Raising Awareness of Cauda Equina Syndrome

Raising Awareness of Cauda Equina Syndrome!

As some of our readers will know one of the objectives of Patient Talk is to raise awareness of the less well known medical conditions.

Today we would like to take a look at Cauda Equina Syndrome with this excellent infographic.

We have cover some of the territory in a previous blog post here on Sciatica.

Raising Awareness of Cauda Equina Syndrome

From Visually.

Vision for Zambia – how you can help children in Africa see again this holiday season.

Orbis, the sight-saving charity that transforms lives by preventing and treating avoidable blindness and visual impairment, is appealing for support. For the next two months, the UK government will be doubling all public donations made to their Vision for Zambia appeal, helping the charity prevent blindness in twice as many children.

Orbis - Vision for Zambia
Orbis – Vision for Zambia
Ophthalmic Nurse, Ann-Marie Ablett (interviewed below) , is the winner of the Royal College of Nursing in Wales 2014 Humanitarian Relief Award, which recognises her amazing contribution and commitment to improving health services in areas of need around the world. She has volunteered with Orbis since 2003, using her annual leave to take part in 29 training programmes, including 7 in Zambia, sharing her skills with nurses and treating over 1000 patients.

Zambian children are four times more likely to suffer from blinding conditions, such as cataract, than those in countries such as the UK. Here the condition is thankfully rare, affecting 3 out of every 10,000. It has one of the highest rates of paediatric blindness globally however there are few ophthalmologists – 15 vs 3,000 here in the UK, and only one paediatric ophthalmologist in the entire country.

With the right access to treatment, half of paediatric vision loss can be avoided or cured. Orbis relies on its amazing medical volunteers, like Ann-Marie, to train eye care specialists, including nurses, surgeons and anaesthetists, who transform lives. Ninety percent of blind children do not attending school and 60% of die within a year of becoming blind; this appeal can make a real difference.

In order to save the sight of over 105,000 children, Vision for Zambia will raise funds to improve outreach work and train over 750 eye care professionals, including nurses. The UK public can help save a child’s sight for free – when they visit www.visionforzambia.org and sign up to find out more, a generous supporter will give £1. Until the 3rd February the UK government is matching all donations, so this simple act will generate £2.

Patient Talk – Who is Orbis and what do they do?

Ann-Marie Ablett – Orbis is a an eye charity focusing on blindness in developing countries, we focus on particularly on children, 90% of children in Zambia do not attend schools so that means there is no door open for them for the future and also shockingly 60% of children die within a year of becoming blind, that’s 3 in every 5 children because they haven’t had the opportunity or the means where they can be screened for avoidable or untreatable blindness.

Patient Talk – Ok and what does the training consist of?

Ann-Marie Ablett – Well we have Doctors, Nurses and biomedical engineers so my role as a volunteer nurse is I will work very closely with the local nurses, I will scrub with them and go through the practises and the principles of safe side surgery, reducing the risk of infection and the easiest way to do that is to make sure you wish your hands properly, there is a specific way when you are scrubbing for cases and so we are there to expose the patient to best practise and we teach the nursing staff because once we go in the door that’s all they say is ‘ help me, please help me to learn ‘ so that they can support their patients and help them to lead a productive life.

Patient Talk – Ok and can you tell us a bit more about the Vision for Zambia campaign?

Ann-Marie Ablett – It’s focusing on Vision for Zambia , focusing on screening and treating up to a 100,000 patients and we are going to do that by working in out of reach areas, we have already been working in Zambia since 2011 and now what we need to do to reach out to reach the patients in outreach areas is to train primary nurses so that they are in a position where they can focus and have a look at the patients eye and determine how early the treatment is required because the earlier you treat the condition, such as cataracts, the sooner the patients vision will be restored. The great thing about this appeal is the UK government is matching the donations which we will have from the public.

Patient Talk – What does being a volunteer involve?

Ann-Marie Ablett – Well it’s one of the easiest things that I have ever done, so what we do is work closely with the nurse, we will present the speciality they have us for ahead of time so that they can learn how to treat the patient so that they can teach their colleagues who are looking after the patients on the wards, so to do that they have got to have an understanding of the problem and the possible complications, nothing is 100% guaranteed and there is always a possibility of a complication so if they know what to look for they can then tell the patient like in cataracts surgery a pain that is not controlled by pain killers than that’s an indication that you need to contact the surgeon.

Patient Talk – Ok who should become a volunteer and how would someone apply to do the types of things that you do?

