Euthanasia- has it really come to this?

Euthanasia- has it really come to this?

 Reflected in today's statistics, England possesses the highest suicide rate since 2004.  But this goes further, as a more global pandemic. WHO predicts the incidence of mental health will soar from 25% to 50%  by 2020.

I see that many people still try to deny that stigmatisation exists. That in part is the problem. By denying a problem exists, we remove our ability to change it. I know that simple recognition is a vacuous achievement in the face of the stark reality but people are counting on healthcare professionals to take a stand. We save lives, by building an environment, where “excellence in clinical care would flourish”.

 A great many people, still don’t have access to mental health support. Times are changing, and the 21^st Century is seeing advancements in the sector. You would think that the news of this, was startling enough. What could be worse than suicide rates increasing? Euthanasia- assisted suicide. Until recently, I was not aware that it was even legal. As a health professional, abiding by the patient-centred approach, implicitly means to do no harm. Then to even considered this, goes against all instinct. I may concede that certain conditions may call for this; certain terminal cancers at a stage where death may be a mercy. To find that the same approach was proposed for mental health sufferers, was at the very least disconcerting.

The rudimentary characteristic of psychiatric conditions is that it robs the victim of sound mind. It, therefore, baffles me that this is even considered a viable alternative offered inpatient care. During my research, I found the procedure was legal Belgium. The clinical psychologist, Ariane Bazan, describes how all possible mental health treatments must first be exhausted before this is proposed. But this in no way mitigates the glaringly obvious fact that this is assisted suicide. In primitive terms, this can be tantamount to saying, “ we have no other treatments available for you, and it seems wrong to leave you in pain, so … would you consider suicide?”. 

Euthanasia is a glamorous, word for the very thing that we go to such lengths to avoid. It negates the effort and funding put into years of mental health research. Why does it come to this? As some struggle in the “battlefields” searching for a solution, others have tragically been handed a solution with no return.

This is not fear-mongering, this heralds the need to end denial, and realise  “without mental health, there can be no true physical health”. If we are to make a change in the status quo, we must address existing, attitude dynamics towards mental health in society. Mental health must be seen to be encompassed within a mind-body dichotomy, inextricably linked and not separate issue. It needs to be recognised and addressed rather than avoided or worse, made to seem terminal.

Women’s Health

I Have PCOS, What Now?

At 19 I was diagnosed with PCOS. My periods were irregular and when they did come the experience was so distressing that the first day was always met with dread. It was difficult to discuss with anyone what I was going through especially when my own GP didn’t believe me. ‘Everyone gets cramps’, I was told in response to my complaint. But I was lucky that I was eventually seen by a specialist that noted some of my symptoms were abnormal and needed investigating. Coarse facial hair, thinning scalp hair, and painful irregular periods, ones which always led me to faint on the first day.

After years of suffering with this, I was grateful for the diagnosis. I had PCOS, poly-cystic ovary syndrome. I was advised by the specialist doctor that the contraceptive pill would control my symptoms. Unfortunately, I wasn’t informed any further about what a PCOS diagnosis would mean.

-Ella Wright

While PCOS is a common hormonal condition, it carries with it broad range of health implications. The presenting symptoms include:

-       Irregular periods (ovulatory disfunction)

-       Excess facial hair

-       Hair loss

-       Acne

-       Infertility

-       Darkening of skin due to insulin resistance

Overall

Other features of PCOS include higher levels of male hormones (androgens). These women are also under higher risks endometrial cancer , infertility and complications in pregnancy. Research also shows that PCOS is associated with weight gain and obesity  and often insulin resistance. These open up a greater risk for diabetes and heart disease.

Tests to confirm PCOS

-Medical History

-Physical Exam

-Blood tests- checking for hormones

-Ultrasound of ovaries

Once a diagnosis is confirmed

-exercise plan- (best for managing the condition)

-regular glucose tolerance testing – diabetes screening

-screening for metabolic syndrome

-testing for diabetes & heart disease

-supporting with pregnancy plans

8 tips on how to become a runner

As pharmacists we are told to encourage the public to exercise at minimum of 150 minutes at moderate intensity each week (1). However, never did I feel more of a hypocrite than when I listed the benefits of a healthy lifestyle to others: good sleep hygiene, balanced dietary habits and finally regular exercise. I couldn't say I did any of those things especially the latter.

Its the realisation that the physical and mental are inextricably linked which made me more open to change. If I was to recover and get better mentally, I was really going to have to force myself into a healthier lifestyle which included regular exercise.

