Top Doctors’ members are respected for world-leading specialist capabilities, but also admired for incisive research and academic skills, too. Whether featured in peer-reviewed journals, book chapters or complete publications shared with the rest of the international medical community and beyond, their academic work advances knowledge, contributes to better technology and improves methods of practice for generations to come.
Leading consultant ophthalmic surgeonMr Stephen Lash, one of our members, is embodying improving surgical practice with the release of his new book ‘Improving Surgical Skills and Outcomes: A Multi-Perspective Approach’, this autumn.
Answering important questions
He tells us: “Since my earliest memories of surgery, I have found myself asking this question, what makes a good surgeon? It has fascinated me mostly because I always wanted to be a good surgeon and it occurred to me that I might be more likely to become one if I had some idea of what one was in the first place! If we can discover what makes agood surgeon then this opens up the possibilities of trying to become a great surgeon, or at least to get better. The quip most commonly heard is that “They have good hands”. This does not really do the question justice and certainly leaves little scope for improvement beyond nail care and regular moisturiser.
“This book represents thoughts formed over my 25 years as an eye surgeon, reflecting on my own practice and, in teaching others, reflecting on others. It is also heavily influenced and perhaps unlocked by my MBA which enabled me to become more comfortable intellectually walking on sand rather than concrete. I have limited the perspectives to ‘three boxes’ but there will be others. You can view the boxes as frames to look through or boundaries to think within but each one sits within and is influenced by the others. It’s hard to think outside all the boxes!”
“If we can discover what makes a good surgeon then this opens up the possibilities of trying to become a great surgeon, or at least to get better.”
What makes itso important?
You’ll find more information on his website about his publication (and those boxes, in particular). It was borne out of a surgical debrief with two of his trainees over coffee.
‘Improving Surgical Skills and Outcomes: A Multi-Perspective Approach’ is available to pre order on Amazon, here.
You’ll find out what those colleagues have to say about the book on his site. Plus, you can discover why it’s such an important addition to medical literature. It also tells you why his new publication is also useful for those in other disciplines.
Leading surgeons toward better practise
Mr Lash added: “My hope is that in exploring surgery, anyone involved in the profession, from podiatry and dentistry on the high street to neurosurgery and ophthalmology in specialist units, might benefit. I hope to stimulate ideas and potential directions of travel that would lead to the surgeon ever upward towards better surgery.
“It may also appeal to anyone interested in this particular breed of human; one that’s willing to cut another in the pursuit of wholeness.”
Top Doctors would like to wish Mr Lash our warmest congratulations on the release. We’re looking forward to reading!
Visit Mr Lash‘s Top Doctors profile to arrange an appointment. Don’t forget, you can pre order the book here.
Empathy is a crucial component of any healthy relationship, especially in committed, romantic relationships. It is the ability to understand and share the feelings of your partner, and it can make all the difference in creating a strong and lasting bond. In this blog post, esteemed Liverpool-based consultant clinical psychologist, Dr Kerry Ashton-Shaw, explores the importance of empathy in romantic relationships and how it can help you build a deeper connection with your partner.
How important is empathy in a committed relationship?
Empathy is a crucial component of healthy committed relationships. It encompasses the ability to love, understand, and share the emotions of others. Empathy is not only essential for making relationships work but also for the smooth functioning of communities and societies. Without empathy, there would be no collaboration, no acts of kindness, no charity, and no love. Thus, empathy plays a vital role in our lives.
What is the key to maintaining a relationship?
Developing and maintaining relationships is one of the most important aspects of human life. To achieve this, we must be able to put ourselves in someone else’s shoes and perceive the world from their perspective. This is where empathy comes into play.
Our ability to empathise with others is shaped by our experiences and interactions with the world around us. If we have grown up in an environment characterised by healthy relationships, care, sharing, attentive listening, and a sense of security, we are more likely to develop empathy towards others.
What is cognitive empathy?
Cognitive empathy refers to the capacity to understand how someone else is feeling without experiencing those emotions ourselves. For instance, if you notice that your friend looks upset and inquire about their well-being, they might recount their terrible journey to college that morning. Responding with “Wow, that must have been so scary!” demonstrates cognitive empathy.
What is the difference between cognitive and emotional
empathy?
On the other hand, emotional empathy involves experiencing similar or identical emotions as another person. For example, you might feel happy when your partner is happy.
Empathy can significantly contribute to a relationship’s well-being. Consider a scenario where you have a partner who is extremely messy while you prefer cleanliness and tidiness. If your partner empathises with your feelings and understands how upset and frustrated you would be if they left a mess behind, they might change their behaviour and start tidying up after themselves, even if they don’t mind the mess.
What should you do if you notice your relationship lacks
empathy?
If your relationship appears to lack empathy and you find
yourself facing difficulties and arguments, it may be helpful to reflect on why
you aren’t experiencing empathy or why your partner might not be demonstrating
it.
First, it’s important to reflect on why you might be
experiencing a lack of empathy towards your partner. Empathy is typically a
natural response to others, so it’s worth considering when this lack of empathy
tends to occur.
You may find that you become overly absorbed in your own thoughts and emotions, making it difficult to understand how your partner feels. Take note of any physical sensations you experience, such as a racing heart or flushed skin, and try to identify the emotions associated with these sensations.
These feelings can sometimes hinder your ability to understand your partner’s emotions. If your thoughts are racing and overwhelming your mind, it
becomes challenging to focus on what your partner might be thinking or feeling.
Once you recognise these signals indicating that you’re unable to empathise, it can be helpful to take a break from the situation. Engage in a conversation with your partner when you no longer feel overwhelmed by your own thoughts and emotions, allowing yourself the mental space to empathise with them. This approach can lead to more positive resolutions of arguments and difficulties.
