Rhubarb Crumble

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Ingredients

500g rhubarb, sliced into  finger chunks

3 tbsp date syrup

140g of home made muesli ( oats, dried bananas and raisins)

140g of wholegrain spelt flour or almond flour

50g flaxeed( optional)

100g butter of your choice or 3 tbsp heated coconut oil

Method

  1. Place the rhubarb, date syrup and a splash of water in a pan, mixing well to ensure the syrup melts into the water.  Cover and cook on a low heat for 15 minutes, checking regularly that it is soft. You may want to add more syrup according to your taste.
  2. Preheat oven to 200C/gas 6. In a separate dish, mix the muesli, flour and flaxseed and then add the butter, mixing the ingredients ith your hands until it becomes crumbly.
  3. Pour the rhubarb in a medium sized baking dish and scatter the crumble over it. place in the oven for about 30 minutes or until brown on top.
  4. Enjoy on its own or with a creamy side. I like mine with ice cream so had some home made ‘nice’ cream!

 

 

Sweet potato and quinoa salad

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Ingredients – serves 2

1.5 cup of quinoa
290g of mushrooms- chopped
200g of spinach – rinsed and drained
2 medium sized sweet potatoes
One green pepper -chopped
Garlic – 2 cloves

Preheat the oven to 180degrees. Wash and chop the sweet potatoes into squares. Leave the skin on for more fibre.
Place on an oven resistant tray. Season with black pepper, sea salt, olive oil, herb seasoning- dried basil, parsley, oregano, turmeric and paprika (enhances the colour), one glove of finely chopped garlic. Let it bake for 39 minutes or until soft and crispy on the outside.

In the mean time, rinse and boil the quinoa- use the cooking instructions on the pack. If no instructions, then it is 2 cups of water for every cup of quinoa. Usually boil for 25 minutes. Season with a bit of salt before boiling.

15 minutes into both above cooking, sprinkle some oil – rapeseed oil or coconut oil in a pan or wok. Add some salt, black pepper and herb seasoning- basil, parsley, oregano, garlic and a bit of ginger. Sauté the mushrooms until soft. Add the spinach and a bit of salt and black pepper- stir fry for a couple of minutes until it is wilted. Add the green peppers and stir fry for a short period so it is still crunch but warm.

Make sure you check the potatoes and quinoa every 10 minutes to give them a stir and ensure it is progressing well.

In a salad bowl, mix the quinoa, sweet potatoes and mushroom stir fry. Taste and add more seasoning if required.

Serve on a plate and enjoy!
Sweet potato and quinoa salad

Recipes

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Vegetarian Thursday

Plant based diets are great as they provide us with alot of nutrients the body needs to thrive. It also helps the environment – ‘two birds with one stone.’

As someone who had animal produce everyday, having a vegetarian day felt like a good way to increase my consumption of nutritious foods.

This section is a work in progress ,please check back regularly for interesting recipe ideas.

Well woman Health screening – The facts

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We as women go through the hustle and bustle of our lives, working a lot and looking after our loved ones without much thought of ourselves as long as we feel and look alright. This is fantastic, however we must sometimes stop and ensure that we aren’t missing vital health checks at various stages in our lives.

In this question and answer session, I would like to discuss and empower you on checks and therapies that are important throughout a female’s life, ranging from adolescence to postmenopausal.

I have daughters age 12 to 18. Are there health checks that are recommended?

By age 12, one would expect most girls to show signs of puberty and start their periods by age 13, however this can vary from 11 to 15 years old. If your daughter has no pubertal changes (for example no breast buds by age 13 and no periods by age 15), it is recommended that you seek medical advice as this means puberty is delayed and needs investigating.

Regular eye and dental checks are also important and should be lifelong. Start early!

In addition to the usual immunisation schedules, based on available evidence and because cervical cancer is the second most common cancer in women under 35 years old, it is recommended girls from age 12, get vaccinated against HPV (human papilloma virus) before they are sexually active. This prevents against cervical cancer and possibly genital warts. There are two types of vaccines and they protect against the two high risk types of HPV that cause 70 per cent of all cervical cancers. One of the vaccines, gardasil, is also effective at preventing genital warts.

