Does it matter What I Eat?

Does it matter what I eat?

You bet it does.  But what specific dietary precautions a person needs to take to ease painful arthritis depends on a number of conditions.  First of all, there are 5 types of arthritis:

Degenerative (Osteoarthritis)

Inflammatory (rheumatoid arthritis, allergic autoimmune)

Toxic (gout)

Traumatic (old fractures, etc)

Infection (Lyme disease)

There are many web sites where you can study and learn what experts have to say about diet and arthritis.  One that I found particularly helpful is found on the WebMD website as the authors have researched the science behind popular dietary recommendations, affirming some and debunking others.  I will not go into great detail about specific dietary strategies as there are so many resources available to you.  I will offer my own experiences with various dietary interventions and especially with the supplements I have found to be helpful.

I started out with a medically induced arthritis in my knees caused by an anti-biotic.  Let’s classify that as an inflammatory arthritis.  I was a teenager, stressed out and sick with a serious sinus infection.  If arthritis results from a weakened immune system, it is perhaps not surprising that the anti-biotic kicked off the symptoms.  (Details of this are in my last post)

Foods that support a strong immune system are discussed, listed, touted, advertised on bill boards, radio, TV, newspapers, talk shows, pod casts and Face Book side bar ads.  Do we not know what they are?  Of course.  Fresh organic fruits and vegetables, especially dark leafy green ones like Chard, Collard and mustard greens, asparagus, and bring on the color: carrots, beets, black berries, blue berries, cantaloupe.  Protein from lean sources like lamb, chicken, fish provides the essential building blocks.  Minerals like zinc are particularly instrumental in the immune battle of attack on bacteria or viruses.

There is no excuse for ignorance on this topic in today’s world.  I googled “foods for immune support” and Whole Foods came up top with its thorough general article on the immune system and foods that  keep it functioning.  Whole Foods sends daily health tips including detailed articles on every vegetable and fruit under the sun and that specific food’s contribution to your health.  My friend and massage therapist Kate McCoy sends these articles on to her client list.  Thank you, Kate.

Back in 1954, we didn’t have all these details, but we knew to eat liver once a week, take cod liver oil, have several servings of brightly colored fruits and vegetables every day.  Today’s 5th graders all watch the movie Supersize Me.  They know the consequences of a poor diet.

Do we make the right choice?  Do they?

Consider traumatic arthritis, the kind that results from injury, my second type of arthritis.  A herniated disc results in arthritis eventually if not immediately.  Doctors expect injury to bring on arthritis. I remember jumping down from a high fence after this herniation.  I needed a short cut and chose to scale a chain link fence about 6 ft tall and drop down on the other side.  Because the nerves in my left leg were no longer functioning, it did not do that springy little bounce when I hit the ground and the top of the tibia broke.  I drove myself to the emergency room.  While discussing with the orthopedist at the University of Washington hospital whether surgery would be necessary, he looked right at me and predicted “You’ll have arthritis in this knee in a couple years and be in here for a knee replacement in 10 years.”

I still have the original knee and have no arthritis in it 20 years later.

I attribute the healthy and long lasting recovery from that knee break and an ankle break while cross country skiing in 1997 to some very specific dietary interventions in the form of supplements.  Every time your body suffers a major trauma like this, there is a lot of inflammation.  “ Inflammation is the body’s healthy response to infection, tissue damage or both. By sending increased amounts of white blood cells to the injured area, the body is better able to repair any damage. Without the inflammation process, injuries would not heal. Most holistic health practitioners feel that taking anti-inflammatory pharmaceutical drugs in fact masks and hence lessens the chances of proper healing.” Quoting from Michelle Schoffro Cook’s Healing Soft Tissue Injury the Natural Way 

There is an appropriate time for anti inflammatory drugs, probably in the first 48 to 72 hours, but after the initial easing of the situation, allowing the white cells to do their job and assisting with the removal of the damaged tissue naturally has a much greater healing effect.  I used copious amounts of Lecithin and Alfalfa.  Lecithin is an emulsifier, so it makes more liquid any sticky clumps of damaged cells thus helping them flow more easily into the blood stream and out in the waste.  Alfalfa is a natural anti-inflammatory bringing minerals to the affected area in ways not fully understood.  Vitamin C helps rebuild the cellular integrity in the damaged area as C is the main component of collagen, the stuff that makes the cell wall strong.  These supplemental nutrients plus daily exercises, sitting on the floor and doing leg raises with the cast on helped me come out of 3 months non-weight bearing with almost no muscle tone loss.  The swelling subsided quickly because of the supplements.  I’d say my left leg is as strong as the right one today even after these two injuries.

The final arthritis I’m going to consider from a dietary point of view is osteoarthritis, by far the most common for people as we age.   This is simply the result of living beyond our joints’ ability to keep us moving.  The joints, especially the knees and hips, wear out.  The soft cushion that protects the joint wears down and the bone itself thickens.  Bone on bone is that awful grinding that makes getting up and down the stairs impossible and kills the hip with every upward step.  Those of us who use our bodies hard with hiking and skiing, running and bending and lifting, wear the joints down even before we think we might be getting old.

Since one in five people in the US today have arthritis, you can bet there are a million stories about what foods help.  A friend of mine who had a cherry orchard in Eastern Washington swore that 10 dried cherries every day kept her from having arthritis pain.  How is a person to decide?  Trying out 10 dried cherries a day to see how that works for you isn’t a very expensive or challenging proposition.  I’m going to pass on a few more that are easy to try out.  But first.

First and foremost, you must do everything you can to get to your best weight.  Even 10 pounds less will help your suffering joints.  If you don’t think it matters that much, try carrying around 10 lbs of flour or potatoes for a couple hours and see how your knees, hips and back hold up.

The food claims—fact or fiction—that help from the article mentioned above includes a few references with which I have personal experience.  I’ll share them here.

Nightshade plants.  Some people seem to get relief when they eliminate the nightshade plants which include tomatoes, egg plant, potatoes and peppers.  I have tried this and it doesn’t seem to make any difference.  However, during one period of particularly bad pain in my lower back from spinal stenosis and osteoarthritis, I evaluated my dietary intake and realized I had greatly increased my seasonal intake of potatoes and peppers.  I cut them out for a couple weeks and did notice improvement.  There is no scientific evidence to support the claim that the nightshade plants cause arthritis pain.  Just experiment and see if you are helped when you eliminate these foods.

