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This classic loving-kindness meditation can help you to awaken to how connected we all are. You don’t have to like everybody, or agree with everything they do—but you can open up to the possibility of caring for them, because our lives are inextricably linked.
This classic loving-kindness meditation can help you to awaken to how connected we all are. You don’t have to like everybody, or agree with everything they do—but you can open up to the possibility of caring for them, because our lives are inextricably linked.
A Meditation to Connect With Loving-Kindness (Even When It’s Hard)
Read and practice the guided meditation script below, pausing after each paragraph. Or listen to the audio practice.
1. Begin by thinking about someone who has helped you; maybe they’ve been directly generous or kind, or have inspired you though you’ve never met them. When you think of them, they make you smile. Bring an image of the person to mind, or feel their presence as if they’re right in front of you. Say their name to yourself, and silently offer these phrases to them, focusing on one phrase at a time.
May you live in safety.
May you have mental happiness (peace, joy).
May you have physical happiness (health, freedom from pain).
May you live with ease.
Don’t struggle to fabricate a feeling or sentiment. If your mind wanders, simply begin again.
2. After a few minutes, move on to a friend. Start with a friend who’s doing well right now, then switch to someone who is experiencing difficulty, loss, pain, or unhappiness.
3. Offer loving-kindness to a neutral person who you don’t feel a strong liking or disliking for: a cashier at the supermarket, a bank teller, a dry cleaner. When you offer loving-kindness to a neutral person, you are offering it to them simply because they exist—you are not indebted to or challenged by them.
4. Offer loving-kindness toward a person with whom you have difficulty. Start with someone mildly difficult, and slowly work toward someone who has hurt you more grievously. It’s common to feel resentment and anger, and it’s important not to judge yourself for that. Rather, recognize that anger burns within your heart and causes suffering, so out of the greatest respect and compassion for yourself, practice letting go and offering loving-kindness.
5. Finish by offering loving-kindness to anyone who comes to mind: people, animals, those you like, those you don’t, in an adventurous expansion of your own power of kindness.
Loving-kindness offers us a profound sense of connection, guiding us to live our lives with greater intention and compassion. In this online course from Mindful, Sharon Salzberg—one of the world’s leading loving-kindness meditation teachers—offers us her distinctive approach to loving-kindness practice. Learn more and sign up today!
How do you rate the quality of people’s diets? Well, “what could be more nutrient-dense than a vegetarian diet?” Indeed, if you compare the quality of vegetarian diets with non-vegetarian diets, the more plant-based diets do tend to win out, and the higher diet quality in vegetarian diets may help explain greater improvements in health outcomes. However, vegetarians appear to have a higher intake of refined grains, eating more foods like white rice and white bread that have been stripped of much of their nutrition. So, just because you’re eating a vegetarian diet doesn’t mean you’re necessarily eating as healthfully as possible.
Those familiar with the science know the primary health importance of eating whole plant foods. So, how about a scoring system that simply adds up how many cups of fruits, vegetables, whole grains, beans, chickpeas, split peas, and lentils, and how many ounces of nuts and seeds per 1,000 calories (with or without counting white potatoes)? Looking only at the total intake of whole plant foods doesn’t mean you aren’t also stuffing donuts into your mouth. So, you could imagine proportional intake measures, based on calories or weight, to determine the proportion of your diet that’s whole plant foods. In that case, you’d get docked points if you eat things like animal-derived foods—meat, dairy, or eggs—or added sugars and fats.
My favorite proportional intake measure is McCarty’s “phytochemical index,” which I’ve profiled previously. I love it because of its sheer simplicity, “defined as the percent of dietary calories derived from foods rich in phytochemicals.” It assigns a score from 0 to 100, based on the percentage of your calories that are derived from foods rich in phytochemicals, which are biologically active substances naturally found in plants that may be contributing to many of the health benefits obtained from eating whole plant foods. “Monitoring phytochemical intake in the clinical setting could have great utility” in helping people optimize their diet for optimal health and disease prevention. However, quantifying phytochemicals in foods or tissue samples is impractical, laborious, and expensive. But this concept of a phytochemical index score could be a simple alternative method to monitor phytochemical intake.
Theoretically, a whole food, plant-based or vegan diet that excluded refined grains, white potatoes, hard liquors, added oils, and added sugars could achieve a perfect score of 100. Lamentably, most Americans’ diets today might be lucky to score just 20. What’s going on? In 1998, our shopping baskets were filled with about 20% whole plant foods; more recently, that has actually shrunk, as you can see below and at 2:49 in my video Plant-Based Eating Score Put to the Test.
Wouldn’t it be interesting if researchers used this phytochemical index to try to correlate it with health outcomes? That’s exactly what they did. We know that studies have demonstrated that vegetarian diets have a protective association with weight and body mass index. For instance, a meta-analysis of five dozen studies has shown that vegetarians had significantly lower weight and BMI compared with non-vegetarians. And even more studies show that high intakes of fruits, vegetables, whole grains, and legumes may be protective regardless of meat consumption. So, researchers wanted to use an index that gave points for whole plant foods. They used the phytochemical index and, as you may recall from an earlier video, tracked people’s weight over a few years, using a scale of 0 to 100 to simply reflect what percentage of a person’s diet is whole plant foods. And even though the healthiest-eating tier only averaged a score of about 40, which meant the bulk of their diet was still made up of processed foods and animal products, just making whole plant foods a substantial portion of the diet may help prevent weight gain and decrease body fat. So, it’s not all or nothing. Any steps we can take to increase our whole plant food intake may be beneficial.
