Long time no write

I don't know why I have been neglecting this blog. I get caught up in other activities but I still need to stay on track here, keep a record.

Several weeks ago I woke with pain in my left arm. The kind of pain that comes when I have overdone something, like gone kayaking and used that paddle too enthusiastically. Yet I had done nothing, and it was just my left arm.

After a few days, when the pain was not going away or diminishing I figured it was probably arthritis. I lived with it for a while but finally, after a few weeks I went to see a doctor. He too figured it was arthritis but said only an x-ray would confirm. I did not want to pay for the x-ray at the time. He also said one help might be an injection of corticosteroid in the arm. I had heard about this from my friend, who has had it done elsewhere, and she said it worked beautifully to take away the pain. We talked of it and I decided to take plan B instead, for now: four acetaminophen tablets a day, spread through the day. See how it goes. I do not take NSAIDs because of the effect on my stomach.

I have been doing the acetaminophen for a couple of weeks now, some days forgetting of course, and in the past few days I have felt less pain. I do not know if this is from the pain relievers or if it happened just naturally, as is the way with arthritis. But it is a hopeful sign.

In other news, I still eat a healthy diet but too much of it and too often I add in fats which are no benefit to me. I have not exercised regularly lately because of recurring pain in my right leg but am trying to get back with a hike now and then.

Real progress

A couple of months ago I started again on the McDougall Plan. This post tells a bit about that start. I have been following it relatively painlessly, although from time to time I lapse and have too much fat or bread.

I have lost 20 pounds. Initially, in the first few days, the overall pain I was having in my joints lessened, and I hoped to find a culprit in the food I eat. I did not, but the pain did not grow again whatever I did, which is good enough. I discovered that coffee was causing me sleep problems and energy problems and stomach problems, all of which I could have guessed but I resisted. So I have cut out drinking coffee except now and then a cup or a half-cup. I have tea sometimes, herb tea.

After several weeks I decided to try hiking again. The pain in my right hip was not coming as often and I thought perhaps I could get through some small hikes. I did start small, and I did have episodes of startling, searing pain, but never anything that crippled me, made it impossibly painful to finish the hike. I have still not done many hikes, about seven or so, but they have gotten a little harder and longer and I am managing better. On my last hike I didn't have any of those bad episodes. I get stiff and I get tired but in a few days I am fine, or not worse anyway. I don't get worse by doing this.

Therefore I do feel hope. More than I've felt in a long time. I continue to do the ageless yoga sometimes, and want to make that more regular.

Right now I feel like I am on a plateau. Not a lot of energy and staying at the same weight. I will move past it.

McDougall conversion take 2

A while back I followed, generally, a low-fat, high-carb diet. Ornish and McDougall are doctors who have promoted this type diet for their patients and have achieved dramatic results conquering heart disease and other diseases. So I got into the habit of using water instead of oil for sauteeing, reducing fat in many ways. I was a nice weight and I had energy and most importantly my arthritis did not bother me much. But over time I let the fat back in. Not to mention other items, like white bread.

I remember several years ago when my then-tenant brought in a big bottle of olive oil and gave it to me. I wondered how long it would take me to use it up, because I simply did not use that much. Over time, though, I started using it rather lavishly, taking to heart the messages that this or that oil is "good" fat, and olive oil certainly was in that category.

Spurred on by my daughter's and son-in-law's recent attendance at a McDougall seminar, I decided to go back. Since then I have waxed and waned, given what I had to deal with (travel, for example), but now I am settling in with a fairly standard McDougall diet. I have two of his books (which include recipes) and have also looked up additional recipes online, and of course it is not difficult to convert a lot of dishes.

The good news is that I am in fact losing weight. I need to lose it to take pressure off my joints and thus stand a chance at relieving my arthritis. The bad news is that the pain persists. Right now I am suffering from hip pain that extends down my leg and often into my right foot as well. Walking has become painful much of the time, and the pain is sometimes not relieved all day long. In spite of eating quite healthily I still hurt.

So now I am considering doing an elimination diet for one week. This diet removes all likely allergens - for that may be what is going on - and if a food is a culprit in the inflammation this diet should show it up. After a week I should notice significant pain reduction.

It will be a challenge but the good part - the second good part - is that with McDougall plans there is no calorie counting, no portion control. I can eat when I want as much as I want. The food as a rule is filling but low-fat and generally low-calorie as well.

There are some things I have on hand that need to be eaten up so I may not achieve the full elimination diet the first day.

Have a look at the McDougall newsletter that explains this diet and lists the foods in it.

What now?

If I were in a controlled study for the improvement of arthritic joints I would be doing just one thing differently from before. But I am impatient and am doing two. I suspect most of us jump in with both feet when we get obsessed with making a real change, and I am no different.

