Understanding Cellulitis: Skin And Soft Tissue Infections

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What’s the difference between a minor passing skin complaint, and a skin condition that’s indicative of something more serious? Dr. Thomas Watchman explains:

More than skin-deep

Cellulitis sounds benign enough, like having a little cellulite perhaps, but in fact it means an infection of the skin and—critically—the underlying soft tissues.

Normally, the skin acts as a barrier against infections, but this barrier can be breached by physical trauma (i.e. an injury that broke the skin), eczema, fungal nail infections, skin ulcers, and other similar things that disrupt the skin’s ability to protect us.

Things to watch out for: Dr. Watchman advises we keep an eye out for warm, reddened skin, swelling, and blisters. Specifically, a golden-yellow crust to these likely indicates a Staphylococcus aureus infection (hence the name).

There’s a scale of degrees of severity:

  • Class 1: No systemic toxicity or comorbidities
  • Class 2: Systemic toxicity or comorbidities present
  • Class 3: Significant systemic toxicity or comorbidities with risk of significant deterioration
  • Class 4: Sepsis or life-threatening infection

…with antibiotics being recommended in the latter two cases there, or in other cases for frail, young, old, or immunocompromised patients. Given the rather “scorched earth” results of antibiotics (they cause a lot of collateral iatrogenic damage), this can be taken as a sign of how seriously such infections should be taken.

For more about all this, including visual guides, enjoy:

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  • Rose Hips vs Blueberries – Which is Healthier?

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    Our Verdict

    When comparing rose hips to blueberries, we picked the rose hips.

    Why?

    Both of these fruits are abundant sources of antioxidants and other polyphenols, but one of them stands out for overall nutritional density:

    In terms of macros, rose hips have about 2x the carbohydrates, and/but about 10x the fiber. That’s an easy calculation and a clear win for rose hips.

    When it comes to vitamins, rose hips have a lot more of vitamins A, B2, B3, B5, B6, C, E, K, and choline. On the other hand, blueberries boast more of vitamins B1 and B9. That’s a 9:2 lead for rose hips, even before we consider rose hips’ much greater margins of difference (kicking off with 80x the vitamin A, for instance, and many multiples of many of the others).

    In the category of minerals, rose hips have a lot more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc. Meanwhile, blueberries are not higher in any minerals.

    In short: as ever, enjoy both, but if you’re looking for nutritional density, there’s a clear winner here and it’s rose hips.

    Want to learn more?

    You might like to read:

    It’s In The Hips: Rosehip’s Benefits, Inside & Out

    Take care!

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  • I’ve recovered from a cold but I still have a hoarse voice. What should I do?

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    Cold, flu, COVID and RSV have been circulating across Australia this winter. Many of us have caught and recovered from one of these common upper respiratory tract infections.

    But for some people their impact is ongoing. Even if your throat isn’t sore anymore, your voice may still be hoarse or croaky.

    So what happens to the voice when we get a virus? And what happens after?

    Here’s what you should know if your voice is still hoarse for days – or even weeks – after your other symptoms have resolved.

    Why does my voice get croaky during a cold?

    A healthy voice is normally clear and strong. It’s powered by the lungs, which push air past the vocal cords to make them vibrate. These vibrations are amplified in the throat and mouth, creating the voice we hear.

    The vocal cords are two elastic muscles situated in your throat, around the level of your laryngeal prominence, or Adam’s apple. (Although everyone has one, it tends to be more pronounced in males.) The vocal cords are small and delicate – around the size of your fingernail. Any small change in their structure will affect how the voice sounds.

    When the vocal cords become inflamed – known as laryngitis – your voice will sound different. Laryngitis is a common part of upper respiratory tract infections, but can also be caused through misuse.

    Two drawn circles comparing normal vocal cords with inflamed, red vocal cords.
    Viruses such as the common cold can inflame the vocal cords. Pepermpron/Shutterstock

    Catching a virus triggers the body’s defence mechanisms. White blood cells are recruited to kill the virus and heal the tissues in the vocal cords. They become inflamed, but also stiffer. It’s harder for them to vibrate, so the voice comes out hoarse and croaky.

    In some instances, you may find it hard to speak in a loud voice or have a reduced pitch range, meaning you can’t go as high or loud as normal. You may even “lose” your voice altogether.