To enhance empathy in your relationships, make an effort to give your partner your undivided attention without being preoccupied by your own thoughts. Encourage your partner to do the same for you. Sometimes, we fall into the habit of solely focusing on our partner’s negative aspects. Instead, try to actively seek out their positive qualities and acknowledge them.
Chronic fatigue syndrome is a condition that affects many worldwide, and can be an incredibly bothersome and difficult illness to have to live with. Having said that though, many people learn how to effectively manage the associated symptoms of the mentally and physically affecting condition.
Here to shed some light on his newly published book, Living with ME and Chronic Fatigue Syndrome, is highly regarded and experienced consultant physician, Dr Gerald Coakley.
Tell us a bit about your new book, Living with ME and Chronic Fatigue Syndrome, including its main themes and key aspects.
Living with ME and Chronic Fatigue Syndrome starts with an overview of what we call classical ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome). This is not just feeling tired all the time, but rather an intrusive condition that results in a marked reduction in many or all types of activity, including education, employment, sport, and leisure.
In particular, the defining feature of the condition is post-exertional malaise, in which a group of symptoms (such as fatigue, headaches, muscle aches, insomnia or thinking problems) increase following mental or physical exertion. We consider related syndromes including post-viral and post-infectious fatigue, fibromyalgia and hypermobility.
We review current theories about the causes of these conditions, and give advice on self-management, medications and supplements, nutrition, and food. We also give some advice on dealing with healthcare professionals and specialist services for ME/CFS, and we finish with some examples of people living well with ME/CFS, because we think that hope is vital for people with this condition.
What was the
inspiration behind your book, and were there any significant events or
experiences that influenced its creation?
I became interested in ME/CFS by chance.
When an elderly physician with an interest in the condition retired, his former
patients looked for a new doctor to take them on. I found many of them had been receiving
regular intravenous infusions of vitamin B from this physician, and were looking
for someone else to provide it for them.
Never having heard of this treatment, I
looked into it and found there was no scientific evidence to support its
use. While I was not prepared to
continue providing what seemed to me to be an expensive placebo (albeit
lucrative for the physician), I was intrigued by the condition and started to
have more and more patients be referred to me. I find it to be a fascinating,
complex, and challenging disorder.
Describe the
target audience for your book, and explain why you believe they will connect
with the story and its characters.
The book is mainly aimed at people with intrusive fatigue symptoms who think they may have ME/CFS, or have recently been diagnosed with the condition. The condition is difficult to understand and explain, and there is a lot of misinformation about it online and in the media.
Both my co-author, Beverly Knops (an occupational
therapist) and I (a physician and rheumatologist) have decades of experience of
seeing and trying to help people with these conditions, and we wanted to create
a book that is up to date, scientifically informed, fair and balanced, and realistic
but hopeful.
In your opinion,
what are the distinctive features or approaches that set your book apart from
others in the same genre?
We bring our professional backgrounds to the book. I have a PhD in molecular immunogenetics, so took a particular interest in reviewing the evidence for genetic, immunological, and cellular factors relating to the condition. As a rheumatologist, it made sense to bring in fibromyalgia and hypermobility, which are linked conditions.
Beverly’s background is in occupational therapy,
so she brought her knowledge of rehabilitation and self-management of symptoms.
While there are many people with ME/CFS in severe forms for whom medicine
currently has little to offer and whose outlook is poor, we both thought it was
vital to bring some optimism and hope to the discourse.
Our experience over the last two decades has shown us that hope is necessary but not sufficient for improvement or recovery to take place. Also, some people recovercompletely from ME/CFS, and many more learn to live well with the condition, and we think it is important to share and learn from these experiences.
Can you share
any intriguing or memorable anecdotes from your writing process or the journey
of publishing this book?
My main memory is many mornings of waking up
at 04.30 a.m. to start writing before my day at the hospital began!
World Health Day 2023; the World Health Organisation’s 75th anniversary. Public health successes that have improved quality of life during the last seven decades are being celebrated. And rightly so. Milestones include the discovery of antibiotics in 1950, the development of the inactivated poliovirus vaccine which has led to the near-eradication of polio and the recent announcement that 74 million lives have been saved through tuberculosisprevention, diagnosis and treatment since 2000.
Top Doctors proudly aligns itself with these celebrations. Our leading health specialists are at the forefront of clinicalhealth research and charity work that seeks to improve just what World Health Day2023 is all about; health success. There are many Top Doctors that have contributed to significant advances in their fields. Here is a selection of Top Doctors healthcare professionals improving public health in the present – and for the future.
“Tomorrow’s medicines today”
HER2-positive breast cancer has gone from being the worst in the early 2000s to the best type of breast cancer you can have. That’s because treatments are so effective now. Internationally-renowned consultant medical oncologist and breast cancer specialistProfessor Andrew Wardley has been involved in the development of many targeted therapies throughout his career.
He says: “Throughout my career, I’ve been involved in the development of the most of today’s important drugs. These include Trastuzumab (Herceptin™), trastuzumab-emtansine (Kadcyla™), and pertuzumab (Perjeta™), trastuzumab-deruxtecan (Enhertu™), tucatinib (Tukysa™) amongst others.”
“There’s a whole host of drugs in use today, each of which has made a massive difference to patient quality of life as well as helping them to survive their breast cancer, if treatment is given early enough.”
He also advocates for breast cancer clinical trials. Considering how you can get access to tomorrow’s medicine today, he says: “Having access to clinical trials is a right that everyone should have. I’ve been involved in clinical trials for over twenty years and have seen many patients benefit from treatments within those trials before they become licensed drugs.”
