DEAR DOCTOR WITH DR CHRIS STEELE
DearDoctor CELEBRITY ANGELS
with Dr Chris Steele
EAT WELL & LOSE WEIGHT
How’s it done?
COVER UP THIS SUMMER!
HEALTHCARE TIPS TO KEEP YOU FIT
Tom Hanks Living with diabetes
Dr Chris Steele MBE MY ONE-STOP HEALTH MAGAZINE FOR YOU & YOUR FAMILY
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90 11 Wise Words
The resident doc on ITV's This Morning and a GP for over 40 years, Dr Chris shares his insights about what’s really important in health today.
Britain’s Healthiest Celebrities 17 Fit and Famous
Many celebrities are great examples of the benefits of fitness and healthy living, and they may even inspire you to start your own personal wellness regime.
Today’s Common and Serious Conditions 20 Diabetes Concerns
The health of the nation has come under serious threat caused by obesity and lack of exercise, causing millions to develop type-2 diabetes. But you don’t have to be obese to become diabetic, as Tom Hanks discovered.
25 Understanding Allergies
Can allergies be cured? Can I prevent my child from developing an allergy?
4 dear doctor with chris steele
These are some of your most common questions for which we provide some advice and guidance.
30 Stay Safe in the Sun
UV rays are becoming stronger. These rays can cause serious damage to our skin and eyes, even after moving into the shade. Dear Doctor shares advice on how to stay safe this summer.
32 Early Diagnosis Saves Lives
Although early diagnosis of all cancers gives us our best chance of a cure, there are few symptoms that warn us of the early stages of pancreatic cancer. Ongoing research is likely to bring some positive developments.
34 Breast Cancer Concerns
Breast cancer is the most common type of cancer in the UK. But awareness, early detection and new treatments are helping to increase survival rates.
38 Reflux: Common but Curable
Acid reflux is a common disease, yet symptoms aren’t always obvious
and are often confused with other conditions. Dear Doctor offers advice to help you understand the disease.
41 Piles of Discomfort
It’s a very personal and very common condition known to virtually all adults. You know what it is, but do you know the causes and the treatments?
Your Health and Fitness 44 Dr Chris’ 7 Steps to Summer Health
With summer fast approaching, Dr Chris shares his essential steps on how to stay healthy in the warmer months.
46 Help Your Heart
Our good heart health depends largely on our own common sense in terms of diet, exercise and lifestyle. Here are some tips and advice that will help your awareness.
50 Quit Smoking and Live Longer Giving up smoking is a challenge, but you will live a longer, healthier life if you quit for good.
41 53 Sweet Dreams
Silentnight’s sleep expert Dr Nerina Ramlakhan shares her top tips for getting a good night’s sleep.
54 Coping with Back Pain
71 Surgery on the beach
Why are so many holidaymakers adding surgery to their holiday checklist?
76 Treating Hair Loss
Various degrees of hair loss, also known as alopecia, is common—especially later in life. We have a look at different treatments available.
One in five of us will visit our GP about back pain every year—how do we solve this pain in the back?
57 Drink me!
Summer is on its way and with the warmer weather the need to drink more water becomes especially important.
59 Preventing Pressure Sores
Prevention is key for those at risk of developing pressure sores as they can cause serious infections.
61 In a Nutshell: The Case for Coconut Water
Endorsed by celebrities, the athletes’ drink of choice, and readily available at most stores. What is it that makes coconut water so popular?
79 Eat Clean
Many extol the virtues of eating organic, but for those of us not in the know, what does it actually mean and why should we do it?
82 Ditching Dairy
From eczema to IBS, dairy products have been blamed for a number of health complaints—prompting an increase in dairy-free diets.
86 Testing Testing
Infertility affects 3.5 million people in the UK. If you’re failing to conceive there are a number of alternatives available.
97 Bowel Supplements
It’s an issue that affects over six million people in the UK, yet many suffer in silence. Here’s what you need to know about bowel difficulties.
The Sugar Swap
Children are consuming more sugar than ever—over three times the recommended maximum allowance.
90 Fertility Facts
Your Visual Awareness
Our modern lifestyle can cause ‘dry eye’, which needs careful attention and treatment.
How to avoid hearing loss
With the NHS’s plan to ration hearing aid devices, Dear Doctor explores preventative methods. celebrityangels.co.uk
A new prenatal test for Down’s syndrome promises to increase accuracy and reduce the rate of unnecessary invasive diagnostic procedures.
62 Essential Oil
We take a look at the beauty applications as well as some of other uses of coconut oil.
Man Up for a Check Up!
Health checks for men are essential for all age groups, and in most cases the process will leave you feeling reassured.
82 DEAR DOCTOR WITH CHRIS STEELE 5
106 Soothing Aches and Joints
Everything you need to know about painful joints and how to fix them.
108 Good to the Bone
Our bones are constantly changing, and as we age, we require more nutrients to keep our bones healthy.
112 Guide to Weight Loss
PUBLISHER & CEO Kevin Harrington
Many of us struggle with weight loss, and according to the British Nutrition Foundation, over half of the people in Britain are overweight or obese and one in four adults is obese.
MANAGING EDITOR Charles Ford SENIOR EDITOR Hannah Guinness
Life starts at 60+
SUB EDITOR Samantha Coles
114 The Silver Line
SENIOR DESIGNER Friyan Mehta
Ester Rantzen talks to Charles Ford about how social media affects self esteem and the effects of loneliness on our health.
EDITORIAL ASSISTANT Anette Lien James Nicoli PRODUCTION DIRECTOR Joanna Harrington PRODUCTION COORDINATOR Iain Wilson
Dear Doctor explores all you need to know about private healthcare.
COVER IMAGE Courtesy of ITV & REX IMAGES
124 Treat Yourself!
If you’ve always dreamed of travelling the world, retirement is the perfect time to indulge.
Dear Doctor with Dr Chris Steele Celebrity Angels Suite 2 143 Caledonian Road King's Cross London N1 0SL Tel: 020 7871 1000 Fax: 020 7022 1694
127 The Cost of Death
The irony of living a longer, healthier life is that when your funeral eventually arrives it will be even more expensive.
For sales enquiries call: 020 7871 1000
6 DEAR DOCTOR WITH CHRIS STEELE
How do you feel about the prospect of retirement? Here are some insights that will help many come to terms with one of life’s milestones.
121 Health Insurance
PUBLISHED BY Copyright © 2016, Celebrity Angels. All rights reserved
Copyright © 2016, Celebrity Angels. All rights reserved. All material in Dear Doctor with Dr Chris Steele magazine is wholly copyright and reproduction without the written permission of the publisher is strictly forbidden. The views expressed in this publication are entirely those of the authors and do not necessarily represent those of Celebrity Angels. The information in this publication is carefully researched and produced in good faith, however, neither the publisher nor the editors accept responsibility for any errors. The Celebrity Angels Series is published in the UK under licence by Damson Media Limited. Damson Media Limited is registered in England and Wales under registration no. 07869300.
119 The Best is Yet to Come
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s far as the health of the nation is concerned—if you’ll forgive that rather grand sounding term—I do have concerns. The health of the nation is you and me, our families and our loved ones. Although there are many aspects of our health and our healthcare today that we should feel pleased and optimistic about, my biggest concern is the national obesity problem we’re facing, as I describe in my interview on pp. 11-14. To put that into context, what I despair about is how the message is not getting through about the importance of eating a healthy diet and more exercise. The other important point is for those approaching the borderline, in terms of obesity, to understand and be aware that the condition of being seriously overweight makes us much more vulnerable to long-term serious health issues, in
particular the development of type-2 diabetes, which in most cases is avoidable. On the upside, it is nearly always possible to pull back from the brink, by taking more regular exercise and following the other good advice you’ll find in these pages. To conclude on an optimistic note, and in view of recent clinical advances, I am optimistic that a cure for cancer will be found. This may not happen tomorrow, but survival rates in recent trials in two different countries have made the scientific community very optimistic that they are on the right track. So, in general health terms, if I put the plusses and minuses together, I will say that I am optimistic, providing that we take charge of our own health and wellbeing by following the overall message in Dear Doctor with me, Dr Chris Steele, and opt for a healthy lifestyle.
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DEAR DOCTOR WITH CHRIS STEELE 9
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WISE WORDS Dr Chris Steele MBE The resident doc on ITV’s This Morning and a GP for over 40 years, Dr Chris is on a mission to share his insights about what’s really impor tant in health today. In the following conversation he talked to Charles Ford
IMAGES © ITV
May we start by looking at some of the topical health issues of the day, for example, the Prime Minister has recently called for the nation to focus on mental health after a review has revealed inadequate, underfunded care, leading to ‘thousands of tragic and unnecessary deaths’. Chris Steele: i fully support this important focus on mental health. i need to start by saying i’ve suffered from severe depression myself a few times, so i’ve been there and it’s an absolutely horrendous condition to cope with. But the big thing with any mental disorders is the stigma. i’ve described the symptoms on this Morning and how i took the medication and how that got me right … so for anyone suffering depression, you take the antidepressants, they’re not addictive, and they will get you right. and a lot of viewers have come back to thank me (for admitting i have had the condition) and to say how helpful the treatment was—and there i am back on screen talking normally and fully recovered. But the stigma is horrendous—if you’ve got a broken leg people accept it but if it’s a mental condition then it has an awful negative effect on people’s minds about you. so this is an area that has to be brought into focus for the nation so that people accept it and accept the treatments that do work. we see kids in school with mental celebrityangels.co.uk
I’ve suffered from severe depression myself a few times, so I’ve been there and it’s an absolutely horrendous condition to cope with problems that are not being identified and so teachers need to be instructed about the signs of depression. a child may be becoming withdrawn, for example, and even parents need to be made more aware of these signs of mental disorders. a new sense of awareness amongst parents and teachers is vital. and there needs to be greater awareness also amongst employers because at the moment if people are off work due to a mental problem, they can’t tell their employers because it becomes a huge black mark against you for the future. so this is a big problem to change people’s attitudes. Antibiotic resistance is another current concern for the medical profession, with MRSA being one of the most infamous antibiotic-resistant strains of bacteria. Do you see the search for solutions as a major challenge for
microbiologists and one they are unlikely to achieve? as far as resistance to antibiotics is concerned, the over-prescribing of these drugs has made things far, far worse. But this is always a dilemma for GPs, when mother comes in with little Jimmy who has a sore throat, do you give antibiotics or not? antibiotics are only useful for bacterial infections, they are no use for viral infections—and most throat infections are caused by viruses. so when you say to a parent, i’m not giving you antibiotics because this is not a bacterial infection, they can walk out very dejected, feeling they’ve been short-changed. But i think GPs have to take a stronger position on this and they are doing so … it was only yesterday i read that the number of prescriptions for antibiotics issued by GPs is dropping. and it has to continue to decrease as there’s serious concern amongst microbiologists because we’re going to end up with bugs that are changing dramatically, mutating and becoming resistant—and there are only one or two antibiotics left that we’ve got in our armoury against these bugs. so it is a huge concern and GPs have to play a role in reducing prescriptions and patients will have to understand that they will not necessarily get an antibiotic as a treatment. and the medication treatment for a viral infection is basically—nothing. dear doctor with chris steele 11
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12 dear doctor with chris steele
Plenty of fluids, painkillers, bed rest, etc., and then let nature take its course. For disappointed patients walking out of the surgery with no prescription, is there any room for placebos?
Moving on to a topic that’s been a growing concern for many years, type-2 diabetes is emerging as a new pandemic, and there are an estimated 250 million people worldwide with diabetes. Yes, and it’s going to get worse.
You have to be careful there. I think in my next life as a doctor I would be a ‘placebologist’—a doctor who only prescribes placebos because, one, [laughing] you’ll never do any wrong, and two, placebos are dirt cheap, and you always get a placebo response but it’s not as effective as a true clinical response to a treatment! Also, to be serious, I think it would trouble your conscience to prescribe a placebo and if something did go wrong you’d be in deep trouble, so it’s not an option. In general terms, do you feel optimistic, or otherwise, about the progress being made towards cures for the big diseases of the day, such as cancer and dementia? With cancer, I’m very optimistic about a cure. Recently there was some research published from two different countries where patients have a type of blood cancer or leukaemia that has a very, very low survival rate. The patients who were treated only had months to live, and 94 percent of the patients treated with this new treatment were then free of the disease. The treatment takes out the white cells, they are genetically modified and then returned to the patient’s body, then these modified cells seek out the cancer cells and destroy them, and these cells have a memory so they are able to protect the patient long term against the cancer returning. This has the scientific community very excited indeed. With dementia there’s nothing powerful out there yet in terms of a cure, such as the cancer treatment just mentioned, although a huge amount of research is going on. It’s a growing problem because we’re living longer. When I was a young doctor, we didn’t see many cases of dementia, but today there are more people with the condition because we have this large elderly population, so when a breakthrough does come it will be very welcome indeed. celebrityangels.co.uk
Why do you say it’s going to get worse? We know there are at least a million people in the UK walking around with diabetes undiagnosed. Now this is the problem, with diabetes you don’t get any obvious symptoms until something goes wrong. People will say, flippantly, oh yes, it’s just sugar in the blood, as if it’s a minor condition. But let me just take you through the risks associated with diabetes, starting with the head: • increased risk of stroke • high risk of loosing your sight • high risk of heart attacks
• high risk of kidney failure • for men, risk of erectile disfunction • legs—amputation through gangrene Now all of these conditions are due to the arteries to those parts of the body becoming narrowed and furred up. And that’s what diabetes does, it affects the arteries that supply all your major organs.
We see kids in school with mental problems that are not being identified and so teachers need to be instructed about the signs of
Dr Chris is on the case, giving good health advice on ITV’s This Morning. DEAR DOCTOR WITH CHRIS STEELE 13
Would you agree that our modern lifestyle—more sedentary than in the past, together with over-eating and resulting obesity problems— is the main cause of diabetes? Yes, well just look at the size of people out there. I despair of the obesity problem, I really do. When I go out I’m more and more aware of people being over weight. Well, why are they overweight? A sedentary lifestyle, not doing enough exercise, watching television, kids playing computer games. We even have schools selling off their playing fields for redevelopment, so the kids aren’t getting activity and sports at school. And as for diet… Most people know they should be eating five portions of fruit and veg a day, but they’re not! You know the sugar debate that’s going on at the moment. I think that sugar tax should be slapped on, especially the fizzy drinks the kids are drinking. [The sugar tax has now been introduced in the UK, as of March 2016]. Bad diet and lack of exercise are both a huge problem. On the topic of weight loss, you’ve had this remarkable example of the help you gave Charlie Walduck who lost a record-breaking 35 stone after his weight threatened his health. He now credits you as his mentor and lifesaver. His problem was that he was eating a lot of high-fat foods; he was so overweight he couldn’t walk far at all. I gave him two pieces of advice: look at the food you’re buying and don’t buy anything that contains more than three percent fats; secondly, I want you to walk. He lives in Manchester so I was able to visit him every day and take him walking. To begin with he couldn’t walk more than twenty yards. So we’d take short walks that were gradually increased day by day. Anyway, he ended up doing the London Marathon, and the Great North Run; half-marathons he’ll do willy-nilly! So, walking is the way to go. That’s what got Charlie into long-term weight loss.
14 DEAR DOCTOR WITH CHRIS STEELE
Dr Chris and Holly Willoughby on ITV’s This Morning during Dr Chris’ Health Alert segment.
Returning to diet, recently on This Morning, viewers were told—forget gluten-free, if you want to shed the pounds. You should think about going dairy-free. Do you support this advice? No, I’m really not in favour of that advice. I’ve got coeliac disease which means I have to have a gluten-free diet, that’s the reason to go gluten-free, because you’re ill if you don’t. For normal people to go gluten-free is ridiculous and recent research shows there’s no benefit whatsoever to people who don’t have coeliac disease. Going gluten-free or dairy-free, it’s almost like a fashion statement and I don’t think anyone should do that unless they have tests that show they have an intolerance of gluten or lactose (which is the sugar in milk and dairy produce). You can do it, but to me you shouldn’t do these things unless there’s a reason for it. Turning to sleep issues, statistics revealed on the ITV Tonight show that out of 250,000 bad sleepers surveyed, 67 percent said that a bad night’s sleep affected not only their mood, but also their relationships, levels of concentration and productivity. Perhaps the result is hardly surprising, but would you say that resolving stress would help towards a good night’s sleep or is it more complicated than that? If you ask people, do you sleep well, a huge proportion will say no they don’t. It’s like asking people, do you get tired all the time—and a lot of people will say, yes, I
Going gluten-free or dairy-free, it’s almost like a fashion statement and I don’t think anyone should do that unless they have tests that show they have an intolerance of gluten or lactose often feel tired. The medical profession abbreviates that in notes as TATT, ‘Tired All The Time’! It’s a very common complaint. In fact, the body is coping quite well. Then again there could be genuine reasons for not sleeping well. Some people think that alcohol will help them sleep. It can help you get off to sleep, but the quality of sleep you get after alcohol intake is very poor quality sleep; you don’t get the deep, restorative, restful sleep. Also we come back again to lack of exercise. What are people doing? Sitting in front of the television for hours every night—so you go to bed and expect to get eight hours of deep, sound sleep? Come on! But this, of course, is only my personal opinion. My best advice? Take a ten-minute walk out every day, non-stop, ten minutes out, ten minutes back. So you’re taking a daily twenty-minute walk! As I’ve said already, I do despair about the obesity problem, so my key message is: get walking! •
HUGHES BANISH THE SYMPTOMS OF THE MENOPAUSE health Hughes Health Red Peony Menopause Tincture is a herbal medicinal product used for the symptomatic relief of hot flushes associated with the menopause. One of the best kept secrets in natural medicine is the herb Peony. Peony has been used for centuries, and is particularly important in the Chinese system of medicine where it has been used as a treatment for many female ailments, such as polycystic ovarian syndrome (PCOS), period cramps and even the mood swings associated with hormonal conditions. However, Peony is classified by the Chinese as a herb that ‘cools the blood’ and ‘clears heat’. Therefore, conditions in which there is heat, perspiration or inflammation in relation to gynaecological or menstrual problems would mean Peony being called upon immediately, and we see where it’s reputation for the treatment of menopausal hot flushes comes from. The main benefit of Peony when treating menopausal symptoms is that it has no oestrogenic/hormonal activity making it safe for women with a history of hormone dependant cancers and meaning it is safe with all medication that acts on female hormone levels. Peony tincture is officially registered with the MHRA (medicines control agency UK) meaning it is manufactured to the standards and quality of pharmaceutical medicines. Any questions about Peony can be directed to Medical Herbalist Stuart FitzSimons MNIMH, please call 028 8778 8141.
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Benefits of Hot Tub Hydrotherapy
Being the owner of a hot tub promises some amazing health benefits, as well as providing a treat for you and your family. Spas have been used as a source of relaxation in spa resorts and fitness centres all over the world and promote wellbeing, and owning a hot tub, can give you more regular access to these benefits. Hot tubs help to relax your body and mind, improving physical and mental health. The warm water and bubbles reduce the gravitational pull of your body, dilating the blood vessels which means less pressure on your heart, helping you cope with stress and anxiety, giving your body and mind time to unwind. The temperature of the water will induce perspiration which helps the body get rid of impurities and water retention, an excellent way to detox your body, aid weight loss and reduce cellulite. The hot tub jets provide a massaging effect easing aching muscles and back pain. Patients with arthritis find this kind of massage especially effective, as the warm water
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helps with blood circulation and the lack of gravity in water lets them move around more easily. The constant warm water will provide a longer pain relief, compared with a hot bath, as the latter will start to cool down before you feel you are ready to get out of the water. The experience of using a hot tub releases the body’s natural feel-good chemicals called endorphins, which will make a person feel happy and relaxed - another factor that will help those suffering from anxiety or depression. A hot tub can also help you with that “getting away from it all” feeling. By relaxing in your hot tub, you can get a similar sense of relaxation as you would on a holiday break, with warm waters and the stress-free atmosphere, and all this can be achieved in your home or garden! Where can I find out more? The British and Irish Spa and Hot Tub Association (BISHTA) is the best place to start. They can put you in touch with reputable companies who work to the BISHTA Code of Ethics and British industry standards.
BRITAIN’S HEALTHIEST CELEBRITIES
Fit & Famous
IMAGES © REX IMAGES, 123RF
Many celebrities are great examples of the benefits of fitness and healthy living. Their diets and exercise routines may even inspire you to start your own personal wellness regime
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DEAR DOCTOR WITH CHRIS STEELE 17
BRITAIN’S HEALTHIEST CELEBRITIES
elebrities have to look good and so they’re known for looking flawless—we see them parading their perfect bodies on the beach, or looking at us from a magazine cover with shiny hair and glowing skin. Although they receive help from clever lighting, many of them maintain strict fitness regimes. Some A-list celebrities have a tendency to support the latest diet fads, but many adopt a healthfocused lifestyle, acknowledging the importance of eating healthily and taking care of your body through exercise. Although we might not have access to their personal trainers, nutritionists and personal chefs, these 10 celebrities set an example we can all follow.
DAVINA MCCALL Best-known as a TV presenter, Davina McCall has also made a name for herself in the fitness industry. She has published a number of healthy eating books, Davina’s Smart Carbs and Davina’s 5 Weeks to Sugar Free, released a number of best-selling fitness DVDs and fronts an active-wear clothing campaign for Tesco. The busy mum has revealed she fits in 10-minute workouts during the day to keep herself in shape.
ELLIE GOULDING UK singer Ellie Goulding recently became a brand ambassador for Nike thanks to her love of exercise, and she is certainly a walking (or running) advert for the healthy lifestyle she preaches. She swears by intense, but relatively short, workout sessions every day, and
18 DEAR DOCTOR WITH CHRIS STEELE
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compliments her active lifestyle with a vegan diet.
able to maintain it and also have a balanced diet’.
Melanie Chisholm didn’t land the nickname ‘Sporty Spice’ without good reason. This year, the former Spice Girls star is backing Vertical Rush, the UK’s toughest stairrunning challenge. Her top tip is to ‘try setting yourself a daily squat target and increase by a few each day and you’ll fly up those flights in no time.’
TOM HARDY Like many actors before him, Tom Hardy has had to go through tough gym sessions to prepare for movie roles. In his breakthrough film, The Warrior, Hardy’s personal trainer had him doing four 20-minute workouts a day with light weights, a technique called ‘signalling’.
CHANNING TATUM Thanks to Channing Tatum’s background in dance, the Hollywood actor manages to stay physically ripped. His favourite form of exercise is CrossFit, which is built upon high-intensity interval training. Tatum, who has a personal nutritionist, is also known to give fitness tips during interviews.
Queen of the I’m A Celebrity Jungle, Vicky Pattinson lost an impressive 43lbs, culminating in a popular fitness DVD. She has since designed and developed her very own nutritional protein and supplement range, Mini V. and says ‘exercise is very important, but the hardest thing is being
The long-legged model prefers ‘fun activities’ to sweating it out in a gym. She is a big fan of pilates, high-powered dance classes and skipping. Rosie also swears by probiotics and adds them to healthy smoothies.
CHRIS MARTIN Coldplay’s lead singer’s daily routine includes running and an hour of yoga—in addition to regular boxing sessions in order to build upper-body strength. In addition to being a vegetarian, Chris Martin has also eliminated alcohol and coffee from his diet.
MADONNA Pop icon Madonna has defied her age and still looks as trim and toned as she did decades ago. She takes exercise seriously: gym sessions six times a week, workouts lasting three to four hours a day. Madonna has long been following a macrobiotic diet, based on a Japanese eating style.
HUGH JACKMAN In just four weeks, the Australian movie star Hugh Jackman managed to boost his physique and go from a lead role in Les Misérables to a wolf man mutant in The Wolverine. According to Jackman’s personal trainer, his training routine is about lifting weights based on a percentage system, which increases every week. Yes, it is hard work—but that’s what it takes to become an action hero. •
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TODAY’S COMMON AND SERIOUS CONDITIONS
Diabetes Concerns The health of the nation has come under serious threat caused by obesity and lack of exercise, leading to an alarming forecast of millions developing type-2 diabetes. But you don’t have to be obese to become diabetic, as Tom Hanks discovered
ith a million-plus people in the UK with undiagnosed prediabetes going about their daily lives, as dr chris has warned (pp. 11-14), this news should be enough to raise our personal awareness of the diabetes pandemic. Might we ourselves be pre-diabetic? how would we know? what are the symptoms?
