We Need More Fun Not More Fun Police

The stupidity of government never ceases to amaze me. So far this year we have seen one local government wanting to charge people to exercise in its parks and a councilor in another claim that the City to Surf race should be “run somewhere else” (rather than to the beach).

Now just in time for summer we have Cottesloe council proposing a new raft of laws to make a day at the beach as much fun as a day listening to the thoughts of councilors. As usual this is all done in the name of making the beach safer and claims to be targeting “bad behavior”.

So what sort of dastardly crimes do the law abiding beach goers of Perth need to be protected from?

A few of the activities to be outlawed are digging holes (which are too big), flying a kite, taking photographs, playing with toy vehicles and having a gathering of more than ten people.

Just who will determine when a hole is too big? Will wee see rangers with tape measures deciding whether the hole dug by a five year old meets council standards. And too bad if your family has more than ten members, or if you have a group if friends, who you like to go to the beach with. And naturally any child caught bringing a toy car to the beach will rightly have it confiscated.

Ultimately this is all about petty bureaucrats and small-minded councilors trying to decide what people can do at the beach and raise some revenue into the bargain. The excuse is that the propose laws are in response to incidents. Even if there have been isolated incidents of “problems” due to a kite is banning flying kites for everyone the answer?

Of course not!

The increasing attempts by petty officials and small minded politicians at all levels of government to control each aspect of peoples lives needs to be stopped. Already a protest is being planned for Cottesloe Beach and a facebook group ha started. There are signs that due to the publicity the council is already backing away and is trying to blame some junior official for “misunderstandings”.

Fun and purpose is one of the pillars of DIY health. Petty laws which make it almost impossible to have fun at the beach without tripping over some ridiculous by-law is actually bad for the health of the community.

We need to have more fun, not engage more fun police.

There are enough laws to deal with antisocial behavior by the few. Infringing the rights of the majority with petty, stupid laws which seek to restrict and codify every possible use of the beach is an attempt by the totally humorless to inflict their view of the world on those who want to have fun. It is also a lazy way for governments to try and stamp out the behavior of a few by penalizing the many.

Freedom is one of those intangibles that we can take for granted until it is gone and you wake up one day to find you cannot play with your children at the beach. Health and freedom are related. Attacks on freedom need to be resisted.

Low Libido Can Be An Issue But Is Not A Disease

The knockback by the FDA of a new drug for female sexual desire again casts a spotlight on the medicalization of life. The drug was knocked back for the simple reason that it had not been found to actually work

Interestingly the comparison is made with drugs like Viagra (sildenafil), of which there are three on the market. Some have claimed that it is discrimination that drugs are made for men whilst women do not have any. Others question the existence of what is described as hypoactive sexual desire disorder.

So lets look at the facts. Tablets such as sildenalil do not actually stimulate desire for sex (libido) in males. They relax blood vessels allowing increased blood flow to the penis. This only happens if a man is actually in the mood or has been stimulated. The tablet does not affect libido.

Hence calling the new drugs a “female Viagra” is wrong as the proposed new drug is designed to work on the brain and affect libido not work on the blood vessels once desire is already established.

The other key issue is whether a low interest in sex is a disease. The fact that it exists does not make it a disease nor does it mean there is something “wrong” with women (or men) who may have a lower interest in sex than others. It becomes a problem it troubles the individual or is a problem in a relationship.

A problem can be real but not every problem is a disease and hence the answer is not necessarily a drug and may lie elsewhere. Worse still, labeling it as a disease, and looking for a drug as the answer, distracts people from the real cause and hence the real solution.

Sexual desire is influenced by a large number of things. Keep in mind that humans are almost unique in nature in that they have sex other than purely for reproduction of the species. Furthermore what constitutes “normal” is impossible to define. Whilst countless surveys are done to determine how often people have sex and their level of interest, all of these studies rely on self reporting and hence people may report what they want to rather than what they do.

Libido is influenced by tiredness, stress, diet, fitness levels, hormones and our emotions to name just a few. Obesity alone has a major impact on people’s sex lives. Obviously how a relationship is going to have a major influence too. At times other issues in life take precedence. When people are focused on work or on raising children, interest in sex can take a back seat. When people reach bed and are exhausted and really ready to sleep it is not surprising that they do not feel like having sex.

There is at times a clash between the mind which says, “we ought to be having sex” and the body which has not got the energy. As a society we also have very mixed attitudes to sex. Bar maids have been arrested for showing a glimpse of nipple yet half the videos watched don the Internet are pornographic. We express concern about teenagers having sex and yet bombard them with sexualized images. Marketers have known from day one that sex sells.