So as a amateur runner, I bring you some of my tips for an easy transition into this new lifestyle:

1.) Decide on a time

Morning runs are usually the preference of many-  you  start your day by priming your body for a day of productivity. It also has other perks: catching the sunrise, and seeing your region at rest.

2.) Prepare an appropriate kit

I would recommend investing in good sportswear. Check out local charity shops at your high street - these places are often abundant with lucky finds including sportswear at discounted prices.

Trainers:
Its important to chose comfortable footwear which would allow you to sustain your running activities without damaging your feet. Certain trainers help avoid calluses, sweating and unnecessary strain.

Other:
Dress for the weather. If you live in the UK, a rain coat is almost always an unquestionable must. Also don't forget hats, to keep you hair out of the way and colds at bay. Certain sports clothing suits are designed to prevent chaffing but usually cotton shirt and sports trousers would work perfectly fine.  Certain runners recommend woollen socks due to ease of washing and apparent reduction in  blisters.

3.) Music Player case ( i.e i-phone case)

Definitely something to consider to avoid being in the awkward position of having to run with a phone in you're sweaty hand. You could invest in one or just as easily make one. DIY life hacks show you how you could make one simply from a single sock.

https://www.youtube.com/watch?v=q-hT2Obsy_4&t=147s

4.) Apps : Health or Zombies, Run

Use technology to keep a record of your progress and to motivate yourself during your run. The 'Zombies, Run' app makes running into a game where you run as part of a story line, progressing each time to different levels. This could be what you need to liven up those runs.

5.) Keep hydrated

This deserves an article on its own.All sorts of complications could arise from lack of water intake so a bottle at hand. Its recommended that you drink 2 Litres a day to support your bodily functions: digestion, body temperature regulation, nutrient transportation and so on.

6.) Make Healthy Snacks

Try cutting up fruit and vegetables and storing them in Tupperware for after your run. Also, making smoothies would not only give you a dash of vitamins but also could potentially motivate you to carry on with your running commitments.

7.)Sunscreen/ Vitamin D

Living in the UK it has vitamin D has become a ubiquitous problem. This once again highlights the great benefits of running. Not only do you complete you recommended weekly exercise but you also replenish your vitamin D stores which is manufactured after exposure to sunlight. However, when summer time comes round it is just as essential to use sunscreen to avoid absorption of harmful UVB and risk of skin cancer.

8.) Therapy 

Running is a kind of therapy. Many mental health charities have recognised the beneficial effects of running on the mind(2).  It's an activity which requires no thought and gives you time to just be present with yourself. Speaking from experience, it is in times of greatest struggle and challenge when its most important to persevere. As difficult as things get in life, I chose to keep on running.

What do you say?

1.)https://www.nice.org.uk/guidance/ph44/chapter/1-recommendations
2.)https://mind.org.uk/get-involved/donate-or-fundraise/take-on-an-active-challenge/run-for-mind/

Books update - latest must reads...

 Just one word which perfectly encapsulates books and reading ...

Velichor

And the long awaited, newest additions to the treasured bookshelf have arrived ! 

Never underestimate the power of time - 

Make use of the few minutes here and there -  read, learn and experience so much more in life.

My recommendations...

The examined life: How we lose and find ourselves -  Stephen Grosz

Hons & Rebels - Jessica Mitford

Very short introduction series - Just about any book

The divided self - R. D. Laing

Emotional intelligence - Daniel Goleman

When Breath Becomes Air - Paul Kalanithi 

Bird By Bird - Anne Lamott

Will add my personal review of each book soon. Till then .... 

'Reading furnishes the mind only with materials of knowledge; 

it is thinking that makes what we read ours.' John Locke

Health care, the NHS and politics - where is it all going?

With talk of NHS financial problems- the overriding feeling is that of a slowly evaporating sense of security. As a healthcare supporter (student and advocate) it has been an aim of mine to witness advancement of the field. However defiant I may feel about the significance of my 'role' as a healthcare  professional,  there is still no escaping that the constant  reminders of under-funding have had a deeply corrosive effect, cutting to the core of our healthcare service's perceived value. As an individual with hopes of positive change, it rarely pays to remain in silence - no tangible results, no fruit can be reaped from such an approach. 

  

 Much of the public share my concerns. There is a prevalent atmosphere of despair with regards to the healthcare system, not helped by perennial press coverage and rhetoric which drains confidence of the workforce.  This must be addressed if we are to preserve the flagship reform of a healthcare system, the UK are so proud of. This detail becomes hugely important in stopping the eminent, mass exodus of skilled healthcare professionals - further burdening the already, over-taxed system (seen in medics).

