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?
 

 

 

 

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.

Vitamin B

Next in our quick series of Vitamin FAQ’s we look at vitamin B (if you missed Vitamin A – you can read it here).

There are actually lots of different types of vitamin B, but for our bodies the main ones are:

  • B1 – thiamin
  • B2 – riboflavin
  • B3 – niacin
  • B5 – pantothenic acid
  • B6 – pyridoxine
  • B7 – biotin
  • Folate (folic acid)
  • B12

 

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In general, they all aid the process of breaking down key aspects of our food, releasing much needed energy into our system, as well as helping keep our eyes, skin and nervous system healthy.

Vitamin B6 has a specific role in using and storing the protein and carbohydrates we take in as part of our diet and helping our body to produce haemoglobin. Haemoglobin is what makes our blood look red and critically carries oxygen around the body.

Folic acid – most well known as the supplement that is needed in pregnancy – is crucial for reducing the risk of developmental defects of the central neural tube of unborn babies. The neural tube is the early form of our central nervous system. Developmental problems at this crucial stage of a baby’s growth can lead to problems such as spina bifida. However it’s not just pregnant women – it also helps all of us to make healthy red blood cells.

Perhaps the most well known is vitamin B12. This actually helps us to use folic acid. It also is vital in keeping the nervous system healthy and plays a key role in making red blood cells.

With so many types of B vitamins, the ways we can get this into our diet are varied. Importantly, some of these vitamins cannot be stored in the body – so we need a daily supply in our diet. Thiamin cannot be stored – and it’s recommended that men need around 1mg/day and women around 0.8mg/day. Similarly we need daily riboflavin at around 1.3mg for men and 1.1mg for women. Niacin also cannot be stored and men should aim for around 16.5mg and women around 13mg.

A word of caution about niacin – too much for a long time can lead to liver problems and cause skin flushes. Similarly B6 in excessive amounts  (e.g. more than 200mg) can lead to a problem called peripheral neuropathy. This is a problem of the nervous system where we can develop loss of sensation in our limbs (peripheries). Men should aim for around 1.4mg/day of B6 and women around 1.2mg.

Many foods are rich in a number of B vitamins including: eggs, fresh/dried fruit,  leafy green vegetables, broccoli, wholegrain bread, fortified cereals, milk (cow’s), nuts,

Some specific diets e.g. vegetarians and vegans can sometimes struggle with B vitamins, and B12 in particular. B vitamins are in abundance in animal products – meats, fish, eggs, cows milk etc. However with careful planning, it is possible to get all the recommended amounts in your diet without additional supplementation. However, a multivitamin can be a helpful addition to more restrictive diets and might be worth discussing with your doctor.

Folic Acid

As we have already learned, folic acid (or folate) is pivotal in a baby’s development and throughout our life by helping us produce red blood cells. The average adult needs 200micrograms of folic acid/day and it cannot be stored meaning you need a daily amount. An additional supplement is provided to pregnant women – either 400mcg of 5mg depending on their medical history. Caution is required with additional supplementation – too much can possibly cover up an existing B12 deficiency.

This is found in vegetables such as asparagus, peas, sprouts and broccoli. It is also prevalent in liver but this should be avoided in pregnancy.

B12

The most well known of all B vitamins is B12. A deficiency of B12 is something that has been in the media more of late. This is the vitamin that those who avoid animal products in their most struggle with – as it is only found naturally in animal products – meats, milks, eggs.  It is some fortified cereals however.

We need around 1.5micrograms/day and this is something we can store in the body.

Deficiency in B12 causes wide ranging symptoms including low mood, changes in mental state, altered or abnormal sensation, fatigue, irritability, anaemia and reduced fertility. Whilst some changes can be reversed with treatment, if left unchecked and untreated, some of the damage can be permanent.