Inside Health

Four years ago, Peter, a retired engineer from Gloucestershire, suffered a small stroke and lost the ability to speak. He communicated by hand signals and writing notes to his wife, Carol. But this summer, as he tells Dr Mark Porter, he woke up one morning and, much to everybody's amazement, began to talk....and he hasn't stopped since. Later that same day, a second stroke was diagnosed but his newly-returned speech was unaffected. It's a remarkable story and Alex Leff, Professor of Cognitive Neurology at the Queen Square Institute of Neurology in London discusses Peter's experience but describes what usually happens when stroke patients experience aphasia. We're all familiar with devices like FitBits and gym monitors that measure your pulse rate but the latest development in wearable tech is a watch that monitors your heart. The latest Apple watch will offer ECG-like capabilities which can spot potentially worrying disturbances in heart rhythm. But Inside Health's Dr Margaret McCartney has serious concerns about the use of such tech for screening in healthy populations. If you're under 50 you've almost certainly had it. The heel prick test or NHS newborn blood spot screening programme is done during the first week of life and it's designed to detect nine different conditions before they can cause symptoms or irreversible damage in young children. Dr Elaine Murphy is a consultant in inherited metabolic diseases at the Charles Dent Metabolic Unit at the National Hospital for Neurology and Neurosurgery in London and she tells Mark about the history of the heel prick test and describes the original condition, phenylketonuria or PKU, that the 1969 test was designed to detect. Producer: Fiona Hill

Every GP surgery should provide access to a dedicated social prescriber, according to the Royal College of GPs. Supporting peoples' non-medical needs - including housing, finance and social care - will, it is hoped, free up GP time for urgent medical care and at the same time, provide much-needed access to activities in the community. Arabella describes how social prescribing worked for her. A support worker helped her to join a choir, sort out finances and plan how to return to work after a period of serious illness. Dr Marie Polley, senior lecturer in health sciences at the University of Westminster and co-chair of the Social Prescribing Network (with Dr Michael Dixon) tells Dr Mark Porter that social prescribing will be embedded within medical and social care in the next decade as long as the voluntary sector is supported.Steroid cream and ointments - like hydrocortisone, clobetasone and betamethasone - are used to treat a number of skin problems. But for some patients long-term topical steroid use can lead to painful, disfiguring and debilitating skin flare-ups. Some call this condition topical steroid addiction. But consultant dermatologist Dr Tony Bewley from Bart's Health in London tells Mark that health care professionals prefer the term topical steroid withdrawal syndrome. He sees the condition fairly often in his clinic and reassures sufferers that there is treatment available. We're used to having our blood pressure checked using a cuff on our arms but we can also have high blood pressure in our lungs. Pulmonary hypertension tends to put our hearts under strain and causes breathlessness. It can be caused by a range of diseases but in pulmonary arterial hypertension (PAH) the raised pressure is due to constriction of the blood vessels. This narrowing of the arteries makes it difficult for the heart to pump blood through the lungs, leading to breathlessness. Inside Health's Dr Margaret McCartney visits the Scottish national specialist centre for the disease at the Golden Jubilee Hospital in Glasgow's Clydebank. She talks to Lorraine who is living with the disease, to pulmonary vascular consultant Dr Colin Church and watches a team led by Dr Martin Johnson performing right heart catheterisation, the gold standard diagnostic test for the disease. Producer: Fiona Hill.

If you are taking low dose aspirin - typically 75 mg day - to protect against heart attack or stroke and you haven't been weighed then there is a good chance you are on the wrong dose. And from prevention to treatment; a new way of managing the most common form of stroke by grabbing the blockage in the brain and pulling it out. Charlotte Smith tells her story of a remarkable recovery from the procedure whilst she was pregnant with her second child. Plus a continuation of our guide to the help available when people lose the capacity to make decisions about their care. This week Mark Porter explains Best Interest Decisions and Lasting Power of Attorney. And GP Dr Margaret McCartney reflects on the Hadiza Bawa Garba case.

