The Modern Art and Science of Mobility – by Aurélien Broussal-Derval
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We’ve reviewed mobility books before, so what makes this one stand out?
We’ll be honest: the illustrations are lovely.
The science, the information, the exercises, the routines, the programs… All these things are excellent too, but these can be found in many a book.
What can’t usually be found is very beautiful (yet no less clear) watercolor paintings and charcoal sketches as anatomical illustrations.
There are photos too (also of high quality), but the artistry of the paintings and sketches is what makes the reader want to spend time perusing the books.
At least, that’s what this reviewer found! Because it’s all very well having access to a lot of information (and indeed, I read so much), but making it enjoyable increases the chances of rereading it much more often.
As for the rest of the content, the book’s information is divided in categories:
- Pain (what causes it, what it means, and how to manage it)
- Breathing (yes, a whole section devoted to this, and it is aligned heavily to posture also, as well as psychological state and the effect of stress on tension, inflammation, and more)
- Movement (this is mostly about kinds of movement and ranges of movement)
- Mobility (this is about aggregating movements as a fully mobile human)
So, each builds on from the previous because any pain needs addressing before anything else, breathing (and with it, posture) comes next, then we learn about movement, then we bring it all together for mobility.
Bottom line: this is a beautiful and comprehensive book that will make learning a joy
Click here to check out The Modern Art and Science of Mobility, and learn and thrive!
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What you need to know about the new weight loss drug Zepbound
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In a recent poll, KFF found that nearly half of U.S. adults were interested in taking a weight management drug like the increasingly popular Ozempic, Wegovy, and Mounjaro.
“I can understand why there would be widespread interest in these medications,” says Dr. Alyssa Lampe Dominguez, an endocrinologist and clinical assistant professor at the University of Southern California. “Obesity is a chronic disease that is very difficult to treat. And a lot of the medications that we previously used weren’t as effective.”
Now, there’s a new option available: In November 2023, the FDA approved Zepbound, another weight management medication, developed by the pharmaceutical company Eli Lilly. Zepbound is different from other drugs in many ways, including the fact that it’s proven to be the most effective option so far.
Keep reading to find out more about Zepbound, including who can take it, its side effects, and more.
What is Zepbound?
Zepbound, one of the brand names for tirzepatide, is an injectable drug with a maximum dosage of 15 mg per week. It’s based on incretin, a hormone that’s naturally released in the gut after a meal. (Mounjaro is another brand name for tirzepatide.)
Tirzepatide is considered a dual agonist because it activates the two primary incretin hormones: the glucagon-like peptide-1 (GLP-1) and gastric inhibitory peptide (GIP) hormones.
According to Dr. Katherine H. Saunders, an obesity medicine physician at Weill Cornell Medicine and co-founder of Intellihealth, tirzepatide is involved with several processes that regulate blood sugar, slow the removal of food from the stomach, and affect brain areas involved in appetite.
This means that people taking the medication feel less hungry and get fuller faster, leading to less food intake and, ultimately, weight loss.
How is Zepbound different from Ozempic?
The medications are different in many ways. Ozempic and Wegovy, which are both brand names for semaglutide, only target the GLP-1 hormone. Studies have shown that Zepbound can lead to a higher percentage of total body weight loss than semaglutide medications. In addition to being more effective, there is some evidence that Zepbound is overall more tolerable than Ozempic or Wegovy.
“I have seen overall lower rates in severity of side effects with the tirzepatide medications. Mounjaro [tirzepatide] in particular is the one that I’ve used up until this point, but there’s a thought that the GIP component of the medication actually decreases nausea,” adds Lampe Dominguez. “Anecdotally, patients that I have switched from semaglutide or Ozempic to Mounjaro say that they have less side effects with Mounjaro.”
How is Zepbound different from Mounjaro?
Zepbound and Mounjaro are the same medication—tirzepatide—but they’re approved for different conditions. Zepbound is FDA-approved for weight loss, while Mounjaro is approved for type 2 diabetes. (However, Mounjaro is also at times prescribed off-label for weight loss.)
What are some of Zepbound’s side effects?
According to the FDA, side effects include nausea, vomiting, diarrhea, constipation, stomach discomfort and pain, fatigue, and burping. See a more comprehensive list of side effects here.
