Do you need a digital detox?

Social media is the phenomenon of our time.

It has allowed each one of us to connect with new and old friends and companies like never before and it has become an integral part of our lives.

A couple of weeks ago, my wife took us both to Rome to celebrate my birthday.  This is me in the photo, caught in the act by my wife, checking social media in the middle of one of the world’s great historical sites – the Colosseum in Rome. Is this not addictive behaviour?

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There are pitfalls and dangers with social media as with any aspect of life and these are well documented. However, for the majority of people, social networks allow greater integration and sharing of our lives with friends and family than has ever been previously possible. From seeing family holiday photos to speaking to friends from years ago or miles away, connecting with people has never been easier. Suddenly the world is a much smaller place.

As a doctor, I have seen social media be a pathway to improving a patient’s health. One young patient had been quite social during their early years in school but had become more reclusive due to bullying. They rarely left the house and had no social interaction other than with their own family.

My patient’s one and only interest was sport. They continued to watch their favourite sport and over time, due to their enthusiasm, started a weekly iTunes podcast which proved quite successful. As part of the promotion for the podcast, they found they had to engage with social media including Instagram and Facebook. Slowly they found they were starting to talk to people online and, over the following months, started to form online friendships. This progressed into face to face friendships and attending sporting events together. From living their life alone in their bedroom to attending large sporting events with friends; the positive power of social networks is easy to see.

I think we engage with social media because as human beings we are inherently social animals. We like to keep up to date with what people are doing because by nature we are interested in what is happening in our surroundings.

Earlier this year, a study of 14-24 year olds found that Instagram was beneficial in terms of self-expression and self-indentity but that it could negatively impact their body image, sleep and lead to a fear of missing out.

Another study suggested that a Facebook addiction could be seen on brain scans of those reportedly affected – showing changes in the same parts of the brain that is affected by cocaine use.

Here are our top tips for spotting a social media addiction:

  1. As soon as you open your eyes in the morning you are already reaching for your phone to check out what has happened over night.
  2. You check in at the bus stop, the tube, your desk, at starbucks (with a selfie of you looking wistful with your coffee – or a boomerang of your coffee), you then update your status as you’re waiting for the work day to end and repeat the check in process on your way home before providing a running commentary in Instagram stories of you preparing your dinner.
  3. When someone tells you a joke you respond with lol instead of an actual laugh.
  4. You use the phrase “hashtag” in normal conversations. #fail.

So you’re worried you might be addicted, or you might need to take a step back from social media – how do you go about doing it? In truth in can be incredibly difficult to digitally detox your life.

  • Start by trying to set some limits – like not checking your phone in bed or after a certain time at night, not taking your phone to the bathroom etc.
  • Try turning off the push notifications – these little messengers of social activity constantly draw us back to our accounts.
  • Try having a device amnesty in your house eg for a few hours in the evening or even for a whole day, and spend time instead with your family

Sure, there are some people who live and die by the number of likes a post or picture gets, but the rest of us just enjoy looking at photos of our friends as they have too much to drink and falling over don’t we?
 

 

 

 

Wonder Woman/Super Man – what’s so great about them anyway?

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This post is inspired by a patient I have, we’ll call her Jane. In reality the patient I met today is like so many that I have, and your doctor has, met before. It could easily be John, or Jenny, or Jeff.

Jane is in a cycle of trying to care for family members and hold everyone together, but the cracks are starting to show. The strain of being everything to everyone is leaving little time to tend to her own needs. Her stress levels are through the roof, she isn’t sleeping well at the moment, her appetite is a little off, she is struggling to focus at work and feels like she is on the verge of tears or anger most of the time. Sound familiar?

It’s not Jane’s fault, she is doing what she knows best. She is trying to support her family whilst being a productive colleague, a good friend, a good spouse… She’s trying to be Wonder Woman and she’s mad at herself because she is struggling. She berates herself for not being “strong enough” and that she “needs to snap out of it” but try as she might, she doesn’t see how she can.

I talked with Jane about imagining ourselves in a house. For any house you need a solid foundation, and that foundation is our sense of self.  The walls of the house our are natural defences to protect us from the storms of life. Repeated adverse life events or stressors, just like a real storm, can chip away at the walls of the house, they might even break the windows.

If our house is built on solid foundations, and we have developed coping strategies that are effective for us then we can weather those storms. If our defences are low – perhaps we have lots of stressful things happening at the same time which are rocking the walls of our house, or our foundations are built on shallow ground, then our house is going to start tumbling down.

