Trust Me I'm A Doctor (2013) s03e02 Episode Script

Series 3, Episode 2

1 We're constantly being told how to live our lives.
But what's the health advice you can really trust? In this series we use our expertise to guide you .
through the contradictions and the confusions.
We'll get to the heart of the debate .
and ensure you get the information you need.
We're here when you don't know where to turn.
I'm Michael Mosley.
In this series I'm joined by a team of doctors.
Together we'll cut through the hype, the headlines and health claims.
This is Trust Me, I'm A Doctor.
This time we're in London, where we're going to be finding out if you can lower your cholesterol just by changing your diet - I'm top of the class.
- Yes, you are! .
witnessing an amazing new treatment for a hospital superbug It is like a doctor's dream.
asking is there is a cure for snoring? Are our shoes damaging our bodies? And how to remove ticks safely.
Oh, no, that's horrible.
On Trust Me, I'm A Doctor we like to investigate the things that you're interested in.
So recently we did a poll and high up was, how can I avoid heart disease? Now, this is a subject that is dear to my own heart because I know that I'm at high risk.
So I decided to take part in a big experiment we're doing here in London.
More of that later.
But first, Dr Chris van Tulleken is on a different mission.
I want to investigate the products on our shelves that are sold on the promise of improving our health.
How do we know we're not just wasting our money? And there is perhaps no area where the marketing is more intense than personal hygiene.
The soap, bath and shower products market in the UK last year was worth a staggering £1.
5 billion.
But do we really need them, or are we wasting our money? Pretty much everyone in this country uses soap or shampoo regularly in one form or another.
These days many of us two or three times a day strip the oils and greases from our skin with products like this -- with shampoos, with shower gels.
And then we get out of our baths and showers and we use these products -- moisturising creams -- to replace those oils and greases.
So is it just a never-ending cycle of illogicality, or could it actually be bad for us? What's your post-bath or shower routine? Body lotion.
So don't you think it's weird that you wash all the oils and grease off your skin and then you put oils and grease back on your skin afterwards? - Yeah, it is.
- Why are we washing it off to put it all back on again? So, I'm going to investigate the two parts of our washing cycle.
First, the scrub.
Now, most of the products we used to take the grease and oils off our body contain detergents.
So what I want to know is, are these chemicals doing us any good? I'm determined to find out, with some help from experts at the University of Bath.
So, Sarah, there's an ingredient I've noticed that seems to be second or third on the list.
This sodium lauryl sulfate.
Now, I use this in the lab and we're quite cautious about using it.
It's quite a strong irritant, so what is it doing in my shampoo? The reason it's in all these products is that it's very good at helping oil mix with water.
That's how you can clean your hair and your body.
But it is quite an aggressive irritant, as you say, so prolonged use or prolonged exposure to SLS can damage your skin.
SLS is used in soaps and body washes as well as shampoo, and to find out just how damaging it is, I'm going to leave dilute SLS on my skin for several days.
So, this is completely painless.
'But before I start, 'Sarah is testing the rate at which my skin loses water, 'a good measure of how healthy it is as a barrier.
' The water loss from your skin is nine grams of water per metre squared per hour.
'Nine is a level you'd expect for normal, healthy skin.
'We'll repeat this test at the end of the experiment and, if I'm 'losing more than nine grams then, it means it's bad news for my skin.
'Next, we dip a piece of gauze in SLS, 'cover it and tape it to my left forearm.
' I'll do this every day for the next three weeks, putting fresh SLS on my left arm at bedtime and leaving it against my skin overnight.
Three weeks later, I'm back in Bath for an expert opinion from Professor Richard Guy.
I haven't actually been examining this very much.
I just sort of put on the stuff at night and left it.
But looking at it in the cold light of day, it is red, isn't it? - It's quite red.
- And it's looking quite inflamed and scaly.
How damaged do you think it is? Let's make another measurement, shall we? So if you can just hold it.
'At the start of our experiment my water loss reading was nine.
'Straight away I can see it's now much higher, 'so my skin is losing more water.
' This number is going really through the roof, isn't it? It's much, much higher, yeah.
If we were to remove completely the barrier layer of your skin, the value would be somewhere around 18.
So you've got up to 33, nearly, there.
So I'm halfway to having the top layer of my skin completely peeled off.
That's correct.
I've essentially given myself eczema here.
It looks like eczema, it feels like eczema.
We've done experiments exactly like you've performed on yourself but in a much bigger cohort of individuals.
And we've seen exactly the same types of things.
And so to the second part of our washing cycle.
After using harsh detergents, our skin can feel dry, and so we put on moisturisers.
But what are they doing? Time for my other arm to get some action.
I'm going to do another experiment on my right forearm.
I'm going to use a very normal, widely available moisture cream.
I'm going to moisturise just the top bit of this right arm here.
I'm not going to moisturise the bit near my wrist.
I'm repeating this routine for three weeks.
Now, I'd expect a moisturiser to make my skin moister.
In other words, my skin should be losing less water where I put the cream.
But in fact the figures for the skin I moisturised and the skin I didn't are almost exactly the same.
