What’s Wrong With, 1 : People’s Health ?.

Exploring the 70/30 rule in everyday health and disease.

Note to readers/how this thread came about : this whole thread came about because of one Youtube channel and a series of observations made one hot and muggy evening during the recent heatwave so called. I won’t name names here notably because I don’t want to attract more views and more attention to it’s creator. My observations came about due to a tight and narrow section of lane where it’s difficult to see oncoming cars until they are forcing their way through, regardless and a similar observation about how angry and fractious some locals have become. I came home saying to myself “What’s wrong with people” ? and was determined then to write about it as that’s how I roll.

My thread doesn’t deal with the things that I experienced that one evening; that’s just angry and entitled car owners not getting their way instantly and having their super important lives not go exactly their way for even a few seconds. Where it really comes from is my personal experiences with anything from drivers, our supermarkets, a local couple whom I think of as dumb and dumber and particularly healthcare which I call our sick management. It also comes from my own experience of being just one of the 70% and what I hear nearly every day about the people presenting to the local accident & emergency department. That’s also something I came across when recently reading author Bill Bryson’s book about the human body.

The TLDR here (Too Long Didn’t Read) is that 70% of all patients presenting with a problem at the A&E department have preventable disease. Another way of looking at the same problem is to say that something has caused people to be as sick as they are, as early in life as they are and in the background state that they’ve inadvertently ended up with. In this i;m trying to make sure that people don’r come back with the idea that i’m pointing the finger and laying the blame but rather i’m trying to pick the problem apart and trying to come up with an answer.

I don’t say they either, rather I say we because i’m one of the 70 % with disease that was easily preventable : in 2024 I spent thirty hours sitting around our local A&E AS i was triaged as a low priority walking wounded. When I had another stroke event a few months later I didn’t even bother with going to the A&E but simply rested up instead. At the same time I was there a similar age guy waited even longer to be seen and ultimately admitted to a cardiology bed. Most days now the department is full to overflowing into it’s corridors and it’s quite normal that patients wait and are managed in the ambulances that take them in.

I happen to think that there are some simple answers and yet I deplore the drive to dumb down and make simple what might not be so. With that in mind I have an example that came to mind recently with the appalling murder of politician Ann Widdecombe. I once heard her speak, about diet and exercise, on a talk program and she did what many politicians tend to do which is to make simple what may well not be so. When asked about diet and exercise she said something like ; eat less and do more – I think in order to manage or lose weight. Even at the time – this must have been in the 1980’s, I thought it a stunningly stupid/simple thing to say as even then the simplistic model of calories in/calories out was seen as a basically weak idea : not necessarily wrong but overly simplistic. The simple answer might be that many people are eating too much or too much of the wrong thing and it’s that which is making them sick, and both sicker and heavier at a younger age.

I don’t know whether that’s true or not but I would respectfully argue that that model is what did it for me as iv’e been basically a sugar addict for my whole life. I was a soft and round kind of kid that turned into an overweight and then obese adult as soon I stopped shooting upwards and went outwards instead. If it is the case then it was the regular consumption of sugar (mainly in the form of biscuits) that drove the accumulation of visceral fat, that which silently gave me high blood pressure and that which one day gave me a stroke – or in fact several strokes.

I take it that my physiology is just the same as everyone else’s ; there’s nothing special about me. I would love to be able to come up with some startlingly original cause for becoming fat, then obese, hypertensive then a stroke sufferer. I might equally have become a diabetic, had heart disease or fatty liver disease whatever : they’re all examples of simple metabolic disease in different people. Why one gets one and not the other is a bit of a mystery although there is a history of stroke in my family : both of my late parents had strokes and neither, to my knowledge, had heart disease so maybe it’s the eventual outcome of my genetic history playing itself out with the circumstances iv’e given it.

I strongly suspect that it’s the same basic model with the 70% of people that present at their local A&E with disease that is said to be preventable ; nothing different or in any way remarkable. It may or may not be true but it seems to be as good an explanation as any and the physiology holds up : the question has to be how best to deal with it. What we have with the NHS is a system that is surprisingly good at managing preventable disease but nothing like as good as preventing it in the first place.

Once again i’m not trying to apportion blame : yes it could be prevented and with simple changes and yet it isn’t. Of course I ask the question of why it isn’t and I think a simple answer (I don’t like simple answers as being simplistic) is that people have too many powerful forces already acting against them. Firstly, there is simple human physiology and evolution, for most of human existence we’ve been living in food scarcity and survival mode ; always looking for the next meal. It’s a model that served us well through hardship, famine and war but now we have an opposite problem : easy availability of energy dense food – or at least food like industrial product that is purposefully designed to be as palatable as possible – and i’d like to say as addictive while making maximum profits for it’s manufacturers.

I accept that i’m highly cynical but we seem to be stuck between the rock of our own craving for energy dense food and the hard place which is the food industry, and if not them then the large pharmaceutical manufacturers as well. Yes, we live in a low trust environment since the Covid 19 debacle and even more so since the pharmaceutical industry came up with a technological solution – except a deadly and expensive trap of one – for the management of diabetes and obesity : profits yet again.

