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  • Centrally Mediated Abdominal Pain Syndrome (CAPS)

    Centrally Mediated Abdominal Pain Syndrome (CAPS)

    People with functional gastrointestinal (GI) disorders can have a variety of symptoms that range from painless diarrhea or constipation to pain associated with diarrhea and/or constipation (usually called irritable bowel syndrome). There is another, less common condition of abdominal pain that is chronic or frequently recurring; it is not associated with changes in bowel pattern or with another medical condition. This condition is called centrally mediated abdominal pain syndrome (CAPS) – formerly known as functional abdominal pain syndrome (FAPS).

    CAPS is a functional GI disorder. There are no abnormal x-rays or laboratory findings to explain the pain. It occurs because of altered sensitivity to nerve impulses in the gut and brain, and it is not associated with altered motility in the intestines. CAPS is characterized by continuous or frequent abdominal pain that is often severe. It has little or no relationship to events such as eating, defecation, or menses.

    For people with CAPS, the pain can be so all-consuming that it becomes the main focus of their life. Not only does it impact quality of life, but it has a major economic impact as well.

    Pathophysiology – Understanding Why People Get CAPS

    To understand the basis for Centrally mediated abdominal pain syndrome it is helpful to understand how the body experiences pain. Nerve impulses travel from the abdomen to the spinal cord, and then to various areas of the brain.

    There are many different areas of the brain involved in the sensation of abdominal pain. One of these connected areas is concerned with the location and intensity of the pain, while another connected area is concerned with memories or emotions. Because of this interconnection, the perception of pain can be affected by emotions or life experiences.

    Functional abdominal pain

    While symptoms of CAPS can appear without apparent cause, they can also occur after infections or events that stimulate the bowel and also after traumatic life events like the death of a loved one, a divorce, or a history of abuse. During times of added stress, symptoms can worsen.

    Repeated injury in the abdomen can cause nerve receptors to become overly sensitive. For instance, if someone has had multiple abdominal surgeries or an infection, a later painful occurrence may be experienced as more painful than previously.

    Even normal abdominal activity may be experienced as being painful. It is as if the volume has been turned up on a stereo receiver. This condition is called visceral hypersensitivity (increased sensitivity of the intestines).

    Furthermore although the brain has an ability to “turn down” the pain signals from the GI tract with CAPS, this ability is reduced, so even small amounts of intestinal disturbance can be amplified to produce severe pain (central hypersensitivity). So these individuals have an altered “brain-gut axis” where there is a failure of the brain to regulate even normal gut nerve activity leading to increased pain.

    Understanding how the brain can modify the pain experience (for better or worse) is essential to beginning any treatment. When someone is feeling anxious or depressed, or focuses attention on the pain, it is experienced as more severe. The use of relaxation training or other techniques can divert attention away from the pain.

    If a person has previously had a bad encounter with pain, the fear of having the pain again can actually make the pain worse the next time. If a person takes steps to feel in control of the pain, symptoms will improve. In addition, the amount of support a person receives from family, friends, and other sources can affect how a person responds to pain.

    Treatment Strategies for Functional Abdominal Pain Syndrome

    Given what we currently know about CAPS, the aim of treatment is to help you gain control over your symptoms and improve daily function, rather than totally eliminate symptoms, which usually is not possible.

    One way to start is to keep a diary to record symptom flare-ups, and to identify possible triggers (emotional and situational). This kind of information may be used by you or your physician to help develop better strategies to control the symptoms.

    The brain not only affects how you sense pain, it is also able to block pain. Think about the basketball player who sprains his ankle during a game and continues to play without awareness of pain. Then, when the game ends, he collapses to the floor, unable to walk. He was able to block the pain by focusing his attention on the game.

    When nerve impulses travel up from the abdomen to the spinal cord, some of them go through a kind of “gate” that is controlled by nerve impulses coming down from the brain. These impulses from the brain can block or inhibit pain signals going from the abdomen to the brain by “closing” the gate. Alternatively, they can increase signals to the brain by opening the gate.

    Because the brain has such a strong influence on the sensation of pain, psychological treatments can relieve symptoms of CAPS by sending signals that close the gate. Different techniques include relaxation, imagery, hypnosis, and cognitive-behavioral therapy.

    Treatments – The Mind-Body Connection

    • Symptom diaries – Help you see what events or emotions make symptoms worse.
    • Stress management (i.e., relaxation techniques, meditation) – Teaches you how to focus attention on something other than the pain.
    • Hypnosis – Helps you focus attention away from the pain. Positive suggestion can change ways you think or react.
    • Cognitive-behavioral therapy – Teaches you how to change non-helpful thoughts, perceptions, and behaviors to control symptoms.

    Medications may also be used in the treatment of CAPS. For continuous or severe abdominal pain, your doctor might prescribe an antidepressant. It is important to understand that these medications are not just used to treat individuals who have depression but also act as pain relievers (central analgesics) for treatment of CAPS and many other painful conditions.

    Antidepressant medications can help stimulate the brain to increase the signals which block pain transmission from the abdomen to the brain. It may take several weeks before a difference is noticed.

    Treatments – Antidepressant Medications

    • Antidepressants act as pain relievers.
    • These medications stimulate the brain to send signals and close the pain-control gate in the abdomen.
    • Antidepressants might take several weeks to work, so you shouldn’t stop taking them until your doctor tells you to do so.
    • Side effects are possible but usually go away after a few days.

    Some people will experience side effects from antidepressant medications. Usually, the side effects will go away after a few days so it is important to stay with the medication until treatment benefit is obtained.

    The tricyclic antidepressants (TCAs) can cause dry mouth and drowsiness. Another group of antidepressants is called selective serotonin norepinephrine reuptake inhibitors (SNRIs). These can cause side effects like nausea. Both of these classes of antidepressants are helpful for treating pain.

    Finally, it is becoming increasingly common to use combinations of treatments like a medication for the bowel and an antidepressant or two types of medications to affect the brain’s pain control or a behavioral treatment like cognitive behavioral treatment with an antidepressant. These combinations can improve the pain benefit while keeping side effects at a minimum.

    The Patient-Doctor Partnership

    It is important that you work with a physician who demonstrates empathy toward you and an understanding of the symptoms of CAPS. It is a disorder where treatment requires the participation of both you and your physician.

