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IBS – dietary advice to calm your gut – book

Our new book IBS dietary advice to calm your gut was published last week. We wrote the book to provide information about diet and living well with IBS.  [Look at talkhealth‘s freebies page with a chance to win a copy of the book (closes 14.12.17)  and also look in the review section to see latest reviews.]

One of the most important facts I tell people who are newly diagnosed with IBS might surprise you, as it is not diet related. The importance of learning as much as you can about IBS and the different treatments that can help, should never be underestimated. Knowledge is power, so people say.

Receiving a diagnosis of IBS is challenging, but it is worthwhile having this diagnosis, however as a diagnosis often described as ‘a diagnosis of exclusion’, you might not feel it is. A few tests to rule out some diseases with similar symptoms are all that are usually needed to diagnose IBS and then doctors can be very confident that a person has it.

IBS is a long-term condition, which has no specific cure. You might then be wondering, how is having this diagnosis possibly worthwhile? Well, knowing what you are dealing with allows the person to start their own recovery by addressing symptom improvement – this is the mainstay in treatment and many people who have had recovery of symptoms have done so by finding their own path to it. If, however you have been told ‘I don’t know what is wrong’ or ‘I cannot medically explain this’ by your healthcare provider, this can leave a person confused and ‘stuck’ in seeking answers for their symptoms and seeking a diagnosis, whilst symptoms sadly continue. My friend and IBS Network Trustee Vicky Grant has said that this diagnosis takes you on a journey of discovery, a journey of knowing about yourself and what is likely to help you with your symptoms. Vicky would describe herself as recovered and her help was crucial in writing our book.

So, IBS is very individual condition and the person that knows best what will work is you, but you need to have the knowledge of what works to be able and confident to apply it. My response to this need was to write the book with my co-author Alex Gazzola to help people learn about how the gut works, what happens when it doesn’t work as well when you have IBS, what dietary and other lifestyle interventions might work – and perhaps more crucially, those that are unlikely to work and the reasons why. It also discusses access and how to work alongside healthcare providers in your journey to learning more about your IBS. The books main focus is diet, but also living well with IBS too and therefore covers other aspects such as emotional well-being, physical well-being and very practical matters such as eating out, travel and something we are not often taught – how to use the toilet properly!

To gain more confidence, being around others who are in the same situation can give much needed reassurance and support. The IBS Network offers such as service and accessing support groups or joining as a member can provide the support people might need on their personal journey to explore recovery. https://www.theibsnetwork.org/ I encourage others to join and also support the charity that is providing real help for people living with IBS.

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Is porridge better for health than statins?

A study conducted by Chris Seal, Professor of Food and Human Nutrition at Newcastle University, has stated that the incredible health benefits of porridge outweigh those gained by taking daily cholesterol-lowering medication.

“Porridge is known to have many health benefits; it’s low in fat, high in fibre, low in sugar, and contains minerals and B vitamins. But the thing that gives porridge’s benefits the edge is its high beta glucan content. Beta glucan is a soluble fibre that forms a thick gel in the stomach, reducing appetite after eating, while lowering the absorption of low-density lipoprotein (LDL) or ‘bad’ cholesterol. Prof. Seal says that, according to studies, eating 3g of beta glucan a day, roughly equivalent to the amount found in a 70g bowl of porridge, can reduce levels of LDL cholesterol by approximately 7%.”

To read the full myth busting story, please find the article here.

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What anaphylaxis feels like and how to live with the fear

I could probably write a whole book about this and maybe I will, but for now this is more about a kind of therapy for me. In September I ate out in a cafe in America and had the worst allergic reaction of my life.

Anaphylaxis - Fear of using auto-injector
Anaphylaxis, Anger and Fear

I often joke about it when anyone asks me, “When was the last time you had a reaction?”
I’ll say something like, “A few years ago, I’m due another one!” and try to laugh it off.

Because that’s how I cope with it.
I have to live with it so I kind of ignore it. I never stop being vigilant but I always think that nothing bad will actually happen to me.

