To Medicate or Not? That is the Question! – by Dr. Asha Bohannon
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Medications are, of course, a necessity of life (literally!) for many, especially as we get older. Nevertheless, overmedication is also a big problem that can cause a lot of harm too, and guess what, it comes with the exact same “especially as we get older” tag too.
So, what does Dr. Bohannon (a doctor of pharmacy, diabetes educator, and personal trainer too) recommend?
Simply put: she recommends starting with a comprehensive health history assessment and analysing one’s medication/supplement profile, before getting lab work done, tweaking all the things that can be tweaked along the way, and—of course—not neglecting lifestyle medicine either.
The book is prefaced and ended with pep talks that probably a person who has already bought the book does not need, but they don’t detract from the practical content either. Nevertheless, it feels a little odd that it takes until chapter 4 to reach “step 1” of her 7-step method!
The style throughout is conversational and energetic, but not overly padded with hype; it’s just a very casual style. Nevertheless, she brings to bear her professional knowledge and understanding as a doctor of pharmacy, to include her insights into the industry that one might not observe from outside of it.
Bottom line: if you’d like to do your own personal meds review and want to “know enough to ask the right questions” before bringing it up with your doctor, this book is a fine choice for that.
Click here to check out To Medicate Or Not, and make informed choices!
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The Art Of Letting Go – by Nick Trenton
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You may be wondering: is this a basic CBT book? And, for the most part, no, it’s not.
It does touch on some of the time-tested CBT techniques, but a large part of the book is about reframing things in a different way, that’s a little more DBT-ish, and even straying into BA. But enough of the initialisms, let’s give an example:
It can be scary to let go of the past, or of present or future possibilities (bad ones as well as good!). However, it’s hard to consciously do something negative (same principle as “don’t think of a pink elephant”), so instead, look at it as taking hold of the present/future—and thus finding comfort and security in a new reality rather than an old memory or a never-actual imagining.
So, this book has a lot of ideas like that, and if even one of them helps, then it was worth reading.
The writing style is comprehensive, and goes for the “tell them what you’re gonna tell them; tell them; then tell them what you told them” approach, which a) is considered good for learning b) can feel a little like padding nonetheless.
Bottom line: this reviewer didn’t personally love the style, but the content made up for it.
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Moore’s Clinically Oriented Anatomy – by Dr. Anne Argur & Dr. Arthur Dalley
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Imagine, if you will, Grey’s Anatomy but beautifully illustrated in color and formatted in a way that’s easy to read—both in terms of layout and searchability, and also in terms of how this book presents anatomy described in a practical, functional context, with summary boxes for each area, so that the primary concepts don’t get lost in the very many details.
(In contrast, if you have a copy of the famous Grey’s Anatomy, you’ll know it’s full of many pages of nothing but tiny dense text, a large amount of which is Latin, with occasional etchings by way of illustration)
Another way in which this does a lot better than the aforementioned seminal work is that it also describes and discusses very many common variations and abnormalities, both congenital and acquired, so that it’s not just a text of “what a theoretical person looks like inside”, but rather also reflects the diverse reality of the human form (we weren’t made identically in a production line, and so we can vary quite a bit).
The book is, of course, intended for students and practitioners of medicine and related fields, so what good is it to the lay person? Well, if you ask the average person where the gallbladder is and why we have one, they will gesture in the general direction of the abdomen, and sort of shrug sheepishly. You don’t have to be that person 🙂
Bottom line: if you’d like to know your acetabulum from your zygomatic arch, this is the best anatomy book this reviewer has yet seen.
Click here to check out Moore’s Clinically Oriented Anatomy, and prepare to be amazed!
PS: this one is expensive, but consider it a fair investment in your personal education, if you’re serious about it!
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Why scrapping the term ‘long COVID’ would be harmful for people with the condition
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The assertion from Queensland’s chief health officer John Gerrard that it’s time to stop using the term “long COVID” has made waves in Australian and international media over recent days.
Gerrard’s comments were related to new research from his team finding long-term symptoms of COVID are similar to the ongoing symptoms following other viral infections.
But there are limitations in this research, and problems with Gerrard’s argument we should drop the term “long COVID”. Here’s why.
