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Mac and cheese – low fodmap

OK, so it really has an Autumnal feel today perhaps a comforting meal is required and macaroni and cheese is definitely one to make. This is a low fodmap recipe made with lactose free milk and cheese suitable for a low fodmap diet – please note that the fat content is high due to the cheese used. If you find that meals higher in fat cause symptoms it probably isn’t worth trying this recipe, although a small portion might be suitable. This is a great recipe if you are underweight and want to increase the calories in your diet. Unfortunately I didn’t have any macaroni so strictly speaking this isn’t mac and cheese but penne and cheese – you can get gluten free macaroni by ordering it on the internet but most supermarkets I use don’t stock it, which is a shame!


300g of gluten free pasta

560ml of lactose free whole milk

28g butter

28g cornflour

70g of cheddar cheese (I used an orange cheese for more effect)

20g parmesan

1 teaspoon mustard powder

2 slices of gluten free bread


Extra grated cheese for topping



Melt the butter in a pan and add the flour, mix well till the flour is incorporated into the butter

Start to add the milk slowly whilst keeping stirring

Add all the milk and warm the sauce till mixed

Add both cheeses to the sauce after grating

Add the mustard powder

Cook the sauce till thickened season if required (do taste the sauce first as the cheese does add flavour)

Cool whilst stirring to avoid a skin forming

Cook the pasta in water till al dente

Add the cheese sauce to the pasta and add to an oven proof dish

Top with gluten free crumbs made from the bread and the extra grated cheese

Bake in an oven for 20 minutes at gas mark 5 or 190 degrees C.

Serves 4 with a green salad


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Is the Robocop knee brace the new ‘must have’ for the treatment of knee osteoarthritis? The celebrities seem to think that it is …

Recent media stories, a landmark study and the Autumn/Winter TV schedules highlight the Össur Unloader’s ability to offer pain relief, improve function and maintain a healthy lifestyle

Recent national news stories (London, UK – August, 2017) have drawn attention to the Unloader One knee brace from Össur – as a key aid in helping leading celebrities to continue with an active lifestyle, whether suffering from osteoarthritis or recovering from injury.

National treasure Ant McPartlin’s historic knee surgery and subsequent addiction to painkillers has been well documented, and the star has been photographed in several newspapers wearing the Unloader One as part of his recovery.

Sharron Davies, the television presenter and former competitive UK swimmer, has been wearing an Unloader One since 2012 and recently returned from filming Celebrity Island with Bear Grylls.

“Some of the tasks that I had to do recently on Celebrity Island with Bear Grylls involved long challenging walks. I wore my unloading brace to help prevent the painful swelling around my knee that can come from doing activities like walking,” said Sharron.

And last week, celebrity chef and Unloader One wearer Simon Rimmer was announced as a participant in the forthcoming series of Strictly Come Dancing, who used an Unloader as part of his recovery following microfracture surgery which led to chondral damage.

Numbers of knee surgeries are growing year on year – around 150,000 knee operations are conducted in the UK each year. The annual cost to the NHS for total knee replacement surgery is currently more than £400 million.

“The Unloader One has been proven to reduce the need for pain medication in patients with chronic knee pain and is available on the NHS,” said Emlyn Lewis, Managing Director Össur UK. “Using the product can empower people like Ant, Sharron and Simon to manage their pain biomechanically rather than through the use of pharmaceuticals, which can have negative side effects.”

The Unloader One is a lightweight, easy to use, non-surgical treatment option for the symptoms associated with osteoarthritis of the knee. Recent research demonstrates that Unloader One reduces pain, improves function and decreases the use of pain medication.

About Össur
Össur is a global leader in non-invasive orthopaedics that help people live a life without limitations. Its business is focused on improving people’s mobility through the delivery of innovative technologies within the fields of braces, supports and prosthetic limbs. A recognised “Technology Pioneer”, Össur invests significantly in research and product development; its award-winning designs ensuring a consistently strong position in the market. Successful patient and clinical outcomes are further empowered via Össur’s educational programs and business solutions.

Content supplied by Ossur UK

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What Is Endometriosis?

Endometriosis   is a condition where the cells that line the womb (uterus) are found elsewhere in the body. The lining of the womb is what is shed during your period but the cells that are found in other parts of your body are unable to leave the body like a period and can cause problems.


