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Archive for the ‘from the consulting room’ Category

How should we respond to increasing dementia rates?

Posted in from the consulting room, health on December 17, 2013| 2 Comments »

David Cameron made a speech at the recent G8 Dementia Summit recently.

Frankly, it seems to me the premises on which his speech was based are wrong-headed, and the language – that fighting, defeating, destroying war type of language which is used way too often in relation to problems in the world – is at best unhelpful and at worst takes us in wholly the wrong direction.

What really bothered me?

this disease steals lives; it wrecks families; it breaks hearts and that is why all of us here are so utterly determined to beat it.

What exactly is this “it”? What kind of creature is it which steals, wrecks and breaks? This is the fundamental problem. Dementia is not a creature, it’s not an alien, it’s not an object even. It’s a process. In fact, I wouldn’t even use the word “it” in relation to dementia (I don’t use “it” in relation to any disease). This is a process which is a process occurring within a human being, a human being who lives within multiple physical, cultural and social environments, a human being who cannot be understood in isolation. If we see dementia as an object we are going to have a hard job achieving sufficient understanding to make a difference.

And then there is this….

In generations past, the world came together to take on the great killers. We stood against malaria, cancer, HIV and AIDS and we are just as resolute today.

We stood against malaria, cancer, HIV and AIDS, Mr Cameron? “Mission accomplished”? I don’t think so. What does WHO think about cancer rates?

The WHO predicts the number of cancer cases will soar to more than 19 million a year by 2025.

(14 million cases in 2012, up from 12.7 million in 2008)

The rest of his speech celebrates the amount being spent on pursuing drugs to treat dementia –

We are throwing everything we have at making the UK the place to invest and locate and work in life sciences. And I can tell you today, this strategy is reaping serious rewards. In the past 2 years we’ve had £1.8 billion of investment into this country announced.

But what do we know already works to reduce the chances of developing dementia?

Is there anything which has been shown to reduce the risk by as much as, say, 50%?

Yes, there is. Exercise.

How much of that £1.8 billion of investment has gone into this proven prevention? Nope, I don’t know either…..

Actually there are many things which seem to reduce the chances of dementia, and they are all related to how we live our lives – diet, exercise, smoking, stress management, mental stimulation and learning, social engagement and healthy relationships. In fact, pretty much the same things which have been shown to reduce chances of getting cancer too.

Turns out the best ways we know of tackling these big rises in these diseases is not to treat them like evil enemies to be defeated but by seriously changing our lifestyles.

We are not, as a species, living sustainable lives on this planet. How about we invest in tackling that issue?

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Awe

Posted in creativity, from the consulting room, from the living room, from the viewing room, health, life, personal growth on December 14, 2013| Leave a Comment »

One of the greatest emotions to you can experience. When I teach Heartmath, I ask people to think of a moment of AWE as one of the possible “heart feelings”

If you’re not quite sure what constitutes AWE try this – it is (no, I’m not going to say “awesome” – yuk!) FANTASTIC!

 

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catching, having or becoming?

Posted in from the consulting room, from the living room, health, life on December 11, 2013| 2 Comments »

I’ve caught a cold.

I bet you’ll say something very like that at some point in the next few weeks, but why do we use that word “caught”? I thought “well caught, sir!” “Good catch!” But, wait! Why on earth would I want to catch this particular experience? We tend to reserve this idea of catching for infections, don’t we? We don’t talk about catching diabetes, or catching asthma, do we?

With chronic, non-infective, diseases we often use the verb, “to have”. We say, “he has diabetes” or “he has asthma”. We might even add an “ic” to the end of name of the disease and claim it as an identity. “I am diabetic”, “I am asthmatic”. Why do we do that? Why do we, first of all, claim some kind of possession by “having”, then turn that having into an identity….a disease which defines us?

It gets even more interesting when we think about health, rather than about disease or illness.

We never talk of “catching health”, and we don’t so often claim possession (although people do say they “have good health”). Do claim health as an identity, “I am healthy”. I suppose we do. However, we don’t really think of health as an object the way we do disease, do we?

Maybe it would be interesting to consider what it would mean to “catch health”. How would we go about that? How would we create favourable conditions to allow us to make such a good catch?

Let me finish this little thought with a consideration of “becoming” (my favourite verb!)

Aren’t we always in a process of becoming? Becoming more or less healthy? Becoming more or less ill?

I prefer the “becoming” verb because it doesn’t objectify either disease or health. It insists on understanding that both disease and health are processes, processes which are an inextricable part of living.

So maybe I woke up having caught a cold, but I’m already becoming well!

