Put Your Feet Up! (Against A Wall, For 20 Minutes)
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Feel free to browse our articles while you do
Here are 10 good reasons to give it a try; there are another 10 in the short (3:18) video:
- Improves blood circulation
- Improves blood pressure
- Relaxes the body as a whole
- Alleviates lower back tension
- Eases headaches and migraines
- Reduces knee pain
- Relieves swelling in feet and ankles
- Improves lymphatic flow
- Stretches the hamstrings (and hip flexors, if you do it wide)
- Helps quiet the mind
As for the rest…
Click Here If The Embedded Video Doesn’t Load Automatically
PS: about that circulation… As a general rule of thumb, anything that slightly confuses the heart (anatomically, not romantically) will tend to have a beneficial effect, in moderation. This goes for being upside-down (as is partly the case here), and also for high-intensity interval training (HIIT):
How To Do HIIT (Without Wrecking Your Body)
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Statins and Brain Fog?
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
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
❝I was wondering if you had done any info about statins. I’ve tried 3, and keep quitting them because they give me brain fog. Am I imagining this as the research suggests?❞
If you are female, the chances of adverse side-effects are a lot higher:
As an extra kicker, not only are the adverse side-effects more likely for women, but also, the benefits are often less beneficial, too (see the above main feature for some details).
That’s not to say that statins can’t have their place for women; sometimes it will still be the right choice. Just, not as readily so as for men.
Enjoy!
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As Nuns Disappear, Many Catholic Hospitals Look More Like Megacorporations
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ST. LOUIS — Inside the more than 600 Catholic hospitals across the country, not a single nun can be found occupying a chief executive suite, according to the Catholic Health Association.
Nuns founded and led those hospitals in a mission to treat sick and poor people, but some were also shrewd business leaders. Sister Irene Kraus, a former chief executive of Daughters of Charity National Health System, was famous for coining the phrase “no margin, no mission.” It means hospitals must succeed — generating enough revenue to exceed expenses — to fulfill their original mission.
The Catholic Church still governs the care that can be delivered to millions in those hospitals each year, using religious directives to ban abortions and limit contraceptives, in vitro fertilization, and medical aid in dying.
But over time, that focus on margins led the hospitals to transform into behemoths that operate for-profit subsidiaries and pay their executives millions, according to hospital tax filings. These institutions, some of which are for-profit companies, now look more like other megacorporations than like the charities for the destitute of yesteryear.
The absence of nuns in the top roles raises the question, said M. Therese Lysaught, a Catholic moral theologist and professor at Loyola University Chicago: “What does it mean to be a Catholic hospital when the enterprise has been so deeply commodified?”
The St. Louis area serves as the de facto capital of Catholic hospital systems. Three of the largest are headquartered here, along with the Catholic hospital lobbying arm. Catholicism is deeply rooted in the region’s culture. During Pope John Paul II’s only U.S. stop in 1999, he led Mass downtown in a packed stadium of more than 100,000 people.
For a quarter century, Sister Mary Jean Ryan led SSM Health, one of those giant systems centered on St. Louis. Now retired, the 86-year-old said she was one of the last nuns in the nation to lead a Catholic hospital system.
Ryan grew up Catholic in Wisconsin and joined a convent while in nursing school in the 1960s, surprising her family. She admired the nuns she worked alongside and felt they were living out a higher purpose.
“They were very impressive,” she said. “Not that I necessarily liked all of them.”
Indeed, the nuns running hospitals defied the simplistic image often ascribed to them, wrote John Fialka in his book “Sisters: Catholic Nuns and the Making of America.”
“Their contributions to American culture are not small,” he wrote. “Ambitious women who had the skills and the stamina to build and run large institutions found the convent to be the first and, for a long time, the only outlet for their talents.”
This was certainly true for Ryan, who climbed the ranks, working her way from nurse to chief executive of SSM Health, which today has hospitals in Illinois, Missouri, Oklahoma, and Wisconsin.
The system was founded more than a century ago when five German nuns arrived in St. Louis with $5. Smallpox swept through the city and the Sisters of St. Mary walked the streets offering free care to the sick.
Their early foray grew into one of the largest Catholic health systems in the country, with annual revenue exceeding $10 billion, according to its 2023 audited financial report. SSM Health treats patients in 23 hospitals and co-owns a for-profit pharmacy benefit manager, Navitus, that coordinates prescriptions for 14 million people.
