Wednesday, November 20, 2013

End of year student parties - more than just Memories.

The end of the College year and High School life means Celebrations with a capital "C". But the mixture of young people, hormones and alcohol can often leave them with more than just memories: Sexually Transmitted Diseases are amongst the most commonly reported infections across the globe.
In this Podcast I talk with Prof Donna Mak of the Communicable Diseases Centre in Perth, Western Australia about STDs and blood born virus infections.

I hope you enjoy.

Click HERE to download the Podcast

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Monday, November 11, 2013

Elvis and Immunization

Click HERE to download my Podcast with  Dr Paul Effler, MD, MPH, FAFPHM on childhood immunizations and why we mustn't become complacent.
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Friday, November 8, 2013

Cancer Council WA - Food labeling.

Click HERE to listen to my third talk in the Cancer Council WA series, where we discuss the food we eat, how to understand food labeling and what foods are good for us.

*my apologies for the quality of the sound: however, the quality of the advice is excellent!

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Thursday, November 7, 2013

Cancer Council WA talks - Protecting your Skin from the Sun

Click HERE to download the second in my series of Podcasts recorded at the Cancer Council of WA. The subject of this Podcast is about reducing the risks of developing skin cancer  and explaining why we need to understand the UV Index. I hope you enjoy it.

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Wednesday, November 6, 2013

Human Papiloma Virus Vaccination and Cancer prevention

Click HERE to listen to my latest Podcast where I talk with Emma Croager about the Human Papilloma Virus, and how vaccinations can reduce the chances of this sexually transmitted infection from triggering Cancer of the Cervix.

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Monday, October 28, 2013

Cancer Council address from Harvard Experts


During the week of 23rd October, I attended a conference here in Australia run by the Cancer Council of Western Australia. The keynote speaker was Associate Profession Eva Schernhammer from Harvard Medical School where she is Associate Professor of Medicine and Epidemiology, as well as holding adjunct faculty positions at the Department of Epidemiology Fielding School of Public Health, UCLA and the Department of Epidemiology at the University of Vienna where she gained her graduate degree.
Over the past 10 years she has levied almost 10 million research dollars from NIH related to her primary interest in the relationship of circadian rhythms and melatonin to cancer risk. This work has led to the establishment in 2007, of a new classification by the World Health Organization, of shift work as a probable human carcinogen - which means that working nights over a long period of time can be a part of the process that leads to the development of cancer.
Her lecture at the conference was based around the findings of the world renowned Nurses Health Study which has been an ongoing Epidemiological research tool since its inception in 1976 - a study which has a definite Aussie flavour as one of the founding “fathers” of that study was Frank Speizer, now Distinguished Professor of Medicine at Harvard Medical School. The original Nurses study recruited 121,700 nurses, and has followed them ever since with a two yearly questionnaire that still evokes a 90% response rate - a truly remarkable achievement! Initially, the researchers looked at things like the oral contraceptive pill which back then had only been commercially available for around 10 years, and was significantly stronger than the more modern combinations. They also looked at smoking, hormone replacement therapy and odd things such as hair dyes, to see if there was any link to specific health issues or risks of cancer.
In 1991, they added a dietary questionniare to their list of inquiries, and in 1993 Quality of Life was added and then in the 1990’s they started to collect blood and urine samples which are still stored in hundreds of refrigerators in the basements of their building at Harvard!
In other words they have amassed a massive amount of information which the epidemiologists have continued to crunch ever since. Many of their findings have subsequently impacted on Government Health Policies around the world, and more information will help refine our understanding of the interaction between the human body and the environment in which we live.
Cigarette smoking has been known to lead to various cancers since the mid 1960’s and this has been confirmed by the Nurses Study in women too. But it’s in the area of diet and obesity that the study has had a particular impact.
A diet rich in red or processed meat raises the risk of getting cancer.
Obesity raises the risk of breast cancer, although interestingly, if a woman loses weight after the menopause she will reduce her risk of breast cancer.
When they looked at causes of becoming overweight, the findings showed that eating potatoes, processed grains and red and processed meat were all implicated in stacking on the kilos. But a diet high in vegetables, salads, nuts and even yoghurt would help keep those kilos off.
When it comes to reducing the risks of developing cancer in women, the Nurses study showed that:
     Maintaining a good level of effective physical activity reduced cancer rates as did decreasing the amount of red and processed meat in the diet. Other factors which point to lower risks of developing cancer in women included being lean at ages 5 and 10 years and avoiding alcohol during adolescence. These last two facts need to reach consciousness in all western parts of the world where childhood obesity is such an increasing challenge, and teenage drinking is at almost epidemic proportions.
Rates of fertility were also looked at in relation to women’s weights: so having a Body Mass index between 20 and 24 was favourable for fertility, but on either side of that range, levels of fertility dropped away.
When it came to skin cancer, it’s generally thought that all sunburns are created equal and were equally dangerous. But it appears that in women at least, if you have blistering sunburns between the ages of 15 and 20 then you double the rate of risk for developing a malignant melanoma. And blistering sunburns, although very painful, were less significant after the age of 30, although they are still associated with other forms of skin cancers such as basal cell cancers and squamous cell cancers. The message here is that once again we have to remind our bullet proof teenagers that alcohol and sunshine are not as great for us as the advertisers would like us to think they are.

On the up side for this now aging cohort of Nurses is the finding that the long term usage of Aspirin - greater than 20 years according to the study - is associated with a reduced incidence of colon cancer. However, before you start thinking of taking long term aspirin, you need to talk it over with your family physician, because aspirin may have been around forever, but it too has it’s drawbacks and certainly is not for everyone.

Finally Prof Schernhammer spoke briefly about her personal research into the cancer causing effects of shift work.
As we all know, we all need sleep and one of the major players in the sleep cycle  - or circadian rhythm - is melatonin which is produced and released by the pineal gland in the brain. When there’s lots of light around Melatonin production is suppressed and there is a compensatory increase in the amount of Oestrogen produced, and it is thought that this process may play a part in the increased rates for cancer to be found amongst shift workers. Across the board, Professor Schernhammer has found a 50% increase in the rate of cancers in long term shift workers.
Naturally this needs to be addressed, and their focus now is on ways of how to reduce those risks by varying the type, frequency and amount of shift work that an individual should do. And perhaps there might be a place to think of more appropriate lighting for certain workers - needless to say there is much work and research to be done, but now at least it has been recognized by the World Health Organization as a real risk for developing cancer.
The other keynote talk was by Assistant Professor Markus Frank also from the US and who is an expert in the field of Cancer Stem Cell biology. This was a really fascinating talk, but very scientific in it’s detail. What I gleaned from this very interesting man was, just like we humans, not all cancer cells are created equal either.
If you think of a cancer anywhere in the body, we have the image of “malignant” cells - nasty things just out to do us no good - a bit like a gang on the street. But not all gang members are really toxic or virulent, there’s usually a few ringleaders who stir up the most anger and cause the most damage, and it’s always best to target the ringleaders in order to control the situation. And it’s the same with cancers - Cancer Stem Cells are the ringleaders and the ones that we really need to focus on. Most cancer treatments do kill off cancer cells, but they don’t kill off the cancer stem cells and that’s why we get recurrences. The trouble is that it’s much harder to kill these cells off than you’d think. I actually sat there thinking, “how come these microscopic individual cells avoid and defeat the best - not only that our own immune system can throw at it - but the combined brain power of the best thinkers and computers that we have at our disposal!” It’s as mind baffling as it is frustrating.
The good news is that researchers are developing several approaches to target these cells and develop specific treatments based on the cancer stem cells DNA, their surface markers and their ability to generate their own blood supplies. It’s early days in the science of Cancer Stem Cells but already effective treatments are appearing in laboratory models. The battle has only just begun.
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Saturday, October 19, 2013

