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In this episode of Stethoscope Stories, the hosts discuss various health topics including endometriosis, NHS waiting times, mental health issues, medicine shortages, and rising cosmetic procedures. They highlight the prevalence of endometriosis in women, its symptoms and impact on daily life, and the lack of awareness and cure for the condition. They also interview Chloe Steele, who shares her experience with the long waiting times in the NHS for endometriosis diagnosis and treatment. The hosts discuss how delays in the NHS can have deadly consequences, citing examples of cancer patients waiting longer than the recommended period for treatment. They also touch upon the growing popularity of cosmetic procedures, with a significant rise in the number of people undergoing such procedures. They discuss the influence of social media on this trend. Lastly, they talk about the state of mental health in the UK, highlighting the persistent prevalence of common mental disorders despite increased Hello and welcome to Stethoscope Stories. I'm Safi Carroll and I'm Sophie Nicholson. In today's episode we look at all things health from endometriosis awareness to Ramadan. We're to cover the dreaded NHS waiting times with our live guest Chloe Steele along with the rising mental health issues where we will finish our episode with medicine shortages and the rising cosmetic procedures. Over to you Safi with our first topic. According to the Royal College of Nursing, 1 in 10 women of reproductive age in the UK suffer from endometriosis. That's 176 million worldwide and 50% of women with the condition have difficulty becoming pregnant. Amelia Johnson is a consultant gynaecologist. She says endometriosis prevents several symptoms and health complications. Endometriosis is a chronic condition where endometrial tissue grows outside of the uterus. Endometriosis causes painful heavy periods, abdominal pain outside of your normal period and pain during intercourse. It can also cause difficulty conceiving. According to the NHS, endometriosis is one of the most painful chronic conditions. There is a lack of awareness for the condition and unfortunately there is no cure. Keira-Rae Jarrett began experiencing symptoms of endometriosis almost 10 years ago. She speaks of the ways the condition affects her daily life. Pain, majority of the day even if it's just on and off. When my pain days are bad I'm sort of in bed, can't move. My attendance at school was like so, so low. Sick day after sick day. No one actually fully understands. Along with the mental and physical issues her condition brings, Keira also has concerns about what the future holds for her in terms of starting a family of her own. Plans, you're just too tired and sometimes your pain days, you don't want to make plans in case you're in pain but then you need to keep your social life up and you need to like see your friends so it's really hard and the struggle is underestimated. People just think it's a period. It is not just a period. It affects so many other areas. We're put on this planet to reproduce. What if my body can't do the one thing that it should be able to do? Endometriosis is the second most common gynaecological condition in the UK. But according to the Royal College of Nursing, it takes seven and a half years for onset of symptoms to actually get a diagnosis. With us in the studio, Chloe Steele shares her experience with the waiting times following her endometriosis diagnosis. Thank you for joining us, Chloe. How are you today? I'm very good, thank you. So how have you been affected by the delays in the NHS? They have had a significant effect on me as they have led me to having to wait over a year for a first appointment at a hospital and then once being seen by a specialist, having to wait even longer for tests and further appointments. Was there anything put in place for you as a patient to help you deal with your diagnosis? No, nothing was put in place which led me going back repeatedly to the GP while waiting for an appointment at the hospital and to be told that there was nothing that they could do until I'd seen the specialist as they didn't know enough about my condition and therefore couldn't do anything for the pain. And finally, do you trust you'll be looked after in the future? Will the treatment in the NHS improve, do you think? No, I'm not overly confident that in the near future many people will be looked after due to the long waiting lists and this will only grow unless something is done soon. Thank you so much, Chloe, for sharing your experience. This leads us to discuss how deadly delays in the NHS means patients are waiting months and sometimes years for appointments. The latest rounds of strikes meant that over 113,000 hospital appointments were disrupted and records in December uncovered that more than 7,000 cancer patients waited longer than the maximum period of 62 days to start treatment. Here we listen to the son of a patient who experienced this. Around a year ago my mum was diagnosed with stage 4 lung cancer. From initial diagnosis there was a catalogue of errors including a lost biopsy, none of the two week waits were two weeks or less