So what are we to do? A low interest in sex is only a problem if it bothers you. If it does then you need to realistically examine what is going on in your life. It may be that you need to change your eating patterns, or get fitter. It may be that you need to get more sleep. It may be that your relationship needs tending. Maybe you need some injection of romance. It may be that at present other things in your life are actually more important.

There is no absolute right or wrong. What matters is honest with yourself (and your spouse/partner) and making changes if you need and want to. Turning aspects of life into a disease and taking a pill is not the solution.

Women Are Smarter Than Governments And Health Experts

When messages get confusing, people switch off. This has been demonstrated in dietary advice, where it has been shown that the more complicated the diet; the less likely people are to follow it. It has now been shown that official government guidelines on drinking alcohol have little impact on the behavior of expectant mothers.

A study in the Medical Journal of Australia shows that 80% of Australian women consume alcohol while pregnant. The study looked at consumption before and after changes in guidelines in 2001. Prior to 2001, the government recommendation was to drink no alcohol during pregnancy. This was changed to a safe limit of 6 standard drinks per week or less than 2 per day. In 2009, the guidelines were changed back to total abstinence.

What has been shown is that the behavior of women during this time was unchanged. Some 60% of women consume a small amount of alcohol (consistent with the 2001 guidelines), 20% drink less than that and a little fewer than 20% don’t drink at all during pregnancy. Less than 1% were found to consume a level regarded as dangerous.

Much effort and expense goes into developing guidelines. Governments and health experts often wring their hands about people not following their advice

What is really interesting in these figures is that the vast majority (over 99%) of women can figure out what is reasonable themselves. The vast majority of women can work out what is a reasonable and safe amount of alcohol to drink. They are clearly dismissive of scare campaigns about the dangers of even one drink. The reason for this of course is that small amounts of alcohol have not actually been shown to do any damage to the fetus. In turn, the reason for this is that small amounts of alcohol are easily processed by the body ,with no adverse effects.

There are of course, renewed arguments over labeling of alcoholic beverages. Governments and in particular, public health officials, love to be seen as doing something and they particularly love to hector the general public who they generally regard as being stupid. This survey shows that women are actually much smarter than government guidelines and health officials.

Interestingly, at about the same time, another study emerged which suggested that women who drank one glass of wine a day might have children who were better behaved than those who either drank no alcohol or drank heavily. To be honest, I would be very suspicious of these findings. There is no reason why one glass of wine consumed during pregnancy should influence the behavior of a child later in life.

What was really interesting though is that the researchers, despite making this finding, advised women to continue to observe Government recommendations of total abstinence. If the finding is valid, then you think they would be advising one glass of wine per day. If this finding is not valid, then why has it been published at all?

It is easy to imaging the noise that would have been generated had the study shown that one glass of wine per day led to worse behavior in children. This would be hailed as vindication of Government guidelines.

Whilst many in health claim to be guided by science, it is fascinating to see how when the results of their science contradicts their pre-existing beliefs that results can be dismissed.

Rather than being guided by confusing and changing guidelines, clearly women are best guided by their own intuition.

Drug Usage Is Not Black And White

The airing of the Ben Cousins story recently has certainly fired up passions. It seems everyone has an opinion and so do I. Interestingly within the next week we saw more drug related headlines from another AFL player, Travis Tuck and actor Matthew Newton. Drug problems are not uncommon.

Ben Cousins has been a champion footballer in the Australian Football League (AFL) but his story could equally apply to a baseball, soccer or rugby or basketball player. It is the story of a kid who was thrust into the limelight at a young age and went off the rails and got into drugs. The television documentary followed the path of his journey through rehabilitation.

To be honest there was not a whole lot new revealed in the program. Most of the events had been reported in the media previously. However candid interviews with his family and his father in particular were revealing. In addition Cousins himself was straight up about his addiction.

There has been much debate as to whether the program sent the “right” or “wrong” message about drug use. Did it glamorize the use of drugs or show the downside. Good questions but they miss the point.

The documentary was about the journey of Ben Cousins. It was showing what happened to him. It was not about a message –it was a story. Rightly or wrongly this is a man who managed to combine a successful sports career with ongoing use of illegal substances. This happened under the noses of his club and the officiating league.

During this time he won the Brownlow medal (for fairest and best in the competition) and played in two grand finals. He managed to slip through various tests for substances and despite drug problems being an “open secret” in his hometown somehow nobody at the club seemed to notice. It is fair to say that drug users are good at deception. It is also fair to say that sporting teams do not want to know things about star players that might rock the boat.

This is the key point and it applies across the board. For as long as you are “useful” your indiscretions will be overlooked or excused. Here was a popular and extremely good player at a club looking for (and winning) a premiership. So long as he did his “day job” and kept his drug use discreet, neither the club the league or the fans really want to know. As soon as he ceased to be discreet and the issue was played out in public then there was outrage sacking and hand wringing over the game being brought into “disrepute”.

