Being Mortal – by Dr. Atul Gawande

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Maybe you want to “live forever or die trying”, and that’s an understandable goal… But are you prepared for “or die trying” being the outcome?

This is not a cheerful book, if you’re anything like this reviewer, you will need a little towel or something to mop up the tears while you read. But it’s worth it.

Dying is one thing; fighting for life is even generally considered a noble endeavor. Suffering alone isn’t fun, losing independence can feel humiliating, and seeing someone who was always a tower of strength, now a frail shadow of their former self, reduced to begging for something that they’re “not allowed”, can be worse.

Do we want that for ourselves? For our loved ones? Can there be a happy medium between that, and the alternative to indeed “go gentle into that good night”?

Dr. Gawande, a surgeon well-acquainted with death and dying, thinks so. But it involves work on our part, and being prepared for hard decisions.

  • What is most important to us, and what tradeoffs are we willing to make for it?
  • What, even, is actually an option to us with the resources available?
  • Can we make peace with a potentially bad lot? And… Should we?
  • When is fighting important, and when is it self-destructive?

These (and others) are all difficult questions posed by Dr. Gawande, but critical ones.

We don’t usually quote other people’s reviews when reviewing books here, but let’s consider the following words from the end of a long review on Amazon:

❝If “dying as we lived” is some kind of standard for how we should go, then maybe alone and medicalized makes some sense right now after all.❞

~ Pamela J. H.

Bottom line: we all deserve better than that. And if we don’t take the time to think about what’s most important, then time will take it from us. This very insightful book may not have all the answers, but it has the questions, and it can help a lot in exploring them and deciding what matters most to us in the end, really.

Click here to check out Being Mortal, and make every day count—because nothing matters more than that.

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  • Breast Milk’s Benefits That Are (So Far) Not Replicable

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Simply The Breast 🎶

    In Wednesday’s newsletter, we asked you for your opinion on breast vs formula milk (for babies!), and got the above-depicted, below-described, set of responses:

    • 80% said “Breast is best, as the slogan goes, and should be first choice”
    • 20% said “They both have their strengths and weaknesses; use whatever”
    • 0% said “Formula is formulated to be best, and should be first choice”

    That’s the first time we’ve ever had a possible poll option come back with zero votes whatsoever! It seems this topic is relatively uncontentious amongst our readership, so we’ll keep things brief today, but there is still a little mythbusting to be done.

    So, what does the science say?

    [Breast milk should be the first choice] at least for the few few weeks and months for the benefit of baby’s health as breast milk has protective factors formula does not: True or False?

    True! The wording here was taken from one of our readers’ responses, by the way (thank you, Robin). There are a good number of those protective factors, the most well-known of which is passing on immune cells and cell-like things; in other words, immune-related information being passed from parent* to child.

    *usually the mother, though in principle it could be someone else and in practice sometimes it is; the only real requirements are that the other person be healthy, lactating, and willing.

    As for immune benefits, see for example:

    Perspectives on Immunoglobulins in Colostrum and Milk

    And for that matter, also:

    Colostrum is required for the postnatal ontogeny of small intestine innate lymphoid type 2 cells and successful anti-helminth defences

    (Colostrum is simply the milk that is produced for a short period after giving birth; the composition of milk will tend to change later)

    In any case, immunoglobulin A is a very important component in breast milk (colostrum and later), as well as lactoferrin (has an important antimicrobial effect and is good for the newborn’s gut), and a plethora of cytokines:

    Cytokines in Human Milk

    As for that about the gut, lactoferrin isn’t the only breast milk component that benefits this, by far, and there’s a lot that can’t be replicated yet:

    Human Breast Milk and the Gastrointestinal Innate Immune System

    As long as your infant/child is nutritiously fed, it shouldn’t matter if it comes from breast or formula: True or False?

    False! Formula milk will not convey those immune benefits.

    This doesn’t mean that formula-feeding is neglectful; as several people who commented mentioned*, there are many reasons a person may not be able to breastfeed, and they certainly should not be shamed for that.

    *(including the reader whose words we borrowed for this True/False item; the words we quoted above were prefaced with: “Not everyone is able to breastfeed for many different reasons”)

    But, while formula milk is a very good second choice, and absolutely a respectable choice if breast milk isn’t an option (or an acceptable option) for whatever reason, it still does not convey all the health benefits of breast milk—yet! The day may come when they’ll find a way to replicate the immune benefits, but today is not that day.

