DVT Risk Management Beyond The Socks
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
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 know I am at higher risk of DVT after having hip surgery, any advice beside compression stockings?❞
First of all, a swift and easy recovery to you!
Surgery indeed increases the risk of deep vein thrombosis (henceforth: DVT), and hip or knee surgery especially so, for obvious reasons.
There are other risk factors you can’t control, like genetics (family history of DVT as an indicator) and age, but there are some that you can, including:
- smoking (so, ideally don’t; do speak to your doctor before quitting though, in case withdrawal might be temporarily worse for you than smoking)
- obesity (so, losing weight is good if overweight, but if this is going to happen, it’ll mostly happen in the kitchen not the gym, which may be a relief as you’re probably not the very most up for exercise at present)
- See also: Lose Weight, But Healthily
- sedentariness (so, while you’re probably not running marathons right now, please do try to keep moving, even if only gently)
Beyond that, yes compression socks, but also frequent gentle massage can help a lot to avoid clots forming.
Also, no surprises, a healthy diet will help, especially one that’s good for general heart health. Check out for example the Mediterranean DASH diet:
Four Ways To Upgrade The Mediterranean Diet
Also, obviously, speak with your doctor/pharmacist if you haven’t already about possible medications, including checking whether any of your current medications increase the risk and could be swapped for something that doesn’t.
Take care!
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Never Enough – by Dr. Judith Grisel
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We’ve reviewed books about addiction before—specifically about alcohol, at least. This one’s more general in that it covers different addictions.
On the other hand, it’s also more specific, in that it covers them from the author’s field: neuroscience.
…and experience too. The author had a plethora of addictions (the serious kind), got sober, and then undertook to study neuroscience. Her hope was to help others avoid, or escape from the same as‚ what she went through.
Dr. Grisel (as she now is) takes a methodical approach in this book. She works her way through the addictive mechanisms of a broad selection of common drugs, explaining each.
The focus here is on neutral explanations, rather than the propagandizing scaremongering that failed at least one generation. Why each drug is alluring, what it really does do—and the neurological price it exacts, down to the molecular level.
She also covers risk factors for addiction; genetic, epigenetic, and environmental. There’s no “if you were stronger”, or “these people made bad choices”, so much as… Many addicts were, in effect, sabotaged from before birth.
That doesn’t mean that to become addicted or not is just fate, but it does mean… There but for the grace of factors completely outside of our control go we.
Why is this useful to us, be we a reader without any meaningful addiction (we’re not counting coffee etc here)? Well, as this book illustrates and explains, many of us could be one (more) mishap away from a crippling addiction and not know it. Forewarned is forearmed.
Bottom line: almost all of us are, have been, or will be touched by addiction in some way. Either directly, or a loved one, or a loved one’s loved one, or perhaps a parent who gave us an epigenetic misfortune. This book gives understanding that can help.
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What’s the difference between miscarriage and stillbirth?
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What’s the difference? is a new editorial product that explains the similarities and differences between commonly confused health and medical terms, and why they matter.
Former US First Lady Michelle Obama revealed in her memoir she had a miscarriage. UK singer-songwriter and actor Lily Allen has gone on the record about her stillbirth.
Both miscarriage and stillbirth are sadly familiar terms for pregnancy loss. They can be traumatic life events for the prospective parents and family, and their impacts can be long-lasting. But the terms can be confused.
Here are some similarities and differences between miscarriage and stillbirth, and why they matter.
christinarosepix/Shutterstock Let’s start with some definitions
In broad terms, a miscarriage is when a pregnancy ends while the fetus is not yet viable (before it could survive outside the womb).
This is the loss of an “intra-uterine” pregnancy, when an embryo is implanted in the womb to then develop into a fetus. The term miscarriage excludes ectopic pregnancies, where the embryo is implanted outside the womb.
However, stillbirth refers to the end of a pregnancy when the fetus is normally viable. There may have been sufficient time into the pregnancy. Alternatively, the fetus may have grown large enough to be normally expected to survive, but it dies in the womb or during delivery.
