TWR - July 2012 - Issue 13:The Waiting Room - Summer 2012 - Issue 13
TRIPLE TROUBLE
inside
SONG LYRICS
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SLEEP WALKING
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FRE E August 2012 D Issue 13
SUN SMART FAIR SKIN ATDANGER p.08
A BIG SECRET THE IMPACT OF IMPOTENCE p.14
ASK YOUR GP GETTHE BESTFROM YOUR CONSULTATION p.20 WWW.WAITINGROOM.IE
A MIGHTY PROBLEM
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TWR - July 2012 - Issue 13:The Waiting Room - Summer 2012 - Issue 13
e struck me th The solution n I received he a have other day w y NCT was The words ‘I ’ will be notice that mual conundrum cunning plan extreme h it w due. The us ke the jalopy ed view e familiar os th by arose: do I ta and ask them sm cynici h ‘O r. de ad ck to the garagehing north of with Bla y, sa l il w ey to fix everyt do I go for the I yeah?’, th ebrow. But g ey an the tyres, or g it will fail, g in ch ar a cunnin ve ha do test, knowin only the faults ly actual and then fix he latter made plan. sed? T tax disclo Last year, I had pecially our a e. es ns s, se w la ur O orth of ly contain about €600 wwork done – laws, invariabs which highic prophylact ed. So off I few loopholewyers and and still fail iled, had the priced tax la duly sniff out s nt went, duly fats put right and ta un co ac r clients ei th of lf offending bi sit. In other ha on be only the , it ce fa s passed the rethe NCT man t’ and, le r fees or ei th rd fo af words, I let t needed fixing rich can their while to th or find out whaving the garage w it nd t fi result: fa he T . instead of gi anche. So why em th hire ces in tax an tt pi ng man carte bl me with yi cats pa pulace po l ra ne ge not do the saLet some fatand the a legislation? y some mumbling up storm. Some ed nt cat client pa wyer a small te on disc holes op lo e th if plump-cat la ot out What Is r wonde left so ly te ra be rtune to ro li aren’t de for hire fo rong With This s er ng li ns W that the gu ng to ferret d then - and Legislation an have somethi utter at the ing bit nn cu e this is th out; others me of our ter for is in M have The incompetenc ho do their that fat-catil Loopholes na quickly it legislators wve them, but flap closed so a Manx of best, God lo get it wrong. ly nt almost makeshas oiled te is cons collusion ’s it er th the one who takes the he But, w e fact th e, nc te pe through and ky fingers with s or incom the loophole at th lawyer’s stic M of L, just ns ai m re e to be er th s it. Then Themmer and nails ay w al are ted on oi pl ex d sits back, ha and waits for an found y-rich ad re al e th at the ready, cat-flap to be behalf of y-becomingkl ic the next fatqu e th by content al m found. nd A . rich e? main the lot Cunning, ay mumblings rece. la pu of the po naill
Maurice O’Sca EDITOR
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inside Summer 2012
EDITOR’S LETTER
Summer 2012 Winners Mr Mike Hirst, Co Cork who wins two nights B&B and one evening meal at the luxury four star Clayton Hotel in Galway. Ms Noreen O’Sullivan, Dublin and Mr Patrick Smyth, Co Meath who both win €50
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Features
08 Sunscreen vs Skin Cancer
How to care for Celtic skin
10 Triple Threat
Two parents and three little ladies tell their story
14 It’ll Be Alright On The Night...Or Will It? An intimate problem
18 Happy Birthday To You
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Just don’t sing it to me...
20 Speak Up
Get the most from your GP
22 The Meaning Of Music
How and why songs speak to you
Regulars
04 Notebook Bits and Bobs
Competitions 28 Crossword
€50 for winning entry
AUGUST 2012 | THE WAITING ROOM
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Don’t ignore danger of sun to young eyes TWO IN THREE PARENTS ARE RISKING THEIR CHILD’S EYESIGHT BY EXPOSING THEM TO HARMFUL UV RAYS WITHOUT APPROPRIATE PROTECTION, EXPERTS AT TOUCHSTONE OPTICIANS AT BLACKROCK HALL PRIMARY CARE CENTRE WARN. DISEASES SUCH AS CATARACTS OR MACULAR DEGENERATION AS ADULTS. Deirdre Dillane, Optician at Touchstone Opticians, says, “The lens of a child can leave 70% more UV rays reach the delicate retina than an adult. Therefore, if anything, extra precaution should be taken with children. However, parents in Ireland can be quite casual about eye protection for their kids, most likely because of the infrequency of our sunny weather. What Irish parents need to realise is
that UV rays can still penetrate under cloud cover, and Irish children are probably more vulnerable than our European neighbours because, like our fair skin, our predominantly blue pale eyes are much more prone to burning.” Deirdre went on to say that, “Although the majority of us are aware that UV rays are bad for our eyes, many do not understand why or how they affect the eye. UV-A Rays penetrate deep into the eye, while UV-B affects the cornea on the front surface and lens, which is your focusing mechanism. Over exposure to either UV Rays can lead to the development of cataracts and even skin cancer in the tissue surrounding the eyes.” Top Tips to protect your eyes: Irish law states that all sunglasses must carry a CE label, which shows “some” UV
protection is offered, but this does not go far enough as the amount of UV protection is unknown. At Touchstone Opticians we recommend only buying sunglasses with the additional information of the amount of UV protection offered. We recommend 99-100% UV protection, and this can sometimes be written as “UV blocking up to 400nm. If it does not state this, then we would advise against purchase Beware of dark coloured lenses as they do not necessarily provide better protection. Do not be misled by price – more expensive does not always mean better protection. Cut out 100% glare with Polarising lenses, which are ideal for improving vision quality in bright or hazy driving conditions. If you are squinting, then yes, you need to put on your sunglasses even if it is a cloudy day.
One –third of people living with HIV are unaware of their infection
HEALTH
OVER ONE-THIRD OF PEOPLE IN IRELAND WITH HIV ARE UNAWARE OF THEIR INFECTION AND ARE THEREFORE MISSING OUT ON TIMELY TREATMENT, DR JACK LAMBERT, A LEADING INFECTIOUS DISEASES SPECIALIST FROM THE MATER HOSPITAL, DUBLIN, HAS SAID.
Speaking to TWR following Irish Aids Day, Dr Lambert spoke about a new campaign to encourage those at-risk to get tested, entitled ‘Don’t Guess, Get Tested’. He said that over half of the 320 people newly diagnosed with HIV in 2011 presented late, suggesting that barriers remain to HIV testing in Ireland. “Barriers to early diagnosis of HIV include
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fear of a positive result, discrimination and a lack of confidentiality and knowledge of medical treatments for HIV,” Dr Lambert said. According to the latest Disease Surveillance Report of the Health Protection Surveillance Centre, 6,287 people have been diagnosed with HIV in Ireland since the early 1980s and a total of 320 individuals (235 males and 85 females) were newly diagnosed with HIV in 2011, representing a 3% decrease to 2010 (330 cases). The figures show that of the 85 female cases newly diagnosed in 2011, 27% were reported to be pregnant at HIV diagnosis. Also, the overall rate of new HIV diagnoses has decreased annually since 2008. “We have to continue challenging the stigma that still
THE WAITING ROOM | AUGUST 2012
surrounds HIV in Ireland in order to effect change. The public needs to know that by avoiding early HIV testing, you put yourself at risk of rapid disease progression, possibly leading to AIDS,” Dr Lambert said. “Presenting late with HIV also causes problems from a socioeconomic point of view, as people tend to be more ill when they do present, leading to a greater burden of care. Healthcare professionals also need to become more pro-active about referring patients for testing at an appropriate time.” Open Heart House, the Sexual Health Centre in Cork), AIDS West in Galway. the Dublin AIDS Alliance and the Red Ribbon Project in Limerick teamed up to launch the campaign, which is supported by Abbott. YOUR FREE COPY
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Breastfeeding help is at hand ELMWOOD MEDICAL PRACTICE IN CORK HAS ADDED A NEW SERVICE TO ITS PRACTICE; BREASTFEEDING CONSULTANCY. Clare Boyle, registered midwife and lactation consultant has recently joined Elmwood Medical Practice providing help and support for women who are experiencing problems with breastfeeding. Clare has been working with breastfeeding mothers in Cork for the past 10 years and also has worked in the US and UK. As more and more women choose to breastfeed there is an increasing need to provide specialised breastfeeding help for those who are having problems, the doctors at Elmwood Medical centre wanted to provide such a service for their patients. Clare says that for most breastfeeding problems there is a breastfeeding solution but often women are advised to give up breastfeeding if they are having problems. This is unfortunate as the benefits of breastfeeding for the mother and baby are profound and every effort needs to be made to help mothers continue with breastfeeding. Clare is delighted to part of the Elmwood Medical Practice and says
“There is so much that can be done to help women having breastfeeding problems and the doctors and team at Elmwood have been very supportive in welcoming me on board”. Elmwood Medical Practice GP Dr Rose Curtin heard about Clare’s work through her colleague and fellow GP, Dr Rachel Barry. Earlier this year Clare helped Dr Barry with some problems she was having with breastfeeding her new baby. Dr Barry says “the advice Clare gave me was invaluable and I was able to overcome the issues I was having and continue to breastfeed. Her advice was up-to-date, practical and very easy to apply. It is reassuring to know that somebody like Clare is available to help at such a time and I would highly recommend Clare to my own patients”. Dr Curtin says “I am delighted to have Clare join us in Elmwood, I know she will be a great asset to the practice”.
To celebrate, Elmwood Medical Practice would like to offer the first ten readers to contact The Waiting Room a voucher for €10 off a Preparing for Breastfeeding Class. Contact tarren@waitingroom.ie To make an appointment with Clare contact her on 087 4198764 or visit her website www.breastfeedingconsultant.ie
HEALTH
Online Education for Parents of Children with Coughs and Colds THE SCHOOL OF PSYCHOLOGY AT NUI GALWAY IS CURRENTLY RECRUITING PARENTS OF YOUNG CHILDREN TO TAKE PART IN AN ONLINE EDUCATION PROGRAMME.
