Author: Hammersmith Health Books

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Ending lockdown for people with dementia and their carers

Blog post written by Mary Jordan, author of ‘The Essential Carer’s Guide’ and ‘The Essential Carer’s Guide to Dementia’.

 

If lockdown has been hard for many people, then emerging from lockdown may cause its own problems! Many have been made so afraid of infection that they have refrained from taking steps back into society again even when this was allowed. I have clients who tell me that they have not left their home for over a year. Many are really afraid to visit their GP (even when they can get an appointment) or to go to the hospital for important outpatient appointments. Some have avoided dental checks or eyesight appointments.

Carers know instinctively that routine is good for those with dementia – they find it easier to cope when there is a set pattern to the day and more difficult to cope when their routine is upset. This past year has disrupted many lives. Routines of social interaction have been interrupted and disturbed. Familiar visitors have stopped visiting. Family have kept their distance. Even those of us who are able to understand the reasoning behind the disrupted routines have been disturbed and depressed – how much more difficult for those unable to understand what is happening?

I have found it quite disconcerting when people have told me that they have become ‘used to’ staying at home and are reluctant to go out and meet others because I know that meeting up with other people, talking, touching and mixing are very important for those with dementia. Perhaps it is easy to forget how vital such activities are for carers too.

The Cognitive Stimulation Therapy groups that I run have been able to continue (under Covid-secure guidelines) since September and people have been very grateful for this, but the Dementia Café has not been allowed to run and carers have told me that they really missed this facility. It seems that the simple chance to meet along with the person they are caring for, in an informal social setting was considered by many to be a lifeline.

Now, hopefully things are changing again and we can once more meet up with family, friends and supporters.  I feel it is important to embrace this new ‘opening up’ of society both for people with dementia and for their carers. But perhaps we should also take note of the fact that life can change suddenly and unexpectedly and that things can happen that are beyond our control. We cannot plan for every contingency but we can all remain open to considering change and accepting the need to adapt – and this is particularly true when caring for someone with dementia.

 

‘Solutions in Dementia’ by Mary Jordan (due in 2022) addresses the many occasions of dramatic change that can happen as dementia progresses and highlights some solutions that have been found helpful.

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How I came to write ‘Feeding Your Vegan Child’

Blog post written by Sandra Hood, author of ‘Feeding Your Vegan Child’. Available for pre-order now, launches 29th June.

 

When I first became vegan I was bombarded by friends and family who were really worried that I would become ill!  But this was back in the 1970’s.  There were no vegetarian, let alone vegan, ready meals available then. Meat and two veg was the norm with the Dairy Council diary being found in most households and adverts for the daily pinta and ‘go to work on an egg’ rife!!   I remember making cheese with the only vegan margarine available – melting it and stirring in soya flour and yeast extract and waiting for it to go hard – it was surprisingly tasty!

I joined the Vegan Society and as a member I received a small A5 magazine every month full of tips and recipes.  I loved the holistic approach, providing information on diet, animals and the environment.  It included a contact list so one could link up with other like-minded people – there were very few vegans back in the 1970’s!  Fortunately, there was a local vegan group near where I lived and my younger sister, who had been vegetarian since a child, and I went along.  I remember food was the main focus, with cakes and dishes being shared with great enthusiasm!  Those groups were so important back then to be able to spend time with others.

What’s cooking?

It was at the local meetings I met the wonderful Eva Batt.  I was so lucky to have a ‘celebrity’ living near me!  Eva wrote the first vegan cook book – ‘What’s Cooking’.  Eva inspired me to cook wonderful vegan dishes – back then everything had to be cooked from scratch, no ready meals then!  Her dishes were nutritious, colourful and tasty.   I still use Eva’s recipes to this day.

The first plant milk in the UK

As a member of the Vegan Society I was invited to attend the Vegan Society AGMs.  Back then, as the membership was so small, the AGM’s were held in the garden of Kathleen Jannaway, secretary of the Vegan Society. It was there where I met the late Arthur Ling.  There were no milk alternatives in the UK in the 1960’s and Arthur and a small group of other vegans tried unsuccessfully to get non-dairy milks imported into the UK.  Failing to achieve this they decided to produce their own and in 1964 Plamil was produced.  Check out the Plamil website to find out more about its fascinating history.  The company went on to produce other vegan products and is still going strong.  Arthur’s son Adrian, vegan from birth, runs the company and is known as the vegan Willy Wonka.

