Sciatica Exercises & Home Treatment – by Dr. George Best
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Dr. Best is a doctor of chiropractic, but his work here is compelling. He starts by giving an overview of the relevant anatomy, and then the assorted possible causes of sciatica, before moving on to the treatments.
As is generally the case for chiropractic, nothing here will be “cured”, but it will give methods for ongoing management to keep you pain-free—which in the case of sciatica, is usually the single biggest thing that most people suffering from it most dearly want.
We get to read a lot about self-massage and exercises, of the (very well-evidenced; about the most well-evidenced thing there is for back pain) McKenzie technique exercises, as well as assorted acupressure-based techniques that are less well-evidenced but have good anecdotal support.
He also writes about preventing sciatica—which if you already have it, that doesn’t mean it’s too late; it just means, in that case do these things (along with the aforementioned exercises) to gradually reverse the harm done and get back to where you were pre-sciatica.
Lastly, he does also speak on when signs might point to your problems being beyond the scope of this book, and seeking professional examination if you haven’t already.
The style throughout is straight to the point, informative, and instructional. There is zero fluff or padding, and no sensationalization. There are diagrams and illustrative photos where appropriate.
Bottom line: if you have, or fear the threat of, sciatica, then this is an excellent book to have and use its exercises.
Click here to check out Sciatica Exercises & Home Treatment, and live pain-free!
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What is a virtual emergency department? And when should you ‘visit’ one?
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For many Australians the emergency department (ED) is the physical and emblematic front door to accessing urgent health-care services.
But health-care services are evolving rapidly to meet the population’s changing needs. In recent years, we’ve seen growing use of telephone, video, and online health services, including the national healthdirect helpline, 13YARN (a crisis support service for First Nations people), state-funded lines like 13 HEALTH, and bulk-billed telehealth services, which have helped millions of Australians to access health care on demand and from home.
The ED is similarly expanding into new telehealth models to improve access to emergency medical care. Virtual EDs allow people to access the expertise of a hospital ED through their phone, computer or tablet.
All Australian states and the Northern Territory have some form of virtual ED at least in development, although not all of these services are available to the general public at this stage.
So what is a virtual ED, and when is it appropriate to consider using one?
Shutterstock/Nils Versemann How does a virtual ED work?
A virtual ED is set up to mirror the way you would enter the physical ED front door. First you provide some basic information to administration staff, then you are triaged by a nurse (this means they categorise the level of urgency of your case), then you see the ED doctor. Generally, this all takes place in a single video call.
In some instances, virtual ED clinicians may consult with other specialists such as neurologists, cardiologists or trauma experts to make clinical decisions.
A virtual ED is not suitable for managing medical emergencies which would require immediate resuscitation, or potentially serious chest pains, difficulty breathing or severe injuries.
A virtual ED is best suited to conditions that require immediate attention but are not life-threatening. These could include wounds, sprains, respiratory illnesses, allergic reactions, rashes, bites, pain, infections, minor burns, children with fevers, gastroenteritis, vertigo, high blood pressure, and many more.
People with these sorts of conditions and concerns may not be able to get in to see a GP straight away and may feel they need emergency advice, care or treatment.
When attending the ED, they can be subject to long wait times and delayed specialist attention because more serious cases are naturally prioritised. Attending a virtual ED may mean they’re seen by a doctor more quickly, and can begin any relevant treatment sooner.
From the perspective of the health-care system, virtual EDs are about redirecting unnecessary presentations away from physical EDs, helping them be ready to respond to emergencies. The virtual ED will not hesitate in directing callers to come into the physical ED if staff believe it is an emergency.
The doctor in the virtual ED may also direct the patient to a GP or other health professional, for example if their condition can’t be assessed visually, or if they need physical treatment.
The results so far
Virtual EDs have developed significantly over the past three years, predominantly driven by the COVID pandemic. We are now starting to slowly see assessments of these services.
