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Radial Head & Neck Fractures In Children - Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing fractures of the radial head and neck in children. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on ...  
YouTube
over 5 years ago
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1
10

Novel Non-Occlusive Temporary Endoluminal Neck Protection Device

Stream Novel Non-Occlusive Temporary Endoluminal Neck Protection Device by BMJ talk medicine from desktop or your mobile device  
SoundCloud
over 5 years ago
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4
489

Clinical Anatomy (A Problem Solving Approach), 2nd Edition

Download it at - http://indianmedicalebooks.blogspot.in  
SlideShare
over 5 years ago
Logo
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59

triangles_of_the_neck.html

The following page will allow you to adopt a systematic approach of describing the anatomical position of a neck mass:  
ole.bris.ac.uk
over 5 years ago
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1
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Hip Fracture (Neck of Femur / NOF)

 
almostadoctor - free medical student revision notes
over 5 years ago
Www.bmj
2
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Airway obstruction after the development of Hashimoto’s thyroiditis

A 67 year old white woman presented to her family doctor in January 2013 with a small asymptomatic thyroid swelling. Her serum thyroid stimulating hormone (TSH) concentration was high (37 mIU/L; reference range 0.5-4.5) and serum free thyroxine was low (5.4 pmol/L; 10-21), consistent with a hypothyroid state. However, she had no clinical features of hypothyroidism. Ultrasonography of the neck showed diffuse hypoechoic enlargement of the thyroid gland, with no retrosternal extension. Her serum anti-thyroid peroxidase (anti-TPO) value was also high (>600 kU/L; <35 kU/L). These features were suggestive of autoimmune (Hashimoto’s) thyroiditis. She was advised to take thyroxine tablets (100 µg) daily, and after two months her neck swelling reduced in size and her serum TSH concentration normalised (1.2 mU/L).  
bmj.com
over 5 years ago
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68

Posterior Triangle Of The Neck - Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing the posterior triangle of the neck. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https:...  
YouTube
over 5 years ago
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7
534

Embryology of the Head and Neck - Chapter 2: Embryology of the Head, Face and Oral Cavity

Diagrammatic representation of the development of the head and neck region for undergraduate students, particularly Oral Biology. The module is available thr...  
YouTube
over 5 years ago
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1
178

Duke Anatomy - Lab 22: Retropharyngeal space

In the last lab you examined many of the structures on the anterior surface of the neck, and looked briefly at the retropharyngeal space and its contents while moving them aside, but you have not yet dissected those structures in detail. Today you will explore the prevertebral area and the back of the pharynx (retropharyngeal space) in much more detail. In order to do this the head must be detached from the vertebral column to allow a posterior approach to the cervical viscera. This is a challenging and labor-intensive dissection.  
web.duke.edu
over 5 years ago
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1
151

Instant Anatomy - Head and Neck

Navigate through the Head and Neck by the by type of body part you are looking for. Instant anatomy is a specialised web site for you to learn all about human anatomy of the body with diagrams, podcasts and revision questions  
instantanatomy.net
over 5 years ago
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Thyroid Anatomy

The thyroid gland is a highly vascularized organ located anteriorly in the neck, deep to the platysma, sternothyroid and sternohyoid muscles, and extending from the 5th cervical  (C5) to the 1st thoracic (T1) vertebrae.  The gland consists of two lobes (left and right) connected by a thin, median isthmus overlying the 2nd to 4th tracheal rings, typically forming an "H" or "U" shape.  Occasionally the isthmus is absent and the thyroid exists as two distinct lobes.  Embryologically, the thyroid gland develops as a thickening in the pharyngeal floor that elongates inferiorly as the thyroglossal duct, dividing into two lobes as it descends through the neck  
fitsweb.uchc.edu
over 5 years ago
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109

Posterior Triangle of the Neck - Subdivisions - TeachMeAnatomy 

The posterior triangle of the neck (also known as the lateral cervical region), is a region of the neck. In this article, we shall look at the anatomy of this area,  
teachmeanatomy.info
over 5 years ago
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Thoughts on lymphadenopathy, splenomegaly, sense of nausea and swelling in left armpit?

