WPPG NEWSLETTER OCTOBER 2012

OLYMPICS AND PARALYMPICS

Our summer of sport and pageant has come to an end and as we watch the closing ceremony both my wife

and I and the rest of the UK are left with a glow of patriotism. What a fantastic achievement by all concerned, from those who strove to bring the Olympics to London, to the design and construction team, the ceremony organizers, the volunteers and the crowds who attended in their millions. Not forgetting, of course, the athletes themselves who gave their all to create the best Olympics and Paralympics of all time! The phenomenal spectacle and outstanding success of the event turned the cynicism of our European neighbours to disbelief, awe and envy! I, for one, am very sad that it has come to an end.

Much has been eloquently said by many eminent people, particularly memorable was Lord Coe’s closing comment ‘MADE IN BRITAIN’ to which I would like to extend to ‘Made in GREAT Britain’. I feel I must add my very small contribution and I am sure you will join me, in thanking all concerned for making us PROUD to be British! We were all in awe of the achievements of the athletes and felt privileged to share their success and elation. The Paralympics were amazingly successful as we witnessed how individuals had overcome immense adversity to achieve spectacular results. I, for one, had a lump in my throat as Elle Simmons stood TALL on the rostrum to accept her medals; what an incredible example she is to our youngsters – a true celebrity!

My wife and I had a specific interest in the Paralympics as Sophie Pascoe, aged 19, who represented New Zealand in the swimming events, is the granddaughter of my wife’s school friend, Yvonne. They were school friends from infant school over sixty years ago. Yvonne emigrated to New Zealand when she was 17 and has been in regular contact with us ever since. Sophie, aged 2, lost her left leg and the muscle from her right calf when caught in a cylinder mower towed by a tractor driven by her father. A moment’s loss of concentration lead to this devastating accident. Sophie’s whole family was traumatized by this accident, as were we, and Sophie’s grandfather, John, took it extremely badly and never really came to terms with the incident. In 2001 my wife and I stayed with Yvonne and family in New Zealand where we met Sophie. We marveled at how well she had coped with her disability but couldn’t help noticing the pain in the face of her grandfather some six years after the accident! Sadly, John died at the beginning of 2002.

Yvonne, regularly took Sophie to the local swimming pool and a chance meeting with a swimming coach lead Sophie to take up swimming competitively. Sophie went on to represent New Zealand at Beijing. As Sophie stood at the starting blocks for her first swimming final, she said to herself “This medal is for my granddad!” Sophie won her first gold medal, fulfilling her promise to her granddad. She then went on to win a second and third gold, plus two silvers! Her grandfather would have been overwhelmed with delight! In the London Paralympics Sophie won three gold medals and three silver, breaking several world records! An incredible achievement and an example of how with a positive attitude, determination and family support, adversity can be overcome! Yvonne is staying with us for a short time before flying back to New Zealand … we will have much to talk about!

THE NEXT WPPG TALK - DIABETES

One in five white Britons will succumb to Diabetes by the time they reach 80! Don’t miss our next Talk on 2 November in the Memorial Hall at 7.30pm. Dr Colin Johnston, Consultant in Diabetes and Endocrinology – and his team – will talk on HOW TO LIVE WITH DIABETES and HOW TO AVOID COMPLICATIONS. There will be a General Practitioner, a Specialist Diabetic Nurse, a Podiatrist, and a Retinal Screener There will be free refreshments during the interval.

There is already a lot of interest and a growing list of those who have already reserved seats. Entry is FREE to WPPG members but there will be a nominal charge of £2.50 for non-members. To reserve your seat telephone 01582 832305. Whilst on the subject of WPPG membership, at £5 per household per year, it would be greatly appreciated if each existing member could introduce one new memberbefore the end of 2012. More funds would enable us to increase our activities on behalf of all patients of The Village Surgery. We need your help and your effort to increase membership would be greatly appreciated.

PILATES IN THE MEMORIAL HALL

Feeling aches and pains? Getting backache? Recovering from an operation or preparing to have one? Would like to shed those extra pounds which have a habit of suddenly appearing? Need help to get your figure back after pregnancy? These and many other problems should be good reasons to turn up on a Tuesday afternoon to enrol for PILATES. So as not to exclude anyone, we charge no more than £5 for a one-hour session. Choose from 2-3pm, 3-4pm and 4-5pm. Classes comprise males and females of all ages and the Instructor is a highly qualified Pilates expert who is also a Physiotherapist. For more information telephone 01582 832305. You won’t regret it – tell your friends!