Children’s case histories

I worked with Arthur for a number of years. Whilst working at Plamil I was able to indulge in its other vegan products including peas pudding, rice pudding and delicious chocolates.  The soya milk came in tins and later moved to tetrapaks.  It came concentrated and you diluted it yourself with water.  The thought was that it was practical, not having to carry the extra weight of water, and also saved on packaging.  Wouldn’t it be great if this was the case today?  More environmentally friendly and really practical!! Arthur was way ahead of his time.

Arthur was so passionate about appropriate nutrition for children and adults.  He meticulously kept records of children whose parents were raising them on vegan diets and I was involved in researching these case histories.  I was fascinated by the simple whole foods that the parents were giving their children and how they thrived.  Plamil Foods produced 4 copies of these case histories over the years, with the first one produced in 1973 and the last one in 2000.

I wanted to learn more and I decided to study nutrition.  I also wanted to find out for sure whether a vegan diet was ‘safe’ and be able to answer the ongoing criticisms from friends and family, the majority without any nutrition knowledge, who said that the vegan diet wasn’t ‘natural’ and was inferior to an omnivorous diet.

Becoming a dietitian

University was tough and I was known as ‘the vegan’.  However, I thrived and decided to do the extra year’s study to qualify as a dietitian.  After qualification I was fortunate to secure a full-time post as a community dietitian.  I kept in close contact with the Vegan Society who welcomed my knowledge and asked me to become their gratis dietitian.  As such as I provided a nutrition page, answered questions and was generally available for any nutrition queries.

My first book

The Vegan Society was regularly being contacted by parents and health professionals alike asking nutrition questions about raising vegan children.  I suggested to the Vegan Society that we produced a book to support parents and health professions and in 2004 I wrote ‘Feeding your vegan infant – with confidence’.  The idea was to produce a complete guide from preconception through to infancy to reassure parents and health professionals alike that it was possible to raise children happily and healthily on a vegan diet.

Today

Over the last couple of years there has been such a growth in plant-based eating.  Vegan diets are now something to aspire to.  Evidence is clear that raising children on plant-based diets not only meets nutritional requirements but indeed can benefit health.  In addition, it is the way forward for the planet.  As my book was still the only UK version on raising vegan children, I thought this was the perfect time for an update.  I wanted it to remain a practical but readable book to assist both vegan parents and health professionals. I am really hoping my book will do this.

 

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Why Volunteer?

With both Volunteers Week and Carers Week this month, it is an important time to think about what we can do for others. Author of ‘Who Cares?’ and winner of The People’s Book Prize 2020/21 Best Achievement Award, Sara Challice, explains how you can offer help to others through volunteering and why it is important to get involved.

I think we are all aware of the countless volunteers who have rallied round to help during this last year’s pandemic. In giving just a little bit of time, we can make a huge difference for many.

I discovered our local charities and the great work they do, after my husband became disabled from a brain tumour. Although he was given six weeks of physiotherapy from our hospital once he came home, this service was stopped soon after and his file was closed. I was then left attempting to pick up a man twice my size from the floor as he continued to have falls and deteriorated further.

During this time, I was told of a charity called INS (Integrated Neurological Services). I had never heard of them – why would I? They were in our local area, and offered one-to-one physiotherapy plus more, and I would also receive support as a carer. We immediately registered with the charity and met a wonderful group of people, who helped support us both during our challenging times.

Had I not become involved with this charity and and the the great work they do, I wouldn’t have known about the difference they were making in others’ lives. I became a trustee for them and discovered that there were times they were financially hand-to-mouth. You would naturally presume these charities would just be there for us forever, as and when we may need them, but that’s just not the case.

Many who have been diagnosed with a neurological condition and those caring for them, are often isolated, left struggling at home – and you don’t need to be old! Any of us may suddenly need this vital support.

Charities and the voluntary sector help to connect and support within our communities – empowering and ensuring a better quality of life for many, even keeping them at bay from hospital.

But what do you, as a volunteer, receive from your altruistic actions?

If you offer to volunteer, it doesn’t have to take up much of your time. You can make a real difference in others’ lives – more than you even realise! You will most definitely gain knowledge and meet some wonderful and inspiring people. Plus, in being kind and offering to help, is actually beneficial for you. There is a term known as the ‘Helpers High’ – as you give to others, this distracts you from your own problems, releasing endorphins making you feel good. Helping others gives you a sense of purpose, boosting your serotonin levels which lowers stress and improves your mood.

And in offering to volunteer, this can create a positive ripple effect, inspiring those around you. I have certainly had friends and family who have become involved with the various charities I have supported over the years.

