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Berwick Area Heart Support Group
January and February 2005 Newsletter
Next meeting February 2nd at the Day Hospital Berwick Infirmary 7pm – 9pm Guest Speaker Jae Jones from PALS The Patient Advice and Liaison Service (PALS) has been created countrywide to offer confidential support and advice to NHS patients North of Tyne PALS has local officers who deal with concerns involving the eight NHS Trusts that cover the area from the Tyne to the Border, from Kielder and the Cheviots to the coast
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Thanks again to Kathy and all her helpers for the lovely buffet they arranged for the December meeting.
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December’s Speakers – “Cardiac Rehab North of the Border”.
Health professionals Jenni Elliot and Diane Edgar crossed the Border in December to give us an account of the gathering pace of cardiac rehabilitation in Scotland. Both are from nursing.
Diane is a ‘clinician manager’ of a team embracing CHD, stroke & diabetes. A consultant, Peter Lesley, heads the team.
For CHD, the system is similar to that in Northumberland, with 4 phases of cardiac rehabilitation. The first phase is the first 5 days in hospital. Jenni is helping organise care for CHD and she stressed the need for follow-up when people get home from hospital (Phase II). After 6 weeks at home there is a return visit to hospital. The plan is then to get people into the next phase (‘Phase III’) [This is a course of exercise and educational talks, and very similar to the course we have at the Swan Centre, which is supervised by Mandy Thompson, from Well Close Clinic.] Nurses have been given key roles in helping to get people with heart disease into a ‘plan for life’.
Diane’s job is to get all the professionals to pull together, not just in the NHS, but involving others in local government, the British Heart Foundation, and additionally volunteer groups such as ours. Rehab organisation is patchy so far and there is still a poor uptake. The scheme needs rehab to be available for everybody. A nurse-led scheme is being put together specialising in dealing with care of Heart Failure. [Heart Failure, HF, can be the result of deterioration in the strength, or action, of the heart muscle, perhaps because of an earlier heart attack. Sometimes the heart enlarges and becomes weak and inefficient.] A lot can be done to restore mobility for HF patients and enable them to obtain the medical and personal benefits of activity. Diane also described the “Chest Pain Clinics” which are similar to these in Northumberland. Specialised nurses do rapid tests and assessments of anybody referred with chest pain
In general the aim is to get patients involved in developing services. [This is where people like us can be useful!] Patients and professionals can attend education and training days. ‘Diabetes UK’ has already shown the way by providing training. There is also scope to extend existing schemes for making emergency procedures, such as ‘clot busting’ available in the home. Overall, there is a great deal of scope for preventing people from having a first or even a second ‘acute event’. Lowering risk is the most effective approach.
The Border is not a barrier to co-operation. Where communities are widely spread and there is the problem of travel, co-ordination is essential. Diane and Jenni actively talk with Alice Whincup who organises the Cardiac Rehab in Northern England. [Alice organises our Phase III courses at the Swan Centre.]
[A note from your Committee; you can be sure we will keep you informed of any future courses you can attend either for Exercise Rehab for yourself, or to keep you better informed about how to manage your own condition and/or to help others. Cardiac rehabilitation is still in its very early days.]
Phil
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Wallys Yarn
Another little ode I came across in my travels
The moral of this, as my tale I unfold
That for me and you who are now growing old
It’s better to say, “I’m fine” with a grin
Than to let folk know the shape we are in.
How do I know that my youth is all spent?
Well, my get up and go, has got up and went.
But I don’t really mind when I think with a grin,
Of some of the places my “get up” has been.
I get up each morning and dust off my wits,
And pick up the paper and read the “Obits”
If my name is still missing, I know I’m not dead,
So I have a good breakfast, and go back to bed.
Wally
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Recipe of the Month
Kathy’s quiche
So many of you enjoyed Kathy’s quiche at the buffet and asked for the recipe again .
1. 1 ptk. Precooked rice. (flavoured if preferred)
2. Mixed vegetables
3. 250 g Cottage Cheese
4. 3 eggs.
Method.
Partially cook mixed veg. Empty rice into ovenproof dish and spread across base, not too thick. Add mix veg. Mix cottage cheese and eggs together, and pour mixture over vegetables. Bake at about 180 degrees until firm to touch and a nice golden colour as all the good books say.
This is the basic recipe; there are all sorts of variations. I’m sure you will have your own favourite fillings; the good bit about this one is no pastry .So if you watch what you do put in, it could be a healthy meal.
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ARE YOU MANAGING YOUR MEDICINES?
Steve Gray, the pharmacist from Union Brae, was our first speaker in 2005. There was a good turnout.
For many reasons many of us do not always take our tablets. Steve highlighted the fact that 50% of prescriptions are not taken as prescribed. Even transplant patients do not always take the immuno-suppressive medicine on which their life depends because they need the drugs to prevent rejection of the transplant. All together, we waste half the £50 billion NHS drugs bill. Why? Perhaps we do not feel the benefit of the drug. For instance, an improvement in hypertension (high blood pressure) is not something we feel. Also, 80% of patients have some reservation about their medicine and 33% feel there are unwelcome side effects. When asked later, 20% say the side effects are still there. As Steve said, these figures make the pharmacist think!
In Berwick, the Infirmary is a partner in a contract scheme with the local pharmacists started 10 years ago to help manage prescriptions and drug regimes of the elderly (over 75) when they are at home.
Ideally there should be a review once a year for everybody on long term prescriptions. The review should ask:
Are there side effects?
When should particular medicines be stopped?
Are they still necessary?
Are they still working?
For CHD (and or diabetes) our statin intake is important. Some people even give up taking their aspirin.
Members raised the matter of the changing names or packaging and appearance of the medicine. Steve Gray recognised the problem, but the pharmacist cannot control the trade-marking by the drug companies. He told us also of his experience in reviewing local patients drug regimes. Even with only 20 minutes devoted to each case, it took more than a year to look at just 250 individuals
New developments?
“Supplementary prescribing” started in 2004. The GP makes the diagnosis and the clinical management plan (for example for hypertension control) and the pharmacist can prescribe within the boundaries of the plan. Your own chemist will be able to check with your medical records. This new approach is part of an attempt to improve management of chronic (long-term) disease, where patients can expect to be on medication over very long periods.
Steve’s pharmacy is feeling the benefit of new ‘robot’ dispensing kit. Essentially, once the number and type of pills has been decided and the instructions for the individual patient are written down, the machine can find and box and label without mistakes. It is safer and quicker. As the chemist types in the details the machine instantly creates the bar code and gets the pills.
There is a new contract this coming year between the chemists and the NHS. We will notice that the GP can issue a prescription good for 6 months. We will also get help if medicines have been discontinued and we do not need them anymore in the package. (The chemist will benefit from better stock control, which should mean better cost-control.)
Steve gave time to members on individual queries. Thank you very much Steve!
Phil
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Calorie-burning activities for the lazy
Proper weight control cannot be attained by dieting alone; however, many people who are engaged in sedentary occupations do not realize that calories can be burned by the hundreds by engaging in strenuous activities that do not require much (or any) physical exercise.
