Arthritis and Me

I have had a sore knee for a long time.

When I was doing rehab after my brain injury they asked me to do exercises such as sit to stands and squats and I had a horrible time because of pain, not just neuro issues. That would be when we finally got an x-ray of my knee and I was diagnosed with osteoarthritis.

I have spent a long time walking with a bad gait and frankly it never did get quite normal. My knees and hip have taken a real beating. I tend to stand with all my weight on my "good right side".  I tend to twist a little on my hip as I walk and I kind of thud down on that right leg because I don't totally trust that my left leg will support me even though there is no good reason to think it won't now. I am a heavy person and have been since I was a child. My father had bad arthritis. The result of all these risk factors is that  I now have arthritis in both knees and my right hip as well as a bit in my lower back.

I have done a lot to keep the arthritis under control over the years but it just keeps getting worse.  I tried using a knee brace about 6 years ago and that was not all that helpful. I found it very uncomfortable and they are harder to fit properly on a heavier leg. I tended to be moving both legs kind of funny when I walked and it just was a bad treatment for me at the time.

I have been going to exercise classes and I find the water programs for people with arthritis to be especially helpful.

I do try and pace myself and sit and rest my leg when I need to be that isn't always easy. One of the issues that the arthritis help sites talk about is severe fatigue. I would say that is one of my issues continuing from the brain injury too. This makes it doubly harder for me to willingly exercise a lot or work on loosing weight - both of which would ultimately help with the same fatigue and the joint issues.

The past year or two my hip pain in particular has gotten really bad. I had a fall at work just over 2 years ago and it was like someone turned on a pain switch. My hip really didn't bother me much until that point.  I suddenly had a lot of inflammation and pulled muscles that eventually settled down with time and physiotherapy but the pain never totally went away. The arthritis in my hip has progressed rapidly over the past year and now the pain is constant and severe.

I have had cortisone injections in my knees and right hip over the past 18 months. The first hip one felt like a miracle but at about 7 months it wore off. The second one only lasted about 4 months and the last time it only took the edge off.

My family doctor, as well as the sports medicine specialist that I have been seeing, told me I needed to get on the waiting list for joint replacements. It is a long wait around here to see an orthopedic surgeon, never mind the long wait for the actual surgery.  I saw the surgeon last week and despite the fact that I am considered a higher surgical risk we are going ahead with the hip surgery.

My plan is to get myself in the best shape I possibly can before this surgery.  I am still focusing on  leading a healthy life.

The Thigh Bones Connected to the Knee Bone

The course we are on now is called Therapeutic Fitness or Fitness Leadership. This has involved trying to learn a whole lot of names of bones and muscles.  It also has involved learning the function or movement of this huge list of muscles or muscle systems.

We have had a couple days in the college gym where we were required to take part in some fitness activities. One day was working out with all the different fitness machines and equipment and another day we sat in a circle in this gym and worked on learning how to lead seated exercises for all the different muscles  and included the use of  dynabands and weights.
I can't say this has been my favorite week of school.

Tuesday will be the final theory exam (25%) for this particular course. Besides short answer we will have pictures of muscles and we will be expected to identify them, list the function and actions of the muscles and then give an example of an exercise that works on the muscle.  I have been staring at the teacher like he arrived from a different planet. Nothing  made a lot of sense to me but I am getting there very slowly.  I am now working hard on memorization if not comprehension.

Next week we will have to develop and hand in plans for group exercise classes for high, moderate and low functioning seniors. The moderate routine should last about 30 minutes. We will be divided into groups of 5 and each of us will have to lead the other 4 in our planned routine and we will be marked and critiqued on how well we do. (65%) On Friday we will be going to a seniors home and each of us will be given a small group of seniors to do our exercise class with. (10%)

I certainly don't qualify as high functioning myself so we will see how this week goes.  

 

Wish me lots of luck!!

The exam will be pictures like this without words.

