British bosses blowing billions

NICE published some new guidance today - subject: the incredibly obvious. The MHF have been making the business case for health at work and against stress at work for several years now. In 2008, Men's Health Week was devoted to the subject; we published reams on malehealth and also looked at work addiction.

It's good to see NICE responding with some new guidance called Promoting mental wellbeing at work. Of course, they have no authority over British business who will no doubt continue with the sort of short-termism that has made them famous. But NICE have, at last, put a figure on the amount of money industry is wasting by not taking stress at work seriously: £28.3 billion a year. Bottom-line numbers like that ought to make even the most self-centred, narrow-minded, unimaginative of bosses take note. After all, just think of the bonuses they could pay themselves with savings like that.

(This report has already done wonders for my health at work. Pointing out the short-comings in British bosses may be as easy as hitting the proverbial posterior of a bovine with a banjo buy, hey, it gets us through the day.)

A breathless Nick Clegg

I'm not a member of the all politicians are scumbags club. I think a lot of them go into it with the intention of doing good things. But, like most people I guess, I've found myself disappointed by them more often than not. Therefore when I heard ahead of yesterday's report launch by the Coalition of Men and Boys that scheduled speaker Nick Clegg had not circulated a speech in advance I assumed that he wasn't intending to turn up.

The Coalition brings together the Men's Health Forum with other organisations interested in men's and boys issues including Relate, Respect and Action for Children. It is a relatively new and largely unknown organisation so securing Clegg's support at the launch of its first major report was quite a coup. Clearly in the run-up to an election the Lib-Dem leader had bigger fish to fry.

But he came. Hot foot, breathless and late having been detained by parliamentary protocol apparently. But he came and made some comments which suggested he genuinely understood what the Coalition were trying to do. Moreover, knowing he would be late he sent an aide ahead of him to deliver the speech. Pretty impressive. OK, so it doesn't put him up there with the saintly Jed Bartlett - the president in TV's The West Wing - but given the terrible impression politicians have been giving of themselves lately it was a step in the right direction. Now, if only the bankers could rehabilitate themselves.

(There's more on the report and a response from the Women's National Commission on the MHF's website.)

50 Cents is on the money: modern business kills

Much gnashing of teeth over the new book from rapper 50 Cents in which he draws interesting parallels between modern business practice and his experiences of selling drugs in southside Queens. The musician, real name Curtis James Jackson, told The Times this week that people in the neighbourhood where he grew up wouldn’t rule out killing the competition. 'I now hang out with people who absolutely have those intentions for their competitors but they don’t have the physical act of killing them as part of their strategy. Two different routes, but they want the same outcome.'

The only difference between 50 Cents and most business people is that he admits it. His central idea is not particularly new. Joel Bakan's 2004 book The Corporation shows how the modern public company whose only obligation it to its shareholders is obliged to behave like a psychopath.

What's this got to do with health? Well, psychopathic behaviour is ultimately pretty unhealthy both for the psychopath and his victims. In this case, the victims are not just competitors but also employees. We heard once again yesterday about how dangerous long hours are to the men who work them. Earlier this year, research was published showing the damage long hours could do to the brain. According to the International Labour Office, one in five workers around the world - or over 600 million persons - are still working more than 48 hours a week, many merely to make ends meet, a significant majority of them men. (Not having a job can be pretty dangerous too.)

In 2008, work was the theme of Men's Health Week. I suggested on malehealth that work was 'the main cause of men's ill health in the developed world'. Nothing that has happened since has made me change my mind.

When someone is killed as collateral damage in a gangland drugs scrap we're rightly outraged. But where's the concern about men and women working themselves into an early grave? Reduce the regulation of business and you increase the health problems of all those involved in it. The best possible health strategy? Workers rights.

Too many questions for statins to be the answer

We'd all love to find the silver bullet - a pill we could all pop that would make us live longer and/or reduce the risk of serious disease. Drugs companies and alternative practitioners alike sometimes like to imply they've found it. I doubt we ever will.

For a while it looked as if statins, drugs which lower cholesterol, could fit the bill. That all changed a few years ago. Ever since cerivastatin was removed from the US and European markets in 2001 because of a link to rhabdomyolysis, a muscle-wasting disease that can cause kidney failure, statins have been controversial.

New research published today adds to the confusion by suggesting that statins might slightly increase the risk of diabetes. This research while not particularly alarming in itself adds to the impression that we still don't really know how statins work. Given that we also don't really know the relationship between cholesterol and heart disease, there seem to be just one or two too many unknowns to justify giving these drugs to otherwise healthy people.

The danger of diabetes

A good mate of mine was diagnosed with diabetes recently - one of the 300 people diagnosed with the disease every day in the UK. Before you ask, he wasn't remotely overweight and didn't have particularly unhealthy refuelling habits. Yes, diabetes really can hit anyone.

There are 2.6 million people in the UK with the disease. Seven million of us also have prediabetes. This means we have blood sugar problems - not severe enough to be called diabetes but still, say Diabetes UK today, potentially dangerous to the heart. That means 1 in 7 of us are directly affected and we all must know someone. You'd think with something this common we'd all know the signs and symptoms but we don't. Ask people what diabetes is and they'll usually say 'something to do with sugar'. We all need to do better than that.

Why? Because we all know about sportsmen like Steve Redgrave and Gary Mabbutt, who became world-beaters despite their diabetes, we assume that the disease must be relatively trivial. It isn't. Diabetes can be controlled very well but it needs to be diagnosed first. Undiagnosed diabetes can kill - as Lee discovered in this month's feature on malehealth. If you think diabetes is anything but serious, read it.

Online GP consultations CAN work

Last night I checked out the new online surgery that I wrote about on Monday. I've had a few health problems recently so it was legitimate but, of course, as a journalist, I couldn't help throwing a couple of curve balls too.

To recap on how it works, it could hardly be easier: you just log on using a nickname if you like and talk to a doctor live online in a private chat room. My verdict is that this sort of consultation can be useful - up to a point.

The downsides first. It's far more time consuming than a real GP's appointment. We spent half an hour on something that would have taken 10 minutes face to face and had all sorts of fun trying to agree over the units we were talking about for some recent blood tests.

At times I got the impression the doc wasn't reading my comments properly which led me to ask if he was talking to other patients at the same time. He assured me that he wasn't. That being so I can only assume he wasn't seeing my inputs properly or in real time. The technology probably needs tweaking and there's a good case for a little IT training for doctors - and I suppose, patients - in using it.

But the positives made up for this, I think. I was far more comfortable in this environment. The doctor-patient relationship felt far more equal. There are no pedestals online or intimidating white coats or ties. I was able to ask what was really on my mind and the doc was able to clarify a few things. The limitation of this - the reason I say online consultations are only useful up to a point - is the same problem as we had on malehealth with our Ask The Doctor feature. Ultimately, the best advice, the only advice a doctor can give over the internet in all confidence, is: you should go and see your own GP about this.

Of course, a good online consultation beforehand can ensure you're better prepared, less intimidated and don't waste anybody's time (a common reason for not using the doctor according to research out today). All good reasons for developing the use of online medicine I think.

The curve ball? This particular online surgery is funded by Pfizer, the drug company whose extensive portfolio includes Viagra. It's a legitimate concern that a doctor's surgery funded by a drug company might result in the over-enthusiastic promotion of their products. I'm delighted to say this didn't happen. At the risk of mixing my baseball and cricket metaphors, the doc played my questions with a straight bat. He gave very good advice about what erection problems might mean and the tests used to find out without once mentioning the sponsor's product.

This particular surgery is open till Friday 9 October. There are also two similar online facilities being run by the European Men's Health Forum, one for questions on sexual health, the other on prostate health. Again, I've written about this EMHF service before. Why not give one - or all - of them a try and let us know what you think.

New GP's surgery online - for one week only

For my 100th post to this blog, I'm writing with some very good news. Well, some good news tempered with a little reality.