Tom Hanks raises awareness
it was in 2013, in a tV interview with david letterman, that tom hanks made an invaluable contribution to the diabetes awareness campaign by telling the world that he had recently been diagnosed with type-2 diabetes. in fact, hanks revealed, he had been living with undiagnosed pre-diabetic symptoms for some twenty years.
I went to the doctor and he said, ‘You know those high blood sugar numbers you’ve been living with since you were 36? Well, you’ve graduated! You’ve got type-2 diabetes, young man.’ 20 dear doctor with chris steele
TODAY’S COMMON AND SERIOUS CONDITIONS
well known for his wide-ranging oscar-winning performances, some of his roles have required drastic weight changes. For example, hanks gained 30lbs for his role in a league of their own (1995) and he both gained and then lost 50lbs for his role in castaway (2000). ‘Gaining and losing weight may have had something to do with this [diabetes],’ he said, ‘because you eat so much bad food and you don’t get any exercise when you’re heavy. But i think i was genetically inclined to get it and i think it actually goes back to a lifestyle i’ve been leading ever since i was seven years old, as opposed to 36.’ he adds that pizza was a key ingredient when he bulked up for roles: ‘Pizza is the most delightful thing ever invented and it’s—for me— diabolically dangerous.’ and how does hanks cope with his type-2 diabetes? he told BBc arts editor will Gompertz, ‘i always joke: you’ve got to maintain the temple. i get regular exercise and i eat right— which everybody should do—and i take certain meds.’ and for the future, hanks has now ruled out roles that require weight gain.
I always joke: you’ve got to maintain the temple. I get regular exercise and I eat right—which everybody should do—and I take certain meds
ises Dr. Christ inacdrevase of type-2
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What are these symptoms?
if, as it proved for tom hanks, you think you could be one of those million-plus people in the UK with undiagnosed pre-diabetic symptoms, you would be right to ask, what exactly are these symptoms that will help me recognise that i might be pre-diabetic? For some pre-diabetics there are no signs or symptoms, however, if you’re overweight and edging towards obesity, dr chris says you are at risk and you should take steps right away to reduce your weight through the avoidance of high-fat foods, and by taking daily exercise. For others, there are what the experts class as ‘red flag’ symptoms that can signal a state of prediabetes:
dear doctor with chris steele 21
TODAY’S COMMON AND SERIOUS CONDITIONS
» » » »
blurred vision frequent urination increased thirst unexplained fatigue
What is my risk?
and for us all, we may find we are within a category in which diabetes is more likely to occur, if… » you have a family history of type-2 diabetes » you lead an inactive lifestyle » you suffer from high blood pressure » you’re overweight or obese » your age group is 50+
helping aWareness With Diabetes Uk
dr chris tells us: ‘while the forecast increase of type-2 diabetes in the UK is alarming, the awareness campaign is extremely important because the disease is preventable, particularly if people work to avoid becoming obese, and in some cases early stage diabetes is reversible if a programme of weight loss through strict diet and exercise is followed.’ diabetes UK runs the UK’s biggest-ever awareness campaign every year. this year diabetes week is scheduled for 12-18 June. this year the campaign aims to ‘set the record straight … we’ll be uncovering the truth about diabetes; what it’s like to live with it every day, and the things you wish everyone knew about living with the condition.’ why is the campaign so important? diabetes UK explains: ‘around seven million people in the UK—that’s one in seven of us—are at high risk of developing type 2 diabetes. it’s a serious condition with no cure, and it can lead to devastating complications. But type-2 diabetes isn’t inevitable. Up to 80 percent of cases of type 2 diabetes can be delayed or prevented. so it’s important that everyone understands their risk, so they can reduce their chances of ever developing the 22 dear doctor with chris steele
condition. that’s why our awareness campaign is so important.’ there is also a world diabetes day every year on 14 November when millions of people around the world come together to raise awareness of diabetes. •
Around 7 million people in the UK— that’s one in seven of us—are at high risk of developing Type 2 diabetes
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TODAY’S COMMON AND SERIOUS CONDITIONS
Can allergies be cured? How can I find out what’s causing my allergy? Can I prevent my child from developing an allergy? These are some of your most common questions for which we provide some advice and guidance are raised—this theory proposes that it is our improved hygiene standards that have actually reduced our exposure to both good and bad germs, germs which in turn can help strengthen the immune system, the body’s mechanism for keeping us healthy. however, with this theory comes a warning not to reduce hygiene levels in the home in an effort to reduce the risk of developing an allergy.
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llergies are common and they are increasing. Not to be confused with an ‘intolerance’ which is a reaction causing unpleasant symptoms, an allergy causes the body’s immune system to react strongly, sometimes in a life-threatening way, when exposed to a normally harmless substance—nut allergies are a well known example, as is pollen for hay fever sufferers.
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why allergies are increasing is a reason for ongoing and, as yet, inconclusive research. scientists believe it is likely there are a number of different causes, including environmental changes, changes to the bacteria within our bodies, and even our modern higher degree of hygiene has been suggested—in the home environment, for example, where babies and infants
amongst children, food allergies are increasing, with nut allergies being the most common. there has been some intensive work by scientists to solve the nut allergy problem in clinical trials, and with some remarkable success. in 2014 a team from cambridge announced that a breakthrough treatment for nut allergies had been discovered when the research project resulted in a majority of youngsters allergic to peanuts being able to eat them without showing ill effects. researchers at the wellcome trust clinical research facility at addenbrooke’s hospital, cambridge, gave 99 children aged between seven and 16 a sample of peanut protein in powder form. they increased the dosage over six months until the youngsters were able to eat a whole nut without any adverse reactions. 84 percent of patients could eat as many as five peanuts a day and more than 50 percent managed 10 peanuts. the dear doctor with chris steele 25
TODAY’S COMMON AND SERIOUS CONDITIONS
results were published in the medical journal, The Lancet.
So is it possible to reduce the chance of our children developing a food allergy? The official NHS response is: ‘It is thought that introducing foods that can cause an allergy (allergens) such as peanuts, milk and egg, during weaning and alongside continued breastfeeding, can reduce the number of children developing allergic disease in later childhood. However, this is only a theory and there are currently a number of studies ongoing around the world that aim to answer this very important question.’
In addition to peanuts, there’s a long list of substances that can cause allergies in many people: » animal dander (tiny flakes of skin or hair) » dust mites » food – particularly nuts, fruit, shellfish, eggs and cow’s milk » grass and tree pollen – the allergy to these is well-known as hay fever (allergic rhinitis), and affects as much as 20 percent of the UK population » household chemicals – including those in detergents and hair dyes » insect bites and stings
» latex – used to make some gloves and condoms » medication – including ibuprofen, aspirin, and certain antibiotics » mould – fungal growth that can release small particles into the air you breathe
If you or your child suffers an allergic reaction but you don’t know the cause, you should see your GP to arrange an allergy test, and there are several different tests available that will result in an accurate diagnosis of the cause. The Skin Prick Test is used mainly to investigate allergies to: » airborne allergens » certain foods » certain medications » insect venoms The test involves putting a drop of liquid allergen onto your forearm, followed by a gentle pinprick through the drop. If you’re allergic to the substance, an itchy, red bump will appear within about 15 minutes. Skin prick testing is very safe and can be performed in people of all ages. If you’re already taking antihistamines these may interfere with the results, so you would need to stop taking them for several days before the test.
Hay fever that can blight your summer Coughing, sneezing and streaming tickly eyes can make those days in high summer a misery for hay fever sufferers, when pollen levels are at their highest. For fast relief, it is often medication taken via a nebulizer that is the most successful remedy. Nebulizers are devices that can convert liquid medicine into aerosol droplets that can be easily inhaled through a mouthpiece or mask. Nebulizers are used for inhaling medication for a range respiratory disorders, including hay fever. OMRON offers a wide range of nebulizers to fit every need and every budget. With each breath, these reliable, portable and discrete nebulizers deliver efficient drug deposition, providing great results. The next generation OMRON A3 Complete Nebulizer provides the complete nebulization solution for asthma and other respiratory conditions. (For more information visit omron-healthcare.com)
HELP AND ALLERGY MANAGEMENT If you suffer from an allergy and are unsure of the cause or the best form of treatment, Dr Chris repeats the advice given above by saying your first choice should be to explain your symptoms to your GP. Advice is also available from Allergy UK. This year Allergy UK is sending out its experts nationwide in an innovative series of ‘Meet the Experts’ events where experts will deliver allergy advice and information at a venue near you. The events will take place throughout the year and into 2017, with each event specialising in a different allergic condition. Allergy UK says: ‘These are excellent opportunities to meet with a healthcare professional, and learn more about how to manage living with allergy.’ Here are the dates and locations: • London, July 9, 2016 – ‘Allergy and Intolerance’ • Exeter, September 14, 2016 – ‘Eczema and Food Allergy’. • Manchester, November 16, 2016 – ‘Asthma, including Indoor Allergy’ • Belfast, March 1, 2017 – ‘Food Allergy in Babies and Children’ (For more information visit allergyuk.org)
26 DEAR DOCTOR WITH CHRIS STEELE
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TODAY’S COMMON AND SERIOUS CONDITIONS
ALLERGIES IN THE HOME If you suffer from allergies, everyday household items could be to blame. We explore ways to lessen the allergens in your home Many substances found within the home can be the culprit for a number of allergic conditions, from asthma to rhinitis. The main symptoms of an allergic reaction are sneezing, wheezing, itchy eyes and shortness of breath, which can cause mild to severe discomfort to sufferers. Here are some strategies on how to manage allergens in your home.
FURNISHINGS AND FABRICS
Cover mattresses in anti-allergy mattress covers and use anti-allergy duvet and pillow coverings. Wash all bedding at over 60 degrees, and avoid bedspreads, padded headboards and quilts, as these attract house dust mites. Vacuum fabric covered upholstered furniture regularly, at least every couple of weeks, and wash covers regularly at 60 degrees. Consider having wooden floors rather than carpets. If that can’t be done, vacuum daily and steam clean monthly. When vacuuming, use a cleaner that has a high ‘hepa’ filtration and does not allow allergens to escape from the exhaust—look out for the British Allergy Foundation Seal of Approval on products.
Make sure windows are closed during early morning and early evening during pollen season. For dust traps (like blinds), damp dusting is best and avoid the use of feather dusters
28 DEAR DOCTOR WITH CHRIS STEELE
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as they ‘flick’ dust into the air. Wash curtains every three months at 56 degrees or above.
AIR AND TEMPERATURE
Using an air cleaner can help cut down and even remove allergens such as dander, smoke and house mites. Thermostats can be used to keep different areas of the property at different temperatures, as different allergens thrive in different conditions. House dust mites like warm, moist, dark environments like bedrooms, while mould will increase if a room is cold and damp.
Try and keep pets out of the bedroom, off the bed and away from all furniture where possible. Give cats and dogs their own beds, ones which preferably have an anti-allergy cover, and wash the beds at over 60 degrees. Make sure you groom animals outdoors, and wash them frequently to remove allergens. •
Keep your floors and the air allergen free with the Complete C3 Allergy Total Solution Vacuum Cleaner Most vacuums simply move allergens around the home, increasing allergic reactions instead of reducing them. The Complete C3 Total Allergy Solution Vacuum Cleaner is the perfect tool for those with allergies. This is thanks to the HEPA13 AirClean filter that can pick up even the finest allergen particles, removing them from both your floors and the air. Plus, it has all the quality Miele Vacuum features you’d expect such as a full sized Turbobrush, flexible hardfloor floorhead, six electronic power settings, 4.5-litre capacity and space saving compact storage. You can see why Which? rated the vacuum the best appliance brand for 2015. Find out more about allergy solutions at miele.co.uk/allergy.
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TODAY’S COMMON AND SERIOUS CONDITIONS
Stay Safe in the Sun
ith 100,000 cases of skin cancer as a result of overexposure to UV rays in Britain every year, we are all too aware of the dangers of too much sun, but a recent study shows that damage to skin cells continues for hours after spending time in the sun. The research, carried out by researchers from Yale University School of Medicine in the US and published in the peer-reviewed scientific journal Science Magazine, monitored skin cells to reveal that UV rays can continue to damage skin cells hours after sun exposure. UV rays are invisible to the naked eye, but are the main cause of the sun’s damaging effects on the skin. UV rays damage the DNA of skin cells, and skin cancers start when this damage affects the DNA of genes that control skin cell growth. 30 DEAR DOCTOR WITH CHRIS STEELE
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Protect your skin
MAIN TYPES OF UV RAYS 1. UVA rays age skin cells and can damage their DNA. These rays are linked to long-term skin damage, such as wrinkles, but they’re also thought to contribute to some skin cancers. Many tanning beds emit large amounts of UVA, which can increase the risk of skin cancer. 2. UVB rays have slightly more energy than UVA rays. They can damage skin cells’ DNA directly, and are the main rays that cause sunburns. They are also thought to cause the majority of skin cancers. 3. UVC rays have more energy than other types of UV rays, but they don’t get through our atmosphere and are not in sunlight. They are not usually a cause of skin cancer.
The National Institute for Health and Care excellence (NICE) has released new guidelines about sun exposure, warning that there is no ‘safe’ way to suntan, but also stressing the importance of moderate sun exposure to ensure we get enough vitamin D (about 10-15 minutes is sufficient for light-skinned people). When spending time outside in the sun, many of us don’t apply enough sunscreen. The amount of sunscreen needed for an adult is around six to eight teaspoons of lotion, and to be applied 30 minutes before sun exposure, and again just before you go out. Sunscreen should be applied liberally, and reapplied frequently (even ‘waterresistant’ types). Try to avoid being outside between 11am and 3pm, when the sun’s rays are at their strongest.
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With summer fast approaching, the UV rays are becoming stronger. These rays can cause serious damage to our skin and eyes, even after moving into the shade. Dear Doctor shares advice on how to stay safe this summer
TODAY’S COMMON AND SERIOUS CONDITIONS
Protect your eyes Protecting our eyes from UV radiation is just as important as protecting our skin. UV radiation not only damages the skin of the eyelid but also the cornea, lens and other parts of the eye. UV exposure contributes to the development of types of cataracts and possibly macular degeneration. Safeguard your eyes from harmful UV rays by wearing suitable sunglasses—look for UV-protection details on product labels and opt for a pair that block 99 to 100 percent of both UVA and UVB rays. Remember that the colour of the lenses doesn’t affect the ability to block UV rays, so choosing the pair with the darkest lenses doesn’t necessarily mean higher protection and can actually cause more damage as our pupils control how much light gets into the back of our eyes, and by wearing darkened lenses, our pupils open wider to let more light in. If you’re sunglasses aren’t rated to block UV rays, you could be letting in more UV light into the back of your eye. An ill-fitting pair of sunglasses can also be damaging, as UV rays can seep onto your skin and into your eyes. The ideal fit should line up with your brow, and shouldn’t be too close to your eyes (touching your eyelashes) or too far down your nose.
‘I’m a two-time skin cancer survivor,’ says Dr Chris ‘I’ve had skin cancer twice, once on my face and back, too. Back in the ’70s, when we didn’t know that skin cancer was caused by the sun, I used to have a sunbed and lie on it everyday and then we’d go on holiday and I’d top up my tan. I was always very deeply tanned in those days. One day I was shaving and noticed something on my cheek and it turned out to be skin cancer. I decided to remove the tumour on the ITV’s This Morning show—it’s the best way to show viewers
what it looks like and what the procedure to remove it involves. It was the size of a 50 pence piece. Then, a couple of years later, my wife (who is a nurse) said to me: “you’ve got a mark on your back like the one on your face.” I got it checked out and removed. I was lucky because out of the three types of skin cancer, squamous cell carcinoma, basal cell carcinoma and melanoma, I had basal cell carcinoma which is the most treatable and least threatening.’
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The UV Index is given daily for regions throughout the country. Many newspaper, television, online, and smartphone weather forecasts include the projected UV Index. Further information about the UV Index, as well as your local UV Index forecast, can be found on the EPA’s website at epa.gov/ sunwise/uvindex.html. As with any forecast, local changes in cloud cover and other factors could change the actual UV levels experienced.
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TODAY’S COMMON AND SERIOUS CONDITIONS
Early Diagnosis Saves Lives Although early diagnosis of all cancers gives us our best chance of a cure, there are few symptoms that warn us of the early stages of pancreatic cancer. Ongoing research, however, is likely to bring some positive developments
ancreatic cancer, known as the ‘silent disease’ due to the lack of identifiable early symptoms, affects around 8,800 people in Britain a year. This type of cancer affects men and women, normally between the ages of 50–80. In recent times we have seen Steve Jobs, Patrick Swayze and Alan Rickman succumb to the disease. According to Cancer Research UK, more than eight in 10 people with pancreatic cancer are not diagnosed until their cancer has already spread, meaning surgery to remove the tumour is no longer an option. For people diagnosed with a locally advanced disease the average life expectancy is a mere six to 11 months. There are currently no reliable methods of detecting the early-stage disease.
New research, however, does offer some hope. Scientists report that they have developed a urine test that may be helpful in detecting pancreatic cancer at an early stage. A report published in Clinical Cancer Research (2015), suggests three proteins—LYVE1, REG1A and TFF1—were measured in higher levels in pancreatic cancer patients. Using all three proteins, scientists were able to detect early stage pancreatic cancer more than 90 percent of the time. However, more research is needed to see if a
32 DEAR DOCTOR WITH CHRIS STEELE
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screening test could be developed based on these three markers.
NATIONAL TISSUE BANK
Another promising scientific development is the launch of the world’s first national tissue bank for pancreatic cancer. This is being set up at Barts Cancer Institute in London to determine earlier diagnoses, which will enable doctors to remove the cancerous tumour before it spreads. The tissue bank will store samples of pancreatic tumours as well as blood, urine and saliva samples, together with their detailed medical and genetic information— helping researchers get exactly the right type for their work. The project is being led by a surgeon at the Royal London Hospital, Professor Hemant Kocher, who explains that: ‘The Tissue Bank will help us to tackle this disease with earlier diagnosis. Many proteins associated with
pancreatic cancer are also found in blood, urine and saliva, so having these materials from patients alongside the tissue samples helps us to find ways to diagnose the disease at an earlier, curative stage.’
TODAY’S COMMON AND SERIOUS CONDITIONS
SYMPTOMS The first noticeable symptoms of pancreatic cancer are often: Stomach pains – In the beginning, the pain might come sporadically, but as the tumour becomes larger and more advanced, the pain may be more constant and last longer. The pain is often worse when you lie down or after you’ve eaten. Unexpected weight loss - Pancreatic cancer is more likely to cause weight loss than some other cancers because the healthy pancreas produces digestive enzymes, which help food to be absorbed into your body. Jaundice - The most obvious sign of jaundice is yellow skin and yellowing of the whites of the eyes. It also causes your urine to be dark yellow or orange. Jaundice, however, is more often a sign of conditions such as gallstones or hepatitis than it is of cancer. It’s important to remember that these symptoms can be caused by many different conditions, and are not necessarily a sign of the onset of cancer. However, you should contact your GP if you’re concerned, or if these symptoms start suddenly.
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DIAGNOSING PANCREATIC CANCER
Though new research is promising, we still have a long way to go towards early detection of pancreatic cancer. If you find yourself experiencing any of the symptoms outlined below, visit your local GP. Your GP will normally test your urine, look at your eyes and the colour of your skin to check for traces of jaundice, and also take a blood sample. Your doctor may also examine your abdomen and check for any swelling. To help make the diagnosis, CT or MRI tests are performed on the abdomen. The diagnosis comes from a biopsy by taking a tissue sample from any tumour located; this is performed either with a needle through the skin or during an operation. • celebrityangels.co.uk
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Risk factors • Smoking Around 30 percent of occurrences of pancreatic cancers in the UK may be due to smoking. Chewing tobacco also increases the risk. • Overweight Some studies have found that being overweight and/ or physically inactive may increase the risk of pancreatic cancer. • Family history About 5–10 of every 100 cases of pancreatic cancer are possibly linked to faulty family genes. • Age As people get older their risk of developing pancreatic cancer increases. Most people who develop pancreatic cancer are 65 or older—it rarely affects younger people.
DEAR DOCTOR WITH CHRIS STEELE 33
TODAY’S COMMON AND SERIOUS CONDITIONS
Concerns Breast cancer is the most common type of cancer in the UK, but awareness, early detection and new treatments are helping to increase survival rates
very year some 58,000 people are diagnosed with breast cancer in the UK, which is the equivalent of one person every 10 minutes. The disease isn’t limited to just women, either, as one in eight women will be diagnosed with breast cancer in their lifetime, and one in 870 men. However, breast cancer is now a disease that most women (and men) survive, thanks to early detection and treatment. Breast cancer is divided into noninvasive and invasive types. Non-invasive breast cancer, also known as carcinoma in situ (CIS), is found in the ducts of the breast, where it hasn’t developed the ability to spread outside of the breast. This form of cancer rarely shows up as a lump in the breast, and is usually found on a mammogram. The most common type of non-invasive cancer is ductal carcinoma in situ (DCIS). Invasive breast cancer has the ability to spread outside the breast (although, 34 DEAR DOCTOR WITH CHRIS STEELE
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this does not necessarily mean that it will). The most common form of breast cancer is invasive ductal breast cancer, which develops in the cells that line the breast ducts. Invasive ductal cancer accounts for about 80 percent of all breast cancer cases.
THE FIGHT FOR HERCEPTIN: A DECADE ON
Herceptin, which is also used to treat stomach cancer, is used to help control the growth of cancerous cells that contain high amounts of HER2 (a type of protein found in all human cells, with the levels of HER2 being unusually high in certain types of cancer). Herceptin works by blocking the effects of the protein and encouraging the immune system to attack these abnormal cells.
line Personal OPERA, or On and Risk Education enables you to Assessment, k of developing ris ur yo ss se as on your family cancer based st cancer and history of breaer. OPERA is ovarian canc ional Institute Nat based on the Care Excellence d an th al He r fo es, and can be (NICE) guidelinmillan.org.uk found at mac
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TODAY’S COMMON AND SERIOUS CONDITIONS
Herceptin is used in early HER2 positive breast cancer, following surgery and/or radiotherapy and chemotherapy to reduce the risk of the cancer coming back. It’s also used for advanced HER2 positive breast cancer that has spread from the breast (metastatic breast cancer). Herceptin can’t cure metastatic breast cancer, but it can slow the growth and increase survival time. When the drug was first introduced in 2005, it was only available on the NHS to patients with advanced cancer, despite being proven in global clinical trials to halve the risk of aggressive cancers coming back in early stage breast cancer treatments. However, the drug had yet to be approved by the National Institute of Clinical Excellence (NICE) and approval would take at least a year—meaning that cancer patients would die waiting for this approval. A group of women (who met in oncology departments when battling the cancer themselves) started The Women Fighting for Herceptin campaign, taking on the government to have the drug licensed. They succeeded, and in 2006, all women who needed the drug could be treated with Herceptin. Since then, the use of Herceptin is being considered for use without chemotherapy. A current study by the Japanese Journal of Clinical Oncology is evaluating the effectiveness of Herceptin-only treatment in women over 70 years of age. As chemotherapy is a tough and invasive treatment, many women are seeking alternatives especially if they’re in their later years. The trial is conducted to investigate the benefit of Herceptin alone in comparison to Herceptin and chemotherapy combined. This trial is expected to complete in October 2016. [Sources: NHS, Macmillan Cancer Support, Cancer Research UK] •
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Symptoms of breast cancer The most notorious symptom of breast cancer that most women notice is a lump in their breast. However, most breast lumps (90 percent) aren’t cancerous, but should still be checked out by your GP. Other symptoms of breast cancer are: • An area of thickened tissue in either breast • A change in the size and shape of one or both breasts • Discharge from either nipple (which may be streaked with blood) • A lump or swelling in either of your armpits • A rash on or around your nipple • A change in the appearance of your nipple, such as it becoming sunken into your breast
CAUSES The causes of breast cancer aren’t fully understood, and it’s difficult to establish why some women develop breast cancer and others may not. There are risk factors, however, that are known to affect your likelihood of developing breast cancer, including: AGE: The risk of developing breast cancer increases with age. At the age of 29, the risk of breast cancer is one in 2,000. At age 49, it’s one in 50, and over 70 years of age it’s one in eight. This is why breast cancer screening begins at 50 years of age. FAMILY HISTORY: If you have close relatives who have had breast or ovarian cancer, you may have a higher risk of developing breast cancer. It’s not necessarily hereditary, but particular genes
(known as BRCA1 and BRCA2) can increase your risk of developing both cancers, and these genes can be passed on from parent to child. OBESITY: If you’ve experienced the menopause and are overweight, you may be at risk of developing breast cancer as it’s thought to be linked to the amount of oestrogen in your body, as being overweight after the menopause causes more oestrogen to be produced. ALCOHOL: The risk of developing breast cancer increases with the amount of alcohol consumed. Research shows that for every 200 women who regularly have two alcoholic drinks a day, there are three more women with breast cancer, compared to women who don’t drink at all.
