• Billy Joel has canceled the rest of his concert tour due to a brain condition.
• Joel, 76, has "normal pressure hydrocephalus," a type of fluid buildup in the brain.
• The condition causes issues with hearing, vision, balance, and memory.

Billy Joel is canceling the rest of his concert tour after being diagnosed with a brain disorder. The news comes after the singer postponed some gigs over health concerns.

In an Instagram post, Joel, 76, shared that he was diagnosed with normal pressure hydrocephalus (NPH), a rare brain disorder which he said leads "to problems with hearing, vision, and balance."

His doctor advised him to refrain from performing and pursue physical therapy in his recovery process.

What is normal pressure hydrocephalus?

NPH is a build-up of cerebrospinal fluid in the brain's ventricles, or fluid-filled chambers. The buildup creates pressure on brain tissue, leading to brain damage if left untreated. NPH is more likely to occur in people over 60.

There are two main types of NPH.

Primary NPH has no known causes and makes up 50% of cases. Secondary NPH is caused by other health issues like a stroke, brain aneurysm, brain tumor, or a traumatic brain injury.

Common symptoms of NPH include struggles with walking, balance, vision, memory, hearing, mood regulation, and urinary incontinence.

NPH is usually treatable

Despite being caused by abnormal cerebrospinal fluid (CSF) levels, NPH is called "normal pressure" hydrocephalus because a spinal tap measuring CSF usually yields normal results. For that reason, it can take a while to diagnose the condition, as it can initially be confused with Alzheimer's or Parkinson's.

NPH is diagnosed with physical and neurological exams, diagnostic tests (such as MRIs and CTs), and spinal taps, which can rule out or identify related conditions like meningitis.

In many cases, NPH is treatable and even reversible. The most common treatment is implanting a shunt into the brain to drain the excess fluid into other parts of the body, like the abdomen.

Matt Thurmond seems like a poster child for tech-forward millennials. He runs an AI-assisted platform for mortgage professionals. He leads a nonprofit that connects longevity researchers, investors, and startups. He was the copresident of a technology conference at Harvard, where he got his MBA.

So it's a little surprising that Thurmond is almost never on his phone.

Count him among the "appstinent" — one of a growing number of Americans, mostly millennials and Zoomers, vowing to live a life free of endless scrolling. "Screen time was just crowding out other things," says Thurmond, who's 41. "That's not where I want to get my entertainment, and it's not really where I want to have any substantive conversation. I prefer to do that kind of stuff in the analog world."

Three years ago, Thurmond became worried that his smartphone use was making him less present, less social, and less productive. He traded in his Android for a Light Phone, a so-called "dumb phone" that allows him to text and make calls but doesn't give him access to email and social media. With its simple interface and limited features, it's built to ward off phone addiction.

The switch wasn't totally seamless. Thurmond, a self-professed "long-winded texter," struggled with the phone's E Ink keyboard, which can take some time getting used to. And not being glued to his phone also meant he was slower to respond to texts, which quickly became a point of friction with his now ex-girlfriend.

But as he reduced his screen time, Thurmond realized he didn't need his Android as much as he thought he did, and that many of the Light Phone's inconveniences were actually "benefits in disguise." He started calling people rather than texting, which led to more satisfying interactions. He began each morning sketching out the day's goals on a whiteboard, rather than "just reacting to things" like emails. And instead of using his Android to unlock the Citi Bikes he uses to get around New York, he requested a $10 key from the company.

"I was more relaxed, because I didn't have all this stuff rattling around in my brain," he says. "I was just more fulfilled by things in day-to-day life."

"Appstinence," a play on abstinence, was coined by Gabriela Nguyen, a 24-year-old graduate student at Harvard. Nguyen, who grew up in Silicon Valley and got her first iPad when she was 9, came to view her addiction to phones and social media as the enemy of productivity and living in the moment. She found her calling in encouraging people to wean themselves off their phones. Last year, she started a club called APPstinence at Harvard and launched a website of the same name.

"After adopting this lifestyle, it felt like this incredible, secret, competitive edge that I wanted to share with other people," Nguyen says.

Still, even Nguyen isn't completely phone-free. She has three dumb phones, including the Light Phone, which she alternates between based on their usefulness to whatever task she's tackling.

For her, appstinence is a bridge to a healthier relationship with technology. "Leaving social media is not a resignation," Nguyen says. "It's not this idea that you've been defeated, now you have to do a walk of surrender."

As evidence mounts of our collective phone addiction — and the toxic effects of social media — there's a growing appetite for the Gospel of Appstinence. Searches for dumb phones have been surging. From Amsterdam to Brooklyn, there's a growing trend of nightclubs requesting that revelers leave their phones at home — or at least keep them off the dance floor.

Adults like Thurmond and Nguyen, who grew up when the internet and social media were just taking off, are perhaps the most desperate to reclaim the attention and focus that technology has taken from them. But lately, the appstinence movement has also begun to capture teens and college students, many of whom grew up seeing their phones as integral to their social lives. A recent survey by the Pew Research Center found that most American teens have access to smartphones — and nearly half reported being online "almost constantly."

Samantha Palazzolo was in sixth grade when she got her first iPhone, and she spent most of her middle and high school years glued to it. "I would stay on social media, scrolling instead of going to sleep, even if I was tired," says Palazzolo, who's now 20.

She began questioning her social media addiction during her freshman year at the University of Illinois. After waking up one morning feeling deeply embarrassed by an Instagram story she'd posted the night before, she began reflecting on how social media was consistently killing the vibe. "Going into college, everyone was telling us, 'You're going to remember these moments forever,'" she says. But her phone was distracting her from her actual experiences. "We were going out to these parties and people would just be scrolling on their phones," she says.

So she and two friends bought flip phones — an old technology that was totally new to them. She loved how the antique-looking gadget served as a natural conversation starter in social situations. And to declare her newfound freedom from social media, Palazzolo turned — where else? — to social media. Her TikTok paean to flip phones went viral, garnering over 18 million views. She also joined a growing number of Gen Zers on TikTok who unbox and offer reviews of their favorite dumb phones. Cult favorites include an HMD Barbie-branded model of the Cat S22, a flip phone compatible with most apps but with a small enough screen to deter doomscrolling.

Seán Killingsworth was an even earlier convert to appstinence. At 15, he traded in his smartphone and started hosting phone-free events at his high school. A few of his peers parodied his events in mocking posts on Instagram — precisely the kind of online bullying he was hoping to get away from. But Killingsworth stuck with it. Today, he runs the Reconnect Movement, which hosts phone-free events across college campuses "to create a fully engaged, uninterrupted social environment that Gen Z rarely experiences."

Killingsworth, who's now 22, recently partnered with Nguyen and Jonathan Haidt, the author of "The Anxious Generation" and a leader in the growing phone-free school movement. Together, they've linked up with Truth Initiative, which advocates against youth nicotine addiction, to plan an international "day of appstinence" to encourage Gen Zers to delete their social media apps.

"It's like a muscular atrophy of our social skills," Killingsworth says of our phone-centric lives. Luckily, he's found that the condition is temporary if it's caught early enough. "They come right back in 15, 30 minutes," he says.

Thurmond's journey to appstinence started in 2022. Craving more in-person interactions as the COVID pandemic wound down, he began hosting monthly digital detox events, which attracted people whose phone use had exploded during the lockdowns — including one man who had spent most of his time messaging with an AI chatbot. The attendees, Thurmond realized, were far more diverse than the people in the algorithm-fueled bubbles of his social media. At one of the events, Thurmond invited Joe Hollier, a cofounder of Light Phone, to make a presentation.

The Light Phone is unabashedly a niche product — a "simple device" that's "designed to be used as little as possible." Given its price tag of $699 for the latest model — $100 more than an iPhone 16e, but with far fewer features — only a true believer would consider buying one. Most of the customers are between 25 and 40. "The whole value is in it not distracting you, but giving you the peace of mind that if there's an emergency, you have a phone," Hollier says.

The idea for the Light Phone came to Hollier a decade ago. At the time, he and his cofounder, Kaiwei Tang, were taking part in a Google incubator program for creatives who were developing apps. But Hollier and Tang found the experience to be more insidious than inspiring. In the world of phone apps, addiction wasn't a byproduct of success — it was the goal. "If an app was sticky, then there was a business model to be made," Hollier says. He wanted to do the opposite.

Hollier developed a prototype of the Light Phone while completing his bachelor's degree at the School of Visual Arts in New York City. Since then, riding the wave of the appstinence movement, he's sold 100,000 phones. In 2023, the company collaborated with pgLang, Kendrick Lamar's creative agency, to release a limited-edition Light Phone. It sold out in less than a day.

But Hollier has also witnessed the limitations of his dumbed-down phone in our hyper-online world. One couple gave a positive report after taking a Light Phone out with them on a date. Being unplugged was so refreshing, they said, that it gave them butterflies again. But the evening took a turn when they couldn't order an Uber, and they got into an argument as they tried to figure out the best way to get home.

And even the biggest boosters of appstinence can find themselves pulled back into the habit of constant scrolling. Palazzolo, who just graduated from college, says she still uses her flip phone a few nights a month when she goes out with friends. But she expects to start using her smartphone more as she hunts for a job and perhaps moves to a bigger city. A dumb phone may be liberating, but a digital age requires digital tools. "It's really impractical," Palazzolo says.

For those who are sticking it out, the hardest thing about liberating themselves from smartphones has been existing in a world of phone addicts. Thurmond feels this acutely when traveling around New York City and navigating hordes of people staring into their devices or using them to create content. It's like giving up alcohol while living 24/7 in a bar.

"It's almost like being in Zombieland," Thurmond says. "There's this spell cast on people and they don't realize, 'Hey, you can get out of that.'"

Julia Pugachevsky is a senior reporter on Business Insider's health team.

• Going into business with someone can be exciting. It can also be highly risky.
• A therapist who coaches co-founders shared red flags to look out for before going into business.
• His best advice? Talk out all the specifics before you sign — and work on a trial project first.

It's hard to beat the rush of brainstorming a genius business idea: the electric back-and-forth over cocktails, the daydreams of a sleek future office, the possibility of making millions.

It's even harder to imagine — and live through — a co-founder breakup. Dr. Matthew Jones, a startup executive psychologist who coaches co-founders, told Business Insider that heavy conflict between business leaders presents "an existential threat to the very existence of the company."