The Alkaline Diet.  “The alkaline diet presumes both OA and RA are caused by too much acid. Among the foods it excludes are sugar, coffee, red meat, most grains, nuts, and citrus fruits.” I have subscribed to this theory and perhaps felt some relief.  Going back to grains, nuts and fruit did not make the arthritis worse.  There are no scientific studies to support this theory.  From my own experience, when I eliminate sugar and white flour in all its delicious forms, my joints do much better.  And my weight has been stable at its ideal level for years now.  It is true that during the holidays, when the tasty pies and cookies show up and I enjoy more than one piece for several days on end, I generally suffer from stiffer joints, more painful limbs and a fuzzy brain as well.  Try doing without refined white flour for a month and see how you feel.  You might be surprised and you’ll certainly drop a pound or two.  Need help identifying aklaline and acid foods? ACID&ALKALINEchart Bevacqua 3-04 (2).pdf is a chart that will help.

Vegetarian Diet.  Especially people suffering from rheumatoid arthritis get relief when they switch to a vegetarian diet and that relief remains pretty constant over time.  I followed a vegetarian diet for several years after being diagnosed with breast cancer at age 34, and ran myself completely in the ground, became extremely anemic and exhausted all the time. I had no idea how to eat a healthy vegetarian diet.  Now that I know more about all the wonderful ways you can get complete protein, I might not be so adversely effected.  When I talk with vegetarians who depend on cheese and pasta, I shudder to think of their joints.  There is a science to getting all the nutrients you need, especially that chief building block, protein, from a vegetarian diet, so get the knowledge you need to eat well.

Switching fats.  Probably the most helpful of the popular suggestions is this one.  Get off butter and corn oil and switch to olive oil.  Omega 3, fish oil, borage oil, Evening Primrose Oil, and Flax seed oil really do make a difference to cranky joints. Butter just congeals.  You’d be surprised how much you can come to enjoy olive oil over butter and you’ll love the results in your joints.

Green Tea.  I was not expecting this in the list, even though I have known about the benefits of a Pomegranate Green Tea that I have been drinking for a couple years now.  Combining green, red, white and red tea in a power that can be taken in hot water or cool has a 2 page of beneficial properties not the least of which is joint comfort.  There is evidence in the scientific community to back the claim that green tea helps with arthritis.

Chondroitin and Glucosamine Many take supplements containing these together and get some relief.  In a fascinating article on an Orthopedics web site, I learned how glucosamine and chondroitin work.
“Glucosamine and chondroitin are two molecules that make up the type of cartilage found within joints. Inside your joints, cartilage undergoes a constant process of breakdown and repair. However, to be properly repaired, the building blocks of cartilage must be present and available. The theory behind using the glucosamine and chondroitin joint supplements is that more of the cartilage building blocks will be available for cartilage repair.

  • Glucosamine is a precursor to a molecule called a glycosaminoglycan-this molecule is used in the formation and repair of cartilage.
  • Chondroitin is the most abundant glycosaminoglycan in cartilage and is responsible for the resiliency of cartilage.

Treatment with these joint supplements is based on the theory that oral consumption of glucosamine and chondroitin may increase the rate of formation of new cartilage by providing more of the necessary building blocks.”

Unfortunately supplemental use of glucosamine and chondroitin “ has not been shown to alter the availability or quantity of these cartilage building blocks inside an arthritic joint.”

Long term users of these supplements do experience less pain and often can discontinue the NSAIDS medications.

The joint health supplements I take are manufactured by the Shaklee Corp.  Their scientists have also found no evidence that chondroitin taken orally increases cartilage.  Their product uses boswellia, a botanical that interferes with the damaging action of chemicals in our body that attack cartilage.  New research suggests that chondrotin interferes with the absorption of glucosamine, the primary building block of new cartilage.  Adding boswellia may indeed deliver more of these glucosamine building blocks to the joints where they can actually build new cartilage.  Shaklee’s glucosamine is shell fish free and has C, zinc, cooper and manganese, all helpful in supporting healthy connective tissue.

I hope these comments have been helpful and have added to your own research into dietary and supplemental help for arthritis.  The most important take away is weight management.  Amongst my hiking and cross-country skiing buddies, most of us in our late 60s and 70s, most of us are at our healthy weight.  We are still moving well. However, joints have begun to wear out and one of our group had a hip replacement last year.  She is back hiking and skiing with us.  Age takes its toll, but good diet, healthy weight and continued exercise can keep the aging joints moving.

In my next post I will consider pain relief.  I’ll be back after a brief hiatus enjoying the sun on the Mayan Riviera.

Be Well, Do Well, Keeping Moving.

Betsy Bell

Betsy Bell’s Health4U

www.hihohealth.com

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Diet, Medicine and Supplements for Arthritis, the back story

Gentle Reader,

Before going into dietary suggestions, I want to share how I came to hold the beliefs and attitudes I have about allopathic medicine.

My father was an Orthopedist.  My mother was a nurse.  They believed in the miracles of medicine.  Mother worked for a General Practitioner during a New York City outbreak of the flu in the 30’s.  It was nothing like the great Pandemic that swallowed up between 20 and 40 million people, but she and her doctor never saw their whole list of patients in a day’s work.  When my parents met at the still new Morrisania Hospital complex in the Highbridge section of the Bronx, he was an intern, she a nurse.  Beginning married life in the Great Depression, theirs was a youthful enthusiasm for life, for medicine as a burgeoning panacea, for a future for any hard working person.

By the invasion of Normandy, recently discovered penicillin would save thousands who might otherwise have died of infection.  He would have had penicillin in his kit on board the USS Boise in the South Pacific where he was a navy doctor from 1942-45.  Before the war, practicing from his office in our home in West Chester County, NY my father became involved in the debilitating and wide spread polio epidemics of the late 1930s, early pre-war and on into the 50s years.  I remember his lecturing to parent groups and civic leaders about good diet and rest.  He encouraged people to continue to mingle in public places, but not large crowded movie theaters or swimming pools.  He felt isolation prevented the buildup of immunity.  He took me and my brother on home visits to polio patients, mostly children, expecting us to get exposed and build immunity.  Imagine his excitement when the poliovirus vaccine against polio wiped out this disease in the later 50s.  Much of his work in New York and later in Oklahoma beginning in 1947 was with polio victims and their rehabilitation through therapies and prosthetics.

