Why Is It Hard for Some People to Swallow Pills? by Heidi Mitchell

Commonly a problem with the ladies. The sweet tooth they developed over time usually frustrates the efforts of a doctor to effectively carry out his duty of making them well. A drug is prescribed for the benefit of the lady and she comes back later with the same complaint, and you discover she did not take the prescribed medication, usually because it is bitter.

For some healthy adults, getting sick enough to require medication is only half of the problem. The other is getting that pill to go down. Stephen Cassivi, a thoracic surgeon at the Mayo Clinic in Rochester, Minn., who specializes in esophageal disorders, offers one explanation for why some people find it difficult to swallow pills.

—Heidi Mitchell

Fear Factor

Dr. Cassivi says the reasons some people can't even get a baby aspirin to go down the esophagus are varied. "People who have underlying swallowing difficulties, called dysphagia, may have trouble swallowing pills, but that is generally the result of other problems, such as stroke or surgery or gastroesophageal reflux," he says.

For the rest of the population, Dr. Cassivi notes, pill-swallowing difficulty is usually related to a fear of gagging, which might come from a bad experience with taking a pill. "Fear of gagging is pretty prominent" and a bad experience can cause one to think a pill is harmful and thus cause the throat muscles to tighten, he says. To swallow pills without worry, one has to "get over the mental hump" and relax the muscles.

It's Just a Phase

There are three phases to swallowing: oral (chewing, moistening and delivering food to the back of the mouth); pharyngeal (which includes the closure of the larynx by the epiglottis and vocal cords, and the temporary inhibition of breathing as the food passes); and esophageal (the rhythmic contractions of the esophagus to deliver food to the stomach, among other actions).

"We have an unconscious ability to know when food is moistened and masticated enough to be delivered to the back of the throat," Dr. Cassivi says. For instance, no one chews yogurt—typically one just swallows it—but not being able to chew a hard substance like a pill can throw the mind-body connection in swallowing off, he says.

The oral phase is the voluntary phase and may be the key to helping many people overcome pill-swallowing difficulties.

Down the Hatch

Many pill-phobes will dissolve medication in water or cut it into small pieces to get it down, but Dr. Cassivi doesn't advise this. "An extended-release pill has layers to delay the release," he says. "If you chew, dissolve or cut it, you're not delivering the medication as it was intended."

A pill with a scored line, intended as a guide for cutting it in half, he says, may sometimes be bitten or split before ingesting, but in general, "it's always better to swallow a pill whole." For some people, gel capsules are easier to swallow than chalky pills, but for other fearful swallowers, a pill is a pill.

Practice Run

Practicing while not in distress is the best way to get over difficulty swallowing pills, says Dr. Cassivi. He used to cut up gummy bears to teach his children.

Another strategy: Sit up so gravity can help the process. Drink a sip of water, then put the pill in your mouth. Take another sip of water and swallow. Positive reinforcement is often a good motivator. "Tell yourself, 'This is a small pill, it's smaller than the last piece of steak I ate,' " he says.

Looking to the side can be helpful. "A team of scientists in Canada found that by turning the neck, the upper esophageal sphincter seems to open slightly more, which may allow for more accommodation of swallowed material," he says.

Distraction is often a good technique. If you place the pill in apple sauce or yogurt, your body may get used to accepting it without feeling the need to chew it, he says.

One thing most people shouldn't worry about is having the pill go down the wrong way. "The vocal cords and epiglottis serve a purpose in coordinating the temporary closing off of the airway and avoiding what we call aspirating," he says. "Unless your wiring is off due to nerve or muscle disorders, it's not a concern."

Dr. Cassivi says there is no perfect solution to overcoming an inability to swallow pills. "But over time we realize that it's what we need to do, and it becomes like riding a bike."

online.wsj.com

THE TRUTH ABOUT SLEEP, SCIENCE, AND PRODUCTIVITY

When the topic of sleep arises, two questions invariably follow:

What's the perfect amount of sleep to keep batteries charged and stay productive?

How do I go to sleep the right way?

Both are common questions, but the answers aren't as simple as they might seem.

THERE'S NO MAGIC NUMBER

The fabled story of the sleep-deprived genius who is recognized for their brilliance after years of work in the witching hour might not be that far off.

Legendary inventor Thomas Edison, for example, once referred to sleep as "a heritage to our cave days." The likes of Nikola Tesla, Benjamin Franklin, Napoleon, and Leonardo Da Vinci were notorious for clocking in roughly four hours a night--or day, as many of them relied on cat naps instead. And a host of today's business leadersfollow suit.

