It was while working on a project called “Dreamland x Reality” with the village’s teenagers during their two-month break that I went deeper into their dreams and aspirations, as they hold the future of the village in their hands. Spending hours each week listening and talking to them made me realise that, despite the challenges, they have many dreams. As a coach, my role was to help turn those dreams into reality and find better ways to achieve them.

It was an incredible experience.

Although there were difficulties, such as the lack of basic amenities like bathrooms, showers, and running water, or even what was for us luxury of eating meat, the smiles on the children’s faces as they arrived at school every morning made up for it. It was intense days of school activities, including English lessons and helping in the kitchen to prepare meals. But it was so rewarding to know that we were somehow contributing to the future and development of an area in great need.

I want to express my gratitude to Dr Sophia Khalique, who helped me during the initial stages of this once-in-a-lifetime experience, as well as my supportive friends and family who were there for me throughout the entire period I was away. Their assistance made a significant difference, and I couldn’t have done it without them.

Johann

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Excess consumption of salt, sugar and saturated fat calories have been linked with an increase in common but often preventable cardiometabolic conditions which include heart attack, stroke, diabetes, insulin resistance and non-alcoholic fatty liver disease. Now researchers have found a link between the non-nutrient components of food and inflammation, which is a driver of chronic diseases including cancers, cardiometabolic conditions and mental disorders. Ultra-processed foods also contain less dietary fibre and fewer vitamins and minerals, making the overall nutritional quality of our diet poorer.

Current research indicates that whole foods, with a little processing as possible, are significantly healthier in many ways. The more processed (ultra-processed) foods we eat, the greater the risks of type 2 diabetes, cardiovascular disease, certain cancers and an early death. research is ongoing, but opting for fresh, minimally processed foods is linked with reduced abdominal obesity, as the body can break down the foods more effectively.

Foods can be divided into four categories based on how much they have been processed during their production: unprocessed or minimally processed; processed culinary ingredients, processed foods; and ultra-processed foods.

Ultra-processed foods typically have five or more ingredients and contain industrial substances such as preservatives, emulsifiers, sweeteners, and artificial colours and flavours, texturizing agents, smell and taste enhancers. They are commonly inexpensive, virtually imperishable, easily consumed, and highly palatable.

The examples listed below may help with making better choices:

Unprocessed foods: fruit, vegetables, eggs, meat, fish and grains

Processed culinary ingredients: butter, lard, oils, salt, sugar and vinegar

Processed foods: Unpackaged freshly made bread, tinned fruit and vegetables, bacon, cheese, salted and roasted nuts, canned fish and cheese.

Ultra-processed: ice-cream, ham, sausages, crisps, mass-produced bread, breakfast cereals, biscuits, carbonated drinks, fruit-flavoured yoghurts, instant soups and some alcoholic drinks, including whiskey, gin and rum.

Processed foods have a place as part of a healthy diet and even small changes can add up and make a difference in improving health.

• Try swapping simple, refined grains/carbohydrates such as white pasta, rice, and bread for wholegrain alternatives, such as brown rice, wholewheat pasta and wholegrain bread. They are higher in fibre and protect against heart disease, diabetes and certain types of cancer.
• Read food labels and compare similar products for ingredients, salt, sugar, saturated fat and additives. Make informed choices.
• start with a few simple food swaps, such as sugary, processed cereal for oats/porridge with fresh fruit.
• make your own vinaigrette with olive oil and vinegar to drizzle over salads instead of processed dressings and mayonnaise.
• Eat less processed meat such as sausages, bacon and packs of sliced sandwich meats. Opt for fresh chicken, turkey, fish and eggs.
• Eat more plant-based proteins, such as lentils and beans.

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Are you feeling tired, lethargic or run-down? Have you recently recovered from an illness but are now lacking energy? IV therapies could be the solution for you.

Intravenous (IV) therapy enables us to administer key nutrients, vitamins, electrolytes, antioxidants and hydration directly to the bloodstream. The IV route allows for a better absorption rate and quicker restoration of levels in comparison to traditional oral treatments.

We are working alongside one of London’s most reputable IV clinics to provide IV therapies for our patients.

The most popular IV therapies that we advocate are the ‘Myer’s Cocktail’ and glutathione therapy.

