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.
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.
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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Fat’s Real Barriers To Health
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Fat Justice In Healthcare
This is Aubrey Gordon, an author, podcaster, and fat justice activist. What does that mean?
When it comes to healthcare, we previously covered some ideas very similar to her work, such as how…
There’s a lot of discrimination in healthcare settings
In this case, it often happens that a thin person goes in with a medical problem and gets treated for that, while a fat person can go in with the same medical problem and be told “you should try losing some weight”.
Top tip if this happens to you… Ask: “what would you advise/prescribe to a thin person with my same symptoms?”
Other things may be more systemic, for example:
When a thin person goes to get their blood pressure taken, and that goes smoothly, while a fat person goes to get their blood pressure taken, and there’s not a blood pressure cuff to fit them, is the problem the size of the person or the size of the cuff? It all depends on perspective, in a world built around thin people.
That’s a trivial-seeming example, but the same principle has far-reaching (and harmful) implications in healthcare in general, e.g:
- Surgeons being untrained (and/or unwilling) to operate on fat people
- Getting a one-size-fits-all dose that was calculated using average weight, and now doesn’t work
- MRI machines are famously claustrophobia-inducing for thin people; now try not fitting in it in the first place
…and so forth. So oftentimes, obesity will be correlated with a poor healthcare outcome, where the problem is not actually the obesity itself, but rather the system having been set up with thin people in mind.
It would be like saying “Having O- blood type results in higher risks when receiving blood transfusions”, while omitting to add “…because we didn’t stock O- blood”.
Read more on this topic: Shedding Some Obesity Myths
Does she have practical advice about this?
If she could have you understand one thing, it would be:
You deserve better.
Or if you are not fat: your fat friends deserve better.
How this becomes useful is: do not accept being treated as the problem!
Demand better!
If you meekly accept that you “just need to lose weight” and that thus you are the problem, you take away any responsibility from your healthcare provider(s) to actually do their jobs and provide healthcare.
See also Gordon’s book, which we’ve not reviewed yet but probably will one of these days:
“You Just Need to Lose Weight”: And 19 Other Myths About Fat People – by Aubrey Gordon
Are you saying fat people don’t need to lose weight?
That’s a little like asking “would you say office workers don’t need to exercise more?”; there are implicit assumptions built into the question that are going unaddressed.
Rather: some people might benefit healthwise from losing weight, some might not.
In fact, over the age of 65, being what is nominally considered “overweight” reduces all-cause mortality risk.
For details of that and more, see: When BMI Doesn’t Measure Up
But what if I do want/need to lose weight?
Gordon’s not interested in helping with that, but we at 10almonds are, so…
Check out: Lose Weight, But Healthily
Where can I find more from Aubrey Gordon?
You might enjoy her blog:
Aubrey Gordon | Your Fat Friend
Or her other book, which we reviewed previously:
What We Don’t Talk About When We Talk About Fat – by Aubrey Gordon
Enjoy!
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Flossing Without Flossing?
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Flossing Without Flossing?
You almost certainly brush your teeth. You might use mouthwash. A lot of people floss for three weeks at a time, often in January.
There are a lot of options for oral hygiene; variations of the above, and many alternatives too. This is a big topic, so rather than try to squeeze it all in one, this will be a several-part series.
The first part was: Toothpastes & Mouthwashes: Which Help And Which Harm?
How important is flossing?
Interdental cleaning is indeed pretty important, even though it may not have the heart health benefits that have been widely advertised:
However! The health of our gums is very important in and of itself, especially as we get older:
Flossing Is Associated with Improved Oral Health in Older Adults
But! It helps to avoid periodontal (e.g. gum) disease, not dental caries:
Flossing for the management of periodontal diseases and dental caries in adults
And! Most certainly it can help avoid a stack of other diseases:
Interdental Cleaning Is Associated with Decreased Oral Disease Prevalence
…so in short, if you’d like to have happy healthy teeth and gums, flossing is an important adjunct, and/but not a one-stop panacea.
Is it better to floss before or after brushing?
As you prefer. A team of scientists led by Dr. Claudia Silva studied this, and found that there was “no statistical difference between brush-floss and floss-brush”:
Flossing is tedious. How do we floss without flossing?
This is (mostly) about water-flossing! Which does for old-style floss what sonic toothbrushes to for old-style manual toothbrushes.
If you’re unfamiliar, it means using a device that basically power-washes your teeth, but with a very narrow high-pressure jet of water.
Do they work? Yes:
As for how it stacks up against traditional flossing, Liang et al. found:
❝In our previous single-outcome analysis, we concluded that interdental brushes and water jet devices rank highest for reducing gingival inflammation while toothpick and flossing rank last.
