health

PC 461 Bumped into Sami

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There’s been so much to write about from our time in Singapore, Australia and New Zealand that I wondered whether I should pause this week and scribble about something else. Coincidentally I bumped into Sami outside Gail’s at the bottom of George Street here in central Hove the other afternoon, so we popped in for a small cake and a coffee; walking to The Hope Café would take too long!

Luana, a Brazilian living in Hove, was not on shift; they have a high turnover of staff and I don’t recognise anyone, then the local manager Steve comes down from upstairs. It’s quieter on the first floor so we go up there!

Sami starts the chit-chat.

“Good to get a fresh perspective on life through travelling, isn’t it? I know I certainly do and you know what, people moan about the state of the United Kingdom, but every country has issues, often exactly the same as ours!”.

“You’re right, Sami. Talking to a relative who works in the health care system in Rotorua in New Zealand, about the crisis in the young and their ‘mental health’, she says it’s exactly the same there. Most have been allowed to opt out of working, whereas they should be encouraged to opt in! Whilst I was in New Zealand I read of the very interesting developments here with regard to the use of weight-loss drugs to combat obesity.”

“You thinking of our gallant Secretary of State for Health and Social Care, Wes Streeting?”

“Indeed. He wants to make these weight-loss drugs more freely available through the NHS. Personally, I think this is absolutely the wrong approach to tackling the country’s fat-verging-on-obesity crisis. Then I read Emma Duncan’s column in The Times ‘The UK’s Addiction to State benefits can be broken’. Think she’s bang on when she writes: “Although genes play a role, the primary determinants of obesity are what you eat, how much you eat and how much you exercise. Obesity is thus largely a matter of personal choice. Unfortunately, the government is reluctant to conduct a campaign like the one on the dangers of smoking, because it fears that fat people would be offended by the implication that they are responsible for their excess weight.” And you’ve heard my views before. Unless you are force-fed, you alone are responsible for putting food into your mouth!”

“I saw this the other morning in an NHS hospital waiting room; the left hand one stopped me in my tracks! Sign of the times huh!”

“OMG! No way?”

“Ah! Yes! ‘Personal Choice’. Isn’t that the one of the very basic differences between socialism and conservatism? Socialism regards people as the victims of impersonal economic forces. Conservatism sees them as individuals in charge of their own destiny. Labour voters are much likelier to believe that “people’s success in life depends mostly on factors beyond their control”; Conservatives that it is the consequence of “their own merit and efforts”. Then we have this ridiculous nonsense about ‘mental health’. Because political parties need voters’ approval, they are unwilling to tell people uncomfortable truths — such as that feeling anxious and stressed is a normal part of working life! Have you written any letters to The Times recently Richard?”

“Funnily enough …… being married to a Brazilian encourages me to keep up-to-date about their macro issues, like the trial of ex-President Bolsonaro. I read this in The Times on the 12th September: “Bolsonaro will not be jailed immediately. He will remain under house arrest at his apartment within a gated compound in the capital, Brasilia. ­According to Brazilian law, a full appeal against the conviction is not possible because only one judge disagreed with the unanimous decision.”

“And you immediately thought it wasn’t a unanimous decision if one judge disagreed?”

“Exactly! Sadly, The Times didn’t publish my short letter. Then I realised that when you pronounce ‘unanimous’, it starts with a ‘you’ sound, whereas for instance ‘unambiguous’ starts with a ‘un’ sound. This is the English language, in all its complexity of pronunciation; then I thought of usual (you!) or unusual (un). Fascinating!”

“Whatever floats your boat!”

“Incidentally, Sami, do you have a will, outlining what should happen to your assets when you die?”

“Oh! Yes. Doesn’t take long and it makes sense, helping your executor sort out your estate. Why do you ask?”

“Families become complicated sometimes. We know of someone who settled in another country and told their father they didn’t want any share in his estate. For whatever reason, he either didn’t believe them, wanted to show his generosity, however misplaced, or didn’t make a will. Now they are continually being drawn back to sort out some legal tangle. There’s a lesson here; a will makes matters easier for those you leave behind.”

“Richard, have been meaning to ask you; when did you I start adding the geographic location of where your postcards are sent from, which, if it’s one about travel, maybe completely different?”

