The quest for fitness may be detrimental to your long term mental state

We are often told how we should aim to have, and maintain, a healthy lifestyle. After all, being physically fit allows your body to function both in physical and mental aspects. Healthy body, healthy mind, right?

The only difficulty, if you can call it that, with exercise is that the first thing that we would normally consider is running, but it is not for everyone. Going forward for a certain distance or time has little meaning for some people, especially children.

The thing about running is that it has to have some appreciable meaning, so unless you have some derivative inner joy of measuring your progress using statistics, it is unlikely to hold your interest for the long term. A better form of exercise is though group sports, as the mental boredom of tracking fitness levels is negated in favour of the social dynamic.

Common group sports such as football  have a large following in England. The football season for example lasts from August to May and provides a welcome distraction during the cold winter months. It is also a simple game that can be improvised using other materials and played on all surfaces. No goalposts? Use bags or some other markers. No football? Use a tennis ball. It is often interesting to see children turn up at a field, establish the boundaries of play using trees and creates goalposts using caps or other loose materials and these are often sufficient for the game; at least until there is discussion about whether the “ball” hit the post or went in the goal after it flies over a set of keys intended to represent the goalpost.

There is increasing concern about the link between dementia and football. The pounding of the ball against a soft surface of the brain, when the ball is headed, over time can cause the destruction of cells and cell function. This is of particular concern in the case of children, whose brains and bodies are developing. This has been of significant interest as members of England’s 1966 World Cup winning squad have found to have developed dementia in their later years. Some of them cannot even remember being there in 1966!

It is not just the impact of ball on head that is concerning, but when the head is moved through a range of motion too quickly. Even though there is no impact on the head externally, internally there is damage as the brain is hitting the sides of the skull supposed to protect it.

It is not just football that we have to be concerned about. There is plenty of head and neck related impact in rugby and American football. In fact, in American football, the head related injuries for offensive and defensive linemen, who every forty seconds start a play by ramming into the player on the opposite side of the line,  and the list of dementia sufferers is growing continually. Some players have even sued the NFL for injuries suffered during the game.

Will the rules of football change so that heading the ball is banned? Don’t bet on it. That would change the fabric of the game so much as to ruin it. When the ball is swung in from a corner, what would you do if you couldn’t head it? The game will not change, but also don’t rule out a consortium of players in the future filing lawsuits for work-related injuries. Perhaps in the pursuit of fitness, it may be wiser to choose less impactful activities for the sake of long term health.

Night time eating? Heart disease coming

That late night snack may be comforting and the perfect end to a day. However, if research is proven to be right, it could be the cumulative cause of heart disease.

Scientists have always known that night shift workers are at greater health risks than workers who work regular patterns. Which is why if you divided the pay shift workers receive by the hours worked, you would find that they have a higher hourly rate compared to those who do the same job during normal hours. That extra pay is to compensate for what is commonly perceived as the extra demand of working during the night, at a time your body is looking to shut down for a rest. The external pressures of going against your body, over a prolonged period, can exert a toll on the body.

Scientists in Mexico researching the links between diet and the human body tested their hypotheses on rats. The rats were fed food at a time when their bodies would normally be at rest, and the results showed that the fats from food remained longer as triglycerides in the body’s bloodstream for longer, because their bodies were at a resting state and not primed to break down food.

Bearing in mind that the research was done on rats, and while some results may have bearing on humans and some may not, what points could we take from these research results?

Having high levels of triglycerides in one’s body means that the risk of cardiovascular diseases such as heart attacks are significantly increased. Hence, if you are eating late at night, you may be at greater risk. Although the research is only at its infancy, they could suggest that the body is better when it comes to the processing of fats, when it is at its most active state, as it comes at more of a natural time.

What can you do if you work shifts? You may not have much control over the food you eat, but you can take steps towards eating a healthier diet and make time for regular exercise so the overall risk of heart disease is lowered. And if you do not work shifts, but work during the day, a big meal late at night is also best avoided for you.

Why mental health problems will never go away

Many people will experience mental health difficulties at some point in their lives. As people go through life the demands on them increase, and over a prolonged period these can cause difficulty and ill health. These problems can manifest themselves both in mental and physical ways.

What kind of demands do people experience? One of these can be work-related. People may experience  stresses of looking for work, having to work in jobs which do not test their skills, or be involved in occupations  which require skills that are seemingly difficult to develop. Another common theme with adults that causes stress is having to work in a job which increasingly demands more of them, but does not remunerate them accordingly. In other words, they have to work more for less, and have to accept the gradual lowering of work conditions, but are unable to change jobs because they have already invested so much in it in terms of working years, but cannot leave and start afresh because the demands of a mortgage to pay off and a young family to provide for means they cannot start on a lower rung in a new occupation. Over a prolonged period, this can cause severe unhappiness.

Is it surprising that suicide affects men in their thirties and forties? This is a period for a man where work demands more, the mortgage needs paying, and the family demands more of his time and energy. It is unsurprising that having spent long periods in this sort of daily struggle, that men develop mental health problems which lead some to attempt suicide. But mental health does not just affect men. Among some of the this some women have to deal with are the struggles of bringing up children, the work life balance, the unfulfilled feel of not utilising their skills, and feeling isolated.

One of the ways ill health develops mentally is when people spend too long being pushed too hard for too long. Put under these kind of demands, the body shuts down as a self preservation measure. But the demands on the person don’t just go away. You may want a break from work. But this may not be possible or practical. In fact, the lack of an escape when you are aware you need one may be a greater trigger of mental illness, because it increases the feeling of being trapped.

