From eye exams to blood tests and surgery: how doctors use light to diagnose disease
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This is the next article in our ‘Light and health’ series, where we look at how light affects our physical and mental health in sometimes surprising ways. Read other articles in the series.
You’re not feeling well. You’ve had a pounding headache all week, dizzy spells and have vomited up your past few meals.
You visit your GP to get some answers and sit while they shine a light in your eyes, order a blood test and request some medical imaging.
Everything your GP just did relies on light. These are just some of the optical technologies that have had an enormous impact in how we diagnose disease.
1. On-the-spot tests
Point-of-care diagnostics allow doctors to test patients on the spot and get answers in minutes, rather than sending samples to a lab for analysis.
The “flashlight” your GP uses to view the inside of your eye (known as an ophthalmoscope) is a great example. This allows doctors to detect abnormal blood flow in the eye, deformations of the cornea (the outermost clear layer of the eye), or swollen optical discs (a round section at the back of the eye where the nerve link to the brain begins). Swollen discs are a sign of elevated pressure inside your head (or in the worst case, a brain tumour) that could be causing your headaches.
The invention of lasers and LEDs has enabled many other miniaturised technologies to be provided at the bedside or clinic rather than in the lab.
Pulse oximetry is a famous example, where a clip attached to your finger reports how well your blood is oxygenated. It does this by measuring the different responses of oxygenated and de-oxygenated blood to different colours of light.
Pulse oximetry is used at hospitals (and sometimes at home) to monitor your respiratory and heart health. In hospitals, it is also a valuable tool for detecting heart defects in babies.
2. Looking at molecules
Now, back to that blood test. Analysing a small amount of your blood can diagnose many different diseases.
A machine called an automated “full blood count analyser” tests for general markers of your health. This machine directs focused beams of light through blood samples held in small glass tubes. It counts the number of blood cells, determines their specific type, and reports the level of haemoglobin (the protein in red blood cells that distributes oxygen around your body). In minutes, this machine can provide a snapshot of your overall health.
For more specific disease markers, blood serum is separated from the heavier cells by spinning in a rotating instrument called a centrifuge. The serum is then exposed to special chemical stains and enzyme assays that change colour depending on whether specific molecules, which may be the sign of a disease, are present.
These colour changes can’t be detected with the naked eye. However, a light beam from an instrument called a spectrometer can detect tiny amounts of these substances in the blood and determine if the biomarkers for diseases are present, and at what levels.
3. Medical imaging
Let’s re-visit those medical images your GP ordered. The development of fibre-optic technology, made famous for transforming high-speed digital communications (such as the NBN), allows light to get inside the body. The result? High-resolution optical imaging.
A common example is an endoscope, where fibres with a tiny camera on the end are inserted into the body’s natural openings (such as your mouth or anus) to examine your gut or respiratory tracts.
Surgeons can insert the same technology through tiny cuts to view the inside of the body on a video screen during laparoscopic surgery (also known as keyhole surgery) to diagnose and treat disease.
How about the future?
Progress in nanotechnology and a better understanding of the interactions of light with our tissues are leading to new light-based tools to help diagnose disease. These include:
- nanomaterials (materials on an extremely small scale, many thousands of times smaller than the width of a human hair). These are being used in next-generation sensors and new diagnostic tests
- wearable optical biosensors the size of your fingernail can be included in devices such as watches, contact lenses or finger wraps. These devices allow non-invasive measurements of sweat, tears and saliva, in real time
- AI tools to analyse how blood serum scatters infrared light. This has allowed researchers to build a comprehensive database of scatter patterns to detect any cancer
- a type of non-invasive imaging called optical coherence tomography for more detailed imaging of the eye, heart and skin
- fibre optic technology to deliver a tiny microscope into the body on the tip of a needle.
So the next time you’re at the GP and they perform (or order) some tests, chances are that at least one of those tests depend on light to help diagnose disease.
Matthew Griffith, Associate Professor and ARC Future Fellow and Director, UniSA Microscopy and Microanalysis Facilities, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Built from Broken – by Scott Hogan, CPT, COES
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So many exercise programs come with the caveat “consult your doctor before engaging in any new activity”, and the safe-but-simple “do not try to train through an injury”.