DEAR DOCTOR WITH CHRIS STEELE 35
RETHINK THE TREATMENT OF
REFLUX The LINX® Reﬂux Management System, a minimally invasive, long-term, surgical treatment option.
Most patients no longer required medication1
Regurgitation score was reduced1
• After 5 years, 85% of patients were able to stop daily PPI medication.
• The proportion of patients reporting moderate-to-severe regurgitation decreased, from 57% before implantation to 1.2% at 5 years.
The LINX device is restricted to sale and use by a licensed practitioner. Please contact an implanting physician to discuss suitability, risks, and side effects with LINX. For more information please visit www.toraxmedical.co.uk/linx REFERENCE 1. Ganz et al: Long-Term Outcomes of Patients Receiving a Magnetic Sphincter Augmentation Device for Gastroesophageal Reﬂux. Clinical Gastroenterology and Hepatology 2015. Torax ® Medical, Inc. and the LINX® Reﬂux Management System are trademarks of Torax Medical, Incorporated.
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Doc no: 4841-1 Rev 1. Date of preparation: Jan 2016.
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TODAY’S COMMON AND SERIOUS CONDITIONS
Common but curable Acid reflux is a common disease, yet symptoms aren’t always obvious and are often confused with other conditions. Dear Doctor offers advice to help you understand the disease, together with what symptoms to look for, and what treatments are available
astro-oesophageal reflux disease (GORD) is a common condition where acid from the stomach leaks out into the oesophagus (gullet). The most common cause of GORD is the failure of the lower oesophageal sphincter, which acts like a valve, which should open to let food into the stomach and then close to prevent acid leaking out. In GORD, this sphincter doesn’t close correctly, allowing the acid to leak out of the stomach. You may be at risk of suffering from GORD if you are overweight, eat a high-fat diet, or are pregnant. There are a number of common (and not so common) symptoms of acid reflux: » Excessive saliva – similar to how our mouths fill with saliva before we 38 DEAR DOCTOR WITH CHRIS STEELE
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vomit, your body may be trying to wash out an irritant in your oesophagus Heartburn – especially after eating Hoarse voice – if stomach acid seeps into your oesophagus, it can irritate your vocal chords and make your voice sound hoarse Nausea – especially if this occurs after eating meals Pain or difficulty swallowing, resulting in a sore throat Pain when lying down – the acid is more likely to escape into your oesophagus when you lie down or bend over Taste – you may have an unpleasant, bitter taste in your mouth, caused by the stomach acid coming back up into your mouth
If you suffer from any of these symptoms, visit your GP who will make a diagnosis and advise on the best form of treatment. Testing for the disease usually involves a long, thin flexible tube called an endoscope, which will be gently lowered down your throat so that any acid damage to the oesophagus can be seen. If you do have GORD, there’s a step-by-step approach for treating it—usually beginning with simple treatments, such as diet changes, and over-the-counter antacid medicines. If these are ineffective, there are more extensive treatments available, such as the LINX Reflux Management System described in the case study opposite.
TODAY’S COMMON AND SERIOUS CONDITIONS
CASE STUDY T
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How the LINX Reflux Management System bought relief for one sufferer of the condition known as GORD or reflux A persistent cough may not initially lead you to think you are suffering from acid reflux, but GORD (Gastro-oesophageal Reflux Disease) can manifest itself in a variety of unexpected ways. Pauline Saunders discovered this after suffering from a cough for sixteen years. Pauline, a HR manager from Oxted, was barely able to hold a conversation and, on occasion, felt like she was going to
vomit due to her debilitating cough. After years of being given various asthma inhalers and medications that didn’t work for her, Pauline eventually underwent further tests and was diagnosed with reflux. Pauline was relieved to finally have a diagnosis, but her nightmare was far from over. 52-year-old Pauline was prescribed a medication called a Proton Pump Inhibitor (PPI), which is generally prescribed for those suffering from reflux. PPIs work by stopping the cells in the stomach from producing too much acid, reducing reflux-related symptoms, such as heartburn. Unfortunately for Pauline, the medication made her feel unwell and, despite trying several types, she was unable to continue with it. Pauline explains: ‘I did not for a second think that my cough could be due to reflux; I had no other symptoms at all at that point. It was eventually diagnosed as reflux and I was put on PPIs, which helped with the cough but bizarrely gave me indigestion. These were changed several times but each type of medication made me feel incredibly unwell. After several tests, it was found that I had a hiatus hernia. I really didn’t want to spend the rest of my life feeling this ill and being on medication.’ PPIs are usually the first port of call for anyone who goes to their GP with reflux, however, for some people they are ineffective or unsuitable. Clinical data and recent studies also highlight that long-term use may cause health problems, and that people should not readily accept that this is a medication for life, instead they should be looking for an alternative, long-term treatment for their reflux condition.
Pauline did just that, and was advised that she was suitable for the revolutionary and minimally invasive LINX Reflux Management System procedure—a device about the size of a ten pence piece, which comprises of tiny magnets encased in titanium that is implanted around the oesophagus during laparoscopic (keyhole) surgery. Upon swallowing, the magnetic bond temporarily breaks to allow food and drink to pass normally, but then the magnets close, restoring the body’s natural barrier to the reflux of acid and bile. Pauline underwent the operation, and has found that her cough has now disappeared. Pauline, whose other long-term treatment option was a fundoplication procedure (a major operation that involves wrapping a portion of the stomach around the oesophagus to reinforce the weakened lower oesophageal sphincter) concludes: ‘I have avoided major surgery, for which I’m grateful, and also avoided a lifetime of medication and feeling unwell. The LINX Reflux Management System is an incredible procedure and I have already recommended it to my mother-in-law!’ For more information on the LINX Reflux Management System and to find out if it is available on your NHS Trust or who your nearest surgeon is, visit toraxmedical.co.uk/linx •
DEAR DOCTOR WITH CHRIS STEELE 39
Are you hiding your bum trouble away? Don’t sit on it. Talk to us and get it fixed. Bottom-related issues such as haemorrhoids, incontinence, colitis and constipation affect over a third of the UK population, making simple, everyday tasks difficult. If you’re one of these people, or concerned that your problem might be something more serious, such as Crohn’s Disease, or even cancer, don’t let your posterior be the elephant in the room. At THC, our consultants are experts in dealing with haemorrhoids and other colon or rectum conditions. They can assess your situation and recommend suitable treatments. Check-ups start from £150 and you could be on the way to a full recovery within 48 hours. We can even facilitate regular check-ups — a bum MOT, if you like. After all, you check your teeth and eyes at regular intervals, why should your bum be any different. Highly skilled people; State-of-the-art procedures; Experience treating thousands of patients. The Haemorrhoid Centre can help put your backside in the background — and keep it there. Don’t suffer in silence. Don’t sit on it.
Find a consultant and book a check-up today at
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TODAY’S COMMON AND SERIOUS CONDITIONS
of Discomfort It’s a very personal and very common condition known to vir tually all adults. You know what it is, but do you know the causes and the treatments?
aemorrhoids affect the anal area and rectum and there are two main types: internal or external, and they can be further classified, depending on their size and severity: » First degree – small swellings that develop on the inside lining of the anus and are not visible from outside the anus » Second degree – larger swellings that may come out of your anus when you go to the lavatory, before disappearing inside again » Third degree – one or more small soft lumps that hang down from the anus and can be pushed back inside (prolapsing and reducible) » Fourth degree – larger lumps that hang down from the anus and cannot be pushed back inside (irreducible)
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There are over the counter creams and ointments that can be effective but if the condition doesn’t improve and perhaps you have some bleeding, then you need to see your GP. The condition is a very common one and doctors are used to diagnosing and
treating piles, so there’s no need to feel embarrassed. It will be important to tell you doctor about any symptoms you may be aware of, such as recent significant loss of weight, if your bowel movements have changed or if your stools look dark or sticky. Your GP may examine the outside of your anus to see if you have visible haemorrhoids, and they may also carry out an internal examination called a digital rectal examination (DRE). During a DRE, your GP will wear gloves and use lubricant. Using their finger, they will feel for any abnormalities in your back passage.
A DRE should not be painful, but you may feel some slight discomfort.
Everyone knows what piles are but what causes the condition is still not clear. Straining due to constipation is considered one cause and will, of course, exacerbate the condition if it already exists. And there are a number of factors that can increase your risk of developing piles: • a family history of haemorrhoids, which could mean you’re more likely to get them • a persistent cough or repeated vomiting
DEAR DOCTOR WITH CHRIS STEELE 41
TODAY’S COMMON AND SERIOUS CONDITIONS
42 DEAR DOCTOR WITH CHRIS STEELE
It is possible that surgery may be recommended by your GP to remove haemorrhoids, and there are other options are available, including freezing and laser treatment, although the number of NHS or private surgeons who perform these treatments is currently limited.
It is often the case that your piles will reduce and clear up altogether within a week. During that time, the discomfort and itching can be unpleasant but there are ointments and other selfhelp treatments that will help alleviate the condition. Making simple dietary changes and not straining on the lavatory are often recommended first. Increasing the amount of fibre in your diet is recommended, such as bran, wholegrain bread, cereal, fruit and vegetables. You should also drink plenty of water and avoid caffeine (found in tea, coffee and cola). Various creams, ointments and suppositories are available over the counter (OTC) from pharmacies without a prescription. They can be used to relieve any swelling and discomfort. It is recommended that these medicines should only be used for five to seven days at a time. If you use them for longer, they may irritate the sensitive skin around your anus. Any medication should be combined with the diet and self-care advice detailed above.
However, if you’re planning to seek any clinical treatments, Dr Chris advises that your first step is to discuss your condition with your GP. •
• being over 45 years of age—as you get older, your body’s supporting tissues get weaker, increasing your risk of haemorrhoids • being overweight or obese • being pregnant, which can place increased pressure on your pelvic blood vessels, causing them to enlarge (the haemorrhoids will usually improve after you give birth) • persistent constipation, often due to a lack of fibre in your diet • prolonged diarrhoea • prolonged sitting down • regularly lifting heavy objects
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If the above OTC and selfhelp remedies are inadequate in solving your condition, clinical tr eatment ma y be your best option. Ultroid is a fast, effective and safe treatment for internal piles recently introduced in the UK. The procedure is straightforward and usually painless. A gentle current is applied to the base of the haemorrhoid for up to ten minutes, causing it to shrink by around 50 percent— with no needles or sharp instruments needed. Ultroid informs us that most people are cured after one treatment session, but the number of treatments depends on how many piles you have and how large they are. You can contact Ultroid’s confidential advice service on 0800 999 3777.
Self-help steps include … Increasing the amount of fibre in your diet is recommended, such as bran, wholegrain bread, cereal, fruit and vegetables. You should also drink plenty of water and avoid caffeine (found in tea, coffee and cola).
The Haemorrhoid Centre: Don’t Sit On It The Haemorrhoid Centre (THC), originally established to better inform and treat people suffering from piles (haemorrhoids), in partnership with top colorectal surgeons, has launched Don’t Sit On It—a national campaign offering people who are concerned about colon and rectum issues (including colitis, incontinence and bowel cancer, in addition to piles) access to consultants across the country to discuss their symptoms and treatment options. THC consultants offer a variety of procedures to get you feeling well again, like THD—a less invasive approach to treating haemorrhoids, which is available at all centres. Importantly, the centres offer access to expert advice without needing a referral, making it quick and easy to allay concerns for anyone suffering symptoms. Go to dontsitonit.com or call 08000 665 645 to get a check up.
Don’t suffer in silence A simple walk-in, walk-out procedure is now available in London and 12 other locations. Ultroid’s procedure can give you lasting relief in as little as
15-30minutes! • Safe and proven method • NICE approved • Treats all grades of internal piles • QUICK – Performed in just 15-30 minutes • Usually no recovery time needed • No preparation, no anaesthesia required • Non-invasive – no needles or cutting • An effective alternative to surgery
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HEALTH & FITNESS
Steps to Summer Health
With summer fast approaching, Dr Chris shares his essential steps on how to stay healthy in the warmer months
ow the weather is getting warmer, many of us are looking forward to relaxing in the sunshine. However, warmer temperatures can bring a list of health complaints: sunburn, hay fever and insect bites, to name a few. We share advice on how to avoid these issues, and what to do if you’re affected.
PROTECT YOUR SKIN
New guidelines from the National Institute for Clinical Excellence (NICE) have warned that 44 DEAR DOCTOR WITH CHRIS STEELE
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there is no ‘safe’ way to tan, and adults need to apply to exposed skin at least 50ml of sunscreen to be safe in the sun. The report does also stress the importance of having some exposure to the sun, to ensure we get enough vitamin D, which is vital for healthy teeth and bones. Enjoy the sun in short periods of time between 11am and 3pm, and keep your skin covered and comfortable in loose, cotton clothes.
number of health benefits (including reducing the risk of heart disease and dementia) and is highly recommended by the NHS. The summer months are the perfect time to adopt the healthy Mediterranean diet.
A recent study from the Netherlands claims that hay fever can affect your driving ability as much as drinking two to three units of alcohol. Hay fever sufferers will know that the symptoms go beyond coughing and sneezing, and can seriously affect day-to-day life. The Met Office provides pollen forecasts on the weather map to provide hay fever sufferers with vital information to help reduce the impact of pollen on their health: metoffice.gov.uk
The Mediterranean diet, which is rich in fish, fruit and vegetables, grains, pulses and olive oil, has been proven to have a
HEALTH & FITNESS
per week. In the warmer months, swimming is the perfect exercise to cool off—it works all your muscles at the same time (as opposed to other actives which only works isolated muscles), including your heart. Water is 1,000 times denser than air so it’s an incredibly effective method of toning muscles safely without using too much force, and the broad range of movement required to move in the water helps joints and ligaments stay flexible in and out of the water. Heated pools also loosen joints and muscles, so if you have any previous injuries from high-impact activities, swimming is the perfect low-impact alternative to keep you fit and injury-free.
6 HEAT WAVES
Although most of us welcome the warmer weather, the rising temperatures increase the chance of heat waves, which can be harmful or potentially fatal. Graham Bickler of Public Health England stresses that: ‘there is considerable evidence that heat waves are dangerous and can kill. In the 2003 heat wave [where temperatures in the UK hit 38°C during a nine-day heat wave, the highest temperature recorded in the UK] there were 2,000 to 3,000 excess deaths in England. Across Europe, there were around 30,000 excess deaths.’ Elderly people, young children and babies are particularly vulnerable to health problems during a heat wave, so stay hydrated and have cool baths or showers. It’s also wise to check up on friends and relatives who may be less able to take care of themselves, and wear loose, cool clothing and a hat if you do go outdoors.
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We all know how beneficial exercise is, and adults are recommended to do 150 minutes of moderate-intensity aerobic activity
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Keeping our eyes safe from the sun’s harmful UV rays is jjust ust as important as protecting our skin, as UV exposure contributes to the development of types of cataracts and even macular degeneration. UV radiation can also damage the skin of the eyelid, the cornea, lens and other important parts of the eye. Make sure you wear sunglasses to protect your eyes, and check the label when buying sunglasses—they should block 99 to 100 percent of both UVA and UVB rays.
BITES AND STINGS
Unfortunately, summer brings a host of unwanted pests that can bite and sting us and occasionally cause painful reactions. Wasps, midges and marching ants are the main culprits with wasp stings causing the most allergic reactions in the UK. Wasps are more likely to sting if they feel threatened, so move calmly away from them and if you are stung be sure to remove the stinger from your skin to prevent infection. If you experience no allergic reaction, use a cold compress on the area to prevent swelling and clean the wound with antibiotic treatments. If you do have an allergic reaction (such as difficulty breathing, nausea, dizziness or difficult swallowing) seek immediate medical help. •
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HEALTH & FITNESS
Help Your Heart Our good hear t health depends largely on our own common sense in terms of diet, exercise and lifestyle. Here are some tips and advice that will help your awareness
Despite a small percentage of cases being linked to hereditary causes, the cause of heart disease for the majority who have this condition is linked to lifestyle. Here are some of the chief causes of CHD: • diabetes • high blood pressure (hypertension) • high cholesterol • obesity • smoking
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Symptoms How will I know if my heart is in trouble?
that a he ergency— medical em you or if you think know is u yo someone art attack, having a he d ask for an dial 999 an . ambulance
Here are some common symptoms: • chest pain, pressure, heaviness or discomfort that lasts more than a few minutes and comes and goes • heart palpitations—a faster-thennormal, strong, throbbing heartbeat • overwhelming feeling of anxiety • pain or discomfort that radiates from the chest to the stomach, neck, arms, shoulders or jaws • shortness of breath or shallow breathing, often occurring before or during chest discomfort • weakness, exhaustion, lightheadedness, fainting, cold sweats or nausea It is the combination of symptoms that is important in determining if a person is having a heart attack, and not the severity of chest pain.
If you think you are at risk of CHD, make an appointment to see your GP. Your doctor will want to know why you think you are at risk; so, to save the doctor’s time, be prepared by having all the information about any symptoms you may have. If your doctor thinks that you are at risk, then a risk assessment will be carried out that will involve asking you about your medical history, your family’s health history, your lifestyle, with the assessment being completed with a blood test. If the assessment reveals any potential problems, you may need further tests that can include an MRI scan, CT scan, and a coronary angiograph.
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lthough fatal heart disease has fallen by 40 percent since 2004, the condition remains the No. 1 cause of death amongst men, accounting for 14 percent of deaths in 2014. It’s responsible for more than 73,000 deaths in the UK each year. About one in six men and one in 10 women die from coronary heart disease (CHD)—a condition that occurs when your heart’s blood supply is blocked or interrupted by a build-up of fatty substances in the coronary arteries.
ises Dr. Chrarist atadtavck is a
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To avoid a life-threatening heart attack, we must look carefully at our lifestyles to see what positive changes we can make, because a healthy lifestyle is the key to a healthy heart. This means eating a low-fat diet for most of the time, taking regular exercise, cutting out tobacco, drinking in moderation, and keeping our weight in check. A diet that is high in saturated fat and cholesterol can increase the build up of plaque, a fatty substance in the arteries that supply blood to the heart. This build up will reduce the flow of blood by narrowing the vessels which, together with the plaque itself, can form a blood clot that blocks the passage. When this happens, a heart attack or stroke can be the result. As the heart itself is a muscle, it needs physical exercise to function at top level. So, a lifestyle without sufficient regular exercise will diminish the heart’s performance. Exercise also lowers blood pressure and, when combined with a healthy diet, will also help us to lose weight and ward off the threat of developing diabetes (see also, pp.20-22). Stress is another factor that can have a negative impact on our heart health. There are many aspects of modern life that can cause us to feel stressed out—pressure of work, confrontational situations, financial worries, unhappy personal relationships. Coping with stress is something that you can learn if you take the trouble to work out what stresses you: you may in time learn to avoid situations that make you feel stressed, or you may be able to reduce the stress at work, for example, by sharing workload anxieties with friends or colleagues—it may not make the workload go away, but it will make you feel less stressed. In turn, managing your own health and lifestyle will help ensure you have a strong and healthy heart. •
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We must look carefully at our lifestyles to see what positive changes we can make, because a healthy lifestyle is the key to a healthy heart
Dr Chris’s do’s and dont’s for a healthy heart
Avoid high-fat foods Eat a healthy diet Get plenty of exercise Take a brisk walk every day Watch your weight
Get stressed out Overdo the alcohol Smoke
DEAR DOCTOR WITH CHRIS STEELE 47
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HEALTH & FITNESS
Quit Smoking & Live Longer The process of giving up smoking is a challenge, but it has been proven that you will live a longer, healthier life if you quit for good
according to the worldwide health organisation, tobacco-related illnesses caused over five million deaths worldwide in 2015, which equates to one death every six seconds. the earlier you give up, the better—but it is never too late to gain valuable years by giving up smoking. here is our advice to get you started.
if you struggle to quit completely,
cutting down the number of cigarettes can be a good first step. in fact, the number of years you smoke affects your risk of cancer more than the actual number of cigarettes you smoke every day. For example, it is more harmful to your health to smoke one pack a day for 40 years, than smoking two packs a day for 20 years, according to cancer research UK. however, the end-goal should always be to give it up completely.
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n addition to living a longer, healthier life, a recent study, published in the British Medical Journal (BMJ) , shows that those who succeeded in quitting experienced reduced depression, anxiety and stress—and also adopted a more positive outlook on life. experts agree that tobacco is the single biggest avoidable cause of cancer in the world, ‘stealing’ decades of people’s lives.
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HEALTH & FITNESS
Over recent years, e-cigarettes have become very popular in the UK as a quit smoking aid. E-cigarettes do not produce tar and carbon monoxide—two of the main toxins in conventional cigarette smoke. They do however contain nicotine, but this can be gradually reduced over time. In 2014/15, two out of three people who used e-cigarettes in combination with the NHS Stop Smoking service managed to quit smoking successfully.
If you find a certain time of day hard to resist temptation, try a new routine. Research from the NHS has shown that exercise—even a five-minute walk—will cause your brain to produce anti-craving chemicals, thus making cigarettes less appealing. Practising yoga and pilates can also help you stay focused and in tune with your body. •
Nicotine Replacement Therapy (NRT)
NRT works by releasing nicotine steadily into your bloodstream at much lower levels than in a cigarette, without carbon monoxide and other poisonous chemicals that are present in tobacco smoke. This helps control your cravings for a cigarette when your body starts to miss the nicotine, and increases the chance of quitting smoking by about 50-70 percent.
If you’re thinking about switching to
NRT comes in different forms, including: - skin patches - chewing gum - inhalators - tablets, strips and lozenges - nasal spray - mouth spray
and accessories, which are designed
You can also talk to your GP, pharmacy team or practice nurse about stop smoking medication that can help with nicotine withdrawal symptoms.
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HEALTH & FITNESS
Sweet Dreams Silentnight’s sleep expert Dr Nerina Ramlakhan has worked with everyone from burnt-out city workers to premiership footballers. Here, she shares her top tips for getting a good night’s sleep
DON’T SKIP BREAKFAST
Skipping breakfast or eating breakfast too late suppresses the production of melatonin (the sleep hormone) and causes the body to produce stress hormones such as adrenaline and cortisol. Include protein in your breakfast to help optimise melatonin production.
DRINK ENOUGH WATER
Not drinking enough water throughout the day causes dehydration and creates restless muscles and ‘scratchy’ sleep. Aim to drink two to three litres per day.
Regular exercise is one of the most effective ways of reducing stress hormone levels (mainly adrenaline), thus enabling you to sleep more deeply. The American College of Sports Medicine recommends three or four sessions of aerobic exercise (swimming, cycling, jogging, fast walking) for 20-30 minutes per week.
GET SOME REST
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Working or pushing yourself relentlessly throughout the day overstimulates your nervous system, leading to that ‘tired but wired’ feeling when you get into bed. Take three to five minute breaks every 90 minutes throughout the day—move, close your eyes, eat something nourishing but most importantly try to get away from technology.
CUT DOWN ON CAFFEINE
Caffeine has a direct impact on reducing sleep quality. The half-life of caffeine is approximately five hours. This means that it can take up to 10 celebrityangels.co.uk
hours to completely remove all of the caffeine from your body if you drink a cup of tea or coffee.
REDUCE TECHNOLOGY BEFORE BED
Electronic devices overload the ‘working memory’ of the brain and leads to noisy thought-filled sleep. Aim for an electronic sundown of 60-90 minutes before getting into bed.
