7 Essential Devices For Hand Arthritis: Regain Control of Your Life
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Dr. Diana Girnita is a double board-certified physician in rheumatology and internal medicine. With a PhD in immunology (on top of her MD), and training at Harvard and top universities, she founded Rheumatologist OnCall, offering integrative medicine to broaden rheumatology access. Here’s what she has to say about things that make life easier:
Get your hands on these…
The seven devices that Dr. Girnita recommends are:
- Hand grip strengthener: helps build grip strength with a spring-loaded mechanism. Regular use can improve strength and reduce pain.
- Finger exerciser: different device; similar principle: it strengthens hand and finger muscles using resistance, enhancing hand function.
- Moisturizing paraffin bath: a heated paraffin wax bath that soothes hands, providing heat therapy and moisturizing the skin.
- Weighted silverware: weighted utensils (knives, forks, spoons) make gripping easier and provide stability for eating.
- Foam tubing grips: foam covers to make kitchen tools, toothbrushes, and hairbrushes easier to grip.
- Electric can-opener: reduces strain in opening cans, making meal preparation more accessible.
- Compression gloves: provide gentle compression to reduce swelling and pain, improving hand flexibility and circulation.
- Door knob cover grips: make it easier to turn doorknobs by providing a larger surface to grip.
- Wider-grip pens: ergonomically designed pens with a larger diameter and softer grip reduce hand strain while writing.
This writer, who does not have arthritis but also does not have anything like the grip strength she used to, also recommends a jar opener like this one.
As a bonus, if you spend a lot of time writing at a computer, an ergonomic split keyboard like this one goes a long way to avoiding carpal tunnel syndrome, and logically must be better for arthritis than a regular keyboard; another excellent thing to have (that again this writer uses and swears by) is an ergonomic vertical mouse like this one (aligns the wrist bones correctly; the “normal” horizontal version is woeful for the carpal bones). These things are both also excellent to help avoid worsening peripheral neuropathy (something that troubles this writer’s wrists if she’s not careful, due to old injuries there).
For more on the seven things otherwise listed above, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Avoiding/Managing Rheumatoid Arthritis
- Avoiding/Managing Osteoarthritis
- Managing Chronic Pain (Realistically!)
Take care!
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Cooling Bulgarian Tarator
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The “Bulgarian” qualifier is important here because the name “tarator” is used to refer to several different dishes from nearby-ish countries, and they aren’t the same. Today’s dish (a very healthy and deliciously cooling cucumber soup) isn’t well-known outside of Bulgaria, but it should be, and with your help we can share it around the world. It’s super-easy and takes only about 10 minutes to prepare:
You will need
- 1 large cucumber, cut into small (¼” x ¼”) cubes or small (1″ x ⅛”) batons (the size is important; any smaller and we lose texture; any larger and we lose the balance of the soup, and also make it very different to eat with a spoon)
- 2 cups plain unsweetened yogurt (your preference what kind; live-cultured of some kind is best, and yes, vegan is fine too)
- 1½ cup water, chilled but not icy (fridge-temperature is great)
- ½ cup chopped walnuts (substitutions are not advised; omit if allergic)
- ½ bulb garlic, minced
- 3 tbsp fresh dill, chopped
- 2 tbsp extra virgin olive oil
- 1 tsp black pepper, coarse ground
- ½ tsp MSG* or 1 tsp low-sodium salt
Method
(we suggest you read everything at least once before doing anything)
1) Mix the cucumber, garlic, 2 tbsp of the dill, oil, MSG-or-salt and pepper in a big bowl
2) Add the yogurt and mix it in too
3) Add the cold water slowly and stir thoroughly; it may take a minute to achieve smooth consistency of the liquid—it should be creamy but thin, and definitely shouldn’t stand up by itself
4) Top with the chopped nuts, and the other tbsp of dill as a garnish
5) Serve immediately, or chill in the fridge until ready to serve. It’s perfect as a breakfast or a light lunch, by the way.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- How To Really Look After Your Joints ← this is about how cucumber has phytochemicals that outperform glucosamine and chondroitin by 200%, at 1/135th of the dose
- Making Friends With Your Gut (You Can Thank Us Later)
- Is Dairy Scary? ← short answer in terms of human health is “not if it’s fermented”
- Why You Should Diversify Your Nuts!
