Category Archives: Pills

WHY WORRY ABOUT SEPSIS?

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If you know much about sepsis, chances are the condition has affected your family.

I’ve blogged about sepsis before, but the condition is still with us and has a high mortality. It kills about 48,000 people a year in the UK. Worldwide, someone dies of sepsis every 3 seconds. Survivors have a high chance of serious long-term effects.

Today being World Sepsis Day, I’m parking the levity once again and using this post to sum up – or update – what you need to know about sepsis. 

Understand what it is.

Sepsis is when the body responds to severe infection in such a way that it attacks its own organs and tissues. Without treatment, this quickly leads to organ failure and death.

Most people have heard of blood poisoning (septicaemia) which is much the same thing. But doctors now prefer the term sepsis because there isn’t always blood poisoning in this condition.  

Sepsis isn’t exactly a household name – yet. Personally I still think ‘sepsis’ sounds weaker than either septicaemia or blood poisoning, but we’re stuck with the term that scientists agree on.

Know the warning signs.

The symptoms depend on age, but the main point is that there isn’t any one specific sign like, say a swollen jaw with mumps. A child with sepsis can have a high fever, or an abnormally low one. The younger the child, the vaguer the symptoms.

Here are some signs to look out for in children (from the UK Sepsis Trust website):

In under-fives the symptoms can be particularly vague:

And here are some signs to watch out for in adults (again from the excellent UK Sepsis Trust):

If you just remember two things about sepsis, remember this:

You or your youngster will be more unwell than expected.

Things get rapidly worse, especially in children.

Understand who gets it.

Anyone can develop sepsis from a bacterial infection (or sometimes a virus or fungus). But some are more at risk, like the very young, very old, pregnant women, diabetics, and people on long-term steroids.

The initial infection can be a serious one like meningitis, or seemingly trivial, like a horse-fly bite.

scalpel

Surgery can be linked with sepsis, especially emergency operations on those in poor health, or with peritonitis or bladder infections.

And yes, Covid-19 can sometimes lead to sepsis too.

Know what to do.

Sepsis is a medical emergency and needs urgent hospital care. Don’t waste a single moment.

Sepsis isn’t one disease, but rather a syndrome that cuts across almost every medical speciality. The first doctor you see could be a paediatrician, a gynaecologist, an orthopaedic surgeon, or your GP, and sepsis may not feature at the top of their list. That’s why it’s so important for you to mention it. When you see the doctor or nurse, or speak to 111, make sure you say, “I’m worried about sepsis.”

Thanks for bearing with me. Hope you stay healthy.

Litmann type stethoscope

The UK Sepsis Trust is a wonderful charity founded to save lives and improve outcomes for survivors of sepsis – by instigating political change, educating healthcare professionals, raising public awareness and providing support for those affected. For their general info on sepsis, click here.

20TH CENTURY MEDICINE, EGYPTIAN STYLE

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Covid-19 has already altered medical practice forever but, thinking back, there’ve been many changes in medicine over the years. Most have been more gradual than the ones made necessary by this pandemic, but no less dramatic. The NHS care that I practise, and receive, is far removed from the care I experienced as a child growing up in Egypt.

With my mother in the garden

Antibiotics were few back then, and usually given by injection with a freshly boiled syringe and a reusable needle. I can still feel the cold oily pain of penicillin as it inched its way from my bottom down my leg.

“I don’t want an injection!”

Penicillin was better absorbed in this way than by mouth. There was also a trend of sparing a patient’s delicate digestion, hence the usual recovery diet of rice with boiled chicken, as recommended by every doctor. If the patient ran a fever, suppositories were deemed preferable to a couple of Aspro.

The French occupation of Egypt may also explain how often the middle and upper classes suffered from liver complaints. “C’est de la bile, chérie.” At least bilious attacks can be genuine. A tired liver or le foie fatigué isn’t even a real diagnosis.