Well this time it did.

My previous reactions have been terrifying.
They’ve been painful.
I’ve felt scared and fought for my breath and wondered if this is the time. If this is the reaction that will get me.

But I’ve never had a reaction which came so suddenly and out of the blue.
One that left me with literally only minutes to react.
An attack which floored me completely.
Left me unconscious and meant my friends, who I owe so much to, had to take over and get me the help I needed.

I am so very very grateful that they were able to get to me and phone for help.
I did try to but after administering two adenaline injectors I knew I was passing out.
I knew I had moments left. Nothing was helping. Inhalers, antihistmines… nothing made any different.

The last conscious thing I did was send a whatsapp message to my friends. We had a chat group to help us meet up while we were away. And I wrote these few words.

“Help me. I’m having an allergic reaction…”

As I sent this message I had the sense to prop my door open and I don’t remember much after that. I had managed to crawl to the bed, to the hotel room phone, but I was phoning the wrong number. The UK emergency number.

Nothing prepares you for the crippling fear of knowing you might be dying.

And that, my friends, is as far as I’ll go on this subject for now.
Because I can’t talk about this yet to anyone with out breaking down in tears. Writing about it is strangely calming. I can delete, rewrite, think and understand how I’m feeling. Faced with another human and I just get so emotional.

I’m slowly pulling together interviews with all the people involved so I can make sense of what happened and learn from it.

I have lots of upbeat, happy, helpful posts planned too which have nothing to do with allergic reactions, but for now you’ll have to join me in my therapy. I think writing about this is going to help me recover, come to terms with it and move on.

And if it helps anyone else who has had a similar reaction and feels fear, anger and rage like I am, you can work through this with me.

I’m hoping to find a therapist and some counselling as well as reading about anger management. Talking and writing have always helped me so this will be key to my future health and well-being. Don’t bottle it up. Talk about it. Tell people how you are feeling. Don’t suffer in silence like I’ve been doing. You don’t have to do this alone.

Special thanks to Hazel and Rebecca who both helped me to realise I need to get some help this week. Angels.

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Osteoporosis

Osteoporosis is a condition that affects many of us. It gradually becomes more common as we age but can also occur in those who are younger with osteoporosis-associated conditions. But what can we do about it?

Firstly lets look at what osteoporosis is.

Osteoporosis is a condition that develops slowly over several years. It causes a weakening of bones and therefore an increased risk of fractures. Osteopenia is a decrease in bone mineral density that is not yet bad enough to be categorised as osteoporosis.

So what causes osteoporosis?

Although a loss of bone mineral density is common throughout life, one of the main factors that speeds this up is menopause. Unfortunately this means that women are more likely to develop osteoporosis than men.

Other common causes and disorders linked to osteoporosis are:

  • Long term use of oral corticosteroids
  • A low body mass index
  • Heavy drinking/smoking
  • Genetics
  • Celiac Disease
  • Parathyroid conditions

So how is osteoporosis diagnosed?

A DEXA scan measures bone mineral density. Your results will then be measured against those of a healthy young adult and against someone of your own age. The deviation between the two will generate what is known as a T score.

Your T score results can be assessed as follows:

  • above -1 is normal
  • between -1 and -2.5 is defined as a decreased bone mineral density compared with peak bone mass
  • below -2.5 is defined as osteoporosis

So how is osteoporosis treated?

Many factors have been found to help those with osteoporosis:

  • Exercise
  • Vitamin D supplements
  • Stopping smoking and reducing alcohol intake
  • Eating foods rich in calcium and vitamin D.

To read further about exercises that benefit those with osteoporosis, please go to the pinnacle posture blog located here: https://www.pinnacle-posture.com/blog

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The operation to remove a cancerous testicle

The operation to remove a cancerous testicle – The surgeon’s view by Dr Ian Eardley, consultant urologist at Leeds Teaching Hospital Trust, Leeds.

“When a man has testicular cancer, almost always it is best to remove the whole testis. The operation is called “orchidectomy”.

