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15/09/10 Back to School for the WPH team

The Brain.  Amazing how little I know about something I carry around with me every day.  This cannot be said for the creator of our latest training course, Dr Edward De Bono.  We had the pleasure of attending the Six Thinking Hats course, after all I have read so much about it and am confident to tell you all about it, I wanted more!

Possibly, like me, you went to school, college, and possibly not like me, Uni, and didn’t learn some of the most powerful things around to help you to learn and be great at your job, quicker, easier, more efficiently and most importantly more creatively.

In fact the De Bono Six thinking hats is now compulsory in all schools in Venezuela and it is on the education agenda in many countries around the world. The appeal of Dr. de Bono’s work is its simplicity and practicality. It can be used by four year olds and by senior executives; by children with learning difficulties and Nobel Laureates.

Why is this course so special? Have you heard rumours that this training can cut meeting times and save companies money?  Well I am so confident about this that I am offering a money back guarantee if you don’t feel it is a worthwhile spend of your companies money!

The NHS recently commissioned facilitation from a De Bono Six Thinking Hats trainer to facilitate a consultation to plan the expenditure of up to £500 million on hospital services in the region.  The facilitation process enabled cross departmental communication, an area that can so often become a sticking point, and resulted in 2,000 new ideas from 500 employees in just a week.  The outcome of the Six Thinking Hats process has formed the basis for the provision of care in the future.

The cost savings of having more productive, often shorter meetings aren’t difficult to calculate.  Coopers & Lybrand worked out that in an organisation of 100 people by saving one hour per week per person with more effective meetings, £250,000 per year could be saved.

J.P. Morgan  “It has reduced meeting times by up to 75%, and changed our culture across Europe.”

There are so many positive things written about this course, with my Black hat on I am trying to think of a negative…. maybe this is where it fails, as I can’t think of one!

We are lucky to welcome into our training team Stuart Scott, one of only 15 trainers internationally to be appointed master trainer for De Bono techniques, Stuart teaches across the globe.   We can teach your team, or we can teach your employee’s to teach your team so that you always have the hats embedded in your business, be warned though, it will spread to your home life and you might become hooked on hats!

Whats next? De Bono Facilitation of course!

15/09/10 Migraine help

Positive steps for Migraine sufferers.

The beginning of September brought us the ‘Migraine Awareness Week’. Surely not many of us can claim to have never experienced a headache, be it ‘the morning after’ type, the ‘way too much pressure’ type or the ‘too much sun’ type, and it is likely that many of us suffer, or are in contact with a colleague/friend/acquaintance who suffers from a disabling condition, ranked as being one of the 20 most disabling conditions by the World Health Organisation, the Migraine.

Not forgetting the intense stress and anxiet it can cause an individual, the economic burden of migraine is huge.  It is estimated to cost the NHS £150 million per year while the cost of absenteeism due to migraine costs £2.25 billion.  In a recent study by the CBI on workplace absenteeism migraine and chronic headache were ranked by employers as being the second highest cause of short term absenteeism.  Only colds and flu ranked higher.

So as an employer what can you do?

An understanding of this affliction can be useful, empathy can be helpful, providing a dimly lit room for sufferers and allowing employees half an hour to retreat, take their medication may be just what the doctor ordered.

Cruikshank-TheHeadAche

In this article:

  • What is a migraine?
  • Tell Tale Signs
  • Migraine Facts
  • Migraine causes & triggers
  • Migraine treatment – alternative solutions

What is a migraine?

Migraine is a neurological syndrome characterized by altered bodily perceptions, severe headaches, and nausea. The migraine headache is more common to women than to men.  Migraine’s can last from four hours up to three days. The headache can be all over or may only affect one side of the head. It can stay in one place or shift. The pain is often made worse by movement and people are likely to become sensitive to light or certain smells.
Once a migraine has gone, some people can feel washed-out and lethargic.

Tell-tale signs

Classic migraines have three distinct phases: a prodromal phase, a headache phase, and a resolution phase.   Many suffers can learn to identify the warning signs and control their reaction by taking their medication, herbal tea or self massage at this point.  During the prodromal phase, it is possible to experience an altered mood, irritability, depression or euphoria, fatigue, yawning, excessive sleepiness, craving for certain food types  (chocolate/coffee), stiff muscles, commonly in the neck and shoulders, hot ears, constipation or diarrhea, increased urination, and other visceral symptoms.  Emotional response may be feelings of anxiety, euphoria, irritability, rage and occasionally panic.