But that's not to say that they weren't getting enough sleep. According to the Sleep Foundation, it's just that: while four hours a night might seem an insanely low figure to you, every person is different.

Just like any other characteristics you are born with, the amount of sleep you need to function best may be different for you than for someone who is of the same age and gender. While you may be at your absolute best sleeping seven hours a night, someone else may clearly need nine hours to have a happy, productive life.

Despite this, most of us are hardwired to think that we don't get enough sleep, even though we really do.

So ignore the mantra that every person needs 8 hours a night to ensure a healthy lifestyle (though we're not saying rest isn't good for you!). The fact remains that if you feel rested after, say, 6 hours, it's probably enough.

However, if you find trouble keeping awake during the day or experience a massive dip in productivity give naps a try. Leo Widrich, co-founder of social media company Buffer, and a Fast Company contributor swears by it, and shares 3 tips to getting the most out of naps in the workplace.

Especially if you work in a big office, or you tend to feel others might consider you slacking off. One of the key things I found here is to make others aware of the fact, that you are napping every day. Try and get encouragement from your co-workers or your boss, so you can set yourself up for developing a successful habit.

Timing is, if not everything, at least very important. Don’t let your naps exceed 30 minutes max. Many sleep20 minutes has proven to be the optimal timing for me.

The last tip I find most crucial is to make napping a consistent habit. Keep both the frequency (daily) and the time of day ( around 3 PM seems to be a very popular time, as productivity dips then) the same and consistent.

NOW THAT I KNOW I'M GETTING ENOUGH SLEEP, HOW DO I DO IT RIGHT?

For optimal snoozing your bed should be used for two things, and two things only: sleep and sex.

Your bedroom should be a palace of sleep. If you have a desk or television in there, that's okay, just make sure it's out of the way when you're getting ready to count the sheep so it doesn't trigger anxiety. If your mind is elsewhere you're going to have a hard time nodding off.

That's not to say that the convenience of relaxing on a comfy mattress and playing on a computer isn't glorious. But to get a good night's sleep you need to resist the urge and do it somewhere else. Your brain should have only one thing on it's mind when you crawl into bed.

It is best to take work materials, computers and televisions out of the sleeping environment. Use your bed only for sleep and sex to strengthen the association between bed and sleep.

You can boost this effect by incorporating sleep-signaling habits in your bedtime routine. Take a hot bath or water the plants. It could be anything, but remember, you're telling your body that by doing a certain activity, it's time for bed.

The bottom line: understand that sleep is highly individual, and to ensure that you can fall asleep when you need to, train your brain into knowing when it's time to turn the lights off.

www.fastcompany.com

SECOND-ACT-CAREER SUCCESS STORIES, FROM THOSE WHO'VE CREATIVELY REINVENTED THEMSELVES

So is traditional job recruiting dead? Not totally. But it may be on life support. New data from Jobvite, an online recruiting platform, found that 94% of recruiters are using or plan to use social media to find qualified candidates. More than three-quarters (78%) have already made a hire through social media.

We've previously noted how a well-placed, expertly crafted 140 characters can open the door to a dream job. YouTube, GitHub, Stackoverflow, Yammer, and Instagram are also emerging as channels that recruiters use to source talent.

While most digitally native millennials like Rodriguez flex easily between Facebooking their friends and tweeting for professional purposes, those over age 40 who started their electronic correspondence on plug-in typewriters might think they’re at a disadvantage. Not so. Fast Company rounded up a few gen-Xers and Boomers who’ve not only found work through a clever use of social channels, they’ve actually transitioned into them from totally unrelated careers. Read on for their inspiring tales of transformation.

The Social Butterfly

Back in 2008, Kay Roseland found herself unemployed along with thousands of other workers whose jobs were casualties of the recession. Unlike many of them, the former merchandise analyst for an online retailer was over 60 and closer to retirement than a new chapter. Roseland simply looked at being laid off as an opportunity to learn something new.

“I knew zero about social media in 2008. I now have 2 certifications in social media,” she tells Fast Company. “When in doubt, go to school.”

While Roseland was getting comfortable tweeting and using LinkedIn, she also started a blog called Shareology the following year. Roseland says that while she can’t recall tweeting directly to a hiring manager, she does credit using all the channels to score her next gig.

I attended a Saturday event called Product Camp. I volunteered to help collate the goodie bags at 7 a.m. It was held at the Minneapolis campus of the University of St. Thomas where I received my MBA about five months before my layoff. I noticed a woman was speaking on social media who was leading the goodie bag collation, and I made it a point to attend her social media session. The rest is straight-from-the-book networking:

-I connected with her on LinkedIn.

