
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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Can You Get Addicted To MSG, Like With Sugar?
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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 😎
❝Hello, I love your newsletter 🙂 Can I have a question? While browsing through your recepies, I realised many contained MSG. As someone based in Europe, I am not used to using MSG while cooking (of course I know that processed food bought in supermarket containes MSG). There is a stigma, that MSG is not particulary healthy, but rather it should be really bad and cause negative effects like headaches. Is this true? Also, can you get addicted to MSG, just like you get addicted to sugar? Thank you :)❞
Thank you for the kind words, and the interesting questions!
Short answer: no and no 🙂
Longer answer: most of the negative reputation about MSG comes from a single piece of satire written in the US in the 1960s, which the popular press then misrepresented as a genuine concern, and the public then ran with, mostly due to racism/xenophobia/sinophobia specifically, given the US’s historically not fabulous relations with China, and the moniker of “Chinese restaurant syndrome”, notwithstanding that MSG was first isolated in Japan, not China, more than 100 years ago.
The silver lining that comes out of this is that because of the above, MSG has been one of the most-studied food additives in recent decades, with many teams of scientists in many countries trying to determine its risks and not finding any (except insofar as anything in extreme quantities can kill you, including water or oxygen).
You can read more about this and other* myths about MSG, here:
Monosodium Glutamate: Sinless Flavor-Enhancer Or Terrible Health Risk?
*such as pertaining to gluten sensitivity, which in reality MSG has no bearing on whatsoever as it does not contain gluten and is not even made of the same basic stuff; gluten being a protein made of (amongst other things) the amino acid glutamine, not a glutamate salt. Glutamate is as closely related to gluten as cyanocobalamin (vitamin B12) is to cyanide (the famous poison).
PS: if you didn’t click the above link to read that article, then 1) we really do recommend it 2) we did some LD50 calculations there and looked at available research, and found that for someone of this writer’s (very medium) size, eating 1kg of MSG at once is sufficient to cause toxicity, and injecting >250g of MSG may cause heart problems. So we don’t recommend doing that.
However, ½ tsp in a recipe that gives multiple portions is not going to get you anywhere close to the danger zone, unless you consume that entire meal by yourself hundreds of times per day. And if you do, the MSG is probably the least of your concerns.
(2 tsp of cassia cinnamon, however, is enough to cause coumarin toxicity; for this reason we recommend Ceylon (or “True” or “Sweet”) cinnamon in our recipes, as it has almost undetectable levels of coumarin)
With regard to your interesting question about addiction, first of all let’s speak briefly about sugar addiction:
Sugar addiction is, by broad scientific consensus, agreed-upon as an extant thing that does exist, and contemporary research is more looking into the “hows” and “whys” and “whats” rather than the “whether”. It is a somewhat complicated topic, because it’s halfway between what science would usually consider a chemical addiction, and what science would usually consider a behavioral addiction:
The Not-So-Sweet Science Of Sugar Addiction
The reasonable prevailing hypothesis, therefore, is that sugar simply has two moderate mechanisms of addiction, rather than one strong one.
The biochemical side of sugar addiction comes from the body’s metabolism of sugar, so this cannot be a thing for MSG, because there is nothing to metabolize in the same sense of the word (MSG being an inorganic compound with zero calories).
People can crave salt, especially when deficient in it, and MSG does contain sodium (it’s what the “S” stands for), but it contains a little under ⅓ of the sodium that table salt does (sodium chloride in whatever form, be it sea salt, rock salt, or such):
MSG vs. Salt: Sodium Comparison ← we do molecular calculations here!
Sea Salt vs MSG – Which is Healthier? ← this one for a head-to-head
However, even craving salt does not constitute an addiction; nobody is shamefully hiding their rock salt crystals under their bed and getting a fix when they feel low, and nor does withdrawal cause adverse side effects, except insofar as (once again) a person deficient in salt will crave salt.
Finally, the only other way we know of that one might wonder if MSG could be addictive, is about glutamate and glutamate receptors. The glutamate in MSG is the same glutamate (down to the atoms) as the glutamate formed if one consumes tomatoes in the presence of salt, and triggers the same glutamate receptors in the same way. We have the same number of receptors either way, and uptake is exactly the same (because again, it’s exactly the same chemical) so there is a maximum to how strong this effect can be, and that maximum is the same whatever the source of the glutamate was.
