Category Archives: Arthritis

Arthritis, Be Well health tips, Health and Fitness, Keep Moving: Managing Arthritis

walking improves brain health

October 24, 2015 betsyjbell

Gentle Reader,

To my delight, my signature byline, Be Well, Do Well and Keep moving, points as much to brain health as managing arthritis. Recent studies show that walking improves brain health.

In August 2010, Live Science reported on a study involving a group of “Professional Couch-Potatoes.” This is what one researcher called the 69 adults, aged 59 – 80, who were sedentary before entering the study. I mean sedentary: they reported exercising no more than twice in the previous six months. The study compared this group of inactive people with thirty-two 18 – 35 year olds.

The result? Walking at one’s own pace for 40 minutes three times a week can enhance the connectivity of important brain circuits and combat declines in brain function associated with aging and increase performance on cognitive tasks.

The goal was not to study specific brain function, but to study connectivity. “Almost nothing in the brain gets done by one area; it’s more of a circuit,” study researcher Art Kramer, psychology professor at the University of Illinois, said in a statement. “These networks can become more or less connected. In general, as we get older, they become less connected, so we were interested in the effects of fitness on connectivity of brain networks that show the most dysfunction with age.”

Previous studies showed a loss of coordination in the DMN (Default Mode Network) when a person is least engaged with the outside world either passively observing something or simply daydreaming. This networking failure is a common symptom of aging and in extreme cases can be a marker of disease, study researcher Michelle Voss said.

People with Alzheimer’s disease tend to have less activity in this network and they tend to have less connectivity, Voss said. Low connectivity means that the different parts of the circuit are not operating in sync. Like poorly trained athletes on a rowing team, the brain regions that make up the circuit lack coordination and so do not function at optimal efficiency or speed.

In a healthy, young brain, activity in the DMN quickly diminishes when a person engages in an activity that requires focus on the external environment. Older people, people with Alzheimer’s disease and those who are schizophrenic have more difficulty “down-regulating” the DMN so that other brain networks can come to the fore, Kramer said.

In this study by Kramer, Voss and their colleagues, they found that older adults who are more fit tend to have better connectivity in specific regions of the DMN than their sedentary peers. Those with more connectivity in the DMN also tend to be better at planning, prioritizing, strategizing and multi-tasking.

Just by walking three times a week for 40 minutes, DMN connectivity was significantly improved in the brains of the older walkers, but not in the stretching and toning group, the researchers report.

If you have friends or relatives who sit around with the remote, tell them about this study and see if they would be willing to get out and walk. It could make a big difference.

One Way to Ward Off Alzheimer’s: Take a Hike

The study began with 299 dementia-free participants, ages 70 to 90, in 1989. Researchers measured how many blocks they walked per week and, at 9 and 13 years after the initial examination, scientists assessed them with high-resolution magnetic resonance imagining (MRI).

In a final evaluation,116 of these people were diagnosed with dementia or mild cognitive impairment (MCI), which can lead to Alzheimer’s disease, while 169 (excluding those deceased prior to the follow-up) remained free of these conditions.

No one has taken a snap shot of an elderly group and followed them over time prior to this study. The participants agreed to walk at least one mile per day. Erickson’s study found that walking at least one mile per day significantly enhanced the volume of several regions of the brain, including the frontal lobe, which is involved in reasoning and problem-solving.

The researchers also found people who walked that distance reduced their risk of cognitive impairment by about half. However, walking more than one mile every day did not further improve brain volume.

We don’t need to do much, but we do need to do something, every day. In my recent visit with the Sports Medicine doctor, she dissuaded me from getting a cortisone shot for my sciatic pain. She gave me some new stretches and said, “Walk 30 minutes every day without fail. It’s the best medicine.”

If my pain is acute, I leave home with walking sticks.

Before long, the pain eases up. BTW, I also take several of Shaklee’s Pain Relieve Complex herbal tablets during the day, depending on how bad the pain is.

It looks as though this advice is helping my brain as well as my joints.

Join me!

Be Well, Do Well and Keep Moving,

Betsy

206 933 1889

www.hihohealth.com shopping for Shaklee

www.EmpoweredGrandma.com for travel suggestions and reflections

Arthritis, Be Well health tips, Health and Fitness, Keep Moving: Managing Arthritis

Charlie Horse remedy

August 21, 2015 betsyjbell

Gentle Reader,

The Charlie Horse remedy is a welcome answer to miserable breath-stopping pain. Read on for suggestions on how to deal with your next Charlie Horse when it happens and how to potentially avoid its coming on.

If you have been following my blog posts from Italy, you know that I have been suffering from pain in my right leg and hip. The pain often woke me at night (and still does) with a cramp in the right calf. After multiple types of therapies, I now know that my pain is caused by the increased spinal stenosis especially around the previous herniation of L5 in my lower spine. I have an appointment to get a shot of cortisone mid-September, something I have tried to avoid for a very long time. In the meantime, this article came across my desk. I presume others have Charlie Horses from time to time. My method has been to put a soft resistant ball under the calf with the weight of my leg pressing into it until the muscle releases. The procedure suggested here sounds like it might do the trick nicely. Julie Donnelly also describes a method of working with the calf muscle prior to hiking or working out. Thanks to Dr. Steve Chaney for passing this information along. Let me know how it works for you. I’ll keep you posted on my progress. I appreciate all your continued support. Betsy

Author: Julie Donnelly, LMT – The Pain Relief Expert

You awaken in the middle of the night in excruciating pain from a cramp in one of your calf muscles. You want relief, and you want it now. What can you do?

A calf cramp is caused by several different conditions, such as dehydration and mineral deficiency. These each need to be addressed to prevent future calf cramps, but when your calf spasms wake you with a jolt at night or send you crashing to the ground in agony, you need a solution NOW!

And, stretching is definitely NOT the first thing to do.

Emergency Treatment For Calf Cramps

A muscle always contracts 100% before releasing. Once started, a calf cramp will not partially contract and then reverse because you stretch, as it may cause the muscle fibers to tear, which will cause pain to be felt for days afterward.

As a result, it is most beneficial to help your muscle complete the painful contraction before you try to stretch it. It sounds counter-intuitive, but it cuts the time of the calf cramp down, and enables you to start flushing out the toxins that formed during the sudden spasm.

Your muscle will be all knotted up, screaming in pain, so it’s good to practice this self-treatment when you are not having a calf cramp.

Grab your calf muscles as shown in this picture. Hold it tightly, and then as hard as you can, push your two hands together.