A bit about the research
The study involved texting a survey to 5,112 Queensland adults who had experienced respiratory symptoms and had sought a PCR test in 2022. Respondents were contacted 12 months after the PCR test. Some had tested positive to COVID, while others had tested positive to influenza or had not tested positive to either disease.
Survey respondents were asked if they had experienced ongoing symptoms or any functional impairment over the previous year.
The study found people with respiratory symptoms can suffer long-term symptoms and impairment, regardless of whether they had COVID, influenza or another respiratory disease. These symptoms are often referred to as “post-viral”, as they linger after a viral infection.
Gerrard’s research will be presented in April at the European Congress of Clinical Microbiology and Infectious Diseases. It hasn’t been published in a peer-reviewed journal.
After the research was publicised last Friday, some experts highlighted flaws in the study design. For example, Steven Faux, a long COVID clinician interviewed on ABC’s television news, said the study excluded people who were hospitalised with COVID (therefore leaving out people who had the most severe symptoms). He also noted differing levels of vaccination against COVID and influenza may have influenced the findings.
In addition, Faux pointed out the survey would have excluded many older people who may not use smartphones.
The authors of the research have acknowledged some of these and other limitations in their study.
Ditching the term ‘long COVID’
Based on the research findings, Gerrard said in a press release:
We believe it is time to stop using terms like ‘long COVID’. They wrongly imply there is something unique and exceptional about longer term symptoms associated with this virus. This terminology can cause unnecessary fear, and in some cases, hypervigilance to longer symptoms that can impede recovery.
But Gerrard and his team’s findings cannot substantiate these assertions. Their survey only documented symptoms and impairment after respiratory infections. It didn’t ask people how fearful they were, or whether a term such as long COVID made them especially vigilant, for example.
Tens of thousands of Australians, and millions of people worldwide, have long COVID.
New Africa/ShutterstockIn discussing Gerrard’s conclusions about the terminology, Faux noted that even if only 3% of people develop long COVID (the survey found 3% of people had functional limitations after a year), this would equate to some 150,000 Queenslanders with the condition. He said:
To suggest that by not calling it long COVID you would be […] somehow helping those people not to focus on their symptoms is a curious conclusion from that study.
Another clinician and researcher, Philip Britton, criticised Gerrard’s conclusion about the language as “overstated and potentially unhelpful”. He noted the term “long COVID” is recognised by the World Health Organization as a valid description of the condition.
A cruel irony
An ever-growing body of research continues to show how COVID can cause harm to the body across organ systems and cells.
We know from the experiences shared by people with long COVID that the condition can be highly disabling, preventing them from engaging in study or paid work. It can also harm relationships with their friends, family members, and even their partners.
Despite all this, people with long COVID have often felt gaslit and unheard. When seeking treatment from health-care professionals, many people with long COVID report they have been dismissed or turned away.
Last Friday – the day Gerrard’s comments were made public – was actually International Long COVID Awareness Day, organised by activists to draw attention to the condition.
The response from people with long COVID was immediate. They shared their anger on social media about Gerrard’s comments, especially their timing, on a day designed to generate greater recognition for their illness.
Since the start of the COVID pandemic, patient communities have fought for recognition of the long-term symptoms many people faced.
The term “long COVID” was in fact coined by people suffering persistent symptoms after a COVID infection, who were seeking words to describe what they were going through.
The role people with long COVID have played in defining their condition and bringing medical and public attention to it demonstrates the possibilities of patient-led expertise. For decades, people with invisible or “silent” conditions such as ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) have had to fight ignorance from health-care professionals and stigma from others in their lives. They have often been told their disabling symptoms are psychosomatic.
Gerrard’s comments, and the media’s amplification of them, repudiates the term “long COVID” that community members have chosen to give their condition an identity and support each other. This is likely to cause distress and exacerbate feelings of abandonment.
Terminology matters
The words we use to describe illnesses and conditions are incredibly powerful. Naming a new condition is a step towards better recognition of people’s suffering, and hopefully, better diagnosis, health care, treatment and acceptance by others.
The term “long COVID” provides an easily understandable label to convey patients’ experiences to others. It is well known to the public. It has been routinely used in news media reporting and and in many reputable medical journal articles.
Most importantly, scrapping the label would further marginalise a large group of people with a chronic illness who have often been left to struggle behind closed doors.
