I am lucky that I experience job satisfaction relatively frequently in my role. Yes there are many aspects that are rather tedious and administrative, but often I’m reminded what a privileged position I am in to be able to help others with something as important as their health. Is there anything more important in fact than health? Being in the service of others is a central tenet of the Buddhist faith, and has remained so for over 2000 years for good reason. It’s a key ingredient in the recipe for human happiness.
Such a moment arrived this week with a patient I had not seen for a year. Let’s call him Martin because he’s not called Martin. He has had a few heart issues here and there, but nothing one would consider super serious. This point isn’t the reason for today’s blog, but worth mentioning as my well resonate with my readers. He had previously been on a statin as had slightly raised cholesterol, and on a CT coronary angiogram had a small, but definite volume of plaque in one of his heart arteries. A bit furred up, you might say. When we went through his medication, the statin was no longer on there. he told me he had stopped it some months ago as had been getting some muscle aches, which had gone away when he stopped it. Perfectly reasonable. About 10% of patients cannot tolerate statins (meaning 90% can, but we tend only to hear about the minority when it comes to statin side effects). However less reasonable in my view was the fact that there was nothing in it’s place. Unsurprisingly, his cholesterol had jumped up a bit off the statin, meaning we now have a patient with coronary artery disease, raised cholesterol, on no medication. He already has a very healthy diet. We are lucky these days to have a menu of lipid-lowering medication to choose from, and I believe no-one should be putting up with side effects.
This also speaks to the often ridiculous system within which we work in healthcare – if Martin had suffered a heart attack or stroke, the costs of treating him are enormous. Yet, there is no clear means to identify and manage side effects of medication routinely. Some people get lucky and there are some great primary care services around, but it’s so variable and patchy. In fact, better primary prevention of heart disease was highlighted at last week’s British Cardiovascular Society meeting in Manchester. It was suggested that NHS heart health checks should start at age 25 instead of 40. Sounds great in theory and I’m all for it, but in practice less than half of eligible people had their 40-year check last year.
I digress. We came up with a plan to manage his cholesterol.
Back to my point. A year ago we got to talking about strength training, and its importance in health, wellbeing and longevity. In my view this should be routine practice for all adults. Yes this will look different for different people, but we can all do something, no matter how little. Martin has never been a gym bunny. He’s retired though, so does have some time on his hands. He also used to work in the care home industry, and does not want to end up like the residents. That is a great motivator I’m sure. As you may know my own Mum was recently admitted to a dementia care home. Perhaps some of my own obsession with exercise is related to that, it’s a horrible disease I want to avoid at all costs.
Martin had got himself some personal training lessons to make sure he was doing the exercises properly, and as he was telling me the story, I felt such an enormous sense of satisfaction, I actually felt rather emotional. He told me when he started, he could leg press 50kg. A year later, he is smashing out 3 sets of 10 reps at 180kg! (which, by the way, means that weight is too light for him – he’s not getting the training stimulus any more at that weight). Martin saw a knee specialist a year or two ago who told him he would need new knees in the foreseeable. Guess what, no knee pain any more. I am so proud of Martin, he’s really taken ownership of his health, and proven that even later in life, you can make huge health and wellbeing gains through exercising, even when you’ve not been an avid sportsman in younger years.
Strength helps everything – it lowers risk of heart disease, cancer, dementia, falls, never mind the day to day improvement in quality of life. It’s not about being super-muscled (and in fact that it really hard as you get older), but I really hope this story helps to demonstrate what is possible. How might you be able to get stronger? We all can, it just looks different for different people. Please spend a few minutes now thinking about that, and making a plan to action.
In this week’s research video, I discuss a trial I read this week looking at genetic testing in patients with atrial fibrillation. This is not routine practice, at least not in the UK, so I was interested to see what the research paper was all about. At present genetic testing is predominantly for patients with inherited heart disease. Whilst there are familial links in AF, it is not considered a genetically inherited condition. Watch the video to find out more.