The intention is to help the muscle complete the contraction as quickly as possible. During an actual calf cramp it won’t be as “neat” as the picture shows, but anything you can do to shorten the muscle fibers will hasten the completion of the spasm.

Follow These Steps To Release Your Calf Cramps

1) Hold your hands and continue pushing the muscle together until you can begin to breathe normally again. Continue holding it another 30 seconds, bringing in as much oxygen as possible with slow, deep, breathing.

2) Release your hands and keep breathing deeply.

3) Repeat #1. This time it won’t hurt, but you are helping any last muscle fibers to complete the contraction before you move to release the spasm.

4) Begin to squeeze your entire calf as if you were squeezing water out of a thick towel. Move from the top of your calf and go down toward your ankle. This will feel good, so do it for as long as you can.

5) It is now safe to stretch your calf muscle because the cramp has completed and you have flushed out the toxins. Stretch slowly, and don’t go past the point of “feels so good”. You don’t want to overstretch.

This calf cramp emergency treatment has been proven successful by endurance athletes who have written to me saying how they could continue their race (or training) without any further pain.

This is a very important tip to share with all athletes. Please tell your friends on Facebook and Twitter, it helps athletes prevent injury and pain.

Julie Donnelly

Julie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

Be well, Do well and Keep Moving,

Betsy

206 933 1889

www.hihohealth.com shopping for Shaklee products

www.empoweredgrandma.com blogging about travel

Arthritis, Be Well health tips, Keep Moving: Managing Arthritis

Lemon water for arthritis

August 11, 2015 betsyjbell

Gentle Reader,

I don’t know about you, but this summer I have gotten lax with some of my foundational health regimen practices One result is an increase in joint pain. Too much gluten, alcohol and sweets. The one exception: my wake-up lemon drink. Even when camping, the first thing to pass my lips in the morning is a glass of warm water and the juice of half a lemon. Lemon juice for arthritis management is one of the surprising benefits of this morning drink.

This past week, an article came across my desk listing the value of the wake-up lemon drink. I learned why what I’ve been doing so long has been so beneficial. Let me pass this on to you from Krissy Brady.

11 Benefits of Lemon Water You Didn’t Know About

I was first introduced to the concept of lemon water when I started doing yoga. An avid drinker (of water!), it was refreshing to learn a new spin on an old favorite. When I started having a glass of lemon water every morning, it was after learning only two of the benefits of lemon water. Little did I know just how many there are!

Why lemons?

Lemons are packed like a clown car with nutrients, including vitamin C, B-complex vitamins, calcium, iron, magnesium, potassium, and fiber. (Fun fact: they contain more potassium than apples or grapes!)

Because of how hard lemon juice can be on the enamel of your teeth, it’s important to dilute it with water of any temperature (though lukewarm is recommended). Drink it first thing in the morning, and wait 15 to 30 minutes to have breakfast. This will help you fully receive the benefits of lemon water, which are listed below.

11 Benefits of Lemon Water

1. Reduces inflammation. Lemon water for arthritis management.

If you drink lemon water on a regular basis, it will decrease the acidity in your body, which is where disease states occur. It removes uric acid in your joints, which is one of the main causes of inflammation.

2. Aids digestion.

Lemon juice not only encourages healthy digestion by loosening toxins in your digestive tract, it helps to relieve symptoms of indigestion such as heartburn, burping, and bloating.

3. Helps you lose weight. Lemon water for arthritis: losing weight helps the joints.

Lemons contain pectin fiber, which assists in fighting hunger cravings.

4. Cleanses your system.

It helps flush out the toxins in your body by enhancing enzyme function, stimulating your liver.

5. Keeps your skin blemish-free.

The antioxidants in lemon juice help to not only decrease blemishes, but wrinkles too! It can also be applied to scars and age spots to reduce their appearance, and because it’s detoxifying your blood, it will maintain your skin’s radiance.

6. Gives your immune system a boost.

Vitamin C is like our immune system’s jumper cables, and lemon juice is full of it. The level of vitamin C in your system is one of the first things to plummet when you’re stressed, which is why experts recommended popping extra vitamin C during especially stressful days.

[warming lemon juice will diminish the vitamin C help, but even a little first thing in the morning is beneficial.]

7. Excellent source of potassium.

As already mentioned, lemons are high in potassium, which is good for heart health, as well as brain and nerve function.

8. Freshens your breath.

It also helps relieve toothaches and gingivitis (say wha?). Because the citric acid can erode tooth enamel, either hold off on brushing your teeth after drinking lemon water or brush your teeth before drinking it.

9. Gives you an energy boost.

Lemon juice provides your body with energy when it enters your digestive tract, and it also helps reduce anxiety and depression. (Even the scent of lemons has a calming effect on your nervous system!)

10. Helps to cut out caffeine.

I didn’t believe this until I tried it, but replacing my morning coffee with a cup of hot lemon water has really done wonders! I feel refreshed, and no longer have to deal with that pesky afternoon crash. Plus, my nerves are thankful.

[I still have my mid-morning Pomegranate Green Tea (a Shaklee 180 item) and I do enjoy a coffee now and then, mostly after a hike as an iced latte.]

11. Helps fight viral infections.

Warm lemon water is the most effective way to diminish viral infections and their subsequent sore throats. Plus, with the lemon juice also boosting your immune system, you’ll simultaneously fight off the infection completely.

How much?

For those who weigh less than 150 pounds, squeeze half a lemon’s worth of juice into a glass of water. If over 150 pounds, use an entire lemon’s juice. You can of course dilute the lemon juice more, depending on your personal taste.

Not only are the benefits of lemon water endless, it’s one of the most substantial yet simple changes you can make for your health.

[I warm the water in the microwave and add the lemon juice after. Microwaving the water with the juice in it might diminish the nutritional value of the lemon.]

Is lemon water part of your daily routine? Let us know in the comments!

Be well, Do well and Keep Moving. Betsy

206 933 1889

www.HiHoHealth.com shopping page

www.EmpoweredGrandma.com travel adventures

Krissy Brady

Arthritis, Be Well health tips, Health and Fitness, Keep Moving: Managing Arthritis

First barrier of resistance

June 9, 2015 betsyjbell

Gentle Reader,

I will tell you what the first barrier of resistance is not. We move right through it in our typical stretches prior to a walk, run, bike or hike.

You are stretching. You put your foot on the lower rail of the fence, leg at full extension and you lean forward to reach for your toes. You push your calf into submission. Hold a few seconds, maybe count to 30. Switch.

The run is over. In the night, a Charlie horse makes wakes you screaming for mercy. You grab your calf, knuckles bouncing off the rock solid knot. You think, Did that stretching do any good at all?

