LIVE TO 100 WITH DR HILARY JONES
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Live to 100 with Dr Hilary Jones
Your 32-page beauty guide
Symptoms, Diagnosis & Treatment
PAMPERING • TR EATMENTS BEAUTY • COS METIC SURGERY
WARD OFF WINTER ILLNESS
TIPS FOR HEALTHY DIGESTION
The Secret to Achieving Mindfulness
Live Longer My Way!
With Me, Dr Hilary Jones DIABETES
H E A R T H E A LT H
WEIG HT LOSS
WINTER 2018 | £3.99 ISSN 1758-597X
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It’s Never Too Late Now is the time to reflect on the health and wellbeing goals we have achieved this year and make new ones for the future
Images: REX FEATURES
ur wonderful NHS is celebrating 70 years this year—a great big ‘thank you’ is owed to all of its tremendous staff, who tirelessly and compassionately care for each and every one of us in our moments of need. As we approach the end of 2018, we should all take a minute to think about what we have achieved this year in regards to our health. Did you finally join that running group? Did you squeeze in as many portions of fruits and veg into your meals as you would have liked? Better yet, are you feeling at peace with your mental wellbeing? If you’re not completely happy with your answers to these questions, keep this one phrase in mind: ‘It’s never too late’. It’s never too late to get active, it’s never too late to follow your passions, it’s never too late to change career if you feel like you’re stuck in a routine that is causing you unhappiness and anxiety. It’s never too late to cut back on your drinking, try a new diet or run that marathon.
This chock-full, brand-new issue of Live to 100 will hopefully be the inspiration you need to continuously better your overall health and wellbeing. With informative and engaging features on the benefits of cardio, keeping well during winter, promoting good gut function, proton therapy and heart health, we hope this edition brings all the knowledge you need to start off a brand-new year full of positive energy, happiness and good health. Living to 100 has never been easier. •
DR HILARY JONES Guest Editor www.drhilaryjones.com
Live to 100 with Dr Hilary Jones | 5
10 THE JOURNEY TO WELLBEING Britain’s favourite TV doctor, Dr Hilary Jones, talks to Annalisa D’Alessio about the nation’s worst health habits, common winter conditions and the NHS’ 70th anniversary
14 CELEBRATING 7 DECADES OF
HEALTHCARE FOR ALL This year, our wonderful NHS celebrates 70 years. In this issue of Live to 100, we want to recognise the achievements of one of the nation’s most loved institutions
Fitness & Nutrition 16 HOW TO LOWER YOUR CHOLESTEROL According to Heart UK, six out of every 10 people have raised or abnormal levels of cholesterol. Here’s how to shake off the ‘silent killer’
18 SMART MEAL PLANNING
Preparing meals in advance for the week ahead can save money and time and massively reduce mealtime stress—but where can the newbies begin?
20 AN ALTERNATIVE VIEW TO WEIGHT LOSS Finding the best weight loss method to suit your individual needs is imperative in reducing the risk of major health concerns including cardiovascular disease, diabetes and stroke
22 WHAT’S THE DEAL WITH CARDIO? While not a favourite pastime for many, cardiovascular exercise should be a central part of everyone’s fitness regime 6 | LIVE TO 100 WITH DR HILARY JONES
10 Your Wellbeing
24 STAYING HEALTHY DURING WINTER Some health complaints are triggered—or worsened—by cold weather. Here’s a breakdown of the most common winter illnesses and advice on how to avoid them
26 CARE FOR HEALTHY HAIR
According to a recent Head & Shoulders survey, 91 percent of women damage their hair almost every day. Whilst battling with our hair may take a backseat when approaching our health, making a few lifestyle changes can effortlessly improve its condition and even prevent hair loss
30 STRIKE OUT ANXIETY
Figures from the World Health Organization indicate that 40 percent of all disabilities worldwide can be attributed to anxiety and depression. If severe, anxiety can take hold of a person’s mental wellbeing and impact their quality of life
48 CHOOSING IVF
In vitro fertilisation can help couples with fertility problems get pregnant
51 SMILE FOR ORAL HYGIENE
According to the NHS, most adults in the UK have gum disease to some extent. Luckily, keeping up with oral hygiene tasks and taking preventative measures against plaque can help to maintain a healthy smile
56 OBESE & AT RISK
Obesity contributes to a plethora of serious health concerns—what are the risks associated with the condition?
60 TREATING CHRONIC PAIN WITH
51 34 9 DIGESTION-BOOSTING RULES
Contrary to popular belief, diet isn’t the only factor that can affect our digestive system
38 GET A LEG UP
From managing health concerns to primping and preening with beauty treatments, our legs need consistent care and nourishment to ensure they remain healthy and working as they should
42 MEN, LET’S TALK ABOUT FERTILITY In one third of infertility cases, the problem lies with the man
Your Healthcare 44 8 ESSENTIAL PROSTATE
HEALTH TIPS Although the majority of common prostate disorders occur later on in life, safeguarding prostate health is imperative—regardless of your age
SPINAL CORD STIMULATION Chronic pain can persist for years, occur anywhere in the body and be very difficult to manage—what are the available treatments today?
62 BEAT THE ACHE
According to the National Health Service, around 10 million people in the UK suffer with some form of arthritis. Finding pain relief methods to suit your needs is key to managing the condition long term
66 EVERY BEAT MATTERS
Maintaining a healthy heart is vital in reducing the risk of cardiovascular disease, stroke, diabetes and some cancers
70 ATRIAL FIBRILLATION & ITS ROLE IN STROKE Atrial fibrillation is the most common heart rhythm disturbance in the UK, affecting more than one million people. Although manageable, the condition can lead to deadly stroke without appropriate treatment
74 DIAGNOSED WITH DIABETES
One of the fastest-growing health concerns in the UK, diabetes diagnoses have doubled in the last 20 years LIVE TO 100 WITH DR HILARY JONES | 7
Contents 78 TAKE A WEIGHT OFF
As obesity rates in the UK continue to climb at an alarming rate, bariatric surgery offers patients a lifeline while providing cost-effective relief to the NHS
86 7 WARNING SIGNS OF VISION PROBLEMS Keeping a close eye on your eyesight— and reporting to a specialist whenever alarming symptoms arise—is imperative at any age
88 BE CLEAR ON MYOPIA
Also known as short-sightedness, myopia is a common eye condition that causes distant objects to appear blurred
92 IDENTIFYING & CURING GLAUCOMA According to experts, around two percent of the UK population over 40 have glaucoma
94 DIAGNOSING LYMPHOEDEMA
Lymphoedema, a condition which causes swelling in the body’s tissues, is thought to affect over 200,000 people in the UK
98 UNRAVELLING BOWEL CANCER
Over half of bowel cancer cases are diagnosed at a late stage—knowing and spotting the symptoms is crucial to early detection
104 BREAST CANCER AWARE
With about one in eight women being diagnosed with the disease in their lifetime, breast cancer is the most common type of cancer in the UK
110 GOING PRIVATE
Private clinics are offering quick and effective cancer treatments as NHS waiting times continue to increase— here’s what you need to know
114 UNDERSTANDING PROTON THERAPY Proton therapy is a type of radiotherapy that can limit the damage to healthy tissue
8 | LIVE TO 100 WITH DR HILARY JONES
116 FIGHTING CANCER WITH RADIOTHERAPY According to Cancer Research UK, around 27 percent of patients diagnosed with cancer in England during 2013-14 underwent radiotherapy as part of their cancer treatment
118 OUT OF JOINT
Joint pain usually occurs as a result of trauma or arthritis and, depending on the severity, can require a knee or hip replacement
120 10 TIPS FOR HEALTHY FEET
Our feet really do carry the weight of our world, and they can suffer for it, too
122 THE M WORD
Though it is an inevitable natural process in every woman’s life, the menopause can also be a time of deep anxiety and distress
124 PAIN IN THE VEIN
Although considered unsightly to some, varicose veins are rarely a cause for concern and don’t usually require medical treatment
126 PRIVATE HEALTH INSURANCE ON A BUDGET Investing in affordable health insurance could save you time and relieve pressures on the NHS—here’s how to make the process easier
Medical Tourism 128 HEALTH TOURISM IN…GERMANY
Major clinics, highly trained staff and special comfort areas are just a few of the reasons why Germany is standing out as a prime medical tourism destination
PUBLISHER & CEO Kevin Harrington EDITOR Annalisa D'Alessio SUB EDITOR Kayley Loveridge
NON-SURGICAL PROCEDURES 145
133 LUSCIOUS LOCKS
The quest for full, shiny hair is a lifelong one—read on for the best salon treatments for healthy tresses
134 AVOID A BOTCHED JOB
We spoke with the national register of accredited practitioners, Save Face, about the lack of legislation in the non-surgical cosmetic industry and discussed their mission to make a positive impact
141 YOUR 4 STEP ANTI-AGEING SKINCARE ROUTINE You can’t stay young forever, but with a little help from the skincare gods, you can definitely try
IRONING OUT THE KINKS With both temporary and permanent solutions available, dermal fillers remain a popular option for those looking to instantly reduce the appearance of wrinkles LASERS ARE HOT RIGHT NOW Laser treatments can improve blemishes, remove wrinkles, plump up the skin and stump hair growth FLATTERING FILLERS The public has been left in a state of panic as celebrities put an end to the big lip trend. Luckily, subtler cosmetic procedures for lip enhancement will never go out of style AESTHETIC TECHNOLOGY 101 With cutting-edge technology comes cosmetic treatments that are able to combine innovative equipment with a hands-on approach
COSMETIC SURGERY AFTERCARE Hydration, a healthy diet and pressure garments are all vital in promoting skin healing
ART EDITOR Friyan Mehta EDITORIAL ASSISTANT Hannah Foskett PRODUCTION DIRECTOR Joanna Harrington PRODUCTION COORDINATOR Ava Keane OFFICE COORDINATOR Adam Linard-Stevens PUBLISHED BY Celebrity Angels © 2018 all rights reserved
Live to 100 with Dr Hilary Jones Celebrity Angels Suite 2, 143 Caledonian Road, London, N1 0SL Tel: 020 7871 1000 Fax: 020 7022 1694 For sales enquiries call: 020 7871 1000 All material in Live to 100 with Dr Hilary Jones 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. Disclaimer: Live to 100 with Dr Hilary Jones has been produced as a family health guide. It does not constitute professional medical advice. In no way does this publication take away your responsibility to seek professional medical advice should you have concerns regarding your health. Please visit your GP should you require professional medical advice.
LIVE TO 100 WITH DR HILARY JONES | 9
The Journey to
Wellbeing Q: The NHS has turned 70. How important is this milestone? HJ: I think it's an important milestone, it focuses people’s attention on the achievements of the past and also on plans going forward. What I think it has established is the incredible things that have been achieved since 1948. You know, we’ve gone from a time when some people could not afford to see a doctor. Women died in childbirth, the perinatal mortality rate was very high, children died of infections simply because people couldn’t afford to see a doctor. And then within a few years, people were getting free healthcare at the point of delivery, whoever they were and independent of their income. And after the war years when everybody pulled together
10 | LIVE TO 100 WITH DR HILARY JONES
for the common good, it was only right that the government thought: ‘We’re going to reward the population with healthcare for all.’ It's equitable and it's equal and everyone is treated the same. Very soon after, there were important advances in technology, in medicine and in diagnostics. We have a fantastic health service and it was almost a victim of its own success. People started expecting more and more. We’ve got to this stage recently where demand had outstripped the budgets that are available and difficult choices have to be made. But the NHS right now is at a pivotal point where it’s loved by the country. Over 84 percent of people in recent polls have said they would be willing to pay more tax if they knew it was all ring-fenced for the NHS—if
Images: Shutterstock; ITV's This Morning
Britain’s favourite TV doctor, Dr Hilary Jones, talks to Annalisa D’Alessio about the nation’s worst health habits, common winter illnesses and the NHS’ 70th anniversary
that is politically possible. There is this great goodwill but, equally, people realise that it can’t provide everything for everybody, especially when we have an ageing population with increasingly complex medical needs and everybody living longer. Social care is in a terrible state, hospitals are full, general practice is under huge stress and we have a sort of year-long crisis in terms of demand on Accident & Emergency. Looking forward, we have to get more staff, we have to have better technologies. We're already efficient, but we have to become more efficient. We have to harness the goodwill of the people and get more resources to match the expenditure that other European countries put into their health services so that we can stay afloat.
Q: Eating and poor diet are huge problems. How can you get fit and healthy without spending money? HJ: I don’t think you need to be a member of a gym, you don’t even have to have expensive equipment. A cheap pair of running shoes is all you need; go out for a brisk walk, go to the park, take the bus one less stop. Everyone can have a jog in the park. Try to put in time in the
diary, get off your smartphone and do exercise. I think that's important. And everybody can choose to make a big batch of healthy food once a week. I'm the worst person in the kitchen, I have got no patience for cooking, but even I could—if I had to—make a nice big pot of something that I could dip into during the week rather than make from scratch every night. You know when you’ve had a long day, when you’re stressed and you’re tired, I can understand it's easier to buy processed food. But if you're doing it time and time again, it's really unhealthy. My wife has taught me how to chop up some veg, put them in a pot with some chicken—you’ve got a fantastic meal. It's easy to do and it's healthy and with a little bit of spice and herbs in there, it's fantastic. If I can do it, basically anyone can do it. Q: The government says we should be consuming five portions of fruits and vegetables a day as well as completing 150 minutes of exercise a week. Why do you think people are still ignoring these guidelines? HJ: I think people are very easily distracted, they know what they should do but they just never prioritise it. I think what people need to do is say: ‘No, actually, this isn’t something I should do, this is something I will do,’ and actually put time in the diary. Staying fit and healthy for me is a priority, the 150 minutes is also the bare minimum. I do a lot more than that because I enjoy it and I’ve always done it. If it’s part of a routine, and you’re not doing it because it’s what the government directs us
I think that the major diseases are still the responsibility of individuals. The epidemic of obesity and diabetes that we have is largely down to poor diet situations. People eating too much
Q: Being a GP, you come across a lot of patients. Are there any bad health habits you constantly see people committing? HJ: I think that the major diseases are still the responsibility of individuals. The epidemic of obesity and diabetes that we have is largely down to poor diet situations. People eating too much. People don’t do enough exercise and there's plenty of fun exercise to choose from. But the problem is people are constantly shown images of food—sugary food, salty food, fatty food. It's all around us and there's so much advertising of it. Whilst we now realise that sugar is the new evil, it's just one of several things that we need to cut down on. No matter how much we try and restrict people buying sweet things, their addiction is very strong. Obesity and diabetes. Obesity is like the new smoking in terms of taking years off people's lives and causing inflammation in the body and leading to cancer. Associated psychological problems are costing the NHS an absolute fortune, so it’s within the power of individuals to turn their lives around. My fervent wish is that people, just once in their lives, find out what it's like to be of normal weight and feel really fit and healthy; because if they did, they’d want to hang on to it forever.
to do—which sounds dull, nobody likes being told what to do—you’re going to enjoy doing it. So, it’s just a question of people having the motivation and saying: ‘Actually, no, this is really important.’ Doctors have a role to play and it’s not just being gentle and diplomatic and making subtle suggestions, it's about saying: ‘You need to do this’. And there’s no point me being your doctor and fixing you when you’re broken, you’ve got to do this for yourself. Doctors have to lead the way by themselves not being overweight and taking time to show their patients that they, too, are quite fit. Q: The NHS is prioritising prevention over cure. What advice do you give to people who are nervous about undergoing certain tests and checks, visiting hospitals or even Live to 100 with Dr Hilary Jones | 11
Q: What do you think are the most common illnesses in winter and what can the public do to prevent them? HJ: I think the biggest threat is probably the annual flu. We haven’t had a bad flu winter for a few years and it tends to come in every few years instead of every year. We do see more winter deaths because of flu-like infections, but if we got a serious flu outbreak—with overcrowded hospitals—it could be very serious. Flu, I think, is the big one and certainly it’s worth people keeping their immunity as high as possible by being as healthy as possible. If they’ve got an existing medical condition, they should have the flu vaccine as soon as October is upon us. I think that's 12 | Live to 100 with Dr Hilary Jones
important. Then, pneumonia. I’ve actually seen quite a lot of pneumonia in relatively younger, healthier patients this year, which is bizarre because we had a good summer. So pneumonia is still there and anyone could be susceptible to pneumonia. So that’s on top of the chronic obstructive airways diseases that millions of people have, which make them more vulnerable to chest infections. There is the random pneumonia that can affect anybody. Of course, the increase in the resistance of microbes to antibiotics is also a big concern; chest infections can easily become septicaemia and people need to be wary. As you know, some are more vulnerable. People with chronic obstructive airway diseases are more vulnerable. People with heart disease are more vulnerable and they particularly need to be vaccinated against flu to protect them. Q: What are your top five tips for warding off illness at any age and time of the year? HJ: I think my first would be a healthy diet. A healthy, balanced, varied diet. Plenty of sleep is the second tip; there’s no doubt that people who don’t get enough good quality sleep will have lowered immunity. So it’s all very well going out, partying, burning the candle at both ends and cramming everything you can into your busy life…but actually, a good night’s sleep is refreshing and stimulates your immune system. Then I think exercise is good for stimulating circulation. It shouldn’t be too vigorous because there is some evidence that really vigorous exercise can reduce immunity slightly. So just regular exercise at a moderate level wold be the way forward. And that helps to break down the toxins and get rid of
Q: You’ve briefly mentioned sleep. Do you think that there’s a link between the use of technology and our sleep patterns? HJ: Definitely. Technology is a massive problem now and one of the main causes of insomnia. People are living on their smartphones, they’ve got TVs in their bedrooms, they’re taking their iPads or computers to bed with them and they’re working until late. Their minds are still working at 100 miles an hour. And the blue light is stimulating and inhibiting sleep because it’s shining the light at the back of the eye and simulating daylight hours. It’s really important to not have technology in the bedroom at all. Try and switch the technology off. It’s just as important to set your alarm to tell you when it’s a good time to go to bed as you would set an alarm to wake you up in the morning. I would like to see people set their alarm at 10.30pm at night for bedtime. No more technology, turn the TV off, have some aromatherapy or a candlelit bath, go to bed and go to sleep. Sleep should be a priority. Q: What is the best piece of advice for people in their 20s? HJ: In your 20s, I think you should ask yourself why you do what you do. Just start and reflect on what you’re doing with your life. At 20, the world is your oyster. Are you going in the right place career-wise, are you doing what you want to do or what you’ve been pushed into doing? Are you comfortable with the work
Images: Shutterstock; ITV's This Morning
getting injections? HJ: I think doctors have got better in blurring the boundaries between them and us, revisiting the doctor-patient relationship. A clinical setting does make people apprehensive, so it’s quite nice to be able to go in and have a chat with the person who’s going to make you fitter. We call them doctors, but actually we shouldn’t really regard doctors as people who treat disease, but people who give good advice about how we get fit and how we lose weight. All done in a constructive and useful way. It would be great if the government would employ organisations like LighterLife or Slimming World who have got a really good track record of being effective. They do get results and that means that people aren’t on waiting lists for bariatric surgery. It’s because they’re private organisations that the government doesn’t see them as part of the NHS. But they could be—and they should be— because they get great results.
inflammation that might otherwise predispose to infection. Then I think addressing stress if you feel that sometimes you’re at your wit’s end and you’re struggling to cope, you’ve just got too much on your plate. Take a look at your life and your work-life balance and see what it is that stresses you out. See what makes you irritable, impatient and frustrated or angry, and see if you can resolve those things, if you can deal with them in a more constructive way. Life can still be busy, but if you’re handling the challenges well and effectively, you won’t feel stressed and you won’t feel anxious and tense. I think that helps to protect you as well. Finally, of course, take sensible precautions. Wash your hands regularly, use hand sanitiser, avoid people who are coughing and spluttering and not using a handkerchief or a tissue. Avoid the things that aren’t good for you: smoking, too much alcohol…and those kinds of things. I think there’s five good tips there.
Q: What is the best piece of advice for people in their 30s? HJ: At 30 you’re probably getting more responsibility and thinking about family. Again, I think the work-life balance is really important. If you find that you’re becoming bogged down in work and there’s not enough time to enjoy life, just take a look at it and see what you can change. Avoid people that stress you out and situations that stress you out. Find things that you love doing, try new challenges. Maybe think about learning a new language or a new skill. Every few years, reinvent yourself. Do something new—it’s a great challenge. Q: What is the best piece of advice for people in their 40s? HJ: In their 40s people are starting to feel the responsibility of looking after kids. I think people in their 40s tend to put themselves last. They stop being kids themselves and now they’re looking after the kids and so the focus is keeping the kids healthy, keeping the kids active and making sure they’re developing well. And you come last. You’re losing out on sleep and losing out on exercise…but you’re still important. You’re still a kid yourself, you’re just a bit older, so do things with the kids. Don’t take them to the gym or the tennis club. Play tennis with them. Go swimming with them. Do things with them that keep you active as well. Because if mum and dad are healthy then the kids are probably healthier and happier as well.
approaching 50, now is the time to say: ‘How can I keep my heart healthy?’ Now is the time to say, ‘I’ve put on a bit of weight and now I need to lose it again’ or ‘I’ve maybe started drinking too much, now is the time to reign it in a little bit and moderate it’. Now is the time to do that holiday that you’ve always wanted to do before it’s too late. But also, 50 is the time to go and get your regular check-ups from the doctor every year or two. Even if it’s just simple things like height, weight, urine, blood pressure, cholesterol. Prostate tests for men and mammograms for women. That sort of thing. Q: What is the best piece of advice for people in their 60s? HJ: At this age, people are looking forward to retirement, so make sure you’ve got something to look forward to. A healthy 60 is the new 40 now. If you want to keep working because you love your work, absolutely do it. But if you’ve had enough of work, then look and plan your retirement so that you’re going to do something you’ve always wanted to do and love. And maybe think about voluntary work which is very rewarding. But, certainly, keep active, it’s really important to keep active. Because, these days, people at 65 have probably got another 20 to 25 years ahead of them. That’s a quarter of their life, so you’ve got to keep that life active and busy. Because if you don’t use it, you lose it and you can have one foot in the grave before you know it unless you keep busy.
I think doctors have got better in blurring the boundaries between them and us, revisiting the doctorpatient relationship. A clinical setting does make people apprehensive, so it’s nice to be able to go in and have a chat with the person who’s going to make you fitter
you’re doing or the career path you’ve chosen or is this the time to change it and to do something you really love and enjoy? Are you drinking alcohol to be in with a certain crowd? Do you really enjoy drinking? Are you smoking and could you be vaping instead? Are you as fit as you could be? Is there any adventure or passion that you’d really love to explore? Is there something you’ve always wanted to do? Don’t wait until you’re 70 to start your bucket list, start it when you’re 20. Go and climb that mountain or go and do that marathon. Do that bike ride across Europe. Do it now when you’re young and you’ve got the chance and make sure you enjoy life.
Q: And, lastly, what is the best piece of advice for people in their 70s and 80s? HJ: There’s still plenty of life left at that age, and a lot of people are still very active—and they should be. We’ve got much better living conditions than we’ve ever had, and we’ve got plenty of NHS help for people to be supported in staying well. These days, people are living the last years of their life relatively healthily. The idea that we’re all decrepit at the age of 70 is really a bit of a myth now. People are spritely and healthy well into their 80s. Now is the time to keep those hobbies going and keep in touch with friends and loved ones. And don’t stop! •
Q: What is the best piece of advice for people in their 50s? HJ: I think now is the time to start thinking about preserving your health for the future. When we’re young, our body can cope better with most things and challenges, but
Live to 100 with Dr Hilary Jones | 13
Decades of Healthcare for All
This year, our wonderful NHS celebrates 70 years. In this issue of Live to 100 we want to recognise the achievements of one of the nation’s most loved institutions
ree healthcare for all at the point of delivery, regardless of income and social class. This was health secretary Aneurin Bevan’s great vision when he founded the NHS on 5 July 1948 at Park Hospital in Manchester (today known as the Trafford General Hospital). For the first time ever—and at a great time
of need, after World War II—doctors, nurses, hospitals, pharmacists, opticians and dentists all worked under one umbrella organisation. Financed by taxation, the NHS operates under three principles: that it meet the need of everyone, be free at the point of delivery and be based on clinical need and not ability to pay. •
An ageing population In 1948, a mere 11% of the population of Great Britain was aged 65 and older. By 2016, this had risen to 18%—that’s an increase from around 5 million to just over 11.5 million people. With recent achievements in longevity, the NHS is also facing significant challenges in the future. The health service is now focusing its efforts on proactive approaches to frailty—this means identifying and managing long-term conditions, improving patient outcomes through prevention of disease and empowering the older population to make better life choices to live a healthy life for longer
PLUMMETING INFANT DEATHS Between 1948 and 2016, the number of infant deaths in England and Wales has plummeted from 26,766 in 1948 to 2,711 in 2016. This can, in part, be attributed to vaccination programmes introduced by the NHS
1.4m The NHS deals with this many patients every 24 hours 14 | LIVE TO 100 WITH DR HILARY JONES
82% to 20% The number of adult smokers has been declining since the NHS was founded in 1948. The highest recorded level of smoking among men in Great Britain that year was 82%—this dropped to 20% in 2014 Source: Action on Smoking and Health
ONE OF THE LARGEST EMPLOYERS IN THE WORLD In 2017, the NHS employed 106,430 doctors; 285,893 nurses and health visitors; 21,597 midwives; and 132,673 scientiﬁc, therapeutic and technical staff
£126bn NHS England’s projected spend for 2018/19
NHS prescriptions In 1949, 225 million drug prescriptions were made in the UK. In 2016, this figure has risen to a staggering 1.3 billion Source: Nuffield Trust
DID YOU KNOW? In 2015/16 there were 40% more operations completed by the NHS compared to 10 years earlier. This is an increase from 7.215 million to 10.119 million
7,400 The number of GP practices in England
GROWING LIFE EXPECTANCY
37% of the population had no teeth in 1968. In 2009, this dropped to a mere 6% Source: Nuffield Trust celebrityangels.co.uk
In 1948, males and females in England and Wales had a life expectancy of 65.86 years and 70.29 years, respectively. In 2016, this rose to 79.46 and 83.03 years, respectively Source: Office for National Statistics
ALARMING RISE IN CANCER DEATHS In England and Wales in 1948, 16.8% of all deaths were cancer-related. In 2017, this rose to 27.8% Source: Nuffield Trust LIVE TO 100 WITH DR HILARY JONES | 15
FITNESS & Nutrition FITNESS & Nutrition
How to Lower Your
Cholesterol According to Heart UK, six out of every 10 people have raised or abnormal levels of cholesterol. Here’s how to shake off ‘the silent killer’
Diet Eating a balanced diet and reducing saturated fat intake is the best way to lower your cholesterol. Some foods also naturally contain cholesterol, called dietary cholesterol. Saturated fat According to the NHS, most people in the UK eat too much saturated fat. Fat is essential for the healthy functioning of the body but eating too much of the saturated type can raise the level of cholesterol in the blood. Replacing these foods with those high in unsaturated fats such as oily fish, nuts, seeds and avocados, can help to reduce cholesterol levels. 16 | Live to 100 with Dr Hilary Jones
HJ7.Managing Cholesterol.indd 16
Fat Reducing trans fats and the total amount of fat in your diet can also help to reduce the risk of cholesterol and heart disease. Small amounts of trans fats can be found naturally in animal products and may also be present in processed foods. Choose lean cuts of meat, lower-fat dairy products and substitute fried foods for grilled, steamed, poached or boiled alternatives. Fibre The NHS recommends that adults eat at least 30 grams of fibre a day, a habit that can help lower the risk of heart disease and cholesterol. Sources of fibre include: wholemeal bread, wholegrain cereals, fruit, vegetables, potatoes, oats, beans, lentils, peas, nuts and seeds.
Exercise Completing 150 minutes of moderate aerobic activity per week has been shown to improve cholesterol levels. This means working hard enough to raise your heart rate and break a sweat, and could include walking, cycling or energetic dancing. A chemical found in cigarettes has also been linked to atherosclerosis, so giving up smoking can help to lower your cholesterol levels.
Foods to cut down on
Meat pies Sausages Fatty cuts of meat Butter Cream Hard cheese Cakes and biscuits Coconut and palm oil Kidneys Eggs Prawns
Statins Statins are medicines that lower cholesterol—they are usually offered to people who have already been diagnosed with coronary heart disease or another cardiovascular condition. Statins may also be prescribed for someone whose personal or family medical history renders them likely to develop it in the next 10 years. •
holesterol is a fatty substance that is carried in the blood by proteins. Having high cholesterol can increase the risk of heart attack, stroke, atherosclerosis and peripheral arterial disease. When cholesterol builds up in the artery walls, it restricts blood flow to the heart, brain and body, encouraging the development of blood clots and coronary heart disease. With the risks of high cholesterol being severe, here’s how you can lower yours.
Maintaining Healthy Blood Cholesterol Levels
with Supplements In addition to a balanced diet and exercise, supplements can also help keep blood cholesterol under control
varied diet, exercise, fresh air and looking after your mental outlook can all contribute to keeping you healthy. Many people also like to take supplements to help support their diet and lifestyle.
WHAT ARE PLANT STANOLS AND STEROLS? Plant stanols and sterols are naturally occurring substances that are similar in structure to cholesterol but found in plants. Most fruits and vegetables will contain a small amount, the highest levels are found in nuts and seeds and plant oils. The most prevalent phytosterols in the diet are beta-sitosterol, campesterol
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and stigmasterol. During digestion, stanols and sterols can play a role in the absorption of dietary and biliary cholesterol in the small intestine.
WHAT IS ALLICIN? Allicin occurs when garlic is crushed but can be unstable. Stabilised allicin is a unique extract from fresh garlic that can be taken as a supplement to ensure that it is usable in the body. Lesterol is a unique combination of plant stanols and sterols and stabilised allicin. The vegetarian capsules are easy to take can be used as part of a healthy diet and lifestyle. The plant stanols and sterols can contribute to the maintenance of normal blood cholesterol levels.
Lesterol can be found in your local independent health food store. To find your local stockist call 0345 241 0505. www.allicin.co.uk AllicinInternational @Allicin_Max
FITNESS & Nutrition
Meal Planning Preparing meals in advance for the week ahead can save money and time and massively reduce mealtime stress—but where can newbies begin?
THE MAIN MEAL Getting to know the core building blocks of any nutritious meal is the first step in smart 18 | LIVE TO 100 WITH DR HILARY JONES
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meal planning. According to the NHS, one third of our diet should consist of starchy foods, so it goes without saying that this food group should form the base of each meal. Opt for potatoes with the skin on, wholegrain rice or whole wheat pasta for a fibre (current guidelines suggest that we should be consuming 30 grams of fibre each day) and vitamin-rich meal. Secondly, protein is a vital component of every meal. The body uses it to build and repair cells and tissues, it provides energy, and it helps to create enzymes that regulate the metabolism, antibodies and neurotransmitters. To calculate how much protein to consume per day, times 0.8 grams of protein per kilogram of bodyweight. Choose protein sources that are low in fat including skinless chicken, omega 3-rich salmon or beans and pulses. Government recommendations advise eating at least five portions (at 80 grams per portion) of fruit and veg per day, so a range of colourful vegetables should comprise the third portion of a meal. Abundant research has found that those who consume the daily recommended amount have a lower risk of cardiovascular disease, diabetes, stroke and some cancers. Leafy greens such as spinach or kale; diced, pre-cooked root
vegetables such as butternut squash, carrots or parsnips, and sweet veggies like peas or sweetcorn, add key vitamins and minerals that are proven to lower blood pressure and cholesterol, keep skin and bones healthy and promote healthy gut flora.
HEALTHY SNACKING Despite our best-laid intentions, the midafternoon slump makes it easy to reach for the biscuit tin. Choose one of these healthy alternatives for an energy boost instead: Mixed berries. Not only do these little fruits deliver vital antioxidants, vitamins, minerals and fibre, they also release energy-boosting sugars that are easy for the body to absorb. Apple slices and peanut butter. Apples are a key source of slow energy-releasing fibre, vitamin C and potassium, while peanut butter (opt for a brand made with 100 percent peanuts) provides protein and keeps you feeling fuller for longer. Edamame beans. Packed with essential amino acid tryptophan, these crunchy veggies are a tasty way to add vital nutrients. Nut mix. Keep a container filled with plain almonds, peanuts, cashews and walnuts for a healthy mix of unsaturated fats, protein and fibre. •
quick search on Instagram reveals the hashtag #mealprep has been shared an astounding 8.6 million times. Among the published posts are images of polished, regimented and colourful meals packed neatly in Tupperware for the week ahead. The trend has become immensely popular over the last five years or so, with major social media influencers including fitness coach Joe Wicks anointing meal prep as the holy grail of health and wellbeing—and it’s easy to see why. One of the key attractions of preparing meals in advance is that it saves time. But beyond the obvious, it has the power to save money, increase nutritional intake and forge a more mindful, healthy relationship with food. While all this is very well, where should meal prep novices begin? The resounding advice among health and fitness experts is: start small. This means dedicating one to two hours each Sunday to prepare simple weekly lunches or breakfasts to begin with to avoid being overwhelmed. From there, introduce other key meals and healthy snacks.
