All posts by AdamPressman

Leadership

11 self-care strategies for freelancers

Andrew Carter

Freelancers Union

This is a post from a member of the Freelancers Union community. If you’re interested in sharing your expertise, your story, or some advice you think will help a fellow freelancer out, feel free to send your blog post to us here.
As freelancers and entrepreneurs, we’ve all heard the standard self-care strategies like take a break, eat well, exercise… yadda yadda. But there are a lot of things that many people don’t talk much about that you can do in your personal life as well as your business to help prioritize your health and well-being. I’d like to run you through a few little-known self-care strategies that you might not have considered thus far to help keep you focused on what’s really important in your business: You.

Know how you spend your time

Do you know how you spend your time? Where do you use your energy throughout the day? To start, do you know how many hours are in a week without Googling it?
FYI, there are 168 hours in a week.
So, let’s break it down, how do you spend a normal week?
  • 8 hours sleeping/day (56/week)
  • 8 hours working/day (40/week)
  • 6 hours cooking/week
  • 11 hours eating/week
  • Everything else
All together that’s 113 hours of things you “must” do. So, what’re you doing with the other 55 hours? TV, Netflix, social media? If you don’t really know, then it’s time to find out.
If you go to a nutritionist, what’s the first thing they’ll tell you? Keep a food log. If you go to a personal trainer what will they pull out? A workout log. Financial planner? A payment log. For these people to do their jobs, they have to know where you are right now to identify the areas of improvement.
It’s easy to keep a time log. Grab a piece of paper, or you can do it in a Word Doc. Create a table with 7 columns, one for each day, and 16 rows, one for each hour that you’re awake. Every hour, write down what you’ve done. At the end of the week you’ll have a very good idea as to where all your time goes.

Turn off non-essential notifications

Notifications were invented for one thing and one thing only: to distract you. I know it feels great that someone commented on your LinkedIn post or shared your newest Pinterest recipe. But, do you really have to know the second it happens? Waiting a few hours until you take a break or a little time to yourself will not change the fact that someone has interacted with your post.
Now, I understand that for social marketing the faster you respond to comments the better the algorithm places your post, so using them for your business in that way is understandable. For your personal accounts though, no way!
Do you need notifications that your Aunt Jannete has sent you an email on Gmail? Probably not. If you have a professional email for clients, then you can set up notifications for time-sensitive emails only if you must, but everything else is just a distraction.
Personally, when I used to get notifications, I would look at every single one, no matter what I was doing. It breaks your rhythm and concentration and it’s been shown to lower productivity and effectiveness. Not being productive and looming deadlines are a huge stress factor in most freelancer’s lives. Just try to avoid as many distractions as you can.
According to a study by Deloitte, if you’re like most people you’re checking your phone on average 47 times per day. But let’s be honest, we freelancers like our technology more than that!
Now, obviously, the numbers are different for different generations but even you’re reaching half those numbers, that’s still 15 hours of social media a week. How can you have any focused work time if you check your phone, on average, about 10 times an hour?

Vision/mission statement

Do you know why people are indecisive, make poor decisions, and waste time? It’s because they lack a vision or a goal. If you don’t know where you’re headed, then every small decision has to be weighed and considered. That takes a lot of willpower and concentration that most freelancers can’t afford to part with.
Creating a mission/vision statement for your company puts up filters that easily allow you to decide if something will help you fulfil those statements or not. If it will help you and you can fit it into your schedule, do it. If it doesn’t, don’t. Easy as that.
You need to have a direction and an endgame, or you’ll end up saying yes to every little project, poorly paying offer, and nightmare client out there. Set your boundaries and stick to them.

Pay yourself first

This is a very part of a financial plan, because if you don’t automatically transfer money out of your account right after getting paid it’s very unlikely that there will be any left at the end of the month. When you pay yourself first, it doesn’t “hurt” as much, and you’re setting yourself up for future success.
Now as self-care strategies go, it’s fairly similar but paying yourself first in this regard means doing non-urgent priorities before you do anything else. What are non-urgent priorities?
Those would be things like exercising, preparing a weekly food menu, meditating, journaling and doing the things that make you happy before you do the time-sensitive things. (Hint: you may have to overhaul your mornings, but most freelancers don’t have a specific time they need to be at the office, so it’s not that important).
If you plan self-care first thing in the morning, you’re much more likely to follow through. If you wait until 6 pm when you finish work, that glass of wine and the couch will beat out any health goals you had established. Pay yourself first, and you won’t have to worry about saving extra energy at the end of the day or money in your bank account. Both are good strategies.

Play a game you can win

When it comes to to-do lists, many freelancers and entrepreneurs are playing a game they can’t win. Our lists have 150 items that seem to just get longer throughout the day. We go to bed defeated because we think “we didn’t do much” and wake up overwhelmed because “we have so much to do”. There isn’t enough time in the day to get everything done on that list. So how do we make this freelance game winnable?
Change it.
I’ve borrowed a few self-care strategies from Michael Hyatt, but I must say, his Big 3 have actually changed my life. In essence, the Big 3 are the three tasks that you need to get done today to make your day a success.
Ask yourself, “What are the 3 most important tasks that will most help me reach my goals today?” Everyone can do three things today. The rest of the to-do list is just bonus points.
I like this strategy for many different reasons, but unlike a few of the common self-care strategies of “make a to-do-list” and “write things down”, the Big 3 prioritizes exactly what will help you the most today. This builds on the idea that “success is a series of small wins” and it’s oh so true!

Set time blocks

If you’ve been freelancing for a while you probably have a normal daily routine already, but you may not have let everyone else in your life know. Setting boundaries on your time is one of the most effective things you can do as someone who works from home. Say for example you work from 10AM-12PM on your biggest task of the day. Phone off, door closed, social media blocked (check out the anti-social app) and get to work.
Can you imagine how much you could get done with zero distractions? You need to be very firm with these time blocks. Although you’re working from home, you’re still at work. No being bothered by the kids, your spouse, the dog, the mailman, nothing. 98% of things can wait an hour or two without the world catching on fire.
Block out your timeslots and make sure everyone in your life knows that during those times you can’t be contacted (besides emergencies of course).

Make your bed

I can hear you now, “really? A list of self-care strategies including make my bed? Great advice buddy…” Now just give me a second. There are certain habits out there like exercising, daily goal setting, family dinners, keeping a food log, and yes, making your bed, which have been linked to improvements in completely unrelated areas. It follows the idea that “success begets success” and there’s hard data to prove it.
One small win like making your bed every morning makes going to the gym, waking up without hitting the snooze button, eating better, and being more productive not seem so hard.

Unsubscribe from everything that isn’t helpful

Let me tell you a little story. I’ve been living in Spain for almost 6 years now, and as of about a year ago, I was subscribed to over 20 newsletters from US-based retailers that I hadn’t used or read in over 5 years. I got daily emails from Target, Best Buy, Walmart, Amazon.com and a lot more. Every day I would go into my email, and I would have to delete them manually. Every. Single. Day.
Why was I doing that to myself? Laziness probably. It may not seem like much to delete a few emails each day, but there’s a theory called Decision Fatigue. It’s based on the idea that the more decisions you make throughout the day, the more difficult each decision becomes, and so you start making worse choices as the day goes on.
So now back to my long list of subscriptions. I was wasting my precious decision-making muscle on whether I should read or delete emails from things I hadn’t used in over 5 years. That’s insane.
So, head into your Gmail and unsubscribe from every newsletter that is not helping you achieve your goals or improving your life (except mine, of course :-D).

