Monday, May 30, 2011

Happy Feet

It's so good to have happy feet: in fact if you think about it, there are so many parts of our body that do an amazing job each day and yet we never give them a moments thought: but when they go wrong, then it's like the end of the world! Think, just reading this now, or listening for the sounds of children in your house and if they're making the right sort of "noises"! Our feet fit into this category too: every day we use them and if we're into exercise then we bang them against the ground perhaps 10 to 15 thousand times a day! But when you stub a toe, then you're whole focus is changed in an instant.
I was reminded of feet yesterday when we had lunch with some friends in the hills: early on the conversation turned to Bunions! One lady was lamenting the fact that she was due to have surgery on her bunions in the near future and that life was currently fairly miserable with her throbbing joints. A male of the species joined in to add his Crocodile Dundee bit with, "That's not a bunion, THIS is a bunion" and demonstrated his plum-sized swellings at the base of his big toes! His, however, currently caused him no grief and he was able to jog happily in the recent 14k Run for a Reason. At which point our delightful hostess announced that she too was the owner of bunions as a result of her days as a Ballet dancer: at which point yours truly mumbled something about wearing sensible wide shoes .... and was met with the frosty reply that there was "No way" that she was about to give up wearing her beloved "Killer" heels! Which leads us to the point of what each of us could do to reduce the chances of having to undergo surgery to correct this often painful condition known as Bunions.
Unfortunately about 60% of people with bunions will have inherited the problem: the good news is that they can take preventative measures to reduced the inflammatory processes that will make them deteriorate, and that will make them painful.
The single most effective weapon we have for managing bunions is wearing appropriate, wide fitting footwear.
Many of the shoes we buy are of a narrow fitting for the fashionable look: however, what being fashionable means is that the bits of the foot that stick out more than they should - bunions - will constantly rub against the inner surface of the shoe. That creates inflammation over the bunion, and inflammation means swelling: swelling makes our friendly bunion even bigger and the process continues until pain forces us to remove our shoes!! If you want to really upset your bunion, then you not only force your lumpy foot into a narrow shoe, but then you also stand and walk on "tippy toes" - popularly known as high heels!!
So: to give your bunion a better life style, wear broader fitting shoes and never wear heels higher than 5cms. If you bunion becomes painful or seems a bit red, then ice it as you would any "sports related injury". Topical anti-inflammatory creams, or anti-inflammatory medication may be of benefit for some, but do check with your GP before taking them as they can have side effects. If you wish to wear narrow shoes, you do increase your risk of pain and possible surgery. You may get some help from using a "Shoe Tree" in your shoes: these can be custom made for you by a surgical boot maker and they are designed to mimic the shape of your forefoot and you leave them inside your shoes when not wearing them. The idea is to stretch the area of the shoe that covers your bunion, so that there is less pressure on the vulnerable area when wearing them out walking.
Some people can also benefit from wearing a night splint that attempts to gently stretch the big toe back into a straighter alignment: this too is a long term project and may help in avoiding surgical intervention, but it does need to be started young, and early in the course of the problem.
Finally, there is surgery: it does work .... mainly! However, foot surgery is painful and can take weeks to months to fully recover from: in my experience, of all the areas of the body to suffer after surgery, the foot has to be very high up on the list of slow "recoverers"!
So hands up all of you who want to start a new relationship with your feet? And how do you pamper your forgotten footsies?
Post Script:
On the subject of feet: the young bride and I have finally got over the virus infection that seems to have gone on for weeks: so this morning we did our first walk/trundle for about 5 or 6 kms. The morning was delightfully fresh after last nights rains as we jogged along the path by the beach: there were some magnificent white cumulus clouds and patches of stunning blue skies, and I was listening to the Rhapsody from the film August Rush on my Nano. I have to tell you that it was a moment of sublime beauty and wonder, so much so that I had tears in my eyes: life is beautiful, lets not waste it. Happy days.
Ampersands & angle brackets need to be encoded.

