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How to cope with IBD at work

How to cope with IBD at work

Sometimes it seems that living with IBD is a full-time job (albeit one with zero pay or benefits!). Time spent at the hospital, recovering from flares and trying to live a healthy life can all add up. Unfortunately, most of us are not millionaires and work is a necessity, and for lots of us a fulfilling part of our lives. Working with IBD isn’t always easy but for the vast majority of us it is possible. However, you may need to talk to your employer and have adaptions made.

 

Be honest

It is very important that you are honest with your employer about your condition and what it involves. IBD, like any chronic illness, is covered under the 2010 Equality Act since it is a physical and long-term impairment (definition of disability under the Equality Act 2010, 2015). This means employers must make necessary adaptions to help you in your role. This could include flexible working hours, access to a disabled toilet or a fridge to store your medicine in. Most employers are accommodating if you talk to them and explain what your condition actually entails (and if this is disclosed at interview, employers cannot discriminate against you in the recruitment process).

 

Be realistic

Many people with inflammatory bowel disease have really high expectations of themselves, which is also reflected in their careers. However, it is important to reflect on your career path and whether it is adaptable to life with IBD. Does it involve lots of travel? Is it stressful? Are you often on the go? Having IBD doesn’t mean giving up on your career dreams but just making sure the job is right for you.

 

Be informed

Reading the paperwork and the terms and conditions that comes with a job is more important than ever with IBD. Here are some things you need to find out:

  • What is the sick pay entitlement?
  • What is the policy for long-term periods of sickness?
  • How flexible are the working hours?
  • If you are working abroad, is medical insurance included and does this include pre-existing conditions?
  • Will you get regular breaks? (This can be easy for office workers; not so easy for those in retail.)
  • Is there the possibility of reduced hours or going part-time further down the line?

Keep records

It may be worth having a notebook to keep a list of any time you have had to take off work for IBD and the corresponding symptoms and hospital trips.

 

My experience of working with IBD

I am a teacher by trade and have taught both in the UK and abroad. In every job, I’ve been honest about my conditions from day one and luckily all my employers have been great. When I was on infliximab, my employers were great at giving me time off to go to hospital appointments and in my previous role I had surgery and the school arranged for me to come back on a phased return. It can be really hard teaching with IBD – I have had days where I felt like I wanted to faint in front of a class – but luckily most of the time I’m fine. In some ways doing a demanding job means I often forget about my symptoms, but I have had to dash out of class on a few occasions. I think this is why talking with colleagues about your condition is so important – it has meant they have been able to quickly step in if needed. Yet over the years, I think I’ve also become more realistic about my teaching career and this year I’ve reduced my workload to three days a week, aiming to spend more time on my health and my writing. I don’t see this as a step down but a necessary adaption to help me live as balanced a life as possible; hopefully I can combine the security of a teaching job with my other passions in life – writing and nutrition.

This blog is taken from Managing IBD: A balanced guide to inflammatory bowel disease by Jenna Farmer.

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Back Pain: Myths and Misconceptions

Chapter 4

Myths and Misconceptions

Back pain, as the statistics demonstrate, is extremely common. In the same way that everybody has a view and advice to give on the best way to cope with and eliminate the symptoms of a head cold, personal experiences of back pain also bring forth theories and guidance without necessarily the professional knowledge to support it. From this inevitably grow myths and misconceptions which, although given with good intention, give rise to a great deal of conflicting information and confusion.
There is also much evidence to suggest that the way in which we overwork our spines and the connecting muscles can do us a great deal of harm. Add this to the many misunderstandings about back care and we not only inhibit our ability to recover speedily from injury, but can also subject ourselves to unnecessary weakening of our back muscles. How to assess the risk involved in a manual task and carry it out safely is more fully discussed in Chapter 8; here I will tackle the most common misunderstandings about what is good and bad for backs.

‘Put your back into it’

Seldom do the sayings and proverbs of past generations convey anything but good sound advice but one such phrase, ‘Put your back into it’, can certainly be misinterpreted. This saying might suggest that increasing physical effort by using enormous force to push, pull or lift something, will help the desired task to be better achieved. It is more likely, however, to have the opposite effect and even give you an injury. Its inference, that the spine is always the strongest part of the body, sometimes leads us to undertake physical effort far beyond our safe capability.

The following commonly believed myths and misconceptions lead many of us to take the wrong sort of action. This is usually at a time when we most need to follow the best possible advice.

