0:00:04 > 0:00:08When it comes to our health, it seems everyone has an opinion.
0:00:08 > 0:00:11But what's the health advice you can really trust?
0:00:14 > 0:00:17We're here to weigh up the evidence,
0:00:17 > 0:00:19and use our expertise to guide you
0:00:19 > 0:00:22through the contradictions and the confusions.
0:00:26 > 0:00:28We do research no-one else has done,
0:00:28 > 0:00:31and put your health at the heart of what we do.
0:00:33 > 0:00:36We listen to the questions you want answered,
0:00:36 > 0:00:39and ensure you get the information you need.
0:00:41 > 0:00:44We're here when you want to know the latest findings
0:00:44 > 0:00:46and not the latest fads.
0:00:47 > 0:00:49I'm Michael Mosley, and in this series,
0:00:49 > 0:00:52I'm joined by a team of doctors.
0:00:52 > 0:00:55Together, we'll cut through the hype, the headlines,
0:00:55 > 0:00:56and the health claims.
0:00:57 > 0:00:59This is Trust Me, I'm A Doctor.
0:01:04 > 0:01:07Hello and welcome to Trust Me, I'm A Doctor.
0:01:07 > 0:01:08This time we're in Guildford.
0:01:08 > 0:01:11We're carrying out a fascinating experiment to see whether eating
0:01:11 > 0:01:14carbs in the evening is bad for your health.
0:01:14 > 0:01:16Also in the programme...
0:01:16 > 0:01:21How to spot the hidden condition that makes millions of us feel cold.
0:01:21 > 0:01:24A pioneering new technology in the fight against cancer.
0:01:24 > 0:01:27Ooh, yep. Starts to give a signal.
0:01:27 > 0:01:30And what can you do to avoid jet lag?
0:01:32 > 0:01:33But first...
0:01:34 > 0:01:36There's plenty of evidence that eating lots of carbs,
0:01:36 > 0:01:39whether in the form of bread or white rice,
0:01:39 > 0:01:42is bad for your waist and for your blood sugar control.
0:01:42 > 0:01:46Now, it's widely believed that eating your carbs in the evening is
0:01:46 > 0:01:49worse than having them for breakfast.
0:01:49 > 0:01:52But, of course, most of us have our main meal in the evening.
0:01:52 > 0:01:55Though, should we be changing our habits?
0:01:55 > 0:01:58The carbs and sugars in your food end up as glucose in the blood,
0:01:58 > 0:02:01which is used for energy or stored as fat.
0:02:01 > 0:02:04If you have more glucose than you need,
0:02:04 > 0:02:07your body has to work harder to remove the excess from your blood.
0:02:08 > 0:02:12If this happens regularly, it can lead to serious health problems,
0:02:12 > 0:02:14like type 2 diabetes.
0:02:15 > 0:02:18In theory, it should be better to get your carbs in first thing in
0:02:18 > 0:02:20the morning when your body is raring to go
0:02:20 > 0:02:24rather than last thing at night when your body is preparing to sleep.
0:02:24 > 0:02:26But is that true?
0:02:26 > 0:02:27To find out, we've set up a
0:02:27 > 0:02:31brand-new experiment with the University of Surrey.
0:02:31 > 0:02:35We've recruited four volunteers to help us compare how our bodies
0:02:35 > 0:02:39cope with eating most of our carbs in the morning, or in the evening.
0:02:39 > 0:02:42Dr Adam Collins is leading the study.
0:02:43 > 0:02:45What we're changing is the amount of
0:02:45 > 0:02:48carbohydrate in breakfast and dinner,
0:02:48 > 0:02:52so what we want to see is, following one pattern or another,
0:02:52 > 0:02:56does that give you better or worse blood glucose,
0:02:56 > 0:02:58or does it make you better or worse
0:02:58 > 0:03:00at dealing with carbs across the day?
0:03:00 > 0:03:03So what I love about this is you don't actually know what's going to
0:03:03 > 0:03:04happen, do you? That's the joy of science.
0:03:04 > 0:03:08We don't! We don't! It could go one way or the other.
0:03:08 > 0:03:12The aim is not to see what happens after a single high carb meal,
0:03:12 > 0:03:16it's to find out whether your body's ability to keep your blood sugars in
0:03:16 > 0:03:21check through the day is affected by what time of day you eat your carbs.
0:03:23 > 0:03:27For ten days, our volunteers are eating a fixed amount of carbs.
0:03:27 > 0:03:31For five days, they'll eat most of their allowance at breakfast.
0:03:31 > 0:03:35And for five days, they'll eat most at dinner time.
0:03:35 > 0:03:37Following each five-day block,
0:03:37 > 0:03:40they have a day where their carb allowance is spread equally over all
0:03:40 > 0:03:45three meals. And we measure their blood glucose throughout.