Injections of vitamin B12 were popular in the mid-20th century, and not just for cases of proven deficiency. The impressive bright red colour of B12 flowing into a vein could hardly fail to make the patient feel better, never mind what was actually wrong with her.

Photo by fabrizio turco from FreeImages

The divide between haves and have nots dominated every aspect of life in Egypt. With no national health provision, the poor died young, blindness from trachoma was common, and amputees were everywhere.

If you could afford one, your family doctor would visit whenever requested, often with a cigarette in hand as he puffed his way upstairs. Once he extinguished it, he would examine the patient. As he usually wheezed more than the patient, I’m not sure he heard much through his stethoscope.

Granny waiting for the doctor to arrive

What medicine lacked by way of treatments back then was made up for by personal attention, much as alternative medicine still functions today. A little baksheesh to the receptionist ensured that you got seen ahead of others in the waiting room. It seemed unfair to me then, as a young child, and it was even less fair that most of the grownups around me couldn’t see a problem.

Photo by Martyn E. Jones from FreeImages

It’s almost incomprehensible now, but polio was a scourge that went back thousands of years. With outbreaks of paralysis among young children every summer, no wonder we all feared it. Jonas Salk’s polio vaccine didn’t come into use in the Middle East until the late 1950s. For some reason, both doses were injected into the back (not the buttock or thigh). The prospect made me run off into the garden where I promptly fell on the gravel. The two skinned knees and two grazed elbows actually hurt for longer than the polio jab. I’m pleased to say that the Salk vaccine, followed by Sabin oral vaccine, began the long road towards conquering polio worldwide.

Photo by Martyn E. Jones from FreeImages

According to hieroglyphics and papyruses, bilharzia was known to the Ancient Egyptians. The flatworms that cause the disease are water-borne, with a complicated life cycle that involves freshwater snails as an intermediate host. Bilharzia causes a heavy burden of ill-health, especially for rural children who paddle (and piddle) in the Nile or in one of the many canals. And yet, despite the toll on the population, many people living a comfortable life in Alexandria or Cairo 50 years ago had barely heard of it. The best remedy is prevention with clean water and good hygiene, so the story continues.

***

Although my forthcoming novel The Girls from Alexandria isn’t a book about medicine, you’ll find many aspects of a cosmopolitan world that has long since ceased to exist.

10 Things You Didn’t Know about Hampstead

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I didn’t know half of them myself till recently – and I live in Hampstead. This part of London is full of surprises.

1 Hampstead is chock full of delightful architecture, much of it Georgian, Victorian or Edwardian. Then there’s 2 Willow Road. Designed by architect Ernő Goldfinger in the 1930s, this modernist home was only made possible thanks to his wife’s great wealth.

2 Willow Road NW3

Goldfinger was a champagne socialist, which is why he concealed the servants’ bell. You could say that he wasn’t popular with everyone. Ian Fleming, you may recall, named the ultimate villain after him.

2 Nightclub hostess Ruth Ellis was the last woman to be hanged in the UK. Her crime? Shooting dead her cheating lover David Blakely in 1955 outside the Magdala Tavern. If you wander up South Hill Park in Hampstead, you’ll still be able to see the bullet holes on the wall of the pub, mainly because they’ve been enlarged with a drill.

Magdala Tavern, NW3

For a thought-provoking novel set around the Ruth Ellis story, I can highly recommend Jane Davis’s brand-new book At the Stroke of Nine O’Clock. 

3 The Whitestone Pond at the top of Heath Street is the highest point in London. It’s a man-made pond with ramps to let horses wash in it. A bit later, it was used for floating model boats and for paddling, earning it the name Hampstead-on-Sea. Now fringed with rushes, nobody much goes into the pond at all, but they do wander up here, and probably tell each other it’s the highest point in London.

