Common Sense Health

“He preaches patience that never knew pain.” That line has been around for more than a century, and it still holds up. Spend time around people who are struggling, and you see why. Some are not just discouraged. They are angry. Angry at their health, at the system, at the people around them, and at life itself.

Chronic disease changes everything. Diabetes can lead to amputation of a leg, sometimes both of them. Cancer brings fear and uncertainty. Arthritis limits movement and pain becomes a permanent companion. Others are trapped in situations that are just as damaging – abusive relationships, financial stress, or a system that promises support but delivers nothing of it. It doesn’t take much for frustration to turn into anger.

But anger carries a very large cost. Research has shown that chronic anger raises blood pressure, increases stress hormones, and raises the risk of heart disease. It also worsens sleep and can make pain feel more intense. In short, it adds another layer of trouble to people who already have enough to deal with.

I knew a man who lived this way. He was angry at everything. Conversations with him went in one direction. Nothing worked. No one was doing enough. Life had treated him unfairly, and he was not going to let it go. Then he had a stroke.

Afterward, something changed. He was calmer. Less reactive. The anger that had defined him was no longer there. Doctors reported that the brain controls more than movement and speech. It also regulates emotion. When it is injured, behaviour can change. Neurologists have reported both increased irritability and, in some cases, a reduction in long-standing anger.

But most people are not going to have a stroke that resets their outlook.

There is growing evidence that certain practices can shift the brain’s patterns over time. Research in neuroscience is showing that even as we age, the brain is not fixed. It doesn’t stop adapting at some particular age. It can continue to be stimulated or exercised in ways that rewire certain circuits.

Cognitive behavioural therapy, for example, teaches people to examine the thoughts that drive anger and disrupt entrenched patterns of thought. Mindfulness training helps create a mental pause before reacting. Exercise reduces tension and improves mood. These are not quick fixes, but they are supported by research.

Still, many people resist. They feel their anger is justified. But being justified does not make it useful. So what do you say to someone who is angry with life?

Telling someone to “stay positive” may not be a helpful message to people who are not yet able to appreciate the intention of the words. When consumed in anger, people perceive even olive branches as kindling to light a bigger fire. But there is a question worth asking. That is, is the anger helping?

And it’s best to find the right person to delve into that discussion. Who is able to open and sustain a wholesome discussion about wellbeing? It might not be the most obvious candidate.

But the point is to note that if the status quo does not involve good sleep, health, or relationships, then it may be time to try something else. This is not to deny the issues or pretend things are fine. But the goal is to reduce the cost of carrying that anger every day.

And time is not always on side with these matters. Managing life’s challenges can be difficult enough on their own. Don’t make them even harder by just waiting for change. Make it happen.

This column offers opinions on health and wellness, not personal medical advice. Visit www.docgiff.com to learn more. For comments, diana@docgiff.com. Follow on Instagram @diana_gifford_jones

Video games have a reputation – and not a good one, at least among parents. For years, I kept my distance. “Brain rot” some experts say. I’ve said it myself, often and with conviction. I’ve worried as my four children have grown up, eyes glued to screens. But over the recent holiday weekend, I caved. My now adult children – gamers, all of them – convinced me to join them. When I sensed their genuine excitement at the possibility that I might finally enter their world, how could I refuse?

The game was Minecraft, where players explore, build, and survive in a blocky, pixelated universe. Think digital Lego meets wilderness survival, with a dash of engineering.

Before I could begin, however, there was the small matter of getting set up. This, I discovered, was no small matter. Out came an assortment of computer equipment that had been gathering dust in closets. A screen, keyboard, and headset. I was instructed to wear ear pods underneath the headset so that I could simultaneously hear a voice chat on my phone and the game’s audio through the computer.

There followed a symphony of muting and unmuting on the phone, on the computer, and on the headset. I was assured not to worry. “We’ve got this,” they said. I did not.

But soon enough, there I was: seated, wired, and ready. My grown children, now giggling playmates, were scattered across three different cities, with one just down the hall. Yet we were all together in the game. I could literally see their characters running circles around me.

Then the real test began. “Click here, Mom.” Easy enough. Except that was merely the beginning of what felt like a neurological stress test. First, I had to grasp perspective. With the click of a button, I could switch from seeing the world through my character’s eyes to viewing my character from the outside.

Then came movement. To walk, I had to use the W, S, A, and D keys with my left hand while my thumb hovered over the space bar to make me jump. My right hand controlled the mouse, which required sliding, clicking left and right, and scrolling with the middle finger. This was no walk in the park. My brain and coordination were being tested.

At one point, I was tasked with making an iron pickaxe. “Simple,” they said. Except it wasn’t. First, you need to get wood for a handle. Then you must craft a furnace. Next, the mining, for coal and iron ore. Then comes the crucial insight: coal goes in the bottom of the furnace, iron ore in the top. The game requires players to use reason, but I would have been helpless without my kids telling me how to survive.

There was laughter. Lots of it. Belly-bursting laughter. There we were: a family spread across distances, connected by technology, having a blast.

But I was thinking about the health benefits. Mental agility, hand-eye coordination, memory, and perhaps most importantly, social connection. Most researchers don’t focus on games like Minecraft; they use cognitive-training tests that miss the elements found in the family fun I’m talking about. So they report modest improvements in attention, reaction time, and memory. But my guess is that a little bit of Minecraft among people of my generation goes a long way in boosting cognitive flexibility, spatial reasoning, and the wholesome happiness factor.

Will I play again? I’m counting on it. Much as I love a good book or a quiet walk in the woods, I’m intrigued by the potential for games like Minecraft to keep me sharp as I age.

This column offers opinions on health and wellness, not personal medical advice. Visit www.docgiff.com to learn more. For comments, diana@docgiff.com. Follow on Instagram @diana_gifford_jones

In my work with universities, I meet an array of Canada’s leading researchers. This week, it was Arghya Paul, Canada Research Chair in the Department of Chemical and Biochemical Engineering and Chemistry at Western University in London, Ontario. Professor Paul and his team of young researchers are investigating new ways to fight cancer.

For decades, the war on cancer has relied on chemotherapy and radiation to kill cancer cells, treatments that often harm healthy cells too.

Now, scientists like Paul are exploring smarter ways to deploy drugs. He is working not at the scale of the tumour or the cancerous lesion, but at the biomolecular level of the nanoscale. That’s one billionth of a metre, where materials can be engineered to interact with the body in highly specific ways.

Instead of flooding the body with toxic chemicals, researchers are designing tiny biocompatible particles that travel through the bloodstream, seek out cancer cells, and act only where needed. It is a guided system rather than a scattershot approach. These particles can be activated by ultrasound waves. When exposed to a specific ultrasound intensity, they heat up and destroy tumour cells from within. Healthy cells nearby are largely spared.

