Monthly Archives: September 2011

What to do about 'The silent cancer killer'

Inflammatory Breast Cancer Association

Image via Wikipedia

The video that made

 

me write the book

 

Some time ago the publishers, Anshan, saw this video

 

Consequences

They were so concerned they wrote to me, asking if I could write a book for those with Inflammatory Breast Cancer (IBC), explaining

  • the processes that happened to all breast cancer patients
  • highlighting the differences for IBC
  • what happens during treatment.

Simple things, in plain English, that might help those with any breast cancer, particularly IBC, understand what was going on.

Normally they publish serious medical books written by eminent doctors.  But they had had great success with a book written by a patient about dealing with pain – and realised there were patients out there who didn’t want all the technical jargon, but just wanted to know about the ‘little’ things doctors brushed aside.

Although it wasn’t a ‘happy’ subject, the book almost wrote itself.  All I had to do was remember what happened to me when undergoing treatment – and in particular what puzzled me – rather than what the doctors expected would be of interest to me.

Every patient is different, but there are so many little things we breast cancer patients – and in paticular those with IBC – want to know.

I finished the book sitting up in bed waiting to have an operation.  I had got on with the writing as I didn’t think I would be able to sleep.   But at 3 am I wrote ‘The End’ and went off to sleep like a baby.  The nurses said they had never had such a relaxed patient, and the operation was a success!

More details from publishers: Enhanced by Zemantahttp://www.anshan.co.uk/ecomcart/

Carol Smillie and using seaweed to zap spots

 

When spots make your life a misery, simple

seaweed can offer help

Undergoing cancer treatment, some people are incredibly lucky.  The drugs they take dry up their skin from inside – making spots shrivel up and disappear.

For others, the spots go on, and there seem to be a constant supply of new zits and blackheads making life a misery.  For some even unluckier people, they suddenly develop crops of spots, and can’t get rid of them.

There is hope

Scientists have discovered a new use for seaweed, and it is helping clear up skins that suffer from these nasties.

Recently Carol Smillie and her daughter Christie were showing off their skins after using the new seaweed-based Oxy products to help control spot outbreaks.

Oxy Tube with fresh looking packaging

Produced by the Mentholatum company, (makers of Deep Heat and Regenovex), their scientists have been harnessing seaweed off the shores of Brittany, as a basis for the Oxy range.

Now Oxy products are being sold in major chemists – alongside their topical gels  such as Deep Freeze and Regenovex.  These do a good job of helping relieve pain and help mega-precious footballers – and cancer patients with aching joints.  So the ‘stable’ is a good one.

Dealing with Spots

We all think acne is something we get in our teens, and hope to grow out of.  Now, this company own the OXY brand of topical skincare treatments, designed to tackle spots, blackheads and excess oil.

For those of us with cancer – spots can be a horrid reminder of our teens as the spots make their unwelcome appearance again.

Seaweed – is this the new miracle ingredient?

Scientists are now using new methods to combat spots, and and a lot of research has gone into using seaweed to combat these nasties.

As a plant, I have been watching seaweed for some time;  it is probably the latest ‘miracle’ ingredient, judging by the uses companies are finding for those long tendrils.  A friend living in Brighton gathers the squishy brown tendrils when she goes for shore walks, then brings them home to add to her bath.  Soaking in the warm, seaweed infused water certainly gives her a gorgeous skin.

This time it is the Laminar or Laminaire (below) variety of seaweed the scientists are using, and also a type of brown seaweed that is helpful – but to get the benefits you need to do a bit more with it than just soak in the bath.

Those clever people at Mentholatum have been working with this at a works by the seashore in Brittany, France, and have now come up with Oxy skincare products that have proven very successful in trials.

I suppose I am lucky – my skin just dried out from cancer drugs, but sitting next to me at the Oxy product launch was a friend who had had  horrendous spots as a result of cancer drugs, and she was saying what a benefit it had been.

Celebrity Trials

Another one who is keen on this product is Carol Smillie, and her very pretty teenage daughter Christie.

