Steele some time with Dr Chris
He’s a regular on ITV’s This Morning – so regular he’s been on the sofa for 23 years and is totally on the ball when it comes to the medical issues that affect his thousands of viewers…
He may look like a friendly uncle with a twinkly smile, but Dr Chris Steele has the drive and vision that has revolutionised the way medical matters are discussed on television. Single-handedly he has dragged the health issues most people are afraid to talk about, right out into the open. Take this; he and the This Morning team were the first to show women first-hand how they should be examining their breasts to look for breast cancer. He pushed hard and eventually won the case with the programme producers to have a man standing in the nude examining his own testicles, again to look for the signs of cancer. Since then the programme has shown a live smear test and rectal examination. And all before lunch!
‘That’s what I love about This Morning,’ he told at home: Ask the Doctor. ‘I am able to educate 1.6 million people about medical issues – that’s a big platform and I take it very seriously.’
Dr Chris’ passion about health concerns has led to him being taken to court because he passionately believed that doctors should be able to prescribe nicotine replacement products. From his experience and research he knew that the products give smokers the best chance of giving up. Although he lost money, he won the case. Dr Chris was proved right and now nicotine replacement products are prescribed by GPs in surgeries nationwide and have helped millions of people to give up the evil weed. And recently, he presented a petition to Downing Street to bring down the age that women should have their first smear test from 25 to 20. He’s not been successful but you get the feeling he won’t give up on that one. Or indeed, any issue he feels strongly about.
And that passion is why Dr Chris has lasted so long on the magazine programme, This Morning – some 23 years this year – which has seen several presenter changes, but the well-loved doc from the north east remaining the same. With 38 years as a GP, four grown-up children and a range of medical problems himself, from heart problems to coeliac disease, Dr Chris knows what he’s talking about. So what does he think about the burning medical issues that directly affect you?
Q A massive study recently suggested that most people around the globe with high cholesterol are not getting the treatment they need. High levels of the blood fat are linked with cardiovascular disease, the world’s biggest killer. What’s your opinion – are people here in the UK not getting the drug treatment they need for it?
A ‘In the UK, 60% of the adult population have high cholesterol. That means their reading is over five millimoles per litre of blood and the aim of drug treatment is to get it down to under five. High cholesterol is the single biggest risk factor for heart attack. The problem with this condition is that you don’t know if you’ve got it because there are no symptoms. That’s why I always say how important it is to ‘know your numbers’. That is your cholesterol, your blood pressure – most people with high blood pressure do not have symptoms either – and your sugar levels, because high sugar levels are linked with diabetes. Pharmacists can carry out the tests or you can make an appointment with the nurse at your GP surgery. If your numbers are high, you will be referred to your doctor for further tests.
‘Treatment for high cholesterol is usually diet-related to begin with. You will be told to reduce your salt and saturated fat – that’s fat that is solid at room temperature, like butter and cheese and fat on meat. People think you need to stop eating eggs but there is no connection between eating eggs and high cholesterol – you can eat two a day with no ill effects.
‘The simple way to help people out with fat content in food is to check the label and to not eat any food that has a total fat content of over 3%. Less than that is fine. If you do reduce the cholesterol in your diet you will lose weight, too. The other way to lower your cholesterol level is exercise and that doesn’t mean rushing to the gym. Try going out for a walk every day for just 15 minutes. Remember you will have to make the return journey and that immediately makes the walk 30 minutes in total. Do it every day or as often as you can and it will help you lose weight, and you can start to walk further and faster as time goes on. By dropping just one point of cholesterol, you reduce your risk of heart attack by 22%.
‘If diet and exercise don’t help to bring your cholesterol level down then you will be put on statins, which are very effective. Whether or not enough people are being treated with these drugs in the UK, I am not sure. But you have to remember that statins are brilliant at bringing down cholesterol. However, like most drugs, there are side effects. With statins, these include muscle weakness and an effect on the memory. So, if the cholesterol is successfully being brought down through diet and exercise then there is no need for medication. And prescribing statins to all people over the age of 40 which has been proposed, whether or not they have high cholesterol, is not in my opinion the right way forward because of the side effects I mentioned.’