Which is all very well and good for someone in fabulous health who sprained an ankle while running and can just wait a bit, but what about those of us carrying…
- long-term injuries
- recurring injuries
- or just plain unfixable physical disabilities?
That’s where physiotherapist Scott Hogan comes in. The subtitle line goes:
❝A Science-Based Guide to Healing Painful Joints, Preventing Injuries, and Rebuilding Your Body❞
…but he does also recognize that there are some things that won’t bounce back.
On the other hand… There are a lot of things that get written off by doctors as “here’s some ibuprofen” that, with consistent mindful training, could actually be fixed.
Hogan delivers again and again in this latter category! You’ll see on Amazon that the book has thousands of 4- and 5-star ratings and many glowing reviews, and it’s for a reason or three:
- The book first lays a foundational knowledge of the most common injuries likely to impede us from training
- It goes on to give step-by-step corrective exercises to guide your body through healing itself. Your body is trying to heal itself anyway; you might as well help it accomplish that!
- It finishes up with a comprehensive (and essential) guide to train for the strength and mobility that will help you avoid future problems.
In short: a potentially life-changing book if you have some (likely back- or joint-related) problem that needs overcoming!
And if you don’t? An excellent pre-emptive guide all the same. This is definitely one of those “an ounce of prevention is better than a pound of cure” things.
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‘It’s okay to poo at work’: new health campaign highlights a common source of anxiety
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For most people, the daily or near-daily ritual of having a bowel motion is not something we give a great deal of thought to. But for some people, the need to do a “number two” in a public toilet or at work can be beset with significant stress and anxiety.
In recognition of the discomfort people may feel around passing a bowel motion at work, the Queensland Department of Health recently launched a social media campaign with the message “It’s okay to poo at work”.
The campaign has gained significant traction on Instagram and Facebook. It has been praised by health and marketing experts for its humorous handling of a taboo topic.
A colourful Instagram post is accompanied by a caption warning of the health risks of “holding it in”, including haemorrhoids and other gastrointestinal problems. The caption also notes:
If you find it extremely difficult to poo around other people, you might have parcopresis.
Queensland Health/Instagram What is parcopresis?
Parcopresis, sometimes called “shy bowel”, occurs when people experience a difficulty or inability to poo in public toilets due to fear of perceived scrutiny by others.
People with parcopresis may find it difficult to go to the toilet in public places such as shopping centres, restaurants, at work or at school, or even at home when friends or family are around.
They may fear being judged by others about unpleasant smells or sounds when they have a bowel motion, or how long they take to go, for example.
Living with a gastrointestinal condition (at least four in ten Australians do) may contribute to parcopresis due to anxiety about the need to use a toilet frequently, and perceived judgment from others when doing so. Other factors, such as past negative experiences or accessibility challenges, may also play a role.
Some people may feel uncomfortable about using the toilet at work. Motortion Films/Shutterstock For sufferers, anxiety can present in the form of a faster heart rate, rapid breathing, sweating, muscle tension, blushing, nausea, trembling, or a combination of these symptoms. They may experience ongoing worry about situations where they may need to use a public toilet.
Living with parcopresis can affect multiple domains of life and quality of life overall. For example, sufferers may have difficulties relating to employment, relationships and social life. They might avoid travelling or attending certain events because of their symptoms.
How common is parcopresis?
We don’t really know how common parcopresis is, partly due to the difficulty of evaluating this behaviour. It’s not necessarily easy or appropriate to follow people around to track whether they use or avoid public toilets (and their reasons if they do). Also, observing individual bathroom activities may alter the person’s behaviour.
I conducted a study to try to better understand how common parcopresis is. The study involved 714 university students. I asked participants to respond to a series of vignettes, or scenarios.
In each vignette participants were advised they were at a local shopping centre and they needed to have a bowel motion. In the vignettes, the bathrooms (which had been recently cleaned) had configurations of either two or three toilet stalls. Each vignette differed by the configuration of stalls available.
The rate of avoidance was just over 14% overall. But participants were more likely to avoid using the toilet when the other stalls were occupied.
