The Anonymous Widower

Phone Call Cuts Hospital Readmissions

The title of this post is the same as that of an article on page 18 of today’s copy of The Times.

This is the first paragraph.

A single phone call to an older patient who has been discharged from hospital can almost halve the odds of readmission, research suggests.

I have mined health-care data in the past several times and often something simple drops out from a simple analysis.

Some analyses produce the obvious like you gets lots of leg injuries on Saturday afternoons, due to football being played.

I also believe that analysis of health data in an area could pick up more sinister links.

This could be picked up by artificial intelligence scanning the various databases, but until such systems are fully developed, a lot can be picked up by analysts using simple tools. Even Excel can find a lot of problems, if used properly.

 

June 14, 2019 Posted by | Computing, Health | , , , | Leave a comment

M4: Alternative Solutions To Motorway Travel

The title of this post is the same as that of this article on the BBC.

It is a good read giving both sides of the problems of commuting.

This is an important section from an expert.

Prof Mark Barry, a transport expert at Cardiff University, said the M4 has been important in attracting manufacturing, but there have been negatives.

“The downside is we’ve built a lot more housing, retail and other business parks around the M4, that’s then made us over-dependent on the car,” he said.

I think Professor Barry is highlighting a problem, that is seen all over the UK. Like the United States, housing, office, medical and leisure developments are being built, where the only way to get there is by car.

I don’t drive because my eyesight has been damaged by a stroke, but I still have a full life, with more travel than the average man of 71.

June 14, 2019 Posted by | Health, Transport | , , | Leave a comment

My Unusual Body

I say unusual, but I suspect there are others out there with similar problems to me.

I was delivered in 1947, by the almost exotically-named; Dr. Egerton White, who was the family GP. He had all the expected characteristics of a three-piece suit, a corporation, a long watch chain and the obligatory Rover car. He also had a rather unusual blotchy skin, that leads me to think he was probably of mixed race.

I was small in stature, not the healthiest of children and was always going to see him and his partner, a Doctor Curley!

  • At times, I would cough my guts out for hours on end.
  • Later I remember my mother saying to my future wife, that I had difficulty eating as a baby, and I would fall asleep as she fed me.
  • Often I would spend three or four months away from school and I can remember spending hours with my head over a large jug of hot Friar’s Balsam.
  • At one point, someone said it could be the lead in the paint in our house, so my father burnt it all off and replaced it.
  • My mother used to make gallons of home-made lemonade according to one of Mrs. Beeton’s recipes, which must have helped, when I drunk it.
  • Doctors White and Curley were puzzled and at one point the new-fangled drug penicillin.
  • It should be remembered that in the 1950s, even in leafy Southgate, where we lived, the air was thick with the pollution from coal fires for a lot of the year.

In the end, one thing that helped was a nasal spray cooked-up by a pharmacist called Halliday. I can still smell it and suspect it was little more than the base chemical still used in some nasal sprays available from pharmacies.

Although my poor health persisted at times, I still managed to pass the 11-Plus and get to Minchenden Grammar School.

But I remember in the first year, I had virtually a term away.

From about ten or eleven, my health gradually improved.

I can suggest these reasons.

  • Getting older helped in some way.
  • I was exercising a lot more by cycling around, although it was up a hill to get home.
  • My parents had bought a house in Felixstowe and we would spend weekends there. Although, as I got older I hated being away from my friends with little to do, so I tended to stay in and read.

In the 1960s, my health seemed to improve dramatically, when I spent three years at Liverpool University and a year afterwards working for ICI at Runcorn.

Liverpool is a Maritime City and in those days, the air was much better than London.

But I also got married in 1968 and I can never remember serious noughts of coughing, sneezing and breathing difficulties in the time Celia was alive.

Although, she did often say that before I went to sleep, I would always sneeze three times and sometimes she would even count them.

She also regularly said, that my sneezes were rather violent at times. They still are!

In the late nineties, I was diagnosed as a coeliac. Regularly, I’d go to the GP around the turn of the year with a general run-down feeling.

Nothing specific, but then an elderly locum decided I ought to have a blood test, which would be the first of my life!

The result was that I was very low in vitamin B12. As a series of injections didn’t improve the situation, I was sent to Addenbrooke’s Hospital for tests.

I was diagnosed as a coeliac, initially on a blood test and then by two endoscopies. Note that Addenbrooke’s used to do them without anaesthetic, as it means the patient can easily get into a better position and doesn’t break teeth. It also means that the hospital doesn’t have to provide as many beds for recovery. Certainly, I’ve had worse experiences with highly-capable dentists!

I thought this was the end of my health problems.