- The Many Health Benefits Of Garlic
- Is “Extra Virgin” Worth It?
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
- Monosodium Glutamate: Sinless Flavor-Enhancer Or Terrible Health Risk? ← *for those who are worried about the health aspects of MSG; it is healthier and safer than table salt
Take care!
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Butter vs Margarine
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Butter vs Margarine
Yesterday, we asked you for your (health-related) opinion on butter vs margarine, and got the above-depicted, below-described, set of responses:
- A little over 60% said butter is a health food and margarine is basically plastic with trans fats
- A little over 20% said that both are woeful and it’s better to avoid both
- A little over 10% said that margarine is a lighter option, and butter is a fast track to cardiovascular disease.
Comments included (we will summarize/paraphrase, for space):
- “…in moderation, though”
- “I’m vegan so I use vegan butter but I know it’s not great, so I use it sparingly”
- “butter is healthy if and only if it’s grass-fed”
- “margarine has unpronounceable ingredients”
To address those quickly:
- “…in moderation” is a stipulation with which one can rarely go too far wrong
- Same! Speaking for myself (your writer here, hi) and not for the company
- Grass-fed is indeed better; alas that so little of it is grass-fed, in the US!
- Butter contains eicosatrienoic acid, linolelaidic acid, and more*. Sometimes big words don’t mean that something is worse for the health, though!
So, what does the science say?
Butter is a health food: True or False?
True or False, depending on amount! Moderation is definitely key, but we’ll return to that (and why not to have more than a small amount of butter) later. But it is a rich source of many nutrients, iff it’s grass-fed, anyway.
The nutritional profile of something isn’t a thing that’s too contentious, so rather than take too much time on it, in this case we’ll point you back up to the scientific paper we linked above, or if you prefer a pop-science rendering, here’s a nice quick rundown:
7 Reasons to Switch to Grass-Fed Butter
Margarine is basically plastic with trans fats: True or False?
False and usually False now, respectively, contingently.
On the first part: chemically, it’s simply not “basically plastic” and everything in it is digestible
On the second part: it depends on the margarine, and here’s where it pays to read labels. Historically, margarines all used to be high in trans fats (which are indeed woeful for the health). Nowadays, since trans fats have such a (well-earned) bad press, there are increasingly many margarines with low (or no) trans fats, and depending on your country, it may be that all margarines no longer have such:
❝It’s a public health success story. Consumers no longer have to worry about reading product nutritional labels to see if they contain hydrogenated oils and trans fats. They can just know that they no longer do❞
Source: Margarines now nutritionally better than butter after hydrogenated oil ban
So this is one where the science is clear (trans fats are unequivocally bad), but the consumer information is not always (it may be necessary to read labels, to know whether a margarine is conforming to the new guidelines).
Butter is a fast track to cardiovascular disease: True or False?
True or False depending on amount. In moderation, predictably it’s not a big deal.
But for example, the World Health Organization recommends that saturated fats (of which butter is a generous source) make up no more than 10% of our calorie intake:
Source: Saturated fatty acid and trans-fatty acid intake for adults and children: WHO guideline
So if you have a 2000 kcal daily intake, that would mean consuming not more than 200 kcal from butter, which is approximately two tablespoons.
If you’d like a deeper look into the complexities of saturated fats (for and against), you might like our previous main feature specifically about such:
Can Saturated Fats Be Healthy?
Enjoy!
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Homeopathy: Evidence So Tiny That It’s Not there?
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Homeopathy: Evidence So Tiny That It’s Not There?