Additionally, these particles can track tumor sites in the body using advanced clinical imaging systems. That means they can do more than one job at a time. They help doctors both see cancer cells more clearly and site-specifically destroy them. Detection and treatment are part of the same process.

This is a big shift in thinking. For years, medicine has treated diagnosis and therapy as separate steps. First find the disease. Then treat it. Now, the two are beginning to merge.

As Professor Paul explains, “This research represents a shift from treating cancer with blunt tools to engineering precise responses at the microscopic level. We’re beginning to program how therapeutic agents should interact with cancer cells rather than simply attacking them.”

His research lab is looking into how these systems can be built to respond to the unique environment of a tumour. Cancer cells often differ from normal cells in subtle ways. They may have slightly more acidic surroundings, different oxygen levels, or altered surface markers. Nanoparticles can be engineered to recognize these differences and act only when they are encountered.

The goal is simple in concept, but revolutionary in practice: maximum damage to cancer, minimal harm to the patient.

There is still a long road ahead. Much of this work is in experimental stages. What works in a laboratory dish or in animal studies does not always translate to human patients. Safety, long-term effects, and large-scale manufacturing are all challenges that must be overcome.

But the direction is clear. We are moving away from a model of medicine that relies on broadly toxic interventions, and toward one emphasizing precision, personalization, and control. This could mean fewer side effects, shorter recovery periods, and more effective treatments.

It could also mean catching and eliminating cancers earlier, before they have a chance to spread.

What’s another important insight? The future of medicine will not come from biology alone. It will come from the merging of physics, engineering, chemistry, and medicine.  We need to stop thinking about doctors solely as people who come out of medical schools. The lifesavers may be graduates of engineering programs in advanced materials.

We are not yet at the point where cancer can be treated without risk or discomfort. But we are closer to a world where treatment is targeted, intelligent, and far less destructive, using microscopic tools designed with extraordinary precision, aimed directly at the disease, and nowhere else.

Carry on, researchers!

This column offers opinions on health and wellness, not personal medical advice. Visit www.docgiff.com to learn more. For comments, diana@docgiff.com. Follow on Instagram @diana_gifford_jones

If doctors depended like actors do on an ability to connect with their audience, the medical profession would get better reviews. But most patients will tell you the same thing about their doctor: they don’t make that connection at a human level. They are elusive – virtually impossible to reach for a discussion. When they appear at appointments, they pay more attention to the computer screen in the examining room than they do you, the patient, the person needing their care. Patients have been complaining about it for decades.

In 1989, a major survey reported patients often felt “dehumanized,” and that doctors cared more about tests and procedures than about the person in front of them. Even earlier, in the 1960s, social researchers noted that patients described physicians as “curt” and “abrupt,” mechanical and impersonal. Studies ever since have confirmed that dissatisfaction with doctors is due to their lack of communication skills.

Medical schools have tried to address this. Teaching interpersonal skills is now part of the curriculum. Students rehearse interviews, practice explaining diagnoses, and even role-play with actors posing as patients. Research shows that effective communication improves diagnostic accuracy, increases adherence to treatment plans, and enhances patient satisfaction. Yet many patients would be forgiven for wondering where those lessons went. Heavy workloads, computer screens between doctor and patient, and complex medical teams continue to create barriers. Medicine may be teaching communication better than ever, but the system often makes it hard for the patient to see the doctor doing it.

Many patients assume they have no choice. “I’m lucky just to have a doctor,” they tell themselves. “There’s no way I could find another one.” This is a false narrative. Doctor shortages and the complexity of healthcare have people believing they must accept poor communication. You would not tolerate being ignored or dismissed in other parts of your life. Why accept it in medicine?

Patients do have power. Does your doctor ask about your life, listen without interrupting, and explain clearly? If the answer is consistently “no,” action is warranted. Even if you stay with the same doctor, your preparation can transform a visit. Write down your list of concerns and what you think the doctor needs to know as background. Prioritize your questions and have them written down too. Ask for clarification. Ask if you have options. Be sure you understand instructions relating to medication.

Communication matters immensely in consultations, where diagnoses are discussed, treatment plans explained, and long-term decisions made. But surgery is different. In the operating room, technical skills are what matter. A brusque surgeon may still be an exceptional technician. Reputation among colleagues, experience, and complication rates are more revealing than personality. Multiple opinions, careful questions about outcomes, and input from nurses or other professionals are the smartest safeguards.

Walking out on a doctor may be right for some patients. But a practical alternative is a health advocate: a trusted companion who attends appointments with you. They can ensure questions are asked, take notes, track instructions, clarify confusing explanations, and follow up on tests or referrals. They act as an extra set of eyes and ears, guiding patients through complex care.

There’s also the possibility that new artificial-intelligence tools capable of notetaking, translating medical jargon into plain language, and helping patients with treatment routines will take up the role of chief communicator. If managed wisely, these tools could make a big difference. But the relationship we all want still rests with two human beings: a doctor who cares and a patient who feels well cared for.

This column offers opinions on health and wellness, not personal medical advice. Visit www.docgiff.com to learn more. For comments, diana@docgiff.com. Follow on Instagram @diana_gifford_jones

This week, I write from Tokyo, where small fish are eaten with remarkable regularity. A traditional Japanese breakfast includes such fish – salted, dried, grilled and served cold – consumed head-to-tail, bones, eyeballs and all. Small sardines are tucked into lunch boxes. Convenience stores sell little fish for snacking. It’s common to add sardines or mackerel to spaghetti sauce. Eating little fish is a way of life.

What is it about little fish? A large Japanese cohort study following more than 80,000 adults for roughly nine years found that people who regularly consumed small fish had significantly lower risks of death from all causes and from cancer, particularly among women. Even modest intake of just a few times per month was associated with measurable reductions in mortality.

Nutrition science offers an explanation. Small oily fish, such as sardines and anchovies, are rich in omega-3 fatty acids, along with minerals and high-quality protein that support cardiovascular, brain, and bone health. Emerging evidence suggests regular sardine consumption may also improve insulin response and reduce the risk of type 2 diabetes.

Eating the head, bones, and organs means the Japanese are consuming concentrated micronutrients such as calcium and vitamin A that are largely lost when fish are filleted. Westerners throw that nutrition away.

A reader recently reminded me of the Japanese word kuchisabishii, translated literally as “lonely mouth”. It describes eating out of boredom, not hunger. But if mindless snacking is the need, then little dried and crunchy fish are a great choice.