It certainly seemed to be, except for occasional breathing difficulties early in the year. I can remember having difficulty climbing Table Mountain.

My stroke was brought on by atrial fibrillation three years after Celia died.

It happened in Hong Kong and before it happened in the restaurant of the Mandarin Oriental Hotel, I had had a walk and remember how well the air felt early in the morning in the City.

The doctors said I had had a serious stroke and I was kept in hospital for twelve weeks on the 29th floor of a hospital with the sun streaming through the windows.

I remember one incident, where I was accused of throwing my water away and not drinking enough, as I wasn’t urinating. But I was drinking, so they checked my waterworks thoroughly and put in a catheter. Nothing improved. Thankfully, eventually they gave up!

So where was all that water going?

Another curious thing in Hong Kong was that their automatic blood pressure machines sometimes didn’t work well on me in the morning. So they resorted to traditional devices and a stethoscope.

After the stroke, I was put on long-term Warfarin and I have been told several times, that I if I get the dose right, I won’t have another stroke.

Now moved to London, I possibly made the mistake of moving to a house, which gets too hot.

One day I collapsed, panicked as I thought it was another stroke.

It wasn’t and UCLH thought that I needed to be put on Ramipril, Bisoprolol Fumarate and Spirolactone.

Since then another cardiologist has dropped the Spirolactone.

As I said mt body is unusual in strange ways.

  • If I have an injection or give a blood sample, I don’t bleed afterwards or need a plaster. With a new nurse, it often causes a bit of a laugh!
  • My nose seems to be permanently blocked and I rarely am able to blow it properly.
  • My feet don’t have any hard skin, which is probably unusual for my age.
  • I used to suffer from plantar fasciitis, which seems to have been partly cured by the Body Shop’s hemp foot protector.
  • I drink a large amount of fluids, with probably six mugs of tea and a litre of lemonade or beer every day.
  • I always have a mug of decaffinated tea before I go to bed.
  • I often have half-an-hour’s sleep in the middle of the day. As did my father!
  • My eyes are very dry and I have a bath most mornings, where I put my head under the water and open my eyes.

Perhaps, the strangest incident was I went to sleep on the floor after a lot of tea, with the window open.

I woke up to find I couldn’t see! There was nothing wrong with me, but my large living room was full of steam, like you’d get if you leave the kettle on.

I came to the conclusion after that incident, that the only place the water could have come, was through my skin.

This was also suggested by a nurse, who said he’d got leaky skin.

As someone, who understands physics, could this leaky skin be the cause of my problems?

And do the drugs make it worse?

My Grandfather

He died at forty, long before I was born.

He was an alcoholic, who eventually died of pneumonia.

Could his drinking like mine, have started because of a need for fluids?

I used to drink a lot of beer until I was about twenty-four, but my father had suffered so badly emotionally because of the death of his father, that he had instilled the right attitude to drink deep in my mind.

Conclusion

This has been a bit of a ramble!

May 29, 2019 Posted by | Health, Uncategorized | , , , | 2 Comments

Tell Patients To Ditch Diesel, Doctors Urged

The title of this post is the same as that of an article on the front page of today’s Times

It may be a sensible idea, but a lot of patients wouldn’t like it.

I suspect too in Inner London, where I live, the message has got through, as you meet more and more people, who are deciding that driving is not for them!

May 24, 2019 Posted by | Health | , | Leave a comment

Schools Should Have ‘No Idling Zones’, Public Health England Chief Says

The title of this post is the same as that of this article on the BBC.

These are the first three paragraphs of the article.

Public health chiefs have proposed a ban on cars idling outside school gates in a bid to cut air pollution.

The measure is among a series of UK-wide recommendations put forward by Public Health England.

PHE medical director Paul Cosford told the BBC: “We should stop idling outside schools and we should make sure that children can walk or cycle to school.”

The article also lists other measures.

  • Redesigning cities so people aren’t so close to highly polluting roads by, for example, designing wider streets or using hedges to screen against pollutants
  • Investing more in clean public transport as well as foot and cycle paths
  • Encouraging uptake of low emission vehicles by setting more ambitious targets for installing electric car charging points
  • Discouraging highly polluting vehicles from entering populated areas with incentives such as low emission or clean air zones

All motherhood and apple pie, but it will be a vote loser for any Government, that tries to i9mplement it.

 

March 11, 2019 Posted by | Health, Transport | , | 2 Comments

A Double Database Cock-Up From The NHS

At three on Sunday morning, I phoned NHS 111 to ask for a bit of help with my terrible cold that was stopping me from even getting to sleep.

I had some advice which helped, but I was also booked in to see a doctor at 09:00 in a surgery a short bus ride away.

So far so good and no complaints.