Q Swine flu is still dominating the headlines. Do you think healthy children under five years should be vaccinated, even though this winter the vaccination was not offered to this group?
A ‘I do think it should be offered in the future because swine flu does kill babies and young children, but it is seasonal so we are not seeing many cases right now. Come next autumn, it is likely there will be a campaign to bring the vaccination back for this group because there have been some deaths. But we will have to wait and see how the flu virus manifests itself – there might be a new strain and viruses do evolve and mutate, which means we may need a different vaccine by then.’
Q The proposed changes to the NHS in the Health and Social Care Bill includes plans for all 151 primary care trusts and strategic health authorities to be disbanded. GPs are being given much more responsibility for spending their budget. How will this affect GPs and more importantly, us patients?
A ‘I am glad I have left! I’ve been a GP since 1969 and I quit four years ago because I could not keep all the balls in the air, with all my media work I do as well. The way I worked as a family doctor included doing weekend visits – night calls and so on – that way you got to know your patients very well. But then it all became about targets, making sure you vaccinated children and did smears for a certain number of people. If you reached the targets, you were given money. It was a form of bribery and it went against the grain for me.
‘Now GPs are going to be responsible for huge budgets – some will settle into that very well, but most GPs are clinicians and not experts in budgeting and fund managing. They will have to appoint financial managers. I suppose at least that will mean the GPs will be making financial decisions at the coalface. But to see GP practices change so drastically twice in under eight years, it is just too radical. I don’t know how it will affect patients, but if there is one GP in the practice spending their time dealing with management issues then they will not be seeing patients so much – and that in itself will be difficult.’
Q Bowel cancer is an issue close to your heart – what are you doing to increase awareness?
A ‘It’s the third most common cancer in the UK but in the early stages of bowel cancer, you don’t know if you’ve got it. A new cancer that is growing in the bowel will cause minute spots of blood that can be detected in poo, but you won’t be able to see it. That’s why an NHS Bowel Screening Programme has been set up, which involves a fecal occult blood test (FOBT) being sent to every person aged between 60-75, which they can do in their own home and return for analysis.
‘I am heading up a campaign set up by Beating Bowel Cancer called the 1, 2, 3 campaign, which shows you exactly how to do the test. What you have to do is scoop a sample of faeces onto the stick provided and then scrape it on to a bit of card. But people are getting the tests and thinking how do I get the poo onto the stick when it’s floating in the loo? The campaign explains to people how to carry out the test, by suggesting they take the poo straight off the loo paper. Sounds horrible, but it’s important to do the test because if bowel cancer is detected early enough and treatment started straight away, the prognosis is very good. For more details, visit www.beatingbowelcancer.org.’
Q At least one in four people experience a mental health problem at some point in their lives, and mental ill health represents up to 23% of the total burden of ill health in the UK – the largest single cause of illness. The government is now launching its No Health Without Mental Health strategy. What do you think needs to be done to help people manage mental health problems, particularly stress?
A ‘It is a massive problem and there is still a huge stigma attached to it. I have suffered from episodes of depression myself and many people see it as a sign of weakness, telling you to pull yourself together and get on with it. It is even more difficult for men to seek help because they are not as used to going to their GP as women are, who have to go throughout their lives for smear tests, during pregnancy, and when they have babies, for example. Men, on the other hand, don’t have that regular contact so they are not used to going, and if they have mental health problems they simply won’t go to their doctor and will try and cope. That’s why I’ve always been open about my own depression – I am on anti-depressants for life but I am not embarrassed or ashamed of that – it is an illness.
‘I’m glad the government is going to invest money into mental health because the one solution that does really work is cognitive behavioural therapy (CBT). This approach has been shown to be very effective and should be more readily available on the NHS. There is a four- to six-month wait at the moment to have CBT, and when you have depression, one day is a long time. That’s why you are much more likely to be given medication which you can start immediately. But ideally a combination of the two would give better results for people suffering from depression – and much more quickly.’