Much elite sport is played by men aged 18 to 30.This is the same demographic which has the highest levels of drug alcohol and violence related problems. Give some of these young men large salaries, lots of spare time and “hero” status because they can throw or kick leather around a park and you are inviting trouble. When it arrives everyone acts surprised. What is really surprising is that there are not more young sports people going off the rails.

Ultimately the outrage over Ben Cousins is not that he used drugs and “got away with it”. It is that he has dared to state this publically. The reality is that not all drug users are in the gutter, they live among us and we do not recognize them because they do not fit stereotypes. The notion of addiction, which is promoted by governments and health authorities, applies to a small percentage of users. Disturb this image and you get the sort of response Ben Cousins got.

Drug usage is not as black and white as health authorities and governments like to portray it. Some people go quickly downhill. Others function “normally in society. Some use often, some occasionally. Young people are not scared by horror stories because they see a different spectrum of reality day to day.

Honesty rather than lecturing would be far more productive.

Use of illicit drugs can and does destroy lives. So too at times does use of prescription drugs-witness Heath Ledger and Michael Jackson. Rather than demonize people perhaps we need to understand what drives them to make these choices. It is through this type of understanding rather than making the drug the problem that we may be actually able to advance our capacity to help people heal and regain their health and their lives.

Inventing Disease

With the huge amount of research that surfaces each day, it is not surprising that the quality varies considerably. Sometimes, you actually have to wonder whether the researchers are having a joke at our expense. Dubious research coupled with the tendency to disease mongering and the creation of new conditions can lead to hilarious outcomes.

If this story had appeared on April first, it could easily be dismissed as an April fool joke. However, as it appeared at the end of June, it seems these researchers take themselves seriously. With straight faces, they warned that Australian teenagers are becoming text addicts and in turn, risk a “range of serious mental and physical disorders from depression to repetitive thumb syndrome”.

To help legitimize this nonsense, new terms have been created. “Textaphrenia” is defined as hearing texts arrive when they haven’t and constantly checking to see if a message has arrived. “Textity “is the anxiety felt when they haven’t received a text or are unable to send texts. Post traumatic text disorder are injuries that occur when texting such as walking into things and feeling depressed when people don’t contact them. Binge texting is sending lots of texts. One can only wonder who pays for this sort of research.

This sort of research can be easily dismissed as absolute nonsense. Clearly, texting, which is a relatively new phenomenon by human existence standards, can, like anything, can be taken to extremes by some individuals if they chose to do so. There is no disease entity involved in this. Unfortunately, creating terms like the ones above, allow people to make excuses for their behavior. One wonders if somebody crashes their car while texting will be able to claim that they were suffering from one of these text related conditions and offer that as an excuse.

Furthermore, it continues the trend to medicalise human behavior. Texting is a form of communication. In exactly the same way some people talk more than others, some people will send more texts than others. Some people have brown eyes and some have blue. None of these represent abnormalities or disease processes. Some people will over do activities be it texting, eating, drinking or any other form of human past time.

The solution to this is not to create fancy new medical terms and pseudo diseases. The answer will certainly not be in developing medications to control these non-existent diseases. The continued medicalisation of life is an invitation to people to not be responsible for their actions. The solution is in fact for people to take ownership of their behavior. If they send too many texts, then the simple solution is to send less. If you walk into walls while texting, then the solution is to look where you are going if you are not able to multitask.

Life can be actually fairly simple when researchers are not involved.

Spending On Disease Does Not have to Keep Rising

You would need to be living under a rock not to know that health (disease) care spending is continuing to increase. The total spending in the OECD is increasing faster than economic growth and inflation in the OECD.

The USA spends the most at around 16% of GDP nearly double the OECD average of 8.3%. This average has gone up from 7.3% in the 1990s . Governments are generally responsible for half or more of this spending. Virtually all the focus at a government level is on how are we going to pay for more disease care in the future.

A different question would be how can we keep healthy so as not to have to spend so much. There are two aspects to this. The first and (dare I say obvious) one is people actually being healthier. With three quarters of spending on “health” being spent on preventable lifestyle related conditions there is plenty of scope . For example 80% of cases of stroke come about in people who are overweight or eat poor diets, smoke or do not exercise. Strokes are extremely costly both in dollar and human terms

There is another aspect as well. One of the big costs in the system is pharmaceuticals particularly those which are “lifelong” treatments. You would think that there would be a interest in making sure that the money was well spent and that there was value, once again, both in dollar and human terms.

Statin drugs, which are used to lower cholesterol, generate billions of dollars in sales on the basis of reducing heart disease. Yet there has never actually been any evidence, which shows that cholesterol in the bloodstream is the problem.