Hi, I'm medical student. I'm 21 now. About 3 months ago I accidentally realized that there are several enlarged lymph nodes in my neck! There was no pain and tenderness at the beginning! In sonography there are 38 lymphadenopathy in my parotid, mandibular angle, posterior cervical chain on both sides of my neck and they are symmetrical. I have no pain and tenderness, solid and fluctuable and splenomegaly (spleen size: 135. 85) and one lymphadenopathy in left axilla! In CBC wbc is normal PT is low about 145000 MCH is low CXR is also normal EBV test(mono test) is negative There are no other symptoms, just a sense of nausea and mild swelling in my left armpit which have appeared recently! I was told that a biopsy is necessary but before the biopsy I was tested for toxoplasmosis for caution! I don't have a cat I never eat vegetables and fruits without completely washing them. I have no contact with soil - nothing! I have had no suspicious contact. I just had a cat about 5 years ago just for a short time (2 or 3 months). Unfortunately my toxo test is positive: IgM is about 2 and IgG is 200! Now my questions are: Does positive toxoplasmosis test rule out other differential diagnosis like lymphoma? ( I have read that clinical manifestations of toxoplasmosis are rare and occur in children who have cat. and most cases have high IgM about 11or 12 in children and in some references about 20 or 43 in adults not a low positive like2!) Is my lymphadenopathy because of a low positive like2? Is biopsy still necessary? Your help will be greatly appreciated! Thank you!  
baran
almost 8 years ago
6
0
63

Does a severely dehydrated patient in a recumbent position have flat neck veins?

Does a person with severe dehydration or hypovolemia has flat neck veins when lying horizontally? If yes, can this be considered one of the dehydration/hypovolemia signs?  
Jan Modric
about 7 years ago
Foo20151013 2023 113s0nw?1444773969
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378

The Medical Book Warzone... Which book is best?