Downs Syndrome

Click on THE LINK to download the Podcast of this article

Back in the 1960’s the British education system was the envy of the world: but it wasn’t great for everyone, especially children who had genetically inherited diseases. Those who had graduated to High School - or as the English called it, Grammar School were mainly Anglo Saxon and generally all fairly healthy. Those who suffered from genetic illnesses such as Haemophilia were admitted, yet readily identified by having to wear red armbands as a warning sign to others - but which in some cases proved to be an invitation to bullying from the less socially inclusive teenager of the time. People who suffered from other genetic conditions such as Down’s syndrome - known in those times as Mongolism because of their non Anglo-Saxon facial features - were sent to special Homes where they might have been heard, but they definitely were never seen.
So we should give our current education systems a huge pat on the back for their far more enlightened attitude to “Education” in the most inclusive sense of the word. Now, whilst schools must rightly focus on improving and guiding the young mind, it must also pass on the social skills that are essential for the smooth running of our far more pluralistic society here in the 21st century. The current high school would have pupils from many different ethnic backgrounds, and most would also have students who also have physical or mental disabilities - or as some would describe them, exceptional students! And the most common disability in this group of students is Downs Syndrome.
Downs Syndrome is a genetic disease where there are three copies of the 21st chromosome and which leads to the classical features of those with the problem, which are
  • Flattened facial features
  • A Small head
  • A Short, squat neck
  • A Protruding tongue
  • Eyes that slant upwards and which are unusual for the child's ethnic group.
  • Unusually shaped ears
Children with Down syndrome may also have:
  • Poor muscle tone
  • Broad, short hands with a single crease in the palm
  • Relatively short fingers and a short thumb
  • and they’re joints are hyper-flexible
In the early part of their lives, they develop as all children do, but will often take much longer to achieve their milestones of crawling, sitting and walking. But they’re also incredibly loving children too. As they continue to grow, they will often be of shorter stature than their peers, and more likely to put on weight and to become obese.
As well as the obvious external signs of Downs syndrome, these children can also have other very real medical challenges to cope with as well. Such as
Heart defects. Approximately half the children with Down syndrome are born with some type of heart defect. These heart problems can be life-threatening and may require surgery in early infancy.
Young children with Down syndrome are more likely to develop leukemia than are other children.
Infectious diseases. Because of abnormalities in their immune systems, children with Down syndrome are much more likely to catch infections, such as influenza and pneumonia.
Dementia.  Symptoms and signs of dementia may appear before age 40 in people with Down syndrome. And not only that, those who become demented also have a higher rate of seizures.
Other problems. Down syndrome patients can also get gastrointestinal blockage, thyroid problems, early menopause, seizures, hearing loss, premature aging, skeletal problems and poor vision.
These children face huge hurdles in every facet of their lives.
But there is some good news for them: about 100 years ago the life expectancy of someone born with Downs was death before the age of 10. Nowadays, people with this genetic disease can live up to the age of 50 years and even beyond that depending on the severity of their problems.
But as well as the obvious physical differences, there are mental disabilities to deal with. And this is an area where there have been great changes both for the individual and for the community as a whole.
As I said earlier, in times past, people with Downs were often sent to special “Homes” where they were kept away from the eye of the public. Today they are integrated seamlessly into the school environment, to the betterment of all concerned. But behind the scenes, there is - or at least there should be - a team of professionals supporting the individual and their families to cope with the many problems that each child faces. This team would contain some or all of the following professionals:
  • A pediatric cardiologist
  • A pediatric gastroenterologist
  • A pediatric endocrinologist for the glandular problems
  • A developmental pediatrician
  • An audiologist
  • A physical therapist
  • A speech pathologist
  • An occupational therapist
  • A pediatric neurologist
As well as helping the child, parents need support too and thankfully there are many organizations around the world that are available to help those families and communities who are living with Downs syndrome whether as a patient, a family member or a school community.
Because Downs is a genetically based disorder, screening tests are available to parents during the first half of pregnancy to help confirm if their baby has Downs or not. Although the rate of Downs syndrome births rises as a woman ages - at 35 the risk is 1 in 400, but by the time the women is over the age of 45 the rate has risen to 1 in 35 - however, most children with Down syndrome are actually born to women under age 35, mainly because younger women have far more babies. Tests for Downs would generally include an Ultrasound and some blood tests looking at certain hormone levels - but the results of these combined tests are not 100% accurate and they do have a certain level of false positive results. The screening tests, by design, are much better at identifying women who may be at risk of having a baby with Down syndrome, rather than women who actually have a baby with Down syndrome.
If these combined ultrasound and blood tests suggest Downs is present, then confirmation requires that genetic material be gained from the infant in the womb and this necessitates a more invasive type of testing such as Amniocentesis, or Chorionic Villus Sampling. Research continues to seek a test that is accurate and non invasive.
There are often no easy options when Downs syndrome is diagnosed, but the paradox is that even though life can be pretty tough for all concerned, there are always so many great memories and so much laughter. And when that child’s life is cut short, as it sometimes is, then there is just as much an empty space left in the families’s and their communities hearts, as there is when any so called normal child dies too.
We still have so much to learn about Downs, and yet those with Downs teach us so much about how to be better people. We need them to become more human, and they need us to care for them - it’s not a bad arrangement really.

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Saturday, October 5, 2013

Family meal times - more than just nutrition.


Recently I read an article heralding the return of family TV viewing time! Apparently we’ve been through an era where seemingly “everyone in the family” had a TV in their own room and consequently family viewing time had gone the way of the dinosaur: but not so apparently! Now we have to thank the ever present tablets - not those of the pharmaceutical variety but rather the electronic ones - that allow each family member to watch the family wide screen whilst following friends on Facebook or, miracle of miracles, actually reading a book ...on their iPad that is.

You may gather by the tone in my voice that I am perhaps a tad cynical about such amazing advances in human interactions, but just call me old fashioned, but when it comes to spending time with family, watching TV together doesn’t come very high up my list of things to do together. Don’t get me wrong, I am a total convert to the electronic age because it’s opened up so many new horizons and spaces, but the downside is that so many of those spaces have been filled with total and absolute ... well .. rubbish.

But even the suggestion that families congregating to view a common TV is important news, and tells me that family still has a huge part to play in our society. Family is not just a group of people living together, it’s also the time when we create so many templates for our children’s future in health, education and value systems and once that period of time has passed, unfortunately we cannot go back and easily fix up the mistakes we made. And realizing that family life has such a big impact on future health is why I’m a big advocate of family meal times.

There is no doubt that we live in a frenetic era far different from earlier generations, and that’s perhaps a reflection of the far higher living standards and expectations that we now enjoy. But with the need to have a nice home and a nice car - in order to provide the best education we can for our little people, this also means that we need the cash to pay for these things and as a result, where there are two parents, both often have to work, and where there is only one the pressures are even greater - and creating the time for a daily family meal together can turn out to be a major juggling act between all the demands that young parents face. But when it is done, then the benefits are huge.

Where families frequently sit down to eat together,  the children tend to eat more vegetables and are less likely to be obese, and if obesity can be avoided then so too can all the health complications that come with it. But physical health is not the whole story. Family meals are not just about the food that we eat, there is a process that has to occur in order to prepare the food and prepare the table - and by involving the children in these activities they start to “own” and be involved in the process of service as well of being recipients of the good deeds of others.

Family meal times are an occasion where that unit of people - whatever the composition by gender, race or religion - sit and share their daily activities within the boundaries of that particularly family unit’s “family rules”. These rules are often unspoken - such as telling the truth, being kind, no bad language and not fighting or shouting at each other - whilst others may base their family rules on the Judeo-Christian ethic that has survived over 2000 years and of which GK Chesterton famously once said “Christianity has not been tried and found wanting, it has been found difficult and largely left untried” - which I suspect also applies to most other major world religions too!  By having such a set of family rules each person is then subject to them .. including the parents. And this can have unexpected and yet positive benefits for everyone: for example, when one of the parents has bent the rules - it might be when a child is unjustly shouted at by a parent - then at the family meal time, if the innocent party feels secure enough to point out the injustice, this can provide the occasion for the parent to apologize for getting it wrong and asking their son or daughter for forgiveness. This is a crucial lesson for a child to learn at an early age and helps them understand and accept personal responsibility for their actions - and how sorrow and forgiveness can heal an emotional injury at source and not allow it to fester into chronic guilt or resentment.