So if you’ve been thinking of offering a bit of time to help others, why not get in touch with either your local or national charities, for a cause that may be close to your heart. You never know, you may learn new skills, gain new insight and meet some wonderful people as I have.

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Mental Health Awareness Week Blog Special

Blog post written by Dr Trevor Griffiths and Dr Marian Langsford, authors of Emotional Logic. Available for pre-order now, launches 27th May.

The authors of Emotional Logic: Harnessing your emotions into inner strength have been married for nearly forty years. Marian still practices medicine under her maiden name of Langsford. They both now teach internationally the Emotional Logic method of preventing stress-related mental and physical illnesses, which Trevor developed while in medical practice. The best compliment they have received, they say, was from a medical student in Bulawayo, Zimbabwe, who stood up after a training session and said, “I have learnt today that it is really cool to be old, and married, and still together, ‘cos you get to travel the world and inspire people like us!” We don’t look very old; we received that as the honour it was intended to convey in that culture.

Learning to activate your inbuilt Emotional Logic helps to build more responsive relationships in any new situations you face. And it can be learnt at any age. An active schools programme in the UK has a wide range of age-appropriate materials, such that a five-year-old boy took an emotion leaf from a ‘Talking Together Tree’ they had made in the classroom, and took it to the teacher saying, “I would like to tell the class why I am feeling angry about something.” Imagine the difference that ability to talk sensibly about emotions rather than only act them out, or regulate them, might have.

In Chapter 1, Trevor comments on Marian’s story about a misunderstanding with a friend who had offered to help tidy her garden one autumn. She had told how understanding the emotional logic of her many loss reactions that followed helped to avoid a break-up. Here is an extract from Trevor:

As the eldest daughter in a Devon farming family, Marian grew up on a mixed dairy and horticulture farm overlooking rolling hills, surrounded by buckets of early flowers that needed bunching each evening for market the next day. They were not rich. She loved it. She has a wisdom from nature that I had missed, having been brought up in the London suburbs. For example, she once said, “Gardening isn’t all about pulling up weeds. You have to plant something in the earth in its place, and care for it.” A comment like that can leave me fixed into a garden chair for ages while I watch her getting her hands covered in earth and planting. Something simple like this can lead me to a lot of thinking, which I consider is my core skill.

So, what do I think about? I think a lot about human nature. I think things like, ‘Seemingly small things that break out on the surface of people’s lives can have deeper roots than we realise at first.’ It took me a few decades to realise that it did me a lot of good to listen to Marian. I think many men discover the same at some point in their married lives…

Emotional Logic was born out of years of experience in general medical practice, and out of a disrupted family background that Trevor experienced as traumatising. With a depth of emotional memories to draw upon, Emotional Logic harnesses the language of emotions into the inner strength needed to come through times of trouble stronger and healthier. Post-traumatic growth is encouraged as a way forward from post-traumatic stress. As a senior Community Psychiatric Nurse who uses Emotional Logic in her work said, “Emotional Logic heals the broken heart behind mental illness.”

Once learnt, people can share their new trauma-responsive conversational skills in their daily encounters with others. This prevents isolation following hurts. It reduces the risk of illness by building greater resilience and a realistic hope for recovery into relationships. Even if setbacks and disappointments occur, knowing how to activate one’s inbuilt Emotional Logic provides a world of constructive options to talk about. And where is there better to talk and to explore new ways forward than in nature, where the seeds of something beautiful in life can take root and grow.

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5 Ways to Prevent or Reverse Hypertension

Blog post written by Dr Eugene Kongnyuy, author of No Pills, No Needles, launching 25th May.

 

10 years ago, I was diagnosed with high blood pressure (hypertension). As a physician and researcher, I decided to self-experiment. My aim was to find out what could successfully reverse my hypertension so that I could stop taking blood pressure (BP) medicine. I tried over 70 different things including salt restriction, meditation, stress management, different dietary regimens, weight loss, walking, etc. After 5 years of self-experimenting, none of the things worked for me and I felt disappointed.

In order to keep fit, I decided to run or jog for 1 hour every morning. Six months after I started this programme of 1 hour per day of regular exercise, I took my BP and it was very low. I stopped the BP medicine and the hypertension was gone.

One hour of regular moderate to high intensity exercise per day may be what you need to reverse your high blood pressure. Over the years, I have kept with 1 hour of exercise per day while tracking my BP and I have learned a lot more. Here are some of things that I have learned that can help you either prevent or reverse hypertension.