The programme offers parents the opportunity to access information relating to the treatment of coughs and colds in their young children. It will focus on dispelling myths relating to over the counter treatments and provide instruction on how to cope with a sick child. The overall aim of the session is to inform and help parents. Young children are at greatest risk of frequent colds, with children catching as many as seven to 10 colds throughout the year, not just during the winter months. There are more YOUR FREE COPY
than 200 different cold viruses, and signs and symptoms tend to vary greatly. The online programme is part of a research project being carried out at NUI Galway by Dr Jane Walsh, a lecturer in psychology at NUI Galway, and PhD student Teresa Corbett. Parents will be in with the chance to win one of two prizes worth €50 in return for their participation in this study. The researchers are specifically interested in hearing from parents of children aged 3-6 years of age. Dr Walsh said: “We all hate to see our children suffer with the symptoms of a cough or cold, so it is important for parents of young children to take the time to learn what can be done to ease those symptoms appropriately. This project is hoping to establish if online education systems may be delivered effectively
to help these individuals. Busy parents can simply log on and learn how a cold can be managed effectively.”“This online setting is particularly fitting for parents as it may be accessed at their convenience, fitting in with their hectic daily schedule”, added Dr Walsh. “The programme layout is easy to use and does not take long for busy individuals who would like to log on and learn more about these everyday symptoms in their child.” The programme is designed to be accessible to all people who have a computer. GPs, friends and family are encouraged to refer interested individuals to participate.
For further information, please contact Teresa Corbett, at t.corbett2@nuigalway.ie, or go to www.nuigalway.ie/psy/sub/coughsandcolds.html
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Unilever Food: Call-to-action
THE WAITING ROOM MAGAZINE is produced and printed in Ireland EDITOR Maurice O’Scanaill maurice@waitingroom.ie MEDICAL EDITOR Dr Sophie Faherty PRODUCTION/DESIGN Colm Geoghegan colm@waitingroom.ie ADVERTISING Tarren Skalska tarren@waitingroom.ie CONTRIBUTORS Hugh Tynan, Dr Michael Moloney, Dr Michelle O’Connor, Mark Morgan, Therese Hegarty, Claire Greene PUBLISHER Danstone Ltd. PRINT Midland Web Print
Unilever Food Solutions has issued a call-to-action to the food service industry: make small changes to your menus and become part of the solution to the growing obesity crisis. With a campaign tagline of ‘Reduce Calories without Compromise’, Unilever believes that by making smart ingredient choices, reviewing portion sizes and rethinking cooking techniques, chefs and operators can reduce the calorie content of their top-selling dishes without compromising on quality and taste. According to the findings of World Menu Report 3: Seductive Nutrition, consumers wish to eat more healthily when dining out. Globally, two-thirds of people said that they look for the healthier option on a menu, even if they don’t end up choosing it.
Here at home, research showed that two-thirds of Irish consumers would prefer slightly healthier options when eating out, with more than half indicating that they often look for the healthy option on menus. Next to this, 80 per cent of Irish consumers said that when they eat out they prefer to treat themselves. This highlights a clear struggle between intention and choice with what people want to eat winning out over what they think they should eat. So why do consumers’ good intentions not translate into action? In Ireland, Unilever’s research findings point to a number of barriers to healthy eating: healthier options tend to be more expensive (54 per cent), the healthy option is not very filling (48 per cent) and the healthy option usually
doesn’t sound very appealing (49 per cent). As part of the Seductive Nutrition Service, Unilever Food Solutions has developed an innovative free tool, which has the potential to support the food service industry in implementing calorie menu labelling. Their new “calorie calculator” allows chefs and operators to experiment with different ingredients and see how they can affect the calories of a dish. Chefs can search for specific ingredients and create a dish from scratch by dragging the ingredients onto the plate then adjusting weights. Alternatively, chefs and operators can search through a database of popular dishes tailored to different types of catering outlets. Check it out at www.unileverfoodsolutions.ie
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Q10 can restore the energy of your youth. As we grow older, our energy levels drop. Some resort to ginseng and other stimulants, but there is a far better alternative: a vitamin-like compound called Q10. Q10 is the key to energy production that takes place inside our cells. Decreasing levels of Q10 is what causes our energy levels to drop with age. Here is the good news: You can take a Q10 supplement and restore the energy levels you had years earlier.
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What is the main function of Q10? A) gives energy B) converts fat to muscle C) maintains healthy joints
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Adhesive Capsulitis
(FROZEN SHOULDER)
EUROPEAN CUP, WIMBLEDON, TOUR DE FRANCE, OLYMPICS . . . WE’RE BEING CARPET-BOMBED BY SUPER-FIT ATHLETES THIS YEAR, WHICH PROMPTED DR MICHAEL MOLONEY, A KILLARNEY GP, TO THINK OF A CONDITION THAT AFFECTS ATHLETES OF A SLIGHTLY LESS LOFTY CALIBRE
Causes
The exact reason is unknown. It tends to occur in middle-aged or older athletes and is believed to arise from some form of irritation to the shoulder joint and its surrounding capsule. Some 2% of adults will experience the condition. Most commonly, the non-dominant shoulder is affected though, in about 20% of cases, the second shoulder also becomes involved at some stage of the condition.
Symptoms
The two main sensations are shoulder pain and loss of movement. Normally, the pain comes first, so pain is referred to as the First Phase of frozen shoulder. The pain may be aching, dull or stabbing, and is most frequently felt deep in the shoulder and over the outside of the upper arm. It is generally aggravated by almost all movements of the shoulder and arm, and its intensity or strength may vary from day to day depending on use of the arm. The pain is often strong enough to interfere with normal activities and may interrupt sleep. This First Phase typically lasts 2-9 months. As the pain gradually eases, the Second Phase develops. This is typified by a progressive stiffness and loss of movement of the shoulder as a result of a gradual formation YOUR FREE COPY
of adhesions or scars within the joint capsule. Stretching of these adhesions may aggravate the pain. This phase can last from 4-12 months. The Third Phase, also known as the ‘recovery’ or ‘thawing’ phase, lasts between 5 months to a number of years. Pain and stiffness gradually ease and shoulder function returns to normal.
What to do
If you suspect you have adhesive capsulitis, consult a sports medicine professional or GP. Do not ignore the problem. Delaying treatment leads to worse symptoms and prolonged recovery.
Long-term effects?
Frozen shoulder usually gets better on its own, though unaided recovery may take up to several years. Treatment markedly reduces this time and, fortunately, once recovery does occur, the long-term outlook is good, unless there is some other underlying condition, such as a tear of the rotator cuff.
Management
Treatment is aimed at reducing pain and improving shoulder movement. Painkillers: Paracetamol should be used first but, if ineffective, your GP may prescribe antiinflammatory painkillers. Shoulder exercises: These are commonly advised to keep the shoulder from 'stiffening up' and keep movement as full as possible. For most benefit, it is important to do the exercises regularly, as instructed by a doctor or physiotherapist. Physiotherapy: Many people are referred to a physiotherapist who can give expert advice on the best exercises. Also, they may try other pain-relieving techniques such as warm or cold temperature packs and TENS machines.
Steroid injection: An injection into, or near to, the joint brings good relief, for several weeks in some cases. Steroids reduce inflammation but do not cure the condition and symptoms tend to return gradually. However, many welcome even the temporary relief. Surgery: An operation is sometimes considered if other treatments have failed. Although surgery has a good rate of success, it does not help in all cases. Techniques include: Manipulation – the anaesthetised patient’s shoulder is moved around by the surgeon. Arthroscopic capsular release – the tight capsule of the joint is released with a special probe. This is a relatively small operation, “keyhole” surgery, often done as a day-case procedure.
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Some 2% of adults will experience the condition. Most commonly, the non-dominant shoulder is affected
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Often referred to as “frozen shoulder”, adhesive capsulitis refers to inflammation and scarring of the capsule which surrounds the shoulder joint. Irritation to the shoulder joint capsule (capsulitis) results in an inflammatory response which often gives rise to the formation of adhesions or small scars between folds within the capsule. Hence, the name: adhesive capsulitis. Without treatment, symptoms usually go, but this may take up to 2-3 years.
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FEATURE SUNSCREEN VS SKIN CANCER
Sunscreen versus
skin cancer TECHNIC ALLY, THE SUMMER SEASON IS WELL UNDERWAY IN IRELAND BUT WITH BLUSTERING WINDS AND DRIVING RAINS DOMINATING JUNE AND JULY, ONE WOULD BE FORGIVEN FOR ASSUMING THE EARTH HAS HASTENED ITS ROTATION AND SKIPPED STRAIGHT INTO AUTUMN
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THE WAITING ROOM | AUGUST 2012
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“ D e r m at o lo g is t s talk about mela no ma s and about having to cut these off the skin; these are the peop le who a re mo st adamant i n wan ti ng th eir p atien ts to use suns creens.”
