Foot Drop!
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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
❝Interesting about DVT after surgery. A friend recently got diagnosed with foot drop. Could you explain that? Thank you.❞
First, for reference, the article about DVT after surgery was:
DVT Risk Management Beyond The Socks
As for foot drop…
Foot drop is descriptive of the main symptom: the inability to raise the front part of the foot due to localized weakness/paralysis. Hence, if a person with foot drop dangles their feet over the edge of the bed, for example, the affected foot will simply flop down, while the other (if unaffected) can remain in place under its own power. The condition is usually neurological in origin, though there are various more specific causes:
When walking unassisted, this will typically result in a distinctive “steppage gait”, as it’s necessary to lift the foot higher to compensate, or else the toes will scuff along the ground.
There are mobility aids that can return one’s walking to more or less normal, like this example product on Amazon.
Incidentally, the above product will slightly shorten the lifespan of shoes, as it will necessarily pull a little at the front.
There are alternatives that won’t like this example product on Amazon, but this comes with the different problem that it limits the user to stepping flat-footedly, which is not only also not an ideal gait, but also, will serve to allow any muscles down there that were still (partially or fully) functional to atrophy. For this reason, we’d recommend the first product we mentioned over the second one, unless your personal physiotherapist or similar advises otherwise (because they know your situation and we don’t).
Both have their merits, though:
Trends and Technologies in Rehabilitation of Foot Drop: A Systematic Review
Of course, prevention is better than cure, so while some things are unavoidable (especially when it comes to neurological conditions), we can all look after our nerve health as well as possible along the way:
Peripheral Neuropathy: How To Avoid It, Manage It, Treat It
…as well as the very useful:
What Does Lion’s Mane Actually Do, Anyway?
…which this writer personally takes daily and swears by (went from frequent pins-and-needles to no symptoms and have stayed that way, and that’s after many injuries over the years).
If you’d like a more general and less supplements-based approach though, check out:
Steps For Keeping Your Feet A Healthy Foundation
Take care!
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The Vegan Instant Pot Cookbook – by Nisha Vora
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We all know that we should “eat the rainbow” (and that no, Skittles do not count)… So why do we often find ourselves falling into the same familiar habits and well-worn comfort foods?
Nisha Vora, of “Rainbow Plant Life“, is here to make things a lot easier—brightening up our plates is her mission!
In this Instant Pot-authorized, beautifully illustrated cookbook, Vora offers us 90 recipes to do just that. And because it’s an Instant Pot cookbook, they’re all super easy.
What if you don’t have an Instant Pot? Well, don’t tell Instant Pot we said this, but another pressure cooker brand will work too. And if you don’t have any pressure cooker, the recipes are modifiable for regular pots and pans. The recipes also lend themselves well to slow-cooker cooking, for that matter!
Where Vora really excels though is in making mostly-one-pot dishes beautiful and tasty.
The recipes, by the way, are drawn from cuisines from all around the world, and cover:
- summer and winter dishes
- breakfasts, sides, mains, desserts
- the healthy and the decadent (and sometimes both!)
As for the presentation of each recipe, we get at least one full-page photo of the finished dish and sometimes extras of the steps. We get a little intro, the usual information about ingredients etc, and a no-fuss step-by-step method. It’s very easy to use.
If you have allergies or other dietary considerations, this book is pretty mindful of those, making substitutions minimal and easy.
Bottom line: this comprehensive book will seriously brighten up the colors of your cooking!
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Can Home Tests Replace Check-Ups?
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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 recently hit 65 and try to get regular check-ups, but do you think home testing can be as reliable as a doctor visit? I try to keep as informed as I can and am a big believer in taking responsibility for my own health if I can, but I don’t want to miss something important either. Best as a supplemental thing, perhaps?❞
Depends what’s being tested! And your level of technical knowledge, though there’s always something to be said for ongoing learning.
- If you’re talking blood tests, urine tests, etc per at-home test kits that get sent off to a lab, then provided they’re well-sourced (and executed correctly by you), they should be as accurate as what a doctor will give, since they are basically doing the same thing (taking a sample and sending it off to a lab).
- If you’re talking about checking for lumps etc, then a dual approach is best: check yourself at home as often as you feel is reasonable (with once per month being advised at a minimum, especially if you’re aware of an extra risk factor for you) and check-ups with the doctor per their recommendations.
