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Archive for the ‘Health’ Category

I cannot really imagine how it came to pass that mutilating one’s children became the traditional thing to do, but it was with great pleasure I read that some African villages are putting steps into place to stop the horrific practice of female genital mutilation.

The article can be found here.

Slowly but surely this practice must be phased out of existence. I would also hope that someday humans stop lopping pieces from perfectly healthy male babies under the guise of religious practice, but suspect that one might be a harder sell.

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A recent Guardian feature asked a number of fashionistas if the comfortable high heel, ‘the holy grail of fashion’ really exists. Oddly, many of the respondents agreed that it does, though there was little consensus as to who actually makes this mythical item. The article featured a bewildering number of shoe designers nominated for the ‘most comfortable heel’ award. One woman was of the view that pain-free high heels cost big bucks, while another argued that you can’t beat good old M&S for comfort in a towering heel.

Oops! Has this woman fallen off her shoe?

I decided that many contributors had to be telling porkies to justify their shoe addiction. In the short term, high heels cause corns, calluses and blisters. They throw the posture out of kilter, stressing joints and forcing weight onto the front of the foot. Prolonged wear shortens calf muscles and Achilles tendons and contributes to bunions and hammer toes. Women are more likely than men to suffer from knee and foot problems in later life.

At this point I must confess that I’ve never really got the whole shoe thing – I think I lack the relevant gene. I live in flat boots and ballet pumps, kitten heels at a push. While I can see that some heels are things of beauty, I find many of the more extreme styles of high heel ugly, ridiculous or downright trashy looking. There is also the small matter of being unable to walk in them.

Victoria Beckham has reportedly already suffered bunions, a painful bone deformity, caused by her obsession with heels. And as for that other killer heel wearing fashion icon, Sarah Jessica Parker – I’ve rarely seen a bandier woman.

Yes yes, I know, heels  are sexy and glamorous. But let’s not kid ourselves that they’re actually comfortable, eh ladies?

(Photo by twicepix on Flickr)

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Brace Yourself

Brave? Stupid? Or a bit of both? Today, at the ripe old age of almost-27, I’m having a brace fitted on my top teeth.

Don’t get me wrong, I’m no Shane McGowan – but my teeth are something that have bothered me for many years. I’ve never had completely straight teeth, not since my one of my adult teeth decided to grow faster than its baby counterpart was ready leave the comfort of my mouth, and consequently, developed slightly wonky. A New Year’s Resolution that I’ve made for as many Januarys that I can remember is finally coming to fruition.

The reaction of people when I told them I’m getting braces has been either a) “Braces? But you don’t need braces” (usually uttered by someone with perfect gnashers) b) “I had braces when I was younger, you’ll be grand”  or c) “Fair play to you” (more…)

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Patrick Holford’s appearance on the Late Late on Friday was televised to the nation as a gospel proclamation: come see my magic works and repent, oh ye of little scientific understanding. I presumed that this would be the part of the show where RTE trot out someone to allow the audience to snigger at their conspiracy theories or visions. Not so with Mr Holford, who was introduced as a world leading nutritionist.
Lets start with the title and work our way downward, Patrick Holford, or, to give him his proper title, ‘pill salesman’, has no qualifications. He has built a business on selling supplements to anyone that will buy them. He is not a medical practitioner, scientist, researcher or expert for a number of reasons.

1: Qualifications from a recognized third level institution :0
Most people agree that qualifications from recognized institutions are a prerequisite to taking medical advice from somebody. The letters after your G.P.’s name denote years of study and examination, something Mr Holford has conveniently sidestepped.

2: His peer reviewed publications : 0
Part of being a scientist is putting your findings out there within the scientific community for peer review. This involves having every minute aspect of your findings interrogated, criticised and if necessary; rejected. It’s a soul destroying process, and why would anyone willingly submit to it? The reason scientists do this is to protect the public, to produce work based on the best evidence available and to advance understanding.

