R2 RAG - AUGUST 2019

SALLY'S SUPERSTARS

Welcome to another edition of the R2 Rag, and thanks as ever to Kirsty for pulling it together. I can’t believe it’s nearly Sept already! So far R2 we are having another great year, and are almost through the ‘tough summer months’ and ready for the final push through Sept-Dec.

As usual I’m highlighting some of our Super Stars YTD.

Starting with YTD Actis call rates, Sandra is our top performer for GP Activity, seeing 4.2 GP/day, followed by Diane on 3.9/day and Mike on 3.8/day. For Pharmacy Fiona and Diane are joint top, seeing 5.8/day, followed by Sandra on 5.7/day and Adam on 5.6/day.There are a lot of other team members over-delivering for both GP and Pharmacy, well done to all of you who are exceeding our KPI’s!

From VEEVA, our FF Target activity stars YTD are Sohail on 2/day and Babu on 1.9/day. From Tony’s report for H2 it looks like Babu, Mike and Diane are off to a flying start, all seeing over 2/day through July and August, brilliant!

Total activity in VEEVA YTD is topped by Sandra on 6/day, followed by Diane on 5.6/day and Paul on 5.4/day.

Our performance for Thea has been exceptional. R2 have had fantastic client feedback. Every one of you who have had a Thea coaching afternoon have received positive feedback. Kirsty and Fiona in particular have been praised for their product knowledge and selling/training skills, Paul for sending in such valuable intel (our spy in N Wales) and Babu for his commercial approach and resulting high volume of TO sales. I am so impressed with how you have embraced this project R2!

We are delivering excellent activity for Thea, with Adam, Mike, Sohail and Fiona all delivering over 5 Thea calls/day. We’ve delivered many quality training sessions (sometimes with certificates). Fed-back on Boots and Rowlands as requested. We also have some excellent results for TOs. I hope these figures are correct, if I have missed anyone do let me know. As of mid Aug Babu has taken 28 TOS, Sandra 13, and Adam and Fiona 8 each. However, this is only part of the story, as some of these are ‘double TOs’ ie 20, or in Babu’s case more, 100 units! I know some of the team are now taking second TOs from pharmacies who have used their initial stock, that’s great!

Finally, I would like to wish Adam all the very best for his future career with the Met Police, and thank him for his hard work and commitment to R2 and the Endeavour team. We’ll miss you in R2, however, you have an amazing opportunity and I’m proud and delighted you are making this career move. I’m sure we all wish the Every Success in your new role.

'THE FUNNIEST THING HAPPENED TO ME....'

 

 

 

 

It's fair to say that we have had some rather interesting weather this year; rain that goes on for days on end, followed by heatwaves that even the best car aircon can't cope with.

Being on the road we are somewhat at a mercy to the elements, which Sandra found out for herself back in June (yes this photo is from June, you know that 'summer' month!)

'Yesterday – in and out of car in the afternoon -My coat was shower proof, but not torrential rain proof!! Wet through to my knickers, I had to strip off and shower to warm up when I got in.  Also went through 2 pairs of shoes as they got so wet.' - Sandra

IN THE HOT SEAT...

In this edition we hear from our latest (and rather lovely) edition to the team, Fiona...

What do you enjoy most about your job? What makes you think “That was a great day?”  

I enjoy interacting with customers, building and maintaining relationships.  Providing solutions and advice that will benefit their patients, improving their health and ultimately helping the HCP’s / NHS to focus their time more effectively.  Hearing about success stories and how Eliquis and our other products have been fundamental in changing patients’ lives.  I enjoy supporting customers with training, demonstrating products, increasing business by gaining commitment, or completing orders – all of which contributes to a great day!

It’s Friday afternoon, the sun’s out, you’ve smashed your call rate, what song do you play full blast on the way home!?  

I recently watched the movie:  ‘A Star is Born’ and love listening to Lady Gaga and Bradley Cooper – any excuse, doesn’t have to be a Friday!

You have a time machine, what date to you travel to and why?  