Many more studies have since been performed, with most pointing in the same direction for a variety of health outcomes—indicating, for instance, higher healthy plant intake is associated with about a third of the odds of abdominal obesity and significantly lower odds of high triglycerides. So, the index may be “a useful dietary target for weight loss,” where there is less focus on calorie intake and more on increasing consumption of these high-nutrient, lower-calorie foods over time. Other studies also suggest the same is true for childhood obesity.
Even at the same weight, with the same amount of belly fat, those eating plant-based diets tend to have higher insulin sensitivity, meaning the insulin they make works better in their body, perhaps thanks to the compounds in plants that alleviate inflammation and quench free radicals. Indeed, the odds of hyperinsulinemia—an indicator of insulin resistance—were progressively lower with greater plant consumption. No wonder researchers found 91% lower odds of prediabetes for people getting more than half their calories from healthy plant foods.
They also found significantly lower odds of metabolic syndrome and high blood pressure. There were only about half the odds of being diagnosed with hypertension over a three-year period among those eating more healthy plants. Even mental health may be impacted—about 80% less depression, 2/3 less anxiety, and 70% less psychological distress, as you can see below and at 5:15 in my video.
Is there a link between the dietary phytochemical index and benign breast diseases, such as fibrocystic diseases, fatty necrosis, ductal ectasia, and all sorts of benign tumors? Yes—70% lower odds were observed in those with the highest scores. But what about breast cancer? A higher intake of healthy plant foods was indeed associated with a lower risk of breast cancer, even after controlling for a long list of other factors. And not just by a little bit. Eating twice the proportion of plants compared to the standard American diet was linked to more than 90% lower odds of breast cancer.
Many healthcare teams rely on surveys and outcomes data to assess experience. But some of the most predictive signals appear earlier, in everyday interactions that traditional systems overlook.
Healthcare organizations collect more experience data than ever before. Surveys measure satisfaction. Dashboards track usage. Quality programs score performance.
Yet many teams still find themselves reacting late to disengagement, escalation, or breakdowns in trust.
The reason, experts say, is not a lack of data but a narrow definition of what counts as a signal. Some of the most consequential indicators of experience risk emerge before complaints are filed or metrics move. They appear in routine interactions that feel ordinary until patterns form.
At Transcom, a global provider of healthcare CX advisory and support services, these signals are increasingly treated as early warnings rather than background noise.
Why Traditional Experience Measures Fall Short
Surveys and performance metrics capture how people feel after an interaction ends. They are less effective at showing how confident or confused people feel while navigating care.
Research published in JAMA Network Open in 2024 found that patient-reported experience measures often lag behind behavioral changes that precede missed care or disengagement (JAMA Network Open, 2024).
By the time dissatisfaction appears in scores, behavior has already shifted.
According to Travis Coates, CEO of Americas and Asia at Transcom, experience strain often becomes visible first in how people seek help.
“Repeated inquiries on the same topic usually reflect unclear communication or fragmented processes,” Coates said. “Those are early warning signs that experience quality and ratings performance are at risk.”
The Experience Signals Teams Often Overlook
Healthcare teams interact with early signals every day without labeling them as such. These indicators tend to surface across support, messaging, and navigation touchpoints.
Commonly missed signals include:
Members contacting support multiple times for the same clarification
Hesitation or uncertainty when confirming next steps
Channel switching to seek reassurance rather than new information
Longer interactions driven by explanation rather than resolution
Tasks that are started but not completed digitally
Individually, these moments appear routine. In combination, they point to rising effort and declining confidence.
A 2023 survey reported that 44% of U.S. adults said they had skipped or delayed needed care in the past two years, citing cost, complexity, and confusing logistics as common barriers even when care was technically accessible (TIME, 2023).
Why These Signals Matter More Now
Healthcare systems are under pressure to do more with constrained resources. When experience friction goes undetected, it often resurfaces later as higher call volume, missed appointments, or avoidable escalation.
The Centers for Disease Control and Prevention has linked delays in care and missed follow-ups to downstream cost and poorer outcomes, particularly for chronic and behavioral health conditions (CDC, 2023).
Experience signals offer a chance to intervene earlier, when clarification and guidance are still effective.
How AI-assisted Workflows Change Timing
AI does not replace human judgment or frontline teams. Its value lies in surfacing patterns that are difficult to see at scale.
When AI is applied to interaction data, messaging content, and workflow paths, it can highlight where experience strain is forming at scale.
These systems help teams identify:
Where instructions consistently trigger follow-up questions
Which steps generate repeated confusion across channels
When effort increases before outcomes decline
How experience risk clusters around specific workflows
According to Coates, this shifts experience management from reaction to anticipation.
“Frontline teams are the earliest indicators of where experiences start to strain,” Coates said. “They encounter confusion before it ever appears in dashboards.”
What Early Visibility Enables
Seeing experience signals earlier allows healthcare teams to act before trust erodes.
Organizations can:
Clarify instructions before confusion compounds
Align digital and live guidance around the same expectations
Reduce avoidable follow-ups and escalations
Protect continuity of care without adding staff
A 2024 report from National Academy of Medicine emphasized that reducing cognitive and administrative burden is central to improving experience and system performance simultaneously (NAM, 2024).
From Measurement to Understanding
Experience is not only about satisfaction. It is about whether people know what to do next and feel confident doing it.
AI-assisted workflows help healthcare teams move beyond measuring outcomes to understanding behavior. They surface signals that have always been present, but rarely captured.
The systems that adapt fastest will be those that treat everyday interactions as data with meaning, not noise.
FAQs
What are experience signals in healthcare?
They are behavioral patterns that indicate confidence, confusion, or rising effort during care navigation.
Why do traditional surveys miss experience risk?
Because they capture sentiment after interactions rather than behavior during them.