Without the house to protect us, we are exposed to the harsh realities in life.

This is where I found Jane today. Her walls are tumbling in, she is trying desperately to barricade the doors and windows but she cannot keep up with the demands that life is throwing at her. Simply put, she cannot be everything to everyone. She is not Wonder Woman.

Fortifying our proverbial houses is tough, especially as we often have to try and fight these fires whilst carrying on with our normal lives.
The first step is acceptance. Accept that you cannot do everything.

“Serenity is accepting the things we cannot change,

courage to change the things I can and

wisdom to know the difference”. 

Acceptance does not mean berating yourself for weakness. It is not a flaw to accept that you need help or that you are struggling. It takes strength of character to stand up and say to someone you need some support.

Next comes rebuilding. For those in caring roles this can be especially challenging. As a carer your focus is inherently on those your care for. Shifting your focus back to you can be unsettling, upsetting and hard to do. However to care for another in the way you want to, you have to be able to care for yourself.

One of my favourite analogies (and I have plenty) relates to a broken leg. If you have a broken leg, society at large knows how to react. They can see the plaster cast and the crutches, they can mentally apportion the right amount of sympathy and understanding. Bones heal, the injury is visible, and it’s much easier for people to get their head around.

Stress, burn-out, depression and anxiety all have few outwards signs. Unfortunately a stigma can still exist around these problems and society can sometimes feel unsure about how to ‘handle’ someone who is suffering. But just because it isn’t visible, and just because it isn’t physical, doesn’t make the problem any less real or relevant.

To rebuild takes time. Patience. Support. Effort. It isn’t easy. Remember that a difficult path can sometimes lead to beautiful destinations.

Talking therapies such as counselling and CBT should never be overlooked or dismissed. Having someone else, impartial to your situation, help you to talk through your current troubles can be a real life saver – and can help to set you up for your future.

Some patients might need medication from their GP. I would always encourage anyone who is facing difficulties in their life that are starting to overwhelm them to speak with their doctor.

Part of rebuilding is learning about yourself. Really understanding yourself is the key to your success. What are your warning signs that things are getting too much? What can you do when those signs start to appear? What strategies to do have to protect that proverbial house?

Whatever it might be, find what re-centers you. It might be yoga or meditation, it might be catching up with an old friend, watching a favourite film, reading a book, going for a run or taking the dog for a walk.  As long as its a positive action – that doesn’t mean opening a bottle of wine or similar.

Exercise can be an incredibly powerful tool at boosting how we’re feeling when we’re struggling. Physical activity is not only good for our physical health but for our mental health too. Not only does it increase endorphins that help promote good feelings, but it also can help with issues such as insomnia.

Being you is enough. You don’t need to be Super Man or Wonder Woman. Besides, they wore their pants over their clothes, and when you stop and think about it, what’s so great about that anyway?

 

 

 

An easy arm work out that you can do at home!

Check out our easy arm work out that you can do at home or in the gym, we’ve used weights but you can use whatever you have at home – remember 1L is 1Kg, so grab that bottle of water and start moving!

Workout

Bicep Curl 2 sets of 8 movements (on each arm)
Hammer Curl 2 sets of 8 movements (on each arm)
Cross body hammer curl 2 sets of 8 movements (on each arm)
Barbell Curl 2 sets of 8 movements
Tricep Extension 2 sets of 8 movements
Tricep Dip 2 sets of 8 movements

Share Your Spare: Organ Donation

This week is Organ Donation Awareness week in the UK.

Transplanted organs save so many lives as medical science and surgical techniques advance, but the sad fact remains that that the number of people who need an organ outstrips the number of people who donate organs. It is thought that every day in the UK, three people die waiting for an organ.

 

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There have been some incredibly moving videos on social media lately – hearing the heartbeat of a deceased child beating strong in another person, meeting the recipient of your partners lung donation and so on. Emotive as they are, they do illustrate just how life changing organ donation can be to those who receive a transplant.

Talking about dying and organ donation can be really difficult, so it is understandable why we might shy away from thinking about it and talking to our loved ones about it. Somehow as if it’s almost tempting fate.

We can donate organs such as heart, lungs, kidneys, liver or pancreas, or we can donate tissues such as corneas (a clear layer of ‘skin’ at the front of the eye), heart valves, skin or bone.

Most people know about organ donation after death, however we can (in some circumstances) donate an organ whilst we are alive. The commonest situation would be to donate a kidney to another person in need, sometimes within our family. We have two kidneys but we can usually manage just fine with one. The brilliantly titled #ShareYourSpare is a social media campaign trying to raise awareness for living kidney donation.