Various dates if possible, to see my little dogs again that have passed on.

What is your favourite quote?  

‘Keep Calm and Carry on!’

You step out of your car and find a lottery ticket, you run the numbers and realise it’s a winning ticket worth 10 million – what would you do?  

Call Phil my husband and buy champagne to celebrate!

If you could be any animal what would you be and why?  

One of my dogs as they’re loved, treasured and adored.

FUNDRAISING FUN!

It seems like an absolute lifetime ago now but back in Easter many of the team were doing their best to dodge any crazy weather and heading out on fundraising challenges! 

Sally and Paul did a Snowdon Challenge, Diane and Tony who joined in ‘remotely’ on Good Friday with their own challenges. Tony ran a hilly 20 miles (and unexpectedly joined a Yoga group briefly at 10 miles). Diane and her husband joined a walking event and walked 16 miles in Cambridgeshire. Mike also joined in remotely with an early morning walk in South Wales on Good Friday, along the beautiful coast I imagine.

The Snowdon Challenge went brilliantly. Alex Davies, Paul Pook, Paul’s friend, and myself all achieved our climbing goals. Paul and I completed the Snowdon Double ascent in about 9 hours. Snowdon looked glorious in the sunshine, and the view from the top was incredible. It was a tough challenge, especially our second ascent via the steeper route, we all had to dig deep and remember Mike’s inspirational quotes!

We are doing so well with the fundraising for the Velindre Cancer Centre. The total so far via JustGiving is £1,780.00 AMAZING!

It is entirely optional, but if you would still like to donate, or have been meaning to donate but not got around to it, it’s very quick and easy via JustGiving, please follow the link below:

https://www.justgiving.com/companyteams/Mightymike

It was also truly fantastic to hear recently that Mike is doing so well and responding to treatment. We are all 100% behind you Mike.

Heading DOWN TO LONDON TOWN

Another event that already feels like a lifetime ago was the trip down to the Big Smoke to attend Step It Up. The celebration dinner was truly fantastic and in such an amazing venue - one dinner I'm sure we will all remember for some time! Plus the band were actually pretty damn good (if Queen is your cup of tea) - rather unusual for these things!

Hi everyone!

This isn't something I often do in our little newsletter but below is a post I've written about Sleep. I have genuinely struggled recently and as you will read, desperation sent me on a very interesting journey. There is so much more I could have written, in regards to memory and cognative function especially but I didn't want to make it an entire book! I do hope you will take the time to read it, it looks long but it's only about an 8 minute read (yes I timed it). I have written this with our team in mind but I may adapt and feature this post on the public section of my website soon. I do hope you find it interesting, I haven't perfected my sleep quite yet (this recent heat has not helped at all), but now I've experienced how a full nights restful sleep leaves me feeling , I never want to go back to what was my previous norm of between 5-6 hours. My stomach issues have reduced massively, the brain fog I experienced and the feeling of needing to sleep at 3-4pm everyday that had been put down to an underactive thyroid is simply not there when I sleep properly. Anyways, hope you enjoy and if you have any questions give me a shout. - Kirsty

SLeep - Why You need to make it a priority

I've never been one to stick to a solid sleep schedule, always considered myself a bit of a night owl and given the choice between staying at the party or a few hours more kip, I'm sure you know which one I'd pick. I've always been very aware of the effect no sleep had on me though - I can be the most grumpy, argumentative person going following a night of minimal sleep, concentrating seems horrifically hard, plus I will eat anything and everything in sight just to keep going.  I've suffered with little episodes of insomnia in the past, as most of us have, but recently this became a real problem. Nights on end of not being able to drift off and when I did waking several times through the night, often as a result of a really unpleasant nightmare. Desperation in needing an answer has sent me on an unexpected yet fascinating path, and now I prioritise sleep in a way I would never have imagined. I'll tell anyone who is willing to listen why they should make sure they sleep enough, in massive contrast to the 'hustle' mentality of my generation. I really hope you'll allow me to share this with you and maybe take some benefit from this post.

