Blog – Dr Juliet McGrattan

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Project Allotment – an update

I blogged back in May about how we had taken a space on our village allotment during lockdown. It was a way to get us active, working together as a family and of course, grow some fresh produce to eat! So how did ‘grow your own’ work out? Did we manage to actually grow some vegetables?

I’m pretty good at planting things but poor at getting them as far as our dinner plates. I badly wanted this to be a success. Seeing the other flourishing allotments around our little patch was encouraging but also rather intimidating. We’ve wandered round and looked at everyone else’s when it’s been quiet so we can get ideas and tips.

So, how has it gone? Well I would say pretty well! We’ve had some successes and some failures.

Courgettes – these grew really well at first and we harvested six big ones. We should have had twice as many but they went brown on the ends and just rotted. It had been quite damp and the flowers had gone a bit mouldy so we should probably have pulled these off sooner. They weren’t sitting on the ground but perhaps putting some straw or something down would help. Anyway, we enjoyed what did grow.
Tomatoes – these were a disaster. We harvested about six in total from four plants. One of the plants died quickly, the others limped on but always looked really unhealthy. We watered them lots. Perhaps too much or too little tomato feed? I think next time we’ll grow them at home where it’s more sheltered. Perhaps they’re not hardy enough for the patch.
Runner beans – a great success. They look lovely as they grow and they’ve been a tasty side dish for our Sunday roasts.
Lettuce – we planted too many! The type of lettuce we planted was a bit peppery Next time we’ll plant a few different varieties. They were at their peak when we were on holiday and had largely bolted by the time we got back making them even more bitter.
Beetroot – we have loads. We’ve eaten them roasted on Sundays and there are many more to come over the coming weeks.
Kale – probably our most successful plant. We kept them covered to stop the pigeons getting them when they were young. Crispy kale is our favourite. We’ve had plenty of iron and vitamin C from this harvest!
Pumpkins – never germinated. Shame. We’ll plant them inside next time rather than straight into the soil.
Carrots – they aren’t quite ready yet but we dug one up the other day to see and it looked really healthy. We should have a big crop and it looks like our makeshift fleece wrapping might have kept the carrot flies away.
French beans – a grand total of one bean! This was supposed to be a low level bush but perhaps we needed to give it something to climb up. Who knows?!
Celeriac – donated by a kindly allotment neighbour. We have two and they seem to be doing ok. Not sure how we will know when they’re ready or quite how to cook them but I guess that’s all part of the learning!
Parsnips – they better work out. They’re so boring to grow- take ages and ages and take up quite a lot of space. No idea when they will be ready, hopefully they’ll have some kind of growth spurt like my kids!

All in all, it’s definitely been a success. The kids (particularly my eldest) have stayed engaged and been down there regularly. I did wonder if the novelty might wear off but it hasn’t. They’ve even taken friends down to have a look which is nice. It’s encouraged them to widen their vegetable preferences too!

It’s a peaceful little haven at the allotment. You’re surrounded by trees, plants and the sound of the river, sheep and birds. I feel very relaxed there, it’s a real escape. Even if nothing had grown I think I’d still be glad we did it, for our mental health during this crazy coronavirus time. As it is, we’re hoping a larger plot comes up and we have all sorts of ideas about what we’d like to plant next year. In the meantime – I’m off for a kale and beetroot salad!

Quick Question – Can I exercise during my period?

Published by Dr Juliet McGrattan

Cramps, heavy bleeding, fatigue. Periods don’t exactly make you want to bound out of the door do they? But, is it actually ok to exercise when you have your period? Is it safe to work out when you’re menstruating? Is one type of exercise better than another when Aunt Flo is in town? There are many myths and misunderstandings when it comes to periods and exercise so let’s start with whether or not you should get fit while you bleed.

When I was teaching on the topic of women’s health to new running coaches at a 261 Fearless international training course, I received a very important reminder. Women’s health knowledge is not the same the world over. Some people may have looked at the title to this blog and said, ‘Yeah, of course you can!’ But in many parts of India, women are not even allowed in the kitchen when they have their period, let alone out on the street in their trainers. The African and Albanian women also said that it wasn’t widely known in their communities that it was ok to do so. Women in some communities are viewed as being more fragile, or even dirty during their period so are best kept away from exertion, other people and foodstuffs. If your answer to the question is an obvious yes, then you are lucky to have that personal knowledge and societal attitude.

