My philosophy of care

Let’s take a break from talking about sleep, food and activity goals. I am going to bring it back to why I do what I do the way I do!

I like to spend time with my patients. My appointments are longer than typical health care practitioners in similar fields such as other osteopaths, chiropractors or physiotherapists. Having worked in this industry since 2007, I have heard a lot of feedback from patients about what they value, often they have felt unheard or rushed by a health care practitioner. I have come to learn that a lot of pain management and pain resolution starts when a patient feels heard. This works in two ways;

One, the patient feels they have the time to say what they want to say about their experience of pain.

Two, as a practitioner it allows opportunity to really understand someone’s pain and their personal values and attitudes towards life, lifestyle choices and any treatment or rehab I suggest.

I see what I do as a partnership with the patient. We discuss and share the decision making of how to manage and treat. I want patients to feel empowered by what we discuss and how I treat. This enables me to help a patient develop the tools to often help themselves and really understand what is going on with their injury or issue.

My initial appointment, if we have never met, I allow an hour. This gives time for the niceties and a full assessment with lifestyle choices and previous history included, It allows for a thorough physical assessment. This may include special tests, recognised by any healthcare practitioner, range of movement, replicating things that aggravate the issue. Finally, I summarise what I have found or assessed for, and treat with manual therapy (AKA hands-on treatment ) and advice on appropriate rehab exercises to do. Because I allow a good length of time we have chance to really get to grips with more nuanced lifestyle choices and personal values.

A follow up appointment is up to 40 minutes. I give this time to be able to really check in with the patient and understand what has worked, how they feel they have improved and how the exercises went. I see a lot of people that in life just feel rushed and enjoy wanting to provide that extra time. This is about patients being individuals and having their own story to tell and I want to hear it.

FOOD!

Feeding yourself appropriately for a physical goal you have set yourself is obviously important. What you consume needs to fuel you adequately, hydrate you and, hopefully, taste good. There are lots of ideas floating around about what diet people should follow depending on what you want to achieve. Some seem ridiculously extreme!

There does seem to be a general consensus on the more moderate side that eating plenty of fruit and veg (fresh meat if you are a meat eater) and pulses and reducing or avoiding highly processed food most of the time is not an awful way to go. My personal approach is along the lines of the 80:20 rule. 80% of the time eat the more natural foods that can be recognised by previous generations. I am not necessarily talking about paleo society specifically, more any generation prior to the last couple. Where food was made mostly from scratch and they had a rough idea where or what it came from. With 20% of the time (often less) eating less recognisable stuff to previous generations but easily available now, it tastes nice, often doesn’t contain a lot of nutritional value except calorific value. But my aim is to be fuelling myself in a way I can sustain for the long term.

I am not keen on meals in a bottle or a shake. They may work to limit your calorie intake for a period of time, often about 6 weeks, which is useful for purely aesthetic reasons, like trying to get into an outfit for a wedding or special event but I have no idea how people manage to survive on these indefinitely! (that is a question, if you do please let me know how you do it.) I don’t get involved in these because over the years I have seen friends and family devote plenty of time and money on these, enjoying great weight loss only to regain it all and more when the struggle has ended and they resume eating. Having learned no new way of eating or retraining their habits. Also, as a health practitioner my concern is with the weight loss how much of it is the actual thing we want to lose (fat) and how much if fluid or muscle. Healthy weight loss is thought to be approximately 1-2.5lbs a week anymore than that and it is fluid and/or muscle. So then you get into messing up your muscle to fat ratios which is a whole other story!

What does this moderate way of eating look like? I follow an array of nutrition related people and have read my fair share of nutrition and training guides. The general idea I get from them is eat a lot of colour. Consume multiple plants and seeds and nuts. I eat seeds on yogurts, nuts as a snack. I have veg or salad with most lunch and dinner meals. Even my breakfast I eat rye toast with crunchy peanut butter (made of only peanuts and some salt). This helps get in the fibre too, which is great for our digestive system.

I am also quite keen on the fermented food idea. I can not give you names of studies or research right now that back it up. But I believe Prof. Tim Spector has covered this a lot. But I feel good for it. The other thing I do is drink water. That and good coffee are my main drinks. I don’t drink much else, oh except for wine and maybe a gin and tonic, but not on a daily basis!

Over the next few months as my training gets more serious I imagine I will get a bit more detailed about calorie in take and meal planning. I have studied nutrition in my first degree and continued to read and study it, which I will put to use over the coming months. But at the moment, I am sitting with the 80:20 (or a little less than 20%) rule and enjoying where I am right now.