Seriously - VOTING for the local police commissioner?

How has it come to this?

On Thursday last week a Poll Card dropped through the letterbox. I didn't think much about it until on closer inspection I noted it was for the local Police Commissioner. Since when did the public choose such a vital local professional? We might as well shut our eyes and pin the tail on the proverbial donkey  - we would have as much chance blindfolded of picking a suitable candidate.

And what does "suitable" mean? Something different for each locality maybe, but that's something I would prefer those who know the candidates to decide. A commissioner needs gravitas, respect, authority, experience and other such attributes I could not possibly assess. Considering there has been absolutely no publicity whatsoever for this election I certainly don't feel qualified to vote - and disagree with the underlying premise that this should be an elected role.

Can you imagine the scenario - someone with some campaign experience and political knowse but little on the job training gets elected and needs to command the respect and obedience of a force responsible for enforcing local law and order. Someone the rank and file might not have picked, or someone with sufficient private resources to to further their external campaign when they would have had little success winning internal votes within the region's force. Chaos. Or at subdued rebellion ... at the very least resentment. How does that work when a united front is needed to fight crime?

Hang on. That all sounds a little familiar? There is a certain theme here both in Education and Health is there not?

It's hard enough at any time, but giving those so ill informed a greater say in issues like this is the same as central government interference in local issues in my book. Two extremes which are equally inappropriate. I'm all for increased openness and accountability but by those qualified to do so. It's not "Big Society", it's passing the buck - or more precisely, passing the target. I sincerely hope these new commissioners are as good as their manifestos and that their qualifications do indeed exceed dog walking and golf.... because when things go wrong they are going to need the powers of a politician to deflect the criticism which will stream from both local and national sources. And surely, that is NOT in the job description of local Police Commissioner?

It is over-politicisation (if that is even a word) and under valuation in the extreme. But it is more than that - it is a basic avoidance by Central Government to tackle a thorny problem and avoid shouldering the criticism weighing them down since the 2011 riots. Which in my opinion is not "Big" on anything except responsibility avoidance. Using decentralisation in this way wraps everything in a political fog and undermines core values we rely on to make society work.

All about Allergies, immunity and Autoimmune Conditions

When most of us think of the word "allergy" we are thinking of a systemic immune response, or at least an immediate and visible reaction. For myself as a child, allergies meant allergic rhinitis - streaming eyes, runny nose, and atopic reactions (rashes, usually itchy) to almost everything it seemed. My bedroom floor was regularly hoovered, as were the curtains and the bedding was washed every few days. My teddy lived in the freezer during the day for some time too to help eradicate the house dust mites I was so allergic to. I was on Beconase inhalers for years and we probably should have taken out shares in Piriton... However there are different kinds of allergic responses.

IgE MEDIATED RESPONSES
The above are all IgE mediated responses. True allergies, and allergies you can test for. IgE is an immunoglobulin. An immunoglobulin is "any of a class of proteins present in the serum and cells of the immune system, that function as antibodies".  There are five subclasses of immunoglobulins, explained here far better than I could. DO read that link, it's the single best source I have found for non medics to explain your immune system and how it is classified.

IgE responses can be tested for - in Skin Prick Tests, and in RAST blood tests. The former have to be properly done to be accurate and reliable - we spent two years carting around an epipen for our second son who was allegedly allergic to peanuts - only to be retested a couple of years later (properly) and be told this was in fact rubbish. (Whilst some allergies can be outgrown, this is almost never the case with an IgE reaction to peanuts.) RAST blood tests are interesting, because they cannot in fact measure the severity of the reaction, the higher the number the higher the exposure rather than severity of response, so an older person would be expected to have a higher count.

NON IgE MEDIATED RESPONSES
You may think that a non IgE response would have to be what is termed an intolerance, but you would be wrong- along with an alarming number of health professionals I have encountered! An intolerance does not involve the immune system at all. A non IgE allergy is also known as a Type IV sensitivity, or cell mediated response. It is a local reaction and is rarely possible to test for. Gut allergies are delayed hypersensitivities, which is why food allergies are so traumatic and difficult to manage, requiring strict exclusion diets to determine responses to possible triggers. Imagine an eczema reaction in the gut - it's a localised response to an allergen (or a false allergen which the body responds inappropriately to) and causes a localised problem - no anaphylaxis, no outside response (although IgE responses are often present in addition in those with gut allergies) and is very difficult to diagnose.
Gut allergies are always responses to proteins, protein molecules are those the immune system responds to. Problems with carbohydrates/sugars such as lactose intolerance are not (as far as I know!) allergies.

