The Two-Second Advantage – by Vivek Ranadive and Kevin Maney
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The titular “two-second advantage” can in some cases be literal (imagine you got a two-second head-start in a boxing match!), in other cases can refer to being just a little ahead of things in a way that can confer a great advantage, often cumulatively—as anyone who’s played Monopoly can certainly attest.
Vivek Ranadivé and Kevin Maney give us lots of examples from business, sports, politics, economics, and more, in a way that seeks to cultivate a habit of asking the right questions in order to anticipate the future and not just be ahead of the competition—some areas of life don’t have competition for most people, like health, for example—but to generally have things “in hand”.
When it comes to personal finances, health, personal projects, and the like, those tiny initial advantages that lead to incremental further improvements, can be the difference between continually (and frantically) playing catch-up, or making the jump past breaking even to going from strength to strength.
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Behind Book Recommendations
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It’s Q&A Day!
Each Thursday, we respond to subscriber questions and requests! If it’s something small, we’ll answer it directly; if it’s something bigger, we’ll do a main feature in a follow-up day instead!
So, no question/request to big or small; they’ll just get sorted accordingly
Remember, you can always hit reply to any of our emails, or use the handy feedback widget at the bottom. We always look forward to hearing from you!
Q: What’s the process behind the books you recommend? You seem to have a limitless stream of recommendations
We do our best!
The books we recommend are books that…
- are on Amazon—it makes things tidy, consistent, and accessible. And if you end up buying one of the books, we get a small affiliate commission*.
- we have read—we would say “obviously”, but you might be surprised how many people write about books without having read them.
- pertain in at least large part to health and/or productivity.
- are written by humans—bookish people (and especially Kindle Unlimited users) may have noticed lately that there are a lot of low quality AI-written books flooding the market, sometimes with paid 5-star reviews to bolster them. It’s frustrating, but we can tell the difference and screen those out.
- are of a certain level of quality. They don’t have to be “top 5 desert-island books”, because well, there’s one every day and the days keep coming. But they do have to genuinely deliver the value that we describe, and merit a sincere recommendation.
- are varied—we try to not give a run of “samey” books one after another. We will sometimes review a book that covers a topic another previously-reviewed book did, but it must have something about it that makes it different. It may be a different angle or a different writing style, but it needs something to set it apart.
*this is from Amazon and isn’t product-specific, so this is not affecting our choice of what books to review at all—just that they will be books that are available on Amazon.
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Long COVID is real—here’s how patients can get treatment and support
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What you need to know
- There is still no single, FDA-approved treatment for long COVID, but doctors can help patients manage individual symptoms.
- Long COVID patients may be eligible for government benefits that can ease financial burdens.
- Getting reinfected with COVID-19 can worsen existing long COVID symptoms, but patients can take steps to stay protected.
On March 15—Long COVID Awareness Day—patients shared their stories and demanded more funding for long COVID research. Nearly one in five U.S. adults who contract COVID-19 suffer from long COVID, and up to 5.8 million children have the disease.
Anyone who contracts COVID-19 is at risk of developing long-term illness. Long COVID has been deemed by some a “mass-disabling event,” as its symptoms can significantly disrupt patients’ lives.
Fortunately, there’s hope. New treatment options are in development, and there are resources available that may ease the physical, mental, and financial burdens that long COVID patients face.
Read on to learn more about resources for long COVID patients and how you can support the long COVID patients in your life.
What is long COVID, and who is at risk?
Long COVID is a cluster of symptoms that can occur after a COVID-19 infection and last for weeks, months, or years, potentially affecting almost every organ. Symptoms range from mild to debilitating and may include fatigue, chest pain, brain fog, dizziness, abdominal pain, joint pain, and changes in taste or smell.
Anyone who gets infected with COVID-19 is at risk of developing long COVID, but some groups are at greater risk, including unvaccinated people, women, people over 40, and people who face health inequities.
What types of support are available for long COVID patients?
