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DR MAX THE MIND DOCTOR: It’s not a tall story – height can be bad for your health 

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dr max the mind doctor its not a tall story height can be bad for your health

Whenever I’m doing a routine physical examination and check a patient’s height, I’m always bemused by how interested they are in the result.

No one seems to care what their blood pressure or pulse rate is, but everyone wants to know their exact height (which they must have a pretty good idea of anyway). And they are almost always disappointed. ‘Oh, I thought I was taller’ they’ll say. Often, they’ll ask me to double check. I’ve never had someone think they were shorter.

We all tend to exaggerate our height, convincing ourselves and others that we are taller than we really are. But why? At 6ft 1in, I’m relatively tall so it’s easy for me to be dismissive of height issues. However, as a society we value height.

Research shows that taller people tend to have higher self-esteem and self-confidence, while a study of Swedish men found that shorter individuals are more at risk of low mood and suicide.

Height appears to confer certain social benefits, too. Taller people are more likely to go into higher education, for example. It holds true even when short and tall people are matched for IQ, suggesting that there must be some unconscious bias at work when they are being selected.

Height appears to confer certain social benefits, too. Taller people are more likely to go into higher education, for example. It holds true even when short and tall people are matched for IQ, suggesting that there must be some unconscious bias at work when they are being selected

Height appears to confer certain social benefits, too. Taller people are more likely to go into higher education, for example. It holds true even when short and tall people are matched for IQ, suggesting that there must be some unconscious bias at work when they are being selected

Height appears to confer certain social benefits, too. Taller people are more likely to go into higher education, for example. It holds true even when short and tall people are matched for IQ, suggesting that there must be some unconscious bias at work when they are being selected

This is borne out by the fact that people who are over 6ft earn on average £100,000 more over a 30-year career compared to shorter people. American studies even show that taller presidents stand a better chance of being re-elected than shorter ones.

Doubtless these advantages stem in part from the pervasive tendency to associate height with power. It is embedded in our language: we look up to people we consider superior, for example, or look down on those who are inferior.

We therefore want to believe we are taller than we really are because this means we have more authority. In fact, this seems to be hard-wired into our brains. In one clever experiment using virtual reality headsets, participants took two ‘virtual’ rides on a Tube train.

They experienced the first journey at their normal height. On the second journey — and without them knowing — the headset was programmed to make them feel shorter in relation to the carriage and other passengers.

When asked how they felt on each journey, the participants reported that they were aware of increased feelings of inferiority, weakness and incompetence on the second journey.

They also felt more intimidated by other passengers. This suggests that we have evolved to assume those who are taller are stronger and more of a threat.

There is a reason for my musings about the psychology of height this week. For once there is some good news for those of smaller stature. People who are over 6ft tall have more than double the chance of catching Covid-19, according to research published by data experts led by a team from Oxford University.

The researchers said the findings do not necessarily mean tall people are genetically more vulnerable to the infection. Instead, they believe the results indicate Covid-19 spreads through tiny particles called aerosols that linger in the air after being exhaled. (Tall people would be at no greater risk if the virus was mainly spread through sneezing or coughing, which produce larger droplets that fall to the ground quickly.)

Public health experts have so far ruled out that Covid-19 is airborne, but the World Health Organisation is reviewing ‘emerging evidence’ to the contrary. Whatever your height, though, you should always walk tall and don’t let the lack of inches determine how you feel about yourself.

But if you do wish you were taller then here’s a tip: always measure yourself in the morning — we are taller when we first wake up because, during the course of the day, gravity compresses our spine and we shrink!

drmax@dailymail.co.uk

If everyone who is overweight loses 5lb, it would save the NHS more than £100 million over the next five years, according to Health Secretary Matt Hancock. Imagine what we could do with that money?