I recount this history to get a better understanding myself of the enthusiastic embrace of pharmaceutical breakthroughs on the part of my parents.  Unfortunately my father’s excitement over each new drug led to indiscriminant experimentation with himself and his children. The largest drawer in the bathroom cabinet was filled with physician’s samples.  At the slightest sniffle, I would be offered the latest anti-biotic.  One such drug caused my first arthritis.

I was in high school, a competitive swimmer and when I came down with a serious sinus infection and was unable to continue swim practice, he gave me several doses of a new drug.  Unfortunately it settled in the synovial fluid of my knees causing pain especially when sitting in the back seat of a 2 door car or balcony seats in the theater.  Folding my legs tight was extremely painful.   I used aspirin for relief, carrying a bottle in my purse and often eating several tablets without benefit of water.

I deviate to tell you a little story about drugs and the Johnson family.  My brother Eric and I raised white Leghorn chickens for a 4H project.  The county extension agent recommended growth hormones.  This is the 50s when better living through chemistry was heralded on every side.  My brother decided he could hurry his growth by drinking one of the vials himself.  He was about 12 at the time.

Sometime during college my knee pain subsided somewhat, but residual creaking persisted.  Nothing stopped me from an active life of biking, swimming, walking, dancing and anything else where movement was involved.  There was always a bottle of aspirin in my purse.

Winters were tough on me.  I often had colds that descended to the chest, became bronchitis and required antibiotics.  A typical winter saw three rounds of colds, bronchitis and antibiotics.  Following my father’s model, at the first sign of the sniffles, I started taking Coricidin, drying up the natural response to a cold virus.

This cycle happened year after year until my senior year in high school, my sinus condition became so severe, and I begged my father to take me to a specialist in Oklahoma City.  It was a 4 ½ hour drive and a full day away from his own medical practice.  I remember sitting next to him in the front seat of our Nash station wagon, feeling special that he would make this effort on my behalf.  I am sure I had been a willing user of all the drugs he had offered me over the years.  After the office visit and some diagnostic procedure like today’s nasal endoscopy, the specialist told me there was nothing that could be done surgically.  I should give up swimming and certainly never dive into the water.

Medicine could not perform the magic I wanted.  My disappointment was profound.  I would not give up swimming.  I would wear ear plugs and a nose clamp, taking precautions.  Within three inactive winter months, I had gained 25 pounds.  No one noticed until one day a Doncaster clothing representative had set up his wares in our living room for my mother and several of her friends.  Mother urged me to try on several stylish slim fitting long skirts from his model size 12.  When I could not close the zipper, standing there in my bra and panties, she all but shrieked at the sight of me, belly too large with angry stretch marks running diagonally in two tracks down each side.  Now that I was the object of close inspection, further stretch marks were discovered on my breasts, buttocks and thighs.

This humiliation was reported dramatically at the breakfast table the next morning.  My father laid down the gauntlet, my two younger brothers cheering him on.  I would lose this weight.  Mother, who had slowly put on a few extra pounds, challenged me to a contest to see who could lose the most by summer.  Drugs to the rescue.  We bought boxes of those little chocolate and caramel chews laced with phenylpropanolamine – a substance the FDA has now ruled “not recognized as safe”.

What were we doing?  Lose weight without dieting.  Miracles through chemistry.

When I married Don Bell after my sophomore year in college, I was still a round person, strong, athletic, but carrying 25 extra pounds.  He gladly took over my father’s task of counting my calories and checking my weight every day.  But I needed to flex my independence from this tyranny and did so by eating a delicious double dip ice cream cone every afternoon from the shop on the University of California Berkeley campus.  After months of this indulgence, I experienced a humiliating episode of uncontrolled bowels.  I was paralyzed with cramps and loose stool as I trying to walk home from campus.  Finding a pay phone, dialing through tears, Don came to pick me up.  Tenderly sympathetic, he helped me to the bathroom where I cleaned myself up.  At an appointment with a proctologist the next week, I had to confess to the daily intake of rich creamy cones which had caused this mess.  Ice cream is not my friend.

In January of 1971, I was diagnosed with breast cancer and wheeled into the operating theater on the day my oldest of four daughters turned 10.  I made a pact that day with God that I would do everything in my power to lead a healthy life so no cancer would return.  Making sense of cancer at age 34 led me to believe all those antibiotics and other medications over the years had destroyed my own immune system’s ability to respond.  Perhaps irrational but nonetheless compelling, I decided against allopathic intervention for any illness I might develop until I had tried everything else.

Now that you have the back story for my crusade to heal the body without medicine, I will tell you what I have discovered to be helpful dietary choices and supplements.  Stay tuned.

I’d be interested in your story around medicine and medical intervention.  How do you feel about drugs?  How did you develop the attitudes you have?  Please share.

Be Well, Do Well and Keep Moving.

Betsy

Betsy Bell’s Health4U

www.HiHoHealth.com

 

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Hiking the Wonderland Trail, Mt. Rainier 1990/2006

Gentle Reader,

The Goodwill Games brought 2300 athletes from 54 countries to Seattle in the summer of 1990.  My husband, Don Bell, chair of the public forum, Target Seattle: Preventing Nuclear War, in 1982, helped organize the representatives to the games from the Soviet Union.  Our house, a few blocks from the University of Washington football stadium where the opening ceremonies were held, was full of Soviets, young Russians in their 30s and a few Uzbeks from our sister city, Tashkent.  During the eight years between the first events in ’82, many groups traveled to and from the Soviet bloc including cooks (Peace Table), a team making and taking prosthetics and organizing competitive handicapped soccer matches here and abroad to name just a couple.  Many had been in our home.

In the middle of this pre-Goodwill Games opening swirl, my youngest daughter, Ruth and I worked in our spacious dining room preparing the food for our 13 day back packing trip on the 95 mile Wonderland Trail around Mt. Rainier.  Visiting Soviets–Uzbek and Russian–were mildly curious as we assembled a large metal bowl full of homemade granola and protein powder and then filled zip lock bags for each morning.  A second bowl contained all the ingredients for our favorite gorp which we mixed by hand, digging deep into the M & M’s, roasted almonds, sunflower seeds, dried cherries, peanuts and dried plums.  Salami sticks, blocks of hard cheese, rye crackers were divided for lunches.  We put together mixtures for the evening meals: peanut butter soup (too rich) and other quick meals, not all freeze dried.

My next youngest daughter, Eleanor, arrived a day before our early departure for the Ranger Station where we obtained our permit and assigned camping spots along the route.  She lived in Berkeley where she was in graduate school and took the train up to join us.