    Coughing can also make things worse. It is the body’s way of trying to clear the airways of irritation, including your own mucus dripping onto your throat (post-nasal drip). But coughing slams the vocal cords together with force.

    Chronic coughing can lead to persistent inflammation and even thicken the vocal cords. This thickening is the body trying to protect itself, similar to developing a callus when a pair of new shoes rubs.

    Thickening on your vocal cords can lead to physical changes in the vocal cords – such as developing a growth or “nodule” – and further deterioration of your voice quality.

    Diagram compares healthy vocal cords with cords that have nodules, two small bumps.
    Coughing and exertion can cause inflamed vocal cords to thicken and develop nodules. Pepermpron/Shutterstock

    How can you care for your voice during infection?

    People who use their voices a lot professionally – such as teachers, call centre workers and singers – are often desperate to resume their vocal activities. They are more at risk of forcing their voice before it’s ready.

    The good news is most viral infections resolve themselves. Your voice is usually restored within five to ten days of recovering from a cold.

    Occasionally, your pharmacist or doctor may prescribe cough suppressants to limit additional damage to the vocal cords (among other reasons) or mucolytics, which break down mucus. But the most effective treatments for viral upper respiratory tract infections are hydration and rest.

    Drink plenty of water, avoid alcohol and exposure to cigarette smoke. Inhaling steam by making yourself a cup of hot water will also help clear blocked noses and hydrate your vocal cords.

    Rest your voice by talking as little as possible. If you do need to talk, don’t whisper – this strains the muscles.

    Instead, consider using “confidential voice”. This is a soft voice – not a whisper – that gently vibrates your vocal cords but puts less strain on your voice than normal speech. Think of the voice you use when communicating with someone close by.

    During the first five to ten days of your infection, it is important not to push through. Exerting the voice by talking a lot or loudly will only exacerbate the situation. Once you’ve recovered from your cold, you can speak as you would normally.

    What should you do if your voice is still hoarse after recovery?

    If your voice hasn’t returned to normal after two to three weeks, you should seek medical attention from your doctor, who may refer you to an ear nose and throat specialist.

    If you’ve developed a nodule, the specialist would likely refer you to a speech pathologist who will show you how to take care of your voice. Many nodules can be treated with voice therapy and don’t require surgery.

    You may have also developed a habit of straining your vocal cords, if you forced yourself to speak or sing while they were inflamed. This can be a reason why some people continue to have a hoarse voice even when they’ve recovered from the cold.

    In those cases, a speech pathologist may play a valuable role. They may teach you to exercises that make voicing more efficient. For example, lip trills (blowing raspberries) are a fun and easy way you can learn to relax the voice. This can help break the habit of straining your voice you may have developed during infection.

    Yeptain Leung, Postdoctoral Research and Lecturer of Speech Pathology, School of Health Sciences, The University of Melbourne

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • The Polyvagal Theory – by Dr. Stephen Porges

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    Do you ever find that your feelings (or occasionally: lack thereof) sometimes can seem mismatched with the observed facts of your situation? This book unravels that mystery—or rather, that stack of mysteries.

    Dr. Porges’ work on this topic is, by the way, the culmination of 40 years of research. While he’s not exactly a household name to the layperson, he’s very respected in his field, and this book is his magnum opus.

    Here he explains the disparate roles of the two branches of the vagus nerve (hence: polyvagal theory). At least, the two branches that we mammals have; non-mammalian vertebrates have only one. This makes a big difference, because of the cascade of inhibitions that this allows.

    The answer to the very general question “What stops you from…?” is usually found somewhere down this line of cascade of inhibitions.

    These range from “what stops you from quitting your job/relationship/etc” to “what stops you from freaking out” to “what stops you from relaxing” to “what stops you from reacting quickly” to “what stop you from giving up” to “what stops you from gnawing your arm off” and many many more.

    And because sometimes we wish we could do something that we can’t, or wish we wouldn’t do something that we do, understanding this process can be something of a cheat code to life.

    A quick note on style: the book is quite dense and can be quite technical, but should be comprehensible to any layperson who is content to take their time, because everything is explained as we go along.

