Are you planning to, or have you written your own book. I can highly recommend my own publishers, click on the link below:
Monday, 16 March 2009
The Stress Factor, Natural Ways To Stay Calm
Are you planning to, or have you written your own book. I can highly recommend my own publishers, click on the link below:
Sunday, 1 March 2009
Is Your Doctor Making You Feel Worse?
'You have the right to know the outcome of any investigation into your complaint'
'You have the right to take your complaint to the independent Health Service Ombudsman, if you are not satisfied with the way your complaint has been dealt with by the NHS'.
'You have the right to make a claim for judicial review if you think you have been directly affected by an unlawful act or decision of an NHS body'.
'You have the right to compensation where you have been harmed by negligent treatment'.
The NHS also commits:
'to ensure you are treated with courtesy and you receive appropriate support throughout the handling of a complaint; and the fact that you have complained will not adversely affect your future treatment (pledge); '
'when mistakes happen, to acknowledge them, apologise, explain what went wrong and put things right quickly and effectively (pledge); and to ensure that the organisation learns lessons from complaints and claims and uses these to improve NHS services (pledge)'.
PATIENTS AND THE PUBLIC - RESPONSIBILITY
'You should give feedback – both positive and negative – about the treatment and care you have received, including any adverse reactions you may have had'.
'to be open with patients, their families, carers or representatives, including if anything goes wrong; welcoming and listening to feedback and addressing concerns promptly and in a spirit of co-operation. You should contribute to a climate where the truth can be heard and the reporting of, and learning from, errors is encouraged; and to view the services you provide from the standpoint of a patient, and involve patients',
Commitment to quality of care. 'We earn the trust placed in us by insisting on quality and striving to get the basics right every time: '
'We welcome feedback, learn from our mistakes and build on our successes.'
Compassion. 'We respond with humanity and kindness to each person’s pain, distress, anxiety or need. We search for the things we can do, however small, to give comfort and relieve suffering. We find time for those we serve and work alongside. We do not wait to be asked, because we care'.
Improving lives. 'We strive to improve health and well-being and people’s experiences of the NHS.'
Working together for patients. 'We put patients first in everything we do, by reaching out to staff, patients, carers, families, communities, and professionals outside the NHS'.
We accept that some people need more help.
Sunday, 22 February 2009
Prescripton Drugs - Kill or Cure?
- pain relief drugs (based on opium)
- heavy tranquillisers (known as antipsychotics)
- sleeping tablets
- anti-depressants
If road safety was treated in the same way as drug safety is, then we'd be driving with few traffic lights, without seat belts, no white lines or street lighting - and crashes would never be investigated, says Charles Medawar, director of the charity 'Social Audit', which monitors the pharmaceutical industry.
It is naive to think that every available drug has been trial tested and not only that, that interaction with other drugs has also been widely tested as this is just not possible. It costs the drug companies £300-600 million for the different trial types and would needs years and years of testing. Needless to state, the drugs companies have found ways around the rigorous process and can be set so they are more likely to show favourable results. Shocked? so you should be. They are likely to use volunteers who are younger and fitter then the elderly people who have the bulk of the prescriptions.
In a study, the 'New England Journal of Medicine' found that only 2 per cent of the people included in trials of aspirin-like anti-inflammatory drugs were over 65, despite the fact that this age group is more likely to use them. Also the elderly are more likely to suffer from drug reactions as when we age we get less efficient at handling toxins.
Women are also under represented in trials so reactions that women are vulnerable to, such as problems with heart rhythm, are less likely to show up in trials until after a drug is considered safe.
20 per cent of the most commonly prescribed drugs do not have a licence for the condition they are being used for. This is known as 'off label prescribing'. This means a drug may be prescribed for another purpose from that which it was intended.
For example: heavy tranquillisers that are licensed for use with schizophrenia are now also being routinely prescribed in the treatment of elderly patients with dementia and children with behavioural problems.
