Health isn’t a luxury. Wellness is.
When someone asks, “How are you?”, if your reply is more than 3 words, it’s too long.
Unless the person asking you is Dr Donnai. In which case, take as long as you want. Because Dr Donnai is an integrated physician (and the CEO) at Viavi, a private health care management firm.
Health care management isn’t the same as spending a day jogging on a treadmill, giving blood and peeing in a flask so you can wave a fresh MOT at the company doctor. Viavi is interested not just in how you are today, but how you will be from today until the last day of your life. And they also believe that particular day is negotiable.
The service they provide isn’t cheap (think small family car) and it isn’t covered by private medical insurers. It is thorough, though, and it is very, very different.
The number of tests they can run on you is in the hundreds. More importantly, the specific permutation of tests you do receive are personalised: decided as a result of that initial, long consultation with Dr Donnai.
Which begins with Dr Donnai asking, How are you?
My answer was longer than 3 words by about 20 minutes. Careful listening and skilful questioning by Dr Donnai led my investigation into territories which would be more fully mapped later: a bad back, an arthritic toe, chronically bad digestion, low energy and high frustration at work, a nostril that bleeds when I get up early in the mornings, and something that will forever remain between me and Dr Donnai.
For other people, there are different enquiries. One man presented himself with a massive drink and drugs problem. Except it wasn’t a problem to him. He was quite happy with life. He just wanted to know how long he could be expected to keep going on like this, and how narrow was the tightrope that he was walking.
For others, it might be a long-lingering chest infection that private medical providers treat as a narrow issue, rather than something which needs controlling by all aspects of one’s life.
The important point is making sure that the subsequent rounds of tests are completely personalised.
My first question and investigation session extended into a couple of hours. The aim of the session isn’t to diagnose but to work out what other ‘health analytics’ should take place in a follow-up session.
So, on that initial day, the first wave of analytics looks at the obvious markers of immediate threats to health. There will be bloods, there will be peeing in a jar, there will be someone peering down your throat and sticking a finger up the other end (though not at the same time).
The next wave looks at true prevention. As Oli Patrick, a physiologist and director at Viavi explains the modern medical condition: “We used to catch illnesses, now we make our own ill health.” The problem is that the old illnesses were sudden and obvious. Modern limiters of life are more subtle and quietly chronic. Some are genetic. For this reason, the bloods that Viavi took on my initial day were sent off to a DNA mapping lab, to hunt for markers of any possible susceptibilities.
And some of the tests you do are in the privacy of your home.
A few days after the initial session, I started receiving packages from Viavi for more diagnostics. These include chest-strap ECG monitors, plastic pots and wooden spatulas. And protective gloves.
The ECG monitor you wear under your shirt for a few days to measure stress levels.
This is corroborated by monitoring cortisol levels, and to do that, you need to spit into a little plastic tube at regular intervals. You’d be surprised at how difficult it is to summon up enough spit at 2am in the morning to fill yet another plastic jar to the fill line.
But that’s not as difficult as correctly using the other bits of kit. Which for me meant using my arms to brace myself against the walls in the toilet cubicle at work, squatting over a small cardboard tray (about the size a butler would use to present someone’s calling card) and then dropping your own calling card dead centre onto the tray so you don’t spill anything over the sides. You then get to chop up your poo with the little wooden spatula and scrape little bits of into another plastic pot. To be followed by a brief moment of confusion while you stand there, bent over, trousers round your ankles, wondering what on earth am I meant to do with a shit-smeared cardboard catcher, even after I’ve scraped the surplus off it? It’s too big for the little bin beside the loo. It’s too smelly to bag up and put in the bigger kitchen bin, isn’t it? Is it?
But once done, and everything picked up by a courier (do you think they know what they’re slinging into their top box, next to their sandwiches?), you get to wait a couple of weeks for the results to be processed and your full day of specific, personalised tests, as programmed by Dr Donnai.
On my full day of personalised assessments, back in Viavi’s offices, I see a lot of people…and a few machines.
This day of uniquely personalised tests are important. Not all 45-year old males are the same. And not all 45-year old males who are carrying a bit too much fat and getting stressed at work and having one drink too many aren’t the same either.
One mid-40s guy came to Viavi because he just couldn’t shift his excess weight. He had joint pain, his blood glucose levels weren’t stable, he had reflux when he ate. All of which had previously been medicated down to a manageable level. But he still couldn’t shift his weight and he still had low energy.