A modelling study published in BMJ Global Health estimated that replacing some red-meat consumption with forage fish – species such as sardines, anchovies, and herring – could prevent up to 750,000 premature deaths annually by 2050. These fish are exceptionally nutrient-dense, and in comparison to any other animal protein, have among the lowest environmental footprints, if one can say that of fish.

In North America, seafood choices tend to centre on large predatory fish such as salmon and tuna. These species are popular and nutritious, but they are also more expensive, accumulate more contaminants over long lifespans, and require greater ecological resources. Meanwhile, vast quantities of small forage fish are processed into animal feed.

There is a practical challenge, however. Achieving the levels of omega-3 fatty acids associated with cardiovascular benefit – particularly EPA and DHA – requires consistent intake. For many North Americans, eating small oily fish several times a week is a stretch, whether because of taste preferences, access, cost, or habit.

For that reason, supplementation can be a sensible adjunct. A high-quality fish oil provides concentrated, purified omega-3s without requiring major dietary overhaul. Readers can find the fish oil recommended by W. Gifford-Jones, MD, Certified Naturals Omega3X, in natural health food stores. It has earned the recommendation because it delivers high levels of EPA and DHA in a purified form that is tested for contaminants and formulated to enhance absorption.

None of this calls for dramatic change. It may simply mean replacing meaty meals with modest, more frequent servings of small fish. Imagine a tin of sardines on whole-grain toast, anchovies folded into pasta, or herring added to a salad. Frequency is better than occasional large portions.

Tokyo’s markets do not advertise their bountiful fish sections with signs proclaiming “Eat fish. Lower the risk of death.” But would it be a crime to encourage people to think about their mortality when grocery shopping? Fresh or tinned, little whole fish are affordable, accessible, and ordinary. Perhaps that is the lesson. Healthful patterns tend to endure when they are woven quietly into daily life, rather than announced as resolutions.

This column offers opinions on health and wellness, not personal medical advice. Visit www.docgiff.com to learn more. For comments, diana@docgiff.com. Follow on Instagram @diana_gifford_jones

It’s a sad irony. But the truth is, loneliness is one of the most crowded experiences in modern society. Some prefer their own company and are emotionally stable. There’s no harm in letting them be. But there is an astonishingly high number of people who can be called “situational loners”. These are people who may have recently retired, become empty nesters, have moved to a new community, or lost a spouse.

Some people, once embedded in a tight group of friends, may find themselves geographically or generationally isolated. Maybe they were part of a scene that was once vibrant, but for one reason or another, the scene changed, and they didn’t. They long for the past and may feel socially out of place in today’s society.

Others have outright rejected a world that offers constant online contact as a proxy for companionship. They see some people thriving with it, but the digital world is not for them.

As a society, we’ve never been more connected. But on a human level, we are disconnecting. Smaller families mean fewer close-in relatives. The ease of mobility uproots connections to the communities our families called home for generations. Our convenience economy means we don’t know basic source information about things that are elemental to our lives.

Call it instability, disconnection, isolation, or uneasiness.  It’s a societal malaise that is evident as an upward trend in chronic high blood pressure, increased inflammatory markers, weak immune systems, hormonal imbalance, poor sleep, declining cognitive function, and worsening cardiovascular outcomes.

A recent large-scale study has added a striking insight. Investigators analyzing tens of thousands of adults found that loneliness and social isolation are associated with measurable changes in proteins circulating in the blood, many linked to inflammation, immune function, and heart disease. In other words, the body registers loneliness as a form of biological stress, not just an emotional state.

During the latter part of the winter season in particular, problems are magnified. After weeks of less daylight and reduced physical movement, the negative effects start to mount.

What many people don’t realize is that the human body responds to connection the same way it responds to good nutrition or exercise. A brief conversation, a shared task, even a familiar greeting can lower stress hormones. These are small interactions, but biologically, they have a beneficial effect.

The mistake many make is waiting to feel better before reaching out. In reality, reaching out is what produces the improvement. Health rarely returns by withdrawal. It improves through participation, however modest.

Late winter is not the time for grand resolutions. It is the season for simple, repeatable habits. A daily walk at the same hour. A regular coffee with a neighbour. A volunteer shift. A phone call made every Sunday afternoon. These patterns rebuild rhythm, and rhythm is deeply reassuring to both mind and body.

It is also worth remembering that nearly everyone you meet at this time of year is carrying some degree of the same burden. The person beside you in the grocery line, the neighbour shovelling snow, the acquaintance you haven’t called in months – many are waiting for someone else to make the first move.

So if you are feeling alone, take comfort in knowing you are not uniquely afflicted. You are experiencing a very human signal that it is time to reconnect with light, movement, purpose, and people.

Winter will pass. In the meantime, don’t hibernate from life. Step outside, reach out, and give your health the companionship it was designed to enjoy.

This column offers opinions on health and wellness, not personal medical advice. Visit www.docgiff.com to learn more. For comments, diana@docgiff.com. Follow on Instagram @diana_gifford_jones

There’s a common organizational saying: structure drives behaviour.  In institutional theory, it’s called path dependence. Once a structure or pattern is established, it becomes self-reinforcing. This is a problem in medicine. Researchers and specialists become deeply immersed in their own areas of expertise. They network within tight knowledge clusters. They protect their territory. And when they train recruits, they filter out possible solutions to problems before deliberation even begins.

This is the story – or an important part of a complex story – of the commitment by so many experts to statins in the treatment of heart disease.

A large meta-analysis recently published in The Lancet and reported in the British Medical Journal concludes that most of the side effects listed in statin leaflets – memory loss, depression, fatigue, sleep disturbance, erectile dysfunction – occur no more often in those taking the drug than in those taking a placebo. Regulators are now considering changes to product labels. Experts speak of “powerful reassurance.” We are told confusion has gone on long enough.

But here’s the question: reassurance for whom?

I am not lambasting the research. Randomized trials involving more than 120,000 participants deserve respect. If the data show that many feared side effects are less common than thought, then provide consumers with that information.

What I object to is the triumphal tone and the relentless march toward medicating ever larger swaths of the population without an equally forceful message about personal responsibility and informed choice – choice that includes information on treatment options that go beyond pharmaceutical drugs.

Seven to eight million adults in the UK already take statins. If guidelines are followed to the letter, that number could climb to 15 million.

And what is the public message?

Not: “Let’s first talk about your waistline, your diet, your blood pressure, your exercise habits, your smoking.”

Not: “Let’s see what happens if you walk briskly for 30 minutes a day.”

Not: “There are safe, effective, natural alternatives to the drugs.”

Instead, it is: “Don’t worry. The pills are safer than you think.”

That is not prevention. It’s pharmacological management.

Doctors complain that “negative publicity” has led patients to refuse statins or stop taking them. They suggest that switching between different statins reinforces “misinformation.” But perhaps patients are not irrational. Perhaps they are wary. And in today’s pharmaceutical marketplace, where billions are at stake, wariness is not a character flaw.

