Archive for the ‘Pain Management’ Category

Lyme Meningitis Leading to Low Sodium, Shoulder & Back Pain


Woman rubbing painful shoulder due to Lyme meningitis.

In their article “A Tick-borne Cause of Hyponatremia: SIADH Due to Lyme Meningitis,” Windpessl and colleagues describe a patient who was initially treated for sudden onset of shoulder pain associated with hyponatremia but later diagnosed with Lyme meningitis. [1]

By Dr. Daniel Cameron

There are many causes of hyponatremia. Any disorder of the central nervous system, including infections, can trigger it. However, only a few case reports of Lyme meningitis or Lyme neuroborreliosis have been published with a focus on hyponatremia, according to the authors.

Hyponatremia is a condition that occurs when the level of sodium in the blood is too low. With this condition, the body holds onto too much water. This dilutes the amount of sodium in the blood and causes levels to be low.²

One month prior to being admitted to the hospital, the 83-year-old woman had presented to the emergency department because of stabbing back pain, localized to the left shoulder.

“The shoulder pain gradually subsided but lower back pain ensued, worsening at night,” wrote the authors. “In parallel, she noticed difficulties in concentrating, unsteadiness, and poor appetite.”

The woman was admitted for an evaluation of unspecific gastrointestinal symptoms and weight loss.

Her sodium was low (hyponatremia (125 mmol/L) consistent with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) secretion.

The doctors could not find a cause. Drug-related hyponatremia was suspected in the absence of another diagnosis. And her blood pressure medication was changed.

The antihypertensive held. As sodium levels were slightly higher when controlled 5 days later, amlodipine was prescribed instead.

However, a month later, her sodium levels were still low (126 mmol/L).

“In view of the history, nocturnal back pain and obscure hyponatremia, she was admitted for a lumbar puncture,” wrote the authors.

Her spinal tap was diagnostic for Lyme meningitis.

SIADS resolved after a 3-week course of antibiotics.

“In hindsight, the lancinating shoulder pain prompting the patient’s first hospital visit likely represented Bannwarth syndrome, a radiculoneuritis occurring early in the course of Lyme disease,” the authors pointed out.

  1. Windpessl M, Oel D, Muller P. A Tick-Borne Cause of Hyponatremia: SIADH Due to Lyme Meningitis. Am J Med. May 27 2022;doi:10.1016/j.amjmed.2022.05.013


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Low Dose Naltrexone for Chronic Pain

Low Dose Naltrexone for Chronic Pain

Low Dose Naltrexone for Chronic Pain


Low doses of a drug that is commonly prescribed to recovering alcoholics and narcotic addicts is being used to help chronic pain sufferers find relief from a variety of pain conditions including fibromyalgia, inflammatory bowel, Crohn’s disease, and complex regional pain syndrome.  The drug is called naltrexone.

What is naltrexone?

Naltrexone is a prescription medication used to suppress narcotic and alcohol cravings in recovering addicts. Naltrexone is used as just one part of an addict’s overall treatment plan. It is prescribed only after a person is no longer dependent on drugs or alcohol.

How does Naltrexone work?

Naltrexone blocks the euphoric sensations associated with narcotic and alcohol use. It is non-addictive and produces no narcotic-like effects.

Researchers believe that naltrexone also modulates the release of inflammatory chemicals in the central nervous system. The drug temporarily binds to and blocks the Mu opioid receptors (MORs) which are central to pain control. When these receptors are blocked, the body responds by producing more pain-relieving endorphins.

Dosage of naltrexone for addiction vs for pain relief

When used for the management of addiction, the typical daily dosage of naltrexone is 50–100 mg per day. For chronic pain relief, the dosage is typically less than 8 mg per day. Patients may start off with a dose as low as .01 mg. A more typical starting dose is 1.5 mg. On average, dosages of low-dose naltrexone (LDN) are approximately 1/10th of the typical addiction treatment dosage.

Prescriptions for LDN can be filled by compounding pharmacies that grind up the higher dose tablet into ultra-low doses.

Are there side effects of naltrexone?

Common side effects of naltrexone when used for addiction management include nausea, fatigue, and loss of appetite. While most side effects are mild, serious side effects are possible. The Mayo Clinic provides a comprehensive list of all possible side effects. Side effects are less likely to occur in patients taking low doses of the drug.