All parents of teenagers know that the teenage years are the years of chaos - and it really is not surprising as the teenage brain is continuing to make new connections during a time when their bodies are physically changing, and at the same time surging with adolescent hormones - a guaranteed recipe for long sullen pauses or inexplicable explosive reactions. If all parents were to realize that teenage development equates with chaos not entirely of their own making, then life for both parents and teenagers could be more serene. Which brings me back to family meal times.
One of the great joys of family life is that just about everyone there is of a different age group, whilst at school for 12 years of their lives, our young people are put in classes where everyone is of the same age and at the same level of life experience. Whilst preparing for, eating and cleaning up after the family meal, the group has to cooperate with people of different ages and life experience. So when the teenager says to the parent “You don’t get it do you?” ... well perhaps they do actually get it better than the teenager thinks! The important thing is to allow the youngsters to express their thoughts in a loving secure atmosphere, within the family rules, and not get a long lecture on why they are wrong, and how they should get their act together.
Family meal times allow for parents to hear whats happened to their children during that day or week and try to understand what outside influences they’ve been under when away from home. It also calls on each member to learn how to listen, as well as to have the confidence to speak out to. And it’s also that important time when issues can be completed and not carried on as hurts for weeks, months or even years. Unfortunately, children still grow up in dysfunctional families where parents continue to pass on the negative ideas and habits they learned from their parents and which still stunt their own children’s emotional development for life.
All of this is so important for the mental health of our young people as about 1 in 3 of the whole population will experience some form of mood disorder during the course of their lives, but if they have experienced the benefits of life in a stable, happy family unit, they will be better prepared to deal with such challenges if and when they arise.
Family meals are not easy to organize in these so called modern times, but they are an essential part of a healthy society - both physically and mentally - so the effort to make it happen as often as possible will be more than rewarded with happy memories and a healthier future generation.

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Friday, October 4, 2013

Hay Fever: how to live with it in Springtime.


It’s October here in the southern hemisphere and after a colder than expected winter in some areas, spring has well and truly arrived with newly greened trees and wild flowers blossoming in city parks and out in the vast countryside too. Whilst in Sydney recently the temperatures reached the low 30’s and a strong swirling breeze tossed hats and papers into the air. But there was something else in the air in Sydney that was making life really miserable for literally hundreds of thousands of its occupants - pollen!

Around the world there seems to have developed the great idea that London Plain Trees are fantastic for the urban streetscape. And yes they do grow quickly, and they do grow to some tremendous sizes and yes they do provide welcome shade in the long hot summers that we all like to experience. But someone forgot to tell the planners about the enormous number of dust balls that these trees produce in spring time, and which you can see as a visible cloud being swept down streets and into the noses, eyes and ears of all pedestrians in it’s path.

Sydney was coughing and sneezing, and rubbing its collective red eyes as this onslaught of nature’s desire to reproduce its species - in this case the mighty Plain tree - invaded every exposed human mucous membrane in sight! This was hay fever on a grand scale.

But although the London plain tree may be a dramatic example of how hay fever can affect whole cities at a time, it’s certainly not the only cause of the problem - not by a long way.

Grasses are everywhere, and all of us love to spend time in a park perhaps eating our lunch under the welcome shade of a tree whilst admiring the bounty of beautiful flowers planted by accommodating City gardeners - but for many this can lead to an afternoon of sneezing and itching, and for those with asthma, it may even bring on an asthma attack.

So what is hay fever and what can we do to reduce it’s impact on us at this glorious time of year?

All plants produce pollen. It’s a part of the sexual reproductive process of all plants on this planet, and plant pollen is the equivalent of our human male sperm cells. We males of the species will produce millions of sperm in the attempt to fertilze one female egg. Plants do a similar thing but in a much more public way - especially in the case of the London Plain tree - and plants do it on a massive scale! Amazingly, scientists have collected samples of ragweed pollen 400 miles out at sea and 2 miles high in the air. And it’s usually these prolific, allergy-causing plants that produce pollen in such huge quantities. For example, a single ragweed plant can generate a million grains of pollen every day. With all those pollen particles looking for someone to love, problems will invariably arise.

One zoologist humorously expressed the cause of hay fever in this way, “ he said that what the pollen is attempting to do is actually trying to mate with the inside of your nose”
The result of this plant human interaction is that our bodies rapidly respond to this foreign plant based protein invader and set off the following chain of reactions. Firstly it tries to make it more difficult for the pollen to settle on the surface of our mucous membranes by producing watery mucus in increased quantities in order to try and wash it off - hence the runny noses and watery eyes. Then it tries to literally distance itself from the invading protein by making the lining of the mucous membranes thicker - so that anything that may be trying to breach our surface defenses has further to penetrate. This leads to swelling of the lining of the nose and the conjunctiva of the eyes. And that’s why hay fever sufferers get runny congested noses and bleary watery eyes. The pollen also triggers an “allergic” response by the bodies immune system, and that leads to the itchiness  as well. For those who suffer from eczema/dermatitis caused by hayfever - usually as a response to grasses and pollens - then not only do they suffer from nose and eye problems but their skin also reacts with furiously itchy areas that are almost impossible to stop oneself from scratching.

Unfortunately we  cannot stop what nature does in abundance each year, producing tons of male plant gametes - or pollen particles - that are hungrily seeking a female partner to fuse with, but we can do somethings to reduce the impact of the resulting hayfever in our daily lives, especially in the spring time.

The first thing to try and do is to avoid going out when all those pollens are in the air - such as a on a hot windy day in springtime on a Sydney street! Stay indoors where possible and keep the windows closed: if you do have to venture out then avoid the windy times and cover your eyes and face where possible to reduce the bulk of air born particles. And once you return home then literally wash your eyes and nose with appropriate fluids to clear any pollen that may have attached themselves on to those lining, surface membranes. For the eyes, simple liquid tears will do the job and for the nose there are saline based irrigation sprays that can be brought over the counter at the pharmacy to do just this. It’s simple, safe and effective.

Some may like to get their retaliation in first by taking a non sedating anti-histamine that will block the body’s immune response to the pollen - again these are simple and safe and can be obtained from your local pharmacy.

If symptoms have started and nasal congestion is causing a problem, then try a mild steroid based nasal spray to help reduce the swelling within the nose - for short term  7 to 10 day usage this is quite safe: but if symptoms are failing to settle then a quick chat with your family Doctor would be in order.

For those who suffer an annual agony as a result of hay fever, there is the choice of de- sensitization. This is an ongoing treatment and is usually conducted over a couple of years - although some physicians do use an accelerated program with similar success rates to the more traditional method - and which aim to dampen the body’s immune response to a specific plant based protein.

Spring is a fantastic time of the year - perhaps the best time when it comes to nature putting on her glorious show for us - but there are downsides for those who suffer from hay fever. Hopefully the suggestions I have made today will help you to enjoy the best of springtime with the least amount of irritation.
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Thursday, October 3, 2013

Do we all need vitamin and mineral suppliments?