If you and your co-founder can't get along to the point of active contention, you might become involved in lawsuits over control of the company. In worst-case scenarios, the business shuts down completely.

"That's the biggest net loss: everybody goes home, all the employees are fired, the investors lose money," Jones said. "Those are situations I really work hard with teams to try to avoid."

One of the best ways to dodge years of financial and emotional pain is to choose the right business partner from the very beginning. "It's important to know your own psychology," Jones said, such as which values matter to you. There are also a few communication mistakes that universally impact all business leaders, he said, like not going over specific details before you commit.

Much like a marriage, you can't predict how high pressure will impact and change you both. But there are red flags you can look out for prior to legally binding yourselves together.

They don't want your relationship to change

Research shows that there are cons to running a business with a best friend, spouse, or family member, Jones said. The people who do it successfully are the ones who have their "eyes wide open," he said, "recognizing that it will fundamentally change some aspect of that relationship."

If you prioritize business growth, you might have to give very direct professional feedback at some point that could hurt the other co-founder on a personal level. If you can't picture yourself saying that to your childhood friend or younger sibling, that's a sign to reconsider entering a business relationship together.

Avoiding the possibility of change can cause more pain down the road. When parting ways, some of Jones' clients have found it "excruciating" to grieve the loss of a business relationship and a deep friendship at the same time.

They're ego-driven

Going into business with someone who is ego-driven — concerned with status or needing a lot of praise — isn't necessarily a dealbreaker, Jones said.

It can get problematic when the relationship feels one-sided and there isn't a natural give-and-take. If you already notice that the other person can't bend a little or meet you halfway, it will only get worse.

Jones said this is especially worrying if you're a people pleaser. "You might easily default to that role and then later find it incredibly restrictive," he said.

In his experience, co-founders may appear to be very similar in the beginning, during the honeymoon phase of starting a company. But later, one person, usually the one trying to preserve the peace, may start to take issue with the power dynamics at play. The fallout when they start speaking up more can get nasty, particularly if the other person has narcissistic traits.

They can't handle feedback

Every thriving business relies on regular feedback, especially the negative kind.

"If you notice a lot of defensiveness, especially early in the relationship, that's a big red flag," Jones said. "That will get worse under pressure."

To grow, you need to level with each other when the other person doesn't meet expectations. If the other person can't take it, it means they can't grow. That's a death knell for a budding business.

"That relationship actually has to scale," Jones said. "It has to change, not just once."

They skip over specifics

Jones said mismatches in contribution are a common source of conflict. Oftentimes, the issue has more to do with communication than work ethic.

He gave one example he sees often in founding teams: in the excitement of the early stages, one person makes grandiose promises. They say they have a fantastic network that will make fundraising a breeze. What they won't mention is that they don't plan to actually lead fundraising beyond making introductions. Cue: conflict.

You can avoid these issues by getting "granular and specific about those contributions," he said. This is especially important when it comes to factors like work-life balance. You need to be candid about how much of your life you plan to commit to the business. If one person is all in on the business and the other wants to be out by 5 p.m. to see their family, that disconnect spells trouble down the line if you've never talked about it.

These conversations also give you an opportunity to spot a subtler red flag, Jones said, which is a lack of curiosity about you. If they only want to see a flatter, business-only version of you, the relationship might get complicated when your life does, like if you get sick or have to care for a family member.

You haven't done a trial run yet

You might have a wonderful relationship with your hopefully-future partner. They text on time and seem even-keeled.

Still, running a business is a different kind of pressure, one that can bring out communication lapses and wildly different reactions to stress. That's why Jones strongly recommends doing a trial project together — something that ideally takes a few months or even a quarter, where you need to be "explicit about negotiating roles and responsibilities."

It won't perfectly replicate the emotional rollercoaster of heading a startup together, he said. "But being able to go through ups and downs with someone will reveal more about their deeper character than superficial pleasantries."

• Tariffs are predicted to drive up the costs of beauty and skincare items.
• Dermatologists said it's worth getting some drugstore products to save money.
• However, it's best to splurge on some products to see real results.

Beauty sales may have persevered through recent tough economic times. The "lipstick effect," however, will be no match for tariffs.

For one, many cult skincare favorites hail from South Korea and Japan, both subject to US tariffs. Plus, plenty of American products are manufactured and packaged in Asia, which will raise the costs on nearly every luxury product, from serums to sheet masks.

Some consumers are stocking up on skincare, especially on pricey multipurpose products that promise to do it all.

Luckily, you don't have to rush to stockpile high-end products. You can keep up your skincare routine by mixing and matching drugstore and luxury brands. Here's how.

Save on drugstore cleansers and moisturizers

Best-selling beauty brands like Aestura, COSRX, and Laneige all have luxurious face creams and moisturizers. They're also all based in South Korea, a country that is still negotiating with the US over potential tariffs.

While US drugstore options may not have the same feel or scent as your go-to favorite, they're likely just as effective and safe for your skin.

Cleansers and moisturizers have a pretty straightforward purpose: cleaning and hydrating your skin. Unlike most expensive anti-aging products, "they're not making any performance claims" like smoothing wrinkles, Dr. Shannon Humphrey, a board-certified dermatologist and clinical assistant professor at the University of British Columbia, told Business Insider.

Whether you have sensitive, oily, or dry skin, the best options all generally fall under similar price points. She said popular drugstore brands like Cetaphil and CeraVe, which are both US brands, carry cost-effective options.

For sensitive skin, Vanicream, a brand that manufactures and packages its products in the US, makes a "beautiful gentle cleanser," Dr. Kate Viola, a board-certified dermatologist practicing in Maryland, told BI.

Try local anti-aging serums

While tariffs will most certainly impact French brands like Caudalie, La Mer, and Avène, you don't need to navigate potential tariff costs on top of already-expensive vitamin C serums. Some US-made anti-aging products are just as effective.

One "gold standard" item to splurge on is US-made Skinceuticals vitamin C serum, Humphrey said. At almost $200, it has a light texture and some solid published research to back its claims of reversing pigmentation and stimulating collagen, she said.

Viola said that the serum is a "holy grail" product, but added that if you're really in a pinch, it might be worth waiting a few months. The company's patent recently expired, opening the formula up for cheaper copycat options. "There are going to be a lot of dupes out there," she said.

Another item worth shelling out on is quality retinol. All retinol products are a form of topical vitamin A, Humphrey said. The one with the most research behind it is tretinoin, a prescription-strength retinoid.

While booking an appointment with your dermatologist requires an extra step, Viola said it can ultimately save you money. Instead of getting a $90 retinol serum, you can get tretinoin. At her practice, which works with a compounding pharmacy, the out-of-pocket cost for tretinoin is $55.

"That little tube is going to last six months," she said.

If you have the budget for it, Humphrey also recommended Plated Intense Serum, a US-based brand, which costs over $250 and "has strong science behind it." It uses exosomes derived from platelets, which signal healing in the body, to reduce redness and smooth skin texture.

While it might be tempting to just get drugstore versions of these anti-aging products, Humphrey said many large-scale commercial companies "really don't have controlled clinical studies" to back up claims of brightening skin or smoothing skin texture.

"They don't publish their data, and their claims are marketing claims, which are not the same as scientific claims," she added. Trying to buy a cheaper serum might end up being a waste of money.

Sunscreen is up to personal preference

Quality sunscreen might be the trickiest to obtain without encountering tariff prices. Sunscreen enthusiasts know that Asian and European brands are better at blocking certain UV rays due to ingredients that aren't approved by the FDA.

Viola's a fan of La Roche-Posay's sunscreens, including the French brand's face moisturizer with SPF 30, usually a little over $20. "I recommend it to everyone," Viola said, referring to it as her personal go-to. "I've never had a complaint, ever."

Viola said some mid-range American options, especially ones that are tinted to match your skin tone, are great. The iron oxide in tinted sunscreens "blocks out blue light that we get from our screens," she said, including computers and phones. She loves the one from the Swiss-American brand EltaMD, usually around $35-$45.

If that still feels a touch too much for a product you're reapplying multiple times a day, she said Eucerin's tinted version, which costs under $20, is "a hidden gem."

Ultimately, you can always go cheaper for sunscreen, as long as it's the recommended SPF 30 and up. The point is to wear it every day, so it's good to find something that doesn't feel greasy, isn't hard to apply, or leaves a white cast. "If you find something that you love, that is truly what matters," Viola said.

• Breeze Hunter, 22, started experiencing fatigue and headaches during her senior year of college.
• Months later, she was diagnosed with acute myeloid leukemia, a rare form of cancer.
• Following a successful cell transplant, Hunter is recovering and plans to walk at her graduation.

Breeze Hunter started off her senior year at Texas A&M University with a typical head cold. She only started to worry when it lasted almost two months.

She was tired all the time, her days dotted with shortness of breath and headaches that she'd never had before. Campus doctors told her she had a sinus infection that was likely prolonged from the usual busyness of being a full-time student and sorority member.

Her symptoms progressed. After a campus doctor pushed her to get bloodwork, she learned her levels were "all over the place," Hunter, 22, told Business Insider.

Days later, at the MD Anderson Cancer Center in Houston, doctors confirmed that she had acute myeloid leukemia — a rare and more aggressive form of the cancer. Abnormal white blood cells grow at a rapid pace, outnumbering healthy blood cells.

"As soon as we found out, we just could not believe that it was actually happening that I had cancer," Hunter said. "It's a very scary moment, and it almost doesn't feel real."

Rushing to treatment

Once she was diagnosed with leukemia, treatment began immediately. The first round of chemotherapy worked very well — she went from a 95% blast, or percentage of abnormal blood cells, to 7%.

To be considered in remission, a person with acute myeloid leukemia must have 5% or fewer blast cells in their body. Hunter did a second round of chemo, one that was "way harder" than the first.

After that, she went straight into 11 days of radiation therapy on her brain and spine. "It burned my skin really bad," she said. "It took a big toll on my body."

'My 200 square foot mansion'

The treatments took her away from her campus life — the first chemo cycle alone involved a month-long stay at the hospital. To pass the time, she started making TikToks about her cancer experience, including a viral video of her parodying MTV's "Cribs" by giving a tour of her hospital room.