Less than a year earlier, I herniated disc L5 and began the therapies to get myself to this point.  We divided the gear, a 3 person dome tent, stove, sleeping bags, mats, clothes and food so each had about 36 pounds.  The girls probably carried more than I did.  I did not have hiking poles which turned out to be foolish.  I now use them on every hike except the short 3 – 4 mile ones in the city parks.

Our permit sent us counter clock wise around the mountain starting at Mowich Lake in the upper north west corner.  Others had secured camping spots high up on the ridges.  We had to settle for the valleys of the Mowich River, the North Puyallup and the South Puyallup rivers, Paradise River, Nickel Creek with Summerland the only up-slope campsite.  Our disappointment turned into delight as we were on top of the world each mid day and could skinny dip in the high lakes unnoticed.  We planned food pickups at Longmire where a car was parked with the next section’s food in the trunk, and again at Sunrise where Don was to meet us with the last segment’s food stash.

I fared well hiking carefully, thinking Pilates moves with each step.  I favored the left leg worrying that it would not sustain strength over the full 13 days.  Eleanor suffered knee pain from the extreme up and down each day.  We descended 2500 ft our first day, carrying full packs.  The next morning we gained 2400 ft by lunch time, took a dip in Golden Lake and descended 1400 ft to our riverside camp site.  I’d been training on stair cases and was managing well.  Eleanor was having so much trouble; she decided to leave the hike and took the car home from the Longmire parking lot.   After picking up a hiking stick and salty gorp (we forgot the need for extra salt when sweating so much), Ruth and I got our campsite settled and then hitched a ride up to Paradise lodge in a camper van from the Narada Falls visitor overlook.  Enjoying a pitcher of beer in the bar at Paradise, we eves dropped on a group from Minnesota just down from summiting Mt. Rainier.  The flatlanders had a tough time with the altitude, and a couple of them could not make the top.  I realized I had no intention of ever climbing a snow capped mountain.  Little did I know then that I would attempt Mt. Shasta in 2005 reaching 13,000 ft.

Hiking around Mt. Rainier weaves in and out of civilization and wilderness. Within 200 yards of a paved overlook, crowds of summer visitors trip along in high heels, flip flops, pushing strollers, tipping back cokes and munching on chips. Into this scene emerging from 4 days in total wilderness appear 3 women, sweaty headbands, heavy boots and packs, unwashed faces and unkempt hair.  We did not dally, but pushed through the milling groups to find the forest trail again.  Only at Longmire and Paradise did we take advantage of the amenities.

By day 7, my right leg and hip were becoming so painful it hurt to take each step.  The right side had compensated for the weaker left leg and ankle.  Using my new walking stick with each left step put more stress on the right side.  It was an eleven hour day covering eleven miles, up over snow fields and through spectacular fields of flowers, high bubbling streams, and alpine moon scapes above the timber line.  One special moment I remember all these years later, I lay down on the trail to rest just a few feet from a large rust, grey and back marmot slowly nibbling his way across our path to the lupine beyond.  We could hear him ripping flower heads and chewing.  Carrying my stick in both hands and putting each foot down as evenly balanced as I could, we finally descended into Summerland in the dark, head lamps locating a camping spot.  All I could do was get into the tent and stick my aching feet straight into the air.  We managed to fix dinner and were sound asleep without seeing the incredible beauty that awaited us in the morning.

From Summerland to the White River camp ground is a short distance.  Thy day was hot and clear.  In the wash house, we washed our hair hoping to look presentable for our men who were meeting us in the late afternoon.  It was August 8.  We began the 2000 ft. ascent in bright sunshine.  Half way up the 2000 ft gain from White River to Sunrise, heavy weather caught us.  Clouds, thunder and lightning moved in quickly followed by hail.  The alpine trees are so short at that elevation, they offered no protection.  We put on everything we had to keep dry and warm and hurried up the last couple of miles, a stair case to the Sunrise parking lot to find Don and Ruth’s boyfriend sitting in the car with the windshield wipers going full blast.  They convinced us to abandon the last segment of the hike, 35 of the 95 miles still to go.  When we got to the Mowich Lake parking lot to retrieve our car, clear sky and full sun greeted us.  Mt. Rainer makes its own weather and the storm was confined to the Sunrise side of the mountain   So disappointing.

Persuading me to quit was not too difficult. I doubted my ability to do the last 35 miles.  That remaining section of the Wonderland Trail haunted Ruth and me.  We tried again to do it from Mowich to Sunrise in 2000 and were snowed out again on August 10th.  Finally after I had trained and climbed Mt. Shasta in July of 2006, I felt was strong enough to carry a pack, and we completed the Northern loop in August.  Our circumnavigation of the mountain did not end on the Wonderland Trail.  Those permits were all taken.  We began in mist hiking in from Lake Eleanor through Grand Park, a little known back entrance to the Park from the north. The second day we walked in heavy wet weather, moisture coming up and in sideways from the water laden plants along the narrow underused trail.  On the third day the sun broke out to reveal the most glorious infrequently visited section of the park, Yellowstone Cliffs.  Climbing out of Carbon River to Seattle and Spray Parks in hot sun, we breathed the fragrant air, eyes feasting on a sea of wild flowers and deep green grass.  Spreading our wet gear out on high rocks to dry, Ruth and I read, sketched and languished lazily before finally hiking the last miles to meet our waiting family.  We could now claim the Wonderland Trail, 95 miles of absolute glorious wilderness.  My first 60 miles celebrated my 53rd birthday.  The last segment celebrated my 68th

This blog post is a reminiscence of triumph over injury, of doing a great physical activity against all odds.  I know you have had similar triumphs.  I hope you are inspired to keep moving.  Do not give up. Leave a comment with your story.

Be Well, Do Well.  Keep Moving,

Betsy

206 933 1889

betsy@hihohealth.com

http://hihohealth.com

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Pilates for back pain?

Pilates for back pain?

Becci announced that after 6 months of attentive Feldenkrais sessions, I was now ready to see Mary Sue Corrado.  Like Becci, Mary Sue is a former dancer and turned to Pilates as a path to help increase body awareness, find pain free exercise movements and improve posture.  After several private lessons in her Bodies in Balance studio, I joined others in her semi-private classes.  The hour and a half sessions were serious business.  For 8 ½ years I showed up, mostly on time, took off my shoes, gathered my tools—ethafoam, blocks, triangular cushion, theraband, little foam roles for my neck, wrists, knees—and began my routine under her watchful eye. (In Seattle, we have http://friendlyfoam.com/ store that sells all sorts of therapeutic foam).