A 2014 review found that the use of LDN for pain relief was “well tolerated” by patients and that there was “low reported incidence of adverse side effects.”

Research on low-dose naltrexone for pain relief

  • Results of a review conducted in 2014 indicated that “Low-dose naltrexone (LDN) has been demonstrated to reduce symptom severity in conditions such as fibromyalgia, Crohn’s disease, multiple sclerosis, and complex regional pain syndrome.” The review found Crohn’s disease to be the condition with the most scientific support when it comes to the efficacy of LDN for pain relief.
  •  A 2018 review found that “Clinical reports of LDN have demonstrated possible benefits in diseases such as fibromyalgia, Crohn’s disease, multiple sclerosis, complex-regional pain syndrome, Hailey-Hailey disease, and cancer.”
  • According to a 2020 review, “Low-dose naltrexone (LDN) has shown promise to reduce symptoms related to chronic pain conditions such as fibromyalgia, inflammatory bowel conditions, and multiple sclerosis.”
  • systematic review conducted by the University of Michigan School of Dentistry concluded that “Low-dose naltrexone provides an alternative in medical management of chronic pain disorders as a novel anti-inflammatory and immunomodulator. It can offer additional management options, as orofacial pain conditions share characteristics with other chronic pain disorders.” Authors of the study consider the drug “a good option for patients with orofacial and chronic pain, without the risk of addiction.”

What pain management specialists say about LDN

According to an article published by Weill Cornell Medicine in September 2020, their pain management specialists have had success treating chronic pain patients with low-dose naltrexone. When interviewed, Dr. Neel Mehta, said, “Generally, my patients report pain relief greater than 50 percent, that they’re sleeping better, or can return to work. And some patients end up responding well to doses as low as 0.1 for reasons we don’t yet completely understand. Patients are experiencing good results with low harm in these early studies.”

In an article published by NPR, Dr. Bruce Vroorman, an associate professor at Dartmouth’s Geisel School of Medicine and the author of the above-mentioned 2018 review, was interviewed. According to the article, “Vrooman says that when it comes to treating some patients with complex chronic pain, low-dose naltrexone appears to be more effective and well-tolerated than the big-name opioids that dominated pain management for decades.” He said that LDN is a “game changer” for some chronic pain patients.

In an interview with Michigan News, orofacial pain specialist Elizabeth Hatfield discussed the use of LDN. She said, “We found a reduction in pain intensity and improvement in quality of life, and a reduction in opioid use for patients with chronic pain.” She went on to say that it is best used on centralized pain disorders including fibromyalgia, complex regional pain syndrome, and TMJ.

Low-dose naltrexone may be a possible treatment for long COVID

According to a recent article published by Reuters, Dr. Jack Lambert, an infectious disease expert at University College Dublin School of Medicine, ran a pilot study on the use of LDN for long COVID. Lambert has reported previous success in using LDN to treat pain and fatigue associated with chronic Lyme disease.

After being treated with LDN for two months, the 38 pilot study participants reported improvement in energy, pain, concentration, insomnia and overall recovery from COVID-19.

Lambert is preparing to run a larger trial to confirm the results. He believes it is possible that LDN may work to repair the damage done to the body by the virus. 


Low-dose naltrexone appears to be safer and more effective for chronic pain than widely used opioids. It might be worth a try if you’re in chronic pain and want to avoid, reduce or eliminate the use of opioids. It’s important to find a knowledgeable healthcare provider who can guide you in terms of dosages and how to taper off of opioids safely.

Other options that involve oral administration of a substance in order to avoid, reduce or eliminate the use of opioids while safely improving pain relief include marijuana, CBD, kratom, an anti-inflammatory diet, nutritional supplements including vitamin D and magnesium.

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Christine Graf is a freelance writer who lives in Ballston Lake, New York. She is a regular contributor to several publications and has written extensively about health, mental health, and entrepreneurship.  

