Naga Munchetty on women’s pain
BODY TALK AFTER THE LAUGHTER COOKING WITH KIDS
Winter is not a season, it’s a celebration.
Welcome
Winter is a time of rest and beauty. When else can you build snowmen, huddle round a warm fire or wrap up in a blanket to watch TV?
This issue is a mixed bag too with lots of options for a good read. We look at how laughter can help with even the most challenging events in our lives on page 26.
We’ve devoted a chunk of this issue to a hot topic – menopause. Why when we talk about other health issues is it still something a woman will be embarrassed to discuss?
We ask experts how social media is affecting the lives of young people – and what we can do to help.
When most of us are grabbing that blanket and settling down for the evening, district nurse Craig Grant is starting a shift. We went with him and met a couple who say Craig is a lifeline.
While many people returned to a commute after the pandemic, some carried on working from home. Is it heaven or hell? We ask an expert.
There’s a host of ways to stay well and active this winter in our special guide.
Enjoy this issue and have a wonderful winter.
The MC Magazine team.
Anamika Mishra
We followed district nurse Craig on a night shift.
Health worker Amanda (above right) wants more open conversations about menopause both at work and at home.
Sound Silence of
It can happen to anyone, so why aren’t we talking about psychosis? An expert explains why early help is vital – and how to spot the signs.
Imagine seeing or hearing things others can’t – thinking loved ones want to harm you. Or worse. This can be the terrifying, all encompassing reality for the one in ten of us who experience psychosis.
Celebrities like chef Heston Blumenthal, Bridgerton star Ruby Barker and actor David Harewood have all spoken about their psychotic episodes.
Consultant psychiatrist Dr Debbie Marsden from Mersey Care’s Early Intervention team provides intensive support for people aged 14 to 65 experiencing psychosis for the first time.
She’s on a mission to end stigma and misunderstanding about the condition.
“We discuss anxiety and depression quite openly now, which is great. Yet there’s still silence and stigma around psychosis. The term ‘psychotic’ is frequently misused which may lead people to believe that someone is a risk to others when we know they’re more likely to
harm or neglect themselves. Psychosis is common and really can happen to anyone. We want people to know it’s often a normal reaction to abnormal or traumatic life events.
“Experiences feel so real that a person may not realise that they are unwell.”
Someone experiencing psychosis may hear voices, have jumbled thoughts or hallucinations, believe someone is reading their mind or feel they’re being followed or monitored. They may lose touch with reality and struggle to keep up with daily life.
Early diagnosis and treatment is crucial says Debbie. “If we can support someone early to get back to work or college, help them get physically healthier and have good relationships with friends and family, they are less likely to become trapped in a ‘revolving door’ of recurring mental health problems and relapses.”
Alongside prescribing medication and therapies, the team also works with The Life Rooms to offer people with psychosis ways to become less isolated. They can also help with debt or housing issues and signpost to addiction services where needed.
Debbie calls on families and friends to help. “Experiences feel so real that a person may not realise that they are unwell. Friends and family are often the first to notice something is wrong. I’d urge anyone who sees signs of psychosis to get help quickly. With early support the person can get treatment and get back their life.”
Where to get help
Contact your GP or for urgent support go to A&E and ask for the mental health team. You can also contact the Early Intervention team in your area directly.
• Watch films about the team and patients’ recovery journeys.
• Hearing Voices website offers support and advice: hearing voices.org
we all NEED signs to know the
Jo was living with health anxiety after losing four people close to her in a short time.
“I’d recently lost two young friends. Then my close neighbour died in his home without anyone’s knowledge. I was shocked but also upset that I hadn’t been able to help him. Soon after, I was told my mum was dying so I travelled to Australia to be with her in her final days. I was on my own with her when she died.
“I came home, went back to my job as a medical secretary and thought I was doing ok but then the anxiety became extreme and terrifying.”
Jo began having delusions. “I became convinced my neighbours were trying to kill me. I thought workers in the flats where I live were poisoning the pipes, so I wouldn’t shower or drink water from the tap.
“I thought my life was in danger. I couldn’t function.”
“I was sure that there were cameras in my light fittings to record my death and put it on the dark web. I was in a continuous state of heightened alertness thinking my life was in danger. I couldn’t function.”
Jo eventually confided in her manager who helped her get support from the Early Intervention team. She now wants people to be able to recognise the signs in someone.
“Talking about it is hard but psychosis needs to be out in the open. It might save someone’s life.”
Read Charlotte’s story on page 6.
psychosis needs to be out in the open. It might save someone’s life.
Signs of psychosis
Hallucinations - where someone sees, hears, smells, tastes or feels things that do not exist outside their mind.
Delusions - where someone has an unshakeable belief in something that is not true. They may believe an individual or organisation is making plans to hurt or kill them, or that they themselves have power or authority. For example, they may think they’re the president of a country or they have the power to bring people back from the dead.
Confused and muddled thinking - this may include rapid and constant speech, switching from one topic to another mid sentence or a sudden loss in train of thought, which brings an abrupt pause to a conversation or activity.
Source: NHS UK (nhs.uk)
you can back come
Like many women giving birth during COVID, Charlotte felt isolated and anxious. A traumatic birth in restrictive conditions left her debilitated. Exhaustion and depression descended into something even deeper – post partum psychosis.
“I was never a nervous person but I worried a lot about COVID when I found out I was pregnant,” she recalls. “I’d had an easy labour with my daughter but my son’s birth turned into an emergency. I had flashbacks afterwards. His first weeks were far from the joyful times I’d been looking forward to. I couldn’t see my mum. I was so isolated.”
Charlotte felt unsafe outside her home. “I could hear voices talking about how I looked and about me as a mum. I had very dark thoughts. I was at the point of no return – I wanted to die.”
Her health visitor recognised the signs and contacted the Early Intervention team. “They were like a ray of light,” she says. “Looking back, I was one step away from taking my own life, but I was also one step away from help.
“I had very dark thoughts. I was at the point of no return.”
“If only more people realised how much help is out there and how it is possible to get your life back on track. Before I became ill, I would have said that psychosis was caused by drugs or by homelessness. But if it can happen to me, it can happen to anyone.”
Looking back I was one step away from taking my own life … but I was also one step away from help.
Heston
shines a light
Celebrity chef Heston Blumenthal has told of his ‘tornado’ of intensifying mood swings, hallucinations, paranoia and suicidal thoughts when he was diagnosed with psychosis.
