Woman's Hour - Deborah James on bowel cancer, Maria Miller, Nitrous oxide, Sandra Newman

Episode Date: May 21, 2019

Author, blogger and podcaster Deborah James on living with bowel cancer and busting taboos with her Sun column and the You Me and the Big C podcast.Maria Miller, chair of the Women and Equalities Select Committee is introducing a Ten Minute Rule Bill to outlaw discriminatory redundancies. She has cross party support for her Bill to give new protections to pregnant women and mothers on maternity leave and for six months after returning to work. So how would her plans works and how hopeful is she that they will become law?The public need to be made aware of the dangers of nitrous oxide say nurses at the Royal College of Nursing Annual Congress. So what is nitrous oxide, what are the dangers, the legal situation and should parents be concerned?The Heavens by Sandra Newman is a time slip novel with a mind-expanding love story, set in New York 2000 and London 1593. Sandra joins Jane to talk among other things about utopias, mental illness and daring to be disrespectful to William Shakespeare.Presenter: Jane Garvey Interviewed guest: Deborah James Interviewed guest: Maria Miller Interviewed guest: Catherine Gamble Interviewed guest: Sandra Newman Producer; Lucinda Montefiore

This BBC podcast is supported by ads outside the UK. I'm Natalia Melman-Petrozzella, and from the BBC, this is Extreme Peak Danger. The most beautiful mountain in the world. If you die on the mountain, you stay on the mountain. This is the story of what happened when 11 climbers died on one of the world's deadliest mountains, K2, and of the risks we'll take to feel truly alive. If I tell all the details, you won't believe it anymore. Extreme. Peak danger. Listen wherever you get your podcasts.

BBC Sounds. Music, radio, podcasts. Hi, this is Jane Garvey. It's the Woman's Hour podcast, Tuesday 21st May 2019. Today we've got bowel babe, at bowel babe on Twitter, Deborah James, who is so brilliant at talking very publicly and quite noisily about bowel cancer. So you can hear from Deborah today. Also Maria Miller, chair of the Women and Equalities Committee

and a Tory MP. She'll talk about how she plans to stop pregnant women and women on maternity leave from losing their jobs. And as the music festival season approaches, what you need to know if you're a parent of teenagers about nitrous oxide, laughing gas noz first of all then the author blogger and podcaster deborah james at bowel babe if you want to follow her on social media she talked about living with bowel cancer and busting taboos about the disease with her

column in the sun and her successful podcast you me and the big c i put it to deborah that she was a taboo buster, so why does she tackle subjects that others just don't want to get close to? I think there's a need for it, and that's exactly why I want to talk about topics that people don't feel very comfortable talking about, because, let's face it, that's the only way change happens, actually. We need to nail down the fact that you're also one of the

presenters of the podcast You, Me and the Big C which won an award at the British Podcast Awards Ceremony on Saturday night. You also have a column in The Sun and we don't always praise The Sun newspaper but The Sun has allowed you and given you a platform to talk about this. Yeah and it's a tough platform actually in terms of who wants to talk about poo and I think that's you know a big challenge. It's not pretty, it's not sexy, it's not a topic of conversation that people want to kind of address and I started writing a blog and I know we'll talk about my diagnosis when I was first diagnosed with bowel cancer two and a half years ago. And as you do, I met one of the editors of The Sun in the pub and they said to me, you know, should we do some articles about this? And I thought, well, why not? The whole point of

me writing, this was very much on a personal level level was to raise awareness. And hats off to them. Because actually, you know, I was talking about difficult things. I was talking about getting my bowel removed. I was talking about the fact that actually, my bowel was not working. I was talking about the fact that I was pooing blood. I was talking about things that a lot of people just do not want to go there. And they started publishing my blog, which became a column, which I've now been writing for two and a half years. And they actually took it on as a larger campaign in terms of campaigning for lowering the screening age,

which, again, we can talk about. But I think, you know, it's a big topic to take on. We know it's the second biggest killer in britain actually after lung cancer which is amazing i didn't know that when i was first diagnosed i think that was a good thing i didn't know that um but i think it's one of those um cancers that we like to hush into the corner we don't really want to talk about it and lung cancer awareness is is another one and we know that awareness of these types of cancers, whilst they are increasing, they're not increasing as much as awareness still of things like breast cancer.

Well, the politics of cancer is a difficult area. But again, it's one that I hope we can discuss in our conversation today. Let's start then with you and your own situation. You were a deputy head teacher, busy, busy woman, but only in your 30s. Only in my 30s. I was on a fast track scheme to headship straight out of university. I decided, fell in love with teaching actually, and just fell in love with inspiring others, educating. As cheesy as it sounds, I actually absolutely loved it and I still love teaching and I wanted to be a head teacher and I was on my NPQH at the age of 33 actually which was my training to become

a head and I'd nearly completed it and I was just really really busy I was working actually at the time in a school that was in special measures and I got in as part of a team and we decided well not decided we had to start turning that school around that school is now a good school and I feel really proud of that but at the time I was just really busy and when you're really busy you don't think about your health your health is secondary to everything else that's going on. And I was losing a bit of weight and I was really, really tired. But I was taking a school out of special measures.