Carol says “the fact that some of its key ingredient properties come from seaweed ……. I much prefer the thought that as a mum, my daughter is using a product which uses ingredients from nature.  My daughter is a normal teenager ….. loves to wear make-up ……  Christie’s been using the new Revitalised Oxy ranged for several months now, and it really has the desired effect”.

Oxy skin preparations contain several active ingredients, including Phycosaccharide – harvested  from brown seaweed along with others from the coast of Brittany.  According to Dr. Carrie Ruxton, this is also a rich source of potassium, sodium, magnesium and iodine – plus also being a good source of anti–inflammatory omega-3 fatty acids.  She has been working on a double-blind randomised and placebo-controlled trial at the San Gallicano Institute and Acne Clinic in Rome.

As a result, Oxy has developed a brand new Oxy range, just launched in major chemists.  More info:  www.oxy.co.uk

 

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It's time after-care for cancer patients got up-dated

Macmillan Cancer Support Logo

Image via Wikipedia

Macmillan’s medical director

hits out

No sooner had I written about assembly-line medicine, and how the Dept. of Health is blaming us, the PBP (poor Bxxxy patient) for lower survival rates post-cancer, compared with European countries,

than up comes Prof. Jane Maher , Medical Director of Macmillan, with some telling things to say about the way we are looked after once we finish hospital treatment.

What does Jane Maher say?

She feared 500,000 people’s symptoms for conditions, including osteoporosis and heart disease, are being missed by GPs.

GP’s lack of knowledge about the long-term side-effects of cancer drugs and a lack of communication with hospitals were to blame.

“Doctors are failing cancer patients ‘far too often’ by not spotting other medical problems caused by their treatment”, says Prof. Maher.  Lack of knowledge about the long-term side-effects of cancer drugs, and a lack of communication with hospitals, were to blame.  Which echoes what cancer patients say, commenting they feel ‘abandoned’ once they have left hospital.

‘GPs and oncologists are failing cancer patients far too often,’ she told The Guardian.

‘By not sharing vital information and recording [this] clearly on the patients’ medical records, they are putting a significant number of cancer patients at risk of having their work, health, relationships and home lives unnecessarily spoiled by long-term side-effects of their treatment.

‘GPs need to recognise that people who have had cancer may have health problems related to their treatment, and GPs are the best people to pick these up. But that doesn’t happen nearly enough at the moment.’

Doctors needed to ensure that cancer survivors’ medical records included more detail about their disease and type of treatment.

‘At the moment GPs aren’t recording whether someone has had chemotherapy or radiotherapy,’  partly because they don’t get enough information from hospitals, but also because they don’t realise why it’s important for them to do that.’

So PBPs  bumble along as best we may, and in the meantime officialdom pumps out mis-information:

Official Myths – from NHS/Dept. Health/GPs and Uncle Tom Cobley

Here are some official ‘sayings’;  they have little or no validity, but are taken as gospel by the medical profession:

  • Dept. Health says :It’s our fault that we have bad post-cancer survival rates as we have a bad take-up rate for screening. FactWorld Health Organisation say UK has one of the best rates in Europe for take-up of breast screening, etc.
  •  NHS/Consultants say: Once you’ve finished cancer treatment, “you’re clear”.                    Fact:  There is a risk of cancer survivors developing a second cancer
  • NHS tells you: Once you leave hospital, you have finished treatment.                                Fact : Long-term consequences can arise anything from a few weeks after treatment to many years later. There is no evidence that the development of late consequences decreases with increasing survival time after treatment.
  • NHS say: If you experience side effects, your GP is the person to consult.                                  Fact – my GP was more honest than most, admitting “you know more about cancer than I do”, when I went to ask about horrible side effects.  And no, he couldn’t help – it was back to the Internet.
  • Pharma company leaflets say:  if you experience side effects consult your GP.             Fact:  (and cue for hollow laughter)  T’aint so – most GPs have no training in dealing with side effects from these drugs.

Side effects NHS etc. brush under carpet

A survey by Macmillan Cancer Support in 2008 showed that while

44 per cent of cancer patients were not aware of the possibility of long-term physical side-effects

78 per cent of them admitted to experiencing at least one of a list of possible side-effects in the preceding 12 months, including: .