An online GPs surgery has opened. Rather than go to the GP, you can log on and talk to a GP in real-time. We know that a) men are reluctant to go to the GP and b) they like to use the internet, so this is a service I've been wanting to announce ever since I became editor of malehealth.

So what's the dose of reality? Well, it will only last for a week and it's being provided by a drug company, Pfizer, rather than the Men's Health Forum. Like the National Obesity Forum and Sexual Dysfunction Association, the MHF is backing the idea. The surgery is staffed by independent GPs, contains links to malehealth and MHF mini-manuals and provides an out of hours service (6pm-11pm) which no GP can match.

In an ideal world, men would go to their GP at the first sign of trouble and, if a site like this were needed, it would be provided by an independent organisation like the MHF. Unfortunately, we don’t live in that world. Coming on the heel of the online consultations provided by European Men's Health Forum on erection problems, premature ejaculation and prostate problems, this new online surgery enhances still further the options available to men with health concerns and that has to be a good thing.

News headlines are no way to discuss complexities around vaccination

There has been understandable concern following the death of 14 year old Natalie Morton shortly after she was given the HPV vaccine Cervarix. We don't know whether the vaccine played a part in her death but we do know - or ought to - that sooner or later someone probably will die as a result of the HPV vaccination programme in the UK.

In the US there have been deaths linked to their HPV vaccine, Gardasil and few if any vaccines are entirely risk-free. The question is whether the number of lives saved is worth the risk. The HPV virus causes cervical cancer which kills over 1,000 women every year in the UK. These issues of balance are not easy for the news-driven media to cover.

But the debate over HPV is not going away anytime soon. Earlier this month the US Food and Drink Administration voted to recommend Gardasil for males ages 9 to 26 to prevent genital warts. Two years ago malehealth readers voted that boys SHOULD get the HPV jab. It's a complex issue - as well as genital warts, HPV is also responsible for 50% of cases of penis cancer - more serious than warts, true, but incredibly rare and, even then, rarely fatal. Vaccinating boys will, of course, protect girls from HPV too.

We need to discuss these difficult issues around vaccination. Otherwise, what will be the reaction when the first vaccinated boy dies? Killed by a vaccine against a virus that is not - in males - life-threatening.

The business case for a shorter working week

Following the fantastic news in New Scientist last week, I don't know if the mag's readers will be out of bed yet to read this. Yes, NS reported favourably on research in the state of Utah, USA in which all state employees except emergency services have been put on a four day week (same hours but worked over four days). So far it has reduced energy costs by 13%, reduced sick leave and 70% of employees prefer it. A full report is due next month.

Health campaigners have long argued that long working hours are dangerous and the Utah experiment could help demonstrate this. (I've even suggested that work will become the main cause of men's ill health in the developed world.) On the other hand it could make things worse if working days become longer and blackberryaholics continue to work over their three day week-end just as they continue to work over a two day one.

What is clear is that if businesses can see that their obsessive need to have people in the office is costing them money, this debate may finally get somewhere. At last there is a business case for a work-life balance.

Online buying: even regulators don't get the real problem

My Radio 4 Case Notes interview is now online. I'm talking about the dangers of buying drugs online without a prescription. The message is still not getting through. And not just to the men who are buying them. Even the regulators don't understand.

The interviewee on the programme from the MHRA (Medicines and Healthcare products Regulatory Agency) only talks about the fact that it is illegal and you might get counterfeit drugs or drugs that don't have the patient information leaflets or are out of date or come in a foreign language box. All true but not the main point. Hardly anyone reads the patient information sheet anyway.

The main point - and it can't be made often enough - is that diagnosing yourself may mean you miss something serious. If you're having erection problems, for example, it may be a symptom of heart disease, diabetes or depression - these are serious illnesses which if left untreated can be fatal. Simple.

We need the regulators and indeed the drug companies to make this point and stop just babbling on about illegality. This mantra misleads men and leads them to assume that all that is really at stake is drug company profits. It's not. It's their own lives. It may be a bit embarrassing to go to the doctor because you can't get an erection but it might save your life.

There's more on this in our Buying Drugs Online section.

Help us update our award-winning websites

Malehealth was commended in the British Medical Association's patient information awards this month.

Obviously we're about communicating with patients or potential ones rather than medics but I was still delighted to see the site recognised once again by the doctors. We’re currently overhauling both the Forum’s sites to bring them up to date with modern media technology so to win an award before this is implemented is a real tribute to the “by men for men” content of malehealth.

The current websites are built on technology that is seven years old - an eon in techie terms - and are currently kept on the road with much the same combination of luck and sweat as a vintage car. But as well as rebuilding the technology behind the scenes, we're updating the design and interface of the sites for, as the marketing men say, a brand new, improved user's experience - looking up health information has never been so easy or so much fun! What do you think of our new designs? Your feedback is warmly welcomed - just post a comment by clicking on the word 'comments' below. Clicking on the image will give you the full size page dummy and then use the back button in your browser bar to return to this page. (Ignore the typos. We do know how to spell exercise - honest.)

Choice is not the issue, especially in health care

Choice is surely the weasaliest word in the modern politician's lexicon. Has choice made our education system better? No. Has it met the pushier aspirations of the handful of middle-class marginal voters who decide elections in our first past the post electoral system? Yes.

I've argued before that when it comes to health care, choice is the reddest of herrings. Yes, the opportunity to register with whichever GP is more convenient makes sense, as health minister Andy Burnham outlined yesterday but if it is accompanied by league tables or some other ludicrous 'performance indicators', it will only increase the risk of a two or even three tier health care system.

If resources follow patients what will happen to the health outcomes of those left in the less popular practices? And in what parts of the city will those practices be, do you think? Let's talk Glasgow, as an example. Are these popular practices more likely to be in, say, Calton, a deprived part of Glasgow with a male life-expectancy of just 54 or in those parts of the same city where the life-expectancy is already 28 years longer? Come on, Mr Burnham, the clue's in the question.

So let's talk about what really matters in health care. More choice never made any sick patient feel better. Quality treatment does. And that should be available to everyone regardless of who their GP is.

The male mid-life crisis at midnight

My odyssey round the studios of the BBC continued yesterday when I was the guest on Richard Bacon’s great little late night show on Radio 5 Live. The subject was mid-life crisis.

Of course, the desire to hang around television centre at midnight getting excited about the prospect of seeing the guests on Later might be a sign of a mid-life crisis in itself but we’ll let that pass. The advantage of a programme going out live is that no editor will cut you for not saying the right thing as happened with the vasectomy programme I posted about yesterday. The disadvantage is that you come out thinking of all the things you should have said but didn't.

I was debating with a comedy writer from New York who thought that mid-life crisis didn’t exist. I said that the mountains of very similar emails from women to malehealth proved that it did. He argued that it was just an excuse for a lot of men to behave badly. Now I can’t disagree with that, but just as swine flu is an excuse for a lot of people to skive off work for a week doesn’t mean that many other people don’t have it and that, for a minority, it may be very serious.

Clearly there is something going on at the mid point in many men’s lives. (The French date it a bit more precisely than we do by calling it la crise de quarantaine – the crisis of the 40s.) Even if a lot of these guys are just swinging the lead or refusing to face up to responsibility, it’s still interesting to ask why. But, because of the argument about whether it existed or not, we never really got onto. My take on it is that, handled properly (ie. not denied), a mid-life crisis could be one of the best things that has ever happened to you because you’ll come out of it knowing yourself better.

I don’t believe you can make yourself happy – although you can make a major mid life mess if you don't understand this point – but you can be happy. And that involves being content and comfortable with who you really are – not who you or someone else would like you to be. In some men it takes a crisis - doing something stupid - to realise this. But I never quite managed to say this during the programme.

I must admit I still find going on the radio exciting and get really nervous beforehand even though I’ve done it a fair few times now. You get caught up in the roll of the show and don’t always manage to get your point over. So was it worth traipsing up to Shepherd’s Bush at the witching hour? You bet. The sight of Jeremy Paxman running out of the Newsnight studio closely followed by a fat man with a clipboard and the Archbishop of Canterbury is not something you see everyday. The perfect image for radio, it was funny to witness but probably even funnier in your mind’s eye. Next stop: Radio 4's Case Notes and online drugs.

