Practical tips on Pregnancy

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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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The air that we breathe.

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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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The domestic dangers of burns - indoors and out!

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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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Blood pressure: why you need to know.

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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.
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Bacteria - the world's first inhabitants!

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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”

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Mens Health - my take on it!

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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

Memoirs of France II

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Saturday

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.


Monday

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.

Tuesday

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.