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Issue 166 ~ 7th June 2024

Hello,  

This week Mary brings some fascinating facts about the science behind ‘jet lag’ and I invite you to take a look at what the surgeon did to my foot! I hope you find both interesting.

As you will realise if you have read the last two or three weeks’ Newsletters, Mary and I are going through one of those stages in our lives when our bodies need some attention. This is perfectly normal and there are few people who will sail through their lifetime without needing some bits renewing! If you are one of them, you are exceptional and very fortunate.

I find the whole process of having orthopaedic surgery fascinating. Just as a car might need new brakes or shock absorbers to keep it safe and more comfortable, sometimes we need to replace bits of us so that we can have a quality of life going forward.

When my specialist looked at the X-ray of my left foot, he was amazed I could even walk on it so, despite the fact that post-operatively I would not be able to weight-bear for three months, I felt it was worth the inconvenience as I acknowledged that the later I left it, the older I would be and the longer it would take me to recover.

I approached my operation with hope and optimism. I didn’t fear it at all. I knew my surgeon Mr Bhatia was incredibly good and I trusted him implicitly to do the best job it was possible to do.

The operation was on Tuesday 14th May and I was given a spinal block to anaesthetise my lower body rather than a general anaesthetic which I was advised against because of my asthma. The spinal block gave Mr Bhatia a three-hour time frame in which to rebuild my left foot. When we have a spinal block, we remain awake for the duration of the operation but have no feeling in the area where surgery takes place. I asked to be sedated which the anaesthetist administered. I then went into a blissfully relaxed state and left the experts to do their job.

I had been told that my operation was likely to take between 2½ to 3 hours so after a couple of hours my sedation was wearing off. I could have asked for more but I chose not to.

When we have an operation with a spinal block, depending on where the surgery is being undertaken, a large ‘curtain’ is placed just in front of our head so that we can’t see what’s going on. There’s always a doctor or nurse nearby so at no time do we feel ‘alone’. I have no doubt this ‘shield’ prevents us seeing the drama unfolding on our limbs!

I was relaxed as I heard the noises of reconstruction – in fact, it sounded as though Mr Bhatia was building a kitchen! I could hear sawing, hammering, drilling, filing… it was incredible! I wasn’t worried but it did drive it home what a complicated job he had to do.

Because of the degradation and deformity of my foot, some of my bone needed a bit of enhancement and this was done using some new bone which, apparently, was obtained from a Bone Bank! Who knew such things existed? Five years ago, when he rebuilt my right foot, Mr Bhatia harvested some bone marrow from my tibia (lower leg) but this time the surgery needed more than he could harvest from my own body. The extra was used rather like special ‘live’ cement in places between the bits of my bone he was fusing together. Over time, they grow into each other and become very strong. They are held together with metal plates and pins which live happily alongside, making it all super strong. Clever stuff as you can see from these X-rays!

After all that, the foot was put back together again - rather like Humpty Dumpty – with the skin sewn up with dissolvable stitches and finally glued to complete the procedure. Then it was time to wrap it all up to keep it secure and protected.

I had a half-plaster cast placed under my foot and right up to just below the back of my knee to ensure I couldn’t bend my ankle or foot, all held in place with loads of protective bandaging. By the time the finished job was revealed, I definitely justified being called ‘Big Foot’ and I left with strict instructions that I could not weight bear on it for 12 weeks. The plan is to have a half-plaster cast for two weeks, a full cast for six weeks then a boot for the final four weeks.

So now, the physio starts. Whilst the right foot gets lots of exercise as I hop around when not in my typist chair or wheelchair manoeuvring myself around, or lifting myself up the stairs backwards, my left (operated) leg is not.

It would be very easy to put my operated leg on a three-month holiday and just let it rest but that would be a massive mistake. After all, I can still exercise that leg so long as I don’t weight bear - I can lift it, bend it, and move it inwards and outwards. There’s nothing wrong with my knee or hip so I need to keep the muscles surrounding and supporting them as strong as possible because, if I don’t, I will lose muscle strength at a frightening rate and if I want to be able to walk normally on the day my leg comes out of incarceration I need to make the effort now. 

