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The best exercises to boost your brain health after 60

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/neva-beraud-peigne-1418228">Neva Béraud-Peigné</a>, <a href="https://theconversation.com/institutions/universite-paris-saclay-2174">Université Paris-Saclay</a>; <a href="https://theconversation.com/profiles/alexandra-perrot-1531671">Alexandra Perrot</a>, <a href="https://theconversation.com/institutions/universite-paris-saclay-2174">Université Paris-Saclay</a>, and <a href="https://theconversation.com/profiles/pauline-maillot-1167901">Pauline Maillot</a>, <a href="https://theconversation.com/institutions/universite-paris-cite-4263">Université Paris Cité</a></em></p> <p>Have you ever thought about why we have a <a href="https://theconversation.com/fr/topics/cerveau-21903">brain</a>? The obvious answer might be “to think”. But scientist Daniel Wolpert came up with a completely different explanation at the <a href="https://www.ted.com/talks/daniel_wolpert_the_real_reason_for_brains">2011 meeting of the <em>Society for Neuroscience</em></a>:</p> <blockquote> <p>“We have a brain for one reason and one reason only: to produce adaptable and complex movements”</p> </blockquote> <h2>Use your brain to stay efficient</h2> <p>The brain, in other words, is the orchestra conductor which orders the body’s movements. We call the faculties that allow us to interact with our environment <em>cognitive abilities</em>. These include concentrating, learning, reasoning, adapting and communicating with others. Every one of them is key in enabling us to go about our routine and help us maintain a good lifestyle.</p> <p>So, how can we best take care of our brains so that they can stay as efficient as long as possible? Contrary to popular belief, the brain does not deteriorate continuously with age. Instead, it only sees the number of its brain cells drop and connections deteriorate <a href="https://www.bmj.com/content/344/bmj.d7622">from the age of 45 onwards</a> as part of a normal ageing process. But cerebral plasticity, although reduced, is present until the end of life. Each individual will build up a cognitive reserve throughout their lives.</p> <p>The more positive, rich and stimulating the lifestyle, the more powerful and effective the reserve. In other words, it’s possible to moderate the effects of age on cognition.</p> <h2>The benefits of physical activity on cognitive capacity after 60</h2> <p>In fact, much research shows indeed that physical activity improves cognitive capacity, even after the age of 60. From increased memory, better reactivity to greater planning skills, the <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-clinpsy-072720-014213">benefits are endless</a>.</p> <p>Despite this, few older folks engage in <a href="https://theconversation.com/fr/topics/activite-physique-adaptee-apa-146288">physical education</a> adapted to their bodies on a regular basis. Poor motivation and access to these exercises are some of the factors don’t help.</p> <p>With that in mind, many carers might be tempted to offer older people monotonous, routine activities because of their diminishing physical, cognitive and sensory abilities. And indeed, for a long time, the range of sports on offer and research in this field revolved around the same triptych: gentle gymnastics, walking and yoga. However, you’ll reap more benefits by <a href="https://www-sciencedirect-com.ezproxy.u-paris.fr/science/article/abs/pii/B9780444633279000175">combining different training methods</a>.</p> <h2>Three ingredients to train the brains of senior citizens</h2> <p>Researchers are currently attempting to crack the winning formula that would flex older people’s cognitive, as well as physical muscles. It’ll consist of three main ingredients:</p> <p><em>First ingredient: complex physical and motor stimulation of at least moderate intensity.</em></p> <p>Moderate cardio workouts not only improve cardiorespiratory health but also make the brain more <a href="https://www.nature.com/articles/22682">efficient</a>. Overall improved cardiofitness, in turn, allows the brain to receive more oxygen and even to generate <a href="https://www.pnas.org/doi/full/10.1073/pnas.1015950108">new neurons in the hippocampus</a>, where memory is lodged.</p> <p>It therefore makes sense for programmes designed to boost cognitive function to include cardio. But it is also <a href="https://journals.sagepub.com/doi/abs/10.1111/1467-9280.t01-1-01430">necessary to combine them with muscle-strengthening, flexibility and balance exercises to achieve greater benefits</a>. In addition, the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0149763413001012">researchers</a> emphasise the importance of adding situations requiring complex motor skills and coordination, as these would have a significant impact on cognitive functions (e.g. memory, attention and mental flexibility), particularly in the elderly.</p> <p><em>Second ingredient: fire up those brain cells during exercises</em></p> <p>Incorporating cognitive stimulation, such as remembering information for a period of time and executing it, anticipating actions, or planning a move, is another winning strategy. When cognitive stimulation is combined with physical activity, it can produce <a href="https://www.tandfonline.com/doi/abs/10.1080/13825585.2011.645010">synergistic effects</a> and, as a result, be more effective on cognitive functions.</p> <p>_Third ingredient: group activities that lead to social interaction. _</p> <p>Working out as part of a group has been shown to help us <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001756">persevere through it</a>.</p> <p>What this winning formula could look like in practice is still being researched. At present, there are two broad types of exercises that have caught our attention that could help older people stay sharp.</p> <h2>Opting for cooperative and oppositional team sports</h2> <p>Team sports offer much more than just physical exercise sessions. What’s particularly great about them is that they don’t only challenge cardiorespiratory balance, but tap into the whole body’s physical skill-set.</p> <p>Take basketball or handball, for example: to move around the court, dribble or score, balance, coordination and flexibility are essential. Muscular strength is also required for passing, recovering the ball and moving around. These team sports can be suitable even after the age of 60, provided they are properly supervised.</p> <p>From a cognitive point of view, these activities create situations that are always new, rich and stimulating. We call this double combination of stimuli <em><a href="https://www.tandfonline.com/doi/abs/10.1080/13825585.2011.645010">simultaneous training</a></em>. A number of researchers have highlighted the importance of this cognitive involvement in team sports and encourage their practice, particularly among the elderly.</p> <p>Recent studies, such as <a href="https://linkinghub.elsevier.com/retrieve/pii/S162748302100129X">the one carried out in 2022</a> by French researchers, have shown that participation in team sports improves short-term visuospatial memory (which enables people, for example, to remember the location of certain objects for a limited period of time) and planning skills in the elderly.</p> <h2>Get your body moving with exergames</h2> <p>Another promising avenue are <em>exergames</em> – video games that require players to move around to play. Named after the contraction of “exercise” and “games”, they grew popular in the 2000s thanks to Nintendo’s Wii and Switch and Microsoft’s Kinect.</p> <p>Exogames have been thought out to exercise different fitness skills, such as balance, endurance, strength, and coordination, while simultaneously stimulating cognitive functions. Among older people, <a href="https://psycnet.apa.org/record/2011-27707-001">several research studies</a> show that this type of training helps to improve many physical and cognitive abilities.</p> <p>In 2020, a new generation of exergames emerged, making use of interactive walls to create an even more immersive gaming experience, such as Neo Xperiences’ <em>Neo-One</em>, Sphery’s <em>ExerCube</em> and Lü’s <em>Aire interactive</em>. In these games combining real and virtual worlds, physical objects (such as balls) and digital objects coexist and interact in real time.</p> <p>A <a href="https://link.springer.com/article/10.1007/s11357-023-00952-w">recent study</a> compared an exergame programme assisted by an immersive wall with a walking and muscle-strengthening programme. Its results suggest that this new generation of exergames may be more effective on cognitive abilities than traditional training.</p> <p>Combining physical and cognitive exercises offers the best chance to keep one’s brain health while keeping fit. This is essential for an active and fulfilling life, whatever your age.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237162/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/neva-beraud-peigne-1418228">Neva Béraud-Peigné</a>, Doctorante en sciences du mouvement, <a href="https://theconversation.com/institutions/universite-paris-saclay-2174">Université Paris-Saclay</a>; <a href="https://theconversation.com/profiles/alexandra-perrot-1531671">Alexandra Perrot</a>, Maitre de conférences HDR, <a href="https://theconversation.com/institutions/universite-paris-saclay-2174">Université Paris-Saclay</a>, and <a href="https://theconversation.com/profiles/pauline-maillot-1167901">Pauline Maillot</a>, Maître de conférences en STAPS, <a href="https://theconversation.com/institutions/universite-paris-cite-4263">Université Paris Cité</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-best-exercises-to-boost-your-brain-health-after-60-237162">original article</a>.</em></p> </div>

Body

Do mobile phones cause brain cancer? Science makes definitive call

<p>The question of whether mobile phones - specifically the electromagnetic radiation or radio waves emitted by these devices - cause cancer has been debated and researched for a long time, and now scientists have made a definitive call. </p> <p>A new comprehensive review commissioned by the World Health Organization has found that mobile phones are NOT linked to brain and head cancers. </p> <p>The systematic review, led by the Australian Radiation Protection and Nuclear Safety Agency (Arpansa), examined over 5,000 studies, which included 63 observational studies on humans published between 1994 and 2022 and is "the most comprehensive review to date" according to review lead author, associate prof Ken Karipidis. </p> <p>“We concluded the evidence does not show a link between mobile phones and brain cancer or other head and neck cancers," he said. </p> <p>The review, which was published on Wednesday, focused on cancers of the nervous system, salivary gland and brain tumours. </p> <p>They found no overall association between mobile phone use and cancer, even if people have used it for a long time (over 10 years) or spend a lot of time on their phones. </p> <p>“I’m quite confident with our conclusion. And what makes us quite confident is … even though mobile phone use has skyrocketed, brain tumour rates have remained stable,” Karipidis continued. </p> <p>Despite emitting electromagnetic radiation, also known as radio waves, the exposure is relatively low. </p> <p>Karipidis said people hear the word radiation and assume it is similar to nuclear radiation, “and because we use a mobile phone close to the head when we’re making calls, there is a lot of concern.”</p> <p>He clarified that “radiation is basically energy that travels from one point to another. There are many different types, for example, ultraviolet radiation from the sun." </p> <p>“We’re always exposed to low-level radio waves in the everyday environment.”</p> <p>While exposure from mobile phones is still low, it is much higher than exposure from any other wireless technology sources since they are used close to the head, Karipidis said. </p> <p>The association between mobile phones and cancers came about from early studies comparing differences between those with and without brain tumours and asking about their exposure history. </p> <p>According to Karipidis, who is also the vice-chair of the International Commission on Non-Ionizing Radiation Protection, the results from these kind of studies tend to be biased, as the group with the tumour tend to overreport their exposure. </p> <p>Based on these early studies WHO’s International Agency for Research on Cancer (IARC) designated radio-frequency fields like those from mobile phones as a possible cancer risk, but Karipidis said "this classification doesn’t mean all that much”.</p> <p>This is because the IARC has different classifications of cancer risk, with some substances classified as a “definite” carcinogen (such as smoking), and others as “probable” or “possible” carcinogens.</p> <p>Tim Driscoll, a professor at the University of Sydney and chair of the Australian Cancer Council’s occupational and environmental cancers committee, also backed the systematic review. </p> <p>“I think people should feel reassured by this study … but it’s worthwhile just remembering that the studies aren’t perfect, but the weight of evidence certainly is that mobile phones should be considered safe to use in terms of any concerns about increased risk of cancer,” Driscoll said.</p> <p><em>Images: Shutterstock</em></p> <p> </p>

