromort or on average extend your life by 40 minutes. I don’t know about you but I’d prefer all that enjoyment from my Hollandais and Bearnaise sauces rather than that extra 40 minutes. The good news is that good quality, rather bitter tasting chocolate is good for you, but as with many things should only be consumed in moderation.

Number 7 – My seventh and final resolution is to be more self compassionate.

Self CompassionFor most of us this is an alien term. We treat others very differently than we treat ourselves. We are more critical and less forgiving of our own short comings than we are of others. We are more likely to accept and take adverse criticism to heart and less likely to accept well intentioned praise.

The secret of becoming self compassionate is to image your twin and what advice you would give them in that situation and then follow that advice. If this simple trick doesn’t work then its worth investing a lot more time and effort and I’d recommend rather than signing up for gym membership to enrol onto a Mindfulness course, which will teach you the skill of accepting your thoughts non-judgmentally and becoming more self compassionate.

Good luck and have a healthy, happy and less stressful new year.

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I’m not worried, just concerned!

WorryAre you worried about your chest pain?

No doctor, I’m concerned but not worried. If I was worried I’d be focussed on the problem, ie the chest pain, but I want to be focused on the solution hence my concern.

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Placebo inhaler

Placebo InhalerMany thanks to the patient who recently returned following a tentative diagnosis of asthma.

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