Q With British women the most overweight in Western Europe, what do you think needs to be done about the obesity epidemic? And if an overweight or obese person came to you and asked what to do, what would you suggest?
A ’The first thing you need to look at is why they are overweight – so many people say “I hardly eat a thing, doctor” but in actual fact they have to be eating too much and not doing enough exercise, or they wouldn’t be overweight. Fifty per cent of the population are overweight and 20% are obese and this is increasing rapidly, leading to a huge increase in Type 2 diabetes. Type 1 diabetes used to be called juvenile diabetes because it is primarily children who contract it, and what is now known as Type 2 was called adult diabetes. But now so many children are getting Type 2, the name had to be changed.
‘Children are eating fatty foods and simply not doing enough exercise, schools are selling off playing fields, children are being driven to school and back. It has been called ‘mad couch disease’ because kids and adults are watching so much TV – on average three-and-a-half hours a night. And that’s where the problem lies.
‘Diabetic experts are saying this will be the first generation when the children die before their parents. And diabetes is not a minor condition – it causes kidney damage leading to kidney failure, so kids will be having to go for dialysis and waiting for transplants. Your vision goes, too – diabetes is the most common cause of blindness in the working population. You are also at increased risk of stroke and heart attack, the arteries going to your legs can become blocked, which can lead to gangrene and eventually leg amputation. It’s a nasty disease and we are going to see more of it because of this obesity problem.
‘And what I find is that the main reason people want to lose weight, even when they are obese, is vanity and not because of health reasons. You don’t feel any of the symptoms of being overweight – if it caused you pain when you ate too much then none of us would do it. One way to check if you are overweight, without worrying about your body mass index (BMI) which can be complicated to work out, is to measure your waist. For women you are at risk if your waist is over 32 inches, and for men if it is over 37 inches. If you are worried, go to your GP for some advice on how to lose weight.’
Q The number of women who are going for a cervical smear test has dropped from 3.6 million in 2009 to 3.3 million in 2010. What can we do about this worrying downward trend?
A ’There was a surge of women who went for smear tests after Big Brother celebrity Jade Goody died in March 2009 – it was called ‘The Jade Effect’ but in the two years since her death, the numbers have dropped back down again and it is important to get those numbers up. Women over the age of 25 will be called for a smear test every three years yet many just can’t be bothered to go. But it is very important. It’s not a test for cancer – it screens for pre-malignant and malignant cells, and early detection can be the difference between life and death.
‘The whole smear test issue is a bugbear of mine – I handed in a petition to Downing Street in 2009, asking to bring down the age for smear tests from 25 to 20. The argument against this is that the smear test may ‘harm’ women so young, but in my opinion I have never seen any harm come from testing women that age. And in some London boroughs they already test them in their early 20s. But the guidelines say that the only way for girls this age to have a smear test is to pay for it, which is disgraceful.
‘The cost for the NHS is just £35 per test, but the cost of treating someone who has developed cervical cancer is so much higher. And the incidence of cancer in that age group is high – it can develop even if they’ve only had one partner. Now girls aged between 12 and 18 are being vaccinated against the virus and the over 25s are being smeared. But if you are under 25 then you have nothing to protect you – and at that age you are far too young to die.’
Q Some hospitals are opening ‘TLC’ clinics for women who have had recurrent miscarriages. Why is miscarriage still almost a taboo subject that people are afraid to talk about it?
A ‘Miscarriage is a death and women need to mourn the loss. Having one miscarriage is a nightmare but having two makes women think they will never get pregnant again, and by the time you have a third you are desperate. Having one is quite common but I agree that women need help when they’ve had two or more – there are so many reasons why it might happen – even coeliac disease, which I suffer from, can be a cause. It is vital that there Is somewhere where women can go and talk about what’s happened and find out what can be done.’
Q What are the main illnesses or conditions children get and how can you deal with them as a parent?
