She Changed My Life

Who would have thought such a trivial, throw-away line could make such a difference. My whole approach to dental self-management was transformed in an instant from a chore to, well, just doing it.

I knew deep down that flossing my teeth was a valuable health routine* but just couldn’t get into the habit of doing it daily after cleaning my teeth. Yes, I read of the short and long term benefits, and tried lots of different flossing apparatus (tape, string, flavoured, waxed, loaded on a plastic stick, tiny bottle-brushes) thinking I would surely find the perfect bit of kit to establish my habit. No luck.

Flossing is a manual skill, it needs to be practiced regularly to become and maintain high performance. The ability to get a couple of fingers and some string or tape into your mouth and manipulate it between each pair of teeth to massage the gum and dislodge food residue is complex and it takes time. Maybe up to a couple of minutes. Time I have not  reckoned into my health/grooming routine because flossing wasn’t invented when I started cleaning my teeth. Not in my world, anyway. In fact teeth brushing was usually the final act before departing for work (in a rush, who can spare extra two minutes) or heading for bed (another activity not to be delayed).

Then she changed my life. My dental hygienist (also not invented way back) was preparing me to see my dentist one day and noted that my flossing needed work as I was missing some gaps and told me it actually works better if you floss BEFORE brushing your teeth. This now was a whole new concept. My habit was to leave the bathroom immediately after brushing, so flossing was just a nuisance, but if I had already flossed….

Then it got even better – Julie (the hygienist) said it doesn’t even have to be immediately prior to brushing!  She changed my life right then.

Now I floss immediately after a shower and it is no longer a chore, just part of the ritual. I shower, I dry, I floss, I shave, I moisturise, I tell the bloke in the mirror he is holding up pretty well and I might brush or I might not – depends what is happening next.

The advantages to flossing after a shower are immediately obvious: you hands are really, really clean. Poking your man-fingers into your mouth is best done when they are clean and after shampooing and soaping they are at their best.

Changed my life and changed my dental health. Double bonus.

*Floss Test – If you are not sold on the value of flossing try this simple test.

  • Complete your normal end of day dental care routine (clean, rinse, spit).
  • First thing in the morning, prior to any eating, floss your teeth thoroughly.
    Any food debris you dislodge has been there at least 12 hours and survived the last brushing.
  • Do this for a few mornings to get an idea of what residue remains overnight.
  • Then start flossing before going to bed AND first thing in the morning.
  • You will see the amount of residue in the mornings will drop considerably, which means your teeth and gums are not exposed to decaying food waste overnight.

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It will change your life too.

Drink, Chew, Breathe

Experiencing gastric reflux or pain is very unpleasant and can be a health risk over time. Changes occur to the lower end of the oesophagus as stomach acid provokes changes in the lining of the lower gullet (Barrett’s Oesophagus). Having experienced this I gave some thought as to how I could manage it without the prescription medication (proton pump inhibitors such as Zoton, Losec or Somac). The answer turned out to be very simple: Drink, Chew, Breathe.

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It Has Another Purpose

A man’s penis is a marvellous bit of gear: it is an indicator of health problems long before the symptoms may become apparent.

The Massachusetts Male Aging Study showed poor quality erections were a significant predictor of an adverse cardiovascular event during the next five years.  Meaning, a heart attack is more likely in men who are having difficulties initiating or sustaining a firm erection. This is most likely due to poor blood flow in the penile arteries as a result of fatty plaques narrowing the bore of the arteries and limiting flow. Exactly what happens in the heart leading up to an ‘adverse cardiovascular event’. Apparently these fatty plaques can’t tell the difference between a coronary artery and a penile artery – they just clog it up.

Here is the message – if your health wand is sending out it’s warning, you need to address the underlying lifestyle risks causing the fatty plaques to gum up the plumbing. These include smoking, obesity, diet, cholesterol, blood sugar control and blood pressure. It would also help to undertake regular exercise.  If you don’t, getting an erection may be the least of your problems down the track.

Here is some other warnings your penis can alert you to:

  • If you can’t see it – you are too fat
  • If you cant reach it – you are way too fat
  • If it won’t pee straight – you may have an obstruction
  • If it won’t start peeing – your prostate may be enlarged
  • If it won’t stop peeing – you may be drunk
  • If it dribbles when you think you are done – you are not alone
  • If it burns when you pee – you may have an infection

See how useful it is? No wonder the girls wish they had one.