    Treatments for CAPS are most effective when the patient and the doctor work as a team, each having a role. Your doctor has the responsibility to educate you about CAPS. He or she should answer your questions and provide you with an understanding of what your symptoms are about and what your treatment options are.

    You need to express your views about your treatment goals, work with your doctor to develop the treatment plan, and work toward putting the plan into action. If you follow the treatment plan closely, you and your doctor will be better able to track your results. This will allow you to achieve the best possible relief of abdominal pain.

    Source
    Adapted from Chronic Functional Abdominal Pain Syndrome IFFGD Publication #141 by Douglas A. Drossman, MD, Drossman Gastroenterology, Drossman Center for the Education and Practice of Biopsychosocial Care, Chapel Hill, NC.

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  • Ideal vs. Normal Cholesterol Levels 

    Ideal vs. Normal Cholesterol Levels 

    Having a “normal” cholesterol level in a society where it’s normal to die from a heart attack isn’t necessarily a good thing.

    “Consistent evidence” from a variety of sources “unequivocally establishes” that so-called bad LDL cholesterol causes atherosclerotic cardiovascular disease—strokes and heart attacks, our leading cause of death. This evidence base includes hundreds of studies involving millions of people. “Cholesterol is the cause of atherosclerosis,” the hardening of the arteries, and “the message is loud and clear.” “It’s the Cholesterol, Stupid!” noted the editor of the American Journal of Cardiology, William Clifford Roberts, whose CV is more than 100 pages long as he has published about 1,700 articles in peer-reviewed medical literature. Yes, there are at least ten traditional risk factors for atherosclerosis, as seen below and at 1:11 in my video How Low Should You Go for Ideal LDL Cholesterol?, but, as Dr. Roberts noted, only one is required for the progression of the disease: elevated cholesterol.

    Your doctor may have just told you that your cholesterol is normal, so you’re relieved. Thank goodness! But, having a “normal” cholesterol level in a society where it’s normal to have a fatal heart attack isn’t necessarily good. With heart disease, the number one killer of men and women, we definitely don’t want to have normal cholesterol levels; we want to have optimal levels—and not optimal by current laboratory standards, but optimal for human health.

    Normal LDL cholesterol levels are associated with the hidden buildup of atherosclerotic plaques in our arteries, even in those who have so-called “optimal risk factors by current standards”: blood pressure under 120/80, normal blood sugars, and total cholesterol under 200 mg/dL. If you went to your doctor with those kinds of numbers, you’d likely get a gold star and a lollipop. But, if your doctor used ultrasound and CT scans to actually peek inside your body, atherosclerotic plaques would be detected in about 38% of individuals with those kinds of “optimal” numbers.

    Maybe we should define an LDL cholesterol level as optimal only when it no longer causes disease. What a concept! When more than a thousand men and women in their 40s were scanned, having an LDL level under 130 mg/dL left them with atherosclerosis throughout their body, and that’s a cholesterol level at which most lab tests would consider normal.

    In fact, atherosclerotic plaques were not found with LDL levels down around 50 or 60, which just so happens to be the levels most people had “before the introduction of western lifestyles.” Indeed, before we started eating a typical American diet, “the majority of the adult population of the world had LDLs of around 50 mg per deciliter (mg/dL)”—so that’s the true normal. “Present average values…should not be regarded as ‘normal.’” We don’t want to have a normal cholesterol based on a sick society; we want a cholesterol that is normal for the human species, which may be down around 30 to 70 mg/dL or 0.8 to 1.8 mmol/L.

    “Although an LDL level of 50 to 70 mg/dl seems excessively low by modern American standards, it is precisely the normal range for individuals living the lifestyle and eating the diet for which we are genetically adapted.” Over millions of years, “through the evolution of the ancestors of man,” we’ve consumed a diet centered around whole plant foods. No wonder we have a killer epidemic of atherosclerosis, given the LDL level “we were ‘genetically designed for’ is less than half of what is presently considered ‘normal.’”

    In medicine, “there is an inappropriate tendency to accept small changes in reversible risk factors,” but “the goal is not to decrease risk but to prevent atherosclerotic plaques!” So, how low should you go? “In light of the latest evidence from trials exploring the benefits and risks of profound LDLc lowering, the answer to the question ‘How low do you go?’ is, arguably, a straightforward ‘As low as you can!’” “‘Lower’ may indeed be better,” but if you’re going to do it with drugs, then you have to balance that with the risk of the drug’s side effects.

    Why don’t we just drug everyone with statins, by putting them in the water supply, for instance? Although it would be great if everyone’s cholesterol were lower, there are the countervailing risks of the drugs. So, doctors aim to use statin drugs at the highest dose possible, achieving the largest LDL cholesterol reduction possible without increasing risk of the muscle damage the drugs may cause. But when you’re using lifestyle changes to bring down your cholesterol, all you get are the benefits.

    Can we get our LDL low enough with diet alone? Ask some of the country’s top cholesterol experts what they shoot for, “and the odds are good that many will say 70 or so.” So, yes, we should try to avoid the saturated fats and trans fats found in junk foods and meat, and the dietary cholesterol found mostly in eggs, but “it is unlikely anyone can achieve an LDL cholesterol level of 70 mg/dL with a low-fat, low-cholesterol diet alone.” Really? Many doctors have this mistaken impression. An LDL of 70 isn’t only possible on a healthy enough diet, but it may be normal. Those eating strictly plant-based diets can average an LDL that low, as you can see here and at 5:28 in my video.

    No wonder plant-based diets are the only dietary patterns ever proven to reverse coronary heart disease in a majority of patients. And their side effects? You get to feel better, too! Several randomized clinical trials have demonstrated that more plant-based dietary patterns significantly improve psychological well-being and quality of life, with improvements in depression, anxiety, emotional well-being, physical well-being, and general health.

    For more on cholesterol, see the related posts below.



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  • Challenges and Solutions When Dealing With Long-Term Illness At Home

    Challenges and Solutions When Dealing With Long-Term Illness At Home

    Anyone who is living with a long-term illness, or who has known a close family member who is living with one, knows that it can be challenging. Apart from the illness itself, there are a range of difficulties that can come with living with an illness. Some challenges are things that have to be overcome every day and can be particularly draining. While long-term illness can often include extended hospital stays, the reality for most people is that they spend most of their time at home.