Quit multitasking

Multitasking is “merely the opportunity to screw up more than one thing at a time”, as Steve Uzzel says in his book, The ONE Thing. Basex, an information-tech research firm, found that interruptions consume an average of 2.1 hours per day or 28% of the workday.
The numbers are probably a bit different than for freelancers–but maybe not all that different if you think about it. Office workers have to deal with their bosses, co-workers, emails, phone calls and everything else that comes with working a 9-5. As freelancers, we have to deal with a lot more distractions that they haven’t thought of.
At home, you have your couch 50 feet away, Netflix is just a few clicks away, your kitchen on the other side of the wall, the dog needs to go out. Maybe I should fold some laundry, I haven’t dusted for a while, how about I just take out the garbage… and on and on and on.
If we don’t firmly separate our personal and professional lives, they start to blend together, and multitasking becomes a part of our reality.
(I’m ashamed to say that I have a load of laundry in the washing machine right now. Hey, I never said I was perfect, but I’m working on it.)

Prepare weekly food menus

A lot of these self-care strategies involve planning, and this one is no different. Setting goals allows you to prioritize decisions. Paying yourself first is planning your morning around different self-care strategies. Setting aside 10 minutes every Sunday night to plan out your weekly meals will not only save you from reaching for the snack drawer but also the decision fatigue when you get to the store.
Tell me this, have you ever gotten to the store around 6 pm and you weren’t sure what you were going to get when you went? What’d you end up buying? I’m sure it wasn’t fish and vegetables.
We’ve all heard the standard self-care strategies of taking a break, exercising, eat well, drink water. Don’t get me wrong though! These are incredibly important self-care strategies, but I believe these don’t happen overnight, and they need to be planned.
Take care of yourselves out there. Freelancers are the future. Happy freelancing!
Andrew Carter is the founder of Healthy Freelancers, where he aims to help freelancers prioritize their health by learning to put themselves first. He’s a full-time translator from the US but currently living in Barcelona.
Measure
Measure
Leadership

14 Extreme Ways to Save (for Those Hungry for Money to Invest)

Craig Curelop | BiggerPockets.com

 

This article is not for beginners. It’s not for those just thinking about purchasing their first property in pursuit of financial independence. It’s for those who are ready, willing, and able to take their life in their own hands. It’s for those ready to seriously start making serious strides towards saving ~$20,000 to get that down payment for a first property.
If you aren’t one of the lollygaggers, if there is absolutely nothing that is going to stand in between you and freedom, this article is for you.
In this post, I am going to describe some extreme budgeting techniques that some of my friends and I have used to save a significant amount of money, allowing us to quickly jump into this real estate game!
Full disclosure: Some of these are extremely affective, while others may seem completely outlandish. I suggest giving them a shot before shutting them down.
Here it goes.

Living: The Rent Hack

The rent hack is house hacking before you have the means to house hack. What you do here is you find a 2-5 bedroom apartment or house that you can rent. You rent the entire thing from the landlord and turn around and rent it by the room (or Airbnb it) to other people such that they are covering your full rent payment.
For example, you find a 3-bedroom house for $1,200 on Craigslist. You rent out the entire place from the landlord for $1,200 and then rent out each of the other two bedrooms for $600 each. That way, you are collecting a total of $1,200 from your roommates, paying your landlord $1,200, and effectively living for free. The more bedrooms you rent out, the higher likelihood that you will bring in money from your living situation.
Note: You need to let your landlord know that you are doing this! This is a new idea so most will likely say no, but it only takes one yes to get started. I would hope that a couple of rejections are worth $600+ per month.

Transportation: Bike to Work & Turo

Ideally, the house or apartment that you find is within walking or biking distance to work. That way you eliminate your need for a car. If you don’t have a car, that’s great! Let’s keep it that way.
If you do have a car and don’t want to get rid of it, then you can rent it out on this site called Turo. People coming into town will borrow your car for a few days and will pay you to use it while you go about your day normally.
This is a very good way to transition your car from a “liability” that takes money out of your pocket to an “asset” that puts money in your pocket.

Food: Grocery Shop & Grocery Shop Cheap

Food is another large expense for many Americans. One of the reasons this is the case is because we so frequently go out to eat where the meals are three times as much. No thanks!
If you want to save in the food department, you need to start making the grocery store a place you frequent. However, grocery stores can be dangerous too! There are a lot of things that are tempting but that you don’t need. Stay strong!
A BiggerPockets user recommended the Mealime app to me. I started using it and it’s great! You can pick what you want to eat, and the app automatically populates the ingredients for you. When you go into the grocery store, ONLY get what is on the list. Once you start to stray from your list, your money starts to stray from your bank account.
I know, I know. That’s really not all that extreme, but I really like it so I wanted to give it a shoutout. Here are some of the extreme tips:

Buy in bulk.

Costco is one of the greatest places in the world to buy in bulk. You don’t need to buy your meat or produce at Costco if you don’t like eating the same thing for a week (though I do it). I’m talking about all non-perishable items: toilet paper, toothpaste, oatmeal, canned goods, etc. Buy these items in bulk ,and you’ll save hundreds (if not thousands) of dollars over the course of the year.

Go meatless for lunch.

If you’re vegetarian, this won’t be too hard for you. However, if meat is the staple of your every meal, there is likely some slimming down you can do (pun intended). Meat is 30%-40% of the average person’s grocery bill. Only eat meat for one meal each day, and you’ll be saving 15%-20% of your total grocery bill AND you won’t get that mid-afternoon groggy feeling. Win-win!

Frequent the “dented can” aisle.

This is something I hadn’t heard of until about 20 minutes before writing this article. Apparently, in almost every grocery store there is an aisle where all of the damaged cans and boxes go. Here, you can pick up cans and boxes for a fraction of the price of the ones that are in “new” condition. The contents on the inside are exactly the same—they just may not look as nice in your cabinets. Unless you’re going to be on MTV Cribs (is that show still on?), I would suggest making a habit of perusing this aisle. I know I’m going to!

Gym Memberships: Convict Conditioning

Hopefully, you have taken my advice and are (or will be) biking to work. There is a good portion of your exercise right there. If that’s not enough (it’s not for me), I would suggest Convict Conditioning.
Convict Conditioning is a program designed by an ex-convict named Paul Wade. While he was in jail, he would help his inmates get into the best shape of their lives through this body weight exercise program, which involves minimal equipment and minimal space. They needed to be able to do this in their jail cells.
Look up the program. I believe there is a PDF version for free online. If not, there are a bunch of YouTube videos around it.

Fun Extreme Budgeting Tips

This is the area that might get the most push back. These are extreme, fun—albeit less impactful—ways to save money, but they do work!
Let’s talk about saving on utilities:

Take military showers.

This is when you only use the water in your shower for functional purposes, to get yourself wet before you lather up and right after to rinse yourself off. For 90 percent of the time, your water is off and you are just washing yourself.
In this same category is making sure you shut your water off while you are brushing your teeth, shaving, and performing all other idle sink-side activities.

