Less pain

Yesterday I did as I planned. I went to a nearby shopping center and walked the perimeter, stopping to drop toys in collection bins and again stopping for tea at Starbucks. My hip hurt but the movement lessened the pain. Later I went downtown and walked some there as well. I was no speed demon and I didn't stray far from my car but I think I got in at least a half-hour of walking.

Last night I felt less pain in that leg, and again this morning. It's far from gone but it's less.

I do believe that the real connection between the resurgence of this pain and my daily activities is that for the last couple of weeks I have again slipped from the program. I haven't been doing the arthritis exercises three days a week and I have skipped the regular half-hour exercise several times, too. The bitch of it is, of course, that when I am in extreme pain exercise is simply impossible. Then I long for some kind of powerful painkiller, in spite of my reservations about those. In this instance I turned to tylenol arthritis a few times. I don't know if it helped. It may have, at night. I suspect, in any case, that such extreme pain can be kept at bay if I stay with the program.

And you may well wonder why you need to read any of this. Of course you don't need to read it. I write it, though, to remind myself of such connections to see if there are patterns, and for those who do read this journal on occasion I write it to let you know just how it is for me. Rather than write the one-page success story that leaves out the bad times I prefer to keep them in. I think they illustrate life as a real person with real failings and real arthritis who somehow stays on the long haul, keeps trying to make it better for herself.

Hip pain

This is the third day in a row when the pain in my right hip - actually it's at the top of my right thigh - has been significant. I am having trouble getting in and out of my car, I had trouble moving my leg up and down in a pedi-chair yesterday, and just walking can be so sharply painful.

The weather has been damp or actually raining. Might there be a connection? I don't know. What I do know is that there is little I can do in terms of exercise with this pain. I was able to do the arthritis exercises yesterday but nothing else.

I am going to try walking a bit, see if it eases.

Another trip, another trial

I flew to Pensacola last Friday, from Burbank. I spent the weekend without my glucosamine (I forgot to pack it) and I didn't do the arthritis exercises (lazy lazy lazy!). But I did spend a fair amount of time in Pensacola standing and walking around. So the trip was a bit of a trial for my knees.

And I'm doing all right. I think the hardest thing for my knees is driving. Whenever I make long trips in the car I feel it that night. But it isn't awful.

Overall, the improvements in my knees seem to be holding, even when I fall off the routine.

Cycling with the grandson

My eight-year-old grandson is visiting me for about ten days. I will put him on a plane on THursday, for home. One of the activities I planned for our time together was bike riding. I figured on two nice family bike paths, both mostly off-street and mostly level.

We rode both of them. Then Joey wanted more. So we rode our bikes to Marigold shopping center the other day, to buy craft materials (the boy loves crafts and his aunt and I are the main ones who like to do them with him). We stayed indoors yesterday, working on these crafts, while I considered other bike paths we might take.

Today we took part of the path in Pismo - there is a path connecting the blufftop parks but there are gaps in it and it isn't all off-street and it is mainly a pedestrian path, so we took a portion that seemed suitable for bikes.

On all these rides I did well. My knee hardly hurt at all and I had no bad after-effects, although I was a bit stiffer in the mornings. I like sticking to these level kinds of paths, not too long. I look forward to finding some a wee bit longer and then a wee bit longer than that. Very gradual buildup. I feel hopeful about bicycling.

Another bike ride

I did the easy route again today. Perhaps I should call it Easy Route #1 in case I later have an Easy Route #2. This time it was cooler and there was wind.

If anything, I think I could say that I felt less pain today than I did the last time. I did not stop at all, challenging myself, and what I most noticed is that my endurance can use a little work and that my seat hurt. A couple of times I stood up on the bike just to relieve my crotch. The elements of that pain:

* I am not adjusted to riding yet.
* I am way overweight.
* My seat hardened while it sat for a couple of years (I could use a new one).

So clearly there are things I can do about it and I intend to.

I was occasionally thinking other thoughts while riding, somewhat not-bike thoughts. I think this comes from greater ease with riding. Right now I am still too fearful. I fear falling off the bike, mainly, because my balance is not great and I am not well coordinated. Yet I have fallen off three times that I can remember in my riding time, and the worst of that was that it hurt and it was embarrassing. Well, big deal. I expect to feel less fear and more exhilaration as my strength builds (and my weight declines). I still remember how great it feels to accomplish what for me is a difficult ride, including those wonderful interludes when I am really on my game.

Bike again

I took my bike out on the easy ride again, Orcutt-Tank Farm-Broad-Orcutt. This time I got off the bike three times - the first at the corner of my street and Orcutt, just to be safe turning the corner, the second when I slid into a gear that wasn't a gear and it froze up on me, the third when I walked it across Industrial Way to avoid traffic while getting back to Broad. I didn't stop for a drink or to buy anything.

My knee felt less pain this time than the last. I suspect the weather contributed, even though I have yet to find a real correlation, personally, between weather and how my knee feels. Yet it was hot and there was little wind, and those two factors might have meant less pressure on the knee joint. It was a nice feeling in any case. I even made the effort to use a little more muscle power. Just a wee bit. It's still a wimp's ride but I'm not proud and I don't care. It's working for me.

I think by this time I can say with near certainty that there has indeed been a change in my knee. It's as if the bottom level, the bad pain, the problem discomfort, has either gone altogether or shows itself very rarely now. This has been consistently so for at least two months. I suspect the glucosamine has done some work repairing the joint.

Getting back on the bike

I took my bike out again today. The last time I went out I felt nervous and edgy for about half the distance, and more comfortable toward the end. I felt I was getting my bike legs back. Today was an effort to do more of the same.

Some things I learned when I rode regularly:

• Don't grip the handlebars. Hold lightly. When I first rode as an adult I had a death grip on them and eventually developed symptoms of carpel tunnel syndrome. After I lightened up the symptoms went away.


• Think ahead. My riding mentor from those days past told me that when I rode a bike I would really be practicing "advance planning", and he was right. You have to be ready to change gears at the right time.


• Don't be afraid of breathing noisily. When I first rode with T, the mentor, I tried to muffle my loud breathing so I wouldn't sound like I was trying too hard. One of those mensch things, I guess. When I let myself breathe naturally, which meant all-out and noisily, I found I had more energy and was more capable.

I have never been a great rider, but I managed to become a competent one. Even at my best I wasn't able to hold still at a stoplight without putting a foot on the ground. I am not particularly graceful or balanced. It's a tribute to the flexibility of the bike design that I can ride at all.

When I power down on the pedals it hurts my knees. Not a good situation for the future of my riding, but I'm counting on the pain to lessen. It is not excruciating. In the meantime I just downshift a lot. And get off the bike when I feel the need. I'm not proud. I've been here before and I will be again.

Today's ride was a simple loop. Orcutt - Tank Farm - Broad - Orcutt. There are a few gentle rises and a couple nice downhills and even a few flats. San Luis Obispo has very few flat areas. It's a wimpy ride, I admit, and yet it gave me such pleasure to sit outside the coffee shop on Broad and Orcutt and realize I had gotten there under my own power. That sense of freedom is what I love so dearly about bicycling. Motorcyclists have absolutely nothing on me.

