"Anticipatory" medical care for the elderly in a Nairn GP practice

Research into end-of-life medical treatment for elderly patients by Nairn and Ardersier GP practice involved the creation of "anticipatory care plans" for 100 high-risk patients.

This sounds all very fine and dandy, but trying to get the medical and care services merely to take more than a passing interest in the care and medical needs of a frail elderly neighbour, also in Nairn but registered with a different GP practice, over the past few weeks has been frustratingly different; one almost gets the impression that they would prefer that she drop down dead to save them the bother (and cost) of intervention. So much for high-falutin' research when contrasted with not-so-'Best Practice'!

Such action, little as it is so far, has only happened because of the intervention of several concerned friends (me and another in the main) intervening direct with Social Services to put a spur to their flanks! Not happy!

Breast implants - in most cases, why?

One thing that has puzzled me for years is why some women have felt the need to have breast implants. I can understand why some women who have been unfortunate enough to become afflicted with breast cancer, necessitating partial or total mastectomy, have wanted to replace the removed cancerous tissue to allow them to regain their former physical profile and perhaps boost their own self-esteem. But I have never understood why a perfectly healthy woman would feel the need to 'enhance' her natural breast profile with artificial implants.

Some women naturally have larger breasts than others, but provided a woman is healthy, what is the point? Is it to boost their own self-worth, or to please a husband or boyfriend? Let's face it, men have different sizes of penises - some 'small', some 'average' and some 'large', but if every man who had (or felt he had) a penis which was too small underwent implant surgery to try and make it appear bigger, it would be a sad commentary both on them and whoever may have encouraged them to do so.

I feel exactly the same about botox or lip enhancement procedures. For goodness sakes, if there is no medical requirement for any of these procedures and they are motivated solely by vanity or to 'please' someone else, then my strong view is that people should leave well enough alone.

This little article has obviously been prompted by the news stories today that many thousands of women had breast implants made using what is described as non-medical grade silicon, manufactured by a now-defunct French company and that there have been some cases of the implants splitting and causing toxic effects in the body.

I seem to have heard this same kind of story a number of times over the years - I'm pretty sure I first heard of this kind of problem at least 20 years ago, perhaps involving breast implants manufactured by a different company for all I know, but just as with the potential dangers associated with smoking tobacco, the risks have been known for a long, long time and in the case of breast implants there is no addictive substance involved, simply what are in my view 'skewed' notions of what constitutes 'beauty'.

Keep religion out of medicine!

I have to say that if I was in hospital as a patient and some nurse or doctor tried to 'pray for me' or talk to me of religion I would be more than upset, I would be tremendously angry. The worrying and frightening thing is, though, that if I was very ill and in much pain I might be reluctant to voice my dislike for fear of possible 'repercussions' in my medical care.

In my experience some people with a strong religious faith simply do not understand that their ministrations are not wanted and can come across as, and actually be, 'pushy' in their efforts to 'help' a poor ignorant person like me who doesn't want them to peddle their religion in my direction. It is equally true that I have known a few deeply-religious individuals who were exceedingly discreet in their faith, without in any way hiding it, but they would never dream of imposing their religious views on others who did not wish to hear it; I certainly respect such people and would never belittle their faith.

For the avoidance of any doubt or confusion it should be left to patients in hospital to express a wish for some kind of spiritual guidance or support - and to the chaplaincy service to provide it. Personally I have no objection to a nurse or doctor wearing a small and unobtrusive crucifix (for example), but unless a patient seeing it asks them for support of a spiritual kind they must not take it upon themselves to offer this - and if I was not actually in extremis and such a thing happened to me I would like to think I would have no hesitation in telling the person who had done so to 'get knotted'!

Red wine in moderation 'good for the heart', but may cause bowel cancer

After my previous post, on the risks associated with of being left-handed, I come across another article in today's Telegraph which takes aim at the simple pleasures that millions of people enjoy. For years I've been reading that a glass of red wine a day is helpful in reducing the risk of heart disease; now it seems that a couple of [large] glasses a day increase the risk of getting bowel cancer by 25 per cent. Just as with the schizophrenia report, though, the person behind this study, Prof Tim Key, Cancer Research UK epidemiologist and deputy director of the cancer epidemiology unit in Oxford, is quoted as saying, to try and put some kind of perspective on this alarmist report:

"The research shows quite clearly that the more alcohol you drink the greater your risk of bowel cancer. "The increase in risk is not large but it is important that people understand they can reduce their risk of a number of different cancers - including bowel cancer - by cutting down on alcohol."

On balance I think I shall continue to enjoy my occasional (not necessarily daily) couple of glasses of wine. Obviously I don't want to get a disease which is likely to cause pain and probably premature death, but on the other hand I don't particularly wish to live for ever - I'll take my chances with a bit of moderate enjoyment.

Lefties more at risk of being complete 'wackos' ...

... of course that's not precisely what the study which the Telegraph reports on has to say. What it does say is that the left-handed have a slightly greater propensity to develop schizophrenia than the right-handed. On the other hand the leader of the study, Dr Clyde Francks of the Wellcome Trust Centre for Human Genetics, is quoted as saying, no doubt in an attempt to soothe the feelings of persecution (recurrent, heh) which were welling up in me when I read of this:

"People really should not be concerned by this result. There are many factors which make individuals more likely to develop schizophrenia and the vast majority of left-handers will never develop a problem. We don't yet know the precise role of this gene."

- OK, OK, the twitching has [mostly] stopped! In case you have not picked up on it yet, I am left-handed. My, my, and I had always attributed my quirky brilliance to being a sinistral; maybe I need to count myself lucky not have exhibited other traits of this 'condition'!
(thru Mr Eugenides)

Glasgow scientists may have made progress in combatting cancer

Like almost everyone else I'm sure, I have lost close family and friends to various forms of cancer over the years. So I was interested last evening (but too tired to blog about it then) to see that a team of scientists at the Beatson Institute for Cancer Research in Glasgow think they have devised a promising new method for attacking cancer cells, making use of a chemical which in tests on mice 'caused cancer cells to "commit suicide"' and seems to be effective against several kinds of cancer cells - 'including bowel, cervical and bone cells'.

No doubt this is at a very early stage, but I do hope they and other scientists around the world can make real progress in the cancer in coming years.