In this multioutcome Bayesian network meta-analysis with equal weight on gingival inflammation and bleeding-on-probing, the surface under the cumulative ranking curve was 0.87 for water jet devices and 0.85 for interdental brushes.
Water jet devices and interdental brushes remained the two best devices across different sets of weightings for the gingival inflammation and bleeding-on-probing. ❞
~ Journal of Evidence-Based Dental Practice
You may be wondering how safe it is if you have had dental work done, and, it appears to be quite safe, for example:
BDJ | Water-jet flossing: effect on composites
Want to try water-flossing?
Here are some examples on Amazon:
- Waterpik Complete Care 9.0 ← example of a top-end water-flossing device
- Philips Sonicare Power Flosser 3000 ← top-tier not-Waterpik-brand device
- INSMART Cordless Water Dental Flosser ← very low price and still average 4.5 star reviews, so in our opinion, a fine first choice
Bonus: if you haven’t tried interdental brushes, here’s an example for that
Enjoy!
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Cottage cheese is back and all over TikTok. Two dietitians explain why social media’s obsessed
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You might remember cottage cheese from your childhood. Back then, it was considered “diet food”. You ate it out of the tub, with celery or spread it on crackers for a low-calorie snack. Then cottage cheese went out of fashion.
But cottage cheese is having a resurgence. In recent months, Google searches for “cottage cheese” have risen to the highest levels since 2004.
Social media influencers have been promoting its benefits on TikTok and Instagram with hashtags such as #cottagecheese, #cottagecheeseforlife, and #cottagecheeserecipe. Sales of cottage cheese around the world have skyrocketed.
Let’s see why cottage cheese is having such a moment.
Karolina Kaboompics/Pexels What is cottage cheese?
Cottage cheese is a fresh dairy cheese product with a mild flavour and a slightly tangy taste. It is made by curdling cow’s milk, then draining the whey, leaving behind the curds. These curds are usually small and lumpy, and the texture can vary from creamy to dry, depending on the amount of whey left in the cheese.
The term “cottage cheese” is said to have originated because the cheese was generally made in cottage-type houses from leftover milk, after making butter.
Cottage cheese is cheap, costing about A$12 per kilogram in the supermarket, similar to ricotta cheese.
It’s also surprisingly simple to make at home using freely available recipes. All you need is milk, salt and a splash of vinegar.
We’re using cottage cheese in new ways
It’s difficult to know what started the latest cottage cheese trend. But the creativity of social media means people are sharing alternative ways to use cottage cheese, changing people’s views from it being boring and lacking flavour to it being versatile and healthy.
People are spreading cottage cheese on toast and using it to make dishes such as porridge, dips, salads, bread and flatbreads. They’re using it in cakes and scones, and in desserts such as mousse and ice cream.
Is cottage cheese healthy?
Compared with other cheeses, cottage cheese is low in fat and therefore energy (kilojoules or kJ). This makes it a smart choice for people looking to cut down on their daily energy intake.
For example, 100 grams of cottage cheese contains about 556kJ. The same amount of cheddar contains 1,254kJ and parmesan 1,565kJ.
Many cheeses are rich in protein but they often contain higher amounts of kilojoules due to their fat content. But cottage cheese has substantial amounts of protein with fewer kilojoules.
This makes cottage cheese an ideal option for people aiming to maximise their protein intake without eating large amounts of kilojoules.
Some 100g of cottage cheese provides 17g protein. This is about the same found in three eggs, 60g chicken breast or 320 millilitres (about 300g) full-fat yoghurt.
People are sharing images of their cottage cheese creations on TikTok and Instagram. New Africa/Shutterstock Cottage cheese also contains high levels of vitamin B12 (important for healthy brain function), riboflavin (supports healthy skin and eyes), phosphorus (helps build strong bones and teeth) and folate (essential for cell growth).
However, cottage cheese is lower in calcium compared with other cheeses. It contains just 89 milligrams per 100g. This compares with parmesan (948mg), haloumi (620mg) and ricotta (170mg).
You’ve convinced me. How can I use cottage cheese?
Beyond its excellent nutrition profile, the resurgence of cottage cheese is enabling people to experiment in the kitchen. Its neutral flavour and varied textures – ranging from smooth to chunky – makes it suitable for a range of dishes, from sweet to savoury.
TikTok and Instagram have some great recipes. You could start with an old faithful recipe of celery and cottage cheese, and work your way towards new options such as cottage cheese ice cream.
The healthiest recipes will be those that combine cottage cheese with wholefoods such as fruits, vegetables, nuts and seeds, and lean protein sources.
For instance, you can make a cottage cheese wrap then fill it with vegetables and a lean source of protein (such as chicken or fish).
Other combinations include cottage cheese salad dressings, vegetable dips and egg salads.
Cottage cheese’s rise in popularity is well deserved. Including more cottage cheese in your diet is a smart choice for getting a high dose of protein without adding processed ingredients or too much energy. Embrace the trend and get creative in the kitchen.
Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Surgery is the default treatment for ACL injuries in Australia. But it’s not the only way
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The anterior cruciate ligament (ACL) is an important ligament in the knee. It runs from the thigh bone (femur) to the shin bone (tibia) and helps stabilise the knee joint.
Injuries to the ACL, often called a “tear” or a “rupture”, are common in sport. While a ruptured ACL has just sidelined another Matildas star, people who play sport recreationally are also at risk of this injury.
For decades, surgical repair of an ACL injury, called a reconstruction, has been the primary treatment in Australia. In fact, Australia has among the highest rates of ACL surgery in the world. Reports indicate 90% of people who rupture their ACL go under the knife.
Although surgery is common – around one million are performed worldwide each year – and seems to be the default treatment for ACL injuries in Australia, it may not be required for everyone.
PeopleImages.com – Yuri A/Shutterstock What does the research say?
We know ACL ruptures can be treated using reconstructive surgery, but research continues to suggest they can also be treated with rehabilitation alone for many people.
Almost 15 years ago a randomised clinical trial published in the New England Journal of Medicine compared early surgery to rehabilitation with the option of delayed surgery in young active adults with an ACL injury. Over half of people in the rehabilitation group did not end up having surgery. After five years, knee function did not differ between treatment groups.
The findings of this initial trial have been supported by more research since. A review of three trials published in 2022 found delaying surgery and trialling rehabilitation leads to similar outcomes to early surgery.
A 2023 study followed up patients who received rehabilitation without surgery. It showed one in three had evidence of ACL healing on an MRI after two years. There was also evidence of improved knee-related quality of life in those with signs of ACL healing compared to those whose ACL did not show signs of healing.
Experts used to think an ACL tear couldn’t heal without surgery – now there’s evidence it can. SKYKIDKID/Shutterstock Regardless of treatment choice the rehabilitation process following ACL rupture is lengthy. It usually involves a minimum of nine months of progressive rehabilitation performed a few days per week. The length of time for rehabilitation may be slightly shorter in those not undergoing surgery, but more research is needed in this area.
Rehabilitation starts with a physiotherapist overseeing simple exercises right through to resistance exercises and dynamic movements such as jumping, hopping and agility drills.
A person can start rehabilitation with the option of having surgery later if the knee remains unstable. A common sign of instability is the knee giving way when changing direction while running or playing sports.
To rehab and wait, or to go straight under the knife?
There are a number of reasons patients and clinicians may opt for early surgical reconstruction.
For elite athletes, a key consideration is returning to sport as soon as possible. As surgery is a well established method, athletes (such as Matilda Sam Kerr) often opt for early surgical reconstruction as this gives them a more predictable timeline for recovery.
At the same time, there are risks to consider when rushing back to sport after ACL reconstruction. Re-injury of the ACL is very common. For every month return to sport is delayed until nine months after ACL reconstruction, the rate of knee re-injury is reduced by 51%.
For people who opt to try rehabilitation, the option of having surgery later is still there. PeopleImages.com – Yuri A/Shutterstock Historically, another reason for having early surgical reconstruction was to reduce the risk of future knee osteoarthritis, which increases following an ACL injury. But a review showed ACL reconstruction doesn’t reduce the risk of knee osteoarthritis in the long term compared with non-surgical treatment.
That said, there’s a need for more high-quality, long-term studies to give us a better understanding of how knee osteoarthritis risk is influenced by different treatments.
Rehab may not be the only non-surgical option
Last year, a study looking at 80 people fitted with a specialised knee brace for 12 weeks found 90% had evidence of ACL healing on their follow-up MRI.
People with more ACL healing on the three-month MRI reported better outcomes at 12 months, including higher rates of returning to their pre-injury level of sport and better knee function. Although promising, we now need comparative research to evaluate whether this method can achieve similar results to surgery.
What to do if you rupture your ACL
First, it’s important to seek a comprehensive medical assessment from either a sports physiotherapist, sports physician or orthopaedic surgeon. ACL injuries can also have associated injuries to surrounding ligaments and cartilage which may influence treatment decisions.
In terms of treatment, discuss with your clinician the pros and cons of management options and whether surgery is necessary. Often, patients don’t know not having surgery is an option.
Surgery appears to be necessary for some people to achieve a stable knee. But it may not be necessary in every case, so many patients may wish to try rehabilitation in the first instance where appropriate.
As always, prevention is key. Research has shown more than half of ACL injuries can be prevented by incorporating prevention strategies. This involves performing specific exercises to strengthen muscles in the legs, and improve movement control and landing technique.
