Posted by: ayrshirehealth | August 20, 2014

Somebody has to change by @fionacmcqueen

Consequence of behaviour

Everett Julyan’s recent blog on kindness in the workplace got me thinking about society’s attitude towards health and how this impacts on those of us who work within NHS Ayrshire & Arran. MoneyRecent headlines on health have been interesting; NICE saying that £90 000 is too expensive for giving women an extra five months of life; and the recent Court of Session ruling on Carstairs being smoke free.Smoking

As a society we seem indignant if the establishment restricts spending on drugs that we want, or our freedom to do things that we want to do – even if they are harmful, cause illness and makes us outraged when the government won’t fund those expensive drugs when we become ill as a consequence of our behaviour……

Those of you who have glanced at my blogs will pick up a theme I come back to frequently; the fact that work is good for our health and that it’s going to be crucial that we improve our health so that the future generation will healthily work until their late sixties.Diet Those of you who also know me know that like many women of my generation, I am a ridiculous yo-yo dieter therefore have a personal interest in reviewing the health of the workforce in the hope that I can be one of the number of staff who can actually improve their health.

Miraculous treatment

So, a treatment that reduces pain and infirmity in arthritis sufferers; reduces the progression of Alzheimer’s in half of those who have the disease; reduces type two diabetes in 58 per cent of people; and also reduces fractures in post-menopausal women as well as improving anxiety and depression must be worth bringing in to NHS funding?

Well, in the words of Jerry Garcia, lead singer of the Grateful Dead; ‘Somebody has to do something, it’s just incredibly pathetic it has to be us’’.

WalkingThe treatment that appears to be so miraculous is………

…… walking

HippocratesIt costs us nothing – other than time, and more importantly, costs the government nothing and will save on our health bill as our health improves. So what is it that stops us from doing something that we know will improve our health?

As Hippocrates said, ‘walking is man’s best medicine.’, and with evidence being piled on from around the world, what is it that stops us from literally taking that first step?

The healthiest life possible…..

The Healthiest Life Possible for the People of Ayrshire & Arran are words that now trip off our tongues. And as most of us both live and work in Ayrshire, then we would go a long way if all staff who work within the NHS were also as healthy as they could be. Our purpose branding 2013_PURPOSE

And herein lies the conundrum……………….

we all want to be healthy and live a happy and healthy life, but we don’t seem able to do the simplest thing to get it. Rather, society expects the NHS to fund high cost medicines; but struggles to actually do the something earlier in our life that would perhaps prevent the long term conditions that cause us such distress, and keep us from both attending our work and also wanting to work later in our lives.

Low Fitness

There are clearly other contributory factors to ill health; hypertension; smoking; obesity; alcohol in excess to name a few. But Low Fitness is a huge contributor to ill health that the drug companies don’t research, as in reality there is no profit for them in us opening our doors, walking for 10 minutes, turning around and coming back.Clock 2

A drug perhaps that gives us motivation to get active, eat healthier foods, stop smoking and reduce alcohol intake would indeed be costly. And the conundrum that is so compelling for behaviour change scientists is how we can change our behaviour to improve our health.

Can we be kind to ourselves?

23.5 hoursIf we can limit our sleeping and sitting to just twenty three and a half hours a day, then perhaps we could attain that healthiest life possible, and live life to the fullest..

So, in addition to being kind to each other, as egged on by Everett, can we take inspiration from our wonderful athletes – both able bodied, and in particular parallel, and be kind to ourselves and just walk for half an hour a day.

Somebody has to do something ……and that somebody is us.

This week’s blogger was @fionacmcqueen (Fiona C McQueen), Executive Nurse Director, NHS Ayrshire & Arran and Honorary Professor at Unversity of the West of Scotland, Chair of the Scottish Executive Nurse Directors Group.

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Responses

  1. Fiona, you blog is spot on. We all work in an environment about health and wellbeing, but sometimes we forget about our own well-being! The 231/2 hours video is great, if you have a few minutes have a look it will make you want to get up and get moving. Thanks for sharing your personal comments as well.

  2. I agree about the walking and am fortunate to be able to walk without a stick, considering I have a 6 inch metal plate on my right fibula, from 3 fractures when just walking down a stair in March 2005, aged 53. I found out recently that the antidepressant venlafaxine can cause bone loss for older people on maximum doses. 2002-4 I was one of those older people on maximum doses of venlafaxine that didn’t work to lift my mood and gave me on occasion suicidal impulse. I was put on lithium to “augment” the antidepressant and that didn’t work either. So I took charge of my mental health, tapered the drugs myself and made a full recovery.

