Total Recovery – by Dr. Gary Kaplan

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First, know: Dr. Kaplan is an osteopath, and as such, will be mostly approaching things from that angle. That said, he is also board certified in other things too, including family medicine, so he’s by no means a “one-trick pony”, nor are there “when your only tool is a hammer, everything starts to look like a nail” problems to be found here. Instead, the scope of the book is quite broad.

Dr. Kaplan talks us through the diagnostic process that a doctor goes through when presented with a patient, what questions need to be asked and answered—and by this we mean the deeper technical questions, e.g. “what do these symptoms have in common”, and “what mechanism was at work when the pain become chronic”, not the very basic questions asked in the initial debriefing with the patient.

He also asks such questions (and questions like these get chapters devoted to them) as “what if physical traumas build up”, and “what if physical and emotional pain influence each other”, and then examines how to interrupt the vicious cycles that lead to deterioration of one’s condition.

The style of the book is very pop-science and often narrative in its presentation, giving lots of anecdotes to illustrate the principles. It’s a “sit down and read it cover-to-cover” book—or a chapter a day, whatever your preferred pace; the point is, it’s not a “dip directly to the part that answers your immediate question” book; it’s not a textbook or manual.

Bottom line: a lot of this work is about prompting the reader to ask the right questions to get to where we need to be, but there are many illustrative possible conclusions and practical advices to be found and given too, making this a useful read if you and/or a loved one suffers from chronic pain.

Click here to check out Total Recovery, and solve your own mysteries!

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  • How To *Really* Pick Up (And Keep!) Those Habits

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    The Healthiest Habit-Building

    Why was that book “Atomic Habits” called that? It wasn’t just because it’s a catchy title…

    Habits are—much like atoms—things that are almost imperceptibly small, yet when stacked, they make up the substance of many much larger and more obvious things, and also contain an immense amount of potential power.

    About that power…

    Habits are the “compound interest” of natural human life. Every action we take, every decision we make, makes our life (often imperceptibly) better or worse. But getting even just 1% better or 1% worse at something every day? That’s going to not just add up over time… It’ll actively compound over time.

    Habits will snowball one way or the other, good or bad. So, we want to control that snowball so that it works for us rather than against us.

    Thus, we need to choose habits that are helpful to us, rather than those that are harmful to us. Top examples include:

    • Making healthy food choices rather than unhealthy ones
    • Moving our body regularly rather than being sedentary
    • Having a good bedtime/morning routine rather than a daily chaotic blur
    • Learning constantly rather than digging into old beliefs out of habit
    • Forging healthy relationships rather than isolating ourselves

    We all know that to make a habit stick, we need to practice it regularly, with opinions varying on how long it takes for something to become habit. Some say 21 days; some say 66. The number isn’t the important part!

    What is important

    You will never get to day 66, much less will you get to day 366, if you don’t first get to day 6 (New Year’s Resolutions, anyone?).

    So in the early days especially, when the habit is most likely to get dropped, it’s critical to make the habit as easy as possible to form.

    That means:

    • The habit should be made as pleasant as possible
      • (e.g. by making modifications to it if it’s not already intrinsically pleasant)
    • The habit should take under 2 minutes to do at first
      • (no matter if it takes longer than 2 minutes to be useful; it’ll never be useful if you don’t first get it to stick, so make your initial commitment only 2 minutes, just to get in the habit)
    • The habit should have cues to remind you
      • (as it’s not habit yet, you will need to either set a reminder on your phone, or leave a visual reminder, such as your workout clothes laid out ready for you in the morning, or a bowl of fruit in plain view where you spend a lot of time)

    What gets measured, gets done

    Streaks are a great way to do this. Habit-tracking apps help. Marks on a calendar or in a journal are also totally fine.

    What can help especially, and that a lot of people don’t do, is to have a system of regular personal reviews—like a work “performance review”, but for oneself and one’s own life.

    Set a reminder or write on the calendar / in your diary, to review monthly, or weekly if you prefer, such things as:

    • How am I doing in the areas of life that are important to me?
      • Have a list of the areas of life that are important to you, by the way, and genuinely reflect on each of them, e.g:
        • Health
        • Finances
        • Relationships
        • Learning
        • Sleep
        • Etc
    • What is working for me, and what isn’t working for me?
    • What will I do better in this next month/week?

    …and then do it!

    Good luck, and may it all stack up in your favor!

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  • The Salt Fix – by Dr. James DiNicolantonio

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    This book has a bold premise: high salt consumption is not, as global scientific consensus holds, a serious health risk, but rather, as the title suggests, a health fix.

    Dr. DiNicolantonio, a pharmacist, explains how “our ancestors crawled out of the sea millions of years ago and we still crave that salt”, giving this as a reason why we should consume salt ad libitum, aiming for 8–10g per day, and thereafter a fair portion of the book is given over to discussing how many health conditions are caused/exacerbated by sugar, and that therefore we have demonized the wrong white crystal (scientific consensus is that there are many white crystals that can cause us harm).