 

  1. Exercise regularly

Exercise is the centrepiece for the prevention or reversal of high blood pressure. Experts recommend 150 to 300 of moderate exercise (or 75 to 150 minutes of vigorous intensity exercise) per week. This is what you need to prevent hypertension. In order to reverse hypertension, you would probably need a lot more. To reverse hypertension, I had to do 1 hour of moderate to vigorous exercise per day (or 420 minutes per week).

First, aerobic or ‘cardio’ exercises cause repetitive contraction of large muscle groups which in turn forces the heart to work hard and pump blood to the muscles. Regular ‘cardio’ workouts, such as jogging, brisk walking, running, cycling, swimming, yoga, dancing, football, golf, hiking and basketball, increase the heart rate and train the heart muscles[1]. You need to train your heart muscles to pump blood more efficiently and this takes time. The longer the duration of each exercise, the better the results. Cardio training over several months causes a significant fall in blood pressure.

Second, exercise causes the endothelium (inner wall of blood vessels) in exercising muscles to produce nitric oxide and prostacyclin, both of which promote enhanced vasodilatation by relaxing the smooth muscle cells in the blood vessel walls[2].

Third, exercise blocks the renin-angiotensin-aldosterone system (RAAS), a hormone system that, when stimulated, raises blood pressure by increasing vascular resistance and causing sodium retention by the kidneys. This causes the blood vessels to widen and the kidneys to flush out sodium.

Fourth, exercise blocks the sympathetic nervous system (SNS). This causes the blood vessels to relax and widen, which in turn reduces the blood pressure. The SNS is one of the two main divisions of the autonomic nervous system (the other being the parasympathetic nervous system – PNS) that is responsible for our ‘fight or flight’ response among other things. The autonomic nervous system is a control system that acts largely unconsciously and regulates bodily functions, such as heart rate, digestion, respiratory rate, pupillary response in the eyes, urination, and sexual arousal. The SNS activation causes BP to rise. Once activated, the system fires electrical signals that lead to the release of the hormone adrenaline by the adrenal gland. Exercise blocks the SNS and therefore lowers the BP.

 

  1. Get active

Exercising plus being physically active throughout the day is more effective than exercise alone. I realised that each day when I came back from work, I did between 1000 to 2000 steps. I spent most of the day sitting. I decided to change my desk to a standing workstation. I remained standing while working, reading emails, writing, and I held standing meetings. The number of steps I did per day increased from 1000-2000 to 4000-5000 steps. I observed that my systolic BP was about 10 mm Hg lower during the day than it would otherwise be when I wasn’t physically active. I also find gardening, cooking and cleaning very helpful in keeping me physically active. There are many other ways to be physically active and each person can figure out what he or she can do to avoid a sedentary lifestyle.

 

  1. Get sweaty

Sweating lowers blood pressure by causing the dilation of blood vessels under the skin as well as loss of water and salt. I found that exercise that caused me to sweat was more effective in lowering my BP than exercise that didn’t. With sweat-inducing exercise, my systolic BP was about 10 to 20 mm Hg lower than exercise that didn’t cause me to sweat. Sweating is a natural method the body uses to control body temperature. When your body starts to heat up, whether because of exercise or outside temperature, it releases sweat from the more than 2-4 million eccrine glands spread out across your skin, pouring liquid through pores to lower body temperature. Sweating induces a ‘diuretic’ effect by causing increased loss of salt, including sodium, and this lowers blood pressure[1]. For those who can afford it, having a sauna at home could be an easy way to get sweaty.

 

  1. Keep warm

I found that my BP was generally lower in warm weather (such as summer or being in a hot country) than in cold weather (such as winter or a cold country) independent of sweating. Numerous studies have found a correlation between temperature and blood pressure, and have also generally shown higher blood pressure during winter. The explanation is that cold weather activates both the sympathetic nervous system and the renin–angiotensin-aldosterone system. Warm weather does the reverse as well as inducing sweating[1]. Therefore, following the sun when booking holidays can therefore be a good way to manage your hypertension.

 

  1. Lose weight

Weight is important if you want to say ‘goodbye’ to your antihypertensive pills. Studies have shown that by losing 5 kg (8.8 pounds), your systolic and diastolic blood pressure can drop by 4.5-3.2 mm Hg respectively[3]. If you have mild high blood pressure, weight loss alone can be sufficient to control it. Weight loss improves blood pressure, although exercise has a greater impact. This is the reverse of what I found for type 2 diabetes. Diabetes is affected more by weight loss than by exercise. In my case, I estimate that my BP was treated 80% by exercise and 20% by weight loss and my diabetes 80% by weight loss and 20% by exercise.