Having said that, when your period has started and you’re feeling lousy, you might well question whether exercise is a good or bad thing. In general, the answer to the question is yes, it’s ok to exercise during your period, but there are a few things you should take into account:

Blood flow

The first couple of days are usually the heaviest; longer for some women. A very heavy period can make you feel light headed, dizzy and even a bit weak. If that’s the case, you might want to chose something less strenuous like walking or a stretch class. There’s the practicalities of dealing with a heavy flow and worrying about blood leaking out too which can make you feel less confident. A moderate or light flow shouldn’t interfere with your ability to exercise or affect your performance either.

Tips: Have a look at period pants which you can use on their own but also alongside tampons and pads to prevent blood leaking onto clothes. Very heavy periods can lower your body’s iron stores so make sure you have plenty of iron-rich foods and consider an iron supplement. Speak to your doctor about whether you need a blood test to check for anaemia (low red blood cell levels) and if there is a way to reduce or stop your period flow.

Period pain

Whether it’s a dull lingering ache or sharper more intermittent pain, period pain is exactly that – a pain! Simple period pain is caused by increased levels of chemicals called prostaglandins which cause the muscular wall and lining of the womb to cramp up. Medications which lower prostaglandins, such as ibuprofen, can help to relieve period pain but whether exercise can is more controversial. In September 2019, a Cochrane review (a large review of all available studies) found that exercising at any intensity for between 45 and 60 minutes, three times per week, caused a large reduction in period pain. The authors pointed out however that the studies that were of poor quality so more research needs to be done. They also focused on women under 25 and didn’t include resistance training. We also don’t know from this whether exercising during a period itself, rather than simply ‘regular exercise’ week to week, will ease pain once it has begun.

Tips: Trial and error of your own situation is the best bet. When in pain, start with something gentle and see how you feel. Use ibuprofen (speak to a pharmacist if you are unsure whether it is safe for you) to reduce pain and make it possible for you to exercise.

Energy levels

There’s no doubt that hormones can affect how we feel and it’s not unusual to be lacking in energy in the lead up to a period and for a day or two once it starts. Oestrogen and progesterone levels fall before a period and gradually start to rise again once bleeding begins. Low energy is particularly common if you have heavy bleeding which can be very draining. (Check the tips in the ‘Blood flow’ section above). Exercise however is well known for giving an energy boost and a feeling of wellbeing. It can help you sleep better too which gives you even more energy. So, while it’s difficult, it’s a good thing to do.

Tips: Be kind to yourself but don’t be afraid to try. Just tell yourself you will exercise for ten minutes, whether it’s an online class or an easy run. The boost in your metabolism and the feel-good hormones circulating might be just the thing to recharge you. Have a healthy, light snack before you go and make sure you are well hydrated – being thirsty or tired won’t help your energy levels.

Mood

Most women have problems with their mood in the week before their period and this tends to improve quickly once the bleeding begins. If there is any persistent low mood, anxiety or plain grumpiness then exercise will definitely help. The mood boosting effects of exercise are well known and a strong reason many of us choose to exercise regularly. It doesn’t matter what type of exercise you do, you will feel some benefit. You might want the stress-busting effects of a high intensity work out such as boxing or running or perhaps a calming swim or yoga class. There’s no reason why your mood shouldn’t benefit as much during your period as at any other time of the month.

Tips: Get something in the diary and make a plan. It’s always best to be flexible and pick the activity you feel suits you best at the time. All exercise is good! Enlist the help of a friend if your motivation is lacking.

In summary, the evidence is clear. In most cases, exercising during your period is fine and beneficial. Having said that, I’m well aware that there are many women who suffer deeply during their period and can’t get out of the front door, let alone to an exercise class. I’d encourage them to seek help and make an appointment with their GP to see what can be done to make their lives easier. In the meantime, just know that any little thing you can do to move more will help to make you healthier.

There are more answers to questions like these and lots of health information to help you lead a happy and active life in my book Sorted: The Active Woman’s Guide to Health. Published by Bloomsbury and awarded First Place in the Popular Medicine category at the British Medical Association Medical Book Awards 2018.

Disclaimer: I can’t give personal medical advice and as always with health advice, reading something online doesn’t replace seeing your doctor who knows your medical history and can assess you in person. So, if you are unsure then always seek the opinion of a health care professional.

Featured Image: S. Hermann and F. Richter at Pixabay

Come and Move The World with 261 Fearless

Published by Dr Juliet McGrattan

I don’t know about you but my running motivation has been lacking recently. I know events are starting to slowly reappear and I’m sure parkrun will be on the horizon soon but there’s nothing like a date in the diary to give you a kick out the door, especially on the endless rainy days we’ve been having up north recently.

