Get The Right Help For Your Pain
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How Much Does It Hurt?
Sometimes, a medical professional will ask us to “rate your pain on a scale of 1–10”.
It can be tempting to avoid rating one’s pain too highly, because if we say “10” then where can we go from there? There is always a way to make pain worse, after all.
But that kind of thinking, however logical, is folly—from a practical point of view. Instead of risking having to give an 11 later, you have now understated your level-10 pain as a “7” and the doctor thinks “ok, I’ll give Tylenol instead of morphine”.
A more useful scale
First, know this:
Zero is not “this is the lowest level of pain I get to”.
Zero is “no pain”.
As for the rest…
- My pain is hardly noticeable.
- I have a low level of pain; I am aware of my pain only when I pay attention to it.
- My pain bothers me, but I can ignore it most of the time.
- I am constantly aware of my pain, but can continue most activities.
- I think about my pain most of the time; I cannot do some of the activities I need to do each day because of the pain.
- I think about my pain all of the time; I give up many activities because of my pain.
- I am in pain all of the time; It keeps me from doing most activities.
- My pain is so severe that it is difficult to think of anything else. Talking and listening are difficult.
- My pain is all that I can think about; I can barely move or talk because of my pain.
- I am in bed and I can’t move due to my pain; I need someone to take me to the emergency room because of my pain.
10almonds tip: are you reading this on your phone? Screenshot the above, and keep it for when you need it!
One extra thing to bear in mind…
Medical staff will be more likely to believe a pain is being overstated, on a like-for-like basis, if you are a woman, or not white, or both.
There are some efforts to compensate for this:
A new government inquiry will examine women’s pain and treatment. How and why is it different?
Some other resources of ours:
- The 7 Approaches To Pain Management ← a pain specialist discusses the options available
- Managing Chronic Pain (Realistically!) ← when there’s no quick fix, but these things can buy you some hours’ relief at least / stop the pain from getting worse in the moment
- Science-Based Alternative Pain Relief ← for when you’re maxxed out on painkillers, and need something more/different, these are the things the science says will work
Take care!
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How To Engage Your Whole Brain
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The Stroke Of Insight That Nobody Wants
This is Dr. Jill Bolte Taylor. She’s a neuroanatomist, who, at the age of 37 (when she was a post-doctoral fellow at Harvard Medical School), had what she refers to as her “stroke of insight”.
That is to say, she had a massive stroke, and after a major brain surgery to remove a clot the size of a golf ball, she spent the next 8 years re-learning to do everything.
Whereas previously she’d been busy mapping the brain to determine how cells communicate with each other, now she was busy mapping whether socks or shoes should go on first. Needless to say, she got an insight into neuroplasticity that few people would hope for.
What does she want us to know?
Dr. Taylor (now once again a successful scientist, lecturer, and author) advocates for “whole brain living”, which involves not taking parts of our brain for granted.
About those parts…
Dr. Taylor wants us to pay attention to all the parts regardless of size, ranging from the two hemispheres, all the way down to the billions of brain cells, and yet even further, to the “trillions of molecular geniuses”—because each brain cell is itself reliant on countless molecules of the many neurochemicals that make up our brain.
For a quick refresher on some of the key players in that latter category, see our Neurotransmitter Cheatsheet 😎
When it comes to the hemispheres, there has historically been a popular belief that these re divided into:
- The right brain: emotional, imaginative, creative, fluid feeling
- The left brain: intellectual, analytical, calculating, crystal thinking
…which is not true, anatomically speaking, because there are cells on both sides doing their part of both of these broad categories of brain processes.
However, Dr. Taylor found, while one hemisphere of her brain was much more damaged than the other, that nevertheless she could recover some functions more quickly than others, which, once she was able to resume her career, inspired her model of four distinct ways of cogitating that can be switched-between and played with or against each other:
Meet The Four Characters Inside Your Brain
Why this matters
As she was re-learning everything, the way forward was not quick or easy, and she also didn’t know where she was going, because for obvious reasons, she couldn’t remember, much less plan.