The Australian Institute of Health and Welfare defines stillbirth as a fetal death of at least 20 completed weeks of gestation or with a birthweight of at least 400 grams.
Internationally, definitions of stillbirth vary depending on the jurisdiction.
How common are they?
It is difficult to know how common miscarriages are as they can happen when a woman doesn’t know she is pregnant. There may be no obvious symptoms or something that looks like a heavier-than-normal period. So miscarriages are likely to be more common than reported.
Studies from Europe and North America suggest a miscarriage occurs in about one in seven pregnancies (15%). More than one in eight women (13%) will have a miscarriage at some time in her life.
Around 1–2% of women have recurrent miscarriages. In Australia this is when someone has three or more miscarriages with no pregnancy in between.
Australia has one of the lowest rates of stillbirth in the world. The rate has been relatively steady over the past 20 years at 0.7% or around seven per 1,000 pregnancies.
Who’s at risk?
Someone who has already had a miscarriage or stillbirth has an increased risk of that outcome again in a subsequent pregnancy.
Compared with women who have had a live birth, those who have had a stillbirth have double the risk of another. For those who have had recurrent miscarriages, the risk of another miscarriage is four-fold higher.
Some factors have a u-shaped relationship, with the risk of miscarriage and stillbirth lowest in the middle.
For instance, maternal age is a risk factor for both miscarriage and stillbirth, especially if under 20 years old or older than 35. Increasing age of the male is only a risk factor for stillbirth, especially for fathers over 40.
An older dad can be a risk factor for stillbirth, but not miscarriage. Elizaveta Galitckaia/Shutterstock Similarly for maternal bodyweight, women with a body mass index or BMI in the normal range have the lowest risk of miscarriage and stillbirth compared with those in the obese or underweight categories.
Lifestyle factors such as smoking and heavy alcohol drinking while pregnant are also risk factors for both miscarriage and stillbirth.
So it’s important to not only avoid smoking and alcohol while pregnant, but before getting pregnant. This is because early in the pregnancy, women may not know they have conceived and could unwittingly expose the developing fetus.
Why do they happen?
Miscarriage often results from chromosomal problems in the developing fetus. However, genetic conditions or birth defects account for only 7-14% of stillbirths.
Instead, stillbirths often relate directly to pregnancy complications, such as a prolonged pregnancy or problems with the umbilical cord.
Maternal health at the time of pregnancy is another contributing factor in the risk of both miscarriage and stillbirths.
Chronic diseases, such as high blood pressure, diabetes, hypothyroidism (underactive thyroid), polycystic ovary syndrome, problems with the immune system (such as an autoimmune disorder), and some bacterial and viral infections are among factors that can increase the risk of miscarriage.
Similarly mothers with diabetes, high blood pressure, and untreated infections, such as malaria or syphilis, face an increased risk of stillbirth.
In many cases, however, the specific cause of pregnancy loss is not known.
How about the long-term health risks?
Miscarriage and stillbirth can be early indicators of health issues later in life.
For instance, women who have had recurrent miscarriages or recurrent stillbirths are at higher risk of cardiovascular disease (such as heart disease or stroke).
Our research has also looked at the increased risk of stroke. Compared with women who had never miscarried, we found women with a history of three or more miscarriages had a 35% higher risk of non-fatal stroke and 82% higher risk of fatal stroke.
Women who had a stillbirth had a 31% higher risk of a non-fatal stroke, and those who had had two or more stillbirths were at a 26% higher risk of a fatal stroke.
We saw similar patterns in chronic obstructive pulmonary disease or COPD, a progressive lung disease with respiratory symptoms such as breathlessness and coughing.
Our data showed women with a history of recurrent miscarriages or stillbirths were at a 36% or 67% higher risk of COPD, respectively, even after accounting for a history of asthma.
Long-term health risks of recurrent miscarriages or stillbirths include developing lung disease later in life. PRPicturesProduction/Shutterstock Why is all this important?