- If you’re talking about general vitals (blood pressure, heart rate, heart rate variability, VO₂ max, etc), then provided you have a reliable way of testing them, then doing them very frequently at home, to get the best “big picture” view. In contrast, getting them done once a year at your doctor’s could result in a misleading result, if you just ate something different that day or had a stressful morning, for example.
Enjoy
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What Your Hands Can Tell You About Your Health
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Dr. Siobhan Deshauer tells us what our hands say about our health—she’s not practicing palmistry though; she’s a rheumatologist, and everything here is about clinical signs of health/disease.
The signs include…
“Spider fingers” (which your writer here has; I always look like I’m ready to cast a spell of some kind), and that’s really the medical name, or arachnodactyly for those who like to get Greek about it. It’s about elongated digits. Elongated other bones too, typically, but the hands are where it’s most noticeable.
The tests:
- Make a fist with your thumb inside (the way you were told never to punch); does your thumb poke out the side notably past the edge of your hand, unassisted (i.e., don’t poke it, just let it rest where it goes to naturally)?
- Take hold of one of your wrists with the fingers of the other hand, wrapping them around. If they reach, that’s normal; if there’s a notable overlap, we’re in Spidey-territory now.
If both of those are positive results for you, Dr. Deshauer recommends getting a genetic test to see if you have Marfan syndrome, because…
Arachnodactyly often comes from a genetic condition called Marfan syndrome, and as well as the elongated digits of arachnodactyly, Marfan syndrome affects the elastic fibers of the body, and comes with the trade-off of an increased risk of assorted kinds of sudden death (if something goes “ping” where it shouldn’t, like the heart or lungs).
But it can also come from Ehlers-Danlos Syndrome!
EDS is characterized by hypermobility of joints, meaning that they are easily flexed past the normal human limit, and/but also easily dislocated.
The tests:
- Put your hand flat on a surface, and using your other hand, see how far back your fingers will bend (without discomfort, please); do they go further than 90°?
- Can you touch your thumb to your wrist* (on the same side?)
*She says “wrist”; for this arachnodactylic writer here it’s halfway down my forearm, but you get the idea
For many people this is a mere quirk and inconvenience, for others it can be more serious and a cause of eventual chronic pain, and for a few, it can be very serious and come with cardiovascular problems (similar to the Marfan syndrome issues above). This latter is usually diagnosed early in life, though, such as when a child comes in with an aneurysm, or there’s a family history of it. Another thing to watch out for!
Check out the video for more information on these, as well as what our fingerprints can mean, indicators of diabetes (specifically, a test for diabetic cheiroarthropathy that you can do at home, like the tests above), carpal tunnel syndrome, Raynaud phenomenon, and more!
She covers 10 main medical conditions in total:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to read more?
- We Are Such Stuff As Fish Are Made Of ← because collagen comes up a lot in the video
- How To Really Look After Your Joints
Take care!
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The Real Benefit Of Genetic Testing
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Genetic Testing: Health Benefits & Methods
Genetic testing is an oft-derided American pastime, but there’s a lot more to it than finding out about your ancestry!
Note: because there are relatively few companies offering health-related genetic testing services, and we are talking about the benefits of those services, some of this main feature may seem like an advert.
It’s not; none of those companies are sponsoring us, and if any of them become a sponsor at some point, we’ll make it clear and put it in the clearly-marked sponsor segment.
As ever, our only goal here is to provide science-backed information, to enable you to make your own, well-informed, decisions.
Health genomics & genetic testing
The basic goal of health genomics and genetic testing is to learn:
- What genetic conditions you have
- Clearcut genetic conditions, such as Fragile X syndrome, or Huntington’s disease
- What genetic predispositions you have
- Such as an increased/decreased risk for various kinds of cancer, diabetes, heart conditions, and so forth
- What genetic traits you have
- These may range from “blue eyes” to “superathlete muscle type”
- More specifically, pharmacogenomic information
- For example, “fast caffeine metabolizer” or “clopidogrel (Plavix) non-responder” (i.e., that drug simply will not work for you)
Wait, what’s the difference between health genomics and genetic testing?
- Health genomics is the science of how our genes affect our health.
- Genetic testing can be broadly defined as the means of finding out which genes we have.
A quick snippet…
More specifically, a lot of these services look at which single nucleotide polymorphisms (SNPs, pronounced “snips”) we have. While we share almost all of our DNA with each other (and indeed, with most vertebrates), our polymorphisms are the bits that differ, and are the bits that, genetically speaking, make us different.
