Under the PPI pump

‘PPI use was recently reported to increase risk of death.
The results were significant and the methodology robust.’
– 
NPS Medicinewise

Most people on proton pump inhibitors (PPIs) would be unaware it doesn’t cure reflux, it just masks it.

The drug was originally designed to heal ulcers. Yet everyone knows someone taking a PPI for indigestion.

Its overuse finally rang alarm bells and recently long-awaited changes came into effect for all PPIs listed on the Pharmaceutical Benefits Scheme (PBS) – esomeprazole, lansoprazole, omeprazole, pantoprazole and rabeprazole.

Changes to restriction levels, terminology, clinical criteria and number of repeats have been made thanks to the Pharmaceutical Benefits Advisory Committee (PBAC) “agreeing that high-dose PPIs are overprescribed in Australia, for excessively long periods of time…”.

Unless you have been diagnosed with hypersecretory conditions, including scleroderma oesophagus or erosive oesophagitis, you should not be taking PPIs. Luckily the PBAC changes now make it clear that severe GORD conditions require a clinical diagnosis, like endoscopy. 

The changes are intended to improve the appropriate prescribing of PPIs, and yet visit your GP and the news hasn’t filtered through. 

You only need mention indigestion and out whips the script for a PPI. Often it isn’t tracked and patients end up staying on it for years, long after their bout of indigestion, which is normal, has resolved.

The reality is PPIs should be given only to those who have a real need. It should involve a gastroscopy by a specialist and a recommendation for “short-term” use of the PPI.

The patient should be advised diet is key to preventing reflux. Yet many are too quick to tell us to pop a pill instead of changing dietary habits.

We should be more scared of the side effects of PPIs than we are to eat less and consume fewer trigger foods (spicy, fatty, sugary).

So if you’re on a PPI, here’s the advice from the PBAC: Diet and lifestyle modifications may be sufficient in people suffering mild and intermittent gastro-oesophageal reflux symptoms (no more than one episode per week).

Think back to when you were prescribed the drug. Were you asked to modify your diet or was the script just written out and you’re now on it for life?

I was among the lucky ones, for want of a better phrase, that reacted badly to PPIs after a gastroscopy revealed erosive gastritis. I was told to take it for 4-8 weeks, then repeat the gastroscopy to see whether the ulcers had healed. They had.

It took me four months to get off the drug safely. Yes, twice as long as the time I was on it. And for all that time the side effects were frightening. I experienced extreme joint pain, nausea, headaches, water retention, heart palpitations and sweats. My blood pressure dropped to 87/49 and I was dizzy 24/7. Worse, within two months on the drug I gained three kilos. In the four months it took to get off it I gained another two. Yes, five kilos and yet the average weight we put on a year is less than a kilo.

TAKE UP THE CHALLENGE
It’s time to pump up the volume on getting off PPIs. This month’s HealthStorylines challenge is to seek help from your GP to quit the drug. It may take months and you’ll need to interchange your PPI with a H2 blocker. That is, take one PPI one day, H2 blocker the next in the first week. Each week you’ll swap out the PPIs for more H2 blockers until you’re only using a H2 blocker. Then gradually wean yourself off the H2 blockers in the same way until you are off them completely. 

It’s a good idea to get a referral to a dietician at the same time you wean yourself off the drug. Eating a healthy diet and using over-the-counter aids, like Mylanta or Gaviscon, will help reduce reflux rebound.

HealthStorylines.com

You owe it yourself to feel great. As a Health Care Ambassador for Health Storylines it is important to be part of the movement to raise awareness of living a healthy life.  Education is key to becoming your own health advocate. You can improve your quality of life through your own data. It’s as easy as tracking symptoms via a journal, or diet log.

Join me here each month in health challenges that are easy to achieve. It’s never too soon to keep your health in check. Just click on this link to get started.

RoamingRAVE has used the Health Storylines app since being diagnosed with midgut neuroendocrine tumours in 2016. After more than a year documenting her health, she was invited to become a Self-Care Ambassador as part of a pilot to encourage others to track their health. 

The heart sees what is invisible to the eye

‘Your health is what you make of it. Everything you do and think either adds to the vitality, energy and spirit you possess or takes away from it.’ – Ann Wigmore

Just like for humans artificial food may not provide adequate nutrition which can lead to health problems. An example is the feeding of mince or processed meats to Kookaburras.