-I invited her to coffee at a time and place convenient for her.

Two months later in January, I was standing on the front steps of the James J. Hill library and actually looking at her office building, freezing to death and waiting for the research library to open when I got an email from [this person] asking if I would be interested in working for her boss. They had always wanted to start a blog for the group and had never gotten it done. I got hired to make that happen.

At age 64, Roseland was hired to blog for Infor--the company that astute readers may remember as the world’s largest startup. She now mentors her boss, the vice president of product management, on how to use Twitter and be more social.

Never Underestimate the Power of Email

Back in 2004, Gail Dosik didn’t have the benefit of knowing the nine deadly sins of email. At 50, this veteran of the fashion industry has just traded designer shoes for an apron and a chef’s toque at culinary school. Getting a job was another story.

“I knew I was too old to work on a restaurant line and I always wanted my own business,” she tells Fast Company. So she started One Tough Cookie, a Manhattan-based gourmet bakery. Even though she was in a completely new milieu, Dosik knew she had to drum up customers.

“The boldest move I made was to send an email and some photos to [the now defunct] Urban Baby and got a write-up from them,” Dosik recalls.  She spent the rest of that day in her pajamas fielding a flood of phone calls and emails.

As time went on, Dosik turned to social media to grow the business. Though she never got far on Myspace, she immediately latched on to Twitter. “It gave me (a) community, (b) introduced me to so many wonderful people I call friends in real life now, and (c) is a fabulous vehicle for promotion. Instagram, too, has been incredible for building business,” she asserts. Dosik also has a number of how-to videos on YouTube.

For Dosik, it's more than promotion. “Social media totally keeps you young, hip, and happening. I've been interviewed a lot from people who've found me on Twitter.  Many thought I was in their age range and were shocked when I told them I could be their grandma.”

I Got Sued By Facebook

Diane Danielson’s story begins before she turned 40. As an attorney, she had no experience with technology but all that changed when she pivoted to take a job in marketing. “I started to see you can’t ignore this website and email thing,” she tells Fast Company. Though she managed to launch the company’s first website, Danielson eventually left marketing behind when the Boston Globe asked her to blog for them. “I had no idea what a blog was but I learned to say yes, sure.”

Along with that, she was running the Downtown Women’s Club, a peer mentoring and networking group in Boston. Danielson started thinking it would be great if the group had an online directory where members could upload their own photos and information and also show who else they knew in the group. Sound familiar? “Well this was in 2005 and we started hearing about this Facebook thing out of Harvard,” recalls Danielson. In keeping with the paper student “facebook” registers of yore, Danielson gave her own online network the same name, but had to stop when Zuckerberg and company asked them to change it.

Danielson continued to forge a path using existing channels as they became available. “I was on Twitter before Ashton Kutcher,” she wisecracks, recalling that there was an app that used to verify if you joined the platform before he did. She also took classes at Code Academy. Though she wasn’t looking for work, keeping her online profiles easily searchable eventually led her current company, the commercial real estate franchiser Sperry Van Ness International Corporation, to come calling. “They wanted someone who did social media and real estate and I was the only one who came up,” she explains. Danielson is now second in command behind the CEO.

The Little Blog That Could

Mike Levine always loved trucks. So when he graduated from college with a degree in finance, he promptly got a job in IT at IBM but also started a blog to share stories with other pickup truck enthusiasts.

“We received funding in 1999--right before the dotcom bust--so I was full time on it for two years but had to go back to software development at Visa in 2001 to make ends meet,” he tells Fast Company.

It would be six years before Levine could get back to his passion project full-time. The site was acquired in 2008 by Classified Ventures/Cars.com, but Levine wasn’t left alone for long. His site had captured the attention of the folks at Ford, and he was offered a position in 2011 managing Ford Truck Communications for North America.

Storytelling is Always a Desirable Skill

What would a classically trained anthropologist have to offer semiconductor chip maker Intel? Plenty, it turns out. It's all how you frame it.

Todd S. Harple is an anthropologist with museum training who did fieldwork for his PhD on the west side of New Guinea. His first job after earning his doctorate degree was on a museum project at Harley-Davidson .

After world politics (the 2002 bombing in Bali) stopped further work in Harple’s chosen field, he had to reinvent himself. “The combination of Monster.com and a hiring manager whose mother did a PhD at the Australian National University helped,” Harple tells Fast Company.

