Body & Mind

FIT FOR PURPOSE

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

You may have noticed that the building works at number 85 Cheap Street have now begun. This is a huge cause of excitement for us, but also for lots of people in the community who are interested in what we are trying to do. For years we have struggled with an old building that was never designed to be a pharmacy, with a step up to the front door preventing access for people with mobility problems, and an internal space that was not really conducive to modern pharmacy practice. The NHS increasingly wants pharmacists to be talking to patients, using our 5 years of medicine-specific training and knowledge to help deal with the challenge of an ageing and ailing population who are living with long-term conditions such as diabetes or respiratory problems for longer. Medicines are the most common healthcare intervention with more than 1.1bn prescriptions written every year. Up to 1 in every 5 hospital admissions are due to a medicine-related problem.

We first started this project in March 2020 when number 85 (formerly Phase Eight) became vacant. At the time Cheap Street was a ghost town with national lockdowns, and it wasn’t clear that anyone would be able to come and talk to us face-to-face, other than to collect prescriptions. But we didn’t really have a choice – the risk of not changing was greater than the risk of doing something different. We have struggled without a decent, accessible consultation room, and there is no guarantee that without one we would be here in the future, such is the emphasis on the provision of healthcare services in the NHS pharmacy contract. We’ve also struggled with managing the workload associated with patients who require Monitored Dosage Systems (MDS in our world, known to the general population as ‘blister packs’, ‘dosettes’, ‘nomads’, ‘trays’…) which require a bespoke container to be produced with all of their tablets in the correct time slots each day to help them to use their medicines as prescribed. Did you know that the World Health Organisation estimates that up to half of all medicines are not taken as prescribed?

Our new premises will enable us to tackle both of these challenges: we will have 5 new consultation rooms, with one fully accessible for patients with limited mobility. This will mean that for the first time in its recent history the pharmacy will be truly open to everyone. As a pharmacist, equality is really important to me – I want The Abbey Pharmacy to be for the whole of the community. Ideally, I would love all of our facilities to be fully accessible, but with old buildings there inevitably has to be a compromise. As with the planners who turned down our 24/7 prescription collection machine on the basis that it did not fit with the look of Sherborne, we have had to compromise in order to do the essential parts of the project. We haven’t given up completely on the prescription collection machine, but we will think

Image: Katharine Davies

again about how we can achieve this.

On the MDS problem, we are going to install a robot that will allow us to fill one pack every 90 seconds, fully automated. This process currently takes a member of staff up to 15 minutes to complete per pack. This will allow us to transform one of the most time-consuming activities that we currently manage into one of the most efficient. It will also be safer as the robot will be able to use its technology to take a picture of every tablet or capsule which goes into every slot in the container – this will allow us to confirm that every pack is correct in the event of a query. This will mean that we will be able to look after more patients at a time when other pharmacies are charging or turning patients away from an equivalent service. We will be providing more information about this service for patients and organisations who could benefit when we have completed our refit.

Back to the refit, the works in number 85 began with ripping out the existing fixtures and fittings to expose the bare shell. This has been like a voyage through shop-fitting strata with successive shop fits layered over each other probably out of fear of what lies behind. The space we have been left with is bigger than we expected – half a metre here and there soon adds up. We have come across some unwelcome news with some massive structural beams defeating some of our plans. We always knew that old buildings would bite back somewhere, and while inconvenient these haven’t yet proved insurmountable. We keep adapting what we are able to achieve and sometimes this has been a real positive. For example, before we took over the new building the landlords had a mullioned window repaired by a master mason – this window was on the second floor facing Long Street. It wasn’t visible internally as it was only lighting a void space. Now we will be able to enjoy Luke the mason’s craftsmanship in one of the new consultation rooms. We want to add back to the heritage of the buildings to provide a facility with character that isn’t just a box.

We were delighted to see Sherborne listed as one of the best places to live in the UK by The Times newspaper. We were even more delighted to see them specifically mention The Abbey Pharmacy as an asset to the town. We want to see people travelling to The Abbey Pharmacy to access the exciting range of products and services which we are planning on offering. We want this to help support the town’s other businesses and services because we recognise that our town centres are a delicate ecosystem of interrelated businesses. Our building works will be finished by midJune and we hope to invite the whole community to see what we’ve been working on. In the meantime sorry about the dust!

HOW TO COMBAT LONELINESS

Lucy Lewis, Assistant Psychologist and Dorset Mind Ambassador

Mental Health Awareness Week (MHAW) runs from Monday 9th – Sunday 15th May. The theme this year is particularly relevant as we emerge from the other side of the pandemic. Loneliness – something that we all felt to some degree during the lockdowns.

Research by the Mental Health Foundation has revealed the expected; people across the UK became a lot lonelier during the pandemic.