At least in terms of measurement of my skin's effectiveness as a barrier, in this experiment, moisturising was essentially a waste of time and money.
In the context of this particular experiment, I think the answer to that would be yes.
So over the course of my experiment, moisturisers did nothing to improve my skin.
So I, for one, am not going to waste my money on those.
But I'm more concerned about the effect of SLS.
So how worried should we be? In terms of products that are washed off -- shampoos, conditioners, body washes, whatever -- I think if you've got normal skin, probably there's not a great deal to worry about.
However, if you've got dermatitis, eczema, then I think you'd be better off avoiding, if at all possible, the use of products that contain these powerful detergents like SLS.
Even for short contact.
And there's one type of product in particular to be aware of.
Aqueous creams, that are sold to relieve skin conditions like eczema, actually contain SLS, even though they're designed to be left on your skin.
So take care when you're buying skin and hair products and, if you're concerned, there are lots of SLS-free ones readily available on the high street.
But they're not always marked as such so you may have to look at the ingredients list just to check.
SLS is particularly powerful, but in fact in almost all soaps, body washes and shampoos there are detergents and they will remove the natural oils from your skin.
You may find that reducing your exposure to any kind of detergent improves the health not only of your skin, but also your wallet.
As a medical journalist, I have covered a huge range of subjects, but there is one that is particularly close to my heart and that is cholesterol.
Now, like 60% of people in the UK, I have an elevated cholesterol score and that puts me at greater risk of heart disease and stroke.
What's more, the latest headlines suggest having even slightly higher cholesterol in our 30s and 40s could raise our risk of heart disease by up to 40%.
Now, like a lot of people, I have wrestled with the cholesterol conundrum.
The obvious thing to do is to take statins, and undoubtedly they work.
They lower cholesterol and they also reduce your risk of having a heart attack.
But in some people they also have significant side-effects.
These range from muscle aches to worries about memory loss.
So I want to know, can I lower my cholesterol without statins by being smarter about the food I eat? To find out, we've recruited a gang of willing volunteers who all have high cholesterol.
And with the help of experts at King's College London, we're going to see if we can lower their levels through diet alone.
All our volunteers have a personal interest in taking part.
Why did you decide to do this study? When I went to the GP he said, "Bad cholesterol is bad.
" My parents both have high cholesterol.
I would always prefer to find a natural solution to a health problem if I possibly can.
What we're not trying to do is get rid of cholesterol altogether.
In fact, it's an essential substance we all need to live and function.
For example, our bodies use it to make vitamin D and the hormones oestrogen and testosterone.
Problems start when we end up with too much cholesterol and, specifically, too much of the wrong kind.
When your doctor tests your cholesterol levels, as well as the total figure, there are two other results to look out for.
One is LDL, known as bad cholesterol, because it can clog up your arteries.
The other is HDL, which is seen as good because it actually removes cholesterol from your arteries.
Now, Tim is about to take some of my blood to measure my cholesterol levels, which are measured in millimoles per litre.
Now, in a healthy individual, your total cholesterol should be less than five, your bad cholesterol, which is LDL, should be less than three, and your good cholesterol, which is HDL, should be more than one.
And I suspect that not all of my numbers are going to be good.
And they're not.
My total cholesterol is eight.
My HDL, the good cholesterol, is excellent at 2.
But my bad cholesterol, LDL, is depressingly high at 5.
So I want to bring that down.
As for our volunteers, they also have unhealthy scores.
But we're going to try and improve them.
We're splitting these brave volunteers into three groups.
Each group will be changing their diet in a different way.
Group one are going to be cutting out foods said to raise cholesterol, so these are all the foods they're not going to be eating.
Group two don't have to give up any foods, but they are going to be eating more oats.
And group three, they're going to be eating a daily handful of almonds.
We want to put to the test the claim that these diets could help cut our cholesterol.
Dr Scott Harding will be helping run our trial to see how well they work.
So the group who are cutting out cholesterol, what are they going to be doing? Any type of fat that comes from an animal source contains cholesterol, so what they're going to do is to switch these usual animal sources of fats with something that's either vegetable-based fats or a low-fat option.
So reducing cholesterol is in effect going to be changing their fat profile as well.
This means that eggs, red meat and high-fat cheese are out, replaced by lean, skinless meats and vegetable-based spreads.
But what about the groups who are adding foods? First, the oat group.
They'll be eating 75 grams per day.
How will the oats lower cholesterol? So, there's a sticky, or viscous, fibre in porridge.
It's also found in high concentrations in barley as well.
And it's a soluble fibre called beta-glucan.
And there are a number of studies now that show that consuming three grams of beta-glucan per day for most people will lower their cholesterol in the area of 5% to 10%.
The beta-glucan in oats does this by binding with the cholesterol in your gut and stopping it from being absorbed into the bloodstream.
And the almonds? How will the almonds work? The group consuming almonds is going to be consuming two of these doses per day, so this works out to about 60 grams.
- One dose will cover an entire Post-it Note.
- OK.
Mm I like almonds.
What is it about them that lowers cholesterol? Some of it could be the phytosterol content.
