Month: May 2015

A letter to the Prime Minister

Claire Robertson is a GP in Inverness. LETTER TO THE PRIME MINISTER Dear Mr. Cameron, I have been meaning to write to you for some time, but, as I am sure you can imagine, life and work take over and the days fly by. The time has come over this last week having watched with interest the election results unfold and the Conservative majority see you remain our Prime Minister. Now that this second term is underway I plead with you listen to your dedicated public servants: I am from a working class background. My grandfathers were a miner and a...

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A letter to the Health Secretary

Adam Staten is a GP trainee in Surrey and is on Twitter @adamstaten. LETTER TO THE HEALTH SECRETARY Dear Mr Hunt, Many congratulations on being re-appointed as Secretary of State for Health in the Conservative cabinet. May I suggest we treat your re-appointment as a fresh start? As a gynaecology SHO performing intimate examinations I was once told to ‘go in like a butterfly and come out like a lion.’ The idea was to cause minimum discomfort by combining a gentle approach with a swift withdrawal. This was not a strategy you adopted when you began your intimate examination...

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Exercise and sudden death in older athletes

John Brooks is a GP from Congleton. The early works of Morris and Rose suggested that those who were more physically active had less coronary heart disease than those who had a more sedentary way of life. The rise in popularity of running in the 1970s and 1980s led to some exaggerated claims that marathon running could somehow give immunity to coronary heart disease. Cases of sudden death in marathon races get a lot of publicity but the risk is probably no higher than people going about their daily activities. Sudden death from cardiovascular disease in young athletes is low and thought to be mainly due to inherited or congenital abnormalities. The most common of these is hypertrophic cardiomyopathy with a smaller group made up of such conditions as Wolf-Parkinson White syndrome, Marfan’s syndrome and mitral valve prolapse1. The cause of the sudden death is a fatal cardiac arrhythmia that occurs in a seemingly fit athlete. Gentle jogging three times a week seems to be relatively safe and good for your health2 but how safe is long term endurance and intensive exercise particularly as we get older ? This question is important for those athletes who want to perform well at club level and elite athletes. Studies of cardiac adaptation to acute and chronic participation in endurance sports have shown both enzyme changes and evidence of cardiac remodelling.3 We...

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