I am also proving to myself that I can reverse many of my metabolic problems using natural means rather than expensive and highly suspect medicines. At the start of my grand project my assumed model was that sugar was the problem and taking it out of my diet as completely as I could the solution. The result, at least for now, is that i;m close to 20 Kg lighter, my blood pressure hardly needs more than one half dose of an anti hypertensive just once per day and my mind feels sharper than it has for years. Also I fast once a week usually and walk upwards of 7500 steps every day – that means that I should be generating loads of BDNF so while i’m improving my health day on day I can’t do anything about my stroke damage : what i’m counting on is reducing my stroke risk and cardiac risk as much as I can in the lead up to surgery.

The turnaround.

You might ask ; where am I going with this ?. My answer is that I don’t know as i’m feeling my way through the subject as I go along ; allow me to explain. In the past life of this blog I used to write about small boats, sailing and the sea. When I wrote a blog piece I would usually do so in just one session apart from leaving it a few days and then giving it a look for technical errors and howlers of grammar.

Nowadays. a post sits in my draft folder for several days and sometimes for weeks while I slowly work on it. Often now I delete a post when i’m not satisfied with it and it doesn’t seem to be going anywhere. My late mother said that she mainly read my posts to find out what was going on in my head ; a lot of it meant nothing to her – my technical or boat building posts for example. Today, my partner Jackie says much the same kind of thing except that i’m not writing posts where I know the likely end point before I start writing. Instead i’m writing to help myself work things out ; and some days that’s a slow process.

With my health related posts as an example, usually what I write is directly relevant to my own situation and at the moment that is mostly about me reducing my surgical and anaesthetic risk prior to a surgical revision of a failing knee replacement. My surgical pre assessment is tomorrow – in writing time that is – so i’m probably looking at surgery in the next 10 weeks or so. There isn’t much more I can achieve by changing things around in my routine, as I often say now I now have to trust the process – the stuff that iv’e now been doing for 7 months.

With this post though i’m thinking more like the registered nurse that I was : when other people’s health was often my concern. Just as tomorrow is my date to be in clinic for a surgical pre assessment it was often my job to do the same for the dozens of people coming through my department for endoscopic procedures. The kind of thing that i’m talking about today is much more what I would call GP territory or maybe that of a specialist nurse.

If you’re wondering why this retired nurse is taking an interest in the generally poor state of health in the UK it’s mainly due to a chance conversation with a one time heart surgeon that I used to work for – at least I used to look after his patients when he’d done his surgery bit. His view was that cardiac surgery is a colossal waste of time and money in most cases and he’d acquired that view from other surgeons working in the same field – so not just him either.

Difficult conclusions.

My first conclusion came as yet another question : Am I my brother’s keeper ? or in other words, am I in some way responsible/is it my problem ?. The answer is of course a resounding no although I think about what the solutions might be most days when i’m out walking and even more so when i’m in the supermarket.

My second conclusion is that iv’e become a bit smug in thinking that iv’e found the solution, or at least a solution to the problem of weight gain and chronic metabolic disease. One post that I worked on for a long time but ultimately deleted went down the route of formalizing everything that I thought i’d learned and even looked to be a reasonable starting point for a longer term book project. The fact of it being deleted was because I really don’t think that the world needs yet another opinionated diet and health book. As it is, I might well blog and write about the subject but something I learned years ago is these health posts are the least read : in the days when I mostly wrote and photographed posts about boats my usual audience (blokes between 50 and 70) are the least interested in their health so if they don’t care why should I care about their health for them ?.

My answer to that is the basis of my next conclusion which is something like ‘once a nurse always a nurse’. Having committed most of my adult life to nursing and knowledge about healthcare I find it hard to be living at a time when health in the UK is generally getting so much worse. One of my starting points for this post was based on a Youtube channel whose entire shtick was telling us how bad many towns in this country have become. I could, kind/sorta do the same thing for places and the health of the people within them as often poor health and early chronic disease correlate somewhat with poor socio-economic conditions.

Taking an interest as I do I happen to think that there are potentially solutions but every one that I think about would be deeply uncomfortable and highly unpopular : allow me to explain – and if you’ve stuck it out thus far then fear not as this will be the end of my posting for a while. Here goes then :

I feel that we’re almost at a crossroads with healthcare. Where we almost are today is where some people were when it became obvious that smoking was the problem to health that it was. The tobacco industry fought that idea tooth and nail but are now fighting a losing battle. Today, we have a new problem in health except metabolic disease rather than lung/cardiac and cancer disease. The cause is almost certainly our industrially poor diet and I say industrial due to the amount of food like industrial product sold cheaply as food – which it isn’t in my definition of food. I’m sure today that if you were a politician or doctor that stood up and said that the first move would be to ban sugary drinks – lets say Coca Cola as a start – then you would be ridiculed and the manufacturers would produce the science to prove that HFCS based drinks can be consumed as ‘part of a healthy diet’.

It would be an extremely brave politician or political party that made that claim and tried to have HFCS based drinks and ultra processed food treated in the way that smoking now is. If I would like to see that happen – and I would – then the other thing I would like to see is a genuinely radical change in the way that healthcare is funded. Instead of being able to spend say £17.000 to perform a single CABG (coronary artery bypass graft) then instead we have that same budget given over instead to preventative medicine – perhaps with more GP’s and more time allocated and funded per patient contact. Maybe even have more GP’s acting as Dr David Unwin did in trying to reverse chronic metabolic disease rather than just managing it on behalf of the major drugs companies.

My final conclusion is that I need to shut up shop for a while and take a blogging break. I may, or may not, catch up with you all again after surgery. Until then………….