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IN TOUCH – Lockdown Shopping Update and Keeping Fit

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TX:Ìý 05.05.20Ìý 2040-2100

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PRESENTER:Ìý ÌýÌýÌýÌýÌýÌýÌý PETER WHITE

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PRODUCER:Ìý ÌýÌýÌýÌýÌýÌýÌýÌýÌý KEV CORE

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White

Good evening.Ìý Tonight, when so much fitness training depends on being able to see what your instructor’s actually doing, visually impaired exercise coach, Jane Taylor, has some tailored made tips for blind and partially sighted people who want to stay in trim.

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Taylor

So, left up, right up, left down, right down.Ìý You will be amazed how hard work that gets to be when you’ve been going on for two minutes.

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White

More from Jane later in the programme.

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And how Scotland is tailoring its eye consultations to people who can’t get to hospital.

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Clip

The optician will press a few buttons and the ophthalmologist will effectively be dialled into that consultation.Ìý The patient, the optician and the eye doctor.

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White

But first, the dilemma for some blind people of how to shop in this lockdown period is taking a long time to sort out.Ìý David Wilkins from Kent, told us that he was one of many blind people caught in a Catch-22 situation – unable to get an online shopping slot, no longer able to be closely guided by strangers.Ìý He’s now reliant on a parent shopping for him.

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Wilkins

I feel that after spending 10 years living alone, doing some jobs and building up independence, at a stroke I’ve lost it all.Ìý I find that I’m not eligible for an online slot or an online delivery because I’m not particularly vulnerable to Covid-19.Ìý I feel the government forgot us completely when social distancing rules were introduced and hope that when they’re relaxed the government will remember to tell people they can sighted guide blind people again.

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White

David Wilkins.

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Well, last week, at the government press briefing the Environment Secretary, George Eustice, said plans were in place for people who couldn’t access help.

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Environment Secretary, George Eustice

We recognise that there are others who are not clinically vulnerable and therefore not in that shielded group but who may also be in need of help, perhaps through having a disability or another type of medical condition or indeed being unable to draw on family and neighbours to help them.Ìý So, we have been working with local authorities to ensure that those people can be allocated a volunteer shopper to help them get their food needs.

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White

Well, we’ll hear more from someone who used this volunteer network in a moment.

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When it comes to those rare online shopping slots, the Department for the Environment, Food and Rural Affairs – Defra – told us there were ongoing discussions with supermarkets about access for blind people who needed help.Ìý That could mean the idea that councils refer people most in need to supermarkets, so that they can access slots.Ìý

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It was welcomed by Sarah Lambert, Head of Social Change at the RNIB.Ìý They’re receiving more than a hundred calls a day from people worried about getting their groceries.Ìý And they teamed up with other blind organisations to create a petition about shopping which attracted 22,000 signatures.Ìý But Sarah says the plans for councils to refer to supermarkets may not be straightforward.

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Lambert

While we think this is a really good first step, we do have a number of concerns that we’re continuing to work with government on.Ìý We’re concerned to make sure that the criteria that councils are using does actually reflect the specific challenges that blind and partially sighted people are facing at the moment.Ìý We’re also worried that given this is going to happen in the 152 councils across the country, that this might lead to some inconsistency into the way that people might be referred and we’re also worried about how this might work in the devolved nations because we think that Defra has probably only, to this date, been speaking to councils in England.Ìý So, our discussions with government have been progressing but we’re really keen to make sure that things can happen quickly, so that as many blind and partially sighted people as possible can benefit from any referral process and that they can access the groceries they need through online delivery as soon as possible.

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White

If you’re not online, help is now available beyond the original medically shielded group.Ìý People who are vulnerable because of disability, frailty, or pregnancy, can now self-refer to the NHS volunteer responder group.Ìý Well, that covers blindness, so listener Geoff Long, also over 70, and having just received a heart pacemaker, did just that.Ìý His first attempt saw him waiting for 20 minutes and then losing the line but his experience, second time around, was different.

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Long

I was told I would get a call from a volunteer, could be that day, could be a day or two, in fact it turned out to be about an hour later.Ìý And we discussed when we should call each other and whatever.Ìý He explained that the services they offered were getting medication and essential supplies.

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White

So, a call back within the hour and a promise of help when he needed it.

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If you’re now able to use the NHS volunteers do let us know how it’s going.Ìý And we’ll be keeping you posted about how the access to those online shopping slots for blind people is progressing.

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The number for the volunteers is 0808 196 9646, that’s 0808 196 9646.

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Another issue which is slowly untangling itself during this covid lockdown is people getting eye treatment if the problem is sight threatening or causing pain.Ìý But it seems different parts of the UK are tackling it in different ways.Ìý We’ve already looked at England and Wales and it seems the need to keep face-to-face treatments to an absolute minimum has led to some radical changes in Scotland.Ìý

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We’ve been given the chance to have a peak behind the scenes of a consultation which is taking place remotely.Ìý Using a smartphone link, an ophthalmologist can see into the eyes of a patient in an optician’s many miles away.Ìý It’s all part of a system made possible by the Scottish government’s technology enabled care programme.Ìý Here’s consultant ophthalmologist Dr Iain Livingstone discussing a problem with Andrew Baird, an optometrist working in the Callander emergency eyecare treatment centre.