Of course I was tired. And what about your bowel habits? Have they changed? Yeah, they had. But I assumed, so I was starting to go to the loo, and I'm going to use the word poo here because I have to. I was pooing up to eight times a day. But not every day?

No, not every day. It was all very intermittent. And I assumed that actually it came with stress because why wouldn't you? So I assumed that maybe when Ofsted was about to come calling, I'd be running to the loo. And I think that's quite a normal rational chain of thought and however the key thing for me is that over a course of about six months I started passing blood. I was going more and more often and the symptoms even though they were waxing and waning they were actually progressively getting worse and I kept on going to my doctors and the doctors would take one look at me and I look healthy from the outside um I would waltz on in with a big smile on my face and they would

put it down to stress you were an athlete as well I was I still I used to be a national gymnast actually I can't do anything now um but I used to be a national gymnast exercise was always a massive part of my life um just participating in exercise at whatever level it was. And so they would take one look at me and assume that it was anxiety, it was stress. And then the change in bowel habits was IBS. And the blood, the quantity and the sort of blood that you were seeing. Yeah, now this is really important, actually. It changed all the time.

And I actually quite often had fresh blood. And because I had fresh blood, people would assume therefore that I had hemorrhoids or I had piles, which is quite common. And statistically, it's way more likely to be hemorrhoids or piles. And actually, what it transpired was when they found my tumour, it was because it was very close to my rectum. So when my tumour was bleeding, the blood was coming straight out. So that is a misconception. But how did they find that tumour? Because in the end you had... In the end, I actually took myself off to have a colonoscopy done privately.

Now, that is because all my symptoms kept on kept on sorry all my tests kept on coming back normal so my blood tests i had a poo screening test and you know i kept on being told basically it's ibs and i kind of said you know actually hang on a moment i don't feel well so i took myself off and i had a colonoscopy which is a camera um up your bum and it was at that moment and it was the 16th of December 2016 I will always remember that date and the reason I will remember it is because for anybody that works in secondary schools or in education will know that it's always the last day of term and I booked in to have the colonoscopy on the last day of term in the morning. And I chose not to have the sedation because I was going to just quickly pop along, have the colonoscopy and then pop back in for lunch and then finish the rest of the day at school. And I never went back in for that term because obviously I was told there and then that they suspected that I had cancer.

Now, you are are we should say statistically you are an outlier. You are young, you are fit, you don't fit the pattern of someone with bowel cancer do you? No but I'm not that unique and the more I've discovered I might be an outlier but I've discovered actually there are lots of outliers like me. Statistically and I know statistics can tell you anything, one in 18 women will be diagnosed with bowel cancer and is more common in men, it's one in 15. It's one in 15 and that's our lifetime risk.

Statistically, it will be more likely to happen over the age of 50 and the risk significantly increases over the age of 50. However, as a report, you know, it was out on Friday, actually, is showing it is the largest growing cancer in women and men under the age of 50, mainly in Western countries. And therefore, I hate this. Therefore, there is an automatic assumption that it must be diet related. You know, the reason that bowel cancer incidences are up is because we're all eating pizza. Now, I've discovered that there are lots more people like me. I was vegetarian.

I am vegetarian and I have been for 25 years. I was fit. I was active. I was healthy. I didn't tick any boxes. And I've discovered in the community that I now move within, in the bowel cancer community, most people are actually like me. When we all meet up as a bowel cancer community, you don't see a bunch of people who are sitting there eating pizza overweight. of reasons perhaps not had a great diet just had a stress-filled life who will wind up with bowel cancer and aren't going to be the sort of people who seek out communities like the one you now

inhabit they're just not going to are they no and that actually we know that that is more likely to happen in older people so we we can't deny we cannot deny that actually that around 50 percent of all bowel cancer cases are diet and lifestyle related. Now, this is when the diagnosis happens at a later stage in life. Now, we cannot deny the fact that there is a link to a lack of fibre, there is a link to too much red meat, to a lack of exercise. And we have to know those risk factors because as somebody sitting here with bowel cancer and advanced bowel cancer I would personally like to at least have a bit of a balanced life and try to reduce those risk factors. Your podcast which is You, Me and the Big C also

featured Rachel Bland, the late Rachel Bland who died last year very sadly, very young. Very young at the age of 40. With young son and and indeed a husband steve bland who's now very much a part of the podcast that you do with another contributor lauren maureen yeah and um i health-wise i'm extremely fortunate and i listen to your podcast and i what am i doing am i eavesdropping on something or what i sometimes feel it almost feels intrusive from my point of view because you talk really frankly about all aspects of living with cancer yeah we want we want to we want you to come and eavesdrop we want you to just feel like you're listening to some

friends talking um that's why we started the podcast because when you are told you have cancer and I was told I have cancer at the age of 35. I was then told about a month later that I have metastatic cancer and the statistics for metastatic bowel cancer means that I, well right now in the UK, have less than an 8% chance of surviving for five years. I wish it, well I'm grateful for the fact that I didn't know that I had more of a chance of dying in my first year than surviving. And one of the reasons we started that podcast is being in that place is an incredibly scary place to be. It is petrifying.