Yesterday, we asked you your opinions on homeopathy. The sample size of responses was a little lower than we usually get, but of those who did reply, there was a clear trend:
- A lot of enthusiasm for “Homeopathy works on valid principles and is effective”
- Near equal support for “It may help some people as a complementary therapy”
- Very few people voted for “Science doesn’t know how it works, but it works”; this is probably because people who considered voting for this, voted for the more flexible “It may help some people as a complementary therapy” instead.
- Very few people considered it a dangerous scam and a pseudoscience.
So, what does the science say?
Well, let us start our investigation by checking out the position of the UK’s National Health Service, an organization with a strong focus on providing the least expensive treatments that are effective.
Since homeopathy is very inexpensive to arrange, they will surely want to put it atop their list of treatments, right?
❝Homeopathy is a “treatment” based on the use of highly diluted substances, which practitioners claim can cause the body to heal itself.
There’s been extensive investigation of the effectiveness of homeopathy. There’s no good-quality evidence that homeopathy is effective as a treatment for any health condition.❞
The NHS actually has a lot more to say about that, and you can read their full statement here.
But that’s just one institution. Here’s what Australia’s National Health and Medical Research Council had to say:
❝There was no reliable evidence from research in humans that homeopathy was effective for treating the range of health conditions considered: no good-quality, well-designed studies with enough participants for a meaningful result reported either that homeopathy caused greater health improvements than placebo, or caused health improvements equal to those of another treatment❞
You can read their full statement here.
The American FDA, meanwhile, have a stronger statement:
❝Homeopathic drug products are made from a wide range of substances, including ingredients derived from plants, healthy or diseased animal or human sources, minerals and chemicals, including known poisons. These products have the potential to cause significant and even permanent harm if they are poorly manufactured, since that could lead to contaminated products or products that have potentially toxic ingredients at higher levels than are labeled and/or safe, or if they are marketed as substitute treatments for serious or life-threatening diseases and conditions, or to vulnerable populations.❞
You can read their full statement here.
Homeopathy is a dangerous scam and a pseudoscience: True or False?
False and True, respectively, mostly.
That may be a confusing answer, so let’s elaborate:
- Is it dangerous? Mostly not; it’s mostly just water. However, two possibilities for harm exist:
- Careless preparation could result in a harmful ingredient still being present in the water—and because of the “like cures like” principle, many of the ingredients used in homeopathy are harmful, ranging from heavy metals to plant-based neurotoxins. However, the process of “ultra-dilution” usually removes these so thoroughly that they are absent or otherwise scientifically undetectable.
- Placebo treatment has its place, but could result in “real” treatment going undelivered. This can cause harm if the “real” treatment was critically needed, especially if it was needed on a short timescale.
- Is it a scam? Probably mostly not; to be a scam requires malintent. Most practitioners probably believe in what they are practising.
- Is it a pseudoscience? With the exception that placebo effect has been highly studied and is a very valid complementary therapy… Yes, aside from that it is a pseudoscience. There is no scientific evidence to support homeopathy’s “like cures like” principle, and there is no scientific evidence to support homeopathy’s “water memory” idea. On the contrary, they go against the commonly understood physics of our world.
It may help some people as a complementary therapy: True or False?
True! Not only is placebo effect very well-studied, but best of all, it can still work as a placebo even if you know that you’re taking a placebo… Provided you also believe that!
Science doesn’t know how it works, but it works: True or False?
False, simply. At best, it performs as a placebo.
Placebo is most effective when it’s a remedy against subjective symptoms, like pain.
However, psychosomatic effect (the effect that our brain has on the rest of our body, to which it is very well-connected) can mean that placebo can also help against objective symptoms, like inflammation.
After all, our body, directed primarily by the brain, can “decide” what immunological defenses to deploy or hold back, for example. This is why placebo can help with conditions as diverse as arthritis (an inflammatory condition) or diabetes (an autoimmune condition, and/or a metabolic condition, depending on type).
Here’s how homeopathy measures up, for those conditions:
(the short answer is “no better than placebo”)
Homeopathy works on valid principles and is effective: True or False?
False, except insofar as placebo is a valid principle and can be effective.
The stated principles of homeopathy—”like cures like” and “water memory”—have no scientific basis.