    When living with a long-term illness from home, while there are challenges presented, there are also solutions to those challenges. Many solutions require only small changes, searching for ways to increase the comfort or enhance the mobility of the ill person, finding ways to bring greater emotional relief or keep motivated, and even decreasing the financial burdens of living with a long-term illness. Let’s look closer at some challenges and solutions that are common for both carers and the person with a chronic illness.

    Staying Comfortable and Increasing Mobility

    For many people who are living with a chronic illness, just getting comfortable can be a struggle. Many chronic illnesses cause fatigue, muscle weakness and pain. All of which makes getting comfortable difficult in even the best circumstances. The reality for many people with a long-term illness is that normal furniture is simply unfit for their use, or for their carers to help them.

    While it can be difficult to remove the symptoms of pain and weakness, it is much easier to acquire some furniture that is designed for people in weaker conditions. By searching out specialized chairs or reliable hospital beds for sale, the comfort of people living with a long-term illness can be marginally increased. Many beds and chairs designed for chronically ill people take into account their lack of mobility, and therefore include features that can help them to sit up or get up. This can be especially welcome when it comes to caring for someone with a chronic illness, as it takes some of the burden off the carer.

    The level of investment in this type of solution should fit the requirements. If there is slight discomfort sitting for long periods of time, a specialized padded chair or bed with backrest elevation could be all that is required. For more extreme needs, there is equipment that can help to lift and rotate supine patients and allow carers to help them up with minimal physical effort on their part.

    Transforming the environment that a chronically ill person spends most of their time in into an environment that is designed to help them will not only ease the physical burden, but it is also likely to help them fight the mental war as well.

    The Emotional and Mental Struggle

    For most people, living with a long-term or chronic illness can be emotionally and psychologically taxing. Coping with the loss of independence, frustration of their situation, as well as feelings of depression and anxiety, are all part of the reality of living with a long-term illness. For the carers and family members of the chronically ill, feelings of guilt and helplessness are also common, as well as the possibility of burnout if they are required to sacrifice their own desires to help their loved one.

    Finding solutions for the mental war is often not as simple or convenient as buying new furniture, but it is every bit, if not more, as important as achieving a level of physical comfort. There are a number of things that can be done to help win the mental battle for people with chronic illness and their carers, including, but not limited to:

    • Freely communicating with each other about needs and feelings. Being able to have an open dialogue can help both carers and chronically ill people to feel closer and understand each other better.
    • Engaging in professional therapy or counselling. Even if it’s just to talk through your feelings, it can be incredibly beneficial to speak to a professional.
    • Joining community support groups. Being part of a community of people with similar experiences helps you feel like you aren’t going through it alone.
    • Picking up hobbies. While it might seem cavalier to suggest, making sure that both chronically ill people are still doing things for no other reason than enjoyment is an important part of helping them to live with their illness.

    Remember, everyone copes with things differently. The key is to find what will ease the mental burden for you. If therapy doesn’t work, maybe hobbies like reading or painting could prove therapeutic.

    The Elephant in the Room, Cost

    It might not be nice to discuss it, but the harsh reality is that, in many cases, living with a chronic illness can be expensive. Not only are there costs, sometimes exorbitant, associated with medication, equipment and potentially necessary modifications to the home, but there is also the consideration that income streams are likely to dwindle or stop. For many families, this means that they have to make sacrifices and attempt to find their way through complicated financial systems.

    There are no silver-bullet solutions for easing the financial reality of living with a long-term illness. Some families will simply have fewer options than others, but there are some things that everyone can do to help, such as:

    • Reaching out to social workers. Getting in touch with someone who specializes in finding assistance and helping people in your situation is a must. They will know the ins and outs of different programs and grants that might be able to help you.
    • Signing up for benefits. Many areas and regions have some levels of government assistance available for chronically ill people who are in difficult financial positions. It might not be ideal, but this is the time to ask for help.
    • Budget and plan. Where you can, plan for the future and budget accordingly.
    • Take advantage of sales and second-hand options. It might not be ideal, but keeping an eye out for refurbished and second-hand options for tertiary needs like furniture could save a good deal of money.

    The financial reality can often be grim, but taking some steps to help feel at least partially in control is likely to alleviate some measure of financial stress.

    Don’t Let the Daily Routine Overcome You

    For many people living with long-term and chronic illnesses, the daily routine can be complicated and tiring. There are medical appointments to keep and complicated medication regimes, add to this that the normal activities like keeping up personal hygiene, cleaning the house and preparing meals might all be difficult or impossible activities. The daily routine can be incredibly difficult for many chronically ill individuals.

    Everyone’s situation is different, but some solutions for easing the daily routine include things like:

    • Using technology. If possible, investing in smart technology and apps can help to organise the day. Reminders for medication and hygiene can help to keep things on track.
    • Plan it out. If you plan out the entire daily routine, it will reduce the likelihood that anything important gets left out.
    • Use automation. Getting groceries delivered or having scheduled prescription refills can be a huge time-saving boon for the chronically ill and their carers.
    • Prepare in advance. Preparing meals, medications and appointments in advance is a smart time-saving method. This means cooking batches of things and setting out the week’s medications ahead of time.

    While specific situations will vary, preparing and planning are likely to be helpful to everyone, even if just to mentally understand what each day is likely to look like.

    Staying Connected and Social

    For many people living with a long-term or chronic illness, feelings of isolation and disconnection can be common. They have to abandon their previous lives and all the connections and socialisation that went along with them. They might be limited by their condition and can often feel as though the world is moving on without them, leaving them forgotten and alone.

    Fighting these feelings is a key part of the mental war against chronic illness. Thankfully, there are plenty of simple ways to help people feel connected to others. This includes, but is not limited to, the following:

    • Keeping in touch. Keeping in contact and encouraging family and friends to visit periodically can be a huge mood-booster.
    • Make use of volunteers. Many regions have volunteer programs designed specifically for the purpose of helping people feel connected, even if they cannot leave their homes.
    • Join digital communities. The modern digital age abounds with digital communities that people can join. Just about any interest or hobby under the sun has a digital community associated with it. Engaging with these communities is a great way to make new friends and remain social.

    Even if their old social life is a thing of the past, chronically ill people can find ways to connect with others and build a new social life.

    Keeping Hope Alive Matters

    One of the most difficult things for many people with chronic and long-term illnesses to do is to keep hope for the future. It can be devastating to be diagnosed with something that dramatically alters what you had planned for your future and hoped for in your life. But losing hope for the future is a hefty blow in the mental war.