Friday, May 27, 2011

Home Help and Health

"Power to the people" is a Sixties slogan, so I suppose that means that I'm a Hippy Health Professional, because I believe in empowering people to do what they can at home to improve their health and well-being.
So here are two simple tools that may help you on your way:

1. A tape measure
2. A Diary

A tape measure is a simple but effective tool to estimate the amount of central fat in your body; and central fat is not a good thing to have as it increases risk for heart disease, blood pressure and diabetes. According to the Mayo Clinic (and remember, Americans tend to be big people, so for we "Athletic Aussies", we should be aiming for lower numbers):

* Men are at risk if their waist measurement is greater than 40 inches (102 centimeters, or cm).
* Women are at risk if their waist measurement is greater than 35 inches (88 cm).

If you're looking for what is normal then in men I would suggest 95cms and for women 82cms. For men, measure at the level of the umbilicus, and for women, half way between the lowest part of the ribs and the top of the pelvis.
So this weekend, get out the tape measure and have some fun measuring each other!

A Diary fulfills three purposes:
Firstly, for those having a "battle with the bulge", a diary is a very useful tool for keeping a daily Food record of everything you eat each day: it literally helps keep you honest. Once you have kept a record for a week, then you have a good idea of your Calorie intake and can make the necessary adjustments.
Secondly, if you aim to get fitter, then the diary is a good place to store your daily physical activity records. The experts tell us that we should find between 30 and 60 minutes daily to reach a good standard of physical fitness: and yet again, the diary will help keep us honest and can also make us feel good about ourselves when we thumb back through the pages and see how much we have actually done.
But I like to think that the third use of a Diary is the best one, and that is to record your personal journal- the "story of your soul". It's a safe place to note how you feel and even let off steam about issues that have got under your skin. It really does help to unload and "complete" psychological problems, and who better to unload upon, but someone who will never let you down -your own dear Diary!
Ampersands & angle brackets need to be encoded.

Thursday, May 26, 2011

Its enough to make a man drink!

Three stories appeared in the paper today all related to alcohol: two of them were about how drunken young men had ended up in court for their various misdemeanors that has left two young women with the life long scars, both physical and emotional, as a result of those encounters. The other alcohol related article was to do with Champagne quaffing Health Department Staff enjoying some Pharmaceutical Company perks on overseas trips, all of which produced a bit of "holier than thou" response from certain quarters.
To paraphrase the US astronauts on an ill-fated way to the Moon many years ago: "Mission Control: we have a problem": and the problem is alcohol.
Now we all know that there really aren't any benefits from smoking tobacco, apart from keeping heart specialist and Oncologist in business: so from a health point of view, that's a definite "No No" as far as I'm concerned. But what about alcohol then? The figures there are almost as bleak: domestic violence, MVAs, various head and neck cancers, damage to unborn children, liver and brain damage: and yet.... we still see in the media that there are positive health benefits for some middle aged people from modest alcohol consumption as it reduces the risk of cardiovascular disease, and we all know that heart disease is the biggest killer of all!
So where does that leave us?
Firstly, prohibition doesn't work: it never has and I suspect, never will. BUT, we have to learn from the facts; for the vast majority of people who drink, we need to drink less; and certainly we have to teach each and every generation of young people, that Binge drinking is dicing not only with your life, but also dicing with the lives of others.
Secondly, I have to ask why is it that you can buy soft drinks, milk and water in containers of varying sizes, and yet when it comes to alcohol there is so little choice - especially with wine bottles? There is no "if" about it: we need to promote safe drinking habits and that means less is best. The chemistry of alcohol's effect on the brain is that after a couple of drinks you go from "chilling the system" to poisoning the system - there is no middle ground: so after that first or second glass you are actually paying good money to make yourself feel ill!
As for those Health Dept honchos who are probably feeling very ill from the exposure they've received in the press, you should know that there is no such thing as a free lunch!
PS If any "Company" wants to send me to Vienna, business class, and put me up at the Intercontinental for a couple of weeks .... I am open to all offers, but be aware that I will naturally pass the information onto all my dear followers: I might even send them all a postcard!
Ampersands & angle brackets need to be encoded.