Being well-informed about the similarities and differences between these two traumatic life events may help explain what has happened to you or a loved one.
Where risk factors can be modified, such as smoking and obesity, this information can be empowering for individuals who wish to reduce their risk of miscarriage and stillbirth and make lifestyle changes before they become pregnant.
More information and support about miscarriage and stillbirth is available from SANDS and Pink Elephants.
Gita Mishra, Professor of Life Course Epidemiology, Faculty of Medicine, The University of Queensland; Chen Liang, PhD student, reproductive history and non-communicable diseases in women, The University of Queensland, and Jenny Doust, Clinical Professorial Research Fellow, School of Public Health, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Healthy Habits for Managing & Reversing Prediabetes – by Dr. Marie Feldman
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The book doesn’t assume prior knowledge, and does explain the science of diabetes, prediabetes, the terms and the symptoms, what’s going on inside, etc—before getting onto the main meat of the book, the tips.
The promised 100 tips are varied in their application; they range from diet and exercise, to matters of sleep, stress, and even love.
There are bonus tips too! For example, an appendix covers “tips for healthier eating out” (i.e. in restaurants etc) and a grocery list to ensure your pantry is good for defending you against prediabetes.
The writing style is very accessible pop-science; this isn’t like reading some dry academic paper—though it does cite its sources for claims, which we always love to see.
Bottom line: if you’d like to proof yourself against prediabetes, and are looking for “small things that add up” habits to get into to achieve that, this book is an excellent first choice.
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Blood-Brain Barrier Breach Blamed For Brain-Fog
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Move Over, Leaky Gut. Now It’s A Leaky Brain.
…which is not a headline that promises good news, and indeed, the only good news about this currently is “now we know another thing that’s happening, and thus can work towards a treatment for it”.
Back in February (most popular media outlets did not rush to publish this, as it rather goes against the narrative of “remember when COVID was a thing?” as though the numbers haven’t risen since the state of emergency was declared over), a team of Irish researchers made a discovery:
❝For the first time, we have been able to show that leaky blood vessels in the human brain, in tandem with a hyperactive immune system may be the key drivers of brain fog associated with long covid❞
~ Dr. Matthew Campbell (one of the researchers)
Let’s break that down a little, borrowing some context from the paper itself:
- the leaky blood vessels are breaching the blood-brain-barrier
- that’s a big deal, because that barrier is our only filter between our brain and Things That Definitely Should Not Go In The Brain™
- a hyperactive immune system can also be described as chronic inflammation
- in this case, that includes chronic neuroinflammation which, yes, is also a major driver of dementia
You may be wondering what COVID has to do with this, and well:
- these blood-brain-barrier breaches were very significantly associated (in lay terms: correlated, but correlated is only really used as an absolute in write-ups) with either acute COVID infection, or Long Covid.
- checking this in vitro, exposure of brain endothelial cells to serum from patients with Long Covid induced the same expression of inflammatory markers.
How important is this?
As another researcher (not to mention: professor of neurology and head of the school of medicine at Trinity) put it:
❝The findings will now likely change the landscape of how we understand and treat post-viral neurological conditions.
It also confirms that the neurological symptoms of long covid are measurable with real and demonstrable metabolic and vascular changes in the brain.❞
~ Dr. Colin Doherty (see mini-bio above)
You can read a pop-science article about this here:
Irish researchers discover underlying cause of “brain fog” linked with long covid
…and you can read the paper in full here:
Want to stay safe?
Beyond the obvious “get protected when offered boosters/updates” (see also: The Truth About Vaccines), other good practices include the same things most people were doing when the pandemic was big news, especially avoiding enclosed densely-populated places, washing hands frequently, and looking after your immune system. For that latter, see also:
Beyond Supplements: The Real Immune-Boosters!
Take care!
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- the leaky blood vessels are breaching the blood-brain-barrier
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Keep Inflammation At Bay
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How to Prevent (or Reduce) Inflammation
You asked us to do a main feature on inflammation, so here we go!