and mum's treatment started long after the NHS 62 day maximum target. This is likely to have shortened her life by many months. A junior doctor who sees the daily impact of delays and cancellations with cases like these and who worked through the strikes this January said. Patient care, absolutely, it goes downhill when the strikes run because you don't have enough doctors to look after all the patients but that's no reflection on the doctors whatsoever. Deputy Director of Primary Care for the North East and Yorkshire region stated that plans are in place to make sure the patients can access the care they need. This often means, however, that routine appointments and procedures are cancelled. Lindsay, a patient who has suffered from the huge delays, shares her story. I was referred to urology three years ago, well just over three years ago now, for just a routine consultation. From doing the referral it took a year for me to get my first appointment through and then a further two years to go through the test and then finally having the operation in January this year. Practised nurse working around the aftermath of the delays highlights her thoughts on how it affects primary care. It massively impacts their health, so they may be waiting for a joint replacement for a colossal long wait as we're all aware of and the impact of that is they can't be mobile, sometimes they become depressed and suffer with other mental health conditions, they're in chronic pain. Since the first quarter of 2024 the NHS faces an estimation of over 125,000 vacancies. This circles me back to Dr Robson who further discusses how he believes the level of pay plays a huge role in the low staffing numbers. You get greater monitoring managers that are making like £15 per hour and I think junior doctors are paying on average about £14 per hour, which is horrendous for the things that we have to do. Well Safi, what are your thoughts on those experiences? Safi, those stories really are heartbreaking aren't they? I hope improvements are made in the coming months. Me too Safi. Moving on from the waiting times we discuss how aesthetics are growing in popularity. The British Association of Aesthetic Plastic Surgeons audit from 2023 shows a significant rise in the number of people undergoing cosmetic procedures. According to the new figures 31,057 cosmetic procedures took place in 2022, up 102% from the previous year. Dr Raj Vyasethi is a multi-award winning aesthetic doctor based in Leeds. He's been performing aesthetic procedures for almost 8 years now. I'd say 60% of my workload is made up of botulinum toxin injections, so what people normally call Botox. I do some facial and neck lifting work, permanent sutures, I do laser work, I do resurfacing of the skin, there's a whole host of different things. Figures were expected to rise post-pandemic due to pent-up demand, however the numbers are higher than they were pre-pandemic. In fact 2023 saw the highest annual rise in procedures since the audit began in 2004. Dr Vyasethi believes social media plays a role in this increase. In terms of the rise, it's definitely the case that social media's got a big part to play. People feel like they've got more knowledge, it's a lot more accessible now, there's less taboo. The generation where they didn't want to talk about potentially having treatment done is kind of fading away. My name's Grace and I'm a nurse at Fnacity OK. In terms of internally people looking at social media and looking at things and comparing themselves, I think it's really sad, it's got a really big, big part to play. I see patients who come in and have kind of got crazy expectations of what they think their skin should be like or what they want their face or their body to be like, and in reality most of those things sometimes are just not achievable and not even real. Women underwent 93% of all cosmetic procedures recorded in 2022, a rise of 101% from 2021. Men made up 7% of all cosmetic surgery procedures, a rise of 118% from 2021. However some of those who undergo minor procedures say they regret doing so. I've had some fillers, I've had it in my lips like two or three times and a little bit in my nose. I think the reason I got it done is more just because it's quite fun to be able to change those things about yourself, not necessarily because I'm self-conscious but it just makes you feel a little bit more confident. I ended up having my own 4.4ml in my lips. To be honest the reason I got it was because of the beauty standards nowadays because I've seen everyone, all of my friends were getting it, quite a lot of celebrities and people that I know were getting it so I just thought I'd hop on the bandwagon. I first got my lip filler done because my friend said that my top lip was lopsided so yeah it made me really self-conscious so I went and I got it sort of fixed and then I cleared on my eyebrows, I do regret. The pigment has gone red and I hate it so now I've got top removal which sucks. Well Safi, it seems there are some really sad but also mixed views on procedures like this. It sure does Soph. Now let's begin to discuss the topic of mental health. A report based on data found in 2023 has found that around 1 in 6 adults are still