Who can take Zepbound?
Zepbound is FDA-approved for adults with obesity (a BMI of 30 or greater) or who have a BMI of 27 or greater with at least one weight-related condition, like high blood pressure, type 2 diabetes, or high cholesterol.
“I tend to advise patients who don’t meet those criteria to not take these medications because we really don’t know what the risks are,” says Lampe Dominguez, adding that people with lower BMI weren’t included in the medication’s studies. “We don’t know if there are specific risks to using this medication at a lower body mass index [or] if there might be some negative outcomes.”
Both doctors agree that it’s important for people who are interested in starting any weight loss medication to talk to their doctors about the potential risks and benefits. For instance, the FDA notes that Zepbound has caused thyroid tumors in rats, and while it’s unknown if this could also happen to humans, the agency said the medication shouldn’t be used in patients with a personal or family history of medullary thyroid cancer.
“Zepbound is a powerful medication that can lead to severe side effects, vitamin deficiencies, a complete lack of appetite, or too much weight loss if prescribed without the appropriate personalization, education, and close monitoring,” says Saunders.
“With all of these medications, and particularly with Zepbound, we would want to make sure that [patients] don’t have a family history of a specific type of thyroid cancer called medullary thyroid cancer,” says Lampe Dominguez.
How long should people take Zepbound for?
“Anti-obesity medications like Zepbound are not meant for short-term weight loss, but long-term treatment of obesity, which is a chronic disease,” explains Saunders. “We prepare our patients to be on the medication (or some type of medical obesity treatment) long term for their chronic disease, which is only controlled for the duration of time they’re being treated.”
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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One Cause; Countless Aches
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What Is The Cause?
Zac Cupples’ video (below) makes an appealing claim: 90% of movement issues and discomforts we experience daily come from one source: reduced joint space due to increased muscle tension.
For Cupples, this could be causing anything from knee pain to foot pain to ankle pain to hip pain to generalized joint pain to…pretty much any sort of pain.
So, why do we describe this as “appealing”?
Well, if there’s just one cause, that means there is only one thing to fix
Can This Be True?
Whilst we normally stray away from oversimplifications, we found Cupples’ example quite powerful.
Cupples defends his thesis by illustrating it with a simple wrist movement experiment: try moving your wrist in a circle with your palm open, and then do the same with your fist clenched.
Did you notice a difference?
When you clench your fist, movement (normally) becomes restricted and uncomfortable, illustrating how increased tension limits joint space.
It’s a powerful analogy for understanding our body’s mechanics.
So How Do We Fix It?
To combat issues with reduced joint space, Cupples proposes a three-step solution: reducing muscle tension, increasing range of motion in commonly limited areas, and enhancing movement efficiency. He delves into strategies for achieving these, including adopting certain positions and breathing techniques.
There are also some elements of strategic muscle engagement, but we’ll leave that to him to describe:
How was the video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!
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Surgery won’t fix my chronic back pain, so what will?
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This week’s ABC Four Corners episode Pain Factory highlighted that our health system is failing Australians with chronic pain. Patients are receiving costly, ineffective and risky care instead of effective, low-risk treatments for chronic pain.
The challenge is considering how we might reimagine health-care delivery so the effective and safe treatments for chronic pain are available to millions of Australians who suffer from chronic pain.
One in five Australians aged 45 and over have chronic pain (pain lasting three or more months). This costs an estimated A$139 billion a year, including $12 billion in direct health-care costs.
The most common complaint among people with chronic pain is low back pain. So what treatments do – and don’t – work?
Opioids and invasive procedures
Treatments offered to people with chronic pain include strong pain medicines such as opioids and invasive procedures such as spinal cord stimulators or spinal fusion surgery. Unfortunately, these treatments have little if any benefit and are associated with a risk of significant harm.
Spinal fusion surgery and spinal cord stimulators are also extremely costly procedures, costing tens of thousands of dollars each to the health system as well as incurring costs to the individual.
Addressing the contributors to pain
Recommendations from the latest Australian and World Health Organization clinical guidelines for low back pain focus on alternatives to drug and surgical treatments such as:
- education
- advice
- structured exercise programs
- physical, psychological or multidisciplinary interventions that address the physical or psychological contributors to ongoing pain.