    While the overall outlook might not seem ideal, taking solace in small victories is often the best solution to keep hope alive. Any reason to celebrate is a good one.

    Add to this the setting of realistic goals. Planning to walk a marathon immediately isn’t realistic, but getting to the end of the garden and back could be within your grasp. Even a small goal or accomplishment like learning a skill online could be enough to give someone a newfound sense of purpose.

    Many people might find comfort in things like meditation, faith or philosophy, and there are huge libraries relating to all of these disciplines online. Sharing your experiences with others and helping them to come to terms with their own illnesses might also provide a sense of purpose and bring hope.

    It might seem impossible, but keeping a positive mindset and having some hope for the future can be massively important for someone’s well-being.

    Final Thoughts

    Living with a chronic or long-term illness is one of the most difficult things that many people will experience. It takes a great deal of strength, both from the chronically ill and from their friends and family.

    We have discussed only a few of the challenges that the chronically ill are likely to experience every day. Everyone will have a different experience and face different challenges, but each challenge they face will have some solutions.

    Keep hope alive and live the best way you can, whatever that means for you and however you can.

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  • Affiliates | Manna from Heaven | Kingdom Wealth

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  • Where To Start When There Is So Much Suffering

    Where To Start When There Is So Much Suffering

    Let’s face it: Things feel incredibly hard right now. Of course, there are always difficulties and challenges, but particularly at this moment, I find myself heartbroken, overwhelmed, and angry more often than usual. Maybe you can relate?

    Perhaps like you, I am at a loss for what to do to address the suffering around me at this time. There is heartbreak, struggle, anger, fear, and despair in our homes, communities, and on the news and social media. Though there are some things we can do and action we can take, often much of this suffering is beyond our capacity to control.

    Self-Compassion Works for Collective Pain, Too

    When it starts to feel like too much to bear, I find myself wondering how to be with it all. How to be with the heartbreak, the suffering, the difficulties inherent in life. In my experience and work, I have found that one of the most helpful ways to navigate these challenges is through self-compassion. 

    Of course, self-compassion is a powerful ally when we are personally experiencing a difficulty. But self-compassion is also a powerful internal resource we can draw on in response to the suffering of others. Even if it is someone we don’t know, our hearts are touched when others are struggling. That is why it is essential to start with ourselves so that we can respond from a place of love and care, rather than fear, despair, frustration, or anger.

    So, what is self-compassion? Imagine if a dear friend was struggling with something, and then consider how you would respond to them. Now, gently turn that care, warmth, and kindness toward yourself; that is self-compassion.

    In the research, self-compassion is shown to have many benefits, including increasing resilience and optimism as well as decreasing anxiety and depression. It helps us hold suffering, both our own and that of others, more spaciously and with tenderness and warmth. The ability to offer ourselves compassion helps buffer the emotional distress that can accompany the empathetic response.

    Though self-compassion doesn’t necessarily fix the problem, it does invite a deeper calm and clarity as we approach it, because we tend to make wiser choices when we feel cared for. Caring for ourselves, especially when things are hard, enhances our capacity to navigate those difficulties and is a skill that we can learn and access readily.

    Practices You Can Try Today

    These practices work to strengthen our awareness and compassion, which can  help us avoid the extremes of being either overwhelmed or numbing out.

    One For Me And One For You:

    Based on the giving and receiving compassion practice from the Mindful Self-Compassion Program, the “one for me and one for you” practice can be tremendously helpful when we are feeling overwhelmed by the suffering of others. With a little repetition, it can even be accessible in the moment when encountering someone who is struggling.

    Bring to mind someone, even a group of people, who you know are suffering. This could be someone you know personally or hear about on the news. Now, check in with yourself and see what would best support you in being with their struggles as much as possible. It could, for example, be patience, calm, strength, or acceptance. Bring your attention to your breath and consciously offer that to yourself on the inhale and gently release on the exhale.

    After a few rounds, and if it feels right for you, you may now consider what they most need—they may have even voiced this need. It may be the same thing you need or something different. Continue to take in for yourself what you need on the inhale and offer them what they need as you exhale. You can even let go of the specific words and simply say to yourself, “One for me, and one for you,” as you continue to focus on your breathing.

    Kind Touch:

    Offering yourself a tender and gentle touch is one of the easiest ways to access self-compassion. Try putting a hand on your heart, holding your own hand, gently touching your cheek, or rubbing your arms like a gentle self-hug. Though it may initially feel awkward, research shows the benefits of this practice. Just as we might reach out to hug a friend or gently touch the arm of someone in need, we can also offer this loving, caring touch to ourselves. This kind touch releases the chemicals that support comfort, care, and connection, giving our body the message that we are safe and cared for in the moment.

    Of Course…Honey Practice:

    This phrase integrates the three aspects of self-compassion—mindfulness, common humanity, and self-kindness—used in the Mindful Self-Compassion Program. When you are struggling with something, you can say to yourself, “Of course, this is hard, honey,” or “Of course, you are scared, honey,” or “Of course you feel sad (angry, overwhelmed…), honey.” Saying the words “of course” as part of this phrase acknowledges our common humanity, that anyone in our circumstances could feel this way. Feeling like this is simply part of being human. Naming the emotion is the mindfulness aspect of the phrase, and using the term ‘honey’ (or another term of endearment) is an expression of self-kindness. I often use this phrase, usually with my hand on my heart, and have found it to be invaluable, especially when caught in a moment of intense reactivity.

    Start Where You Are, and Go From There

    If you are feeling heartbreak, fear, outrage or anything else in response to the depth and breadth of suffering in the world (or in your own life), start right where you are. Take a moment to care for your own heart and mind before responding to the world, which so desperately needs our loving presence.



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  • Kitchen Renovations

    Kitchen Renovations

    Introduction to Kitchen Renovations

    Kitchen renovations are an exciting and complex process that involves transforming your existing kitchen into a modern, functional, and beautiful space. Whether you’re looking to update your kitchen to increase the value of your home, to make cooking and entertaining easier, or simply to give your kitchen a fresh new look, a renovation project can be a great way to achieve your goals. In this article, we’ll explore the world of kitchen renovations, including the benefits, the process, and some essential tips to keep in mind.

