Medication Compliance- Trouble taking Tablets?

Healthcare professionals are understandably concerned that people, especially people with serious health problems, take medication appropriately, as prescribed by their doctor. The reasons they often do not are explored here, and may differ from some commonly held ideas. The causes of non-compliance are seldom immediately clear, and individual reasons for stopping medication can appear arbitrary, “I couldn’t get to the chemist”.. If I focus here on individuals with mental health problems, it is because compliance with medication is a comparatively larger problem in this group, but certainly not exclusively so.

Many writers have highlighted the importance of terminology in healthcare, and suggest that the use of words like “compliance” infer that patients should be passive recipients, and should obey professionals. It has recently been proposed that “concordance” should replace the words “compliance” and “adherence”.

Concordance emphasizes patient rights, and the importance of two-way decision making. More controversially, it also reminds us patients have the right to make choices such as stopping medication, even if doctors do not approve of the decision.

How a person thinks an illness will affect him is determined by his previous knowledge or experience, as well as fear of the outcome.

The law imposes a duty of care on those that administer medication to others, for example, on a hospital ward. Administration of medication is not without its complications. Minor prescribing errors, allergies, adverse drug reactions, interactions with food, or herbal products, overdoses, and even possible irreversible health problems or death, must all be considered.  No one should take medication that is normally only available on a doctor’s prescription without this essential professional help.

There is however, still widespread concern in the UK over the administration of non-prescribed medicine and the practice of covert administration in the non-compliant.

The law is clear that covert administration is only justifiable in cases of incapacity. Incapacity occurs where the patient is unable to comprehend and retain information material to the decision, or the patient is unable to weigh up the information as part of the process of an informed decision..

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The Cholesterol Myth that is Harming Your Health

This is such an important subject for anyone diagnosed with high cholesterol, or prescribed statins, I have publicized it here.
Dr. MercolaDr. Mercola is the founder of the world’s most visited natural health web site, You can learn the hazardous side effects of ‘over the counter’ remedies by getting a FREE copy of his latest special report The Dangers of Over the Counter Remedies by going to his Report Page.

Cholesterol could easily be described as the smoking gun of the last two decades.

It”s been responsible for demonizing entire categories of foods (like eggs and saturated fats) and blamed for just about every case of heart disease in the last 20 years.

Yet when I first opened my medical practice in the mid 80s, cholesterol, and the fear that yours was too high was rarely talked about.

Somewhere along the way however, cholesterol became a household word — something that you must keep as low as possible, or suffer the consequences.

You are probably aware that there are many myths that portray fat and cholesterol as one of the worst foods you can consume. Please understand that these myths are actually harming your health.

Not only is cholesterol most likely not going to destroy your health (as you have been led to believe), but it is also not the cause of heart disease.

And for those of you taking cholesterol-lowering drugs, the information that follows could not have been given to you fast enough. But before I delve into this life-changing information, let”s get some basics down first.

What is Cholesterol, and Why Do You Need It?

That”s right, you do need cholesterol.

This soft, waxy substance is found not only in your bloodstream, but also in every cell in your body, where it helps to produce cell membranes, hormones, vitamin D and bile acids that help you to digest fat. Cholesterol also helps in the formation of your memories and is vital for neurological function..

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Living Proof: A Medical Mutiny

Living Proof: A Medical Mutiny  (2003) by Michael Gearin-Tosh

Guest Review by Mr Chris Wollams, and originally published in Icon magazine

Rating: ★★★★★

This is the inspiring story of one man following a diagnosis of cancer, and the decisions he faced.

This book is both excellent and controversial. Over a six month period, Michael Gearin-Tosh found out about the options available for treatment of Myeloma including chemotherapy, but in parallel, he became more intrigued by the Gerson Therapy and embarked on his own personal treatment plan. The Gerson Therapy is time consuming and not for everybody and it must be remembered that cancer is a very individual disease.

But Michael believed in the Gerson Therapy and this, coupled with his self-belief and natural energy, has seen him through the last eight years. All credit to him; he should be an icon for cancer patients and his book an essential read. His book does highlight the extraordinary gulf between ‘conventional’ medicine and ‘alternative’ medicine and the success of Michael Gearin-Tosh in controlling his cancer has significant implications for us all.