Glucosamine

The story from Wikipedia, admittedly not a perfect source but probably adequate for my purposes:

Oral glucosamine is commonly used for the treatment of osteoarthritis. Since glucosamine is a precursor for glycosaminoglycans, and glycosaminoglycans are a major component of joint cartilage, supplemental glucosamine may help to rebuild cartilage and treat arthritis. Its use as a therapy for osteoarthritis appears safe, but there is conflicting evidence as to its effectiveness.


Use
A typical dosage of glucosamine salt is 1,500 mg per day. Glucosamine contains an amino group that is positively charged at physiological pH. The anion included in the salt may vary. Commonly sold forms of glucosamine are glucosamine sulphate and glucosamine hydrochloride. The amount of glucosamine present in 1500 mg of glucosamine salt will depend on which anion is present and whether additional salts are included in the manufacturer's calculation. Glucosamine is often sold in combination with other supplements such as chondroitin sulfate and methylsulfonylmethane.

Glucosamine is a popular alternative medicine used by consumers for the treatment of osteoarthritis. Glucosamine is also extensively used in veterinary medicine as an unregulated but widely accepted supplement.


Safety
Clinical studies have consistently reported that glucosamine appears safe. Since glucosamine is usually derived from shellfish, those allergic to shellfish or who have kosher concerns may wish to avoid it. However, since glucosamine is derived from the shells of these animals while the allergen is within the flesh of the animals, it is probably safe even for those with shellfish allergy. Alternative sources using fungal fermentation of corn are available. Another concern has been that the extra glucosamine could contribute to diabetes by interfering with the normal regulation of the hexosamine biosynthesis pathway, but several investigations have found no evidence that this occurs. The U.S. National Institutes of Health is currently conducting a study of supplemental glucosamine in obese patients, since this population may be particularly sensitive to any effects of glucosamine on insulin resistance.

In the United States, glucosamine is not approved by the Food and Drug Administration for medical use in humans. Since glucosamine is classified as a dietary supplement, safety and formulation are solely the responsibility of the manufacturer; evidence of safety and efficacy is not required as long as it is not advertised as a treatment for a medical condition.

In Europe, glucosamine is approved as a medical drug and is sold in the form of glucosamine sulphate.

Clinical studies
There have been multiple clinical trials of glucosamine as a medical therapy for osteoarthritis, but results have been conflicting. The evidence both for and against glucosamine's efficacy has led to debate among physicians about whether to recommend glucosamine treatment to their patients.

Multiple clinical trials in the 1980s and 1990s, all sponsored by the European patent-holder, Rottapharm, demonstrated a benefit for glucosamine. However, these studies were of poor quality due to shortcomings in their methods, including small size, short duration, poor analysis of drop-outs, and unclear procedures for blinding. Rottapharm then sponsored two large (at least 100 patients per group), three-year-long, placebo-controlled clinical trials of the Rottapharm brand of glucosamine sulfate. These studies both demonstrated a clear benefit for glucosamine treatment. There was not only an improvement in symptoms but also an improvement in joint space narrowing on radiographs. This suggested that glucosamine, unlike pain relievers such as NSAIDs, can actually help prevent the destruction of cartilage that is the hallmark of osteoarthritis. On the other hand, several subsequent studies, independent of Rottapharm, but smaller and shorter, did not detect any benefit of glucosamine.

This situation led the National Institutes of Health to fund a large, multicenter clinical trial studying reported pain in osteoarthritis of the knee, comparing groups treated with chondroitin sulfate, glucosamine, and the combination, as well as both placebo and celecoxib. The results of this 6-month trial found that patients taking glucosamine HCl, chondroitin sulfate, or a combination of the two had no statistically significant improvement in their symptoms compared to patients taking a placebo. The group of patients who took celecoxib did have a statistically significant improvement in their symptoms. These results suggest that glucosamine and chondroitin did not effectively relieve pain in the overall group of osteoarthritis patients. However, exploratory analysis of a subgroup of patients suggested that the supplements may be effective in patients with pain classified as moderate to severe (see testing hypotheses suggested by the data).

In an accompanying editorial, Dr. Marc Hochberg also noted that "It is disappointing that the GAIT investigators did not use glucosamine sulfate ... since the results would then have provided important information that might have explained in part the heterogeneity in the studies reviewed by Towheed and colleagues[PMID 15846645]" But this concern is not shared by pharmacologists at the PDR who state, "The counter anion of the glucosamine salt (i.e. chloride or sulfate) is unlikely to play any role in the action or pharmacokinetics of glucosamine". Thus the question of glucosamine's efficacy will not be resolved without further updates or trials.

A subsequent meta-analysis of randomized controlled trials, including the NIH trial by Clegg, concluded that hydrochloride is not effective and that there was too much heterogeneity among trials of glucosamine sulfate to draw a conclusion.

From this it appears that the jury is still out.

34 Weeks

I finally went back to my calendar and counted up. This is my 34th week on the program. That's approximately eight months.

I have read that it takes six months or so for glucosamine to have an effect on joints. That is, for it to start rebuilding the joint, to some extent. Is this true? My memory is that there have been actual studies that show joint regeneration but is my memory wrong?

If it is true than what I have noticed in the last several weeks can probably be attributed to rebuilding. That would account for the lessening of pain overall, my ability to take on stairs without so much pain.

I'm going to hunt down the facts now.

Biking

Yesterday I took my newly-tuned bicycle out for a test ride. It had been so long - years - since I rode it that I felt a bit uneasy just riding. I worried that I would not get my foot out of the stirrup in time when I stopped the bike (I have had stirrups for many years). I worried that I would not be able to control it in traffic.

Of course I found I am way out of shape. More, my left knee hurt. But not so much that it stopped me. Ever optimistic, I am counting on that pain to lessen over time.

I rode down the railroad path into downtown. I stowed the bike in a rack while I went into Barnes & Noble and bought a book and an iced coffee. Then I rode back by way of Osos and Broad Streets. By that time I was starting to get some of my street smarts back.

My knee makes it just about impossible to stand up and power anywhere. In other words, I really need to keep my seat on the seat to avoid more pain. But if I lose weight I figure I'll be able to use my strength more effectively.

It's a bitch always struggling with weight. But then, I don't struggle enough, really.

Bike!

Yesterday I went to the gym and did thirty minutes on a stationary bike. My knee acted up, made it painful, but not so bad that I had to slow my pace. I gradually went from level 4 to level 8, doing the random hill program, and when I got off the bike I did not limp.

I consider it a positive outcome.

So today I got my bike carrier out to put on my car. I was unable to attach it correctly, so I had the sense to take it to a bike shop and let them do it. Then I went home, put the bike on the rack, and went right back to the bike shop. The bike is getting a tuneup! Plus a new rear tire and a few other sundry parts. At last!

What I love about bike shops, the real types that is, is that the workers there never seem to suggest that one might get a new bike. If you bring a bike in for repair then they will repair it and not even stop to glance at a newer better bike that you might want. I think they know, because they are cyclists too, that 1) bikes essentially can last forever and 2) we form deep attachments and 3) when we're ready for a new one we'll tell them.

I say this about "real" bike shops because I've been in some where the owner and workers don't even ride bikes and they certainly don't repair them. My advice: do not buy a bike there. This shop where I went brags that everyone who works there rides. For whatever reason this makes them nice people, too.

Small hike

I walked the Jim Green Trail in Atascadero for the second time Thursday. I accidentally took a little shortcut at the top but I still feel I did a decent job of it. I was not in pain.