0:03:45 > 0:03:46This will show whether the body's
0:03:46 > 0:03:49ability to deal with carbs has changed.
0:03:49 > 0:03:52A few weeks later,
0:03:52 > 0:03:54the volunteers and their friends
0:03:54 > 0:03:57have come back to find out the results.
0:03:57 > 0:04:00Hi, all. Hello. Before you're allowed to eat anything,
0:04:00 > 0:04:03I think Adam's going to give you some results.
0:04:03 > 0:04:04OK, so what we're looking at is
0:04:04 > 0:04:07overall glucose response across the day,
0:04:07 > 0:04:11and the higher the number, the worse you are.
0:04:11 > 0:04:14So, when you followed the high carb breakfast and the low-carb dinner,
0:04:14 > 0:04:19your blood glucose response was 15.9 units.
0:04:19 > 0:04:22This level after five days of high carb breakfast
0:04:22 > 0:04:25was roughly as expected.
0:04:25 > 0:04:29But what happened after five days of high carb dinners?
0:04:29 > 0:04:33When you followed the low-carb breakfast and the high carb dinner,
0:04:33 > 0:04:35that went down
0:04:35 > 0:04:38to 10.4 units,
0:04:38 > 0:04:40so that's a reduction in terms of that glucose response.
0:04:40 > 0:04:42Remarkably better.
0:04:42 > 0:04:45Suggesting your high carb dinner was actually better.
0:04:45 > 0:04:48Which is the exact opposite of what you would have predicted, isn't it?
0:04:48 > 0:04:49Absolutely, yeah.
0:04:49 > 0:04:52So after just five days of high carb dinners,
0:04:52 > 0:04:56their ability to process carbs through the day had improved.
0:04:56 > 0:04:58An unexpected result.
0:04:59 > 0:05:01So, these results were very surprising.
0:05:01 > 0:05:04- What do you think's going on?- When they're following the high carb
0:05:04 > 0:05:08breakfast, they're having their peak carbohydrate intake in the morning,
0:05:08 > 0:05:11so they can't really improve very much because people are inherently
0:05:11 > 0:05:14already good at dealing with carbs in the morning.
0:05:14 > 0:05:17But when you give them a high carb dinner,
0:05:17 > 0:05:19that entrains them to become better
0:05:19 > 0:05:21at dealing with carbs in the evening.
0:05:21 > 0:05:25Our test is a pilot for a much larger study that Adam is launching.
0:05:25 > 0:05:28But already it's given a surprising result.
0:05:28 > 0:05:31Contrary to what we've long believed,
0:05:31 > 0:05:32it suggests our bodies are better
0:05:32 > 0:05:36than we thought at adapting to eating carbs in the evening.
0:05:36 > 0:05:38Within limits, of course.
0:05:38 > 0:05:40So, as long as you're healthy,
0:05:40 > 0:05:44you needn't worry too much about what time of day you eat them.
0:05:44 > 0:05:47In other words, if you've had a lot of carbs in the evening,
0:05:47 > 0:05:49try and minimise them in the morning.
0:05:49 > 0:05:51And on the other hand, if you've had,
0:05:51 > 0:05:53say, a pile of toast for breakfast,
0:05:53 > 0:05:56then do try to avoid the pasta that night.
0:06:04 > 0:06:06Now it's wintertime,
0:06:06 > 0:06:10and up to 10 million people in the UK are thought to be affected by a
0:06:10 > 0:06:12painful and potentially disabling
0:06:12 > 0:06:15condition that often goes unrecognised.
0:06:15 > 0:06:17GP Zoe Williams
0:06:17 > 0:06:20has been investigating Raynaud's syndrome
0:06:20 > 0:06:21and what we can do about it.
0:06:24 > 0:06:27Feeling cold is something that most of us find pretty unpleasant,
0:06:27 > 0:06:30but for people with Raynaud's syndrome,
0:06:30 > 0:06:33the winter months can bring with them a sense of absolute dread.
0:06:33 > 0:06:37And the drop in temperature can cause their fingers and toes to be
0:06:37 > 0:06:39extremely cold and numb.
0:06:39 > 0:06:41And simple things like just
0:06:41 > 0:06:44fastening up a coat can become impossible.
0:06:44 > 0:06:47It can also be extremely painful,
0:06:47 > 0:06:50but many sufferers simply live with it.
0:06:50 > 0:06:52It's estimated there are millions of
0:06:52 > 0:06:56people with undiagnosed Raynaud's in the UK.
0:06:56 > 0:06:58To help change this,
0:06:58 > 0:07:01a pop-up clinic is giving people the chance to be tested for Raynaud's.
0:07:02 > 0:07:06Leading the initiative is Dr Francesco Del Galdo.
