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Alana’s Health Journey:

The Darkness I See is Your Shadow Protecting Me

Preface: This blog post is much different than anything we have shared before. It’s a deeply personal experience from my dear wife, Alana. It touches on her near death experience and her interaction with our local health delivery system. It also exposes the problems with the response that has been taken to deal with COVID-19 pandemic. I feel that some of the response our healthcare system has decided on is definitely not in the best interest of the patient.

I often write about resilience and how it’s not just a physical characteristic. It’s comprised of emotional (psychological), mental (cognitive), social (relationships), and spiritual characteristics that are all important to one’s health and recovery. Our healthcare system is great at saving lives, but may have forgotten that these other characteristics of resiliency are just as important as the physical component to recovery.

In her recount, Alana gives strong praise to the surgeon and the team. The nursing staff did their best, but was overburdened. (It placed extra stress on them since a family member couldn’t be in the hospital room to support the patient during the COVID-19 restrictions.)

My plea for any healthcare worker out there that may read this: don’t forget the patient! You’re in healthcare to help people. We cannot neglect the mental state of our patients if we hope to have positive long term results. Let’s find a better way to keep everyone safe and to really help those in need. Our patients are likely in their darkest hour.

Humans, people, and your loved ones are complicated and so is their health. It’s not just the physical aspect of things. It’s also the emotional, mental, social, and spiritual aspects that make up a person that dictate how he/she will physically heal. It’s not just what we do for a person; it’s how we make them feel that will stick with them for a life time. There is never too much compassion for those in need. Thank you for your continued service in tireless work that you’re often not acknowledged and thanked for!

By Alana Shatto

Thurs., 5/14/20

On Thursday morning, I enjoyed a mushroom coffee blend for the first time at breakfast. Not thinking too much about it, I started getting a stomachache by lunch time to the point that I couldn’t eat. After sitting, I had trouble walking around the house. I lied down in my bed with a racing heart and chills (which was unusual for me since I can typically just push through). Ben brought home dinner, and I was able to eat. Although tired, I went to be at 9 p.m. thinking I would be just fine.

Fri., 5/15/20

I tossed and turned most of night. My heart felt like it was racing, and I had the same right calf pain that had been bothering me most nights (I struggle with tight calves and achiness in them at night). Ben got up at 5:15 a.m. to get ready for CrossFit. At about 5:35 a.m., I called out for him several times. I had severe shaking and chills, and I was having trouble breathing. Long gasps for breathe. He took my temperature, 99.1 degrees. He then got out his pulse oximeter, and my heart rate read at 150-160 beats per minute. Very alarmed, he told me that we needed to go to the emergency room (ER) and that he’d go wake up our ten year old daughter, Alexis, to get ready to leave.

He had to help me get dressed to leave. I could hardly think clearly. I could barely walk and make it out to the car. I tried to drink bottled water, but threw it up into a bag as we drove to St. Luke’s Meridian ER in the cold darkness of the morning.

Because of the COVID-19 pandemic, we had to wear masks. Ben told me that I would have to do this alone. He told me that they would be running an EKG and all of these tests to figure out what was wrong. He was sorry that he couldn’t be with me because of the visitor restrictions due to COVID-19.

I don’t really remember saying goodbye to Ben and Alexis nor did I grab my phone thinking maybe he put in my fleece jacket pocket. They wheeled me away in the wheelchair, and things got really crazy (fast)!

The fully masked staff asked me a lot of questions as they began to put in an IV in my wrist and my left inner elbow. They started hooking my body up for an EKG to check my heart. I told them about the mushroom coffee that I had drunk the day before and the symptoms from the day before. It was difficult to breathe in addition to wearing a mask and fogging up my glasses as I tried to calm down.

I was sure I had COVID-19 and would be one of the random younger adults that suffered from cardiac arrest due to it. I thought to myself, “This is the end. I’m going to die alone.”

I could hear the whispers in the hall of the staff going over my symptoms. A man’s voice asked, “Did you hear her cough?”

I thought back earlier in the year…

Alexis, always healthy and strong, had gotten sick on Valentine’s Day, 2/14/20. Over the following six weeks she was diagnosed with adenovirus, pink eye, mono, and an ear infection! A crazy series of illness that kept us home long before the quarantine / stay at home order. I had wondered if we had already had COVID-19, just before all of the fear and testing. I thought this was it; we were through all the illnesses. I had thought we were on the up and up…just in time for summer.