Body

Can a 10-year-old be responsible for a crime? Here’s what brain science tells us

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/susan-m-sawyer-109573">Susan M. Sawyer</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nandi-vijayakumar-1644262">Nandi Vijayakumar</a>, <a href="https://theconversation.com/institutions/deakin-university-757"><em>Deakin University</em></a></em></p> <p>The age a child can be arrested, charged and jailed in Australia is back in the spotlight.</p> <p>Last year, the Northern Territory became the first jurisdiction to raise the age of criminal responsibility from ten to 12. Now its new, tough-on-crime government has pledged to <a href="https://www.sbs.com.au/nitv/article/incoming-chief-minister-says-age-of-criminal-responsibility-to-be-lowered-to-10-years-old/a1xm9jy9c">return it to ten</a>. It comes after Victoria <a href="https://www.abc.net.au/news/2024-08-13/victoria-youth-justice-reform-criminal-age/104217160">walked back</a> its earlier commitment to raise the age to 14, settling instead on 12.</p> <p>But the United Nations Committee on the Rights of the Child says 14 should be the absolute <a href="https://www.ohchr.org/en/documents/general-comments-and-recommendations/general-comment-no-24-2019-childrens-rights-child">minimum</a>. It raised this age from its earlier recommendation (in 2007) of 12, citing a decade of new research into child and adolescent development.</p> <p>So what does the science say? What happens to the brain between ten and 14? And how much can those under 14 understand the consequences of their actions?</p> <h2>Who is an adolescent?</h2> <p>Our research shows adolescence is a <a href="https://pubmed.ncbi.nlm.nih.gov/30169257/">critical period</a> for development. It’s the time children’s experiences and explorations shape how they develop cognitive skills (including critical thinking and decision making), as well as social and emotional skills (including moral reasoning).</p> <p>Adolescence also lasts longer than we tend to think. Important brain development begins during late childhood, around eight to nine years. Intense changes then follow during early adolescence (ages ten to 14). But these changes continue well into the twenties, and full cognitive and emotional maturity is not usually reached until around age 24.</p> <p>However, everyone’s brain matures at a different rate. That means there is no definitive age we can say humans reach “adult” levels of cognitive maturity. What we do know is the period of early adolescence is critical.</p> <h2>What does puberty do to the brain?</h2> <p>Puberty is a defining feature of early adolescence. Most of us are familiar with the changes that occur to the body and reproductive systems. But the increase in puberty hormones, such as testosterone and oestrogen, also trigger changes to the brain. These hormones <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306453017313252?via%3Dihub">increase most sharply</a> between ten and 15 years of age, although gradual changes continue into the early twenties.</p> <p>Puberty hormones change the structures in the brain which process emotions, including the amygdala (which encodes fear and stress) and ventral striatum (involved in reward and motivation).</p> <p>This makes adolescents particularly reactive to emotional rewards and threats. <a href="https://doi.org/10.1016/j.cortex.2019.04.024">Our research</a> has shown the brain’s sensitivity to emotions increases throughout early adolescence until around 14 or 15 years old.</p> <p>At the same time, changes in puberty have <a href="http://dx.doi.org/10.1037/pspp0000172">been linked</a> to increased sensation seeking and impulsive behaviours during early adolescence.</p> <p>This context is crucial when we discuss the behaviour of children in the ten to 14 age range. The way their brains change during this period makes them more sensitive and responsive to emotions, and more likely to be seeking experiences that are new and intense.</p> <h2>How do adolescents make decisions?</h2> <p>The emotional context of puberty influences how younger adolescents make decisions and understand their consequences.</p> <p>Decision making relies on several basic cognitive functions, including the brain’s flexibility, memory and ability to control impulses.</p> <p>These cognitive abilities – which together help us consider the consequences of our actions – undergo some of the <a href="https://doi.org/10.1523/JNEUROSCI.1741-13.2013">steepest development</a> between ages ten and 14. By age 15, the ability to make complex decisions has usually <a href="https://doi.org/10.1037/lhb0000315">reached adult maturity</a>.</p> <p>But adolescents at this age remain highly susceptible to emotions. So while their brain may be equipped to make a complex decision, their ability to think through the consequences, weighing up costs and benefits, can be clouded by emotional situations.</p> <p>For example, <a href="https://doi.org/10.1111/cdev.12085">research has shown</a> 13-14 year-olds were more distracted from completing a task and less able to control their behaviour when they viewed images that made them feel negative emotions.</p> <p>The social world of teenagers also has a significant impact on how they make decisions – especially in early adolescence. One study found that while older adolescents (aged 15-18) are more influenced by what adults think when weighing up risk, adolescents aged 12-14 <a href="https://journals.sagepub.com/doi/full/10.1177/0956797615569578">look to other teenagers</a>.</p> <p>Experiments <a href="https://doi.org/10.1177/0272431616648453">have also shown</a> adolescents aged 12-15 make riskier decisions when they are with peers than by themselves. Their brain responses also suggest they experience a greater sense of reward in taking those risks <a href="https://doi.org/10.1093/scan/nsy071">with peers</a>.</p> <h2>How do teens understand the consequences of their actions?</h2> <p>The concept of <a href="https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp2122/Quick_Guides/MinimumAgeCriminalResponsibility">criminal responsibility</a> is based on whether a person is able to understand their action and know whether it is wrong.</p> <p>Moral reasoning – how people think about right and wrong – depends on the ability to understand another person’s mental state and adopt their perspective. These skills are in development <a href="https://doi.org/10.1016/j.biopsych.2020.09.012">across adolescence</a>.</p> <p>Research suggests it may take more effort for adolescent brains to process <a href="https://doi.org/10.1162/jocn.2009.21121">“social” emotions</a> such as guilt and embarrassment, compared to adults. This is similar when they make <a href="https://doi.org/10.1080/17470919.2014.933714">moral judgements</a>. This evidence suggests teenage brains may have to work harder when considering other people’s intentions and desires.</p> <p>Young adolescents have the cognitive ability to appreciate they made a bad decision, but it is more mentally demanding. And social rewards, emotions and the chance to experience something new all have a strong bearing on their decisions and actions in the moment — possibly more than whether it is right or wrong.</p> <h2>Early adolescence is critical for the brain</h2> <p>There are also a number of reasons adolescent brains may develop differently. This includes various forms of neurodisability such as acquired brain injury, fetal alcohol spectrum disorder, attention-deficit hyperactivity disorder (ADHD) and intellectual disability, as well as exposure to trauma.</p> <p>Teenagers with neurodevelopmental disorders will likely cope differently with decision making, social pressure, impulse control and risk assessment, and face <a href="https://www.mcri.edu.au/images/research/strategic-collaborations/Flagships/Neurodevelopment/Neurodevelopment_Flagship_Brochure.pdf">extra difficulties</a>. Across the world, they are <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(19)30217-8/fulltext">disproportionately incarcerated</a>.</p> <p>In Australia, Indigenous children and adolescents are incarcerated <a href="https://www.indigenoushpf.gov.au/measures/2-11-contact-with-the-criminal-justice-system#:%7E:text=On%20an%20average%20day%20in%202021%E2%80%9322%2C%20there%20were%3A,AIHW%202023d%3A%20Table%20S76a">in greater numbers</a> than their non-Indigenous peers.</p> <p>Each child matures differently, and some face extra challenges. But for every person, the period between ten and 14 is critical for developing the cognitive, social and emotional skills they’ll carry through the rest of their life.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237552/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/susan-m-sawyer-109573">Susan M. Sawyer</a>, Professor of Adolescent Health The University of Melbourne; Director, Royal Children's Hospital Centre for Adolescent Health, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nandi-vijayakumar-1644262">Nandi Vijayakumar</a>, Research Fellow, School of Psychology, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/can-a-10-year-old-be-responsible-for-a-crime-heres-what-brain-science-tells-us-237552">original article</a>.</em></p> </div>

Mind

Jimmy Barnes shares heartwarming health update

<p>Jimmy Barnes has shared a series of heartwarming updates following his emergency hip surgery earlier this month. </p> <p>While on the New Zealand leg of his tour in early August, the 68-year-old rockstar was taken to <a href="https://oversixty.com.au/health/caring/bad-news-jimmy-barnes-reveals-shocking-health-update" target="_blank" rel="noopener">hospital</a> after complaining of "unbearable pain", telling his fans, "The doctors have recommended a remedial medical procedure ASAP followed by some physio to address the issue."</p> <p>Now back at home with his family, Barnes has posted a series of messages to Instagram describing how thrilled he was to be out of hospital.</p> <p>“I can’t tell how great it feels to be back in my own bed, back to our home and the beautiful garden. Of course, being very spoilt,” he said on Monday.</p> <p>Barnes has also now commenced a high-protein diet and continued with his physio, which he said was “getting tougher”.</p> <p>“If I’m to be on a high-protein recovery diet, I’ve come to the right place,” he said of his wife Jane Barnes’ expert cooking skills.</p> <p>“I’m being loaded up with protein and iron to rebuild muscles that I never had,” he explained in an Instagram caption.</p> <p>He also shared a sweet photo with his grandchildren who have been keeping his spirits high during his recovery, writing alongside the photo, "Rosie and Dylan here to cheer me on at the end of the day. The physio is getting tougher and the protein shakes are growing on me. I sure am a lucky guy."</p> <p>When sharing the news of his surgery with his fans, he said, “Providing all goes to plan, I’m expected to make a full recovery in six weeks.”</p> <p><em>Image credits: Instagram </em></p>

