Trust Me I'm A Doctor (2013) s01e01 Episode Script

Episode 1

1 We are constantly being told how to improve our lives Every day, we are bombarded by health claims.
How to get fit, slim down, look young.
But, all too often, that advice can be confusing .
So, how do you know what's best for you? I'm Michael Mosley.
In this series, I'm joined by a team of doctors.
Together, we'll use our expertise to cut through confusing adverts, headlines and health claims.
This is Trust Me, I'm A Doctor.
We're starting in Guildford to run a surprising experiment.
Can staying in bed an hour longer improve your health? We'll also be asking, can you be fat AND fit? Good job! That was fantastic.
Could this 1p pill help you live longer? When did you start taking it? What germs lurk on our hands? Rub it all over.
And how best to protect yourself.
I've just been on the train, as well.
It's going to be filthy, mate.
Don't want to know! Absolutely filthy.
Can Mozart make you more intelligent? And how to save someone's life with the touch of a button.
But first I've been a medical journalist for more than 25 years, and I've noticed that, increasingly, we are being warned about the dangers of being overweight.
Now, one of the standard ways of assessing whether you are obese or not is the Body Mass Index, but how reliable is this mathematical formula? Well, we've put it to the test to try and answer the question, can you be fat and healthy? A&E Doctor Saleyha Ahsan is stepping on the scales.
Today, we're going to put some scientific-sounding body measurements to the test.
Professor Janice Thompson from the University of Birmingham is going to be putting a bunch of volunteers, of a range of shapes and sizes, through their paces.
'Including me!' That's short, innit? That's perfectly acceptable.
OK, good! Our brave volunteers are going to be sized up in two different ways, and then we'll see how well those measures predict their fitness - the best indicator of health.
First off, a measure used every day by doctors - we line them up according to their Body Mass Index.
This is calculated by dividing your weight in kilos by your height in metres, squared.
OK, Janice, we've got everyone lined up 'The standard doctors' classification says that 'a BMI between 18.
5 and 25 is normal.
'Over 25 means you are either overweightor obese.
' So, my number I'm 30.
That puts you right at the beginning of what we would call the obese category for BMI.
So I am, officially, according to BMI, obese.
That's quite a shock.
That is quite a shock What a title! People carrying excess fat tend to suffer from health issues like diabetes and heart disease, but BMI is not looking directly at fat, just a person's overall weight.
Before I trained as a medic, I was in the British Army and there were plenty of big, muscly people around, who would have had a high BMI, but certainly weren't fat.
So, I want to check exactly how fat our volunteers are.
This is our second test.
We're measuring our volunteers using body fat meters - Machines that calculate your body's electrical conductivity and, from that, estimate your percentage fat when given details such as your gender, weight and height.
I'm going to enter some information for you.
We got your height as 166.
The results of THIS test are quite different from the results of the simple BMI test for some of our volunteers.
So, Janice, we've got new numbers - what've we got here? OK, this is now reflecting everyone's percentage body fat.
So, some surprising shift arounds.
Corrin, for example.
So, Corrin Her BMI reflected that she was at the high end of overweight, but her percentage body fat is actually a good number.
We'd like to see women at less than 35% body fat, and she's down at 31.
And if you're a man, you should aim to be below 25% fat.
By simply comparing weight and height and ignoring WHY they are heavy, BMI classifies many as obese - even athletes who have lots of muscle, but not much fat.
So, although Corrin's BMI accuses her of being overweight, her body fat percentage is actually good.
And the BMI equation doesn't serve taller than average people well either - giving them higher BMIs than their weight deserves.
So, time for the final stage - do either of our measures of 'fatness' actually reflect how healthy our volunteers are? OK, let's get going.
Time to start the test.
Janice thinks that THIS is the best way to find out When we look at the components of things that predict people dying prematurely, aerobic fitness is a really strong marker.
It's a much better indicator, than your body weight might be, of what your risk is.
Keep going! We're calculating a measure of fitness called VO2 max for all our volunteers.
To do that we measure their oxygen intake as they are pushed to their physical limit.
Research has shown that THIS is the most powerful predictor of actual health.
Well done, hang in there.
Stay on there.
Good job, no, great.
Really good.
That was fantastic.
So, when our volunteers are lined up not according to their body shape, but their VO2 max, it's clear that our two fat measurements don't reflect our volunteers' health and fitness.
Some whose BMI and body fat would have rung alarm bells, have VO2 max levels which show they are fit - above 40 for a man or above 30 for a woman.
Antony is a prime example.
His VO2 max comes out at whopping 47 - which is very good and shows he's fit and healthy.
His BMI and body fat percentage, would've given no indication of that.
It sounds inconsistent, maybe a bit surprising, but people can be what we call fit and fat, if you will.
So, although certain kinds of fat - the kinds that sit around our organs and our bellies - CAN be dangerous to our health, having a bit of junk in the trunk or a high BMI doesn't necessarily mean that you are unhealthy.