According to scientists, there is little doubt that we inhabitants of the 21st century have all evolved from the primitive hunter gatherer who came out of Africa and who survived on nuts, berries and the occasional kill of meat, fish or fowl. And even now, in various parts of the globe, indigenous peoples still follow a similar lifestyle in an often hostile environment: environments in which we we city slickers would succumb at a fairly rapid rate.
But as the hunter gatherer moved from the idea that humans should hunt in isolation or in packs, to living together in small communities, they then took on the challenge of controlling the environment by farming crops and husbanding animals, with the hoped for intention of replacing the feast/famine cycle with the more constant production of basic foods.
And over the many hundreds of thousands of years from the hunter gatherer to the present day, our bodies have adapted to the consumption of the wide variety of foodstuffs that we eat and which contain the essential nutrients that our bodies need. In fact we are now only just beginning to glimpse, and understand the role of, the billions of organisms that have evolved inside our intestines during this same period of time and which help us digest these foodstuffs. Not only do these internal organisms help us digest our meals, but they also supplement our nutrition with essential nutrients that help maintain our health, and it now looks like they also play a part in helping our immune system, regulate our nervous system and even interact with other organs around our body!
These are some of the reasons why I’ve always had some concern about the “pellitization” and widespread promotion of vitamins and minerals: formulations that are sold worldwide and which are promoted as aids to improving our health,  boosting the immune systems, or changing us from flu ridden wretches to bouncy smiling super athletes in a matter of minutes after consuming one of these marvelous, Multivitamin pills.
Vitamins weren’t in fact discovered until the early part of the 20th century - which in the evolution of mankind is literally only a few minutes ago. Vitamin C has a slightly longer history as it had been noted by a ships surgeon back in the 18th century that the scurvy, which affected all sailors who embarked on long sea voyages and which we now know to be caused by vitamin c deficiency, could be prevented if they ate limes which are rich in vitamin C. However it was to be another 200 years before the active constituent in limes  was identified, and not until 1935 that it was first produced commercially and which has since made billions of dollars for the manufacturers.
Many of the vitamins were first isolated in foods as a result of deficiency syndromes found in sick patients : for example Beri Beri is due to thiamine - or vitamin B6 - deficiency, and pernicious naemia is due to a lack of vitamin B12 in the body. The problem is that once these critical substances were identified, the “idea” developed that “more is better” so if we all took more of these life - and the Latin word for life is Vita - these life enhancing chemicals, then we’d all live healthier lives. But unfortunately, that has not proved to be the case.
Vitamins are to be found in all well balanced, healthy diets and the vast majority of people do not need any vitamin replacement. But as well as the vitamins we get in a well balanced diet, there are other beneficial micro-nutrients: for instance an orange provides vitamin C plus some beta carotene, calcium and other nutrients: which cannot be said of vitamin C supplements which lack these other Micronutrients. Food stuffs can also contain essential fibres that are very helpful with conditions as varied as constipation to diabetes and heart disease. Other health positive nutrients to be found in a well balanced meal are Phyto-chemicals and anti-oxidants which have their own unique benefits in maximizing our health.
However, just as I am against the blanket promotion of Vits and Mins for the whole population, I also recognize that certain people definitely do need replacement therapy for proven medical conditions and some, such as those with Cystic Fibrosis, would be at critical risk should they fail to take their daily vitamin supplements.
Neonatal Folic acid is essential for pregnant Mums to prevent the occurrence of neural tube defects such as Spina Bifida. Vitamin D is recommend for pregnant Mums to help with healthy bone formation in infants. Iron supplements may be necessary for menstruating women who have heavy periods or who are pregnant. And those people who cannot produce or absorb Vitamin B12 need regular replacement in order to protect and maintain healthy functioning of their nervous system.
One of the major drawbacks of single substance replacement - which is what vitamins and minerals offer us - is that their potential for good has failed to live up to the promised expectations. In fact trials aimed at showing the benefits of vitamin E have proven potentially, to do more harm than good.
Then there are the health supplements which contain herbal extracts
: and these have proven to be much more difficult to assess. Fresh herbs are far closer to the natural foodstuffs that we eat, and the greener and fresher the leaf the better it is especially when it comes to Cruciferous vegetables such as spinach, broccoli and arugula. With herbal extracts however, there is a huge disparity between whether the leaf, stem or root of the herb is used and at what time of year they are collected. Also, there have been many reports of sports-related herbal extracts being tainted with anabolic steroids and other chemicals in order to enhance their effects. So if you do choose to take a herbal extract,then it’s very important to read the label, see where it was manufactured and see what’s actually in the supplement that you are taking. Then check out the expiry date as this can have a big impact on the potency of the supplement involved.
Herbal extracts and even vitamins and mineral supplements can interact with medications that people take - especially older people who are on anti-coagulant medication and on young women who take the oral contraceptive pill, so always discuss what you are taking with your pharmacist and when in any doubt, seek professional advice first.
But to put the whole thing in perspective, Vits and Mins as well as herbal supplements can cause problems, but when held up against the adverse drug reactions, the inappropriate use of medications and the hospital deaths that are caused by the wrong medications being given, they do pale into insignificance.
The vast majority of young families who are enjoying good health do not need any supplementation if they are eating a varied diet of healthy food. Even those recovering from the flu can get all their nutrients replaced in a few days by resuming a normal diet. For more serious infections that may have required powerful medications, then you should consult with your treating doctor and even a dietician to get the correct advice on what is best for you.
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Our Human Microbiome

Our bodies are home to a huge bio-diversity of organisms and they all play a part in our health and well-being. Scientists are just beginning to understand how our co-inhabitants interact with us and literally make us tick.


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Saturday, September 14, 2013

Practical tips on Pregnancy


When I was a med student back in the UK, the subject I enjoyed most during the pre clinical years was anatomy. Going into the dissecting room with it’s chemical atmosphere of formalin and row upon row of benches with white sheeted cadavers certainly added a intriguing element to the whole thing. But the best, and most amazing part of anatomy for me was the embryology.
What happens in the first six weeks of human life is absolutely awesome: that short period of time after the male sperm penetrates the female egg and fusion occurs is truly mind bending. The single cell, formed as a result of this fusion, will then undergo a number of divisions to form a microscopic blob of cells: and within these cells a plate of cells form which will then undergo a series of twists, bends and folds and hey presto, by 6 weeks there is a recognizable human life with a tiny pumping heart circulating blood around this floating look-a-like spaceman. In fact, just about everything inside the body has been formed by the 6 weeks mark but the maturation process that is necessary to allow the embryo to become an independent human will take several months more, and some structures such as the human brain will continue to mature well into the late teens and early 20’s - which maybe helps explain to often exasperated parents why their teenagers can often appear to be on a different wavelength!
But back to pregnancy.
Put simply, pregnancy needs a male sperm to ascend into the uterus, find the egg in the fallopian tube and then penetrate it’s protective mucous barrier: in adult terms, this would be the equivalent of one of us running a marathon, wading through thick, glutinous jelly and then breaking into a bank vault.  Some sperm can achieve this feat within 5 to 10 minutes whilst others may take up to 72 hours to reach the fallopian tube - but only one of the approximately 180 million sperm released with each ejaculation will fuse with the female egg. Interestingly, over the past 50 years the number of sperm per ejaculate has fallen by 50% and the number of healthy motile sperm has fallen too: but even of more interest is that fact that in those areas of the world with the least amount of pollution, the sperm count has not altered during the same period of time.
For her part, the female of the species will nearly always produce just one egg per cycle and this will survive for less than 48 hours before disintegrating. However, fertile mucus within the vagina that is produced just prior to ovulation can help nourish sperm and help them survive until the egg appears. All this means that there is only a narrow window of opportunity each menstrual cycle for a woman to become pregnant, and for many, “falling“ pregnant can be a difficult process. It is also thought that as many as 75% of all pregnancies will fail to continue past the early cell cluster stage, and without implantation, these cells will become a part of the next normal menstrual flow.  But even those pregnancies that are confirmed early on with a pregnancy test, of those, 15 to 20% can miscarry too: so the message is, wait until after your missed period when the likelihood of a healthy pregnancy continuing to full term is much much higher, before you get a pregnancy test.
Preparing for pregnancy is just as important as caring for yourself during and after pregnancy. It’s a well known fact that if you eat a folate rich diet  - think lots of green leafy vegetables and salads or a folate supplement - prior to pregnancy then the risk of neural tube defects such as spina bifida are greatly reduced. Spina bifida can vary from a very mild, assymptomatic defect in the bones of the lower spine to massive exposure of the nerves that control the bladder, lower bowel and the muscles of the legs. Eating your greens to help protect your hoped-for infant from such a life long physical disability, seems a pretty good idea to me, and it sets a great example for the rest of the family too!
The one principal I strongly promote at all ante natal visits is that “What’s good for Mum’s health is good for her child health too”: so no smoking, no alcohol in the first 12 weeks and just one glass if necessary to celebrate family occasions after that. Whatever you put in your mouth will probably end up in your baby’s body, so if you’re not sure what is best for you, then please do ask a professional who knows.
And on a practical level, every Mum who has been confirmed to be carrying a child needs to link up with a Medical practitioner. Your Family Doctor is the best link in this chain as he or she knows you and will continue to help you when the baby becomes an infant, and continue that care when your infant goes on to become a child at a school in your local community where your Family Doctors practice just happens to be too.
For a normal pregnancy you should be seeing a Doctor every 4 weeks until 30 weeks - assuming all is going well. After that it should be 2 weekly visits until 36 weeks and then weekly until the baby is born.
For many Mums, having a Specialist deliver their baby is important to them and your GP will arrange this: but the two of them can continue with “shared care” during the majority of your pregnancy - should all go smoothly - and that depends on you, your specialist and your GP. Others may go through the “Public” system but these shared care arrangements can still apply in these situations too, again depending on the wishes of the Mum, the Hospital Doctors and your usual GP. But he critical thing is that you should be seeing a Doctor on a regular basis because it is so important to pick up problems early and reduce the health risks to both babe and Mum.
At each visit you will be weighed, have your blood pressure and a urine sample checked: your tummy will be examined and the baby’s heart beat listened too. You need to report any changes in health and tell your Doctor of any medications or supplements that you might be taking, or if you are planing any overseas trips - all of this is normal routine, but it is very important and should never be ignored.
And because you change your shape and of necessity put on weight, pregnancy should not be a time when you ignore your fitness routine - it might have to be adapted, but never ignored. Being fit and healthy prior to pregnancy and during pregnancy will flow over into after pregnancy and help you regain your normal shape and lifestyle in the shortest period of time possible. Having seen the amazing effort that women exert during normal vaginal delivery, I stand in awe of their power and endurance.
Having a baby can be a bit like climbing Everest, but the benefits are glorious and they last a lifetime.
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Monday, August 5, 2013

The air that we breathe.