FITNESS & Nutrition
Workweek lunch bowls These very simple workweek lunch bowl ideas provide a perfect base for beginner meal preppers: MONDAY
Sweet potato cubes
Roasted baby potatoes
Pesto whole wheat pasta
Cubed chicken, kidney beans
1 hard-boiled egg
Steamed tenderstem broccoli, peas
Roasted carrots and parsnips
Sliced red, yellow and green peppers
Chopped cherry tomatoes, wilted spinach
Sweetcorn, shredded carrot, avocado slices
Berry Yummy overnight oats Serves 2
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100g rolled oats 240ml milk (or a dairy-free alternative, like almond milk) 145g mixed raspberries, blueberries and strawberries 14g honey (or golden syrup) 1/2 tsp vanilla extract (optional)
1. Combine all ingredients before storing in a mason jar. 2. Cover and refrigerate overnight. 3. Serve cold the following morning.
LIVE TO 100 WITH DR HILARY JONES | 19
FITNESS & Nutrition
An Alternative View to
Finding the best weight loss method to suit your individual needs is imperative in reducing the risk of major health concerns including cardiovascular disease, diabetes and stroke
AYURVEDA Ayurveda is an ancient Indian spiritual healing system that combines holistic medicines and treatments to connect mind and body to prevent diseases. Methods for aiding weight loss using Ayurveda include eating your largest meal at lunchtime, sipping on warm water throughout the day, practising mindful, slow eating and exercising upon awakening between six and 10am. A study published in the International Journal
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DIET & EXERCISE
A combination of diet and exercise is still the most effective natural weight loss solution. Eat a diet rich in fruits and vegetables—and low in saturated fats—and exercise 30 minutes a day, 5 times a week
of Obesity in 2005 found that subjects who used Ayurvedic herbal preparations experienced greater weight loss than those who did not. Currently, Ayurveda is considered a complementary medicine in the UK, so it should be used alongside traditional methods of weight loss only.
ACUPUNCTURE Acupuncture—inserting long, fine needles into pressure points in the body—is a traditional Chinese medical practice typically used to relieve chronic pain. There has been no major significant research to suggest acupuncture is an effective weight loss strategy; however, a study published in the International Journal of Obesity in 2005 found acupuncture application was associated with a significant reduction of body weight.
SUPPLEMENTS It is key to note that weight loss supplements on the market today are not actually able to eradicate fat directly. However, they can indirectly aid weight loss by providing consumers with more energy to help you feel motivated to work out and may contain hungercurbing ingredients that make you feel fuller and more able to resist snacking. If you are unsure about whether supplements are right for you, consult with your doctor. •
t the beginning of 2018, Orbis Research released their Global Weight Loss and Weight Management Market report which found that the weight loss industry accounted for $168.95 billion in global spending in 2016. With the industry forecasted to reach a staggering $278.95 billion, weight loss products and advice have never been more readily available—or confusing to navigate. Here’s what you need to know about alternative and unconventional weight loss methods.
Visit the Celebrity Angels website to enter exclusive free-to-enter competitions Enter the competitions at celebrityangels.co.uk
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FITNESS & Nutrition
What’s the Deal with
While not a favourite pastime for many, cardiovascular exercise should be a central part of everyone’s fitness regime
Depression & the brain In addition to releasing mood-boosting endorphins, cardiovascular exercise can also combat depression and improve self-esteem. In a pilot study led by a German university, people with severe depression spent 30 minutes walking on a treadmill for 10 consecutive days. The research concluded there was ‘substantial improvement’ in mood in patients with major depressive disorders 22 | Live to 100 with Dr Hilary Jones
30mins Guidelines state individuals require this much moderate-intensity cardio exercise 5 days a week or 20-minute vigorous cardio sessions three days a week Source: American College of Sports Medicine
45mins Men who did this amount of moderate to intense cardio 4 days a week saw an average increase of 5-6% in leg muscle size Source: Exercise and Sport Science Reviews
in a short time. In addition to this, cardio has been shown to protect against memory difficulty and age-related decline in brain connectivity.
The 3 - pronged approach Every cardio workout should include the following three elements: Warm-up—it’s essential to warm up for five to 10 minutes before each workout to prepare your cardiovascular system for physical activity and increase blood flow to your muscles. Conditioning—complete at least 30 minutes of cardio per session to develop your aerobic capacity and increase your heart rate, muscle endurance and depth of breathing. Cool-down—cool down for 10 minutes after every workout by stretching your muscles. This will allow your heart rate to return to normal. •
redited as being a natural mood booster, calorie burner and promoter of brain health, cardio has recently been hailed as a panacea. With levels of inactivity dramatically rising in our society, it has never been more important to get our hearts pumping faster—how exactly does cardio affect our body…for the better?
FITNESS & Nutrition
WHAT IS CARDIO'S EFFECT ON THE BODY? BRAIN • • • •
Increases blood flow to the brain, decreasing the chances of stroke. Improves memory and thinking ability. Combats decline in brain functioning with age. Protects against developing Alzheimer’s disease.
SKIN • Increases circulation, leading to clearer and healthier-looking skin.
REMEMBER It’s important to start slow and check with your doctor before commencing any type of physical activity. If you’re just getting started, focus on simply ﬁnding an activity that gets you moving and your heart rate up. Any form of exercise will do—whether that is a bike ride, brisk walk, treadmill session or organised sport. Moderate activity should cause you to breathe faster and work up a sweat. Stop immediately if you experience unusual pain or alarming symptoms celebrityangels.co.uk
BLOOD • Helps control blood sugar. • Improves the ‘good’ cholesterol (high-density lipoprotein) and lowers blood fats.
MUSCLES • Increases oxygen supply, allowing muscles to work harder. • Helps muscles adapt to an increased workload, making regular activities seem easier.
PANCREAS • Improves blood sugar control, decreasing stress on the pancreas. • Reduces risk of developing Type 2 diabetes.
LUNGS • Helps decrease demands on the lungs as exercise ability improves. • Helps reduce fatigue and shortness of breath in those with chronic lung problems.
WEIGHT • Helps individuals maintain a healthy weight by burning more calories throughout the day.
SEXUAL FUNCTION • Decreases the chances of erectile dysfunction in men. • Leads to enhanced arousal in women.
BONES & JOINTS • Fights osteoporosis and reduces chances of a hip fracture. • Helps manage arthritis discomfort and maintain joint range of motion.
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Staying Healthy During
Some health complaints are triggered—or worsened—by cold weather. Here’s a breakdown of the most common winter illnesses and advice on how to avoid them
long with frost, snow and colder weather, winter also brings with it an uptick of illnesses as the year comes to a close. Colds, sore throats and chesty coughs are
more likely to strike at this time of year—read on for a list of the most common winter ailments and how to spot them and send them packing. •
ASTHMA Cold weather is a major trigger for asthma and symptoms such as wheezing and shortness of breath. The NHS advises sufferers to be especially vigilant of their condition in winter.
Stay indoors on extremely cold days or wear a loose scarf over your nose and mouth if venturing into the cold air. Remember to take any medication as prescribed by your doctor.
People aged 65 and over, pregnant women and individuals with chronic conditions—such as COPD and kidney disease—are particularly at risk of developing flu. The condition is a major killer of vulnerable people. Some symptoms include fever, aching muscles, fatigue, nasal congestion and chills.
The best way to avoid the flu is to have the flu jab—an immunisation that gives good protection for a year. Speak to your doctor or pharmacist to find out if you’re eligible for one on the NHS.
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NOROVIRUS More commonly known as the winter vomiting bug, norovirus can actually occur all year round. It is most widespread in places such as hotels, hospitals, schools and nursing homes. The unpleasant illness can last a few days and bring about symptoms such as vomiting, nausea, diarrhoea, headache, high temperature and aching joints.
Drink plenty of fluids to prevent dehydration. As norovirus is extremely infectious, take all necessary precautions to keep the bug from spreading. These could include avoiding close contact with people affected by norovirus and touching infected surfaces. Wash your hands regularly.
YOUR Wellbeing YOUR Wellbeing
Sore throat Almost always caused by a viral infection, sore throats are a very common occurrence in winter. NHS Choices suggests there is evidence that dramatic changes in temperature—brought about by the changing of the seasons as well as going from a heated room to the icy outdoors—can provoke this ailment.
An easy home remedy is to gargle with warm, salty water. Dissolve one teaspoon of salt in a glass of part-cooled boiled water. Although it won’t completely cure the discomfort, the liquid will soothe the throat with its anti-inflammatory properties.
DRY SKIN When cold weather strikes, environmental humidity is low. This is why dry skin is especially common in the winter. Moisturising is imperative, though it must be done at the right time of the day. As moisturisers simply act as a sealant to stop the skin’s natural moisture from evaporating, these are better off applied after a bath or shower, when the skin is still moist. For best results, moisturise again at bedtime.
TOP TIP NHS Choices advises to have warm—not hot—showers and baths. This is because water that is too hot may make skin feel more dry and itchy.
Cold A very common health complaint during winter, a cold can cause debilitating symptoms including body aches, fever, cough, malaise and congestion. Fight it by washing your hands frequently and keeping household items—such as towels and cups—clean to avoid germs from spreading.
TOP TIP Consume a healthy diet full of fruits and vegetables to keep your immune system working as it should. Make sure to use disposable tissues instead of fabric ones to keep germs at bay and avoid constantly infecting your own hands.
A condition that causes the fingers and toes to throb, tingle and turn white, blue and red, Raynaud’s phenomenon can cause the body’s extremities to become very painful. Raynaud’s makes the blood vessels in the hands and feet go into spasm, temporarily reducing blood flow to the affected areas.
Although it’s still unclear how and why cold weather affects the joints, arthritis sufferers maintain their symptoms get worse when winter comes around. According to NHS Choices, certain ailments appear worse during the winter, including joint pain. Many people get lonely and depressed during the winter, which can make them react to pain and ill health more acutely.
COLD HANDS & FEET
While the most severe cases of Raynaud’s phenomenon may require medication, there are simple precautions that can help alleviate symptoms. Don’t smoke or drink caffeine and make sure to always wear gloves, socks and shoes when going out in the cold. celebrityangels.co.uk
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Engage in daily exercise to improve joint movement and relieve pain. In addition to promoting physical health, exercise also does wonders for our mental wellbeing. Swimming is an ideal pastime for relieving joint pain. LIVE TO 100 WITH DR HILARY JONES | 25
26 | Live to 100 with Dr Hilary Jones
Healthy Hair According to a recent Head & Shoulders survey, 91 percent of women damage their hair almost every day. Whilst battling with our hair may take a backseat when approaching our health, making a few lifestyle changes can eﬀortlessly improve its condition and even prevent hair loss
hen it comes to hair care, advice is often contradictory and confusing. Unfortunately, most promises to ‘repair’ damaged hair are marketing myths. Products and treatments may temporarily cure the appearance of damaged hair, but they will not get rid of split ends. In fact, damaged hair decreases the hair’s elasticity, making the hair even more prone to damage. The good news is, once you’ve trimmed off the split ends and shed a few tears, you can begin to make your hair healthy and excel growth.
STRATEGIC STYLING It In the constant rush of modern life, day-today activities and timesaving routines can have a detrimental effect on our hair. Dye Ammonia in hair dyes breaks through hair cuticles in order to penetrate the hair shaft. Peroxide (bleach) completely strips the inner strand to break down pigment and often results in damaged, broken hair. Consider choosing darker dye instead celebrityangels.co.uk
DRY, FLAKY SCALP?
• Avoid using harsh products and wash hair with a gentle shampoo that targets the scalp • Massage the scalp with your fingers to stimulate blood flow • Finish your wash with a cold water rinse to close pores from bacteria • Try tea tree oil for a natural cure
of lighter to remove peroxide from the equation. Always see a licensed hair professional—box dyes may seem cheaper but are damaging and sometimes unreliable. Wait for hair to recover before dyeing it again and continue to use deepconditioning treatments regularly. Heat Too much heat can damage the keratin proteins that give hair its strength, breaking the hair cuticle. Keep heat below 210C and use heat protectant when styling. Never apply heat to wet or damp hair, as it is more fragile in this state. Reduce the amount of heat that you use on your hair, or avoid it by trying some heat-free styling techniques, like foam rolling or braiding. Wash routine Over-washing strips the hair of its natural oils and will also tempt you to use heat more often. It is recommended to wash your hair once a week with a sulphate and silicone-free shampoo and conditioner. Brush hair from the bottom, working LIVE TO 100 WITH DR HILARY JONES | 27
LET THE INSIDE SHINE OUT As hair is made of the second fastestgrowing cells in the body, it makes sense that general health and nutrition can greatly impact its quality. Diet Like the rest of the body, hair responds best to a diet that is balanced. Eating healthily and incorporating more fatty acids and proteins can help make hair strong and healthy, as well as promote growth and decrease hair loss. Some rumoured foods for hair growth include eggs and (thankfully) dark chocolate. Vitamins According to Healthline, the five best vitamins for your hair are: vitamins A, C, D, E and B vitamins such as biotin. Iron and zinc are also recommended to prevent hair loss and promote growth. There is a wide variety of hair-specific supplements on the market.
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Sleep It is well known that sleep deprivation is related to stress—one of the most common causes of hair loss. Getting enough sleep and putting your hair in a hair-protective style before bed can help protect against loss and breakage. Some experts swear by silk pillowcases, which reduce friction.
MAINTENANCE Regularly nourishing your hair can help to maintain strong, moisturised locks and prevent damage. Oils Whilst there are countless products on the market, coconut oil, castor oil and argan oil are all natural hair favourites. Apply a little to wet or dry hair after washing. Masks Hair masks often contain nourishing ingredients to hydrate your hair. Let them sink in for some time before washing. Natural ingredients such as avocado and honey can be applied to the hair for a deeply nourishing pamper session, which may reduce stress (and hair loss) at the same time. •
Healthy locks Achieve healthy, stronger and longer locks by using celebrity adored healthy hair range, Hairburst. Hairburst’s Chewable Hair Vitamins and Shampoo & Conditioner bundle offers a 1 month supply of their bestselling chewable vitamins and Shampoo & Conditioner—set to help achieve your #hairgoals. Hairburst’s Chewable Vitamins The new, tasty way to grow your hair... • Heart-shaped strawberry & blackcurrant flavoured vitamins. • Gummy texture—completely chewable. • Contains the vital ingredients for hair growth: biotin, selenium, zinc, B5, B6 & B12. • Increase hair strength & elasticity. • Reduces hair breakage. Hairburst’s Shampoo & Conditoner • Supercharge your hair growth for maximum length in minimal time. • Reduce hair breakage. • Grow faster and thicker hair. • Strengthen your hair. • Grow your hair safely (SLS & paraben free).
upward to prevent breakage. Drying the hair with a soft, cotton t-shirt, can also help to protect it. Avoid over-wearing tight hairstyles and rubber bands.
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YOUR Wellbeing Figures from the World Health Organization indicate that 40 percent of all disabilities worldwide can be attributed to anxiety and depression. If severe, anxiety can take hold of a person’s mental wellbeing and impact their quality of life
nxiety is a term used to describe feelings of intense worry and nervousness about situations with an uncertain outcome. It occurs when a combination of the stress hormones cortisol, adrenaline and norepinephrine are released by the adrenal glands into the bloodstream. Anxiety is as normal an emotion as joy or anger, and is a useful tool in helping take control of stressful situations. But it’s when it persists—occurring more days than not for six months or more—that it begins to have a devastating impact on a person’s overall wellbeing. Unlike stress, which tends to come and go as the causing factor of the stress is dealt with (be it a work deadline or relationship issues), anxiety lingers on sometimes without an identifiable cause and can erupt for seemingly no reason whatsoever. Symptoms of anxiety manifest physically, psychologically and emotionally. Sufferers may experience an increased heart rate, sweating, dizziness, difficulty breathing, nausea, stomach pains, tension headaches and a dry mouth. Those with the chronic condition have also reported feeling as though they might die, feelings of dread and irritability, having a fear of losing control and avoiding social situations which can lead to agoraphobia. What’s most frightening about anxiety is its role in inducing physical illness. Anxiety has been implicated in heart diseases, respiratory disorders and gastrointestinal conditions such as bloating and irritable bowel syndrome (IBS). Despite its tendency to cling onto sufferers, anxiety can be treated. Read on for proven ways to help manage this chronic condition before considering medical interventions.
EXPRESSIVE WRITING Psychology experts have long extolled the benefits of ‘expressive writing’ on emotional wellbeing. This technique involves writing thoughts and feelings down onto paper celebrityangels.co.uk
GET SUPPORT You are not alone. If you suffer with anxiety, reach out: MIND: Call 0300 123 3393 or text 86463 SAMARITANS: 116 123 NO PANIC: 0844 967 4848 without thinking too much about the content or the form, structure and grammar. A study published in Advances in Psychiatric Treatment journal (Emotional and Physical Health Benefits of Expressive Writing; Jaren A. Baikie and Kay Wilhelm, 2005) found that writing about emotional, traumatic or stressful events for 15 to 20 minutes, three to five times a week led to significantly improved psychological and physical health in participants. Interestingly, major long-term benefits of expressive writing also included reduced depressive symptoms, reduced blood pressure, greater psychological wellbeing, improved lung function and improved immune system functioning. Spend 20 minutes uninterrupted each morning to write about anything that comes into your mind. This may include fears, recollecting traumatic events, relationships with friends and family and workplace anxieties. The idea is to diminish mental clutter for the day ahead and to provide an emotional catharsis that will ultimately lead to reduced anxiety.
MINDFULNESS The term ‘mindfulness’ sounds fairly abstract, but, simply put, it is the practice of awareness of the present moment and taking non-reactive stock of your thoughts, feelings and environment. This technique works to counteract feelings of anxiety directed to the future or the past by bringing your awareness to those feelings, accepting them and then detaching from them.
For beginners, apply the simple ‘anchoring’ method when feeling stressed by focusing first on your feet inside your shoes and how that feels. Do they feel warm? Tingly? Comfortable? Then expand that awareness to any sensations in the legs, stomach and chest. In time, practitioners can apply this process to a number of daily activities including non-judgementally observing their anxiety and even eating and speaking with friends. Mindfulness has been shown to have numerous health benefits including increased self-esteem and significantly reduced cortisol levels—one of the main perpetrators of anxiety.
APPS LEADING THE ANXIETY-FREE REVOLUTION It should be stressed that apps cannot cure anxiety, nor are they a replacement for therapy, but they can aid in relieving day-to-day stresses: 1. Beat Panic guides users through a panic attack. 2. Catch It is a free app that teaches users to manage anxiety by changing their perspective of negative feelings to more positive feelings. 3. Chill Panda is currently being tested in the NHS. The app measures the heart rate of the user and suggests tasks to improve mental wellbeing, including simple breathing techniques and light exercises. If the above methods don't provide enough anxiety relief, then it is time to consult with a doctor. They may suggest psychological therapies like cognitive behavioural therapy (CBT) or prescribe medication suited to individual circumstances. These may include selective serotonin reuptake inhibitors (SSRIs) such as escitalopram and paroxetine; serotonin and norepinephrine reuptake inhibitors (SNRIs) including venlafaxine; and benzodiazepines. • LIVE TO 100 WITH DR HILARY JONES | 31
Depression can be characterised as a persistent feeling of sadness for prolonged periods of time, sometimes months to years. For those who do not suffer with the condition, it can be difficult to understand, but this mental health concern presents real symptoms and can be debilitating. Depression is also fairly common—according to NHS Choices, around one in 10 people in the UK will suffer with depression in their lifetime. The NHS also reports that four percent of children aged five to six in the UK are anxious or depressed. Fortunately, with the correct treatment and support, those with depression can make a remarkable recovery.
WHAT CAUSES DEPRESSION? For some, major life-changing events can cause the onset of depression. These may include a bereavement or dissatisfaction in an area of an individual’s life such as a job. Studies have also revealed that
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depression can be hereditary. People with a family history of depression are more likely to suffer with depression themselves. In some circumstances, it can occur for seemingly no reason whatsoever.
SYMPTOMS A wide range of symptoms can be associated with depression, including feelings of deep unhappiness, hopelessness and losing interest in the things you once enjoyed. Symptoms of depression can manifest physically, with fatigue, lack of appetite or libido and muscular aches and pains being among the most reported. For some people, depression can take a strong hold and induce feelings of suicide.
TREATMENT A doctor will recommend a treatment based on whether a patient presents with mild or severe symptoms and can involve a combination of lifestyle changes, therapy and medication. Cognitive
behavioural therapy (CBT) is among the most effective methods of treating symptoms of depression. In some cases, antidepressants such as citalopram or sertraline may be prescribed to help balance the neurotransmitters in the brain responsible for mood and emotions. These drugs can help to improve mood and sleep and can also increase appetite and concentration. •
GET SUPPORT If you are feeling depressed, there are organisations you can contact today for help: CALM: 0800 58 58 58 (Daily, 5pm-12am) SUPPORTLINE: 01708 765 200 (Hours vary) PAPYRUS (Young suicide prevention society): 0800 068 4141 (Mon-Fri, 10am-5pm; Weekends, 2-5pm)
TMS - The NICE Approved Depression Treatment You Have Never Heard Of
Dr Leigh A. Neal
Consultant in Psychiatry and Neuromodulation Smart TMS Medical Director
TMS treatment has been approved by the National Institute of Health and Clinical Excellence (NICE) as a safe and effective treatment for depression.
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What is Transcranial Magnetic Stimulation (TMS)? TMS is a clinically proven treatment which uses pulsing magnetic fields to increase or decrease activity in relevant brain centres. A purpose made electromagnetic coil is held against the scalp above the affected area of the brain. For example, the left frontal cortex is involved in depression so is therefore the focus for the TMS depression treatment. TMS is non-invasive and has minimal side effects.
For the first time in 10 years, I am excited about the future and my suicidal thoughts are gone. The mental pain I once suffered is now a thing of the past and that is all because of TMS Freddie, 30
Smart TMS Patient
There have been relatively few innovations in psychiatry which have resulted in major shifts in practice and treatment outcomes. The fairly new science of neuromodulation, which is the ability to accurately target electrical or magnetic stimulation or suppression to specific parts of the brain, shows promise for driving major change in medical practice. Previous psychiatric treatments have treated the whole brain, rather than the locus of the condition like Transcranial Magnetic Stimulation (TMS) can. By direct treatment of the appropriate part of the brain, it’s not overstating it to say TMS has the potential to cause a seismic shift in treatment outcomes for many patients.
What conditions can be treated with TMS?
Depression | Bipolar Disorder Anxiety | OCD | PTSD Borderline Personality Disorder DPD (Depersonalisation Disorder) Chronic Insomnia
0345 222 5678 firstname.lastname@example.org www.smarttms.co.uk
Contrary to popular belief, our diet isn’t the only factor that can affect our digestive system
asked with breaking down all the food we consume, the digestive system is greatly impacted by our diet as well as our lifestyle choices. Keeping it in top shape—and helping it function efficiently—ensures our body gets all
the nutrients it needs to survive as well as increases our overall sense of wellbeing. Follow Live to 100’s easy-to-use guide on the simple things each and every one of us can do to maintain a healthy gut. •
AVOID FATTY FOODS It’s a known fact that foods high in fat negatively affect digestion. This is because they can stimulate contractions in the digestive tract, either leading to constipation or diarrhoea. However, no food group must be completely cut out as part of a healthy regime. Instead, try pairing fatty foods with high-fibre options so as to cancel out the negative effect they can have on your gut.
A diet high in fibre—and plentiful in foods such as whole grains, vegetables, legumes and fruits—works to keep food moving through the digestive tract, effectively making individuals less likely to become constipated. In addition to this, a high-fibre diet can also go some way in preventing, or even treating, conditions such as irritable bowel syndrome (IBS), haemorrhoids and diverticulosis.
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SCHEDULE MEALS Research suggests that consuming meals and snacks at similar times of the day can go a long way in keeping the digestive system in top shape. Although the ‘on-the-go’ lifestyle is common nowadays, it’s important to try and sit down for breakfast, lunch and dinner and to eat balanced meals at the same time each day.
Exercise The government advises 150 minutes of moderate-intensity exercise each week, so it’s important to schedule some physical activity into your day. Keeping active will do wonders for your digestive health; it keeps food moving through the body and reduces constipation.
CHOOSE LEAN MEATS Protein is a crucial part of a healthy diet, and foods such as eggs, almonds, oats, chicken and cottage cheese are plentiful of it. When choosing a meat-based dish to have as a meal, select lean cuts such as pork loin and skinless poultry.
Probiotics versus prebiotics Both probiotics and prebiotics play a vital role in digestive health, but for different reasons. Probiotics are characterised as a large number of different strains of live bacteria and yeasts found in certain foods and supplements. These add to the bacteria that already exist in the gut. Probiotics can be taken as a supplement, or they may be found in live yoghurt and fermented foods such as kefir, miso and sauerkraut. Prebiotics are non-live, non-digestible plant fibres that nourish and fertilise existing gut bacteria in the lower gut and large bowel in order for it to multiply and thrive. They are able to resist stomach acid, meaning that they are more likely to get to where they need to be in order to benefit the health of the gut. While more research is needed in this area, some sources claim that prebiotics have numerous health benefits. They occur naturally in many fruits and vegetables including bananas, garlic, asparagus and artichokes.
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Quit bad habits
When stress activates the ‘fight of flight’ response in the body, this can have a detrimental effect on your gut. This is because stress and anxiety can cause the oesophagus to spasm and increase the acid in the stomach, causing painful indigestion. In addition to moderate exercise to alleviate stress and tension, both relaxation and talking therapy can have positive effects on the digestive system.
Smoking and excessive liquor and coffee intake can all interfere with the healthy functioning of your digestive system, leading to problems like stomach ulcers and heartburn.
HYDRATION IS KEY Insufﬁcient water consumption is heavily linked to constipation. In order to combat this, drinking plenty of ﬂuids throughout the day is key. Hydration also helps transport nutrients around the body, maintain a healthy urinary tract and ﬂush out waste products and toxins. However, not all liquids are good for your digestion: stay away from ﬁzzy, sugary drinks—these may cause an adverse effect on your gut.
CONSUME PROBIOTICS Probiotics—the healthy bacteria naturally present in our digestive tract—keep the body healthy by counteracting the negative effects caused by antibiotic use, anxiety, stress and poor diet. In addition to this, probiotics can also increase the body’s ability to absorb nutrients, break down lactose, strengthen the immune system and alleviate symptoms of IBS. LIVE TO 100 WITH DR HILARY JONES | 35
Every Moment Matters to the 730,000 people living with leg ulcers in the UK. If the signs of venous disease are picked up early, some cases of leg ulceration can be prevented. These are the common signs to look out for: Spider veins - a web of thread like veins visible on the surface of the skin. Tired achy legs - legs feel heavy and ache at the end of the day or when youâ€™ve been standing for a while. Mild swelling - legs and ankles appear swollen and the skin feels tighter. Mild varicose veins â€“ leg veins become more visible and can be seen above the skin.
Be leg health aware!
If you notice signs like this, you may benefit from hosiery from L&R to prevent venous disease progression. Contact your GP or visit www.Lohmann-Rauscher.co.uk/My-Legs for more information.
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Thereâ€™s a reason why we have supplied over 10 million pairs of compression hosiery in the UK.
ActivaÂŽ compression hosiery by L&R - trusted to help keep legs healthy since 1998.
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Get a Leg Up From managing health concerns to primping and preening with beauty treatments, our legs need consistent care and nourishment to ensure they remain healthy and working as they should
o keep our legs healthy and functioning, it is important to identify and treat any underlying health conditions if they arise, nourish the skin and use exercise to strengthen and protect the muscles, joints, ligaments and veins.
THERAPEUTIC MASSAGE As well as being incredibly relaxing, this typical spa treatment boasts a wealth of health benefits. A targeted leg massage helps promote blood flow and circulation in the legs, delivering oxygen and vital nutrients which help the healthy functioning of the limbs. Regular therapeutic massages may also help to manage health complaints such as lymphoedema—swelling as a result of a dysfunctional lymphatic system—by distributing accumulated lymphatic
fluid back into circulation and reducing swelling as a result.
HAIR REMOVAL Hair removal is often a contentious issue—for women in particular. Some opt for permanent hair removal, while others forgo such treatments in favour of growth. But which option is the best for you? Shaving at home offers a quick and painless route to fuzz-free legs that lasts around two to three days. For longerlasting solutions, salons offer waxing and laser treatments. Lasers work by directing highly concentrated light into the hair follicles. The pigment in the follicles absorbs the light which then destroys the hair. This method is more successful in those with dark hair and pale skin, and only eliminates the follicle of actively
Poor blood circulation in the legs can be experienced as tingling, numbness, swelling, muscle cramps or a throbbing sensation, making day-to-day tasks difficult to fulfil. There are a number of causes of poor blood circulation, including peripheral artery disease (PAD), where plaque buildup in the arteries blocks blood flow to the legs; atherosclerosis, which occurs when arteries harden as a result of plaque buildup; diabetes; and
leading an unhealthy lifestyle. Experts recommend taking up regular exercise, elevating the legs when resting, wearing therapeutic socks to promote blood flow and reducing intake of salt, sugar and saturated fats.
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YOUR Wellbeing growing hair, meaning new follicles are likely to grow. If used incorrectly or by an inexperienced practitioner, it may also lead to scarring or skin discolouration—so proceed with caution.
A HEALTHY DIET Interestingly, the same dietary rules apply for healthy leg vein circulation as for a healthy heart—some of the body’s major arteries reside in the legs. To keep the leg muscles, ligaments and veins healthy, a nutrient-rich diet is essential. As well as ramping up fruit and vegetable intake—to soak up essential vitamins, fibre and minerals including iron—replace fatty red meats with polyunsaturated fats that can be found in salmon (which is also rich in heart-happy omega 3s), avocados, nuts and seeds. •
LEG-STRENGTHENING EXERCISES Strengthening the muscles in the legs supports the joints and ligaments. This will help protect them from potential future trauma, boost cardiovascular health and strengthen the core. Try these simple leg-strengthening exercises at home for stronger, healthier legs: Squats. Stand with feet shoulder-width apart and toes facing slightly outward. Keeping the back straight and core pulled in, hinge forward and bend the knees until the thighs are parallel to the ground. Push up through the heels to stand back up straight. Repeat 10 times. Side lunges. Stand with feet hip-width apart. Take a large step out to the right and bend the right leg, keeping the left leg straight, before pushing back up to a standing position. Repeat 10 times, then swap to the left. Side leg raises. Lie on one side with legs straight and stacked. Prop the body up using your forearm. Lift the top leg up and straight towards the ceiling in a slow, controlled movement. Pull the leg back down and repeat 10 times before repeating on the other side. Glute bridges. Lie on your back with knees bent and feet hip-width apart and ﬂat on the ﬂoor. Keeping the thighs parallel to each other, push up through the heels and lift the hips while squeezing the glutes in a slow, controlled movement. Return back to the ﬂoor and repeat 10 times.
Smokers are at higher risk of major health complications in the legs including peripheral arterial disease (PAD) and Buerger’s disease (inflammation and thrombosis usually found in the leg veins). Smoking can also dramatically impact blood circulation. To get support on quitting smoking, visit: nhs.uk/smokefree
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LIVE TO 100 WITH DR HILARY JONES | 39
BETTER TESTING FOR MALE INFERTILITY
Male problems are now the leading cause of infertility. Male tests have barely changed since the 1930s. Experts agree that a semen analysis is poor at diagnosing most cases of male infertility. Checking out sperm DNA quality is the missing piece of the puzzle. Why is semen analysis not enough? Because many men with normal test results cannot get their partners pregnant. But lots of couples with abnormal results do conceive naturally. If we can’t find the problem, we can’t fix it. Better tests are needed to understand why men can be infertile when their sperm look good under a microscope. Why is sperm DNA testing better? Semen analysis tells us nothing about the sperm’s precious cargo – its DNA. Good sperm DNA is essential for every step of the fertility process. After all, it’s a man’s sperm DNA that makes his child look and act like him. Sperm DNA can be damaged during sperm production or by poor lifestyle choices. Men with damaged sperm DNA are less likely to have babies naturally or after IVF. Sperm DNA damage has also been shown to double the risk of miscarriage. So, even if a man’s semen analysis
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is normal, sperm DNA damage may be preventing the couple having a baby. SpermComet® – the leading sperm DNA test The SpermComet® test was developed following 25 years of research into better tests for male infertility. SpermComet® accurately identifies fertile from infertile men. Abnormal SpermComet® results are found in over 80% of infertile men with normal semen analysis.The SpermComet® result gives new information to diagnose a couple’s fertility problem. Secondly, SpermComet® identifies couples unlikely to be successful with IVF. Abnormal SpermComet® results are associated with all the IVF checkpoints from fertilisation, embryo quality, clinical pregnancy to live births.