A recent evaluation my colleagues and I did of Queensland’s Metro North Virtual ED found roughly 30% of calls were directed to the physical ED. This suggests 70% of the time, cases could be managed effectively by the virtual ED.
Preliminary data from a Victorian virtual ED indicates it curbed a similar rate of avoidable ED presentations – 72% of patients were successfully managed by the virtual ED alone. A study on the cost-effectiveness of another Victorian virtual ED suggested it has the potential to generate savings in health-care costs if it prevents physical ED visits.
Only 1.2% of people assessed in Queensland’s Metro North Virtual ED required unexpected hospital admission within 48 hours of being “discharged” from the virtual ED. None of these cases were life-threatening. This indicates the virtual ED is very safe.
The service experienced an average growth rate of 65% each month over a two-year evaluation period, highlighting increasing demand and confidence in the service. Surveys suggested clinicians also view the virtual ED positively.
The right advice could tell you whether you need to visit hospital in person or not. 1st footage/Shutterstock What now?
We need further research into patient outcomes and satisfaction, as well as the demographics of those using virtual EDs, and how these measures compare to the physical ED across different triage categories.
There are also challenges associated with virtual EDs, including around technology (connection and skills among patients and health professionals), training (for health professionals) and the importance of maintaining security and privacy.
Nonetheless, these services have the potential to reduce congestion in physical EDs, and offer greater convenience for patients.
Eligibility differs between different programs, so if you want to use a virtual ED, you may need to check you are eligible in your jurisdiction. Most virtual EDs can be accessed online, and some have direct phone numbers.
Jaimon Kelly, Senior Research Fellow in Telehealth delivered health services, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Tomatoes vs Carrots – Which is Healthier?
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Our Verdict
When comparing tomatoes to carrots, we picked the carrots.
Why?
Both known for being vitamin-A heavyweights, there is nevertheless a clear winner:
In terms of macros, carrots have a little over 2x the carbs, and/but also a little over 2x the fiber, so we consider category this a win for carrots.
In the category of vitamins, tomatoes have more vitamin C, while carrots have more of vitamins A, B1, B2, B3, B5, B6, B9, E, K, and choline. And about that vitamin A specifically: carrots have over 20x the vitamin A of tomatoes. An easy win for carrots here!
When it comes to minerals, tomatoes have a little more copper, while carrots have more calcium, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc. Another clear win for carrots.
Looking at polyphenols, carrots are good but tomatoes have more, including a good healthy dose of quercetin; they also have more lycopene, not technically a polyphenol by virtue of its chemical structure (it’s a carotenoid), but a powerful phytochemical nonetheless (and much more prevalent in sun-dried tomatoes, in any case, which is not what we were looking at today—perhaps another day we’ll do sun-dried tomatoes and carrots head-to-head!).
Still, a) carrots are not short of carotenoids either (including lycopene), and b) we don’t think the moderate win on polyphenols is enough to outdo carrots having won all the other categories.
All in all, carrots win the day, but of course, do enjoy either or both; diversity is good!
Want to learn more?
You might like to read:
Lycopene’s Benefits For The Gut, Heart, Brain, & More
Enjoy!
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Reading As A Cognitive Exercise
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Reading, Better
It is relatively uncontroversial to say that reading is good for cognitive health, but we don’t like to make claims without science if we can help it, so let’s get started:
There was a 2021 study, which found that even when controlling for many other factors, including highest level of education, socioeconomic status, and generalized pre-morbid intelligence:
❝high reading activity, as defined by almost daily reading, was associated with lower odds of cognitive decline, compared to low reading activity❞
Source: Can reading increase cognitive reserve?
However, not all reading is the same. And this isn’t just about complexity or size of vocabulary, either. It’s about engagement.
