It turns out that he has been married to his wife for nearly 30 years and she is more like his sister than his wife; he loves her dearly but the passion has long since left their relationship. He reckoned that that process had started after about 15 or 20-year stage.

I have been together with my husband for 20 years and of that time married for 15 years… Oops, is it time to panic? Does he feel the same way? Do couples slip into a comfortable relationship and forget to keep the fires of passion burning, preferring to watch football or soap operas on TV with a bottle of wine rather than talking to each other on a candle-lit balcony. What was the last romantic gesture I did for my husband, and more importantly for me, what was the last romantic gesture he did for me? When you see a man open a car door for his wife you can guarantee that either it is a new wife or a new car! It does not have to be this way.

Relationships can die and the passion can fade away if we allow it to and all we are left with then is a mediocre relationship that doesn’t thrill you, but may still work. It’s tough to keep the passion in a relationship when you have other responsibilities like work, school, friends, etc., however make time for it though to savour the longevity of a full and vibrant relationship. Remember the endless chatting and laughing. I am amazed when I see a couple sitting with nothing to say to each other.

Remember what you initially found attractive about your partner and ask them what they found attractive about you. Be honest with each other, with what you like and don’t like. You would be amazed that in a lot of my relationship counselling sessions one or both of the clients will say, “I didn’t know you hated that,” or even worse, “I didn’t know you liked that.” Be prepared to be shocked by some of the replies.

Remember it’s very important to keep talking and maintaining a sense of humour with each other. It is in the fun and playfulness that true passion and romance can flourish even in everyday life. The other day I was out shopping with my husband and he hates shopping. He was looking for a birthday present for his mother. “What do you want to buy for her,” I asked. He replied, “She would probably like something electric,” I seized the opportunity of suggesting, “How about a chair!” It put a smile on his face.

So the new ‘XYZA’ would contain half a molecule attached to the old ‘XYZ,’ which makes it a new chemical compound upon which a new patent/copyright will be issued and a new 10-year period of paradisic ‘non-competitive’ selling lies ahead. You do not believe that? I am happy to name a few examples.

OK, ok – this is only marketing and doctors should be able to look through that. They should be capable enough to prescribe good-old, well-known ‘XYZ’ for 10 € a month instead of prescribing brand-new, mainly-unknown, ‘XYZ2’ for 60 € a month.

Why do they not do that? Maybe their wife runs a pharmacy next door! Again I would be happy to name examples.
But now let’s take a salto mortale back to medicine, because twice a year there is real innovation coming into our hands and I would like to present two.

Many people do know of or take Warfarine (UK) or Sintrom (E) or Marcumar (D) to keep their blood thinned for the most varied reasons. All of them are aware that any injury may bleed profusely, that other medicines must not be taken unless a doctor has approved, that no intramuscular injections can be given because they might be life-endangering and that they need regular blood tests once a month to check the correct dose.

The new drug Dabigatran is an oral medicine, can be given at a fixed dose and does not require laboratory monitoring. In cases of atrial fibrillation and deep vein thrombosis, it seems comparable to, or even more effective than, Warfarine. It is available in this ‘pequeño gran país,’ but as indicated above, at a considerably more uneconomical price than Warfarine.

But: fixed dose for everybody (is that why the PSOE government has approved it?), no lab monitoring and no probs with injections – that’s why we love it too!
The second candidate is outperforming the notorious ‘the-day-after-pill.’ No, No – not the handful of Aspirins or Nurofens for a hang-over; rather the real one, once remorse has kicked in or the condom’s burst or been neglected.
Within 72 hours (3 days) after unprotected intercourse, two tablets of Levonorgestrel (Postinor) would prevent in most cases the start of an undesired pregnancy.

The new Ulipristal can be used within the first 120 hours (aprox. 5 days). And it seems to prevent a pregnancy more reliably than Levonorgestrel.
Side effects are described as mild and not significantly different from the other scheme.

At the moment, as data are still preliminary, it will not be available as an over-the-counter medicine. Postinor though is available at hosptial Emergency Departments as well as pharmacies as on O.T.C. product.

When the day of departure came I was so excited and grinning from ear to ear in anticipation of the weekend that lay ahead of me. And what a weekend we had! It was fantastic and lived up to all my expectations. On Sunday evening I said thank you and goodbye in preparation of my return home very early Monday morning. I wanted to get back into the bosom of my family with its daily routines.