Thankfully, 261 Fearless has come up with just the thing to ignite our running spark and get us in our trainers. The Move the World running series is a celebration of the power of running to unite people around the globe. In a time when we’re becoming more divided and ‘distanced’, goodness knows we need something to bring us together. I love working for 261 Fearless as their Women’s Health Lead and Master coach, being a Director at 261 Fearless Club UK CIC and coaching at 261 Club Lancaster. It’s pure joy and a lot of hard work but the rewards are great. Seeing the power that running has to create communities and empower women is always a highlight of my week.

Like all 261 Fearless activities, Move the World is for all abilities. Runner or walker, short or long, at whatever pace you choose. You can select your own distance too. Enjoy a sociable run with friends (men and women are welcome) or set yourself a personal challenge. Make it your own.

Head to the Move the World page on the 261 Fearless website to register. You can choose from four different weeks to complete your challenge. These weeks match up with some big marathons in the USA that 261 Fearless were due to have charity runners at and the ribbon on your medal will correspond with that event. But don’t worry, you don’t need to run a marathon.

The Boston challenge kicks off today and as it lasts all week you can still sign up. You can join in all four if you like and receive your fourth entry for free. Alongside a medal you will get a podcast to listen to while you run (you might hear me make an appearance!), a 261 shop voucher and a chance to win a necklace from Fair Anita, a fair-trade, social enterprise. All proceeds from Move The World will be used towards the 261 mission of empowering more women through running and education

So, what are you waiting for? Set your dates and challenges, get registered. Let me know when you’re taking part, take a selfie and tag @261Fearless and me in so we can share the celebrations. Together we can Move the World!

Tips for Peri-menopausal Anxiety

Published by Dr Juliet McGrattan

My last blog talked about how common anxiety is around the menopause and how women often don’t realise that hormonal changes can be the underlying cause for their anxious symptoms (you can read it here). Let’s move on to what we can do to relieve anxiety. What can you do when you’re feeling anxious? How can you calm your mind and stop anxiety overwhelming you?

Here are my top tips for easing anxiety in the peri-menopause:

Understand it. Read about it, listen to podcasts, talk to other women. The more you understand what’s going on in your body, the more informed you feel. This can really help you feel in control.

Tackle it positively. Anxiety is a horrible feeling but there are things you can do to ease it. Approaching it with a positive mind set and a problem solving head, will help you through.

Reduce anxiety-inducing drinks and food. Caffeine is known to produce the same jitteriness and increased heart rate as anxiety. Reducing or cutting out caffeine can help hugely if you’re someone who always has a cup in hand. (I recently blogged about my experiences of giving up caffeine). During the peri-menopause, you may find you are less tolerant of caffeine but also of alcohol and possibly high sugar loads too. Keep a track of how they make you feel and cut down accordingly.

Identify stressors. Sadly we can’t make all our stress go away but we can be pro-active in trying to reduce it where possible by delegating, asking for help and being a bit creative. Be kind to yourself and don’t beat yourself up if you don’t feel you are coping as well as you normally would, doing the best you can is enough.

Look for patterns. See if there is a cyclical pattern to your anxiety. Is it linked to certain times of the month? You may no longer have regular menstrual bleeds but you may still find there’s a pattern and times when you feel more robust. This will help you to plan the best time to tackle things such as tricky work tasks or difficult conversations.

Seek and practice relaxation. Find what calms and relaxes you. Often it may just be finding something that absorbs you and distracts you from your anxiety such as playing a musical instrument, baking or drawing, whatever you enjoy (if you’re stuck for ideas, then think of what you used to enjoy when you were a child). The buzz word is being ‘present’ – focusing fully on what you are doing at that moment in time. The next level is trying relaxation techniques or meditation to clear your mind. Even simply taking slow deep breaths can be calming. There are plenty of apps to help you with this.

Get outside. Nature is known to have a calming effect, especially if you can walk in woodland or by rivers. Even time in your own outdoor space or looking at the sky can help. Try and get outside every day and consider it a rescue remedy if anxiety starts to feel overwhelming.

Exercise. Physical activity is well known to reduce the effects of anxiety. It might be that a slow walk in a green space or some gentle yoga calms your mind or it could be a blast of feel-good and calming brain chemicals that flood your body after a vigorous work out. It works and it’s free.

Nourish your body. Get back to the basics of maximising your sleep and eating well. Fresh, unprocessed foods and cooking from scratch are best but you have to be realistic about what you can manage on your budget and in your busy life so just make small changes and do your best.