Caring

Do you have knee pain from osteoarthritis? You might not need surgery. Here’s what to try instead

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/belinda-lawford-1294188">Belinda Lawford</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/joshua-zadro-504754">Joshua Zadro</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/rana-hinman-1536232">Rana Hinman</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>Most people with knee osteoarthritis can control their pain and improve their mobility without surgery, according to <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">updated treatment guidelines</a> from the Australian Commission on Safety and Quality in Health Care.</p> <p>So what is knee osteoarthritis and what are the best ways to manage it?</p> <h2>More than 2 million Australians have osteoarthritis</h2> <p>Osteoarthritis is the most common joint disease, affecting <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">2.1 million Australians</a>. It <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">costs the economy</a> A$4.3 billion each year.</p> <p>Osteoarthritis commonly <a href="https://pubmed.ncbi.nlm.nih.gov/33560326/">affects</a> the knees, but can also affect the hips, spine, hands and feet. It impacts the whole joint including bone, cartilage, ligaments and muscles.</p> <p>Most people with osteoarthritis have persistent pain and find it difficult to perform simple daily tasks, such as walking and climbing stairs.</p> <h2>Is it caused by ‘wear and tear’?</h2> <p>Knee osteoarthritis is most likely to affect older people, those who are overweight or obese, and those with previous knee injuries. But contrary to popular belief, knee osteoarthritis is <a href="https://pubmed.ncbi.nlm.nih.gov/31192807/">not caused by</a> “wear and tear”.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/21281726/">Research shows</a> the degree of structural wear and tear visible in the knee joint on an X-ray does not correlate with the level of pain or disability a person experiences. Some people have a low degree of structural wear and tear and very bad symptoms, while others have a high degree of structural wear and tear and minimal symptoms. So X-rays are <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">not required</a> to diagnose knee osteoarthritis or guide treatment decisions.</p> <p>Telling people they have wear and tear can make them worried about their condition and afraid of damaging their joint. It can also encourage them to try invasive and potentially unnecessary treatments such as surgery. We have <a href="https://pubmed.ncbi.nlm.nih.gov/37795555/">shown this</a> in people with osteoarthritis, and other common pain conditions such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9545091/">back</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/33789444/">shoulder</a> pain.</p> <p>This has led to a global call for a <a href="https://pubmed.ncbi.nlm.nih.gov/38354847/">change in the way</a> we think and communicate about osteoarthritis.</p> <h2>What’s the best way to manage osteoarthritis?</h2> <p>Non-surgical treatments work well for most people with osteoarthritis, regardless of their age or the severity of their symptoms. These <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">include</a> education and self-management, exercise and physical activity, weight management and nutrition, and certain pain medicines.</p> <p>Education is important to dispel misconceptions about knee osteoarthritis. This includes information about what osteoarthritis is, how it is diagnosed, its prognosis, and the most effective ways to self-manage symptoms.</p> <p>Health professionals who use positive and reassuring language <a href="https://pubmed.ncbi.nlm.nih.gov/35750241/">can improve</a> people’s knowledge and beliefs about osteoarthritis and its management.</p> <p>Many people believe that exercise and physical activity will cause further damage to their joint. But it’s safe and can reduce pain and disability. Exercise has fewer side effects than commonly used pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/36593092/">paracetamol and anti-inflammatories</a> and can <a href="https://pubmed.ncbi.nlm.nih.gov/26488691/">prevent or delay</a> the need for joint replacement surgery in the future.</p> <p>Many types of exercise <a href="https://pubmed.ncbi.nlm.nih.gov/30830561/">are effective</a> for knee osteoarthritis, such as strength training, aerobic exercises like walking or cycling, Yoga and Tai chi. So you can do whatever type of exercise best suits you.</p> <p>Increasing general physical activity is also important, such as taking more steps throughout the day and reducing sedentary time.</p> <p>Weight management is important for those who are overweight or obese. Weight loss <a href="https://pubmed.ncbi.nlm.nih.gov/34843383/">can reduce knee pain and disability</a>, particularly when combined with exercise. Losing as little as 5–10% of your body weight <a href="https://pubmed.ncbi.nlm.nih.gov/36474793/">can be beneficial</a>.</p> <p>Pain medicines should not replace treatments such as exercise and weight management but can be used alongside these treatments to help manage pain. <a href="https://pubmed.ncbi.nlm.nih.gov/33786837/">Recommended medicines</a> include paracetamol and non-steroidal anti-inflammatory drugs.</p> <p>Opioids are <a href="https://pubmed.ncbi.nlm.nih.gov/35137418/">not recommended</a>. The risk of harm outweighs any potential benefits.</p> <h2>What about surgery?</h2> <p>People with knee osteoarthritis commonly undergo two types of surgery: knee arthroscopy and knee replacement.</p> <p>Knee arthroscopy is a type of keyhole surgery used to remove or repair damaged pieces of bone or cartilage that are thought to cause pain.</p> <p>However, high-quality research <a href="https://pubmed.ncbi.nlm.nih.gov/24369076/">has shown</a> arthroscopy is not effective. Arthroscopy should therefore not be used in the management of knee osteoarthritis.</p> <p>Joint replacement involves replacing the joint surfaces with artificial parts. In 2021–22, <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">53,500 Australians</a> had a knee replacement for their osteoarthritis.</p> <p>Joint replacement is often seen as being inevitable and “necessary”. But most people can effectively manage their symptoms through exercise, physical activity and weight management.</p> <p>The new guidelines (known as “care standard”) recommend joint replacement surgery only be considered for those with severe symptoms who have already tried non-surgical treatments.</p> <h2>I have knee osteoarthritis. What should I do?</h2> <p>The <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">care standard</a> links to free evidence-based resources to support people with osteoarthritis. These include:</p> <ul> <li>education, such as a <a href="https://www.england.nhs.uk/wp-content/uploads/2023/07/making-a-decision-about-knee-osteoarthritis-v1.pdf.pdf">decision aid</a> and <a href="http://www.futurelearn.com/courses/taking-control-hip-and-knee-osteoarthritis">four-week online course</a></li> <li>self-directed <a href="https://healthsciences.unimelb.edu.au/departments/physiotherapy/chesm/patient-resources/my-knee-exercise">online exercise</a> and <a href="https://myjointyoga.com.au/">yoga</a> programs</li> <li><a href="https://www.gethealthynsw.com.au/program/standard-coaching/">weight management support</a></li> <li>pain management strategies, such as <a href="https://www.myjointpain.org.au/">MyJointPain</a> and <a href="http://www.paintrainer.org/">painTRAINER</a>.</li> </ul> <p>If you have osteoarthritis, you can use the <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">care standard</a> to inform discussions with your health-care provider, and to make informed decisions about your care.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/236779/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/belinda-lawford-1294188"><em>Belinda Lawford</em></a><em>, Postdoctoral research fellow in physiotherapy, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/joshua-zadro-504754">Joshua Zadro</a>, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/rana-hinman-1536232">Rana Hinman</a>, Professor in Physiotherapy, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">original article</a>.</em></p> </div>

Body

Australia’s IV fluids shortage will likely last all year. Here’s what that means for surgeries

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/stuart-marshall-1115779">Stuart Marshall</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722"><em>The University of Melbourne</em></a></em></p> <p>The current <a href="https://www.tga.gov.au/about-IV-fluids-shortages">shortage of sterile intravenous (IV) fluids</a> is a serious ongoing concern for doctors across Australia. During surgery, these sterile fluids are essential to administer drugs and hydrate patients intravenously (via the veins).</p> <p>But supplies of two of the most common solutions are critically low.</p> <p>The Australian government has recently moved to <a href="https://www.theguardian.com/australia-news/article/2024/aug/16/australia-iv-fluid-shortage-government-distribution">coordinate supplies</a> of IV fluids to increase manufacturing and ensure distribution. Despite this, supplies are not expected to return to normal levels <a href="https://www.health.gov.au/sites/default/files/2024-08/joint-statement-on-iv-fluids-health-ministers-meeting-16-august-2024.pdf">until the end of the year</a>.</p> <p>So, what will this mean for surgery in Australia? And are there any alternatives?</p> <h2>Why do we need IV fluids for surgery?</h2> <p>IV fluids are used before, during and after surgery to maintain blood volume and the body’s normal functions. They also combat dehydration, which can happen in a number of ways.</p> <p>Before surgery, patients may become dehydrated from illnesses that cause vomiting or diarrhoea. They are also asked to stop eating and drinking for several hours before surgery. This is to minimise the risk of stomach contents being regurgitated and inhaled into the lungs – a <a href="https://my.clevelandclinic.org/health/diseases/21954-aspiration-pneumonia">complication that can cause injury or death</a>. But it can also make them more dehydrated.</p> <p>During surgery, the body continues to lose fluid through normal processes such as sweating and making urine. But some aspects of surgery also exacerbate dehydration, for example, through blood loss or when internal organs are exposed and lose more fluid through evaporation.</p> <p>After the operation, IV fluids may be required for some days. Many patients may still be unable to eat and drink until the function of the gut returns to normal.</p> <p>Multiple research studies, including <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1801601">a trial </a>of 3,000 patients who underwent major abdominal surgery, have demonstrated the importance of adequate fluid therapy throughout all stages of surgery to avoid kidney damage.</p> <p>Apart from hydration, these sterile fluids – prepared under strict conditions so they contain no bacteria or viruses – are used in surgery for other reasons.</p> <p>Anaesthetists commonly use fluid infusions to slowly deliver medications into the bloodstream. There is some evidence this method of maintaining anaesthesia, compared to inhalation, can improve patients’ experience of “waking up” after the procedure, <a href="https://medcast.com.au/blog/total-intravenous-anaesthesia-tiva">such as being clearer headed and having less nausea and vomiting</a>.</p> <p>Surgeons also use sterile fluids to flush out wounds and surgical sites to prevent infection.</p> <h2>Are there workarounds?</h2> <p>Fluid given intravenously needs to closely resemble the salts in the blood to prevent additional problems. The safest and cheapest options are:</p> <ul> <li>isotonic saline, a solution of water with 0.9% table salt</li> <li>Hartmann’s solution (compound sodium lactate), which combines a range of salts such as potassium and calcium.</li> </ul> <p>Both are <a href="https://www.tga.gov.au/about-IV-fluids-shortages">in short supply</a>.</p> <p>One way to work around the shortage is to minimise how much IV fluid is used during the procedure. This can be achieved by ensuring those admitted to surgery are as well hydrated as possible.</p> <p>Many people presenting for minor surgery can safely drink water up until an hour or so before their operation. A recent initiative termed “<a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15855">sip ‘til send</a>” has shown it is safe for patients to drink small amounts of fluid until the operating theatre team “sends” for them from the waiting room or hospital ward.</p> <p>However, this may not be appropriate for those at higher risk of inhaling stomach contents, or patients who take medications including <a href="https://www.journal.acorn.org.au/cgi/viewcontent.cgi?article=1291&context=jpn">Ozempic</a>, which delay the stomach emptying. Patients should follow their anaesthetist’s advice about how to prepare for surgery and when to stop eating and drinking.</p> <p>Large research trials have also helped establish protocols called “<a href="https://www.bjanaesthesia.org/article/S0007-0912(17)53976-8/fulltext">enhanced recovery after surgery</a>”. They show that using special hydrating, carbohydrate-rich drinks before surgery can improve patients’ comfort and speed up healing.</p> <p>These protocols are common in <a href="https://aci.health.nsw.gov.au/__data/assets/pdf_file/0003/736617/ERAS-Key-principles-for-colorectal-surgery.pdf">major bowel surgery</a> in Australia but not used universally. Widespread adoption of these processes may reduce the amount of IV fluids needed during and after large operations, and help patients return to normal eating and drinking earlier. Medications reducing nausea and vomiting are now also routinely administered after surgery to help with this.</p> <h2>What will the shortage mean for surgeries?</h2> <p>The Australian and New Zealand College of Anaesthetists <a href="https://www.anzca.edu.au/news/guidance-on-sparing-of-intravenous-fluid-use">has advised anaesthetists</a> to reduce the consumption of fluid during operations where there might be limited or minimal benefit. This means that the fluid will only be used for people who need it, without a change to the quality and safety of anaesthetic care for any patient.</p> <p>Even with these actions, there is still a chance that some planned surgeries may <a href="https://www.abc.net.au/news/2024-08-15/iv-fluid-shortage-elective-urgery-delays/104225280">need to be postponed</a> in the coming months.</p> <p>If needed, these cancelled operations will likely be ones requiring large volumes of fluid and ones that would not cause unacceptable risks if delayed. Similar to cancellations during the height of the COVID pandemic, emergency operations and surgery for cancers are unlikely to be affected.</p> <p>Monitoring of the supplies and ongoing honest and open dialogue between senior health managers and clinicians will be crucial in minimising the disruption to surgical services.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237009/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/stuart-marshall-1115779">Stuart Marshall</a>, Associate Professor, Department of Critical Care, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/australias-iv-fluids-shortage-will-likely-last-all-year-heres-what-that-means-for-surgeries-237009">original article</a>.</em></p> </div>