Name of muscle: or muscle group:

Bicep Femoris   (hamstrings)    

 The actions:

•  It extends the thigh at the hip joint, (your thigh can go behind you) 
• flexes the leg at the knee (you can bend your knee) and
• Assists in adduction of the thigh. (pulls your thigh inward toward the middle line of  your body

Possible exercises would include:

• leg curls
• squats

I should personally do a heck of a lot more squats and leg curls.

clipart girl image from classroomclipart.com



Spring Camp

Dawn reflecting off the frozen surface of Lake Winnipeg

I went camping with my Girl Guides of Canada - Pathfinder Unit last weekend. We went to a district camping event with about 70 girls and women at a beautiful camp about an hour and a half north of our city. It has terrific grounds and indoor facilities including a pool, meeting spaces, and dining hall. The food was wonderful and we really appreciated having the staff prepare it for us instead of us cooking over a camp-stove! Camp was not exactly roughing it. 

Our small cabin for the weekend

This was supposed to be a winter camp but the unusual warm weather we had this past week made a lot of the cold weather activities we  planned  impossible.   

Snow shoeing and spraying colored food dye on snow won’t work without a reasonable amount of snow. The ground was "crusty-icy" and "slushy-muck" with several areas deeper than our rubber boots.  It was by far the worst walking conditions I have experienced in many years, and of course my little cabin was the furthest from the parking lot and the mess hall.  I stayed in a small cabin with my daughter who is also a leader, another leader, a parent volunteer and 6 teenage girls.

Solar S'mores and yucky wet slippery ground

The theme for the camp was environmental awareness.  We did activities about water filtration and keeping our waterways clean and we planted little seedlings into containers.  Our girls helped run a couple of sessions such as making s’mores (graham crackers with melted marshmallows and chocolate) in the snow using a solar oven and wide games and a scavenger hunt about recycling.  Some of my girls are still very young 12 year olds and these were huge task for them but the pride in their accomplishments was undeniable. The younger girls, ages 5 up, looked up to the BIG girls and that encouraged the big girls to try all that much harder. The 12 to 17 year old participants ran an amazing campfire for the whole group on Saturday night. They led an hour of songs by memory and the 12 to 13 year olds even made up the cutest little skit about what the animals want us to do to take care of the environment.

The main activity hall in the early morning light

I had a really hard time moving around in that miserable snow. Sleeping on a strange, squeaky bottom bunk - with a wiggly young lady on top was pretty tough too. I did have fun though. I visited with the other adults, I played in the pool and I sang my little heart out even when I had trouble remembering the lyrics. My unit made adorable no-sew, green fleece hats. I walked back and forth to see all the girls who were dispersed all over the campgrounds doing their volunteer jobs. I spent a lot of time helping the girls prep for the activities they were leading, debriefing them afterward and I even helped work on some extra program materials that were appropriate learning for the older girls. 

I got around wonderfully this year in comparison to last spring at camp. Last year I needed a walker and could barely move, but this year I was in the thick of things despite the tricky conditions!

 I must admit that Sunday morning did not go well. It was enough strain over the weekend that my affected side started to spasm and I was in a tremendous amount of pain for the last few hours at camp. The muscles in the left side of my back contracted from shoulder blade to hip and I was pulled right over to the left side and unable to straighten. Every time I moved it triggered a whole new wave but I was too uncomfortable to sit or lay down and eventually my hip and left leg started to spasm as well. The car ride home was pretty long and miserable too.  It was a bit scary for the girls to see me in that much pain and I feel pretty bad about that.  I am feeling better today, but the episode was long and severe enough to leave me feeling pretty beat up.

I was feeling pretty happy with how I am moving lately and I have become pretty lax about doing my exercises. This incident was just proof that I still need to do a LOT of work on strengthening my whole body.

Our next camp will be tenting in May. I am not sure if I should go or not. I don’t want to miss anything, but I also don’t want to risk a repeat of last Sunday. 

Reasons to Exercise

I am posting this video while missing my beloved Tai Ji class. I have a cold, feel rotten and I am probably contagious.

Here is a video that puts health improvement so simply!
 I wish I could draw like that!

Does anyone else have a free half hour a day?

Red Rubber Ball ---Physiotherapy

I promised to try and share a bit more about my various physiotherapy and exercise efforts and it has taken me a while to get  it written down. It is hard to explain without good pictures or video so I am sorry if I am less than clear and a little long winded. (grin)

I thought I would just start by describing yesterday's physiotherapy appointment at the hospital rehab department and save the "at home" set of exercises for another post.

