It’s OK That You’re Not OK – by Megan Devine
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Firstly, be aware: this is not a cheerful book. If you’re looking for something to life your mood after a loss, it will not be this.
What, then, will you find? A reminder that grief is also the final translation of love, and not necessarily something to be put aside as quickly as possible—or even ever, if we don’t want to.
Too often, society (and even therapists) will correctly note that no two instances of grief are the same (after all, no two people are, so definitely no two relationships are, so how could two instances of grief be?), but will still expect that if most people can move on quickly from most losses, that you should too, and that if you don’t then there is something pathological at hand that needs fixing.
Part one of the book covers this (and more) in a lot of detail; critics have called it a diatribe against the current status quo in the field of grief.
Part two of the book is about “what to do with your grief”, and addresses the reality of grief, how (and why) to stay alive when not doing so feels like a compelling option, dealing with grief’s physical side effects, and calming your mind in ways that actually work (without trying to sweep your grief under a rug).
Parts three and four are more about community—how to navigate the likely unhelpful efforts a lot of people may make in the early days, and when it comes to those people who can and will actually be a support, how to help them to help you.
In the category of criticism, she also plugs her own (paid, subscription-based) online community, which feels a little mercenary, especially as while community definitely can indeed help, the prospect of being promptly exiled from it if you stop paying, doesn’t.
Bottom line: if you have experienced grief and felt like moving on was the right thing to do, then this book isn’t the one for you. If, on the other hand, your grief feels more like something you will carry just as you carry the love you feel for them, then you’ll find a lot about that here.
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Learning to Love Midlife – by Chip Conley
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While the book is titled about midlife, it could have said: midlife and beyond.
Some of the benefits discussed in this book really only kick in during one’s 50s, 60s, or 70s, usually. Which, for all but the most optimistic, is generally considered to be stretching beyond what is usually called “midlife”.
However! Chip Conley makes the argument for midlife being anywhere from one’s early 30s to mid-70s, depending on what (and how) we’re doing in life.
He talks about (as the subtitle promises) 12 reasons life gets better with age, and those reasons are grouped into 5 categories, thus:
- Physical life
- Emotional life
- Mental life
- Vocational life
- Spiritual life
It may surprise some readers that there are physical benefits that come with aging, but we do get two chapters in that category.
The writing style is very casual, yet with references to science throughout, and a bibliography for such.
Bottom line: if you’d like to make sure you’re making the most of your midlife and beyond, this a book that offers a lot of guidance on doing so!
Click here to check out Learning to Love Midlife, and age in style!
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Elon Musk says ‘disc replacement’ worked for him. But evidence this surgery helps chronic pain is lacking
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Last week in a post on X, owner of the platform Elon Musk recommended people look into disc replacement if they’re experiencing severe neck or back pain.
According to a biography of the billionaire, he’s had chronic back and neck pain since he tried to “judo throw” a 350-pound sumo wrestler in 2013 at a Japanese-themed party for his 42nd birthday, and blew out a disc at the base of his neck.
In comments following the post, Musk said the surgery was a “gamechanger” and reduced his pain significantly.
Musk’s original post has so far had more than 50 million views and generated controversy. So what is disc replacement surgery and what does the evidence tells us about its benefits and harms?
What’s involved in a disc replacement?
Disc replacement is a type of surgery in which one or more spinal discs (a cushion between the spine bones, also known as vertebrae) are removed and replaced with an artificial disc to retain movement between the vertebrae. Artificial discs are made of metal or a combination of metal and plastic.
Disc replacement may be performed for a number of reasons, including slipped discs in the neck, as appears to be the case for Musk.
Disc replacement is major surgery. It requires general anaesthesia and the operation usually takes 2–4 hours. Most people stay in hospital for 2–7 days. After surgery patients can walk but need to avoid things like strenuous exercise and driving for 3–6 weeks. People may be required to wear a neck collar (following neck surgery) or a back brace (following back surgery) for about 6 weeks.
Costs vary depending on whether you have surgery in the public or private health system, if you have private health insurance, and your level of coverage if you do. In Australia, even if you have health insurance, a disc replacement surgery may leave you more than A$12,000 out of pocket.