Body

"Bad news": Jimmy Barnes reveals shocking health update

<p>Jimmy Barnes has been taken to hospital after complaining of "unbearable pain" while on the New Zealand leg of his tour. </p> <p>The Aussie rock legend took to Instagram to tell his fans that he would be out of action for six weeks after experiencing pain in his hip that requires surgical intervention. </p> <p>"I’ve got some bad news unfortunately," he started the post. "I had a twinge in my hip when I was leaving Dunedin on Thursday morning and by late last night the pain was unbearable so I went off to hospital."</p> <p>"The doctors have recommended a remedial medical procedure ASAP followed by some physio to address the issue. These doctors don’t muck around! Providing all goes to plan, I’m expected to make a full recovery in six weeks."</p> <p>The 68-year-old then clarified that because of the upcoming surgery, his August and September shows on his <em>Hell of a Time</em> tour would be impacted. </p> <p>"Ticket holders will be contacted with further info in the coming days once we have new plans in place," he said.</p> <p>"As you know, I hate to let anyone down, but I’m also never going to compromise the quality of my gigs. I apologise for the inconvenience this will cause everyone – I HATE moving shows! - but thank you for understanding."</p> <p>Just hours after his post, Jimmy's wife Jane took to his social media accounts to tell his fans that he was out the ICU and "recovering well" while he awaits the procedure. </p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/p/C-PaHMCT78j/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C-PaHMCT78j/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Jimmy Barnes (@jimmybarnesofficial)</a></p> </div> </blockquote> <p>"Jimmy is out of ICU and recovering well. I brought in some healing chicken soup and chocolate chip cookies for afternoon tea, a bit of home always helps hospital days," she said. </p> <p>"Our kids always around watching over us. Full of Love."</p> <p>The health shock comes just months after he underwent open heart surgery for a life-threatening infection, while also following on from a hip replacement surgery Barnes underwent in 2022 after experiencing more pain while performing.</p> <p><em>Image credits: Instagram </em></p>

Caring

What happens in my brain when I get a migraine? And what medications can I use to treat it?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>Migraine is many things, but one thing it’s not is “just a headache”.</p> <p>“Migraine” <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1029040/">comes from</a> the Greek word “hemicrania”, referring to the common experience of migraine being predominantly one-sided.</p> <p>Some people experience an “aura” preceding the headache phase – usually a visual or sensory experience that evolves over five to 60 minutes. Auras can also involve other domains such as language, smell and limb function.</p> <p>Migraine is a disease with a <a href="https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(18)30322-3/fulltext">huge personal and societal impact</a>. Most people cannot function at their usual level during a migraine, and anticipation of the next attack can affect productivity, relationships and a person’s mental health.</p> <h2>What’s happening in my brain?</h2> <p>The biological basis of migraine is complex, and varies according to the phase of the migraine. Put simply:</p> <p>The earliest phase is called the <strong>prodrome</strong>. This is associated with activation of a part of the brain called the hypothalamus which is thought to contribute to many symptoms such as nausea, changes in appetite and blurred vision.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=485&fit=crop&dpr=1 600w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=485&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=485&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=610&fit=crop&dpr=1 754w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=610&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=610&fit=crop&dpr=3 2262w" alt="" /><figcaption><span class="caption">The hypothalamus is shown here in red.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/brain-cross-section-showing-basal-ganglia-329843930">Blamb/Shutterstock</a></span></figcaption></figure> <p>Next is the <strong>aura phase</strong>, when a wave of neurochemical changes occur across the surface of the brain (the cortex) at a rate of 3–4 millimetres per minute. This explains how usually a person’s aura progresses over time. People often experience sensory disturbances such as flashes of light or tingling in their face or hands.</p> <p>In the <strong>headache phase</strong>, the trigeminal nerve system is activated. This gives sensation to one side of the face, head and upper neck, leading to release of proteins such as CGRP (calcitonin gene-related peptide). This causes inflammation and dilation of blood vessels, which is the basis for the severe throbbing pain associated with the headache.</p> <p>Finally, the <strong>postdromal phase</strong> occurs after the headache resolves and commonly involves changes in mood and energy.</p> <h2>What can you do about the acute attack?</h2> <p>A useful way to conceive of <a href="https://www.migraine.org.au/factsheets">migraine treatment</a> is to compare putting out campfires with bushfires. Medications are much more successful when applied at the earliest opportunity (the campfire). When the attack is fully evolved (into a bushfire), medications have a much more modest effect.</p> <p><iframe id="Pj1sC" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/Pj1sC/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe></p> <p><strong>Aspirin</strong></p> <p>For people with mild migraine, non-specific anti-inflammatory medications such as high-dose aspirin, or standard dose non-steroidal medications (NSAIDS) can be very helpful. Their effectiveness is often enhanced with the use of an anti-nausea medication.</p> <p><strong>Triptans</strong></p> <p>For moderate to severe attacks, the mainstay of treatment is a class of medications called “<a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1678146819/Factsheet_15_2023.pdf?1678146819">triptans</a>”. These act by reducing blood vessel dilation and reducing the release of inflammatory chemicals.</p> <p>Triptans vary by their route of administration (tablets, wafers, injections, nasal sprays) and by their time to onset and duration of action.</p> <p>The choice of a triptan depends on many factors including whether nausea and vomiting is prominent (consider a dissolving wafer or an injection) or patient tolerability (consider choosing one with a slower onset and offset of action).</p> <p>As triptans constrict blood vessels, they should be used with caution (or not used) in patients with known heart disease or previous stroke.</p> <p><strong>Gepants</strong></p> <p>Some medications that block or modulate the release of CGRP, which are used for migraine prevention (which we’ll discuss in more detail below), also have evidence of benefit in treating the acute attack. This class of medication is known as the “gepants”.</p> <p>Gepants come in the form of injectable proteins (monoclonal antibodies, used for migraine prevention) or as oral medication (for example, rimegepant) for the acute attack when a person has not responded adequately to previous trials of several triptans or is intolerant of them.</p> <p>They do not cause blood vessel constriction and can be used in patients with heart disease or previous stroke.</p> <p><strong>Ditans</strong></p> <p>Another class of medication, the “ditans” (for example, lasmiditan) have been approved overseas for the acute treatment of migraine. Ditans work through changing a form of serotonin receptor involved in the brain chemical changes associated with the acute attack.</p> <p>However, neither the gepants nor the ditans are available through the Pharmaceutical Benefits Scheme (PBS) for the acute attack, so users must pay out-of-pocket, at a <a href="https://www.migraine.org.au/cgrp#:%7E:text=While%20the%20price%20of%20Nurtec,%2D%24300%20per%208%20wafers.">cost</a> of approximately A$300 for eight wafers.</p> <h2>What about preventing migraines?</h2> <p>The first step is to see if <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043428/Factsheet_5_2023.pdf?1677043428">lifestyle changes</a> can reduce migraine frequency. This can include improving sleep habits, routine meal schedules, regular exercise, limiting caffeine intake and avoiding triggers such as stress or alcohol.</p> <p>Despite these efforts, many people continue to have frequent migraines that can’t be managed by acute therapies alone. The choice of when to start preventive treatment varies for each person and how inclined they are to taking regular medication. Those who suffer disabling symptoms or experience more than a few migraines a month <a href="https://www.nejm.org/doi/full/10.1056/NEJMra1915327">benefit the most</a> from starting preventives.</p> <p>Almost all migraine <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">preventives</a> have existing roles in treating other medical conditions, and the physician would commonly recommend drugs that can also help manage any pre-existing conditions. First-line preventives include:</p> <ul> <li>tablets that lower blood pressure (candesartan, metoprolol, propranolol)</li> <li>antidepressants (amitriptyline, venlafaxine)</li> <li>anticonvulsants (sodium valproate, topiramate).</li> </ul> <p>Some people have none of these other conditions and can safely start medications for migraine prophylaxis alone.</p> <p>For all migraine preventives, a key principle is starting at a low dose and increasing gradually. This approach makes them more tolerable and it’s often several weeks or months until an effective dose (usually 2- to 3-times the starting dose) is reached.</p> <p>It is rare for noticeable benefits to be seen immediately, but with time these drugs <a href="https://pubmed.ncbi.nlm.nih.gov/26252585/">typically reduce</a> migraine frequency by 50% or more.</p> <hr /> <p><iframe id="jxajY" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/jxajY/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe></p> <hr /> <h2>‘Nothing works for me!’</h2> <p>In people who didn’t see any effect of (or couldn’t tolerate) first-line preventives, new medications have been available on the PBS since 2020. These medications <a href="https://pubmed.ncbi.nlm.nih.gov/8388188/">block</a> the action of CGRP.</p> <p>The most common PBS-listed <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">anti-CGRP medications</a> are injectable proteins called monoclonal antibodies (for example, galcanezumab and fremanezumab), and are self-administered by monthly injections.</p> <p>These drugs have quickly become a game-changer for those with intractable migraines. The convenience of these injectables contrast with botulinum toxin injections (also <a href="https://www.migraine.org.au/botox">effective</a> and PBS-listed for chronic migraine) which must be administered by a trained specialist.</p> <p>Up to half of adolescents and one-third of young adults are <a href="https://deepblue.lib.umich.edu/bitstream/handle/2027.42/147205/jan13818.pdf">needle-phobic</a>. If this includes you, tablet-form CGRP antagonists for migraine prevention are hopefully not far away.</p> <p>Data over the past five years <a href="https://pubmed.ncbi.nlm.nih.gov/36718044/">suggest</a> anti-CGRP medications are safe, effective and at least as well tolerated as traditional preventives.</p> <p>Nonetheless, these are used only after a number of cheaper and more readily available <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043425/Factsheet_2_2023.pdf?1677043425">first-line treatments</a> (all which have decades of safety data) have failed, and this also a criterion for their use under the PBS.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/227559/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, Associate Professor, Clinical Academic Neurologist, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, Lecturer, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-in-my-brain-when-i-get-a-migraine-and-what-medications-can-i-use-to-treat-it-227559">original article</a>.</em></p> </div>

