Tuesday, December 28, 2010

Don’t Be A Winter Ostrich

There is something about winter that makes ostriches of so many people (except that at present they have to stick their heads in the snow rather than sand). Even after twenty years in general practice, it is something that never ceases to amaze me. What is it that I am speaking of? It is the simple issue of people not wishing to protect themselves against a potentially serious infection, and the infection I refer to is influenza.

As a doctor, it concerns me that less than 50% of the eligible population of North Lincolnshire have had the influenza vaccine this year. Put bluntly, being 'eligible' basically means that you have a significant risk of dying from influenza and its side-effects. So, if that is the case, why do people choose not to protect themselves? Simply assuming that you are super-immune to influenza simply because you have not caught it for so many years doesn't guarantee your survival. I have never had the misfortune to be knocked down by a car; but I still take the precaution of looking both ways before I step into the road; if I do not then one day my folly will catch me out, at which point it will be too late.

In an average winter, there are 25,400 more deaths in England and Wales than at other times of the year. The precise death rate depends on various factors, including the temperature. However, influenza is implicated in many of these deaths. The peak period is between December and March, so we are now entering that time; and as you are aware, it is very, very cold.

Everyone who has not been immunised has the chance of catching influenza. However, amongst those most at risk are children and adults with asthma or diabetes, those with heart disease, anyone whose immunity is reduced (e.g. because of treatment for cancer) people over the age of 65 years, and pregnant women. Anyone within those categories should seriously consider having the influenza vaccine as soon as possible. Carers and health professionals should also be setting the standard by getting themselves vaccinated; by not doing so, they are putting other people at added risk.

The serious side effects of influenza include bronchitis, pneumonia, exacerbation of asthma, convulsions, heart failure, and encephalitis (inflammation of the brain). I am sure that you would agree that none of these sound particularly trivial, and they are not. They are very distressing to the sufferer and the observer, and often cannot be cured. On the other hand, the side effects of the vaccine are usually very mild or non-existent despite all the myth surrounding it.

So, let us not think of the risk of death from influenza in terms of statistics. Consider instead individual human beings known to you. If you are not personally in the high risk categories, do you have a relative or friend who is? Have they been vaccinated against influenza this year? If not, start nagging them to go and get vaccinated. Let us face it, none of us would wish our elderly parents, our children with asthma or diabetes, our husband with heart disease, or our pregnant wife to be one of those 25,000 extra deaths this year. However, without the influenza vaccine, they are at significant risk of becoming one of them. I know I would not want that on my own conscience.

(This article was first published in the Scunthorpe Telegraph on Wednesday 8th December 2010.)

Saturday, December 18, 2010

Something for After School, Young Man?

One month ago, Pope Benedict XVI announced that the use of condoms may be morally justified 'when the sole intention' is to combat the spread of AIDS. My immediate response was to ask 'so what?'

As I am writing this column in my capacity as a physician, this is not the place for me to start a religious debate, and I certainly have no wish to upset anyone. However, whilst the Pope's edict may influence the use of condoms in parts of the world, I feel sure that it will do very little to improve condom usage in this country; especially amongst our younger members of society where such improvement is desperately needed.

Two months ago it was announced that the teenage pregnancy rate in the United Kingdom has fallen from 46.6 per 1,000 in 1998, to 40 per 1,000 in 2010. Whilst we should be pleased to make any improvement on this front, it remains deplorable that, in this country, there are 40,000 pregnancies per year in people under the age of 18 years. Although I am all for the United Kingdom taking the lead in respect to many issues the world's stage, having the highest teenage pregnancy rate in Europe is not an achievement to be particularly proud of.

Unfortunately (in respect to condoms), the majority of our young people are not influenced by the traditional teachings of the Roman Catholic Church. Neither (speaking from a Northern Lincolnshire perspective) are they greatly influenced by the risk of contracting AIDS, as the incidence of the latter is mercifully low in this region compared to some of our cities, and very low compared to certain countries in Africa. Nor do our teenagers particularly concern themselves with preventing other forms of venereal disease; except that is, in respect to Chlamydia infections. Though, with the latter, my perspective is that we also seem to have got the message over in the wrong way. Anecdotally, I come across teenagers informing me that they have responsibly taken another Chlamydia test (note the word 'another') as they have recently changed partners. Yes, that is good news to a point. However, if they were to use condoms in the first place then there would not be the same need for the Chlamydia tests. We are not doing very well in communicating the real messages.

The truth is, our sex education program is not working. Yes, there is a place for moralistic debate and reasoning, greater parental responsibility and informing youngsters of the health risks. However, there is also the pressing need to make condoms 'cool' in the eyes of those most influenced by fashion. Regardless of society's laws, or the best of moralistic and religious teaching, sex happens and will continue to happen within an hormonally fuelled younger generation.

Thus far, we health and social educationalists have got it wrong. Perhaps our sporting and celebrity heroes are the people to recruit in a renewed drive to relegate us from the top of this particular league table.

(This article was first published in the Scunthorpe Telegraph, Friday 3rd December 2010)

Friday, December 03, 2010

Do You Have a Mo?

For one brief moment this month I thought I was a trendsetter; a man of the moment; a fifty-year-old icon of fashion.

What was the cause of the delusion that I had become a leading light in the world of masculine style? It was the realisation that upper lips were becoming hirsute; or at least some male ones were. As someone who has sported lip foliage ever since my teenage days (apart from when fellow students shaved it off during a university Rag Week in 1980), I was happy to form the advance party of 21st century masculine chic.

Then I read about 'Movember'; the Canadian-based movement to raise awareness of prostate cancer. Now, for older readers of this column, the name Little Mo may bring back memories of the 1950s tennis star, Maureen Connolly. However, younger readers may be more familiar with the character from the soap opera, EastEnders. Nonetheless, I suspect that neither group will immediately guess that 'mo' is slang for moustache, and that these chaps are therefore in the process of sprouting a 'little mo'; hence the renaming of last month as Movember; witty people those Canadians.

So, you may well be asking what all the fuss (or fuzz?) is about. It involves the recognition that 35,000 men per year develop prostate cancer. It is the second most common cancer in men, with a 1-in-13 lifetime chance of developing it. 90% of cases occur in men over the age of 60, and there is a 2.5 times greater chance of developing it if there is a family history of prostate cancer.

That makes for some cheerful reading, doesn't it? However, before you decide all is lost, there are certain things you can do to help reduce your individual risk or improve your chance of responding successfully to treatment. Preventative measures include adopting the healthy lifestyle we keep hearing about, which means eating less saturated fat, meat and dairy products; all of which adversely influence the risk of prostate cancer.

The next action is not to ignore any urinary symptoms. Whilst problems with urinary flow and middle-of-the-night 'calls of nature' are familiar to many older men, do not ignore such issues, and certainly do not ignore the presence of blood in the urine: go and have a chat with your GP. Not all of these symptoms suggest prostate cancer, and (except for bleeding) may be caused by age-related growth of the prostate. However, your GP may recommend a blood test and possibly a scan; neither test being unpleasant to have.

Oh, and how is your sex life, chaps? According to Italian scientists, a healthy sex life makes men live longer. Apparently, sexual activity reduces the risk of heart disease and diabetes, and helps to avoid prostate problems.

So, gentlemen, although the month of Movember is now over, still give consideration to your prostate and go to it! I will leave you to decide whether that means growing a winter moustache; you may find some of the alternative activities are more enticing...

(This article was first published in the Scunthorpe Telegraph on Thursday 25th November 2010)

The Power of Love

Looking through my writing archives for the month of March, I came across the following article, initially published in my weekly column for...