He feels sleeping just two hours a night damaged his mental wellbeing. “Since my diagnosis I’ve learned a lot more about myself ... I’m hoping that talking about it can change the way we see the condition and put it in the spotlight for all the right reasons.”
Charlotte developed psychosis after the birth of her son.
As twilight falls, work is just beginning for the NHS night nurse. Jo Fairclough witnesses these beacons of light that shine bright in the darkness.
We’ll always respond to someone who needs our help… We have to be ready, adapt and go where we’re needed.
8.30pm: It’s pitch black outside. Streets are deserted, curtains are drawn but the out of hours district nurses are gearing up for a busy shift.
Craig Grant and his team have appointments planned throughout the night and already a dozen extra calls have come in from patients or concerned relatives.
9.00pm: Calls are scheduled for through the night and into the next morning. Craig and his colleagues have come to expect the unexpected.
“Every shift is different. We have to be ready, adapt and go where we’re needed.”
9.15pm: A few minutes later
Craig sets off into the night to his first call in Southport. It’s a familiar journey for him. He’s been supporting patient Brenda and her husband Arthur for more than a year after Brenda injured her leg. Tonight she needs help for a large wound which hasn’t yet healed.
Arthur, Brenda’s husband of 58 years, opens the door. Relief is written across his face. The couple greet Craig like an old friend, their anxiety has visibly reduced with our arrival.
It’s 10pm and Craig prepares to move on to his next call. There’s an eeriness about the deserted streets, a sense of uncertainty at what the night shift holds. I wonder if he ever feels isolated, so I ask.
Born to Care
I was a carer for my mum. She died when I was 15. At first I wanted a career in catering but I was drawn to caring for people.
2000
Craig checks Brenda’s wound, redresses it and reassures her that all is well. As he stands up, she looks at him, reaches out and takes his hand, holding on in gratitude. Being with them in the room, the strong bond between patient and nurse is clear.
“He’s almost like a grandson to us,” says Brenda. “The nurses know everything about us. We don’t have to explain and nothing is too much trouble. It’s a huge relief and peace of mind to know they are always at the end of the phone.”
“I love how my care makes an immediate difference to people. This
job is everything nursing is about.”
“You know I never actually feel alone,” he says without hesitation.
“We have such a good, experienced team just a phone call away and the out of hours GPs are a huge support too. I enjoy the responsibility of making decisions and I love how my care makes an immediate difference to people. This job is everything nursing is about - compassion, sensitivity and kindness to people when they’re at their most vulnerable.”
My shift is over. Craig’s has just begun. I thank him for giving me a glimpse into his world. We say our goodbyes, he disappears into the shadows - and I truly understand how Brenda and Arthur feel.
As a young carer, Craig’s GCSEs were disrupted. After school he chose to go to catering college.
2003 to 2007
Drawn to a caring role, he worked full time in a hospice while studying NVQ L2 and 3 in Health and Social Care.
2010
Graduated from Edge Hill University in Adult Nursing (diploma).
Worked as a registered nurse in a care home.
2011
Became an out of hours district nurse in Manchester.
2012
Joined out of hours district nursing team in Southport.
2024
Promoted to team coordinator.
A smile on arrival sets Brenda at ease.
Craig enjoys knowing his care is making a difference.
The touch of a hand shows the close bond between nurse and patient.
BodY Talk
Social media is a huge part of growing up. But what’s the cost to children’s mental health? We ask experts and hear real stories.
Six out of ten girls say they feel consumed by negative thoughts about how they look. Eight out of ten feel too much pressure from the media.* Body image issues among young people are escalating – what can we do to help?
Mersey Care’s School Health team supports young people with body image issues. They’ve created a six week programme offering one to one support for pupils who they feel need help. The sessions help young people understand how external influences like social media and diet culture affect their view of themselves and teach them life long skills to challenge harmful ideas. Workforce Development and Education Lead, Georgia
Bagnell says supporting children early can prevent more serious problems later.
“we all need to empower the next generation to love the skin they’re in.”
“We know pressures on appearance affect someone’s mental health and wellbeing. Occasional insecurities are normal but a high level of dissatisfaction with how you look can lead to long lasting problems like eating disorders and drug use. Adults can help by not criticising their own appearance around young people – we all need to empower the next generation to love the skin they’re in.”
Look out for:
• Changes in behaviour or avoiding activities like PE
• A child avoiding time with friends or family to be alone
• Changes in eating habits
• Wearing different types of clothing and covering up their body
• Comparing themselves to others.
How to help – Georgia’s tips:
• Avoid talking about weight and diets
• Don’t put emphasis on lookscelebrate their achievements and personality
• Monitor social media time and unfollow negative accounts
• Don’t label food as ‘good’ and ‘bad’ – try using ‘fun food.’
Lexie is 13, chatty and full of fun. She has glowing skin, glossy hair and an infectious grin. Yet she’s not always confident about her appearance.
Lexie’s friends look out for each other and she’s bolstered by support from her family. But she still feels the pressure both online and in real life.
“I’ve seen videos on TikTok and Snapchat where kids as young as seven are posting make up and skin care routines.
”Everyone airbrushes or puts filters on their photos, so you feel like you should do the same.”
“My dad says, ‘Why would you want to look like someone else? Don’t follow the crowd, be yourself.’ But sometimes people call you names and it gets to you. I try to ignore it but sometimes I can’t.”
A survey in Lexie’s school as part of the Healthy Child Progamme highlighted her worries. With support from the School Health team, she’s learned to think more positively about herself and has helped them develop a body image intervention programme to help other young people struggling with the same issues.
Lexie shares a smile. “I still feel pressure sometimes, but I’ve learnt how to deal with it much better.”
*Source: Girlguiding Survey 2023/2024
“I’ve seen seven year olds posting make up and skin care routines online.”
What girls say
Every year the Girlguiding organisation asks over 2,500 girls and young women aged 7 to 21 how they feel about their everyday lives.
Lexie, 13 Find out more Mersey Care School Health Service: merseycare.nhs.uk bebodypositive.org.uk
Young Minds website offers advice on how to have a positive time online. Understanding your social media feed, blocking or reporting accounts and dealing with online bullying are among the topics covered.
youngminds.org.uk
Young Minds: youngminds.org.uk 36% feel pressure to use filters on social media knew girls their age who had experienced anxiety, self harm, depression or an eating disorder 85%
Beat Eating Disorders charity: beateatingdisorders.org.uk
anyone can be a role model
It’s not just family members who can act as a role model. Jason recalls how a member of his team supported a 17 year old patient, Daniel (not his real name) who struggled with his emotions.