New surgical techniques impress, even when it comes to bunions
People today might not realise just how labour-intensive, risky and potentially painful surgical techniques from the past were. Out of all the surgeries you could think of in the world, let’s look at bunion correction surgery.
Revered consultant orthopaedic surgeonMr David Redfern and co-inventor of the MICA technique, highlights how traditional open surgical techniques in bunion correction surgery used a large oscillating saw. Yes, a large oscillating saw. Ouch.
He says: “It was used to make cuts through the bone so the necessary realignment can be achieved. This involves making a large incision and stripping the soft tissue from the bone and has meant that bunion surgery has developed a reputation for being painful.”
“The small size of the instruments used in MICA surgery means only tiny incisions need to be made and using X-ray imaging, the surgeon is guided precisely through the procedure. These smaller incisions leave the blood supply in this part of the foot intact and mean less soft tissue damage is sustained during surgery, ensuring a quicker and less painful recovery compared to open surgery.”
The evolution of this removal surgery is something we can all marvel at, even when it comes to bunions.
Health success thorough charity – but there’s more work to do
Consultant endocrinologist Dr Helen Spoudeas is the founder of Success Charity, which is the predecessor of her SUCCESS project, the first and largest neuroendocrine surveillance service in the UK.
It’s exclusively devoted to improving the quality of life of patients surviving a brain tumour in childhood. While technology has provided us with the possibility to cure brain tumours in children, the support they require afterwards is also just as essential but not as well funded. This is where Success comes in.
“A cure is not enough”
Dr Spoudeas states: “A cure alone is not enough. We also have to give back these children’s futures.
“Children with brain tumours (whether cancers or low grade) not only endure toxic chemotherapy on a vulnerable, growing body (at doses we adults wouldn’t tolerate), but they have an injury to the brain that we’ve ignored, we don’t recognise or routinely rehabilitate, and we don’t support beyond the end of treatment.
“Children can go on to experience blindness, deafness, paralysis, stroke, difficulties with memory, learning and behaviour, disfigurement, and bullying. Teachers often don’t understand this because they deem them cured. but these children struggle to keep up and as time passes, if they’re not supported, they slip away from their peers and their own potential.”
One of the many strands to Success’ work is advocating for further research.
Dr Spoudeas says: “There are many low grade (so-called benign) tumours where we simply don’t have randomised controlled trials about whether to treat them or not, or to operate or not.
“We’re advocating for further research that examines the long-term effects of brain surgery and chemotherapy on neurological development and, not least how structured and ongoing rehabilitation throughout vital growing years may benefit this.”
It shows there is still some work to do, despite all of the medical advancements in neurology. Which is why World Health Day 2023 is so important. We can look forward to the work that still needs to be done. It’s evident this is undergoing with the combined commitment and knowledge of the Success team.
More health success to come
It’s difficult not to have deep respect for the medical profession and our Top Doctors. They’re putting patient quality of life at the forefront of innovation. I know I’d rather undergo the MICA technique’s minimally invasive procedure in comparison having to be operated on with a saw.
Plus, it’s impressive to think about how in the early 2000s one type of breast cancer would have resulted in an even more difficult treatment journey than what it is today. It’s exciting how we can assist in making an appointment with a Top Doctors breast cancer professional at the forefront of this innovation.
The WHO says that World Health Day 2023 is “also an opportunity to motivate action to tackle the health challenges of today”. Learning all about Dr Helen Spoudeas, Success Charity and her team’s commitment to expanding what healthcare solutions can mean after a ‘cure’, shows that there is much more to come in terms of public health.
There are undoubtedly more ground breaking public health milestones to come in the next 75 years. Top Doctors wholeheartedly stands with the WHO in this journey: to achieve Health For All.
Whether it’s finding out the initial news, during the process, or even after giving birth, pregnancy can be an utterly life-changing experience for any woman. Both the mental and physical health is affected quite significantly, and in this latest blog post here below, we pinpoint the main effects pregnancy typically has on a woman’s body, whilst also detailing what exactly changes in the initial stages of pregnancy, and what pregnant mothers, and those wishing to become pregnant, should be aware of.
First trimester pregnancy: what should
mothers expect?
Receiving the confirmation that you are
pregnant, can, of course, be an incredibly exciting moment in anyone’s life.
You may find yourself feeling generally more positive, with plenty of things to
look forward to in the coming months. Not to mention the fact that your very
own baby is growing and blossoming inside of you.
With all the excitement, though, comes various physical changes to your body that you will begin to notice during the first 12 weeks of pregnancy. The main changes and symptoms of first trimester pregnancy can include:
Another well-known change that you’ll surely notice during the first few weeks of pregnancy is a change in your particular food cravings. No need to panic if you’re suddenly asking your partner to drive you to the nearest McDonalds at 4am just so you can satisfy those cravings. Perhaps you can forgive yourself for panicking slightly though if you’re a vegan or vegetarian in this situation.
For some, little to none of these symptoms mentioned above are experienced, and it depends entirely on the individual and to what extent their hormonal changes affect them. It should also come as no surprise to you if you notice frequent mood swings and irritability. The increased level of tiredness, fatigue, stress, and the overall physical discomfort of being pregnant can inevitably take its toll on your mood and emotional well-being.
The oestrogen levels in particular are known to skyrocket during the first trimester of one’s pregnancy, and due to this sudden significant change, the chances of a pregnant woman experiencing anxiety and irritability more often than perhaps they’re used to are increased.