You do not know how to put one foot in front of another. And so by letting people into the most intimate parts of our life, actually, they're helping us as much as hopefully we're helping them. Because ultimately, you know, you are scared, you are in the kind of the trenches. But actually, when we have our listeners and our listeners reach out to us, and they say, you know, you really helped us or carry on going or whatever it might be, you feel like you're in the trenches with thousands and thousands of people. And so, you know, we get as much as, you know, people give us as well. And the politics of cancer and the pink aspect. This is a terrible expression, but sometimes breast cancer,

which is an absolutely horrendous disease, we should say. It is. Rachel died from breast cancer. Indeed. And it is, unfortunately, the biggest cancer killer of women. But it dominates the space. Would you say that? A hundred percent. I cannot stand pink, fluffy stuff. Do not get me wrong for one second. I think the work that has gone on in terms of advocating awareness of breast cancer over the last 20, 30 years is phenomenal. It's saving women up and down the country.

And I think it needs to be applauded. It has been applauded. But I think there is space to start addressing other cancers. And we have to. We have to. There are more women dying of lung cancer and bowel cancer in the uk than are dying of breast cancer and the reality is actually these fashion uh you know campaigns or these makeover campaigns all looking at kind of making women with breast cancer feel

better is all good and well but there are more women living without breast cancer with other types of breast cancer with other types of breast cancer in the uk and they also want to feel good about themselves you know i like a good lipstick and you know i have bowel cancer and you know i don't want to feel excluded just because i have a different type of cancer and you know what it's time for women for women for people to start shouting about these other types of cancers because that is the that's what happened with breast cancer what happened with breast cancer is people stopped you know thinking of boobs in a way that you know we can't talk about breasts and and as a result it's saving lives but

you know what we need to do it for other things and and you know i'm here talking about bowel cancer and i can you know that's what i will continue doing is talking about bowel cancer and it's not pink and it's not fluffy um and maybe more companies could get on board I know you've had the help of at least one manufacturer of a cracker form of biscuit a cracker form of biscuit because fiber you know fiber can be fun um it's rye vita we should say it is rye vita but you have struggled to get I have struggled yeah absolutely because yeah, absolutely. Because the reality is that the perception is that actually breasts sell. So if you're creating a T-shirt to support cancer, it is much more likely that big brands will get behind a breast cancer awareness campaign

because that's where they feel their fashion market is. You know, how can you, you know, you're not going to really put a big poo on a T-shirt and say, come on guys, buy this. But I just think that's a mindset. I said that I'm going after toilet paper because we all have to wipe our bum at the end of the day, don't we? No, we do. This is an email from Rachel who says,

I'm really glad you're talking about this. I was diagnosed in 2012, not long after I hit 40, and I put my symptoms down to my body getting back to normal after my fourth child. I was tired, losing weight, strange aches and pains. When I finally went to the doctors, I was told it wouldn't be bowel cancer because I was too young. After four months of going backwards and forwards

to doctors and consultants, tests and scans, I did start treatment. Seven years on and a to doctors and consultants, tests and scans, I did start treatment. Seven years on and a run of clear results, I'm still here to tell the tale. You are never too young or too fit to have bowel cancer and this is the important bit from Rachel and we thank you for this, Rachel. You shouldn't be embarrassed to go to the doctors.

The world and his mum has seen my buttocks over the years and bowel cancer awareness needs to continue to be promoted. It is embarrassment, isn't it, that stops people stops people it is and we know that from every research piece that has gone on in terms of what is one of the key blockers to people not going to see their gps and across all ages um it is embarrassment people kind of they'll go to their doctors and they'll say, things have changed down there. Well, what do you mean? Kind of front, middle, back? What are we talking about? And it's using the correct terminology. People are too scared to use the words poo. They're too scared to actually say this is exactly what's happening. And that in itself is hindering early diagnosis. And we know this because the majority of young people, two thirds of young people under the age of 50, when they are diagnosed with bowel cancer, they're diagnosed at a late stage or they're diagnosed in A&E.

It's just, it's not ideal. It's not ideal. To put it mildly. Deborah, thank you so much. Thank you. And you're an inspiration, I know, to many. And you are on social media at Bowel Babe. And also there's not ideal. To put it mildly. Deborah, thank you so much. Thank you. And you're an inspiration, I know, to many. And you are on social media, at Bowel Babe. And also there's the podcast, You, Me and the Big C, which you can get, of course, via BBC Sounds.

Thank you very much. Take care of yourself. Now, nearly three years ago, the Women and Equalities Select Committee reported on what it judged to be a shocking rise in workplace pregnancy discrimination over the past decade. It called for the government to take action within two years. judged to be a shocking rise in workplace pregnancy discrimination over the past decade. It called for the government to take action within two years. And today, Maria Miller, Tory MP and chair of that committee, is introducing a 10-minute rule bill in Parliament to try to outlaw discriminatory redundancies.

