Many of our readers will probably have heard the comments made by Mr.
Edward Donald, the CEO of the
As this was hardly the robust rebuttal one would expect if there were no
truth in the story at all, I discussed the matter with our Chairman, Mrs. Lynn
Warner, and on 3rd September I visited Ms. Fiona Mactaggart (MP for
On 13th October, Ms. Mactaggart wrote to me,
enclosing a copy of a letter from Rt. Hon. Andrew Lansley, CBE., MP., Secretary of State for Health, dated
11th October, in which he states
that no changes would be made without “....a full consultation with all
stakeholders (of H&WP), including patients, staff and the local
community”. He also refers to a
loan (of £18M) that he has authorised his Department to make to H&WP to
underpin its recovery plan approved by Monitor, the independent regulator for
NHS Foundation Trusts. Finally, he
says that it will be for local GPs to decide where to commission services to
provide the best outcomes for their patients. In her letter of 13th October, Ms. Mactaggart makes the point that GPs in
In the latest edition of health matters, the H&WP newsletter,
Chris Langley also refers to the loan of £18M from the Department of Health,
repayable over ten years on “commercial principles” and the newsletter also
carries a story about the new arrangements, operating since July, under which
emergency cardiac cases needing procedures in the Catheter Lab outside WP’s
normal hours are transferred to Harefield, which has
more labs and operates 24/7. There
is also news of other new technology already implemented in the form of
interactive whiteboards (Smartboards), which improve
the case management of patients in the Paediatric and Neonatal Units.
From the above, it would seem that WP is reasonably secure for the
foreseeable future. We are greatly
indebted to Ms. Mactaggart for her
assistance.
Ed Robson
Websites
The Government funds a website which allows charitable organisations to
have their own website page free of charge. THROB has now got its own page on this
website - www.guidestar.gov.uk - which gives a brief run-down on our
organisation, our objectives, our activities and our services to the community.
There is a link to our website www.throbrehab.org.uk
We have also been asked to publicise Elaine Role’s websites which have
catchy little names like www.heartrehabilitationexercise.com and
www.healthyheartsexerciseinretirement.com These sites were brought to our
attention in discussions between our Chairman, Lynn, and Elaine Roles as
reported in the February issue. The
latter one for retirees who are not cardiac patients (yet) is certainly worth a
mention.
Watch Your
Waistline
People who have been using their Body Mass Indicator (BMI) to persuade
themselves that they are in pretty good shape (medically speaking) might want to
think again. The size of a person’s
waist is now shown to be a better indicator of potential heart disease. Recent
work suggests that an extra few inches of fat around the waist is enough to lead
to heart failure. For ladies that
level of increase raised the likelihood of heart disease by 15% even if they
were the correct weight for their height.
The old argument - “I’m not fat, it’s just that I’m short for my weight”
- will not wash! Men were slightly
worse off being 16% more likely to develop a life-threatening heart condition if
they had a pot belly. American
studies gave an even higher risk of 18% but did not distinguish between male and
female. Women with
sizes above
What is my BMI?
Divide your weight in
kilograms by your height in metres squared, i.e. BMI =
W/(HxH).
Values between 20 and 25 are considered normal - above 25 is
overweight.
What or where is my waistline?
The waistline in this context is measured at the level of the belly
button. It is not the same as the
waistband or belt size.
David Read
Heart Disease and
Cancer
You will have heard me banging on about how unfair it is that heart
patients should also succomb to cancer. Now I see that cancer patients are put
at risk by radiotherapy which can cause thickening of arteries and lead to heart
disease. There is risk down to a
level 0.5 Gray ( a unit of radiation dose) but to put
this into perspective you would need 50 CAT scans or 25,000 X-rays to get an
exposure of this level. In
radiotherapy treatment for cancer a patient can get an exposure of several
Gray. The Advisory Group on
Ionising Radiation has advised that the levels of exposure to hearts and brains
should be kept as low as possible.
The Health Protection Agency said that it was reassuring that the
Advisory Group was largely satisfied by the present
practices.
David Read
Pharmacy – Then
and Now
All members
of THROB are likely to be regular users of a pharmacy and I felt that it might
be of interest to you to share some general comments on the changes in the world
of pharmacy which have affected us all.
My family
has a long history of involvement in pharmacy going back to 1877. My father was one of four brothers who
qualified as pharmacists, then referred to as chemists and druggists. My oldest uncle married a fellow student
who had father, uncle and brother who all qualified as pharmacists. I followed in the family tradition and
qualified in 1961. Between all
these family members, we add up to 389 years on the Pharmaceutical Register,
which I suspect is a record which no other family can match.
The pharmacy
course which I entered in 1957 trained students to identify materials and to
manufacture medicines and this had not significantly changed since all the other
family members had qualified. The
identification of materials stretched from useful botanical specimens to
potential adulterants such as mouse droppings. I never found any use for this during my
professional career.