It's about avoiding the visual, and not focussing and obsessing so much about our weight in general, but really trying to focus more on our fitness levels, on being more active on a regular basis.
To be honest, I've always been suspicious about BMI.
Body Mass Index and body fat percentage don't actually tell us much about the individual person, and yet these are two very common tests.
But they fail to tell us about that one very important factor, which is our health.
The best way to find out about that is through measuring our fitness.
Now, we have been round the country assessing the evidence behind all sorts of health claims, but, today, we're based in Guildford because, just down the road, surgeon Gabriel Weston has been looking at the evidence behind what I think is a particularly interesting bit of research.
This is the Sleep Research Centre at the University of Surrey.
The scientists here are world leaders in studying the effect on the body of sleep - or the lack of it.
Research suggests that, before the advent of electricity, we slept about nine hours a night, whilst now, two thirds of us sleep less than seven hours.
As sleep has declined in society, the seemingly unconnected conditions of obesity, diabetes and heart disease have increased.
Recently, researchers have been recently asking whether we can actually blame these diseases on lack of sleep.
To investigate, we have recruited a group of seven volunteers who have been taking part in an experiment.
They come from all walks of life and show a typical range of sleep patterns So, Claire, what's your normal pattern of sleep, of a night? I'd say probably about seven and a half hours, depending on housework, sick children, that kind of thing.
What sort of time do you go to bed? About midnight.
Then I get up just in time for work, about seven o'clock.
I get up about 6:15.
Um, I function a lot better in the morning, and I fall asleep about My brain turns off about six o'clock at night.
So, early to bed, early to rise? Yeah.
As you might expect, it's a student who gets the most shut-eye Nine hours, maybe? Yeah I sleep quite a bit.
In our experiment, we're running a range of physical and mental tests on our volunteers, after they've spent a week of sleeping six and a half hours a night, and then again after a week of seven and a half hours a night.
Everyone in this room has different patterns of sleep.
But we're here to see whether getting just one extra hour's sleep a night could improve our overall health.
It's already the end of week one for our volunteers, and some are finding the restricted sleep difficult.
I've been on six and a half hours sleep this week, which has been a bit of a shock, really.
Within the first couple of days, I really felt the difference.
I found myself a little bit more grumpy than normal.
Um I'm generally quite a happy person, so Researchers here think the fairly small change of one hour in a night sleep could be enough to make dramatic changes to our bodies.
So, we're taking blood samples now to compare with another set at the end of the second week.
These will allow the researchers to see how the two different sleep regimes affect which genes are active in our volunteers' bodies.
We'll be looking out for changes in the activity of genes associated with obesity, heart health and common diseases, to see whether our modern sleep patterns really could be affecting our health.
We'll find out our results later in the programme.
Meanwhile, watch out London! Infectious disease doctor Chris van Tullekan has got his white coat on I'm a doctor and we're looking at different bacteria that are on people's hands - so what I want to do is just get a swab.
When I'm in the hospital or the lab, working with infectious diseases, of course I have to wash my hands thoroughly all the time and use antiseptic washes.
But now everyone's being sold these antimicrobial gels, wipes and foams.
The question is, do we need them? How filthy are the average person's hands and are these products really the best way to clean them? They're old hands! No, you've got gorgeous hands! I'm hoping to collect swabs from 50 peoples' hands, and then see what bacteria they're carrying.
Where're you from? Switzerland.
Switzerland! Well, I do wash all the time Have you got kids? Thank you, bye! That will tell us what sort of a hygiene problem we're really dealing with.
Rub it all over.
And I've just been on a train, as well.
Don't want to know! They're going to be filthy, mate.
Absolutely filthy.
You've got? 14.
Plus 10 is 24 31 11.
42 Seven.
49 So, let's get one more.
My hand swab.
A few days later, I catch up with microbiologist Dr Ron Cutler, who has been growing the bacteria we collected until there are enough to see who had been carrying what.
And there is quite a range from the super clean to the rather less hygienic.
Some people are quite normally contaminated So, this is typical? This is a typical one.
OK, so we've got a few different bugs, and that's what the blobs are, the bacteria growing.
That's right.
Now, this one here, we've got a huge range of different bacteria - and a fungus, which is up at the top there, and you can see there are far more colonies there than there are on the other plate.
Some of them will be from your nose, and some of them will be from your bottom.
And it smells odd, doesn't it? The plate The plates smell funny.
Yeah, well, I'm glad you sniffed it, because I certainly wouldn't! Not going any closer! From our testing, a third of people's hands were what Ron called "heavily contaminated" with bacteria.
And of those, around 10% were "grossly contaminated" - they had between 10 and 50 times more bacteria than average.
But worst of all - nearly a third of people's hands were contaminated with bacteria normally found in poo.
