Direct access to physiotherapy is a pain

As I’ve mentioned, my hands have gone to hell over the last few weeks and my doctor reckons it’s carpal tunnel syndrome – so I’ve been referred to physiotherapy (although as far as I can see, physiotherapy is completely useless in cases of CTS. But I digress). I don’t know what the system’s like in other parts of the country, but round here we have direct access to physio: if we want an appointment we just phone the physios directly. Excellent!

In theory, anyway.

I called last week, only to discover that you can’t call in the afternoons. I called the next day, and got an answering machine. The leaflet tells you that you’ll get an answering machine and that you should leave a message, but this particular answering machine won’t let you leave a message because the staff are too busy. Instead, it suggests you call back the next day – which I do, and this time I get a different answering machine. This time I can leave a message, and somebody will phone me back within two working days.

That was three working days ago.

This access to physio may be all kinds of things, but “direct” it ain’t.

Ear mutations, why it hurts when I Wii, a completely unbiased review of the new Eels album, and a quick thing about iPhone 3G coverage

Hello there. Sorry for the lack of blogging recently, I’ve been taking a break from the computer. Here are a few things that have been occupying me lately.

First up, headphones and mutating ears. I’ve been reviewing some high-end headphones – in-ear ones – and while I can’t put any details up here until the reviews hit print, I can say that once you start spending £80-plus on headphones you end up with something pretty amazing. Such phones deliver so much bass that even the nicest, prettiest acoustic number feels like somebody driving an 18-wheel truck into the side of your head.

My existing headphones weren’t quite as dramatic as that, but they were pretty good – until recently, when they stopped delivering any bass at all. The problem is the seal. With in-ear headphones, once you get a good seal you get bass; if the seal isn’t perfect, you don’t get bass at all. If you ever see user reviews of £150 headphones where an outraged punter accuses the cans of being a bass-free zone, you can be sure the problem was that either the phones didn’t fit properly or the punter didn’t put them in properly.

The problem with my ones, however, is a bit different. I can’t get a seal any more. I’m not putting them in any differently, there’s no damage to the headphone covers. They just don’t fit any more, and because I’ve thrown out all the other spare covers, there’s not much I can do about it. I think the problem may be that I’ve been using earplugs quite a lot recently – our neighbours have a new dog, which can be noisy, and I often need to nap during the day – and the earplugs have widened my ear canals slightly. Not hugely – I’m not able to put, say, a large carrot into my lugs – but enough that the headphones that did fit, don’t. Very annoying.

Next up, the Wii. If you played Dead Space on Xbox, you’ll love Dead Space Extraction on the Wii – especially if you can get it for £15, as I did in ASDA. Unfortunately while it’s a brilliant game and superb fun, it’s absolutely hellish to play if you’re using the Wiimote. I was diagnosed with carpal tunnel syndrome the other week, and playing with the Wiimote makes the symptoms appear pretty much instantly. I don’t know if things are any better if you use the Wii Zapper, the gun-shaped holder for the Wiimote, but it’s probably not a good idea for me to try.

On to phones. If you’re getting crappy 3G coverage from your current provider you might find that switching makes a huge difference. According to their online coverage maps both O2 and Orange deliver great 3G coverage to my bit of the world, but in reality I can’t get an O2 signal in much of my house, anywhere near the gym or in either pub I frequent. I switched to Orange this week and I get full-strength signals everywhere.

It’s worth thinking about if you’re switching and taking a number with you: to do that you need to hand over a code called a PAC code, which your new provider uses to transfer the number. If I were moving from Orange to O2 I’d be bloody furious at the coverage in my neck of the woods, but having transferred the number over there would be a lot of hassle if I wanted to go “your coverage is crap! Shove your contract!”. The moral? Make sure the coverage is good enough and *then* hand over the PAC code.

The new Eels album, End Times, is very good. If you like music made by people with beards, you should buy it.

Last but not least, I had a complete mental blackout today on the radio and couldn’t remember which key press gets a right-click on a Mac when you don’t have a two button mouse. The correct answer is, of course, the Windows key.

A-ha-ha-ha.

Could Apple’s tablet hurt your hands?

Sorry for yet another tablet post, but it’s the tech that lots of people want to read about right now. It struck me earlier that among all the excited predictions, nobody’s pointing out that it could be an ergonomic disaster area. So I wrote about it.

It’s likely, then, that typing on the tablet will be uncomfortable. At the risk of sounding like a character from The Day Today, Uncomfortable plus time equals pain.