Another kick in the nuts for men with PVP

Forget yesterday's post. Email from the lovely Dawn at BBC Scotland who interviewed me for the vasectomy programme:

'I've just seem your update on malehealth and thought I should email straight away. Unfortunately in the end I did not use you in the programme as my editor wanted it to be case study heavy and to feature the actual operation.' Great radio, Dawn but what will we learn?

Mark Williams is also on the cutting room floor. 'What my editor wanted in the end was a programme that represented the normal experience of a vasectomy.'

This editor does to seem to have understood that post-vasectomy pain (PVP) and poor erections are the normal experience of vasectomy for too many men. So this decision is a bit of a kick in the crutch for them really - rather like having another vasectomy.

The BBC, eh? No, I'm not going to join in the chorus of criticism. The reason this timidity has come as such a surprise to me is that it's so rare that the beeb miss the real story. Perhaps Dawn can persuade her editor to do a future programme on PVP.

'You’d never catch a urologist having a vasectomy'

Vasectomy continues to be one of the most popular topics on malehealth. I'll be talking about it on Radio Scotland at 11.30am on Wednesday 16 September 2009.

One malehealth reader Mark Williams will also be on the programme telling his story of ‘a continuous and sometimes excruciating pain’. He was told, amazingly: 'You’d never catch a urologist having a vasectomy'. Shame then that he'd already had the operation.

What's going on here? We are building up quite a file on vasectomy at malehealth. How come this supposedly routine operation seems to leave so many men in pain? And why are there no meaningful guidelines on the procedure from any of the Royal Colleges or the National Institute of Clinical Excellence?

It seems to me that the truth is as uncomfortable as a post-vasectomy patient. We'd all like vasectomy to be a pain-free and simple as described because, if it was, it would be ideal way to avoid unwanted pregnancy. Trouble is it doesn't work like that and a lot of doctor, health campaigners, men and women are struggling to accept that we may need to talk about the more complicated alternatives.

This online service is just what we've been waiting for

Ever since malehealth's Ask the Doctor feature closed down for lack of funding we've had dozens of emails a month from men wanting to ask a doctor a question online. Prostates, erection problems and premature ejaculation have been common topics.

Now, thanks to two pioneering new websites from the European Men's Health Forum (EMHF), men can at last get an answer to these questions in complete confidence without ever going near a GP's surgery or even talking on the phone - it's all online and all anonymous. The two sites are Your Prostate (www.yourprostate.eu) and Malehealth Questions (www.malehealthquestions.eu) which will deal with any aspects of ED and PE.

These are among the topics we are most frequently asked about on malehealth. There's lots of stuff out there on the internet all these issues but can you trust it? The EMHF is a trusted source. The MHF are members. Nobody will try to flog you anything and nothing goes on your medical records. There's no pressure and because it's by email, you go at your own speed at your own convenience at a time that suits.

Men have been asking for this for a long time and at last it's here. In fact, I was so impressed by what they were offering that I was happy to let the malehealth name be used. The service won't be available for ever so if you have a question on prostates, erection problems or premature ejaculation - and most men will have something to ask on at least one of these - now is your chance to ask.

Approach your problem side on

Here's an idea that may make it easier to talk about what's on your mind: Be active to the front and talk to the side.

By focussing on an activity in front of you, something arty, fixing the car, gardening or just doing the dishes will make it easier for you to discuss what’s on your mind with someone standing or sitting next to you. This will improve your mental health and may help improve other aspects of your relationship with that person too.

Good advice? Don't thank me, thank an anonymous malehealth reader. For our Men's Health Week competition, we were looking for an original and simple health tip. And this one leapt out at me - it works and yet I'd never heard it before. It was the best of nearly 1500 entries to the competition and many of them are equally simple yet effective. It proves what I've always believed: that good health is pretty simple and rarely requires major life changes. It also proves that you can never know it all and that there are always good ideas out there.

These two ideas are at the forefront of my mind as we redevelop the malehealth website. In the future it will be easier for you to share ideas with our readers. Watch this space for news of our redesign because we'll be looking for your views.

Meanwhile check out our Men's Health Week readers' tips plus our regular tips of the month section.

Latest Exercises for Scott Pearson's column

This month's videos from Scott (Sept 2009). Scott's column is here.

Incline/Wall Press Up:



Chair Squat



Box - or tricep - dips:



Bodyweight lunge:

Take our swine flu vaccine survey

Will you take the swine flu vaccine if it's offered to you? Tell us in the malehealth Snap Survey.

Ashes win and the flame of desire

Your team's sporting success can give you a shot in the arm of testosterone just as if you were playing yourself. Indeed, it's so effective, that it's one of malehealth's top ten health tips that any fool can do.

So English cricket fans - and, even more incredibly, Tottenham Hotspur supporters - should have a spring in their stride this morning. But while testosterone - like alcohol - might increase the desire, it won't make a lot of difference to performance which could result in disappointment for many blokes (and their partners).

If you want to celebrate with a roll in the sack but can't, what do you do? You might be tempted to ignore it but don't. Erection problems may be the sign of another more serious health problem such as heart disease or diabetes.

Phil Tufnell, the England spinner turned TV pundit has been fronting a drug-company website aimed at helping men with erectile dysfunction (ED). (This blog isn't just cobbled together, you know, one item leads on seamlessly to another!) But, of course, drugs aren't the only treatment for ED and self-diagnosing with drugs and self-prescribing could mean those more serious problems get missed.

Check out malehealth's advice on sorting out your sexual problems and talk to your GP. Unless he's an Australian, he'll understand.

We're not all Psychos

Good stuff this morning from Time For Change, an organisation trying to improve public understanding of and attitudes to mental health problems. Peter Byrne, a leading psychiatrist and film expert, says that characters with mental health problems are being depicted as ‘more demotic and crueler than at any time in movie history’.

Cinema is very sensitive these days to charges of racism or homophobia but when it comes to dealing with 'nutters' it's still a free for all. Byrne's report says that this affects public attitudes to mental health and it's hard to disagree. Male mental health is poorly understood in the media, in the medical profession and among men themselves. Simplistic screen misrepresentations can't help. Cinema is supposed to be about innovation - it would be great to see some here.

Byrne's report is mainly about schizophrenia which is particularly badly represented and particularly widely misunderstood. But what about more common mental health problems? Anyone know of any movies that portray male depression accurately? Garden State, perhaps, or Sideways?

I'm surprised more NHS staff aren't sick

As a regular user of the NHS, the news that NHS staff are 50% more likely to be off sick than those in private hospitals comes as no surprise - in fact, I'm amazed it's not higher.

Over the past 13 years, I've watched the cancer clinic I attend move hospital once and move location within each hospital at least half a dozen times. I've seen procedures and practices change and morph pretty much every other visit. I've seen umpteen health professionals and watched the doctors get younger even more quickly than I've got older. The one thing all these health professionals have had in common is a fantastic commitment to their work in the face of the swirling vortex.

If the NHS staff had done to health services what bankers have done to financial ones, we'd all be dead yet who gets the bonuses? Earlier this week, Alastair Darling rejected the call for a high pay commission to look at the obscene pay differentials in this country. That attitude in the face of a report such as this on the state of the health of the staff in Britain's best loved institution makes me feel quite ill really.

Too much Tamiflu on the shelf?

We have Tamiflu coming out of our ears. In January health minister Dawn Primarolo told the House of Commons that the nation had 11,000,000,000 milligrams of Oseltamivir (Tamiflu). The adult dose is 750mg per treatment course. She also said that 'the bulk of the current stockpile of Tamiflu is due to reach the end of its shelf life in financial year 2010-11, the remainder is due to expire in financial years 2011-12 and 2012-13'.