That's a surprising number of people who could do with washing their hands more often And it's not just from the loo that germs get onto our hands.
The kitchen sink typically contains 10,000 times more germs than a toilet.
Most chopping boards have faecal bacteria on them.
And those famous stomach bugs, E.
coli, lurk in washing machine water.
How did mine look? Were my hands filthy, or about normal? Well Not so good.
You basically were not one of the cleaner ones.
As you can see, you've got a whole range of different organisms.
Nice! But I should be doing better than this, probably.
You should be doing better than this, but I didn't like to say.
And THAT'S why we doctors wash our hands so much.
Being out on city streets means inevitable contamination for everyone.
So, it's clear that we all need to wash thoroughly to avoid harmful bacteriabut how? Are all those fancy products, from alcohol-based gels to antimicrobial foams, the way to go? Now, these products were first developed for use in hospitals and most people tend to assume that they work better.
But is that actually the case? I'm going to put them to the test.
Elena and Ellie are professional dog walkers in South London, and today, I'm giving them a helping hand.
As anyone who has dogs knows, it doesn't take long to get your hands dirty.
And dirty hands are just what we need to test our cleaning products.
We've got these three different products We've got the very fancy foam that claims to kill 99.
We've got the alcohol gel.
That makes the same claim.
And we've got old fashioned soap and water.
We want to see if they all do the same thing, or if one of them is better.
Swab first Then Elena is trying the alcohol-based gel This is going to be cold! I'm going to try the antimicrobial foam The foam acts rather like the alcohol gel, but it's got some other fancy chemicals as well, hasn't it? Absolutely.
It's got chemicals that claim to be like little swords, and they burst the bacteria open.
And, finally, Ellie, the good old fashioned soap.
The soap will have some effect on killing and destroying bacteria, but most of what's happening here is physically removing dirt from the hands? Right.
And we always say in the hospital that you should take as long as it takes to sing Happy Birthday twice.
'Yes, and we really do mean the whole song twice.
' Just rinse them off and we'll get an after swab.
So, in our very simple test, how did the different products compare? What we found was that the antimicrobial foam reduced it by about 96%, the alcohol based gel by 84%, but the soap and water reduced the number of bacteria by 99%.
Really? Yes.
So, in our test, in fact, the soap and water was the most effective way of getting rid of bacteria.
Why? Basically, they're all effective at removing bacteria from hands, It's just the fact that, when you were demonstrating, you actually showed how to get in between the fingers where all the dirt actually can reside.
So, soap and water not only kills the bacteria, but if you put in nice, warm, hot water, rub your hands around, then you're physically removing many of the bacteria from your hands.
Although our test was only on three people, research on the best way to clean your hands repeatedly shows that it's not so much what you use, it's the way that you use it.
There's no need to spend lots of money - instead, spend a bit more time when you're washing.
Foams and hand gels are, in a sense, the lazy man's handwash.
They're fine at what they do, but as long as you're washing your hands regularly, soap and water does the job.
Later in the programme What do you need to know to save a life? Saleyha has the answers.
And can you do brain surgery without making a single incision? But first Earlier we met a group of volunteers at the Sleep Research Centre here in Guildford.
All are part of our experiment to see if just one extra hour of sleep at night can bring major physical health benefits, protecting us from killers like diabetes and heart disease.
As they enter the second week of the study, I can't resist a little experiment of my own.
What can science tell us about getting a better night's sleep? Some people think of sleep as a luxury - you can slash back on it.
After all, that's what caffeine is for.
Many other people, however, struggle to get enough sleep.
So what is going on inside your brain when you're sleeping? How do you know if you're getting enough? And what, if anything, can you do to improve the quality? Apparently THIS is the easiest and most reliable way to find out.
At least that's what the researchers tell me.
What's happening now is they're attaching EEG electrodes to my scalp, so that they can measure what happens to me as I fall asleep and while I am asleep.
I'm slightly worried as to whether I'll actually be able to sleep with these things on my head but, um, we shall see.
Whilst the volunteers in our experiment prepare to go to bed, changing the quantity of their sleep, I do too, but I am interested in sleep QUALITY.
The initial problem is how to drop off in the first place, and here technology is actually getting in the way.
Our eyes have special receptors for blue light, which help set our body clocks.
Unfortunately, computer screens, phones and modern TVs often give out a lot of these blue wavelengths, which can make you less sleepy.
So, avoid the screens late at night, or if you are desperate, adjust the colour balance to make them yellower.
Then darken your bedrooms as much as possible.
Just doing that should help you get right off to sleep.
Then there's caffeine, which will keep most of us awake.
And I've only recently discovered why that is.
It turns out there is a chemical called adenosine which builds up in your body and in your brain during the course of the day, and that normally puts you asleep.
But if you take caffeine, caffeine blocks the receptors in the brain that adenosine normally latches onto.
The caffeine is there, it stops adenosine getting to the receptors, and therefore stops you falling asleep.