Why have the SpermComet® test? The test allows men to take back control. Sperm DNA damage detected by the SpermComet® can often be treated with medical or surgical interventions improving a couple’s chanceof conceiving. In other cases, the SpermComet® result can help direct couples towards the best fertility treatment for them first time round.
Who should have the SpermComet® test? • Couples with normal semen analysis; still struggling with infertility • Couples with IVF or ICSI failure • Couples experiencing repeated miscarriage
THE INSIDE TRACK ON MALE FERTILITY HIGHLY ACCURATE Clearly diagnoses male infertility CLINIC-GRADE Used by leading fertility clinics and specialists ORDER ONLINE No doctorâ€™s referral needed DISCRETE SERVICE Produce sample at home or at an Examen Hub
HOW IT WORKS
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Men, Let’s Talk About
In one third of infertility cases, the problem lies with the man
CAUSES According to the NHS, the most common cause of infertility in men is poor-quality semen. Nevertheless, there are multiple factors that can influence male fertility— bad diet, poor overall health and excessive alcohol consumption being a few.
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Abnormal semen Quality sperm is vital for fertilising an egg during conception. Having a low sperm count—fewer than 15 million sperm per millilitre of semen—is quite common and can make it more difficult for conception to occur. Similarly, sperm that does not move properly, or is of an abnormal shape, will have a harder time fertilising an egg. Semen analysis is readily available and can even be done with a home-testing kit. The testicles The testicles produce and store sperm. Naturally, if the testicles are damaged, it can have an effect on the semen’s quality. Infection, cancer, surgery or injury to the testicles can all impact
sperm quality. In addition to this, undescended testicles or a congenital defect could also play a part. Other symptoms to look out for include pain or prominent veins in the area. Ejaculation disorders Ejaculation problems can make it difficult for men to release semen during sex, reducing the opportunities for natural conception. There are a number of practices, therapies and medications available that could help in this instance. Individuals with ejaculation disorders may also notice cloudy urine after sex. Hormone levels Rarely, infertility can result from a hormone deficiency. Hypogonadism is
round one in seven couples have trouble conceiving and the term ‘infertility’ is often used to identify a couple who have not conceived after one year of regular, unprotected sex. However, for some couples, it can take up to two years to conceive naturally and there are multiple solutions to different infertility problems—the following are all targeted towards men.
YOUR Wellbeing when a man has an abnormally low level of testosterone—the male sex hormone involved in making sperm. A tumour, illegal drugs or birth defects can also cause low testosterone levels. Symptoms of the condition include erection difficulties, mood changes, weight gain, lower sex drive and less facial hair.
TREATMENTS When consulting a doctor about infertility treatments, men may have to relay their medical and sexual history and undergo a physical examination or a semen analysis. Treatment for a fertility problem will largely depend on its cause. Medicines Whilst fertility medicine is usually prescribed to women, gonadotrophin hormones can help to stimulate the production of sperm. Pseudoephedrine can also help to treat retrograde ejaculation, and sildenafil (more commonly known as Viagra) may be helpful for those who have trouble getting an erection. Surgery Surgery can be undertaken to help treat infertility. For example, surgery to correct the blockage of the epididymis—a coil in the testicles that helps store and transport sperm—can help sperm to be ejaculated normally. Sperm can also be surgically extracted under local anaesthetic, and vasectomies can often be reversed. If a man has varicoceles— swollen veins in the scrotum—surgery can often improve the quality of sperm. However, there is little evidence that this also improves fertility. Assisted conception Assisted reproduction treatments, such as in vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI) or donor insemination, can help a couple to conceive. These treatments work by fertilising an egg externally, before replanting it back into the womb. •
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HOW TO IMPROVE FERTILITY WITHOUT OUTSIDE HELP In around a quarter of cases, doctors are unable to ﬁnd a cause for infertility. If you’re not ready to try IVF, there are certain lifestyle factors that are known to inﬂuence fertility in men. Here’s how to boost your chances of conception: Regular sex. This means two to three times a week, or every two to three days. Tracking your partner’s ovulation cycle can also increase the chances of conceiving. Sperm temperature. The ideal temperature for sperm production is 34.5C, which is slightly below body temperature. Keep your testicles cool by moving regularly, avoiding tight underwear and removing your laptop from your lap. Quit smoking, alcohol and drugs. These recreational habits are known to reduce fertility. Diet, weight and exercise. Eating a balanced diet and maintaining a healthy weight will help to keep sperm in good condition. Being overweight can reduce the quality of sperm and the chances of conception. Stress. Struggling with fertility problems can be stressful, and this can lower your (and your partner’s) sex drive. Severe stress can also limit sperm production. Supplements. Whilst the scientiﬁc evidence for this isn’t solid, vitamins C and E are supposedly beneﬁcial for boosting fertility. Avoid taking testosterone. You may feel like you should turn to testosterone, but this is likely to do more harm than good. When you take testosterone, you are telling your body that it no longer needs to produce sperm.
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Essential Prostate Health Tips
Although the majority of common prostate disorders occur later on in life, safeguarding prostate health is imperative—regardless of your age Do your research and speak with a doctor before making drastic changes to your diet.
It’s imperative that individuals complete the government-advised 150 minutes of moderate exercise per week. In addition to strengthening the heart, exercise can also help individuals stay within appropriate weight brackets. Vary your exercise routine and try a combination of walking, running, cycling and swimming.
Fruits and vegetables are sources of essential antioxidants, polyphenols, vitamins and minerals and can carry anticancer and anti-inflammatory properties. Maximise your intake for a balanced, healthy diet.
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Diet can directly affect cancer risk. Limit your intake of processed and red meat as well as salt-preserved foods. Individuals are recommended to incorporate foods high in fibre—as well as at least five portions of fruits and vegetables per day—into their regime.
There have been numerous studies on the effects of specific foods and compounds on the prostate. A study in 2013 found that men with a high concentration of omega 3 in their blood are more likely to develop prostate cancer. Research by the Mayo Clinic has also linked dairy products—or diets high in calcium— to an increased risk of prostate cancer. Additionally, low folate levels in the blood may also be linked to prostate conditions.
There is a strong link between obesity and many types of cancer— including aggressive forms of prostate cancer. Avoiding gaining excess weight is important to lowering cancer risk as well as reducing the risk of other chronic diseases.
Alcohol consumption should be limited to government guidelines of no more than 14 units per week for men and women. However, recent research suggests there is no real ‘safe’ amount of alcohol individuals can drink without increasing their risk of ill health conditions. Smoking is one of the biggest killers— quitting is advised in any circumstance. Prostate cancer patients who smoke are more likely to have a recurrence of the disease as well as a higher risk of dying from the condition.
ound only in men, the prostate is a small gland surrounding the urethra—the ‘tube’ that carries urine out of the body. It produces a white fluid that combines with sperm to create semen. As men age, the risk of developing prostate conditions increases; it can sometimes become swollen by conditions such as prostate enlargement, prostatitis and prostate cancer. Although some conditions cannot be prevented through lifestyle changes, there are a few self-care measures individuals can take to safeguard their prostate’s health for as long as possible.
Multiple studies have suggested there is a link between animal fats and an increased risk of prostate cancer. These are found in animal meats and celebrityangels.co.uk
YOUR Healthcare YOUR Healthcare products such as lard, butter and cheese. Replace these animal fats with their plantbased counterparts for a healthier diet.
KNOW THE SIGNS
It’s important to know the symptoms and signs of prostate conditions. Talk to your doctor about your risk of developing these diseases, as well as what medical tests you should undergo, any relevant family history and dietary and lifestyle recommendations. Consult with your doctor as soon as possible if you experience discomfort in your pelvic area, difficulty urinating, blood in your urine or blood in your semen. •
What are the main symptoms of prostate problems? Your prostate naturally enlarges as you get older. In some men, this enlargement leads to a common condition called Benign Prostatic Hyperplasia (BPH), often also referred to as Benign Prostate Enlargement (BPE). As many as 50 percent of 60-year-old men and up to 90 percent of 80-year-old men are troubled by symptoms of BPH. BPH is not cancer and it cannot turn into cancer. However, an enlarged prostate gland can cause physical problems that may considerably reduce quality of life. The enlarged prostate puts pressure on the urethra, causing it to narrow. Symptoms of BPH may include the frequent or urgent need to urinate, increased frequency of urination at night, difficulty starting urination, weak urine stream, or a stream that stops and starts, dribbling at the end of urination or the inability to completely empty the bladder. Less common signs and symptoms include urinary tract infection, inability to urinate or blood in the urine. Even if the symptoms are mild, they could be caused by a condition that needs to be investigated. You should see your GP if you have any of these symptoms. —Joshua Hicks, urology product manager, Olympus
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THE THREE OFFENDERS Prostate enlargement. A common condition associated with ageing, a swollen prostate affects more than one in three men over 50. Although it’s not connected with prostate cancer, it can cause discomfort and difficulty urinating. Some symptoms to look out for include: a weak flow of urine, straining when peeing, needing to pee more frequently, feeling like you’re not able to fully empty your bladder. The condition can be treated with medication and—in severe cases—surgery. Prostatitis. Sometimes caused by a bacterial infection, prostatitis is where the prostate gland becomes inflamed. Although it can happen at any age, men between the ages of 30 and 50 are more susceptible to it. Some symptoms include: pain in the pelvis and genitals, pain when urinating, a frequent need to pee, pain when ejaculating and pain in the perineum. Prostatitis can be treated with painkillers and alpha-blockers. Prostate cancer. According to NHS Choices, this type of cancer is the most common type of cancer in men, with more than 40,000 new cases diagnosed each year. It mainly affects men over 65 and is more common among men of African-Caribbean and African descent and people with a family history of the disease. Its symptoms are similar to those caused by prostate enlargement; they include: needing to rush to the toilet, blood in urine or semen, straining or taking a long time while peeing, and difficulty starting to pee.
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Increase Your Knowledge of BPH Treatment
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What is BPH and how can it affect me? Benign Prostatic Hyperplasia, or BPH, is a condition in which the prostate enlarges as men get older. BPH is a very common condition that affects over 500 million aging men worldwide. Over 40% of men in their 50s and over 70% of men in their 60s have BPH. 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 can place pressure on the bladder and urethra (the tube through which urine passes), causing such symptoms as: • Weak or slow urinary stream
• Difficulty or delay in starting urination
• Frequent need to urinate both day and night
• A urinary stream that stops and starts
Benign Prostatic Hyperplasia, or BPH, is more common than you think - 8 out of 10 men will develop BPH in their lifetime.
How has PLASMA treatment helped over 3 million men with symptoms of BPH? The Olympus PLASMA system for treatment of BPH, has been shown to be much safer compared to conventional treatment options. This means there will be less thermal damage and bleeding during the procedure, thus less pain, discomfort and infection after the operation. This means, you will go home quicker, compared to other treatment options. The first step is talking to your doctor about what this condition means for you. Next, it’s time to get the facts about BPH, including the technology and treatment options that will deliver relief and get you back to your everyday routine.
Watch our explainer video online
To learn more about the treatment, please visit: www.bph-plasma.eu @OlympusMedUKIE
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Choosing IVF In vitro fertilisation can help couples with fertility problems get pregnant
So you want IVF The National Institute for Health and Care Excellence (NICE) recommends that IVF be offered to women under the age of 43 who have been regularly trying to conceive for two years. The criteria may vary—or be stricter—depending on different clinical commissioning groups (CCGs) around the country. IVF treatment can also be performed at a private clinic. Ultimately, local CCGs make the final decision about who can undergo NHS-funded IVF. IVF availability can depend on whether a couple has had any previous children, and whether they are a healthy weight and non-smokers. According to NICE, women under the age of 40 should be offered three cycles of IVF on the NHS. Some CCGs may only provide one cycle, and some may only offer funded treatment for women under the age of 35. The price for private treatment can also vary, with one cycle of IVF costing around £5,000. Discussing exactly what 48 | Live to 100 with Dr Hilary Jones
Did you know? More than 8 million IVF babies have been born since the world’s first test tube baby in 1978 Source: ESHRE monitoring
this price includes is important, as there may be additional costs for medicines, consultations and tests. Pursuing IVF abroad is another option, but it can be a risk. Clinics in other countries may not be as regulated as those in the UK.
Success rates Success rates of IVF are dependent on the cause of infertility and the age of the woman involved. According to the NHS, the percentage of treatments that resulted in a live birth between 2014 and 2016 were: • 29 percent for women under 35 • 23 percent for women aged 35 to 37 • 15 percent for women aged 38 to 39 • Nine percent for women aged 40 to 42 • Three percent for women aged 43 to 44 • Two percent for women aged over 44 The possibility of success decreases as the number of unsuccessful IVF cycles rises, but there are a few lifestyle improvements that may increase the chances. Being a healthy weight, reducing alcohol consumption to no more than one unit per day and stopping smoking can all increase the effectiveness of IVF. Caffeine
consumption has also been linked to lower success rates.
Advantages An improved chance of pregnancy is the biggest advantage of undergoing IVF. It can bypass problems with a woman’s fallopian tubes and especially helps couples with a male infertility problem. IVF also confirms that fertilisation takes place and an embryo is created. If this isn’t possible, it may provide the couple with some answers as to why they couldn’t conceive naturally. In most cases, IVF is very safe. It can also help same-sex couples that wish to have a child and be used to screen embryos for inherited diseases and abnormalities.
Disadvantages The main risk with IVF is that success in getting pregnant is not a guarantee, and it can be expensive. In these cases, counselling should be provided, as an unsuccessful pregnancy can cause stress and—even—depression. In addition to the above, side effects from hormone medication include hot flushes and headaches. Multiple births are a possibility and can be dangerous to the mother and babies; and the treatment also increases the risk of an ectopic pregnancy, where the embryo develops in the fallopian tube. Ovarian hyperstimulation syndrome (OHSS)— where too many eggs develop in the ovaries—can also be a severe result of IVF treatment. •
VF is one of the most popular procedures available to assist couples that are finding it difficult to have a baby. The technique involves removing an egg from a woman’s ovaries and fertilising it with sperm in a laboratory. The embryo is then transferred back into the womb to grow and develop. Trouble conceiving and fertility procedures can be emotionally and physically draining, so it is useful to familiarise yourself with the available options before you commit to treatment.
A typical treatment
The natural menstrual cycle is suppressed with medication for about 2 weeks.
A fertility hormone called the follicle-stimulating hormone (FSH) is injected daily for about 10 to 12 days. This increases the number of eggs that the ovaries produce.
Vaginal ultrasound scans monitor the ovaries and a final hormone injection is administered to help the eggs mature.
Under sedation, the eggs are collected using a needle that is passed through the vagina and into each ovary. This only takes around 15 minutes. A hormone is then administered to prepare the lining of the womb to receive the embryo.
The eggs are mixed with sperm in a laboratory and the embryos continue to grow for up to 6 days. The best 1 or 2 are transferred into the womb by a tube that is passed through the vagina.
After 2 weeks, a pregnancy test can be carried out to see if the treatment has been successful.
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A Drill-free Treatment for Tooth Decay Healing dental decay at an early stage without having to go through a painful procedure? A new innovative technology to naturally stop dental decay, so that ‘drilling and ﬁlling’ is a thing of the past, is now available to your dentist in the UK Now, Credentis has partnered with the global dental company Straumann as distributor for the UK. Straumann Ltd will make this award-winning product available to dentists starting October 2018. Complementary products developed by the company for patient use and also based on same technology, biologically protect the teeth from dental decay (CURODONTTM PROTECT) and treat sensitive teeth by placing a protective barrier on them (CURODONT™ D’SENZ). Available directly from the curodont.com online shop.
A dental cavity and its treatment is something that can really be unpleasant. Our goal is to prevent cavities and the need to drill and ﬁll —Dr Stefan Buchloh
redentis’ solution is based on a groundbreaking discovery by the University of Leeds in the early 2000s. Dr Dominik A. Lysek, Credentis founder, recognised the potential of their idea and developed CURODONTTM REPAIR, the first product to rebuild lost tooth structure. 'Inspired by nature, it reverses tooth decay by enhancing a natural regeneration mechanism,' Dr Stefan Buchloh, product manager at Credentis AG explains. He adds: 'We have created the missing link between prevention and invasive procedures. A treatment of this sort hasn’t existed before.' 'Up until now, most dentists used prevention-based fluoride to treat the early stages of tooth decay and often failed to prevent a cavity. Today, with CURODONTTM REPAIR, the dentist can dramatically increase the number of cases where he saves the tooth from cavities. No drilling and filling needed. The product is applied after a dental cleaning process with a small applicator sponge.' The Swiss company launched the product in 2012 and gained a steadily growing number of private practices and university clinics in Switzerland and Germany using this revolutionary product with high success.
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Oral Hygiene According to the NHS, most adults in the UK have gum disease to some extent. Luckily, keeping up with oral hygiene tasks and taking preventative measures against plaque can help to maintain a healthy smile
ooth decay can occur when acid and bacteria are produced from the plaque that builds up on teeth. Such buildup erodes the tooth’s enamel and can lead to holes (cavities), dental abscesses and gum disease—labelled by the National Institute of Dental and Craniofacial Research (NIDCR) as the most common cause of tooth loss in adults. Visiting a dentist may lead to fillings, a root canal or a deep cleaning treatment, but it is important to remember that oral hygiene starts from home. Here are some things to consider for a mouth that looks (and smells) healthy.
ROUTINE Simply keeping your entire mouth clean and healthy can help prevent most dental problems. Ensure that you are brushing your teeth for two minutes, at least twice a day, with fluoride toothpaste. Although it may feel odd at first, brushing the gums, tongue and the roof of the mouth will help to eliminate bad breath (just don’t scrub too hard as this may cause more harm celebrityangels.co.uk
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than good). Daily flossing will also keep hard-to-reach areas clean and healthy.
SUGAR Consuming large quantities of sugary foods and drinks causes the bacteria in plaque to produce acids, which attack tooth enamel. Eating a balanced diet and limiting snacks between meals can help to decrease the risk of tooth decay and gum disease. Chewing sugar-free gum and drinking water after meals can also help to reduce the effects of the acid.
COSTLY HABITS Smoking can lead to tooth staining, gum disease, tooth loss and oral cancer, and these risks are also being linked to alcohol abuse. Substances such as nicotine and tar can stain the teeth yellow and produce copious amounts of bacterial plaque. Sadly, pigments from drinks such as tea and coffee can also stain teeth over time.
KNOWING THE FACTS Changes to your lifestyle may be
HEALTHY TEETH HACKS Try these lifestyle hacks to improve your oral hygiene: • If you do drink sugary drinks or alcohol, try drinking through a straw to reduce contact between the sugars and tooth enamel. • Do not rinse your mouth out with water after brushing your teeth— leaving fluoride residue on your teeth can help protect the enamel. • Make ‘detergent’ foods the final thing that you eat in a meal—crisp foods such as celery help to strip and clean the teeth as they’re eaten. • Wait at least 30 minutes after consuming sugary foods or beverages before brushing your teeth as enamel is more susceptible to damage when the mouth is acidic.
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YOUR Healthcare introduced too late. Whilst prevention is a huge focus in oral healthcare, once tooth decay has progressed, fluoridation will stimulate little improvement. Knowing the signs of tooth decay and gum disease can help your dentist to treat the problem before it becomes more serious.
Tooth decay You may hear tooth decay being called dental caries by your dentist, but regardless of technicalities, it needs to be treated quickly to prevent further damage. As the tooth’s dentin and enamel break down, a cavity is created and a filling may be needed. It can take about three years for premature dental caries on the surface of a tooth to become a large cavity that reaches the pulp, with early tooth decay being much easier and cheaper to treat. Tooth decay may not cause pain, but symptoms include: • Toothache • Tooth sensitivity • Grey, brown or black spots on the teeth • Bad breath • An unpleasant taste in the mouth
Gum disease The early stage of gum disease is known as gingivitis, signposted by bleeding gums and bad breath. If gingivitis is not treated, periodontitis can develop—a condition where the tissues that support and hold the teeth in place are affected. Eventually, the bone in your jaw may become damaged and small spaces between the gums and teeth will open up, causing them to become loose and fall out. Mild cases of gum disease can usually be treated by maintaining an oral hygiene routine or having your teeth cleaned by a hygienist. Eventually, however, surgery may be needed.
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Gum disease can lead to: • Swollen and sore gums • Gum abscesses (a collection of pus) • Receding gums • Loose teeth • Loss of teeth
Bridges & crowns A bridge is a fixed replacement for a missing tooth that is made by taking an impression of the surrounding, supporting teeth. A crown is a type of cap that completely covers a real tooth. Made from either metal or porcelain and metal, crowns can be fitted when a tooth is broken, decayed or damaged to make it look better.
Fillings A filling may be needed to restore a tooth that has been damaged by decay back to its normal function and shape, whilst at the same time sealing off the spaces that invite further bacteria. The process involves removing the decayed tooth material, cleaning the affected area and then filling the cavity. Materials used for fillings include a composite resin, porcelain, gold and an amalgam (an alloy of mercury, silver, copper, tin and sometimes zinc).
Root canal Root canal treatment (endodontics) is a procedure that targets infection at the centre of the tooth—its root canal system. The teeth’s roots actually extend up into the bone of the jaw, anchoring the tooth in
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DID YOU KNOW? Dentures actually need to be replaced every 5 to 7 years, as they wear down and stain, just like natural teeth
place. This system contains the soft dental pulp that can become damaged by a bacterial infection in severe cases of tooth decay. During a root canal procedure, either the infected pulp is removed, cleaned and filled, or the entire tooth may be extracted. The symptoms of pulp infection may disappear as the pulp dies and the tooth appears healed. In actual fact, this means that the infection has spread through the root canal system. Symptoms of pulp infection include: • Pain when biting, chewing, eating or drinking. • A loose tooth. • Swelling of the gum near the affected tooth. • Pus oozing from the affected tooth. • Facial swelling. • The tooth becoming a darker colour. •
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CLEAN IN BETWEEN TEETH
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& At Risk Obesity contributes to a plethora of serious health concerns—what are the risks and complications associated with the condition?
Complications As well as causing severe health conditions, being obese can seriously impact daily life. Problems include: • Breathlessness • Heavy sweating • Snoring • Fatigue • Joint and back pain • Finding physical activity difficult • Asthma • Low confidence and self-esteem • Conception and pregnancy difficulties
56 | Live to 100 with Dr Hilary Jones
Risks Being obese can also increase the risk of developing serious—and even lifethreatening—health complications. Some risks of being overweight are: Heart disease and stroke. Overweight people are more likely to have high blood pressure and high cholesterol—where deposits of fat narrow and clog the arteries. Both of these conditions make heart disease and strokes more likely. Type 2 diabetes. Around 85 percent of people with Type 2 diabetes are overweight. Diabetes causes blood sugar levels to become too high and can be deadly. Sugary foods and excess weight can progress diabetes. Cancer. Obesity is so far linked to cancers of the breast, colon, bowel, womb, kidney and oesophagus. Gallstones. Gallstones are small stones of cholesterol that can become trapped in an opening inside the gallbladder.
Gallstones and gallstone disease— persistent abdominal pain, jaundice and fever—are more likely when a person is overweight. Osteoarthritis and gout. These painful conditions affect the joints and their likelihood correlates with increasing weight gain. Joint problems can wear away protective cartilage and cause uric acid to deposit crystals in the joints. Liver and kidney disease. Being obese can cause a buildup of fat in the liver and can also cause the kidneys to stop working properly. These conditions are, in turn, associated with their own risks—such as diabetes, heart attacks and strokes. Depression. Psychological struggles, such as depression and anxiety, are not uncommon in those who are overweight. These problems can also affect a person’s relationship with family and friends.
ccording to the NHS, one in every four adults and one in every five children aged 10 to 11 is obese. With the daily conveniences and speed of modern living, consuming more calories from sugary and fatty foods than the body is able to burn off through physical activity can cause the body to store excess fat. For such an increasingly common problem, the risks associated with obesity are unprecedented.
YOUR Healthcare LOSING WEIGHT Whilst there is no quick treatment for obesity and lifestyle habits are difficult to break, losing weight safely can reduce the risks associated with being overweight. The NHS states that to lose weight at a sustainable and safe rate, most people will be advised to reduce their energy intake by 600 calories a day. For men, this means eating around 1,900 calories a day, and for women around 1,400 a day. Sourcing these calories from healthy foods is essential, and reducing salt intake will also decrease dangerous levels of blood pressure. Physical activity is also important for maintaining a healthy weight and burning energy. Exercise itself can reduce the risk of Type 2 diabetes by 40 percent, and can also speed up weight loss and make the body stronger. It is recommended that adults complete 150 minutes of moderate physical activity per week. Alternatively, discuss the possibility of weight loss surgery—or medication— with a doctor. Other strategies for healthy weight loss include: • Making an action plan and setting realistic goals. • Eating slowly and listening to the body. • Avoiding situations that will create temptation. • Joining a local, or online, weight loss group. • Involving family members and friends. • Monitoring progress. • Understanding that setbacks are okay. •
DID YOU KNOW? On average, obesity reduces life expectancy by 3-10 years and contributes to 1 in every 13 deaths in Europe Source: NHS
CALCULATE YOUR BMI The World Health Organization’s (WHO) deﬁnition of obesity is a body mass index (BMI) that is greater or equal to 30. BMI is the most widely used method to classify a person’s health in relation to their weight. BMI should only be used as a guide as it does not always account for muscle mass or fat distribution. Measuring the circumference of the waist can be used as an additional measure in those who are overweight or obese.
TO CALCULATE YOUR BMI: • Divide your weight in kilograms by your height in metres. • Then, divide the answer by your height again to get your BMI.
LIVE TO 100 WITH DR HILARY JONES | 57
Managing Chronic Pain with Spinal Cord Stimulation Therapy Boston Scientific Spinal Cord Stimulator (SCS) systems have helped thousands of patients find relief from chronic pain â€“ often when other therapies have failed.
If you or someone you love suffers from chronic pain, ask your Pain Management Specialist about customised therapy options from Boston Scientific. Visit www.controlyourpain.co.uk for more information.
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How Spinal Cord Stimulation can help Chronic Neuropathic Pain With SCS, a small implanted pulse generator (or IPG) and thin wires (known as leads) are placed into your body. To manage pain, the leads deliver tiny pulses to the nerves that mask pain signals travelling to your brain. Boston Scientific SCS systems are designed to tailor stimulation to target your specific pain areas, now and in the future, as pain patterns can change over time.
Boston Scientific SCS systems offer you:
spinal cord to the brain
• Customisable therapy with a combination of multiple waveform options • Rechargeable IPG with a battery life of up to 12 years • Unmatched lead portfolio • Inﬁnion™ CX-16 – contact lead • Illumina™ 3D pain targeting software
2 pulse generator
The Precision Montage™ MRI SCS System provides safe access to full-body MRI scans when used with specific components and exposed to the MRI environment under the defined conditions in the ImageReady MRI Full Body Guidelines for Precision Montage MRI Spinal Cord Stimulator System. CAUTION: The law restricts these devices to sale by or on the order of a physician. Indications, contraindications, warnings and instructions for use can be found in the product labelling supplied with each device. Information for use only in countries with applicable health authority registrations. This material not intended for use in France. Product available in the European Economic Area (EEA) only. Please check availability with your local sales representative or customer service. NM-576301-AA © 2018 Boston Scientific Corporation or its affiliates. All rights reserved. MR Conditional
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YOUR Healthcare In Association with Boston Scientific
Treating Chronic Pain with
Spinal Cord Stimulation
Chronic pain can persist for years, occur anywhere in the body and be very diﬃcult to manage—what are the available treatments today?
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PERSONAL IMPACT Individuals suffering with chronic pain can find it difficult to perform everyday tasks and even go to work. The condition can make sufferers feel lethargic and anxious, susceptible to depression and experience side effects from extended use of strong pain medication
TREATMENTS There are various treatments associated with chronic pain, though the one chosen will depend on the severity and the location of the pain itself. NHS Choices recommends a combination of exercise, meditation, physical therapy and painkillers to reduce and manage pain. In severe cases, individuals may be advised to undergo spinal surgery. Whilst this is a viable pain relief method, it is invasive to the spine, can be traumatic for the patient as well as carry risks and side effects. According to The Painful Truth Survey, a report sponsored by
debilitating condition that is still largely misunderstood, chronic pain affects as many as one in five adults across Europe. On average, people endure the condition for up to seven years; a fifth will live with it for 20 years or more. Classified into two main types— neuropathic, caused by a problem with the nerve pathways affecting the way pain messages get sent to the brain; and nociceptive, which includes injuries, burns and cuts—chronic pain can develop for no apparent reason and affect any part of the body.
YOUR Healthcare In Association with Boston Scientific Boston Scientific aiming to bring awareness to this chronic condition, only one in 10 of those who suffer with lasting pain have had back surgery.
Spinal Cord Stimulation Where medication, surgery and exercise hasn’t been sufficiently effective, Spinal Cord Stimulation (SCS) may be a better long-term pain relief method than additional surgery or extended opioid use. What’s more is The Painful Truth Survey found less than half of respondents reported a good experience with conventional medication such as non-steroidal antiinflammatory drugs (NSAIDs), antineuropathic agents and opioids. Drug dependency due to use of the latter is often an additional burden to healthcare systems. SCS, an additional pain relief method, sends electrical impulses that activate nerve fibres along the spinal cord, disrupting the pain messages travelling to the brain. This treatment, often known as neuromodulation, has helped over 400,000 patients worldwide, according to the International Neuromodulation Society. Although it often can’t eliminate pain completely, SCS therapy can dramatically relieve it. The procedure itself—which is reversible—consists of an implantable pulse generator (IPG) which is positioned below the skin surface in the upper buttocks or abdomen. The IPG is connected to thin wires called leads, which are placed in the epidural space of the spinal cord. The IPG sends electrical stimuli to specific nerves in the spinal cord, effectively masking pain signals travelling to the brain. A rechargeable IPG can last up to 12 years and a non-rechargeable up to 5.2 years. The vast majority of patients respond to the procedure and can potentially return to work, achieve better pain control and ultimately lead a better quality of life. The device is designed to allow patients to take their pain management into their own hands. Individuals will be able to turn the stimulation on and off via a remote control and adjust the stimulation
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1 in 5 adults—approximately 100 million people—suffer with chronic pain worldwide. Women are more likely to be affected than men Source: Brunton S. Approach to assessment and diagnosis of chronic pain
areas as well as the level of stimulation. The procedure can be prescribed for the following conditions: Failed back surgery syndrome (FBSS). Pain that persists despite spine surgeries and other medical procedures. Complex Regional Pain Syndrome (CRPS). Chronic pain affecting one limb— such as an arm or leg—after an injury. This specific condition is believed to be caused by damage to the peripheral and central nervous systems. Peripheral Neuropathy (PN). Involves damaged nerves in the body’s extremities causing tingling, burning or shooting pain in affected areas. This condition can also cause loss of balance, poor coordination and muscle weakness. Despite the fact that SCS can be a real solution for those struggling with chronic pain, The Painful Truth Survey found that two thirds of respondents who could benefit from the treatment have never heard of it. It is important to keep in mind that the procedure should be carried out by an experienced pain specialist and, as with all surgeries, it comes with potential side effects and risks. • Product available in the European Economic Area (EEA) only. Please check availability with your local sales representative or customer service. All cited trademarks are the property of their respective owners. CAUTION: the law restricts these devices to sale by or on the order of a physician. Indications, contraindications, warnings and instructions for use can be found in the product labelling supplied with each device. Information for use only in countries with applicable health authority registrations. Material not intended for use in France. 2018 Copyright © Boston Scientific Corporation. All rights reserved. NM_582601_AA_OCT2018_FINAL
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Beat the Ache According to the NHS, around 10 million people in the UK suffer with some form of arthritis. Finding pain relief methods to suit your needs is key to managing the condition long term
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Get support Visit Arthritis Care at bit.ly/2wFbejF to find out what support your area provides for arthritis sufferers, or call their helpline on
0808 800 4050 is ongoing, there’s currently no cure for most types of arthritis, which makes pain management a vital aspect of coping in the long-term.
