You Are Not Broken – by Dr. Kelly Casperson
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Many women express “I think I’m broken down there”, and it turns out simply that neither they nor their partners had the right knowledge, that’s all. The good news is: bedroom competence is an entirely learnable skill!
Dr. Casperson is a urologist, and over the years has expanded her work into all things pelvic, including the relevant use of both systemic and topical hormones (as in, hormones to increase overall blood serum levels of that hormone, like most HRT, and also, creams and lotions to increase levels of a given hormone in one particular place).
However, this is not 200 pages to say “take hormones”. Rather, she covers many areas of female sexual health and wellbeing, including yes, simply pleasure. From the physiological to the psychological, Dr. Casperson talks the reader through avoiding blame games and “getting out of your head and into your body”.
Bottom line: if you (or a loved one) are one of the many women who have doubts about being entirely correctly set up down there, then this book is definitely for you.
Click here to check out You Are Not Broken, and indeed stop “should-ing” all over your sex life!
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Chew On This… But Don’t Swallow − by Dr. Blanche Grube & Anita Vasquez-Tibau
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Dr. Blanche Grube is a dentist with over 40 years of experience, and Anita Vasquez-Tibau is a well-respected research scientist with many peer-reviewed publications to her name, and both have lectured extensively.
So, what do they want us to know?
It’s mostly about the iatrogenic (i.e., caused by treatment) harm done by many common conventional dental practices (including dental mercury amalgams, metal crowns, root canals, implants, and even braces), and how we can avoid such, and enjoy better treatment instead.
After an introductory overview of the basics (and also where her own work came from in the first place, namely, her own root canals that were established as largely responsible for her leukemia), the largest part of the book is practical advice, laid out practically. What things come with what risks, what things get advertised differently than they really are, and which way to go in the case of unenviable situations where one must choose the “least bad” option out of a bunch of bad options.
Lastly, she discusses a range of solutions that can help side-step most problems, provided one implements them early. The good news is, they are “do these small things every day” recommendations, not “get this prophylactic surgical treatment” options. And yes, they are beyond the obvious of good dental hygiene, though she does cover that too.
The style is in part narrative, in part explanatory, and/but very readable throughout.
Bottom line: if you love having teeth and/but don’t love going to the dentist, this book will help you take good care of yourself, and also mean you can safely and informedly advocate for yourself if you do find yourself in the dentist’s office.
Click here to check out Chew On This… But Don’t Swallow, and protect your teeth!
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A new emergency procedure for cardiac arrests aims to save more lives – here’s how it works
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As of January this year, Aotearoa New Zealand became just the second country (after Canada) to adopt a groundbreaking new procedure for patients experiencing cardiac arrest.
Known as “double sequential external defibrillation” (DSED), it will change initial emergency response strategies and potentially improve survival rates for some patients.
Surviving cardiac arrest hinges crucially on effective resuscitation. When the heart is working normally, electrical pulses travel through its muscular walls creating regular, co-ordinated contractions.
But if normal electrical rhythms are disrupted, heartbeats can become unco-ordinated and ineffective, or cease entirely, leading to cardiac arrest.
Defibrillation is a cornerstone resuscitation method. It gives the heart a powerful electric shock to terminate the abnormal electrical activity. This allows the heart to re-establish its regular rhythm.
Its success hinges on the underlying dysfunctional heart rhythm and the proper positioning of the defibrillation pads that deliver the shock. The new procedure will provide a second option when standard positioning is not effective.
Using two defibrillators
During standard defibrillation, one pad is placed on the right side of the chest just below the collarbone. A second pad is placed below the left armpit. Shocks are given every two minutes.
Early defibrillation can dramatically improve the likelihood of surviving a cardiac arrest. However, around 20% of patients whose cardiac arrest is caused by “ventricular fibrillation” or “pulseless ventricular tachycardia” do not respond to the standard defibrillation approach. Both conditions are characterised by abnormal activity in the heart ventricles.
DSED is a novel method that provides rapid sequential shocks to the heart using two defibrillators. The pads are attached in two different locations: one on the front and side of the chest, the other on the front and back.
A single operator activates the defibrillators in sequence, with one hand moving from the first to the second. According to a recent randomised trial in Canada, this approach could more than double the chances of survival for patients with ventricular fibrillation or pulseless ventricular tachycardia who are not responding to standard shocks.
The second shock is thought to improve the chances of eliminating persistent abnormal electrical activity. It delivers more total energy to the heart, travelling along a different pathway closer to the heart’s left ventricle.
Evidence of success
New Zealand ambulance data from 2020 to 2023 identified about 1,390 people who could potentially benefit from novel defibrillation methods. This group has a current survival rate of only 14%.
Recognising the potential for DSED to dramatically improve survival for these patients, the National Ambulance Sector Clinical Working Group updated the clinical procedures and guidelines for emergency medical services personnel.