In this respect, if MSG is addictive, then so is a tomato salad with a pinch of salt: it’s not—it’s just tasty.
We haven’t cited papers in today’s article, but it’s just because we cited them already in the articles we linked, and so we avoided doubling up. Most of them are in that first link we gave 🙂
One final note
Technically anyone can develop a sensitivity to anything, so in theory someone could develop a sensitivity to MSG, just like they could for any other ingredient. Our usual legal/medical disclaimer applies.
However, it’s certainly not a common trigger, putting it well below common allergens like nuts (or less common allergens like, say, bananas), not even in the same league as common intolerances such as gluten, and less worthy of health risk warnings than, say, spinach (high in oxalates; fine for most people but best avoided if you have kidney problems).
The reason we use it in the recipes we use it in, is simply because it’s a lower-sodium alternative to salt, and while it contains a (very) tiny bit less sodium than low-sodium salt (which itself has about ⅓ the sodium of regular salt), it has more of a flavor-enhancing effect, such that one can use half as much, for a more than sixfold total sodium reduction. Which for most of us in the industrialized world, is beneficial.
Want to try some?
If today’s article has inspired you to give MSG a try, here’s an example product on Amazon 😎
Enjoy!
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Fix Tight Hamstrings In Just 3 Steps
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There’s a better way to increase your flexibility than just stretching and stretching and hoping for the best. Here’s a 3-step method that will transform your flexibility:
As easy as 1-2-3
Only one part actually involves stretching:
Step 1: reciprocal inhibition
- Concept: when one muscle contracts, the opposing muscle relaxes—which is what we need.
- Goal: engage hip flexors to encourage hamstring relaxation.
- Method:
- Kneeling hamstring stretch position with one leg forward.
- Support with yoga blocks or a chair; use a cushion for comfort.
- Maintain a slight arch in the lower back and hinge forward slightly.
- Attempt to lift the foot off the floor, even if it doesn’t move.
- Hold for around 10 seconds.
Step 2: engaging more muscle fibers
- Concept: our muscles contain a lot of fibers, and often not all of them come along for the ride when we do something (exercising, stretching, etc), and those fibers that weren’t engaged will hold back the whole process.
- Goal: activate more fibers in the hamstring for a deeper stretch.
- Method:
- Same kneeling position, slight back arch, and forward hinge.
- Drive the heel into the floor as if trying to dent it.
- Apply significant effort but hold for only 10 seconds.
- A small bend in the knee is acceptable.
Step 3: manipulating the nervous system
- Concept: the nervous system often limits flexibility due to safety signals (causing sensations of discomfort to tell us to stop a lot sooner than we really need to).
- Goal: passive stretching to reduce nervous system resistance.
- Method:
- Avoid muscle engagement or movement—stay completely relaxed.
- Focus on calmness, with slow, steady breaths.
- Avoid signs of tension (e.g. clenched fists, short/sharp breathing). While your nervous system is trying to communicate to you that you are in danger, you need to communicate to your nervous system that this is fine actually, so in order to reassure your nervous system you need to avoid signs that will tip it off that you’re worried too.
- Don’t overstretch; prioritize a relaxed, safe feeling.
For more on all of this, plus visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like:
Tight Hamstrings? Here’s A Test To Know If It’s Actually Your Sciatic Nerve
Take care!
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Terminal lucidity: why do loved ones with dementia sometimes ‘come back’ before death?
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Dementia is often described as “the long goodbye”. Although the person is still alive, dementia slowly and irreversibly chips away at their memories and the qualities that make someone “them”.
Dementia eventually takes away the person’s ability to communicate, eat and drink on their own, understand where they are, and recognise family members.
Since as early as the 19th century, stories from loved ones, caregivers and health-care workers have described some people with dementia suddenly becoming lucid. They have described the person engaging in meaningful conversation, sharing memories that were assumed to have been lost, making jokes, and even requesting meals.
It is estimated 43% of people who experience this brief lucidity die within 24 hours, and 84% within a week.
Why does this happen?
Terminal lucidity or paradoxical lucidity?