We’d love to show the science for this, but we cannot prove a negative.
However, the ideas were conceived in 1796, and are tantamount to alchemy. A good scientific attitude means being open-minded to new ideas and testing them. In homeopathy’s case, this has been done, extensively, and more than 200 years of testing later, homeopathy has consistently performed equal to placebo.
In summary…
- If you’re enjoying homeopathic treatment and that’s working for you, great, keep at it.
- If you’re open-minded to enjoying a placebo treatment that may benefit you, be careful, but don’t let us stop you.
- If your condition is serious, please do not delay seeking evidence-based medical treatment.
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Building & Maintaining Mobility
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Building & Maintaining Mobility!
This is Juliet Starrett. She’s a CrossFit co-founder, and two-time white-water rafting world champion. Oh, and she won those after battling thyroid cancer. She’s now 50 years old, and still going strong, having put aside her career as a lawyer to focus on fitness. Specifically, mobility training.
The Ready State
Together with her husband Kelly, Starrett co-founded The Ready State, of which she’s CEO.
It used to be called “Mobility WOD” (the “WOD” stands for “workout of the day”) but they changed their name as other companies took up the use of the word “mobility”, something the fitness world hadn’t previously focussed on much, and “WOD”, which was also hardly copyrightable.
True to its origins, The Ready State continues to offer many resources for building and maintaining mobility.
Why the focus on mobility?
When was the last time you had to bench-press anything larger than a small child? Or squat more than your partner’s bodyweight? Or do a “farmer’s walk” with anything heavier than your groceries?
For most of us, unless our lifestyles are quite extreme, we don’t need ridiculous strength (fun as that may be).
You know what makes a huge difference to our quality of life though? Mobility.
Have you ever felt that moment of panic when you reach for something on a high shelf and your shoulder or back twinges (been there!)? Or worse, you actually hurt yourself and the next thing you know, you need help putting your socks on (been there, too!)?
And we say to ourselves “I’m not going to let that happen to me again”
But how? How do we keep our mobility strong?
First, know your weaknesses
Starrett is a big fan of mobility tests to pinpoint areas that need more work.
Most of her resources for this aren’t free, and we’re drawing heavily from her book here, so for your convenience, we’ll link to some third party sources for this:
- Timed Up and Go—start with this, before progressing to the next!
- Sit To Rise Test—not to be underestimated (this page also has excerpts from Starrett’s mobility book, by the way)
- Shoulders/Spine/Hips—7 quick tests; note any that you can’t do, or struggle with
Next, eliminate those weaknesses
Do mobility exercises in any weak areas, until they’re not weak:
Want to train the full body in one session?
Try out The Ready State’s 10-Minute Morning Mobility Routine
Want to learn more?
You might enjoy her book that we reviewed previously:
Built to Move: The Ten Essential Habits to Help You Move Freely and Live Fully
You might also enjoy The Ready State App, available for iOS and for Android:
The Ready State Virtual Mobility Coach
Enjoy!
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Nicotine Benefits (That We Don’t Recommend)!
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Does nicotine have any benefits at all? I know it’s incredibly addictive but if you exclude the addiction, does it do anything?❞
Good news: yes, nicotine is a stimulant and can be considered a performance enhancer, for example:
❝Compared with the placebo group, the nicotine group exhibited enhanced motor reaction times, grooved pegboard test (GPT) results on cognitive function, and baseball-hitting performance, and small effect sizes were noted (d = 0.47, 0.46 and 0.41, respectively).❞
Read in full: Acute Effects of Nicotine on Physiological Responses and Sport Performance in Healthy Baseball Players
However, another study found that its use as a cognitive enhancer was only of benefit when there was already a cognitive impairment:
❝Studies of the effects of nicotinic systems and/or nicotinic receptor stimulation in pathological disease states such as Alzheimer’s disease, Parkinson’s disease, attention deficit/hyperactivity disorder and schizophrenia show the potential for therapeutic utility of nicotinic drugs.
In contrast to studies in pathological states, studies of nicotine in normal-non-smokers tend to show deleterious effects.