  • Fatigue
  • weight gain
  • lymphoedema
  • neuropathic pain
  • heart damage leading to an increased risk of cardiovascular disease
  • lung damage
  • bowel and bladder dysfunction
  • increased risk of osteoporosis
  • carpal tunnel syndrome
  • eye problems, etc. etc. .

And they seem to have forgotten skin problems, splitting and crumbling nails, etc. etc.

Many patients can also suffer psychosocial consequences, including anxiety and depression, memory loss and problems with concentration. This can lead to increased risk of job loss, financial problems, marital breakdown and divorce, and lower educational attainment for children and adolescents with cancer.

Feeble Excuses for bad care

Dr Clare Gerada, chair of the Royal College of General Practitioners said doctors needed help with the issue.

Admitting that GPs were generally unaware of the risks associated with specific treatments, she said: ‘If Prof Maher and the NHS tell us exactly what cancer someone has had, and what treatment, and what the possible risks are of that, and in a way that’s easy to understand, we will do things better.’

My personal view is, if we are aware, why aren’t doctors?  Surely we tell them enough times of the problems we are experiencing, but it seems they aren’t listening.  It’s time Dr. Gerada told her members to wash out their ears.

What’s being done?

The National Cancer Survivorship Initiative was launched in 2008 in response to the Cancer Reform Strategy, with the aim of co-ordinating a response to this challenge across all care settings.  This is a collaboration between Macmillan and the NHS.

Yet three years later, the website is still under development, and nothing seems to have been accomplished.

We still have the assembly-line system, which is way out-of-date – the NHS needs to follow what’s happening in the Personalised Medicine field, and STOP WASTING OUR MONEY on useless treatment.

But with side effects destined to increase, now that procedures such as Platinum-based treatments are getting more sophisticated,  doctors must be trained how to deal with our problems.

Or else Macmillan-funded GPs must be available to patients as and when needed – not locked away out of our sight.  It’s our donations that fund them – why can’t we book a consultation with one?

Osteoporosis
The latest Hormonal treatment, including the use of gonadotropin-releasing hormone analogues for prostate cancer and aromatase inhibitors for breast cancer, is associated with an increased risk of bone fractures due to osteoporosis.  NICE has recommended that women with early invasive breast cancer should have a baseline DEXA scan to assess bone mineral density.

Increasingly urologists are adopting the same approach with men with metastatic prostate cancer. Osteoporosis, when identified, should be treated with bisphosphonates and exercise.

What is role of GPs now?

GPs need to be aware of the possibility of late effects for patients with a history of cancer. When a patient presents with new symptoms,

  1. consider if they are related to the past cancer, its treatment or possibly the development of a new cancer.
  2. patient records should be clearly coded with details of past oncological treatments and also coded as ‘At increased risk of …’ if appropriate.
  3. Cancer specialists need to provide clear information to both patients and GPs about possible long-term consequences, and GPs need to ensure that information is appropriately recorded and coded on the patient’s GP records.
  4. Practices should create a register of those who have had oncological treatment including radio and chemotherapies, so that those patients can be highlighted on their computer system and alerts set.
  5. Proactively ask patients about possible treatment-related problems and potential psychosocial effects as part of any regular review, and consider offering patient information on long-term effects.
  6. Remember that second cancers are common in patients who have already had one cancer.  It is vital to give suitable lifestyle advice to all cancer patients to try to reduce that risk.
  7. Actively identify and manage other risk factors for those patients at increased risk of developing cardiovascular disease or osteoporosis.

Cancer follow-ups are a waste of time

According to Prof. Maher, the current follow-up system for cancer patients is a waste of time and needs to be completely overhauled.

Instead cancer patients should be given ‘the skills and knowledge to self-manage their condition, and provide support if needed, which would be far more effective at spotting re-occurrences of cancer.’

At the moment cancer patients who survive initial treatment enter what is called the ‘follow-up system’ – regular appointments to check that the cancer has not returned. Jane Maher, says: ‘The curent system is wasteful, ineffective, and not the best way to spot many recurrent cancers.’

There is surprisingly little evidence that this method is the best way to spot recurrences of cancer or the other possible long term health consequences of being treated for cancer.

