Physiotherapy – what’s it all about?

November 9, 2009 at 3:03 pm | Posted in rheumatoid arthritis (RA) | 2 Comments
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Wren posted a comment asking about physio and I thought it might get a bit long-winded for a comment answer, so I’m making a post out of it!

This was Wren’s comment – sorry Wren, just realised that this answer is going to come a bit too late for your appointment! “On another subject: How often do you see your physio (physical therapist)? What do you do at the appointments? Are there special exercises? I’m curious because I keep reading of others having PTs they go to frequently, but this is something that I’ve never done, or even had suggested by my doc. I’m seeing him on Saturday morning, and I plan to ask about it, but in the meantime, how does this work for you?”

I personally see my physio every two weeks at the moment, but that’s a timing that we decided between us and it’s changed over the months I’ve been seeing her. I started seeing her weekly when things were really bad and we’ve moved on to two weekly. We tried three-weekly but that didn’t work out – by the time I saw her after three weeks my shoulders were in agony!

There are indeed special exercises, but again they’re entirely individual to each patient. I think it’s fair to say that generally you don’t do any exercises during a flare, reduced exercises during a “fizzle” (if you have fizzles, as I do!) and you try really hard to do them when things are fine, but frequently forget! Luckily I have a very understanding physio (this is afterall the woman who recommended a year’s supply of cake, but she says I’m not allowed to post that story!!) and she appreciates that it’s hard to remember to do the exercises when things are good!

What we do at the appointments is 1) Talk through how I’ve been over the last couple of weeks since I’ve seen her 2) Decide what needs doing this time 3) Do it. Usually, what needs doing is either ultrasound on my knee(s) or ultrasound on my neck and shoulder(s) or both. Again, I’m lucky to have such a flexible and understanding physio. By the time I got to see her, I’d been seeing another physio privately for months. Long story – see here and we’d established that ultrasound works for me. Again, it’s a very personal thing. Some people find acupuncture fantastic, especially, apparently, for knees – I don’t. Some people find ultrasound completely useless – I don’t.

If there’s a different joint giving me problems we’ll talk through that and discuss if there are any exercises that might help, or whether ultrasound, TENS etc. might help.

I have a whole selection of exercises that I should do regularly for my neck, shoulders and knee, and a bunch of others to ease morning stiffness in other parts of me. The knee, neck and shoulder exercises are more to strengthen the muscles in those parts, so that they can do a better job of supporting the joints, rather than to actually do anything to the joints themselves.

The attitude of the nurse practitioners is ‘use it or lose it’, so the consensus seems to be that the more you exercise (within limits), the better. Not being the world’s most active person the only time I’m likely to overdo those limits is when I’m having a flare (where minimal exercise is fine) or if I’m doing crochet, embroidery etc. and don’t want to stop although my hands hurt!

I hope this helps explain the whole physiotherapy/physical therapy thing a bit, but it is, I stress again, only my own very personal viewpoint, and I know that every physio is different (because I’ve seen at least five over the years) and every patient is different. I reckon if you find a physio that suits you it can only help, so why not give it a try?

I hope the RA isn’t creaping back

November 6, 2009 at 2:02 pm | Posted in rheumatoid arthritis (RA) | 4 Comments
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I’ve had several virtually pain and stiffness free weeks now – fantastic! But for the last few days I’ve woken up just sliiiiiiightly stiff, and had little bits and pieces of rheumatoid arthritis pain in the evenings and at night … certainly not a flare, not even a fizzle, but just a bit worrying.

I have my six-monthly hospital appiontment at the end of next month and I was joking with my physio the other day that everything would probably jog along very nicely, with just the odd twinge and few minutes of stiffness, until the day after my hospital appointment,when I’d get a flare.

I hope it was a joke … especially as my hospital appointment is 23 December!

World Arthritis Day – Let’s Work Together!