And that level of engagement remains the key factor, no matter how quickly or slowly someone reads, as the brain tends to automatically adjust reading speed per complexity, because the brain’s “processing speed” remains the same:
Read more: Cognitive coupling during reading
Everyone’s “processing speed” is different (and is associated with generalized intelligence and executive functions), though as a general rule of thumb, the more we practice it, the faster our processing speed gets. So if you balked at the notion of “generalized intelligence” being a factor, be reassured that this association goes both ways.
So is the key to just read more?
That’s a great first step! But…
The key factor still remains: engagement.
So what does that mean?
It is not just the text that engages you. You must also engage the text!
This is akin to the difference between learning to drive by watching someone else do it, and learning by getting behind the wheel and having a go.
When it comes to reading, it should not be a purely passive thing. Sure, if you are reading a fiction book at bedtime, get lost in it, by all means. But when it comes to non-fiction reading, engage with it actively!
For example, I (your writer here, hi), when reading non-fiction:
- Read at what is generally considered an unusually fast pace, but
- Write so many notes in the margins of physical books, and
- Write so many notes using the “Notes” function on my Kindle
And this isn’t just like a studious student taking notes. Half the time I am…
- objecting to content (disagreeing with the author), or
- at least questioning it, or which is especially important, or
- noting down questions that came to my mind as a result of what I am reading.
This latter is a bit like:
- when you are reading 10almonds, sometimes you will follow our links and go off down a research rabbit-hole of your own, and that’s great!
- sometimes you will disagree with something and write to tell us, and that’s great too (when this happens, one or the other or all of us will learn something, and yes, we have published corrections before now)!
- sometimes what you read here will prompt a further question, and you’ll send that to us, and guess what, also great! We love questions.
Now, if your enjoyment of 10almonds is entirely passive, don’t let us stop you (we know our readers like quick-and-easy knowledge, and that’s good too), it’s just, the more you actively engage with it, the more you’ll get out of it.
This, by the way, was also a lifelong habit of Leonardo da Vinci, which you can read about here:
How to Think Like Leonardo da Vinci: Seven Steps to Genius Every Day – by Michael J. Gelb
a very good book that we reviewed last year
How you read (i.e. what medium) matters too!
Are you reading this on a desktop/laptop, or a mobile device? That difference could matter more than the difference between paper and digital, according to this study from 2020 that found…
❝The cumulation of evidence from this and previous studies suggests that reading on a tablet affords different interactions between the reader and the text than reading on a computer screen.
Reading on a tablet might be more similar to reading on paper, and this may impact the attentional processes during reading❞
What if my mind wanders easily?
You can either go with it, or train to improve focus.
Going with it: just make sure you have more engaging reading to get distracted by. It’s all good.
Training focus: this is trickier, but worthwhile, as executive function (you will remember from earlier) was an important factor too, and training focus is training executive function.
As for one way to do that…
If you’d like a primer for getting going with that, then you may enjoy our previous main feature:
No-Frills, Evidence-Based Mindfulness
Enjoy!
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How Emotions Are Made – by Dr. Lisa Feldman Barrett
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We’ve previously reviewed Dr. Barrett’s (also good) book Seven And A Half Lessons About The Brain, and this one is very different, and of more practical use:
The main thrust of the book is: the bioessentialist model of emotions is flawed; there is also no Platonic perfect form of any given emotion, and in fact emotions are constructed by the brain as a learned adaptive response.
She argues this from the dual vectors of on the one hand hard sciences of affective neuroscience and clinical psychology, and on the other hand sociology and anthropology.
In the category of criticism: Dr. Barrett, a very well-known and well-respected cognitive neuroscientist, is not an expert on sociology and anthropology, and some of her claims there are verifiably false.
However, most of the book is given over the psychophysiology, which is entirely her thing, and she explains it clearly and simply while backing everything up with mountains of data.
The usefulness of this book is chiefly: if we understand that emotions are not innate and are instead constructed adaptive (and sometimes maladaptive) neurological responses to stimuli and associations, we can set about rewiring things a little in accord with what’s actually more beneficial to us. The book also outlines how.