Here's the guide to calorie-burning activities and the number of calories per hour they consume.
Beating around the bush . . . . . . . . . . . . .75
Jumping to conclusions . . . . . . . . . . . . .100
Climbing the walls . . . . . . . . . . . . . . . . 150
Swallowing your pride. . . . . . . . . . . . . . .50
Passing the buck . . . . . . . . . . . . . . . . . . . 25
Pushing your luck. . . . . . . . . . . . . . . . . 250
Making mountains out of molehills. . . . 500
Hitting the nail on the head . . . . . . . . . . .50
Bending over backwards . . . . . . . . . . . . .75
Running around in circles. . . . . . . . . . . 350
Climbing the ladder of success . . . . . . . 650
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Recipe of the month
Broccoli soup
Serves 4
1 medium red onion - chopped
1 medium carrot - chopped or sliced
½ clove garlic - finely chopped
375mls chicken/vegetable stock
25g uncooked rice
150g broccoli chopped
250mls semi-skimmed milk
Pepper (cayenne works well) to taste
Method.
1. Place onion, carrot, garlic and stock in a pan and bring to the boil.
2. Add the rice, simmer for about 15 - 20 minutes or until the rice is tender.
3. Add the broccoli and simmer until broccoli is just tender.
4. Transfer to blender/food processor and blend until smooth.Return to pan, add milk and pepper.
5. Why not use wholemeal rice to increase the fibre (you may need a little more liquid to cook it through).
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Porridge makes a comeback
The media attention that porridge is getting as part of the new!!! GI "glycaemic index" diet will undoubtedly be followed by TV adverts pushing various "Instant porridges". You can in fact make porridge in the microwave using normal porridge oats.
Recipe for Microwave Porridge
Serves 1
Original, old fashioned or Wholemeal porridge oats
Put a 1/4 pint water or semi skimmed milk in jug
add enough oats to fill the water or milk
cook on full power 2 1/2 - 3 minutes watch for the mixture to rise in the jug as it cooks ,add sugar, salt, milk to taste, it delicious with soya milk.
Real Scotsmen don't add sugar to their porridge, but according to the "Sunday Post" they put jaffa cakes on the top and wait till they melt.
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The oat bran part of the product is particularly useful. Oats have the highest protein of all the food grains (typically 12%, but it can be higher) and oatbran is 17% protein. The oat protein is the most 'complete' and useful of all the different grain protein. Oats are also rich in other useful substances, particularly soluble fibres that tend to reduce blood cholesterol. Highly processed oats, however, might be too easily digested - see below - and you could lose some of the benefit. The latest 'instant oats' are very expensive, usually 12 times the price for the same size bowl of porridge!
The GI diet, was originally designed for diabetics and is often prescribed to cardiac patients. The diet is based on scientific evidence that different sources of carbohydrate raise blood sugar levels faster than others. (However, it is not always easy, scientifically, to get fully reproducible results showing a clear difference between the enormous variety of products that we can buy. Generally, though, white bread or any processed food made with "refined" flour or sugar, is digested very quickly, and rapidly raises blood sugar. We get the "sugar spike". Potato does the same.) The evidence was first identified by Dr David Jenkins, a professor of nutrition at Canada's University of Toronto in 1980. Unlike many other fashionable celebrity high protein, low-carb or fruit-specific diets, the GI diet allows you to eat a variety of different foods including protein, carbohydrates and fats. The difference is that if you no longer eat much of the high glycaemic index (G.I.) carbohydrates then, on average, the energy in the food is released more slowly. Some people find that this reduces the urge to keep on eating, and allows them to feel fuller for longer. White bread and jam, cake or biscuits, for example, seem to stimulate appetite not satisfy it, especially in the first 20 minutes, and lead to "2nd helpings". Try a small experiment!
It is IMPORTANT to note that although FAT is very low GI and does not give you any "sugar spike", a high fat meal does give a "FAT SPIKE", and your arteries notice the effect for hours! (Do not try this experiment!)
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LOWER GLYCAEMIC CHOICES
CARBOHYDRATES
Vegetables
Avocado, lettuce, asparagus, mushrooms, green beans, olives, peppers, onions, broccoli, peas, brussel sprouts, peas, cabbage, carrots, potatoes (boiled new), cauliflower, radishes, celery, sugar snap peas, cucumbers, spinach, aubergine, tomatoes, courgette, leek.
Fresh fruits
Apples, blackberries, blueberries, cherries, grapefruit, grapes, lemons, oranges, peaches, plums raspberries, strawberries. Fresh currants are wonderful if you can get them, and all the berries, including the wild ones.
Bottled, canned, frozen fruits
Canned peaches in juice or water, canned pears in juice or water, bottled apple sauce (unsweetened).
NOTE. If you drink or eat a lot of processed fruit or juice, especially the sweeter ones, you will take in a lot of sugar very fast compared with chewing 2 or 3 apples!
PROTEINS
Meats
Choose lean cuts or trim off visible fat. Back bacon, beef (lean cuts), chicken breast (skinless), minced beef (extra lean), lean ham. This selection significantly cuts down the 'saturated' fat, even though it does not eliminate it.
Fish
A typical portion should fit into the palm of your hand and be about as thick. All fresh, frozen or canned fish and seafood isa good source of protein, although some of the useful anti-MI fish oil has been lost from much of the canned fish. The list includes bass, trout, sole, sardines, herring, mackerel, salmon, tuna, fresh, tuna tinned in water, dory, cod, haddock, halibut, snapper, swordfish, calamari, oysters, clams, crayfish, lobster, crab, scallops.
Eggs
You can perhaps (?) buy "omega-3 eggs" - eggs laid by chickens who have been fed with foods that have had omega-3 oil, such as linseed, added to them. Eggs are high in protein and very low in fat but the yolks are very high in cholesterol. Probably the yolk cholesterol does not matter for most of us, but if you are worried, the egg-white contains most of the protein and no cholesterol. Any source of omega-3 oil will help a bit in preventing heart attack.
Dairy
Buttermilk, fat-free cheese, low-fat or fat-free cottage cheese, sugar-free frozen yoghurt, sugar-free fruit yoghurt, low-fat and sugar-free ice cream. Whey protein is expensive but is almost pure protein, with the milk sugar and milk fat taken out. (Milk fats are very high in saturated fat).
Vegetarian options
Soy protein powder is the highest value of the plant (vegetable) proteins.. It's great for non-vegetarians too. The purified Soy protein is expensive, but Soya wholemeal, which is less expensive, can be obtained. Soya wholemeal although high in oil is low in saturated fat.
Textured vegetable protein (TVP) is reasonably high in Soya protein and very low in oil, but may have lost some of the other useful Soya substances.
"Peas, beans, lentils are all low GI foods and are very nutritious. Lentils and most types of beans are 25% protein in the dry state. Beans need soaking overnight before cooking, lentils can simply be cooked. The protein will add value to the protein from grains such as oats, rice etc."