“Orchidectomy in men with testicular cancer is a short surgical procedure that is usually performed under general anaesthesia. Most patients are able to go home on the day of surgery.

“The skin incision is a 10-15m incision in the groin, with the surgeon being able to access the spermatic cord through the incision. The testis lies in the scrotum, at the end of the spermatic cord, which contains several structures, most importantly the blood vessels that supply the testis. The cord is clamped before the testis is delivered into the incision. The cord is then divided between ligatures and the testis is removed and then sent to the laboratory so that the cells of the tumour can be examined. This may influence subsequent treatment. The wound is closed with sutures or clips.

“In some cases, if the patient wishes, a prosthetic testis can be replaced into the scrotum through the groin incision to give a better cosmetic appearance post operatively. Prosthetic testicles are the same shape and size of a testis and are made of silicone.”

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A Guide to… The Flu

The common cold or flu?

It’s not uncommon around wintertime for you, or the people you know, to start falling ill, complaining of sore throats and blocked noses – maybe even missing a day or two of work. Often, people will say that they’re “down with the flu”. But can you tell the difference between the common cold and a proper bout of the flu? Influenza can be a very serious illness depending on who it infects and what the strain is. After all, 20 million people died of influenza in 1918! While there has never been an epidemic anything like as bad as this since, it will make you sick far beyond the sniffles that many of us are prone to melodramatically label ‘flu’. In this post, we’ll find out how to tell the difference between these two seasonal afflictions, as well as when it’s appropriate to seek medical advice.

What is it?

The flu, short for “influenza”, is a viral infection of the upper and lower respiratory tract. This includes the nose, throat, sinuses, voice box and lungs. While it can happen at any time of the year, it is most common around winter. Although an annual flu vaccine is released, the virus undergoes genetic changes as it passes from person to person, leading to new outbreaks yearly across the world. The virus is spread through the air, infecting other people in droplets spread by coughing and sneezing. Although it is very contagious, hand-washing and not touching your face can play a significant role in preventing spread.

Symptoms

Unlike the common cold, which comes on gradually, the symptoms of the flu develop very quickly. Usually they begin a couple of days after exposure to the virus, but fortunately, the disease tends to run its course in a week or so. Some of the symptoms are the same as with a cold: blocked nose, sore throat, sneezing and coughing. However, the flu is also associated with a sudden fever with muscle aches and pains all over the body, as well as significant fatigue. Other common symptoms that are less associated with a cold are headaches and chills. Less frequent symptoms include:

  • Nausea and vomiting
  • Diarrhoea
  • Stomach pain
  • Loss of appetite
  • Difficulty sleeping

Although the flu is very rarely life-threatening in healthy people, an important distinction between it and the common cold is that the flu will disrupt normal activities of daily living, such as going to work. If you do have the flu, it is recommended that you stay at home and get some bed rest – chances are you won’t want to be out and about in any case!

Should I see my GP?

The short answer is: It is hard to say for certain, but probably not, not unless you feel really sick – or have another condition as listed below. The virus causing the flu cannot be treated with antibiotics however sometimes people do get pneumonia which does need antibiotics. The only way to treat most cases is with bed rest, making sure to drink a reasonable amount of fluids and taking over-the-counter medications for fever and soreness, such as paracetamol or ibuprofen.

Nevertheless, there are certain people for whom coming down with the flu should mean visiting their local GP:

  • People over 65 years of age
  • Pregnant women
  • People with chronic health conditions
  • People with weakened immune systems

These groups of people are also eligible for the flu vaccine, which is available for free every year on the NHS.

Even if you don’t fall into any of these categories, there are certain symptoms that should prompt you to seek medical attention. These include:

  • Chest pain
  • Shortness of breath
  • Coughing up blood
  • If the normal symptoms last for longer than a week
  • If your symptoms are getting worse over time

These symptoms may mean that you may be developing a chest infection or pneumonia, which is the most common complication of the flu. Fortunately, these are usually treatable with a course of antibiotics.