She has cross-party support to give new protections to pregnant women and women on maternity leave, and indeed for six months after returning to work. Well, back in 2016, the Women and Equality Select Committee's inquiry into maternity discrimination had a significant amount of evidence from women who really felt they got no choice but to leave their job when they were pregnant, despite the current laws and protections that are in place. Whether it's a factory worker I can remember talking to who wasn't allowed to have a stool to perch on when she was seven months pregnant, or women who were simply made redundant when they were on maternity leave and had no idea that it had happened until they went back to their employer to say they were coming back to work. Can we just unpick this a little bit then? In some cases, it wasn't that they were fired as such, but their working lives were made awkward or basically completely unacceptably bad. That's right. I mean, one in 20 women when they're

pregnant were being made redundant. Others were simply being put into such difficult circumstances where they either feared for their own safety or were just really distressed and uncomfortable at work. You know, the idea of leaving work when you're pregnant is a very drastic step to take. And I think that the bill that we're putting forward today is a way of trying to, you know, really shake up employers to say that this has to stop. Well, how were employers getting away with it? Ultimately, very few women decided to take forward their cases to employment tribunal for all the reasons that we know. Those employment tribunals can be extremely stressful at a time when you don't want stress if you're pregnant or you've got a new baby. But the other pressing

problem there is that you have to bring the case within three months of the incident happening. And often for pregnant women, that would be when they've got a very tiny baby to look after. And the cost of it? And indeed the cost of it as well, although some would be eligible for some sort of support. Ultimately, these employment tribunals are not really what they were set out to be,

which was an easy way of getting redress. Of course, there's also the cuts to legal aid as well, which have had a huge impact in this area. Well, yes, but I think it's more fundamental than that. It's that women don't want the stress of taking a case forward. I think even if that support was there, the idea of spending, you know, some women were telling us the best part of a year taking a case forward through employment tribunal is not what you want to do when you've got a tiny baby to look after. What about the employers? Are we talking big household names, small family firms or is everybody in the mix here? comes through very clearly is that the current system really is quite complicated where women are supposed to, if there is a redundancy process and women are on leave, they're supposed to be given preference for taking jobs that are in other parts of the organisation. But in reality,

if those women are on maternity leave, they're not there, they're not able to go to interviews, really that process doesn't bear much scrutiny. So what we're talking about here is to say really give complete protection so that women do not have to keep an eye out for whether redundancy processes are going on while they're on maternity leave. Tell us about your bill then. What changes are you keen to make? Well the changes we're making are rooted completely in the system that's already in place in Germany where women are not able to be made redundant either when they're pregnant, on maternity leave, or for up to six months after

they return from that maternity leave. You know, this is a time where we know that stress is bad enough, the financial stress of having to look after a new member of the family, of childcare, changing the way you live. And the idea of being made redundant in that time would effectively leave women out of work and struggling to get back into work when they go back after their maternity leave finishes. And my understanding is that actually in Germany, it's not the same as the UK. Relatively speaking, fewer women with children are in the workplace. Well, we have record numbers of women in work now. No, I'm talking about Germany. I mean, you're making reference to the situation in Germany.

My understanding is that, as I've just said, fewer women with children are in the workplace. Well, the number of the relative number of women in the workplace is not really relevant for this particular bill. I mean, we have got here in the UK. You're saying it worked well in Germany. I'm just pointing out that as I understand it, actually, in Germany, there aren't that many women with children in the workplace. So it might suggest that this sort of legislation is putting employers, well, one factor might be that it's putting employers off hiring women of childbearing age. Look, I don't think the idea of making sure that women are protected in

law is going to put good employers off from employing anybody. But this does have to, you're right, go alongside a much broader package of support and protection, which will encourage employers to respect the needs of all parents. So as well as protection from redundancy for pregnant women. What I'd like to see is shared parental leave for dads, flexible working for all jobs from day one, which is something the government's already looking at. And these sorts of factors to modernise the workplace, I think, should be looked at here and across Europe. Shared parental leave, I suppose you could argue that if men do start taking it up in rather greater numbers than they are currently doing, they may also begin to pay the penalty that actually employers might say, well, he could become a father. So I don't think we'll touch him for a while. is a part of everybody's possible sort of life journey. And therefore employers have to take this into consideration.

You know, the big change that's happened in the UK over the last two decades is seeing more women in the workplace. And that's something that we have to adapt to. We can't expect the current process or the current system of work to remain completely unchanged. We're seeing some changes that are happening around the edges with more flexibility. But measures like the one that I'm putting forward today really are the way to try and cement that change amongst employees who are less progressive than the ones that often speak out on these issues. But you know there is resistance, not least from small businesses. And of course, many small businesses are run by women.

