The Mental Health of Sport

 

As Australia imploded when news of the ball tampering saga reached our shores I felt all the sadness, outrage and shock along with my fellow cricket enthusiasts. I watched the story unfold and grew increasingly concerned by the aggressive nature in which people were attacking their fallen heroes. I watched on social media as people labelled Steve Smith a “cheating w–ka” and ruthlessly tore into his partner and family. I cringed seeing the comments on Candice Warner’s social media calling her an “attention seeking materialistic cheater’s wife.” Despite all the open discussions in schools, workplaces and the media about bullying, everywhere I looked there were people clearly crossing the line to make deliberately hurtful and negative comments about another individual. As a GP, a health professional who deals with the consequences of bullying nearly every day in my clinic, I watched with sheer horror.

 

For me, one of the interesting aspects about the ball tampering saga was the subsequent discussion that flowed about the culture within the Australian cricket team and their antics on field – suddenly the sledging and, let’s be honest, bullying on field was being openly discussed. The footage of the former Australian captain Michael Clarke telling Jimmy Anderson to “get ready for a broken f—ing arm” was replayed again and again– overt bullying had somehow pervaded the “gentleman’s game” and now we were talking about it. And cricket was not alone – AFL, NRL, other codes were succumbing too.

 

I’ve intentionally delayed the release of this piece until the (saw) dust had settled from the ‘sandpaper saga’, because I wanted to talk about the much bigger issues that arise from such a horrific incident. Yes, the ball tampering is bad, but the bullying and lack of awareness for a fellow human’s mental wellbeing is worse.

 

As a GP I frequently encounter patients who are dealing with bullying in some capacity. It’s not just the school children you might be envisioning; of course, I see the 13-year-old girl who is picked on because she is “too hairy” and the 16-year-old boy whose friends suspect he might be gay so he is berated in the locker room when other boys are changing. But I also see the 42-year-old woman who is at breaking point, now afraid to leave the home and battling significant depression because of persistent subtle and targeted bullying at work. I’ve also treated the secretary who was deliberately excluded from social events, a clear message from her colleagues she wasn’t wanted – she eventually left after unsuccessfully trying to lodge a Work Safe claim for the damage done to her mental health by a workplace drenched in bullying. Bullying comes in all shapes and sizes and to me, a GP, bullying in sport is no different. We have seen bullying from spectators towards competitors (just remember the horrific racial slurs against Adam Goodes) and we’ve seen people bullied on various sporting fields across the country – from the MCG to the local footy field. At what point did we deem that “sledging” was acceptable? At what point did bullying become part of any game?

 

I frequently talk to adolescents alone as a GP; often their parents willingly leave the room when I ask so that someone else can have a crack at finding out what’s going on with their increasingly withdrawn and flat teenager. Adolescents often open up much more to a GP without their parent there. I always ask about school – do they enjoy it, have they got friends, do they play sport? I cannot tell you the number of times they disclose that are being picked on for some reason – be it their skin colour, sexuality, their parents jobs or their choice in clothing. My job is to provide support, involve adults (parents, the school) if physical or mental wellbeing is at risk. My doctor brain works on how we can prevent deterioration of mental health in an individual and keep them safe from ongoing emotional or physical harm, but, my soul is crippled by their pain, at knowing how much they dread going to school, leaving the safety of their parent’s car or the bus.

 

We know children who are bullied are more likely to experience anxiety and depression – so why are adults any different? Why do we assume that because a person has large biceps, countless bruises and a strapped shoulder that he or she is able to withstand persistent bullying on a sporting field? And, how can we expect our children to know what is acceptable and what isn’t if their sporting heroes reflect that bullying, sledging, putting down your opponent verbally is the norm?

