The juniors doctors aren’t striking for themselves.

This is a cross post from my Huffington Post column. Feel free to read it there instead…

This week, the junior doctors are going on strike. Again.

Most of the people reading this won’t know why. All these professionals, who claim to be committed to caring for some of the most vulnerable in our society, why would they refuse to turn up to work?

The government has done its best to confuse the issue. Some of the more biased newspapers have followed suit. There are headlines claiming that junior doctors are greedy, that they’ve been offered a 11% pay rise, but they want more. The general theme of the spin has been simple: the junior doctors are looking out for themselves.

I’d like to let you in on a little secret. The junior doctors aren’t striking for themselves. There’s actually lots of things they aren’t striking about:

moneyIt’s not about money. Sure, I think doctors would be right to be upset about the new contract, which – despite government claims of a “pay rise” offer – actually threatens huge cuts in pay. Mr Hunt has offered to increase the “base rate” of pay by 11%, but refuses to say what will happen to the “banding” that the vast majority of trainees also receive.

As a personal example, my pay is made from the base rate plus a 45% banding rate. I may lose my entire banding rate. Even with an 11% increase in base pay, that’s a drop of nearly 25% in my annual salary. How would you feel if your employer announced a non negotiable drop in your salary? Great video asking members of the public the same question here…


It’s not about working long hours.
Doctors are used to working long hours, we know its par for the course. We actually work more hours in our contracts than most professions, 48 hours rather than the more common 37.5 or 40. We understand that – despite the Government’s blindness to the fact – the NHS runs a 24 hour service, and we are all part of providing that.

What scares us is the removal of current safeguards: at the moment, if a hospital breaks the rules and forces juniors to work extra hours, there is a significant financial penalty. This happens fairly often. In the new contract, the hospital may just be asked to enforce the limits, with no penalty. How would you feel if your employer decided to start ignoring the time limits on your contract?

It’s not about weekends. Junior doctor already work weekends. I’m a GP trainee, but I’m still working 2 of the next 3 weekends. Do I get days off either side? Nope. I only have one day off in the next 18. Its going to be hard work!

The government keeps talking about the risk of being in hospital over a weekend. Whilst this has been extrapolated from statistics that prove nothing of the sort, it does mean there is a push to further jeopardise our junior doctors’ already limited opportunity for normal social lives. How would you feel if you were told Saturday is now the same as Monday morning? How would you balance family, friends, childcare…

Money, long hours, weekends. These may seem like totally reasonable causes for a strike. But there are even more important issues at stake…

It’s about safety. Junior doctors are on the front lines. We know how understaffed A&E is; we see how thin on the ground clinical cover is during hospital on calls, and how GP surgeries are fighting against a sinking ship of paperwork, appointments and shrinking finances.

We know that patients are suffering, and, currently, junior doctors are working out of goodwill to hold up the creaking system. Junior doctors logged more than 10,000 hours of unpaid overtime during one 5 day period in October. Push the junior doctors harder? Goodwill gives way to exhaustion. Do you want a tired, unhappy doctor?

It’s about making sure we have enough doctors. The government scares us. They don’t value junior doctors, and they don’t see that junior doctors become senior doctors.

I posted previously about how general practice and psychiatry training schemes are running half empty. Five years ago, over 71% of newly qualified doctors joined training schemes. Last year? 52%. With record numbers of doctors leaving to work overseas, Jeremy Hunt is causing an exodus of professionals we desperately need.

juniordoctorcontractIt’s about saving the NHS. The NHS is at risk of being terminally ill. It needs treatment, or its going to die. Trust us – doctors know about this sort of thing.

I’ll be brutally honest here. If the NHS fails, I’ll be okay.

Sounds cocky, but its probably true. In fact, I’ll probably earn more than I do currently. I’ll be able to afford health insurance premiums for my family, for myself. I’ll be fine.

If the NHS fails, Jeremy Hunt will definitely be okay. More than okay. He will join a private healthcare company board, and earn vast bonuses in a climate of charging people for care they currently receive for free.

If the NHS fails, there’s a big group of people that will not be okay. It’s not doctors. It’s not irritating politicians. It’s the poor. 

There will be hard working people at the bottom choosing between healthcare… and food.
People getting cancer, then losing their homes.
Patients deciding its better to live in depression than in debt.
Children dying because they don’t have parents with enough money to afford treatment.

