David Perrott - Warwick, England, 1916 - 2008

David died peacefully this morning in Warwick hospital. He was 92 and full of years. Our final memory is of a man peacefully sleeping and slipping away. We need our beliefs in an afterlife at these times. Life seems such a short time in relation to eternity. All actions that are done with love have eternal value. David certainly loved. The minister from St Paul's in Warwick said that he always remembered him with a smile on his face. After his heart operation two years ago he was grateful for every day on this earth. They were all a bonus. We all have stories of him, his kindness and generosity, his willingness to hold possessions lightly, his interest in and recognition of everyone he met, his mischievous humour, his stubbornness that kept him alive. Even in hospital it was not possible to feed him or find a vein to replace the drip that had to be removed. Perhaps the medical books need to be revised. They say that a human being can survive for only three days without water. David survived 11 days without food and 7 days without water. When we returned to his flat my sister Liz offered me his pot of vitamins. I hunted through his cupboards and found calcium with vitamin D, garlic capsules, fish oils, Senior ABC vitamins, selenium, glucosamine, joint complex. No wonder he passed away so with grace and dignity. His body will decay very slowly in the mortuary.  Thanks Dad for being such a great example. You knew how to love life and when to let go. You gave everyone who wanted to say goodbye a chance to see you. We all loved you. One of my daughters said tonight that you were the greatest grandad she could have; you were the greatest dad too.

John Perrott

Understanding stroke

David Perrott - coming to terms with dying

The last two weeks my family have been coming to terms with my father dying. He is 92. His philosophy of life included maintaining his independence, keeping himself out of debt, accepting what happened to him in life; knowing that something good always comes out of something bad. He was wise in his advice. One of his grandchildren Zoe, asked his opinion about a boyfriend of hers. He was seventeen years older than Zoe. Dad said that when it came to long term relationships or marriage you had to think about the later part of life not just the early part when you are, "In love". Many men died sooner than women. If you choose someone much older the likelihood is that that you are choosing to spend much of your later life on your own; unless of course you are fortunate to meet another companion. You needed to share your values. Zoe asked her boyfriend what were his moral values. what mattered the most to him. He replied that being successful and having money were the most important. Those are not uncommon values. She simply did not share them, so they decided to split up. 

He had a couple of falls in the last two months. Old people do fall and stumble. In dad's case it was possibly a minor stroke. There are two kinds of stroke and ischaemic one and a haemorrhage. Ischaemic strokes suddenly cut the blood supply to part of the brain. They are caused by small blood clots. A haemorrhage is a bleed into the brain. Even aspirin or sodium diclofenac gave dad nose bleeds so he was more susceptible to bleeds. In hospital he was bright, cheerful and optimistic. A nurse said that she remembered him from two years ago when he had a heart operation. she said that he was a real gentleman. He had another fall the night before he was due to leave. This time a massive bleed pushed his brain over to the side. he completely lost consciousness for days. the pupils of his eyes were pinpricks. That was 8 days ago. It was almost impossible to find a vein to bring fluids into his body. On Christmas Eve I spoke to him as we did every day. I told him about one of his grandchildren going for ski lessons at Milton Keynes Xscape building. He opened one eye, looked at me and smiled a broad grin. Now you can see his eyes move if you gently lift his eyelids. Every day he is weaker and more dehydrated. His breathing is laboured. But there is nothing else much wrong with him. The hardest part is knowing what he wanted out of life and respecting those wishes. To him the ability to walk was an essential part of his independence. he kept his own flat, washed his own clothes, pulled his shoes on with a pair of pliers, did up his buttons and tie with a piece of wire, replaced light bulbs, made minor repairs and modifications to his flat. The great thing that we met was his kindness. He collected the papers for the flats in his block. He called in every day to see his friend Brenda. Her grip was weak and his was strong. He opened the car door. she drove the car. That got them to Probus, Masonic functions, the shops, Recorded music society, National Trust retirement fellowships and a few years ago; trips to National Trust properties. 