4 Hampstead Heath covers 790 hilly acres and has something for everyone, with magnificent views over London as well as woodlands and a string of ponds, three of them for swimming (if you don’t mind cold water). The Heath enchanted author C.S. Lewis, inspiring him to write The Lion, the Witch and the Wardrobe. 

Hampstead Heath

5 Fancy a bite to eat? Hampstead has not one Streatery, but two. The Belsize Village Streatery opened for summer 2020 on the paved area of the village to help keep a wide range of local restaurants and cafés running. It brings a continental vibe to this corner of London and is an excellent place to meet friends or celebrate a special occasion. The floor is clean enough to eat off, as the saying goes, but the socially distanced tables and chairs in the square are a better bet.

Belsize Village Streatery

Following on from the success in Belsize Village, there’s also a second Streatery at South End Green.

6 Hampstead is awash with celebs. Do you know Mrs Newbie? She and her cob lived together in bliss on the Heath, until Mr Newbie died in 2016. At some point, the grieving Mrs Newbie flew off and hurt herself on a nearby roof. While at the swan sanctuary for treatment, she met fellow patient Wallace who had come from Waltham Forest. Their relationship blossomed.

pair of swans

Once both of them were well enough, they were released to Hampstead Heath’s Number One Pond and have since raised seven cygnets. Mrs Newbie had to return to the swan sanctuary earlier this year after she was attacked by a dog, but is now back with Wallace and their cygnets. Vive l’amour! 

swan with one cygnet

7 Originally from Suffolk, painter John Constable relocated when his wife developed TB. At the time, the air in Hampstead was considered a lot healthier than elsewhere. Unfortunately there were no anti-TB drugs at the time and Mary didn’t improve. Most of the family is now buried in the family tomb at St John-at-Hampstead.

Constable family tomb

8 The Royal Free Hospital in Pond Street was founded in 1828 to give free treatment to those unable to afford it. To begin with, the Royal Free was in central London, and then moved near the site of the previous Hampstead Fever Hospital, a name which inspired the title of my novel Hampstead Fever.

For years, the Royal Free was the only London teaching hospital in London to train women doctors. The Royal Free’s pioneering heritage continues. It was the first UK hospital to have a high level isolation unit (HLIU) for infectious diseases like Ebola.

Royal Free Hospital

9 Hampstead has cats. Many, many cats. This busy fluffball knows exactly where she is going. You’re lucky the others moved too fast for me to photograph them all.

long-haired Siamese cat

10 You don’t have to go into the Freud Museum to see a fine statue of Sigmund Freud. Here he is outside the Tavistock Clinic in Fitzjohn’s Avenue, leaning forward in a pose suggesting period pain. I call it womb envy.

If you know Hampstead, please leave a comment with your favourite fact about the area. Meanwhile, until September 9, you can download a copy of Hampstead Fever for just 99p/99c. 

 

Janet and John Do Lockdown

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“Gin and tonic?” says John. He points at the clock. “It’s almost six.”

alarm clock

“It’s actually 6am, John,” says Janet. “But make mine a double. We’ll need sustenance to go food shopping.”

When Janet and John get to the supermarket, they find a long queue all round the car park. “Have you seen all these people?” says Janet, fiddling with her mobile.

“I know. This is going to be so boring,” says John.

“You’re telling me. They’re the least Instagrammable people ever.”

“I’m worried about how close some of them are standing,” says John. “That’s much less than two metres apart. More like nine inches, if you ask me.”

“It’s nothing like nine inches, John,” says Janet.

When they get to the entrance, John says, “Where’s the shopping list?”

Janet frowns at him. “You don’t get this lockdown, do you, John? We just buy lots of anything that looks like it’s running low in the shop.”

“Let’s not forget biscuits,” says John.

“I never forget biscuits,” says Janet.

“Or gin,” says John, grabbing two bottles off the shelf.

An hour later, Janet and John are in aisle seven. John is confused about the contents of their trolley. “But you don’t need TENA pads, Janet.”

“I will do by the time we reach the checkout, John.”