And that’s not a United Kingdom I’m willing to accept.

Junior doctors aren’t striking for themselves. They are striking for all of us. Support them. #notsafenotfair

Review: Snood

Me in a snood, looking excitedIt’s reached that point in the year where its getting horribly cold. Pretty enough on a Christmas card, much less appetising when its 1 degree outside, and you are heading off to work on the bike at 7am.

This year, I treated myself to a snood. I would recommend it.

It feels like still having the duvet wrapped around you, even as you brave the icy streets. The one I have even has airholes for your mouth, so you can breath through it without feeling like you are suffocating.

I do whole-heartedly advise you to splash out on one, if you do any winter cycling. However, I have a long history of complaining about cycling, so it would be remiss of me not to complain just a little bit…

Problems with a snood:

Reduced peripheral vision

It hardly seems much, but the snood overlaps the edge of my face by around 1cm. It’s amazing how much this affects my view of cars, especially when peering over my shoulder for overtakers.

If possible, try to peel back the edges just parallel with your eyes, since the feeling of being cosy is definitely diminished a bit by being run over by a lorry.

The terrors of snood condensationCondensation

As soon as you stop moving, the warmth of your body and the steam from your breathing rapidly cloud your vision.

Once you set off again, the flow of cold air sorts it out, but I have gone almost completely blind at traffic lights a few times!

Looking like a serial killer.

I have not problem with looking like an idiot – see lycra trousers – but there’s something a little bit bank-robber-esque about covering ones mouth and nose. More than a few people have commented on my sinister appearance.

 

Problems aside, I love my snood, and I wish you all well in your snooding over the rest of this winter!
Have an emotional snood story? Why not share it below…

 

‘Will I Be Able to See You Next Time?’

This is a cross post from my Huffington Post column. Feel free to read it there instead…

Or… “Why patients miss having a regular doctor, and how the new junior doctor contract risks making the situation worse.”

Despite being nearly thirty, married for nearly a decade, with two children, I am a “junior” doctor. Technically, I am a GP Registrar. It’s written on my door, and none of my patients understand what it means. I often get the joke “Does that mean you can marry us after you’ve listened to my chest?”.

2016-01-11-1452522367-1128787-gpregistrar.jpg

I explain that “registrar” means that I am a trainee GP, with one year left before I’m a fully qualified GP.

They always follow this up with the same question: “Does that mean that you are staying here long term…” There’s always a look of hope in their eyes; that I can be a familiar face who knows them; a traditional family GP; a doctor, and a friend.

General practice has changed dramatically over the last 20 years. Practices were commonly run by one or two partners. My training practice has more than 10 partners. Getting an appointment is a scramble of ringing continuously at 8am – hoping to get lucky today – and there’s no guarantee you will see the same doctor each time.

I know that patients are suffering from this lack of continuity: because they complain to me about it. It is no exaggeration to say that 5 patients each day mention how hard it is to get an appointment. Sometimes, on a day when I’m frankly fed up with nodding defeatedly and apologising, I explain why things are changing…

“Why is it so hard for me to get an appointment, doctor?”
You see, Mrs Jones, these days people visit their doctor more often than they used to.

In 1995, on average, a patient would see their GP 3.9 times per year. In 2008, this had risen to 5.5 times. If that trend has continued, in an average practice of 9,000 patients, that would mean a practice will need 22,153 more appointments in 2016 than they did in 1995.

A GP will see around 40 patients a day – although some will see many, many more than this. To meet people’s desire for seeing a GP, every practice would need 3 new GPs. This is the reason nurses have become so vital in GP practices; they help to share the burden of extra appointments.

“Why don’t we just hire more GPs, doctor?”
Unfortunately, Mrs Jones, there aren’t as many GPs as there used to be.

When I applied, 4 years ago, GP training was relatively popular, and there were 30 trainees in my year, locally. This year? We have 7. In London, the problem is less extreme, but it has been devastating across the rest of the country. My colleagues in Chesterfield have just 12 trainees; Lincoln, just 4. And Bassetlaw? Bassetlaw have no new GPs being trained this year. Overall, 30% of General Practice training posts remain unfilled in the UK.

To make the problem worse, GPs are retiring much faster than replacements are being trained. In a recent survey, more than a third of all the GPs in the country plan to retire in the next 5 years – and many others plan to go part time!