There is no question in my mind that my surroundings have a dramatic effect on how well I do physically. When I walk on the sidewalks and next to the railroad tracks near where I live I do not find the surroundings particularly stimulating. I focus too much on how I feel and think about how I am going to feel on the way back home. When I do a hike through a beautiful area I almost forget I have legs. Instead I am looking up, over, away, I am hearing birds and feeling breezes, I am stopping to say hi to an occasional dog. I can go a lot longer and feel a lot less pain.

The Las Vegas Blues

When I was in Las Vegas I was not in as good shape as I was in New York. I was only in LV a couple of days, hardly time to make significant moves, so I do not know why.

Still, although I limped a bit and had a little trouble standing now and then, I wasn't in excruciating pain and looking for a wheelchair.

Feeling good in New York

The real test for me, for the effectiveness of this arthritis program, is New York. And I'm there now.

I am petsitting my daughter and son-in-law's pets again. They have an apartment up two flights of steep, worn, marble stairs. I take the doggie on walks three times a day, down those stairs and up again. The last couple of times I did this I felt pain going down and pain going up, every time.

So far not this time. I am stiff and I don't move quickly but I am not feeling pain when I climb down or up the flights. This is only my third day at it but it's like night and day so far. I am able to enjoy my walks much more than previously because I am not trying to ignore knee or hip pain. I have had a bit of back discomfort, but not debiliating.

I have challenged myself, too. I went to Riverside Park the first day, then to Central Park the next, and up Amsterdam ten blocks, over one and back again today. I'm fine. I find myself plotting where we'll go next. I'm thinking of taking the subway, carrying the doggie in his bag, going somewhere, anywhere, just for the adventure. I might do that this afternoon, or maybe tomorrow.

So far so very good.

Back on track

After weeks of missing exercises and supplements I am almost back on track entirely. This last week I did the Rx exercises M, W, F and did 30-min aerobic activities T, Th, S. I took glucosamine every day. I have, however, run out of ginger.

After those days of excruciating pain in the mornings I am back to more of a discomfort, a manageable pain in the morning. Perhaps it was good to go off for a bit to find that this program is helping. It is a little disconcerting to suspect that it is the regular maintenance of these activities that keeps it working. In other words, I doubt there have been any meaningful physical changes that are longer-term. I wish there were a way to test.

My 30-minute exercises tended to be less painful than before. Because I am just getting back into this, though, I can't count that as a done deal. I have to see if it keeps up. It is the roller-coaster nature of this condition that makes it hard for me to sift through what's working and what isn't. What I can tell right now is this: I have not lost weight and I have stopped taking ginger and still I am experiencing less pain. This suggests that there may actually be some longer-term effects or that the glucosamine and exercises alone are effective.

One more thing I am doing: I have been a vegetarian for almost 25 years. Most of that time I have not been vegan. In the last several months I have moved more toward veganism and right now am just about there. Very few exceptions. The occasional ice cream treat. I am wondering if the diminishing of pain might be related to the diminishing of high-fat dairy products, like cheese. I looked in the Arthritis Rx book and saw dairy products on the inflammatory foods list (except low-fat). So perhaps I am onto something here. Doing a better job on the diet can reap rewards.

testing, testing

Over the past several weeks I fell off the program. I was traveling and missed several days of exercises and then started missing days of glucosamine and ginger as well. Interestingly, the inflammation in my knee really kicked up and I have had some truly awful mornings. Waking up and putting my feet on the floor and standing up has been excruciating.

So on Monday I got back on track. Exercise and supplements both. And I am already starting to feel less pain.

Still not with it

I am on the road. I have been since June 10. Some of the time I have done everything in the program, other times I have not. I usually manage the 30-minute exercises at least three times a week and I always get to the supplements but I don't always get to the specific arthritis exercises. Today I did, after a gap of a week or so.

I managed a hike in Mount Charleston that took almost two hours, fairly steep, with no ill effects. I also hiked in Cedar Breaks, Utah, two miles that went up and down and was at a high altitude - over 10,000 feet above sea level. I noticed the change in elevation but it was also clear just how out of shape I am. Still! The only after-effects have been a bit more stiffness for the following couple of days.

It's a long process for me, this getting rid of the pain, but I feel the progress.

Not with it

This week has been a bad one in that I haven't done all of the exercise required in this program. It is my last week in my old house and I have felt like I can give myself a break.

Last night, however, was a "riser rehearsal" in the performing arts center. We were on the risers for over an hour, during which time I briefly leaned and "sat" on one of the bars behind me a few times. Mostly, though, I was standing like everybody else. The good news is that although it was uncomfortable I was not in much pain. Actually, I can't say I was in pain at all, just discomfort. That's distinctly different from the last time I had to do a riser rehearsal. I usually start feeling pain almost immediately and just do whatever I can to get through it, mostly by trying to focus on the music and exclude everything else.

We were fortunate that we were done earlier than usual. I was expecting a three-hour rehearsal, total, and was certainly not looking forward to it. But we got loose early because the orchestra had to rehearse a concerto.

pain

I may have turned a corner. I have noticed an overall decrease in pain in my knees, and the pain I've been getting in my right leg and hip has diminished as well. I feel like I can walk with less of a feeling of stiffness in my legs, although I still have some trouble with the rest of my body.

I think if I lose weight I will notice a huge difference.

Water, water everywhere

Today I tried out an aqua aerobics class. I wore my water socks because I remembered that the last time I had tried one of these classes I kept losing my balance. I figured those things would grip the floor of the pool better than my bare feet.

They did, but it still felt awkward to me. What's odd is that I cannot see, for the most part, what others are doing in the pool, and I can't usually follow the teacher with anything like a good rhythm. So I felt like I was flubbing a lot but couldn't really tell.

A lot of the moves also hurt my knees and that discouraged me. But by the end they felt okay, and I figure it may just be that they are needing to get used to stresses from different directions. It didn't feel like we were doing anything particularly aerobic, although the moves clearly were. Mild aerobic activity, I guess you'd call it. And that's not so different from walking.

In the last third of the class we used the "noodles" to do some kinds of strength training. I rather enjoyed that.

When the class was done I headed for the spa. It's a terrific one. The jets are strong, felt like wonderful fingers massaging me, and the water temperature is perfect. The spa is large enough for several people, and there do tend to be people in there a lot of the time. Maybe the next time I'll also hit the sauna or steam room. Might as well get full benefit of being there.

I think I will continue to do these classes about once a week, more maybe. That will fulfill one of my aerobic days. Perhaps these classes will also strengthen my arms a bit, which will benefit my swimming when I do that.

It's a change

The pain in my right leg and hip have overtaken, for the most part, pain in my left knee. I wonder if I have made enough of a difference in knee pain to have it take a back seat to pain I didn't even notice before, or noticed rarely.

Perhaps the program I am following works well for my knees but needs something extra for my hips. There is a section at the end of the book that makes recommendations on various types of arthritis and offers additional treatment for them. I will look to see if there are specific recommendations for what I am now experiencing.

Week 19

I am getting my glucosamine by mail from evitamins now, on a monthly basis. If you sign up for regular deliveries you get a little discount. Unfortunately, they don't have a version of ginger that I like, that I can include in that monthly delivery. That would save me trouble and postage.

My day off.