Hunter, who didn't grow up watching the show, got the idea from her sister. They watched clips for the first time before Hunter took to the camera, sharing her makeshift closet and framed photos of her family.

Hunter leaned on her family, boyfriend, and friends during this period of time. "When you're alone, you overthink things and you think the worst of the worst," she said. "I never had that happen, which is amazing."

She also connected with other young people with leukemia, including a former high school classmate she used to cheerlead with.

"I ask how she is almost every day and just see if she needs anything or someone just to talk to," Hunter said. "It is very hard — we are so young and we're missing out on a lot of young adult things."

A successful cell transplant

As of December, Hunter is in remission.

Even so, Hunter needed a stem cell transplant after chemo and radiation to replace her cancer cells with healthy ones. Her brother was a 100% donor match.

The transplant was completed in January and was "definitely the hardest thing I've ever done," Hunter said. In her ongoing recovery, she said she lost a lot of weight and developed mucositis, a common inflammatory condition that can develop after cancer treatment.

Now, she's slowly gaining weight back and hoping to grow out her hair. Hunter's hospital and doctors' visits have gone from daily to once a week.

Hunter, who continued to take online classes so she could recover at home with her family, received her degree in agricultural leadership and development with economics on May 9. She's excited to walk at graduation.

After that, she's going on a vacation with her family — something she hasn't been able to do due to being immunocompromised.

"Just going back to normal and being able to do normal things, I'm really looking forward to," she said.

• Ultima Espino, 35, developed symptoms of osteoporosis after giving birth.
• She had multiple unexplained bone fractures and started using a walker.
• She was diagnosed with pregnancy and lactation-associated osteoporosis, a rare form of the disease.

Less than six months after giving birth to her second son, Ultima Espino was using a walker.

Espino, 35, remembers the first jolt of pain in her back three months postpartum, when she lifted her three-year-old son out of the car. She thought she had tweaked it.

"I felt like I pulled a muscle so severely that every single hour of every day, that pain was compounding," Espino told Business Insider.

It wasn't until months later — after cycling through multiple doctors offices — that she learned she actually had multiple bone fractures in her spine, a rare syndrome triggered by breastfeeding.

Espino was confused. She was very active throughout both her pregnancies, attending Orangetheory classes. She worked out all throughout her first pregnancy — her water broke while she was exercising — but she had to stop during her second when she felt some joint pain two months before her due date.

"I just chalked it up to 'most women don't work out that far into pregnancy,'" she said. After giving birth, Espino felt fine until the back incident. Within months, the pain became so severe that she started wearing a back brace recommended by an interventional spine and pain management physician. Eventually, when she was struggling to walk, her husband suggested they buy a walker.

The cause turned out to be osteoporosis, a disease most associated with post-menopausal women.

Excruciating pain with no answers

At first, Espino, who works as a senior director of sports partnerships at Orlando Health, thought she had a common sports and postpartum issue: a weakened core. She booked an appointment with a pelvic floor physical therapist.

By the time she saw the PT, her pain was much more severe. "I couldn't put on pants without crying," she said. The PT reiterated that her pain wasn't related to her core. "They're like, 'You belong somewhere else,'" Espino said. "It's definitely not here."

Her pain accelerated for months, with no clear answers. She couldn't lay her newborn down without first needing to rest her forearms on either side of the bassinet. She also couldn't do it without "wailing in pain."

Putting the car seat in and out of the car was even more challenging. Once, when she was trying to remove the car seat with her baby still in it, she felt the pain again, and the seat started to fall. A dad ran up to catch the car seat in time.

That's when Espino started to realize there were bigger issues besides a pulled muscle or tweaked back. Her husband, concerned about her pain, suggested they get her a walker for the time being. Once she did, it helped her get from one end of the house to the other "without feeling like I was going to break."

The true wake-up call came one morning, when Espino was already feeling a lot of pain. She was helping her older son get dressed for school. Suddenly, she felt a sneeze coming.

"My entire body knew that that was not going to go well," she said.

The pain was "out of the park" the worst she'd felt in her life, more debilitating than long hours in labor. "It felt like my spine was being pulled apart," she said.

An 'aha' diagnosis moment

Espino was rushed to the Orlando Health Jewel Orthopedic Institute and got an MRI. She learned she had four compression fractures in her spine.

She was immediately sent for testing, from calcium analysis to ultrasounds. A DEXA scan, which measures muscle and bone mass, finally confirmed that she had osteoporosis — though it was still unclear how or why.

We spoke to one of Espino's doctors: Dr. Christine Jablonski, who specializes in bone health and orthopedics at Orlando Health. She suspected that Espino, whose mother was also diagnosed with osteoporosis at a young age by Jablonski, might have a rare form of osteoporosis related to lactation. In both pregnancies, Espino had an overproduction of milk, which could lead to calcium loss. When the body can't rebound from overproduction, it can result in osteoporosis.

"It's not very common and I hadn't seen it before, but I suspected this was the cause of Ultima's condition," Jablonski told Business Insider.

Around that time, Jablonski just so happened to attend the annual Interdisciplinary Symposium on Osteoporosis in Washington, DC, when one of the speakers gave a talk on pregnancy and lactation-associated osteoporosis (PLO). After the presentation, she rushed over to the speaker and shared Espino's symptoms. He confirmed that it sounded like PLO.

From there, she was able to piece together what likely happened: Espino was genetically predisposed to develop osteoporosis. Because she had two pregnancies close together — at 30 and 33 — and had an overproduction of milk, it created a "perfect storm" for developing osteoporosis, Espino said.

Parenting while recovering

Espino was instructed to stop breastfeeding her son to curb her calcium loss. Emotionally, it was a hard rule to follow: her first son didn't latch, and she loved the bond she felt breastfeeding her second. She was also discouraged from getting pregnant again, as it could exacerbate her osteoporosis even more.

"We were planning to probably be done with two, but to be told, in the height of pain, that you likely shouldn't carry another baby and to stop breastfeeding, that was super hard," she said.

For the past year, Espino has been receiving bone growth injections and taking calcium supplements. Within the first six months of treatment, her bone density increased by 15% and one of her compression fractures healed. While her pain became less constant, she has no hard timeline for when she'll be pain-free.

Still, she's seen small improvements in her quality of life. She can hold her one-year-old and lower herself on the floor to play with her four-year-old son.

Ultimately, she's glad she sought medical help and wishes more moms would do the same, even if her condition is very rare. "Especially as moms, we really just take it all on and say, 'we know these years are going to be hard,'" she said. "If Mom isn't taking care of herself, no one else can."

• Naiké Vorbe, 42, experienced abdominal pain for years and went on multiple diets.
• At 31, she learned she had a genetic predisposition for colon cancer and was diagnosed at stage 3B.
• After learning about the genetic risks, Vorbe's mom was diagnosed early with stage 1 uterine cancer.

For years, Naiké Vorbe tried to ease her abdominal pain. A dietitian advised her to cut gluten and lactose, but nothing worked.

Stomach discomfort wasn't new for her: throughout most of her adult life, she cycled from being constipated to having diarrhea. "I was constantly one or the other," Vorbe, 42, told Business Insider. When she was pregnant with her second child, she saw a gynecologist. Her bowel movements were explained away as common pregnancy symptoms.

Then the pain intensified. After she gave birth to her daughter, "going to the bathroom was more excruciating for me than giving birth," Vorbe said. She kept touching her stomach, knowing that something was wrong. Lying down, she felt a lump.

Shortly after, Vorbe, who lived in Haiti, booked an appointment with a GI. He immediately told her to fly to Miami from Haiti and see a specialist for colon cancer at the Sylvester Comprehensive Cancer Center at the University of Miami.

At 31, two months after giving birth, Vorbe was diagnosed with stage 3B colon cancer.

Fighting for her fertility

In 2014, a few weeks after her colonoscopy revealed a malignant tumor, Vorbe underwent surgery to get part of her colon removed. Months later, the cancer spread to her liver.

Vorbe had no idea what her immediate future would look like. She had a six-year-old daughter and a newborn back in Haiti, along with the rest of her family. Her then-fiancé (now husband), a film director, was traveling a lot for his first movie.

She said she asked her doctor to end her chemotherapy appointments on Thursdays, so she could fly back to Haiti on Friday and stay through Monday to be with her older daughter for the next 10 days. Then, she'd repeat the process.

Zooming out even more, she was concerned about how chemotherapy would affect her fertility. She wanted more kids, so she asked her doctor if she'd be able to have children after treatment.

She said he told her that saving her life was the priority. "But for my life to be worth it, I need the answer to this," Vorbe told him.

He connected her to a gynecologist who administered a gonadotropin-releasing hormone (GnRH) every month, which temporarily suppressed ovary function and reduced the risk of chemotherapy-induced infertility.

Vorbe described him as a "big angel" in her life. "Every ball I threw at him, he worked with me," she said.

She did 12 rounds of chemotherapy. After her 4th, she was scheduled to have part of her liver removed. She took a break from chemo for a few weeks to recover, marrying her husband back in Haiti. When she returned, the tumor on her liver was gone. The part was still removed out of caution, but when it was dissected, no traces of cancer could be found.

Vorbe wanted to quit chemotherapy earlier, now that the tumors were gone. Her doctor insisted on 12 cycles, to give her the best chance of long-term survival. Dr. Daniel Sussman, Vorbe's physician and a gastroenterologist at the University of Miami Health System, told BI that in 2014, when Vorbe was treated, 12 cycles of chemo was "probably considered what was necessary" to increase the likelihood of successful treatment.

An underlying genetic risk

As a child, Vorbe remembers having unexplained stomach pain. Her father would take her to the doctor to be tested for worms and parasites. When she developed the lump in her abdomen as an adult, a gynecologist initially told her to try an enema.

"I was overlooked and pushed to the side because I was so young, I looked healthy," she said.

Additionally, she said discussions around bowel movements are taboo in Haitian culture. "You don't really speak about gastrointestinal issues."

When she was diagnosed with colon cancer, she took a recommended gene panel and learned she had Lynch syndrome, a symptomless genetic condition that raises the risk of developing colon cancer. She wondered if her grandmother, who died at 48, had it, too. "Nobody ever understood that's what happened to her," Vorbe said.