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NSAIDs: Unsafe for Chronic Pain

NSAIDs: Unsafe for Chronic Pain

NSAIDs: Unsafe for Chronic Pain

The Problem

If you take any of the following nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief you are putting your life at risk: aspirin, celecoxib (Celebrex), diclofenac (Cambia, Cataflam, Voltaren-XR, Zipsor, Zorvolex), ibuprofen (Motrin, Advil), indomethacin (Indocin), naproxen (Aleve, Anaprox, Naprelan, Naprosyn), oxaprozin (Daypro), piroxicam (Feldene). This may come as a shock to you. After all, these drugs have been around for decades and many are available over the counter.

It has long been known that NSAIDs increase the risk of potentially fatal stomach and intestinal adverse reactions including bleeding, ulcers, and perforation of the stomach or intestines. These events can occur at any time during treatment and without warning symptoms. Elderly patients are at greater risk for these adverse events. Aspirin alone causes over 3000 deaths annually in the United States.

NSAIDs, except for aspirin, increase the risk of a potentially fatal heart attack or stroke, according to an FDA advisory issued in July, 2015. The FDA warned that “those serious side effects can occur as early as the first few weeks of using an NSAID, and the risk might rise the longer people take NSAIDs”. “There is no period of use shown to be without risk,” says Judy Racoosin, M.D., M.P.H., deputy director of FDA’s Division of Anesthesia, Analgesia, and Addiction Products. People who already have cardiovascular disease, particularly those who recently had a heart attack or cardiac bypass surgery, are at greatest risk. However, “Everyone may be at risk – even people without an underlying risk for cardiovascular disease,” says Racoosin.

Heavy or long term use of NSAIDs can also cause kidney damage.

Unfortunately, another widely available over the counter pain reliever, acetaminophen (brand name Tylenol) also carries significant risks. If used long term at higher than recommended doses or in individuals whose liver function is compromised, acetaminophen can cause liver failure. Liver failure is fatal without a liver transplant. Acetaminophen is the most frequent cause of liver failure in the United States today.

The Solution

With prescription opioids becoming increasingly restricted due to concerns about addiction, as well as growing evidence that they may cause more pain over the long term, what can a chronic pain patient do?

Fortunately, there are many safe and effective natural treatments for chronic pain. Here are some things you can take for pain relief: medical marijuana, CBD oil, kratom (a Southeast Asian herb that the FDA and DEA are currently trying to ban based on false allegations that it is unsafe), wild lettuce, turmeric, omega 3 fatty acids, homeopathic remedies such as arnica, ruta or hypericum, magnesium, vitamin D3 and many other herbs and nutrients. Here are some things that you can do: acupuncture, biofeedback, chiropractic, EMF treatment, exercise, hypnotherapy, low level laser therapy, massage, nutritional therapy, physical therapy, psychotherapy and much more. Some combination of these treatments can not only reduce your pain, they just might heal the underlying problem and eliminate your pain for good. 

To find out more about safe alternatives for pain relief, visit the online Alternative Pain Treatment Directory

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Lyme/MSIDS patients often cope with intractable, grueling pain.  The stuff that stops you in your tracks & brings life to a grinding halt leaving you a shell of your former self.

I have found the following to be of great help:

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Unrecognized Lyme Disease Leads to 16 Joint Surgeries

Unrecognized Lyme disease leads to 16 joint surgeries

Sept. 19, 2022

By Meghan Holohan

When Meghan Bradshaw began fainting and experiencing joint pain, she visited many doctors. At first, they suspected that she might have a vitamin D deficiency or that she was anemic.

By her early 20s, her symptoms became “debilitating” and she passionately searched for answers. After years of being misdiagnosed, she learned she has Lyme disease, which caused arthritis, leading to 16 joint surgeries before the age of 30.

Meghan Bradshaw has had the joints in her lower extremities completely replaced. A late diagnosis of Lyme arthritis plus a connective tissue disorder likely contributed to the severity of her joint deterioration and the need for so many joint replacements before turning 30. (Courtesy Meghan Bradshaw)

“While it’s extreme, my story really highlights a lot of the things that other people experience, like delayed diagnosis and misdiagnosis and having a general unawareness of the dangers of ticks,” the 29-year-old told TODAY.



Important quote:

When Lyme disease goes untreated, the chance of developing arthritis increases. Lyme arthritis often starts in the knee, Gaston said.

