It’s On Me – by Dr. Sara Kuburic
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This isn’t about bootstrapping and nor is it a motivational pep talk. What it is, however, is a wake-up call for the wayward, and that doesn’t mean “disaffected youth” or such. Rather, therapist Dr. Sara Kuburic tackles the problem of self-loss.
It’s about when we get so caught up in what we need to do, should do, are expected to do, are in a rut of doing… That we forget to also live. After all, we only get one shot at life so far as we know, so we might as well live it in whatever way is right for us.
That probably doesn’t mean a life of going through the motions.
The writing style here is personal and direct, and it makes for quite compelling reading from start to finish.
Bottom line: if ever you find yourself errantly sleepwalking through life and would like to change that, this is a book for you.
Click here to check out It’s On Me, and take control of what’s yours!
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Some women’s breasts can’t make enough milk, and the effects can be devastating
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Many new mothers worry about their milk supply. For some, support from a breastfeeding counsellor or lactation consultant helps.
Others cannot make enough milk no matter how hard they try. These are women whose breasts are not physically capable of producing enough milk.
Our recently published research gives us clues about breast features that might make it difficult for some women to produce enough milk. Another of our studies shows the devastating consequences for women who dream of breastfeeding but find they cannot.
Some breasts just don’t develop
Unlike other organs, breasts are not fully developed at birth. There are key developmental stages as an embryo, then again during puberty and pregnancy.
At birth, the breast consists of a simple network of ducts. Usually during puberty, the glandular (milk-making) tissue part of the breast begins to develop and the ductal network expands. Then typically, further growth of the ductal network and glandular tissue during pregnancy prepares the breast for lactation.
But our online survey of women who report low milk supply gives us clues to anomalies in how some women’s breasts develop.
We’re not talking about women with small breasts, but women whose glandular tissue (shown in this diagram as “lobules”) is underdeveloped and have a condition called breast hypoplasia.
Sometimes not enough glandular tissue, shown here as lobules, develop.
Tsuyna/ShutterstockWe don’t know how common this is. But it has been linked with lower rates of exclusive breastfeeding.
We also don’t know what causes it, with much of the research conducted in animals and not humans.
However, certain health conditions have been associated with it, including polycystic ovary syndrome and other endocrine (hormonal) conditions. A high body-mass index around the time of puberty may be another indicator.
Could I have breast hypoplasia?
Our survey and other research give clues about who may have breast hypoplasia.
But it’s important to note these characteristics are indicators and do not mean women exhibiting them will definitely be unable to exclusively breastfeed.
Indicators include:
- a wider than usual gap between the breasts
- tubular-shaped (rather than round) breasts
- asymmetric breasts (where the breasts are different sizes or shapes)
- lack of breast growth in pregnancy
- a delay in or absence of breast fullness in the days after giving birth
In our survey, 72% of women with low milk supply had breasts that did not change appearance during pregnancy, and about 70% reported at least one irregular-shaped breast.
The effects
Mothers with low milk supply – whether or not they have breast hyoplasia or some other condition that limits their ability to produce enough milk – report a range of emotions.
Research, including our own, shows this ranges from frustration, confusion and surprise to intense or profound feelings of failure, guilt, grief and despair.
Some mothers describe “breastfeeding grief” – a prolonged sense of loss or failure, due to being unable to connect with and nourish their baby through breastfeeding in the way they had hoped.
These feelings of failure, guilt, grief and despair can trigger symptoms of anxiety and depression for some women.
Feelings of failure, guilt, grief and despair were common.
Bricolage/ShutterstockOne woman told us:
[I became] so angry and upset with my body for not being able to produce enough milk.
Many women’s emotions intensified when they discovered that despite all their hard work, they were still unable to breastfeed their babies as planned. A few women described reaching their “breaking point”, and their experience felt “like death”, “the worst day of [my] life” or “hell”.
One participant told us:
I finally learned that ‘all women make enough milk’ was a lie. No amount of education or determination would make my breasts work. I felt deceived and let down by all my medical providers. How dare they have no answers for me when I desperately just wanted to feed my child naturally.
Others told us how they learned to accept their situation. Some women said they were relieved their infant was “finally satisfied” when they began supplementing with formula. One resolved to:
prioritise time with [my] baby over pumping for such little amounts.
Where to go for help
If you are struggling with low milk supply, it can help to see a lactation consultant for support and to determine the possible cause.