It then becomes almost like a tug and war
fight between the woman’s oestrogen hormone and her progesterone hormone, as
the changes (increase) in progesterone results in the pregnant mother feeling
very relaxed. It’s no wonder then that while pregnant you experience extreme
and frequent mood swings: your oestrogen pulling you one way, and your
progesterone pulling you the other.
Second trimester: does it get easier?
The second trimester, for many, does get easier, with symptoms such as nausea and fatigue starting to fade away. While these symptoms thankfully take the back seat, though, women will notice other changes to their body from around the 13-week mark of their pregnancy. The woman’s abdomen will begin to expand gradually as the baby continues to grow.
The main symptoms that you can expect
during your second trimester (week 13 to 28) of your pregnancy include:
Again, it is important to stress that not every pregnant woman will experience the symptoms outlined above, but nonetheless, it is important to be as aware and as prepared as possible if you have just fallen pregnant or plan to be pregnant in the near or distant future. It is also worth noting here that the pregnant mother will be expected to be able to feel their baby moving towards the latter stages of the second trimester. So, I think it’s fair to say that it will be worth the ups and downs of the second trimester and the pregnancy as a whole. No greater feeling to be able to physically feel your baby kicking and moving around before being born.
Is the final stretch of pregnancy symptom-free?
Not quite, but you shouldn’t be alarmed if you
fear that your baby will cause either yourself or themselves serious health
complications. More changes to the body are expected to occur in the final
trimester of pregnancy, and these alterations include:
These, just like all of the symptoms
mentioned within this blog post, are to be expected, are completely normal, and
so the woman needn’t be alarmed if she notices them. Pregnancy is a difficult
journey for any woman to go through, but the reward is the greatest possible
gift.
In the final stages of pregnancy, the woman’s cervix will also gradually become thinner. This is a condition known as effacing, and again, is a completely normal occurrence. Effacing occurs in order to help the vagina to open during the actual process of giving birth. The baby will also typically move lower into the abdomen as both mother and baby near the expected due date of delivery.
Although a gruelling journey, the final
destination is an incredibly overjoying one. It is important though that we are
made aware that, for some, it is certainly not plain sailing (far from it), but
this blog post is designed for people who may think or fear that their symptoms
are abnormal and that either they or their baby will be adversely affected by
the body’s changes during pregnancy.
It is estimated that between one to two per cent of the world’s overall population suffer from OCD (obsessive compulsive disorder), which, at first glance, doesn’t necessarily sound a lot, but when analysed, actually accounts for one in every 100. Whereas we’ve probably all heard about OCD in some shape or form, we probably haven’t been as exposed or heard the term pure obsessional OCD (Pure-O) tossed around as much. In this blog post, more light will be shed on what exactly Pure-O OCD is, comparing it to OCD in its most known, traditional form so to speak.
The main difference between OCD and Pure Obsessional OCD
OCD is quite the serious condition that can detrimentally affect one’s mental well-being. It is experienced by millions worldwide, and is characterised by causing those affected to obsess over certain physical compulsions, such as having to turn a light switch on and off a specific number of times, or feeling as if they have to wash their hands a certain amount of times, in order to alleviate the crippling anxietythat has been built up due to the obsession.
When we talk about Pure-O OCD, on the other hand, we are just talking about the obsessions, and not the physical compulsions that people with traditional OCD feel they need to complete. When it comes to Pure-O, the individual does not focus on the physical compulsions, but rather obsesses over the troubling nature of their intrusive thoughts.
Pure-O OCD makes people who suffer from it
obsess over the reasons why a possibly (and most commonly) disturbing intrusive
thought popped into their head. “Why did I just imagine running over that
person crossing the street? Am I a psychopath? What is wrong with me?” are just
some of the questions that most sufferers will ask themselves over and over and
over again, until they eventually get exhausted from their own obsessive
self-analysis.
In simple terms, people who are affected by their intrusive thoughts suffer from Pure-O OCD. Although intrusive thoughts are almost impossible to avoid and affect pretty much every human being on planet Earth, not everyone will give too much of a second thought to the thought. These individuals are not troubled in the slightest by the random appearance of the mostly-disturbing-in-nature thoughts, and therefore, are considered to be Pure-O OCD-free.
What Pure O OCD feels like
Interestingly, in the majority of cases, the intrusive Pure-O OCD thoughts actually tend to go completely against what people themselves believe, whether it be morally, ethically, or religiously, also going against what their overall perception is of their own self. Pure-O makes its victims question their entire identity, and makes them obsess over whether they are a bad person or not. Needless to say, this leads to an intense amount of emotional upset and unrest.
These intrusive thoughts, which are normally either violent or sexual in nature, are so distressing to the person experiencing them due to the fact that these thoughts are ones that the individual could never possibly imagine themselves having or thinking, which leads to the person questioning their morality and good nature. They also then worry to no end about if they will, at some point in the future, feel compelled or have a sudden urge to actually physically do what they were thinking about doing.
Generally speaking, the three most common
ways that Pure-O OCD expresses itself include the following:
intrusive thoughts
unwanted or inappropriate mental images
frightening impulses that go against the person’s beliefs or nature
Cognitive compulsions of Pure-O OCD
Mental avoidant behaviour, or cognitive avoidance, is quite common in people who suffer
from Pure-O OCD. Simply put, cognitive avoidance is actively and consciously
turning one’s mental focus away from either distressing, triggering, or
disturbing thoughts or memories. This active mental avoidant behaviour can take
form in a variety of ways, and could range anywhere from the individual having
the thoughts simply telling themselves not to think about the thought, to toxic
positivity, fantasizing, or dissociation.