What is Truth?

Ampersands & angle brackets need to be encoded.

Wednesday, May 25, 2011

Sit up straight, and pay attention!

I've seen my fair share of patients with terrible spinal problems over the years, and yet relatively few of them were the direct result of traumas such as MVAs or sporting injuries. Most of them developed insidiously and were well advanced long before the patient actually became aware of them.
But first a few general principals about the spine:
Health professionals talk about the spine having three sections:

The Cervical Spine which is the neck part and quite flexible in most directions
The Dorsal, of Thoracic, Spine which is the mid section and is the part to which the ribs are connected making it the least flexible part of the spine.
The Lumbar Spine, that is also fairly flexible and links the Dorsal spine to the pelvis.

When viewed from the back, the spine should be a "straight up and down" structure: any deviation to one side or t'other, and we talk of a Scoliosis.
When viewed from the side, the spine presents three natural curves: the cervical spine has a slight curve backwards, the Dorsal spine has a slight curve forward and the lumbar spine has a slight curve backward.
The aim in life is to maintain these three natural curves with their flexibility: unfortunately, most of us don't until it is often too late, because if you do lose flexibility and distort those curves, not only do you lose function, you will invariably suffer pain and discomfort as well.
So, three simple tips to remember to help maintain good POSTURE:

Stick your chest out
Tuck your chin in
Tighten your core abdominal muscles.

When you do this for the first time, like me you will probably feel like the proverbial "Dill": but practice a few times in front of a mirror until you feel comfortable: don't over-exaggerate what you do, it's really only a subtle change just to get those curves back into their natural shape. The next thing to do is to keep remembering to do it on a daily basis, but like most habits, once ingrained, it's difficult to kick.
Ampersands & angle brackets need to be encoded.

Tuesday, May 24, 2011

Children's leisure reading and computers in the home

Computers have been a massive boon for all of us: I am writing this blog on an Apple Mac in the kitchen: if I want to find information, I use Google, the list is endless. However, there may be a downside, as computer use has eaten into our leisure time and replaced reading, and that can be a serious disadvantage to the smaller people on this planet.
Professor Monica Rosén of the Department of Education and Special Education at the University of Gothenburg, has analyzed differences between different countries over time in order to explain change in reading achievement among 9-10-year olds. What she found was that "reading ability has improved steadily in Italy and Hungary, while it has fallen rapidly since 1991 in both the US and Sweden". The common link was that in both Sweden and the US, leisure use of computers in the home had rapidly increased whilst visits to the local library and the frequency of leisure reading have both declined: and it's not just the children who are reading less, it's adults too.
Now, don't get me wrong, I think that our children need to find their way around computers and the relevant software, as they are an intrinsic part of daily life: however, here's the big BUT...
BUT, there's no taking away from the fact that if our next generation is not going to be less literate than the previous ones, then we do need to think about how to encourage our children to read more in their leisure time. This can be done using the traditional book form, or on a computer, an iPad or laptop if they prefer that method; but if they use the electronic format, then they will have to be more "disciplined" (I was once told that the origin of the word discipline is a Greek word that means "to allow to grow") and not be distracted by the myriad of games that currently tempt them.
Leisure reading is about going to another part of the brain where the imagination lives, and this is a critical part of a child's development: it is also a gift that parents can give their children for life
Ampersands & angle brackets need to be encoded.

Monday, May 23, 2011

Social Networks and tracking Infections.