Your lower back is cranky. To get relief you lie down on the mat, swing one ankle over the other standing leg, grab your thigh and pull the bent leg in, feeling it in the T-band running down the crossed leg, thigh and into the butt. Your hip still screams when yet another set of stairs appears on the trail to Snow Lake. What good was that stretch, really?

Thinking you have been helping yourself all these years with these classic stretches, you feel despair. At the next appointment with the Myofascial Release therapist, you ask what you might try that could be a more effect method of self-care.

The first barrier of resistance. Feel for it. Stop there and hang out.

You have no idea what this feels like even though you have had a dozen treatments which have reshaped your body and given you far more flexibility than you have had in 40 years. You get on the floor together. You sit, legs out-stretched, leaning back on your arms, stiff behind you. You slowly point your toes. The pain up the T-band involving the Sciatica begins immediately. The toes barely push toward the floor. In perceptively pointed. You hold right there, listening to the body, applying a tiny bit of pressure with the toes, just short of inducing pain. After about 2 minutes, there is a release, a melting of fascia and you can point the toes a little further toward the floor before the next “first barrier of resistance” engages.

(If you explore myofascial release videos, they all present poses that are way past the first barrier of resistance for most of us over 50. Do not force yourself into a position. You will not be able to feel the resistance.)

Intolerable, you think. How can you bare to wait patiently for the fascia, that girdle of collagen that has formed an inner armor against too much fluid movement, to relax its hold? Not only is it boring but also it seems like such a tiny effort when you are used to big effort to overcome anything troubling. You find a meditation download and put on your head set. The small pressure against the first barrier of resistance becomes a mindfulness exercise, self-care on all levels. You decide to allow 24 minutes for this each morning. Stair climbing, hiking, sitting and walking are less painful. Amazing. It doesn’t take large lunges, pigeon pose, figure four ankle over bent knee.

Perhaps your neck and shoulder are your problem area. You ice, use a brace, put heat on the painful muscles and joints. You might give this self-care a try. Turn your head toward the pain and stop the minute the movement induces pain. Back off just a little and then lean gently into the pain producing position and hold. You will soon feel the fascia melt and you can move a little further until the next first barrier of resistance.

I was standing in line in Costco today and my shin and hip were bugging me. I found a comfortable standing position and moved slightly to produce this pain, then backed off just a little. I breathed into the pressure I was putting so gently on the leg. By the time I was summoned to the counter, the fascia had released and I walked without that discomfort. This is a self-care you can do sitting on a bus, at the movie or in a concert, at the dinner table or in a restaurant. Mindfully notice when pain lurks in your body. Shift so the pain lessens. Lean into the pain-producing position just to the first barrier of resistance, and hold. Deepen your breathing. Soon you will feel the relaxation of the tension that is causing the pain.

I searched the web to find videos and websites with hints for self-care. Everything I found was too far ahead of where my pain kicks in. You may find them helpful so I have included several for you to watch/read. They just left me more frustrated because I was working so hard to get into the position that my body tightened up and could not relax. I couldn’t find the first barrier of resistance. You may be less bound up than I have been.

I’d love to hear how this goes for you if you try it. Please send me any questions if I have not explained the simple self-care technique adequately.

Until next time,

Be well, Do well and Keep Moving,

Betsy

Shopping for supplements that help: www.HiHoHealth.com

Travel tips and tales: www.EmpoweredGrandma.com

Arthritis, Keep Moving: Managing Arthritis

Myofascial Release

March 26, 2015 betsyjbell

Gentle Reader,

My newest therapeutic intervention for progressive osteoarthritis and spinal stenosis is Myofascial Release. Since hurting my back in 1992 and dealing with arthritis, I have sampled and treated with private Feldenkrais (Becci Parsons). Becci restored me to functional walking, sitting, rising up from sitting, lying down and even entering and exiting a car. The next therapy was private sessions with Mary Sue Corrado, a therapeutic Pilates specialist, who, after about eight years, helped me develop enough core strength to enjoy yoga without hurting myself. You can read my arthritis history here, and longer explanations of both Feldenkrais and Pilates.

I have had some sessions with a Rolfing specialist. I get regular deep tissue massage and have benefitted from acupuncture. Myofascial Release goes to the heart, the source of the structural problems in my body that contribute to pain. It does not cure arthritis, but it helps the body gain fluid movement.

Through a series of synchronicities, a friend introduced me to Cedron Sterling. She suffered from knee pain and her doctors recommended knee replacement surgery. Instead of surgery, Cedron worked with her through myofascial release therapy. The restrictions melted away and she walks without pain.

I decided to try this treatment. I have a lot of pain in my lower back, hips and feet and my right leg goes numb especially when standing around for a long period of time, choir practice and performance, museum viewing for example. In a recent diagnostic MRI, the sports doctor could see bulging discs in the thoracic and lumbar spine, but did not feel I was at risk for a major problem that would interrupt a walking tour in England. It is troublesome to have a leg go numb, I can tell you, even if danger of debilitating injury is slim.

You can read about the therapy on Cedron Sterling’s web site. You can listen to his teacher’s talk about the treatment and the resistance to embracing it as a viable therapy.

The fascia is a thin film, an internal skin that holds muscles, organs, blood vessels, tendons in place, interconnecting everything in our bodies from the top of the head to the big toe. Over the years, I have had a number of surgeries, strains, twists and each time the fascia adjusts its hold on the effected muscles, tendons and organs. Things get tight.

For example, I had a mastectomy of the left breast in 1971 and the scar area has been rigid for 44 years. By applying gentle pressure into the barrier of resistance, Cedron was able to release all tightness in the rib cage, the chest wall, the muscles and tissue where the incision was made all those years ago. My whole left side opened up. My left arm swings wide and strong without restriction.

He has worked on my feet which have large bunions and an inflexible second toe that has held an immovable arch after a neuroma in the ball of my foot. I have been able to walk long distances without pain because of the masterful craftmanship of Dr. Huppin. He fashioned an orthotic which spread the weight bearing function of the foot out and away from this damaged area. Cedron has released the holding that caused the problem in the first place. I have been grateful for Dr. Huppin’s band-aid, but I realize now that it is no more than a band-aid. Correcting the problem at its root requires release of the fascia which was stuck in a holding position that served some purpose at one time.

Myofascial Release cannot make the body new with one treatment. You are on the treatment table for 90 minutes and the cost is $160 per treatment. Insurance usually does not reimburse for this treatment. I will probably have upwards of twelve sessions before the most binding fascia relaxes enough to give me a fluid range of motion. Once we agree that one to two times a week is no longer necessary, I will return for fine tuning monthly or every couple of months.