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Tamiflu

Posted in from the consulting room, health, Uncategorized on December 9, 2013| 3 Comments »

Remember the big swine flu scare? Where governments threw around Tamiflu by the bucket load? This antiviral which had never been shown to successfully treat or prevent swine flu was stockpiled by the government (apparently at  cost of about one pound for EVERY 200 pounds spent on the entire NHS in England and Wales in 2009!) and “prescribed” in the UK after telephone tick box consultations.

I was astonished at the time that so many millions and millions of pounds were spent on this drug. I don’t remember such mass, thoughtless prescribing before the Tamiflu debacle. It struck me as horrendously irresponsible of the authorities. Most of it, I thought would just be pee’d down the toilet without doing any good.

Well it’s an even more disturbing story than I knew at the time. A new piece of research reveals that the amount of Tamiflu in the toilet water which was flushed into the rivers has now caused resistance to this drug in the viruses.

If it was ever going to do any good, and that is seriously in doubt because after determined campaigning by researchers, scientists and journalists, it turns out that the evidence Roche didn’t publish shows that Tamiflu doesn’t even do what they claimed it did , that good is sure reduced now.

But then the drug company got its billions didn’t it?

And isn’t that the point of a drug company? To make billions?

 

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Health, happiness and buying stuff

Posted in from the consulting room, health, life, psychology on December 2, 2013| Leave a Comment »

Here’s an interesting piece of research for this time of year….it’s one of several publications which show that buying stuff isn’t that good for you!

If you’re a materialistic individual and life suddenly takes a wrong turn, you’re going to have a tougher time recovering from that setback than someone who is less materialistic

It’s pretty easy to find research which shows you materialistic values are stronger in people with low self-esteem, and that what people who have these values do when they are stressed is find materialistic coping strategies……you’ll have heard of “retail therapy”. This particular piece of research looks at how this world view and coping mechanism affects recovery from stressful events.

In times of stress, people often seek solace through shopping,” he said. “The idea here is that we need some form of a cultural-based coping mechanism, because the research suggests that there is actually a short-term fix with retail therapy. Soon after purchasing something, there is a reduction of anxiety. But it doesn’t last very long. It’s fleeting. Materialists seek that as one of their coping mechanisms. And Black Friday and the holiday shopping season play into that

I think this issue relates to more complex, underlying factors but it does highlight the issue of how values and how we see the world influences our coping strategies and that not all coping strategies are equal.

I’ve read a number of other works which make it clear that experiences are more powerful than things when looking at their impact on happiness. In other words, spending a good time with someone contributes more to the happiness of the participants than spending in a shop. Retail therapy just isn’t that therapeutic!

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The angel moon of George Square

Posted in from the consulting room, from the dark room, from the living room, health, life, photography on November 30, 2013| Leave a Comment »

Angel moon

 

Yesterday morning I noticed the moon above the Christmas lights in George Square in Glasgow.

This got me thinking about rhythms – the lunar cycle, which so few city dwellers are aware of, and the cultural cycle of the Christmas season. Actually as I wrote that sentence I realised that American readers will probably use the term “Holiday season” instead of “Christmas season” and that’s something else which is interesting….about our cultures, our language, our beliefs and traditions.

The people who I meet in the consulting room day by day have such diverse beliefs – from followers of Islam, to Jehovah’s Witnesses, to Catholics, Hindus, Sikhs, Buddhists, New Age thinkers, agnostics, atheists, materialists…….and does that matter?

Of course it does.

How can I make any sense of what someone is experiencing if I don’t gain an understanding of what kind of world they live in? If I don’t take into consideration their values, beliefs, traditions, their ways of living, how can I understand their illness experience, and more than that…..how can I even conceive of what health might look like for this person?

Rhythms and cycles are such a fundamental characteristic of Life. Which ones are important to you and contribute to your perception of the world?

Which ones are you aware of today?

 

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A seriously disturbing indictment of drug companies

Posted in from the consulting room, from the reading room, from the viewing room, health, science on November 28, 2013| 5 Comments »

Dr Peter Gøtzsche is the founder of the Nordic Cochrane Centre, a highly respected medical researcher who examines clinical trials.  The Cochrane centres are widely accepted as the most reliable sources of unbiased information about the research evidence for medical interventions. He has written a thoroughly disturbing book comparing drug companies to organised crime. His messages are clear, rational and evidence based. Here’s a quote from his new book, Deadly Medicine and Organised Crime.