And that is why I'm drinking hot lemon tea.
Surprisingly enough, once you drop off, your brain doesn't switch off.
Instead it remains intensely active.
The sensors on my head are picking up the electrical activity in the different parts of my brain and beaming them to a laptop to be analysed.
When I fall asleep, they clearly show that my sleeping brain is very busy, and at different phases of the night, it's doing different things.
My whole night's sleep has been analysed at Oxford University by Dr Katharina Wulff, and it seems that like most of us, I went immediately into a phase called "deep sleep".
Although it sounds restful, our brains are actually working hard.
So what happens when you go into a deep sleep is that the brain starts to work on the information it gathered during the day, the memories.
And so if you don't have that, then it could get stored in all the wrong places, or get lost for ever? It's probably getting lost.
During deep sleep our memories are moved from short-term into long-term storage, allowing us more memory space for the next day.
Since deep sleep is essential for consolidating memories, then it is a good idea if you are revising or perhaps taking an exam, to make sure that you're getting a reasonable night's sleep.
In one study, people who failed to do so did 40% worse than their contemporaries.
But as we all know, facts aren't everything in life, and equally important are emotions.
My electrodes show that during the night my brain had phases of another kind of activity, called "REM sleep", that deals with those.
This sleep is the phase where you are usually paralysed.
Completely unable to move, right.
And the only muscles which are not paralysed are the eye muscles, and that's why it's called rapid eye movement sleep.
During REM Sleep something very surprising happens.
One of the stress-related chemicals in the brain, noradrenalin, is switched off.
It's the only time - day or night - this happens.
It allows us to remain calm whilst our brains re-process all the experiences of the day, helping us come to terms with particularly difficult emotional events.
We get more REM sleep in the last half of the night.
Which means that if you are woken unexpectedly PHONE ALARM CHIMES .
your brain may not have dealt with all your emotions, which could leave you stressed and anxious.
That means the alarm clock could have a lot to answer for.
As could alcohol, which reduces your REM sleep while it's being processed in your body.
If you stop drinking a little bit earlier before you go to bed, you will give yourself more of that invaluable REM sleep time.
EASY LISTENING MUSIC You might think, "I'll cut back during the week "and then make up for it at the weekend.
" But unfortunately, it doesn't work like that, because memories, for example, need to be consolidated within 24 hours of being formed.
So, maybe watching that extra episode of your favourite drama, or having one more drink with friends, isn't quite as harmless as you'd hoped.
But what about quantity? Does altering the amount of sleep we get by just an hour really affect our health? We'll be finding out later in the programme, when our volunteers come back to Guildford.
And on the streets of Guildford, we've been inviting people to share those niggling questions that they've always wanted an authoritative answer to.
Firstly, one for Chris.
I was wondering how much water you need to drink in order to be healthy? There are loads of myths that drinking two litres of water a day will do wonders for your body and mind.
Now that's about eight glasses, and if you've ever tried to do it, you spend a huge amount of your day on the loo.
So where did this almost mythical figure come from? It might date back to the 1940s, when researchers calculated that this was how much water a person's body used up in 24 hours.
About half our body is made up of water - it's vital to keep the important chemical reactions in our body functioning.
But the researchers also said that we get much of the water we need each day from our food let alone the number of drinks like coffee and tea most of us indulge in, which all count, despite what some people say.
So this idea that drinking two litres of water a day is good for you has absolutely no evidence to back it up.
The boring truth is - drink when you're thirsty, and you'll be absolutely fine.
Was it a fall? 'In my A&E department, people are being brought in 'whose lives might have been saved 'if only someone nearby had known some basic first aid.
' Over the series, I'll be showing people up and down the country what to do before the paramedics arrive.
I am going to show you how to save a life.
'Would you know what to do if someone collapsed in front of you? 'Most people would go into a panic, 'but it's actually something almost anyone can deal with.
'Every year in Britain around 60,000 people suffer a cardiac arrest 'away from a hospital.
'Their heart suddenly stops beating, 'and the survival rate can be as low as two in 100.
'But in countries like Norway, more than twice as many survive.
'Because there, everyone is taught what to do.
' I've come to give some tips to Ely Rugby Club's 1st XV.
Last year, one of their players collapsed with a cardiac arrest in the middle of a game.
Luckily, he has made a full recovery, but like most people, his team-mates had no idea what to do.
When it happens, you'll be like It'll be different! 'If you are faced with someone who is unconscious, then don't panic.
'You can help them.
'Firstly, simply tilt their head back to ensure that their tongue 'doesn't obstruct their airway.
'If they start to breathe normally, then it is not a cardiac arrest, 'and you don't need to do anything else until help arrives.
'But if they're still not breathing, then call for help, 'and get going on CPR - cardio pulmonary resuscitation.
' Get more over.
Do it like this, really get over them.
'The advice is simpler these days.