So, by looking just at the SNPs, it means we “only” need to look at about 3,000,000 DNA positions, and not our entire genome. For perspective, those 3,000,000 DNA positions make up about 0.1% of our whole genome, so without focusing on SNPs, the task would be 1000x harder.
For example, the kind of information that this sort of testing may give you, includes (to look at some “popular” SNPs):
- rs53576 in the oxytocin receptor influences social behavior and personality
- rs7412 and rs429358 can raise the risk of Alzheimer’s disease by more than 10x
- rs6152 can influence baldness
- rs333 resistance to HIV
- rs1800497 in a dopamine receptor may influence the sense of pleasure
- rs1805007 determines red hair and sensitivity to anesthetics
- rs9939609 triggers obesity and type-2 diabetes
- rs662799 prevents weight gain from high fat diets
- rs12255372 linked to type-2 diabetes and breast cancer
- rs1799971 makes alcohol cravings stronger
- rs17822931 determines earwax, sweating and body odor
- rs1333049 coronary heart disease
- rs1051730 and rs3750344 nicotine dependence
- rs4988235 lactose intolerance
(You can learn about these and more than 100,000 other SNPs at SNPedia.com)
I don’t know what SNPs I have, and am disinclined to look them up one by one!
The first step to knowing, is to get your DNA out of your body and into a genetic testing service. This is usually done by saliva or blood sample. This writer got hers done many years ago by 23andMe and was very happy with that service, but there are plenty of other options.
Healthline did an independent review of the most popular companies, so you might like to check out:
Healthline: Best DNA Testing Kits of 2023
Those companies will give you some basic information, such as “6x higher breast cancer risk” or “3x lower age-related macular degeneration risk” etc.
However, to really get bang-for-buck, what you want to do next is:
- Get your raw genetic data (the companies above should provide it); this will probably look like a big text file full of As, Cs, Gs, and Ts, but it make take another form.
- Upload it to Promethease. When this writer got hers done , the cost was $2; that price has now gone up to a whopping $12.
- You will then get a report that will cross-reference your data with everything known about SNPs, and give a supremely comprehensive, readable-to-the-human-eye, explanation of what it all means for you—from much more specific health risk prognostics, to more trivial things like whether you can roll your tongue or smell decomposed asparagus metabolites in urine.
A note on privacy: anything you upload to Promethease will be anonymized, and/but in doing so, you consent to it going into the grand scientific open-source bank of “things we know about the human genome”, and thus contribute to the overall sample size of genetic data.
In our opinion, it means you’re doing your bit for science, without personal risk. But your opinion may differ, and that’s your decision to make.
Lastly, on the pros and cons of pharmacogenetic testing specifically:
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- What genetic conditions you have
The Circadian Rhythm: Far More Than Most People Know
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The Circadian Rhythm: Far More Than Most People Know
This is Dr. Satchidananda (Satchin) Panda, the scientist behind the discovery of the blue-light sensing cell type in the retina, and the many things it affects. But, he’s discovered more…
First, what you probably know (with a little more science)
Dr. Panda discovered that melanopsin, a photopigment, is “the primary candidate for photoreceptor-mediated entrainment”.
To put that in lay terms, it’s the brain’s go-to for knowing approximately what time of day or night it is, according to how much light there is (or isn’t), and how long it has (or hasn’t) been there.
But… the brain’s “go-to” isn’t the only method. By creating mice without melanopsin, he was able to find that they still keep a circadian rhythm, even in complete darkness:
Melanopsin (Opn4) Requirement for Normal Light-Induced Circadian Phase Shifting
In other words, it was a helpful, but not completely necessary, means of keeping a circadian rhythm.
So… What else is going on?
Dr. Panda and his team did a lot of science that is well beyond the scope of this main feature, but to give you an idea:
- With jargon: it explored the mechanisms and transcription translation negative feedback loops that regulate chronobiological processes, such as a histone lysine demathlyase 1a (JARID1a) that enhances Clock-Bmal1 transcription, and then used assorted genomic techniques to develop a model for how JARID1a works to moderate the level of Per transcription by regulating the transition between its repression and activation, and discovered that this heavily centered on hepatic gluconeogenesis and glucose homeostasis, facilitated by the protein cryptochrome regulating the fasting signal that occurs when glucagon binds to a G-protein coupled receptor, triggering CREB activation.
- Without jargon: a special protein tells our body how to respond to eating/fasting at different times of day—and conversely, certain physiological responses triggered by eating/fasting help us know what time of day it is.