experiencing a common mental disorder. Despite the NHS spending £16 billion on mental health services between 2022 and 23, the UK has still not seen an improvement since Covid. Sophia has been looking into the report. Last week when the House of Commons Library released this report, it was unfortunate to find that the condition of the mental health concerns in the UK haven't changed. One of the more worrying statistics released is that 20% of children below the age of 16 had a mental health condition in 2023 which has risen by 8% in the last 6 years. I spoke to Olivia who is 15 and suffers from panic disorder. So I started having panic attacks in mid 2020 and I did have to get help through the NHS. It took a while to get the help that felt right for me and I really can't understand why people find it hard adjusting to and from the lockdown. I also spoke to Ray Freeman earlier, a psychologist based in West Yorkshire and I asked him about what he thought about mental health concerns in the UK. Since the pandemic in 2020, I can report as many of my colleagues in other areas of therapy will agree, we have seen an increase in requests for therapy. I tell my colleagues at the NCIP that the world changed with Covid and we'll never go back to how it was before. Four years moving forward, the world has still not settled and we are still feeling the aftereffects of Covid whilst living with a new strain of at least once a year. It seems clear to me that the increase in people asking for help has come from the effects of lockdown and this has led to the focus on mental health by the media and I think between the two, this is why we are seeing an increase in people asking for help. You know, I have to agree with that Soph. I feel there are still a lot of people still facing the consequences of the isolation during Covid. Yes Safi, I mean to be fair, I know many people who felt lonely during these lockdowns. Medicine shortages is a huge current issue in health. It's been affecting the whole country. Molly Cook is here today to talk about the shortages. So Molly, how big of an issue are we talking here? Hi everyone, thank you Safi and Sophie for having me on the pod today. Yeah, medicine shortages is a huge issue right now. Reports by the European Association of Hospital Pharmacists detail that 95% of pharmacies across Europe are experiencing medicine shortages right now. I asked the Leeds-based pharmacist Manoj Kumar what's going on. Do you think that the issue of medicine shortage is on the increase or the decrease? I think it's probably on the increase. Certainly in the last year or so there's been a massive shortage of lots of different kinds of medicines. There's no one particular group that stands out. It's just very erratic what's in and what's not in. Are there any specific medicines that are in short supply? Well Sophie, there have been various shortages across different sectors of health. Including a nationwide scabies outbreak resulting in shortages of permethrin cream. We've also seen a significant shortage in Tregnetol which helps treat epilepsy. But the most significant shortage which has been all over the media is type 2 diabetes medication such as Ozempic. I spoke to Dawn Barker who suffers with type 2 diabetes and how it impacts her. I have type 2 diabetes and I've had trouble getting my prescriptions. This is due to the ongoing shortages. And my GP said this is due to the craze in the media for weight loss as medicines like Ozempic can aid weight loss. I find this really shocking as people like myself are worried about surviving and others only care about their appearance. So have there been any kind of response from Parliament about how they're going to tackle this issue? Yes Sophie, this week in the Commons MP Alan Brown discussed the impact that Brexit has had on the importations of medicine to the UK. This has resulted in a shortage of many crucial medicines. However Health Minister Andrew Stevenson strongly disagrees that this is an issue. The Department has no evidence to suggest EU exit is leading to sustained medicine shortages. Shortages occur for a wide range of reasons and are affecting countries all over the world. Manoj Kumar backs the MP's claims but also suggests that there are additional factors impacting the shortages. I don't know whether going out of the EU has had an impact. I suspect it probably has had an impact. There's lots of reasons why medicines aren't available. It could be not being able to get hold of some of the raw ingredients. It could be because a company's taken over a different company and then there's obviously change in the literature, so repackaging, that kind of thing. Thank you so much for coming on our podcast today Molly, that was absolutely brilliant. My pleasure, I hope the listeners have learned something. Well we certainly did and I will be watching my back for scabies. Me too Sophie. Now moving on to something a little bit more light hearted. This weekend marks the beginning of Ramadan and for many the start of a month long period of fasting. So what does this mean Sophie? Well it's a sacred month in the Islamic calendar. Put simply, they can't eat or drink anything while the sun is up and must awake up