I’m sure many of us, myself included, take health for granted much of the time, and it’s only when a health issue occurs do we suddenly appreciate quite how much we should value it. Clearly I see ill-health day in day out, so you might suppose that I would be more aware than most. I expect I am, but as a doctor one has to stay at a certain mental distance much of the time. It is an emotionally demanding job, and I don’t think one could do it effectively dwelling on all the difficult things we see and deal with. However, family and friends will get sick, and that’s a different kettle of fish. Regular readers will know my Mum is in a dementia nursing home, and I write often about lifestyle strategies to help prevent that horrible condition. Today’s blog isn’t about Mum though. My sister in law went through a 5 hour operation this week. The details are unimportant (aside from the fact it went well), but it really made me stop and think about a whole host of things.
In no particular order: The surgery itself was a testament to the NHS functioning well: multiple team members, planning, the consent process, surgical skill, diagnostic imaging. How a surgeon does a 5 hour operation I don’t know. The longest complex pacemaker procedure I’ve ever done was probably 3 hours and I was very ready to finish by then! Surgical recovery is a lonely place. My poor sister in law has been in a lot of pain, can’t eat, drink or talk normally. She is a single mum, but luckily there are a lot of family nearby (I haven’t seen my wife since Tuesday as she has been hands on caring), but how hard must it be for patients who don’t have that support? How difficult must recovery be if a person goes into surgery in poor health to begin with? As this was elective surgery there was time to plan, but emergency surgery is a whole different ball game.
The bottom line is, we must appreciate our health whilst we have it, and ideally do all we can to preservice good health and wellbeing for as long as possible, with all that entails.
We don’t really talk about pre-habilitation much, but we should do. That is the concept that a patient gets fit before an operation to maximise the chances of a speedy recovery. This can take many forms: optimising weight, nutrition, joint strength, flexibility, blood pressure, diabetes, hormones, heart function (I get a lot of referrals from anaesthetists asking my opinion on how to ensure a patients heart is in the best spot pre-operatively). I think in America pre-hab clinics are more commonplace, and perhaps in time they will be here too. Of course, I would always advocate being in the best health possible regardless, rather than waiting until you’re on the waiting list for an operation before making lifestyle changes. One never knows when an emergency is around the corner.
Speaking of America, I couldn’t write today’s blog without a word on the Ryder Cup. I’m a fan of many sports, but The Ryder Cup is my all time favourite event, eclipsing even the World Cup. I went to the 2018 edition in Paris, and they were some of the most memorable days of my life. I’m writing this on Sunday morning, so clearly don’t want to jinx things, but the European lead looks unassailable. The camaraderie and teamwork on display has been exceptional. The resilience in the face of extreme adversity extraordinary. The players ability to deliver and execute sublime golf shots under unbelievable pressure defies belief. I also think the American crowds cross the line of decency far too frequently. Shouting insults about players families, calling out just as they are about to hit a shot. Even the American MC on the first tee suggested on the PA that crowd sing expletives at Rory McIlroy (she has been removed of her duties for today). That’s not golf. However, the Europeans have silenced them in the best way possible, and I hope we go on to crush them this afternoon in record breaking fashion. Perhaps it’s symptomatic of the divide in the country right now, but it’s definitely one thing we should not be looking to emulate from across the Atlantic.
In this week’s research video, I outline my final trial from last month’s European Society of Cardiology meeting. I actually found myself in the session by accident, but listened with interest about flu vaccines. Flu season is coming up, and if you’ve ever had it, you will know it’s one to be avoided if possible. I’ve had it once, and was horribly unwell, soaking the sheets in sweat one minute, freezing the next. The data now on reducing cardiovascular morbidity with flu vaccines is such that both the European and American Heart Associations have issued statements this year supporting the use of flu vaccines for heart patients. At least that’s one thing we can agree on!