Sussman, who specializes in Lynch syndrome and was involved in diagnosing Vorbe, said that because the field of genetics is so young, entire families may have unknown genetic predispositions for certain cancers. Naiké "ended up being that first person in the family to undergo that genetic evaluation," he said.

Her mom was diagnosed with uterine cancer earlier

Vorbe, now a mom of five, has been in remission for 10 years. As a former colon cancer patient, she gets the recommended yearly colonoscopies. She also gets an endoscopy every two years, as Lynch syndrome puts her at risk of developing other cancers.

She said learning about Lynch syndrome not only helped her understand her diagnosis better. It also helped her mom, who carries the same genetic risk, to get diagnosed with uterine cancer early.

Her mother had a polyp in her uterus that was left alone because it hadn't grown over the years. When she told her gynecologist that Vorbe had Lynch syndrome and was being treated for colon cancer, her doctor immediately scheduled a biopsy. Vorbe's mother was diagnosed with stage 1 uterine cancer and had her uterus removed.

Vorbe said her family is what kept her going through treatments. She remembers thinking "There's no way I can die: I have these two beautiful little girls right in front of me. I want to see them grow up."

Despite being over a two-hour flight away, her family buoyed her throughout her recovery. Her godmother flew with her to her first chemo appointment. Her cousins flew to Miami to be in the house after the appointment, to cheer her up. In Haiti, her sister-in-law would care for Vorbe's baby overnight, then bring her to Vorbe in the morning.

"I had so much love and light around me, it just carried me," Vorbe said.

• Michelle Kloese, 42, gained weight from early menopause and a stressful job.
• When she started a new job, she joined a health app paid for through work.
• Walking every day, logging her water intake, and meal swaps helped her lose over 60 pounds.

At 40, Michelle Kloese felt like she didn't recognize her body. In five years, she gained 38 pounds and developed high cholesterol, high blood sugar, and plantar fasciitis, a kind of foot pain caused by inflammation.

She didn't always feel like this. In her 20s, running was her main form of exercise, and she loved 5K races. Her body started to change in her mid-20s, when she experienced symptoms of early menopause, like infertility. By her 30s, bloodwork confirmed she had perimenopause, around 15 years earlier than most women.

Then, in her mid-30s, she started a demanding job as a middle school assistant principal, often starting before the school day and wrapping up after school hours. With less time to work out, a busy schedule, and irregular meals, she started to snack more.

"Somebody would leave a cupcake on my desk, so I'd eat that, or parents would bring in a basket of candy," Kloese, now 42, told Business Insider.

The change in her body really struck her after a surprise trip to Ireland for her 40th birthday. "I looked at the pictures and went, 'Oh gosh, I need to do something different,'" she said.

She had just started a new, less stressful edtech job, Kloese learned about a health app, Personify Health, connected through their insurance. The timing was perfect: she signed up, logging her steps and water intake.

She lost 38 pounds in the first year and 23 pounds the following year. Now she's in a "weight maintenance" phase, seeking to stay within a few pounds of her current weight.

"I have so much more energy — I'm not as sluggish and tired as I was feeling all the time," she said. The issues related to her weight, like high cholesterol and high blood pressure, also went away. "I have just felt a whole lot better."

Kloese shared the three habits she started and still maintains to keep the weight off.

She woke up to a full glass of water

Before, Kloese didn't drink much water — sometimes, she'd only remember to have around eight ounces of the recommended eight cups in one day. "That's one of the most challenging ones for me to do," she said.

Her goal was to get to at least 72 ounces, or nine cups per day.

Tracking her intake helped. The first thing she did every morning was drink a full, 8-ounce glass of water and log it in the app. For the rest of the day, she'd log in "steady sips", using a marked water bottle to measure her progress. It was more manageable for her to track two ounces at a time rather than feel pressure to chug a lot of water at once.

Drinking water helps with weight loss by curbing your appetite. It can also help you reach a calorie deficit if you swap it for high-calorie drinks like soda.

She swapped running for walking and yoga

While she used to run a lot in her 20s, Kloese's knees and hips hurt when she tried in her 40s. She knew she needed to try something different.

When she first made a plan to lose weight, Kloese communicated with a personal trainer through an app. The trainer said that, in her 40s, it was important for Kloese to focus on strength training as we naturally lose muscle with age. Muscle-building can also help with weight loss — gaining muscle boosts your metabolism and burns fat.

Kloese started doing at-home and online circuit workouts 3-4 times a week with light weights.

The rest of the time, she walked. She took part in a fitness challenge of walking 30 minutes a day. Weight-loss-wise, she said she saw about the same results as running.

Now, she aims to walk at least 7,000 steps a day, whether on her walking pad or on trails near her home in Florida. Occasionally, she trains for Mammoth Marches, 20-mile hikes all over the country.

She also swapped out some of the strength training with yoga, which relaxes her while still improving her strength and flexibility.

Being more active transformed her relationships with her friends. "Before, where we might've just picked a restaurant to hang out at, instead, we go out and do a hike," she said.

She made simple meal swaps

Despite snacking on sugary treats at her old job, Kloese isn't much of a sweets person. "I was a pasta-potato-bread kind of person," she said. Still, she wanted to make some more nutritious swaps.

Through the KickStart app, she logged her meals by taking photos of them. If she got a burger and fries, the app suggested lower-carb sides for next time, like a side salad or sweet potato wedges.

Eventually, she naturally made those swaps on her own, like cooking quinoa instead of white rice. She also gets pre-made meals through Factor, which she said helps her with portion control and eating a balanced diet when she's busy.

"Those were all small changes that evolved over time," she said.

• Vadim Fedotov, the CEO and founder of Bioniq, used visualization techniques when he was in college.
• Visualization, often used in sports, improved his basketball performance when he was injured.
• Fedotov also used visualization to build Bioniq, his personalized supplements company.

Vadim Fedotov first learned about visualizing success after a knee surgery at 23.

In the early 2000s, Fedotov played power forward for the Buffalo Bulls, the University of Buffalo's NCAA Division I basketball team. He worried about repeat injuries on the court — during an eight-year professional basketball career, he had four ACL tears.

Fedotov, 44, told Business Insider that he began seeing a sports psychologist in his junior year to "talk about the mental aspects of the game."

The psychologist taught Fedotov about visualization techniques, commonly used in sports to mentally rehearse the steps to reaching success.

"It started off with a very hesitant approach," Fedotov said. When he saw "quantifiable improvement" in his three-point percentage, it became a regular part of his routine.

Many years later, in 2019, he applied the same visualization techniques when he started Bioniq, a supplement company that creates personalized formulas based on bloodwork.

"If you can't imagine what you're trying to do, then you're not going to do it," Fedotov said.

Visualizing relaxed him on the court

Like many athletes, Fedotov was routine-focused. He didn't waver from his diet and went to bed at the same time every night. Eventually, he tacked on visualization techniques the nights before games.

For about 10 minutes, he'd close his eyes in a quiet space and slow his breathing, visualizing the feel of the court and specific situations like free throws and defensive plays. He would picture the moments after making a basket, too, like the sounds of the crowd or his coach's reaction.

The idea was to create "muscle memory through thoughts."

He compared it to programming your body ahead of time. "Your body and your mind don't have to come up with something to do — they already know what's going to happen," he said.

He felt calmer, and in a few months of consistent practice, saw improvement in how often he scored.

That success convinced him to continue with visualization long after his basketball days were over.

He applied the techniques to starting a company

Fedotov's idea for Bioniq came from experience. In his early 30s, he was trying to optimize his health. He couldn't find a company that provided tailor-made suggestions on what nutrients he needed to improve his cognition or longevity.

He first visualized Bioniq as filling the gaps he saw in the market: supplement brands with no customization or "real reason to stay loyal" and at-home blood tests that offered no follow-up to address issues.

He said visualizing the brand's success wasn't about imagining the fun parts of reaching the end goal, like press interviews or holding meetings as a CEO. It was about convincing investors and consumers to get on board in the first place.

"I knew we were entering a very crowded and complex space," he said. He had to visualize who the clients were and what they needed to trust a new supplement brand.

Just like he did before basketball games, he'd find 10 minutes to run potential interactions with stakeholders in his head. "I'd imagine walking into the room, greeting everyone with calm energy, presenting the idea clearly," he said.

He'd anticipate questions and how he'd respond, including to energy shifts in the room.

Fedotov, who previously worked as the CEO of Groupon in Eastern Europe, knew firsthand the common challenges — and high failure rates — of most startups. He anticipated roadblocks like having too niche of a market, lacking resources, or simply getting the timing wrong.

Visualization got him into a mindset where he felt knowledgeable and confident about the product even in high-stakes presentations.

He'd zoom in on tiny details in his mind, like a key slide in a deck or a conversation pivot where he knew he had to connect with his audience. Doing those mental reps ahead of time helped him "stay grounded when things were moving fast."

Brainstorming future investors

Fedotov drew inspiration from brands like Nike, which, like Bioniq, features collaborations with prominent athletes.

In the early stages of the company, Fedotov remembers brainstorming with his small team about the "perfect embodiment" of the brand. It would have to be someone results-driven and dogged about their performance. Cristiano Ronaldo, considered one of the GOATs of soccer and known for his longevity in the sport, came up in the meeting.

Ronaldo became a Bioniq investor in 2024.

Visualization isn't a magic cure-all for roadblocks. Fedotov said there were events he couldn't have visualized when he launched the company, from Brexit to the pandemic. At launch, Bioniq's business model relied on nurses visiting clients in their homes to take blood samples. Since then, Bioniq has added other versions of its supplements that don't require blood biomarkers.

The early obstacles taught him that visualization, while a powerful tool, isn't everything. The ability to pivot is just as important.

• Dr. Giselle Prado-Wright, a cosmetic surgeon, has seen an uptick in Gen Zers asking for fillers.
• She said many ask for under-eye filler, partly due to social media filters.
• Under-eye fillers can start migrating weeks after being injected and come with risks like blindness.

In the past four years, cosmetic surgeon Dr. Giselle Prado-Wright noticed an uptick in younger, first-time clients asking for fillers.

She chalks the trend up to pandemic lockdowns and more time spent online. "You're looking at yourself on camera, you're seeing everybody perfectly filtered on social media," Prado-Wright, the co-owner of EXERT BodySculpt in Florida, told Business Insider. "All of a sudden, you feel less than because you're noticing a little bit of darkness, a little bit of wrinkles."