October 12, 2009 at 12:01 am | Posted in arthrits, rheumatoid arthritis, fibromyalgia, joint pai, rheumatoid arthritis (RA) | 1 Comment
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It’s World Arthritis Day and this year’s theme is ‘Let’s Work Together!’ It’s got me thinking about how lucky I am to still be in work considering I’ve got this dratted disease/illness/condition, whatever you want to call it.

I’m very grateful that I can still work, in spite of the R.A. It’s been a difficult road to travel, but I feel not nearly so difficult as for those in employment. Yes, it’s “mild R.A.” but when my symptoms are bad it doesn’t feel mild to me! As a self-employed person I don’t have to worry about breaking the news to the boss, explaining why I can’t play golf with the company, or put up with silly comments or lack of understanding from colleagues. I only have one colleague and she’s very understanding … if she’s not then she does a good job of hiding it, since I’m her boss (at least officially – we suffer from role reversal now and then).

There has been some research, sited in the excellent book on Living a Full Life With Rheumatoid Arthritis by Jasmine Jenkins (a delightful lady whom I had the pleasure to meet in Barcelona – Gosh – who’d have thought you could name-drop in the world of rheumatoid arthritis?), that suggests that self-employed people are likely to remain in work longer than those who are employed. If I remember rightly, since I can’t lay my hands on the book right now, it was suggested that this is due to difficulties with employers. On a bad day I wonder if it’s more to do with desperation – there’s no going off sick and still being paid by the company! On a normal day though I’m grateful that I can take small amounts of time off here and there to cope with a flare, and that I have been able to cut my hours back to normal full-time hours from slightly in sane morning and evening and weekend hours that I used to work, without having to justify myself to anyone except myself.

It would be good if World Arthritis Day, and indeed the My Day for RA site, brought some real understanding of rheumatoid arthritis to those who don’t have it but who have friends, family or colleagues who do, to lighten the load of those people in employment who have to put up with R.A. on top of all the usual frustrations of a job!

Trying to remember to pace myself!

September 16, 2009 at 9:16 pm | Posted in rheumatoid arthritis (RA) | 2 Comments
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Feeling sooooo much better after two excellent physio sessions that I went shopping straight after the last one, came home, unpacked it all and attacked my much neglected embroidery, in the meantime sorting out bits and bobs relating to Spain (not least of which is that I’ve finally got the itinerary, but due to a small mix-up, still not got my e-ticket). I am now feeling somewhat shattered and trying to persuade myself that the best thing to do is STOP. Fortunately I won’t take much persuading as I know if I keep going I’ll just put myself into another flare just in time for my little trip. So … night night everybody …

Well I really hope I’ve just had a flare

August 27, 2009 at 8:35 pm | Posted in rheumatoid arthritis (RA) | 2 Comments
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Yeah, I know; sounds like a pretty dumb thing to say, but here’s the thing … if it WAS a flare then it really was very mild indeed and it’s the worst I’ve got to put up with (at least for a while) I’ll be quite content. I’ve been doing really, really well for the last couple of months, and then a couple of weeks ago I started to get a bit of morning stiffness (and sitting too long in the chair in the office stiffness) and some pain in hands and feet, but not too severe, and then it got gradually worse (although still not THAT bad!) and I thought oh-oh, it’s creeping back and this is the slippery slope … not sure what happened to positive thinking, but that’s what pain does to you!

But now it seems to have cleared up again. Hurrah for that! I suppose it was just a wobble, rather than a flare – there ought to be a name for them … mini-flares, flarettes, sparks … anyone got any ideas?

I’m bloody glad I’m not flaring!

August 13, 2009 at 2:25 pm | Posted in rheumatoid arthritis (RA) | Leave a comment
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I can now claim to know the car park at the hospital where I have physio quite intimately. I know how many spaces there are, I know what sort of trees surround it, I know the view across the fence over the corn field, I know there are blue tits and great tits and some sort of finch foraging in the trees, I know that the oak tree has a few early common spangle galls on it.