I am taller. I can breathe with more lung capacity. I have not had any numbness in my right leg. Better yet, I am learning how to do my morning stretches more slowly, meeting the point of resistance and gently, with the breathe, increasing the pressure and range of motion as the restrictions melt. This is not about pushing through pain. It is about release. Athletes, young and old, find new movement, relief from chronic pain. People who sit at desks all day, or do repetitive activities like playing the violin, giving facials and massage or bagging groceries can get relief. Self care instruction is part of the deal.

I recommend myofascial release therapy highly.

Be well, Do well and Keep Moving,

Betsy

Please add your comments and be in touch. 206 933 1889.

Arthritis, Be Well health tips, Health and Fitness, Keep Moving: Managing Arthritis

personal training results

February 23, 2015 betsyjbell

Gentle Reader,

I was wondering if I could walk to the car on my rubbery legs from the lunges with a weight vest on when PJ Glassey captured me on video. I had just finished my 21 minute workout with Dan this morning at the Xgym on Alki in Seattle. My goal in going to the Xgym 2 x a week for personal training is to increase bone density. At my next annual physical in Sept 2015, I’ll get that tested and report on the success. What has surprised me is the functional improvement in my daily life tasks.

Betsy X Gym Testimonial

Here’s one of the exercises, bench row with barbells.

I am in the middle of what they call splits: controlled small movements monitored for form, lasting until the muscles in use fatigue completely, about 4 1/2 minutes. Efficient and not damaging to joints. Can you see that it’s 25 lbs in each hand?

Two things: I have hiking friends who give me a run for my money without this kind of training. Some people are lucky with their genes and don’t have as much to overcome as I do. Secondly, I am convinced diet and supplements make a big difference in my recovery and improvement. I always take an after workout recovery drink Physique or the 180 smoothie Shaklee makes, to repair the muscle break down. The protein powder has leucine in it that heals muscle. I get enough protein every day from both plant and meat and fish sources, at least 100 grms. And I eat many servings of vegetables, beets, carrots, celery, kale, other greens, onions, tomatoes plus apples, raspberries and blueberries. No grains, or very little. It seems to be working to keep this arthritis-ridden body going. Hiking, anyone?

Be well, Do well and Keep Moving,

Betsy

www.GrandmaBetsyBell.com/be-well/ for more health stories and tips

www.HiHoHealth.com to shop for Shaklee products on my personal web site

206 933 1889 I still love to talk to people, answer questions, hear your stories.

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Arthritis, Be Well health tips, Keep Moving: Managing Arthritis

Pain Management

January 29, 2015 betsyjbell

Last week I questioned the wisdom of masking pain, asking if I might be missing a diagnosis by taking my Pain Relief Complex. Following up with you after 72 hours of no herbal pain tablets, I can tell you that taking them alleviated discomfort. Not taking them left me with the discomfort of aching hip joints, sore knee and ankle. The numbness in my right leg came and went, mostly went. I experienced a tough workout at the hands of JR at the Xgym, walked four miles up and down the hills of West Seattle, sat at the computer, drove the car, and attended meetings all without debilitating pain. I was happy at the end of the experiment to take a Pain Relief Complex before going to bed to insure a pain-free sleep.

I visited my chiropractor, David Kirdahy, during this hiatus. He found the usual pelvis miss-alignment, clicking and prodding everything back in place. He wondered if I might have a neuropathy in the right leg and foot. I was not able to give him specific cues as to the center of the numbness. It is hard to help with pain management when I can’t identify exactly where the pain is.

In answer to the questions, is there anything you can’t do because of numbness or pain? I had to answer, no.

I am left with the annoying unanswered question, in spite of advice from a neurologist and a nurse who read my blog post, if my activities are not impaired, why seek further diagnosis? I did that already in May of last year and have the report from the sports medicine doctor at the Polyclinic. Clearly, taking Pain Relief Complex is not covering up a condition that may need attention. I seem to be able to handle my pain management with all the measures I already use.

I wanted to show you a schematic of the COX 1 and COX2 pathways, but the pictures and science is too complicated for me to introduce here. I don’t understand it well enough to comment scientifically. I do remember the schematic the Shaklee scientist used to describe how Pain Relief Complex works. You can explore this for yourself if you are interested.

My intention here is to look at the more typical medications prescribed and over the counter that people use for pain management. The wisdom in the alternative world is that pain medication masks conditions and that pain is an indicator of something that needs medical attention. I agree with that, hence my experiment. What I have been taking for pain did alleviate discomfort. Stopping it did not reveal a condition that seems to require immediate attention.

Type of pain

Every one experiences pain differently. Some of us push through. Others of us want to eliminate the slightest hint of discomfort. Pain is a communicator from the body to us, telling us something is amiss. Pain management is different for each of us. If it weren’t for pain, we wouldn’t know to take our finger off the hot stove, or to rest with our foot elevated after spraining an ankle.

Pain can be categorized. Acute pain typically comes on suddenly and has a limited duration. It’s frequently caused by damage to tissue such as bone, muscle, or organs, and the onset is often accompanied by anxiety or emotional distress.

Chronic pain lasts longer than acute pain and is generally somewhat resistant to medical treatment. It’s usually associated with a long-term illness, such as osteoarthritis. In some cases, such as with fibromyalgia, it’s one of the defining characteristic of the disease. Chronic pain can be the result of damaged tissue, but very often is attributable to nerve damage. See WebMD. A third type of pain is psychogenic, the emotional side of physical pain.

The WebMD article classifies pain in a couple other ways: tissue damage or nerve damage; type of tissue or part of the body affected such as back pain or chest pain, muscle or joint pain.

Drug Therapy most often prescribed for acute or chronic pain

Milder forms of pain may be relieved by over-the-counter medications such as Tylenol (acetaminophen) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen. Both acetaminophen and NSAIDs relieve pain caused by muscle aches and stiffness, and reduce inflammation (swelling and irritation). Topical pain relievers are also available, such as creams, lotions, or sprays that are applied to the skin in order to relieve pain and inflammation from sore muscles and arthritis.

If over-the-counter drugs do not provide relief, your doctor may prescribe stronger medications, such as muscle relaxants, anti-anxiety drugs (such as diazepam), antidepressants (like Cymbalta for musculoskeletal pain), prescription NSAIDs such as Celebrex, or a short course of stronger painkillers (such as codeine, Fentanyl, Percocet, or Vicodin). A limited number of steroid injections at the site of a joint problem can reduce swelling and inflammation.

