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Archive for the ‘health’ Category

Drug taking for health

Posted in from the consulting room, health, life on June 14, 2014| 3 Comments »

There’s a lot of controversy this week about statins because NICE (the body which makes recommendations for the NHS in England) seems about to recommend a huge increase in the number of people taking statins. A group of senior medics have written to the government criticising this recommendation. The letter,

signed by nine doctors and academics including the president of the Royal College of Physicians (RCP), warns “public and professional faith” in the National Institute for Health and Care Excellence (NICE) could be lost and harm could be done to “many patients over many years”. It accuses the standards body of seeking to “medicalise five million healthy individuals”.

Their criticism includes concern about the quality of the evidence being used by NICE. They say they are….

seriously concerned that eight members of NICE’s panel of 12 experts for its latest guidance have direct financial ties to the pharmaceutical companies that manufacture statins”. They also warn that “overdependence on industry data raises concerns about possible biases”

But whatever you think about the quality of the evidence, do you think it really makes good sense to medicate millions of healthy people? This excellent summary from John Middleton really struck home for me

The Nice proposals suggest putting five million extra people on statins to prevent fewer than 500 deaths a year. For every death postponed, 10,000 people will have to take a statin to no purpose.

Let me just be clear that I understand the potential benefit statins can bring to people who have heart disease, and avoiding strokes and heart attacks is a perfectly reasonable goal. What bothers me is the idea that the way to ensure a healthy life for already healthy people is to get masses of them to take drugs for life. That makes absolutely no sense to me.

Surely, if we want to stack the odds in favour of healthy lives in already healthy people, we need to be making the changes to our society which will ensure healthier ways of living, not prescribing more drugs to more people for more of their lives.

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Progress

Posted in from the consulting room, from the dark room, health, photography on June 2, 2014| Leave a Comment »

Come a long way, haven’t we?

Plague doctor

 

 

image

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Drug company crime

Posted in from the consulting room, health on May 30, 2014| 5 Comments »

Does this bother you?

GSK

 

It obviously bothers the investors who wiped $1 billion off the share value of GSK after this story appeared.

Dr Peter Gøtzsche, the founder of the Nordic Cochrane Centre, recently described drug companies of behaviours which we would normally attribute to organised crime. He strikingly said

The main reason we take so many drugs is that drug companies don’t sell drugs, they sell lies about drugs.

A post I wrote a couple of years back about GSK being fined $3 billion mentioned that between 2009 and 2012 drug companies had paid $11 billion in fines. ProPublica summaries some of the biggest fines from 2009 to 2014 here.

An analysis by Dr Syndey Wolfe at the end of 2013 showed Big Pharma had paid $30 billion in fines from 1991 to 2012. He concluded

“There is a pathological lack of corporate integrity in many drug companies.”

Well fines like these, large as they seem to be, aren’t stopping these behaviours and why is that?

Over the past decade, the 11 largest global drug companies reaped about $711 billion in profits, according to a new analysis from the Health Care for America Now (HCAN) advocacy group. In 2012 alone, the drug companies’ annual profits totaled nearly $84 billion.

No wonder there are profits like this. A recent report titled “Health, United States, 2013” — found

the percentage of Americans taking prescription drugs has increased dramatically. During the most recent period, from 2007 to 2010, about 48 percent of people said they were taking a prescription medication, compared with 39 percent in 1988-1994.

and

One in 10 Americans said he or she had taken five or more prescription drugs in the previous month.

and, shockingly,

About one in four children took one or more prescription drugs in the past month, compared to nine in 10 adults 65 and older, according to the study.

Don’t you think we have a problem here?

Are prescription drugs the best way to increase the health of human beings? And if it is, why are more and more people needing more and more drugs? Or are more and more drugs being prescribed because of the way drug companies behave?

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Passion, compassion, humor and style

Posted in books, from the living room, from the reading room, from the viewing room, health, humour, life, personal growth, philosophy, psychology, video, writing on May 29, 2014| 2 Comments »

Maya Angelou was wonderful with words. You’re probably coming across some of them just now as the internet spills over with memories and thoughts about her provoked by the news of her death.

Here is one of my favourites

My mission in life is not merely to survive, but to thrive; and to do so with some passion, some compassion, some humor, and some style.

I especially like this one because I just don’t accept the sole point of living is to make it to the end. Is a Life survived for a number of years something you’d aspire to? Isn’t the sole goal of survival ultimately 100% doomed? (Nobody makes it out of here alive!). You can spend a life like a robot, or, in terms of this blog, like a zombie, on some kind of autopilot, surviving, but there’s something else you can do. You can thrive. You can flourish. You can express the uniqueness you are in this universe, and become what only you could become. You can live with passion, fully engaged with the wonder of the everyday (l’émerveillement du quotidien), you can connect, feel, respond, use your imagination to put yourself in the shoes of others, you can laugh, live with a twinkle in your eye, and you can do it with beauty, grace and, yes, style.