Stockpiled for the bird flu epidemic that never really was, this mountain of medication has led conspiracy theorists to suggest that the whole swine flu business is just about getting the stuff down our throats before the use-by date. I don't know about that but I am concerned that by trying to use it all up in time we may not be doing ourselves any favours further down the line.

While welcoming the telephone diagnosis of swine flu, Dr Holden, the British Medical Association's lead GP on pandemic flu, has said in Pulse magazine that he is worried that the threshold for issuing Tamiflu has been set too low, a policy that could come back to haunt the Department of Health if the virus becomes resistant to Tamiflu.

All Tamiflu does is limit by an extra day or two, symptoms that will, anyway, be self-limiting in most of us. That being so, how many of us really need it? Surely it's best to keep it for those whose age or circumstances mean their lives are at risk from the virus while sparing the rest of us both the side-effects of Tamiflu today (nausea, vomiting, diarrhoea and headache) and the possible danger of having nothing to take tomorrow.

Dept of Health have forgotten men's health

The Men's Health Forum, who run the malehealth site, have today hit out at the Marmot Review, the Department of Health's strategic review of health inequalities, because it fails to mention men's health at all.

MHF CEO Peter Baker says: 'Our main concern is that gender health inequalities are barely mentioned in the papers published recently as part of the consultation process. Where gender is mentioned, it appears solely as an issue for women. Men's health appears to be consistently overlooked.'

The Forum is calling on its supporters to back their campaign to get gender back on the agenda. Let us know what you think.

One John Hartson

When a young man like John Hartson is diagnosed so suddenly with such an advanced cancer we all feel a wild variety of emotions, me included. At 34, he is about the same age as I was when I was diagnosed with a different form of cancer. I'm still here and I feel lucky, I feel guilty and I feel glad that I was a bit of a hypochondriac which meant that I kept going back to the GPs when I thought something was wrong.

A friend of John Hartson's has apparently said that he thinks the former footballer was aware of the lump in his testicles for a while before he went to the doctor's. I don't know if he's right but this should be the lesson that we learn: seek treatment promptly if you find a lump. Testicular cancer is not any more common than it was before and it is not any more dangerous than it was before. (Testicular cancer can be cured in 99% of cases provided it is treated in time.) You don't need to examine your testicles every five minutes - I very much doubt John Hartson did - but you do need to be do is to be testicle-aware. If you have a lump, get it checked out.

AFC Wimbledon fans still get a little misty-eyed over a goal of John Hartson's at Selhurst Park that almost kept the Dons in the Premier League. Now the Welsh hardman, also a hero to fans of Arsenal, Celtic, West Brom, Luton and West Ham, has everyone wishing him well - even Eyal Berkovic. Get well soon, John.

McKinnon's crime is the worst: 'embarrassing a government'

The news that under our totally imbalanced extradition agreement with the USA, this government is prepared to expose a UFO fanatic to a potentially long prison sentence for the crime of hacking into US military computers looking for information about his favourite subject is worrying enough.

The Crown Prosecution Service say there's not enough evidence to charge him with any offence here even though he has admitted to hacking so clearly this is not the crime of the century. (Apparently, he found his way in to the Pentagon's network by guessing that the passwords would still be set to their default of 'password'.)

When you learn that the man in question, Paul McKinnon, has a form of autism, Asperger's Syndrome, it becomes doubly worrying. McKinnon's lawyers told the high court yesterday that former home secretary, Jacqui Smith's decision to extradite him was 'flawed' because it didn't take this into account. They're hoping to get the decision reversed.

If, as we're often told, we're all equal before the law, they should succeed. When Spain tried to extradite former Chilean dictator General Pinochet to answer war crimes charges, then home secretary Jack Straw turned the appeal down and let Pinochet fly home because, after looking at the medical evidence, he considered him medically-unfit to face trial. What's more McKinnon's case is far more clear cut than the General's. There was some doubt about Pinochet's medical capacity at the time and indeed, four years later Chilean judges ruled that he was perfectly capable of facing charges. But Asperger's Syndrome is not something that comes and goes.

McKinnon, whose Asperger's was diagnosed by the UK's leading authority Cambridge Professor Simon Baron-Cohen is backed by the National Autistic Society.

Mark Lever, chief executive of the National Autistic Society, said yesterday: 'We strongly believe that Gary should be allowed to stand trial in the UK where he has a familiar support network in place and his needs in relation to his Asperger syndrome can be better met. People with Asperger syndrome are often much more vulnerable than first appearances would suggest and are particularly susceptible to mental health difficulties; extradition would be highly inappropriate and potentially very damaging.'

McKinnon's only crime appears to be embarrassing the US government and no reasonable human being would want to see a man with a developmental disability clapped in jail for that. Trouble is, as we learned last week through the case of Ronnie Biggs: embarrassing a government is pretty much the worse crime you can commit.

What celebrities can teach us about health

Celebrities are great for helping to get media coverage for a difficult health story. But you need to be careful.

We've got a really interesting interview on malehealth with Steve Redgrave - a man with nearly as many long-term health conditions (3) as he's got Olympic Golds (5). But listening to all that people like Steve or former Spurs captain Gary Mabbutt have achieved despite having a condition like diabetes might lead you to conclude that diabetes is not a serious condition. It is. It can kill.

Today's news that men over 35 are twice as likely to develop diabetes as women of the same age ought to kick any complacency into touch. Yes, diabetes can be managed but only if you're getting treatment and you can only get that if you see a doc. If Mabbutt's diabetes hadn't been diagnosed he wouldn't have even been playing park football let alone turning out alongside Glen Hoddle and Ossie Ardiles at one of the world's finest clubs. So what is the conclusion you should draw from celebrity interviews like Redgrave's? It's this: managed conditions are not the the end of the world but unmanaged ones can kill.

Talking of celebrity tie-ups, drug company Lilly who make the erectile dysfunction drug Cialis have teamed up with former England spin king Phil Tufnell to raise awareness of the problem. Picking up on the Ashes theme, the site's called Bowl Your Maiden Over.

There are cricket puns all over the shop - a bit like Phil's bowling on a bad day - and a rather stilted conversation between the great man and Dr Rob Hicks about England's Ashes chances. It's easy to be cynical about this sort of puff but if it encourages men to discuss a subject that affects, frankly, all of us at some time in our lives it's got to be a good thing. And Tuffers deserves credit for having the balls - sorry, couldn't resist - to get involved.

Of course, England's jammy Ashes escape yesterday must have put a spring in every Englishman's stride but if things don't go so well at Lords - where England haven't beaten the Aussies since 1934 - the site should get more hits than even Ricky Ponting's bat.

Breast cancer screening: everybody hurts

'The question is no longer whether breast cancer overdiagnosis occurs, but how often it occurs' says an editorial yesterday's British Medical Journal.

Many women it appears are having unnecessary chemotherapy, surgery and other treatments for breast cancer. This is unpleasant and dangerous for them, a waste of money for the NHS and misleads the rest of us about what modern medicine can really do. The apparent rise in breast cancer is, it appears, linked not to a real rise in breast cancer but to a rise in breast cancer screening.

The problem is that breast cancer screening - the mammogram - is not sophisticated enough. It cannot tell - and nor can the docs - whether the tumours it detects are life-threatening or not. You might argue that it's good to err on the safe side. The problem is there isn't a safe side.

Patients tend to be pro-screening. Ask a cancer patient and they'll demand screening on the grounds that it might well have picked up their cancer sooner. Ask the family of a dead cancer patient and they'll be even more vehement.

It's understandable but it makes no sense if screening is not possible. The MHF does not call for prostate cancer screening because there are no screens currently available that don't carry the risk of overdiagnosis. The same appears to be the case with breast cancer - and to quite a shocking degree. The research into overdiagnosis in several countries including the UK concludes that one in three breast cancers detected in a population offered organised screening is overdiagnosed.

Of course, every case is different and nobody is calling for the end of the mammogram. Overdiagnosis particularly affects older women because they have slower growing tumours and fewer years of life ahead - a point that isn't particularly well-covered in the press today and may lead to younger women making poor treatment decisions. But at medical school all students are taught on day one: first do no harm. That's why the NHS recently scrapped its leaflet inviting women to have a mammogram.