People troubled by Pure-O OCD will also typically excessively ruminate. This means that the person is stuck with that thought, finding it near impossible to escape from it, thinking about it over and over and over again. Imagine a horrifyingly gruesome thought or mental image quite literally being stuck in our head throughout the day, with no way of escape.
Everyday tasks that most people take for granted can become quite the challenge, and social interactions stressful. “Will they be able to read my mind? What if they found out I was having this thought?” are some spiralling questions that people experience on a regular basis. This can, inevitably, lead to mental health conditions such as anxiety, depression, and panic disorder, but to mention a few.
George Ezra: ‘I’m not a freak, I’m not alone’.
Speaking candidly and openly on Elis James and John Robins’ award-winning BBC Radio 5 Live podcast ‘How Do You Cope’ in 2020, Brit-award winner and singer/songwriter George Ezra provided a personal insight into how he learned how to cope with Pure-O OCD. The Shotgun singer revealed that he would find himself feeling vacant to the world around him, and would obsess over his particular intrusive thought that day until he went to bed and fell asleep that night.
Cognitive behavioural therapy and how it can help
A highly recommended treatment option for individuals suffering from OCD or Pure-O OCD, cognitive behavioural therapy can effectively allow people experiencing distressing thoughts or emotions to identify them and take control of them so to speak instead of vice versa. The commonly practiced technique hones in on our thought patterns, analysing how these thoughts can affect our emotions and overall behaviour.
In the episode of the podcast mentioned
above, George Ezra shared with the hosts that he was being exposed to the
things and thoughts that worried him the most as he underwent cognitive
behavioural therapy, which, although at the time, left him feeling emotionally
exhausted, helped him confront the thoughts, not allowing them to negatively
affect his emotional and mental well-being.
Acceptance
A cure for OCD and Pure-O OCD depends on
the person suffering from it, really, and, in George Ezra’s case, he found the
process of simply accepting that he would have to learn to live with Pure-O OCD
to be quite “relaxing”, embracing the challenge of managing the mental illness.
Patients might notice that the thoughts pop up during times of intense stress
and anxiety, and may be triggered in certain scenarios, but Pure-O OCD can be
effectively controlled through techniques such as cognitive behavioural therapy
or transcendental meditation, which Ezra also practiced during his
initial management of Pure-O OCD.
Hon Lik was 47 years old when he developed the first modern e-cigarette. The year was 2003 and Lik, a heavy smoker, was struggling to quit. Using his knowledge of Chinese medicine and mechanics, Lik set out to create a product that would satisfy his sharp nicotine cravings without tobacco smoke, that is. Vapour was the key. Today, it is generally believed that vaping is not harmful – or at least, when compared to smoking – but to what extent is this true?
E-cigarette basics: What is vaping?
E-cigarettes, also called e-cigs or vapes, are small lithium battery-powered devices. Rather than burning tobacco leaves, e-cigarettes work by heating a liquid (known as e-liquid) until it turns into an aerosol (vapour). This aerosol is inhaled into the lungs and exhaled as a cloud into the air. Although the chemical compound of the e-liquid can vary, the typical combination includes: nicotine, for the buzz; vegetable glycerine, for the cloud of vapour, flavouring agents, for the taste and smell; propylene glycol, for the flavour to bind to, and other mixing agents that form the liquid – many of which have not yet been identified. Some e-cigarettes are available without nicotine.
Since 2003, the popularity of e-cigarettes has swept the global market, with use not only gaining traction among ex-smokers and smokers, but also among people experimenting with cigarette products for the first time. More than 4.3 million people use e-cigarettes in the UK alone. Of this figure, 2.4 million people are ex-smokers, 1.5 million people are current smokers and 350,000 people had never smoked a cigarette before taking up vaping. The reasons for vaping are far-reaching, from quitting smoking to having a cheaper alternative to regular cigarettes that doesn’t smell as bad and tastes much better.
The silver
bullet for smoking cessation?
E-cigarettes were originally designed to help smokers manage the transition from regular cigarette smoking to not smoking at all. Evidence over the years has shown that e-cigarettes may be as twice as effective as conventional smoking treatments. Working like nicotine replacement therapy, e-cigarettes can give vapers the nicotine hit they need to beat their cravings, but without exposing vapers to the toxic chemicals in tobacco smoke. Switching to vaping can thus help to prevent more than 50 health conditions associated with regular cigarettes, including stroke, chronic obstructive pulmonary disease, and 15 different types of cancer.
In fact, e-cigarette aerosol generally contains fewer chemicals than regular cigarettes. This includes solid particles like smoke, which can be deposited deep in the bronchial tree of the lungs. Since there is no ignition involved, tar and carbon monoxide are also absent in e-cigarettes. These are two of the most harmful chemicals found in tobacco smoke. Although studies are limited, there is also no clear evidence so far that the secondhand vapour from e-cigarettes is harmful to the health of others. This compares to the dangers of secondhand smoke from regular cigarettes, which contains more than 4,000 irritants, carcinogens, and toxins, exposing others to the same health risks as smokers.
E-cigarette
aerosol is not harmless ‘water vapour’
Yet, while e-cigarettes can help smokers quit, vaping is not completely safe.
Nicotine, the main agent in e-cigarettes, is a highly addictive chemical. It causes intense urges and cravings, as well as withdrawal symptoms that can disrupt quality of life. Nicotine also stimulates the adrenal glands, which leads to the sudden release of adrenaline. This in turn can cause acute increases in blood pressure, heart rate and respiration, which raises the risk of suffering cardiovascular disease, hypertension, or a heart attack. Along with the physical perils, studies have shown that there are also cognitive risks linked to nicotine exposure in the developing brain, which does not fully form until the age of 25. This puts teenagers and young people who vape at risk. Inducing molecular activity, nicotine can harm the parts of the brain responsible for decision-making, memory, learning, and impulse control.