Exercise and arthritis

The doctor reporting on this study concludes that some exercise, even a type that is not recommended, is better for arthritis sufferers than none at all.

I have a friend who has had arthritis for a long time. He moved his head stiffly or not at all when I worked with him and one time he told me that he had seen a doctor about this stiffness.

"It hurts when I bend my neck," he told the doctor.

"Then don't bend it," answered the doc.

Terry thought that was great. A simple solution. Simple it is, but unfortunately not really the best advice. Finding a gentle way to move it and doing it often is a better way. However, if Terry is fine with the way he is I am not one to quibble.

Today I went back to the pool, to put in 30 minutes. I got in all of 11 laps, with several short breaks. It felt good to be there and to be done, later. I still don't love swimming. I believe, though, that it is one of the best things I can do for my body.

Week 18

Into week 18. I am having trouble staying committed. Days slip and I make the time up the next day. Last week I had so much pain in my hip I missed one day of walking.

Yesterday, though, I walked and it was okay. I still had some pain but it felt like it was easing.

Today I waited at the veterinarian's office, standing at the counter, and I noticed that I was not in pain standing there. I didn't even feel much of that discomfort, the tightness in my leg.

I actually started to imagine using some exercise videos again.

Week 17

So begins week seventeen. Last week I broke from the program. I missed one day of the exercises and didn't completely fulfill the walking another day. On the other hand, I noticed an improvement. Yesterday I went to see a production of Hair at a local theater. I had to stand in line for a while and then sit for over 90 minutes, yet when it was over I felt barely any stiffness when I stood again. A good thing.

I didn't slip deliberately. I just didn't get myself in gear. This week I am back. I shall continue.

mariwhat?

For the fourth or fifth day in a row I am having pain in my right thigh and hip. I suspect I have arthritis in my hips as well as my knees. This made me think that if I had surgery on my left knee I may still be in pain. Probably would be. Not a cheery thought.

I was listening to XMPR as I drove home from the market this morning, thinking about my hip, and this weekend is a marathon of Bob Edwards interviews. The one playing at that time was about the border. He noted that the value of marijuana confiscated from Mexican migrants every year is in the millions of dollars. I thought about that marijuana and where it has gone. Did they burn it? If so, did they stick around to breathe it in? It occurred to me that I have one of the conditions that is listed in the medical marijuana law here in California. I could register with the health department - I think that's how it works - and if I then have marijuana around for my arthritis it would be legal. And right now that sounds like a great idea.

Of course there is the matter of the potency. The last hit I had of marijuana was maybe eight years ago and it was far more powerful than anything I had in my youth. I would not want to be *that* stoned. I would just want the pain reduced. So perhaps I could find out about cannabis extracts that can be purchased - with a prescription, I presume.

Week 16!

I fear if I stop writing the week number I will forget which week it is. So there it is. Middle of the 16th week.

hanging in

I have been on three trips within the past couple of weeks, all by car. I seem to be suffering some aftereffects of the driving and being driven. The morning after I returned from the third trip my lower back was in a lot of pain. It was a walking day so I struggled to walk, thinking the pain would ease as I went on. But it didn't. The next day and the next I have had pain in my right thigh, reaching somewhat into my hip area. But the back pain is gone.

I didn't have any knee pain, or not much in comparison. However, the night after I rode in the back of a van, with my knees forced into a bent position that they do not normally like, I had muscle cramps in both legs.

Added to these whiney notes is the fact that after all these weeks I have run into some walls here and there. In the fourteenth week I almost talked myself out of doing the exercises. Today I have in fact talked myself out of walking. I could have tried swimming instead but I didn't. Sometimes the pain just makes me want to rest a bit.

Honestly, I am not a hard-working person! I just make it sound that way at times.

Sometimes an extra challenge is a good thing

Yesterday I miscalculated bus times and ended up having to walk home from downtown, which is a distance of about 2.4 miles as I recall, all on hard surfaces. This isn't a long distance but in my present state it is certainly a challenge. I could have called a cab or a friend but I decided to take on the challenge instead.

I started out relatively pain- and limp-free, which in itself was a good sign. By the time I reached home I was limping and stiff, and that stiffness remained for the rest of the evening. I had no cramps during the night or any weird twists in my knee. This morning I awoke very stiff and in some pain. It is already starting to ease, though, and I know that the walk did not harm me. It pushed me farther than I was ready to go on a regular basis but I believe such pushes, from time to time, give me some extra courage and belief in myself. I don't relish the kind of pain that I endure when I do things like this so I am not likely to go out there the next day and do it again. But I suspect that my next smaller walk will seem easier.

Distraction

As I understand it, there are two primary camps in "prepared childbirth". By far the most-used has to be the LaMaze method, which emphasizes distraction from discomfort. Through breathing and focal points, the woman diverts her attention from labor discomfort. Even the term - "discomfort" instead of "pain" - is a diversion, a distraction. The Bradley method emphasizes essentially being one with the pain, going into it.

These two methods seem like opposites but I suspect they accomplish the same thing physically. They cause us to slow down our responses, to relax.

I use distraction when I hike. I bring a camera with me and stop to take pictures. My focus is on what I see through the viewfinder and away from my knees. While I hike I am always looking around for possible photo opps, which is also distracting.

When I do other types of walks, like the one to Marigold, I try to distract myself by reading a book. This isn't all that successful. Reading isn't all that conducive to walking, or I should say walking isn't all that conducive to reading. I have to keep an eye out for things I might stumble over and cars that might run me over.

What I have found to be remarkably effective is listening to podcasts on my ipod shuffle. The Shuffle is so small and light I can clip it to whatever I am wearing. There is no fiddling with numerous controls, either, as there are very few of them. I download free podcasts from iTunes, along with the occasional paid tune or paid book.

Some of my favorites are "The Ethicist" and "LSAT Logic in Everyday Life". These titles certainly reveal where some of my interests lie. These podcasts are short analyses of everyday situations or issues that arise in the news, from ethical and logical standpoints. As I am naturally logical, really logical, mathematically and philosophically logical, and because I have a strong ethical component, these podcasts are enlightening and entertaining to me. I think, too, that because they are spoken words they tend to be more distracting than music would be. I am paying attention on what comes next, what the argument is, how the reasoning goes. I believe that takes more focus than music usually does.

Today I walked up to Staples and back, certainly more than a 30-minute walk, and on concrete, and I did not rely on many stops for rests. I was able to plunge forward with the aid of the shuffle and it even seems like my knees feel less pain as a result.

As I end week 13

Today I walked to the Marigold shopping center again. The walk there was relatively pain-free. I was hopeful. I spent an hour there, most of it sitting in one place or another, so I hoped I would be refreshed for the walk back. But I wasn't. It was painful the entire way. I stopped whenever I found a rock or branch or anything I could find to sit or lean on.

I am certain that my heavy weight is a huge contributor to the pain and possibly to the inflammation as well. I have got to focus on losing some of that excess. Every ten pounds means a relief of forty pounds on each step.

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setbacks

I drove to Los Angeles this last Monday and returned yesterday, Thursday. While there, I visited ("toured") three different buildings, and on Wednesday went to some exhibits at the Getty Center. These activities had me standing a lot of the time, and walking on hard surfaces frequently. My knee stiffened and did not handle it well.

I look at this as a goal, too, then: to be able to see exhibits at museums or galleries and not be in pain.