What they don’t tell you about miracle stop-smoking drug Champix

Once you’ve binned the cigs, you’ll need to bin the Champix – and the withdrawal symptoms of that are pretty similar to the withdrawal symptoms from stopping smoking. Insomnia, strong physical cravings, the inability to handle even the slightest irritation without flying into an Yngwie Malmsteen-esque “fockin’ fury” (linked MP3 NSFW)… better than smoking, I know, but it’s still bloody annoying.

Vaccines bad, m’kay?

Here we go again. Malcolm Coles argues that media reports are doing an MMR, this time with the cervical cancer vaccine:

Let’s be clear. The only reason parents are worried, boycotting the vaccine, and demanding suspensions of the vaccination program is because the media whipped up a storm with no evidence whatsoever.

Perhaps it’s Scotland’s politicians that need “rebalancing”

Oh joy, the new Scottish booze legislation comes into force today. Supermarkets are reorganising their displays, pubs are spending thousands of pounds on applying for new licenses (which, in the case of North Lanarkshire, mean some 25 pubs won’t legally be able to sell booze from today due to delays in the application process. Council says don’t worry, cops say WE WILL BUST YOU) and staff will require mandatory training to make sure they don’t encourage drinkers to have another drink. Imagine it! Pub staff asking if you want another drink!

Apparently the move, which makes my life that little bit more annoying by preventing me from buying wine or beer when I do my normal 8am shop (you can’t buy booze before 10am now, which I’m sure will prevent alcoholism) is about “rebalancing” Scotland’s relationship with booze. There’s another bill along on Thursday which will flout EU law by trying to impose price controls on booze too. Rebalancing, again.

Which reminds me of a story.

Barney is a decorator, and he cracks me up. A while back he was telling me about a woman whose house he was working in, or trying to work in: she had one of those really yappy little dogs, and it was driving Barney daft. She did apologise for the dog’s incessant barking, and said she had no idea why it was so hyperactive.

“Oh, I know why it is,” Barney said. “It’s out of balance.”

“Balance?”

“Yeah. Sometimes their wee heads get out of balance, and they become really bad tempered. Easy to fix, though.”

“Really?”

“Yep.”

“How do you fix it, then?”

“Well, what you need is a little bit of metal. Lead’s best. And what you do is, you put the lead into the dog’s ear and that rebalances it.”

“My goodness! So how do you get the lead into their ear?”

“With a FUCKING GUN!”

I can’t help thinking some of our elected representatives would benefit from a similar procedure.

E-cigarettes: looks like the “E” stands for “Eek! Cancer!”

The US FDA has been testing some electronic cigarettes. It seems they’re aren’t the safe alternative to real cigarettes they claim to be.

Specifically, DPA’s analysis of the electronic cigarette cartridges from the two leading brands revealed the following:

• Diethylene glycol was detected in one cartridge at approximately 1%. Diethylene glycol, an ingredient used in antifreeze, is toxic to humans.
• Certain tobacco-specific nitrosamines which are human carcinogens were detected in half of the samples tested.
• Tobacco-specific impurities suspected of being harmful to humans—anabasine, myosmine, and β-nicotyrine—were detected in a majority of the samples tested.
• The electronic cigarette cartridges that were labeled as containing no nicotine had low levels of nicotine present in all cartridges tested, except one.
• Three different electronic cigarette cartridges with the same label were tested and each cartridge emitted a markedly different amount of nicotine with each puff. The nicotine levels per puff ranged from 26.8 to 43.2 mcg nicotine/100 mL puff.
• One high-nicotine cartridge delivered twice as much nicotine to users when the vapor from that electronic cigarette brand was inhaled than was delivered by a sample of the nicotine inhalation product (used as a control) approved by FDA for use as a smoking cessation aid.

(Via Techradar)

When readers won’t behave

This is brilliant: The Guardian hosts a reader Q&A with Neal’s Yard Remedies, an ethical beauty/homeopathic remedy company. The readers duly post questions and NY changes its mind about participating. [Via MetaFilter]

Linked below is a book [NY sells] on ‘Homoeopathy for Mother and Baby’. Given that homoeopathy has never been shown to have any effect distinguishable from placebo, do you regard it as ethical to profit from publications which seek to exploit the anxiety of new mothers to sell pseudo-medicines?

Does your part in the MMR scare make you feel guilty? Do you feel bad when you think of the children who have suffered measles and possibly even had brain damage or died because of the scare which you promote?