Some of her clients in their early 20s initially come in for lip filler. Then they start asking for under-eye filler.

While Prado-Wright occasionally offers under-eye filler to help clients with "very sunken under-eyes," she said she's very conservative with how much she uses. Most of the time, she says no to under-eye filler because she believes that, at best, the results are usually very mixed — and that the greater risks are not worth it.

Short-lived Instagram Face

Like Botox and other fillers, under-eye filler is appealing to clients because there's no downtime. "You might get some slight bruising, but compared to surgery, it's not something where you have to do this big recovery, this big investment," Prado-Wright said.

Under-eye filler also looks great right after injection. On social media, post-filler videos are usually shot a day or two after the treatment. "The problems come months down the line, maybe weeks later," she said.

Fillers, which usually contain hyaluronic acid, draw in moisture. Over time, the under-eye area can become really puffy, with the fillers impairing lymphatic flow and potentially causing blockages.

"The immediate before-and-after is being propagated a lot on social media, versus 'let's see what that looks like a year from now,'" Prado-Wright said.

Risks include blindness and strokes

In the worst case scenario, Prado-Wright said under-eye fillers can pose serious health risks. If a syringe pokes the infraorbital artery, a significant blood vessel below the eyes, it cause cause blindness. It can also create a blockage called a vascular occlusion, which can lead to a stroke.

More likely, the filler will look amazing at first and swell later, she said. Ultimately, if the filler migrates or puffs up, it can be removed. But the process isn't easy — or cheap.

The filler itself, at its cheapest, will cost you $500 to $600, she said — though it can cost up to $1,500.

The cost of getting it dissolved is charged per vial of Hylenex, a solution that dissolves hyaluronic acid. That can range from $250 to $600 per vial. Because the solution has to be injected exactly where the filler is, it can take multiple sessions to get rid of all of it.

Try tretinoin and lifestyle changes

Prado-Wright said she sees a lot of clients who keep wanting to add more filler. She tries to counsel them into dissolving some of it and looking for other anti-aging solutions.

One is using collagen injections instead of hyaluronic acid fillers. Collagen injections, made from cow collagen, are also used to add volume to the face and reduce fine lines.

Because collagen is naturally occurring in the skin and collagen injections have a thinner consistency than filler, there are lower risks of vascular occlusions or bad reactions, she said. Injecting collagen closer to the nose and cheeks can fill out the face and camouflage any under-eye hollowness.

She also suggested going to offices that offer other treatments besides filler, as under-eye concerns vary and can't always be fixed with injections. Laser treatments can help with dark circles, for example.

Before you do all that, she said it's worth making some simple skincare changes. You can try tretinoin, a prescription retinoid that boosts cell turnover. "It's the gold standard just to help that skin quality look better, look brighter," Prado-Wright said.

Of course, nothing will help if you're not maintaining good sleep, decreasing your alcohol intake, and drinking enough water. "Not just your under-eyes are going to look better," she said. "Your skin overall is going to look much better."

• A new study found that the number of teens using nicotine pouches nearly doubled from 2023 to 2024.
• An author of the study was shocked by the sharp rise in Zyn use, though he expected an increase.
• There was also an increase in people using both pouches like Zyn and e-cigarettes.

Teens aren't into e-cigarettes anymore. Nicotine pouches like Zyn are quickly becoming their new nicotine replacement.

A new study published in the JAMA Network on Wednesday explored the nicotine habits of over 10,000 teens in 10th and 12th grade.

The researchers found that their nicotine pouch use nearly doubled from 2023 to 2024. Many teens reported using both pouches and vapes. The only metric that decreased was using vapes alone.

Adam M. Leventhal, the executive director of the USC Institute for Addiction Science and one of the authors of the study, told Business Insider he had a feeling that pouch use would increase among teens, as demand for Zyn soared and caused continual shortages.

However, he said he was surprised to see such a huge rise, so quickly.

It's harder to ban pouches

If you look up "Zyn" on TikTok, your feed will be littered with young people using it, commenting on the flavor options and demonstrating how to insert "upper deckies."

Leventhal said that teens' general draw toward nicotine hasn't changed over the years despite efforts to spread awareness about the health risks.

Based on his team's previous research, teens like that nicotine can stimulate mood, increase metabolism, and suppress appetite.

Pouches are especially alluring to teens because they're more discreet, Leventhal said. "They can use them in school without teachers seeing them or even in front of their parents," he said.

Pouches can be a supplement in places they can't bring their vapes, like in movie theaters or on planes.

It's also what makes pouches risky. Because of their inconspicuousness, they're easy to use continuously throughout the day.

A surprising gender divide

The study showed that teen girls vape more than teen boys — another unexpected finding, Leventhal said.

"Historically, any kind of substance, you typically see that males have higher-use levels than females," he said. "But vaping, it's appeared to kind of switch over recent years."

One theory is that pouches have more masculine branding. Zyn, a Swedish brand, was originally marketed to women who wanted to quit cigarettes. Now, everyone from Wall Street bros to Josh Brolin uses Zyn. Tucker Carlson, a former Zyn user, now plans to start his own brand, as he feels Zyn is not manly enough.

It all points to marketing that could make pouches "particularly attractive to boys," Leventhal said.

The health risks of Zyn and vapes for teens

Leventhal's main concern with the pouch trend among teens is that they're likely "exposing themselves to higher levels of nicotine" than using e-cigarettes alone.

Zyn can harm gum tissue, change your brain chemistry, and increase your heart rate. Vaping, meanwhile, is considered as harmful as smoking traditional cigarettes. Both are highly addictive.

While some TikTokers say they use Zyn to try to quit vaping, Leventhal said it's not a viable solution to e-cigarette addiction, especially since many just start using both.

"We don't want children to use any nicotine products," he said. "So all nicotine products should be avoided."

• Mike Crabtree, a data engineering director at Ford, took over 25 online courses to skill up.
• He said learning new skills is crucial to protecting your job amid recession fears.
• Online courses improve your problem-solving and communication skills, applicable in multiple fields.

This as-told-to story is based on a conversation with Mike Crabtree, the Director of Data Engineering at Ford. The following has been edited for length and clarity.

In 2008, I had just received my associate's degree in industrial mechanics and electronics engineering. Then, the recession flooded the labor market.

In a crowded field, my degree and resume — mostly retail experience — didn't stand out as much to employers.

As I pursued a bachelor's in business and computer information systems, I knew I needed to differentiate myself more. I started taking paid online courses from platforms like Coursera, edX, and Udacity, earning certifications in everything from business analytics to leadership skills that I shared on my LinkedIn.

While I didn't major in data science, I took supplemental online classes that helped me stand out and pivot into the field. Ford reached out months after I graduated in 2016. The company hired me as a data scientist that November, a role I stayed in for five years before becoming the manager of a data engineering team. After leaving Ford to work for a data-specific organization, I returned in 2023 and eventually became the director of data engineering.

These days, the job market is a little tougher to break into, let alone stay in. Some people are looking to recession-proof their jobs amid concerns of AI disruption and economic uncertainty.

My experience taught me that the key is to keep learning. By choosing challenging online courses, I tapped into skills I never used before, from technical ones like programming to soft skills that helped me grow as a manager. Taking classes in everything from entrepreneurship to self-driving car engineering also signaled to managers that I was proactive and willing to learn — qualities that are important for feeling secure at a job or getting a promotion.

Here are three ways to recession-proof your job as much as you can — or land a more stable one.

Find your gaps

To feel like you're in good standing at your job or that you're prepared for upcoming interviews, you need to be as well-rounded as possible. If you're incredibly self-aware, you might already know your skill gaps. Personally, I didn't learn mine until I started challenging myself with online courses.

Because statistics and the scientific method are foundational in data science, I took a statistics course. I got stumped on probability and had to improve my understanding before I could move forward. Later, I took a machine learning class and realized that linear algebra wasn't my strong suit. In addition to learning the needed technical skills from those courses, I also learned how to spot my weaknesses — and take action to fix them by studying more.

This can apply to all fields. You might be a manager, for example, and need more leadership training. If your job doesn't directly offer many opportunities to push yourself outside your comfort zone, courses can help you quickly spot what you struggle with.

Grow your problem-solving skills

Being able to think critically, solve problems, and lean into your intuition makes you a more valued team member.

The good news is you don't need to stuff your brain with as many facts or programming techniques as you think. It's more important to be able to assess direction, build business acumen, and make confident decisions.

You might know how to build a linear model as well as AI does. But when you can just look that up, what matters more is realizing that a linear model isn't the best solution to a problem in the first place.

One way I beefed up my critical thinking skills was by taking a course in quantum computing taught by IBM, which heavily involved physics — something I wasn't an expert in at all. It taught me to think quickly and wrap my head around a lot of conceptual topics. I went in thinking I was learning one skill, but I left learning four.

Be communicative

Forming strong workplace relationships is important, especially in a tough job climate. After I worked at Ford as a data scientist, I left for a managerial role at a data company. When I exited that job, some old coworkers at Ford started reaching out the moment they knew I was back on the market.

Throughout my career, I've seen many brilliant technical professionals struggle to move up — not because they're mean or ornery, but because they're super quiet and keep their heads down. Because they weren't assertive enough, people didn't know much about them.

In my own career, I've taken public speaking courses to improve my communication and confidence. Beyond simply speaking up, it's also crucial to be able to share your suggestions in a clear and approachable way. This is especially true if your job is highly technical.

You can be the smartest person in the room, but if no one knows your name or understands your ideas, it doesn't really matter. Bridging that gap by building up your soft skills is the best way to set yourself up for success.

• Rachael Piltch-Loeb, 35, noticed signs of cognitive decline in her father after she gave birth.
• Her father was diagnosed with early-onset Alzheimer's at 58, when her son was a baby.
• Part of the "sandwich generation," Piltch-Loeb had to balance caretaking a child and a parent.

Rachael Piltch-Loeb was always excited for her dad to become a grandfather.

He was the picture of longevity, pursuing hobbies like basketball, biking, tennis, and playing the guitar. Most of all, he loved kids: after building a career as an architect and general contractor, he decided to become a middle-school teacher in his 40s, while still raising his own children.