Scientists under pressure for a good story

Journalists might be about a popular as estate agents and politicians but most of us understand how difficult it is to do the job properly these days when content is just words and pictures to go between the ads.

The other day I saw a story saying that depression can cause Alzheimer's Disease. Now I've been engaged in a lifelong battle with depression and have a memory like the proverbial wire-meshed kitchen utensil so you can imagine I leapt on this like Silvio Berlusconi on a showgirl. But closer examination showed that this was actually a trial for a drug to treat Alzheimer's and that the patients in question were all over 55 and had a mild cognitive impairment to begin with. It's easy to oversimplify in the search for something newsworthy, especially as today's multi-platform, multi-tasking journalists are expected to produce more stories in less time.

No wonder the over-worked hack is a target for the hoaxer. There's a hoax health study that's been doing the rounds since at least 2000 suggesting that looking a women's naked breasts is good for a man's health. It still appears in the media from time to time. But it's not just tabloids and desperate for anything websites and bloggers who can be hoaxed. There was much laughter this week as the editor of the Open Information Science Journal was forced to step down after his title published a hoax paper full of computer-generated goobledegook from an organisation styling themselves CRAP (Centre for Research in Applied Phrenology).

But it doesn't stop there and this is the worrying part for those of us who rely on science for our 'evidence'. Check out the survey showing that as many as third of scientists admit to fiddling their data. In the desire for headline-making, funder-pleasing, career-enhancing research, scientists appear to be under similar pressures to media editors. Are research scientists the new estate agents?

Should we rename breast cancer?

Looking through the press cuttings for this month's exceptional Men's Health Week, I came across the story of Nicky Avery from Southend. At 27, he is believed to be the youngest man to have been diagnosed with breast cancer. He's now campaigning for the disease in men to be renamed. He says: 'I want to get the terminology changed so men get checked if they find something. For men it’s such a taboo and so many men don’t know they can even get it. I want the name less feminine so I say call it what it is – chest cancer.'

Indeed, many will be surprised to learn that men can get breast cancer. But they can. Would changing the name make a difference? Would the 300 men affected every year seek treatment more quickly if it had a more neutral name?

Clearly it's an issue. I've heard of doctors writing 'chest wall cancer' rather than 'breast cancer' on men's death certificates which puts the disease on the same taboo level as suicide. A recent survey shows that men are 70% more likely to die of cancer than women and not going to the doctor soon enough is clearly a factor in this. But with breast cancer it's not just men who are reluctant to present with a lump, women are too because, as one man with breast cancer put it to me: 'for a woman the loss of a breast is a loss of a part of her personality as well as part of her body'. If changing the name encouraged just a handful more men and women to seek treatment sooner it would be worth it.

Did stress kill Michael Jackson?

Is it really possible to die of stress? Both Paul Gambaccini and Yuri Geller have fingered it as a possible cause of Michael Jackson's shockingly premature death. If you look at his much mediatised life it certainly makes sense.

Talking about Jackson's proposed concerts later this year, Gambaccini told the BBC: 'I always doubted that he would have been able to go through that schedule, those concerts. It seemed to be too much of a demand on the unhealthy body of a 50 year old. I'm wondering that, as we find out details of his death, if perhaps the stress of preparing for those dates was a factor in his collapse.'

Certainly work-related stress can kill. The Japanese even have a word for 'death from overwork' – Karoshi. In 2007, the government published its highest karoshi figures ever.

The great Gambo's comments reminded me of a TV programme I saw the other day about biologist Robert Sapolsky, a guy who has devoted his life to measuring stress in monkeys. His research shows that monkeys lower down the hierarchy a) tend to die younger and b) have higher stress levels. Asked to explain the death rates, he points out that it can't be smoking, drinking too much or poor diet as all the monkeys eat the same food. He puts it down to stress.

You might counter that Jackson was a multi-millionaire and hardly at the bottom of the food chain. I'd say that when it came to media treatment 'Whacko Jacko' was very much at the bottom of the food chain. The bullying he's been subjected to by the press down the years is not at all unlike that meted out every day to the weaker baboons by the alpha-males and those eager to please them. Many people have complained about the stress heaped on Susan Boyle by the media and rightly so. Michael Jackson, whatever he might have done, was clearly no less mentally frail.

We need better food not more exercise adverts

Eating too much makes you fat. That's June's tip of the month on malehealth. Wow. Hardly going to knock MPs expenses out of the headlines.

Except that this research proves that just because a lot of people say something doesn't make it true. The research knocks for six the commonly held notion that the USA is fat because its citizens both don't do enough exercise and eat too much. No, it is purely the latter. Food alone is responsible. Lead researcher Dr Boyd Swinburn of the World Health Organisation says Americans have been eating much more but physical-activity levels haven't really changed all that much.

The trouble is with this thesis is that food industry don't like it. They have played the 'reduced physical exercise' card for all it's worth. It's their 'Get Out Of Jail Free' card. Talk about getting off the hook. Every hamburger ad, every soft drink commercial is accompanied by a strapline exhorting us to get active. Now we know that it's the mountains of crap food and fizzy pop doing all the damage. Voluntary organisations and government rightly keen to 'work with industry' now need to find the courage to demand that the food industry do more and that means changing their products and the way they sell them. The WHO research proves there is no alternative.

Videos for Scott Pearson's column

This month's videos from Scott (June 2009).

The Burpee:



Dumbbell Swing



Clean techniques

It Boyles down to responsibility

That Susan Boyle might have a breakdown was surely about as predictable as Simon Callow being a tad arrogant or Piers Morgan coming over a just a wee bit insincere. Do we really care what release form or whatever Susan Boyle signed? When is TV going to take responsibility for the mental health of the people that reality TV propels to fame and then every bit as swiftly dumps with a smug smirk? I don't think there's anything more to say really.

User's Guide to the Male Body out now

My new book on men's health comes out this week. 'The User's Guide to the Male Body' is a short, sweet introduction to men's health. You can download the flyer here, find more information here and watch the ’no expense incurred’ promo video featuring the inside of my office and the book jacket in walk-on roles below.



Price £8.99 in paperback, the book is available from bookshops, Amazon.co.uk or Sheldonpress.co.uk. Or order direct from Marston Book Services on 0123 546 5500.

Don't get too excited over the latest male pill

The male pill appeared to move a step closer this week with the publication of results of a study in China of a hormone-based contraceptive that lowers sperm count. But as that trial moves to Manchester, we shouldn't get too excited too quickly.

The Chinese trial involved men having hormone injections in the backside. The high drop out rate - 312 out of 1045 volunteers (or nearly 30%) - will have women wondering once again whether men can really be trusted to handle any contraception requiring more forward-planning than the condom. Certainly, it's hard to see how monthly jabs in hubby's backside would work for more than a handful of couples as a long-term form of contraception.

Given the amount of booze, tobacco and crap food we shovel down our throats, doctors may find this hard to believe but men do worry about what they put in their bodies. Men will, rightly, be concerned about how long it takes for sperm counts to return to normal once the contraceptive is stopped. For most men it took around 200 days but 17 men still hadn't recovered their fertility after a year. Most men won't want to take that risk. Nor, indeed, will most couples - it's tough enough trying for a baby without having to wait six months for hubby to stop firing blanks.

Yes, despite the enthusiasm we're still a good way yet from an effective male contraceptive.

Quentin Willson and his pen*s extension

Much media interest in a device being tested in London which could regulate the speed of cars by automatically keeping them to the speed limits. No more boy racers at a stroke.

The motoring lobby, of course, will tell you that speed doesn't cause accidents. This is a heavily-pushed viewpoint - where do they get the money from? - but not one that stands up to any scrutiny. Even if you can show that speed per se is not the main cause of an accident, any accidents caused by driver error, driver fatigue, driver intoxication, or indeed, any mechanical cause, will be made worse - far, far worse - by the addition of speed. We're not just talking about minor injuries here either. Despite improvements in road safety, a person is killed every three hours on Britain's roads - nearly 3,000 deaths in 2007.