How do you convince them that this isn't going to really clobber what they're doing as a small business? Well, already there's a very clear requirement for businesses to respect pregnant women. Most businesses are not going through regular rounds of redundancy. Yet pregnant women tell us that they feel insecure, that they're not treated properly during their pregnancy, that even things like health and safety are not taken seriously when they may be in positions where, you know, they are doing physical work or indeed travelling abroad. So I think it's not just about employers who are making individuals redundant, who need to start to think more carefully about the implications of pregnant women in their workplace. It's actually more general than that. But perhaps the small business is worried about

Brexit, for example, about the hit they may or may not take as a result of that. They know they need to make redundancies. It's hard to feel sympathetic in some ways, but in other ways, not so much. Maybe a woman in the seventh month of her pregnancy might be someone that I'd look at potentially to get rid of. Well, looking at somebody to be made redundant because they're pregnant is already illegal against the law unlawful. But as you say yourself, it's happening. So what we've got to do is to try and change that attitude and change that mindset. And what I'd say very firmly is that, you know, as we leave the EU, one of the biggest challenges that many businesses will have is a lack of people coming forward to fill vacancies.

So rather than rely on that constant churn of new people coming in, what employers will have to increasingly do is, as good employers already do, is to make sure that they're keeping those that they've got. You know, whether they're mums, whether they're dads, whether they have elder care issues. This is going to become, I think, an issue that employers are going to have to tackle and not duck out of. In a way, this is a much bigger thing. It's a cultural issue, this, isn't it? You can have as much legislation as you want, but it's ingrained. There are cultural issues there, but then legislation can be used to try and change that culture. And that's why I'm putting forward today a bill which very firmly says it is completely unacceptable to make a pregnant woman redundant. And by doing that, it's about challenging that mindset that they're actually just easy pickings, that they can be made redundant, because overall, employers know that they're very unlikely to take action against

them. So we've got to change that. And that's what this bill is about. Now, I know you have cross-party support for this bill. And also the backing of Dominic Raab, who was, of course, one of many people to have taken the role of Brexit secretary. Are you backing him in the leadership race? Well, Dominic and I worked together when he was minister and the 2016 maternity discrimination inquiry that my select committee did came out and what he and I were working on was to try and extend the time limit that people could

bring a case to an employment tribunal so he's got a deep interest in this he is backing my my bill today and I'm grateful for that and yes I would be backing him for leadership because I think he's shown that he really understands these issues as a dad himself. Right. So because he's a parent, that qualifies him perhaps to venture into these territories. And you think he'd make a good prime minister? Well, it's not just about being a dad, is it? But it does help if you've lived through it and you've got a working wife. And you understand, you know, the pressures that are put on women who, you know, can face redundancy when

they're on maternity leave. And I think that that is, you know, that's in essence what I'm trying to do through this bill today is to relieve that pressure, which we know is so bad for families and so bad for unborn babies. That's the Tory MP Maria Miller. So one vote for Dominic Raab there. Now, in the interview with Deborah James, I got something wrong. So we need to make sure we get our facts right. And I apologise. Lung cancer is actually the biggest cause of cancer death in the UK for women, followed by breast, followed by bowel. So just to make that absolutely clear, that was my mistake. It certainly wasn't Deborah's or indeed anybody else's. Now, on Friday, can a relationship survive infidelity? That's going to be one of Jenny's talking points on Friday morning.

If you'd like to get involved, you can email the programme via the website. If you missed yesterday's show, Shakespeare's sister are back. They're reunited. They're talking to each other again after 26 years of not communicating. And they sounded very friendly to me. So if you missed that interview you can hear it on yesterday's programme which you can get of course via BBC Sounds.

Now we're heading towards the music festival season and you should probably be aware if you've got teenagers in particular that use of nitrous oxide is something that is very much a teenage reality in 21st century Britain. The Royal College of Nursing says the public need to be made more aware of its dangers.

So-called laughing gas was made illegal to sell for psychoactive purposes three years ago. But the Home Office estimates that in the last year, half a million 16 to 24 year olds in England and Wales used it. So Catherine Gamble is from the Royal College of Nursing. She's its professional lead for mental health nursing. Catherine, good morning to you. Hello from Liverpool. You're in Liverpool right now.

OK, well, that's a lovely place to be, but it's a gorgeous morning on the Mersey Riviera. It is actually. Yeah, no, I know. It's about to be the debate on this issue in a few minutes' time. Right. Let's go back then to the changes in the law three years ago. What exactly happened three years ago? Well, it was the Psychoactive Substance Act in 2016, actually, when the former chief prosecutor said that there needed to be a new law, and as previously it had failed to stop the supply

in what was described as the product as a death in a box. And so they have now made it. The law actually outlines that it's illegal to supply the drug, well, I'm calling it a drug, to supply for psychoactive effect. It isn't illegal to buy it for other purposes, for example, to make it into the whipping cream canisters. Yeah, and hence the problem we have and hence the reality, which is that 500,000 teenagers and people in their early 20s in England and Wales have used it in the last year so this stuff is still out there still being consumed. Yes and why we're wanting to debate it today at the Congress is in relation

to the fact that we believe there's a real need for a public awareness campaign on the dangers of nitrous oxide as particularly as you have highlighted at the beginning of the festival seasons it's people are finishing exams those young people will be going to proms and wouldn't it be funny to have some laughing gas because it's so readily available and incredibly cheap. It is the same stuff is it that you might have got at the dentist or you might routinely be offered in childbirth? Yes, yes, yes. But it's different in relation to the fact that this is in tiny, small silver canisters. For those of you who are going to festivals or will have been in the last few years, actually, that's apart from plastic bottles.

