Body & Mind

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THE NEXT CHAPTER

Mike Hewitson MPharm FFRPS FRSPH IP MRPharmS, Pharmicist, The Abbey Pharmacy

As always, January’s been a strange month in the pharmacy; on the one hand it can be incredibly busy, particularly for people wanting to give up smoking, but on the other its best feature is universally regarded as it not being December! As regular readers will know we are about to begin a new chapter in the 232 year history of The Abbey Pharmacy with an exciting project to transform it and make it into an even more indispensable asset for Sherborne and its environs. Since I bought the business in 2014, we have been hampered by the lack of an accessible consultation room. Try as we might we couldn’t make a useable space anywhere on our current footprint, which was deeply concerning as the NHS increasingly wants to see patients accessing faceto-face clinical services through community pharmacies like ours. In fact, they have said that they will move our funding towards clinical service and away from dispensing which has been the core of our NHS income for decades. We were faced with a clear choice: find a way to incorporate a better consultation room or face an uncertain future. But where? How?

For years I have battled this conundrum, but it was only when I was walking past the empty dress shop next door that I began to ask myself what if…? And so began what I thought was a crazy pipe dream. Waiting for someone to say no; firstly the landlord, then the builder, then the planners – my idea to expand the business during what has been a disastrous time for town centres everywhere began to take shape. With the help of award-winning designers Black Circle we began to write the future of The Abbey Pharmacy. We began by listening to what our customers and patients thought of us (good and bad), and what they wanted, which was more access to the pharmacist and to a wider range of healthcare services, which was exactly what we wanted to give them! When I saw the first draft of the designs I knew that we had to do this.

It would have been easy to give up after nearly a year of battling Dorset Council’s planning system, but we’ve now received permission to move forward with the majority of our plans. Sadly, we had to concede our 24/7 prescription collection machine for now, as the planners have not sought to understand how public behaviours and expectations are changing in a digital age. That said,

Image: Katharine Davies

we’re happy to be able to proceed with the bulk of the works. In particular, I am looking forward to having two new high-spec consultation rooms, enabling us to offer a huge new range of services.

You don’t need me to tell you that demand for healthcare has never been greater than during the pandemic. What has shifted hugely is public expectation on what they want from healthcare – it needs to make people not only healthier, but feel better. We want to change your expectations of what to expect from a pharmacy, and from any other healthcare setting really. The physical change to our premises is only one part of this transformation – we’re also looking at how we can use technology to make it easier for patients and the public to interact with us, as well as helping our team to develop new skills which will help to keep you in the best of hands as we move forwards. This might sound quite grandiose, but I truly believe we can deliver one of the best pharmacy experiences in the country. Don’t believe me? We want everyone to be a part of our story and would like to actively invite the whole community to support us.

We’re an independent, family-owned business and we’re in this for the long haul. We’ve listened and acted upon your ideas, thoughts and concerns as we’ve been planning our changes and will continue to do so as we move forward. If there is something you think we should be offering drop us a line: pharmacy.fl223@nhs. net. While there is probably a lot of comfort in being part of a huge chain, we have seen during the pandemic that the ability to be flexible and adapt to changes has been vital, and our team has delivered more than 14,000 COVID vaccinations across West Dorset and South Somerset since October. We’ve lead a multidisciplinary team of clinicians and this has been an exceptionally positive experience which we hope to replicate. This has given us more confidence to think big and be bold with our vision for the future.

While there will no doubt be a few bumps on the last few months of the journey, my team and I are incredibly excited to open the next chapter for The Abbey Pharmacy. You can register for project updates on our website theabbeypharmacytransformation.com.

THE LGBTQI+ COMMUNITY AND MENTAL HEALTH

Lucy Lewis, Assistant Psychologist and Dorset Mind Ambassador

Anyone can experience a mental health problem. But those of us who identify as LGBTQI+ are more likely to develop issues such as low selfesteem, depression, social anxiety, eating problems and misuse of drugs and alcohol. They are also more likely to develop suicidal feelings as they battle isolation and difficult experiences coming out to society.

February is LGBTQI+ History Month, where the nation comes together to focus on celebrating and raising awareness of LGBTQI+ history and the many accomplishments of people from the LGBTQI+ community.

But, it’s important to recognise that the fight for equality and respect is far from over. Many LGBTQI+ persons still experience hate crime, stigma and discrimination from prejudiced people today. Simply for being who they are and loving who they do.