I read an article this morning and was immediately reminded of my much loved grandson.
The article was about about tracking an outbreak of Tuberculosis in a town in Canada, and was reported by Jennifer Gardy from the British Columbia Centre for Disease Control at the 111th General Meeting of the American Society for Microbiology. To track the outbreak they used whole genome sequencing of bacteria combined with intense social network screening of carriers of the disease - not just the usual "who have you been in contact with", but an intense look at what each person had done during each day.
In this particular case they discovered that the infection was being spread at a couple of local crack cocaine houses, where users sat most of the day in poorly ventilated room and weren't particularly concerned who they coughed on.
Now, the word that made me sit up and take notice, and hence made me think of beloved grandchild was, SUPER-SPREADERS! Apparently, a few of those crack users (please note dear reader that my little relative is known to crack a smile, or even crack his head when falling over, but of the illicit chemical, he is blissfully ignorant - and may he remain so for the rest of his long life): a few of the users were described as "socially well connected and symptomatic for long periods of time". Hands up those of you with young ones who go to Kinder or primary school?
Now I'm not suggesting that we start genomic sequencing of all infants with runny noses, but just imagine the help it would give older people, or those on chemotherapy for cancer, those with immune diseases, diabetes, heart and lung disease, if they knew that there was a nasty virus going through their locality? These people could then avoid obvious contact with our young "super-spreaders" in places such as trains, buses, shopping centres etc.
My suggestion is, put up a brief post if your little one has picked up a virus, and just indicate which suburb they might have contracted it (no need to name Kinders, schools or child minding centres -just the postcode) and give others the "heads up", because you never know, your child might be like my precious grandson: not only a Superstar, but also perhaps a Superspreader!
Ampersands & angle brackets need to be encoded.

Saturday, May 21, 2011

Need a Reason to Run?

This time last year the young bride and I were preparing for the first 14km Run for a Reason: we even raised $2000 for the Heart Foundation, which was another first. This year we have been struggling with one of those "Boomerang" virus infections that has lingered for the past two weeks, and consequently, we wont be running the event this year - but we will be back exercising once we recover from our current indispositions!
Physical activity is great: I love it, even though getting out of bed on cold mornings is always a severe test to my will-power! I like starting the day having done something difficult and uncomfortable, which programs the mind into a "can do" attitude for the day. Of course there are many medically documented positives from being a regular exerciser: it lowers the risks of heart disease, certain forms of cancer, blood pressure: it helps with the control of diabetes and depression and is essential for those with lung diseases too.
The Run for a Reason and the C2S are great Community activities and over the years I've been involved in promoting both of these fantastic events. Nowadays the young bride and I cycle more - you should read what happened to us on our Moravian Mountain Biking adventure - but still run (well, it's more of a trundle than a real run) two to three times per week when in the full bloom of health.
There is no doubt that most of us can find time to go out the front door and exercise at least three times per week: all it takes is that little word "yes" - I can do it.
Let me know how you go!
Ampersands & angle brackets need to be encoded.

Friday, May 20, 2011

Drive to stay alive

With the advent of some wet and wild weather, the roads will be treacherous and accidents liable to happen: in fact, there are probably several thousand "P Platers" out there who have never driven in such wet conditions: so be warned and be prepared!
As tens of thousands of parents drive their kids to and from school, there are bound to be delays and there may be a temptation to take a risk if you're running late: take my advise, arrive alive and arrive late if you have to.
It is a sad fact that most of the Quadriplegic Centers worldwide have been created as a result of motor vehicle accidents involving young people - mainly young men on motorbikes - and not all of them were at fault. One of the most inspirational guys I've ever met was a young Kiwi who had been sitting on his motorbike at an intersection and was "taken out" by driver who was rushing. The van driver walked away, but my friend suffered a broken neck and has since been a ventilator-dependent quadriplegic. He needs 24 hour assistance and every outing is a major operation: but then this is a very special guy and he still does live life to the full!
He has taught himself to sail in a specially adapted boat (plus entourage in following rubber ducky) and enjoyed it so much, he paid for another boat out of his compensation, so that he could take other spinal injured patients out on the water too! Not content with helping fellow quadriplegics, he also goes to Cambodia and sponsors a couple of orphanages up there as well: in other words, he still embraces life to the full despite his severe limitations.
The reason I mention all this is that researchers have developed a "Stimulator" for damaged spines that has allowed one person to regain some function below the damaged area of his spine: he can now move his lower limb and walk on a treadmill with assistance. This technology has huge potential because it is much more likely to help sufferers in the short term, as opposed to the more distant promises of Stem Cell therapy. But from my time as Director of the Quadriplegic Centre in Shenton Park, whilst most of these guys would love to walk again, what they would really like to regain control of is their bladder and bowels.
Loss of control of bladder and bowels means a much greater risk for wee infections and damage to the kidneys. Bowel care for spinal injured persons is not a pretty event; in fact it's quite humiliating for them, and it's something they face every day of their lives: to regain control of bladder and bowel is for them, Nirvana!
So as you drive in the wet today, be very aware that there is danger on the roads - if not directly to you, then to unseen others, especially cyclist and motor cyclists. Slow down, be patient, don't answer the phone and please don't txt - it can all wait until you have dropped your precious bundles off at school: or even better, after the stress of driving, treat yourself to a well deserved coffee and use your phones then.
Ampersands & angle brackets need to be encoded.