I have my own example where I was prescribed a drug that was supposed to help with my hot flashes (but it did not), which was marketed to treat high blood pressure! (belonging to a group of med's called vasodilators - which cause blood vessels to dilate (widen) thereby increasing the blood flow). These were originally trialled as an anti-depressant but were found not to be of much use. The leaflet says that it should not be taken if 'you have a history of depression or you are depressed' with such possible side effects as: low blood pressure, tiredness, difficulty in sleeping, hallucinations, confusion, nightmares, depression, anxiety, etc., etc., so be warned!
This 'off label prescribing' is widely practiced both in the UK and the US but it's one that is widely abused and it must be recalled the drug disaster stories that were around at the time - the link between HRT and heart disease and suicides and anti-depressants drugs for children - which were prescribed 'off label'.
As many as 200,000 dementia patients are being prescribed antipyschotics even though large scale studies have shown that they are not suitable for such people and can increase their risk of a stroke. There are also bad side effects such as: involuntary or repetitive movements, large weight gain, very low blood pressure, intense dreams or nightmares, lethargy or seizures.
They are also being prescribed to children with behavioural difficulties and is like giving chemotherapy for a headache.
The average person over the age of 65, is taking 29 different prescriptions! and as mentioned above, none of these multiple combinations have ever been tested in clinical trials and taking such a combination is likely to do more harm than good (Dr Malcolm Kendrick, a columnist for GP magazine 'Pulse'). Nobody is going to test them all because it would cost billions plus the drugs are made by different companies so co-operation between them all would be a problem.
It is mentioned that most elderly patients would be far healthier with fewer prescriptions. In-fact, an Israeli study in 2008 found that when a group of elderly patients reduced the number of drugs they took, they were 3 times less likely to have an emergency dash to hospital.
Relative and Absolute Risk
As well as becoming aware of the possible dangers from drugs, there are two things that can help you get a better idea of how effective a drug is. The first is the difference between relative and absolute risk. Your GP may tell you that a certain drug reduces your risk of some conditions by 25-30 per cent making it sound worth taking, but they might not mention how big the risk is to start with.
In trials of the risk of having a first heart attack, for example, it is 4 per cent on a placebo and 3 per cent on a cholestrol-lowering statin. That is a drop of 25 per cent - known as the relative risk. But the real (absolute) risk reduction is only 1 per cent. Not so impressive.
The second is something known as NNT (numbers needed to treat). This tells you how many people have to be treated with a drug over a certain period for one to benefit. So an NNT of one means that everyone who is treated benefits; NNT2 means that it works for one in two. e.g. head lice lotion has an NNT of one, aspirin has an NNT of two for reducing the pain of a sprain. Preventative treatments like the cholestrol-lowering statin drugs have very high NNT's, such as 641 to prevent one stroke.
So, it is up to us to ensure that we know everything we can about the drugs we are taking. My book stresses the fact that you must thoroughly read the leaflet accompanying your prescription. Do not be afraid to ask your GP questions about your med's and if you do suffer any of the side effects then it is vital you go back and tell him.
10 Questions to ask your Doctor (taken from Candis) - make an informed decision
- Is this a drug that has only recently been licensed?
- Is it a replacement for one that has just run out of patent?
- Is this drug being prescribed 'off label' or not?
- Have there been any trial of the drug run by researchers who are not financed by the drug manufacturers?
- Was the drug tested on the same sort of people who are most likely to use it?
- Has the drug been tested against any drugs already in use and how did it perform in those tests?
- Are there any non-drug treatments that could be more effective than drugs for this condition?
- Have all the trials carried out on the drug been registered anywhere so we know what all the results were? Did any trials show no effect or signs of problems?
- What is the actual percentage figure for this drug's absolute risk versus relative risk and what is it's NNT?
- What side effects are there and what serious side effects should I make sure I report immediately
I personally think that we probably won't have much luck in getting answers to some of these questions! Number 7 particularly interests me because when I told my doctor I was taking an alternative to anti-depressants he made it more than clear (on more than one occassion) that he did not believe in these alternatives, so I would be very suprised if your doctor recommends a 'non drug treatment that could be more effective'. If they do, then I suggest you hang on to them!
Remember - you must never just stop taking any medication that you have been prescribed as it is dangerous and could even be fatal. - I am not a doctor.
