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Monday, December 12, 2011

Isokinetic exercise

i·so·ki·net·ic exercise  (s-k-ntk, -k-)
Exercise performed with a specialized apparatus that provides variable resistance to a movement, so that no matter how much effort is exerted, the movement takes place at a constant speed. Such exercise is used to test and improve muscular strength and endurance, especially after injury.

The American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.

I first heard the word "isokinetic" at the physical therapist's office where I worked on my left knee. Paul, the therapist, was testing an intern, asking her what it meant. She did not know. I guessed from the name something close to what it means.  In essence, however hard you work, the machine or exercise responds with an equal resistance.

In my present therapist's office is an isokinetic machine hooked up to a seat with a removable leg holder. My leg goes into the holder, is strapped in with a soft padded brace and velcro, and the machine is set. Right now I do eight sets of ten leg lifts using this apparatus. The harder I work the harder it works.  But never beyond what I can handle.

When I am on the stepper - a step machine in which I sit and step in a recumbent position - the machine is also set to "isokinetic". The harder I work the harder it works. So far, from my looks at the gauge, I don't work it particularly hard. But what I seem to get most from that machine is a stretch. I stretch each leg each time I push the step.

Swimming is a type of isokinetic exercise. If you move your arms slowly through the water you encounter a minimum resistance. The faster you move, though, the greater the resistance of the water. This may be one (of many) reasons swimming is such a good all-around exercise for just about everybody. I do wish I liked it more!

Today's therapy went well. I felt better, moved better, and Chuck noticed I was walking better too. Over this past weekend I have felt like I turned a corner. I still have a lot of pain walking much of the time, but I am noticing that more and more often the pain is not centered as much in my knee as in other body parts. My foot. My hip. Perhaps this is because they are adjusting to this new alignment. I still have pain in my knee, particularly in one place, and I just have to ride that out.

Saturday, December 10, 2011

Just Cut off the Legs, Please

Yesterday my therapist joked, "just leave the leg here and I'll fix it". If only. I keep trying to find a way to detach myself from the hard part of therapy, the pushing done by hand. It not only hurts because it is stretching those long-tight muscles in back, but also because I am still having trouble with some pain spots on either side of the knee.

Lately I am having more restless leg issues, both during the day and during the night. I have increased the dose and used up all but one of the Requip (Ropinirole) tablets already. I need to get back to the doc to get the prescription amped up. But yesterday I looked at as well as medline to find out more about patients' experiences with this drug. Over 300 people had reported on their experience with it on askapatient, and some of the reports were frightening: "I wish I had never started it." "I want to get off it but can't". "I am taking more all the time". Signs of addiction, in other words. Among other "side effects".

I know of no other alternatives. I tried many remedies before heading for the doctor, and none worked.  I used to think I'd have this nerve manifestation less often if I were more active but it seems to get me no matter how active I've been. I am going to try to get into the doctor's office today because it is open on weekends and even into the evenings. Unfortunately, their early fame to short waiting times and on-time appointments have mostly been thrown away by an increased patient load. I'll bring a book, of course.

Friday, December 9, 2011

Getting On

I am feeling hopeful again. For the last few nights I have awoken less often and had less difficulty getting out of bed - less pain. I felt I got going more easily this morning. And the therapist continues to be confident that we'll get my legs straight.

I asked him today if we can get Medicare to pay for the extra therapy that is needed to get those straight legs and he said absolutely. My condition warrants it and my goals are reasonable - to have straight legs so I can walk right.

I will be going to Las Vegas for Christmas, spending ten days, so I also asked Chuck, the therapist, if he can let me know what I can do at Las Vegas gyms while there to help stay on track. He will do this. He's very easy in this way, flexible and helpful. He also has 42 years' experience, which pretty well speaks for itself. If the number of clients didn't already, including many with sports injuries. I learn different stories all the time, making my time there seem pretty darned mild in comparison sometimes.

Chuck told me that the stiffest leg he ever dealt with was on a nine-year-old boy. The boy had injured it skiing and it did not need surgery but it would not bend. He evaluated it in conjunction with the boy's doctor and found that he could bent it less than an inch. The boy was going around with crutches and a useless leg. The surgeon decided to do a "manipulation". This means the boy gets put under anesthesia and the surgeon then bends the leg. No cutting, just bending. The surgeon invited Chuck to join him in the operating room and the two of them tried to get the leg bent while the boy was under anesthesia and it still would not budge! So it was not merely a matter of the boy's fear. This is how they approached it: they put him in a rehab center, in bed with a Continual Passive Motion machine bending the leg as best as it could 24/7, for a LONG time. I do not know how long, but until it started to overcome the resistance and show some softening. Once he got to that point, he got to get out of bed and undergo more traditional physical therapy four times a day. And this way they got it to bend again. He is now in high school and remembers those days well, Chuck said. Doing well.

And here I am, going to PT three times a week and getting to the gym for Aqua classes three times a week and I moan about pain and inability to do everything I want. Seriously!

Driving is still painful but a wee bit less so. I figure I'll take the plunge and drive myself to the Santa Maria airport for my trip this time. Extending the effort.

In general I am trying to get up and move around more frequently. I was doing this while seeing a home therapist but somehow lost my habit when I moved to outpatient. Get up, move around, sit down again. Rest, get up and go again. I am using my iPad and my iMac to play favorite music on iTunes a lot more, too. It just cheers me up. Cat Stevens right now. What can I say? Some things don't get old.

Wednesday, November 30, 2011

A Status Check

I went for therapy this morning, then later to my surgeon's office for a recheck. The therapist measured my range of motion: flex is at 125 degrees, extension is about 14 degrees from zero. The extension is the major concern, of course, but the therapist, Chuck, is confident that we will get there with both knees. He said that my bent legs make it harder for me to walk straight and tire me out sooner. With straight legs I will go further and with less pain.

He himself has a bad knee, he said, and he noted that it too is bent and that he can't straighten it because it is too painful. He has not yet scheduled the surgery because the recovery time is so great. In his favor, of course, is the fact that he can get as much therapy as he wants and needs as long as he likes. I would expect that after the first couple of weeks he could be back at work and on the machines himself from time to time.

I took the info on my range of motion to the doctor. He continues to be concerned about getting my leg straight and mentioned the Dyna-splint again - I nixed that one, saying I simply could not tolerate it the last time. Then he said there was the option of using progressive casts, holding the leg in one position for a while, then moving to a straighter cast. I simply could not abide the idea, frankly, especially because the therapist is confident that we can get me there. I would much rather get there by going to therapy three days a week, stretching both legs as part of that experience, than by walking around with a cast on. If he had said we could try a special brace that might relieve the pain you're having I'd have gone for it. But no, that was not in the picture. The pain doesn't seem to register with him the way it does with me. He's out for the straight leg, period. We agreed that I would continue to see the therapist and he, the doc, will be happy to extend the prescription for therapy to give me the time I need to get this done.  He did not say to return for a recheck and when I checked at the counter the person there said that if he did not give me a recheck time then I do not need to come back. Well, that's fine if I can just keep up with therapy.

This isn't the way I envisioned it, of course. I thought I might swim through this second surgery, and initially I really did. But things like these tight legs, which have been tight for so many years, cannot be corrected so easily.

Bragging Rights

Today's challenge (and the end of the 30-day challenge!):

Play that horn. Want to hear a secret? You’re awesome. (It’s actually not even really a secret.) This is going to be hard for you, O Modest One, but you gotta give yourself props today. Write three things you love about yourself – things you’re great at – or just want to share. Don’t you dare signpost or undercut those self-compliments!
1. I am honest and ethical. I won't say I have never lied. Everybody lies. But I try to be as honest as I can be without unnecessarily hurting others. I look at what I say and do as if it were to be posted in the newspaper the next day. Some days that paper would say, "Lautner barely moved all day. Hooked on Real Housewives". I'd admit that anyway.

