The Insider’s Guide To Making Hospital As Comfortable As Possible
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Nobody Likes Surgery, But Here’s How To Make It Much Less Bad
This is Dr. Chris Bonney. He’s an anesthesiologist. If you have a surgery, he wants you to go in feeling calm, and make a quick recovery afterwards, with minimal suffering in between.
Being a patient in a hospital is a bit like being a passenger in an airplane:
- Almost nobody enjoys the thing itself, but we very much want to get to the other side of the experience.
- We have limited freedoms and comforts, and small things can make a big difference between misery and tolerability.
- There are professionals present to look after us, but they are busy and have a lot of other people to tend to too.
So why is it that there are so many resources available full of “tips for travelers” and so few “tips for hospital patients”?
Especially given the relative risks of each, and likelihood, or even near-certainty of coming to at least some harm… One would think “tips for patients” would be more in demand!
Tips for surgery patients, from an insider expert
First, he advises us: empower yourself.
Empowering yourself in this context means:
- Relax—doctors really want you to feel better, quickly. They’re on your side.
- Research—knowledge is power, so research the procedure (and its risks!). Dr. Bonney, himself an anesthesiologist, particularly recommends you learn what specific anesthetic will be used (there are many, and they’re all a bit different!), and what effects (and/or after-effects) that may have.
- Reframe—you’re not just a patient; you’re a customer/client. Many people suffer from MDeity syndrome, and view doctors as authority figures, rather than what they are: service providers.
- Request—if something would make you feel better, ask for it. If it’s information, they will be not only obliged, but also enthusiastic, to give it. If it’s something else, they’ll oblige if they can, and the worst case scenario is something won’t be possible, but you won’t know if you don’t ask.
Next up, help them to help you
There are various ways you can be a useful member of your own care team:
- Go into surgery as healthy as you can. If there’s ever a time to get a little fitter, eat a little healthier, prioritize good quality sleep more, the time approaching your surgery is the time to do this.
- This will help to minimize complications and maximize recovery.
- Take with you any meds you’re taking, or at least have an up-to-date list of what you’re taking. Dr. Bonney has very many times had patients tell him such things as “Well, let me see. I have two little pink ones and a little white one…” and when asked what they’re for they tell him “I have no idea, you’d need to ask my doctor”.
- Help them to help you; have your meds with you, or at least a comprehensive list (including: medication name, dosage, frequency, any special instructions)
- Don’t stop taking your meds unless told to do so. Many people have heard that one should stop taking meds before a surgery, and sometimes that’s true, but often it isn’t. Keep taking them, unless told otherwise.
- If unsure, ask your surgical team in advance (not your own doctor, who will not be as familiar with what will or won’t interfere with a surgery).
Do any preparatory organization well in advance
Consider the following:
- What do you need to take with you? Medications, clothes, toiletries, phone charger, entertainment, headphones, paperwork, cash for the vending machine?
- Will the surgeons need to shave anywhere, and if so, might you prefer doing some other form of depilation (e.g. waxing etc) yourself in advance?
- Is your list of medications ready?
- Who will take you to the hospital and who will bring you back?
- Who will stay with you for the first 24 hours after you’re sent home?
- Is someone available to look after your kids/pets/plants etc?
Be aware of how you do (and don’t) need to fast before surgery
The American Society of Anesthesiologists gives the following fasting guidelines:
- Non-food liquids: fast for at least 2 hours before surgery
- Food liquids or light snacks: fast for at least 6 hours before surgery
- Fried foods, fatty foods, meat: fast for at least 8 hours before surgery
(see the above link for more details)
Dr. Bonney notes that many times he’s had patients who’ve had the worst thirst, or caffeine headache, because of abstaining unnecessarily for the day of the surgery.
Unless told otherwise by your surgical team, you can have black coffee/tea up until two hours before your surgery, and you can and should have water up until two hours before surgery.
Hydration is good for you and you will feel the difference!
Want to know more?
Dr. Bonney has his own website and blog, where he offers lots of advice, including for specific conditions and specific surgeries, with advice for before/during/after your hospital stay.
He also has a book with many more tips like those we shared today:
Calm For Surgery: Supertips For A Smooth Recovery
Take good care of yourself!
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Super Joints – by Pavel Tsatsouline
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For those of us for whom mobility and pain-free movement are top priorities, this book has us covered. So what’s different here, compared to your average stretching book?