Medicinal pain relief Over-the-counter pain medications like paracetamol, co-codamol and ibuprofen may be used to ease arthritic pain. In severe cases, doctors may prescribe stronger non-steroidal anti-inflammatory drugs (NSAIDs) including diclofenac, naproxen or indometacin to reduce inflammation, swelling and stiffness. In some cases, doctors may administer steroid injections into the affected joint itself or in the surrounding tissue to reduce redness and swelling and relieve pain, although this method usually offers only temporary relief.
Complementary therapies Normally used in conjunction with traditional medicines, complementary therapies, like massages, osteopathy and chiropractic, may help to reduce arthritic pain and stiffness. Other popular therapies include acupuncture, where fine needles are inserted by a practitioner into pressure points in the body. Hydrotherapy, which refers to the use of water in treating various medical conditions including arthritis, has been scientifically proven to improve the strength and general fitness of people with the condition. Other non-traditional routes of remedy include homeopathy. Homeopathy practitioners prescribe small doses of herbal and natural substances to treat medical ailments and relieve symptoms. While much research has been carried out on the subject, there is still no substantial evidence to support the efficacy of this method. Experts strongly advise that those with arthritis also keep up a regular exercise regime. Exercise, whether it be a light jog, swimming or yoga, increases the strength and flexibility that are crucial to pain management. The government advises 150 minutes—that’s 30 minutes, five times a week—of moderate exercise per week. •
rthritis is an umbrella term used to describe inflammation and pain of the joints, with osteoarthritis (affecting around eight million Britons) and rheumatoid arthritis (which affects around 400,000 people in the UK) being among the most common types. Other common types of arthritis include ankylosing spondylitis (a long-term inflammation of the spine) and gout, a condition caused by an excess of uric acid in the body. Arthritis typically occurs in people over the age of 40, or in those with a family history of the condition. Arthritis tends to affect the neck, lower back, hips, hands, knees and feet and occurs because of a breakdown of the cushioning cartilage tissues nestled between the joints. Symptoms of the lifelong affliction include tenderness, stiffness and inflammation of the joints, restricted movement of the joints and weakened muscles. There is no single reason as to why some people develop these musculoskeletal conditions. Instead, says Arthritis Research UK, they can be caused by several igniting factors including infections, previous injury or trauma and physically demanding occupations—even smoking significantly increases the risk of developing arthritis. While medical research in the field
Is this the proof that copper can heal arthritis?
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Copper has long been Copper Heelers, is that the used by practitioners copper is absorbed through as a form of the skin and circulated alternative medicine through the body to relieve in the treatment of pain. Professor Singer said: pain, but to date, there About 10 million has been no proof it people in the UK works. That could change are affected by after an eminent medic Arthritis. A simple was so impressed by solution and of great copper insoles in treating 14 times more copper benefit would be to his own arthritis. insert a copper insole than the braclet Albert Singer, into their shoes. Professor at the Professor Singer elderly lady saying that Whittington Hospital, since she’d worn copper also tried the insoles and London, then held a study insoles, her arthritic pain within three weeks he says of 230 arthritis patients who had gone and she had the pain had gone. ‘When were given Copper Heeler been able to stop some of I see a consultant and they insoles. An overwhelming her medication. I asked look at my X-rays, they 96 per cent reported an my orthotist what she was say my arthritis is so bad I improvement in symptoms. talking about. He showed should be in chronic pain. Professor Singer me the Copper Heelers. But I’m not – and I’m not discovered copper insoles All his patients said taking any medication. As by accident. Now aged these insoles helped their a scientist I can only put it 80, he has suffered from arthritis. down to the copper heelers. osteoarthritis in his knees Copper is an essential and feet for several years, trace mineral found in all and has worn custom-made body tissues. But many orthotics for the past six people, especially the years. elderly, are deficient in I was at the orthotist it. The theory behind the when I overheard an
The Heart Valve Voice 2017 Heart Valve Disease Survey Revealing new survey data indicating the need to educate people about the condition Calling for improved awareness, early diagnosis and treatment
Heart Valve Disease: Who is Aﬀected?
Chances of developing heart valve disease increase
An online survey of 1,608 people over the age of 60 living in the UK evaluated:
Expected to rise to
3.3 million by 2056,
valve disease and treatment options
1.5 million people over the age of 65 currently aﬀected1
Awareness and understanding of heart
due to ageing population1
Lack of Heart Valve Disease Awareness and Concern: Heart Valve Disease Awareness
Aortic stenosis is one of the most common forms of heart valve disease, yet 97% of respondents are unaware of aortic stenosis, up from 94% in 2016
knew of open-heart valve replacement surgery2
Concern for heart valve disease
Frequency of stethoscope testing
of over 60s in the UK unaware of any treatment options for heart valve disease2
knew of minimally invasive option transcatheter aortic valve replacement (TAVI)2
Heart Valve Disease Concern Majority of respondents no more concerned about heart valve disease after receiving more information, despite annual mortality of severe aortic stenosis being higher than most cancers3,4,5
7% were more concerned and recognised the symptoms in themselves.2 Symptoms include:6 chest pain fatigue shortness of breath fainting & dizziness diﬃculty exercising
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Worryingly, over a 1/4 of over 60s admitted to being more concerned about heart valve disease but having no plans to do anything2
1/2 of patients will die
within 2 years of developing symptoms if severe aortic stenosis is left untreated, yet, patients can regain their quality of life and life expectancy with heart valve repair or replacement7,8
*Similar survey conducted in 2015
Changes of any of the above over time*
Stethoscope Use: The More We Listen, The More Lives We Save A doctor can use a stethoscope to simply and easily listen for a characteristic heart ‘murmur’ - usually the ﬁrst indication of a problem with the heart valves9 However, 78%
of UK over 60s reported their
doctor rarely or never checked their heart with a stethoscope during regular health visits – an increase of only 4% since 20152 The following statistics
from across UK cities show the percentage of over 60s
Female 19.7% Rural 8.6%
who claim that their doctor rarely or never checks their
heart with a stethoscope:2 Brighton Cambridge Manchester Nottingham Cardiﬀ Birmingham Plymouth Norwich Sheﬃeld Leeds London Liverpool Newcastle Glasgow Belfast
85.3% 84.3% 81.4% 81% 80.2% 80% 79.5% 78.7% 78.7% 78.6% 77.9% 73.9% 73.7% 68.3% 63.2%
Women and people in urban areas are less likely to receive regular stethoscope checks compared to males and people in rural areas, putting women and those in urban areas more at risk of receiving a late diagnosis2
The UK has the lowest self-reported rates of stethoscope use in Europe, with 79% of French respondents receiving important stethoscope
checks at every visit compared to only 7% in the UK2
The ﬁrst European Heart Valve Awareness Day calls for improved awareness, early diagnosis and treatment focused on four key areas: 1. Greater awareness
2. Stethoscope checks for over 65s 3. National heart valve disease guidelines 4. Equal access to therapies providing return to good quality of life
References 1. d’Arcy JL, et al. Large-scale community echocardiographic screening reveals a major burden of undiagnosed valvular heart disease in older people: The OxVALVE Population Cohort Study. European Heart Journal; First published online: 26 June 2016 http://dx.doi.org/10.1093/eurheartj/ ehw229 2. CensusWide. Aortic valve stenosis – What do people know? A Heart Valve Disease Awareness Survey of 12,821 people across Europe aged 60 or over. Survey carried out November 2017. Data on ﬁle. Survey funded by Edwards Lifesciences. 3. Luise, G., Lars, A., George, B.B.B. et al. Clin Res Cardiol (2018). https://doi.org/10.1007/s00392-018-1312-5. Accessed July 2018. 4. New Heart Valve. Aortic Stenosis Facts: Data on ﬁle, Edwards Lifesciences LLC. Analysis courtesy of Murat Tuczu, MD, Cleveland Clinic. Available at: https://
newheartvalve.com/hcp/about-aortic-stenosis/ Accessed July 2018. 5. National Cancer Institute. SEER Cancer Stat Fact Sheets. Seercancergov. Available at: http://seer.cancer.gov/ statfacts/. Accessed July 2018. 6. Heart Valve Voice. Symptoms. Available at: https://www. heartvalvevoice.com/heart-valve-disease/symptoms Accessed July 2018 7. Leon M, Smith C, Mack M, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363(17):1597-1607 8. Heart Valve Voice. Giving a voice to those with Heart Valve Disease. A Heart Valve Voice White Paper. 2014. Available at: https://www.heartvalvevoice.com/application/ ﬁles/6714/6005/9042/White_paper.pdf Accessed July 2018. 9. Heart Valve Voice, Diagnosis of Heart Valve Disease. Available at https://www.heartvalvevoice.com/heart-valvedisease/diagnosis Accessed July 2018.
Heart Valve Disease The more we listen, the more lives we save
At Heart Valve Voice we believe diagnosis of heart valve disease doesnâ€™t have to mean a death sentence. The earlier that heart valve disease is detected, the sooner it can be diagnosed and treated. Book a stethoscope check with your GP today.
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Every Beat Matters Maintaining a healthy heart is vital in reducing the risk of cardiovascular disease, stroke, diabetes and some cancers
When one or more of the valves in the heart get damaged or diseased, this is called heart valve disease. Damaged or diseased arteries can restrict essential blood flow through the heart causing symptoms of breathlessness, fatigue and swelling of the ankles and feet. According to the British Heart Foundation, there are numerous known causes of heart valve disease, including cardiomyopathy, rheumatic fever, congenital heart disease and simply ageing. Luckily, most valve conditions can be treated—if needed—using medication. In severe circumstances, heart valve surgery may be necessary to replace the damaged valves with either an artificial heart valve or a bioprosthesis.
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£9bn The healthcare costs related to heart circulatory diseases each year Source: The British Heart Foundation
diseases of the heart. This condition causes the walls of the heart chambers to become thick, rigid or enlarged; in rare instances, diseased heart tissue may be replaced with scar tissue. Unfortunately, there is no cure at present for cardiomyopathy, but there are medical treatments available to help control the symptoms and prevent further complications. Medications including betablockers, diuretics, anticoagulants and those used to treat high blood pressure and heart failure may be prescribed. In some cases, cardiomyopathy can be hereditary. When it is not, however, medical experts generally advise following a healthy diet, reducing alcohol intake, stopping smoking and making sure any underlying medical condition, such as diabetes, is being managed appropriately. It is important to speak with your doctor about the right method of treatment for you should you be diagnosed with the disease.
Take stock Taking preventative measures when it comes to your heart’s health is imperative to reduce the risk of heart failure and disease. High blood pressure. Also known as hypertension, high blood pressure places strain on the heart which can weaken
Heart valve disease
The risk of developing heart valve disease increases with age but is not necessarily linked to lifestyle. In fact, it is a disease that can affect those who have previously led an active life and so the symptoms of the disease can often be put down as a natural consequence of ageing. This may result in it not being detected and so it is important to raise awareness of the symptoms and how to recognise them —Nick Walker, country manager, UK & Ireland, Edwards Lifesciences
round seven million people in the UK are living with cardiovascular disease, say the British Heart Foundation, with 152,465 people dying from the disease each year. While lifestyle choices can prove a great indication of susceptibility to heart disease, in some cases, it can be caused by genetics, or as a result of other underlying medical conditions.
DID YOU KNOW? 1 person dies every 8 minutes as a result of coronary heart disease Source: The British Heart Foundation
it and lead to heart disease over time. While the condition affects some seven million people in the UK, it presents with little symptoms and often goes undetected until it’s too late. Your doctor can measure your blood pressure, which should be below 130/80mmHg. Lifestyle changes such as increasing exercise and eating a balanced, nutrient-rich diet may help to reduce blood pressure to healthy levels. Medication such as statins may be necessary in the event that lifestyle changes are not effective. Blood cholesterol. Cholesterol is a fatty substance that builds up in the arteries and can restrict blood flow. When cholesterol levels become dangerous, it can lead to heart failure and even stroke. Foods high in saturated fats including processed meats, dairy or cakes can increase the risk of high cholesterol. According to the NHS, cholesterol levels in a healthy adult should be celebrityangels.co.uk
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five millimoles per litre of blood; this can be measured by your doctor via a blood sample. You can control your cholesterol levels by cutting down on foods high in saturated fats and replacing them with ‘healthy’—or unsaturated—fats which can be found in avocados, nuts and seeds. Stop smoking. Smoking is a major risk factor in many health conditions including some cancers. It is also highly indicated in cardiovascular disease. Smokers are twice as likely to have a heart attack than non-smokers. Shockingly, around 20,000 deaths caused by heart disease can be linked to smoking as the primary cause. The chemicals in cigarettes can severely damage the lining of the arteries which can lead to a buildup of atheroma—a fatty, sticky substance—that narrows the arteries. Carbon monoxide levels in cigarettes also reduces vital oxygen
AM I HAVING A HEART ATTACK? If you exhibit these symptoms, then call 999 immediately: • Discomfort in the chest • Pain in the right or left arm • Nausea or shortness of breath
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levels in the bloodstream. This means that the heart pumps blood harder and faster in an attempt to deliver enough of the vital life source around the body.
Experts agree that diet is inextricably linked to heart health. Being conscious of what you put into your body is the first step towards promoting a strong, healthy ticker. Include an abundance of green, leafy vegetables, which are high in heart-loving iron, calcium, fibre and vitamins C and K, in your day-to-day diet. Juicy berries including blueberries, strawberries and blackberries are extremely high in phytonutrients and soluble fibre—all of which play a vital role in heart health. Omega 3 has long been touted the panacea of heart health. According to the Mayo Clinic, these fatty acids may decrease triglycerides (fat), reduce high blood pressure and decrease the risk of major heart-related 68 | LIVE TO 100 WITH DR HILARY JONES
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conditions like stroke and heart failure. Omega 3-rich foods include fatty fish like salmon, tuna and herring and nuts and seeds such as walnuts or chia seeds.
MOVE TO THE BEAT It may seem that every media outlet reporting on heart health bangs the same drum in terms of exercise, but there is scientific evidence to back up its efficacy. Not only does it strengthen the muscles
of the legs and arms, it also strengthens the heart muscle, making it more efficient at pumping blood—and therefore vital nutrients—around the body. Current government recommendations advise 150 minutes of moderate-intensity exercise per week (or 30 minutes, five times a week). Take up jogging, swimming or dancing to not only increase heart health, but boost your mood and keep weight at a healthy level. •
Heart Valve Disease The more we listen, the more lives we save Behind the work of Heart Valve Voice, the UK’s dedicated heart valve disease charity, is the mission to bring attention to a disease that affects over 1.5 million people over the age of 65 in the UK. Unfortunately, heart valve disease isn’t well understood or well known by the general public with 97% of over 60 year olds in the UK not knowing what aortic stenosis, the most common form of heart valve disease, is, according to a 2017 Heart Valve Disease Survey. A lack of awareness means that far too many patients are not receiving the life saving treatment and care they require. “Many over 65’s mistakenly believe that the symptoms of valve disease such as breathlessness and fatigue are merely a result of getting older,” says Wil Woan, Heart Valve Voice CEO. “We hope to raise awareness of the importance of not ignoring these symptoms, improving the rates of diagnosis and of having your heart checked with a stethoscope.” As many of us age, one or more of our four heart valves that control
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the flow of blood can become worn, diseased or damaged. Heart valve disease can cause our valves to either leak or regurgitate, or become narrowed or calcified, known as stenosis. The most common forms of heart valve disease are both mitral and aortic stenosis or regurgitation. Diagnosis of valve disease often starts with primary care. Patients presenting with the red flag symptoms of breathlessness, tiredness, feeling old, chest pains or dizziness should be receiving a stethoscope exam. This can help to determine if the patient has the characteristic heart “murmur” which can be a first indication of a heart valve disorder. The next step is a referral to a cardiologist for an echocardiogram which can provide confirmation of the diagnosis and advice on the best treatment for the patient. Once a patient has been diagnosed, they face a number of life changing treatment options. Depending on the severity of the disease, a patient’s best chance at overcoming it are through either valve repair or
replacement. Great progress has been made recently on less invasive procedures allowing for less trauma and a much quicker recovery such as minimally invasive surgery and Transcatheter Aortic Valve Implantation (TAVI). With timely treatment, many patients find that they are able to return to a good quality of life and can often return to work, caring for their families and participating in the activities they once enjoyed. In fact, some of the patients that Heart Valve Voice has worked with have accomplished some great things since their treatment including, going back to work as a midwife, volunteering for the mountain rescue team in Snowden and getting back to their favourite hobbies like dancing. “At Heart Valve Voice we believe diagnosis of heart valve disease doesn’t have to mean a death sentence,” said Chris Young, Heart Valve Voice Chairman and Consultant Cardiothoracic Surgeon. “The earlier that heart valve disease is detected, the sooner it can be diagnosed and treated.”
Atrial Fibrillation & Its Role in
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Images: Images: Shutterstock Shutterstock
Atrial fibrillation is the most common heart rhythm disturbance in the UK, affecting more than one million people. Although manageable, the condition can lead to deadly stroke without appropriate treatment
n the UK, around 1.2 million people have atrial fibrillation (AF), a term used to describe an irregular and abnormally quick heartbeat. The heart condition has been shown to significantly increase the risk of stroke. AF happens when electrical pulses within the heart fire randomly from the atria (upper chambers of the heart), causing it to twitch. This erratic heart rhythm reduces the efficacy of the heart and, in severe cases, can lead to heart failure. A normal, regular heart rate should pump between 60 and 100 beats per minute at resting. The heartbeat in those with AF, however, can be considerably quicker, sometimes exceeding 100 beats per minute. Typical symptoms of AF include feelings of dizziness, shortness of breath, fatigue and chest pains. One of the key symptoms of AF to watch out for is heart palpitations. Those who experience palpitations report feeling their heart pounding in their chest or experience a fluttering sensation; an episode may last anywhere between a few seconds to minutes.
DIAGNOSING AF It’s important to keep in mind that in certain instances, the condition may not present with any symptoms whatsoever. In some cases, AF is only identified during a routine check-up with a doctor. A quick, painless procedure called an electrocardiogram—or ECG—is sometimes used to diagnose AF. This test records the rhythm and electrical activity of the heart to give doctors a clear picture of a patient’s overall heart health. A patient may also be offered an echocardiogram to produce an image of their heart’s structure and to see how it is working. Commonly, doctors will take a blood sample to test for the condition.
WHAT CAUSES AF? While it is not entirely clear what causes AF, medical experts recognise that the
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CHECK YOUR HEARTBEAT Regularly check your heartbeat to keep an eye on any rhythm irregularities: • Sit and rest for 5 minutes. Do not smoke or drink during this time • Hold out your left hand, palm facing upwards, elbow slightly bent • Place the index and middle fingers of your right hand firmly on the left wrist at the base of the thumb • Count the number of beats you feel for 60 seconds using second hand on a clock. A normal heart rate during rest should be between 60 and 100 beats per minute
30,000 people in the UK suffer with atrial fibrillation-related strokes every year—that’s 1 person every 18 minutes Source: mytherapyapp.com
condition is more common in elderly people and those with other pre-existing heart conditions such as atherosclerosis, congenital heart disease, pericarditis and hypertension (high blood pressure). There are also various other medical conditions that can be attributed to AF, including diabetes, asthma, an overactive thyroid gland, lung cancer and pulmonary embolisms. In some cases, an AF diagnosis is not associated with any other medical condition, which can be confusing for patients. This may occur in athletes, for example, and is called ‘lone atrial fibrillation’. According to the NHS, lifestyle choices such as excessive alcohol consumption, obesity and smoking are among the highest risk factors for developing AF.
HOW DOES AF CAUSE STROKE? Stroke, commonly referred to as a ‘brain attack’, occurs when the blood supply to the brain is cut off. AF can cause blood clots to form in the heart chambers. If a blood clot travels to the brain through the bloodstream, it can block essential blood flow to the brain and ultimately
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YOUR Healthcare result in a stroke. According to the British Heart Foundation, the risk of stroke is increased by a huge four to five times in those with AF than those without the condition.
WHAT TREATMENT IS AVAILABLE?
REDUCING THE RISK OF STROKE Beyond prescription medications, there are measures patients with AF can take at home to reduce their risk of stroke. Cardiovascular specialists advise quitting smoking, avoiding heavy consumption of alcohol, eating a healthy, balanced diet and taking regular exercise (current government guidelines state that individuals get 150 minutes of moderate-intensity exercise per week). Quit smoking today with advice from NHS Choices and speak with your doctor before radically overhauling an unhealthy lifestyle. It is also vital to schedule regular check-ups with your doctor to monitor blood pressure and cholesterol levels— conditions known to significantly increase the risk of stroke.
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HEART PALPITATIONS: WHEN SHOULD I WORRY? Heart palpitations—or heartbeats that suddenly become more noticeable— may seem alarming. They can be caused by a wide range of factors including hormone changes, lack of sleep, strenuous exercise, heart conditions, smoking, alcohol, illegal drugs, stress, anxiety, excitement and nervousness. Even though they are usually harmless, heart palpitations can also be caused by or associated with underlying conditions. These include congenital heart disease, heart failure, AF, supraventricular tachycardia, anaemia, diabetes and heart failure. As some of these conditions can be serious, individuals should visit their doctor if they experience frequent heart palpitations that last a long time or have a history of heart problems.
Examining the heart Everyday technology is developing at an incredible rate, and this includes medical technology. A huge drive by the NHS towards prevention of disease rather than just cure will help free resources and reduce waiting times. One approach is to engage patients in playing a greater part in their healthcare and new devices that use smartphones and apps are helping to achieve this. If a doctor needs to examine your heart, they typically perform an electrocardiogram or ECG. Until recently, this was performed using a machine with adhesive electrodes and wires or ‘leads’ printing various traces onto graph paper. Today, simple, low cost devices can be clipped to your smartphone allowing you to take a quality ECG anytime, anywhere. Results can then be emailed to your doctor. Thus, time to reach diagnosis and treatment are significantly reduced. Undoubtedly, patients will experience a step-change in healthcare over the coming years.
With appropriate treatment, the risk of stroke in those with AF can be significantly reduced. To this end, doctors will typically prescribe anticoagulant (blood-thinning) drugs such as warfarin and NOACs to patients with the condition to reduce the risk of blood clots. Some patients may be prescribed with anti-arrhythmic medication to help restore a normal heart rhythm. These include betablockers like bisoprolol and sotalol, flecainide and amiodarone. If a patient doesn't respond well to the prescribed medications, a catheter ablation will be offered. This minimally invasive procedure involves inserting a flexible, thin tube into the blood vessels that lead to the heart to ablate (terminate) the abnormal electrical pathways in the heart tissue that cause AF.
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KardiaMobile can give it a quick check-up in just 30 seconds*. A portable clinical grade ECG device, as used by the NHS, that works on smartphones and tablets. Accurately detects atrial fibrillation.
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Always consult your doctor if you have concerns over your heart health
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One of the fastest-growing health concerns in the UK, diabetes diagnoses have doubled in the last 20 years
Type 1 diabetes Only around 10 percent of people with diabetes in the UK have Type 1 diabetes, but it is an unpreventable, lifelong condition. 74 | Live to 100 with Dr Hilary Jones
Type 1 diabetes has nothing to do with diet or lifestyle, but is due to the body attacking cells in the pancreas, rendering it unable to produce any insulin at all. This causes glucose to build up in the bloodstream. To manage Type 1 diabetes, the patient must check their glucose levels several times a day, and inject insulin into their body to keep glucose levels under control.
Type 2 diabetes Making up the remaining 90 percent of diabetes diagnoses in the UK, Type 2 diabetes also causes glucose levels in the blood to become too high. Often linked to being overweight or having a family history of the condition, Type 2 diabetes is a result of the body’s insulin being unable to work
properly. The pancreas then responds by releasing more insulin, and can eventually tire out. Consequently, Type 2 diabetes is a progressive condition that will eventually require medication.
Symptoms • • • • • • •
Feeling extremely thirsty Frequent urination Fatigue Accidental weight loss Wounds taking longer to heal Thrush Blurred vision
Management Actively managing diabetes is essential for keeping blood sugar levels under control.
iabetes is a condition that causes blood sugar to become too high. If a person has diabetes, the body is unable to break down glucose into energy. This is due to the fact that there is not enough insulin to transfer glucose out of the blood and into cells, or the insulin that is produced does not work properly. With nearly 3.7 million people now living with the condition in the UK—and with longterm complications including heart disease and eye damage a possibility—preventing an epidemic is crucial.
YOUR Healthcare However, it can be challenging, as many different factors can trigger these levels to rise and fall. Food. Counting carbohydrates, monitoring portion sizes and sugar intake and eating a healthy, balanced diet are all necessary when living with diabetes. Knowing how much food to eat alongside insulin medication can also prevent the dangers of hyperglycaemia and hypoglycaemia—the sharp rise and fall of glucose levels that can be fatal. Exercise. Exercise causes the muscles to use glucose for energy, helping the body use insulin more efficiently. Making an exercise plan with your doctor, sticking to a schedule and knowing what sugar levels are appropriate before exercise can help. Always be prepared with a small snack and check your blood sugar levels throughout any activity.
DID YOU KNOW? It is estimated that more than 1 million people in the UK have undiagnosed diabetes it more difficult to manage diabetes. Knowing when to check your blood sugar levels more frequently and keeping a log can help. Women with diabetes can safely use most forms of birth control.
HOW TO PREVENT DIABETES According to the NHS, over five million people in the UK are at risk of developing Type 2 diabetes. Luckily, there are many small changes that can be made to prevent the condition, including: • Finding out if you are at risk
• Setting realistic goals and making an action plan • Eating a healthy, balanced diet • Exercising more • Losing weight, if you are overweight
REVERSAL Reversing diabetes—or putting diabetes into remission—is a term that refers to a significant long-term improvement in insulin sensitivity. Losing body weight can be particularly beneficial if Type 2 diabetes is obesityrelated, as being overweight makes it harder for the pancreas to produce the right amount of insulin. Low carbohydrate diets, low calorie diets and exercise can help to improve the condition. Studies have shown that reversing diabetes may require a body weight loss of around 25 percent. The longer a person has Type 2 diabetes, the harder it becomes to reverse.
Medication. Insulin and other diabetes medications can lower blood sugar levels, depending on the timing and the dose. Always check with your doctor before taking any medications that are not related to diabetes, as these can also impact blood sugar levels. Alcohol. Alcohol can result in low blood sugar because the liver is distracted from releasing stored glucose. If your doctor agrees, moderate alcohol consumption and sugar-free mixers should be safe. Always eat before drinking alcohol and check your blood sugar levels afterwards. Stress. Stress hormones can cause a rise in blood sugar levels. Learning relaxation techniques and keeping a log of stress patterns and glucose levels can help to pinpoint any triggers. Menstruation. Similarly, changing hormone levels throughout the menstruation cycle can cause blood sugar levels to fluctuate. Menopause can also cause unpredictable variations, making
LIVE TO 100 WITH DR HILARY JONES | 75
Helping you to make a change for a
The weight loss service at Benenden Hospital offers a range of self-pay medical and surgical options for patients who wish to reduce the health risks of being overweight and want to gain the benefits of increased life expectancy and mobility. The service is provided in response to a growing obesity trend across the UK along with its associated weight-related conditions such as type 2 diabetes, hypertension and obstructive sleep apnoea. The bariatric team at Benenden Hospital is led by Consultant bariatric surgeon, Mr Ahmed Hamouda and they work closely with patients before and after surgery to deliver high quality care in a safe, supportive and modern environment. The comprehensive after-care support is designed to help patients achieve their weight loss goals and to continuing to follow a healthier lifestyle.
MR HAMOUDA, Consultant bariatric surgeon
“At Benenden Hospital our comprehensive weight loss service fully supports the involvement of the patient in the decision making process and we offer expert advice and support to help them achieve the change to a healthier lifestyle”. MARIA DUCKWORTH, Surgical Care Practitioner
“Weight loss procedures are simply tools that can help you to achieve your weight loss goal.
Finance options are available for these procedures For terms and conditions please visit: www.benendenhospital.org.uk/liveto100
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To be successful it’s important to choose the right tool for you and the right support from a dedicated team who can support you fully on your weight loss journey”. KATIE PECK, Dietician
“We offer practical advice on what to eat pre and post-surgery, portion control and nutrition optimisation. All of which are vital to helping you to achieve long lasting and beneficial effects”. Weight loss surgery is a lifestyle choice and our full consultation process allows patients the time to ask any necessary questions and ensure that they choose the right treatment for them and fully understand all aspects of their surgery and post-operative care.
Benenden Hospital offers a full range of bariatric procedures and comprehensive all inclusive treatments: • • • •
Gastric band Gastric sleeve gastrectomy Gastric balloon Elipse™ balloon – the balloon that you can swallow
If you’re interested in chatting with Mr Hamouda and his team and finding out about our weight loss service, please call our private patient team on 01580 230 660 to book a consultation. Visit our website benendenhospital.org.uk Benenden Hospital is rated outstanding by the Independent Care Quality Commission and our procedures follow the National Institute for Health and Care Excellence (NICE) compliant package pathways.
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Take a Weight Off
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As with any surgery, it's important that you are involved in the decisionmaking process and that you make the right choice for you. In addition, choose experienced and qualified professionals and organisations who will be responsible for your care and who will put your needs first, both pre and postsurgery, to provide you with the best possible outcome —Benenden Health
ecent figures published in the March 2018 House of Commons Obesity Statistics report show that obesity levels in the UK have increased from 16 percent to 26 percent since 1993—meaning that we now have the second highest rates of obesity in Europe. Today, 61 percent of the nation is classified as overweight or obese, a condition that contributes great risk to various types of cancer, Type 2 diabetes, cardiovascular diseases, high blood pressure and respiratory problems. While doctors will advise that lifestyle changes—including a diet overhaul and exercise—are pertinent to successful weight loss, for some, additional procedures like bariatric surgery pose a radical but necessary option to kickstart a healthy life. Between 2015 and 2017, some 18,528 weight loss surgeries took place in the UK. Yet some medical experts have warned that thousands more operations should be made available
to those who require it, as the cost of surgery offsets other obesity-related medical care costs. It seems that the climbing rates of obesity and the high medical costs that come with them may actually be threatening the sustainability of the NHS. As with most surgical procedures, bariatric surgery does carry risks, and potential patients should consider them carefully before opting for the drastic procedure. Patients may be at risk of wound infections, a blocked gut or a leak that can cause infections inside the stomach, the gastric band falling out of place and developing gallstones. Weight loss surgery can also increase the likelihood of malnutrition, as it may become more difficult for the gut to absorb vital nutrients from food. For this reason, surgeons may recommend patients take extra daily nutritional supplements for life after the operation. With this in mind, however, experts surmise that the health benefits do
As obesity rates in the UK continue to climb at an alarming rate, bariatric surgery offers patients a lifeline while providing cost-effective relief to the NHS
617,000 The number of admissions in NHS hospitals where obesity was a factor Source: Statistics on Obesity, Physical Activity and Diet—England 2018
Weight loss surgery abroad
DID YOU KNOW? Men are more likely to be obese than women Source: healthierweight.co.uk
outweigh the risks. Not only does bariatric surgery provide a cost-effective resolution for the obesity epidemic, it can lead to significant weight loss in a short period of time and has been shown to improve—and in some cases eradicate or reverse—conditions like high blood pressure and Type 2 diabetes.
DO I QUALIFY? To receive bariatric surgery on the NHS, patients must meet certain criteria. Patients will only be offered this procedure if they have a body mass index (BMI) of 40 or more. This may be reduced to a BMI of between 35-40 if the patient has an obesity-related
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condition (like diabetes) that could be improved should surgery take place. In most incidences, patients who have committed to trying other mainstream weight loss methods such as regular exercise and healthy diets with no luck will be recommended the procedure. Weight loss surgery is also available privately, although qualifying criteria may differ from provider to provider and costs can be high.