 

In conclusion, by combining regular exercise with being physically active throughout the day, doing something what makes you sweat, keeping warm and losing some weight, you can prevent or reverse hypertension. In this article, I decided to focus on my experience. But it’s important to note that there are other ways which, although they didn’t work for me, could work for other people. These include salt restriction, healthy diet, quitting smoking, moderating alcohol intake and managing stress.

One of my self-experiments was to find out the effect of altitude on my BP. It’s well known that the higher you climb, the higher the BP. However, I found that the effect of exercise and sweating was so strong that it completely overrode any effect of altitude on my BP.

These are just a few of the lessons I have learnt self-experimenting which helped me reverse both hypertension and type 2 diabetes. After hesitating for several years, I finally decided to put my experience in writing because I felt it could help many people, or at least the methods I used could be applied by anyone to find out what works for them. I have written down all my lessons in a book No Pills, No Needles which is coming out in May 2021.

 

[1] Rosenthal T. Seasonal variations in blood pressure. American Journal of Geriatric Cardiology 2004; 13(5): 267–272.

[2] Nystoriak MA, Bhatnagar A. Cardiovascular effects and benefits of exercise. Frontiers in Cardiovascular Medicine 2018; 5: 135.

[3] Fortenberry K, Ricks J, Kovach FE. How much does weight loss affect hypertension? Journal of Family Practice 2013; 62(5): 258–259.

 

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Mary Jordan reviews ‘When the Time Comes’

Book review by Mary Jordan, author of ‘The Essential Carer’s Guide’ and ‘The Essential Carer’s Guide to Dementia’, of ‘When the Time Comes: Stories from the end of life‘ by Dr Magnolia Cardona and Nurse Ebony Lewis. 

This is a very thought-provoking book. It is a collection of short stories about actual experiences of dying and end of life care. Because each story is told by a different individual we hear from many viewpoints and cultures but the emotion which comes most often to mind is the general feeling of dissatisfaction experienced with standard medical attention at end of life.

Mostly the people relating these accounts to do not blame those medical professionals concerned at the end of these lives. But they do wish generally that things could be managed better. One of the problems in our civilisation is that hospitals and doctors are not seen as helping to make death a more comfortable experience. Doctors and hospitals are concerned with curing illness and bringing people back to health and this means that many of us at end of life get carried along by the medical path that is concerned with ‘trying one more treatment’ or tackling one more crisis. For example, we are told about a patient who is ‘ready to go’ but who continues to ‘endure the efforts of a health system determined to do all they can to keep him here’.

What we seldom have at this stage is the time to take a step back and consider the options.

Ideally this thinking would be done before the crisis arises and indeed this book advocates thinking ahead and giving time to planning our own end of life as well as helping our loved ones to do the same. Each account in the book ends with a few questions which can form the basis of considering end of life, looking at many different practical and ethical points.

I would perhaps like to have seen a little more room given in the stories to people who are not yet ‘ready to go’ and who do want every effort to be made to keep them in this life but over all that is not what the book is meant to be about. The points about having a good quality end of life experience and about communicating your wishes in this respect to those around us are very well made.

This is a book well worth reading and using as a discussion focus with those you love best.

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Ten Things We Want People to Know About Dying Well

Blog post written by Dr Magnolia Cardona and Nurse Ebony Lewis, authors of When the Time Comes: Stories from the end of life. Launches 25th March. 

 

Receiving a diagnosis of an irreversible progressive disease can be confronting and intimidating. On the other hand it gives us opportunities to prepare for the end of life in a way that can be a fulfilling activity that helps us tie the loose ends – not a morbid duty we should avoid. We have witnessed people of advanced age with chronic disease and their families facing the dilemma of deciding between life support and resuscitation in their last days of life without sufficient preparation for it. Wouldn’t it be better to have had time for that conversation with significant others much earlier, at home over a cup of tea rather than in the emergency room?

 

The following is a list of lessons learnt from clinicians and patients, from years of research and clinical experience:

  1. Older people today are more willing and able to discuss preference for place of death and to participate in treatment decisions than they used to be a couple of decades ago
  2. Cancer is not the only life-threatening illness of old age: chronic lung disease, kidney failure, heart failure and dementia are other examples less recognised by the public
  3. Talking about treatment wishes and personal values with our families and doctors should happen as early as possible, not only after receiving a diagnosis of chronic irreversible or life-threatening illness
  4. Just as we prepare celebrations for life events we should be in control of our preparation for death if we can help it
  5. Living life to the fullest can be followed by a good death if we prepare by talking to others about our wishes and objections towards the end
  6. An advance health directive is not a death-sentence but a passport, with clear instructions on our wishes, which can be renewed periodically so others don’t have to guess our treatment preferences before our final trip
  7. Families’ requests for use of medical technology, such as intensive care, should be made only if it prevents suffering and provides benefit, not just to prolong life
  8. A palliative care referral is an early admission to a pathway that prevents unnecessary pain and physical suffering; we should take it if it is offered
  9. Hospices are not places where patients are abandoned, but places where loving specialists help dying people experience a dignifying transition
  10. By normalising the end-of-life discussion we will be helping doctors make decisions aligned with our wishes and be removing the burden from our families having to choose for us.