Premature Congratulations

Unlike the Captain of the Italian cruise ship that recently ran aground I do not suffer from premature evacuation.

I do however, display repeated symptoms of premature congratulation (PC) – a condition I have observed in many men.  While not technically a medical condition PC does impact on the health of those afflicted. So what exactly is PC?

Premature Congratulations

La erección que se produce después de tomar Viagra Original es absolutamente natural, insuficiencia cardíaca NYHA y válvula II en los últimos 7 meses, debe tomar no más 25 mg de Lovegra una vez por cada 24 horas. Es un principio activo perteneciente a una nueva generación de inhibidores de la PDE5. Pero le sugerimos a la gente que consulte con sus doctores antes de tomar comprimidos de Tadalafil hcl 20mg, que se persiguen una vez y proporcionan el flujo durante 26-57 horas.

This condition is very common at this time of year, around four to six weeks after the making of New Year Resolutions.  Whether the promise was to drink less, lose weight, stop smoking, spend more time with the family, reduce working hours, tidy the backyard or read more books is irrelevant.

The first week or so of the program is usually quite positive.  You are at your most motivated and changes come more easily when fired up and the early signs of improvement are good.  A few kilos less on the scales, knocking off earlier at work, and half a book dealt with. In fact, you are surprised how easy this is and wonder why you didn’t do it years ago.

The next couple of weeks are also good, you goal is in sight. It is clear that if you continue the smoking will be forgotten, the beer will last longer and again you are pretty chuffed about the progress you are making and the ease with which it is happening. You are so chuffed and finding it so easy that you start to imagine you have achieved the goal already!  I mean, it is going well and obviously working so it wouldn’t matter if you eased up a little on the discipline…

Bang! There it is – Premature Congratulations: the foreseen achievement of a goal when it is in sight but not yet actually completed leading to a lapse of concentration and relapse of your previous habits. Have you ever seen an athlete begin to celebrate before passing the finish line as he or she enjoys the moment of achievement and basking in the adulation of the crowd (or themselves), only to be passed at the penultimate moment by a competitor who has not waivered and fallen victim to PC.

This happens a lot.  I am an expert in this PC phenomenon because I have indulged it many times.  And consequently disappointed myself. So how to combat this common problem?

  1. Set a goal beyond what you want to achieve so if you get PC you still make the grade.  This strategy requires the unique ability to believe your own lies.
  2. Stay the course. When PC kicks in, focus on what remains to be done, not what you have already accomplished. This may have to be repeated several times as you near your goal.
  3. Seek help. Recruit either a like minded and perhaps a little bit competitive colleague who will provide an external drive to your internal project.
  4. Give up. Recognise that your expectations exceed your ability and remain as you were: a disappointment to yourself.

Now, how close am I to my pre-holiday preferred weight……. Damn, no where near it.  I will let you know when I make it, not when I get close.

Craig Allingham

Don’t Get Stressed About Dying Younger

Despite western men getting more physical activity (on average) than women, we still manage to die 5 to 10 years younger.  So obviously exercise alone isn’t the answer to a longer life. Other research shows the fitter you are in your mid life (using aerobic fitness factors) the lower your risk of developing degenerative diseases such as diabetes, Alzheimers and heart disease (Arch Int Med. Published online August 27, 2012). So perhaps exercise does help quality of life (not being sick).

Genetic factors (including testosterone and the associated aggression and risk taking behaviour, read: dumb decisions) apparently account for around 30 per cent of the longevity equation while environmental factors kick in for the rest.  These include smoking, food decisions, alcohol, exposure to pollutants and toxins and stress.

Stress is the interesting one on the list because it is not the stress itself that can shorten your life, but how you react or deal with the stress.  Women tend to involve other people (usually women) by sharing their problems and seeking solutions. Whereas blokes tend to deal with it solo, either fighting on or moving on.  The Fight or Flight Response. This reaction is fueled by testosterone, especially in your younger years, and perhaps becomes your habitual default position later on even when your testosterone has waned.