If everyone who is overweight loses 5lb, it would save the NHS more than £100 million over the next five years, Matt Hancock has claimed

If everyone who is overweight loses 5lb, it would save the NHS more than £100 million over the next five years, Matt Hancock has claimed

If everyone who is overweight loses 5lb, it would save the NHS more than £100 million over the next five years, Matt Hancock has claimed 

We could treat every single cataract in the country. We could do every single knee and hip replacement. And that would just be the start. Treating obesity eats up half the entire NHS budget, so what if, rather than just 5lb, everyone who was overweight got their weight to within a healthy range. We could effectively double what the NHS has to spend. That would be incredible — and we have the power to make that happen.

Would you take a test to learn if you are at risk of an incurable disease later in life? Scientists have developed a blood test that they say can identify Alzheimer’s disease at the earliest stage.

The test looks for tiny fragments of a protein that appears in the brains of people with dementia, which start to circulate in the blood up to 20 years before the onset of symptoms.

No doubt that this is a great, scientific discovery. Some experts, however, have raised concerns about the ethics of telling someone they’re likely to develop the disease.

Personally, I wouldn’t take such a test. Why discover something that will cast a permanent shadow over your life, and about which there is nothing you can do?

Every mistake you made, every time you forgot someone’s name or went into a room and couldn’t remember why — you’d be torturing yourself it was a sign dementia was setting in.

It reminds me of a line in the poem by the celebrated poet Thomas Gray: ‘Where ignorance is bliss, ’tis folly to be wise.’

Under plans announced this week, health and social care budgets could be merged. This is a brilliant proposal.

The distinction between health and social care is completely arbitrary and causes all sorts of problems. It works against joined-up thinking and prevents treating patients holistically — with both their health and social needs catered for.

Currently, the NHS tries to protect its own budget by discharging patients to social care. But when health problems emerge, the only option is to try to have the patients re-admitted to hospital.

Hopefully, a merger will put an end to this pass-the-patient game. I am also in favour of mental health and general health trusts merging for the same reason. There’s no reason why the two should be treated separately — it just creates more division and bureaucracy.

But sad to say that in the NHS there’s a belief — and some doctors are guilty, too — that mental health isn’t ‘proper’ medicine, that the patients aren’t really sick. Consequently, their physical health needs are routinely ignored. Yet someone with schizophrenia, for example, dies on average 25 years earlier than those who do not have it.

By having separate trusts, we help maintain that stigma around mental illness. And provision of mental health is costly and resource heavy, meaning that many of these trusts are in debt.

In recent years there’s been talk of ‘parity of esteem’ — that mental health should be treated the same as physical health. Merging mental and general health trusts would be a quick and easy step towards this.

Dr Max prescribes… 

While England has struggled to contain rising levels of knife and gun crime, Scotland has dramatically reduced such offences in the past 15 years. Journalist and trainee child psychotherapist Kate Silverton presents this fascinating insight into Scotland’s Violence Reduction Unit, which has adopted a radical approach. 

Violent crime is treated as a public health issue. This is a thought-provoking documentary on how we can tackle crime and the causes of offending. Something that our leaders south of the border should take a note of. Available on BBC iPlayer. 

Throughout this pandemic, and with increasingly tough times to come, there isn’t a lot to be optimistic about. Yet being pessimistic could actually shorten your lifespan.

According to Australian research, pessimists die two years younger than the average person. It’s not clear why negativity has such a damaging effect. 

According to Australian research, pessimists die two years younger than the average person. It’s not clear why negativity has such a damaging effect

According to Australian research, pessimists die two years younger than the average person. It’s not clear why negativity has such a damaging effect

According to Australian research, pessimists die two years younger than the average person. It’s not clear why negativity has such a damaging effect

It may be because it raises the level of the stress hormone cortisol which, in turn, increases the risk of illnesses such as stroke or heart attacks.

However, the researchers found that being an optimist doesn’t actually extend your life either! That’s not the most important thing, though.

Life is so much better when you walk on the sunny side of the street. You might not live longer if you’re an optimist, but your life will certainly be more enjoyable. And that’s all that really matters.

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Health

Doctors test out new treatment in bid to boost your blood flow

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doctors test out new treatment in bid to boost your blood flow

Standing on a pulsating plate for half an hour is a treatment being tested to help with reduced blood flow in the legs, easing the pain of a common circulatory condition.