How many of you got the recommended hours of sleep every night last week? If you didn't you are not alone, two thirds of adults throughout developed nations don't get eight hours of nightly sleep either. This isn't shocking I'm sure, but the health outcomes truly can be.

Ignoring Fatal Familial Insomnia (an incredibly rare, genetically inherited disorder with no cure. Patients can never sleep and tragically usually die within ten months of diagnosis), sleeping just a few hours less than the recommended amount has surprising detrimental effects on the body and mind which I found both fascinating and alarming. 

Let's start with the body, in fact, let's start with how sleep can change the way we look - yes really.

There are now various studies that can demonstrate links beween short sleep and weight gain. There are several factors to this but the first starts with hormones Leptin and Ghrelin. Leptin is responsible for signalling that you are full, Ghrelin however gives us the feeling of hunger. Dr Eve Van Cauter at the university of Chicago has researched the link between sleep and appetite for many years and in one study she conducted found that inadequate sleep (defined as 5 1/2 hours sleep) resulted in decreased levels of Leptin and elevated levels of Ghrelin. Put simply, if you don't sleep enough you will feel hungrier AND less likely to feel satiated. You don't have to be a genius to work out what will happen to your diet plans with this going on!

For the sceptics among us this hormonal imbalance does lead to overeating - in another landmark study individuals who were only allowed 4 1/2 hours sleep ate 300 more calories per day than the control group, despite having access to the same foods and all other conditions being identical. Consider the extra calories you might consume over a year if you are getting less sleep and all of a sudden you realise where that extra stone may have come from! In another similar study it was discovered that cravings for sweet and carb rich foods increased by 30-40% when sleep was reduced by a few hours each night.

The most shocking study for me though was as follows - in 2010, two groups of overweight individuals were placed on a calorie controlled diet during a two week stay at a medical centre. Participants who slept for 5.5 hours lost 55 percent less body fat, and 70 percent more of their lean body mass than those who slept for longer. Those who slept for 8 hours had well over 50% of their weight loss from fat whilst preserving muscle. At a very basic level, those who slept for a shorter time held on to their fat reserves and instead lost muscle tissue .

Think going to bed on time isn't very 'manly'? Well boys I'm afraid I have bad news for you. Men who under sleep have significantly smaller testicles, 29% lower sperm count and testosterone levels of a man 10 years senior! Jokes aside, testosterone is vitally important. Those with low testosterone often suffer from fatigue and are unable to concentrate thoughout the day, along with a low libido and low mood.

Don't need to lose weight? Well you don't escape either, turns out there is such a thing as 'beauty sleep'. In a study at Stockholm university, healthy men and women were photographed in the exact same conditions twice, except once when they were well rested, and once when they had been given just 5 hours sleep. These photos were then shown to members of the public randomly, who knew nothing about the experiment and asked to rate the individuals in the photos on percieved health and attractiveness. The scores were unanimous - the faces after one night of short sleep were rated as looking more tired, less healthy and significantly less attractive. 

There is tons more data around the way in which sleep affects our body, with the above simply scratching the surface. For example, let's look at the cardiovascular system - a 2011 study of more than half a million men and women shows that shorter sleep was associated with a 45% increased risk of developing coronary heart disease within 7-25 years of the study. In another study over 14 years, those sleeping 6 hours or less were 400-500% more likely to suffer a cardiac arrest than those who slept for longer. Adults 45+ who sleep fewer than 6 hours a night are 200% more likely to suffer a heart attack or stroke in their lifetime - truly alarming stuff.

Given that diabetes now is considered an epidemic, it's interesting that lack of sleep has now shown increased rates of type 2 Diabetes in two seperate and large independant studies. This is interesting but doesn't prove a true link - so further studies were conducted. Healthy participants with no issues with blood sugar were limited to sleeping just 4 hours a night for 6 nights. By the end of the study participants were 40% less effective at absorbing a standard rate of glucose. To put this into persepective, if you presented at your GPs office with similar blood sugar readings you'd be classified as pre-diabetic.