“Daniel would become aggressive when things didn’t go his way. He was scathing towards his mum and grandma and struggled with friendships. He’d spend most of his time alone and would often go down the YouTube ‘rabbit hole’ on websites where violence was the norm.”
Mental health practitioner Gary McCluskey was asked to help. Jason explains, “Gary spent time building a connection with Daniel. He’d talk about how he felt when
he was Daniel’s age. Gary listened to him and then gently guided him to a way of thinking where he was able to consider things from other people’s point of view. He helped Daniel understand that there are other ways for men to behave.
“He helped Daniel understand that there are other ways for men to behave.”
“Daniel’s now gained confidence in himself and has social skills he didn’t have before. He’s back in college and his family say he’s much more respectful and outgoing.”
In her book From Boys to Men, author and parenting expert Maggie Dent empowers parents to stay calm as they help boys progress through adolescence. Topics include communicating to defuse conflict, help them to cope with and recover from loss and failure, foster healthy relationships and navigate the digital world.
Published by Pan Macmillan Australia.
Who can boys turn to as they become men? We look at the influence of social media on young men’s identity and talk to an expert about the importance of positive male role models.
Social media is king for both sexes. But research suggests boys without a positive real life role model can find online versions where aggression and violence is the ‘norm.’
While opinion is divided on whether focusing on male role models could downplay the contribution of women in a boy’s life, the overall view is that young people value respect, trust and consistency. They need to know someone is commited and cares about them.*
Clinical psychologist Jason Poole supports young men with emotional issues.
“I see so many boys struggling to discover what kind of man they could be,” says Jason. “If they’re lacking in confidence, social media
can appear to offer all the answers but sites that glorify aggression, emotional distance and disrespect as ‘manly’ can become their influence.
“Boys can be ashamed to talk about what they really want and need.”
“Boys can also be victims of what’s known as toxic masculinity - they can be anxious about what other men will think of them. It can make them ashamed to talk about what they really want and need.”
Jason says it’s important for parents and carers to take notice. “The reality is that by the time a child is 15, parents and carers don’t have a huge amount of
Model behaviour
Former US president Barack Obama’s book, Dreams of My Father, describes his feeling of loss and isolation as he journeyed through adulthood as a young black American. Central to his story is his maternal grandfather Stanley Dunham, who he lived with from the age of ten.
“I am a black man who grew up without a father and I know the cost I paid for that. And I also know I have the capacity to break that cycle and, as a consequence, I think my daughters are better off.”
Former US president Barack Obama (pictured with his wife and daughter) was influenced by his grandfather.
If you’re concerned about a young person, let their school or college know. More advice can also be found at:
Future Men: futuremen.org MIND: mind.org
influence on them. The big question is ‘do you know who does?’ It’s important to keep a connection with them even if you don’t get much back at first. If you notice someone who you care about talking in derogatory ways about women, that person needs your support. They need to understand that this is an unacceptable and unkind way to think or talk about another human being but that you still care and love them.
“They need to know you are there for them, no matter what.”
*open.edu/openlearn/educationdevelopment/working-youngpeople/do-boys-need-male-rolemodels
Ways
to
help
– Jason’s tips:
• Ask which accounts they’re following and watch with them. Encourage a discussion but don’t lecture
• Interest in media encouraging ‘toxic’ behaviour is often because of social anxiety or body image issues. Try to resolve their concerns and improve their self confidence by helping them join a club or a gym
• Let their school or college know you are concerned. These ideas are often an issue involving a group of classmates.
let’s shout about
menopause
It’s a hotly debated media topic but it’s clear that women need more practical support. How can we all change how we deal with ‘The Change’?
Almost a million women left their job last year because of the impact of menopause on their health and one in four women say severe symptoms affect them every day.*
The Government’s new Menopause Employment Ambassador, broadcaster and TV presenter, Mariella Frostrup, launched the ‘Menopause Mandate’ in 2022 as a platform for women to share their experiences. “We have been absolutely inundated – it’s clear there is a general lack of understanding about women’s biological journey which is so different from men’s. We need a seismic shift in the workplace. Until that’s done, we’re basically throwing money and
opportunities away with all these amazing women, at the peak of their professional abilities, migrating from the workforce.”
“Women need to know they are safe to speak boldly about menopause.”
Forward thinking employers across the UK are taking action. “Change can come with conversation. Women need to know they are safe to speak boldly about menopause and the people around them need to have the confidence to ask what support they need,” says Katie Derrick from Mersey Care’s Occupational Health
and Wellbeing service. “Women don’t feel they can talk about how they’re feeling because generations before have ‘just got on with it’. We need to crack the cycle and try to understand and destigmatise this completely natural stage of life.
TV presenter and menopause ambassador Mariella Frostrup
Help to grow
A government menopause resources hub offers free resources to employers wanting to support their staff.
Visit: helptogrow. campaign.gov.uk
An internal renovation – the superpower of menopause
Sources:
*NHS England - nhs.uk
GOV.UK - gov.uk
How you can help yourself
“There’s a huge health inequality and pressure on women at a time when other life events are also taking their toll. Children leaving home and caring responsibilities for grandchildren or ageing parents can mean a woman’s entire identity is in flux – all while they are physically and mentally drained. Women should be able to talk openly with their manager, colleague or anyone else without losing credibility or feeling embarrassed about a problem that’s seriously affecting their life.
“If we’re honest, most people dance around the subject because we’re worried about causing offence. As the culture around menopause evolves, we’re educating managers at Mersey Care making sure they’re familiar with our menopause policy and encouraging them to offer flexible hours, lightweight uniforms and simple but important things like fans or fresh air.
“We run information sessions specifically for men so they can support their colleagues in work and their family members at home. Having understanding will bring compassion and open the door to conversations. It’s the only way forward.”
A nutritious diet, regular exercise and staying hydrated can all make a difference.