This contradiction can be resolved by consideration of cognitive and biological baseline dependency differences between study populations in terms of the relationship of optimal cognitive performance to nicotinic receptor activity.
Although normal individuals are unlikely to show cognitive benefits after nicotinic stimulation except under extreme task conditions, individuals with a variety of disease states can benefit from nicotinic drugs❞
Read in full: Effects of nicotinic stimulation on cognitive performance
Bad news: its addictive qualities wipe out those benefits due to tolerance and thus normalization in short order. So you may get those benefits briefly, but then you’re addicted and also lose the benefits, as well as also ruining your health—making it a lose/lose/lose situation quite quickly.
As an aside, while nicotine is poisonous per se, in the quantities taken by most users, the nicotine itself is not usually what kills. It’s mostly the other stuff that comes with it (smoking is by far and away the worst of all; vaping is relatively less bad, but that’s not a strong statement in this case) that causes problems.
See also: Vaping: A Lot Of Hot Air?
However, this is still not an argument for, say, getting nicotine gum and thinking “no harmful effects” because then you’ll be get a brief performance boost yes before it runs out and being addicted to it and now being in a position whereby if you stop, your performance will be lower than before you started (since you now got used to it, and it became your new normal), before eventually recovering:
In summary
We recommend against using nicotine in the first place, and for those who are addicted, we recommend quitting immediately if not contraindicated (check with your doctor if unsure; there are some situations where it is inadvisable to take away something your body is dependent on, until you correct some other thing first).
For more on quitting in general, see:
Addiction Myths That Are Hard To Quit
Take care!
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Older Americans Say They Feel Trapped in Medicare Advantage Plans
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In 2016, Richard Timmins went to a free informational seminar to learn more about Medicare coverage.
“I listened to the insurance agent and, basically, he really promoted Medicare Advantage,” Timmins said. The agent described less expensive and broader coverage offered by the plans, which are funded largely by the government but administered by private insurance companies.
For Timmins, who is now 76, it made economic sense then to sign up. And his decision was great, for a while.
Then, three years ago, he noticed a lesion on his right earlobe.
“I have a family history of melanoma. And so, I was kind of tuned in to that and thinking about that,” Timmins said of the growth, which doctors later diagnosed as malignant melanoma. “It started to grow and started to become rather painful.”
Timmins, though, discovered that his enrollment in a Premera Blue Cross Medicare Advantage plan would mean a limited network of doctors and the potential need for preapproval, or prior authorization, from the insurer before getting care. The experience, he said, made getting care more difficult, and now he wants to switch back to traditional, government-administered Medicare.
But he can’t. And he’s not alone.
“I have very little control over my actual medical care,” he said, adding that he now advises friends not to sign up for the private plans. “I think that people are not understanding what Medicare Advantage is all about.”
Enrollment in Medicare Advantage plans has grown substantially in the past few decades, enticing more than half of all eligible people, primarily those 65 or older, with low premium costs and perks like dental and vision insurance. And as the private plans’ share of the Medicare patient pie has ballooned to 30.8 million people, so too have concerns about the insurers’ aggressive sales tactics and misleading coverage claims.
Enrollees, like Timmins, who sign on when they are healthy can find themselves trapped as they grow older and sicker.
“It’s one of those things that people might like them on the front end because of their low to zero premiums and if they are getting a couple of these extra benefits — the vision, dental, that kind of thing,” said Christine Huberty, a lead benefit specialist supervising attorney for the Greater Wisconsin Agency on Aging Resources.
“But it’s when they actually need to use it for these bigger issues,” Huberty said, “that’s when people realize, ‘Oh no, this isn’t going to help me at all.’”
Medicare pays private insurers a fixed amount per Medicare Advantage enrollee and in many cases also pays out bonuses, which the insurers can use to provide supplemental benefits. Huberty said those extra benefits work as an incentive to “get people to join the plan” but that the plans then “restrict the access to so many services and coverage for the bigger stuff.”