 

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Michael Pollan. Cooked

Posted in from the consulting room, from the living room, from the reading room, from the viewing room, health, personal growth, science, video on May 21, 2014| 1 Comment »

I like Michael Pollan’s views on food. You might be aware of his “food rules”……summarised in the following seven words

Eat food. Not too much. Mostly plants

What he is great at doing is bringing together knowledge from a number of disciplines (nutrition, economics, agriculture, anthropology, politics and so on), and weaving them into a seamless, and convincing narrative. He does that wonderfully in this google talk where he discusses his latest book, “Cooked”. Settle yourself down and watch this. It’s just under an hour, but that includes the Q&A, and I recommend skipping the over two and half minute intro from the google staffer!

In “Cooked” he describes learning the four transformations of food – using fire, using pots (water), baking (air) and fermentation (earth). His argument is compelling and the area of fermentation (using microbes to produce cheeses, pickles etc) is a completely fascinating new subject to explore.

One of the gems from this talk is his telling of the answer he received from someone working in the food processing industry when he asked what we could do about the obesity epidemic. The answer was “Only eat what you have made yourself”. He thinks that one principle (probably hard to adhere to 100% but a good target to aim at) would result in a healthier and more nutritious diet.

This piece doesn’t just get you thinking about the place of food in your life, it gets you thinking about the food industry, about politics and about how we might create a more sustainable way of life just by considering this important (probably central) issue of what we eat, and how it is prepared.

 

 

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The A to Z of Becoming. S is for Sleep

Posted in from the dark room, from the living room, health, life, personal growth, photography on May 11, 2014| 1 Comment »

Sleep.

Is that a problem for you?

I’m afraid if it is, you’re not going to like this next sentence…….Sleep is my core skill. I seem to have some kind of spirit level in my brain, so that whenever I lie flat, the sleeping potion floods my brain and, instantly, I mean instantly, I’m asleep. I move between the two states of sleeping and waking the same way. It’s like some kind of switch. Click. I’m asleep. Click. I’m awake. Now you know what really puzzles me about this? I have absolutely no voluntary control over this switch. I can’t just “decide” to move between the two states. Mind you, if I need to be up at a certain time, then I tell myself that before lying down, and usually, (I’m not confident enough to not use an alarm), I wake up about 2 minutes before the set time (and switch the alarm off before it goes off by itself!) How does the brain do that? How can it do it so accurately?

There are many, many mysteries about sleep and I know lots of people really struggle with sleep, whether it’s trouble getting off to sleep, or waking repeatedly or just too damn early. In my role as a doctor I suggest a number of things….I don’t have a one size fits all approach to anything, but try Heartmath for starters. Lots of people find that helps. I don’t just mean try it before sleeping time, I mean integrate it into your day. I believe various different meditation practices can help, as can the usual areas of exercise, diet, and “sleep hygiene” (which involves establishing pre-sleep habits).

People sleep differently in different cultures too. Tokyo must the be city with the greatest number of day time sleepers. You see people asleep in cafes, on the metro, everywhere really. It’s quite surprising for a visitor. The countries on the Med have a habit of the siesta, which might have more to do with sunshine than anything else (“Mad dogs and Englishmen…..?”)

So, have a think about sleep this week. What patterns and rhythms work best for you? What induces a “good” sleep for you?

And here’s a couple of photos of sleepers I took earlier (first one in Tokyo, second one in the afternoon in Provence)

 

sleeping in tokyo

barrow

And here’s what we all hope for (this taken again in Tokyo, on the hoarding around a building site)

Sleeping baby on hoarding

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The A to Z of Becoming. R for reflect

Posted in from the consulting room, from the dark room, from the living room, health, life, personal growth, photography on May 4, 2014| 2 Comments »

Untitled

Mirror, mirror

 

In the A to Z of Becoming, R is for reflect.

What does it mean to reflect? I think reflecting has a number of elements. There’s a pace to it. When we reflect, we slow down. Instead of reacting, or “pressing on” with busy-ness, we temporarily stop, pause, take a breath. So taking a moment to reflect acts a natural break, creates that “necessary distance” the neuropsychologists talk about.

