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FIT or SIT

“5/2, tried that, and I know someone who religiously followed the Hay diet/Atkins/Keto/Paleo diets. I even met a Breatharian (just air to eat!), nothing works,” bemoaned a patient. Another talked of their gym plan/walking 10,000 steps/ultimate workout/cardio in guilt laden tones. Then I heard of work life balance/mental gym & health gurus. Despite all these wonderful ideas {and most if not all, contain pearls of wisdom} we still struggle to keep our health and looks. In the ‘diets’ the missing ingredient was knowledge of the gut microbiome which now provides an exciting explosion of insight as to how our food keeps us healthy. If there is a secret for our digestion is there one for our bodies?

The Bible states that we are ‘wonderfully and fearfully made’, but made for what? It seems we started as hunter gatherers for 500,000 years and our bodies were formed for walking, running and squatting. Later for 20,000 years we were moulded by an agricultural life of stretching, lifting, bending and squatting. Then 200 years ago the industrial revolution mass produced the chair (and there are now 7 chairs for every person in the world).

Now, we sit.

We are sitting at the breakfast table, sitting in the car to work, sitting at work, sitting for lunch, returning to sit through the afternoon. Thence car home…and on the couch for the TV. In his wonderful book Primate Change, Prof V. Cregan-Reid estimates that the average employed adult sits 15 hours per day.

In 2010 an American cancer society study compared women who were sedentary for less than three hours per day with those who were sedentary for more than six. The latter had an increased risk of death of 94% during the trial. It turns out that similar to lack of sleep (that one cannot catch up after a week of late nights by spending Sunday mornings in bed), we cannot do hardcore exercise to make up for the stationary lifestyle.

In 2020 British stats reveal that our average day is six and half hours in front of the screen before we add in yet more sitting around.

At this point we need to leave the science of statistics (so often called ‘evidence based’) and use logic-based deduction. When the tissues of the body are under-used there is a reduced flow of blood and the inter-cellular fluids stagnate. Just as a slow flowing stream will silt up, so the tissues will start to accumulate debris and deposits. At first this will negligible, like tax at 1% but as the months pass it will take a greater toll. Remember a VAT rise from 8% to 17.5%. This was said to be the leading cause of business bankruptcy and similarly a stealthy rise of dregs in the tissues will cause degeneration. Just as a good business deal will keep a firm afloat but not change the direction of decline, so a visit to the gym will be wonderful today but leave the reckoning till tomorrow.

Like tuning a piano, finding the adjustments needed for one’s own body is both a skilful art and satisfying science. Perhaps first is to realise each piano is different so each player must learn about their own instrument and not rely on the average, ie take advice but make a decision based on knowledge learned from using your own body. One women’s perfect hairstyle is another women’s fright. Next is to include movement in your day. Even office-based work can include built in activity be it a roly-poly stool, a stand-up desk or even a bicycle desk! Other ideas are to include regular breaks for errands etc, change seating, change the seat adjustment. The real winner, however is to create movement in your work. Also ensure it is thought out for those working for/with you and notice when it gives increased energy. A London survey in 1953 found that bus conductors had half as many heart attacks as the drivers, so bear this in mind if people laugh at you.

It turns out that ‘being fit’ is not about triathlons and exercise machines, which are great for strength building and endurance, but a question of ‘sit a lot and you won’t stay fit for long’. Perhaps we have come to believe that if we’re not training for a Marathon we might as well not bother to do anything? In Dan Buettner’s book, the Blue Zones, we are introduced to the joy-filled lives of the eldest [and healthiest] communities in the world – older people who still use their bodies for growing their food, walk or cycle to wherever they wish to go, take time to prepare simple meals to share with friends or family - brings an inner smile and a breath of hope for our future. Indeed, it all turns out to be simple - Keep on the go and you will go on.

I had to sit still! for three hours to write this so thank you for reading it.

Aug 2020

Christopher Grey, Osteopath


Halloween blog

Grey’ve Robber

“You don’t have to buy one, you can get them free,” Bernard, a fellow Osteopathic student, said to me. We were discussing a second-hand skeleton for sale for 1000 French Francs on the school boards.