When a study funded by a major heart foundation reassures us that side effects are minimal and uptake should increase, skepticism is healthy. Not cynical. Healthy.

Yes, cardiovascular disease is a leading killer. Yes, lowering LDL cholesterol reduces risk. But medicine has drifted from treating disease to treating risk scores. The new threshold recommends considering statins for people with less than a 10% ten-year risk of cardiovascular disease. Think about that. We are medicating people who are, statistically speaking, unlikely to have an event in the first place.

And what do we tell them about the other levers they can pull?

Lifestyle changes can reduce cardiovascular risk by 30%, 40%, sometimes more. Weight loss lowers blood pressure and improves blood sugar. Exercise raises HDL cholesterol and reduces inflammation. A Mediterranean-style diet lowers cardiovascular events.

But lifestyle medicine takes time. It requires conversation, follow-up, and motivation. A prescription takes 30 seconds.

The pharmaceutical industry thrives on expanding definitions of risk and broadening treatment thresholds. That is the business model. But physicians are not supposed to be extensions of that model. They are supposed to be educators and advocates.

When the dominant message is “don’t worry, just take the pill,” they fail in that role.

This column offers opinions on health and wellness, not personal medical advice. Visit www.docgiff.com to learn more. For comments, diana@docgiff.com. Follow on Instagram @diana_gifford_jones

The Olympics showcase people pushing to their limits. Athletes soar, leap, slide and score! Watching from the couch, feet up, drink in hand, we marvel at these feats.

In the natural world, certain animals push their limits too. Some migratory birds can fly for days – sometimes weeks – without landing. The bar-tailed godwit, for example, travels more than 11,000 kilometres nonstop across the Pacific Ocean, fueled only by stored fat and instinct. No cheering crowds. No gold medals. Just a destination and the will to reach it.

Such accomplishments are for the gifted. But what are the rest of us capable of doing?

I attended an event last week designed to inspire university leaders to be more innovative. There, one of the speakers talked about the “magic 10%”. Wholesale change is rarely successful, but changing 10% of something is a good strategy for getting results over time.

Many people fail to learn this lesson, even as history repeatedly teaches it. Lasting accomplishments, especially those related to health, tend to come not from heroic bursts of effort, but from setting a clear, achievable goal and working at it in increments.

It used to be true in sport too. Take the first marathon runners in the late 19th century. They were not elite athletes by modern standards. Many were ordinary people with day jobs, inspired by the idea of testing their endurance over a long distance. Training methods were basic, nutrition was poorly understood, and injuries were common. Some failed spectacularly. Others quit. A few persevered. What separated them was not brilliance, but persistence.

Change has come the same way in most medical advances, even when heroes should have won gold medals. When Edward Jenner proposed vaccination in the 1790s, he was ridiculed. When Ignaz Semmelweis insisted that handwashing could prevent deadly infections, his colleagues rejected him. Ultimately, it was the long accumulation of evidence that drove progress.

When it comes to our own health, we err in strategies that are entirely self-driven – overhauling our diet overnight, acquiring a treadmill, cutting out alcohol, and so on. But all-or-nothing thinking is an obstacle to better health.

The body responds best to steady and enduring signals, not sudden shocks. Lowering blood pressure by ten points, improving balance by daily practice, and enjoying one drink slowly instead of several in succession. These are not Olympic feats. But when adopted bit by bit and maintained, the benefits are cumulative.

There is a famous line often attributed to Goethe: “Whatever you can do, or dream you can do, begin it. Boldness has genius, power, and magic in it.” The key word is begin. Not finish. Not perfect. Just begin.

Most people who successfully improve their health do so with help. A walking partner. A spouse who changes grocery habits. A health advocate who listens.

Failures along the way are not signs to stop. They are part of the process. Athletes fall. Birds are blown off course. History’s innovators were dismissed before being vindicated. The goal matters, but the best achievements to celebrate are day-by-day good choices.

We may never leap like Olympians or cross oceans on wings, but we can set goals that stretch us just enough to matter. Better sleep. Stronger muscles. More energy. Fewer pills. These are reasonable feats, and they are within reach.

Extraordinary health does not arrive suddenly. It is built methodically, one decision at a time, by ordinary people who decide that the effort is worth it.

Send me your examples of success with taking small, incremental steps to better health and I’ll post them at the end of the column at www.docgiff.com for your reference and inspiration.
This column offers opinions on health and wellness, not personal medical advice. Visit www.docgiff.com to learn more. For comments, diana@docgiff.com. Follow on Instagram @diana_gifford_jones

History has a way of humbling doctors. When my father, Dr. W. Gifford-Jones, was a student at Harvard Medical School in the late 1940s, one of his professors – Paul Dudley White – told the class something that would be unthinkable today: heart attacks used to be rare. So rare, in fact, doctors at Massachusetts General Hospital clamoured to see any case that appeared.

Today, every 20 seconds, someone in North America has a heart attack. Every 37 seconds, someone dies from heart disease.

Something went wrong. It wasn’t a sudden failure of the human heart.

My father spent his career repeating the message: the medical establishment often gets it wrong, for decades.

Doctors mocked Semmelweis for telling them to wash their hands, and women died as a result. The British Navy ignored citrus fruit as a cure for scurvy for 60 years, and sailors died needlessly. Today, we’re told to fear cholesterol above all else and to trust cholesterol-lowering drugs as the solution to heart disease. Yet half the people who suffer heart attacks have normal cholesterol. If cholesterol were the villain, this would be impossible.

Japanese living in Japan and in California can have identical cholesterol levels. Yet the Californians have far more heart attacks. Scots have three times the rate of heart disease as Swedes with similar cholesterol numbers. Something else is going on.

Heart health is not rocket science. Eat real food. Exercise. Sleep. Maintain a healthy weight. Stay socially connected. Laugh. Relax.

Drugs don’t fix a lousy lifestyle. They mask the consequences.

Medicine’s obsession with cholesterol has done real harm. Cholesterol-lowering drugs come with side effects doctors are far too quick to dismiss.

Dr. Linus Pauling, one of the greatest scientists of the 20th century, and a two-time Nobel Prize winner asked a simple question: why don’t animals suffer heart attacks? And his finding? Animals make their own vitamin C. Humans don’t.

Vitamin C is essential for making collagen – the “mortar” that holds cells together. When collagen is weak, microscopic cracks develop in artery walls. The body tries to patch those cracks. Plaque forms. Blood clots follow.

Pauling showed that high doses of vitamin C – far beyond what’s needed to prevent scurvy – combined with lysine, an amino acid that strengthens collagen like steel rods in concrete, could help prevent and possibly reverse atherosclerosis.

