The Comfort Book – by Matt Haig
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This book “is what it says on the tin”. Matt Haig, bestselling author of “Reasons to Stay Alive” (amongst other works) is here with “a hug in a book”.
The format of the book is an “open it at any page and you’ll find something of value” book. Its small chapters are sometimes a few pages long, but often just a page. Sometimes just a line. Always deep.
All of us, who live long enough, will ponder our mortality sometimes. The feelings we may have might vary on a range from “afraid of dying” to “despairing of living”… but Haig’s single biggest message is that life is full of wonder; each moment precious.
- That hope is an incredible (and renewable!) resource.
- That we are more than a bad week, or month, or year, or decade.
- That when things are taken from us, the things that remain have more value.
Bottom line: you might cry (this reviewer did!), but it’ll make your life the richer for it, and remind you—if ever you need it—the value of your amazing life.
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The Many Faces Of Cosmetic Surgery
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Cosmetic Surgery: What’s The Truth?
In Tuesday’s newsletter, we asked you your opinion on elective cosmetic surgeries, and got the above-depicted, below-described, set of responses:
- About 48% said “Everyone should be able to get what they want, assuming informed consent”
- About 28% said “It can ease discomfort to bring features more in line with normalcy”
- 15% said “They should be available in the case of extreme disfigurement only”
- 10% said “No elective cosmetic surgery should ever be performed; needless danger”
Well, there was a clear gradient of responses there! Not so polarizing as we might have expected, but still enough dissent for discussion
So what does the science say?
The risks of cosmetic surgery outweigh the benefits: True or False?
False, subjectively (but this is important).
You may be wondering: how is science subjective?
And the answer is: the science is not subjective, but people’s cost:worth calculations are. What’s worth it to one person absolutely may not be worth it to another. Which means: for those for whom it wouldn’t be worth it, they are usually the people who will not choose the elective surgery.
Let’s look at some numbers (specifically, regret rates for various surgeries, elective/cosmetic or otherwise):
- Regret rate for elective cosmetic surgery in general: 20%
- Regret rate for knee replacement (i.e., not cosmetic): 17.1%
- Regret rate for hip replacement (i.e., not cosmetic): 4.8%
- Regret rate for gender-affirming surgeries (for transgender patients): 1%
So we can see, elective surgeries have an 80–99% satisfaction rate, depending on what they are. In comparison, the two joint replacements we mentioned have a 82.9–95.2% satisfaction rate. Not too dissimilar, taken in aggregate!
In other words: if a person has studied the risks and benefits of a surgery and decides to go ahead, they’re probably going to be happy with the results, and for them, the benefits will have outweighed the risks.
Sources for the above numbers, by the way:
- What is the regret rate for plastic surgery?
- Decision regret after primary hip and knee replacement surgery
- A systematic review of patient regret after surgery—a common phenomenon in many specialties but rare within gender-affirmation surgery
But it’s just a vanity; therapy is what’s needed instead: True or False?
False, generally. True, sometimes. Whatever the reasons for why someone feels the way they do about their appearance—whether their face got burned in a fire or they just have triple-J cups that they’d like reduced, it’s generally something they’ve already done a lot of thinking about. Nevertheless, it does also sometimes happen that it’s a case of someone hoping it’ll be the magical solution, when in reality something else is also needed.
How to know the difference? One factor is whether the surgery is “type change” or “restorative”, and both have their pros and cons.
- In “type change” (e.g. rhinoplasty), more psychological adjustment is needed, but when it’s all over, the person has a new nose and, statistically speaking, is usually happy with it.
- In “restorative” (e.g. facelift), less psychological adjustment is needed (as it’s just a return to a previous state), so a person will usually be happy quickly, but ultimately it is merely “kicking the can down the road” if the underlying problem is “fear of aging”, for example. In such a case, likely talking therapy would be beneficial—whether in place of, or alongside, cosmetic surgery.
Here’s an interesting paper on that; the sample sizes are small, but the discussion about the ideas at hand is a worthwhile read:
Does cosmetic surgery improve psychosocial wellbeing?
Some people will never be happy no matter how many surgeries they get: True or False?