Just to keep numbers stable, we would need to graduate 4,000 new GPs a year. This year? Only 2,732 new trainees started GP VTS training, a figure that’s reducing annually. We are heading for an absolute crisis, a shortfall of tens of thousands of GPs across the country.

“Oh dear doctor. What can be done?”
Its a difficult problem Mrs Jones, and no one really has an answer. But there are some simple things that need to be addressed:

We need more medical students. At the moment, there are only 6,800 places in medical schools each year in the UK. In 2007… there were 7,300! Why, oh why, is that number going down? We would need 58% of those students to graduate and become GPs in order to address the crisis that is happening. That would leave the rest of the health service with just 2,800 a year – or just 2.5 new doctors annually for each of our 1069 hospital sites.

We need more encouragement to junior doctors. Jeremy Hunt has tried to unilaterally impose a wildly unpopular new junior doctor contract. There are fears of increased normal work hours, uncertainty about pay cuts and, most worryingly, a very forceful attitude that is leading to a strike tomorrow by junior doctors. Right now, junior doctors need to decide whether to apply for specialty training: primary care is going to see even worse recruitment unless the uncertainty is resolved quickly and positively.

“Is there anything else we can do, doctor?”
Well, Mrs Jones, I’m glad you asked that…

We need to use our brains. The patient before you attended because he had a spot on his nose. Since yesterday. Did he really need to see me? When I work in A&E, I regularly see people who have mild sunburn. I see patients who’ve had a sore throat for 3 days and saw their GP earlier today, but want a second opinion. I’ve seen parents at 9pm because their 2 year old hasn’t gone to sleep yet.

We seem to be afraid to say it, but the NHS needs patients to take some responsibility for minor ailments. Every doctor you will see has a hundred stories about patients attending needlessly. We need a prescription of that very British quality: good old common sense.

If we are going to save the NHS, we need to work together, doctors and nurses, patients and politicians. Its our health service, and its up to us to keep it healthy!

Now, Mrs Jones, let’s get back to you. How can I help you today?
“Well you see doctor, my nose has been running since Monday. I went to the Urgent Care Centre last night, but its not better yet. I thought maybe you could give me some antibiotics…”

Looking back at 2015

I’ve started to write this on December 30th, sitting on a train in Lincolnshire at 7:30am, on my way to work. It’s still completely dark outside, and half the country is still on holiday. I feel slightly jarred, like the alarm clock went off, but no one else has had to get up.

Feeling disjointed is somewhat appropriate – it aids my reflections on the last 12 months.

2015 has been a year of experiences. We’ve lived in three continents; I’ve had an epiphany in healthy living, exercise & weight loss; my medical skills, for the first time, feel formed; and, as a family, we’ve started to have some clarity about how we want to live.

Home

This year has shaken my understanding of home. In many ways, “home” still means “Epping” to me. My parents live there, I grew up there – the streets feel familiar, comfortable and safe.

“Home” is any place that has touched your heart.
Leaving doesn’t stop that.

But in a much more practical way, our lovely house on Woodthorpe Avenue in Boston is home. It’s the place we can best exhale. We can kick off our shoes, settle comfortably onto a high chair on the breakfast bar, and watch the chickens, dogs and children flap around in the garden.

YEditedGroupPhotoet Restore Church, full of our friends, is also home. We seek the heavenly realms together, we drink moderately bad cups of tea together and we laugh about the projector turning everything purple again. This whole year has been a mess of realising that “Home” is any place that has touched your heart. Leaving doesn’t stop that.

If you’ve read Harry Potter, there’s a concept where Voldemort tears apart his soul and stores it into objects that have emotional value to him. That’s not quite how I’m feeling – home is not a horcrux – but there’s no doubt that putting roots down involves investing a part of oneself.

Now I’m coming home
I’m coming home to you again
I hope things haven’t changed
New Found Glory

Many homes

This year, “home” has been Mseleni hospital in South Africa. It’s been Sea Point in Cape Town. Jackson in Missisippi. Alterna community and Koinonia Farm in Georgia. QC Family Tree in North Carolina. Grace & Main in Virginia. The Simple Way and Inner Change in Philadelphia. A little bit of us still lives in the homeless shelters of the Catholic Worker movement in New York City

IMGP3158

Returning to the UK has brought us face to face with the contradiction of “home”: it means a state that is temporary and yet, somehow, extraordinarily enduring.