However it works, it isn’t working very well. As one who is prone to sweating the small stuff I can tell you changing how you initially respond to stress (gut churns, focus narrows, rational thought ceases, breathing becomes shallow, heart rate increases) is an uphill battle.  Deep breathing, centering, counting to ten, imagining being bathed in a healing white light – these are very simple to practice in the absence of stress, but darned hard to program when the excrement hits the ventilator.

I don’t have a magic answer, but I do understand the importance of the social aspect of dealing with stress.  So even if you feel like strangling someone or kicking the garden hose (never ends well), hold off and try and explain to someone (perhaps even yourself) why the situation is so challenging and what might be the worst possible outcome.  Usually it is not too drastic, and by the time you have considered this, the initial testosterone surge is easing and the other strategies can help smooth out the remaining bumps.  Not sure about the white light, however.

If you get good at this, you will have more years to practice it even further.

The Art of Coaching

A couple of weeks ago there was  a great interview in the national press with one of the most respected sports coaches in Australia.  A man who has a long record of successfully bonding men, guiding them and more often than not achieving their combined goals.

The interviewer asked him directly, ‘What is the secret to your coaching technique?’ Characteristically he rejects the whole concept of him being a master coach with a system for success. The men he coaches play a fierce game demanding courage and pain. Every week, every season. 

It was a long article, many column inches, but hidden amongst the analysis was his answer.  Well, it was the answer that rang true for me as the measure of a successful leader of men.  Another coach who had worked with him for years commented that he ‘genuinely cares for his players’.  He almost nailed it, but missed the essential element.

He doesn’t care for ‘players’, he cares for men. His secret strategy is to help them be better men,  a strategy he has observed over the years actually makes them better footballers. Some coaches try and turn men in to players, this guy turns players into men and in turn they become better players.

Great coaches turn people into better people, and from that they both gain.  Let alone a company, a community, a society and a football team.

Who have you helped to be a better person recently?

Oh, the coach? A bloke named Wayne Bennett.  You can google him.


Continence after Radical Prostatectomy

I read an article today in the Journal of Neurourology and Urodynamics that appears to be a realistic counterpoint to the optimistic predictions from urologists and medical practitioners regarding the likelihood of a bloke being incontinent after a radical prostatectomy.

Many of my clients tell me the advice they received gave them a 10-20 percent chance of incontinence following the procedure, and that it might take months to come good (following an early period when almost all men have continence problems in the first four to six weeks of recovery). My clinical observations suggested this might be much higher. But then, I see those blokes who are struggling with the problem.

The study analyzed data from 1990 to 2007 and found that 90.3% of 1,616 men who underwent a radical prostatectomy without any radiation or hormonal treatment remained incontinent at 12 months post surgery.  The researchers cautioned that this needs to followed up with other large studies to confirm their findings chiefly because they could only follow up 37% of those who underwent surgery.  A further 4367 blokes were not fully followed up after surgery.

Perhaps of most interest to me was their attempt to link the ongoing incontinence to a range of independent factors. Having looked at the stage of the prostate cancer, the blood loss during surgery, the nerve sparing status at surgery and age of the men, the only one of these factors that correlated with the incontinence was age.  Sparing of the nerves did not make a significant difference.

Obviously more research is needed. For example, is the outcome different if the men undergo pelvic floor training before and/or after surgery?  A study along these lines is currently being done in Australia on the Sunshine Coast, but data is not in yet.

Ref:  Petersen A., Chen Y., 2012. Patient reported incontinence after radical prostatectomy is more common than expected and not associated with the nerve sparing technique: Results from the  Center of Prostate Disease Research Database.  J Neurourol0gy & Urodynamics, 31(1):60-63

Prevention is OK – if within budget

I was reading a very interesting article on Medscape this week which makes the point that preventative medicine is quite likely the only healthcare area in which cost is the prime driver.

Holding preventative medicine to a cost standard is something not practiced in disease care where a cure is the prime driver irrespective of price. Hence there are many government subsidised medical procedures, pharmaceuticals, screening programs and so on of questionable evidence base or cost/benefit value but are based in the disease care model so are less questioned.

Any suggestion of a preventative program is immediately costed and if not meeting budget targets, discarded. This may be a bit strong, but you get the idea.