TYPES OF SURGERY The type of weight loss surgery offered will depend on a patient’s specific needs. There are various types of bariatric surgeries available. These procedures are typically carried out under anaesthetic via laparoscopic (keyhole) surgery to minimise invasiveness. Gastric band. In this procedure, an adjustable silicone band is placed around the top of the stomach; this band is tightened around six weeks following surgery. The narrow passage
Weight loss surgery can lead to significant weight loss and a healthier lifestyle. Weight Loss Riga is the number 1 weight loss surgery choice for UK, Ireland and Norway patients. It has some of the best prices in Europe, the most experienced surgeons and accredited doctors who specialize in performing multiple weight loss procedures. Based in Riga, Latvia, the surgical unit provides peaceful, private rooms with all the modern conveniences a patient could need. With a focus on patient comfort, as well as safety, friends or family members can stay to share the flat screen television, air conditioning and Wi-Fi. Leading bariatric surgeon, Dr Igors Troickis has had over 25 years worth of surgery experience and has been performing weight loss surgery for 10 years. UK patient coordinator, Mim, even had a gastric bypass herself and is available to discuss any worries or questions by telephone. For more information, visit weightlossriga.co.uk and join Weight Loss Riga on Facebook
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Weight Loss Surgery Abroad! Prompt appointment system, safe, reasonably priced and professional
Weight Loss Riga is the number one choice for patients from the UK, Ireland and Norway who are considering undergoing weight loss surgery abroad.
Clinic & Surgeons Our independent, smart surgical unit in Riga, Latvia can only be compared to the highest-rated medical institutions located across Europe. The comfortable, private rooms come with all the modern conveniences including flat-screen television, air conditioning and wifi. A friend or member of your family may also reside with you in your private room for the duration of your stay. Although the hospital is conveniently located in Riga, it is quiet and peaceful. The medical and nursing teams at the hospital are focused on patient needs, and both doctors and nurses are available 24 hours a day. Our medical personnel's focus and attention are on the safety and comfort of our patients. Our surgeons and medical personnel are highly experienced. All our doctors have been accredited and have approval to operate in the European Union. Our leading bariatric surgeon is specialized in gastric sleeve, gastric bypass, mini gastric bypass and revisional bariatric surgeries, with twenty-five years’ experience in general surgery and over ten years' experience in weight loss surgery.
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Dr. Igors Troickis —Leading bariatric surgeon An eminent surgeon with 25 years’ experience in general surgery and over 10 years’ experience in bariatric surgery, Dr. Igors Troickis is the Clinical Director of Surgery at Riga Hospital. Performing over 500 procedures annually, his specialties include: • Gastric sleeve, gastric bypass, mini gastric bypass. • Revisional bariatric surgery. In 1991 he graduated from Riga P.Stradina University as a general surgeon. He studied further, gaining additional qualifications and experience in the UK (Bassetlaw Hospital ward B6), Switzerland (St. Claraspital Basel), France (TYCO Healthcare Education Center), Italy, Norway and Sweden. The Englishspeaking surgeon is also a member of: • The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). • The Latvian Bariatric Surgeon Association. • The Latvian Surgeon Association.
Meet our UK Patient Coordinator —Mim Dickens I am very proud to say that I am a UK Patient Coordinator here in the UK. I also had a gastric bypass with our outstanding surgeon at our clinic and am delighted with the whole experience. I am based in the UK and can help you on your journey. I am only a phone call away and can answer any questions you may have. I look forward to hearing from you.
firstname.lastname@example.org Tel: 02070963996 Mob: 07758131818 www.weightlossriga.co.uk WeightLossRiga Patient community for Support, Patient Stories, Clinic Reviews
Weight loss surgery abroad! Prompt appointment system, safe, reasonably priced and professional
Weight Loss Riga is the number one choice for patients from the UK, Ireland and Norway who are considering undergoing weight loss surgery abroad. Some of the best prices in Europe with the most experienced surgeons! WeightLossRiga Patient community for Support, Patient Stories, Clinic Reviews
10 Reasons to choose us Efficient appointment system A private contemporary surgical centre Extremely experienced surgeons and medical team Finest quality surgical equipment 5 year follow up Half the price of UK surgical treatment English speaking medical personnel Twenty four hour care Direct flights from the UK to Riga Surgeon’s liability insurance
UK Patient Coordinator Mim Dickens email@example.com | Tel: 02070963996
| Mob: 07758131818
www.weightlossriga.co.uk Overvekts Operasjoner.Rev3.indd 1
between the top and bottom halves of the stomach works to limit food intake, so that patients feel fuller, quicker. Gastric bypass. Surgical staples are used to create a pouch at the top of the stomach which is then connected to the small intestine. Food then effectively bypasses the rest of the stomach. Sleeve gastrectomy. A restrictive procedure, surgeons remove around 75 percent of the stomach, so that what remains is much smaller and less calories can be consumed. Gastric balloon. A soft balloon is placed into the stomach using a thin tube passed down the patientâ€™s throat. Once in place, the balloon is filled with air or saltwater, making it difficult for individuals to eat as much before feeling full. Biliopancreatic diversion. A biliopancreatic diversion is very similar to a gastric bypass, but it carries more 82 | Live to 100 with Dr Hilary Jones
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6% of all cancers are caused by obesity, which is the secondbiggest cause of cancer after smoking Source: Cancer Research UK
risks. This operation involves creating a small stomach pouch and connecting it further up the small intestine than with a gastric bypass.
Which Procedure is best? Each type of weight loss surgery results in significant weight loss, but there are differences. According to the NHS, you
are more likely to lose weight following a gastric bypass or sleeve gastrectomy than following a gastric band procedure. It is also crucial to consider the risks associated with each. Surgical complications are more likely after a gastric bypass or sleeve gastrectomy. For further advice, speak with your surgeon.
Life after surgery Patients are typically able to leave the hospital a few days following bariatric surgery and can resume normal activity around six weeks post-op. Doctors require that patients commit to regular follow-up appointments for the rest of their lives to keep an eye on their general health and wellbeing. To help keep the weight off, patients should eat a healthy, balanced diet and commit to the governmentrecommended 150 minutes of exercise each week. â€˘ celebrityangels.co.uk
Ahmed Hamouda MD, FRCS, FRCS (G. Surg)
Specific area of Interest: Bariatric surgery. Fully comprehensive service offering balloon (both swallow and endoscopic), gastric bands and sleeve procedures
Full name: Ahmed Hamouda Qualifications: MD, FRCS, FRCS (G. Surg)
e says: 'This is one of the most gratifying fields I have worked in, primarily because it changes people's quality of life and outlook for the better.' Since 2016, he has led the development of bariatric services at Benenden Hospital which has seen it grow into a regionally significant service with over 100 procedures being performed in the last year. Initially, Mr Hamouda began his work at Benenden Hospital with gastric band and sleeve procedures and has more recently introduced the swallow balloon (Elipse) which has proven very popular as it does not require any sedation, anaesthetic or intervention. He explains: 'Gastric balloons are a temporary weight loss aid that create a feeling of fullness, allowing you to eat less without feeling hungry.
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'The food you do eat stays in your stomach for longer, reinforcing the feeling of fullness and avoiding the need to snack between meals. 'Most people would be able to return to normal activities in a day or two. However, as with all gastric procedures, some may experience abdominal cramping, nausea and vomiting. 'Our after-care package will offer dietary advice that will help to support you in your weight loss journey.' During the past two years, Mr Hamouda has worked with Benenden Hospital to form a team of dedicated anaesthetists, dieticians, psychologist and clinical nurse specialist to support the service. Benenden Hospital has undergone a recent, multi-million pound major redevelopment which sets it apart as one of the leading private hospital facilities in the UK. â€˘
Positions held Consultant Bariatric Surgeon, Bariatric Lead, Benenden Hospital Specific area of Interest Bariatric surgery. Mr. Hamouda developed this expertise through a Fellowship programme in a Centre of Bariatric Excellence. Services provided Fully comprehensive bariatric service offering balloon (both swallow and endoscopic), gastric band and sleeve procedures. Contact details Mr Ahmed Hamouda, Benenden Hospital, Goddardâ€™s Green Road, Benenden, Cranbrook, Kent, TN17 4AX.
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Could your child be short-sighted (myopic)? ‘Short-sightedness’ or ‘nearsightedness’ are the common terms for myopia – a common eye condition that makes distance vision blurry. It usually starts around 8-12 years old and continues to get progressively worse until the child stops growing. The younger the child is when they first become short-sighted, the worse their prescription is likely to become. Most children who become shortsighted at a young age are often totally reliant on glasses to see by the time they have stopped growing. Glasses are more popular than they used to be, though some children would prefer not to wear them, and there are times when they aren’t practical like when playing school sport. Later in life, short-sightedness can lead to eye health and vision issues; the more short-sighted you are, the greater these risks become.1
What causes myopia? There are two main factors which can mean your child is more at risk of developing myopia – genetics and lifestyle. Genetics
The risk of myopia in children increases when parents are myopic.2 The risk is nearly:
When both parents are myopic.
When one parent is myopic.
When neither parent is myopic.
Modern lifestyles may influence the development of myopia:
Low levels of Prolonged near tasks such outdoor activity.3,4 as reading and gaming on portable devices.3,1
Poor lighting levels.3,1
Having your children’s eyes examined regularly is vital to ensure any issues that may impact their school performance can be acted on soon.
Did you know that there are twice as many short-sighted children now than 50 years ago? In fact, by 2050, half of the world’s population will be short-sighted, that’s a whopping five billion people!5 TYPICAL EYE
What signs should you look out for?
Distance vision becoming blurry.
Moving closer to the TV.
Reduced performance at school.
In many cases, there will be no signs at all. Complaints of headaches or tired eyes. Light is focused here
Squinting or screwing eyes up.
What options are available to manage myopia? Encourage time outdoors
Did you know that spending time outdoors (at least 90 minutes a day) has been shown to reduce the risks of becoming shortsighted?6
It is recommended that children spend at least 90 minutes a day outdoors to decrease the risk of developing myopia.7
These can help your child see clearly and will often need updating frequently as they have little or no effect on slowing down the speed of myopia progression.8,9
Disposable contact lenses
Research has shown that contact lenses are as safe for children as they are for adults, plus kids are used to being taught new things all the time. Studies have shown that contact lenses can help to improve children’s self perception of physical appearance, athletic competence and social acceptance.10 Modern daily disposable contact lenses are soft, comfortable and are disposed of each night so no cleaning is needed.
Regular eye exams for young children are important to identify and treat myopia early. If you think your child might be myopic, ask your Optician about the options available. www.coopervision.co.uk 1. DI Flitcroft. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res 2012 Nov; 31 (6):622-60. 2. Morgan P. Is Myopia Control the Next Contact Lens Revolution? The Optician 2016. 3. Wolffsohn JS, Calossi A, Cho P, et al. Global Trends in Myopia Management Attitudes and Strategies in Clinical Practice. Cont Lens Anterior Eye. 2016; 39:106-16. 4. Rose KA, Morgan IG, Ip J, et al. Outdoor Activity Reduces the Prevalence of Myopia in Children. Ophthalmology 2008; 115:1279-1285. 5. Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, Wong TY, Naduvilath TJ, Resnikoff S, Global Prevalence of Myopia and High Myopia and temporal trends from 2000 through 2050, Ophthalmology, May 2016 Volume 123, Issue 5, Pages 1036-1042. 6. Gifford P. Gifford, K. The Future of Myopia Control Contact Lenses. Optometry and Vision Science. Vol. 93 April. 7. IMPACT OF INCREASING PREVALENCE OF MYOPIA AND HIGH MYOPIA, The impact of myopia and high myopia a Report of the Joint World Health Organization – Brien Holden Vision Institute Global Scientific Meeting on Myopia THE IMPACT OF MYOPIA AND HIGH MYOPIA University of New South Wales, Sydney, Australia 16–18 March 2015. 8. Gwiazda J, Hyman L et al. A Randomized Clinical Trial of Progressive Addition Lenses versus Single Vision Lenses on the Progression of Myopia in Children. IOVS, April 2003, Vol. 44, No. 4. 9. Heiting G. Myopia Control – A Cure For Nearsightedness? allaboutvision. 2016. 10. Walline JJ et al, The Adolescent and Child Health Initiative to Encourage Vision Empowerment (ACHIEVE) study Optom Vis Sci. 2006 Jan;83(1):37-45 *Compared to single vision 1 day lenses. Individual results may vary and are not predictable.
In Association with CooperVision
Warning Signs of
Keeping a close eye on your eyesight—and reporting to a specialist whenever alarming symptoms arise—is imperative at any age
EAT RIGHT …to protect your sight. Consuming a diet rich in fruits and vegetables and fish high in omega 3 fatty acids will do wonders for your eye health
FLASHING LIGHTS OR FLOATERS
An increase in the number of floaters—usually harmless cobwebs, spots or strands that float around in your field of vision—flashing lights, or 86 | LIVE TO 100 WITH DR HILARY JONES
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Although it can come and go, blurred vision can be a sign of conditions such as glaucoma, uveitis—inflammation and swelling of the middle coating of the eyeball—a torn retina or age-related macular degeneration. Slowly losing vision in one eye can also be an early warning sign of an oncoming stroke. This may be caused by a blockage of the carotid artery, a major supplier of blood to the eyes.
Most eye conditions are largely painless; however, sudden eye pain can be a warning sign of glaucoma, dry eye, an eye injury, a scratched cornea or even cancer of the eye. In the case of eye injury, individuals should present to their doctors surgery if redness or pain lasts more than 20 days.
including macular degeneration, a leading cause of vision loss in individuals aged 65 and over. Sudden loss of vision could also be caused by a type of glaucoma, a condition that damages the eye with a rapid buildup of fluid pressure.
shadows in your peripheral vision could be signs of a detachment of the retina. Retinal detachment can be caused by nearsightedness and eye diseases like glaucoma. Unless treated promptly, the condition can lead to blindness.
SUDDEN LOSS OF VISION
This symptom could signify the presence of a number of eye diseases,
RED & SORE EYES
According to experts, having ‘two red eyes is probably not as serious as having one red eye’. While a redness in both eyes could be a symptom of a cold or conjunctivitis—both minor ailments—one red eye can be a sign of a deeper infection such as scleritis—the inflammation of the outer protective barrier around the eye— or uveitis.
If you feel discomfort when moving your eyes or blinking, report to a specialist to make sure you don’t have a foreign
Images: Images: Shutterstock Shutterstock
ccording to the World Health Organization (WHO), over 250 million people are visually impaired worldwide. Of these cases, 80 percent could have been avoided or cured. You wouldn’t let years pass without regular physical examinations, so why should your eyes be any different? Eyes are among the body’s most developed sensory organs; ensuring they stay healthy for as long as possible has a direct impact on our overall health and wellbeing. Vision loss is a common symptom of the normal ageing process; however, other eye conditions can be monitored and even prevented with the right precautions. Keep a close eye on your sight by watching out for the following symptoms.
YOUR Healthcare In Association with CooperVision particle in the eye that could damage the retina or cause an infection. Alternatively, while most will not experience any discomfort when using contact lenses, infections can sometimes occur. Never ignore eye pain, discomfort or redness caused by lenses—schedule a visit with your doctor.
Double vision—a condition also known as diplopia—may happen for a number of reasons, including drinking alcohol and exhaustion. Short-term diplopia is—usually—nothing to be concerned about, but if it’s long-lasting, a visit to the doctor is imperative. Reasons for recurring double vision involve stroke, head injury, brain tumour, brain swelling or aneurysm.
on VISION CORRECTION Nowadays, individuals who want to correct vision problems have a wealth of methods to choose from. Glasses and contact lenses are the perfect choice for individuals that don't want to undergo surgery—in recent years, contact lenses in particular have evolved and become easier to use than ever. Other—more permanent—vision correction measures include eye laser surgery such as LASIK, SMILE and surface laser treatments. Consult with your doctor if you think these procedures may be right for you. •
Remember Some eye conditions are hereditary—if you have a family history of eye diseases, ensure you monitor your sight regularly
Contact lenses have changed so much over the years. Daily disposable lenses now offer great convenience and freedom with no cleaning required, plus they come in many prescription types and in newer, softer materials including silicone hydrogels for better eye health and longer wearing times. Your eye care practitioner can advise you on the best lenses to suit your individual lifestyle and prescription needs —CooperVision
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DID YOU KNOW? Myopia is thought to affect at least 1 in 3 people in the UK and is becoming more common
How is myopia diagnosed?
Also known as short-sightedness, myopia is a common eye condition that causes distant objects to appear blurred
condition caused by the elongation of the eyes, myopia ranges from mild— where no treatment is required—to severe, where a person’s ability to see is severely affected. Shortsightedness means light doesn’t focus properly on the retina, instead focusing just in front of the light-sensitive issue. The condition usually starts around puberty, but it can also develop in young children. Some signs that you may be myopic include needing to sit close to the TV,
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complaining of headaches or tired eyes and regularly rubbing the eye area.
TREATMENT OPTIONS Myopia can be corrected with a variety of treatments. The most common are: Corrective lenses. Depending on preferences, individuals may choose eyeglasses or contact lenses to aid the eyes in focusing on distant objects. Laser eye surgery. A straightforward procedure with relatively little recovery time, laser eye surgery alters the shape of the eye. A laser is used to burn away
Katie Harrop Optometrist and professional services director, No7 Contact Lenses
small sections of the cornea, correcting the curvature. Artificial lens implants. A permanent man-made lens is inserted into the eyes to help them focus.
ASSOCIATED CONDITIONS Although it is not a life-threatening condition, myopia—if severe and untreated—can cause a series of other eye conditions. These include a squint, a common condition where the eyes point in different directions; lazy eye, where the vision in one eye doesn’t fully develop; glaucoma, increased pressure in the eyes; cataracts, cloudy patches that develop inside the lens of the eyes; and retinal detachment, when the retina detaches from the blood vessels that supply it with nutrients and oxygen. •
Be Clear on
The signs of myopia are that your vision becomes blurred in the distance but stays clear close-up. This is why it is also sometimes known as shortsightedness. It is most common for myopia to develop in childhood, but it can also begin in adulthood. It is usually diagnosed during an eye examination with an optometrist. The optometrist will check what you (or your child) can see without any help and then find the prescription for lenses that make the vision clearer. All school-aged children are entitled to an eye test paid for by the NHS, so why not get their eyes tested?
I DREAM OF BEING WORLD CHAMPION Charlie Emmett, 17 European Championship Water-ski Finalist
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THE MICROSCOPIC IMPLANT THAT TREATS GLAUCOMA Glaucoma can lead to sight loss – even blindness – if it’s not diagnosed and treated early. Consultant Ophthalmic Surgeon, Imran Masood describes the treatments that could help save your sight. Q. So, I can have glaucoma without realising it? Mr Imran Masood, Consultant Ophthalmic Surgeon
Q. What is glaucoma? A. Glaucoma is a serious, progressive eye disease. If left untreated, it can lead to blindness. Glaucoma is asymptomatic, meaning it occurs without noticeable symptoms appearing. Glaucoma usually occurs when the optic nerve is damaged by an increase in the pressure of the fluid in the eye when the fluid can’t drain properly. It’s estimated that around half a million people in the UK are currently diagnosed with glaucoma ‒ but that many more are going undiagnosed and experiencing the steady, permanent eye damage glaucoma can cause without realising they have the condition.
A. Yes. We call glaucoma the ‘silent
thief of sight’, because there are often no obvious symptoms until significant damage has been done to the eye. The less sensitive peripheral vision ‒ your side vision ‒ is usually the first to be affected by pressure damage to the optic nerve, which can be difficult to detect without an eye test.
Q. How can I protect my sight? A. Annual eye tests are the best way to
check the health of your eyes and for the start of glaucoma. Free eye tests are available on the NHS if you are over 60, or, if you are over 40 and have close family that have been diagnosed with glaucoma as you are considered to be at a greater risk of developing glaucoma. (Other circumstances can entitle you to free eye tests too ‒ go to nhs.uk for a full list).
Q. What will happen if I’m found to have glaucoma? A. Damage to the optic nerve from
A major risk factor for glaucoma is increased eye pressure that occurs when fluid (aqueous) in the eye – used to transport important nutrients to the lens – accumulates and cannot drain naturally.
glaucoma is permanent and irreversible, so it’s really important to get the fluid pressure in the eye under control as quickly as possible. The most common treatment for this at the moment is prescription eye drops, sometimes up to three or four different types in combination ‒ which may help to slow fluid production or increase drainage out of the eye ‒ and will sometimes need to be applied up to three times a day, every day, for the rest of your life.
The first sign of glaucoma is often loss of peripheral or side vision.
Q. Daily eye drops sound like hard work. Is there an alternative? A. Yes. The eye drops needed to treat
glaucoma can cause uncomfortable reactions in some people like redness, soreness and dryness. The commitment required to use them regularly can be problematic for some people too, particularly if some of the drops need to be kept refrigerated, or instilled frequently ‒ which is where MIGS, Minimally Invasive Glaucoma Surgery, can help.
Q. What is Minimal Invasive Glaucoma Surgery (MIGS)? A. Surgery used to be reserved for only the most severe cases of glaucoma ‒ but things have moved on dramatically in the last 10 years, and there are now highlyrefined, safe and minimally-invasive surgical techniques we can use that can be performed under local anaesthetic in no time at all, which can help control
The iStent inject ® Device (enlarged image)
glaucoma and potentially reduce the need for eye drops. One of the most effective MIGS for controlling open angle glaucoma (the most common form of the disease) at the moment involves inserting two tiny 0.4 mm titanium iStent inject ® implants in the eye’s natural drainage pathway to help control intraocular eye pressure.
number of studies that show its efficacy and safety1. The devices can be implanted at the same time as cataract surgery, or during a separate surgery. There is a very good chance that the medication can be reduced after the procedure. An international study has shown 72 % of patients who were treated with iStent inject ® no longer need glaucoma medication after 12 months2. More than 400,000 iStent inject ® and iStent® implants have been implanted around the world to date3.
Q. How can I get this treatment? iStent inject ® is designed to create a permanent channel through the primary blockage site (trabecular meshwork) to restore the eye’s natural outflow.
Q. Surely putting titanium stents into an eye is asking for trouble? A. No. It is a safe surgery and one
A. First, you need to see a consultant for a full assessment of your condition, to find out if it’s suitable for you. It’s available through the NHS in some areas ‒ usually, where appropriate, as an add-on to cataract surgery or for uncontrolled eye pressure problems. It’s also available through some private healthcare schemes.
About Glaukos Glaukos Corporation* is an ophthalmic medical technology company focused on the development and commercialisation of breakthrough products and procedures designed to transform the treatment of glaucoma, one of the world’s leading causes of blindness. Our mission is to pioneer and lead the global glaucoma market with micro-scale injectable therapies that advance the existing glaucoma standard-of-care and enrich the lives and treatment alternatives for glaucoma patients worldwide. *manufacturers of iStent® and iStent inject ®.
Read more at glaukos.com/en-uk/
performed by ophthalmologists under local anaesthetic. There are a significant
1: Chang, DF. intraocular pressure reduction and safety outcomes after micro-invasive glaucoma surgery with 2 trabecular bypass stents in oag. presented at the 2013 American Society of Cataract and Refractive Surgery Annual Meeting; April 19-23, 2013; San Francisco, California, USA. 2: Voskanyan L, GarcÍa-FeijoÓ J, Belda J, Fea A, Jünemann A, Baudouin C. “Prospective, unmasked evaluation of the iStent inject ® System for open-angle glaucoma: Synergy trial”. ADV Ther 2014; 31:189-201. 3: Glaukos Corporation, data on ﬁ le • Credit: Mediaplanet • PM-UK-0009
Identifying & Curing
Glaucoma According to experts, around two percent of the UK population over 40 have glaucoma
More often than not, the damage to the optic nerve occurs due to the pressure within the eye pushing down on the nerve and damaging it. The optic nerve is a crucial player in an individual’s sight, it is tasked with carrying sight images to the brain. While a certain amount of pressure is necessary for the eye to keep its shape, excessive pressure will destroy fibres in the eye—leading to vision loss. Unlike other eye conditions, glaucoma doesn’t usually
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cause any obvious symptoms, therefore regular eye checks are vital. If it is left untreated, total loss of vision can occur in extreme cases. Although it is still relatively unclear why glaucoma occurs, there are certain risk factors that can increase an individual’s risk of developing the condition. These include: age, glaucoma is more common in old age; ethnicity, people of African, Caribbean or Asian origin are at a higher risk; family history; and other health conditions such as diabetes and long and short-sightedness.
TREATMENT Although treatment for glaucoma can’t reverse loss of vision, it can stop it from getting worse. Available treatments for the condition include surgery, specialist eye drops and laser treatment. It’s also important to remember that treatment will depend on the severity and type of the condition.
WHY IT OCCURS
Annual eye tests are the best way to check eye health and for the ﬁrst signs of glaucoma. Glaucoma is often called the ‘silent thief of sight’ because there are no obvious symptoms until signiﬁcant damage has occurred. The less sensitive peripheral vision—side vision—is usually the ﬁrst to be aﬀected by pressure-induced damage to the optic nerve. This can be diﬃcult to detect without an eye examination which consists of pressure measurements, a visual ﬁeld test and a photograph/scan of the optic nerve —Imran Masood, consultant ophthalmic surgeon
name given to a group of eye conditions caused by a damaged optic nerve, glaucoma is one of the world’s leading causes of blindness. Although vision lost to glaucoma cannot be regained, early detection and diagnosis of the condition will prevent further vision loss from taking place. Coupled with careful monitoring and regular treatment, patients suffering with glaucoma can retain useful sight for life.
Eye drops work to reduce the pressure in the eyes and are normally used from one to four times a day. Although this is the most common treatment for glaucoma, eye drops can cause unpleasant side effects such as eye irritation. Laser treatment is usually a course of action that is recommended if eye drops are deemed to not be working. This type of treatment consists in highenergy beams of light being aimed at the eye to stop fluid from building up inside it. The three main types are: laser trabeculoplasty, where a laser opens up the drainage tubes within the eyes to reduce pressure; cyclodiode laser treatment, which uses a laser to destroy the eye tissue that produces the liquid; and laser iridotomy, a procedure which creates holes in the iris to flush out fluid from the eye. This type of treatment is usually performed while the patient is awake and under local anaesthetic in the form of numbing eye drops. In rare cases, surgery may be recommended if treatment with laser
or eye drops hasn’t been effective. Trabeculectomy, the most common type of surgery for glaucoma, involves allowing the fluid buildup to drain more easily by removing part of the eye drainage tubes. This type of surgery can be carried out both under local anaesthetic or general anaesthetic. According to the NHS, patients who choose this route rarely present with pain after surgery and find they no longer need to take eye drops to manage the condition. Your doctor should discuss the different types of glaucoma surgery, whilst outlining the risks and side effects. Other types of glaucoma surgery include: trabeculotomy, where an electric current is used to remove a part of the eye drainage tubes; viscocanalostomy, the removal of the sclera (the white outer covering of the eyeball) to facilitate fluid drainage; deep sclerotomy, where the drainage tubes in the eye are widened; and trabecular stent bypass, where a tiny tube is placed into the eye to increase fluid drainage. Post-surgery, the affected eye may water and your vision may be slightly blurred for up to six weeks—this should all return to normal thereafter. •
SYMPTOMS Glaucoma doesn’t present with symptoms to begin with—it tends to develop slowly over time and affect peripheral vision ﬁrst. However, occasionally, the condition develops quickly, causing symptoms such as: • Intense eye pain • Nausea and vomiting • A red eye • A headache • Tenderness around the eyes • Seeing rings around lights • Blurred vision
REMEMBER It’s vital to attend regular follow-up appointments to monitor your vision and check that treatment is working
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long-term chronic condition, lymphoedema can cause swelling to any part of the body, but usually affects the arms or legs. It is divided into two main types—primary and secondary—that have a different cause and prevalence. According to the NHS, primary lymphoedema, the rarer type, only affects as many as one in 6,000 people. It occurs as a result of mutations in the genes responsible for the development of the lymphatic system. These damaged genes cause the parts of the lymphatic system that drain fluid to not properly do so. Primary lymphoedema can also be hereditary; however, not every child born to someone with the condition will go on to develop it. Secondary lymphoedema has many different causes and can develop in
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individuals who previously had a normal functioning lymphatic system. Some of these causes include: treatment for cancer, as surgery can involve removing sections of the lymphatic system; radiotherapy, as it can damage healthy tissue; infections such as cellulitis; inflammations such as rheumatoid arthritis and eczema; obesity; trauma and injury; and venous diseases such as deep vein thrombosis and varicose veins.
DID YOU KNOW?
It’s important that the condition is identified as soon as possible, as it can get worse without treatment. If you experience swelling in your arms and legs, visit your doctor. In many cases, lymphoedema can be diagnosed by medical history and symptoms alone. Occasionally, your doctor may refer you to a specialist or lymphoedema treatment centre for further testing.
Secondary lymphoedema affects around 2 in 10 women with breast cancer, 5 in 10 women with vulval cancer and 3 in 10 men with penile cancer Source: NHS Choices
Although the main symptom associated with lymphoedema is swelling, other symptoms may include: • An aching, heavy feeling • Difficulty with movement • Repeated skin infections • Hard, tight skin • Folds developing in the skin • Wart-like growths on the skin • Fluid leaking through the skin
TREATMENT Although there is no cure available for lymphoedema, it is possible to control its symptoms. This can be done by minimising fluid buildup and stimulating the flow of fluid through the lymphatic system.
Individuals may control their symptoms by wearing compression garments, looking after their skin, exercising regularly, consuming a healthy diet and using specialist massage techniques. •
Lymphoedema, a condition which causes swelling in the body’s tissues, is thought to affect over 200,000 people in the UK
Managing Lymphoedema at Home Swollen heavy legs can be very uncomfortable and often requires many lengthy clinic or hospital visits to get treated. If the lymphatics are not working effectively then lymphoedema is often diagnosed. Managing lymphoedema requires support from healthcare professionals to help an individual to manage themselves with the best treatment options available— compression and massage. Once an appropriate plan is in place then self-management is key to keeping control of the swelling long-term. Effective, evidence-based treatments normally delivered in the clinical setting can now be done at home. Using LymphAssist Homecare, patients can manage their lymphoedema in their own homes themselves, by compressing and massaging at the same time. This reduces hospital or clinic visits and allows
the individual to manage the swelling when it’s convenient to them, not the other way round. LymphAssist Homecare can be taken on holiday, giving all year round self-management at the times it’s often most needed. Nothing makes a healthcare professional more satisfied than when they have helped someone to help themselves. Now LymphAssist Homecare is available for self-management, it gives individuals the opportunity to manage their condition, and do just that. Very satisfying all round we’d say! Mrs Justine C Whitaker MSc, RN Director & Nurse Consultant – Northern Lymphology Ltd Senior Lecturer – University of Central Lancashire
Effective, evidencebased treatments normally delivered in the clinical setting can now be done at home ree Interest F Payment ow Options N * Available * Terms and Conditions apply, UK residents aged 18 years and over. Huntleigh Healthcare is acting as a credit broker offering ﬁnance products from Omni Capital Retail Finance, authorised and regulated by the Financial Conduct Authority (720279)
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ccording to Cancer Research UK, one in 15 males and one in 18 UK females will be diagnosed with bowel cancer in their lifetime. Statistically the second most common cancer death in the UK, the disease claims 44 lives each day, according to the leading charity. Read on for a breakdown of its symptoms, risk factors and treatment options.
RISK FACTORS An individual’s risk of developing cancer depends on a variety of factors 98 | LIVE TO 100 WITH DR HILARY JONES
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DID YOU KNOW? Bowel cancer is a general term for cancer that begins in the large bowel. Depending on where the cancer starts, bowel cancer is sometimes called colon or rectal cancer
including age, genetics and lifestyle choices. Diet is an especially important risk factor—research shows that 13 percent of bowel cancer cases are caused by eating processed meats, 11 percent are attributed to obesity and a whopping 28 percent are linked to insufficient fibre consumption. While smoking is more closely associated with lung cancer, it is also responsible for seven percent of bowel cancer cases. Drinking (six percent of cases) and physical inactivity (seven percent of cases) are also notable risk factors. Preventable lifestyle factors aside, an
individual’s risk of developing bowel cancer also increases with age—nine in 10 cases of bowel cancer occur in people aged 60 and over—and family history of the disease.
SYMPTOMS There are three main symptoms of bowel cancer, these are: persistent blood in the stools that occurs for no obvious reason, a persistent change in bowel habit and persistent lower abdominal pain, bloating and discomfort. These symptoms may be accompanied by a loss of appetite, a pain or lump in the stomach, unusual fatigue and significant, unintentional weight loss. It’s important to keep in mind that some of these physical symptoms may also be signs of another condition altogether, such as haemorrhoids.