    Planning Your Kitchen Renovation

    Before you start tearing down walls or picking out new countertops, it’s essential to plan your kitchen renovation carefully. This involves assessing your needs, setting a budget, and defining your goals for the project. Consider how you plan to use your kitchen, including the type of cooking you do, the number of people you’ll be cooking for, and any specific features you need, such as a large island or a Walk-in pantry.

    It’s also crucial to measure your kitchen carefully and create a detailed layout of the space. This will help you determine the best configuration for your cabinets, appliances, and countertops, and ensure that everything fits together seamlessly. You can use online kitchen design tools or work with a professional designer to create a 3D model of your kitchen and visualize different design options.

    Choosing the Right Materials and Fixtures

    One of the most exciting parts of a kitchen renovation is selecting the materials and fixtures that will bring your design vision to life. From cabinets and countertops to flooring and lighting, there are countless options to choose from, each with its own unique characteristics, benefits, and drawbacks.

    When it comes to cabinets, you’ll need to decide on the style, material, and finish that suits your taste and budget. Stock cabinets are a cost-effective option, while custom cabinets offer more flexibility and design possibilities. You’ll also need to choose the right countertops, such as granite, quartz, or laminate, considering factors like durability, maintenance, and aesthetics.

    In addition to cabinets and countertops, you’ll need to select a range of other materials and fixtures, including flooring, appliances, lighting, and plumbing fixtures. Hardwood flooring, tile, and laminate are popular options for kitchen floors, while LED lighting and smart appliances can add a touch of modernity and convenience to your kitchen.

    Managing the Renovation Process

    Once you’ve planned and designed your kitchen renovation, it’s time to start the construction process. This can be a messy and disruptive time, especially if you’re living in the house while the work is being done. To minimize stress and ensure a smooth renovation, it’s essential to work with a reliable and experienced contractor or project manager.

    Your contractor will oversee the renovation process, including demolition, installation of new materials and fixtures, and any necessary plumbing, electrical, or HVAC work. They’ll also coordinate with subcontractors, such as carpenters, electricians, and plumbers, to ensure that all aspects of the project are completed to a high standard.

    To keep your renovation on track, it’s crucial to establish a clear communication plan with your contractor, including regular progress updates and a system for addressing any issues or concerns that arise. You should also plan for contingencies, such as unexpected delays or cost overruns, and have a plan in place for dealing with any problems that may arise.

    Budgeting for Your Kitchen Renovation

    Kitchen renovations can be expensive, with costs ranging from a few thousand dollars to $50,000 or more, depending on the scope of the project. To ensure that your renovation stays on budget, it’s essential to create a detailed budget plan, including all the costs associated with the project, from materials and labor to permits and inspections.

    You should also prioritize your spending, focusing on the elements of the renovation that are most important to you, such as new cabinets or a high-end appliance package. Consider phased renovation, where you complete the project in stages, to help spread the cost over time.

    In addition to the upfront costs, you should also consider the long-term value of your kitchen renovation. A well-designed and well-executed renovation can increase the value of your home, making it more attractive to potential buyers if you decide to sell in the future.

    Maintaining Your New Kitchen

    Once your kitchen renovation is complete, it’s essential to maintain your new space to ensure it continues to look and function its best. This includes regular cleaning and upkeep, as well as addressing any issues or problems that may arise.

    You should also take steps to protect your investment, such as using cutting boards and trivets to prevent damage to your countertops, and avoiding harsh chemicals or abrasive cleaners that can damage your finishes. By following a few simple maintenance tips, you can enjoy your new kitchen for years to come and ensure that it remains a beautiful, functional, and enjoyable space.

    Conclusion

    Kitchen renovations are a significant undertaking, requiring careful planning, precise execution, and a clear understanding of the process. By following the tips and guidelines outlined in this article, you can create a beautiful, functional, and modern kitchen that meets your needs and exceeds your expectations. Remember to prioritize your spending, communicate clearly with your contractor, and maintain your new kitchen to ensure it continues to look and function its best.

    Whether you’re a seasoned DIY enthusiast or a first-time renovator, a kitchen renovation project can be a rewarding and exciting experience. With the right planning, materials, and expertise, you can transform your kitchen into a stunning and functional space that enhances your lifestyle and increases the value of your home.

    FAQs

    Q: How long does a kitchen renovation typically take?

    A: The duration of a kitchen renovation can vary widely, depending on the scope of the project, the complexity of the work, and the availability of materials and labor. On average, a kitchen renovation can take anywhere from a few weeks to several months to complete.

    Q: What is the average cost of a kitchen renovation?

    A: The cost of a kitchen renovation can range from a few thousand dollars to $50,000 or more, depending on the materials, fixtures, and labor involved. On average, homeowners can expect to spend around $20,000 to $30,000 on a mid-range kitchen renovation.

    Q: Do I need to hire a contractor for my kitchen renovation?

    A: While it’s possible to DIY certain aspects of a kitchen renovation, such as painting or installing new lighting, it’s generally recommended to hire a professional contractor to oversee the project. A contractor can ensure that all work is completed to code, on time, and to a high standard.

    Q: How can I stay on budget during my kitchen renovation?

    A: To stay on budget, it’s essential to create a detailed budget plan, prioritize your spending, and consider phased renovation. You should also establish a clear communication plan with your contractor and be prepared to make adjustments as needed to stay on track.

    Q: What are the most important elements to consider when planning a kitchen renovation?

    A: The most critical elements to consider when planning a kitchen renovation include your budget, your needs and goals, the layout and design of the space, the materials and fixtures you’ll use, and the timeline for the project. By carefully considering these factors, you can create a beautiful, functional, and modern kitchen that meets your needs and enhances your lifestyle.

  • How culinary nutrition is changing dietetic practice

    How culinary nutrition is changing dietetic practice


    Culinary nutrition is reshaping how dietitians connect food, culture and science – and Sharon Croxford is leading the way. An award-winning academic, chef and dietitian, Sharon shares her journey from Istanbul cooking schools to Australian classrooms, and how she’s helping redefine the role of food and culture in dietetic practice. Tune in for a thought-provoking conversation on this evolving field.

    Hosted by Brooke Delfino

    Biography

    Sharon Croxford is an award-winning academic with 30 years’ APD experience. Sharon also trained as a chef, wanting to bridge the gap between nutrition and dietetics, and food and cooking. She lived between London and Istanbul for more than a decade, opening a cooking school focusing on Ottoman and Turkish cuisine. Sharon returned to Australia and has focused on research on dietary acculturation and bringing food and cooking, and culinary nutrition, into nutrition and dietetics curricula. She is a published academic and popular writer, photographer, and a mum.