‘You should sleep on a hard mattress’

How often have we been enticed to purchase an extra firm ‘orthopaedic’ mattress, believing it to be good for our backs? A mattress that is too hard and does not yield slightly to the contours of our spine can put considerable strain on that small area in the lower lumber region which is left with no base on which to rest. The back muscles, when they should be completely relaxed, are therefore given the work of supporting the weight of the lower organs of the body throughout the night. This can result in stiffness and pain in the mornings. A slightly gentler mattress, therefore, will not only provide consistent support along the length of the natural curvature of the spine, but will aid more restful sleep.

It is important when buying a mattress to take plenty of time to try it out for comfort before making your choice. Lie on the bed. All good stores provide shoe protection on their display beds. Mattresses should be neither too hard nor too soft. Slide a hand under the small of your back and feel if there is a gap. Lie on your side or in the position which you normally find most comfortable at night to establish whether the whole line of your body is straight and will be adequately supported during the hours of rest and sleep. A mattress which sags is equally bad for you. Spending many hours curved like the shape of a slice of melon will mean that you will not only start the next day with a stiff, aching back but with lethargy as well from insufficient quality sleep.
It is a very good idea to try a range of beds from different manufacturers before making your choice. A bed should be one of our most important purchases, especially as we spend almost one third of our lives in bed, so don’t be afraid to be fussy. You will be spending many hours of every day either appreciating or regretting your eventual choice.

‘I hurt my back because I got tired’

One fact which often causes surprise is the time of day when you are most likely to strain your back. It is not always in the late evening when you are tired, but more likely to be in the early morning before the muscles have had time to warm up. The pain, however, may not be felt until later in the day or even when you eventually sit down to rest. Unfortunately, before embarking on household tasks or ‘DIY’ jobs, we seldom consider that we should ‘warm up’ our muscles like a sportsman. It may seem a little extreme to be stretching and carrying out a few exercises before hanging wallpaper or digging the garden, but it can be the difference between a successful day and one which results in misery.

‘I’ve put my back out’

Another misconception is that a sudden, severe onset of back pain is always as the result of a ‘slipped disc’. Intervertebral discs do not just carelessly slip out of position and in fact less than 5% of all back pain suffered is the result of a disc becoming displaced or squeezed between the bones of the spine. The vast majority of back pain is caused by the distressing spasm resulting from over-stretched muscles.

However, if the symptoms appear more serious than just muscle spasm with generalised aching, and involve leg pain, severe immobility or numbness/pins and needles down the legs, then the possibility of a prolapsed disc should be considered. This should be examined by a medical practitioner as the situation requires accurate diagnosis before embarking on any programme of rehabilitation. Very occasionally, as the result of severe trauma such as a fall or sporting injury, a fracture dislocation is possible, but this is a matter requiring urgent medical attention.

‘I need to lie on the floor for six weeks’

At one time, when back pain struck, it was common practice to lie on the floor for perhaps up to six weeks, or to go to bed and stay there until the pain subsided. Although initially rest and analgesics (pain-killers) for a day or two will help to relax the injured muscles and relieve spasm, prolonged bed rest has now been proven to worsen the pain and delay recovery. Walking and gentle exercise should be resumed as soon as they can be tolerated. If the spasm is so bad that walking is too painful, frequent stretching and rotation of your ankles will help to stimulate the circulation to your legs and lower part of your body.
‘I’m too young to get back ache’

A popular misconception held by young and fit individuals is that they cannot harm their backs because they are supple and their muscles well-developed. Although youth and fitness are of enormous benefit, nobody can be said to be exempt from a back injury. A single movement repetitively carried out, such as stooping to polish a car, or maintaining an awkward position, for example, sitting slumped in a chair, can bring about the first signs of weakness.

Contrary to common belief, back pain is not infrequent in 30-50 year olds. This is often a time when poor posture and inappropriate lifting techniques which have persisted during the earlier years eventually reveal a physical weakness in the back muscles. Good practice learned in childhood is the best protection against harm. In later years, although natural degenerative processes are responsible for a slight shortening of the spine, reduced muscle tone and decreased bone strength and thickness, elderly people are less likely to over-estimate their ability to move or lift a heavy item. Young men in particular are often reluctant to ask for assistance with a heavy load, perhaps fearing that to do so may appear weak in the presence of their peers.