Pain in a variety of forms is the main complaint of endometriosis. For example, women may find that they have:

  • Painful periods
  • Painful sex
  • Lower tummy pain (pelvic pain)
  • Pain passing faeces or urine
  • Difficulty becoming pregnant
  • Unusual vaginal bleeding (outside of normal periods)

Why Do I Have Endometriosis?

The causes of endometriosis are still unclear and there have been a few possible theories. One of them includes the concept of “retrograde menstruation ”. This is the idea that during a period, some of the lining falls into the pelvic area through the fallopian tubes and endometrial tissue is deposited in sites other than the womb.

Although the cause is unknown, there are multiple factors that contribute to the condition:

Genetics: For example, endometriosis can run in families – therefore there is a genetic aspect to endometriosis.

Age: It is also rare in women who have gone through the menopause as endometriosis is strongly linked with the female hormone, oestrogen, which falls after menopause. This means endometriosis is more likely in women aged 25 to 40 years old.

How Is Endometriosis Diagnosed?

Your GP will ask questions about your symptoms and address any concerns you may have. To get a confirmed diagnosis of endometriosis, it is best to have a laparoscopy which is a small operation where small cuts are made into your tummy and then a thin camera is inserted to look for evidence of endometriosis patches.

Is there a Cure?

Unfortunately, there is no cure for endometriosis at the moment. However, there are many options available to help reduce the symptoms and improve your quality of life. Your GP will be able to discuss what options are best suited to you.

Treatment Options 

The treatment options available to you are surgery, hormone treatments and painkillers.


Your GP would not jump straight to offering you an operation. This is because there are many women whose main concern is with the symptoms such as painful periods. In these cases, your GP can offer you initial treatment of anti-inflammatory painkillers such as ibuprofen, mefenamic acid or naproxen.

Painkillers & Hormonal Treatment

These painkillers can also be offered with the combined oral contraceptive pill. The combined pill helps the symptoms of endometriosis by stopping ovulation and therefore reducing the amount of oestrogen in the body.

Hormonal Intra-Uterine System (IUS)

Another treatment that is available is the levonorgestrel-IUS (LNG-IUS, Mirena Coil), which is a small plastic hormonal contraceptive device that is placed within the womb. It is effective for up to 5 years and works by thinning the lining of the womb, abolishing or reducing periods and reducing pain associated with periods.If your symptoms do not improve then other hormonal medications such as GnRH analogues  or progestogen hormone tablets can be used.

Surgical Intervention

If you are concerned with your fertility  or the severity of your symptoms then a laparoscopy can be discussed, where diagnosis and treatment (where endometriosis patches are removed) can be carried out.

Dr Seth Rankin is founder of London Doctors Clinic

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3 Reasons to See a Therapist

Despite the major advances in mental health, seeing a therapist still holds a stigma in general society. We are afraid to seek out help because in some way it’s means that we are “broken”. That we aren’t as healthy as society says we should be. However, there are many reasons why you would need to see a therapist. None of which indicate that you are “broken”. Read on so that you can see the 5 top reasons to see a therapist and how they can help you get back on track.

Fighting Addiction

Fighting an addiction is a battle being fought by more people than most realize. We have addictions that include food, shopping, sex, and substances. We typically engage in substance abuse to fill a hole within ourselves that is empty or hurting. They become a habit that we become co-dependent on. When it comes to substance abuse, there are places that can help. Places like Above It All Alcohol Rehab & Detox will allow you to come in and get around-the-clock therapy care that will empower you to gain control of your life. Various groups surrounding other addictions, such as Sex Addicts Anonymous, allow for you to commit time each week to speak with your peers and volunteer therapists to work through your issues and keep you anonymous respectively. Other therapists will see you privately when it comes to food or shopping (and sometimes sex) addictions.

Battling Anxiety

You may not know it, but you probably know quite a few people who suffer from anxiety or another form of chronic stress. Anxiety can feel so debilitating; you get lost in your thoughts and find yourself suffering attacks that make it feel like you can’t breathe. Sometimes moments in the past repeat themselves in your head or your dreams and all the emotions with it come bubbling it up in such a way that you feel like that moment is happening again. You find yourself afraid to be in public around crowds. You suddenly don’t feel safe in casual settings that would be otherwise safe for you. Seeking out a therapist can help you! They can provide medications to help slow the anxiety attacks and talk with you on how to work through those painful memories that are hurting you. They will work to help you feel like you are normal again.