About 60% will end up with some arthritis,” Gaston said.


I am currently dealing with this now.

While I am not a doctor, it is my experience and opinion that the quicker you deal with this inflammation/pain the better.  Allowing this process to fester could lead to irreversible damage.  The root, of course, is inflammation which must be addressed and dealt with.

Things that have helped tremendously:
  • MSM & DMSO
  • Proteolytic/Systemic enzymes
  • LDN
  • CBD
  • Niacinamide/vitamin C protocol
  • Curcumin
  • Diet can have a huge impact.  Gluten was my problem, but never appeared to be a problem before.  Removing it has made all the difference. I’m not celiac.  Some also struggle with dairy or the nightshade plants as well as alcohol and sugar.  Do an elimination diet to determine if getting rid of these things can help you.
  • Staying hydrated with water
  • Various laser therapies
  • Heat therapies
  • Massage therapy
  • Chiropractic care
  • If you are willing to spend $50, you may want to read a brief testimonial from someone who used  “The Arthritis Strategy” by Shelly Manning.  While I have not used it myself, it appears to be sound advice – although as always “buyer beware.”  It’s always wise to run things by your LLMD to make sure.  What’s nice about this is it’s about a month long strategy that will educate you fairly quickly on the things you can tangibly do yourself that could make a world of difference.  Sometimes it’s overwhelming to attack all these issues on your own.  With this strategy, you will have someone who has been there, giving you advice that worked for them.

You can also check out these resources:

Curcumin for Pain

Curcumin Helps Patient Recovery

Curcumin, the pigment that lends turmeric its yellow-orange color, has been recognized for millennia as a healing spice.

curcumin helps patient recovery


  • Studies show curcumin’s ability to repair and regenerate damage caused by strokes, enhancing verbal, visual and memory abilities and improving patients’ attention spans and other brain functions
  • Studies show that people who eat lots of curcumin-containing foods show fewer incidences of Alzheimer’s disease and sharper cognitive function and suggest meaningful cognitive benefits over time
  • Researchers have found several powerful health effects from curcumin, the active compound in the spice turmeric, particularly in relation to treating and preventing several common disorders
  • Eating foods and spices such as turmeric, which have high amounts of antioxidant compounds, may increase cognitive and mitochondrial function and mood, while decreasing depression caused by brain inflammation
  • Because the curcumin in turmeric is poorly absorbed through your gastrointestinal tract, it’s more effective to use a high-quality bioavailable curcumin extract

For those who appreciate the unique spiciness of turmeric, it’s serendipitous to learn there are several layers of extraordinary health benefits included with the active ingredient known as curcumin. One of the latest was revealed in a study in which scientists tested the powerful compound for its effects on heart failure patients.

Heart failure, experienced by over 6 million people in the U.S., weakens your heart and affects its ability to pump sufficient oxygen. Patients no longer have the ability to participate in activities and exercise like they once did, which could be described as life altering.

Heart failure is also described as chronic, progressive and incurable, although a change in lifestyle, such as eating a balanced, healthy diet and performing regular exercise can decrease feelings of fatigue and enhance their mood enough to help people resume their lives to a large degree.

Research published in the Journal of Applied Physiology reports that curcumin may help patients with chronic heart failure by increasing skeletal muscle strength, endurance and exercise capacity. Although mice were the subjects used in the trial, the scientists are hopeful their research can eventually be translated to human patients in a clinical setting.

Turmeric is in the same botanical family as ginger, another powerful spice with proven, health-beneficial compounds. With that in mind, corresponding study author Dr. Lie Gao, assistant professor of cellular and integrative physiology at the University of Nebraska Medical Center (UNMC), notes:

“This study showed an important proof of principle. Some foods and spices, such as broccoli and turmeric, contain a rich supply of antioxidant compounds. Consumption of these foods or spices may improve skeletal muscle health. For patients with stable heart failure that have limited ability to exercise, compounds like these may be beneficial.”

Interestingly, previous studies proposed that targeting skeletal muscle with antioxidants may be advantageous for heart failure patients, but Gao states that it’s not possible to use curcumin on humans because of the high amounts it would take.