Baby bottles, boards and making mums feel like Hitler

This advert is causing a bit of controversy: it’s an EU ad about work/life balance, and it shows a laptop and a baby bottle.

There’s a very impassioned argument against it here:

But when I see a media image of a baby bottle…
…I see death.
I see all the the real maggots crawling in all the real bottles.
I see the tiny white bundles being put in the shallow shallow graves.
I see corporate greed and profiteering, being put before baby’s lives.

It’s a bit dramatic for my taste, but she does have a point. There are risks to bottle feeding, especially in developing countries.

The water mixed with baby milk powder can be unsafe and it is often impossible in poor conditions to keep bottles and teats sterile. Bottle feeding under such circumstances can lead to infections causing diarrhoea, the biggest killer of children worldwide.

Baby milk is also very expensive, often costing more than half the entire family income. This means that bottle feeding will contribute to family malnutrition. Furthermore, poor mothers trying to make the milk go further sometimes overdilute the powder, and the baby may not then receive the nutrition he or she needs.
Bottle baby disease is the name given to the deadly combination of diarrhoea, dehydration and malnutrition which is the result of unsafe bottle feeding.

Even in developed countries there are risks, which is why the NHS offers this advice:

Powdered infant formula milk is not a sterile product, and even though tins and packets of milk powder are sealed, they can contain bacteria such as Enterobacter sakazakii and more rarely Salmonella. If the feed is not prepared safely, these bacteria can cause infections – and even though these are extremely rare, when they do happen they can be life-threatening. Therefore, it is important to make up the formula milk with water at a temperature of around 70ºC.

Factor in the way that formula milk companies have behaved in the past and you can understand why people might be dead against formula. However, on mums’ discussion boards that’s often translated into something a bit different: posts telling mums that if they bottle feed their kids, they’re trying to kill them.

Here’s an example from iVillage.co.uk. This one’s a fairly innocuous example, because while I’ve seen much more aggressive posts on the subject I forgot to bookmark the links. Anyway. The post title:

higher risk of cot death in formula fed

The post links to this news story:

The Foundation for the Study of Infant Deaths (FSID) announces its latest advice that breastfeeding your baby can reduce the risk of cot death.

In the footnotes, the article links to various studies, including this one (emphasis mine), which is the one I’ve seen posted most often to support Formula Is Evil posts:

A history of breastfeeding is associated with a reduced risk of many diseases in infants and mothers from developed countries. Because almost all the data in this review were gathered from observational studies, one should not infer causality based on these findings. Also, there is a wide range of quality of the body of evidence across different health outcomes.

Back to iVillage. The original post has sparked a debate, and this post is fairly typical.

The exact reason that fewer breastfeeded babies die from cot death is actually unknown.

Which is true.

(mainly because so many of the properties of breastmilk are still unknown. And because they change form baby to baby, day to day and morning to night.)

That’s not so true. The reason we don’t know why fewer breastfed babies die of SIDS is because we still don’t know what causes SIDS.

However the most popular theories that i have heard have been these:

That as the protective properties of breastmilk result in far fewer illness and infections, this in turn is thought to lower the chances of cot death.

That as breastmilk is more easily digested by babies, and does not over fill their tummies, breastfed babies do not fall into such a deep sleep. It is thought the deeper sleep that formula milk produces, makes it harder for a baby to wake it’s self when it has difficulty breathing. (the scary sudden jolt and then deep breath, that is often seen in tiny babies).

But they’re just theories.

Here’s another theory. It could be the environment around breastfeeding in the developed world. Let’s have a look at Glasgow, courtesy of the Evening Times.

In the East End just 14% of mums were breastfeeding alone at six to eight weeks compared with 32.2% in the West End. Statisticians say there is a clear link between breastfeeding rates and levels of deprivation.

Glaswegians are all too familiar with the grim statistics coming out of different parts of the city. The Herald:

In some postcode areas in the east end, 60% of children live in workless households, almost 50% of adults of working age are on incapacity benefit and life expectancy can be as low as 54.

The contrast with some west end postcodes is staggering, where life expectancy is over 80, fewer than 5% of children live in workless households and there are virtually no benefit claimants.