There’s now new eating advice for a healthy heart. The Australian Heart Foundation has removed its restriction on full-fat milk, cheese and yogurt. 

While the evidence was mixed, the foundation says this type of dairy was found to have a neutral effect, in that “it doesn’t increase or decrease your risks for heart disease or stroke”.

Good news for those who enjoy full-fat products, but is that option really OK for those among us with a family history of heart disease or who have other chronic diseases that expose us to a heart condition?

Of course there is always a caveat. Heart Foundation chief medical advisor, cardiologist Professor Garry Jennings recommends unflavoured reduced-fat milk, yogurt and cheese and less than seven eggs per week for those who suffer high cholesterol or heart disease.

The foundation has also introduced a limit of less than 350 grams a week for unprocessed beef, lamb, pork and veal. In effect, that’s around one to three lean red-meat meals a week.

So for anyone wanting to ensure they maintain a healthy heart, the Australian government’s Eat for Health website offers information on food essentials, eating well and tips to track nutrition via a calculator. Here’s its advice for a healthy heart.

  • Eat plenty of vegetables (aim for five serves every day) and fresh fruit (aim for two serves every day).
  • Choose wholegrain types of breads, cereal, pasta, rice and noodles.
  • Select lean meat (meat trimmed of fat and poultry without skin). Limit processed meats, including sausages, and deli meats such as salami.
  • Have two to three serves (150g) of fish and seafood every week (fresh, frozen or canned).
  • Include legumes in at least two meals a week (for example, lentils, split peas, dried or canned beans like four bean mix, or baked beans).
  • Limit take-away foods, such as pastries, pies, pizza, hot chips, fried fish, hamburgers.
  • Limit salty, fatty and sugary snack foods (think crisps, cakes, biscuits, lollies and chocolate).
  • Choose healthier fats and oils for cooking, spreads, dressings and mayonnaises. Some suitable choices include canola, sunflower, soybean, olive, sesame and peanut oils.
  • Snack on plain, unsalted nuts.
  • Drink mainly water, and avoid sugar sweetened drinks. Choose caffeinated drinks like coffee and tea in moderation.

Still not convinced healthy eating is for you? Consider this. By following Australian Dietary Guidelines you’ll be contributing to the nation’s health and wellbeing by reducing the risk of diet-related conditions such as high cholesterol, high blood pressure and obesity. The knock-on effect helps to lessen the risk of chronic diseases such as type 2 diabetes, cardiovascular disease and some types of cancers.

All that just by changing your diet. It couldn’t be easier.

TAKE UP THE CHALLENGE

So this month’s HealthStorylines challenge is to add a new vegetable or fruit to your diet a day. Variety is great for your gut. Our microbiome needs diversity. Enjoying a new vegetable or fruit daily is an easy way to achieve that goal. Just select the Diet Log icon via HealthStorylines to track what you eat, or simply to log that you ate something new each day. For some healthy eating food ideas, check out the Australian Guide to Healthy Eating graph.

Remember, you owe it yourself to feel great. If you’d like to join me to inspire others to improve their quality of life through their own data, email support@healthstorylines.com. Or just check in here and join me in a health challenge that’s easy to achieve. It’s never too soon to keep your health in check.

RoamingRAVE has used the Health Storylines app since being diagnosed with neuroendocrine tumours of the GI tract in 2016. After more than a year documenting her health, she has become a Self-Care Ambassador as part of a pilot to encourage others to track their health.  

Keep your health in check

‘To keep the body in good health is a duty… otherwise we shall not be able to keep our mind strong and clear.’ Buddha

It’s common to suffer from a particular health condition without even knowing it. Even if you’re in great physical shape, it is still important to self-monitor, given many issues have no symptoms.

If you want to age healthily, introduce an annual physical because the last thing any of us want, or need, is for illness rob us of our health.

We’re so lucky these days that technology has come a long way. It can predict whether we’ll have a heart attack within the next five years by keeping tabs on vitals such as cholesterol and blood pressure and, if you 40+ there’s FREE scans for breast and bowel cancer, even osteoporosis.

Online health portals MyDr and WebMD suggest health screening is important for disease prevention. They explain why checking for conditions early, before symptoms develop, improve outcomes.