I understand what it means to do the right thing. It is not always obvious and sometimes the "right thing" could actually be more than one choice. I try to do my best, without slanting the action in favor of myself. My brother made me executor of his will and he could not have made a better choice. I knew from the start that I was representing him, not his heirs, and I did my best to represent him as he would have wanted me to. At times it was difficult because others in the family did not agree with my decisions. But I knew what it meant to have this responsibility and I did not shirk it to make somebody else happy.

2. I am compassionate. It may be that my own early experiences prepared me. I was fat and dirty as a child and other children ridiculed me. I learned, on the one hand, how to ignore those who were cruel to me, and on the other, how it feels to be on the outside. Ever after I felt compassion for others in similar situations, from small children to difficult adults to farmed animals. What makes me most proud, though, is that I did not shut down my feelings. I feel deeply. It hurts to feel pain deep inside me but I do not shut it out. I embrace it. And this, too, helps me feel for others.

3. I am big on reading. I read for pleasure and for information. Even books read for pleasure often have in them feelings, emotions, experiences that move me, make me somehow different. I have read such a wide variety of books over the years that I feel this reading has shaped my view of the world. It is as if I were a world traveler or even a time traveler in that I understand much of other cultures, other times, as well as the world within our heads, the way our brains work. I am no expert in any of these things but the accumulation of such wealth makes me see the world more clearly and be able to question assumptions, even those I have held since childhood.  I believe that reading has opened my mind in the best possible way.

I'll take this opportunity to mention a few things I am good at, just to gild the lily: photography, cooking, teaching one-on-one, sewing, writing, math, music. In this I follow in the footsteps of my mother and grandmother, both of whom pursued several interests through their lives. Let us celebrate this Jill-of-all-trades-but-master-of-none, for it makes for an interesting person.

This post was written as part of NHBPM – 30 health posts in 30 days:

Tuesday, November 29, 2011


Today's challenge:

Greeting card post! The greeting card industry is all about writing generally universal feelings in a presentable way that you can use to express yourself when you just can’t think of the words to say. Write a greeting card for someone in your community to help them express themselves about a new diagnosis, treatment, or experience.
Here we go:




On not one but TWO new knees!! More fun! More therapy! More pain! Life with two is just MORE.

This post was written as part of NHBPM – 30 health posts in 30 days:

Monday, November 28, 2011


Today's challenge:

Say WHAT?! What’s the most ridiculous thing you’ve heard about health or your condition. Was there any context? What did you think at the time you heard it – and what do you think of it now?

So many choices! Not many about arthritis that I can think of, but many about health.

What many may think is not ridiculous but is: the assertion that depression is caused by a chemical imbalance. If you read the fine print you will see that the advertisers are quick to say "it is thought that..." rather than outright lie. The scientists have been trying to prove this theory for over 50 years and have not been able to, which suggests strongly that the theory is wrong. There are several books debunking this so-called "common wisdom". One that I especially like is Blaming the Brain by Elliot Valenstein. If you're curious you can read my review of it.

I have heard the "chemical imbalance" theory so often that I cannot pick a certain time. It is ridiculous every time.

Another claim that I have heard often is that vegetarians are weak. Again, this is such a commonly-held belief that I cannot place it together with one specific person. Typically I read this online. People do not say it to my face. I am vegetarian - vegan, in fact. NO animal products. I am strong. But of course don't take just my word for it. There are several world-class athletes who are vegan. Here is just one article on tough vegans.

About arthritis: I clearly had arthritis over 30 years ago but it was no diagnosed. I went to see the doctors in my thirties and while some doctors said it might be arthritis they ruled it out, thinking I was too young. It was only many years later that I was able to see the x-rays that show the extensive damage done to my knee joints through osteoarthritis. Was this ridiculous? That the doctors did not figure it out? I think so.

This post was written as part of NHBPM – 30 health posts in 30 days:

Sunday, November 27, 2011


Today's challenge:

Quote Unquote. Grab a quote from this site (  (type in any word – see what comes up!) and use that quote to set you writing.

The following excerpt is from a blog post on WegoHealth:

According to the Mayo Clinic:
Restless legs syndrome (RLS) is a condition in which your legs feel extremely uncomfortable while you're sitting or lying down. It makes you feel like getting up and moving around. When you do so, the unpleasant feeling of restless legs syndrome temporarily goes away.
Restless legs syndrome can begin at any age and generally worsens as you get older. Women are more likely than men to develop this condition. Restless legs syndrome can disrupt sleep — leading to daytime drowsiness — and make traveling difficult.
The reality for many - who have RLS - is so much worse than that description. Their lives are miserable - with symptoms that almost never go away, and never having enough sleep. The RLS symptoms alone can make it a depressing, and demoralizing existence. When you add in most people's misunderstanding - including many doctors - about this disorder, patients often feel as if they are alone - with no support system.

I have Restless Legs Syndrome. At least, it appears that I do. It was diagnosed by a Physician's Assistant based on my symptoms, which I described. I am always suspicious of diagnoses made this way but perhaps there is no biological way to diagnose this condition. Like many people, I tend to downplay the condition because it is not life-threatening. It is an inconvenience. But as many of my posts in the blog have shown, as well as in the full blog post excerpted above, it can be much more than inconvenient.

In the past several years I have had an occasional episode of RLS. It did not continue for days on end so I never considered it a really difficult situation. After surgery on my left knee, however (total knee replacement), that leg went into frequent bouts of RLS. They became so constant that I could hardly sleep. At the recovery center I mentioned them but nobody had a solution other than taking the maximum amount of Percocet allowed me. This really did not do the job. I mentioned the situation to physical therapists, who were concerned and relayed the information to the surgeon, and then to the surgeon, who essentially shrugged. I think he was sympathetic but he had no solution.

After months of dealing with it I went to my regular physician office and saw the PA noted above, who prescribed Requip at a very low dose, to see how it goes. She had the good sense to order blood tests and a thyroid test as well, to rule out disorders that have restless legs as a symptom. The tests were all negative so we are assuming I have a neurological condition, that RLS is nerve-based.

The Requip is working. Sometimes I have to take an additional dose but most of the time one dose at night takes care of it. Sometimes I go without, just to see, and sometimes that works. When I travel on a plane I make sure I have the medication within easy reach and that I take some before boarding. I am starting to take it when going to see a movie as well. Recently I saw a movie with family and took one, then another later, and still, by the end, was uncomfortable. I am sure that my stretching and getting up and down was as discomforting to my family as it was for me.

I am bothered that it appears that this condition is in the same place as Chronic Pain Syndrome, for example - no clear biological proof that it exists. I hope that this changes in the future and that future treatment is based on the biological cause. I tend to be embarrassed to admit that I have it, yet whenever I do the response is sympathetic and real, and I learn that many others are dealing with it as well.

My surgeon and the PA had no explanation why the surgery might have brought on the increased incidence of RLS.  However, about 72% of persons with RLS also have osteoarthritis. I hope, too, that this connection is explained in time.

This post was written as part of NHBPM – 30 health posts in 30 days:

Saturday, November 26, 2011

This Is How It Is

I called in two prescriptions Friday afternoon, when I got home from Las Vegas. One of them had no refills so the Costco pharmacy had to fax in a request for it to be filled. The other had another refill available. This morning I checked on them and found out that the request had not been answered yet but the other prescription was filled and ready to pick up.

I went to an Aqua class at the gym this morning and felt pretty good at getting through it well. But my knee still hurt and my foot hurt as well. I have just begun to realize that my right foot hurting has been another part of my current situation. I really did not want to make my way over that concrete floor after crossing the wide concrete expanse outside the building to pick up that one prescription. But as the day, today, wore on, I thought that I might have difficulty picking it up tomorrow when the pharmacy is closed.