The guidelines now specify that if ventricular fibrillation or pulseless ventricular tachycardia persist after two shocks with standard defibrillation, the DSED method should be administered. Two defibrillators need to be available, and staff must be trained in the new approach.
Though the existing evidence for DSED is compelling, until recently it was based on theory and a small number of potentially biased observational studies. The Canadian trial was the first to directly compare DSED to standard treatment.
From a total of 261 patients, 30.4% treated with this strategy survived, compared to 13.3% when standard resuscitation protocols were followed.
The design of the trial minimised the risk of other factors confounding results. It provides confidence that survival improvements were due to the defibrillation approach and not regional differences in resources and training.
The study also corroborates and builds on existing theoretical and clinical scientific evidence. As the trial was stopped early due to the COVID-19 pandemic, however, the researchers could recruit fewer than half of the numbers planned for the study.
Despite these and other limitations, the international group of experts that advises on best practice for resuscitation updated its recommendations in 2023 in response to the trial results. It suggested (with caution) that emergency medical services consider DSED for patients with ventricular fibrillation or pulseless ventricular tachycardia who are not responding to standard treatment.
Training and implementation
Although the evidence is still emerging, implementation of DSED by emergency services in New Zealand has implications beyond the care of patients nationally. It is also a key step in advancing knowledge about optimal resuscitation strategies globally.
There are always concerns when translating an intervention from a controlled research environment to the relative disorder of the real world. But the balance of evidence was carefully considered before making the decision to change procedures for a group of patients who have a low likelihood of survival with current treatment.
Before using DSED, emergency medical personnel undergo mandatory education, simulation and training. Implementation is closely monitored to determine its impact.
Hospitals and emergency departments have been informed of the protocol changes and been given opportunities to ask questions and give feedback. As part of the implementation, the St John ambulance service will perform case reviews in addition to wider monitoring to ensure patient safety is prioritised.
Ultimately, those involved are optimistic this change to cardiac arrest management in New Zealand will have a positive impact on survival for affected patients.
Vinuli Withanarachchie, PhD candidate, College of Health, Massey University; Bridget Dicker, Associate Professor of Paramedicine, Auckland University of Technology, and Sarah Maessen, Research Associate, Auckland University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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What You Should Have Been Told About The Menopause Beforehand
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What You Should Have Been Told About Menopause Beforehand
This is Dr. Jen Gunter. She’s a gynecologist, specializing in chronic pain and vulvovaginal disorders. She’s also a woman on a mission to demystify things that popular culture, especially in the US, would rather not talk about.
When was the last time you remember the menopause being referenced in a movie or TV show? If you can think of one at all, was it just played for laughs?
And of course, the human body can be funny, so that’s not necessarily the problem, but it sure would be nice if that weren’t all that there is!
So, what does Dr. Gunter want us to know?
It’s a time of changes, not an end
The name “menopause” is misleading. It’s not a “pause”, and those menses aren’t coming back.
And yet, to call it a “menostop” would be differently misleading, because there’s a lot more going on than a simple cessation of menstruation.
Estrogen levels will drop a lot, testosterone levels may rise slightly, mood and sleep and appetite and sex drive will probably be affected (progesterone can improve all these things!) and
not to mention butwe’re going to mention: vaginal atrophy, which is very normal and very treatable with a topical estrogen cream. Untreated menopause can also bring a whole lot of increased health risks (for example, heart disease, osteoporosis, and, counterintuitively given the lower estrogen levels, breast cancer).However, with a little awareness and appropriate management, all these things can usually be navigated with minimal adverse health outcomes.
Dr Gunter, for this reason, refers to it interchangeably as “the menopausal transition”. She describes it as being less like a cliff edge we fall off, and more like a bridge we cross.
Bridges can be dangerous to cross! But they can also get us safely where we’re going.
Ok, so how do we manage those things?
Dr. Gunter is a big fan of evidence-based medicine, so we’ll not be seeing any yonic crystals or jade eggs. Or “goop”.
See also: Meet Goop’s Number One Enemy
For most people, she recommends Menopausal Hormone Therapy (MHT), which falls under the more general category of Hormone Replacement Therapy (HRT).
This is the most well-evidenced, science-based way to avoid most of the risks associated with menopause.
Nevertheless, there are scare-stories out there, ranging from painful recommencement of bleeding, to (once again) increased risk of breast cancer. However, most of these are either misunderstandings, or unrelated to menopause and MHT, and are rather signs of other problems that should not be ignored.
To get a good grounding in this, you might want to read her Hormone Therapy Guide, freely available as a standalone section on her website. This series of posts is dedicated to hormone therapy. It starts with some basics and builds on that knowledge with each post:
Dr. Gunter’s Guide To The Hormone Menoverse
What about natural therapies?