     


    In this episode, we discuss:

    • What makes culinary nutrition distinct from traditional approaches to food prep and cooking skills
    • Key competencies and pathways into the field
    • Strategies to understand diverse food cultures
    • The importance of curiosity and lifelong learning in dietetics

    Additional resources


    Additional reading:

    The content, products and/or services referred to in this podcast are intended for Health Care Professionals only and are not, and are not intended to be, medical advice, which should be tailored to your individual circumstances. The content is for your information only, and we advise that you exercise your own judgement before deciding to use the information provided. Professional medical advice should be obtained before taking action. The reference to particular products and/or services in this episode does not constitute any form of endorsement. Please see  here  for terms and conditions.


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  • The Role of Trauma in Chronic Health Conditions and Healing

    The Role of Trauma in Chronic Health Conditions and Healing

    Healing Trauma: Updated Insights and Approaches

    Dr. Stephen Feig believes that healing from trauma is possible with the right tools and with emotional, physical, and behavioral support. By becoming more aware of trauma’s impact and seeking a professional who can assist in resolving the trauma that remains embedded in the mind, body, and nervous system, resilience can grow, and an entirely new life perspective can be achieved.

    Trauma can result from a wide range of distressing experiences, such as accidents, abuse, neglect, or prolonged stress. Interactions that are less obviously intense can affect someone deeply if they are sensitized to them by previous trauma. Because trauma depends on how a person experiences and interprets an event, almost any situation can feel traumatic to someone. New neuroscience confirms that trauma alters the brain’s alarm system (amygdala), memory processing (hippocampus), and decision-making (prefrontal cortex), often leaving survivors stuck in a loop where the body reacts as if the threat is still present. Traumatized individuals remember past events in dysregulating ways and may perceive future events with anticipatory trauma. Past trauma can make people feel constantly on edge. When trauma is unresolved, there is a tendency for stressful bodily sensations and thoughts to arise even when there is no danger. However, it’s also very common for an individual to function well in most of their life experiences, but have certain very specific experiences that are related to past trauma, causing great emotional and physical dysregulation.

    How Perception Shapes the Experience of Trauma

    Madison grew up in a warm, affectionate family where hugs were a natural way to express love. For her, physical touch feels safe and comforting. Katherine, on the other hand, was raised in a family that expressed love through words, with little physical affection. For Katherine, hugs are deeply personal and reserved for those she trusts after a long period of dating or developing a friendship.

    At a party, Madison greets Doug with a long, heartfelt hug. Doug feels uplifted by her warmth and wants to share that feeling with others. His nervous system shifts into a protective state after hugging Madison. He turns to Katherine and offers her the same kind of hug. But Katherine, who sees hugs as intimate and private, perceives Doug’s gesture as intrusive. Her body reacts with tension, her heart rate increases, and her nervous system shifts into a protective state. She interprets the hug as a violation of her boundaries and leaves the party feeling unsafe and emotionally shaken.

    This example highlights how the same event—a hug—can trigger vastly different physiological and emotional responses depending on a person’s past experiences and internal beliefs. Madison’s nervous system interprets the hug as safe and joyful, while Katherine’s interprets it as threatening. These interpretations activate different stress responses in the body, influencing heart rate, muscle tension, hormone release, and even memory formation.

    Trauma isn’t defined solely by the event itself, but by how the nervous system perceives and processes that event. A sudden loss in the family may devastate one person and inspire personal growth in another. The difference lies in how the event is interpreted, the meaning assigned to it, and the body’s ability to return to a state of safety afterward.

    Unresolved trauma can have a lasting impact on both our mental and physical health, especially when the body doesn’t fully process and release the emotional charge of what happened in the past. Sometimes, individuals may not even recognize an event as traumatic until symptoms like anxiety, depression, sexual dysfunction, moodiness, anger outbursts, or avoidant behavior surface. Complex trauma refers to the psychological and emotional effects that result from prolonged or repeated exposure to traumatic events, especially those that occur during critical developmental periods such as childhood.

    The Impact of Unresolved Trauma on Health

    When trauma is resolved, you can think about what happened without a significant emotional charge and without a strong physiological response, such as an elevated heart rate, intrusive thoughts, or sleep disturbances. When trauma is unresolved, the body may remain stuck in a cycle of alarm, hypervigilance, and stress, which can have detrimental health effects over time. This ongoing state of stress can interfere with the body’s ability to repair itself and maintain balance.

    Unresolved trauma often leads to coping behaviors that may further harm health, such as eating disorders, addictions to food, substances, or pornography, sleep disturbances, and emotional dysregulation. These behaviors can compound the effects of trauma and create a feedback loop of continual physical and emotional distress. The combination of trauma, addictions, and poor health choices can increase inflammation, suppress immune function, and disrupt hormonal balance—factors commonly linked to the development of chronic illnesses.

    Research has connected early-life trauma—known as Adverse Childhood Experiences (ACEs)—with increased risk for a wide range of health conditions throughout life:

    • Mental Health Conditions:
    • Depression
    • Anxiety
    • Post-traumatic stress disorder (PTSD)
    • Suicide
    • Substance use disorders, including alcohol and prescription drug misuse
    • Physical Health Conditions:
    • Heart disease
    • Obesity
    • Diabetes
    • Chronic pain and autoimmune disorders
    • Asthma and respiratory issues
    • Neurological and Developmental Effects:
    • Altered brain development
    • Disrupted stress response systems
    • Cognitive impairments such as reduced executive function and learning difficulties
    • Behavioral and Social Outcomes:
    • Poor academic performance
    • Risky behaviors, including early sexual activity, delinquency, and violence
    • Unstable employment and lower socioeconomic status
    • Relationship difficulties and social isolation

    Trauma activates brain regions responsible for emotion and threat detection, such as the amygdala and prefrontal cortex. This can affect mood, sleep, digestion, and blood pressure. People with unresolved trauma may remain in a state of hypervigilance, reacting strongly to minor stressors without understanding why. These patterns can become deeply embedded, shaping identity and self-image. Living in a constant state of alertness can create a disconnect between the mind and body. Many traumatized individuals feel unsafe in their own bodies and rely heavily on mental processing, which can lead to brainwave patterns associated with anxiety, insomnia, and vigilance.