WIND DOWN AND RELAX BEFORE BED
Try and get yourself in to a regular wind down routine and you will notice a huge
difference to the quality of your sleep. Read a book, listen to relaxing music, have a bath and use some relaxing essential oils such as lavender to help promote sleepiness.
DON’T TAKE EMOTIONAL BAGGAGE TO BED
Write your worries or ‘to do’ lists down before going to bed and think of all the small positive things that happened in your day as you drift off to sleep. • silentnight.co.uk. DEAR DOCTOR WITH CHRIS STEELE 53
HEALTH & FITNESS
One in five of us will visit our GP about back pain ever y year, 80 percent of adults suffer with it, and 10 million working days were lost due to it last year—how do we solve this pain in the back?
ehind coughs and colds, lower back pain is the most common reason for a trip to the GP. if you’ve ever suffered from back pain (nearly a third of the population suffers in any given month) you will know how debilitating it can be to your day-to-day life, and your bank balance: £1bn was lost in earnings last year due to back-pain sick days. the number of reported cases of back pain has doubled in the past 40 years, a trend repeated in other western countries. it’s thought that this is a result of higher levels of obesity, stress and depression.
there are a number of treatments available for back pain, including painkillers, spinal manipulation, acupuncture, specialised exercise classes and cognitive behavioural
therapy. when experiencing back pain, your instinct will be to lie down to try and relieve pain but the recommended advice is to keep as active as possible. a recent study, published in the annals of internal Medicine, found that back pain sufferers who attended weekly yoga classes recorded greater improvements in everyday physical tasks, which they would have preciously struggled with. a group of 156 patients with chronic lower back pain were assigned to have the 75-minute yoga classes, in addition to normal GP care. a control group of 157 just saw their GPs. the participants of the study reported enhanced function compared with those just receiving standard care, even nine months after the yoga classes had finished. they also reported lower overall pain levels on average. For more information and to find a class near you, visit yogaforbacks.co.uk
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HEALTH & FITNESS
The average person spends 33 percent of their life in bed, so a good night’s sleep is worth investing in. Bad sleep patterns can lead to an increased risk of heart disease, diabetes, and obesity, as well as effecting your mood and daily performance. However, if you suffer from back pain, then sleeping soundly through the night can be a struggle. Sleeping on the wrong mattress can worsen or even cause back pain, and lack of support from a mattress can cause poor sleeping posture, muscle strain, and does not keep the spine aligned. A good mattress can help to support your back whilst you sleep, and the ripple orthopaedic mattress from Putnams (who supply products to the NHS) is made of high-density ripple orthopaedic foam, which helps to distribute weight evenly, providing pressure relief. When we sleep, it is important for the spine to remain aligned and many fiber or feather filled pillows do not have the support and height required to maintain a healthy posture. A good pillow is essential to keeping your spine supported, especially if you sleep on your side. The Putnam Pillow comes in various heights depending on your shoulder width and is recommended by chiropractors. For more information, visit: putnams.co.uk •
Sleep posture Along with having a good mattress, your sleeping posture can make a difference to back pain. By making small, simple changes to your sleeping position, you can take the strain off your back. Sleeping on your side: Draw your legs up slightly toward your chest and put a pillow between your legs. Use a full-length body pillow if you prefer. Sleeping on your back: Place a pillow under your knees to help maintain the normal curve of your lower back. You might try a small, rolled towel under the small of your back for additional support. Support your neck with a pillow. Sleeping on your front: Sleeping on your stomach can be hard on your back. If you can’t sleep in any other position, reduce the strain on your back by placing a pillow under your pelvis and lower abdomen. Use a pillow under your head, but if it places too much strain on your back, try sleeping without a pillow under your head.
1bn was lost in earnings last year due to back-pain sick days.
More than just a pain in the back… If you are suffering back pain along with any of the following symptoms, seek urgent medical assistance:
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• • • • • • • •
High temperature Inability to pass urine Loss of bladder or bowel control Numbness around your genitals/buttocks Pain in your chest Pain started after an incident, such as a car accident Swelling or deformity in your back Unexplained weight loss
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HEALTH & FITNESS
A Sound Sleep Dear Doctor examines a product that promises to solve a range of sleep-related issues
rom sciatica to bed sores; there’s a range of ailments and conditions that can seriously affect your sleep, and while there are a host of products available to help, from orthopaedic pillows to adjustable mattresses, it’s hard to find just one product that can offer a solution for a wide range of health issues. that is, unless you talk to a company like oro Bed. What’s ORO Bed and why are we talking about it? actually, we’re talking about oro Bed’s main product: the oro advanced sleep system, an adjustable bed that comes with a range of intriguing features.
There are lots of adjustable beds on the market—why should we pay attention to this one? Unlike most other adjustable beds, this one automatically adjusts as you change position throughout the night. it’s also handy for a range of ailments—those with back, neck or spine problems, for example, will find it keeps the spine in perfect alignment. Sounds good—but we need more details… one of the biggest unique selling points is a feature called the Pressure relief comfort recess in the mattress, which ensures you maintain a natural posture whilst sleeping, as well as removing the weight and pressure from your shoulders. this aids circulation and relieves stiff necks, tense shoulders and back pain. 56 dear doctor with chris steele
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Anything else? the mattress contains more technological cleverness—the top part is a high-density slow recovery foam which is sensitive to weight and temperature. it slowly adjusts and distributes the load of the sleeper evenly, and the bottom layer is made of a medium firm polyurethane foam that provides support. Won’t my sleep be disturbed if I still have to wake up to adjust the bed? as we said earlier, it’s all automatic: you’ll sleep soundly because the bed base can sense when you change sleeping position and adjusts the bed automatically throughout the night (you can also program preferred sleeping positions in advance). this is also useful for people who are unable to change position in the bed at night.
I don’t have back pain, sciatica or anything like that. My partner, however, is a chronic snorer… apparently, the bed has a ‘stop snoring’ position—at the touch of a button the bed will automatically move your partner to a position that stops him/her snoring, where he/she’ll stay for a pre-programmed time until he/she stops, and the bed moves back into its original position. We’re nearly convinced…. how about this: the bed also has a patented smoke and carbon monoxide alarm system built in that will shake and wake you, sound an alarm and tell you the type and location of danger in your home, so you can get to safety in time. For more information, visit oromed.co.uk • celebrityangels.co.uk
HEALTH & FITNESS
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Summer is on its way and with the warmer weather the need to drink more water becomes especially impor tant
he best advice for staying hydrated this summer, whether at home or aboard, is given here by the Natural hydration council. ‘whether you’re enjoying the British sunshine or holidaying abroad, topping up your fluid intake might be the last thing on your mind, but is important,’ says dr emma derbyshire, public health nutritionist and adviser to the Natural hydration council, ‘when the weather heats up this can drive up the body’s temperature and lead to over-heating i.e. feeling very warm, dizzy and disorientated. in worst cases, more typically among children, the elderly or those exercising for long periods in the heat, this may lead to heat stroke when the body’s temperature rises too high, which can be a very serious condition. ‘so, if you are planning some time in the sun, especially if you’re looking to exercise,’ says dr derbyshire, ‘it’s important not to forget to drink cool fluids at regular intervals so you feel at your best and can enjoy your holiday to the utmost.’ Public health england’s new eatwell Guide recommends drinking six to eight glasses of fluid per day. this is supported by european recommendations. whilst you can meet your body’s water requirements from other drinks, water is one of the healthiest ways to hydrate, as water contains no sugar or calories.
THREE TIPS foR youR SummER TRavEl
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For car journeys, keep different sizes of water bottles—smaller for children, larger bottles for parents. if you’re concerned about spillage, opt for pure water that isn’t sticky if spilt. sports caps also help to reduce spills.
For short- and long-haul flights make sure you drink enough fluid before flying, as air-conditioning systems during the flight can increase water evaporation from your skin. on particularly hot days, always make sure you have access to enough fluid to help keep you feeling cool.
fouR TIPS foR youR SummER HolIdayS
Fancy a few lengths in the pool, a round of golf or a seaside stroll? Physical activities often immerse you in what you’re doing and it can be easy to forget to drink, or you may not realise how necessary it is, so taking little breaks with easy access to fluid is advisable. For most people, water alone is adequate and this will hydrate you without you consuming sugar or calories, so packing a bottle of pure water is a must. heading to the beach? there may not be access to drinking water, so don’t forget to take drinks with you. a cool bag with ice helps to keep the drinks chilled. Young children don’t recognise the early signs of thirst, which can make them particularly vulnerable to being dehydrated, so give them drinks on a regular basis. an easy way to monitor changes in hydration status is to check the colour of your urine. this should be a pale straw colour—anything darker means you need to drink more water. •
• For more information, go to: naturalhydrationcouncil.org.uk the Public health england eatwell Guide is available online at: gov.uk/government/publications/theeatwell-guide
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HEALTH & FITNESS
Preventing Pressure Sores
The NHS estimates that half a million people in the UK will develop at least one pressure sore this year. Prevention is key for those at risk of developing pressure sores as they can cause serious infections
ressure sores, also known as bedsores, pressure ulcers or decubitus ulcers, commonly develop when constant pressure or friction on one area of the body leads to damaging of the skin. Pressure sores often affect those with underlying health conditions, and are particularly common among those confined to lying in a bed or sitting still for prolonged periods of time. Pressure sores usually develop on areas that are not covered by much body fat and are in direct contact with a surface, such as a bed or a wheelchair. These areas include: knees, ankles, heels, toes, spine, shoulders, elbows, back of the head or the rims of the ears. People over 70 years old are often particularly vulnerable to pressure sores due to mobility problems and ageing skin, but according to the NHS it is a wide-spread health problem, affecting around one in 20 people who are admitted to a hospital. For some people, these wounds are a mere inconvenience that might require minor nursing care. For others, they can lead to life-threatening complications, such as blood poisoning, infections or gangrene. It is therefore much better to prevent pressure sores than to treat them once they have happened.
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CHANGE OF POSITION
Relieving pressure is obviously the best way of preventing pressure sores. According to the NHS, one should change position at least every two hours. This is especially important for people confined to a bed.
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Wheelchair users will need to change their position at least once every 15 to 30 minutes.
Some equipment, such as special beds, mattresses and cushions, can help prevent pressure ulcers. A Cochrane review in 2011 found that people who lay on special mattresses were less likely to develop pressure sores when compared to ordinary mattresses. Cushions that can mould around your body are also available to make it more comfortable to sit for a long time in a chair, or support certain exposed areas to pressure sores. Dan Medica South specialise in portable pressure care products that provide comfort and relief. For more information, visit danmedicasouth.co.uk or telephone them direct on 0208 133 2851.
CHECK YOUR SKIN
If you are predisposed to pressure sores, it’s important that you check your skin on a daily basis for any signs, such as discoloured areas of skin. Make sure you check the parts of your body that you rarely see, such as the back of your shoulders and the heels of your feet.
Smoking reduces the levels of oxygen in your blood and weakens your immune system, which increases your risk of developing pressure ulcers. Smokers also tend to develop more severe wounds, and they often heal more slowly.
IDENTIFYING A PRESSURE SORE
At first glance, a pressure sore may look like a bruise as the damaged skin darkens or goes red—often turning purple in fair skinned people. The damaged area will feel sore when touched, and is often warmer than the surrounding areas. If left untreated, the skin gradually wears away and can break open. Tell your GP if you notice any of these skin changes. • DEAR DOCTOR WITH CHRIS STEELE 59
Chada Oriental Foods Advertorial.indd 1
HEALTH & FITNESS
In a Nutshell: The Case for Coconut Water Endorsed by celebrities, the athletes’ drink of choice, and readily available at most stores. What is it that makes coconut water so popular?
he popularity of coconut water has rapidly increased over the past few years, attracting a loyal following of fans that swear by its health-boosting properties. Coconut water is the juice present inside the cavity of young, tender green coconuts. The clear liquid within is sweet, and each coconut contains between 200 and 1,000ml of water, depending on size. Unless you live in a tropical climate, most of us won’t be able to tap coconut water direct from a coconut. However, there are a great number of packaged versions that can deliver the drink to colder climates, such as Chadha Oriental’s Foco coconut water. We explore the possible benefits of coconut water.
essential electrolytes (potassium, sodium, chloride and bicarbonate). Coconut water is an excellent source of replenishing these electrolytes, with an average of 294mg of potassium, 250mg of sodium and 5mg of natural sugar per glass, whereas most sports drinks contain only half this potassium and five times the amount of processed sugar.
If you experience discomfort during the digestion process, coconut water can provide relief. As it has a high concentration of fibre, it can help to prevent indigestion and can reduce the occurrence of acid reflux. Coconut
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Coconut water is thought to be more effective at hydrating the human body than sports and energy drinks. During rigorous exercise or long periods of physical activities, our bodies lose
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THE MORNING AFTER
If you’ve had a heavy night drinking and are feeling the effects the next day, coconut water can help settle your stomach due to the high levels of potassium. It can also help to replace the electrolytes that will exit the body if you’ve experienced bouts of repeated urination or vomiting.
water has been offered to patients with diarrhoea in tropical regions to replace the fluid loss from the gastrointestinal tract, reducing the need for hospitalisation. •
FOCO Coconut Water
FOCO Coconut Water is one of the best tasting coconut waters in the world because of the delicious and refreshing coconut water sourced from young, green coconuts grown in Southeast Asia. Today, many brands source coconuts from all over the world, blending and mixing coconuts from various countries, compromising the quality and taste and distorting the natural flavour. However, FOCO 100 percent Pure Coconut Water is harvested exclusively from dedicated plantations that enable the taste, quality and supply to be consistent. Refreshing taste, low in calories, nutrient rich with five essential electrolytes and awesome hydration, FOCO is available from selected Tesco and Sainsbury’s stores, leading oriental supermarkets and online at focococonutwater.co.uk
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HEALTH & FITNESS
Essential Oil The immense popularity of coconut oil has been helped by many A-list celebrities using it as a beauty routine staple. We take a look at the beauty applications as well as some of the other uses of coconut oil
Kate Hudson has posted pictures to her Instagram account of her face slathered in coconut oil, and Gwyneth Paltrow raved about the benefits during an interview with E! Online. Coconut oil works well as a moisturiser as it penetrates the skin, so it’s especially valuable if you have dry skin. It can also be used as an excellent make-up remover, and is particularly effective at removing eye make-up—including notoriously stubborn waterproof mascara. [Source: E!, Instagram]
mouth, improving dental health and reducing bad breath. Place two tsps. of coconut oil in your mouth and let it melt. Swish around your teeth for around 20 minutes, and then spit out the oil. Rinse thoroughly with warm water before brushing your teeth as normal.
If your hair is dry, coconut oil can provide a luxurious deepconditioning treatment as hair easily absorbs the moisturising properties, as the smaller particles penetrate the shaft. Try massaging coconut oil into the mid to ends of your hair, and leave for 20 minutes. Then shampoo twice, or until no residue remains.
SHAVING CREAM/AFTERSHAVE BALM
Shaving can be pretty rough on the skin and can cause dry skin and rashes.
Prolonged exposure to the sun can damage and dry our skin. It’s important to nourish the skin and repair this damage. Coconut oil is rich in a number of proteins, which help to keep skin revitalised from the inside out. Proteins contribute to tissue repair, so any damaged cells in the skin require a healthy flow of proteins in order to heal sun-damaged skin quicker.
Using coconut oil as a mouthwash, known as ‘oil pulling’, is thought to help kill harmful bacteria in the
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n 2015 it was reported that the popularity of coconut oil and its many uses, from baking to cosmetics and medicinal, caused demand to increase by 500 percent. What follows are some of the most popular trends for the use of coconut oil.
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HEALTH & FITNESS
Coconut oil is perfect as a shaving cream as it’s soothing and leaves skin silky smooth. After a hot shower or bath, apply coconut oil to the desired area and shave, then rinse. The coconut oil is so moisturising that it will remain on your skin leaving it nourished for days. It’s also recommended to exfoliate the skin a few days after shaving to reduce the chance of ingrown hairs. Mix two tsps. with one tsp. sugar for a homemade, allnatural exfoliator.
RECOMMENDED … Always chose organic virgin coconut oil as opposed to the refined versions. Try: Neal’s Yard Organic Virgin Coconut Oil £9, 300g nealsyardremedies.com Vita Coco prices vary, vitacoco.com Groovy Food Coconut Oil £6, 283ml groovyfood.co.uk
Sore, cracked lips are not only unsightly but also quite painful. Coconut oil can help to restore the condition of your lips whilst providing a soothing salve to chapped skin. •
Did you know? Coconut oil contains three unique fatty acids: lauric acid, capric acid and caprylic acid, which are quite uncommon in nature. These acids have disinfectant and antimicrobial properties, and are also easily broken down by the body during digestion, meaning they contribute to usable energy in a fast and efficient way.
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Remember! ges Coconut oil chan rding to co ac cy en ist ns co conut temperature. Co lid in so oil will become r than we lo s re tu tempera pe m ratures 24°C; warmer te conut oil co e th t will mel into a thick liquid.
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HEALTH & FITNESS
Your Visual Awareness I n the twenty-first century when our occupations and our leisure time means, for many of us, time spent looking at computer screens for most of the day, as well as looking at tablets and smart phones, our eyes can develop symptoms that then becomes a condition known as ‘dry eye’.
DRY EYE – WHAT IS IT?
Dry eye syndrome is a condition where the body is not able to produce enough tears to protect the front surface of the eye to provide quality vision. Millions of people suffer from dry eye, and the condition is more common for contact
wearers, computer users, previous eye surgery patients and those over 55. Common symptoms of dry eye • Blurry vision • Foreign body sensation • Frequent tearing • Itchy or burning eyes • Red eyes • Sore or tired eyes In the past, the only treatment for dry eyes was daily therapies such as drops and lubricating ointments that merely mask the condition and provide temporary relief. Thankfully, there have been a number of advancements in the field of dry eye treatment that address
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While we all hope to have good eyesight for many years, we need to be aware that our modern lifestyle can cause a specific eye condition know as ‘dr y eye’ that needs careful attention and treatment
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BURNETT HODD OPTOMETRY CONTACT LENS PRACTITIONERS, EYE CARE SPECIALISTS AND DISPENSING OPTICIANS
Our resident optometrists perform comprehensive eye examinations and carry out specialist tests to assess and diagnose various eye conditions including cataract, glaucoma, macular degeneration, retinal problems (including retinal detachment) and changes related to high blood pressure and diabetes. The specialist tests include OCT, OPTOS and corneal topography, which are not commonly available at high street opticians. Our optometrists have expertise in complex prescriptions and contact lens fitting for myopia control (Orthokeratology), presbyopia and complex corneal conditions such as keratoconus or post refractive surgery. Working closely with a network of consultant ophthalmologists within the Harley Street area, the practice is often seen as a general practitioner for ocular health. 7 DEVONSHIRE STREET LONDON W1W 5DY 020 7636 2444 firstname.lastname@example.org www.burnetthoddoptometry.com
This is a centre dedicated solely for the
diagnosis and treatment of dry eyes. Our
specialist optometrists combine experience and the latest diagnostic techniques to
establish the root cause of your dry eye
symptoms. Treatment and management of the condition is tailored towards each
patient. The centre has pioneered the use of
the latest treatments available, and we are
the first and currently the only clinic in the UK to provide Intense Pulsed Light (IPL)
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HEALTH & FITNESS
the condition at its source, providing increased tear functionality. One of these exciting new treatments is Intense Pulsed Light (IPL). This treatment uses IPL therapy to reduce the discomfort of dry eye by stimulating the function of the meibomian glands that help produce the essential tears necessary to lubricate the eye. Intense Pulsed Light (IPL) therapy is a painless procedure with no downtime that can provide immediate improvement for dry eye sufferers. The treatment consists of administering pulses of light to the surrounding area. The light energy from the IPL reduces inflammation and acts as a warm compress to liquefy the secretions obstructing the tear producing meibomian glands. After treatment these meibomian glands are expressed to clear any blockage, allowing for improved tear flow. Why Choose IPL For Your Dry Eye Treatment? • Painless procedure • No downtime • Alternative to medical treatment • Treats the cause of dry eye • Repeatable
Interestingly, the causes of the dry eye condition are said in part to be linked to our modern way of life—constantly looking at our mobile phones and tablets, and long hours gazing at computer screens, when the number of times we blink our eyes are often greatly reduced when concentrating on the screen. And blinking is important to us all as it distributes the tears over the eye, lubricating the surface and also providing oxygen and nutrients to the eye. If we’re not blinking enough, then we don’t lubricate the eye and this leads to symptoms such as the burning sensation that we associate with dry eyes. If there is not enough lubrication then there is also an increase in friction between the lid and the eye and this can exacerbate symptoms even more.
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The Dry Eye Centre (dryeyecentre. co.uk) in Devonshire Street, in the vicinity of Harley Street, is a specialist clinic dedicated to the diagnosis and treatment of this particular condition. The Centre informs us that, ‘We understand that having dry eyes seriously impacts your quality of life, we want to listen and we want to help. We take the time needed to establish the root cause of your dry eye combining the latest diagnostic techniques and we have pioneered the use of the latest and most modern treatments available—we are the first clinic in the UK to provide the Intense Pulsed Light treatment.’ Simply described, this treatment is via a device that generates a polychromaticpulsed light. The energy, spectrum, and time period are precisely set to stimulate the meibomian glands in order for them to return to their normal function. In addition, the heat generated by the flash of IPL warms and unblocks the glands. •
General eye health advice If you notice eye discomfort or any changes in your vision, then you need to take some prompt action. Dr Chris advises that you make an emergency appointment to see an optometrist because the condition may require treatment as soon as possible to prevent the condition becoming worse. Also, for those who have a parent who has the eye condition known as glaucoma, mentioned above, it is known that there are hereditary links, meaning that siblings may possibly be affected later in life. For this reason, those with a family history of glaucoma should have regular checks for the condition. If you’re aged 40 or over and you are the parent, brother, sister, son or daughter of a person diagnosed with glaucoma, or you have been advised by an ophthalmologist that you are at risk of glaucoma.
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Mr Ali Mearza
Mr Ali Mearza FRCOphth is a renowned cornea, cataract and laser eye surgeon. He is a Consultant Ophthalmic Surgeon at London’s Imperial College Healthcare NHS Trust, the UK’s ﬁrst Academic Health Sciences Centre. He also sees patients privately around the Harley Street area of London W1. As well as treating eye disease, he specialises in reducing dependency on glasses and contact lenses.
Refractive Lens Exchange For patients in the 40+ age group with very high prescriptions, or where laser vision correction is not suitable, refractive lens exchange is becoming an increasingly popular option. Effectively, a refractive lens exchange (RLE) is like doing cataract surgery but without the presence of a cataract. The aim of the treatment is to reduce dependency on glasses. The natural lens is removed and a new customised lens is put in its place which corrects the spectacle prescription. The lens options include monofocal lenses (correct only distance or near), multifocal lenses (correct distance and near) and toric lenses, which also correct astigmatism. The procedure can also be combined with laser vision correction to correct any residual refractive error, a procedure called Bioptics. At the pre-operative consultation, Mr Mearza establishes the degree of refractive error present (glasses prescription) and determines which lens option would work best based on the tests performed and your requirements.
Testimonial ‘Magic! For years I was fumbling with glasses and now I’m able to read the small print.The procedure was painless, quick and effective. It’s only ten days since I had it done and I’m absolutely delighted with the result.’ —Catherine Telscher
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About The Surgery The surgery is generally done with local anaesthetic eye drops and takes around 10-20 minutes (although it can be done under general anaesthetic if specifically requested). During the surgery, a tiny incision is made into the eye and the natural lens is removed with a sophisticated small ultra-sound probe. The capsule of the lens is left behind and this is used to house the new lens implant. Recovery is very quick with patients seeing within a few minutes of the procedure. The vision then progressively improves over the next few days. Mr Mearza has performed over 3000 lens procedures and his rate of any complication is less than 1%. See what other patients have said about Ali Mearza on Trust Pilot or on our website Testimonial page.