I left it for two weeks after the op before I started exercising it, and then it was time for action. No excuses. As far as I am concerned, at the end of my 12 weeks, I want it to be ‘business as usual’.

Take a look at our pre- and post-op exercises on our website:

Recipe of the Week

Kim's Cake
 

Serving size 1cm (½ inch) slice
Prep time: 15 mins + overnight to soak the fruit
Bake time: 1½ - 2 hours
 

2 mugs of mixed dried fruit
1 mug of hot black tea
1 mug soft brown sugar
2 mugs self-raising flour
1 large egg, beaten

(In the video Rosemary and Dawn use a 300ml mug but if you use a smaller mug the quantities will still work proportionately)
 

  1. Soak the dried fruit overnight in a bowl with a mug of hot black tea to allow the fruit to swell.
  2. Place all the ingredients together in a large mixing bowl, including the fruit and tea, and mix well.
  3. Line a 2lb loaf tin and bake for 1½ hours at 160°C, 325°F or Gas Mark 3. Then check to see if the cake is cooked through by piercing the centre with a skewer. If it comes out clean it is cooked. If not, place back in the oven for up to a further 30 minutes
Don't forget, you can download and print a copy of this recipe if you click on the image above to go to this recipe's page on the website.
Click here for more recipes

Fun, Facts & Fitness from Mary Morris MSc.


Travelling back from our recent holiday we travelled east across a timeline, which meant that we had to readjust to losing 8 hours, resulting in the most awful jet lag. You may have suffered too at some point. I have often wondered why it makes you feel so bad. It can completely wipe us out, disturbing sleep for several nights, and when we should be eating breakfast, we are probably eating our dinner!

Then I listened to a most fascinating podcast about circadian rhythms in the body and it all became clear. It is often referred to as the Circadian Clock and is a very clever mechanism in the body that is a natural timer, a 24-hour clock that runs constantly from all parts of the body with the 'central' clock in the brain (the hypothalamus to be precise), and the peripheral clocks that run from all other tissues such as the liver and kidneys and all our muscles.  

Let me try to explain it because it is not just linked to jet lag, but also to much of our daily activity and can result in our using the very best time of day to eat and exercise.

This clock runs constantly with a timer attached to all the major organs of the body, including the heart and lungs, liver, kidneys etc. and for us to feel 'on form' all these timers need to be in sync. So, the jet lag scenario is a great example of being 'out of sync'. Our brain may be saying it's 3am, but our digestive system might be at noon and our liver is telling us its 5pm. The result is we feel very washed out and very uncomfortable until they all get back into sync - which can take several days.

Interestingly, these clocks are not linked to night and day. Daylight does not turn the clock on. It is just our regular pattern and schedule of eating and activity that the body adapts to, and makes your personal clock run smoothly. To prove this a group of students went down a dark cave for a period of 40 days, so light was not relevant at all, and they discovered that their sleep and wake cycle remained exactly the same. Fascinating.

Your Muscle Clock

This is where it gets very interesting for those of us who like to exercise regularly. Firstly, it is very important that each day we have a period of 'activity', and for most of us that takes place during the daylight hours. We then follow that with a period of 'rest' where we go to bed to sleep. The interesting thing is that during the active part of the 24-hour clock, scientific research has found that we are at our most 'powerful' in the afternoon. That means that if we want to promote muscle growth (yes please!) then we should take up our hand weights and resistance band during the afternoon.

You are now so familiar with our, often repeated, message about maintaining strong muscles as we get older, and that by using resistance exercise (using a band or light weights) you are going to keep strong enough to lead an independent life. These circadian clocks within our muscles allow us to gain greater strength if we do our resistance exercise later in the day. Apparently, the very best time is around 4pm but there is some flexibility around that. 