In April 2005, the FDA asked that Celebrex, an anti-inflammatory drug, carry new warnings about the potential risk of heart attacks and strokes, as well as potential stomach ulcer bleeding risks. At the same time, the FDA asked that over-the-counter anti-inflammatory drugs — except for aspirin – revise their labels to include information about potential stomach ulcer bleeding risks. [WebMD article on pain management]

A couple hundred milligrams of aspirin, or other NSAIDS, Tylenol or other acetaminophens for a short period of time, say 48 hours, is fairly safe. However, one of the most well known risks of painkillers is liver damage from acetaminophen. “Although [acetaminophen] has been used for years and overall is extremely safe, liver toxicity can occur with use of more than 4,000 milligrams in a day,” says Dr. Glaser. “This would be eight 500-milligram pills, which is the dosage of extra-strength Tylenol. Liver damage or failure may also occur at lower doses in those who drink alcohol regularly or who have pre-existing liver disease, such as hepatitis C.”

Because acetaminophen is often incorporated into other drugs, you may not be aware of exactly how much you’re taking, which further compounds your risk. “It’s also included in multiple other remedies for colds or sinus symptoms and is commonly paired with other stronger painkillers in medications such as Vicodin and Percocet,” says Glaser. “If an individual is not aware of this fact, he may unintentionally expose himself to amounts of acetaminophen in the danger zone.”

NSAIDs and Ulcers

Taking ibuprofen and naproxen doesn’t pose as great a risk to liver function as acetaminophen. However, some damage to the stomach lining is a possibility, which can lead to blood loss from the irritated area, stomach pains (gastritis), and even ulcers. This is also true of aspirin, which is related to NSAIDs and has many of the same properties. And if you use aspirin along with ibuprofen or naproxen, the risk to your stomach is even greater.

“Any of these pain drugs alone can cause ulcers, and using them together only increases the risk,” says Glaser. “All three of these medications reduce pain through their effects on the prostaglandin pathways.” Unfortunately, those same effects are what lead to an increased risk of gastritis and ulcer formation.

The prostaglandin pathways carry the pain signal to the brain. What these drugs are doing is interrupting the COX 2 pain pathway. Unfortunately these drugs also affected the COX 1 pathway, which resulted in stomach bleeding. Celebrex was the miracle when it came out because it did not cause damage to the stomach. Unfortunately for patients and for the drug company, Celebrex was implicated in heart attacks. [for further understanding of COX 1 and COX 2, go here.]

NSAIDs and Kidney Function

Though it’s rare, some people could risk kidney problems from using ibuprofen or naproxen. “A less common but severe complication related to these medications is kidney failure, which occurs more commonly in patients who have co-existing risk factors, such as diabetes or high blood pressure,” Glaser says.

Addiction

Some painkillers prescribed by doctors can become addicting, in particular Vicodin and Percocet which contain opiates. You can explore the internet to discover how high the abuse of these drugs has become, especially among high school students seeking to numb psychological suffering. If you have unused painkillers in your medicine chest, left over after surgery, get rid of them, especially if there are teenagers in your world.

But I digress, showing my bias against the use of medications. My original blog post tells my anti-drug bias.

There are many other options. My blog posts are full of them. I am particularly unwilling to take NSAIDS given the fact that I had Hepatitis C as a young adult, communicated by a dirty needle in the hospital when I was having a D&C after a miscarriage. In and of themselves, these drugs can be helpful. It is when they are used frequently and without regard for other conditions, such as high blood pressure, stomach issues, high consumption of alcohol. It can become a stew of interacting foreign substances.

Personally, I have found that the herbal Pain Relieve Complex does a pretty good job of keeping me pain free, along with chiropractic, Feldenkrais, frequent long walks, yoga, massage, Pilates moves and strength building training sessions at the Xgym. My trainers constantly check for good posture and make sure I avoid putting stress on joints that are compromised by osteoarthritis. Pain Relieve Complex is a COX 2 inhibitor. The Shaklee scientists found plant compounds that interrupt the pain path without any damage to the stomach or heart. I plan to keep doing what I am doing until break-through pain or severe numbness stop me in my tracks. Then I will check in with the sports doc for a new MRI. I am convinced I am not increasing my risk by waiting.

To understand how Pain Relief Complex works, click here. To order some from my personal Shaklee web site, click here.

I welcome your comments. It takes a village.

Be well, Do well and Keep moving,

Betsy

Arthritis, Be Well health tips, Keep Moving: Managing Arthritis

Do I need a pain diagnosis?

January 22, 2015 betsyjbell

Do I need a pain diagnosis?

I was standing in front of the piano along with my fellow choir members. Heading back to my seat, I realized my right leg was dangling from my hip. No feeling. Just a dead weight. While standing for rehearsal something, probably in my back, pinched off a nerve to the entire leg. Numb. If I took a step, would I crash to the ground?

This has happened before. I was alarmed by the numbness in late May of 2013. I was leaving in a few days for a writers’ retreat in southern France. While I have experience the numbness off and on during the past two and a half years, when it came on right before leaving for a 100-mile hike in England in May of 2014, I was worried. I remembered walking from Montmartre to the Shakespeare and Company bookstore on the left bank, talking to my right leg the whole way, “Lift, swing, step, lift, swing, step.”

The incident last week was much worse.

Dr. Kirdahy, the chiropractor who has been keeping me out of the operating room for years, was puzzled when I went to see him. “You have no pain?” “No” I reassured him. “I have no pain.” “How can that be?”

Maybe because I take Shaklee’s Pain Relief Complex first thing in the morning and as often as required to keep pain at bay all day long.

“What’s in this Pain Relief?”

Pain Relief contains two herbs: Boswellia and Safflower

Boswellia extract

A controlled clinical trial found that a daily dosage of 1,000 mg of Boswellia

Extract taken in divided doses significantly improved joint discomfort,

Knee flexion, and walking distance.1

In a clinical study, an extract containing boswellic acids was shown to promote

comfortable joint movement.2

Safflower extract

The benefits of the safflower are newly discovered in the West, but have a long

tradition of use in Asia.3

Kimmatkar et al. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee: a

randomized double blind placebo controlled trial. Phytomedicine. 2003;10:3–7.

Etzel R. Special extract of Boswellia serrata (H15) in the treatment of rheumatoid arthritis. Phytomedicine.

1996;3:91–94.

Hsu HY. Oriental Materia Medica. A Concise Guide. 1986. New Canaan, CT, Keats Publishing Inc. and

Oriental Healing Arts Institute, Long Beach, CA.