Spectre promises ( not even including the disavowed fact - £350 million a week for the NHS ) are ringingly increasingly hollow as the scale of the financial challenge faced is becoming more apparent. Annual, NHS funding increase of  1.1% countered with a cost increased by 3.8%  translates to a £4.5 billion rise, markedly reducing spending per person. The government mantra speaks of a profound disconnect when tackling the injustice of the yawning inequality in healthcare, without the investment to underpin the ambitious reforms.  Factors to consider  are the inefficiency of divided budgets for social and health care, effective cross government policies particularly in the region of prevention, emphasised in the 5 Year Forward View. This is essential to ensure long-standing benefit avoiding the weight of past political failures which magnify the sense of impending crisis, million-fold.

With that I  subsequently decided to channel my concern a little more positively deciding to  reflect on the current state of healthcare.Is anything constructive being done? What can be done further? And is there anything still remaining, that I as a healthcare professional or citizen can do to help?

Reading the five year forward plan, the emergence of STPs and various schemes run despite financial demands of NHS (combating childhood obesity), only did so much in allaying my arising fears as a healthcare professional and user of the NHS. It was by struck of fortune that I found myself, in the very position I hadn't even realised that I had been waiting for - listening to an MP speak at length of the healthcare agenda. A good friend invited me to 'bright blue' event where Sarah Wollaston, answered the very questions preying on everyone's minds.

I couldn't help but listen in rapt awe as the ex-medic spoke with an unparalleled passion of the possibilities that the NHS still heralds. The idea of tactful management of the NHS rather than complete discarding of the current system in place seemed like a plausible idea ( as well as a welcome message of hope).

 A widespread of  compelling ideas were covered.  

-Strategic expenditure-  not wasting budget on outdated ( no longer approved medication i.e Co-Proximol) as well as providing services in place of drug treatment when there is a viable alternative.  

-Tackling issues with geriatric care which is becoming an increasing problem - adequate social care are no match for rising demands (number of people living to 85 and over increased by 31%  in decade  to 2015) . 

-Addressing the failures to implement structures which allow newly qualified/trainee doctors to feel their most valued as a team.  

-Retaining the benefit of CCG scheme but implementing a scheme which  shares management responsibility effectively ceasing inequality in standard of care. 

-Forgoing the term ‘purchaser-provider’ with the implementation of Sustainable Transformation Plans. These carry a greater promise of targeted commissioning in a time when state of finances call for quality resourcefulness.

Of course, a discussion of improving the NHS, would not be one without proposing potential alternatives – Bismark or US model. It was fair to say with an all resounding consensus from the audience, that the Beveridge model was one considered to be most worth maintaining and seeing through. It was a reminder that the value of the NHS, the support it’s receiving and its potential must not be allowed to dissipate in crisis.

As I delve further into governmental policies and standards for healthcare, I’ll share my insights here and always welcome everyone’s views. As a parting message, it’s far too easy to subscribe to the ever present notion of an all encompassing failing system. But whilst we still find within ourselves the conviction to see past the challenges through to the victories, however small, there is still hope for a positive change.

http://www.gponline.com/failing-ccgs-disbanded-26-declared-inadequate-new-ratings-regime/article/1403113

https://www.theguardian.com/healthcare-network/views-from-the-nhs-frontline/2016/aug/26/nhs-plans-bring-benefits-barred-telling-public-sustainability-transformation-plans

https://www.kingsfund.org.uk/topics/integrated-care/sustainability-transformation-plans-explained

Motivation for pharmacy students during exam time

We are more than half way through, with just another semester, that's only four months to go. But not everyone is taking this cheery view.

Some of us need a moral booster. And so a blog idea became clear this morning as I was having my cup of coffee, sat in the library enjoying the sun streaming in.

Dan (pharmacy student) joined me pointing to the table, apparently too drained to speak.  He hadn’t had much sleep because of late revision, the night before. Looking at the sheet at the table, I could see what he meant- the list of exams and coursework deadlines seemed endless.

At the beginning of the year everyone is ready to go to any lengths  to achieve stellar exam scores. Now as the fatigue descends its easy to fall to a place of complacency hoping for just 'passing' grades or worse giving up all together.

So here are a few tips to keep on track...

 1.Remember why you are here- you wanted to become a pharmacist. Assuming you still do and  have not been discourage by the long journey ahead of you, imagine your end point- make that your motivation. It will feel great in the end!