I am between age 18 and 24, do I need any checks?

Young women are usually fit and well, however, if you are sexually active or are about to become active, it is important that both you and your partner have a screen done for sexually transmitted infections. Chlamydia for instance is an important one to check for as it is common amongst people aged 18 to 24, easily detected and readily treated with antibiotics.

One might be pleased to know that other than a sample of blood for hepatitis, syphilis and HIV, other sexually transmitted infections such as chlamydia and gonorrhoea can be tested from a self-taken vaginal swab. These can be carried out by visiting a sexual health clinic or your GP. Some are also available at local or online chemists. Treatment varies depending on your results.

Aged between 25 and 39, What do I need to know?

Healthy lifestyle changes regarding diet and exercise must be part of our daily routine. The health changes we make now will sustain us for many years to come as long as we make it a lifestyle choice.
It is also important to start being aware of your body and know what various parts feel like. In particular, breast awareness is very important and knowing how to check for any abnormalities is vital. Breast cancer affects one in eight women and is the most common cancer in the UK and among women age under 40. Being breast aware – how they look, feel, nipple changes and any lumps or bumps- is vital to pick any early signs. Do seek medical attention should you notice changes.

As well as continuing the checks above, it is important to have cervical smears every 3 years until the age of 49. Following this, every 5 years should be sufficient unless otherwise indicated by your doctor. This involves taking a small sample from the cervix (the neck of the womb) to check for any abnormal cells that might lead to cervical cancer.

If you are on contraception, having regular discussions and checks of your blood pressure and weight are also recommended as hormones can affect these.

This is the age range in which longstanding heavy periods can begin to show their effects and you may experience symptoms of tiredness and low energy. Should this be the case, it is advisable to have a blood test to check for your iron levels. This is easily corrected with supplements and dietary changes as well as considering medication to make the periods lighter.

This is the time in our lives when we consider having children. It is therefore important to see a health care professional for preconception advise and checks (these include use of supplements and weight, blood pressure checks respectively) should that be the case. This is especially important if you have a pre-diagnosed medical condition such as thyroid problems or diabetes or are on regular prescribed medications.

Age 40 to 60, am I healthy?

Compared to our ancestors in the 18th century- who had a life expectancy of 40 years – thanks to modernisation, we still feel young and healthy well beyond this age.

However, we might begin to question how healthy we are. This is the time to have regular health screenings such as your blood pressure, blood sugars, bone health and cholesterol (fat in the blood). Attending the NHS health check programme (offered to those between age 40 to 74) is advisable as it aims to help prevent heart disease, stroke, diabetes, kidney disease and certain types of dementia. It is offered once every 5 years. Also known as a ‘midlife MOT’, it checks that the body’s most important systems are running well. Your healthcare professional takes a comprehensive assessment and does tests including your cholesterol, blood sugar and weight. These result are then discussed with you during the appointment.

From the age of 50 onwards, it is even more important to be breast aware as the risk of breast cancer goes up with age. Attending regular mammograms every 3 years is vital. This is a breast x-ray to look for any changes that might suggest cancer. Breast cancer affects 1 in 9 women and checking for changes helps greatly in decreasing its impact.

Age 60 plus- Am I healthy enough to look after my grandchildren or travel the world?

Having maintained a healthy lifestyle throughout the years, we should be able to take this through into our 80s and 90s and remain fit and active. Unfortunately, certain conditions are more common at older ages and it is vital to have more checks.

Important ones not to be missed are regular eye tests, to check for eye pressures, cataracts and degeneration. Seeing an optician yearly should pick up on any problems.

It is essential to regularly monitor our gut health and have regular screens for bowel cancer. A simple stool test is usually all that is needed on the NHS, everyone age between 60 to 74 years old are sent a home test kit every two years.

The health of our bones becomes even more important especially as we are now post menopausal. We must keep moving and / or exercise regularly and get adequate doses of calcium and vitamin D. A screening test for osteoporosis may be indicated, depending on your medical history. The test is usually a dexa scan- a bone density xray using very low doses of radiation- which takes about 10 to 15 minutes, causes no discomfort and involves lying down whilst a scanning arm passes over you to take pictures of your spine and hip. Please discuss with your doctor wether you will benefit from this.