Deborah Lupton, SHARP Professor, Vitalities Lab, Centre for Social Research in Health and Social Policy Centre, and the ARC Centre of Excellence for Automated Decision-Making and Society, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Pomegranate’s Health Gifts Are Mostly In Its Peel
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Pomegranate Peel’s Potent Potential
Pomegranates have been enjoying a new surge in popularity in some parts, widely touted for their health benefits. What’s not so widely touted is that most of the bioactive compounds that give these benefits are concentrated in the peel, which most people in most places throw away.
They do exist in the fruit too! But if you’re discarding the peel, you’re missing out:
Food Applications and Potential Health Benefits of Pomegranate and its Derivatives
“That peel is difficult and not fun to eat though”
Indeed. Drying the peel, especially freeze-drying it, is a good first step:
❝Freeze drying peels had a positive effect on the total phenolic, tannins and flavonoid than oven drying at all temperature range. Moreover, freeze drying had a positive impact on the +catechin, -epicatechin, hesperidin and rutin concentrations of fruit peel. ❞
Once it is freeze-dried, it is easy to grind it into a powder for use as a nutritional supplement.
“How useful is it?”
Studies with 500mg and 1000mg per day in people with cases of obesity and/or type 2 diabetes saw significant improvements in assorted biomarkers of cardiometabolic health, including blood pressure, blood sugar levels, cholesterol, and hemoglobin A1C:
- Effects of pomegranate extract supplementation on inflammation in overweight and obese individuals: A randomized controlled clinical trial
- Beneficial effects of pomegranate peel extract on plasma lipid profile, fatty acids levels and blood pressure in patients with diabetes mellitus type-2: A randomized, double-blind, placebo-controlled study
It also has anticancer properties:
- Punicalagin, a polyphenol from pomegranate fruit, induces growth inhibition and apoptosis in human PC-3 and LNCaP cells
- Punica granatum (Pomegranate) activity in health promotion and cancer prevention
- The extract from Punica granatum (pomegranate) peel induces apoptosis and impairs metastasis in prostate cancer cells
…and neuroprotective benefits:
- Long-term (15 mo) dietary supplementation with pomegranates attenuates cognitive and behavioral deficits
- Neuroprotective Effects of Pomegranate Peel Extract
- An Evaluation of the Effects of a Non-caffeinated Energy Dietary Supplement on Cognitive and Physical Performance
…and it may protect against osteopenia and osteoporosis, but we only have animal or in vitro studies so far, for example:
- Pomegranate Peel Extract Prevents Bone Loss in a Preclinical Model of Osteoporosis and Stimulates Osteoblastic Differentiation in Vitro
- Pomegranate and its derivatives can improve bone health through decreased inflammation and oxidative stress in an animal model of postmenopausal osteoporosis
Want to try it?
We don’t sell it, but you can buy pomegranates at your local supermarket, or buy the peel extract ready-made from online sources; here’s an example on Amazon for your convenience
(the marketing there is for use of the 100% pomegranate peel powder as a face mask; it also has health benefits for the skin when applied topically, but we didn’t have time to cover that today)
Enjoy!
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Life After Death? (Your Life; A Loved One’s Death)
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The Show Must Go On
We’ve previously written about the topics of death and dying. It’s not cheery, but it is important to tackle.
Sooner is better than later, in the case of:
Preparations For Managing Your Own Mortality
And for those who are left behind, of course it is hardest of all:
What Grief Does To Your Body (And How To Manage It)
But what about what comes next? For those who are left behind, that is.
Life goes on
In cases when the death is that of a close loved one, the early days after death can seem like a surreal blur. How can the world go ticking on as normal when [loved one] is dead?
But incontrovertibly, it does, so we can only ask again: how?
And, we get to choose that, to a degree. The above-linked article about grief gives a “101” rundown, but it’s (by necessity, for space) a scant preparation for one of the biggest challenges in life that most of us will ever face.