On Monday at 6.00am I checked the airline website, just before I left for the airport, to discover my flight had been cancelled due to the ‘Ash Cloud.’ Argghh! With a weekend of excessiveness behind me I was not in the right frame of mind to be dealing with this kind of drama! I followed the instructions on the website with regard to re-booking but to no avail. I could not get another flight out of Bournemouth until the following Friday.

The stress and panic began to hit me. Oh, I had work appointments for the forthcoming week and as a mum of two, I became concerned about the children’s needs, but also more than anything I wanted to get home. What next! This irritation turned from worry, to frustration, and finally into mild anger and even tears. Over a period of six hours I was getting more and more stressed. I ran through all the alternatives to get me home: trains, buses, ferries, hitchhiking, rowing boat…only joking! I needed to take some mild breaths to calm down.

Then it dawned on me that the only person panicking was me. My husband didn’t mind, my clients didn’t mind, my boss wouldn’t notice and my two children are clever enough to look after the dog and my husband. I had money to spend. So what was the problem?

I decided to take the opportunity to spend a few days with my brother and his family and fly back from another airport later in the week. It would be a twin-centred holiday…fabulous.
Now I had a plan. I suddenly felt lighter and again in control. My initial reaction to my little drama now appeared excessive even a little ridiculous. Why do we do this? I guess it is all about making a decision and having a plan. When you know what you are doing and how you are going to achieve it, then life is much more fun. Be flexible and look to find the best in every situation. Sometimes you might need a friend or counsellor to help you see these other more positive alternatives. Don’t be afraid to ask. Remember, it will only be a problem if you want it to be.

I hope my husband sees it that way when I tell him I spent an extra €250 on shopping and wine! (No need; he reads the Gazette – you’re doomed! – Ed)

I guess she’d benefit from food, shelter and access to free health care, psychological support, access to the labour market, good education facilities for her children and an environment promoting female emancipation.

This list would keep a number of charities busy. Imagine how surprised I was when I heard a few months ago, that a charity in Rwanda offers yoga classes to such women. It is so successful, that it wants to expand due to growing demand. Participants feel that their quality of life has improved, even blood parameters of HIV carriers.

Yoga has quietly found its way into Western medicine. Like acupuncture, which has been recognized by the school medicine years ago, it has been practiced thousands of years; a fact western medicine never will be able to claim. Yoga in modern medicine is used as complementary therapy, offering additional relief to standard treatment. It brings together mind and body through controlled breathing and movements and through meditation.

The quiet precise movements in yoga help to focus away from troubling issues, thus reducing stress. It increases fitness levels through learning and refining the poses, giving cardiovascular benefits, physical strength, joint flexibility and improved balance (the latter ones being equally important to cardiovascular fitness in older age). Yoga has been shown to be beneficial in many chronic health conditions like cancer-related symptoms, depression, anxiety, insomnia, pain management, weight loss, fatigue, high blood pressure and asthma, but only expect relief; not cure.

Yoga is considered to be safe for everybody and free of side effects, however start gently.

There are different styles of yoga. Hatha yoga, which apparently is very common, uses slower movements and easier poses compared to other styles, which sounds ideal for beginners.

When you learn yoga in a class, talk with the instructor about your needs and concerns and about your suitability for the particular class. Ask about qualifications and teaching experience. Talk about your illnesses if in doubt, particularly balance problems, severe osteoporosis back problems and arthritic or artificial joints. Some eye conditions and uncontrolled high blood pressure may need treatment before starting with yoga. You do not have to do every pose demonstrated and never do poses that are uncomfortable or you can’t hold for long enough. Just skip them and focus on your breathing until the rest of the class moves on.

What a Life
A big thank-you to Craig Venter and his team; didn’t he manage to present an artificially created bacteria last month? This is absolutely the right contribution to the year of biodiversity proclaimed by the WHO for 2010.

Only one thing would have been even better; he should have talked with BP instead.