Now we are faced with Dad as he is; in his present condition. He has not eaten for 9 days. He has had no water intake for 5 days. It is not possible to insert a needle into his veins. They are too difficult to find. Yet he is still alive. During the war he commanded 450 men in the signals. They laid copper cabling from Calcutta to Rangoon fighting in the Burmese jungle under Japanese occupation. He is used to deprivation. The dilemma of dying is not how the person copes. It is how the relatives cope. We put on a brave face, a practical face, an emotional face, a nostalgic face but the people who express the pain and grief are those who are left behind. 

Dad learned the precious lesson of letting go when his wife Betty died. She tried to control his decisions in many ways. The relationship was closely interdependent. Even though she died of an "accidental aortic aneurysism" she knew roughly when she was going to die. She was so precise about it that she tied the house, cleared the loft and designated some of her possessions. She knew that she was not going to see in the millenium. Dad even found a note under the Christmas pudding with instructions on how to cook it. Soon after she died he cleared his own possessions, sold what he could and gave away the rest. He bought a McCarthy and Stone retirement flat in Warwick with no garden to maintain and moved in. His time of freedom to make choices had come so he made them. Picking up her social calendar he enlarged his own horizons. Off he went on coach trips around the country. He even went off to the British Virgin Islands to give away a young bride of much loved relatives. 

When we get married we exchange one kind of freedom for another. Before we had the choice of what to do at weekends, where to go on holiday, how to keep our house or flat, where to spend our money. Once we are married we enter a new kind of debt; the debt of loving and being loved in a possessive way. Before we could "go out with our friends" and come home not entirely sure how we got there. Now there is someone waiting, watching the clock, listening for the door to open. To the person who strives for "freedom" that kind of love seems to be a tie. Yet we enjoy the benefits of love when they are freely given. In dad's struggle to maintain his independence there is one thing that he could not take, the need for others to control him. He had faced in for his married life and he was not going to give in again. You could have called him stubborn, perhaps he was, but it was that very stubbornness that kept him alive. 

Tennis elbow

Tennis Elbow is a troublesome condition. The pain is caused by inflammation of tendons that anchor muscles of the forearm to the outer side of the elbow. Pain in the inner side is called golfers elbow. Let's try and understand what is happening. Take a look at your hand. You notice the hollow palm that allows you to grip. Your hand is cleverly designed by the way the muscles are placed. The muscles that operate your little finger and thumb are mainly in the hand itself. (There are two muscles that lift your thumb outwards). The muscles that operate your three middle fingers would take up too much space if they were in your hand. They run from your elbows down into the hand through long tendons. Gripping a racquet tightly, cocking the wrist, constant small movements of a computer mouse, typing with the wrists too low lead to shortening of these muscles. The constant tiny amount of pulling on the elbows inflames the tendons. The elbow and triceps muscle (chicken wings on some people) are served by a nerve from the neck called the radial nerve. Sometimes golfers cannot rotate their upper bodies far enough on the back swing. They compensate by cocking the wrist to make for the lack of rotation. That can lead to golfers elbow. The solution is to work on rotation or twisting of your rib cage.

Treatment includes stretching and exercising the muscles in your forearm. Stretches are hard to describe, but try opening your hands wide, spreading your fingers at frequent intervals. Try a loose drumming action with your wrists. 

Acupuncture helps, so does deep massage along the muscles of your forearm. They feel quite fibrous when you or someone else starts to work through them. Ultrasound or laser help, short frequent treatments work more effectively. The muscles on the outside of the forearm are attached mainly to the bone called the radius. The radius rotates around the ulna which is underneath. Sometimes the muscle contraction pulls the head of the radius slightly out of alignment. Treating this is very satisfying. If this is the cause I have seen tennis elbow improve dramatically after only one session. Treatment will also include decompressing the motor nerves (especially the radial nerve), as they emerge from your lower neck. This is not painful but helps to raise the potential of your nerves to increase energy to your muscles.

Avoiding recurrence

The most important thing that you must do is to identify what aggravates your tennis elbow and change what you are doing. Using a roller ball or tracker mouse, changing your mouse hand once a week, exercising your shoulders, improving your posture, using a gel pad or lowering your keyboard, fitting a sleeve on the handle of your tennis racquet, changing to a lighter racquet are all positive changes that you can make. 