It was whilst I was reading around the subject of the massive volume of viruses and bacteria found in our water supplies and in the oceans of the world, that I thought I’d also check out what organisms might be found in the air that we breath.
Two things brought this into my mind - firstly, it’s winter here and the wild winds are blowing in from the Indian ocean as I tap away at the keyboard, the rains are falling and after a long hot summer, the air feels clean and pure ... but after what I’d read about the what’s lurking in the ocean, I began to think “how clean and how pure”. The second thing that winter always reminds me of is that of being a little kid growing up in the UK and after the traditional British Sunday bath - and because I was the youngest, I was always the last to have my bath - my Mum always used to say “Don’t you dare go outside with wet hair because you’ll catch your death of cold”. Apart from being linguistically incorrect, I could never imagine that it was possible to be infected by a virus from the cold air through my wet hair! And in fact, my dear Mum’s age old adage has no basis in fact, but does seem to have a colourful history. That’s because if you go back just under a couple of hundred years ago, it was thought that the body stayed healthy by maintaining the balance of the four humours within the body - black bile, yellow bile, blood and phlegm. Now, if you went out into the winter’s cold and took in “great gulps ” of cold air, then this would more than likely have irritated the lungs thus producing more phlegm - in other words they’d develop very productive coughs - and if it that then turned into a pneumonia then you would literally catch your death ..because ... of cold!
But can we catch infections out of the air, and if so what sort: and if we do, then how do we reduce the risk of catching such infections?
When we think of air-born infections, we have to consider three main groups of infective agents: Viruses, Bacteria and Funguses.
When considering spread, viruses come in two major groups: those with a fatty coating and which includes most respiratory viruses, such as influenza and parainfluenza viruses: the febrile rash infections caused by measles, rubella, varicella zoster virus or as it is better known - chicken pox: and finally the coronaviruses which cause severe acute respiratory distress syndrome - or SARS. Those without fatty coatings would include the common cold viruses - the adeno, and rhinoviruses - and the now almost eradicated polio virus. This has importance when considering reducing the spread of these viruses because the fatty coated viruses will survive longer at lower relative humidities - in other words drier air - and the ones without the fatty coating will tend to survive longer in higher relative humidities.
These viruses do not exist in the wild and need a human vector in order to spread. However, they can be spread by the so called aerosol effect when infected people cough and sneeze in confined areas such as on public transport, or in schools, shopping centres and even outdoor markets - indeed, wherever people crowd together.
Generally, as the temperature rises, virus survival decreases. Maintaining temperatures above 60°C for more than 60 min is generally sufficient to inactivate most viruses, they will survive longer if they have a moist covering of organic material such as blood, faeces, mucous or saliva to protect them- and most air born viruses will have a covering of salvia or mucous.
And the thing with viruses is that they don’t just cause infections, in fact it’s been estimated that only half of those infected actually go on to develop an illness, but these viral particles can also trigger an immune response leading to an attack of asthma in those who are susceptible.

Bacteria are another, much larger type of organism that can be spread through the air, although most problems caused by these organisms will be a result of infections acquired indoors. The terrible consequences from aerosolized bacterial infections are generally only seen on news broadcasts when biological weapons of mass destruction are talked about: as these are exactly what they say they are - the use of deadly bacteria, sprayed into the atmosphere to kill the maximum number of people with an invisible weapon: an evil practice that must be condemned by all civilized peoples.
Then there are the funghi. The two types of organisms that we have discussed so far nearly always require a human vector to spread the disease, and they mostly cause problems because they happen indoors. But funghi are a natural part of the outdoors and need air currents to spread their spores as a natural part of their life-cycle. The thing with funghi is that they spore on a seasonal basis and don’t get into our living areas unless we actually leave the windows open. This is particularly important for those who are taking medication to suppress their immunity - such as people on cancer treatment or who are taking Steroids for various immune based conditions. It is also the reason why hospitals don’t have windows that open, as those who have a critical illness do not need the added burden of being challenged by a Crytococcus or Aspergillus fungus which can both cause potentially life-threatening illnesses when blown into wards.

So what conclusions can we draw from all of this? Firstly, that although we think the air is devoid of organisms - it isn’t  - and in places where crowds gather, both viruses and bacteria can be spread from person to person by aerosol spread. And the way we overcome this is by annual vaccination against the Flu which is 60% effective, and the more of the population that gets vaccinated, the better chances we have of stopping an epidemic or pandemic. But vaccination only covers 3 viruses and has no effect over colds or other viral infections, so protect yourself by giving "Sneezers and Coughers" a wide berth - about 4 meters should be OK, and remember that infectious droplets land on surfaces that you touch too, so avoid touching your face before you have time to effectively wash your hands or clean them with an alcohol wash. And for those who take medications to suppress their natural immunity, then they need to be extra vigilant at all times when these organisms are more likely to be in the air.
But as well as causing infections, these organisms can also trigger asthmatic attacks when the aerosol particle or fungal spore is inhaled - so at the times of year when viruses are common or fungi are sporing, then asthma sufferers should be more conscious of protecting their airways and preventing an asthmatic attack.


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Wednesday, July 24, 2013

The domestic dangers of burns - indoors and out!