'There's no need to attempt mouth-to-mouth resuscitation.
'Just firm chest compressions.
' The landmark, we say, is the centre of the chest.
Palm down, flat.
Get your other hand and wrap your fingers round it.
Get yourself into a good, strong position.
Get your elbows locked out straight, your back straight.
and you're basically above your hands in the centre of the chest.
And you push down about 5-6cm.
The rate is about 100-120 compressions in a minute, but I just do it to the song Staying Alive! SHE LAUGHS MUSIC: "Staying Alive" by the Bee Gees 'Famously, this is a tune with exactly the right rhythm.
'Each thrust is pumping the blood around the body to keep 'the organs - especially the brain - supplied with oxygen, 'and the action will also bring 'a little fresh air into the lungs each time.
' How long do you reckon you could carry on doing that for? A good 10 minutes? A good arm work-out.
Yeah? Save me a gym session, wouldn't it? 20 minutes, do you reckon you could last? No! It's tiring, isn't it? No! I'd be like, "Ambulance, where are you?" Aren't you going to hurt them? Well, if it's an older patient, they will have quite brittle, frail bones, so you may well feel a few cracks.
That would be lovely, that would(!) But the important thing is to keep going.
'You should try to continue CPR until professional help arrives.
'Whatever happens, just have a go, that's what matters.
'But whilst CPR will keep their organs alive, 'it won't restart their heart.
'Luckily there's a piece of technology that can do exactly that, 'a defibrillator, or AED.
'They're in public places everywhere 'so that anyone can use one.
They're incredibly simple and effective.
'As soon as someone can bring one to you, stop CPR 'and start using it.
Follow the voice prompts calmly.
Remove all clothing from chest and stomach.
Rip clothing if necessary.
'Like a sat nav, the machine will guide you through every stage.
'It will measure the casualty's heart rhythm 'and tell you exactly what needs to be done to help save their life.
' Peel off the pad labelled one and stick to the bare skin of the patient, exactly as shown in the picture.
'If they need a shock to restart the heart Analysing heart rhythm.
the defibrillator will be able to tell you, and will do it all for you.
' Shock advised.
'Of course, there's only one thing you must do - 'stay clear when it delivers the electric shock.
' Stand clear.
Deliver shock now.
Oh, no, you mustn't touch.
That's what you're not supposed to do! LAUGHTER You've got another unconscious casualty now! SHE LAUGHS Defibrillators are found all over the country in public places like stations and shopping centres.
When you call 999, they will tell you where the nearest one is.
Begin CPR now.
'And if you find yourself near someone who has 'a cardiac arrest, remember' If they're not breathing And if there's a defibrillator around, Those main points are all on our website.
One day they could help you save a life.
Still to come Can listening to Mozart improve your brain? And could one hour of extra sleep be the secret to a healthier life? Our experiment results are in.
But first Experts are often sharply divided over the pros and cons of different drugs, and it can be very difficult for the rest of us to decide what's best.
WHEELBARROW SQUEAKS Throughout this series I'm going to be asking the world's leading researchers their opinions on some of the most common and controversial medications.
Because, believe it or not, the average Brit consumes around 40,000 pills in their lifetime.
That's enough to fill a wheelbarrow.
Paracetamol, ibuprofen, vitamins, laxatives not to mention herbal remedies and prescription drugs.
And this is one.
Probably the most versatile drug we have ever created.
Grind it up, add a bit of water, bit of paste, stick it on your pimples.
Or you can use it to treat bee stings.
Good for headaches as well.
It is, of course, aspirin.
Now historically, people have used it to treat minor aches and pains, but increasingly it's being used as a form of preventative medicine, you take it every day.
Aspirin's preventative power against heart attacks and cancers has been all over the health pages, as have reports of it causing bleeding in the stomach or brain.
It's all very confusing.
So, should we be taking aspirin daily? I'm generally against taking any medication unless it's necessary.
So you're a paramedic, is that right? That's right, yeah.
And you carry it around with you? It's there in our pouch every day for heart-attack victims.
I've heard that they make your stomach bleed, so I'd be a bitsort of, wary of it.
Aspirin is one of the world's most popular drugs.
An estimated 100 billion tablets are taken every year, and not just for headaches.
Millions of people take aspirin to reduce the risk of having a heart attack or stroke, and let me demonstrate how it all goes on.
Ah! OK.
There we go, a nice drop of fresh blood.
Now, within moments platelets are going to be rushing to that area to form a clot and stop me bleeding to death.
That's good if it happens outside the body, but the trouble is it can also happen inside the body.
You get a clot that forms in an artery and it then blocks another smaller artery, and then you are having all sorts of problems.
What happens with aspirin is that it delays the clotting time, it makes clots much less likely to form and therefore much less likely that you will have all those associated problems.
Aspirin also seems to protect against some cancers, but it increases the risk of internal bleeding.