Ann-Marie Ablett – Well the easiest thing to do is ring up Orbis it’s the most amazing charity, it’s very supportive and I am lucky enough to go to all those countries where the need is greatest, 60% of children die within 1 year of becoming blind and that’s 3 out of 5 children so if you have the opportunity to go there and work with the local nurses to prevent that you would certainly take it up and once you go once you are going to be addicted as I have been addicted for 13 years now and I carry on going so if you were to contact Orbis.org.uk they will take it further and before you know where you are you will be on the plane to an interesting developing country and meeting new colleagues.

Patient Talk – Ok and I just wanted to ask, why did you volunteer?

Ann-Marie Ablett – There are 2 doctors at the hospital who volunteered at Orbis and I asked if I can go and they said ‘no orbis has got their own personal staff ‘ so I wasn’t going to take no for an answer so with further investigation and a bit of determination I found myself going to Zambia And once I got there I realised my practises were no different, we go there to exchange our skills and knowledge and the reception we had from the nurses, really nurses are nurses the world over and all we want to do is care for our patients but I would like to say that once you do it once you won’t ever want to stop just if you don’t do it it’s as though there is a piece if the jigsaw missing and to complete that part of your life you have to go and do something, it’s very addictive.

Patient Talk – Well I was going to say, what is the best thing you have got out of the experience?

Ann-Marie Ablett – Well the opportunity to change the lives of children and their family as well as to do the job I do and exchange the information I have got to make sure my skills are up to date and evidence based but when you think that just by going there for a week or maybe two week you can change the life of the patient and their family and the community, it’s such a warm feeling that you can’t get anywhere else, you can’t buy it and its really quite a selfish feeling because when you go home you think I did something that not many are doing, how lucky am I but then that’s because I work with Orbis and that focuses on education so it boils down to education.

Patient Talk – Ok and what other resources are out there for patients and for people who wish to donate?

Ann-Marie Ablett– Well if they sign up to VisionforZambia.org then we will receive a £1 from generous donors and that will be matched by the UK government so please just sign up to that.

Patient Talk – Ok thank you very much Ann-Marie.

Ann-Marie Ablett – Thank you.

Green-lipped Mussel Extract = Could this be a treatment for arthritis?

Given our ageing population, osteoarthritis is the most common arthritic disorder affecting the greatest number of people in the UK with more than eight million people estimated to be affected.

Green Lippled Mussels - a treatment for arthritis?
Green Lippled Mussels – a treatment for arthritis?

A couple of weeks ago I received a press release which, I have to say, bowled me a googly, but which did deserve a bit more investigation. Simply put the press release (which I have pretty much reproduced verbatim below) suggested that green-lipped mussel extract (GLME) can be used as a treatment for arthritis.

They very kindly gave me the opportunity to interview John Croft, a New Zealand marine scientist and one of the world’s leading experts on the life cycle of the green lipped mussel who have written extensively on GLME as a treatment for arthritis.

You can read my interview below as well.

Now I have no idea how well GLME works so if you have used it to treat arthritis then it would be great if you shared your story in the comments section below.

Arthritic disorders are one of the most significant causes of debilitating mobility and pain problems. Thanks very much.

So first up the PR story.

The number of people who have arthritis is thought to have risen four fold over 50 years and by 2030, it is estimated that 67 million adults will have doctor diagnosed arthritis with 37% of those estimated to report arthritis related activity limitations.

20% of adults in the UK consult their GP each year with a musculoskeletal problem accounting for one in six consultations, 8.8 million physiotherapy consultations and over 3.5 million calls per year to emergency services. The demands on the NHS are already considerable with experts predicting an unsustainable weight in years to come.

There are now more people over 60 years of age than there are children under five. Ensuring a quality of life for an ageing population is key. Prevention or cure for joint degeneration is not possible however, in many cases the progression can be slowed down. Knowing what treatments are best to take to maintain a lifestyle is well debated especially with some pain relieving products causing stomach discomfort and other side effects for a number of people that take them.

One such alternative which has been extensively researched is green-lipped mussel extract (GLME) which is the basis for a new book by renowned marine scientist, John Croft. John’s review, ‘Arthritis and Aging, Solutions from the Sea’ explores more than 40 years of international research into the use of marine based compounds in human and animal health. The findings within John’s review have particular relevance for sufferers of chronic rheumatoid arthritis, osteoarthritis and age-related degenerative disease.

John’s published review has indicated that the specific nature of GLME – known as Seatone in the UK – may help inhibit age related joint degeneration and may help reduce inflammation, pain and joint immobility caused by arthritic disorders.

