Body & Mind

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FACT-FINDING

Mike Hewitson MPharm FFRPS FRSPH IP MRPharmS, Chief Pharmacist, The Abbey Pharmacy

In today’s world we are constantly bombarded with information, whether we like it or not. In the world of healthcare new evidence can be both confusing and can appear at breakneck speed. Knowing who to trust and where to get reliable information can be the difference between opting for or against treatment. What is the signal and what is noise? Every day in the pharmacy I find myself on the front lines of this information war where people can become entrenched into camps based on what they believe more than what they can prove. The noise can be immense, with false equivalence rife especially in the world of social media where a lie can travel around the world twice while the truth is still putting on its boots.

For people who are used to being able to look up facts on their phone within seconds, there is perhaps a need to develop critical thinking skills to assist in the evaluation of competing evidence in areas where there is some debate. What do I mean by this? If I am looking up a phone number for a dentist, I would generally trust the information I find on the internet because it is a simple fact. If I try the number and it isn’t right there is no great harm at the end of the day. Whereas if I am trying to help a patient to work out if they should take a particular medicine, I would look at several different trusted sources of information in order to present the patient with a balanced assessment. At the end of the day, it is every individual’s right to decide whether they wish to use a treatment or not, it is my duty as a healthcare professional to ensure that those decisions are informed decisions. The NHS says that for consent to be informed, ‘the person must be given all of the information about what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments and what will happen if treatment does not go ahead’.

Sometimes that discussion about whether the patient should take a medicine gets more complicated when patients reach out to their own network of friends and family – ‘my friend took that and ended up in hospital’, ‘you wouldn’t catch me taking those’, ‘I read in the paper’ … While every person that takes a medicine might respond slightly differently to it, side effects in particular are quite documented through the drug development

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process and after it is launched through a system called pharmacovigilance – this is where companies have to report side effects which have been reported to them by patients or healthcare professionals to the government medicines regulator, Medicines and Healthcare products Regulatory Agency (MHRA). Patients & healthcare professionals can also report side effects directly to them using what is called the ‘yellow card scheme’ – this can be completed online at gov.uk/reportproblem-medicine-medical-device. This information is regularly reviewed and monitored, and where trends or serious problems occur there are systems in place, for example to recall a batch of a medicine if quality issues arise, and to update the prescribing information so that we may help to keep patients informed. Thankfully, serious problems are very rare but I would encourage you to speak to your pharmacist in the first instance if you are having problems with your medicines. I digress, back to the matter in hand…

There are a variety of reasons why people share negative experiences of medicine taking. Firstly it makes for a better story than, ‘I took my tablets and I got better’. Second when information is 3rd hand there is a tendency for crucial details to be misremembered, which can make a huge difference to whether the medicine was actually to blame. Being slightly cynical when the newspaper runs a story, ‘drug x causes…’ I instantly know that a large proportion of patients using drug x will buy the paper – when millions of people take statins this is not an insignificant audience. What they don’t necessarily print is the tens of thousands of lives that have been saved as a result of using statins, or the tens of thousands of heart attacks and strokes which have been prevented. Of course, some patients can develop problems with them but a tiny proportion of the overall numbers taking them and this can be managed by talking to your healthcare professional.

So, how can patients navigate the minefield of disinformation? To start with, don’t believe everything you read online, and always, always check the source of the information. NHS information should always be reliable and accurate – nhs.uk has a wealth of really helpful information about conditions and drugs. Another website that I often use is patient.info which is another reliable source of information written by healthcare professionals, but in plain English so that it should be accessible. Health charities often have good websites such as the British Heart Foundation bhf.org. uk which will talk in more detail about more specialist problems and may have useful resources. Failing this come and talk to us!

By the way, if you, or anyone in your household uses inhalers regularly, you could help the UK to save the equivalent of more than 500,000 tonnes of carbon dioxide by returning any old and empty inhalers to the pharmacy for destruction. Even if your inhaler is ‘empty’ it can still leak harmful gases into the environment. By disposing of these through the pharmacy these gases are incinerated. In some facilities aluminium components can be recycled as well.