The Myers’s Cocktail

The Myer’s cocktail was originally developed by the late John Myers MD who used it to help patients battling chronic illnesses for 25 years, before his passing in 1984. It has become increasing popular in recent years following research built on John Myer’s original framework.

The Myer’s cocktail contains high dose vitamin C, B vitamins, folic acid and magnesium. These supplements support the function of a healthy immune system and can act as ‘natural antihistamines.’ Research has shown that the Myer’s cocktail can be effective as an adjunctive treatment for conditions such as asthma, migraines, chronic fatigue, upper respiratory tract infections, chronic sinusitis and even acute muscle spasm.

Glutathione Therapy

Glutathione is a potent antioxidant which plays a vital role in many body processes to include tissue building, cell rejuvenation, strengthening of the immune system and the regulation of homeostatic pathways. It has become particularly popular in recent years following the discovery of oxidative stresses and their subsequent negative impact on the body. Oxidative stress results in the release of ‘free radicals.’ When the body is unable to detoxify these free radicals, age related damage can occur over time which directly impacts on cell rejuvenation. Sources of oxidative stress include smoking, UV radiation, pollutants and even stress. Boosting your intake of glutathione can help to treat cellular damage and oxidative stress.

Treatments are available at the practice, where our doctors are always on hand.

#myerscocktail #ivtherapy #ivdrip #vitaminb #folicacid #magnesium #vitaminc #vitamins #health #ivhydration #ivinfusion #ivvitamintherapy #ivvitamins #iv #wellness #immunesystem #ivhydrationtherapy #medicalpracticemarylebone #privategpharleystreet #privategplondon #privatedoctorharleystreet #privatedoctorlondon #gphomevisitlondon #gpofficevisitlondon #mentalhealth #healthylifestyle #menshealth #womenshealth #familyhealth

REFERENCES

Gaby A. Intravenous nutrient therapy: the Myers’ cocktail. Altern Med Rev. 2002 Oct;7(5):389-403.

Ali A, Njike VY, Northrup V, Sabina AB, Williams AL, Liberti LS, Perlman AI, Adelson H, Katz DL. Intravenous micronutrient therapy (Myers’ Cocktail) for fibromyalgia: a placebo-controlled pilot study. Altern Complement Med. 2009 Mar;15(3):247-57.

Spasov AA, Sanzharovskaia NK, Ostrovskiĭ OV, Martynova LA, Temkin ES, Mazanova LS. Clinical and experimental rationale of policatan administration in upper respiratory tract inflammation. Vestn Otorinolaringol. 1999;(5):47-50.

Caulfield, T, & Rachul, C. Supported by science: What Canadian naturopaths advertise to the public. Allergy, Asthma {&} Clinical Immunology, 2011. 7(1), 14.

Vollbracht, C.; Kraft, K. Feasibility of Vitamin C in the Treatment of Post Viral Fatigue with Focus on Long COVID, Based on a Systematic Review of IV Vitamin C on Fatigue. Nutrients 2021, 13, 1154.

Carr, A. C., Vissers, M. C. M., & Cook, J. S. The effect of intravenous vitamin C on cancer- and chemotherapy-related fatigue and quality of life. Oncol., 16 October 2014. Sec. Cancer Molecular Targets and Therapeutics.

Ciarallo, L., Sauer, H, & Shannon, M. Intravenous magnesium therapy for moderate to 62 severe pediatric asthma: Results of a randomized, placebo-controlled trial. The Journal of Pediatrics. 1996. 129(6), 809-814.

Shrader, W. A. Short and long term treatment of asthma with intravenous nutrients. Nutrition Journal, 2004 3, 6.

Igal M, Bordini C, Tepper S, Speciali J. Intravenous Magnesium Sulphate in the Acute Treatment of Migraine Without Aura and Migraine with Aura. A Randomized, Double-Blind, Placebo-Controlled Study. Cephalalgia. 2002;22(5):345-353.

Fukagawa NK, VR. Plasma methionine and cysteine kinetics in response to an intravenous glutathione infusion in adult humans. The American Journal of Emergency Medicine. Volume 50, 2021,Pages 242-250.

Reid, Marvin, Jahoor, Farook. Glutathione in disease. Current opinion  on clinical nutrition and metabolic care. Oct 2022.