How can AI surface experience signals earlier?
By analyzing patterns across interactions, messages, and workflows at scale.
Why does early detection matter for care delivery?
It allows teams to intervene before disengagement or escalation occurs.
Are experience signals different from satisfaction scores?
Yes. Signals reflect behavior in real time, while scores reflect reflection afterward.
Knee replacement surgery has become one of the most successful orthopedic procedures performed today, with millions of patients experiencing life-changing improvements in mobility and pain relief.
Whether someone is considering the procedure or preparing for an upcoming surgery, understanding what lies ahead, from recovery timelines to physical therapy requirements, can significantly ease anxiety and improve outcomes.
Understanding Total Knee Arthroplasty: The Procedure
Total knee arthroplasty (TKA), commonly known as knee replacement surgery, involves removing damaged bone and cartilage from the knee joint and replacing it with artificial components made from metal, plastic, or ceramic materials.
The procedure typically lasts 1-2 hours and is performed when arthritis, injury, or wear and tear causes severe pain and mobility limitations that conservative treatments cannot resolve.
The decision to pursue surgery usually comes after patients have exhausted non-surgical options like physical therapy, medications, and injections. Modern implants are designed to replicate the natural knee’s movement, providing patients with improved function and quality of life.
Knee Replacement Surgery Recovery Time: What the Timeline Looks Like
Understanding the recovery progression helps patients set realistic expectations and stay motivated throughout their healing journey.
Immediately After Surgery (Days 1-3)
Most patients spend 1-3 days in the hospital following knee replacement surgery. During this period, pain management and infection prevention are primary concerns. Hospital staff will begin gentle range-of-motion exercises, and patients typically start walking with assistance and supportive devices.
Early Recovery Phase (Weeks 1-6)
The first six weeks are critical for establishing foundational strength and mobility. During the initial two weeks, swelling and bruising are common. Most patients transition from a walker to crutches around week two, and many begin using a single cane by week four.
By week six, patients typically achieve approximately 110-120 degrees of knee bending, reduced dependence on pain medication, and the ability to walk independently for 10-15 minutes. Return to desk work often becomes feasible during this window.
Progressive Strengthening (Weeks 7-12)
Weeks seven through twelve represent a significant transition phase. Swelling continues to decrease, strength improves noticeably, and most patients can resume light household activities. Stairs become more manageable, and many individuals can walk 20-30 minutes without assistance.
Long-Term Recovery (Months 4-12)
While basic recovery may occur within three to six months, complete healing extends to one year post-surgery. By the six-month mark, approximately 80% of patients report substantial improvement in pain and function. Full recovery, including plateau in strength gains and pain reduction, typically occurs between nine and twelve months.
How Long Does Knee Replacement Last? Understanding Implant Longevity
A common concern for patients, particularly younger ones, involves how long their new knee will function. Research demonstrates impressive longevity: approximately 90% of replacement knees function well for 15 years, while 82% continue functioning after 25 years.
Modern implants are engineered with improved materials and biomechanics compared to earlier generations. Most patients will never require revision surgery during their lifetime.
However, individual factors like activity level, weight, and overall health influence implant durability. Younger patients may face eventual revision surgery, though advances in implant technology continue to extend lifespan.
Total Knee Arthroplasty Success Rates: The Data Behind the Numbers
Total knee arthroplasty success rates are among the highest of any surgical procedure. Approximately 95% of patients report satisfaction with their results, while 75-90% experience significant pain relief and improved mobility within the first year, according to the World Health Organization.
These impressive statistics hold across age groups. Patients over 70 show similarly high success rates, while younger patients (under 50) report even higher satisfaction levels. Pain reduction is remarkable, most patients transition from severe, limiting pain to manageable discomfort or complete pain relief within weeks of surgery.
Beyond pain relief, functional improvements matter equally. Patients regain the ability to walk longer distances, climb stairs, and participate in recreational activities previously abandoned due to knee problems. Quality of life improvements extend beyond physical function, often reducing depression and improving overall mental health.
Knee Replacement Physical Therapy Exercises: The Foundation of Recovery
Physical therapy is arguably the most important component of successful recovery. Active participation in structured exercises dramatically influences outcomes, strength development, and long-term function.
Early-Stage Exercises (Weeks 1-3)
Initial exercises focus on gentle range-of-motion and basic strength:
Ankle Pumps: Point and flex the foot to improve circulation and prevent blood clots
Quad Sets: Tighten the thigh muscle above the knee, holding for 5-10 seconds
Heel Slides: Slowly bend the knee by sliding the heel toward the buttock
Straight Leg Raises: Straighten the leg and lift it off the bed to strengthen the thigh
Short Arc Quads: Place a towel roll under the knee and straighten the leg while tightening the thigh muscle
Intermediate Exercises (Weeks 4-6)
As strength improves, exercises increase in intensity and complexity:
Step-Ups and Step-Downs: Using a low step, practice stepping up and down with careful control
Assisted Wall Squats: Lean against a wall and slowly bend the knees to 45-60 degrees
Stationary Cycling: Once range of motion allows, cycling provides excellent low-impact strengthening
Extended Walking: Gradually increase walking duration and pace
Advanced Exercises (Weeks 7-12+)
Later-stage therapy introduces more demanding movements:
Single-Leg Stance: Improve balance by standing on the operated leg for increasing durations
Swimming or Water Walking: Provides resistance without joint stress
Hiking or Varied-Terrain Walking: Challenges stability and strength with natural terrain variations
Physical therapists typically recommend 3-5 therapy sessions weekly for the first 6-12 weeks, with home exercises supplementing formal sessions.