There was no side talk amongst the other students.  “Make a coffee date to talk about that,” she would instruct if we fell to gossiping.  Mary Sue was free to talk about what was on her mind, however.  We just turned to Pacific Standard Time and I can hear her voice complaining about moving toward the dark of the year and fussing with the clock to hasten it.  Mary Sue would describe walkers she had observed as she did Green Lake and exclaim that she wanted to go up to people and indicate ways to improve their stride, back position, swing of the arms.  It is no wonder that her nickname is the “Posture Police.”

I loved and hated those sessions.  They saved my life.  With Feldenkrais, Becci had moved me.  Our effort on her table was to gentle my tendency to push my body; to learn to listen to it and use all supportive muscles to lift, twist, bend for natural flow.  My graduation to Mary Sue’s brand of Pilates meant bringing effort to the work.  She showed me how to place a gentle finger on my abs as I lifted a bent knee leg inches off the floor so that I could be sure they—the abs were doing the work and not some other muscle.  I was to isolate the working part and its tendons and muscles and teach the particular mechanism to do the job without engaging non-essential parts.

One particularly difficult lesson for me was lying on the mat face down, arms out-stretched over my head, and lifting one arm and the opposite leg barely off the ground.  I was instructed by her gentle hand on the muscle below the shoulder wings to lift from way down, the erector spinae,  not the trapezius.  Of course, my shoulder muscles wanted to scrunch up around my ears to help.  She would lightly touch the big triangular muscle below.  I gradually learned to engage it and leave my traps lying quietly along side the upper spine.

Do you know where your multifidi muscles are?  Lying under the erector spinae.  This ropy length of muscles on either side of the spinal column are primarily responsible for holding you up.  Mary Sue was helping me re-discover these essential muscles.  I needed them to function if I was going to carry a heavy pack for 12 days on the Wonderland Trail.

I call this blog NoWheelChair for a reason.  When Dr. Herring, the UW Sports Medicine Neurologist

looked at my Magnetic Resonance Imaging—MRI, he declared my bones to be poor candidates for surgery.  They already looked worn out at age 53.

“You are going to have to build strong supportive muscles.  Your bones are no good.  If I didn’t know you and with only your pictures to go by, I’d think you should be in a wheel chair.”

Pilates was my ticket to strong muscles.

Let me add here that not all Pilates is the same.  Mary Sue had more than one client refugee from improper Pilates technique.  In a large class with no personal, hands-on supervision, one can easily over-strain the back, especially in the 100’s, a Pilates exercise where you form an inverted triangle with your bottom at the base, your torso and legs extended to form the sides.  With your arms held tight and straight, you pulse forward engaging the abs as you breathlessly count to 100.  Mary Sue did not approve this posture although her students did plenty of ab strengthening V shaped exercises as we progressed to that level.  I confess that I have never attended any other Pilates classes.  You see, I am such an energetic learner that I will attempt anything the instructor calls out and end up over doing and hurting myself.  Remember in my first post when I described following Jack LaLanne as he performed doggy leg lifts, even though it hurt like the blazes.  I figured pushing through the pain would cure the pain.

“Nothing should ever hurt,” was Mary Sue’s mantra.  Since my daily activities often produced aches and pains, I showed up in her studio once too often hurting in the tiniest beginning exercises and she made me start all over at baby steps.  It was the always having to begin again that made me search for something else after eight and a half years.  Happily I still begin most days with her voice in my ear, my index finger lightly touching my abs as I do my tiny leg lifts, pelvic tilts, and controlled crunches.  I bought a strong iron footstool on Ebay to use for the standing exercise where one foot is placed in a length of sports tubing, the other end of which is held tight over the top of a closed door.  Standing on one foot, the other swings back and forth across the erect, perfectly postured body.  This exercise particularly helps with balance and strengthens each leg’s abductors and adductors.

I have not found a Pilates instruction You Tube for you.  Everything I looked at is geared to athletic strengthening, does not use any of the foam pillows and blocks designed to help an injured body isolate the muscles that need to be recovered while the others rest.  We learn so many compensatory strategies to help us avoid pain and keep us moving.  Quite often, these strategies exacerbate the painful condition rather than help it.  Therapeutic Pilates may be necessary before Pilates itself, in the normal studio for normal people, will be beneficial for someone like me.  I found one website that advertises a therapeutic approach to Pilates.  If you have plenty of money and time, you can check it out.  I was lucky enough to have a couple former dancers bring my back to life again right here in Seattle.

Next week I will tell you about the hike.  We nearly made it all the way around Mt. Rainier. It was one of the greatest adventures of my lifetime.

Be well.  Do well.  Keep Moving.

Betsy

BetsyBell’s Health4U

www.HiHoHealth.com

Betsy@HiHoHealth.com

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Feldenkrais for back pain?

Dear Reader,

Feldenkrais for back pain.  My neurologist, head doc for theUniversityofWashingtonsports teams, suggested I see Becci Parsons, former dancer, now Awareness Through Movement and private Feldenkrais practitioner.  “Watch out for your pants,” she said.  “Your clothes can be dangerous to your health.” Her levies were on the baggy side.  You could put your balled up fist between flesh and belt when she sucked in her breath.  I remembered that when I put a new (ValueVillage) pair of genuineLevis, hip hugger style, which I love, and my back talked to me nastily.

She laid me on a low table just wide enough for me with her kneeling next to me to move my legs, my head, my shoulders.  Her movements were minuscule.  I struggled to let go, to allow her to be the conductor.  I attempted to refrain from guarding, tensing, pulling back or from anticipating her next move and helping her lift, roll, twist.  My only job was to let her have my body, let her move it and pay attention.

When the session was over, I could identify my surroundings but I seemed to inhabit Oz’s Scarecrow navigating uneven ground.  A dreamy hand opened the car door.  Taking the wheel, putting on the gas, I began to reengage with this road, this stop sign, this merge onto the freeway.

Subsequent sessions began lying on the table with the gentle rocking, lifting, moving by Becci while I slowly allowed her to propel my limbs in tiny unchecked movements.  She taught my muscles to reclaim movement appropriate to healthy, uncomplaining joints.  She brought me to homeostasis.  On the table.  To teach me to roll out of bed, to sit on the side of the bed, to lift myself off the bed, to take steps, find the bathroom, lower myself on the toilet and rise again, she gently rocked my hips, held my hands, lifted my leg and set in down.  Retraining.