Viavi’s personalised tests for him dug beneath the surface of the symptoms. In particular, they found he had a problem sleeping. And not just that, he really wasn’t getting enough deep-sleep to allow him to recover fully before the next day. Blood tests confirmed his hormones were out of line and his digestive system was reacting by failing to produce enough secretions. His medication was solving the symptoms but making the underlying causes worse. Viavi recommended a specific lifestyle strategy, which ranged from a practical restructuring of parts of his day to taking counterintuitive measures like reducing his exercise training volume and focussing on a couple of different exercise formats.
It was no quick fix but a year later, the guy’s weight was down. Even better he was off the medication.
My tests were top-down. Literally. Starting with my cognitive function and short-term memory. I was given a screen, 3 minutes and … well, if I tell you, the test won’t work for you.
After that, I was given an EEG test to look at my brain waves. This involves wearing a cranial cap of electrodes, looking at a wall and being asked some questions by the professorial Dr Parker who sits behind you. One of her early questions was whether I lost my temper easily? I ripped the cranial cap off, kicked my chair over and left the room…but only in my head.
I was walked around the corner to London’s Human Performance Centre, where a facemask and ECGs were strapped onto me and I was strapped onto an exercise bike whose previous occupants included Premier League stars and top division City ballers. I pedal until the workload overcomes me (a familiar experience) and my functional VO2 max is identified, and afterwards, my proportion of body fat measured.
Back in Viavi’s offices, my last assessment is with a physiotherapist who quickly identifies that my arthritic toe isn’t arthritic, and that I have a terrible postural control, which would go a long way to explaining my bad back. And my aching, ‘arthritic’ toe.
The culmination of all this work is another half-day session with Dr Donnai and the physiologist, Oli Patrick. It’s called the “health strategy review”. It’s more than just a funky name.
Becoming a client of Viavi doesn’t mean you can necessarily sever ties with your current primary medical provider. If you have a lung infection, you still need someone to see you and listen to your chest and prescribe medicines. Instead, Viavi see themselves as being ‘strategists’ for your health.
In my health strategy review, there were areas on my final report which were marked green, amber and red.
In the green section, most medical assessments would agree I have a good cardiovascular system, with a body fat of 11%, low circulatory risk factors and my internal organs were all pristine. If I had to run up a mountain, I would be fine.
But when I got to the top, I would still have a bad back, nose bleeds in the morning, gut problems and be a bit stressy with people around me. (And there’s also the thing that will forever remain between me and Dr Donnai.)
Some of the reasons for this were apparent in the amber-coloured sections of my report.
My stress levels were ok, but not great. During the day, my heart rate was highly variable (which is used as proxy for the working of the autonomic nervous system) and I had elevated levels of stress hormones when I wake up, more typical of someone preparing for a fight.
The fix for these is usually lifestyle adaptations. Which didn’t include getting my teenage children to move out. But did include looking at building in moments or sessions in my day to allow me to recover from stress.
My bad back might be caused by my stress, or it might be the cause of the stress. Either way, a simple 6-week programme with Six Physio could fix a lot of what I was experiencing.
The red sections of my analysis were mostly around the state of my gut. It was basically a mess. The markers indicated gut inflammation and that I wasn’t breaking down my fats properly. I was also low on the gut’s beneficial bacteria, which meant I wasn’t extracting maximum nutrition from my food. That in itself would go a long way to explaining lack of energy and mood swings. But the cure?
Well, the cure is more complicated. The gut biome is like a whole new universe, only partially explored and poorly understood. I am not yet ready for a faecal transfusion, but some digestive enzymes and a specific vitamin supplement would help.
And the problems with my mood? Here’s where things are more ‘nuanced’. Dr Parker runs a neuro-feedback programme. Each programme is different, but some clinics are you to wear the cranial cap of electrodes while watching a computer screen: you learn to tune into your brain waves and as you nurture the healthier waves, you see the success represented on the computer screen.
Would I do that? I would if there were strong enough evidence for it. The only evidence I can find which shows that neurofeedback training is successful is for people suffering from ADHD and epilepsy.
So, are Viavi early adopters, working with the most overlooked organ in health evaluation? Or are they supplementing accepted and proven medical tests with bouts of superstition?
And perhaps the biggest question for someone thinking about parting with enough money to buy a small car is this: have I received truly life-changing medical help as a result of these tests? Or have I merely looked a little deeper into things which are unavoidable consequences of modern life?
The truth is, like all the tests I received, personal. For me, the rock n roll days are a long way behind me. And they weren’t that rock n roll either. A bit too much drinking, a few too many late nights. Yes, I would benefit in some ways if I spent a little less time at work and a little more time doing yoga. And I would lose out in other ways while I did that.
But here’s an unexpected benefit. When I’d finished the tests, I bumped into an old friend and they asked me, How are you?
For the first time in my life, I was able to answer confidently, comprehensively, without any doubt, in just one word: fine.