“I guess trying to be accurate! In years gone by I remember buying postcards abroad and, if the shop didn’t have sell stamps, forget to buy them somewhere else. I would find them in my suitcase when I got home and post them using a British stamp. Then I wondered what the recipient would have preferred, the photograph showing some exotic location, the foreign stamp or the simple message ‘thinking of you/wish you were here’.

“You still obsessed with your hot yoga?”

“Actually, I am and it’s one obsession I am happy to be controlled by. Great for staying reasonably fit, good for its mental challenge and I need a regular routine. On Friday it’s something of a milestone; it’ll be my 4000th session. I started in March 2009 so have averaged 250 per year for 16 years! Never too late, never too old to start; you thinking of joining Celina and me, Sami?”

“Er! Got to go, Richard. Good to see you and we’ll get together in The Hope Café shortly.”

And off he went, down the stairs, muttering to himself …. ‘If he thinks I’m going to ……’ then he was out of earshot!

Richard 17th October 2025

Hove

http://www.postcardscribbles.co.uk

PS I have an Excel spreadsheet that tracks my sessions …..

20096520163162023174
201022220171802024144
201133920183132025124
20123432019287
20132492020288
20142702021218
20152792022189

PC 457 Low Level Health Care in the United Kingdom

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(Following on from PC 456; I was talking to Lisa in the Hope Café)

“Earlier this year I recognised that my ‘gut health’ was in a poor state following three general anaesthetics in 14 months, so started taking a probiotic, Symprove, one recommended by a dietician/nutritionist called Caroline Laidlaw.”

“Surely you can just eat more fermented fruit and vegetables and drink Kombucha. Isn’t that the same?”

“Possibly!! According to the various health bibles, ‘you can support your gut health by eating a diverse, fibre-rich diet, managing stress, prioritising sleep, exercising regularly and staying hydrated, while also limiting processed foods, sugar and excessive alcohol.’ I wish! Anyway, I decided to follow Caroline’s advice and sense a big improvement. Sadly the ‘original’ flavoured liquid tasted like cat’s piss, so now I’ve opted for the Strawberry & Raspberry flavour.

“Cat’s piss? How would you know what that tastes like? Actually don’t answer that!”

“We use ‘piss’ in a variety of ways. There’s ‘weak beer’s the colour of piss’ and then ‘he’s pissed’, in informal English suggesting someone’s angry and annoyed, a contraction of ‘pissed off’. Confusingly ‘he’s pissed’ might also mean ‘he’s drunk’, probably because one’s subsequent actions may piss off those around you.” 

“Come on Richard. Forget about gut health for a moment, I need you to concentrate on GPs etcetera. Having done lots of research already I suspect that low level healthcare provision in the United Kingdom is not in a good shape.”

“Well, I looked at my own, Trinity Medical Centre, the one I am registered with in Hove.”

“Ah! I am just up the road with Charter. And ……”

“According to their website, they have eight doctors who are partners and eight who are salaried general practitioners, but not all the doctors spend five days a week in the practice, carrying out other roles within the NHS, committee work, training research etc.”

There’s a certain symmetry in having a medical centre in a decommissioned church!

“So, 16 doctors in total. The World Health Organization norm is one doctor for 1000 patients. Here in the UK the average is some 2250, an increase of 17% in ten years. ….”

“That’s a huge increase!”

“My doctor at Charter says they plan on some 8-12 minutes per patient ….. and you can only present one issue!”

“Trinity has, according to their website, about 24,000 registered patients. GP Surgeries are paid £136 per patient per year for the Practice’s operational costs, including heating, staff wages and administration. There are separate funds for specific patient care services such as specialist referrals or prescription drugs. Twenty-four thousand registered patients give them an income of £3,264,000. One of the doctors told me that unscrupulous practices just sign up as many individuals as possible, giving them more revenue and making that patient/doctor ratio unworkable.

“You know that one in seven GP Practices have closed since 2018? There are now 6,229 active practices in England, down 14 per cent on seven years ago. Just at a time when there are additional 5 million individuals registered”

“I had an interested comment from one of the GPs at Trinity. Some years ago, very few patients needing to see a doctor were in the 18-50 age bracket, so a practice could cope with a large number of registered individuals. Today everyone clamours to see a doctor – especially the ‘worried well’ and the anxious Millennials and Generation Z; and they want to be seen ….. now!”

“I assume that, when they can’t get an appointment, in frustration they head to the private practices, of which there are more and more.”

“Well I have certainly done that …….”