Furthermore there has been a trend to place more and more people on these drugs as a form of “prevention”. Yet a major analysis has shown that for people without heart disease there is no decrease in mortality in those with risk factors who take a statin. Fully three quarters of the people taking these tablets are in this group.

Basically millions of people are taking an expensive drug, which is not actually doing them any good. Questions have also emerged about a study in 2008, which showed benefit from one statin in reducing heart disease given that nine other trials found no such benefit. These focus on the independence of the researchers.

Meanwhile an expensive diabetes drug (Avandia) is under question due to evidence that those taking it had higher rates of heart attacks and strokes than those not taking it. These two conditions are more common in diabetics and one of the aims of managing diabetes is to reduce these conditions. Again you would think that this would raise alarm bells in medical and government circles.

There are more and more examples of this emerging with long term drug use. Medications are trialed over short time periods and then used over long periods. Problems not apparent after two years might become apparent after ten years.

Our reliance on pills is costing us in both dollar and human terms. Every person taking a tablet they do not need is risking side effects for no benefit not to mention enduring cost to their hip pocket. Every time a use for a pharmaceutical is widened to capture more people being in a “risk” group the more this cost increases.

It is time we rejected unnecessary use of pharmaceuticals and were far more questioning of the cost benefit equation in the ones we do use.

Relationships Do Not Have To Be Complicated

Relationships form one of the pillars of DIY Health. There are many different relationships that we have and over the last week we have seen examples of how the way we conduct these this impacts on people, for better or worse.

There are two separate events, which caught my eye; resignation of the CEO of David Jones department store after allegations of sexual harassment, and the furor over allegedly racist comments by a former footballer. Both say something about our relationships.

Firstly were the comments made at a private function by a former footballer Mal Brown who allegedly made references to Aboriginals and cannibals in jest. Not surprisingly this made the news for a few days and led to the usual screaming from those with a vested interest in doing so.

Now I was not at the function, so do not know the context of the comments. However following media reports millions of people became aware of the comments of one person instead of the small number in the room. More interesting are the claims that one person’s remarks are widened out to suggest it represents “systemic racism” either in football or society in general.

Of greater significance is that the man who made the comments has a long track record of playing and coaching Aboriginal footballers and has probably done much more to help their advancement than many of those now screaming out in “horror”. A sign of maturity in race relations will be when jokes whether bad or good are seen as jokes rather than put into a political context. Laughter is one thing we all have in common as humans.

The resignation of David Jones CEO Mark McInnes again highlights how traits, which serve people well, can lead to their downfall. There is a long long history of leaders be it in business or government having multiple affairs, relationships, mistresses or whatever term was popular at the time. This goes back to the days of Caesar and continued through to Bill Clinton. “Leaders” in other fields have a similar track record.

In this particular case the man has resigned and is forgoing something in the order of $16 million in lost entitlements compared to seeing out his contract. There is no way a fine of that magnitude would be imposed by a court. Furthermore nobody is disputing he was extremely good at his job.

None of this excuses behavior, which is unacceptable and he has paid a high price. Equally one can also wonder if the behavior is shaped by the fact that other women may well have warmly received or even sought his attention. It is likely that some did. It is also likely others did not but were not prepared to speak out. There will undoubtedly be more stories emerge over the next week or two

The problem is that often the exact same drive and personality traits which led to success and rising up the power ladder can send you right back down again. A football coach who calls a spade a spade may go far on the playing field but come unstuck at after dinner functions. A CEO who charms women does well in running a retailer but comes unstuck from his private dealings with people if he does not learn where to draw the line.

Relationships are often made more complicated then they need to be. They are never helped when people who are in no way affected jump in with opinions or interpret behaviors through their own biases or worldview.

The old golden rule of do onto others as you would have them do onto you does not even quite work in the politically correct age. You need to do onto others, as they would have you do onto them. For that to occur we need to be honest and open in our dealings with people. We can not expect others to be mind readers. We need to tell them what we do and do not accept and we need to act on that accordingly.

Maybe relationships are not that difficult after all.

Be Questioning

A survey of Australians shows that church attendance has fallen about one third over the last 16 years. A number of other “religion” parameters such as belief in heaven and god have also fallen although running in parallel with this is an increasing interest in spirituality, separate from religion.

This trend is part of a broader trend in society away from “authority” figures and institutions in general and to a greater desire to find ones own way rather than be told which way to go. We see this in declining church attendance but also declining regard for judges, police politicians (of course) and dare I say even doctors.