I am reminded of a meeting I attended at the local private hospital some ten years ago where the Director was outlining their increase in medical specialists based at their brand spanking new specialist centre attached to the hospital. ‘Four cardiologists, two orthopaedic surgeons, two ENT, three physicians…’ and on he went proudly.

Later I sidled up and asked how many preventative medicine specialists they had recruited? He look at me incredulous and said ‘None, of course – they keep people out of hospital. We want doctors who admit patients.’ The business model of private hospitals is based on people getting ill or injured, and while they can’t actually promote this, they can certainly pave the way to their admission desk.

It makes you think.

Work Life Balance – Is it Achievable?

What a load of wishful thinking.  When I was a trainee physiotherapist studying human gait and locomotion skills my tutor pointed out that walking is a process of constantly losing balance in a forward direction, and catching it again by thrusting out a leg.  Repeat and you have walking.  Repeat at speed and you have running.  Don’t repeat and you have standing still, which itself is a constant process of almost losing balance and automatically correcting to remain stable.

Such is work life balance.  A constant process of being out of balance and trying to restore equilibrium before falling over. Sometimes it is work that dominates other times it is family or leisure activities.  If we sway too far toward work or life – one or other aspect will become neglected, triggering a recovery movement which will probably be an overcompensation until we perceive the next imbalance. 

To remain perfectly balanced demands extraordinary awareness and perception of small changes acting on us.  Increased work demands, family commitments, study, relationship maintenance, recreation, leisure hobbies or sports will all act on our balance.  It is easy to be unaware of the shifts until brought to your notice by a spouse, partner, child, employer, mate or mentor that you are getting out of control.

Personally, I feel work life balance an impossible concept.  Work is part of life, a subset of life that can swell or shrink from time to time.  It can never be larger than the life that contains it.  So if life is always larger, balance is not possible. Instead, I think of the work life ratio.  The proportion of life taken up by the physical, mental and emotional demands of work that will displace the same applications to the other aspects of life.  This ratio constantly varies as the demands ebb and flow.  It varies throughout a work day, a week, a year and a career.  It varies with the cycle of child rearing, steering and cheering. And, the optimal ratio for happiness, productivity and health will differ between individuals as well as across time. Understanding this concept within relationships (work, home, friends) should allow some elasticity without breaking the links.

The trick for each of us is to be conscious of the appropriate work life ratio for us at any particular stage, and to recognise when we have departed from this optimum and in which direction we need to shift to maintain equilibrium.  And to make the correction before too much damage is done to career, family, relationships, health or sanity.

Being open to advice, counsel or at least listening to the view of others may provide us with an early warning that we may be swaying too far.  Our natural hubris or confidence in our coping abilities can shield us from the internal messages, so the external input is vital.

What is the action plan?  Give some thought to your optimal work life ratio, and how close you are at the moment to achieving it.  Think back to when you had it right and what tools you used to get and keep it there.  If you are currently outside your preferred range, are the reasons legitimate and within your influence to manage them toward equilibrium using such skills as delegation, negotiation or just saying ‘no’. Discuss the concept with important people in your life (life partner, kids, business partner, employer, coach or parent) and consider their thoughts instead of putting up your defense shields.

Diseases of Lifestyle – choosing to be sick

At a UN gathering of NGOs and Public Health Organizations a consensus ‘Statement of Concern’ has been released asking the United Nations (UN), to hold accountable those in the food and beverage industry “whose products and marketing contribute substantially to the development of non-communicable diseases (NCDs) that kill 36 million people every year.” They are talking about lifestyle diseases such as diabetes, obesity, many cancers, cardiovascular disease and other diseases predisposed by consumption of alcohol, tobacco and foods high in salt, sugar and/or fat.
This is a fantastic idea but only strikes at the supply side of the market.  Until individuals are held accountable for the actual consumption of these products and prepared to foot their bills for healthcare costs and the lost social capital due to illness and death of parents, breadwinners and producers little will change.
Excessive consumption of these products, combined with an inactive lifestyle, often results in disease and associated costs of care.  The decisions made and actions taken on a daily basis by individuals exert market pressure on suppliers – we just need a critical mass of people changing the way they think, shop, consume and live to back up the Statement of Concern.
It starts with each of us.