Before we start, it’s worth noting an important difference between acute and chronic inflammation:
- Acute inflammation is generally when the body detects some invader, and goes to war against it. This (except in cases such as allergic responses) is usually helpful.
- Chronic inflammation is generally when the body does a civil war. This is almost never helpful.
We’ll be tackling the latter, which frees up your body’s resources to do better at the former.
First, the obvious…
These five things are as important for this as they are for most things:
- Get a good diet—the Mediterranean diet is once again a top-scorer
- Exercise—move and stretch your body; don’t overdo it, but do what you reasonably can, or the inflammation will get worse.
- Reduce (or ideally eliminate) alcohol consumption. When in pain, it’s easy to turn to the bottle, and say “isn’t this one of red wine’s benefits?” (it isn’t, functionally*). Alcohol will cause your inflammation to flare up like little else.
- Don’t smoke—it’s bad for everything, and that goes for inflammation too.
- Get good sleep. Obviously this can be difficult with chronic pain, but do take your sleep seriously. For example, invest in a good mattress, nice bedding, a good bedtime routine, etc.
*Resveratrol (which is a polyphenol, by the way), famously found in red wine, does have anti-inflammatory properties. However, to get enough resveratrol to be of benefit would require drinking far more wine than will be good for your inflammation or, indeed, the rest of you. So if you’d like resveratrol benefits, consider taking it as a supplement. Superficially it doesn’t seem as much fun as drinking red wine, but we assure you that the results will be much more fun than the inflammation flare-up after drinking.
About the Mediterranean Diet for this…
There are many causes of chronic inflammation, but here are some studies done with some of the most common ones:
- Beneficial effect of Mediterranean diet in systemic lupus erythematosus patients
- How the Mediterranean diet and some of its components modulate inflammatory pathways in arthritis
- The effects of the Mediterranean diet on biomarkers of vascular wall inflammation and plaque vulnerability in subjects with high risk for cardiovascular disease
- Adherence to Mediterranean diet and 10-year incidence of diabetes: correlations with inflammatory and oxidative stress biomarkers*
*Type 1 diabetes is a congenital autoimmune disorder, as the pancreas goes to war with itself. Type 2 diabetes is different, being a) acquired and b) primarily about insulin resistance, and/but this is related to chronic inflammation regardless. It is also possible to have T1D and go on to develop insulin resistance, and that’s very bad, and/but beyond the scope of today’s newsletter, in which we are focusing on the inflammation aspects.
Some specific foods to eat or avoid…
Eat these:
- Leafy greens
- Cruciferous vegetables
- Tomatoes
- Fruits in general (berries in particular)
- Healthy fats, e.g. olives and olive oil
- Almonds and other nuts
- Dark chocolate (choose high cocoa, low sugar)
Avoid these:
- Processed meats (absolute worst offenders are hot dogs, followed by sausages in general)
- Red meats
- Sugar (includes most fruit juices, but not most actual fruits—the difference with actual fruits is they still contain plenty of fiber, and in many cases, antioxidants/polyphenols that reduce inflammation)
- Dairy products (unless fermented, in which case it seems to be at worst neutral, sometimes even a benefit, in moderation)
- White flour (and white flour products, e.g. white bread, white pasta, etc)
- Processed vegetable oils
See also: 9 Best Drinks To Reduce Inflammation, Says Science
Supplements?
Some supplements that have been found to reduce inflammation include:
(links are to studies showing their efficacy)
Consider Intermittent Fasting
Remember when we talked about the difference between acute and chronic inflammation? It’s fair to wonder “if I reduce my inflammatory response, will I be weakening my immune system?”, and the answer is: generally, no.
Often, as with the above supplements and dietary considerations, reducing inflammation actually results in a better immune response when it’s actually needed! This is because your immune system works better when it hasn’t been working in overdrive constantly.
Here’s another good example: intermittent fasting reduces the number of circulating monocytes (a way of measuring inflammation) in healthy humans—but doesn‘t compromise antimicrobial (e.g. against bacteria and viruses) immune response.