In 2009, researchers Michael Nahm and Bruce Greyson coined the term “terminal lucidity”, since these lucid episodes often occurred shortly before death.
But not all lucid episodes indicate death is imminent. One study found many people with advanced dementia will show brief glimmers of their old selves more than six months before death.
Lucidity has also been reported in other conditions that affect the brain or thinking skills, such as meningitis, schizophrenia, and in people with brain tumours or who have sustained a brain injury.
Moments of lucidity that do not necessarily indicate death are sometimes called paradoxical lucidity. It is considered paradoxical as it defies the expected course of neurodegenerative diseases such as dementia.
But it’s important to note these episodes of lucidity are temporary and sadly do not represent a reversal of neurodegenerative disease.
Sadly, these episodes of lucidity are only temporary. Pexels/Kampus Production Why does terminal lucidity happen?
Scientists have struggled to explain why terminal lucidity happens. Some episodes of lucidity have been reported to occur in the presence of loved ones. Others have reported that music can sometimes improve lucidity. But many episodes of lucidity do not have a distinct trigger.
A research team from New York University speculated that changes in brain activity before death may cause terminal lucidity. But this doesn’t fully explain why people suddenly recover abilities that were assumed to be lost.
Paradoxical and terminal lucidity are also very difficult to study. Not everyone with advanced dementia will experience episodes of lucidity before death. Lucid episodes are also unpredictable and typically occur without a particular trigger.
And as terminal lucidity can be a joyous time for those who witness the episode, it would be unethical for scientists to use that time to conduct their research. At the time of death, it’s also difficult for scientists to interview caregivers about any lucid moments that may have occurred.
Explanations for terminal lucidity extend beyond science. These moments of mental clarity may be a way for the dying person to say final goodbyes, gain closure before death, and reconnect with family and friends. Some believe episodes of terminal lucidity are representative of the person connecting with an afterlife.
Why is it important to know about terminal lucidity?
People can have a variety of reactions to seeing terminal lucidity in a person with advanced dementia. While some will experience it as being peaceful and bittersweet, others may find it deeply confusing and upsetting. There may also be an urge to modify care plans and request lifesaving measures for the dying person.
Being aware of terminal lucidity can help loved ones understand it is part of the dying process, acknowledge the person with dementia will not recover, and allow them to make the most of the time they have with the lucid person.
For those who witness it, terminal lucidity can be a final, precious opportunity to reconnect with the person that existed before dementia took hold and the “long goodbye” began.
Yen Ying Lim, Associate Professor, Turner Institute for Brain and Mental Health, Monash University and Diny Thomson, PhD (Clinical Neuropsychology) Candidate and Provisional Psychologist, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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9 Little Habits To Have A Better Day
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Practically gift-wrapped, here are 9 key things to improve any day!
Mindfully does it
These are all things that seem obvious when you read them, but take a moment to consider: how many do you actually do on a daily basis, really? And could you implement the others?
- Remember to be thankful: train your brain to focus on the good in life, either in the morning to start the day positively or at night to unload stress. Or both!
- Change your scenery: visiting new places, even just a walk in the park, can refresh your mind and improve your mood.
- Do one thing at a time: multitasking leads to unfinished, low-quality work. Focusing on one task at a time all but ensures better results.
- Laugh: laughter releases feel-good hormones of various kinds, spreads joy, and relieves tension, making the day more enjoyable. It has longevity-boosting effects too!
- Help someone: helping others boosts happiness, enhances self-worth, and might even provide insights into your own problems. As a bonus, it actually helps the other person, too—so “pay it forward” and all that 🙂
- Prepare the night before: prepping ahead prevents morning stress, making for a smoother and more confident start to the day—which sets the tone of the rest of the day.
- Hype yourself up: even temporary self-belief can boost confidence and its effects are incrementally cumulative over time.
- Relaxation: establish an evening routine (like reading or listening to calming music) to de-stress and improve sleep quality.
- Take your time: being present in the moment enhances enjoyment, improves focus, and cultivates gratitude—which takes us back to #1!
For more on each of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like:
Are You Flourishing? (There’s a Scale)
Take care!