Put a two-liter bottle in toilet tank.

Get a two-liter bottle, put a few rocks in it, fill it with water, and place it in the back of your toilet tank. By doing this, your toilet will need less water to fill the tank, and therefore less water will be flushed. If a two-liter bottle is too big, try a one-liter bottle.

Hang clothes to dry.

This is self-explanatory. It’s no secret that your dryer uses a whole lot of utilities. I’d recommend getting a clothes rack, and if it’s a nice day, hang dry your clothes. Depending on where you live, it may only take two or three hours to complete.

Unplug electronics when not in use.

When your electronics lie idly but are plugged in, they are still using electricity. If you aren’t using your TV, appliances, and other electronic devices, unplug them! You’ll save quite a bit of electricity this way.

Cut sponges in half.

Look at the size of most of the things that you wash. I would bet that in most cases you do not need the ENTIRE sponge. Why not cut them in half or even thirds to make them last two or three times as long?

Put a soap bowl next to the sink.

Now that your sponges are cut in half, I would bet that they can fit in a small bowl beside your sink. Fill that bowl with soap and water, and put the sponge in there. That way, you are saving water and saving soap all at the same time!
There it is—some extreme ways you can save to expedite the time towards your next investment. Again, some of these are silly and some are affective, but I do, have done, or know people who do all of these ideas. If it works for us, it can certainly work for you.
Startups

There’s No Such Thing as a Bad Idea

“Any idea can be a great idea if you think differently, dream big, and commit to seeing it realized.”
-Richard Branson, CEO and Founder, Virgin Group
You have a great idea and you want to turn it into a viable product or business. What do you do? Here are some tips from one of the world’s most successful entrepreneurs, Richard Branson, from a guest column he wrote for Entrepreneur magazine.

Step 1. Take It to the Hammock

Don’t be in a rush to start building a spreadsheet of projections and ordering inventory. Start out by relaxing in a comfortable place. Branson prefers using a hammock at his home on Necker Island. This is where he can relax, settle in, and envision the development of his idea.
There are two things Branson believes are crucial to the success of a new venture: frustration and enthusiasm. His first business was selling records in the late 1960s, selling them for less than the major retail outlets. He was successful because he combined his passion for music with his aggravation at prices the big stores were charging customers for it.
But the key is to love what you do. “Are you enthusiastic about how this business will make a difference in people’s lives?” Branson asks. If you are, he goes on to say, you’re more likely to persevere in the face of struggles you will inevitably encounter.
A mind map is a very effective way to brainstorm new ideas.

Step 2. Give It the Mom Test

Sometimes the people closest to you can be your best intitial sounding board. Tell them about your project and if they don’t get it, other people might not either.
Branson says “Ask your mother for her honest thoughts on your plans. If she glazes over when you describe the new venture, return to your hammock and start over. If she gets excited, you could be onto a winner.”

Step 3. Take a Risk

This is the part where most people hesitate, because it’s risky. It’s easier to hold back and wait for the perfect time to move forward. But this is a mistake, Branson says. “Successful entrepreneurs don’t wait for the perfect moment—they create it.”

Step 4. Test it Out

It’s said that entrepreneurs are willing to take risks. This is true, but successful entrepreneurs are the ones who mitigate the risks they take. This means developing, testing, and and getting market feedback on your product or service, then refining and improving upon it, as you move forward.
Branson’s advice: “Develop some samples of what you intend to sell, and when you’re happy with your product or service, begin the best and cheapest form of market research you can—ask your friends, family members, neighbors, and social media followers to try it out.”
Don’t get down about adverse feedback. This is a process, and you need to be prepared to be flexible, willing to make adjustments to your product or your plan. (Without saying so, Branson is applying the lean startup philosophy of the MVP—minimum viable product.)

Step 5. The Ultimate Test

Once the product or service has been tested and refined to your satisfaction, it’s time for the final test: Will it sell?
Once you’ve made those changes, try selling small batches of your product or offer initial introductions to the service wherever you can — online, door to door, at street fairs, and so on. Continue asking for feedback, and keep in touch with those customers. Make sure you get the branding right: Does it stand out? Do your brand values attract eager customers? Will they also attract talented employees?
When this happens, you’ll encounter new, practical problems. Such as how to distribute your product, how to manage cash flow, and whether to raise capital from investors.
The kinds of problems we hope you will have.
Leadership

This Is Why You Need to Build a 7-Figure Business

Scott Oldford
Guest Writer,Entrepreneur

I often meet entrepreneurs who say something along the lines of “Once I get to six figures, I’ll be happy.”

But then they get there, and guess what? They’re as stressed and burnt out as ever.

I call this getting stuck in the “six-figure hamster wheel,” and it’s a vicious cycle I’ve lost myself in before. It’s hard to escape, and most people try to overcome it with even more hustle. After all, it was “hustle mode” that got them to six figures, so more will get you to seven figures … right?

Wrong!

Hustling to seven figures is not the answer.

And this is why I believe every single entrepreneur needs to build a seven-figure business if they are ever to fulfill their potential and live a life of freedom, abundance and happiness.

It’s not about the money!

Most people don’t want to take the hard route. They’re driven by security and comfort, and they are afraid to take the necessary risk to achieve what they really want. Yet, the riskiest thing you can ever do is to not live up to your fullest potential!

Every entrepreneur should strive to have a profitable seven-figure business, and no, it’s not about the money. It’s not about the bragging rights. It’s not about the fame or status. It’s not even about the lifestyle that comes with it.

Related: 25 Common Characteristics of Successful Entrepreneurs

The reason you need a seven-figure business is simple: freedom.

With freedom, you can truly escape “hustle mode” forever. That isn’t to say you won’t have to work hard and put in the hours, but never again will you find yourself caught in the hamster wheel where every time you scale to a new level, it’s at the expense of your health and sanity.

A seven-figure business gives you the freedom to build a world-class team, invest in yourself (mindset, therapy, health), regain control of your time (so you have more time to do what you do best) and work “on” your business, rather than get stuck inside it.

At six figures, you cannot do any of this. I’ve tried it, and I’ve seen plenty of other people try, too. But it doesn’t happen. You can live a happy life at six figures, sure. But a life of true freedom? Nope!

The biggest obstacle between you and a seven-figure business is …

You. Because although you may fear failure, chances are you fear success even more.

Freedom, for most, is scary. It forces you to tap into your fullest potential and live it, because you no longer have the excuse of hustling, a lack of money or not enough time. So, you ask yourself, Who will I become when I can truly be myself?

I remember the anxiety I felt when I asked this question on a random Thursday night. I almost had a panic attack, because I realized I didn’t know the answer. What happens now that I’m out of debt? I asked. Who will I become? What will I create? Will people care? How can I make an impact? What impact do I even want to make?

Well, I’m here to tell you not to panic like I did. Because you’ll become the exact person you need to be in order to live out your vision and purpose.

Related: 9 Steps to Increase the Value of Your Business

“But, hold on, Scott,” I hear you say. “What if I don’t know my purpose?”