3: Nutritionist is not a protected title; in other words, anyone can call themselves a nutritionist. I can call myself one and recommend daily snickers and bottles of Lucozade to beat the winter blues. My next bestseller will be ‘The Barbarians Nutrition Bible’, brought to you by Creme Eggs.

4: His ‘honorary diploma’ was awarded to him by The Board of the Institute for Optimum Nutrition, which is an educational trust that HE founded in 1984. The same as if I opened ‘The Barbarian Center for Barbarian studies’  and awarded myself a PhD from it. That’s Doctor Barbarian to you.

Moving swiftly on, his first contention that women have less serotonin than men and thus are far more susceptible to depression. That’s quite a statement there Patrick, so let’s see what you left out?
What he fails to mention is that serotonin –which he refers to as the ‘happy’ chemical’  – is also serotonin the ‘aggression’ chemical. So yes, we have less of that particular chemical than our larger male counterparts, evolution has yet to catch up on the need for greater amounts of serotonin in males. But to claim that this is why women present with greater rates of depression ignores the under-diagnosis of male sufferers, it ignores the greater pressures and burdens on women in society and it ignores the social aspects of women’s as opposed to men’s lives. Outside of the fact that the serotonin hypothesis of depression is but a part of the neurochemical reasons for depression and correlation should not be read as causation. There are other chemicals at play in the depression etiology, but Patrick did not feel like talking about those.

Why would he say this? As stated earlier, Patrick Holford is a pill salesman, carefully targeting the audience at home, in particular the ladies. They might be sitting there on a Friday night patiently awaiting the next ‘cure’, ready to go out shopping for it on Saturday. By appealing to women with half truths he reached his market, EPIC WIN for Patrick, 100 points off the bat, uncontested by the host. At this stage I was having a full John McEnroe freak out, hollering ‘you cannot be serious maaaaaannnnn’ at the TV. Holford was allowed ride roughshod all over Ryan, his facts, cherry picked from obscure sources, citing trials but failing to mention participants, full findings or financial backing involved. For, as Mr. Holford loves to points out, there are forces at play in big pharma, forces that want to manipulate the facts to suit themselves, but that’s not the way science works. The slow but steady erosion of confidence in science continues unabated, with the portrayal of massive organisations working to keep you hooked, unhappy and dependent. As opposed to ‘Alternative Pharma’ with such constraints. No one mentions how the humble supplement is now a multimillion pound industry in its own right.

The problem with manufacturing medicine is all the damn procedures! Peer reviewed publications in general science are open to criticism and stringent testing and retesting before they can be marketed to the general public. If you want to manufacture a supplement it’s much simpler:  all you need is one small link between two things, causal or correlation-we don’t care. Bang them in a bottle, stick the ould ‘may help’ claim before any claims, and bob’s your uncle.

Minute effects based on the interaction of cells in petrie dishes are lauded as proof of the efficacy of drugs. None more disturbing than Mr. Holford’s marketing of Vitamin C as a cure for AIDS in Africa. Ah yes, Tubs, you forgot to ask him about that, forgot to mention that inconvenient fact.

For facts have very little to do with Mr. Holford’s business. For a man who claims to be interested in improving the lives of people, of making people happy, could you really ignore that this man was recommending that people avoid using tried and tested drugs for the treatment of AIDS?.

I leafed through one of the few remaining copies of Holford’s book in the local bookshop Saturday evening, with chapters about how medicine is out to get you and how his pills will cure you. While a small minority of people will achieve placebo effects from Holford’s claims, the majority will not. Yet more will be negatively biased towards medicinal treatments for depression. Don’t get me wrong, I’m just as favorable as the next person to proper help and supports as well as environmental and social interventions to aid depression recovery. I am not, however, about to throw the baby out with the bath water; your G.P. is not there to dispense items which they know don’t work.