We were very keen to see a reduction in the environmental impact of medicines, and until recently were running a scheme where we could take back used blister strips for recycling. Sadly, this scheme was discontinued by the recycling company because it was too successful. We are keeping an eye out for any similar schemes because we know how popular it was and will update you via the Sherborne Times if a successor scheme becomes available.

MENTAL HEALTH IN AN UNEQUAL WORLD

Lucy Lewis, Assistant Psychologist and Dorset Mind Ambassador

World Mental Health Day, established by the World Federation for Mental Health (WFMH), is held annually on 10th October. This year’s theme is ‘Mental Health in an Unequal World’, a very important topic as not everyone has the same access to mental health education, support, and treatment. This is not acceptable and there is much work to do to make mental health resources and services available for all. This month, we are exploring this important issue and sharing what we do at Dorset Mind to try to reach everyone in the county.

Mental health support should not be a benefit reserved for privileged sections of the world and society. Opportunities to develop mental health knowledge and coping skills, as well as access to treatment, should be universally available. Unfortunately, the world is becoming increasingly divided. The rich are growing ever richer, whilst more and more people are struggling. The WFMH reports that mental health services are inaccessible to 75-95% of people experiencing mental health difficulties in low or middle-income countries. But surprisingly, even in high-income countries, services are only slightly more accessible – which suggest that mental health is still not regarded in the same manner as physical health.

What’s more, people from marginalised groups in society are not receiving the same opportunities for mental health improvement and recovery as other people. In the UK, the Centre of Mental Health (CMH) has collated some shocking findings. For example, adults over 65 only make up 7% of those accessing Improving Access to Psychological Therapies (IAPT) services.

Additionally, people from disadvantaged socioeconomic backgrounds who do access IAPT services are significantly less likely to recover from their mental

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health difficulty. People who access IAPT services are also significantly less likely to recover if they identify as bisexual or homosexual and almost a quarter of people from the LGBTQI+ community have witnessed discrimination from healthcare staff. It is therefore unsurprising that 14% of those from the LGBTQI+ community avoid treatment for their health due to concerns about discrimination. This has to change.

Mental health inequality is not simply ‘unavoidable’. It is a complex, multi-faceted issue that needs improving at every level. At Dorset Mind, we

truly believe that no one should have to face a mental health problem alone, regardless of age, ethnicity, gender identity, disability, religion, or sexuality. We offer 1-2-1 and group support for people struggling with mental health difficulties, with specific groups offered to people from the LGBTQI+ community, women-only, and carers.

Please visit dorsetmind.uk/help-and-support to learn more about our wellbeing support groups and other services we deliver across Dorset for adults and young people, from age 11 upwards. We recognise that we can do more to help increase mental health service accessibility for all and are working hard to address this. If you have any suggestions for how we can better support people from marginalised backgrounds who are experiencing mental health difficulties, please email your suggestions to contact@dorsetmind.uk

Why not volunteer for us and help us ensure that no one in Dorset faces a mental health problem alone? For details, visit dorsetmind.uk/get-involved/volunteerfor-us. Together, we can help to reduce mental health inequality in this unequal world.

TRIATHLON

Craig Hardaker BSc (Hons), Communifit

We not only provide all age groups of the local community with group exercise classes but also organise events sponsored by local businesses. We are delighted to be returning to our popular 5k series on 17th October, raising funds and awareness for Sherborne Community Kitchen (sign up via our website and help support this fantastic charity). Recently, we hosted a sportive at The Story Pig and a ‘colour run’ and triathlon at Leweston School. But, some of you may wish to ask, what is a triathlon and should I be wanting to participate in one? A triathlon is an athletic contest consisting of three different disciplines: swimming, cycling and running. There are several distances in which you can compete, but three in particular are most popular. The shortest distance is a sprint which consists of a 400m swim, 20km cycle and a 5km run. Next is an Olympic distance consisting of a 1.5km swim, 40km cycle and a 10km run. The longest, and therefore most gruelling, is a full Ironman consisting of a 3.8km swim, 180km cycle and a 42km run! Whichever triathlon you choose, the idea is to complete all three disciplines, including the transition between, as fast as you possibly can. Let us take you through the journey from start to finish.