This is the exact reason why you need to build a seven-figure business. Because once you reach this level, you remove all the excuses standing between you and your true potential, and gain the freedom you need to make this happen. When you have true freedom, you finally understand what you’re most passionate about and what impact you want to make in this world.

It’s impossible to truly know yourself when you’re stressing over the day-to-day, caught in “hustle mode.” How are you going to pay your bills? How is your business actually going to work? Is there enough money coming in? Are you charging enough?

It’s impossible to fulfill your potential if these questions consume you each day. It doesn’t matter how smart you are or how talented you may be; you cannot be your best self with this sort of stress. You must elevate to a higher level of understanding and thinking, and the best way to do this is to have a near-limitless level of freedom.

Having a profitable, seven-figure business gives you this!

So, no matter who you are and what impact you wish to have, the key to unlocking this is to scale to seven figures so you can escape the “six-figure hamster wheel,” say goodbye to “hustle mode” and welcome true freedom, true abundance and true success.

Leadership

How Blockchain Is Poised to Disrupt the Gig Economy

Guest Writer, Entrepreneur

Co-founder & General Partner at Revel Partners
July 17

There is much debate these days as to whether the gig economy is growing or shrinking, but most agree it’s still massive and, importantly, ripe for disruption. Distributed ledger-based technologies — commonly known as blockchain — is one of the forces with the most potential to affect the gig economy over the next several years. This potential is of particular interest to enterprises, which has recently shown an increased reliance on alternative work arrangements.

Corporations like FedEx, P&G and Verizon now outsource between 20-50 percent of their jobs. They embrace this independent workforce to increase efficiency and remain nimble. This is big news for the gig economy and the platforms that drive it. But those on both sides of the hire/hired coin can recite chapter and verse the problems they encounter in this new labor bazaar. Whether it’s low-pay, increased income inequality, lack of benefits, unpredictable performance, broken contracts, scope creep or any of the other issues that come with gigging and/or using an independent workforce, it’s clear there are areas that need improvement if the gig economy is going to continue to be a reliable source of alternative work arrangements for enterprises.

Enter blockchain and the ongoing innovations that are shaping that technology today. A transparent, trusted and verifiable tech stack that drives gig work could raise pay, cut overhead, drive scalability and fair labor practices for both workers and employers. These capabilities are of major importance to corporations as technical innovation and fair play are needed to sustain an independent workforce model they’ve come to rely on.

One of the dilemmas for enterprises is that a crucial part of the gig economy’s growth to date has been centralized platforms such as Uber, MTurk or Fiverr. They do a great job of connecting work with workers, providing a framework for compensation and a system for tracking work processes. Yet, most of these platforms are tolerated, not celebrated — particularly when they pocket a large percentage of a job’s value without offering many of the benefits workers find in more traditional work arrangements.

Fiverr, for example, is a centralized two-sided platform for people to buy and sell a variety of digital services typically offered by freelance contractors. Fiverr also takes a 20 percent cut of all transactions to the detriment of both worker and enterprise by introducing inefficiencies and pain points that threaten the long-term viability of the gig arrangement. Blockchain could eliminate that.

Ethlance is a blockchain-based project launched by District0x. It offers a platform that combines smart contracts, a file exchange protocol and a web interface to allow people to sell their goods and services on the ethereum blockchain. Ethlance is totally free because it’s 100 percent open source and runs at no cost — unlike Fiverr, which requires a centralized database and online hosting. Chronobank is another blockchain-based company attempting to disrupt the centralized platform model. It launched its LaborX platform to connect gig workers with jobs anywhere in the world for just 1 percent of the job’s pay. For both companies, it’s still early days as far as adoption rates go, but with so much at stake, smart businesses will need to consider these sorts of solutions to help the gig economy continue to attract and maintain a large workforce pool without alienating it or burning it out.

For Your Body

Get an Extra Edge Against Cancer

from Bottom Line Health

Get an Extra Edge Against Cancer

More than one-third of American adults reach for vitamins, herbs or other natural medicines when they have colds or other routine (and hopefully mild) health problems. Similar remedies can help when you have cancer.
To learn more about the best and safest ways to use natural therapies—also known as complementary and alternative medicine (CAM)—to fight cancer and its complications, Bottom Line Health spoke with Mark A. Stengler, NMD, a naturopathic physician who treats cancer patients.

HOW CAM CAN WORK

Research has shown that many so-called “alternative” treatments can enhance the effects of conventional cancer care such as surgery, radiation or chemotherapy…reduce treatment side effects…and possibly improve survival.
This type of integrative care doesn’t replace conventional cancer treatments. Rather, with the guidance of a doctor, complementary therapies are added to a patient’s treatment plan.
Important: To ensure that the therapies described below would be appropriate for you, consult the Society for Integrative Oncology (IntegrativeOnc.org) to find an integrative oncologist near you…or check with The American Association of Naturopathic Physicians (Naturopathic.org) to locate a naturopathic doctor who also treats cancer patients. Also: Be sure to ask the doctor you choose to be in touch with your oncologist. Here’s how CAM can help with problems that plague most cancer patients…
Get relief from “chemo brain.” It’s estimated that three-quarters of cancer patients will experience some degree of mental cloudiness. Known as “chemo brain,” it can include mood swings, memory loss and mental fatigue. It eventually improves, but some patients will feel like they’re in a mental fog years after their treatments have ended.
What helps: The omega-3 fatty acids in fish oil supplements—a typical daily dose is 1,000 mg total of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) combined—help regulate acetylcholine, a neurotransmitter that increases nerve growth factor and improves memory as well as energy levels.
The omega-3s also increase the effectiveness of 5-fluorouracil and other chemotherapy drugs, according to a study published in Clinical Nutrition Research. In research published in Cancer, lung cancer patients who took fish oil along with chemotherapy had a greater one-year survival rate than those who didn’t take the supplements.
Note: Fish oil may cause stomach upset in some patients, along with bleeding in those who are taking anticoagulant medications such as warfarin (Coumadin), apixaban (Eliquis) and rivaroxaban (Xarelto).
Boost energy levels. Ginseng is one of the more effective supplements for cancer patients. A number of studies have shown that it reduces treatment-related side effects, including weakness and fatigue. A double-blind study in Journal of the National Cancer Institute found that patients who took ginseng had less fatigue than those given placebos.
My advice: The American form of ginseng (Panax quinquefolius) is more effective than the Asian form. Typical dose: 1,300 mg to 2,000 mg daily. It rarely causes side effects, although it may lower blood sugar in those with diabetes.
Also helpful: Glutathione, a “super antioxidant” that can be combined with chemotherapy to reduce toxin-related fatigue and other side effects. It’s usually given in an IV solution. Side effects are unlikely, but it may interfere with some chemotherapy drugs. Be sure to consult an integrative oncologist to see whether you will/won’t benefit from glutathione.
Improve immune response. Turkey tail is one of the best–studied medicinal mushrooms. Available in capsule form, the supplement has chemical compounds (beta–glucans) that stimulate many aspects of the immune response, including antibody activity—important for inducing the death of cancer cells.
Impressive research: A study published in Cancer Immunology and Immunotherapy found that postsurgical remissions in colorectal cancer patients were twice as common in those who were given turkey tail. Typical dose: 3,000 mg daily. Side effects are unlikely.