So what's the problem with speed limits? Former Top Gear presenter Quentin Willson gave the game away on the Today programme this morning talking about how the device would 'emasculate' drivers. In other words, for drivers like Quentin the car is simply an extension of the pen*s. How long are we going to let these chumps determine public health policy?

In what way are we responsible for our children drinking more?

Interesting research from JRF showing that young men are drinking less. Not what we've been led to believe.

Alcohol consumption in general is up. We average about nine litres of alcohol each a year - up from 4-5 in the 60s and 70s (but still less than the 10-11 we averaged at the start of the 20th century). So if the lads aren't drinking it, who is? The answer is women and older drinkers. It shouldn't be a surprise. We're reading how women are behaving more like men and how older people never grow up all the time.

There is a statistical point here. The Office for National Statistics changed the way it calculated units in drinks in 2007 to reflect the trend to stronger wines and larger glass sizes. This had the effect of increasing the number of women binge drinkers at a stroke.

But this research remains significant not least because of the curiouser - and more worrying finding - that fewer children are drinking but that those who do are drinking much more.

In 1997, about two 11-15 year olds in three had had a proper alcoholic drink. By 2006 barely half had. Quite a fall. Especially when you look at how consumption has rocketed: 11-15 year old boys were consuming an average of fewer than six units/week in 1997. Now it has more than doubled to more than 13. In other words, those youngsters who are drinking are really caning the stuff.

Why? Is it, as JRF suggest, mainly the influence of the home environment? In part, probably. But have we also somewhere along the line demonised drink among the young with the result that it is no longer seen as the everyday lubricant of adult life but as something abhorrent. Has it moved from being a soft drug to a hard one with fewer taking it but all of them addicted? And if so is there a lesson here for health campaigners about oversimplification of the message?

Swine flu: worried the media is telling you porkies?

Swine flu is all over the media right now but picking your way through it to the facts is a pig of a job. What you need to know is:

1. There are enough drugs to go round in the UK. The government says it has enough drugs to treat over half the population (23 million treatments of Tamiflu and 10.5 million of Relenza).
2. But tamiflu needs to be taken 24-48 hours of symptoms beginning. Any later and it's useless. So if you're concerned by cold or flu-like symptoms, don't fanny around. See your GP.
3. Meanwhile, take the standard cold prevention advice like washing your hands (especially before touching your face) and getting some sleep seriously.

It's about as simple as that really. More information and links on malehealth.co.uk. And, by the way, you can still eat bacon.

There are plenty of safe online health options

The Advertising Standards Authority's ruling that the Pfizer-backed ad raising awareness of the dangers of buying drugs online is not misleading or unduly distressing has put this issue back in the news. That's no bad thing.

I say this not because I'm interested in drug company profits but because I'm interested in men's health. By buying drugs online without a prescription you're not depriving drug companies. Global spending on prescription drugs was about $643 billion in 2006 so big pharma won't be passing the hat round anytime soon. What you are doing is depriving yourself of a diagnosis. By diagnosing yourself you might well miss something serious. Erection problems, for example, don't just happen - they are often the sign of potential killer diseases like heart disease and diabetes. Go and see your doctor and get a prescription before buying online.

The attractions of using the internet for health are obvious. That's why malehealth has had three million unique visitors in the last two years. And we know from our own survey that most men would consider buying drugs online in the right circumstances. So it's good to see some organisations rising to the challenge.

If you have a prescription there are umpteen online pharmacies to choose from. If you haven't, Dr Thom have been providing online treatment for erection problems for a while now. Today we report on a new online initiative that can enable the under 25s to test themselves for chlamydia, the most common sexually-transmitted infection at home in private. It's attracting web-savvy men in droves: a shrewd move because chlamydia is symptomless but dangerous - it can make men infertile as well as women.

Times are changing. Smart internet users don't have to turn to the pirates and risk buying dodgy pills, today there are plenty of safe online options and the number is growing.

Why is there no news in our newspapers?

The government is often criticised for announcing new funding or new initiatives more than once. They're accused of spinning and of trying to pretend they're doing more than they really are. But perhaps it's the media that are spinning? I've discovered another reason why the government sometimes announces something more than once: because nobody takes the slightest bit of notice the first time around.

So it is with the Department of Health's Third Sector Strategic Partner programme. The Department have teamed up with 11 strategic partners including the Men's Health Forum in a move that could radically change the way government works with the not-for-profit health sector.

The scheme was announced in February and covered by the MHF website. It was press released again this week. It's shocking really that nobody in the mainstream media is interested in running with the story. There are big issues here with pros and cons. Will it help government understand patient needs better by working more closely with their organisations? Or will third sector organisations be compromised?

Of course police brutality, MPs' dodgy expenses and the economy are big stories that need covering but it's not lack of space in our increasingly bloated newspapers. No, it seems that as our daily rags get fatter, the news coverage gets lazier. No wonder readers are turning to the internet.

Avoid a hazardous waist, have an NHS health-check

If you're aged between 40-74 (and in England) look out for your invitation for a free health check. The government reckons it can save over 500 lives a year and prevent over 1500 heart attacks and strokes through preventative check-ups. And the MHF agrees. If you're invited, I strongly urge you to go along. It won't be long or painful - a few questions, weight, height and a simple blood test. Let us know how you get on - especially if you don't find it helpful.

The downside - as usual - is that it will take time for everyone to be seen. Local Primary Care Trusts are designing their own plans and government admits the scheme won't be available everywhere in England until 2012/13

Why now? Well, perhaps the government has been reading Hazardous Waist, a book the MHF helped produce with Radcliffe Publishing back in 2007 but which suddenly, for some unknown reason, has started attracting the reviews it deserves. Edited by MHF chair Alan White and Maggie Pettifer, the book has been described as 'the perfect antidote to the laissez faire attitude that seems to pervade male health problems at the present time' (Dr Jeremy Sagar, Univadis).

While in Perspectives in Public Health, Dr Bashir Qureshi admits: 'the account in this book was so moving that I have decided to do something to shrink my own middle-age spread. I cannot think of any health professional or general reader who would not like to read and benefit from this slim book.'

Praise indeed - if you've not been invited for your free check-up yet, why not give it a read?

Job insecurity: destroying us from the inside out

Every so often something that you've long suspected is proven by a piece of research. So it is today with the publication of a study in Cambridge showing the damaging impact of the threat of unemployment on male mental health. We ought to be pleased that we have the evidence to back the hunch but nobody can be happy at evidence demonstrating just how badly wrong we have got things in our society.

According to the study, men are affected by job insecurity - the threat of losing your job - far more than women. This may be because men define themselves in terms of their work far more than women do. The trouble is that all jobs are becoming increasingly insecure. Outsourcing, temporary contracts, freelancing. Nobody gets a job and is set up for life anymore (unless you're Fred Goodwin but I won't get into that again). Yet clearly, psychologically, security is what we need.

In the past to criticise job insecurity was seen as a political position, considered unhelpful by governments who saw job security as a barrier to prosperity. Today's research shows that this is not a political issue but a health one. Not only does this way of working not create wealth, it is destroying us from the inside out.

Congratulations to the government

Nobody's got a good word to say for the government at the moment - not even the bailed-out bankers.

However, the announcement earlier this month that the Men's Health Forum is to be an official strategic partner of the Department of Health is good news for men's health and the government should be congratulated on it. Tomorrow also sees the first ever men's health debate on the floor of the House of Commons - an indication of how far we've come since 1997.

Six exercises using a bar

For technical reasons we can't currently embed videos on the main malehealth site so here you'll find the videos to accompany our fitness coach Scott Pearson's series on exercises every man should know. For the original article, click here.