As the days are slowly getting longer, and spring looms in the near future, it can only be the deep inhale of the medical student ready to embrace the months of revision that lies ahead. Books are dusted off the shelves and Gray's anatomy wrenched open with an immense sigh of distain. But which book should we be pulling off the shelves? If you're anything like me then you're a medical book hoarder. Now let me "Google define" this geeky lexis lingo - a person who collects medical books (lots of medical books) and believes by having the book they will automatically do better!... I wish with a deep sigh! So when I do actually open the page of one, as they are usually thrown across the bed-room floor always closed, it is important to know which one really is the best to choose?!? These are all the crazy thoughts of the medical book hoarder, however, there is some sanity amongst the madness. That is to say, when you find a really good medical book and get into the topic you start to learn stuff thick and fast, and before you know it you’ll be drawing out neuronal pathways and cardiac myocyte action potentials. Yet, the trick is not picking up the shiniest and most expensive book, oh no, otherwise we would all be walking around with the 130 something pounds gray’s anatomy atlas. The trick is to pick a book that speaks to you, and one in which you can get your head around – It’s as if the books each have their own personality. Here are a list of books that I would highly recommend: Tortora – Principles of anatomy and physiology Tortora is a fantastic book for year 1 medical students, it is the only book I found that truly bridges the gap between A levels and medical students without going off on a ridiculous and confusing tangent. While it lacks subtle detail, it is impressive in how simplified it can make topics appear, and really helps build a foundation to anatomy and physiology knowledge The whole book is easy to follow and numerous pretty pictures and diagrams, which make learning a whole lot easier. Tortora scores a whopping 8/10 by the medical book hoarder Sherwood – From cells to systems Sherwood is the marmite of the medical book field, you either love this book or your hate it. For me, Sherwood used to be my bible in year two. It goes into intricate physiological detail in every area of the body. It has great explanations and really pushes your learning to a greater level than tortora in year one. The book doesn’t just regurgitate facts it really explores concepts. However: I cannot be bias, and I must say that I know a number of people who hate this book in every sense of the word. A lot of people think there is too much block text without distractions such as pictures or tables. They think the text is very waffly, not getting straight to the point and sometimes discusses very advanced concepts that do not appear relevant The truth be told, if you want to study from Sherwood you need to a very good attention span and be prepared to put in the long-hours of work so it’s not for everyone. Nonetheless, if you manage to put the effort in, you will reap the rewards! Sherwood scores a fair 5-6/10 by the medical book hoarder Moore & Dalley – Clinical anatomy At first glance Moore & Dalley can be an absolute mindfield with an array of pastel colours that all amalgamate into one! It’s also full of table after table of muscle and blood vessels with complicated diagrams mixed throughout. This is not a medical book for the faint hearted, and if your foundation of anatomy is a little shakey you’ll fall further down the rabbit hole than Alice ever did. That being said, for those who have mastered the simplistic anatomy of tortora and spent hours pondering anatomy flash cards, this may be the book for you. Moore & Dalley does not skimp on the detail and thus if you’re willing to learn the ins and out of the muscles of the neck then look no further. Its sections are actually broken down nicely into superficial and deep structures and then into muscles, vessels, nerves and lymph, with big sections on organs. This is a book for any budding surgeon! Moore & Dalley scores a 6/10 by the medical book hoarder Macleod’s clinical examination Clinical examination is something that involves practical skills and seeing patients, using your hands to manipulate the body in ways you never realised you could. Many people will argue that the day of the examination book is over, and it’s all about learning while on the job and leaving the theory on the book shelf. I would like to oppose this theory, with claims that a little understanding of theory can hugely improve your clinical practice. Macleod’s takes you through basic history and examination skills within each of the main specialties, discussing examination sequences and giving detailed explanations surrounding examination findings. It is a book that you can truly relate to what you have seen or what you will see on the wards. My personal opinion is that preparation is the key, and macleod’s is the ultimate book to give you that added confidence become you tackle clinical medicine on the wards Macleod’s clinical examination scores a 7/10 by the medical book hoarder Oxford textbook of clinical pathology When it comes to learning pathology there are a whole host of medical books on the market from underwood to robbins. Each book has its own price range and delves into varying degrees of complexity. Robbins is expensive and a complex of mix of cellular biology and pathophysiological mechanisms. Underwood is cheap, but lacking in certain areas and quite difficult to understand certain topics. The Oxford textbook of clinical pathology trumps them all. The book is fantastic for any second year or third year attempting to learn pathology and classify disease. It is the only book that I have found that neatly categories diseases in a way in which you can follow, helping you to understand complications of certain diseases, while providing you with an insight into pathology. After reading this book you’ll be sure to be able to classify all the glomerulonephritis’s while having at least some hang of the pink and purples of the histological slide. Oxford textbook of clinical pathology scores a 8/10 by the medical book hoarder Medical Pharmacology at glance Pharmacology is the arch nemesis of the Peninsula student (well maybe if we discount anatomy!!), hours of time is spent avoiding the topic followed immediately by hours of complaining we are never taught any of it. Truth be told, we are taught pharmacology, it just comes in drips and drabs. By the time we’ve learnt the whole of the clotting cascade and the intrinsic mechanisms of the P450 pathway, were back on to ICE’ing the hell out of patients and forget what we learned in less than a day. Medical pharmacology at a glance however, is the saviour of the day. I am not usually a fan of the at a glance books. I find that they are just a book of facts in a completely random order that don’t really help unless you’re an expert in the subject. The pharmacology version is different: It goes into just the right amount of detail without throwing you off the cliff with discussion about bioavailability and complex half-life curves relating to titration and renal function. This book has the essential drugs, it has the essential facts, and it is the essential length, meaning you don’t have to spend ours reading just to learn a few facts! In my opinion, this is one of those books that deserves the mantel piece! Medical Pharmacology at a glance scores a whopping 9/10 by the medical book hoarder. Anatomy colouring book This is the last book in our discussion, but by far the greatest. After the passing comments about this book by my housemates, limited to the sluggish boy description of “it’s terrible” or “its S**t”, I feel I need to hold my own and defend this books corner. If your description of a good book is one which is engaging, interesting, fun, interaction, and actually useful to your medical learning then this book has it all. While it may be a colouring book and allows your autistic side to run wild, the book actually covers a lot of in depth anatomy with some superb pictures that would rival any of the big anatomical textbooks. There is knowledge I have gained from this book that I still reel off during the question time onslaught of surgery. Without a doubt my one piece of advice to all 1st and 2nd years would be BUY THIS BOOK and you will not regret it! Anatomy colouring book scores a tremendous 10/10 by the medical book hoarder Let the inner GEEK run free and get buying:)!!  
Benjamin Norton
over 7 years ago
Foo20151013 2023 1f9109k?1444774063
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2583

Criticizing the NHS - Can students do this productively?