Health Conditions in the Summer

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Summer brings on a sense of vitality and health. The longer, warm days means spending time on activities outdoors. Whilst this is enjoyable and therapeutic, some hazards can occur. Here’s a few to be aware of and ways to prevent them.

Eye injuries

We often take our eyes for granted and whilst we might remember to use sun screen, we often forget to protect our eyes. The sun rays can lead to several problems in the eyes, even on a cloudy day. From inflammation of the cornea(photokeratitis) to an overgrowth of the conjunctiva(pterygium) to longterm damage with cataracts and macula degeneration, these eye conditions are associated with exposure of the eyes to sunlight. Symptoms include pain, noticing a growth in the eye and a decrease in your vision respectively. In order to prevent these, it is important to protect the eyes using sunglasses that are labelled as uv rays protective. Wearing a widebreamed hat also helps.

Food poisoning

Summertime means barbecues and salads. Whilst this can be healthy, it also increases the risk of food poisoning if the food handling rules are not adhered to. Symptoms usually start between one to three days of exposure and often range from mild with bouts of diarrhoea and/ or vomiting to severe with associated fevers, dizziness, decrease in urine frequency, dehydration, persisting abdominal pain, blood and mucous in the stools. Mild food poisoning tends to be self-limiting and staying hydrated with roughly 200mls of fluids for every episode is all that is required. If associated symptoms or concerns, then it is best to seek medical advice. According to the food standards agency, adherence to the ‘4 Cs’ helps to prevent food poisoning- Cleanliness, Cook thoroughly; Chill appropriately; avoid Cross contamination.

Swimmer’s Ear

Also known as otitis externa, this is inflammation of the skin in the ear canal. Swimming frequently is a risk factor because water gets into the ear which then irritates and inflames the skin. This provides the right environment for micro-organisms to grow and cause an infection. The ear may become itchy, discharge or uncomfortable. Hearing may also become dull. Topical ear drops often settles this. The best way to prevent otitis externa is to keep the ears dry, using a tight fitting cap when swimming, or silicone based earplugs- if they do not irritate the canals. Avoid irritating the ears by using cotton buds, fingers or towels.

Hay fever

Becoming increasingly common, it affects approximately one in four of us in the UK; one is more at risk if they have other allergies such as asthma or eczema. It is due to a reaction to the pollen from plants resulting in inflammation and the typical symptoms of itchy and watery throat, nose, eyes; sneezing; cough; headaches and tiredness. Some people are affected earlier in the spring, whilst others in late summer. This is because of the different pollens released. Decreasing pollen exposure can help to prevent symptoms. This includes avoiding outdoors during peak pollen count times, protecting eyes when outdoors, using protective balms around nostrils, showering and changing once indoors, and keeping doors/windows shut. Treatments that help include antihistamines and nasal sprays which can be obtained over the counter. To prevent symptoms, it is often worth taking medications a couple of weeks before the season starts. If symptoms are severe or you have other allergies, especially asthma, seeing your healthcare provider would be beneficial as other treatments such as immunotherapy may be beneficial.

Sunburn

This can happen within a few hours of sun (including sun beds and sunlamps) exposure. Hot skin that feels painful to touch is usually the first sign of sunburn. Blisters can also occur and over a few days the skin can start to peel. At the extreme end, you can get fevers, chills, headaches, fatigue, nausea or a rash. In the long term, this can cause chronic skin damage with wrinkles, sun spots and skin cancer. Sun protection,even on a cloudy way is the best way to prevent this.
We all need vitamin d and though dietary sources exist, the sun is an important source. Various opinions exist among dermatologists and scientists on sun exposure risk and obtaining vitamin d. The incidence of skin cancer is increasing, therefore sun protection is vital. Also, even with sunscreens, some rays still reach the skin and this, combined with dietary vitamin d may be adequate.
If you do get sunburned, keeping hydrated, cooling the skin down with showers, cool compresses and topical gels such as aloe vera and moisturisers can help. Anti-inflammatory medications can help with the pain. Seek medical help if it doesn’t improve in a couple of days or there is associated fevers, headaches, dizziness, nausea, confusion, features of an infection or blisters affecting a large part of the body.