Currently, there is still no single, FDA-approved treatment for long COVID, but doctors can help patients manage individual symptoms. Some options for long COVID treatment include therapies to improve lung function and retrain your sense of smell, as well as medications for pain and blood pressure regulation. Staying up to date on COVID-19 vaccines may also improve symptoms and reduce inflammation.
Long COVID patients are eligible for disability benefits under the Americans with Disabilities Act. The Pandemic Legal Assistance Network provides pro bono support for long COVID patients applying for these benefits.
Long COVID patients may also be eligible for other forms of government assistance, such as Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), Medicaid, and rental and utility assistance programs.
How can friends and family of long COVID patients provide support?
Getting reinfected with COVID-19 can worsen existing long COVID symptoms. Wearing a high-quality, well-fitting mask will reduce your risk of contracting COVID-19 and spreading it to long COVID patients and others. At indoor gatherings, improving ventilation by opening doors and windows, using high-efficiency particulate air (HEPA) filters, and building your own Corsi-Rosenthal box can also reduce the spread of the COVID-19 virus.
Long COVID patients may also benefit from emotional and financial support as they manage symptoms, navigate barriers to treatment, and go through the months-long process of applying for and receiving disability benefits.
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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Older Americans Say They Feel Trapped in Medicare Advantage Plans
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In 2016, Richard Timmins went to a free informational seminar to learn more about Medicare coverage.
“I listened to the insurance agent and, basically, he really promoted Medicare Advantage,” Timmins said. The agent described less expensive and broader coverage offered by the plans, which are funded largely by the government but administered by private insurance companies.
For Timmins, who is now 76, it made economic sense then to sign up. And his decision was great, for a while.
Then, three years ago, he noticed a lesion on his right earlobe.
“I have a family history of melanoma. And so, I was kind of tuned in to that and thinking about that,” Timmins said of the growth, which doctors later diagnosed as malignant melanoma. “It started to grow and started to become rather painful.”
Timmins, though, discovered that his enrollment in a Premera Blue Cross Medicare Advantage plan would mean a limited network of doctors and the potential need for preapproval, or prior authorization, from the insurer before getting care. The experience, he said, made getting care more difficult, and now he wants to switch back to traditional, government-administered Medicare.
But he can’t. And he’s not alone.
“I have very little control over my actual medical care,” he said, adding that he now advises friends not to sign up for the private plans. “I think that people are not understanding what Medicare Advantage is all about.”
Enrollment in Medicare Advantage plans has grown substantially in the past few decades, enticing more than half of all eligible people, primarily those 65 or older, with low premium costs and perks like dental and vision insurance. And as the private plans’ share of the Medicare patient pie has ballooned to 30.8 million people, so too have concerns about the insurers’ aggressive sales tactics and misleading coverage claims.
Enrollees, like Timmins, who sign on when they are healthy can find themselves trapped as they grow older and sicker.
“It’s one of those things that people might like them on the front end because of their low to zero premiums and if they are getting a couple of these extra benefits — the vision, dental, that kind of thing,” said Christine Huberty, a lead benefit specialist supervising attorney for the Greater Wisconsin Agency on Aging Resources.
“But it’s when they actually need to use it for these bigger issues,” Huberty said, “that’s when people realize, ‘Oh no, this isn’t going to help me at all.’”
Medicare pays private insurers a fixed amount per Medicare Advantage enrollee and in many cases also pays out bonuses, which the insurers can use to provide supplemental benefits. Huberty said those extra benefits work as an incentive to “get people to join the plan” but that the plans then “restrict the access to so many services and coverage for the bigger stuff.”
David Meyers, assistant professor of health services, policy, and practice at the Brown University School of Public Health, analyzed a decade of Medicare Advantage enrollment and found that about 50% of beneficiaries — rural and urban — left their contract by the end of five years. Most of those enrollees switched to another Medicare Advantage plan rather than traditional Medicare.
In the study, Meyers and his co-authors muse that switching plans could be a positive sign of a free marketplace but that it could also signal “unmeasured discontent” with Medicare Advantage.
“The problem is that once you get into Medicare Advantage, if you have a couple of chronic conditions and you want to leave Medicare Advantage, even if Medicare Advantage isn’t meeting your needs, you might not have any ability to switch back to traditional Medicare,” Meyers said.