Jane draws on recent work which ‘suggests that around 70% of recurrence for breast cancer could be detected by either patients noticing symptoms themselves or by surveillance testing alone, with a face-to-face appointment if needed.’

She continues ‘this is only possible if patients are helped to understand their illness, can access regular tests and know how and when to contact specialists if problems arise.’

One in five people living after treatment for cancer will develop long term emotional, psychological and physical problems that seriously affect their quality of life. Yet there are few, if any, NHS services specifically for cancer survivors.

The NHS needs to radically transform the way it provides support for patients following hospital treatment.  If enough patients tell their GP about Prof. Maher’s chilling words, perhaps we might get the attention and care we need, without going round and round the houses looking for joined up care.

And Jane, one thing you haven’t mentioned – patients need to be LISTENED to – and not dismissed out of hand when we query our treatment, or even offer a possible solution.  There is a thing called the Internet – and sadly many of us HAVE to learn how and where to look up treatment options – otherwise we would find outselves on the medical scrapheap.


http://www.guardian.co.uk/world/2011/sep/25/cancer-patients-side-effects-treatment?newsfeed=true

http://news.bbc.co.uk/1/hi/health

/8429995.stm

 

http://www.dailymail.co.uk/health/article-2041878/Doctors-failing-500-000-cancer-patients-spotting-medical-problems-caused-treatment.html

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Pixley Blackcurrants

Blackcurrants burst out

 

When I try out a blackcurrant drink, that actually tastes of blackcurrant, I almost believe in Fairy Folk.

I am sure you are as fed up as I am with all the ‘new’ flavours  one’s tongue gets assaulted with.

Manufacturers today can’t leave old-fashioned tastes alone, and everything I am sent is ‘improved’.

My tongue is still lac erated from some evil brew I was sent, guaranteed to fill me up with flavonoids, anti-oxidants and anything else the PR boys could come up with, but tasting evil.

So when I was round discussing wines with Rosamund Barton, of R & R Teamwork (she knows her vintages), and she said she was drinking a ‘new’ fruit drink, my ears pricked up.  Thrusting a bottle of Pixley Blackcurrant and Ginger in my hands, I couldn’t wait to try it out.

Sure enough – it actually did taste of Blackcurrants.

Edward the Cordial

How on earch Edward Thompson (known as Edward The Cordial) manages to get a production line going to make enough of the stuff for all fans, but still keep the taste – must be a secret known to Hereford Pixies.

Anyway, it’s good.

Edward is the messianic brains behind the whole operation. He’s passionate about the environment and about creating fruit with real flavour – blackcurrants, apples, raspberries and hops.

He’s also prepared to take risks as seen by his replanting programme, bringing in new blackcurrant varieties, which thrive in our globally warmed climate.

His forward thinking is also shown by the commissioning of his own ‘Pressoir’, the only blackcurrant grower in Britain to be entirely vertically integrated and in control of every element of his production, from the soil to the shelf.
All in all he takes as much care with his fruit cordials as a wine-maker does with his wines.

How I ‘use’ it

It comes to us all – medicine fatigue.  I keep on looking for new ways to disguise the powder Cacit-D for my osteoporosis;  last week I mixed it with tomato juice and that was the worst mistake of all time.  It fizzed up and left a gunky mass of curdling tomato in the glass – Ugh.

But this week I have mixed up a Pixley Blackberry drink, and it is delicious.  The Blackberries can more than hold their own with the powder, and the Ginger seems to give my medicine the extra oomph.

Rosamund suggests a Hot Toddy in the winter;  I would also think it could make a wonderful Kir;  Pixley uses it in fruit and spirit jellies – have fun!

Where can you buy this?

It’s £3.99 for 500 ml bottle (diluted it makes 16 servings of 44 calories each)

www.pixleyberries.co.uk

  • Waitrose stores nationally

www.waitrose.com

  • Ocado, Online Groceries

www.ocado.co.uk

  • Co-op Stores across the West Midlands
  1. Health food shops across the West Midlands
  • Farm shops across the West Midlands

 

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What did Patient Week achieve?

Enhancing patient value

 

Congratulations to eyeforpharma for making doctors, nurses and patients get round the discussion table and TALK!