True! We’re going to refer to the above paper again for this one. In particular, here’s what it said about one group for whom surgeries will not usually be helpful:
❝There is a particular subgroup of people who appear to respond poorly to cosmetic procedures. These are people with the psychiatric disorder known as “body dysmorphic disorder” (BDD). BDD is characterised by a preoccupation with an objectively absent or minimal deformity that causes clinically significant distress or impairment in social, occupational, or other areas of functioning.
For several reasons, it is important to recognise BDD in cosmetic surgery settings:
Firstly, it appears that cosmetic procedures are rarely beneficial for these people. Most patients with BDD who have had a cosmetic procedure report that it was unsatisfactory and did not diminish concerns about their appearance.
Secondly, BDD is a treatable disorder. Serotonin-reuptake inhibitors and cognitive behaviour therapy have been shown to be effective in about two-thirds of patients with BDD❞
~ Dr. David Castle et al. (lightly edited for brevity)
Which is a big difference compared to, for example, someone having triple-J breasts that need reducing, or the wrong genitals for their gender, or a face whose features are distinct outliers.
Whether that’s a reason people with BDD shouldn’t be able to get it is an ethical question rather than a scientific one, so we’ll not try to address that with science.
After all, many people (in general) will try to fix their woes with a haircut, a tattoo, or even a new sportscar, and those might sometimes be bad decisions, but they are still the person’s decision to make.
And even so, there can be protectionist laws/regulations that may provide a speed-bump, for example:
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10 Oft-Ignored Symptoms Of Diabetes
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Due in part to its prevalence and manageability, diabetes is often viewed as more of an inconvenience than an existential threat. While very few people in countries with decent healthcare die of diabetes directly (such as by diabetic ketoacidosis, which is very unpleasant, and happens disproportionately in the US where insulin is sold with a 500%–3000% markup in price compared to other countries), many more die of complications arising from comorbidities, and as for what comorbidities come with diabetes, well, it increases your risk for almost everything.
So, while for most people diabetes is by no means a death sentence, it is something that means you’ll now have to watch out for pretty much everything else too. On which note, Dr. Siobhan Deshauer is here with things to be aware of:
More than your waistline
Some of these are early symptoms (even appearing in the prediabetic stage, so can be considered an early warning for diabetes), some are later risks (it’s unlikely you’ll lose your feet from diabetic neuropathy complications before noticing that you are diabetic), but all and any of them are good reason to speak with your doctor sooner rather than later:
- Polyuria: waking up multiple times at night to urinate due to excess glucose spilling into the urine.
- Increased thirst: dehydration from frequent urination leads to excessive thirst, creating a cycle.
- Acanthosis nigricans: dark, velvety patches on areas like the neck, armpits, or groin, signalling insulin resistance.
- Skin tags: multiple skin tags in areas of friction may indicate insulin resistance.
- Recurrent Infections: high blood sugar weakens the immune system, making skin infections, UTIs, and yeast infections more common.
- Diabetic stiff hand syndrome: stiffness in hands, limited movement, or a “positive prayer sign” caused by sugar binding to skin and tendon proteins.
- Frozen shoulder and trigger finger: pain and limited movement in the shoulder or fingers, with a snapping sensation when moving inflamed tendons.
- Neuropathy: numbness, tingling, or pain in hands and feet due to nerve and blood vessel damage, often leading to foot deformities like Charcot foot.
- Diabetic foot infections: poor sensation, weakened immune response, and slow healing can result in severe infections and potential amputations.
- Gastroparesis: damage to stomach nerves causes delayed digestion, leading to bloating, nausea, and erratic blood sugar levels.
For more on all of these, plus some visuals of the things like what exactly is a “positive prayer sign”, enjoy:
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Want to learn more?
You might also like to read:
Cost of Insulin by Country 2024 ← after the US, the next most expensive country is Chile, at around 1/5 of the price; the cheapest listed is Turkey, at around 1/33 of the price.
Take care!
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Kettlebell Sport & Fitness Basics – by Audrey Burgio
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Professional athlete & coach Audrey Burgio covers how to get a full-body workout that will make you stronger and more flexible (there are stretches here too, and many exercises are about strength and suppleness), as well as building stability and balance. In short, more robust and with better mobility.