    And I agree that “somebody has to do something, and that somebody is us”. It’s up to each of us, as individuals, to manage our physical and mental health, and to speak out when necessary so that others can learn from our experience. For we are all experts of our own experience.

    The issue unfortunately in mental health care is that we are not always allowed to have a voice and are not deemed to have the “capacity” to think for ourselves. As an aside, I don’t agree with the Carstairs decision and think that the patients in this institution should be allowed to smoke if they want to. Prisoners have that choice so there should be difference with the locked up “mentally ill”. I think it’s discrimination to force this on to them.

    My youngest sister is on clozapine and venlafaxine, aged 47, and walks with a stick but she does get exercise despite this and walks round the block where she lives. However it is a balance issue that she has, due to the clozapine, and I know of many other women who have been in receipt of mental health treatment over many years to be walking with sticks. My mother was the same. The other issue is the lack of motivation when on certain drugs, especially psychiatric drugs.

    I am very fortunate to have got off all the psychiatric drugs and to be able to walk, swim and do weights at the gym. I know this. My independent spirit and unbelief in mental illness helped me resist the lifelong disability prognosis, and to leave mental health services behind. I think that we have to remember that not everyone has the strength or resilience to take charge of their own health and wellbeing. Whatever gets people through is the thing is how I now see it.

    • Chrys
      Thanks for your comments on the blog – despite the story you recount regarding yourself and your family, it’s good to hear that your strength and independence of spirit enables you to be able “to walk, swim and do weights at the gym”. It is clearly your resilience that enables you to take charge of your own health and wellbeing.
      I’m sure that approach is worth us all learning from.
      Thanks
      Derek

    • Chrys, you’re absolutely right about not everbody has the ability to engage in physical activity – and unfortunately this denies them the opportunity to improve their health. Perhaps the NHS needs to pay more attention to supporting people in self care and understanding how challenging this can be for some people. Your tenacity is fantastic regarding your approach – an example to us all.

  3. Reblogged this on Chrys Muirhead and commented:
    my response to this blog post by @FionaCMcQueen
    “I agree about the walking and am fortunate to be able to walk without a stick, considering I have a 6 inch metal plate on my right fibula, from 3 fractures when just walking down a stair in March 2005, aged 53. I found out recently that the antidepressant venlafaxine can cause bone loss for older people on maximum doses. 2002-4 I was one of those older people on maximum doses of venlafaxine that didn’t work to lift my mood and gave me on occasion suicidal impulse. I was put on lithium to “augment” the antidepressant and that didn’t work either. So I took charge of my mental health, tapered the drugs myself and made a full recovery.

    And I agree that “somebody has to do something, and that somebody is us”. It’s up to each of us, as individuals, to manage our physical and mental health, and to speak out when necessary so that others can learn from our experience. For we are all experts of our own experience.

    The issue unfortunately in mental health care is that we are not always allowed to have a voice and are not deemed to have the “capacity” to think for ourselves. As an aside, I don’t agree with the Carstairs decision and think that the patients in this institution should be allowed to smoke if they want to. Prisoners have that choice so there should be no difference with the locked up “mentally ill”. I think it’s discrimination to force this on to them.

    My youngest sister is on clozapine and venlafaxine, aged 47, and walks with a stick but she does get exercise despite this and walks round the block where she lives. However it is a balance issue that she has, due to the clozapine, and I know of many other women who have been in receipt of mental health treatment over many years to be walking with sticks. My mother was the same. The other issue is the lack of motivation when on certain drugs, especially psychiatric drugs.

    I am very fortunate to have got off all the psychiatric drugs and to be able to walk, swim and do weights at the gym. I know this. My independent spirit and unbelief in mental illness helped me resist the lifelong disability prognosis, and to leave mental health services behind. I think that we have to remember that not everyone has the strength or resilience to take charge of their own health and wellbeing. Whatever gets people through is the thing and how I now see it.”

  4. I couldn’t agree with your blog more Fiona. I try to take a short walk every day (meetings permitting) … It gives you a new lease of life and sets you up for the afternoon ahead. I also walk most nights, and since doing so, has improved my sleep pattern too.

    Cost neutral and makes you feel good …. It would be great if we had walking routes around al out hospitals.

    • Jackie, so true about how a short walk can help us feel better – just a challenge to fit it in – but should be possible

  5. After feeling pretty crap for a couple of years I was finally diagnosed with Diabetes (type 2 diet controlled) in April 2013. I listened to the drs and dieticians etc , followed a
    ” healthy diet” . It made no difference to how I was feeling.