These are simple, lifestyle things that we can all do. If these aren’t sufficient to ease your symptoms or anxiety is having a detrimental effect on your daily life, then it’s time to visit your GP. HRT can be life-changing for some women. There are some situations where anti-anxiety and anti-depressant medications will be appropriate too but HRT is first line for these symptoms if they’re resulting from the peri-menopause.

I’ve made a couple of videos for IGTV on this topic and my own experiences so join me there if you’d like to watch.

Featured image: Wokandapix from Pixabay

Coffee image: Gratisography

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Anxiety in the Peri-menopause

Published by Dr Juliet McGrattan

Anxiety is very common. In 2013 there were more than 8 million cases of anxiety in the UK and with the Covid-19 pandemic, there are certainly many more this year. Feeling anxious is really horrible and can lead to a lot of self doubt. Sometimes there is a trigger but more often than not, anxiety seems to come out of the blue. Many women find they feel anxious at certain times of their menstrual cycle and many women experience anxiety symptoms in the lead up to the menopause. So what is the link between hormones and anxiety and why is it that anxiety can be the first sign of the menopause?

Let’s first remember that anxiety can be a good thing. A state of hyper alertness was designed to help us when we meet an enemy, to either stay and fight or to flee the scene (the fight or flight response). That can certainly help us to perform well when it matters, perhaps in an exam, interview or a tricky conversation. It’s only when that hyper alert state happens when there isn’t a threatening situation that problems arise. We don’t need that racing heart, increased breathing rate or jitteriness when all we’re trying to do is go to work!

Our brain is the control centre and it is responsible for taking in all the messages from around our body, interpreting them and sending out messages which determine our actions and feelings. It is a highly complex and not fully understood organ. The information the brain receives may come in the form of nerve impulses or chemical messages which include hormonal messages. The brain is striving for equilibrium for our body, to keep everything in balance so we can function at our optimum.

As a GP, I frequently had women coming to me fearing they were losing their minds, with symptoms of anxiety and associated poor memory, inability to concentrate and huge self doubt. Often the cause was that they had moved into the peri-menopause – the years leading up to the menopause when periods have fully ceased. To discover this was their reason for how they felt was often a huge relief as they feared early onset dementia.

Oestrogen and progesterone are the two main female sex hormones and they increase up and down throughout the menstrual cycle with oestrogen being the predominant hormone in the first half and progesterone in the second half. It’s not just the absolute quantities of these hormones that can affect your mood but the balance between them and the way their effect on the brain influences the release of other hormones such as cortisol and adrenaline, the main stress hormones responsible for that fight or flight response.

During the peri-menopause, both oestrogen and progesterone levels fall. Oestrogen is generally thought to have a positive effect on mood and progesterone can have a calming effect so when they decline, then low mood and anxious feelings can appear. It’s not quite as simple as this, nothing is simple in the brain because so many systems interact with each other, but just knowing that the hormone changes that are occurring can be fully responsible for your mood is very reassuring to some women.

It’s also important to remember that the changing hormone levels of the peri-menopause may have indirect effects causing anxiety. For example, night sweats are attributable to reducing hormone levels and can lead to many sleepless nights. A single disturbed night or a more chronic sleep deprivation can leave you feeling on edge, jittery and extremely anxious. Similarly, there’s nothing like the threat or presence of a hot flush when you’re in the middle of giving a presentation to make you feel anxious!

There’s plenty else going on around this time of life which can lead to anxiety too. Life events including elderly parents to care for, family stresses and career changes all cause stress and strain and trigger anxiety in their own right, independent of hormonal fluctuations.

So, if you’re feeling anxious, take a step back and consider whether it could be the peri-menopause. It may well be a great big jumble of everything but knowing that it isn’t your fault, others experience the same and that it won’t last for ever, can give you hope in what can be a confusing and tricky time.

The next blog will look at simple things we can do everyday to ease anxiety in the peri-menopause.

Featured Image: Arek Socha at Pixabay

Brain: ElisaRiva from Pixabay

Giving up Caffeine – one year on

Published by Dr Juliet McGrattan

I gave up caffeine last summer. Caffeine can have all sorts of effects on the body, both positive and negative. It can increase your alertness, give you an energy boost and even help your sporting performance. On the other hand it can make your heart race, give you heartburn and irritate your bladder. It’s addictive and without it you can find yourself feeling irritable, drowsy and with a banging headache.