‘I hurt my back once, so I know it is weak’

Back problems developed in youth or middle age do not have to be an indication that it is the start of a slippery downhill slide into a world of disability, walking sticks or wheelchairs. Strengthening exercises, improved posture and more accurately assessing the tasks to be carried out, will help to prevent recurrence.

‘If I ignore it, it will go away’

Back pain is not something in your imagination or which can easily be ‘worked off’ by persevering with a strenuous physical task. All pain is real and a symptom that something is wrong. By ignoring the pain and continuing with the activity in the hope that eventually it will go away, will more likely exacerbate the problem and delay healing of the strained tissues.

‘An operation is the only answer’

Unfortunately there is no ‘quick fix’ for back pain. Surgery to the back does not guarantee to cure all types of back pain in the long term. Statistics show that up to 30% of patients may suffer in some way from the effects of the surgery or may not even gain adequate relief from their original backache. Your orthopaedic surgeon will discuss both the need and implications of any kind of invasive procedure to make sure that you fully understand the anticipated outcome of such surgery. He will also want to be sure that all other more conservative treatments have been thoroughly explored first.

‘You can see that I am in pain’

There are very few signs, if any, to the casual observer that someone is suffering from constant, nagging back pain. Recovering from back pain can take anything from a few days to several weeks. This sometimes means that sympathy and patience can wear a little thin, even drawing accusations of laziness or being ‘workshy’. Back pain is not, however, a problem that you have to live with. There are many solutions, appropriate to individual circumstances, including both orthodox medical treatments and alternative therapies, which can be very helpful.

Positive conclusion

Back pain that is not actively challenged is unlikely to be a ‘once-in-a-lifetime’ event. It is important to keep that in mind – it is not a myth! However, when life is back to normal and full mobility restored, the whole event and its accompanying misery may be quickly forgotten. Do not drop your guard – it is a recognised fact that following one episode of back pain, you are three to four times more likely to suffer its wrath again. Therefore, as soon as full mobility has been restored is the time to make the conscious decision to improve your everyday posture and lifting techniques. This makes muscle-strengthening exercises (see chapter 12) all the more important to prevent that recurrence. First, however, we will look at the causes of back pain.

This blog is taken from ‘The Smart Guide to Back Care’ by Janet Wakley.

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Nutritional approaches to CFS

Food choice and quality

The value of choosing, where possible, locally grown or produced food has been much reviewed and generally agreed upon in recent years. We all have access to news items, television programmes, magazine articles and, for many of us, internet information on this subject. The value and availability of local, seasonal produce have been discussed at length. Many authors in Europe and America have written controversial books covering such subjects as poor food quality, food commercialisation, food additives, pressure advertising and many other contentious topics. A selection of my favourite authors includes: Michael Moss, Bee Wilson, John Humphreys, Ben Goldacre, Barry Groves, Stanley Feldman with Vincent Marks, and Eric Schlosser.

Meanwhile our chefs and celebrity cooks have made us more aware of our poor-quality school meals (Jamie Oliver), the use of country produce (Hugh Fearnley-Whittingstall), or simply good quality food and healthy cooking methods (Gary Rhodes, Nigel Slater, Simon Hopkinson etc). Having scanned today’s main TV channels (Free-Sat) today being a typical quiet Thursday in March, I have identified 13 programmes whose subject matter is cooking or food. This does not include the radio programmes.

With such unrelenting advice on food selection, preparation and cooking it is difficult to believe that an unhealthy diet is possible in the UK. Although media and governmental advice on ‘healthy’ eating can be conflicting, we are all aware that refined, processed and generally harmful ‘junk food’ is best avoided. At the same time, I frequently encounter patients who admit that their diets are dreadful; their excuses range from lack of time to dislike of cooking or shopping, or simply a result of craving all the wrong foods.
Regrettably, a major motivation for many people’s food selection is a result of economic necessity. Such items as convenience foods, TV snacks, cakes, biscuits, crisps, chocolate, cola-drinks and alcohol feature as essential components in many weekly housekeeping bills. Quality proteins, in particular beef and fish, are beyond the household budgets of many families. The failure of many schools to give basic education in cookery is also very much to blame. It would be so easy for all teenagers (both sexes) to have basic cookery skills taught to them whilst at school, to form a basis upon which to draw in their adult life. It is common knowledge that many school children do not know where milk, eggs and common vegetables (potatoes, tomatoes etc) have come from, or how they are grown.