Sadly, the mental health profession has contributed to this stigma through the pathologisation of people who are not heterosexual or cisgender (someone whose gender identity is the same as their sex assigned at birth).

To understand the issues this community faces, here’s a closer look at the history of mental health professionals versus the LGBTQI+ community.

Pathologisation Until 1973, the American Psychiatric Association (APA) classed homosexuality as a mental illness in its manual, the Diagnostic and Statistical Manual of Mental Disorders (DSM). It’s still used to diagnose mental disorders today.

The first edition of the DSM characterised

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homosexuality as a ‘sociopathic personality disorder’. This perspective of homosexuality provided by an influential authority in mental health validated the prejudice of the ignorant and hateful. It gave businesses and the government excuses to discriminate against and repress LGBTQI+ persons.

It is unclear if this pathologisation was simply a symptom of pre-existing prejudice, but regardless, it contributed to the suffering of the LGBTQI+ community. The classification provided medical support for abusive treatments, such as electroshock therapy and lobotomies to ‘treat’ homosexuality.

Fortunately, thanks to the tireless work of remarkable LGBTQI+ activists such as Barbara Gittings, the APA voted to remove homosexuality from the second edition of the DSM. However, the

The Present Unfortunately, the fight towards equality is not complete.

You might have heard of the phrase ‘conversion therapies’ recently in the news. According to NHS England, conversion therapy - sometimes called ‘reparative therapy’ or ‘gay cure therapy’– tries to change someone’s sexual orientation or gender identity. The NHS and other professional bodies had deemed all forms of conversion therapy ‘unethical and potentially harmful’.

And yet, it still takes place today. Despite acknowledging the potentially devastating traumatic effects of these ‘therapies’, the APA still have not banned their use.

Research by Stonewall Charity indicates that people from the LGBTQI+ community still experience discrimination in healthcare settings. About 14% of those surveyed avoid seeking healthcare due to fear of discrimination from staff.

Evidence like this confirms that healthcare still has a long way to go to ensure that LGBTQI+ persons can experience the same level of care and respect as everyone else. And particularly in the realm of mental health.

Dorset Mind At Dorset Mind, the charity believes that everyone in Dorset deserves support and respect.

They run a safe, online confidential and accepting space for LGBTQI+ people experiencing mental health issues. The group is called MindOut and it’s delivered pan-Dorset every other week online. It comprises recovery-based peer and guided support. Each session involves a guided relaxation or mindfulness exercise, time to share experiences and concerns, followed by discussion workshops based on group members’ requests that cover a diverse range of topics.

Visit the charity’s website at dorsetmind.uk for more information.

If you find yourself in a crisis, call 999 or the Samaritans FREE on 116 123. If you need emotional support – it’s available 24/7. Alternately, Dorset Connection helpline is also 24/7 and can help FREE on 0800 652 0190 or by dialling 111 and selecting mental health.

For additional non-urgent mental health resources, support, and information, visit dorsetmind.uk

NAVIGATING THE MENOPAUSE NOURISH

Julia Witherspoon, Nutritional Therapist

Imentioned briefly last month the four-step system I have developed for managing the menopause mayhem. One of these steps is ‘nourish’ – ensuring we are eating a nutritious wholefoods diet and are well hydrated at all times. And this of course doesn’t just apply to perimenopausal women!

What we eat during menopause transition and beyond really matters, as the hormonal changes taking place at this time of our lives can detrimentally affect mood, cardiovascular health, bone health, brain health and weight long-term. I have already spoken about the importance of blood sugar regulation in preventing chaotic spikes and plunges in blood glucose levels, which exacerbate hormonal imbalances as well as encouraging weight gain. But what else can women struggling with any number of exhausting perimenopause symptoms do in terms of nutrition to mitigate the hormone havoc and future-proof their health as far as is possible?

A great diet to use as a baseline is the Mediterranean diet. This is a pretty well-known diet and is centred around vegetables, nuts and seeds, fruits, wholegrains, legumes, fish and unsaturated fats like olive oil (extra virgin please!) with less focus on meat and dairy and minimal processed foods, sugar and salt. From this starting point, aim for at least 5 portions of fruit and veg per day (nearer 8-10 would be great) and a couple of portions of oily fish per week for those really important Omega 3 essential fatty acids.

