Thursday, January 17, 2013

Pilates for better backs

I may have mentioned in previous Blogs that both myself and the Young Bride have had problems with our backs. The YB recently had a couple of spinal injections to relieve her pain, whilst some years ago, yours truly had a micro-discectomy to remove the fragments of a prolapsed disc that was painfully impinging on one of my lumbar nerves!

Back problems are one of the major reasons people attend their Doctors, they cause a massive amount of time lost from work, they cost the economy hundreds of millions each year and they can be bl**dy painful! So we should take back care far more seriously, and do all we can to prevent problems occurring or recurring, and that's why the YB and I have started Pilates classes with an accredited Physiotherapist. And what a learning curve it's been!

Firstly, there is no doubt that as your age increases, your flexibility decreases! Also, modern living dictates that we sit down for far too long which encourages poor posture and reduced movement at hips, knees and ankles - just try squatting down on your "haunches" and keep your feet flat on the ground! Many aged people in poor economies hold conversations and drink copious amounts of tea whilst in the "squatting" position: I could last about 60 seconds before several of my joints would scream "Masochist", and many of patients wouldn't even be able to assume the squat position!

Which leads me onto Pilates, which focuses on the "Powerhouse" area of the body - below the ribs and above the pubic area - commonly known as the abdominal muscles. And what the Pilates experts talks about  is

  1. Centering
  2. Control
  3. Concentration
  4. Precision 
  5. Breathing
According to our Physio at West Perth & Mosman Park Physiotherapy the exercises are designed to activate these "stabilizers" which reduces the stress on the spine and joints of the body and help attain correct postural alignment and muscle balance.

From our first two sessions I would add laughter too as watching the YB balance on a fit ball whilst trying to raise her left arm and right leg without tumbling off was a sight for sore eyes - we both fell about laughing until we had to move onto other, less amusing exercises.

After two weeks and two lessons we are more aware of the position of our lower back whilst sitting, standing, jogging, on the scooter and even now whilst I am typing. We obviously have so much more to learn and to practice, but I suspect that although it may not be 100% preventative, it will give us more protections and help us recover faster should we suffer from renewed back problems.

I intend to make 2013 the year in which, whenever I can, I'm going to try and improve how we care for our spines and promote all those things that are known to help reduce the burden of back problems. Having strong backs is the only known predictor of reducing the frequency and pain of back problems - so we need exercises like Pilates to achieve that. We also need to look at our work stations - both at home and at work - and spend less time sitting and more time standing: which is the reason the good Lord gave us two legs and one bottom - we should stand twice as much as we sit!

For all of you who do want to start up some back exercises, PLEASE make sure that the person you get your training from knows what they are talking about - that's why I like Physiotherapists who have studied Pilates, because they really do know their stuff.


Ampersands & angle brackets need to be encoded.

Sunday, January 13, 2013

Dr James Watson's Novel new theory

I think my mind runs on the chaos theory because it will often pick up on quirky facts and ideas that are currently seen as "definitely left field"!

The other day I saw a headline that has left me mulling over its contents, and thinking perhaps that it may cast a chink of light into that enormous vault that contains "Things we've yet to discover". Dr James Watson is best know for receiving the Nobel Prize for his work on the structure that we now know as the Double Helix of DNA - in other words he's a bright spark - so when he says something, it's probably worth listening!

His current theory is bound to cause controversy as it challenges one widely held public health idea on how best to "beat cancer" which is that we should all eat a diet rick in anti-oxidant containing vegetables as they help reduce the risks of certain cancers. Actually, there is (to my knowledge) no concrete data to suggest that eating lots of veggies will stop you from getting cancer: and before all vegetable loving people scream at me with loud howls of "Rubbish", I happen to be very "pro veggies" because:

  • I like them.
  • Fresh vegetables have less exposure to chemicals/hormones/antibiotics than meat and chicken do.
  • They contain essential vitamins and minerals that are good for maintaining a high level of bodily health.
  • Nuts, green teas, coffee, pomegranates, cruciferous vegetables etc all have positive health benefits that make them important ingredients in a well balanced diet.