Our idea of home is shaped by the setting and society we live in. This year it’s meant our children sitting naked, in dusty mud, next to the road. It’s meant seeing giraffes on the drive to the shops. Getting excited about a visit to the town café that pretty much only sells chips. Friends who have never had – and will never have – the life opportunities that I take for granted. Patients who have never slept in a bed, and thus don’t know how to sleep when they are admitted to hospital. Evenings without a TV, without electricity, without water, spent cooking pizza on a wood fire, and laughing. So much laughing.

John M PerkinsAnd it’s meant eating sweet potato wedges with John M Perkins. Jugs and jugs of sweet tea. Contemplative silence in LaGrange, and board games late into the night. Cooking pizza for the entire residency of Koinonia farm. Shaving heads and eating chocolate.

In Charlotte, it meant reincarnation through recycling, through gardening, through relationship, through reimagining an unloved locality. And a little girl doing a poo in a public water fountain. It’s meant permaculture, community gardens, ultra thick milkshakes and sitting on porches in Danville. In Philadelphia it meant pizza (home == pizza), and gunshots, and an understanding that all of us need our home to be sustainable. New York meant $1 pizza slices, enjoying glorious mess surrounded by healing people, and my first ever visit to a board game cafe!

Returning to the UK has brought us face to face with the contradiction of “home”: it means a state that is temporary and yet, somehow, extraordinarily enduring. In common with many others who have crossed cultures, there will always be a discomfort in us, even in situations that have been familiar to us for years.

wp-1451644198031.pngHealth

Alongside learning more about the mental framework we use to fit into the world, I’ve also come to terms with my physical existence here.

For the first time, I can say I genuinely love exercise. I even hate running a bit less!

Sure, 2013 was the year I decided to start losing weight. And 2014 was the year that I realised healthy eating is going to be a life long commitment. But 2015 was the year I started to understand the link between health and happiness.

For the first time, I can say I genuinely love exercise – I even hate running a bit less! I’m more aware than ever how rubbish I feel after an episode of gluttony – Ben & Jerry’s, I’m talking to you here – and I’m starting to have the self control to just not go down that path.

I’ve hammered out a few personal milestones, such as my first Triathlon, my first sub 25 minute 5k, and consistently dropping below 70kg. I’ve also managed sustained periods of exercise, accountablity and weight management – see my blog series: six kilos in six weeks.

Medicine

babychris-800x817Working in South Africa was a privilege – a scary one at points. Having a baby named after me was a highlight, as was being signed off as competent to perform caesarian sections without supervision. It was also the first time I’ve ever worked with a degree of autonomy, and the only time I’ve been at a grass-roots level in the midst of the community I live. Being a doctor… at home.

When I was 17, I made a decision to apply to medical school. I’m now 29.

As I look towards the end of my training, I know that the only way I’m going to be able to sustain the enthusiasm and purpose I need is for my career to have integrity. When I was 17, I made a decision to apply to medical school. I’m now 29. It’s only at the end of this year that I will no longer be on a training scheme. I’ll actually be an adult, able to apply for a job where I get told in advance where I’ll be working, what hours I’ll do and how much I’ll be paid! I’ll be able to raise concerns and suggestions for improvement without putting my entire career at risk! Brill.

In 8 months, I’ll be able to choose my hours, select my workplace and start to explore my sense of vocational calling. Medicine needs to line up with our life goals, my heart and my sense of home. Who knows exactly what shape that will take, but its an exciting prospect.

Next

The bible is full of phrases like this:

“And calling the crowd to him with his disciples, he said to them, “If anyone would come after me, let him deny himself and take up his cross and follow me. For whoever would save his life will lose it, but whoever loses his life for my sake and the gospel’s will save it.”
Mark 8:34-35

When I read a passage like that, I think: “I’m not really doing that”. I’m not saying that I believe God calls us all to martyrdom; but I do believe a luke-warm 50% lifestyle simply doesn’t cut the mustard.

SAM_0952I’ve become certain of one thing this year: we desire to live out the gospel. Really live it. Not half live it, tacking on a bit of grace and love to a plastic Western lifestyle, but LIVE it. Our hope is to explore, sacrifice, pray and practice until “The Kingdom of Heaven is near” starts to resonate with us.