Visual Signs:  There are a variety of visual symptoms (Aura) that exhibit themselves variably during the prodromal phase of the classic migraine. The most common visual aura  - the scintillating scotoma usually begins as a shimmering arc of white or coloured light in the left or right visual field. The arc of light gradually enlarges, becomes more obvious, and may take the form of a definite zig-zag pattern.  These symptoms in themselves can be debilitating, combined with the knowledge of the struggle for up to 3 days with chronic headache pain, the Migraine can cause increased stress and anxiety to individuals lives both at home and at work.

Migraine facts

  • Almost six million people in the UK have migraine
  • Migraine is the most common neurological condition in the developed world. It is more prevalent than diabetes, epilepsy and asthma combined
  • Over half (54%) of migraineurs experience one or more attacks per month, and 13% claim one or more attacks per week
  • Women are three times as likely to have a migraine than men
  • The first attack usually happens when you are a child or teenager
  • Around 10% of school children suffer from migraine

What causes a migraine?

No one knows what causes migraines, there is no diagnostic test or cure.  Exactly what triggers a migraine is very individual to each person. For most people it is rarely just one trigger but a combination of factors which individually can be tolerated but when several occur together or accumulate a threshold is passed and an attack is triggered.

Some possible triggers you may notice in yourself could be:

  • Food
  • Missing meals can result in a drop of blood pressure which can lead to an attack
  • Specific foods can trigger a migraine in some people it can help to keep a food diary to help you identify the foods/or food groups
  • Changing sleep patterns
  • Too much or too little sleep can cause a migraine
  • Hormonal changes in  women
  • 50% of women notice a link between migraine and their period
  • Most women also suffer attacks at other times of the month
  • A migraine is most likely to occur 2 days before a period and three days into it
  • Keep a diary for at least three menstrual cycles to help you realize if you suffer menstrual migraine
  • The oral contraceptive pill can make migraines worse
  • Head and neck pain
  • Muscle tension can trigger an attack
  • Be careful not to hunch over a desk all day
  • Try simple neck exercises to alleviate tension
  • Travel
  • A long journey or flight can often trigger a migraine
  • Stress
  • Stress is one of the biggest causes of migraine

Treatment for Migraine

We recommend that all migraine sufferers visit their GP to obtain a formal diagnosis.  It is believed that up to 50 – 60% of sufferers don’t seek help as they feel that nothing can be done for them.  It may be likely that you will have to try different medications and dosages before finding the most effective medical treatment. Migraine is a complex health condition which means that patients may need to review their management strategy from time to time.

Complimentary treatments for migraine suffers. Many migraineurs find themselves turning to complementary treatments out of frustration when they are having limited success with prescription drugs and other approved medical treatments.   These treatments offer many of people additional relief, but are not an excuse to abandon approved medical care.  They will work better if integrated into your overall care programme, and you should always advise your GP of every non-drug treatment you are trying, no matter how irrelevant you feel it may be, I have an acquaintance who decided to seek Chinese herbal remedies for a condition whilst being under medication from his GP, he was uncomfortable telling his GP about this new avenue of exploration and as a result suffered liver damage and was at risk of failure.  So to avoid any uncomfortable situations, please be sure to seek approval from your doctor before commencing any alternative treatment, if your GP is not open to your idea’s, perhaps you could try taking in some research on the effectiveness of the treatment you choose, and if you continue to feel uncomfortable, remember, you can ask to see a different doctor.  This list is not exhaustive and is based on knowledge gained from my clients, together with some useful research statistics.

Acupuncture This has been endorsed by the British Medical Association as an effective treatment for headache and migraine.  Its treatment consists of small fine sterile needles being inserted into your skin at certain points; they may be left in for just a few seconds or for several minutes.

Traditional Chinese acupuncturists will position the needles at various points along the body’s energy meridians, according to their assessment of each individual (i.e. different migraineurs could have differently positioned needles).