    Something had to change.

    I signed up for the 5×50 challenge, 5km every day for 50 days … gulp!!!!

    In February of this year I bought an exercise bike in preparation for doing 5km on it for 50 days . I felt so much better.
    The challenge started on 30th March and I completed it 50 days later. I felt so much better and was amazed that I had been active for 50 days in a row (previously I was THE couch potato). I had either walked or peddaled for 5km (usually more by the end) for 50 days. My diabetes was under control (may have been my reduced carb diet too) and I had lost weight .

    When the 5×50 challenge came to an end I was terrified I was going to revert back to my “old ways”. By then I was actively posting on the Diabetes UK (DCUK) forum, and was following a lower carb diet. My diabetes was, and is under control … most of the time.
    I jokingly asked people on DCUK if they would help me by doing “a new you in 42” challenge , 30minutes activity (tried to stay away from the word “exercise” because it scares people sometimes). I couldn`t believe the response, there was a group of people with Type 2 diabetes who really wanted help and support. I got loads of support from them and together we have come a long way.
    One man had had major surgery and his 30 minutes was split initially into 5 min walks up and down the stairs 6 times a day , he called it his “ups and downs”, another woman initially walked around her garden and there are many stories similar. They have progressed so much. They are reporting that their diabetes control has improved (I have no proof of that though).
    At the end of the 42 days it was decided that the daily activity between us had to continue and “Sporty forty ” came about , they actually all wanted to increase their activity to 40 minutes a day. We all have become “virtual friends” and help each other to keep it going, even when we don`t always want to.

    During all of this there are also a small group of us on facebook who are being more active and helping and supporting each other too.

    Myself and one of my colleagues try to go for a lunch time walk , diaries permitting .. we find this helps us to concentrate in the afternoon. Ooohhhh and I even ran the other day, down hill admittedly by I ran..

    I was 49 on Sunday and my daughter has given me a new challenge – to learn to swim . My first lesson was yesterday …gulp eek.. It was ok, my daughter is a swimming instructor and is very patient with her old Mum lol. I am going back tonight to practice before my next lesson on Monday …

    In short, my life since I started to move more has changed drastically, I feel healthier ,better, happier and people say I look better which always helps haha.
    I would encourage everyone to get out there and do something, anything it has really changed my life. There is something for everyone, you don`t need a lycra clad gym.

    Thanks for reading my story , I hope it makes sense .
    Ex Couch Potato

    • Marie, I take my hat off to you – all of our team should follow your example – mysefl included. Well done and thanks for sharing your story – it helps get the rest of us going

  6. Thank you Fiona….you inspired me to watch the 231/2 hours film by Dr Mike Evans. It’s very powerful and whilst I was watching was thinking if we knew a pill could deliver all of the health benefits outlined (as you’d described too), people would be banging on their GPs’ door to get it!
    I was shocked too to find out that 6 hours of watching TV each day reduces life span by 5 years….and apparently the average American spends 5 hours a day watching TV!
    I’m a yo-yo dieter too and realise now that slow and steady is better with sustainable changes….and some activity thrown in! I just need to take the first step with the activity!
    Thank you for your enthusiasm and encouragement in your blog.

    • Fiona , bet you didn`t realise you had such an active team lol

    • Marie – I did not – full of surprises

  7. […] had asked me to do a blog for Ayrshirehealth – which I did on physical health and wellbeing (Somebody has to change) and it was published on Wednesday, with loads of comments on how important it is – if not […]

  8. Fiona, thank you for your blog this week – thought provoking as usual. One of the questions that many of us ponder on is about motivation and decision making; why is it that we know the theory yet are unable to put better decision making practice in relation to our health?

    Recent learning has taught me that it is not only about motivation – we also need to really care for and be kind ourselves to enable us to make better choices. How many of us are our own worst (internal) critics, beating ourselves up when we do not do as we know we should?

    Talking of the SHOULD word, a resource that I have been finding useful is http://www.thework.com/index.php In particular, her worksheet which we can use to explore our thinking about various things; relationships, decisions, problems.

    I now try to replace should with could as I personally don’t like being told what to do “you should stop smoking”, however “you could stop smoking” is more like a choice.

  9. Ruth I totally agree.
    I know set myself small challenges, small steps of change if you like.
    I know have changed “should do” for “will do”. I used to go for a walk in the country around my home and think ” I should run a little” the other day I thought ” I will run a little” and ran home , or at least until I got back to civiilsation…
    My biggest challenge to date is learning to swim in the passed 3 weeks


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