HEALTH TIPS

– from the BRITISH HEART FOUNDATION

It’s already well established that poor oral hygiene can increase the risk of endocarditis. Endocarditis is when the lining of the heart becomes infected, which damage your heart’s valves. It is very rare but also very serious. Good oral hygiene can help to protect you against endocarditis, so it’s really important to clean your teeth everyday after meals and visit your dentist regularly.

- from BLOOD PRESSURE UK

Blood Pressure UK is the country’s leading charity providing information and support to people with high blood pressure. For more information on high blood pressure please visit website or telephone (020) 8772 4994). Manor Pharmacy in WheathampsteadVillage are offering free blood pressure checks. Just pop into the Pharmacy to make an appointment.

- from HEALTHY START NHS (FREE VITAMINS)

Healthy Start vitamins are important for your health and the health of your unborn baby because all pregnant and breastfeeding women are at risk of not having enough Vitamin D. Particularly at risk are: teenagers, young women and those from ethnic minority communities. It is important that you get enough Vitamin D whilst you are pregnant to keep your bones healthy. This also provides your baby with enough vitamin D to support them in their first few months. Young children who do not get enough Vitamin D can develop softening of the bones which can lead to rickets. Women’s Vitamin Tablets – FOLIC ACID – reduces the chance of your baby having spina bifida, a birth defect where the spine does not form properly.

VITAMIN C – Helps maintain healthy tissue in the body. VITAMIN D – Helps your body to absorb calcium and so supports your baby’s bones to develop properly. TO GET YOUR FREE VITAMINS, along with your free milk, vegetables and fruit vouchers which comes every 4 weeks, there will be a vitamin coupon, which can be exchanged for vitamins in your local area. These vitamin coupons come every 8 weeks. Ask your midwife or health visitor where you can swap these coupons for the free vitamin tablets. For further information about Healthy Start visit or telephone 0845 607 6823.

In the July Newsletter I reported on my HIP REPLACEMENT operation performed by Professor Briggs at the RoyalNationalOrthopaedicHospital. I mentioned that 5 weeks after my operation my wife, Audrey, was having a hip replacement, not because of an arthritic condition but because she had broken her hip some years previously. Here is the promised report on her operation. She had had three screws inserted when she broke her hip, one of which some years later broke through into the hip socket causing considerable pain. Always easier to put screws in than take them out, her operation was considerably longer than mine and she had to take iron tablets, due to blood loss, to increase her haemoglobin reading. With only five weeks’ between the two ops we considered ourselves lucky having 3 daughters who very efficiently arranged a rota system to look after us! Audrey has been slower to recover than me but with staunch upper lip she does her Pilates exercises regularly and is hoping to ‘catch up’.

ABPM’ – AMBULATORY BLOOD PRESSURE MONITORING – By Dr Roger Gibbs

The Village Surgeries are pleased to announce the arrival of a new ABPM to assist in the diagnosis and management of hypertension for our patients.

Why is it important to diagnose hypertension (high blood pressure)? Hypertension remains an under-diagnosed condition and contributes to premature cardiovascular disease and potentially preventable illness and death. It causes damage to blood vessels, in particular arteries to the heart, brain, kidneys and legs. The effects of this can be angina, heart attacks, strokes, kidney failure and walking limited by pain. However, even seriously high blood pressure seldom causes symptoms until significant damage has been done. Therefore early recognition is vital.

What is ‘normal’ blood pressure? When we measure blood pressure we take two readings: the systolic or high number, which records the highest pressure, and the diastolic or low number, which records the lowest pressure in arteries. Most commonly the measurement is taken by placing a monitor cuff on the upper arm. Ideally your blood pressure should be less than 135/85, although slightly higher levels may be considered acceptable but require occasional review. However, the real relevance of blood pressure needs to be assessed in relation to other risk factors: smoking, diabetes, family history, ethnicity and cholesterol levels being the most important. As doctors our role is to assess this risk and treat hypertension when your risk is considered significant. To do this we have established risk calculators which take all the relevant contributory factors into account and give us a risk score.