Gao then suggests that “other antioxidants” such as dimethyl fumarate, a drug currently popular for treating multiple sclerosis, could be used for its health-improving benefits. That said, curcumin is one of hundreds of plant-based nutriments, from carrots to tobacco, to be unapologetically sourced and manufactured into pharmaceuticals.

Curcumin: Gingery, Earthy, Healing

Curcumin, taken from the underground rhizome of the plant, is the pigment that gives curry its bright yellow hue, explaining why turmeric is an ingredient used to complement and color stir-fries and sautéed root vegetables, rice, scrambled eggs and braised greens such as kale and collards.

In just the past few years, queries about the spice touted to have a “cult following” have increased exponentially, according to The Guardian. It’s showing up in foods like smoothies and the trendy turmeric latte known as golden milk, a potent blend of organic turmeric powder and coconut milk and/or virgin coconut oil.

Optional flavor additions include vanilla, raw honey or stevia, a stick of ginger and/or cinnamon, and sometimes a healthy dash of black or white pepper. The addition of ghee is used to soothe a sore throat.

In fact, the use of black pepper in golden milk is supported by a study in which the “curcuminoid-piperine combination” addressed the symptoms of metabolic syndrome in 117 study subjects who exhibited both oxidative stress and inflammation. According to the randomized, controlled trial and updated meta-analysis,7 oxidative and inflammatory status showed significant improvement, even with short-term curcumin supplementation.

Tellingly, turmeric is called the “spice of life” in India. Golden milk is becoming increasingly popular not just as a pleasant, warming drink for cool autumn evenings, but as a sleep aid for people who struggle with insomnia. Further, curcumin has been identified as a substance that’s safe, effective and natural.

A plethora of studies point to the anti-inflammatory properties of curcumin (Curcuma longa) and reveal more than 160 separate physiological and cell-signaling pathways, positively influencing arthritic conditions, cancer, obesity, inflammatory bowel disease, and, more recently, metabolic syndrome and dementia.

Studies Reveal Curcumin’s Powerful Potential for Your Brain

In another study from mid-2018, scientists at Texas A&M endeavored to relieve patients suffering from Gulf War illness (GWI), characterized by “substantially declined neurogenesis, chronic low-grade inflammation, increased oxidative stress and mitochondrial dysfunction in the hippocampus.” In the animal study, GWI rats treated with curcumin (CUR) maintained better memory and mood function. In addition:

“Enhanced neurogenesis, restrained inflammation and oxidative stress with normalized mitochondrial respiration may underlie better memory and mood function mediated by CUR treatment.”

The scientists wrote that their use of curcumin was due to its long-recognized ability to positively influence several aspects of brain health. The rats in the study were exposed to low doses of DEET, or N-diethyl-m-toluamide, a common insect repellant, and other chemicals related to GWI, such as pyridostigmine bromide and permethrin. They were also subjected to restraint for five minutes daily for a period of 28 days.

Even more recently, another study shows that chronic neuropathic pain and the cognitive impairment that accompanies it can be addressed with the antinociceptive (reduced sensitivity to painful stimuli) and neuroprotective application of curcumin, demonstrated using rats in a lab setting subjected to cobra venom.

Interestingly, the rats exhibited improvements in spatial learning and memory deficits, as well as increased exploratory activities due to the ability of curcumin to reverse the damage done to hippocampal neurons and synapses. Scientists concluded that curcumin can “alleviate pain, improve spatial learning and memory deficits, and treat chronic neuropathic pain-induced cognitive deficits.”

Mood and Memory Enhancement via Curcumin

The inflammatory and antioxidant properties of curcumin to improve memory and mood were again confirmed when UCLA published results of a double-blind, placebo-controlled 18-month trial in the American Journal of Geriatric Psychology, in which 90 milligrams (mg) of a bioavailable form of curcumin, taken twice a day, “led to significant memory and attention benefits” in people with mild memory loss.

Curcumin has been suggested as the explanation for why senior citizens in India, whose regular diets include generous amounts of curcumin-containing foods, show both a lower incidence of Alzheimer’s disease and sharper cognitive function. Further, the study “results suggest that taking this relatively safe form of curcumin could provide meaningful cognitive benefits over the years.”

