Dave Snowden

Early detection, fast recovery

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One of the points I have been making for years is that a degree of failure is inevitable in any system and what matters is early detection, fast recovery and fast exploitation of the new space created.  Now this applies to the whole health and life style question and I promised to pick up on a personal example in yesterday's post.  My own experience when I was first diagnosed with Diabetes was that the reaction of the diabetes nurse was to start me down a process driven pathway of palliative care starting with diet, then metformin and eventually insulin injections and premature death.  My arrival with evidence that a partial starvation approach coupled with exercise could allow a curative pathway was ignored or in the immortal words of General Melchett pooh-poohed although it was (in the immortal worlds of Captain Blackadder) purely circumstantial.  My GP was happy to support the process but critically did not propose it.

Now lets look at this in a little more detail.  A dietary and exercise approach can reverse diabetes if you catch it early enough, while statins and meformin have multiple side effects.  Diet and exercise provide long term change, drugs mitigate the symptoms.  Nothing wrong with per se, but they are not the only pathway.   However to take that journey I needed multiple reinforcement, from a dietician, apps, a physiotherapist and a podiatrist all of whom not only did their jobs professionally but also talked to me as a adult and responsible human being who wanted to take a curative route.  I also picked up multiple negative and positive stories as a result of going public (too many people keep these things to themselves) which provided day to day feedback and reinforcement.  Public declarations require more commitment than private ones and so on.   The whole thing cost me £250, seven months of my life and transformed my health and well being saving the NHS a fortune in terms if diabetes management and the the many other consequences of obesity (there I can say the word now).

So why not give people that option?  It is easy to measure, if you take it and your weight and fitness is not dropping in measurable ways then take the palliative route.  The problem is we don't seem to like contextualised coherent diversity we prefer conformity with single pathways.  Better still, start the process when people reach 40 rather than trying to make statin prescription universal at the age of 50, that links back to the heading of this post.  Once you get through the barrier of diet change life becomes easier and better and you can exploit many advantages.  But you have to get through that barrier and that requires multifaceted fragmented reinforcement for a sustained period.  

You know it makes sense (sic)

The overall story of my particular journey I summarised in three blog posts for those interested.