A ‘Meningitis is the biggie – it is not very common but it is frightening. Make sure you are clued up on its signs
– visit the website www.meningitis-trust.org to read about these. Earaches are always a worry for parents, particularly first-time mums. Coughing is another one – if a child has a persistent cough for more than three weeks then it can be a symptom of asthma. I don’t want to frighten parents but it is important they realise that it could be asthma and they must see their doctor. Many parents think asthma is all about wheezing but it isn’t necessarily.
‘Nose bleeds are common, too, and most parents don’t know how to respond. Mums often make their child lie back and then stuff tissue up the nostrils to stem the flow, which doesn’t work. The simple solution is to put a cork or finger between their front teeth to keep the airway open and the hold the nose on the fleshy parts between your finger and thumb. Ask them to sit forward and stay like that for two or three minutes. They will be able to breathe through their mouth because of the cork or finger and it’s a clever little trick that distracts them.
‘Another scary condition is when your child has a febrile convulsion, which is a type of fit. It can be a sign the child has epilepsy, but it usually occurs when a child has a fever and is too hot because mum has wrapped him up and shut all the windows. You need to keep him cool, so open the windows, put a sheet over him and give him lollies and ice cream to cool him down. This will help to bring the fever down and hopefully prevent febrile convulsions from happening.’
Q Over one million people will have dementia by 2025. What can we do to prevent it happening to us, or at least reducing the risks?
A ‘We are all living longer and even though we are not healthier generally, wonder treatments are keeping us alive, which means there is an increasing elderly population. When you get older, you do mentally decline. There are things you can do to reduce the risks and that is keeping active both mentally and physically.
‘Some people don’t have any hobbies when they retire but it’s important to do something – I play the piano which keeps me stimulated and evokes memories and emotions. Take up something you’ve always wanted to do, be it golf or gardening that will engage your mind and keep you moving. Crosswords and mind puzzles are good too – it’s true that if you don’t use it, you lose it. Physical activity stimulates the mind, too, and increases blood flow to the brain.
‘And diet is another one – a high saturated fat diet will clog up the arteries that go to your brain. Stick to a Mediterranean diet with oily fish and plenty of vegetables, salads, and fruit. A couple of glasses of wine a day will help, too, although more than that will degenerate your memory.’
Q What are the key health issues facing middle-aged men in the UK and what do you think can be done to help reduce these problems?
A ’One of the main issues is not going to see their doctor when they have a problem – not seeking that medical help they need until it is too late. More men’s magazines are talking about health now, but there is far more written about women’s health.
‘I battled with the producers of This Morning to show on air how you should examine your testicles for signs of testicular cancer, and we were the first live show to do it. We were also the first programme to show a rectal examination for prostate, and I know we’ve saved lives doing this because I’ve had emails and letters from people saying that their partner found something having seen our show, and then went to the doctor and had treatment.
‘Again, men need to know their numbers – that is cholesterol, sugar levels and blood pressure, particularly if they are over 40 and even more so if they smoke. If they are fat as well, then they are a ticking time bomb. What I say to people is to ask themselves if they want their kids to grow up without a daddy, because that is what will happen if they carry on as they are.‘
Q Most people are not doing enough exercise in adulthood. What do you think is the way to motivate people to get moving, even if it’s the minimum amount required?
A ‘I don’t like the word exercise – I prefer the word walking. What I suggest is that you spend £1 on a pedometer and count the amount of steps you do a day and write it down, then the next day aim to do a few more. Even if you start off doing 2,000 you can build it up by walking to the shops or getting off the bus early and before you know it, you’ll be up to the recommended 10,000 steps a day, which sounds a lot but it isn’t if you walk up the stairs several times a day.
‘Go out for a walk – take 15 minutes and then come back. This will benefit your health whatever your age and however big or small you are. If you do it every day then it will bring your blood pressure and cholesterol down, you’ll feel better because of the endorphins and you’ll lose weight. Regular exercise reduces the risk of certain cancers and also prevents deterioration of joints. It’s simple but it works.’
This article was first published in at home’s ’Ask the Doctor with Dr Chris Steele’ in April 2011.