    Bottom line: if you’d like to better understand the mysteries of how you feel vs how you actually are, and what that means for what you can or cannot wilfully do, this is a top-tier book

    Click here to check out Polyvagal Theory, and take control of your responses!

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  • Apple Cider Vinegar vs Apple Cider Vinegar Gummies – Which is Healthier?

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    Our Verdict

    When comparing apple cider vinegar (bottled) to apple cider vinegar (gummies), we picked the bottled.

    Why?

    There are several reasons!

    The first reason is about dosage. For example, the sample we picked for apple cider vinegar gummies, boasts:

    2 daily chewable gummies deliver 800 mg of Apple Cider Vinegar a day, equivalent to a teaspoon of liquid apple cider vinegar

    That sounds good until you note that it’s recommended to take 1–2 tablespoons (not teaspoons) of apple vinegar. So this would need more like 4–8 gummies to make the dose. Suddenly, either that bottle of gummies is running out quickly, or you’re just not taking a meaningful dose and your benefits will likely not exceed placebo.

    The other is reason about sugar. Most apple cider vinegar gummies are made with some kind of sugar syrup, often even high-fructose corn syrup, which is one of the least healthy foodstuffs (in the loosest sense of the word “foodstuffs”) known to science.

    The specific brand we picked today was the best we can find; it used maltitol syrup.

    Maltitol syrup, a corn derivative (and technically a sugar alcohol), has a Glycemic Index of 52, so it does raise blood sugars but not as much as sucrose would. However (and somewhat counterproductive to taking apple cider vinegar for gut health) it can cause digestive problems for many people.

    And remember, you’re taking 4–8 gummies, so this is amounting to several tablespoons of the syrup by now.

    On the flipside, apple cider vinegar itself has two main drawbacks, but they’re much less troublesome issues:

    • many people don’t like the taste
    • its acidic nature is not good for teeth

    To this the common advice for both is to dilute it with water, thus diluting the taste and the acidity.

    (this writer shoots hers from a shot glass, thus not bathing the teeth since it passes them “without touching the sides”; as for the taste, well, I find it invigorating—I do chase it with water, though to be sure of not leaving vinegar in my mouth)

    Want to check them out for yourself?

    Here they are:

    Apple cider vinegar | Apple cider vinegar gummies

    Want to know more about apple cider vinegar?

    Check out:

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  • 10 Ways To Naturally Boost Dopamine

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    Dopamine is the “reward” hormone, and is responsible for motivation, as well as various oft-forgotten functions (such as spatial skills, motor functions, task processing, planning, and language). Sometimes, our relationship with dopamine isn’t what it could be, so here’s how to fix that:

    Let’s get hormone-hacking…

    Here are the 10 ways:

    1. The seesaw effect: reduce overstimulation by taking tolerance breaks from high-dopamine activities that aren’t particularly useful (like social media or phone games), allowing for natural enjoyment of daily activities that you’d normally find enjoyable. Think: if you died and negotiated to be sent back to life on the condition you’d appreciate it properly this time, what things would you then spend your time doing? It’s probably not Kingdom Crush Saga Farm 2, is it?
    2. Conscious state meditation: practise conscious state meditation, focusing inward to reduce anxiety and release dopamine. Even a few minutes a day can significantly enhance dopamine levels.
    3. Hack your REM cycles: optimize sleep, especially REM cycles, which produce the most dopamine. Aim to wake up after your final REM cycle to feel energized and happy.
    4. The runner’s high: engage in regular exercise, which boosts dopamine through physical exertion and can lead to feelings of relaxation and euphoria, often known as the “runner’s high.”
    5. Mood-enhancing music: listen to music that makes you feel good. Favorite songs can stimulate dopamine production, improving your mood and well-being.
    6. Bright light therapy: spend time in natural sunlight to stimulate dopamine production and elevate your mood, countering the negative effects of extended indoor time. If natural sunlight is not very available where you are (e.g. this writer who lives next to an ancient bog surrounded by fog and the days are getting short, at time of writing), then artificial daylight lamps are respectable supplement—but just that, a supplement, not a replacement. Despite how it looks/feels, natural sunlight (especially in the morning, to cue the circadian rhythm to do its thing) is beneficial even through cloud cover.
    7. Relieve stress for good: actively reduce stress, as it inhibits dopamine. Simplify daily routines and eliminate stressors to naturally boost dopamine and feel more relaxed. Of course, you cannot remove all stress from your life, so get good at managing the stress created by the stressors that do remain.
    8. Tap into your flow state: enter a “flow state” by focusing deeply on an engaging task, which can elevate dopamine levels and boost motivation and happiness.
    9. The hormesis effect: embrace mild physical challenges, like cold showers. The temporary discomfort will paradoxically increase dopamine (it’s the body’s way of saying “congratulations, you survived the hard thing, here’s a little treat, so that you’ll be motivated to survive the next hard thing, too”)
    10. Activate your inner artist: engage in creative activities that you find fun. The process of creating boosts dopamine and provides motivation, enhancing mood and enjoyment in life.