Personally I decided to give it up because I was getting a few symptoms that I thought might be caffeine related and I felt drinking it had become a habit that I just didn’t need. Since I started working from home, going to the kettle had become my break from my desk and I’d slowly increased up to five or six cups of tea a day. I only drink coffee once or twice a week.

How much caffeine there is in tea varies according to the type of tea and how long you have brewed it for but there are about 70mg of caffeine in a mug of tea. Five of those a day is 350mg. The recommended maximum daily amount of caffeine is 400mg so I was drinking less than the recommended max amount but it still felt too much for me. (Pregnant women are recommended to have less than 200mg of caffeine per day). By the way, a mug of black filter coffee is around 140mg of caffeine so four of those would put you over the suggested daily amount.

I had been experiencing some palpitations and generally feeling jittery and on edge over a period of months. I wasn’t sure if this was due to caffeine or whether I was starting to become peri-menopausal but there was no easy way to find out other than to ditch the caffeine. I was also finding I was very sleepy in the afternoons and badly needed some caffeine after lunch and then again around 4pm to keep me alert and concentrating on my work. I didn’t like this feeling and it wasn’t helping my work productivity.

I figured I’d just give it up and see what happened! I decided to stop when we went on holiday. I thought a change of routine and the fact I wouldn’t be working might make it easier. I also thought that if I did have any withdrawal symptoms then it would be harder to be irritable in a lovely place!

I didn’t go cold turkey, I kept my morning cuppa to start with – that was the one I thought I couldn’t function without and I had two Greek coffees (just for the experience) during a two week period. I had a mild headache for a day or two but nothing much to speak of. I felt the urge to have one in the afternoons but I was able to ignore it. It was easier than I thought it would be. Being away and out of my normal routine definitely helped. When I came back from my holiday I dropped the morning cup of tea too. That was actually easy and I discovered I didn’t ‘need’ it after all.

My palpitations definitely stopped, quite quickly too, within two weeks I think. I began to feel less ‘on edge’ and after a few months I realised that the afternoon slump in energy levels had gone. I was no longer crawling my way to the kettle at 4pm. Funny really because you’d think that you’d feel more tired without it but I think my body didn’t like being on the roller coaster; for every caffeine high there was a following low that required more caffeine to pull me back up.

One year on I can definitely say I don’t regret it. I feel better for it and I don’t miss it at all. I have more energy, fewer eyelid battles and I’m sleeping better too. My afternoon working has improved as a result. What was vital for me was finding a decaffeinated option that I enjoy. I love making and drinking tea, it’s a comforting and sociable ritual. Once I’d found Yorkshire Tea – decaf and Raw Bean – Definitely Decaf, there was no looking back. I could drink it guilt free.

I’ve become that person who carries their own tea bags around with them. I’m not super precious about it, if I’m somewhere where there’s no decaf and I’ve been offered a cuppa, I won’t say no. If I do drink caffeine now I’m very aware of the effect it has on my body. I feel jittery and sometimes mildly nauseous. I’ll also not be able to sleep for a good six hours afterwards! The half life of caffeine varies between individuals but five to six hours is common.

I might use a shot of caffeine to my advantage when we’re back to racing again, it might just make me shoot off like a rocket! Although reduced in number, I’ve still been having the odd moments of feeling on edge and anxious but I’m certain these are linked to the peri-menopause. I’m discovering it’s a time in life when I’ve just become more sensitive to things; caffeine, alcohol and I think possibly sugar too but I’m not ready quite yet to stop those.

I know some people find it very hard to give up caffeine and have far more dramatic stories than mine. I’d love to hear your experience of caffeine – either giving it up or continuing to drink it.

Featured image: Gratisography

Coffee mug: David Schwarzenberg for Pixabay

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Quick Question – Can I run with sciatica?

Published by Dr Juliet McGrattan

I’ve been asked whether it’s ok to run with sciatica several times recently, by different people so I thought I’d answer it in my #quickquestion series. Will running with sciatica make it worse? Could exercise make sciatica better? Should you just rest when you have sciatica? What’s on many runner’s minds is how long they will have to take off running with sciatica and whether sciatica means they might never run again.

Understanding what sciatica is helps to answer all of these questions and more so let’s start there.

What is sciatica?

The sciatic nerve is the longest and widest nerve in the body. We have one on each side. It leaves the spinal cord in the lower back and travels through the buttock, down the back of the thigh and calf and underneath the foot. Any damage to or squashing of the nerve causes symptoms of pain, tingling, numbness and sometimes weakness in the area of the nerve below the point that it is compressed. So, if it is squashed behind the knee, the symptoms will be in the calf and foot. Pain can feel like a dull tooth ache but shooting pain, especially on movement and in certain positions is frequent.

