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Saving Lives In Slow Motion
Hydration - how to get it right: the life saving power and perils of fluid balance
Hydration is something many of us take for granted but in this episode I bust some myths around hydration, cover why it is important to give it some thought and why urine colour is not the best measure of how hydrated we are.
Too much vs too little: https://www.instagram.com/drayanpanja/p/C16g1vfI3ZP/
BUY THE HEALTH FIX NOW: https://www.amazon.co.uk/Health-Fix-Transform-Your-Weeks/dp/1914239296/ref=nodl_?dplnkId=1ba53367-030f-4f3f-ad09-4a1fc81eadf5
Plethysmography: https://www.healthline.com/health/plethysmography
Water intoxication: https://my.clevelandclinic.org/health/diseases/water-intoxication
Diarrhoeal disease and oral rehydration therapy (ORT): https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease
ORT: https://ourworldindata.org/oral-rehydration-therapy
8 glasses of water a day?: https://www.bbc.co.uk/news/uk-scotland-north-east-orkney-shetland-63755475#
Overhydration dangers: https://www.healthline.com/health/overhydration
Delirium: https://www.mayoclinic.org/diseases-conditions/delirium/symptoms-causes/syc-20371386
What hydrates us: https://www.webmd.com/parenting/features/healthy-beverages
Excessive thirst: https://www.nhs.uk/conditions/thirst/
Tap water: https://www.independent.co.uk/life-style/tap-water-uk-safe-to-drink-b2600254.html
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184. My doctor or any doctor? How continuity of care could save your life
17:14||Season 1, Ep. 184Continuity of care saves lives. There is evidence that outcomes are improved and itused to be a core part of medicine. In recent years for many reasons continuity has been slightly eroded. In this episode I make the case for it and give examples of why it can beof critical importance.Links:Please help me improve my content for you by taking this audience survey which takes 10 minutes:http://bit.ly/savinglivesinslowmotion-surveyStudy on continuity and outcomes: https://bjgp.org/content/72/715/e84How seeing the same doctor has changed in the UK: https://www.bmj.com/content/389/bmj.r833Patient examples of the benefits: https://www.nuffieldtrust.org.uk/news-item/the-importance-of-continuity-four-personal-viewpoints183. Polycystic Ovary Syndrome (PCOS)
15:14||Season 1, Ep. 183PCOS is a growing global issue. Its prevalence has increased in recent years and the reasons behind it are complex.In this episode I look at its roots, causes and impact plus what we can do about it in terms of lifestyle and treatments.Links: Depression and PCOS: https://pmc.ncbi.nlm.nih.gov/articles/PMC10607337/LH (luteinziing hormone): https://my.clevelandclinic.org/health/body/22255-luteinizing-hormoneLH:FSH ratio in PCOS: https://gpnotebook.com/en-GB/pages/gynaecology/polycystic-ovarian-syndrome-hormonal-measurements-inPancreatic function in PCOS: https://pmc.ncbi.nlm.nih.gov/articles/PMC9962893/The gut microbiome and PCOS: https://pmc.ncbi.nlm.nih.gov/articles/PMC9998696/The steroid synthesis pathway starting with cholesterol: https://www.researchgate.net/figure/Biosynthesis-of-steroid-hormones-from-the-cholesterol-pathway_fig1_258055538Angelique Panagos book on hormonal balance: https://www.amazon.co.uk/Balance-Plan-Optimize-Hormonal-Health/dp/1844039447182. Metabolic Health - what it is and why it is so important
15:42||Season 1, Ep. 182In this episode I look at metabolic health which is one of the most important aspects of our long term health. I look at the mechanisms and measures of metabolic health and what we can do to improve ours.Continuous Glucose Monitoring: https://my.clevelandclinic.org/health/articles/continuous-glucose-monitoring-cgmHba1c: https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/hba1c#American metabolic health stats: https://www.liebertpub.com/doi/10.1089/met.2018.0105High fructose corn syrup; https://www.healthline.com/nutrition/why-high-fructose-corn-syrup-is-badFibre in your diet: https://www.healthline.com/nutrition/why-is-fiber-good-for-youExercise and metabolic health: https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2024.1365761/fullMetabolic health and Alzheimer's risk: https://pmc.ncbi.nlm.nih.gov/articles/PMC10001958/Non-communicable diseases: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases181. 5 top tips for gut health (and they’re not what you might think)
14:53||Season 1, Ep. 181In this episode I cover my own personal tips from the view point of a GP and lifestyle medicine doctor. Gut symptoms Around 86% of us in the UK have experienced gut symptoms at some point. My tips are simple, for everyone and hopefully make sense.Parasympathetic drive for digestion: https://www.livescience.com/parasympathetic-nervous-system-rest-and-digestDigestive enzymes: https://www.webmd.com/diet/what-are-digestive-enzymesBlue Zones eating habits: https://www.bluezones.com/2020/07/blue-zones-diet-food-secrets-of-the-worlds-longest-lived-people/Mediterranean Diet: https://my.clevelandclinic.org/health/articles/16037-mediterranean-dietLate night eating: https://hms.harvard.edu/news/late-night-eating-impactTime restricted eating: https://www.healthline.com/nutrition/time-restricted-eatingIleo-caecal valve issues: https://www.carygastro.com/blog/what-are-the-symptoms-of-a-faulty-ileocecal-valveHydration and the gut (an academic paper): https://www.sciencedirect.com/science/article/pii/S2589004224011258Buy my book The Health Fix now: https://www.amazon.co.uk/Health-Fix-Dr-Ayan-Panja/dp/1914239326/ref=tmm_pap_swatch_0180. Inflammation - the ‘fire’ within that leads to chronic disease and how we can manage it
14:43||Season 1, Ep. 180Chronic inflammation is a key process which is linked to almost all non-communicable disease. In this episode I look at how it arises and why it is so harmful.Links: Age-related end glycation products: https://www.healthline.com/nutrition/advanced-glycation-end-products#what-they-are'Leaky gut’ syndrome: https://pmc.ncbi.nlm.nih.gov/articles/PMC8305009/Depression as an inflammatory condition: https://www.sciencedirect.com/science/article/pii/S1043661824002676Probitoics after antibiotics?: https://www.bbc.com/future/article/20190124-is-it-worth-taking-probiotics-after-antibioticsDiabetes and inflammation: https://www.webmd.com/diabetes/inflammation-and-diabetesInflammation from toxins (metals and brain inflammation): https://www.sciencedirect.com/science/article/abs/pii/S2468202021000127Anti-inflammatory diet: https://www.hopkinsmedicine.org/health/wellness-and-prevention/anti-inflammatory-dietFibre: https://dremilyleeming.substack.com/p/is-fibre-the-missing-link-to-trueOmega-3 and inflammation: https://pubmed.ncbi.nlm.nih.gov/37606147/179. Psychiatry and Surgery - essential specialties which may appear worlds apart but in some ways are similar and deserve more recognition.