If the condition is left untreated it becomes a repetitive strain injury or syndrome (a syndrome is a set of symptoms).

Wholefood Diets

The wholefood movement grew out of the belief that eating food in as near a state to the original will do you more good. You will experience more energy and live a longer more healthy life. The idea is that hunter gatherers went about collecting berries, nuts and seeds in season, and killing animals for food only occasionally. Sweet foods like honey were a highly prized treat that made the risk of climbing trees, or roping down cliffs a risk worth taking. Farmers came into hunter gatherer territories and had to justify taking their land. Inuit, Athabaskan, Nisga, Masai and other Aboriginal tribal communities have had to justify their existence in the face of colonisation. Read the book by Hugh Brody called "The Other side of Eden", if you want a fuller story. 

For 16 years I worked in the wholefood industry. the obvious escapes many people's attention. For instance, food comes from soil, animals, bushes or trees. We used to visit apricot farmers in Turkey. I asked them why organic unsulphured apricots contained more stones and grit than sulphured apricots. They said that they dried them on the soil instead of cotton sheets to absorb the heat from the ground. We encouraged them to change their practice to avoid harming our customers. So what was the industry like 20 years ago? You would be surprised. Our immune systems were stronger simply because we were less protected from insects and vermin. Cashew nuts looked grubby and nibbled simply because they were grubby and nibbled. Sesame seeds had tiny insect droppings in them simply because the growing countries harboured an awful lot of cockroaches. Moist figs and apricots smelt fermented and crawled with mites simply because they were fermenting and crawling with mites. Mites themselves don't cause much harm. It is what they leave behind that causes the stomach upsets. Nuts went mouldy simply because mould spores were already present. Nuts sometimes tasted off because they were off. Here are some tips for choosing wholefoods:

Remember that most of the farmers have only one crop a year. Think of the part of the world were they are grown. Find out when they were harvested, add two months and you will probably be buying new crop nuts, seeds or fruit.

Avoid sales: special offers, two for one, they are probably selling off last year's stock. 

Buy your Christmas fruit as late as possible. The retailers will sell off older stock first.

Look carefully at the colour. For instance light and dark walnuts might be a mixture of this year's and last year's crop.

Slipped or Bulging Disc

I run manual handling courses. The participants look together at the causes of back pain. Here are some of their comments: Back pain is caused by poor posture, lifting things badly, twisting, over-stretching, badly designed beds or soft chairs, wrong shoes, body shape - for instance a long back, musculoskeletal diseases, osteoporosis, type of job, stress, depression, pregnancy, overweight, falling, accidents. All of these comments are valid but the groups never mention the most common story that people with back pain are told - the slipped disc. The story is that some of the gel from the disc or cushion between your vertebrae  is pressing on a spinal nerve and causing pain that radiates through the back and across the back of your pelvis. In my experience only about 1 in 100 people who come to see with severe back pain suffer from this condition. 

The bulging disc does not particularly lead to back pain. More commonly it affects the buttocks, back or outside of your leg or calf muscles. It might cause numbness to a big toe. If you lose feeling when you go to the toilet, or lose bladder control you must go to hospital as a medical emergency.

Bulging discs are not the cause of back pain. they are the result of a long series of events that start with the list that the manual handling course people rightly point out. To live with the story of a herniated disc is to take health out of your control. It is important to remember that you are responsible for your weight, your fitness, your posture, the way you do your job, sports, hobbies, your choices of diet. Just about everything in your life can come back under your control. 

Conception Childbirth & Infertility

As an osteopath women often came to see me with pelvic problems. Some common factors emerged. They either had back pain or sciatica. They had difficulties in pregnancy or giving birth. Emergency caesarians were sometimes needed. They had symphysis pubis disorder (SPD) in pregnancy. This condition is a softening of the ligaments that join the pubic bones putting a strain across the groin. It leads to lack of stability & difficulty in walking. In studying the anatomy of the pelvis and through helping hundreds of women I discovered that osteopathic treatment can not only relieve back & hip pain or some causes of sciatica, but also help improve the chances of fertility. A number of women found that they became fertile not long after osteopathic treatment or that they did not experience severe difficulties in pregnancy or childbirth.