Disc replacement surgery is not performed as much as other spinal surgeries (for example, spinal fusion) but its use is increasing.
In New South Wales for example, rates of privately-funded disc replacement increased six-fold from 6.2 per million people in 2010–11 to 38.4 per million in 2019–20.
What are the benefits and harms?
People considering surgery will typically weigh that option against not having surgery. But there has been very little research comparing disc replacement surgery with non-surgical treatments.
Clinical trials are the best way to determine if a treatment is effective. You first want to show that a new treatment is better than doing nothing before you start comparisons with other treatments. For surgical procedures, the next step might be to compare the procedure to non-surgical alternatives.
Unfortunately, these crucial first research steps have largely been skipped for disc replacement surgery for both neck and back pain. As a result, there’s a great deal of uncertainty about the treatment.
There are no clinical trials we know of investigating whether disc replacement is effective for neck pain compared to nothing or compared to non-surgical treatments.
For low back pain, the only clinical trial that has been conducted to our knowledge comparing disc replacement to a non-surgical alternative found disc replacement surgery was slightly more effective than an intensive rehabilitation program after two years and eight years.
Many people experience chronic pain. Yan Krukau/Pexels Complications are not uncommon, and can include disclocation of the artificial disc, fracture (break) of the artificial disc, and infection.
In the clinical trial mentioned above, 26 of the 77 surgical patients had a complication within two years of follow up, including one person who underwent revision surgery that damaged an artery leading to a leg needing to be amputated. Revision surgery means a re-do to the primary surgery if something needs fixing.
Are there effective alternatives?
The first thing to consider is whether you need surgery. Seeking a second opinion may help you feel more informed about your options.
Many surgeons see disc replacement as an alternative to spinal fusion, and this choice is often presented to patients. Indeed, the research evidence used to support disc replacement mainly comes from studies that compare disc replacement to spinal fusion. These studies show people with neck pain may recover and return to work faster after disc replacement compared to spinal fusion and that people with back pain may get slightly better pain relief with disc replacement than with spinal fusion.
However, spinal fusion is similarly not well supported by evidence comparing it to non-surgical alternatives and, like disc replacement, it’s also expensive and associated with considerable risks of harm.
Fortunately for patients, there are new, non-surgical treatments for neck and back pain that evidence is showing are effective – and are far cheaper than surgery. These include treatments that address both physical and psychological factors that contribute to a person’s pain, such as cognitive functional therapy.
While Musk reported a good immediate outcome with disc replacement surgery, given the evidence – or lack thereof – we advise caution when considering this surgery. And if you’re presented with the choice between disc replacement and spinal fusion, you might want to consider a third alternative: not having surgery at all.
Giovanni E Ferreira, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, University of Sydney; Christine Lin, Professor, Institute for Musculoskeletal Health, University of Sydney; Christopher Maher, Professor, Sydney School of Public Health, University of Sydney; Ian Harris, Professor of Orthopaedic Surgery, UNSW Sydney, and Joshua Zadro, NHMRC Emerging Leader Research Fellow, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Intuitive Eating – by Evelyn Tribole and Elyse Resch
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You may be given to wonder: if this is about intuitive eating, and an anti-diet approach, why a whole book?
There’s a clue in the other part of the title: “4th Edition”.
The reason there’s a 4th edition (and before it, a 3rd and 2nd edition) is because this book is very much full of science, and science begets more science, and the evidence just keeps on rolling in.
While neither author is a doctor, each has a sizeable portion of the alphabet after their name (more than a lot of doctors), and this is an incredibly well-evidenced book.
The basic premise from many studies is that restrictive dieting does not work well long-term for most people, and instead, better is to make use of our bodies’ own interoceptive feedback.
You see, intuitive eating is not “eat randomly”. We do not call a person “intuitive” because they speak or act randomly, do we? Same with diet.
Instead, the authors give us ten guiding principles (yes, still following the science) to allow us a consistent “finger on the pulse” of what our body has to say about what we have been eating, and what we should be eating.
Bottom line: if you want to be a lot more in tune with your body and thus better able to nourish it the way it needs, this book is literally on the syllabus for many nutritional science classes, and will stand you in very good stead!