After his own heart attack at age 74, my father had to choose. Follow cardiologists who insisted on cholesterol drugs he didn’t trust or follow nature’s rules. He chose nature. And he lived another 28 years.

An English optometrist, Dr. Sydney Bush, documented improvements in hardened retinal arteries – visible proof that arteries elsewhere in the body were improving too – using high-dose vitamin C and lysine.

My father eventually got tired of swallowing handfuls of vitamin C pills every day. He helped develop a powdered formula that made it easier to take the high doses required for cardiovascular support – not the tiny doses meant for fighting the common cold. His legacy formula, Giff’s Own CardioVibe, also includes CoQ10 and quercetin, nutrients known to support heart muscle function and reduce inflammation.

Yes, your immune system benefits too. People taking high doses of vitamin C get fewer infections. But that’s a bonus, not the main event.

Heart disease requires daily high doses of C – in February’s heart health month, and all year long, forever.

Will the medical establishment embrace this tomorrow? Don’t hold your breath. Vitamin C can’t be patented. There’s no fortune to be made. And natural solutions are the hardest for medicine to accept.

But if there’s one lesson my father taught me, it’s this: nature doesn’t break her own laws.

This column offers opinions on health and wellness, not personal medical advice. Visit www.docgiff.com to learn more. For comments, diana@docgiff.com. Follow on Instagram @diana_gifford_jones

In 1982, PubMed, a research database, indexed 740 papers with “vitamin D” in the title. In 2020, there were 5,566. Clearly interest has increased. Today, vitamin D is studied as a system-wide regulator and an essential component of skeletal, immune, metabolic, cardiovascular, neurological, and inflammatory processes.

But even a century ago, nutritionists feared the dangers of vitamin D deficiency. Warnings were dismissed as “alternative thinking.” 

Vitamin D was discovered in the early 20th century, when researchers noticed that children deprived of sunlight developed rickets, a bone-softening disease that left them bow-legged and deformed. In 1903, Niels Ryberg Finsen, a Danish physician with Icelandic roots, received a Nobel prize for pioneering the therapeutic use of concentrated light. Sanatoriums, which emphasized sunlight exposure, and cod liver oil, rich in D, were common treatments for tuberculosis and other infections, but Finsen’s work explained it.

For decades afterward, vitamin D was viewed narrowly as a “bone vitamin” in spite of the success of sanatoriums. Once rickets was largely eliminated through supplementation of food, the medical profession lost interest. Blood levels were rarely tested. The assumption was that a normal diet and a bit of sunshine were enough.

More recent research has shown D is not just a vitamin, but a hormone, influencing hundreds of genes involved in immune function, inflammation, muscle strength, and brain health. Across the human lifespan, as much as 3-4% of the human genome is influenced by vitamin D.  It’s confirmed what early advocates suspected – deficiency is the norm, not the exception.

With aging, skin becomes far less efficient at producing D from sunlight. An 80-year-old produces only a fraction that a 20-year-old can make with the same sun exposure. And if you live north of Atlanta, GA, you aren’t making enough D from sunlight in winter, period. Vitamin D is vital for mothers and developing children too.

Diet alone often isn’t enough. Very few foods naturally contain meaningful amounts of vitamin D. Unless someone regularly eats fatty fish or takes supplements, intake is usually inadequate. That means blood levels fall well below what researchers now associate with optimal health, 40 – 100 ng/mL. 

Low vitamin D levels are strongly associated with increased risk of fractures and osteoporosis; loss of muscle strength and balance, leading to falls; impaired immune function and higher susceptibility to infections; chronic inflammation, which underlies heart disease, diabetes, and arthritis; and cognitive decline and mood disorders, including depression.

In other words, vitamin D deficiency worsens many of the conditions we attribute to “normal aging.”

Perhaps the greatest irony is this: vitamin D deficiency is easy to detect and inexpensive to correct. A simple blood test can reveal deficiency. Sensible supplementation can restore healthy levels. Yet many elderly patients are never tested, and when they are, the “acceptable” levels recommended by some authorities are likely too low to provide full protection. 2000 – 5000 IU or 50 – 125 mcg of D3 per day is a good start, guided by testing blood levels.  Magnesium and Vitamin K2 are important companion nutrients to optimize vitamin D metabolism.

Medicine is very good at treating disease once it appears, but far less interested in preventing it. Vitamin D deficiency is a textbook example of this failure.

No vitamin is a magic bullet, and vitamin D is no exception. But ignoring a widespread deficiency that affects bones, muscles, immunity, and brain health makes no sense. 

If there is a lesson here, it is one that’s been repeated in this column many times: when common sense, biology, and well-conducted research point in the same direction, it’s time to pay attention, no matter how long it takes conventional thinking to catch up.

This column offers opinions on health and wellness, not personal medical advice. Visit www.docgiff.com to learn more. For comments, diana@docgiff.com. Follow on Instagram @diana_gifford_jones

Why is it the face lines of aging men can make them handsome while a wrinkled female face needs improvement? That double standard should be put to bed. Nevertheless, looking and feeling younger is not a cosmetic matter, for women or men. Studies show that “feeling younger”, or perceiving oneself as younger, correlates with better health outcomes.

A study of three large longitudinal U.S. samples found that people who felt older than their real age had a 24% higher risk of mortality compared with those who felt younger. Researchers following over 6,000 people in the U.K., found a rate of death of 14.3% for those who felt 3 or more years younger than their age, compared with 24.6% for those who felt older.

Feeling younger is a worthwhile goal! That’s why collagen supplements are big business, promising to make you look younger by helping keep skin firm and hydrated. But the real health story isn’t at the surface.

The body is comprised of tens of thousands of different proteins that conduct all kinds of functions. Collagen is the most abundant of them, accounting for nearly a third of all the protein we have. It’s the glue that holds us together, forming the scaffolding for our skin, joints, bones, tendons, blood vessels, and even the lining of our gut. It gives tissues their shape, flexibility, and ability to repair themselves when stressed or injured.

But starting in our 40s, our fibroblasts – the cells that produce collagen – slow down. The fibers they create lose structure and strength. Declining collagen means joints feel stiffer, muscles recover more slowly, and tissues take longer to heal. Blood vessels lose some of their elasticity. Even digestion can be affected, as the gut lining depends on collagen. Aging, in other words, begins from within.

Collagen supplements have surged in popularity, with sales climbing every year. Many forms require large doses – up to ten grams daily – usually consumed as powders. Capsules are more convenient, but few deliver enough active material to make a measurable difference.