Recovery time: take two...or three

After yesterday's trip to the store, walking mostly on concrete, I was limping. This morning I awoke stiffer than usual and stayed that way longer.

I mention these symptoms because I want to see a difference. I want to look back later and say that I can now walk to that same store and come back and not be limping and not have any recovery time the next day. I'm not there yet.

A walk to the grocery store

Today I walked down the tracks and over to the Marigold shopping center, a walk of a bit over 15 minutes. I brought a folding shopping cart with me.

The walk there went well, but by the time I was heading back my knee was bothering me quite a bit. What would have made a difference would have been a place to sit. There is a rock I can sit on close to the center but later, when I'm near the tracks, nothing.

I will feel like I have come quite a way when I can make this walk regularly without pain.

Recovery time

Yesterday I hiked partway up the Irish Hills trail, near the south end of San Luis Obispo. This hike is fairly steep, especially at the start. Keeps climbing and climbing. I decided I would go fifteen minutes up and then turn around. To allow for the faster descent and the stops on the way up, though, I modified my plan; I went up for about 22 minutes, then turned around and came down. I therefore probably was actively hiking for about 32 minutes, more or less, because I stopped to get my breath several times.

Steep hikes can play hell with the knees, and I was tired out by such a short hike when I got back to my car. I didn't want to subject my legs to anything more.

Today, though, no ill after-effects. And last night, no cramps or anything else. I think this is a change. It feels like it is.

Into week 12

Here, in the midst of week 12, I am again taking stock. What I have noticed most of all is that my legs are more comfortable when I sleep, when I sit for long periods (like in a theater), and when I am in any situation where I have to put them up. Yesterday I went to the dentist for a teeth-cleaning. I remembered that usually my leg is uncomfortable and I am constantly trying to find a place where it won't bother me. Yesterday it did not bother me at all.

I suspect the primary reason for this change is the exercises. They work the muscles that need to be worked, enough so that they don't get "restless".

And speaking of that. That "restless leg syndrome": I really think it has more to do with lack of exercise than anything else. But I have no evidence at all. Just my own experience that when I exercise regularly my legs are more comfortable resting.

Surface differences

Last Thursday I hiked along a part of the Bob Jones Bike Trail. I mentioned in here that my knee was hurting before ten minutes was up. That trail is asphalt, a great surface for bikes, not so great for a person with arthritic knees.

Last Saturday I hiked along the Reservoir Canyon trail, not far from San Luis Obispo. The trail is mostly flat, winds through trees, across a small creek, within a typical riparian forest area. Yesterday I walked along the trail that borders the Oceano Lagoon, a lovely little lake near the ocean. The first picture on the left is from the Reservoir Canyon trail. The other three are from the Oceano Lagoon trek.

I found it much easier going on these dirt trails. My knees did not suffer as much, although my back felt a bit of pain - most likely from my weight.

I was limping when I finished the Bob Jones walk. I was feeling good when I finished the other two, and in both of those cases I trekked a little longer than I had on the bike trail. I think it pays to look for the softer dirt paths.

Yesterday's walk

I walked part of the Bob Jones bike trail yesterday. I walked for fifteen minutes then turned around and returned. Along the way I took full advantage of the three benches I saw.

The trail is pretty but it's made of asphalt. My knee was hurting after ten minutes, so I really needed those benches. I think if I had a "shooting stick" I could do trails like this more often, because I would be able to stop and sit whenever I want. I took all of these photos from the trail - taking photos has a double use for me: I like to take pictures, and it distracts me somewhat from any discomfort. I get a feeling of accomplishment and I'm always tuned in to my environment.

Night

It has dawned on me over the past couple of weeks that I no longer feel discomfort or pain in the night. My knee does not give me that dull ache or weird discomfort. I can sleep comfortably. This doesn't mean that I am no longer stiff in the mornings. I am. But not as stiff; there isn't as much pain and I adjust and regain flexibility more quickly.

Week 10

Last night I went to an opera at the local performing arts center. I noticed that I was able to stand for short periods without pain, something that has become apparent over the past several weeks. I think this is the first noticeable improvement. My calf still retains its stiffness, that stiffness that started with the "flareup" a few years ago, but I don't have nearly as much pain. I also notice that I do not stiffen as much as I did before, so that when I stand up after sitting for a while I recover my flexibility more quickly.

I read a report on an extensive study that was completed recently that concluded that the use of glucosamine and chondroitin - both and separately - appear to be beneficial for those of us with moderate to severe arthritic pain. It's more difficult to determine if it is of any benefit to those with mild pain. This study recommended that people with moderate to severe arthritis pain try these supplements for three months, then evaluate the effects. Although it's impossible for me to separate the effectiveness of the supplements from the effectiveness of the exercises, I think it's safe to say the supplements can't hurt and are probably helping.

Week no. 9

I begin another week, still hopeful.

The other day I did a small hike, one that used to take 30 minutes but now takes 40 when I'm speedy, and that usually leaves me limping. The other day was no exception that way. But it seemed like the pain going up was less. And I could stand better, longer, which isn't long.

What I need to do is focus now on losing weight. The rest I'm doing.

Progress

I was talking to my sister Cathy about how to measure progress and she said she is in the same place with her fibromyalgia. She too has a few days that are not good, then better days that show improvement, and she has a sense of overall improvement.

What I notice most right now is that I am willing to go to places where I have to sit for a while, even when there isn't a large space in front of me. I find that I do not stiffen up as much when I get up and there isn't as much pain. It isn't definitive progress, measurable, but just the fact that I have discovered that I am more willing to chance these situations suggests that my body knows something is better.

Week 8

I continue to have ups and downs and am far from pain-free. I have found some differences that are hard to prove, though: both on airplane flights and in the theater I have been able to sit comfortably (as comfortably as these seats allow) for long periods and to get up afterwards without finding that I am extremely stiff. Yes, I'm stiff, but not as bad as I was before. I do wish there were a way to measure these things.

Week 7!

Today, Sunday, is a day of rest. I started doing the exercises and then remembered that I will be doing them tomorrow, so I stopped. Not that it would have hurt to do them one more day, I expect.

I am beginning to think about doing things that take more energy and a good attitude. I'm getting ready to tackle more clutter. It seems I do this in waves, but I want it to become a regular activity, one that I feel strong enough and pain-free enough to do every day. So as of today I am committing to just fifteen minutes of decluttering every day. I suspect that as I feel better about what I have accomplished I will in turn gain more energy just because I will like myself more.

I think my golden words are worth more.

My blog is worth $0.00.
How much is your blog worth?

Week 6

Six weeks seems like a magic number. I think that is the length of the trial of ginger supplement, the one that showed that about 2/3 of the people found ginger to be as effective as tylenol arthritis. I am starting week six and not too auspiciously.

It's snowing outside, and wet. There are so many variables to account for that I can't sort them out, can't determine if this program is definitively helping me or not, but I suspect that I need more time. Five weeks doesn't undo so many years of pain. Today, anyway, I am feeling extra pain, and I think it may have to do with the weather more than anything else.

supplements

I finished my bottle of glucosamine and chontroitin yesterday and moved to my new bottle of vegetarian glucosamine. I was not taking the recommended dose of glucosamine, I realized when I reread that section in Arthritis Rx. Now I am. However, I am now taking no chondroitin. Unless a vegetarian source is found I won't be. I am hopeful that the full dose of glucosamine will make a difference, though. My ginger supply is running low. I will probably need more before I leave New York.

