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This Really Makes me Sick! (Health)
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Mick Harper
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Following advice from a well-known radio-nutritionist with the initials MM, I have adopted the 'intermittent fasting' regime. This is when you eat all the same things you always do only they have to be eaten in a twelve- (better, ten-) hour window. This gives digestive bugs in your gut a twelve- (better, fourteen-) hour break while cleaner-bugs (not cleaner bugs) get to work polishing the gut wall. It sounds like a science fiction film from the seventies but it's all been proved scientifically.

The reason I adopted it was because I already do it. My last meal is, say, ten o'clock at night, later I have a kip, then I wake up and write feverishly -- like now -- and before you know it, it's ten o'clock in the morning and I can tuck into a healthy Mediterranean breakfast of eggs on toast and a couple of rashers of bacon. Plus fried tomatoes as part of my one-a-day.

Until today, the first day of my intermittent fasting regime. I'm bleedin' famished and there's still four hours to go.
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Mick Harper
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A snag has arisen in my intermittent-fasting. The period between last meal and night-night is long enough for food pangs to occur. Traditionally this has been addressed by a Cornetto, a mini-Magnum or whatever my mini-Tesco is stocking that week. Obviously that is right out but I have found that drinking fizzy sweet drinks does the job nearly as well. But does it, bug-wise? The drinks may be sugar-free but they are still packed with elderflower or blackcurrants or whatnot. I am going to assume the bugs will cut me some slack on this one.
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Mick Harper
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"I've come for my blood test."
"Name?"
"Harper"
"Time?"
"Twelve o'clock."
"No record of it, sorry."
"Are you sure? I wrote it down very carefully."
"Um aah... oh, yes, it's twelve o'clock, Tuesday, but next week. You must have written down the date wrong."
"And July instead of August?"
"Um aah... oh yes, it's the doctor you've got to see today."
"First I've heard of it. What for?"
"Um aah... to discuss the blood test results."
"A week before they're due to be taken?"
"I couldn't really say, Mr Harper, I'm only a receptionist."
"Well, okay, since I'm here I'd better see the doctor."
"You can't, it's a telephone consultation."
"Do you have a phone?"
"Sorry, all phone consultations must be done at the patient's place of residence."
"I'd better get home then."
"I'm sorry, you'll have missed your slot by then."
"What do you suggest?"
"Come back next week for your blood test. I'm sorry there really isn't anything more I can do."
"Well, I'll just sprawl over here while you make a few phone calls. You know, just in case. I've got bags of time. You don't close till five, do you?"

Two minutes later: "Mr Harper, could you go to upstairs reception?"
Two minutes later: "Mr Harper, the nurse will see you now."
Two minutes later: Mr Harper is on his way home.
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Mick Harper
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It's not often the Newsnight wall tries to pull a fast one on us but last night's piece on cancer survival rates had a good go.

Lung cancer survival rates between 1995 and 2014 increased by nearly eight per cent

So that's good news, right? No

What the UK needs to be more worried about is that survival rates in other countries, broadly comparable to the UK were still ahead.

So that's bad news, right? No. The chart showed that our increase was better than three of them, worse than three of them. But they were all starting from a position ahead of ours so they all ended up ahead of ours. Hence it looked by a casual glance as though we were behind them all. But surely that's bad news, being behind all of them? No. Every country has a different overall lung cancer position depending on all sorts of local factors. But you just said, we were the worst. That's very bad news, isn't it? No. Here are the countries being used for the comparison chart

Canada
Australia
Norway
Ireland
Denmark
New Zealand
UK

What an odd collection. Are they countries 'broadly similar to our own?' Yes, they are. What about all the others? Yes, that's the question to ask because presumably we did better than all of them.
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Mick Harper
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A perfect example of politics-as-bad-decision-making swiftly followed when the talking heads got involved. It was perfectly clear that cutting the seven benchmarks for cancer treatment to three was eminently sensible from the point of view of cancer treatment. The opposition tried to portray this as the government moving the goalposts because it couldn't meet the seven benchmarks. The government then riposted by saying Wales (under Labour) was doing worse than England (under government control). The Welsh talking head then refuted that by changing the goalposts. To ones in which they were doing better.