throughout the night to break their fast. So how do they manage that for a whole month? Well we sent Ben Dunning to find out. Members of the Islamic community will soon be taking part in a period of fasting known as Ramadan. During this period, Muslims must test their mental and physical results to determine if they are in a good state of health. During this period, Muslims must test their mental and physical results in accordance with the guidance found in the Quran. Diab Barda explains what Ramadan means for him. It's based around trying to get closer to God and just trying to feel closer to people who are less fortunate than yourselves. It's quite weird really, you feel a bit of peace throughout the whole month. You just feel really close to God and peaceful. So how does Ramadan differ then from normal day to day life? Obviously you're having to change your sleeping and your meal patterns. We're told from an Islamic point of view to maintain your daily activities. Don't treat it as something different. If you're going to work, still go to work. If you go to the gym, then still go to the gym. It varies from person to person, but for me personally, Sometimes it can get pretty difficult with sleep. Towards the latter parts of the month, you do struggle a little. What kind of impact does something like Ramadan have on your mental health? I think a lot of people are less stressed during Ramadan because they know that's not the most important thing. Things will come and go. It happens a lot where you're stressed and then you wait to see the outcome and then you realise, I was stressed for nothing. I think Ramadan just helps you stress a little less just because you leave it in God's hands. It's really refreshing because you just feel as though what will happen will happen and stressing about it is not going to do much for you. So what kind of change do you tend to see in people during Ramadan? You'll see that a lot of people who are quite hot-headed during Ramadan and especially during the last 10 days are a lot less heated. They don't get as angry as they would do outside of the month. They tend to take that on in the weeks leading up to Ramadan. So it's pretty different. A lot of people after Ramadan are a lot calmer and deal with stressful situations a lot better. What sort of physical benefits are there to having this prolonged period of fasting? You'll see during these 29-30 days, we probably drink more water than we do through the rest of the year. It's pretty bizarre. People lose a lot of weight and then they carry on those habits for the rest of the year. Sticking with the physical side of things, how would someone who maybe needed to take medication throughout the day, how would they cope with fasting? Different illnesses have different rulings. We feel as though our religion is quite inclusive in that sense. So I've got really bad hay fever. So I need my hay fever tablets from about February to about October, November time. So it's pretty severe through those months. Now while I'm fasting during the summer, what I do is, it's the last thing I eat before the fast starts. And I take my nasal sprays and whatever. But yeah, for different illnesses, it's very different. It depends on how severe your illness is. If you can't cope without those medicines, then do your best until you need those medications. So for you as a cricketer, how much harder is it to fast during the season? I've always thought that cricket helps me because it occupies your mind. Being at work as well occupies your mind, being in the gym. I think what does affect you is the fluids affect you more than the food. Because obviously you can't drink water or have any type of fluids while you're fasting. You try to cram in as much water and fruits while you can. But yeah, I enjoy fasting, especially playing cricket while I'm fasting. Because it just means that I'm concentrated more. Because I've got to keep up to the standard where my teammates are. So I know I can't lapse in concentration. What was school like then? Obviously being introduced to fasting, but at the same time, having to do well in your studies. When I was in school, my school day wasn't broken up into fasting. My fasts weren't broken up into school days. But I know my eldest brother as well. So I know that at a certain time when he was in high school, the fast would be just after the school day would finish. So they'd let children out about half an hour earlier. But I had exams during Ramadan. And I remember I found that really hard. Just being able to keep that focus. Because then those GCSE exams shape your future in essence. What might you say to someone who might be thinking about giving fasting a go? I think before people judge it in a sense, I think they should at least try to eat one or two fasts. And just see how you deal with it. Because it is really, really refreshing. I can't actually imagine how hard it must be to fast. What do you think Soph? Is it something we should maybe give a try? Oh, I'm not so sure about me Safi. I tend to get a little bit hangry when I've not eaten. And nobody wants to see that! Fair enough. Well, that's all for this episode of Stethoscope Stories. Thank you so much for watching. Goodbye!