Around 10% avoided going when all toilets were available. This rose to around 25% when only the middle of three toilets was available. Men were significantly less likely to avoid going than women across all vignettes.
For those who avoided the toilet, many either said they would go home to poo, use an available disabled toilet, or come back when the bathroom was empty.
Parcopresis at work
In occupational settings, the rates of anxiety about using shared bathrooms may well be higher for a few reasons.
For example, people may feel more self-conscious about their bodily functions being heard or noticed by colleagues, compared to strangers in a public toilet.
People may also experience guilt, shame and fear about being judged by colleagues or supervisors if they need to make extended or frequent visits to the bathroom. This may particularly apply to people with a gastrointestinal condition.
Reducing restroom anxiety
Using a public toilet can understandably cause some anxiety or be unpleasant. But for a small minority of people it can be a real problem, causing severe distress and affecting their ability to engage in activities of daily living.
If doing a poo in a toilet at work or another public setting causes you anxiety, be kind to yourself. A number of strategies might help:
- identify and challenge negative thoughts about using public toilets and remind yourself that using the bathroom is normal, and that most people are not paying attention to others in the toilets
- try to manage stress through relaxation techniques such as deep breathing and progressive muscle relaxation, which involves tensing and relaxing different muscles around the body
- engaging in gradual exposure can be helpful, which means visiting public toilets at different times and locations, so you can develop greater confidence in using them
- use grounding or distraction techniques while going to the toilet. These might include listening to music, watching something on your phone, or focusing on your breathing.
If you feel parcopresis is having a significant impact on your life, talk to your GP or a psychologist who can help identify appropriate approaches to treatment. This might include cognitive behavioural therapy.
Simon Robert Knowles, Associate Professor and Clinical Psychologist, Swinburne University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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What You Should Have Been Told About The Menopause Beforehand
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What You Should Have Been Told About Menopause Beforehand
This is Dr. Jen Gunter. She’s a gynecologist, specializing in chronic pain and vulvovaginal disorders. She’s also a woman on a mission to demystify things that popular culture, especially in the US, would rather not talk about.
When was the last time you remember the menopause being referenced in a movie or TV show? If you can think of one at all, was it just played for laughs?
And of course, the human body can be funny, so that’s not necessarily the problem, but it sure would be nice if that weren’t all that there is!
So, what does Dr. Gunter want us to know?
It’s a time of changes, not an end
The name “menopause” is misleading. It’s not a “pause”, and those menses aren’t coming back.
And yet, to call it a “menostop” would be differently misleading, because there’s a lot more going on than a simple cessation of menstruation.
Estrogen levels will drop a lot, testosterone levels may rise slightly, mood and sleep and appetite and sex drive will probably be affected (progesterone can improve all these things!) and
not to mention butwe’re going to mention: vaginal atrophy, which is very normal and very treatable with a topical estrogen cream. Untreated menopause can also bring a whole lot of increased health risks (for example, heart disease, osteoporosis, and, counterintuitively given the lower estrogen levels, breast cancer).However, with a little awareness and appropriate management, all these things can usually be navigated with minimal adverse health outcomes.
Dr Gunter, for this reason, refers to it interchangeably as “the menopausal transition”. She describes it as being less like a cliff edge we fall off, and more like a bridge we cross.
Bridges can be dangerous to cross! But they can also get us safely where we’re going.
Ok, so how do we manage those things?
Dr. Gunter is a big fan of evidence-based medicine, so we’ll not be seeing any yonic crystals or jade eggs. Or “goop”.
See also: Meet Goop’s Number One Enemy
For most people, she recommends Menopausal Hormone Therapy (MHT), which falls under the more general category of Hormone Replacement Therapy (HRT).
This is the most well-evidenced, science-based way to avoid most of the risks associated with menopause.
Nevertheless, there are scare-stories out there, ranging from painful recommencement of bleeding, to (once again) increased risk of breast cancer. However, most of these are either misunderstandings, or unrelated to menopause and MHT, and are rather signs of other problems that should not be ignored.
To get a good grounding in this, you might want to read her Hormone Therapy Guide, freely available as a standalone section on her website. This series of posts is dedicated to hormone therapy. It starts with some basics and builds on that knowledge with each post:
Dr. Gunter’s Guide To The Hormone Menoverse
What about natural therapies?