So while some doctors advocate taking a small 75mg aspirin tablet daily - that's a quarter of a normal pill - others disagree.
I really don't know what to think, so I'm going to hear from two of the country's leading experts, who have radically opposing views.
In 1974, Professor Peter Elwood from Cardiff University led the team that uncovered aspirin's ability to prevent heart attacks and strokes.
Since then he has taken aspirin every day.
He is 83.
Now, I know there's very good evidence aspirin, if you've already had a heart attack Yes.
you should be taking it.
But the argument is really all around someone like me, who has not had a heart attack is there really benefit? There is benefit, I mean, there still is a reduction.
The difficulty is someone like you, who is healthy, has a very low risk.
So, a 30% reduction in a low risk, is a very, very small risk.
And which sorts of cancers does it affect, reduce? It seems The evidence obviously is very thin on rarer cancers, but the evidence suggests that it's effective with all solid cancers.
You mean bowel cancer, tumours of the breast Yes.
prostrate, kidneys, liver, the works? The uterus.
For instance, bowel cancer, the reduction's about 60%.
There is no doubt that the balance is in favour of taking aspirin over the age of, perhaps, 50.
When my team published the very first trial showing benefit, and that was 1974, I started taking low-dose aspirin, and I've been taking it ever since.
How old were you at the time? 44.
44, OK, right.
And did you ever experience bleeds? No, no, not even stomach irritation.
I've made a specialty of examining the evidence on risks on bleeding from aspirin.
There's no doubt about it, the risk of a stomach bleed is increased by 60, 70% in people on aspirin.
But there is no increase in fatal bleeds.
So a bleed is a crisis, very unpleasant, may require rushing into hospital and having a blood transfusion.
But it's not going to kill you.
Whereas a stroke, a heart attack, a cancer, will leave tremendous disablement - if you're lucky enough to survive.
So why aren't people embracing it? Why aren't GPs dishing it out? I think largely because of misconceptions.
Half the people who are on aspirin are taking a full aspirin tablet, which is too much, gives no extra benefit and increases the risk of a bleed.
So they are self medicating and they don't realise that what they should be doing is taking a quarter of that? Yes.
They haven't got good evidence.
They've taken it off on scrappy evidence from a woman's magazine or from a newspaper article.
Really, the medical profession I think is dragging their feet and I think better evidence should be made available.
Someone who has a radically different point of view is Peter Sever, professor of Clinical Pharmacology and Therapeutics at Imperial College London.
He specialises in assessing medications that could help with heart disease.
So are you tempted to take aspirin? Not at the moment, no.
But sitting there, as you are now, you don't buy the idea that you should be taking a small dose of aspirin in order to reduce your risk of developing future heart disease and bowel cancer? Certainly not.
I think, if you look at the comprehensive analysis that have been published over the last few years, there is very, very clear evidence that the benefits, if I've not had a heart attack or a stroke, in preventing such an event, are very, very small, and that they are more than outweighed by the risks of bleeding.
Why do you think people like Peter Elwood are so evangelical about it then? I go along with the protection against bowel cancer.
I think the evidence is, is fairly impressive and particularly for, for colon cancer.
Long term benefits are 25, 30% risk reduction, which is highly significant.
However, you've got to ask the question of risks and benefits.
I've had patients turning up in the clinic with a history of tiredness and lethargy.
They're extraordinarily pale, and you do their blood count and it's dropped to less than 50%, and it's simply because they've been on aspirin and they've no awareness whatsoever that they've been slowly bleeding into their gut.
So should I be taking aspirin? I will give you a choice.
Now you're likely to have a bit of blood pressure, and if I was to give you a tablet for your blood pressure that would reduce your chances of having a stroke by about half, 50%, and your chances of having a heart attack by about 25%.
Alternatively, I could offer you a statin, a cholesterol lowering drug, that'll reduce your chance of a heart attack by a third and stroke by about a quarter.
On the other hand, you can have aspirin - that will reduce your risk by about 10%.
And the price you will have to pay for that, is that you'll be about 30% increased of having a severe bleed.
So, you takes your choice.
And I know what I would take, and it's those two.
Thank you.
So, there you have it.
Two different professors with radically different views about the benefits and risks of aspirin.
Where they do agree is that, if you have had a heart attack then aspirin can reduce the risk of another.
And it can also inhibit some cancers.
But, aspirin can cause internal bleeding, so the question is whether that risk outweighs the benefits for you.
Now you may have come to a conclusion having listened to the arguments, but I would absolutely suggest you do not self medicate, but go and talk to your GP before starting anything.
I've spent the last 25 years reporting on advances in science and medicine from around the world, so we thought, in this series, as well as looking at treatments that are currently available, we'd also have a look at procedures which are a little bit further out there.
Now, there are a million people in the UK who suffer from unintentional tremor - they cannot stop some part of their body from shaking.