• Aim for a good sleep routine. Reduce light and background noise (white noise might help). Changing your bedding or cooling gels may help maintain the right temperature
• Try to reduce stress. For example, the Headspace app is just £10 per month or free for NHS staff. Talking about how you’re feeling can help. Try not to feel a need to keep things secret –this can make anxiety worse
• Check your workplace’s menopause policy and the support on offer. This might include flexible or hybrid working, time to take regular breaks outside, access to drinks, support with writing things down or recording meetings
• Menopause cafes have been set up across the country as places where women are encouraged to talk about how they’re feeling. To find your nearest venue visit: www. menopausecafe.net
After the challenges, there is – it seems - an upside to menopause. Neurology professor Lisa Mosconi says once the brain’s links to the ovaries are no longer needed, it rewires. This brings emotional stability, calmness and contentment.
In her book The Menopause Brain, Mosconi reveals that the emotion centre of the brain becomes less reactive to negative or upsetting things after menopause.
“Many postmenopausal women all over the world report feeling more self confident, at greater peace with themselves and more comfortable in their own skin than they were before.”
As well as inner peace, menopause is thought to boost crucial life skills. Scientists say compassion and empathy are enhanced during this biological transition, improving relationships and reducing the chances of loneliness in older age. Looks like there’s plenty to look forward to besides no more periods!
www.frontiersin.org
Mersey Care is seeking people to become menopause ‘experts by experience’ and menopause champions.
Contact: wellbeinghub@ merseycare.nhs.uk
If you’re living or working with women, you need to understand and have the conversation.
What can I tell the family?
Right this second more than 15 million women are on a journey through menopause. We look at the impact on relationships and talk to a woman spreading the word to younger generations.
Menopause can impact our most precious relationships. Partners and children can struggle to understand what’s happening - 7 in 10 women surveyed by The Family Law Menopause Project blame the menopause for the breakdown of their marriage.
“It’s a tough ride,” says health worker Amanda Bennett. The worst thing is you don’t know when it’s going to end.”
“I felt like the light inside me had gone out, The vibrant girl I used to be has gone and I feel at times like I’m just existing.”
As well as working two jobs, Amanda helps look after her grandchildren and she feels the pressure to just ‘carry on’. “You pull your socks up and just absorb stuff. But you’re dealing with all these symptoms that amplify other parts of your life – relationships, bills, kids. You get overwhelmed very quickly.”
She’s resolute that younger women are well informed so they’re better prepared.
“If you’re living or working with women, you need to understand and have the conversation. I’d been judging myself harshly. Women are suffering alone and for no reason because there is help out there.”
Positive thinking, meditation and mindfulness have helped Amanda cope. “I try to work on myself and remember what I’m grateful for. It takes practice but it does work.” Her sister Sharon (pictured above right with Amanda) can empathise both as a sibling and expert by
experience. Both women have had hysterectomies and grieve for their past selves, yet they are a source of mutual support.
“I can see a change in Amanda,” says Sharon. “She’s lost her spark. But she’s still beautiful and I tell her that all the time.”
What can we do to help?
• Ask how they feel
• Take their lead – not everyone wants to talk
• Let them know you understand and want to help
• Almost half of women lose their libido. Show love and care in different ways
• Find sources of help, like menopause cafes
• Encourage the person to go out for walks and go with them.
Go to: My Menopause Centre for a wealth of easy access advice and support mymenopausecentre.com
Sisters are doin’ it for themselves
Health worker Amanda Bennett (left) talks menopause openly with sister Sharon. She’s resolute that younger women are informed and prepared.
Talking to children
It’s not easy to explain things that you don’t fully understand yourself but be honest and say that there’s a reason why you’re teary, cranky, flushed or not yourself. Knowing it isn’t because of them will often be enough and help them relate. It will be a relief for you to be honest and feel understood during those moments.
What are the symptoms?
Over 50 recognised symptoms means that everyone’s story is completely individual. A current research project by the University of Liverpool is investigating how menopause symptoms and risk factors can vary depending on women’s ethnicity.
You may have noticed some without realising they could be connected to menopause - fatigue, insomnia, hair thinning or growing in new places, dry skin, oily skin,
No one warns you about the emotional roller coaster … you think you’re going mad.”
Actor
Emma Thompson.
dry eyes, pins and needles, tinnitus, muscle aches, joint pain, palpitations, bloating and weight gain. No wonder other signs of menopause can include low self esteem, anxiety and panic disorders.
For a full list of symptoms visit The Menopause Charity symptom checker: www.themenopausecharity.org
Get the most from your GP
Dealing with these symptoms can make life harder and your GP can help. The Menopause Charity advises the following to get the most out of your appointment:
• When you make the appointment ask if there’s a person with a particular interest in menopause at the surgery
• Book a double appointment to give yourself time to discuss your concerns
• Look at the symptoms list and write down which ones you’re experiencing
• Make a note of changes to your periods
• Bring a list of your current medication, including supplements
• Jot down worries or concerns so you don’t forget to mention them
• If you’re feeling anxious, bring someone with you for moral support.
“I was bewildered by what was happening to me. Nobody was talking about menopause. I left work because I thought work was the problem but my sense of identity was tied up with my status. I was spiralling.”
Karen Arthur, broadcaster, author and menopause diversity campaigner.
guidelines
NICE guidelines recommend a review three months after your first appointment but go back sooner if you notice side effects or if the treatment doesn’t seem to be working.
get help
mymenopausecentre.com themenopausecharity.org
wellbeingofwomen.org.uk menopausemandate.com nhs.uk/conditions/menopause henpicked.net daisynetwork.org
menopausewhilstblack.com
@menopausewhilstblack
@BLKMenopause
@Blackwomenmenopause
IT’s probably nothing
Journalist Naga Munchetty’s new book asks why women’s pain is dismissed as normal. In an exclusive Q and A with MC Magazine, she talks frankly about her own pain, what needs to change and how women can advocate for themselves.
MC: What sparked your interest in the topic of women and pain?
NM: For years my periods involved passing out, throwing up, extreme fatigue, and excessive painkiller consumption. I wasn’t asked the right questions by health care professionals and was just told it was normal.
Women’s pain has been dismissed for so long. It’s almost as if we’re made for pain because we are ‘designed’ to give birth. There’s a feeling that if we can put up with that, we should be able to put up with everything else. It’s total nonsense.
It was a piece by columnist Caitlin Moran on coil insertion that really got me thinking about women and pain. I remember ranting at work about my own coil fitting. There was silence and I thought I’d gone too far, but they said, ‘No, you have to tell this story’.
MC: Why did you decide to write a book?