Over the course of the next few hours I was tested for the following:

  • COVID-19 – Rapid 30 minute testing in which a nurse shoved a 14 inch long looking swab up into my left nostril until it hit the sinus cavity.
  • Cat Scan – Chest view as they suspected a blood clot in my lungs or possible pneumonia.
  • Virus Swab – Another test in which a nurse shoved a 14 inch long looking swab up into my right nostril until it hit the sinus cavity. She later came back to tell me that there was a problem with the swab, so I bared it again in my right nostril for a total of three times.
  • Cat Scan – Abdominal view as they hadn’t quite figured out the source of the infection.
  • EKG – Second test to confirm that my heart was functioning and not enlarged.

Of course, all of these tests take time as I’m wheeled on the hospital bed back and forth to get the CAT scans. It’s one heart pounding moment after the next…

“You might have a blood clot in your lungs or you may have pneumonia.”…BUT YOU DON’T.

“You might have COVID-19.”…BUT YOU DON’T.

“Your heart is fine—normal and not enlarged.”

Probably between 9 and 10 a.m., the radiology report came back that they had found the source of the infection:

APPENDICITIS

“Whoa, what?!” Where did that come from?

The ER doctor continues on to say that I have an inflamed appendix and that it needs to come out. There is no other treatment—just surgery.

I think we were all a bit dumbfounded as I didn’t arrive in the ER with right lower quadrant pain, so I wasn’t fitting the medical diagnosis for appendicitis.

After all of the ups and downs, I wasn’t sure about how I felt about going into surgery alone. I knew I didn’t have a choice. I had only been under anesthesia once before for my wisdom teeth to be pulled. I had only been to the hospital to deliver Alexis (natural childbirth). Why at 41 years old am I sitting in the ER with appendicitis?!

“This is the end,” I thought to myself. I’m going to die alone and not even have a phone to call on.

Luckily, at that point the nurse gave me the hospital room phone to call Ben once we discovered that I didn’t have my iPhone in my fleece jacket pocket after all.

The ER doctor had called Ben previously, so he somewhat knew what was going on. I was able to tell him myself about the appendicitis and the surgery. We spoke a few times before I was moved to Pre-Op. At that point, we knew that they were admitting me into the hospital.

Although the staff at Pre-Op was caring, things got worse after giving a urine sample (to make sure that I wasn’t pregnant). I started getting chills no matter how many warm blankets I was given. Between talking to the anesthetist and the surgeon, I was nauseous and dry heaving.

Finally by 12:30 p.m., I was wheeled into the operating room and transferred to the table.

I don’t remember anything after that besides music playing the background.

When I came to, I was struggling to breathe. The breathing tube was still in my throat—I couldn’t move my left hand or speak…An orange plastic cover was over my face. Then things went black again.

I woke up in the recovery room after that. It was likely after 3 p.m. At some point, the surgeon came in to speak with me. He told me that they had removed my appendix, but that there was vein that ran along side of the appendix that had pus which had been sending bacteria through my bloodstream and the appendix was leaking into my abdominal cavity, sepsis! They had cleaned out my innards with saline and an antibiotic solution and had given me 6 liters of fluid since coming to the ER to keep me alive. I would stay at the hospital with intravenous antibiotics.

I don’t remember too much about Fri. night other than I cried on and off. Overnight, I experienced chills, shakiness, and changes in my breathing. Although the night shift nurse consoled me by telling me that this was common with sepsis and after surgery, I felt utterly alone. Again, with the COVID-19 pandemic the hospitals are not allowing any visitors at all.

God was silent though I continued to pray. The darkness of the night overwhelmed me. I was experiencing nighttime terrors. I saw black flashes and movements throughout my empty hospital room. When I closed my eyes, I saw the cloaked Grim Reaper face. I jolted in and out of rest. Darkness like a black ink spilled surrounded me…

Sat., 5/16/20

The morning went poorly. I cried with the surgeon when he came by making his rounds. He had warmth about him and a caring spirit. He told me to expect a three to five day hospital stay.

My best friend Mandy called me on the hospital room line before noon, and I wept with her. I also spoke to my mother-in-law, Debbie, who encouraged me and prayed over me. I spoke briefly to my parents, but the hospital telephone line was low and muffled, making it difficult for people to hear me and for me to hear them.

Once Ben knew that I was staying, he arranged a drop off of my phone and a change of clothes to wear home at some point. He had to package everything up in a plastic bag and drop it off with the guard station at the hospital. Although he was physically there, he could not come to room to see me, encourage me, and pray with me because of the visitor restrictions due to COVID-19. My mental health upon arrival up until now remained poor as I felt so alone.

It was an instant boost in moral to have my phone again and to be able to text. Now I didn’t feel as alone.

In the afternoon, I walked the hospital hallway slowing pushing my IV machine. I started to feel better, but how strange it was to walk the halls of the 6th floor wing and see all these other patients alone in their rooms and in their beds…no friends, no family, no support.