But Ryan, like many nuns in leadership roles in recent decades, found herself confronted with an existential crisis. As fewer women became nuns, she had to ensure the system’s future without them.
When Ron Levy, who is Jewish, started at SSM as an administrator, he declined to lead a prayer in a meeting, Ryan recounted in her book, “On Becoming Exceptional.”
“Ron, I’m not asking you to be Catholic,” she recalled telling him. “And I know you’ve only been here two weeks. So, if you’d like to make it three, I suggest you be prepared to pray the next time you’re asked.”
Levy went on to serve SSM for more than 30 years — praying from then on, Ryan wrote.
In Catholic hospitals, meetings are still likely to start with a prayer. Crucifixes often adorn buildings and patient rooms. Mission statements on the walls of SSM facilities remind patients: “We reveal the healing presence of God.”
Above all else, the Catholic faith calls on its hospitals to treat everyone regardless of race, religion, or ability to pay, said Diarmuid Rooney, a vice president of the Catholic Health Association. No nuns run the trade group’s member hospitals, according to the lobbying group. But the mission that compelled the nuns is “what compels us now,” Rooney said. “It’s not just words on a wall.”
The Catholic Health Association urges its hospitals to evaluate themselves every three years on whether they’re living up to Catholic teachings. It created a tool that weighs seven criteria, including how a hospital acts as an extension of the church and cares for poor and marginalized patients.
“We’re not relying on hearsay that the Catholic identity is alive and well in our facilities and hospitals,” Rooney said. “We can actually see on a scale where they are at.”
The association does not share the results with the public.
At SSM Health, “our Catholic identity is deeply and structurally ingrained” even with no nun at the helm, spokesperson Patrick Kampert said. The system reports to two boards. One functions as a typical business board of directors while the other ensures the system abides by the rules of the Catholic Church. The church requires the majority of that nine-member board to be Catholic. Three nuns currently serve on it; one is the chair.
Separately, SSM also is required to file an annual report with the Vatican detailing the ways, Kampert said, “we deepen our Catholic identity and further the healing ministry of Jesus.” SSM declined to provide copies of those reports.
From a business perspective, though, it’s hard to distinguish a Catholic hospital system like SSM from a secular one, said Ruth Hollenbeck, a former Anthem insurance executive who retired in 2018 after negotiating Missouri hospital contracts. In the contracts, she said, the difference amounted to a single paragraph stating that Catholic hospitals wouldn’t do anything contrary to the church’s directives.
To retain tax-exempt status under Internal Revenue Service rules, all nonprofit hospitals must provide a “benefit” to their communities such as free or reduced-price care for patients with low incomes. But the IRS provides a broad definition of what constitutes a community benefit, which gives hospitals wide latitude to justify not needing to pay taxes.
On average, the nation’s nonprofit hospitals reported that 15.5% of their total annual expenses were for community benefits in 2020, the latest figure available from the American Hospital Association.
SSM Health, including all of its subsidiaries, spent proportionately far less than the association’s average for individual hospitals, allocating roughly the same share of its annual expenses to community efforts over three years: 5.1% in 2020, 4.5% in 2021, and 4.9% in 2022, according to a KFF Health News analysis of its most recent publicly available IRS filings and audited financial statements.
A separate analysis from the Lown Institute think tank placed five Catholic systems — including the St. Louis region’s Ascension — on its list of the 10 health systems with the largest “fair share” deficits, which means receiving more in tax breaks than what they spent on the community. And Lown said three St. Louis-area Catholic health systems — Ascension, SSM Health, and Mercy — had fair share deficits of $614 million, $235 million, and $92 million, respectively, in the 2021 fiscal year.
Ascension, Mercy, and SSM disputed Lown’s methodology, arguing it doesn’t take into account the gap between the payments they receive for Medicaid patients and the cost of delivering their care. The IRS filings do.
But, Kampert said, many of the benefits SSM provides aren’t reflected in its IRS filings either. The forms reflect “very simplistic calculations” and do not accurately represent the health system’s true impact on the community, he said.
Today, SSM Health is led by longtime business executive Laura Kaiser. Her compensation in 2022 totaled $8.4 million, including deferred payments, according to its IRS filing. Kampert defended the amount as necessary “to retain and attract the most qualified” candidate.
By contrast, SSM never paid Ryan a salary, giving instead an annual contribution to her convent of less than $2 million a year, according to some tax filings from her long tenure. “I didn’t join the convent to earn money,” Ryan said.