NM: Journalists are not usually the subject of the story, but when I publicly shared my coil experience and pain from adenomyosis,* the response was incredible. I realised just how many women are affected. The noise we created back then meant that the adenomyosis reference on the NHS website was updated from a single link to hysterectomy to more detailed information.
It made me wonder why so many women are dismissed and left undiagnosed for common conditions, often being told they’re overdramatic or hysterical. Once you realise it’s happening, you
can’t unsee it and the more I talk about it, the more people share their struggles.
MC: Isn’t it true that women seek help more quickly than men?
NM: I don’t believe that women are more likely to seek help. When a woman goes to see a doctor, it could have been weeks or months since her symptoms began, because women are often so busy and often prioritise others over their own health.
I think there’s a perception that when men go to the doctors, they need to be taken seriously because they’re so reluctant to ask for help generally. Women don’t necessarily talk about their pain; they don’t want to waste anyone’s time.
Statistics may show that women visit their GP more often than men, but maybe it’s because more things are going wrong in their bodies.
MC: Why don’t doctors help more?
NM: Health care professionals do want to make things better for their patients but often don’t have the time, information, resources or tools to make that happen. As a result, women are told there’s nothing wrong, that nothing can be done, or that their pain is normal. Women know when something is wrong but they’re often left not knowing where to turn. I’ve spoken to women who were made to feel like their lifestyle was to blame for their problems, which just isn’t right.
I want to emphasise that pain is not normal. Our bodies are not designed for pain and anything that negatively impacts our day to day lives is not normal.
MC: What should happen?
NM: Pain needs to be validated and recognised. Being told that there is a problem can actually
be one of the most reassuring things for someone because the perception of pain as standard is hurtful. People’s experience of their own bodies is unique and individual, and the attitude that women are hysterical and weak needs to change.
If a solution hasn’t been found after your first consultation or you don’t believe the doctor is properly hearing you, you should ask for a second opinion. Keep asking and don’t worry about ‘wasting’ anyone’s time. We put more pressure on the health care system by using it when we’re even more ill, so it’s beneficial for medical professionals to treat us better and sooner.
Your appointment with a doctor has to be a collaboration. Doctors don’t have all the answers. We need to take responsibility for understanding what is abnormal for us and be able to articulate that well. Doctors may have a medical background, but we are the experts of our own bodies.
We need to go in armed with information so the doctor can find an answer more quickly. But no one is taught how to do this and that’s a big problem.
MC: What do you want from the book publication?
NM: To become informed we need the right tools, knowledge and information. We need to have fewer stories where women have been in pain, dismissed and frustrated, unable to live the life they deserve. I hope the book will go some way to helping women advocate for themselves. Things need to change because when women are healthy and they’re able to be their best selves, it will benefit all of us.
*Adenomyosis is a condition where the lining of the womb (uterus) starts growing into the muscle in the wall of the womb.
Source: NHS (nhs.uk)
Naga Munchetty’s book includes an interview with Dr Chris Barker who leads Mersey Care’s pain management service.
According to the British Medical Journal, around 28 million adults in the UK live with chronic pain. The pain management service has developed a suite of videos to raise awareness about how they help reduce the impact of living with persistent pain.
View them here.
Naga Munchetty is best known for presenting BBC television’s Breakfast show.
It’s Probably Nothing by Naga Munchetty publishes in May 2025 (Harper NonFiction, £22)
SouL soup
Is there anything more warming on a cold winter’s day than a bowl of home made soup?
Dietitian Amy Wilkinson thinks not. Her hearty lentil and vegetable soup is tasty and packed with the fibre and vitamins we need during winter months.
“You can use whatever you have handy”, says Amy, a community dietitian in Knowsley.
“If you have children, it’s a great family activity.”
“If you have children, it’s a great family activity. Mine love to get involved in measuring out ingredients and chopping vegetables. Kids enjoy eating food they’ve helped to cook and it helps them develop good eating habits as they get older.”
stay well feel great
Amy’s hearty lentil and vegetable soup
Prepare: 15 minutes
Cook: 30 minutes
Serves 4
Ingredients
• 1 large onion, chopped
• 4 carrots, chopped
• 1 red pepper, deseeded and chopped
• 900ml reduced salt vegetable stock
• 50g dried red lentils
• Quarter teaspoon ground ginger (optional)
• 4 tablespoons low fat natural yoghurt (optional)
• Pinch of ground black pepper.
1. Put the carrots, onion, red pepper, lentils and ginger (if using) into a large pan. Add the stock and bring to the boil. Once boiling, reduce the heat and simmer, partially covered, until the vegetables and lentils are tender (about 25 mins).
2. Blend the soup using a hand held stick blender to the consistency you prefer. Or you can use a liquidiser or food processor if you have one. Season to taste with pepper.
3. Ladle the soup into four bowls and swirl the yoghurt on top (optional). Garnish with extra black pepper and chopped chives if using and serve!
Save
money and time
Double up on the ingredients and you’ve made two meals in one. Once cool, the soup can be kept in in the fridge for up to three days or frozen for up to three months.
Amy’s tip
To save money, replace the pepper with 500g of carrots or add potatoes, tomatoes, sweet potato or butternut squash.
To serve
• 2 teaspoons fresh chives (optional)
• 4 wholemeal bread rolls (Amy uses pitta bread cut into shapes with a cookie cutter).
Proof of the pudding
It’s proven that cooking with kids sets them up for a healthy life. A Cambridge University study showed pre-schoolers with a balanced, healthy diet are less likely to be obese.
In Knowsley family cookery sessions show children how healthy ingredients can be made into tasty food. Manager Joanne Cotter says as well as developing culinary skills, the sessions will help children know how to include healthy food in their diet.
“Cooking together is fun and gives you quality time. Children enjoy activities so learn how to choose well.”
Dietitian Amy agrees, “My son Bobby loves ‘hiding’ the vegetables by making them into soup. He’s always asking when we can do it again!”
Bite size chunks
CBeebies experts advise talking about food texture and counting ingredients to grab a child’s attention
CBeebies:bbc.co.uk
Kids Fruit website says peer pressure can be positive –get together with families and have them round for tea. Their website has a fruit and vegetable alphabet game. Kidsfruit.org
Amy’s food tips:
• Give your child what you’re eating
• Make food colourful and appealing
• Eat together so they see you enjoying food
• Offer small portions and praise your child for eating even a small amount
• If they refuse food don’t force the issue, try again another time
• Try to involve children in the planning and preparation of healthy snacks and meals.