This is the fifth week. I believe I am in less pain than I was when I was here last November. But I can't prove that definitively. Perhaps in a few more weeks the differences will be more noticeable.

good day

This morning I took some extra-strength excedrin because I had a headache. So I can't sort out what's happening. I felt less pain going both up and down the stairs this morning, and the walk was pleasant, if cold, because my knees did not hurt. I am tempted to keep taking the excedrin but I think it makes more sense to try again without it, to sort out what's happening.

Bed

Last night I slept in a bed for the first time since I've been in NYC. I woke with less pain in my knees. Getting up was not excruciating. It seems odd that the way I sleep would have an effect on my knees. I can understand it helping my back, but don't quite get the knees.

Fifth week

I start out my fifth week somewhat unhappy with my progress. It is difficult to measure changes in pain levels incrementally. I do not know if any objective measurements could be made at this point, either - measures of ligament improvement, for example.

I am in a challenging situation, with stairs and a cold outside. It's possible that when I return to Las Vegas, and then San Luis Obispo, I will notice more of a change. But at this point I suspect it may be another several weeks before I can say definitively that this program is working.

It would help, of course, if I followed the food recommendations more closely. I would be eating fewer inflammatory foods (I think the main transgressors right now are white bread or crackers, the wrong kinds of oils; I continue to eat many kinds of vegetables but not as many fruits as I could). If I were doing a better job on the food end I would also be losing weight, which by itself would make a big difference. Which, of course, leads us to the question: when the pain is reduced will it be because I lost weight or will the exercises and supplements take the prize?

I can only wait and see. Today is "rest day". But I will still be walking the doggie. I am sure that "rest day" does not mean one plops on the couch and stays there all day long.

Bad knees day

Today I am out of sorts physically. I made it through the exercise series this morning but it seemed to hurt more than usual. I made it down the steps and out the door with the doggie, and later out the door by myself, but my knees didn't get over hurting.

I suspect a ride on the subway last night did this to me. It wasn't such a long ride, but we stood up the entire trip, pushed on all sides by other riders. I gripped the bars and clutched the papers I was carrying and kept feeling the camera I had in a side pocket, in case anyone near me was an opportunist. So I was tense the whole way and standing up and that's not a good combination. Today I seem to be paying for it.

It sucks when one small thing like a subway ride can have such an effect.

How to measure

I don't know how to measure my progress with the arthritis program. I am currently in New York, staying in an apartment that is two slippery flights of stairs from the street. The stairs are a challenge. It is cold outside, there is snow on the ground, and I think the cold also has an effect on my arthritis.

I am still in pain, particularly when I wake in the mornings. I dread standing up for the first time. But do I dread it more or less than I did before I started this program? I don't know. I am sure not more, but because I am challenging myself with this visit to New York I know I have pushed the pain out there more.

I have done a few things, though, that seem to suggest there has been improvement. My daughter and I visited the site of the World Trade Center and walked about a bit the other day, and I noticed that I was walking all right. The stiffness was still there but I didn't go into pain mode. I had the sense to move to places to sit when I had the chance, though.

Last night I took the subway to Symphony Space to see a radio favorite: Selected Shorts. I had dinner, then went to the program and returned to the apartment. The last time I was in New York I felt too drained and in pain to do anything at night. It's possible that this excursion, too, means something.

But the real answer will come when the pain is gone. Will the pain go? Completely? Keep reading. And I'll keep writing.

Finding space

Today I did my A series exercises early in the morning. I pushed the couch out of the way and lay a sleeping bag down on the wooden floor to make it softer. When I lay on my back to do the sun salutation lying down, I was not able to make my arms stay straight as I stretched them to the side and then on up above my head.

I have to make compromises every time I do these because I do not have a large flat floor area, free of obstructions, no matter where I am. I do not think that bending my arm here and there, while lying down, is a significant amendment to the exercise, however. The joy of doing these exercises has been that not only do they take a short amount of time but they also can be done just about anywhere you find yourself. No, I do not think you would do them in the middle of a crowded airport but generally where there's a will there's a way.

Week Four

Week four begins today! Sunday is rest day, but I took the pooch for a walk, thereby getting a jump on the aerobic segment. I am in NYC, in the cold, and I'm feeling it in my knees, of course. Yet I handled the walk today, about 12 blocks, without severe pain.

Tomorrow is a test I do not need. We have to stand in line for about three hours to get into a show I want to see. I am going to look for a shooting stick or something else I can sit on.

Setback?

I flew to Las Vegas last Wednesday. I took a small plane to Los Angeles, had a two-hour layover, then took a larger plane to Las Vegas. My home airport is small, can only accommodate small planes and has only three ticket counters. So there was no walking there. But in Los Angeles I had to trek some distance from one gate to another. When I got to Las Vegas I had to make my way through the terminal, to the shuttle, through the main terminal to the baggage claim area, and finally to the passenger pickup area, where my daughter Mary waited.

Mary and I had lunch, then went to the Tropicana Casino to see the Bodies Exhibition. There was a bit of walking involved in getting to and through the exhibit, although I did take advantage of the benches within the exhibit.

All of this walking on hard surfaces took a toll on my legs, on my knees. I followed up, yesterday afternoon, by heading back to the Las Vegas airport, trekking through to the same distant terminal, and flying to New York City. I arrived at midnight, took a cab to my daughter and son-in-law's apartment, and tried to sleep. But it was just about no use.

My knees hurt a lot. I couldn't get comfortable. Wednesday night, at Mary's place, I took a couple of Tylenol pm tablets, giving in. But I didn't take any last night and perhaps I should have.

So here I am, as stiff as I ever get. Dealing with stairs again, feeling quite a bit of pain. Is it a setback? Or just a challenge? The last time I visited New York my body took a hit but it wasn't permanent. I expect the same to happen this time.

This morning I did the A series of exercises. I haven't missed any since I started this program. I feel this is where the change will start to take place. Right now it is hard to feel there has been any difference, but it is only week three.

Third week

I'm starting my third week on the program. Yesterday morning I managed to do my A series exercises in a hotel room I was sharing with a friend, while she was getting dressed in the bathroom. It's encouraging to find that there is little to prevent anyone from doing these moves. I don't have a lot of room in my house so sometimes I have to move my arms a little differently when doing the "sun salutation lying down" but I don't think my minor adjustments affect the basic exercise.

Sunday I drove to Desert Hot Springs and yesterday I drove back. It takes over five hours each way. I am happy to report that I have no lasting effects in my knees from the drive and I didn't have any difficult times along the way. I say this because sometimes pressing the accelerator or clutch can be very painful. I am not saying, of course, that the program is entirely responsible for a reasonably pain-free drive. Certainly I still had to stop a few times to get my legs working again after they stiffened up. I wonder if this will change over time.

In the swim

Today, for my aerobic activity, I swam. When I left off swimming last October I was doing 20 laps a day, four days a week. There is no doubt it was helpful for my arthritis. Yet I don't really enjoy swimming and I really dislike having to fight for a free lane. When I went traveling for extended periods I got completely out of the habit. So today I started over again.