Osteoarthritis isn’t just an age-related condition however and can also affect people with physically demanding lifestyles.

Joining Croft for the interview was Dr Chris Steele from ITV’s This Morning.

PATIENT TALK: Dr Chris first, what exactly is arthritis and what are the symptoms?

Steele – Arthritis is basically in an inflammation of a joint, and most of us will know somebody with arthritis – normally osteoarthritis – which is the most common form of arthritis. Osteoarthritis is a condition of wear and tear and inflammation in the joint that comes on over time and is more common in people over 55.

PATIENT TALK – What is the difference between as osteoarthritis and rheumatoid arthritis, and other forms such as gout?

Steele – Well there are many different types of arthritis, and it does get complicated.

Rheumatoid arthritis is a different type of disease process altogether. It’s not the wear and tear of osteoarthritis but a condition known as an autoimmune disease where the body attacks its own tissue – and we are not sure why. It tends to affect the joints of the fingers , wrist and the toes. Interestingly it tends to affect both sides. It is symmetrical and women are more affected than men. It also comes on in a younger age group, so 20 – 50 years of age.

PATIENT TALK – Is fibromyalgia a form of arthritis?

Steele – Myalgia means pain in the muscles, and fibro refers to fibres: tissues, tendons, ligaments etc. So with fibromyalgia you have got the inflammation or tenderness of muscles, tendons and ligaments which can cause acute tender spots, specific spots all over the body. It can cause fatigue, sleep disturbance and is one of those conditions for which there is no test: they can’t test you and say, ‘yes, the test is positive – you’ve got fibromyalgia’. But a lot of people suffer the symptoms of fibromyalgia.

PATIENT TALK – And what are the typical treatments for arthritis at the moment?

Steele – Well, basically if you have “twinges in your hinges”, pain in your knees and joints, and are over 55 years old, you will just try and help yourself – take some painkillers or stronger anti- inflammatory tablets you can get over the counter.

If you are not getting much response then you should probably be going to see your G.P who can give you something stronger or maybe a different type of medication, maybe get some physiotherapy booked for you and then see how it goes. But alongside all of this, a lot of people will look for alternative or complementary therapy even before they get to the G.P by just trying to help themselves.

PATIENT TALK – John, tell us about your research into arthritis and the possible benefits of this substance called ‘Green Lipped Mussel Extract?’

Croft – This dates back to 1972 in New Zealand. It was there that we learned that the green lipped mussel had anti- inflammatory properties and so we began the research with the University of Auckland and the department of medicine there.

They were able to make a powder from the extract which actually did work and helped both human and animal subjects. It has been in clinical trials in several countries. My contribution has also been on the laboratory side, finding out precisely how it works , what it does to help alleviate the symptoms of arthritic disorder, and now also with age-related joint degeneration.

PATIENT TALK – Can you tell us a little bit more about how you think it works?

Croft – What we now know is that has range of anti-inflammatory properties, the main one is due to carbohydrate component in the muscles which inhibits the immune cells, the white cells, in the blood stream from escaping, being over-excited, out of balance and attacking our own tissues, attacking good cells instead of just antigens.

The green mussel extract also contains omega 3 fatty acids naturally, which inhibit the components that actually cause the degeneration of cartilage in the joint.

PATIENT TALK – How long do you have to take it for before it starts to work?

Croft – For most people it takes 4 – 6 weeks for it to start working, slowly and progressively. The maximum time would be 12 weeks. If it hasn’t worked for someone in 12 weeks-time, well then it’s probably not suitable for that person.

PATIENT TALK – And have you taken this yourself?

Croft – I have taken it for the last 16 years because of my age, I’ve never had arthritis but I’ve now got age-related joint degeneration simply by growing old and I’m fully fit, I’m fully mobile and pain free, I’m grateful to say.

PATIENT TALK – What are the cost implications? Is this potentially an expensive treatment, or is it something that could be made available on the NHS?

Croft: I have no idea what it costs in the UK. I know what it costs in New Zealand, and it doesn’t seem expensive to me. I do know that you cannot get it on prescription. It is not a prescription item, but doctors can actually ask people or suggest that people try it.

PATIENT TALK – Would it also help with fibromyalgia and rheumatoid arthritis?

Croft: For rheumatoid arthritis, the anti-inflammatory compound in it can help there with chronic rheumatoid, not acute. With fibromyalgia, I can’t really comment as we have never looked at that disorder.

PATIENT TALK – Thank you both very much.