 

We know that sportspeople are often reluctant to openly seek help for or discuss mental health issues – the rolled ankle, sore knee, torn hamstring will always take precedent. When Buddy Franklin took time off for mental health issues everyone watched shocked that an in-form player was sitting out the crucial stages of Sydney’s finals campaign. The truth is that mental health is potentially harder to recover from, harder to recognise and deal with than a knee reconstruction. I thought it was wonderful Buddy openly discussed his mental health issues and need to take time off football, but by the same token, the media storm that followed his openness further perpetuated the stigma that many males battling mental illness already struggle with. “A man admitting to mental health issues is a big deal, I can’t tell anyone” a young male patient recently told me as I suggested he was significantly depressed and should share this with someone to increase his support network; the Buddy attention highlighted that.  As a GP I agree that we need to talk about mental health more openly, but when it gets sensationalised it only emphasises the stigma in some ways. And on the note of mental health, as I watched the press conferences of the 3 players embroiled in the ball tampering saga I felt for them – yes, they had done the wrong thing, but was someone monitoring their mental wellbeing with all the negative media attention and overt bullying being directed their way?

 

Some argue that sledging is harmless and part of the game. Personally, I disagree. If someone were to come up to me at a cocktail party and comment on my race, husband, child or that I was “weak as piss” – I would most likely cry, loudly. To say that sledging is acceptable on any field is unacceptable.

 

I ask you to sit in my chair for one day – see the broken people who walk through my door; successful, well dressed, functioning people who will disclose how hurt they are by someone else’s careless words. I ask you to see with your own eyes the pervasive bullying that happens in countless workplaces across our country and the damage it really does to people’s mental health.

 

Bullying is bullying. Let us not blur lines accepting that some sledges are OK, but some go too far. We shouldn’t need to attack another human to win a sporting competition. We shouldn’t need to deliberately hurt a fellow human to help our team succeed. If you’re good enough, you’ll win anyway.

 

To put it simply, my soul would ache if my daughter was ever called names, put down for her sporting abilities or targeted for her choice in partner or sexuality. It would hurt me if it happened to her at school, on a playground, at work or on a footy field. We are all human, we are all vulnerable – bulging biceps, a 6 pack, a gold medal doesn’t change that.

 

Bullying is bullying – and I say no way.

 

 

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A Healthy Spin on a Comfort Meal Version 1 – Tuna Mornay

 

 

Tuna mornay is a love of mine – it holds a special place in my heart… alongside twiggy sticks (I know I know!), smoked salmon and goats cheese. It’s a meal I yearn for when I’m celebrating something or when I’m devastated and need a pick-me-up. But MY tuna monray isn’t like yours- I can assure you. It’s one of the healthiest and easiest meals I make and lasts in the fridge for 2-3 days feeding the entire family – Miss S included.

 

If you follow me on Instagram you’ll have seen it in my posts – I make it often – so I thought it was time to share how I do it. So here it is – the Preeya twist on tuna mornay.

 

Firstly, tuna mornay (or my version of it sans white sauce and other fancy bits) is a very healthy vegetable packed meal that only needs one pot. Tuna is so good for you – rich in omega 3 hence, great for the heart and the brain of little ones especially. If you’re attempting to adopt the Mediterranean diet, because of all its wonderful evidence-based health benefits including reduced risks of cancers and heart disease, then it’s a wonderful meal for you because it contains seafood, is loaded with vegetables and uses olive oil as the cooking base.

 

What you will need:

Step 1 – Pick 2 425g cans of tuna (this makes a mammoth quanitity to last for 2-3 days, if you don’t need this much only use 1 can). It doesn’t matter what type of tuna you pick – either spring water or olive oil will do but ensure you don’t pick a flavoured one – we can add that ourselves! You will also need 1 or 2 cans of creamed corn (you can get this from the canned vegetable area at the supermarket) – 1 can for a small batch, 2 for large. In the recipe you might find some other bits I add sometimes.

 

Step 2 – Look in your fridge, veggie patch and pantry – what veggies do you have? I always use what I have – the half chewed broccoli sitting in the crisper is perfect, so are the tomatoes in the garden! Sometimes I’ll use cauliflower I have sitting around and other times I’ll use some celery, mushrooms and tomatoes. Grated zucchini is always easy and fabulous. Use what you have but make sure you add at least 3 types of veggies and one that adds some crunch like celery. I hear the critics already – “tomato in a tuna mornay??” – it’s a great addition – adds some additional moisture and sweetness!