Most nicotine vaping products in the UK are covered by tight quality and safety regulations designed to protect vapers. This includes the banning of certain chemical compounds in e-liquid. Despite this, the wide range of e-liquids available means that vapers don’t always know what chemical ingredients they are consuming in their e-cigarettes. Carcinogens (cancer-causing substances) and ultrafine particles have been found in e-cigarettes, for example, whilst some e-cigarettes marketed as being nicotine-free have actually been found to contain nicotine. Other e-cigarettes can even be modified to deliver higher substance dosages and recreational drugs, such as marijuana.
The heating process of e-cigarettes can also release new chemicals, including formaldehydes, a flammable gas linked to cancer in some studies. Other contaminants like nickel, tin, and aluminum have been found in e-cigarette aerosol as well, which worsen asthma and can potentially cause irreversible chronic lung diseases. One of these risks is the one caused by the flavourings that are used to infuse e-cigarette liquid. Although approved for ingestion, not all of these flavourings have been tested and considered safe for inhalation as aerosol. First-time vapers should especially look out for symptoms of cough, mouth and throat irritation, shortness of breath, and nausea. These may be the signs of e-cigarette associated lung disease.
Additionally, there are concerns that e-cigarettes (which simulate smoking) could act as a gateway to future tobacco cigarette consumption. A model in 2015 concluded that for 2,070 adult smokers who had quit that year through vaping, more than 167,000 teenage and young adult vapers had made the transition from e-cigarettes to regular cigarettes. In some cases, however, people choose not to do either, deciding to dual instead, which refers to the use of e-cigarettes while continuing to smoke regular cigarettes at the same time. Dual use increases the risk for heart attack by five times.
Cigarette
users looking to quit
Overall, vaping is less harmful than smoking, but not risk-free. There is still a lot that remains unknown about e-cigarettes, including their exact chemical content, and while their use shows potential in helping smoking cessation, smokers wanting to quit will need to use conventional smoking treatments as well to be truly free of smoke.
The safest health option is to not use e-cigarettes at all.
If you
vape or smoke, it is important to have any lung or chest pain checked by a
specialist. If you are experiencing symptoms associated with cigarette use, do
not hesitate to make an appointment with a Top Doctors pulmonology and respiratory medicine
expert
today.
With the 2022 World Cup kicking off this week over in Qatar, it seemed an ideal moment to shed a bit of light on some of the most common injuries a good chunk of footballers representing their countries over the next month will be at risk of sustaining. Football is (subjectively, of course) a beautiful sport, and largely considered to be the world’s ‘beautiful game’, but just like any sport that includes running, twisting and turning, and sudden changes in direction, the risk of acute injuries is, understandably, quite high.
Whether it’s a sudden muscle cramp
or a pulled hamstring, there are quite a handful of injuries that
players could potentially suffer from in football’s most prestigious event this
winter. Let’s take a look then at some of the main ones here below!
Concussion
Whether it’s goal kicks from the goalkeeper
(or some defenders in some instances), long throw-ins, free kicks, or corner
kicks, modern-day football involves significant amounts of long passes,
crosses, and clearances, where the ball will be travelling in the air for a
significant amount of time. Inevitably, this encourages aerial duels between
opposing players.
With elbows flying, and both heads jumping
for the same ball, both players put themselves at risk of sustaining
concussion, which is a mildly traumatic injury to the brain. Although mild,
football players who suffer from concussion could suffer from serious (albeit
largely temporary) medical complications, such as a loss of consciousness that
can last as long as 30 minutes.
As outlined by Top Doctors member and highly esteemed consultant neurologist, Dr Ioannis Mavroudis, in an article he shared on concussion last month, concussion can take up to six months to fully heal, and, in some severe cases, more than two years. It is certainly something all footballers should be aware of whilst participating at the World Cup. It is, of course, much easier said than done though when you are representing your country at such a renowned sporting event worldwide, where emotions, understandably, are going to win the battle against caution and rationality.
Groin pull/strain
This is quite a common one in football, and
if you are a regular viewer of the sport, you’ll have seen a fair share of
footballers pull up holding the inner muscles of the thigh. Why does this happen
though? Well, groin pulls or groin strains occur as a direct result of sudden
movement, such as kicking, running, jumping, or twisting quickly and suddenly
to change direction.
What factors influence these kinds of injuries, though? Dr David Porter, a distinguished and renowned London-based senior football and sports medicine physician, recently shared some insight with us at Top Doctors with regards to the main causes of these types of common pulls and strains in of one his informative Top Doctors articles, highlighting fatigue and poor muscle conditioning as the two main reasons behind the occurrence of them.
Hamstring pull/strain and hamstring tear
Hamstring injuries are, today, the single most common injuries in the footballing world. Just like groin pulls or strains, hamstring pulls/strains or tears can occur as a result of changing direction suddenly, although the most common cause of this injury is powerful and intense acceleration and deacceleration. Hamstring pulls or strains, which are less serious than hamstring tears, typically occur when a footballer overstrides, or when they do not stretch their hamstring correctly before a football match, or when they do not stretch their hamstring at all.
Hamstring tears are more painful, and tend to take longer to recover from. Either a partial or complete hamstring muscle tear can occur in professional footballers, with the principal causes being, as mentioned, sprinting, lunging, or jumping.
All of these activities overstretch the
hamstring tendon and muscle. Thus, ensuring proper stretching exercises in both
the warm-up and warm-down before and after football matches is essential when
it comes to avoiding hamstring pulls or tears. Depending on the severity of the
hamstring injury, recovery time can take as long as a couple of months.