Practitioners of western acupuncture will usually be health professionals (e.g. GPs, physiotherapists, doctors and specialist nurses working in pain clinics) who have received additional training in this method of treatment. They will position the needles in certain areas determined by the condition they are treating (i.e. all migraineurs are likely to have the needles placed in similar positions). If western acupuncture has not helped you, it may still be worth considering traditional acupuncture.

On site Massage If you are needle phobic or have access to an on-site masseuse at your work place, then you could give this treatment a try.  Acupressure works by treating the same pressure points used in acupuncture and has the added benefit of working the key muscle groups and encouraging a sense of calm during the treatment.  There is research to show that massage can help with migraine frequency and sleep quality during the intervention weeks, and this effect can last up to 3 weeks after treatment, with reduced anxiety, heart rate and cortisol levels.  The treatment is performed on a fully supported massage chair and pressure points and muscle groups are worked through the clothes.

Reflexology There has been some interesting research into reflexology recently, in terms of the efficacy of the treatment and the way in which the therapy works.  A functional MRI study, which took place at the University of Tohoku, investigated three reflex areas relating to the eye, shoulder and small intestine. A statistical analysis showed that reflexological stimulation of the foot reflex areas corresponding to the eye, shoulder, and small intestine activated not only the somatosensory areas corresponding to the foot, but also the somatosensory areas corresponding to the eye, shoulder, and small intestine or neighboring body parts.

According to a large nationwide research study undertaken in Denmark, reflexology treatment has a beneficial effect on patients suffering from migraine and tension headaches. The study was conducted at the Department of Social Pharmacy, The Royal Danish School of Pharmacy in co-operation with five reflexology associations. 220 patients participated with treatment being given by 78 fully trained reflexologists across the country.

Three months after a completed series of reflexology treatments, 81 percent of patients confirmed that reflexology had either cured (16%) or helped (65%) their symptoms. 19 percent of the patients re-ported that they had been able to completely dispense with the medications they had been taking before the study.

Chiropractic Chiropractic methods employ a holistic approach to pain relief through massage, spinal manipulation and periodic adjustment of joints and soft tissue.  I would recommend trying McTimoney Chiropractic as it is gentle and effective from my experience.  There are several studies that show promise:

One hundred and twenty-seven Migraine patients (at least one Migraine per month) were divided into two groups for comparison. Group 1 received chiropractic adjustments at specific vertebral subluxations determined by the treating practitioner; group 2 served as controls and received inactive treatment (electrical stimulation with no current delivered). Subjects receiving chiropractic adjustments reported substantial improvement in Migraine frequency, duration, disability, and medication use following two months of treatment. One in five participants reported a 90% reduction in Migraines, and half reported significant improvement in Migraine severity.

Feverfew Leaf Researchers at the London City Migraine Clinic made a study, which, reported in the British Medical Journal, investigated seventeen patients who had been using the herb to treat their symptoms for a minimum of three months. Of these patients, all of them were told to stop using the herb with eight of them being given a feverfew capsule and nine of them being given a placebo.

The patients who received a placebo reported an increase in the intensity and frequency of their migraine headaches while those who took the feverfew noticed no rise worsening of these symptoms.

A great deal of other studies have since taken place to prove that feverfew works in treating the symptoms of migraine headaches. People who took the herb also reported no significant side effects.

The herb also has other properties such as anti-inflammatory like ibuprofen or aspirin. One of the contents of the herb, parthenolide, is also an inhibitor for the forming of compounds, which cause inflammation. Parthenolide also reduces the secretory activity in blood platelets and the white blood cells.

If you would like to try this remedy, please consult your GP, it is also advisable to seek advice from a qualified medical herbalist.

If you have any personal experience with natural controls for migraine, please do get in touch.

15/09/10 Know your numbers

The UK charity the Blood Pressure Association, are running the 10th Know Your Numbers! Campaign this week – developed to encourage Britons to monitor and maintain a healthy blood pressure.

You can visit locations near to you/your office and get your blood pressure taken for free.

To find a centre near to you click here.

If you would like to test your workforce ‘on mass’ to get an idea of the overall cardio health of your employees, we can arrange for one of our Occupational health nurses to visit you, please contact us for rates and further information.