Slipped discs

The most common site for the sciatica nerve to be compressed is at the spine. This leads to symptoms that can be felt right up and down the nerve anywhere from the lower back to the toes. It’s a common result of a ‘slipped disc’ where the gel like pouches that act as shock absorbers between our vertebrae, bulge out and squash the nerve at its root. You might feel some back pain but the main symptoms will be in your leg.

In this situation, it’s easy to see why you shouldn’t run. High impact exercise will put more pressure on to the bulging disc and therefore compress the sciatica nerve further. You need to allow time for the sciatica to resolve, this is usually around four to six weeks. This doesn’t mean you should rest completely though as gentle exercise and stretching is beneficial for back pain and sciatica. Keep active on and off throughout the day if you can.

Always see your doctor if:

You cannot control your pain at home with simple pain killers
Your pain isn’t settling after two weeks or is getting progressively worse

Get urgent medical attention from A and E if:

You get sciatica, numbness or weakness down BOTH legs
You pass urine or faeces without meaning to
You are unable to pass urine
You feel numb around your genitals or your back passage (anus).

It’s essential to make a gradual return to running after sciatica. Ideally this should be done with help from a physiotherapist to ensure full and successful rehabilitation. They will also identify underlying biomechanical issues that may have triggered the sciatica in the first place and advise you on steps you can take to minimise the risk of recurrence.

Piriformis syndrome

Sciatica does however have causes other than slipped discs. Piriformis syndrome is one. The sciatic nerve runs close to the piriformis muscle and if the muscle is tight, cramped or spasms, then the sciatic nerve can become compressed. This is common in runners, particularly those that do a lot of uphill running. Treatment centres on stretching the muscle. There are lots of videos online demonstrating piriformis stretches. Piriformis syndrome can take around four to six weeks to settle and it’s best not to run if it is causing discomfort. Avoiding too much sitting and making sure you have an upright posture when you do sit can help. Again, a physiotherapist assessment is very beneficial in identifying the cause of symptoms and directing treatment.

So, to summarise:

Sciatica describes pain, tingling or numbness coming from the sciatic nerve anywhere along its course
Sciatica doesn’t just come from a slipped disc
Do not run if you have a slipped disc or if running aggravates pain from piriformis syndrome
Input from a physiotherapist can be invaluable in getting a diagnosis and getting you back to running safely
Watch for the warning signs of a more serious condition and get medical help
Remember that generally being active helps back pain and bed rest is no longer advised
Stay positive, with good rehabilitation and working to prevent relapses, sciatica doesn’t mean the end of your running journey.

Featured image: Gratisography

Why I Started Running

Published by Dr Juliet McGrattan

It’s fair to say that running changed my life. It’s not an over exaggeration. I went from someone who thought running wasn’t for her to someone who left her career to spend more time running, writing about running and helping others to find good health through running. I can honestly say when I started out, it was absolutely not my intention that any of that should happen. It wasn’t even on my radar.

In trying to understand how to help other people to become active, I’ve been reflecting (as you know, I do a lot of this!) on why I started running twelve years ago. What was it that I was looking for? What did I need that I thought running could give me? And, in turn, how does that influence what I now say to people to encourage them to be active? I wanted to share it with you to see if you identify, if you are a runner or to see if it would encourage you if you were thinking about running. These are the conclusions I’ve come to:

It might not have been running. Ultimately I just wanted to get fit. It could just as easily have been cycling or swimming. Running was the most accessible to me at the time. I didn’t need to buy anything, learn how to do it (at least I didn’t think I did) and it was quick. I could do it from my front door in a few minutes and as a working mum with three kids of pre-school age, time wasn’t something I had a lot of.
I needed to prove I could do it. I’d tried running eight years previously and thought it was awful. My intention to run a half marathon was quickly given up when my knees hurt and each run left me feeling out of breath and pretty useless. I‘m stubborn and I don’t like it when I can’t do something. I’m prepared to work hard to achieve things and I didn’t like that running had one up on me.
I wanted to look different. I was flabby and unfit. My body had stunned me by its amazing capabilities to give me three children in close succession but it changed a lot in the process and I certainly wasn’t loving how it looked and felt. I wanted to be lean and toned and to look like what I perceived a runner to be. In hindsight I know I was being hard on myself, I was really fine and normal and I shouldn’t have felt any pressure to change but I did.
I needed peace. I needed to be away from the constant demands of work and young children. Don’t get me wrong, I enjoyed them but I needed to be inaccessible for a short time with no risk of someone calling for me. I needed quiet. My mind needed space and I longed for more than one minute undisturbed. A friend was up for running with me and I wanted the novelty of being able to finish a sentence.
I needed to get better at something. I’d learnt that being a mother is really hard. After number three I’d realised that you have to lower your expectations in a lot of areas. Your house is never going to be as tidy or clean as you want it to be. You’re never going to feed your kids as healthily as you’d ideally like. You won’t manage as much professional development at work as you know you should. etc etc. I was fed up of not meeting the high bars I set for myself so I wanted to start from scratch and get better at something. I needed to feel and see self-improvement and taking up running which I knew I couldn’t get any worse at seemed a good move.
I wanted an adventure. I was ready for something different, something unknown. Life has to be a bit predictable when you’re tied to work and childcare routines. We’d gone off script and spent a year in New Zealand just after number two had arrived but this was a distant memory and I certainly wasn’t up for travelling again at that point. I wanted to just do something random. I had no idea that my running would become quite the adventure it has!