Does running damage your knees? And is cycling any better? Runner, cyclist, GP and Inside Health regular, Dr Margaret McCartney goes to the new Motion Analysis Lab at Glasgow's Jubilee Hospital and asks orthopaedic surgeon and competitive cyclist Jason Roberts about the latest evidence.Around 30,000 people a year suffer cardiac arrest - their heart suddenly stops pumping blood around their body - and fewer than one in ten survive. Paramedics and ambulance crews will give CPR and use a defibrillator to try to restart the heart, and for the past 50 plus years, most patients will be given a shot of adrenaline too. But a landmark new study funded by the government and run by Warwick Medical School reveals that giving adrenaline barely increases survival and almost doubles the risk of severe brain damage. Dr Margaret McCartney discusses likely changes to policy with Dr Mark Porter.It's said that eyes are the windows to the soul - and certainly looking into other peoples' is the key part of human interaction. But what if one of yours isn't real? Sixty thousand people in the UK have an artificial eye and Europe's largest maxillo-facial laboratory at Queen Victoria Hospital in East Grinstead offers a bespoke service where specialists make individual eyes from live sittings. Susan lost one eye as a child and she tells Mark that her latest prosthesis is her favourite. Why? Because it's almost half the weight of eyes she's had fitted before. Dr Emma Worrall, principal prosthetist, has invented a lighter sphere. In a lightbulb moment sitting in a café stirring a sugar cube into her coffee and watching it melt, Emma tells Mark that she realised she could build the plastic sphere around sugar, drill a tiny hole, then melt the sugar out of the middle! Twenty patients at the hospital are now benefiting from lighter eyes (which means less surgery). And there's another plus. The new eyes float in the swimming pool and the sea!Producer: Fiona Hill.

The relationship between when babies are weaned and the amount of time they sleep has hit the headlines after a new study has been published. Now UNICEF has got involved. Margaret McCartney reviews the evidence. Also proof that seeing the same GP saves lives. Mark Porter meets the man behind new research on mortality and continuity of care, Sir Denis Pereira Gray, who also works in the same GP surgery as his father and grandfather did. And a guide to Mental Capacity, an issue that touches many people but is increasingly pressing as more families manage elderly relatives living with dementia. Plus research and the NHS charter.

Copycat biologic drugs, to treat conditions from arthritis and psoriasis to breast cancer and lymphoma, could save hundreds of millions of pounds off the NHS drugs bill. Called biosimilars, these close copies give the same clinical benefit at a fraction of the cost. Up to now the problem has been take-up, but a new initiative led by the specialist UK cancer centre, London's Royal Marsden, run across the NHS Cancer Vanguard, has demonstrated that patients can be switched effectively onto the cheaper drugs. Chief pharmacist at the Royal Marsden, Dr Jatinder Harchowal, who led the national staff education programme, tells Mark that getting clinicians and patients on board was key to achieving an 80% take up for the blood cancer biosimilar, rituximab. This month a biosimilar copy of the breast and stomach cancer drug, Herceptin (generic name trastuzumab) is being introduced to patients too. Imogen had sleep problems for almost 30 years and she admits that at times, her insomnia left her in a desperate state. For years she took sleeping tablets but she ended up increasing the dosage, to no effect. Eventually she found help at Queen Victoria Hospital's Sleep Disorder Clinic in East Grinstead. Mark visits the clinic and finds out from its Clinical Director Dr Peter Venn that sleeping tablets aren't the answer to insomnia and cognitive behaviour therapy, which Imogen used, is the best treatment.Scotland has led the UK nations in allowing early medical abortion at home. Wales in the past 10 days has followed their lead. So where does this leave England? Dr Margaret McCartney reports from Glasgow about the choice now available for Scottish women who opt for a medical termination. Since last autumn the second pill that induces the breakdown of the womb lining can be taken at home, a practice that already happens in Scandinavia and parts of the USA. Dr Audrey Brown, a consultant in sexual and reproductive healthcare, tells Margaret that the impetus for the change in practice in Scotland came directly from women who didn't want to make the second clinic visit for the second set of drugs and risk cramping and bleeding on the way home. A woman who has opted for early medical abortion at home in Scotland shares her experience with Inside Health.Producer: Fiona Hill.