0:07:06 > 0:07:10To show me what's happening inside the hands of people with Raynaud's,
0:07:10 > 0:07:12he set up a test with a thermal camera.
0:07:14 > 0:07:16Hi! How are you?
0:07:16 > 0:07:19Yvonne Searle is one of his patients.
0:07:19 > 0:07:22Ready? One, two, three, go.
0:07:22 > 0:07:24We'll stay one minute.
0:07:24 > 0:07:28We're comparing how our hands respond to changes in temperature.
0:07:28 > 0:07:29It's not too bad, actually.
0:07:29 > 0:07:31I thought it was going to be much colder.
0:07:31 > 0:07:33Yeah, it's only 15 degrees Celsius.
0:07:34 > 0:07:36OK, you can take your hands off now.
0:07:37 > 0:07:39Our hands have been kept dry,
0:07:39 > 0:07:41so should warm up quickly.
0:07:41 > 0:07:43- Let's have a look.- Here you go.
0:07:45 > 0:07:47My hand's on the right.
0:07:47 > 0:07:50The red and yellow colours show that it's warming up quickly back to
0:07:50 > 0:07:52normal body temperature.
0:07:52 > 0:07:54Yvonne's hand is on the left.
0:07:54 > 0:07:56The green, blue, and purple colours
0:07:56 > 0:08:00show that most of her hand and fingers are still cold.
0:08:00 > 0:08:02Yvonne's fingers have disappeared!
0:08:02 > 0:08:06Yvonne's fingers are the same temperature of the table now.
0:08:06 > 0:08:10Unlike mine, Yvonne's hand is just not warming up.
0:08:10 > 0:08:14So, why is that? Normally, when we're exposed to cold,
0:08:14 > 0:08:16our blood circulation changes.
0:08:16 > 0:08:19To help us conserve heat, the blood
0:08:19 > 0:08:21vessels in our hands and feet narrow.
0:08:21 > 0:08:23This reduces blood flow to the
0:08:23 > 0:08:27extremities of our body and helps keep our vital organs warm.
0:08:27 > 0:08:31But in Yvonne's hand, the blood vessels are hyper sensitive,
0:08:31 > 0:08:34and shut down with even the mildest drop in temperature.
0:08:34 > 0:08:36I can feel my fingers getting warmer.
0:08:36 > 0:08:39- For Yvonne, it would take a lot longer.- I can't feel much.
0:08:39 > 0:08:41They feel cold!
0:08:41 > 0:08:43I can tell that they're cold, yeah.
0:08:43 > 0:08:45Yvonne's hands look fine at the moment.
0:08:45 > 0:08:48But clearly on the screen, with the thermal camera...
0:08:48 > 0:08:49- You can see.- They're cold!
0:08:49 > 0:08:52- They're really cold!- I wish I could show my husband this.
0:08:52 > 0:08:54Did you expect there to be such a difference?
0:08:54 > 0:08:55No. No, I didn't.
0:08:55 > 0:08:59So, yeah, that just... It's quite a contrast, isn't it, to see it there?
0:08:59 > 0:09:01It is. It really is.
0:09:01 > 0:09:03As well as shutting down more readily,
0:09:03 > 0:09:05the blood vessels in someone with Raynaud's
0:09:05 > 0:09:08will also take longer to reopen fully,
0:09:08 > 0:09:11and then the blood returning to the fingertips causes pain.
0:09:13 > 0:09:15It's not just cold that can trigger the symptoms.
0:09:15 > 0:09:18It's anything that affects the circulation.
0:09:18 > 0:09:23Anxiety, stress, or simply gripping a heavy bag.
0:09:23 > 0:09:25But for one in ten sufferers, it's more serious.
0:09:27 > 0:09:30And that's because their Raynaud's is caused by an underlying disease
0:09:30 > 0:09:31or an injury that's permanently
0:09:31 > 0:09:34damaged the arteries or the nerves that supply them.
0:09:34 > 0:09:38And this is known as secondary Raynaud's.
0:09:38 > 0:09:40Causes include some autoimmune diseases,
0:09:40 > 0:09:43vibration damage, smoking,
0:09:43 > 0:09:45and it can be a side-effect of some medicines,
0:09:45 > 0:09:47so do check with your doctor.
0:09:49 > 0:09:52So, how can you spot if you might have Raynaud's,
0:09:52 > 0:09:54and what can you do about it?
0:09:54 > 0:09:58One common sign is if your fingers change colour when you're cold.
0:09:59 > 0:10:03They may go white or even blue, and have a waxy texture.
0:10:04 > 0:10:07And you'll experience numbness and pain.
0:10:07 > 0:10:10But there are some simple steps you can take to help.
0:10:12 > 0:10:14To improve your circulation,
0:10:14 > 0:10:17quit smoking and exercise regularly.
0:10:18 > 0:10:20And to avoid pain, wear gloves.