    For more on all of these, enjoy:

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    Want to learn more?

    You might also like to read:

    Rebalancing Dopamine (Without “Dopamine Fasting”)

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  • The Dopamine Precursor And More

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    What Is This Supplement “NALT”?

    N-Acetyl L-Tyrosine (NALT) is a form of tyrosine, an amino acid that the body uses to build other things. What other things, you ask?

    Well, like most amino acids, it can be used to make proteins. But most importantly and excitingly, the body uses it to make a collection of neurotransmitters—including dopamine and norepinephrine!

    • Dopamine you’ll probably remember as “the reward chemical” or perhaps “the motivation molecule”
    • Norepinephrine, also called noradrenaline, is what powers us up when we need a burst of energy.

    Both of these things tend to get depleted under stressful conditions, and sometimes the body can need a bit of help replenishing them.

    What does the science say?

    This is Research Review Monday, after all, so let’s review some research! We’re going to dive into what we think is a very illustrative study:

    A 2015 team of researchers wanted to know whether tyrosine (in the form of NALT) could be used as a cognitive enhancer to give a boost in adverse situations (times of stress, for example).

    They noted:

    ❝The potential of using tyrosine supplementation to treat clinical disorders seems limited and its benefits are likely determined by the presence and extent of impaired neurotransmitter function and synthesis.❞

    More on this later, but first, the positive that they also found:

    ❝In contrast, tyrosine does seem to effectively enhance cognitive performance, particularly in short-term stressful and/or cognitively demanding situations. We conclude that tyrosine is an effective enhancer of cognition, but only when neurotransmitter function is intact and dopamine and/or norepinephrine is temporarily depleted❞

    That “but only”, is actually good too, by the way!

    You do not want too much dopamine (that could cause addiction and/or psychosis) or too much norepinephrine (that could cause hypertension and/or heart attacks). You want just the right amount!

    So it’s good that NALT says “hey, if you need some more, it’s here, if not, no worries, I’m not going to overload you with this”.

    Read the study: Effect of tyrosine supplementation on clinical and healthy populations under stress or cognitive demands

    About that limitation…

    Remember they said that it seemed unlikely to help in treating clinical disorders with impaired neurotransmitter function and/or synthesis?

    Imagine that you employ a chef in a restaurant, and they can’t keep up with the demand, and consequently some of the diners aren’t getting fed. Can you fix this by supplying the chef with more ingredients?

    Well, yes, if and only if the problem is “the chef wasn’t given enough ingredients”. If the problem is that the oven (or the chef’s wrist) is broken, more ingredients aren’t going to help at all—something different is needed in those cases.

    So it is with, for example, many cases of depression.

    See for example: Tyrosine for depression: a double-blind trial

    About blood pressure…

    You may be wondering, “if NALT is a precursor of norepinephrine, a vasoconstrictor, will this increase my blood pressure adversely?”

    Well, check with your doctor as your own situation may vary, but under normal circumstances, no. The effect of NALT is adaptogenic, meaning that it can help keep its relevant neurotransmitters at healthy levels—not too low or high.

    See what we mean, for example in this study where it actually helped keep blood pressure down while improving cognitive performance under stress:

    Effect of tyrosine on cognitive function and blood pressure under stress

    Bottom line:

    For most people, NALT is a safe and helpful way to help keep healthy levels of dopamine and norepinephrine during times of stress, giving cognitive benefits along the way.

    Don’t Forget…

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