“Home” this year has meant common threads: friends, community, adoption, Jesus, vegetarianism, pizza, board games, fitness, laughter… shared values in others that reflect the hope we have for this life.

One of our mentors, Colin, recently said to us “You need to find your tribe“. As we continue to explore what and where “home” is for us, I think God will make it clear to us who our tribe is. Maybe it’ll be through pulling on some of those common threads, and more importantly, following back to the heart behind them, one that says “My God; my neighbour; our life together.”

Thanks for reading this, and thank you to everyone who has been part of home for us this year. Have a great 2016!

PS. I leave you with a song that is very much on the same page as us…

Board Gaming in December!

I love spending time with people, and I love crushing them in games of skill, humour and imagination. Hence why I’m a proud member of…

boardgamesgroupfacebookBoston Board Games group

Meeting on sporadic nights in and around Boston, we get to try out various exciting new games. All games are fully explained by nerds experienced board gamers, and beginners are welcome.

Go on… join the group on Facebook!

We’ve play games like Lords of War, 6nimmt!, Carcassone, Coup, 7 Wonders, Dead of Winter, Android: Netrunner, Between Two Cities, and Discworld: Ankh Morpork. In other words: no Monopoly, just fun new table based explosions of co-operation and competition.

Last night…

My wife was away, so I sneaked in a cheeky board game session. Given that if something is worth doing, it’s worth blogging about…

Betrayal at House on the Hill

BetrayalHouseHillBetrayal at House on the Hill is a tile based game where you explore the three floors of a house with your companions. The tiles are random, and only appear as you walk through a doorway from a previous tile, so there’s a nearly limitless range of possibilities for the layout of the house.

The premise of the game? You explore the house together until, at some unpredictable point, something horrible happens.

At that point, one of you is sent out of the room with a page of new rules to read, and the remaining explorers have some other rules to absorb.

12465364_10154293656351111_814896827_oSuddenly, the game gains a combative game, with one player trying to bring an evil ghost to life, or summon a monster, or releasing a swarm of vampire bats (no spoilers)… and everyone else trying to stop them. The re-playability is great, since every mansion will be totally different, and there are 50 unique scenarios, decided by where and how the horror is triggered.

Our game was a lot of fun; I became the traitor, and rather enjoyed hunting down James & Jamie, then hacking them up with an axe. They managed to gain control of the horror, but didn’t have time to finish their final objective before I caught up with them…

boxLevel 7: [Escape]

Level 7: [Escape] is one of my favourite games, and I’m always keen to sneak it out of the cupboard. Again, there’s no board, just a steadily expanding map as you panic your way around the level, picking up new room tiles.

Cursed with a slightly complex rulebook, its strength lies in its theme – you are attempting to escape a crazy Government laboratory, hiding from the guards and aliens, occasionally attempting to use them against one another to held you escape.

12465688_10154293656651111_348408277_oYour abilities are shaped by your Adrenaline level. Feeling calm and collected? Your intelligence increases. Heart racing and agitated? Your strength jumps up. The only downside… you run out of adrenaline card, you die. Too much adrenaline? The aliens get super attracted to you and start spawning all over the place.

Each mission steadily unfolds, but there comes a crunch point: Lockdown kicks in, leaving you a set number of turns to escape before the doors are sealed… forever!

Our mission involved setting the aliens on the guards, opening a route for us to reach the elevator. Our plan was beset by problems immediately, when a clone attacked James on his first turn, and knocked me out on mine. Eventually, the aliens did kill all the guards… but then James and myself found ourselves trapped and pulverised by a huge Hybrid.

This gave Jamie just enough time to boost his adrenaline into overdrive, shove the Hybrid out the way and sprint to the elevator, moments before it sealed shut… leaving two of us alone with the aliens. His innate untrustworthiness put him in good stead for our next game…

Coup

Despite it being a stalwart of the gaming scene for several years, I’ve never managed to find myself at a table with Coup, so I was happy that James brought it.

A microgame, lasting just a few minutes per round, your aim is to knock out the other players. Each player gets two cards representing characters in the royal court, such as Duke, or Ambassador. Each had different skill, but the key? You don’t know what cards someone has.