It’s funny looking back at my motives. When we talk to people about why they should start running or getting active now, we often focus on the health benefits. I’m not sure the usual explanations about how running would improve my sleep or reduce my risk of disease would have made me want to do it. I didn’t see that I needed the mental health benefits either. Yes, I knew I needed peace and quiet but it didn’t go any further than that. Using running to manage my mental health is probably my biggest driver that keeps me running now. Back then though, ultimately, I just wanted a different body, to be away from the house and to succeed at something when I felt I was being a bit rubbish at all the other things I was trying to do. I hoped running could offer some of that.

We need to carefully consider how we frame our conversations with people we are trying to encourage to be active. Rather than simply sharing our stories and giving advice, we need to ask questions. New habits are very hard to form and to really find the motivation to introduce something new into your life, you have to get to the depths of what you need, what you’re looking for and why you want to do it. Everyone has different reasons and motivations. Only then will a new habit form and be long-lasting. Just listing the benefits of being active is not enough. It has to get personal.

Thankfully, running ticked all of the boxes for me. It delivered! It was more luck than judgement. If you had told me what would happen over the following years, I would have laughed in your face. I wasn’t looking for a new job, to travel the world talking about health and running or even a book deal. No, I simply thought I’d have a bash at it and hope it made me lose some weight and have an excuse to get out for a chat with a friend. Funny old thing running.

Why did you start running?

Featured image: Credit to Horst von Bohlen

Quick Question – How do I check my breasts?

Published by Dr Juliet McGrattan

How do you do a breast self-examination? What should you look for when checking your breasts? What do you do if you find a breast lump? It can feel a little overwhelming so don’t worry if you don’t know where to start. With some simple tips and advice you’ll soon grow in confidence.

Thank you for all the comments and shares of my previous blog – How often should I examine my breasts? I explained it was all about being generally breast aware rather than having a set time to do an examination but that routine and reminders can help to avoid the months flying past without you doing a check. A helpful comment from a reader pointed out that the wonderful charity CoppaFeel do a text reminder service so you’ll get sent a monthly message to remind you.

No let’s learn how to examine ourselves.

First up …

Remember that every woman is different and so is every breast.

Breasts are made of fatty tissue and fat is lumpy so at first you might think it’s an impossible task! Breasts change with ageing, the menstrual cycle, pregnancy, breast feeding and more. Some women have very lumpy breasts, others softer with few lumps. Many women find their breasts change dramatically with their menstrual cycle and for some women it makes little difference. It’s all about knowing what is normal for you and your normal may change throughout the month.

If you get very lumpy tender breasts before your period, then you may find a few days after your period is the best time for you to examine yourself. Similarly women who are peri-menopausal may experience intermittent breast tenderness and find it uncomfortable to examine themselves and want to move their self-check to a week or two later.

Get to know what works for you and what feels normal for you. Remember no one is symmetrical! And most importantly, if you notice changes or things you aren’t sure about then see your doctor.

Look first

Strip to the waist and stand in front of the mirror. With your back straight and your arms by your side just look at your breasts. Look for:

Any skin changes – rashes, redness or rough patches of skin.
A change in the outline – is the skin swollen, puckered or dimpled?
Check your nipples – look for crusting and give them a gentle squeeze to make sure no discharge come out.

Now look again while you raise your arms above your head and then put your hands on your hip.

Then feel

You can feel your breasts while you stand in front of the mirror or you can jump in the shower. Some women find it easier when they have a wet, soapy hand as it glides over the skin.