As a girl, I proudly walked to school several blocks with a marble held tightly between my buttocks.  In 4th grade, I could carry that marble clamped tight all day as I sat at my desk and walked to the black board, to the coat closet, out the door for home.  What glut control!  My father, the orthopedist, had a cartoon on his office wall of a woman whose naked breasts sat on top of a dresser.  The top drawer, open just a little, pressed her ribs; the second drawer down, open about half way, pressed her waist; the bottom drawer pulled out all the way pressed her pelvic girdle forcing her butt to tuck under.  The female version of the military stance.  I aspired with all my 9 year-old might to conform my body to this most unnatural posture.

As a slouchy teen ager, my father poked my butt every time he passed by and commanded, “stand on two feet.”  “Tuck your bottom in.”  I danced tap and ballet and swam all summer, movements that relax and produce flow.  Or should.  Again constant reminders of  “stroke, kick, kick, kick; stroke, kick, kick, kick.  Lift your bottom” (I was a back stroke champion).

Feldenkrais method took me back, back to the earliest movements.  A gentle curve relaxed down my spine.  I learned the pelvic clock where you tilt your pelvis from 12 to 6, from 3 to 9, back and forth in ever smaller movements until the mind images and the body feels the suggestion.

“Becci, now come and show me how to get in my car,” I entreated after successfully getting in and out of a chair with no pain, no firing of the muscles in jerky movements.  It took about six months of weekly sessions for me to graduate to private and semi private Pilates.

I strove fiercely for pain free movement and returned strength.  My daughters Ruth and Eleanor and I planned the hike around Mt.Rainier on the Wonderland Trail.  I had to be strong enough to carry a 35 pound pack and walk 95 miles in 11 days, each day gaining and losing around 2200 ft or more in elevation.  We wanted to make this trip in August of 1990, one month short of a year after the injury.

Burroughs Mt. hike from Sunrise Visitor Center on Mt. Rainier, August 2009

Burroughs Mountain from Sunrise visitor center, Mt. Rainier, August 2009

 

This reminiscence of the Feldenkrais process is fresh in my mind.  I just had a session with Erik LaSeur, Alki Moves, Feldenkrais practitioner here inWest Seattle.  I met him at a West Seattle Chamber meeting and was drawn to investigate his work as a way of refreshing my body’s acceptance of organic flow.  I have developed my own set of muscle and posture strategies designed to avoid chronic, daily pain.  I wanted to discover how I was getting in my own way.  Erik’s session helped enormously.  A salsa CD has me dancing, hips swaying, legs gently and loosely swinging.

What is your experience of Feldenkrais?  Ready to try it to see if it would lessen your chronic pain?  I would love to hear your comments, questions and suggestions.

Be Well, Do Well and most of all Keep Moving.

Betsy

 

BetsyBell’sHealth4U

4455 51st Ave. SW

Seattle,WA98116

206 933 1889

www.HiHoHealth.com

www.TiredNoMore.com.

 

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I need a doctor! What kind?

Gentle Reader,

If you suffered trauma to your back, perhaps you would turn to a traditional medical practitioner. An orthopedist, a neurologist, at least your primary care physician. Surely, a medical problem like an excruciating pain in the lower back and the inability to walk unaided would send one to a regular doctor. I chose a chiropractor. Let me explain.

I grew up in a medical household. My father was an orthopedic surgeon and my mother, a nurse. After the Second World War, my father relocated us New York City people to Oklahoma. He wanted to start fresh and chose to do a year of specialty study with his fellow Naval officer, a professor at the University of Oklahoma Medical School. I was 10 years old when we moved to Muskogee, OK. It was 1947, only 40 years since statehood. The leading bone doctor in town had established himself during Indian Territory days.

I spent my summer evenings with my father, sitting on the hood of our station wagon watching rodeo riders crashing off bulls into the dust; stock car race drivers roaring into the barricades and each other; football players carried off on stretchers. He was waiting for the next injury, getting his Bone and Joint practice going. Youthful bodies he could put back together. A bone carpenter at work.

Back trouble was another thing. “People with back aches are no good malingering bums,” he would say. I now had back pain, unbelievably debilitating. As a high school student, I scrubbed in with him as he performed lumbar laminectomy surgery. I heard the stories of lengthy rehabilitation, set backs, never working again. Was my youthful athleticism going to end at age 42?

Our family lives in Seattle. I worked for a multi-national telecommunication company in outside sales. The office talk about stress often included reference to a chiropractor and the help she gives to tense neck and back pain. Three years earlier, on the eve of my daughter’s wedding, she woke up with a neck so tense she could not move it from side to side. On the advice of my co-workers, I decided to take her to a chiropractor. I embarrassed my daughter by grilling the doctor about the treatment she was about to perform. I could hear my father’s voice “charlatan, fraud” ringing in my ears. I was terrified. In 1986 neither Wikipedia, nor Google search engine was available. I wanted to learn more about the practice of chiropractic medicine. Briefly, chiropractic emphasizes diagnosis, treatment, and prevention of mechanical disorders of the musculoskeletal system, especially the spine. The hands-on manipulation of my daughter’s neck was successful.

The day after my angry early morning exercise session with Jack LaLanne and horrendous thrust of disc into the spinal nerve, Don drove me to my chiropractor. I knew her through my business-networking group. She had never treated me, but many in the group said wonderful things about her. The massage therapist who helped calm my muscles and spasms enough so I could get out of bed and into a car, referred clients to her. That visit and several more got me on my feet again.

Next steps: my chiropractor sent me to a physical therapist and to the leading sports medicine neurologist for the University of Washington Huskies. The physical therapist wired my thigh muscles, put me on a stationery bike and measured the power output. The left side functioned at about 75% capacity compared to the right. I had no reflex when they tapped below the left kneecap. The nerve down the shin was dead. No movement was comfortable, fluid, exhilarating. Were my running days over? Would I head for the mountains with a pack on my back again? What about the trip my daughters and I dreamed of, circumnavigating Mt. Rainier, the 95-mile Wonderland Trail?

Looking at my MRI results, my neurologist said my bones were not strong enough or dense enough for a laminectomy to be helpful. I had to build a strong structure of muscles to support the weaker skeletal frame. He suggested Feldenkrais.