Some of those people will have surgery to remove the part of the brain which seems to be responsible for that tremor.
Gabriel, who is herself a surgeon, is well aware of the risks of such procedures, so she was particularly interested in a new approach being pioneered in the US, which might make such surgery unnecessary.
For patients, all surgery is terrifying, none more so than brain surgery.
It's not just that we think of the brain as our most precious and delicate organ, but it's hidden behind a very thick layer of bone, and even reaching it requires a certain amount of brute force and saws and drills.
But it could be that all of that is about to change.
I've come here to Virginia to witness something truly groundbreaking.
Joe Brunk has a tremor, it affects the right side of his body and is caused by Parkinson's disease, although similar symptoms can be caused by a range of conditions such as multiple sclerosis or stroke.
It can be very difficult to live with.
About three years ago, I did notice that my writing was starting to deteriorate.
Eating cereal in the morning, I can do it, but I have to really concentrate with my right hand, and most of the time I just go ahead and eat with my left hand.
Unable to tolerate the drugs that could control his tremor, Joe has come to the University of Virginia to have an operation to remove the bit of his brain causing it.
The day starts with Joe's head being shaved, as it would for any brain surgery.
But that's where the comparison ends because what we're not seeing here today is surgeons scrubbing, patients being draped, incisions being made on the skin.
In fact, this razor is the only blade that will be used on Joe today because his surgery is going to be performed by a highly focussed beam of sound.
In the room next door, neurosurgeon Dr Jeff Elias and his team are preparing equipment that will deliver this powerful ultrasound to Joe's brain.
His head will be placed inside of this helmet for the treatment.
There are 1,000 ultrasound elements embedded within and each one of those can be individually controlled by the computer to shift the ultrasound beams into phase so that they all focus to the very same spot.
It's very much like if you focussed a magnifying glass on a leaf.
That one area where all the energy converges receives a lot more treatment.
When concentrated like this, the intense ultrasound energy will make one tiny spot burning hot.
So, Joe's head will need to be kept absolutely still throughout, as Dr Elias uses an MRI machine to guide the ultrasound beams inside his brain.
There's a lot of things that we're worried about.
If we're malpositioned by a millimetre or two in any direction we could cause a problem, so it's imperative that we have an accurate device and that we monitor the patient while we're doing the treatment.
First they have to scan Joe's brain to find the spot they need to focus the beams on.
They're aiming to burn out a tiny bit of the region called the thalamus, right in the middle of the brain, which is responsible for the unwanted tremor.
The key really with this kind of surgery is that it's all in the preparation.
So, all of these hours are spent making sure that the MRI and the transducer, and the patient are perfectly in line with each other.
Dr Elias has to be certain that the invisible beams are going to meet at exactly the right spot in Joe's brain before he turns the power up.
He and the other specialists are constantly going in to check Joe's condition because Joe's perfectly conscious and talking throughout.
We're moving right along Now he's going to increase the intensity of the ultrasound and hopefully we should start to see a difference in the patient's tremor.
Sonication number three.
Everything looks really good from the imaging perspective and the clinical perspective.
Here you can see the area that has been heated Yep.
and the temperature is about 57 degrees at the hottest spot.
He still has some tremor.
We'll treat more.
Sonication number 15.
And after four painstaking hours, they feel their job is done.
If this surgery has been as successful as they hope, Joe will never need to return for more treatment.
He's doing really well.
He's cheerful.
I'm quite flabbergasted by what we've seen happening here today, to see a man awake and comfortable and conscious throughout a treatment like this.
Joe may be in high spirits, but the extent of the success of his procedure isn't immediately obvious.
The next morning, I catch up with him and his wife.
Morning, Joe and Mary.
You've had a night's sleep now.
How are you feeling today? I feel like it was a miracle in a sense.
Just for our benefit, would you mind showing me how your hands are when you lift them up? Yeah.
That's astonishing.
Do you think you're going to be doing that to everyone that you see for the next week or so now? Probably.
Although not a cure for Parkinson's, the ultrasound appears to have made a remarkable difference to Joe's tremor.
And there are around a million people in the UK living with a tremor like his.
I feel really astonished by what I've seen here in Virginia.
I saw a man turn up yesterday for really what was a very serious operation, you know.
In bald terms, he was having a hole burned in his brain.
And I saw him come out of the scanner at the end and chat away to us as if nothing really very big had happened.
And then I suppose, most amazing of all was to see a man who had had a violent tremor in one of his hands able to hold that hand completely still.
And I just think that the whole overall wonder of that is something I won't be forgetting for a very long time.
Joe has continued to live without disabling tremor since his treatment.
Ultrasound surgery is already being used in the UK for a number of procedures in other parts of the body, but its use in the brain for removing tremors is still in clinical trials.
Go to bbc.
uk/trustme for more details.
Meanwhile, back on the streets of Guildford, more questions are coming in.
I have heard that listening to Mozart can make you more intelligent.