I particularly loved this cartoon that appeared in one article,  graphically showing the assembly-line we often feel is our treatment path.

 

One article, posted by Davis Walp, head of Value Based Solutions at Quintiles, explains the importance of tailoring programs to patients based on cultural and psychographic factors.  It deserves a very wide audience:

 

There are many different definitions of

value.

 

In healthcare, when patients think about value, what they are really looking for goes well beyond measured ‘health outcomes’, which are achieved as a result of their treatment.

Patients want to feel better, have more energy, and do more of the things that they like to do.

Patients generally don’t want to feel like they are defined by their illness; they look to the healthcare system to provide solutions that enable them to focus on what is important to them in their lives.

For example, to a diabetes patient, the value of their drug is in the ability to feel better, to maintain their lifestyle and to minimize the intrusiveness of their disease.

This is why oral once a day therapies are so desirable; patients can ‘take it and forget it’, which allows greater convenience and control than an injected treatment.

Patients also value knowing that control over their disease lowers the chances that it will progress or that they will develop co-morbidities.

One of the most important elements of ‘patient value’ extends beyond the medications patients take.

Everyone benefits when patients feel like empowered consumers of healthcare who are in control of their disease, more compliant with treatment, and healthier.

Patient engagement is therefore an important objective that can improve the value an individual gets from their medication.

The most engaged patients are those who

  • Are switched on and highly motivated to take ownership over their disease or engage in preventative behaviors
  • Are intrinsically motivated to seek information, take medication and, be educated about their condition
  • Believe that they have the ability to make decisions and take actions that will positively impact their health condition
  • Cognitively understand their condition and view their physician as an important partner in treating their disease
  • Understand the treatment options and pros and cons of each.
  • Engaged patients have better outcomes

It is typically highly engaged patients who seek earlier diagnosis and treatment, adhere to medication, and live healthy lifestyles—all of which work together to improve quality of life and outcomes for these patients.

For example, the Center for Disease Control (CDC) performed a study and determined that human behaviors are a bigger factor in impacting public health than the health system or our genetics in isolation.

The American Association of Retired Patients published a study that showed ‘activated’ patients experience a lower rate of hospital readmission, medical errors, and negative health consequences arising from poor communication amongst providers.

However, the jury is still out on return on investment for disease management programs.

I have seen several examples of very successful programs and many more examples of programs that did not drive meaningful effect.

I believe this is primarily the result of ‘one size fits all’ program design where patients of all walks of life and orientations experienced the same program content.

It goes without saying that you cannot talk to a 26-year-old male the same way you talk to a 73-year-old female.

I believe that we should be tailoring programs to patients based on not just demographics but also cultural and psychographic factors.

 

My summing up:

Talk TO patients – not AT them – and LISTEN.

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Using SMS as a tool to help patients

Smstextmessage

Image via Wikipedia

Patients’

Week 2011

~shows

importance

of  SMS

by Claire Hallas

 

As a contribution to Patient Week, Claire Hallas posted this article about using SMS for Patients’ benefit:

 

Text message or SMS (short message service)  interventions can improve adherence and disease management across a number of illnesses

A study published in the British Journal of Health Psychology  shows that text message (SMS) interventions targeting people’s beliefs significantly improve adherence to asthma medication and have the potential to improve adherence and disease management across a number of illnesses.

The study further confirms the value of SMS as a communications channel and suggests that other digital channels have a growing part to play in delivering successful interventions.

SMS is relatively inexpensive and increasingly available to a broad cross-section of the community.

This study shows the potential benefits of using SMS not just as a passive device to deliver a generic reminder, but as a way to actively engage with individual patients and drive behavioral change.

As other forms of communication, such as smartphones, move into the mainstream, it is fair to assume we will be able to take greater advantage of their potential to deliver targeted interventions and ultimately better patient health outcomes.

The study was initiated to address the common issue of non-adherence to preventative asthma medication.

The research concluded that if targeted SMS messages are used to communicate with asthma patients, adherent behavior will increase for the long term.

Even nine months after the SMS messages ceased, the majority of people who took part in this were found to have continued adherence.

