Paris in spring, Bali in winter. How ‘bucket lists’ help cancer patients handle life and death

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In the 2007 film The Bucket List Jack Nicholson and Morgan Freeman play two main characters who respond to their terminal cancer diagnoses by rejecting experimental treatment. Instead, they go on a range of energetic, overseas escapades.

Since then, the term “bucket list” – a list of experiences or achievements to complete before you “kick the bucket” or die – has become common.

You can read articles listing the seven cities you must visit before you die or the 100 Australian bucket-list travel experiences. https://www.youtube.com/embed/UvdTpywTmQg?wmode=transparent&start=0

But there is a more serious side to the idea behind bucket lists. One of the key forms of suffering at the end of life is regret for things left unsaid or undone. So bucket lists can serve as a form of insurance against this potential regret.

The bucket-list search for adventure, memories and meaning takes on a life of its own with a diagnosis of life-limiting illness.

In a study published this week, we spoke to 54 people living with cancer, and 28 of their friends and family. For many, a key bucket list item was travel.

Why is travel so important?

There are lots of reasons why travel plays such a central role in our ideas about a “life well-lived”. Travel is often linked to important life transitions: the youthful gap year, the journey to self-discovery in the 2010 film Eat Pray Love, or the popular figure of the “grey nomad”.

The significance of travel is not merely in the destination, nor even in the journey. For many people, planning the travel is just as important. A cancer diagnosis affects people’s sense of control over their future, throwing into question their ability to write their own life story or plan their travel dreams.

Mark, the recently retired husband of a woman with cancer, told us about their stalled travel plans:

We’re just in that part of our lives where we were going to jump in the caravan and do the big trip and all this sort of thing, and now [our plans are] on blocks in the shed.

For others, a cancer diagnosis brought an urgent need to “tick things off” their bucket list. Asha, a woman living with breast cancer, told us she’d always been driven to “get things done” but the cancer diagnosis made this worse:

So, I had to do all the travel, I had to empty my bucket list now, which has kind of driven my partner round the bend.

People’s travel dreams ranged from whale watching in Queensland to seeing polar bears in the Arctic, and from driving a caravan across the Nullarbor Plain to skiing in Switzerland.

Humpback whale breaching off the coast
Whale watching in Queensland was on one person’s bucket list. Uwe Bergwitz/Shutterstock

Nadia, who was 38 years old when we spoke to her, said travelling with her family had made important memories and given her a sense of vitality, despite her health struggles. She told us how being diagnosed with cancer had given her the chance to live her life at a younger age, rather than waiting for retirement:

In the last three years, I think I’ve lived more than a lot of 80-year-olds.

But travel is expensive

Of course, travel is expensive. It’s not by chance Nicholson’s character in The Bucket List is a billionaire.

Some people we spoke to had emptied their savings, assuming they would no longer need to provide for aged care or retirement. Others had used insurance payouts or charity to make their bucket-list dreams come true.

But not everyone can do this. Jim, a 60-year-old whose wife had been diagnosed with cancer, told us:

We’ve actually bought a new car and [been] talking about getting a new caravan […] But I’ve got to work. It’d be nice if there was a little money tree out the back but never mind.

Not everyone’s bucket list items were expensive. Some chose to spend more time with loved ones, take up a new hobby or get a pet.

Our study showed making plans to tick items off a list can give people a sense of self-determination and hope for the future. It was a way of exerting control in the face of an illness that can leave people feeling powerless. Asha said:

This disease is not going to control me. I am not going to sit still and do nothing. I want to go travel.

Something we ‘ought’ to do?

Bucket lists are also a symptom of a broader culture that emphasises conspicuous consumption and productivity, even into the end of life.

Indeed, people told us travelling could be exhausting, expensive and stressful, especially when they’re also living with the symptoms and side effects of treatment. Nevertheless, they felt travel was something they “ought” to do.

Travel can be deeply meaningful, as our study found. But a life well-lived need not be extravagant or adventurous. Finding what is meaningful is a deeply personal journey.

Names of study participants mentioned in this article are pseudonyms.

Leah Williams Veazey, ARC DECRA Research Fellow, University of Sydney; Alex Broom, Professor of Sociology & Director, Sydney Centre for Healthy Societies, University of Sydney, and Katherine Kenny, ARC DECRA Senior 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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  • Pelvic Floor Exercises (Not Kegels!) To Prevent Urinary Incontinence

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    It’s a common threat, and if you think it couldn’t happen to you, then well, just wait. Happily, Dr. Christine Pieton, PT, DPT, a sport & women’s health physical therapist, has advice:

    On the ball!