Swim: This is the discipline that most people dislike! It can be completed in a swimming pool for the shorter distances, or open water such as a lake or sea for longer distances. Swimming pool start times are structured, with specific starting times allotted, allowing only a limited number of triathletes in the pool at any given time. An open water swim tends to be a rolling start – carnage! Most triathlons give you a timing chip to record your time, with a breakdown of each segment.

T1: This is transition one – where you get out of the water and head straight to your bike. Against the clock there is no time for shower or to dry yourself! Take off your wetsuit (if an open water swim), put on your t-shirt with race number on the back, slip into your cycling shoes and you are off!

Cycle: This is the discipline that most enjoy – you don’t have to cycle downhill! It can be a strange experience cycling whilst wet, but you soon get used to it. Due to the long distances, there are no marshals so keeping an eye on the bright coloured arrows to give you direction is hugely important! The cycling leg provides a great opportunity to hydrate and refuel. Triathletes often carry water, an electrolyte drink too for longer distances, as well as a source of nutrition such as energy gels. This discipline can make or break your

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overall time, so a huge effort is needed. Just hope and pray for no punctures!

T2: This is transition two – coming off the bike to rack. Helmet off, cycling shoes off, turn your race number from the back to the front, running shoes on and away you go – just like that!

Run: This is a very strange sensation, using the same muscle groups as the cycle but the different motion can give you ‘jelly legs’ before you find your rhythm. At this point you may be flagging, yet knowing it is the final segment of a triathlon helps keep you going!

A combination of spectators cheering you on, more energy gel and your previous training help push you over the finish line. All that is left now is an unbelievable sense of achievement and a huge sense of well-being. So, there you have it, a triathlon. Next time you see us promoting an event, you will know what a triathlon is, how hard it is to complete, but how worthwhile it can be if finished. Now is the time to set your fitness goals for the winter months, maybe some of you will ponder on whether a triathlon is right for you. Stay safe, stay healthy.

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WHY PERSONAL TRAINING? WHAT IS IT REALLY?

Simon Partridge BSc (Sports Science), Personal Trainer SPFit

Over my 16 years of being a personal trainer I believe ‘listening’ to my clients about why they want a personal trainer is an important skill. We can all be passionate about our business but talking to clients about why they use a coach and what they want to get out of personal training is always illuminating. Having set up a private studio in Sherborne more than six years ago has given me a valuable insight into people’s motivations for that.

The Pandemic Lockdown and Covid Lockdown has affected different people in different ways. I could write numerous articles on this topic alone. But from the regular flow of new clients that we are now seeing, it is safe to say that lockdown has had a detrimental effect on many people’s physical and mental health. Suffice to say that personal training and good coaching can help.

Motivation Many people just aren’t motivated to exercise on their own; others want to be pushed beyond their limits. But the really pleasing outcome is that when clients start to see results, they become more motivated.

Goals and Results The range of clients’ goals never ceases to amaze me: losing weight/body shape or specific health goals, running a 5km or a marathon, press-ups and pull-ups to deadlifting twice bodyweight. The list is endless and fascinating. Once you have a goal, you need a plan to put into practice in order to achieve the desired results. Nothing gives me more pleasure than seeing a client achieve their goal.

Improving Technique and New Skills Personal training is coaching. Andy Murray and Mo Farah have coaches. Coaching is for beginners to advanced athletes and anyone in between. Knowledge is power. A new skill can keep you motivated, whilst improving your technique can improve your performance. Improving your performance will get you better results. Again, coaching new exercises or drills is one of the most rewarding aspects of being a personal trainer. When a client says ‘I never thought I would be able to do that’, I know we have done something special.

Progression Clients want to know that what they are doing makes a difference. Coaches often talk about periodisation – this is where we train for a specific period for a specific goal. At the start of a new programme the body and the mind can be challenged in a whole new way. It stops boredom, which leads onto the final point below.

Fun This is the bottom line. You can be motivated, achieve your goals and keep progressing, but nothing beats having fun. ‘Crossfit’ and yoga for example have all changed what many of us do in the ‘gym’. These are all so rewarding to coach as we see so many people doing amazing things.

In conclusion, whether you train on your own or with a personal trainer, I hope you achieve your goals and really enjoy your training. Good luck and never be afraid to ask any question. None of us stop learning, most of all me.