An exception is the new generation of marine collagens. When buying it, look for the ingredient Cartidyss, a hydrolyzed Type II collagen derived from the cartilage of sustainably caught skate fish in northern France. The collagen is extracted using only water. No chemicals. And the cartilage itself is upcycled from fish already harvested for food. It’s a clean, environmentally responsible source.

What makes this marine collagen distinct is its composition. Cartidyss doesn’t just supply collagen. It naturally contains other compounds that are key building blocks for joint cartilage, skin elasticity, and hydration. And it’s been produced to facilitate absorption by the body, so only two capsules a day yield effective benefits.

In a 90-day study involving women aged 45 to 59, those who took 500 milligrams of Cartidyss daily showed a 38% increase in skin dermis density leading to a 26% reduction in crow’s feet wrinkles around the eyes and a 31% reduction in laugh line wrinkles. Those are the measures that are easy to see on the surface, and signal stronger connective tissue everywhere collagen is functioning in the body.

We’ll all get wrinkles and that’s not a bad thing. Every line tells a story. But there’s nothing wrong with fighting back if it helps you feel younger. If you’re looking to boost collagen naturally, make sure you are getting enough vitamin C and lysine, the essential building blocks of collagen formation. If you choose a collagen supplement, make it a high-quality one – clean, clinically tested, and built on real science. That’s the smart way to age strong from the inside out.

This column offers opinions on health and wellness, not personal medical advice. Visit www.docgiff.com to learn more. For comments, diana@docgiff.com. Follow on Instagram @diana_gifford_jones

I hear paternal grumbling at what I’m about to say. Dr. Gifford-Jones often warned we are a “nation of wimps” when it comes to pain. He believed we were losing the toughening effect that ordinary aches and setbacks once gave us. Furthermore, anyone who has run a marathon, climbed a mountain, or given birth knows that discomfort can be part of life’s great achievements. But we can agree that when pain becomes relentless, disabling, or overwhelming, medicine should do better.

Here’s a familiar story. Mrs. B. arrived in the recovery room after surgeons repaired a fractured hip. The operation was textbook. The pain was not. The medical team’s routine treatment was an opioid. Within an hour Mrs. B. was comfortable. A few days later she was calling for refills. Soon she was taking more than prescribed, feeling anxious when she tried to stop, and sleeping poorly.

Older people may remember a time when pain was treated with what now seem like modest tools: aspirin, codeine, local anesthetic, ice, rest, even hypnosis. None were perfect, but none carried the dangerous seduction of modern opioids. When drugs such as oxycodone and hydrocodone arrived, they were welcomed as miracles. They work by attaching to opioid receptors in the brain and spinal cord, muting pain but also activating the brain’s reward system, the same pathway that leads to craving and dependence.

What followed became one of the great public-health disasters of our time. Prescription opioid use exploded in the 1990s and 2000s, fueled by aggressive marketing and the false belief that these drugs were safe when prescribed by doctors. They were not. By 2017, about 2.1 million Americans were living with opioid use disorder, and nearly 48,000 died from overdoses in a single year. The economic cost exceeded a trillion dollars in health care, lost productivity, and broken families. Numbers like that cannot capture the grief of parents who lose a child or the despair of people trapped by addiction that began with a prescription.

Last year, the U.S. Food and Drug Administration approved a new drug — suzetrigine — the first truly new kind of painkiller in decades. It is not an opioid. It does not act on the brain. Instead, it blocks pain at its source by targeting a protein on pain-sensing nerves called the NaV1.8 sodium channel.

To explain, pain travels along nerves like electricity through a wire. Sodium channels are the switches that allow that signal to fire. The NaV1.8 channel is found almost exclusively in peripheral pain-sensing neurons, not in the parts of the brain that produce euphoria, addiction, or breathing suppression. By blocking this channel, drugs like suzetrigine prevent pain messages from ever reaching the brain, without the high or sedation.

Clinical trials show that suzetrigine reduces post-surgical pain compared with placebo. It does not erase pain the way high-dose opioids do, but it takes the edge off in a way that allows healing to begin. Side effects have mostly been mild itching or muscle spasms, not the nausea, constipation, confusion, and addiction risk so familiar with narcotics. Other sodium-channel blockers are now in development, including those that could quiet pain for weeks after a single injection.

These new drugs may be costly. Insurance coverage may lag. They may not work for all needs. And we may yet discover side effects. There is also the risk that a shiny new “non-opioid” label could distract us from the value of physical therapy, exercise, and other non-drug approaches.

Still, this is science worth watching. And hopefully of better help to people in need.

This column offers opinions on health and wellness, not personal medical advice. Visit www.docgiff.com to learn more. For comments, diana@docgiff.com. Follow on Instagram @diana_gifford_jones

How many of us can recall our grandfathers leaning back in a favourite chair, saying, “Let me tell you something you should remember.” What followed was usually a story that had grown larger with time, about hardship, happenstance, or a decision made when the stakes were high.

On the other hand, if your grandmother was anything like one of mine, the stories amounted to a different kind of education. Hers were stories that began with confidence and ended in laughter. “I never worried,” she’d say, before describing in detail how she worried about everything. Funny at the time. Instructive in retrospect.

At the turn of a new year, when families gather and time loosens its grip just a little, stories come out naturally. It’s a great time of year to be paying closer attention, and perhaps asking for, the stories we haven’t heard.

I’m talking about the stories buried in the family tree.

Norman Cousins, the longtime editor of The Saturday Review, remarked, “History is a vast early warning system.” It is as true for kings and queens as for each one of us. Royal families once reshaped nations through ignorance of genetic disease. And when inherited risks for disease go unrecognized in our own families, we are missing the chance to avoid them and to change the life course for ourselves and those who follow.

Factual stories are important in the family tree. You may ask, “Could you remind me, how did Uncle Frank die?” To which the response might be, “Oh, a heart attack.” Followed by, “No, it was a stroke.” And that correction matters. A lot.

Family history remains one of the most powerful predictors of future health problems. Long before genetic tests and predictive algorithms, doctors relied on family stories to identify patterns – heart disease, diabetes, cancer, autoimmune conditions, mental health challenges. And here’s the truth: even today, many people walk into a doctor’s office with no idea of their family medical history.

That’s a mistake. Studies show that people who know their family health history are more likely to get screened earlier, take preventive steps, and give their doctors the information needed to make better decisions. Knowledge doesn’t guarantee good health, but ignorance almost guarantees missed opportunities.

Children and grandchildren benefit the most. Understanding health patterns in the family gives them power. “Your grandfather ignored high blood pressure for years, and that’s what caught up with him.” Knowledge becomes the motivation needed for prevention.

But many families avoid these conversations. They feel awkward. It’s too personal. Or people assume “someone else knows.” And then the memories fade. Details disappear. And before long, no one remembers who had what, or when.