DRINKS
Water or filtered or sparkling water is a good idea before and after each meal or snack. Green or black tea (without fat milk) is fine. Tea, particularly green tea continues to get a 'good scientific press' as a source of anti-cancer, anti-heart attack substances. , Coffee (decaffeinated probably has less diuretic effect), sugar-free soft drinks, skimmed milk, fruit juice with no added sugar, and in moderation - see the note above, are 'low GI' alternatives.
FATS AND OILS
Nuts are 'low GI' and good sources of proteins and minerals, but generally are high or very high in oil. Fresh almonds are very low in saturated fat, and are probably good for hearts and arteries. Hazelnuts are also nutritious. Walnuts also get a very 'good scientific press' as anti-heart disease food and have some omega3 oil. Linseed (the Americans call it flax seed) is rich in omega3 and can be taken in small quantities as crushed seed. (If you buy the food-grade linseed oil, it must be stored in the fridge, otherwise it becomes more useful for cricket bats). Olive oil is a good substitute for 'vegetable oil', for salads or dressings generally. Rapeseed oil is a good choice for cooking oil. Margarine without trans-fats and based on olive oil or polyunsaturated oil can be taken sparingly.
Phil & Terry
Berwick Area Heart Support Group
March 2005 Newsletter
Next meeting March 2nd at the Day Hospital Berwick Infirmary 7pm – 9pm Guest Speaker David Shell Modern Matron at Berwick Infirmary
Jae Jones from Patient Advice & Liaison Service, PALS, gave the talk at our February meeting. Did we know PALS existed? The posters are in most medical venues but do we recognise them? I guess few if any of us knew that the NHS has the PALS’ facility. Jae not only told us about PALS but also gave us a broader picture of the NHS. The NHSisourservice. We expect high standards. There is a formal complaints procedure. (Each Trust has its own complaints system, as does BGH at Melrose). Most of us already know that, but most are probably reluctant to use it. PALS could be the answer to such problems. We can be assured of a confidential follow up. Also any pattern, which shows that a problem is not just a ‘one-off’, will result in the NHS taking notice at every level. PALS make quarterly formal reports. Many of us have had warm experiences with the NHS (…well … afterwards, blue lights and all…) and will have written our gratitude to the hospital, ward staff etc. Why not log it with PALS and tell the service when (and how) it is getting it right?
PALS has a local officer (Jae) at Alnwick (free phone 0800 032 02 02) with 11 officers North of the Tyne and a HQ in Morpeth. They are also recruiting volunteers. They have a rapid response in office hours if you think the matter is urgent. This is not ‘formal complaints’. Probably most of the time PALS is acting like a NHS version of Citizens Advice Bureau. Those queries about NHS services, including dentists *, pharmacists, GPs, hospital, and LINKS with Social Services, Benefit Agency, can all be handled. Those 6 phone calls. PALS can do them for you. Do you understand your hospitalresults, tests and so on? Do you know what you want to ask your GP?
CONFIDENTIAL ADVICEis available from PALS.
[* my emphasis, Phil H] Phil adds a personal note. Some of our members at the meeting remembered a few horror stories, some of them admittedly going back a bit. Cleanliness? Late ambulance? Come on don’t moan. Raise it. As a group we now know to whom we can turn. (PALS will both help and log the matter). I personally have seen huge improvements since I had my big event 15 years ago. De-fib? In those days my Doctor had to follow behind the ambulance all the long way to BGH. Clot busting? Whoever gets to you first can do it. When we started our support group we were writing letters asking why was there no cardiac rehab in Berwick? We have got it. Specialist nurse led clinics for chronic problems (and lifestyle adjustment, stopping smoking etc.) They are here, or coming. Chest pain clinics? These appear to make a difference. We can show our support by saying so.
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Donations
General Mills Charity Committee Berwick (Jus Rol ) have given us an initial donation of £50.00 towards our running costs, and are also going to help by providing the paper for our newsletters and leaflets. Through this years Border Marches on 15th May, which General Mills Berwick are supporting, they will be able to make a further donation as their “marchers” will obtain sponsorship for taking part. Two “marchers” have already said that the sponsorship they raise will come directly to the group. Next months newsletter will have a sponsor form attached for anyone wishing to help, and if any one from the group is taking part in the walks and would also like to help our funds by raising sponsorship please let us know
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Fruits, Vegetables, and Heart Disease
We are always being told to eat at least 5 portions of fruit and vegetables a day to reduce the risk of heart disease, diabetes and cancer. We all try to eat these five portions daily but what benefits do the different fruit and vegetables give us? We know the old tales that an apple a day keeps the doctor away, eating carrots will help you see in the dark, eating garlic keeps your partner at bay. I've read some of the latest research papers and picked some of the more interesting information for the newsletter.
Although not all of the research is consistent, there is compelling evidence that a diet rich in fruit and vegetables can have many positive effects upon health. Fruits and vegetables can lower the risk of heart disease, high blood pressure, diabetes and cancers. Their high dietary fibre content helps control blood glucose levels and reduces blood cholesterol. They contain not only antioxidants but also other phytochemicals (plant and vegetable nutrients) which reduce the risk of coronary heart disease.
More than any other foods, fruits and vegetables are filled with heart-healthy vitamins such as A, B, C, E and fibre, which can reduce the risk of blood clots, potassium, which can help control blood pressure, folic acid which can help lower levels of a heart disease. (Folic acid promotes reduction of homocysteine in the blood).
Homocysteine is thought to be an important risk factor for heart disease. High levels may not only injure the walls of the coronary arteries which can start the build up of cholesterol they can also promote blood clots.
Minerals like potassium, calcium, magnesium, zinc and manganese, are all vital for good health and disease prevention Fruits rich in vitamin C and green, leafy vegetables seem to be particularly beneficial.
One of the most heartening results of one study was its conclusion that increasing fruit and vegetable intake by as little as one serving per day can have a real impact on heart disease risk. For every extra serving of fruits and vegetables participants added to their diets, their risk of heart disease dropped by 4%.
Fruits, Vegetables, and Blood Pressure.
High blood pressure is a high factor for heart disease and stroke, and research increasingly finds that diet can be very effective tool for lowering blood pressure. One of the most convincing associations between diet and blood pressure was found in the Dietary Approaches to Stop Hypertension (DASH) study. This study examined the effect on blood pressure of a diet that was rich in fruits, vegetables, and low-fat dairy products and that restricted the amount of saturated and total fat.
The researchers found that people with high blood pressure who followed this diet reduced their systolic blood pressure (the upper number of a blood pressure reading) by about 11 mm Hg and their diastolic blood pressure (the lower number) by almost 6 mm Hg. These findings suggest that making such changes in dietary patterns--which include increasing fruit and vegetable intake--can lower blood pressure without medication.
Include in your vegetable and fruit intake some of the blue, the orange, and the red, yellow and dark-green varieties. The more colourful and varied your choice the healthier it usually is and, as an easy rule, the darker and brighter the colour of the vegetable the more useful nutrients they usually contain.