It’s winter here in Western Australia and now that the mercury has started to drop to 1 degree Celsius overnight, we’re really starting to feel the cold. On the other side of the globe in the United States, they are suffering the opposite extremes, with temperatures in the high 30’ and low 40’s triggering terrifying bush fires in many areas.
Heat or the absence of it are a daily part of our lives and colour our conversations about the weather, fashion and lifestyle activities. But what is Heat and what happens when heat gets dangerous?
According to one dictionary definition, “Heat is the transfer of kinetic energy from one medium or object to another, or from an energy source to a medium or object. Such energy transfer can occur in three ways: radiation, conduction, and convection.”
We experience heat through radiation on a daily basis with the effect of infra-red radiation coming from the sun to heat our earth: on a more local level, we can experience the same effects from a domestic fireplace when the fire warms furniture within the room even though it may be some distance from the fire. Both these examples of heat through infrared radiation also demonstrate how these two forms of radiation can pose a potential danger to our health.
We expect to see the sun each day and forget that the sun, although a tremendous distance from our planet, is in fact a massive ball of gigantic thermonuclear reactions spewing out radiation in all directions - the miracle of it all is that our planet is in the so called Goldilocks position - just the right distance away not to be fried, and not too far away to be a snowball! It also has the advantage of having a magnetic field around it that protects us all from some of the sun’s more deadly radiation. But even though we are in such a blessed position, the infrared radiation from the sun still causes hundreds of thousands of preventible skin cancers around the world each year. And for some with the more deadly malignant melanoma, this can even threaten their lives. We must be more diligent in protecting ourselves and especially our little people by applying sunblock on a daily basis all year round, and wearing hats and sunglasses during the summer months. And if you love the great outdoors, you must remember to keep re-applying the sunblock as it can rub off those exposed areas.
On the domestic front, open fires are great for warming the home and for the older person, they are a wonderful place to just sit and reflect on some of life’s memories. But older folk are at risk of suffering radiation burns to their lower legs as sensation in those areas can diminish in people with Diabetes and other nerve damaging conditions. Also, open fires are a real danger to young children so please do protect them from open fires within the house, and barbecues and fire-pits outside the house.
Conduction is the next form of heat transfer and happens when two object are in direct contact and the warmer one will transfer heat to the cooler one until both are at the same temperature. A reviving example is coming in from the cold outdoors and soaking in a hot bath. But the interaction between something very hot and something colder can also have tragic effects on humans too. Just think of what happens when hot oils from a frypan get spilt on an inquisitive toddler in the kitchen: or if a youngster is just left for a short time in the bath and accidentally turns on the hot tap? - a dear friend of ours suffered such an injury and still has the scars from serious burns on his legs to show for it many years later - although he actually tells his kids that he got the scars from wrestling a crocodile! Another example of conduction of heat that can lead to short term pain is when you eat a mouthful of really hot food and burn the inside of your mouth. Always remember to check the temperature of food given to your little ones before they eat it - especially if its just come out of the microwave oven.
Convection is the final way that heat dissipates, and is the way that heat rises and then drops as it cools, in a room causing the air to circulate and finally warm the whole area. Heat from convection can be a problem if you lift the lid off a boiling saucepan, or open the door of a hot oven and have your face over the top of it, as the heat from steam can cause very nasty burns.
But heat isn’t the only form of energy that can lead to burns to we humans -
serious problems can occur as a result of electrical and chemical burns too. The first patient I ever attended as a medical student was a man who had been digging up the road in London with a pneumatic drill: disastrously, he hit a mains power line and suffered terrible flash burns to his body. I can still vividly recall his screams decades later as they changed his dressings on a daily basis! On the domestic front, electric irons and their dangling cords can be a great attraction to a crawling toddler and should be kept well away from them - in fact they should be designated a “no go zone” early on in every toddlers life! And remember to put plastic plugs in power outlets as little children can be tempted to poke things such as keys and sharp metal things into them with potentially terrible results.
Domestic chemicals such as oven cleaners and drain cleaners contain highly corrosive elements that can cause serious burns to the skin and should be kept far out of the reach of children. If contact does occur then :
Remove the cause of the burn by first rinsing the chemical off the skin surface with cool, gently running water for 10 to 20 minutes or more.
Remove clothing or jewelry that has been contaminated by the chemical.
Wrap the burned area loosely with a dry, dressing or a clean cloth.
Rewash the burned area for several more minutes if the person experiences increased burning after the initial washing.
and if in any doubt, or if there is continuing pain or blistering of the skin then seek prompt medical attention.
On a gloriously sunny day we should all be able to enjoy the privilege of living on the wonderful planet: but we should never take any of it for granted, but rather respect what we have - and that means taking measures that allow us, and our families, to enjoy our lifestyle and yet protect ourselves from any potential harm both within our homes and outdoors.


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Wednesday, July 17, 2013

Blood pressure: why you need to know.


William Harvey was born in Kent, England on April 1st 1578 and received his Medical Degree from the University of Padua, Italy in 1602. After his return to England he became Fellow of the College of Physicians and physician to St. Bartholomew's Hospital - my old Alma Mater. In 1618, Harvey was appointed physician extraordinary to James I. Harvey's famous Book, commonly referred to as "De Motu Cordis" was published in Latin at Frankfurt in 1628, when Harvey was 50 years old. The first English translation did not appear until two decades later. In Chapter 13, Harvey summarized the substance of his findings: "It has been shown by reason and experiment that blood by the beat of the ventricles flows through the lungs and heart and is pumped to the whole body. There it passes through pores in the flesh into the veins through which it returns from the periphery everywhere to the centre, from the smaller veins into the larger ones, finally coming to the vena cava and right atrium..... It must therefore be concluded that the blood in the animal body moves around in a circle continuously and that the action or function of the heart is to accomplish this by pumping. This is only reason for the motion and beat of the heart."
Thus, for over 380 years we have known that blood circulates around our bodies as a direct consequence of the pumping action of the heart - and of necessity, the blood within those blood vessels must be under pressure: and the challenge since then has been how best to measure that pressure and relate it to the pressure-related diseases that can affect the heart and those blood vessels which transport the blood to the organs which they supply .. the kidneys, the brain, the eyes and so on. And we had to wait for 2 centuries for one Siegfried Karl Ritter von Basch to invent the first primitive blood pressure machine - or sphygmomanometer - in 1881 and another 15 years for Scipione to modify it into the mercury manometer that was to remain the mainstream tool to indirectly measure the pressure of the blood within the blood vessels. It wasn’t until the latter part of the 20th century when the mercury manometer was slowly but surely replaced by more modern electronic equipment. But it wasn’t just the electronics that made Von Basc’s original concept obsolescent, his device was replaced mainly because the mercury within them is known to be extremely toxic to we humans  and disposal of those instruments was considered a health hazard!
A blood pressure machine works by occluding the flow of blood in the upper arm with the aid of an inflatable rubber cuff. The cuff is then slowly deflated and 2 numbers are recorded which relate to the pressure within the artery when the blood is pumped out of the heart, and the pressure within the artery when the heart is relaxed - in medical terms these are called the systolic pressure and the diastolic pressure. When I started medicine, the healthy reading for an adult was 140/80 but over the years this dropped to 120/80, but just when we were getting used to those numbers, the most recent advice is that the normal figure should be .... 140/80 again! Which can be interpreted as either what’s old is new again, or more correctly that scientists are constantly reviewing the information they have and then giving the most up to date and informed advice on how to best use that information in the clinical setting.
Knowing what the normal pressure is has allowed us to look at very large populations of people and realize that as blood pressure goes up so does the rate of heart disease, the risk of having a stroke and of suffering more serious kidney damage. The problem is that high blood pressure does not have any symptoms and the only way you can discover if your blood pressure is up is to actually measure it! And why do people get blood pressure? Well in about 90% of cases we have absolutely no idea why! The good news is that we have developed many good and effective medications that can control it and bring it down to the normal range - but even then it is really important that the blood pressure is measured long term to make sure that it remains normal.
Despite having more user friendly electronic blood pressure machines,  the challenge has always been to interpret the results that these machines give us. For instance, some people with normal blood pressure - and this is thought to be about 20% of the population - when they go to a Doctors surgery actually get a little agitated and their blood pressure goes up: this is known as the white coat effect, and in reality these people should not be treated for blood pressure problems, but rather for a case of mild “Social anxiety disorder” brought on by being in a medical environment. At the other end of the spectrum are those who do have higher blood pressure yet feel reassured by being in a Doctors surgery and their blood pressures actually fall a little bit - and this is known as the reverse white coat effect.
Added to this confusion is the challenge of which blood pressure measurements do we determine to be useful - office testing, home testing or random testing - because if treatment is based on unreliable blood pressure results, this can lead to unnecessary long term - and in many cases expensive - medications which also have the potential for side effects.
So what is the correct way to get an accurate measure of blood pressure? Resting blood pressure has long been the gold standard measurement - this is to be taken on a patient who has been lying down for a few minutes in comfortable surroundings, and then the pressure recorded using a blood pressure cuff on the upper arm: and most professionals will repeat the measurement a second time after a few more minutes to confirm the recordings are accurate. This method of recording blood pressure has now been backed up by Ambulatory  blood pressure monitoring that allows the specialist to see how a persons blood pressure reacts over a 24 hour period. Of course, when you undergo physical exertion, your blood pressure will go up - and this is a very normal response to  physical activities - but it should come down afterwards in someone who has normal blood pressure, and having access to information gleaned over 24 hours allows the experts to determine what is normal and what is probably not normal.
Where ambulatory blood pressure monitoring is not easily available, I encourage patients to perform home monitoring to back up what the Doctors are recording in their offices, as it does give instant feedback to the individual: and with the cooperation of the treating Doctor, this can also allow the patient to fine tune their medications in order to obtain tighter control.
Once high blood pressure has been confirmed, it is important to continually gather blood pressure readings both at home and at the Doctors office - so that medications can be adapted to the individual and the changing circumstances of their lives.
But having high blood pressure doesn’t always mean taking medications, each individual can have an impact by adopting lifestyle changes that can help lower their blood pressure:
Lose weight
Stop smoking
Exercise regularly
Cut down on excess salt intake
Cut down on alcohol consumption to the recommended intake
Take up meditation or yoga

These lifestyle changes will not only help lower blood pressure, they can also enhance your health and overall well being, and reduce the chances of developing other chronic health diseases too.