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.
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This article first appeared on KFF Health News and is republished here under a Creative Commons license.
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Navigating the health-care system is not easy, but you’re not alone.
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Hello, dear reader!
This is my first column for Healthy Debate as a Patient Navigator. This column will be devoted to providing patients with information to help them through their journey with the health-care system and answering your questions.
Here’s a bit about me: I have been a patient partner at The Ottawa Hospital and Ottawa Hospital Research Institute since 2017, and have joined a variety of governance boards that work on patient and caregiver engagement such as the Patient Advisors Network, the Ontario Health East Region Patient and Family Advisory Council and the Equity in Health Systems Lab.
My journey as a patient partner started much before 2017 though. When I was a teenager, I was diagnosed with a cholesteatoma, a rare and chronic disease that causes the development of fatty tumors in the middle ear. I have had multiple surgeries to try to fix it but will need regular follow-ups to monitor whether the tumor returns. Because of this, I also live with an invisible disability since I have essentially become functionally deaf in one ear and often rely on a hearing aid when I navigate the world.
Having undergone three surgeries in my adolescent years, it was my experience undergoing surgery for an acute hand and wrist injury following a jet ski accident as an adult that was the catalyst for my decision to become a patient partner. There was an intriguing contrast between how I was cared for at two different health-care institutions, my age being the deciding factor at which hospital I went to (a children’s hospital or an adult one).
The most memorable example was how, as a teenager or child, you were never left alone before surgery, and nurses and staff took all the time necessary to comfort me and answer my (and my family’s) questions. I also remember how right before putting me to sleep, the whole staff initiated a surgical pause and introduced themselves and explained to me what their role was during my surgery.
None of that happened as an adult. I was left in a hallway while the operating theater was prepared, anxious and alone with staff walking by not even batting an eye. My questions felt like an annoyance to the care team; as soon as I was wheeled onto the operating room table, the anesthetist quickly put me to sleep. I didn’t even have the time to see who else was there.
Now don’t get me wrong: I am incredibly appreciative with the quality of care I received, but it was the everyday interactions with the care teams that I felt could be improved. And so, while I was recovering from that surgery, I looked for a way to help other patients and the hospital improve its care. I discovered the hospital’s patient engagement program, applied, and the rest is history!
Since then, I have worked on a host of patient-centered policy and research projects and fervently advocate that surgical teams adopt a more compassionate approach with patients before and after surgery.
I’d be happy to talk a bit more about my journey if you ask, but with that out of the way … Welcome to our first patient navigator column about patient engagement.
Conceptualizing the continuum of Patient Engagement
In the context of Canadian health care, patient engagement is a multifaceted concept that involves active collaboration between patients, caregivers, health-care providers and researchers. It involves patients and caregivers as active contributors in decision-making processes, health-care services and medical research. Though the concept is not new, the paradigm shift toward patient engagement in Canada started around 2010.
I like to conceptualize the different levels of patient engagement as a measure of the strength of the relationship between patients and their interlocutors – whether it’s a healthcare provider, administrator or researcher – charted against the duration of the engagement or the scope of input required from the patient.
Defining different levels of Patient Engagement
Following the continuum, let’s begin by defining different levels of patient engagement. Bear in mind that these definitions can vary from one organization to another but are useful in generally labelling the level of patient engagement a project has achieved (or wishes to achieve).
Patient involvement: If the strength of the relationship between patients and their interlocutors is minimal and not time consuming or too onerous, then perhaps it can be categorized as patient involvement. This applies to many instances of transactional engagement.
Patient advisory/consulting: Right in the middle of our continuum, patients can find themselves engaging in patient advisory or consulting work, where projects are limited in scope and duration or complexity, and the relationship is not as profound as a partnership.
Patient partnership: The stronger the relationship is between the patient and their interlocutor, and the longer the engagement activity lasts or how much input the patient is providing, the more this situation can be categorized as patient partnership. It is the inverse of patient involvement.
Examples of the different levels of Patient Engagement
Let’s pretend you are accompanying a loved one to an appointment to manage a kidney disease, requiring them to undergo dialysis treatment. We’ll use this scenario to exemplify what label could be used to describe the level of engagement.