So in addition to the yoga routines, I have changed my diet somewhat. I have been vegan for about two years, vegetarian for about 26. Vegan diets, like any other diets, can be healthy or not. I could try to live on french fries, for example. Vegan, but not healthy. Over the past several years I have slid into the use of more oil and more bread. Neither of these is necessarily unhealthy. Too much of either, though, can have a bit of an impact. So while I eat a lot of good, fresh foods - fruits and vegetables and grains - I have been shoveling in calories that aren't doing so much for me, and because my body is what it is, those calories have turned into extra pounds.

I do not apologize for my weight or feel guilty about it. I do not believe that I am "bad" or lacking in "will". I'll put my will against a host of thinner folks and likely come out ahead. But my body easily puts on pounds. This isn't the place to get into why my body more than that of somebody who has never been fat, so I'll leave it at that. The issue is simply that the extra weight puts more strain on my joints and causes increased pain and difficulty in moving and I'm sick of it.

So I have also moved to more of a McDougall-style diet. When I say "diet" I don't mean calorie-controlled, portion-controlled, any of that. I mean a way of eating. This way of eating means cutting out the oils that don't come naturally in the food. It means eliminating the white breads. Otherwise, it's a vegan diet based on the use of whole plant foods. I eat as much as I want.

I therefore expect that when I see improvements (note that I say "when", not "if"), they will come from both ends: from the yoga-style exercises and the change in diet.

Ageless Yoga - continuing

I have chosen to take the Ageless Yoga, Chair and Standing DVD one routine at a time. The DVD promises two hours of routines, which actually translates to five separate smaller workouts. Additional routines are created by combining elements from these five routines. So one can choose a routine from about five minutes long to about 80-90 minutes long.

My second Ageless Yoga routine, the second one I chose, was "Loosen Up", a 17-minute routine that gently loosens the body. Some of the moves are the same as for the joint routine, and the entire routine is run the same way, very gently and simply. No absolutes. Simple moves to loosen up. If you can imagine some things you might do to loosen your body those things are likely in this routine.

Third: Balance and Breath. 18 minutes. Same format as the others: the instructor sits in the middle, the two students behind and to the sides. No music. Another gentle routine, featuring movements related to balance and breathing. Nice simple balance exercises that I can see using when standing in line, for example, and breathing, of course, you can use anywhere. The series, so far, is like "pre-yoga" - using movements that may be precursors to standard poses, ways to get benefits without having to strain.

Fourth: I chose Strength. 19 minutes. The two "models" were different this time. All four I have seen so far look like ordinary people, not yoga experts, which I find encouraging. The strength moves include some we've done before - it's good to repeat, I'll remember them better - plus some new stuff. We worked feet, legs, inner and outer thighs, shoulders, arms, possibly more. But we didn't do anything for long, just little bits. I enjoyed it. There is one exercise I had a bit of trouble with, and I will want to see if I can improve. It involves lifting both legs from the floor (while sitting on a chair) and holding them in front of me. I couldn't life them fully in front of me. As usual, the instructor is very giving and forgiving, and emphasizes that we "make it yours". Find the comfort place.

At this point I am wondering if I should do more per day? Follow some kind of increasing routine? Or just keep on going through one at a time as I have been. I therefore went back to the website (agelessyoga.org) to look it over. There are so specific recommendations but there are a lot of testimonials and some of those gave me an idea that I'm doing just fine as I am. I'll keep up with it every day (when I have a DVD player - I do go on trips) and see how much I improve.

Fifth: Stretch Out. 18 minutes. As advertised, we do gentle stretching moves, most in a chair. I recognize some of the moves as some I might be able to substitute for more challenging moves in other videos. For example, when I can't do a cat stretch on the floor I can do an equivalent stretch in a chair. Some of the chair moves actually appear to do a better job on the focused area because I am not having to strain a part of my body that is in pain.

One woman who reviewed this DVD said her pain had reduced by half in two days. I would love to make such a claim. I can't, but it made me think. Concentrating on breathing and relaxation is going to help with pain, and the simple, almost comic way these are demonstrated always makes me smile.

The DVD is divided into two parts. There is a regular menu with six routines on it. And second menu labeled "Other options". These other options include "Gentle", "Chair only", "Challenges", and a few more. I am not sure if these are separate routines from the first set. I will soon be finding out, because there is just one more routine in the first group for me to try.

My sixth day I went for "Sitting only", a 30-minute routine. This routine combines the sitting portions of the other routines, primarily the stretching and loosening up routines. Even the relaxation portions from both are included, which gives us about seven minutes of relaxation. I don't know if I have ever relaxed quite as much, and it felt very good.