Ultimately the problem we have is that people have used authority badly and come to feel that it is the position they have which confers importance upon them rather than position being recognition of what they bring to it. In other words putting a robe on me does not give me moral authority if I do not have it without a robe. If a person is corrupt, putting them in a police uniform does not change who they are. Yet we see time and again the excuse of position being offered when people are caught out.

There is no doubt in my mind that the response to child sexual abuse by the church has contributed to its loss of credibility. There has been more energy expended trying to defend people and position than trying to resolve the issues.

In other fields similar problems emerge. Reports of two undercover policemen arresting and charging a skimpy barmaid for showing too much buttock will leave many wondering why the police are not spending their time investigating murders and robbery. A similar thought goes through my mind every time I cruise by two policemen under a shady tree holding a speed radar.

The medical profession is not immune to this trend and is also guilty of undermining public trust by its own actions. Reports of researchers and doctors being paid by pharmaceutical companies for research which invariably is favorable to the sponsors does not help credibility. Neither does beat ups like swine flu.

Despite overwhelming evidence that this is not a major threat, health authorities are at it again with claims of chaos and horror to come. This is after a vaccine, which was not needed, was rushed to market and then withdrawn from use in children under five following an unexplained death. Official pronouncements of safety do not sound good in these circumstances. Little wonder that peoples confidence is shaken.

Meanwhile we are constantly told that the whole reason for vaccination is that people are protected against the illness they are vaccinated against. This flies in the face of the actions of the WA health department after a case of measles was found. A frantic search was done to find all possible contacts. If the herd immunity principle works, then why the panic? Interestingly one of the three cases was a paramedic who you would assume was vaccinated.

A two page circular to doctors gives “useful “advice like conducting an examination in a room which can be left vacant for two hours and avoid “suspects” using the waiting room. And who are these suspects? People with a fever ,cough and sore throat. The average doctor would of course not see many of them in winter would they? Apparently people born before 1966 are automatically immune!

Now measles is not a pleasant illness and vaccination has contributed to its decline. However generations survived it in much lesser circumstances than we enjoy today. If the whole purpose of mass vaccinations is called into question when one case is found is it any wonder that people become questioning.

Wealth and Health are Connected

Whilst being rich does not of itself guarantee a long or happy life and many people with little by way of monetary wealth live a long and happy life wealth and health are linked.

As nations become wealthier the overall standard of health rises. We have seen over the course of the twentieth century that as nations industrialize, standards of living improve and so does health. This is not due particularly to medical science and owes very little to high technology medicine.

It comes about through people having clean water, better overall hygiene and sanitation, better protection from the elements and of course access to enough healthy food. The last one can go the other way as we see with problems of too much of the wrong sorts of food being consumed leading to a whole different set of health problems.

The other aspect that is important in health and is pillar eight of DIY Health is fun and purpose. As humans we need to be doing something that we feel matters and that we enjoy. As nations become richer the diversity of opportunities increases exponentially. Once we are free from having to spend much of our time looking for food or defending our territory we can focus on other things.

This may be a job, running a business, creating works of art travelling or a myriad of other things. The key things from a health perspective is that we enjoy what we are doing, that it has some challenge and that we feel there is a purpose. These three components are what the University of Pennsylvania has described as constituting authentic happiness.

Equally, we all need a certain amount of money to live. I am not talking about living in a palace or flying first class but enough to be comfortable and do most of the things we would like to do. People who are successful usually become wealthy because other people are attracted to the value they create. This can be in business or in the arts or any field of human endeavor.

When people have made an effort and created value it is fair and proper that they be rewarded for it. Furthermore, often these people create wealth for other people too either in the form of paid jobs or investment opportunities. Once again this is right across the board with regards human activity. Many who are successful increasingly put back into their community in a variety of ways.

The current debate about the mining tax in Australia highlights the passions aroused when those who create wealth and opportunity for themselves an others find themselves subject to arbitrary government rule changes. Governments by their nature can never create wealth or add value. This can only be achieved by individuals, acting alone or with others, in some form of business.

Different countries have prospered because of different industries. All countries, which have prospered, have done so because individuals and businesses were prepared to take risks in the hope of reward. To attack the reward after the risk has been taken will naturally arouse anger. I am not aware of any other country, which deliberately set out to weaken the business sector, which had been its most successful. Australia’s most successful industry is mining.

Governments argue that the taxation money can be spent in the community. Sadly governments of all persuasions have a bad record of efficient use of funds. Suffice to say the current one is true to this pattern. Excessive taxes and government interference in the economy leads to increased unemployment.

The best way to strengthen the community and for people to prosper is for people to have purpose, like a job or business, and the opportunity to invest their monies. Diminish this and you diminish the community and the nation.

When the wealth of the nation is collectively affected, the health of the nation will also be affected. It is little wonder passions are running so high and across so many levels of Australian society.