SUNSCREEN VS SKIN CANCER FEATURE
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VEN THOUGH THE SKIES ARE NOT LACED WITH BLUE AND THE SUN ISN’T MELTING THE TAR IN THE ROADS, HOWEVER, SUNSCREEN STILL REMAINS A NECESSITY. DR CURTIS COLE, SENIOR DIRECTOR OF RESEARCH AND DEVELOPMENT AT JOHNSON & JOHNSON, THE WAITING ROOM SPOKE TO HEALTHY U ABOUT THE IMPORTANCE OF DEFENDING YOUR SKIN EVEN WHEN THERE MAY SEEM LIKE NO NEED TO DO SO. Having worked on developing and evaluating models for sun protection for the past 24 years, Dr Cole should be greatly heeded when he advises people to wear a product with “a minimum of Sun Protection Factor (SPF) 30 everyday”. Likening himself to the majority of Irish people, Dr Cole said, “I also have fair skin. And I would absolutely recommend that the minimum factor to use should be SPF30.” Sunlight, which contains vitamin D, has its benefits, but too much can damage the skin. It is known that Ultraviolet C (UVC) is the most dangerous type of ultraviolet light in terms of its potential to harm life on earth, however, it cannot penetrate the earth’s protective ozone layer. UVA and UVB rays both penetrate this layer of protection. While both can stimulate vitamin D, which promotes the growth of bones and teeth, the negative implications are that these rays can cause skin cancers.Sunscreen shields from these rays. Dr Cole advised that different reasoning appeals to different sectors of the population around the use of sun protection. He suggested that in order to raise awareness of the importance and everyday necessity of using SPF, healthcare professionals should use different measures of communication with different age groups. “Dermatologists talk about melanomas and about having to cut these off the skin; these are the people who are most adamant in wanting their patients to use sunscreens. And it is talking about melanomas that certainly gets the attention of an older population,” he outlined. In order to hook the attention of the younger population, Dr Cole said healthcare professionals need to appeal more to the immediacy of “what will happen if I don’t use sunscreen”. “The immediacy of it is, if I don’t use this protection on my skin, then I’m going to get burned and it’s going to hurt,” he stated bluntly. Reseach has shown that melanoma, the most deadly type of skin cancer, will continue to rapidly rise in Ireland. There has been an increase of 41 per cent in the incidence of skin cancer in the country in the last 10 years, from 5,776 cases in 2000, to 8,145 in 2009. “We’re really recommending that people use SPF 30,” Dr Cole stressed. “Fair skin is one of the most sun sensitive skin YOUR FREE COPY
types in the world. The whole idea of using a higher SPF is to limit the total amount of exposure.” The amount of cancer causing rays people are exposed to can be a lot more than imagined. “Even being in an office, there is a fair amount of UV from all of these new fluorescent office lamps and these low energy type of fluorescent fixtures,” he said. Gesturing around the space, he added, “there is much more exposure nowadays to harmful rays from being in the office”. “In my office, right by the window and first thing in the morning, I get direct sunlight through the window, which allows UVA radiation through also,” he said. “The glass filters the UVB, which is good as you are much less likely to get sunburnt. But you still get a lot more of the UVA that comes directly through the glass, so if I sit like this at my computer, one side of my face is constantly being exposed.” Dr Cole drew special attention to the fact that sun exposure causes skin cancer. During his 12 years working at the Dermatology Department of Temple Medical School, Dr Cole was involved in extensive research on the effects of ultraviolet light on skin; both the acute effect, which is sunburn, and chronic effect, which is skin cancer. He concluded by warning that in the case of skin cancer and melanomas, prevention is better than cure, and begins with daily application of sunscreen. AUGUST 2012 | THE WAITING ROOM
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FEATURE TRIPLETS
TRIPLE Trouble
In 2009, there were thirteen sets of triplets born in Ireland. Only one set was born in Galway University Hospital and Sophia and Jimmy, the parents of those three gorgeous young lassies, take a breather from their full-time job to tell their story so far
So phia’s st or y ARE YOU SURE THREE HEART BEATS WEREN’T CONFIRMED?” THE LADY OPERATING THE SCANNER ASKED. AT 22 WEEKS, I WAS HAVING MY FIRST ULTRASOUND IN GALWAY UNIVERSITY HOSPITAL. JIMMY AND I BOTH SAID IN SHOCKED UNISON: “THREE! YOU’RE JOKING!”
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The initial small scan in our local doctor’s office had shown one heartbeat; the second, at 13 weeks, had shown two and, after the initial surprise, we were delighted. When we had decided to try for a baby we were aware of the fact that there were twins on both sides. But there was no record of triplets. And so, at 22 weeks, began our journey with three. I was very well taken care of in
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hospital, had scans almost every month and, towards the end, almost every two weeks. Apart from morning sickness and heartburn throughout, my pregnancy was uneventful, no high blood pressure, swelling or mobility issues, and, once the ultrasound confirmed that all three babies were growing well and healthy, I relaxed and enjoyed the pregnancy. I kept active, swimming, walking and made sure I ate well for the little ones growing inside. The babies were born by planned Caesarean at 35 weeks and 4 days, all at 9:03 in the morning. Roisin (5lbs 2oz) and Meera (4lbs 10oz) were left with me but little Shona (just 4lb 4 oz) had to stay in the special baby unit for over a week to get her weight up. Then all five
THE WAITING ROOM | AUGUST 2012
of us went home. Having three babies in the house meant being very organised. I expressed milk for a short while and the girls were fed a combination of breast milk and formulae. We followed the feeding charts from the hospital and recorded every feed and also any difficulties the girls might have, like reflux and wind. All the books said how important this was because if any of them got sick it would be important for the doctor to know about their appetite and general wellbeing, and with three it would be so easy to forget who finished her bottle and who didn’t! Thankfully the girls have been healthy to this day with very little doctor visits needed. From the outset we maintained a YOUR FREE COPY
routine because this made life manageable and enjoyable for everyone. Part of that routine has included getting out for a walk every day and we are lucky to live in a beautiful area with many beaches and walks. Looking back over photos and journals, we realise that all the effort we’d put into those early months actually paid off. All three girls slept through the night at 11 weeks and anyone who has a baby will agree that parenting on a full night’s sleep is a much more pleasant experience. The kids would probably also agree! IMBA (Irish Multiple Birth Association) put us in contact with two other couples in the Galway area who had triplets. It was, and still is, great to be able to chat about what’s going on with another family with multiples, particularly as their triplets are older and they’ve been through it all already. Hopefully we can repay the service some day.
Jimmy’s tale Being a Dad of three small children means being fully involved in everything from feeding, changing, dressing and giving hugs from bangs and bumps. Our routine involves the girls feeding and napping at the same time so it is a full time job for both of us. As I also work full time, life can sometimes get so hectic that there is little time to think about how it feels. But having three little girls run out
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to greet me when I get home is endlessly amazing. As three individuals, they have their own personalities, likes and dislikes and, as sisters, get on well together with just the normal moments of annoyance. They all sleep in the same room and they chat together before they go to sleep and also first thing in the morning. It’s lovely to hear them discussing subjects like who likes blueberries, who might come and visit, and whose teddy is hungry, important stuff, like. From the moment we discovered we were expecting triplets, right through their birth, and to this day, we have really been blessed with support from the community: pairs of hands to help with feeds; delivery of food and clothes in the early days; people still popping by to say hello and spend time with the girls. We can, without doubt, say that, apart from the work involved, having three babies at once means being the recipients of a truly amazing tide of kindness and practical friendship. Now the girls are 2½ and we are not beginners anymore. Having three children the same age is normal to us and, although some moments can still be daunting (toilet learning at the moment), we have learned that nothing can match the joy of watching them all laugh at some private joke or help each other close buttons or even catching one of them taking three strawberries to share with her sisters in the tent in the garden.
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TRIPLETS FEATURE
From the outset we maintained a routine because this made life manageable and enjoyable for everyone.
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FEATURE HEART HEALTH
New treatment can prevent heart-related mortality H ow would you like to reduce your risk of dying of cardiovascular disease by over 50 per cent? According to a whole new study conducted by researchers from Linköping University Hospital and The Karolinska Institute, combining a mineral with a vitamin-like compound called coenzyme Q10 will do the job, at least for the elderly. In their study of 443 Swedish men and women aged 70-88 years, the researchers observed how those who took this combination had less than half the cardiovascular deaths as those who took identical “dummy pills” - also called placebo.
ACCORDING TO A NEW SWEDISH STUDY, RETIRED PEOPLE CAN REDUCE THEIR RISK OF DYING FROM HEART DISEASE BY OVER 50%, BY TAKING SUPPLEMENTS OF TWO NATURAL COMPOUNDS
Better heart function
In addition to reducing cardiovascular mortality by over 50 per cent, the Q10 supplement improved heart function substantially. Volunteers taking the supplements had lower levels of a substance called NT-proBNP. An elevated level of this substance is normally a sign that the heart is working under pressure. Secondly, the scientists observed by means of echocardiography, that the hearts of those in the active treatment group functioned significantly better than those in the placebo group. Source: International Journal of Cardiology
What is coenzyme Q10?
Q10 is a vitamin-like compound that is found in the diet which is also produced endogenously by the human liver. All cells need it in order to produce energy in a process where fat, carbohydrate, and protein are converted into ATP (adenosine triphosphate). 95% of the body’s energy is made that way. As we age, our levels of Q10 decrease. Also, reduced levels of the substance have been observed in the heart muscle tissue of e.g. patients with chronic heart failure. In studies, supplements of Q10 have been seen to confer clinical improvement in the form of improved cardiac output.
1) Fat, carbohydrate, and protein enter the mitochondria 2) Here, the different nutritious elements are converted into ATP with help from Q10. ATP is energy stored in molecular form 3) When the cell needs energy, it breaks down ATP and releases the energy trapped inside Source: Alehagen U, et al. Cardiovascular mortality and N-terminal-proBNP reduced after combined selenium and coenzyme Q10 supplementation. Int J Cardiol. 2012. E-pub ahead of print.
Results from a new Swedish study on elderly people shows that nutritional supplements have a significant effect on improving heart function and overall health. The study was administered by 5 professors from Linköping University Hospital and The Karolinska institute
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HEALTH IMPOTENCE
IT’LL BE ALRIGHT ON THE NIGHT– OR WILL IT? Guys, face it: at some point in your life you will experience some form of sexual dysfunction, either personally or through a partner. The incidence increases with age (see attached graph) and, as life expectancy increases, both the pharma and medical fields are challenged to address this issue. The difficulties experienced by men can be devastating as it is an issue inextricably linked to self-esteem. Newstalk presenter, rugby commentator, and impotence spokesperson, George Hook, says: “Sex and your ability to perform sex, for a man, strikes at your very core.’ Erectile dysfunction (ED) or impotence is an inability to sustain an erection during sexual intercourse. ED affects 7YOUR FREE COPY
D r M ic he ll e O’ C o n n o r, specialist in male reproductive health issues, looks at a fear that haunts most men – Impotence!