I have already outlined my opposition to high-carbohydrate diets and criticised the ‘healthy eating’ maxim that advocates five portions of fruit and vegetables daily. Such disorders as syndrome X, diabetes, obesity and a huge range of health problems can result from such diets. I have emphasised the value of eating proteins at each meal and also animal fats as part of a recommended diet. There is only one advantage to a high-carbohydrate diet: it is inexpensive. A diet rich in cereal foods and root vegetables has been defined as ‘peasant food’. Protein foods have for centuries been the preferred food of the middle and upper classes. One only has to look at the favoured food of different countries and cultures to identify this class bias. Obvious examples of ‘people’s foods’ are rice in China, cereals and pulses in India, pasta in the Mediterranean area, wheat in Europe and America and potatoes in Ireland. Carbohydrates are cheap, filling, tasty and usually easy to prepare.

This has made the current official recommendation for the diet to consist of 50–70% carbohydrates all the easier for people to adopt. However, it is seen by many as a major cause of the obesity, diabetes and heart disease epidemics that afflict the so-called civilised nations. Perhaps CFS should be added to the above list; certainly the prevalence of chronic fatigue, with the often related symptom of depression, is increasing each year.

The treatment of many health problems requires nutritional intervention and advice. Problems that are directly food related include gastro-intestinal complaints, leaky gut, candidiasis and food allergies, but systemic general health problems may also benefit from this approach.

Food digestion

Having reviewed the relative value of fresh, locally produced food versus processed ‘junk’ food, the next topic must be the part digestion plays in the breakdown of our health.
I want to start by considering several, generally held misconceptions concerning our digestion:

1. It doesn’t matter what we eat, as rubbish is eliminated and all the nutrients are absorbed.

2. The typical symptoms of indigestion – such as stomach fullness and wind, diarrhoea and/or constipation, heartburn and nausea – are all transient symptoms resulting from hurried meals or stress and are not serious health disorders.

3. The symptoms of indigestion can usually be solved by ant-acids, Immodium, paracetamol and other self-prescribed medicines. Advice or treatment is rarely necessary.

These misconceptions may be reassuring, but they prevent us from seeing what the problems really are. Digestive disorders, as with many ailments, do not always present matching symptoms. Achlorydria (lack of stomach acid), reduced pancreatic enzyme status, leaky gut, and low short-chain fatty acid levels do not present predictable diagnosable symptoms. To put it simply, a lot can go wrong before you are aware of the problem. This can result in a situation where quite serious gut problems can develop over several years before real action is taken to accurately diagnose and effectively treat the condition. I have a patient who had been prescribed ant-acids for eight years, for an acid stomach, before a gastroscopy was requested and a stomach tumour diagnosed. This resulted in surgery to remove one third of his stomach, yet this life-saving emergency surgery was preceded only by occasional heartburn and nausea until a few days before the stomach operation, when he developed severe blood loss and black stools. Not surprisingly, he had no awareness of the potential seriousness of his condition.

The gastro-intestinal tract is vital for energy production for our entire metabolism. The efficiency of every body organ can be compromised by digestive disorders. Naturopathic medicine, or ‘functional medicine’ as it has been termed in America, has promoted many clinical approaches designed to treat gastrointestinal disorders.

A brief review of these diets and treatment methods will serve to emphasise the value of the drug-free systems that have been prescribed to normalise gut function. I do not endorse all of these regimes, but I do agree with the common theme of non-invasive therapies to treat indigestion, without recourse to drug-based symptom relief.

This blog is taken from Why Am I So Exhausted? by Martin Budd.

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How food influences your mood

How Food Influences Your Mood

Learning to feel differently about food includes recognising the link between nutrition and mental wellbeing. There is no point in achieving a slimmer body if the price is depression and increased anxiety. Scientific researchers suggest people should be cautious in how they reduce their calorie intake while attempting to slim down as research findings show that sudden changes in nutrition, or reducing certain nutrients in a diet, can result in a worsening of depressive symptoms. (Sathyanarayana et al, 2008)

A study in the British Journal of Psychiatry (Akbaraly et al, 2009) also found evidence that eating a wide range of real foods versus processed foods of poor nutritional quality increased the likelihood of depression.