In this month’s SBMJ (May 2013) a GP called Dr Michael Ingram has written a very good article highlighting some of the problems with the modern NHS’s administrative systems, especially relating to the huge amount of GP time wasted on following up after administrative errors and failings. I personally think that it is important for people working within the NHS to write articles like this because without them then many of us would be unaware of these problems or would feel less confident in voicing our own similar thoughts. The NHS is a fantastic idea and does provide an excellent service compared to many other health care systems around the world, but there is always room for improvement – especially on the administrative side! The issues raised by Dr Ingram were: Histology specimens being analysed but reports not being sent to the GP on time or with the correct information. Histology reports not being discussed with patient’s directly when they try and contact the hospital to find out the results and instead being referred to their GP, who experiences the problem stated above. GP’s are being left to deal with patient’s problems that have nothing to do with the GP and their job and have everything to do with an inefficient NHS bureaucracy. These problems and complaints often taking up to a third of a GP’s working day and thereby reducing the time they can spend actually treating patients. Having to arrange new outpatient appointments for patients when their appointment letters went missing or when appointments were never made etc. Even getting outpatient appointments in the first place and how these are often delayed well after the recommended 6 week wait. Patients who attend outpatient appointments often have to consult their GP to get a prescription that the hospital consultant has recommended, so that the GP bares the cost and not the hospital. My only issue with this article is that Dr Ingram highlights a number of problems with the NHS systems but then does not offer a single solution/idea on how these systems could be improved. When medical students are taught to write articles for publication it is drummed into us that we should always finish the discussion section with a conclusion and recommendations for further work/ implications for practice. I was just thinking that if doctors, medical students, nurses and NHS staff want to complain about the NHS’s failings then at least suggest some ways of improving these problems at the same time. This then turns what is essentially a complaint/rant into helpful, potentially productive criticism. If you (the staff) have noticed that these problems exist then you have also probably given some thought to why the problem exists, so why not just say/write how you think the issue could be resolved? If your grievances and solutions are documented and available then someone in the NHS administration might take your idea up and actually put it into practice, potentially reducing the problem (a disgustingly idealist thought I know). A number of times I have been told during medical school lectures and at key note speeches at conferences that medical students are a valuable resource to the NHS administration because we visit different hospitals, we wander around the whole hospital, we get exposed to the good and bad practice and we do not have any particular loyalty to any one department and can therefore objective observations. So, I was thinking it might be interesting to ask as many medical students as possible for their thoughts on how to improve the systems within the NHS. So I implore any of you reading this blog: write your own blog about short comings that you have noticed, make a recommendation for how to improve it and then maybe leave a link in the comments below this blog. If we start taking more of an interest in the NHS around us and start documenting where improvements could be made then maybe we could together work to create a more efficient and effective NHS. So I briefly just sat down and had a think earlier today about a few potential solutions for the problems highlighted in Dr Ingram’s article. A community pathology team that handles all of the GP’s pathology specimens and referrals. A “patient pathway co-ordinator” could be employed as additional administrative staff by GP surgeries to chase up all of the appointments and missing information that is currently using up a lot of the GP’s time and thereby freeing them to see more patients. I am sure this role is already carried out by admin staff in GP practices but perhaps in an ad hoc way, rather than that being their entire job. Do the majority of GP practices get access to the hospitals computer systems? Surely, if GPs had access to the hospital systems this would mean a greater efficiency for booking outpatient appointments and for allowing GPs to follow up test results etc. In the few outpatient departments I have come across outpatient appointments are often made by the administration team and then sent by letter to the patients, with the patient not being given a choice of when is good for them. Would it not be more efficient for the administrative staff to send the patients a number of appointment options for the patient to select one appropriate for them? Eliyahu M. Goldratt was a business consultant who revolutionized manufacturing efficiency a few years ago. He wrote a number of books on his theories that are very interesting and easy to read because he tries to explain most of his points using a narrative – “The Goal” and “Critical Chain” being just tow. His business theories focussed on finding the bottle neck in an industrial process, because if that is the rate limiting step in the manufacturing process then it is the most essential part for improving efficiency of the whole process. Currently, most GPs refer patients to outpatient appointments at hospitals and this can often take weeks or months. The outpatient appointments are a bottle neck in the process of getting patients the care they require. Therefore, focussing attention on how outpatient appointments are co-ordinated and run would improve the efficiency in the “patient pathway” as a whole. a. Run more outpatient clinics. b. Pay consultants overtime to do more clinics, potentially in the evenings or at weekends. While a lot may not want to do this, a few may volunteer and help to reduce the back log on the waiting lists. c. Have more patients seen by nurse specialists so that more time is freed up for the consultants to see the more urgent or serious patients. d. An obvious, yet expensive solution, hire more consultants to help with the ever increasing workload. e. Change the outpatient system so that it becomes more of an assembly line system with one doctor and a team of nurses handling the “new patient” appointments and another team handling the “old patient” follow up appointments rather than having them all mixed together at the same time. I am sure that there are many criticisms of the points I have written above and I would be interested to hear them. I would also love to hear any other solutions for the problems mentioned above. Final thought for today … Why shouldn’t medical students make criticisms of inefficiencies and point them out to the relevant administrator? If anyone else is interested in how the NHS as a whole is run then there is a new organisation called the Faculty of Medical Leadership and Management that is keen to recruit interested student members (www.fmlm.ac.uk).  
jacob matthews
over 7 years ago
Foo20151013 2023 1nuvntv?1444774080
2
818