Bottom line: if you’d like to be able to not merely manage emotions as they are, but also prune and/or grow them from the stem up, then this book provides a robustly scientific approach for doing that.
Click here to check out How Emotions Are Made, and get more discerning about yours!
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A Fresh Take On Hypothyroidism
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The Three Rs To Boost Thyroid-Related Energy Levels
This is Dr. Izabella Wentz. She’s a doctor of pharmacology, and after her own diagnosis with Hashimoto’s thyroiditis, she has taken it up as her personal goal to educate others on managing hypothyroidism.
Dr. Wentz is also trained in functional medicine through The Institute for Functional Medicine, Kalish Functional Medicine, and the American Academy of Anti-Aging Medicine. She is a Fellow of the American Society of Consultant Pharmacists, and holds certifications in Medication Therapy Management as well as Advanced Diabetes Care through the American Pharmacists Association. In 2013, she received the Excellence in Innovation Award from the Illinois Pharmacists Association.
Dr. Wentz’s mission
Dr. Wentz was disenchanted by the general medical response to hypothyroidism in three main ways. She tells us:
- Thyroid patients are not diagnosed appropriately.
- For this, she criticises over-reliance on TSH tests that aren’t a reliable marker of thyroid function, especially if you have Hashimoto’s.
- Patients should be better optimized on their medications.
- For this, she criticizes many prescribed drugs that are actually pro-drugs*, that don’t get converted adequately if you have an underactive thyroid.
- Lifestyle interventions are often ignored by mainstream medicine.
- Medicines are great; they truly are. But medicating without adjusting lifestyle can be like painting over the cracks in a crumbling building.
*a “pro-drug” is what it’s called when the drug we take is not the actual drug the body needs, but is a precursor that will get converted to that actual drug we need, inside our body—usually by the liver, but not always. An example in this case is T4, which by definition is a pro-drug and won’t always get correctly converted to the T3 that a thyroid patient needs.
Well that does indeed sound worthy of criticism. But what does she advise instead?
First, she recommends a different diagnostic tool
Instead of (or at least, in addition to) TSH tests, she advises to ask for TPO tests (thyroid peroxidase), and a test for Tg antibodies (thyroglobulin). She says these are elevated for many years before a change in TSH is seen.
Next, identify the root cause and triggers
These can differ from person to person, but in countries that add iodine to salt, that’s often a big factor. And while gluten may or may not be a factor, there’s a strong correlation between celiac disease and Hashimoto’s disease, so it is worth checking too. Same goes for lactose.
By “checking”, here we mean testing eliminating it and seeing whether it makes a difference to energy levels—this can be slow, though, so give it time! It is best to do this under the guidance of a specialist if you can, of course.
Next, get to work on repairing your insides.
Remember we said “this can be slow”? It’s because your insides won’t necessarily bounce back immediately from whatever they’ve been suffering from for what’s likely many years. But, better late than never, and the time will pass anyway, so might as well get going on it.
For this, she recommends a gut-healthy diet with specific dietary interventions for hypothyroidism. Rather than repeat ourselves unduly here, we’ll link to a couple of previous articles of ours, as her recommendations match these:
She also recommends regular blood testing to see if you need supplementary TSH, TPO antibodies, and T3 and T4 hormones—as well as vitamin B12.
Short version
After diagnosis, she recommends the three Rs:
- Remove the causes and triggers of your hypothyroidism, so far as possible
- Repair the damage caused to your body, especially your gut
- Replace the thyroid hormones and related things in which your body has become deficient
Learn more
If you’d like to learn more about this, she offers a resource page, with resources ranging from on-screen information, to books you can get, to links to hook you up with blood tests if you need them, as well as recommended supplements to consider.
She also has a blog, which has an interesting relevant article added weekly.
Enjoy, and take care of yourself!
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- Thyroid patients are not diagnosed appropriately.
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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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