Please do not fear the fat! We have been conditioned to think that fat is bad and for over 40 years fat has been blamed for causing obesity, heart disease, high cholesterol and more. Unfortunately, following low-fat diets hasn’t resulted in people controlling their weight or becoming healthier – in fact, the opposite is true. Minimising our intake of some types of fat (like those chemically-altered industrial vegetable oils found in most processed foods) absolutely reduces our risk of several chronic illnesses, but eating healthy fats like those found in nuts, seeds, olive oil, eggs, avocado and oily fish are absolutely essential for our health and well-being.

Foods containing phytoestrogens have been shown to be helpful for some women experiencing severe perimenopause symptoms and frequent hot flushes. Phytoestrogens are a group of plant-derived chemicals, molecularly similar to the oestrogen produced in the body. Because they are so similar, they can bind to oestrogen receptors on cells. This can be helpful when oestrogen levels start declining and the receptors are not getting the oestrogen ‘hit’ they are used to and start playing up, causing symptoms. Phytoestrogens are found in flaxseeds, sesame seeds, miso, tempeh, chickpeas, soy beans and edamame beans (avoid GMO soy), tofu, oats, garlic and peaches. If consumed regularly, these foods may be helpful for reducing severity of symptoms.

Eating foods that benefit our good gut bacteria is also important for whole-body health as well as positively supporting perimenopause health, including in relation to the psychological symptoms many women (including myself) can experience during this time. Serotonin is our happy hormone and almost all the serotonin in our body is

Image: Barbara Leatham

synthesised by our gut bacteria. Research has shown that having a healthy gut can also improve energy levels, and support immune system health and weight management. Our gut bugs love lots of fibre (from wholegrains, veg and fruit) as well as probiotic and prebiotic foods. Probiotic foods contain live good bacteria and include live yoghurt, kefir, kombucha, unpasteurised sauerkraut and kimchi. Prebiotic foods feed and stimulate the growth of our good bacteria and include onions, leeks, garlic, chicory, asparagus, beetroot, blueberries, apples and ginger.

Carbohydrates (which includes sugar) have been given a bit of a battering in recent years as people have become more knowledgeable about their involvement in chronic disease and the obesity crisis in this country. However, carbs are not all bad and are a vital part of our diet, perimenopause or not, but what is key is to avoid refined ‘beige’ carbs like white bread, white rice, white pasta, pizza etc, as these are the culprits that cause the huge blood sugar dysregulation I’ve mentioned. Switching to low glycaemic index (GI) carbs will help stabilise blood sugars, which in turn will better support hormone balance during perimenopause. Think wholegrains, legumes, sweet potatoes and other low GI vegetables and salads.

As a woman’s bone density starts to weaken post 40, getting enough calcium and vitamin D is really important. Calcium is needed for bone and muscle strength and vitamin D is needed to help absorb calcium. Vitamin D also supports immune health and can help lift mood. Note: calcium isn’t just found in dairy products! Calcium-rich foods also include leafy greens, nuts, sesame seeds, tinned fish (because the bones are eaten), white beans, tofu and even cabbage and broccoli.

The other part of ‘nourish’ is hydration. Think of every cell in your body like a lovely, plump, juicy grape. Now dehydrate until it becomes a raisin. I am sure you agree that our cells will be healthier and happier if they are plump and hydrated. A couple of litres of fluids per day (water preferably) is about right.

There are 34 – yes 34! – recognised symptoms of perimenopause and although it is highly unlikely that any women would have that many, the more nourishing the food is that we put on our plates, the easier our perimenopause experience is likely to be.

Next month: ‘restore’

EXERCISE REFERRAL

Craig Hardaker BSc (Hons), Communifit

Image: Stuart Brill

Iam sure you’ll agree when I say we are incredibly blessed to have some of the best GPs, physiotherapists and other medical professionals not only in Dorset but also in the UK. You only have to look at the vaccination programme that’s been rolled out in Sherborne to see how lucky we are to have such a wonderfully dedicated team of medical practitioners. I know all Communifit members, as well as myself would like to thank them for all their hard work in keeping us safe by making sure we have been able to be vaccinated so efficiently.

They also need to be credited for rolling out an effective local exercise referral scheme within Sherborne and the surrounding areas. For local people recovering from medical conditions or surgery, such programmes are of vital importance. I have been part of the referral programme in Sherborne for the last 10 years and it is a scheme I am both very fond of and committed to.