The more starchy vegetables such as corn, butternut, pumpkin, peas, root vegetables and sweet potatoes should also be balanced with the less starchy vegetables such as courgettes, green beans, spinach, broccoli and cauliflower.
Food sources of vitamins and antioxidants
Almost all fruit and vegetables and plant-based foods have something going for them nutritionally. A few plant sources can be picked out as especially rich in certain nutrients. Soya and lentils are rich in folic acid as well as protein. Almost all nuts have useful amounts of protein and minerals and B vitamins. Almonds and walnuts are particularly good. Brazil nuts are an exceptional source of selenium. Bananas are rich in Vitamin B6 (but they contain also a lot of calories!), Carrots have 2 kinds of beta-carotene, which is the starter material for our body to make our own Vitamin A. Black currants are very rich indeed in Vitamin C. Tomato, especially the paste cooked with a little oil, has a useful anti-oxidant called lycopene. Strawberries and blueberries particularly are rich in other anti-oxidants. All the berries, plums and cherries have plenty of anti-oxidants. Onions (especially raw) and broccoli and kale are rich sources of similar plant “phyto” nutrients. Turmeric also has an ingredient valuable enough for health for it to be a regular addition to recipes.
Phil & Terry
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Wally’s Yarn
A monkey is sitting in a tree smoking a joint when a lizard walks past and looks up and says to the monkey "Hey! What are you doing?" The monkey says "Smoking a joint, come up and have some."
So the lizard climbs up and sits next to the monkey and they have a few puffs. After a while the lizard says his mouth is 'dry' and is going to get a drink from the river.
The lizard is so stoned that he leans too far over and falls into the river. A Crocodile sees this and swims over to the lizard and helps him to the shore, then asks the lizard, "What's the matter with you?" The lizard explains to the crocodile that he was sitting smoking a joint with the monkey in the tree, got too stoned and then fell into the river while trying to get a drink. The crocodile says he has to check this out and walks into the jungle, finds the tree were the monkey is sitting, finishing a joint, and he looks up and says "Hey you!" The Monkey looks down and says "Jeepers creepers “ How much water did you drink?!!!!"
Click to return to Wally’s yarns
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High Blood Pressure
Research has found that diet affects the development of high blood pressure, or hypertension (the medical term). Recently, two studies showed that blood pressure can be lowered by following a particular eating plan-called the Dietary Approaches to Stop Hypertension (DASH) eating plan-and reducing the amount of sodium consumed. While each step alone lowers blood pressure, the combination of the eating plan and a reduced sodium intake gives the biggest benefit and may help prevent the development of high blood pressure.
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Tips To Reduce Salt and Sodium
Use reduced sodium or no-salt-added products. For example, choose low- or reduced-sodium, or no-salt added versions of foods and condiments when available.
Buy fresh, plain frozen, or canned with "no-salt-added" vegetables.
Use fresh poultry, fish, and lean meat, rather than canned, smoked, or processed types.
Choose ready-to-eat breakfast cereals that are lower in sodium.
Limit cured foods (such as bacon and ham), foods packed in brine (such as pickles, pickled vegetables, olives, and sauerkraut), and condiments (such as MSG, mustard, horseradish, catsup, and barbecue sauce). Limit even lower sodium versions of soy sauce and teriyaki sauce-treat these condiments as you do table salt.
Use spices instead of salt. In cooking and at the table, flavour foods with herbs, spices, lemon, lime, vinegar, or salt-free seasoning blends. Start by cutting salt in half.
Cook rice, pasta, and hot cereals without salt. Cut back on instant or flavoured rice, pasta, and cereal mixes, which usually have added salt.
Choose "convenience" foods that are lower in sodium. Cut back on frozen dinners, mixed dishes such as pizza, packaged mixes, canned soups or broths, and salad dressings-these often have a lot of sodium.
Rinse canned foods, such as tuna, to remove some sodium
Click to return to index
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Recipe of the month
Spicy Baked Fish
1 pound cod (or other fish) fillet
1 Tbsp olive oil
1 tsp spicy seasoning, salt free
1. Preheat oven to 350°F. Spray a casserole dish with cooking oil spray.
2. Wash and dry fish. Place in dish. Mix oil and seasoning, and drizzle over fish.
3. Bake uncovered for 15 minutes or until fish flakes with fork. Cut into 4 pieces. Serve with rice.
Makes 4 servings.
Berwick Area Heart Support Group
April 2005 Newsletter
Next meeting 6th April 2005 at The Day Hospital, Berwick Infirmary. Guest speaker Graeme Gillespie, Clinical Phychologist from North Tyneside General Hospital will give a talk on the health benefits of relaxation for heart patients.
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Our speaker at the March Meeting was David Shell, who is a modern Matron at Berwick Infirmary.I hope I didn't miss the explanation between a modern matron and an old fashioned one, but I'm not sure where the modern bit comes in. Whilst listening to David's talk there is no doubting that he is very qualified, and experienced , but the job seems to be more administrative now than I imagined a matron's job to be, but he has plenty of medical experience to help him make those decisions.
David started his nursing career in 1976 as an auxiliary nurse at Newcastle General. In 1980 he became an enrolled nurse, and did some of his training at Berwick. He later concentrated on Mental Health work. In 1991 he worked at Sheffield mainly on Orthopaedics, spending some time at St. Jimmy's. He later returned to the Newcastle area and was a Charge Nurse at the RVI.
Over the next few years there were big changes in Health working practices, and job specification and responsibilities. David went to Wansbeck where he stayed for about 5 years, mainly on nights giving early assessments on patients, prior to the arrival of the Doctors.
In 2004 he came to Berwick in his current role, and is responsible for three hospitals, Berwick, Alnwick and Rothbury.
In his current role he sits on many management committees on medication, various diseases, drug assessment, training packages for nurses, patients discharge, falls and accidents on hospital property and how to prevent them, and probably one that on everyone's minds due to media attention is cleanliness and hygiene including MSRA checks. On recent cleanliness check by an outside body, Berwick scored 4 out of 5 (5 being the max.). Most of the points lost were due to the exterior of the building i.e. condition of the paint and stone work, something the management have little control over.
David did say that Rothbury are to get a new hospital. A site has been earmarked on the other side of the river to the location of the current hospital. With sympathetic landscaping it will blend into the hillside.
On the subject of current duties performed at Berwick, and why so many people seemingly receive little or no treatment, before being 'sent down the road', David did say that all patients are assessed before travelling on, and maybe on occasions this assessment is made once a patient is in the ambulance, and it makes sense to travel south rather than come back to Berwick. This was due to lack of qualified staff at Berwick. Berwick has no Pathology Lab, so samples cannot be tested quickly enough to help Doctors make a decision as to the best treatment. Infact the list is endless as to what is not at Berwick, and in all cases all the required medical expertise like paediatrics, special care, intensive or high dependency beds etc. etc. etc. are available 'down to road' whether it be Wansbeck, RVI, The General, The Freeman or North Tyneside or across at the Borders.