It’s about functional strength with the stretches. The author’s background as a special forces soldier means that his interest was not in doing arcane yoga positions so much as being able to change direction quickly without losing speed or balance, get thrown down and get back up without injury, twist suddenly without unpleasantly wrenching anything (of one’s own, at least), and generally be able to take knocks without taking damage.
While we are hopefully not having to deal with such violence in our everyday lives, the robustness of body that results from these exercises is one that certainly can go a long way to keep us injury-free.
The exercises themselves are well-described, clearly and succinctly, with equally clear illustrations.
Note: the paperback version is currently expensive, probably due to supply and demand, but if you select the Kindle version, it’s much cheaper with no loss of quality (because the illustrations are black-on-white line-drawings and very clear; perfect for Kindle e-ink)
The style of the book is very casual and conversational, yet somehow doesn’t let that distract it from being incredibly information dense; there is no fluff here, just valuable guidance.
Bottom line: if you would like to be more robust with non-nonsense exercises, then this book is a fine choice.
Click here to check out Super Joints, and make yours flexible and strong!
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Uric Acid’s Extensive Health Impact (And How To Lower It)
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Uric Acid’s Extensive Health Impact (And How To Lower It)
This is Dr. David Perlmutter. He’s a medical doctor, and a Fellow of the American College of Nutrition. He’s a member of the Editorial Board for the Journal of Alzheimer’s Disease, and has been widely published in many other peer-reviewed journals.
What does he want us to know?
He wants us to know about the health risks of uric acid (not something popularly talked about so much!), and how to reduce it.
First: what is it? Uric acid is a substance we make in our own body. However, unlike most substances we make in our body, we have negligible use for it—it’s largely a waste product, usually excreted in urine.
However, if we get too much, it can build up (and crystallize), becoming such things as kidney stones, or causing painful inflammation if it shows up in the joints, as in gout.
More seriously (unpleasant as kidney stones and gout may be), this inflammation can have a knock-on effect triggering (or worsening) other inflammatory conditions, ranging from non-alcoholic fatty liver disease, to arthritis, to dementia, and even heart problems. See for example:
- David Perlmutter | Uric Acid and Cognitive Decline
- American Heart Association | Uric acid linked to later risk for irregular heart rhythm
- World Journal of Gastroenterology | The role of uric acid in non-alcoholic steatohepatitis development
How can we reduce our uric acid levels?
Uric acid is produced when we metabolize purine nucleotides, which are found in many kinds of food. We can therefore reduce our uric acid levels by reducing our purine intake, as well as things that mess up our liver’s ability to detoxify things. Offsetting the values for confounding variables (such as fiber content, or phytochemicals that mitigate the harm), the worst offenders include…
Liver-debilitating things:
- Alcohol (especially beer)
- High-fructose corn syrup (and other fructose-containing things that aren’t actual fruit)
- Other refined sugars
- Wheat / white flour products (this is why beer is worse than wine, for example; it’s a double-vector hit)
Purine-rich things:
- Red meats and game
- Organ meats
- Oily fish, and seafood (great for some things; not great for this)
Some beans and legumes are also high in purines, but much like real fruit has a neutral or positive effect on blood sugar health despite its fructose content, the beans and legumes that are high in purines, also contain phytochemicals that help lower uric acid levels, so have a beneficial effect.
Eggs (consumed in moderation) and tart cherries have a uric-acid lowering effect.
Water is important for all aspects of health, and doubly important for this.
Hydrate well!
Lifestyle matters beyond diet
The main key here is metabolic health, so Dr. Perlmutter advises the uncontroversial lifestyle choices of moderate exercise and good sleep, as well as (more critically) intermittent fasting. We wrote previously on other things that can benefit liver health:
…in this case, that means the liver gets a break to recuperate (something it’s very good at, but does need to get a chance to do), which means that while you’re not giving it something new to do, it can quickly catch up on any backlog, and then tackle any new things fresh, next time you start eating.
Want to know more about this from Dr. Perlmutter?
You might like his article:
An Integrated Plan for Lowering Uric Acid ← more than we had room for here; he also talks about extra things to include in your diet/supplementation regime for beneficial effects!
And/or his book:
…on which much of today’s main feature was based.
Take care!
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How Not To Get Sick: A Cookbook – by Dr. Benjamin Bikman and Diana Keuilian
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We’ve previously reviewed Dr. Bikman’s excellent “Why We Get Sick”, and if you haven’t read that yet, we recommend doing so.