Bench Press

Back Squat

Deadlift

Bent Over Row

Military Press

Upright Row

Nicole, stop frightening us

Which? have questioned the lack of science behind brain trainers that tell you your 'brain age'. These products have always interested me not just because Nicole Kidman advertises them but because, to be honest, I'm terrified of dementia. I've seen it eat into grandparents on both side of my family and given that I never had much a memory in the first place, I've always wanted to know what i could to avoid the inevitable or, at least delay it as long as possible.

I tried one of these online brain tests and I have to say it did nothing at all to ease my fears, quite the opposite. With every single question a race against a 30-second clock, I felt like a chess player being timed out, reeling from bad move to bad move. I never finished the thing as - thankfully - I was interrupted but I have no doubt that my 'brain age' would have been up in three figures as I panicked, made daft mistakes and clicked in the wrong place.

Like everybody I want to believe that there is a magic bullet out there but there isn't one for Alzheimer's any more than there is for cancer or heart disease. As ever, it's about money. Some of these products are not cheap. Private medicine will always be there to exploit our fears of illness and as science advances so do their marketing techniques. One of the great things about the NHS is that we never have to ask ourselves the question 'Is this treatment for the benefit of my health or my medic's bank balance?' (Under any health care regime where money changes hands between doctor and patient - not just terrible ones like in the USA but even supposedly good ones like France - you're asking it every five minutes.)

The worry for health campaigners - and this is the men's health angle here - is that people who can't afford to be scared because they can't afford the solutions will simply turn off and not take any notice of any health advice. You may not need a 'brain trainer' but doing the odd crossword won't hurt. If anybody wants to help me with mine, I'm stuck on 'instinctive sense of self-preservation on which commerce preys' (4). First letter F.

Cooking up a health treat at White Hart Lane

It's rare that I get the chance to write about football in this blog and to be able to do so twice in the same week is a rare treat so thanks to MHF chair Professor Alan White for giving me the opportunity.

The MHF are backing a new Premier League initiative which will deliver a men's health promotion package worth over £1.5 million. 17 of the current Premier league clubs are involved. The idea is to help football fans become healthier. How? Well, Alan, the world's first professor of men's health, puts it perfectly: 'The biggest lesson I've learned is that if you sit in your nice clinic waiting for men to come to you, chances are you'll be waiting a long time. But if you go out to where the men are, you'll have more success.'

Fulham will be giving 'specific attention' to sexual health, apparently. Chelsea will encourage local men to take their coaching badges (the credit crunch must have hit Blues owner Roman Abramovich harder than I thought). West Ham will target bowel cancer (the disease that killed former captain Bobby Moore at just 51). Everton will offer health MOTs on matchdays (a job for Mikel Arteta, perhaps, out for six months with ruptured cruciate knee ligaments). Newcastle will appoint two health trainers to work with dads and, catching them young, their kids. Tottenham Hotspur, innovative as ever, will be running 'cooking sessions'. This is presumably because their fans have been feeling sick all season.

Why is Defoe injured and not Ronaldo?

As the Carling Cup Final approaches, this is the question all Tottenham Hotspur fans are asking themselves. Why is their star player Jermain Defoe out for ten weeks while their opponents Manchester United can still call on the talismanic Cristiano Ronaldo and all their other big name stars.

Of course, to sports fans, the headline Spurs Player Injured is about as surprising as Cyclist On Drugs. Spurs players are notoriously injury-prone. (When Spurs enlarge their ground capacity it's not to add additional seating but additional treatment tables.) But is it just Spurs' bad luck?

When Jermain Defoe limped out of a training session earlier this month, it didn't just sum up his club's season but, arguably, English football as a whole.

Defoe was the fifth Premier League player this season to go down with a broken metatarsal bone in the foot (the injury made famous by David Beckham). He joins on the treatment table fellow Spur Alan Hutton, former Spur Michael Carrick (are you detecting a pattern here?) plus Liverpool's Phillip Degen and the man who put the ars in metatarsal, Newcastle's Joey Barton. But none of this will surprise osteopath Don Blyth who has been monitoring metatarsals for years and, as he explains on malehealth, these injuries have nothing to do with foot shape, flimsy boots or playing too many games. It's about sedentary lifestyles and failing to toughen up the feet, especially in childhood.

Nineteen England internationals have fractured their metatarsals since 2002. No African players have. Don says: 'a disproportionate amount of English and European players are fracturing their feet compared to African players which rules out the boots, studs, pitches and number of matches which are the same for all players.'

Intriguingly, Cristiano Ronaldo was considered a likely candidate for a metatarsal injury when I last spoke to Don in the summer but so far the Manchester United and Portugal international has been spared. Why?

'Cristiano Ronaldo's feet are bearing up well, considering his lengthy lay off last summer. This suggests his feet are tougher and of a higher density, than the average Brit/European. I suspect his upbringing in Madeira may have helped, maybe playing bare foot beach soccer has hardened his feet more like an African's. Maybe he drinks a lot of milk? Maybe he does barefoot kick boxing as a hobby? Barefoot keepy uppy? All would help prevent the injuries.'

So the key to a healthy and successful football career? Play barefoot on the beach like the Brazilians. If Harry Redknapp reads this, Spurs training sessions may never be the same again.

RSI - it's just like childbirth, really

RSI or repetitive strain injury is back in the news today. The Chartered Society of Physiotherapy tell us that levels are as high as they ever were.

Now, in general the idea that you can only understand something if you've gone through it yourself does not convince me. I don't think you need to experience genocide or cancer or an episode of Top Gear to know they're not very pleasant. Being able to put yourself in someone else's shoes is part of what makes us human. But with RSI I'm prepared to make an exception.

Some 220+ British workers succumb to RSI every single working day. Make no mistake. It is clearly the employers fault. Employers have a legal obligation to prevent preventable injuries and we've known about RSI for at least 20 years now. But I don't think the problem is a callous disregard for health and safety. I just don't think the bosses get it. They don't realise just how painful and debilitating simply using a computer can be. Until they really know what it's like, nothing much will change (after all, the media only started writing about RSI when journalists started getting it). I know how the bosses feel. Even those of us who have experienced it, forget.

I've had RSI on and off since the early 1990s. At first it was so bad that I couldn't work and lost my job. Even now I know I could never go back to regular office hours. (As a freelance I can pace myself and spread out the working day.) But sometimes I forget, overdo it and get a flare-up. The result is an excruciating pain that knocks me for six every time. Your body forgets just how much it hurts - like childbirth, I suppose. Whilst you're going through it, you can't take the lid off a jam-jar or even open a door (again, just like childbirth.) But then you rest, it settles down (unlike childbirth) and over time you forget again.

So shut your boss's hand in the door today. Put his wrist in a vice and turn the handle. Twist his arm behind his back and tie it there for a week. What are these? Dick Cheney's favourite refined interrogation techniques? No, an RSI awareness-raising campaign.

Our 2006 survey finally gets its day in The Sun

The were mixed feelings among the Men's Health Forum team this week following our appearance in The Sun. (No, not on page three.) Despite the growth in the internet and the decline in newspaper sales, The Sun still sells over 3 million copies a day so a story quoting an MHF survey in the top paragraph is not to be sneered at.

The trouble is that the story, which appeared under the headline Why men don't want sex anymore, was based on research the Forum carried out for Men's Health Week in 2006! The Sun's headline statistic was culled from our story 18 million men have mental health problems which was not, of course, primarily about couples' sex problems.

I imagine that some eager Sun researcher - why does seeing those two words together make me snigger? - picked the story up off the internet. It shows how the media has changed in the online age and how important it is therefore that the MHF websites keep up with the development of the web. (We'd really welcome your help on this, by the way.).

Yes, the UK's tabloid newspapers may be first when it comes to sticking a camera up the skirt of the latest movie starlet but when it comes to men's health they're still way off the eight-ball. Thanks anyway, guys - we're emailing over our 1963 survey which suggests that smoking could actually cause cancer.

Three cheers for Alastair Campbell

It is healthy to express anger as I did in yesterday's blog. It is also healthy to give praise. So three cheers for Tony Blair's former spin doctor Alastair Campbell who is now doing his bit to encourage us to take a healthier attitude to mental health problems.