That is the biggest litter that you will find, these silver canisters all over fields where they have been discarded by people who have used them. So what are its adverse effects? Well, this is what the sort of young people don't realise, that if you inhale it via the canister, particularly if you're in a closed space, it can actually suffocate you because it immediately fills your lungs with no oxygen. And it can cause throat spasms. Over a longer period of times of using it, it reduces your vitamin B uptake,

so you can cause severe anemia. People start to describe tingling in their fingers and their toes, and it causes changes in their thinking. And they can also, we know that immune systems are affected and people's thinkings and brain function are particularly affected but people don't recognize it as as being that and that's what we're really concerned about and is it addictive well that's a bit of a question mark but it is um uh it's the effects are addictive it's great to feel this euphoria. So that's what people like.

They like the sort of sound distortions. They like the mini hallucinations. They like the fact that it's giggly. But you can then induce paranoia. How would you know if your child had taken it, apart from finding the canisters? Yes, apart from that. Now, this is something that you do need to have um an opportunity to be quite observant it might be that they start talking about hilarious recalling hilarious stories

that you know mate such and such did this hilarious thing and you might want to think oh hang on what's what's uh you know put your antennae's out a bit you might also notice the signs of burning around the mouth and nose because, as you know, that if you light one of these canisters, it's a very freezing effect, so it can actually burn your skin. People may well be starting to buy balloons and you might not think very much about it, but that's the way that actually some people will will be using it they fill the balloons and then inhale from the balloon and if a child is asthmatic or has some sort of breathing condition is it more dangerous potentially yeah of course so you should really be watchful and i mean the problem is as you know i'm sure if you've got teenagers they don't listen or they don't want to hear the message from you so what do do parents do, particularly, as you say, ahead of events like, for example, the Reading Festival?

Well, this is why we're calling for this public awareness. I think there is something around being very, very clear and doing some health promotion advice as parents to say this is what you need to do to do it safely. There's some nice websites uh frank the website does a very nice um explaining uh explanation of what signs to look for and actually what to do uh we know that they can um you know so that's really those are the principles and is it really something that parents need to be alarmed about? Because we're not talking here about, well, for example, substances that we have discussed on the programme, ketamine and crack cocaine. No, it isn't. But we do need to be very, that this is a drug and it is dangerous because people die.

And so I don't want to, we don't want to make light of this. You know, it's called laughing gas, but it isn't a laughing matter. No, but of course, we also need to, it's been made illegal. The legislation hasn't worked, has it? In terms of young people getting access to this stuff, it's not worked. No, it isn't. And that's why, again, the RCN are calling for a public awareness campaign to look at that in much more detail. Thank you very much, Catherine.

Catherine Gamble from the Royal College of Nursing. She's at the Congress, which is, as she says, it's in Liverpool over the next couple of days. So I hope that goes well for everyone involved. Matthew on Twitter says, these canisters are discarded by the box load on the streets where I live. It's one of the biggest littering issues locally right now.

At BBC Women's Hour, if you want to tell us anything this morning. Sandra Newman, who's a novelist, is here. Welcome to the programme, Sandra. Thank you. Your book is called The Heavens. Now, I'm going to try and set this up because it's a time slip novel

set partly in the New York of 2000 and partly in the London of 1593. That's right. But the New York 2000 in your novel is not quite the place that I, well, that we know or that we think we know of New York in 2000. There is a president, a female president and the leader of the Green Party. And this isn't the New York of 2000 in real life, is it? No, it's one of these, it's a time-slipped novel of what's possibly a familiar kind to people who are into science fiction anyway, where a character goes back in time

and whenever she goes back in time, anything she does changes the course of history. So the slight difference from most such narratives is that the timeline she begins with is actually a bit better than our timeline. And it gradually, she gradually damages it and damages it and damages it until it's just as bad as what we see around us now. When she is in the 20th or nearly, well, just in the 21st century, she's called Kate. And then in Elizabethan England, she's somebody else? Yes, she is an actual historical figure, Amelia Bassano, who was a very, very interesting person.

I mean, best known for many decades for being one of the best candidates to be the dark lady of Shakespeare's sonnets and thus Shakespeare's girlfriend. This is one of his muses? Yes, I suppose. His only known muse, really, or his only known female muse, there's a certain amount of debate. There's also a fair youth in the sonnets. So there's a question about whether the fair youth was his lover, as well as the dark lady. It's all much more salacious than we're often given to believe when we study it at school. Right. Is she known though? Is Amelia discussed widely? Yes, Amelia, and she's having a bit of a moment. There's a play now in the West End called Amelia,

because she went on in her early 40s to publish what was the first full-length book of poetry published in England by a woman. And she's terribly interested. She's thought to have been Jewish. Her father, Baptista Bassano, was brought over by King Henry VIII with his four brothers.