Contact If you would like to find out more about how Refractive Lens Exchange surgery can change your life, give one of our team a call on 07932 679 000 or email us at email@example.com www.alimearza.com
The Sugar Swap Children are consuming more sugar than ever—over three times the recommended maximum allowance
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ealth officials have recently reported that children aged five are eating and drinking their own body weight in sugar each year, and are consuming three times the recommended maximum daily intake of 19g of sugar a day, or five cubes. obesity costs the Nhs £5.1 billion per year, which is expected to rise to £9.7 billion by 2050. aside from the health implications (including diabetes, heart disease and tooth decay) obese children can also suffer from low self-esteem, and are more likely to be bullied— the psychological effects of both can carry on into adulthood. it’s not just the obvious culprits that contain mass amounts of sugar, but many seemingly ‘healthy’ foods and drinks contain excessive amounts of sugar (such as fruit juices) and this can be difficult for parents to monitor. a new campaign by Public health england (Phe) has been launched to help parents see how much sugar there is in everyday food and drink, allowing them to make informed choices on what to cut down on. the free ‘change4life’ app scans the barcode of the product and reveals the amount of total sugar contained in cubes and grams. the Nhs approved ‘change4life’ campaign also focuses on healthy eating tips for the family and information on local activities. For more information, visit: Nhs.uk/change4life children will learn from example, so it’s important for parents to be educated on healthy eating so children can pick up good habits. a good way to educate children about eating healthily is to get them involved with cooking. this will not only help parents monitor what their children eat, but also can create a sense of accomplishment for the child.
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HEALTH & FITNESS
How to avoid
hearing loss Our ears are fragile structures that can be damaged in a number of ways. With the NHS’s plan to ration hearing aid devices, Dear Doctor explores preventative methods
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earing loss is one of life’s inevitabilities as we reach our later years. hearing loss due to ageing, known as presbycusis, begins from around 30-40 years old, and by the time most people reach 80 they may have experienced significant hearing loss. approximately 10 million people in the UK currently suffer from hearing loss, and many experience feelings of social isolation as a result. in 2015, the Nhs controversially made plans to ration access to hearing aid devices as a cost saving. in some areas, Nhs hearing aids will only be provided to those suffering hearing loss in both ears, and other areas are introducing eligibility criteria that will deny hearing aids to those with mild to moderate hearing loss. hearing loss happens gradually, which can make it harder to identify and on average it takes people over 10 years to detect their hearing loss, during which time their hearing will significantly worsen. Vivienne Michael, chief executive of deafness research UK encourages visiting your GP regularly to get your hearing checked, as the earlier hearing problems are detected, the more treatable it is. as with many ailments, prevention is often better than cure—especially
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in this case, if treatment is becoming less accessible.
Turn iT down
one of the most common causes of hearing loss is exposure to loud noise, and damage caused by noise is usually irreversible. experts agree that continued exposure to noise above 85dB (similar to a lawn mower) could cause hearing loss over time. the advice is to keep your television, radio and music at a suitable volume—you should be able to have a conversation with someone who is two metres away from you, and you shouldn’t hear ringing after listening to music. this is particularly important if there are young children in the house, as their ears are more delicate than an adult’s.
Be sure that you listen to your music at no more than 60 percent of the maximum volume, for no more than 60 minutes a day. Most MP3 players bought within the eU have a ‘smart volume’ feature (iPods, iPhones and most androids have this feature) to help regulate the volume. it’s also worth noting that cheaper headphones don’t transmit bass well, so it’s wise to invest in good quality headphones to protect your hearing and improve the sound quality.
Noise-related hearing loss is becoming increasingly common in younger people, thought to be due to iPods and other portable music devices.
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HEALTH & FITNESS
AN APPLE A DAY
The American Journal of Clinical Nutrition examined associations between the intake of antioxidant vitamins, such as vitamins C and E and magnesium, in relation to preventing hearing loss. The results showed that higher intakes of these antioxidants and magnesium are associated with lower risks of hearing loss, so be sure to include fresh fruit and vegetables in your diet, particularly those with higher vitamin C and E content such as citrus fruits, dark leafy greens, bell peppers and tomatoes.
If you work in a noisy environment, such as a building site, garage workshop or the emergency services, it’s important to protect your ears, as you will be exposed to much louder noises. Earmuffs and earplugs can help muffle the noise, and can prevent damage to your hearing.
CHECK IT OUT
As mentioned above, it takes people over 10 years to address their hearing loss as many adjust to the gradual change in hearing levels, by turning up the television or music, which can ultimately make hearing worse. If you notice a change in your hearing, visit your GP who will perform an examination of your ears with an instrument with a light at the end called an auriscope to look for anything abnormal, such as earwax blockages or infections. •
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DECIBEL BY DECIBEL Whilst we all know that loud noises can damage our hearing, the Health and Safety Executive (HSE) says that noise levels above 150 decibels (dB) can damage your hearing if endured for more than 15 minutes a week. Lower levels, between 80dB and 90dB, can also cause permanent damage if you’re exposed to them for hours every day. As we obviously can’t accurately measure the decibels around us, here’s our handy guide to show the average level of decibels in everyday sounds: • normal conversation: 60-65dB • a busy street: 75-85dB • lawn mower/heavy traffic: 85dB • forklift truck: 90dB • hand drill: 98dB • heavy lorry about seven metres away: 95-100dB • motorbikes: 100dB • cinema: some films regularly top 100dB during big action scenes • disco/nightclub/car horn: 110dB • MP3 player on loud: 112dB • chainsaw: 115-120dB • rock concert/ambulance siren: 120dB
HEALTH & FITNESS
Surgery on the Beach Passpor t, boarding pass, sun block, and medical procedure. Why are so many holidaymakers adding surgery to their holiday checklist?
edical tourism is a multibillion pound industry—not only from the money spent on the medical procedure, but also hotel stays, transportation costs and all the other typical ‘holiday’ expenses. Florida, for example, has allocated millions of dollars to medical tourism, with over half of the money reserved for a grant program endorsing Florida as a favourable destination for both patients and medical
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conferences. as the Us is the most expensive healthcare market in the world, the prices of the treatments aren’t negotiable—instead, Florida is promoting its hospitality culture, notably temperate climates and renowned tourist attractions (disneyland, for one) whilst promoting the quality of its medical centres. as there are a number of procedures that aren’t available on the Nhs or have extensive waiting lists, medical tourism can be the only choice for some. Fertility treatments and bariatric surgery are often sought after abroad, but also cosmetic treatments, as they’re usually
cheaper in cost than in the UK—breast implants in Poland cost £1,972, but in the UK they can cost up to £3,736. it may seem like an ideal solution: saving money on a procedure, skipping Nhs waiting lists with the added bonus of a holiday, but there are many important elements to consider before going under the knife abroad.
surgery is not a decision to be taken lightly, so investigate and compare as many clinics as possible—research the hospital, the surgeon, the procedure,
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M E D I S PA
Dr Nyla Raja is the founder and the Medical Director of the Medispa, Wilmslow. She is a highly respected and much sought after Cosmetic Dermatology GP. She has been named as one of the "Top botox doctors in the country". Having performed over ﬁfteen thousand treatments with truly exceptional results, she has gained the admiration and respect of TV personalities, celebrity ﬁgures and some of Britain’s most familiar faces in the media industry. ‘Dr Raja is the best skin doctor,’ tweeted Abbey Clancy; while Helen Flanagan posted: ‘Really pleased with my results! Thank you Dr Raja.’ TREATMENTS
The state of the art Medispa, Wilmslow oﬀers 12 consulting rooms to accommodate the exceptional demand for the very latest technologies Dr Raja oﬀers, for skin rejuvenation and body contouring. The foundation of her success rests upon the detailed assessment process which is undertaken with each client. Dr Raja says: ‘Every one of my clients has an innate beauty. I help to realise this natural beauty by combining the principles of science with art, to reconstitute what nature intended.
Skin health and appearance
Revolumising and relaxing facial wrinkles Wrinkles with the appearance of less hydrated and less volumised skin are one of the ﬁrst signs of aging. Dr Raja has perfected the application of botox combined with dermal ﬁllers into an art form to give the perfect smooth relaxed face with the appearance of a facial freshening treatment. Dr Raja believes that as a gatekeeper to the aging process it is necessary to combat aging with a multi-modular approach with a methodical planned approach using the latest technologies rather then just botox and ﬁllers alone. She therefore oﬀers a plethora of highly advanced technologies to ensure that all treatment modalities are being applied to her patients to achieve the perfect skin rejuvenation.
This is increasingly becoming a real concern for clients, Skin can be safely and non-invasively tightened using the latest ultrasound technology called Ultherapy. Ultherapy targets the dermis of the skin, producing heat energy to stimulate collagen resulting in a very natural looking much ﬁrmed and lifted appearance to the skin, which lasts several years, literally pushing back the years.
The appearance of the skin can be improved using a number of treatment modalities and Dr Raja adopts not only the industry gold standard, but also the latest innovative treatments for the delivery of exceptionally ﬂawless skin. Fractional laser resurfacing treatments are used to smooth, lift and tighten skin. Harmony clear lift is the worlds ﬁrst non ablative 1064nm laser, known as “The Hollywood Laser Facelift.” It is a 30 minutes treatment that lifts and ﬁrms the face and neck with instantly visible results with no downtime.
Fat Reduction Coolsculpting by Zeltiq is an FDA cleared procedure which uses cryolipolysis technology to freeze the fatty deposits, which your body ﬂushes naturally. it is a very eﬀective treatment with incredible results which are long lasting.
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speak to past patients, and consider recovery time. A number of clinics will pressure you to secure a sale, offering fantastic treatments with a limited-timeonly offer. Don’t be coerced into making a snap decision, take your time and ask as many questions to ensure you won’t be compromising on your health. If you’re travelling abroad for a treatment that isn’t available in the UK, you need to consider why it isn’t available here. Visit gov.uk to check if the Medicines and Healthcare products Regulation Agency licenses the treatment in the UK, and whether the National Institute for Health Care and Excellence approves the treatment.
Considering the after-care of your procedure is especially important if you’re in another country. Depending on the type of procedure, you may not have much of a holiday if you’re recuperating, and if your recovery takes longer than expected there may be a delay in you travelling home. There’s also the check ups to consider—if you have to travel back to the country again for check ups, and if any complications arise post-treatment then you may not be able to receive help in the UK. Insurance is also vital as most travel insurance policies will not cover you for your elective treatment, so be sure to find out what insurance the clinic or doctor has, and if it will cover you.
In the UK, a surgeon’s performance is strictly monitored and they will go through routine training and frequent appraisals. A surgeon must be registered to perform cosmetic surgery, and to be considered ‘highly qualified’ they should have carried out around 5,000 major operations. These regulations vary from country to country, and these fluctuating standards can result in treatment you weren’t expecting. Again, research in this area is key—ask your surgeon for their qualifications, how many times they have performed the operation, and ask to be put in touch with past patients. There’s also the language barrier to consider. If your surgeon doesn’t speak English, ask if a translator will be provided, and also think of how your medical files will be documented. If you are considering surgery abroad, think about your reasons for doing so. Make your decision based on the quality of the medical care, and not on how appealing the destination seems as a holiday. •
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Cost of surgery in UK
Dr Chris says … Along with any of your own questions you may have, Dr Chris recommends asking these key questions to your surgeon:
Cost of surgery abroad
Czech Republic, £847
Poland, £1, 972
Dental surgery (Cost per veneer)
• What are your qualiﬁcations, and how can I verify them? • Do you have a specialism, and where can I verify this? • How many times have you carried out this procedure? • What are your rates of success, complication, and infection? • What are the side eﬀects or risks associated with this procedure? • What are the post-operative infection rates at this clinic? • How would the clinic deal with an emergency if complications were to arise during the procedure? • What should I expect after the procedure (swelling, bruising, pain etc.)?
Prices are approximate
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NATURAL KAPYDERM HAIR LOSS & SCALP DISORDERS TREATMENTS ARE FINALLY IN THE UK!
YOUR HAIR LOSS & SCALP DISORDERS EXPERT Hair and scalp therapy to bring hope to those who feel that all is lost
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How important is your hair? Where would we be without our hair? It says so much about what we want to and need to say about ourselves. We attract our partners and ﬁnd our social groups according to our hair and our hairstyles. We all struggle to leave the house on a ‘bad hair day’. So what happens when the worst happens? When hair begins to thin and break and patches of scalp break through. Millions of people, both men and women, experience hair loss. The crucial thing to deal with the problem is the right diagnosis and the right treatment. Having a consultation with a dermotrichologist (hair & scalp specialist) is the most important thing New Man Clinic can do to get the right diagnosis and choose the right treatment for alopecia.
New Man Clinic is the ﬁrst and unique dermotrichological clinic in the United Kingdom, which offers the best individual and effective hair loss and scalp disorders therapy based on natural ingredients, and more importantly at affordable price.
Call 01212 247404 to book your FREE hair & scalp consultation today.
New Man Clinic treats: Every type of hair loss Scalp conditions such as: dry scalp, greasy scalp, hydroseborrhoea, pityriasis (dry scalp with dandruff), psoriasis, seborrhoea, seborrhoeic dermatitis, seborrhoeic pityriasis (greasy scalp with dandruff) Hair shaft disorders.
From nature to your hair At New Man Clinic we use natural dermotrichological Kapyderm products for all of our alopecia and scalp disorders treatments. Kapyderm products have earned the support of the International Association of Trichologists, and, most importantly to us, the recognition of our clients.
Kapyderm’s hair & scalp treatment effect: Stops hair loss and stimulates new hair growth without causing side effects Quickly repairs damaged hair follicles and oxygenates deep skin layers Restores scalp balance which reduces inﬂammations and promotes natural hair regrowth Soothes painful production.
VISIT OUR WEBSITE: www.newmanclinic.co.uk
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Treating Hair Loss Various forms of hair loss, also known as alopecia, are common—especially later in life. Here we look at some of the treatments available
here are many myths surrounding hair loss— including poor diet, frequent hair washing or stress. in most cases, however, hair may simply thin as a result of predetermined genetic factors and the overall process of aging. according to new Nhs figures, 50 percent of men will experience some degree of male pattern baldness by the time they are 50. some experience hair loss much sooner, battling the condition in their late teens. while female pattern baldness is less common, many women may notice mild hair thinning starting in their 50s—usually around the time they go through the menopause. Biologically speaking, what exactly is the root of the problem? For men, testosterone is usually to blame. with aging, testosterone morphs into a female hormone called dihydrotestosterone, which attacks the hair follicles and slowly kills the roots. on the other side, female pattern baldness is due to having fewer female hormones later in life. there are many types of hair loss with different symptoms and causes. other forms of hair loss include alopecia areata, which causes
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patches of baldness. in most cases hair will grow back in a few months. Use of chemotherapy, illness, emotional trauma, and hormonal changes (like those in pregnancy) may also cause hair loss, which is usually reversible.
way of preventing hair loss, and current treatments often affect patients differently. consult your GP or a hair loss specialist before you make the move towards treatment, and be aware of side effects.
Used to treat male pattern baldness, Finasterdie comes as a tablet to be
when hair-loss is irreversible, there are treatments available. the Nhs classifies hair-loss treatments as an optional, as it does not pose a direct risk to your health. however, hair loss can be the cause of emotional distress. a recent survey of treatments for female-pattern hair loss suggested that women feel ‘removed from what is considered a “normal” female appearance’ when dealing with hair loss. Many men also report that it has affected their self-esteem. there are currently many treatments on the market, but don’t expect a miracle cure. scientists have yet to come up with a foolproof
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taken daily. It works by preventing the hormone testosterone being converted to dihydrotestosterone (DHT). Expect it to take around three to six months before any effect is seen. Side effects for Finasteride are uncommon. Less than one in 100 men who take finasteride experience a loss of libido.
Currently the only medicine available to treat female-pattern baldness, Minoxidil is available as a lotion you rub onto your scalp daily. Like Finasteride, Minoxidil usually needs to be used for several months before any effect is seen. It may cause dryness or itchiness in the area it’s applied, and results can vary greatly.
ULTRAVIOLET LIGHT TREATMENT
Two to three sessions of UV light therapy are given every week in hospital. The rays are said to stimulate blood circulation and add nutrients to the hair follicles. The results of light therapy are often poor. It’s often not a recommended treatment because side effects can include: nausea, pigment changes to the skin and an increased risk of skin cancer.
Surgical hair restoration includes various versions of hair transplantation, where you remove hair from the back of the head and put it near the front. Another approach includes scalp reduction, cutting away bald areas and stitching the rest together. Hair transplants are often costly and time-consuming, can leave scars and there is also a possible risk of infection. •
New Man Clinic—from nature to your hair New Man Clinic is the first and unique dermotrichological clinic in the United Kingdom, created with a few simple goals in mind: 1) To help everybody who suffers from hair loss or hair or scalp medical conditions (e.g. dandruff, seborrhoeic dermatitis and devitalized hair), who need professional advice on how to keep healthy hair and scalp. New Man Clinic helps to recover, not only selfconfidence, but also a healthy look. 2) To provide hair or scalp treatments and products based on natural ingredients that really work. 3) To establish a relationship with salons and clinic owners in order to increase their profitability and educate their personnel. To help stylists identify their customers’ hair and skin needs or issues. To provide the salons with the necessary tools to keep their customers happy, not just with the haircut, but with the overall care of their hair and skin.
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A treatment for extensive or total hair loss, where a chemical solution called diphencyprone (DPCP) is applied to a small area of bald skin. The solution eventually causes an allergic reaction and the skin develops mild eczema. A possible side effect of immunotherapy is a severe skin reaction. Less common
side effects include rashes and patchycoloured skin.
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Many extol the virtues of eating organic, but for those of us not in the know, what does it actually mean and why should we do it?
rganic food is one of those things which people vaguely know is ‘good’ for them, without, often enough, being able to explain why. here, we lay out the facts and let you decide.
What is organic?
essentially, an organic product has to have been grown or produced without the likes of man-made fertilisers, antibiotics, artificial pesticides, livestock feed additives and genetically modified products. organic farmers rely on methods such as crop rotation, animal and plant manures for fertilising, some hand weeding and biological pest control.
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Why eat organic?
there’s a blanket assumption that organic food is beneficial for your health, and better for you than nonorganic products. experts have disagreed though as to whether the nutritional benefits of organic versus non-organic food are truly tangible. however, research published in the British Journal of Nutrition has found significant nutritional differences between organic and non-organic farming. in 2014, a team at Newcastle University concluded that organic crops are up to 60 percent higher in a number of key antioxidants than conventionally grown foods. Furthermore, organic meat and milk were both shown to contain around 50 percent more beneficial omega-3 fatty acids than conventionally produced products. those who are concerned about controversial food additives, like celebrityangels.co.uk
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GMo ingredients, hydrogenated fats and certain artificial colours and preservatives, should opt for organic, as all of these are banned in organically produced foods. it’s still important to remember though that just because something is organic doesn’t mean you can eat as much as you want of it—chocolate for example, whether it’s organic or not, should always be eaten in moderation!
a greener option
intensive farming can have a deeply negative impact on the environment, including soil erosion, chemicals
Eating organic: what to look for When shopping for organic food, keep an eye out for labels like the Soil Association—the gold standard of organic labelling. When you’re searching for composite foods (foods that are made up of more than one food group), at least 95 percent of the ingredients must have come from organically produced plants or animals. This means that some non-organic foods are allowed, although all artificial colourings and sweeteners are banned. soilassociation.org
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leaching into water systems, soil contamination and certain weeds and insects becoming resistant to herbicides and pesticides. In comparison, organic farming doesn’t rely on synthetic or petroleum-based pesticides or fertilisers. It also reduces water and soil contamination. In addition, organic farming could help combat climate change. Agriculture is responsible for around 14 percent of total greenhouse gas emissions worldwide. The Soil Association claims that the widespread adoption of organic farming practices in the UK could offset at least 23 per cent of the country’s current emissions. Healthy soils are a major store of carbon, and the impact of switching to organic farming could save 64 million tons of carbon over 20 years across cultivated land and across the country.
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Research published in the British Journal of Nutrition found significant nutritional differences between organic and nonorganic farming
When it comes to meat and dairy, organic farming standards also include strict guidelines regarding animal welfare. All animals have to be genuinely free range, and Soil Association standards also cover the use of antibiotics and hormones, living conditions, transport and slaughter. •
Get Fresh with Yeo Valley Milk, as we all know, doesn’t last very long. So buying fresh British milk from cows who graze outside and have high forage based diets makes a difference, not just to the economy, but to the taste too. All Yeo Valley organic milk comes from their own cows, or from friends at the Organic Milk Suppliers Co-operative, and they’ve been working together with some of these farmers for over twenty years. As with all organic dairy, the cows are fed on a diet that is free from pesticide and GMOs, and their food is mostly produced on the farm where they live.
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The Dairy-free Question From eczema to IBS, dair y products have been blamed for a number of health complaints—prompting an increase in dair y-free diets
Lactose, found in all dairy products, is a form of sugar. Though the sugar content cannot be described as extremely high, it is still enough to elevate your insulin levels. Additionally, there are more calories in cow’s milk than other types of milk, tempting many to look for alternatives. Almond milk, for instance, 82 DEAR DOCTOR WITH CHRIS STEELE
is lower in calories than other milks (as long as it is unsweetened). It’s also free of cholesterol and saturated fat, making it a good choice for those watching their weight.
Dairy has been labelled as a key trigger in IBS (irritable bowel syndrome) and various other digestive conditions, such as chronic constipation. When casein, a milk protein, is not properly digested, it gets into your bloodstream and the immune system reacts by causing inflammation. For those who experience digestion issues on a regular basis, a dairy-free diet might be worth looking into. If this seems too daunting, try eliminating different dairy products from your diet over a two-week period.
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here are several reasons why people give up cow’s milk and dairy products—some simply cannot tolerate milk due to an allergy or intolerance, whereas others opt for a vegan lifestyle or Paleo diet. Dr Chris advises that unless you have an actual intolerance or allergy, then there’s no real reason to give up dairy, as you could be missing out on healthy nutrients such as calcium and vitamin D. However, if you’ve struggled with digestion or skin problems then trying a dairy-free diet might lead to new answers about your body.
To determine if eczema or acne symptoms are due to milk consumption, celebrityangels.co.uk
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doctors often conduct milk-free diet trials on their patients. The exact link between skin issues and milk is not known, but it might be down to a milk allergy or sensitivity causing inflammation, or milk hormones acting as aggravators. Whatever the reason, an increasing number of dermatologists are now recommending the dairy-free diet as a first step in treating acne.
WHAT ABOUT CALCIUM AND VITAMIN D?
Calcium is an important mineral involved in the formation and maintenance of strong bones and teeth, and also plays a regulatory role in muscle contraction and blood clotting functions. However, there are plenty of other dairy-free sources of calcium—it is readily available in foods such as fish, green leafy vegetables, nuts, seeds, dried fruit, pulses and whole grains, and is increasingly found fortified in a variety of foods. Alongside calcium, vitamin D
plays a central role in the condition and strength of bones. Sunlight helps the body naturally synthesise vitamin D. When sunlight is scarce, opt for sources of dietary vitamin D found in oily fish, eggs, liver and fortified cereals. •
Dr Chris says …
Allergy vs. intolerance.
People with allergic reactions to dairy, eg. immediate rashes and swelling, are reacting to the protein in milk. Those who have lactose intolerance tend to experience more vague symptoms over time, such as flatulence, abdominal pain or diarrhoea. Rates of lactose intolerance differ significantly between different ethnic groups, according to the NHS. People from places where milk is not readily available (such as Africa or east Asia) have not evolved the ability to digest lactose—simply because there was no point in being able to do so.
Alternatives to cow’s milk and dairy products: Plant based milk substitutes These include rice, oat, almond and soya milk, and often come with extra health benefits, such as being low in calories. Soya milk has been a staple vegetarian ingredient for many years, and comes in many varieties (eg. cream, yoghurt and cheese). Goat, sheep and buffalo milk It’s worth checking if you are able to tolerate small quantities of other animal milks as they are now quite easy to obtain in shops. Coconut milk An excellent cooking milk to which very few people react. Coconut oil is also a healthy butter substitute. Alternative spreads and margarines Check the labels as some may contain whey or casein. Most can be used in sauces and baking.
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Clear ANSWERS to Questions that Matter
HARMONY PRENATAL TEST is a non-invasive maternal blood test. AS EARLY AS 10 WEEKS, the Harmony Prenatal Test evaluates the risk of Down syndrome (trisomy 21), Edwards syndrome (trisomy 18) and Patau syndrome (trisomy 13) for pregnant women, of any age or risk category.