Traditional Medicare can be too expensive for beneficiaries switching back from Medicare Advantage, he said. In traditional Medicare, enrollees pay a monthly premium and, after reaching a deductible, in most cases are expected to pay 20% of the cost of each nonhospital service or item they use. And there is no limit on how much an enrollee may have to pay as part of that 20% coinsurance if they end up using a lot of care, Meyers said.
To limit what they spend out-of-pocket, traditional Medicare enrollees typically sign up for supplemental insurance, such as employer coverage or a private Medigap policy. If they are low-income, Medicaid may provide that supplemental coverage.
But, Meyers said, there’s a catch: While beneficiaries who enrolled first in traditional Medicare are guaranteed to qualify for a Medigap policy without pricing based on their medical history, Medigap insurers can deny coverage to beneficiaries transferring from Medicare Advantage plans or base their prices on medical underwriting.
Only four states — Connecticut, Maine, Massachusetts, and New York — prohibit insurers from denying a Medigap policy if the enrollee has preexisting conditions such as diabetes or heart disease.
Paul Ginsburg is a former commissioner on the Medicare Payment Advisory Commission, also known as MedPAC. It’s a legislative branch agency that advises Congress on the Medicare program. He said the inability of enrollees to easily switch between Medicare Advantage and traditional Medicare during open enrollment periods is “a real concern in our system; it shouldn’t be that way.”
The federal government offers specific enrollment periods every year for switching plans. During Medicare’s open enrollment period, from Oct. 15 to Dec. 7, enrollees can switch out of their private plans to traditional, government-administered Medicare.
Medicare Advantage enrollees can also switch plans or transfer to traditional Medicare during another open enrollment period, from Jan. 1 to March 31.
“There are a lot of people that say, ‘Hey, I’d love to come back, but I can’t get Medigap anymore, or I’ll have to just pay a lot more,’” said Ginsburg, who is now a professor of health policy at the University of Southern California.
Timmins is one of those people. The retired veterinarian lives in a rural community on Whidbey Island just north of Seattle. It’s a rugged, idyllic landscape and a popular place for second homes, hiking, and the arts. But it’s also a bit remote.
While it’s typically harder to find doctors in rural areas, Timmins said he believes his Premera Blue Cross plan made it more challenging to get care for a variety of reasons, including the difficulty of finding and getting in to see specialists.
Nearly half of Medicare Advantage plan directories contained inaccurate information on what providers were available, according to the most recent federal review. Beginning in 2024, new or expanding Medicare Advantage plans must demonstrate compliance with federal network expectations or their applications could be denied.
Amanda Lansford, a Premera Blue Cross spokesperson, declined to comment on Timmins’ case. She said the plan meets federal network adequacy requirements as well as travel time and distance standards “to ensure members are not experiencing undue burdens when seeking care.”
Traditional Medicare allows beneficiaries to go to nearly any doctor or hospital in the U.S., and in most cases enrollees do not need approval to get services.
Timmins, who recently finished immunotherapy, said he doesn’t think he would be approved for a Medigap policy, “because of my health issue.” And if he were to get into one, Timmins said, it would likely be too expensive.
For now, Timmins said, he is staying with his Medicare Advantage plan.
“I’m getting older. More stuff is going to happen.”
There is also a chance, Timmins said, that his cancer could resurface: “I’m very aware of my mortality.”
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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Everything you need to know about cervical cancer
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Every year, around 11,500 new cases of cervical cancer are diagnosed in the U.S. While cervical cancer used to be one of the most common causes of cancer death for U.S. women, the vaccine against the human papillomavirus (HPV), and increased early screening and detection have resulted in a decrease in rates.
“Cervical cancer is almost always preventable and typically diagnosed in patients who have either never had a screening test or have gone many years without one,” says Fred Wyand, director of communications at the American Sexual Health Association, which includes the National Cervical Cancer Coalition.
January is Cervical Cancer Awareness Month, so we spoke to experts to learn more about what it is, its symptoms, and what you can do to prevent it.