Long Term Drug Use Can Have Unexpected Side Effects

Much is made of the fact that pharmaceuticals are tested before being released. Trials are done to assess whether the drugs work and to assess the side effect profile. Many drugs never make it to market because in the trial process either they are not found to so much or there are significant other problems, which outweigh their benefit.

This process is a useful one. However it also has limitations. Over the last few weeks we have seen data emerge about long term unexpected problems with widely used drugs. Statins and proton pump inhibitors are in the top five for widely used drugs in many western countries. They are also amongst the most costly to the health system. Statins are used to “treat” cholesterol and proton pump inhibitors are used for ulcers reflux and other stomach acidity problems.

When trials are done they are conducted on relatively small numbers of patients for a relatively short period of time. At tops it may be a few thousand people and often for less than two years. Indeed it may be so many hundred people for so many months. It should not come a s a surprise then that less common problems or those which may take many years to show up will not be picked up in these trials.

When the drugs are used by millions of people for many years new problems may emerge. For example an effect, which occurs one in every 100,000 people, may not be seen in a trial of 5000 but there may be 20 by the time 2 million people have used it. Of course effects, which take ten years to show up, will not be seen for at least that time.

So after nearly 20 years of statin use we are seeing that there are increased rates of liver dysfunction kidney failure, cataracts and myopathy (muscle damage) in those taking long-term statins. The increase may be as high as eight fold. These figures come from studying 2 million people over a six year period. The findings were published in the British Medical Journal.

Meanwhile the FDA has called for labeling changes on proton pump inhibitors after finding an increased rate of fractures in people using them long term. It has also been found that long-term users have much higher rates of clostridium difficile infection causing diarrhea.

It is not surprising to me that when you interfere with the gut there will be consequences. The stomach has acid for a reason. Block it and you will affect absorption of food and other gut functions. The higher rates of diarrhea suggest that the bacteria are better able to survive in a less acidic stomach. Bone fractures suggest the absorption of minerals is being affected. There may be other direct effects on bones too, which have not been determined.

Does this make these drugs dangerous? No it does not. What it shows is that long term use of medications have unexpected consequences. In also shows we do not always know the long term safety of drugs when they are released.

Most importantly it tells us that reliance on drugs for lifestyle related conditions is not a free lunch. The notion that it is easier to take a pill than to change our eating patterns (for example) may seem fine in the early days. After the unexpected long term problems arise it may not seem like as good an idea.

The bottom line is that lifestyle related conditions require lifestyle solutions. Some people may need medication but this should be used for as few people as possible and for the shortest possible time.

No,Prime Minister,People Need Sleep To Function Effectively

It is fair to say that many government decisions are not particularly good. There may be an obvious reason for this emerging. Australian Prime Minister Kevin Rudd is “unapologetic” about his staff working long hours and there being a high turnover rate of staff.

Apparently staff can start at 4.30 am and still be on the go at 10pm.Seven day weeks are not unusual. Mr Rudd claimed a year in politics is like a dog year, seven years crammed into one. He claimed that people expected their government and politicians to work hard.

It seems the PM is unable to differentiate between quality and quantity when it comes to work. Furthermore he also seems to be unaware of the health effects of long hours and its impact on decision-making and the impact of high turnover.

Any human resources manager will tell you that staff turnover places a huge burden on business. There is loss of corporate knowledge, and the time taken to get a new staff member up to speed can be some months. All the while productivity suffers. This is quite aside the monetary costs of paying people out and the costs of recruitment. In business these costs affect profit whereas in government it is just borne by the taxpayer.

It gets worse. Sleep deprivation affects both health and productivity. NASA studies have shown that after 20 hours continually awake your brain is affected the same as with a blood alcohol reading of 0.05%. This is the cut off level governments set in most countries for drink driving. At this level you are not fit to drive. So how can you run the country?

In addition to this lack of sleep contributes to an increased rate of high blood pressure and heart disease. People who do not get enough sleep are more likely to be obese. When they do finally drive home, obviously there is a greater chance of a road collision and injury to them or someone else. Lack of sleep contributes to stress and in turn this can increase the likelihood of getting cancer five fold over a ten-year period.

For governments who claim to be concerned about health and wanting the population to be healthier this is a strange way to act. However even if we totally ignore this (and one wonders what the Health Minister would say if a public company forced employees to work these hours) there is another aspect.

Experiments have also been done on productivity and sleep. Sleep deprived people are less likely to work co operatively with others, are more irrational and more prone to emotional outbursts. Has anyone ever seen the behaviour of a tired child? Well it is the same in adults.

People want government to be effective. This is measured by outcome not hours spent. Indeed what we are seeing is that the modus operandi of government leads to poorer results by making its employees less healthy and getting them to work when their brains are far past their best for the day.