He argues that in today's prejudicial climate leaders who changed the world such as Winston Churchill and Abraham Lincoln - both of whom were frequently mentally ill - would never get elected. Campbell is in some ways his own proof. Although Tony Blair knew what he'd been through, the rest of us didn't.

Most people with mental health problems keep quiet about them at work until for some reason they can no longer do so. Why? I think our macho working culture might be to blame. It's increasingly difficult to express weakness, doubt or vulnerability. Bosses particularly are worried that to do this might destroy their magic. I know, it's a joke, really in the current economic climate.

But I reckon those bankers I wrote about yesterday are probably dealing with some tricky feelings right now - guilt, anger, sadness, low self-esteem. Just the sort of thing that can lead to depression and mental health problems. It is a shame for society - and all of us who have to work in it - that they can't talk about it.

Ex-RBS boss Fred Goodwin or 168 nurses? It's your call.

Sorry does not seem to be the hardest word for bankers. Responsibility, fairness and justice are all a lot harder and, indeed, if yesterday's shambolic performance before the Treasury Committee is any guide, some words are impossible. There was a lot of talk about bonuses in 2007. Sir(!?) Fred Goodwin, the man who destroyed RBS, was paid £4,190,000 in salary and bonus. Andy Hornby the man who presided over HBOS's demise was on a paltry £1.93m bonus and benefits.

I mention this not because like any sane person I cannot believe that the government, the regulators and most of all us, the general public, allowed this to come to pass but because the date - 2007 - triggered a memory. Wasn't 2007 the year the NHS was cancelling operations left, right and centre as it ran out of money and trusts desperately tried to balance their books by the end of the year? A quick web search proved my memory had not, on this occasion, failed me.

So here's another word that bankers and government better learn quickly: priorities.

Last week a lot of British workers went on unofficial strike to complain about other EU workers being paid the minimum wage. Surely what we need next is an official strike demanding a new maximum wage. Aside from the economic and moral benefits, it would have another advantage: apparently Sir Fred told the MPs yesterday that if bankers felt they were not paid enough, they would leave.

Sorry, I do try to avoid politics in this health blog but Fred Goodwin's 2007 salary could have paid for 28 hospital consultants (on £150k) or 140 heart transplants (based on BBC 2006 estimate) or 168 band 5 nurses (on £25k). Not to comment would be to be complicit in obscenity.

Six exercises using dumbbells

For technical reasons we can't currently embed videos on the main malehealth site so here you'll find the videos to accompany our fitness coach Scott Pearson's series on exercises every man should know. For the original article, click here.

Dumbbell Shoulder Press

Bicep curl

Dumbbell lateral raise

Dumbbell Flys

Dumbbell Swing

Men and women aren't THAT different

It's good to see that hospitals continuing with mixed-sex wards will face penalties. It can be dehumanising. But I was still amused to hear the PM programme on Radio 4 citing the fact that a woman had woken up to find a man 'pleasuring himself' in the next bed as an example of why the practice should be stamped out. (The practice of mixed-sex wards, I mean.) The implication was that a man waking up to find the man in the next bed pleasuring himself would consider it perfectly acceptable.

Will this NHS Constitution stand up?

The contradictions from this government never cease to amaze. Once upon a time, they made some very sensible noises about how the mother of parliaments - ours - was fatally compromised by having an unelected second chamber built on privilege and patronage. They did away with part of the House of Lords but then got bored and left the rest of it looking, in constitutional terms, like a mad hatter's tea party.

Why mention this on a health blog? Because I was reminded of it when I saw the government's new constitution for the NHS. Gordon Brown called its signing a 'momentous day'. And to some extent, he's right. Clarifying our rights and responsibilities with regard to our most popular institution makes perfect sense. So presumably the next step will be a written constitution for the country as whole. You know, the sort of thing that Barack Obama has pledged to defend in the USA. Don't hold your breath.

It's these contradictions that make me wonder whether when push comes to shove, the NHS constitution will be worth even a wholly-devalued pound of the £1million spent on putting it together.

Will it, like the US constitution, be subject to amendment? Will Saturday night shift casualty doctors be given the right to bear arms, for example? Or, given the wages some of the sub-contractors are paid to clean our hospitals, what about an equivalent of the 13th amendment which abolished slavery? Either way, download it now ahead of the first amendment.

You've got to laugh at this research

Much amusement among the MHF staff following a news story claiming that men are better able to suppress their urges to scoff the sorts of tasty, tempting treats that can cause us to put on weight. Anyone who has ever been to an MHF event will confirm that this is patently untrue.

Of more serious concern is the widespread media coverage that was given to these findings which were based on a survey of just 23 people. How big is the study is one of the key questions to ask when trying to assess whether research is reliable.

Of course, male weight problems are often down to drink as much as food and the National Statistics office's data that more than 40% of men had exceeded safe drinking limits in the week before the survey. (The source of the stats is another important consideration and National Statistics are - usually - a pretty good one.) One man in 4 had drunk more than double the safe amount.

Less widely reported was the news that more people have heard of safe alcohol limits than 10 years ago - up from 75 to 86%.
Trouble is most people don't know what the safe limits are. Only 38% of people knew that the safe limit for men was three or four units a day. Check out the limits if you're not sure what they are or don't know exactly how much a unit is. (You'll need pop-ups enabled to get the best from this link.)

Don't barrack Obama

Christmas went by in a flash, new year in a blur. Cards forgotten, even emails and blogs uncomposed. But it's not too late to wish all malehealth readers a Happy Obama Day. As outlined on the MHF website, the USA's first black president has promised to reform the USA's health care system and make health insurance accessible to all including the 45 million Americans who currently have no cover for all.

This is a country where people move out of their homes and live in tents to afford chemotherapy so let's hope he can do it and do it quick. He's promised it by the end of his first term. We wish him luck. With the insurance and drug companies solidly against any changes to the system which has made them so wealthy, he'll need it. if he manages it, he'll have justified every ounce of the hype that surrounds this historic day.

Cheap online drugs? You should smell a rat.

Ever seen a man regurgitate a rat? You will if you visit the cinema anytime soon. It's part of a new cinema ad by drug company Pfizer designed to raise awareness of the dangers of buying drugs online. Here's the You Tube version of the ad:



Pretty hard-hitting, isn't it? What do you think?

The Men's Health Forum which runs the malehealth site is backing the campaign because as well as the risk of finding something dangerous such as rat poison in a fake drug, there is another even bigger risk. Problems like poor erections can be a symptom of a dangerous underlying health problem like heart disease or diabetes. By diagnosing yourself and buying online you'll never know. The result could be fatal.

We know men want to use the internet buy drugs and it can be done safely. The malehealth guide to online drugs includes everything you need to know.

Recession can seriously damage your health

It's been so long since I blogged you probably thought I'd joined the increasing army of unemployed. But fear not, we're still here and the day MHF president Ian Banks compares the P45 to the loaded gun is a good day to get back to the blog.

As the recession bites, we need our health - mental and physical. It's important, as the president of the Association of Directors of Public Health says this month, that health is not neglected by the government as it tries to find solutions to the economic crisis.

As belts are being tightened everywhere, it's really important to know what you can expect from the NHS. This month's article from the man from NICE (National Institute of Clinical Excellence), the organisation who set guidelines for the NHS will help. The dole and and depression go hand in hand. Did you know that for mild depression, NICE recommends talking therapies like counselling? Your GP ought to offer this.

There's also advice on malehealth about how get the best to use the NHS and how to deal with depression when it hits. Losing your job happens. It's not your fault. It's a joke of system. How can society be richer than it has ever been but it members more insecure than they've ever been? No, it's not your fault. But understand the danger. An economic downturn can change the way you feel about life and yourself. You need to be aware of that and get help sooner rather than later if you feel yourself falling.

Government and health policy makers need to understand the real health impact of unemployment and recession but it's important that those of us affected by it understand it to.