Ting Li, Jun Zeng, Di-huan Li, Guang-yu Yang, Kai Wang, Hong-fei Deng, Hua Jiang. Efficacy of intravenous vitamin C intervention for septic patients: A systematic review and meta-analysis based on randomized controlled trials. The American Journal of Emergency Medicine. Volume 50, December 2021, Pages 242-250

Erol, A. (2020, February 26). High-dose intravenous vitamin C treatment for COVID-19. https://doi.org/10.31219/osf.io/p7ex8

Padayatty SJ, Sun AY, Chen Q, Espey MG, Drisko J, Levine M (2010) Vitamin C: Intravenous Use by Complementary and Alternative Medicine Practitioners and Adverse Effects. PLoS ONE 5(7): e11414.  Lukaski HC. Vitamin and mineral status: effects on physical performance. Nutrition. 2004 Jul-Aug;20(7-8):632-44.

Boulis M, Boulis M, Clauw D. Magnesium and Fibromyalgia: A Literature Review. J Prim Care Community Health. 2021 Jan-Dec;12.

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Being an adolescent can also be a fascinating time of self-discovery. Some navigate this period with more excitement than discomfort, whereas others might show signs of anxiety, mood, attention, and behaviour disorders. It can be difficult to determine whether a troubling adolescent behaviour is a natural part of growing up or a concern that needs to be brought up with your GP. You should speak with a health professional if an adolescent exhibits behavioural symptoms that persist for weeks and if these problems affect the child’s day-to-day activities at home, school, or with friends.

It is well known that adolescent mental health is enhanced by good eating and sleeping habits, exercise, mindfulness, and meditation. I often hear from parents: “This is so well known, I wish my child would just do that.” My answer is often straightforward: as human beings, we tend to preserve and perpetuate how we ‘re-act’ to circumstances.

That being said, you might ask me how psychotherapy can be helpful in those cases. Let’s keep in mind that we may not be able to change the circumstance that is generating stress, but we can alter how we respond to it. Psychotherapy for adolescents helps young people to learn about themselves, recognise why they behave and respond to stress in a certain way and understand how to regulate their emotions. With space and time to think about their problems, psychotherapy helps adolescents not only to learn new ways of relating to themselves and others, but also master new ways of solving problems in a resilient and compassionate manner.  Our brain has a vast potential to change.  It is constantly evolving as we learn new things every day. We all need time and practice to change our behaviours. Remember, everything that is faced can be changed, but nothing can change until is faced.  

Mental health is a crucial component of wellness and overall health for children and adults. Early intervention can be very effective and help a child avoid more serious, long-lasting issues as they develop. Adolescence can be a tumultuous time, but it can also be a time where one learns how to manage internal feelings at a young age and use these tools throughout their adult lives. One does not need to have a diagnosis to engage with a therapist. Any child, adolescent, young person, or parent might want someone to talk to from time to time in their life.

#MedicalPracticeMarylebone #adolescent #teen #teenager #parenting #psychotherapy #puberty #mindfulness #BehaviouralSymptoms #growingup #wellbeing #PrivateGPHarleyStreet #PrivateGPLondon #PrivateDoctorHarleyStreet #PrivateDoctorLondon #GPHomeVisitLondon #GPOfficeVisitLondon #MentalHealth #FamilyHealth

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When I ask a client: “Where is the feeling of anxiety?” I am often met by a blank look or sheer incredulity. “What do you mean? Where is what feeling?”

So, I have to explain that anxiety is a set of physical feelings that often include: Tight-chest/queasy stomach/constriction in the throat/light-headedness, and nearly always triggering a racing mind riven by critical self-judgement and worry.

Anxiety really is normal. It is our body responding to threat and risk. It links to Flight/Fight and sometimes we get stuck in Freeze – especially in response to Trauma.

Put very simply it is our autonomic nervous system (and its sympathetic and parasympathetic pathway) kicking in.

Our body is amazing truly, before you even realise what is going on the Vagus nerve is s sending messages to the part of the brain the Thalamus to start producing adrenaline and cortisol – high octane fuel to help us get moving in response to threat.

Anger and anxiety are both responses to threat and risk. So integrative therapy which blends numerous theoretical approaches can really help us to learn how to regulate our emotions and understand why we are reacting in the way that we do – how valuable is that?

It is like having an artist’s palette of colours – rather than a one size fits all therapeutic approach that has its limitations.

You see, anxiety is a felt sense, so we must become more aware of our body-mind. We Sapiens are not thinking automatons, we are feeling highly sensate organisms who think.