 

Be creative with the veggies especially if you have kids. I tend to blitz my broccoli and cauliflower (if I’m using it) in the thermomix before I add it to the pot – it makes it like a cous cous and makes the mornay thick and creamy!

 

Step 3 – Always add peas and corn – it’s just how I roll.

 

Step 4 – Be creative with your grain! Doesn’t HAVE to be pasta. I sometimes add brown rice (cooked before I throw it in to the mix) but more often than not add quinoa which is just lovely and adds a nice texture! You can use wholegrain pasta or even chickpeas. Sometimes I don’t add a carbohydrate at all – usually because I’ve put in so many veggies there is no room. It’s always just as delicious!

 

The actual steps I follow:

 

  1. I heat olive oil in a fry pan and fry off onions (brown or red) until browned – about 5 mins
  2. I add the tuna (with the olive oil or spring water drained beforehand) and just brown it slightly for another 4 mins
  3. In go ALL the veggies I have – the spinach, tomatoes, peas and corn, cauliflower – whatever it is I chuck it in now. Stir it all in and give in another 2-3 mins.
  4. Add your binder of the dish (some fluid!) – the creamed corn! If you have a load of veggies you might need 2 cans – but 1 is usually enough. Once the binder is in – chuck you grain in now – whatever it is: pasta, quinoa – this is its moment to join the party!
  5. SOMETIMES I add a soup packet (cream of chicken or celery) to bind it further but I rarely need this. If you do choose to add a cream of chicken soup pick one with low salt (especially if your child is going to eat this).
  6. Add your herbs – I normally add parsley and spring onion from the garden but play around –there are no fixed rules – try what you have!! Parsley goes beautifully in this though as does basil.
  7. Pepper – of course!!! Be careful with salt ESPECIALLY if your child is going to eat this. I don’t add any if Miss S is going to have this for dinner – which is always given she loves the stuff!!
  8. Once it’s all bound, shove it in an oven dish – 2 cans of tuna gives you lots of food so you will need a big tray – sprinkle some cheddar cheese on top and pop it in the oven on 180 degrees for 20 mins until the cheese is golden on top! Don’t freak out – I know there isn’t any white sauce nor bread crumbs but trust me this is delicious! People don’t realise that adding something like white sauce to a meal is adding extra calories you don’t need.

 

And that’s it – you have a healthy tuna mornay!! You may be skeptical – is this even delicious? Hell yes it is – the veggies give it texture and sweetness, the cheese gives it the edge and the tuna is the hero as it should be!

If you have a serve for dinner this meal will give you at least 2 serves of veggies easily. Imagine how good it is for kids! I can hear you saying “Preeya this isn’t really a strict recipe with steps to follow” – I know but this is how I cook – it changes every time and you have a framework now to work off.

 

The wonderful thing about my mornay, like all my cooking, is there are no set rules – play around, try things out, chuck in as many good tasty things as you can! Try a comfort meal without the naughty things like white sauce – it can be just as delicious and good for you!

 

If you like this – I’ll pop up some of my other healthy versions of comfort food – lasagne, pasta sauce, shepard’s pie, enchiladas!! The possibilities are endless!!! Check out my Instagram feed for other healthy food ideas!!

 

 

 

 

 

 

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What You Need to Know About Common Over the Counter Medications

 

It’s so easy to grab a packet of Panadol or Nurofen from the Chemist or supermarket.

 

For some reason if you can grab a medicine over the counter people assume it “must be safe.”

 

Golly gosh – anti inflammatories like Ibuprofen (brand name Nurofen) are some of my most feared drugs and in the wrong hands (or should I say body) can cause serious damage!

 

So here’s what you need to know about 2 of the most commonly used medications – and why you might want to rethink popping the packet!

 

Drug Name: Paracetamol (Commonly known as brand name Panadol)

 

Most people have taken paracetamol at some point for a headache, period pain or backache. 2 tablets here and there are fine, but are you reaching out for the stuff more often? And do you know how much is safe to take?

 

Too much paracetamol can cause liver failure –which can lead to death.