 

In our book When the Time Comes, we have compiled short stories from real-life to illustrate when the discussion of values and preferences has prevented suffering or guilt, and when the absence of an end-of-life conversation has led to excessive and futile treatment. We invite readers to reflect on the different scenarios and to be ready, no matter their age or state of health. Useful lessons can be learned from the circumstances and motivation of people in the stories who have shared their experience to help others prepare.

 

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Corneal Grafts and Vaccinations

Blog post written by Nat Hawes, author of the Nature Cures series of books.

Nat Hawes shares important information for anyone having the COVID-19 vaccine who has had a corneal graft. There is a risk of graft rejection if ameliorating action is not taken. This means you can have the vaccine but must take special care of your eyes at the same time.

Corneal grafts are also referred to as corneal transplants or keratoplasty. They are used to correct problems caused by medical conditions or injury e.g. from infection.

Nat tells us:

‘Anybody who has had a corneal graft should be aware of the possible risk of rejection of the transplanted cornea following vaccination because vaccinations enhance the immune system. They should contact their eye consultant to be prescribed steroid eye drops to administer four times a day, or they may be advised to increase steroid drops if they are already using them. They will also need to have their eyes checked two weeks after they have had the vaccine. This is appropriate for both the influenza and the COVID-19 vaccines.

‘Although, as yet, there have been no confirmed cases of rejection due to the COVID-19 vaccine, there has been some documented from flu vaccinations.[1] It is still early days though and most people have only had the one dose of the COVID-19 vaccination so far in the UK. Rejection can take place up to 2 months after the influenza vaccination and is potentially reversible.[1]

‘Corneal rejection is caused by CD8 and CD4 T cells (defensive white blood cells) fighting to eradicate the foreign body (transplanted cornea) from the body and it is these very same T cells which are boosted by the COVID-19 vaccines so it is a distinct possibility that corneal rejection might occur.[2]

‘This may be much more of a risk after the second dose of the vaccine so it is important that corneal graft patients are made aware of this so that they can take the appropriate steroid drops to counteract it, and have their eyes checked. They should still go ahead with having the vaccine, but cautiously.’

 

  1. Wertheim MS, Keel M, et al. Corneal transplant rejection following influenza vaccination. Br J Ophthalmol 2006; 90(7): 925-926. doi: 
  2. Pluddemann A, Aronson JK. What is the role of T cells in COVID-19 infection? Why immunity is about more than antibodies. The Centre for Evidence-Based Medicine. 19 October 2020. 

 

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Coping with osteoarthritis during Covid-19

Blog post written by Frances Ive, author of One Step Ahead of Osteoarthritis

 

The Covid-19 pandemic is the number one health issue everywhere, but despite that we still have to manage osteoarthritis. According to a recent article in the British Medical Journal, Covid impacts on osteoarthritis in a couple of ways:[1]

  • There is more likelihood of being hospitalised when suffering from the virus if you already have osteoarthritis.
  • OA sufferers are likely to have additional pain in the joints when they contract Covid.

A key recommendation in the BMJ article is that physical activity is extremely important, regardless of age. Although this would seem to be difficult during a severe outbreak of the virus, it is feasible if the symptoms are mild. Also, all activity keeps us healthy and more able to fight illness.

I emphasise the importance of exercise in One Step Ahead of Osteoarthritis, in order to keep us active and mobile and enjoying a good quality of life. A glowing statement from Professor Sir Sam Everington, GP in Tower Hamlets, Chair of NHS Tower Hamlets Clinical Commissioning Group, and a board member of NHS Clinical Commissioners, who wrote in his foreword for my book: ‘This book should be prescribed on the NHS by all doctors. It can’t be, but if you have osteoarthritis or want to live a happier and healthier life, buying this book is the best investment you could ever make.’