Roughly 5000 people in the UK are waiting for a kidney transplant and as many as 250 patients died last year waiting for a kidney transplant – because they could not get a transplant in time.

Parts of the UK have different laws regarding consent for organ donation, and you should always check what the law is where you live.

In Wales there is an ‘opt-out’ system. This means that you can still voluntarily register to be an organ donor if you wish. However if you specifically do not want to be a donor, you need to register your intention not to donate. If you do nothing, it will be presumed that you do not object to donation.  For the rest of the UK, you still need to register your intention to donate your organs.

Regardless of your feelings or decisions about donation, it is important that you tell your next of kin or family. In the event that the worse happens, your family can help to share your wishes and make these known to the medical team looking after you. If they do not know you wanted to donate your organs, this could blind side them in an already very difficult time.

Talking about death and dying with our loved ones can be a difficult and painful process. As hard as these discussions are, having them sooner rather than later will ensure we’re all on the same page if the worse should happen. As we look to raise awareness of organ donation this week, try and take the opportunity to think about what you might want.

You can register as an organ donor or find out more about donation on the NHS donation website 

 

Vitamin D

Of all the vitamins, it seems like vitamin D has had the most air time of late. Certainly in our clinics, it’s the one patients seem to ask most about – are they getting enough, how do they know if they are getting enough and do they need to take supplements?

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Vitamin D helps our bodies to regulate the crucial minerals Calcium and Phosphate in our bodies. We need these to keep our bones, teeth, nerves and muscles healthy.

A lack of vitamin D causes bone abnormalities – you might have heard of rickets? Rickets is a disease in children caused by a vitamin D deficiency.

For most of us, we actually get our vitamin D from exposure to sunlight. This means here in the UK, it can be a challenge to get enough sun during the long winter months. We all know the dangers of sun exposure and it’s a sad fact that skin cancers seem to be on the rise. There is a real delicate balance between enabling the sun to provide us with enough vitamin D and over-exposing our skin to the sun and increasing our risk of sun-related skin damage.

It is recommended that to allow enough exposure of the skin to the sun, that our forearms, hands or lower legs are uncovered, for short periods of time, without sunscreen. There is no set amount of time we need in the sun – and this is because we all make vitamin D at different rates. Darker skin colours seem to take longer to produce vitamin D and will need longer in the sun than those with lighter skin colours.

Being in the sun enough to cause the skin to burn is never recommended – and if you do start to feel burnt – you need to cover up or apply a good strength sunscreen (at least SPF 15). Increased time in the sun or allowing the skin to burn can increase the risk of developing sun-related skin damage or skin cancers.

There are some foods which can provide vitamin D such as red meat, liver, fortified foods, cereals and oily fish such as salmon or mackerel. However if you follow a diet that does not include meat – it can be especially challenging to make sure you get enough vitamin D.

Children over the age of one and adults need 10 micrograms of vitamin D a day.

Recently, the guidelines on vitamin D supplementation changed. Here in the UK it is recommended that babies from birth to the age of one are given a daily supplement containing up to 10 micrograms of vitamin D. However if your baby is fed by formula, most of these have vitamin D and as such they would not need supplementation until they were having less than a pint (around 500ml) of formula feed. Children up to the age of four should also be given a daily supplement.
There is now advice that adults should also have a supplement during winter months, when we are less able to get our fix of sunshine.

It is also worth considering those who are at higher risk of vitamin D deficiency – and primarily these are people who do not get much sun exposure. Whether that be due to immobility or being housebound, or those who choose to cover up most of their body with clothing.

 

 

 

You can get too much vitamin D – and this can cause an increased build up of calcium. Although we need calcium to keep our bones strong, actually too much can weaken our bones and cause heart and kidney problems.

“If a migraine is just a headache, then Godzilla is just a lizard”

One in seven of us will suffer from migraines, so there is a good chance that someone you know suffers with migraines – it might even be you.

It is estimated that there are nearly 200,000 migraines every day in the UK. More common in women than in men, it can affect us at any age – even as children.  On average, a migraine sufferer will have 13 attacks a year, lasting up to 72 hours at a time.

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Migraine is a complex problem and the truth is that medical science isn’t entirely certain on its cause. Whilst many people with migraines will experience headaches (usually a severe, throbbing, one-sided headache), there are many other symptoms and features of a migraine, such as: flashing lights or visual changes or sensitivity to the light, sensitivity to sound or smells, nausea or vomiting, numbness or pins and needles, slurred speech, irritability or abdominal pain. Sometimes, someone with a migraine will not even have a headache.