    The vagus nerve, which regulates the parasympathetic nervous system responsible for ‘rest and digest’ functions, is often affected by trauma. People with Post Traumatic Stress Disorder (PTSD) may show signs of vagal nerve dysregulation, such as digestive difficulties, sleep disturbances, increased anxiety and stress sensitivity, fatigue, and difficulty recovering from illness.

    Recognizing the Physical and Emotional Signs of Unresolved Trauma—and Its Impact on Relationships

    Many people don’t immediately connect their physical or emotional symptoms to past trauma. Yet trauma often leaves behind a lasting imprint—not just in the mind, but in the body. This phenomenon is known as body memory, where the body retains sensations and reactions associated with traumatic experiences, even when the conscious mind has suppressed or forgotten them.

    Physical Signs

    Unresolved trauma can manifest through a variety of physical symptoms that may seem unrelated at first glance. These include:

    • Racing thoughts and chronic anxiety
    • Muscle tension, especially in the shoulders, neck, or jaw
    • Digestive issues, such as bloating, nausea, or irritable bowel symptoms
    • Sleep disturbances, including insomnia or restless sleep
    • Fatigue or chronic pain without a clear medical cause

    These symptoms often reflect a dysregulated nervous system, where the body remains in a heightened state of alertness long after the original threat has passed. The sympathetic nervous system (responsible for fight-or-flight responses) may stay overactive, while the parasympathetic system (responsible for rest and recovery) struggles to restore balance.

    Emotional and Relational Signs

    Emotionally, unresolved trauma can show up as:

    • Mood swings, irritability, or emotional numbness
    • Hypervigilance, or constantly scanning for danger
    • Difficulty concentrating or making decisions
    • Avoidance behaviors, such as withdrawing from relationships or responsibilities
    • Overreactions to minor stressors, often without understanding why

    These emotional shifts can deeply affect how individuals relate to others. In work environments, trauma may lead to difficulty trusting colleagues, misinterpreting feedback as criticism, or feeling unsafe in hierarchical structures. In friendships, people may struggle with vulnerability, fear of abandonment, or emotional detachment. In intimate relationships, trauma can manifest as fear of closeness, difficulty with physical affection, or cycles of conflict and withdrawal.

    These reactions are not signs of weakness—they are survival responses. The brain, particularly the amygdala and hippocampus, may misinterpret neutral stimuli as threats, triggering emotional and physiological responses that feel disproportionate to the situation.

    The Intergenerational Impact of Unresolved Trauma

    Unresolved trauma in parents can significantly hinder the emotional development of their children, often in ways that are subtle yet deeply impactful. When parents carry unhealed emotional wounds, they may struggle with emotional regulation, attachment, and communication—key components in nurturing a child’s sense of safety and self-worth. Children are highly perceptive and often internalize the emotional states and behavioral patterns of their caregivers. As a result, they may develop anxiety, low self-esteem, or difficulties in forming healthy relationships. Inconsistent emotional availability, heightened reactivity, or emotional numbing in parents can create an unpredictable environment, leading children to adopt maladaptive coping mechanisms. Over time, these early experiences can shape a child’s worldview, influencing how they perceive themselves and others, and potentially perpetuating cycles of trauma across generations.

    This phenomenon is often referred to as generational or intergenerational trauma, where the psychological effects of trauma are passed down from one generation to the next. Even in the absence of direct exposure to traumatic events, children can inherit the emotional and behavioral consequences of their parents’ unresolved trauma.

    Emerging research in the field of epigenetics supports the idea that trauma can lead to biological changes that are passed on to future generations. Stress and trauma can alter gene expression, particularly in genes related to stress regulation and emotional resilience, potentially predisposing offspring to heightened sensitivity to stress and mental health challenges.

    The Mind-Body Disconnect

    Unresolved trauma can also create a disconnect between the mind and body. It may cause individuals to have nonstop thinking, feel detached from their physical sensations, or experience dissociation—a sense of being “zoned out” or disconnected from reality. This is the brain’s way of protecting itself when overwhelmed, but over time, it can interfere with emotional regulation, self-awareness, and the ability to connect meaningfully with others.

    Pathways to Regulation and Repair

    Recognizing these subtle and not-so-subtle signs of unresolved trauma is a critical first step toward healing. Therapists trained in trauma-informed care can help individuals identify when they are in a state of dysregulation and teach strategies to return to a balanced state. These may include:

    • Somatic practices like breathwork, movement, or grounding exercises
    • Mindfulness and body awareness techniques
    • Cognitive approaches to reframe and process traumatic memories

    Healing begins when we learn to listen to the body’s signals and respond with compassion, rather than judgment. As regulation improves, so does the capacity for connection—allowing individuals to build healthier relationships, communicate more clearly, and feel safer in both personal and professional environments.

    Approaches to Healing and Recovery

    Healing from trauma often begins by working with a professional who can look at the traumas that have occurred throughout your lifetime and who has special training that gives him/her specific trauma-clearing tools. This frequently goes beyond standard talk therapy. Trauma-informed care is becoming essential in addressing the trauma-related aspects of chronic illness. Trauma-informed professionals can make a significant difference in healing and recovery from trauma because they understand how trauma shows up in both behavior and biology. New approaches now include body-based therapies and tools that help calm the nervous system, giving individuals more pathways to healing. Some individuals benefit greatly from body-based practices. Breathwork, exercise, and mindfulness can re-establish a connection between the body and mind, especially when words are hard to find.

    Some of the tools to resolve trauma include the following:

    • Eye Movement Desensitization and Reprocessing (EMDR): Helps people process traumatic memories by using guided eye movements to reduce emotional intensity.
    • Family Constellation Therapy: Explores family dynamics and hidden patterns that may contribute to emotional distress, helping individuals find resolution and peace.
    • Somatic Experiencing: Focuses on bodily sensations to release trauma stored in the nervous system, promoting physical and emotional healing.
    • Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): Combines cognitive restructuring with emotional processing to help individuals reframe negative thoughts and reduce trauma symptoms.

    Recent studies show that combining conventional therapy with gentle stimulation of a nerve in the body called the vagus nerve (vagal nerve stimulation) can help people recover from trauma, even when other treatments haven’t worked. New methods like brain training (neurofeedback), virtual reality, and guided therapy with special medicines are showing great promise in helping people recover from trauma. Engaging in creative outlets like art or music can also support healing when verbal expression feels limited. Not every method works effectively for everyone, so personalizing the approach is key.