That's me, Ms Start Over. If I dwell on how much ground I've lost I will give in to depression. So I don't. I give myself a minute here and there for self-pity, tell myself that it isn't getting me anywhere, and charge ahead. "Charge ahead" really does not describe what I do, though. I take steps slowly and carefully.

Today I swam 10 laps. I could tell I wasn't even as good as I was last October. But I'm doing the program. 22 minutes (min) three times a week; today's swim was about 25 minutes.

I realized while swimming that one reason swimming is good for the pain is the breathing. I swim freestyle, breathing, no devices except goggles and a swim cap. It's harder for me to do the breathing underwater but I know it's better and I have it down in a basic way. Today I did no flip turns. That I can get back to.

Pain and gain

Yesterday I chose the recumbent bike instead of the treadmill. My left knee did not want to do it. I adjusted the seat as well as I could but there was no avoiding pain in my left knee.

I made it through my 22 minutes, then left. I am looking to see a change in the pain over time. That is, a decrease. Watch this space...

Week 2

I'm into the second week on the Arthritis Rx program. Yesterday, when I did the series A exercises, I noticed my arms were stiffer and I generally felt stiffer all over. Perhaps I was in too much of a hurry and didn't let myself relax. Must breathe more.

Today I will go to the gym to use the treadmill.

I continue to take the supplements faithfully. I am not as good at sticking to the diet perfectly, but I believe I've made improvements. It's all those cravings! Like so many people with "weight issues" I have cravings for exactly what is not good for me.

walking

Today I went to El Chorro Regional Park to walk. I parked in the first parking lot, then walked to the off-leash doggie area, went in to sit down for a while (and watch doggies), and then returned to my car.

I walked on asphalt. The walk hurt my back and my left foot. My foot has a callous on the left side, which was irritated by my shoes. The total time spent on this walk was about 24 minutes, and I'd guess I took it at a pace a little bit faster than I did the treadmill the other day.

I think it's better that I stick with the treadmill or other softer surfaces, to avoid pain.

I don't publish information like this because I like to whine about my aches and pains. It is so I have a record I can look back upon.

The A series

Second time doing the A series. I let myself down on the floor using a pillow. Getting up is still a problem. I can do the exercises. I did them faster today, and I plugged myself into my ipod shuffle, listened to electronic new age stuff.

The last couple of exercises are done standing up, and one of them involves standing on one foot and then the other (there is more to it, of course, than just that). I noticed both today and the day before yesterday that I felt no pain in either leg when I did this one. I suspect the deep breathing has me anesthetized by that time. Excellent. Seems very promising. I am hopeful.

The alternate days

The book recommends easy walking on alternate days - three days a week. It says to start with 16 minutes and add two minutes a week until you reach 30 minutes. If walking isn't possible it suggests aqua exercises, same length of time.

I went to the gym today and did 20 minutes on the treadmill. Although I'd like to jumpstart the program by going right to 30 minutes it occurred to me that I might do myself more of a favor if I follow it more closely. So I took it easy, walking an average of 30-minute miles. I jogged the incline up to 2.5 by the end, not much of an incline.

I have been taking a glucosamine and chondroitin supplement with breakfast and today I added a ginger extract. The book recommends 1500 mg of glucosamine - I am taking about that much of the two together right now. It also recommends 520 mg of ginger extract - I'm taking 500 mg. Because I didn't realize that the supplement does contain animal products (the chondroitin) I will finish it up and then start on the pure veggie glucosamine supplement that I also purchased. One thing at a time.

Breathing

I just completed the series A exercises. It took me over a half-hour because I was reading the instructions as I went along. I am sure it will take less and less time as I become more familiar.

Breathing is a big part of these exercises. Long, deep yoga-type breaths. I tend to resist this sort of thing, being impatient, but I made myself do it right. Deep breaths just by themselves can reduce pain, which became apparent to me when we got to the last pose, which was done standing.

I think that when I have the sequence memorized I will add my own music to it, too. Could become a really nice part of the day.

Getting on the floor

The page on the left is from the Arthritis Rx book (see link at right side of this blog). It's one in the A series of exercises. The exercises are based on yoga and pilates but are modified to prevent damage. Thus the first one, which is normally done standing up, is done lying down. Of course for many of us getting down will be a challenge in itself.

There are several exercises, each done with deep breathing, and few involving repetition. So no mindless "sets", which is a bit of a relief to me. The plan is to do this series three times a week until I am essentially pain-free. The first two weeks are expected to result in increased pain but after that it should subside. I can live with that. I expect after a few weeks that I will have the series memorized.

Today will be the first day.

Supplements

One of the three elements of Arthritis Rx (see this post) is the use of supplements. The author has developed his own supplement, combining glucosamine, chondroitin, and ginger extract. No other joint health compounds include the ginger, which has been shown to be a good pain reliever (see this article). I am not buying his supplement because I am a vegetarian and want vegetarian supplements. Fortunately, vegetarian versions of glucosamine and chondroitan do exist, and I found one at Trader Joe's yesterday. TJ's did not have a ginger supplement, however. I am sure I can find one at the more extensively stocked New Frontiers market in town, though.

The above article specifically notes that a ginger product named Zinaxin, produced in Australia, was used in the story - it is formulated from ginger varieties with the greatest anti-inflammatory effects and is enclosed in a capsule that arrives intact in the bloodstream and can be delivered directly to the joints.

Further investigation into the ginger study led me to this site: HealthWatcher.net, a Canadian site that tries to expose quackery. The writers of the articles on Zinaxin are apoplectic over the claims its makers make, based on the above study. Their complaints are two:

1. Health Canada has not yet studied this supplement and therefore cannot determine if the claims are valid; and
2. The study was conducted for only six weeks, and it appears to healthwatcher that that is not long enough for a disease like osteoarthritis.

These concerns do not in themselves negate the possible benefits of the supplement. For my part, I'm willing to take a chance. I think a great part of the issue for healthwatcher is that many of these supplements were advertised heavily around the time that Celebrex was getting such bad press, and the ginger supporters were suggesting its use as an alternative. Frankly, it seems like a good idea to me. There are side effects, mainly stomach discomfort, not considered serious. Other than possibly spending too much on the supplement I am having a hard time seeing the downside of giving it a try.

tea and me

In Arthritis Rx (see last post for link) the author lists the "best foods" alphabetically and describes the benefits of each. His knowledge of these foods is far greater than the typical nutritionist's or the typical online analysis. One of the foods he extolls is green tea. His description of the many characteristics of this tea and of the studies that have proven its benefits have made me a believer (not that I wasn't already). I hereby resolve to drink four cups a day, the number that seems to show the best effects.

Arthritis Rx

The book arrived Saturday; I picked it up from the mailbox yesterday. I am about halfway through, in part because it is written simply and in part because much of the earlier material is stuff I already know.

The book is Arthritis Rx: A Cutting-Edge Program for a Pain-Free Life . And it's all it's advertised to be.