[From the Shaklee Product Guide, a fact sheet]

I told Dr. Kirdahy I would come back next week after 36 hours without any Pain Relief Complex.

This chiropractic visit induced a search of the literature for the answer to my question: does pain help diagnosis?

According to Spine Health, because the causes of back pain can be very complex, it is often more difficult to get an accurate diagnosis for back pain than for other medical conditions. While some spinal diagnoses are relatively straightforward (such as tumors, infections, or fractures), for many conditions there is little agreement among spine specialists about a diagnosis.

However, getting an accurate diagnosis of the cause of back pain is critical, because different diagnoses will require very different treatment approaches. And the sooner an accurate diagnosis is made, the sooner the patient can find an appropriate treatment for pain relief and to improve his or her ability to enjoy everyday activities.

Pain is our friendliest enemy — it keeps us out of trouble even though it often seems to actually be the problem.

The body ‘locates’ pain near the surface quite well but has trouble indicating the source when the pain is deep. Pain from deep injuries, diseases or infections of organs, such as the heart, stomach, lungs and back may seem to come from somewhere else nearby or may radiate into multiple places. Intense pain may be more localizing but not always.

Therefore, when back pain is accompanied with other changes, fever, swelling, redness, heat, neurological problems or changes in body functions, the diagnosis may be sharper — and the back pain diagnosis may be more serious.

The milder backaches that one feels over one’s lifetime can generally be successfully managed by simple back pain treatments — rest, medication, massage, the application of salves, exercise, weight loss and learning to put up with it.

So, if the severity of back pain does not serve as a guide for when to see a physician, the question is how does one know? While there are exceptions, there are several generally accepted guidelines of when to see a doctor for back pain:

If the back pain has any of the following characteristics, it is a good idea to see a physician for an evaluation:

Back pain that follows a trauma, such as a car accident or fall off a ladder
The pain is constant and getting worse
Back pain that continues for more than four to six weeks
The pain is severe and does not improve after a day or two of typical remedies, such as rest, ice and common pain relievers (such as ibuprofen or Tylenol)
The pain is worse at night (most common forms of back pain are alleviated by rest)
Severe pain at night (e.g. pain that wakes one up from deep sleep)
Abdominal pain that accompanies the back pain
Numbness or altered sensation in the saddle area (upper inner thighs, groin area, buttock or genital area)
Neurological problems, such as weakness, numbness or tingling in the leg(s) or arm(s).

I have seen orthopedists, neurologists and sports medicine doctors for my chronic pain. Currently, I handle the pain with Pain Relief Complex, exercise, Back2Life machine every morning, and moving as much as possible during the day (sometimes a challenge as I am a writer!) So I would say I live my life pain free.

The above article persuades me that it is time to cut out the Pain Relief for a day or two to see just how bad this pain is. Before leaving for England last May, I had an MRI and a consultation with the Sports medicine doctor at my clinic. She told me I have several bulging discs, a normal condition in people my age, but that I was not at risk for hospitalization or major trauma on my hike. In fact, she assured me, the 100 miles hike would be good for me.

And it was.

The degree of increase in the numbness worries me. Doing without Pain Relief even for 48 hours worries me, too.

I’ll keep you posted. Next week, I will discuss the most common medications used to handle osteoarthritis pain, and why you might want to think twice about using them habitually. Stay tuned.

Be well, Do well and Keep moving,

Betsy

206 933 1889

betsy@hihohealth.com

Leave your comments. They help other readers and me, too.

Arthritis, Be Well health tips, Health and Fitness, Keep Moving: Managing Arthritis

Sitting causes premature death

December 27, 2014 betsyjbell

Gentle Reader,

Sitting causes premature death. Wow, that’s a big statement. Imagine my surprise when an NRP report on the radio last week suggested that sitting will be the next “smoking” as a cause of early death. I have harped ad nauseum about the need to keep moving, but I didn’t think it would come to this.

“Sitting is more dangerous than smoking, kills more people than HIV and is more treacherous than parachuting. We are sitting ourselves to death.” Dr. James Levine, director of the Mayo Clinic-Arizona State University Obesity Solutions Initiative and inventor of the treadmill desk. Read more.

a work station that helps you keep moving.

A study conducted as part of the Women’s Health Initiative titled Sedentary Behavior and Mortality in Older Women concluded that the women with the highest rate of sedentary life had a 95% increase in death by all causes than the women with the lowest rate of sitting. The study was conducted with over 92,000 women aged 50 – 79; body mass, age, ethnicity, physical function, physical activity and chronic disease were taken into consideration. They wanted to know if there is a correlation between a sedentary life style and diseases of cancer, cardiovascular and coronary heart disease. Sure enough, there is. What we all intuited is a sure thing: you lose it if you don’t use it. Keep moving!

In the radio report, the final word was “the next position is the best position,” i.e. move.

A similar study was conducted by Kaiser Permanente with over 85,000 men aged 45. The research covered 10 years of self-reporting for activity outside of work. Men with the lowest level of physical activity were more than twice as likely to develop heart failure than those in the most active group (7.8 heart failure cases per 1,000 person years compared with 3.8 cases). The men who spent the most time sitting were also more than twice as likely to develop heart failure than those who sat the least (8.8 heart failure cases per 1,000 person years compared with 3.8 cases).

For a lot of us this is bad news. We sit at our work, sometimes for hours at a stretch. I sit for hours in front of my computer. My “to-do” list everyday includes multiple tasks that require sitting at my desk. Many of us have office jobs where we are chained to our desks. Even work that requires moving around a fair amount includes several long stretches sitting at the computer.

In the study involving men, it didn’t matter what they did for work. Only their activity outside of work was considered. Apparently a man who moves all day at work but sits all evening and on the weekends, is not protected by his physical activity on the job. I find this “outside of work” fact to be particularly interesting. KUOW reported on this study in January of last year.

What happens to the body when we sit for long periods of time? The effects are scary.

Muscle atrophy. Mushy abs; tight hips; limp gluts. You have to work your muscles to keep them.
Organ damage. Heart, pancreas and colon begin to malfunction.
Foggy brain. Slow circulation and a bent neck cause poor brain function.
Soft bones and bad back. Joint health in general deteriorates when there is prolonged sitting. Avoiding osteoporosis requires weight bearing movement.
Type II Diabetes risk increase It takes movement to get insulin into cells and control blood sugar
Cancer risk increase Colon, endometrial and possibly lung cancers in particular
Obesity increase even without an exercise program, simply moving more throughout the day keeps fat away
Depression risk seven hours of sitting a day greatly increases depression

Benefits of moving are legion. My daughter Priscilla, personal trainer and group exercise specialist, is a strong proponent of the benefit of aerating your body. She believes that a half hour of vigorous exercise a day will flush the impurities from your blood and carry away bacteria, viruses and other unwanted invaders from your system. When your circulation slows down, blood pools, clots could form.