8% of men in the 20-40 age group and more than half of men over 70. As a man’s body succumbs to aging, his blood vessels begin to narrow; this restricts blood flow to the penis (the cause of an erection) and can cause ED. For older men this can be an early indicator of peripheral vascular disease, coronary heart disease, diabetes, hypertension, high cholesterol or prostate cancer. A GP will investigate these possibilities when confided in. ED can also be due to weight gain, spinal injury, hormonal imbalances and the use of many drugs, including alcohol. When a young man (under 40) experiences a loss of libido, it is often down to psychological factors. ‘Hollywood’ and pornography have
glamorized the act of sex to the extent that it surpasses realistic expectations. There is also a great disparity between casual, anonymous sex and the more intimate love-making between committed partners, and it can be difficult for young men to make this transition. However, as men age, physiological rather than psychological factors play a greater role in causing ED. Sexual dysfunction, ED in particular, seems to be more prevalent in recent times but the increase in couples seeking help doesn’t necessarily indicate an impotence epidemic; people are now reaching out for a cure where previously they had felt there was none. C O N T I N U E D O N PA G E 1 4
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HEALTH IMPOTENCE
The first step is undoubtedly for couples to talk to each other and to book an appointment with a GP.
The development and widespread marketing of drugs like Viagra, Cialis and Levitra have given new hope and these medications are now used to successfully treat two thirds of men with ED. Although Viagra was originally only available through GP, in 2007, demand led Boots pharmacies in the UK to introduce the sale of four Viagra pills over the counter for £55, following a consultation with a pharmacist. Various health websites and shops sell herbal remedies that claim to mimic the effects of Viagra. Citrulline, found in watermelons, is being marketed to improve virility, as it can relax blood vessels around the groin and allow blood flow to the penis. Vacuum pumps have also been successful in increasing blood flow to the penis and can help the user maintain an erection in 90% of cases. Other solutions include intracavernosal injections (injections to the penis), transurethral therapy (inserting a small pellet into the penis) and penile implants. While ED is one form of sexual dysfunction, another problem at the opposite end of the spectrum is Premature Ejaculation. This occurs when a man ejaculates either before or within one minute of commencing intercourse. The average time for sexual intercourse is around five and a half minutes. Premature Ejaculation affects close to one third of men and can be due to psychological issues or an overly sensitized penis. Couples’ counselling will help address any psychological issues and partners can learn helpful techniques to delay ejaculation such as the ‘squeeze technique’. A thicker condom can help to desensitize a penis and a specific selective serotonin reuptake inhibitor (SSRI) pill has also been developed for the treatment of premature ejaculation. Men are living longer healthier lives and can be sexually active into their 60s and 70s. These men are more likely to encounter ED in their senior years. When such a problem occurs, it’s important to discuss it with partners. Women may blame themselves for becoming less desirable to their partner. GPs are accustomed to hearing about sexual dysfunction and men should not feel embarrassed or awkward about discussing this common problem with them. The GP can then establish if ED is symptomatic of a more serious underlying condition and suggest treatment options. There are many effective treatments for sexual dysfunction, but the first step is undoubtedly for couples to talk to each other and to book an appointment with a GP. For further information on male infertility issues, go to www.fertilitycheck.com or email info@fertilitycheck.ie
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Viagra (Sildenafil), became licensed in the UK in September 1998. Not recommended for: Men being treated with organic nitrates and Men with cardiovascular disease
Dr. Michelle O'Connor B.Sc. Ph.D. established ‘Fertility Check’ in Cork which focuses on Male Reproductive Health issues YOUR FREE COPY
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ADVERTORIAL DRINK AWARE
Alcohol
A GUIDE FOR PARENTS
Young People and Alcohol, can parents have an Influence? by Mark Morgan and Thérèse Hegarty THE
PURPOSE OF THIS ARTICLE IS TO HELP PARENTS TO DISCUSS DRINKING WITH THEIR CHILDREN. Although it is mainly aimed
at the parents of teenagers it may also be useful for parents of younger children and, generally, for all adults concerned with the development of children. This article has been prepared by professionals who have expertise in the area of young people and alcohol but it does not set out to tell parents what they must or must not do. Instead it tries to provide useful information, which may help parents to openly discuss the issues with their children. Parents have an important influence on their children’s behaviour. Many parents may be surprised by this – but it is true! A key guiding idea is that alcohol consumption requires maturity and responsibility. For this reason postponing a first drink to an agreed age has a lot of merit. The exact age will need to be negotiated between children and parents and we take the view that the age of drinking by many young people is too young. Better information can help parents to make the right decision. We often think that we know about our children’s drinking but many parents tend to underestimate the scale of consumption. In Ireland, drinking patterns differ from, for example, wine producing countries – where children are introduced to alcohol in the home. We also differ in where alcohol is drunk, what we drink and in many of our attitudes. INFLUENCES Many factors influence the drinking patterns of young people. FAMILY Families are of major importance in children’s drinking. Your example is important. We are not saying that all parents who abstain from alcohol will have children who are abstinent or temperate. Nor are we suggesting that the children of heavy drinkers will necessarily have drinking problems. What is clear however is that parents who drink moderately have children whose use of alcohol is quite different to the children of those whose drinking is problematic. How you react to their drinking is also important. The research shows that a
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moderate and balanced approach to underage drinking is most likely to bring about positive outcomes. In other words if parents take an indifferent attitude it does not produce positive results and a very strict and authoritarian attitude can also cause problems. Many recovering alcoholics remember their childhood as one where love was not communicated and where they felt they were not valued. The research indicates that children who feel loved and valued are less likely to abuse alcohol. We often worry that alcohol problems ‘run in families’ and will be inherited by the children. This is not necessarily true – alcohol problems develop over several years – and we should focus on those conditions in the individuals’ lives which give rise to problem drinking. FRIENDS Parents identify peers as the most important influence on their children’s decision to start to drink. This is understandable – young people who drink regularly are likely to have friends who drink, while those who do not are likely to have friends who do not drink. Whether to drink (or not) is one of the most central decisions during adolescence and influences the selection of friends. Many of us worry about ‘peer pressure’, which is often considered to come from all the peer group in the locality and school. The reality however is that it is the peer group of those selected friends, especially best friends, which matters most. SCHOOL AND COMMUNITY You may know about the Social, Personal and Health Education (SPHE) programme, which is now running in most schools in the country. This focuses on the health, personal development, decision making and self esteem of young people and it also deals with the use of alcohol. However we cannot leave it all to the schools and, as parents, we can influence our children’s attitude to school and to participation. ‘She will be taught about alcohol at school soon enough – maybe I should leave alcohol education to the experts. Besides, I don’t want to put ideas in her head before she’s even a teenager.’ When a young person drinks too much it is usually part of a broad set of behaviours. Here are some suggestions that can help prevent these behaviours: • Encourage commitment at school –
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either to study or sport or other activities; • Find out about your school's policies on alcohol. Partnership between parents and schools is likely to bring about a better outcome than any effort made by either on their own; • Encourage children to read or to take up a hobby that does not involve drink. Moving from Primary to Secondary school is a stressful time – new subjects, new teachers, possibly new classmates and making new friends. If the transition isn’t smooth young people are more likely to become involved in underage drinking. Our children may want to appear ‘grown up’ at this time but in fact they are very vulnerable and we need to be alert to any changes and be available for a chat. Teachers have insights into our children which we may not have. Many are parents themselves and they all play a significant role in our children’s formation. Do talk to them if you have concerns about alcohol abuse. HOW YOU CAN HELP Alcohol abuse is not confined to any particular sector in society. You can be sure that your teenager (or preteen) will be offered alcohol. You cannot be sure that your children will not make silly mistakes with alcohol (You probably did too!) Young people who come through all this with responsible drinking habits often share many of the following characteristics: Healthy self esteem. They know their own strengths and weaknesses and have the confidence to know they are liked and to like themselves. Because of this they are unlikely to harm or abuse themselves. Parents can encourage selfesteem by being supportive of their children’s efforts from an early age and being willing and interested listeners to their ups and downs. They can make decisions. There are many influences on young people, often with conflicting messages. These young people can make up their minds without worrying too much what others think. Parents walk a fine line here. Too much control and children have no opportunity to think for themselves – too little and they may feel that decisions are not important. What young people need is encouragement to think on their feet, follow their own advice and resist YOUR FREE COPY
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DRINK AWARE ADVERTORIAL following the herd at times. They understand that some rules are necessary. Through learning to live with clear and reasonable rules young people develop personal responsibility. Parents can help by having a few clear rules at home and by explaining the values behind the rules. A rule about telling those at home where you are going and what time you will be home is a great protection. They appreciate the value of money. They realise that they must manage on a limited amount of money. Parents can limit their children's pocket money or control the amount available from parttime jobs – by, for example, requiring a contribution to collective household expenses from income earned outside the home. They are busy with interesting lives. Some are involved in school, others in sport, dancing, music or youth clubs. They do not have much time to be bored. Boredom is one of the greatest causes of alcohol abuse. Try to spot their talents early and give them every encouragement to develop them. Their families either drink moderately or are open about their problems. They have seen their adult relatives drink in a moderate way, and have seen them choose not to drink when driving. They may have had an occasional drink in the safety of the home with their parents. Alternatively, if there are problem drinkers in the family, these issues have been openly and frankly discussed with them. Children of alcoholic parents can use the lessons from frank and compassionate discussion of the issue to help protect themselves and their friends. Children are not taken in by appearances – they are more influenced by what we do than by what we say. Teenagers in particular are rarely fooled at home and honesty is certainly the best policy.