So I reluctantly went out at about 3:30, cats nipping at my heels, wanting to be fed before I left. Walking from my car (all the disabled spots were taken as usual) to the building and all the way to the pharmacy against the far wall was really uncomfortable. I kept waiting for the pain to let up but it did not. I took my time, used my cane. At the door the greeter asked if I wanted to use one of the motorized chairs and I said no. I still have such trouble being seen in a wheelchair. But oh, how much I really wanted it.

I got there, was so happy to see that there was nobody in front of me. Waiting in line is not comfortable either, not yet. I got my prescription and took my time back and eased my way into the car, hurting.

Driving is still not without pain. It seems to have settled at a steady level of pain, not getting worse but not getting better either. I think the foot pain contributes here.  I made it home, stopping at the mailbox for another painful effort, getting out to get the mail and returning to the car, and finally into my driveway.

I am walking around without my shoes now and I feel a little bit better but only a little. This is how it is now, right now. There have not been too many times when I have been without pain. I'm trying to figure it out.

I Still Remember

Today's challenge:

I still remember... Free write a post that starts with the line “I still remember...”

I still remember the day I did a long hike at Montana de Oro in Los Osos, CA, about 13 miles from my home. I was in my fifties and feeling good. I was of average weight and my knees were not giving me too much trouble. I loved hiking then as I do now but I was not in the habit of doing long climbs. That was another level for me. I decided to take a chance, try it, one day.

I prefer to hike alone, usually. Unless I am with a family member who doesn't mind my pace. I don't care to go with groups who are gracious enough to stop from time to time to let me catch up. One thing they may not realize is that by the time I catch up they have gotten their little break. And I still need one. So I like to take as long as it takes for my own body and for my mind. I do not hike to break speed records but for the beauty of it, the feel of the breeze, the smells of the native vegetation and the occasional treat of a wild animal crossing my path. I bring my camera. One time I caught a bobcat with my camera. All I could think about was getting that picture, not getting to safety. Not that a bobcat is likely to attack me.

This day that I did the long hike I took several breaks as I climbed higher and higher. When I reached the peak I was so pumped. I took out my camera and grabbed a photo of myself from below, looking out, and it captured the feeling I had then, very well. If I run across that photo I will insert it here later.

Then it was time to return. I started down the path and somehow got my signals mixed. There are several trails in and around that area and I did not take the same one back that I came up on. I do not remember if I had expected or planned to do some sort of circuit, a loop, rather than out-and-back. Whatever the reason, I was on a different trail. After some time I realized I was really on the wrong trail. I did not seem to be getting much closer to the trailhead at all. But I was descending, which was a good thing, and I figured I would get there eventually. I started to see signs of the ocean in the distance and I headed that way. I got to the point where my legs were so tired that I had to talk myself into taking each step. I also remembered a tip my sister gave me when I was quite young: to "detach" my legs from my body. I tried to divorce them so I would not feel them. It does help to do this, but just so much.

Eventually I did get back to the trailhead, or perhaps a different trailhead, I don't remember. From there it was not far to my car and I was ever so happy to see it. I was proud and exhausted at the same time.

I very much want to reach the point where I can consider this type hike again, where I feel so good it seems like a reasonable challenge.

This post was written as part of NHBPM – 30 health posts in 30 days:

Friday's Challenge: Never Have I

Friday's challenge:

Never Have I Ever. You stick to your guns – now tell us about what. What is something you’ve never done but want to. What’s something you’ve never done and won’t budge on?
I have never sung a solo. I love to sing but have never taken lessons. I took a class in voice in college, a requirement for the music major I was pursuing (my focus was piano). In that class the teacher managed to bring out a hint of the voice I might have and she was excited about it. But I have never followed through. I have sung in choirs to keep my hand in, to be able to perform music without too much responsibility.  But I have never sung a solo. I have had visions of doing this, over the years. I would not ask for something impossible - a solo in a small production with a small audience would be fine. A church solo would be fine, if I belonged to a church. A solo at a wedding or funeral would be such an honor. I am sixty-five years old. Is it too late for this dream?

I have never ...

This is harder than I thought it would be. I am a highly ethical person and yet:

I have lied.
I have stolen.
I have cheated.
I have hurt others.

Milder confessions:

I have skipped school.
I have smoked pot.

And I can't say I would never do any of these things again, under the right circumstances.

I have never murdered. I can say with 99% assurance that I never will, but again, there may be circumstances that would lead me to do so.

I have never married and am unlikely to do so but it isn't something I'd not budge on.

I have never blackmailed someone. But would I? Again, to protect somebody else I just might.

Here we go:

I have never surrendered an animal to a shelter that kills animals who are not adopted. And I never will. Similarly, I have never entered an animal in a judging contest at a fair, and I never will. I have never bought a cat or dog from a pet store and I never will, nor have I ever bought an animal from a breeder and I never will.

This post was written as part of NHBPM – 30 health posts in 30 days:

Thanksgiving Day Post - Delayed

Thanksgiving was simply too busy a day for arthritic me. I was too tired to tackle the day's challenge and will do that now.

Thursday's challenge:

My Mascot! Give your condition, community, or self a mascot. Who is it? What do they represent? What is their battle cry?
Yikes! I am drawing a blank on this one! I could choose a dog or cat, both of whom do get arthritis too. But perhaps a creature that represents coping, aging, non-glamorous acceptance. No flashy character, but one that everyone knows, that stays in the background for the most part. For my money, a mockingbird.

When I first came to California from Michigan and heard these birds singing in the middle of the night (which they do in mating season), I was astounded. I had never heard such a thing. It was wondrous, other-worldly, and I quickly had to find out what it was. It was the ubiquitous mockingbird, singing its little heart out at least as lustily as it does during the day. So many people ignore this bird and even curse it when it wakens them from a sound sleep. Yet for me its song energizes and makes me feel that much more alive. So why not? Why not have this symbol of strength and song carry us along?

This post was written as part of NHBPM – 30 health posts in 30 days:

Wednesday, November 23, 2011

Anything Goes

Today's challenge - I think this time we get to write about whatever we want. I left my list at home and I haven't found a list easily online. One blogger wrote that we could write about whatever we want so I'm going for it.

 It is the day before Thanksgiving, and like many other families, ours has been preparing for tomorrow. We try to keep things simple but we do want to have something of a traditional thanksgiving. Traditional for us, that is. I offered to make pumpkin pies, because I had just made some last week for a special event and they got rave reviews (new recipe, not my own).

We worked out the day today, which was to include shopping for what's missing. I made a list. I wanted to get in a water exercise class, too. So, using my son-in-law's pass to his gym, I took a class at 10:30. My daughter took a yoga class at 10:45. We got out of the gym at noon and had scheduled a stop at the library, then lunch. We did these things and by then my grandson of 23 months was needing a nap. So was I.

The class and the subsequent time at the library and the lunch out took it out of me. My knee was hurting and I felt almost exhausted. This is rather the thing about healing and getting old and feeling pain - one can get tired more easily. What with one thing and another I did not get to making the pies until just about 20 minutes ago. They are in the oven now. when they come out I will put them in the fridge, then pack my few remaining things and walk to my other daughter's house, which is literally around the corner. This daughter called me a "procrastinator" because this has taken so long. She simply does not comprehend how difficult it can be for me to do a lot of simple things, and how those efforts can quickly tire me. It won't always be so! When this knee is healed I will have a lot less pain and my alignment should be better and I should be able and happy to go hiking again. When that time comes I will have more energy and I will be able to do more things. For now, I simply have to hang on and take the time it takes. That is a huge part of healing.