Some tests like X-rays can be done at Berwick. The X-rays can, if required, be sent down the phone for advice by Radiographer, or will be at the receiving Hospital by the time the patient arrives. Some changes at Berwick Infirmary, (I've tried to write this several ways and it seems to read wrong), so I will try again. Dewar Ward has been renamed Cheviot Ward, and Tweed Ward is now Dewar Ward. Cheviot is now a rehab. Ward for strokes and orthopaedics. As from April 4th there will be a Macmillan Room in Dewar Ward.
Accident and Emergency is very operational. The staff are well qualified in this field, with many of them having qualified in specialist subjects. This all aids the running of a successful department. Some other changes which have already taken place or are about to are Eye surgery and cataracts and Cardio echoes, done by visiting technicians.Video links for treatments. This is where a patient has had surgery at one of the major hospitals, and returns to Berwick for recovery. The Consultant is able to check on progress via the video link. Trials for this were done in the Hebrides.
Some other subjects under consideration are visiting times, cross contamination, and protected meal times for patients when there is no visiting is allowed either by relatives or medical staff.
This is a personal observation but this already happens at the Borders. When I was an inpatient it was open visiting, but just this week I have been there visiting, and there are hand sprays every where, and visiting is between 4 and 7 only.
David then went on to answer many questions posed by those present. Many were expressing some of the fears many of us have about the current role of our hospital and our Doctors.
Wally
Wally's Yarn
I've had a few months off and I'm not' back to speed' as they say. Just a couple of things I've noticed recently.
With their mother two young kids visited their Granny, for Sunday lunch. Mum helped Granny to serve the kids their lunch and returned to the kitchen to fetch something. Whilst away the little boy started to eat, and on her return Mum said to the boy, "Michael have you forgotten something?" Michael said, "No" Mum said, "At home we say grace before we eat, should you not do the same at Granny's?" "We don't have to pray at Granny's" said Michael, "She knows how to cook properly"
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Two middle aged men stood at the bar drinking when the most beautiful female imaginable, aged about 22, walked past. Both men passed comment to each other on her beauty, the slightly younger one continued the conversation suggesting what he would like to do with her given the chance. He then said to his pal," What would you do if you had the chance, with a woman as beautiful as that?" The other said," I am not too old to appreciate beautiful women, nor that the grass is greener and all that stuff, but I am just slightly too old now to climb the fence"
****
The boss of a big company needed to call one of his employees about an urgent problem with one of the main computers, dialed the employee's home phone number and was greeted with a child's whisper.
"Hello."
"Is your daddy home? " he asked.
"Yes," whispered the small voice.
"May I talk with him?"
The child whispered, "No."
Surprised, and wanting to talk with an adult, the boss asked, "Is your Mommy there?"
"Yes."
"May I talk with her?"
Again the small voice whispered, "No."
Hoping there was somebody with whom he could leave a message, the boss asked, "Is anybody else there?"
"Yes," whispered the child, "a policeman."
Wondering what a cop would be doing at his employee's home, the boss asked,
"May I speak with the policeman?"
"No, he's busy", whispered the child.
"Busy doing what?"
"Talking to Daddy and Mommy and the Fireman," came the whispered answer.
Growing concerned and even worried as he heard what sounded like a Helicopter through the earpiece on the phone the boss asked, "What is that noise?"
"A hello-copper" answered the whispering voice.
"What is going on there?" asked the boss, now truly alarmed.
In an awed whispering voice the child answered,
"The search team just landed the hello-copper."
Alarmed, concerned, and even more then just a little frustrated the boss asked, "What are they searching for?" Still whispering, the young voice replied along with a muffled giggle:
"ME."
****
Border Marches
The Border Marches take place on Sunday 15th May 2005. and some of the employees of General Mills Berwick " Jus Rol " are looking for sponsorship to raise funds for our heart group, I have included sponsorship forms with the newsletter.
In the past we've had quite generous annual grants which have covered most of our costs of the newsletters, leaflets stationary ect. This year the grants have dried up and we are having to find our own funding so any help you can give in raising sponsorship, (however little) would be appreciated.
Terry
****
NHS finds the plot.
Integrated health and Social Care Plan for Berwick
Terry and I were invited by Northumberland Care Trust (NCT) and the Northumbria Health Care NHS Trust to attend, on your behalf, a large workshop in the Maltings on 3rd March. The meeting included a whole range of health professionals and many voluntary people like us.
We heard some very well done talks from NHS experts and a lot from 'the floor' about the problems of Berwick, sitting as we do, not always comfortably on the Border.
Berwick has an increasing number of older people to care for, and this is more significant than in many other parts of the country. The greater number of older people means more chronic disease. Deaths from heart disease have gone down dramatically in the last few years, and Northumberland has done particularly well, but the big killer is still heart disease and the underlying arterial disease, rather than cancer. The drop nationally in 'arterial disease deaths' has been due largely to more people giving up smoking. (Of the 50% fewer deaths from arterial disease, about 50% of these were because people stopped smoking.) This picture will continue to change for the better as heart disease is brought more under control and if people take avoiding action.
Because we are farther away from big centres, and a sizeable number of us live in the country, it is difficult to deliver high quality health care without a large amount of travel. "First aid" emergency care for heart attack has improved significantly, but keeping emergency cases in Berwick is not a safe option. The quicker that you are in intensive care with all the facilities the better. Some services, however, are much better if they can be provided locally. For us this can mean rehab, stopping smoking, breathing and diabetic clinics. Some routine tests can be done locally, but accurate laboratory tests and those requiring latest scans and assessment can only be delivered where the equipment and trained personnel are situated.
We heard an interesting account of the sensible services being provided in Community Hospitals, Rothbury, Alnwick and Berwick Infirmaries, and the devoted effort to provide X ray cover. The ambulance service and A&E cover (co-locate Primary Care and A&E at Berwick and Alnwick ) and skill development and workload all need co-ordination.
There is a major concern in Northumberland over "NHS Direct". The review of future plans for 'out of hours' GP cover, is due to report very shortly. "In future, GPs will be mostly female and 80% of those in training now at Newcastle are women and we must get conditions of service right if we want to recruit them."
One message from the floor was repeated many times. The two sides of the Border should talk and make maximum use of NHS services in order to minimise travel and to provide best care locally for chronic problems. This message applies across the board, not just to those services affecting heart patients. Us older folk cannot monopolise the health service. There are great strengths in Berwick GP surgeries and a great Family Centre, and expert pharmacists locally, that can all be built on. We should play a part as a group and as individuals. Chronic conditions like ours require us also to build up our own expertise.
Phil
****
BERWICK AREA HEART SUPPORT GROUP
MAY 2005 NEWSLETTER
Next meeting May 4th at the Day Hospital Berwick Infirmary 7pm – 9pm Guest Speaker. Dr. Mike Lavender, Director of Public Health for Northumberland Dr Lavender has worked in Northumberland since 2000, and was appointed as Director of Public Health when the Care Trust was established in 2002. His main responsibilities are co-ordinating services for heart disease, stroke and diabetes and leads on drug and alcohol issues for the Care Trust.