Body Dysmorphia

Many of us struggle with our physical bodies. We never quite see ourselves the way others see them and often we dislike a body part of ours. Perhaps we wish our neck was a bit longer or our second toe was a little shorter. However, body dysmorphia goes even further in which we have social anxiety over anyone seeing our bodies. We miss school, work, nights out with our friends, and family functions because we dislike our bodies that much. For transgendered folks, it’s a matter of feeling like we are inside the wrong bodies. This can cause some severe depression in which we begin to hate our inner selves along with our bodies. Therapists specializing in body dysmorphia are there to help you to work out those feelings and combat the depression often associated.

People have challenging times and they struggle. When we don’t allow ourselves to seek out help to heal that part that hurts, we continue to inadvertently hurt ourselves. We suffer silently and fall into a downward spiral of despair. When we seek therapy, we can begin to feel good about ourselves. We can learn to want to wake up and get out of bed again. Whether we need an addiction psychiatrist or someone to help us heal from a death in the family, you can rest assured that no one has to know that you are getting help. If you decide to speak about it to friends and family, we are positive that someone will speak up about their adventures in therapy.


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Online Doctor v Patient-to-patient Support

Do people seek information from HCPs online or do they prefer online support from fellow patients?

Over recent years there has been a steady increase in the availability of patient-focused websites offering health information and support across a wide range of conditions.

A survey of c7,000 patients carried out by the Nuffield Trust, found that 50% of people in the UK self-diagnose online long before they make a doctor’s appointment.

When it comes to discussion around their condition, it’s interesting to see where patients go online. Do they seek information from HCPs online or do they prefer online support and personal experience-based information from fellow patients?

Read more …

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4 Ways to Stay Healthy

One of the things you will want to do is remain as healthy as possible. This can allow you to get more out of life and enjoy the good things it has to offer. Another reason to work towards the best health possible is that doing so will set a good example for your children. There’s no doubt your kids are watching some of the things you do each day and practicing good health habits is ideal.

Here are some top ways to stay healthy:

Get off drugs

Being healthy as naturally as possible is a great place to start. It’s no secret the fewer drugs you introduce into your body, the better you will feel and the better for your long-term health, as well.

For instance, it can be easy to get addicted to painkillers if you deal with an enormous amount of pain during an injury or another sickness. However, taking drugs that you can live without is one of the best ways to remain healthier.

It’s a good idea to consider places such as Georgia Drug Detox if you need to work with professionals in this area to assist you in eliminating your need for drugs. This is sure to improve your health in the long and short run when you do so.

Choosing the right foods

It’s no secret that eating nutritious and healthy foods can be the key to living a longer and healthier life. The foods you consume on a daily basis will determine your overall health.

It’s important to work to keep your weight under control and avoid the possibility of being obese. The most efficient way to make this happen will rest in counting calories and trying to stay in the right calorie range for your weight and height.

Some top healthy food options include all types of fruits and vegetables. These can improve your overall health and provide you with the right amount of nourishment each day. According to information from Fruit & Veggies – More Matters, only 33% of the adults are meeting the recommendation for fruit consumption.

Don’t forget to rely on the right sources to get the protein your body needs, as well. Some of your best options include chicken, tuna, and lean meat.

Stay active

Keeping your body moving and getting strong is the key to enjoying the best health possible. This can be done by engaging in a variety of exercises that can work to strengthen your heart rate and work to lower your blood pressure.

Some of the top activities you can enjoy that will allow you to get optimal results in include walking, jogging, strength training and many various cardio type exercises. Be sure to check with your doctor to ensure you’re healthy enough to begin an exercise program to work towards better health.

Enjoy meditation

Taking time to stop and breath is one thing you may do on a daily basis. However, enjoying a session of meditation can be the key to getting more out of life and working to drastically improve your health.

Enjoying this quiet time can be the key to renewing your spirit and your mind. This is essential to have the good health your body craves on a routine basis. Be sure to enrol in classes to assist you in learning the many techniques to allow you to get the results you want.

The key to having the health you want and need will largely rest on the things you do each day. This will add up and assist in a better well-being with continual use. Set the example your kids want to see by getting started today for a life you will love living!


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How to Cope with What Life Sends Your Way

Stress is a part of life. Sometimes the stress that comes out of each situation is good and sometimes it’s bad. For instance, achieving a goal can become stressful but once you reach it you feel a sense of accomplishment, that’s good stress. Raising a family and trying to keep everyone in order and a home functioning properly can overwhelm you and make you tired, that’s bad stress. In order to keep stress from causing you harm it’s important to learn how to deal with the bad stress in a positive way.