    Indeed, sugar can be a big health problem, but reading it at such length felt a lot like when all a politician can talk about is how their political rival is worse.

    A lot of the studies the author cites to support the idea of healthy higher salt consumption rates were on non-human animals, and it’s always a lottery as to whether those results translate to humans or not. Also, many of the studies he’s citing are old and have methodological flaws, while others we could not find when we looked them up.

    One of the sources cited is “my friend Jose tried this and it worked for him”.

    Bottom line: sodium is an essential mineral that we do need to live, but we are not convinced that this book’s ideas have scientific merit. But are they well-argued? Also no.

    Click here to check out The Salt Fix for yourself! It’s a fascinating book.

    (Usually, if we do not approve of a book, we simply do not review it. We like to keep things positive. However, this one came up in Q&A, so it seemed appropriate to share our review. Also, the occasional negative review may reassure you, dear readers, that when we praise a book, we mean it)

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  • We’re only using a fraction of health workers’ skills. This needs to change

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    Roles of health professionals are still unfortunately often stuck in the past. That is, before the shift of education of nurses and other health professionals into universities in the 1980s. So many are still not working to their full scope of practice.

    There has been some expansion of roles in recent years – including pharmacists prescribing (under limited circumstances) and administering a wider range of vaccinations.

    But the recently released paper from an independent Commonwealth review on health workers’ “scope of practice” identifies the myriad of barriers preventing Australians from fully benefiting from health professionals’ skills.

    These include workforce design (who does what, where and how roles interact), legislation and regulation (which often differs according to jurisdiction), and how health workers are funded and paid.

    There is no simple quick fix for this type of reform. But we now have a sensible pathway to improve access to care, using all health professionals appropriately.

    A new vision for general practice

    I recently had a COVID booster. To do this, I logged onto my general practice’s website, answered the question about what I wanted, booked an appointment with the practice nurse that afternoon, got jabbed, was bulk-billed, sat down for a while, and then went home. Nothing remarkable at all about that.

    But that interaction required a host of facilitating factors. The Victorian government regulates whether nurses can provide vaccinations, and what additional training the nurse requires. The Commonwealth government has allowed the practice to be paid by Medicare for the nurse’s work. The venture capitalist practice owner has done the sums and decided allocating a room to a practice nurse is economically rational.

    The future of primary care is one involving more use of the range of health professionals, in addition to GPs.

    It would be good if my general practice also had a physiotherapist, who I could see if I had back pain without seeing the GP, but there is no Medicare rebate for this. This arrangement would need both health professionals to have access to my health record. There also needs to be trust and good communication between the two when the physio might think the GP needs to be alerted to any issues.

    This vision is one of integrated primary care, with health professionals working in a team. The nurse should be able to do more than vaccination and checking vital signs. Do I really need to see the GP every time I need a prescription renewed for my regular medication? This is the nub of the “scope of practice” issue.

    How about pharmacists?

    An integrated future is not the only future on the table. Pharmacy owners especially have argued that pharmacists should be able to practise independently of GPs, prescribing a limited range of medications and dispensing them.

    This will inevitably reduce continuity of care and potentially create risks if the GP is not aware of what other medications a patient is using.

    But a greater role for pharmacists has benefits for patients. It is often easier and cheaper for the patient to see a pharmacist, especially as bulk billing rates fall, and this is one of the reasons why independent pharmacist prescribing is gaining traction.

    Pharmacists explains something to a patient
    It’s often easier for a patient to see a pharmacist than a GP. PeopleImages.com – Yuri A/Shutterstock

    Every five years or so the government negotiates an agreement with the Pharmacy Guild, the organisation of pharmacy owners, about how much pharmacies will be paid for dispensing medications and other services. These agreements are called “Community Pharmacy Agreements”. Paying pharmacists independent prescribing may be part of the next agreement, the details of which are currently being negotiated.

    GPs don’t like competition from this new source, even though there will be plenty of work around for GPs into the foreseeable future. So their organisations highlight the risks of these changes, reopening centuries old turf wars dressed up as concerns about safety and risk.

    Who pays for all this?

    Funding is at the heart of disputes about scope of practice. As with many policy debates, there is merit on both sides.

    Clearly the government must increase its support for comprehensive general practice. Existing funding of fee-for-service medical benefits payments must be redesigned and supplemented by payments that allow practices to engage a range of other health professionals to create health-care teams.

    This should be the principal direction of primary care reform, and the final report of the scope of practice review should make that clear. It must focus on the overall goal of better primary care, rather than simply the aspirations of individual health professionals, and working to a professional’s full scope of practice in a team, not a professional silo.

    In parallel, governments – state and federal – must ensure all health professionals are used to their best of their abilities. It is a waste to have highly educated professionals not using their skills fully. New funding arrangements should facilitate better access to care from all appropriately qualified health professionals.

    In the case of prescribing, it is possible to reconcile the aspirations of pharmacists and the concerns of GPs. New arrangements could be that pharmacists can only renew medications if they have agreements with the GP and there is good communication between them. This may be easier in rural and suburban areas, where the pharmacists are better known to the GPs.