Body

Pauline Hanson's surprising act of kindness for struggling family

<p>Pauline Hanson has revealed a surprising act of kindness for a struggling Queensland family, who have been battling the private healthcare system. </p> <p>Nine year old Kadee Byrnes, from Yeppoon, about 740km north of Brisbane, has been on the public hospital waiting list for seven years waiting for the adenoid surgery she desperately needs.</p> <p>The surgery is a procedure to remove the adenoids, small tissue lumps in the nasal cavity, to address her chronic tonsillitis.</p> <p>While on the waitlist, Kadee had to repeat the fourth grade after missing so much school due to reoccurring infections. </p> <p>After hearing of Kadee's plight, the One Nation senator said she was "disgusted" the young girl had to wait so long for surgery and promised to cover the cost of her private treatment.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Queensland Senator Pauline Hanson has promised to cover the surgery costs for a nine year old Yeppoon girl, who has been on the public hospital waiting list for more than seven years. <a href="https://t.co/WbYeQT6ZHu">https://t.co/WbYeQT6ZHu</a> <a href="https://twitter.com/cpenny_6?ref_src=twsrc%5Etfw">@CPenny_6</a> <a href="https://twitter.com/hashtag/7NEWS?src=hash&ref_src=twsrc%5Etfw">#7NEWS</a> <a href="https://t.co/AdToZNR6Ii">pic.twitter.com/AdToZNR6Ii</a></p> <p>— 7NEWS Central Queensland (@7NewsCQ) <a href="https://twitter.com/7NewsCQ/status/1817847532908912803?ref_src=twsrc%5Etfw">July 29, 2024</a></p></blockquote> <p>"I'm grateful for the opportunity to help 9-year-old Kadee by covering the cost of her private treatment," Ms Hanson said on Tuesday.</p> <p>"It is unacceptable that young Kadee was told she would have to repeat Grade 4 due to missing so many school days because of tonsillitis."</p> <p>"Situations like this are sadly all too common and highlight the severe consequences of the Labor government's lack of investment in our public hospitals, especially outside South East Queensland."</p> <p>Senator Hanson broke the happy news to Kadee's mother, Kahlia, at a speaking event in Roslyn Bay.</p> <p>"Straight away, I said we're going to get this operation done. Kahlia you don't know, I'm paying for it, all right, I'm going to pay for it," Senator Hanson said. </p> <p>Kahlia said she was grateful for Senator Hanson's generosity and to see her daughter finally have a normal life. </p> <p>"I am very that it's going to end this way," Kahlia said. "She is finally going to have a surgery and she is finally going to be able to live a life as a normal nine year old."</p> <p><em>Image credits: 7News </em></p> <p class="mol-para-with-font" style="font-size: 16px; margin: 0px 0px 16px; padding: 0px; min-height: 0px; letter-spacing: -0.16px; font-family: Inter, sans-serif;"> </p> <p> </p>

Caring

Think you’ve decided what to buy? Actually, your brain is still deciding – even as you put it in your basket

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/tijl-grootswagers-954175">Tijl Grootswagers</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>; <a href="https://theconversation.com/profiles/genevieve-l-quek-1447582">Genevieve L Quek</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>, and <a href="https://theconversation.com/profiles/manuel-varlet-156210">Manuel Varlet</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p>You are standing in the cereal aisle, weighing up whether to buy a healthy bran or a sugary chocolate-flavoured alternative.</p> <p>Your hand hovers momentarily before you make the final grab.</p> <p>But did you know that during those last few seconds, while you’re reaching out, your brain is still evaluating the pros and cons – influenced by everything from your last meal, the health star rating, the catchy jingle in the ad, and the colours of the letters on the box?</p> <p>Our recently published <a href="https://www.nature.com/articles/s41598-024-62135-7">research</a> shows our brains do not just think first and then act. Even while you are reaching for a product on a supermarket shelf, your brain is still evaluating whether you are making the right choice.</p> <p>Further, we found measuring hand movements offers an accurate window into the brain’s ongoing evaluation of the decision – you don’t have to hook people up to expensive brain scanners.</p> <p>What does this say about our decision-making? And what does it mean for consumers and the people marketing to them?</p> <h2>What hand movements tell us about decision-making</h2> <p>There has been <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-psych-010419-051053">debate within neuroscience</a> on whether a person’s movements to enact a decision can be modified once the brain’s “motor plan” has been made.</p> <p>Our research revealed not only that movements can be changed after a decision – “in flight” – but also the changes matched incoming information from a person’s senses.</p> <p>To study <a href="https://doi.org/10.1038/s41598-024-62135-7">how our decisions unfold over time</a>, we tracked people’s hand movements as they reached for different options shown in pictures – for example, in response to the question “is this picture a face or an object?”</p> <p>When choices were easy, their hands moved straight to the right option. But when choices were harder, new information made the brain change its mind, and this was reflected in the trajectory of their hand movements.</p> <p>When we compared these hand movement trajectories to brain activity recorded using neuroimaging, we found that the timing and amount of evidence of the brain’s evaluation matched the movement pattern.</p> <p>Put simply, reaching movements are shaped by ongoing thinking and decision-making.</p> <p>By showing that brain patterns match movement trajectories, our research also highlights that large, expensive brain scanners may not always be required to study the brain’s decision evaluation processes, as movement tracking is much more cost-effective and much easier to test on a large scale.</p> <h2>What does this mean for consumers and marketers?</h2> <p>For consumers, knowing our brains are always reevaluating decisions we might think of as “final” can help us be more aware of our choices.</p> <p>For simple decisions such as choosing a breakfast cereal, the impact may be small. Even if you have preemptively decided on a healthy option, you might be tempted at the last minute by the flashy packaging of a less healthy choice.</p> <p>But for important long-term decisions such as choosing a mortgage, it can have serious effects.</p> <p>On the other side of the coin, marketers have long known that many purchase decisions are <a href="https://www.sciencedirect.com/science/article/pii/S0969698912000781">made on the spot</a>.</p> <p>They use strategies such as attractive packaging and strategic product placement to influence people’s decisions.</p> <p>New ways of studying how people’s brains process information – right up to the last minute – can help marketers design more effective strategies.</p> <h2>Opportunities for further research</h2> <p>Further research in this area could explore how different types of information, such as environmental cues or memories, affect this continuous decision evaluation process in different groups of people. For example, how do people of different ages process information while making decisions?</p> <p>Our finding – that hand movements reflect the inner workings of the brain’s decision making process – could make future studies cheaper and more efficient.</p> <p>The ability to fine-tune marketing in this way has implications beyond just selling products. It can also make public strategic messaging far more effective.</p> <p>This could include tailoring a public health campaign on vaping specifically for people aged under 30, or targeting messaging about superannuation scams more effectively at those of retirement age.</p> <p>The act of reaching for a product is not a simple consequence of a decision already made; it’s a highly dynamic process. Being aware of what influences our last-minute decision-making can help us make better choices that have better outcomes.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/234167/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/tijl-grootswagers-954175">Tijl Grootswagers</a>, Senior Research Fellow in Cognitive Neuroscience, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>; <a href="https://theconversation.com/profiles/genevieve-l-quek-1447582">Genevieve L Quek</a>, Research Fellow, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>, and <a href="https://theconversation.com/profiles/manuel-varlet-156210">Manuel Varlet</a>, Associate Professor in Cognitive Neuroscience, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/think-youve-decided-what-to-buy-actually-your-brain-is-still-deciding-even-as-you-put-it-in-your-basket-234167">original article</a>.</em></p> </div>

