WHAT DOES THE DOCTOR THINK THIS MONTH? January

VAPING: I have never been one to preach to patients about lifestyle choices and their effects upon health. Talking to patients about the dangers of being overweight always resulted in them looking up and down at my chunky form with a quizzical look so I didn't talk about weigh very much. Everyone knows that alcohol addiction, drug use or excessive gambling are not good for you, so not too much need to discuss those matters! However, the one habit about which I used to bang on relentlessly was smoking. There is no doubt in my mind that it is extremely dangerous and kills people right, left and centre. OK, some people are protected by a gene which prevents damage from smoking (eg. My Grandfather smoked 120 a day for 80 years and lived to be 98 years old with never a symptom) but many smokers succumb to lung disease such as Chronic Obstructive Airways Disease or lung cancer or, perhaps more likely, cardiovascular disease such as heart attacks, circulation problems (leading to leg amputations, etc) or strokes, one form of which causes multi-infarct dementia. About a year ago, the Great and the Good in the medical profession declared vaping to be safe and recommended its use for people who wish to give up the fags. They said it could also be a safe alternative for those who wanted to start polluting themselves with nicotine. At the time, I disagreed violently. Vaping had only been around for 5 years or so, not nearly long enough to assess its long-term safety. Now, for many years, there has been an occupational disease, Hard-metal Pneumoconiosis, a very rare disease which affected metal workers and leads to lung scarring and chronic cough. The disease usually occurs in people who work with tungsten or cobalt. This disease has now been found in a patient with no work exposure to metal who did vaping. The vapour from the patient's e-cigarette showed the presence of cobalt, nickel, aluminium , manganese, lead and chromium, These metals have also been found in the vapour of other e-cigarettes and the consensus is that these contaminants come from the heating coils in the e-cigarettes and not from the liquid which is being vapourised. This could cause future problems for “Vapers” as problems such as lung scarring will not become apparent until the scarring is irreversible. So, my advice is to stop smoking and also vaping which could be more dangerous than eating too much fish (heavy metal contamination – another article!). FATHER CHRISTMAS: A couple of weeks before Christmas, Head Office and I took a trip on our local steam railway (The Severn Valley Railway – absolutely superb in so any ways) fro Kidderminster to Bridgnorth. The train was a Santa Special with 8 carriages for children of preschool age – all lined up in pairs, holding hands, reflective jackets, shepherded by teachers and carers They were lovely to watch, so excited and vibrant. We were in a 1930s wooden dining carriage and really enjoyed a Christmas lunch at the end of which Father Christmas appeared, having seen about 500 children. I had not met Father Christmas since I was about three years old (and terrified) and I was absolutely amazed to discover that he comes from Birmingham. He has a strong Black Country accent. I had always assumed that he came from Lapland or somewhere like that, never dreaming that he was from around here. The accent set me thinking. Lenny Henry and Jasper Carrot come from the Black Country and, with Julie Walters from nearby Smethwick, they can all turn on the accent. Next month, I shall write about the Black Country which is absolutely fascinating in many ways. Please contain yourselves in patience! A woman is cooking eggs in the kitchen when her husband comes running in. He takes one look at the eggs and screams BE CAREFUL, VERY CAREFUL. Put some more butter in. The wife rushes to put more butter in the pan. YOU'RE COOKING TOO MANY AT ONCE, Turn them over now. The wife forgets about the butter and runs to turns the eggs over. WHERE'S THE BUTTER. THE EGGS ARE GOING TO STICK. YOU NEVER LISTEN TO ME. TURN THE EGGS NOW. OH, YOU REALLY DONN'T KNOW HOW TO COOK. The wife bursts into tears and asks why her husband is behaving like this as he has never queried her cooking before. The husband smile benignly and said “Oh, I just wanted you to know what I feel like when I am driving with you in the car. I have discussed this matter with many of my male friends and relatives and, without exception, we cannot work out how we manage to drive safely when unaccompanied! A woman visits a fortune teller who stares into her crystal ball and announces somewhat apologetically the the lady's husband will, within a year, suffer a violent and terrible death. The lady takes a few moments to compose herself and then asks “Will I be acquitted?”

Best wishes from Management and me to you all for 2020. May it be healthy. Ian Nisbet