It need not feel like a medical interrogation. The conversation can start with the spark of a story. “What do you remember about how your father’s health changed as he got older?” “I remember great-Aunt so-and-so, but whatever happened to her?”

If you are the source of family knowledge, use the holidays to share what you know. Laughter about good memories can be interspersed with important details about family health history and advice to avoid preventable problems.

If you are the recipient of the stories, let them unfold. Then write things down.

As we edge into a new year, people love to make resolutions: eat better, exercise more, stress less. Fine goals, all of them. But here’s another one to consider: resolve to preserve the family story.

How many heart attacks, strokes, or cancers could be delayed – or prevented – if warning signs are recognized earlier? We’ll never know. But it’s worth a good story.

This column offers opinions on health and wellness, not personal medical advice. Visit www.docgiff.com to learn more. For comments, diana@docgiff.com. Follow on Instagram @diana_gifford_jones

Last week I shared thoughts on aging parents. Many of you wrote asking for more, particularly about the challenges of caring for a parent with dementia. It’s not an easy assignment, but here is a list of practical advice.

1. Start legal, financial, and medical planning now, not later. The experts are emphatic on this: early planning reduces crisis-driven decisions. You need powers of attorney, advance directives, and banking access. Be aware of recurring bill payments. Have access to medical files. Have future care options written down.

2. Establish routines and simplify daily life. Studies on “person-centred dementia care” show that routine lowers confusion and distress. Keep meals, medications, bathing, and bedtime at consistent times. It can help to use consistent cues when adjusting to new routines, like the introduction of a walker. “The doctor asks you to use this new walker…”, to which you’ve attached soft handgrips, a favourite photo, a name tag, or anything (safe) they suggest making it their own.

3. Modify the home for safety before problems escalate. Because homes aren’t designed like care facilities, take steps to remove tripping hazards, add grab bars, and improve lighting. Use medication organizers. If wandering is a risk, use alarm or monitoring systems.

4. Learn how to respond to behavioural changes. Caregivers in multiple studies reported less stress once they learned strategies for redirecting instead of arguing. That can include offering choices (not commands), using a calm voice and simple instructions, and knowing how to step back from power struggles. When caregivers know that behaviour is disease-driven, not intentional, then it’s a matter of training, not stressful relationships.

5. Share the load, formally and informally. Research consistently shows caregivers who “go it alone” burn out first. Ask siblings, cousins, neighbours, or friends for help with specific tasks: a meal, an hour of supervision, a ride to an appointment. If people say, “Let me know how I can help,” respond with a concrete request. Use respite programs.

6. Keep medical professionals looped in, and don’t downplay symptoms. Studies find that adult children often minimize behavioural or functional declines when speaking to doctors. Be factual and detailed: “When I visited last week, Mom left the stove on twice.” This allows physicians to adjust care, medications, or supports earlier, improving outcomes.

7. Monitor nutrition, hydration, and medication adherence. Refusal to eat, dehydration, or skipped medications are common and linked with hospitalizations. Try smaller, more frequent meals, finger foods, hydration through soups, fruit, herbal teas, and even musical or lighting cues to announce meal and medication times.

8. Decide early which battles matter. Caregivers reduce problems when they prioritize safety over perfection. If a parent refuses to change clothes daily but is otherwise calm and safe, let it go. Save energy for the things that truly matter, like wandering, falls, medication, financial risk, or self-neglect. Support groups have experience identifying tips and tricks for solving the serious problems.

9. Prepare emotionally for “role reversal”. Adult children struggle most when they become the decision-maker for a parent who once taught them independence.
Acknowledge this shift. Talk about it with family or support groups. It’s not a failure. It’s a transition the disease eventually demands of almost all families touched by dementia.

10. Protect your own health as rigorously as you protect your parent’s. Caregiver stress and depression are among the strongest predictors of poor outcomes for both caregiver and parent. Self-care is not indulgence. It’s prevention. Get your own regular medical check-ups. Prioritize sleep, exercise, and social contact by having regular, dependable backup support.

More soon on knowing your personal health history, and how this can help.

This column offers opinions on health and wellness, not personal medical advice. Visit www.docgiff.com to learn more. For comments, diana@docgiff.com. Follow on Instagram @diana_gifford_jones

I have been lucky as my parents aged past 90. My father, Dr. W. Gifford-Jones, stayed vibrant longer than most people dare hope. In his nineties he was still hopping on planes, giving talks across Canada, researching and writing his next column, and scheming about the next promotion or the next stunt that would amuse him – like rappelling down Toronto’s 35-storey City Hall to raise money for the Make-a-Wish Foundation. He relished a challenge. Growing old, for him, didn’t mean slowing down. It meant a development of new priorities.

He was well past 95 when I offered to help with the computer work involved in distributing his weekly column to editors. He suffered too much frustration from IT. I should have helped sooner. But once I did, I grew closer not just to the logistics of his writing, but to the writing itself. Wouldn’t it be fun, I proposed, to write together?

He agreed and the collaboration took off. We talked through ideas, shaped arguments, laughed (and feuded) over opposing ways of seeing the same thing. It was an era of our long relationship I will forever hold precious.

As the youngest of his children, born when he was 44, I was still relatively youthful as he extended his extraordinary longevity. I had a lot of energy to give.

But not everyone’s story looks like this. In many cases, people find themselves in their seventies caring for parents in their nineties, pushing eighty supporting centenarians. A close look at what is happening in those situations reveals scenes that are anything but easy. Not everyone ages as healthily as my father did. Most elderly seniors are wrestling with chronic diseases. Add dementia into the mix and the loving commitment to care shifts to an exhausting, sometimes heartbreaking, endurance test.

The problems are varied: refusing to eat; resisting walkers or other safety supports; forgetting medications; making unsafe decisions; losing the ability to manage finances or medical appointments; neglecting property or household tasks. There are those who get very angry and sometimes violent. These issues often begin quietly and seem manageable – especially to children who are themselves aging and determined to respect their parent’s independence. But over time, the strain mounts. The risks mount. And the emotional toll mounts.

What would my father advise? He was never hesitant to speak plainly. When writing, he would use a quote, as from Will Rogers, who said, “Good judgment comes from experience, and a lot of that comes from bad judgment.” My father would say, “Don’t kid yourself. No one gets it perfect, but don’t make foolish mistakes.”

He would remind people that caring for aging parents requires equal measures of compassion and practicality. He would urge families to plan early, before a crisis, and to involve physicians, trusted friends, and community supports. He would insist that safety is not a betrayal of dignity. And he would encourage caregivers to look after their own well-being too, because no one can pour from an empty cup.