So phytosterol is the plant version of cholesterol and that's been shown in numerous studies to lower your cholesterol levels.
It could also be the nature of the almond itself -- it doesn't get broken down as it passes through your digestive tract and it may be interfering with lipid absorption, so fat absorption in general, which affects the cholesterol absorption.
- Can I? - Yes, thank you.
Each group will be given instructions telling them how to integrate these changes into their normal diet.
My three sets of volunteers have now embarked on their three very different diets, and I'm about to join them.
Well, sort of -- I'm actually doing to try something which is even more radical.
I'm going to try combining all these interventions, and other potentially cholesterol-busting foods, in an epic diet challenge.
I want to see just how low I can get my cholesterol to go without medication.
We'll find out more about my diet and about the results of our study later in the show.
Here we are in the heart of London with our lovely Trust Me I'm A Doctor video booth.
People have been dropping in to ask their burning health questions which we do our very best to answer.
And our first question this time Is there a cure for snoring? One for A&E doctor Saleyah Ahsan.
One in four of us are snoring culprits, giving our bodies -- and our partners -- a hard time.
Hands up who snores? - I've been told I do.
- Yeah.
It's like a chainsaw - Does anyone snore here? - He does.
- I snore.
What does it sound like? When you go to sleep, the muscles in your throat and neck relax and go floppy.
This makes the airways narrow, so air has to be forced out through them, which makes the soft tissues rattle and vibrate.
But how can we stop it? Here are some top tips and some brand-new and exciting research to try.
Avoid alcohol before bedtime.
Booze relaxes the muscles of the soft palate and the throat, causing the airways to narrow even more.
There's a reason why we're told to lie on our sides.
When we lie on our back, our tongue, chin and the skin and fat around here can relax and squish our airways.
And finally If your snoring comes mainly from your nose, you could try this nasal strip.
Basically, they work by pulling your nostrils apart.
And if your snoring comes mainly from your mouth, you could try this mouthpiece.
It works by essentially forcing you to breathe through your nose.
But the best way to keep those airways open and stop the snoring? Strengthen your muscles.
'A brand-new study has shown that doing a simple set of exercises 'every day can drastically reduce snoring.
'They have allowed us to reveal their secret.
' So, get your tongue, push it to the roof of your mouth.
On your hard palate And then push your tongue backwards.
Kind of makes you want to gag a bit.
Does it, yeah? Can you feel it? Up and backwards.
Another one is push your tongue down on your soft palate and the tip of your tongue forward, like that So it's like it's almost stretching your tongue.
Show me? Uh-huh, like that.
Can you feel it kind of stretching? Fantastic, she's doing it! Open your mouth wide.
And you know the dangly bit, the uvula? Push it upwards and go, "Ah".
Ah Brilliant! 'For the best results, you need to do these exercises 'for two minutes each three times a day, 'and in the study, snorers saw improvements after three months.
' All these exercises and more are available on our website if you want to give them a go.
Or suggest that someone else does.
Still to come -- a remarkable new treatment for a hospital superbug, and the best way to stop hiccups.
But first Backache and knee-ache are both very common, and they may be linked, because when you stand up, you carry your weight through your spine, knees, to the end of your feet, where you normally find shoes.
Now, shoes are a relatively recent invention -- at least from an evolutionary perspective -- and, as surgeon Gabriel Weston has been finding out, if you change your footwear, you can improve your health.
80% of us will experience back pain and around 14% suffer from some form of osteoarthritis that can affect the hips, knees or ankles.
But could it be that some of our problems are actually caused .
by our shoes? I've seen reports that claim just about every kind of shoe you can think of is bad for you, whether for your joints or your back.
High heels get a really bad press, but are they the worst culprits? And what can we do about it? To find out, we've come to the centre of Glasgow and set up our own catwalk, rigged with some hi-tech kit to analyse how we walk.
And Dr Jody Riskowski of Glasgow's Caledonian University is going to show one shopper what high heels really do to us.
You're obviously committed to wearing your high heels.
Is this the sort of shoe you'd usually use to be out and about? Em, I think if I came to Glasgow, shopping, yes, I'd like to wear a pair of heels.
When you look at what heels do to your feet, it's pretty frightening.
They can lead to painful bunions and even damage the bones themselves.
But what are they doing further up the body? To show us, Jody's kit can make a computer model of the skeleton as people walk.
Perhaps unsurprisingly, wearing heels does affect our posture.
We tend to sort of rotate the hips such that the trunk or the torso rotates forward and the hips and the pelvic and the butt go backwards.
So heels give us a catwalk strut, but what's that doing to our joints? The blue arrow shows how the pressure travels up from our feet and into our joints.
When barefoot, the pressure goes up directly and safely through our knee joint, but in heels, it's off-centre.
This can twist our knees, damage the soft tissues in the joint and put us at risk of osteoarthritis.
So is the solution to wear something more comfortable? Flat shoes? Ron, I see you're wearing some kind of outdoorsy footwear.
Are these the kind of shoes that you would usually wear? Generally, yeah.
They're easy on the feet, if you're on your feet all day long.