Further information

For more information about the causes and features of the flu, check out the NHS Choices website. If you are unsure about any of the symptoms you might be experiencing, call NHS Direct on 111 or, if you are particularly concerned, visit your local GP.

NHS Choices: http://www.nhs.uk/Conditions/Flu/Pages/Introduction.aspx

 

Dr Seth Rankin is Founder of London Doctors Clinic

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Spaghetti Cabonara -low fodmap

Whilst reading the Guardian newspaper recipe booklet this weekend I decided to have a go at one of the recipes in the pasta special and reduce the parmesan and low fodmap modify it. OK – this recipe scared me, adding egg to freshly cooked pasta – surely a recipe for scrambled egg, right? This is a classic Italian dish and no cream in sight and is a rich dish that is suitable for a low fodmap diet. It is easier to make than I first anticipated and much to my surprise, no scrambled egg in sight. This is a really creamy dish without adding cream and a tasty supper for chilli winter evenings.

I used bacon rather than pancetta as it is slightly leaner and 2/3 of the parmesan. Sometimes pecorino cheese is used instead – it really doesn’t matter. Having bacon occasionally is fine – I can’t actually remember the last time I did eat bacon, but obviously not a choice that should be included in your diet regularly and certainly not every day. This recipe was so easy but it could be included in an Italian themed dinner party or a relaxed meal with friends – it doesn’t take much effort at all – so give it a try.

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Ingredients

4 egg yolks

6 rashers of lean bacon

60g parmesan

400g of gluten free spaghetti

2 tablespoons of olive oil

Freshly ground black pepper

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Method

Bring a pan of water to the boil and cook the spaghetti according to the instructions on the packet – make sure that you follow the instructions carefully as this is the key to cooking the perfect gluten free pasta.

Whilst the water is boiling separate 4 egg yolks from the white (you can use the egg white to make meringue later) and beat.

Grate the parmesan

Add the olive oil to a pan and fry the bacon.

Drain the water from the pasta sauce saving a cup full.

Add the pasta to the bacon, off the heat and ensure the pasta is coated with the oil.

Add the eggs and cheese to the pasta with some of the pasta water and stir well till combined. The heat of the pasta will cook the sauce.

Add some freshly ground black pepper before serving and serve on warmed plates.

That’s it – serves 4.

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Jeweled Koshari – low fodmap

Koshari is a dish served in Egypt and usually has plenty of fried onions on the top and pulses mixed in the rice/pasta blend and added as a topping. Obviously the onion is a no-go for low fodmap diets, but the chickpeas? This could be used in small portions as long as the chickpeas are canned and have been rinsed well. No more than 2 tablespoons should be used per portion and this is tolerated well and will contribute slightly to the fibre and protein content of the dish. Also Koshari is served with a spicy tomato based sauce, which can also be low fodmap modified – see future posts for the topping. This does taste good without though although a little non traditional perhaps and a totally vegan carbohydrate to add to a meal with sources of protein such as a small handful per portion of low fodmap suitable nuts (walnuts, pecans, Brazil nuts, pine nuts for example) or firm tofu pieces.

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Ingredients

150g of white rice

50g of Camargue red rice

50g gluten free pasta

100g of celeriac

1 parsnip

1 heaped teaspoon of Lebanese seven spice (available from Marks & Spencer and low fodmap)

Chopped tarragon and thyme

2 tablespoons of olive oil

Chopped stalks of rainbow chard (the leaves can be cooked separately and served alongside the dish)

seasoning

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Method

Cook the carbohydrates in boiling water add a little salt and drain.

Whilst the rice/gluten free pasta is cooking chop the vegetable ingredients finely.

Add the olive oil to a pan and fry the spices to release the flavour and add the chard, celeriac and parsnip to the pan and coat well with the oil then roast in an oven till cooked.

Combine the ingredients and top with freshly chopped herbs.

Serves 5


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Osteoarthritis in the knee and exercise.