For more information email firstname.lastname@example.org or call +44 (0)20 7307 7409
If you are a woman in your 20s, you are at – from a medical point of view – your optimal time to have a baby. It is the most fertile time of your life, and your risk of miscarriage, birth defects and other complications is lowest. Today, however, many women are choosing to delay starting a family until they are in their 30s or even 40s. As age increases, the risk of having a baby born with Down syndrome also goes up. In your 20s, the risk is low – less than 0.01%. At 36 it is 0.025%, at 40 it is 1% and by the time you are 44 it is about 3%. So it used to be that older pregnant women in particular were offered the option to test for Down syndrome. However, traditional screening tests are only around 70–80% accurate, and Down syndrome babies are born to younger women too. Harmony is a new DNA-based blood test that can be offered to nearly all pregnant women and from next year will be offered within the NHS to women identified with higher risk pregnancies. It has been extensively tested in pregnant women both over and under 35, and detects more than 99% of pregnancies with Down syndrome – it is significantly more accurate than traditional tests. The test works by looking at fragments of a baby’s DNA that pass from the placenta into the mother’s blood. It can be performed as
early as the tenth week in pregnancy and involves taking a blood sample from your arm. Results are nearly always available within a week. To have this test, we need you to go through your Consultant, GP, midwife or ultrasound team so that they can refer you, and give you your results in context with your medical details and family history. The Harmony test would be in addition to your usual scan appointments before and following testing. As well as screening for Down syndrome (which is caused by the baby having 3 copies of chromosome 21 instead of 2 copies), Harmony can test for Edwards syndrome (3 copies of chromosome 18) and Patau syndrome (3 copies of chromosome 13), and can identify missing or extra copies of the X and Y chromosomes. Your result will give you a clear answer about the risk to your pregnancy for any of these genetic conditions. All non-invasive prenatal tests, like Harmony, are screens. Although the most accurate test currently available, it cannot definitively detect whether a baby is affected or not. This means that if a test result is reported as high risk, you will be offered the option of an invasive test (a CVS or amniocentesis) to find out, and will be offered support and counselling to help you with your decision.
Three Simple Steps to Clarity 1. At 10 weeks or later, you get a simple blood test. 2. Your blood sample is sent to the Harmony laboratory, where it is analysed. 3. Your results are sent to your healthcare provider in 3-5 business days from receipt of sample in the laboratory.
Your Results The test result will give you a clear answer about the risk to your pregnancy of having any of the genetic conditions included in the test. Non-invasive prenatal testing based on cell-free DNA analysis is not considered diagnostic. All results will be given to you by your healthcare provider and will be interpreted in the context of your medical details and family history. You should continue with your usual scan appointments before and following testing.
For help, email email@example.com or call +44 (0)20 7307 7409 TDL Genetics, 60 Whitfield Street London W1T 4EU Tel: +44 (0)20 7307 7409 E-mail: firstname.lastname@example.org
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Testing Testing A new prenatal test for Down Syndrome promises to increase accuracy and reduce the rate of unnecessar y invasive diagnostic procedures
creening for three genetic conditions: down syndrome, edwards syndrome and Patau syndrome, are currently offered to all pregnant women. which tests women are offered depends on how far along their pregnancy is. women between 10 and 14 weeks pregnant are offered a blood test plus an ultrasound scan, called the combined test, while women between 14 and 20 weeks of pregnancy are offered a different blood test, which is less accurate than the combined test. if you test positive, your doctor will then recommend you undergo diagnostic testing, specifically chorionic villus sampling (removing and testing a small sample of cells from the
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placenta) or amniocentesis, when a needle is used to extract a sample of amniotic fluid, the fluid that surrounds the fetus in the womb.
the combined test has its drawbacks. it has a false positive rate (when a fetus is diagnosed with a problem, but is in fact healthy) of around three to four percent. what this means is that many women have unnecessary, invasive diagnostic tests that come with around a one in 100 chance of causing a miscarriage. what is needed is a test that reduces the false positive rate of the screening test. this would reduce the number of women with healthy babies who need invasive testing.
A beTTer meThod?
a new technique promises to reduce the false positive rate of prenatal screenings. the harmony Prenatal test works by analysing the fragments of fetal dNa contained in the motherâ€™s blood to predict the risk of certain genetic conditions. all thatâ€™s needed is a maternal blood sample taken at week 10 of pregnancy or later, which is then submitted to a laboratory. results can be received within seven days.
Published studies have shown that the harmony test results in a 0.1 percent false-positive rate for trisomies 21, 18 and 13 (down, edwards and Patau syndrome) which is lower than the celebrityangels.co.uk
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three to four percent rate in traditional screening tests. It also has superior detection rates. The Harmony Test will detect over 99.9 percent of Down Syndrome fetuses compared to just 80 percent for the combined screening. It is important to remember, however, that if you do test positive you will still need to undergo diagnostic tests. •
Screening during pregnancy
Did you kno
of DNA that are packages Chromosomes ed to grow ne we n formatio of contain the in le have 23 pairs ormally, peop s like Down, on and develop. N iti nd co tic py . But in gene e is an extra co chromosomes syndrome ther u ta s Pa en d pp an ha s Edward ually this mosomes. Us nts, of certain chro from the pare ed rit he in t n’ is d an red ce fe of an e by ch men ar l pregnant wo s re su ea which is why al m st e Harmony Te screening. Th e if there se to 21 d an 13, 18 chromosomes copies. are any extra
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It’s routine to be offered screening tests during pregnancy to try to find any health problems that could affect you or your baby, not just to test for genetic conditions like Down syndrome but also for infectious disease and physical abnormalities. These tests can help you then make choices about care while you’re pregnant and after the birth. The tests offered during pregnancy are either blood tests or ultra sounds, or a combination of both. Ultra sounds can detect physical abnormalities like spina bifida, while blood tests can find the risk for inherited disorders such as sickle sell anaemia. Combined tests can be used for detecting chromosomal abnormalities, like Down syndrome. It’s important to remember that screening tests typically don’t say for certain if you or your baby have a health problem, it just tells you whether you or your baby have a high or low risk of having a problem. A diagnostic test is usually needed to give a definite ‘yes’ or ‘no’ answer. It’s also entirely up to you whether you choose to have a screening test. For more information on the Harmony Test, visit ariosadx.com
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nfertility can be emotionally and physically draining for a couple, and indeed their family and friends. if you and your partner are failing to conceive, you may feel you are the only couple in this predicament but around one in seven couples have difficulty conceiving, which amounts to approximately 3.5 million people in the UK. a couple will only be diagnosed as infertile if the woman has not fallen pregnant after one year of trying,
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and there are two types of infertility: primary infertility, where a woman who has never conceived fails to become pregnant, and secondary infertility where a woman who has already been pregnant fails to fall pregnant again. women aged 36 and over, or who are aware of existing fertility problems, should see their GP, who can suggest treatments that may help. there are a number of treatments available, including medical treatments for lack of regular
ovulation, surgical procedures and assisted conception such as intrauterine insemination (iUi) or intro-vitro fertilisation (iVF). there’s also the option of adoption or surrogacy. there’s a stigma attached to infertility—couples often speak about feelings of failure when they can’t conceive. a number of celebrities have spoken candidly about infertility, which can be reassuring for those who may be suffering in silence.
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Infer tility affects 3.5 million people in the UK. If you’re failing to conceive there are a number of alternatives available
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ANGELIA JOLIE & BRAD PITT
The couple have six children, three of whom were adopted internationally. Angelina Jolie adopted two children before her relationship (and later marriage) to Brad Pitt, but he has since officially adopted the two children and their surnames were changed to Jolie-Pitt. Soon after, the couple announced they were expecting their first
biological child together. A year later, they decided to adopt again for the third time, and Angelina then announced another natural pregnancy and gave birth to twins in 2008.
to conceive on her FABlife talk show, saying that she and her husband, award-winning singer John Legend, would have had children years ago. The IVF treatment was successful for the couple, and they welcomed a babygirl, Luna, in April 2016.
CHRISSY TEIGAN & JOHN LEGEND
SARAH JESSICA PARKER & MATTHEW BRODERICK
Supermodel Chrissy Teigen recently told People magazine that she was undergoing IVF treatments during a swimsuit photo shoot for Sports Illustrated : ‘I had a little medical kit. It was hard because you bloat from it, and you bruise—if I hit the wrong area, we had to cover it with makeup.’ The 30-year old has spoken about her lengthy struggle 92 DEAR DOCTOR WITH CHRIS STEELE
After conceiving their first son, James, naturally, Sarah Jessica Parker and Matthew Broderick were unable to get pregnant with a second child. The 50 year-old actress told US Vogue , ‘we tried and tried and tried to get pregnant. It was just not to be. I would give birth … if I could.’ They chose to use a surrogate mother, and welcomed twin girls in June 2009.
Causes of infertility There are a number of potential causes of infertility, and they can affect either the man or the woman. Sometimes, it is not possible to identify the cause. Common causes in women include lack of regular ovulation (which can occur as a result of certain conditions, such as polycystic ovary syndrome and endometriosis). For men, the most common cause is poor quality of semen; decreased sperm count, decreased sperm mobility or abnormal sperm are all contributing factors to male infertility.
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Preserve your fertility in preparation of chemotherapy or other medical treatments that may threaten your ability to have children in the future. We offer a full-range of fertility solutions. Even if your desire is simply to defer child-bearing with Egg Freezing, New Hope Fertility Center, the worldâ€™s leading fertility preservation center, is here for you. Now is always the best time to freeze.
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In some cases, infertility canâ€™t be prevented. However, there are measures we can take that may help to prevent certain cases.
Weight: Women who are underweight or overweight ovulate less regularly, or in some cases not at all, compared to women of a healthy weight. If a healthy weight is maintained, it will make it easier to conceive.
Stress: Stress can impact fertility, as generally, stressed couples have sex less frequently. Unfortunately, this stress might be due to struggling to conceive, which ironically can make it harder. Talk to your partner, or consider counselling. Regular exercise can also help.
Diet: Eat a nutritious, balanced diet of at least five portions of fruit and vegetables a day. Include wholemeal bread and pasta, lean meat, fish and pulses. Green, leafy vegetables such as spinach and pak choi can help prevent birth defects and cut out alcohol and cigarettes.
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HEALTH & FITNESS
It may seem that everywhere you look, you see another expecting mother (especially if you are trying to conceive yourself) but the chance of getting pregnant in a month is only 15-25 percent, and over 10 percent of all pregnancies result in a miscarriage. Infertility is defined as the inability to achieve clinical pregnancy in 12 months of unprotected sex for people under 35 years of age, and six months for people 35 years of age and over. ‘We separate the groups since it has been determined that age is directly linked with fertility,’ says Dr. John Zhang, Medical Director of New Hope Fertility Center in New York City. ‘A woman’s fertility starts to decrease around the age of 30 and significantly decreases above the age of 40. This is most notably seen in egg quality and number.’ Unlike men, who will produce new sperm daily for most of their life, women are born with about two million immature eggs, also known as follicles. Each month, one egg will mature and descend into the fallopian tube where it may be fertilised. If no sperm is present or for some reason the egg doesn’t get fertilised during ovulation, the egg will degenerate and then be expelled during the woman’s period. By the time she reaches puberty, a woman will only have around 400,000 follicles left. There are many factors that contribute to infertility. One third of these are male related: sexual dysfunction, sperm quality and sperm motility. Another third of these factors are attributed to the female: egg quality, uterine environment (health of your uterus), overall health and tubal blockage. A final third of infertility is attributed to unknown factors. While it is crucial to identify what is causing an inability to become pregnant, many cases end up in the same place: In Vitro Fertilisation (IVF). Dr. Zhang shares several different approaches to IVF, suggesting that while searching for the right IVF
centre for yourself, make sure you find one that can customise treatments and protocols to your body. Variations on traditional IVF could work for different ages, circumstances, and medical backgrounds.
CONVENTIONAL IVF: The most common form of IVF, recommended for damaged fallopian tubes or poor sperm quality, the procedure involves multiple injections of hormones to stimulate the ovaries to produce multiple eggs to be retrieved and fertilised. NATURAL IVF: This technique captures the one egg that is released during ovulation, the mid-cycle of a woman’s period. As this egg is usually the highest quality, the chance of pregnancy is increased. There are no medications for this, except possibly to prepare your uterus for embryo transfer. MINI-IVF: This is New Hope Fertility’s gentler approach to IVF, minimising the amount of chemicals and drugs typically used in IVF. Oral medication stimulation is used so that the ovaries produce the highest quality eggs in a cycle. A nasal spray will replace the need for repeated injections, although up to three injections may be necessary. Mini-IVF has high success rates and is less expensive than typical treatments. This is suitable for older patients, patients with poor egg quality, people who want a holistic approach, and women with complicated situations like polycystic ovary syndrome (PCOS) or endometriosis.
conclusive. Thousands of healthy IVF babies have been born, and many are already in adulthood with families of their own. New studies show that mini-IVF is an equally successful and safe approach to IVF and that less medication with more cycles has a higher chance of pregnancy. With a decreasing population and increasing infertility rate, more successful approaches to becoming pregnant are needed. Coincidentally, more and more people are looking abroad for fertility experts, but these patients should be careful. While it is true that other countries offer more progressive approaches to IVF, some don’t have the stringent governmental regulations in place to ensure your (and your future baby’s) safety. Competitive pricing, progressive approaches, and even the ability to work remotely with your existing physician throughout much of your treatment can be done from places like New York City. Top clinics may be found online and some will offer phone or internet consultations so that you can thoroughly research and assess before committing to a trip overseas. •
ULTRA MINI-IVF: Much like miniIVF except with no injections, only oral medication stimulation. There has been some negative press lately about the health of IVF babies and an increased likelihood of blood diseases like leukemia. This isn’t
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Breaking the last taboo At some point in our lives, one in 10 of us will have problems with bowel control. What can be done to help those who are too embarrassed to even talk to their GP?
oping with Accidental Bowel Leakage (ABL) can be more than just a practical inconvenience. Many people are too embarrassed to discuss their problem, afraid they are ‘the only one’ and that there is no treatment to help their condition. ABL is surprisingly common. The Bladder and Bowel Foundation estimates one in 10 adults will have problems with their bowels at some point in their lives. Many live in fear of not knowing when they will lose control and manage as best they can. One patient, who wishes to remain anonymous, says: “I am now retired and would love to have the life I worked
so hard to attain, but I am stuck close to home for fear of incontinence. I have never felt more alone and sad.” Historically, effective treatment for ABL has been limited. So a new product that is safe and easy to use, and is supported by the medical profession, offers hope and reassurance. Renew Inserts are a clean, hygienic alternative to pads. Renew Inserts softly and comfortably ﬁt your body and seal the rectum from the inside to help prevent leakage. They provide reliable and discreet protection and give you the conﬁdence that comes
from restored bowel control. Carolynne Vaizey, consultant surgeon and Chair of Surgery at St Mark’s Hospital and Academic Institute, London, says: “These Renew Inserts provide a new, non-surgical option for managing ABL. They may restore patients’ dignity and provide them with the conﬁdence to live a normal and active life.”
I am back in control
A new product aims to put an end to the fear and embarrassment caused by problems with bowel control ● Renew Inserts help prevent Accidental Bowel Leakage (ABL)
● A clean and hygienic alternative to pads and incontinence pants ● Soft, comfortable and easy to use internal protection for men and women
“So soft and comfortable, I forgot I was wearing them. I can ﬁnally go out and feel secure.” -Lynn, Renew Inserts user
Renew Inserts are available on prescription and can be delivered directly to your home or dispensed by your local pharmacy.
Regain control today!
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To order a sample or speak conﬁdentially with a nurse who understands ABL, call 0800 542 0814 or visit www.renew-medical.uk
HEALTH & FITNESS
It’s an issue that affects over six million people in the UK, yet many suffer in silence. Here’s what you need to know about bowel difficulties
Suffering in B Silence owel incontinence is the inability to control bowel movement, resulting in unexpected anal leakage. This can range from the occasional leakage of stool when passing gas, to a complete loss of bowel control. Common causes of bowel incontinence include diarrhoea, constipation or weakening of the sphincter muscles, which can happen as people age and the muscle loses tone, or as a result of giving birth. It can also be caused by long-term conditions such as diabetes, multiple sclerosis, IBS and dementia. It can affect people of any age, but is more common in the elderly, and women are more likely to be affected than men. It can be an upsetting and difficult condition to deal with, and one that many feel too embarrassed to talk about. However, there is a range of treatments available and a cure is often possible so it’s important to speak to a doctor. The NHS also has a continence service where you can book an appointment without a referral and speak to specialist nurses who can offer useful advice.
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Those suffering from bowel incontinence may be reluctant to speak to their doctor, but they will understand that the condition is emotionally distressing and patients may be embarrassed. By being as honest and giving as much information as possible, you’re more likely to receive the most suitable treatment. Be sure to let your doctor know about: • Changes in your bowel habits lasting more than a few weeks • Rectal bleeding • Stomach pain • Changes to your diet • Any medication you’re taking celebrityangels.co.uk
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Treatment In many cases, the condition can be cured. With the right treatment, a person can maintain normal bowel function throughout their life (depending on the causes and severity). If it isn’t possible to completely cure the condition, symptoms can significantly improve and be easier to control. Diet: A high-fibre diet is usually recommended— plenty of fruit, vegetables, wholegrains (rice, pasta and bread), seeds, nuts and oats, along with drinking plenty of fluids to soften the stool. It’s advisable to keep a food diary to keep track of any foods that cause a reaction. Exercise: Pelvic floor exercises can help strengthen the muscles that control the bowel, and if exercises are carried out three times a day for six to eight weeks, there should be a noticeable improvement in symptoms. Medication: If a medical illness (such as IBS or an inflammation of the bowel) is causing the bowel
incontinence, medication can be prescribed. Supplements: For those suffering with IBS, supplements can help stabilise digestion and control the syndrome. Surgery: There are a number of surgical options available, including sphincter repair or replacement. For those with severe bowel incontinence, a colostomy can greatly improve their quality of life. Products: Many people become anxious about leaving the house or taking part in everyday activities, in case accidental anal leakage occurs. Disposable pads or anal plugs can be used until symptoms are better controlled.
DEAR DOCTOR WITH CHRIS STEELE 97
Open up to a new BPH treatment
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PET Suture 8 mm
Stainless Steel Urethral End Piece
Without cutting, heating or ablating The UroLift® System is a unique minimally invasive alternative to major surgery for the treatment of BPH. UroLift permanent implants are individually tailored during delivery to transprostatically reshape the prostate, thus reducing urethral obstruction directly without ablating, cutting or removing prostate tissue. The procedure may be done in an outpatient setting and often local anesthesia is used.1 • Immediate, visible result1 • Rapid symptom relief2 • Preservation of sexual function3 • Typically no catheter required after treatment1 Clinical data shows patients receiving UroLift implants report rapid symptomatic improvement, improved urinary flow rates, and sustained sexual function. Patients also experience a significant improvement in quality of life.1 Most common adverse events reported include hematuria, dysuria, micturition urgency, pelvic pain, and urge incontinence. Most symptoms were mild to moderate in severity and resolved within two to four weeks after the procedure.
Check out the data and learn more at UroLift.com
1. Data on file at NeoTract; 2. Chin, P, et al., Urology 2012; 3. Woo, H, et al., Journal of Sexual Medicine 2011 ©2015 NeoTract, Inc. All rights reserved. MAC00189-01 Rev A
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Z I M M E R / M A D I C H UroLift/NeoTract Trees Ad | Celebrity Angels
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HEALTH & FITNESS
Man Up for a Check Up! I
a result of neglecting their health and failing to get a check-up. so it’s time to face up, and man up, and arrange your health check Mot.
Health checks for men are essential for all age groups, and in most cases the process will leave you feeling reassured. For older men, prostate problems can also be relieved via a new treatment
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’m feeling fit, so why would i need a health check? this is the attitude of most fit men under the age of fifty who have never had a health check. another more worrying cause for resisting a complete health check-up is that some men simply don’t want to face up to the fact that a test might reveal there’s something wrong. Bizarre though this sounds, GPs acknowledge that this has indeed been a barrier, although a more positive recent trend has been helped by the message getting through that early diagnosis of almost any condition may help us avoid a life-threatening illness. the Nhs tells us that more than 100,000 men die prematurely every year simply as
How sHould I go about It?
in the UK we are fortunate to have the option of a free Nhs check-up (with your GP and a nurse, that takes about 25 minutes), or you can book in to a private health clinic if that’s your preference. there are many private health clinics that will give men a full health check-up and if your job provides you with a private healthcare plan, this may be the option for you. For example, Bupa offers health assessments with a ticket price in the region of £400. and for that, you get an overview of your current general health, help to identify any future health risks and practical lifestyle advice, as well as, if necessary, access to an appropriate private referral. celebrityangels.co.uk
HEALTH & FITNESS
the london claremont clinic, based in the vicinity of harley street, offers ‘executive’ health checks for men (and women), giving you an intensive two hours or more of specialist attention for around £200. rated by many as best of all options is the Nhs well Man clinic. here the health checks vary according to your age—18-39; 40-60; 60+
men die prematurely every year simply as a result of neglecting their health and failing to get a check-up
What Will they do to me?
as mentioned above, the tests you receive, whether you’ve opted for a private clinic or Nhs, will vary according to age. if, for example, you’re in the 18-39 group, it’s not likely that you’ll need a prostate test that’s on the cards for the older age groups. here’s a list of some of the exams and screening you may expect: • blood pressure • chest X-ray, if you’re a heavy smoker • cholesterol • electrocardiogram (ECG) to check for heart problems • family health history/any known hereditary conditions • hearing and vision • lung function • urine test for diabetes or kidney infection • weight and height • your lifestyle assessment, including diet, exercise, alcohol and smoking • your personal medical history
What if …?
here are some of the top health issues men should worry about enough to get checked out if you think you have a problem:
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a lump on your testicle
testicular cancer is the most common cancer in men aged 20 to 35. Nearly 2,000 men are diagnosed with testicular cancer each year in the UK. in reality, this is quite a small number, however, the number could be smaller if men get into the habit of selfexamination on a regular basis—while taking a shower is an ideal time. it was in 2014 that dr chris made the headlines by checking a man’s testicles live on itV’s this Morning show. the
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occasion helped to raise awareness of safeguarding against testicular cancer. Given early diagnosis, the current survival rate is 95 percent.
Benign Prostatic hyperplasia, or BPh, is a condition in which the prostate enlarges as men get older. over 70 percent of men in their 60s have BPh symptoms, so it is very common. while BPh is a benign condition and unrelated to prostate cancer, it can greatly affect a man’s quality of life. as the prostate enlarges, it presses on and blocks the urethra, causing bothersome urinary symptoms such as: • a sense that you cannot completely empty your bladder • a urinary stream that stops and starts • difficulty or delay in starting urination • frequent need to urinate both day and night • urgent feeling of needing to urinate • weak or slow urinary stream if you suffer from the above symptoms, you are not alone. BPh is one of the leading reasons for men to visit a urologist.