    They both have their strengths and weaknesses: True or False?

    True! But formula’s strengths are only in the category of convenience and sometimes necessity—formula conveys no health benefits that breast milk could not do better, if available.

    For many babies, formula means they get to eat, when without it they would starve due to non-availability of breast milk. That’s a pretty important role!

    Note also: this is a health science publication, not a philosophical publication, but we’d be remiss not to mention one thing; let’s bring it in under the umbrella of sociology:

    The right to bodily autonomy continues to be the right to bodily autonomy even if somebody else wants/needs something from your body.

    Therefore, while there are indeed many good reasons for not being able to breastfeed, or even just not being safely* able to breastfeed, it is at the very least this writer’s opinion that nobody should be pressed to give their reason for not breastfeeding; “no” is already a sufficient answer.

    *Writer’s example re safety: when I was born, my mother was on such drugs that it would have been a very bad idea for her to breastfeed me. There are plenty of other possible reasons why it might be unsafe for someone one way or another, but “on drugs that have a clear ‘do not take while pregnant or nursing’ warning” is a relatively common one.

    All that said, for those who are willing and safely able, the science is clear: breast is best.

    Want to read more?

    The World Health Organization has a wealth of information (including explanations of its recommendations of, where possible, exclusive breastfeeding for the first 6 months, ideally continuing some breastfeeding for the first 2 years), here:

    World Health Organization | Breastfeeding

    Take care!

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  • How To Recover Quickly From A Stomach Bug

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    How To Recover Quickly From A Stomach Bug

    Is it norovirus, or did you just eat something questionable? We’re not doctors, let alone your doctors, and certainly will not try to diagnose from afar. And as ever, if unsure and/or symptoms don’t go away or do get worse, seek professional medical advice.

    That out of the way, we can give some very good general-purpose tips for this one…

    Help your immune system to help you

    So far as you can, you want a happy healthy immune system. For the most part, we’d recommend the following things:

    Beyond Supplements: The Real Immune-Boosters!

    …but you probably don’t want to be exercising with a stomach bug, so perhaps sit that one out. Exercise is the preventative; what you need right now is rest.

    Hydrate—but watch out

    Hydration is critical for recovery especially if you have diarrhea, but drinking too much water too quickly will just make things worse. Great options for getting good hydration more slowly are:

    • Peppermint tea
      • (peppermint also has digestion-settling properties)
    • Ginger tea
    • Broths
      • These will also help replenish your sodium and other nutrients, gently. Chicken soup for your stomach, and all that. A great plant-based option is sweetcorn soup.
      • By broths, we mean clear(ish) water-based soups. This is definitely not the time for creamier soups.

    ❝Milk and dairy products should be avoided for 24 to 48 hours as they can make diarrhea worse.

    Initial dietary choices when refeeding should begin with soups and broth.❞

    Source: American College of Gastroenterology

    Other things to avoid

    Caffeine stimulates the digestion in a way that can make things worse.

    Fat is more difficult to digest, and should also be avoided until feeling better.

    To medicate or not to medicate?

    Loperamide (also known by the brand name Imodium) is generally safe when used as directed.

    Click here to see its uses, dosage, side effects, and contraindications

    Antibiotics may be necessary for certain microbial infections, but should not be anyone’s first-choice treatment unless advised otherwise by your doctor/pharmacist.

    Note that if your stomach bug is not something that requires antibiotics, then taking antibiotics can actually make it worse as the antibiotics wipe out your gut bacteria that were busy helping fight whatever’s going wrong in there:

    A gentler helper

    If you want to give your “good bacteria” a hand while giving pathogens a harder time of it, then a much safer home remedy is a little (seriously, do not over do it; we are talking 1–2 tablespoons, or around 20ml) apple cider vinegar, taken diluted in a glass of water.

    ❝Several studies indicate apple cider vinegar (ACV)’s usefulness in lowering postprandial glycemic response, specifically by slowing of gastric motility❞

    (Slowing gastric motility is usually exactly what you want in the case of a stomach bug, and apple cider vinegar)

    Source: Effectiveness of Nutritional Ingredients on Upper Gastrointestinal Conditions and Symptoms: A Narrative Review

    See also:

    Take care!

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  • Figs vs Banana – Which is Healthier?

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    Our Verdict

    When comparing figs to banana, we picked the banana.

    Why?