I duly saw the doctor and he prescribed several drugs, which I took to my local Boots later in the morning.

I should say at this point, that four years ago, I officially changed my name from the one my parents gave me to the one I’ve used continuously since 1968. I was starting to get problems with some airlines, where my passport had a different name to my bank account. My current GP has only ever known me by the latter name and I’m registered with their surgery using it.

When I got to Boots, they initially rejected the prescription, as for some reason it showed by old name, although my address, NHS number and other personal details were correct.

How did the wrong name get on the prescription?

Luckily, Boots were pragmatic and as they recognised me, I got some of thew drugs.

But not all!

The pharmacist recognised that two drugs were incompatible with the Warfarin I take.

So why did the NHS computer system allow the doctor to prescribe the drugs?

As someone who was at the forefront of database technology, I believe, these two problems are inexcusable.

My incorrect name could have led to failure to obtain needed drugs.

The lack of interaction checking, could have led to serious problems for a patient.

January 7, 2019 Posted by | Computing, Health | , , , , | 4 Comments

Have I Regressed To My Childhood?

Growing up in the early 1950s in London, I wasn’t the healthiest of children.

  • At some time most winters, I would have several weeks off school with a severe cold with extras.
  • I can remember my mother cutting up old sheets for hankerchiefs.
  • These would be boiled after use in a large saucepan on the gas cooker.
  • I would  cough all night and a good part of the day.
  • I would  inhale steam from a large jug of hot water and Friar’s Balsam.

Dr. Egerton White was always round our house.

Things improved towards the end of the 1950s.

  • The passing of the Clean Air Act in 1956.
  • I would be given penicillin which seemed to help. Naughty! Naughty!
  • At weekends we’d go to Felixstowe.

What finally improved my health was going to Liverpool University.

Now over fifty years later, I’ve got a cold like I had in the 1950s.

  • I can’t stop coughing for more than ten or twenty minutes.
  • Nothing seems to work to stop the cough!
  • It’s gone on for eight days now!
  • I’m not getting much sleep.

Could the pollution from all the diesel vehicles be the key?

January 3, 2019 Posted by | Health | , , , , | 6 Comments

Parking Fees Rise At Many Hospitals In 2017-18, Analysis Finds

The title of this post is the same as that of this article on the BBC.

This is the first paragraph.

Four in 10 NHS hospitals in England have increased car parking prices in the last year, new data suggests.

I don’t drive, so it doesn’t effect me and the only hospitals I’ve visited in the last few years; Addenbrooke’s, Homerton, Royal London and University College have been easily accessible by public transport.

The real scandal is that so many hospitals are not easily accessible using fully-accessible public transport.

  • Addenbrooke’s has a large bus interchange, which has connections to Cambridge City Centre and at least one of the City’s large Park-and-Ride sites.
  • Nottingham’s Queen’s Medical Centre has a tram connection to the large Park-and-Ride sites.

But I can think of several hospitals, where the only public transport is an expensive taxi.

I also remember a hospital administrator in London telling me, that the largest number of complaints they received was about car parking.

 

December 28, 2018 Posted by | Health, Transport | , , | 2 Comments

Thoughts On a Red And Processed Meat Tax

This article on the BBC is entitled Should There Be A Tax On Red Meat?.

This is the first two paragraphs.

A “meat tax” could prevent almost 6,000 deaths per year in the UK, according to researchers, but should politicians be telling people what they can and can’t eat?

Scientists at the University of Oxford say governments should consider imposing price hikes on red meat – such as beef, lamb and pork – to reduce consumption.

They also go on to suggest these levels of tax, with examples.

In the UK, the study suggests a tax of 14% on red meat and 79% of processed meat.

This would mean the price of a 227g Tesco Sirloin Steak would increase from £3.80 to £4.33.

And for a pack of eight pork sausages from Sainsbury’s the price would increase from £1.50 to £2.69.

It is probably peer-reviewed research, but I doubt it would ever be introduced.

I have few questions.

Would I As A Coeliac Get Extra Tax Relief, As I Need To Eat Red Meat?

I don’t eat much red meat, but to keep my B12 at a good level, I need to eat a quality steak or burger.

Regular levels of B12 help to keep your immune system strong, which is the body’s first line of defence against cancer.

Why Do Coeliacs On A Gluten Free Diet Have A 25% Less Chance Of Getting Cancer?

Research at Nottingham University has shown this.

Being coeliac is unlikely to be beneficial, as whoever heard of a disease that let you live longer?

,So could it be the non-eating too of gluten?

Also, as many who eat a lot of red and processed meat, eat it with a bun or lots of bread,

Could this be significant?

Research needs to be done that considers consumption of red and processed meat, taking eating gluten into account.