Most men have suffered some minor form of erectile dysfunction (ed) and this can occur at any time and is often caused by stress and worries of one kind or another, with psychological issues tending to affect men in the younger age group (20-40). however, if the ed lasts for several weeks, the expert advice is to see your GP because the condition can be a sign of more serious conditions, such as heart disease, diabetes or high blood pressure. dr John tomlinson of the sexual advice association says ed is ‘much more common than people realise. in the 20-40 age group it affects around 7-8 percent of men; in the 40-50 age group it affects 11 percent. in the over-60s it affects 40 percent, and more than half of men over 70.’ Seeking advice from your GP may reveal that some lifestyle changes, such as losing weight and exercise, can correct the problem; however, some men may need medication such as sildenafil, which is prescribed as Viagra.
this is a treatable medical condition and by recognising this you’ll be taking the first step in the right direction. the loss of your job or the loss of a loved one, or financial worries, can cause feelings of extreme sadness that can be treated usually through a combination of self help, talking therapies and drugs. although women are more prone to depression than men, men are less likely to seek help, and this is one of the main reasons why the suicide rate is higher for men. the bottom line is having health awareness. if men can give some time to follow a lifestyle that helps nurture good health, which includes having the necessary health checks, then this will help us significantly reduce the risk of developing serious ill health in later years.•
dear doctor with chris steele 101
HEALTH & FITNESS
0 BUY 2
UroLift System treatment is a straightforward procedure that is performed by a urologist. The Urologist places tiny implants to hold the prostate lobes apart, like open curtains on a window, to relieve compression on the urethra. This allows urine to flow normally again. The UroLift System treatment can be done in the physician’s office under local anesthesia. Typically, patients return home the same day without a catheter. The UroLift System is an alternative for patients looking for something other than drug therapy or more invasive surgery. Treatment might be right for you if any of the following apply to you: • You do not want to take another pill everyday • You have tried BPH medication but are unhappy with the side effects • You do not want to undergo major surgery due to potential surgical risks of side effects and complications • You want a BPH solution that preserves your sexual function • You want to regain your quality of life with minimal downtime Beneﬁts of the UroLift System include: • durable results • minimal downtime • minimally invasive • preservation of sexual function • rapid symptom relief, as early as 2 weeks post procedure • straightforward procedure • typically no catheter or overnight stay required after treatment
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HEALTH & FITNESS
A breakthrough for patients with an enlarged prostate It was meant to be a trip of a lifetime—two weeks in Canada and America with his wife—but five days in, Robert Jesse was being flown home after complications with an enlarged prostate. Robert, a retired engineer from Fleet, Hampshire, had been taking tablets for two and a half years to control weak urine flow and needing to frequently and urgently pass water. But before leaving, the 69 year-old had muddled his heart tablets with those for his enlarged prostate and in the following days mistakenly took double the dose of his angina medication. This led to the disturbing situation where he could not pass water for several days. ‘The irony was not lost on me that we were there watching the
Niagara Falls and I could not go,’ says Robert. After two episodes of having catheters fitted, Robert knew he needed a permanent solution. He was treated with UroLift, a minimally invasive treatment where a permanent implant is inserted that lifts the enlarged prostate tissue out of the way so it no longer blocks the urethra. Studies have shown it improves urinary flow without compromising sexual function. ‘I didn’t need to think about it. It was less intrusive, quick and carried less risk,’ he adds. After a wait of several months, Robert was admitted as a day patient and fitted with the device under local anaesthetic in February 2015. ‘My wife Heather dropped me off at 1pm, picked me up afterwards and we were back home by 6pm. I’ve never looked back.’ He has since been able to come off medication, and Robert no longer has to worry about needing
to visit the toilet urgently; he wakes less in the night, his libido has returned and the couple have rediscovered their intimacy. ‘I’d definitely recommend UroLift,’ says Robert whose experience was pain free. ‘I just felt a slight burning the first time I passed water.’ Now the couple feels free to travel again. Robert’s wife Heather adds: ‘We can just get on with things without being concerned and are far more relaxed. It has improved our lives enormously.’
I didn’t need to think about it. It was less intrusive, quick and carried less risk
What is BPH? An enlarged prostate, or BPH, is a condition in which the prostate gland that surrounds the male urethra becomes enlarged with advancing age and begins to obstruct the urinary system. Symptoms can include sleepless nights and urinary problems and can cause depression and affect general quality of life. Approximately
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one in four men experience BPH-related symptoms by the age of 55 and by 70, more than 80 percent of men suffer from the condition. The UroLift System is a new minimally invasive approach to treat BPH that lifts or holds the enlarged prostate out of the way so it no longer blocks the urethra.
Safety statement: Most common adverse events reported include hematuria, dysuria, micturition pain, and urge incontinence. Most symptoms were mild to moderate in severity and resolved within two to four weeks after the procedure. To find out more, call 0330 088 9549.
DEAR DOCTOR WITH CHRIS STEELE 103
INNOVATIVE SOLUTIONS The TURis system from Olympus Medical used to treat prostate enlargement, could benefit a large number of patients and save the NHS more than £4million per year. As the prostate enlarges, it can put pressure on the urethra, which can cause a multitude of lower urinary tract symptoms. Of which may include difficultly urinating, dribbling after urination, increased frequency of urination, and pain during urination.
The TURis loop electrode for prostate resection
The prostate presses on the urethra, causing symptoms
Benign prostate enlargement (BPE) is the most common cause of lower urinary tract symptoms in men. Around 60% of men aged 60 and above have some degree of prostate enlargement. What causes it is unknown, but it is thought to be linked to changes in hormone levels in a man’s body due to ageing. BPE affects quality of life in around 40% of men in their 50s and 90% of men in their 90’s. Now, the Olympus Medical Transurethral Resection in Saline (TURis) system has been recommended by the UK National Institute for Health and Care Excellence (NICE) as the new gold standard for transurethral resection of the prostate in men. The saving to the NHS could be millions of pounds per year, while also reducing risks to patients leading to better outcomes from surgery to reduce enlarged prostate gland. NICE has concluded the use of TURis for transurethral resection of the prostate for benign prostate enlargement avoids the risk of
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transurethral resection syndrome and reduces the need for blood transfusions. TURis also demonstrated equivalent efficacy to monopolar systems—long considered the ‘gold standard’ for transurethral resection of the prostate (TURP).
SAVINGS FOR THE NHS Approximately 15,000 TURP procedures are carried out each year in England and Wales. With potential savings of between £285 and £375 per patient, at least £4million could be saved per year by NHS implementation of the new NICE guidelines. BPE is the most common cause of lower urinary tract symptoms, also known as LUTS, in men. These symptoms can include increased frequency of urination, painful urination, excessive passage of urine at night, hesitancy (worsened if bladder is very full), incomplete voiding and overflow incontinence. Neil Barber, Urological Surgeon at Frimley Park Hospital, Surrey, and a leading expert adviser for the TURis NICE consultation, says: ‘With an ageing population, treating
this condition via surgery, which is required in approximately half of those experiencing problems of this type, is a growing issue for our healthcare system. ‘The new NICE guidelines should be welcomed by patients, surgeons and the NHS due to the improved patient outcomes, efficiencies and potential cost savings the newly recommended system provides.’ Additionally the committee found that, as a result of using TURis, there is potential to reduce the length of hospital stay and its associated risks for each patient, as well as reducing hospital re-admissions. Not only may these benefits improve patient satisfaction and outcomes, but could also result in improved waiting list times, general health system efficiency and increased hospital revenue by switching to day-case procedures.
HOW IT WORKS The TURis bipolar resection system was launched in the UK in 2009. It differs from monopolar resection in that the tissue effect takes place between two electrodes that are part of the same device. Through utilising the knowledge that impedance is lower in saline than in body tissue, the TURis bipolar current flows to the saline irrigation fluid, meaning only a very small fraction of the current passes through the tissue. Air bubbles are then created around the TURis electrode by the heat generated from the current flow. The electrode becomes
covered by small bubbles, causing the TURis loop wire to be coated by an insulation layer. High frequency current is used to create a plasma corona around the electrode. After plasma ignition, cutting or vaporisation can take place.
MAKING LIVES HEALTHIER As a worldwide leading manufacturer of optical and digital precision technology, Olympus provides innovative solutions for state-of-the-art medical systems, digital cameras as well as scientific solutions in the fields of microscopy and industrial inspection. The company’s award-winning products are instrumental in detecting, preventing and healing illness and driving scientific research. In the hands of its customers, Olympus’ high-tech products help to make people’s lives healthier, safer and more fulfilling. Since its foundation in 1919, Olympus has epitomised pioneering spirit and innovation. Inventor of the world’s first gastro-camera in 1950, Olympus has retained its worldwide leading position in medical endoscopes ever since. Gareth Walsh, director of the company’s medical systems division, says: ‘The TURis system provides an outstanding treatment option for benign prostatic enlargement with more than one million successful clinical cases proving its safety and efficacy. The TURis system provides benefits for patients and for the NHS without the need for radical changes in care pathways.’
FOR MORE INFORMATION Call 01702 616333 Visit www.olympus.co.uk/medical Email email@example.com
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HEALTH & FITNESS
Aching Joints Everything you need to know about painful joints and how to fix them
ccording to the National Joint registry, approximately 160,000 total hip and knee replacements are performed each year. what happens during these procedures, and why do we need them?
Why do We need it?
a damaged hip or knee joint can cause pain and problems with everyday movements such as walking and driving. a hip or knee replacement is a procedure where all or part of the damaged joint is replaced with an artificial version, in order to improve quality of life, mobility and relieve pain.
hoW does it Work?
Did you know?
By making an incision into the skin, the surgeon removes the damaged joint and replaces it with an artificial one made out of a metal or ceramic alloy. the operation usually takes around 60-90 minutes to complete.
For knees the worn ends of the bones in your knee joint are removed and replaced with metal and plastic parts. a total knee replacement, where both sides of your joint are replaced, takes one to three hours. if only one side of your knee is damaged you may have a partial knee replacement, which uses a smaller incision and requires less bone removal. 106 dear doctor with chris steele
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Recovery after a hip replacement, youâ€™ll typically need a walking aid like crutches for the first four to six weeks. certain exercise programs can also help you regain and improve your mobility. Most people can go about day to day life within two to three months, but it could take up to a year for complete recovery. For a knee replacement, if youâ€™ve had minimally invasive surgery you may be able to walk on the same day as your operation. at the very least, you will generally be helped to stand from within 12-24 hours. during your stay in hospital, a physiotherapist will teach you exercises to help strengthen
Scientists are currently researching how to regenerate a hip joint by transfusing stem cells into damaged tissueâ€”stem cells have special properties that allow them to replenish other types of cells.
your knee. Most people are able to walk independently with sticks after about a week, and you should be able to walk unaided six weeks after surgery. it may take up to three months for the pain and swelling to disappear, and it could take up to two years for your new knee to fully recover.
HEALTH & FITNESS
HIP & KNEE REPLACEMENTS – NON-SURGICAL SOLUTIONS AND REMEDIES
A hip or knee replacement doesn’t have to be your only option. Today there are many practical alternative solutions and remedies available
If you are suffering from hip or knee pain there are a number of possible solutions that you can talk to your doctor about. These solutions range from simple non-surgical procedures to increased exercise, and their effectiveness will depend on your age, health, and level of discomfort.
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Physical therapy is used to not only help reduce pain, but also to strengthen muscles and joints. Because damaged joints often get worse without regular activity, physical therapy is an important first step in treating hip and knee complaints.
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PAINKILLERS & INJECTIONS
There is a variety of over-the-counter and prescription painkillers that may be able to reduce hip or knee pain. These can include non-steroidal anti-inflammatory drugs, steroid injections, or pain-relieving creams, gels and rubs. Of course, there is the possibility of side effects so it’s best to consult a professional beforehand.
EXERCISE & WEIGHT LOSS
Increased exercise can help strengthen muscles and relieve pain in your joints. Weight loss is also extremely important, as studies have shown that being just 10 pounds overweight will put an added 60 pounds of pressure on your knees.
Acupuncture is becoming increasingly popular as an alternative remedy to treat body aches and pains. With the use of thin needles, acupuncture aims to change the flow of energy within the body and is used to treat a variety of issues. It’s important to remember that the success of any of these, or other remedies, will be determined by your individual situation. What might work for some may not be so effective for others, so it’s best to consult your local doctor to get a proper assessment of the best options available. •
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HEALTH & FITNESS
Our bones are constantly changing, and as we age, we require more nutrients to keep our bones healthy. Here’s what you need to know
ur bones are continuously changing—old bone is broken down, and new bone is made. In our childhood years, our bodies make new bone faster than it breaks down old bone, resulting in an increase of bone mass. Most of us will reach our ‘peak’ bone mass around 30 years old, and after that, the bone remodelling will continue but at a slightly lesser rate—we will lose more bone mass than we gain. The key nutrients in building and maintaining strong bones are calcium and vitamin D: Calcium supports your bones and teeth structure, while vitamin D improves calcium absorption and bone growth. Adults up to the age of 50 years should get 1,000mg of calcium and 200 international units of vitamin D a day. Adults over 50 should get 1,200mg of calcium and 400-600 international units of vitamin D. There are a number of foods that will help achieve these daily targets, such as yogurt and milk, but there are also a number of supplements available to support both your vitamin D and calcium intake.
SEVEN SEAS PURE COD LIVER OIL PLUS OMEGA-3 FISH OIL, £9.25, BOOTS Cod liver oil is useful for those suffering from arthritis, as the anti-inflammatory effect of fish oils can reduce pain. This supplement is fortified with vitamin D, and a rich source of omega-3 nutrients. 108 DEAR DOCTOR WITH CHRIS STEELE
Bone Key nutrients explained Vitamin D is essential for the absorption of calcium and maintaining bone and teeth health. A lack of vitamin D can lead to bone deformities such as rickets in children, and bone pain and tenderness caused by osteomalacia in adults.
VITAMIN D3, £8.99, HOLLAND & BARRETT Vitamin D3 is produced in our bodies underneath our skin as a reaction to sunlight exposure. For those that are housebound, of Asian origin or rarely outdoors, this supplement can help to regulate the amount of calcium and phosphate in the body to help keep teeth and bones healthy. Each tablet contains 1,000 international units (I.U.) of vitamin D.
CALCIUM AND MAGNESIUM WITH VITAMIN D, £8.99, HOLLAND & BARRETT
These three nutrients contribute to the maintenance of healthy bones and teeth, whilst maintaining normal muscle function and regulating blood calcium levels. Each tablet contains 1,000mg of calcium, 500mg of magnesium at 400 I.U. of vitamin D.
Calcium helps to build strong bones and teeth, regulates muscle contractions and ensures that blood clots normally. A lack of calcium could lead to osteoporosis in later life. Magnesium helps to make sure that the parathyroid glands (which produce hormones that are important for bone health) work correctly, and also helps to turn the food we eat into energy. Omega-3 fatty acids are a type of healthy fat that can help protect the body against heart disease, but also help to keep our joints healthy and can ease the pain for those suffering from rheumatoid arthritis.
HEALTH & FITNESS
Dietary sources of calcium and vitamin D Remember, supplements are intended to help reach the daily-recommended intake, and should not be used in place of food. Add the following nutrient-rich foods to your diet:
Adults up to the age of 50 years should get 1,000 milligrams of calcium and 200 international units of vitamin D a day. Adults over 50 should get 1,200 milligrams of calcium and 400-600 international units of vitamin D.
MAINTAIN YOUR BONE HEALTH
Dairy products: Low-fat milk, yogurt and cheese
GET OUTSIDE Exposure to sunlight causes your body to make vitamin D, which helps your body absorb calcium. Itâ€™s recommended to get at least an hour of sunlight a day. STAY ACTIVE Try to get a total of at least 30 minutes of physical activity a day. Try walking, gardening or dancing. MEDICATION Your doctor can advise you as to whether you should be taking prescription medications to improve your bone health.
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Fortified foods and drinks: Orange juice and some cereals
QUIT SMOKING Smoking and heavy alcohol use can decrease bone mass. Quitting smoking and limiting alcohol intake can prevent this decrease, along with improving your overall health.
Dark green vegetables: Broccoli, collard greens, bok choy
Fish:: Sardines, salmon and tuna
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More than just weight loss
Germany’s No.1 meal replacement can not only make you slim, it also brings a host of positive benefits.
oday in the UK, the prevalence of overweight and obesity continues to rise; in fact trends predict that by 2050, 60% of adult men and 50% of women will be classified not only as overweight, but also obese1. What’s more, being overweight or obese is associated with an increased risk of developing chronic diseases such as Type 2 diabetes,
cardiovascular disease and cancer. This stark reality shows the importance of being able to control and maintain a healthy weight. Even though more than half of the UK population have tried various diets as a means of slimming down, many are often cited as being counterproductive or even detrimental to health and can actually result in greater weight gain. However,
help is at hand in the form of a successful food product from Germany. Almased® is Germany’s No.1 clinically tested weight loss programme which not only contributes to effective and sustainable weight loss, but most importantly retains essential muscle mass while losing weight2.
Lose weight effectively with Almased® This scientifically proven formula has contributed to fat loss, while retaining the body’s essential muscle mass. More than 25 years ago, Hubertus Trouillé a German holistic therapist and the creator of Almased®, developed a natural solution to improve his patients’ energy levels. Subsequent improvements in his overweight patients’ energy resulted in a reduction of unhealthy body fat. Today, Almased® is sold in every pharmacy in Germany, making it the best selling weight loss product in the country.
This meal replacement programme, even though low in calories, keeps you full for longer, reduces fat and makes it possible to lose weight. With some diets, weight loss can be achieved but at the expense of starving the body of vital nutrients. Consequently, muscle wastage and a feeling of mental and physical lethargy ensue. In contrast, using the Almased® programme, the body gets what it needs to function healthily. Supportive scientific studies have shown that Almased® nourishes and retains essential muscle mass. Moreover, it was clinically found that twice as much weight loss was achieved compared to a normal low-fat diet3.
Made with natural ingredients: What’s in Almased®? The unique production method used to make Almased® ensures that three high-quality raw ingredients provide optimum nutrition for the body.
Fermented Soya Easily digested plant protein, rich in essential amino acids and low in saturated fat, the high protein content results in a longer and improved feeling of satiety. Importantly, protein contributes to the maintenance of essential muscle mass and bones.
Yogurt Made from p r e m i u m quality milk, c a l c i u m present in the yogurt helps maintain healthy bones and the normal function of digestive enzymes. Additionally both the yogurt and soya provides very high levels of biotin, which contributes to energy release as well as the maintenance of healthy skin and nails.
Honey Sourced from protected nature reserves in North America, this honey is carefully processed in order to optimise the raw enzymes that aid healthy digestion. Since the aim of Almased® is to produce a product as wholesome as possible and free from artificial sweeteners, the small amount of honey provides natural sweetness while also enhancing the taste.
What is not in Almased®? Almased® is free from artificial flavours, fillers, preservatives and stimulants, and contains only naturally occurring sugars and added sugars. It is also gluten free, non-GMO and suitable for vegetarians.
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Clinical research on Almased
25 years of scientific research has validated all key claims about Almased® and its benefits to health and well-being. One such clinical study conducted by the University of Freiburg, showed the effectiveness of an Almased® programme on body weight and body shape after a period of four weeks. Twelve overweight subjects consumed Almased® for breakfast and dinner, as well as a low-fat regular meal at lunchtime. The participants lost significant weight which the researchers attributed to the positive influence Almased® had on hormonal levels4. Today, we know that a multitude of mechanisms are responsible for the effect Almased® has on the body. In a follow-on longer-term intervention2, the effect of Almased® on body composition was examined. The sixmonth study showed participants lost fat but unlike other diets they also retained important muscle mass. This retention of the muscles integrity is key to any successful weight loss programme (Figure 1).
Figure 1: Significant advantages of using Almased
Almased® can help people with Type 2 diabetes lose weight DID YOU KNOW?
Almased® is suitable for people with Type 2 diabetes because it has a high proportion of plant based protein and is lower in carbohydrates. This is positively reflected in Almased®’s low glycaemic index (27) and extremely low glycaemic load (4). Foods with low GI and GL values ensure a slower release of insulin, not only supporting healthy blood sugar levels, but subsequently inhibiting the storage of fat and stimulating fat loss. As clinical
testing has shown, a diet supported by Almased® leads to improved weight loss, reduced fasting and long term blood glucose levels, as well as fasting insulin levels5. N.B. Please consult your healthcare professional before starting any weight loss programme. Almased® is a meal replacement which can be used to replace up to two of your daily meals. Depending on how your diabetes is treated, you may require support 1) to start checking your blood glucose levels/ to check them more regularly; 2) to make changes to your medications.
How to use Almased® Almased® is a meal replacement that can be used to replace any daily meal; alternatively it can be used as supportive nutrition to a balanced diet. A 50g serving (5 heaped tbsp) of Almased® mixed with 200-350ml of water or 200ml of low-fat milk and 2tsp of oil (i.e. flaxseed, walnut, rapeseed, olive) is important to achieve your energy and nutritional needs. It is recommended to add a small amount of oil to each Almased® shake in order to ensure an adequate intake of essential fats which our bodies need. The Almased® programme offers two different plans which you can follow; the 14-Day Figure Plan ensures timely and effective weight loss, while the Long-Term Plan can be used for an extended period or until you have reached your desired weight.
only available at
Download your FREE Almased® Figure Plans at figureplan.co.uk and enter code DD1. For more information call 0207 969 1886 or email firstname.lastname@example.org.
1 Department of Health (2011). Healthy Lives, Healthy People: A call to action on obesity in England; 1-51. 2 Deibert, P. et al (2004). Weight loss without losing muscle mass in pre-obese and obese subjects induced by a high-soya-protein diet. International Journal of Obesity; 28(10):1349-52. 3 König, D. et al (2008).Effect of meal replacement on metabolic risk factors in overweight and obese subjects. Annals of Nutrition and Metabolism; 52(1):74-78. 4 Berg, A. et al (2000).Using Almased in an Enriched Soya Diet for Weight Loss. German Journal of Sports Medicine, 51:39. 5 Martin, S. et al (2013) Protein-rich meal replacement significantly reduces HbA1c, weight and antidiabetic medication in Type 2 diabetes patients – a randomised controlled trial. Diabetes 62 (Suppl 1): 768-P.
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HEALTH & FITNESS
Guide to Weight Loss Many of us struggle with weight loss, and according to the British Nutrition Foundation, over half of the people in Britain are overweight and one in four adults is obese
s we all know, being overweight or obese can seriously affect our health as the risk of developing type 2 diabetes, coronary heart disease and some cancers is increased. a healthy weight is measured by BMi (body mass index), and is calculated by dividing your weight in kilograms by your height in metres squared. a BMi between 18.5 and 25 is defined as healthy, a BMi of over 25 is defined as overweight, and over 30 is defined as obese. if you’re classed as obese, governing experts usually recommend that you lose five to 10 percent of your bodyweight. Most people aim for the 10 percent, which can seem daunting, but recent
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research has shown the results of losing just five percent. the study of 40 obese men and women aged 32 to 56 found that losing five percent of their weight led to substantial improvements in health through the better control of insulin in the liver, fat and muscle tissues. the changes also led to a lower risk of diabetes, heart disease and some cancers. the study, which is published in the journal cell Metabolism, noted that a number of participants went on to lose another 10 percent, and later, 15 percent. tracy Parker, a heart health and dietitian at the British heart Foundation, said, ‘this study is good news for people who struggle with their weight as it suggests that even losing a small amount of weight can have a positive impact on heart health.’
there are a vast number of diets, from atkins to Paleo, but if you’re aiming to lose weight and keep it off then consider weight loss as an overall lifestyle change instead of a quick fix. a sensible approach to weight loss means that the weight is more likely to stay off for good, as opposed to crash diets where you may lose weight initially but will be more likely to re-gain the weight once the diet has ended. the Nhs has a free 12-week guide that has been downloaded over two million times. the guide is designed to help you lose weight at a safe and sensible rate of 0.5kg to 1kg (1-2lbs) each week by adhering to a daily calorie allowance. the guide is full of diet, healthy eating and physical activity advice, and includes weekly challenges to keep you motivated.•
HEALTH & FITNESS
25 years of scientific research have ensured Almased remains Germany’s No. 1 meal replacement for weight loss
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Finally available in the UK, Almased is a unique soya, raw-enzyme honey and yogurt-based meal replacement proven to offer safe and effective weightloss. It contains important nutrients the body needs, essential amino acids and enzymes for easy digestion. Almased is gluten-free, vegetarian, has no preservatives, artificial flavours, fillers or stimulants and contains only naturally occurring sugars.
Almased uses a clinically tested formula that can be used for the purposes of weight loss, maintenance and what’s more, is even suitable for people with diabetes due to its low glycaemic index. Simply use it to replace any meal of the day and not only can you lose weight, but you will do so in a healthy, nutritious way, all while retaining the body’s essential muscle mass which supports long term weight maintenance and overall health. Almased offers two diet plans, which are easy to follow; the 14-Day Plan caters for timely and effective weight loss, while the Long Term Plan can be used until your weight loss goals are achieved. For further details, visit almased.co.uk. Almased is only available at Boots or Boots.com
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The Silver Line
As one of the nation’s great campaigners for ‘social wellbeing’ and the brains behind ChildLine and The Silver Line, the helpline for older people, Ester Rantzen talks to Charles Ford about how social media affects self esteem, how society changes the way families live together, and the effects of loneliness on our health
Both ChildLine and The Silver Line have helped to combat many callers’ problems, helping when they feel they have no one to talk to. Have you always been motivated to help other people, or has the motivation usually developed through your own personal situation, as with The Silver Line? Ester Rantzen: i’ve always thought that as i’m Jewish, (and because no Jew is in this country by accident, we’re all asylum seekers originally) asylum seekers are always aware of what they owe their country of adoption, the country that has provided a refuge. i think that feeling of gratitude and wanting to give back the kindness and generosity you have received may be part of our dNa. 114 dear doctor with chris steele
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Perhaps it’s in your genes. So, with our progressively aging society, do you think loneliness is likely to become an increasing problem for what we might hope is a caring society? ER: it’s interesting, isn’t it? there was a time when the oldest members of the family were living with the family. they would be surrounded, by the noise, the laughter, the tears, and the chat of family life. But it’s not the way we live these days. the constant phrase we hear from silver line callers is ‘i don’t want to be a burden’. So you think the change in society, and how families live these days, causes older people to feel like a burden to their children?