In this article:

  • Monitoring your blood pressure
  • Cardiovascular risk factors
  • Tips for lowering Blood pressure
  • Free pressure tests and corporate screening

Monitoring your blood pressure

You may have your blood pressure taken in many environments nowadays, the gym, the chemist, at work or at your GP surgery.   One important point – a one-off blood pressure reading that is high does not mean that you have ‘high blood pressure’. Your blood pressure varies throughout the day. It may be high for a short time if you are anxious, stressed, or have just been exercising.

You are said to have ‘high blood pressure’ (hypertension) if you have several blood pressure readings that are high, and which are taken on different occasions, and when you are relaxed.  So if your blood pressure reading has been high, we or whoever has taken your reading will advise you to go for a time of observation, this will mean several blood pressure checks will be taken at intervals, depending on your health risk factors.

Some people are given (or buy) machines to monitor blood pressure at home (home monitoring) or when they are going about doing their everyday activities (ambulatory monitoring). One reason this may be advised is because some people become anxious in medical clinics which can cause the blood pressure to rise. (This is called ‘white coat’ hypertension.) Home or ambulatory monitoring of blood pressure may show that the blood pressure is normal when you are relaxed.

Cardiovascular risk factors

Everybody has some risk of developing a cardiovascular disease, certain ‘factors’ increase the possibility. These include:

Lifestyle risk factors that can be prevented or changed:

  • Smoking
  • Lack of physical activity (a sedentary lifestyle)
  • Obesity
  • An unhealthy diet
  • Excess alcohol

Treatable or partly treatable risk factors:

  • Hypertension (high blood pressure)
  • High cholesterol blood level
  • High triglyceride (fat) blood level
  • Diabetes
  • Kidney diseases that affect kidney function

Fixed risk factors – ones that you cannot alter:

  • A strong family history. This means if you have a father or brother who developed heart disease or a stroke before they were 55, or in a mother or sister before they were 65
  • Being male
  • An early menopause in women
  • Age. The older you become, the more likely you are to develop atheroma
  • Ethnic group. For example, people who live in the UK with ancestry from India, Pakistan, Bangladesh, or Sri Lanka have an increased risk

Risk factors interact.  So, if you have two or more risk factors, your health risk is much more increased than if you just have one. For example, a middle aged male smoker who takes no exercise and has high blood pressure has a high risk of developing a cardiovascular disease such as a heart attack before the age of 60.

Therefore, the benefit of lowering a high blood pressure is to reduce the risk of developing a cardiovascular disease in the future.

Tips for lowering Blood Pressure

If you have high blood pressure then you will need to listen to your GP and medication may be an option.  Here are some additional avenues that you can investigate, try and see if they work for you:

Lose weight if you are overweight Losing some excess weight can make a big difference. Blood pressure can fall by up to 2.5/1.5 mmHg for each excess kilogram which is lost. Losing excess weight has other health benefits too.

Regular physical activity If possible, aim to do some physical activity on five or more days of the week, for at least 30 minutes. For example, brisk walking, swimming, cycling, dancing, etc. Regular physical activity can lower blood pressure in addition to giving other health benefits.

If you previously did little physical activity, and change to doing regular physical activity five times a week, it can reduce systolic blood pressure by 2-10 mmHg.

Try the Om Sitting crossed legged under a tree in the car park may not be everyone’s cup of tea, but read on.  As well as having significant effect on our brain structure (more about this anther time!) Meditation has been shown to reduce blood pressure.

Science Daily reports ” Meditation is an effective treatment for controlling high blood pressure with the added benefit of bypassing possible side effects and hazards of anti-hypertension drugs, according to a new meta-analysis conducted at the University of Kentucky.” … The study’s lead author, Dr. James W. Anderson, professor of medicine at the University of Kentucky College of Medicine, said that blood pressure reductions of this magnitude would be expected to be accompanied by significant reductions in risk for atherosclerotic cardiovascular disease—without drug side effects.”

There are lots of other reasons to try meditation, increased creativity, reduced anxiety, I could go on (and will do at another time) for now, if your BP is high, you could do no worse than learning this skill (why not organise a workplace course?).