Everything starts within the body. Through evolution we traded off a safer birth for the capacity to stand upright/have fine motor skills/and a highly advanced cognitive brain that is capable of learning how to split the atom/find cures for cancer/invent aircraft. Oh, and worry. Our imagination can run riot in both good ways and bad.

Then our belief in those predictive thoughts goes UP and then yes absolutely the catastrophic thinking sets in, and it feels so REAL.

No wonder our anxiety levels as a society have gone through the roof.

So, understanding the roots of our anxiety/our attachment style/building a mindful and compassionate approach to our self and to others and building resilience to cope with the slings and arrows that life will throw at us for certain – is key.

Integrative therapy is a gift to our selves and to those we love. Worth exploring. Life changing and certainly life enhancing.

Why not give yourself that gift? You are worth it.

#MedicalPracticeMarylebone #anxiety #anxietysupport #depression #mentalhealth #mentalhealthawareness #mentalhealthsupport #selfcare #love #mentalhealthmatters #stress #therapy #healing #health #wellness #mindfulness #anxietyrelief #motivation #recovery #life #psychology #anxietyawareness #loveyourself #happiness #wellbeing #positivity #mindset #PrivateGPHarleyStreet #PrivateGPLondon #PrivateDoctorHarleyStreet #PrivateDoctorLondon #GPHomeVisitLondon #GPOfficeVisitLondon #MensHealth #WomensHealth #FamilyHealth

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I don’t know how you feel but I am so done with new year’s resolutions to go on crazy diets, detox cleanses, total abstinence from alcohol and exercising in an unmanageable way. How long do these changes last? Surely to improve physical and mental health, one must alter one’s mindset on a sustainable basis. Read this:

Modern day life for many has become task based or a constant state of doing. We set goals and desires, we may or may not achieve, which activate our body’s stress response (the fight or flight system). This constant state of doing can lead to exhaustion – mental and physical. Even when we try to factor in rest, we are still trying to achieve in that moment. Without the state of just being we cannot experience true joy or a state of inner calmness.

As stress is now a part of everyday life, juggling responsibilities between work, family, and home, it becomes overwhelming. The over stimulation of the body’s stress response means hormones such as adrenaline and cortisol continue to remain in your system. This leads to health problems – physical and mental. While we cannot eliminate stress it is our reaction to stress that we can grasp a hold of leading to wellbeing.

Mindfulness is one of the most powerful approaches to achieve this. The concept of mindfulness is remarkably simple, it means paying attention to the present moment. It means awareness of the weather system inside and outside of ourselves, moment by moment. Rather than obsessing about the past or procrastinating about the future, we free up our energy and thoughts and focus on the now moment, the only real moment.

Mindfulness is compassion. So, we free ourselves from self-criticism or judgment. By noticing our thoughts and feelings, it can help us improve our well-being. Knowing how to respond to stress, such as noticing our jaw clenching, our heart rate accelerating or a feeling in our abdomen, we can use it as an internal warning system. We can dampen the stress response and activate the body’s natural relaxation response (rest and digest system), where adrenaline is reduced and happy hormones such as dopamine and serotonin are released.

Often clients say their biggest barrier to self-care is time. The truth is we all have time, but it is where we allocate it to is where we need to negotiate. Self-care, in whatever form, should be incorporated into daily life, such as brushing our teeth, taking a shower, having a meal. Self-care is helpful in treating and promoting good health. Maintaining wellbeing in yourself will have a ripple effect in other areas such as relationships, self-esteem, and confidence.

Practicing mindfulness requires only one thing, to show up. Everybody can practice mindfulness. It does not require a special posture, clothing, place, or props. By awareness of the breath and guided imagery you can relax the body and mind. Take a break from the doing mode, that has become a default way of life and enter the being mode.

Stress and anxiety respond very well to mindfulness, other benefits range from an increased immune function to the experience of being calm and feeling connected. This will in turn impact your relationship with others and yourself. Studies have shown that mindfulness has benefits for many conditions such as:

·         Stress

·         Depression

·         Migraine

·         Anxiety

·         Insomnia

·         Pain

·         High blood pressure (Hypertension)

·         Irritable Bowel Syndrome

·         Acne

One study showed that those who practice mindfulness are more likely to engage in positive health behaviours related to health such as exercising, avoiding addictive substances and attending health checks. Scientists have used MRI scans to show that the grey matter in your brain’s amygdala – a region known for its role in stress – can become smaller in those who regularly practice mindfulness.