I had previously heard Code Gray announced over the hospital’s public address system, possibly indicating the need for an emergency management response to a combative person with no obvious weapon. I had also heard Code Blue indicating a medical emergency, possibly involving cardiac or respiratory arrest. My heart broke for these patients as they were miserably alone as well.

I dreaded the darkness of the approaching evening…

Early morning on Sun., 5/17/20

Although exhausted and not feeling well, I drifted off to sleep in-between the nurses waking me up to check my vitals or to replace my IV bags with medication. The night terrors returned after 2 a.m.

I laid silently in the hospital bed with tears streaming down my cheeks. I sang, “Come, Holy Spirit.”

The lines of the song, “Way Maker”, filled my head:

You are
Way maker, miracle worker, promise keeper
Light in the darkness
My God, that is who You are

I called out upon the name of JESUS to reprimand the evil spirits. Quiet tears streamed down my face.

Jesus’ voice told me to call out for prayer…breaking the silence I had endured.

I put on my glasses and grabbed my phone. I fumbled to Vineyard Boise’s Facebook page and started my prayer request:

“Prayer request: I had emergency surgery to remove my appendix on Friday. I was already sick beforehand, but I had no idea that I had a serious infection. I have sepsis, bacteria in my bloodstream. Because of COVID-19, no hospital visitors, so Ben and Alexis can’t be here with me. Please pray for healing and a complete recovery so that I am strong and can go home to be with my family. Thanks”

Within in moments of publishing, I was surprised to see that a couple of ladies had already responded and starting praying for me! Wow—people really are awake and on Facebook at all times of the day! Hopeful, I shared the same call for prayer on my personal page.

Setting my phone aside, I laid there thinking, “OK, at least two people are praying for me, and I’m not alone.”

I felt a presence of an invisible scan come over me. It started above my head and traveled across my body to my toes. It was like a sheet pulled off of me from top to bottom. He knit me back together. And I felt peace and drifted off to sleep.

6 a.m.

The hospital room lights glared on! The blood lab technician stormed in (like the previous morning without warning or easiness) with his equipment to draw my blood. I was startled awake.

After he left, I popped up out of the hospital bed and start my bathroom routine. I ordered my breakfast (vanilla pudding and hot tea) at 7 a.m. and was sitting down to eat when the nurse came in.

She was surprised to me eating at the shift change. She said she’d never seen anyone up like that before.

I was up and around until about 10 a.m. I walked the hallway pushing my IV machine. I felt like I had turned the corner. I felt like myself again.

By 11 a.m., the surgeon and his physician assistant (PA) came by during their rounds. The surgeon reported that my 6 a.m. blood test results had come back completely normal! The white blood count was normal. I was only minor low on potassium.

He had expected me to stay in the hospital at least through Mon. and possibly until Wed.

He told me that he had been practicing since 2006 (14 years) and never seen a case like mine before. I was in serious sepsis shock prior to surgery to remove my appendix. They had to pump me full of 6 liters of fluid to keep me alive.

If I hadn’t have come to the ER when I did, I would have died. Ben could have left for CrossFit. I could have died alone in bed while Alexis was asleep in her room.

The surgeon and his PA were warm, caring, and encouraging. He discharged me from the hospital on Sun. afternoon. We addressed my swelling: my stomach, thighs, and ankles were very puffy. He told me that I’d pee out all of the fluid within a couple of days.

I was able to independently shower, dress (though my normal clothes felt tight), and pack my own belongings. I made sure to request my medical records for the hospital stay.

Ben and Alexis got all of my prescription medication (including an 8 day course of two antibiotics) and met me at the hospital parking lot sometime after 3 p.m. It wasn’t all smooth sailing after that. I had nausea from being pushed (way too quickly) in the wheelchair, being in the elevator, and during the car ride home to the point that I had to take the anti-nausea medicine in the driveway.

It wasn’t until I saw my picture that Ben took of me at the hospital, that I realized how swollen, fat, and ugly I felt, but I was alive. It hadn’t dawned on me that I was having trouble moving around due to the water weight gain. Turns out I put on 15 lbs. of swelling while hospitalized. I was worried about how Alexis would “see” me after such a traumatic event for her to witness.

It was later that day that I found out that Ben awoke at that same time (Sunday morning at 3 a.m.) to what sounded like dropping marbles, so he laid awake in bed praying for me. My brother-in-law and sister in-law were awake with their almost 2 ½ year old praying for me at the same time. It turns out that hundreds of people (I didn’t even personally know) began to pray on my behalf throughout Sun.

I won’t lie and say that everything was fine after that because it wasn’t. I had jittery chills and a terrible night of sleep. I was worried about my breathing and my heart rate and that I’d have to go back to the ER. I second thought my decision to come home—knowing the stress and pressure it placed on Ben and Alexis.