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Remote consultation

Livingstone

Hello.

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Baird

Hello.

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Livingstone

Hi Andrew, how are you doing?

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Baird

Good.Ìý Can you hear me?

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Livingstone

I can hear you well.

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Baird

I’ve got Obeda in today, referred in from Spec Savers, and I’m trying to… and we’ve got a very dry eye and I’m not entirely sure why it’s dry, I’ve not seen any sign of…

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White

Dr Livingstone explained how work has been transformed.

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Livingstone

Covid-19 has completely disrupted the way we deliver healthcare.Ìý All routine aspects of healthcare that can be cancelled are cancelled and only emergencies are coming through.Ìý So, the vast majority of opticians have been closed and only a few, that are well equipped with very experienced staff that can prescribe medications, are open.Ìý And recalling these the emergency eye treatment centres.Ìý And emergency eye cases are filtered through to these centres.Ìý In many ways, these opticians’ practices have become extensions of the hospital eye clinic.Ìý And from a patient’s perspective when an opinion of an eye doctor is felt necessary, the optician will press a few buttons and the ophthalmologist will effectively be dialled into that consultation, which becomes like a Skype call with three people – the patient, the optician and the eye doctor – with the unique difference that I can see the view from inside the microscope.Ìý So, from the patient’s perspective the slit lamp will be talking, helping guide parts of the examination and giving advice, when it’s needed, to treat as much as we can without bringing the patient to hospital.

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White

Here he is preparing his equipment for the remote consultation.

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Remote consultation

Livingstone

Okay, thanks, sorry that took a while.Ìý Okay, I’ve heard you’re acuting Andrew?

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Baird

The vision is 6.5.

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Livingstone

Right, so it’s down a good bit.Ìý Okay.Ìý

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Baird

…the number [indistinct words].

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Livingstone

I’ll take that as well, yeah, give me one sec.Ìý

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This new group method of consultation doesn’t have to stop with two experts.

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Livingstone

What’s been really interesting is when we think the patient needs surgery that can only be offered in a specialist centre and we can add into the video call another eye doctor, for an opinion on next steps.Ìý And in three cases since Covid-19 measures started, we’ve had three patients listed for specialist vitreoretinal surgery in a tertiary centre directly from the high street with the VR surgeon talking through the video call directly to the patient, whilst looking at the retina, allowing them to plan the surgery.

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White

Despite the discomfort in her eye it’s been a good experience for Obeda Hussain, the patient being viewed through a scope and a smartphone.

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Remote consultation

Livingstone

Do you have any – does the patient have any questions for me?Ìý Obeda?

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Hussain

No, I’m just worried about my eye, will it be okay?

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Livingstone

I think it’ll be fine.

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Hussain

…my vision because I’m struggling at work right now as well.

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Livingstone

Yeah, what do you do?

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Hussain

I work in a shop but looking at the prices and that, we don’t have a scanning system, just looking at the prices.

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Livingstone

I mean it looks very dry…

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Hussain

My vision is getting worse.

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Livingstone

Yeah, it’s very dry.Ìý Is the eye itchy?Ìý It is itchy.

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Hussain

It’s very itchy, just very sore, just very… yeah.

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Livingstone

The other big advantage of teleophthalmology, during Covid-19, is that we can make the most of a well but decommissioned workforce who may be self-isolating at home and can offer an unprecedented level of consultant opinion availability to help support decision-making in primary care.

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White

Now it’s time for a conclusion and time for the patient to be put at her ease.

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Remote consultation

Livingstone

So, Obeda, I’m not particularly worried about it, I know that it’s very sore and dry eyes are very, very painful but I think if this is some sort of reaction to the drop, intensive lubrication, it should improve within the next few days.Ìý But there are so many sensitive nerves in the cornea it does feel like a rock’s in there.

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Obeda

It does, it feels really uncomfortable.

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Livingstone

Yeah, but it should improve.

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Well not just a peek into an emergency solution but into the future perhaps.

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And out thanks to Dr Iain Livingstone, consultant ophthalmologist and honorary lecturer at the University of Strathclyde.

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Now, there’s plenty of this around at the moment…

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Music and Virtual PE

Good morning and welcome back to PE with Joan.

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It’s going to be fast, 20 to 25 minutes with minimal rest.Ìý Let’s get right to it.

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Really quick, let’s get our heartrate up, let’s really go for it now.

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Fitness training on TV, fitness training online but the problem is with poor sight or none it’s very heard to know what they’re actually up to and whether you are doing it right.Ìý So, for visually impaired people, who want to stay in trim during the lockdown, we’ve asked specialist fitness trainer, Jane Taylor, to talk us through some simple routines which could help.