Thursday, May 19, 2011

Break the chain of infection

What do ties, going to Church and hand washing have in common? The simple answer is people!
I was reading in a national paper the other day about the very real threat in the community from a bug known as Community Acquired MRSA, or CA-MRSA as it’s known to the boffins. As you may gather from its name, this differs from the hospital based “super bugs” in so far as it’s “out there” in the community. Its one of the Golden Staph family of bugs that in the normal run of events, is a harmless commensal on our skin: often found living in the nose of all places! But due to the advent of antibiotics which have threatened their existence, these bugs have developed resistance to antibiotics to such an extent, that some are resistant to all but the most powerful of our pharmaceutical weaponry: and one or two, in fact, are resistant to them all! The nasty community acquired one mentioned in the newspaper article, produces a toxin which can be rapidly fatal even in people who were previously fit and well: this is not good news!
Today, in most hospitals, Doctors have stopped wearing ties as they are a real hazard for the spread of infections, as germs have been shown to take up residence on gents ties, and can then drop off onto patients as the doctor leans over to examine them. I would like to claim that for many years I wore a bow tie for that reason: and in fact I found that not wearing a “standard” tie was a great boon when doing minor procedures such as stitching people up, as bow ties are very well behaved staying nicely tucked under ones chin, whereas “standard” ties have the knack of swooping down in the direction of the wound whilst inserting sutures!

Over Easter I, along with thousands of others, attended Church services and, as is usual at this time of year, the Churches are packed to the rafters with the frail old, “amped up” infants and all the "in-betweens". At times of quiet solemnity, there are the coughs and sneezes which reminds me that not everyone who attends Church is necessarily in peak condition, and that if Easter was in the middle of the “Flu season” then it would be an ideal time for the Influenza virus to spread round a community of several hundred in a few minutes: and in some cases with fatal consequences. I mention the Church because that's where people congregate, but this could equally apply to the local derby footy match, or the winter sales at the big shopping centres, or on the train in the rush hour and very definitely at International Airports.

What it all boils down to is good personal hygiene for ourselves, and for our children who have yet to reach the age of reason. If we, or someone in our family, have a contagious illness, then it behooves us to practice good personal hygiene:
• Cover the nose and mouth when coughing or sneezing.
• Sneeze or cough into the crook of your elbow, as you will be using your hands to touch things and thereby can pass on infection with “dirty” hands.
• Wash your hands frequently, especially after touching your nose or face, as this is where infectious germs tend to hang out.
If you’re feeling unwell, just imagine what your infection may do to someone who has heart disease, is on drugs for cancer treatment, or has recently had a kidney transplant and is on powerful immuno-suppressants; because these people ARE at Church, are at shopping centers, are on the train and at footy matches and they don’t carry big signs saying “I’m vulnerable: stay away from me”!!

We, as individuals, live in community, but we must all understand that we have a huge community of germs living on and in our bodies, and by our actions we can pass these germs on to others. Thankfully, the vast majority of these germs are friendly, but sometimes they are not, and like the vulnerable, they don’t carry signs, so it’s impossible to know if they’re harmless or deadly.
What we need to do is practice good personal hygiene at all times, and then perhaps we can reduce the burden of disease by breaking the chains of infection
Ampersands & angle brackets need to be encoded.