www.thehealthequation.co.uk
The Health Equation 4 th Floor North 25 Wimpole Street London W1G 8GL 020 7631 1414 www.thehealthequation.co.uk The Health Equation s core values are caring, excellence and partnership. We aim to integrate conventional and complementary medicine to deliver individual patient healthcare strategies. We have a superb connection to many of the specialists in London s medical district, having been in the West End for over 31 years, should referral to a medical specialist be necessary. Name DOB AGE: 2019 Conducted by Mr Gerry Gajadharsingh DO Osteopath Diagnostic Consultant- Complementary Medicine Metabolic Balance Nutritional Coach Advanced Breath Practitioner 2
2019 Dear Patient Name Thank for you attending The Health Equation for your on Date This report has been based on your consultation, clinical examination and laboratory test results. It has been broken down into several subsections to make it easier to understand. My recommendations have been highlighted and you are invited back to discuss this report, if you so wish, with me during a 15-minute follow up consultation. This can be done over the phone, Skype or booked in for you to attend The Health Equation. Please call my office to book your follow up consultation on 020 7631 1414 or email on info@thehealthequation.co.uk With best wishes Mr Gajadharsingh DO Osteopath Diagnostic Consultant- Complementary Medicine 3
Presenting Complaints Past Medical History General Health Family History Social History/ Work/Sports/Hobbies 4
Dietary Recall Breakfast: Lunch: Dinner: Snacks/Sweets: Hydration: Caffeine WHO guidelines are <150mg of caffeine a day, this equates to Black Tea 237ml 14-70mg Green Tea 237l 24-45mg Espresso 30ml 47-75mg Latte 237ml 63-175mg Alcohol UK Government guidelines are Women <14 units per week Men <14 units per week (1 unit = 10ml or 8g of pure alcohol, this equates to 2 units for a 175ml glass of wine, 2 units for a pint of normal lager and 2 units for a 25ml shot of spirits) Nicotine There is no safe limit for smoking nicotine Recreational Drugs Medication 5
Nutritional Supplements Clinical Examination Your Height Weight BMI Body Waist Waist/Height Age (cm) (kg) Fat% (cm) Ratio 50 165 63 23.16 30% 90 55% Range for Male 20-25 11-22% Female 18.5-25 23-35% <50% <50% Visceral Fat 10% (healthy range 1-12%) Metabolic Age 48 Actual Age 44 Body Water 58% (health range 50-65%) Action: BMI: Non-Required Body Fat: Non-Required but could develop more muscle tissue Waist/Height Ratio: Reduction in Central fat deposition Waist /Height Ratio: Based on research by Dr Margaret Ashwell, Cass Business School, City University, London 2014. 6
Male, number of years lost from average lifespan if Waist/Height Ratio is > 50% 25 20 15 10 Age 30 Age 50 Age 70 5 0 50% 60% 70% 80% Female, number of years lost from average lifespan if Waist/Height Ratio is >50% 12 10 8 6 4 Age 30 Age 50 Age 70 2 0 50% 60% 70% 80% 7
General Observation Respiratory Function Lung Auscultation/chest sounds: Nothing abnormal noted Lung Function via Spirometry reveals FEV1 equals 2.38 (88% of the expected), and FVC equals 2.84 (92% of the expected). Breathing Behaviour via Capnometry and Heart Rate variability revealed: Baseline levels of ETCO2: 33 mmhg (optimum greater than 35) Breathing rate: 16 cycles per minute (optimum 6 to 8 cycles per minute) Pulse 70 bpm (normal 60-80bpm) Heart rate variability: 6-8, slightly low Oxygen saturation 97% adequate You were able to increase your ETCO2 to 36mmHg (improving cellular delivery of O2 and better regulation of ph) and heart rate variability up to 18 by slowing your breathing rate and doing biofeedback exercises. Heart rate variability is a non-invasive way of assessing your autonomic nervous system functioning. Breathing in is a sympathetic nervous system response, heart rate goes up, breathing out is a parasympathetic nervous system response, heart rate goes down, this difference is called Heart Rate Variability, specifically Breathing Heart Wave. Low heart rate variability (HRV) s associated with reduced lifespan, cardiovascular diseases (CVD), diabetes, several mental health diseases and a growing list of other conditions, people with a higher rate of variability are considered healthier. 8
The Health Equation Action: Improvement in Lung function and Breathing/autonomic nervous system behavior needed. 9
Smoking Lung Cancer Risk Action: Option of Early CDT-Lung blood test to calculate enhanced risk assessment 10