BOWEL CANCER SCREENING In order to detect cases of bowl cancer early, the NHS currently offers two
Over half of bowel cancer cases are diagnosed at a late stage—knowing and spotting the symptoms is crucial to early detection
WHEN TO SEEK MEDICAL ADVICE If you have experienced 1 or more of the symptoms associated with bowel cancer for over 4 weeks, you should visit your doctor. During the appointment, your physician will ask about your symptoms and may also carry out a rectal examination. While this practice may seem embarrassing and uncomfortable, it is a crucial step towards solidifying a diagnosis, putting your mind at ease and starting treatment as soon as possibleâ€”if needed
PALLIATIVE CARE If youâ€™re told there is nothing else that can be done to treat your bowel cancer, you can refer to your doctor for additional support and end-of-life care
41,804 new cases of bowel cancer were diagnosed in the UK in 2015 Source: Cancer Research UK
16,384 deaths from bowel cancer occurred in the UK in 2016 Source: Cancer Research UK
57% of people survive bowel cancer for 10 or more years in England and Wales Source: Cancer Research UK
54% of bowel cancer cases in the UK can be prevented Source: Cancer Research UK celebrityangels.co.uk
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when it comes to our own health and wellbeing.
TREATMENT Where the cancer is located in your bowel and how far it has spread will dictate the course of treatment. If the cancer is confined to the bowel, surgery is usually carried out to remove the diseased tissue—this is the most effective way of curing the condition. If surgery isn’t possible, medical professionals may choose to prescribe rounds of chemotherapy, radiotherapy, or biological treatments, a newer type of complementary medication which boosts chemotherapy’s effectiveness and prevents the cancer from spreading further.
BOWEL CANCER SURVIVAL Bowel cancer survival is improving and has more than doubled in the last 40 years in the UK. According to Cancer Research UK, mortality rates for bowel cancer are estimated to fall by 23 percent in the UK between 2014 and 2035 to 25 deaths per 100,000 people in 2035. •
What types of operations are available for treating bowel cancer? There are 5 main operations for treating bowel cancer. All can be performed by keyhole surgery in the majority of people. In a right hemicolectomy, the right side of the colon (large bowel) is removed, in a left hemicolectomy, the left side of the colon and in a sigmoid colectomy, the S-shaped sigmoid colon. In all these operations, 1-2 feet of bowel are resected and the 2 remaining bowel ends are joined up. In an anterior resection, the lower sigmoid colon and part of the rectum (back passage) are removed. The remaining colon is joined to the rectum. In some cases, the join has to be protected with a temporary ileostomy (small bowel stoma bag) for 3-6 months. In an abdomino-perineal excision of the rectum, the back passage and anus are removed and a permanent colostomy is made.
different types of screening to adults registered with a doctor in England. Every two years, men and women aged 60 to 74 are sent an at-home faecal occult blood (FOB) test used to collect a stool sample. The sample is then sent to a laboratory to be checked for tiny amounts of blood, a potential sign of bowel cancer. The second type of screening method, a one-off test called bowel scope screening that is being introduced in England, is currently offered to men and women at the age of 55. This type of exam involves a nurse or doctor looking inside the lower part of the bowel using a thin, flexible instrument. If any of these tests yield unusual results, patients may be asked to undergo further testing. Taking part in bowel cancer screening may save an individual’s life, however, all screening involves a balance of potential harm. No test is 100 percent reliable, and patients may receive a false positive or false reassurance. As there is also a very small risk that certain screening tests could damage the bowel, it’s important to always make educated decisions
Alex von Roon PhD FRCS Consultant colorectal surgeon King Edward VII's Hospital
A Day in the Life of… a colorectal Clinical Nurse Specialist
ecky Slater has been a colorectal and stoma nurse specialist for 12 years, and prior to taking on the role as a clinical nurse specialist (CNS) at King Edward VII’s Hospital she was a senior ward sister managing a ward caring for patients with complex gastrointestinal and colorectal diseases. This is what Becky had to say about working as a colorectal CNS at King Edward VII’s Hospital.
The role of the colorectal CNS has been widely accepted as an invaluable role in supporting patients through their clinical pathway, from consultation with their surgeon/physician, right up to discharge from hospital. The CNS is pivotal in the provision of information, reassuring and reducing anxiety or fears. Although hard to quantify, the CNS specialist spends a large part of their time supporting patients and their families, enhancing the quality of care provided. My working week is predominantly Monday to Friday, but I will often work outside of the nine-to-five routine and provide an inpatient service at the celebrityangels.co.uk
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weekend. Providing a specialist service within the private sector, I believe, means my role should encompass the care needs of my patients. Not all of our patients undergo surgery during the day—some may have surgery on a weekend so it is imperative that those patients are reviewed in a timely manner to provide a holistic service.
I enjoy the clinical diversity involved in being a colorectal and stoma nurse, it is extremely fulfilling as well as mentally challenging. A number of our patients undergo the formation of a stoma as a result of having bowel resection surgery. This can be very daunting and patients fear how it will affect them physically. I provide emotional, mental and practical support to my patients in order for them to manage and accept their newly fashioned stoma. The fear of having a stoma can be reduced by faceto-face contact; I answer any questions they may have and discuss what to expect after surgery. All of my patients undergoing elective surgery are placed on an Enhanced Recovery Programme (ERP). The ERP is
a care pathway designed to reduce the complications post-surgery by reducing the length of hospital stay, incorporating a care pathway that includes: preassessment, laparoscopic (keyhole) surgery, eating after surgery, sitting out (of bed) and walking after surgery. I personally pre-assess my patients undergoing colorectal surgery as I feel this benefits the patient’s recovery.
WORKING AT KING EDWARD VII’S HOSPITAL
King Edward VII’s Hospital is a small hospital but I think that is endearing and most definitely why I applied to work here full time as the CNS specialist. The size of the colorectal service here allows me to focus on inpatient care with no time restraints. It allows me to provide a seamless care pathway to all my patients from admission through to discharge and ongoing in clinic and over the telephone. •
To learn more about the first-class bowel cancer service at King Edward VII’s Hospital, call 020 7467 4344 www.kingedwardvii.co.uk LIVE TO 100 WITH DR HILARY JONES | 101
Would Knowing Your Family’s
Risk of Cancer Affect Your Lifestyle Choices?
id you know that inherited genetic mutations can increase lifetime cancer risk by 40 times? Now though, it is possible to determine the risk of hereditary cancers by a simple saliva-based DNA test. • Would knowledge encourage you to take control of your health? • How could you help your children and grandchildren to do the same? • Could you benefit from interventions such as early health screening? Inherited genetic mutations can increase lifetime cancer risk by up to 40 times. As these mutations can be passed through generations, they may not only affect an individual but also their family members – if you have children you could pass on faulty genes, passed to you by your mother or father.
Studies frequently show that detecting cancer early dramatically improves survival rates and the success of any required treatment.
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Harmful mutations in BRCA1 and BRCA2 genes are responsible for the disease in nearly 50% of families with multiple cases of breast cancer and up to 90% of families with both breast and ovarian cancer. Faulty BRCA genes affect around 1 in every 400 people, but certain groups of people are at a much greater risk. The PALB2 gene is reported to be nearly as high as the risk for BRCA in breast and/or ovarian cancers. • A nalyse your risk for 98 genes associated with 25 hereditary cancers including breast, ovarian, pancreatic and colon cancer. • B reast cancer specific test analyses for mutations in 15 genes, including BRCA1, BRCA2 and PALB2. • C omprehensive report reviewed by a certified clinician.
What if you get a positive result? A positive result means you have a faulty gene that increases your cancer risk. It doesn’t mean you are guaranteed to get cancer – other factors like your
medical history, lifestyle and environment also contribute.
You Are Unique And Deserve A Personalised Approach To Your Health Often with medicine it isn’t a case of “one size fits all”. Pharmacogenomics refers to the response of DNA in drug response – it is a powerful tool that uses a person’s genetic makeup to predict their response to treatment as a unique individual. This knowledge determines which medication and which dosage is the optimum choice, leading to fewer side effects, increased response and lower relapse rates and is highly effective for both Physiological and Psychiatric conditions. • Between 40-50% of people will not respond to the first drug they try for conditions including asthma, diabetes and arthritis. • Up to 50% of patients with
“Inherited genetic mutations can increase lifetime cancer risk by up to 40 times.”
Ultimately, Pharmacogenomics can help eliminate the trial-anderror approach to medicine. Studies show clinically-measurable improvements of 91% in “treatmentresistant” patients following genetic testing. Genetic testing is therefore a highly effective approach that guides clinicians to tailor treatment to the
“Up to 50% of patients will not respond to the ﬁrst drug they try” “After genetic testing, up to 91% of patients previously labelled as “treatmentresistant” showed clinically-measurable improvement”
depression don’t respond to first-line therapies. • Relapse rates of patients with bipolar disorder reach up to 70%. • 75% of patients with schizophrenia discontinue treatment within 18 months, due to intolerable side effects.
individual, achieving improved patient outcomes in a shorter time-frame. • Pharmacogenomics testing analyses over 200 variants within 50 well-established pharmacogenomics genes. • Psychiatric Pharmacogenomics testing – analyses 18 key genes and provide information on medication response for conditions including depression, anxiety, bipolar disease, autism, OCD, ADHD, PTSD, schizophrenia + more. For simple, one-time saliva based Hereditary Cancer, Pharmacogenomics and Psychiatric Pharmacogenomics tests contact MYOGENES today for more information:
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Breast Cancer Aware With about one in eight women being diagnosed with the disease in their lifetime, breast cancer is the most common type of cancer in the UK
Symptoms One of the first noticeable symptoms of breast cancer is a lump or an area of thickened breast tissue. Whilst most lumps won’t be cancerous, it is always best to get them checked. Other symptoms include: • A change in the size or shape of the breasts • Discharge from the nipples • A lump or swelling in the armpits • Dimpling on the skin 104 | Live to 100 with Dr Hilary Jones
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• A rash on or around the nipple • A change in appearance or a sinking of the nipple
Age. The risk of developing breast cancer increases with age, with about eight in 10 cases occurring in women over 50. Family history. If a person’s close family members have been diagnosed in the past, they have a higher risk of developing breast cancer. Previous diagnosis. If a person has previously had breast cancer, they are at a higher risk of developing it again. A benign breast lump may also increase the risk.
Dense breast tissue. Younger women tend to have denser breasts, and are at risk of developing breast cancer because there are more cells that can become cancerous. Hormones. Oestrogen can sometimes stimulate breast cancer cells to grow. The female hormone is dependent on puberty, menopause, pregnancy and hormone replacement therapy. There is also evidence that the contraceptive pill can slightly increase the risk of breast cancer; Cancer Research UK reports that around one percent of breast cancers in women can be attributed to oral contraceptives. Lifestyle. People who drink more alcohol are at a higher risk of developing
ften associated with women over the age of 50, breast cancer can actually affect younger women, and even men. Thankfully, awareness is on the rise—here’s what you need to know.
HOW TO CHECK YOUR BREASTS FOR CANCER There's a good chance of recovery if breast cancer is detected in its early stages. Whilst there is no right way to check your breasts, being aware of them and knowing what to look for can help to identify cancer early. Here’s how to be breast aware: • Know what’s normal for you • Familiarise yourself with breast cancer symptoms • Attend routine screenings if you are 50 or over • Report any changes without delay
breast cancer. Similarly, being overweight or obese has been shown to increase the risk. Radiation. If chest radiotherapy is administered, a patient should be invited to talk about the slightly increased risk of breast cancer.
SCREENING Mammographic screening takes X-ray images of the breasts and is the most commonly available method of detecting a breast lesion. Mammograms may fail to detect some cancers and may also increase the chances of extra tests and surgery, even if breast cancer is not present. Most susceptible, women between the ages of 50 and 70 are encouraged to be screened for breast cancer every three years. Mammograms are more difficult to read in women under 50, but some women may be invited for screening if they are considered ‘high risk’. celebrityangels.co.uk
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New genetic testing for breast cancer Myogenes offers a new comprehensive genetic test for breast cancer. The test is highly competitive in price and backed by Vitality Health Insurance. The test assesses for BCRA1, BRCA2 and PALB2 gene mutations, and 12 other gene mutations that are strongly related to breast cancer. The key benefit of this simple saliva-based test means you can take steps to manage your risk of developing cancer and be proactive about it. You may take part in regular and earlier screening programmes and consider preventative treatment. You can also choose to make certain lifestyle changes to lower your risk. Ultimately, this genetic test gives you knowledge, enabling you to take control of your health. Visit myogenes.com or call +44 208 387 1266.
In front of a mirror: 1. Look at your breasts and feel them for any lumps or swelling 2. Look at your nipples and note any changes or discharge 3. Place your hands on your hips and press down to tighten the muscles beneath your breasts 4. Bend forward and tighten your chest muscles to look for any changes in contour 5. Clasp your hands behind your head and turn side to side
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Treatment Deciding what treatment is best for each individual can be dependent on the stage and grade of the cancer, as well as the patientâ€™s general health, and whether the patient has experienced the menopause. The main treatments are: Surgery A patient will have breast-conserving surgery to remove the tumour, or a mastectomy to remove the whole breast. Lymph node surgery can also be carried out to determine whether the cancer has spread. Surgery is usually followed by chemotherapy or radiotherapy. Chemotherapy Chemotherapy involves using cytoxic medication to kill the cancer cells. This is usually done after surgery to destroy any remaining cancer cells, but can be done before surgery to shrink a large tumour. Radiotherapy Radiotherapy uses controlled doses of radiation to kill cancer cells. With celebrityangels.co.uk
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breast cancer, a patient can have breast radiotherapy to the whole of the remaining breast tissue, chest wall radiotherapy if the patient has had a mastectomy, a breast boost of highdose radiotherapy in the area where the cancer was removed, or radiotherapy to the lymph nodes.
Remember Being diagnosed is emotionally, as well as physically, draining. Take it easy and talk to your friends and family, as well as people in the same situation as you. Most importantly, know that youâ€™re not alone
Prevention The causes of breast cancer aren't fully understood and it is not known whether the disease is possible to prevent. Attending routine screenings, regularly checking your breasts and leading a healthy lifestyle can help to lower the risk of cancer. According to studies referenced by the NHS, regular exercise can reduce the risk of breast cancer by as much as a third. A healthy lifestyle may also help the outlook of those living with breast cancer. Maintaining a healthy weight and decreasing intake of saturated fat and alcohol is especially important for women who have been through the menopause. Being overweight or obese causes more oestrogen to be produced, which, in turn, can raise the risk of breast cancer. If you have an increased risk of developing breast cancer, undergoing a mastectomy, or a nipple-sparing mastectomy, can reduce the likelihood by up to 90 percent. Medication may also be available for increased-risk women, usually taken once a day for five years. â€˘ Live to 100 with Dr Hilary Jones | 107
A cancer survivor’s story This is Margarita’s story. It’s a powerful reminder about how regular breast self-examination, fast cancer diagnosis and the latest technology can save lives and improve how people feel about their treatment.
In 2017, Margarita discovered a lump in her right breast. She decided she wasn’t going to take any risks and immediately arranged to see her GP. Following a mammogram, she was told that she had cancer and needed an intensive course of treatment. This included a lumpectomy and radiotherapy typically involving permanent skin markings to target the treatment area. Thanks to Surface Guided Radiation Therapy (SGRT) technology, and the expert treatment and support she received from GenesisCare’s Nottingham centre, Margarita was able to make a full recovery. And this new treatment avoided the need for the permanent skin markings Margarita wanted to avoid. “When I found the lump in my breast I assumed the worst. The mammogram showed it was cancer. I felt like I’d been hit by a train. All I could think was, “Please don’t let me die”. I have a profoundly autistic son who needs me, and my daughter was in her second year of her nursing degree. I was frightened of leaving them, and worried about the implications of the treatment. “I was diagnosed with stage 2 breast cancer, but the prognosis was good, and the tumour was relatively straightforward to treat. However, my cancer still required a lumpectomy, four weeks of radiotherapy and years of tamoxifen tablets. Telling my family and friends was also extremely difficult. “I had my lumpectomy in February 2017 and was transferred to the GenesisCare centre in Nottingham, under the care of Professor Chan, to begin radiotherapy. “I’d heard that radiotherapy involves permanent tattooing. So, when Professor Chan explained that I would be the first patient at the Nottingham centre to receive SGRT, which doesn’t require a tattoo, I was incredibly relieved. My scars were fading, but the tattoos would have been permanent.
I wanted to move on with my life, put the cancer behind me, so not having to look at a tattoo every day was a huge positive for me. “Professor Chan also explained that, by using SGRT, they could ensure maximum dosage to the treatment area whilst minimising radiation to normal healthy cells. It was comforting to be shown this technology and have it carefully explained.
“When I found the lump in my breast I assumed the worst. It was particularly bad timing as my father was in hospital.” Margarita
“The procedure itself was non-invasive, with no side-effects, and all of my many appointments were arranged to suit me. The centre in Nottingham was also easy to get to, all the appointments ran to time, and the receptionists were happy to arrange for a car to pick me up on any days I didn’t feel up to driving. “Now the radiotherapy treatment is over, I really appreciate spending time with my family and I’m so pleased that I can get on with my life without too many physical reminders of the cancer. “My advice to other women with breast cancer, and about to have radiotherapy, is to trust the professionals. Don’t be afraid to ask questions: the GenesisCare team, including my brilliant professor, couldn’t have been more friendly and helpful. The technology did its job for me and also took away the stress of having permanent tattoo markings. That was worth its weight in gold.” SGRT is a sophisticated technology and not widely available. GenesisCare is one of only two healthcare providers in the UK able to offer this advanced treatment.
Life doesn’t stop when you’re diagnosed with cancer. We think that’s a good thing. That’s why we provide the most up-to-date treatments and technology as standard.
GenesisCare centres: Birmingham
YOUR Healthcare In Association with GenesisCare
Going Private Private clinics are offering quick and effective cancer treatments as NHS waiting times continue to increase—here’s what you need to know
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Private cancer care offers patients fast and easy access to top clinicians, who treat patients at world-class facilities, empowering them to make treatment choices and be involved in their care —GenesisCare
the NHS and better facilities. But before moving forward with private cancer treatment, there are various things wouldbe private patients should consider.
Private versus NHS The NHS is working to improve cancer care by investing in new technologies in more NHS hospitals across the country, and offering vital and more accessible diagnostic imaging services in mobile and off-site locations. Recent reports have indicated, however, that its record of delivering efficient cancer care treatment has decreased. According to new statistics published by NHS England, 130,553 people in England alone waited for more than the recommended two weeks for their first appointment with an oncologist after being referred by their doctor, and 27,246 patients did not receive their first treatment for cancer within the recommended 62 days in the
round 8.4 million people in the UK live with some form of cancer, and, shockingly, one person dies of the disease every four minutes. These figures are enough to panic anyone, but Cancer Research UK indicates that half of all cancer patients survive the disease for 10 years or more following treatment. Some more common cancers also have extremely positive survival outcomes if diagnosed early— testicular cancer patients, for example, have a 98 percent chance of survival following treatment. While oncological treatment is available on the NHS to anyone who presents with the illness, more and more patients are opting to go private. Reasons for choosing private medical treatment for cancer vary from patient to patient but include the benefit of reduced waiting times, quicker test results, access to therapies and medicines otherwise unavailable on
YOUR Healthcare In Association with GenesisCare year from June 2017 to June 2018 (the biggest total since 2009). Days can feel like a lifetime to those awaiting diagnosis and treatment for a potentially deadly disease, which makes private cancer treatment all the more attractive. Some private clinics also offer same-day consultations for diagnosis, and, in some cases, provide same-day test results. Generally speaking, the same traditional cancer treatments like radiotherapy and chemotherapy are provided by both the NHS and in private medical clinics alike. Treatments on the NHS, however, are rigorously regulated. The NHS can only offer treatments that have successfully completed clinical trials set out by National Institute for Health and Care Excellence (NICE). This means that some alternative—or newer—cancer treatments may not be accessible to NHS patients. Private clinics, on the other hand, can often offer their patients new treatments and medicines which may not be automatically available on the NHS.
consultation with a cancer specialist alone can cost upwards of £100. Patients can either pay for private cancer treatment outright, or they may wish to acquire private health insurance. Private health insurance is a policy patients can take out to cover their medical expenses. Policies vary from provider to provider and the amount that can be covered depends on an individual’s medical history. Patients can tailor a plan to meet their needs. Many plans cover cancer screenings, surgical procedures and therapies including radiotherapy and chemotherapy for a relatively low monthly lump sum. •
CLINICAL TRIALS A clinical trial aims to tell researchers whether a new treatment is safe and effective, or whether it offers better outcomes than treatments already in place. Patients may be able to join a clinical trial if they meet certain criteria. For more information about joining a cancer-specific clinical trial, speak to your doctor or visit the Cancer Research UK website for more information
NEW & UNTESTED TREATMENTS Before a treatment or drug can become available on the NHS, it must be reviewed and approved by NICE (or in Scotland, the Scottish Medicines Consortium (SMC)). This cannot be done unless clinical trials testing the new therapy have been successful. Even if a new treatment has completed a clinical trial, the NHS may still not offer it to patients. This is because some new treatments are costly and require specialist training, meaning NHS hospitals in the UK may not be able to provide them by the time patients need to receive them. In private medical centres, however, these treatments may be available to patients without having fully undergone testing in clinical trials.
PAYING FOR PRIVATE CARE Private healthcare, while attractive, can sometimes be pricey; a single celebrityangels.co.uk
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Revolutionising Cancer Care with
Proton Beam Therapy The UKâ€™s first proton beam therapy patient heralds a new era for cancer care in britain
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Treating the ﬁrst person in the UK with high energy proton beam therapy is a signiﬁcant event, and it opens up a new frontier for treatment in the UK
his year saw a landmark moment for cancer patients in this country, when it was announced that the first patient to receive high energy proton beam therapy here in the UK had commenced treatment, heralding a fundamental change in British cancer care. Simon Hardacre received treatment for prostate cancer at the Rutherford Cancer Centre South Wales in Newport, which is currently the only clinic in the UK where high energy proton beam therapy is available. Its sister site, the Rutherford Cancer Centre North East, in Northumberland, officially opened in August, whilst the centre in Reading opened in October. Construction is in progress on the centre in Liverpool; it is due to open its doors in 2019. Mr Hardacre said: ‘When I was diagnosed with prostate cancer, I wanted to research the best possible form of treatment for me, which is how I came across proton beam therapy. I am delighted to say the treatment has gone exceptionally well in that I have been given intensive cancer care without suffering any gruelling side effects. ‘It will take some time before I know that the therapy has been a complete success, but what I know is that my body has been spared damage to healthy tissue and I have been able to go about my daily life during treatment. ‘I was told to expect that my body would show signs of improvement in terms of how I was feeling within three months and that has already happened in even less time. I realise that protons are not the answer in every case—and I still have to wait to see how things finally work out— but I genuinely believe we are in a new era of cancer care in this country now that proton beam therapy is finally available.’ Mr Hardacre, aged 56, from Woolaston in the Forest of Dean, was treated for another form of cancer a few years ago with chemotherapy and radiotherapy, and found recovery tough. He said: ‘Being treated at the Rutherford Cancer Centre South Wales
meant that I was only a half-hour drive from home during treatment, and I could go about my daily life. ‘It’s brilliant that we now have a worldclass facility here in the UK where patients like myself can be treated. This was a game changer for my own cancer treatment, and I’m sure that this will transform the outlook for many other patients up and down the country.’ Dr Jason Lester, the consultant oncologist who treated Mr. Hardacre at the Rutherford Cancer Centre, said: 'Treating the first person in the UK with high energy proton beam therapy is a significant event, and it opens up a new frontier for treatment in the UK. ‘In the case of Mr. Hardacre, we feel really positive about the way he coped with treatment. He will need regular check-ups in order to monitor his progress,
and it was great to see him benefit from having treatment so close to home with minimal disruption to his daily life. We hope Mr. Hardacre is the first of many to see the benefits from proton beam therapy treatment here in the UK.’ Proton Partners International is building eight centres across the country over the next few years to provide a treatment centre within 90 minutes of 75 percent of the population. Each centre will offer treatments such as chemotherapy, radiotherapy and immunotherapy on top of high energy proton beam therapy. There are more than 90,000 cancer patients in the UK who are treated with radical radiotherapy every year. Proton Partners International believes around 10 percent of patients treated with radical radiotherapy—the figure accepted at European level—could be better treated with proton beam therapy. Proton beam therapy is particularly effective for tackling hard-to-reach tumours, as well as the treatment of children, as it reduces damage to surrounding healthy tissue. Mike Moran, chief executive officer of Proton Partners International, said: ‘For us, it is hugely important that patients are treated as close to home as possible, and it’s great that this year the country will have significant facilities available to patients. The NHS is opening a proton beam therapy centre soon in Manchester and our own facility in Newport, Wales, is already fully operational and is treating patients with proton beam therapy.’ At present, treatment at the Rutherford Cancer Centres is open to self-funded and insured patients, as well as NHS patients should the centre be commissioned to provide proton beam therapy for them.
www.therutherford.co.uk 0800 210 0402
Proton Therapy an area of the body where subsequent damage would be serious—such as complex child cancers of the brain, spinal cord or optic nerve—proton therapy may be recommended.
Treatment planning for proton therapy is similar to conventional radiation procedures. The treatment is an external beam of positively charged particles that are sped up using a machine called a synchrotron or cyclotron. The protons are directed to the intended area and deposit a dose of radiation into the cancerous tumour before stopping. Usually, the treatment lasts around 15 to 30 minutes with the patient spending up to one hour a day in the treatment room. The patient must be in the same position for each day of treatment and may be fitted with an immobilisation device. For example, a facemask or bite-block may be used. Fiducials may also be inserted to guarantee that the procedure is precisely
hilst conventional radiotherapy is normally safe and effective in killing cancer cells, like all treatments, it has a list of side effects. Most concerning is that radiotherapy damages the healthy cells surrounding the cancerous area being treated. Proton therapy—also known as proton beam therapy—is a type of radiotherapy that combats this. Unlike conventional radiotherapy, proton therapy uses beams of accelerated protons (sub-atomic particles) to kill the cancer cells. This beam stops once it targets the cancerous cells, resulting in less damage to the surrounding tissue. If the cancer is in
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What to expect
located every time. This type of therapy is painless, patients have not reported any discomfort during their sessions. The number of treatment sittings also depends on the type and stage of cancer. Treatment does not require an overnight stay and doctors may use proton therapy alone or combine it with other treatments. After the therapy, patients may experience side effects.
Is it as good? According to the NHS, it is still unclear whether proton therapy is as good at destroying cancerous tissue as conventional radiotherapy. The therapy is considerably new to the UK and is recommended for rare, specific types of cancer, limiting the systematic evidence available. People who have received proton therapy in other countries have reacted well—figures and research seem very promising. Proton therapy may deliver up to 60 percent less radiation to surrounding
Proton therapy is a new and innovative type of radiotherapy that can limit the damage to healthy tissue
Side eﬀects of conventional radiotherapy and proton therapy can occur during treatment, directly after treatment or months to years after treatment
cancer patients are offered proton therapy per year at the Christie NHS Foundation Trust in Manchester and University College London Hospitals NHS Foundation Trust
Source: Cancer Research UK
healthy tissue. Other benefits may include the possible allowance of a higher, controlled dose of radiation that can increase the chances of all cancer cells being destroyed. There are also some studies that suggest patients present with fewer side effects after undergoing proton therapy compared with conventional radiotherapy treatment. In a study funded by the US National Cancer Institute and Massachusetts General Hospital, 59 children with medulloblastomas (brain tumours) were treated with proton therapy. The results concluded that both hearing loss and cognitive impairment effects were both slightly less than conventional radiotherapy statistics. The NHS has analysed these results on their website, stating that they 'seem positive’.
PROTON THERAPY IN THE UK Currently, there is a low energy proton machine at the NHS Clatterbridge Cancer Centre in Merseyside, used to treat some specific eye cancers. Around £250 million has also been committed for the NHS to build a proton beam centre in both London and Manchester—these centres are expected to open in the near future. Meanwhile, there have been around 400 optimal patients, mostly children, who have been sent abroad for centrally funded treatment since 2008. On average, these patients were abroad for nine weeks. Some overseas clinics strongly recommend proton therapy as a treatment to parents who have sick children. This could be problematic as proton beam therapy is more costly than conventional radiotherapy. •
Side effects How do proton therapy side effects compare with those of conventional radiotherapy? There are far fewer side effects with proton beam therapy compared to conventional radiotherapy. This is because less ‘normal’ tissue is irradiated, and the proton beam is able to directly target the tumour itself, stopping at a defined point and not continuing beyond the cancer throughout the rest of the body. Recent technology has made precision radiotherapy a reality for proton beam therapy— through the use of modern imaging with computerised tomography (CT), an MRI scan allows us to define precisely where in the body the beam needs to go, making this a hugely accurate and effective procedure. —Professor Karol Sikora, chief medical officer at Proton Partners International
DID YOU KNOW? Cancer Research UK estimates that only 1 in 100 people with cancer would be suitable for proton beam therapy Source: NHS
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Fighting Cancer with
adiotherapy is a type of cancer treatment that uses high-energy rays to kill cancerous tissue and stop it from growing or
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spreading in the body. Although this type of treatment can also damage healthy cells, these can usually repair themselves, while cancer cells can’t. Radiotherapy— which is considered the most effective cancer treatment after surgery—may be used in the early stages of cancer or after it has spread. It can be used to: try to cure the cancer completely, also known as curative radiotherapy; complement other treatments—such as chemotherapy— and make them more effective; reduce the risk of the cancer recurring after surgery; and relieve symptoms if a cure isn’t available. Discuss the suitability of this treatment with your doctor—its effectiveness greatly varies from person to person.
Different types of radiotherapy According to Macmillan, the leading cancer charity, there are two main ways to administer radiotherapy. External-beam radiotherapy is given from outside the body by a machine, injection, capsule or drink, while internal radiotherapy consists in a radioactive material (usually metal) temporarily placed inside the body. External radiotherapy will most likely require an outpatient visit, whereas internal radiotherapy may require the patient to spend a few days in hospital. This is also the case for individuals undergoing chemotherapy at the same time, a treatment called chemoradiation. While radiotherapy
According to Cancer Research UK, around 27 percent of patients diagnosed with cancer in England during 2013-2014 underwent radiotherapy as part of their cancer treatment
YOUR Healthcare sessions will take place in a hospital’s radiotherapy department, it’s important to take note that not all hospitals have these— this is because radiotherapy machines are very expensive, and the treatment must be given by highly trained staff.
BEFORE & DURING TREATMENT A specialist cancer doctor will schedule scans to detect the position of the cancer to plan treatment. Patients may need to stop eating or drinking for a while before therapy, but this depends on individual cases. External beam radiotherapy doesn’t hurt, but individuals may find it difficult to stay in position while undergoing it. It will take place in a special room with a linear accelerator machine and may last up to 20 minutes per session. The type of internal radiotherapy patients undergo depends on their condition; this is done as an inpatient procedure.
SIDE EFFECTS Even though radiotherapy is effective in killing cancer cells, this sometimes comes at the expense of healthy cells. Many of its side effects can be treated or prevented and most will disappear after treatment ceases. Patients may also be asked to remain in hospital and avoid close contact with other people as a precaution as radiation from implants and injections can remain in the body for a few days. External radiotherapy, on the other hand, will not make patients radioactive as the radiation passes directly through the body. According to NHS Choices, some side effects of radiotherapy may include: • Sore, red skin. • Feeling tired most of the time. • Hair loss in the area being treated. • Feeling sick. • Loss of appetite. • A sore mouth. • Diarrhoea. •
Improving the lives of people with cancer Elekta is the leading innovator of equipment and software used to improve, prolong and save the lives of people with cancer and brain disorders. Our treatment solutions and oncology informatics portfolios are designed to enhance the delivery of radiation therapy, radiosurgery and brachytherapy, and to drive cost efficiency in clinical workflows. Crawley, our UK headquarters, has played a critical role in Elekta’s innovation and manufacturing history. The world’s first digital accelerator to deliver precision and radiation therapy was developed and built in Crawley more than 60 years ago. Elekta’s Crawley facility is also where the company’s latest groundbreaking innovation—the Elekta Unity magnetic resonance (MR) radiation therapy system— was developed. By integrating diagnostic-quality MR imaging, advanced linear accelerator technologies and advanced treatment planning into a single platform, Unity allows clinicians to see and track difficult-to-visualise soft tissue anatomies while radiation dose is being delivered and ushers radiation therapy into the age of personalised, precision cancer care. Elekta believes that Unity will become a cornerstone of new radiation therapy regimes. To learn more about how Elekta is using precision radiation medicine to work towards a future where everyone can benefit from precise and individually tailored radiotherapy treatments, visit elekta.com.