When people abruptly stop eating large amounts of processed foods containing unhealthy fats, and loaded with sugar, they can often experience withdrawal symptoms similar to those of going “cold turkey” from drugs. The withdrawal symptoms can last for several days and for some people the symptoms of headache, muscle pain and feeling below par can be powerful enough for them to return to their old eating habits just to make them feel “normal” again. Stick with the process, though, as the rewards will far outweigh any temporary discomfort.

Other nutritional deficiencies have a part to play in feeling low or even depressed. These include deficiencies in zinc, omega-3 fats, B vitamins, B6 and B12 especially, and vitamin D.

Missing meals can cause a dip in blood sugar levels, resulting in the release of adrenaline which increases feelings of anxiety and can even be a trigger for raised levels of anxiety generally.

Disordered eating often involves binge eating. This causes physical discomfort but can also often be a trigger for feelings of despair and shame. If overeating happens late at night, the inevitable bloating can interfere with the ability to sleep, again lowering mood.

Following a restrictive diet where carbohydrates are eliminated has an impact on serotonin levels in the brain that can lead to feelings of depression. We encourage eating a balance of complex, unrefined starchy carbohydrates such as vegetables and protein and healthy fats to maintain a positive mood, and promote satiety.

Making changes towards healthier food choices is obviously beneficial on many different levels. The changeover can happen during a radical period when mass changes are made, or one meal at a time, gradually reducing the amount of processed sugars and high fat foods that are eaten. How this is tackled is down to personal choice, and what best suits each individual.

In essence, a healthy diet will not cause ecstatic happiness but a poor diet could be a contributing factor to feeling low, so it’s important for mental wellbeing to eat a wide variety of real foods.

This blog is taken from How to Feel Differently About Food by Sally Baker and Liz Hogon. You can read the first chapter here!

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So, what is the Paleo diet?

What is the paleo diet

First, it is important to state there is no such thing as ‘the Paleo diet’ per se. Pre-agricultural diets were regionally variable and seasonally cyclical. In colder climates, they tended to be meat-based as the land was either under snow for much of the year or of poor quality and only suited to grazing. In warmer regions fewer red meats were eaten and fruits and plants dominated. Although the ancestral diet may have varied in content, it was more nutrient dense than that of today. So, although no standardised Paleo diet exists, the Paleo diet is usually defined by what it excludes, and is generally accepted as being, legume and dairy free.

It is thought that the advent of agriculture around 10,000 years ago marked the demise of the nomadic way of life, giving way to the cultivation of grains and legumes and the domestication of animals for milk. Archaeological remains suggest an abrupt decline in health at this time. Loss of stature, arthritis and other diseases associated with poor mineralisation seem to coincide with the introduction of grains into the diet. Ten thousand years might seem like a long time to those of us who hope to live to around 80 but is, in fact, the evolutionary equivalent of the ‘blink of an eye’, and would not have given us enough time to adapt.

However, there is archaeological evidence that some hunter-gatherers were eating grains much earlier than this. It seems the closer to the equator, the greater the intake of plant-based foods, which in some cases may have included wild grains. This may explain why gluten (and dairy) intolerance is more prevalent in colder latitudes, and why those with Scandinavian or north European ancestry are poorly suited to a vegetarian diet. What the hunter gatherer diet seemed to have in common was that they were highly nutritious and all contained meat or fish. They provided good levels of minerals, saturated fat and fat-soluble vitamins, with little or no grain or dairy and variable amounts of protein, most of which was derived from meat.

Much of the diet was raw which further increased the nutrient density and provided good levels of fibre. I suspect that rather than being historically accurate, the modern assumption that the Paleo diet was a high protein diet results from the misplaced fat and carb phobia diet that is still influencing nutritional thinking today. In fact, the food group most highly prized in the ancestral diet was saturated fat. Carbs have been given a bad press because they are nearly always derived from grains, a food group that causes problems in a number of people.

However, carbs from vegetables and fruits are much easier for the body to handle. A diet high in raw vegetables and salads does not have the same effect as a diet high in cereals, although both are high in carbohydrate. Whilst it may seem impossible to imagine a diet without grains, they are easily replaced by alternatives such as vegetable pastas, and coconut, seed and nut flours in baking and break making. Nuts can be fermented into cheeses, coconut cream into yoghurt and soft cheese, and the milk from nuts and coconuts can be made into delicious desserts and ice-creams, making Paleo eating varied and enjoyable.