Stress and your health

Stress can cause you to break down, feel anxious and lose sleep. It can also cause you to indulge in alcohol or drugs as a way of coping. The problem is that a once a day drink or pill to relax can quickly turn into a dependency that increases slowly to a level that’s harmful and even life threatening. If you come home from work and look for your drink or drugs upon entering you may very well have a serious addiction. Luckily there are places like BLVD Hollywood detox, where you can get the help you need to make a full recovery.

Pinpointing the source of your stress

Sometimes you put yourself directly in front of a course that’s destined for a collision without even realizing it. It may be your job that stays on your mind long after your day finishes. Or, perhaps, it’s your inability to say no to a favor that tacks more on your to-do list than is humanly possible. In order to remove the bad stress or at the very least reduce it, you need to find out from where it where it derives.

Positive ways to handle your stress

If you are the do-all in your family and on the job, it’s in your best interest to learn to say no and delegate the responsibilities to others. For instance, if you spend your entire evening checking homework, running baths, cooking and doing laundry, give up some of the responsibilities. No one person can do it all and by allowing others to help with the chores you’re making them responsible and you’re giving you well-deserved down time. The same goes for the office, stop handling everything and micromanaging. It’s time to trust others to complete tasks. In the beginning, this will seem difficult, but once you release some of the responsibility off your shoulders you’ll feel better.

Say what’s on your mind

Stress comes from various sources and one may be that you hold everything inside. This is not good for you or those you love. Releasing things that bother you lets others know how you feel and it gets it out of your system. It’s OK to express your thoughts and become assertive.

Ways to reduce stress

If you feel tense and out of control release your thoughts through an activity. Exercise is a great way to remove the stress from your body. When you work up a sweat feel good hormones called endorphins. After your workout, they make you happy, energized and leave you feeling refreshed. Find some form of physical activity you enjoy like aerobics, a brisk walk or jog, tennis or swimming. In addition to including exercise sessions a few times a week, learn to take time out for the ones you love. The connection with family and good friends puts you in a safe zone where you can mentally relax and unwind. Go to the park, take a day trip or get together for a lunch.

Find me time

Everyone needs time for them. You are not superhuman and have needs the same as the next person. Without having any time set aside for you, you can subconsciously feel resentment. Instead, take up a hobby, go out shopping alone, or enjoy your favourite movie uninterrupted. You’ll feel better and those around you will get to enjoy a relaxed version of you.

Stress can cause you to acquire bad habits, lose sleep and eventually lead to a mental breakdown. Learn how to relax and avoid the people or situations that bring on bad stress.

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Why you might wee when you are running or exercising?

Most women, at some point in their lives have experienced urine leakage while running, but never talk about it and more often than not, this is due to weaker bladder muscles. Exercising should be enjoyable and not uncomfortable and there are a number of things you can do to effectively manage and in many cases improve the problem.



  • Before you run make sure you have gone to the toilet.
  • If you are running a long-distance check that there is a toilet stop on your route as you may need to drink more in order to stay hydrated which may result in the need to use the toilet more frequently.
  • Try using an incontinence pad. Many of the continence pads available today are slim and discreet.
  • Squeeze your pelvic floor muscles when running to minimise leakage.

If you are experiencing bladder weakness when you either run or undertake other forms of exercise, you might like to try a sample of Always Discreet. You can get hold of your FREE sample here

It is estimated that between three to six million people in England experience urinary incontinence. Urinary continence is the passing of urine unintentionally. There are several types of urinary incontinence – you can find out more about them here.

Urinary continence arises for a number of reasons; pregnancy can cause temporary or longer term continence problems and women of menopausal age often experience bladder weakness. Urinary incontinence is a common problem that many people face and you should not feel in any way embarrassed to talk to anyone about your symptoms.

How to improve your Pelvic floor muscles

You may also like to consider doing some pelvic floor exercises which can help. The pelvic floor is made up of layers of muscles and ligaments that move from the pubic bone to the coccyx, side to side. Strong pelvic muscles support the bladder, womb and bowel. To strengthen the muscles, regular exercise is advised to support and improve bladder control and urine leakage. The more you exercise the stronger your pelvic floor muscles will be.

Here are some exercises for you to try:

Exercise 1

  1. Slowly tighten your pelvic floor, lifting the muscles in and out.
  2. Continue lifting up through your pelvis and into your tummy.
  3. Hold it for five seconds, then release gently.
  4. Slowly increase the length of the hold, then release slowly at the end.