Mind

Dr Charlie Teo's surprising next move after Aussie surgery restrictions

<p>One year after being slapped with restrictions that effectively stopped him from operating in Australia, Dr Charlie Teo is restarting his career overseas. </p> <p>The neurosurgeon was investigated by Australia’s Health Care Complaints Commission, who last year placed restrictions on the surgeon after they discovered he had been operating on tumours that had been deemed "inoperable". </p> <p>Now, one of China’s most respected neurosurgeons has thanked Australia for imposing such restrictions because it has allowed her country to benefit from the controversial surgeon’s ability to remove high-risk brain tumours.</p> <p>Dr Teo has been operating regularly in China including on high profile VIPs, and at least eight other countries around the world, according to reports from the <em>Sunday Telegraph</em>. </p> <p>An investigation has found Dr Teo has operated on 150 patients, with many of them being from Australia, in China, Spain, Germany, India, Switzerland, Brazil, Peru, South Africa, and Nepal since the restrictions effectively stopped him from operating in Australia.</p> <p>In an interview from Beijing, Professor Ling Feng, Deputy Director of the China International Neuroscience Institute, said she is “not worried” about the restrictions imposed on Dr Teo a year ago for unsatisfactory conduct.</p> <p>“I took a careful look into what happened over there. I don’t think it should be imputed to Charlie’s neglect of care and passion for the patients,” Professor Ling told the <em>Sunday Telegraph</em>.</p> <p>“It is just a different view of the indications for surgery. Similar cases occur across the world. Instead, I ‘thank’ Australia for the restrictions on Charlie, which gave me the opportunity to work with him.”</p> <p>In the past year, patients have travelled from Australia, Romania, Britain, Saudi Arabia, France, Indonesia, and Singapore to have Dr Teo operate.</p> <p>Of those surgeries Dr Teo’s logbook documents one death, one “poor” outcome, three “fair outcomes”, 20 “good outcomes” and 145 cases have been documented as “excellent”.</p> <p>Dr Teo says his results are better than ever and he feels terrible for patients in his own country that he can’t help, but hopes that he may one day be able to return to Australian operating rooms to help patients. </p> <p>“All it would take is one sensible and brave person in one hospital somewhere in Australia to change the status quo,” Dr Teo said.</p> <p>“Just one person to sit back and go ‘okay he might be an a**hole, he might be into money, he might be a bit of a cowboy, he might be all the things the media have said he might be, but the fact is that patients, Australian patients, some need him and he does operations that other people don’t do and most of those outcomes are good so what about we just drop the politics and allow him to operate in Australia?"</p> <p>“That’s all it would take … some common sense for the greater good, not for his sake but for the sake of patients.”</p> <p><em>Image credits: Instagram </em></p>

Caring

Grisly find in Sam Armytage's surgery

<p>Samantha Armytage has revealed the grisly find doctors made when she underwent hip replacement <a href="https://www.oversixty.com.au/health/caring/sam-armytage-in-hospital-for-major-surgery" target="_blank" rel="noopener">surgery</a>. </p> <p><em>The Farmer Wants A Wife </em>host, 47, took to Instagram to share a photo of a piece of cartilage surgeons removed from her joint during the surgery. </p> <p>“Do you want to see something disgusting from my recent operation?” she began with a warning to more squeamish followers. </p> <p>“Lol. I knew you’d all look,” she continued.</p> <p>“This is a 3cm chunk of rock-like cartilage that’s been floating around inside my hip joint for decades. As my surgeon said; ‘you must have been in soooooo much pain!’ I was.”</p> <p>The TV star previously said that she had a skiing accident 30 years ago, which took a toll on her right hip. </p> <p>“I’d torn all the cartilage out,” she wrote on Instagram at the time.</p> <p>“It was bone-on-bone and then became full of severe osteoarthritis.”</p> <p>“I’m now truly bionic and my nearest and dearest are pleased to not have to watch me limp around in pain anymore,” Armytage said.</p> <p>“Huge thanks to the wonderful nurses (at St Vincent’s Hospital Sydney) for the care, a lil’ bit of Endone … heaps of rehab and all my beautiful friends for my flower-filled room!”</p> <p><em>Images: Instagram</em></p>

Body

Sam Armytage in hospital for major surgery

<p>Former <em>Sunrise </em>host Samantha Armytage has undergone major hip replacement surgery following a severe case of osteoarthritis. The 47-year-old TV personality shared her journey on Instagram on Tuesday, posting photos from St Vincent's Private Hospital in Sydney.</p> <p>Armytage revealed in a detailed caption that she had been struggling with osteoarthritis after tearing the cartilage in her right hip. This condition, a degenerative joint disease, causes the tissues in the joint to break down over time and is more prevalent among older individuals.</p> <p>Reflecting on her experience, the host of <em>The Farmer Wants a Wife</em> explained that the hip replacement was necessary to address the bone-on-bone friction and the severe osteoarthritis. Despite the challenges, she reassured her followers that her recovery is progressing well.</p> <p>"Hip, hip hooray. New hip, new me, no worries," she wrote. "A few weeks ago, I had a total hip replacement. After a very active, outdoorsy childhood (& a skiing accident 30 years ago), I'd torn all the cartilage out of my right hip. It was bone-on-bone & then became full of severe osteoarthritis. I'm so proud of how strong my body is & how well I've healed. I'm now truly bionic...& my nearest & dearest are pleased to not have to watch me limp around in pain anymore."</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/C85u8pqPlGS/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C85u8pqPlGS/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Samantha Armytage (@sam_armytage)</a></p> </div> </blockquote> <p>Armytage extended her gratitude to the medical staff and her loved ones, adding a touch of humour by sharing a photo of herself with a bit of Endone, a pain relief medication. She also praised her surgeon, Dr Michael Solomon, highlighting that hip replacements are common in Australia, with approximately 54,000 performed each year.</p> <p>Her post quickly garnered support from friends and fans alike. Presenter Kylie Gillies suggested a celebratory purchase, writing, "I think this deserves a new pair of Jimmy Choos …just to kick up those old heels and new hip! Glad to hear it’s gone well x" Meanwhile, singer Ricki-Lee Coulter expressed her encouragement, saying, "You’ll be dancing in no time. Sending you love xxx"</p> <p>Fans also chimed in with well wishes and supportive messages. One commented, "Good luck with the recovery and welcome to the Hip New Hip Gals Club," while another noted, "Oh a bit young for that Sam. Good luck on your recovery."</p> <p>Recovery from hip replacement surgery can be a lengthy process, often requiring dedicated physiotherapy. However, with her positive outlook and the support of her community, Samantha Armytage is well on her way to a full recovery.</p> <p><em>Images: Instagram</em></p>