Looking backwards after her eventual full recovery, she noted a lot of things that she needed during that recovery, some of which she got and some of which she didn’t.
Most notably for her, she needed the right kind of support that would allow all four of the above “characters” as she puts it, to thrive and grow. And, when we say “grow” here we mean that literally, because of growing new brain cells to replace the lost ones (as well as the simple ongoing process of slowly replacing brain cells).
For more on growing new brain cells, by the way, see:
How To Grow New Brain Cells (At Any Age)
In order to achieve this in all of the required brain areas (i.e., and all of the required brain functions), she also wants us to know… drumroll please…
When to STFU
Specifically, the ability to silence parts of our brain that while useful in general, aren’t necessarily being useful right now. Since it’s very difficult to actively achieve a negative when it comes to brain-stuff (don’t think of an elephant), this means scheduling time for other parts of our brain to be louder. And that includes:
- scheduling time to feel (emotionally)
- scheduling time to feel (gut feelings)
- scheduling time to feel (kinesthetically)
…amongst others.
Note: those three are presented in that order, from least basic to most basic. And why? Because, clever beings that we are, we typically start from a position that’s not remotely basic, such as “overthinking”, for example. So, there’s a wind-down through thinking just the right amount, thinking through simpler concepts, feeling, noticing one’s feelings, noticing noticing one’s feelings, all the way down to what, kinesthetically, are we actually physically feeling.
❝It is interesting to note that although our limbic system fucntions throughout our lifetime, it does not mature. As a result, when our emotional “buttons” are pushed, we retain the ability to react to incoming stimulation as though we were a two-year-old, even when we are adults.❞
~ Dr. Jill Taylor
Of course, sometimes the above is not useful, which is why the ability to switch between brain modes is a very important and useful skill to develop.
And how do we do that? By practising. Which is something that it’s necessary to take up consciously, and pursue consistently. When children are at school, there are (hopefully, ideally) curricula set out to ensure they engage and train all parts of their brain. As adults, this does not tend to get the same amount of focus.
“Children’s brains are still developing”—indeed, and so are adult brains:
The Brain As A Work-In-Progress
Dr. Taylor had the uncommon experience of having to, in many ways, neurologically speaking, redo childhood. And having had a second run at it, she developed an appreciation of the process that most of us didn’t necessarily get when doing childhood just the once.
In other words: take the time to feel stuff; take the time to quiet down your chatty mind, take the time engage your senses, and take it seriously! Really notice, as though for the first time, what the texture of your carpet is like. Really notice, as though for the first time, what it feels like to swallow some water. Really notice, as though for the first time, what it feels like to experience joy—or sadness, or comfort, or anger, or peace. Exercise your imagination. Make some art (it doesn’t have to win awards; it just has to light up your brain!). Make music (again, it’s about wiring your brain in your body, not about outdoing Mozart in composition and/or performance). Make changes! Make your brain work in the ways it’s not in the habit of doing.
If you need a little help switching off parts of your brain that are being too active, so that you can better exercise other parts of your brain that might otherwise have been neglected, you might want to try:
Enjoy!
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Fat’s Real Barriers To Health
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Fat Justice In Healthcare
This is Aubrey Gordon, an author, podcaster, and fat justice activist. What does that mean?
When it comes to healthcare, we previously covered some ideas very similar to her work, such as how…
There’s a lot of discrimination in healthcare settings
In this case, it often happens that a thin person goes in with a medical problem and gets treated for that, while a fat person can go in with the same medical problem and be told “you should try losing some weight”.
Top tip if this happens to you… Ask: “what would you advise/prescribe to a thin person with my same symptoms?”
Other things may be more systemic, for example:
When a thin person goes to get their blood pressure taken, and that goes smoothly, while a fat person goes to get their blood pressure taken, and there’s not a blood pressure cuff to fit them, is the problem the size of the person or the size of the cuff? It all depends on perspective, in a world built around thin people.