GUT INFLAMMATION
Now imagine that patch of inflamed, irritated gastrointestinal tract - if your skin has a patch of eczema it is less supple, less flexible, cannot function at its best. Gut tissue is the same - it cannot function as well as it becomes inflamed. Inflammation ANYWHERE in the GI tract can cause symptoms anywhere else along its length. So, you can have reflux (which is only ever a symptom, be it from food allergy, obesity, muscle disease, ligament laxity, developmental delay etc) constipation, vomiting, diarrhoea, trapped wind, acute pain, chronic pain, bloating, wind - all from gut inflammation due to a localised allergic response. All too often I hear of children and adults with reflux symptoms, who have an upper endoscopy ("scope" where a camera is used to look down your throat as far as your stomach, and sometimes down to the small intestine below but only a small way down.) and a ph study which is negative and they are told there is no inflammation, no problem. It's happened to us too, my daughter was fobbed off for years until someone bothered to look lower and found inflammation and ulceration, causing the reflux further up. Bowel inflammation can, and does cause reflux. There are often other clues but sometimes it is that simple.

APPROPRIATE CARE
What is so concerning is the difficulty so many parents are having in getting appropriate care for children with clear reactions to food. Any parent with a child suffering from food allergies will tell you how their child reacts - yet if skin prick tests and RAST tests are negative many doctors come to the conclusion there cannot possibly be an immune response. Some doctors prescribe patch testing, which does indeed show delayed responses, but only on the skin. If it is only your gut tissues which is reacting, they are not going to be particularly helpful.

Another useful test is an serum IgA blood test. Immunoglobulin A is the major antibody found in the membranes of the respiratory and gastrointestinal tract. The second most common immunoglobulin in the human body, IgA can also be found in tears, saliva, mucus, and colostrums. IgA is one of the most important immonoglobulins in local immunity. Interestingly those with gut allergies often have low IgA levels, and in those who outgrow their gut allergies their IgA levels often rise approximately 6 months before such improvement become obvious when closely monitored. This is another reason why the antibiotic Azithromycin is so successful as an anti inflammatory agent in the gut, because of its role in the absence of IgA.

REFLUX and GUT INFLAMMATION
There is a huge surge in babies with reflux in the West, which is often due to gut allergies such as Cows Milk Protein allergy or reactions to other food proteins. It is often outgrown by the age of one but in those whom it persists into childhood underlying causes need to be investigated - any paediatrician should tell you that. The gold standard test for reflux used to be a ph study, measuring the ph at the top of the stomach. However, reflux caused by bowel inflammation is unlikely to be acidic unless the stomach contents at that time are acidic! Reflux caused by bowel inflammation is more likely to be alkaline, and shows up best using an impedance study or pressure test, used in conjunction with a ph probe. Gut inflammation will reduce gut functionality and therefore cause pressure changes along the GI tract.

No one is exactly sure why there is almost an epidemic of gut inflammation in the West. Many will tell you it is the overuse of antibiotics, the increasing prevalence of GM foods, over production , pesticides, chemicals etc but the truth is we just don't know. One thing is certain though that gut allergies are on the rise. In America there has been a surge in the number of diagnosed Coeliac Disease cases - interestingly Coeliac is another delayed hypersensitivity, as is Chrohn's Disease. Eosinophilic Disease is also thought to fit into this category which makes it so very difficult to treat and manage.

FOOD ALLERGIES AND BEHAVIOUR
Until quite recently there was little understanding of the way gut allergies worked. Recent research at Great Ormond Street has shown how neurotransmitters in the gut sit next to mast cells which are responsible for these local gut reactions. As these mast cells degranulate they release huge quantities of toxins which cause a local pain feedback cycle. They are also soaked up by the neurotransmitters and enter the central nervous system. This is thought to be how food allergic reactions cause the behavioural issues we often see in children with food allergies and could also explain why the casein and gluten free diet for Autism might just work for some children, who in fact display ASD type behaviours due to delayed gut hypersensitivities.