They were all musicians to play at Henry's court. So this is a whole kind of rich and very peculiar history of her family background. She was a teenager, possibly as young as 13, became the mistress of the Lord Chamberlain of England. So it's conceivable that she might have come across Shakespeare. She almost certainly would have known Shakespeare. There's almost no question they would have been in the same room together dozens and dozens of times. This is a book that does mess with your mind, I have to say, but that's by design, isn't it? Because you're never quite sure whether anyone is living in any sort of reality.

Yes, it gets very confusing for the main characters. So Kate is going back and forth in time, and when she wakes up in the present day of the year 2000, everything has changed, and she has to pretend to know what's going on. At the same time, she often fails to pretend to know what's going on. She doesn't know who the president is, and she slips up and says the wrong thing, and people don't understand what's going on with her. So they gradually begin to think that she's mad, that she has a neurological problem. Well, that's what I was going to ask. Is this essentially a novel about mental illness?

What would you say about that? There's certainly a strain through it, which is about mental illness. And a lot of it is seen from her boyfriend's point of view. So it's specifically about losing someone to mental illness, the falling in love with somebody who then develops mental illness, and you begin to see that their reality diverges from yours. And you have to decide where your loyalties lie. Do you go with them down that path? If they refuse to try to get better, do you still have a responsibility to stay with them and to live that life with them, where you can't trust them and you don't know whether they're safe at any given time? So that's the dilemma that he faces. Whereas from her point of view, she's not mad and

all of this is really happening. It is all real to her. It's all real to her. And in the terms of the book, it's all real too. It actually is all real. It is a time slip novel and not just a novel about mental illness. It's kind of both. And you did mention, you alluded earlier to the butterfly effect, the idea that something that happens can have a much wider impact

than you might even begin to contemplate. Can you just, in about a minute, can you explain the butterfly effect? Yes, the butterfly effect, it's a principle whereby tiny things can have massive, like a butterfly flapping its wings can cause a hurricane in China, I believe is the example. And here it's really standing in for the fact

that we, as political subjects, we want to save the world. We want to have some sort of effect on political events, especially as we see the world careening into a very, very bad place. And we don't know what to do. And we, I think, have to have some faith that the very, very small things we can do will have an effect. The novelist Sandra Newman, whose new book is called The Heavens. Now to your thoughts on today's programme. Lots of admiration for Deborah James. This is from Louisa. Actually, just wants to tell us about her experience. It's important. I'm a 54 year old woman who's had bowel cancer. My story is that I had a life-threatening accident in 2017,

and that meant that I was in ICU for eight days with multiple broken bones. Now, while recovering, I lost weight, but my bowels weren't normal. And at the time, it was put down to the cocktail of drugs that I was on. When I was in hospital, I was given a poo chart, so pictures of poo, and I realised at that point that my poo really had changed. When I went home, I went to my GP and then things started to happen quickly. A colonoscopy and discovery of a four centimetre tumour. After that, a removal of four foot of bowel, as well as a hysterectomy and a belt and braces chemo. This was the worst of everything that I've been through. 2019, all going well. Bloods are good.

Hope this will promote the wider use of that poo chart. It is a lifesaver as I didn't have other symptoms. Right. Thank you very much for that, Louisa. And I'm so chuffy that things are going well at the moment. Jane says, let's not blame the success of the breast cancer campaign for a lack of funding, stroke awareness in bowel cancer. Celebrate that good campaigning by brave women slowly woke us up. The same can happen with bowel cancer.

Thank you for that, Jane. I think that's exactly what Deborah is intending to do, just to wake us all up on the subject. From Alison, horrified as a GP to hear that Deborah's doctor ignored her history of passing blood. I can't imagine that wasn't referred for investigation, even if the top of the list of differential diagnoses is inflammatory bowel disease. From Pat, I really feel there should be mention of the fact that GPs need greater training on this subject. There had been a failure on the GP's part to recognise the symptoms and their significance. I advise anybody experiencing symptoms discussed on the programme

to request a colonoscopy. Margaret, I've been listening to the interview with Deborah. Her story related exactly to that of my beloved son, Daniel, who, after several visits to doctors during 2008, was finally sent for a colonoscopy in the January of 2009. On the 29th of January, he received the devastating news that he had bowel cancer and only had a short time to live. In spite of chemo, Daniel died in 2009. He was just 32. Margaret, I'm so sorry. None of us knew about bowel cancer at the time, and because Daniel was young and fit, it was just 32. Margaret, I'm so sorry. None of us knew about bowel cancer at the time,

and because Daniel was young and fit, it was overlooked. How I wish the subject had been talked about years ago. It's 10 years now, but I am still grieving and to some extent feeling guilty that I believe the doctors who said there was nothing to worry about. Really nothing you can say about that is there beyond extending your sympathy to Margaret. From Erica, this is a good informative piece. Thanks to Deborah for sharing so frankly. Vitally important that people are not embarrassed or ignore symptoms. Get them checked out.