One in five over-60s has peripheral arterial disease (PAD), a build-up of fatty deposits in the walls of the arteries in the legs, causing restricted blood flow and preventing muscles from working properly.

Muscles require a regular supply of oxygen and nutrients, which is provided by blood that flows through a network of arteries. 

While some patients with PAD have no symptoms, in others, blood flow is so restricted that even walking causes crippling pain, a problem known as intermittent claudication. This pain usually disappears after a few minutes’ rest.

The vibrating plate treatment, called Revitive, is being trialled in the NHS and is hoped to improve blood flow in the legs and ease the pain of peripheral arterial disease. (Stock image)

The vibrating plate treatment, called Revitive, is being trialled in the NHS and is hoped to improve blood flow in the legs and ease the pain of peripheral arterial disease. (Stock image)

The vibrating plate treatment, called Revitive, is being trialled in the NHS and is hoped to improve blood flow in the legs and ease the pain of peripheral arterial disease. (Stock image)

People with the condition — a form of cardiovascular disease — often also have furring of other arteries in the body, putting them at risk of heart attack and stroke, and damage to vital organs. 

Treatment of PAD usually involves surgery, taking a segment of healthy vein from elsewhere in the body, and using it to bypass the blockages and restore an adequate blood supply in the legs. Some 23,000 such procedures are performed each year in the UK.

The two-hour operation is highly effective in many cases. After surgery, exercise is recommended as this has been shown to have beneficial effects on the workings of the blood vessels in the legs. 

However, many patients fail to follow these rehabilitation programmes, says Dr Punit Ramrakha, a consultant cardiologist at Hammersmith Hospital in London, and as a result, the graft can fail.

If this happens, tissue becomes starved of oxygen and nutrients and can get infected and die, leading to the leg being amputated, typically below the knee.

The vibrating plate — called Revitive and being trialled in the NHS — offers a new way to help keep these grafts working.

During a 30-minute session, patients will receive  electrical pulses to the soles of the feet which activate nerves in the legs and helps boost blood flow. (Stock image)

During a 30-minute session, patients will receive  electrical pulses to the soles of the feet which activate nerves in the legs and helps boost blood flow. (Stock image)

During a 30-minute session, patients will receive  electrical pulses to the soles of the feet which activate nerves in the legs and helps boost blood flow. (Stock image)

During a 30-minute session, it delivers electrical pulses to the soles of the feet which activate nerves in the legs, causing muscles to contract and relax and boost blood flow.

The device offers varying degrees of stimulation in different settings. Improvements in blood flow suggest a promising role for the device in keeping these grafts open and helping them last longer, say doctors from Charing Cross Hospital in London, who are carrying out a trial with 34 patients. 

These patients will have a one-off session with the device after surgery to see whether it improves blood flow.

A new study, published in the journal Wound Management & Prevention, found that blood flow to the foot increased by more than 40 per cent when healthy volunteers used the device for ten minutes.

Dr Ramrakha says: ‘Neuromuscular electrical stimulation of leg muscles . . . may effectively substitute, promote or complement physical training. This trial will show whether this technology will assist the patients on the road to recovery.’

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DR MARTIN SCURR answers all your health questions 

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dr martin scurr answers all your health questions

QUESTION: I get post-nasal drip. I was told it might be caused by acid reflux, but I don’t have the classic symptoms. What else could be causing it?

Stephen Pearson, by email.

ANSWER: Post-nasal drip (clinically, known as chronic rhinitis) is where mucus accumulates in the nose and drips down the throat, causing a sensation of excess fluid. Other symptoms include nasal discharge, a blocked or stuffy nose, sneezing, coughing and, in some instances, loss of smell.

While acid reflux (where stomach acid rises up the oesophagus) can cause this, I think there is another, much more common, explanation here: in 90 per cent of cases, the cause is allergy. 