This study targeted five illness perceptions: short timeline (no symptoms = no asthma), low personal control, low symptoms, high symptoms, and poor understanding; and two medication beliefs: low necessity and high concerns.

What happened

A bank of 166 messages designed to counter these seven beliefs, all of which had previously been found to be associated with non-adherence to preventer medication, was prepared ahead of the study.

Participants received tailored SMS messages based on their responses to a questionnaire assessing their individual illness perceptions.

The report found that those study participants receiving the text messages had an increased perception of their asthma as a chronic condition, the degree of personal control they had over their asthma, and their need for preventer medication.

As these findings would imply, the intervention group also recorded adherence rates around 10 percent higher than the control group and a significantly higher achievement of 80 percent-plus adherence levels.

What’s in it for cancer patients?

First thing that springs to mind is that those on weekly rather than daily doses of a drug could be sent a reminder every week – saving having to write rewminders into the diary.

Then reminders re annual mammograms – check-ups, etc. could be sent.

Am sure readers can think of many other uses.

 

Claire Hallas is a health psychology specialist with Atlantis Healthcare.

 

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It's Patients' Week – and hospital food shows signs of improvement

 

Putting the ‘oooh’

back into food

Do you remember when you were young, and ill in bed – your Mum coming in with a tray with lots of tempting food?

Well, thanks to James Martin and other brave chefs, Danielle Faulkner of British Food Fortnight says,

“there has been a significant uptake of hospitals taking part in British Food Fortnight this year.

 

Chelsea and Westminster Hospital had a fruit cart outside the door;  sadly, with the cold weather this has disappeared, but whilst it was there friends could buy small packets of delicious peaches, cherries, bananas and other fruit, hygienically wrapped, and easy to carry in to patients.

Perhaps the Governors might be a bit more pro-active and give the vendor permission to operate inside the hospital?  After all, they permit flowers to be sold inside the foyer.

Some of the hospitals who have been in contact with British Food Fortnight include:

  • Roseberry Park Hospital
  • Royal Brompton Hospital
  • Countess of Chester Hospital
  • Southmead Hospital
  • Basildon Hospital

although many more take part too!

British Food Fortnight

Next year dates 27 July – 12 Aug  –   during the Olympics!

If you want to improve your hospital food, keep on at Governors.

Make them realise you are worried about the amount of hospital food that is thrown away.

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Christmas food needn't be too fattening!

English: Turkey (bird)

Image via Wikipedia

 

Autumn food

This article is not for vegetarians, but I must confess that, provided what I am eating has been allowed to roam free, I do enjoy this time of year when pheasant, grouse, partridge and other game is in season.

And, of course, the Christmas Turkey is going to be around for some time.  Don’t groan – it’s one of the healthiest foods you can eat.

British reared turkey is not only tasty, but 100g of grilled breast meat contains just 124 calories and 1.7g of fat. What’s more, there are so many different cuts to choose from, and so many ways to cook them, that you can never tire of turkey.

And if you really want to cheat away the calories, instead of slathering the bird in butter, just use a little, but copy the Belgian way of roasting a bird – cook it upside down with stock or water in the bottom of the tin, and lots of herbs scattered around.  Just turn it over about 20 mins before you take it out of the over, to brown it, and you get a very moist bird.

Check out convenient cuts like turkey mince – perfect for spicy chilli, homemade meatballs and low fat lasagne. Tender turkey strips are just right for speedy stir fries, while tasty leg meat comes ready diced for delicious hot pots and casseroles.

Look out for the familiar farm assured Red Tractor logo alongside the Quality British Turkey mark on the pack. That way you’ll know you are buying meat from producers who achieve high standards.

And look for more recipes on  www.britishturkey.co.uk  call the British Turkey hotline 0800 783 9994.

Pheasant and partridge – or quail
This is known as ‘Game’, and can only be eaten when the females have finished breeding.  They start breeding again February – so the season isn’t long.

If you eat meat, there is growing evidence that we should ensure that chicken and meat we eat is  raised outdoors, eating grass or foraging for fresh food.  This is definitely healthier for us. Anyway, who wants to eat an animal that has been kept caged up all its life?  But game generally roams freely – just be careful when buying quail.