One of the most high-profile football players to fall victim to a career-disrupting hamstring injury in the last few years was Barcelona’s dazzling winger Ousmane Dembele. The Frenchman suffered a torn hamstring on his full debut for Barcelona in a 2-1 win against Getafe in LaLiga back in September 2017, an injury which would keep him ruled out of action for four months.
ACL and PCL injuries
Undoubtedly the most severe of footballing
injuries mentioned thus far in the blog post, we simply can’t avoid mentioning ACL
(anterior cruciate ligament) or PCL (posterior cruciate ligament)
injuries when talking about the most common injuries in football. These
injuries can occur to a player’s knee ligaments in two main scenarios:
If he or she receive a direct
blow to the knee.
If the player makes a sudden
turn or change in direction while running at a high speed.
As explained in one of distinguished orthopaedic surgeon Mr Arjuna Imbuldeniya’s articles for Top Doctors, “ACL injuries usually occur as a result of twisting or pivoting injuries to the knee, such as stopping and changing direction quickly whilst running or jumping.” Mr Imbuldeniya also revealed in this informative article that although sportsmen and sportswomen can partially tear or indeed sprain their ACL, complete ACL tears are the most common of the three.
One of the most documented ACL injuries to
occur in the last decade of English football was that of Arsenal legend Robert
Pires. The French winger was side-lined for six months towards the end of the
2001/2002 football season, missing out on the 2002 World Cup completely as a
result. Arsenal fans at the time will remember how that injury changed the way
Pires played the game from then onwards: from the way he ran, to the way he
dribbled, it was clear that the winger’s knee was never going to quite be the
same.
It looked stiff once he had eventually
returned, but, thankfully for Arsenal fans, and football lovers in general at
that time, Pires was able to adapt his game and style, sacrificing his running
and dribbling with the ball with a more clever and balanced approach to
wing-play. More recently, Liverpool’s Dutch centre back, Virgil Van Dijk,
ruptured his ACL in the Merseyside derby against Everton back in 2020. He was
out for nine months, and underwent ACL reconstruction surgery.
What about injuries to the posterior
cruciate ligament, then? Simply put, they occur as a result of heavy and direct
force from the front to the back of the knee, and most commonly happen when
footballers are already falling to the ground while their knee is in a bent
position.
Muscle cramps
Footballer or not, we’ve all been there.
After a long, tiresome day where we’ve overexerted ourselves without properly
taking necessary breaks nor eating and drinking enough, our body simply yells
out in agony. Usually occurring in our big toe, muscle cramps can occur
anywhere in the body.
They can be so debilitating, that
footballers (and non-footballers, too, of course) will be physically unable to
move the affected body part until the cramp has been rid of. They mainly affect
sports athletes during high-intensity and long-lasting sporting activities, and
can be quite the common occurrence in extra time of football matches. Expect to
see quite a lot of footballers at the Qatar World Cup pull up with cramp,
particularly leg cramp, where they will have to wait to be ushered to by
teammates to help stretch it out and get rid of it.
Ankle sprains
Ankle sprains are extremely common in football. You’ll often see a horrific sliding tackle on a television slowed-down replay that shows an opposition player slide and crash into the player in question’s ankle. Obviously a terribly painful injury, and one that can keep a player on the side lines for quite some time.
Depending on the playing surface, some
football players can nastily get their ankle caught in the grass, as their boot
studs dig deep into the (mainly when it happens) uneven pitch. This can result
in an excruciating twisted or sprained ankle. Let’s hope for all the players’
sake that the playing surfaces in Qatar are up to standard!
This year the fox eye trend has been on the lips of many people looking to emulate the raised oval eye shape of supermodels Bella Hadid and Kendall Jenner. However, it hasn’t just been the subject of admiration but also caution due to a multitude of reports in the press that have highlighted how dangerous the procedure can be in in the wrong hands.
Looking good for festivities doesn’t mean making bad decisions
Now Christmas is coming, pressure to look good at parties or for your Instagram feed might take over the cautionary tales we heard in the summer. There could be a rise in fox eye surgery uptake again through gifts or with the money received as presents, too. So as a reminder with love and care, whether you want to capture the look or correct a heavy brow, asymmetry or hooded lids, Top Doctors takes a look at how to stay safe and choose the best specialist for this kind of aesthetic procedure.
Taking care leads to top results
Fox eye is a type of thread lift. Thread lifts
are a relatively recent innovation in plastic surgery and aesthetics.
They are popular due to their minimally-invasive nature which means you
get an instant lift without having to go under the knife.
Furthermore, fox eye lifts are famously speedy;
between 20 to 30 minutes depending on the clinic you select for the fox
eye lift.
One of our leading thread-life specialists Dr Dayal Mukherjee
has been providing expert services in minimally-invasive thread lifts for
several years at Aura Clinic, where he is the CEO. Him and his team are all medically
qualified, and are held to the highest standards of clinical care,
with ethics and confidentiality being of utmost importance.
And those qualities are top of the list in
terms of what you should be looking for when it comes to getting the best
results without putting yourself at risk.
Just watch this interview with Big Brother star Ryan Rutledge and leading facial aesthetic practitioner Dr Pamela Benito. She advises that it can be safe, but it’s always important to do your own research before going ahead with any kind of aesthetic procedure. She suggests to (at 7.16 in the video):
Look at the doctor’s profile;
Look at their experience and expertise,
and;
Go for a consultation and have a thorough
assessment.
Are fox eyes worth the risk?