VACCINATIONS
Local gut reactions also cause an increase in histamine levels which make the gut wall more permeable. Anyone heard of Leaky Gut Syndrome? Something I thought highly "alternative" and improbable until I was immersed unwillingly into the world of gut allergies. What is more concerning is recent GOS research which is supporting the theory that the blood brain barrier is permeable (as is the gut) when local immune activity is present. Teething can also precipitate this permeability by raising histamine levels. There is in fact current speculation as to whether a highly allergic child - whether IgE or non IgE  - and/or one who is actively teething should have their vaccines postponed/delayed. This is similar to the theory postulated by Andrew Wakefield, whose totally flawed study left him hung out to dry but which buried the real message that timing is actually important with vaccination and that the links between the gut, Autism and vaccination might well have more to do with histamine and gut permeability than multiple vaccination programmes.

AUTOIMMUNE DISEASES
Lastly what i find particularly interesting coming from an EGID perspective is that several Autoimmune diseases are also Type IV hypersensitivites. Hashimoto's Thyroid Disease (which I suffer from) Diabetes Type 1, Arthritis... all the same type of reaction by the body. There are extremely strong links between gut allergies, immune profiles and autoimmune diseases. My children also have low IgM and IgG levels - again, common in those with autoimmune disease, but also caused by gut inflammatory conditions!

So despite being non-IgE, impossible to test for allergies, the immune profile of these localised, delayed hypersensitivities is perhaps more profound than the more obvious, recognisable IgE responses we are all more familiar with. I think it's about time the medical profession sat up and took notice of the autoimmune time bomb in the West and the surge in gut allergies - REAL food allergies so many people (and particularly so many children) suffer from ARE relevant, and health professionals in the twenty first century have a responsibility to take them very seriously indeed.


DISCLAIMER - I am not a doctor, the information above I have ben told, read and learned over the years. The opinions are not only my own, but it must be stressed that this is a Blog not a medical document and whilst knowledge and opinion is useful you must follow the advice of your/your child's doctor. By all means discuss the above, I have carefully referenced the information but I am not medically trained. I support and endorse vaccination programmes - having children with reduced immunity I know the importance of herd immunity and prevention of disease. I always endeavour to research issues affecting our family however and take each intervention as an individual case. 

The Bigger Picture

Well, as predicted we have a double dip recession. No one should really feign surprise given the turbulent world economy and the complete failure to date of the Eurozone to make decisive and effective plans for their intra economy. How we dig ourselves out of this mess is becoming more urgent an issue which is going to require action rather than merely babysitting the economy until it gets stronger.

I'm no economist, and thankfully no politician either, but I suspect it's going to take a situation more desperate to precipitate the necessary action for recovery, whatever that may be. Far reaching, bold decisions which focus on the "bigger picture" are rarely popular, neglect the individual and compromise the many "smaller pictures" of which they are composed. Who is to say which is right, let alone preferable, but changing direction with a heavy load in tow - be it massive debt, unemployment, social deprivation or all of the above - is never easy.

Whilst I admire those who take such bold and frankly terrifying decisions I'm not sure I could ever ignore the individual to such an extent. Sir Winston Churchill made a first class leader during wartime Britain because he possessed this attribute - yet not so many years later Britain's electorate was quick to dismiss an apparently uncaring politician. But tough times call for tough measures - the Battle of Britain would never have been won if Churchill and his government had allowed themselves to focus on the individual pilots, giving way to misty eyed sentimentality would have cost us the War - and the future of millions. But how you justify the decisions taken on such a large scale when those very decisions cause the suffering of many individuals is a dilemma as old as time.

Take the Greek debt - the country's people suffer now, will suffer far more if the debt is to be paid off anytime soon but without paying that debt off, at least in part, the future of Greece economically, socially and politically is extremely fragile. Yet who is going to take tough decisions for the many at the expense of the few?

I think the crucial point is support and endorsement. If, as in Britain in 1940 there is a clear and definite threat, an almost certain future which is far less attractive, or more terrifying than any short term or individual sacrifice then there is invariably popular support for decisions aimed at a larger purpose which neglect the individual. But the current economic situation - whilst in desperate need of some far reaching, bold and decisive big plan lacks the social and political support it would need for any hope of success.

History used to be the "History of Great Men", the storytelling Whig History of the nineteenth century. Men like Macaulay and Trevelyan allowed for sweeping generalisations to facilitate their seemingly impossible task of chronicling History to portray the bigger picture. As an historian myself I abhorred the obvious neglect of the less important individual, of social and economic trends and the use of the past to justify the present but undoubtedly without their brave attempts to achieve so much we would have been deprived of the fascinating stories which contributed so much to the understanding and appreciation of our shared past.