Gary Small, director of the University’s Semel Institute for Neuroscience and Human Behavior and the study’s first author, notes that while the mechanisms behind curcumin’s brain benefits aren’t yet known definitively, they might be due to its inhibitory effect on brain inflammation, which has been associated with both major depression and Alzheimer’s disease.

Forty people, including healthy people without dementia as well as those with the characteristic “microscopic plaques and tangles” of Alzheimer’s, ranging in age from 51 to 84 years, participated in the study. Scientists took standardized cognitive assessments at the beginning of the study as well as at six-month intervals, and participants’ curcumin levels were checked in their blood after 18 months. Further:

“Thirty of the volunteers underwent positron emission tomography, or PET scans, to determine the levels of amyloid and tau in their brains at the start of the study and after 18 months. The people who took curcumin experienced significant improvements in their memory and attention abilities, while the subjects who received placebo did not …

In memory tests, the people taking curcumin improved by 28 percent over the 18 months. Those taking curcumin also had mild improvements in mood, and their brain PET scans showed significantly less amyloid and tau signals in the amygdala and hypothalamus than those who took placebos.”

The participants’ amygdala and hypothalamus — regions of the brain known to control several memory and emotional functions, which were positively influenced by the curcumin — were defined as critical areas of the brain.

Curcumin Is Used to Alleviate Stroke Damage

Still another study, this one presented at an American Heart Association International Stroke Conference, uncovered curcumin’s ability to repair damage caused by strokes, which have been called “brain attacks” caused when a blood clot blocks an artery or blood vessel, effectively cutting off blood flow and triggering brain cell death and sometimes brain damage and even death.

Stroke symptoms include an inability for individuals to walk due to a loss of balance, a sudden, severe headache, difficulty seeing, weakness, often on one side only, and sudden confusion. It’s crucial to know that the longer your brain goes without oxygen, the greater your risk of lasting damage.

A drug used on stroke victims, referred to as “clot-busting,” the current and most common intervention, is a synthetic contrast to the curcumin-hybrid known as CNB-001, which repairs damage sustained at the molecular level by the lack of oxygen.

Besides crossing the blood-brain barrier, CNB-001 works by influencing the mechanism responsible for the regeneration of brain cells and offers future stroke victims new hope for more complete recovery.

This is a specific example of a time when a drug can both save your life and prevent the very frequent and devastating outcomes of a stroke. Incidentally, medical intervention is crucial to help prevent such damage from stroke, but must be obtained within 60 minutes.

Curcumin to Help Prevent Cancer

Curcumin has been identified as one of the most powerful chemopreventive and anticancer agents, and recognized for its wide spectrum of pharmacological properties and inhibitory effects on metabolic enzymes, according to PubChem, which notes its wound healing and antimicrobial effects, and states:

“Curcumin blocks the formation of reactive-oxygen species, possesses anti-inflammatory properties as a result of inhibition of cyclooxygenases (COX) and other enzymes involved in inflammation; and disrupts cell signal transduction by various mechanisms including inhibition of protein kinase C.

These effects may play a role in the agent’s observed antineoplastic properties, which include inhibition of tumor cell proliferation and suppression of chemically induced carcinogenesis and tumor growth in animal models of cancer.”

The same study shows curcumin as able to suppress cancer proliferation and apoptosis (programmed cell death), thereby acting as a chemopreventive agent in skin, colon and stomach cancers. Other studies using animal models list breast, bladder, brain, esophageal, kidney, liver, lung, pancreas and prostate cancers, and more.

Significantly, the active elements in curcumin attack cancer while leaving healthy cells untouched. For the purpose of disease intervention, while turmeric is available in powdered form, it contains very little of the active compounds in curcumin, or only about a 3 percent curcumin concentration.

Because it’s not easily absorbed through your gastrointestinal tract, it’s more effective to use a high-quality bioavailable curcumin extract, according to a 2013 study. A typical anticancer dose is just under 1 teaspoon of curcumin extract three or four times daily.

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I recently added this form of curcumin to my regimen for arthritis pain.  I was pain free after one pill which is hard to even believe to me.  (I do not receive any payment from this or any supplement company)

I also use many other things for inflammation/pain as well.  I’ve found that all of these things have some benefit.