0:10:20 > 0:10:23More than one pair if it's cold.
0:10:23 > 0:10:27Start wearing your gloves before you go outside,
0:10:27 > 0:10:31and once you are outside, keep moving to increase your circulation.
0:10:33 > 0:10:38Some people do need medication to help manage their Raynaud's.
0:10:38 > 0:10:42But the most effective drug is one famous for a very different purpose.
0:10:42 > 0:10:45One of the drugs we use the most is Sildenafil now.
0:10:45 > 0:10:47Hang on a minute, that's Viagra!
0:10:47 > 0:10:51Yes, yes. It was known as Viagra. Viagra is the brand name.
0:10:51 > 0:10:53And, as you probably know very well,
0:10:53 > 0:10:54it was branded to increase
0:10:54 > 0:10:57circulation for that specific extremity,
0:10:57 > 0:10:59but it works on all extremities.
0:10:59 > 0:11:01And it's very effective for treatment of Raynaud's.
0:11:01 > 0:11:03So presumably you have men on this treatment as well,
0:11:03 > 0:11:06and are they walking around in a state of...?
0:11:06 > 0:11:08That is one of the possible side effects, of course, but no,
0:11:08 > 0:11:11we didn't receive any of these complaints about this side effect.
0:11:11 > 0:11:14I'm not surprised there was no complaints.
0:11:14 > 0:11:16It's very manageable,
0:11:16 > 0:11:19and it's quite effective for Raynaud's.
0:11:21 > 0:11:24If you have unusually cold hands,
0:11:24 > 0:11:27or if the tips of your fingers go white and waxy,
0:11:27 > 0:11:29or if you get pain when they're warming up,
0:11:29 > 0:11:31then you could have Raynaud's.
0:11:31 > 0:11:34There are effective treatments to treat the discomfort,
0:11:34 > 0:11:37and it could be a sign of a more serious underlying condition.
0:11:37 > 0:11:41So if you think you might have it, please do go and see your GP.
0:11:42 > 0:11:46Still to come - if you're heading off for some winter sun,
0:11:46 > 0:11:48how can you avoid jet lag?
0:11:49 > 0:11:53And a new technology that could transform cancer surgery.
0:11:53 > 0:11:54But first...
0:11:55 > 0:11:57In this series of Trust Me,
0:11:57 > 0:11:59we're exploring some common mental health conditions.
0:11:59 > 0:12:02This time, psychiatrist Dr Alain Gregoire
0:12:02 > 0:12:06is looking into post-traumatic stress disorder, PTSD.
0:12:06 > 0:12:10So, how do you recognise the warning signs, and what can you do about it?
0:12:13 > 0:12:17Post-traumatic stress disorder is often thought of as something that
0:12:17 > 0:12:19affects soldiers returning from war zones.
0:12:21 > 0:12:26However, the reality is that anyone can develop PTSD after experiencing
0:12:26 > 0:12:28or witnessing traumatic events.
0:12:28 > 0:12:34And those events aren't necessarily just physical or violent ones.
0:12:34 > 0:12:39They're often emotional traumas such as bullying or abuse,
0:12:39 > 0:12:42and they tend to be worse the younger you are.
0:12:43 > 0:12:46In fact, about a third of us will have a traumatic experience
0:12:46 > 0:12:48at some time in our lives.
0:12:48 > 0:12:50And in the last month,
0:12:50 > 0:12:524% of us will have suffered from PTSD.
0:12:57 > 0:13:00Michelle and Brett are both long-term sufferers.
0:13:01 > 0:13:04The PTSD itself
0:13:04 > 0:13:08started from a needle-stick injury that I sustained from where I work.
0:13:08 > 0:13:13It was a used hypodermic needle with dried blood on it.
0:13:13 > 0:13:16So there was a fear that you'd be infected.
0:13:16 > 0:13:18Frightening experience.
0:13:18 > 0:13:20It was horrendous.
0:13:20 > 0:13:22That thought pattern of, "What if?"
0:13:24 > 0:13:28Sometimes the symptoms of PTSD only surface many years after the
0:13:28 > 0:13:29experience of trauma.
0:13:31 > 0:13:35Brett was physically and mentally abused when he was young,
0:13:35 > 0:13:37but symptoms only emerged in adulthood.
0:13:39 > 0:13:42I had a good job. I was a teacher.
0:13:42 > 0:13:44I was being primed for senior management.
0:13:44 > 0:13:47I had a lovely partner.
0:13:47 > 0:13:51And then suddenly I started doing things that I wouldn't normally do.
0:13:51 > 0:13:54I ended up running away.
0:13:54 > 0:13:55Flashbacks started...
0:13:56 > 0:13:58..of the actual incident.
0:13:58 > 0:14:01I couldn't sleep, I was irritable, I couldn't sit still.