My physiotherapy is supposed to be working on my 3 "S"s;  Stability, Strength and Stamina. The idea is that I should not loose my balance and fall as frequently, but that if I do I will have enough strength to right myself. I am also exhausted most of the time and we want my physical endurance to improve.

Tony, my therapist, does most of the exercises along with me. He says it is good for him to get a workout too, but a lot of it is that I still can't seem to exercise and count at the same time or keep any kind of a pace on my own, but I do a pretty good job of mirroring his movements. I also have trouble with movement, lights and sound throwing my balance so watching others movement in a controlled way is good training. He occasionally has a radio on or alters the lights and  it is a source of great irritation to me, but it is all in the direction of acclimating to these stresses.

My therapist, as usual, had me start warming up by walking on a treadmill. It has only been a couple of months that I have been able to even stand upright on the darn thing because of my balance problems.

I  have had a lot of severe pain and problems with my right (good) hip as a result of my bad gait.  I also have physical damage in my left knee as well as the neuro caused problems. Tony wants me to work on my walking skills with the treadmill because there is a hand rail on both sides and I even out my stance that way. When I use my cane I lean heavily to the side and when I am using a walker I tend to lean forward too much. I can walk more upright and I self correct better on the treadmill. The other odd feature is that I can hear my left foot when it drags against the tread of the base and I can respond by picking up my foot when I hear the noise clue.

The next set of exercises was over to the parallel bars where he had me do some mild squats, again watching that I pay attention to keeping upright and my back straighter as I move. This has at least two purposes. One is to work on building up the muscles to support my weak left knee and ankle, and the second is that that kind of up and down motion triggers nasty nausea and vertigo.

Next we moved on to the double width plinth (exercise bed).
Lie on my tummy and do leg lifts going backward about 10 X per leg and do two sets. My right leg lifts high and  left leg really struggles to do anything much in that direction.
Lie on each side, with the lower leg slightly bent and lift upper leg toward the ceiling.
Lie on my back and basically pull my bent leg across in front of me in order to stretch the hip. Repeat with the other side.

The Exercise Ball is more my idea of a fun time.  I even have one at our lake cottage.  (yes I have a blog about our lake too)
I faced my therapist who was sitting on a different ball and we started rolling the balls in little circles under us. (side to side version of nausea) Next we raised one arm and lowered it, raised the other arm and lowered it. It got trickier as I tried to raise one foot at a time off the ground and I managed not to fall off the ball.  Interestingly the hard part is not lifting the weak left foot -- it is raising the right foot and trying to use the left foot on the ground for stability. Next we tried lifting a leg and straightening the knee so the foot goes out in front. Advanced moves would include lifting an arm and the opposite leg at the same time and an even more advanced goal eventually will be the same side arm and leg together.

Once again we moved on to the plinth and I laid down with the ball at my feet. I got to take it easy for a minute and wait for the world to stop spinning.  Next he had me put my legs up on the ball and I did some bridges. "Pull tight the abdomen and lift your behind off the bed while pushing the legs down into the ball to balance!".  My legs and body fell off the ball sideways and we tried again and again.

The hour long session was over and I had really earned the cup of water Tony was handing me.
I went to get myself a second cup and I tried to hold the cup with my left hand while I pulled the water cooler lever with my right.  The cup went flying and I had water all over the floor and myself. Tony got down and moped it all up while assuring me that things like that happen all the time.

I was tired and I started having major speech issues as I usually do when I get too stressed, excited or exhausted.  I needed to sit in the hospital waiting room and rest for a long time before I could be understood well enough to call a cab to take me home.

I went home and napped.

Red Rubber Ball 

is written by Paul Simon and was recorded by a group called Cyrcle.

The lyrics that run through my head when I am "playing" with that exercise ball are:

And I think it's gonna be alright
Yeah, the worst is over now
The mornin' sun is shinin' like a red rubber ball

The story's in the past with nothin' to recall
I've got my life to live and I don't need you at all
The roller-coaster ride we took is nearly at an end
I bought my ticket with my tears, that's all I'm gonna spend

And I think it's gonna be alright
Yeah, the worst is over now
The mornin' sun is shinin' like a red rubber ball

Heart and Stroke Month

I wanted to make a Heart Smart related post for Heart and Stroke Month

What are your risk factors?