Obesity Part 1 – Fat Kid in a Fat Society

Introduction to Obesity One of my favourite past-times is to sit in a bar, restaurant, café or coffee shop and people watch. I am sure many of you reading this also enjoying doing this too. People are fascinating and it is intriguing to observe: what they do; how they act; what they wear and what they look like. My family and I have always observed those around us and discussed interesting points about others that we have noticed. When I first came up to visit Birmingham University my family all sat in a coffee shop in the centre of Birmingham and noticed that on average the people walking past us looked much slimmer than what we were used to seeing back in south Wales. Now, when I go home it is more painfully obvious than ever that the people in my home region are much, much heavier than they should be and are noticeably bigger than they used to be even a short number of years ago. This change in the population around me is what first made me seriously think about obesity, as a major problem affecting the world today. Nowadays obesity is all around us! It is noticeable, it is spreading and it should worry us all. Not just for our own individual health but also for the health of our society. Obesity affects everything from the social dynamic of families, to relationships at school or work, to how much the NHS costs to run. Obesity is a massive problem and if we as a society don’t start getting to grips with it, then it will have huge implications for all of us! I am currently in my 5th year at medical school. While I have been here I have taken a keen interest in obesity. The physiology, the psychology, the anatomy, the statistics and the wider affects on society of obesity have all been covered in curriculum lectures and extra curriculum lectures. I have taken part in additional modules on these subjects and sort out many experts in this field while on hospital placements. Obesity is fascinating for some many reasons and I thought that it would be a great topic to write some blogs about and hopefully start some discussions. Warning For my first blog on the topic of obesity I quickly want to write a bit about myself and my battle with weight. Everyone’s favourite topic is themselves, but I like to think that’s not why I have written this and I hope it doesn’t come across as a narcissistic ramble. I don’t intend to try and make myself come off well or suggest that I have all the answers (because I know very well that I don’t) and I hope it doesn’t come across like that. I want to write a bit of an autobiography because I wish to demonstrate how easy it is to go from a chunky kid to a technically obese teenager to a relatively fat adult without really realising what was happening. Chunky Child to Fat adult While planning this blog I realised that my Meducation profile picture was taken when I was at my all time fattest. At the graduation ceremony at the end of my 3rd year at university after completing my intercalation I was over 19 stones. At 6 foot 2” this gave me a BMI of >33 which is clinically obese. I had a neck circumference of >18”, a chest circumference of 48”, a waist of >40”, a seat of >52” and a thigh circumference of >28” per leg. Why do I know all of these rather obscure measurements? Partly because I am quite obsessive but mainly because I had to go to buy a tailor made suit because I could no longer buy a suit from a shop that I could fit into and still be able to move in. The only options left to me where massive black tent-suits or to go to a tailors. After the graduation I sat down at my computer (whilst eating a block of cheese) and compared my face from the graduation photos to pictures I had taken at the start of university and the difference in shape and size was amazingly obvious. I had got fat! I realised that if I had a patient who was my age and looked like me with my measurements then I would tell him to lose weight for the good of his health. So, I decided that finally enough was enough and I that I should do something about it. Before I describe how I got on with the weight management I will quickly tell the back story of how I came to be this size. I have always been a big guy. I come from a big family. I have big bones. I had “puppy fat”. I was surrounded by people who ate too much, ate rubbish and were over weight themselves, so I didn’t always feel that there was anything wrong with carrying a bit of tub around the middle. When I went to comprehensive school at age 12 I had a 36” waist. I thought I carried the weight quite well because I was always tall and had big ribs I could sort of hide the soft belly. Soon after arriving at the new school I had put on more weight and for the first time in my life I started to get bullied for being fat! And I didn’t like it. It made me really self-aware and knocked my confidence. Luckily, we started being taught rugby in PE lessons and I soon found that being bigger, heavier and stronger than everyone else was a massive advantage. I soon got my own back on the bullies… there is nowhere to hide on a rugby field! This helped me gain my confidence and I realised that the only way to stop the bullying was to confront the bullies and to remake myself in such a