This post was written as part of NHBPM – 30 health posts in 30 days:

Tuesday, November 22, 2011


Today's #NHBPM Day 22 Prompt is: Be present. Describe a scene with lots of imagery. Show, don't tell! My bedroom. I am over 400 miles away from it right now but it is present in my mind. When I walk into it I first see the bed. IT is queen-sized, head up against the far wall. It is covered with a blue and white striped-design comforter, on top of which are three pillows. The pillows are spread across the head of the bed. Two are of a green flowery design and the third is plain off-white. The white one sits in the middle. LIght from the window to the right of the bed flows in to create a comfortable afternoon wash: no glare, just soft light. I can pull the dark maroon curtains to cover the window, the material reaching to the floor, but I don't. I usually hook them on the one large hook on the right side of the window, and swirl the curtains over the hook a few times, to form something like a knot. The room is larger than others I have had in past years, but not what most people would call "large". It takes up all but about six feet of the width of the house, the 20' width, and it is about fourteen feet deep. The bed is almost against the left wall, but there is a gap of about two feet there, allowing me to get in from that side and to make the bed. A black two-tiered bedside table sits in the corner, with a lamp, the type that can be bent to face down or up, at the back of it, against the wall. Also on the table are books - usually two or three, a small alarm clock, black, with glowing numerals, a pink plastic tray with a matching plastic pitcher, and at night some medicines I am currently taking. Right now there is a glass on the tray. It is what I think they call an "old fashioned" glass, but I could be wrong. It is about three inches high, sturdy, with a heavy bottom. It has a green pattern stamped around the outside. Why is the bed so far to the left when there is so much room? Because a 7-foot long "parlor grand" piano sits lengthwise on the right side. The keyboard faces the rear wall, with about two feet or so between the piano and the wall. A heavy wooden bench that has seen better days takes most of that space. The piano lid is closed but the keys are exposed. On top of the lid are piles of music, in random order, always knocked about by my cats.On the main part of the lid are odds and ends of things, like clothes that need to be put away or a laundry basket or some jewelry or a suitcase that I have not emptied since the last trip. Under the piano are a couple of bags of fabric and related materials, for sewing. There is also a basket with all sorts of odd stuff in it, culled from other places. I need to sort through that mess. One of the house's four cat litter boxes is next to the piano but not under it. It is green, fairly large, with a domed cover. There is a set of "stairs" inside the box, allowing a cat to enter by going up this ramp and into the box. The bottom steps usually have an accumulating of litter on them, often wet from one of the cats peeing right there. In the near right corner as I face into the room is a music cabinet that I inherited from my grandmother. IT has an old-fashioned type lock and I have lost the key. Inside are beautiful little trays that slide out, drawers for sheet music. The case is a dark wood, I am not sure what kind, and it is neatly carved but not elaborately. Just to my right is a black two-tiered table, about three feet high, containing my "boom box". IT is in three parts: the center part and one speaker are on the lower level while the other speaker is on top. Some odds and ends sit next to the upper speaker. To my right is a tall bookcase, Ikea, with doors covering the bottom half. the doors donwt line up exactly right. I did something wrong in putting it together. The upper shelves are stuffed with books, some layered on top of others. ON top of the shelf are a large puzzle in a box and some games. This post was written as part of NHBPM – 30 health posts in 30 days:

Monday, November 21, 2011


Today's challenge:

Ekphrasis post. Ekphrasis (writing about another art form) – Find a Flickr Image in Creative Commons that inspires you in some way (positively or negatively) and free write about it. Give yourself exactly 15 minutes to write without stopping. Don’t think! Brave bonus: Publish to your blog without editing! (You can include a disclaimer)

I searched for "creative commons images" and found, through a post on that site, CadYou, a site for 2D and 3D cad images of high quality. What a great concept! I joined and did a quick look around and chose this image:

NO IMAGE...turns out the images are available in formats that do not work here, and I do not want to take the time to download the program I would need to convert any of the images. Perhaps in a later post I will look into this page more, though, because it looks, to me, very cool.

So instead! I went to WikiMedia. And chose a "random image".

And so begins the 15 minutes:

The owl sits on a fence post outside a conservation park in the United Kingdom. I visited some parts of the UK in 2008 and when I saw this photo I was immediately reminded of that visit. My sister Cathy and I took two weeks first in Ireland and then Scotland. Our week in Ireland was spent in the Dingle peninsula, in a vacation house - a cottage rented by the week by its owner. An old cottage outside the community of Dingle, in the countryside, but with several neighbors, including many sheep. We met the neighbors across the street and we had beer at the pub down the street.

The Dingle peninsula has to be among the most beautiful places in teh world, and it is somewhat primitive as well. We looked out on craggy rocks in the ocean (Atlantic), took sheep paths, drove on tiny windy roads and kept running into walls on the sides of the roads. We got to know the local body shop in Dingle quite well. They did a great job of rubbing out the scratches in our rental car. And replacing tires. Tyres, I guess they are really.

Dingle is a great little town, old and "quaint" but hardly full of itself. It's a real place, with all the mod cons, more or less, including an internet cafe and a phone place where we could make inexpensive trans-atlantic calls.  But I really shouldn't be making this some sort of travelogue. Lordy. We loved it there but also loved Edinburgh. I was determined, when we got to that Scottish city, to find some areas written about in the books by Alexander McCall Smith, who lives there. I found one of the pubs, and it fit the descriptions very well. I loved Edinburgh. We knocked about there, looking at castles and a lot more, but at one point I was dealing with a lot of stomach pain and while we were in a restaurant for lunch I nearly fainted. This is when Cathy called for serious action and got me to a hospital. It was a little complicated - we made our way back to the older little hotel where we were staying and called on the concierge or whatever she was to guide us. Then I took a cab to the hospital. Spent four days there, with a hole in my stomach. This made us have to extend our stay, and changing our plane tickets was not really a treat. Had to pay for that one. Didn't get the insurance. Who'd a thunk??

How much time have I used? Eight minutes? Oh heck.

I loved being in that country. I love the oldness of it, the customs, the walking, the way one could come up on a treasure unexpectedly, like the cemetery that was up high - on a roof, it seemed like, but couldn't have been. And the portrait museum. But this is still being a travelogue. Surely I can do better than that.

The television is playing an episode of Glee right now. It is one I have seen so I am not missing it. I will want to watch the one after this one. I am watching through Hulu Plus, using my Roku. I am trying to wean myself off cable television (which I have not yet cut out, however). I watch episode after episode of so many shows. I can't remember when I last watched so much television. I do have an excuse. I am recovering from knee surgery, remember?? And I need a lot of rest and I need to do many little exercises sitting on the couch. However, I am flying to Las Vegas tonight so I should not be watching anything but instead packing and cleaning up. Trouble is, I still hurt. I figured why not get this blog post done first.  12 minutes in.

My body feels done in. I went to physical therapy this morning and iced my knee when I came back. Now, perhaps, I will get more warmed up, feel better, get my bag packed, get ready. I am not checking a bag so I am getting by with a carry-on. It will be interesting to see how well I do packing. I usually fill my car with stuff. No extras this time. No computer even - but I am bringing my iPad and I'll use that to continue with blog posts while in Vegas. Plus the computer keyboard I am using now, the one that goes with my iMac.  It's seriously time to get out of here and into...there you are! 15 minutes.

This post was written as part of NHBPM – 30 health posts in 30 days:

Sunday, November 20, 2011

Laughing Out Loud?

Today's challenge:

LOL post. Write a post about a moment that made you laugh. Or a video, picture, blog post, or something else that made you.
I can't help it. It's a video of a cat. The cat was lying on a chair, next to a soft mask of a rabbit head. The cat pushed the mask onto its head and lay back, showing off its bunny ears. It is hilarious and I did laugh out loud. I guess there will never be a shortage of cat videos online.