This article is available in Podcast format on iTunes ... and it's free!
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Sunday, June 30, 2013

Bacteria - the world's first inhabitants!

In the late 1960s, US Surgeon General William H. Stewart is alleged to have made the now infamous declaration that “[it] is time to close the book on infectious diseases and declare the war against pestilence won”. Well time has certainly proved that comment to be totally false! Bacteria and other microbial organisms are past masters at adapt and change techniques and leave we human Johnny come latelies eating their dust when it comes to facing such challenges. Here are a few facts that help put the whole “war on pestilence” into some perspective:

Microbes have been around for 3.5 billion years and have adapted to most environments on the planet: which has allowed them to survive freezing, boiling, to living without oxygen or sunlight and in conditions of extreme salinity. They can survive pressure at the bottom of oceans that would crush just about any man made submersible and thrive on the poisonous gas Hydrogen Sulphide.

These Microbes are also ubiquitous and represent 60% of the Bio-mass on earth and that figure rises to 90% if you remove cellulose from the equation, and yet we’re talking about individual organism that can often only be viewed through high powered microscopes. In fact, as noted in a previous program on the Human Micro-Biome, there are about 6 times as many bacteria living on or in we humans than we have human cells.

Then there is the fact that a bacteria has the ability to replicate in as short a time as 20 to 30 minutes as compared with humans who take two to three weeks to replace our skin and about 20 to 30 years to completely replace all our bodily cells! So not only do they out number us by a factor of 10 to the power 22, they’ve existed for a 1000 times longer and can reproduce half a million generations in the time it takes us to live one generation!

The genetics of bacteria are primed to deal with challenges, and the addition of human generated antibiotics in the last 80 years must surely rate as just a tiny hiccough in their ability to populate the globe and all that lives upon it: and therein lies our challenge.

When Albert Florey and Alexander Flemming first introduced the penicillin antibiotic the results were astounding: susceptible bacteria were destroyed and infections previously seen as a death sentence were completely cured, which led to enormous activity in research to find other effective antibiotics to treat a whole spectrum of infectious diseases. And that was perhaps when the folly of man led to over-confidence in the use of such chemicals against seemingly defenseless germs!

Such overconfidence created an environment whereby antibiotics were prescribed freely and in many cases for probably the wrong reasons - especially against viruses where they have absolutely no place to play at all. But of even more concern has been the worldwide use of antibiotics in farming and for treating domestic animals too. In 1999 in the UK alone, 1,225 metric tonnes of antibiotics were used and 63% of that total was used on farm and domestic animals. When you consider how many hundreds of thousands of tonnes of antibiotics are now being used worldwide in our food chain and in our homes, then it is not perhaps surprising that we face a perfect storm of bacterial resistance.

However, it’s not just the overuse of antibiotics that we should be concerned about, there is also the issue that there has not be a new class of antibiotics released onto the market for many many years and according to reports, there are virtually non in the pipeline of the pharmaceutical companies either. There are a number of reasons for this, and one of those is the paradoxical past success of antibiotics.

Most antibiotics are given in 5 to 7 day courses and then the infection is fixed. Such a short course of medications doesn’t offer the Pharmaceutical Industry much incentive to produce new treatments. For them, chronic diseases offer a far greater reward for their hard earned research: diseases such as HIV where the anti-retrovirals are needed lifelong: cholesterol lowering medications, cancer treatments, blood pressure medications are all well funded as they need long term medication and provide the opportunity of long term profits too.

But before we seriously criticize Big Pharma too much, it should also be noted that they don’t receive too much Governmental incentive to go out on a limb and research new drugs, which can often take 10 years or so to bring to market and cost multi-millions of dollars in the process. Until Governments worldwide realize that the costs of dealing with rampant, multi-drug resistant bacterial infections is far more than targeted research, then we could be returning to a  pre-antibiotic era.

But one of the things that we humans have is wit and insight, and we are learning to exchange information with each other almost as seamlessly as our bacterial co-habitors! All of us are a part of the equation when it comes to solving this problem. Awareness of the magnitude of the problem is the first step and then each of us committing to good personal hygiene in order to reduce the transmission of some of these infectious diseases. Routine vaccination programs have led to dramatic decreases in childhood deaths from entirely preventible diseases and we need to keep up the rates to those already proven programs.
Should a trip to the Doctor result in the need for an antibiotic, then we should ask whether it really is appropriate and if so then we should complete the full course - as shortened courses can raise the risk of bacterial resistance. We should never use someone else’s antibiotic for our illnesses - because in effect that means that they will end up with a shortened course of treatment, and you may be taking a completely inappropriate antibiotic too! Always seek medical advice for any treatment that might be necessary.

Finally, one of the theories that might account for some of the current antibiotic resistance is that we take medications by mouth and they enter our gut tube which is home to a vast array of symbiotic bacteria who do us no harm at all. By disturbing their balance through the introduction of such chemicals, their pooled genetic history can allow them to swap information and quickly work out how to survive such a challenge. If this information is then passed onto the infecting organism, then antibiotic resistance is established. One recent researcher has noted that when antibiotics are given by injection, antibiotic resistance is much slower to develop.
It’s through such simple observations and imaginative thinking that we might be able to face down the impending storm: or to use the words of Dr Joshua Lederberg the Nobel Prize winner, “The future of humanity and microbes will likely evolve as… episodes of our wits versus their genes”

The Podcast of this Blog will shortly be on iTunes along with others recorded for Puggle FM the family friendly site.

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Tuesday, June 18, 2013

Mens Health - my take on it!


One of the many paradoxes of the male of the species is that just about every little boy wants to be like his Dad, but when they get to their teenage years, probably the last person any adolescent wants to be like,   is to be like their Dad. But eventually, when the boy becomes a parent himself he will develop  a degree of respect for his Dad and the circle of life is complete.

Being a bloke is not always easy, and sometimes we are given a really hard time when perhaps we don’t always deserve it. But it has to be admitted, that on many occasions we are our own worst enemy and I suspect that most of us could do a whole lot better.

Firstly, we must remember as a Dad, even when they’re not actually in the room with you, children DO know what’s going on: they do listen in on conversations, and they DO notice things like whats on the computer screen and what you were drinking the night before and they DO copy many of the things that they see you doing! So we have to get it into our heads that first and foremost, if you’ve got a young family, then you are the Defacto first teacher of those children - and these little people learn remarkably quickly!

By the age of five, eating habits have become ingrained and before the age of 10, in children who are overweight and eat fat-rich diets, fatty streaks are already detectable within their arteries - and these fatty streaks are the ones that can lead to future heart disease and strokes. So if Dad’s can lead by example and eat great food - food rich in vegetables, salads, nuts, fruits, chicken, fish and low in saturated fats - then it is very likely that their children will do what they do and that will give them some great eating habits and a much healthier start to life.

The same thing goes for smoking - if children grow up in homes where smoking happens, not only do they suffer from more chest infections and asthma, they miss more days from school and worse of all, they too may experiment with addictive cigarettes when they reach those chaotic years also known as the teenage years! And the male of the species has a huge role to play here: because when they are respecting their own bodies and caring for their own health, they are also showing their children how to care for their own health too and establish habits that will allow them to reach their fullest potential in life.

Children of parents who are physically active, will also tend to take part in physical activities themselves - another lifestyle that is linked with lower heart disease, lower rates of certain cancers and lower incidences of depression and mood disorders: and what a great gift that is to give to your children!

When we talk of Mens Health, it’s often done in isolation, but we are all someones child and we bring with us both burdens and benefits from those self same parents. The challenge for we men is to make sure that whilst we are working on our health, we show example to our own children so that they don’t repeat the mistakes of our past, but learn from the good things that we do. The other consideration for both male and female parents is to acknowledge that often we set double standards in our own homes. We expect our children to be honest, be respectful, and do all the good things good children are expected to do. However we know that perfection is impossible: and that bad things do happen to good people - but it’s how we respond to that bad luck, or what we do when we ourselves misbehave or do something bad, which marks out who we really are.