How Would I Reduce Cancer?

There are other substances and circumstances that are proven to cause cancer.

  • Smoking tobacco and other drugs.
  • Eating too much and being obese
  • Drinking too much.
  • Too much sunbathing.
  • Diesel and petrol vehicles
  • Gas appliances in the home, not venting outside.

Some of these also cause other health problems.

I’d start with absolute bans on these.

  • Diesel and petrol vehicles.
  • Smoking tobacco
  • Possession of illegal drugs.
  • Gas appliances in the home, not venting outside.
  • Sales of high strength alcohol.
  • Jobs with a proven record of causing cancer like coal mining.

And these things would be compulsory or introduced.

  • Everybody should keep a record in a smart-phone app of what they ate and their weight.
  • Owning a diesel or petrol vehicle would need a special permit.
  • Alcohol could only be bought in special licensed shops.

Obviously, other draconian measures could be introduced.

I doubt it will ever be acted upon, by any Government that wants to win an election.

So What Can We Do That Is Practical?

My view is that we have to nudge people into doing the right thing.

Diesel And Petrol Taxes To Subsidise Zero-Emission Vehicles

Note that I use the term zero-emission vehicle, which is a category that includes battery and hydrogen power at present. But it is a class, that could include other vehicles in future, that have yet to be invented.

If diesel and petrol taxes were to rise and the revenue were used to subsidise the purchase of zero-emission vehicles, then this might persuade more people to switch to zero-emission vehicles.

Money could also be allocated to research into zero-emission vehicles.

Zero-Emission Zones In All Towns And Cities

London is getting an Ultra Low Emission Zone, but this is only the start.

They should be Zero Emission Zones.

They should probably be paired with parking areas outside the zone and connected to it, by a zero-emission high quality rail or bus link.The link could be a segregated walking or cycling route.

The first town or city that uses this model to create healthy air quality will probably reap an enormous dividend.

From recent developments, I suspect it will be the City of London.

Smoking Would Only Be Allowed By Consenting Adults In Private

As smoking had a lot to do with the death of my son I feel strongly about this.

My wife also may have died from secondary lung cancer. But she had never smoked, although she got enough cigarette smoke from her tutor at University, who chain-smoked Capstan Full Strength.

Is There A Radical Approach?

Liverpool University Pancreatic Cancer Research Unit have one of the most impressive databases I have ever seen! It contains every pancreatic cancer case, that has been notified to the University.

They use it to look for links between factors, that might be a clue to what causes this terrible disease and for possible cures.

But imagine an enormous database of all UK cancer cases, that was processed to show how the cancers related to post codes, occupation, age, weight, smoking and drinking habits etc.

Access to an anonymised version of the database would be allowed through the Internet or a phone app.

Would access to the data, nudge people to change their bad habits?

I also know of ten-year-olds, who pester their parents to stop smoking, so imagine what a tech-savvy child would do, if given access to the app. Schools could teach them to use it responsibly.

Could it bring the whole country together to reduce levels of cancer?

 

 

 

 

 

 

 

November 7, 2018 Posted by | Health | , , , , , | Leave a comment

Should We Exempt Low Alcohol Beer And Wine From The Age Regulations

I drink Marks & Spencer ).5% Southwold Pale Ale for four main reasons.

  • It is low alcohol and doesn’t interact with the Warfarin, that I am prescribed to control the INR of my blood, so I don’t have another stroke.
  • Because it is made with less barley, it appears to be gluten-free to my body.
  • It also has the proper taste of real beer.
  • It is brewed by Adnams in Suffolk and I started drinking their beers at fourteen under supervision of my father, whilst we played snooker in Felixstowe Conservative Club.

As my GP says, at 0.25 alcohol units a 500 ml bottle, you’d have difficult drinking enough to affect your health.

There is one annoying thing about it and that is buying it.

This morning, I bought three bottles in the M & S store at the Angel, where my family has been shopping since before the First World War.

As I usually do, I used one of the automatic tills and had to wait for a minute or so, whilst the assistant verified that I was over eighteen.

The store was busy and she was helping someone with another till.

I wonder what would happen at the checkouts, if there was no age check on low alcohol beer and wine.

  • It would obviously speed up the tills with some customers.
  • But would it have the affect of brewers and winemakers, making more quality low alcohol products?
  • And would these be purchased by those who knew they should cut their alcohol intake?

It’s probably one of those ideas, that would go down well in London boroughs like Barnet, Islington and Richmond, but how would it go down in places where alcohol was a necessary way of life for many?

How too, would such a drink fit with those of a Muslim faith?

September 19, 2018 Posted by | Food, Health | , , | 7 Comments