    Or rather, we’re going to be doing ball-squeezing here, if you’ll pardon the expression. You will need a soccer-ball sized ball to squeeze.

    Ball-squeeze breathing: lie on your back, ball between your knees, and inhale deeply, expanding your torso. Exhale, pressing your knees into the ball, engaging your abdominal muscles from lower to upper. Try to keep your spine long and avoid your pelvis tucking under during the exhalation.

    Ball-squeeze bridge: lie on your back, ball between your knees, inhale to prepare, and then exhale, pressing up into a bridge, maintaining a firm pressure on the ball. Inhale as you lower yourself back down.

    Ball-squeeze side plank: lie on your side this time, ball between your knees, supporting forearm under your shoulder, as in the video thumbnail. Inhale to prepare, and then exhale, lifting your hip a few inches off the mat. Inhale as you lower yourself back down.

    Ball-squeeze bear plank: get on your hands and knees, ball between your thighs. Lengthen your spine, inhale to prepare, and exhale as you bring your knees just a little off the floor. Inhale as you lower yourself back down.

    For more details and tips on each of these, plus a visual demonstration, plus an optional part 2 video with more exercises that aren’t ball-squeezes this time, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Psst… A Word To The Wise About UTIs

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  • Carrot vs Pumpkin – Which is Healthier?

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    Our Verdict

    When comparing carrots to pumpkin, we picked the carrots.

    Why?

    Both are great, but…

    In terms of macros, carrots have 6x the fiber for slightly more carbs and (for what it’s worth, which isn’t much) slightly more protein, winning this round.

    In the category of vitamins, carrots have more of vitamins A, B1, B3, B5, B6, B7, B9, E, K, and choline, while pumpkin has slightly more of vitamins B2, C, and E, giving a 9:3 win to carrots here.

    Looking at minerals, carrots have more calcium and manganese, while pumpkin has more copper, iron, phosphorus, potassium, selenium, and zinc, finally winning a round.

    In other considerations, both have a modest yet comparable array of polyphenols, for a tie in this round.

    Adding up the sections makes for an overall win for carrots, but by all means enjoy either or both, as diversity is good!

    Want to learn more?

    You might like:

    What’s Your Plant Diversity Score?

    Enjoy!

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  • Pear vs Pineapple – Which is Healthier?

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    Our Verdict

    When comparing pear to pineapple, we picked the pineapple.

    Why?

    They do both have their merits, and pear started off strong!

    In terms of macros, pears have 2x the fiber, for approximately the same carbs and protein, winning in this category.

    In the category of vitamins, pear has more of vitamins E and K, while pineapple has more of vitamins A, B1, B2, B3, B5, B6, B7, B9, C, and choline, winning easily.

    Looking at minerals, pear has more phosphorus and potassium, while pineapple has more calcium, copper, iron, magnesium, manganese, and zinc, scoring another win for pineapple.

    In other considerations, pineapple gives a lot of extra benefits because it contains bromelain, an enzymatic mixture that is unique to it—you can read all about that in the link below!

    Adding up the sections makes for a clear overall win for pineapple, but by all means enjoy either or both; diversity is good!

    Want to learn more?

    You might like:

    Bromelain vs Inflammation & Much More

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  • How to Be Miserable: 40 Strategies You Already Use – by Dr. Randy Paterson

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    What would you do if you wanted to make your life as miserable as possible? Maybe you’d ensure you are sleep-deprived; maybe you’d adjust your diet and exercise to make disease as likely as possible. Maybe you’d be a consumer of addictive substances. But these are easy, entry-level ways to be miserable—most people do them already!

    Psychologist Dr. Paterson lays out advice to take things to the next level. After covering the above, he gives many more tips, ranging from rehearsing the regrettable past, to constructing future Hells. Engaging in toxic positivity to maximize the blows when bad things happen, and insisting on perfection (to make failure more likely, if not inevitable).

    But still, one can do more. In fact, the author recommends giving 100% to one’s work (he neglected to advise giving 100% when giving blood, perhaps because that would become only a short-lived problem), dropping your boundaries, and at the same time having the highest expectations of others—all the better to feel worse when they turn out to be fallible humans merely doing their best.

    Each of these wise pieces of advice and many more (there are 40 strategies, after all) get a short chapter to them, explained clearly so that the reader can easily apply them in life.

    There’s also a small follow-up about what to do if, for whatever reason, you’ve decided you’ve had enough of your carefully-constructed miserable lifestyle, and would like to flip the tips to try a change of pace instead.

    Bottom line: this is all very effective advice, and how you choose to put this information into practice is up to you!

    Click here to check out How To Be Miserable: 40 Strategies You Already Use, and maximize your misery!