Anthony Nasser, Senior Lecturer in Physiotherapy, University of Technology Sydney; Joshua Pate, Senior Lecturer in Physiotherapy, University of Technology Sydney, and Peter Stubbs, Senior Lecturer in Physiotherapy, University of Technology Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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12 Things Your Urine Says About Your Health (Test At Home)
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Urine has been used to assess health since Ancient Egypt (fun fact: because of Egyptian language having multiple sounds that get transliterated to “a” in English, the condition of passing blood in one’s urine was known as “Aaaaa” ← this word has three syllables; “Aa-a-aa”).
Modern techniques are more advanced than those of times past (for example, diabetes is no longer diagnosed by a urine taste-test), but basic urine inspection is still a very useful indicator of many things. Recognizing changes in urine can even help detect life-threatening conditions early:
Traffic lights?
How urine works: water that we consume is absorbed into the bloodstream and filtered by the kidneys. Urine is essentially blood with actual the blood cells filtered out and/or broken down. The yellow color comes from urochrome, produced during red blood cell breakdown. Here’s how things can happen a little differently:
- Fluorescent yellow: caused by excess vitamin B2 from supplements; harmless.
- Red urine: can indicate blood (bladder cancer, UTIs), hemoglobin, or myoglobin; seek medical attention.
- Dark brown/tea-colored urine: may result from muscle damage or blood cell destruction; requires evaluation.
- Orange urine: caused by dehydration, medications, or liver/bile duct issues (if paired with pale stools).
- Purple urine: UTI bacteria produce pigments that can cause this; treatable with antibiotics.
- Green urine: rare; caused by medications or dyes like methylene blue.
- Frothy/foamy urine: indicates high protein levels, often from kidney damage (e.g. per diabetes and/or hypertension).
- Crystal-clear urine: suggests overhydration, which can dangerously lower sodium levels.
- Dark yellow/amber urine: may mean dehydration; drink more water to maintain a light yellow color.
- Not peeing enough: may indicate severe dehydration or kidney failure; urgent medical attention needed.
- Peeing too much: often linked to diabetes or excessive water intake; can lead to dehydration or low sodium.
- Color-changing urine: port wine color signals porphyria; black urine indicates alkaptonuria (oxidation of homogentisic acid). Both are serious.
Bonus: if you eat a lot of beetroot and then your urine is pink/red/purple, that’s probably just the pigments passing through. If it persists though, then of course, see above.
For more on each of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Why You Don’t Need 8 Glasses Of Water Per Day
Take care!
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3 Day Juice Fasting? Not So Fast!
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Juice fasts are trending… Again. They have been before, and this will probably not be the last time either.
The rationale is that by having nothing but fruit and/or vegetable juice for a few days, the body can clear itself of toxins while it’s not being preoccupied by dealing with what you’re eating on a daily basis.
This is not bad in theory, and in fact is a sort of parallel to the actually good advice to help the liver regenerate—by abstaining from things that the liver has to do hard work about, it has more internal resources to devote to taking care of itself.
Learn more about this: How To Unfatty A Fatty Liver
Just one problem
By having only juice for a few days, you are doing the opposite of what the liver needs.
In fact, by giving it what’s basically straight sugars in water with no fiber and not even any fats to slow it down, you are making your liver work overtime to deal with the flood of sugars, and it will not cope well.
Indeed, processed carbs without sufficient fiber are one of the main drivers of non-alcoholic fatty liver disease.
And yes, that’s what juice is: processed carbs without fiber
(juicing is a process!)
You can read more about the science of that, here:
From Apples to Bees, and High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same? ← we get into quite some detail about how, exactly, such a harmless-seeming thing as fruit juice messes up the liver so badly
Here be (more) science
A three-day interventional study was performed on juicing and microbiome health, with three groups:
- Juice only
- Juice with whole foods
- Only whole plant-based foods
The results?
- Juice only: biggest growth in bacteria that cause inflammation and gut permeability (that’s bad; very bad)
- Juice with whole foods: the same bad effects, but much less pronounced than the juice-only group
- Only whole plant-based food: notable improvements in the microbiome
That’s what the changes were immediately post-intervention; what’s interesting to note is that the bad effects of the juice-only group also lingered longer, whereas the juice+food group enjoyed a relatively quicker recovery in the two weeks after the intervention.
Here’s the paper itself; be warned, you’ll be reading a lot about feces and saliva alongside eating and drinking:
Effects of Vegetable and Fruit Juicing on Gut and Oral Microbiome Composition
Ok, what can I do to detox?
Well, the advice we gave up top in the linked article about liver health is very sound, and also you might like to check out:
Detox: What’s Real, What’s Not, What’s Useful, What’s Dangerous?
Want to learn more?
Here’s a video explainer from the ever-charming French biochemist Jessie Inchauspé (and our own text overview, for those who prefer reading):
Fruit Is Healthy; Juice Isn’t (Here’s Why)
Take care!
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