Actually this was a prime opportunity to see which system is better, insofar as they differed and insofar as they were comparable. This chimes with my own belief that the NHS should be broken up into autonomous local bodies, all following their own policies. This is for purely administrative reasons but it would make it easy to see what is best practice.
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Mick Harper
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"Mr Harper? What can I do for you?"
"No idea. I received an email saying you were going to call to discuss the results of some blood tests I discussed with you last month."
"Yes, I was wondering about that myself. So how have you been?"
"Fine."
"OK. Anything else?"
"Can you send a complete repeat prescription to my pharmacist. I've been on emergency supplies because of constant snafus."
"Yes, I can do that for you."
"Thanks, cheerybye."
"Cheerybye."
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Mick Harper
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In the 1980's kidney stones and gallstones were being zapped by concentrated sound ('shock') waves, thereby avoiding invasive surgery to remove them. It became pretty standard practice. It was regularly observed that surrounding bone and tissue regeneration seemed to be stimulated by the shock waves but, since this wasn't germane to the treatment, not much notice was taken. Medicine is as much compartmentalised as any other academic subject.

Until in the 2000's surgeons at Innsbruck decided that this effect might be useful in treating patients after heart attacks since, while various ameliorative things could be done surgically, there was no way of getting the heart back to its normal state after the parts destroyed by strokes et al had occurred. Stem cell therapy had been tried but proved unsuccessful. Zapping the heart with concentrated sound waves looks more promising. And if it works with the heart, it will work other places.

In the fullness of time it will be seen that cutting people up is positively medieval.
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Mick Harper
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My GP practice is doing their bit to keep the drugs bill down. They refuse to give you a script, presumably because people are using them to get their pills online now that e-chemists accept a photocopy and send it to to your door, free of charge and free of bother. Instead the GP sends the prescription direct to a designated local chemist. You have to lumber off to them to get it. But that's not the problem. Repeat prescriptions are the problem. When you lumber off to the chemist for one, the GP does nothing about it!

"You have to ring them up to remind them," says the long-suffering chemist after my repeat visit. "Then they probably will." When I did -- or rather when I had overcome all the hurdles erected by GP's surgeries to discourage contact -- the receptionist cheerfully promised, "It will be with them this afternoon." She appeared in no way surprised that it hadn't been for the previous ten days. When I asked why, she didn't know but apologised cheerfully. When I asked why this is constantly happening, she didn't know but apologised cheerfully.

This remember is for something that happens every two months regular as clockwork, has been happening for years and shouldn't even need any human intervention at all. Instead it requires

1. Three visits to the chemist for me
2. One email from the chemist to the GP
3. One phone call from me to the GP
4. One email from the GP to the chemist
But everyone cheerfully accepts the whole folderol.
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Mick Harper
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I came across a new job title today, a 'health navigator'. This is someone who guides you through the intricacies of the system. They used to be called receptionists but I think that was when you didn't need a degree to do the job.

I only know about them because I spent a bit of time on the phone to one today trying to get her to explain why they won't respond to repeat prescriptions from pharmacists until we (the patients) have (a) asked for a repeat prescription at the chemist (b) the chemist has sent it to the GP (c) the GP has ignored it (d) the patient has returned to the chemist (e) the chemist has shrugged wearily (f) the patient rings the GP (g) the GP sends it to the chemist (h) the patient picks it up from the chemist. The health navigator kept woodenly saying that I would have to ask the pharmacist why they weren't sending in repeat prescriptions. None of them, every time.

This sequence operates with such regularity, for so long and with so little comment from all parties, that it must be a deliberate policy. The purpose of it though is something I still haven't been able to fathom. It is a genuine puzzle.
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Mick Harper
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I've been having some trouble with my eyes -- worn out in your service I shouldn't wonder -- so I popped into the chemist and asked for something. Optrex was the name in my head. I had vague memories of eye drops that always missed or eyebaths that were a complete pain. After the half-dozen souls in the shop went into conclave they produced 'the latest thing', it was a spray! Just the ticket.

I hurried home to use it. I took out the instructions leaflet. No luck. It was an invitation to sing the product's hosannas on the internet and get a new one free. I looked on the box. No luck, the writing was so small you would have to be gyrfalcon to read it, not an elderly gent with gunmmy eyes. What the hell, I thought, a spray is just a spray, a sigh is just a sigh. But something held me back. I got out my Wiley & Co philately-for-beginners box set with its patented magnifying spyglass, 'The Gyrfalcon'.

Thank God I did. You spray it on with the eyelids shut! What's that all about?
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Mick Harper
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The doctor rang completely out of the blue. "I'm worried about your blood pressure, Mr Harper." Strewth, if she's worried, I'm worried. I told her it's been about 150 lately. "What about the other two numbers?" The systolic dubry and the pulse thingy. I told her I hadn't bothered recording these. Since I don't know what they mean, I couldn't see the point. "Oh, they are very important. I want you to record all three, twice a day, and I'll ring again on Monday."

She never did so they can't have been all that important.
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