Sir Herbert Butterfield pioneered a more rigorous and philosophical approach to History which continues to this day, and my subject has become more vibrant and far reaching as a result, but as it seems with every strand of life political correctness has stifled and devalued any recent attempts to focus on bold and revolutionary strategies to see themes and to "bravely go where no man has gone before"visualising the bigger picture.

What the present economic situation makes abundantly clear however is that we are a society of individuals, with overlapping, similar yet fundamentally different needs, desires and aspirations. Obtaining political consensus today is far more of a challenge than it ever was in the past, yet I shudder to think the desperate situation that might be needed to precipitate the necessary agreement for moving forwards. The bigger picture will eventually take primary importance and must do so if we are to escape the current recession - but I sincerely hope we don't neglect too many individuals in the process.

If this is making you think of the current political situation in the USA, you're not wrong. The Presidential campaign in America makes this clear as the two candidates attempt to bring millions of people together in their support, people from such different states as California and the Carolinas, Kentucky and New York. The bigger picture is at the heart of American politics, as candidates cleverly (or deviously!) hide their bigger goals with heart string twanging slogans to pile everyone on the political bandwagon. For me this is a clear warning of how focussing on the bigger picture must not disenfranchise swathes of people, of individuals in the process. It would take a dire situation indeed to legitimise such a process in the UK and we need to hang on to this thought as we seek a bold and daring strategy to escape our own economic turmoil that does remembers we are not, at least not yet, facing a situation as desperate as that of 1940. Business undoubtedly needs tax breaks, we need to stimulate growth without further burdening the country with debt and spending cuts from the heady days of Labour spending may well be necessary. But when I see those cuts falling disproportionately on the most disadvantaged in society I believe there has to be a better way. I'm all for bold, for brave, for aspiration and growth, for the bigger picture, for progress........ but it does not have to impact unfairly on those least able to speak up. Facebook is awash with comments about Romney's archaic posturing, but we need to stop and think before we do something similar here too.

Rose amongst thorns

It's Wine O'Clock on a Friday night and I am sitting here proud as punch of my youngest child. I say "youngest" because those ten minutes count for something in the sibling pecking order, and can frequently be used against you by an over-controlling elder brother with zero empathy. (See "Sibling Rivalry" )

Being the only girl in a family with three boys can be tough. Initially held in awe and wonder by two adoring older brothers when she was a baby, the novelty wore off once her desire to take on the role as "Mummy's Deputy" kicked in. With one incredibly disorganised brother and two who try hard but often need a little help the temptation was too much to resist. K used to even dress her twin brother on occasion, and has been known to wash his hair and clean his teeth even recently. She is naturally maternal and caring and has a large family of dolls on whom she lavishes her affections, and I still receive daily drawings of cute puppies to try and break down my refusal to allow her one. But this care and concern for her brothers incited huge resentment from H. Being autistic he struggled to relate to twins, needing to "divide and conquer" to have any chance of social success with either. And what is easier than to ally yourself with the sibling you have more in common with? So for years K has endured daily ridicule and a verbal onslaught from H which we have tried to limit and control.

Added to this she has had to cope with her twin excelling in pretty much everything he tries, particularly in the classroom. But the situation is changing, and I couldn't be more pleased. Our little Rose (and that is her middle name too) is showing herself to be quite the artist, more precise and particular than her twin brother who loves making and is extremely good at construction, but she has a real eye for colour, detail and the ability to visualise from 2D to 3D with ease. She also dances beautifully and can sing in tune - which her brothers find more difficult. But none of this impresses H who is far more concerned with Minecraft, Java and the last episode of Tracy Beaker, and has continued to put her down relentlessly.

But today she earned his respect. H has always loved swimming and is pretty good in the water, and although he is perhaps overly optimistic he has aspirations to be the next Michael Phelps. So on learning that in today's Year 1 swimming gala K helped her class win (over the parallel class favourites) as one of the fastest swimmers H stopped in his tracks.

"Really? But you're so little!" he exclaimed.
and then the best bit......

"That's amazing. Wow - you must be really good. Like me! Respect. Much respect."

Indeed. Much respect, and much happiness on hearing her older brother consider and value her achievement. Happy day.

Spontaneous Combustion

 

This is a wonderful phrase (and the title of a play I believe) which I have coined many a time during my adult life. It's not so much that I wish to get OFF, more that it would be nice if the world would just kindly slow down a little, or perhaps even stop for long enough for me to a) make a cup of tea b) allow me to drink it without the usual reheating (twice) and c) perhaps even let me SIT to drink it? 