This post was written as part of NHBPM – 30 health posts in 30 days:

Saturday, November 19, 2011

"best of"

Today's challenge:

“Best of” post. Grab a post from your archives and repost it! Add a few sentences at the beginning to frame it. Why you chose it. Why you liked it. And why it should be shared again.
I chose this post from June 15, 2010. I was in the midst of working in the gym to relieve the effects of my arthritis. I worked with a personal trainer who specializes in working with older people and I had visited with a physical therapist to do some measurements and get recommendations. I developed this program somewhat by accident - by learning, in a seminar at a gym, that some gyms have trainers who work with people before and after orthopedic surgery. I had a flash that these trainers might be able to work with someone who is trying to overcome the limitations of arthritis, a person who is not considering surgery. In this post I wonder why it took an accident for me to come up with this program. I am still wondering.


June 15, 2010

The Arthritis Foundation reports on a study done in Canada that suggests that a majority of persons with arthritis of the knee choose their own course of treatment. The participants in the study were recruited by pharmacists and the majority were white heavy women, average age 63. (The report calls them "overweight" or "obese". I reject these terms because there is no perfect weight and "obese" is a word with no medical basis. I am fine with calling myself "fat".) I laughed because I fit that description, almost perfectly.

The researchers were surprised to find that so many of these participants started exercise programs or took drugs or supplements without advice from a doctor. Interestingly, at the start of the study about half of the participants exercised regularly, and at the end over 3/4 did. This is far higher than the average in this country, where about 15% of adults exercise regularly. This suggests to me that this is a group of take-charge persons.

It does not surprise me that so many went out on their own, without medical advice. The times I have gone to doctors for help with my arthritis have been many, and the assistance I have gotten has been minimal. In the early days of my arthritis, when I was in my 30s, the condition was not even diagnosed but I was sent to a physical therapist a couple of times. I think this was good but I did not keep it up and it was only when I started bicycling (something I did on my own) that I started to see results.

I cannot recall any suggestion from any physician that a physical fitness program could be designed specifically for me. Losing weight has been suggested and of course that's a good idea (easier to recommend than to do) but the main treatments suggested have been the use of drugs and, if possible, knee replacement. More than once I have been in such pain that I left the medical office feeling I was not heard, that my pain was not recognized. Perhaps because arthritis is not life-threatening it is also just not interesting enough. Many people have it so it's a big boring pain to the medical personnel as well.

Wouldn't it be nice if some of these doctors really thought, "How can this person really be helped?" Wouldn't it be great if some of them were enthusiastic about working with us to achieve results? When I met with Clara, my "trainer", I was most struck by her enthusiasm and hope for me, as well as her care in determining just what was hurting and how I responded to different moves. Would that I had even heard that it would be possible to design a workout specifically for me, from a doctor.

This post was written as part of NHBPM – 30 health posts in 30 days:

Friday, November 18, 2011

Return to Aqua

Yesterday I returned to an Aqua class at my gym. The Thursday leader is one of the milder ones, so I felt it was a good way to get back in. However, after 20 minutes, she relinquished the class to Cindy, one of the Movement Maniacs, who finished the class with us.

Cindy is a personable, highly active fifty-something teacher, who knows all of us. She remembers my name, what has been going on with me, the fact that I have daughters in Las Vegas, and more. She remembers these things about everyone! I have other instructors who have never even asked my name. Cindy is way at the opposite end.

And she is famous for keeping us moving. Back and forth, up and down, high and low. Yesterday she got into the pool with us because there were only five of us and it was cold. The numbers always decrease as the weather gets colder but I do keep going on the days I have chosen.

There were a few times I felt the twinge, especially when we had to do things that called for quick high bending of the knees and bicycling type moves. I made it through all right but I knew it had taken a bit out of me.

Afterwards I went to Costco to pick up a prescription refill for pain killers. I needed them, or else I would have waited and gone straight home. I found it painful to walk across that concrete floor, even though I had my cane with me. I went home as soon as I got the pills and propped up my knee with an ice pack on it. That helped. Got to work that into the plan for now, until I get better adjusted.

When I went into therapy at 8:30 this morning the therapist said I was already walking better. Clearly the Aqua class didn't hurt anything and it probably helped. My plan for now is to do therapy MWF and Aqua TThS. I may adjust that as I feel stronger, increasing my time at the gym.

Blog post comment: Translating the Jargon

Today's challenge:

A comment as a blog post. Pick someone else’s post (from the past or from today) and write a comment to them. Write that comment as your blog post for today. Link back to them to let them know you were inspired.
I responded to tmana's post on being a "polyglot". I hope I am not misstating her point: that those of us who are health activists translate the jargon of the various medical trades to patients and to others in other related trades.

As a city planner, I did something of the same thing: "translated" laws to the people who used them. Even more importantly, I often had the chance to write those laws, and did so, to the extent possible, in plain English. I think it's important to leave the jargon behind, no matter how fond of it you are, and speak in clear English. If you cannot explain a situation in plain English I believe that you do not fully understand it yourself.

This post was written as part of NHBPM – 30 health posts in 30 days:

Thursday, November 17, 2011

Let it be

Today's challenge:

Let It Be. What’s something that bothers you or weighs on you? Let it go. Talk out the letting go process and how you’re going to be better to yourself for it.
Sad to say, my weight is what has always weighed on me. I was a chubby child who grew into a really fat child and extra-large adult. At my heaviest I was challenging 300 pounds. Not that I was checking at that time, or not too often anyway. How do I let this go? I don't let it go completely. I don't know any way to do that, and believe me I've tried.

What I can let go is the belief that my weight defines anything at all about who I am. I have made this a mantra, frankly, and I repeat it often. I discourage cheering when I lose weight and I try to show up when I gain. I know that part of my perception of how I am received is in my head, but I also know that part of it is fact. I can't ignore the actions of others when they spell out what they think, when they treat me with condescension or fail to include me in activities where they feel maybe I wouldn't fit in.

From childhood I have felt that I was not as good as those of normal weight. Other children, especially boys, helped me solidify these feelings. I became defensive and was especially sensitive to anything that seemed humiliating. Over the years I have let go of a lot of that! I am much less defensive now and I have even sought humiliation (that's for another post- another blog!). I am creeping up on the fat thing.

Letting go of consciousness of my weight has freed me from inhibitions, allowing me to jump into ballroom dance classes, kayaking, and other activities that could easily make me look ridiculous. I gave up a fear of looking ridiculous and gained some confidence. I go to the gym regularly, not caring how I compare to the fitness freaks (fortunately, there are a LOT of us in the same category).

Although I have not completely let go of the fat thing I have come far enough to realize significant gains: have been able to open up more, become more vulnerable and let more of life in. I look forward to more of that.

This post was written as part of NHBPM – 30 health posts in 30 days:

Wednesday, November 16, 2011

Second time at outpatient clinic

I drove myself to my therapy this morning. Therefore, I did not take drugs to blur the pain, because driving is not compatible with pain killers. Yet it went all right. I was quite stiff when I got there, and in pain. What I did:

The bike: 12 minutes. I felt pain in both my knee and my ankle, but it eased some by the end.
The recumbent stepper: 15 minutes. Warmed up more, and the stepping helps stretch my legs a bit.
The lying-down leg press: four sets of 12 with both feet, then four sets of 12 with just the right leg (lower weight)
Leg extension: three sets of ten
Leg curl: three - or was it four? - sets of ten
Leg stretch: 7 minutes - BOTH legs. Cool. Light weight so I won't resist it.
Then, as usual, time on the table, when the therapist pushed the leg back several times, to increase flex, then pressed it down several times, with me helping at the end. This is the painful part, the most painful part, but he didn't make it last too long.