Knee Replacement Complications & Risks: A Realistic Overview
While knee replacement surgery is generally safe, complications can occur. Overall complication rates range from 1.65-11.3%, with most being minor and manageable, as per Harvard Health.
Common Complications
Blood clots, occurring in 0.6-3% of patients, represent the most frequently discussed risk. Deep vein thrombosis (DVT) can develop in the leg after surgery, though modern prevention strategies, including compression stockings, medication, and early mobilization, significantly reduce incidence.
Infection, though rare (less than 2%), requires immediate medical attention if fever, increased swelling, or drainage occurs. Persistent pain or stiffness affects approximately 2.44% of patients and typically improves with continued therapy.
Nerve damage causing numbness or tingling is generally temporary and often resolves within months. Wound complications occur in roughly 7% of cases but usually respond well to appropriate care.
What to Expect After Knee Surgery: Getting Back to Life
Recovery extends beyond pain relief and strength. Patients wonder when they can resume normal activities, driving, working, exercising, and pursuing hobbies.
Returning to Work
Most desk workers can return within 4-6 weeks. Jobs requiring significant walking or standing may require 8-12 weeks or longer. Patients should discuss their specific work demands with their surgeon and physical therapist.
Driving After Knee Replacement
Approximately 80% of patients resume driving within 6-8 weeks, though individual timelines vary. Readiness depends on whether the right or left knee was replaced, pain control, range of motion, and knee strength. Left knee replacements typically allow earlier return to driving than right knee surgeries.
Return to Recreational Activities
Low-impact activities like swimming, walking, and cycling can usually resume at 3-4 months post-surgery. High-impact activities like running or tennis may require 6-12 months or more.
Moving Forward: Maximizing Your Knee Replacement Success
Successful long-term outcomes depend largely on patient engagement. Consistent physical therapy participation, weight management, appropriate activity selection, and regular follow-up appointments all contribute to sustained improvement.
The investment in rehabilitation during the first year pays dividends for decades. Patients who commit fully to physical therapy, gradually challenge their new knee within appropriate limits, and maintain strength through ongoing exercise experience the best long-term results.
Knee replacement surgery offers a remarkable opportunity to reclaim mobility, reduce pain, and improve overall quality of life. With realistic expectations, active participation in recovery, and proper precautions, most patients enjoy excellent outcomes lasting 15-25 years or beyond.
Frequently Asked Questions
1. Can You Fly After Knee Replacement Surgery?
Most surgeons recommend waiting 4-6 weeks before flying, as prolonged sitting increases blood clot risk. Once cleared, compression socks during flights and frequent movement help prevent complications. Always consult your surgeon before booking travel.
2. What Should You Wear After Knee Replacement Surgery?
Loose-fitting, elastic-waistband pants and slip-on shoes are ideal during recovery. Avoid tight clothing that restricts swelling and shoes that require bending or untying. Compression garments prescribed by your surgeon help manage inflammation and improve circulation.
3. How Much Does Knee Replacement Surgery Cost?
In the United States, knee replacement surgery typically costs $35,000-$60,000 without insurance, including hospital fees, surgeon fees, and implant costs. Most insurance plans cover the majority of expenses. Many hospitals offer financial assistance programs for uninsured patients.
4. Can You Get a Knee Replacement on Both Knees?
Yes, bilateral knee replacements are possible. Surgeons can perform both surgeries on the same day or schedule them weeks apart. Same-day bilateral procedures require excellent overall health, while staged surgeries (4-6 weeks apart) reduce stress on the body and allow one leg to bear weight during recovery.
I’m delighted to offer you a series of meditations on building emotional resilience. Over the next four classes we’ll explore how to mindfully practice with four really common emotions: anger, anxiety, longing, and joy. I’ll offer some practices you can use both while you meditate and also in your life, when these emotions arise. Here, we’re looking at how to connect with your anger in a way that offers insight and choices, rather than just reactivity and overwhelm.
What’s An Emotion?
Let’s first explore what an emotion is. This is a rich topic that has even inspired some heated debate. If you find you’re interested beyond the scope of what we talk here, I encourage you to explore the work of two psychologists: Paul Ekman, and Lisa Feldman Barrett, who wrote a recent book calledHow Emotions Are Made: The Secret Life of the Brain. The work of these two author/scientists provides a good overview of the two differing viewpoints of the current discussion around human emotion. In the meantime, I’ll be sharing what I know with you here.
I don’t know about you, but I experience emotions as a combination of thoughts in my mind, plus physical or energetic sensations in my body, and the interaction between those two. When we’re meditating, we can see, via our moment-to-moment experience, that emotions are indeed made up of both mental content—such as visual and auditory thoughts—and physical sensations. And when we talk about physical sensations, let’s include all kinds: so, sensations we receive through our sense doors (seeing, hearing, tasting, smelling and touch), but also all of the physical sensations within our bodies.
I don’t know about you, but I experience emotions as a combination of thoughts in my mind, plus physical or energetic sensations in my body, and the interaction between those two.
There’s a great deal of nuance when it comes to our emotions and our understanding of them, but physical sensations in our bodies tend to get divided into two categories: physiological (ie: digestion, breathing, temperature, the feeling of our body and the weight of gravity); and what I refer to as emotional sensations or the felt sense in our body. A couple of examples: when we talk about having butterflies in our stomach when we’re nervous or excited; or the feeling of listening to a heart-warming story, which can actually produce a physical feeling of warmth in our chest. (Try to notice that the next time it happens).
Essentially, emotions are energy moving in our body. And that energy calls us to certain kinds of actions. Our emotions also help us connect with other people, and they provide us insight into our lives and a better understanding of what we value, what we want in the world.