Cardiovascular Function No abnormality detected BP 100/60, slightly low Pulse 70 bpm and regular, normal sinus rhythm Heart auscultation, normal Cardiovascular risk Assessment via QRISK 2 2017 Action: Non-Required QRISK is 6.6% For completeness sake, I can arrange a Carotid Doppler Ultrasound or Coronary Calcium CT scan, when people have elevated cholesterol. These investigations give information as to the state of plaque build-up in either the carotid artery of the neck (stroke risk) or coronary arteries. However, I don't think there is an immediate need to do this. 11
Holter 24 hr ECG Analysis 12
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The Health Equation Action: Non-Required 17
Neurological Function No abnormality detected Action: Non-Required Abdominal Examination and other systems No abnormality detected, apart from a tense iliocaecal valve. Action: Non-Required Musculoskeletal system The clicking noises in your knees are as a consequence of poor patella tracking. As I explained during the consultation this is a consequence of having a tense and tight lateral quadriceps and a weak vastus medialis (inside quadriceps muscle). This causes the patella to track laterally roughening the cartridge underneath the patella leading to the noise; this eventually can cause inflammation and pain. The range of movement in the right hip is actually very reasonable, there is no indication at this stage to image the right hip as I do not do believe there to be significant degenerative change. However, you have a chronically short and tense right Iliopsoas muscle. This can give rise to inflammation of the tendon insertion at the hip or sometimes inflame the bursa underneath this tendon, both giving rise to pain. Previous MRI of the lumbar spine and I believe the cervical spine have revealed wear and tear change at several levels both in the disc and facet structures. However functionally their movement is currently reasonable. You have poor range of movement in the sacro-iliac joints the right worse than the left. There is decreased range of movement in the thorax and rib cage particularly in the right upper cage. You hold the muscle structures around the right shoulder very tense, this can cause some neurovascular compromise of the structures of the upper extremity, which I believe give rise to your Right-hand numbness. There is no evidence that it is related to carpal tunnel syndrome, as Tinnel s sign is negative. You keep a lot of muscle tension around the temporomandibular joint on both sides. Action: Osteopathic Manual Treatment and a structured rehabilitation/exercise programme 18
Bone Density Risk 19
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Urine Analysis Leucocytes Nitrites Protein ph Blood Specific Gravity Ketones Glucose Your Result Neg Neg Neg 7 Neg 1.101 Neg Neg Target Neg Neg Neg 7 Neg 1.010 Neg Neg Action: Non-Required Faecal occult blood Result: Not-Detected Action: Non-required Blood Tests Action: No medical suggestions but see Supplementation suggestions for functional improvement. 22
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Prostate Profile Action: Non-Required 24
Functional Blood Analysis 25
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Recommendations: I would like you to look at the video on metabolic balance which is on my website, to give you better information regarding improving your diet. The aim would be to eat protein and low glycaemic load carbohydrates for breakfast lunch and dinner and ideally do not snack between meals. Eating in this healthy way should have a positive impact at continuing to improve your cholesterol markers as well. Ironically eating low-fat things is often not helpful because low fat essentially means high sugar. Excess carbohydrate consumption is often converted into cholesterol. Also making sure you have a good amount of essential fats in your diet can also naturally help lower bad cholesterol. You may also choose to download my ibook The Health Equation- A Way of Life to give you some additional ideas to improve your metabolism and optimise your health. 42
Additional Investigations Suggested: None Follow up consultations with GP/Consultant: None arranged Nutritional supplementation Given your history, symptoms and blood results I would recommend the following: Thank you for choosing The Health Equation With best wishes Mr Gerry Gajadharsingh DO Osteopath Diagnostic Consultant-Complementary Medicine 43