The ability to apologize to your children when you get it wrong is a great example for them. Admitting fault or error is a real sign of maturity and allows people to move on with dignity - something that often appears lacking in our modern society. And when bad things happen to good people, it’s not a matter of the victim carrying the burden of the perpetrator, but of focusing on regaining your equilibrium and even releasing the guilty party by the simple act of forgiveness. Some of the most dignified people I have ever met are those to whom terrible tragedies have occurred and who bare no malice to the person or persons who inflicted the suffering: these have been the truly great people of my time.

But for we men to operate at our maximum, it is very important that we take time out to reflect on what we need to do, why we are doing it and how best to achieve those goals. Being physically healthy is a basic part of this process and relies on simple daily routines: never smoke: eat a Mediterranean styled diet: if you drink alcohol, then drink in moderation and have a couple of days off alcohol during the week: be physically active 4 or 5 times a week doing something you like - and if you are married or in a long term relationship, then see that relationship as a part of YOUR healthy lifestyle and aim to keep it as vital and alive as you can: have date nights and take time out to do things that you enjoy doing together. Not only will you both benefit from such special times but your children will benefit too as a result of you making your marriage something special.

Mens health week comes around every year, just as all the other Health weeks come and go: but I believe that every week is mens health week and like all good health practices I also believe that we should review what we are doing from time to time just to see whether what I am doing is having positive results, or if there is anything else that I could do which would suit me better, or any way that I could make myself a  better people - not only for me, but for my partner and perhaps most critical of all, for the next generation. Because if I can  avoid repeating the mistakes of my past, and teach that to my children, then they too will take that habit forward with them allowing them to constantly refine their lives, and pass positive habits onto their children, so that slowly but certainly we will make the world a better place.

A Podcast of this article can be found at Puggle FM
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Wednesday, June 12, 2013

Memoirs of France II


I'm of the generation who believes in early to bed early to rise, more because after 20 hours of international jet travel, I innocently hope that my aches and pains will be better in the morning. But a hefty dose of jet-lag means that by 5.00am that same body is telling me its time to get up! But in winter in Bailly, it’s very dark for the next 3 hours and this morning it was seriously cold with a frost on all the roofs and cars. However, as long term parents, three hours to ourselves is always  a blessing and one which which cherished with shared delight today. Yet again I danced into the kitchen, and even after just a few days I think that my voice is improving! “lets go to Chartres I announced”. “Done” came the answer and so by 9.00am we headed off into the limp wintery sunlight through the frost touched countryside towards Chartres Cathedral, a place that only ever figured in my dreams and imaginations.
We trusted ourselves to “Madam Lash” our GPS device and she didn’t let us down, sadistically giving us directions which she knew we couldn’t follow, but she relented in the end and the spires appeared out of a pale blue winters morning sky.
Trying to describe Chartres, which others better skilled with words than I have failed to capture, is partly due to the deep emotion of this place. It’s not a building but a hymn to the gift of faith and a belief that there is a transcendent realm. It’s also a book retelling ancient truths mixed with human weakness and distilled with love and hope. It is also a story of Love. To see the ancient cobalt blues in glass created a thousand years ago by souls like us is to stand between times and hear a distant music that somehow, we all know.
Malcolm Miller has been sharing this story for 50 years and is still learning new stanzas of the aged saga that is Chartres Cathedral. He is an elegant scholar who shares his wisdom with witty insights and deep empathy to his beloved building. It was a privilege to share an hour with him: I hope we can spend some more time over the next 6 months.
On leaving the Cathedral, we were FROZEN! The temperature was below zero, but the gentle breeze ripped into our layered clothing and found all the easy ways in to the soft skin beneath. Thankfully we found a Boulangerie that sold fresh HOT mini pizzas which were delicious, and warm to hold too. We were regenerated and stepping back into our car, Madam L was in a benign mood and we sailed home in and easterly direction to the peace and warmth of our wonderful home.

I wish I had words to capture the sun in the lightly fogged fields, or its cold gleam in the bare branches of the forest, but it’s something that has to be experienced and I don’t have the words to bring that experience to life.
Tonight, our new neighbours have invited us for “aperitifs”: how gorgeously civilized!
The wonderful thing about going next door for an aperitif is that you don’t have to worry about driving! But when your neighbours barely know you and you don’t even speak each others language, then the potential for a strained few hours is high. But our guardian angel must have been on full-time duty as  we could not have met a nicer family, we could not have been offered more hospitality and we could not have be in a warmer, kinder environment. The family of Isabella and Alexis is a wonderful fusion of smiles, love and welcome! Their two sons, one 21 and the other 15 are in the Scouts, and at 8.00pm on a Saturday evening they came home from a scout meeting and greeted us like one of the family, having never set eyes on us before! And their daughters are not only young beauties, but charming, engaging, interesting and interested. We were offered “sweetmeats” of varying shapes, flavours and delights - even a special Epiphany cake with its hidden “favour”. We can all learn so much from the wonderful example of their politeness and  hospitality.
Our French stuttered along and their english flowed more easily, but neither side was too worried by any syntax errors as the evening wore on. It was a wonderful time and we will always have happy memories of it.

Today was Sunday and in our house that means Mass time. It was a frosty cold start and the walk to Mass best described as bracing. M was preoccupied with pain on the walk, but during the ceremony where they stand for prolonged periods here, she was in serious pain! The poor love was in a bad way for about an hour, but on returning home and lying down, the pain went and she bounced back. After lunch I went for a jog and M followed on the bike - gloriously pain free  - through the Foret de Marley, where in times gone past Louis XIV went hunting! We saw wild deer and pheasant and it was a total delight: then it was with childish delight that I ran down the last hill and came home, followed by a happy lady on her bicycle. This evening has been gentle bliss and we are so happy.


I just love these mornings: long, dark, lingering, making time seem more reasonable than it has for decades. Breakfast was prepared and eaten and then we headed for the supermarket to stock up for the invasion of tomorrow - daughter and young family arrive after the adrenaline rush of sliding down slippery snowed slopes in Austria. The French have the wonderful tradition of not working on Mondays if they can get away with it, and it’s to be recommended!   There are a smattering of grey haired folk to be seen wandering around a tad confused, but otherwise the gallic world continues to spin contentedly on its quirky axis.
The sun shone symbolically, although the icy breeze was the dominant partner in the weather department, but we decided to take the bikes to Versailles to visit La Trianon - the home of Marie Antoinette. It was wonderful, but we’d forgotten that on Monday, the French don’t like to work and so the place was shut! Poor us, we’ll just have to go back on another day!
This evening has been gentle and warm with M struggling a bit with her recovery. It is difficult to watch but although her body is doing it tough, her spirit is alive with the energy that she’s getting from this french visit. Rest and heal, rest and heal.


Minus four degrees and a brisk start to the day, but we went to the shops early and I bought a book in French which should be a good challenge: it’s by the man who wrote Shadow of the Wind, and it was written for children so it will be right up my street.

There is evidence to suggest
that those people who are
bilingual have a reduced risk
of developing Alzheimer’s
dementia. Other suggested aids
are staying fit, keeping up social
contact and eating a Mediterranean
styled diet.

Because it was clear and sunny and rain forecast for later in the week, we decided to go for a jog/cycle in the forest again. In the shade is was seriously cold and jogging felt harder than the other day: perhaps it was just that my muscles were frozen? But I  was coping well until a delightful man, 20 years younger than I drew level with me and asked whether I was running around the whole park. I would have thought that the purple colour of my face would have suggested otherwise. But it was nice of him to ask. I do find it hard to let people who have run past me - which is most people - actually get out of sight, so the last 2 kms was “faster” than I intended - which again was probably
good too.

Physical activity is not only good for helping reduce risks
of dementia but is also a key
lifestyle habit that has been shown
to help with managing Cardiovacular
Disease, Moods disorders such as Anxiety
and Depression, and reducing the risk
of suffering from certain cancers.

Later on the young family arrived and we had a delightful reunion and the kids were fantastic. We walked to the Boulangerie and bought fresh baguettes which son-in-law devoured with glee as we walked back up the street, much to the delight of the children. A lovely evening meal was prepared and eaten, and we all settled down for an early night. Tomorrow they leave early for Euro Disney, a place that M and I will happily decline: we have a fresh market, with vegetables, fresh meat, fowl and fish, to attend and which will be far more interesting than Micky Mouse and Co.

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