Nevertheless, you don’t need to have read it to benefit from this one, which is about cooking with those learnings (from the other book) in mind.
Before getting to the recipes, we get a section recapping what we learned previously, as well as adding some more general lifestyle advices beyond the kitchen. The science is also expanded a bit, to include such things as the two-way relationship between insulin and aging, as well as the interplay with other metrics of health, including blood lipids, for example.
The authors then provide a plan, in the three stages: reverse (insulin resistance), prevent (insulin resistance), maintain (insulin sensitivity).
The recipes themselves, of which there are 70, are of course tailored to do the above three things; they’re also quite diverse, albeit if you are vegetarian or vegan, you should know in advance that most of these recipes are not.
Bottom line: if the above doesn’t apply to you, and you would like to improve your insulin sensitivity, this book can indeed help.
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Gentle Nutrition – by Rachel Hartley, RD, LD
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The subtitle here claims “a non-diet approach”, but doesn’t everything, nowadays? Even books titled “The such-and-such Diet” tend to also assure us “it’s not actually a diet; it’s just a way of eating”, as if a diet is not—by definition—a way of eating. Usually what they want to communicate is that it’s not a restrictive diet, usually meaning not restrictive in quantity, or not restrictive in food type (rarely both).
This book is about intuitive eating, which is about as non-restrictive as any dietary approach can be, since it doesn’t restrict food type at at all, and it doesn’t restrict quantity in advance—rather, we learn to pay closer attention to our full signals.
No wait, we don’t. This time, it’s not about “full”, it’s about “satisfied”. This comes in two forms:
- A principle somewhat akin to the “eat until 80% full” idea
- A principle of ensuring the good is culinarily satisfying
This latter is important, if we want to have a good relationship with eating, and it also helps reduce portion sizes, when we truly take the time to mindfully savor a tasty morsel, rather than wolf down a plate of mediocre food.
The style is one that balance being encouraging with delivering science to back up that encouragement. This not only means encouragement to take up this dietary approach, but also, encouragement to let go of things like calorie-counting and BMI.
The recipes arranged per meal type, and indeed include things not found in many healthy eating books, such as gyoza dumplings, gnocchi, wontons, and shortbread. The recipes are mostly not, by default, vegan, vegetarian, gluten-free, dairy-free, or such. So if you have your own food restriction(s), the number of usable recipes will be diminished, barring any substitutions you can make yourself.
Bottom line: this is more about about how to go about intuitive eating, than it is a book with a lot of nutritional information (though there is some of that too). If you’d like to get going with intuitive eating, then this book can help.
Click here to check out Gentle Nutrition, and nourish gently!
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Turkish Saffron Salad
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Summer is upon us, and we need salad options. Coleslaw’s all well and good, until you’re the 4th person to bring it to the pot luck. Tzatziki’s great—and healthier than a standard coleslaw, being based in yogurt rather than mayonnaise as most Western coleslaws are (Eastern European coleslaws, for example, more often use a vinaigrette), but today our tastebuds are traveling to Turkey for this gut-healthy, phytochemical-rich, delicious dish.
You will need
- 12 oz carrots, cut into very thin batons (alternatively: use a peeler to peel it into super-thin strips)
- 2 oz chopped nuts (pistachios are traditional, almonds are also used sometimes; many other nuts would work too e.g. walnuts, hazelnuts, etc; not peanuts though)
- 2 cups kefir yogurt (if unavailable, substitute any 2 cups plain unsweetened yogurt; comparable plant yogurt is fine if you’re vegan; those healthy bacteria love plant yogurts as much as animal ones)
- 1 bulb garlic, grated
- 1 tsp chili flakes
- 1 pinch saffron, ground, then soaked in 1 tbsp warm water for a few hours
- 2 tbsp olive oil for cooking; ideally Extra Virgin, but at least Virgin
Method
(we suggest you read everything at least once before doing anything)
1) Put the olive oil and carrots into a saucepan and heat gently, stirring. You want to soften the carrots just a little and absorb the olive oil, without actually fully cooking the carrots; this will probably only take 2–3 minutes at most. Take it off the heat and transfer it to a bowl to cool.
When the mixture has cooled…
2) Add the kefir yogurt, garlic, chili flakes, and saffron water into the carrots, mixing thoroughly.
3) Add the chopped nuts as a garnish
(after mixing thoroughly, you will probably see more of the yogurt mixture and less of the carrots; that’s fine and correct))
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Making Friends With Your Gut (You Can Thank Us Later)
- The Many Health Benefits Of Garlic
- Capsaicin For Weight Loss And Against Inflammation
- Why You Should Diversify Your Nuts!