Loneliness is a very important health issue due to its damaging effects on both physical and mental health. Not only can loneliness contribute to and exacerbate mental health issues such as anxiety and depression, some research also suggests that prolonged loneliness can be as damaging to physical health as smoking 15 cigarettes a day.

Loneliness is a unique experience. Someone can be lonely due to social isolation, where they do not have much contact with anyone else, such as an older adult with no family. However, it is also possible to feel lonely in a full household of family or a room full of people. This is because loneliness can also stem from not feeling heard, understood, or cared for by the people around you.

Equally, it is possible for someone to feel very content being alone a lot of the time. Everyone is different and all emotions are valid.

So how do we combat loneliness? One obvious option is to make a concerted effort to meet new people. Although this can be daunting, it is worth giving yourself a little push and giving it a go whilst remembering that you can always leave if you feel overwhelmed. This may be through joining a club or activity - something you’re interested in, where you can meet like-minded people with similar interests.

Alternatively, you can sign up to volunteer for a worthy cause (such as Dorset Mind!) where you can meet people with similar passions whilst giving back to the community. Helping others can work to combat loneliness as it can make us feel more connected to society as a whole, which is refreshing in our increasingly individualistic society. Research findings suggest that giving back is one of five proven ways to improve your mental health, meaning the benefits are numerous.

Another strategy would be to appreciate and strengthen your existing social connections. Sometimes we can be too focused on what we believe are active demonstrations that someone cares (i.e. regular phone calls) but not recognise other gestures,

ZeroThree/shutterstock

such as a friend who is always willing to help with errands when asked. Additionally, sometimes we are reluctant to make the first move, such as initiating plans or reaching out to a family member that you’ve lost touch with. But there is nothing to lose when making an effort to connect with people. Even if it doesn’t work out as you hoped, you can feel comfort in the knowledge that you tried to be there.

It is possible to become better at managing and accepting the experience of loneliness. The first step is to accept the feeling and learn to sit with it, tolerate it, and know that you can survive the feeling without trying to block it out. Try to learn to enjoy your own company by making a bigger effort to do enjoyable things. Follow a routine of self-care, recreational, and learning activities to keep yourself busy and rediscover the benefits of enjoying your own company.

You can also learn strategies to better manage difficult emotions such as loneliness through various talking therapies and psychological treatments.

But, if your feelings of loneliness are affecting your ability to function in various areas of your life, it is time to seek additional support. Speak to your GP, or in a crisis, call 999 or The Samaritans at 116 123. For additional resources, 1-2-1 and group support, visit our website.

NAVIGATING THE MENOPAUSE DETOX

Julia Witherspoon, Nutritional Therapist

Image: Barbara Leatham

The world we live in has never been more toxic and women going through the menopause need to be particularly aware of the toxins in their homes and environment.

In 2012 the WHO reported there may be up to 800 chemicals known, or suspected, to be able to interfere with hormone receptors, hormone synthesis or hormone conversion. Known as endocrine-disrupting chemicals (EDCs), not all have even been tested. Many of them are fat-soluble and stored in our fat cells and brains.

The reason EDCs can be so damaging is that they are molecularly similar to some hormones and it’s not always easy for our bodies to tell the difference. Over time the bioaccumulative effects could lead to chronic disease.

Xenoestrogens are a sub-category of EDCs, socalled because they can activate oestrogen receptors in the body and either inhibit or stimulate hormone activity. They can disrupt normal signalling mechanisms, leading to malfunctions in other tissues. Menopause is challenging enough, without chemicals getting

involved, accumulating in our bodies and potentially exacerbating symptoms.

So where are all these EDCs? This is not an exhaustive list, but it shows just how much we are all drowning nowadays in a cocktail of chemicals:

Plastic (containers/bottles/cling film), tinned foods, till receipts, perfume, cosmetics, toiletries, nail polish, cleaning products, candles made from paraffin wax or with synthetic fragrance, insecticides and pesticides, food and skincare preservatives (of which there are many), medications, antiperspirants, sun-screen, non-stick cookware, stain/water resistant textiles, fire retardants, exhaust fumes, petrol, air fresheners, fabric softeners…

There are literally hundreds more, but you get the picture.

Of course, we can and will never be toxin-free, but switching out some of our chemical-laden cleaning products, toiletries and cosmetics in our homes for more natural alternatives will go a long way to reducing our toxic load. We can also reduce plastic, eat more organic foods, ditch paraffin wax candles and throw out chemical-filled air fresheners. Switching to reed diffusers with essential oils and candles made of soy or beeswax, for example, are easy swaps.