Both list the types of checks needed at different stages in life, and provide health tools and calculators that look at symptoms, diseases, tests, medicines, treatments, nutrition and fitness.

As a Health Care Ambassador for HealthStorylines, RoamingRAVE has been spruiking the benefits of documenting symptoms once an illness has taken hold but now it is time to broaden that approach, think prevention, to keep your health in check.

It’s time to monitor your health. Ask yourself how you really feel? Are you tired all the time? Stressed out? Suffer from aches and pains. Do you seek out comfort foods? Pop over-the-counter pills? If you answer yes to any or all, it’s time to turn things around.

SIMPLE CHECKS such as Blood pressure / Weight / Cholesterol / Blood sugar / Vitamin deficienies / Immunisations / Skin check

First set up that annual physical with your GP. Once you’ve got the all clear it may be as simple as making a few dietary changes to improve your lot. Remember nothing changes if nothing changes.

Sure it’s hard to get motivated when you feel beat 24/7 so take it one step at a time. Start swapping out some of those comfort foods for a more balanced diet. It takes less than two minutes to microwave frozen veggies, providing half your daily intake. Throw in a salad at lunch and you’re on your way to achieving a balanced diet.

Next it takes two pieces of fruit, a handful of nuts, and four serves of carbohydrates like breads or crackers. Keep meat down to small portions of 100g or under and a few legumes (four bean mix, or lentils) and you’re done!

Unsplash

Soon adding those greens to your diet will put a spring in your step and you’ll be up to adding exercise to the mix. Think of exercise as just another daily task. Strap on your step counter and see what you get mowing the lawn, or vacuuming the house. Now compare that to walking around the block? Which exercise do you prefer? Walking is great for your heart and connects you to nature in your neighbourhood.

TAKE UP THE CHALLENGE
This month’s HealthStorylines challenge is to make just one healthy change a day. It can be as easy as achieving eating two pieces of fruit a day, or adding extra greens to cutting out something sweet, or two!

HealthStorylines.com

You owe it yourself to feel great. If you’d like to join me to inspire others to improve their quality of life through their own data, email support@healthstorylines.com

Or just check in here and join me in a health challenge that’s easy to achieve. It’s never too soon to keep your health in check.

RoamingRAVE, aka Judy Wilkinson, has used the Health Storylines app since being diagnosed with neuroendocrine tumours of the GI tract in 2016. After more than a year documenting her health, she has become a Self-Care Ambassador as part of a pilot to encourage others to track their health.  Read her story via Zebra Tales.

 

 

Get the health care you deserve

“When people take an active role in their care, research shows they fare better.”  ― Dr Paul Haidet, on WebMD

Courtesy Pixabay

Imagine what it’d be like if a medical practitioner listened to your reason for your visit, asked questions and welcomed further questioning.

Now imagine their recommendations for treatment were based on research into your particular complaint, and additional resources were provided on your condition.

You’d probably leave feeling like you were given a solid strategy to manage your health successfully.

Trouble is, this scenario rarely happens.

Most of us get 15 minutes to cram numerous health issues into a consultation where the majority of questions go answered, and we leave feeling disappointed with the exchange.

No wonder patients are pushed into using online platforms like Dr Google to help manage health.

Courtesy Business Directory Australia

The ideal doctor-patient relationship, says Dr Paul Haidet, at DeBakey VA Medical Centre in Houston, is like a meeting of two “experts”.

He says when people take an active role in their care, research shows they fare better – in satisfaction and in how well treatments work – and that a passive patient is less likely to get well.

Yet patients often don’t speak up for themselves. So how do we change from passive patient to an active advocate for our own health care?

First it requires finding a quality practitioner. No surprise that it also requires research, and a lot of luck.

Once you’ve identified a provider, the next strategy is to ensure you know what questions to ask.

After experiencing three cancers the late Jessie Gruman, who founded the non-profit Center for Advancing of Health (1992-2014), told WebMD her experiences taught her to ask, “What does that mean?”

“If I didn’t … they’d just assume that I knew,” Gruman said. “The onus is on the patient to indicate when they don’t understand.”

Caleb Alexander, MD, an assistant professor of medicine at the University of Chicago also told WebMD there were “many barriers that prevent patients from raising concerns”.

Some are embarrassed, he says, while others think there is nothing doctors can do.