PARENTS’ WORRIES “How do I explain the dangers of drink?” Most adults in Ireland take a drink when relaxing and socialising and it is helpful to acknowledge the enjoyable aspect of this. It is also helpful to discuss with young people the harmful aspects such as losing control, taking risks and wasting money. A good time to bring up these discussions is when watching TV when the issue arises. We can talk to our teenagers, listen to their views and convey information and guidance in a distanced way that is not too threatening for them. This has proven more useful than scare tactics or punishment, which can turn young people off. “I worry about the friends they are with.” The ‘best friends’ have a lot of influence in the development of a pattern of drinking. Parents are wise to be aware of the pattern of drinking among young people in the area. It is also helpful to get to know the ‘best friends’ and make them welcome at home. Often parents criticise friends when they fear their influence. This can lead to a young person feeling torn between parents and friends and this is not helpful in maintaining good communication. It is better for parents to convey their worries about the safety of the young people than to run down YOUR FREE COPY
the friends themselves. “Will they end up in a fight?” We also need to discuss the increasing trend towards rowdy and violent behaviour, often under the influence of alcohol, and to clearly state that violence at all levels is unacceptable. Parents can help teenagers to think about places that are dangerous and how levels of alcohol consumption can leave them vulnerable to involvement in fights. Young people need the older generation to be clearly concerned with their safety. “I’m so worried I can’t sleep.” Parents often worry when their teenagers begin to drink. Often that fear is not so much about the drink itself as the consequences of drinking. At its worst the fear can be about drink related violence or poor decision making around sexual activity. “Are they having sex?” We all worry about pressure on our children as they enter puberty and the confusion and anxiety that can follow. The age of sexual activity has fallen and peer pressure along with media pressure can make decision making difficult. Sometimes young people drink in response to this pressure and alcohol consumption can lead to inappropriate decisions. Parents can make it clear to their sons and daughters that sexual activity is always their choice and it is always OK to say "NO". Once again TV and films can provide us with opportunities to discuss this with our young people. “I just don’t know how to begin. I know she drinks sometimes when she’s out with her friends. She’s usually quite a sensible girl, but I just hope she doesn’t take any stupid risks. Should I have drink in the house?” Most households do have drink at home and will often offer a drink to visitors. Drink however needs to be kept in a place where younger children cannot access it by accident. It is unfair to teenagers, especially if parents are away for a night, to leave them in a situation where they have access to a large supply of drink at home especially during the years when they are likely to experiment.
ARE THESE STATEMENTS TRUE OR FALSE? 1 The average age of beginning to drink is 14-15 years FALSE Since the early 80's the average age of beginning to drink has reduced from 15 years to 13 years. The whole 'timetable' of drinking (starting with an occasional drink and following with more regular drinking) is now earlier than a generation ago, but has levelled off, with recent (2011) evidence showing it has increased somewhat. 2 The number of young people who have never tried alcohol has decreased over the years. TRUE There has been a dramatic change here. Thirty years ago about 1 in 4 those leaving post-primary school had not tried alcohol even once.Today the number reaching 18 without having tried alcohol is very small. Some teenagers start to drink because they wrongly think all teenagers are drinking. Recent research shows that the number of teenagers under 15 experimenting with alcohol has dropped and that half of 15 year olds are not regular drinkers. Delaying drinking reduces the risks of harmful drinking in later life. 3 Under 18's know that they will not be able to buy alcohol, even if they want to FALSE Young people aged from 16 upwards say that they can get access to alcohol if they want to. (We are not suggesting that alcohol is always easily obtained – what is crucial is that young people see it as easy to obtain). 4 There is more drinking in cities than anywhere else FALSE people from all backgrounds begin to drink at roughly the same age. 5 All young people do not start drinking in the same setting TRUE There are three broad locations for the 'first drink'. Own home or home of a friend (sometimes when parents are away), pubs/off- licences (sometimes bought by a 'friend' who is overage), and parks/beaches/ waste-ground.
USEFUL CONTACTS Your school’s Parents Council Your school’s Home Liaison Officer Your Health Board's Health Promotion Officer Your local Residents Association VISIT DRINKAWARE.IE for information on alcohol and drinking, from fascinating facts to practical tips. DOWNLOAD FREE GUIDE S including the 'Student Survival Guide' the 'Festival Survival Guide', 'Alcohol Sport & You' and the 'Christmas Survival Guide'.
drinkaware.ie was developed by MEAS (Mature Enjoyment of Alcohol in Society Limited) MEAS is a drinks industry initiative against alcohol misuse MEAS,Merrion House, 1/3 Lower Fitzwilliam Street, Dublin 2. Tel: 01 611 4811 Email: info@meas.ie www.meas.ie
Young People & A lc o h o l Q u iz
6 The changes in Irish Society are part of the picture that influence the drinking of young people TRUE Childhood is shorter in modern Ireland than it was even 20 years ago. Young people are independent minded at an earlier age, are sexually active, and make decisions about their lives earlier. 7 The best time to talk to your children about alcohol is when they enter the early teens FALSE Children often ask about alcohol and drinking when they are very young. When this happens a positive response is better than ducking the issue. Many parents do not see the need to raise the subject until their children reach their teens when they apparently start drinking alcohol. Ideally you should speak to your child before he or she is likely to start experimenting with alcohol.
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FEATURE HAPPY BIRTHDAY
Happy Birthday to you... The song is all very fine but why, oh why, can’t birthdays be spread out over the year? Hugh Tynan casts his usual cynical eye on the phenomenon of birthday clusters
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t's autumn, the season of mists and mellow fruitfulness. Thank God! Because summer brought only rain and birthdays... birthdays, birthdays, and yet more birthdays. Statisticians have always known that babies come in waves, prompted by the prevailing conditions nine months previously – like the boomers of WWII, whose parents fumbled frantically for hope in those apocalyptic times. That's probably why so many Irish people were born in summertime, what with our winters being so bleak and dreary, and generally containing at least one apocalyptic Budget. Repeated studies have confirmed this trend, with August usually topping the natal date chart. In fact there's an interesting mathematical effect called the Birthday Paradox which proves that you only need 23 people in a group to hit a 50% chance that two were born on the same day (and only 57 to hit 99%). Hey, if you're reading this in a waiting room, you could test the maths right now by running a quick survey – surely all those strangers will be happy to reveal their dates of birth? But somehow, we instinctively know all that anyway. We don't need no stinkin' mathematics to tell us the world is full of summer babes. We've got anecdotal evidence coming out our ears. I, for one, bought way too many birthday cards this summer, and I bet you did too. This is great news for Hallmark and the other mega-corps that so kindly define for us the correct sentiments for our major life events, in eight or fewer lines of rhyming doggerel. It's good news also for providers of bouncy castles, piñatas, and whatever the must-have gimmicks were this 2012 birthday season - superherothemed cockfighting, I think. But it's bad news for that famously long-suffering entity, the Man in the Street. Along with his unfortunate fellowtravellers, Joe Soap and the Taxpayer, the Man
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in the Street is seriously impacted by the annual summer blitz of birthdays. And here's why. Firstly and most obviously, greeting cards are comically expensive (in other news: rain wet! Politicians crooked! Life nasty brutish and short!). We all know this, but should never lose sight of it. You can buy a paperback for the price of many birthday cards, especially those with such advanced technology as "classy" embossed writing, googly eyes, or holes in the front to make the gateau pictured inside look like a scantily-clad nymphette. What japes! Oh, and don’t forget the stamps. Impact on Man in Street: Expense. Secondly, consider how many birthdays you're honour-bound to observe. Each one means trips to the newsagent and/or post office, most likely. And you'd better be on in time, because a card delayed is almost as bad as none at all. Now, people will forget stuff, bless 'em. So our benevolent cardmaking overlords do offer "Sorry I'm late!" varieties in the Belated Greetings section. But it's always bothered me that there's no shelf for Premature Greeting Cards, to be sent weeks or even months in advance. "Fecked If I Know When Your Big Day Is!" they'd proudly proclaim in jaunty purple letters. "But This Covers Me Till Next Year, Right?" Until such wonders appear in Londis, however, I'll fume quietly away in my local An Post, sometimes up to thrice a week. Impact on Man in Street: Inconvenience. Finally, there's the pressure to be witty and affectionate. Yes, many are content to write "To Joe Soap, love Jane Doe." And indeed many are content to receive such lazy laconics. But if a thing's worth doing, it's worth doing well. And after shelling out the price of a pint for some saccharine cardboard salutations, it seems wasteful not to customise it somehow, to put something of yourself in the envelope – and not
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something containing DNA, thanks. This leads to either long rambling paragraphs of tawdry cliché, or half an hour of desperate headscratching and a witty epithet that makes sense to no-one but its author. Either way, it's an emasculating ordeal. Impact on Man in Street: Inspiration (or lack thereof). Pity, then, our archetypal Man in the Street. Not only is he doomed to reside outdoors (why is he in the Street? Does anyone know?), but once June rolls round he's bankrupted by birthday obligations. Expense, inconvenience and a dearth of inspiration – these three privations combined could shred the fabric of even the most robust life. And all the birthday cake in the world won't make up for that.
“IT'S ALWAYS BOTHERED ME THAT THERE'S NO SHELF FOR PREMATURE GREETING CARDS, TO BE SENT MONTHS IN ADVANCE . . .” YOUR FREE COPY
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FEATURE ASK YOUR GP
SPEAK UP The Most Important Questions to Ask Your GP
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ASK YOUR GP FEATURE
Research shows that men are less likely to take time off work to attend their GP. Perhaps this is ingrained within society, but it’s time to address the problem. Men in Ireland die, on average, five years younger than their female counterparts and have higher death rates at all ages, and from all leading causes of death.