    The second issues paper points to the complexity of achieving scope of practice reforms. However, it also sets out a sensible path to improve access to care using all health professionals appropriately.

    Stephen Duckett, Honorary Enterprise Professor, School of Population and Global Health, and Department of General Practice and Primary Care, The University of Melbourne

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Breaking The Age Code – by Dr. Becca Levy
  • How To Reduce Knee Pain After Sitting

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Sitting is bad for the health, and doubly so if you have arthritis, as a lack of regular movement can cause joints to “seize up”. So, what to do about it if you have to sit for an extended time?

    Dr. Alyssa Kuhn, arthritis specialist, explains:

    Movement remains key

    The trick is to continue periodically moving, notwithstanding that you may need to remain seated. So…

    1. Heel slides
      • Straighten and bend your leg by sliding or lifting your heel.
      • Promotes blood flow and reduces fluid buildup in the knee.
      • Helps lubricate the joint, making standing up easier.
    2. Heel lifts
      • Lift your heels up and down while keeping feet on the ground.
      • This one’s ideal for tight spaces, such as when riding in a car or airplane.
      • Improves blood circulation and can reduce ankle swelling and leg heaviness.

    Do 20–30 repetitions every now and again, to keep your joints moving.

    Note: if you are a wheelchair user whose legs lack the strength and/or motor function to do this, in this case it’s the movement of the leg that counts, not where that movement originated from. So, if you use one hand to lift your leg slightly and the other to push it like a swing, that will also be sufficient to give the joint the periodic movement it needs.

    For more on all of this plus visual demonstrations, enjoy:

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

    Want to learn more?

    You might also like to read:

    Stand Up For Your Health (Or Don’t) ← our main feature on this also includes more things you can do if you must sit, to make sitting less bad!

    Take care!

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  • Unlock Your Menopause Type – by Dr. Heather Hirsch

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We featured Dr. Hirsch before, here, and mentioned this book which, at the time, we had not yet reviewed. So, here it is:

    What sets this apart from a lot of menopause books is that there’s a lot less “eat these foods and your body will magically stop exhibiting symptoms of menopause” and a lot more clinical observations and then evidence-based recommendations.

    Which is not to say don’t eat broccoli and almonds; by all means, they’re great foods and contain valuable nutrients that will help. But it is to say that if your doctor’s prescription is just broccoli and almonds, maybe have those as a snack while you’re looking for a second opinion.

    Dr. Hirsch goes through various “menopause types”, but it’s not so much “astrology for gynecologists” and more “here are clusters of menopause symptoms set against timeline of presentation, and they can be categorized into six main ways that between them, cover pretty much all my patients, which have been many”.

    So if you, dear reader, are menopausal (including peri- or post-), then the chances are very good that you will see yourself in one of those six sets.

    She then goes about how to prioritize relief and safety, and personalize a treatment plan, and maintain the best menopausal care for you, going forward.

    The style is easy-reading pop-science, punctuated by clinical science and 35 pages of references. She’s also, unlike a lot of authors in the genre, manifestly not invested in being a celebrity or making a personality cult out of her recommendations; she’s happy to stick to the science and put out good advice.

    Bottom line: if you or someone you love is menopausal (including peri- or post-), this is a top-tier book.

    Click here to check out Unlock Your Menopause Type, and get the best care for you!

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  • Eat Dirt – by Dr. Josh Axe

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Dr. Axe describes leaky gut as “a serious disease with a silly name”, and hopes for people to take increased intestinal permeability (as it is otherwise known) seriously, because it can be found at the root of very many diseases, especially inflammatory / autoimmune diseases, which obviously also has significant implications for dementia (of which neuroinflammation is a fair part of the pathogenesis) and cancer (which has been described as largely a matter of immune dysfunction).

    He starts strong, albeit anecdotally, with the story of his own mother’s battle with cancer and other diseases, and how her health did a U-turn (for the better) upon taking care of her gut as per the methods described in this book. Dr. Axe doesn’t go so far as to claim the gut-healthy protocol cured her cancer, but makes the (very reasonable) argument that it was a major contributory factor, especially as it was the main input variable that changed.

    The book describes the various things that can go wrong with our gut and why, and for each of them presents a solution.

    Some of it is as you might guess from the title—live a little dirtier, because the ubiquity of antimicrobials is leaving our immune system slack and maladjusted, causing it to varyingly a) turn on us b) not rise to the occasion when an actual pathogen arrives c) often both. Other matters of consideration include normal gut health nutrition (prebiotics and probiotics, skipping inflammatory foods), matters of medication (especially those that harm the gut), nutraceuticals such as Boswellia serrata, and even stress management.

    He provides a program so that the reader can follow along step-by-step, and even a chapter of recipes, but the greatest value in the book is the explanation of gut pathology—because understanding that is foundational to recognizing a lot of things (and he does provide diagnostic questionnaires also, which are helpful).

    Bottom line: if you’d like to improve almost any aspect of your health, then your gut is almost always an excellent place to start, and this book will set you on the right path.

    Click here to check out Eat Dirt, and heal your gut!

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