“I recall my job talk being framed like Forrest Gump,” he explains. “I'd been to strange places, met influential people, and heard all sorts of stories. The nub of my interview/job talk was about storytelling and how people express values via stories.”

Eight years and a promotion later, Harple is still at Intel as experience engineer for new devices innovation.

www.fastcompany.com

CREATIVITY IS REALLY JUST PERSISTENCE, AND SCIENCE CAN PROVE IT

If we want to be super creative, we have to learn to be super dedicated. It's a hardworking thing, as War of Art scribe Steven Pressfield has insisted:

• When we sit down each day and do our work, power concentrates around us. The Muse takes note of our dedication. She approves. We have earned favor in her sight. When we sit down and work, we become like a magnetized rod that attracts iron filings. Ideas come. Insights accrete.

His exhortations have been echoed elsewhere: As Brain Pickings' Maria Popova arranges, artists have long known that the muse loves a working stiff:

• Writer E. B. White: "A writer who waits for ideal conditions under which to work will die without putting a word on paper.”
• Painter Chuck Close: “Inspiration is for amateurs--the rest of us just show up and get to work.”
• Composer Peter Tchaikovsky: “A self-respecting artist must not fold his hands on the pretext that he is not in the mood.”

What's amazing is that advances in science have allowed us to get a better idea as to why better ideas come after jumping into our workflow, rather than waiting for sudden inspiration to strike.

THINK, CONCENTRATE, AND IDEAS WILL COME.

There's a lot more happening in your mind than what's immediately observable--as in, lots of your thoughts happen without your active thinking. Writer and neuroscientist David Eagleman wrote the book on how so much of our mental lives are incognito. And as he told NPR, it's pretty wild in there:

"All of our lives--our cognition, our thoughts, our beliefs--all of these are underpinned by these massive lightning storms of [electrical] activity [in our brains,] and yet we don't have any awareness of it," he says. "What we find is that our brains have colossal things happening in them all the time."

The question, then, is how to work a little more deftly with these lightning storms and better awaken our inner mental meterologist. Consciously or not, it seems that the slow, disciplined effort of concentration helps work with that weather.

THE AHA MOMENT ISN'T ALWAYS SO ALL OF A SUDDEN.

When insights seem to come out of nowhere--for instance, say, while you suds up in the shower--they, in fact, come from somewhere. An oft-cited paper by John Kounios of Drexel University and Mark Beeman of Northwestern University contends that "although the experience of insight is sudden and can seem disconnected from the immediately preceding thought, these studies show that insight is the culmination of a series of brain states and processes operating at different time scales."

Expressed in plain English, this means that a single moment of insight is the result of thinking that happens before it--often, the authors state, due to reorganizing or restructuring the elements of a situation or problem. This echoes the favored Fast Company definition of creativity, that it's finding the connections between seemingly unrelated things.

IN YOUR LIFE: HOW SHOWING UP--AND KEEPING FOCUSED--ENABLES CREATIVE INSIGHT

Working memory is the psychology-like term for all the stuff that you're paying attention to right now and what you can readily recall. If you lost your keys this morning, it's likely that you weren't paying attention to that automatic action, so that act never entered into your working memory--, at least if you're a Fast Company staffer. You've got a finite amount of attention stuff--and the way you invest it kinda decides your life.

Researchers at a group of Dutch universities studied the productive effects of a finely tuned working memory, saying that it "enables persistent, focused, and systematic combining of elements and possibilities"--right in line with how we define creativity.

They call that getting-there ethic persistence. We call it getting to know the Muse.

www.fastcompany.com

The Unofficial Guide To Being A Man

We’ve all seen and perhaps grown tired of guides and lists that are rife with tedious clichés and full of humdrum regurgitated meme wisdom.  

For that very reason, @GSElevator — in collaboration with John Carney (@Carney) of CNBC.com — presents a fresh, and hopefully thoughtful, look at what it means to be a man today.

• Stop talking about where you went to college.
• Always carry cash.  Keep some in your front pocket.
• Rebel from business casual. Burn your khakis and wear a suit or jeans.
• It’s okay to trade the possibility of your 80s and 90s for more guaranteed fun in your 20s and 30s.
• The best public restrooms are in hotels: The St. Regis in New York, Claridge’s in London, The Fullerton in Singapore, to name a few.
• Never stay out after midnight three nights in a row … unless something really good comes up on the third night.
• You will regret your tattoos.
• Never date an ex of your friend.
• Join Twitter; become your own curator of information.
• If riding the bus doesn't incentivize you to improve your station in life, nothing will.
• Time is too short to do your own laundry. 