This will involve helping you try different strategies, such as optimising positioning and attachment during breastfeeding, or breastfeeding/expressing more frequently. You may need to consider taking a medication, such as domperidone, to see if your supply increases.
If these strategies do not help, there may be an underlying reason why you can’t make enough milk, such as insufficient glandular tissue (a confirmed inability to make a full supply due to breast hypoplasia).
Even if you have breast hypoplasia, you can still breastfeed by giving your baby extra milk (donor milk or formula) via a bottle or using a supplementer (which involves delivering milk at the breast via a tube linked to a bottle).
More resources
The following websites offer further information and support:
- Australian Breastfeeding Association
- Lactation Consultants of Australia and New Zealand
- Royal Women’s Hospital, Melbourne
- Supply Line Breastfeeders Support Group of Australia Facebook support group
- IGT And Low Milk Supply Support Group Facebook support group
- Breastfeeding Medicine Network Australia/New Zealand
- Supporting breastfeeding grief (a collection of resources).
Shannon Bennetts, a research fellow at La Trobe University, contributed to this article.
Renee Kam, PhD candidate and research officer, La Trobe University and Lisa Amir, Professor in Breastfeeding Research, La Trobe University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Woman Petitions Health Insurer After Company Approves — Then Rejects — Her Infusions
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When KFF Health News published an article in August about the “prior authorization hell” Sally Nix said she went through to secure approval from her insurance company for the expensive monthly infusions she needs, we thought her story had a happy ending.
That’s because, after KFF Health News sent questions to Nix’s insurance company, Blue Cross Blue Shield of Illinois, it retroactively approved $36,000 worth of treatments she thought she owed. Even better, she also learned she would qualify for the infusions moving forward.
Good news all around — except it didn’t last for long. After all, this is the U.S. health care system, where even patients with good insurance aren’t guaranteed affordable care.
To recap: For more than a decade, Nix, of Statesville, North Carolina, has suffered from autoimmune diseases, chronic pain, and fatigue, as well as a condition called trigeminal neuralgia, which is marked by bouts of electric shock-like pain that’s so intense it’s commonly known as the “suicide disease.”
“It is a pain that sends me to my knees,” Nix said in October. “My entire family’s life is controlled by the betrayal of my body. We haven’t lived normally in 10 years.”
Late in 2022, Nix started receiving intravenous immunoglobulin infusions to treat her diseases. She started walking two miles a day with her service dog. She could picture herself celebrating, free from pain, at her daughter’s summer 2024 wedding.
“I was so hopeful,” she said.
But a few months after starting those infusions, she found out that her insurance company wouldn’t cover their cost anymore. That’s when she started “raising Cain about it” on Instagram and Facebook.
You probably know someone like Sally Nix — someone with a chronic or life-threatening illness whose doctor says they need a drug, procedure, or scan, and whose insurance company has replied: No.
Prior authorization was conceived decades ago to rein in health care costs by eliminating duplicative and ineffective treatment. Not only does overtreatment waste billions of dollars every year, but doctors acknowledge it also potentially harms patients.
However, critics worry that prior authorization has now become a way for health insurance companies to save money, sometimes at the expense of patients’ lives. KFF Health News has heard from hundreds of people in the past year relating their prior authorization horror stories.
When we first met Nix, she was battling her insurance company to regain authorization for her infusions. She’d been forced to pause her treatments, unable to afford $13,000 out-of-pocket for each infusion.
Finally, it seemed like months of her hard work had paid off. In July, Nix was told by staff at both her doctor’s office and her hospital that Blue Cross Blue Shield of Illinois would allow her to restart treatment. Her balance was marked “paid” and disappeared from the insurer’s online portal.
But the day after the KFF Health News story was published, Nix said, she learned the message had changed. After restarting treatment, she received a letter from the insurer saying her diagnoses didn’t actually qualify her for the infusions. It felt like health insurance whiplash.
“They’re robbing me of my life,” she said. “They’re robbing me of so much, all because of profit.”
Dave Van de Walle, a spokesperson for Blue Cross Blue Shield of Illinois, said the company would not discuss individual patients’ cases.
“Prior authorization is often a requirement for certain treatments,” Van de Walle said in a written statement, “and BCBSIL administers benefits according to medical policy and the employer’s benefit.”