At that time all osteopathic students (like our medical colleagues) were expected to own a skeleton and not a plastic one. It had to be real to train the hands properly. One might wonder, when there are so many human bones no longer needed why it is so difficult to find one but it was all the fault of William Wilberforce. He is best known for his lifetime crusade to abolish the slave trade. However, he took some time out to campaign for reform to the justice system. At that time, it was the custom that every person condemned to death was hung publicly, and so lost the rights over their body. This gave a plentiful supply of bodies for medical teaching. His reforms stopped this practice, the convicted being executed inside the prisons and buried in unmarked graves lined with quicklime. The first effect of this change was the rise in grave robberies to supply the hospitals. A later method was bribery, as in the case of Charles Byrne. He was 7ft 7ins and fearing his body would be dissected after his early demise paid a ship’s captain to bury his coffin at sea. At his death the prominent surgeon John Hunter paid the captain more to bring the coffin to him. Byrne’s skeleton is still in a (very tall) specimen case in the Royal College of Surgeons in London. Later in 1985 the Indian government banned the sale of bones from India which had long made up the deficit. Laudable reforms but disastrous for poor Osteopathic students, who could only find animal bones.

Bernard went on to explain that in France they bury people in mausoleums, which are like low-rise blocks of flats each with long, low and thin compartments made to be able to slid a coffin into. Each one was sealed with a little marble slab carrying the person’s details. Like any apartment, these are rented and after 20 years of arrears a notice is posted that unless the rent is paid the coffin will be removed. Making it all sound completely normal, he added that any cleared ‘remains’ were put in a shed in the graveyard. When full, this would be emptied and burned by the Council, “so nobody would miss a few bones or even a whole skeleton”, he assured me. The only problem, he noted, was that the bones were brown and mottled however, boiling them in bleach restored them to new.

In seconds I had decided to save my Francs for more essential items such as wine, gauloises and cheese etc making the decision to strike out on my next free afternoon.

And so it was I found myself driving to Vence, a beautiful mountain village, far enough from where I lived to assure I would not be recognised. I parked, picked up my empty my suitcase, and nonchalantly strolled the two streets toward the church. I found I was sweating in the summer sun more than normal and I refused to acknowledge my heart rate increasing. I slid into the church yard feeling like a spy, caught myself and calmly put on a tragic face, acting as if I had come to visit a grave. All the while I was looking for ‘the shed’. My heart lurched as I noticed it. It was in the far corner. I sidled up to it, looked over my shoulder and opened the door. First a wave of disappointment, then a much greater wave of relief; I saw it was full of gardening tools. Well, I had tried but my informant was clearly misinformed. Jauntily I strode back toward the gate. It was then I noticed the second shed. My pride forced me to check inside and there in the middle of the floor was the promised pile of mottled and brown bones, all mixed up with rotten cloth and splintered wood.

Surreptitiously I squeezed inside. It smelt musty, a mix of rotting old socks and manure. Closing the door tightly, so no one could see me sorting through their beloved’s bones, I squatted down to sort out a full set. Unfortunately, I had no torch (and the mobile phone hadn’t even been invented) so I was working in pitch blackness. I felt the length of a femur (the thigh bone), it was rough with something attached. Next I touched a bone that seemed like a rib, then another. Little by little, feeling each one carefully to identify it, a jaw here, a vertebra there I carefully sorted them into piles around me. Some were dry, others less so, others seemed deformed, and again others were stuck to what I assumed were bits of clothing. As the piles around me grew slowly the temperature rose steadily. The midday sun beat down on the roof and all the while it seemed to grow darker and hotter inside. My feverish brain was blocking out worry… by worrying; first about finding a full set of 24 ribs - perhaps there were many sets of rib bones in this pile and I might end up with a skeleton of ill matched bones. Then I worried that the tiny wrist bones could have fallen to the bottom so I would have to turn the whole pile of human remains on its head to find them. The simple job of finding a complete matching set of 206 human bones had become implausibly complicated. To my satisfaction I finally felt a skull, only to find the back of it smashed in. I tried to believe it was damaged during the clearing out but my mind began to imagine the person was in an accident… or had their head clubbed in. It was at this point, while the sweat was running down my face and my adrenaline was in the red, that a long-suppressed image exploded in my mind. The picture of what an angry French lynch mob would do if they found an Englishman robbing their dead. To mark the spot and celebrate my punishment, they would rename the local bar, ‘The Hanging English grave robber’.

I broke. I heaped up the pile of dead bones as respectfully but quickly as I could, ripped open the door and ran for dear life. Minutes later I was in a bar perspiring into a double whisky. Perhaps I mused, those grave robbers, who dug up bodies in the dark, often partially decomposed and carried them by cart to hospital back doors, were amongst the bravest people in history. Even if their morals like mine were a little questionable, they must have been remarkable people.

The next day I went to buy the skeleton advertised, the price seemed a steal.

Christopher Grey, Osteopath

October 2020