For more family friendly recipes visit nhs.uk/ healthier-families
Buddy up
Jamie Oliver is synonymous with kids and healthy eating. Now youngest son Buddy (above with Jamie) fronts a BBC TV series, ‘Cooking Buddies’.
“We underestimate our kids’ abilities,” says Jamie. “They often do so well when we give them responsibility. But remember there will be more mess than usual! Your child is not an adult, so cut them a bit of slack.”
Youtube.com/ CookingBuddies
The power Rest of
should we follow animals and hibernate in winter? In her best selling book Wintering –the power of rest and retreat in difficult times, author Katherine May says slowing down is ok.
“Plants and animals don’t fight the winter,” she says. “They prepare. They adapt.”
May sees winter as both a season and a time in life when we feel out in the cold. Reflections on her own experiences mingle with an appreciation of nature’s coping strategies.
How to think about rest
• See resting as healing your mind and body
• Think about nature as a reminder that nothing lasts forever, including pain, loss or hardship. By tuning into nature’s rhythms we can navigate life’s ups and downs with grace and patience
• Treat yourself with kindness and give yourself permission to rest.
Wintering - the power of rest and retreat in difficult times is available in bookstores and eBooks.
Five things to do indoors during winter
• Have friends round for a night in
• Watch a favourite film or TV show under a blanket
• Start a book you’ve been meaning to read
• Put soft, clean sheets on the bed and go to bed early
• Put bird feeders outside where you can see from a window.
Why do we love hot chocolate?
It could be because cocoa contains theobromine which releases our ‘happy chemical’, serotonin. It’s not just in your head though, the feeling is real. Holding a warm mug enhances blood flow which makes you feel more relaxed. It’s a chance to indulge in a little self care.
hug Mug in a
Five a day
As winter sets in we’ve put together ways to enjoy, rather than plough through it. Take your pick or give them a go one at a time. Remember – you’re doing the best you can!
Need a shot of comfort? Visit these hot chocolate hot spots:
• Ropes and Twines in Liverpool use chocolate made on site: ropesandtwineslpl.co.uk
• Mother Espresso’s hot chocolate contains only cacao and raw cane sugar, so it’s vegan, gluten, dairy and soya free: motherespresso.co.uk
• Bean There Coffee Shop on Smithdown Road is renowned for dark and white varieties: beantherecoffeeshop.com
• Boutique Chocolaterie in Southport has its own hot chocolate lounge. rsfinechocolate.com
• Toast Coffee House is a little piece of Paris in St Helens. toast-cafe.co.uk
Honey, lemon and ginger jar
This warming winter brew is also a natural way to soothe symptoms of cold and flu. Local honey will contain more antibiotic properties than supermarket options.
Slice an inch of fresh ginger and two unwaxed lemons (remove the seeds). Add alternate layers of lemon, ginger and honey into a 500ml glass jar until full. Firmly secure the lid and marinate in a fridge for 12 hours. Add a spoonful of the mixture to a mug of hot water. (Keep in the fridge and use within one month).
Wrap up and embrace winter
Five of the best for Vitamin D
Vitamin D is known as the ‘sunshine’ vitamin because we absorb it from the sun’s rays. With less sunshine about, you can get your daily dose through supplements from your pharmacy or supermarket or through certain foods.
Oily fish such as salmon, sardines and mackerel
Liver (avoid if you are pregnant)
Red meat
Adults and children over four should consider taking a 10 microgram Vitamin D supplement in autumn and winter. Source: NHS (nhs.uk)
Five tips for staying positive in winter
Egg yolks
Fortified foods such as some fat spreads and breakfast cereals
Don’t suffer in silence, we all struggle at times. Don’t be scared to ask for help if you need it.
Call 116 123 to talk to the Samaritans.
Text SHOUT to 85258 to contact the Shout helpline (or text YM to 85258 if you’re under 19).
If you’re under 19 you can call Childline on 0800 1111 The number will not appear on your phone bill.
Call 111 or ask your GP for an appointment. If you feel you, or someone you know, has a mental health emergency call 111 and ask for the mental health option. You won’t be wasting anyone’s time.
1 2 3 4 5
Get as much natural light as you can - it will regulate your sleep.
Go for a walk - coming back to a warm house feels good.
Be whimsical - fairy lights add winter sparkle indoors or outside.
Bring out your winter woollies so you feel ready to embrace the weather.
Keep in touch - phone friends and family for a chat.
you’ve got to laugh
I don’t dance, I haven’t danced, I can’t dance, I can’t see the dancing I will have to do. WHAT COULD POSSIBLY GO WRONG?
Liverpool comedian Chris McCausland became a national treasure when he swapped punchlines for paso dobles in BBC’s Strictly Come Dancing in 2024. But pundits credited his success as much to his dry humour as his ability to dance despite being totally blind. We look at the power of laughter – no sequins required.
Chris McCausland’s opening gambit, “I don’t dance, I haven’t danced, I can’t dance, I can’t see the dancing I will have to do. What can possibly go wrong?” had the nation laughing with him.
British Heart Foundation research says laughter in the face of adversity is good for you. Endorphins – feelgood hormones – reduce stress. A hearty chuckle lowers blood pressure while a giggle boosts your immune system – laughter can even burn calories!
“It’s important that a smile isn’t masking how we really feel.”
But how easy is it to crack a genuine smile? Sheldon Rodrigues, Senior Psychological Wellbeing
Practitioner for Talking Therapies, says the key is finding the joy in life.
“It’s important that a smile isn’t masking how we really feel – it’s got to be meaningful. During times of hardship or loss it’s hard to smile. But our thoughts, feelings and behaviour are all connected and we can change how we feel. By making time for ourselves and doing things we enjoy, we will start to feel happier and laugh more.
“Start by working out what makes you feel happy and make a point of adding it back into your life. You’ll reap the benefits.”
Comedian and Strictly Come Dancing finalist Chris McCausland’s dry humour was as popular with viewers as his dancing skills.
Chris’s Climb
Chris McCausland never planned on becoming a comedian until sight loss forced him to give up his job as a web designer. As the world got more blurred, he struggled to cope. "I was very self conscious. I hated using a white stick. I was very slow coming to terms with it.