The app ‘Think Dirty’ can show you how clean or not your current products are using a traffic light system. A great website for natural cosmetics and toiletries is lovelula.com and there are a variety of websites where you can find more natural household products including biggreensmile.com and bowercollective.com. Locally of course, we have Naturalife on Church Lane and Sherborne Market Store on Cheap Street. Yes, you may pay a bit more for these products but surely it’s worth it!

As well as trying to reduce our toxic load, we can also support our liver, the body’s over-burdened primary detoxification system. The liver has to filter everything and anything that is swallowed, inhaled or absorbed through the skin, before either sending it round the body to be utilised (nutrients etc) or eliminated (spent hormones, toxins, medications etc) via the digestive system, lungs, kidneys and skin. If it underperforms or struggles to cope with the onslaught, toxins and waste can get backed up and could end up being reabsorbed into the bloodstream. The liver has around 500 jobs to do in the body, so we need it to be working optimally all the time.

Relating liver health to perimenopause, once oestrogen has been used by the body – whether it be the oestrogen produced endogenously or via HRT – it needs to be broken down (metabolised) and this happens in the liver. There are several different pathways through which oestrogen is metabolised, via different enzymatic reactions. There is a good/protective pathway and there are not-so-good ones, and one of these not-so-good ones can make oestrogen ‘reactive’. This could be really problematic, health-wise, particularly if a woman has a lot of oestrogen and too much of it is being metabolised this way. The best foods for liver health are cruciferous vegetables (broccoli, kale, cabbage, cauliflower, Brussels sprouts, bok choy, watercress, collard greens, rocket) as these contain compounds that support detoxification and improve the chances of oestrogen being metabolised down the protective pathway. They also contain lots of lovely antioxidants which help fight inflammation in the body. Anyone with a poorly functioning thyroid gland should ensure cruciferous veggies are not eaten raw too often, as they could interfere with thyroid function if not cooked.

Keeping well hydrated (filtered water preferably) is also important for liver health. If it becomes too dehydrated, it becomes less efficient.

Our digestive system plays its own crucial role in detoxification processes. Poor digestion can cause a build-up of toxins and result in systemic problems throughout the body. Metabolised oestrogen can even be reabsorbed and recirculated around the body if gut health is poor, which is far from ideal, particularly for those women who are metabolising too much oestrogen down the reactive pathway above.

Symptoms such as bloating, flatulence, indigestion, heartburn, constipation, diarrhoea, brain fog, low energy and pale skin can all indicate a compromised digestive system and potential increased toxicity in the body. A lot of these issues can often be resolved by really working on good gut health.

So focus on eating lots of fibre, lots of veggies, healthy fats and good sources of protein as well as pro-and pre-biotic foods. Ditch the simple carbs, sugary foods, biscuits, crisps, fizzy drinks, ultra-processed and fast foods. Eating this way will not only provide your body with the necessary nutrients to keep you healthy, but also provide your liver with what it needs to do its very important detoxification work.

Next month: Brain Health

PERMISSION TO RELAX…

Dawn Hart, YogaSherborne

Microgen/Shutterstock

At the end of each yoga class, we spend around 10 minutes lying on our backs on the floor in Savasana – relaxation pose. You may be surprised to hear I think it is one of the most difficult postures. Not because it is physically challenging but because we are encouraged to be busy, to stay connected so we can achieve more in every moment. Simply stopping and ‘doing nothing’ can feel like a waste of precious time.

Even our downtime can be full of stimuli; TV, music, reading. These activities help us unwind but we can still find ourselves holding tension physically or mentally afterwards. This underlying tension can have longlasting effects for all of us including; anxiety, high blood pressure, headaches, IBS, insomnia, even drug/alcohol/ tobacco dependency.

Regular, deep relaxation in a peaceful space where we can be fully aware of our breathing and the

sensations in our body has huge benefits. Instead of adrenaline, endorphins flow through the body reducing pain, improving sleep, lowering blood pressure and enhancing the immune system. It can also help us manage emotions more effectively when dealing with life’s challenges. This has a positive effect on the people around us too.

Prepare your space and pick the right time •It doesn’t have to be for long – start with 5 minutes and build up from there, 20 minutes is a good guide. •If inside, close the door – put a ‘do not disturb’ sign up if needed. •Listen to the sounds around you for a moment to get used to your surroundings especially if you are outside. •Set an alarm (something gentle!) or ask someone to come and get you so you can relax without worrying you will fall asleep. If you need your phone close by switch it to silent. •Although the aim isn’t to fall asleep you could use this as part of your bedtime routine, helping you experience better quality sleep.

Why do we lay down? For meditation we are usually sitting to stay in a waking state of consciousness – you are aware of your thoughts but able to let them go without getting caught up in them. We lay down for a relaxation or Nidra so we are able to go beyond that into a deeper healing state, allowing both the body and mind to rest. It is very common to drift off to sleep and that is not a bad thing but with practise, you will be able to stay in the place where your consciousness is still engaged.