A NUTRITIONAL BOOST

Conventional oncologists receive little training in nutrition, but it’s a critical issue for cancer patients. One study found that 91% of cancer patients had nutritional impairments, and 9% were seriously malnourished. Research shows that malnutrition contributes directly or indirectly to a significant number of cancer deaths due to poor appetite and the disease process of advanced cancer.
Loss of appetite is a major cause of malnutrition and muscle loss (cachexia). I advise patients who are losing weight to address these problems by getting more calories.
With every meal, include high-fat foods such as olive oil, coconut oil, avocado, nuts and seeds. A 10-year study, published in Archives of Internal Medicine, looked at more than 380,000 adults and found that a Mediterranean-style diet, which is high in olive oil and other healthy fats, reduced cancer deaths in men by 17% and 12% in women.
Also helpful: Protein shakes. They can provide the extra protein that’s critical for cancer patients. Up to 80% of those with advanced cancer experience muscle loss. Protein shakes can help reverse it. Best option: Ready-made whey protein or pea protein shakes—both are nutritious, have 5 g of sugar or less per serving and are readily available in health-food stores.
My advice: Get 1 g to 1.2 g of protein per kilogram (2.2 pounds) of body weight daily. This means that someone who weighs 150 pounds will need about 68 g to 82 g of protein daily. You can get that much from two or three servings of a typical whey protein beverage, which comes ready-mixed or in powdered form. Caution: If you have moderate or severe kidney disease, check with your doctor for advice on your protein intake.

HOW TUMOR BOARDS HELP

Cancer care is rarely a straightforward process. From the time you are diagnosed until your treatments end, your care will depend on the opinions of a surprising number of specialists—and good communication among those experts can strongly affect how well you do.
Important recent finding: Among nearly 5,000 patients with colorectal and lung cancers, those whose doctors participated in weekly tumor boards lived longer, according to a study presented at a symposium of the American Society of Clinical Oncology.
To ensure that the medical center where you’re being treated relies on a tumor board’s guidance, you should seek out a cancer center designated by the National Cancer Institute or accredited by the Commission on Cancer.
Large cancer centers usually have separate tumor boards for different types of cancer. At smaller programs, a single board will review all or most cancer cases.
Tumor boards provide important oversight because what seems like a perfect treatment plan can fall short in real-world circumstances. For example, chemotherapy might be the recommended treatment for a specific cancer, but a tumor-board oncologist might argue that a particular patient isn’t healthy enough to withstand the treatment. A psychologist or social worker at a meeting might point out that the patient will need transportation to and from the chemotherapy clinic.

WHO GETS REVIEWED?

At MD Anderson Cancer Center and other large cancer centers, virtually all cases are discussed at a tumor board, although doctors give most of their attention to rare/complicated cases. There’s no separate charge to patients for the review.
My advice: If you’re not sure that your case has been discussed at your treatment center’s tumor board, ask your doctor whether it has been (or will be). Your doctor should not be offended by this question—especially if he/she will be presenting the case. If your case hasn’t been reviewed, ask why not. You have the right to request a tumor board review, but it might not be available at a smaller medical center.
Most tumor boards meet weekly or twice a month and are comprised of a dozen or more specialists, including surgeons, medical oncologists, radiation oncologists and pathologists. Depending on the cancer, other doctors—gynecologists, urologists, etc.—may participate. Meetings often include a nutritionist, nurses, mental health experts and a social worker.

THE BENEFITS

Your case might go before a tumor board prior to treatment…after a preliminary treatment plan has been initiated…or during treatment when there is an important change in clinical circumstances.
Important finding: When the records of more than 200 pancreatic cancer patients collected from various institutions without tumor boards were later evaluated by a panel at Johns Hopkins University School of Medicine that included medical and radiation oncologists, surgical oncologists, pathologists and other experts, treatment changes were recommended in nearly 25% of these cases.
Research also shows that patients tend to have better outcomes in terms of treatment responsiveness, recovery times and survival, among other factors, when their cases are discussed at a tumor board.
Also: Patients whose cases are reviewed are more likely to be guided to a clinical trial—one that their primary oncologist might not be aware of. Many cancer patients are eligible for these trials, which provide excellent care…yet only about 3% of patients ever participate. The more patients there are enrolled, the more quickly important clinical questions can be answered.
The National Cancer Institute website lists thousands of clinical trials that are looking for participants—to compare drug treatments, study new surgical techniques or radiation treatments, etc. Most tumor boards have a “checklist,” which includes the question of whether there is a trial for which the patient might be eligible.

THE PERSONAL TOUCH

The services provided by tumor boards go beyond the nuts and bolts of treatment. For example, many cancer patients lose weight during chemotherapy or radiation treatments. If poor nutrition is threatening your recovery—or even your ability to continue treatments, a nutritionist might recommend nutritional counseling, or even help you find a free meal service in your area.
Many cancer patients suffer from mental health issues—depression, bipolar disorder, etc. The best cancer plan won’t help if you’re unable (or unwilling) to continue treatments. A tumor board will attempt to address—or correct—all the issues that can affect how well or poorly you respond to treatments.
Patients don’t typically attend tumor boards. Many different cases are reviewed at any one meeting. The presence of a patient would affect the confidentiality of others’ personal health information.
Source: Richard A. Ehlers II, MD, associate professor, department of breast surgical oncology and associate vice president in the Division of Houston Area Locations at The University of Texas MD Anderson Cancer Center. He is also adjunct assistant professor in the department of surgery at The University of Texas Medical Branch at Galveston. Date: May 1, 2018 Publication: Bottom Line Health

The Right Team to Treat Your Cancer

If you or a loved one is being treated for cancer, you may not be aware of so-called “tumor boards.” But if you’re getting care at a major academic or cancer-specific medical center, these regular face-to-face gatherings of cancer specialists—oncologists, radiologists, surgeons, pathologists, psychologists and others—play a key role in assessing individual cases. This may involve reviewing the pathology report…tracking disease progression…and discussing the treatment options for different types of cancer.
What gets reviewed: If your case comes before a tumor board, the doctors likely will address a variety of issues. Is surgery an option or will radiation and/or chemotherapy be more appropriate? If surgery can be done, should it or chemotherapy be used first, followed by other treatments? Is this patient battling mental health issues…or getting the runaround from insurance to get coverage for certain drugs?

 

Leadership

5 Reasons You Should Toss Your Affirmations and Start Asking Questions

I know this runs contrary to every meme and bit of self-help advice you’ve ever heard; even thinking of it makes you look at your refrigerator magnets or those framed little sayings you held so dear.

But, alas, affirmations don’t work.

Research shows that no matter how often you say, “I will be stronger when challenged,” that declaration won’t, in fact, motivate you to be stronger the next time there’s a boulder in your path.

Ditto for, “I am beautiful and empowered,” and any other positive, first-person statement that supposedly will help you conquer a belief about yourself that is less than positive.

So, you’re looking at the mountain and you keep repeating, “I will climb it, I will climb it,” but does that really help? It doesn’t.

The affirmation is more like a doorstop. It doesn’t throw your brain into high gear, trying to figure out precisely how you’re going to climb that mountain and, moreover, how you’re going to overcome the impediments and obstacles that could doom your climb to failure.