“I’ve got this note: The Royal College of General Practitioners’ plan ‘Fit For the Future’ urges new investment and retention measures, warning of a mass exodus of nearly 19000 GPs in the next five years.”

“That’s interesting; I have first-hand knowledge of this. I asked a couple of GPs, actually friends, actually a couple, how they were. “We are in the process of moving out of NHS general practice in the main due to the issues outlined in the RCGP’s ‘Fit for The Future’ plan. We as a bunch are highly resilient, committed and actively excited by the ability to change, to suit our patients’ needs, but the clunky system is no longer able to deliver this and we are fatigued. For a long time we’ve been squeezed financially and our newly qualified GPs don’t have job prospects. And those of us with experience have to work longer hours to earn the same pay, as our practices are aware they can employ someone willing to earn less because there is such demand. Morale is low! All a bit gloomy I’m afraid! But we are fine!” This really annoys me! On the one hand we have a high wastage rate of skilled individuals, on the other the Department of Health and Social Care saying: “GPs are front of centre of the Ten-Year Health Plan ……..  that’s why they will benefit from an increasing proportion of NHS funds, and we’ve already made great progress, including recruiting over 2,000 extra GPs in a year”.

“Wouldn’t it be better to try and reduce the wastage rate? I was told about 30% of trained doctors leave within five years. This seems such a waste of time, talent and experience.”

“My daughter says it’s the same, the wastage rate, in the teaching profession. Maybe it would be possible to work on some retention scheme ….. or improve the working conditions. No business would accept this loss of skill; they would start looking as to why it was happening and how to lessen the wastage.”

“Richard this has been really useful and I’ve probably got enough copy for my article. Thank you!”

“No problem. Before you go …… we were talking about cat’s piss ….. in Estoril, Portugal Celina feeds a black cat that lives on the street and has also made friends with Mirela Gatos (Note 1), a Romanian who looks after dozens of strays down on the promenade.

Celina and Mirela

“Ah! We always need examples of good deeds. Enjoy Singapore, Perth and New Zealand.”

“Thank you. We will.”

Richard 19th September 2025

Perth Australia

www.postcardscribbles.co.uk

PS The provision of both good health care and education are the bedrocks of a mature society.

Note 1 ‘Gatos’ is Portuguese for Cat!

PC 443 ‘ere in the ‘ope!

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PC 443 ‘ere in the ‘ope!

Almost a month has gone by since I was last in the Hope Café and it was good to be back in its familiar surroundings. As I was getting a double espresso I put a little card on the counter, with Josh’s permission of course! It read:

‘If you have a favourite quote about the ear, would you come across and tell me? Richard’

I have scribbled about teeth (see PCs 64 & 66 Molars and Wisdom March 2016) and eyes (see PC 94 Sight and Eyes April 2017) but not, surprisingly, about one’s ears. So why now, I sense you ask. After my food poisoning and virus infection, I managed to develop an inner ear problem which affected my balance big time.

The diagnosis is Benign Paroxysmal Positional Vertigo (BPPV – see note 1), which causes short periods of intense dizziness or vertigo when the head is moved in certain directions. It’s thought to be caused by tiny solid fragments in the inner ear labyrinth. Who knew?

So a quick revision. The ear:

The inner ear includes the cochlea, responsible for one’s hearing, and those ‘semi-circular canals’. These are small shell-like structures containing narrow fluid-filled channels called the labyrinth. They sit in the three planes, two horizontal and one vertical. Just like in a gyroscope, small movements send signals to the brain, essentially telling it which way is up!

“In your shell-like ear – having a quiet word with someone – but a poetic simile comparing the shape of the outside of an ear to that of a shell” Sami’s contribution

BPPV can be treated by a series of simple exercises devised by Brandt and Daroff. I assume these two are doctors specialising in the ear, but nowhere could I find out more details!

This is the first time I’ve had an ear problem, apart from the frequent removal of wax and temporary deafness caused by being near a loud noise. I spend twenty years in the Royal Artillery; being near a field gun firing a shell with a large charge can be instantaneously deafening. In my early years no one had ear-deafeners and the joke was we all had Gunner-ear (just say that out loud!).