Ageless Yoga - part 1

I got my new Ageless Yoga DVDs in the mail yesterday. Today I tried out Volume 1: Chair & Standing Routines. I tried only one routine: joint freedom.

Almost the entire set is done in a chair. The exercises are almost not exercises in the normal sense. They are gentle movements of all of the joints, one type at a time. For example, stretching out the fingers, then making fists. No music and no mandatory type breathing. Just remember to breathe comfortably. The joint freedom routine takes 18 minutes and doesn't strain anything.

It felt like I had not done much, but I can see how using this routine regularly would be of great benefit, especially if you remember the different moves and just use them wherever you are, when you think of them. A good way to keep moving.

I'll be trying the other routines and reporting on them here as well. I am feeling hopeful.

Trying yoga

Well, I completed workout no. 64 on my wii Fitness Coach. Some of the workouts weren't wii workouts but DVDs instead. My Fitness Coach allows me to substitute other types of exercise and get credit for them. And what good is the credit? Well, it earns me additional wii workout spaces and wii workout music when I do use My Fitness Coach. Who wouldn't want those!??

I think it's good that I am still using this program. Because it keeps track of the frequency of my workouts I am more inclined to get it done. It makes me accountable in its funny little way. So I do it. At least fifteen minutes at least five days a week. It isn't much but it's how we get used to it. Further, I have found that if I do one of these little workouts before I go out I am indeed moving better. Not always a lot better but a little is a lot.

In fact, I keep thinking of the recommendation by that British arthritis organization: a little and a lot. Do a little but do it a lot. More and more I just get off the couch, wander around a bit, sit down again. I try to do a little a lot.

Now that I have been doing these little workouts for a while I am branching out. I am interested in yoga. We hear that yoga is good for arthritis. And my arthritis RX exercises are based in part on yoga. So when I got an email from Amazon several days ago advertising a Yoga for Dummies DVD for $5.99 I went to Amazon to read reviews and hunt down more yoga DVDs that might be suitable for me. The descriptions of the DVDs sounded good, all of them offering opportunities to skip poses, choose workout levels, and use alternative moves. Even though the descriptions and reviews did not specifically mention arthritis I thought they'd be worth a try.

Today I tried two of the DVDs: Yoga for Any Body and Yoga for Dummies.

I first put in Yoga for Any Body. The DVD is divided into several sections: an interview with the yoga teacher, a discourse on yoga definitions by that same teacher, and workouts divided into beginning, intermediate, and advanced. The beginning sets include several options. I chose the morning workout.

The yoga teacher starts right out sitting on the floor, cross-legged, and goes into the first position. She does not remind us to breathe nor does she spend much time describing the posture. I think one could follow the moves easily enough - if one were without physical limitation. She did not offer alternative positions or options. I hunted around on the DVD for some hint on how to use this DVD, because it felt to me like I was starting in the middle. I found nothing that met this need of mine. I decided to try another DVD.

After my aborted effort with Yoga for Everyone I put in the Yoga for Dummies. This DVD is organized in a way that made a lot more sense to me. The organization is simple: she offers twelve different "poses", which she calls the Daily Dozen. She tells us at the start that we can choose among the twelve, focus on just one if we want, or go through the entire dozen. I went through all twelve today.

But that doesn't mean I did all of the poses, frankly. I simply could not do all of them. However, she does offer alternatives for some of the poses. Some alternatives made the moves easier for folks like me, some were intended for those who wanted to move in a more advanced way. Throughout each description, which was detailed and included detailed information on breathing, the leader emphasized that the intent was the important thing. Not everyone can do every pose perfectly, and one should not push beyond comfort. I found her emphasis on doing what you can an important one. I like this DVD and expect to use it again.

However, there were times while doing these poses that I actually started to cry, just little tears, just a little whimper. Not because of pain but because I felt so limited in my function and wondered if I were so disabled that I would never be able to do this. I am always happy to start where I am and improve little by little but it seemed impossible in this case. I was already testing DVDs that proclaim they are for "every body" but they aren't.

It's the same thing I ran into with the wii workout: no recognition of physical limitations beyond being out of shape. I remembered, too, a comment on Amazon that responded to complaints that My Fitness Coach does not make any allowances for disabilities. The commenter said the workout does not advertise itself as a workout for those with disabilities. So there. Get over it.

I am not ready to get over it. I can't imagine nobody has considered this situation. There are so many of us with arthritis and with such a need for yoga for us. So I decided to do a simple search: "yoga for arthritis".

And it worked! I found several websites discussing yoga and arthritis and some that actually offered DVD workouts for us. I was so excited I ordered a double-DVD set from Ageless Yoga: one DVD is for floor and standing routines, the other for chair and standing. I look forward to reporting on these DVDs here.