What is Feldenkrais? Stay tuned for the process that taught me how to lie, sit, stand, walk and transition in and out of each of these positions and actions.

Tell me about your encounters with chiropractors? How did you come to embrace alternative medical practices? If you have not tried alternative healing methods, why not? Until next week,

Be well, Do well and Keep Moving!

Betsy

BetsyBell’s Health4U
206 933 1889
www.HiHohealth.com
www.TiredNoMore.com

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Traumatic Injury: my story

 

Traumatic injury: my story

Posted on 

 

Hello, Gentle Reader,

In 1989, I lifted, or should I more accurately say, yanked a large drink box full of wine bottles out of the back seat of a two door Datsun.  I heard something go in my lower back.  I was angry about carrying these bottles up a long flight of stairs to the social hall of a large church.  My husband in his characteristic generosity offered to cook an elegant meal for a visiting prelate from the Russian Orthodox church inMoscow.  While I approved a grand reception for this honored guest and his entourage, I criticized my husband for trying to do this alone.  Plenty of people would love to cook with Don Bell.  My only task was delivering the drink.

I could feel the place in my back where the terrible sensation had come from.  I carried the box and several more like it upstairs anyway.

The next morning, I awoke early, still smoldering over the piles of potato skins on the kitchen counter and the olive oil slick floor, remnants of the single-handed cooking effort the night before.  Jack LaLanne was just beginning his exercise routine on TV.  I took my position on the large expanse of our hook-latched rug covering the living room floor.  I would work out my anger through exercise.  On all fours, he called out doggie leg lifts.  Snap.

Whatever happened lifting the box, leg lifts finished me off.  I rolled on the floor sobbing in pain.  All my previous judgments against people who complained of bad backs taunted me.  Pay back for lack of understanding and sympathy.   Those legions who suffered, did they suffer as I was now suffering?  Were they not the malingering lazy bums I judged them to be?  What was I going to do?

I could not stand or sit but remained on all fours.  I slowly in extreme pain pulled myself to the staircase and up to our bedroom where Don still lay sleeping.  Once I struggled into bed and lay on my back, I began to breathe more deeply.  I went into head honcho mode commanding my groggy husband to get my day planner and find the phone number of my massage therapist.  It was 7 a.m.

This amazing person came over two hours later.  Don had already gotten me a 24-inch bolster cushion so my legs were in a chair position while lying flat on my back.  This was the only pain free position I could find.  Mary worked on me for over an hour, calming the sympathetic spasms in my shoulders, neck, upper back and arms.  She persuaded me against my wishes to take a muscle relaxant.  She came back twelve hours later and repeated the treatment.

The next morning I was able to inch my way painfully down the stairs and into the car.  Ouch.  That move brought tears to my eyes.  Don drove me to my chiropractor who gently calmed the spinal column and relocated the offending L5 into its proper place.

I was 52 years old.  A skier, hiker, biker, dancer, runner, I valued physical fitness next to Godliness.  More than Godliness.  I was determined to overcome this glitch.  Little did I know what was in store for me as I set about healing from an L5 .

Tell me your story.  How did your back begin to hurt?  What makes you worry about ending up in a wheel chair?  How did arthritis begin and where has it taken you?

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Traumatic injury: my story

Hello, Gentle Reader,

In 1989, I lifted, or should I more accurately say, yanked a large drink box full of wine bottles out of the back seat of a two door Datsun.  I heard something go in my lower back.  I was angry about carrying these bottles up a long flight of stairs to the social hall of a large church.  My husband in his characteristic generosity offered to cook an elegant meal for a visiting prelate from the Russian Orthodox church inMoscow.  While I approved a grand reception for this honored guest and his entourage, I criticized my husband for trying to do this alone.  Plenty of people would love to cook with Don Bell.  My only task was delivering the drink.

I could feel the place in my back where the terrible sensation had come from.  I carried the box and several more like it upstairs anyway.

The next morning, I awoke early, still smoldering over the piles of potato skins on the kitchen counter and the olive oil slick floor, remnants of the single-handed cooking effort the night before.  Jack LaLanne was just beginning his exercise routine on TV.  I took my position on the large expanse of our hook-latched rug covering the living room floor.  I would work out my anger through exercise.  On all fours, he called out doggie leg lifts.  Snap.

Whatever happened lifting the box, leg lifts finished me off.  I rolled on the floor sobbing in pain.  All my previous judgments against people who complained of bad backs taunted me.  Pay back for lack of understanding and sympathy.   Those legions who suffered, did they suffer as I was now suffering?  Were they not the malingering lazy bums I judged them to be?  What was I going to do?

I could not stand or sit but remained on all fours.  I slowly in extreme pain pulled myself to the staircase and up to our bedroom where Don still lay sleeping.  Once I struggled into bed and lay on my back, I began to breathe more deeply.  I went into head honcho mode commanding my groggy husband to get my day planner and find the phone number of my massage therapist.  It was 7 a.m.

This amazing person came over two hours later.  Don had already gotten me a 24-inch bolster cushion so my legs were in a chair position while lying flat on my back.  This was the only pain free position I could find.  Mary worked on me for over an hour, calming the sympathetic spasms in my shoulders, neck, upper back and arms.  She persuaded me against my wishes to take a muscle relaxant.  She came back twelve hours later and repeated the treatment.

The next morning I was able to inch my way painfully down the stairs and into the car.  Ouch.  That move brought tears to my eyes.  Don drove me to my chiropractor who gently calmed the spinal column and relocated the offending L5 into its proper place.

I was 52 years old.  A skier, hiker, biker, dancer, runner, I valued physical fitness next to Godliness.  More than Godliness.  I was determined to overcome this glitch.  Little did I know what was in store for me as I set about healing from an L5 .

Tell me your story.  How did your back begin to hurt?  What makes you worry about ending up in a wheel chair?  How did arthritis begin and where has it taken you?

My story of treatment and recovery continues next week.  Stay tuned.

Betsy Bell

Betsy Bell’s Health4U

4455 51st Ave. SW

Seattle,WA98116

206 933 1889

www.TiredNoMore.com

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Keep Moving! What do I mean by that?

Hello, Gentle Reader,

This morning I began my day with movement.  How do you begin yours?  Here’s my routine:

6:00 or so    Up, stumble into the kitchen to draw and heat a 16 ounce glass of water and squeeze half a lemon in it.  This wakes up my stomach and helps digestion.  More about this in a future blog post.