*****
Wrist Bands
All us grand parents have heard our grandchildren talking about the “latest craze” collecting all the different coloured wrist bands for different charities, the BHF wrist band is available at their charity shop in Berwick cost £1.
*****
Border Marches
The Border Marches take place on Sunday 15th May 2005. and some of the employees of General Mills Berwick “ Jus Rol “ are looking for sponsorship to raise funds for us the Berwick Area Heart Support Group, I included sponsorship forms with last months newsletter.
In the past we’ve had quite generous annual grants which have covered most of our costs of the newsletters, leaflets stationary ect. This year the grants have dried up and we are having to find our own funding so any help you can give in raising sponsorship, (however little) would be appreciated. Please make cheques payable to Berwick Area Heart Support Group
*****
At our meeting on 6th.April our speaker was Dr. Graeme Gillespie, a Clinical Psychologist, based at North Tyneside Hospital, and having responsibility for patients in Northumberland NHS. He was assisted by Doctor Jennifer Gracie.
That sounds like a double act on television, Paul Daniels assisted by Debbie McGee, only Graeme did not cut Jennifer in half.
Graeme was with us in March 2004 when he talked about stress, and it how affected medical complaints, especially heart related complaints. This year his plan for the evening concentrated more on relaxation as a way to help avoid stress.
We also had open group discussion on the following subjects.
- Stress, what is it?
- Stress and Heart disease, is it a risk factor?
- Coping with stress
- Relaxation, what does it mean?
- Group relaxation.
So what is stress?
Just to remind ourselves what stress is, I’ll copy a paragraph from last year’s news letter.
Stress
To help understand stress, we have to remember that our bodies were designed 1000s of years ago, when our ancestors live in caves, (When according to cartoonists, sexual foreplay consisted of a bump over the head with a club, and then being dragged by the hair to the nearest cave)
Stress starts as some form of threat, in reply to which our bodies release a hormone called adrenaline. This gives our bodies an immediate boost of power or energy. Threats to our early ancestor usually came in the form of another predatory animal, and the boost of energy was to give him the strength to either run away, or the stay and fight, and possibly have the predator for his tea. It is called the “fight or flight syndrome”, but when the danger was past, our caveman could relax, and contemplate his actions.
The trouble arises when, for one reason or another we cannot do either and the adrenaline keeps our
body keyed up, which is very likely in our modern world.
Today, stress it is more likely to be: “An emotional or physical strain caused by our response to pressure from the outside world”. But make no mistake it has the same effect as meeting a sabre tooth tiger in Morrison’s car park.
We all need a degree of stress in our lives, it would be impossible to live without it; it gives life some spice and excitement. It’s when it gets too much and out of control that it may harm our health, our relationships and our enjoyment of life.
Signs of stress getting out of control
- Increased irritability
- Difficulty getting to sleep, and early morning waking
- Increased use of alcohol or cigarettes.
- Variety of physical systems, including, headache, fast heartbeat, indigestion, and other aches and pains.
- Loss of concentration
- Feeling low or depressed.
Stress and the heart, what do you think?
- Do you think there is a link between stress and heart disease?
- Can stress cause a heart attack or angina?
- Does heart disease cause stress
Stress affects different people in different ways.
Effects on most people
- Trying to take in complex information to try and understand the condition.
- Symptoms to interpret and live with
- Adjusting to a potentially life threatening condition/event
- Its stressful for family not just the patient
Behaviour changes to make (stopping smoking, taking more exercise, changing diet and taking medicines daily)
Effects on some people.
- Anxious wait for heart investigations and procedures
- Loss of previous role, job, self image.
- Traumatic experiences
- Dealing with setbacks.
- Past difficulties resurfacing
- Fears a bout exercise/returning to work
Relaxation: What does it mean?
Graeme asked the question, and invited replies. Here is a list of various way in which fellow members relax, and I bet there a few no one is going to admit to.
Hobbies, non competitive sport, golf, fishing, etc. reading, crosswords, relaxation exercises /tapes, reiki, music, peace and quiet, work, keeping busy, being at home, computer, focus attention on something external, walking, baking, doing something useful or productive, slow breathing exercises/techniques and a lot of people suggested a warm relaxing bath.
It’s accepted that all these don’t work for everyone, and that there are others, it really is finding some for yourself, which works for you, which in itself is another way of relaxing.
Graeme did break relaxation into two categories; those listed above, describing them as, things people enjoy. The other category is “Therapeutic Relaxation” Examples of these methods are:
Physical Methods
Psychological Methods
We did have examples of these; both Graeme and Jennifer read relaxing stories where we had to imagine ourselves in the stories. (Honestly, for those that know me I didn’t go to sleep, so any snoring was not me). These stories are very similar to the relaxation tape we get with the Heart Manual. We have written copies of these but they would need transferring to tape for them to work, reading them to yourself doesn’t seem to have the same effect.
Stress can be reduced by having regular breaks. Not the quick ‘pop outside for a quick puff’ type of break, you have to be able to relax, be comfortable, quiet and maybe listen to some relaxing music, which is referred to as Your protected time, and remember, although for many of us this next bit of advice will be hard to accept after a working lifetime of being told just the opposite.
‘It is not lazy to relax’.
Graeme did recap of some of the facts surrounding . Heart Disease. Some reasons for heart disease cannot be changed like
- Increasing age
- Gender, male sex
- Heredity (Including race)
But others can like
- High blood pressure
- High cholesterol
- Obesity
- Smoking
- Physical inactivity
- Diabetes
Treatment and risk factor changes in England and Wales show.
- 68,230 fewer heart related deaths in 2000 compared with 1981.
- 42% (26,000) of the mortality decrease was due to medical and surgical treatments.
- Most substantial contributions came from secondary prevention medications and heart failure treatments.
- 58% (36,000) was due to change in risk factors
- Largest proportion from a fall in smoking
- Revascularisation from coronary bypass surgery and angioplasty together accounted for only 4% of the total decrease.
Some other facts worth noting,
- By reducing the average cholesterol levels in the UK from 5.8 to 5.2 mmol/l, as already achieved in Sweden, Finland, the US and Australia, would prevent approximately 25,000 fewer deaths each year.
- Simply reducing smoking levels to that of the Americans would result in 17,000 fewer deaths each year.
Wally
*****
Sleep
Graeme mention sleep (take a power nap for 10 min) as a good form of relaxation and also to relieve stress, so if a short nap does you good a full nights sleep must be even more important.
When we are asleep, our heart is in its most relaxed state, our heart rate slows down, our blood pressure is lower, our heart is relaxed, and our body can restore itself. Problems with sleep can lead to fatigue, which can then lead to stress and depression so you end up in a “cycle of helplessness” These are things you can do to help you sleep better and break this cycle.