I feel hopeful. I love these machines. They really seem to work just what I need. The therapist is sensitive to pain and goes slowly. Here's a cool thing: I am scheduled to go there Friday but I can go at any time! If I feel up for it I can get there at seven, or I can sleep in and come in later, or even up to seven at night. I think this is possible because there are duplicates of all machines, enough to accommodate many clients.

After therapy I went to Panera Bread and had a bagel and latte, feeling the freedom even as I still was dealing with some pain while driving. I felt that the pain was reducing, though. I'm hopeful, hopeful, and considering going to an Aqua class tomorrow morning.

I think I can...

Today's challenge:

Write a list post with 10-15 lines that start each with “I think I can…” Write 5 lines at the end that start with “I know I can.”

I think I can hike again.
I think I can get back into real photography.
I think I can organize my office!
I think I can keep my house reasonably clean.
I think I can write a book.
I think I can get over my addiction to the Real Housewives.
I think I can find a way to sleep well at night and not so much during the day.
I think I can reach 130 degrees flex with my right knee.
I think I can get to zero degrees extension with my right knee, and closer to zero with my left.
I know I can get stronger.
I know I can learn to walk well.
I know I can get back to regular visits to the gym.
I know I can hike again!
I know I can hike again!
I know I can hike again!
I know I can get to zero degrees extension with my right knee, and closer to zero with my left.

Very much related to my recovery from knee surgery. I wonder what I would have written if this challenge had come at another time.

This post was written as part of NHBPM – 30 health posts in 30 days:

Tuesday, November 15, 2011

This one's for you

Today's challenge:

This one’s for you, baby. Dedicate a song to your condition. Why did you pick that song? Find a youtube or link to a version to embed in your post.
I am dedicating The Beatles' Blackbird to my arthritis. "Take these broken wings and learn to fly" says it all for me - find a way to live and thrive with arthritis, as I have been doing in my blog. Arthritis is a crippling condition that leaves so many of us disabled, but there is a lot of hope for many, particularly for those of us with osteoarthritis. I am aiming to learn to fly again. 

This post was written as part of NHBPM – 30 health posts in 30 days:

Belated Post: Elevator Blog

Yesterday's challenge:

Elevator blog. If you were in an elevator with someone and they asked about your blog. What would you tell them? Make a version for a 30 second elevator ride. Make a version for a 1 minute elevator ride.
Make a version for a 2 minute elevator ride.
30 seconds.

I write about my experiences with arthritis, about how I am coping with it and what I have done about it. I  do it for myself as well as for others, to keep track of specific details in my experiences.

1 minute.

I have arthritis, particularly in my knees.  I have had it for over 30 years. It has become progressively worse and I experimented, over the years of the blog (and before) with different ways to relieve the pain. I write about these experiences to keep track of what might be promising and what not, and to add to the information others gather about this disease and its treatments.

My latest effort has been total knee replacements of both knees. I am currently in recovery of the right knee surgery, and recording how I feel and what I am doing.

2 minutes.

I have had arthritis, particularly in my knees, for over 30 years. Early on, I was sent to physical therapy, which worked to some extent, but eventually did not help. The clinic I went to in those years never actually diagnosed it as arthritis, so I do not know what I might have tried had I known.

I started this blog several years ago when I came upon a book called Arthritis Rx. It is by a doctor at a prestigious medical center who has many patients with arthritis. Interestingly, he developed a program that calls for changes in diet, inclusion of some yoga-style exercises, and the use of supplements. Although he is a doctor he felt most people could alleviate their pain with these simple changes and avoid more invasive efforts. I did the exercises, made the changes, for many months. recording them in my blog. Eventually I found myself looking further out, into related techniques, to expand the effort. I tried elimination diets, additional exercises, and more. I started going to a gym that had a trainer who specialized in working with elderly people and who understands arthritis. My goal was to overcome the damage done to my knee joints by increasing the strength in different muscles, to compensate.

After being on this track for nearly a year I found I was not improving, although I was quite diligent. I read information on knee treatments provided by the Foundation for Informed Medical Decision-Making and realized that a knee replacement was likely the only course that could make a significant difference for me.  I have since had both knees replaced and have recorded those experiences.
This post was written as part of NHBPM – 30 health posts in 30 days:

Monday, November 14, 2011

Back to Outpatient

Coincidentally, I ended up going to outpatient therapy at six weeks - today - just as I did with the left knee.  I just checked my journal notes for that time, in May, and saw that I was at about the same place with flex and extend as I was with the left knee too.

I am going to a different therapist this time. I thought I'd try something different, see if somebody else might hear me better when I mention the gym and not get distracted as much while I am on various machines. I went for the ortho center that is in the same building as my surgeon's office. Same door, in fact.

I liked it. I like the machines. There are many different types, more tuned to conditions like mine. I used a step machine that is "recumbent" - I sit down while stepping. And I did leg presses while lying down. I suspect these types of changes enable the machine to focus on what is needed here. After a fairly conventional bike, I also used an interesting combo machine that let me do leg extensions (weight on top of leg), leg curls (weight under leg), and even leg stretches. This last was the most ingenious. You'll never see machines like these at the gym. I liked the therapist,too. He seemed a very comfortable person and he did not push me too far and he was encouraging. We started a low weights, which was just jolly to me. I like that. Finally he asked if I wanted to ice there or at home and I said let's do it here. I wanted to see how he did it. I sat on a comfortable soft thing with my head leaning against pillows (I was sitting up) against the wall, and my leg sitting on a pillow. Blue ice bags were set under and on top of my leg, no barriers. I managed it without too much discomfort. I guess I have been a baby about the ice at home!

The therapist - whose name I did not catch - said he'd like to work some on my right leg, too. Perfect. I want to get really good at walking nice and straight. It's quite a challenge.

While there, I talked to a guy who had surgery around the same time as I had, but he came straight home and had in-home care, then came to outpatient, so he had been coming to outpatient therapy longer than I had. He had developed an infection, which had to clear up, and then he went ahead, and he seems to be doing very well. I had thoughts that maybe I should have gone straight to outpatient after transitional care. I was concerned about getting rides, though. Maryann kindly gave me a ride today, but gradually I am going to try to do this myself.

Sunday, November 13, 2011

A Book! A Book!

Today's challenge:

Open a book. Point to a page. Free write for 10-15 minutes on that word or passage. Post without editing if you can!
This one is SO up my alley! I have hundreds of books, even though I am always "releasing them". Others creep in to take the place of the ones that have left. The question for today is - which book? The book I am reading? Which is A Million Little Pieces, by James Frey, aka A Million Little Lies? No, I think I'll leave that for now.

Just to make it more interesting I am also watching Psych on television at the same time.

The book is Tangled Webs, by James B. Stewart. Page 114, first new section. The sentence:

 Doug Faneuil was working at the art gallery when one of his lawyers called with the news.
I have no idea who this Doug guy is but the Psych episode I am watching is no. 1 from season 4, and it is about an art thief. Interesting coincidence. The news Doug received was that his favorite artist had been robbed,and not for the first time. Shirley Prattle was famous for her collages. The bigger the better, so the collages were visible all over the state, especially in public buildings.  So one being stolen was big news indeed.

Shirley was not just Doug's favorite artist. She was a good friend. Doug felt he felt he felt he - oh boy, I am starting to write like James Frey - Doug felt like he had been stabbed, it hurt so much. Doug was dusting the paintings in the gallery when he heard the news, and the brush slipped out of his hand and landed on the floor. He started to step down the ladder and slipped and fell onto the brush, which caused a bruise on his side. He yelled.