The Heart and Stroke Foundation of Canada recently released a report showing that 9 out of 10 Canadians have at least one risk factor for cardiac disease. Ninety percent of Canadians believe they are healthy, however most are in denial about the true amount of risk they are under.

"Matters of the Heart"

My friend Dave and I spent today at a really interesting event at The Wellness Institute which is located at the Seven Oaks Hospital in Winnipeg.

This is Heart and Stroke Month, and the Wellness Institute hosted a 5 hour event focused on heart healthy living.

We arrived with a lot of time for the nine am opening. The event had about 90 people attending and there was a little registration package with some information and my pack had a red heart and Stroke association Frisbee.

We started with a welcome followed by a stretch break. It was really a little crowded for that kind of stretching but everyone seemed to appreciate the exercise break.

We listened to the keynote speaker, Dr Lerner discuss the role of Atrial Fibrillation in heart disease. He shared the statistic that people with this form of heart rhythm are at a hugely increased risk of stroke and acknowledged that many doctors are not being aggressive enough in their care of such patients. His language was a little technical for the audience but he was interesting and he did show a fair bit of humor through his presentation. He was incredibly willing to answer questions and to clarify points.

There was a break with a healthy snack, blood pressure testing stations and educations information pamphlets followed by another session of mild exercising and a draw for door prizes.

We also attended a healthy baking session where Dave and I learned a lot of information about improving our baking. More important, we learned a lot about how cooking information can be shared in a public forum like that. I think we have a lot to share at upcoming Healthy Cooking sessions at The Stroke Recovery Association. The dietitian, Carolyn Somerville, gave a handout of information and recipes that will be incredibly useful for me. I am going to try out most of them and I will share some of the results on this blog.

The last session we did was about relaxation and reducing stress and improving blood pressure. She discussed the role of humor, deep breathing and she gave a brief introduction to a body scan approach to relaxation. As part of the humor section she had us listen to the following You Tube clip about Tim Horton's. It really had the whole group relaxed and laughing and receptive to what she had to share. http://www.youtube.com/watch?v=LvoB5rP-flY

Dave and I thought it was a great experience and we definitely plan to attend next year's Matter of the Heart event.

Physiotherapy in the New Year

Today was my first real therapy session with my new physiotherapist and it went very well. He was very optimistic about the possibilities for good progress.

My biggest concerns are dizziness and balance issues and I have also developed a lot of pain in my "good" hip and leg. It is probably in response to my awkward gait. Tony is assuring me that we are going to do great things and it will make a real difference.

It feels like staring over with physio but that is a good thing. It is a new year, new therapist and a new set of goals. I am very proud of the progress I have made over the past two years and I think I got pretty complacent with where I have found myself. Now looking at how I am doing through the fresh eyes I can see where I still have a ways to go still and change is really still possible!

We went through a few exercises and he checked how well I could do them. I now have a new set of exercises for homework. We also worked on some balance tasks. (I am back to using the dreaded stabilization belt... sighhhhhhhh) Tony firmly stated that THOSE exercises were NOT for doing an home... yet.

I meet with my dietician next week and I know she has a whole new plan for me too.

''Year's end is neither an end nor a beginning but a going on, with all the wisdom that experience can instill in us.'' ~ Hal Borland

It looks like I am well on the path to an even healthier 2011.

I have a new Physiotherapist

I have had two meetings with my new physiotherapist.

The first one was a conversation about what I want to accomplish with Physiotherapy and about my medical history. I found myself telling my life history and saying that I want to be really fit for the first time in my life. Loft goals perhaps. I didn't manage to pull that off before I got ill.

Meeting number two was added in last week to do a physical assessment in particular the balance assessments. I got kind of upset the night before the appointment and hardly slept. Then I was being really tense during the assessment and I wonder how much that threw it all off. At any rate, I am pretty sure I scored worse than that last time with my former therapist. Maybe he is just a tougher marker. I absolutely know that I am functioning better than I was during the summer and I don't feel dizzy and nauseated anywhere near as often. I am going the right direction with recovery.

I do like the new PT so far and look forward to seeing what the new plan is in January. I also have some plans for getting more exercise in during the New Year.

Wish me luck!