What is also known about the Paleo diet is that it contained virtually no sugar. Refining has enabled us to concentrate sugars in quantities that our bodies are ill equipped to handle. For example, a soft drink contains the equivalent of eight and a half feet of sugar cane – an impossible quantity to get through in its unrefined state. The high proportion of carbohydrates in the modern diet compounds our inbuilt predilection for sweet foods.

Until technology got involved in food production, foods that were bitter were generally poisonous and those that were sweet were usually safe to eat, but that doesn’t apply today since many foods are laced with sugar, high-fructose corn syrup and artificial sweeteners – and they definitely aren’t safe to eat. Our first food, breast milk, contains a sugar called lactose and thus the early association between feeding and being loved is established before we are capable of conscious thought. Eating is associated with emotion, and this is one of the reasons sweet foods can be comforting, and why we can feel deprived and miserable when trying to give them up.

Despite their pervasive presence at nearly every meal today, in Europe and America grains were only elevated from animal fodder to dietary staple at the time of the industrial revolution, cultivating in us a taste for stodgy, high-carbohydrate foods, which has been a contributory factor to the obesity epidemic. The Arabic nations seem to have been eating grains the longest, and their wheat sensitivity and carbohydrate intolerance are rare. The rapid increase in degenerative disease that has characterised the last 100 years demonstrates that most of us have struggled to adapt. It is estimated that 80 per cent of cancers are related in some way to diet, and it is probably evident to you that much of the food we eat today could not be described as healthy.

In fact, much of it wouldn’t be recognised by even our recent ancestors. Not only are the foods themselves different – the result of selective cultivation or the products of technology – but the ratios of fat, protein and carbohydrate have been reversed. Fat phobia flourishes, and grains – previously dismissed as mostly animal feed, as I have said – now form the foundation of almost everything we eat. In addition, some of what passes for food isn’t food at all but a concoction of chemicals, conceived in the laboratory rather than grown on the land. Modern grass eaters, particularly cows, may not have had access to grass, and non-organic crops will have been forced to grow in demineralised soils, which is why today’s produce contains an average of 80 per cent less nutrients than it did only 50 years ago.

This blog is taken from Go Paleo – Feeding the Urban Caveman by Eve Gilmore. You can read the first chapter here!

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Trick and Treat: How healthy eating is making us ill

Trick and treat: how healthy eating is making us ill

Every year the amount of money the Chancellor gives to the UK’s National Health Service goes up and so do our taxes to provide for it. And every year we hear more and more complaints about falling levels of service, lengthening waiting times for treatment, and worsening levels of hospital-borne diseases. With the billions of pounds we pump into the NHS each year, have you ever wondered why we don’t get a better service? The reason seems to be because we do pump billions of pounds into the NHS every year. Continue reading Trick and Treat: How healthy eating is making us ill

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A gentle introduction to IBS for IBS Awareness Month

Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is an invisible, fluctuating disease and as such it is often difficult for family members, friends, colleagues, health service professionals, welfare insurance administrators and others who encounter people with the disease to understand the suffering of the individual.

People with IBS are often faced with troublesome and sometimes severe physical symptoms that in different ways obstruct or challenge their everyday life. The disease is by its nature potentially shameful. In our modern western society some of our most fundamental bodily functions, like flatulence and defecation, are considered to be private and nothing you would want others to know about. Hence, for many persons with IBS, sharing their illness experience does not come easily.

Among healthcare professionals, knowledge about IBS is quite often insufficient and it is regarded as a low-priority disease. Sometimes IBS patients find that their troubles are dismissed or belittled, for example, in healthcare encounters or by family members. Not being taken seriously – at home or by healthcare professionals – can be a devastating experience which affects self-image. For some people getting the diagnosis is affirming, providing a legitimate passport to the healthcare system. For others, however, being diagnosed means nothing but being a ‘closed-case’, and they feel left with insufficient information, advice and support. They find they have more questions than answers. In the jungle of potential self-management suggestions (available through various websites, blogs and chat forums) about what to eat, when to sleep or how to behave if you get urgent bowel movements and start to panic on the bus, it is easy to get confused. Being on your own, having to figure out how to live the rest of your life with an illness that won’t go away, and a disease for which there is no treatment or clear and certain ‘rules’ to follow but learning to know one’s own body and what works best, is not an easy task.