Post-nasal drip is where mucus accumulates in the nose and drips down the throat, causing a sensation of excess fluid. (Stock image)

Post-nasal drip is where mucus accumulates in the nose and drips down the throat, causing a sensation of excess fluid. (Stock image)

Post-nasal drip is where mucus accumulates in the nose and drips down the throat, causing a sensation of excess fluid. (Stock image)

Symptoms may occur all year round or can be seasonal, depending on the trigger. Most GPs prescribe allergy suppressants, such as antihistamine tablets. If these end the symptoms, it confirms the cause is an allergy.

In severe cases, patients should be referred to an ear, nose and throat (ENT) specialist or allergy clinic for skin-prick tests (where a small amount of the suspected allergen is scratched on to the skin).

For most patients, regular treatment is the best way to keep symptoms at bay. This starts with corticosteroid nose drops, usually betamethasone, for a few months or until symptoms are abolished (it works by reducing inflammation and swelling in the nose). This is then followed by a nasal spray as maintenance therapy.

A more recent innovation has been a mix of steroid and antihistamine, such as Dymista, given via nasal spray. 

Dr Martin Scurr (pictured) examines post-nasal drip and its treatments

Dr Martin Scurr (pictured) examines post-nasal drip and its treatments

Dr Martin Scurr (pictured) examines post-nasal drip and its treatments

This can be highly effective and avoids the potential side-effects of steroids given via nose drops (which include excessive nasal dryness and nosebleeds with long-term use).

You say in your longer letter that you get some relief using Beconase, a mild corticosteroid nasal spray, but it makes you drowsy — this can be a side-effect of even the most modern antihistamines. 

Given your partial response to Beconase, it might be worth trying the more potent steroid fluticasone, which your doctor may prescribe, and then moving on to the Dymista spray.

If fluticasone is not helpful, then I suggest you seek referral to an ENT specialist for further consultation.

QUESTION: My grandson, who is eight, suffers tummy pains after eating. His GP has ruled out coeliac disease and advised a dairy-free diet. My wife and I are worried and want a referral to a paediatrician.

David Swift, Watford, Herts.

ANSWER: A history of recurrent pain for longer than two months with no other alarming symptoms — such as weight loss, vomiting, unexplained fever or bloody diarrhoea — is called chronic abdominal pain.

Acute pain with any of the symptoms I describe is linked to potentially life-threatening problems, such as appendicitis, intussusception — when part of the intestine ‘telescopes’ inside another part — or volvulus (when the intestine twists on itself). But in your letter you say that, in between episodes, your grandson is happy and sporty.

A history of recurrent pain for longer than two months with no other alarming symptoms is called chronic abdominal pain. (Stock image)

A history of recurrent pain for longer than two months with no other alarming symptoms is called chronic abdominal pain. (Stock image)

A history of recurrent pain for longer than two months with no other alarming symptoms is called chronic abdominal pain. (Stock image)

It would seem the GP views him as having a form of ‘functional’ abdominal pain — this is where the pain is real but there’s no definitive test for it, and includes functional dyspepsia (abdominal discomfort or a sense of over-fullness), irritable bowel syndrome and abdominal migraine (intense pain).

In general, it’s better that this kind of pain is treated in primary care as there’s evidence that referral for specialist investigations may carry a message to patient and family that there’s an underlying disorder yet to be discovered, causing them more anxiety.

In my view…we must improve the care we give older patients 

When it comes to the care of older people, it’s clear that the NHS is stumbling badly. I see or hear evidence of this daily — most recently I was told about a woman in her 70s found dead after a neighbour noticed her curtains remained closed for days.

There was no record of her having seen a doctor for years, so a post-mortem examination was mandatory. This revealed she’d likely had a heart attack.

She died alone without support or care. If she had experienced symptoms and sought medical attention, her death probably could have been prevented. But she was on the autistic spectrum and in the past had been confused and frightened by the complexity of her GP’s recorded phone system, so she had given up trying to call.

You might wonder why friends didn’t help but, if any had called on her behalf, it’s likely they would have been told they didn’t have the authority to do so, as indeed I was when calling a practice on behalf of my 93-year-old neighbour after recognising she had heart failure. 