way as that they would be unable to bully me. I decided to take up rugby and to start getting fit. I joined a local club, starting playing regularly, joined a gym and was soon looking less tubby. Reflecting (good medical jargon, check) on my life now I can see that my PE teachers saved me. By getting me hooked on rugby they helped get me into many other sports and physical activity in general and without their initial support I think my life would have gone very differently. Rugby was my saviour and also later on a bit of a curse. As I grew up I got bigger and bigger but also sportier. I started putting muscle on my shoulders, chest and legs which I was convinced hid how fat I actually was. I developed a body shape that was large but solid. I was convinced that although I was still carrying lots of excess weight I no longer looked tubby-fat. When I was 14 my PE teachers introduced me to athletics. They soon realised that I was built for shot putt and discuss throwing and after some initial success at small school competitions I joined a club and took it up seriously. At this age I had a waist of about 38” but was doing about 3-4 hours of exercise almost everyday, what with rugby, running, gym, swimming and athletics – in and out of school. My weight had by now increased to roughly 15 stones and my BMI was over 30. I was physically fit and succeeding at sport but still carrying quite a lot of fat. I no longer thought of myself as fat but I knew that other people did. Between the ages of 14 and 18 I started to be picked for regional teams in rugby and for international athletic competitions for Wales. My sporting career was going very well but the downside of this was that I was doing sports that benefited from me being heavier. So the better I got the heavier I wanted to become. I got to the stage where I was eating almost every hour and doing my best to put on weight. At the time I thought that I was putting on muscle and being a huge, toned sports machine. It took me a while to realise that actually my muscles weren't getting any bigger but my waist was! By the time I had completed my A-levels I was for the first time over 18 stones and had a waste of nearly 40”. So, at this point I was doing everything that I had been told that would make me more adapted for my sport and I was succeeding but without noticing it I was actually putting on lots of useless excess weight that in the long term was not good for me! During my first year of university I gave up athletics and decided that I no longer needed to be as heavy for my sports. This decision combined with living away from home, cooking for myself and walking over an hour a day to and from Uni soon began to bear fruit. By the summer of my first year at Uni, aged 19, I had for the first time in my life managed to control my weight. When I came to Uni I was 18 stone. After that first year I was down to 14 stone – a weight I had not been since I was 14 years old! I had played rugby for the Medical school during my first year but as a 2nd row/back row substitute. These positions needed me to be fit and not necessarily all that heavy and this helped me lose the weight. During my second year I began to start as a 2nd row and was soon asked to help out in the front row. I enjoyed playing these positions and again realised that I was pretty good at it and that extra weight would make me even better. So between 2nd year and the end of 3rd year I had put on nearly 5 stone in weight and this put me back to where I started at my graduation at the end of 3rd year. The ironic and sad thing is about all this that the fatter, less “good looking” and unhealthier I became, the better I was adapted for the sports I had chosen. It had never occurred to me that being good at competitive sports might actually be bad for my health. The Change and life lessons learnt At the beginning of my 4th year I had realised that I was fatter than I should be and had started to pick up a number of niggly injuries from playing these tough, body destroying positions in rugby. I decided that I would start to take the rugby less seriously and aim to stay fit and healthy rather than be good at a competitive sport. With this new attitude to life I resolved to lose weight. Over the course of the year there were a number of ups and downs. I firstly went back to all the men’s health magazines that I had stock piled over the years and started to work out where I was going wrong with my health. After a little investigation it became apparent that going running and working out in the gym was not enough to become healthy. If you want to be slim and healthy then your diet is far more important than what physical activity you do. My diet used to be almost entirely based on red meat and carbs: steak, mince, bacon, rice and pasta. Over the year I changed my diet to involve far more vegetables, more fibre, more fruit, more salad and way less meat! The result was that by Christmas 2012 I was finally back below 18 stones. The diet had started to have benefits. Then came exams! By the end of exams in April 2013 I had gone back up 19 stones and a waist of >40”. I was still spending nearly 2 hours a day doing weights in the gym and running or cycling 3 times a week. Even with