 

The recommended dose is no more than 4 grams per day, which is a total of 8 tablets. But there are so many times a patient will come into a consult and tell me they have tried 10 to 12 tablets to get rid of their headache or belly pain – which subsequently gives me a headache from anxiety.

 

There are people who try to overdose on this stuff and its availability everywhere from a 7/11 to a service station often has me worried. How can something potentially so dangerous be so easy to get?

 

In the recommended dose it’s fine (so long as you don’t have underlying liver problems) but chugging it down by the truckload (just because its on your supermarket shelf) isn’t necessarily safe.

 

 

Drug Name: Ibuprofen (Brand name: Nurofen)

 

We doctors call anti inflammatories NSAIDs (non-steroidal anti-inflammatory drugs) but you would know them as Nurofen or Voltaren.
These babies work a charm for muscular pain and inflammation. Sore ankle after netball training, period pain, neck ache or backache – this stuff can work a miracle!

 

BUT – they aren’t all the goodness you might think they are.

 

Take them on an empty stomach for a prolonged period of time and you are potentially facing gastritis, which is inflammation of the stomach lining causing pain, blood loss and even ulcers.

 

They can also cause kidney troubles as they reduce the amount of waste products filtered through the kidney. In the elderly especially we get VERY worried about causing kidney failure with these drugs.

 

So between ulcers and shutting the kidneys down – these medications aren’t as safe as you think. And look at how easily you can buy the stuff!

 

Some think rubbing Nurofen or Voltaren gel on their ankle or back is ‘safer’ – I’ve heard this arugment from patients many times! Not necessarily – firstly, you shouldn’t be using the gel and tablet form of the same drug (it’s essentially over dosing on the stuff) and secondly, the gel should only be used for the shortest term possible too. Just because you’re rubbing it on doesn’t mean it’s safer – it still ends up in the blood stream!

 

If you need these tablets – use them with food and for the shortest duration possible. If you find yourself using them a lot – its time to see your GP to work out what’s causing your pain and what else can be done!

 

 

As you can see just because the tablets are sitting on the shelf (with no prescription or discussion with the pharmacist needed) does not mean they are 100% safe. I am seriously scared of anti inflammatories (after having seen patient’s end up on dialysis with kidney failure and with ulcers in their stomach!), and you should be wary too.

 

So before you pop that foil packet today – do you need the drug? Have you got food in your belly before you swallow an anti-inflammatory? Are you taking over the recommended dose for the day?

 

And most importantly, have I made you think twice about popping another pill today?

 

 

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My Top 5 Tips for Healthy Weight Loss

We all want to talk about this don’t we? A great friend of mine recently picked my brains about weight loss and asked me to dish some tips out on the blog. With my rubber arm I started typing this blog BUT I have just 1 proviso – we are beautiful creatures inside and out and I’m talking weight loss/management for health benefits (to reduce risk of high blood pressure, type 2 diabetes and high cholesterol). I am not talking weight loss so you can fit into a size 6 dress for a party or attain this ridiculous goal of a thigh gap. So if you feel you body mass index (BMI) is on the higher side or you are worried you might be gaining unhealthy weight then this is for you:

 

  1. Reduce your portion sizes

 

If you eat too much of anything – you won’t lose weight. In Australia (mainly thanks to food availability) we eat too much and portion size control is how most of my patients will lose weight.

 

Put your hands in a circle and slightly separate your fingers – you should not be eating more than this per meal. Hello, most people’s steak or piece of chicken is that big not their entire meal. I’ve had patients come up with all sorts of excuses “I’ll die – that’s not enough food” and a lovely man who on his follow up appointment admitted he had been stacking his food UP to fit in the circle – which I thought was highly intelligent and innovative but NOT successful for weight loss (I now specify no stacking up to all my patients thanks to him!!).

 

You may feel hungry for the first 2 days but your body adapts I promise. And if you feel peckish post meal -my rule to patients is drink 2 glasses of water and wait 40 minutes before you even THINK about putting more food in your belly. Most people will be full if they just let the food settle.

 

Envision your dinner plate from last night – did you eat outside the circle? If you are serious about weight loss – you need to start here.