Caring

I’ve been given opioids after surgery to take at home. What do I need to know?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/katelyn-jauregui-1527878">Katelyn Jauregui</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/asad-patanwala-1529611">Asad Patanwala</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jonathan-penm-404921">Jonathan Penm</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/shania-liu-1433659">Shania Liu</a>, <a href="https://theconversation.com/institutions/university-of-alberta-1232">University of Alberta</a></em></p> <p>Opioids are commonly prescribed when you’re discharged from hospital after surgery to help manage pain at home.</p> <p>These strong painkillers may have unwanted side effects or harms, such as constipation, drowsiness or the risk of dependence.</p> <p>However, there are steps you can take to minimise those harms and use opioids more safely as you recover from surgery.</p> <h2>Which types of opioids are most common?</h2> <p>The <a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">most commonly prescribed</a> opioids after surgery in Australia are oxycodone (brand names include Endone, OxyNorm) and tapentadol (Palexia).</p> <p>In fact, <a href="https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/bcp.16063">about half</a> of new oxycodone prescriptions in Australia occur after a recent hospital visit.</p> <p><a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">Most commonly</a>, people will be given immediate-release opioids for their pain. These are quick-acting and are used to manage short-term pain.</p> <p>Because they work quickly, their dose can be easily adjusted to manage current pain levels. Your doctor will provide instructions on how to adjust the dosage based on your pain levels.</p> <p>Then there are slow-release opioids, which are specially formulated to slowly release the dose over about half to a full day. These may have “sustained-release”, “controlled-release” or “extended-release” on the box.</p> <p>Slow-release formulations are primarily used for chronic or long-term pain. The slow-release form means the medicine does not have to be taken as often. However, it takes longer to have an effect compared with immediate-release, so it is not commonly used after surgery.</p> <p>Controlling your pain after surgery is <a href="https://www.nps.org.au/assets/4811a27845042173-00a4ff09097b-postoperative-pain-management_36-202.pdf">important</a>. This allows you get up and start moving sooner, and recover faster. Moving around sooner after surgery prevents muscle wasting and harms associated with immobility, such as bed sores and blood clots.</p> <p>Everyone’s pain levels and needs for pain medicines are different. Pain levels also decrease as your surgical wound heals, so you may need to take less of your medicine as you recover.</p> <h2>But there are also risks</h2> <p>As mentioned above, side effects of opioids include constipation and feeling drowsy or nauseous. The drowsiness can also make you more likely to fall over.</p> <p>Opioids prescribed to manage pain at home after surgery are usually prescribed for short-term use.</p> <p>But up to <a href="https://pubmed.ncbi.nlm.nih.gov/35545810/">one in ten</a> Australians still take them up to four months after surgery. <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/msc.1837">One study</a> found people didn’t know how to safely stop taking opioids.</p> <p>Such long-term opioid use may lead to dependence and overdose. It can also reduce the medicine’s effectiveness. That’s because your body becomes used to the opioid and needs more of it to have the same effect.</p> <p>Dependency and side effects are also more common with <a href="https://www.anzca.edu.au/getattachment/535097e6-9f50-4d09-bd7f-ffa8faf02cdd/Prescribing-slow-release-opioids-4-april-2018#:%7E:text=%E2%80%9CSlow%2Drelease%20opioids%20are%20not,its%20Faculty%20of%20Pain%20Medicine.">slow-release opioids</a> than immediate-release opioids. This is because people are usually on slow-release opioids for longer.</p> <p>Then there are concerns about “leftover” opioids. One study found 40% of participants were prescribed <a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">more than twice</a> the amount they needed.</p> <p>This results in unused opioids at home, which <a href="https://www.anzca.edu.au/getattachment/558316c5-ea93-457c-b51f-d57556b0ffa7/PS41-Guideline-on-acute-pain-management">can be dangerous</a> to the person and their family. Storing leftover opioids at home increases the risk of taking too much, sharing with others inappropriately, and using without doctor supervision.</p> <h2>How to mimimise the risks</h2> <p>Before using opioids, speak to your doctor or pharmacist about using over-the-counter pain medicines such as paracetamol or anti-inflammatories such as ibuprofen (for example, Nurofen, Brufen) or diclofenac (for example, Voltaren, Fenac).</p> <p>These can be quite effective at controlling pain and will lessen your need for opioids. They can often be used instead of opioids, but in some cases a combination of both is needed.</p> <p>Other techniques to manage pain include physiotherapy, exercise, <a href="https://theconversation.com/hot-pack-or-cold-pack-which-one-to-reach-for-when-youre-injured-or-in-pain-161086">heat packs or ice packs</a>. Speak to your doctor or pharmacist to discuss which techniques would benefit you the most.</p> <p>However, if you do need opioids, there are some ways to make sure you use them <a href="https://www.safetyandquality.gov.au/sites/default/files/2022-04/opioid-analgesic-stewardship-in-acute-pain-clinical-care-standard.pdf">safely and effectively</a>:</p> <ul> <li> <p>ask for <a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.16085">immediate-release</a> rather than slow-release opioids to lower your risk of side effects</p> </li> <li> <p>do not drink alcohol or take sleeping tablets while on opioids. This can increase any drowsiness, and lead to reduced alertness and slower breathing</p> </li> <li> <p>as you may be at higher risk of falls, remove trip hazards from your home and make sure you can safely get up off the sofa or bed and to the bathroom or kitchen</p> </li> <li> <p>before starting opioids, have a plan in place with your doctor or pharmacist about how and when to stop taking them. Opioids after surgery are ideally taken at the lowest possible dose for the shortest length of time.</p> </li> </ul> <h2>If you’re concerned about side effects</h2> <p>If you are concerned about side effects while taking opioids, speak to your pharmacist or doctor. Side effects include:</p> <ul> <li> <p><a href="https://theconversation.com/health-check-what-causes-constipation-114290">constipation</a> – your pharmacist will be able to give you lifestyle advice and recommend laxatives</p> </li> <li> <p>drowsiness – do not drive or operate heavy machinery. If you’re trying to stay awake during the day, but keep falling asleep, your dose may be too high and you should contact your doctor</p> </li> <li> <p>weakness and slowed breathing – this may be a sign of a more serious side effect such as respiratory depression which requires medical attention. Contact your doctor immediately.</p> </li> </ul> <h2>If you’re having trouble stopping opioids</h2> <p>Talk to your doctor or pharmacist if you’re having trouble stopping opioids. They can give you alternatives to manage the pain and provide advice on gradually lowering your dose.</p> <p>You may experience withdrawal effects, such as agitation, anxiety and insomnia, but your doctor and pharmacist can help you manage these.</p> <h2>How about leftover opioids?</h2> <p>After you have finished using opioids, take any leftovers to your local pharmacy to <a href="https://theconversation.com/health-check-what-should-you-do-with-your-unused-medicine-81406">dispose of them safely</a>, free of charge.</p> <p>Do not share opioids with others and keep them away from others in the house who do not need them, as opioids can cause unintended harms if not used under the supervision of a medical professional. This could include accidental ingestion by children.</p> <hr /> <p><em>For more information, speak to your pharmacist or doctor. Choosing Wisely Australia also has <a href="https://www.choosingwisely.org.au/resources/consumers-and-carers/patient-guide-to-managing-pain-and-opioid-medicines">free online information</a> about managing pain and opioid medicines.</em><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/228615/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/katelyn-jauregui-1527878">Katelyn Jauregui</a>, PhD Candidate and Clinical Pharmacist, School of Pharmacy, Faculty of Medicine and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/asad-patanwala-1529611">Asad Patanwala</a>, Professor, Sydney School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jonathan-penm-404921">Jonathan Penm</a>, Senior lecturer, School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/shania-liu-1433659">Shania Liu</a>, Postdoctoral Research Fellow, Faculty of Medicine and Dentistry, <a href="https://theconversation.com/institutions/university-of-alberta-1232">University of Alberta</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ive-been-given-opioids-after-surgery-to-take-at-home-what-do-i-need-to-know-228615">original article</a>.</em></p> </div>

Body

John Farnham steps out at son's wedding for first time since jaw surgery

<p>Beloved Aussie rock legend John Farnham exuded pride and joy as he stepped out in style at his son Robert's wedding on the weekend. After enduring extensive surgery due to oral cancer, Farnham, now cancer-free, appeared in high spirits at the intimate wedding of his oldest son and his new wife, Melissa.</p> <p>The 74-year-old icon looked remarkably well and largely unchanged since his challenging surgery in August 2022. In the heartwarming photos shared on Instagram, John posed alongside his son, both beaming with happiness. John looked dapper in a black suit with a bronze tie and matching pocket square, while Rob opted for a stylish white tux with black accents.</p> <p>The joyous occasion was beautifully captured in a series of family photos, including John's wife, Jill, and other close family members. Fans flooded the comments with heartfelt messages, celebrating the happy family and John's remarkable recovery. "Such a beautiful father and son pic," one fan wrote, while another added, "Congratulations to you both. It's so nice to see your Dad, he looks fantastic! Love to you all."</p> <p>The bride, Melissa, looked stunning in an off-the-shoulder ivory gown, posing for romantic photos with her new husband against the lush backdrop of their wedding venue. Rob's touching caption on Instagram encapsulated the joy of the day: "Shared the happiest moment with my favourite person in the universe and she said I do. Melissa, my life is forever better that you’re apart of it. You looked radiant, beautiful and elegant. I can’t wait to see what the future has in store for us and I’m truly honoured to have you by my side as my wife for life❤️."</p> <p>The couple had announced their engagement in November 2022, with Rob expressing his excitement about their future together: "My best friend and love of my life said yes to marrying me. I can't wait to spend the rest of my life with you."</p> <p>John Farnham's presence at the wedding was particularly special, as it marked a year since his successful battle against cancer. In August 2023, Farnham revealed he was cancer-free, a triumph after numerous surgeries and a challenging recovery process. In a heartfelt statement, he shared his gratitude: "It's been a year since my first surgery and to be honest, I've lost count as to how many other procedures there have been since then. But, I'm home now and I'm a very grateful and happy man. I'm sitting here in my living room lapping up the attention from my beautiful wife, Jill, my boys Rob and James, and my mini Schnauzer, Edmund."</p> <p>Throughout his recovery, John's family provided updates on his progress. His son Robert shared that his father was "doing fantastic" after a 12-hour surgery for throat cancer and was even dancing a little and walking his dog regularly. "He's really, really happy. He's doing really good, he's super positive," Robert said in an interview.</p> <p>While it is unlikely that John will perform again after his extensive surgery, the love and joy he shared at his son's wedding are a beautiful reminder of life's precious moments.</p> <p><em>Images: Instagram</em></p>

Relationships

AFL great's son in induced coma after mystery brain infection

<p>Geelong great Peter Riccardi has revealed his son, Osca, was briefly put on life support after suffering a mystery infection on the brain. </p> <p>Speaking on the podcast Beyond The Boundary, the former AFL player revealed that his son became suddenly ill a fortnight ago. </p> <p>“A couple of Sundays ago (Osca) came home, been out with a few of his mates, he’d been to the beach, went out for dinner, went out to play 10-pin bowling ... and said he was going to bed,” Peter Riccardi said. </p> <p>“Then halfway through the night he was up, he was vomiting, he was feeling a bit crook ... we just thought he was run down.</p> <p>“But come lunchtime, he couldn’t talk, he could hardly walk.”</p> <p>He added that they were extremely lucky his wife Mel worked from home that day and rushed Osca straight to hospital, where they found some "swelling" on his brain following a scan. </p> <p>Doctors also found that he had a sinus and ear infection and glandular fever all “rolled into one”.</p> <p>“Whether the swim did something with his ears and went into his brain, I’m not 100 per cent sure, yet,” Riccardi said.</p> <p>“They put him an induced coma for three days. He was in ICU (Intensive Care Unit) for four days.</p> <p>“But he’s back home now recovering ... you wouldn’t know that two weeks ago, watching him on life support, and seeing him now, it’s amazing what they do in there.”</p> <p>The podcast hosts then asked how scary the situation was for Riccardi and his wife, and he responded: “It was, yeah ... obviously they have got to prepare you for the worst (outcome)."</p> <p>“That was probably the worst thing to hear, because we didn’t know how he was going to come out of it.</p> <p>“But again, like I said, if Mel had gone to work that day, he wouldn’t be here today.</p> <p>“We’re pretty lucky, we’re pretty lucky.</p> <p>“It must have been a mother’s intuition or mother’s instinct to stay at home that day.”</p> <p><em>Image: Facebook/ Geelong Cats</em></p>

Caring

Beloved Home and Away star shares major health update

<p><em>Home and Away</em> star Georgie Parker has shocked her online followers by revealing she has undergone a major surgery. </p> <p>The actress, who plays Roo Stewart in the Channel Seven soap, is currently recovering from her second hip replacement and this week posted a series of pictures taken from her hospital bed after the operation.</p> <p>Now three weeks into her recovery, the 59-year-old is undergoing extensive rehabilitation.</p> <p>“I’ve been busy. Finishing a play and then straight into another theatre (get it) for a new hip,” she said on Instagram.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/p/C7rI2iApE3K/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C7rI2iApE3K/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by georgieparker (@georgieparker)</a></p> </div> </blockquote> <p>“My second in six years, and thank god I had the same brilliant surgeon and his team."</p> <p>“I hate the drugs but love the rehab. I’m three weeks post op, recovery is going well and I’ve had the most brilliant support from my family, my workplace and my incredible friends.”</p> <p>She ended her post saying, “Practising patience now while I heal ... so I can get back to work baby.”</p> <p>Parker's famous friends took to the comments to wish her the best during her recovery, including fellow actor Hugh Sheridan who said, “Hip hip hooray!! We’ll be bending and stretching on play school together again in no time.”</p> <p>“Wishing you the speediest of recoveries Georgie!” actor Kat Stewart said.</p> <p>Parker previously spoke out about living with scoliosis, something she has suffered from since a child when she dreamed of becoming a dancer. </p> <p>“Every scoliosis is different, it’s like a fingerprint — but mine is all in the torso, I’ve lost about three inches (7.6cm) in height,” she told <a href="https://www.bodyandsoul.com.au/health/celebrity-profiles/how-the-home-and-away-stars-stay-healthy-all-year-round/news-story/a4072ec268f7e26cbc4926faf4e7fede" target="_blank" rel="noopener" data-link-type="article-inline"><em>Body + Soul</em> in 2020. </a></p> <p>“It impacts me on a daily basis and I just have to stay fit to keep my back as functional as possible.”</p> <p><em>Image credits: Instagram </em></p>