0:14:01 > 0:14:05It was like boxes that flick open, and all these thoughts,
0:14:05 > 0:14:06and what can I do with them?
0:14:06 > 0:14:09I can't put them back in and close the lid.
0:14:09 > 0:14:10I just thought my life was over.
0:14:11 > 0:14:13Left untreated,
0:14:13 > 0:14:17PTSD can develop into a serious condition that prevents a sufferer
0:14:17 > 0:14:19from functioning normally.
0:14:19 > 0:14:22If you're concerned that you or somebody you know might be suffering
0:14:22 > 0:14:26from PTSD, what are the signs to look out for?
0:14:26 > 0:14:30Symptoms include flashbacks where the person vividly re-lives the
0:14:30 > 0:14:33traumatic event or something similar.
0:14:33 > 0:14:36Difficulty sleeping or nightmares.
0:14:36 > 0:14:41Physical sensations, such as pain, sweating, nausea, or trembling.
0:14:41 > 0:14:45Negative or self-destructive thoughts or behaviour.
0:14:45 > 0:14:47Being emotionally switched off.
0:14:48 > 0:14:52To access treatment, your GP should be your first port of call.
0:14:52 > 0:14:56A psychological therapy will probably then be the next step.
0:14:56 > 0:15:00Something like trauma focused cognitive behaviour therapy or CBT.
0:15:00 > 0:15:03We've been doing mindfulness things,
0:15:03 > 0:15:06and a part of that is I've done a camera course,
0:15:06 > 0:15:08I'm doing an art course,
0:15:08 > 0:15:11and the approach there is actually thinking about what you're doing
0:15:11 > 0:15:13when you're doing it and being in the moment,
0:15:13 > 0:15:15and it works for me.
0:15:15 > 0:15:19Mindfulness. It's helping me to understand my mind.
0:15:19 > 0:15:24How I feel, how I react with my emotions.
0:15:24 > 0:15:26Sometimes you can be sat at home,
0:15:26 > 0:15:29thinking you're the only one who is like this.
0:15:29 > 0:15:30And that's not true.
0:15:30 > 0:15:32You share your experiences,
0:15:32 > 0:15:35and it makes you feel better because you're not on your own.
0:15:35 > 0:15:39Dealing with mental health issues made me where I am now,
0:15:39 > 0:15:41and it does make you a stronger person.
0:15:43 > 0:15:45PTSD can be very difficult to recognise.
0:15:45 > 0:15:49Even professionals can misunderstand and misdiagnose it,
0:15:49 > 0:15:53particularly if the trauma was a long time ago or in childhood.
0:15:53 > 0:15:57It can be very disabling, but treatment can be very effective.
0:15:57 > 0:16:00So persist in your efforts to get the right help
0:16:00 > 0:16:02and make use of it.
0:16:10 > 0:16:12Thousands of you have been sending
0:16:12 > 0:16:14questions to the Trust Me website and
0:16:14 > 0:16:18we've been finding answers to some of the more popular ones.
0:16:18 > 0:16:20What can I do to avoid jet lag?
0:16:22 > 0:16:25Zoe has been investigating.
0:16:25 > 0:16:26Most of us are familiar with the
0:16:26 > 0:16:29unpleasant feeling we call jet lag,
0:16:29 > 0:16:30the disruption to our body clock
0:16:30 > 0:16:33when we travel to a place several time zones away.
0:16:38 > 0:16:42The feeling that time difference gives you has a medical name -
0:16:42 > 0:16:43desynchronosis.
0:16:45 > 0:16:50For many people, the most obvious symptom is disrupted sleep.
0:16:50 > 0:16:52But you can also suffer indigestion,
0:16:52 > 0:16:57constipation, nausea, disorientation,
0:16:57 > 0:17:01headaches, memory loss, muscle soreness, sweating,
0:17:01 > 0:17:04or a general feeling of being unwell.
0:17:04 > 0:17:07The underlying cause of desynchronosis
0:17:07 > 0:17:10is more complex than you might think.
0:17:10 > 0:17:14That's because we don't just have one body clock - we have many.
0:17:14 > 0:17:16And they all need to be perfectly coordinated
0:17:16 > 0:17:19to keep our body working well.
0:17:19 > 0:17:22These clocks don't just influence when we sleep.
0:17:22 > 0:17:26They also influence all kinds of other processes in our body,
0:17:26 > 0:17:30like our digestion, temperature, and blood pressure.
0:17:34 > 0:17:39Amazingly, every cell in our body has its own tiny clock keeping time.
0:17:39 > 0:17:41And all of these little clocks are
0:17:41 > 0:17:44synced up every day by our master body
0:17:44 > 0:17:49clock in our brain called the suprachiasmatic nucleus or SCN.
0:17:49 > 0:17:52And our master body clock is kept on track by daylight.