- Saffron For The Brain (& More) ← do not underestimate saffron’s neuroprotective qualities, and many other beneficial properties!
Take care!
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How Old Is Too Old For HRT?
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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 think you guys do a great job. Wondering if I can suggest a topic? Older women who were not offered hormone replacement therepy because of a long term study that was misread. Now, we need science to tell us if we are too old to benefit from begininng to take HRT. Not sure how old your readers are on average but it would be a great topic for older woman. Thanks❞
Thank you for the kind words, and the topic suggestion!
About the menopause and older age thereafter
We’ve talked a bit before about the menopause, for example:
What You Should Have Been Told About The Menopause Beforehand
And we’ve even discussed the unfortunate social phenomenon of post-menopausal women thinking “well, that’s over and done with now, time to forget about that”, because spoiler, it will never be over and done with—your body is always changing every day, and will continue to do so until you no longer have a body to change.
This means, therefore, that since changes are going to happen no matter what, the onus is on us to make the changes as positive (rather than negative) as possible:
Menopause, & When Not To Let Your Guard Down
About cancer risk
It sounds like you know this one, but for any who were unaware: indeed, there was an incredibly overblown and misrepresented study, and even that was about older forms of HRT (being conjugated equine estrogens, instead of bioidentical estradiol):
As for those who have previously had breast cancer or similar, there is also:
The Hormone Therapy That Reduces Breast Cancer Risk & More
Is it too late?
Fortunately, there is a quick and easy test to know whether you are too old to benefit:
First, find your pulse, by touching the first two fingers of one hand, against the wrist of the other. If you’re unfamiliar with where to find the pulse at the wrist, here’s a quick explainer.
Or if you prefer a video:
Click Here If The Embedded Video Doesn’t Load Automatically!
Did you find it?
Good; in that case, it’s not too late!
Scientists have tackled this question, looking at women of various ages, and finding that when comparing age groups taking HRT, disease risk changes do not generally vary much by age i.e., someone at 80 gets the same relative benefit from HRT as someone at 50, with no extra risks from the HRT. For example, if taking HRT at 50 reduces a risk by n% compared to an otherwise similar 50-year-old not on HRT, then doing so at 80 reduces the same risk by approximately the same percentage, compared to an otherwise similar 80-year-old not on HRT.
There are a couple of exceptions, such as in the case of already having advanced atherosclerotic lesions (in which specific case HRT could increase inflammation; not something it usually does), or in the case of using conjugated equine estrogens instead of modern bioidentical estradiol (as we talked about before).
Thus, for the most part, HRT is considered safe and effective regardless of age:
How old is too old for hormone therapy?
👆 that’s from 2015 though, so how about a new study, from 2024?
❝Compared with never use or discontinuation of menopausal hormone therapy after age 65 years, the use of estrogen monotherapy beyond age 65 years was associated with significant risk reductions in mortality (19% or adjusted hazards ratio, 0.81; 95% CI, 0.79-0.82), breast cancer (16%), lung cancer (13%), colorectal cancer (12%), congestive heart failure (CHF) (5%), venous thromboembolism (3%), atrial fibrillation (4%), acute myocardial infarction (11%), and dementia (2%).❞
❝Among senior Medicare women, the implications of menopausal hormone therapy use beyond age 65 years vary by types, routes, and strengths. In general, risk reductions appear to be greater with low rather than medium or high doses, vaginal or transdermal rather than oral preparations, and with estradiol rather than conjugated estrogen.❞
Read in full: Use of menopausal hormone therapy beyond age 65 years and its effects on women’s health outcomes by types, routes, and doses
As for more immediately-enjoyable benefits (improved mood, healthier skin, better sexual function, etc), yes, those also are benefits that people enjoy at least into their eighth decade:
See: Use of hormone therapy in Swedish women aged 80 years or older
What about…
Statistically speaking, most people who take HRT have a great time with it and consider it life-changing in a good way. However, nothing is perfect; sometimes going on HRT can have a shaky start, and for those people, there may be some things that need addressing. So for that, check out:
HRT Side Effects & Troubleshooting
And also, while estrogen monotherapy is very common, it is absolutely worthwhile to consider also taking progesterone alongside it:
Progesterone Menopausal HRT: When, Why, And How To Benefit
Enjoy!
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