• When the bartender asks, you should already know what you want to drink.
• If you perspire, wear a damn undershirt.
• You don’t have to like baseball, but you should understand the concept of what a pitcher’s ERA means.  Approach life similarly.
• When people don’t invite you to a party, you really shouldn’t go.
 And sometimes even when you are invited, you shouldn’t go.
 

• People are tired of you being the funny, drunk guy. 

• When in doubt, always kiss the girl.
• Tip more than you should.
• You probably use your cell phone too often and at the wrong moments.

• Buy expensive sunglasses.  Superficial? Yes, but so are the women judging you. And it tells these women you appreciate nice things and are responsible enough not to lose them.
• If you want a nice umbrella, bring a sh*tty one to church.
• Do 50 push-ups, sit-ups, and dips before you shower each morning. 

• Eat brunch with friends at least every other weekend. Leave Rusty and Junior at home.
• Be a regular at more than one bar.  
• Act like you’ve been there before.  It doesn’t matter if it’s in the end zone at the Super Bowl or on a private plane.
• A glass of wine or two with lunch will not ruin your day.

• It’s better if old men cut your hair.  Ask for Sammy at the Mandarin Oriental Barbershop in Hong Kong.  He can share his experiences of the Japanese occupation, or just give you a copy of Playboy.
• Learn how to fly-fish.  
• No selfies. Aspire to experience photo-worthy moments in the company of a beautiful woman.
• Own a handcrafted shotgun.  It’s a beautiful thing.
• There’s always another level. Just be content knowing that you are still better off than most who have ever lived.
• You can get away with a lot more if you're the one buying the drinks.
• Ask for a salad instead of fries.

• Don’t split a check.
• Pretty women who are unaccompanied want you to talk to them.
• Cobblers will save your shoes. So will shoe trees.
• When a bartender buys you a round, tip double. 


• The cliché is that having money is about not wasting time. But in reality, money is about facilitating spontaneity.
• Be spontaneous.
• Find a Times New Roman in the streets and a Wingdings in the sheets. She exists.
• Piercings are liabilities in fights. 

• Do not use an electric razor. 

• Desserts are for women. Order one and pretend you don’t mind that she’s eating yours.

• Buy a tuxedo before you are thirty. Stay that size.

• One girlfriend at a time is probably enough.

• #StopItWithTheHastags
• Your ties should be rolled and placed in a sectioned tie drawer. 

• Throw parties. 
But have someone else clean up the next day.
• You may only request one song from the DJ. 

• Measure yourself only against your previous self.
• Take more pictures.  With a camera.
• Place-dropping is worse than name-dropping.

• When you admire the work of artists or writers, tell them. 
And spend money to acquire their work.


• Your clothes do not match. They go together. 

• Yes, of course you have to buy her dinner. 

• Staying angry is a waste of energy.

• Revenge can be a good way of getting over anger. 


• If she expects the person you are 20% of the time, 100% of the time, then she doesn't want you.
• Always bring a bottle of something to the party.


• Avoid that “last” whiskey. You’ve probably had enough. 

• Don’t use the word “closure” or ever expect it in real life. There may still be a mortally wounded Russian mobster roaming the woods of south Jersey, but we’ll never know.
• If you are wittier than you are handsome, avoid loud clubs. 

• Drink outdoors.
 And during the day.
 And sometimes by yourself.
• Date women outside your social set. You’ll be surprised.

• If it’s got velvet ropes and lines, walk away unless you know someone. 

• You cannot have a love affair with whiskey because whiskey will never love you back.

• Feigning unpretentiousness is worse than being pretentious. Cut it out with the vintage Polo and that ’83 Wagoneer in Nantucket.
• The New Yorker is not high-brow. Neither is The Economist. 

• If you believe in evolution, you should know something about how it works.
• No-one cares if you are offended, so stop it. 

• Never take an ex back. She tried to do better and is settling with you.
• Eating out alone can be magnificent. Find a place where you can sit at the bar.
• Read more. It allows you to borrow someone else’s brain, and will make you more interesting at a dinner party – provided that you don’t initiate conversation with, “So, who are you reading …”
• Ignore the boos. They usually come from the cheap seats.
• Hookers aren’t cool, and remember, the free ones are a lot more expensive.
• Don’t ever say, “it is what it is.”
• Start a wine collection for your kids when they are born.  Add a few cases every year without telling them.  It’ll make a phenomenal gift in twenty years.
• Don’t gamble if losing $100 is going to piss you off.
• Remember, “rules are for the obedience of fools and the guidance of wise men.”

www.businessinsider.com