But flat shoes have their own dangers.
When we walk in them, our heel strikes the ground with force, and this sends pressure up through the leg which can affect our knees and back, and, as if that wasn't bad enough, there's something else a lot of us get wrong -- our shoe size.
If you're anything like me, you won't have had your feet measured in ages.
But our feet change with time -- up to two shoe sizes in 40 years, when we're adults.
What typically happens with ageing is that the arch drops a little bit, which is then what helps spread the foot out.
And wearing shoes that are too small can create pressure at the side and front of the foot.
That can also affect our joints and back.
Too high, too flat, too small.
So what can we do? With shoes that some people might call bad, what we can do is add some of the good.
Firstly, whatever style you prefer, make sure you get your feet measured so you can be sure you're buying the right size.
Secondly, if you're buying flat shoes, choose ones that have some support for your arch and heel, or you can be fitted with a corrective insole called an orthotic.
This is a full-length orthotic and it's just designed as cushioning so added cushioning and support.
And that can help alleviate some of the aches and pains that you might feel under the heel after a long day of wearing flats.
You can find them on the high street, but specially-fitted ones can be better if you have foot problems.
Finally, if you like heels, then for everyday use, choose heels that are lower and wider.
These tend to cause fewer problems.
And if you know your favourite shoes are bad but can't bear to ditch them, then simple foot exercises can help relieve some of the stresses and strains.
Generally, we would start with a tennis ball as a massage, so you step on it and then just roll it around.
And that's particularly good for the heel and the arch, and then sometimes for the forefoot, the golf ball tends to be a little bit better.
I think I would still wear my high heels but I would certainly think about getting home and trying the golf ball because you do get that tension in the toe area.
And picking up marbles with your toes strengthens your foot muscles and reduces pain.
Exercises like these can help look after your feet and counteract the effects of shoes that may look good but aren't doing us any good at all.
Now, most of us don't want to consider changing the kind of shoes we want to wear, but what I've seen is there are things that we can do just to make those healthier choices to enable us to choose the shoes we want but still have healthy feet and bodies.
Earlier in the programme, we started our big cholesterol experiment.
We're testing whether we can lower our levels by eating more oats, more almonds, or reducing our cholesterol by cutting down on animal fats.
But this is not the only cholesterol experiment we're running.
I, too, have begun a challenge of my own.
My cholesterol levels tend to be high, so I have taken statins to lower them, but for the next eight weeks, I'm off all pills.
I'm going to see how far I can get my levels down just by making changes to my diet.
I've got this list of the things that I'm allowed on my new diet and the things that I am definitely not allowed.
And top of the list of not-allowed is red meat, and that means goodbye to the mince, beef and bacon.
Goodbye to the prawns.
And it's goodbye to eggs as well.
Now, the butter and cheese, they have to go.
The milk I'm going to keep.
It's on the banned list, but I don't think I can do without it.
So I'm left with a decent amount of food, including, I'm pleased to say, bottle of red wine.
Now, it's time to add things.
Like some of the participants in our study, I'm eating more oats and almonds.
But my list also includes walnuts, pistachios, various fruits and vegetables and some intriguing-looking products that I've never tried before.
Now, the diet I'm about to go on was developed by a nutritionist in Toronto and it's called a Portfolio Diet because the idea is that you attack the cholesterol from all sorts of different angles.
Now, the first thing I'm going to be eating a lot more of is soluble or sticky fibre.
You can get it in oats, also in aubergine or okra.
Plus, there is a lot in beans and pulses.
Now, the next thing I'm going to be adding to my diet is plant sterols.
As the name implies, you get them from plants.
You can also get them in special margarines.
I'm also going to be eating something I have never tried before and that is soya.
And finally, I'm going to be eating a lot more nuts.
So, how did I get on? I'm currently filming in the Gambia for another series, but I'm still sticking to my diet of porridge and lots of nuts.
But I'm also branching out in some of the local cuisine.
This is porridge Gambian-style.
I think it's mainly made out of couscous so I suspect it's not going to do the same thing as the oats.
I'm back in the UK.
Time to try something completely new, something I have never sampled before -- that is soya milk.
Doesn't look fantastic.
All I can say is it's really boring.
It has almost no flavour.
It's certainly been an interesting experience.
But will the results be worth it? We'll find out later in the programme.
Back in London, more people are coming to our video booth to record their health questions.
Is there a cure for hiccups? One Dr Chris van Tulleken.
Hiccups are one of those things that everyone gets at some point.
And there are a whole load of theories as to what causes them and how to get rid of them.
- Something scary, usually.
- Does that work? - Yeah, I find it does.
- What? - You just get a mate to do something frightening? - Yeah, or hold my breath.
If you sit in a dark cupboard, it goes away.
Isn't that an old wives' tale, like if you've got the hiccups, you're meant to go in a dark cupboard? So what's going on is hiccups are a spasm of a big muscle in your body called the diaphragm.
The diaphragm sits as a sheet of muscle under your lungs and it moves up and down and helps you breathe.