    Empowering Clients Beyond the Victim Identity

    It’s essential for therapists to avoid reinforcing a client’s identity as a victim within the framework of the Karpman Drama Triangle, which consists of three roles: victim, rescuer, and persecutor. While acknowledging a client’s pain and validating their experiences is a critical part of trauma-informed care, therapists must be cautious not to inadvertently entrench the “victim” role as a fixed identity. Doing so can limit the client’s sense of agency and reinforce patterns of helplessness, dependency, and external blame—making it harder for them to move toward healing and empowerment.

    Instead, effective therapy encourages clients to recognize their resilience, develop self-regulation skills, and take ownership of their healing journey. When therapists help clients shift from identifying as a victim to seeing themselves as active participants in their recovery, it fosters growth, accountability, and healthier relational dynamics. This shift is especially important in trauma work, where the goal is not just to process past harm, but to build capacity for safety, connection, and autonomy in the present.

    Functional Medicine

    Functional medicine offers a holistic approach to trauma recovery by examining how physical health imbalances may contribute to emotional distress.

    Trauma can disrupt hormone regulation, particularly stress hormones like cortisol and adrenaline. Chronic stress may lead to adrenal fatigue, thyroid imbalances, and reproductive hormone shifts, all of which can affect mood, energy, and sleep. Functional medicine practitioners assess these hormone levels and use targeted interventions such as bio-identical hormones, adaptogenic herbs, lifestyle changes, and nutritional support to restore balance.

    Gut health is another critical area impacted by trauma. The gut and brain are closely connected through the gut-brain axis, and trauma can lead to digestive issues, leaky gut syndrome, and changes in the gut microbiome. These imbalances may increase inflammation and reduce the production of neurotransmitters like serotonin, which are essential for emotional stability. Functional medicine addresses these issues by thoroughly testing urine, stool, blood, and sometimes even the home environment. After reviewing test results, recommendations may include probiotics, food allergy elimination protocols, anti-inflammatory diets, hormone balancing, detoxification protocols, microbiome balancing supplements, and gut-healing nutrients to support both physical and emotional recovery.

    Inflammation is often elevated in individuals with unresolved trauma. This systemic inflammation can worsen symptoms of anxiety, depression, and fatigue. Functional medicine uses lab testing to identify inflammatory markers and personalized interventions such as omega-3 fatty acids, antioxidant-rich foods, and stress-reducing practices to lower inflammation. Nutrition plays a foundational role in this approach, as nutrient deficiencies can impair brain function and emotional resilience. Personalized dietary plans help ensure the body receives the vitamins and minerals needed to heal and thrive.

    Conclusion

    Healing from trauma is a courageous and deeply personal journey. As we deepen our understanding of how trauma affects the mind, body, and spirit, we open the door to more compassionate and effective paths to recovery. From recognizing the signs of unresolved trauma to exploring integrative approaches like functional medicine and somatic therapies, individuals are increasingly empowered to reclaim their sense of safety, identity, and purpose.

    This journey is not about erasing the past but about transforming pain into resilience and wisdom. With the right support, tools, and a nurturing environment, healing becomes not only possible but profoundly transformative. As we continue to embrace holistic, trauma-informed care, we foster a world where individuals are seen, heard, and supported in their full humanity—where healing is honored as both a personal and collective act of restoration.

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  • RADx Programs

    RADx Programs

    Source: National Institutes of Health – From the National Institutes of Health
    Related MedlinePlus Pages: COVID-19 Testing

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  • What Entrepreneur and Innovator Joe Kiani Has Been Up to One Year After His Masimo Resignation

    What Entrepreneur and Innovator Joe Kiani Has Been Up to One Year After His Masimo Resignation

    In over three decades, Joe Kiani led Masimo from a California startup into a global leader in patient monitoring. Since his resignation in late 2024, Kiani has not slowed down but rather redirected his energy into a series of ventures that combine health, technology, and human connection.

    Continuing a Legacy of Health Innovation

    Soon after his departure, Kiani deepened his focus on Willow Laboratories, a company he founded in 1998 to advance human health through data and behavioral insights. Willow’s mission centers on empowering people to manage their health proactively rather than reactively.

    A key part of that mission is Nutu, a digital platform designed to help individuals improve their well-being through small, measurable changes in diet, activity, and sleep. The app uses wearable data and user inputs to generate a “Nutu Score,” a personalized indicator of progress. The system emphasizes gradual lifestyle improvements and sustained engagement, rather than one-size-fits-all recommendations.

    The company’s approach reflects Kiani’s longstanding belief that technology should simplify health decisions and help people live longer, healthier lives.

    Entering Media Technology with Like Minded Labs

    In July 2025, Kiani became CEO of Like Minded Labs, a Santa Monica–based media technology company focused on transforming digital communication and creative collaboration.

    Former Disney CEO Bob Chapek also joined the company’s board around the same time, highlighting its focus on scalable, content-driven innovation.

    Kiani’s leadership at Like Minded Labs appears to be grounded in the same principles that guided his previous ventures: technical rigor, long-term thinking, and a commitment to products that improve the way people connect.

    A Consistent Commitment to Safety and Purpose

    Kiani continues to chair the Patient Safety Movement Foundation, which he established in 2012 to reduce preventable deaths in hospitals worldwide. The foundation works with healthcare providers, policymakers, and technology companies to share best practices and advance transparency in patient outcomes.

    This ongoing advocacy reinforces a throughline across all of Kiani’s work: a dedication to applying technology ethically and effectively to improve human wellbeing. Whether in hospital systems, personal health apps, or media platforms, his focus remains on how innovation can serve people more directly.

    Strategic Investments in Healthcare Innovation

    Kiani has also recently put capital, board roles, and domain expertise into emerging and established health-tech ventures, including MY01, SMS Biotech, IRIDAMED, and CDX Medical Technologies, all of which reinforce a commitment to transforming the frontiers of medical care.

    Building on a Proven Foundation

    Joe Kiani’s professional trajectory shows a consistent pattern: identify a problem, build the technology to address it, and scale that solution until it changes an industry.

    While the industries and companies have evolved, the core mission remains clear: leveraging engineering and creativity to make technology serve humanity more effectively.

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