As you can see in the pictures taken of Ryan after his surgery,
your answer might be no. He was left hospitalised following complications.
He experienced:
Intense pain after the anaesthetic wore
off;
Swelling;
A severe infection two weeks after the
procedure resulting in hospitalisation, that took over six monthsto fully
clear.
Just type in ‘Fox eye surgery’ in Google News and you’ll find horror stories, pictures and advice about safety and even why some would completely avoid it.
Avoiding fox eye altogether? Or just tread carefully?
It isn’t surprising why people would choose to avoid it. Many
aesthetic procedures are still unregulated in the UK. Practitioners
that work without this correct knowledge and expertise are also less likely to
provide the necessary aftercare and advice about recovery.
However, the right doctor will provide expert care
even when things do go wrong. For example, world-renowned cosmetic doctor Dr Jean-Louis
Sebagh tells us: “I previously had to remove some threads from my patients as
some of the PDO unidirectional barb threads did not hook on well enough. There
was no scarring after removal and the problems completely resolved.”
The message is clear. While there are plenty of benefits to fox eye, there are risks too. Take them seriously, get the best doctor for you, and you’ll be giving foxy yet sensible in no time
Stress is something most of us deal with daily, it’s a normal reaction we have to certain situations. Too much stress, however, can have a negative impact on our health, both mentally and physically. International Stress Awareness Week is held annually to raise awareness about stress management and combat the stigma around mental health issues. It began in 2018 and was established by the International Stress Management Association (ISMA). Running this year from November 7th to 11th, the theme of this year’s Stress Awareness Week is “Working Together to Build Resilience and Reduce Stress.” How can we do that exactly?
Why is stress unhealthy?
In order to understand how it can impact our health, we need to know what stress is. Stress is the term used to describe the feeling of being under a lot of pressure. It is a completely normal bodily response to stimulants, and sometimes it can even have a positive effect! Stress triggers the release of adrenaline which can heighten our reactions, increase energy, and boost cognitive function.
However, if the adrenaline isn’t used in a productive way, it can have a negative impact. Symptoms of stress can include (but are not limited to) headaches, body pain, such as in the neck, shoulders, and back, loss of appetite, a heavy chest, upset stomach and bowel problems, and problems with the skin.
Chronic stress, which lasts a long time, can have a grave impact on one’s health and even life expectancy. It’s linked to cardiovascular diseases and can lead to high blood pressure which may lead to a heart attack or stroke. Stress can affect the brain also, notably by shrinking one’s memory capacity, which can increase the risk of developing dementia or Alzheimer’s. Digestive disorders can also occur, which might seem strange but think about stressful situations, we often experience butterflies in our stomachs! The intestines are, after all, often called the second brain. The digestive system cannot function normally if there is too much stress. Irritable bowel syndrome is a common long-term illness that can develop as a result of being stressed.
Stress is something that we often overlook and accept as a normal part of modern-day life. Obviously, we can’t avoid stress but we need to be able to manage it in a way that isn’t going to have long-term impacts on our health.
Why are we collectively becoming more stressed?
There are many causes of stress and we
are living in unprecedented times and experiencing a lot of uncertainty. One of
the main causes of stress is financial problems. Inflation has
risen by 8.8%, leaving people struggling to pay
their bills. This has created a cost-of-living crisis, which is a big cause of
stress for many households, especially during one of the most expensive times
of the year as we enter the festive period.
Work is another leading reason many
people feel stressed. Being able to work under pressure is often an admirable
trait that employers look for, but shouldn’t it be ‘being able to deal with
pressure in a positive way’ that is focused on instead? Working overtime,
having a lot on our plates, and conflicts in the workplace all contribute to employees
feeling overwhelmed and stressed. During a time of heightened economic
pressure, a number of people feel under more pressure to perform well at work.
There are many, many other factors in our personal lives that can cause stress; family or relationship issues, grief, experiencing discrimination, or even organising a large event or holiday, to name a few. Everyone reacts to situations differently also, so what might be a walk in the park for someone, could cause a lot of stress for another. We should always be mindful of recognising what triggers cause stress, regardless of what other people think or feel.
How can we help each other deal with stressful times?
It’s important to remember that we
aren’t always in control of things that cause stress. We can, however, choose
how we react to the stressful situations we deal with. There is a wide variety
of ways to manage stress and deal with it better.
The first step is recognising what
our bodies interpret as being stressful. Understanding how stress affects your
body is key. In a stressful situation, consider how you feel. Take note of this
and if you notice these sensations and be mindful of them. Recognising your
body is beginning to feel stressed can help to control your reaction to a
situation.
How can we control our response
though? There are several different ways to try and deal with stress, and it
will take some trial and error before you find the way that is best for you. Here
are some suggestions that you could try, in isolation or combination, to better
control your response to stress:
Set boundaries you’re comfortable
with
Avoid working overtime and losing
time for yourself
Practice mindfulness
Exercise and move your body
Eat a healthy, balanced diet
Take breaks from social media and
negative news stories
If someone close to you is feeling stressed, encourage them to speak about how they feel. They might not understand why they are feeling the way they are until they try to express themselves and put their thoughts into words. Sometimes something as simple as a hug or grabbing a coffee together can be enough to help someone feel listened to and more prepared to face the challenges in front of them. If someone is experiencing stress in your workplace, help there where you can to better manage their tasks and encourage other members of the team to support them. Always share your tips and tricks with those who might not be managing very well, maybe they haven’t tried yoga or journaling yet. If you think someone could benefit from speaking to a professional, perhaps you could suggest someone local they could visit. Like any other mental health issue, the more we talk openly about it, the less taboo there will be around it.