But Nix is a Southern woman of the “Steel Magnolia” variety. In other words, she’s not going down without a fight.
In September, she called out her insurance company’s tactics in a http://change.org/ campaign that has garnered more than 21,000 signatures. She has also filed complaints against her insurance company with the U.S. Department of Health and Human Services, U.S. Department of Labor, Illinois Department of Insurance, and Illinois attorney general.
Even so, Nix said, she feels defeated.
Not only is she still waiting for prior authorization to restart her immunoglobulin infusions, but her insurance company recently required Nix to secure preapproval for another treatment — routine numbing injections she has received for nearly 10 years to treat the nerve pain caused by trigeminal neuralgia.
“It is reprehensible what they’re doing. But they’re not only doing it to me,” said Nix, who is now reluctantly taking prescription opioids to ease her pain. “They’re doing it to other patients. And it’s got to stop.”
Do you have an experience with prior authorization you’d like to share? Click here to tell your story.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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Kiwi vs Lime – Which is Healthier?
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Our Verdict
When comparing kiwi to lime, we picked the kiwi.
Why?
Looking at the macros first, kiwi has more protein, more carbs, and more fiber. As with most fruits, the fiber is the number we’re most interested in for health purposes; in this case, kiwi is just slightly ahead of lime on all three of those.
In terms of vitamins, kiwi has more of vitamins A, B2, B3, B6, B9, C, E, K, and choline, while lime has a tiny bit more vitamin B5. As in, the vitamin that’s in pretty much anything and is practically impossible to be deficient in unless you are literally starving to death. You may be thinking: aren’t limes a famously good source of vitamin C? And yes, yes they are. But kiwis have >3x more. In other big differences, kiwis also have >6x more vitamin E and >67 times more vitamin K.
When it comes to minerals, kiwi has more calcium, copper, magnesium, manganese, phosphorus, potassium, and zinc, while lime has more iron and selenium. Another easy win for kiwis.
In short: enjoy both; both are good. But kiwis are the more nutritionally dense option by almost every way of measuring it.
Want to learn more?
You might like to read:
Top 8 Fruits That Prevent & Kill Cancer ← kiwi is top of the list; it promotes cancer cell death while sparing healthy cells
Take care!
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Cold Medicines & Heart Health
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Cold Medicines & Heart Health
In the wake of many decongestants disappearing from a lot of shelves after a common active ingredient being declared useless*, you may find yourself considering alternative decongestants at this time of year.
*In case you missed it:
It doesn’t seem to be dangerous, by the way, just also not effective:
FDA Panel Says Common OTC Decongestant, Phenylephrine, Is Useless
Good for your nose, bad for your heart?
With products based on phenylephrine out of the running, products based on pseudoephedrine, a competing drug, are enjoying a surge in popularity.
Good news: pseudoephedrine works!
Bad news: pseudoephedrine works because it is a vasoconstrictor, and that vasoconstriction reduces nasal swelling. That same vasoconstriction also raises overall blood pressure, potentially dangerously, depending on an assortment of other conditions you might have.
Further reading: Can decongestants spike your blood pressure? What to know about hypertension and cold medicine
Who’s at risk?
The warning label, unread by many, reads:
❝Do not use this product if you have heart disease, high blood pressure, thyroid disease, diabetes, or difficulty in urination due to enlargement of the prostate gland, unless directed by a doctor❞
Source: Harvard Health | Don’t let decongestants squeeze your heart
What are the other options?
The same source as above recommends antihistamines as an option to be considered, citing:
❝Antihistamines such as […] cetirizine (Zyrtec) and loratadine (Claritin) can help with a stuffy nose and are safe for the heart.❞
But we’d be remiss not to mention drug-free options too, for example:
- Saline rinse with a neti pot or similar
- Use of a humidifier in your house/room
- Steam inhalation, with or without eucalyptus etc
See also: Inhaled Eucalyptus’s Immunomodulatory and Antimicrobial Effects
Take care!
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Avoiding Anemia (More Than Just “Get More Iron”)
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The Iron Dilemma: Factors To Consider
Anemia affects around 10% of American seniors, and that number jumps to 34–39% if there’s a comorbidity such as diabetes, hypertension, or hypercholesterolemia, which in turn climbs with increasing age or with other chronic conditions:
So, what can we do about it?
Get iron yes, but how?
We’d be remiss not to say: yes, do of course make sure you get plenty of iron.