I was told my only option was to register online as her carer, which I tried to do, only to be informed that, due to Covid, the website was not operational. I’ve written to the GP and practice nurse but had no reply — a patient in heart failure all but abandoned.

Finally, my mother, 91, frail and diabetic, was told by text to go for a blood test at the local hospital, only to find out later that it was closed for blood tests and that she needed to go to a hospital in central London, more than ten miles away.

This is the status of primary healthcare in the NHS for a big part of our community.

 

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Nurse invited grief-stricken 81-year-old grandmother to her house for Christmas Day 

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nurse invited grief stricken 81 year old grandmother to her house for christmas day

After Angela Coverdale-Robinson missed the last train back to her home in Cambridge on Christmas Eve, she faced a bleak few days alone, hundreds of miles from her family.

The 81-year-old grandmother resigned herself to spending a solitary Christmas in a hastily booked bed and breakfast in Newcastle upon Tyne, mourning her brother-in-law Alfie, who had died that evening at South Tyneside District Hospital.

But when ward sister Nicola Peat learnt of Angela’s plight, she was having none of it.

The 44-year-old’s nursing team had told her about Angela’s predicament, and she immediately invited the grief-stricken pensioner to spend Christmas with her and her family.

Nicola Peat (pictured), 44, from South Tyneside, invited a grief-stricken grandmother to her home on Christmas Day

Nicola Peat (pictured), 44, from South Tyneside, invited a grief-stricken grandmother to her home on Christmas Day

Nicola Peat (pictured), 44, from South Tyneside, invited a grief-stricken grandmother to her home on Christmas Day 

‘I’m coming to get you in the morning and I would love for you to be with us,’ Nicola told Angela over the phone.

So a grateful Angela found herself the impromptu guest of honour on Christmas Day at Nicola’s home in East Boldon, South Tyneside, where she was made welcome by Nicola’s husband David, 48, a teacher, and children Jacob, 16, and Isabella, 12.

‘It could have been so bleak for me, but the kindness shown by Nicola blanketed that,’ says Angela, a former paediatric nurse. ‘Alongside her compassionate nursing and care for Alfie, Nicola showed the true spirit of Christmas.’

Angela first met Nicola two weeks before Christmas in 2019. She had travelled to Newcastle upon Tyne to see Alfie, 82, who was the brother of her late husband, John. Angela sat at Alfie’s bedside every day, until late on the night before Christmas.

‘We are a close family and, even though it was Christmas Eve, I wanted to be with Alfie in his final hours,’ says Angela.

But that evening, at the urging of a doctor, Angela had reluctantly left Alfie to travel home to her children and grandchildren 240 miles away so she could spend Christmas with them.

Upset and distracted — ‘I wasn’t thinking straight’ — she missed the last train home, so decided to return to the hospital to be with Alfie, without knowing how to get there in the wintry dark.

‘I was crying and tired,’ says the grandmother of seven. And then, in a surreal moment, she spotted a man dressed as Father Christmas, much the worse for wear, who pointed her to the right bus stop for the hospital.

‘I was so pleased I did go back, as Alfie died just before midnight,’ she says. ‘ ‘He waited for you to come back,’ whispered a nurse as she comforted me.’

Angela Coverdale-Robinson, 81, missed the last train back to her home in Cambridge on Christmas Eve

Angela Coverdale-Robinson, 81, missed the last train back to her home in Cambridge on Christmas Eve

Angela Coverdale-Robinson, 81, missed the last train back to her home in Cambridge on Christmas Eve

Retired health visitor Nora Alnes (right with Nicole), 100, from East Boldon, believes Nicola has done her absolute best for those in her care

Retired health visitor Nora Alnes (right with Nicole), 100, from East Boldon, believes Nicola has done her absolute best for those in her care

Retired health visitor Nora Alnes (right with Nicole), 100, from East Boldon, believes Nicola has done her absolute best for those in her care

After Alfie’s death, the nurses made Angela a hot drink and a sandwich while her son, Daniel, a 53-year-old businessman who lives in Saffron Walden, Essex, phoned around to find her a B&B to stay in until Boxing Day. But then came Nicola’s invitation.