0:17:54 > 0:17:57If you rapidly change to a new time zone,
0:17:57 > 0:17:59this master body clock gets reset.
0:17:59 > 0:18:01But it can take a lot longer for
0:18:01 > 0:18:03the message to filter down to all the
0:18:03 > 0:18:06other clocks in our organs and cells.
0:18:06 > 0:18:09Meaning everything is out of whack and we feel awful.
0:18:10 > 0:18:15Our body clocks naturally want to run slightly longer than 24 hours,
0:18:15 > 0:18:18so travelling west is easier than travelling east.
0:18:18 > 0:18:23That's because your day becomes longer and it's easier to cope with.
0:18:23 > 0:18:25Go east, and your day gets shorter,
0:18:25 > 0:18:27something your body clocks don't like.
0:18:27 > 0:18:31In short, going west is best, while going east's a beast.
0:18:32 > 0:18:36To work out roughly how long your jet lag will last,
0:18:36 > 0:18:39count one day for every time zone you travel through.
0:18:39 > 0:18:42So, is there anything you can do to avoid it?
0:18:43 > 0:18:46Because our master body clock is set on daylight,
0:18:46 > 0:18:50the single most effective thing you can do is to get some.
0:18:50 > 0:18:52So, if you're arriving during daylight hours,
0:18:52 > 0:18:56try and keep the window blinds open and try and stay up until it's dark,
0:18:56 > 0:18:57even if you're tired.
0:19:02 > 0:19:04But if you're arriving while it's dark,
0:19:04 > 0:19:07you need to get your body ready for sleep earlier,
0:19:07 > 0:19:09so you want to avoid light.
0:19:09 > 0:19:11That's because exposure to light
0:19:11 > 0:19:13makes your body produce less melatonin,
0:19:13 > 0:19:16a hormone that helps you sleep better.
0:19:16 > 0:19:18This is especially true of blue light,
0:19:18 > 0:19:22like early morning daylight or the light from your electronic devices.
0:19:22 > 0:19:24So avoid too much screen watching.
0:19:25 > 0:19:29For serious jet lag, GPs can prescribe melatonin tablets,
0:19:29 > 0:19:34which can help with sleep but only for those aged 55 and over.
0:19:34 > 0:19:36Others prefer sleeping pills,
0:19:36 > 0:19:37but they're not recommended for
0:19:37 > 0:19:40long periods because they can be addictive.
0:19:41 > 0:19:43Recent scientific research shows
0:19:43 > 0:19:46that it's not just light that affects our
0:19:46 > 0:19:49body clocks, but they're also influenced by food.
0:19:49 > 0:19:50And for some of our clocks, our
0:19:50 > 0:19:52mealtimes will override other signals.
0:19:55 > 0:19:58When you get on the plane, or even before you travel,
0:19:58 > 0:20:00try to eat your meals at the
0:20:00 > 0:20:02appropriate time for your new time zone.
0:20:02 > 0:20:05This simple trick can make a big difference.
0:20:06 > 0:20:11And tempting though the free wine might be, alcohol is off the menu.
0:20:11 > 0:20:14Although it can help you get to sleep quicker,
0:20:14 > 0:20:15you have a lower quality of sleep.
0:20:17 > 0:20:20It can also dehydrate you and could lead to a hangover,
0:20:20 > 0:20:22which can exacerbate jet lag symptoms.
0:20:25 > 0:20:27However bad it feels at the time,
0:20:27 > 0:20:29there's no evidence that jet lag
0:20:29 > 0:20:32causes any long term health problems.
0:20:32 > 0:20:35So get out in the daylight, join the new mealtimes,
0:20:35 > 0:20:37and embrace your new time zone as soon as possible because, before you
0:20:37 > 0:20:40know it, you'll be doing it all again on the way home.
0:20:49 > 0:20:53Every day in the UK, 140 women are diagnosed with breast cancer.
0:20:53 > 0:20:55Many will require surgery.
0:20:55 > 0:20:59But accurately locating small tumours can be a problem.
0:20:59 > 0:21:01Surgeon Gabriel Weston has been
0:21:01 > 0:21:05investigating a new technique which may help.
0:21:05 > 0:21:07In the fight against cancer,
0:21:07 > 0:21:09the key aim of screening programmes
0:21:09 > 0:21:11is to detect tumours before they have
0:21:11 > 0:21:14a chance to grow and spread.
0:21:14 > 0:21:17The next step is to remove the tumour and to be able to do this,
0:21:17 > 0:21:19the surgeon needs a way to find it
0:21:19 > 0:21:23within the patient once the operation has begun.
0:21:23 > 0:21:27So what surgeons use to help them is this guide wire,
0:21:27 > 0:21:30which is inserted right into the tumour,
0:21:30 > 0:21:32with the wire left hanging outside of the body,
0:21:32 > 0:21:34and then the surgeon in the
0:21:34 > 0:21:37operating room follows this wire down and
0:21:37 > 0:21:38cuts out the cancer at the end.