Which is one of the best things about kettlebell training—unlike dumbbells and barbells, a kettlebell requires the kind of strength that one has to use when doing many routine tasks, from carrying the groceries to moving a big pan in the kitchen.
Because it is otherwise absolutely possible to look like Arnold Schwarzenegger in the gym, and then still pull a muscle moving something at home because the angle was awkward or somesuch!
However, making one’s body so robust does require training safely, and the clear instructions in this book will help the reader avoid injuries that might otherwise be incurred by just picking up some kettlebells and guessing.
Bottom line: if you’d like to get strong and supple from the comfort of your own home, this book can definitely lead the way!
Click here to check out Kettlebell Sport & Fitness Basics, and see the difference in your body!
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Why do I poo in the morning? A gut expert explains
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No, you’re not imagining it. People really are more likely to poo in the morning, shortly after breakfast. Researchers have actually studied this.
But why mornings? What if you tend to poo later in the day? And is it worth training yourself to be a morning pooper?
To understand what makes us poo when we do, we need to consider a range of factors including our body clock, gut muscles and what we have for breakfast.
Here’s what the science says.
H_Ko/Shutterstock So morning poos are real?
In a UK study from the early 1990s, researchers asked nearly 2,000 men and women in Bristol about their bowel habits.
The most common time to poo was in the early morning. The peak time was 7-8am for men and about an hour later for women. The researchers speculated that the earlier time for men was because they woke up earlier for work.
About a decade later, a Chinese study found a similar pattern. Some 77% of the almost 2,500 participants said they did a poo in the morning.
But why the morning?
There are a few reasons. The first involves our circadian rhythm – our 24-hour internal clock that helps regulate bodily processes, such as digestion.
For healthy people, our internal clock means the muscular contractions in our colon follow a distinct rhythm.
There’s minimal activity in the night. The deeper and more restful our sleep, the fewer of these muscle contractions we have. It’s one reason why we don’t tend to poo in our sleep.
Your lower gut is a muscular tube that contracts more strongly at certain times of day. Vectomart/Shutterstock But there’s increasing activity during the day. Contractions in our colon are most active in the morning after waking up and after any meal.
One particular type of colon contraction partly controlled by our internal clock are known as “mass movements”. These are powerful contractions that push poo down to the rectum to prepare for the poo to be expelled from the body, but don’t always result in a bowel movement. In healthy people, these contractions occur a few times a day. They are more frequent in the morning than in the evening, and after meals.
Breakfast is also a trigger for us to poo. When we eat and drink our stomach stretches, which triggers the “gastrocolic reflex”. This reflex stimulates the colon to forcefully contract and can lead you to push existing poo in the colon out of the body. We know the gastrocolic reflex is strongest in the morning. So that explains why breakfast can be such a powerful trigger for a bowel motion.
Then there’s our morning coffee. This is a very powerful stimulant of contractions in the sigmoid colon (the last part of the colon before the rectum) and of the rectum itself. This leads to a bowel motion.
How important are morning poos?
Large international surveys show the vast majority of people will poo between three times a day and three times a week.
This still leaves a lot of people who don’t have regular bowel habits, are regular but poo at different frequencies, or who don’t always poo in the morning.
So if you’re healthy, it’s much more important that your bowel habits are comfortable and regular for you. Bowel motions do not have to occur once a day in the morning.
Morning poos are also not a good thing for everyone. Some people with irritable bowel syndrome feel the urgent need to poo in the morning – often several times after getting up, during and after breakfast. This can be quite distressing. It appears this early-morning rush to poo is due to overstimulation of colon contractions in the morning.
Can you train yourself to be regular?
Yes, for example, to help treat constipation using the gastrocolic reflex. Children and elderly people with constipation can use the toilet immediately after eating breakfast to relieve symptoms. And for adults with constipation, drinking coffee regularly can help stimulate the gut, particularly in the morning.
A disturbed circadian rhythm can also lead to irregular bowel motions and people more likely to poo in the evenings. So better sleep habits can not only help people get a better night’s sleep, it can help them get into a more regular bowel routine.