There’s an element of checking yourself out too isn’t there? The way we do when we look in a mirror. We see how we seem. We look at how others might see us. Or even without mirrors, but in conversation, or with the help of a journal, we can consider how we are living, what choices we are making, what habits we have acquired. We can think about our direction, our goals, hopes and fears. We can take a moment to reflect on how decisions we’ve taken are working out.

I think reflecting is something I do every day as a doctor too. In psychotherapy and counselling students are taught to reflect someone’s words back to them. This might even be called “mirroring” and when it’s done mechanically, or clumsily, it can feel a bit annoying (“What I hear you say is……..[insert clients own words here]”) but when it becomes a natural conversation, it lets the person reflect on the words they are using, the phrases they are repeating, and the beliefs which are underpinning their current state of mind or body.

When you can spend some time with someone who cares about you and will listen to you without judging you, you can gain some very fruitful insights as you reflect together.

So, here’s your verb for this week – reflect. Try it out and see what happens…….

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Do we have a problem with drug based Medicine?

Posted in from the consulting room, health on April 29, 2014| 2 Comments »

Here’s an interesting article which makes 20 points suggesting that we have a serious problem with drug based Medicine.

Just to keep this nice and simple and direct, let me just pick ONE –

The CDC says that spending on prescription drugs more than doubled between 1999 and 2008

Just take a moment to ponder that one….in NINE years, yes, just less than a single decade, the amount the US spent on prescription drugs more that DOUBLED! What on earth does that mean? Have twice as many problems been cured? Are twice as many people healthier? Has this spending peaked? Is it on the way down now?

What kind of way is this to practice Medicine?

 

 

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Witnessing not measuring

Posted in from the consulting room, from the dark room, from the living room, from the reading room, health, life, personal growth, photography on April 26, 2014| 2 Comments »

Seedling

 

I woke up up the morning with this phrase in my head “witnessing not measuring”, which was quickly followed by “witnessing not controlling”.

I’ve been wondering about that since.

That’s the essence of my work. I sit with people, engage with them, enable them to tell their stories and be heard without judgement which leads to understanding and recognition. Everything I do therapeutically is intended to support and stimulate the individual’s self-healing. I think this is something we often forget in health care – there really is only one way to heal, and that’s by the person’s own ability to self heal. Stop and think for a moment. If you have a cut, how does it heal up? If you break a bone how does it knit back together? If you have a viral infection how does your throat return to normal? Ultimately it’s done to your amazing capacity to self heal and self repair. Any therapy should assist that process if it is to be effective. It’s not ME who produces healing. It’s not my therapies which produce healing. It’s the patient’s own healing system which does the work.

And I can’t control that. Nobody can accurately predict the outcome of any particular treatment given to any particular individual on any particular day.

We like to pretend that by making measurements we can predict and so control. It’s an illusion.

I amazed every single working day by human beings and their amazing healing powers. Witnessing this is powerful. Understanding and caring come with the witnessing, and therapies are then tried within that context. It’s humbling.

Today I read in Gary Lachman’s excellent “Caretakers of the Cosmos”

Love, for Scheler, was the sine qua non of phenomenology, which in its essential form, is a way of allowing the world to be what it is, without interference by human concepts or aims. It is, in a sense, a way of listening to what the world has to say to us, from which follows the recognition that it has something to communicate, and is not simply a vast inanimate machine.

I think, by the way, there is a lot to be gained from witnessing yourself……whether through mindful meditation, reflective writing, or however you might do that for yourself.

Maybe that’s the third variation of the phrase I woke with – witnessing not judging.

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The best of all connections

Posted in from the dark room, from the living room, health, life, personal growth, photography on April 18, 2014| 2 Comments »

Links

 

Connections are important – whether we think if links, bonds, or relationships – we can understand nothing if we ignore the connections.

Christakis describes the importance of social connections in “Connected”

Barabasi describes this beautifully in “Linked” where he shows the usefulness of thinking about “nodes” and “links”.

Bloom describes the essential “social” nature of the universe by focusing on connections in “The God Problem“.

McTaggart comprehensively focuses on connections in “The Bond”

But, you know, there is a special kind of link, bond or connection which lies at the heart of all healthy, flourishing, growing organisms, all forms of Life, and all aspects of Nature – its the kind we see when we look at “integration”

Here’s a definition of “integration” – the creation of mutually beneficial bonds between well-differentiated parts.

There’s the key – “mutually beneficial bonds” (or links, or relationships)

I’m thinking this might be THE touchstone value – if you want something to grow, create mutually beneficial links between whatever it is and the rest of the world. If you want a relationship to thrive, create mutually beneficial links. If you want to know how to choose between different possible actions, ask yourself, do these actions create, or enhance, mutually beneficial links?

 

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