- Simplest: our body keeps on its best cycle if we eat at the same time every day
This is important, because our circadian rhythm matters for a lot more than sleeping/waking! Take hormones, for example:
- Obvious hormones: testosterone and estrogen peak in the mornings around 9am, progesterone peaks between 10pm and 2am
- Forgotten hormones: cortisol peaks in the morning around 8:30am, melatonin peaks between 10pm and 2am
- More hormones: ghrelin (hunger hormone) peaks around 10am, leptin (satiety hormone) peaks 20 minutes after eating a certain amount of satiety-triggering food (protein does this most quickly), insulin is heavily tied to carbohydrate intake, but will still peak and trough according to when the body expects food.
What does this mean for us in practical terms?
For a start, it means that intermittent fasting can help guard against metabolic and related diseases (including inflammation, and thus also cancer, diabetes, arthritis, and more) a lot more if we practice it with our circadian rhythm in mind.
So that “8-hour window” for eating, that many intermittent fasting practitioners adhere to, is going to do much, much better if it’s 10am to 6pm, rather than, say, 4pm to midnight.
Additionally, Dr. Panda and his team found that a 12-hour eating window wasn’t sufficient to help significantly.
Some other take-aways:
- For reasons beyond the scope of this article, it’s good to exercise a) early b) before eating, so getting in some exercise between 8.30am and 10am is ideal
- It also means it’s beneficial to “front-load” eating, so a large breakfast at 10am, and smaller meals/snacks afterwards, is best.
- It also means that getting sunlight (even if cloud-covered) around 8.30am helps guard against metabolic disorders a lot, since the light remains the body’s go-to way of knowing the time.
- We realize that sunlight is not available at 8.30am at all latitudes at all times of year. Artificial is next-best.
- It also means sexual desire will typically peak in men in the mornings (per testosterone) and women in the evenings (per progesterone), but this is just an interesting bit of trivia, and not so relevant to metabolic health
What to do next…
Want to stabilize your own circadian rhythm in the best way, and also help Dr. Panda with his research?
His team’s (free!) app, “My Circadian Clock”, can help you track and organize all of the body’s measurable-by-you circadian events, and, if you give permission, will contribute to what will be the largest-yet human study into the topics covered today, to refine the conclusions and learn more about what works best.
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Why You Can’t Just “Get Over” Trauma
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Time does not, in fact, heal all wounds. Sometimes they even compound themselves over time. Dr. Tracey Marks explains the damage that trauma does—the physiological presentation of “the axe forgets but the tree remembers”—and how to heal from that actual damage.
The science of healing
Trauma affects the mind and body (largely because the brain is, of course, both—and affects pretty much everything else), which can ripple out into all areas of life.
On the physical level, brain areas affected by trauma include:
- Amygdalae: becomes hyperactive, keeping a person in a heightened state of vigilance.
- Hippocampi: can shrink, causing fragmented or missing memories.
- Prefrontal cortex: reduces in activity, impairing decision-making and emotional regulation.
Trauma also activates the body’s fight or flight response, releasing stress hormones like cortisol and adrenaline. These are great things to have a pinch, but having them elevated all the time is equivalent to only ever driving your car at top speed—the only question becomes whether you’ll crash and burn before you break down.
However, there is hope! Neuroplasticity (the brain’s ability to rewire itself) can make trauma recovery possible through various interventions.
Evidence-based therapies for trauma include:
- Eye Movement Desensitization and Reprocessing (EMDR): this can help reprocess traumatic memories and reduce emotional intensity.
- Trauma-focused Cognitive Behavioral Therapy (CBT): this can help change unhelpful thought patterns and includes exposure therapy.
- Somatic therapies: these focus on the body and nervous system to release stored tension.
In this latter category, embodiment is key to trauma recovery—this may sound “wishy-washy”, but the evidence shows that reconnecting with the body does help manage emotional stress responses. Mind-body practices like mindfulness, yoga, and breathwork help cultivate embodiment and reduce trauma-related stress.
In short: you can’t just “get over” it, but with the right support and interventions, it’s possible to rewire the brain and body toward resilience and healing.
For more on all of this from Dr. Marks, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- PTSD, But, Well…. Complex.
- Undoing The Damage Of Life’s Hard Knocks
- A Surprisingly Powerful Tool: Eye Movement Desensitization & Reprocessing
Take care!
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