Tamoxifen, the so called "statin of breast cancer prevention" is recommended for healthy women with a family history of the disease. So why are only 1 in 7 of those eligible taking it? And Mark Porter speaks to Professor Gareth Evans working with his team at the Wythenshawe Hospital in Manchester to reliably identify women at higher risk of breast cancer. They are testing for SNPS, spelling mistakes in the DNA that influence growth and survival of cancer cells and that give a more accurate assessment of a woman's risk.

The UK has one of the highest recorded rates of acid attacks in the world, nearly 500 cases in 2016. Most of the victims are men and most have corrosive liquid, typically acid or bleach, squirted into their faces while they are being mugged for their phone, bag or car. Andrew Keene was attacked in London last year while he sat in his car, and blinded by a robber who then drove off in his car. He's had five operations, including two corneal grafts, to try to restore the sight in his right eye. Dr Mark Porter talks to Andrew at Queen Victoria Hospital in East Grinstead, where sight-saving eye surgery was pioneered over sixty years ago. This hospital set up the UK's first Eye Bank for donor eyes and it is from these donations that eyes, damaged like Andrew's, are repaired using grafts. Mark hears about the shortage of donated corneas which mean long waiting lists for eye surgery and Eye Bank head Dr Nigel Jordan tells him they're having to import donor eyes from the USA to meet demand. BBC News anchor George Alagiah has gone public with the news that his bowel cancer has come back three years after it was diagnosed at an advanced stage. He has questioned why screening starts at different ages in different parts of the UK. If he lived in Scotland where the bowel cancer screening programme starts at 50, up to 10 years before the rest of the country, he would have been screened earlier and his cancer might have been picked up earlier, making it easier to treat. Inside Health's Dr Margaret McCartney discusses the complexities involved in rolling out national screening programmes and tells Mark why there's a difference in Scotland and the rest of the UK about the starting age for bowel screening.Until a couple of years ago, children who were born without a limb, or those who lost a limb after illness or injury, could get a traditional prosthesis, or artificial limb fitted, but it was a limb of the most basic kind which would enable them to walk, but not to run or do sports. But thanks to money released into a special fund by the Department of Health in England, for the last 18 months these children have been fitted with the high-tech futuristic-looking prostheses - racing blades - that allow them to run, jump and compete in all sorts of activities and sports. Mark visits a paediatric rehabilitation clinic at the Royal National Orthopaedic Hospital in Stanmore and meets the children who are benefiting from these new activity blades.

Deciding between healthy ageing and early dementia; how useful are modern imaging techniques in deciphering this difficult question that many families are grappling with. Margaret McCartney tries to make sense of conflicting research on the impact of fish oils on children's reading ability and memory - how can the same research group, in the same university run two trials and get completely opposite results? And recently Baroness Tessa Jowell called for more access to adaptive trials but what does this type of research actually mean for patients taking part? Plus the evidence for the health benefits of yoga.

There are many myths about recovery from a heart attack. The most dangerous is that exercise is too risky. The truth is that for most people, they should be doing much more exercise, not less. Patrick Doherty, Professor of Cardiovascular Health at York University and lead author for the National Audit of Cardiac Rehab tells Dr Mark Porter that 70,000 people who should be accessing life saving cardiac rehabilitation therapy are missing out. The answer? Don't blame the patients but improve the design of rehab packages, he says. Inside Health visits a rehab session at Charing Cross Hospital in London and hears from cardiac patients about the impact of supported exercise programmes on their health.A group of psychiatrists, psychologists and patients have complained to the Royal College of Psychiatrists about the withdrawal effects of antidepressants. They say claims that side effects are resolved, for the majority of patients, within a few weeks of stopping treatment are false and in fact, many people suffer unpleasant, frightening symptoms for much longer. Inside Health's Dr Margaret McCartney looks at the evidence.We're all familiar with hearing aids, amplifiers which boost volume in a failing ear. And you might have heard of cochlear implants which, in people too deaf for aids, can be used to send signals directly to the inner part of the ear, and on to the brain. But in the future we're likely to hear more about middle ear implants, devices implanted because the outer ear hasn't developed properly. ENT surgeons at Guy's and St Thomas' Hospital in London, Professor Dan Jiang and Harry Powell, have performed a middle ear implant on the UK's youngest ever patient, Charlotte Wright was just three years old when she had this pioneering treatment. Producer: Fiona Hill.