You do not need to be unwell to start a mindfulness program. Improving your wellbeing can bring out major shifts in your life. With all the advances in modern society we can still feel that time is running out, living in a constant heightened state. So rather than going through life just surviving, experience true joy. Invest in yourself.

To learn more about mindfulness, and how it can improve both your physical and mental health, please contact the practice to schedule a consultation.

#medicalpracticemarylebone #mindfulness #selflove #loveyourself #positivevibes #selfcare #mindset #mentalhealth #coaching #healing #wellness #meditation #positivity #believe #inspire #spiritual #privateclinic #privatedoctor #privategp #privategplondon #privatehealthcare #gpharleystreet #health #mentalhealth #healthylifestyle #menshealth #womenshealth #familyhealth #homevisit #harleystreet

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After a non-existent Christmas party season in 2020, many people are looking forward to making up for lost time this year. However, if you get the timings and intake of alcohol and food wrong, it could become one you want to forget, or cannot remember at all.

You may have heard those wise words to ‘line your stomach’ before drinking alcohol and this is good advice that will help you enjoy the party without suffering (too much) the next day. 

Eating before drinking alcohol makes sense for many reasons.

Firstly, almost all foods contain water, even those that look dry and hard. This means that if food enters the stomach before alcohol, it will help dilute it.

Secondly, as soon as we eat something our body sets about breaking this down to provide us with essential fuel. As this process begins the absorption rate of the alcohol slows down. This is why the type and quality of food we eat before drinking – not just the quantity – is key to how good or bad we feel the morning after.

A cocktail of the wrong type of food and alcohol can result in some unpleasant side effects on the night itself, never mind the next day – bloating, heartburn, indigestion, gas, nausea, sickness and food cravings, to name just a few. 

Talking of cocktails, these can lead you astray faster than many other alcoholic drinks. The heady mixture of sweet fruit juice, syrup and a combination of spirits and bubbles makes them easy to knock back and delicious to drink. But before you know it, the damage is done.

Electrolytes, and the need to balance them, are commonly mentioned when discussing hangovers without explaining why or how. They include sodium, calcium, potassium, magnesium and bicarbonate and we need them to live. As our body excretes the toxins in alcohol via urine, we also lose electrolytes. Therefore, good food pre-drinking and again the next day to manage and replenish our electrolyte balance is key to our sickness and recovery.

Top pre-party food choices are:

Oats and other high fibre carbohydrates, such as rye bread, wholemeal pittas, wholemeal pasta or oat cakes are perfect for lining the stomach, slowing the absorption of alcohol and also keeping blood sugar levels stable. This helps us manage cravings and impulsive food and drink choices better.  Studies also show that oats can protect against alcohol-induced liver damage and improve liver function.

Eggs and salmon are excellent sources of protein and can delay the stomach emptying, slowing the absorption rate of alcohol. This makes an egg or salmon sandwich on wholegrain bread a winning combination.

Bananas are high in potassium which helps to rebalance electrolytes. The high water content helps with hydration. Take a few oatcakes and a banana to work for a simple snack before the celebrations kick off.

Full fat natural yogurt with fruit is excellent for lining the stomach, slowing the alcohol absorption rate. The high water content of both also helps with dehydration and the dilution of alcohol. Choose yogurt with live bacteria and it will help restore the health of your gut microbiome after an upset stomach caused by too much alcohol.

Avoid high fat, spicy foods or sweet foods as they can increase bloating, nausea and reflux.

Remember that wholegrain/wholemeal (brown) carbohydrates will slow the speed at which we absorb alcohol, whereas white bread, cakes, crisps, pasta, etc increases the rate of absorption.

Finally, drink lots of water during the party, interspersed with alcohol, and this will lessen the effects of any headache the next day due to the dehydrating effects of booze.

Get a good night’s sleep and when you wake, drink water and have a hearty breakfast.

Cheers!

#medicalpracticemarylebone #drinkless #mindfuldrinking #drinklesslivemore #moderatedrinking #privateclinic #drinkaware #privatedoctor #privategp #privategplondon #privatehealthcare #gpharleystreet #health #healthylifestyle #menshealth #womenshealth #harleystreet

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The prostate gland is part of the male reproductive system.