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Joint pain usually occurs as a result of trauma or arthritis and, depending on the severity, can require a knee or hip replacement
he most common causes of joint pain and subsequent replacement are trauma and arthritis, a condition that affects around 10 million people, says the NHS. According to Arthritis UK, more than 30 million working days are lost because of arthritis and other musculoskeletal conditions each year, with many sufferers giving work up entirely because of the condition. In cases where arthritis is severe, hip or knee replacements may be necessary to regain mobility and improve quality of life.
Hip replacement Hip replacement procedures are most commonly carried out in people between the ages of 60 and 80, and involve replacing a damaged hip joint with a prosthesis. Hip replacement surgery is only offered if all other methods of treatment, including physiotherapy or steroid injections, have been exhausted. The surgery, which is usually carried out under anaesthetic or epidural, takes around 60 to 90 minutes to complete. Recovery Recovery post-op tends to be quite 118 | Live to 100 with Dr Hilary Jones
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demanding and requires dedication to a regimented routine to heal well. NHS Choices states that a walking aid (such as crutches) will be necessary for four to six weeks following the procedure. Patients may be required to participate in an exercise programme designed to help improve joint mobility. Patients are usually able to resume normal activities within two to three months. Potential risks While the risk of complications following hip replacement is relatively low, these can include injuries to the blood vessels and nerves, increased risk of fracture, dislocation of the hip joint and infection.
Knee replacement Also referred to as arthroplasty, knee replacement surgery becomes necessary when the joint is damaged to the point that normal mobility is significantly reduced and the area is painful when resting. While the most common reasons for knee replacement surgery is osteoarthritis, gout, haemophilia, bone dysplasias and rheumatoid arthritis are listed among the common causes for
98% Osteoarthritis was the main indication for surgery in this percentage of knee replacement patients in 2015 Source: State of Musculoskeletal Health 2017, Arthritis UK
knee joint damage. There are two main types of knee replacement surgery: total knee replacement (TKR), whereby both sides of the knee joint are replaced; and partial knee replacement (PKR), whereby just one side of the joint is replaced. Which procedure you will need will depend on the severity of damage. Recovery Hospital stay time can vary, but typically lasts between three to five days. Walking aids may be required for up to six weeks following surgery. Full recovery can take up to two years, with some patients still reporting pain even after this time period. Potential risks The risks associated with arthroplasty include infection, stiffness of the wound, ligament or artery damage, blood clots, deep vein thrombosis and fracture. Complications tend to be quite rare, however, as knee replacement surgery is a very common procedure. â€˘
Out of Joint
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“The perfect place to recover from orthopaedic surgery” MR MARK RICKMAN, CONSULTANT ORTHOPAEDIC SURGEON The Clavadel is a 32-bed, purpose-built treatment and recuperation centre situated close to the Surrey Downs in leafy Guildford. Specialising in post-operative rehabilitation and convalescent care, it offers round-the-clock nursing and is the ﬁrst of its kind in the UK. Whilst successfully managing a wide range of conditions, The Clavadel offers particular expertise in rehabilitation following knee and hip replacement. Under the supervision of experienced therapists, its state-of-the-art hydrotherapy pool with underwater treadmill, massage jets and walk-in
INFO@THECLAVADEL.CO.UK OR CALL
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access at poolside will help stimulate movement and recover mobility. In addition, a dedicated physiotherapy suite, equipped with cutting-edge GAME READY technology, is on hand where skilled physiotherapists can employ a system of ice therapy and intermittent compression to treat chronic injury and aid recovery. Often likened to a hotel, our inclusive care and treatment packages start from as little as £1425 for a ﬁve day short stay. The well appointed rooms are air conditioned and feature en suite bathrooms, WiFi, Sky TV, and all meals and drinks.
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10 Tips for Healthy Feet
Our feet really do carry the weight of our world, and they can suffer for it, too
Check your feet frequently
Once a week, inspect the soles of the feet for scaling and look for any peeling between the toes that could indicate athlete’s foot. Nail fungus can be identified by discolouration of the nails, and diabetes may cause visible foot sores and infections.
Wash often & dry well
Daily washing with soap and water is necessary to maintain foot hygiene. Fungal organisms thrive in moisture, so it is important to thoroughly dry the feet and the space between toes. 120 | Live to 100 with Dr Hilary Jones
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3Moisturise & file
Applying a moisturising cream to the feet (avoiding between the toes) can replenish dry skin. For hard skin and calluses, soften the feet in warm water and use a pumice stone or a foot file to exfoliate and remove dead skin cells.
Trim toenails properly
When trimming toenails, it is important to cut straight across. Cutting at an angle, cutting too close to the skin or cutting down the edges of the nail can cause painful ingrown toenails.
Wear suitable shoes
Wear heels and pointed shoes sparingly, as these can damage your feet and cause calluses. On the other hand, wearing flipflops too often can cause arch and heel pain. Shoes that do not fit properly can also cause long-term foot problems.
6Change your socks
Changing your socks daily will help your feet stay fresh and odourless. Bacteria are more likely to sit on the surface of polyester and synthetic fabrics, causing fungal infections.
7Avoid foot bugs
Protect your feet in public areas—such as gym showers and public swimming pools—by wearing flip-flops. These areas can be breeding grounds for fungi, which cause infection.
is not caring 8Sharing
Sharing shoes and socks can invite fungal infections to the feet. This includes rental shoes, such as those at a bowling alley.
There are 250,000 sweat glands in a pair of feet, and sweat is the perfect cause for bacteria to thrive. Shoes made of leather or mesh fabrics will provide air circulation and help the feet to breathe.
when to see a doctor 10Know Self-treating foot conditions can often make the problem worse. Talk to a doctor about any persistent swelling, discolouration or pain to prevent the development of more severe complaints. Symptoms can normally be cleared up with prescription medicines, orthopaedic insoles or minor procedures. •
ccording to the College of Podiatry, nine out of 10 individuals experience a foot problem and one in five suffer with constant foot pain. Neglecting the feet can lead to unnecessary aches and other foot-related health problems, and can even affect the way you walk. Symptoms can also be a sign of underlying medical conditions such as diabetes, arthritis and kidney or heart disease. Here’s how to keep your feet healthy and pain-free.
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E-–M-– T S Y S –– –––-–----
REVOLUTIONARY FOOTWEAR TO SUPERCHARGE YOUR WALK A groundbreaking development in Wolky footwear is taking Europe by storm! Everyone who tries our new e-walk® shoes is shocked and amazed with how comfortable they are. It only takes a few steps and even skeptics are convinced. e-walk® footwear has elevated and redefined the comfort shoe. So what makes them so special? e-walk® offer a triple threat of excellent features. They are fashion, support and maximum comfort – all in one shoe. 1. STURDY SOLES MAKE WALKING A PLEASURE When you try on an e-walk® you will immediately notice the sturdiness of the soles. They are made up of two parts: a dual-density EVA midsole and a rubber outsole. The thin layer on the top of the midsole is firm and stops at the bending point to give the special Roll Effect. This is our special Roll-a-Way technology that gets your foot rolling off the ground effortlessly and automatically. The bottom layer of the midsole is thicker and softer for extra shock absorption. The outsole provides a firm grip and wear resistance. You don’t have to worry about slipping or twisting your feet ever again. 2. BETTER SUPPORT THAN ATHLETIC SHOES You can’t compare the e-walk® to traditional sneakers! They consistently outperform sneakers in every way. Sneakers don’t have the Roll-a-Way technology and their soles are too soft to be properly supportive. And while soft soles might feel more comfortable at first, lasting comfort comes from having the correct support where you need it, for long term foot health. 3. FITS LIKE A GLOVE We cut zero corners to make e-walk® the absolute best in comfort. We chose a special stretching leather that is produced by only two tanneries in the world. This top-grade material is used in the upper and the apron, so the shoe fits every foot regardless of size and shape. The stretching leather means the shoe feels great all day, everyday, on every foot. Even those who suffer from a bunion or a hammertoe can easily wear the e-walk® because the leather just stretches where it needs to.
–-–---––-–-––-–-– ULTR A-SOFT
STRETCH LEATHER –-–---––-–-––
The Roll-a-Way system (A) in the lightweight sole gets your foot rolling off almost automatically. So you can cover longer distances with less effort. What’s more, the e-walk® has an upper made of ultra-soft stretch leather (B), so this shoe fits like a glove. FEATURES GALORE! And are you ready for the best part? It’s a great deal! There’s no shoe on the market that even comes close to the e-walk® when considering all the features: • The unique Roll-a-Way technology that eases the repetitive heel-to-toe rolling motion of walking (1). • The rubber outsole providing a firm grip and wear resistance (1). • Proper support of the foot (2). • The upper of exclusive stretch leather for a perfect fit (3). • Use of top-grade materials. • A removable footbed. MORE THAN MEETS THE EYE Once you try on the e-walks® you will understand why everyone who has tried on a pair says the same thing, “The BEST shoes ever!”. The firm grip of the shoe and the incredible support make it unlike any other shoe on the market. But you can’t tell by just looking! You might think they look bulky at first – but once you put them on you’ll never want to take them off. There’s so much more than meets the eye.
Shop online: www.wolkyshop.co.uk/e-walk
e-walk® 05802 e-boot / 05804 e-walk / 05805 e-step
The M Word A
ccording to a recent study carried out by the British Menopause Society (BMS), around three-quarters of women say the menopause caused them to change their life and over half admitted its symptoms had a negative impact on it. The menopause is still very much a taboo subject in the UK, something many don’t feel comfortable talking about. The report, which was published on World Menopause Day 2017 (18 October),
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DID YOU KNOW? Women can lose up to 20% of their bone density in the 5 to 7 years after the menopause; this is caused by a decrease in the levels of oestrogen in the body, a hormone which helps protect bone strength. To maintain healthy bones, stay active, eat a balanced diet, get as much sunlight as you can, drink sensibly, quit smoking and consider HRT
highlights the need for greater support for women experiencing this inevitable change in their life. Brought about by a biological shift, the menopause is when a woman stops having periods and is no longer able to get pregnant naturally. Although it typically occurs between the age of 45 and 55, around one in 100 women experience it before the age of 40—a condition known as premature menopause or premature ovarian insufficiency.
Though it is an inevitable natural process in every woman’s life, the menopause can also be a time of deep anxiety and distress
OVER60 60 OVER
TIPS FOR A HEALTHY MENOPAUSE • Eat regularly. Skipping meals will make it difficult to maintain a healthy weight and achieve daily nutritional requirements • Five a day. Consume five or more portions of different fruits and vegetables a day • Phytoestrogen-rich foods. Eat foods rich in phytoestrogen— compounds that naturally occur in plants—like soya milk, pulses and linseed bread to reduce flushing and lower cholesterol • Oily fish. Consume at least one portion of omega 3-rich oily fish a week like herring, mackerel, tuna and salmon • Keep caffeine low. Watch your intake of stimulants like caffeine and alcohol • Physical activity. Walk or cycle at least 30-40 minutes a day to keep weight under control
POSSIBLE TREATMENTS Menopause cannot be treated, but its symptoms can be managed. Although not all women will want or need treatment, family doctors are best placed to advise patients on the various management options. The most well-known treatment—possibly because it has been controversially linked to a higher risk of breast cancer in multiple studies—is hormone replacement therapy (HRT). This form of treatment involves taking oestrogen to replace the decline of the hormone in the patient’s body. Available as tablets, skin patches, gel or implants, it is an extremely effective way of relieving symptoms. Some side effects include headaches and breast tenderness—in some women, it is also associated with blood clots and breast cancer. Alternative treatments, such as herbal remedies celebrityangels.co.uk
and natural hormones are generally not recommended by the health service and are considered non-traditional; this is because their safety and effectiveness are still relatively unclear. These therapies include supplements, acupuncture, chiropractic, homeopathy and specialised diets. Botanicals (medicines derived from plants) are also available to relieve uncomfortable symptoms of the menopause—make sure to discuss your wishes and options with your doctor. They will be able to advise you on the best course of action.
EARLY MENOPAUSE Premature ovarian failure (POF) affects around one in 100 women before the age of 40 and five in 100 before the age of 45. While doctors have different opinions on what the ‘normal’ age for menopause is, most consider it to be ‘early’ if it occurs before a woman turns 45. Some natural causes of POF are chromosomal abnormalities—such as Down’s syndrome—enzyme deficiencies and autoimmune diseases. According to NHS Choices, POF can also be induced through medical treatments damaging
egg production (like radiotherapy or chemotherapy), hysterectomies and infections such as tuberculosis, mumps, malaria and chickenpox. Women with premature menopause are also at a higher risk of osteoporosis. In these circumstances, many doctors recommend HRT until a woman reaches the 'normal' age of natural menopause (which is considered to be around 52).
EMOTIONAL EFFECTS Going through the menopause is a difficult time for many women. Despite it being a natural phase of every woman’s life, the subject is still surrounded by stigma. Every change that occurs in the body can affect your emotions and mental wellbeing. Many women report mood swings, anxiety and irritability. As hard as it may sound, it is important to think of the positives. Not having a period anymore can be freeing, especially if you’ve been plagued with particularly heavy or painful ones. Visit your doctor if you feel like you are struggling to cope with the menopause—whether that’s due to its symptoms or the anxiety it can cause. • LIVE TO 100 WITH DR HILARY JONES | 123
OVER 60 are more likely to develop varicose veins if a close relative also has them. Typically, varicose veins do not present with any problems and if they don’t cause discomfort or pain, then a visit to the doctor isn’t necessary. In some cases, however, varicose veins may induce worrying symptoms including aching, muscle cramps, dry and itchy skin over the affected vein and a burning sensation. In these instances, the NHS recommends patients seek medical advice where further tests can be carried out to assess any underlying medical problems and ascertain whether treatment is needed.
Although considered unsightly to some, varicose veins are rarely a cause for concern and don’t usually require medical treatment
aricose veins are swollen veins that typically occur on the legs or feet and are knotted and bulging in appearance. They happen when the elasticity in vein walls becomes weak and stretched, causing the venous valves (a flap-like structure within the veins) to lose strength. The valves work by keeping the blood flowing in one direction; if they fail or become weak, blood may flow backwards and collect in the veins, making them swell and bulge. This then results in varicose veins.
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CAUSES & SYMPTOMS Why some people get varicose veins isn’t fully understood, but experts have found that a number of factors increase the chances of susceptibility. For one, women are more likely than men to develop them. This may be, in part, because the hormone progesterone, usually present during pregnancy, relaxes the artery walls. Other risks include obesity, old age and standing for long periods of time. Genes may also be a contributing factor; the health service suggests that individuals
PREVENTION While it is not possible to completely eradicate the risk of developing varicose veins, there are some measures individuals can take to reduce the chances: • Try to walk around or move every 30 minutes to avoid standing or sitting still for too long. • Exercise regularly. • Raise legs when resting to ease discomfort and pressure. •
COSMETIC REMOVAL Removal of varicose veins for cosmetic reasons is not typically available on the NHS. Patients can choose to pay for private treatment, but this route tends to be quite expensive, costing anything between hundreds to thousands of pounds
Pain in the
Treatment of varicose veins is only recommended if complications arise, such as painful symptoms and leg ulcers or extra swelling. The most common treatments for varicose veins include: Endothermal ablation. Heat is used to seal the affected veins. Sclerotherapy. A chemical foam is inserted into the affected vein to close it off. Ligation and stripping. The affected vein is surgically removed while the patient is sedated under general anaesthetic.
Kiss goodbye to your veins Expert Consultants Day Case Procedure Minimal Discomfort Speedy Recovery Competitive Package Pricing
Consultation (including duplex ultrasound scan) Varicose Vein Laser Treatment - one leg Varicose Vein Laser Treatment - both legs Spider Vein Treatment
£300 £1,975* £2,675* £300
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For more information or to book an appointment:
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Private Health Insurance on a Budget
Investing in affordable health insurance could save you time and relieve pressures on the NHS— here’s how to make the process easier
KNOW WHAT YOU NEED Selecting a health insurance plan based on your independent needs will save money on unnecessary expenses. A few options are: outpatient cover, comprehensive cancer cover, mental health cover and therapies cover. Reducing outpatient cover, tweaking your policy to include fewer hospitals and adding an excess can also save on fees.
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SHOP AROUND Comparing health insurance quotes will help you to find a more suitable premium for the lowest price—there are plenty of online tools that compare quotes. You can also buy directly through insurance companies, or through a broker if you need the assistance.
CHECK IF YOU QUALIFY Around three quarters of the UK’s policies are provided by companies and cover around seven million staff members. In these cases, you can often add your spouse and children to the insurance at a subsided cost. Other money-saving areas to look into are: adding a six-week-clause option, taking out a joint policy, building a no claims discount and choosing a moratorium policy over a fully underwritten one.
and premiums tend to rise, making it more difficult to get a favourable deal.
STAY HEALTHY Some insurers provide discounts and cashbacks if you stay healthy and go to the gym. On the other hand, if you’re a smoker, your health insurance costs will likely be higher than those who do not smoke. Smokers must abstain for at least 12 months to be considered a non-smoker. •
DID YOU KNOW? Private health insurance doesn't usually cover pre-existing illnesses, drug abuse, normal pregnancy costs, organ transplants, infertility, A&E visits and non-essential cosmetic treatments
DON'T CHOP & CHANGE Unlike with car and home insurance, switching out your current provider can cause problems as most policies exclude pre-existing conditions. Also, as you get older you become more of a health risk
nly around nine million people in the UK have private health insurance, but covering the cost of your own medical care could shorten waiting times on the NHS, speed up diagnosis and provide access to specialist treatment and better facilities. Health plan options vary dramatically, allowing policies to be tailored to the needs of the individual. However, this can make navigating the world of medical cover overwhelming. Whether your health insurance is provided by your employer or comes out of your own budget, here’s how to make sure you’re getting the most affordable and effective cover for you.
You are in safe hands with HSF health plan
With HSF health plan, your healthcare is in safe hands. We provide healthcare for you and your family. Take advantage of over 30 benefits including money back for treatment on: l
Dental & Optical care
Chiropody & Podiatry
Specialist Consultations, scans and health screening
Hospital & Day Case combined
Plus much more.
Visit hsf.eu.com or call 0800 917 2208 and quote “CA” to find out more.
HSF health plan is the trading company of the Registered Charity, The Hospital Saturday Fund a Registered Charity in the UK No 1123381 and in Ireland No 20104528. HSF health plan Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority.
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MEDICAL Tourism MEDICAL Tourism
Health Tourism in… Major clinics, highly trained staff and special comfort areas are just a few of the reasons why Germany is standing out as a prime medical tourism destination
POPULAR SPECIALTIES The most requested specialties in Germany are orthopaedics, internal medicine, cardiology and cancer treatment Source: IMTJ
2,000 Germany has this many hospitals— they treat around 18.5 million people annually Source: IMTJ
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being a perfect hub for medicine and medical research. Standout clinics in the capital have elevated their status in the healthcare industry due to their highly trained staff and world-class facilities. Known for innovation, clinics and hospitals in Germany are also armed with the latest technology such as 3D ultrasounds, surgical robots, heart catheters and targeted radiation. In addition to state-of-the-art equipment, German medical facilities also adhere to strict hygienic measures, boast transparent treatment outcomes and offer comprehensive follow-up care to patients.
PRACTICALITY For anyone looking to bypass long waiting times, Germany offers patients
GERMAN HEALTHCARE The healthcare system in Germany is one of the most advanced and efficient in Europe. Its high standing can be attributed to the fact that Germany invests more financial resources into the development of its medicine than any other country in the EU—what’s more, the country also boasts more advanced results in the fields of cancer treatment, blood disorders, infertility and epileptic disorders. •
ccording to data published in the International Medical Tourism Journal (IMTJ), over 25,000 people from 177 foreign countries received medical treatment in Germany in 2018. The body also estimated that the country receives over €1.2 million from the medical tourism industry alone. But why are people choosing to travel to Germany for their healthcare needs, and what makes the country such a popular destination?
the possibility of booking and scheduling appointments quickly and easily. Nowadays, many companies offer travel insurance specifically for this purpose. Patients may choose to organise the trip themselves or enlist the help of a third-party company specialising in this particular industry. Alternatively, some clinics will facilitate the process, providing everything from travel and accommodation to post-operative care.
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For more interviews, news and features on the latest beauty treatments and procedures, visit celebrityangels.co.uk
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Flawless Pampering • TREATMENTS
BEAUTY • COSMETIC SURGERY
Plump Lips The New Craze Injectables
Safety Tips from Save Face
TREATMENTs for GREAT Hair
Turn Back the Clock Achieve Clear, Radiant Skin
ANTI-AGEING SKINCARE Flawless2-18.w-o spine for LTo100.indd 1
www.celebrityangels.co.uk laser treatments
the beauty industry continues to go from strength to strength, with non-invasive procedures more popular than ever
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eco-friendly in their packaging. Lastly, a major trend that has recently surfaced is customisation. Whether that means creating a foundation tailored to your skintone or a cleansing foam for your exact skin type, beauty companies are catering for this new demand for personalised beauty. Flawless presents you with all you need to know about some of the most common procedures from skin peels and keratin treatments to lip fillers and laser hair removal. This beauty manual will hopefully serve as your guide to the latest aesthetic treatments and help you make informed decisions. For more health and beauty-related news and features, visit celebrityangels.co.uk.
onsumers are increasingly looking for new technologies and products to add to their beauty routines. The cosmetic industryâ€”which is now estimated to be worth around ÂŁ3.6 billionâ€”continues to grow at an astounding rate and shows no signs of stopping. This is mostly due to new trends that are taking the market by storm. Treatments that allow consumers to see an instant 'fix' are now a main staple of the antiageing skincare movement. Individuals are now choosing 'environmentally responsible' products, giving rise to a very profitable area of the market dedicated to products that are made of natural ingredients and
The quest for full, shiny hair is a lifelong one—read on for the best salon treatments for healthy tresses
ore often than not, when we decide to pamper ourselves, giving our hair some much-needed TLC isn’t at the top of our priority list. Nails, massages, peels and scrubs usually take the top spots. However, whether it’s due to persistent straightening, styling or dyeing, our hair is constantly under massive amounts of stress.
Olaplex This treatment gives celebrity-worthy hair by reconnecting the hair strand where it’s broken. Especially beneficial for hair that is bleached or coloured, Olaplex conditions, locks and restores all hair types by linking damaged bonds. This particular treatment is done in three steps, two of which are carried out in a salon. The third step is a take-home treatment to be used once a week: apply to damp hair, comb through and leave on for about 10 minutes before washing.
Kérastase Fusio Dose Formulated with the aim of restoring some life into dull strands, this treatment targets anything from dryness, damage, frizz and lack of volume. A stylist will ‘diagnose’ your hair to determine its main issues. A custom-blended Kérastase treatment—specific to your hair type—is then generously applied. It will penetrate the hair fibre by using nanotechnology. With a duration of only five minutes, you’ll find your hair immediately transformed.
Inphenom Predominantly aimed at colour-treated hair that is prone to breakage, this treatment deeply penetrates the hair shaft and adds proteins to strengthen damaged locks. The Inphenom treatment consists of five steps—the first three are applied and rinsed with shampoo while the rest are processed with heat and left on—and takes about 30 minutes to complete.
Linkage Meu Perfect for anyone looking for softer and smoother hair, the Linkage Meu treatment is, essentially, a strong conditioner. It leaves hair feeling soft and smooth without weighing it down. Three different hydrating formulas are applied to damp hair—much like traditional hair masks. The process takes no more than 15 minutes and can be topped up at home to maintain results for as long as five weeks. F celebrityangels.co.uk
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We spoke with the national register of accredited practitioners, Save Face, about the lack of legislation in the non-surgical cosmetic industry and discussed their mission to make a positive impact
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id you know that practitioners who administer nonsurgical cosmetic procedures require no specific qualifications or certification by law? As the popularity of these treatments grows, so does the risk involved for potential clients. Save Face—a national registry of accredited nonsurgical aesthetic practitioners—discusses the dangers that exist for patients, the psychological effects of a botched job and how consumers can avoid such an experience.
provided services in association with beauty salons. This chartered new territory without reference to any expert authority to interpret and apply regulation developed with accountable institutions in mind. Given the exponential growth of the market and the commercial gains to be made, it is no wonder that providers have exploited the apparent loopholes in legislation and regulation and seized the opportunities to practice with apparent impunity. The resulting diversity of practice and growing accessibility of services—left unchecked for over two decades—has led us to Q: What impact do you hope Save Face will have on the where we are today. non-surgical cosmetic industry as a whole? Non-surgical cosmetic services may be provided by anyone, Save Face: Save Face is a government-approved register of anywhere. Where legislation and regulation are breached, healthcare professionals who provide sanctions are not robustly applied non-surgical cosmetic treatments. and fail to deter. It is reliably Entry to the register is only open to estimated that there are some registered medical professionals who 10,000 providers in the UK alone. Sadly, dotted in amongst all of can demonstrate that they are insured Approximately 800 belong to the reputable practitioners, there and have received certified training. All professional associations providing premises are inspected. Practitioners influence, guidance and political are a mass of unscrupulous must operate against best practice representation on standards and standards and have policies and education related specifically to people masquerading as trained procedures that demonstrate this. aesthetic medicine. This suggests professionals The ultimate goal is for the Save there are thousands who don’t know Face Kite Mark to become a default what they don’t know and likely do factor in the decision-making process not care. for someone who is considering a Q: What are some of the potential risks of having a non-surgical non-surgical cosmetic treatment. Through our public awareness procedure at a clinic that is not accredited? campaigns we hope to continue to educate the public about the SF: As our investigations continue to demonstrate, finding a safe, unnecessary risks they may be taking by choosing a practitioner reputable practitioner can quite simply be a lottery. Sadly, dotted who isn’t accredited. in amongst all of the reputable practitioners, there are a mass of The reality is, these sorts of procedures are becoming unscrupulous people masquerading as trained professionals. They increasingly popular amongst men and women of all ages and have often had little or no training and purchase cheap illegitimate consequently the number of unscrupulous practitioners is also products over the internet. rising. For Save Face, the objective and message is simple: to Frighteningly, these treatments are all too often considered provide an accessible service that enables people to obtain and categorised as everyday beauty treatments like having your non-surgical cosmetic treatments easily and safely. Save Face hair or nails done. In reality, it is a clinical procedure that can have removes the ambiguity and uncertainty on behalf of the patient, disastrous consequences when it is administered by the untrained empowering them with a service that means they no longer have to and unqualified. take practitioners at face value. It’s because of this that the consumer is blind-sighted by cheap Q: Why do you think that this particular industry isn’t governed deals and how glossy the website and clinic décor might be. People by the same rigorous regulations that others are? often neglect to pay any attention to the fundamental thing that is the SF: This field of practice is quite unique. Though medical in difference between a good treatment and what can be a nightmare: nature, there is no provision, nor ever has there been in the NHS, the skills and qualifications of the person holding the needle. which has left training and standards to evolve organically and In the last 12 months, we have seen an alarming increase in without recognised accreditation. The client base is healthy and the number of reports regarding procedures gone wrong and treatment is a choice rather than a necessity. Unlike other medical rogue practitioners. Figures have almost trebled in comparison procedures, it is possible to provide these in a variety of venues to the previous year. Over 83 percent of the reports we received with relatively low capital cost and overheads. Because of the were about treatments that were administered by beauticians, association with beauty, the vanguard of early adopters commonly hairdressers and other non-healthcare professionals. Upon
Images: Shutterstock; 123RF
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beauty treatments further investigation, a staggering 30 percent of all complaints we received were performed by people who had set themselves up with no relevant training whatsoever and were believed to be purchasing their products such as dermal fillers and botulinum toxin (Botox) over the internet. We received complaints relating to the following procedures (in order of the most numbers received): • Dermal fillers, which included lip fillers, cheek fillers, facial fillers to improve the appearance of skin folds and wrinkles, tear trough fillers to reduce eye bags and non-surgical nose jobs • Botulinum toxin • Laser treatments • PDO thread lifts • Chemical peels • Blepharoplasty; non-surgical eye lift using plasma skin tightening technology Seventy-nine percent of the complaints we received were related to dermal fillers, which can present serious risks if complications are not identified and managed properly. The vast majority of which were lip filler procedures. The most common complaints were: • Poor/uneven results • Unsightly lumps and nodules • Unusually painful swelling and bruising • Infection; more than 20 of the people who reported complications following botched lip filler treatment had to seek treatment from their doctor • Three women suffered vascular occlusion or impending necrosis (tissue death), which could lead to permanent compromise of healthy tissue
Q: What are the psychological effects of having a ‘botched’ treatment?
SF: Being a victim of a botched procedure has so many ramifications both physically and mentally. Many people spend months contemplating a procedure to address a particular concern and restore their confidence, only to be left feeling worse and more self-conscious than they did before. It has a devastating effect on their state of mind. We have had people contact us who won’t leave the house or that cry when they look in the mirror and have had to be prescribed anti-depressants. In most cases they have no way of seeking redress from the person who treated them as they have ceased trading or have no insurance. In fact, 72 percent of all complaints we received last year were from patients who had found the practitioner on social media pages such as Facebook and Instagram. This is a major concern and something that has escalated enormously in the last few years. Social media has become a hotbed for unscrupulous practitioners to advertise unethical deals and offers, which flout advertising rules. These practitioners only have Facebook or Instagram pages and often do not disclose the full name of the practitioner. This
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Being a victim of a botched procedure has so many ramifications both physically and mentally. Many people spend months contemplating a procedure to address a particular concern and restore their confidence, only to be left feeling worse and more self-conscious than they did before. It has a devastating effect on their state of mind
makes them nigh on impossible to trace when things go wrong, and when that happens, more often than not, they close down their page and then set up another one using a different business name. It is a vicious cycle which is opaque and impossible to police. Patients who fall into the wrong hands end up paying the price in every possible way: emotionally, financially and physically.
Q: In 2013, the Department of Health (DoH) commissioned a review into non-surgical aesthetic procedures. In it, they described dermal fillers as a ‘crisis waiting to happen’. Do you agree with this assessment? SF: Absolutely. We have received an increasing number of reports from patients who have been injected with cheap products that have been purchased over the internet from China. Our statistics confirm that dermal fillers can cause serious complications if they are not administered by a trained healthcare professional that is competent in identifying and treating side effects. When untrained practitioners administer unidentified products that have been purchased over the internet, the consequences could potentially be life-threatening.
Q: Generally, what legal rights do patients have if a nonsurgical procedure goes wrong? What advice would you give to somebody in this position? SF: Unfortunately, if a client has been treated by someone that is uninsured and unaccountable, there is little than can be done. Sadly, where there is legislation in place, little action is taken to act as a deterrent for those who continue to flout the rules. We are contacted all the time by patients who have fallen into the wrong 138 | Live to 100 with Dr Hilary Jones
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beauty treatments hands and have been completely ignored by the practitioner when something has gone wrong. We support them in every way that we can. We published a guidance document called the Anatomy of a Complaint, which informs patients how and where they can make a complaint.
Q: What specifications must a practitioner meet in order to be included on the Save Face website?
SF: Each and every practitioner and clinic listed on our register has been inspected against our robust set of standards. Entry to the register is only open to doctors, nurses, dentists and prescribing pharmacists. Although minor, these treatments are medical procedures, which we believe should only be carried out by trained healthcare professionals. We visit each clinic location and undertake all the necessary checks to ensure that the practitioner and the clinic have met each of our standards before they are listed on our register. When a patient uses Save Face to find a practitioner they can be assured that: • They are who they say they are • They are a registered nurse, midwife, doctor, dentist or prescribing pharmacist with specialist training and insurance in each treatment listed on their profile • They use licensed products sourced from reputable suppliers • They have all of the necessary paperwork in place to protect you from undue risk and harm • Their practice standards meet the requirements to provide you with safe treatments, in a safe environment Full details of the assurances that come with selecting a Save Face Accredited practitioner can be found on our patient charter.
Q: Are there any success stories you can share with us that involve a patient finding a safe and reliable clinic through your service? SF: We have had over 5,000 positive reviews from patients that are published on our website. Getting feedback from patients who have found a practitioner that they can trust and are happy with via the website is the best feeling and what makes it all worthwhile.
Q: You have received a considerable amount of press coverage regarding your involvement in exposing a fake doctor who had administered fake Botox treatments. Is this part of a wider initiative to stamp out dangerous practitioners? Do you have any plans in place to facilitate the discovery of other similar cases? SF: We have an endless list of unscrupulous practitioners we are currently investigating to ensure that they are exposed and are brought to justice—each has involved a breach in regulations. We are working with several patients who have been affected by practitioners who have left them with irreversible damage. We will ensure that they get the help and support they need and that these practitioners are stopped from operating in the future. F celebrityangels.co.uk
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Hello. We’re Skinsmiths. We’re a membership-based skin clinic on a mission to give everyone access to skin confidence.