I am supremely grateful that years ago, when I had one small not-so-demanding child no one told me that I should enjoy the (relative) calm I then enjoyed. Working full-time as a single parent, going to bed at midnight after marking books and preparing lessons, waking to transfer washing to tumble drier (yes, they've ALL had reflux...) at 2am and then finally up at 6am for work I felt as if I was at times struggling to keep the plates spinning. Little did I know then that it was but an oh-so-gentle introduction into the world of additional needs, not even close to the "extreme parenting" I seem to have to hit the ground running with on a daily basis now.

Most of the time it's fine, and fun. Hard work but exactly, totally and utterly what I was made for, I *need* busy like most people need air. And Jelly Snakes... definitely Jelly Snakes too. I thrive on being insanely, frantically busy - but only when I feel in control. Just as well really, considering. The problem with living life on the edge however, is that you have to cling on tight when you get to the hair-pin bends. The moments when the incline suddenly becomes a vertical ascent, which (just for kicks) you have to scale blindfolded with a deafening roar in your ears. I hate those bits.

My sense of humour failed me this week, it's been a full-on month with a lot of highs, good bits to remember, and a load of "stuff" I could really have done without. One good thing about being ridiculously overly-busy is that you can lost the long term perspective and keep your head down. Not much choice really when the here and now takes every ounce of energy and focus to be honest. It IS a useful survival mechanism though and I have used it many times to my advantage, volunteering the few spare minutes I have to others or considering crazy plans such as satisfying my daughter's desperate need for a dog - or even feeling guilty that I am still a full time mum when the children are at school - and maybe I really should consider getting a job. The busier I am the less time I have to ponder the future.

I think that is what has made this past week so difficult. In so many ways I am being forced to look ahead, and I don't have the time or emotional capacity to deal with it right now. There is no need to fill spare minutes to fix myself stubbornly in the present - there are no spare minutes and the future I must face.

Firstly there is the start of the planning process for H's transition to High School. He's only entering Year 6 this September but we have Multi Agency Meetings, Annual Statement Reviews and more with SENCOs and teachers. Transferring a child totally dependent on full time 1:1 support to stay in school  -and hopefully have a positive experience there - is no walk in the park. Ideally I would like to give him and his future my undivided attention... but that isn't possible. We also have quite an important review at GOSH for the twins next week - neither is that well right now and neither can continue as they are long term. More decisions, more.... *thinking*.

Added to all that my parents have FINALLY exchanged contracts and are moving house next week. This is GOOD news, no complaints there, but it has definitely precipitated a few feelings and emotions I am struggling with. They are leaving the house I grew up in, it has been their home for 47 years and my Home with a capital "H" since I came home from hospital at a week old. Twice we have returned as a family to camp on floors whilst waiting to move ourselves, it is where a piece of me most certainly will always be. It is one of the most special places in the world to me, saying goodbye will be a huge wrench. I don't do moving on very well....I think in many ways the past is always more attractive than the unknown future!

So once again I find myself thinking how perfect it would be if I could just press pause for a while, to allow my brain the necessary time and space to process so many thoughts and emotions. But I guess that was never the life I signed up for, and probably not the kind of life I would ever choose either. (There would be at least a couple of dogs resident here and a job application in the post by the end of next week if someone did find that button.) So I am hoping I can find the inner strength to get me through the next couple of weeks (and my poor parents as they move!) and hope I don't spontaneously combust along the way! Normal is way too overrated anyway....

Healthy Eating?

Today K and A's school included in their weekly "newspaper" an editorial on "Healthy Eating", asking parents to support the school's two week drive to improve on an already ongoing campaign.

NHS "Health Eating" Campaign photo

But just what IS Healthy Eating? 

The school in question has twice termly cake sales and hands out sweets in "birthday assembly", which hardly fits the "Healthy Eating" criteria that the school is so keen to promote?

Resilience

Resilience. Not a word I use very much to be honest. And one that was oh-so-painfully overused at H's previous school by the Headteacher who had co-authored a book on "Building Learning Power". Don't get me wrong, there are some inspirational ideas and a lot of good practice in that book, but the nomenclature grated ever.so.slightly. For example focussing on "Brave Spellers" was a useful means of encouraging emergent independent writing but even the children felt it was slightly overdone at times.  But I digress.

Today I am a Resilient Learner however. Today I binned Hope and Trust in a positive move, but somehow "Goodbye Hope and Trust" didn't strike me as a particularly positive title to a Blog post!