No, I wasn’t doing some sort of strange nature survey of the hospital car park – I was waiting for the RAC! Yes, the car has broken down AGAIN! Having lost my marbles and my rag, I have now also lost my car! (Well, hopefully not permanently, but it’s in the garage.)

My wonderful hubby drove out to see if he could help and,although he couldn’t, he waited another hour with me until the RAC arrived. It was a 2.5 hour wait in total – not fun.

Fortunately the RAC guy (who was nowhere near as lovely as the adverts would like you to believe, but OK) got the car going – but I had to take it into the garage because it was still showing faults.

I was patting myself on the back last night thinking how well I was coping with all this … but when I got home it all finally hit me. I felt absolutely exhausted, headachy, aching all over, sore hands, sore feet … hmm, so looks like a fibromyalgia AND RA flare, I thought. Lovely …

But no – I made myself get an early night, convinced myself that the car would probably be OK,managed not to worry too much and … well, I’d like to say I feel a million dollars today but that would be rather overstating things, but AS YET I am flare free. Yippee!

I can’t promise that’ll still be the case if there’s real car disasters on the horizon, but I’m OK for now!

Could be that having just had physio helped too!

Psychology of Flares

June 15, 2009 at 1:03 pm | Posted in rheumatoid arthritis (RA) | Leave a comment
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I had a really good week last week – out three evenings during the week (OK, not exactly boogieing the night away, but still out and having fun), an exhibition and a carnival at the weekend, and some gorgeous walks in the local wood and heath with hubby.

I can’t say it was a pain-free week unfortunately, but it wasn’t TOO bad. I did worry, of course, that was overdoing it, and perhaps I did … I feel fairly rubbish this morning … but then again it’s Monday morning and I’m back at work, so that’s normal, isn’t it?

So while I absolutely KNOW that flares are a thing that happens and they are not ‘just in your head, dear’, I do wonder if I’ve kind of talked it up by thinking I was overdoing it and worrying that I’d have one.

Not that I’m sure I’m having one now – but you see, I’m still worrying about it … very silly really; why can’t I just get on with my life and put the worry to one side?

Maybe it’s because I’m for once NOT particularly stressed at work, not stressed about Tiny cat etc. etc., stopped stressing about someone I used to consider a friend and don’t anymore … I’ve run out of other things to get wound up about and I have to stress about my RA!

Hmm, I’m not really managing to say what I want to say here, but I’ll post anyway and perhaps someone can make sense of my ramblings. If so, please comment as I could od with some sense right now!

I have a real incentive to exercise!

April 10, 2008 at 9:25 pm | Posted in Me, rheumatoid arthritis (RA) | Leave a comment
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I’ve been trying to lose weight for years with limited and yo-yoing success. Of course about the only symptom of RA I haven’t had in the last few months is weight-loss. (And I know that weight-loss can be a very serious problem for some people, so I shouldn’t be flippant!) However, on top of all the evidence that exercise helps anyone, there’s quite a bit of evidence that it specifically helps with RA, and that even if you’re hurting, provided it’s not a flare-up, you should carry on. I haven’t really managed to work out what a flare-up is exactly yet – some places say it’s when you have pain and stiffness, and then you’re in remission when you don’t; well I have pain and stiffness every day but it’s very variable in its intensity. Other sites/books say that some people will have pain and stiffness all the time but flare-up is more intense. So I don’t know if I’ve had a few flare-ups (days of relatively intense pain) or none, and it’s a treat I’ve got to look forward to! Anyway, the point is that I had a really bad day today – feeling ill as well as very stiff and in quite a lot of pain. Still managed some work, but then in the evening did my exercises and immediately felt SO much better. I’ve had a good week until today and yesterday was the first day I didn’t exercise, and today … bam!

Now it could be coincidence. ‘As a scientist’ as the great Kathy Sykes is wont to say, I know that could be sheer coincidence but I’m keeping an exercise/pain/food diary so hopefully if there is a pattern I’ll find out. In the meantime I feel very motivated to exercise for a change, which is great!

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