Unemployed and ‘a little bit depressed’, he dared himself to do an online course in comedy and an open mic set. He’s since appeared on TV and radio – now he’s earned his dancing stripes and a place in the nation’s heart.
Let the laughter in
• University of Derby research used ‘laughies’ (recordings of someone’s own laughter) to make participants laugh. Three minutes was enough to induce good vibes.
• Funny videos on social media or TV comedy shows are a surefire way of inducing a chuckle.
Did you know?
A child laughs 300 times a day on average, adults laugh just four times.
balancing act
The COVID cultural shift to working from home was short term for many. But what about those who never went back? Is WFH heaven or hell? We asked an expert what people are saying – and how to stay balanced.
“Most of us went to working from home almost overnight during COVID. We had no choice but to adjust,” says Phoebe Fothergill, Senior Employment Advisor at Talking Therapies Liverpool (pictured).
“It’s in our nature to adapt but leaving your comfort zone again after four years can heighten
anxiety – it can feel like your first day again and you might envy those who work from home.”
On the other hand, what may have once felt like a novelty - home made lunches, more control over childcare, no commute - is not the Utopia it appears.
“I try to surround myself in nature or go for a walk to ground myself.”
In surveys, 8 out of 10 workers said working from home had negatively impacted their mental health. Not being able to leave work behind,
especially if you work with technology, can be a challenge. We fall victim to overworking ourselves and can often feel isolated.
Finding the right balance between working remotely and maintaining a healthy work life balance is key. Phoebe follows her own advice to take breaks and remind herself what’s real.
“If I feel anxious, I might listen to music or a podcast during breaks,” she explains.
“I try to surround myself in nature or go for a walk to ground myself.
“You’re not alone and there are many ways your employer can help make reasonable adjustments to ease your anxieties. We’re also creatures of habit. The more we do something, we’ll build it into our routine and it will get more manageable. If you’re really struggling, speak to your line manager or a colleague. You can also talk to us at Talking Therapies.”
“I like to come in on days when I know my colleagues or friends are in – it’s a good chance to connect.”
NHS worker Pat McGuinness.
The Challenges
“More than a third (36 per cent) of home workers feel as though they always have to be at their computer to respond quickly… while 34 per cent say that it has placed a strain on relationships within the household with both partners and children.”
Nuffield Health.
Sources: Mental health impact of remote working | Nuffield Health How to Manage Anxiety About Going Back to the Office | Psychology Today
1. Deep breathing – try the lion’s breath (breathe in and exhale with force and sound), abdominal breathing (use your diaphragm muscle to control and focus on your breathing) or alternative nostril breathing.
2. Plan for your journey to work and arrange to meet a colleague when you arrive.
3. Pick up the phone. Hearing someone’s voice can be just as powerful a connection as seeing them, so if you’re feeling under pressure to maintain your physical appearance on camera, phone for a chat instead.
4. Tell colleagues when you’re taking a break so their expectations of a response are managed, and you can leave without worrying.
5. Create headspace to unwind. Mark the end of the working day by shutting down your laptop, switching off your work phone or closing the door on the room where you’ve been working. If you do need to check in later, keep it short.
Talking Therapies employment service supports existing clients who have employment needs.
For more visit: merseycare.nhs. uk/talking-therapies
Employment Advisor Phoebe follows her own advice to take breaks and remind herself what’s real.
set me up for the
Navy life NHS
Gina Ben Salem’s career has taken her from war zone to ward as a hospital phlebotomist. She’s living proof that skills learned in the armed forces are a perfect match for a career in the NHS.
As a child Gina was inspired by her grandfather, Theodore, a naval diver. “It was a challenge for girls who wanted to join the forces but my grandad, who was my hero, convinced me women can do anything a man can.”
Theodore was a talent in his own right. His record for underwater pipe laying still stands. Sadly, he also suffered torture as a prisoner of war and Gina’s early ambitions to follow him were halted by her dad who feared for his daughter’s safety.
She became an apprentice hairdresser and worked in clothes shops. But aged 30 with three young children, Gina saw an advert for naval reservists. She joined and trained as a phlebotomist.
In 2003, she and a friend were the first Wrens to be deployed to the front line between Kuwait and Iraq.
“I learnt to stay cool in stressful situations.”
“I was elated yet fearful for my family, knowing I was in a war zone. I know they suffered, but I was so proud to be a forerunner for women. It wasn’t easy, you had to forget you were female, but I had the greatest respect for the guys I worked alongside.
The communication skills and resilience, so vital in a war zone, have since proved crucial in Gina’s NHS role.
“Panic is not an option in the forces and I learnt to stay cool in stressful situations. My patients have told me that my calmness puts them at ease. I’ve trained the rest of my team in emergency life saving skills.
“Naval life taught me how important it is to work for the greater good, to motivate your team and pass on your strengths. You learn a lot about self respect. I’m proud of what I can bring to the NHS – I know my grandfather would be too.”
Interview guaranteed
Ex armed forces staff and reservists are guaranteed an interview at Mersey Care. Ann Hanlon, Assistant Director for Carer Engagement, says, “We recognise the skills reservists and people who have served in the forces bring. We want to make it as easy as possible for them to find a role with us.”
For information about how Mersey Care supports applications from former armed forces personnel, visit merseycare.nhs.uk/armedforces-application-support
Further support
www.poppyfactory.org Career Transition Partnership - GOV.UK militarystepinto health.nhs.uk
Find out more about the support available scan here
Mersey Care welcomes applications from former members of the armed forces and our workforce includes many who have previous experience serving in the army, navy or air force. The Ministry of Defence has awarded Mersey Care Gold in the Defence Employer Recognition Scheme (ERS), given to organisations who employ and support people serving or who have served in the armed forces and their families. Join us. Visit: merseycare.nhs.uk and search current vacancies.
“I learnt the power of teamwork from my time in the military.”
NHS phlebotomist Gina Ben Salem Deep Dive
1975 to 1984
Hairdressing apprentice, factory worker and sales assistant.
1993
Qualified as phlebotomist.
2024
1987
Saw an advert for reservists and joined the Royal Navy to be a diver then transferred to Medics Corp to train as medical assistant.
2003
Deployed to Iraq, serving on the front line. Continued as a phlebotomist while on reserve for the Navy. Full time phlebotomist at a Mersey Care walk-in centre.
The
unlikely
pharmacist
Pharmacist Shahbaz Ashraf is at the forefront of a digital revolution in mental health medicines.