They are about to leave the supermarket when Janet shrieks. “Look, John! The food bank donation box has gone!”

“Don’t worry, Janet. I expect we can donate money online.”

“That’s not the point. I was hoping to pick up tinned tomatoes because there aren’t any left on the shelves.”

After they get home, Janet and John wash their hands for 20 seconds and have a nap for two hours.

Janet wakes up with an idea. “Do you fancy a game of Scrabble, John?”

John agrees on one condition. “Only if you promise not to store all the blank tiles and Ss down your bra.”

“But John, stockpiling is what pandemics are all about. If you won’t play properly, then we shall have to sit on our sagging sofa and watch another episode of Poirot instead.”

After three episodes of Poirot, Janet and John are sitting much closer together on their sagging sofa.

“I say, Janet,” says John as he strokes Janet’s rounded belly. “I don’t know how many weeks gone you are, but I’m so looking forward to our baby.”

“Don’t be silly, John. It’s not your baby. It’s McVitie’s.”

***

Don’t be like Janet and John.

With the cancellation of major events such as the London Marathon due to coronavirus, many charities are on the brink of collapse, while at the same time facing increased need for their help. Please give generously where and when you can. If you want to help a hungry family, consider the Trussell Trust which supports a nationwide network of food banks.

Fax for the Memories

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Fax machines were once cutting edge. “I just got a sandwich faxed to my desk!” claimed a colleague in the early 90s.

He wasn’t quite right, as it happens, since only his order was transmitted by fax.

Photo by Griszka Niewiadomski from FreeImages

For those who aren’t sure how a fax works, the gist is that the original document is scanned, converted into a bitmap, then transmitted down a phone line as audio-frequency tones. The receiving fax machine deciphers the tones, recreates the image, and prints it more or less legibly.

Before email, fax was the only way to send a sizeable amount of data quickly without an expensive courier. It made it possible to send letters quickly and, for reporters, to submit articles to newspapers on the day without dictating them to copy-takers.

It also enabled my mother, who lived abroad and had, like most seniors, a keen interest in the weather, to keep me updated without phoning.  I well remember the message in which she said it was SNOWING! (underlined three times). She seemed a bit miffed when I faxed back to ask what she expected from Switzerland in January.

Photo by Martin Wehrle from FreeImages

I also had a relative in the Middle East who liked using fax. She generally rang first to tell me her message was on its way, and her pronunciation was different to most. As my children enjoyed putting it, “Aunt Delia likes sending fux.”

The desktop fax came into existence around 1948, but it wasn’t widely used until the 1970s and 1980s. Some machines used dedicated lines, while others shared with a regular phone by means of a switch which didn’t always work. Well, mine didn’t.

Another snag is that one rarely knew how many pages would come in, so the supply of paper had to be kept topped up. My roll of thermal paper often ran out inconveniently mid-flow, like a loo roll. And the paper, being thermal, was useless for archiving as the print soon faded like a receipt. You’d have to photocopy the image or message to preserve a record.

Photo by Joanna Kopik from FreeImages

Some machines were advanced and did colour, but smaller businesses, like individuals, tended to have basic models and the image definition wasn’t great. When I was arranging the funeral of a cousin, there was a choice of coffins. As it wasn’t clear over the phone how they differed, the undertaker offered to fax over images of each one. This generated a long ribbon of paper with blurred photos that looked identical. Still, I expect the details made little difference to dear cousin Gladys at that stage.

The arrival of email meant the end of the fax for most, but the NHS doggedly continued to favour faxes for important communications such as urgent referrals, citing confidentiality as the reason. Emailing was banned for transmitting patient info – despite the fact that NHSmail is encrypted. Perhaps nobody at the top considered the risk posed by a clutch of paper messages sitting in the out tray of a machine for all to see.

Thus the NHS became the biggest purchaser of fax machines. Some hospitals had over 600 of the things each, and of course GP practices needed them too, using up money that could have found its way into patient care.