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verall, men and women have similar rates of developing cancer, but men are more likely to die from it. Why is this? Researchers believe that since men are less likely to seek help, in many cases, they simply leave it too late for treatment to be effective. However, it is not all bad news. Reassuringly, in a recent Central Statistics Office report, life expectancy for men in Ireland was shown to be 76.7 years, showing an increase in 1.6 years since a similar report in 2004. Part of the problem lies in the fact that men tend to be unaware of symptoms to look out for and lack the knowledge or confidence to ask important questions when attending their GP. If men became more aware of their bodies, and more confident in reporting health problems, then treatment would be easier and more effective. The crucial factor is time: if detected early enough, many serious illnesses can be controlled or treated successfully.
Look Out for Symptoms
Do you experience any of the following? If so, you should consult your GP straight away, explaining your symptoms and asking for more investigation if he or she thinks it is necessary. In many cases, these symptoms may be the result of a condition that is not life-threatening, but it is always important to rule out more serious illnesses.
Chest pain; Headaches or migraine; Unexplained tiredness or fatigue; Loss of appetite Problems with vision; Extreme hunger or thirst; Nausea or vomiting; Fever; Mental confusion; Breathing difficulties; Unintended weight loss; Unexplained pain anywhere in the body; Persistent changes in bowel habits (including diarrhoea or constipation); Unexplained bleeding from any part of the body (eg. Bowel or mouth); A persistent cough or hoarse throat; Impotence; More frequent urination; Changes to the skin.
Please note: The above is not an exhaustive list and is meant only as a guide - it would be impossible to carry all the possible symptoms of various diseases here.
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Health Checks
Book an appointment with your GP for a general health-check – even if you are feeling well - and discuss with him or her whether you could have the following basic checks or ask his or her advice on how often these should be done, considering your age, family history and lifestyle habits. These checks are essential as many illnesses such as Type 2 diabetes do not show symptoms at all. Consider this, many people are unaware that their blood pressure has elevated to a dangerous level as often there are no symptoms or pre-warning signs. “Some men attend their GP due to an acute illness,” says Dr Damian Jennings, from Grange Clinic in Donahmede, a GP for more than 37 years. “But basic examination and/or investigation shows that sometimes – apart from that illness – they have diabetes or hypertension, or another illness that they may be totally unaware of it. But simple measures, at an early stage, may well correct and stabilise any disease state.” ESSENTIAL CHECKS: Cholesterol Blood pressure Body Mass Index (BMI) Diabetes Depression
Family and Medical History
Discuss your family history with your GP. If you had a close relative who died from a disease at a young age (anything under 50), this could increase your risk of this particular disease. Extra screening tests may be recommended for you and lifestyle advice will be given to help prevent your risk of the disease. Likewise, it’s worth discussing your own, personal medical history. If, for example, you have a history of polyps or inflammatory bowel disease, this could put you at an increased risk of bowel cancer. Polyps will need to be removed regularly and your GP will refer you for a full colonoscopy (an internal examination of the bowel during which a biopsy may be taken) every few years once you are aged 50 or over.
Prevention
Often GPs don’t have time to discuss prevention, but it is an essential component of health care. Take time to discuss the following with your GP if any concern you, or consider asking her or him to refer you to a specialist to get more advice.
Quit smoking – phone Quitline on 1850 201 203 Watch what you drink – the World Cancer Research Fund recommend limiting it to just two drinks a day for men Be physically active – Starts small and work up to 30 minutes of moderate activity each day Eat a healthy diet – fill your plate with colourful fruit and veg, plenty of wholegrains and pulses; opt for healthier fats and small servings of fish, chicken, eggs or meat Stay at a healthy weight – to prevent gradual increase of weight over time, cut back on food and beverage intake and step up your physical activity Take recommended screening tests – ask your GP about which ones, if any, apply to you and enquire about home DIY tests you could take.
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FEATURE SONG LYRICS
The Meaning of Music I Don’t Like Mondays
When Bob Geldof wrote this song, he wasn’t just expressing the universal antipathy to the start of another working week. The event that inspired it occurred in 1979 when Brenda Ann Spencer (16) from San Diego, California, took a gun to school and went on a schoolyard shooting spree, killing two adults and wounding eight students and a policeman. When asked why, she replied: ‘I don’t like Mondays. This livens up the day.’
Starry, Starry Night
Inspired by the loneliness and tragedy of the life and death of Vincent Van Gogh, Don Maclean wrote this beautiful ballad. He wrote it in the second person, addressing the longdead artist, as if trying to comfort him and reassure him that, despite the failure of his career during his lifetime, he has now become one of the best-known artists of all time. During a solitary life that was marked by bouts of ‘madness’, Van Gogh sold just one of his many paintings. In his final months, Van Gogh famously cut off his right ear, supposedly to present it to a prostitute to prove his love for her. He later committed suicide, though a recent and comprehensive biography suggests that Van Gogh might have been murdered. I don’t know, though: The artist lived for over a day after the fatal gunshot, conversing freely. Wouldn’t you think he might have mentioned it in passing if someone else had shot him?
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It’s usually love won, lost or longed for, that inspires songs, but mass murder, madness, suicide, execution, wrongful hanging and disaster have all provided inspiration, too, like in these well-known anthems. . . .
John Brown’s Body
Hatred of slavery led John Brown, America’s first ‘domestic terrorist’, to lead an ill-fated raid on the Federal Armory at Harper’s Ferry, Va. He believed that, once he had secured the arsenal’s arms, slaves from the surrounding plantations would immediately rise up and this new army would soon see the abolition of slavery. The idealistic raid was doomed from the outset; seven men were killed and others injured but it was all soon over and the raiders were quickly rounded up. John Browne was convicted of treason, of murdering five Southern pro-slavery men three years before, and of inciting a slave revolt, and was hanged. He became a legend among both slaves and abolitionists and the song became popular among Union soldiers during the American Civil War, which began shortly after and was waged largely over the question of ending slavery.
been Anne who killed Laura and that Tom was merely being noble in accepting the blame. On the gallows, he said: "Gentlemen, do you see this hand? I didn't harm a hair on the girl's head." Anne Melton died a few years later, insane.
The Wreck Of The Edmund Fitzgerald
Gordon Lightfoot’s ballad tells the sad tale of the loss of the bulk carrier, SS Edmund Fitzgerald on Lake Superior in a storm in November 1975. The largest ship ever to sink on the Great Lakes, she was carrying a full load of taconite ore, bound for Duluth, Minnesota when she became caught in a massive winter storm. No distress signal was ever reported, but it is unlikely that any ship could have gone to her rescue anyway, due to the waves which were over 35ft high. She sank quickly in 530 ft of water with the loss of all of her crew of 29. No bodies were ever recovered.
Hang Down Your Head Tom Dooley
Tom Dooley (actually Dula) was hanged for a murder he probably didn’t commit. Before the American Civil War, Tom had been ‘walking out’ with Anne Melton. After he returned from fighting on the defeated Confederate side, he took up with Laura Foster and they may have even been engaged. Anne, it is reported, was not happy. Then Laura was stabbed to death. It was Anne who told authorities where to find her body and Tom was arrested. He was tried, convicted and hanged. It looks now like it might have
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FEATURE SLEEPWALKING
Sometimes seen as the stuff of horror-fiction, and sometimes viewed cynically as a very lame excuse for being caught in the wrong bedroom, sleepwalking is in fact a very real phenomenon . . .
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‘During my sleepwalking days, or rather nights, in addition to rooftop and street sleepwalking, I had various series of episodes, several nights in a row. For example I had an “earthquake” series and a “train” series. My peak performance of the “train” series unfolded one particular night. I had driven for 15 hours straight (Frank is Canadian), was exhausted and mesmerised from staring at fleeting white lines. It was after midnight and all I wanted was to collapse. So I turned into the first B & B, only to find that all rooms were booked. Pleading that I just had to crash, even on the floor, the manager took pity on me. She had one very large room, occupied by one regular, an early-to-bed sound sleeper. There was a second bed in the room, and, if I went in quietly and straight to bed . . . That suited me fine – I was already out on my feet. Soon I was slipping into Non-REM and the “train” scenario began. A train appeared on the horizon chugging toward me, fast . . . Of course, next morning, apart from noticing that the bed seemed to have moved a little during the night, I recalled nothing. At breakfast, I noticed a man giving me strange looks. I nodded at him and got stuck into the orange juice and cereal. Throughout breakfast, he continued to cast odd glances in my direction and eventually, when it looked like I was about to leave, he coughed and asked. “What the blazes happened last night?” It was my room-mate. The poor man had gone to sleep in his room, alone, but, at 2am, had come suddenly awake to find a fully-dressed man racing towards him pushing a bed at full throttle. In a state of shock, half-asleep and not knowing what to do, he had done nothing. But, when the stranger had said, in a slurred voice: “Phew, that was close!” and pushed the bed away again, his panic had begun to ebb. He watched the stranger stretch out on the bed and soon fall asleep and, after some more watchful, worried minutes, he, too, nodded off. This morning he knew it hadn’t been just a vivid dream because there was the stranger, large as life, still flat out on the spare bed. I could only make my apologies and explain. I couldn’t recall much of the action but his story did awaken a general sense of a train bearing down fast on me and feeling that I had to escape. So don’t complain too much if your partner snores – it could be worse!