So a player with the Captain can say “I’m going to take your money now”, and you have three options. Lose the money, say “I don’t think you have the Captain”, or pretend to have a cards that lets you block the theft.

It instantly develops into a game of bluffs and challenges: the reward, victory; the stakes, failure. We played 5 or 6 rounds, and whilst Jamie continued to, frankly, be really evil, it was a great end to the evening…

That’s all! Feel free to drop a comment below, or check out the post from November

New phone? Try my favourite Android apps…

Found a new Android smartphone under the tree this year? Why not try a few of my favourites…

I apologise: I don’t usually write stuff that’s so click-baity. However, I was struck by how useful one of my apps was yesterday, so I thought I’d recommend 6 of my faves for anyone unwrapping a new Android phone this year.

By the way, I don’t get any money for sharing this stuff, so you don’t need to worry about me being biased: I just love efficient things!

mightytextMightyText

Site: https://mightytext.net
Price: Free, premium options (which I don’t use)

Manage your texts from any browser on any computer.

This fantastic app is something I genuinely don’t understand how people cope without. So much easier than tapping out texts on a little touch screen, you can access all your text messages, respond to replies and generally manage that whole world of communication way more efficiently.

It even notifies you on your desktop PC when you get new texts. My phone spends all day in my coat pocket, whilst I’m in continuous contact on my computer throughout the work day.

smsbackupSMS Backup+

Site: SMS Backup + on Google Play
Price: Free, donate option for 93p, which you should do!

Keeps a permanent backup of call logs and texts in Gmail.

This bad boy has saved me hours of hunting down tit tats of information. Every single text I’ve recieved since 2013 is store in a folder in my gmail account, linked to the name of the Google contact in my address book.

You install it, you forget about it, and then when you are visiting that friend you saw two years ago and need his postcode again… you already have it! Well worth making a donation for.

4.-MyFitnessPal-Android-iOS-Windows-Phone-FreeMyFitnessPal

Site: MyFitnessPal.com
Price: Free.

The most efficient way to track calories and lose weight.

I suspect I would still be fat if MFP did not exist. As any of my blog readers will know, I’ve managed to get on top of health and fitness pretty heavily over the last year. A cornerstone of that has been the simple truth: you need to eat less calories than you use in order to lose weight.

Calorie tracking is a bit tedious, but MFP manages to minimise that. Using it, I estimate that I can keep track of 98% of my daily calorific intake with around 4 minutes work a day. This seems to have a reasonable benefit-to-effort ratio.

I recommend it purely because its got the largest database of any of the calorie tracker apps. The larger the database, the more likely you don’t have to try any work out calorific value from raw ingredients, which is possible but time costly.

Week 5 weight graphLibra

Site: Libra on Google Play
Price: Free, donate option for £2.50 which I recommend!

A nice graph with some simple stats for your daily weights

I weigh myself every day, and recommend it for my patients trying to lose weight. It keeps you motivated (and guilty), and gives you a more accurate picture of your weight over a week than a single measurement. If you’ve ever read The Hacker’s Diet, this app is for you…

Libra is dead easy to use, gives you nice graphs, with a great weighted average so you get a useful measure of your overall direction of travel. It also works about a few neat stats, such as estimated calorie deficit based on your weight loss: I’ve previously found this to exactly correlate with my diet and weights.

Google KeepGoogle Keep

Site: Keep.Google.com
Price: Free

Simple post-it note app with effortless sync to all your devices.

You know when you need to remember to buy milk? Or you have a list of dates someone told you to keep free? Or a not very important password that you occasionally need? Google Keep is there for that data.

Its instant to use, works great on Android and on the web, and gets the job done. Does it do everything you could ever possibly need? No. Does it do a reliable, well designed job for you with no questions asked? Yup.

Pocket Casts

pocketcastsSite: Shiftyjelly.com/pocketcasts
Price: £2.49

The best podcast app out there, makes listening and hunting for new ones a breeze.

My phone died the other day, so I picked up my wife’s phone, logged into Pocket Casts, and was listening at the point I’d been interupted about 3 minutes later. That alone explains how great this app is.

For discovering new podcasts, listening to old favourites, and for doing all the hard work for you, with automatic downloads, and auto-deletion, I’ve not tried anything else that comes close.