There are some non-hormonal things that work, but these are mostly things that:
- give a statistically significant reduction in symptoms
- give the same statistically significant reduction in symptoms as placebo
As Dr. Gunter puts it:
❝While most of the studies of prescription medications for hot flashes have an appropriate placebo arm, this is rarely the case with so-called alternative therapies.
In fact, the studies here are almost always low quality, so it’s often not possible to conclude much.
Many reviews that look at these studies often end with a line that goes something like, “Randomized trials with a placebo arm, a low risk of bias, and adequate sample sizes are urgently needed.”
You should interpret this kind of conclusion as the polite way of saying, “We need studies that aren’t BS to say something constructive.”❞
However, if it works, it works, whatever its mechanism. It’s just good, when making medical decisions, to do so with the full facts!
For that matter, even Dr. Gunter acknowledges that while MHT can be lifechanging (in a positive way) for many, it’s not for everyone:
Informed Decisions: When Menopause Hormone Therapy Isn’t Recommended
Want to know more?
Dr. Gunter also has an assortment of books available, including The Menopause Manifesto (which we’ve reviewed previously), and some others that we haven’t, such as “Blood” and “The Vagina Bible”.
Enjoy!
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6-Minute Core Strength – by Dr. Jonathan Su
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We don’t normally do author biographies here, but in this case it’s worth noting that Dr. Su is a physiotherapist, military rehab expert, and an IAYT yoga therapist. So, these things together certainly do lend weight to his advice.
About the “6-minute” thing: this is in the style of the famous “7-minute workout” and “5 Minutes’ Physical Fitness” etc, and refers to how long each exercise session should take. The baseline is one such session per day, though of course doing more than one set of 6 minutes each time is a bonus if you wish to do so.
The exercises are focused on core strength, but they also include hip and shoulder exercises, since these are after all attached to the core, and hip and shoulder mobility counts for a lot.
A particular strength of the book is in troubleshooting mistakes of the kind that aren’t necessarily visible from photos; in this case, Dr. Su explains what you need to go for in a certain exercise, and how to know if you are doing it correctly. This alone is worth the cost of the book, in this reviewer’s opinion.
Bottom line: if you want core strength and want it simple yet comprehensive, this book can guide you.
Click here to check out 6-Minute Core Strength, and strengthen yours!
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Winter Wellness – by Rachel de Thample
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Winter is often the season of comfort foods and, in much of the Western world, there’s a holiday season slide of forgotten diets and instead sugar, alcohol, pastry, and the like.
What de Thample does here is an antidote to all that, without sacrificing happiness and celebration.
Before the recipes get started, she has a chapter on “food as medicine“, and to our immense surprise, proceeds to detail, accurately, many categories such as
- Foods for immune health
- Foods against inflammation
- Foods for gut health
- Foods against aging
- Foods for energy levels
- Foods against anxiety
- Foods for hormonal balance
…and so forth, with lists of ingredients that fit into each category.
Then in the rest of the book, she lays out beautiful recipes for wonderful dishes (and drinks) that use those ingredients, without unhealthy additions.
The recipes are, by the way, what could best be categorized as “fancy”. However, they are fancy in the sense that they will be impressive for entertaining, and (again, to our great surprise) they don’t actually call for particularly expensive/rare ingredients, nor for arcane methods and special equipment.Instead, everything’s astonishingly accessible to put together and easy to execute.
Bottom line: if you’d like to indulge this winter, but would like to do so healthily, this is an excellent way to do so.
Click here to check out Winter Wellness, and level-up your seasonal health and happiness!
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Who Will Take Care of Me When I’m Old? – by Joy Loverde
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Regular readers of 10almonds will know we’ve written before about how isolation kills (in numerous ways), and this book tackles that in much greater length and depth than we ever have room for here.
Specifically, she talks about preparing for medical and related (financial, living will in case of dementia, housing, etc) considerations down the line, with checklists and worksheets and such to make it easy, and help you make sure it actually gets done.
She also talks about creating a support network, from scratch if necessary (“foraging a family”), so that even if you will now be prepared to handle things alone, you’ll become a lot less likely to need to do so.
Unlike many books of this genre, she also covers managing your mortality; that “just shoot me” is not a plan, and what lessons can be learned from the dying to make our own last years the best they can be.
The style is upbeat and positive in outlook; less “prepare for doom” and more “get ready to do things right”, and it’s worth mentioning that the format is particularly helpful, outlining objectives towards the beginning of each chapter, and additional resources at the end of each chapter.
Over on Amazon, most of the reviews that contain any criticism are some manner of “I’m in my 70s and wish I had read this sooner”. Still, better late than never.
Bottom line: if you do not have an overabundance of support network around you, then this is an important book to read and to put into action.
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Learn to Age Gracefully
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