- Get a comfortable bed that allows you to move easily and supports your body well.
- Find a comfortable sleeping position. Try using small pillows to help.
- Keep your bedroom at a warm temperature.
- Use a vaporizer if the air is dry; warm and moist air makes breathing easier.
- Keep a lamp and telephone beside your bed.
Things to Avoid Before Bedtime
- Eating. Digesting food takes energy and means that your body will not have the energy resources to restore itself.
- Alcohol. Alcohol leads to a shallow sleep and means that you will wake up several times during the night.
- Caffeine. Caffeine is a stimulant and can keep you awake, Caffeine is found in coffee, tea, colas and other soft drinks and also in chocolate.
- Food with MSG. (monosodium glutamate). Chinese food and pre-packaged meals often contain MSG which can act as a stimulant.
- Smoking. Nicotine in cigarettes is a stimulant.
Develop a Routine
- Go to bed at the same time and get up at the same time. If you need to, take a nap in the afternoon. Stay awake after your evening meal until you are ready for bed.
- If you want to get back to a normal pattern of sleep ( for example, if you are going to bed at 3 a.m. and sleeping until midday) you will need to reset your sleep clock. Try going to bed 1 hour earlier or later each day until you get to the pattern you want
- Regular exercise can help you sleep well.
- Get out into the fresh air for a hour or so every day.
- Get used to doing the same thing every evening before you go to bed. A ‘time-to-get-ready-for-bed’ routine helps your body and mind to relax.
Other Tips
- If you get into bed and can’t fall asleep, get up and go into another room until you are sleepy.
- To take your mind of worries, try a distraction technique such as counting backwards from 500 by 3’s or naming a country for every letter of the alphabet
- Don’t worry about not getting enough sleep, it stops you sleeping.
Terry
*****
Wally’s Yarn
Something I heard.
A nun, Sister Anna, joined a silent order nunnery. After the first year of silence, as a special treat, on one evening of the year each nun was allowed to utter two words.
On the appointed day, after their evening meal, The Mother Superior went around the table asking each nun in turn what their two words were.
To make her words count Sister Anna had thought hard about what she wanted to say, so when Mother Superior asked Anna what she would like to say she said “Hard bed” She thanked her and moved on to the next nun.
The next year Mother Superior again asked Sister Anna for her two words, and she replied, “Cold porridge”. Mother Superior thanked her and moved on.
The next year when asked, Sister Anna said, “Damp Room”. Again Mother Superior thanked her and moved on.
When asked the following year, Sister Anna replied, “I quit”.
Before moving on Mother Superior said, “Thank goodness, you’ve done nothing but moan since you got here
BERWICK AREA HEART SUPPORT GROUP
JUNE 2005 NEWSLETTER
Next meeting June 1st At the Day Hospital, Berwick Infirmary from 6.00pm - 9.00 pm the Guest Speaker Dr Higham is Honorary President of our group and on his previous visits both as a speaker and as a guest he has proved to be very popular within the group. This months meeting starts with our AGM at 6pm, followed by the normal meeting at 7.00pm.
****
Our speaker on the 4th of May was Dr. Mike Lavender who is Director of Public Health for Northumberland. He has worked in Northumberland since 2000, and was appointed to his current role when the Care Trust was established in 2002. His main responsibilities are co-ordinating services for heart disease, stroke and diabetes and lead on drug and alcohol issues from the Care Trust.
Dr. Lavender did send me a copy of his slide presentation to help with my notes. I thought it was going to be fairly easy to just reproduce them, but unfortunately they do not reproduce very well and are unreadable in a small format so I will have to rewrite them, but as each slide was shown he gave his views on each subject, and in many cases it generated discussion.
Slide 1
This is the National Service Framework for Cardiac Heart Disease (CHD) to which he has to work, setting out reduction / prevention, treatment, management and rehabilitation.
Standards
- 1 and 2 - Reducing heart disease in the population.
- 3 and 4 – Preventing CHD in high risk patients in primary care.
- 5, 6 and 7 - Treating heart attacks and other acute coronary syndromes.
- 8 - Investigating and treating stable angina.
- 9 and 10 – Revascularisation.
- 11 - Managing heart failure.
- 12 – Cardiac rehabilitation.
Slide 2
This slide was entitled;
CHD is a priority for health
- CHD is common, frequently fatal and largely preventable disease.
- CHD is the commonest cause of death in Northumberland.
- CHD cause 420 deaths among people aged less than 75 living in Northumberland each year.
- CHD accounted for 27% of all deaths in this age group in men, and 24% in women.
Slide 3
This one showed the link between CHD and deprivation, but was in a graph which I am unable to reproduce, but the National average is shown on a line of 100. Berwick is shown very slightly under and Morpeth is very slightly above this line. The North East and Northumberland is on 120, Tynedale and Alnwick are about 115, but Blyth Valley and Wansbeck are up on 140. Dr. Lavender suggests the later two are higher because of the ‘dirtier’ industries in the areas recent past, and the fact that they are now gone resulting in high unemployment. He cannot suggest a reason why Alnwick should be as high, but did add that most of Berwick’s improvements were 60% lifestyle changes, i.e. smoking cessation, and better eating habits, and 40% treatment.
Slides 4, 5 and 6
Again these were graphs and showed how death rates are falling for Circulatory Disease between 1993 and projected through to 2010. In 1993 the National Average was 160, Northumbria’s though was 180. In 2001 it was on a par with the National Average, and if it keeps on this way by 2010 will be down to 40, although the target for then was predicted to be 100, which is where we are at today.
The next slide showed how the ‘gap’ is closing between all classes of society. (I don’t like that expression), but basically, the have and have nots, the rich and poorer, north and south, the brains and the not so brainies, and manual and n on manual workers. Heart disease has less of a preference, but fortunately it going down for all of u
There was another slide to show how both Northumberland and Berwick have both on parallel downward trends over the past 8 years, whilst Alnwick has remained on a level course during the same time.
Slide 7
This showed how death rates from CHD were changing on a global scale. Whilst this didn’t cover all Countries, falls in death rates were better in the Scandinavian Countries, Britian was best in the European Countries, but in many of the former Eastern European and USSR States things are getting worse. One suggestion is that because there is no restriction on cigarette advertising in these countries and the populations there are smoking more, so their heart problems rise. This is for both men and women.
Slide 8
This slide was entitled
Risk factors for CHD
Smoking is estimated to account for about 24% of deaths from CHD in men and 11% in women.
- 43% - raised cholesterol
- 25% raised blood pressure
- 17% obesity
- 35% low physical activity.
Slide 9
This slide entitled
Preventing CHD
- 51% of prevented or postponed deaths due to changes in risk factors.
§ 36% due to reduction in smoking
§ 6% changes in cholesterol
§ 6% lowered blood pressure
- 40% due to treatment for CHD.
The next two slides were entitled
Progress and plans for the NHS….