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Jane Taylor told me you may feel okay now but we could be in this for the long haul.

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Taylor

This is not a short-term situation and it may be worth your while taking stock right now.Ìý If you are visually impaired, you have some useful vision, you should be able to find something which is a cardio-based workout that you’re going to be able to tap into at home.Ìý I think if you have no vision at all, then you’re in a much more restricted game but I did take a look and I’ve seen some quite useful resources on the British Blind Sport website, particularly a link that goes through to an American site which is called Blind Alive, where they actually have quite a good list of audio-described sessions, including some quite heavy duty – there’s a boot camp one, there’s some quite high level cardio sessions.

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White

Really the problem is that with the mainstream ones, the descriptions of what’s going on, they don’t perhaps bear in mind the fact that someone who can’t see won’t know what they’re talking about, what they’re trying to describe.

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Taylor

It is a major problem because – and I include myself in this because I’ve made a few videos – and you are constantly thinking about visual representations and never enough about speaking to that.Ìý There are particular disciplines like Pilates and Yoga where they’re much more verbally described.Ìý So, if you’re already familiar with those disciplines, those are actually more accessible in a way than standard workout material.

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White

Thinking of the rest of us, who aren’t necessarily that organised or think that our normal day-to-day routines of work or doing things around the house and the odd walk will keep us fit, what is it important for people like that to do?

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Taylor

The first thing is you have to look after your heart health, the government recommendation is 30 minutes a day of making your heart work harder and making your breathing heavier.Ìý I would recommend you do a 10-minute cardio session three times a day and it’s no more complicated than this.Ìý Stand with a chair, if you need one for balance, stepping gently at your chair.Ìý Two minutes of gentle stepping, then up the pace by marching briskly – lifting your feet a little bit higher – a couple of minutes of that.Ìý Then add in arm movements, like swimming arms, or scissor arms or punching arms, you can make it up but it’s stuff that’s going to make your feel like you’re working a lot harder.Ìý After you’ve done about six minutes, move to your step – this is the lowest step in your staircase – make sure you’ve got one hand on your banister if you need it – and just step on that first step, hand on your bannister and then go, stepping up – left, right, left, right, down again.Ìý So, left up, right up, left down, right down.Ìý You will be amazed how hard work that gets to be when you’ve been going on for two minutes.Ìý Then you finish off by coming back, two minutes of just gentle stepping with your chair, letting your heart and lungs get back to normal.Ìý And that’s a 10 minutes workout, cardio.

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After that, number one – squats – so you’re standing in front of your chair, as though you just stood up from it.Ìý You’re going to sit back, pull your abs in, push your bottom backwards, as though you’re halfway down to your chair and stop still.Ìý Stay there, five seconds, and then you come back up again.Ìý And then you repeat – these are squats – do 10 of them.

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White

Okay, so we’ve done the heart, we’ve done the legs, what about your back.

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Taylor

Okay, down on to the ground, face down.Ìý Imagine if you were standing up and someone just raised a gun and pointed it at you, you’d put your hands up in front and say – I surrender.Ìý So, that’s the position you want lying down on the ground with your hands palms down, somewhere round by your ears out to the sides.Ìý Just raise your head far enough to look forwards at the end of the floor in front of you, then use your hands and forearms to help, as you lift your back up away from the ground.Ìý Don’t go too high, if you feel it scrunching your lower back you’ve gone too high.Ìý Five seconds, lower back down gently.Ìý That is back strengthener, everyone needs to be doing work for strengthening their back.Ìý However, if you find getting down on the ground a problem and you’re not sure if you can safely get up please don’t do this exercise.

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White

Do you have to do all these every day or can you mess about with it a bit?

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Taylor

You can mess about with it, but I would say do it every day – why not?Ìý It’s not as though you have to get up early to do it, you’ve got plenty of time in your day now.

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White

Jane, what do you need to watch out for in terms of making sure you’re carrying out the instructions properly, that you’re not overstretching yourself, what do you need to check?

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Taylor

If you’re not used to doing regular exercise or even any exercise, always, always start at beginner level, assume that you are an absolute beginner.Ìý Secondly, anyone who has medical conditions, underlying problems, if you’re living with pain and disability, you must be really cautious, you should go with what your medical practitioners advise or what your physiotherapists already advise and if you’re on your own here start very cautiously indeed.

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White

Jane Taylor.Ìý And while you get your breath back you can go online to see Jane, she can be found on YouTube at Ginger Can Do It.Ìý And if you have fitness techniques you’d like to share, you can email intouch@bbc.co.uk or just go to our website bbc.co.uk/intouch from where you can download tonight’s and plenty of previous editions of the programme.Ìý

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From me, Peter White and producer Kev Core, goodbye and it would be rude after all Jane’s efforts, not to do a few one arm press ups.

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Music

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You probably don’t believe me, do you?

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Music