Shirley had called Doug first, and when she heard the crash over the phone she hung up and finally called the police about the stolen collage. They were tired of hearing about her losses, because this was the third one. How could anyone load such huge pieces of art onto a truck and not be seen? Needless to say, they were suspicious.

I guess this is why I don't write much fiction...

This post was written as part of NHBPM – 30 health posts in 30 days:

Saturday, November 12, 2011

A Class Act

Today's challenge: 

Teach a class. What’s something that you’re uniquely great at and could teach a class on? Write the tutorial in a blog post. Bonus points for images, links to resources, and video.

I am good at "technical writing", at writing instructions. That should help. I have learned how to overcome fears. So I'll have a go at a tutorial on overcoming fears.

1. Define the fear. Is it fear of heights? Of the dark? Of a haunted house? This step is usually simple, but sometimes the fear is hard to define. In that case, ask yourself questions until you get to it, until you feel it in your gut. (I apologize for the lack of detail in this post. It could really take a book.)

2. Ask yourself why you fear this thing. Because you might die if you fall down a steep height? Because you might bump into things in the dark or be accosted in the dark? What is it specifically that you fear?

3. Now challenge yourself. What are the chances that your fear will be realized? How likely is it that you will fall over that balcony or be shot by an intruder in the dark? What is the more likely situation? If the worst is to come then what would be the result? You will die? You will be embarrassed?  And if you die what then? No more fear. Consider the likelihood question seriously. What is the real risk? You are likely to discover that there may be certain situations that are dangerous but that in general there is little likelihood of a bad outcome if you engage in the activity.

4. Do the activity. But don't just do it. While you are standing on that balcony, continuously challenge your fears. Every time you face a fear challenge it. Don't just let it be. In time you will discover that your inner voice will be less afraid. It may happen quickly or it may take some time. Some people need help and ask a trusting person to help them through this. Many therapists, I have discovered, use a similar method, going with their clients to the source of the fear and challenging it and helping the client learn that they will not die.

Admittedly, this is a really short version of the method. But trust me, if you try it you'll find it works. Please ask me questions if you have any. I'd love to answer them.

This post was written as part of NHBPM – 30 health posts in 30 days:

Belated Blog: If it's not broke...

Today's challenge: (Or rather, yesterday's challenge)

If it’s not broke, don’t fix it. What is working well in your community, healthcare, blogs, social media, or your work in particular? What do you like about it?
I like that my arthritis blog is easy to get to, to update, to change in appearance, to post in. I love the ease of publication because it makes it much more likely that I will go ahead when inspired to write, and not put it off - as I did this one!

My blog is a simple one-person effort, which means that I have complete control. There are no external deadlines, except when I sign up for a challenge like this one. Challenges can be fun largely because they have an end! Not so much fun if they go on forever.

My blog is whatever I want it to be. I do not have to meet anyone else's expectations.

All good.

This post was written as part of NHBPM – 30 health posts in 30 days:

Thursday, November 10, 2011

Some Specifics

I am 5-1/2 weeks in from surgery on my right knee. Today these things are true about me:

* It hurts to stand on my right foot for any length of time.
* Walking is still not pain-free. But not bad.
* I am still taking pain meds, day and night. And becoming sleepy often.
* Nighttime pain seems a little less. I am crying out less.
* I have yet to have a really comfortable shower, standing up.

Future Online Activism

Today's challenge:

The future of online activism. Our favorite social media sites are constantly undergoing renovations to become quicker to navigate, easier to interact with, all encompassing, mobile, and everywhere. Imagine the same thing about your community – how will they evolve, improve, and grow?

I have not given this much thought. I think the coolest action right now is with the mobile devices. Being able to see your favorite health blogger's posts on your Android or iPhone or iPad will increase their visibility. Using tools to copy posts to your facebook page automatically is another way to spread. Facebook is killing their own app that allows automatic copies of posts but there are other options, like, that I hope will continue to work.

My wish is that we bring in more nonprofits that are focused on evidence-based medicine, and incorporate information from their sites into our blogs. The Foundation for Informed Medical Decision Making is one such nonprofit. Worst Pills, Best Pills is another. We need to get away from relying on medical websites that are supported by advertising by medical corporations. The conflicts of interest are obvious.

The health blog sites that I belong to are changing so rapidly that I am at a loss to suggest much more at this time!

This post was written as part of NHBPM – 30 health posts in 30 days:

Wednesday, November 9, 2011

My Brand?

Today's challenge:

My personal brand. As a Health Activist, you are a front-facing leader. What do you imagine you look like to your readers? What qualities do you possess. It’s ok to toot your own horn today – you have full permission to indulge. And don’t hold back.
I am what they call a "patient expert" or something like that. It means I tell the world what it is like to be me with this particular health condition. I have arthritis and I have been writing about what it feels like, what has gone well and what has not, for me, over the past several years.

The primary quality I have is my honesty and my ability to convey what is true to me. I don't pretend to know what I don't, or to be able to do what I can't. I admit it when I try something and it does not work or when I do not give my all to an effort. I admit to my fundamental laziness. You can take to the bank what I say, for what that's worth. Because we all have such differing experiences with arthritis, of course, my experiences aren't really "bankable". But they can provide some insight into the condition and some treatments. I also offer as many details as I think make sense so that others can have a better idea how a particular activity will actually be.

Another quality I have is a realistic view of the world. I like evidence. I look for it and try to find it in my own experiences. It is not always easy to measure improvement so I try to find tools or to expand my observational skills so that I can see differences when they exist.

I believe I am less fearful than many. I have noticed that many people will not attempt some things that might make them better because they are afraid of possible pain or other consequence. I consider the possibilities - what are the chances, honestly, that this action will harm me? - and take action accordingly. In my writing I clearly advocate evidence-based action and facing of fear, for I believe that we have a great deal more power over our own pain and abilities than we may think. If there is one message I hope I convey through my writing it is this, that we have the power, we are not victims.

This post was written as part of NHBPM – 30 health posts in 30 days:

110 degrees and counting

My recovery from my second total knee replacement is similar to that of the first, but also different. According to all of the therapists I have seen (and that's a lot), every knee is different, even on the same person. In fact, some people who go for both knees at the same time (a concept I find nuts) usually have different experiences with each knee, one doing better than the other. Even at the same time, with the same treatment exactly.

In the case of this knee, my right, I am having more pain now than I was at five weeks with the left knee. It isn't unusual, but it has been dissatisfying for me. I find myself wondering what I should have done differently, which is an exercise in futility. I am here now and the best thing is to go forward and to expect a good outcome. Which I do, honestly, down the line. I have been a little discouraged about not making much progress in the flex and extension departments.

Today, though, after focusing more the last two days on elevating and icing, as well as on some specific flex exercises, more than before, I reached 110 degrees flex. A solid 110. I had been stuck at about 104 so this really charges me. I feel more capable and energized. I just need to keep up the good work and hope I see the same results with the extension on Friday.

Tentatively I am scheduled to go for outpatient therapy starting next week, but if I don't feel ready for it I can keep the home therapy going longer. I am beginning to understand the advantages of each:

Home therapy: One therapist focuses entirely on me. No distractions. I get from 45 minutes to an hour (even more today, as it happened) of undivided attention. I also don't have to find a ride. The therapy comes to me.

Outpatient therapy: Appointment times may be more consistent, but this varies with the therapist, of course. There is a lot of equipment available which I do not have at home. I feel more capable because I am outside of my house.

Clearly, the disadvantages fall from a comparison of the two: with home therapy I sometimes have to make more appointment changes, based often on traffic, for example, or longer stays with the previous patient than anticipated. I also have to use what equipment I have at home, which is limited. I would love to be able to use a bike of some sort. And those stim machines available in PT offices can be helpful, although I have now learned of home "tens units" that are really inexpensive and yet effective for pain relief. Different focus, though.