Lyme disease

As the warm weather sets in, we spend more time in the countryside. There are numerous health benefits to this, however, insect bites, in particular from ticks, can be a cause for concern. Lyme disease or tick bite fever can occur and causes both short and long term effects. Most people do not recall being bitten, but notice a bite with a red circular rash around it. This can happen between three days to about one month after. There can be associated flu like symptoms.Some people can clear this without treatment, however, it can progress to cause joint pains, weakness, fatigue, heart and neurological problems if not treated with antibiotics. In the long term, chronic lyme disease can manifest itself as mental or cognitive problems and arthritis.
Treatment is therefore important should you be bitten by a tick. Prevention by being aware of areas with infestation, using insect repellants, wearing long sleeves, trousers in socks and closed shoes is key. Checking the skin daily for tick bites and removing them as soon as possible also helps. If found, use tweezers, forceps or a tick removal device to grasp the head and mouth parts as close to the skin as you can, and slowly pull upwards, away from the skin without crushing the tick.

Heat exhaustion

Due to excessive sweating, we lose salt and water and can easily become dehydrated in the summer. The body temperature rises and this can lead to heat exhaustion. Associated nausea, headaches, feeling faint and dizziness can occur. Moving to a cool place and drinking loads of fluids usually leads to recovery within 30 minutes. If left untreated, this can lead to heatstroke-when the body temperature rises above 40 degrees centigrade. Confusion, vomiting, fast breathing and loss of consciousness can occur. Heatstroke is a medical emergency and you should summon immediate medical help.

Skin rashes

From prickly heat rash,due to clogged sweat glands, to allergic skin reactions from insect bites or exposure to plant sap or oak processionary moths, different skin rashes can occur in the Summer.
Keeping the skin cool and exfoliating regularly to minimise build up of dead skin cells can help to prevent miliaria(prickly heat rash). Allergic skin rashes tend to be self limiting. Oral antihistamines and topical creams can help with the symptoms of itch and inflammation. The rash from oak processionary moths( can occur if up to around 20m from affected oak trees) in particular can last a few weeks. There may be associated sore throat, eye and breathing problems- a condition called lepidopterism. Should this occur, it is advisable to seek medical help. If you have a history of severe allergic reactions, always remember to have your adrenaline pen with you.

Embarrassing symptoms you should not ignore

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Everyday we experience disturbances in our bodies that we might perceive as normal, self limiting or potentially worrying. How do we know which to ignore, treat ourselves or seek advice? There are of course, red flag symptoms which should not be ignored. Other disturbances may be problems we would rather not talk about.
I would like to share with you some embarrassing symptoms that are potentially worrying and would urge you to get checked out. You may be worried about what would happen when you see your healthcare professional. This is understandable, however we are here to make sure you are well looked after and have all appropriate tests and treatments and feel healthy. As well as discussing these signs and symptoms you shouldn’t ignore, I would also like to share with you what to expect when you see your doctor.

Excessive sweating

Sweating helps to cool down the body, however there are various reasons why it can become excessive. Sweating continuously, regardless of activity or stress levels, usually indicates that the sweat glands are constantly activated. This is a condition called hyperhidrosis. And it can be focal -in the armpits or palms – or generalised. The cause of this can range from infections to drugs to hormone problems to idiopathic. Finding and treating the underlying reason is therefore crucial. Focal sweating can be reduced with topical preparations available on prescription, should antiperspirants not work. A referral to a dermatologist may be required as other treatment options such as ionotophoresis (the use of water currents to stop focal sweating), oral medications or botox are available.

Painful bowel motions

This can occur as a result of passing stools too frequently or infrequently. It is often due to haemorrhoids or fissures around the back passage. Straining due to constipation exacerbates this as it causes trauma to the surrounding area. The pain makes you less inclined to pass stools and this can make it worse as stools get drier and more difficult to move. It is important to have this treated so as to prevent severe constipation, profuse bleeding or infection in that area. Treating constipation with dietary modifications including fibre rich foods, exercise and water is vital to help piles or fissure heal. Laxatives and topical ointments and suppositories can also be obtained from a pharmacy or prescribed. It can also be associated with bleeding, heavy periods or lower abdominal discomfort. This warrants a review by your healthcare provider.