Caring

Major TV star's 7-year-old undergoes third open heart surgery

<p>Jimmy Kimmel's seven-year-old son has undergone his third, and hopefully final open heart surgery after being born with congenital heart disease. </p> <p>In 2017, Jimmy <a href="https://www.youtube.com/watch?v=MmWWoMcGmo0" target="_blank" rel="noopener">revealed</a> that Billy was only three days old when had to undergo his first open heart surgery, after doctors found “a hole in the wall of the left and right side of his heart” that was preventing enough oxygen from reaching his blood. </p> <p>Billy was only seven months old when he had to undergo his second open heart surgery, and over the weekend he had to undergo his third major surgery at the Children's Hospital Los Angeles. </p> <p>A few days later, the TV host took to Instagram to share an update following his son's successful surgery. </p> <p>"We went into this experience with a lot of optimism and nearly as much fear and came out with a new valve inside a happy, healthy kid," Kimmel wrote, alongside a picture of his youngest son smiling in a hospital bed. </p> <p>He then thanked all the surgeons, doctors and other medical staff who "came through for us with immeasurable kindness and expertise." </p> <p>"Walking around this hospital, meeting parents at their most vulnerable, children in pain and the miracle workers who do everything in their considerable power to save them is a humbling experience," Kimmel continued.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/p/C7fE-p4S7YN/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C7fE-p4S7YN/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Jimmy Kimmel (@jimmykimmel)</a></p> </div> </blockquote> <p>He then highlighted the hospital's dedication to providing help to families "regardless of their ability to pay". </p> <p>Jimmy then extended his thanks to his family and friends and the "loving strangers who took time to pray for and send positive energy to our baby".</p> <p>He gave a special shout out to his wife Molly – for "being stronger than is reasonable for any Mum to be". The pair also share daughter Jane, nine. </p> <p>The late night TV host then praised his son for being "the toughest (and funniest) 7 year-old we know."</p> <p>"There are so many parents and children who aren't fortunate enough to go home after five days," he added and encouraged his followers to send their thoughts and prayers to these families. </p> <p><em>Image: Instagram/ X</em></p> <p> </p>

Caring

After 180 years, new clues are revealing just how general anaesthesia works in the brain

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/adam-d-hines-767066">Adam D Hines</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a></em></p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4773932/pdf/BLT.15.159293.pdf/">Over 350 million surgeries</a> are performed globally each year. For most of us, it’s likely at some point in our lives we’ll have to undergo a procedure that needs general anaesthesia.</p> <p>Even though it is one of the safest medical practices, we still don’t have a complete, thorough understanding of precisely how anaesthetic drugs work in the brain.</p> <p>In fact, it has largely remained a mystery since general anaesthesia was introduced into medicine over <a href="https://www.tandfonline.com/doi/full/10.3109/08941939.2015.1061826">180 years ago</a>.</p> <p>Our study published <a href="https://doi.org/10.1523/JNEUROSCI.0588-23.2024">in The Journal of Neuroscience today</a> provides new clues on the intricacies of the process. General anaesthetic drugs seem to only affect specific parts of the brain responsible for keeping us alert and awake.</p> <h2>Brain cells striking a balance</h2> <p>In a study using fruit flies, we found a potential way that allows anaesthetic drugs to interact with specific types of neurons (brain cells), and it’s all to do with proteins. Your brain has around <a href="https://onlinelibrary.wiley.com/doi/10.1002/cne.21974">86 billion neurons</a> and not all of them are the same – it’s these differences that allow general anaesthesia to be effective.</p> <p>To be clear, we’re not completely in the dark on <a href="https://linkinghub.elsevier.com/retrieve/pii/S0165614719300951">how anaesthetic drugs affect us</a>. We know why general anaesthetics are able to make us lose consciousness so quickly, thanks to a <a href="https://www.nature.com/articles/367607a0">landmark discovery made in 1994</a>.</p> <p>But to better understand the fine details, we first have to look to the minute differences between the cells in our brains.</p> <p>Broadly speaking, there are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6591655/">two main categories of neurons in the brain</a>.</p> <p>The first are what we call “excitatory” neurons, generally responsible for keeping us alert and awake. The second are “inhibitory” neurons – their job is to regulate and control the excitatory ones.</p> <p>In our day-to-day lives, excitatory and inhibitory neurons are constantly working and balancing one another.</p> <p><a href="https://www.nature.com/articles/npp2017294">When we fall asleep</a>, there are inhibitory neurons in the brain that “silence” the excitatory ones keeping us awake. This happens <a href="https://askdruniverse.wsu.edu/2018/01/07/why-do-we-get-tired/">gradually over time</a>, which is why you may feel progressively more tired through the day.</p> <p>General anaesthetics speed up this process by directly silencing these excitatory neurons without any action from the inhibitory ones. This is why your anaesthetist will tell you that they’ll “put you to sleep” for the procedure: <a href="https://www.nature.com/articles/nrn2372">it’s essentially the same process</a>.</p> <h2>A special kind of sleep</h2> <p>While we know why anaesthetics put us to sleep, the question then becomes: “why do we <em>stay</em> asleep during surgery?”. If you went to bed tonight, fell asleep and somebody tried to do surgery on you, you’d wake up with quite a shock.</p> <p>To date, there is no strong consensus in the field as to why general anaesthesia causes people to remain unconscious during surgery.</p> <p>Over the last couple of decades, researchers have proposed several potential explanations, but they all seem to point to one root cause. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7709148/#:%7E:text=At%20presynaptic%20part%2C%20voltage%2Dgated,anesthetics%20to%20inhibiting%20neurotransmitter%20release.">Neurons stop talking to each other</a> when exposed to general anaesthetics.</p> <p>While the idea of “cells talking to each other” may sound a little strange, it’s a <a href="https://qbi.uq.edu.au/brain-basics/brain/brain-physiology/action-potentials-and-synapses">fundamental concept in neuroscience</a>. Without this communication, our brains wouldn’t be able to function at all. And it allows the brain to know what’s happening throughout the body.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" alt="Two branching structures in orange, green, blue and yellow colours on a black background." /></a><figcaption><span class="caption">Colourised neurons in the brain of a fly.</span> <span class="attribution"><span class="source">Adam Hines</span></span></figcaption></figure> <h2>What did we discover?</h2> <p>Our new study shows that general anaesthetics appear to stop excitatory neurons from communicating, but not inhibitory ones. <a href="https://www.jneurosci.org/content/40/21/4103">This concept isn’t new</a>, but we found some compelling evidence as to <em>why</em> only excitatory neurons are affected.</p> <p>For neurons to communicate, proteins have to get involved. One of the jobs these proteins have is to get neurons to release molecules called <a href="https://my.clevelandclinic.org/health/articles/22513-neurotransmitters">neurotransmitters</a>. These chemical messengers are what gets signals across from one neuron to another: dopamine, adrenaline and serotonin are all neurotransmitters, for example.</p> <p>We found that general anaesthetics impair the ability of these proteins to release neurotransmitters, but only in excitatory neurons. To test this, we used <a href="https://www.eneuro.org/content/8/3/ENEURO.0057-21.2021"><em>Drosophila melanogaster</em> fruit flies</a> and <a href="https://imb.uq.edu.au/research/facilities/microscopy/training-manuals/microscopy-online-resources/image-capture/super-resolution-microscopy">super resolution microscopy</a> to directly see what effects a general anaesthetic was having on these proteins at a molecular scale.</p> <p>Part of what makes excitatory and inhibitory neurons different from each other is that they <a href="https://journals.physiology.org/doi/full/10.1152/physrev.00007.2012">express different types of the same protein</a>. This is kind of like having two cars of the same make and model, but one is green and has a sports package, while the other is just standard and red. They both do the same thing, but one’s just a little bit different.</p> <p>Neurotransmitter release is a complex process involving lots of different proteins. If one piece of the puzzle isn’t exactly right, then general anaesthetics won’t be able to do their job.</p> <p>As a next research step, we will need to figure out which piece of the puzzle is different, to understand why general anaesthetics only stop excitatory communication.</p> <p>Ultimately, our results hint that the drugs used in general anaesthetics cause massive global inhibition in the brain. By silencing excitability in two ways, these drugs put us to sleep and keep it that way.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/229713/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/adam-d-hines-767066">Adam D Hines</a>, Research fellow, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/after-180-years-new-clues-are-revealing-just-how-general-anaesthesia-works-in-the-brain-229713">original article</a>.</em></p> </div>

Body

“My darling wife": Newlywed's tragic death overseas

<p>Madison Noronha (née Chatham) was in Amsterdam with her husband Kyle Noronha after only a few weeks of getting married when she suddenly collapsed on the street. </p> <p>When she was rushed to hospital last week, scans revealed that she had suffered a brain aneurysm and despite getting immediate surgery to relieve the pressure, she unfortunately <span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">could</span><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;"> not be saved. </span></p> <p>“Madi fought like she always does right to the very end,” her heartbroken husband wrote on social media. </p> <p>She passed away in his arms and was surrounded by loved ones. </p> <p>“My darling wife I cannot comprehend what has happened, I’m in a million pieces. Forever and always babe.”</p> <p>Now, her family have set up a <a href="https://www.gofundme.com/f/madison-noronha-chatham" target="_blank" rel="noopener">GoFundMe</a> in attempt to raise funds to “help with flights, funeral costs and to help bring our beloved Madison home to be laid to rest”.</p> <p>Since the launch of the fundraiser, people have come together and raised over $30,000 for the family. </p> <p>Taylah Wicks, the organiser of the fundraiser and a family friend, said that Madison was loved and cherished beyond measure”.</p> <p>“We are all left heart broken, but can’t imagine the pain that Kyle and her immediate family are experiencing,” she wrote on the page.</p> <p><em>Image: GoFundMe</em></p>

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After 180 years, new clues are revealing just how general anaesthesia works in the brain

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