Is there any truth to this? This is the sort of story we love - a shortcut to genius-level powers.
But I'm always suspicious when I hear claims like this, so what is the evidence? It's actually based on a study in 1993 where a team from the University of California exposed people to Mozart's music and they did seem to get better at solving simple puzzles.
MUSIC: "Symphony No.
40" by Wolfgang Amadeus Mozart Sounds amazing and, naturally, the media leapt on the research, not to mention a vast commercial industry selling Mozart CDs.
But what is less reported is that the tests the researchers found an improvement on were very limited, and they then admitted that the effect was probably short-lived - only 15 minutes - rather less useful.
MUSIC: "Is That All?" by U2 And Mozart doesn't seem to be special.
Follow-up studies have been confusing.
All sorts of music or even listening to a story have been claimed to have the same result, but often the effect can't be repeated.
It may all depend on whether you like what you hear - that might boost your brain activity as you try to remember the moment.
In the short term, music may help you become more focused and concentrate, but it won't make you more intelligent.
And it doesn't really matter whether you are listening to Mozart or U2.
Back at the University of Surrey, I've come to meet our sleep volunteers as they finish their second week of the experiment.
They've now all spent a week sleeping six and-a-half hours a night, and a week sleeping seven and-a-half.
Even this longer sleep was disruptive for those not used to it.
It was perhaps an hour or more than I would normally get of sleep and I actually found myself really lethargic during the course of the week.
Kind of wanting to go for naps quite regularly.
It was really noticeable that things I say things suffered, but I ran out of time during my day.
Today they are undergoing all the same tests that they did last week, allowing the researchers to compare the two sets of results.
This analysis should reveal if that single hours' difference in sleep, over just a week, has really made a significant impact on the volunteers.
The computer tests they undertook reveal that most were struggling with mental agility tasks when their sleep was restricted by just an hour.
It just goes to show how sensitive our brains are to lack of sleep.
Next are the blood test results.
Depending on what your body is up to, the activity of different genes is increased or decreased as they are switched on and off.
The researchers here have been looking the genes switched on in our volunteers' cells, depending on whether they were either getting around six and-a-half hours' sleep or an hour more.
And I'm hoping to find out if there's a difference between the two.
Doctor Simon Archer and his team have been hard at work all night analysing the blood samples.
So, Simon, what did we find? We found that, overall, there were around 500 genes that were affected - some that were going up and some that were going down.
So, the same genes that are there, in the cells all the time, but depending on how much sleep the subjects had, they were either Increased or decreased in their levels.
And what were you able to say about the kinds of genes that were increased or decreased between those two sleep groups? We find that genes whose expression increases are associated with processes like inflammation, immune response, response to stress.
The gene whose expression or activity increased the most was a gene called CKM, which is known to be associated with cardiovascular problems.
Long-term sleep deprivation has been linked to health problems.
But it now seems that in just a week of sleeping six and-a-half hours a night, our volunteers' cells switched on genes that are associated with an increased risk of heart disease.
We also saw increases in the levels of genes associated with diabetes and risk of cancer, whilst genes that help our bodies to replenish and repair took a hit.
It's an incredible result, but one that actually carries a very positive message because just an hour's extra sleep reversed all these problems.
I think one of the most amazing things about what you're telling me is that, while going to the gym might be a really good thing to do for your health, getting into bed for an extra hour's shut-eye somehow seems a lazy way to behave.
I think that's one of the big messages.
Sleep isn't something that you just have to do every night.
It has an important biological function, and somebody may not think that their sleep is significantly altered when, in fact, what's going on inside their body says otherwise.
Since you embarked on this sort of research, have you changed your own sleeping patterns at all? Yes, I have, actually.
I now try to get eight hours sleep a night and I generally manage to do that.
These results really show not only how important sleep is to our bodies, but how just a little extra bit of sleep can really improve the way they function in a very short time.
Quite Quite interesting results, eh? Such a small amount - one hour - to have that great an impact.
It's like the difference between watching a TV programme for an hour before you go to bed and just getting into bed and going to sleep.
So, it's not just our weight and metabolism, but the health of our hearts, the repair of our cells and even our risk of getting cancer all could be improved by just getting around seven and-a-half to eight hours' sleep a night.
Not much more and certainly not much less.
Now it might seem difficult, and especially if you've got a busy life, but if you can alter your sleep habits even just a little bit, you could be healthier and happier.
And that's the kind of health message that doesn't come along very often.
That's it from Guildford.
Next time, we're coming from Chester where we're going to be testing the claim that just standing up for a few hours a day will lead to some remarkable changes in your body.
And should you be taking vitamin supplements? Or simply money flushed down the loo? Chris does an experiment.
And are private health screens as worthwhile as the adverts would have you believe? Trust me, we'll find out.
# I just made an appointment for a special rendezvous To see a man of miracles and all that he can do