More exercises!

I continue to do the wii workouts, modified as needed. And now I have another little set of exercises to try out.

For some reason I was hunting around the web the other day and I came upon the Arthritis Research Campaign, a nonprofit organization based in the UK. There is a section on arthritis of the knee that includes these recommended exercises:

Quadriceps (thigh muscle) exercises

The most important thing is to choose exercises which you can do regularly. The easiest one to do is when sitting down in a chair.

1. Straight-leg raise: sitting Get into the habit of doing this every time you sit down. Sit well back in the chair with a good posture. Straighten and raise the leg, hold it for a slow count to 10, then slowly lower it.

Repeat this several times with each leg – at least 10 times with each. If this can be done easily, repeat the exercises with a weight on the ankle (buy ankle weights from a sports shop or improvise, for example with a tin of peas in a carrier bag wrapped around the ankle).

2. Straight-leg raise: lying Get into the habit of doing straight-leg exercises in the morning and at night while lying in bed. With one leg bent at the knee, hold the other leg straight and lift the foot just off the bed. Hold for a slow count of 5 then lower. Repeat with each leg 5 times every morning and evening.

3. Muscle stretch At least once a day when lying down do the following exercise. First, place a rolled-up towel under the ankle of the leg to be exercised. Then bend the other leg at the knee. With the straight leg, use your leg muscles to push the back of the knee firmly towards the bed or the floor. Hold for a slow count of 5. Repeat with each leg 5 times. Not only does this exercise help to strengthen the quadriceps muscles, but also it prevents the knee from becoming permanently bent.

4. Clenching exercises During the day, whether standing or sitting, get into the habit of clenching and releasing the quadriceps muscles. By constantly stimulating the muscles, they become stronger.

Go to http://www.arc.org.uk/arthinfo/patpubs/6027/6027.asp to see the original page.

I also appreciated this bit of advice:

For most people with osteoarthritis the best advice is 'little and often': a little rest, followed by a little exercise.

My wii workouts fall generally into this category - 15-minute workouts. Sometimes I do longer workouts, using exercise DVDs, or I take a walk if I feel good. I can usually do a little of something if I can rest.

I will report more specifically on the exercise DVDs I like using in a later post.

gone again

The pain in my right leg - hip, I guess- has been gone for a few days now. I've been paying attention. It didn't take long for it to leave again, which is a good sign.

I do think my little workouts are helping here.

Today I did new one. It is called Strong and Safe or Safe and Strong, I forget. I will look it up.

Safe and Strong at 50, by Cindy Kozacek (pronounced Kozak). It is a strength training workout for us older folks. It isn't specifically for arthritics and I found I could not do one of the exercises. I could do the rest. Cindy offers us three different versions of every exercise, including one that's seated. She is excellent at cueing and explanations without wasting time. And she's generous in her understanding of where we may be at. The workout requires weights and resistance tubes. It is the first time I have used resistance tubes and I like them. I can see why people would like to bring them when they travel. They are versatile and lightweight and inexpensive.

I recommend this workout. I will be using it "in rotation" with others and with my wii workouts.

I am also now keeping a little notebook in which I jot down how I feel each day and any other notes that may be relevant to my health and state of mind. It's good to keep track.

Pain management

Well, curses. I do not remember when the pain in my right leg left. You'd think I would have marked that day in my memory forever but apparently I was distracted.

I do remember when the pain came back. It was this last Thursday, two days ago. I also remember what I did the day before that may have contributed to its return.

Wednesday night I went to my local college, Cal Poly San Luis Obispo, to attend the screening of a documentary. The film was to be shown in the Education building, a building I had not been in before. I looked at a Cal Poly map before I took off and I thought I had a picture in my head of where the building was. But I didn't. I wandered, actually walked rapidly (for me, considering I'm a bit slow these days) for fifteen or twenty minutes, circling and going through buildings, before I found it. Most of my trekking was on hard surfaces, asphalt and concrete. So this walking may have contributed.

My money, though, is on the standing. After the film I went to the front of the room to talk to the filmmaker. I had to wait a while to get to her and to wait for a friend who also had questions and comments. My friend noticed my discomfort, even though I was trying to hide it. I don't know how long I was standing but I do know that my experience has been that standing is far worse for me than walking.

It irritates me that I did not keep closer track of the pain so I could correlate the rise and fall better than I have so far. I now intend to get a small daily planner type notebook. I will bring it to my bedside with me at night and take it with me through the day. I will note how I feel when I get up in the morning and will note the activities I engage in as well as pain levels, as best I can. That's my plan. I hope, though these actions, to narrow down what causes me the most grief and what helps with the pain as well.