And if you get a spasm of that muscle, you get that sudden intake of breath and you also get a spasm in your voice box, in your larynx, so you get that characteristic like that.
And that's what's so embarrassing.
It's only by knowing what causes those muscle spasms that we can work out how to cure hiccups.
At the more housewives'-remedies end of the spectrum are techniques that just try to give your brain something else to think about and hope that the hiccups then sort themselves out.
For example, you could put some sugar on the back of your tongue and then wait till it dissolves to eat it.
Like that.
A bit distracting.
You can take a bit of lemon and suck it as if it was a sweet.
All of them are distracting, and it's the same principle that a lot of people recommend that a fright will sometimes distract you.
Argh! And then there are the slightly more medical cures.
Some people think that hiccupping is to do with low levels of carbon dioxide.
Now, I'm not sure I believe this but there are a couple of ways that you can raise the level of carbon dioxide and they all revolve around holding your breath or slowing down your breathing.
My producer has a particular favourite which is where you close your eyes and you breathe in very slowly and you concentrate and then you breathe out very slowly and if you can avoid hiccupping just at that moment when you breathe out, you'll be cured.
Or finally, researchers suggest this.
You can do diaphragm exercises to try and relieve the spasm, you can draw your knees up to your chest and hold them there for a couple of minutes, you can lean forward and compress your chest and try to relieve the spasm that way, or you can take in some very deep breaths and even see if you can reach up under your ribs and give the diaphragm a little rub.
These diaphragm exercises have scientific backing but when it comes to it, no-one's totally sure whether they really work.
And that's a prospect we at Trust Me simply can't ignore.
Since research into cures for hiccups is so hard to carry out, we want to enlist your help to see what works and what doesn't.
What we need is loads of different people to try loads of different things each time they get hiccups, and if you want to be part of the experiment, you can go to our website at .
and sign up.
In my job as an emergency medicine doctor, I've seen, time and again, how devastating the effects can be if people ignore the warning signs of serious illness.
If people don't recognise the symptoms and don't come to see us, their condition can deteriorate and it might be too late for us to help them.
That's why I want to talk to you about what we call red flags -- the danger signs that can help you protect yourself or others from serious illness.
This time, I'm in the Peak District to look at Lyme disease, something that's a particular danger at this time of year as we head outdoors.
Cases have risen more than fourfold in the UK in just ten years.
It's caused by a bacterial infection and it's carried by these guys -- ticks.
And they can be found commonly in places like parks, woodlands, moors and even gardens.
If left untreated, Lyme disease can cause debilitating neurological problems and has been known to be fatal.
So if you're out in the countryside, you should try and avoid getting bitten.
Ticks can be sneaky operators.
They climb up long blades of grass and stalks and lie in wait for people and animals to brush past -- that's when they latch on, attach themselves and stay there for days at a time.
But it's during that time when they're attached to the body that we are at risk of them passing on bacteria to us which will cause infection.
Getting rid of a tick that's attached itself to you as quickly as possible is therefore really important and I've come to talk to a group of climbers about how to do just that.
First up is giving your body a thorough check for ticks.
Is there, like, a preferred place that they'd go? Well, they like warm, dampish places so knees, toes, armpits.
Basically, give yourselves a top-to-toe check.
You can help protect yourself by covering up, tucking trousers into socks and wearing insect repellent.
But sometimes, ticks can get through these defences.
If a tick does manage to latch on to you, it may feed off you for around seven days, swelling up in size before falling off.
That's horrible.
That's absolutely horrible.
And if you find a tick, removing it carefully is key, and there are lots of myths circulating about how to do this.
- Do you burn them out? - Some tape, like the sticky bit of a plaster, stick it on and pull it off? I think my sister had one when we were little and she put Vaseline on it and it's supposed to suffocate it.
- And did it? - I don't think so.
These are all things you shouldn't do.
Instead, you should try to use a tick-removal tool.
All these bits of kit help you to remove a tick effectively without leaving anything behind, and that's the main point -- you just do not want half a tick still left in you.
Fortunately, only around 4% of ticks carry the bacteria that cause Lyme disease, but if you're bitten by one of these, there are some important red flags to look out for.
This is what you want to make sure you don't develop.
- You wouldn't miss that, would you? - No.
- It's quite a big rash.
It's darker on the outside and paler in the middle, yeah? This distinctive rash is called erythema migrans.
It occurs in two-thirds of cases, and if you see it, you will need to go in and see your doctor immediately.
You should also watch out for flu-like symptoms -- red flags like headaches, muscle pains and fever.
These clues can help us treat you with antibiotics in time.
If you follow these pieces of advice, you could identify an infection and get treatment before it develops into later-stage Lyme disease.
All this information and more on every item on the programme is available on our website at Coming up, can home DNA tests help you lose weight? And the results of our big experiment -- can changing your diet really lower your cholesterol? But first It's not often in medicine that you come across a new therapy that is not only safe, but 99% effective against a life-threatening condition.
Well, surgeon Gabriel Weston has been to Rhode Island in the US to watch this extraordinary treatment in operation.
Be warned, however, there is a certain yuck factor.