‘The main reason we take so many drugs is that drug companies don’t sell drugs, they sell lies about drugs. This is what makes drugs so different from anything else in life… Virtually everything we know about drugs is what the companies have chosen to tell us and our doctors… the reason patients trust their medicine is that they extrapolate the trust they have in their doctors into the medicines they prescribe. The patients don’t realise that, although their doctors may know a lot about diseases and human physiology and psychology, they know very, very little about drugs that hasn’t been carefully concocted and dressed up by the drug industry… If you don’t think the system is out of control, then please email me and explain why drugs are the third leading cause of death… If such a hugely lethal epidemic had been caused by a new bacterium or a virus, or even one hundredth of it, we would have done everything we could to get it under control.’​

 

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Mindbody

Posted in from the consulting room, from the dark room, health, life, photography on November 13, 2013| Leave a Comment »

twostone1

twostone2

I was gifted this stone recently.
I love it’s yin yang quality of inextricably bound black and white. You can’t have one side without the other. You can’t separate one side from the other.
This is what the “mind body” idea is to me. I don’t tend to use the term “mind body” because I don’t accept it’s duality. I don’t accept the implication that mind and body are separate/separable entities.
We live with our whole being. We become ill in our whole being.
Health involves the coherence of the whole organism, not just a part of it. Aren’t mind and body just two different perspectives on a person? Each with its own qualities, but each inseparable from the other.

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Patient centred-ness in Integrative Care

Posted in art, creativity, from the consulting room, from the dark room, from the living room, health, life, photography, Uncategorized on November 12, 2013| 3 Comments »

Facing the Med

There’s a lot of talk around just now about “patient centred care”. It’s one of those concepts that nobody argues against. In fact, pretty much everyone claims to be doing it. If that’s true, then it must mean different things to different people. Or it must have so many aspects, that different people resonate with the concept because they understand and value one of those aspects.

There’s a vast and growing literature on “patient centred care” but I’d like to make a contribution to the debate. I’m writing here from the perspective of a generalist, holistic, integrative doctor. I work at the “NHS Centre for Integrative Care” which, we claim, is a patient centred service within the NHS.

Some health care services are disease centred. There are Diabetic Clinics, Asthma Clinics, Hypertension Clinics and so on. These are specialist services where only people with particular diseases are seen, and where progress is measured primarily by measuring changes in the disease activity.

Some services are therapy centred. When you attend one of those services, only particular therapies will be used, no matter what your diagnosis, or who you are. The two biggies are surgery and drugs. Most services are designed to support the delivery of one of those two therapies. “CAM” (“complementary and alternative medicine”) clinics are often therapy centred too. Acupuncture Clinics, Osteopathic Clinics, Homeopathic Clinics etc. When you go to one of those you will see someone who has specialised in that particular therapy, and they will try to help you using that therapy.

Integrative Care is a patient centred therapy. It delivers individualised, multidisciplinary care using a range of different therapies, based on a holistic, personalised understanding of the individual patient. It is generalist, in that it is not limited to patients with specific diseases, and it is integrated in that it is not limited to the use of one particular therapy.

Now, I’m sure, there are many who will explain why their disease-centred, or therapy-centred service is also patient-centred, but I hope it’s helpful to clarify why an “integrative care” service cannot be defined by either the therapies used, or the disease diagnoses of the patients attending.

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Hope

Posted in from the consulting room, from the dark room, from the living room, health, life, personal growth on November 8, 2013| 1 Comment »

the colour of light

Václav Havel said

[Hope] is not the conviction that something will turn out well, but the certainty that something makes sense, regardless of how it turns out.

One of the commonest things patients tell me is that our work together has given them hope. That’s always very heart-warming feedback, because without hope, it is difficult to live.

But reading Havel’s statement about hope not being “the conviction that something will turn out well” got me thinking. I suppose because I completely agree. I don’t think hope is about giving people the conviction that all will be well. How could anyone give that guarantee after all? The future remains unknowable….whether we are well, or whether we are sick.

But if hope is not about believing a disease will go away, what is it? Havel says it is the “certainty that something makes sense” and I think that is right. One of the values of integrative practice is that it is sense making. Taking a holistic, individualised approach to a person, listening empathically and non-judgementally, with full attention and acceptance, sets up the potential for understanding – for the practitioner to understand the patient, and, for the patient to understand themselves, their illness and its place in their life. Understanding is sense making.

I think hope is something else too, though. A lot of people who consult me feel stuck, trapped, suffering, or in despair…..they are scared that this is now how life is going to be. Hope emerges when it becomes clear that change is not just possible but probable. Havel uses the word “certainty” and as the future is unknowable in detail we can’t offer certainty about specific outcomes.

But change is one of life’s certainties. As every individual is actively involved in creating their own experience, hope emerges when we realise life can be different, and that our choices can influence how different it can be.

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