Professor Sir Sam’s involvement in the social-prescribing initiative increasingly being adopted by GPs (pre-Covid) would account for his enthusiasm. The main message in One Step Ahead of Osteoarthritis is taking responsibility for your own health through:

  • exercise
  • weight management
  • healthy eating
  • supplements
  • complementary therapies
  • practical tips (shoes, keeping warm, bathing, etc.)

Even in lockdown we can walk locally and there’s no limit to how long you can stay out. If you are used to doing yoga, Pilates or other classes, there is a wealth of sessions being provided online either free of charge or for a nominal sum under £10. For those people who find exercise very hard due to chronic arthritis or other conditions, Chair Yoga provides a good alternative and that too is available online.

Finally, try not to overeat when confined at home and stick to the Mediterranean diet with plenty of fruit and vegetables. Recognised by doctors as the best diet for all conditions, it can also help us to keep our weight down, an important factor for reducing pressure on weight-bearing joints. Both Vitamin C and Vitamin D are essential for supporting the immune system, helping all conditions and giving us a fighting chance against Covid.

 

[1] https://ard.bmj.com/content/80/2/151

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Therapist Sally Baker tells it like it is – one sober day at a time

Blog post written by Sally Baker, author of Seven Simple Steps to Stop Emotional Eating and How to Feel Differently About Food with Liz Hogon.  

I decided to stop drinking for a while.

There was no set target on the number of days I planned to stay abstinent because I wasn’t confident I could last even seven days. I thought I had a normal relationship with alcohol as a social drinker, but I didn’t want to put too much pressure on myself.

I’ve now been sober for more than one hundred days.

I had been aware for a long time that there was a part of me that was too eager to pour a glass of wine every night.

Without consciously acknowledging it I’d begun marking the end of my working day and the beginning of an evening’s relaxation with a glass of wine.

It was easy to justify to myself what I considered was my light-weight drinking habit as I know so many of my women friends drink much more. It’s a self-deluding game to play.

Opportunities for excess were certainly more common in my twenties and thirties, but if I was feeling happy or reckless I would press my internal ‘fuck it’ button. Then I wouldn’t want to stop drinking, laughing, dancing or even to go home.

Abnormal drinking has been normalised

As a therapist, I have clients who black-out from drinking. Or wake up naked in strangers’ beds with terrible hangovers, struggling to recall names or even the events of the previous evening. They all tell me they think their drinking habits are pretty normal.

Sometimes people come to see me because their insomnia is ruining their lives and they have crippling anxiety. If they speak about their desire to cut down their drinking or take a sobriety break it tends to emerge later. People rarely identify their use of alcohol as the root cause of mental health challenges.

Working therapeutically with clients to help them transform their relationship with booze made me sober curious.

I also know when I recommend a period of total abstinence to a client they are often anxious about being able to manage even a few days without drinking and would much rather cut down or limit the number of drinks they have during a session than go without completely.

For my own authenticity, I wanted to know and understand what teetotal felt like and the challenges it involved, so I set about going without booze just like they tell you in Alcoholics Anonymous — one day at a time.

Day 1

I’m not drinking but it feels like an energised state in as much as I’m very aware I’m not drinking. I’m counting days and I’m using red dots in my desk diary to signify days of no drinking.

It feels okay. I’m interested in my progress and feeling a bit like a lab rat observing myself and how all this feels.

Day 8

I’ve felt more tired since I’ve stopped drinking. I’ve wanted to go to sleep earlier at night and sometimes even had an afternoon nap. I feel slightly despondent as I thought I’d have more energy not less.

Other than that I’ve not noticed feeling very much else. Wondering if, as the weather is so cold, that my feeling tired could be my natural seasonal desire to hibernate and sleep more. Hope so.

Day 12

I’m sleeping more soundly than I have for years and I’m not waking up at all during the night. Previously I would wake around three or four in the morning and then struggle to go back to sleep. These days I’m sleeping for England!

Day 14

I feel like I’m being tested this month.

In my personal life, an upsetting and not completely unexpected dispute erupted over some legal and financial arrangements.

Professionally, the marketing mentors I was thrilled to have working with me for over a year have badly let me down and we’ve parted company.

To say I’ve been having a trying time would be an understatement.

It would have been very easy to drink more with this all going on around me. I feel really appreciative that I’m not drinking at all. I feel confident I can trust and fully own my emotional responses because I feel clear-headed. I love not drinking — hey who knew!

Day 18

I am naturally waking consistently an hour earlier in the morning — every day.

I’ve been using EFT (Emotional Freedom Technique) for several days in a row to work through some of the painful emotions I’ve been experiencing from the fall-out to the events in my personal and professional life.