Pain education is central. Monkey Business Images/Shutterstock Two recent Australian trials support these recommendations and have found that interventions that address each person’s physical and psychological contributors to pain produce large and sustained improvements in pain and function in people with chronic low back pain.
The interventions have minimal side effects and are cost-effective.
In the RESOLVE trial, the intervention consists of pain education and graded sensory and movement “retraining” aimed to help people understand that it’s safe to move.
In the RESTORE trial, the intervention (cognitive functional therapy) involves assisting the person to understand the range of physical and psychological contributing factors related to their condition. It guides patients to relearn how to move and to build confidence in their back, without over-protecting it.
Why isn’t everyone with chronic pain getting this care?
While these trials provide new hope for people with chronic low back pain, and effective alternatives to spinal surgery and opioids, a barrier for implementation is the out-of-pocket costs. The interventions take up to 12 sessions, lasting up to 26 weeks. One physiotherapy session can cost $90–$150.
In contrast, Medicare provides rebates for just five allied health visits (such as physiotherapists or exercise physiologists) for eligible patients per year, to be used for all chronic conditions.
Private health insurers also limit access to reimbursement for these services by typically only covering a proportion of the cost and providing a cap on annual benefits. So even those with private health insurance would usually have substantial out-of-pocket costs.
Access to trained clinicians is another barrier. This problem is particularly evident in regional and rural Australia, where access to allied health services, pain specialists and multidisciplinary pain clinics is limited.
Higher costs and lack of access are associated with the increased use of available and subsidised treatments, such as pain medicines, even if they are ineffective and harmful. The rate of opioid use, for example, is higher in regional Australia and in areas of socioeconomic disadvantage than metropolitan centres and affluent areas.
So what can we do about it?
We need to reform Australia’s health system, private and public, to improve access to effective treatments for chronic pain, while removing access to ineffective, costly and high-risk treatments.
Better training of the clinical workforce, and using technology such as telehealth and artificial intelligence to train clinicians or deliver treatment may also improve access to effective treatments. A recent Australian trial, for example, found telehealth delivered via video conferencing was as effective as in-person physiotherapy consultations for improving pain and function in people with chronic knee pain.
Advocacy and improving the public’s understanding of effective treatments for chronic pain may also be helpful. Our hope is that coordinated efforts will promote the uptake of effective treatments and improve the care of patients with chronic pain.
Christine Lin, Professor, University of Sydney; Christopher Maher, Professor, Sydney School of Public Health, University of Sydney; Fiona Blyth, Professor, University of Sydney; James Mcauley, Professor of Psychology, UNSW Sydney, and Mark Hancock, Professor of Physiotherapy, Macquarie University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Does This New Machine Cure Depression?
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Let us first talk briefly about the slightly older tech that this may replace, transcranial magnetic stimulation (TMS).
TMS involves electromagnetic fields to stimulate the left half of the brain and inhibit the right half of the brain. It sounds like something from the late 19th century—“cure your melancholy with the mystical power of magnetism”—but the thing is, it works:
The main barriers to its use are that the machine itself is expensive, and it has to be done in a clinic by a trained clinician. Which, if it were treating one’s heart, say, would not be so much of an issue, but when treating depression, there is a problem that depressed people are not the most likely to commit to (and follow through with) going somewhere probably out-of-town regularly to get a treatment, when merely getting out of the door was already a challenge and motivation is thin on the ground to start with.
Thus, antidepressant medications are more often the go-to for cost-effectiveness and adherence. Of course, some will work better than others for different people, and some may not work at all in the case of what is generally called “treatment-resistant depression”:
Antidepressants: Personalization Is Key!
Transcranial stimulation… At home?
Move over transcranial magnetic stimulation; it’s time for transcranial direct-current stimulation (tDCS).
First, what it’s not: electroconvulsive therapy (ECT). Rather, it uses a very low current.
What it is: a small and portable headset (as opposed to the big machine to go sit in for TMS) that one can use at home. Here’s an example product on Amazon, though there are more stylish versions around, this is the same basic technology.
In a recent study, 45% of those who received treatment with this device experienced remission in 10 weeks, significantly beating placebo (bearing in mind that placebo effect is strongest when it comes to invisible ailments such as depression).