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Are you planning to, or have you written, your own book? Then I can highly recommend my own publishers, click on the link below for details
Bonnie
The Truth About Depression and How You Can Beat It
Sunday, 15 February 2009
Depression And Alcohol
- brain damage
- heart problems
- strokes
- bad skin
- cancer
- infertility
- not sleeping well
- leading to feeling guilty and shameful about drinking too much
People also think that you have to drink 'bucket loads' before being classed an an alcoholic - not so I'm afraid - because if you habitually have a bottle of wine a night you will already be in this bracket. Because of the way our bodies work - women are even more vulnerable to physical damage from alcohol.
Medical definition of addiction:
- physical cravings
- withdrawal symptoms
- build up of tolerance
- a compulsion to drink
Even if you don't suffer withdrawal symptoms such as sweating, shaking, upset stomach and anxiety you may need to drink more to get the same high. Even if you don't suffer from this as yet, it can creep up on you before you realize it.
Warning signs:
- You may plan your day or weekend around alcohol
- You may prioritise people and places that will reinforce the behaviour and cut out those who don't
- You may think about drinking all the time
- You may plan to cut down but can't, or find yourself drunk at a work function when vowing to stay sober
There is evidence that genetics play a part in whether we become alcoholics because a child with an alcoholic parent is four times more likely to develop a drink problem. Experts believe (what I have always thought myself) that drinking too much is a sign of deep inner unhappiness and not necessarily because people actually enjoy the taste of drink - they may drink to remove themselves from reality, what's in their head, low self esteem or depression and are unable to deal with their feelings - feeling fear, anxiety or pain.
If you think that you are drinking too much out of habit, boredom or stress, then try to make changes in your life. Plan more fun, alcohol free activities such as playing a sport, learn relaxation techniques (and I quote several in my book) or meeting friends for coffee.
They say 'once an alcoholic, always an alcoholic' and it is reckoned if you give it up then it is likely to be impossible to be able to drink socially again. It takes 2 years for your brain to lose the habit of craving drink or drugs as an automatic response to any problem or situation and you will have your work cut out trying to keep it up.
(typing all of this, and thinking about my own situation which inspired me to write my own true story - I am feeling rather pleased with myself that I resisted going down this road).
Because women are so used to 'multi-tasking' we can actually drink to excess without our lives falling apart! because we are so good at coping with things. 'Life Works Addiction Centre' says that 60-70% of their clients are women and well over half of these managed to hold everything together. They go for help because they know that they are addicted and can't see a way out. Apparently we can hold it together - look great on the outside but are falling apart on the inside.
You can get outside help if you cannot stop yourself - via your GP or AA (Alcoholics Anonymous) or you can even try a helpline as sometimes you may just need somebody to talk to. You do not have to go through it alone and it is suprising that many people go through life wanting to do something about it but not willing to take the first simple small step.
Now for the bit of fun I promised you! (to end on a lighter note)
Have you heard of 'twitter'? it is a social site, a bit like 'Facebook' or 'MySpace' but you only have up to 140 characters to inform people 'what you are doing'. You can follow people, and gain followers. You even get to follow No. 10 Downing Street (home of UK's Prime Minister), Barack Obama, Al Gore, New York Times, NPR Politics, etc., You can even sneakily include your URL.
I signed up for it on Thursday to divert myself from what ended up to be a bad day for me, and a setback. I will give you my personal 'tweeter' referral link below. When you have signed up I suggest downloading (free) a TweetDeck (just google). This means that you do not have to keep logging in and all your contacts are there, in one place. You even get a sweet little 'trill' when there is a new entry added.
First you need to sign up for a twittter account, so just click the link http://twitter.com/ as you need your log in details to sign up to 'tweeter' below. You can also see what I am up to.
Check it out! one way to banish depression without the need for alcohol!
http://tweetergetter.com/bonnietoner
Don't forget to sign up for automatic alerts - you do not want to miss my book launch date
Are you planning to, or have you written, your own book? If so, I can highly recommend my own publishers. click the link below for details:
Bonnie
The Truth About Depression and How To Beat It - launching soon.