But what Dr Watson is suggesting is that in LATE STAGE cancers, pumping extra anti-oxidants into your diet may in fact be COUNTER-PRODUCTIVE. From his studies, he believes that in such late stage situations, chemicals know as Reactive Oxygen Species - ROS - play a major role in what is called "planned cell death" - or Apoptosis. These ROS are found in all human cells that have outlived their normal "use-by" date and need to be cleared from the system before they cause any damage. The problem is that if these ROS are left unfettered in healthy, working cells then they can irreversibly damage key proteins and nucleic acid molecules [e.g., DNA and RNA]: so there needs to be a control procedure for ROS, and these are called Anti-Oxidants!

In the healthy person, taking anti-oxidants will help maintain balance within the cells and keep the ROS under control. But in cases of advanced cancer where there are a great many damaging malignant cells invading the system, the ROS need all the help they can get and that's when supplementing your nutrition with bucket loads of anti-oxidants may well be counter productive, and according to Dr Watson, it may be sending you to an early grave! He is also quoted as saying that “Unless we can find ways of reducing antioxidant levels, late-stage cancer 10 years from now will be as incurable as it is today.”

This highlights for me from his article are that firstly, there is no one magic bullet for cancer or indeed any health challenge - our bodies are far more complicated than that. Secondly, a healthy diet is vital for maintaining maximal health - and that definitely means eating a variety of vegetables, fruit and nuts - but it won't cure cancer! Thirdly, our bodies change over time and the needs of our bodies change too. And finally, that vast vault of unknowing is diminishing and it's thanks to people like Dr Watson who dare to challenge the "norm" and cast a new light in dark places. 


Ampersands & angle brackets need to be encoded.

Tuesday, January 8, 2013

Pap smears: are we doing a good job?

Public health screening tests for things like Breast Cancer, Prostate cancer and Cervical cancer are never far from controversy. And NO screening test is a 100%, gold-plated certainty to pick up all the cases of cancer that it is designed to detect. Also, more and more malignancies are being found to have some form of environmental link -

  • Smoking and lung cancer
  • Alcohol and bowel/breast cancer
  • Hepatitis C and liver cancer
  • Papilloma viruses and Head and neck plus Cervical cancers

   so prevention is a much better approach than shutting barn doors after horses have bolted!

Also, although we tend to assume that Pap smears are a simple procedure, like getting your passport checked at immigration, from a practical point of view - both for the patient and the practitioner - they are sometimes far from easy to perform!  For instance, strange though it may seem, the Cervix is not always easy to locate by an inexperienced Practitioner who does not have their examination room set up to perform them on a routine basis. Anatomically, in a woman who is overweight and not very "agile", and who has lax pelvic structures,  it can be very difficult to directly view the cervix as it is doesn't come with a label, nor is it distinctly a different colour to the rest of the surrounding vaginal structures!

But even in those cases where the experienced person can perform the screen and send the "smear" off for cytological examination, again the results cannot be claimed to be 100% certain. However, there are certain broad guidelines that are used to reduce the risk of missing early, treatable Cancer of the cervix, and these guidelines are based on age. BUT EVEN THEN THESE GUIDELINES MUST BE TAILORED TO THE INDIVIDUAL NEEDS OF EACH WOMAN.

In 2012, the U.S. Preventive Services Task Force, American College of Obstetricians and Gynecologists and American Cancer Society recommended that:

  1. Cervical screening should begin at the age of 21
  2. Screening should be every 3 years and not annually.
  3. Screening is NOT necessary for women who have had a Hysterectomy for non-cancerous reasons.
  4. Screening is not necessary for women over 65 who have had several previously normal Pap smears.