0:21:40 > 0:21:44This technique has been used effectively for over 40 years.
0:21:44 > 0:21:48But with screening programmes now able to detect tumours early,
0:21:48 > 0:21:51as many as 50% are so small that the
0:21:51 > 0:21:54surgeon may not be able to feel them.
0:21:54 > 0:21:56This makes it difficult to know the
0:21:56 > 0:21:59best route of approach or what tissue to remove.
0:21:59 > 0:22:02So surgeons need new ways to pin-point
0:22:02 > 0:22:04the cancer with precision.
0:22:05 > 0:22:07This tiny magnetic marker could
0:22:07 > 0:22:11transform the way surgeons locate small
0:22:11 > 0:22:13tumours in the breast.
0:22:13 > 0:22:14The technique involves using a
0:22:14 > 0:22:17mammogram or ultrasound scan to locate the
0:22:17 > 0:22:21tumour, and then implanting the magnetic marker or seed.
0:22:21 > 0:22:24The hope is that during surgery
0:22:24 > 0:22:26the device will help guide the
0:22:26 > 0:22:29surgeon to the tumour reliably and precisely.
0:22:29 > 0:22:34Today, Julie Werne is having an operation for breast cancer at the
0:22:34 > 0:22:37Royal Marsden Hospital in Surrey.
0:22:37 > 0:22:41She's taking part in a new clinical study of the magnetic technology.
0:22:42 > 0:22:46Three days ago, she had a magnetic marker implanted in her tumour.
0:22:48 > 0:22:51Julie, where did it all start?
0:22:51 > 0:22:53It all started when I was due for my
0:22:53 > 0:22:57usual three-year check-up at the local mobile unit.
0:22:57 > 0:22:59Went along, had the mammogram,
0:22:59 > 0:23:02and I was just expecting to get the letter on the mat three weeks
0:23:02 > 0:23:05later, saying everything's fine and we'll see you in three years.
0:23:05 > 0:23:07And that didn't happen.
0:23:07 > 0:23:10It's sort of every woman's worst fear, isn't it?
0:23:10 > 0:23:13- Oh, a complete nightmare. Yes, yeah. - How did you find out about the new
0:23:13 > 0:23:17technology that you've been a part of trialling today?
0:23:17 > 0:23:18Well, I had a phone call from my
0:23:18 > 0:23:22surgeon and she explained all about this
0:23:22 > 0:23:25new procedure, and she said would I like to try this out?
0:23:25 > 0:23:29And I thought it sounded wonderful and, yes, I agreed to it.
0:23:30 > 0:23:33Breast surgeon Jennifer Rusby will be operating on Julie.
0:23:34 > 0:23:37If the patient has a lump, I can remove the lump.
0:23:37 > 0:23:40But this lady's cancer is so small that I wouldn't be able to feel it.
0:23:40 > 0:23:42This is the seed here.
0:23:42 > 0:23:46The cancer is almost undetectable, so we've got the seed put in
0:23:46 > 0:23:47because at the time of surgery I
0:23:47 > 0:23:50need to know which bit of breast to remove. With the seed,
0:23:50 > 0:23:54we can place the probe on the breast and X marks the spot.
0:23:54 > 0:23:56How do you see this giving an
0:23:56 > 0:23:59advantage in terms of curing or removing
0:23:59 > 0:24:01cancer from your patients?
0:24:01 > 0:24:03One of the benefits of the seed may
0:24:03 > 0:24:05be that I can get to that point in the
0:24:05 > 0:24:09breast more accurately and therefore take away less normal, healthy
0:24:09 > 0:24:11tissue from around it. And the main
0:24:11 > 0:24:13goal of cancer surgery is to remove the
0:24:13 > 0:24:15cancer and to get clear margins,
0:24:15 > 0:24:17but the secondary intention is to
0:24:17 > 0:24:20leave the breast looking as natural as it possibly can.
0:24:20 > 0:24:23And the way we achieve that in breast surgery is by minimising the
0:24:23 > 0:24:25amount of normal tissue that's removed.
0:24:25 > 0:24:27One key advantage of the magnetic
0:24:27 > 0:24:30marker is that it can guide the surgeon
0:24:30 > 0:24:33to the tumour from any angle of approach.
0:24:33 > 0:24:35Doctor Quentin Harmer is chief
0:24:35 > 0:24:37technology officer for the company that has
0:24:37 > 0:24:39developed this system.
0:24:39 > 0:24:42- Can I have a turn? - Have a go.- Thank you.
0:24:42 > 0:24:45To demonstrate, the seed is buried under a silicone breast.
0:24:47 > 0:24:49Oh, yup. It starts to give a signal.