How do we measure blood pressure? The first record of blood pressure being taken was in 1773 by a physiologist interested in blood circulation. Stephen Hales inserted a hollow pipe connected to a 12 foot glass tube into an artery in the neck of a horse, the blood rose 9 feet into the glass tube, indicating the blood pressure. His device was known as a manometer. In 1881, Samuel Ritter von Basch, a doctor in Vienna, developed the basic design for a sphygmomanometer, which was the forerunner of devices still in use. The principle of applying pressure to an artery until the pulse disappeared remains the method for modern devices. Many of you will still be aware of mercury sphygmomanometers where the reading is recorded from the height of a glass column of mercury and this method is still regarded as being the most accurate. Indeed blood pressure is still measured in millimeters of mercury. Today there are three main types of sphygmomanometer in use: mercury, aneroid (using air pressure) and digital. Mercury monitors have largely been superseded by safer, smaller electronic machines which are widely available and often purchased by patients.

Why do we need ABPM? Whilst we still know that hypertension is under-diagnosed, we also recognize that some patients may be falsely labelled because their blood pressure is high when taken in the doctor’s surgery (‘white coat hypertension’!) This is because blood pressure is influenced by the sympatheticnervous system which is activated by being anxious or stressed. Many patients find it hard to relax resulting in erroneously high readings. We often try to calm our patients or take several readings, but for some this remains inadequate. In order to allow for these patients we may loan out small digital monitors, requesting that they take a series of readings in their own homes. However, even with these readings we may not get a ‘true’ reading of the blood pressure experienced throughout the day. For some time now ambulatory blood pressure monitoring (ABPM) has been organized by hospital clinics to aid an accurate diagnosis, but previously the equipment has been expensive and required skillful interpretation of the results. Now the equipment has become affordable and allows computerized interpretation such that it is suitable for use in general practice. The monitor is worn, usually for 24 hours, and gives a continuous record of blood pressure, allowing an interpretation of how often significantly high levels occur. This means that only those with genuine hypertension can be targeted for treatment. The Village Surgeries now has its first ABPM for the benefit of its patients and we look forward to using it to maintain the health of our patients.

DIABETES AND DIET By Pat Walker, Dietician

DIABETES is the subject of the next PPG Talk on 2 November at 7.30pm in the Memorial Hall – DON’T MISS IT! Dr Colin Johnston and his team will give a thorough overview of the condition; how to PREVENT it and how to MANAGE it. There are two types of Diabetes:

1Type 1 – Mainly young people – controlled by insulin injections and diet

2Type 2 – Non-insulin dependent – usually controlled by diet and tablets

Diet – Eating a healthy diet plays an important role in the treatment of Diabetes.

The aim of the diet is to maintain the Blood sugar within normal levels and prevent complications.

To do this:

-Eat regular meals

-Have starchy foods such as potatoes, bread, rice, cereals.

-Avoid very sugary foods, such as sugar, jam, sweets, chocolate. These foods raise the level of glucose very quickly. The aim is to have a gentle rise and fall of blood sugar, rather than have peaks and troughs.

-Choose foods that have a low G.I. (Glycaemic Index). Low G.I. foods take longer to break down and are therefore slower to raise the blood sugar. For example, choose basmati rice instead of white rice, granary bread instead of white bread, porridge oats instead of cornflakes.

-Have more fibre – eat 5 fruit and vegetables per day. It is good for you. These foods contain vitamins and minerals, soluble fibre, etc, and will help to lower the cholesterol.

-Maintain body weight, within normal range – keep the portion size down. Being overweight makes it harder to control Diabetes and prevent problems.

-Cut down on fatty foods, especially saturated fats. High levels of fat in the diet are more likely to lead to coronary heart disease. Adapt your meals, opt for low fat or reduced fat foods such as yoghurt/cheese/milk. Try lean cuts of meat, cut the fat off meat and take the skin off chicken. Grill rather than fry.

-Alcohol – limit your intake, keep within limits and always have a snack or a meal with your alcohol.

-Avoid Diabetic foods, ie sweets. They are not necessary and are expensive.

-Sorbitol – Take care, for although it is used in the diabetic products as it does not raise the blood sugar, it can cause diarrhoea if you take too much.

-Keep the blood sugar within normal levels by having a healthy diet. This will help to prevent/reduce

-the complications that can occur. Remember everything in moderation and enjoy what you eat.

Comments from members always appreciated, also suggestions for future articles. Email your contributions to (Andy Capy 01582 832305)