With outpatient therapy the biggest disadvantage is the need for the therapist to work with more than one patient at a time. So I get stuck on a machine and left until he or she returns to me. I keep feeling I could do this sort of thing at home or at the gym. The actual time spent with specialized therapy - like "mobes" and "stims" is rather small, it seems, in comparison to home therapy.

Outpatient therapy, though, is a sign of progress. So I welcome it. I also don't need to vacuum before my appointment.

Tuesday, November 8, 2011

Three true things and one lie

Today's challenge is to tell three things that are true about me, my condition, my health activism, or my life. And one lie. Will you be able to tell the difference if I mix them up?

* I have had arthritis for over 30 years, and I am 65 now.
* I drink apple cider vinegar every day and it helps reduce joint pain.
* I have learned how to overcome fears, starting with a fear of heights that I had all my life.
* I eat a plant-based diet.  When I went vegan my migraine headaches went away. Was it the cheese?

This post was written as part of NHBPM – 30 health posts in 30 days:

Monday, November 7, 2011

For today: Write about something that gets you down, burns you out, or makes you sad. Purge it in a blog post. Turn it around at the end. Tell Tuesday why you’re ready for it.

What gets me down today is personal. I am essentially a lazy person who has to be pushed to get something done. During my work years I managed to stay on top of things, hating to turn things in late, but now I find it hard to keep from couch-potatoeing all day long. Most of the time I don't particularly mind this about myself. I have put in the time, after all. I don't pretend to be anything other than who I am.

During this "enforced" imprisonment - recovering from knee surgery - I am unable to get around on my own because I am taking pain meds and am not sufficiently recovered to be able to drive easily. So I slog around even more so than usual, doing less and less, finding it hard just to do the little physical therapy exercises that I have taken the time to list in a chart. Admittedly, some of these activities involve some pain and I avoid them. But several of the others are uncomfortable at most and it is just laziness that keeps me from doing them. So I get down on myself. It does make me sad. All around me people are actually accomplishing things. I can't even get myself to finish sewing an apron I started a couple of weeks ago.

But I do have the ability to put things in perspective. Getting it down in writing is the first step, then coming up with little plans and taking one step at a time helps me to get past difficulties that make me sad.

In about a week I expect to be back out on my own, going for outpatient therapy and doing more outside of the house. Even though I may have to ask for rides to do it. Once I am getting out of the house I will feel more in control of my life and will actually get more done. This is my pattern. I should be able to get back to the gym as well, even if only for a few days a week at first. The imprisonment, then, is nearing its end and brighter lights shine ahead.

This post was written as part of NHBPM – 30 health posts in 30 days:

Sunday, November 6, 2011

If I could do anything...

Oh lordy. Today's challenge:

If I could do anything as a Health Activist... Get aspirational. Money is no longer an option. What is your biggest goal that is now possible? How could you get there? Now bring it back down to size. How much of this can you accomplish now, in a year, in five years?
An aspiration. I can't say that my main goal in life is to be a health activist. At this point, in fact, I have no aspirations. I do have wishes and frustrations, so perhaps I am not altogether free of wanting.

Admittedly, my biggest goal is not really possible. I would like to see people facing their fears and thinking for themselves. Not relying strictly on doctors or other health professionals or even on favorite medical websites. Be skeptical, pay attention to the fine print, ask if the treatment suggested is the best, based on real evidence. Evidence-based medicine - that's what I want for this world. And a citizenry that asks the questions that need to be asked.

Start with medications. If you take any medications now are you absolutely sure that they are doing what you think they are? That they are really necessary? That they are the best medications for the purpose? That you actually need any meds at all - in other words, are you sure there is no other way to approach whatever medical problem you have? So many people take so many medications that are not as advertised and would be surprised to learn that they are not doing the job and may even be dangerous. A good start would be to contact a consulting pharmacist. I do not know how one goes about this, but a Google search is probably a good start. These pharmacists mainly work with elderly persons on many medications, but you don't have to be elderly to need one. You just need to be taking meds. In many cases these pharmacists are more familiar with a wide range of drugs and can recommend changes that reduce the number you take and even save you money (as well as improve your life).

I am going to take this a bit farther, down the near-impossible track. I realize I am not following today's challenge exactly but I am exploring and setting out my own beliefs and hopes and offering advice based on my extensive reading.

Another move to make is to do some research. Read the labels carefully and ask questions about side effects. Check with websites like Worst Pills, Best Pills, for less-biased information on drugs and for alerts on possible dangers with medications (to get full benefits from this website you have to get a subscription. It isn't that expensive and it's worth it, in my opinion). The Worst Pills website may be a little alarmist for your taste but it speaks plainly and you can easily follow up on the information it offers and make your own decisions.

If you are contemplating surgery or some other treatment look into the foundation for Informed Medical Decision Making. This organization is non-profit and dedicated to helping patients make informed decisions, without bias, about medical treatments. Their booklets and DVDs can help you understand the condition you have, success rates for different types of treatment, and other patients' experience with the different approaches.  This can be very helpful. I read their information and watched their DVD on total knee replacement surgery when I was considering this option and it clarified a great many issues for me. Unfortunately, the foundation has only begun its work and does not have information about every condition.

In general: read. Be skeptical. Get the treatment that real evidence shows is effective. Do not rely on your doctor's advice alone; many doctors are so busy that they are not able to keep up with all of the information that affects their practice, unfortunately. They may well not be aware that the treatments they recommend are not optimal.

Finally, switch to a plant-based diet. Ideally, no animal products at all, but if you can keep those products to under 10% of total calories your health will thank you. There is overwhelming evidence that this type diet is effective in reversing heart disease, diabetes, and many other serious medical conditions, and of course it helps avoid getting those conditions in the first place. Admittedly my own experience is anecdotal but when the doctors and nurses looked at my medical tests prior to and after knee surgery they said it was very unusual to have somebody with such normal readings, at my age, and of course especially unusual considering I take no regular medications. I eat a plant-based diet, no animal products, and while I overeat (a lifelong habit!) still I have good blood pressure, cholesterol, and other numbers - without really trying.

This is what I'd love to see happen in this world. I do not see how to get there. But I'll keep writing about these same recommendations.

This post was written as part of NHBPM – 30 health posts in 30 days:

Trying it out again

Friday I belatedly called for a refill of my pain medication. I went through automated systems and did not even confirm that the doctor's office had indeed authorized a refill (the prescription had no more refills authorized; the pharmacy had to fax a request to the doctor's office). Why did I wait until Friday afternoon and why did I not confirm? If the prescription were not refilled then I would have to make it through the weekend without it. I think that part of me wanted to see how I would manage.

Nevertheless, on Saturday morning I called the Costco pharmacy to see if the prescription was ready. And it was. I decided to take this opportunity to try driving again, and to pick up cat food and kitty litter while out.

I was surviving on no pain meds by the time I set out and had been in pain since I awoke. But still I thought I might do all right. Not so much. From getting into the car to pressing on the gas to moving to the brake pedal to getting out of the car it was nothing but pain. Not excruciating but damned uncomfortable. I managed to get to Costco, wait in line at the pharmacy (cursing the fact that they don't have a "take a number" system so I could just sit down on their bench), get the prescription, drive to PetCo, buy food and litter (plus the usual bag of cat food for the feline network, which was having an adoption day outside of the store), and even go to Vons to buy some groceries.

It was no picnic and by the time I got home I was very much ready to take some of that pain medication, which helped. I realized that 1) I am not yet ready to drive regularly and 2) I am not yet ready to go off the pain meds. It's disheartening but I must take deep breaths and accept where I am. I am just shy of five weeks from surgery and not progressing as quickly as I would like but there is no reason for me to expect that I won't get there.