Now the NHS has seen the light and the new GP contract decrees that by April 2020 all GP practices should become fax-free. Some already are, but it’s possible that not all practices, or the agencies they deal with, will be prepared to unplug their faxes despite the 17 pages of guidance on the subject. The death throes of the fax, I suspect, could go on for a while.

 

The Most Disgusting Diseases in the World (and how to catch them) – part 3

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If your stomach has now settled post-Christmas, you may be ready for the final instalment of the most disgusting diseases in the world. Those who were born a lot longer ago than yesterday may notice that it’s in the same vein for which the late lamented Punch magazine was known.

Should you fancy a condition that goes the distance, consider keeping a pet worm like dracunculus medinensis, aka the Guinea worm. The best place to pick one up is in Africa with your drinking water. Maintenance is dead easy. There’s no need for an aquarium, hutch, or a garden, as it lives just under the skin.

I remember one patient who had his worm for so long that he named it Ali, which seemed the best bet as he couldn’t tell if it was male or female. Ali kept him company for some time, forming little red bumps all over him, until the day she (as we discovered) tried to escape through a huge blister on his arm.

When the blister finally burst, the little dracunculus poked through. Ali turned out to be several feet long. She had to be wrapped around a stick and pulled out gently to avoid breaking her during her outward journey which took two and a half weeks. Bon voyage, Ali!

You needn’t leave these shores to catch something sensational. Syphilis is all Columbus’s fault since, or so the story goes, his sailors brought it back to Europe in 1493.

An epidemic of syphilis spread from Naples throughout Europe in the 16th century. The English and Italians called it the French disease, the French called it the Neapolitan disease, and pretty well everyone thought of it as the Great Pox because smallpox was small potatoes by comparison.

Syphilis is far more contagious than leprosy, as just a few minutes in a shared bed will do. A bed may even be superfluous. One man, inspired by notices in public WCs, claimed to have caught the infection in the loo. “That’s a filthy place to take a woman,” replied the consultant.

Syphilis can mimic anything from tonsillitis to athlete’s foot. It all depends on the stage of the infection.

Early syphilis can be just a painless ulcer called a chancre (pronounced Shankar, which is most unfair on Ravi and family). A few months later, the secondary stage produces symptoms like fever, headache, general malaise, aches and pains, mouth ulcers, enlarged lymph nodes, and rashes. Of course, that’s pretty much what everyone goes to the GP with.

Late syphilis takes years to develop, and it’s downhill from there. Nerves in the legs no longer transmit signals about position, which is one cause of the stomping gait you can see all over London. It also makes you fall into the handbasin when you close your eyes to wash your face. If very wobbly, you may fall into the toilet unless you’ve closed it.

No account of dreadful diseases would be complete without that scourge of the western world that has medics clamping their hands over their mouths and recoiling in horror. You may not be able to get a hospital referral, or, if you do, you’ll find yourself being bundled out of the clinic as soon as possible, usually while you’re still talking, so that the consulting room can be fumigated forthwith.

They may offer you surgery, but you may not live long enough to get to the top of the waiting list. Should you manage to reach the operating theatre, the procedure is likely to be relegated to the most junior doctor because nobody else wants to do it. Blood and pus often pour out, and the hapless trainee surgeon may throw up as a result. The patient has it relatively easy by now, as the whole gory mess is soon tidy and bandaged.

Unfortunately, this unsavoury condition is on the increase. Experts call it IGTN and claim that it spreads via shoe shops. It will impair games of footsie-footsie. It may even interfere with walking.

Like many disfiguring conditions, IGTN has a long incubation period. As I’d like you all to enjoy a healthy and happy New Year, I believe the public should be told more about this disorder. I particularly look forward to the day when every pair of winkle-pickers carries the government health warning Wearing shoes may cause ingrowing toe-nails.