Lack of sleep also decimates your immune system. Studies have shown clear, lineal relationship with infection rate of the cold virus and sleep. In those sleeping an average of 5 hours per night, infection rates were almost 50%, yet in those with 7 hours or more this dropped to just 18% It also affects your antibody rate should you decide to get a vaccination for flu for example. One study showed that patients who had 7 or more hours of sleep showed a powerful antibody reaction to a flu shot, yet this dropped by more than 50% for those who only had 4 hours. Even more shocking is that one landmark study at the University of California demonstrated that a single night of just 4 hours sleep caused a decrease of natural killer cells by 70%.

So what about our minds? Well I'm afraid I don't have good news here either.

Alzheimers is tipped to be the next health epidemic with rates expected to triple worldwide by 2050. Alzhiemers is associated with a build up of a protein called beta-amyloid which forms plaques known as Amyloid plaques in the frontal lobe.

Within the last 10 years there has been an amazing discovery about our brains, Dr Maiken Nedergaard discovered there is a system called the glymphatic system made up of glia cells throughout the brain. This system acts like a cleaning system in that it collects and removes metabolic contaminants created by neurons as they do the work they do, day in day out. Whilst this system is active when we are awake, it operates at a much higher level when we sleep. Once we enter deep NREM sleep we are effectively treated to the equivalent of a brain deep clean. Glial cells shrink in size by up to 60% and cerebrospinal fluid can move more freely to clean away all the unneeded waste from neural activity. As if that wasn't enough, it also remarkably is able to remove amyloid protein from the brain. There are now many who believe that improving your quality of sleep now could in fact reduce your risk of developing Alzheimers in the future.

One very important thing we should consider given our roles is how lack of sleep could effect us day to day. One area even the smallest lack of sleep hugely affects all of us is concentration. Every single hour in the US someone dies in a traffic accident as a result of a fatigue related error. Many people think this is caused by falling asleep at the wheel, which actually happens infrequently. The more common is a lapse in concentration called a microsleep. These last only a few seconds, and are suffered by individuals who routinely sleep less than 7 hours a night - I'd guess at that being a huge amount of the drivers on our roads. Most of us have no awareness of actually having a microsleep, but when you do, momentarily you lose decisive control. A 2 second microsleep can drift you into oncoming traffic; do this at 70 mph and it could be game over. 

In a truly worrying study in Australia, researchers took two groups - one they got drunk to the legal driving limit, the other they sleep deprived for one night. They both performed concentration tests and those who had been sleep deprived were as cognatively impaired as those who were legally drunk.

Drowsy driving can be truly catastrophic. Driving after just 5 hours sleep you are 3 times more likely to crash, reduce that to just 4 hours sleep and you are 11.5 times more likely.

I could go on with more (depressing) information, but by now I'm sure you get the point. Sleep is vitally important for us all, much more so than I have even cared to consider. So what can you do about it? Here's a few things I've implemented that are helping me massively, some may sound 'boring' but if you've ever suffered insomnia for more than a night or two, you'll try almost anything. 