The word ‘prostate ‘is taken from the Greek expression meaning ‘one who stands before’ – which describes the position of the prostate in-front of the bladder. The prostate surrounds the top of the urethra, the tube that drains urine from the bladder.’ The primary function of the prostate is to produce the seminal fluid that nourishes and transports sperm in the semen during ejaculation.

As men get older the prostate tends to grow in size and this enlargement is caused by one or more of the three following conditions:

BPH (Benign Prostatic Hyperplasia) – a normal condition of ageing where an enlarged prostate gland puts pressure on the bladder and urethra causing:

• Difficulty starting urination

• A frequent or urgent need to urinate (particularly at night)

• Inability to fully empty the bladder

Prostatitis – Inflammation, and/or swelling, of the prostate gland which can sometimes be extremely painful and distressing. 

Prostatitis can be severe and come on suddenly (acute), often caused by a bacterial infection and requires immediate treatment with antibiotics, this though is rare but can be potentially life-threatening.

More commonly Chronic Prostatitis is seen in General Practice where the patient complains that symptoms come and go over several months, including pain in the groin, pain when passing urine with a frequency or urgency to urinate, the cause is often unknown.

Prostate Cancer – The most common cancer in men in the UK and one of the easiest to treat if caught early. It is usually slow to develop so there may be no signs for many years until the prostate is large enough to affect the urethra causing an increased need to pass urine and a feeling that the bladder is not fully emptied.

Many of the initial symptoms of these three conditions, BPH, Prostatitis and Prostate Cancer overlap and therefore none of the symptoms, should ever be ignored; a medical check with the Doctor is always encouraged.

Many men are very cautious when seeking medical help with urinary problems often due to embarrassment but also fearing what the Doctor may find, and what tests or examinations may be performed, so it’s useful to understand what to expect when attending for an appointment to discuss urinary problems.

The Doctor will usually start with:

 • A full history, including any family history of Prostate cancer which may be very significant.

• Examination of the abdomen and rectum, the latter to ascertain if the prostate is enlarged

• A blood test known as the PSA – Prostate Specific Antigen Test, a sensitive, but not a very specific test, this means it will pick up any prostate issues, but the cause could be many things, BPH being the most common – many patients become concerned and anxious when the PSA is high but reassuringly it does not often indicate Cancer.

MRI Scan

If the PSA test does come back raised an MRI scan of the prostate may be offered to help decide if any further testing and treatment is required.

Biopsy

If suspicious areas are visualised on the MRI scan then a biopsy of the area will be taken of these.

There are two main types of biopsy:

• Transperineal ultrasound guided method, where a needle goes through the skin between the testicles and the back passage (the perineum).

• Trans- rectal ultrasound guided biopsy (TRUS), where a needle goes through the wall of the back

passage.

Prostate Cancer – Treatment

Prostate biopsy results will take at least 1 week, and treatment options will be discussed when they are received. Consideration is given to age, general health, PSA level, Gleason grade and stage of the tumour. Surgery, hormone treatment, chemotherapy and radiotherapy are all options that will be discussed, and the appropriate pathway chosen in conjunction with the patient and the stage of the cancer.

If the tumour is at low risk of progression, it may be more appropriate for the cancer to be monitored closely and treated only if there are signs of progression.

BPH

Treatment for BPH depends on the severity of symptoms and the effect on quality of life.

Simple treatments can include lifestyle changes, bladder training, medications that help to relax the muscle in the prostate gland, other options include simple surgery, and more invasive surgery if required.

Chronic Prostatitis

Treatment of Chronic Prostatitis is usually aimed at symptom control.

Depending on how long the symptoms have been present the following may be suggested:

• Painkillers, such as paracetamol or Ibuprofen

• A medication known as an Alpha-blocker to help to relax the muscles in the prostate gland and the base of the bladder, which improves urine flow

• Antibiotics

• A laxative, if passing stools is painful, (due to the close proximity of the rectum to the prostate)

The most important message to be taken from this is that prostate problems are common, particularly in men over 50 years, and early consultation with your Doctor is to be encouraged. If you are experiencing any of the symptoms mentioned and listed again here:

• The need to pass urine more frequently, particularly at night,

• The need to rush to the toilet

• Difficult starting to urinate

• Straining or taking a long time to pass urine

• Weak flow

• Feeling that your bladder has not emptied fully

• Blood in your urine or semen

#medicalpracticemarylebone #prostate #prostatecancer #cancer #menshealth #urology #prostatehealth #prostatitis #men #oncology #prostatecancerawareness #cancerawareness #erectiledysfunction #bph #trus #urologist #psa #privateclinic #privatedoctor #privategp #privategplondon #privatehealthcare #gpharleystreet #menshealth #harleystreet

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Around 10 million British adults smoke cigarettes, which accounts to approximately a sixth of the UK population.