 

  1. Make smart choices

 

You’re dairy should be low fat.

You’re meat should be lean – with fat trimmed off.

The drink of choice is water as opposed to cordials/fruit juices and god forbid energy drinks, which are loaded with sugar!

Alcohol = calories – so if you’re serious about weight loss – you need to cut this too.

Take away like Maccas or HJ’s is crazy when you are talking serious weight loss. If you need a break – make smart choices like sushi, a Vietnamese pho or grilled fish.

Snacks – celery, carrots and hummus should replace all biscuits/cakes/chocolate/other horrendous things we crave to snack on.

 

  1. Exercise, exercise, exercise!

 

You NEED to be active not just to lose weight but for your heart health – remember 30 minutes every day is what the Heart Foundation guidelines recommend. To lose weight you likely need 4-5 hours a week – so get moving and shaking and as I highlight in the blog “Can Exercise Adapt to You?” – find an option that works for you!!

 

  1. No eating after 8pm

 

That bikkie you have at 10pm or the paddle pop you sneak out of the freezer (hello pregnancy cravings!) does you no good! No eating after 8pm is the key – put your body into fat burning mode so the next meal you eat after dinner is breakfast the next morning. Tell yourself “my body is now burning the fat I don’t want” to drive you, that will usually stop you reaching for a treat! Drink water if you feel hungry and if you MUST eat something – celery, carrot, some nuts – NOT the fat filled treat!

 

  1. Have realistic expectations

 

My patient’s will often claim they are going to lose 20 kilograms by the end of the year or fit into a size 8 (from a 16) in 3 months. No, no, no – you will crash and burn with goals like that. Be realistic – set small goals – 5 kilograms in 6 months is do-able, reasonable and SUSTAINABLE. This is not a diet – this is you kick starting a whole lifestyle change to improve your health.

 

Don’t weigh yourself every day – do it weekly or fortnightly at the same time (ideally first thing in the morning after a wee) OR my rule with patients is they only weigh themselves in my room – to prevent obsessive scale watching. Be kind to yourself- the changes in your body will come and not always with the numbers on the scale first but in how you feel, how your t-shirt fits around your arms and how your jeans start to feel a bit looser on the belly.

 

I hope that helps and gives you some tools for your journey! And to my friend who picked my brains – I’ll be checking in with you in 2 weeks!! For the rest of you – feel free to share your journey with me on Facebook or Instagram (I’d love to see it!!). But don’t forget why you are doing this – for the health benefits – and let that motivation drive the journey!!

 

Good luck!!

 

 

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You Can Make Friends with Salad

Ahhh the 2 fruit and 5 serves of vegetables a day – it causes so much discussion – “how could I possibly fit this in my day” and “why do I need so much?”

 

I’ve asked the same questions but the truth is – it makes a difference and as a Doctor I harp on about this every single day to my patients. Eating more fruit and vegetables helps to maintain a healthy weight and prevent obesity. It also protects against chronic diseases like cardiovascular disease and can help the prevention of diabetes. When I tell a patient “look if you bump up the fruit and veggies you can lower your risk of diabetes, heart attack, stroke and bowel cancer” – I anticipate excitement “oh yes, tell me how I can change my life please!!” but I am so often met with resistance “its so hard” or “I don’t have the time.”

 

The numbers sound big – 2 and 5 but really they are achievable I promise.

 

A serve of fruit is equivalent to an apple or banana or a cup of canned fruit. A serve of vegetables is equal to 1 cup of raw veggies or half a cup of cooked green veggies like spinach or broccoli. Canned and frozen fruits and veggies count (thank goodness).

 

So how do I do it? I whip up a soup most weeks for lunches and easy on the run dinners – canned tomatoes, fresh tomatoes, carrots and celery whipped together – easily my 3 serves of vegetables at lunch time. Tuna salad for lunch with 2 handfuls of baby spinach and a medium tomato and a tuna can chucked in at work – and done – another 3 serves of vegetables easily. A tub of no sugar added fruit as a snack or fruit and yogurt and I easily fit in the 2 serves of fruit.