  1. Try to go to bed around the same time every day, and get up at around the same time every day (including weekends). This should help your body to establish a sleep pattern. Sleeping late on weekends doesnt make up for a weeks worth of short sleep, but if you do enjoy a lie in (I know I do) try to make it no more than an hour later than your normal wake time.
  2. Set a screen shut off time. Mobile devices, laptops etc emit blue light which supresses melatonin making it harder to fall asleep. If you have an iPhone consider turning on 'Nightshift' which reduces the amount of blue light during the evenings. If you must use your laptop after dark consider running f.lux in the background. This free programme will again reduce the blue light making the screen look somewhat orange at night. Its weird at first but it works. Keep phones away from the bed if you can't resist that late night scroll through social media. Social media is a known cause of anxiety for many and also keeps us addicted through random reward conditioning, meaning that quick look often lasts 20 minutes.
  3. Limit caffeine if you can. I love caffeine personally and although I've successfully quit it several times, I just love a cuppa. Caffeine does however have a half life of around 5-6 hours, so I tend to stop drinking it and switch to water after 5-6pm. Decaf often only contains 20% less caffeine so often this isn't all that helpful.
  4. Carve out time to relax before bed. Reading or listening to calm music can be very helpful. I've personally started turning the TV off if there's nothing I want to watch (I was guilty of watching any old rubbish just because it was on in the past) and reading, and it's been truly transformative to my evenings. I seem to fall asleep far quicker and even look forward to that time to go and read. Reading is said to reduce stress levels by 68% and reading for just six minutes has even been found to reduce heart rate. I've found I get just as many benefits reading ficton or non fiction so you might even learn something new! Paper is best though, one study found reading from an iPad vs paper book at night suppressed melatonin by 50% and reduced significant amounts of REM sleep.
  5. Try to make your bedroom a sleep sanctuary. Try to make it as dark as possible and invest in black out curtains if you need them. It's also best to be kept on the cool side, if the room is too warm it's harder to sleep - a lower temperature will help you to feel drowsy. A temperature of no more than 18 degrees but higher than 12.5 degrees is usually good for most people.
  6. Avoid alcohol. Alcohol seems on the surface like it might help, but its merely a sedative. It also fragments sleep meaning you awake momentarily many times throughout the night, even if you don't remember doing so. It keeps you in only the lighter stages of sleep and powerfully supresses REM sleep.
  7. Exercise - but early in the day. Studies have shown that even just 10 minutes of exercise completed early in the morning can aid falling asleep at night, don't do it late at night though or you might find it harder to drift off. If you can exercise outside this is helpful too as getting daylight early in the morning can help circadian rhythm.
  8. The last thing I've found incredibly helpful is the Phillips Hue system I splashed out on a little while ago. At night the lights are set to very warm colours with as little blue light as possible, I also dim them as much as I can especially in non task areas like a hallway. I also use the sunset feature on my bedside lamps - This works similarly to Lumie light alarm clocks you may know of. Over a period of 15-60 minutes (as set by the user, I use the 45 mins option) the lights gradually fade to emulate a sunset. This sounds bonkers but it really does work, you aren't aware of them fading until you feel really quite sleepy and it's becoming challenging to read. In the morning they can be set to a cool, ever so slightly blue light - this can help you feel more awake and aid concentration. 

FAREWELL ADAM

Adam, I wish you every success in your new career. It's been a pleasure to share some time with you. All the best, Mike.

Good luck in your new career Adam - I'm sure you'll be a great copper! Best Wishes, Diane xx

Goodbye Adam (we'll miss you) and big thanks from me for your contribution to the team. Good Luck in your new role. Your next adventure! I wanted to include a couple of quotes to inspire and inform your next steps so over to the 'real' experts, Morse & Sherlock: "Crime is common. Logic is rare. Therefore it is upon the logic rather than upon the crime that you should dwell" & "There's always time for one more pint" Sir Arthur Conan Doyle  Wishing you all the best, Sally.

I'm genuinely so pleased for you Adam, sounds like a great opportunity and I'm sure you will be fabulous. I will however very much miss putting the world to rights and debating ethics with you, albeit tipsy! On the plus side I get to be the baby of the team again which makes me feel younger than my years, so thanks! Much Love, Kirsty x

Good luck in all your future pursuits. Aim for the BIG five 0.....retirement age in the Met! Enjoy, Sandra.

Adam, what can I say, other than you’re really a gentleman, over the course of your time with the Endeavour team, we’ve had many conversations, mainly at our regional and BMS meetings. Often we discussed the future of pharma industry and you had talked interest in doing something different. Well joining the Metropolitan Police force as a trainee detective is excellent choice. I am sure with your personality, you’ll do well, and in time to come, be very successful in your role. I take the opportunity to wish you all the best in your new endeavour and good luck, I’ll miss your company, at meetings. Babu.