Obviously, the downside to the affirmation also applies to everyday life and how you can be more resilient and resourceful the next time life puts a boulder in your path.  Or what plan of action you should take when you pledge that you’ll improve your communication skills or learn to manage your anxiety or any other goal you might set.

But, thankfully, there’s a solution: It’s called a question.

Why questioning works

Research by Ibrahim Senay and his colleagues showed that participants trying to solve anagrams fared better when they prepped themselves by writing down “Will I succeed?” twenty times and fared worse when they prepped with the affirmation statement “I will succeed.” So why is that? Following are five reasons you must toss those affirmations and start usingquestions to gear yourself up when you need to.

  1. Asking questions puts your brain in search mode

    2. When you ask yourself “Will I succeed?” your mind begins to search for the answers to what you could do to succeed and, equally, what might stand in the way of your possible success. Unlike the affirmation which just puts a smile on your face and rose-colored glasses on the bridge of your nose, the question forces you to plan.

  2. Asking questions shakes up your status-quo thinking

    3. You’ve turned to affirmations in an effort to convince yourself that you can do something you’ve previously either had trouble with or outright failed at. Let’s say that you’ve had trouble voicing your own needs in relationships and revert to being a people-pleaser as a default setting. Telling yourself that “I will speak my mind” won’t force you into examining what precisely stops you from doing so. By comparison, asking “Will I speak my mind?” should bring up both the historical reasons why you haven’t and potentially ways that you can in the future. This is especially valuable if you’re tackling a problem that is part of a repetitive pattern in life

  3. Asking one question leads to others

    4. In my latest book, Daughter Detox: Recovering from an Unloving Mother and Reclaiming Your Life, I detail what I call “default settings,” or unconscious behaviors learned in response to an unloving mother’s treatment, many of which are maladaptive in nature. Using the format of the question, research shows, facilitates understanding. Let’s say that your goal is to be less self-critical and that one way to do that is be more self-compassionate. (This is research based.) Asking yourself “Will I be self-compassionate?” opens the door to other questions, including why it’s so hard for you to be accepting of yourself and what obstacles stand in your way. An affirmation won’t do that.

  4. Asking forces you to answer (and puzzle it out)

    5. The chances are good that you suspect that your inability to get something done—deal with relationships, stop procrastinating, lose weight, or any other goal—has to do with some flaw in your character, which it doesn’t. Asking yourself, “Will I manage my relationships better?” “Will I stop procrastinating?” “Will I lose weight” etc. gets you into a proactive stance and forces you to come to terms with the underlying reasons you haven’t been able to get whatever it is done.

  5. Questioning opens up blind spots in self-knowledge

    6. This is more of a summary point rather an additional one but it’s worth emphasizing.

    When you use affirmations, you’re essentially confirming something about yourself you wish to be true. But what if your affirmation is based on something you’re not seeing about yourself? What if you’re not reaching your goals because you’re not seeing the obstacles clearly? What if you’re having trouble losing weight because you haven’t confronted how you self-soothe with food?

    If that’s true, then managing your stress has to be step one before you can lose weight, and no affirmation about losing weight is going help. But asking, “Will I manage stress better?” will help get you on the right path.

    What if you haven’t gotten as far in your career because you haven’t tackled how you avoid failure at all costs and are unable to take any risks? Questioning that fear of failure, rather than repeating, “I will get a better job,” or “I will be promoted,” over and over, will more likely put you on the path.

The take-away?

A question yields answers; a statement doesn’t.

Senay, Ibrahim, Dolores Albarracín, and Kenji Noguchi, “Motivating Goal-Directed Behavior Through Introspective Self-Talk: The Role of the Interrogative Form of Simple Future Tense” Psychological Science (2010), vol.21(4), 499-504.

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Leadership

5 ways to get the most out of leadership coaching

Rosalind Cardinal
Guest Writer,Huffington Post

This blog was originally published by Leaders in Heels.

At some point in their careers, many leaders will opt to receive high-level coaching. Executive coaching is one of the best investments you will ever make in yourself. A good coach helps you gain clarity and provides a safe yet challenging environment for you to practice self-awareness and to learn from experience. Whether you want to learn how to be more effective at work, need guidance in navigating a transition in the workplace, want to hit the ground running in a new leadership position, or simply want to further develop certain skills, the right coaching can help you accelerate your learning curve, gain more confidence, and reap benefit after benefit.

Moving forward with an executive coach is a very big investment, not to mention an important commitment. Just as you might ‘shop around’ for other big investments, you want to do the same when it comes to a coach. Below are 5 things to keep in mind to make the most of your leadership coaching.

1. Set up a ‘discovery session’ before moving forward with a coach

A discovery session is an informal conversation that precedes a commitment to coaching. Think of it as a ‘get to know you’ conversation. This is your opportunity to speak with your potential coach, discuss your challenges and goals, and truly gauge whether or not you and your potential coach are a good fit.

Though this is a conversation, think of it also as an interview. You’re trying to find the right individual to help you achieve your goals. Don’t be afraid to ask your coach questions about their experiences, their methods, their accreditations, and so on. Most importantly, don’t feel pressured to make a commitment at the end of this conversation. If you want to think it over, you’re under no obligation to commit on the spot, and you shouldn’t feel as if your coach is pressuring you to move forward.

Though this is a conversation, think of it also as an interview.

Throughout the conversation, check in with yourself: do you feel comfortable and relaxed with this coach? Remember, you’ll be spending a great deal of time with them, so this is important.

2. Make sure you and your coach have compatible styles

Are you a very structured and time-conscious person? Then you might find it frustrating to work with a coach who is always late or reschedules appointments regularly. Are you very organized? Then a coach who doesn’t follow-up with you as promised may drive you up the wall. Maybe you’re a deep, reflective thinker who needs time to process information. If that’s the case, then a coach who talks all the time and doesn’t give you thinking space will overwhelm you rather quickly.

An expert coach will gauge your style and seamlessly adapt to you, but if you find that your coach isn’t doing this, then it’s time to move on and find someone else who’s a better match. That said, get clear on who you are as a person, as a leader, and as a thinker…and then ask yourself what qualities you need to have in a coach in order to feel as if your regular coaching sessions are spaces in which you can grow and thrive.

A coach often wears a number of hats during the coaching experience. They can be a feedback provider, reflective thinking partner, expert mentor, practice partner, accountability creator, positive reinforce, supporter, and more. Ideally, your coach will flexibly switch hats depending on your needs at the time, which is why it’s important you know what those needs are.

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3. Ask yourself if you feel confident in your coach’s expertise

One of the worst things you can do is enter into a coaching commitment with your head full of doubts

Don’t be afraid to ask for testimonials and references. An expert coach who’s worked with countless people and has helped them to achieve their goals will be more than happy to point you in the right direction when it comes to praise from past clients. The same goes for qualifications and accreditations, especially if you’re interested in working on specific skillsets or with certain diagnostics/psychometrics.

One of the worst things you can do is enter into a coaching commitment with your head full of doubts regarding your coach’s qualifications. You’ll begin to question their guidance at every turn, which will result in a waste of time, money, and energy. However, when you do feel confident in your coach’s expertise, it’ll motivate you to put their recommendations into practice and you’ll find yourself growing like never before.