 

The point I’m making is its possible – when your packing the lunch box (for you or your kids) chuck in a piece of fruit or do a massive soup batch on your free night of the week and let that fill you with you veggie intake. Don’t forget lentils and legumes are vegetables too – whip up a hommus or chuck in some beans when you next do a meat dish…

 

The way I do it is to plan ahead and to put all the veggie requirements into a meal and THEN think about the other stuff like the piece of baked chicken or cous cous on the side. Let the veggies be your first thought – not the steak! It’s a mind set change – but its one that we as a country have been very poor at doing!

 

The benefits are amazing and when you think of all the benefits I mentioned before- 2 and 5 doesn’t seem like much at all!

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Stressing about Stress

 

Sometimes I wonder if I stress because I think I should be stressed. You have an upcoming exam or presentation and you know you should be stressed so you work yourself into a frenzy thinking “well Im meant to be stressed, I feel stressed, oh my goodness I’m stressed” – and just like that you are freaking out! Some degree of stress can be helpful and some people find this drives them – but there can be a point when it’s no longer helpful.

 

So what can we do to manage stress? How do we keep the mind calm and manage that rising fiery pit of stress and anxiety in our stomach?

 

The truth is I can’t give you a concrete answer because we are all different but I can share some tips that I share with my patients a lot of the time:

 

  1. Regular physical activity is key – I do harp on about this a lot but the truth is regular physical activity can do a lot to manage stress. Yes, its great for your cardiac health but its also great for the mind. So despite feeling like the stress levels are climbing and you don’t have time for exercise – you always do and it will help!
  2. Yoga/meditation – anything that gives your body and mind some down time.
  3. Avoid caffeine and alcohol – there can be a tendency to use these types of substances to ‘self medicate ‘ but it can worsen stress – and if you feel stress levels climbing then I tend to avoid both of these.
  4. Write lists and sort out the things that are stressing you – stressed because you have an exam coming up and you feel under prepared – start building in more study. Stressed because you feel like you cant balance the kids, work and life – write down things you could do to get some help- do you need to call on more family or friend support? Avoiding what is stressing you doesn’t make it go away – acknowledge it and start finding ways to deal with it!
  5. Sleep – make time to let your body relax – sleep abates stress.
  6. Accept some level of stress – remember when the cave man was chased by a lion he was most certainly stressed and ran super fast and thats what saved him. Stress is helpful so harness some of it – but don’t let it get the better of you!

So theres some of my tips – see if some of them work for you! If you’re feeling stressed just reading this then I’m sorry! But maybe its time to start managing those stress levels… Good luck!

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The Grape Debate

After a hard day at work it’s too easy for me to reach out for a glass of wine.

 

On Wednesday to celebrate “hump day” the tendency is to celebrate the mid week achievement with a drink!

 

When you meet the ladies on a Friday night after work – of course we are having champagne!

 

A casual gathering of friends on a Sunday afternoon is usually going to involve a cider (or two!).

 

Most of us at some point will consider “cutting down” – so does this mean we are drinking too much?

 

My husband and I make a conscious effort now – after realizing we were having a glass of wine most nights with a meal – to have alcohol free days and drink only two days a week.

 

The National Health and Medical Research Council of Australia suggest no more than 2 standard drinks per day and actually you don’t need alcohol free days anymore (yay!). A standard drink is 100mL of wine – how often do you pour a glass that small at home? At our home never – our beautiful bucket glasses would look pathetic with 100mL of wine it in! A standard drink is 285mL of beer – but how often do you stop at 2?

 

The problems of drinking too much are endless – it contributes to high blood pressure, increases risk of stroke and heart attack and also your risk of certain cancers (such as bowel and breast cancer). The liver takes a major hit and so can the brain.

 

When I gently point out to patients that they might be drinking too much – the response is very often “well if it’s 2 drinks per day can I save them up and have them all on the weekend?” The answer is NO! If only it were that easy – if only you can bank your red wines all week and save them for Friday night! The rules are 2 standard drinks per day – no negotiation and no bartering (trust me I’ve tried)!

 

So have a think – is the glass of wine tonight worth it?

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