Emotions In the Body vs. In the Mind
In my daily life, and in my meditation practice, I find it’s more helpful to attend to the physical sensations related to emotions rather than the thinking around those emotions. I say that because thoughts happen so quickly. It’s also so easy for us to get caught up and swept away in a story—to forget that thinking is happening and just be caught up inside of it. Physical sensations, on the other hand, are less subtle. That makes bringing our attention to them and holding them in our attention a lot easier. Physical sensations don’t move as quickly as thoughts, so we can notice them and notice how they shift and change. An added bonus: simply noticing the sensations in our body can provide us with a kind of grounding, an anchor. It’s a great starting point in both daily life and when we meditate, and we’ll explore that together here.
As we get to know our emotions, I really encourage developing an attitude of acceptance, respect and care for them—think of it as an honouring of our emotional world. Our emotions can offer so much rich information about our lives, about what we value, what we want; they also play a vital role in our relationships, providing the foundation of our connection in communication with others. In fact, some social scientists posit that the main role of emotions in our lives is really about social interaction and connection. It’s worth repeating: emotions deserve and are worthy of our attention, respect and care.
So together we’re going to practice skilfully connecting with and being curious about our emotions. And here’s our aim: not to act out with regards to the emotions we feel, but also not to suppress them. We’re going to practice just connecting with the emotion, holding it, being curious about it, with no expectation or drive to have to act it out, and not having to suppress or deny or ignore it either.
I really want to emphasize, too, that finding this middle way doesn’t mean we’re aiming to be indifferent or passive about our emotions. It just means that we’re going to take the time to actually be with the emotion long enough to figure out what the skillful response is—rather than get caught up in reacting to the surging energy of that emotion we’re feeling. Oftentimes we will still want to take action based on an emotion. In fact, that’s what they’re telling us: something has arisen that we need to act on. But what we’ll do in this practice is try to nudge ourselves into territory where we can act out of connection and care rather than a buzzing desire to get rid of the feeling we’re feeling—because that’s not acting, it’s reacting.
How to Connect With Your Anger Mindfully
In this first class together we’ll explore anger. We’ll think about a recent situation where we may have been angry, or for the lucky ones joining this meditation, maybe you’re feeling a little anger right now? (Talk about excellent timing!)
Before we get started, let’s talk a little bit about anger. Like every emotion, anger is totally natural and actually an extremely life-affirming emotion. Anger’s fundamental role is to protect us and protect what we care about in the world. It lets us know when a limit of ours, or a boundary, has been crossed. It lets us know when our needs are not being met or when someone we care about is in danger. So anger both lets us know something about what’s happening around us, and it energizes us to act. It rouses us to the necessary energy level to be able to respond to a threat. It’s essentially about protecting life.
At the same time, we know that when anger is misdirected or when we act on it compulsively, it can be a truly destructive force—for our own physical health, our relationships, and in some instances, in the wider world. So we want to learn how to respect, honour, care for and be with our anger—and gain some insight into the most skilful response in any given situation, rather than go with the reactive response that could cause more harm.
The first step, then, is to recognize and respect anger. This is what’s happening, and it’s part of the human experience. And we respect it by understanding that our anger is trying to take care of us in some way, even if it’s maladaptive for the situation. We’re aiming to learn how to be with the anger, see what’s really there, and then see how we want to respond. So let’s try this together.
Meditating on the Power of Anger
Watch the video:
Listen to the practice:
Read and practice the guided meditation script below, pausing after each paragraph. Or listen to the audio practice.
When you’re ready, come into a comfortable seated position. If it feels comfortable to close your eyes, please do so. Let’s take a few deeper breaths. Just allow yourself to feel the points of contact with the cushion or chair beneath you; feel your feet on the ground. Feel a sense of grounding here. Take a few longer inhales and exhales just to settle.
Now let’s bring to mind a recent situation when we felt angry. As with any practice around difficult emotions, for anger, let’s think about the angriest we’ve ever been as a level 10. What we’re seeking for the purposes of this exercise, then, is a situation that’s a three, or maybe a four. Consider something you experienced at the level of irritation or annoyance; don’t choose the last time you felt, say, enraged. When was the last time you felt irritated, annoyed or frustrated, perhaps about something someone did or said? Just bring to mind that situation.
Draw an image of this past situation into your mind. Recall the words that were spoken. Remember your own thought process related to the experience. At this point, you may be feeling some sensations in your body. Let’s go deeper. Can you recall the story you told (or tell) yourself around this experience? For example: What this person did or shouldn’t have done? How you were wronged? How it should have been different. Whatever it is, let that story run its course for you right now. Let it run until you begin to feel a sense of irritation or annoyance in your body.
Once you feel the irritation, we’re going to cut off the thoughts we’re having. Just cut off the storyline. This is vitally important with almost every difficult emotion. Step one: firmly direct your attention away from the story you’re telling. Next: bring your attention to your body. Really feel what’s going on inside your body. Where do you feel the anger in your body? Maybe in your chest? Your hands? Just notice that.
Now, what else is happening in your body? Find something that feels neutral, spacious or maybe even pleasant in your body. Maybe you feel this in your feet, or your contact with the chair. Maybe you’re focused on your hands touching. We’re simply creating some space around the anger. Notice the tip of your nose; notice your breath. If you can’t find any sensations in your body that feel safe or free from anger, take a moment to listen to the sounds around you. You can even broaden your awareness to include the whole room; and even further to include sounds that are far away. Rest your attention with these sensations for a few minutes. Allow yourself to find some ease and a bit of calm.
If you find your mind wanders back to the story, the thoughts about what’s making you angry, gently but firmly redirect your attention to the neutral sounds and neutral sensations you’ve identified. Just take a few breaths here.