- Thrombolysis–‘clot busters’ if given in time can prevent a lot of the damage caused to the heart in the event of an attack. Currently Paramedics can take ECG, pass results to Wansbeck and then give the required dose of medicine.
- Angiography and revascularisation. There will be a Suite at the Wansbeck within 2-3 years.
- Rapid access chest pain clinics, These already exist
- Cardiac rehabilitation nurses, This is all about prevention. Well Close Surgery has one.
- Heart Failure specialist Nurses, There is one at Berwick at present, but this will be increased.
- Prevention in Primary Care. Giving constructive advice during and after an incident
- Smoking Cessation Service, These clinics have been going for some time, I went to one almost 5 years ago, and it worked for me, but Dr. Lavender was speaking of extending them together with a Media Campaign. As we see from last months figures and again this month, stopping smoking seems to make the biggest impact on prevention of and recovery from heart disease, or related incident.
…. And Others
- Healthy Schools Programme, Education about life styles, eating habits, drugs, and numerous other things, all related to prevention.
- Whilst on this subject there was discussion on Domestic Violence, Alcohol, Drug Misuse, Teenage Pregnancies and similar subjects, all of which Dr. Lavender has to manage.
- Walking to Health, As many of us already walk, either alone or as part of a walking group, we realise the benefits. If you don’t already walk regularly see elsewhere in this newsletter for walks near you.
- Exercise on referral. Like walking there are lots of benefits. There are two classes twice a week at the Swan Centre, and one at Berwick Middle School Gym, details of which are mentioned elsewhere in this newsletter.
- Health in the workplace, This discussion could have gone on forever. Health and Safety cover many of the problems, but smoking was again high on the list, but proper rest periods were also required, as was being able to relax and turn off whilst on a break.
- Tobacco Control, This to cover both illegal tobacco sales, and smoking in public places.
Whilst this last subject did not have a slide it was included. Dr. Lavender admitted he liked a glass of red wine, and that there were medical benefits in moderate amounts of alcohol. Rather than try and pick out relevant bits I have reproduced the paper Dr. Lavender sent so you can read it for yourselves.
Alcohol
Moderate alcohol consumption (one or two drinks per day) is associated with a reduced risk of CHD. However, at high levels of intake - particularly in 'binges' - the risk of CHD is increased. It is therefore difficult to make estimates of the numbers of deaths from CHD which are due to the level of alcohol consumption in the UK or of the numbers of deaths which could be avoided if levels of alcohol consumption were to alter.
The Government currently advises that 'regular consumption of between three and four units a day by men' and 'between two and three units a day by women of all ages will not lead to any significant health risk'. Consuming in excess of four units on the heaviest drinking day of the week in men, or over three units in women, is not advised, and the Government’s recommendations on sensible drinking are now based on these daily benchmarks.
This advice is consistent with previous advice, based on weekly alcohol consumption: that men should drink less than 21 units a week and women less than 14 units a week.
Family History
What is the actual risk of me developing coronary heart disease if my parents have coronary heart disease?
If one parent has coronary heart disease (CHD) the risk of having CHD is increased by 15% compared to the general population. The risk rises to above 30% if the CHD happened before 55 years old in the parent.
If both parents have early coronary heart disease (under 55 years) the risk to the sibling of having CHD, can rise to 50% compared to the general population.
It is important that family members are aware of their own risk factors and take active steps to prevent coronary heart disease.
What does Family History of coronary heart disease mean?
Coronary heart disease has been proven to run in families (hereditary). People may inherit risk factors that increase an individual's chance of developing coronary heart disease. One of these factors is Familial Hypercholesterolaemia (FH) or inherited high cholesterol levels.
What is Hypercholesterolaemia?
One of the major causes of coronary heart disease (CHD) is a high level of cholesterol in the blood (hypercholesterolaemia). To be more specific it is a high level of low-density lipoprotein (LDL) cholesterol in your blood. This can increase your risk of heart disease due to a build up of fatty deposits in arteries (arteriosclerosis). A high cholesterol level is generally associated with the food we eat. A fatty diet is more likely to increase the blood LDL - cholesterol level.
What is Familial Hypercholesterolaemia (FH)?
However, in some individuals this high blood LDL - cholesterol level is caused by a defect of a specific gene inherited from a parent or parents. This is known as familial hypercholesterolaemia (FH). Each cell in your body has a specific receptor that allows LDL - cholesterol to be cleared from the blood. People with FH have a gene that causes a defect in this receptor. The defective receptor is unable to clear LDL - cholesterol from the blood and instead results in a build up of LDL - cholesterol. This in turn can lead to coronary heart disease. People with FH generally develop coronary heart disease at an earlier age.
Children of parents with heart disease are more likely to develop it themselves. African Americans have more severe high blood pressure than Caucasians and a higher risk of heart disease. Heart disease risk is also higher among Mexican Americans, American Indians, native Hawaiians and some Asian Americans. This is partly due to higher rates of obesity and diabetes. Most people with a strong family history of heart disease have one or more other risk factors. Just as you can't control your age, sex and race, you can't control your family history. Therefore, it's even more important to treat and control any other risk factors you have
****
I have had a busy month, travelling here, there, and thither but have not heard any new stories, apart from my Grandson who asked me if I was old. I reminded him that he knew exactly how old I was but he replied, “Is that old?”
I told him I didn’t feel old but why was he asking.
He said that he had heard on the television that you know you are getting old when your teeth don’t sleep in the same bed as you.
I did see Terry yesterday and he said he had a good story, so this months yarn is not mine. I don’t know what its about so I will have to wait.
Wally
Wally’s Yarn
A couple decide to go for a meal on their anniversary and after some deliberation decide on their local Chinese restaurant.
They peruse the menu and finally agree to share the chef's special chicken surprise.
The waiter brings over the meal, served in a lidded cast iron pot.
Just as the wife is about to start in on the meal, the lid of the pot rises a tiny amount and she briefly sees two beady little eyes looking around before the lid slams back down.
Did you see that!?" she asks her husband. He hasn't so she asks him to look in the pot.
He reaches for it and again the lid rises, and again he sees two beady little eyes looking around before it firmly slams back down.
Rather perturbed he calls the waiter over, explains what is happening and demands an explanation.
Well sir", says the waiter, "What did you order?"
We both chose the same", he replies, "the chicken surprise"
Oh I do apologise, this is my fault" says the waiter, "I've brought you the Peking Duck"
****
Recipe of the Month
Raspberry Porridge
(Serves 2)
Ingredients
- 50g oatmeal, plus extra for serving
- 450ml semi-skimmed milk
- 2 tbsp (40g) heather honey
- 125g pack raspberries
Method
Place the oatmeal, milk and honey into a saucepan. Bring to the boil over a medium heat, then simmer for 4-5 minutes, stirring throughout, until thick and creamy. Remove from the heat and stir in the raspberries until they begin to break up and release their juice.
Spoon into bowls and serve hot with a little oatmeal scattered over the top.
Variation Try replacing the raspberries with chunks of fresh pear and add some chopped roasted hazelnuts.
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