“
However, the ‘But I was asleep at the time, your honour!’ plea doesn’t always work
“
O
ur sleep is divided into two phases, REM (Rapid Eye Movement) and non-REM, and it is during the nREM phase that sleepwalking occurs. Most people, during nREM sleep, are like puppets without strings, incapable of movement, but sleepwalkers, for some reason, are not inactivated and can take some part in their dreams. Though somnambulists’ eyes are open, their general facial expression is dull and nonresponsive. Sleepwalking generally occurs during the first few hours of sleep and may last mere seconds or up to half an hour. Normally there is just one episode during any sleep period. Relatively common in children, somnambulism is less so in adults when it can be associated with mental disorders, though many sleepwalkers are fully sane. Sleepwalking/somnambulism is something of a misnomer as those affected don’t always actually get out of bed. They may merely sit up, seemingly awake, and either talk (often incoherently) or make some repetitive movements. However, they do sometimes perform activities that usually require full consciousness, like walking to the bathroom, cleaning their room, making phone calls, sending emails (often gibberish), or even something dangerous like using the oven or kettle, cooking or driving. Violence is not unknown and more than one brutal assault has been accepted by the courts to have been the result of an unconscious attack carried out while asleep. In 2008, a British man was acquitted of killing his wife as she slept beside him because he had dreamt that she was an intruder. In Canada’s Supreme Court (1992), a man was acquitted of the murder of his mother-in-law and the attempted murder of her husband, while still asleep and therefore not capable of acting responsibly. However, the “But I was asleep at the time, your honour!” plea doesn’t always work: in 1999 an Arizona wife killer tried it, but the murder was judged to have been too complex to have been carried out by a sleepwalker, and he was jailed for life. Sleepwalkers often have no memory of their actions. I mentioned to my next-door neighbour, Frank, that I was writing this article and he held up his slightly misshapen left arm. ‘Courtesy of falling from a hotel roof when I sleep-walked out the dormer window of my room,’ he grinned. ‘Nearly fifty years ago.’ Pressed, he continued:
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PROMOTION WEIGHT WATCHERS
Apple and Raspberry Muffins
4
10 MINUTES TO PREPARE. 20 MINUTES TO COOK. SERVES 12 4 ProPoints per serving
Low fat cooking spray 225g (8 oz) self raising flour 1 teaspoon bicarbonate of soda A pinch of salt 25g (1 oz) porridge oats 100g (3 ½ oz) caster sugar 150g (5 ½ oz) apple sauce 3 tbsp sunflower oil 175g (6 oz) low fat natural yogurt 6 tbsp skimmed milk 1 egg, beaten 100g (3 ½ oz) raspberries, fresh or frozen 1. Preheat the oven to Gas Mark 6/ 200oC/ fan oven 180oC. Lightly grease a non stick 12 hole muffin tin with the cooking spray or simply use 12 paper cases and place in the holes in the tin. 2. Sift the flour, bicarbonate of soda and salt into a mixing bowl. Reserve 1 tablespoon of oats for the muffin tops, then stir the remaining oats and sugar into the flour. 3. In a separate bowl, mix the applesauce, oil, yogurt, milk and egg together, then stir in this wet mixture into the dry ingredients, mixing until just combined but still slightly lumpy. Stir in the raspberries, then spoon into the muffin tins, dividing the mixture evenly to make 12 muffins. Scatter with the reserved oats and bake in the oven for 20 minutes until risen, firm and golden brown. 4. Cool on a wire rack.
Florentine Mushrooms 10 MINUTES TO PREPARE. SERVES 1 3 ProPoints values per recipe
3
2 large, flat mushrooms, stalks removed Low fat cooking spray 100g (3 ½ oz) baby spinach leaves 1 tablespoon low fat soft cheese 1 egg Salt and freshly ground black pepper 1. Preheat the grill to medium. 2. Place the mushrooms in a baking dish, lightly spray with the cooking spray and season inside and out. Grill for 2 minutes, stalk side down, then turn over and grill for 2 minutes more, or until tender. 3. Meanwhile, bring a pan of water to the boil for the poached egg and place the spinach in a separate lidded saucepan. Cover the spinach and cook over a low heat until wilted. Stir in the soft cheese and seasoning, then keep warm. 4. Break the egg into a cup. Use a spoon to create a whirlpool effect in the pan of boiling water, then slip in the egg. Reduce the water to a gentle simmer and cook for 3-4 minutes or until the egg is cooked to your liking. 5. To serve, nestle the mushrooms side by side on a warm plate, and spoon the creamy spinach on top. Lift the egg out of the pan using a slotted spoon and rest on top of the mushrooms. Serve immediately.
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THE WAITING ROOM | AUGUST 2012
Tarragon chicken 8 with lemon braised potatoes TAKES 10 MINUTES TO PREPARE. 25 MINUTES TO COOK. SERVES 2 15 ProPoints values per recipe
300g (10½ oz) baby new potatoes, halved 300ml (½ pint) chicken or vegetable stock, made using ½ stock cube Juice and zest of ½ a lemon 2 tablespoons chopped fresh tarragon 3 tablespoons chopped fresh parsley Low fat cooking spray 2 x 150g (5 oz) skinless, boneless chicken breast fillets 16 cherry tomatoes on the vine ¼ teaspoon granulated sugar Freshly ground black pepper 1. Preheat the oven to gas mark 6/200°C/fan oven 180°C. Place the potatoes in a saucepan with the stock, 1 tablespoon of lemon juice and ½ teaspoon of lemon zest. Bring to the boil and simmer, covered, for 15 minutes until tender. 2. Meanwhile, mix the remaining lemon zest with the tarragon and 2 tablespoons parsley on a plate. Use a little low fat cooking spray on the chicken breasts and season them lightly. Roll the chicken in the herb mixture to coat completely and place in a lightly greased roasting tin. Drizzle the rest of the lemon juice over the chicken and cook in the oven for 10 minutes. 3. Add the tomatoes to the roasting tin with the chicken, lightly coat with low fat cooking spray and sprinkle with the sugar. Return the roasting tin to the oven for 10 minutes, or until then chicken juices run clear when the thickest part of the breast is pierced with a sharp knife or skewer. 4. When the potatoes are tender, remove the lid and increase the heat under the pan. Reduce the liquid for about 10 minutes or until it has almost all evaporated and you are left with about 2 tablespoons of syrupy juices. Toss the potatoes in the juices to glaze and scatter with the remaining parsley. Serve with the chicken and roasted tomatoes. Tip: Replace the chicken breasts with plain Quorn fillets for a vegetarian version. This will be 5 ProPoints values per serving. YOUR FREE COPY
From Couch to Fridge to Ironman
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WEIGHT WATCHERS PROMOTION
“My life changed the moment I heard Patricia Maher, my Weight Watchers leader say, ‘Emer you have hit your goal weight’! In that moment I could see the excitement in her eyes that I was feeling.”
At seven I weighed seven stone, from then on for me growing older meant growing wider; by the age of 21 I weighed a colossal 21st 10lbs / 138kg. Right on track, I thought my weight matches my age. Right on track has a whole new meaning for me now! I continuously keep my tracker to maintain my weight between 10st 10lbs 11st / 68-70kg. Before attending Weight Watchers I used food as my comfort, protection and my security. I also used it as a reward and as a punishment. Strong and determined I ate myself into the category of ‘super morbid obese’. I thought of my school days where I became the class ‘clown’, the joker, the fun child, the rebellious child. Another memory which came back to haunt me was the day of First Aid class. The teacher said ‘now if we had someone as big as Emer, this is how we would have to do it’. As she went on to demonstrate I cringed with embarrassment and shame. Joining Weight Watchers created a whole new world for me. Meeting my leader, Patricia and other likeminded people in a friendly supportive environment I felt I had found something better than a diet. It was about opening up a healthier lifestyle, with better food choices. This motivated me to become more active. I discussed this new way of living with my mother, she encouraged me to take regular walks, by accompanying me. Step by step our walks grew longer as did our chats. My mother continued to inspire me, reminding me that nothing is impossible in this life. She encouraged and supported me through all YOUR FREE COPY
her creative cooking! I successfully completed my course in Social Studies at Athlone Institute of Technology and studied Counselling at Trinity College Dublin. There were periods I couldn’t attend Weight Watchers, however, some of the vital guidelines remained with me. During my time at college I went through my own personal therapy process and it became obvious how I had previously used food in order to fill emotional voids in my life. It reminded me of a psychologist Albert Ellis whose lines struck a chord within me, “Eating is always a decision; nobody forces your hand to pick up food and put it in your mouth”. Post-training, I returned and fully committed to the programme. This enabled me to continue losing the pounds of pain I no longer needed or wanted to hold onto. In January 2011 Weight Watchers introduced the ProPoints® system which created a new focus to work on. Learning, understanding and applying the new system was challenging but very rewarding. My leader Patricia then proposed it was time to look at my goal weight and healthy BMI. My dream was becoming a reality. The healthy BMI is the one and only category in life I wanted to fit into. Then I made a decision if losing 11 stone is possible then training and completing an Ironman 70.3 is also a possibility. I was now living the motto ‘anything is possible’. At the finish line of the Ironman it was suggested this must be ‘the best moment of your life’. I replied ‘no the best moment
of my life was reaching my goal weight and that made this day possible’. I have recently added my MSc in Clinical Supervision –Psychology from Trinity College to my CV and look forward to the challenge of developing my professional life further. A PhD is also possible! Not long ago my world was my misery, now it is my oyster. Thank you Weight Watchers.