Once we feel a little calmer, we can explore the anger more directly again. Let’s come back to where we feel anger in our body. Explore that: Do you feel tightness in your throat? Are there any sensations in your shoulders? How about your arms? Do you detect any sensations in your belly? If you find a place, really explore the sensation: Is there a temperature to this felt sense of anger, is it hot or cold? Is it throbbing? What are the edges like? Is it shifting and changing? As you stay with the felt sense of irritation, frustration, anger, and the directly felt sensations of hot, cold, vibrating, sharp—hold all of this with a lot of care and curiosity.
Now let’s notice what other emotions might be present. Is there anything else inside or beneath the anger? Can you detect any other emotions there? Fear? Sadness? Wanting? Just notice. Is there anything the anger might be masking? Be curious. Allow this to be very somatic. We’re not thinking about it, we’re not trying to understand it cognitively, we’re just letting the emotion reveal itself in a very direct, body-based way.
Notice if any other information arises from this anger. You could even drop in a question, such as: What does this anger need? What does it want me to know? Again, we’re just dropping the question into the felt sense in our bodies, and then seeing what arises. Are there flashes, images, words that could help you understand what’s needed? Do you get a sense of what action you may need to take? Let’s take another few moments of holding and being with the felt sensation of the irritation. Be curious about what your anger wants you to know, perhaps about what is needed.
As we bring this practice to a close, see if you have any insights into what you could do skilfully to respond to this irritation or anger. What would truly take care of this anger or frustration? Exploring our emotion in this way, we’re better prepared to respond in a rooted and grounded way; we’re better equipped to address what’s needed. As we finish, then, we can make a commitment to take whatever skillful action is needed. It might be something personal, such as some kind of self-care: maybe a walk, a nap, a meal. Or we might commit to having a direct and difficult conversation with someone, perhaps to ask for what you need or to set a limit. Just see if you can commit to taking one skillful action to address this situation.
When you’re ready, open your eyes if they’ve been closed and take a deep breath. Look around the room and orient yourself to your space, wherever you are.
Try to practice these skills in your daily life. If at any point you encounter in yourself feelings of anger or frustration, first: notice how you’re feeling: “Oh, anger,” or “I’m irritated.” Next, find some ground: feel your feet on the ground, feel the back of your body. And then notice what is not feeling angry in that moment, too. Get some space around the anger, and really open your awareness wide to the sounds and the space around you.
I can’t recommend this enough. And it can take as little as five seconds simply to connect with your feet on the ground and broaden your awareness. Then, when you feel some space and calmness around the anger, you can direct your attention back to the difficult emotion and ask that question: What is needed? What is needed right now? And then proceed from that place.
Zindel Segal explores the 3-Minute Breathing Space practice to develop your ability to ground yourself, return your attention to the present, and fully find yourself at any moment. Read More
In December 2004, when a tsunami killed more than 200,000 people in 11 countries around the Indian Ocean, the United States was reminded of its own tsunami risks. In fact, devastating tsunamis have struck North America before and are sure to strike again. Especially vulnerable are the five Pacific States–Hawaii, Alaska, Washington, Oregon, and California–and the U.S. Caribbean islands…
Skin cancer affects millions of people each year, yet many cases go undetected until they reach advanced stages. Understanding the differences between melanoma and non-melanoma skin cancers, recognizing warning signs, and knowing when professional evaluation is necessary can make the difference between a simple treatment and a complex medical journey.
This guide breaks down everything people need to know about skin cancer screening, detection methods, and dermatological care.
Understanding Melanoma and the ABCDE Rule
Melanoma represents the most serious form of skin cancer, developing when melanocytes, cells responsible for skin pigmentation, become malignant.
Unlike other skin cancers that grow slowly, melanoma can spread rapidly to other parts of the body if not caught early. This is why early detection through regular skin cancer screening has become so critical.
The melanoma ABCDE rule serves as the first line of defense for detecting potentially dangerous spots. Each letter represents a key warning sign that distinguishes melanoma from benign moles.
Asymmetry means one half of the lesion doesn’t match the other half. Normal moles typically appear symmetrical, with both sides mirroring each other. A spot that looks lopsided warrants professional evaluation.
Border irregularity refers to edges that appear scalloped, notched, or poorly defined. Benign moles usually have smooth, even borders. Melanomas often display uneven or fuzzy boundaries that blur into surrounding skin.
Color variation occurs when a single lesion contains multiple shades, browns, blacks, tans, reds, whites, or even blues. While common moles tend to be uniform in color, melanomas frequently show dramatic color differences within the same growth.
Diameter larger than 6 millimeters (roughly the size of a pencil eraser) represents another red flag. Though some melanomas start smaller, this measurement helps distinguish suspicious growths from typical moles.
Evolving characteristics, the “E” added to the original ABCD rule, describe any changes over time. Enlargement, shape shifting, color changes, bleeding, itching, or crusting all warrant medical attention. The key insight here is that normal moles remain stable throughout life, while melanomas actively change.
It’s important to note that not all melanomas fit neatly into the ABCDE criteria. Some melanomas appear as flat, uniform-colored spots that don’t match the typical pattern.
This is why the “Ugly Duckling” sign, identifying any lesion that looks different from a person’s other moles, provides an additional detection tool with excellent sensitivity for catching melanomas.
Non-Melanoma Skin Cancers: Basal Cell and Squamous Cell Carcinoma
While melanoma receives significant attention, basal cell carcinoma and squamous cell carcinoma account for the vast majority of skin cancer diagnoses. These non-melanoma skin cancers originate from different layers of skin and behave differently than melanoma.
