Social Isolation

(Sunday)A weird sort of world we're currently living in. Government advise is that we should all go into a sort of hibernation whilst the coronavirus is rampant around the world. We didn't have church this morning, but instead Ross and his wife Joy did worship inline via Facebook. After some considerable effort I managed to watch using my Fire Stick plugged into my HD television, and I must say it was an interesting experiment and the quality of the picture and sound was excellent, as was the teaching. Alfie got and extra walk, because of me not going to church as I usually do at around 8.40.

It looks as if those who are vulnerable, and as I have already said, I will have to remain in isolation for 12 WEEKS! I know it's serious, having had two heart attacks, but being stuck indoors for that length of time is going to be really difficult. I'm not sure about doing grocery shopping, because I can do that on-line. What happens when the delivery arrives? Do they leave the groceries on the doorstep? Will I need to have gloves to handle the bags of groceries? Then, what about other on-line deliveries, such as from Amazon? Also, what about mail? The postman is going to be as much at risk of infection as any other person who delivers parcels, whether it be books, clothing, food or whatever.
Then there's my repeat prescriptions. I can make the order on-line, as I have done for the past couple of months and I usually get a text message from Lloyd's in Sainsbury's, which means I can then go to Sainsbury's in Witan Gate to collect the order. Will Lloyd's deliver to me, direct. (It's not far. Within walking distance, which takes no more than 10-15 minutes.

(Monday) I have been looking at the government's official website where a lot of information is explained and it would appear that I'm not vulnerable, which I was expecting to be, having had a heart condition. Regardless of this, I still intend to be socially isolated, however difficult  it is likely to be (actually not that difficult, because since Carol died my life has become quite considerably more isolated as I don't do anything which we used to do on a regular basis, visiting National Trust properties for example. So it shouldn't be too difficult. It is, nevertheless, rather confusing. I have enough food for at least two weeks. All I really need is stuff like fruit, which I eat a lot of, easy-peel tangerines or satsumas, apples, bananas and probably those tubs of prepared pineapple which I love. Probably eating all this fruit has partially been responsible for my low cholesterol. Also, milk and potatoes.

There are many people who have simply not taken the government advice about social distancing and isolation. Yesterday apparently many outdoor places, such as parks, gardens and beauty spots were very crowded and it's clear that nobody adhered to the 2 meter distance from people. Why is this? Don't they realise that all this is serious, or are they merely selfish? It's the same with those people who panic buy and stock up on things like toilet rolls and then most likely just hoard them. I have been attempting to buy liquid hand soap, the sort that comes in handy pump bottles. Not a single one can I find anywhere, having looked in Sainsbury's and then at supermarket websites as well as Boots, Superdrug as well as Lloyds. Another case of selfishness. As long as I'm right, I don't care about anybody else.

(Tuesday) So, the government has now bought in tougher controls. The police can now arrest those who don't comply with guidelines. It's tough, but unless it's done, then this pandemic will never be bought under control. Whatever your political views, it must be difficult for Boris Johnson. Whatever he does will be criticised. He can't do right whatever is decided. He needs support and not get a lot of criticism.

I'm at home again today and not going to Camphill as I normally would on a Tuesday. I don't want to do this, but I know it's absolutely necessary. I really miss the guys in the drama workshop. I trust I'm able to return soon rather than later, but it obviously depends on how quickly this pandemic is bought under control.

Hot, Hot Day

So, here it is. Summer. It's arrived. Make the most of it. Because if you blink, it'll be gone. How long will the heatwave last? Probably only a few days.

Anyway, however long it lasts, it's been an extremely hot day and to be honest, I'm not sure I like it. I do like it warm and sunny, but if it's too hot I frankly can't cope with it. Just sweaty and unpleasant. I don't want to be out in it too long and just want to be in the shade. Our dogs don't know how to cope and flop around the house. 

I had to get to the doctor's at Ashfield Medical Centre in Beanhill before 8 a.m. as I had a blood test booked. It was a fasting blood test, which meant I couldn't eat for 12 hours previous, which can be difficult. Carol came with me and there was already a queue outside when the doors eventually opened. I checked in (the computer system you use to self-check-in was working, surprisingly, as it wasn't working last time I came in. 

As you will know, if you follow this blog on a regular basis, you will no doubt know that I have a problem with blood tests. I hate needles. But this time there wasn't a problem and the nurse was able to find a vein in my left arm and it was over very quickly. Efficient and effective. Thank goodness. This blood test was for cholesterol, because when the doctor did my medication review a few weeks ago he said I should have to have a blood test to just keep an eye on my cholesterol levels.

Carol had booked a blood test for herself and had to check when it was on Wednesday. She also had to get a repeat prescription for cream from the doctor. The receptionist said that the doctor would ring during the course of the day to give her a sort of review and have a prescription made up and sent to Sainsbury's pharmacy to have it made up but we waited in all day and no telephone call came which was somewhat annoying. Maybe he will ring tomorrow.

'Thousands More to be prescribed statins in new NICE guidelines'

BBC Breakfast television news this morning had an item about NICE's  (National Institute for Health and Care Excellence) recommendations that more people should be prescribed statins to reduce cholesterol levels in their blood.

The following is a quote as it appears on the NICE website:

'Thousands more people could be prescribed statins to help lower cholesterol levels and reduce the risk of heart attacks and strokes, under draft guidance.'

'In an update to the existing guideline on lipid modification, NICE is proposing that the threshold be halved for offering statins to people to prevent cardiovascular disease (CVD), the cause of 1 in 3 of all deaths in the UK.'

'Currently, only people with a 20 per cent or greater 10-year risk of developing CVD are offered statins. Draft guidance now recommends offering statins to people who have a 10 per cent or greater 10-year risk of developing CVD.'

