Rheumatoid Arthritis (RA) is a condition I always look out for.  Symptoms can be exactly the sort of thing a patient may come to an osteopath to treat, so I do see these patients from time to time.  Apart from the fact that medications, for all their faults, can prevent joint destruction and disability, and I want my patients to be able to make an informed choice as soon as possible about their treatment pathways, there are some osteopathic techniques which would have an increased risk for a patient with this condition, so I would avoid them and work differently.  We know what RA is, that it is an autoimmune inflammatory condition that affects the synovium (the material lining synovial joint capsules) but we don't fully understand why some people are susceptible and what triggers it on those people.   Some interesting research involving a very large group of people studied over many years has come to the conclusion that high overall cholesterol levels are linked with later development of Rheumatoid Arthritis - in women only, in men there is no relationship.  How does this information help us?  Well!  The link is not so clear as to suggest that the high cholesterol is responsible for the RA and high cholesterol is not suggested as a reliable indicator for future RA, but the findings suggest that the early development of RA may use hormone-related metabolic pathways and the findings may have implications for future disease prevention and management of patients at risk of RA associated cardiovascular disease.

I love the NHS!  I know I don't work within it but if I have an emergency or need medication or surgical intervention, I love the fact I can go and get help free at the point of need.

Did you know that the government wants your views on the future of the NHS?  

​Me neither.  Apparently they do, just not enough to tell us about it.  

The proposal is a bit impenetrable but here are some of the items that I fed back as, of concern, to me:

Unless I am mistaken it doesn't include 'healthcare free at the point of use' as an aim, surely that is one of the cornerstones of the NHS.

The planning is built on the basis that there are £22bn of efficiency savings available over 5 years when most pundits say £15bn maximum http://www.theguardian.com/society/2015/nov/18/nhs-cannot-make-22bn-cut-sought-by-government-finance-chiefs-warn

The plan relies on our already broken GP system to keep people out of hospital and wants them to offer more out of hours services but fails to acknowledge how overstretched GPs are now (try booking an appointment for a specific day).  Given the number of GP trainees has fallen, how will they staff this increase in service, even if they manage to fund it?  

Very close to home for me at the moment the plan looks to provide care in the home yet doesn't mention carers at all.  I know from firsthand experience how much support carers need both to provide the care and to ensure they in turn are looked after and don't fall ill.

Anyway, those are my main concerns, yours may be different.  Have your say by clicking the link below

I was in the gym today...No, really I do go.  Once again I saw the foot end of the decline sit-up bench was propped on a Reebok Step.  This seems to have the norm for young men (it is almost always men).  I think the thought process is 'it gets harder the more declined it is, I must be working my abs more'  WRONG.   Your abs only work over a very small range, once you go beyond that you are flexing your hips, not your back.  Your upper body is exerting maximum effect as a lever being pulled by gravity on the muscles trying to move or hold it when it is horizontal, so to be effective the muscle you want to be firing when you are horizontal should be your abs.  If you're starting at 60' , you'll be past the abs by about 45' and predominantly strengthening your Psoas muscle, which is great but an overlarge Psoas can trap the nerves going into yous legs and particularly the outer thigh causing numbness or discomfort, it can irritate the bowel causing diarrhoea and worst of all...No one can see your Psoas anyway!   There's a reason these benches are made so they only decline about 30'