Persist with getting a diagnosis. Young, healthy and fit doesn't mean you can't get bowel cancer. From Saskia, I want to say that symptoms are not always dramatic. Young, healthy and fit doesn't mean you can't get bowel cancer. From Saskia, I want to say that symptoms are not always dramatic. I was 43 and I was diagnosed with stage 3 bowel cancer in April. The only red flag symptom I had was actually a small amount of fresh blood when I wiped. And it only happened twice in two months. Luckily, the GP I saw referred me for a colonoscopy,

but as I was considered low risk, I waited two and a half months before I was seen. I'm the mother of a two and a half year old. I'm a gardener. I'm relatively fit and healthy. From Sheila, at the age of 52, immediately after telling my GP I had blood in my stools, I was sent for a colonoscopy and was diagnosed with colon cancer in December of 2000. I had an operation in January 2001, was told I had a less than 60% chance of living five years, but chemotherapy and I'm still here

after a wonderfully fulfilling 18 years. It's not luck, Sheila wants to point out. It's as a result of the rapid response of my GP, an excellent surgeon and oncologist with wonderfully supportive medical teams. Our NHS needs to be protected. So such a superb service is available to all. Thanks to everybody who wanted just to tell us their stories because it is so important and deborah you're right deborah is just a truly brilliant communicator now to maria miller um elaine says i was made redundant on maternity leave i had a horrendous time with a four-year-old

and a 14 week old baby i never cleared my desk never said goodbye to colleagues and was generally made to feel like i'd done something wrong. Awful times. From Ray, I came back to find my job had been given to someone else. Would love to tell you more, but I signed an NDA, a non-disclosure agreement. Incredibly stressful, and I'm still affected seven years on. There are quite a few of those NDAs about, aren't there? An email from Rafe.

In Germany, they see the child as a baby of the nation, so the attitude is different, seen as the new generation, future taxpayers, etc. In the UK, there's a negative approach in the workplace. Mothers are a burden, not nurturing the future. It will take media campaigns, not legislation, to change attitudes. I know a business where they won't consider young women of mothering age. From Nikki, and this is important, as a child-free

woman in my 50s, I've spent a large proportion of my working life picking up the pieces of colleagues taking maternity leave. My various employers have taken on maternity cover, usually from outside the business. This has meant that I've had to train, help, guide and support many of these people and take on the work they haven't been able to do within their hours. Have I ever had any recognition, thanks, extra pay or even official additional hours? No. Once the happy mother returns to work, there is often additional work covering for time off for illness, both mother and child, appointments, childcare issues. The list is endless.

I appreciate I chose not to have children, but I already feel discriminated against here. If they now allow women on maternity leave to avoid redundancy, this is yet another disadvantage for me. And here's an anonymous one. I was made redundant from a children's charity whilst on maternity leave. I didn't have the time or energy to appeal against the decision and I didn't want it to take me away from caring for my baby. But at the same time I feel guilty for not fighting more to help prevent other women experiencing the same. Now yesterday actually we talked about getting older and about ageing and about attitudes, particularly to women ageing.

And we've heard loads of stuff from you on this. And quite a lot of you actually pointing out, and it certainly bears repeating in the light of what we discussed on today's Woman's Hour, that actually growing old is a privilege. It isn't something that any of us should take for granted because, unfortunately, some people don't get the opportunity. Here's Julie, though, who is happy. I listened with interest to your item on ageing and ageism yesterday. I'd just like to say I took up, now it's not for everyone, but this is what Julie did.

I took up bell ringing at the age of 73 and four years later, I am still really enjoying it. Although, she's sounding a note of caution here, it can be very frustrating. But the company of other ringers, most of whom are the age of my children, has been brilliant for me. It's got so much going for it, exercise, sense of achievement, friendship and fun.

Just as many women as men ring and I think it would be an excellent topic for Women's Hour. You've almost, if you can tell us, Julie, where you bell ring, then I can't see why we can't pay a visit. I know I'd be absolutely useless at that, but I can hear the feature. It might be quite funny. I don't know whether any community in Britain would like to hear me doing some amateur bell ringing.

No, I don't sense a lot of, I don't sense waves of enthusiasm, but you never know. Thanks to everybody who's been in touch today. Jenny's here tomorrow. Her guests include the Russian violinist Alina Ibrahimova. This is Planet Puffin. There's a fair chance you will get bitten at some point. Planet Puffin is a new podcast coming to you from a tiny island off the east coast of Scotland.

Across the summer, we're going to be following the breeding season, no matter what it takes. Now there's an encouraging piece of poo at the entrance. There's a nice white guano. So Becky, I'm going to let you take the first game of Puffin Roulette. Summer 2019's hottest Puffin podcast. Well, only Puffin podcast. For BBC Sounds. I'm Sarah Trelevan, and for over a year,

I've been working on one of the most complex stories I've ever covered. There was somebody out there who was faking pregnancies. I started, like, warning everybody. Every doula that I know. It was fake. No pregnancy. And the deeper I dig. Every doula that I know. It was fake. No pregnancy. And the deeper I dig, the more questions I unearth. How long has she been doing this? What does she have to gain from this? From CBC and the BBC World Service,

The Con, Caitlin's Baby. It's a long story, settle in. Available now.