A regular morning coffee can help relieve constipation. Caterina Trimarchi/Shutterstock Regular physical activity and avoiding sitting down a lot are also important in stimulating bowel movements, particularly in people with constipation.
We know stress can contribute to irregular bowel habits. So minimising stress and focusing on relaxation can help bowel habits become more regular.
Fibre from fruits and vegetables also helps make bowel motions more regular.
Finally, ensuring adequate hydration helps minimise the chance of developing constipation, and helps make bowel motions more regular.
Monitoring your bowel habits
Most of us consider pooing in the morning to be regular. But there’s a wide variation in normal so don’t be concerned if your poos don’t follow this pattern. It’s more important your poos are comfortable and regular for you.
If there’s a major change in the regularity of your bowel habits that’s concerning you, see your GP. The reason might be as simple as a change in diet or starting a new medication.
But sometimes this can signify an important change in the health of your gut. So your GP may need to arrange further investigations, which could include blood tests or imaging.
Vincent Ho, Associate Professor and clinical academic gastroenterologist, Western Sydney University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Hearing loss is twice as common in Australia’s lowest income groups, our research shows
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Around one in six Australians has some form of hearing loss, ranging from mild to complete hearing loss. That figure is expected to grow to one in four by 2050, due in a large part to the country’s ageing population.
Hearing loss affects communication and social engagement and limits educational and employment opportunities. Effective treatment for hearing loss is available in the form of communication training (for example, lipreading and auditory training), hearing aids and other devices.
But the uptake of treatment is low. In Australia, publicly subsidised hearing care is available predominantly only to children, young people and retirement-age people on a pension. Adults of working age are mostly not eligible for hearing health care under the government’s Hearing Services Program.
Our recent study published in the journal Ear and Hearing showed, for the first time, that working-age Australians from lower socioeconomic backgrounds are at much greater risk of hearing loss than those from higher socioeconomic backgrounds.
We believe the lack of socially subsidised hearing care for adults of working age results in poor detection and care for hearing loss among people from disadvantaged backgrounds. This in turn exacerbates social inequalities.
Population data shows hearing inequality
We analysed a large data set called the Household, Income and Labour Dynamics in Australia (HILDA) survey that collects information on various aspects of people’s lives, including health and hearing loss.
Using a HILDA sub-sample of 10,719 working-age Australians, we evaluated whether self-reported hearing loss was more common among people from lower socioeconomic backgrounds than for those from higher socioeconomic backgrounds between 2008 and 2018.
Relying on self-reported hearing data instead of information from hearing tests is one limitation of our paper. However, self-reported hearing tends to underestimate actual rates of hearing impairment, so the hearing loss rates we reported are likely an underestimate.
We also wanted to find out whether people from lower socioeconomic backgrounds were more likely to develop hearing loss in the long run.
Hearing care is publicly subsidised for children.
mady70/ShutterstockWe found people in the lowest income groups were more than twice as likely to have hearing loss than those in the highest income groups. Further, hearing loss was 1.5 times as common among people living in the most deprived neighbourhoods than in the most affluent areas.
For people reporting no hearing loss at the beginning of the study, after 11 years of follow up, those from a more deprived socioeconomic background were much more likely to develop hearing loss. For example, a lack of post secondary education was associated with a more than 1.5 times increased risk of developing hearing loss compared to those who achieved a bachelor’s degree or above.
Overall, men were more likely to have hearing loss than women. As seen in the figure below, this gap is largest for people of low socioeconomic status.
Why are disadvantaged groups more likely to experience hearing loss?
There are several possible reasons hearing loss is more common among people from low socioeconomic backgrounds. Noise exposure is one of the biggest risks for hearing loss and people from low socioeconomic backgrounds may be more likely to be exposed to damaging levels of noise in jobs in mining, construction, manufacturing, and agriculture.
Lifestyle factors which may be more prevalent in lower socioeconomic communities such as smoking, unhealthy diet, and a lack of regular exercise are also related to the risk of hearing loss.
Finally, people with lower incomes may face challenges in accessing timely hearing care, alongside competing health needs, which could lead to missed identification of treatable ear disease.
Why does this disparity in hearing loss matter?