Current national policy in Australia is:
  1. Routine screening with cervical smears should be carried out every two years for women who have no symptoms or history suggestive of abnormal cytology.
  2. All women who have ever been sexually active should commence having a cervical smear between the ages of 18 and 20 years, or one or two years after first intercourse, whichever is the later.
  3. Cervical smears may cease at the age of 70 years for women who have had two normal cervical smears within the last five years. Women over 70 years who have never had a smear or who request a cervical smear should be screened.
From a recent CDC report, it appears that many women - 22 million in fact - may have had unnecessary Pap smears. The reasons behind this massive failing are probably not limited to the US: they're just far more honest about it!

My take on all of this? Sex is literally in our DNA, but we have to be aware that casual sex can cause permanent damage! As far as cancer of the cervix goes:

  • We need to improve our rates of vaccination with the most effective HPV vaccines currently available. 
  • We need to educate the most vulnerable groups on how to best protect themselves with vaccination and condoms. 
  • We need to screen those groups who are known to be more at risk (and at this stage I would tend to favour the American guidelines over the Australian ones). 
  •  Finally, those who are screening for Cervical cancer should only be screening those at risk and there should be no place for "over-servicing" of inappropriate cases.



Ampersands & angle brackets need to be encoded.

Friday, January 4, 2013

Let sleeping toddlers lie!

I'm sitting in a new place looking out the window at a "green scene" of trees, grass and dappled sunlight. Out of the other window, I can see sailing boats flying over the water in the afternoon breezes: this is a quiet, beautiful place to write!

I mention this because for many a young family, peace is not what they get when they have babies in the home. Babies cry at night, and it's always difficult to know what exactly is the right thing to do when their darling infant keeps waking at night and cries until their parents ears bleed!

In a recent report in Developmental Psychology, a study reported that it is probably best for "most" infants to let themselves "self-sooth" and let them fall asleep again on their own.

Apparently, by 6 months of age nearly all babies sleep through the night and will often only wake once per week - or more accurately, wake their parents once a week!

Naturally, we males are the more common offenders when it comes to attention seeking behaviour when the lights go down, but the vast majority seem to have settles into a good sleep pattern by 24 months.

Now herein lies the rub: what happens if you just happen to have 2 or three, or even 4 children in quick succession? And what if they're boys (we had 5 boys!)? How do you ignore the feral sounds of a screaming infant at 2 in the morning when the others have school in the morning and the breadwinner is working shift work? Not everyone has the comfort of a 5 bedroom, padded walled, solid brick, sprawling mansion to hush the sound of an infant that is determined not to self sooth and would rather have Dad or Mum sing them to sleep!

But behind the levity there lurks a serious issue: what is normal crying and when should parents intervene? And how can parents survive the "joys" of sleep-deprived parenthood when you still have to hold down a hectic "day job" in order to pay the mortgage etc?

Well unfortunately, there are no hard and fast answers: but it would appear that when night time comes, if your baby decides to wake and cry - control your primal urge to go and comfort them, they will probably settle with time. As long as they were safe and healthy when you put them into the cot, they probably will be OK until they settle of their own accord. It's a fine point of judgment to decide whether to persist with patience,or admit that the decibels of the crying infant are more likely to wake the whole house, and get out of your warm bed to sooth them. At this stage, no one can tell when to draw the line and each parent has to learn the what's right for them and their babe!

Common sense dictates that each parent should take it in turns to "be on call" so that at least you know that you're going to get 3 OK sleeps per week, but where there is only one parent available then my advice would be to seek help from their family, their Doctor, the local District Nurse or infant welfare person - in other words, don't' be embarrassed to ask for help and ask early.

Sleep problems can affect us all at any stage in our lives, but toddlers present their own unique set of challenges, and caring for the child who wakes frequently every night crying can put a serious physical, emotional and mental strain on the whole family.  My beloved mother-in-law used to say "All you need is a little patience" and she lived to the ripe old age of 96! So try "controlled crying", and if it's not working then ask an expert who might be able to offer some positive suggestions.

Image: he's one of my beautiful grandsons!

Ampersands & angle brackets need to be encoded.