The King, who is Captain General of the Royal Artillery, having just fired a L118 Light Gun on a visit to RSA Larkhill. Wearing Ear Defenders of course! (Photo Times)

I know I shouldn’t, but I love using a cotton bud to keep my ears wax-free. There’s something very satisfying about carefully digging around and this reminds me of something else. In my military service it was vitally important to keep one’s weapon clean. Getting rid of explosive residue in its barrel required a ‘pull-through’; a cord with a weight at one end and a little slit at the other, into which you could thread a piece of ‘four by two’, a strip of cloth 4 inches by 2 inches. Drop the weighted end into the barrel, pull it through and hey presto the barrel was spotless. Sometimes I think it would be good to insert one into one’s ear and pull it through the mush inside; a sort-of brain cleaner! Or you could use this Chinese ear vacuum cleaner?

Kay our masseuse swears by the benefits of using an ear candle to get rid of wax. In for a penny, in for a pound; I tried it. She’s very good and some wax came out. But the general consensus amongst health professionals is that you don’t need to remove it at all, as it’s beneficial!

One of my yoga teachers, Carrie, said her father often massages his ears using the QiGong technique. The Chinese believe that the ear has Qi energy connections with the whole body. I have scant knowledge of Chinese medical traditions, although had a few sessions of acupuncture a decade ago. Apparently, the outside of the ear, its ridge, connects with the spine, the lobes the liver and heart, and the inner part with the kidneys and lungs. So go on, get massaging. I also read that a study in China found that those who wore dangly earrings lived longer than others. I must try and find a suitable pair.

Most of the sayings about ‘ears’ are to do with hearing. On cue, Lisa comes over and offers: “Friends, Romans and countrymen, lend me your ears. I come to bury Caeser not to praise him.” Everybody should recognise these first lines from Mark Antony’s speech in Shakespeare’s Julius Caeser.

The statistics tell me that one in three adults in the UK have some form of hearing loss, tinnitus or are deaf. In a recent TV drama, ‘Code of Silence’, one of the main characters was played by Rose Ayling-Ellis, deaf since birth and a user of British Sign Language. Good to see those with disabilities getting major roles.

Mo, who’s sitting at a table close by, leans over with a piece of paper: ‘The War of Jenkin’s Ear’. Ah! Yes, I know about this, fought by Great Britain and Spain between 1739 and 1748. Most of the fighting took place in the Caribbean. The name derives from Robert Jenkins, a British captain whose ear was allegedly severed in April 1731by Spanish coastguards searching his ship for contraband. It’s commemorated annually on the last Saturday in May at the Wormsloe Plantation in Savannah Georgia.  

Duncan gives me three: “I’m all ears”, “In one ear, out the other” and “playing it by ear”.

Anna, who’s been listening, comes across in her wheelchair; “How about – ‘Walls have ears’? That was World War 2, but it’s not new! In 1645 a poet wrote: ‘For the halls of our masters have ears and hear, and the walls of the palace have eyes and watch.’”

And the free coffee goes to Robert, who came up with “‘ere in the ‘ope”! (Note 2). I loved his play on ‘ear’ and here!

Richard 13th June 2025

Hove

www.postcardscribbles.co.uk

PS No mention of ‘cauliflower’ ears!

Note 1 Benign – not serious; Paroxysmal – symptoms come and go without warning; Positional – certain positions of the head trigger symptoms; Vertigo – you feel unsteady on your feet, a little like being at sea on a ship.

Note 2 ‘aitch-dropping’ is the deletion of the ‘voiceless glottal fricative’ (H-sound). It’s common in most English regions, but often seen as a sign of uneducated speech, due to its strong association with the lower class.

PC 429 Behind the Glass

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I don’t know about you, but I am often intrigued to know what goes on behind shop fronts that have frosted windows. They are the complete opposite of those using the shop window to entice potential customers, displaying something to make you want to go inside, maybe a poster showing a sale percentage reduction. Sometimes restaurants have an opaque window to give their customers some privacy and it’s the same for The Hove Practice, a private GPs’ surgery, which recently moved onto Church Road. Along the street is a massage clinic, with the obligatory hazy windows! We are lucky enough to have Kay Delphine, a very experienced masseuse, who comes to our apartment, otherwise we might have used one of these places. Some had a seedy reputation, offering more than a simple massage, but I sense those days have long gone.

Opposite etch (note 1), a restaurant on the corner of Church Road and Hove Street run by Steven Edwards, a winner of MasterChef The Professionals, is one such place. A non-descript opaque window with its shop signage, ‘CryoBright’, offering no real clue to what goes on inside.