Literature about IBS has until now tended to be either too medically orientated, complex and difficult for lay people to understand, or to be like a pamphlet, too brief to be useful. Irritable Bowel Syndrome is therefore a very much welcomed contribution for all laypersons – people with IBS, family members, colleagues, neighbours and others who for some reason need to learn more about the disease, what life with IBS is about and what help is out there. The book offers a thorough explanation of the mechanisms and (as far as there is scientific evidence) likely causes of IBS, and of available pharmacological and non-pharmacological treatment options. It also portrays life with the illness from the perspective of those who live with the disease, and linked to this, a variety of self-care strategies are described. The book can of course be read as a whole, but it also forms a very useful reference book for certain aspects or topics of particular interest to the reader. I am certain that anyone who is interested in knowing more, or has specific questions, about IBS will find useful information and answers to their questions.

Cecilia Håkanson RN, PhD is a researcher and senior lecturer at the Palliative Research Centre and the Department of Health Care Sciences at Ersta Sköndal Bräcke University College, Stockholm, Sweden. She is also an affiliated researcher at Karolinska Institutet, Department of Neurobiology, Care Science and Society, in Stockholm, Sweden.

This extract is taken from Irritable Bowel Syndrome: Navigating your way to recovery By Dr Megan Arroll and Professor Christine Dancey

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Sleeping for Health

We love bed times. Nothing beats a good night’s sleep, but it isn’t always so easy to get one so we’ve put together some of our favourite sleep facts and tips from three of our health books. If you’re catching more AAAAAH!s than ZZZZZZs we hope this blog can help you find the sleep of your dreams.

 

Prepare to snooze or prepare to lose

Ensure that you don’t eat within three hours of bedtime – easy to say, possibly harder to do. I know many people who snack in front of the TV in the evenings. Watching TV late in the evening can interfere with your sleep patterns, and we need that surge of human growth hormone that occurs shortly after we fall into deep sleep. Reading, or meditation, to calm the mind prior to going to bed allows the body to go into sleep mode more naturally. Eating too close to bedtime also causes a surge in cortisol, the stress hormone that we know is bad for bones, so don’t fall into this trap. If you have trouble sleeping, try a camomile or valerian tea before bed. These herbs are non-addictive and have no adverse side effects.

Love Your Bones: the essential guide to ending osteoporosis and building a healthy skeleton by Max Tuck

 

Food, water…sleep?

Humans evolved to sleep when it is dark and wake when it is light. Sleep is a form of hibernation when the body shuts down in order to repair damage done through use, to conserve energy and to hide from predators. The normal sleep pattern that evolved in hot climates is to sleep, keep warm and conserve energy during the cold nights and then to sleep again in the afternoons when it is too hot to work and to hide away from the midday sun. As humans migrated away from the Equator, the sleep pattern had to change with the seasons and as the lengths of the days changed.

After the First World War a strain of Spanish ‘flu swept through Europe killing 50 million people worldwide. Some people sustained neurological damage and for some this virus wiped out their sleep centre in the brain. This meant they were unable to sleep at all. All these unfortunate people were dead within two weeks and this was the first solid scientific evidence that sleep was as essential for life as food and water. Indeed, all living creatures require a regular ‘sleep’ (or period of quiescence) during which time healing and repair take place. You must put as much work into your sleep as your diet. Without a good night’s sleep on a regular basis all other interventions are undermined.

Prevent and Cure Diabetes: Delicious diets, not dangerous drugs by Sarah Myhill and Craig Robinson

 

Sleep and mental health

When sleep requirements are not being met on an ongoing basis, teenagers will present with fatigue, low energy, exhaustion, and a lack of motivation. It is generally recommended that teenagers get eight to 10 hours’ quality sleep a night. This is vital for the body to relax, repair and refuel. Lack of sleep has a domino effect and impedes mental and physical wellbeing, inviting the onset of self-defeatist syndrome. As I have said already, parents are advised to take their child to a GP to rule out any organic causes of fatigue. In instances where no organic cause is established it is highly likely that the Gremlin has moved in. The Gremlin loves and thrives on the darkness. It becomes alert and active, coming out to play its evil games at night when we are programmed to relax, unwind and fall into a peaceful slumber. The Gremlin is very powerful and demanding, wanting to keep us awake, bolstering and encouraging negative thinking, which leads to rumination, tossing and turning and feeling like our head is going to explode! Thoughts are negative, racing and exhausting. It is vital that teenagers who have been taken hostage by the Gremlin receive appropriate support and professional intervention so they may be facilitated in developing the tools and techniques needed to evict the Gremlin.

