An impression of Bangkok

I had the incredible opportunity to go to Bangkok not once, but twice this year for work. I had a few hours to be a tourist the second time round, so I revisited some of the places I saw years ago.

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The Agony and Ecstasy of Running

A year or so ago, I got it into my silly head that I could run. After a hard gym session, I looked down my street and thought “I wonder what would happen if I ran down that road and back.” So, I did, and I didn’t disintegrate. And then I did it again, and again, and again, very slowly building up the mileage, counting every kilometer, every minute, cadence, pace and speed, reveling in the fact that I, me! the girl who couldn’t, was somehow managing to freaking run. I was elated, and terrified at the same time. I was also incredibly slow, which was hardly surprising considering the shape I was in (in other words, in no shape at all). But I didn’t care. I put on my expensive shoes, my inexpensive everything else, and went out in the dark where no one could see me and my wobbly bits. It was just me, my music and the road. When I wasn’t running, I was thinking about it. It was insane.

My motto

My motto

I realized quickly though that my body wasn’t really built for running. First of all, due to chronic medical conditions, my energy levels were never consistent. Then, my ankles were hopelessly overpronated. Further, my knees were impossibly crossed. And so there was pain. I immediately asked for help and got referred to the podotherapist, who made me orthotic insoles. And then off to the physiotherapist I went, who started me on a regime of stability exercises. Running is not just endurance you see, it is also coordination and stability. Essentially I was learning to walk again, the right way this time. Finally, I started experiencing tiny little points of pain that kept cropping up in various places in my legs. For this, there was another solution – dry needling.

Say *what* ?

So dry needling is an acupuncture technique, where a solid needle is inserted into the annoying knot of muscle, which is then teased loose. Yes that is every bit as cringey as it sounds – you know it is working when you feel the whole muscle contract with a dull, cramping pain. Ouch.

I was curious about this procedure, so I looked up some literature. Dry needling is primarily used to treat myofascial trigger points – “hyperirritable spots in the fascia surrounding skeletal muscle, associated with palpable nodules in taut bands of muscle fibers” (~ Wikipedia), till a muscular twitch is achieved (however I understand that this is, while preferable, not necessary). Clearly there is a similarity with acupuncture, but dry needling treats pain points directly – the trigger points, rather than acupuncture points. There are several reviews on the subject out there (here and here for example), which deem this treatment effective, safe, and efficacious.

In my personal experience, dry needling has been pretty effective – the pain is pretty much gone in the treated areas, and I am thankful for it. Recovery is fairly quick, in spite of feeling rather fragile for a few days after. However, for me it gets more complicated. I have been having serious pain in my right knee, first in the runners’ knee area, and now due to issues with my hamstring. My physiotherapist is sure that the knee pain is referred, and now the mission is to find the right trigger points that are causing this misery. Long story short, I haven’t been able to run in weeks. WEEKS.

As you can imagine, breaking up with running has had its emotional toll on me. I have raved in anger, cried in misery and wallowed in self pity as I went cold turkey, as any addict would. I’ve come to terms with it though, with the following rationality –

  • The running ban is very probably temporary.
  • At least my muscles are not damaged.
  • No running does not mean no cardio at all. Hello, gym!

Upwards and onwards, as they say, as the goal changes. I’ve set my sights on upper body strength, among other things, with the secret hope that I will run again, and soon. Till then, I will willingly lie on the physiotherapist’s table with needles sticking out of me, if that is what it takes. Wish me luck.

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Mindfulness and Genetic health

For centuries, we have been fascinated by the possibility of reversing the ravages of time and disease on the physical body. The idea of something material restoring youth and vitality is certainly an attractive one (which intuitively leads to the idea of immortality), but what if the secret of youth was within, instead of without?

Earlier this year, this article caught my eye, where breast cancer survivors did 90 minutes of yoga a week for 12 weeks, ultimately showing a lower level of fatigue and an increased level of vitality as compared to the control group. The novel bit though, was that this effect was observable at the molecular level – there was a decrease of inflammation markers in the blood of the group doing yoga, and after only 12 weeks!?

A search on the keyword “Yoga” on the website of the journal that published the study above, revealed 44 publications, all showing benefit of exercise and yoga for cancer patients, and their general well-being, as shown by standardized questionnaires. Looking further, I saw that that there have been other studies done which show an effect of meditation, yoga and other techniques on gene expression, as reviewed here, so this is not a new idea at all.

And then this paper was published, which just blew this concept into a whole new dimension. The study showed that on average, there was a significant difference between the length of telomeres of breast cancer survivors that engaged in the mindfulness sessions – the control group’s telomere lengths decreased, while they were maintained in the active group. In spite of the authors cautioning that their sample sizes needed to be larger for larger significance, this initial paper contributing to the concept that mindfulness could affect cellular and genetic health to this extent is very exciting. Could yoga and meditation be the ultimate fountain of youth?

Doing another quick and dirty search, I came up with articles showing the effect of yoga on white matter change, chronic pain, psychological health, stress levels, type 2 diabetes, and cardiovascular health. OMG, so. We should all be doing yoga! But it also makes me wonder what is it about the whole mindfulness concept that results in such discernible differences down to our DNA. The devil’s advocate in me asks if it is a simple placebo effect, that is, the mind being tricked into thinking that all is better with the body without anything actually medicinal. But if in the end the net result *is* feeling better, is the placebo effect actually effective?