all this exercise and a new self- awareness of my size, a terrible diet over the 3 week exam period had meant that I gained a lot of fat. After exams I went travelling in China for 3 weeks. While I was there I ate only local food and lots of coffee. Did not each lunch and was walking around exploring for over 6 hours a day. When I got back I was 17.5 stone, about 106kg. My waist had shrunk back down to 36” and I could fit into clothes I had not worn in years. This sudden weight loss was not explained by traveller’s diarrhoea or any increased activity above normal. What made me lose weight was eating a fairly healthy diet and eating far less calories than I normally would. I know this sounds like common sense but I had always read and believed that if you exercised enough then you could lose weight without having to decrease your calorie intake too much. I have always hated the sensation of being hungry and have always eaten regular to avoid this awful gnawing sensation. I had almost become hunger-phobic, always eating when given the opportunity just in case I might feel hungry later and not because I actually needed to eat. The time in China made me realise that actually I don’t NEED to eat that regularly and I don’t NEED to eat that much. I can survive perfectly ably without regular sustenance and have more than enough fat stores to live my life fully without needing to each too much. My eating had just become a habit, a WANT and completely unnecessary. After being home for a month I have had some ups and downs trying to put my new plans into action. Not eating works really easily in a foreign country, where it’s hot, you are busy and you don’t have a house full of food or relatives that want to feed you. I have managed to maintain my weight around 17.5 stones and kept my waist within 36” trousers. I am counting that as a success so far. The plan from now on is to get my weight down to under 16.5 stones because I believe that as this weight I will not be carrying too much excess weight and my BMI will be as close to “not obese” as it is likely to get without going on a starvation diet. I intend to achieve this goal by maintain my level of physical activity – at least 6 hours of gym work a week, 2 cardio sessions, tennis, squash, cycling, swimming and golf as the whim takes me. BUT MORE IMPORTANTLY, I intend to survive off far fewer calories with a diet based on bran flakes, salad, fruit, nuts, chicken and milk. I am hoping that this very simple plan will work! Conclusion Writing this short(-ish) autobiography was quite cathartic and I would really recommend it for other people who are trying to remake themselves. Its helped me put my thoughts in order. Over the years I wanted to lose weight because I wanted to look better. This desire has now matured into a drive to be not just slimmer but healthier; I no longer want to be slimmer just for the looks but also to reduce the pressure on my joints, to reduce the pressure on my cardiovascular system, to reduce my risks of being fat when I am older, to hopefully reduce the risk of dying prematurely and to some extent to make life cheaper – eating loads of meat to prevent hunger is expensive! I hope this blog has been mildly interesting, but also informative of just how easy it is for even a health conscious, sporty individual to become fat in our society. I also wanted to document how difficult it is to lose weight and maintain that new lower weight for any prolonged length of time. At some point I would like to do a blog on the best methods for weight loss but that may have to wait until I have found what works for me and if I do actually manage to achieve my goals. Would be a bit hypercritical to write such a blog while still having a BMI yo-yoing around 32 I feel! Thought for the day 1 - Gaining wait is easy, becoming fat is easy, losing fat is also technically easy! The hard part is developing AND then maintaining a healthy mental attitude towards your weight. The human body has evolved to survive starvation. We are almost perfectly made to build up high density fat stores just in case next year’s crops fail and we have to go a few months on broth. I will say it again – We are designed to survive hard conditions! The problem with the modern world and with modern society is that we no longer have to fight to survive. For the first time in human history food is no longer scarce… it is in fact incredibly abundant and cheap (http://www.youtube.com/watch?v=-Z74og9HbTM). It is no surprise that when a human body is allowed to eat want and how much it craves and then do as little activity as possible, that it puts on fat very quickly. This has to be one of the major ironies of our age – When the human race has evolved society enough that we no longer need to have fat stores in case of disaster, that we are now the fattest humans have ever been! 2 – The best bit of advice I was ever given is this: “Diets ALWAYS fail! No matter what the diet or how determined you are, if you diet then within 2 years you will be the same weight or heavier than you are now. The only way to a healthy body is through a healthy LIFESTYLE CHANGE! You have to make changes that you are prepared to keep for a long time.”  
jacob matthews
about 7 years ago