    Both of these fruits have a reputation for being carb-heavy (though their glycemic index is low in both cases because of the fiber), and they both have approximately the same macros across the board. So a tie on macros.

    When it comes to vitamins, figs have more of vitamins A, B1, E, and K, while banana has more of vitamins B2, B3, B5, B6, B9, C, and choline. So, a win for banana there.

    In the category of minerals, figs have more calcium and iron, while banana has more copper, magnesium, manganese, phosphorus, potassium, and selenium. Another win for banana.

    Adding up the section makes for a win for bananas, but by all means, enjoy either or both; diversity is good!

    Want to learn more?

    You might like to read:

    Which Sugars Are Healthier, And Which Are Just The Same?

    Take care!

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Related Posts

  • It’s Not A Bloody Trend – by Kat Brown
  • This Is Your Brain on Music – by Dr. Daniel Levitin

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Music has sometimes been touted as having cognitive benefits, by its practice and even by the passive experience of it. But what’s the actual science of it?

    Dr. Levitin, an accomplished musician and neuroscientist, explores and explains.

    We learn about how music in all likelihood allowed our ancestors to develop speech, something that set us apart (and ahead!) as a species. How music was naturally-selected-for in accordance with its relationship with health. How processing music involves almost every part of the brain. How music pertains specifically to memory. And more.

    As a bonus, as well as explaining a lot about our brain, this book offers those of us with limited knowledge of music theory a valuable overview of the seven main dimensions of music, too.

    Bottom line: if you’d like to know more about the many-faceted relationship between music and cognitive function, this is a top-tier book about such.

    Click here to check out “This Is Your Brain On Music”, and learn more about yours!

    Don’t Forget…

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    Learn to Age Gracefully

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  • Cabbage vs Kale – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing cabbage to kale, we picked the kale.

    Why?

    Here we go again, pitting Brassica oleracea vs Brassica oleracea. One species, many cultivars! Notwithstanding being the same species, there are important nutritional differences:

    In terms of macros, kale has more protein, carbs, and fiber, and even has the lower glycemic index, not that cabbage is bad at all, of course. But nominally, kale gets the win on all counts in this category.

    In the category of vitamins, cabbage has more of vitamins B5 and choline, while kale has more of vitamins A, B1, B2, B3, B6, B7, B9, C, E, and K. An easy win for kale!

    When it comes to minerals, it’s even more decisive: cabbage is not higher in any minerals, while kale has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc. Another clear win for kale.

    Adding up the sections makes it very clear that kale wins the day, but we’d like to mention that cabbage was good in all of these metrics too; kale was just better!

    Want to learn more?

    You might like to read:

    21 Most Beneficial Polyphenols & What Foods Have Them

    Enjoy!

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  • Hormone Replacement

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? 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 cant believe 10 Almonds addresses questions. Thanks. I see the word symptoms for menopause. I don’t know what word should replace it but maybe one should be used or is symptom accurate? And I recently read that there was a great disservice for women in my era as they were denied/scared of hormones replacement. Unnecessarily❞

    You’d better believe it! In fact we love questions; they give us things to research and write about.

    “Symptom” is indeed an entirely justified word to use, being:

    1. General: any phenomenon or circumstance accompanying something and serving as evidence of it.
    2. Medical: any phenomenon that arises from and accompanies a particular disease or disorder and serves as an indication of it.

    If the question is more whether the menopause can be considered a disease/disorder, well, it’s a naturally occurring and ultimately inevitable change, yes, but then, so is cancer (it’s in the simple mathematics of DNA replication and mutation that, unless a cure for cancer is found, we will always eventually get cancer, if nothing else kills us first).

    So, something being natural/inevitable isn’t a reason to not consider it a disease/disorder, nor a reason to not treat it as appropriate if it is causing us harm/discomfort that can be safely alleviated.

    Moreover, and semantics aside, it is medical convention to consider menopause to be a medical condition, that has symptoms. Indeed, for example, the US’s NIH (and its constituent NIA, the National Institute of Aging) and the UK’s NHS, both list the menopause’s symptoms, using that word:

    With regard to fearmongering around HRT, certainly that has been rife, and there were some very flawed (and later soundly refuted) studies a while back that prompted this—and even those flawed studies were not about the same (bioidentical) hormones available today, in any case. So even if they had been correct (they weren’t), it still wouldn’t be a reason to not get treatment nowadays, if appropriate!

    Don’t Forget…

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