The book is for those of us who want to take control of our arthritis directly. It focuses on exercise, diet, and supplements, but also offers advice beyond these basic elements. As I expected, the diet part focuses on anti-inflammatory foods and those rich in Omega-3 and Omega-9 fats:

Good fats:
Fatty cold-water fish
flaxseed and olive oils
avocados, walnuts, macadamia nuts
broccoli, kale, collards, spinach, chard, cabbage, caulifower, kohlrabi

Bad fats: (Omega-6)
red meat
corn, sfflower, sunflower, soy, and peanut oils
fast food
commercial baked goods
deep-fried foods

Good anti-inflammatory foods:
cold-water fish
fruits (apples, oranges, berries, avocados)
whole grains
dark-green leafy veggies
olive oil, flaxseed oil, borage oil, evening primrose oil
soy products
walnuts, butternuts, soy nuts, flaxseed
green tea, oolong tea, water, mineral water
spices (ginger, turmeric)

Pro-inflammatory foods (bad):
red meat, hot dogs, hamburgers, fast food, frozen dinners
chips, packaged snack foods
refined grain products
most commercial, non-organic salad dressings and energy bars
vegetable oils (corn, sunflower, safflower, peanut, coconut, palm)
dairy products (except low-fat)
dry-roasted peanuts, beer nuts
carbonated drinks, juice drinks, soda
refined sugars, sweets

The diet can be explained simply: eat a wide variety of plant foods, incorporating at least five servings of varied fruits and veggies each day. Best choices are those that are rich in color - dark berries, deep green veggies. Beans, of course, make an excellent substitute for meats, and black beans in particular have the most to offer.

I eat a diet very similar to this already, but I have been lax and have slipped way too many refined carbs and not-great fats in, which has resulted in weight gain and not feeling as well as I can. I can make a few changes and feel better about myself and get healthier. Dr. Vad, the author, points out that the diet is really good for everyone, not just those who suffer from arthritis.

The exercises are divided into three groups. The A series are the first to tackle. Do them three times a week, fifteen minutes at a time. When I reach a pain-free state (I can't even imagine this!) then I can move to the B series if I want, and then to C. Many people stick with A and are just fine with that. The B and C series are for those who want to be more active. I hope to make it to B. The following posts will explain the exercise series in greater detail, yet still just summarize them. It's best to buy the book. It isn't that expensive, it answers your questions, and it's easy to read.

Water and pain killers

Two nights ago I took two acetaminaphen pm tablets at night, and awoke feeling less pain. It was easier to get going in the morning than it had been. Was it the pain killers or was it the water I've been gulping? Throughout the day I drank more water and did not take any arthritis pain killers. Last night I went to bed without the pms and this morning awoke again with less pain. It's not a scientific study but I think the water is working.

More water

I have continued to drink a lot of water. I don't yet sense a difference. I believe I have seen a difference when I take acetaminaphen pm at night, however. When I take it my knees are not in as much pain during the night or when I awake.

The book has not yet arrived. I ordered it through QPB, along with several other books, and unfortunately that company is not so speedy in mailing books out.

Along with drinking more water I am drinking less wine and not eating later in the evening. I am keeping track of what I eat and drink in dietpower (yes, as I said before, I'm a dietpower dealer). What I always notice when I do this is that I eat less and eat more healthily. I also notice that I have more time to do other things because I am not raiding the cupboards or looking for a snack while driving somewhere. This means that, even though I have not yet lost any weight, I am feeling a bit better about myself. All of which goes to show that we don't always choose what's best for us - I have to work at it.

Water and blueberries

Yesterday I drank lots of water, again, and had one glass of wine. When I got up this morning it seemed like I wasn't quite as stiff. However, I had also taken acetaminaphen pm last night, so it could be that was the reason.

This morning I had a "blueberry milk". I put one cup of milk in the blender and added one-half cup of frozen blueberries. I blended it well. The consistency was good. It could be sweeter but it tasted fine. The antioxidants, of course, should be good for my body. Help prevent "rust" - oxidation - inside.

starting fresh

Like so many other people, I am starting the new year with new goals. For me, it's not really because it's a new year. I eschew the making of resolutions. But periodically I start over. It's the only way I can hang in there. I give myself permission to start over again and again and again.

While I wait for my new book (mentioned in the post labeled "facing pain") I am making some small changes. I am drinking more water, logging my food and any exercise in dietpower, and not eating after dinner. I will probably cut back on wine consumption, too, given that I have recently begun to drink two glasses a day. For now, one glass a day. Later I will cut it out altogether except for the occasional treat.

After drinking lots of water yesterday I tried to gauge any difference in my joints when I got up this morning. I didn't really notice. More time is needed.

Shameless plug: If you look into dietpower and think it may be for you (I have used it for years and whenever I do I become healthier), and you decide to buy it, just enter my name - Judith Lautner - in the space where you can put in a dietpower dealer, and you will get $5 off the price. I have been a dealer for a few years but tend not to sell it actively. Considering how good a program I think it is, and how unpushy this company is, I do recommend it.

How it feels

When I wake in the mornings, or in the middle of the night, I have trouble putting my weight on my left leg (the more damaged one). I have to grab something to hold onto as I stand up and when I am standing it hurts. I have to limp to the bathroom. All I want to do is sit down again.

In time I get more flexible and can walk without that much pain. Ever since my "flareup" of a couple of years ago, though, that strange kind of stiffness remains. When I sit on a low, soft seat, I have to help myself up, often lifting myself sideways as I lean on one side of the couch.

If you were to see me when I first get up in the morning you would think I am seriously crippled. That isn't quite true, because later in the day I can often walk without any limp.

Water

One piece of advice I've read about preventing pain is to drink a lot of water. In the past several months I have fallen out of that habit, and before that I didn't directly attribute my lesser pain to the water. Starting today, then, I am drinking lots of water. Ten glasses a day, at least.

Facing pain

Most people use medications to control arthritis pain. The most common type of pain relief medication is the group of drugs called NSAIDs (Non-steroidal anti-inflammatory drugs), including ibuprofen, aspirin, Celebrex, and a host of others. Unfortunately, all of these drugs have side effects ranging from stomach bleeding to heart effects. I have read that they also weaken the bones over the long term, but I do not have that evidence in front of me. It pays, in any case, to look at treatments that might strengthen the joints and improve health over the long term rather than just kill pain in the short term.

To that end, I have ordered a book on arthritis that promises dietary and exercise changes that can make a dramatic difference in "fifteen minutes a day". I have already read of dietary changes that might be worth looking at: getting rid of foods that cause or increase inflammation, for example. I am hoping that this book, called Arthritis RX, by Vijay Vad, will spell out a clear path for me that I can actually follow for the rest of my life.

What's it all about?

There are so many of us with arthritis, and there certainly are many resources for this degenerative disease. But I have trouble finding the kind of help that I want.

I have severe arthritis (osteo) in my knees and I am starting to feel some form of arthritis in my hands and arms. My knees give me the worst trouble, of course. Several years ago I saw an arthritis specialist to find out if there were exercises or other things I could do that would help me live better with my condition. He told me that the only real solution for me is surgery. Knee surgery is problematic even when one has health insurance, and I don't. I asked him for an estimate of the cost and he said about $50,000 - and that the surgeon's fee would be only a small part of that.

Because I do not have health insurance and am not wealthy I am waiting it out. I might be able to get the surgery when I turn 65 and am on Medicare, but maybe not. In the meantime I need to find a way to deal with life as I am.

Thus this blog. I have done some investigation already and intend to do more. I will post my experiences, as objectively as I can, with various types of treatment. It isn't always possible to separate what is simply a "good day" from a real improvement, so I hope that by recording as much as I can here that I will be able to draw some conclusions down the line. And through this means I hope I can help others as well as myself.