4. Have a contract or coaching agreement in place.

You and your coach should both be clear about the timeframe of your coaching commitment. This is best outlined within a formal contract or agreement that both parties sign. Such an agreement will highlight the duration of the coaching as well as the cost of the investment.

In addition to regular sessions, there may also be a provision for ‘on demand’ sessions. Just as well, there should be an ‘out clause’ that allows you to discontinue coaching if you at any time don’t feel that you’re getting what was agreed upon.

5. Get clear on what you want to get out of your coaching

Finally, you and your coach should both be clear about the objectives of the coaching. What is it that you want to achieve over the course of executive coaching? How would you like to grow? What would you like to learn about yourself? What goals would you like to accomplish? What skills would you like to acquire and/or develop further?

These objectives will help to create a structured approach in your coaching sessions. You and your coach should also discuss how you both plan on measuring your progress from session to session.

Additionally, ensure that your coach has a system in place to keep you moving forward in between sessions. This might mean following up with you with a reminder of next action steps, providing you with key notes from a previous session, and/or delivering any promised materials or readings.

These are 5 ways you can ensure that you make the most of your next commitment with an executive coach. Of course, your results aren’t dependent on your coach alone. You need to be committed to making change and be prepared to put in the time and energy. The leaders I work with who achieve the biggest outcomes are people with skin in the game. They have a very compelling reason to be coached, they are committed, responsive and reflective, and they are open to challenge. As with anything, people who are not committed to change will not get results. Ultimately, while your coach is a trusted guide, the outcome of the sessions depends on you.

Startups

Rule #1 in Angel Investing – It’s All About the Team

Note: This article is part of Angel 201, an ongoing series for Angel Investors. To learn more about developing the key skills needed to make great investments, download this free eBook today Angel 201: The 4 Critical Skills Every Angel Should Master or purchase our books at Amazon.com.
Team Huddle
Great ideas are a dime a dozen.  Living in the Boston/Cambridge area, we are surrounded by some of the most innovative researchers in the world working at institutions like MIT and Harvard. I’m pretty confident when I say, in Boston, hardly a day goes by when some graduate student or professor doesn’t invent a new product, discover a new molecule or create a cool app. Unfortunately, without a great team behind that new product, it’s doubtful that a great company will result.
There is an old saying that goes something like this… “I’d rather invest in an A team with a B plan than a B team with an A plan.” Without a doubt, we feel this is the most important point for investors to embrace. Once you understand how critical the team is to a successful outcome, the greater success you will have as an investor. As a long term serial entrepreneur and a successful angel investor, I asked Ham to tell me how he evaluates teams and differentiates the A teams from the B teams.

Q: Ham, let’s start with the person at the top. How do you evaluate startup CEOs and what are the most important characteristics you look for?

First and foremost, I look for integrity. That character trait might sound obvious and a bit trite, but I feel it’s very important to be on alert for trust issues when you are interacting with an entrepreneur. From the initial meeting with the company, during the due diligence process, and finally while negotiating the deal, I want to make sure the CEO is being honest and negotiates in a fair manner. If I sense any duplicity at this early a stage, I can be sure that things will only get worse as the company progresses through the challenges faced by all startups.
That leads me to my second character trait, tenacity. It’s not easy being a startup CEO. The pressure to succeed is enormous, and CEOs struggle every day to motivate their team. Life in a startup is a series of highs and lows not too dissimilar from riding a roller coaster. One minute life is great as you ship your first product. The next day you hear back from customers that your product is lousy. It takes resilience to handle the good and the bad that a CEO faces on a daily basis. A CEO’s tenacity allows her to continue the battle to succeed even when others would give up in despair.

Q: Okay. Those make sense, but there has to be more in the mix than that? What else do you look for?

Next on my list is a combination of IQ and EQ. In other words, a CEO needs to be smart and self aware. By “smart”, I mean the CEO has the intelligence to discover a major market opportunity, and articulate a plan that will address that opportunity. The CEO has the intelligence to develop high-level strategic plans, and the problem solving skills to deal with day-to-day tactical and execution challenges.  By “self aware”, I mean the CEO works well with a great team and is willing to take guidance from close advisors. In other words, the CEO must be coachable. A great CEO wants to hire “A” team members who are better than he is for the job being filled.
A deep market understanding is an important skill set for a CEO because it provides the North Star from which the CEO will navigate the company. Great CEOs are two steps ahead of the competition because they have an inherent understanding of where the market is heading.
The final characteristic I look for in a CEO is presence. I define presence as follows… A CEO with presence has the leadership charisma to command any audience. This type of charisma allows the CEO to take charge whether speaking with employees, customers or investors. When the CEO walks into a meeting, you know who is in charge! Furthermore, this ability to command an audience gives the CEO a unique ability to create a winning culture. Building a winning company culture takes constant care and attention from the CEO, and the best way to tend to this task is by communicating a compelling story on a regular basis to the entire company.

Q: Wait – what about experience?  What role does experience play in startup success?

This is a trick question, right? The obvious answer is that experience is critical. You should always back serial entrepreneurs with decades of market experience. Well… that’s true in some cases. If you are looking to build the next generation of product or service in a well established market, having a few grey hairs and a deep network of contacts is probably the right way to go.
But, suppose you are trying to totally disrupt a market. For example, you are Jeff Bezos and you are looking to change the way people buy stuff. When he started Amazon, online retailing was in its infancy. Lots of market experience didn’t exist. He had to make it up as time went on. So disrupting markets takes a very different type of entrepreneur. Success at Amazon had very little to do with experience and much more to do with the ability to try new things and learn as fast as possible!

Q: So you hear the CEO give her pitch and then you spend an hour or two digging into the company to learn more. How are you able to really get to know the CEO and figure out whether she has the key characteristics you are looking for?

The first step that most investors take to learn more about the CEO is to reach out and perform reference checks. Some of the references will be from contacts that the CEO provides to you. Other contacts will be people in your network that know the CEO. This type of background information is useful if you ask the right questions. At Launchpad, we have a well defined set of questions we use to guide these interviews. It helps us uncover red flag issues that we need to keep an eye out for, and it helps us apply resources to help the CEO be successful.
Personally, I find the reference checks to be useful but not sufficient in helping me get to know the CEO. I like to take things one step further. In addition to typical due diligence meetings, I arrange for time with the CEO in a non-business setting. For example, I like spending an evening with the CEO at dinner or a sporting event. Hopefully, our conversation flows smoothly with most of the discussion focused on personal topics. This way I get to know the CEO in a different context.

Q: Moving beyond the CEO, what skills do you look for in a startup company team?

There are four skills that I look for in a startup team. Given the small size of an early stage company, sometimes these skills are part of the CEO’s repertoire, but I like to see them incorporated in the skill set of the other founding members.
  • First, I look for selling skills. Whether talking to prospects, investors or future employees, the management team has to be able to sell. If you ain’t sellin’, nobody’s buyin’!
  • Second, I look for technical skills. I invest in tech companies and so I expect the company will have a great product that will build some competitive barriers to entry.
  • Third, I look for a deep market awareness. As I discussed in one of the above questions, this market awareness is critical for developing the company’s strategy.
  • Fourth, I look for product management skills. This is closely related to market awareness, because it requires the ability to listen to customers and understand the competitive environment. It also requires the ability to translate market needs into a plan that engineering can actually deliver in a timely fashion given limited company resources. Product Management is an often under appreciated skill set. A greater number of tech companies would succeed if they invested more in this critical resource.