Sometimes known as GP referral, exercise referral was introduced by the NHS in 2001. It is where a medical professional, normally a GP or physiotherapist, refers you to an exercise professional to help with your requirements. Medication is still of great importance in most cases, with exercise providing a potent alternative or addition – one which can help so many people.

There are many medical conditions that exercise can help with. Two examples are obesity and mental health – conditions which in addition can be sometimes linked. Sensible exercise invariably improves both a person’s mental and physical state and can help prevent an over-dependence on prescription medicines. MIND, a charity focusing on mental health, further highlights that our physical health and mental health are closely linked, with many people not getting enough exercise to stay healthy. Exercise can help motivation, low mood, anxiety and stress. Low mood and anxiety can lead to emotional eating. Exercise helps with improving your wellbeing and can help you control your urge to eat.

The cancer.gov website gives detailed information on how obesity can be linked to many types of cancer, including cancers associated with your gut and liver, breast cancer, ovarian and uterine cancer, multiple myeloma and thyroid cancer.

All of our classes here at Communifit welcome exercise referrals. Not only providing a more general opportunity to meet people and stay motivated to exercise, classes may lead to talking to others that are in the same position and can support you through your journey. You are never alone and talking to people is central to recovery.

A talk with your GP or medical professional may lead to an exercise referral, and ultimately to a happier, healthier you.

‘Prevention is the best medicine’ and regular exercise is a positive way to safeguard your future, ensuring you give your body and mind the best chance of being healthy. It is never too late to make a start. The team of medical professionals in Sherborne are here to refer exercise when needed, and here at Communifit we will welcome you with open arms.

Together, let’s ‘strengthen the local community’.

KETTLEBELLS II:

HOW TO PROGRESS YOUR TRAINING Simon Partridge BSc (Sports Science), Personal Trainer, SPFit

Last month I wrote about the benefits of kettlebells but now I want to drill down deeper into the benefits and how you can progress.

Make the most of your workouts – train smart Three of the main movement patterns we use in weight training are squats, deadlifts and lunges. But these are not what we use for kettlebell conditioning because they do not take advantage of the key benefits of kettlebells:

•Combined cardio and strength training •Developing greater core strength •Improved ankle, knee and hip extension to help produce more power for a range of activities including running and jumping.

One of the challenges as a coach is ‘beginner’ clients rarely try the vast library of exercises beyond the popular common basic exercises. Swings, snatches, jerks, cleans are all big, explosive hip hinge movements from which you will get the biggest gains from kettlebell training.

But while we should definitely focus on these big power moves, kettlebells allow exercises in different planes of movement. This simply means moving in different directions. This is often called functional training – a fitness industry ‘trendy’ word which means it will benefit us in our everyday real life and for those that play sport there will be massive benefits. Many people use machines, dumbbells and barbells in one plane of movements, namely ‘forwards’. But in real life activities and all sports, we have to change direction, twist, rotate, move sideways, backwards and diagonally.

Five ways to progress your kettlebell training: 1 Change your programme: In its simplest format, change the number of reps, sets and shorten your rest periods to challenge your body and mind more. 2 Learn new movements: Once you have mastered basic kettlebell swings and lifts, try more complicated exercises such as lunge snatches and, my favourite, windmills. 3 Use complexes: Try doing kettlebell swings, squat jumps, press-ups and thrusters one after the other with no rest. Then use AMRAPS – which stands for As Many Rounds as Possible – try 10 reps of each of the above exercises in five minutes. 4 Combine kettlebells with other kit: have some fun and create new challenges to get great new results by using a TRX single arm hold while using a kettlebell to do a renegade row. 5 Try the sport of kettlebell lifting: similar to Olympic lifts, this consists of two movements, the jerk and the snatch. Kettlebell sport lifting requires the athlete to complete as many reps as possible in 10 minutes.

And the big catch, you cannot put the kettlebell down during the 10 minutes. Hence, there is a huge cardiovascular component to the sport and there are clearly massive calorie and fat burning benefits.

So, who out there knew that there was actually a competitive sport for kettlebells with a world championship? But whatever your goals are, try more complex kettlebell movements to learn new skills, reap all sorts of benefits and have a whole load of fun. Good luck and be creative. Never get bored.