I only wish that our esteemed Late Late show host could find time in his busy schedule to read the background check on his guests and ask hard questions. One can only hope that a scientist turns up with Tubs next week to redress the balance. Learning a little about science can save you a fortune, it can save you from false promises and it always strives to save lives. I heartily recommend Ben Goldacre’s Bad Science; it’s a tenner you won’t waste, as it will pay for itself 100 times over when you find yourself reaching for the next ‘magic diet pill’ or ‘collagen rich cream’.

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Hospital Tales

We only spent 48 hours together. Three shoulders, a hip and a spine; female patients on an orthopaedic ward in various stages of recovery from surgery. But in that short time, we really bonded.

My mother has been in hospital a few times in recent years, and we were always amazed how quickly she got to know other women on the ward. I won’t be like that, I thought to myself, snootily. I’ll shut myself off with my books and my phone.

Time for your medication

It didn’t really work out like that. During my first two days after surgery, I welcomed the company of my fellow patients. We laughed, we cried, we hurled. We sympathised with each other’s pain (the shoulders seemed to have the worst of it), sleeplessness and, in my case, relentless nausea. How we moaned about Nurse A, who delivered the nightly drugs round with plodding slowness and a slightly unnerving air of confusion. We all agreed that she only had three wheels on her trolley. An unexpected moment of hilarity came when the occupational therapist gave me, with indecent haste I felt, a leaflet entitled ‘Sex After Your Hip Replacement’. Not exactly at the top of the ‘To Do’ list at the time.

But as well as this camaraderie, I also heard unbearably sad stories from two of the women.

While she was waiting to go to theatre, Mary, a woman in her fifties, told us a bit about her life. Her mother had become pregnant with her at 17 and, being unmarried, was packed off to the UK by her family to give birth. She stayed there after the birth and looked after Mary for the first two years of her life. But on returning to Ireland, she placed her daughter in an orphanage run by nuns. Mary never saw her mother again. She spent fifteen years there because her mother refused to allow her to be adopted. There was an even more cruel twist – Mary’s childless uncle and his wife offered to adopt her, but this was also refused. Maybe her mother always intended to return for Mary, but in the end she emigrated to Australia and had another family. What an awful, awful start in life.

Then, shortly before I was moved to another room, another tragic tale. Christine, who had been extremely anxious to be discharged, was waiting for her husband to collect her. The ward was quiet; another woman had left earlier that day and the other two were asleep. She began to tell me about her 25 year old son. A few days before she was admitted to hospital, he took an overdose of anti-depressants. He survived, but this had come as an immense shock to her and she was still struggling to comprehend why he had done it. He is the father of two beautiful children, whose photo she had proudly shown us all. Like so many others, he had lost a well paid job, He is currently working long hours for the minimum wage in a job he hates. Despite this, he insisted on taking the family for their usual holiday abroad last year. She felt that perhaps this struggle to keep up appearances and provide for his family had finally become too much for him.

Now I understood why she was so keen to go home. She was terrified. All she wanted to do was mind her precious son, put her arms around him and protect him from the unthinkable. Hearing this, I was amazed at how well she had managed to hold things together during her hospital stay. She dried her eyes, her husband arrived and she was gone. Her story, and Mary’s, have stayed with me.

The experience of hospital and surgery leaves you emotionally vulnerable. It’s unlikely these women would have opened up to strangers in another situation. And it’s sad to think how their stories are typical of so many others in this benighted country.

(Names have been changed)

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A place of concern

One of the fittest women I know made a remark the other day that caused me to snort. A relative mentioned that she was afraid this incredibly strong woman was becoming ‘too thin’ and various other remarks that were even less complimentary- and unasked for- about her physique.  The fit person was rather perturbed by this, seeing as how she’s been packing on plenty of muscle and has never felt better. I can attest to the fact that she looks bloody amazing. You could bounce a Euro off her arse and catch it a few feet away.

"You should get rid of those glasses and wear totally different clothes! I'm not being mean, I'm just concerned about you!" Unwanted advice, Liz Wakefield-style.

‘Do I look scrawny?’ she asked.