Sitting on an airplane is one of the worse things you can do to your circulation. For those of us who love to travel, the 9 – 12 hour flights can be deadly. For those who have to fly for work, here are some tips to keep moving in the air. Flex your calves. “Your calves are often called your second heart because of the role they play in helping pump venous blood from the lower extremities,” says Leslie Kaminoff, a yoga therapist and breathing specialist in New York. Something as simple as tapping the feet will also create movement in the shins and thighs, and even in the hip joint. Drink a lot of water because it will force you to get up and head for the lavatory.

I find that when I get up from a prolonged seated position, I have more pain and stiffness in my joints. I have noticed that if I can make myself take a short walk, the pain eases. In college I used to walk around the dorm reading, mostly to stay awake, but, I now realize, I needed to move then, too.

Working at home as many people do nowadays, you have to create a schedule for moving. I use a timer to remind me to get up. I might garden for 20 minutes; fold laundry; check on the chickens. The biggest problem with interrupting yourself as an at-home worker, is getting back to the desk. You could look at the clock and realize you’ve been in the garden for two hours. It requires vigilance and discipline to take a break, move, and get back to work.

Digestion issues from sitting too long, the pancreas and colon sluggishness, can be corrected so easily. Just a short walk will get things moving. I have a friend who takes a walk with her husband nearly every night after dinner. She’s the lovely person who introduced me to Shaklee and a whole new way of life back in 1985.

This article gives suggestions for moving: sit on a ball, walk around during commercials, get out of your chair and stretch the hip flexors every hour or so, get a standing work station (I found several references to using a treadmill desk) and do the cat/cow yoga exercise several times a day. Some of these are easier than others in an office setting.

Imagine what would happen if the Surgeon General of the US decreed that movement is a health necessity, not just a health benefit.

Sitting is often a relief, a relished pleasure when you are worn out from cooking, shopping, cleaning house, wrapping packages, wandering through an art gallery and you just can’t wait to sit down. I love that instant comfort that comes from collapsing into a chair or sofa. Fine. Enjoy. Just don’t let 4 – 5 hours go by in that sitting position before you get up and move again.

All the best for this holiday season. Get out and take a walk, snow shoe, ski, shoot baskets with your kids and grandkids, dance. I’ve just started attending my oldest daughter, Grace and Jon, her husband’s Free Form Dance Dance on Saturday mornings. What a joy to move my body to great music for about 80 minutes in a big room with a wall of glass looking out into trees, and a group of people all joyously moving according to their inner guide!

Want to have a long, engaged, active life?

Be Well, Do Well and Keeping moving.

Betsy

206 933 1889

www.HiHoHealth.com shopping for Shaklee

Arthritis, Be Well health tips, Keep Moving: Managing Arthritis, travel

Chronic disabilities won’t hold you back

December 19, 2014 betsyjbell

Gentle Reader,

Chronic disabilities won’t hold you back. Get out and explore the world. If by my bravado in the face of aches and pains irritates you, my intention is not to belittle, but to inspire. This story inspires me. It may seem as though I am never down, but leap about all the time. I do get grumpy when everything hurts and I will do anything to sit down for a few minutes to rest my back, hips and knees. So, I’m with you if you are one of the people caught up short by arthritis.

Joan and Polly — Jaon and Polly at the Botanical Gardens

I just spent twelve days in Mexico with three companions, two of whom use support for walking: a walker and a hiking stick. All three are several years older than I which puts two of them in their 80s. I worried when I invited them to accompany me to my lavish time-share in Nuevo Vallarta because the walking distance from the unit to the pool is quite far. There are steps involved. Any trips into Puerto Vallarta and beyond would have uneven pavements and sketchy handicap access. Only in the USA is there a preoccupation for the welfare of a handicapped person.

So imagine my relief and my delight when these gals said, “Yes” to every adventure, walked the vast campus of the Gran Mayan complex, took a public bus home from the Puerto Vallarta Arboretum way south of town and climbed the steep ramp to worship at the great church of the Virgin of Guadalupe in downtown PV.

CAM02072[1] — Waiting for the taxi in Boca de Tomatlan

For five days before the four of us met at my time-share, my sister-in-law and I vacationed at a beach cottage at the far south end of Bandera Bay. She found it on Vacation Rental by Owner (http://www.vrbo.com/465074), La Casa de las Olas. To get there you have to take a taxi from the Puerto Vallarta airport all the way through the city which lies in the center of the Bay, to the town of Boca de Tomatlan. At this village, the coastal highway 200 turns up into the jungle covered mountains touching the Pacific again just northwest of Manzanillo. In Boca, we were supposed to meet Raul Ramos, a fisherman with an open panga, a high-powered motor and the keys to La Casa, our destination on a beach several coves along the coast. Because my s-in-l’s plane was 5 hours late and because neither of us had cell phone or internet coverage, we had no way to telling Raul we would be very late. Undaunted, we set out at 10 p.m. for Boca, routed out a guy drinking beers in the beach restaurant where we were supposed to rendezvous and asked him to help us find Raul. He knocked on the door of a boat owning Raul who appeared toothbrush in hand, wearing boxer shorts and responding, “I’ve got a boat. Let me put on a shirt and I’ll take you to Quimixto.” “Fine,” I answered him in Spanish, “but you don’t have the keys nor do you know which house it is.” Our taxi driver, wild with worry at what I would try next, begged us to let him take us away from this little town with no hotel and go back to civilization where he could put us down in safety (and go home to tell his wife and neighbors about these two crazy old ladies who insisted on climbing into a boat at midnight). We found a Best Western along the way and set out again the next morning, this time with charged cell phones and phone numbers. We were happily in the hands of Raul before noon who settled us into our fabulous beach cottage. Getting into his boat in Boca and out again in Quimixto required wading in the surf and climbing in. My s-in-l was guided onto the gunwales and Raul lifted her stick in and then each leg; then hefted our large suitcases into the open motor boat. On the beach in Quimixto, we had to reverse the process, tottering on Raul’s arm from the surf up the beach to our cottage. That was courageous of my s-in-law. She made it with fierce determination.