So perhaps more research is required to help prepare your list but always ensure sites you visit are reputable and target your complaint.

Previous RoamingRAVE blogs have focused on quality apps that can help with health goals. Some websites and apps provide information about the condition in question and will guide you to track your symptoms.

When you track how you feel, it can help on the question front. 

Failing that, adopt Dr Haidet’s simple mnemonic: ABC.

  • A = Ask questions
  • B = Be prepared
  • C = Communicate Concerns and Desires

He explains that communication means asserting yourself if you have a problem with the care you’re getting, or if there’s an issue you want your doctor to consider.

You’d have to agree with Gruman who advocated that everyone should expect to be taken seriously and treated with respect. Dr Haidet believes shared medical decision-making is best: “Accept nothing less.”

The author has used Health Storylines since being diagnosed with neuroendocrine tumours in 2016. After more than a year documenting her health via the app, she has become a Self-Care Ambassador as part of a pilot to encourage others to track their health.

Can we really find healthy living through apps?

“Few apps aimed at increasing health and wellbeing actually contain strategies and functions that lead to long-term change.” ― Life Matters, ABC

You’d have to agree that today’s time-poor lifestyle pushes most of us to seek quick-fix solutions to achieve our health goals.

RoamingRAVE posts often focus on the hard graft required in the form of behavioural change to achieve a healthier lifestyle but now there’s some real science behind using apps to help us rise to the challenge.

Relying on willpower is one reason why most of us don’t stick to our health goals but if using an app is your thing, as it is mine, research by Dr Fiona McKay at Deakin University School of Health and Social Development has provided a silver bullet.

It came up with a reliable, theory-based scale to help us select the RIGHT app.

The research looked at more than 300 healthy living apps available for Apple® and Android™ devices between July and October 2018. 

It found that apps that encouraged behaviour change included the following elements:

  1. Setting goals for the actions you like to achieve
  2. Tailoring the app to suit you
  3. Sharing your progress with others (through connections with social media)
  4. Receiving rewards or acknowledgements when you complete activities or make progress towards your goal. 

Each app description was reviewed by independent experts to determine if that app could be classified as behaviour-changing (change in this instance referring to activities or actions done regularly to achieve a healthier lifestyle such as exercising, eating healthier food, or managing stress).

Apps reviewed in the research had to have at least two of the four behaviour change elements. Next a systematic review to investigate the app’s potential for behaviour change was conducted allowing the creation of the App Behaviour Change Scale, or ABACUS. Cool huh?

So I guess you want to learn more about this rating system? VicHealth is where you’ll find the results of the potential effectiveness of apps that can help you achieve a healthier lifestyle. Select this link to find out more on how apps were selected, reviewed and rated.

Cue the Health Storylines app. It also has the elements required to stick to your goals. It works well for those living with a chronic disease but anyone wanting to track their health will find peace of mind. By monitoring symptoms, it allows anything unusual to come to light that can be raised with a health professional.

And it has that all-important share function, called Circle of Support, to encourage you along the way. There’s many other features to check out. So if you’d like to improve your quality of life through your own data and join me in living a healthier life, just click on this link to get started. 

After more than a year documenting her health via the Health Storylines app, the author has become a Self-Care Ambassador as part of a pilot to encourage others to track their health.

Everyone’s going through something

No act of kindness, no matter how small, is ever wasted. – Aesop

Sometimes we forget that everyone’s going through something.

So this month’s Health Storylines challenge is to do a small act of kindness.

The best form of kindness starts with being kind to yourself but if you want to broaden that approach there’s a kindness movement you can tap into. It was launched way back in 1995.

RAK unites people around the world through kindness, capping off the week with “Random Acts of Kindness Day” on February 17.

That’s all and good if you’ve enough energy to go around but sometimes you just need to bring it back to the power of one, you.

It’s important to offer yourself kindness. Like love, if you’re kind to yourself, you’ll be kind to others. It becomes automatic.

Therefore over the next seven days do a small act of kindness every day. After a week you’ll find being kind to yourself becomes that little bit easier. To really cement this habit, do it for six weeks.

Health Storylines is a helpful tool to guide you. By using MyJournal you can track good deeds by selecting one of five topics, but the one that fits best is under accomplishments (where you can list any random act of kindness).

Random acts don’t need to be big. It can be things like sharing expensive magazines among extended family members to smiling or saying hello to a stranger in the street.