I would not want to be operated on by a surgeon with a blood alcohol level of 0.05% or equivalent in sleep deprivation. I do not want decisions made about the governing of the country by people with a blood alcohol of 0.05% or the equivalent in sleep deprivation.

The final irony is that the hard work keeping everyone up was on … health reform.

Health Reform Is Not More Services - It Is People Being Healthy

Health reform is on the front page in Australia, again. Prime Minister Kevin Rudd revealed a plan for the Commonwealth Government to take over the funding of public hospitals from state governments. Prior to being elected in 2007 Mr Rudd promised to fix the health system and stop the “blame game”.

Funding of the health (read “disease” system in Australia is split between the two levels of government. In simplest terms the Commonwealth raises tax dollars. It then gives the states a pot of money under the Australian Medicare agreement, to run the public hospitals. This allows Canberra (the capital) to blame the states for not wisely spending the money they have and allows the states to blame Canberra for not providing them enough money to do the task.

Strange anomalies occur. For example, if you get a prescription from a doctor in a private practice and get it dispensed at a pharmacy, the Commonwealth will in part pay it for. If you get a prescription at an emergency department and it is filled out there, it is paid for by the state. See a specialist in their consulting room and it costs the Commonwealth. See the same specialist in a clinic and he will be paid by the state. This has also led to attempts by both levels of government to try to push costs on to one another. For example hospitals now send people home with little or no medication whereas previously they got two weeks worth. This “pushes “ the cost of tablets onto the Commonwealth.

These discussions about funding cause the eyes of the average person to glaze over. The dollars involved are astronomical. The Treasury’s Intergenerational report suggested that spending on “health” would rise from 15% of Commonwealth outlays to 26% by 2050. Type 2 Diabetes is estimated to increase six fold by 2033. It is already estimated that obesity costs Australia $56 billion a year.

As usual all these arguments centre on how to pay for an inexorable increase in demand for services. The issue is the same in the USA and all western countries. Australian Health Minister Nicola Roxon told Fairfax radio taxes might need to rise, as “ …we have to be able to fund delivery of services into the future”.

Has it ever occurred to any of these bozo politicians that the solution may not be in trying to fund more and more services? Has it occurred to them that the solution may be in finding ways to lower the need to provide services? Are they aware that 75% of spending on services is already for preventable lifestyle related conditions, which are preventable, or reversible with simple changes to how people live their lives?

Or is it better to promise to fix people and hence make themselves look important. Oppositions always promise to fix health. When in government they find that they cannot do this. I doubt it comes as a surprise.

Western Medicine is great at acute care. If you break your leg, I do not believe that herbs or meditation will fix it. However Western medicine does chronic disease very badly. It offers expensive pills and technology when lifestyle changes are what are needed. This is why our disease systems are unable to cope with demand. They are not suited to the task. Hospitals are not the answer to diabetes obesity and other lifestyle related chronic diseases or the consequences thereof. Hence our systems are struggling. More of the same will not be the answer.

The answer lies in the hands of individuals who can choose to be healthy rather than wait for the system to “fix” their disease. In this scenario the disease systems will easily be able to cope with the demand for what they are good at, treating acute illness and injury.

Learning From Falling - Personal Responsibility Versus The Nanny State

Anyone who has learned to walk has fallen over. The way babies learn to put one leg in front of the other and keep balance is through practice and the neural feedback that comes from falling down. The brain fairly quickly learns what does and does not work so that the baby learns how to walk.

Without the feedback of falling we would never learn to walk. As we go through life we may fall down doing other things and learn from this too. This is both literally in learning various sports, including monkey bars as children and metaphorically when we “fall down “ in exams or in business. In fact no one who has succeeded at anything in life has done so without falling down, usually many times. Those who learn from their falls get stronger and better at what they do. They are not fearful of falling, as they understand it is part of the process of life and learning.

Try playing any football code without falling over. Try learning any snow sport without falling over. You cannot do it. This last week we have seen the Winter Olympics and there have been many falls. Australian Torah Bright fell on her first run at the snowboard half pike, got up and then nailed a perfect run on her second attempt and received the gold medal.

This, get on with it attitude, was sharply contrasted with the events in a British town which in the same week banned contestants from running in the annual Shrove Tuesday Pancake race. The event has been held since 1445. In 2010 health and safety council officials in St. Albans, Hertfordshire decided that any person caught running would be disqualified as conditions were unsafe and someone might … fall.

One contestant was quoted in the Daily Mail as saying “I have been disqualified from a running race for running”. Now if the ground is wet, and let us remember that February is winter in the UK and it is known to rain, then this has been the case since 1445.