Now it’s my turn to offer counsel. I can speak to the matter of love. And I can attest that it doesn’t always look like those old greeting cards. Sometimes love is repetitive, tiring, and unglamorous work. Sometimes it is stepping in sooner than you expected. Sometimes it is saying “no” to someone who once taught you to say “yes.” But it is still love.

And if my father taught me anything, it’s that the hardest work we do for the people we love often becomes, in time, the work we treasure most.

This column offers opinions on health and wellness, not personal medical advice. Visit www.docgiff.com to learn more. For comments, diana@docgiff.com. Follow on Instagram @diana_gifford_jones

What’s happened, that we feed our children a single definition of success? Grow up and leave home, climb the ladder, buy a house, and live an “independent” life. At the same time, aging parents assert they must never become a burden on their grown children. These aspirations for self-reliance are ingrained in our concept of good living.

But I wonder if we have it wrong.

Personal conviction, self-directed decisions, accomplishing goals on one’s own – these are all powerful elements of autonomy that come with the reward of feeling accomplished and satisfied.  But interdependence – begin together and relying on others – is what keeps people healthy. We are a social species, and in social groups is how human beings are best suited to live.

In our modern ways of organizing ourselves in society, we have forgotten that multigenerational households were the norm for most of human history. It’s been a relatively recent development that we have measured success by dispersing the family into multiple homes, each behind its own closed door.

The social experiment is not going well. Loneliness has become a public-health epidemic, increasing the risk of premature death at rates comparable to smoking and obesity!

Meanwhile, the housing data tell a striking story. While the buzz is loud about lack of housing, in fact, our communities are full of empty bedrooms. Literally millions of them, most in the homes of older adults living alone. At the same time, young people are struggling to find an affordable apartment, weighed down by debt, and postponing milestones like starting families because rent consumes too much of their income. We have a structural surplus of space and a structural deficit in seeing solutions.

What if the answer is not more construction, but more connection?

Small but powerful examples are showing the benefits. Home-share programs match seniors with university students. Cohousing developments arrange single older adults in private suites around shared kitchens and gardens. Some young people, groups of friends, are going in together on the purchase of a jointly-owned first home. In these settings, researchers find better mental health, greater life satisfaction, and fewer emergency-room visits by older residents. Togetherness is good medicine.

As for the fear of being a burden, it deserves reconsideration. Studies show that adult children who help care for a parent often feel more purpose and emotional closeness, not resentment. Older adults living with family tend to stay healthier and independent longer. Ironically, the determination to avoid burdening anyone can lead to the very outcome people are trying to avoid.

And more good news, as there are environmental benefits. Multigenerational households use far less energy per person. Three generations under one roof leave a much smaller environmental footprint than three separate homes. Living together is climate friendly.

But the biggest factor is economic. A large body of research has shown that one of the most significant determinants of health is economic status. Yes, studies on the health impacts of living alone, of single parent versus traditional family structures, or of communal living, offer insights. But the research is clear that these factors are less important to health than the mighty dollar. So, if living together will improve financial wellbeing, then it’s an excellent investment in health.

Multigenerational living isn’t right for every family. But for many, it could be exactly the right antidote – to financial stress, and to today’s fractured social landscape. We would do well to create more well-designed cohabitation, with vetted roommates, seniors paired with students, and shared community spaces. As a result, we could expect stronger family ties, improved housing utilization, reduced loneliness, and better health.

This column offers opinions on health and wellness, not personal medical advice. Visit www.docgiff.com to learn more. For comments, diana@docgiff.com. Follow on Instagram @diana_gifford_jones

Hernias are an ancient ailment. And modern medicine still debates the best ways to repair or live with them.

One of the earliest references appears in the Ebers Papyrus, an Egyptian medical scroll from around 1550 BCE. The treatment for hernias was to push them back into place, in techniques described by Hippocrates. Galen, a Greek physician to gladiators and Roman emperors, had a preference for treating “surgical conditions by means other than the knife.” One can only imagine.

An enduring piece of hernia lore is the truss. A truss was essentially a belt with a pad designed to apply pressure to the protrusion. Trusses were made of leather, metal, or fabric. Some people wore them for decades. Apparently Benjamin Franklin, suffering from a hernia, customized the design of his own truss for improved comfort.

Look no further than to Medieval Europe to find the most absurd so-called cures.  Some believed that passing through a split tree trunk – literally crawling through it – could cure a hernia. The tree would then be bound shut, as though healing the patient by analogy. Odd times.

Early hernia surgery was crude, painful, and often fatal. Before the late 19th century, the combination of infection, lack of anesthesia, and poor anatomical knowledge made abdominal operations deeply dangerous.

The turning point came with Eduardo Bassini, an Italian surgeon who, in the 1880s, meticulously studied the groin’s anatomy and introduced a systematic way to reconstruct it. His technique, though modified many times since, is widely regarded as the first reliable hernia repair.

The 20th century brought the introduction of surgical mesh. Using mesh allowed surgeons to reinforce weakened tissue and reduce recurrence rates. It was heralded as a breakthrough, though in recent decades it has also sparked debate and litigation. Mesh can be enormously effective, but as with many medical advances, its success is not guaranteed.

Today, many people delay treatment out of fear, embarrassment, or the hope that the problem might resolve itself. They can result from lifting, chronic coughing, pregnancy, or even genetic predisposition. They are democratic: they affect the young, old, athletic, sedentary, cautious, and risk-takers alike.

In the internet era, the ancient impulse to treat hernias at home has been revived by self-proclaimed experts posting videos of DIY abdominal wraps, self-reduction tutorials, and miracle cures. Some echo centuries-old remedies – compresses, belts, or herbal treatments. Others are newly imagined, drawing on the vast creativity of people in online forums.

The fact is, hernias can occur in many different parts of the body, from a variety of causes, and with a wide range of implications, sometimes inconsequential and sometimes fatal. So go and see a doctor to determine the best treatment for you.

Readers often write requesting information about what the take of Dr. W. Gifford-Jones was on one medical issue or another. He had a much appreciated “no nonsense” philosophy. From reading his column for years and years, he was known and trusted.

Well, you can still find what he had to say on topics like hernias. Go to www.docgiff.com and type the keywords of interest into the search engine (a little magnifying glass icon in the top right of the page). For example, type “hernia” and you’ll get access to columns on “how to decrease the risk of large bowel hernias”, “if it’s partly broken, should you fix it?”, and advice to “think twice about hernia surgery”.

Columns since around the year 2000 are posted. I’m posting more and more of the older archive of columns too. Among them, some gems!

This column offers opinions on health and wellness, not personal medical advice. Visit www.docgiff.com to learn more. For comments, diana@docgiff.com. Follow on Instagram @diana_gifford_jones