Exercise can play a vital role in managing osteoarthritis. People are often fearful of exercising the affected joint in case it causes further pain and damage yet this review of studies done on exercise programmes states  “People with OA should be reassured that it is unlikely to exacerbate their pain if performed using the appropriate methods and at the appropriate dose.”

Osteoarthritic symptoms are a normal response to what the joint is interpreting as an over stimulus, when the joint has settled down then exercise can be used to increase the joints capacity (however adherence of at least 3 months is needed).  In fact a Cochrane study in 2015 drew the following conclusion

“High-quality evidence indicates that land-based therapeutic exercise provides short-term benefit that is sustained for at least two to six months after cessation of formal treatment in terms of reduced knee pain, and moderate-quality evidence shows improvement in physical function among people with knee OA. The magnitude of the treatment effect would be considered moderate (immediate) to small (two to six months) but comparable with estimates reported for non-steroidal anti-inflammatory drugs”

Studies have shown that aerobic and resistance exercise of moderate intensity are safe and effective therapies for osteoarthritis,  but whilst any type of exercise maybe helpful targeting specific deficits seen in clients with knee osteoarthritis can effectively reduce pain.

Whilst there might be a fear of taxing the affected joint the only way to get muscle strength improvement is to overload the muscle group. Stronger muscles take the stress off the joints and help support unstable joints. There are methods of strength training that will ensure you gain muscle strength without stressing the affected joint.  In fact evidence has shown that incorporating strength training into an exercise programme decreased pain by 43% in osteoarthritic patients.

In any exercise programme it’s helpful to measure progression so the client can see the results of their effort, in osteoarthritis of the knee both maximal strength of muscles and strength endurance can be measured to show progression.  This in itself can provide motivation and self-management to the client.

Exercise is not a quick fix, adherence is the main predictor of long-term outcome from exercise in knee osteoarthritis therefore a important part of any programme will be promoting self- management. Each client is different but it could be an exercise programme they can do at home or, if a more social aspect is enjoyed, then classes in the community or local leisure centre.

The current ACSM guidelines for people with arthritis is cardiovascular work 30-60 minutes 5 days per week accompanied by resistance training with major muscle groups twice a week and flexibility activities. However if you are not currently active these are long term goals and you could start out slowly with 2-3 short sessions a day.  Arthritis Research UK has several exercise sheets  you may find useful.

I hope you have found this article informative.  If you do have osteoarthritis and are interested in an exercise programme to help then please email contact@wholelifefitness.co.uk. If you have any questions on this article please post a comment. By subscribing to this blog you will be informed of any new articles. You will not receive any spam email.

The post Osteoarthritis in the knee and exercise. appeared first on Whole Life Fitness.

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World Diabetes Day

There are two main types of diabetes with type 2 being the most common. In the last decade the number of obese people developing Type 2 diabetes has increased, despite the condition being preventable with a healthy diet and regular exercise. The high number of people with diabetes is almost costing the NHS £10 billion a year, with Type 2 diabetes costing £8.8 billion a year.

 

Diabetes is a serious disease and one that requires more awareness.

World Diabetes Day on the 14th November, is the world’s largest diabetes awareness day, created by the International Diabetes Federation and The World Health Organisation. The campaign aims to highlight the issues and growing concerns surrounding diabetes internationally.

This year’s theme is ‘Women and diabetes – our right to a healthy future’ it is estimated around one in ten women live with diabetes globally. However, not all women are aware that they may have diabetes. That is why campaigns like World Diabetes Day are important to increase awareness about diabetes.

If you’d like to find out more about diabetes, read one of our patient journeys on talkweight, talkwomenshealth and talkmenshealth for more information and support.

Are you living with Type 1 or Type 2 diabetes? Are you concerned that you may be at risk of developing diabetes later in life? talkhealth are developing a dedicated diabetes hub to offer support and advice to those who are living with diabetes , or think they may be at risk of developing the condition. Prior to the launch, we would like you to tell us about your experience and understanding of diabetes.

The survey will close on Friday 8th December. On closure all entrants who have completed the survey in its entirety will be entered into a prize draw for the chance to win 1 of 100 pedometers!

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