 

The Most Disgusting Diseases in the World (and How to Catch Them) – part 2

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Following on from part one, and in the same vein for which Punch magazine was known, I bring you four more of the most disgusting diseases in the world.

I had to include acromegaly as the insistence of my son whose interest in endocrinology began at the tender age of four when we were on holiday in Switzerland and happened on a particularly florid case of the condition. By then, the diagnosis could have been made from a cable car 50 metres away (which it was).

“Mummy, why are that man’s hands so big? And why has he got pillows instead of shoes?” He pointed, I told him not to, and so on, until I noticed the man in question who really was sporting pillows strapped to his feet.

I explained about the pituitary gland and growth hormone, and my youngster thereafter abandoned Postman Pat books in favour of the British Medical Journal.

However florid acromegaly may become, the onset is invariably subtle, with coarse skin, greasy hair, an increase in hat size, a little deepening of the yodel, and difficulty making watches or doing up lederhosen. To avoid resembling our Alpine acquaintance, it’s best to seek help while you can still fit into your ski boots.

Even pillows may not be roomy enough if you’re infected with wuchereria bancrofti. Everyone seems to have heard of elephantiasis but there are two important things to note: you don’t catch it from elephants, and it usually begins with just a few enlarged lymph glands on the groin. Walking is therefore still possible, for a while. Swelling sets in later, often only in one leg, and sometimes in the scrotum too, should you possess one.

Eventually the skin develops rough folds and warty outgrowths, and the scrotum, if affected, can hang down to the knees, which poses problems at the tailor’s, and elsewhere. Prevention is key. Use a mosquito net, and avoid falling into Burmese septic tanks if you want to wear both legs of your trousers at the same time.

If you dislike rodents, you’ll hate Lassa fever. Transmitted by rats, it was discovered in the Nigerian village of the same name, which you might like to make a note to avoid on your travels.

After it was first described in 1969, the department of health send circulars so that no GP would miss this diagnosis.  As the years passed, I never saw a case, but the bumph was useful for wobbly dining tables.

Lassa has an insidious onset with symptoms that resemble other conditions, like fever, malaise, a flushed face, red eyes, nausea, and vomiting. Later, the nose, gums, mouth, stomach, and lungs bleed spontaneously – a plague of blood, with a high mortality rate. As I recall, Lassa is similar to other haemorrhagic fevers such as Marburg-Ebola, Green Monkey Disease, and Crimean-haemorrhagic-Congo-Hazara fever, though I’d have to check under the dining table to be sure.

Anyone who’s unconscious when arriving by plane from West Africa runs the risk of his drunken state being mistaken for Lassa fever, with the result that masked attendants whisk him off to a plastic tent in the nearest isolation unit until the tests are back. I need hardly add that the outlook is far worse when Lassa fever is mistaken for excess alcohol.

Next up is typhus, not to be confused with typhoid. Typhus is caused by germs called rickettsiae which breed in the gut of the louse, and spread to humans via louse faeces. Louse bites are itchy, and scratching them rubs infected droppings into the skin.

Weakness is one of the early symptoms, and it all goes downhill from there, eventually, if untreated, leading to multiple organ failure.

As alarming as typhus is, Tsutsugamushi fever (aka scrub typhus) is much more popular with medical students, because it has so many syllables and because it forms a painless but picturesque ulcer covered with a crust. More importantly, unlike other forms of typhus, an attack of Tsutsugamushi gives no immunity against further infection. Medics can therefore imagine repeated episodes of scrub typhus at each outbreak of acne, and some of them have been known to scratch for years after exposure to a single lecture.

In the next instalment of The Most Disgusting Diseases in the World (and How to Catch Them): head, shoulders, knees, and toes.

You may also like to catch up on The Most Disgusting Diseases part one.

The Most Disgusting Diseases in the World (and How to Catch Them) – part 1

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Putting my decades of medical practice to use, I bring you the chance to brush up on all the gruesome diseases you don’t remember, especially if they’re ones you never knew about in the first place.