There are some non-hormonal things that work, but these are mostly things that:
- give a statistically significant reduction in symptoms
- give the same statistically significant reduction in symptoms as placebo
As Dr. Gunter puts it:
❝While most of the studies of prescription medications for hot flashes have an appropriate placebo arm, this is rarely the case with so-called alternative therapies.
In fact, the studies here are almost always low quality, so it’s often not possible to conclude much.
Many reviews that look at these studies often end with a line that goes something like, “Randomized trials with a placebo arm, a low risk of bias, and adequate sample sizes are urgently needed.”
You should interpret this kind of conclusion as the polite way of saying, “We need studies that aren’t BS to say something constructive.”❞
However, if it works, it works, whatever its mechanism. It’s just good, when making medical decisions, to do so with the full facts!
For that matter, even Dr. Gunter acknowledges that while MHT can be lifechanging (in a positive way) for many, it’s not for everyone:
Informed Decisions: When Menopause Hormone Therapy Isn’t Recommended
Want to know more?
Dr. Gunter also has an assortment of books available, including The Menopause Manifesto (which we’ve reviewed previously), and some others that we haven’t, such as “Blood” and “The Vagina Bible”.
Enjoy!
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How To Triple Your Breast Cancer Survival Chances
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Keeping Abreast Of Your Cancer Risk
It’s the kind of thing that most people think won’t happen to them. And hopefully, it won’t!
But…
- Anyone (who has not had a double mastectomy*, anyway) can get breast cancer.
- *and even this depends on the type of double mastectomy and other circumstances, and technically there will always be a non-zero risk, because of complicating factors.
- Breast cancer, if diagnosed early (before it spreads), has a 98% survival rate.
- That survival rate drops to 31% if diagnosed after it has spread through the body.
(The US CDC’s breast cancer “stat bite” page has more stats and interactive graphs, so click here to see those charts and get the more detailed low-down on mortality/survival rates with various different situations)
We think that the difference between 98% and 31% survival rates is more than enough reason to give ourselves a monthly self-check at the very least! You’ve probably seen how-to diagrams before, but here are instructions for your convenience:
(This graphic was created by the Jordan Breast Cancer Program—check them out, as they have lots of resources)
If you don’t have the opportunity to take matters into your own hands right now, rather than just promise yourself “I’ll do that later”, take this free 4-minute Breast Health Assessment from Aurora Healthcare. Again, we think the difference early diagnosis can make to your survival chances make these tests well worth it:
Click Here To Take The Free 4-Minute Breast Health Assessment!
Lest we forget, men can also get breast cancer (the CDC has a page for men too), especially if over 50. But how do you check for breast cancer, when you don’t have breasts in the commonly-understood sense of the word?
So take a moment to do this (yes, really actually do it!), and set a reminder in your calendar to repeat it monthly—there really is no reason not to!
Take care of yourself; you’re important.
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- Anyone (who has not had a double mastectomy*, anyway) can get breast cancer.
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Red Bell Peppers vs Tomatoes – Which is Healthier?
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Our Verdict
When comparing red bell peppers to tomatoes, we picked the peppers.
Why?
In terms of macronutrients, these two fruits-that-get-used-as-vegetables are similar in most respects; they’re mostly water, negligible protein and fat, similar amounts of carbs, even a similar carb breakdown (mostly fructose and glucose). One thing that does set them apart is that peppers* have about 2x the fiber, which difference results in peppers having the lower Glycemic Index—though tomatoes are quite low in GI too.
*for brevity we’re just going to write “peppers”, but we are still talking about sweet red bell peppers throughout. This is important, as different color peppers have different nutrient profiles.
In the category of vitamins, peppers have much more of vitamins A, B1, B2, B3, B5, B6, B9, C, and E. In contrast, tomatoes have more vitamin K. An easy win for peppers.
When it comes to minerals, the margins are narrower, but peppers have more iron, zinc, and selenium, while tomatoes have more calcium and copper. They’re approximately equal on other minerals they both contain, making this category a slight (3:2) win for peppers.