"He was calm, he was cool, and he really led with empathy," Piltch-Loeb told Business Insider. "He didn't need to be the loudest person in the room, but when he spoke, you wanted to hear what he had to say."

Six months after Piltch-Loeb gave birth to her first child, her father was diagnosed with early-onset Alzheimer's at 58.

She was now part of the "sandwich generation," needing to care for her child and a parent at the same time. Aside from figuring out the logistics and costs of balancing both responsibilities, she also had to process her grief, watching her father slowly slip away. He died at 62, a little over three years after getting diagnosed.

"There was so much anxiety, so much sadness, and so much unknown when that diagnosis came," she said. "It was an overwhelming feeling."

A difficult role reversal

The diagnosis confirmed what the family deep down knew, after witnessing signs of his decline even before his grandson was born.

Piltch-Loeb has a vivid memory of her parents traveling from Boston to New York City to meet their grandson. Her mom drove because her father, normally great with directions, started to get lost on the road. At intersections, it would take him a moment to realize the light turned green.

"My dad was huffing and puffing as he arrived at the hospital because he hadn't been the one to drive," she said. "He was always the driver in the family."

At the time, the family suspected he was going through some cognitive decline; he'd had a stroke at 54, which can cause lasting brain damage. As his symptoms progressed, they suspected Alzheimer's.

"Once the label was there, there was no turning back," Piltch-Loeb said. Because Alzheimer's progresses more quickly in people under 65, her father was given a five-year horizon of life.

"It was kind of this pit in your stomach, this dreaded feeling that the end will come, and it will come a lot sooner than you're prepared for," Piltch-Loeb said.

Post-diagnosis, the family had to adjust to a new normal. While family gatherings used to be joyful and relaxed, they became more about scheduling and management. Who was keeping an eye on Dad? Would a public place be too overwhelming for him?

There were also limitations in how her dad could interact with her son. Over the coming months, his hands started to shake when he held his grandson. By the time her son became a toddler, capable of moving around more, her father's decline had progressed. She realized she couldn't leave them alone together.

Part of Piltch-Loeb's grief came from no longer being able to lean on her dad for support. "I really miss having him just listen, or having a brief conversation with him to hear his thoughts," she said.

Still, she said she was able to share some sweet moments with her dad and son. "When I look back at all those memories, he's the one on the floor with him as he's learning to pick his head up, encouraging that mobility," she said. "He's the one pushing him in the stroller or holding him in the baby carrier."

Supervising her son and dad

Piltch-Loeb felt lucky that her dad had a huge support system: her mom and two siblings all participated in caring for him. Meanwhile, Piltch-Loeb and her husband traveled back and forth from New York to Boston as often as they could.

But her situation felt unique in the family. She was the only one with a very young child and had to split time between being a caregiver to him and a parent with Alzheimer's.

The parallels in caring for both were stark: Both son and father had "this perception that they can do a lot more independently than they actually can," so she would need to find the right balance between setting boundaries and letting them have some autonomy.

They also needed to be supervised in similar ways. While she needed to feed her son, she also had to remind her father to eat, sitting with him to make sure he did it. When watching her son or father wash their hands, she had to make sure they turned off the sink. Once, her parents' house had a minor flood because her dad left the sink running.

In taking care of a parent, "you recognize that these are things that they did for you, but it is heartbreaking to do that for somebody who you previously recognized as just so capable," she said.

How to get by in the 'sandwich generation'

As millennials now reach their early 30s and mid-40s, they're taking on new roles. For some, like Piltch-Loeb, it involves simultaneously navigating parenthood and caretaking.

Piltch-Loeb, a public health academic, was inspired to write her book, "The Millennial Caregiver," a guide on how to handle the practical and emotional challenges of being a dual-caregiver. While there were plenty of resources on Alzheimer's, she didn't feel there were many tailored to her experience.

For one, her father was younger than the average Alzheimer's patient: when her mother attended support group meetings, she noticed everyone else was decades older than her. Financially, caring for him became complicated. Because he was under 65, he didn't qualify for Medicare, which could pay for some of his treatments. He also didn't have long-term care insurance, so extra services like speech or music therapy were all out of pocket.

"You want desperately for the person who is impacted to just be themselves for a little bit longer," she said. However, paying for supplemental therapy can be a huge financial burden, impacting retirement savings.

It was also difficult to know how to talk about the experience. When someone asked her how she was doing, she didn't know what to say.

"He can't use the bathroom by himself, the sink is flooding, he needs to be fed, he's wandering outside," she said. "How much detail do you think folks really want?"

Piltch-Loeb said the experience taught her to manage her expectations and focus on what were absolute priorities — in her case, focusing on her son and father. Above all else, she learned to "let go of that desire to predict and plan everything perfectly."

• The US birth rate grew by 1% in 2024, according to a new CDC report.
• Moms in their early 40s and late 30s experienced the biggest increases in births.
• Meanwhile, births declined the most among teens and people in their early 20s.

After years of ominous headlines about the world's shrinking birth rates, there's a bright spot. The US birth rate slightly increased in 2024, according to preliminary data from the CDC.

The 1% rise in births was largely driven by moms in their early 40s, who gave birth to 2% more children in 2024 than in 2023. Moms in their 30s and late 20s also experienced slight increases in births.

Brady Hamilton, the lead author of the report, told Business Insider that the stats are a continuation of the trends of the last three decades.

Women in their late 20s to early 40s are having more kids, while those in their teens and early 20s are having fewer. These numbers "support the contention that women are having children at later points in their lives," he said.

Millennial moms are leading the way

While millennials are having fewer kids compared to past generations, they're still having more kids than Gen Zers.

In 2024, the CDC found that women between 30-34 had the most kids, followed by moms in their late 20s (the oldest of Gen Zers).

Emily Oster, the founder of ParentData.org, a bestselling author, and a professor of economics at Brown University, told BI that the CDC's data points to two large trends.

One is that people are choosing to have kids later: fertility peaks in your early 20s, yet women in those age groups have been having fewer kids since the 1990s.

At the same time, medical developments give people more control over when they have kids, if at all, Oster said.

Teenage births continue to decline, dropping 3% since 2023, as birth control access increased. IVF allows women to conceive well into their 40s.

Young people need more time to feel financially ready for kids

Not everyone feels ready to have kids before their 30s and 40s.

"People are just taking longer to get to the place in their life when they think they want to have children," Sarah Hayford, a professor of sociology and director of the Institute for Population Research at The Ohio State University, told BI.

Millennial and Gen Z parents need more time to feel financially secure enough to start families compared to past generations.

Some are staying in school longer to land higher-paying jobs and afford the homes they want.

"What we see is people postponing births early on and then sort of catching up later on," she said.

Trump is on a mission to get more American babies

Despite the uptick in births, the Trump administration is on a mission to boost the birth rate, from "menstrual cycle classes" to giving $5,000 in cash to parents after delivery.

Many Americans want more kids than they have. The challenge is getting parents to actually have more.

Hayford said other wealthy countries, like Japan and South Korea, have introduced policies in the hopes of increasing their birth rates, like four-day work weeks and bonuses for men who reverse their vasectomies.

"None of them have been super successful," she said. While baby bonuses can have some impact, "they have to be really big," and even then, they have a modest influence on birth rates. She said Trump's proposed $5,000 would be under the average cost of delivery in the US, which is around $13,000 before insurance kicks in.

Other policy proposals often mentioned by parents, like lowering childcare costs or lengthening paid parental leave, aren't guaranteed to significantly raise birth rates: Some Scandinavian countries with better childcare support than the US are also experiencing birth declines.

"I don't think we know what it would take to get a bunch of 26-year-olds to want to have three kids," Oster said. "I'm not sure we have the answer to that."

• Dice president Paul Farnsworth has over 25 years of experience.
• He shared tips on how to get promoted if there aren't many job openings at your company.
• Finding small leadership opportunities and quantifying your wins can fast-track a promotion.

This as-told-to story is based on a conversation with Paul Farnsworth, the president of Dice, a tech careers marketplace. The following has been edited for length and clarity.

When it comes to getting a promotion, every business looks for similar values in its employees: people who are organized, dependable, and passionate.

Displaying those qualities isn't always straightforward but there are some tried and true strategies to leveling up — or at least give yourself the best shot possible, even when your company isn't in a high-growth period.

Based on my 30 years of work experience, here are the ways you can fast-track a promotion.

Document your wins

Regardless of what industry you're in, the biggest question you have to ask yourself is: how are you adding value to the company? Can you point to a project that's generating revenue or managing costs in some way?

It's not enough to work hard or advocate for yourself — you also have to document your wins as often as possible.

If you meet with your manager once a quarter and say "I've been doing a lot of work and feel ready for a promotion," it can feel like a shallow conversation if you don't have concrete numbers or achievements to point to. If you can point to evidence of your growth and contributions, you're on much steadier ground.

Show clear enthusiasm

Another big quality employers look for is eagerness. It doesn't mean you have to agree to everything or have zero boundaries. But it's always better to say yes to a task — and ask for any adjustments in workload for you to achieve it — than to say "No, I'm busy."

In the post-pandemic hybrid world, this can also mean going to the office more. In my career, I've sometimes been given opportunities simply because I was at my desk when a higher-up needed something. They would point to me and ask me if I could take the assignment when someone else couldn't. If you work fully remote, you might have to make an effort to find more in-person interactions, like a company on-site.

From my experience, the people who are easy to work with and willing to find ways to get things done are the ones who get more visibility. Usually, that also leads to more growth opportunities.

Find small ways to lead

If your current role involves mostly producing something, you might not see many opportunities to lead and move up the career ladder. But you can always find new ways to show that initiative.

For example, you can brainstorm a more efficient way to produce your product, such as automating parts of the process. It isn't about doing more of the same; it's about how you can get the same result differently. If you can come up with a successful plan, it shows leadership — and promotion — potential.

This can also apply to your relationship with your manager. If your boss doesn't schedule regular check-ins, you can put them on their calendar and create that framework yourself. Not only does it ensure that you chat more often and have more of a chance to showcase your wins; it also shows that you can take the lead.

Be trusted to stand in

A great sign that you might be considered for a promotion is if your boss trusts you to stand in for them in meetings or projects. It means they see you as at their level — or close.

One way to bridge that gap is to look for ways to collaborate with your manager directly. In my experience, these are some of the best ways to understand your boss's work style and what they value. Weekly check-ins are good, but working on projects together accelerates that relationship.