What is cervical cancer?
Cervical cancer is a type of cancer that starts in the cervix—the lower part of the uterus that connects the vagina to the uterus. Cervical cancer can affect anyone with a cervix but is most frequently diagnosed in women ages 35 to 44, according to the American Cancer Society.
There are two types:
- Squamous cell carcinoma: Cervical cancer that starts in the thin squamous cells on the outside of the cervix. This is the most common type of cervical cancer.
- Adenocarcinoma: Cervical cancer that starts in glandular cells that line the inside of the cervix. This type of cervical cancer is less common.
In some cases, cervical cancer has features of both types.
What causes cervical cancer?
Almost all cases of cervical cancer are caused by high-risk cases of HPV, a virus that is spread through sexual activity or other close skin-to-skin contact. But don’t panic: HPV is very common, and getting HPV doesn’t always mean you’ll get cervical cancer. Around 85 percent of people in the U.S. will get an HPV infection in their lifetime, but for most people, the virus clears on its own.
However, there are many strains of HPV, and some are linked to cervical cancer. In those cases, when the virus does not clear on its own and the HPV infection persists, it can cause a range of cancers in both men and women, including cancers of the cervix, anus, penis, throat, and vagina.
That’s why HPV vaccination is so important for all people: It can help prevent many types of cancer, including cervical cancer caused by those high-risk HPV infections.
What are the symptoms of cervical cancer?
Cervical cancer doesn’t usually have symptoms in its early stages, but once cancer begins to spread, the symptoms can include:
- Vaginal bleeding between periods, after sexual intercourse, or after menopause.
- Heavier and longer menstrual periods than usual.
- Vaginal discharge that has a strong odor and is watery.
- Pelvic pain or pain during sexual intercourse.
In more advanced stages, symptoms of cervical cancer can include:
- Leg swelling.
- Difficult or painful bowel movements or bleeding during a bowel movement.
- Blood in urine or difficulty urinating.
- Back pain.
“Most women present with no symptoms,” Dr. Kristina A. Butler, gynecologic oncologist at Mayo Clinic, tells PGN. “Therefore, the checkups with visualization of the cervix, speaking with your provider, and having a Pap smear are so important.”
How can you help prevent or reduce your risk for cervical cancer?
Vaccination: Cervical cancer is highly preventable. The most effective way to help protect yourself from it is by getting the HPV vaccine. The HPV vaccine is most effective before a person is first exposed to HPV, typically before becoming sexually active.
“If we are able to vaccinate children before they become adults [and] are subsequently exposed, those individuals are maximally protected against the [worst effects] of the virus, which could ultimately be cancer,” Butler adds.
You’re eligible to get the vaccine if you’re between 9 and 45 years old, but there are specific guidelines for each age group. The Centers for Disease Control and Prevention recommends HPV vaccination for children ages 11 or 12 (though it can start at 9 years).
The CDC says that you can get catch-up doses until you’re 26 if you didn’t get vaccinated earlier, but if you’re between 26 and 45 years old, you should talk to your health care provider about your individual risk for HPV and to see if you should get the vaccine.
Screenings: This is another effective way to prevent cervical cancer.
Dr. Deanna Gerber, a gynecologic oncologist at NYU Langone’s Laura and Isaac Perlmutter Cancer Center, tells PGN that regular screenings can catch HPV before it has a chance to become cancer.
“Now that we’re encouraging people to see their gynecologist and get screening more regularly, we’re catching cancer at earlier stages,” she says.
Screenings for cervical cancer include:
- Pap smear: During a Pap smear, also known as a Pap test, cells are collected from your cervix to find precancerous or cervical cancer cells. Pap smears should start at 21 years old, regardless of when you start having sex.
If you’re between 21 and 29, you should get a Pap smear every three years. If you’re 30 to 65 years old, it’s recommended you get one every three years, a Pap and HPV test together every five years, or an HPV test alone every five years.
- HPV test: During an HPV test, cells are collected from your cervix to look for infection with high-risk HPV strains that can cause cervical cancer. If you’re between 21 and 30 years old, it’s only recommended that you get an HPV test if you had an abnormal Pap smear result. After 30, an HPV test is recommended with a Pap smear every five years, as long as other results were normal.