Once we were settled and had a look around, we were smitten by the place: an unbroken view of the ocean, waves crashing just beyond the low wall; majestic native trees rising out of pale blond sand; pelicans swooping along the wave crests; the occasional horsed rider passing by on the beach. Raul’s wife brought us a fabulous dinner of fresh mahi mahi and homemade tortillas. I made fresh lime margaritas and guacamole from the groceries I had bought in the Mega Comerciante while waiting for my s-in-l to arrive. The kitchen was a dream to cook in with its gas stove, big counter and all the condiments you could ask for plus every insect repellant you could imagine. I did get a few sand flea bites, but no mosquitoes. The air was fresh, the stars brilliant after the full moon set. The hammock perfectly located on the veranda. We each had our own bedroom and bath, not luxurious, but homey and comfortable.

The next day we decided to see the village of Quimixto knowing there was a stream to cross. The “steam” turned out to be a wide river, slow moving and shallow, thank goodness. My s-in-l used her sticks and her water shoes.

I put on my tevas and replaced them with walking shoes on the other side. The village is about five cobble stone paved blocks along with a pier at the far end and a few shops, an open church and a primary school plus private houses along the way. The little harbor is full of open fishing boats.

Vallarta Adventures brings a boatload of tourists from the cruise ships in to Quimixto and takes the people walking through town to a corral where 20+ Mexican ponies wait. Once the tourists are saddled up and instructed, they file up a trail to a dramatic waterfall about a mile and a half up into the jungle. I decided to walk this and had to cross the “creek” four more times, climb quite a bit to a bar perched on the edge of a deep pool into which the waterfall plunged. The tourists arrived by horse back after I had my viewing spot picked out, a good place to watch them jump in the water, haul the brave ones up hand over hand to a ledge and shoot down the water fall’s natural sluice. Enterprising locals had souvenirs for sale and one man offered me a giant iguana for a picture. And a tip, of course.

In the other direction from the village, a trail ran along the shore and then climbed to a long undulating ledge to another cove and another village, this one much larger though still accessible only by boat. Perched on this trail’s hillside amidst the jungle plants is a yoga center, sleeping cottages stair step up to the main yoga room at the top. The place is only 3 years old. http://www.xinalaniretreat.com/ Check it out. I walked the trail below the center, across their beach and up into the jungle towards Las Animas beach, about two miles along the coast. Believe me; I will take my hiking sticks with me in my suitcase every time I travel from now on. This trail was steep and rugged, rising and falling to streamlets.

Besides describing the wonders of this place, I want you to understand that my s-in-l suffers from neuropathy caused by complication that developed after a knee surgery. For two years now she has had a hard time walking, going numb in her foot and lower leg and the other knee is bone on bone. But, she is determined to continue adventures and will not sit down in resignation.

At the Grande Luxxe, Polly, Liz, Joan and I used the golf carts and trolleys to get from place to place on the vast campus, and walked miles to the beach, restaurants, the Santuario nightclub and to take taxis off on adventures. With careful on line research, I was able to locate an accessible restaurant right in the middle of the art galleries. We spent time admiring the art and talking to the artists, taking advantage of the weekly Wednesday art walk. The restaurant, if you are looking for fine cuisine and atmosphere, is Café de Artistas. The violin and piano duo rank right up there with the finest musicians and have a unique electronically connected way of playing together without occupying the same space. Hence, the violinist could wander throughout the many spaces and you heard them as if they were playing in the same room.

Walking to the main street that runs the length of the center of Puerto Vallarta, we watched several groups of Peregrinantes making their pilgrimage to the Church of Our Lady of Guadalupe. Typically, the groups come from parishes in the area, businesses, hotels and schools. They choose their theme which could be a float with a Virgin surrounded by the Bishop and Juan Pedro, the Indian whose miraculous vision of the Virgin is celebrated for twelve days. Other themes are dancers, flute, and drum players in Aztec costumes. We happened to be on the street corner when a motorcycle club roared to a standstill and waited their turn to process toward the church. Each group enters the church when their turn comes, brings their offering to the Virgin, receives a blessing and then disperses to the central square or along the streets where food booths invite with local delicacies: roasted ears of corn, flat bread, cups filled with cut melon and pineapple, freshly made tortillas, enchiladas, and so on. It is a logistical nightmare for some organizer and seems to work. Every group has its moment in church beginning at six and going until midnight. A Bishop is there at midnight on the 12^th, the actual Saint’s day.

On Sunday, we attended the 10 o’clock mass which was in English and Spanish. The nave was packed with ex-pats and there were a few missals in English for the people who got their early. A visiting choir sang magnificently. We looked at each other with tears in our eyes, the music was so beautiful. Most churches in PV have no choir so this was a special treat. Talking with the soprano who sang the Ave Maria, (we met her at Starbuck’s after church); we found out that she grew up in the States singing in girls’ choirs. She got her first job after college in the American School in PV teaching the kindergarteners and immediately searched for a choir. She finally located one in the Iglesia del Refugio. It was their choir who so inspired us. I’ll know where to attend mass the next time I am in Puerto Vallarta.

Another brave adventure was a trip to the spectacular botanical gardens

south of town in the mountains above Quimixto, https://www.vbgardens.org/ , the

brainchild of a group of ex-pats. Several years ago, they bought an bontanical gardns

old ranch, and its Hacienda de Oro is authentic Mexican residence, now restaurant set above the Rio Los Horcones. Birds and butterflies abound. They just opened a new Conservatory of Mexican orchids housing a collection of orchids from many regions of Mexico, some very rare. This was my third visit. I have hiked the trails through the jungle and gone skinny-dipping in the beautiful river, but this time stayed close to the orchids, Hacienda and other plantings.

Returning to Puerto Vallarta is when the adventure began. We decided to take the bus, which meant getting from the Hacienda to the highway, an uphill cobblestone drive of 200 yards, more than either a walker or a pair of hiking sticks could manage. A gardener offered to take my companions on his ARV. What a sight! Unfortunately, climbing on was almost too much for bum knees, but we all survived, managed to board the bus and ride to the center of Puerto Vallarta. Whew!

The buses run on Basilio Badillo Street which is full of art galleries, a large blown glass sales room which specializes in exports, and an oasis restaurant owned by a Canadian. We went in there and had the best, most refreshing sangria I have ever been served. A great ending to a glorious adventure and everyone feeling all their limbs, joints and bones still functional. Pretty amazing.

In conclusion, I will say that the best adventure is the one you are determined to take, regardless of your challenges, walker, sticks and all. Attitude makes the difference. These ladies were brave and resilient even when the circumstances were difficult. If you can, go, and don’t let chronic disabilities hold you back. Next year you may not be able to go.

Be well, Do well and Keep Moving,

Betsy

206 933 1889