Sir David Wetherall FRS, Regius Professor of Medicine at Oxford University said in his letter to the Sunday Times about the book, “Though I do believe passionately in scientific medicine, I have not got to the stage of being so blinkered that I cannot believe that at least some aspects of the more complementary approach may have a lot to offer. I think they could be put to the scientific test, and should be, but whether this will happen is far from clear. But of one thing I am sure; regardless of what a patient is suffering from, their personal reaction to their situation and their state of mind is of critical importance, and to ignore them in the face of high technology and medical practice is to court disaster”..

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Almost all of us have experienced some form of depression, perhaps one in four or five at any one time.  For the ones that haven’t (or haven’t yet), it can be near impossible to adequately understand what the partner or friend is going through, and by the nature of the beast, near impossible for them to tell you.

There is a huge amount of material in print and online about depression, and it is my view that much is good, but much is not so good. My reasons for adding the following comments are as follows.

  • Let’s not be dogmatic. We do owe a lot to all the professional doctors, researchers, and modern medication; however, they would not be telling the truth if they claimed to have the perfect answer. For all our similarities, we are not robots, we are all unique.
  • Although I fully accept the need for up to date advice, depression is almost as old as mankind, and the thoughts we do have in writing, from the Bible, the Koran, Confucius, and others, as well as modern first person accounts, can be helpful, even illuminating.

Timothy Bright (1586) wrote: ‘How diversely the word melancholy (depression) is taken’. He categorised depression as that type which ‘is not moved by any adversity present or imminent’ in which ‘the melancholy.. abuseth the mind’. He was describing a depressive disorder, almost certainly bipolar depression. He also described a second type of melancholy where ‘the peril is not of body’ but ‘proceedeth from the mind’s apprehension’ requiring ‘cure of the minde’, or as we would say, psychotherapy..

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Loneliness and the appeal of Robinson Crusoe

Robinson Crusoe

Robinson Crusoe is the tale of a lonely human being who manages to survive shipwreck and confinement on a deserted island for years without human companionship. It was written by Daniel Defoe and was published to enormous acclaim in 1719.  It is a story about the different ways that men cope with reality when hardship comes, but it is also the tale of a man creating his own reality, rescuing another man (Friday), and fashioning his own world out of the untamed wilderness of a desert island.
In writing Robinson Crusoe, Defoe created a character who appeals to us on a deep level. The search for Defoe’s model or models continues, with Alexander Selkirk being the favourite. Tim Severin (Seeking Robinson Crusoe , 2002) has recently explored the intriguing possibilities, and visited likely island locations for the story, such as Juan Fernández, Chile, and Salt Tortuga, Venezuela.

Loneliness is not the same as being alone. Many people have times when they are alone through circumstances or choice. Being alone can be experienced as positive, pleasurable, and emotionally refreshing if it is under the individual’s control. Solitude is the state of being alone and secluded from other people, and often implies having made a conscious choice to be alone. Loneliness is unwanted solitude. Loneliness does not require being alone and is experienced even in crowded places. It can be described as the absence of identification, understanding or compassion. Loneliness can be described as a feeling of isolation from other individuals, regardless of whether one is physically isolated from others or not.

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Sleep and Sleep Disorders

In order to keep up with a busy daily schedule of work or social engagements, some people only surrender to sleep when extremely tired. It is part of our culture, ‘nightlife’ being seen as cool, exciting or trendy. Fact: among Americans and Britons, 1 in 3 sleeps no more than 6.5 hours a night. In contrast, others, for many different reasons, would give anything for a good night’s sleep. The saying “No one died through lack of sleep” probably isn’t true.

Occasional insomnia lasting a few days or so is not uncommon, and it is generally related to stress and the ups and downs of life. When insomnia becomes chronic, however, emotional or physical disorders may be involved, and it is important to seek medical help. This discussion does not suffice to self-diagnose.

A new-born sleeps for frequent short periods that total about 18 hours a day. According to sleep experts, although some adults appear to need only three or four hours of sleep a day, others need up to ten hours, eight hours representing a norm. As we get older, our sleep needs may lessen, but old age in itself does not mean poor sleep.

When you do not get enough sleep, you are likely to become more irritable and even depressed.

“Scientists theorize sleep has a restorative function for the brain, and that learning continues during sleep,” said one sleep expert, “at night you consolidate your memories and any learning that happened during the day gets put into place at night. Not having that period of rest actually impairs memory and learning.” Moreover, he says that “when you get enough sleep, it probably serves some function to stabilize your emotions.” Continue reading Sleep and Sleep Disorders

Bullying at School, Bullying at Work, What can be done?