And some of our meat, rabbit and chicken is imported from countries such as China, where food standards and animal welfare may not be up to our standards.

So I asked Alison Jee, meat expert for her advice.

“For everyone, the quality of the meat they eat is paramount.  If you have or are recovering from cancer it is even more important to choose top quality produce, and buy it from a good local butcher, or a supermarket that has high standards.

So choose British meat, and a butcher where you can be sure the meat has been reared in this country to the higest welfare standards.  Look for ‘Quality Standard’ marks from the English Beef and Lamb Executive (EBLEX) and British Quality Assured Pork (BQAP), the company supplies meat under the ‘Red Tractor’ scheme managed by Assured Food Standards and ‘Free-Range’ criteria.

When eating in a restaurant, ask where they get their meat and chicken from.  Any hesitation, and it could mean that you are eating Chinese battery chicken.  Uggh!

GAME IS LOW IN CALORIES

When you are bored with beef or fancy a change from chicken, it’s time to give game a go!  Pheasant, Partridge, Grouse, Venison – or the almost unknown Snipe or Widgeon, are all products raised in the wild (or almost) that roam free.

Whether you are planning a special treat or want a simple supper that’s on the table in minutes, game will always fit the bill.

Not only is it healthy and nutritious – and almost certainly Organic, but calories are low.

Wk/cals Per 100 grams :

  • Venison  104
  • Chicken 105
  • Partridge 112
  • Pheasant
  • 119 Lamb
  • 172 Beef 191

Supermarkets such as Waitrose are stocking fresh and frozen game, and so do good butchers.  They love to sell Game, and are keen to give recipes for cooking.  Although you can roast it whilst young;  towards the end of the winter when the birds get older, put them into a casserole with veg and red wine – scrummy!

There are lots of country myths about hanging game until it is falling off the string holding it up, and crawling with maggots.  Well, that may be all very well well for some old country codgers, but I was raised in the depths of the country and game that is 3 – 5 days old is just right for me.  So you don’t need to worry too much about it being as fresh as fish, but if you like a ‘softer’, not so game-y taste, then around 5 days is ideal.

However, if you buy a bird and can’t cook it that night, it will happily stay in the fridge for 2 – 3 days.  Or in the freezer for a month or so.

Serve it with bread sauce, or the old way (which was horribly unhealthy) with fried breadcrumbs!  and Game chips.  You can make those by hand or buy good old plain crisps!  Then green and/or roast vegetables such as parsnips and potatoes are scrumptious with these, and don’t be afraid to pick up the bones and gnaw them.  I ha

ve seen the Royal family eating game in a restaurant and happily gnawing a bone.

What wine goes well with game?

I asked Rosamund Barton, of the noted wine agency R & R Teamwork, what wines would go well with game?

She said “these two should go really well with many game dishes”:·

Louis Jadot Beaujolais Villages 2009/2010, 12.5% ABV,  rrp £9.49

From:  Tesco, Waitrose , Budgens, Booths, Fresh & Wild, Wholefoods, http://www.yourfavouritewines.com and many independent wine specialists

 

Or/

 

Villa Maria Private Bin Pinot Noir 2010, New Zealand,  13.5% ABV, £10.99 Tesco, Co-op, Wholefoods, http://www.nahouseofwine.co.uk

Cheers!  and bon appetit!

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Patients matter pledges Eyeforpharma during Patients' Week

It’s about time Patients

stopped being

ignored by medics

 

For too long patients have been ‘talked over’ around the bedside,

smiled at if we venture an observation (even if this is more knowledgeable than that proferred by a doctor),

and as I was told by a nurse, “you are ONLY a patient”.

In Britain, you ask a pharmaceutical company for help with handling drugs, and the companies are experts at brushing you off – using excuses ranging from ‘data protection act‘  (we supply the data for the Yellow Cards – then can’t access what we have told companies), or ‘patient confidentiality‘ when we ask about our own circumstances.

Frankly, it is pathetic.

However, things are changing, so welcome to eyeforpharma’s 2nd Patients’ Week, a week where the company devotes their website to those who matter most in healthcare.