Think like your boss

Even though your boss is your superior at work, it's not their responsibility to guide your career. You have just as much of an equal part in that, including understanding what gaps you can fill.

Before you pitch a promotion, it's important to know what your manager values. For example, you might be super fast and organized, but they want someone more thoughtful and creative. The better a relationship you have, the easier this will be to spot.

The best practice is to always think about your boss's vantage point: how would your promotion benefit them and the company? Can you position the promotion as a win for everyone?

If you can take that burden off their shoulders when you ask for a promotion, you bring a potential solution instead of a complaint. That alone puts you in much better standing to get one.

• My friend and I booked the Portuguese airline TAP Air Portugal to fly to and around Portugal.
• Months before we flew, we were notified our return flight to the US had been pushed back a full day.
• Later, we were bumped from an overbooked flight and another was canceled.

In November, my friend and I began booking a March trip to Portugal.

We selected our hotels and then moved on to flights.

While comparing prices, we found TAP Air Portugal, the country's national airline, had the most affordable nonstop flights, both from the US to Lisbon and from Lisbon to Madeira, a Portuguese island 600 miles into the Atlantic Ocean.

We each paid $565 roundtrip to fly from New York City to Lisbon, and $171 roundtrip to fly from Lisbon to Madeira.

Normally, I'm wary of low-cost flights from and within the US — I believe you always pay for something, be it a less-than-stellar flight experience or hidden fees.

However, TAP's flight costs seemed somewhat comparable to ones from other airlines so we didn't feel the need to research the airline too deeply. I've also flown other national airlines before — like Turkish Airlines, Air France, Icelandair — without a hitch. I assumed this would be the same.

We experienced our first red flag months before we flew, and our experience only got worse from there.

Our return flight changed 2 months in advance

In January, two months before our flight, we received an email stating that our itinerary had been changed.

Our return flight, from Lisbon to New York, was delayed 24 hours, with our flight now leaving on Friday, March 28, instead of Thursday, March 27.

We weren't given an explanation as to why. TAP Air Portugal did not respond to Business Insider's request for comment.

We had planned to fly on Thursday to save money. Staying an extra day would cost us around $200 for the hotel alone, plus other expenses, like dining out for the day (probably another $100).

Still, we decided to make the most of it. We accepted our new flight, budgeted for an extra day, and booked another hotel.

We planned to use the extra time in Lisbon to do a quick day trip to Sintra, a resort town about an hour away by train from Lisbon.

Although it wasn't the end of the world for us to stay longer, this would've been a huge inconvenience if either of us had a tighter budget or needed to be back in the States sooner.

Flying to and from Madeira didn't go as planned, either

Four days after we landed and explored Lisbon, it was time for us to fly to Madeira. Our flight was set to land on Wednesday afternoon.

We arrived at Lisbon's Humberto Delgado Airport almost three hours early. Once we checked in, we learned the flight was overbooked, and we didn't have assigned seats.

We joined a crowd of about a dozen people who were at the check-in desk looking to book new flights.

A TAP Air representative gave us two new seats for a flight five hours later, meaning we'd land at midnight and get only a few hours of sleep before our 5:30 a.m. hike the next morning.

He gave us $250 flight vouchers as well as meal and snack vouchers. We took them and played cards to pass the time until our next flight.

It was around 1 a.m. by the time we got to our Madeira hotel.

Soon, we were surprised with another flight cancellation

The next day, around 4 p.m., we got an email notifying us that our return flight to Lisbon in two days was canceled.

A few hours after receiving that message, we were notified that we had been automatically booked for a new, 9 p.m. flight on the day we planned to leave — a full 12 hours later than our original one.

Frustrated, my friend booked us on an earlier Ryanair flight back to Lisbon instead, which cost $113 each. Once again, we changed plans and unexpectedly spent more money.

Instead of going to Sintra, as we planned the first time our flights were altered, we looked for more things to do in Madeira because we'd be back in Lisbon later.

We booked a morning sunset excursion (with a 5:15 a.m. pickup time) to still feel like we did some exploring.

We didn't find TAP's website or customer service to be very helpful, either

After this flight cancellation, we were eligible for a refund, according to TAP Air's terms and conditions, because our flight was more than five hours delayed and we weren't taking a replacement flight through the airline.

There was just one problem: We weren't able to access the refund through the airline's website. I watched my friend input all her information, land on a confirmation page, hit "request refunds," and be prompted to restart the process again.

When she tried to file an online complaint, the message wouldn't go through. Instead, she was met with: "Your request was not sent successfully!" Because my friend bought both of our Madeira tickets, I tried inputting her information on my phone, with the same results.

Once we landed in Lisbon, we had about 24 hours until our flight home. We saw it as an opportunity to slow down after all the travel mishaps, spending the last few hours unwinding in our hotel.

When we arrived at the Lisbon airport for our flight back to New York City, we stopped by the TAP customer-service desk.

My friend took screen recordings of her trying to use the website and showed them to the representative. She was told by TAP Air's customer service that she could only request refunds on the website or over the phone.

"But the website doesn't work," my friend said.

"You have to use the website," the rep said.

While waiting to board our flight, I Googled other reviews of the airline. Reddit users lamented the customer service in particular, some saying it could take months to hear back. (One user said it took over three years).

We gave up on trying to get a refund through TAP Air. Weeks later, my friend is waiting to hear back on a credit-card chargeback she filed shortly after we landed.

We'd pay more for a different airline next time

Ultimately, we ended up paying way more than we budgeted for, both in money and time.

All in all, we each spent $113 for the new flights, $125 for the hotel, plus a little over $100 for dinner, breakfast, and lunch combined. Nearly $400 extra.

The problem wasn't that we had a canceled flight or got overbooked — it happens and is always something I'm mentally prepared for.

It's that we ticked off multiple unlucky flight experiences, all in one week. Next time, I'd definitely pay the extra $100 or $200 for a flight from an airline I've had better experiences with for an international flight, like Delta or United. I'd also stick to Ryanair or easyJet for shorter flights because I've at least had decent experiences with both.

Even with the free voucher, I wouldn't book TAP Air again. Or if I did, I would prepare to be disappointed and adjust my trip, over and over again.

• More men are getting cosmetic treatments and anti-aging procedures.
• A plastic surgeon in New York said he's seen an uptick in male clients.
• He shared the most popular treatments requested by men, from fillers to breast reduction.

Women aren't the only ones getting Botox injections.

Dr. Mark Epstein, a dual-board-certified plastic surgeon, told Business Insider he's seen an uptick in male clients over the past decade.

Where men used to make up about less than 2% of his clientele about 10 years ago, they now make up closer to 10%.

"Men are definitely getting more and more interested in taking care of themselves and looking good — it's not just for women anymore," Epstein told BI.

Age-wise, they run the gamut — 18 to 80 — requesting treatments for anti-aging and weight loss. Even facials and skin-tightening procedures, previously only performed on female clients, are seeing more male interest, Epstein said.

Epstein shared the most popular procedures men are asking for, from facial fillers to breast reduction.

Men want more hair, minus the plugs

Epstein's most popular non-surgical procedures are tied to male pattern baldness, which affects 50 million men in the US, studies suggest.

In the US, hair transplants can cost anywhere from $10,000 to $20,000. (Or you can go to Turkey for $3,500).

Transplants can also cause scarring if not done well. Epstein believes that offices should specialize in hair transplants for clients to get the best results, not as an add-on with other treatments.

He offers a less invasive (and less expensive) option: platelet-rich plasma (PRP) therapy, an increasingly buzzy treatment that stimulates hair growth after platelet-rich plasma is injected into the scalp.

"A lot of patients don't want to undergo a surgical procedure; they want to take advantage of PRP and all the other male hair restoration technology that is now available," he said.

Filler facelifts continue to rise

Men are becoming more interested in filler and other injectibles, whether it's for their face or penis enlargement, Epstein said.

The former is more popular in his office, with men getting Botox to smooth wrinkles and filler to make up for volume loss and skin laxity that comes with aging — a form of filler facelift that's cheaper and less invasive than a surgical one, which is nearly $12,000 on average.

Another popular non-surgical option is using "lifting threads," dissolvable sugar strands that "give a little bit of regional hike to the skin," he said.

Breast reduction is more common than you may think

Another popular option in Epstein's office is breast reduction to treat gynecomastia, or enlarged breasts in men. He's had patients ranging from their teens to their 70s, as enlarged breasts can be caused by everything from hormones and steroid use to aging.

While it's technically a surgical procedure, he said it's minimally invasive and only takes a few weeks to recover from, making it more appealing to men who want to get back into their workout routines.

Men over 40 look to eyelid lifts

Epstein's older male clients in their 40s to 60s are increasingly interested in eyelid lifts, which can reduce the appearance of aging and fatigue by removing excess skin and fat around the eye.

With over 30 years of experience in the field, Epstein said the surgery has evolved over time and is "much better than older procedures" at hiding the surgery scar and preserving the eye shape.

It's also not as expensive as a surgical facelift, costing around $3,300-$3,800 on average (though it varies on location).

Liposuction is still hot, especially in the age of Ozempic

Despite the popularity of GLP-1 medications like Ozempic and Mounjaro, which are used for weight loss, Epstein said he's "busier every year" with liposuction clients, including a growing number of men.

Unlike weight-loss drugs, liposuction is more targeted, Epstein said. "I like to call it 'lipo-sculpture,'" he said. "It's not just removing bulk fat, it's about sculpting the body." In fact, he said his liposuction clients are usually fit or have recently undergone some weight loss.

They just want "a little bit of tweaking," such as removing fat around their midsection to reveal their muscles more.

Men want their muscles to pop

Some of Epstein's male clients are primarily focused on toning their bodies. They opt for treatments like CoolSculpting, which uses a device to freeze fat cells in certain areas, and CoolTone, which uses electromagnetic waves to stimulate muscle contraction, thereby defining muscles more.

"You really feel it's like doing 10,000 sit-ups," Epstein said.

• Krissy Oechslin, 48, moved to New York City from Charlotte, North Carolina, in February 2024.
• She always wanted to walk every block of a city, but Charlotte wasn't pedestrian-friendly enough.
• It took her 13 months to walk every block in Manhattan. It helped her adjust to her new home.