As a surgeon, I'm always interested in new ideas but this one is special.
It's bringing hope for a radically new approach to a whole range of conditions from multiple sclerosis to Crohn's disease.
At the moment, it's being used to treat a severe infection of the gut, something that affects over 17,000 people every year in the UK.
This is Rose Sabatini.
Almost a year ago, she was struck down by a ruthless bacterium called Clostridium difficile, or C diff.
It takes control of the gut, causing inflammation, diarrhoea and a loss of fluid that can be fatal.
I wake up all hours of the night and have to rush to the bathroom.
It doesn't stop.
If I take a sip of water, I run to the bathroom five minutes later.
If I eat a cracker, it goes right through me.
It's so confining, you know, because you never know when it's going to occur.
C diff can be present in a healthy person but is normally kept in check by the good bacteria that exists naturally in the gut.
But if you're given strong antibiotics, as Rose was, the good gut bacteria can be wiped out and allow C diff to thrive.
Once it's taken hold, it can be impossible to shift, but an extraordinary new procedure is now giving patients hope.
It's known as "faecal microbiota transplant" and basically involves taking poo from one person and implanting it into someone else.
The idea behind FMT is to restore good, healthy bacteria to the patient's gut which can get the C diff back under control, and poo is extremely rich in bacteria, so though it sounds pretty unpleasant, it's a potential life-saver.
I'm about to see one of these procedures for myself, carried out by Dr Colleen Kelly, a pioneer in this field.
My initial reaction was, like, "OK, this was some kind of a placebo effect.
" I mean, I didn't even believe it myself because I just thought, "Nothing is this good.
" And it really wasn't until about the seventh patient, where each time it worked, that I said, "This is really something.
" Dr Kelly is going to transfer some poo from a healthy donor into Rose's gut.
It has been screened to make sure it's safe.
Rose, I'm going to get started and if you're uncomfortable, let us know and we can give you a little more medicine, all right? Dr Kelly inserts a tube into the gut, guided by a tiny camera, a procedure known as a colonoscopy.
She's looking for the sigmoid colon, the lower part of the large intestine.
This is as far as we really need to go.
With the tube now in place, the material can be implanted.
- Push it right in this way.
- And this is about 300ml in all? - Yep, correct.
And that's it, we've put all five in.
And I come out pretty quickly.
'The whole procedure has been completed in just ten minutes.
' Now, we need to wait to see if the treatment has been successful for Rose.
But I want to find out more about how doctors make sure these transplants are safe so I've come to OpenBiome in Boston, a not-for-profit company that collects, screens and delivers poo to the clinics and patients that need it.
Overseeing this process is Dr Zain Kassam, a gastroenterologist.
Way back 30 years ago, when we were screening blood for blood transfusion, we didn't know about HIV.
Do you have any concerns that there's something that might be dangerous about taking someone's ecosystem - and giving it to someone else? - Yes, there's absolutely a concern.
But that said, patients with C-difficile are dying today, and everything in medicine, whether it's giving someone an aspirin pill, has risks and benefits.
We have a very, very rigorous process where we actually screen donors before and after, and so less than 6% of candidate donors are able to pass through our rigorous schedule.
It's actually much easier to get into Oxford or Cambridge or Harvard than it is to actually be a poop donor.
OpenBiome currently sends transplant material to hundreds of clinics across the country, helping desperate patients like Rose.
It's now been 24 hours since Rose's procedure, and amazingly, her horrific pain and diarrhoea have already improved.
Before I had the procedure, I probably would have to go as much as ten times a day.
Today, I think I've only gone I only went once this morning.
Just once.
Oh, my God, I can't believe that.
Just once.
I feel like I can do anything.
My spirits My spirits have been lifted, and I feel so good.
It's wonderful.
It's rare in medicine to come across a treatment that has such an immediate impact, and all from such a simple procedure.
What I've seen here is like a doctor's dream.
What Dr Kelly has achieved is a success rate of over 90%, which is the kind of number that seems almost more like a miracle than a real cure.
If Dr Kelly would agree to train me up over the next couple of hours and let me go back to the UK and start doing this procedure tomorrow, I'd be sold.
Despite its success, faecal transplant remains a last-resort treatment for C-diff in both the US and the UK.
But research in the field is advancing at pace.
Today, over 100 trials are under way worldwide, looking at how our gut bacteria could be affecting a range of diseases, from irritable bowel and Crohn's to multiple sclerosis.
What really interests me about FMT is that it's part of a broader thought shift happening in medicine at the moment.
We need to start thinking of the human body less as a pristine vessel and more as a complex ecosystem.
It's a new approach that could have a big impact on the way we treat all sorts of diseases in the future.
Every day, the newspapers run eye-catching health stories.
But what's the truth behind the headlines? Dr Salehya Ahsan investigates.
Recently, it was reported that the NHS in Essex was starting to give personalised obesity treatment based on DNA tests.
It's a small trial based on a study in Italy which showed that a personalised weight-loss plan based around a genetic test helped people lose a third more weight than those on a generic diet plan.
So, now we can buy DNA-testing kits at the chemist, could we all be doing this for ourselves? It sounds tempting for all of us.