See also: How To Leverage Placebo Effect For Yourself ← this explains more about how the placebo effect works, to the extent that it can even be an adjuvant tool to augment “real” therapies
And as for the study, here it is:
…which rather cuts through the “depressed people don’t make it to the clinic consistently, if at all” problem. Of course, it still requires adherence to its use at home, for example three 30-minute sessions per week, but honestly, “lie/sit still” is likely within the abilities of the majority of depressed people. However…
Important note: you remember we said “in 10 weeks”? That may be critical, because shorter studies (e.g. 6 weeks) have previously returned without such glowing results:
Home-Use Transcranial Direct Current Stimulation for the Treatment of a Major Depressive Episode
This means that if you get this tech for yourself or a loved one, it’ll be necessary to persist for likely 10 weeks, certainly more than 6 weeks, and not abandon it after a few sessions when it hasn’t been life-changing yet. And that may be more of a challenge for a depressed person, so likely an “accountability buddy” of some kind is in order (partner, close friend, etc) to help ensure adherence and generally bug you/them into doing it consistently.
And then, of course, you/they might still be in the 55% of people for whom it didn’t work. And that does suck, but random antidepressant medications (i.e., not personalized) don’t fare much better, statistically.
Want something else against depression meanwhile?
Here are some strategies that not only can significantly help, but also are tailored to be actually doable while depressed:
The Mental Health First-Aid You’ll Hopefully Never Need ← written by your writer who has previously suffered extensively from depression and knows what it is like
Take care!
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8 Critical Signs Of Blood Clots That You Shouldn’t Ignore
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Blood clots can form as part of deep vein thrombosis or for other reasons; wherever they form (unless they are just doing their job healing a wound) they can cause problems. But how to know what’s going on inside our body?
Telltale signs
Our usual medical/legal disclaimer applies here, and we are not doctors, let alone your doctors, and even if we were we couldn’t diagnose from afar… But for educational purposes, here are the eight signs from the video:
- Swelling: especially if only on one leg (assuming you have no injury to account for it), which may feel tight and uncomfortable
- Warmness: does the area warmer to the touch? This may be because of the body’s inflammatory response trying to deal with a blood clot
- Tenderness: again, caused by the inflammation in response to the clot
- Discolored skin: it could be reddish, or bruise-like. This could be patchy or spread over a larger area, because of a clot blocking the flow of blood
- Shortness of breath: if a clot makes it to the lungs, it can cause extra problems there (pulmonary embolism), and shortness of breath is the first sign of this
- Coughing up blood: less common than the above but a much more serious sign; get thee to a hospital
- Chest pain: a sharp or stabbing pain, in particular. The pain may worsen with deep breaths or coughing. Again, seek medical attention.
For more on recognizing these signs (including helpful visuals), and more on what to do about them and how to avoid them in the first place, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Further reading
You might like to read:
Dietary Changes for Artery Health
Take care!
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The End of Heart Disease – by Dr. Joel Fuhrman
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We’ve previously reviewed another of Dr. Fuhrman’s books, “Eat To Live”, and this time, he’s focusing specifically on preventing/reversing heart disease.
Dr. Fuhrman takes the stance that our food can either kill or heal us, and we get to choose which. As such, nutrition is central to his heart-healthy plan; he mostly leaves matters of exercise, sleep, etc to other sources.
His dietary approach is mostly uncontroversial: for example, advices include: enjoy nutritionally dense foods, skip processed foods, eat at least mostly plants, skip the added salt. A slightly more controversial aspect is that he advocates for avoiding cooking oils, including the healthiest oils, including olive and avocado, which are by current scientific consensus considered heart-healthy in moderation. As in, not even just heart-neutral, but rather, they actively improve triglycerides.
He compares different cardioprotective diets, and while he’s not unbiased, he does provide 40 pages of scholarly references, so we may understand that at the very least, his approach is sound.
There are also recipes—94 pages of them—for any who might wonder “how do I cook without…?” and some ingredient he would rather you omit.
The style is information-dense (and this is a 448-page book) but still very readable.
Bottom line: if you’re serious about improving your heart health, this book can help a lot with that.
Click here to check out The End Of Heart Disease, and end heart disease for yourself!
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