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  • Acorns vs Chestnuts – Which is Healthier?

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    Our Verdict

    When comparing acorns to chestnuts, we picked the acorns.

    Why?

    In terms of macros, chestnuts are mostly water, so it’s not surprising that acorns have a lot more carbs, fat, protein, and fiber. Thus, unless you have personal reasons for any of those to be a problem, acorns are the better choice, offering a lot more nutritional value.

    In the category of vitamins, acorns lead with a lot more of vitamins A, B2, B3, B5, B6, and B9, while chestnuts have more of vitamins B1 and C. However, that vitamin C is useless to us, because it is destroyed in the cooking process (by boiling or roasting), and both of these nuts can be harmful if consumed raw, so that cooking does need to be done. That leaves acorns with a 6:1 lead.

    When it comes to minerals, things are more even; acorns have more copper, magnesium, manganese, and zinc, while chestnuts have more calcium, iron, phosphorus, and potassium. Thus, a 4:4 tie (and yes, the margins of difference are approximately equal too).

    We mentioned “both of these nuts can be harmful if consumed raw”, so a note on that: it’s because, while both contain an assortment of beneficial phytochemicals, they also both contain tannins that, if consumed raw, chelate with iron, essentially taking it out of our diet and potentially creating an iron deficiency. Cooking tannins stops this from being an issue, and the same cooking process renders the tannins actively beneficial to the health, for their antioxidant powers.

    You may have heard that acorns are poisonous; that’s not strictly speaking true, except insofar as anything could be deemed poisonous in excess (including such things as water, and oxygen). Rather, it’s simply the above-described matter of the uncooked tannins and iron chelation. Even then, you’re unlikely to suffer ill effects unless you consume them raw in a fair quantity. While acorns have fallen from popular favor sufficient that one doesn’t see them in supermarkets, the fact is they’ve been enjoyed as an important traditional part of the diet by various indigenous peoples of N. America for centuries*, and provided they are cooked first, they are a good healthy food for most people.

    *(going so far as to cultivate natural oak savannah areas, by burning out young oaks to leave the old ones to flourish without competition, to maximize acorn production, and then store dried acorns in bulk sufficient to cover the next year or so in case of a bad harvest later—so these was not just an incidental food, but very important “our life may depend on this” food. Much like grain in many places—and yes, acorns can be ground into flour and used to make bread etc too)

    Do note: they are both still tree nuts though, so if you have a tree nut allergy, these ones aren’t for you.

    Otherwise, enjoy both; just cook them first!

    Want to learn more?

    You might like to read:

    Why You Should Diversify Your Nuts

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  • The Circadian Diabetes Code – by Dr. Satchin Panda

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    We have previously reviewed Dr. Panda’s “The Circadian Code” which pertains to the circadian rhythms (yes, plural) in general; this one uses much of the same research, but with a strong focus on the implications for blood sugar management.

    It’s first a primer in diabetes (and prediabetes, and, in contrast, what things should look like if healthy). You’ll understand about glucose metabolism and glycogen and insulin and more; you’ll understand what blood sugar readings mean, and you’ll know what an Hb1AC count actually is and what it should look like too, things like that.

    After that, it’s indeed about what the subtitle promises: the right times to eat (and what to eat), when to exercise (and how, at which time), and how to optimize your sleep in the context of circadian rhythm and blood sugar management.

    You may be wondering: why does circadian rhythm matter for blood sugars? And the answer is explained at some length in the first part of the book, but to oversimplify greatly: your body needs energy all the time, no matter when it was that you last ate. Thus, it has to organize its energy reserves to that at all times you can 1) function, on a cellular level 2) maintain a steady balance of sugar in your blood despite using it at slightly higher or lower levels at different times of day. Because the basal metabolic rate accounts for most of our energy use, the body has to plan for a base rate of so much energy per day, and to do that, it needs to know what a day is. Dr. Panda explains this in detail (the marvels of PER proteins and all that), but basically, that’s the relevance of circadian rhythm.

    However, it’s not all theory and biochemistry; there is also a 12-week program to reverse prediabetes and type 2 diabetes (it will not, of course, reverse Type 1 Diabetes, sorry—but the program will still be beneficial even in that case, since more even blood sugars means fewer woes).

    They style is friendly and clear, explaining the science simply, yet without patronizing the reader. References are given, with claims sourced in an extensive bibliography.

    Bottom line: if you or a loved one have diabetes or prediabetes, or just have a strong desire to avoid getting such and generally keep your metabolic health in good order, this book will definitely help.

    Click here to check out The Diabetes Code, and enjoy better blood sugar health than ever!

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