We like to think of Australia as an egalitarian society – the land of the fair go. But nearly half of people in Australia with hearing loss are of working age and mostly ineligible for publicly funded hearing services.
Hearing aids with a private hearing care provider cost from around A$1,000 up to more than $4,000 for higher-end devices. Most people need two hearing aids.
Hearing loss might be more common in low income groups because they’re exposed to more noise at work.
Dmitry Kalinovsky/ShutterstockLack of access to affordable hearing care for working-age adults on low incomes comes with an economic as well as a social cost.
Previous economic analysis estimated hearing loss was responsible for financial costs of around $20 billion in 2019–20 in Australia. The largest component of these costs was productivity losses (unemployment, under-employment and Jobseeker social security payment costs) among working-age adults.
Providing affordable hearing care for all Australians
Lack of affordable hearing care for working-age adults from lower socioeconomic backgrounds may significantly exacerbate the impact of hearing loss among deprived communities and worsen social inequalities.
Recently, the federal government has been considering extending publicly subsidised hearing services to lower income working age Australians. We believe reforming the current government Hearing Services Program and expanding eligibility to this group could not only promote a more inclusive, fairer and healthier society but may also yield overall cost savings by reducing lost productivity.
All Australians should have access to affordable hearing care to have sufficient functional hearing to achieve their potential in life. That’s the land of the fair go.
Mohammad Nure Alam, PhD Candidate in Economics, Macquarie University; Kompal Sinha, Associate Professor, Department of Economics, Macquarie University, and Piers Dawes, Professor, School of Health and Rehabilitation Sciences, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Doctors From 15 Specialties Tell The Worst Common Mistakes People Make
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Whatever your professional background, you probably know many things about it that are very obvious to you, but that most people don’t know. So it is for doctors too; here are the things that doctors from 15 specialties would never do, and thus advise people against doing:
Better safe than sorry
We’ll leap straight into it:
- General Surgery: avoid rushing into musculoskeletal or spinal surgery unless absolutely necessary; conservative treatments like physical therapy are often effective.
- Interventional Gastroenterology: avoid long-term, around-the-clock use of anti-inflammatory pain medications (e.g. Ibuprofen and friends) to prevent stomach ulcers.
- Podiatry: never place feet on the car dashboard due to the risk of severe injuries from airbag deployment.
- Rheumatology: avoid daily use of high heels to prevent joint and foot deformities, bunions, and pain.
- Otorhinolaryngology: never smoke, as it can lead to severe consequences like laryngectomy and other life-altering conditions.
- Pediatrics: avoid dangerous activities for children, such as swimming alone, eating choking hazards, biking or skiing without a helmet, or consuming raw meat/fish/dairy. Also, be cautious with firearms in homes.
- Orthopedic Surgery: avoid riding motorcycles and handling fireworks due to high risks of accidents.
- Emergency Medicine: never drink and drive or ride ATVs. Always use eye protection during activities like woodworking.
- Ophthalmology: always wear safety glasses during activities like grinding metal or woodworking. Sunglasses are essential to prevent UV damage even on cloudy days.
- Urology: avoid shaving pubic hair if diabetic or immunocompromised to prevent severe infections like Fournier’s gangrene.
- Gastroenterology: do not use gut health supplements as they lack proven efficacy and are often a waste of money*
- Plastic Surgery: avoid contour threads (barbed sutures for facial rejuvenation) and butt implants due to risks like infection, complications, and poor outcomes.
- Psychiatry: never take recreational drugs from unknown sources to avoid accidental overdoses, especially from substances laced with fentanyl. Carry Narcan for emergencies.
- Dermatology: use sunscreen daily to prevent skin cancer, aging, pigmentation issues, and texture problems caused by UV exposure.
- Cardiology: avoid the carnivore diet as it increases heart disease risks due to its negligible fiber content and high saturated fat intake.
*We had an article about this a while back; part of the problem is that taking probiotics without prebiotics can mean your new bacteria just die in about 20 minutes, which is their approximate lifespan in which to multiply or else die out. Similar problems arise if taking them with sugar that feeds their competitors instead. See: Stop Sabotaging Your Gut!
For more on each of these, in the words of the respective doctors, enjoy:
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