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Heavy Metal Detox In A Pill?
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We have previous discussed assorted approaches to “detoxing”:
Detox: What’s Real, What’s Not, What’s Useful, What’s Dangerous?
Today we’re going to be looking at one we didn’t cover there, which is zeolite.
What is zeolite?
Zeolite is a mineral that occurs naturally and can also be synthesized, and it’s famous for absorbing other stuff from around it. Because of this property, it’s used in many things, including:
- Petrochemical catalysis
- Water treatment
- Nuclear waste reprocessing
- Cat litter
- Supplements (for detox purposes)
That’s, uh… An interesting list, isn’t it? So, we were curious as to whether this mineral that’s also used in fish tank filters is, in fact, overpriced gravel being sold to the gullible as a health supplement.
We had to do some digging on this one
Our journey didn’t start well, with this very dubious-looking paper being cited by a company selling zeolite supplements:
This immediately prompted two questions:
- Who is eating graphene?!* That stuff does not occur in nature (or at least; it hasn’t ever been found; the universe is a big place so it might exist elsewhere), has only relatively recently been synthesized, is very difficult to produce, is two-dimensional while being hard as diamonds, and exists only in truly tiny lab-made quantities worldwide. It would be orders of magnitude easier to find and eat uranium.
- Is this a reputable journal? Which question was easier to answer than the former one, and the answer is “no”; we hadn’t heard of this journal (ACTA Scientific), and neither it seems had most of the Internet, but we did find it on a list of predatory journals, here.
*The citation given in the above paper should by rights answer the question of who is eating graphene, since by rights they must have demonstrated it somehow, but it just doesn’t. Instead, it links to what it claims is a paper titled “Oxygenated Zeolite (Clinoptilite) Efficiently Removes Aluminum & Graphene Oxide”, but is in reality just someone’s blog post with a screenshot of an actual paper entitled “Novel, oxygenated clinoptilolite material efficiently removes aluminium from aluminium chloride-intoxicated rats in vivo”). Looking up this real paper in its real journal, it does not mention graphene.
All this to say: sometimes, unscrupulous people will just plain lie to you, which is why peer review is important, as is sourcing data from reputable journals. Which is what we do for you so that you don’t have to 🙂
It does, actually, work though (for heavy metal detox)
Notwithstanding the aforementioned bunk, we found this from a more reputable publisher:
❝In this study, we have presented clinical evidence supporting the use of an activated clinoptilolite (zeolite) suspension to safely and effectively increase the urinary excretion of potentially toxic heavy metals in healthy volunteers without negatively impacting the electrolyte profiles of the participants.
Significant increases in the urinary excretion of aluminum, antimony, arsenic, bismuth, cadmium, lead, mercury, nickel and tin were observed in the subjects participating in the two study groups as compared to placebo controls.❞
Also good for the gut and against inflammation
Specifically, it’s good for gut barrier integrity, i.e., against “leaky gut syndrome”:
❝Twelve weeks of zeolite supplementation exerted beneficial effects on intestinal wall integrity as indicated via decreased concentrations of the tight junction modulator zonulin.
This was accompanied by mild anti-inflammatory effects in this cohort of aerobically trained subjects.❞
May also be good against neurodegenerative diseases
If it is (which is plausible), it’ll probably because of removing heavy metals and improving gut barrier integrity—in other words, the things we just looked at in the two reputable peer-reviewed studies we examined above.
But the science is young for this one; here’s the current state of things:
Zeolite and Neurodegenerative Diseases
Is it safe?
Safety reviews have found it to be safe, for example:
Critical Review on Zeolite Clinoptilolite Safety and Medical Applications in vivo
However, if you are taking regular medications, we recommend checking with your pharmacist or doctor to ensure that zeolite will not also remove those medications from your system!
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon 😎
Enjoy!
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5 Things To Know About Passive Suicidal Ideation
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If you’ve ever wanted to go to sleep and never wake up, or have some accident/incident/illness take you with no action on your part, or a loved one has ever expressed such thoughts/feelings to you… Then this video is for you. Dr. Scott Eilers explains:
Tired of living
We’ll not keep them a mystery; here are the five things that Dr. Eilers wants us to know about passive suicidal ideation:
- What it is: a desire for something to end your life without taking active steps. While it may seem all too common, it’s not necessarily inevitable or unchangeable.