Overcoming Self-Harm and Suicidal Thoughts: a practical guide for the adolescent years by Liz Quish

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Discussing dementia with Jeremy Hunt, Secretary of State for Health

Since I began working with a national dementia charity nine years ago there have been many improvements to the level of support that people living with dementia (by which I mean both those with a diagnosis and their families and carers) receive. It is now rare for me to meet someone who has struggled for months to get a diagnosis. More GPs are aware of the signs and symptoms and people are more likely to be referred for memory assessment. When I met Jeremy Hunt he explained that he had been campaigning for earlier diagnosis knowing that this can make it easier for people to get the help and support they need. We discussed what still needed to be done for those affected by dementia.

It seems to me that the most important thing now is to get society in general to accept those with dementia and to keep them integrated in the company they know and enjoy. Day centres, Dementia cafés and other specialist services like musical memory groups all serve a useful function and are popular -until recently I ran a very well attended and popular dementia café myself – but our real aim should be to make it possible for people with dementia to continue to go to the social groups, clubs and events which were part of their life before diagnosis.

Some things are already being done. In many places, in Britain there is a huge campaign to make businesses, shops, and public areas ‘dementia friendly’.  The ‘Dementia friends’ campaign by Alzheimer’s Society has also had a big impact in terms of making people generally aware of the difficulties experienced by those with dementia trying to function in everyday life. These are all good initiatives. But acceptance is the key. The above initiatives make people aware of dementia and they may make people more willing to help when they see someone having difficulties but do they make people with dementia more accepted?

Dementia is a problem for all of society but this is still little recognised. Most public places are now ‘accessible’ in terms of physical disability with level paths, ramps for wheeled access, better signage, bigger parking spaces and so on. We should now consider making changes to improve accessibility for those with the cognitive disability. Such changes might include material factors such as better street signs, clear demarcation of different areas and well defined entrances and exits but they should also include the vital human factor. People with dementia need support from other humans. Assistive technology can be helpful in a limited way but social interaction is what slows the slide into helplessness. Just as the public have been educated to recognise the rights and needs of those with a physical disability, so the rights and needs of those with a cognitive disability need now to be addressed in our neighbourhoods and our public places and by all of us in our local communities.

Mary Jordan is an expert in dementia care and works for a national dementia charity. Her books The Essential Carer’s Guide to Dementia and The Essential Guide to Avoiding Dementia offer invaluable insights into the condition and how to care for those with the condition.

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UK Blog Awards 2017 Health & Fitness Mixer

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Hammersmith Health Books are proud to be sponsoring the Health and Social Care category at the 2017 UK Blog Awards. Last week we threw an event with Action PR to celebrate our partnership with the UK Blog Awards and the fantastic entries to the brand new Sport and Fitness category. We met some very inspirational people who have chosen to share their health journeys through the medium of blogging. It was lovely to see new friendships form as people were able to put faces to those who they had previously only known by their blog names. It was also announced that the stunning Chessie King, who inspires her many Instagram followers with her sunny attitude and her dedication to health and fitness, will be hosting the UK Blog Awards.

In keeping with the theme of the Awards, which will be ‘blog heroes’, Action PR sourced an array of weird and wonderful fancy dress outfits. Throwing themselves into the spirit in true superhero style, the bloggers embraced the theme and posed for photos. With a giftcard up for grabs (generously donated by Active in Style), our very own Director Georgina Bentliff was tasked with judging the snaps and awarding the prize to the best one. The winner went to the delightful Patricia, whose battle with ME and record breaking rowing success was a truly humbling journey to follow, documented on her blog, Girl on the River.

The event was catered by the wonderful Mr Prempy’s, who provided raw vegan cakes, from chocolate ganache to beetroot and passion fruit. Bloggers and judges mingled, cake and prosecco in hand, with some feeling distinctly merry by the end of the evening. We went home armed with Action PR chocolate bars, healthy takes on traditional Mars and Snickers bars, full of raw cacao and other delicious ingredients.

Hopefully there weren’t too many sore heads the next morning! Thank you to Action PR for a wonderful mixer and a great opportunity to meet some fantastic bloggers and influencers in the health and fitness space.

Are you a #bloghero? Don’t forget to enter your blog the The UK Blog Awards 2017.