It is little wonder that when people go through periods of mental ill health, an enforced period of short-term rest will allow them to reset their bearings to be able to continue at work, or return to work with some level of appropriate support. But this is only temporary.

With mental ill health problems, lifestyle adjustments need to be made for sufficient recovery.

Under the Equality Act (2010), your employer has a legal duty to make “reasonable adjustments” to your work.

Mental ill health sufferers could ask about working flexibly, job sharing, or a quiet room, a government report suggests.

The practicality of this however means more cost to the employer in having to make adjustments to accommodate the employee, and unless the employee is a valued one, whom the employer would like to keep, often the case is that they will be gradually phased out of the organisation.

In fact, when an employee attains a certain level of experience within an organisation, employers often ask more of them because they know these employees are locked in to their jobs, and have to accept these grudgingly, or risk losing their jobs, which they cannot do if they have dependents and financial commitments.
And you know the irony of it? The mental ill health sufferer already knows that. Which is why they don’t speak out for help in the first place.

If these employees complain, employers simply replace them with younger employees, who cost less, and who are willing to take on more responsibilities just to have a job. Any responsibilities the redundant employee had simply get divided up between his leftover colleagues, who are in turn asked to take on more responsibilities. They are next in line in the mental health illness queue.

And what if you are self employed? And have to work to support yourself and your dependents? The demands of the day to day are huge and don’t seem to go away.

You can see why mental health is  perceived a ticking time bomb. Organisations are not going to change to accommodate their employees because of cost, but keep pressing them to increase productivity without pay, knowing that they cannot say no, and when all the life and juice has been squeezed out of them, they can be chucked away and replaced with the next dispensable employee.

A ticking time bomb.

The financial considerations of investing in medicine and medical research

BBC News reports that a drug that would reduce the risk of HIV infection would result in cost savings of over £1bn over 80 years. Pre-exposure prophylaxis, or Prep, would reduce infection and hence lower the treatment costs for patients in the long term.

The catch? There is one. It’s the long term.

The cost of the treatment and prevention is such that its provision for the first twenty years – bundling together the cost of medical research and production of medicine – would result in a financial loss, and parity would only be achieved after a period of about thirty to forty years; this period is hard to define because it is dependent on what the drug would cost in the future.

Prep combines two anti-HIV drugs, emtricitabine and tenofovir. The medical trials behind it have concluded it has an effective rate of over one in five when it comes to protecting men who have unprotected sex with men from HIV infection. The exact figure is close to 86%.

Prep can be used either on a daily basis, or on what has been termed a sexual event basis – using it for two days before, during and after periods of unprotected sex.

The research model analysed the potential impact of Prep and found that it could reduce infection rates by over a quarter. The cost of the treatment itself, comparative to the cost of treating infection, would result in a saving over one billion pounds over eight years.

However, it does raise a few ethical questions. If the National Health Service is aiming to be a sustainable one – and one of the aims of sustainability is to empower citizens to take responsibility for their own health –  shouldn’t it be considering less about how it will balance the books, but spend more on education for prevention in the first place? The cost of producing Prep on the NHS would be £19.6 billion over 80 years; while the estimated savings from treatment would be £20.6 billion over the same period. Educating people not to have unprotected sex with those at the risk of HIV arguably would result in a higher saving over a lower time period. Perhaps the NHS should consider ways of reducing cost more significantly, rather than latching on to a cheaper prevention drug immediately. If consumer behaviour is not going to change, symptoms are still going to surface, and the provision of Prep on the NHS may only encourage less self-regulation and awareness.

Airbnb style recuperation for hospital patients

Would you welcome a stranger into your home? Would you have a spare room set aside for them? Perhaps not. But what if you were paid to do so? This is what some hospital bosses are considering to relieve overcrowding in hospital wards, that patients do their recuperating in private homes, rather than in the hospital. You offer a room if you have one available, and the hospital rents it from you for a patient. It is like an airbnb for hospitals.

On the face of it, this seems like a good idea. Hospital overcrowding is lessened, home owners get a bit of spare cash, the recuperating patient gets a bit of company … everyone’s happy. Patients staying out of hospitals mean that the backlog of operations can be cleared more quickly, resulting in a better streamlined NHS that benefits every citizen.

This idea is being piloted by the startup CareRooms. “Hosts”, who do not necessarily need to have previous experience in healthcare, could earn £50 a night and up to maximum of £1000 a month putting up local residents who are awaiting discharge from hospital. The pilot will start with 30 patients and the hope is that this will expand.

AgeUK claims that patients were being “marooned” in hospitals, taking up beds while 2.2 million days are lost annually to delayed transfers of care.

The specifics, however, do not seem to hold up to scrutiny. Who is responsible for the overall welfare of the patient? Once a patient is transferred to this “care” home, the responsibility of medical care is devolved to someone with basic first-aid training.

Prospective hosts are also required to heat up three microwave meals each day and supply drinks. Unfortunately it opens the issues of safeguarding, governance and possible financial and emotional abuse of people at their most vulnerable time.

The recuperating patients will “get access to a 24-hour call centre, tele-medical GP and promised GP consultation within four hours.”

The underlying question, though, is would you, though, want your loved ones to be put through this kind of care?

This is cost-cutting at its worst. The NHS is cutting costs, cutting ties and cutting responsibilities for those supposedly under its care. It would be a sad day if this kind of devolved responsibility plan became approved.