- What it means in terms of severity: it isn’t a clear indicator of how severe someone’s depression is. It doesn’t necessarily mean that the person’s depression is mild; it can be severe even without active suicidal thoughts, or indeed, suicidality at all.
- What it threatens: although passive suicidal ideation doesn’t usually involve active planning, it can still be dangerous. Over time, it can evolve into active suicidal ideation or lead to risky behaviors.
- What it isn’t: passive suicidal ideation is different from intrusive thoughts, which are unwanted, distressing thoughts about death. The former involves a desire for death, while the latter does not.
- What it doesn’t have to be: passive suicidal ideation is often a symptom of underlying depression or a mood disorder, which can be treated through therapy, medication, or a combination of both. Seeking treatment is crucial and can be life-changing.
For more on all of the above, here’s Dr. Eilers with his own words:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- The Mental Health First Aid You’ll Hopefully Never Need ← about depression generally
- How To Stay Alive (When You Really Don’t Want To) ← about suicidality specifically
Take care!
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Aspirin vs Cancer Metastasis
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Aspirin is a bit of a mixed bag.
In the category of things in its favor, it’s a modest analgesic with few side effects from occasional use, so it’s a good option if you have a headache, for example.
Unless you’re already on blood thinners or having a bleeding disorder, in which case, aspirin is not the thing to reach for.
About aspirin and heart disease
This is actually a complicated one, and we covered it at length in a dedicated main feature. If you want a one-line summary, it’s “chronic low-dose aspirin use can lower overall CVD risk, but does not reduce CVD mortality or all-cause mortality, and you may pay for it with gastrointestinal bleeding, and increased risk of ulcers“.
For a more nuanced explanation, see: Aspirin, CVD Risk, & Potential Counter-Risks
On the other hand, if you are having a heart attack and are waiting for the ambulance that you already called, and have aspirin to hand that you don’t have to go looking for, then it can be good to take a dose then.
For more on that, see: How To Survive A Heart Attack When You’re Alone
There are more problems
In the case of chronic use of low-dose aspirin, not only does it increase the risks of bleeding, especially gastrointestinal bleeding, and ulcers, but also it increases the risk of anemia. Given that anemia also gives the symptom “dizziness”, this is also a significant threat for increasing the incidence of falls in the older population, too, which can of course lead to serious complications and ultimately death.
For the science about this, see: Low-Dose Aspirin & Anemia
Now, about aspirin and cancer metastasis
This one’s a point in aspirin’s favor.
Cancer is, in and of itself, obviously a big problem. In terms of when it’s most likely to kill someone, that is usually when the cancer becomes metastatic, that is to say, it has spread.
So, while preventing cancer and, failing that, killing cancer are very important goals, there is a third axis to cancer care, which is preventing metastasis in someone who has cancer.
And that’s what aspirin does. How, you ask?
Scientists found this one out by accident!
They were doing genetic research in mice, to find genes that had an effect on metastasis. In the process, they found a certain gene that instructs the creation of a certain protein, and mice that lacked that gene (and thus its associated protein) had less metastasis.
The protein in question suppresses T-cells, which are programmed to recognize and kill metastatic cancer cells (amongst having other great jobs; they are an important part of the immune system in general, and one that declines with aging; most people in their 60s or older are producing very few T-cells).
About that, see: Focusing On Health In Our Sixties
Tracing the cell signaling, the researchers found that the protein is activated when T-cells are exposed to thromboxane A2 (or TXA2 to its friends).
And TXA2? That’s produced by platelets, and aspirin works by inhibiting TXA2 production, effectively making platelets (and thus the blood as a whole) less sticky.
So, that’s quite a few steps in the process, but ultimately:
- Aspirin inhibits TXA2 production
- Lower TXA2 levels mean ARHGEF1 (that’s the protein) isn’t activated
- ARHGEF1 not being activated means T-cells are free to do their thing
- T-cells are now free to kill metastatic cancer cells
You can read the paper here:
Aspirin prevents metastasis by limiting platelet TXA2 suppression of T cell immunity
Take care!
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