I find it ironic that the ancient Asian practices of yoga and other mindfulness techniques are under modern scrutiny, especially after being dismissed for the many years in between. I guess our ancestors knew their benefits without molecular and other scientific techniques, and perhaps we, in the fast paced world of today, should learn to slow down once in a while to explore the apparently inherent power of healing within ourselves.

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When Fact and Fiction collide

As an avid reader, the escapism value of reading a gosh-darned good book is absolutely undeniable – this fact I knew since I could read. I admit that I am also one of those snobbish purists. I love my classics, and if anyone else tries to write a book using the original characters, it is pretty much akin to blasphemy. I could not bring myself to read the sequels of Rebecca for example, because no one can match the sheer brilliance of Daphne du Maurier, I am sorry.

I am starting to make exceptions though.

I’ve read the stories of Sherlock Holmes many times over since my youth, and have stubbornly resisted reading anything featuring the famous detective by anyone else other than Arthur Conan Doyle. Even films and TV series fell all kinds of short when compared to my mental image of the man – until of course BBC’s Sherlock, where Benedict Cumberbatch is simply brilliant, in spite of being slightly silly. I forgive him.

I have always wondered why Mr. Doyle never tackled the particular problem of Jack the Ripper. I mean the time frames overlap, so surely there must have been some interest in the creator of the most famous detective of literature. In fact, I’ve read that the person who inspired Sherlock Holmes, Dr. Joseph Bell, did in fact investigate the murders, but this information is unverified and might be urban legend.

Anyway, in comes fiction and imagination. With a clear and open mind, I picked up Lyndsay Faye’s Dust and Shadow, which she claims is an account of the Ripper Killings by Dr. John H. Watson. Well, what can I say – I loved this book and I couldn’t put it down. Having read so much about the Ripper murders (to the point of doing the Ripper tour while I was in London), the fact that my beloved Holmes is featured in the temporal vicinity of the killer, and is involved in unmasking him still makes me shiver in delight. Lyndsay Faye is a good writer, capturing quite perfectly the writing style of Dr. Watson, which I incredibly thankful for. Plus she gives him a bit of a human heart – Holmes is known to be emotionally removed from his cases, but even he is moved when discovering the last victim of the Ripper.

There are definitely some loose ends that seemed more like distractions, like the inclusion of a female version of the Baker Street Irregulars, Mary Ann Monk. And then there is the glaring exclusion of the killer’s story and mental profile – there is no mention of his trigger to become one of the most notorious of historical killers. However, none of these short comings struck a sour note with me as I galloped towards the end of the story. I was deeply satisfied when I was done.

So read Dust and Shadows, and leave some of your inhibitions behind as you do, for while there is only one Arthur Conan Doyle, Lyndsay Faye comes pretty damn close to his perfection.

PS. Another book recommendation is Anthony Horowitz’ House of Silk, where he also brings Sherlock to life in an incredibly beautiful and shocking story.

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The demonization of fat

These days as I get more and more interested in body composition, BMI and balanced diets, I am devouring articles about health inspiration from a lot of different sources. This particular one caught my attention recently, as you can see for yourself from the title …

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Rejoice all!

The word “fat” has so many negative connotations these days, it scares off just about everyone. I remember going to a dietitian who told me to low fat *everything* (it didn’t work).

I like this article because it addresses the idea (myth?) that health is connected linearly to BMI, which is clearly not necessarily the case. He makes the example of himself –

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Not sure if he has ANYTHING to worry about, no.

I do wish he had given some alternatives to the clearly flawed BMI measurement though. It would have been nice to also talk about those that do carry curves, spare tires and some wobbly bits, especially the differentiation between being apple shaped and pear shaped, having visceral fat versus subcutaneous fat, that sort of thing. The differences are stated nicely in this article for example. Simply put, visceral fat coats the internal organs, making it more dangerous than subcutaneous fat, that is under the skin. Visceral fat makes you apple shaped, while subcutaneous makes you pear shaped. Ergo, if you have a high waist to hip ratio, you might be in trouble. This paper shows the relationship quite nicely, although the cohort of patients are older (>75 years), probably because the end point measurement was mortality :) but it is possible that the results can be extrapolated to other age groups. Here is a review which says that we should look much more closely at waist to hip ratio as a determinant of individual health.

By the way, if you PubMed the name of the Danish researcher who is involved this line of research, Professor Berit Heitmann, you will find that she’s actually done some really nice studies, such as obesity as a function of socio-economic status, eating habits of kids who watch TV at the same time and so on. Very cool.

Ok, so clearly, there are real medical dangers of being seriously “fat”, and that is not just society’s stigmatization of it. However, I don’t think having a bit of excess fat is a bad thing, especially for women. I mean we are meant to be voluptuous, and it’s fat that makes us so, not muscle right? All in all, the message is clear – the idea of a perfect health is undefined and elusive. So we should stop being obsessed with the numbers on the weighing machine! Now pardon me while I go for one of my many, MANY daily weigh-ins 😉

The interesting thing is that as I am getting more and more physically active these days, I am realizing that perhaps body weight and measurement as a whole is not an accurate measure of health at all. Why not measure it by what the body can do? If you can’t climb up a flight of stairs without getting winded for example, it doesn’t matter if you are fat or thin, you are simply unhealthy. I would say that is more dangerous than the figure on the weighing machine or tape measure.

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