Surprisingly, we have almost identical 'muscle clocks' to mice and they found that those mice who used the running wheel at the end of the day were by far the healthiest, lived longer and were less likely to become diseased.

I admit this is not good news for those who have always exercised first thing in the morning and for people such as shift workers who may find it hard to be consistent around the timing of their exercise sessions. In that case the message seems to be that we are best exercising before we go to work rather than after.

Timing of Eating

Here again the circadian rhythm clock for eating is best later in the day. This is a shock for those who have always believed (me included) that eating breakfast is vital for starting the day. That still holds true but the point here is the amount you eat at the start of the day and here too, the message is to eat more as the day progresses.

This actually fits in very well for most of us, as generally we like to eat a main meal later in the day.  Added to this message is the need to eat protein (meat, fish, eggs, cheese, milk, yogurt, pulses and legumes, etc) at every meal, as the evidence is very striking for ensuring our overall muscle health.

Personally, as I have become older, I find it hard to eat very late in the day, so this idea that we should be eating a main meal late in the afternoon now fits perfectly for me. Many of the people I speak to often say the same. What also seems to be important is the 'window' of time that we eat our meals and there seems to be a consensus that the best mix is to fit them into a 12 hour period with a 12 hour rest from eating. This allows the body to 'repair and restore'.

The Good News

On exploring this concept further than the original podcast I heard, it became clear that the most important thing to be aware of is that our circadian clock works best when we have a regular 'schedule' of eating and exercising every day. If we veer away from that, the clock becomes disrupted. So, if we have always exercised early in the morning and our meals are at the same times every day then we should have a beautifully 'set' clock.  

I hope that these little pearls of wisdom I occasionally drop on you are as interesting to you as they are to me. I love continuing to explore how our bodies work with the intention of keeping mine in the very best working order possible. As you are reading this, I can only assume you are of the same mind!

This Week's Fitness Challenge


  1. This week, if possible, do your strength programmes as close to 4 pm as possible. If not then make sure you stick to your normal routine and do a good solid 3 sessions.

  2. An early morning 30+ minute daily walk is still the best option for fat burning but always make your walks at the same time of day. It develops a regular habit and your Circadian Clock will be happy!   

  3. Make sure you keep up your balance training. Ideally, stand on each leg for 30 seconds every day and do the Balance Exercises on the website twice this week.
Did you know... 

We've all heard of blood banks, but whoever heard of a bone bank?

The Leicester Bone Bank which started as a small-scale facility at Glenfield Hospital collects, stores and supplies bones and other tissues to transplant surgeons all over the United Kingdom.

Bone is donated to the Bone Bank by living donors, that is patients undergoing procedures such as hip replacement surgery. Excess bone which would otherwise be discarded is saved, tested, processed and stored for transplant.

The Bone Bank also stores donated heart valves, and Glenfield Hospital is now one of the most active centres for this type of transplant in the country.  Heart valves can be transplanted into patients whose own valves are damaged or diseased, and are often transplanted to save the lives of young children or babies who are born with defective valves in their hearts.

Though thousands of lives are saved every year with the help of donated organs such as heart and kidneys, many people are not aware that donated tissues such as heart valves, corneas and skin can dramatically improve the quality of life for recipients and even save lives. Although organs need to be retrieved quickly after death, tissues can be retrieved up to 48 hours afterwards, so it is often possible to donate tissue even if organ donation is not feasible. Many more tissue donors are needed in order to maintain this supply.

Every year, thousands of people's lives are saved or improved by organ, bone and tissue transplants. You can find out more and register your decision to donate at NHS Organ Donation.

And finally...

Well, that was a packed Newsletter. I hope you found it interesting whether or not you are preparing for a stay in hospital or recovering from jet-lag!

Have a great week.

With love and best wishes,

Rosemary Conley CBE DL

LIVE LONGER | LIVE HEALTHIER | LIVE HAPPIER

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