Use the pad of your middle three fingers of one hand. (Use your right hand to check your left breast and vice versa). Keep your fingers together and keep them flat against your breast. Press lightly, moving your fingers in a small circular motion. Imagine your breast is a clock face, move around from 12 o’clock, right round the numbers until you are back to 12 again, make sure that all areas of the breast are checked. Always check right up to your collar bone and into your armpit too as breast tissue extends here. Repeat this process but press a little more firmly this time so you can feel right through to your ribcage which lies beneath the breast.

It’s a good idea, especially if you have large breasts to repeat this when you are lying down. Lying down spreads out the breast tissue and can make it easier.

What to feel for

The most important thing is that you notice things that are different for you. Obviously, you need to have checked at least once to know if there are any changes but you will soon feel confident.

You are feeling for breast lumps – not all lumps are harmful so don’t panic. Lumps may be small or large, soft or firm, circular or a longer thickened area. Breast tissue is naturally lumpy so it is difficult. If you are having regular periods and discover a lump then you might choose to re-examine yourself just after your period to see if the lump persists.

See your doctor if you discover a lump or any of the other changes mentioned above. Do not feel embarrassed, they will be pleased that you have been checking yourself and can either quickly reassure you or arrange for you to go to a specialist breast clinic for them to examine you and carry out any further scans or tests that might be necessary. Remember breast lumps are often due to non-cancerous reasons such as cysts or hormonal lumpiness.

Check today and be proud that you are taking care of yourself.

If you’d like to read about my experience going for my first mammogram then you can read it here.

Featured Image: Luisella Planeta Leoni from Pixabay.

Quick Question – How often should I examine my breasts?

Published by Dr Juliet McGrattan

I was examining my breasts the other day and suddenly realised that I couldn’t remember the last time I had done it. Then I felt worried that if I found a lump it could have been there for several months. There’s nothing like the fear of breast cancer to invoke anxiety. Thankfully all was well but it served as a reminder to me of the importance of this quick, simple home check that we can all do. So, how often should you check your breasts? Should you examine yourself every time you get in the shower, once a month or is a quick feel every now and then when you remember enough?

Cancer Research UK states, ‘When diagnosed at its earliest stage, almost all (98%) people with breast cancer will survive their disease for five years or more, compared with around 1 in 4 (26%) people when the disease is diagnosed at the latest stage.’ However, not all breast cancers can be detected by breast self-examination. Other methods such as breast screening through mammography are used to help detect cancers early. It does however make sense to give yourself the best chance of picking up a cancer early with a simple home examination and awareness of your breasts.

Be breast aware

Generally being breast aware is more important than regularly timed checks. Get to know your breasts. You’re more likely to notice changes and will feel more confident about spotting them. This means knowing how your breasts look as well as how they feel. Here are some simple everyday actions give you an opportunity to check your breasts:

If you are undressing in front of the mirror, always just cast a quick eye over the silhouette, shape and outline of your breasts, sometimes skin can pucker or dimple.
When you’re in the shower and your hand is soapy, just run it over your breasts as you wash yourself.
If you’re applying body cream use that as an opportunity to notice how the breast skin and nipples look and feel.
If you’re shaving your armpits, just feel gently with your fingers as you rub on the shaving gel; breast tissue can extend into the armpits.
When you’re putting on your bra, just notice how your breasts sit in the cups.

Develop a habit

There is actually no set recommended frequency with which you should specifically check your breasts and being breast aware all the time is more effective. Most information says that around once a month is adequate. The problem with busy lives is that time flies and months and months can go before you realise you haven’t checked. Simple memory isn’t a reliable way for the majority of women to ensure they do it. If you’d like to create some kind of pattern, habit or prompt that means you don’t forget, here are some suggestions:

Check on the first day of each new month.
If you regularly menstruate, tie the check in with your menstrual cycle.
Set a reminder on your phone or computer.
Write it on the kitchen calendar!
If you are taking daily medications, use the completion of a month of your tablets as the reminder to check your breasts.
Do you get through a bottle of shampoo or face cream roughly each month? Use the opening of a new bottle to remind you.

Just find what works for you. Whatever activity you do around once per month, use it as the trigger and associate it with a breast check.

Remember, if you notice any lumps or bumps or something that feels or looks different to you, it’s always best to get it checked by your doctor.

How often do you check and what reminds you to do it? Let me know in the comments.

In the next blog I’ll explain how to carry out a self-breast examination and what to look out for.

Featured image: Gratisography