This as-told-to story is based on a conversation with Krissy Oechslin. The following has been edited for length and clarity.

For years, I wanted to walk every block of a city.

In 2012, I read a New York Times story about Matt Green, who was on a mission to walk every block of all five boroughs of NYC. I thought it was incredible and wanted to replicate a similar walking project one day.

During the pandemic lockdowns, I toyed with the idea of doing it in Charlotte, North Carolina, where I lived at the time. It wouldn't really be possible — Charlotte is very car-centric, and there are parts of the city that just aren't pedestrian-friendly. I knew I would get odd looks if I was strolling next to a highway.

When I decided to move to New York in February 2024, I thought exploring every block of Manhattan would be a cool way to get to know my new city.

It took me 13 months of on-and-off effort to walk every block. When I was finished, I felt like I saw so many unique parts of Manhattan — ones even lifelong New Yorkers might not know about.

I tracked my progress with a 6-foot map

Originally, I planned to both bike and walk the city, so I couldn't use CityStrides, a map that only tracks running and walking. (In the end, I walked over 99.5% of the project.)

Because I wanted to tackle the blocks out of order, tracking them was a multi-step process. First, I needed a map of Manhattan.

Finding a complete one was trickier than I expected. The first one I bought on Amazon stopped after 110th Street and many I found capped the island at Central Park. Manhattan stretches over 100 blocks further north, ending at Marble Hill right before West 230th Street.

The best one I could find was from 2011, a 6-foot-long version that I stuck to the wall in my apartment.

By the time I was done with the project, I learned that one was not fully up to date, either — I encountered areas in real life that were blank on the map, like Waterline Square on the Upper West Side, which was completed in 2020.

I downloaded Strava to track exact steps every day, then traced my progress to the map with a Sharpie.

My first entry began in Harlem, right after I returned my moving truck and walked 10 blocks to my new home.

Afterward, I started trying to find unique routes when I made plans — how could I incorporate a new block on my way to meet my friends? Other times, I specifically walked to new areas on my list, like the FDR Drive highway service road on the easternmost side of the borough.

The oldest streets were my favorites

I didn't want to miss any historic landmarks.

When I started the project, I bought "The New York Nobody Knows" by William B. Helmreich, a sociologist who walked every block in NYC. It felt more like a sociology textbook than a walking guide, but it gave me some ideas of what I wanted to stop and look at on certain blocks, so I saved them in Google Maps.

I also stopped a lot during my walks to search different buildings or historical figures on Wikipedia, with what felt like hundreds of tabs open on my phone. I snapped photos of the original Statue of Liberty sculpture in Midtown and old, weathered ads for omega oil in Harlem.

Walking up to 10 miles a day sometimes, I ended up saving a lot of buildings on Google Maps that I plan to revisit during Open House New York, a weekend when normally private buildings are accessible to the public.

I'm a sucker for cobblestone streets, so some of my favorite neighborhoods were the West Village and Tribeca. I also loved the Financial District — some of the oldest streets in New York combined with towering skyscrapers made for such a cool contrast of old and new.

One of the most beautiful streets I discovered was on St. Nicholas between 152nd and 153rd — it was lined with historical rowhouses and pockets of greenery.

In the East Village, I encountered the two oldest cemeteries in New York: New York Marble Cemetery and New York City Marble Cemetery. The former, established in 1830, is partially obscured: I could only see it at the end of the block through an iron gate.

I stumbled upon other hidden gems like a Mexican folk art store or a used record shop in the middle of an apartment block. I loved learning that they exist.

I finished at an iconic New York spot

By March 2025, I bought a co-op apartment in a neighborhood I hadn't finished exploring: Morningside Heights, at the top of Manhattan.

That month, I officially ended my project near my new home, in front of Tom's Restaurant, otherwise known as the "Seinfeld" diner.

Four people completely ignored me when I asked them to take a photo of me in front of the restaurant. It made me feel like a real New Yorker.

Moving to a new city, I didn't have many friends yet. Having this project gave me built-in plans every weekend — if I had nothing else going on, I could always go for a walk.

When I tell people I walked every block of Manhattan, I can tell how long someone's lived here based on their response. The ones who've been here the longest aren't too impressed: walking everywhere is just part of the experience.

• In her new memoir, Melinda French Gates shared her first pregnancy experience.
• She said Bill Gates went to work and she was "cheerfully alone" at the hospital.
• Gates joined her when she was in active labor, which took over 14 hours.

Right before giving birth, Melinda French Gates was alone at the hospital. She said she loved it.

In her new memoir, "The Next Day," Gates, 60, shared details of her 27-year marriage and divorce from Bill Gates, including how she dealt with different life transitions.

One of them was the birth of Jennifer Gates, the first of the Gates' three children, in 1996. Gates said the birthing process was long, and that she spent the beginning of her labor experience by herself while Bill Gates returned to work.

Bill Gates went to work as a 'compromise'

First-time deliveries often take longer because the body's tissues and muscles haven't been stretched before. Gates was told that "labor can last an astonishingly long time," she wrote in the book.

The Gates's arrived at the hospital before Gates technically started feeling contractions. Because they were early, their doctor debated sending them back home to wait.

Instead, Gates said she "settled on a compromise" with her husband: he would go to the office while she stayed at the hospital. The plan was to call him once she entered active labor.

She enjoyed the solo time

"Before you roll your eyes, keep in mind that there really wasn't anything for him to do yet," Gates wrote in the book.

She said she was "cheerfully alone," roaming the halls of the Overlake Medical Center in Bellevue, Washington. To keep herself occupied, she read Edith Wharton's "The Custom of the Country" and thought about her upcoming delivery.

Gates said Bill Gates' assistant was "hovering by the phone" all day, expecting a call at any minute. Once she entered active labor, Gates told Bill to hurry over.

When he arrived at the hospital, she said he was "fascinated" by the delivery process, which took over 14 and a half hours. She described the experience as "really hard," due to a complication in the baby's positioning. Gates also opted out of pain medication, wanting to "feel every sensation."

In the end, Gates remembers immediately falling in love with her new daughter. "I was absolutely smitten," she wrote. "A new chapter began."

• Eating enough protein is important for muscle development and your overall health.
• Protein is also more filling than other foods, which can make it hard to eat a lot of.
• Making high-protein swaps and splitting meals into snacks can help you hit your targets.

I calculated my recommended protein intake, as someone who works out and wants to build muscle. I needed a minimum of 53 grams of protein a day, but closer to 114 grams if I really wanted to make gains.

But hitting that isn't so easy. On a typical day, my morning oatmeal is 5-6 grams of protein, my lunch salad or grain bowl is a measly 10-15 grams, and my salmon fillet dinner is 25 grams — just 40-45 grams of protein total.

Morgan Walker, a sports nutritionist at Lebanon Valley College, said this is a common occurrence.

For one, high-protein foods fill you up faster because they're structurally more complex than most nutrients. Protein needs additional enzymes to be broken down in the body, Walker told Business Insider. When we consume protein, hormones are released that "help to promote satiety, too," she said.

Additionally, if you work out a lot, you might even lose your appetite. "Exercise itself can be appetite-suppressant for a lot of individuals, especially high-intensity exercise and endurance-type training," Walker said, due to anti-hunger molecules that form in the body.

Ironically, very active people who need to eat more protein for muscle repair may struggle to get adequate amounts of protein in their diets.

Walker shared a few ways to eat enough protein if you feel too full to even think about another hard-boiled egg.

Use versatile ingredients like cottage cheese and Greek yogurt

Walker is a "big fan" of cottage cheese and Greek yogurt, which are complete protein sources and easy to snack on, such as Greek yogurt with honey and berries or cottage cheese on toast.

They both have more amino acids than lower-protein foods, which help muscle-building by repairing and growing new muscle fibers.

You can also use them as protein boosters in other meals. Cottage cheese, at about 200 calories and 23-28 grams of protein per cup, can be blended into pasta sauce or eggs. Greek yogurt, with similar levels of protein and caloric content, can be used in smoothies, dips, or condiments.

Make easy protein swaps

A balanced diet isn't all protein — you also need fiber and carbohydrates. Fitting all of that in can be tough, though.

Walker recommended protein swaps to get more protein and other nutrients, such as using farro or quinoa as a base instead of rice. You can also replace regular pasta with higher-protein versions that use lentils or chickpeas.

If you're cooking grains and want to sprinkle in some extra protein, Walker said you can also boil them in bone broth, which contains 9 to 11 grams of protein per cup.

Break your meals up into snacks

If fitting in three big, protein-heavy meals a day just isn't working for you, there's good news: snacking might be better for you in the long run, anyway.

"Consistent protein intake throughout the day is very beneficial for promoting muscle-protein synthesis," Walker said.

Breaking big meals down into smaller and more frequent protein-rich snacks also makes it easier to get more protein without stuffing yourself. In the long run, consistent protein intake is more important than chugging a huge protein shake after a workout.

Walker loves Greek yogurt, string cheese, hard-boiled eggs, turkey jerky, shelled edamame, nuts, and smoothies to graze on throughout the day.

Divvy up your protein powder

Protein-packed liquids, such as smoothies and shakes with protein powder, are usually less filling than big meals.

Still, not all protein drinks are the same. Walker said ready-to-drink shakes, which can pack 20-30 grams of protein per bottle, tend to be more filling. If they're too difficult to chug, she suggested incorporating protein powder in drinks and meals throughout the day, rather than all at once.

"Maybe it's scooping a little bit of the protein powder and mixing it into a yogurt, smoothie, or oatmeal," she said. If one scoop is 30 grams of protein, you can have 15 grams in your breakfast and 15 grams in a post-workout shake.

Add variety

Some active people assume gains require culinary sacrifice, subjecting themselves to the same cliché gym bro meal of chicken breasts, brown rice, and broccoli every night.

"I have a lot of clients who will eat very similar meals and even though they're extremely well-balanced, they're not getting a lot of variety," Walker said. Not only is variety important for gut health; it also keeps you from getting bored.

Walker said sheet pan dinners are an easy and versatile way to change up your main protein source, like chicken or fish, as well as your vegetables and seasonings. You can also use Greek yogurt or cottage cheese to create a high-protein sauce.

Fitting in enough daily protein, especially if you're strength-training, can take some creativity.