‘No, you don’t,’ I said through gritted teeth ( I was squatting at the time), ‘don’t mind her. Is she normally so pass remarkable?’ ( thank you Granny!)

‘Naw, but she’s pregnant and has put on a bit of weight herself.’

‘Well there you go, pregnant people think every body looks skinny. I’d take what she said with a pinch of salt.’

‘She kept going on about it though, said she was concerned about me.’

She rolled her eyes.

‘Concerned my hole.’ I said, totally in my head though because is does not do to pass comment on the relatives of others. Ever.

I don’t know about any of you, but I have noticed before that there is a certain brand of ‘concern’ that usually goes hand in hand with a touch of ‘the smugs’ and a hint of green eye.

My best friend was gravely insulted from a place of concern once. Heavily pregnant, in the highest of heels and attending a wedding, she was having a blast until she learned that a middle-aged woman of renowned bitchiness had remarked that she was ‘sick looking, even with all that ould make up plastered on her face’. When called on her rudeness, the woman claimed that her observation came not because she was a jealous harpy but because she was ‘concerned’ that my friend might be overdoing it.

When another friend finally broke up with her cheating arse of a boyfriend, all manner of insults were tossed her way under the guise of ‘concern’.  It seemed no matter what she did, if she cried, if she spoke of her fears, if she didn’t, she was picked apart by the ‘terribly concerned’, the general jist being she was clearly a bit stupid and needed to be told things she already knew, regularly.  Poor woman was terrified to open her mouth lest someone slot another wedge of concern in there. Yep, nothing speaks to concern- and friendship- more than rubbing another’s face in it.

When I piled on weight after short but effective battle with nearly 17 years worth of nicotine addiction, people could not wait to get in my face about my health, all under the banner of concern you understand. Diets were mentioned oh so casually, throw away remarks that could cut to the quick were bandied about willy nilly. ‘You don’t want leave it too late and get too heavy’ I was told once, leaving me to wonder what the cut off point was for ‘too‘ late.

I am currently considering giving up alcohol. I train a lot, see, alcohol and training are a poor mix. I never drink during January anyway out of habit, and I am enjoying the lack of hangovers and the clear headedness. I mentioned this to a person in passing the other day and was hit with a wave of ‘concern’ that I might somehow turn into a dry shite with all the social skills of an amoeba should I undertake this ‘radical’ course of action.

I pondered this for a spell. While it is true that socially most things take place around the pub scene, many things do not. It seems unlikely my lust for life might turn to dust simply because I have ceased to gargle, well, gargle. So where on Earth was this particular ‘concern’ coming from?

Well who knows, all I do know is that every so often someone we love will say something from a place of concern and mean it.  But  if you’re happy in your nappy, harming no one and getting on with life, sometimes it behooves us to remember that not all concerns are created equal and some concerns are not concerns at all and to those concerned, they can shove it where the sun don’t shine.

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Mothers’ milk

Breastfeeding’s been in the news again over the last few days, and some irritating coverage of a paper in the BMJ got me thinking again about why Irish breastfeeding rates are so poor.

The British Medical Journal has just published a paper suggesting a rethink of the current World Health Organisation guidelines on weaning babies – that is, that optimally, babies should be exclusively breastfed for six months, then weaned onto solids. The papers leapt all over it, of course. The Daily Mail chose to focus on “warnings that exclusively breast-feeding for six months ’causes allergies‘” while the Telegraph breathlessly (and with poor grammatical structure) announced that “Only breastfeeding for six months may increase anaemia in babies: experts”

Now, mothers with new babies usually don’t have the time to brush their teeth or read to the end of a takeaway menu. In the few spare chunks of time they get they’re more likely to be sleeping (or in my case, sobbing) than knuckling down to review scientific papers, but they might well wheel the pram past sensationalist headlines such as the one the Guardian chose on Friday: “Six months of breastfeeding alone could harm babies, scientists say” and take them at face value. In fact, of course, the paper is couched in far more cautious terms and says that the (British) Department of Health might agree with a recent European Food Safey Authority conclusion that complementary foods may be introduced from four to six months and that six months of exclusive breast feeding may not always provide the necessary nutrients in exceptional cases, etc etc.