See for yourself: Dietary Intake Regulates the Circulating Inflammatory Monocyte Pool ← the study is about the anti-inflammatory effects of fasting
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What is PMDD?
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Premenstrual dysphoric disorder (PMDD) is a mood disorder that causes significant mental health changes and physical symptoms leading up to each menstrual period.
Unlike premenstrual syndrome (PMS), which affects approximately three out of four menstruating people, only 3 percent to 8 percent of menstruating people have PMDD. However, some researchers believe the condition is underdiagnosed, as it was only recently recognized as a medical diagnosis by the World Health Organization.
Read on to learn more about its symptoms, the difference between PMS and PMDD, treatment options, and more.
What are the symptoms of PMDD?
People with PMDD typically experience both mood changes and physical symptoms during each menstrual cycle’s luteal phase—the time between ovulation and menstruation. These symptoms typically last seven to 14 days and resolve when menstruation begins.
Mood symptoms may include:
- Irritability
- Anxiety and panic attacks
- Extreme or sudden mood shifts
- Difficulty concentrating
- Depression and suicidal ideation
Physical symptoms may include:
- Fatigue
- Insomnia
- Headaches
- Changes in appetite
- Body aches
- Bloating
- Abdominal cramps
- Breast swelling or tenderness
What is the difference between PMS and PMDD?
Both PMS and PMDD cause emotional and physical symptoms before menstruation. Unlike PMS, PMDD causes extreme mood changes that disrupt daily life and may lead to conflict with friends, family, partners, and coworkers. Additionally, symptoms may last longer than PMS symptoms.
In severe cases, PMDD may lead to depression or suicide. More than 70 percent of people with the condition have actively thought about suicide, and 34 percent have attempted it.
What is the history of PMDD?
PMDD wasn’t added to the Diagnostic and Statistical Manual of Mental Disorders until 2013. In 2019, the World Health Organization officially recognized it as a medical diagnosis.
References to PMDD in medical literature date back to the 1960s, but defining it as a mental health and medical condition initially faced pushback from women’s rights groups. These groups were concerned that recognizing the condition could perpetuate stereotypes about women’s mental health and capabilities before and during menstruation.
Today, many women-led organizations are supportive of PMDD being an official diagnosis, as this has helped those living with the condition access care.
What causes PMDD?
Researchers don’t know exactly what causes PMDD. Many speculate that people with the condition have an abnormal response to fluctuations in hormones and serotonin—a brain chemical impacting mood— that occur throughout the menstrual cycle. Symptoms fully resolve after menopause.
People who have a family history of premenstrual symptoms and mood disorders or have a personal history of traumatic life events may be at higher risk of PMDD.
How is PMDD diagnosed?
Health care providers of many types, including mental health providers, can diagnose PMDD. Providers typically ask patients about their premenstrual symptoms and the amount of stress those symptoms are causing. Some providers may ask patients to track their periods and symptoms for one month or longer to determine whether those symptoms are linked to their menstrual cycle.
Some patients may struggle to receive a PMDD diagnosis, as some providers may lack knowledge about the condition. If your provider is unfamiliar with the condition and unwilling to explore treatment options, find a provider who can offer adequate support. The International Association for Premenstrual Disorders offers a directory of providers who treat the condition.
How is PMDD treated?
There is no cure for PMDD, but health care providers can prescribe medication to help manage symptoms. Some medication options include:
- Selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants that regulate serotonin in the brain and may improve mood when taken daily or during the luteal phase of each menstrual cycle.
- Hormonal birth control to prevent ovulation-related hormonal changes.
- Over-the-counter pain medication like Tylenol, which can ease headaches, breast tenderness, abdominal cramping, and other physical symptoms.
Providers may also encourage patients to make lifestyle changes to improve symptoms. Those lifestyle changes may include:
- Limiting caffeine intake
- Eating meals regularly to balance blood sugar
- Exercising regularly
- Practicing stress management using breathing exercises and meditation
- Having regular therapy sessions and attending peer support groups
For more information, talk to your health care provider.
If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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