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Drop Acid: The Surprising New Science of Uric Acid – by Dr. David Perlmutter
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A lot of books have “the new science of” in the title or subtitle, and most of the time the science is not, in fact, new. So, how does this one measure up?
The science is so new that, in fact, it’s largely still in the hypothesis stage. Dr. Perlmutter acknowledges this, and simply makes the argument that it is a reasonable hypothesis, and that in time, it’ll either be validated or refuted.
Meanwhile, he advises us about (well-established) health risks associated with high uric acid levels, and recommends we avoid foods high in purines (as is also current scientific consensus), as well as fructose that has been stripped of fiber (scientific consensus holds for that fructose-without-fiber is indeed terrible for metabolic health, but does not hold that it has anything to do with uric acid levels), and grains (current scientific consensus holds that whole grains are positively healthy for most people, and again, does not connect them to uric acid levels).
The potential tie between metabolic health and uric acid levels is something this book explores a lot, before going on to give us a week-by-week guide to reducing our uric acid levels. There are also recipes, but not many.
The style is light pop-science, very easy to read, little hard science. There is a bibliography, but more often the references are for cited statistics, rather than for scientific claims, which frequently go unsupported by the science that has yet to be done.
Bottom line: this is a very speculative book, but it makes a reasonable case, and is at the very least an interesting read with some ideas one won’t find in every second dietary health book out there.
Click here to check out Drop Acid, and drop your uric acid levels!
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The Brain-Training Game That Reduces Your Pain
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A little while ago, we wrote about How Nature Provides Us With A Surprisingly Powerful Painkiller—literally, that viewing nature scenes (even if just on video) alleviates physical pain—not just in self-reported subjective assessments, but also by a reduction of the neural activity that signals pain (unlike placebo, which changes our response to pain when the signal arrives).
That means, of course, that virtual reality can be a potential painkilling technology, if used to view nature scenes.
Of course, a top-tier option in this regard is to view actual nature scenes directly (i.e., spend time in green spaces), but we recognize that it’s not possible for everyone, especially not on-demand.
Beyond virtual reality
Today, we’re going to talk about a new synthesis of existing technologies, to reduce pain (in the case of the study: neuropathic pain) by adjusting one’s brain waves directly.
How? The software monitors brain activity via an electroencephalogram (EEG) headset, and responds in real-time with visual cues as the user learns to regulate abnormal brainwave patterns using biofeedback (specifically: neurofeedback), because…
❝The brainwaves of people with neuropathic pain show a distinct pattern: more slow theta waves, fewer alpha waves, and more fast, high beta waves.
We believe these changes interfere with how the thalamus talks to other parts of the brain, especially the sensory motor cortex, which registers pain.
I wondered, can we develop a treatment that directly targets and normalizes these abnormal waves?❞
~ Dr. Sylvia Gustin, lead researcher
And the answer to that question appears to be “yes”. We say “appears to be”, as so far there’s only been a small pilot study, but they’re recruiting for a larger study to launch soon.
The game itself is tablet-based and simple, and involves a simple visual challenge, on the tablet screen, in various possible ways, but generally taking the form of “this thing on the screen moves this way when your brain state is what it needs to be”, and then the user performs mental exercises (instructions are given) to make the thing on the screen move in the appropriate direction.
Doing this correctly yields—according to preliminary results at least (which admittedly are very preliminary)—pain relief comparable to opioids.
A small but significant portion of the readers may be thinking: wasn’t this the plot of a Star Trek episode in the 90s? And yes it was, but we promise that the headset-based move-the-object-with-neurofeedback opioid-like relief-giving game is not part of an alien takeover attempt this time.
You can read about the pilot study, here: The effect of an EEG neurofeedback intervention for corneal neuropathic pain
If, on the other hand, you don’t want to wait for this to become widely available, you can use other mental techniques to achieve a similar end, without technology; we did a main feature on this before; here it is: How To Dial Down Your Pain
Want to learn more?
We’ve written quite a bit about pain management, including:
- How To Stop Pain Spreading
- Managing Chronic Pain (Realistically!)
- Get The Right Help For Your Pain
- The 7 Approaches To Pain Management
- Science-Based Alternative Pain Relief (When Painkillers Aren’t Helping, These Things Might)
Take care!
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