I’ll cheerfully admit to doing what some of the anti-formula mums do on boards: I’m taking two different things and sticking ‘em together to support the particular argument I want to make – which is that if breastfeeding is more common among well-off, well-educated people with excellent support networks and the like, in areas where fewer people smoke and exist on poor quality food, then it’s hardly surprising that health outcomes for kids are better in those areas. It could be the breastfeeding, but equally it could be that people aren’t sterilising the bottles properly. Or it could be the better food, the nicer houses or the proximity to really good restaurants. I’m not a scientist, and I’m not an expert in this field, so I have absolutely no bloody idea.

Which is why I’m not hanging around parenting discussion boards shouting OMG FORMULA WILL KILL YOUR KIDS or OMG FORMULA IS TEH BEST.

But some people are, and when I see mums try to argue against it – without disputing that breast is indeed best – they’re jumped on. People post links to scientific papers they haven’t read, or to articles whose footnotes make a very different point to the one they’re trying to make, or to other people’s interpretations of scientific papers they haven’t read, and they argue again and again that formula milk is by definition bad. Which would be fine if every single woman could breastfeed, but every single woman can’t. Some can’t for physical reasons, others because they can’t afford to stay at home with the baby. And in those circumstances, telling a mum she’s a child killer really isn’t very helpful.

Back to the advert. This time, a discussion about it on Mumsnet – from which I got the impassioned blog link.

However the fact that some parents need to, and some parents choose to bottle feed does not make it OK for governments to portray it as ‘normal’ or aspirational. Its not the same as breastfeeding and we shouldn’t have to apologise for wanting more babies to be fed in the optimal way.

All too often, though, the issue of whether governments should promote breastfeeding gets confused, and manifests itself on messageboards where mums tell other mums that bottle feeding is bad. Most women who don’t breastfeed are ill-informed, the argument goes. Which may be true, but most is not the same as all. Not all women who choose bottle feeding are doing it because they’re uninformed, or because they’re lazy, or because they’re influenced by the evil marketing of formula companies. “We shouldn’t have to apologise for wanting more babies to be fed in the optimal way” is fair enough, but the mums who don’t go that route shouldn’t have to apologise or feel guilty either.

Should formula companies be ashamed of themselves for the way they’ve marketed their products? Sure. Should more effort be devoted to encouraging mums to breastfeed? Absolutely. Should mums who can’t or won’t breastfeed be made to feel like Hitler? I’d like to think not. Messageboards can be a lifeline for new parents, and they get enough crap without getting more of it online.

Laser surgery: lyin’ eyes

Like many four-eyed people, I really don’t like wearing glasses. Sadly I’m stuck with them. I used to wear contact lenses, but I had to stop a few years back when my prescription changed: I’m slightly astigmatic, but I’m on the borderline – and that means I’m too astigmatic for normal contact lenses and not astigmatic enough for toric lenses, which are designed for people whose eyes are shaped like rugby balls.

On paper, contact lenses are just fine; in my eyeballs, they’re not. If lenses enable me to read, I can’t wear them for driving a car at night; if they enable me to drive at night, I can’t use them for reading. Again and again I’ve tried lenses which all the tests say are perfect in my eyes, but which don’t give me perfect vision.

I still hate wearing specs, though, and a few years ago laser surgery started coming down in price to the point where it wasn’t the preserve of millionaires. I looked into it, looked into the side effects and looked into what’s considered a success – and I discovered that what a laser clinic would consider 100% successful wasn’t necessarily 100% successful from my point of view. As with contact lenses, it’s entirely possible to have a successful treatment that doesn’t give you perfect vision. Side-effects can be quite serious, and even if the correction is acceptable it’s a short-term fix, not a permanent one.

That put me off a bit, but the main thing that put me off is the risk of it all going wrong. My late grandfather, a keen reader and writer, had laser surgery many years ago (for medical reasons) and it went wrong, essentially blinding him. Being unable to read, to write… that’s pretty much the worst thing imaginable for me.

That doesn’t mean laser eye surgery is dangerous. Lots of people get it and are delighted with the results. But the worst-case scenario is too scary for me, and my experience with contact lenses suggests that it wouldn’t work for me anyway.

Which brings me to Which? magazine, whose researchers have been in a few high street laser clinics.

clinics played down the level and possible duration of risks and complications, which can include permanently poor night vision or some loss of sight in extreme cases. The spokeswoman said that almost half of Which?’s researchers were not told that even if they had laser eye surgery, they would probably need glasses when they were older.

Optical Express say the article is “misleading and poorly researched”, but Which?’s comment seems sensible enough to me:

people need to be aware of the potentially serious and long-term risks, so that they have realistic expectations and commit to the procedure with their eyes open.

I’m quite sure the pun is intentional.