2.Speak to a friendly tutor- Whenever I feel downtrodden, there are certainly a few lecturers that come to mind from whom I can seek advice and support. After speaking to one such university professor   – relaying  to him my concerns about achieving my fullest potential, I am made to rethink my words. Giving me exactly the kind of penetrating stare I know so well was an easy motivator in causing me to rush out of his office and in a dash finish all my work. I pace myself well in my studies now - never wanting to be at the receiving end of that withering look again.

3. Make a list of tasks- once you start checking them off, you'll feel more motivated to complete more of your work. Just get the ball rolling. Some friends urged me to do this at the beginning of the year. I didn’t like the idea at first but now with serious worries growing, it helps to have them on a list to keep track of them.

4.Believe in yourself and your own methods-  Sam (another pharmacy student) asks everyone for advice, then confused and worried, rushes from task to task in attempt to complete them. Dan takes no ones advice, and does whatever his instincts tell him. Both are acing their exams so make sure to go by your own style of student life management.

 5.Give yourself time to regain your breath- I tried to point this out to my friends partly because I notice that without taking even a 10 minute break from studying long hours, revision becomes counterproductive. I can imagine that by this point in the academic year, stress running high and revision piling, it is tempting to think revising endlessly would be the solution. However,  I’m equally certain you’ll feel better and be a lot more productive if you set yourself specific targets per day. For example, set yourself a reasonable target of finishing the first draft of an essay within a set  limit of time, say 5 hours max. You are more likely to achieve a target that is 'SMART'.

6.  Resilience is Key - especially true for us pharmacy students. The ability to get back up after a setback is incontrovertibly important for excelling in your osces, in pre-reg applications and in general every day assignments. If you do not see the immense significance of this quality, let Mo Farah's success speak for itself. He won his 3rd Olympic gold medal (long-distance) even when he'd  fallen half way through the race. So called 'mistakes' are merely paving stones to success!

 So, hope this helps and now I'll return to my list of tasks for the day. If you felt unmotivated before, I hope these points act as something to think about or at least prove to you that you are not in this alone.

Good luck  – may everyone achieve their best!!!

Medical and Ethical debate – why it is so important?

( Readers to whom I dedicate this to, thank you all for your patience, will update you on weekly schedule soon)

It is interesting studying on a course with fellow healthcare professionals- we all seem to be fighting the same battles, united by our challenges, and desires to do well  in the course- understand the material and pull through to become the great healthcare professionals we aim to be.

Sometimes, it is easy to forget that behind the grades, the numbers, we still remain to be people. We are still very much different in how we perceive life and in essence how despite equal acquisition of knowledge, how we would still act differently when placed in the same situation. 

The reason for this lies in our beliefs. Our core beliefs those that we tenaciously hold onto whatever circumstance we face are those that inform our everyday decisions. These core valued will reflect who we are in our defining moments and therefore are a very significant part of healthcare practice and by extension our lives. 

So what determines them- these core beliefs? Sometimes you might find yourself in an argument, debating something so vehemently, until you lose your momentum. An unexpected loophole and the whole, neatly constructed idea collapses into a pile of rubble. That’s when you might come to the realisation that the belief that you previously held, really had no backing.

It is a dangerous place to be. Without consciously forming beliefs, they begin form by default. Without careful evaluation, accurate research and reliable evidence, heresy directs your core values. As a healthcare professional, as any person in fact, this should never happen. 

Lack of self-analysis, means leaving your fate in the hands of someone else. In the case of health, it means being more susceptible to fear mongering and other poor practices conducted by those aiming to serve a dubious agenda.

As I see it, medical debate can be an invaluable tool in debunking the fallacies surrounding important matters. Practicing a reflective attitude, may even give rise to the analytical thinking necessary to find solutions to the challenges we face in medical healthcare. If that is an overly aggrandised claim, well at least it would serve the imperative role, of preventing us from becoming victims of poorly informed decision-making. 

For the healthcare professionals, forever and always, this echoes the highly prevalent, fast-held initiative to empower the patient. The Realising the value programme building on the NHS Five Year Forward View is just another project recognising the value in patient making their own decision. How better to reach this, than by forming our own concrete arguments, before objectively delivering them, for the patient to make the ultimate decision.

This is a preliminary to what I hope to be a series of brief introductions to various contentious issues, we now face in the world of healthcare.

Till next time.

https://www.england.nhs.uk/2014/11/realising-value/ a