Do you recall looking for your perfect home here in Spain and viewing over 40 properties and feeling you have spoken with every estate agent in the town as well as those out of town? Taken advice from colleagues, friends, relatives as well as strangers on the street in attempt to find what you are looking for. You feel exhausted and are beginning to believe that what you require actually doesn’t exist. You are about to throw the towel in and stay where you are, as you begin to convince yourself the alternative was just a dream. But despite this, there remains a nagging doubt, just a fault line flicker, an avenue unpursued – maybe hope – you give it one last shot. You do one more search and there it is! Just what you have been looking for!

Hope means many things to many people. To some it is an incantation, to others it is fate or superstition; whilst to others it is a religion, culture or outward belief to keep on believing despite the odds. Psychologist CR Snyder states “It’s exhilarating when you meet high hopeful individuals, how they think about life is infectious and they leave trails of energy and positive feelings wherever they go.”

We all know someone like that and possibly all aspire to be like that. Maybe the only difference between these inspiring, uplifting and positive people and Joe Average is they never give up on hope. On a personal level I believe high hopers procrastinate less, have less depressive symptoms and according to studies, have a higher pain threshold (twice in fact) than their less hopeful peers.

It’s important to remain realistic whilst being hopeful and that means facing the obstacles that might come up and formulating a plan to deal with them. As Snyder states, hope has two components: a map or pathway to get what you want and the motivation and strength to follow that pathway. Winston Churchill wrote: “Success is going from failure to failure without losing enthusiasm,” I say to my clients, not that I compare myself to Winston or Snyder, but there is no such thing as failure, only feedback. I believe the difference between getting stuck and getting there is only a mindset. It has also been suggested that hope is different to optimism, which is a generalized expectancy that good things will happen, whereas hope in fact involves having goals, along with the desire and plan to achieve them.

Hope therapy focuses on looking at individual’s strengths and how to build on them in order to help people live up to their full potential. It differs from other therapies in that it looks more on simply learning to change a mindset, without much examination of what caused the negative mindset in the past.

The good news is that hope is something that can be developed in all of us. It involves learning from people who are doing very well and figuring out what hopeful people are doing right. And the great news is it seems to work – we can teach people how to be more hopeful.

Firstly, we have a WHO that seems to have acted mainly to promote pharmaceutical products, the first of which, the vaccine, has been discredited to a degree that most governments – advised to order huge amounts – desperately try to wriggle our of their contracts with the pharmaceutical industry.

Should it not be of utmost public interest to trace back who advised the governments? Their decision has cost European taxpayers a fortune and I am wondering why there is no public nor media interest in clarifying decision pathways to date?

The second act of this drama unrolls, presenting the by-now-world-famous Tamiflu, live on stage – and, surprise, surprise, in a rather dim light. Millions of doses have been stockpiled by several governments to combat future pandemic influenza outbreaks. One can only assume the drug works. Or is it that it may not?

A team of Cochrane reviewers surveyed the literature on safety and efficacy of Oseltamvir (the generic name of Tamiflu) and its cousin, Zanamivir (Relenza). For pre and post-exposure prophylaxis against influenza both drugs were mildly effective. Treatment trials found that both drugs shortened duration of flu-symptoms by 12 to 24 hours – if taken early in the course of the infection.

The reviewers report that there are problems in evaluating Oseltamvir’s claimed ability to prevent complications of influenza – such as pneumonia or death. They found that the major study supporting such benefit is based on unpublished data belonging to the manufacturer Roche!This data were not made accessible for scientific scrutiny.

Other published studies had found no benefit. The reviewers found little evidence of harm from the drug (that’s something at least).
In conclusion: in healthy adults Tamiflu is tolerated well, has some
preventive efficacy and can shorten the course of a symptomatic flu, but only by one day. The preventative effect of flu complication remains hypothetical and in question (BMJ 2009 Dec 8).
These results do not really come as a surprise to those of us (doctors) who have long questioned the ongoing tamiflu-mania.
The manufacturer Roche is not happy though and has published two lengthy rebuttals to this analysis, stating that only ‘qualified’ researchers can access the data…? The highly reputable Cochrane Institute does not seem good enough for them As a consequence, independent researchers and editorialists have called for new global standards on transparency when it comes to drug testing.

What a laugh: if you look after your mother who has come down with the flu and you are smart enough to take a course of Tamiflu immediately, you will still get the flu, but instead of 7 days it will only last 6 and a half!

Should I as a Doctor recommend you take Tamiflu? And if so, why? Zillions of taxpayer’s bucks wasted!