Tesco's Value

A friend called Deanne did not like her own friend's choice of boyfriend. He was too much into himself. Deanne said, "Men come into a few categories. There is Tesco's finest. Then there is Tesco's Basic. Then there is Tesco's value. Then there is Lidls." I disagree about Lidls. You find lots of good value bargains in there if you keep dropping in. 

Energy Medicine

One of my daughters kindly bought me a CD on relaxation. The voice on the tape told me to breathe deeply and to experience an energy shower every day. I like a shower but I could not understand what she was on about. We took the tape back. It got me thinking about energy. We hardly think about energy until we feel that we have not got any.  We expend energy by work and lose it as heat. So every day we need to replace the lost energy. Where does it come from? Ultimately it comes from the sun. Light travels in tiny units called photons. Sometimes photons act like particles, sometimes like waves. Energy also arrives as heat. Plants take up the energy and convert it by photosynthesis. Either we, or animals eat the plants, or we eat the animals. Plants store energy as either starch or as sterols. Sterols are fats. Ergosterols are plant fats (ergo means work). Cholesterol is a type of human fat. Humans also store energy as glycogen. Glycogen is found in muscles and in the liver. How much energy you feel depends on your ability to convert food, and stored energy into work and heat. People who train their bodies to use energy become very efficient at converting it.

School Exams

If you don't  know the answer make it up and hope for the best, is a reasonable approach to exam questions. Here are a couple of creative answers,

"Flirtation makes water fit to drink. It removes particles like grit, sand, dead sheep and canoeists."

As a physiotherapist I like the following:

What is the fibula? "It is a small lie."

Near Misses make the best stories

Yesterday I saw an e mail asking for someone to help lead a Duke of Edinburgh Gold group. Someone else had responded by the time I had cleared the weekend. The leader still invited me to go as it would be great to share the group. It was one of my favourite stretches of white water, the upper river Wye. The Wye and Usk Foundation are a charity that manage the two rivers. They work hard to build the stocks of salmon, trout and coarse fish. I phoned the administrator Angela, to check the access situation. She said that there was a right of navigation below Hay and an access point at Glasbury. From March 15th there was no access above Glasbury. The only exception was if the river level was above the red line on the depth gauge at Erwood. I packed my boat and camping stuff for the 100 mile journey. Early the next morning I phoned the organiser to ask whether he had checked the access situation. It was news to him as he assumed that canoeists had the right to paddle the river. I disagreed and said that I probably would not come. It left me with a dilemna. If we took a group of young people on water that pushed their abilities, what if something happened? Where would we stand with insurance liability? Their parents would show us no sympathy if, for instance, one of them suffered a head injury. The insurance company might claim that we were paddling water that had no rights of access, therefore we were not covered. The leader was prepared to follow his understanding of the Welsh Canoeing Associaton guideline: paddle anyway and be polite to fishermen. What kind of example would we set to the young people? Given all of these questions I decided not to go on two grounds. One is is safety; another is the example that we set to young people. 

Later in the day I thought, well the canoe is on the car so I might as well use it. However there is a snag. None of the rivers that I normally paddle have an access agreement. My wife suggested Derbyshire but I cannot think of anywhere where I could go for a last minute paddle. Over 90% of the rivers in England and Wales are denied to canoeists between March and October. Is there a difference between a quiet paddle on our own and leading a group down water with lots of fun and some risk? I think that there is a difference.

This evening I checked the webcam at Erwood for the river Wye. At 8 am it had been above the gauge; by 12 noon it had dipped below the gauge. Does that mean that having driven 100 miles I could have paddled from 8 am to 12 pm but had to leave the water for the afternoon? No, because canoeists are only allowed on the river between 10 am and 4 pm. The situation for river access is heavily weighted in favour of anglers but note this: the close season for coarse fishing starts on 15th March. That should give us 3 months of uninterrupted paddling until 16th June. It does not, because coarse fish are thought to be spawning & the trout and salmon season has started. I am a fisherman & a canoeist. As a fisherman I find a canoe to be a fantastic way of reaching swims that are not normally accessible. In the winter I cut branches that block the river, remove fishing tackle and trim back nuisance branches. Most of the fishermen in Scotland have a different attitude to those in England and Wales. Paddling once on the Tweed, the river that straddles the border we passed a ghillie and his client. He ran towards me gesticulating wildly after I had shot a natural weir in their swim. I stopped a little puzzled. Seeing that I had a bowsaw in my boat he asked if I could cut a troublesome branch that was sticking up out of the water. Reaching deep down I cut the branch below water level. It would have needed a JCB to remover. Now what disturbed the fish more. The ghillie & his client were so delighted that they showed us a beautiful place to camp in the grounds of a stately home.