In MyJournal just tick Box three to enter actions in the Entry panel. It’s a way to affirm and track those moments when you’ve been kind to yourself, or someone else. Next share it with friends or family that can view your story, or just add it to your journal. It’s always there in the history for you to recall. And you can also personalise your Health Storylines according to your condition, to receive additional Tools to better track your health.

Whether you have a chronic illness or not being kind to yourself, and others, releases powerful feel-good endorphins. The act helps you to live more in the present. It also allows you to accept what you can, and can’t, control.

If you need further help to be kind to yourself, try this mindfulness mediation. Previous RoamingRave posts on Mindfulness explain how it takes time and effort for positive thoughts to override the negative. But it’s worth pursuing.

Being kind to yourself when living with a chronic condition is huge part of bearing it. Therefore it’s important others know about your illness so they understand what’s going on. It’s also important to track symptoms. It can help those who may share the same symptoms or experience.

Health Storylines is always seeking people to tell their story. For NETs patients that’s shared under Zebra Tales. But anyone living with a chronic condition (a long-term health condition that may not have a cure) such as Arthritis, Asthma, Crohn’s disease and COPD. If you’d like to share your story, email support@healthstorylines.com.

OK, are you ready to join me in living in the moment with each random act of kindness? You are? Great, just click on this link to get started. 

The author has used Health Storylines since being diagnosed with neuroendocrine tumours in 2016. After more than a year documenting her health via the app, she has become a Self-Care Ambassador as part of a pilot to encourage others to track their health. Her story also appears on the app under Zebra Tales

The Importance of Being Optimistic

“Instead of worrying about what you cannot control, shift your energy to what you can create.”  ― Roy T. Bennett, The Light in the Heart

It’s a new day, a new year, and a new way to live your life.

This year all zodiac signs will benefit from the Year of the Earth Pig. Chinese astrology suggests 2019 will be a year full of joy, friendship and love. It’s an auspicious year because the Pig attracts success in all the spheres of life.

But there’s a catch. According to Chinese tradition we will need to learn how to take advantage of everything that’s beautiful in life in 2019. So it is time to ramp up optimism and positive thoughts as all qualities of the Pig sign will find a way to express themselves this year.

We’ll be exposed to gentleness and generosity, but we’ll need to be more attentive to others and, on a collective level, to altruistic initiatives.

And yes, optimism doesn’t solve all of life’s problems but sometimes it can make the difference between coping and collapsing.

‘It’s not easy being optimistic but positive self talk is the core of optimism.’ ––  LUCY MACDONALD, Learn to Be an Optimist  

Sounds great so we’ll need to catch our negative inner critic before it starts beating us up. 

When that happens, make a start by telling yourself: It’s your right to enjoy life.  Use Health Storylines to give yourself some Healthy Doses of positive thoughts. Choose from Love, Gratitude, Optimism, Funny and Mindfulness. Each saying will lift your spirits. For example, under Mindfulness Mother Teresa tells us to “be happy in the moment, that’s enough. Each moment is all we need, not more.”

Or use Health Storylines to practise regular gratitude. Use the Journal or Positive Thoughts Diary tools to become more optimistic by writing down the things you are grateful for.

www.confidentlife.com.au says not only does expressing gratitude light up parts of the brain that make us feel good, but also the effects are long-lasting and have a self-perpetuating cycle. So the more gratitude we feel, the more attuned we are to things to be grateful for, and the more benefit we find from it.

And of course, there are great health benefits from thinking positively.

The Mayo Clinic suggests the following health benefits of positive thinking and optimism: 

  • Increased life span
  • Lower rates of depression, and distress
  • Greater resistance to infection
  • Better psychological and physical well-being, cardiovascular health and coping skills

So lets ditch the common forms of negative self-talk such as filtering, personalising, catastrophising and polarising. Instead we can learn to turn negative thinking into positive thinking. Sure it takes time and practice, but given it’s the year of the Pig, we’ve got the best chance of making a change.

Are you ready to join me in living a healthier and more joyful life? You are, great. Just click on this link to get started.

The author has used Health Storylines since being diagnosed with neuroendocrine tumours in 2016. After more than a year documenting her health via the app, she has become a Self-Care Ambassador as part of a pilot to encourage others to track their health.