The truth is, no matter what your skin concerns are, regular treatments are better than one-offs. “Consistency gets results!” says Skinsmiths Founder, Jackie Smith. We believe that great skin should be simple, achievable and accessible, that’s why we developed a Skin Health Membership to help you get your best skin. A tailored Skin Health Membership treats a range of skin concerns including; uneven skin tone, texture, lines and wrinkles, redness, rosacea, scarring and pigmentation. Working with us, you’ll plan a tailored treatment schedule with a mix of Conditioning Treatments and High Intensity Treatments to ensure your skin is being treated with the right tools, at the right time, to achieve the best results. And with easy monthly payments, great skin is accessible to all. Pop into your closest Skinsmiths clinic in Belgravia, Hanwell, Putney, Wimbledon, Clapham, Liverpool St, Tower Bridge, Esher or Bushey! Start your skin confidence journey today with a free skin consultation. Call us on 020 3473 3829, email email@example.com and quote FLAWLESS18. Head to skinsmiths.com or @skinsmithuk to get to know us better in the meantime!
(Below left) Selection of Skinsmiths products (below right) inside a Skinsmiths clinic
Laser Hair Removal
Including Microneedling, Fractional Laser & IPL
With our signature 2-year hair free guarantee!
Pay per unit for Dermal Filler & Wrinkle Relaxers
You canâ€™t stay young forever, but with a little help from the skincare gods, you can definitely try
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beauty treatments Step 2: Exfoliate
Step 1: Cleanse Ageing skin tends to lose moisture, nutrients and natural oils. Ditching the foam and opting for a gentle cream or oil cleanser can help to replenish moisture, making the skin on the face smoother and suppler. Cleansing in the morning and double cleansing at night is important for removing bacteria and pollution and for preventing pores from becoming clogged. It may sound obvious, but the purpose of cleansing is to clean your face. Save your active ingredients for later as cleansers aren’t on your skin for long.
Step 4: Moisturise + SPF Did you know that fine lines are often just symptoms of skin dehydration? This step is ideal for including hyaluronic acid products—a naturally occurring substance in the skin that has the capacity to attract and hold a thousand times its weight in moisture. Applying moisturiser (morning and night) to your neck and chest areas is also a must for ageing skin. Sunscreen is actually the most important anti-ageing product you can use. Apply it every day or include it in your moisturiser—even when it’s cloudy and raining.
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As you age, dead skin cells build up and the skin loses its ability to replenish fresh cells as quickly. Exfoliating with a physical or chemical exfoliant at least once a week will help to remove dead cells and brighten a dull, uneven complexion. Physical exfoliants are great, but it’s more sustainable to use natural DIY scrubs—like coffee grounds. Chemical exfoliants—or peels—add active ingredients into your routine. These work by dissolving the bonds between skin cells and allowing them to detach. Hydroxy acids are among the most common ingredients found in chemical exfoliants; the best for ageing skin are alpha-hydroxy acids (AHAs). Choose products that contain AHAs like glycolic acid and lactic acid to combat signs of ageing, such as fine lines and wrinkles.
Step 3: Apply a serum Serums are excellent sources of active ingredients and should be applied before your moisturiser to increase collagen production and lock in antioxidants. The most beneficial anti-ageing ingredients are vitamin A derivatives known as retinoids (retinol, tretinoin and tazarotene) and vitamin C (L-ascorbic acid and magnesium ascorbyl phosphate).
What’s the deal with eye creams? The skin on the eyelids is the thinnest on the body and becomes especially delicate as you age. Choosing to invest in a retinol or caffeine eye cream may reduce puffiness, pigmentation and fine lines celebrityangels.co.uk
Sensilift by Sensica The Rise & Rise of Non-surgical Anti-ageing Solutions
Long gone are the days when surgical procedures were the only way to tackle the obvious signs of facial ageing the fastest growing region, especially in the energy-based devices segment.
Sensilift by Sensica Perhaps with non-invasive anti-ageing devices you won’t look in the mirror and see a 20-year, youngerlooking version of yourself. However, for many, this outweighs the pain and risks of medical procedures. Women are also looking for cost-effective solutions with the least amount of down-time. Enter the Sensilift device by Sensica. A leader in the non-invasive devices market, Sensilift reverses signs of facial ageing and takes things a step further. Sensica’s medical aesthetics experts have adapted professional grade technologies used in clinics into a handheld device for convenient home use with the same remarkable results.
How does Sensilift work?
eople have always been absorbed with their outward appearance—today that is truer than ever. Whilst going under the knife was once the primary way to reverse signs of facial ageing, technological advancements have impelled global demand for non-invasive aesthetic devices and treatments. People are also increasingly aware of the negatives associated with invasive procedures, but are still willing to go to great lengths to look younger. With Sensica, they don’t have to go too far.
Statistically speaking The statistics speak for themselves. Data on the medical aesthetic devices market by Research and Markets shows that out of an estimated 23 million global cosmetic/aesthetic procedures in 2017, the majority were minimal or non-invasive. Non-surgical treatments generally include energy-based devices, such as radio frequency (RF), lasers and intense pulsed light (IPL). While North America is the biggest market globally for medical aesthetic devices, Asia-Pacific is
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Sensilift uses unique and proprietary patented dynamic RF anti-ageing technology to reach multiple deep skin layers simultaneously. This stimulates collagen and elastin production and provides a facial massage covering a wider surface area of the skin. In five minutes you can already see visible results. How? It reduces wrinkles by eliminating their depth and removing fine lines; improves the skin’s appearance, radiance and texture; and provides a feeling of firmness by lifting and tightening the skin. The device comprises safety sensors and is virtually painless. For optimum results, Sensilift should be used for five minutes once a week. It works on crow’s feet, cheeks, smile lines, chin and jawline, neck and décolletage and even the hands. Sensilift is intuitive and easy to use. It certainly provides a far less risky, painful and expensive alternative to a facelift or other cosmetic procedures. Who said you have to suffer for beauty? F
Available in larger Boots stores and online
0800 923 4830 | www.sensica.com
The New York Laser Clinic + MediSpa has been established as an award winning aesthetics company for over 14 years. Weâ€™ve built our brand by offering safe, effective treatments that deliver AMAZING results using revolutionary medical lasers, medical-grade treatments and skin-care products.
Baker Street Clinic | W1U 4HG 020 7935 0196 Bakerstreet@thenewyorklaserclinic.co.uk Bishopsgate Clinic | EC2N 4AJ 020 7256 6341 Bishopsgate@thenewyorklaserclinic.co.uk Fulham Clinic | SW6 1PU 020 7409 1083 Fulham@thenewyorklaserclinic.co.uk
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Ironing Out the
With both temporary and permanent solutions available, dermal fillers remain a popular option for those looking to instantly reduce the appearance of wrinkles
nti-ageing solutions and products have long dominated the wider beauty market space. So high is the demand that, according to Statista, global antiageing market sales are set to reach a colossal $199.5 million by 2022—up from just $89.7 million in 2017. It’s no surprise then that the popularity of dermal fillers—injections administered to plump skin and iron out wrinkles—is increasing. Practitioners promise rejuvenated and youthful skin in as little as 30 minutes. Before hopping off to the nearest cosmetic clinic for a lunchtime appointment, though, there are various things would-be patients need to consider.
Choices, choices Why are dermal fillers the anti-ageing go-to these days? As we age, the skin on our face loses its elasticity (collagen) leading to wrinkles around the eyes and mouth and sagging skin surrounding the jawline. Dermal fillers work to reverse the appearance of fine lines, wrinkles and scarring with instant results, creating a smoothlooking and filled out appearance. Dermal fillers can be either permanent or temporary depending on the type of filler product used. Collagen is used for an effect that lasts three to four months; hyaluronic acid works for around four to six months; calcium hydroxylapatite about a year and a half; poly-L-lactic acid can remain effective for up to two years; and polymethylmethacrylate beads (PMMA) is a lifelong—but most risky—option. What dermal fillers can’t do, however, is promise desired results or correct a sagging jawline. celebrityangels.co.uk
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Safety first As dermal fillers remain unregulated in the UK, make sure to research treatments, get professional advice and select an accredited, safe non-surgical practitioner by using organisations such as Save Face before committing to a procedure
Risks As with most procedures, there are risks associated with the use of dermal fillers. These range from rashes, swelling and bruising that are common at the injection site immediately after the procedure, to more severe risks such as infection and the development of lumps beneath the skin. In extreme cases, dermal fillers may block a blood vessel. With this complication, patients may experience permanent blindness, tissue death or a pulmonary embolism—a blocking of an artery in the lungs that can lead to a shortness of breath, chest pain and coughing up blood. If you are unhappy with the results or experience medical complications following the procedure, speak with the practitioner who administered the injections. If this is not possible and symptoms get worse, speak with your doctor or visit A&E. F Live to 100 with Dr Hilary Jones | 145
M A N A G E M E N T
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laser treatments can improve blemishes, remove wrinkles, plump up the skin and stump hair growth
n the past, getting a laser treatment was considered a drastic devotion to beauty, but new technology has made the use of lasers common, pain-free and extremely effective. With numerous different types of lasers and light therapies available, here are some problem areas that can be targeted for quick results.
Laser hair removal is a long-term method for hair reduction. The beam targets the skin and is absorbed by high pigment areas, i.e. hairs. The heat energy damages the follicleâ€”inhibiting growth, shrinking the follicle and eventually rendering it unable to grow new hairs. Most likely, several treatments will be needed because hairs are less responsive at different stages of the growth cycle.
Skin tightening Laser skin tightening heats the collagen under the skinâ€™s surface and causes skin cells to contract and clump together, making it appear tighter and smoother. This method encourages new collagen to grow in treated areas and also stimulates celebrityangels.co.uk
the absorption from surrounding, untreated areas. Two to three treatments are typically needed for optimal results. Skin tightening can also be customised to treat other areas of the body, such as the abdomen.
Skin resurfacing Laser skin resurfacing removes layers of skin with precision. During healing, new skin cells form to make the skinâ€™s surface look tighter and younger. A full-face treatment can take up to two hours, but parts of the face can be treated in around half an hour. Skin resurfacing can target wrinkles, sun damage, rosacea, scarring and unwanted lines or pigments.
Acne treatment Laser treatment is the fastest way to remove hyperpigmentation and scarring from healed acne, and it can also benefit inflamed breakouts. Lasers can target acne bacteria, reduce sebaceous gland volume and promote collagen, all without damaging the surrounding tissue. Again, multiple sessions are needed to build up results. Laser treatment for acne is also considered temporary, as colonies of acne bacteria can grow back quickly. Live to 100 with Dr Hilary Jones | 147
Do it at home Investing in an IPL (intense pulsed light) device can provide safe, longterm laser hair removal at home. Similarly, handheld LED blue light lasers work as a cheaper alternative to acne treatments
Thread vein removal Laser treatment can remove thread veins—fine, twisted blood vessels that run close to the surface of the skin—from the face, body and legs. The laser heats the blood vessels so that the blood coagulates and the vein breaks down. On average, five sessions are recommended to remove all blemishes, but a noticeable difference can be seen for many people after two treatments. This method can also be used to remove varicose veins.
Fungus removal Fungus can be very difficult to treat. Using a laser can penetrate through the nail plate to the nail bed, targeting the infection beneath the nail. The laser eliminates the fungus without harming the surrounding nail tissue.
Tattoo removal Tattoos naturally fade over time because the body recognises the ink as a foreign substance and tries to remove its particles. This natural process is incredibly slow, but can be sped up using lasers. Laser tattoo removal heats up the ink and breaks it down into smaller pieces that can be expelled quicker. The shallowest layers of ink come into contact with the laser first, so the process requires multiple treatments to penetrate the deepest layers. A dark or bold tattoo will also require more treatments than a lighter, shaded tattoo. F 148 | Live to 100 with Dr Hilary Jones
Is laser treatment right for me? ✤ Skin and hair tone. Treatments such as laser hair removal work best when there is a contrast between the colour of the skin and the colour of the hair. If the colours are similar, the laser could target the melanin in the skin instead of the pigment of the hair, resulting in burning, scarring and pigmentation. Black hairs on lighter skin work best as there is more pigment for optimal absorption. ✤ Side effects. The use of lasers in beauty treatments can cause redness, swelling, itching, breakouts, pigmentation, scarring and infection. Complications are rare, but receiving treatment from a reputable clinic can reduce the risk even further. ✤ Discomfort. Whilst most laser treatments are marketed as painless, many have described the procedure as a stinging sensation, or the feeling of a rubber band being snapped across the skin. ✤ Results. In most cases, laser treatments do not provide instantaneous results that last a lifetime. Multiple treatments are required to build up visible changes and these may need topping up, making the process pricey.
Better Spent? WITH A FIVE-YEAR DECLINE IN COSMECEUTICAL SKINCARE PRODUCTS, WE LOOK AT ALTERNATIVE NON-SURGICAL SKINCARE TREATMENTS
or years, anti-ageing skincare products dominated the UK cosmetics marketplace, with women using a variety of products— sometimes starting as young as their early twenties! —promising to ‘fight’ the key signs of ageing. According to Mintel, there has been a significant decline in sales of cosmeceutical skincare products over the past five years; a trend that could be easily attributed to consumers’ growing awareness of alternative, non-surgical aesthetic treatment options that promise them an ‘instant result’. Despite the importance of a good skincare regime and the role it can play in improving the appearance and health of our skin over time, consumers' demand for instantaneous improvement to their skin’s appearance is at an all-time high. British cosmetic laser manufacturer, Lynton, have recently launched 'the ultimate non-surgical' skin rejuvenation device, 3JUVE, which can be used to treat the three most common skin and anti-ageing concerns, using a variation of three different aesthetic technologies.
Dr Samantha Hills, clinical director at Lynton, said: ‘It is clear from both our research and growing industry trends, consumers are tired of spending thousands of pounds on anti-ageing skincare products every year, and now demand more noticeable, instant antiageing results without undergoing surgery. When we asked consumers about their main ageing concerns, the three overwhelming answers were: wrinkles, discolouration of the skin and a general loss of firmness and sagging of the skin. 'Our new 3JUVE treatment has been designed to tackle all three of these symptoms, allowing a professional aesthetician to build a bespoke treatment regime for every client.'
Find your local 3JUVE clinic at: 3JUVE.co.uk
Resurface | Wrinkles
By choosing a 3JUVE anti-ageing and skin health treatment, you are on your way to achieving a completely natural look and feel. The first technology, Resurface, retextures the surface of your skin, dramatically stimulating collagen fibres to reduce lines & wrinkles.
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Rebright | Veins & Pigmentation
As we all know, ageing skin isn’t just about lines and wrinkles, but also the noticeable discolouration of our skin caused by various factors e.g. sun damage, vascular outbreaks, diet, health and so on. Rebright IPL technology selectively heats and destroys any discolouration in your skin, helping to provide a flawless ‘airbrushed’ appearance.
Remodel | Tightening & Lifting
A loss of firmness and sagging around the eyes and jawline (sometimes referred to as jowls) are usually the most obvious signs of ageing. Utilising radio waves, Remodel causes micro-vibrations within the skin tissue to stimulate fibroblast cells, which then produce new collagen and elastin, creating stronger, firmer skin.
The public has been left in a state of panic as celebrities put an end to the big lip trend. Luckily, subtler cosmetic procedures for lip enhancement will never go out of style
ylie Jenner has allegedly decided to have her famous lip fillers removed. The youngest of the Kardashian/Jenner family, 21-year-old Kylie recently posted a more natural look on her Instagram account, informing shocked followers that she had removed her fillers. Whilst this may mean that the big lip phase is officially over, more natural enhancements have experienced a newfound popularity and demand. Cosmetic procedures have been on a definite rise in recent years (in fact, the UK cosmetic industry alone is worth a staggering £3.6 billion, says Harley Street Aesthetics), but a pair of full, plump lips has been a sign of beauty and health in women since long before the Kardashians were born. Luckily, recent cosmetic advancements have made them more accessible than ever—without the need for dreaded invasive procedures. By choosing the right doctor and knowing what to ask for, you can enhance your lips for the perfect, plump look.
Non-surgical lip injections Today, lip fillers commonly contain substances similar to hyaluronic acid—a natural compound that is found in the body and helps increase volume in the lips, reducing the chance of reactions. Fillers are injected into the lips to improve the shape, structure and volume. These effects typically last for around six months, so regular sittings are needed to maintain the desired results. Fillers allow for control over the volume of the lips, are reversible and generate significantly less bruising compared to other methods. In fact, this procedure has been dubbed a ‘lunchtime procedure’ with a quick and painless recovery— allowing you to show off your enhanced pout with confidence.
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Surgical fat transfers Another more natural-looking treatment; fat transfers use liposuction to move fat from other areas of the body, such as the patients’ thighs or hips. A portion of the fat augmentation will become permanent, but more than one sitting may be needed to achieve the desired result. Fat transfers can achieve subtle, aesthetic changes to the lips and make the skin appear smoother. Recovery is usually longer than with lip filler procedures. However, with fat transfers, there is no tissue reaction and less risk of extrusion. Once the swelling goes down, you’ll be left with the naturallooking lips you desire.
What to ask for Before jumping into the world of fillers, remember that research is key. Do you want a voluminous pout or a more rounded bow? Choose a reputable clinic—not a beauty bar—and request to see some before and after photos. Ask your doctor if your desired results are achievable and for additional information on the type of filler used, anaesthetic options, procedure and possible side effects.
The mini lip fill A mini lip fill treatment injects a small amount of filler in the body of the lips for a subtle plump. Alternatively, a small amount of dermal filler in the corners of the mouth may be a good introduction to more committed projects. For a more voluminous lip or for larger lips, more filler may be required.
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Tips for the perfect natural look ✤ Avoid too much filler. Gradually build up the amount of filler you insert. Starting with less is better and definitely more subtle ✤ Double-check the filler that your doctor is using. Do your research and avoid inactive ingredients like stabilisers, petroleum and colours and dyes ✤ Instead of trying to create an entire new set of lips, take control of the procedure and ask your doctor to enhance what you already have ✤ Some people believe that heavily altering the Cupid’s bow with cosmetic surgery generates a more obviously artificial look
If you decide you no longer like the look of your lips and are unwilling to wait for the effects to wear off, don’t panic. As hyaluronic acid is a natural component of the skin, enzymes can break it down. The procedure will completely dissolve any filler but has been know to cause allergic reactions in some people
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Born this way It is recommended that patients try more temporary lip injections before committing to a fat transfer, but if the pain and price of both procedures is putting you off, you can always rely on drugstore products to help you enhance what your genes gave you. Lip plumpers Completely safe and reasonably priced, lip plumpers use ingredients, such as cinnamon oil, that create a slight irritation when mixed with the natural compounds in the skin. This will make the lips feel slightly tingly and swollen, giving them that coveted plumped look. The magic of makeup Another gift from the Kardashians, face contouring is becoming increasingly popular, and you can achieve a similar effect on your lips. Gently exfoliate your lips regularly with a lip scrub or a toothbrush to help them reflect more light. Next, add a lip balm or plumper as a hydrating base coat, outline and fill your lips in with a pencil that is slightly darker than your lipstick and add a touch of highlight to your Cupid's bow. Dark lipsticks tend to flatten the mouth and an extra coat of gloss will give the illusion of dimension. F celebrityangels.co.uk
say goodbye to stubborn fat & cellulite at the dr rakus clinic
f you are dreaming of the perfect bikini body or of ways to get rid of your dreaded cellulite, the award-winning Dr Rita Rakus Clinic in Knightsbridge, London, has the solution with two new body sculpting treatments - Cristal Ice and BTL Unison. Cristal Ice is our latest fat reduction treatment - it is non-invasive, highly effective and permanent results can be seen in as little eight weeks. The Dr Rita Rakus Clinic is the first in the UK to offer this treatment, which uses cryolipolisis - fat freezing - to reduce stubborn fat and contour the body in a range of areas including the stomach, hips, thighs, back, upper arms, buttocks and the chin. Cellulite affects 90% of women and has always been difficult to solve - until now! BTL Unison targets all 5 causes of cellulite in one go, with no surgery and no downtime! Using radiofrequency and strong targeted pressure energy, the procedure improves the texture of the skin and reduces those unsightly and unwanted dimples. But why stop at your bikini body? The clinic also offers an array of the latest non-surgical face lifting and skin rejuvenating treatments, as well as lip enhancements with Dr Rita, known as ‘the London Lip Queen’.
Dr Rita Rakus
Book a complimentary consultation with Dr Rakus at her award-winning cosmetic clinic in Knightsbridge, London, opposite Harrods. Call us on +44 (0)20 7460 7324 or visit www.drritarakus.co.uk.
call 020 7460 732 4 visit www.dr r itar ak us.com
Dr Rita Rakus
3 4 Hans Road, Knightsbr idge, London (opposit e har rods)
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Aesthetic Technology 101 With cutting-edge technology comes cosmetic treatments that are able to combine innovative equipment with a hands-on approach
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Lasers From hair removal and skin tightening to body contouring and tattoo removal, lasers are officially in—and for good reason. With hundreds of laser procedures on the market, it’s comforting to know that the different variations tend to fit into two basic subclassifications: ablative and non-ablative. The main difference here is wavelength—different laser wavelengths target different issues. Consequently, combining laser variations with treatments has become a popular method for creating targeted procedures. How it works Lasers work in cosmetic practices through a process called selective photothermolysis. Essentially, this means that the frequency of light is regulated to produce heat in a specific area. The light beam must be in sync with the colour of the target— 156 | LIVE TO 100 WITH DR HILARY JONES
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which is why pigmentation, redness and dark hairs against lighter skin can be best targeted. Ablative versus non-ablative lasers The basic difference between ablative and non-ablative treatments is that ablative lasers remove the top layers of damaged skin, while non-ablative lasers penetrate deeper in the skin so that the body produces new collagen, without damaging the outer layers. Choose ablative laser resurfacing to treat mild to moderate wrinkles, facial scarring and skin discolouration, and non-ablative treatments to improve skin texture, tone and pigmentation.
Light Recent years have witnessed the rise of light therapy, specifically the preoccupation with intense pulsed light (IPL). Again, often used for long-term hair removal and skin rejuvenation, IPL is usually cheaper than laser treatment—the main difference between the two is the light source used. Instead of a single laser, IPL uses broad-spectrum visible light to target complaints such as brown spots, dark hair follicles and rosacea. How it works Similar to the principles of laser treatments, IPL uses technology to convert light into heat energy and target pigments found in
here’s no doubt about it—technology can be complicated. With a multitude of confusingly named variations, all offering slightly different signature procedures with similar technology, it can be difficult to narrow down the search for the perfect aesthetic treatment. The good news is, these devices aren’t nearly as scary as their names often suggest—here are the machines behind some of the most popular non-surgical techniques.
non-surgical procedures the skin. Considered a non-ablative resurfacing technique, IPL systems deliver many wavelengths in each pulse of light and can filter the energy to treat certain areas, drastically improving the skin’s appearance and complexion.
ICE-COLD WEIGHT LOSS
IPL versus LED LED—also known as light emitting diode—light therapy is also a technique commonly used for skin rejuvenation treatments. An LED mask or lamp with varying light wavelengths is held to the affected area for a period of time, promoting collagen production and increasing the rate of skin renewal. Consequently, LED treatment can be effective in treating the cause of skin complaints, rather than just the symptoms—which is often the case with IPL. Blue LED light therapy destroys acnecausing bacteria and helps to normalise sebum production. Alternatively, red LED light therapy has proven to be an effective treatment for ageing skin, sunspots, fine lines, texture and psoriasis.
Whole-body-cryotherapy (WBC) involves standing in a freezing tank (minus 90C) for 4 minutes. Besides muscle healing, inflammation and skin benefits, the extreme temperature essentially tricks the body into thinking it’s dying, causing it to burn energy and calories to survive
Microdermabrasion One of the most popular non-surgical skin resurfacing treatments, microdermabrasion uses fine crystals and a vacuum to remove dead skin cells and reduce the effect of fine lines and blemishes. The results are dependent on the percentage of vacuum suction and the grade of crystals chosen. This exfoliation technique can banish dullness, hyper-pigmentation, uneven skin texture and fine lines. How it works A microdermabrasion procedure usually takes less than 30 minutes and may be accompanied by medication in the form of a relaxant. A handheld device directs a fine stream of tiny crystals across the skin to loosen dead cells and exfoliate the skin. A vacuum then draws out debris and impurities and sucks the removed skin cells away.
Radiofrequency Radiofrequency facials have been credited by celebrities and praised as the equivalent of a facelift or a contour palette— definitely on trend. By stimulating collagen production for six-weeks following a treatment, radiofrequency gives the appearances of tighter, lifted skin. Over time, it can also soften fine lines and firm the facial contours. How it works Radiofrequency treatment involves the application of a cosmetic gel and the sweeping motion of a warm wand. The wand heats the lower levels of the skin to approximately 40C, tricking the brain into stimulating a healing response. This elicits the production of collagen, the tightening of elastin fibres and the promotion of fat cell reduction. celebrityangels.co.uk
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Cryolipolysis Body contouring is the new liposuction, and procedures involving lasers, radiofrequency and injection lipolysis are available as non-surgical fat reduction options. Another popular option is controlled cold lipolysis (cryolipolysis), a technology that uses localised cooling or ‘fat freezing’ to extract heat from fat cells and reduce stubborn pockets of fat. The results can sculpt localised areas of the body, reduce cellulite and tighten the skin. How it works Cryolipolysis is a non-invasive treatment that uses vacuum technology to cool a fatty area to a freezing temperature. This causes cell death of subcutaneous fat tissue, without damaging the skin or underlying cells. After the procedure, the body naturally removes the fat cells, decreasing an area of fat by an average of 20 percent.
Surgery With the additional rise in popularity of cosmetic surgeries, technology has led to treatments being more advanced, controlled and effective. For example, endoscopic microsurgeries have allowed surgeons to perform procedures with minimal scarring, and computer-assisted imaging has produced major benefits to plastic surgery. Advancements in tissue engineering have also led to the development of silicone implants and reduced the chances of rejection. F LIVE TO 100 WITH DR HILARY JONES | 157
Oxygen Treatments are very effective, but beware of ‘hot air’
e all know that Oxygen is essential for all metabolic processes of the body, and moreover in a high concentration, to fight against bacteria, increasing the healing process; and therefore is an ideal medium for aesthetic use. What is it then, what makes an oxygen treatment? This can be answered quite simply: oxygen! In order to receive this precious gas in concentrated form, you need a device which able to separate the 21 percent of oxygen available in the ambient air from other gases, and at the same time be able to concentrate it up to 95 percent. The process can be depicted as follows: by means of a strong compressor the ambient air is drawn into the device, whilst at the same time it is led through a fine filter system which keeps dust, bacteria and viruses apart. Then the highly purified air is directed through two molecular sieve chambers. These separate the oxygen and nitrogen molecules because of their different sizes, so that finally the nitrogen is expelled out of the device and only the pure oxygen remains with a concentration of up to 95 percent.
In the aesthetics industry, oxygen is used in different ways as a carrier for active ingredients—for example in the form of an oxygen spray treatment using an air brush or in the form of the patented pulsed oxygen pressure injection. Both of these methods have one thing in common: the duel use of oxygen as a carrier medium and as an energy proving active ingredient. To achieve this high level of concentration the unit needs to be large enough to hold the compressor, electronic components, storage tanks and the important molecular sieves. In addition, a good device needs an effective sound insulation, so that it is whisperingly silent despite its high performance. This benefits the aesthetician and client alike. To achieve our aims the device must be able to produce oxygen at this concentration, be of a minimum size and a minimum weight. A table device with spray cannot be an oxygen device, although it is promoted that way by many manufacturers. Anyone who wants to know exactly what performance levels and what concentration should ask their supplier to
show them the technical specification of their ‘oxygen machine’ and proof thereof. Then the buyers can be certain whether they get the concentrated oxygen they require or simply hot air. Jutta Bode MD Chemist and pharmacist NORA BODE Kosmetik, GERMANY The Oxyjet PRO is a clinically proven oxygen treatment machine maunfactured in Germany by Nora Bode the inventors and patent holders of Oxygen therapy. It produces a constant average concentration of 95 percent oxygen and is warranteed for three years from the date of purchase. It is used in over 57 different countries worldwide.
T: 01775 722243 E: firstname.lastname@example.org W: www.oxyjetuk.co.uk
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Cosmetic Surgery Aftercare
COSMETIC SURGERY PATIENTS CAN PLAY AN ACTIVE ROLE IN THEIR RECOVERY; HYDRATION, A HEALTHY DIET AND PRESSURE GARMENTS ARE ALL VITAL IN PROMOTING SKIN HEALING
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What to expect Before undergoing cosmetic surgery, your doctor will explain the recovery process involved in your procedure. They will also provide helpful information on bathing techniques, changing dressings and wound cleanliness. Make sure to follow these instructions carefully. Generally, patients tend to experience varying degrees of bruising, swelling and tenderness of the skin after surgery. These effects may seem alarming—especially during the first few days of recovery. However, they will eventually subside and patients will be able to see the desired results of their procedure after some time.
Arrange a caretaker Immediately after your cosmetic procedure, you will need to arrange a caretaker; somebody to take you home and help you for the first 24 to 72 hours. During these initial stages of recovery, you will most likely suffer from fatigue—both from your medication and the surgery itself. As a result, simple tasks may seem difficult. celebrityangels.co.uk
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Your assigned caretaker may need to assist in feeding you and redressing your bandages. Some clinics may include a personal caretaker as part of the package they offer—check this with your doctor beforehand.
Aiding your recovery After any procedure, the body will require time to heal. Allowing yourself an adequate period to recuperate will aid your recovery. Patients can play an active role in the healing process by following their post-operative guidelines to a tee and leading a healthy lifestyle. Aim to consume a balanced diet filled with whole foods, fruits and vegetables. Staying hydrated is also imperative—drinking plenty of fluids will aid the body’s natural healing process and regulate its overall temperature. Applying an ice pack to the affected areas of the body is an effective way to combat postsurgery bruising and relieve any discomfort. Try to elevate the area as directed by your surgeon or practitioner; this will help to Live to 100 with Dr Hilary Jones | 161
Seeking medical assistance If you experience any unusual side effects after surgery, report these to your doctor immediately. Make yourself aware of the key signs of infection which may include pus, redness, inflammation, fever, chills and excessive drainage from the affected area. Additionally, seek medical advice if your pain isn’t alleviated by your prescribed medication, you have difficulty breathing or are suffering from persistent nausea
reduce swelling and blotching. There are a number of things that can hinder your skin’s ability to heal, including smoking and sun exposure. Sunscreen should be applied liberally before leaving the house and smoking should be avoided at all costs. Check with your doctor that any medications you are already taking—such as blood thinners or heart medication—won’t impede your recovery. Generally, sutures will be removed between five to 10 days after surgery. Your doctor will notify you of this during your followup appointments. These appointments are designed to allow your physician to track your progress. Recovering patients may also be asked to avoid operating heavy machinery, driving and strenuous exercise for a few weeks.
Scar management Cosmetic surgeons will always aim to keep scarring to a minimum, however, some scarring is usually unavoidable. Luckily, patients can assist with the reduction of post-surgery scars. After elective surgery on the face, abdomen or breasts, a pressure garment should be applied to the scar site. To prevent any redness, discolouration or hypersensitivity, aim to use hypoallergenic products to moisturise the affected area. If you notice any flaking or scabbing of the skin, avoid touching it. Picking at the skin can result in infection or aggravate scars.
Consuming alcohol after surgery Most clinics will recommend that you reduce (or preferably eliminate) your alcohol intake for some time after your surgical procedure. There are a number of reasons for this: It dries the skin. When consumed in excess, alcohol depletes the skin's moisture. This can be hazardous when trying to recover the skin’s elasticity. Dry skin is more prone to stretch marks, cracks and scars than hydrated skin. It thins your blood. The thinning of your blood can wreak havoc on your recuperation. This can cause prolonged bleeding and infections to arise. It mixes badly with medication. Pain medication is almost always prescribed after a cosmetic procedure—the type and strength will depend on the circumstances. Mixing prescribed drugs with alcohol can have dangerous consequences and should be strictly avoided. It can increase risk of swelling. Alcohol naturally widens the blood vessels; this can lead to increased swelling in wounded areas of the body—the last thing any patient wants. F 162 | Live to 100 with Dr Hilary Jones
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This issue of Celebrity Angels' Live to 100 with Dr Hilary Jones has an exclusive interview with Dr Hilary Jones and covers a huge range of...
Published on Nov 30, 2018
This issue of Celebrity Angels' Live to 100 with Dr Hilary Jones has an exclusive interview with Dr Hilary Jones and covers a huge range of...