Q: What’s the right size for a startup company founding team?

It’s not as though there is any magic number here, but I tend to like founding teams with 2 or 3 people. Here’s my thinking on why that’s the right size. To start with, we won’t invest in a company that has only one person involved. If a founder can’t convince a co-founder to join him in this crazy startup, why would the founder think he can convince investors to put money into the business?? With 2 co-founders, the company is moving in the right direction (read more on Key Founder Issues). Hopefully, the team has complementary skills that help round out the need for the key skills I discussed in the previous question. And, if 2 people can’t pull that off, then 3 team members usually can.
Once you move up to founding teams of 4 or more you run into a lot of issues with coat-tail riders, founder dilution, outgrowing the co-founders who aren’t producing, etc.  Another issue to be aware of in this context is that founders always obsess about negotiating valuation and they can become overly focused on issues relating to dilution. That makes little sense when you consider the deadweight college buddy / co-founder who owns 25% of the company.  Fussing about dilution by bringing in great investors and capital while having no-ops on the team, is like locking the front door but leaving the back screen door swinging in the breeze!
Want to learn more about building an angel portfolio and developing the key skills needed to make great investments? Download Angel 101: A Primer for Angel Investors and Angel 201: The 4 Critical Skills Every Angel Should Master for free, or purchase our books at Amazon.com.
For Your Body

Stop A Migraine Before It Happens

Date: January 1, 2017
Publication: Bottom Line Health

The best options aren’t prescribed often enough…

There are more than 37 million Americans who suffer from migraines, but the odds aren’t in their favor when it comes to drug treatment.

Sobering statistics: Preventive drugs work for only about half of the people who have these awful headaches—and even when the medication does help, migraine frequency is reduced by only about 50%.

The drugs that stop migraines once they’ve started—mainly prescription triptans (such as sumatriptan, rizatriptan and almotriptan) …as well as OTC nonsteroidal anti-inflammatory drugs, such as ibuprofen (Motrin), and Excedrin Migraine, which contains acetaminophen, aspirin and caffeine—are not always effective. They work best when they’re taken soon after the pain begins. Some of the drugs also cause side effects, such as fatigue or gastrointestinal bleeding. And taking them too often can lead to more—and more severe—headaches, known as overuse headaches or “rebound” headaches. So preventive drugs may be needed to avoid overuse of these medications.

A COMPLEX PROBLEM

Why are migraines so hard to manage? Experts once believed that migraines were mainly caused by the dilation (widening) of blood vessels in the brain. That’s why drugs usually prescribed for other conditions, such as propranolol, a blood pressure drug, have been used to reverse these changes.

But we now believe that migraines have more to do with overstimulation of the trigeminal nerve in the face and head—this can cause blood vessels in the brain to expand and become inflamed. Treatments that affect this nerve (see below) are often very effective.

Important: Everyone who suffers from migraines should pay attention to possible triggers that precipitate attacks. Some people react to strong scents. Others are vulnerable to specific foods (such as bacon, ripened cheeses or alcohol)…food additives such as monosodium glutamate (MSG)…emotional stress…bright lights, etc. Avoiding triggers can be an effective way to prevent some attacks.

BEST NONDRUG OPTIONS

Preventing a migraine is always better than trying to treat one that’s already taken hold. Unfortunately, not all doctors are aware of the more recent effective migraine-prevention approaches. Among the best…

Cefaly. Nearly three years ago, the FDA approved the first device for migraine prevention. Cefaly is known as an external trigeminal nerve stimulationunit. It electrically stimulates branches of the trigeminal nerve, which transmits sensations to the face and head.

How it works: The prescription-only device, which blocks pain signals, includes a battery-powered headband with a reusable, self-adhering electrode. Patients position the headband around the forehead, just above the eyes. It may cause a slight tingling, but no pain. It’s used for 20 minutes once a day. Anyone who has an implanted device in the head, a pacemaker or an implanted defibrillator should not use Cefaly.

Scientific evidence: One study found that more than half of migraine patients who used Cefaly were satisfied and intended to keep using it. The unit costs about $350 and is usually not covered by insurance. The device manufacturer offers a 60-day guarantee, so people can get their money back if it doesn’t seem to help.

Biofeedback. Emotional stress is one of the most common migraine triggers. A biofeedback machine allows people to monitor skin temperature, muscle tension, brain waves and other physical stress responses that affect blood flow in the brain. The idea is that once people feel how they react to stress—with tightened forehead muscles, for example—they can modify their reactions with things like deep breathing, muscle relaxation, etc.

Scientific evidence: There’s strong research showing that biofeedback can reduce both the frequency and severity of migraines by 45% to 60%—but only for patients who are willing to practice.

Biofeedback can work about as well as many drugs, but it takes most people a few months before they’re good at it. It can also be costly because you have to work with an instructor at first. To find a certified biofeedback practitioner, go to the website of the Biofeedback Certification International Alliance, BCIA.org. Insurance often won’t cover it.

Supplements. Some people do well when they combine one or more of these supplements with the previous approaches…*

Riboflavin, a B vitamin, may improve oxygen metabolism in cells. In one study, migraine frequency was reduced by 50% in patients who took riboflavin (400 mg daily).

Feverfew is an herbal headache remedy. Some research shows that 50 mg to 125 mg daily can help prevent and ease migraines, while other studies suggest that it’s no more effective than a placebo. For some people, it might be a helpful addition to more mainstream treatments.

Magnesium (500 mg daily) can help reduce the frequency of migraines in people with low levels of the mineral.

BOTOX

Known for smoothing facial wrinkles, these injections were FDA-approved for chronic migraines in 2010. Botox is a good treatment option for patients who have 15 or more days of headaches each month.

We still do not know how Botox works to prevent headaches. It probably deactivates pain receptors in the scalp and blocks the transmission of nerve signals between the scalp and the brain.

How it’s done: The drug is injected in multiple locations on the head and neck—and the injections are repeated every three months. It sounds terrible, but the injections are only mildly painful. The procedure takes about 15 minutes, and it’s usually covered by insurance if drugs or other treatments haven’t worked. Botox treatments are given by headache specialists. Side effects may include swallowing problems, blurred vision and speech difficulties.

Important: I advise patients to commit to at least three treatments. If Botox relieves your pain, you and your doctor can decide how frequently you need additional treatments. If you haven’t noticed relief after three treatments, Botox is unlikely to be a good choice for you.

*Check with your doctor before taking these supplements, since they can interact with certain medications and/or cause side effects such as diarrhea.

Source: Mark W. Green, MD,a professor of neurology, anesthesiology and rehabilitation medicine at Icahn School of Medicine at Mount Sinai in New York City, where he directs Headache and Pain Medicine and is the vice chair of Neurology for Professional Development and Alumni Relations. He is coauthor of Managing Your Headaches and several medical textbooks.