Patient involvement: In our case, if your loved one – or you – fills out a satisfaction or feedback survey about your experience in the waiting room and all that needed to be done was to hand it back to the clerk or care team, then, at a basic level, you could likely label this interaction as a form of patient involvement. It can also involve open consultations around a design of a new look and feel for a hospital, or the understandability of a survey or communications product. Interactions with the care team, administrators or researchers are minimal and often transactional.
Patient advisory/consulting: If your loved one was asked for more detailed information about survey results over the course of a few meetings, this could represent patient advisory/consulting. This could mean that patients meet with program administrators and care providers and share their insights on how things can be improved. It essentially involves patients providing advice to health-care institutions from the perspective of patients, their family members and caregivers.
Patient advisors or consultants are often appointed by hospitals or academic institutions to offer insights at multiple stages of health-care delivery and research. They can help pilot an initiative based on that feedback or evaluate whether the new solutions are working. Often patient advisors are engaged in smaller-term individual projects and meet with the project team as regularly as required.
Patient partnership: Going above and beyond patient advisory, if patients have built a trusting relationship with their care team or administrators, they could feel comfortable enough to partner with them and initiate a project of their own. This could be for a project in which they study a different form of treatment to improve patient-centered outcomes (like the time it takes to feel “normal” following a session); it could be working together to identify and remove barriers for other patients that need to access that type of care. These projects are not fulfilled overnight, but require a collaborative, longstanding and trusting relationship between patients and health-care providers, administrators or researchers. It ensures that patients, regardless of severity or chronicity of their illness, can meaningfully contribute their experiences to aid in improving patient care, or develop or implement policies, pilots or research projects from start to finish.
It is leveraging that lived and living experience to its full extent and having the patient partner involved as an equal voice in the decision-making process for a project – over many months, usually – that the engagement could be labeled a partnership.
Last words
The point of this column will be to answer or explore issues or questions related to patient engagement, health communications or even provide some thoughts on how to handle a particular situation.
I would be happy to collect your questions and feedback at any time, which will help inform future columns. Just email me at [email protected] or connect with me on social media (Linked In, X / Twitter).
It’s not easy to navigate our health-care systems, but you are not alone.
This article is republished from healthydebate under a Creative Commons license. Read the original article.
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Take Care Of Your Lymphatic System To Beat Cognitive Decline
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First of all, for any unfamiliar with the lymphatic system, it’s mostly the body’s clean-up system (as well as a big part of the body’s anticancer system).
See: The Lymphatic System Against Cancer & More
It may not be the most glamorous job, but it’s certainly an essential one.
There’s no lymph in the brain, but…
Because of the blood-brain barrier (BBB) that keeps the astonishingly sensitive brain as safe as it can from unwanted things, there are many aspects of our physiology that only happen inside the brain, or only happen outside of it, as the compounds in question may be too large to get through the BBB.
The lymphatic system is, in and of itself, an entirely outside-of-the-brain affair. So, how does stuff get cleaned out from the brain (such as beta-amyloid and alpha-synuclein clearance, to avoid Alzheimer’s and Parkinson’s, respectively)?
The glymphatic system (a portmanteau of glial cells doing the job of the lymphatic system) is the brain’s own cleanup crew, and we wrote about it here:
How To Clean Your Brain (Glymphatic Health Primer)
Why lymph still matters for the brain
Although the glymphatic system is doing a (hopefully) fine job of scrubbing up the brain, if the lymphatic system isn’t working at least as well, then this becomes the equivalent of what would happen if you at home were very attentive to taking the trash out, but the garbage disposal crews stopped doing their job, or did it much less well than they need to. Soon, you’d end up with a mountain of trash at home, even though you were doing your part correctly.
In short: the glymphatic system needs to pass the waste on somewhere, and the lymphatic system is its go-to.
You may be wondering about the role of blood in all of this, and the answer is that no part of any of the above systems can do its job without adequate oxygenation, and our blood also assists in the transport of things removed—which is one of the reasons why there are blood-based Alzheimer’s tests that can be done; they measure certain markers of neurodegeneration that become present in the blood having left the brain:
Early Dementia Screening From Your Blood & More ← the “and more” is actually quite interesting, but it’s the blood we’re interested in for this section
What can be done about it
Our first two links up above, about the lymphatic and glymphatic systems, respectively, also tell how to look after each of them, but we’ll mention a few salient pointers here.