Emer’s Statistics Name:
Emer Kilmartin
From:
Athlone
Start weight: 21 st 10lb/ 138kg Now:
10 st 10lbs/68kg
Lost:
11 st/ 70kg
Class:
Athlone
Leader:
patricia Maher
See www.weightwatchers.ie or call 1850 234 123 to find your local meeting now. Can't find a meeting that suits? Try Weight Watchers At Home or an 8 week course in your workplace. For more information on 'At Work' courses see www.weightwatchers.ie or call 1850 234 123. For the 'At Home' service call 056 7722276. Men welcome at all meetings AUGUST 2012 | THE WAITING ROOM
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A N E W WAV E O F AN OLD DISEASE COVER STORY ANIMAL HEALTH
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ANIMAL HEALTH COVER STORY
W
Veterinarian C l a i r e G r e e n e has worked in several zoos and is studying towards a specialist certificate in exotic animals. She now looks at a disease that affects us humans, domestic animals and zoo animals and examines the vicious circle that goes round and round and round . . .
hen in 1882, the Nobel Prize winner Robert Koch announced that he had discovered the bacterium responsible for Tuberculosis he remarked that "If the importance of a disease for mankind is measured by the number of fatalities it causes, then tuberculosis must be considered much more important than those most feared infectious diseases, plague, cholera and the like.” The Irish people needed no such reminder: for much of the 19th and 20th centuries, tuberculosis (TB or consumption) was the leading cause of premature death in Ireland. It claimed more lives than the famine. At its peak, it claimed 13,000 lives a year. But TB’s suffocating grip on the country started to weaken in the 1940s: the BCG vaccine started to become available; the Minister for Health, Dr Noel Browne, introduced free mass-screening; and in 1946, the development of streptomycin meant that, finally, TB could be cured. But TB wasn't just rife in the human population. Cattle are one of many mammals that are also afflicted by tuberculosis, and coughing cattle and unpasteurised milk were two major sources of infection for the populace. The 1950’s saw two more important improvements, the widespread introduction of pasteurisation and compulsory TB testing of all cattle. Fifteen years after it began, the TB testing scheme was rashly declared a success and eradication was predicted within 10 years. But that wasn’t to be. Numbers of infected cattle did drop down to very low levels but then stubbornly refused to budge any further. There was another mammal, the badger, that hadn’t been taken into consideration. Badgers affected with TB continued to act as a reservoir. Often, they show no clinical signs - though, being shy, nocturnal and living underground, they are rarely seen - so they can live undetected for a long time and be effective disease transmitters.
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In recent years, 50,000 badgers have been culled by the Irish government as part of the TB eradication program. Unfortunately, culling this protected species may even lead to further disease dissemination as emptying an area of its resident badgers encourages others to move in. Despite all efforts, the incidence of cattle TB reactors in the country has stagnated at around 3.5%. A TB vaccine for badgers has been developed in UCD, but work is still ongoing to make it suitable for oral delivery. Badger-proof cattle fencing has also been developed. Today, tuberculosis is also of major concern in captive zoo animal collections and in conservation projects. Both the cattle strain, Mycobacterium bovis, and the human strain, Mycobacterium tuberculosis, readily affect zoo species such as elephants, sea lions, parrots and primates. Signs in mammals are mostly the same as with humans; weakness, difficulty in breathing and weight loss in spite of a good appetite. Eventually a hacking cough develops. As in human-to-human transfer, it is this coughing that aerosolises the germs and really spreads the disease. Zoos take this human risk seriously and susceptible animals are tested regularly. In fact, it now seems that animals are more at risk of catching tuberculosis from people than the other way round! Tuberculosis is also a disease of domesticated elephants, and there is a real fear that this disease, contracted from humans, could spread to the wild population. In the 1980s, hopes of completely eliminating TB were dashed after the rise of drug-resistant strains. The subsequent resurgence of tuberculosis resulted in the declaration of a global health emergency by the World Health Organization in 1993. The BCG vaccine is the most widely-used vaccine in the world, with 90% of children vaccinated. This vaccine is very effective in children but provides inconsistent adult protection against
pulmonary tuberculosis. TB is more of a problem today than it ever was. Human tuberculosis is the most important infectious cause of death worldwide - affecting approximately one third of the world population and accounting for the deaths of 3 million people each year, particularly in Africa and Asia. Other factors, like HIV infection, overcrowding and malnutrition, greatly increase the risk of tuberculosis infection, making it is a disease of poverty, while smokers double their risk of developing TB. With the recent increase movement of people into and out of the country, the number of national cases is on the rise. In forgotten corners of Irish fields, sanatoria can still be found, rotting buildings where “consumption” sufferers would go to breathe the fresh air on the veranda. Unfortunately, many of them were never to leave. Having been on the ropes for the last 50 years, the disease is gaining ground and so the age-old battle between man and Mycobacterium tuberculosis continues.
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QUICK QUIZ
TheWaitingRoom
CROSSWORD
Question 1
WIN €50
Question 2
Penguins are found in a) The Arctic b) The Antarctic c) Both
Question 3
Frederic Chopin composed music mainly for associated with? a) Piano b) Violin c) Cello
HOW TO ENTER: Text TWR2 followed by your answer, name and address to 53307 or post your answers to us!
Question 4
NO TIME TO FINISH? NO WORRIES! THIS MAGAZINE IS YOURS TO TAKE HOME!
Elvis Presley’s wife’s name was a) Lisa-Marie b) Priscilla c) Suzanne
Question 5 Casablanca is in a) Morocco b) Tunisia c) Spain
Question 6
The Pacific Island famous for its huge stone heads is a) Christmas Island b) Tonga c) Easter Island
Question 7
Who wears the suit of lights? a) An electrician b) A matador c) A clown
Question 8
With which modern European state is Prussia most associated? a) Germany b) Russia c) Italy
Question 9
Was a Penny Black a) A type of sweet b) An old newspaper c) A postage stamp
Question 10
Europe is separated from Asia by which mountains a) The Caucasus b) The Urals c) The Appalachians
No.13
When completed, the letters in the shaded squares will spell out the winning word: Like this magazine (10)
Valletta is the capital city of: a) Sardinia b) Sicily c) Malta
ACROSS
DOWN
C on g r a t u l a t i o n s !
1 Badinage. (8)
1 A more unwise food source, avoided by vegetarians. (6)
Solution to the Summer 2012 Crossword Mr Mike Hirst, Co Cork
5 Remote rearrangement of heavenly body. (6)
2 Grasslands of South 9 Any miser can be involved in America. (6) religious college. (8) 3 Wash out soap. (5) 10 Cornish moor. (6) 4 Joins up. (7) 11 Coated with hard surface, 6 The art of speaking like teeth. (9) properly. (9) 13 To do with the smaller of 7 Dairy product that turns me the three bones involved in mad in the end. (8) your elbow joint. (5) 14 The fish with the lowest voice. (4)
8 Stampedes. (4, 4)
16 The windy city. (7)
11 The poetic part of melodic or periodicals? (4)
19 The first two letters on their own can yield mother-of-pearl. (7)
15 Making up for film with Saoirse Ronan. (9)
21 puts on as professors do. (4)
17 Old song with crazy beginning. (8)
24 The extent over which a fixed kitchen appliance can move. (5)
18 Savage turned bin upside down in artificial waterway.(8)
25 They live to the west of Libya. (9)
20 Made up for dairy production. (4)
27 Fancy cup or chalice. (6)
21 Could be Sirius or Lassie. (3,4)
28 Food poisoning causing pain to me possibly. (8)
Terms: 18+. 60c per entry incl VAT. Network charges vary. Competition closes midnight September 15th 2012 Entries made after the close date do not count and you may be charged. Sp phonovation Ltd. pO Box 6, Dun Laoghaire, Co Dublin. Helpline 0818217100 Enter at www.waitingroom.ie or write in to The Waiting Room, The Studio, Maple Avenue, Stillorgan, Co. Dublin
SUDOKU
Fill in the grid so that each row, column and 3x3 square contain all the digits from 1 to 9
22 White stuff produced by 29 Nabokov’s young heroine. Colombian city company. (6) (6) 23 Judge might be a female 30 Are they found in the back donkey! (6) of boats or above doors? (8) 26 Norma gets mixed up with
Answers: 1c, 2b, 3a, 4b, 5a, 6c, 7b, 8a, 9c, 10b
Crossword is open to readers aged 18 or over, are resident in the Republic of Ireland, except employees and their families of The Waiting Room Magazine, its printers, or anyone connected with the competition. The magazine is not responsible for entries lost, delayed or damaged in the post. Proof of postage is not accepted as proof of delivery. Any number of entries will be accepted. Winner will be the sender of the first correct entry to be drawn at random after the closing date. Winner will be notified by post, and only their name and the county in which they live may be published in the magazine. All personal information obtained through entry into this competition will be destroyed following its completion. Entry implies acceptance of these rules.
PUZZLES
THE WAITING ROOM | AUGUST 2012
an Italian. (6) YOUR FREE COPY
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PUZZLES
s
Cross reference
WORD SEARCH Robbie sent an excited email home to his brother. ‘Have travelled the States, bro, surfing and Deep-sea fishing everywhere I’ve been! Here’s a list – eat your heart out!’ But his brother knew he’d got it wrong. One of the states below doesn’t have a coastline! Find the other 20 in the grid to identify the landlocked one. And, if you’re a smarty-boots and know which one it is already, just enjoy finding the others
Maine Hawaii Massachusetts Alaska Connecticut New Jersey New York
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Delaware Maryland Virginia North Carolina Georgia Wyoming Florida
California Oregon Washington Alabama Mississippi Louisiana Texas
CRACK THE CODE AND WIN €50 Each letter of the Alphabet appears as a code. Complete the grid and put the corresponding letters into the boxes below to spell the prize word. Then Text TWR3, followed by your answer, name and address to 53307 or post your answers AUGUST 2012 | THE WAITING ROOM
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KIDS PUZZLES
Colouring fun for kids
KIDS CROSSWORD
Across 1 prickly plant used as decoration at Christmas. (5) 2 The real name for The Three Wise Kings is almost magic. (4) 4 They are red and round and you find them on 1Across. (7) 7 people put gifts underneath it at Christmas. (4) 8 Red-breasted bird who is Batman’s young companion. (5) 9 The opposite of good which uses the letters of ‘veil’. (4) 10 It will grow into a mighty oak tree. (5) 11 They are what we sing. (5) 14 One of the four main directions. (4) 15 What the Baby Jesus slept on in the manger. (5) Down 1 Go to sleep for the whole winter, as hedgehogs or polar bears do. (9) 2 If you’re under it, you might get kissed! (9) 3 Messages of goodwill exchanged at Christmas. (9) 5 Used to tie up presents or hair. (6) 6 Where there was no room for Mary and Joseph. (3) 12 A short sleep. (3) 13 Where a pig lives. (3)
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