Migraines are thought to occur in five stages: prodrome, aura, main attack, resolution, recovery.

The prodrome can be tricky to pick out from normal day-to-day life, but those who can recognise it will talk about feelings of lethargy or irritability, or just feeling a bit off.

For some this will be followed by an ‘aura’. This would typically happen up to an hour before the attack. Someone might notice flashing lights, changes to their vision or speech, or other neurological features such as tingling or numbness. Migraine aura’s do not happen with every migraine, and it is estimated around one-fifth of migraines are associated with an aura.

I suffer with migraines – thankfully very rare these days, but when I get one they wipe me out. I don’t usually suffer with an aura when I do have a migraine  – but it has happened. If I do get one, it will be flashing lights – strange flickering light towards the edge of my vision – just enough to make me wonder if I have seen it at all – and I get a bit muddled – almost as if my brain is suddenly wading through thick treacle and I feel I have to work hard just to think. 

The main stage of the migraine is the ‘attack’ phase – this is when a headache (if present) will occur and can last up to 72 hours.

In the resolution and recovery phases, the headache and any other symptoms start to ebb away but patients will often say they feel particularly tired or wiped out, sometimes for a couple of days.

So if you suffer with migraines, what can you do about them? First off, it’s really important that if you are experiencing new, changing or worsening headaches you get these checked out by your doctor. If your doctor agrees that you are suffering with migraines you might then want to think about ‘triggers’.

Many migraine sufferers have triggers unique to them and there are so many possible triggers out there. To be able to start working out what might be setting your migraine off, a headache diary can be a great tool. You can download pre-set diaries or just use your calendar on your phone. Do this for a month or so and then look back over the information you have collected and see if any patterns jump out at you.  For me, it’s lack of sleep – every time!

Common triggers are: emotional upheaval whether that be happy or sad, worry or anger, poor sleep or over tiredness, changes to environment, periods for women (as well as contraceptive pills and the menopause), dehydration, citrus, caffeine, cheeses, chocolate, alcohol, pork and monosodium glutamate.

Treatments vary depending on the type of migraine, how often they happen and your medical history, Broadly speaking these can be divided into ‘acute’ treatments – ones you take when an attack is happening and ‘preventative’ treatments – ones to take to try and stop attacks from happening. Simple measures such as paracetamol, anti-inflammatories such as ibuprofen and rest in a darkened, quiet room can be enough for some people. A word of warning about using codeine containing medications though – codeine and other opiates can can worsen or even cause headaches so should be avoided unless your doctor has advised you specifically to use them.

So if you’re one of the one in seven people in the UK who are thought to suffer from migraines, first off I feel for you and share your (head) pain. Secondly, don’t suffer in silence.

Migraines cannot be cured, but they can be managed. To talk about treatments that might help, speak with your doctor. As with so many medical conditions, there is a lot we can do to help ourselves – so why not consider keeping a headache diary and see what you can learn about your migraines.

Vitamin C

This crucial vitamin helps our skin to heal and protects the cells within our bodies.

 

You may have heard of scurvy, a scourge common in pirates, when they would spend days and months at sea and have limited access to fresh and varied foods. Scurvy is a lack of vitamin C. In patients suffering from scurvy, brown spots may appear on the skin and in more severe cases there may be open wounds, bleeding gums, loss of mobility and even death.

 

The good news for us, unlike our pirate ancestors, is that scurvy is relatively rare these days largely thanks to the abundance of sources of vitamin C. Good sources include citrus fruits such as oranges and orange juice, peppers, brussel sprouts, broccoli and strawberries.

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It is estimated that an adult needs around 40mg a day of vitamin C. It is possible to have too much vitamin C though, and too much can give us stomach upsets such as stomach pain and diarrhoea.

 

Patients often ask us if taking vitamin C supplements will protect them from common illnesses and infections, particularly from colds, but there is no evidence to support this.

 

There have been a number of studies in the last few years looking to the benefits of vitamin C and cancer prevention. Whilst there is no clear evidence to support this, there have been some suggestions of a weak correlation between vitamin C and reduced risk of lung cancer and possibly bowel cancer. However for every study that demonstrates a benefit, there appears to be another that demonstrates no benefit of vitamin C.

 

For the vast majority of people, a balanced healthy diet will enable you to get enough vitamin C.