Basal cell carcinoma represents the most common form of skin cancer, accounting for 70-90% of all diagnoses. Developing in the basal cell layer, the deepest layer of the epidermis, BCC typically grows slowly and rarely spreads to other areas, according to the World Health Organization.
People often describe early basal cell carcinoma as a pearly lump or nodule with a waxy, translucent appearance. Some lesions develop a central indentation or crusting, while others appear shiny or bright pink. The condition usually emerges on sun-exposed areas like the face, neck, shoulders, and back.
Squamous cell carcinoma accounts for 20-30% of non-melanoma skin cancers and grows more aggressively than BCC. Originating in the upper layer of the epidermis, squamous cell carcinoma has a slightly higher risk of spreading to lymph nodes and distant organs compared to basal cell carcinoma.
The typical appearance includes a rough, scaly patch or wart-like growth, often with reddish coloration and irregular borders. Some squamous cell carcinoma lesions develop a crusted or bleeding center.
A common question arises about whether basal cell carcinoma can transform into squamous cell carcinoma. The answer is no, they develop from different cell types and remain distinct cancers.
However, individuals who develop one type of non-melanoma skin cancer face increased risk for developing the other type later in life. More significantly, people with a personal history of basal cell carcinoma have approximately 6.6 times higher risk of eventually developing melanoma.
Risk Factors and Who Should Consider More Frequent Skin Cancer Screening
Understanding personal risk factors helps determine appropriate screening frequency. Ultraviolet light exposure remains the primary cause of all skin cancers. Chronic sun exposure, intense intermittent sunburns (especially during childhood), and tanning bed use all significantly increase risk.
Fair skin that sunburns easily, light hair, and light-colored eyes indicate higher susceptibility.
Additional risk factors include age, melanoma increasingly affects younger populations, while basal and squamous cell carcinomas typically emerge later in life.
People with 50 or more moles, a personal history of skin cancer, or family members with melanoma or non-melanoma skin cancers require more vigilant monitoring. Immunosuppressed individuals and those with certain genetic conditions face elevated risk as well.
Geographic location matters too. People living in sunny climates experience greater cumulative UV exposure. Occupational factors, outdoor workers in construction, agriculture, and landscaping, similarly need enhanced screening protocols.
Early Detection Through Self-Examination and Professional Assessment
Monthly self-examination provides the foundation for catching skin cancer early. A thorough exam requires a well-lit bathroom, a full-length mirror, and a hand-held mirror for difficult-to-see areas. Using a blow dryer helps examine the scalp methodically, as per the International Agency for Research on Cancer.
The eight-step self-exam process covers every body surface: face and ears, scalp, hands and arms, front of upper body, back of upper body, lower back and buttocks, front and sides of legs, and feet and genital area. Documenting findings with measurements and photographs creates a baseline for tracking changes over time.
People should schedule professional skin cancer screening appointments based on their risk level. Those with standard risk, no personal history, minimal sun exposure, typically benefit from annual full-body exams starting around age 40, with every-three-year exams in their 20s and 30s.
High-risk individuals may need exams every six months or even quarterly, particularly those with previous melanoma diagnoses.
When to See a Dermatologist
Certain red flags warrant immediate professional evaluation. Any lesion fitting the ABCDE criteria, an “ugly duckling” spot that looks different from surrounding moles, new moles appearing in adulthood, existing moles showing changes in size or color, and any sore that doesn’t heal within three weeks should prompt a dermatology appointment.
During a professional skin exam, dermatologists perform complete visual inspection from scalp to soles, pay special attention to often-missed areas like behind ears and between toes, and use dermoscopy (magnified examination) for suspicious lesions. Biopsies of concerning spots provide definitive diagnosis.
The importance of early detection cannot be overstated. Melanomas caught in stage 1 (localized) show approximately 95% five-year survival rates, while stage 4 metastatic melanomas drop to 15-20% survival rates.
Thickness remains the most significant prognostic factor, thinner melanomas caught before spreading have far better outcomes.
Frequently Asked Questions
1. Can skin cancer develop on areas of my body that never get sun exposure?
Yes. Melanoma and other skin cancers can appear anywhere on the body, including the scalp, between toes, under fingernails, and genital areas. This is why full-body exams that include every skin surface are essential, not just sun-exposed areas.
2. If I have a family history of melanoma, does that mean I will definitely develop it?
No. Family history increases risk significantly, but genetics interact with environmental factors like UV exposure. Someone with family history who practices sun protection and gets regular screening has better outcomes than someone without family history who avoids sun safety.
3. Why do dermatologists sometimes remove moles that look completely normal?
Dermatologists may remove moles that are dysplastic (atypical), in irritation-prone locations, showing subtle changes, or cosmetically bothersome. Dysplastic moles have increased melanoma potential and warrant removal even if they appear normal.
4. How long does it take for skin cancer to develop, and can it appear suddenly?
Most non-melanoma skin cancers develop slowly over 10-20+ years. Melanoma timelines vary, some develop gradually while others change rapidly. Regular monthly self-exams and professional screening catch cancers earlier, before they advance.
Pregnancy fatigue hits nearly every expectant parent, especially early on when hormones surge and the body rapidly adapts to support new life. Feeling tired during pregnancy can resemble jet lag that never fully lifts, even after a full night’s sleep. While this exhaustion is often normal, certain patterns may point to pregnancy complications such as anemia, gestational diabetes, thyroid imbalance, or infection. Knowing when pregnancy fatigue is expected—and when it signals a medical concern—helps safeguard both maternal health and fetal development. Understanding the difference allows timely care without unnecessary worry.