Nipple changes

This includes leaky or inverted nipples or skin changes. There are several causes for this including problems with your hormones. Provided you are not breastfeeding, producing breast milk should be investigated as it may be due to excess of a hormone called prolactin. Excess prolactin may be due to a benign growth in the pituitary gland in the brain. Other causes include medications, stress, thyroid and kidney problems. These are all treatable. If left untreated, it can affect your periods, cause infertility, contribute to osteoporosis and cause pressure effects if due to the benign growth. Your health practitioner would ask further questions regarding associated symptoms. This may include your family history, menstrual cycle, contraceptive use and vision. They would then carry out an examination and might organise blood tests. Depending on their findings, a referral to a breast or hormone specialist may be warranted.

Abnormal smell

When the natural environment in the vagina becomes upset, this can lead to an overgrowth of bacteria which causes a ‘fishy’ smell. This is a condition called bacterial vaginosis. It might be associated with discharge and itching. Triggers for this can include menstruation, douches and semen. This is different from a yeast infection which causes itch with an odourless discharge and can easily be treated with an over the counter medication such as canesten. Depending on your symptoms and sexual history, your doctor may examine you and take samples to rule out other infections. A vaginal gel or antibiotics may be prescribed. Usually, bacterial vaginosis doesn’t cause further problems, however, if it occurs at certain times, such as during pregnancy, it may increase the risk of delivering earlier than expected. It is also associated with a higher risk of sexually transmitted infections and inflammation of the pelvic region.

Bloating

Though often benign and due to eating foods or drinks that produce excess wind, it can also be due to other conditions. If unexplained or associated with other symptoms, for instance, urine or bowel frequency, abdominal pain, then a visit your doctor is warranted. Depending on their findings, they may do blood tests and scan to rule out anything sinister such as ovarian cancer.

Incontinence

Women often find they leak urine when exercising, especially running. This is known as stress incontinence. This can be due to the increase in abdominal pressure with exercise. Incontinence can also occur because of an overactive bladder. The latter is known as urge incontinence. Some women have both. In addition to exercise, other causes for this include medications, weak pelvic muscles, urine infections, to name a few. Treatment options vary depending on the underlying cause. It is important to see your doctor to rule out any structural abnormalities, test your urine and direct you in the treatment path that would be more suited to your symptoms. This include pelvic floor exercises or bladder retraining or seeing a (gynea) urologist.

Low libido

The cause of this is complicated and could be due to physical, psychological and social reasons. Women can experience this due to hormone changes, however, mental health problems, such as depression is a common cause for this. It affects the chemicals in your brain which are required for
a normal libido. There may be other symptoms of depression such as trouble sleeping, general aches, as well as feeling sad and hopeless. Some may be subtle and you might not put them together as being related. Speaking to your healthcare professional can help working out wether your symptoms are due to depression or stress and also signposting you to the best treatment option for you- such as talking therapy, mindfulness, exercise therapy. Medication might be required as a last resort, depending on the severity of your situation and should ideally be one with minimal effects of libido.

10 signs you may recognise in the Perimenopause and what to do about it?

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You are getting on in life, following your monthly routine, with no obvious changes in the body for the last 5 to 10 years. It works like clockwork, including your monthly cycle. Suddenly, your period is late! And your first thought is: ‘Am I pregnant?’. You are aware it is highly unlikely as you have an effective contraceptive. You do a pregnancy test and it is negative. Your period eventually shows up, however at the back of your mind you wonder if you are going through the menopause.

The good news is there is a transition period to get to the menopause. This can also be termed the perimenopause. This is a natural step in a woman’s body towards permanent infertility. It starts at different ages, however, women sometimes notice changes in their early forties, and occasionally in their mid 30s. This is due to female hormone changes, mainly oestrogen, rising and falling unevenly.

Here are 10 signs that you may be heading towards the menopause and tips on managing it.