'As many as 7 million people in the UK are currently believed to take statins, at an estimated annual cost of £450 million.'

'GPs should estimate the level of risk among their patients using the QRISK2 assessment tool and measurements including whether or not they smoke, their cholesterol levels, blood pressure, and body mass index. The calculator then provides a percentage risk of developing CVD in the next 10 years.'

'NICE had previously recommended the US Framingham risk tool before withdrawing advice about which risk assessment tool to use in February 2010. New evidence has suggested that QRISK2 is a more accurate CVD risk tool particularly among ethnic populations.'

'Patients with type 2 diabetes should, however, have their risk assessed using the UKPDS risk tool.'

'NICE recommends that GPs start statin treatment for the primary prevention of CVD with atorvastatin 20 mg. Patients with established CVD, type 1 diabetes or type 2 diabetes should be offered a higher strength 80mg dose of atorvastatin.'

I have been on statins since I had my heart attack in 2006. As I have mentioned in earlier posts on this blog, I had tried various forms of statins, Simvastatin for example, some of which had quite extreme side-effects, one being, when I was in hospital, being like having flu, muscle cramps,etc etc until I eventually settled on Pravastatin, which is what seems to have the least of the side effects. Reading the leaflet which is enclosed with the tablets you can see what these might be. They are, to mention only a few:

insomnia, dizziness, tiredness, headaches, sleep disturbances (surely insomnia would cover that?), muscle and joint pain, nausea, diarrhoea, wind, (I'm sure I suffer from most of these, unfortunately. I'm not so sure whether it's because of the statins though.) 

I think personally it's best to have a decent diet, low or fat-free food, for example I have always had semi-skimmed milk and use low-fat spreads instead of butter, eat plenty of fresh fruit and vegetable, give up smoking (I have never smoked so that doesn't matter to me, and cut down on alcohol intake (I drink very little so that doesn't effect me. I'd personally rather spend the money on a good book than alcohol, so I don't find that a hardship to give up.) Also, take plenty of exercise (we recently joined a gym and go swimming twice a week, and walk regularly. Not perhaps at the moment, but that's down to the poor weather, unfortunately. 

I don't personally think just putting healthy people on statins is such a good idea. If they have a risk of stroke or heart attack, maybe it's a good idea. As there was a family history of heart problems in my family then it would have been a good idea to be prescribed statins (as it happened I wasn't. Would it have prevented me having a heart attack? That, of course, is open to doubt. I was told by my doctor years ago to go on a low-fat diet, which is one reason why I went over to using semi-skimmed milk. It took some getting used to after having full-fat milk, but now I actually prefer it. Some low fat products are frankly awful, thin, tateless and now particularly nice, but there are quite  few quite nice alternatives, such as spreads, yoghurts etc etc.)

Irish Surgeon Gagged over research into Cholesterol-lowering medicines

  The following item is here reproduced from the Irish Independent newspaper website, dated 5th October 2013:

'Sherif Sultan, a senior medic at University College Hospital, Galway, reviewed a range of studies of statins and found a lack of evidence to show they should be given as a means of prevention to healthy people with  high cholesterol but no heart disease.'

'Mr Sultan and his surgeon colleague Niamh Hynes said lifestyle changes to reduce cholesterol were better because this allowed people to avoid the risk of statins' side effects.'

'However, in a statement last night, Dr Pat Nash, a cardiologist and the group clinical director in University College Hospital said the recently published views of his colleagues were "not representative" of those in Galway or neighbouring hospitals.'

 ' "As group clinical director of the West/North West Hospitals Group, and a working cardiologist, I wish to reassure patients that statins are safe," said Dr Nash.'

 ' "These are very important, well-validated drugs for the treatment of elevated cholesterol. We have extensive evidence to show their benefit and to show that they improve outcomes for patients with heart disease and stroke and that they have a role in preventing heart disease and stroke.
"As always, if patients have any concerns, they should not discontinue their medication without discussing with their GP or consultant."'

'Asked to comment, Mr Sultan said: "I have received an official warning from the HSE and have been instructed not to liaise directly with the press in my capacity as a HSE consultant." '

 'However, he said he could continue to comment as a consultant vascular surgeon at the Galway Clinic, where he has a private practice.'

'The HSE declined to comment on the reasons for ordering Mr Sultan not to speak as a public consultant.'
 
'He said he stood by his analysis of the role of statins in otherwise healthy patients with high cholesterol. He pointed to another recently published review on exercise versus drug therapy in the management of pre-diabetes and cardiovascular disease.'

 ' "That 'British Medical Journal' analysis showed the superiority of exercise over drug therapy extends even to secondary prevention (where patients have developed disease).'

' "The most convincing evidence is in stroke prevention." '

 'He pointed out that his own review had found there were benefits in prescribing some dosages of statins for certain patients who were already diagnosed with heart disease or had a history of a previous heart attack or stroke.'

CONCERNS

 'He had advised any patient who was taking statins and had concerns to talk to their doctor about them and heed their advice. '

 'Around 250,000 prescriptions for statins are written monthly and they account for 8pc of the HSE's €1.7bn drugs spend. This amounts to one euro in every €12 spent on all drugs.'

'The Irish Medicines Board has received 59 reports of suspected adverse reactions to statins since the start of 2012. Side effects include a potential increased risk of diabetes, eye cataracts and male impotence.'

 'Women who are past the menopause and who are on statins were found to have a higher chance of developing diabetes and this was associated with taking the drug.'

 'The Irish Heart Foundation said the mainstay of preventing heart disease involved lifestyle changes, including not smoking, being active, having a healthy weight and getting regular checks for blood pressure and cholesterol.'

- Eilish O'Regan Health Correspondent

Irish Independent