For many people, processing grief involves a kind of “saying goodbye”. For others, it doesn’t, as in the following cases of grieving the loss of one’s child—something no parent should ever have to face, but it happens:
Dr. Ken Druck | The Love That Never Dies
(with warning, the above article is a little heavy)
In short: for those who choose not to “say goodbye” in the case of the death of a loved one, it’s more often not a case of cold neglect, but rather the opposite—a holding on. Not in the “denial” sense of holding on, but rather in the sense of “I am not letting go of this feeling of love, no matter how much it might hurt to hold onto; it’s all I have”.
What about widows, and love after death?
Note: we’ll use the feminine “widow” here as a) it’s the most common and b) most scientific literature focuses on widows, but there is no reason why most of the same things won’t also apply to widowers.
We say “most”, as society does tend to treat widows and widowers differently, having different expectations about a respectful mourning period, one’s comportment during same, and so on.
As an aside: most scientific literature also assumes heterosexuality, which is again statistically reasonable, and for the mostpart the main difference is any extra challenges presented by non-recognition of marriages, and/or homophobic in-laws. But otherwise, grief is grief, and as the saying goes, love is love.
One last specificity before we get into the meat of this: we are generally assuming marriages to be monogamous here. Polyamorous arrangements will likely sidestep most of these issues completely, but again, they’re not the norm.
Firstly, there’s a big difference between remarrying (or similar) after being widowed, and remarrying (or similar) after a divorce, and that largely lies in the difference of how they begin. A divorce is (however stressful it may often be) more often seen as a transition into a new period of freedom, whereas bereavement is almost always felt as a terrible loss.
The science, by the way, shows the stats for this; people are less likely to remarry, and slower to remarry if they do, in instances of bereavement rather than divorce, for example:
Timing of Remarriage Among Divorced and Widowed Parents
Love after death: the options
For widows, then, there seem to be multiple options:
- Hold on to the feelings for one’s deceased partner; never remarry
- Grieve, move on, find new love, relegating the old to history
- Try to balance the two (this is tricky but can be done*)
*Why is balancing the two tricky, and how can it be done?
It’s tricky because ultimately there are three people’s wishes at hand:
- The deceased (“they would want me to be happy” vs “I feel I would be betraying them”—which two feelings can also absolutely come together, by the way)
- Yourself (whether you actually want to get a new partner, or just remain single—this is your 100% your choice either way, and your decision should be made consciously)
- The new love (how comfortable are they with your continued feelings for your late love, really?)
And obviously only two of the above can be polled for opinions, and the latter one might say what they think we want to hear, only to secretly and/or later resent it.
One piece of solid advice for the happily married: talk with your partner now about how you each would feel about the other potentially remarrying in the event of your death. Do they have your pre-emptive blessing to do whatever, do you ask a respectable mourning period first (how long?), would the thought just plain make you jealous? Be honest, and bid your partner be honest too.
One piece of solid advice for everyone: make sure you, and your partner(s), as applicable, have a good emotional safety net, if you can. Close friends or family members that you genuinely completely trust to be there through thick and thin, to hold your/their hand through the emotional wreck that will likely follow.
Because, while depression and social loneliness are expected and looked out for, it’s emotional loneliness that actually hits the hardest, for most people:
Longitudinal Examination of Emotional Functioning in Older Adults After Spousal Bereavement
…which means that having even just one close friend or family member with whom one can be at one’s absolute worst, express emotions without censure, not have to put on the socially expected appearance of emotional stability… Having that one person (ideally more, but having at least one is critical) can make a huge difference.
But what if a person has nobody?
That’s definitely a hard place to be, but here’s a good starting point:
How To Beat Loneliness & Isolation
Take care!
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Exercise, therapy and diet can all improve life during cancer treatment and boost survival. Here’s how
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With so many high-profile people diagnosed with cancer we are confronted with the stark reality the disease can strike any of us at any time. There are also reports certain cancers are increasing among younger people in their 30s and 40s.
On the positive side, medical treatments for cancer are advancing very rapidly. Survival rates are improving greatly and some cancers are now being managed more as long-term chronic diseases rather than illnesses that will rapidly claim a patient’s life.
The mainstays of cancer treatment remain surgery, chemotherapy, radiation therapy, immunotherapy, targeted therapy and hormone therapy. But there are other treatments and strategies – “adjunct” or supportive cancer care – that can have a powerful impact on a patient’s quality of life, survival and experience during cancer treatment.