The Department of Health has woken up to the fact that loneliness is as dangerous as smoking 15 cigarettes a day and more dangerous than obesity as a life-threatening condition.
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Contact the Elderly is a registered charity in England and Wales (1146149) and in Scotland (SC039377). Company Number (07869142) Registered office: 2 Grosvenor Gardens, London SW1W 0DH.
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afternoons Research shows that feelings of loneliness amongst older people can have detrimental effects on health and wellbeing, sometimes leading to depression and even early onset dementia. National charity Contact the Elderly organises free monthly Sunday afternoon tea parties for small groups of people aged 75 and over, who live alone and find it hard getting out by themselves. Our volunteer drivers collect people from their homes and accompany them to local tea parties held in a volunteer hostâ€™s home. Everyone receives a warm welcome and plenty of tea and sandwiches. The solution is simple, and with 80% of guests feeling less lonely and 25% visiting their GP less since joining a group - itâ€™s an ideal way to brighten up a Sunday. If you or someone you know would like more information about Contact the Elderly in your area, please contact us today.
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ER: i think there’s a very interesting tension between loneliness and independence. People are wary about giving up their independence and moving into sheltered housing or a retirement village, where they do get the company of other people but they may have limited space. so these days, as people get older, they prefer to live independently for as long as they can. i’m not sure it’s sensible. So do you think loneliness will become an increasing problem? ER: Yes. it exists across every age group. children often find that social media creates the illusion that everyone is popular, beautiful and having a terrific time except you. it can exacerbate the loneliness of children who perhaps have nobody to talk to about the things that worry him or her, except childline. But certainly people who are used to being needed, and the centre of family life, and then everything slowly retreats from them can feel this tremendous sense of loss, which i equate with loneliness and is becoming more and more common. I wonder if you would agree that better recognition by young people can help improve loneliness in older people— perhaps, for example, by making more time to visit their elderly relatives?
driving license, loss of sight or hearing … there are many different types of loss. But i think that once you’ve felt a loss, particularly of a partner or family member that can lead to the vacuum in your life we call loneliness. How difficult was it to get the national recognition that The Silver Line now has? ER: i think the time was right. People had begun to look at the physical impact of loneliness. the department of health had woken up to the fact that loneliness is as dangerous as smoking 15 cigarettes a day and more dangerous than obesity as a life-threatening condition. then, when i went to comic relief and the National lottery with the idea of a silver line helpline, confidential, free and open 24/7, they could see the point. But i have found that [the plight of] older people doesn’t tug on the heartstrings in the same way that children do, so getting donations from the public is much harder. we rely on philanthropic individuals, organisations, and grant-making foundations. i do think that loneliness amongst older people is beginning to be understood as something that is having an impact on the health service and the mental health services as well.
From your point of view, are you pleased with what The Silver Line has achieved so far, or is there a lot more to do? ER: there is a lot more to do. i would love doctors to have the silver line helpline number posted on their notice boards, leaflets in their surgery; i would love community nurses to refer people to us; i would love the pharmacists handing out repeat prescriptions to older people to include information about the silver line—not because it makes us money, it doesn’t, but because it does enable isolated older people to recognise they can ring us any time of day or night for a chat. Looking ahead, do you have new initiatives for The Silver Line? ER: we have. if people have hearingimpaired patients, or friends, or family who would like to receive a letter or two every month—we’re starting up silver letters. we have volunteers who are very happy to write and exchange letters and we think this would be particularly valuable to people who can’t use the phone service. The Silver Line helpline is free, confidential and open 24/7: 0800 4 70 80 90, thesilverline.org.uk •
ER: You can be lonely in many different kinds of circumstance. i think we all need to be aware of loneliness and the stigma of admitting to loneliness. we did a survey around christmas time of our silver line callers, and the phrases that came up repeatedly (besides ‘burden’) were: ‘they’re so busy’, ‘my family is so busy’. i think people need to ask themselves, what is the priority in my life? do i have to be this busy? You may not have unlimited time to enjoy the company of the older people in your life … you may not have infinite time to have that conversation, to share that joke. And of course it’s the loss that causes the loneliness, to a large extent … ER: For the older callers [to the silver line] it can be the loss of a partner, loss of a job, loss of mobility, loss of a 118 dear doctor with chris steele
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The Best is Yet to Come advises Dr. Chris to m a in ta in How do you feel about the prospect of retirement? Here are some insights that will help many come to terms with one of life’s milestones
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f the best is yet to come for those facing retirement, it’s not how everyone feels. while some cross off the remaining days with eager anticipation, there are others who dread the prospect of retirement. Most of those in the first category are not necessarily those with solid financial security, more importantly they are those who have plenty of interests outside of a professional trade or career. they are likely to have constantly busy days later in life, with activities that will help bring years of contented retirement. those who dread the idea of retirement have often made their work their entire life, the centre of their universe, and it’s when that work comes to an end that what lies ahead looks like a huge void. what am i going to do with my days?
Able And Agile
Many who reach retirement age are well equipped with unique abilities and agile minds, which is why for some retirement looks like an abyss. But with some minor adjustment to lifestyle and mind-set, the 65+ generation are often a great asset to local communities. You might join local committees or serve on the Parish council, bringing your valuable expertise to a range of local issues. or the newly retired might come to the realisation that you can take up activities that you once enjoyed but had no time for it in the bustle of a busy working life.
HeAltH And fitness
as we see throughout the pages of dear doctor, our health and fitness should remain a lifetime’s priority at any age. dr chris advises that working to maintain physical and mental fitness should be part of everyday life for the retired. walking, quite serious walking, is enjoyed by many in this age sector, who join local rambling groups that offer not only the pleasures of walking, but also the social activity and companionship with like-minded people. Golf, too, is a very popular activity and even if the ramblers agree with Mark twain who
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said ‘golf is a good walk spoilt’, perhaps that’s the point.
Mind And body
there’s no doubt that our faculties can decrease in the later years of life, but there have been many convincing tests showing that the more active we can be in mind and body, the longer we will help to keep our mental and physical abilities in good condition. reading, playing chess, doing crosswords and many other similar mind activities are excellent for maintaining our brainpower— remembering that the brain is a muscle and, like all muscles, it needs regular exercise. so, once you’ve overcome what you may at first feel is the downside of retirement, we can often discover a new type of freedom and new opportunities to enjoy new experiences. Perhaps we’ll finally take that cruise ship to a far off destination or see the sights we’ve only dreamt of, knowing, as you step into your retirement years, that life is good. • dear doctor with chris steele 119
i di n
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✓ A wide choice of cover
We have a range of health plans offering varying levels of benefits to suit your needs, from truly comprehensive cover, to lower-cost options.
✓ Competitive prices Customer surveys conducted between September 2015 and February 2016, found that 94% of customers who switched to us saved money, on average reducing their payment by more than a third.
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this is as good as it gets. Caroline Tse, Leeds
Saga’s range of insurance products is designed specifically for our customers and is unique to us. Saga Health Insurance is provided by AXA PPP healthcare Limited who meets our high standards of quality and service.
If you’re over 50 and looking for health insurance for the first time or want to see how we compare to your existing health insurer, call our UK-based Customer Care Team for your quote on
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Insuring your Health CASE STUDY: Saga HealthPlan
Deciding whether health insurance is a wor thwhile investment can get a little confusing. Dear Doctor explores all you need to know about private healthcare
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pproximately five million people in the UK currently use private health care as opposed to the NHS. As many of us are aware, the NHS can have a lengthy waiting list and, depending on the injury or illness, this wait can affect quality of life. Many people choose to go private to avoid these waiting lists, or to receive treatment that is not available on the NHS. celebrityangels.co.uk
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However, private health care can be expensive, so most choose to have health insurance to cover the costs of medical care.
COSTS AND BENEFITS
There are a number of issues to consider when choosing private healthcare, such as how active you are, if you have a history of illness and injury, and if you have had surgery in the past and are likely to require further procedures in the future. If you play certain sports or take part in activities where injuries are more likely to occur, this might increase your need for medical assistance. It’s also important to consider the premiums. It might sound obvious, but it pays to think about whether health insurance will fit into your budget, especially as some providers require you to pay upfront before being reimbursed. •
Caroline Tse, a retired staff nurse who worked for the NHS for more than 40 years, has first-hand experience of private healthcare with Saga. ‘I did loads of research. I was looking for something straightforward and Saga fitted the bill perfectly. There were no hidden clauses and their policy was simply the best in terms of price and benefits.’ Sometime after switching to Saga, Caroline discovered she needed a hip replacement. ‘I went to see the GP and was promptly referred to a specialist who told me that, although I was young, I needed a hip replacement.’ Thanks to her Saga HealthPlan, the operation was carried out within three weeks of diagnosis. ‘There is no doubt that, if I’d had to have my hip replacement on the NHS, I would have waited much longer,’ says Caroline. ‘When I called Saga it was incredibly simple. There was someone I could speak to and they sent the letter out the next day to say I could proceed.’ Caroline stayed in hospital for six days and was very pleased with the care. ‘The consultant I requested carried out the operation in a lovely private hospital. The hospital is in beautiful surroundings, it’s very quiet and clean and the staff were lovely. It was great having a private room so I could rest without interruption. When it comes to private health insurance, this is as good as it gets.’ If you’re over 50 and would like to benefit from the same quality private healthcare, please call 0800 096 4083, stating reference P7501.
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Treat Yourself If youâ€™ve always dreamed of travelling the world, retirement is the perfect time to indulge. We look at the summer cruise options on offer for the newly retired
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ne of the perks of living as a retiree is the luxury of travelling. Cruises may well have been designed for the newly retired—they’re available all year round whilst providing an easy way of sightseeing and experiencing different countries—and all for a fixed price. Most cruise ships have activities for all age groups, and if you don’t feel like doing much you can always just sit back and relax while exotic scenery floats by. Cruises come in many types: different destinations, durations, and activities aboard the ship as well as on land. In fact, cruise lines will carry more than 22 million passengers during the course of 2016, with the Caribbean and Bahamas accounting for the majority of global itineraries. Pick a cruise that best fits your preferences, especially if you are opposed to cruises aimed at a younger generation or you have certain physical or medical limitations. As a retiree the world certainly is your oyster, as you can bag cheaper deals outside school holidays. Choose from a vast selection of cruise ships especially tailored to your way of life, and prepare for a refreshing sea breeze and beautiful panoramic views. In other words—treat yourself this summer!
OCEANIA CRUISES – A FOOD-LOVER’S DREAM
Founded in 2002, Oceania Cruises is the world’s largest cruise line focused on an all-adult demographic. The company has won numerous awards for their food—making it a popular choice for so-called ‘foodies’. In fact, their six ships offer a varied selection of gourmet restaurants with open seating, and the option to try out wine tasting. Apart from Oceania’s culinary efforts, the Canyon Ranch SpaClub, cultural seminars and concerts are popular activities among the guests. Discover a new, fascinating destination in 2016, as the company offers intriguing itineraries to the Mediterranean, Asia and Africa. For the adventurous they also offer a 180-day around the world cruise.
LINDBLAD EXPEDITIONS – FOR THE ADVENTUROUS TRAVELLER
For active seniors, this premier cruise line offers light expeditions to some of the more exotic, less-travelled destinations in the world. The fleet consists of 10 ‘intimately scaled’ ships, which guarantees the traveller up-close experiences in a number of wild and remote places. For the newly retired, this can be your chance to explore Antarctica, the Amazon, Africa and the South Pacific. Each voyage comes with a team of experts, including historians, various guest speakers and dive masters. You’ll have the opportunity to immerse yourself in life-changing experiences, while travelling in style and luxury.
HURTIGRUTEN – A NORWEGIAN FAIRYTALE
This Norwegian national treasure is a combination of a cruise ship and a ferry, providing passengers with ample opportunity to view the dramatic scenery as the ship make more than 35 port calls. Hurtigruten also has a unique system of shore excursions, where you disembark at one town’s pier, take a tour and meet up with the ship a few port calls later. This voyage, or fjord-scape if you will, usually lasts for a week and could include sights such as the Northern Lights and the midnight sun. Take a look at rural Scandinavian life up close, while enjoying live entertainment and a good selection of restaurants.
CUNARD – BRITISH ELEGANCE ON THE SEVEN SEAS
Janeiro to Santiago, Brisbane to Singapore … and the list goes on. If you are a dogowner, Queen Mary has ‘the world’s only kennel at sea’ on-board.
AMERICAN CRUISE LINES – A PERSONALISED EXPERIENCE
Adults age 65-plus are the main market for this line’s small ships, all carrying 150 or fewer passengers. American Cruise provides passengers with the opportunity to see America, with history-focused itineraries along inland waterways and rivers (including the Mississippi, Columbia and Snake), up and down the eastern seaboard and other sea routes that visit the coast of Alaska. Personalised service included on every cruise. •
Travel Insurance Avanti specialise in travel insurance for people over 50 and those with pre-existing medical conditions. Their tailored travel insurance policies are built around each individual’s circumstances so that customers can rest assured that they have the right cover. All pre-existing medical conditions are considered and there is no upper age limit on their policies. The friendly Avanti team are trained to give each customer as much time as they need to receive the right advice, and Avanti love to hear about customers’ travels when they renew their Annual Multi-Trip or Single Trip policies. For quality, travel insurance and peace of mind, Avanti Travel Insurance can help.
The Cunard cruises, founded back in 1840, were designed to celebrate British-style grandeur. Guests can appreciate proper afternoon tea, dance to live bands in a real ballroom and attend various seminars if the view isn’t enough on its own. Long and leisurely days at sea are to be expected, always with beautiful backdrops. This summer, Cunard’s flagship Queen Mary 2, will be re-mastered to deliver new levels of luxury while travelling from Rio de
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Thoughtful Planning The irony of living a longer, healthier life is that when your funeral eventually arrives it will be even more expensive. Dear Doctor shares all you need to know about pre-paid funerals
t’s becoming more apparent that leaving this mortal coil is one of the most expensive things you’ll experience, and no matter how hard you try, it can only be delayed and not avoided completely. Funeral costs have risen constantly for the last decade and show no signs of slowing. the reasons why are almost irrelevant—emissions play their part, so does a lack of burial space in some areas, third party costs continue to rise and funeral directors, many of which are independent family businesses, have to keep up with the ever rising costs of running an sMe in the UK. in the end these costs will land on your doorstep, or more accurately, the doorstep of your family and loved ones. But there is something you can do to mitigate what could be a bill running into many thousands of pounds. the average cost of a funeral in the UK in 2016 is currently just under £3,700, an increase of just over 90 percent since 2004. it’s estimated that by 2025 the average cost celebrityangels.co.uk
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of a funeral will be just over £6,700— another huge increase. But, if you were to take out a prepaid funeral plan (not an insurance policy), you’d pay today’s prices and your family would have nothing to pay at the time of need. additionally, you can detail your personal requirements such as music, readings, hymns, a religious or non-religious theme and remove the vast majority of the financial and emotional burden from your family and loved ones. Prepaid funeral plans have been around in their current form since the early nineties and the market had grown steadily, albeit modestly until the last three to five years when the general awareness and acceptance of the concept started to take hold. Now there are an ever growing number of new providers and resellers jumping on the bandwagon. the concept is simple in principal. the majority of mainstream funeral plan providers operate a trust based plan. each provider has two parts to their business, the company that operates the plan and handles of all the sales, marketing and administration and a separate trust Fund managed independently, which is where all your money as a plan holder is taken care of. the trust is invested and at the time of need it pays the funeral director for the funeral as per your plan. who you choose to use is personal but it’s recommend that you take the following points on board when considering your plan provider:
The average cost of a funeral in the UK in 2016 is currently just under £3,700, an increase of just over 90 percent since 2004 DON’T use a plan provider less than 10 years old—they will still be learning what really works and what doesn’t. DON’T buy on price alone, cheapest is not best when it comes to funeral plans. DO ask about administration fees and commissions paid, some plan providers take £750 to £1,000 in fees from the price you pay for your plan, sometimes more. DO ask for confirmation that your plan will actually be allocated to a specific funeral director. some plan providers have up to 80 percent of their plans unallocated before the time of need. DON’T allow yourself to be ‘sold’. Good plan providers won’t try to hurry or pressure you. if you’re uncertain, take time to reflect. DO check cancellation clauses, if you decide to cancel your plan in the future some providers can charge up to 20 percent of your plan price, others range from £150 to £395. • dear doctor with chris steele 127
PRODUCTS & SERVICES
Dear Doctor’s r
National charity, Contact the Elderly, organises free monthly Sunday afternoon tea parties for small groups of people aged 75 and over, who live alone and find it hard getting out by themselves. The volunteer drivers collect people from their homes and accompany them to local tea parties held in a volunteer host’s home. contact-the-elderly.org.uk
a B h t l a e H
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OMRON’s Gentle Temp 720 digital forehead thermometer’s advanced features include one-second measurement, selectable Centigrade/ Fahrenheit readings and room temperature display. As your child sleeps, the backlight function makes night time readings easier and a 25 reading memory allows you to track temperature changes over a period of time. Plus OMRON’s 3-in-1 function enables you to measure room and surface temperature. omron-healthcare.co.uk
PROTECT YOUR HAIR
New Man Clinic’s Collagen Balsamic Emulsion gives volume to the hair by providing nutrients and protecting the cortex, cuticle and medulla of the hair, as well as relieving epidermal tension. It will not leave hair feeling greasy, and its curative, regenerative power at the epidermal level makes it effective for dry dermatitis, seborrhoeic dermatitis, profound dehydration of the dermis, atopic psoriasis, eczema, irritation, itching and more. newmanclinic.co.uk
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MONITORING YOUR BLOOD PRESSURE OMRON’s M3 Comfort is a new addition to OMRON’s blood pressure monitor portfolio. W ith O MRON’s uni que, pre-formed Intelli Wrap Cuff, the measurement zone of the cuff fully covers 360 degrees, for easy and accurate readings in any position around the upper arm. The monitor also features a high blood pressure colour indicator, irregular heartbeat detection, cuff wrap guide and body movement detection. omron-healthcare.co.uk
Travelsox are unique graduated compression socks, which help stimulate blood flow. The patented compression starts mid foot for additional arch and plantar fascia support. Silver ions are infused into the core of the fibre so feet stay dry and odour free. Made in Italy and recommended by commercial airline pilots. vitalsox.co.uk
ORO have designed a unique sleep system that provides solutions to sleep problems and many other ailments, including back pain. The ORO Ultimate Sleep System is the first and only ‘intelligent’ bed in the world. It comprises a unique mattress with its pressure relief comfort recess and a motorised adjustable bed base with memory positions. It automatically adjusts as users turn in their sleep, thus maintaining the ideal sleeping position to give a restful night’s sleep. Email email@example.com or call free on 0800 999 7060.
PRODUCTS & SERVICES
Caresox are a range of diabetic socks developed by leading podiatrists and made in Italy. All socks include the Dual-Tone Technology and are made in antibacterial fibres. In addition, Caresox have lean-toe closure to reduce blistering, padded terry soles and come in a choice of either light compression or constriction free. vitalsox.co.uk
PURE COCONUT WATER
Loaded with vitamins and minerals, FOCO 100% Pure Coconut Water is an all-natural, refreshing energy drink that helps you and your family live life to the fullest. Superior taste, low in calories, nutrient rich with five essential electrolytes and awesome hydration, FOCO is available from selected Tesco and Sainsbury’s stores, leading Oriental Supermarkets and online at focococonutwater.co.uk.
VAPOUR WITH FLAVOUR
Available in both pre-filled cartridges and bottles, V2 Cigs’ range of best-selling Platinum e-liquids suits all levels of vapers. The range, regularly top in blind taste tests, offers a selection of 12 flavours: three tobacco and three menthol as well as six speciality flavours available with nicotine strengths from 0 percent to 2.4 percent. Find the whole selection in the online store: buyv2cigs.co.uk.
Red Peony Menopause Tincture is a herbal medicinal product used for the symptomatic relief of menopausal hot flushes. It’s safe with other hormonal medication and does not affect hormone levels. hughes-health.com
When researched by two of the most respected independent funeral websites, The Good Funeral Guide and Final Fling, Open Prepaid Funerals were the only company that each of these businesses would put their name to. Their findings were based on performance and service and not on price and commissions. Open Prepaid Funerals is the customer focused plan provider. openprepaidfunerals.co.uk
QUIT ON THE GO
Bedfont has created the world’s first CO monitor for your smartphone. Quit smoking on the go with the iCO™ Smokerlyzer®, using the Smokerlyzer app to track and share your progress.
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PRODUCTS & SERVICES
SAY NO TO THINNING HAIR
PEACE OF MIND
Westfield Health, a leading health and wellbeing company, is proud to be investing in 3rings: a smart plug designed to reduce the worry that families may have about ageing relatives. The 3rings plug gives peace of mind that ageing loved ones are OK, whilst respecting their privacy and helping them to live independently in their own homes. Call: 0114 250 2000 westfieldhealth.com/3rings
New Man Clinic’s Kapyderm Allogenic Tonic is a potent cellular blood flow activator, decongestant, regulator and nutrient. It acts therapeutically on acute alopecia, androgenic alopecia and alopecia areata, spot baldness, post-partum, papilla cysts and bulb dysfunction. It is extremely well tolerated by the skin, and doesn’t trigger irritation or rebound effects. With its dual internalexternal action, it’s deal for thinning hair and severe hair loss. newmanclinic.co.uk
BETTER THAN WATER?
Did you know many athletes and experts consider FOCO 100% Coconut Water to be a better hydrator than plain or bottled water? It’s low in calories and loaded with five essential electrolytes so it’s the perfect recovery drink and refresher for people with an active lifestyle. FOCO Coconut Water is gluten free, vegan friendly, non-GMO and contains sugars that are naturally present in green coconuts. No added sugars are added, ever! focococonutwater.co.uk
THE COMPLETE C3 TOTAL ALLERGY SOLUTION VACUUM CLEANER BISHTA – THE BRITISH AND IRISH SPA AND HOT TUB ASSOCIATION
If you’re considering buying a hot tub, BISHTA Members will answer your questions on what type of hot tub will suit your needs and budget. They also have a sound knowledge of other key issues, such as the correct water treatment, selection of chemicals, location, access, running costs and guaranteed after-sales service and support. Every BISHTA Member has proven skills in water hygiene management and can offer expert advice and service on their products, and because BISHTA Members work to a Code of Ethics, you will be given honest, reliable advice. bishta.co.uk 01264 356211
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Most vacuums move allergens around the home, increasing allergic reactions. Miele set out to fix that. The Complete C3 Total Allergy Solution Vacuum Cleaner is the perfect tool for dust allergy sufferers. The HEPA13 AirClean filter picks up the finest dust or allergen particles, removing them from your floors and the air. miele.co.uk
DON’T SIT ON IT
THD is a medical device manufacturer dedicated to research and development in the fields of colorectal and laparoscopic care. Striving for excellence, they work in partnership with surgeons and healthcare providers to deliver products that enhance patient outcomes. dontsitonit.com
Introducing the Platinum collection from Silentnight. A new range of beds and mattresses guaranteed to meet all your comfort and style needs developed exclusively for premium independent retailers.
To find out more call 01282 851111 or visit silentnight.co.uk
Silentnight Group Limited.indd 1
Chada Oriental Foods.Ad.indd 1
Published on May 13, 2016
Celebrity Angels: Dear Doctor with Dr Chris Steele, Summer 2016 issue.Dr Chris Steele answers the nation's most pressing health questions, o...