Most people know that red meats, which are terrible for the heart and for cancer risk, are good sources of iron.
Well, good insofar as they provide plenty of it! They’re bad for other reasons.
❝Studies consistently show that consumption of red meat has been contributory to a multitude of chronic conditions such as diabetes, CVD, and malignancies.
There are various emerging reasons that strengthen this link-from the basic constituents of red meat like the heme iron component, the metabolic reactions that take place after consumption, and finally to the methods used to cook it.
The causative links show that even occasional use raises the risk of T2DM.❞
Source: Red Meat Consumption (Heme Iron Intake) and Risk for Diabetes and Comorbidities?
To heme or not to heme
Did you catch that in the middle there, about the heme iron component?
Dietary iron is broadly divided into two kinds: heme, and non-heme.
- Heme iron comes from animals
- Non-heme iron comes from plants
Bad news for vegans: non-heme iron is not so easily absorbed as heme iron.
This means that if you’re just eating plants, the RDA may be significantly lowballing the amount actually required. As a rule, about 1.8x more iron may be needed for vegans, to compensate for it being less easily absorbed.
Why this happens: it’s because of the phytic acid / phytate in the plants that contain the iron, blocking its absorption.
Good news for vegans: however, taking iron with vitamin C increases its absorption rate by about 5x better absorption, and several other side-along nutrients do similarly, including allium (from garlic), carotenoids (from many colorful plants), and fermented foods.
Why this happens: it’s because they bind with similar sites as phytic acid, without causing the same effect. To make a metaphor: these foods steal phytic acid’s parking space, so phytic acid can’t do its iron-blocking thing.
By happy coincidence, today’s featured recipe has all of these things in, by the way (vitamin C, allium, carotenoids, and fermented foods), and the star ingredient (fava beans) is a rich source of iron.
What are good sources of iron, then?
In the category of plants:
- Beans (pick your favorites / eat a variety)
- Lentils (pick your favorites / eat a variety)
- Greens (especially dark leafy greens)
- Apricots (you can get these dried, for convenience!)
- Dark chocolate (5mg per 1oz square!)*
*Ok, technically dark chocolate is not a plant; cacao is a plant; dark chocolate is usually plant-based, though, as there is no reason to add milk.
In the category of dairy products:
That’s not a publication error; dairy products are just not great for iron. Cheeses are more nutrient-dense than milk, and have less than 0.5mg per oz, in other words, the top dairy product has around 10x less iron than dark chocolate, which came in 5th place and let’s face it, we were doing broad categories there. If we listed all the beans, lentils, greens, etc it’d be a much longer list.
Eggs, which are sometimes considered under the category of dairy by virtue of not being an animal (yet!) but an animal product, have around 1mg per egg, by the way, so considering eggs are nearer 2oz, that’s not much better than the cheese.
“But what about if…”
The above is good science and general good advice for most people. That said, some people may have conditions that preclude the foods we recommended, or have other considerations, and so things may be different. Anemia can sometimes be caused by things that can’t be fixed by diet (beyond the scope of today’s article; another time, perhaps), but for example, if you have leukemia then definitely discuss things with your doctors first. Other illnesses, and some medications, can also have troublesome effects that can contribute to anemia. Again, we can offer very good general information here, but we don’t know your medical history, and our standard legal/medical disclaimer applies as always.
See also: Do We Need Animal Products To Be Healthy?
Take care!
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The How Not to Die Cookbook – by Dr. Michael Greger
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We’ve previously reviewed Dr. Greger’s “How Not To Die”, which is excellent and/but very science-dense.
This book is different, in that the science is referenced and explained throughout, but the focus is the recipes, and how to prepare delicious healthy food in accordance with the principles laid out in How Not To Die.
It also follows “Dr Greger’s Daily Dozen“, that is to say, the 12 specific things he advises we make sure to have every day, and thus helps us to include them in an easy, no-fuss fashion.
The recipes themselves are by Robin Robertson, and/but with plenty of notes by Dr Greger; they clearly collaborated closely in creating them.
The ingredients are all things one can find in any well-stocked supermarket, so unless you live in a food desert, you can make these things easily.
And yes, the foods are delicious too.
Bottom line: if you’re interested in cooking according to perhaps the most science-based dietary system out there, then this book is a top-tier choice.
Click here to check out The How Not To Die Cookbook, and live well!
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