Fisherman might rightly argue that they pay good money for sections of river or beats, that allow them to quietly search for the fish. In comparison canoeists pay a nominal sum to a national body. Canoeists might argue that they would respect access agreements if they were fair. In Belgium for instance there is a rule that canoeists paddle between certain times. That keeps the hire companies with their inexperienced groups off the water at key times. 

Coming back to the safety issue. My memory of group canoeing and of Duke of Edinburgh trips is that unless the preparation is done very carefully, anything that could go wrong does go wrong, not just to trainees. Four times I personally have suffered hypothermia. Once I rescued a tipsy sea kayaker who fell out of his boat. The "victim" was rushed off in a Landrover to a warm bath and rehydration. I was left on the beach in my swimming trunks and cagoule at that stage beyond shivering. On two other occasions I was taking part in canoeing assessments as a leader. On one more occasion I had completed the four star assessment run by a hard taskmaster off the coast of the Orkney Islands where we used to live. 

Another experience of things going wrong was on a walking trip. As a gold assessor I took an independent role to the groups. However I made it clear to the supervisor that I was not happy with the route that the gold groups intended to take. It involved a traverse of huge scree slopes the day that snow melted, loosening the rocks & boulders. We comprimised in that I guided the boys group, the girls took a lower level route. Half way through the day I had to find a way down a particularly steep boulder strewn slope. I asked the boys not to follow me if it was too steep. They could not see an alternative route so they followed me. Boulders dislodged from their boots. I saw them flying down and took evasive action. One boulder bounced sideways and struck me on the back of the head. That started the longest fall of my life. I bounced an estimated 350 feet down the mountain in Austria 2000 metres above sea level. Miraculously despite a large gash in my head and knee and extensive grazing I broke no bones. The first aid training instinctively came into play, full body scan, stop the bleeding, reassure the group and call for a helicopter. The boys were great and I made a good recovery even though it took 2 years of living to win back my strength. 

Risk assessment always asks the question, "What if?" What if a young person had been almost killed? What if we had taken them into a situation way beyond their competence? What if the press got hold of the story? What if our insurance did not cover us? 

The experiences have made me cautious about taking risks. Possible litigation is a big issue. Balanced against that we must allow young people to make decisions, push themselves, prove their resources, care for each other and enjoy an adventure with a limited degree of risk. I would value the thoughts of others who have had to face similar circumstances.

Movement

Everything has a twist to it. Beans and climbing plants grow with a twist looking for something to hang onto. Water goes down the plug hole with a whirlpool or vortex. A mother in labour contracts her uterus with a twisting action to squeeze the baby out into this world. The baby emerges in a twisting motion. The fluids in your body also flow with a twisting motion. The craniosacral fluid from your brain flows down your spinal chord in a twisting motion. Your tendons that attach muscles to bones have a twist like a rope. Rope makers have always known that a twisted rope is stronger than the individual collection of strands. Network cables are twisted to cancel out resistance from the electromagnetic field. An electromagnetic field is created when electrons passe through a collection of wires. Some of the strongest muscles in your body, for instance the pectoral muscles, twist their fibres before anchoring to the top of your arm bones. Even your bones have a twist in them. If you look in detail at the neck of the femur you will see a twisted pattern to the layers of bone. Bones develop along lines of stress. A new born baby only needs one proper bony joint, between the base of the skull and the neck. The rest of the bones develop out of cartilage or membrane. Weather systems come over us a huge twisted pattern. They are called cyclonic or anti-cyclonic. In the Northern hemisphere a cyclone rotates counter - clockwise into an area of low pressure. It comes from the word Kuklos (circle) or Kukloma (wheel or coil of a snake). Some of the early symbols show a snake coiled around a stick. To some it is the wheel of life; to others, like in the Mosaic code, it is the curse of death. Deer cannot see above them. That is why when we go hill walking we see lots of deer but the stalkers don't see very many. If they started stalking from the top of the mountains they might see more deer. If you watch deer gathering into a herd in a large open space you will see them forming a spiral. Deer farmers know this so they build their corals to catch the deer in this way. Perhaps sheep farmers should try the same? 