PeopleImages.com – Yuri A/Shutterstock Keep moving if you can
Physical exercise is now recognised as a medicine. It can be tailored to the patient and their health issues to stimulate the body and build an internal environment where cancer is less likely to flourish. It does this in a number of ways.
Exercise provides a strong stimulus to our immune system, increasing the number of cancer-fighting immune cells in our blood circulation and infusing these into the tumour tissue to identify and kill cancer cells.
Our skeletal muscles (those attached to bone for movement) release signalling molecules called myokines. The larger the muscle mass, the more myokines are released – even when a person is at rest. However, during and immediately after bouts of exercise, a further surge of myokines is secreted into the bloodstream. Myokines attach to immune cells, stimulating them to be better “hunter-killers”. Myokines also signal directly to cancer cells slowing their growth and causing cell death.
Exercise can also greatly reduce the side effects of cancer treatment such as fatigue, muscle and bone loss, and fat gain. And it reduces the risk of developing other chronic diseases such as heart disease and type 2 diabetes. Exercise can maintain or improve quality of life and mental health for patients with cancer.
Emerging research evidence indicates exercise might increase the effectiveness of mainstream treatments such as chemotherapy and radiation therapy. Exercise is certainly essential for preparing the patient for any surgery to increase cardio-respiratory fitness, reduce systemic inflammation, and increase muscle mass, strength and physical function, and then rehabilitating them after surgery.
These mechanisms explain why cancer patients who are physically active have much better survival outcomes with the relative risk of death from cancer reduced by as much as 40–50%.
Mental health helps
The second “tool” which has a major role in cancer management is psycho-oncology. It involves the psychological, social, behavioural and emotional aspects of cancer for not only the patient but also their carers and family. The aim is to maintain or improve quality of life and mental health aspects such as emotional distress, anxiety, depression, sexual health, coping strategies, personal identity and relationships.
Supporting quality of life and happiness is important on their own, but these barometers can also impact a patient’s physical health, response to exercise medicine, resilience to disease and to treatments.
If a patient is highly distressed or anxious, their body can enter a flight or fight response. This creates an internal environment that is actually supportive of cancer progression through hormonal and inflammatory mechanisms. So it’s essential their mental health is supported.
Chemotherapy can be stressful on the body and emotional reserves. Shutterstock Putting the good things in: diet
A third therapy in the supportive cancer care toolbox is diet. A healthy diet can support the body to fight cancer and help it tolerate and recover from medical or surgical treatments.
Inflammation provides a more fertile environment for cancer cells. If a patient is overweight with excessive fat tissue then a diet to reduce fat which is also anti-inflammatory can be very helpful. This generally means avoiding processed foods and eating predominantly fresh food, locally sourced and mostly plant based.
Some cancer treatments cause muscle loss. Avoiding processed foods may help. Shutterstock Muscle loss is a side effect of all cancer treatments. Resistance training exercise can help but people may need protein supplements or diet changes to make sure they get enough protein to build muscle. Older age and cancer treatments may reduce both the intake of protein and compromise absorption so supplementation may be indicated.
Depending on the cancer and treatment, some patients may require highly specialised diet therapy. Some cancers such as pancreatic, stomach, esophageal, and lung cancer can cause rapid and uncontrolled drops in body weight. This is called cachexia and needs careful management.
Other cancers and treatments such as hormone therapy can cause rapid weight gain. This also needs careful monitoring and guidance so that, when a patient is clear of cancer, they are not left with higher risks of other health problems such as cardiovascular disease and metabolic syndrome (a cluster of conditions that boost your risk of heart disease, stroke and type 2 diabetes).
Working as a team
These are three of the most powerful tools in the supportive care toolbox for people with cancer. None of them are “cures” for cancer, alone or together. But they can work in tandem with medical treatments to greatly improve outcomes for patients.
If you or someone you care about has cancer, national and state cancer councils and cancer-specific organisations can provide support.
For exercise medicine support it is best to consult with an accredited exercise physiologist, for diet therapy an accredited practising dietitian and mental health support with a registered psychologist. Some of these services are supported through Medicare on referral from a general practitioner.
For free and confidential cancer support call the Cancer Council on 13 11 20.
Rob Newton, Professor of Exercise Medicine, Edith Cowan University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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