Try it out, and find those boring runs, drives and cycle rides way more interesting. Eventually realise you’ve listened to 30 hours of Dungeons and Dragons role play in the course of a month, and wonder if there’s something wrong with your life…

That’s all for now… Got any apps you’d recommend? I’m all ears… leave a comment below!

Six kilos in six weeks: The end

wpid-wp-1447062912089.jpgRead the first post in this series here – Six kilos in six weeks: finishing what I started.
Just a warning, I’m going to be talking about weight loss, dieting and body image. If you struggle with your relationship with food, or have any self image difficulties, you may find it hard to read.

And the grand result is…

endomondoI lost 4.1kg. I feel pretty good about myself. This whole series was never really about weight loss “numbers”; it was about getting healthier. My achievements include:

Isn’t the maths wrong?

Lots of people enjoy getting their knickers in a twist about calories. Google “calorie myth”, and find a million different websites arguing about the idea that calorie deficit is the most important part of weight loss.

Maintaining a decent calorie deficit led to a decent amount of weight loss.

Happily, we can test the theory:

weightloss week 6 highlightCalorie Deficit

During this challenge, based on my approximations, I’ve run up a calorie deficit of around 36,500 calories. That means, I’ve eaten around 36,500 kcal less of food than I’ve burnt by living, breathing and exercise.

Weight loss

According to my calculations, each 7,000 should equate to around a kilo of fat loss. That would mean I should have lost around 5.2kg. I’ve lost 4.1… is the maths wrong?

Where did that 1.1kg go? 

In the last 6 weeks, I’ve done just under 32 hours of exercise. I think its a fair assessment to say that I’ve probably put on at least 1.1kg of muscle.

Conclusion

I’m pretty confident in saying that maintaining a decent calorie deficit led to a decent amount of weight loss.

I could have eaten healthier foods, sure, but just sticking to a low calorie diet meant I ate way more green veg, because if you eat chocolate, you end up hungry. And the exact mix of foods you eat doesn’t have much impact on weight loss.

The diet also encouraged me to exercise. You go for a run, you get to eat more nice things. The evidence is pretty clear that physical exercise is really good for you. Its healthier to eat a bit of rubbish, and burn it off in exercise than to be slim, but unfit.

Macros!

The other side of the coin regarding calories is what they are made from. My key discovery over these 6 weeks: meeting macro targets and calorie targets at the same time is hard work, and likely not very helpful.

I have uniformly found that, for me, not bothering to keep track = weight gain.

Its hard enough work keeping track of all your calories, and comparing one option with another. When also trying to add in proteins, fats and carbs, it becomes much harder to have confidence about any single option:

For example, what’s better, an omelette, or two sausages? It can become a little paralysing having to always think “well, how much fat, and carbs, and protein, and calories do I have left today?”

Anything that makes keeping track of what you eat arduous increases the chance you won’t bother. I have uniformly found that, for me, not bothering to keep track = weight gain.

How to effectively manage my food intake to lose weight?

Therefore, my advice to fellow weight loss devotees? Keep track of calories.

If you are doing a fair amount of exercise, you may want to also try to hit a 0.8g of protein per kilogram of bodyweight target. Let the fats and carbs take care of themselves, allow your decision on eating something go like this:

  1. Do I have enough calories left for this today? !If not, you can’t have it!
  2. Will this fill me up? Then you realise the two sausages, mushrooms and huge pile of broccoli are probably a better option than the single cookie.
  3. Which has more protein? So you look at the lentil and tomato bake, and realise the chickpea omelette might be the more effective option. You soon also realise the protein heavier option will likely be more filling anyway, so you stop at point 2 before ever reaching this step.

Changes, changes, changes.

weight loss over 6 weeks

Above is the whole catalogue of weekly pictures. I’ve been aiming to maintain at around 67kg until after Christmas, at which point I’m going to hit myself with a range of new goals.

Shout out thanks to Jon Smith for nagging me, and texting me daily to tell me to “put down the butter dish and walk away”. Check out his ace 5K running app at RunwithKick.com

Results

These were all updated live from a central database, so feel free to check back daily for updates…

my other sites

Names Not Numbers charity - because individuals matter! MedRevise - free medicine revision for student doctors When Will I Be Sober? An alcohol sobriety calculator. Plenty of Room - The Lowry family and life.

board games

Cheap Ass Games - Inexpensive and Wonderful Tabletop Games! Cool Mini Or Not!