22% of adult men and 19% of adult women are smokers. Amongst both sexes, the prevalence is highest in the 20 to 34 age group. In 1974, 51% of men and 41% of women smoked cigarettes – which accounted to nearly half of the adult population. Therefore, trends are changing. 22% of women and 27% of men are now ex-smokers.

Smoking is still the largest cause of premature death and preventable disease in the UK and attributes to approximately 100,000 deaths per year. Eventually, half of all smokers will die of a smoking related illness.

Tobacco can be consumed in various different forms, including cigarettes, pipes, smokeless tobacco products such as snuff and e-cigarettes, cigars, cigarillos, roll your own tobacco and more international products such as bidis and kreteks.

So how exactly does smoking harm the body?

Smoking cigarettes causes the inner layer of the blood vessels to become rather ‘sticky’ so to speak, making it easier for fatty material to stick to the vessels which ultimately can result in blockage. Smoking is therefore one of the leading contributors of heart disease and stroke. 

Can smoking affect fertility?

Yes, smoking can affect the chances of conceiving in women and there is an association between smoking and reduced semen quality in men. 

Aren’t smokeless tobacco products better for you?

This is a question that we get asked on a regular basis as doctors. The answer is that unfortunately, smokeless tobacco products are equally as addictive and damaging to health. They also quite often contain ingredients that can increase the risk of cancer of the head, neck, throat, oesophagus and oral cavity. The long-term effects of which are currently unknown, however it’s likely that they will almost certainly lead to some degree of respiratory disease.

What about shisha?

Shisha traditionally contains cigarette tobacco and therefore nicotine, tar, carbon monoxide and various other chemicals. During a typical shisha session, say between 30-60 minutes, research has shown that consumers are likely to inhale the same amount of smoke as approximately 100 cigarettes and contrary to popular belief, drawing tobacco through water does not make shisha less harmful than cigarettes.

Are the government doing enough to encourage people not to smoke?

As you’ve most likely seen, graphic pictorial warnings are now mandatory on all cigarette packaging and tobacco advertising is now at an all-time low. This along with increasing taxes on cigarettes, has certainly resulted in lower consumption rates.

If I stop smoking will my lungs recover to those of a non-smoker?

This depends entirely on a case-by-case basis, dependent on the number of years and quantity smoked.

Research shows that 20-30 minutes after stopping smoking, the heart rate and blood pressure can return to normal. After 12 hours the body can cleanse itself of the excess carbon monoxide that can accumulate after smoking. Even after day one of quitting, the risk of heart attack begins to decrease. Three days in, nicotine levels in the body become depleted causing nicotine withdrawal in long term smokers. It’s at around this time that most people will experience symptoms of withdrawal such as irritability, mood swings, headaches and cravings.

By one month a person’s lung function starts to improve and exercise can become easier. After nine months the lungs will start to significantly heal and the delicate hair like structures within the lungs known as the ‘cilia’ will begin to function normally again, to help push out mucus build up from the lungs. It’s by this time that many former smokers will notice an improvement in the frequency of lung infections that they acquire. After one year a person’s risk of heart disease will decrease to half that of a smoker.  Following this the blood vessels will continue to heal and by 10-15 years the likelihood of developing coronary heart disease can become equivalent to that of a non-smoker. However, we must remember that smoking can lead to irreversible lung disease such as that of COPD and lung cancer.

So how should I go about quitting? Should I just go cold turkey?

As with any addiction, going cold turkey doesn’t usually work. Using weaning regimes containing nicotine replacement therapy tends to be the best way to tackle the problem. Cognitive behavioural therapy can also be beneficial.  You can speak to your GP about trying medications such as bupropion and varenicline. Remember the first three weeks are usually the hardest, once you get over this hurdle it does get easier. Research has shown that changing habits and rewarding yourself can also be beneficial.