Eat a healthy diet Briefly, this means:

  • AT LEAST five portions, and ideally 7-9 portions, of a variety of fruit and vegetables per day
  • EAST WHOLEGRAIN instead of refined starch-based foods (such as cereals, wholegrain bread, brown rice, wholegrain pasta), plus fruit and vegetables
  • NOT MUCH fatty food such as fatty meats, cheeses, full-cream milk, fried food, butter, etc.
  • INCLUDE 2-3 portions of fish per week. At least one of which should be ‘oily’ such as herring, mackerel, sardines, kippers, pilchards, salmon, or fresh (not tinned) tuna
  • If you eat meat it is best to keep the portion size down a tad, enjoying every mouthful of your 8 oz steak and then 6 oz replacing the 12 oz!  You can eat a plate full of delicious vedgetables with it, even a side salad as well.  Eat lean meat, or poultry such as chicken
  • If you do fry, choose a vegetable oil such as sunflower, rapeseed or olive oil
  • Low in salt

A healthy diet provides benefits in different ways. For example, it can lower cholesterol, help control your weight, and has plenty of vitamins, fibre, and other nutrients which help to prevent certain diseases. Some aspects of a healthy diet also directly affect blood pressure. For example, if you have a poor diet and change to a diet which is low-fat, low-salt, and high in fruit and vegetables, it can lower systolic blood pressure by up to 11 mmHg.

Have a low salt intake The amount of salt that we eat can have an effect on our blood pressure. Government guidelines recommend that we should have no more than 5-6 grams of salt per day. (Most people currently have more than this.) Tips on how to reduce salt include:

  • Use herbs and spices to flavour food rather than salt
  • Limit the amount of salt used in cooking, and do not add salt to food at the table
  • Choose foods labelled ‘no added salt’, and avoid processed foods as much as possible
  • Watch – cereals, bread, marmite – these can be high in salt

A massage a day When learning massage in the 90’s I remember being told that massage reduces your blood pressure.  Not ‘your’ blood pressure, your therapists!  Perhaps it is the being in the moment action of massage that can do this, the rhythmic flow, or the soothing environment, and I have never taken my blood pressure before or after, but I always feel great after practising massage. Recent reports suggest that scientists believe a regular neck massage could also prove a life-saver.  It can lower blood pressure and reduce the risk of stroke and heart disease.

Researchers from Leeds University found signals from the neck play a key role in helping the brain maintain blood pressure, heart rate and breathing when we change posture, for instance by standing up.

When these signals stop – perhaps because the neck is stiff and not being moved – we can suffer from problems with blood pressure and balance.  Having a regular on site massage can keep back neck and shoulder muscles healthy and performing at their peak, which is especially essential for those of us who are hunched over our laptops (I am writing this on the train!), who drive long distances or feel the weight of the world on their shoulders.

Three quarters of us in the UK reportedly suffer from neck pain at some point in our lives, and I will write next month about self help techniques for exercising and self massage to keep in tip top condition.

Restrict your number of caffeine drinks Caffeine is thought to have a modest effect on blood pressure. It can affect some people more than others.  It is advised that you restrict your coffee consumption (and other caffeine-rich drinks) to fewer than five cups per day.

Drink alcohol in moderation A small amount of alcohol (1-2 units per day) may help to protect you from heart disease. One unit is in about half a pint of normal strength beer, or two thirds of a small glass of wine, or one small pub measure of spirits. However, too much alcohol can be harmful.

Men should drink no more than 21 units of alcohol per week (and no more than four units in any one day)

Women should drink no more than 14 units of alcohol per week (and no more than three units in any one day)

Cutting back on heavy drinking improves health in various ways. It can also have a direct effect on blood pressure. For example, if you are drinking heavily, cutting back to the recommended limits can lower a high systolic blood pressure by up to 10 mmHg.

Finally… if you read this far!…make time for yourself.  Demands are all around us and so many of us don’t have the time to just sit and be, I recently read an inscription whilst out walking the downs, it read “how lovely it is to do nothing and then sit down for a rest afterwards”!

Free Blood Pressure tests and Corprate Screening

If you would like to arrange for an occupational health nurse to visit your company, we offer a wide range of screening services.

For more information on Know Your Numbers and the free Blood Pressure screening click here.