But while I initially thought, Christ, here we go, with the media whipping up a  mini-frenzy and creating more confusion over babies’ health recommendations for parents to digest, my immediate follow-up was to think that, depressingly, in my experience in Ireland, the WHO recommendations haven’t exactly been highlighted and hammered home here yet anyway.

Perhaps on paper we are behind the WHO, but when I had my last baby two and a half years ago, not one medical professional I encountered suggested exclusive breastfeeding up to six months. I was told to feed for a few weeks if I really wanted to, and switch to a bottle if I had “a hungry baby” or if I wanted to rest, and wean onto solid food from about four months.The early days of breastfeeding are hard work and often very painful, and they’re not made easier by mothers, instead of being encouraged and supported in their (often hideously painful and disheartening) early attempts at breastfeeding, being encouraged to give a bottle or mix feeding early on, by which I felt I’d be risking either the supply dwindling or the (faster-flowing) rubber teat becoming more appealing. The message I got was, formula bottles are easier all round, but we won’t stop you breastfeeding if you want to, and yes, it is better for the baby.

I do want to feed the baby myself, I said, and they said that was fine, and wasn’t I great, but the formula option was always there, especially if I wanted the baby to feel fuller for longer and get a bit more sleep myself. This was also what the public health nurses told me, saying that I had a large baby and he would prove hard to satisfy. On the one hand, you might think it a surprisingly human and mother-centric approach, but on the other hand it’s not the official Department of Health line, which is to endorse the WHO in saying that the best route for your baby is to be breastfed exclusively to six months, and weaned onto solid food from then on.

The pro-breastfeeding lobby takes a battering every now and then: get back in your yurt, knit yourself a Breastapo membership card, stop bullying new mothers who already feel overwhelmed, stop trying to make women feel guilty, didn’t you know some women can’t breastfeed? Ultimately, every woman will choose for herself and her child, which is as it should be, but the choice should be made on the basis of all available information and I’m not sure how well educated we are here. There’s no getting away from the fact that Irish breastfeeding rates are among the lowest in Europe – described in the Irish Medical Times in 2009 as “abysmal”. Why is this? Why is it still so rare here to see someone breastfeeding in public, even though it’s perfectly legal, even in pubs (thank you Equal Status Act and Intoxicating Liquor Act), and precisely what your breasts were made for? How is it that until I came to write this blog post I didn’t even know that if you are breastfeeding when you go back to work, you can have an hour off in every eight-hour day to facilitate your feeding? If I’d known that would it have made a difference to how soon I went back to work?

From the point of view of public health education, there is overwhelming evidence that breastfeeding is your best bet, as, for example, it decreases the likelihood of diabetes and obesity in the child, and of breast cancer and post-natal depression in the mother. There are tons of other benefits too, which an artificial milk cannot replicate.

On the other hand, we are active in the formula business and Batt O’Keeffe announced just after Christmas that once Danone gets cracking in Cork one in five babies worldwide will be fed on Irish-produced infant milk formula.

You get what information you can, you read your baby as best you can, you skim the leaflets scattered about the health centre, you trawl the internet for impartial advice, you believe the person you trust most. What is really shaping our view of breastfeeding – who are we listening to? Why are our rates so low, and how could we boost them?

Edit 19th January:

I thought, given that I’m complaining about lack of support and information, it might be useful if I actually added a couple of general support links:

Breastfeeding.ie

Cuidiu (The Irish Childbirth Trust)

La Leche League

Friends of Breastfeeding (Ireland)

And the HSE provides weekly breastfeeding clinics at local health centres. And there are usually discussions going on at any of the parenting websites like eumom, Rollercoaster, Mumsnet, MagicMum and probably a thousand others.

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