No doubt the council officials will cite legal concerns as the reason as well as concern for injury. And therein lies the problem. Firstly, no one is forced to run in this race and anyone who does will be aware of the ambient conditions. The fact that any legal system would allow a person who has chosen to run in a contest and falls over to “blame “ the council is ridiculous and is something that governments in a number of countries need to address.

The second issue is that health and safety has gone from being a good idea to nearly a cult with some in officialdom who see it as their role to save everyone from every possible form of hurt, no matter how slight. Yet it is not possible to protect people from themselves and worse still, attempting to do so robs those people of the opportunity to learn how to manage risk themselves.

Closer to my home, a former mayor of Cottesloe bemoaned that all the fun had been taken out of playgrounds which needed to be risk free and hence provided no challenge to children. The po-faced reply from the town CEO was that playgrounds needed to conform to Australian standards. How are children to develop motor skills without some form of challenge? This again is all about legal issues and nothing to do with what is best for children.

Like all things in life there is a happy point in the middle. It is not about leaving babies unattended by fires in the hope that they will learn that fires burn you. It is also not about stopping adults from making a choice to move along a road on foot at a speed, which they feel they can manage.

The notion that adults can be protected from all risk is not only wrong but also not achievable. The notion that children can be protected from falling is also wrong and not achievable. Worse than that it is counterproductive. Governments complain about childhood obesity in one breath and make outdoor activity boring for children in the next.

What is the answer? With children it is about teaching them to manage risk in exactly the same way as they learn to walk. Falling at times will be part of this. In adults it is about taking back responsibility for our behaviors. If I fall over while running then that is not the fault of the person or entity that owns the piece of ground, it is mine.

Those of us who feel that the state has gone too far in seeking to control all aspects of life need our voices to be heard.

Dr Joes DIY Health Guide to Christmas

At live presentations this month I have been asking the audience “Who is looking forward to Christmas”? A number of hands go up. The next question is Who is looking forward to Christmas being…over? A second set of hands goes up.

If I asked a group of year one school children the same questions all hands would go up the first time. The reason that some of us look forward to Christmas being over is of course stress.

It is a slightly sad reflection on society that so many people see Christmas as a stressful time. Yet as I have said before “stress is not about events themselves but what we make of them”

At one level Christmas is a day of the year like any other. At another it is a day of celebration of the birth of Jesus Christ. At a third level it is a secular celebration with gifts and get togethers. Finally there is the “festive season” which can start in mid November involving a series of events at which one may eat and drink.

The biggest stress issues around Christmas are weight gain from overindulging, bank balance loss from overspending and anxiety from interacting with those who you would prefer not too.

So this year rather than Survive Christmas why not enjoy Christmas. There is much that can be done to make sure you enjoy Christmas based on the 8 Pillars of DIY health.


1 Each day spend 30 seconds to take 3 slow deep breaths do this at least 4 times a day. This will reduce stress.
2 Drink water. Before you go to a function have a glass or two of water. Keep yourself hydrated. If at a party alternate water with alcoholic drinks.
3 Finger food is notoriously high in calories. Eat a carrot or other piece of vegetable before you go out. This way you will not be as hungry and hence you will eat less.
4 Keep active. Do some walking or other exercise everyday (or at least 3 times a week).
5 Don’t be the last to leave. You need your sleep.
6 Realize you have choices about whom you see and what you buy. Your stress levels will be a function of your choices not the “world out there”. Be honest with yourself and others about what you can and can’t reasonably do.
7 Buy your Christmas presents with cash. That way you know you can afford them and you won’t stress about the credit card bill in January
Only buy gifts for people you really want to give one to.
8 Christmas is a time for goodwill to all but if you really don’t like spending
time with certain people (even if they are your family) then it may still be better not to. Be polite but firm in declining invitations. Make sure you spend time with those you really care about If there is “no way out” then say to yourself “this too will pass” as often as needed. It will pass and by adopting this approach you will not stress.
9 Christmas day lunch is a meal. If you are having people around you don’t need more food than if they were coming any other day. If it’s a big gathering have everyone contribute a plate. You don’t have to eat till you feel like you will “explode”.
10 For some the preferred option is to “cancel” Christmas and just go to ground and emerge again on December 27.
11 Have fun. Children enjoy Christmas. There is no reason adults can’t do the same. Allow yourself to be a child again. Pop crackers enjoy unwrapping presents and playing with the wrapping paper.
12 Consider having some “purpose” around Christmas. Maybe do some volunteer work? Perhaps reflect on what you can do to be a better person or how you can contribute to your community.

For virtually everyone there was a tie when Christmas meant fun. Somewhere along the line this has been lost for some of us. This year ask yourself what needs to happen for me to enjoy Christmas as much as when I was six years old? Then go and have fun.