You may experience sensations like floating or your body sinking into the floor – experiences may differ depending on how you are feeling that day. Immediately afterwards you are likely to feel sleepy but that soon gives way to a relaxed but energised feeling. You’ve heard of a power nap, this is exactly that – it powers up your body and your mind.

Relaxation pose – Savasana •Lay down on your back on a soft but supportive surface; carpet, mat, bed, grass. •To begin with bend your knees so you can draw your lower back gently down. •Feel your back connecting with the surface below you from the base up to and across the shoulder blades.

There will be natural lifts and curves – don’t force

these out just be aware of them. •Draw your chin in a little so you feel the neck gently extend. •If comfortable stretch your legs out now positioning them at least as wide as your hips and let your feet drop out to the sides. This allows the pelvis area to release and relax. •If this is not comfortable for your lower back you can leave the knees bent or place a rolled-up blanket or cushion under the backs of the knees. •Place your arms out a little way from your body and turn the palms facing upwards, fingers relaxed. This allows the shoulders to relax and the chest to open helping you breathe more deeply. •Make sure you are warm – you will cool quickly once resting so a blanket is a good idea. •Close your eyes.

Find your guide Find a class or if at home use an audio recording – this will really help to begin with. A nidra usually uses your body as an anchor through your breathing or by scanning up or down focusing on each part of your body. Find a voice that is calming and makes you feel secure. Listen to the recording all the way through before you do your relaxation to make sure you like it.

Not as easy as it sounds At first, your mind may be really busy. Or you may have restless, fidgety muscles. Do not try to relax. Instead, notice then let go of thoughts, worries and expectations. Softening and loosening your muscles and thinking of things that encourage peace and contentment will help. If we try, we set expectations and put the energy into the process rather than the outcome. We risk increasing anxiety and tension which is exactly the opposite result we want.

Relaxation is free. It takes practise but you can’t get it wrong and you don’t need huge changes to your lifestyle to do it. There are no negative side effects or health risks. So if you practise yoga at home don’t be tempted to skip this part after you have done your other postures. If you don’t practise yoga, find other spaces where you can include it in your life. I hope knowing some of the benefits will help you give yourself permission to stop for a moment and relax.

@yogasherborne yogasherborne.co.uk

EXERCISE OUTDOORS

Craig Hardaker BSc (Hons), Communifit

Image: Stuart Brill

Hopefully, we can stop being concerned by the dark, cold winter weather because, just like that, it is May! Summer is many people’s favourite time as the prospect appears of dry, warm conditions (well hopefully), lighter nights and better weather to meet friends and family outside. Isn’t it also great to have brighter mornings and evenings which provide even more opportunities for outdoor exercise?

May is a busy month for Communifit this year as we have several outdoor activities – a stand at the excellent Sherborne Market on the 15th, our Camelot Challenge on the 22nd, and we are excited to have entered a team for the Dragon Boat Race at the country fair on the 29th. We are looking forward enormously to all three events.

There is a strong argument to make that we spend far too long indoors. Count the waking hours spent indoors compared to how long you spend outdoors, and the result for many of us will be shockingly uneven. According to recent research, we spend only 7% of our time in the fresh air. Bearing in mind that here in Sherborne we live in a wonderful rural location, we need to consider getting out more. Perhaps we need more reason and motivation to leave our homes and what better reason than to enjoy the benefits and enjoyment of outside exercise.

Since Covid struck over two years ago the biggest shift in the fitness industry has been towards outdoor activity. Whether this be cycling, open-water swimming, outdoor bootcamps or running, there has been a significant surge in participation. No longer is the gym the go-to place for exercise. Although the gym will always have an important role in the fitness world, being outside in all weathers, breathing in fresh air, looking at the wildlife and being able to move around whenever you desire is being viewed by many as a more desirable alternative. It can also be claimed that exercising outside has important mental health benefits, similar to those of enjoying a long walk, or even vigorous gardening. Studies have shown that physical activity outdoors can lower both a person’s blood pressure and heart rate. This therefore can result in exercising outdoors feeling less strenuous than undertaking similar exercises indoors, also ultimately resulting in a performance increase.

Similarly looking at rolling fields, at wildlife and getting fresh air is perhaps much more suitable to some than working in a gym – looking at a wall, tv screens and listening to music. It’s a personal preference of course but exercising outdoors certainly has benefits. Consider those benefits, and if you feel that the ‘outdoor option’ appeals to you then please take those extra steps outside and increase your enjoyment by harnessing what outdoor exercise has to offer you.

Over the coming months, we will be taking as much of our personal training, exercise classes and of course events outside. Take the opportunity and we hope to welcome you outdoors soon!