0:24:49 > 0:24:52Yes, so the noise increases as they get closer,
0:24:52 > 0:24:55and in fact you can translate the reading into a distance,
0:24:55 > 0:24:59so surgeons can use that to help work out where they are
0:24:59 > 0:25:00relative to the cancer.
0:25:00 > 0:25:02And that's the sound you're
0:25:02 > 0:25:04after when it starts to get very high like that.
0:25:04 > 0:25:07And it's quite interesting that just changing the sort of
0:25:07 > 0:25:10angle of how I'm tilting it makes a difference.
0:25:10 > 0:25:12The probe gives you the ability to
0:25:12 > 0:25:14pinpoint where the seed is and that's critical
0:25:14 > 0:25:17so the surgeon has a very clear picture in their mind.
0:25:17 > 0:25:21It enables them to get closer to the perfect excision -
0:25:21 > 0:25:24just the tumour and the little margin around it.
0:25:24 > 0:25:28Julie is one of the first women in the UK to be operated on using the
0:25:28 > 0:25:30magnetic system.
0:25:30 > 0:25:32One, two, three.
0:25:36 > 0:25:38Can you pass the probe, please?
0:25:43 > 0:25:45Getting a very high signal there
0:25:45 > 0:25:46because we're right over the cancer.
0:25:48 > 0:25:51It's making a very clearly high-pitched sound
0:25:51 > 0:25:52to show her that she's getting
0:25:52 > 0:25:55much nearer to her surgical target.
0:25:56 > 0:25:58Guided by the probe,
0:25:58 > 0:26:00Jenny is able to choose the shortest,
0:26:00 > 0:26:02most direct route to the tumour.
0:26:02 > 0:26:06This is less destructive to healthy tissue and also means that the
0:26:06 > 0:26:08operation could be quicker.
0:26:09 > 0:26:12It should almost be free now.
0:26:12 > 0:26:15Just going to disconnect it from the breast tissue at the bottom here.
0:26:16 > 0:26:20The cancerous tissue is now sent to be X-rayed to check that the tumour
0:26:20 > 0:26:23has been completely removed with the minimal margin
0:26:23 > 0:26:25of healthy tissue around it.
0:26:27 > 0:26:30This is the seed which was located within the tumour and here's the
0:26:30 > 0:26:33cancer, the sort of white hazy area in there.
0:26:33 > 0:26:35So I think we need to take a little bit more here,
0:26:35 > 0:26:38just to check that we've got some normal healthy tissue around it.
0:26:38 > 0:26:40But the seed is present in the specimen.
0:26:40 > 0:26:42This image for me
0:26:42 > 0:26:48really shows the beauty of this kind of surgical ability married with
0:26:48 > 0:26:51technology. Because what this seed
0:26:51 > 0:26:54is enabling a surgeon like Jenny to do
0:26:54 > 0:26:58is to be very specific about where she's going and where she's cutting.
0:26:58 > 0:27:02And enabling her as best she can
0:27:02 > 0:27:06to obey those two surgical demands of
0:27:06 > 0:27:09removing all the cancer whilst preserving
0:27:09 > 0:27:11as much healthy tissue as possible.
0:27:15 > 0:27:19A few hours later, and Julie is able to go home.
0:27:19 > 0:27:22Further lab tests on the removed tissue
0:27:22 > 0:27:25should confirm the success of the operation.
0:27:25 > 0:27:28Depending on the results of this small pilot study,
0:27:28 > 0:27:32the research will move to a bigger trial involving 200 patients.
0:27:35 > 0:27:39And the application doesn't stop with breast cancer.
0:27:39 > 0:27:43Surgeons are also considering this technology for lung cancer patients,
0:27:43 > 0:27:46for whom the preservation of healthy tissue is vital.
0:27:48 > 0:27:50It really does look as if this may
0:27:50 > 0:27:53in the future have a huge role to play
0:27:53 > 0:27:55in the treatment of all kinds of cancer.
0:28:04 > 0:28:05That's it from Guilford.
0:28:05 > 0:28:08Next time, we're in Glasgow,
0:28:08 > 0:28:12carrying out a fascinating experiment to find out the best way
0:28:12 > 0:28:16to get a neglected nutrient, iodine, into our diets.
0:28:16 > 0:28:20# I just made an appointment for a special rendezvous
0:28:20 > 0:28:26# To see a man of miracles and all that he can do
0:28:26 > 0:28:30# I checked in at reception put my hat to my lap
0:28:30 > 0:28:35# And when he walked in dressed in white I had a heart attack
0:28:35 > 0:28:38# Doctor, I want you
0:28:38 > 0:28:40# Do what you want to do
0:28:40 > 0:28:42# I can't get over you
0:28:42 > 0:28:45# Doctor, do anything that you want to do. #