WHAT causes a person to begin bullying others? If you have ever been victimized by a bully, you probably would say, “There’s no excuse for that kind of behaviour.” But there is a big difference between a reason and an excuse. The reason why a person becomes a bully does not excuse the wrong behaviour, but might help us understand it. And that can have real value.

Anger at the bully’s conduct can blind us, filling us with frustration, but we need see more clearly how we can find solutions. So let’s look at some factors that give rise to this unacceptable behaviour.

Social or financial background can be little to do with it. Often a bully’s childhood is marred by poor parental example or by outright neglect. Many bullies come from homes where the parents are cold or uninvolved or have, in effect, taught their children to use violence, outright or suppressed, to handle problems. Children raised in such an environment may not see their own verbal attacks and physical aggression as bullying; they may even think that their behaviour is normal and acceptable. Sometimes bullying begins with younger siblings, or cruelty to animals..

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The Power of Words

The making of a good Dictionary
is a contribution of the highest order to the welfare of a language.
It clarifies and stabilises the pronunciation, orthography and meaning of its words;
garners and stores the varied wealth of its vocabulary.
To the farmer, his barn; to the manufacturer, his warehouse;
to all who use and value their native tongue, a dictionary.

— David Lloyd George

Without arguing with David Lloyd George, who after all, was trying to make a valid case for dictionaries everywhere, things change over the course of a hundred years. Not in itself a problem, as it provides a reason to keep selling new dictionaries.

‘We all know words don’t mean what they meant sixty, or six hundred years ago.  And yet..words do contain within themselves echoes of their previous lives.  We hear in them not only the way we use them now, but also the way our parents used them, and their parents before them.  Words are like living things, as they move around, they grow, they change.  A word is nothing but information.  English spelling and pronunciation, simply tell us where the word came from, how it relates to other words, and what it likely meant…    (Frantic Semantics: Snapshots of Our Changing Language).

We learn a word’s connotations, the associations it carries beyond the current dictionary meaning, by hearing it in context, from childhood, or when we first heard the word. This may explain why we don’t like certain words. In the ‘caring professions’ at present (a term I also personally dislike), we have ‘Service user’. No one likes it because of the tendency to abbreviate everything, and who wants to be a ‘user’? On the other hand, one of the terms it replaced, along with ‘patient’, or ‘inmate’, was ‘client’. Such is the dilemma. What about ‘customer’? Why is it also unpopular? Apparently, in the time of Shakespeare, it too, was linked to the brothel. This is a much wider problem than it first appears, many otherwise respectable words end up with sexual overtones. As if you needed more examples, here are some.

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Altered Body Image- Anorexia and Bulimia

Today’s teenagers face demands and expectations, as well as opportunities and risks, that are more numerous and complex than only a generation ago. High divorce rates, ambiguous moral guidance, and complex media images all contribute to a lack of stability. Nonetheless, contrary to powerful stereotypes of teenagers as highly stressed, over-assertive, or incompetent, the majority attain adulthood with a positive self-conception and good relationships with both peers and older persons.

However, some teenagers do not have the circumstances, support or opportunities to gain competence and control over their own futures. Before looking at the psychological factors of weight gain or loss, it is essential to consider any physical health factors. To give just two, and there are many, weight gain is an unwelcome side-effect of many types of drugs, and weight loss is often an early sign of malignant disease.

It is now known that more than half the female population of the UK between the ages of 15 and 50 suffer from some form of eating problem, which gives an idea of the scale of the problem, and also, the many individual reasons there are for women to feel dissatisfied with their bodies. It should be noted moreover, that Anorexia Nervosa and Bulimia are not solely female-oriented problems; there is an increasing incidence of both in males. There are many causative factors, but without doubt one is what doctors have called ‘the cult of slimness’, the malign side of the fashion industry. Fashion extremes are designed to influence people..

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Life’s Dominion- an argument about Abortion and Euthanasia

Rating: ★★★★★

Life’s Dominion: Argument About Abortion and Euthanasia

Today, doctors command technology that can keep people alive, sometimes for weeks, sometimes for years. People near death, people under constant sedation, either through permanent incapacity or severe pain, people for whom there is little or no chance of improvement or recovery.

Most of us dread such a scenario, for ourselves or a loved one, life without thought or feeling, or to use the familiar analogy, a vegetable. Increasingly, people recognize the value of advance medical directives, legal documents stipulating that specified medical procedures should not be used to keep the signer alive under certain circumstances, and/or appointing someone else to make such decisions should the signer be unable.

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