I’ve been embracing all of these feelings as a way to face up to them and do the work to get clear. There is no hiding. I’m accepting negative emotional triggers as the gift they are to see where clearing work needs to be done and getting on with it.

Day 24

I notice that I experience moments of feeling awesome, energised and really healthy. They are fleeting but savoured and highly prized.

Day 34

Not drinking feels much more normal now. Abstinence has lost its high energy status and I’m feeling much more relaxed about it. I am now really fussy about having classy, high quality chilled bottled water on the table at dinner with lots of ice and slices of fresh lemon or lime. It feels like a treat.

Day 37

Still sleeping well. I rarely wake in the night now. Not feeling particularly energised when I wake in the mornings though and, without alcohol, I feel tired earlier in the evening. Perhaps this is just my new normal but it’s hardly thrilling. If anything, not drinking feels slightly underwhelming.

Day 40

It feels a bit like a watershed day as I’ve had the realisation that I’m waking every day clear-headed and energised. It feels like my new normal plus feeling more energised and positive in the afternoon too. All of these feelings might be the holy grail I’ve been waiting for.

Day 65

Being sober feels completely normal now, so much so I hardly even think about drinking at all. That old trigger of preparing dinner comes and goes without me missing a glass of wine at all.

I can even sit in pubs and bars with my husband or with friends and it’s fine. I do notice how noisy people get when they drink and how after about 9.30 pm I want to go home. Even though I might be struggling with their vibe, sometimes there is no sense of deprivation or going without for my part. Booze seems to have disappeared off my agenda.

Day 67

On numerous nights out or at dinner parties I must have tried all the alcohol-free wine out there and they all taste pretty disgusting. The small number of wine producers who create zero wine seem to be on a mission to take out the alcohol and replace it with sugar so that they all taste revolting and are undrinkably sweet.

There are a couple of pleasantly drinkable Prosecco fizzy wines that are okay but fizzy wine without the accompanying fuzzy feelings from imbibing the alcoholic versions leave me feeling a bit flat.

Day 68

There are more alcohol-free beers available now than ever before. Most of the big breweries seem to be producing their own version of a zero beer but many seem to brew it just to tick a box and they seemingly don’t care how awful they taste.

Microbreweries tend to try harder and are better tasting. Some alcohol-free beers successfully achieve the criterion of looking like an appetising beer and some even taste pretty much like beer.

Ultimately though it doesn’t matter how good the facsimile of a beer or wine or even gin is, I resent their empty calories and their carb load without the benefit of making me feel different.

Of course, none of the alcohol-free drinks out there causes a change of state and that is why most people drink — to create a change in how they feel and, without that, booze is pretty boring in and of itself.

Day 70

My favourite drink now is Angostura Bitters with ice and soda water and fresh lime. Looking at it mixed in a glass it could even pass as a proper grown-up drink and so, having surveyed all the fake beers and wines, I’ve embraced that I’m not actually a drinker any more and let go of the fantasy of fake alcoholic drinks.

Day 80

I’ve noticed I’m far more awake in the evening and more alert in the mornings too. I barely ever think about drinking and although I’ve had plenty of opportunities to drink alcohol I haven’t been tempted once.

I no longer make a note every day that I’m not drinking as it just feels very normal.

Day 90

The strangest thing has happened. I used to never ever remember my dreams. I know we all dream every night when we sleep but for years I would remember only one or two dreams every few months. Now when I wake I remember what I have dreamt!

I love having access to my dreams and now I regularly wake and can recall them I realise what a loss it was all those years not being able to access that part of my subconscious processing. I’m really thrilled to have my dreams back.

Day 100

I’m ready to say goodbye to alcohol without a backward glance — taking it one day at a time, of course, for as long as I want, and I’m excited to face the prospect of my future as a non-drinker. I never thought I’d ever say that when I embarked on this experience over one hundred days ago.

If you think you have normalised your own drinking and you know alcohol is adversely affecting your life and your relationships, you too could benefit from taking a break from drinking too.

Useful contacts for alcohol problems (UK)

  • Drinkline is the national alcohol helpline. If you’re worried about your own or someone else’s drinking, you can call this free helpline in complete confidence. Call 0300 123 1110
  • Alcoholics Anonymous (AA) is a free self-help group. Its “12-step” programme involves getting sober with the help of regular support groups.

With thanks to www.nhs.uk

If you realise you have normalised your drinking habits and need to take a break or recalibrate your relationship with alcohol book an obligation free discovery call with me via the link on this page.

Sobriety isn’t for everyone nor does it need to be forever. Make that call now.