Saving Lives In Slow Motion

Continuity 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-viewpoints

PCOS 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/1844039447

In 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-diseases

In 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_0

Chronic 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/

What 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/

There 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/s42234-022-00100-3

Medicine 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-hepatitis

Not 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