As a boy I was determined to make water go down the plug hole the other way. We did not have central heating so the bath was a welcome soak when the frost decorated the window panes. I noticed as a little boy that water always went down the plug hole in an anti-clockwise manner. I used to stir the water to make it go the other way. It did it, just, but looked uncomfortable. Someone told me that I should try the same experiment in the Southern hemisphere. Perhaps you would let me know which way it goes? Could the same apply to plants?

The origin of this twisted action is DNA itself. DNA is the series of codes that pre-determined organic matter. It is built into proteins that look like doubled coiled helixes. Because your body is made up of DNA the movements in your body will follow the same patterns. 

How can this twisting motion help us? Yoga teachers know that to create strength you need to create opposite and equal forces. By consciously creating opposing rotations you create tremendous strength. Try this - place your hand on your lap, now lift your hand up until your arm is straight, uncomfortable is it not? Now lift your hand twisting it outwards as you lift it upwards. the palm should land up facing the ceiling like a dancer carrying their partner. You create a more graceful and easier movement on the shoulder. Now place your hand on your lap again. This time push the arm back behind your chair. Now push your arm back as if you were giving a waiter a tip or handing over a relay batten. Do you feel the difference? When you lift and create an outward twist you create strength. When you take your arm back with an inward twist you keep your shoulder secure.

The constellations

the Plough used to known as the Bear or the Big Dipper. Scientists call it Ursa Major. The lead star is called alpha UMa. It is 25 times larger than the sun and 86 light years away. That does not mean a lot to me but if I were inside a great big brain I would look for patterns of behaviour in the nerves (or neurons). Perhaps the constellations influence us because they reflect what is going on inside our brains? Perhaps we are living inside the mind of the great architect of the universe?

The moon has a strong influence on the earth and the earth on the moon. The water in the earth is drawn towards the moon then released again as our gravity takes over. The effect is that of great waves called tides. They fill up twice a day. Each tide is a little later every day. Spring tides are larger when the moon is fuller. Neap tides are in between when the moon appears thinner. The moon exerts a pull on our human bodies as well. The menstrual cycle is a lunar cycle of 28 days. we have lots of other tides in our bodies. There is the pulse of our hearts, the rhythm of our breathing, our biorhythms that dictate night and day, our hormonal rhythms and the deep inherent motion of craniosacral fluid in our brains. Hormonal rhythms have both daily and monthly cycles. For instance some men's steroid hormones are most active early in the morning when their bodies are relaxed. Some women's hormones are most active just before a period starts. The craniosacral fluid bathes and nourishes our brains and nervous system. Imagine that the brain weighs about 1500 gm. Suspend the brain in craniosacral fluid; the nett weight now becomes 50 gm. A blow on the head can cause the brain to gently oscillate or rock from side to side inside your head. That might give you a recurring nauseous headache. A craniosacral therapist can work with the gentle rhythms to bring your brain back to a still point. 

Moon & Stars

Sleeping under the stars is a great experience. The constellation that I see the most  is the Plough. Some races call it the Bear or the Big Dipper. Scientists call it Ursa Major. the Head of the 'Plough is a star called alpha UMa. It is about 25 times larger than the sun and 86 light years away. None of that means very much to me. Naming things helps us to place them in context. Perhaps we feel a sense of ownership by naming something? Not many of us use a plough so what do the constellations mean to us now? Perhaps they are there to teach us something about the human brain. For instance there are 300 million connections of nerves between the right and left brain. The galaxies are groups of millions of star with connections between them. Perhaps the constellations represent patterns of nerve (or neuron) behaviour in our brains?