 Exercise 2

  1. Tighten and lift your pelvic floor in one quick contraction, squeezing the muscles in and out.
  2. Take a pause for 10 seconds and breathe slowly.
  3. Relax fully at the end.
  4. Repeat as many times as you like with the same speed.

Remember to breathe slowly and gently when doing pelvic floor exercises!

There are also many types of products that can help to improve your Pelvic floor muscles such as Pelvic floor toners like Kegel8 and The PelvicToner.

On the talkhealth site there is lots of practical information on our talkbladder hub and the talkwomenshealth hub.  You can also become a member which enables you to talk to others in the patient discussion forums and talk to our clinic experts, and much more. Joining talkhealth is completely FREE!

If you are at all concerned about any aspects of incontinence, you are advised to talk with your doctor who will be able to discuss other treatment options with you if necessary.

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Next stage of world-leading childhood obesity plan announced

Publich Health England (PHE) are now considering the evidence on children’s calorie consumption and are setting the ambition for the calorie reduction programme to remove excess calories from the foods children consume the most. These foods include pizzas, burgers, ready meals and savoury snacks and sandwiches.

Over the past year or so, there has been progress around reducing the level of sugar in many products.

The Soft Drinks Industry Levy has become law, coming into effect in April 2018 and PHE has formulated a comprehensive sugar reduction programme with the aim of a 20% reduction in sugar in key foods by 2020. Leading retailers and manufacturers have also announced they are, or already have, lowered the amount of sugar in their products as a result of these programmes.

Adults currently consume on average between 200 to 300 calories too many each day and children are following suit which is concerning. Reducing calorie consumption from sources other than sugar is critical to reversing the worrying obesity trend.

  • 1 in 3 children are either overweight or obese by the time they leave primary school
  • more children in the UK than previously are being diagnosed with type 2 diabetes, some as young as 7
  • children from disadvantaged backgrounds are more likely to be obes

Philip Dunne, Minister of State for Health said:

“Too many of our children are growing up obese, which can lead to serious health complications. We all have a responsibility to help people live healthier lives, but with a third of children leaving primary school obese we must take a comprehensive approach and now focus on excess calories.

This can only be done through strong guidance, grounded in evidence – that’s why we have funded a new £5 million dedicated Obesity Research Policy Unit to understand the deeper causes of obesity.”

Duncan Selbie, chief executive of PHE, said:

“A third of children leave primary school overweight or obese and an excess of calories – not just excess sugar consumption – is the root cause of this.

We will work with the food companies and retailers to tackle this as the next critical step in combating our childhood obesity problem.”

Evidence will be published by PHE early in 2018. It will then consult with the food industry, trade bodies and health non-governmental organisations to develop guidance and timelines for the calorie reduction programme.

The Department of Health has also funded the £5 million National Institute for Health Research (NIHR) Obesity Research Policy Unit at University College London (UCL), which will look to develop a deeper understanding on the causes of childhood obesity, including marketing to children and families, social inequalities, and the early years of childhood.

Professor Russell Viner, Policy Research Unit Director and Professor of Adolescent Health, UCL Great Ormond Street Institute of Child Health, said:

Obesity is one of the greatest health concerns of our time and we welcome this considerable and very timely investment from the government. We are delighted that the UCL Great Ormond Street Institute of Child Health will host the new Obesity Policy Research Unit (OPRU). Preventing obesity in early life is key to turning the tide on this modern epidemic.”


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Psoriasis Treatment – Approval from the MHRA of Dovonex

The Medicines and Healthcare products Regulatory Agency (MHRA)  have just announced the approval of Dovonex Psoriasis Ointment to be made available through pharmacies without a prescription.

At talkhealth we would like to thank everyone that responded to our request to volunteer to take part in the public consultation, as from this the Commission on Human Medicines (CHM) advised in favour of the product being available in pharmacies for the treatment of mild to moderate plaque psoriasis which has been previously diagnosed by a doctor in adults aged 18 years and over. The treatment is for application once daily, with maximum duration of use of 12 weeks and maximum pack size of 60g of ointment.

If you are interested to take part in the public consultation process of the reclassification on drugs, please do keep a look out for future requests on talkhealth.  The process is very simple, and entails just taking a short survey on talkhealth to see if you qualify and then you will be invited to the MHRA offices in London to take part in a closed panel discussion normally for half a day.

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