Fatigue tends to ebb and flow across trimesters as hormones, blood volume, and metabolism shift. Short naps, balanced meals, and proper hydration often help, but they don’t address every cause. When tiredness becomes extreme, sudden, or limits daily function, pregnancy complications should be ruled out. Early recognition allows for simple screening and treatment that can restore energy and reduce risks later in pregnancy.
Pregnancy Fatigue Causes: Normal Hormonal Shifts
Pregnancy fatigue is most intense in the first trimester, driven largely by progesterone. This hormone rises rapidly and has a sedative effect on the brain, slowing reaction times and increasing sleep pressure. At the same time, estrogen fluctuates and blood production ramps up to supply oxygen and nutrients to the placenta, forcing the heart to work harder even at rest.
According to the American College of Obstetricians and Gynecologists (ACOG), early pregnancy fatigue is closely tied to hormonal changes and increased cardiovascular demand as the uterus grows and blood volume expands. ACOG notes that these shifts are expected and usually stabilize after the placenta takes over hormone production in the second trimester.
Other contributors stack on quickly. Nausea and vomiting reduce calorie intake and deplete electrolytes, while emotional stress disrupts sleep cycles. Many pregnant people also experience fragmented sleep from frequent urination or vivid dreams. Energy often rebounds around weeks 14–20, only to dip again late in pregnancy as physical strain, back pain, and breathing discomfort return.
Tired During Pregnancy: When Anemia or Diabetes Strikes
Feeling tired during pregnancy can cross from normal into concerning when anemia or gestational diabetes enters the picture. Iron requirements jump significantly during pregnancy to support red blood cell production. When iron stores fall, oxygen delivery drops, leading to exhaustion that rest alone cannot fix.
Based on information from the World Health Organization (WHO), anemia in pregnancy is commonly defined by hemoglobin levels below 11 g/dL and is associated with fatigue, dizziness, and reduced physical tolerance. WHO emphasizes that iron deficiency remains one of the most common and treatable causes of excessive tiredness during pregnancy worldwide.
Gestational diabetes creates a different fatigue pattern. Hormones from the placenta interfere with insulin function, causing blood sugar spikes after meals followed by sharp crashes. This can feel like sudden exhaustion paired with thirst, nausea, or blurred vision. Routine screenings during mid-pregnancy catch most cases early, but unexplained, persistent fatigue can be an early clue worth investigating.
Red Flags: Extreme Tiredness Needing Urgent Care
Extreme tiredness during pregnancy becomes a red flag when it appears suddenly, worsens rapidly, or comes with other symptoms. Fever, burning during urination, or back pain may signal infections that stress the body and increase fatigue. Shortness of breath, chest pain, or calf swelling require immediate evaluation for clot-related conditions.
According to the Centers for Disease Control and Prevention (CDC), severe fatigue combined with symptoms like shortness of breath, headaches, or vision changes can also be associated with hypertensive disorders of pregnancy or serious infections. The CDC stresses that prompt care significantly reduces risks for both parent and baby.
Mental health also matters. Depression during pregnancy often presents as overwhelming exhaustion, loss of motivation, and emotional numbness rather than sadness alone. When fatigue makes daily tasks feel impossible or is paired with hopeless thoughts, reaching out for support is essential and effective.
Managing Pregnancy Fatigue Safely Day to Day
Managing pregnancy fatigue starts with small, consistent habits rather than drastic changes. Eating balanced meals every few hours helps stabilize blood sugar and prevents energy crashes. Pairing protein with complex carbohydrates keeps fuel steady, while adequate hydration supports circulation and amniotic fluid levels.
Light movement plays a surprising role. Short walks or prenatal stretching increase oxygen delivery and reduce stiffness that worsens tiredness. Sleep quality matters more than quantity, so side sleeping with pillow support and limiting late-day naps can improve nighttime rest. Prenatal vitamins fill nutritional gaps, but supplements should always match provider guidance.
Mind-body approaches also help. Breathing exercises, gentle yoga, and brief relaxation breaks lower stress hormones that sap energy. When fatigue is addressed from multiple angles, many pregnant people notice meaningful improvements within weeks.
Pregnancy Fatigue and Tired During Pregnancy: Knowing When to Act
Pregnancy fatigue and tiredness during pregnancy sit on a wide spectrum, from normal adaptation to warning signs that deserve attention. Listening to the body and noticing changes over time matters more than comparing energy levels to others. Most causes of extreme tiredness are identifiable and manageable with simple tests and targeted care. Acting early protects long-term health and supports a steadier, safer pregnancy experience. Awareness, not alarm, is the key to staying well.
Frequently Asked Questions
1. Is pregnancy fatigue worse in the first trimester?
Yes, pregnancy fatigue is usually strongest in the first trimester due to rapid hormonal changes. Progesterone has a calming effect that increases sleepiness. The body is also using extra energy to build the placenta. Many people feel some relief in the second trimester.
2. Can dehydration make tired during pregnancy worse?
Dehydration can significantly worsen fatigue during pregnancy. Blood volume increases, raising fluid needs beyond normal levels. Even mild dehydration can cause headaches and low energy. Regular water intake throughout the day helps prevent this.
3. How do I know if my fatigue is anemia-related?
Anemia-related fatigue often comes with dizziness, pale skin, or shortness of breath. It doesn’t improve much with rest alone. A simple blood test can confirm iron levels. Treatment usually improves energy within weeks.
4. When should I call a doctor about extreme tiredness during pregnancy?
You should call if fatigue is sudden, severe, or paired with fever, chest pain, or breathing issues. Persistent exhaustion that interferes with daily life also warrants evaluation. Mental health symptoms alongside fatigue are equally important. Early care leads to better outcomes for both parent and baby.