Could a simple home DNA test predict our future, helping us to diet and lose weight? Surely, if the NHS is trialling it, there must be good evidence that it works.
But is there? A simple swab of the cheek is all you need to collect cells containing your genetic code.
Companies already offer tests to look for genes known to be linked to around 100 diseases, including Alzheimer's, cancer and hereditary hearing loss.
But can such tests really allow you to look into your own future, or to change your health for the better through tailoring your diet and habits? While it's true that some conditions have a very strong genetic component, in most cases, it's very complex.
So, even though a test kit might tell you what gene variant you have, it's likely that it won't tell you what this means for your health.
We simply do not know enough at the moment about the relationship between our genes and our health, and that's where the NHS trial in Essex comes in.
Studies like this are vital to help discover how much our genes can tell us, and how that might benefit our health in the future.
At the moment, we are in the very early days of understanding how our genes can influence our health.
Personalised medicine is one of the big hopes for the future, but for now, my advice is not to waste your money on home test kits.
None of them can give you any information that will make a significant benefit to your health.
On Trust Me, I'm A Doctor, we try to tackle issues that most matter to you.
We wanted to find out which questions you particularly wanted answers to, so we commissioned a poll of 2,000 people.
When the results came in, almost a third of you wanted to know, "How can I avoid heart disease?" Now, after cancer, heart disease is the leading cause of death in the UK, so what, if anything, can you do to reduce your risk? There are a lot of claims reported in the media.
It seems that just about anything can be linked to heart disease.
I want you to put down here things that you think will increase your risk of heart disease, things which will reduce the risk - and things you're not sure about or which you think are unimportant.
- OK.
- So, er - So, obesity.
- Mm-hmm.
- Oh! - Alcohol! Are you going "yes" or "no" with alcohol? Moderate amount's OK, too much is bad.
Too much TV? That's ridiculous to have that there.
- No, it's not.
- It is, cos - It just makes you sick.
There's no excuse if you've got rheumatoid arthritis, cos you can still do other things.
- Brazil nuts, where would you put them? - Well, they are radioactive.
You're supposed to have a few of them every night.
There's clearly a lot of confusion.
So, how can we get to the truth? I've come to Glasgow University's Institute of Cardiovascular and Medical Sciences to meet one of the world's leading experts in the field, Professor Naveed Sattar.
So, what are the risks? What are the chances of somebody in the UK having a heart attack? It depends on your gender, so roughly speaking, one in six males will die prematurely from heart disease and around about one in ten females.
In total, 80,000 people have heart attacks and die from heart disease in the UK.
That's roughly 200 people a day.
200 people a day.
That's quite a figure, isn't it? Over the last two to three decades, in particular the last decade, it's come down substantially, by at least 50%, so things that we are doing in the medical field are actually having a benefit, but we have a long way to go, yes.
Do you think there is consensus around what we should be doing? I think there's very good evidence in this area, more so than many other parts of medicine, about what works in terms of preventing heart disease, so we know absolutely categorically that lowering cholesterol lowers heart disease risks, lowering blood pressure also helps, and of course, stopping smoking is a major beneficial effect in terms of heart disease risk as well.
Say you were a 50-year-old man.
If you smoke 20 cigarettes per day, your heart age would be nine years higher than you really are, so roughly speaking, talking about a decade lost because of smoking.
So, how does high blood pressure relate to heart disease? When the heart pumps, it delivers blood through our blood vessels.
High blood pressure, effectively, is higher pressure in those blood vessels, so in a sense, the heart has to work much harder to actually create the flow through the blood vessels.
One of the things we're told is, cut down on salt consumption.
- Absolutely.
- Is the evidence strong on that? I think the evidence is strong enough that certainly salt intake is associated with high blood pressure.
OK, so, what's the evidence that certain foods are likely to affect your risk of heart disease? There is emerging evidence that if you have a diet, for example, in high levels of fibre or fruit and veg, that might be protective.
Having a Mediterranean-type diet with nuts, - it reduces the risk of heart disease by 30%.
- What about meat? I think the evidence base is reasonably clear-cut.
Processed red meat is really quite harmful in the sense it contains lots of saturated fat, and we'd recommend, do not eat much processed meat.
There is clear epidemiological evidence that reducing saturated fat and cholesterol has helped lower risk of heart disease over - the last three to four decades.
- What about alcohol, then? So, obviously, we love the idea that a bit of red wine is probably good for us.
- Do you buy that? - I actually don't buy that.
All the evidence about - You killjoy! - I am a killjoy, I'm sorry.
The really important thing, though, is -- and I'm involved in writing guidelines for heart disease around the world -- doctors have to get their heads round new types of evidence, and I'm reasonably comfortable now that we cannot see alcohol as protecting against heart disease, and that, I think, is probably a good public health message.
What about aspirin? So we now recommend that aspirin is used only in people who already had a heart attack or a stroke, whereas people who've not had a heart attack or stroke, we probably are moving away from using aspirin.
The reason being that aspirin doesn't come without risks.