David Meyers, assistant professor of health services, policy, and practice at the Brown University School of Public Health, analyzed a decade of Medicare Advantage enrollment and found that about 50% of beneficiaries — rural and urban — left their contract by the end of five years. Most of those enrollees switched to another Medicare Advantage plan rather than traditional Medicare.
In the study, Meyers and his co-authors muse that switching plans could be a positive sign of a free marketplace but that it could also signal “unmeasured discontent” with Medicare Advantage.
“The problem is that once you get into Medicare Advantage, if you have a couple of chronic conditions and you want to leave Medicare Advantage, even if Medicare Advantage isn’t meeting your needs, you might not have any ability to switch back to traditional Medicare,” Meyers said.
Traditional Medicare can be too expensive for beneficiaries switching back from Medicare Advantage, he said. In traditional Medicare, enrollees pay a monthly premium and, after reaching a deductible, in most cases are expected to pay 20% of the cost of each nonhospital service or item they use. And there is no limit on how much an enrollee may have to pay as part of that 20% coinsurance if they end up using a lot of care, Meyers said.
To limit what they spend out-of-pocket, traditional Medicare enrollees typically sign up for supplemental insurance, such as employer coverage or a private Medigap policy. If they are low-income, Medicaid may provide that supplemental coverage.
But, Meyers said, there’s a catch: While beneficiaries who enrolled first in traditional Medicare are guaranteed to qualify for a Medigap policy without pricing based on their medical history, Medigap insurers can deny coverage to beneficiaries transferring from Medicare Advantage plans or base their prices on medical underwriting.
Only four states — Connecticut, Maine, Massachusetts, and New York — prohibit insurers from denying a Medigap policy if the enrollee has preexisting conditions such as diabetes or heart disease.
Paul Ginsburg is a former commissioner on the Medicare Payment Advisory Commission, also known as MedPAC. It’s a legislative branch agency that advises Congress on the Medicare program. He said the inability of enrollees to easily switch between Medicare Advantage and traditional Medicare during open enrollment periods is “a real concern in our system; it shouldn’t be that way.”
The federal government offers specific enrollment periods every year for switching plans. During Medicare’s open enrollment period, from Oct. 15 to Dec. 7, enrollees can switch out of their private plans to traditional, government-administered Medicare.
Medicare Advantage enrollees can also switch plans or transfer to traditional Medicare during another open enrollment period, from Jan. 1 to March 31.
“There are a lot of people that say, ‘Hey, I’d love to come back, but I can’t get Medigap anymore, or I’ll have to just pay a lot more,’” said Ginsburg, who is now a professor of health policy at the University of Southern California.
Timmins is one of those people. The retired veterinarian lives in a rural community on Whidbey Island just north of Seattle. It’s a rugged, idyllic landscape and a popular place for second homes, hiking, and the arts. But it’s also a bit remote.
While it’s typically harder to find doctors in rural areas, Timmins said he believes his Premera Blue Cross plan made it more challenging to get care for a variety of reasons, including the difficulty of finding and getting in to see specialists.
Nearly half of Medicare Advantage plan directories contained inaccurate information on what providers were available, according to the most recent federal review. Beginning in 2024, new or expanding Medicare Advantage plans must demonstrate compliance with federal network expectations or their applications could be denied.
Amanda Lansford, a Premera Blue Cross spokesperson, declined to comment on Timmins’ case. She said the plan meets federal network adequacy requirements as well as travel time and distance standards “to ensure members are not experiencing undue burdens when seeking care.”
Traditional Medicare allows beneficiaries to go to nearly any doctor or hospital in the U.S., and in most cases enrollees do not need approval to get services.
Timmins, who recently finished immunotherapy, said he doesn’t think he would be approved for a Medigap policy, “because of my health issue.” And if he were to get into one, Timmins said, it would likely be too expensive.
For now, Timmins said, he is staying with his Medicare Advantage plan.
“I’m getting older. More stuff is going to happen.”
There is also a chance, Timmins said, that his cancer could resurface: “I’m very aware of my mortality.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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