6:30  after a relaxed complete bowel movement (chewing the warm lemon water helps this), I lie down with the Back2Life machine, which gently lifts the pelvis in a passive Feldenkrais type movement.

6:45   a 20 minute seated workout to the Hot Body/Cool Mind DVD by Jennifer Kreis

7:15   breakfast and I am ready to go.

Logged on to gmail and there was an announcement that Wednesday, Oct 12, is World Arthritis Day.  Who would have thought!

Here’s my first pillar article:

Move to Improve

What are we talking about here?

Everybody knows we need to be physically active.  But if we have arthritis and hurt much of the time, wouldn’t it be better just to find a comfortable position, take our medication and not invite more pain.  Movement makes you hurt, right?

Not necessarily.  In fact the opposite is true.  Trust me.  Get up and move.  Movement can have specific benefits for people with rheumatic or musculoskeletal disease (RMDs).  Those joints that hurt with every step and every bend, will actually hurt more and more WITHOUT moving them.  To keep the motion you have, you must move.  Moving also improves circulation and will help keep other degenerative diseases at bay.

So what can I do? The most appropriate form of activity will depend on a number of factors including the type of RMD you have.  Which joints are affected and how bad is the joint damage?  Articles like this always tell you it is important to consult your doctor or physiotherapist about the type of exercise you need therapeutically, as well as the type of activities you enjoy doing to keep you healthy.  One friend who was just one step from a wheel chair because of her arthritis, did not like any activity.  Her chiropractor told her she just had to find an activity she loved.  She stumbled on a scull, a single racing shell.  She fell in love with the water and rowing.  Got off all her medication.  Began taking a prescribed regimen of food supplements from Shaklee Corp and went on to win world championships in her age group.  Her arthritis remains a condition of the past.

Find something you love to do and begin, slowly with guidance.  Don’t stop.

Let’s see what physical activity is.   Physical activity is any form of daily activity that involves movement, rather than sitting or lying still. This could include playing with children, doing housework, walking the dog, gardening etc. Being physically active can release stiffness and lift your mood.  I find that the playing, housework, gardening activities often lead to more stiffness while some form of regulated, prescribed exercise reverses or controls those negative results from just any daily physical activity.  In other words, exercise can make the fun stuff easier.

The term exercise describes planned, structured and repetitive movements that are performed frequently, at a given intensity and for a set duration of time. Exercise can be therapeutic, such as in rehabilitation, or taken as an enjoyable way of improving or maintaining:

§ muscular strength and endurance

§ flexibility and joint mobility

§ motor functions including coordination and balance

§ aerobic capacity and increased energy expenditure, which can help with weight control

§ bone mineralisation contributing to the prevention of osteoporosis

§ mood and self-esteem leading to increased positive attitude

Level of exercise

You have to decide what you can handle.  One person may have an easy time doing water aerobics while another will have to begin slowly and increase intensity. For example, walking, cycling or swimming at a gentle pace (low intensity), might have an aerobic effect (increase your heart rate and breathing) for some people, whilst others would need to exercise at a moderate to high intensity to experience the same effect. How old are you?  How is your general state of health?  How advanced is your disease?  How regularly have you been exercising?  Are you carrying too much weight?  Begin at a level of exercise that works for you.

Starting out

Always begin gently and build up slowly over time. It is better to do little and often than to try and overdo things and to push yourself too hard when you start exercising.  So many people begin with fervor and peter out after the third day or so.  I believe that dietary changes need to accompany a new exercise program to support your recovery.  Watch for a future article about foods and supplements that help.

If you do need to stop exercising for any reason, always start again gently and build up slowly. When you reach your desired level of function, you will need to keep up regular activities to maintain this level.

How much exercise

When you repeat activities regularly your body will adapt over time and you will find you can do more with less effort. You may need to change up your program to continue improvement.  People hit a plateau and get frustrated because they are not improving beyond a certain point.  Make little alterations in your routine and your muscles will respond.  It’s the surprise factor in training.

Really.  Regular exercise slows, or may even prevent loss of function due to disease progression.

Ideally, do stretching/flexibility exercises every day, muscle strengthening and endurance exercises two to three times a week and some form of aerobic exercise for 20 minutes three times a week. Mix it up.

The key is to find things you enjoy doing so that being active is something you look forward to and becomes part of your daily life.

Did you know?

The word ‘fit’ comes from:

Frequency – how regularly you exercise

Intensity – how hard you exercise

Time – how long you exercise

Now the word fitness is used to describe health and the ability to meet the demands of a physical task.

 What are we talking about when we say exercise?

 Aerobic / cardiovascular – Exercise that raises the heart rate and breathing, e.g. walking, cycling, swimming, dancing etc. at a moderate or high intensity

 Balance – The ability to control the body’s position when either stationary or moving

 Endurance – How long you are able to exercise at low, medium or high intensity

 Flexibility – The ability of muscles to stretch. Stretching muscles helps to keep them supple and relieves stiffness

 High impact – Exercises where the body weight impacts forcefully against a surface, for example running or jumping

 Low impact – Exercises where there is minimal impact through the joints and pelvic floor or where the body is supported whilst exercising, e.g riding a bicycle or swimming

Mobility – The ability of joints to move through a range of motion

 Posture – Good body alignment

 Strength – The extent to which muscles can exert force by contracting against resistance (e.g. free or fixed weights, bands, moving in water etc)

 Weight bearing joints – Joints that support the weight of your body against gravity when you are upright, i.e. your spine, hips, knees, feet and ankles

 Weight bearing exercises – Exercises where your body is working or moving against gravity, for example walking (swimming is non-weight bearing because the water supports your body weight)  Weight bearing exercises also help maintain bone density and reduce the risk of osteoporosis

I want to that the Arthritis Foundation.  Their website has excellent articles about taking control.  This posting borrows heavily from their pages.

To your good health!  Betsy

Betsy Bell’s Health4u

206 933 1889

Betsy@hihohealth.com

http://HiHohealth.com

http;//Tirednomore.com

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Hello World! Got any aches and pain?

This is a brand new blog about keeping moving when the pain sets in.  Don’t fall into a wheelchair if you can possibly help it.  I’ll be sharing ideas about how to handle pain from arthritis, some things I’ve done to stay upright and walking with severe spinal stenosis.  We all need to help each other stay away from the knife and drugs.  Stay tuned for my story.

Keep Moving, Betsy

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