(People over 65 years old should talk to their health care provider about whether they need screening.)
Not smoking: Avoiding smoking can reduce your risk of developing cervical cancer because “HPV and smoking tobacco work together to accelerate the negative effects of HPV,” says Gerber.
Wearing condoms: Although condoms don’t completely prevent HPV infection, they provide some protection. And according to the CDC, the use of condoms has been associated with a lower rate of cervical cancer.
There is hope with early detection
There is hope for people diagnosed with cervical cancer. “Compared to the survival [rates] 10 years ago, women survive much longer now with the great treatments we have,” adds Butler.
Some of those treatments and advances include radiation, chemotherapy, and surgical therapy.
And while there may be some stigma surrounding sexual health, it’s important to advocate for yourself, says Gerber.
“Being comfortable and bold talking to your doctor about your health or any concerns that you have, feeling comfortable with your provider by asking all these questions is really the best thing you can do.”
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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8 Signs Of Hypothyroidism Beyond Tiredness & Weight Gain
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When it comes to hypothyroidism, most people know to look out for tiredness and weight gain, and possibly menstrual disturbances in those who menstruate. But those symptoms could be caused by very many things, so what more specific signs and symptoms of hypothyroidism should we look out for?
Dr. James O’Donovan shows us in this short video:
The lesser-known signs
Dr. O’Donovan discusses:
- Asteatotic eczema (also called: eczema craquelé): dry, cracked skin with a “crazy paving” appearance, leading to fissures. It’s common on the lower legs, back, torso, and arms, especially in older patients and especially in winter.
- Cold peripheries with pale, dry, coarse skin: cold hands and feet, along with dryness due to decreased sweating; these invariably come together, though the exact link is unclear.
- Yellowish hue to the skin (carotenoderma): yellow-orange discoloration from elevated beta-carotene levels. This can easily be mistaken for jaundice and also occurs in diabetes, liver, and kidney diseases.
- Thin, brittle hair: the hair on one’s head may become dry, coarse, and fall out in handfuls.
- Loss of hair on the outer third of eyebrows: thinning or disappearance of hair in this very specific area.
- Slow-growing, rigid, brittle nails: slowed nail growth due to decreased cell turnover rate. Ridges may form as keratin cells accumulate.
- Myxedema: puffy face, eyelids, legs, and feet caused by tissue swelling from cutaneous deposition.
- Delayed wound healing: is what it sounds like; a slower healing process.
10almonds note: this video, like much of medical literature as well, does focus on what things are like for white people. Black people with hypothyroidism are more likely to see a lightening of hair pigmentation, and, in contrast, hyperpigmentation of the skin, usually in patches. We couldn’t find data for other ethnicities or skintones, but it does seem that most of the signs and symptoms (unrelated to pigmentation) should be the same for most people.
Meanwhile, for more on the above 8 signs, with visuals, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
The Three Rs To Boost Thyroid-Related Energy Levels
Take care!
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Dry Needling for Meralgia Paresthetica?
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Could you address dry needling, who should administer it, and could it be a remedy for meralgia paresthetica? If not, could you speak to home-based remedies for meralgia paresthetica? Thank you?❞
We’ll need to take a main feature some time to answer this one fully, but we will say some quick things here:
- Dry needling, much like acupuncture, has been found to help with pain relief.
- Meralgia paresthetica, being a neuropathy, may benefit from some things that benefit people with peripheral neuropathy, such as lion’s mane mushroom. There is definitely not research to support this hypothesis yet though (so far as we could find anyway; there is plenty to support lion’s mane helping with nerve regeneration in general, but nothing specific for meralgia paresthetica).
Some previous articles you might enjoy meanwhile:
- Pinpointing The Usefulness Of Acupuncture
- Science-Based Alternative Pain Relief
- Peripheral Neuropathy: How To Avoid It, Manage It, Treat It
- What Does Lion’s Mane Actually Do, Anyway?
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
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