That’s a trivial-seeming example, but the same principle has far-reaching (and harmful) implications in healthcare in general, e.g:
- Surgeons being untrained (and/or unwilling) to operate on fat people
- Getting a one-size-fits-all dose that was calculated using average weight, and now doesn’t work
- MRI machines are famously claustrophobia-inducing for thin people; now try not fitting in it in the first place
…and so forth. So oftentimes, obesity will be correlated with a poor healthcare outcome, where the problem is not actually the obesity itself, but rather the system having been set up with thin people in mind.
It would be like saying “Having O- blood type results in higher risks when receiving blood transfusions”, while omitting to add “…because we didn’t stock O- blood”.
Read more on this topic: Shedding Some Obesity Myths
Does she have practical advice about this?
If she could have you understand one thing, it would be:
You deserve better.
Or if you are not fat: your fat friends deserve better.
How this becomes useful is: do not accept being treated as the problem!
Demand better!
If you meekly accept that you “just need to lose weight” and that thus you are the problem, you take away any responsibility from your healthcare provider(s) to actually do their jobs and provide healthcare.
See also Gordon’s book, which we’ve not reviewed yet but probably will one of these days:
“You Just Need to Lose Weight”: And 19 Other Myths About Fat People – by Aubrey Gordon
Are you saying fat people don’t need to lose weight?
That’s a little like asking “would you say office workers don’t need to exercise more?”; there are implicit assumptions built into the question that are going unaddressed.
Rather: some people might benefit healthwise from losing weight, some might not.
In fact, over the age of 65, being what is nominally considered “overweight” reduces all-cause mortality risk.
For details of that and more, see: When BMI Doesn’t Measure Up
But what if I do want/need to lose weight?
Gordon’s not interested in helping with that, but we at 10almonds are, so…
Check out: Lose Weight, But Healthily
Where can I find more from Aubrey Gordon?
You might enjoy her blog:
Aubrey Gordon | Your Fat Friend
Or her other book, which we reviewed previously:
What We Don’t Talk About When We Talk About Fat – by Aubrey Gordon
Enjoy!
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America’s Health System Isn’t Ready for the Surge of Seniors With Disabilities
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The number of older adults with disabilities — difficulty with walking, seeing, hearing, memory, cognition, or performing daily tasks such as bathing or using the bathroom — will soar in the decades ahead, as baby boomers enter their 70s, 80s, and 90s.
But the health care system isn’t ready to address their needs.
That became painfully obvious during the covid-19 pandemic, when older adults with disabilities had trouble getting treatments and hundreds of thousands died. Now, the Department of Health and Human Services and the National Institutes of Health are targeting some failures that led to those problems.
One initiative strengthens access to medical treatments, equipment, and web-based programs for people with disabilities. The other recognizes that people with disabilities, including older adults, are a separate population with special health concerns that need more research and attention.
Lisa Iezzoni, 69, a professor at Harvard Medical School who has lived with multiple sclerosis since her early 20s and is widely considered the godmother of research on disability, called the developments “an important attempt to make health care more equitable for people with disabilities.”
“For too long, medical providers have failed to address change in society, changes in technology, and changes in the kind of assistance that people need,” she said.
Among Iezzoni’s notable findings published in recent years:
Most doctors are biased. In survey results published in 2021, 82% of physicians admitted they believed people with significant disabilities have a worse quality of life than those without impairments. Only 57% said they welcomed disabled patients.
“It’s shocking that so many physicians say they don’t want to care for these patients,” said Eric Campbell, a co-author of the study and professor of medicine at the University of Colorado.
While the findings apply to disabled people of all ages, a larger proportion of older adults live with disabilities than younger age groups. About one-third of people 65 and older — nearly 19 million seniors — have a disability, according to the Institute on Disability at the University of New Hampshire.
Doctors don’t understand their responsibilities. In 2022, Iezzoni, Campbell, and colleagues reported that 36% of physicians had little to no knowledge of their responsibilities under the 1990 Americans With Disabilities Act, indicating a concerning lack of training. The ADA requires medical practices to provide equal access to people with disabilities and accommodate disability-related needs.