16:18||Season 1, Ep. 179What do surgery and psychiatry have in common? They are both demanding specialties, occasionally of last resort, that save lives acutely and help people back to better health.LinksAntipsychotic drug discovery: https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2022.903156/fullPyrrole Disorder: https://www.healthline.com/health/pyrrole-disorder#diagnosisRationing in the NHS: https://www.kingsfund.org.uk/insight-and-analysis/blogs/nhs-rationing-under-the-radarAn example of risks vs benefit in surgery: https://www.neurosurgeonsofnewjersey.com/blog/spinal-fusion-surgery-risks/178. The Vagus Nerve - what’s all the fuss about and could it be the key to battling chronic disease?
15:44||Season 1, Ep. 178There are so many posts, papers and publications about the vagus nerve.In this episode I look at why it’s so popular and whether it really can be a key to future treatments with advances vagus nerve stimulation.Links: Quick overview: https://www.mayoclinic.org/tests-procedures/vagus-nerve-stimulation/about/pac-20384565Polyvagal Theory: https://www.polyvagalinstitute.org/whatispolyvagaltheoryThe Great Nerve: https://www.amazon.co.uk/Great-Nerve-Science-Harness-Reflexes/dp/059371699XResearch on the vagus and rheumatoid arthritis: https://pubmed.ncbi.nlm.nih.gov/27382171/Ear stimulation: https://medicine.ouhsc.edu/news/article/ear-clip-stimulation-of-vagus-nerve-shows-promise-as-pots-treatment-according-to-ou-college-of-medicine-studyVasovagal attacks: https://my.clevelandclinic.org/health/diseases/23325-vasovagal-syncopeCrohn’s Disease and vagus nerve stimulation: https://pubmed.ncbi.nlm.nih.gov/32515156/Vagus nerver and inflammation: https://bioelecmed.biomedcentral.com/articles/10.1186/s42234-022-00100-3177. Curious cases and mystery symptoms - a swollen knee, pins and needles, an unexplained allergy and the enlarged liver.
16:02||Season 1, Ep. 177Medicine is an inexact science. My patients who are engineers find it frustrating that there is so much conjecture and educated guess work in medicine. But this episode highlights why diagnoses can take time. It’s a mix of detective work, bias and listening to the patient story.Links:Chilblains: https://www.mayoclinic.org/diseases-conditions/chilblains/diagnosis-treatment/drc-20351103STI and painful knee: https://www.medicalnewstoday.com/articles/gonococcal-arthritisCarpal tunnel syndrome: https://orthoinfo.aaos.org/en/diseases--conditions/carpal-tunnel-syndrome/Psychodermatology (the mind-skin link): https://www.psychodermatology.co.uk/Liver inflammation and glandular fever: https://www.healthline.com/health/mono-hepatitis176. Collapses, faints, fits and dizziness - a quick 101
18:02||Season 1, Ep. 176Not a week goes by in practice where I don’t see a patient who hasn’t collapsed or had a dizzy spell.There are so many reasons for this, some preventable, some not. I look at some of the syndromes that lead to these issues.Links:Fainting: https://www.healthline.com/health/fainting#causesPseudoseizures (non-eplieptic seizures): https://my.clevelandclinic.org/health/diseases/24517-psychogenic-nonepileptic-seizure-pnesAbsence seizures: https://www.mayoclinic.org/diseases-conditions/petit-mal-seizure/symptoms-causes/syc-20359683Epilepsy and driving: https://www.gov.uk/epilepsy-and-drivingBPPV (a type of vertigo): https://my.clevelandclinic.org/health/diseases/11858-benign-paroxysmal-positional-vertigo-bppvPatient perspective of Mal de Debarquement syndrome: https://www.rarediseaseday.org/heroes/a-uk-patient-perspective-on-mal-de-debarquement-syndrome/Heartblock: https://www.nhs.uk/conditions/heart-block/Gluten ataxia: https://www.medicalnewstoday.com/articles/320730Proprioception: https://my.clevelandclinic.org/health/articles/proprioception