How does nicotine replacement therapy (NRT) work?

NRT is available in many different forms and can take effect even in a few seconds to minutes. They contain nicotine so they help with cravings without the harmful effects of smoke. Chewing gums and sprays tend to take effect very quickly, with nasal sprays, lozenges and patches taking a bit longer.

But can’t I just become addicted to NRT?

Well, the risk of dependence on NRT is actually quite small at around five percent. The safety however of the long-term use of NRT is still under investigation.

Remember that your GP is here to help you to stop smoking permanently. It’s a process that might take some time, but it will most certainly be worth it.

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Erectile dysfunction (ED) is a common problem where a man finds it difficult to get or keep an erection. Also known as impotence. Unfortunately, even though it is often seen as a taboo subject, most men will experience ED at some point in their life. ED can cause relationship problems, embarrassment and low self-esteem, stress and anxiety, and fertility issues for a couple.

Causes of ED are complex. In order to obtain an erection, a man needs to have healthy blood vessels, nerves, male hormones and a desire to have sex.

There are many physical as well psychological causes for ED.

The medical causes can include:

• Diabetes Mellitus
• Heart disease
• High blood pressure
• High Cholesterol
• Parkinson’s disease
• Multiple Sclerosis
• Sleep disorders
• Treatment for prostate cancer or in large prostate
• Surgeries or injuries that affect the pelvis or spinal-cord
• Certain prescription medications
• Low testosterone.

Case study, a patient in his 20s, newly diagnosed diabetic who is suffering with ED in silence. This has been bothering him and he has no idea that this could be related to his diabetes. He is treated with Viagra. Once he understands the cause, he is able to overcome his psychological fears which are making the problem worse. It causes low self-esteem and paranoia about sexual failure. He is much more relaxed and it is no longer a problem.

The lifestyle causes:

• Alcoholism
• Substance abuse
• Smoking
• Obesity

The brain plays a key role in triggering a number of physical events which cause an erection.

Psychological causes play a key role:

• Depression, anxiety and other mental health conditions
• Stress
• Relationship Problems
• Low self-esteem and paranoia about sexual failure

These are estimated to cause between 10% and 20% of ED cases alone.

To diagnose ED there will need to be:

• A full medical history taken including a medical and sexual past history, any prescription or non-prescription drug use
• Physical examination, as bodily features can give clues to the cause
• Laboratory tests can also be key for diagnosing ED
• Further tests such as monitoring nocturnal erection (nocturnal penile tumescence) can help to rule out some causes
• Psychological examination can reveal any psychological factors

Poorly controlled diabetes can lead to damage of nerves and blood vessels caused by poor long term blood sugar control. Erectile dysfunction can also be the first sign of coronary artery disease where plaque builds up in the arteries.

Try to cut down on the cigarette smoking, limit alcohol and stop any illicit drug use.

Regular exercise, a balanced healthy diet, adequate sleep and stress management will all help.

Treating ED

Medications:

There are a number of oral medications that can be prescribed to help improve blood flow to the penis. These include well-known brand names such as:

• Viagra

• Cialis

• Levitra

These medications can affect the heart and interact with other medications. Please consult your doctor before taking.

Alternative treatments include:

Vacuum constriction devices. A pump creates a vacuum that will draw blood into the penis making it erect. A rubber ring will need to placed around the bottom of the penis to keep it erect.

Alprostadil is a form of hormone medication that stimulates blood flow to penis and may be given by two different methods: Intracavernous injection therapy where alprostadil is given by injection into the penis. Intraurethral application where a pellet of alprostadil is inserted into the urethra via a urethral stick.

Psychosexual Therapy

Any underlying psychological factors can be addressed.

Cognitive Behavioural Therapy (CBT) is often used in addressing ED as it is a proactive and actionable therapy targeted at helping you change the way you think and behave. It can be used to address any performance anxiety, low self-esteem, and loss of sexual arousal.

Erectile Dysfunction Moving Forward

There are frequent advances in this field. Better medications, implants, vacuum devices and suppositories have all increased options for men suffering with ED.

Men are renowned for not wanting to talk about feelings, weaknesses or struggles. Erectile dysfunction is a medical condition like any other and needs to be discussed openly. No taboos, no stigma; let’s talk. 

The post Let’s Talk: Erectile dysfunction appeared first on Dr Sophia Khalique.