Among the practical consequences: Few clinics have height-adjustable tables or mechanical lifts that enable people who are frail or use wheelchairs to receive thorough medical examinations. Only a small number have scales to weigh patients in wheelchairs. And most diagnostic imaging equipment can’t be used by people with serious mobility limitations.
Iezzoni has experienced these issues directly. She relies on a wheelchair and can’t transfer to a fixed-height exam table. She told me she hasn’t been weighed in years.
Among the medical consequences: People with disabilities receive less preventive care and suffer from poorer health than other people, as well as more coexisting medical conditions. Physicians too often rely on incomplete information in making recommendations. There are more barriers to treatment and patients are less satisfied with the care they do get.
Egregiously, during the pandemic, when crisis standards of care were developed, people with disabilities and older adults were deemed low priorities. These standards were meant to ration care, when necessary, given shortages of respirators and other potentially lifesaving interventions.
There’s no starker example of the deleterious confluence of bias against seniors and people with disabilities. Unfortunately, older adults with disabilities routinely encounter these twinned types of discrimination when seeking medical care.
Such discrimination would be explicitly banned under a rule proposed by HHS in September. For the first time in 50 years, it would update Section 504 of the Rehabilitation Act of 1973, a landmark statute that helped establish civil rights for people with disabilities.
The new rule sets specific, enforceable standards for accessible equipment, including exam tables, scales, and diagnostic equipment. And it requires that electronic medical records, medical apps, and websites be made usable for people with various impairments and prohibits treatment policies based on stereotypes about people with disabilities, such as covid-era crisis standards of care.
“This will make a really big difference to disabled people of all ages, especially older adults,” said Alison Barkoff, who heads the HHS Administration for Community Living. She expects the rule to be finalized this year, with provisions related to medical equipment going into effect in 2026. Medical providers will bear extra costs associated with compliance.
Also in September, NIH designated people with disabilities as a population with health disparities that deserves further attention. This makes a new funding stream available and “should spur data collection that allows us to look with greater precision at the barriers and structural issues that have held people with disabilities back,” said Bonnielin Swenor, director of the Johns Hopkins University Disability Health Research Center.
One important barrier for older adults: Unlike younger adults with disabilities, many seniors with impairments don’t identify themselves as disabled.
“Before my mom died in October 2019, she became blind from macular degeneration and deaf from hereditary hearing loss. But she would never say she was disabled,” Iezzoni said.
Similarly, older adults who can’t walk after a stroke or because of severe osteoarthritis generally think of themselves as having a medical condition, not a disability.
Meanwhile, seniors haven’t been well integrated into the disability rights movement, which has been led by young and middle-aged adults. They typically don’t join disability-oriented communities that offer support from people with similar experiences. And they don’t ask for accommodations they might be entitled to under the ADA or the 1973 Rehabilitation Act.
Many seniors don’t even realize they have rights under these laws, Swenor said. “We need to think more inclusively about people with disabilities and ensure that older adults are fully included at this really important moment of change.”
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.
Subscribe to KFF Health News’ free Morning Briefing.
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Treat Your Own Back – by Robin McKenzie
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A quick note about the author first: he’s a physiotherapist and not a doctor, but with over 40 years of practice to his name and 33 letters after his name (CNZM OBE FCSP (Hon) FNZSP (Hon) Dip MDT Dip MT), he seems to know his stuff. And certainly, if you visit any physiotherapist, they will probably have some of his books on their own shelves.
This book is intended for the layperson, and as such, explains everything that you need to know, in order to diagnose and treat your back. To this end, he includes assorted tests to perform, a lot of details about various possible back conditions, and then exercises to fix it, i.e. fix whatever you have now learned that the problem is, in your case (if indeed you didn’t know for sure already).
Of course, not everything can be treated by exercises, and he does point to what other things may be necessary in those cases, but for the majority, a significant improvement (if not outright symptom-free status) can be enjoyed by applying the techniques described in this book.