Roughly speaking, I would say to you that statins are probably about 100-200 times safer than aspirin, for example.
So, you've got the heart, the heart is obviously a muscle.
- Muscles like exercise.
- Sure.
So, there's good evidence that doing exercise lowers your risk of heart disease? I mean, is there good evidence? If you look at the evidence, it looks like people's fitness does relate to a lower risk of heart disease, yes, but the message there is, take any obvious opportunity to be physically active.
For example, if you see some stairs and you have to go up three floors, don't take the lift, take the stairs.
Run up the stairs, for example, and if that doesn't work, I usually say go buy a dog, but I'm being facetious.
So, when it comes to heart disease, it turns out there are plenty of ways you can reduce your risk.
If you want to avoid heart disease, then there are three things you should do.
If you're a smoker, don't, because smoking doubles your risk of having a heart attack or stroke.
Get your blood pressure checked, and if it's high, do something about it.
And finally, get your bad cholesterol down.
We know you can do it with statins, but can you do it by modifying your diet? We're about to find out.
For the past month, we've had three groups of volunteers trying out different ways to lower their cholesterol.
One group cut down on foods said to raise cholesterol.
The other two added either oats or almonds to their diet, two foods that studies suggest can lower our levels.
So, how did they all get on? - Which group were you in? - Low cholesterol, low fat.
- Deprivation.
No sausages and no bacon.
That was the biggest challenge for me, a week in France without any cheese.
No roast potatoes.
All the foods you like.
- You were the oat-eaters.
- Yes.
- Did you enjoy it? - It was a struggle.
I lost weight.
Half a stone.
Well pleased with that.
- Almonds.
- I think we got the best group.
While the volunteers were taking part in our big trial, I was doing a different cholesterol challenge.
My levels were high at the start, and for eight weeks, I've been following what's called a portfolio diet.
I'd cut down on foods with animal fat, as well as adding a range of different foods believed to help lower cholesterol.
Soluble fibre, nuts, plant sterols, I even tried soy.
I'll be very interested to see the results.
It may turn to out to be spectacularly good, but I wait to be convinced.
The final blood tests will reveal what has happened to our total cholesterol, our bad LDL cholesterol and our good HDL cholesterol.
We all started off with LDL levels that were too high, but did our different diets succeed in bringing them down? First up, the lower animal fat group.
They came out on top, with an average 11% drop in total cholesterol and a 13% drop in the bad LDL.
The oats group also had a significant drop, nearly 9% in total cholesterol and just over 10% in bad LDL.
But for the almonds group, little change.
On average, their cholesterol levels stayed about the same.
So, looking at the group averages, eating oats and cutting animal fats had a significant effect.
Almonds, it seems, were less effective.
But this isn't quite the end of the story.
Dr Scott Harding has a graph that shows the individual responses of each person in the almond group, and the results are fascinating.
Here you can see the almonds, half the group actually had a positive response, and one individual had close to an 18% reduction in their total cholesterol.
And on the other side of the coin, we've got the people who had an adverse response, their cholesterols went up.
- In some cases, significantly.
- Blimey.
It's an intriguing result, and suggests the response to eating almonds is highly individual.
I was surprised by the almond results.
There is enough data to support that it does work in general for the average person, but a concept of responders and non-responders is something that's been appearing more predominately in nutritional research.
It's an interesting angle to look at, - because this is really getting into personalising nutrition.
- I think It seems to me that one of the morals of this thing is that you have to try it out yourself.
Now, we kept our groups separate.
But what if you combine these changes to your diet? Well, that's what I did with my portfolio diet.
So now, the moment of truth.
How has it affected my cholesterol? - You want your results? - Of course I do.
I've been very patient.
Well, here's a slide dedicated just to Michael.
So, when you started, you had a total cholesterol of eight MMOs per litre.
That's very high.
So, overall, across the eight weeks, - your total cholesterol was down 30%.
- Whoo! - 42% reduction in your LDL.
- Wow.
- So, very significant.
- That's very big.
- That's statin level reductions.
- Bloody hell.
That's the equivalent of a statin.
So, I'm top of the class.
Yes, you are! I'm astonished and delighted to find that my cholesterol level has fallen by so much.
It's similar to the effect of taking statins, and all just by changing what I ate.
So can you lower your cholesterol through diet? The answer is yes.
Whether you can do it by any particular diet depends very much on you.
All three of our interventions brought a degree of success.
In fact, some people saw a surprisingly big effect just from eating more oats or almonds.
And, as my experience showed, combining different changes to a diet can produce even better results.
So, why not go and get your levels tested, and if they're high, see if you can improve them by cutting back on animal fats or adding in some of the foods we've tried? If you can lower your cholesterol, it should reduce your risk of heart disease.
That's it from London.
Next time, we're coming from York, surrounded by lots of chocolate, and we're going to test out new ways to cut cravings.
We'll also be asking, is organic food actually better for you? And how can you spot a stroke before it happens? I just made an appointment For a special rendezvous To see a man of miracles And all that he can do Doctor, I want you Mm, my Dr Wanna Do I can't get over you Doctor, do anything that you want to do.