Irregular periods

The hormone changes affects your ovaries releasing an egg and this in turn can make your period longer or shorter or absent for a couple of months. These could be signs of early and late perimenopause respectively. No periods for three months or more as well as very heavy periods, particularly if associated with feelings of tiredness or breathlessness warrants a review by your doctor, especially if you are under 40 years old.
Hot flushes

Suddenly going hot and sweaty can vary in duration and intensity throughout the day and at night – this often contributes to insomnia and sleep disturbances. This occurs as a result of the hormonal fluctuations and can be different for every woman. It can last anything between 2 years to 15 years. Wearing breathable clothing such as cotton and staying hydrated can help in alleviating symptoms. Avoiding other causes of hot flushes including being overweight, alcohol, excess caffeine, spicy foods, monosodium glutamate and some medications can also help in alleviating symptoms.
Mood disturbances

This can happen frequently with mood swings, as well as feeling irritable, short-tempered or anxious. A change from your usual temperament can be a sign of the perimenopause. A lack of good quality sleep can also contribute to this. Regular exercise and a healthy diet to ensure your blood sugar levels remain stable can help.
Vaginal dryness

The hormone changes mean the vaginal wall decreases the amount of fluid it produces and also its elasticity. Some women can find it generally uncomfortable, others only notice it during intercourse. Also, the length of time it takes to get aroused increases with age. Using vaginal lubricants can alleviate this.
Urine disturbances

In general, women are prone to urine infection because of our anatomy. This can happen for the first time during the perimenopause or increase in frequency. You might notice urine frequency and pain. This warrants a review from a healthcare professional. A decreased ability to hold urine can also happen. This is because the elasticity and tone decreases. Ways of preventing this includes passing urine after intercourse, using lubricants and doing regular pelvic floor exercises.

Loss of libido

There are various causes for this and the mood changes, lack of sleep and decreased arousal time can certainly contribute. However many women have no problems with this.

Problems conceiving

Ovulation decreases and this leads to fertility problems. It can take up to one year to fall pregnant naturally, however if you are in your very late 30s or early forties and have trouble conceiving, it is worth seeking medical advice sooner. Using contraception until 12 months after your last period is advisable if you do not want to fall pregnant.
General aches and pains

As oestrogen decreases, the body cannot replace bone as efficiently. The ligaments and cartilages are also affected. Research also suggests that the hormone changes are associated with the development of osteoarthritis. aches and pains can also be a sign that your bones are getting thin due to osteoporosis. Getting adequate level of calcium and vitamin d and exercising to strengthen the bones and muscles can help to prevent this. Several studies have looked at the use of glucosamine for pains and though individual women have reported improvement in their symptoms, evidence for its use is limited.

Weight changes

There are several contributory factors for this. This includes the metabolism and our ability to build muscle slowing done as well as higher levels of stress due to lack of sleep and worry about other signs mentioned above. Improving the underlying cause is therefore needed. Regular exercise and a healthy diet, with particular attention to your nutrient to calorie ratio can help negate weight gain. This is because you use up fewer calories as you get older. A sudden increase in weight warrants a visit to your doctor.

Chest pain

As oestrogen levels drops, the cholesterol and sugar level in the body increases. The heart and vessels also become more stiff. This puts you at risk of heart disease as it contributes to clogging up the blood vessels. Left sided chest discomfort, especially on exertion requires urgent medical attention.

The perimenopause is a natural transition in a woman’s life and should not be a cause for alarm. Lifestyle intervention can help significantly with the perimenopause. This includes regular exercise and a diet rich in phytooestrogens. These can be found in foods such as soybean, dark leafy green and cruciferous vegetables such as broccoli. However, if it is interfering with your quality of life and well-being, then see your doctor. Depending on your symptoms, further tests may be carried out. Various medical therapies including hormone replacement and non hormonal options are available on prescription.

This has been posted on healthista.com and The Daily Mail online

http://www.healthista.com/0-perimenopause-symptoms-that-could-explain-your-moods-aches-and-low-libido/

Hello world!

~ Doctor Deyo ~ 1 Comment

Welcome! Thanks for visiting!

I am Dr Deyo and here’s some information about myself and why I started my blog:).

A UK trained GP working in London with over ten years of medical experience, I have an avid interest in health and nutrition and I am keen to empower people to take control of any medical, health and lifestyle issues by providing expert insights and practical tips.

Hope you enjoy reading them and find it useful.

Please feel free to leave comments and suggestions on topics you would like me to discuss.

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