However, one of my father’s closest friends and a contemporary at the
West of England School of Pharmacy did use his knowledge of pharmacognosy in a Japanese prisoner of war camp, to provide
fellow prisoners with medical preparations made from plants which he found
growing in the compound. In the
early years of my career, I was using the skills of manufacturing medicines as,
at my father’s pharmacy in Uxbridge, the day would start with the manufacture of
large bottles, Winchesters, of liquid medicines, all with Latin titles. During the day, these would be
transferred to smaller bottles for dispensing to customers against
prescriptions.
Many of you will have
followed the recent television series A Victorian Pharmacy and all the
procedures shown in that series were taught when I was at college. However, after leaving college, I never
needed to manufacture suppositories, pills or powders. As a student, I worked at a pharmacy in
the
Dispensing
was further complicated by the units which were used: liquids were dispensed in
minims and fluid ounces, while powders and ointments were weighed in grains,
scruples and ounces. This was even
further complicated by ounces being either Avoirdupois or
In those
days, a pharmacy had an individual smell, which one noticed on arrival each
morning. This has now disappeared,
like many of the products that were sold.
When I first started work, the chemist’s shop was the place that sold
toilet rolls and lemon barley water, as well as other strange items. At Uxbridge, we had a major business in
photographic chemicals and papers. We also sold materials for chemistry sets,
such as Bunsen burners, test tubes and chemicals. For some strange reason, we also sold
brass nuts and bolts, though I have no idea why! When instant coffee first appeared, we
stocked that too.
Self-service was an unknown concept at that time and stock was kept in
closed cupboards and drawers with little cards recording the prices. These had to be remembered before being
entered into the old-fashioned mechanical till. The dispensary was not the only part of
the pharmacy where Maths was necessary.
What a
change from today’s pharmacies, where prescriptions are
computer produced, sent directly from the surgery to the pharmacy, sometimes
even by electronic transfer. All
medicines are in packages simply taken off the shelf and labelled by the
computer. In the shop, all goods
are on display for self-service and then priced by reading the bar code. Most of the time, no cash will change
hands as payment is by credit card.
Furthermore, today’s pharmacists need to know vastly more about the
pharmacology of the medicines they dispense. I am not certain that my relatives would
recognise it as the same profession!
Certainly more efficient, and the products much more effective, but I do
wonder if it is as much fun as it used to be.
Roger Mills
CPR
It appears I’m not the only one who recycles news items
when it is hard to fill the pages so when
I came across a piece in the paper about Cardio Pulmonary Resuscitation
(CPR) and how it is better to use all chest compressions and skip the “kiss of
life” bit, I thought “What brought this on?....like you would... This problem
was aired in THROBNews back in May
2008. Then the penny dropped -
perhaps they’ve changed the regulations.
The internet came to the rescue, as always, informing me that as of
October 2010 the advice on CPR had been updated Europe-wide.
Being a loyal subject I turned to the Resuscitation Council (UK) for
chapter and verse - and what a lot of verses there were! As THROB members, the
bit we are most interested in is Basic Adult Life Support but the guidelines go
on to advise on the use of Automated External Defibrillators (AEDs) and lots of other special cases. In essence, the advice is to establish
that the victim has stopped breathing and then give chest compressions at a rate
of 100-120 per minute. If you have
had no training in CPR this is the safest course of action. For trained people then 30 compressions
at the above rate followed by two mouth-to-mouth or mouth-to-nose lung
ventilations is recommended.
Apparently, in a cardiac arrest event the blood oxygen is quite high for
the first few minutes which is why compression-only CPR
is effective in many cases. If you
want to read the detail then simply google
Resuscitation Council (UK) or the European Resuscitation Council who also
provide pictures - and thereby get some value out of your financial contribution
to the EU.
David Read
Omega -
3
It was only in the last issue that we explained the value of eating fish
rich in Omega-3 fatty acid. Now we
learn that studies have shown that a good daily dose of Omega-3 can improve the
lot of people suffering from heart failure - that’s when the heart fails to beat
with sufficient force leading to breathlessness and
fatigue. In a joint effort between
THROB is, of course, initiating its own study which currently comprises
one male between the ages of 70 and 80.
This subject gets tired and breathless but the cardiological experts assure him he isn’t suffering trom heart failure but say the Omega-3 will do him good
anyway! If any other THROB members
want to join this highly scientific study they are more than welcome but they
will have to buy their own Omacor - unless of course
they can con their GPs into supplying it!
The best price found to date on the internet is from Rowlands Pharmacy at £16.37 for a four week supply. Keep taking the
capsules!
David Read
Beware Cheap Statins
Research has shown that the Government’s drive to cheaper drugs could put
lives at greater risk. The study
showed that one third of patients switched from a branded statin to a cheaper generic one received a less powerful
equivalent. Thus people taken off
Atorvastatin (Lipitor) and
given Simvastatin, a generic drug, would see a rise in
their cholesterol level of 5-6%.
This would give a rise in probability of a heart attack or stroke of
about 3%.
The financial incentive for the Government is quite clear - Lipitor costs £26 for a month’s supply compared to £2 for
Simvastatin.
THROB members taking Simvastatin might want to
have a chat with their GPs.......