As for phytochemical benefits, both are good sources of lycopene (both better when cooked) and other carotenes (for example lutein), and both have an array of assorted flavonoids.
All in all, a win for peppers, but both are great!
Want to learn more?
You might like to read:
- Brain Food? The Eyes Have It!
- Bell Peppers: A Spectrum Of Specialties
- Lycopene’s Benefits For The Gut, Heart, Brain, & More
Take care!
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Hate salad or veggies? Just keep eating them. Here’s how our tastebuds adapt to what we eat
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Do you hate salad? It’s OK if you do, there are plenty of foods in the world, and lots of different ways to prepare them.
But given almost all of us don’t eat enough vegetables, even though most of us (81%) know eating more vegetables is a simple way to improve our health, you might want to try.
If this idea makes you miserable, fear not, with time and a little effort you can make friends with salad.
Why don’t I like salads?
It’s an unfortunate quirk of evolution that vegetables are so good for us but they aren’t all immediately tasty to all of us. We have evolved to enjoy the sweet or umami (savoury) taste of higher energy foods, because starvation is a more immediate risk than long-term health.
Vegetables aren’t particularly high energy but they are jam-packed with dietary fibre, vitamins and minerals, and health-promoting compounds called bioactives.
Those bioactives are part of the reason vegetables taste bitter. Plant bioactives, also called phytonutrients, are made by plants to protect themselves against environmental stress and predators. The very things that make plant foods bitter, are the things that make them good for us.
Unfortunately, bitter taste evolved to protect us from poisons, and possibly from over-eating one single plant food. So in a way, plant foods can taste like poison.
For some of us, this bitter sensing is particularly acute, and for others it isn’t so bad. This is partly due to our genes. Humans have at least 25 different receptors that detect bitterness, and we each have our own genetic combinations. So some people really, really taste some bitter compounds while others can barely detect them.
This means we don’t all have the same starting point when it comes to interacting with salads and veggies. So be patient with yourself. But the steps toward learning to like salads and veggies are the same regardless of your starting point.
It takes time
We can train our tastes because our genes and our receptors aren’t the end of the story. Repeat exposures to bitter foods can help us adapt over time. Repeat exposures help our brain learn that bitter vegetables aren’t posions.
And as we change what we eat, the enzymes and other proteins in our saliva change too. This changes how different compounds in food are broken down and detected by our taste buds. How exactly this works isn’t clear, but it’s similar to other behavioural cognitive training.
Add masking ingredients
The good news is we can use lots of great strategies to mask the bitterness of vegetables, and this positively reinforces our taste training.
Salt and fat can reduce the perception of bitterness, so adding seasoning and dressing can help make salads taste better instantly. You are probably thinking, “but don’t we need to reduce our salt and fat intake?” – yes, but you will get more nutritional bang-for-buck by reducing those in discretionary foods like cakes, biscuits, chips and desserts, not by trying to avoid them with your vegetables.
Adding heat with chillies or pepper can also help by acting as a decoy to the bitterness. Adding fruits to salads adds sweetness and juiciness, this can help improve the overall flavour and texture balance, increasing enjoyment.
Pairing foods you are learning to like with foods you already like can also help.
The options for salads are almost endless, if you don’t like the standard garden salad you were raised on, that’s OK, keep experimenting.
Experimenting with texture (for example chopping vegetables smaller or chunkier) can also help in finding your salad loves.
Challenge your biases
Challenging your biases can also help the salad situation. A phenomenon called the “unhealthy-tasty intuition” makes us assume tasty foods aren’t good for us, and that healthy foods will taste bad. Shaking that assumption off can help you enjoy your vegetables more.
When researchers labelled vegetables with taste-focused labels, priming subjects for an enjoyable taste, they were more likely to enjoy them compared to when they were told how healthy they were.
The bottom line
Vegetables are good for us, but we need to be patient and kind with ourselves when we start trying to eat more.
Try working with biology and brain, and not against them.
And hold back from judging yourself or other people if they don’t like the salads you do. We are all on a different point of our taste-training journey.
Emma Beckett, Senior Lecturer (Food Science and Human Nutrition), School of Environmental and Life Sciences, University of Newcastle
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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