It’s tongue in cheek, but, if you’re squeamish or easily offended, you may prefer a blog about macramé instead.

Feeling out of sorts lately? If friends think you look tired, colleagues call you burnt out, and Great-Aunt Frieda reckons you need a tonic, better check out your appearance in the bathroom mirror. Are your fancy new glasses slipping down your nose? If so, either you’ve been too busy to pop into Specsavers to get them adjusted, or that jaunt to South America didn’t agree with you.

You may have got New World Leishmaniasis. Don’t let the name fool you. It’s as old as the hills, and it’s still a neglected disease. The parasite finds a sandfly to hang out in, until the sandfly finds you. Within 18 months or so, the bridge of the nose collapses. Leishmaniasis also destroys the mouth and tongue, so that bottle of Gevrey-Chambertin you’ve been saving tastes just like British sherry. Soon, however, you will no longer care.

The cause of all the trouble is the innocent-looking leishmania parasite with a cute little tail. Rather like a spermatozoon, actually. But, unlike pregnancy, leishmaniasis can be avoided by simple measures such as sleeping on the roof. Sandflies can’t fly much higher than three metres. 

What could be worse than leishmaniasis, apart from income tax, baldness, and wheel clamps? It’s the infection so dreadful that doctors often refer to it as Hansen’s disease to avoid inducing panic in the waiting room. The condition starts with a bit of catarrh then progresses to muscle pains, enlarged lymph nodes, and sometimes a patchy rash.  If you’re any kind of hypochondriac at all, you’ll suspect from the very first sneeze that this is leprosy.

Soon you lose a little pigmentation, then a few fingers because they’re numb and you chop them up with the celery. By the time leprosy bacilli gets into their stride, the face is covered in boils and bumps, and friends are apt to be too busy to see you. There may be other complications including inflamed testicles and a spleen the consistency of sago. But enough. More details might be in poor taste.

Leprosy is highly infectious. Or else it isn’t. The experts don’t all agree. If your doctor rushed out of the consulting room, you’ll know which school of thought she favours. One study showed that the only sure way of contracting leprosy is to share a bed for twelve years with a leprosy patient. So there’s really no need to avoid waiting rooms, though you might want to steer clear of lactating ladies with leprosy because they shed the bacilli like there’s no tomorrow.

Actually, there is a tomorrow because leprosy is curable. Too bad that treating an entire village for a month costs nearly as much as a good lunch for four, not including service. 

In the next instalment of The Most Disgusting Diseases in the World (and How to Catch Them), I’ll be talking about conditions affecting hands, feet, and other members.

My earlier version of this series originally appeared in Punch, an iconic magazine that eventually succumbed to circulation problems.

One Year Older, Still Alive and Kicking

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On my birthday just recently, I experienced a disconnect between the joy of being the birthday girl and the reality of being, frankly, older than I’ve ever been before. One day, I’m scoring goals in the back garden. The next thing I know, I sit down with an audible Oof! at every possible opportunity.

If you’re anything like me, you don’t always appreciate how fast things are changing until something pulls you up short. Like the photo that shows how short you are compared with your children. Or a birthday card like this one.

What presents might be heading my way? Another pair of slippers, maybe, or a voucher for Specsavers. Material gifts lose some of their appeal as the years slip by, as does blowing out candles on a birthday cake. I don’t have that kind of puff. Or a fire extinguisher to hand.

But I’m not a grumpy old thing who pads around in her gardening clothes and moans about the passing years. On my birthday I dressed up in my new shoes.

Along with a top from Help the Aged. Don’t tell me the shop is now called Age UK. This purchase goes way back.

I didn’t fancy going out for a celebratory lunch. Not when we have so much in the fridge, and the tarragon on the patio is doing so well this year that it’s a shame not to use it. So risotto it was.