As eyeforpharma say, “let’s not beat about the bush. The pharmaceutical industry, our industry, caught in its struggle to manage new stakeholders and new regulations, often forgets about Customer Number One.

Unfortunately, the higher you go in an organisation, the further away individuals can be  from the reality of the situation. The potential pharma has for providing real patient service remains, today, unfulfilled.

So we’d like to help. It’s time to hand control to the patient and hear directly from them.

And hearing from the patient is no longer something we do while rolling our eyes and a wry smile on our faces. Patients increasingly understand their disease, have access to reliable information and are able to participate in Health 2.0 crowdsourced exchanges where new findings affecting R&D can arise. We need to sit up and listen.

Over the course of the week we are publishing no less than fifteen different perspectives, including the latest thoughts from ePatient Dave, Jeanne Barnett and Sara Riggare.
We will also keep you informed as we bring you information on topics such as chronic care universities, patient effectiveness and comparative effectiveness.

We’d like to thank our partner Quintiles, who have been invaluable in preparing Patients’ Week this year. You’ll witness many of their expert insights over the next few days. For a full list of our Patients’ Week supporters, visit our partners page.

As we publish articles throughout the week, we will update this article to include all the links. So remember to check back here and keep informed.

www.eyeforpharma.com

In the USA

For everything patient-related, join the sector’s other key players at Patient Adherence, Communication and Engagement (PACE) USA on October 24-25 in Philadelphia. For the full PACE agenda and speaker line-up Contact laura@eyeforpharma.com.

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James Martin fights for Sticky Toffee Pudding

Is this the most popular recipe ever shown on TV?

James Martin’s sticky toffee pudding

 

James' sticky toffee pudding

 

The web has been buzzing after James Martin won over Scarborough Hospital’s Catering Manager, Pat – and she allowed him to put this pudding on their menu – much to the delight of patients.

However, it wasn’t without a fight between the two of them (all friendly – I think!)  James said the pudding had to be made with butter (first problem), then Pat said the sauce wasn’t thick enough,  so James said it would have to be made with double instead of single cream – and twice the calories.  Eventually it was made with single cream, which wasn’t thick enough for Pat but the patients approved!

We still haven’t been able to get the authentic recipe out of anyone, probably because I suspect there is going to be a cookbook somewhere – but will let everyone know if I get it.  Meanwhile I did ‘tweak’ a couple of recipes. I did try to get permission to quote them;   so if you like it copy it quickly before I get chucked in jail!

Ingredients

55g/2oz butter, plus extra for greasing
2 free-range eggs
200g/7oz self-raising flour, plus extra for flouring
200g/7oz pitted dates
290ml/10fl oz boiling water
For the sauce

This is James’ recipe off the BBC website – but for the hospital he used single cream, and cut out the ice cream.

Also, I was up at Cartmel which Cumbrians say is ‘home’ of this pudding, although there is dispute over its origins but Cumbria and the Lake District seem to have the strongest case to claim its birth.
If you like, you can use chopped dates instead of pureeing them – it’s up to you.  If’ using chopped dates, try flouring them to make sure they don’t all drop to the bottom.
To make
Preheat the oven to 200C/400F/Gas 6.
Grease and flour 6 individual pudding moulds.   Or use one large one for family, but you may have to increase cooking time.

Cream the butter and sugar together until pale and fluffy. Add the golden syrup, treacle and eggs, a little at a time, and blend until smooth. Add the flour and blend until well combined. Transfer to a bowl.

Meanwhile, chop dates or blend with boiling water in a food processor to a smooth purée. Stir in the bicarbonate of soda and vanilla.

Pour the date mixture into the pudding batter and stir until well combined.

Pour the mixture into the moulds and bake for 20-25 minutes, or until the top is springy and golden-brown.

To make the sauce, heat all of the ingredients in a pan, stirring occasionally, until boiling.

To serve, remove the puddings from the moulds, pour over the sauce and serve with a scoop of vanilla ice cream.

 

And if visiting someone in hospital, you could make lots of friends by making one each for other patients in ward, plus enough for staff, and asking Sister if you can use the ward microwave to heat up.

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