A voucher at Christmas gave us a couple of ‘experiences’ at CryoBright and in late January we pushed open the door. CryoBright provides ‘convenient, affordable access to the most advanced wellness and recovery techniques.’ These include an infrared sauna, red light therapy, fat freezing, leg compression therapy, physiotherapy, whole body cryotherapy and massage, mainly aimed at those recovering from some form of sports injury, which I am not! I was interested in the leg compression trousers, to improve blood circulation to my feet, and in the cold chamber – out of curiosity!

The ‘Compression’ trousers slide over your legs then go through a 20-second sequence of inflate/deflate, inflate/deflate for 20 minutes. It seems very gentle, too gentle almost and so I decide to concentrate on the cold chamber.

The idea is that extreme cold acts as a stimulus to your nervous system, particularly to the hypothalamus, responsible for reacting to dangerous situations; the ‘fight or flight’ trigger. It initiates several physiological reactions in the body, the main one being to restrict blood flow to the periphery, concentrating it around one’s vital organs.  

I said I am curious. Most of my experience of ‘cold’ is from winter weather, either skiing or on military exercises many years ago, when the wind chill can drop temperatures alarmingly. I am a pussy when it comes to swimming in a cold sea, such as in Estoril in Portugal, but the benefits of cold-water immersion are becoming more mainstream. Here in Hove many people swim in the sea all the year around, part of their daily routine, and swear by the invigorating afterglow. (Note 2) I guess we’ve all heard of Dutchman Wim Hof, aka the Iceman. In addition to plunging himself, and other paying customers, into freezing cold water, he markets a particular technique of breathing. Proper breathing is an essential part of practising yoga; in the hot yoga series you only breathe through your nose for the first hour.

My Wim Hof T Shirt

Hof’s technique involves inhaling through your nose or mouth, filling both belly and chest, and exhaling through your mouth. Each breath should be short and powerful; do 30 to 40 then stop. We all take our lungs for granted, never bothering to exercise them – it’s estimated we only use some 60% of our lung capacity. And I certainly hadn’t heard of COPD (Chronic Obstructive Pulmonary Disease) until those first COVID months. In summary, I breathe well but wouldn’t want to plunge myself into a bath full of ice. (Note 3)

But when we returned from Portugal in September last year, a new cold-water shower, installed in the outer courtyard as part of the yoga studio’s new sauna offering, offered an opportunity to cool down quickly. Now, at the end of my 90 minutes 40°C hot yoga class, I go straight out and have a cold shower. Strangely, I have begun to look forward to it; odd huh! It’s wonderful!

At CryoBright, Rob explains that the cold chamber is designed to give your body a thermal shock so, wearing shorts, a facemask, gloves, socks and slippers and with a set of headphones clamped around my ears, I open the door and enter. Oh! I should have said, it’s minus 85C. I have opted for 4 minutes but after 5 seconds my brain is already saying ‘fly!’. Fortunately, I decide to stay, moving around, glancing at the large clock on an iPad outside that’s counting down the four minutes, listening to music. I wonder how my body is reacting, why my nipples are feeling particularly cold, and resist the temptation to focus on the time. Just enjoy the experience. Outside, I put my clothes back on; my back is tingling in a delicious way and I feel fantastic. We sign up for a package of sessions; this Monday was my eighth and now I look forward to freezing my b******* off!

Our curiosity has encouraged chums to try it. Spread the word!

Richard 7th March 2025

Hove

www.postcardscribbles.co.uk

PS Celina also enjoys the cold chamber!

Note 1 Note the small ‘e’. Generally the first word of a sentence uses a capitalised first letter. There’s a distinction between ‘Etch’ and ‘etch’, although it’s personal! As a verb, to etch means to eat away the surface of something; I can only guess this is the tenuous connection for the title of the restaurant.

Note 2 In the summer of 1966, as an Officer Cadet at Sandhurst, I was attached to a Germany-based Artillery Battery for its two weeks Adventure Training near Oberammergau. I went with Staff Sergeant Curtis to recce a lake for some canoeing. The water looked inviting; he suggested I jump in. It was absolutely freezing, almost heart-stopping (!) and I got out as quickly as I had got in! Curtis laughed.

Note 3 The outdoor swimming pool water at Dauntsey’s School was fed directly from a cold spring. Maybe our lap times were quick as we wanted to get out as soon as possible.