For the lymphatic system:
- do lymphatic massage
- exercise, with a focus on maximizing movement
- eat an anti-inflammatory diet
For the glymphatic system:
- do vagal massage (Vagal! Not vaginal, which will not help! Or rather: it won’t help the glymphatic system, anyway)
- exercise, and/but also rest well (good quality sleep)
- eat omega-3 fatty acids
For more details and suggestions on each though, do check out:
Lymphatic health primer | Glymphatic health primer
How this was discovered
Until as recently as 2014, it was not known that there was any part of the lymphatic system around the brain, waiting to take things from the glymphatic system. Since then, research has slowly been done about the relationship between the two, how things work, and what affects what and how.
Most recently (the study was published two days ago, at time of writing this) it was discovered that, in mice at least, improving lymphatic function just outside of the brain (the meningeal lymphatic vessels, responsible for draining waste from the brain) improves memory.
Aged mice who underwent a process that rejuvenated the meningeal lymphatic vessels, performed better in memory tests afterwards.
How this worked, step-by-step:
- The mice were given a special protein that rejuvenated the meningeal lymphatic vessels¹
- The lymphatic vessels were then able to do their job better
- This meant that the glial cells of the glymphatic system were no longer drowning in excess stuff
- This reduced levels of a protein that says “help, too much stuff!” and starts inhibiting everything it can to try to cope²
- This meant that neural activity was no longer being suppressed, and memory improved
Technical bits for those who want it:
¹ We’re not being secretive about what this special protein was; it’s just that the special protein is called adeno-associated virus 1 cytomegalovirus murine vascular endothelial growth factor C, or “AAV1-CMV-mVEGF-C” for short, so for readability, “a special protein” does the job. Suffice it to say, a) you can’t exactly buy AAV1-CMV-mVEGF-C on Amazon, and b) you wouldn’t want it anyway, you’d want its close cousin AAV1-CMV-hVEGF-C (“m” for murine, i.e. mousey, vs “h” for human)
² This one’s just called interleukin-6 (IL-6); perhaps you’ve heard of interleukin; we’ve mentioned it sometimes before.
You can read the paper in its entirety here; if you don’t mind reading very technical stuff, it is very interesting:
Meningeal lymphatics-microglia axis regulates synaptic physiology
Enjoy!
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Kiwi vs Lime – Which is Healthier?
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Our Verdict
When comparing kiwi to lime, we picked the kiwi.
Why?
Looking at the macros first, kiwi has more protein, more carbs, and more fiber. As with most fruits, the fiber is the number we’re most interested in for health purposes; in this case, kiwi is just slightly ahead of lime on all three of those.
In terms of vitamins, kiwi has more of vitamins A, B2, B3, B6, B9, C, E, K, and choline, while lime has a tiny bit more vitamin B5. As in, the vitamin that’s in pretty much anything and is practically impossible to be deficient in unless you are literally starving to death. You may be thinking: aren’t limes a famously good source of vitamin C? And yes, yes they are. But kiwis have >3x more. In other big differences, kiwis also have >6x more vitamin E and >67 times more vitamin K.
When it comes to minerals, kiwi has more calcium, copper, magnesium, manganese, phosphorus, potassium, and zinc, while lime has more iron and selenium. Another easy win for kiwis.
In short: enjoy both; both are good. But kiwis are the more nutritionally dense option by almost every way of measuring it.
Want to learn more?
You might like to read:
Top 8 Fruits That Prevent & Kill Cancer ← kiwi is top of the list; it promotes cancer cell death while sparing healthy cells
Take care!
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The Oxygen Advantage – by Patrick McKeown
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You probably know to breathe through your nose, and use your diaphragm. What else does this book have to offer?
A lot of the book is aimed at fixing specific problems, and optimizing what can be optimized—including with tips and tricks you may not have encountered before. Yet, the offerings are not bizarre either; we don’t need to learn to breathe through our ears while drinking a glass of water upside down or anything.
Rather, such simple things as improving one’s VO₂Max by occasionally holding one’s breath while walking briskly. But, he advises specifically, this should be done by pausing the breath halfway through the exhalation (a discussion of the ensuing physiological response is forthcoming).
Little things like that are woven throughout the book, whose style is mostly anecdotal rather than hard science, yet is consistent with broad scientific consensus in any case.
Bottom line: if you’ve any reason to think your breathing might be anything less than the best it could possibly be, this book is likely to help you to tweak it to be a little better.
Click here to check out The Oxygen Advantage, and get yours!
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