The old joints may be creakier than they were, but I can’t complain. Getting older is a privilege. Give me a head of grey hair and as many laughter lines as Mick Jagger (though, come to think of it, nothing is that funny).

Health problems become more likely as the years pass, but then ill health can strike at any age. Having worked in paediatric rheumatology, I can see just how challenging mobility issues can be at a young age. And of course there are many other conditions that can become limiting.

That’s why I’m delighted to get behind the new campaign from Sport England. It doesn’t have to involve a sport. #WeAreUndefeatable aims to help the two thirds of people with health conditions increase their physical activity in any way they can.

I’d need a really long blog post to cram in all the benefits of moving more. Instead, watch this lot living every moment. The clip lasts just 30 seconds. 

If you have a long-term condition, or know anyone who does, please take a look at some of the inspiration at We Are Undefeatable. 

Happy Birthday to Hope Hospital

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April 5 is the end of the tax year, but, if you’re hoping for a side-splitting post about ISAs and tax returns, you need to look elsewhere. This week it’s a serious message about sick kids.

Just over two years ago, the People’s Convoy set off from London on an overland journey, taking with it supplies to build a new children’s hospital in Syria.

War has devastated Syria

After six years of war – with the deliberate and outrageous targeting of hospitals – the humanitarian situation was dire. There was no children’s hospital left in Eastern Aleppo, leaving about 250,000 people without medical care.

Hope Hospital, enabled by the People’s Convoy and run by the Independent Doctors’ Association, literally rose from the ashes of oblivion. As the world’s first crowdfunded hospital in a war zone, Hope is a triumph of humanity.

It took 8 dedicated organisations, over 5,000 generous people and £246,505 to open Hope Hospital. When the hospital was damaged by a car bomb, it was repaired. And when funding ran low last year, people raised an additional £480,505 to keep the light of Hope on.

Hope Hospital has now provided 98,707 consultations, checked 26,309 children for malnutrition and given specialist treatment to 52,846 children – children like Hanan, shown here.

Young Hanan’s story

Hanan’s mother suffered hugely during Hanan’s birth in October last year, not least because she had to travel for more than 60 km to reach hospital. Then, at 10 days old, Hanan developed a fever which wouldn’t respond to initial treatment.

Dr Hatem, Hope Hospital’s Director and lead paediatrician says, “Hanan came to the hospital suffering from convulsions… A CT scan showed cerebral oedema, which can cause irreversible damage and even death.” 

Thanks to Hope Hospital’s specialist care, Hanan improved enough for her to be discharged, to the great relief of her mother. She needs to continue with treatment and have ongoing hospital check-ups at the hospital, but is expected to make a full recovery.

Thousands of children need medical care

Dr Hatem says, “We receive dozens of cases like Hanan’s monthly. We are so grateful for the unique presence of this free hospital. Despite the dangerous environment, we are able to save the lives of thousands of children annually.”

Friday 5th April will mark two years since Hope Hospital officially opened its doors. To celebrate, CanDo – one of the lead organisations of the crowdfunding campaign – and the Independent Doctors Association of Syria are sending messages of thanks, hope and humanity.

Dr Rola Hallam, co-founder of CanDo who travelled with the People’s Convoy, says, “Hope Hospital is a shining beacon of what we can do when we believe in our shared humanity. The amazing staff there are saving lives every day thanks to people-to-people care, action, and hope.”  

Hope Hospital is a beacon in a dark world

My grandmother’s family was Syrian, and I’m often glad so few of them are left to see what the conflict has done. But, in a war that has been raging for over eight years, has killed hundreds of thousands and displaced over six million people, the story of Hope Hospital is a rare and precious positive. So I thought you’d like to hear this uplifting story.  You can watch a short video celebrating two years of Hope Hospital.

And here’s where to find out more from CanDo. 

You too can send a message

Many happy returns to Hope Hospital. If you too would like to send a personal message for #2yearsofHope, it’s easy to do on this link Happy Birthday to Hope.