He tells of his unconventional career path and how data is the key to improving our health and our lives.
I
’m not how you’d imagine a pharmacist, I don’t wear a white coat or dispense medicine over the counter. As a digital pharmacist, I look after computer systems and medicines data to offer every patient the safest and most effective combination for them. It’s a complex puzzle and pharmacists are the experts in solving it.
I came into pharmacy late – I was 33. Although I had a degree in pharmaceutical chemistry, I couldn’t see myself in a lab, so I
went into property development. It was fun but a bit volatile! When the markets crashed, I worked in a busy call centre – it wasn’t my calling, but it taught me to connect and build rapport.
“My first exposure to mental health care came through my mum.”
My first exposure to mental health came through my mum. She had a psychotic episode 18 years ago and changed overnight - she was later diagnosed with bipolar disorder.
“People can be overburdened by medicines that may not be needed.”
When the medicines kicked in, I got my bubbly, chatty mum back for a while but I saw there were side effects. I became curious about the effects of medications, so much so that I went back to university and studied pharmacy.
My placement in a mental health hospital confirmed what I thought - this was where my future lay. I’m nosy, in my early jobs I’d ask questions and gate crash management meetings to find out more!
People can be overburdened by medicines that may not even be needed. I once saw a lady who took more than 28 drugs a day. She was sluggish and kept falling. I analysed and reviewed her prescription, taking out medicines she didn’t need that were causing problems. She became more animated and stopped falling – it was like watching a different person.
I realised data was key to giving us insights to how drugs work and improve health. In recent years there’s been an explosion
in prescribing data. At Mersey Care we hold more than 200 million medicines administration records. Through our major research programme M-RIC and other initiatives, data is now seen as the key to making massive improvements in patient care. It’s an exciting time for us and for patients.
I love the crossroads of computers, data science and pharmacy and I feel privileged to be part of this future.
Mersey Care is rolling out a new system called Count Me In. The aim is to increase the number of patients and service users involved in research so future care and treatments can be improved. Patients and service users may be contacted about potential research opportunities that are relevant to them, unless they choose to opt out.
How does it work?
If you are a Mersey Care patient or service user and a research study may be relevant to you, the Count Me In team may reach out to see if you’re interested in learning more.
Count Me In allows researchers to connect directly with people who could be suitable for the study. This eases the workload on health care professionals and ensures more people get the chance to be part of meaningful research that can make a real difference to people’s lives.
Is it safe?
Just like your medical records, your information is protected by strict privacy rules. You will not be enrolled into any research automatically. You’ll always have the option to find out more, and if you decide it’s not for you, opting out is simple.
Who else is involved?
The Mental Health Research for Innovation Centre (M-RIC) is supporting the project. M-RIC is a partnership of Mersey Care NHS Foundation Trust and the University of Liverpool.
Where can I find out more?
Visit: www.merseycare.nhs.uk/ count-me-in.
If you are a Mersey Care service user, you can speak to your care team or call 0151 351 8476.
Stay well this winter
Get your vaccines
Protect yourself and others by having your flu vaccine. If you are in an at risk group have a COVID-19 booster.
Stock up on medicines
Don’t spread germs
Wash your hands with warm, soapy water and cover your mouth when you cough or sneeze.
Stock up and lock up with over the counter medicines. Seek advice from your pharmacist if symptoms persist.
Paracetamol and ibruprofen
First aid kit with plasters and a thermometer
Where to go if you need help
• If you live in Merseyside or Cheshire visit merseycare.nhs.uk/help-us-help-you It’s a one stop shop for tips and advice about keeping warm, looking after your physical and mental health and which service can help you best
• If you need medical help fast, use NHS 111 online or by phone. It’s available 24 hours a day, seven days a week and they’ll know the best service for your treatment need. They can even book you in to be seen at your local urgent treatment centre or walk-in centre. You can also turn up without an appointment
• Help is available 365 days a year at our urgent treatment centres (UTCs) and walk-in centres (WICs) for minor injuries and illnesses that are not life threatening. NHS 111 online can arrange an appointment for you or simply walk in to your nearest centre. Check opening times before attending, visit www. merseycare.nhs.uk/urgent-treatment
Cold remedies and cough syrup
Indigestion and diarrhoea treatments
• Our 2 hour Urgent Community Response (UCR) service is available for adults over 18 in need of urgent care. It aims to treat people in their own home within two hours of a call to avoid possible A&E admissions after a referral from a GP or other health professional. Every neighbourhood has an urgent community response service and it’s available 365 days a year, 8am to 8pm. Visit www.merseycare.nhs. uk/urgent-community-response
• If someone is seriously ill or injured and their life is at risk, call 999 or visit A&E.
Poorly child?
Check symptoms before going to hospital at: alderhey.nhs.uk/ conditions/symptoms-checker/
It’s about people
I’d been a governor at my local school but this is very different. My first year has been great though, I’ve had so much help from staff, service users and other governors.
I’m down to earth. In discussions I always think, ‘This could be my relative or friend. Will what we’re planning help them?’ I try to see things from all angles but be realistic and pragmatic.
As an example, there’s a push for using technology to improve care. I’ve worked with computers for most of my life, I appreciate we
need to gather data. But it’s vital we keep explaining clearly to people that being involved in giving their information is safe and painless.
Having said that, they are the real experts because of their life experiences. I like how governors meet with them and take their views on board. I’m in awe of staff too. I’ve been bowled over by how they step up time after time.
“The work going on here is impressive.”
The difference we governors make is by bringing a sense of perspective. We call for assurances from non-
Bill Ponzini, public Governor
executive directors that we’re heading in the right direction, that our strategies, plans and improvements truly reflect the voice of service users and members of the public.
The governors are here to listen to issues raised by service users and our and, through our questioning and monitoring, help services improve.
I’m always curious, I want to know more. The work going on here is impressive. It’s about people and I feel privileged to be part of it.
Governor elections will take place early 2025. If you would like to find out more about what a governor role involves, please visit our website: merseycare.nhs.uk/about-us/council-governors
Find out more about our membership and governors at: merseycare.nhs.uk/about-us/council-governors Tel: 0151 471 2303 Email: ft.membership@merseycare.nhs.uk
Help Us Help You
Visit www.merseycare.nhs.uk/HelpUsHelpYou
Or
medicine and first aid cupboard for minor ailments