Bottom line: for most people, this book gives you the tools required to do exactly what the title says.
Click here to check out Treat Your Own Back, and treat your own back!
PS: if your issue is not with your back, we recommend you check out his other books in the series (neck, shoulder, hip, knee, ankle) 😎
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What Happens To Your Body When You Stop Drinking Alcohol
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Immediately after we stop drinking is rarely when we feel our best. But how long is it before we can expect to see benefits, instead of just suffering?
Timeline
After stopping drinking alcohol for…
- Seconds: the liver starts making progress filtering out toxins and sugars; ethanol starts to leave the system
- 1 hour: fatigue sets in as the body uses a lot of energy to metabolize and eliminate alcohol. However, sleep quality (if one goes to sleep now) is low because alcohol disrupts the brain patterns required for restful sleep
- 6–12 hours: the immune system starts recovering from the suppression caused by alcohol
- 24 hours: immune system is back to normal; withdrawal symptoms may occur in the case of heavy drinkers
- 3–5 days: resting blood pressure begins to drop, as stress levels decrease (alcohol may seem anxiolytic, but it is actually anxiogenic; it just masks its own effect in this regard). Also, because of insulin responses improving, appetite reduces. The liver, once it has finished dealing your last drinking session (if you used to drink all the time, it probably had a backlog to clear), can now begin to make repairs on itself.
- 1 week: skin will start looking better, as antidiuretic hormone levels neutralize, leading to a healthier maintenance of hydration
- 2 weeks: cognitive abilities improve as the brain begins to make progress in repairing itself. At the same time, kidneys start to heal.
- 3–4 weeks: the liver begins to regenerate in earnest. You may wonder what took it so long given the liver’s famous regenerative abilities, but in this case, the liver was also the organ that took the most damage from drinking, so its regeneration gets off to a slow start (in contrast, if the liver had “merely” suffered physical trauma, such as being shot, stabbed,
or eaten by eagles,it’d start regenerating vigorously as soon as the immediate wound-response had been tended to). Once it is able to pick up the pace though, overall health improves, as the liver can focus on breaking down other toxins. - 1–2 months: the heart is able to repair itself, and start to become stronger again (dependent on other lifestyle factors, of course).
- 3 months and more: bodily repairs continue (for example, the damage to the liver is often so severe that it can take quite a bit longer to recover completely, and repairs in the brain are always slow, for reasons beyond the scope of this article). Looking at the big picture, at this point we also see other benefits, such as reduced cancer risks.
In short… It’s never too soon to stop, but it’s also never too late, unless you are going to die in the next few days. So long as you’ll be in the land of the living for a few days yet, there’s time to enjoy the benefits of stopping.
Most importantly: the timeline for the most important repairs is not as long as many people might think, and that itself can be very motivating.
For more detail on much of the above, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Can We Drink To Good Health?
- How To Reduce Or Quit Alcohol
- Addiction Myths That Are Hard To Quit
- How To Unfatty A Fatty Liver
Take care!
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The Menopause Manifesto – by Dr. Jen Gunter
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From the subtitle, you may wonder: with facts and feminism? Is this book about biology or sociology?
And the answer is: both. It’s about biology, principally, but without ignoring the context. We do indeed “live in a society”, and that affects everything from our healthcare options to what is expected of us as women.
So, as a warning: if you dislike science and/or feminism, you won’t like this book.
Dr. Jen Gunter, herself a gynaecologist, is here to arm us with science-based facts, to demystify an important part of life that is commonly glossed over.
She talks first about the what/why/when/how of menopause, and then delivers practical advice. She also talks about the many things we can (and can’t!) usefully do about symptoms we might not want, and how to look after our health overall in the context of menopause. We learn what natural remedies do or don’t work and/or can be actively harmful, and we learn the ins and outs of different hormone therapy options too.
Bottom line: no matter whether you are pre-, peri-, or post-menopausal, this is the no-BS guide you’ve been looking for. Same goes if you’re none of the above but spend any amount of time close to someone who is.
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