‘I couldn’t fault the nursing Alfie received from Nicola and her team, and not a day goes by when I don’t think of her kindness, patience and tolerance,’ says Angela. ‘Compassion shines from her and she is a role model for any nurse.’

Retired health visitor Nora Alnes, 100, from East Boldon, couldn’t agree more.

Nora, who started nursing during World War II, met Nicola while in hospital recently with hip problems. ‘Nicola was so kind to me, and when she knew I loved perfume, she gave me a bottle of her favourite Jo Malone scent, which made my day,’ she says.

‘On my 100th birthday in December, Nicola called in to see me after work with flowers and chocolates. She also nursed my sister Margery [who had been a theatre nurse] before her death aged 94 in February. Nicola is very special and brilliant at her job.’

These are not unique examples of her kindness and willingness to go above and beyond the call of duty. 

Nicola, who has been a manager on a 42-bed surgical ward for the past 12 years, is known in normal nursing times to do a patient’s washing if they have no family who can do it.

She regularly makes quiches and cakes for patients and staff, and even brings in meals for the younger staff when their parents are away on holiday.

‘Her Thai red curry is fab,’ says staff nurse Abby Carr, 23. ‘She is so inspirational as a role model. We learn so much from her.’

Nora, who started nursing during World War II, met Nicola while in hospital recently with hip problems

Nora, who started nursing during World War II, met Nicola while in hospital recently with hip problems

Nora, who started nursing during World War II, met Nicola while in hospital recently with hip problems

Nicola leads by example. One day recently, after a long shift and having changed out of her full PPE (during the pandemic the ward has been transformed into a Covid intensive care ward), she was heading home when she passed a bay and noticed a patient who was extremely distressed because he could see a fellow patient deteriorating.

She immediately returned to the changing rooms, put on the hot and uncomfortable PPE again and went to comfort him, sitting by his bed for more than an hour.

Nicola, who became a nurse 22 years ago, following in the footsteps of her mother and grandmother, is strikingly modest about her work. ‘Helping patients like this is just part of my job,’ she says.

Angela, who has nominated Nicola for a Daily Mail Health Hero Award, says: ‘I was upset at the prospect of spending Christmas Day apart from my own family, but it was fabulous being with Nicola and her family, who enfolded me in their love at a time of grief. It was a Christmas I will never forget.’

It is people like Nicola who exemplify what the Daily Mail Health Hero Awards are all about — NHS staff quietly getting on with their work but going that extra mile.

We’d like you to nominate your own Health Hero. It could be a nurse or ward sister like Nicola, a porter, a consultant — anyone who you feel deserves recognition.

Seven finalists will be treated to an all-expenses-paid trip to London for an awards ceremony, and the winner will receive a £5,000 holiday. This year, we have introduced two extra awards. 

The Daily Mail Health Hero Awards runs in partnership with eBay and NHS Charities Together

The Daily Mail Health Hero Awards runs in partnership with eBay and NHS Charities Together

The Daily Mail Health Hero Awards runs in partnership with eBay and NHS Charities Together

The first is the Mental Health Hero Award, to highlight the unsung work of those who specialise in this often very difficult field. The other is an eBay Health Hero Award, to recognise volunteers who support health professionals working in the NHS.

As Rob Hattrell, the vice president of eBay UK, one of our partners for this year’s awards, explains, this category ‘is dedicated to an incredible individual who has kept us going and smiling when the country ground to a halt and needed it most’.

As a mark of Angela’s gratitude to Nicola, she gave a handwritten copy of a poem, A Nurse’s Prayer, to the ward, where it now has pride of place.

The poem, which was given to Angela in 1958, when she was working at the Royal Papworth Hospital in Cambridgeshire, includes the lines: ‘When the day is done and evening stars, shine through the dark across the sunset bars, when weary quite, I turn to seek my rest, Lord, may I truly know I’ve done my best.’

As former nurses themselves, both Angela and Nora believe Nicola has done her absolute best for those in her care.

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