Mon., 5/18/20

That Mon. morning, God met me in my devotions that I get automatically emailed every day. It was exactly what I needed to hear, and it encouraged me to keep going.

But he knows the way that I take; when he has tried me, I shall come out as gold. My foot has held fast to his steps; I have kept his way and have not turned aside. (Job 23:10-11)

Later in the day when Ben heard me sneeze or cough, he couldn’t believe that I didn’t have pain my abdominal area. He said that he figured I would be doubled over in pain, but I wasn’t. I told him that I couldn’t believe it either. I truly believed that God had knit me back together.

Thurs., 5/21/20

Unfortunately, I hadn’t lost any of the swelling within the predicted time frame. After speaking with the surgeon’s nurse, I was given a three day course of Lasix, a prescription diuretic that causes you to pee more in order to help your body get rid of extra water.

During that phone conversation, I was given the pathology results: no cancer and no tumor were found in my appendix. The bacteria culture showed that I had an E. Coli (a type of bacteria that normally lives in your intestines) infection. I was on the correct antibiotics to treat the infection.

Luckily, the Lasix worked and by Sun., I had lost 19 lbs. and had minimally swelling in my feet!

LEFT: Sun., 5/17/20 Hospital Discharge with 15 lbs. of water weight gain. RIGHT: Sun., 5/24/20 One week later and 19 lbs. lighter!

In summary, my recovery has been slow and steady. The three laparoscopic incisions on my lower abdomen are slowly healing. The bruises are fading. The nurse said that it could be another one to two weeks before I have my energy and appetite back. I know I’m on the right track though the CAT scan showed that I have a nodule on my thyroid that needs to be further looked at by ultrasound. My thyroid lab tests result fell within the normal range, but it needs to be further followed up with my general practitioner.

It was the worst time amid the COVID-19 pandemic to have an emergency surgery and lonely hospital stay without Ben or Alexis, but I made it and truly appreciate all of the prayers and support we have received…Family and friends brought delicious meals, beautiful flowers, and get well cards. I appreciated the encouragement amidst the struggle.

My story did not end on 5/15. I was lucky to have been given another chance as I know that many others in the hospitals, nursing home, and assisted livings have faced death alone with family outside the window or building because of COVID-19 restrictions. I’m truly sorry for those who have endured such horrendous circumstances.

Although I am still grappling and processing through all that has happened, I have gained a fresh clarity of what is important and what I need to let go of. I hold my relationships with family and friends dearly to my heart. I let go and released my hand of anger, control, and perfectionism. It no longer served me. I feel as though I have been given the opportunity to push a giant “RE-SET” button. I’m more mindful of my thoughts, behaviors, and even the food I’m willing to reintroduce. I have given up my coffee for now as the caffeine seems to directly affect my heart rate at rest, causing it to push near 100 beats per minute, where 60 is typically normal for someone my age.

Should you find yourself or a loved one in a similar situation one day, I hope my honest and candid sharing of my health journey might help you or your loved one through the process.  Mental and spiritual health is so important to recovery and resilience. Forced solitude is very difficult to bear even in short situations and especially, when battling an illness. Any kind of interaction is precious and helpful.

Hold fast. Stay strong.

Take the time to focus on your health and recovery. Often, small changes in your diet, activity level, and relationships can make a big difference. You can take control of your health and your life!

Reach out to others for support. No matter how you feel or where you find yourself, YOU ARE NOT ALONE. God Bless You!

Remember what you’ve learned about the Lord through your experience with Him. (Deuteronomy 11:2)

If you do that, our messes will become our messages.

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How to Improve your Recovery from Injury, Illness or Surgery

There are many reasons and factors that affect a person’s ability to heal and recover from an injury, illness or surgery. One of the most common reasons is poor nutrition. The healing tissue along with the body may not be receiving proper base components to actually heal. Poor nutrition can negatively impact how one heals from an injury or illness. Consuming the right foods can provide the proper nutrients for your body to fully heal and recover from an injury, illness or surgery. If you truly want to take all of the steps possible to improve your chance of recovery, then addressing nutritional needs and food quality is a must! Continue Reading

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The Clamshell: A “go to” Exercise for Treating Foot, Hip, and Knee Pain

Do you suffer from foot, hip or knee pain? If so, hip external rotation weakness and poor single leg balance may be part of the reason for the ongoing pain as you overload and overuse other muscle groups in order to gain extra lower leg support. Weakness in the deep external rotation muscles is commonly associated with many lower extremity overuse injuries.

Injuries commonly associated with hip weakness include:

  • Foot/ankle injuries such as plantar fasciitis, Achilles tendinitis or posterior tibialis syndrome.
  • Hip related issues including piriformis syndrome, hip bursitis, and hip impingement.
  • Knee injuries such as Patellar Femoral Pain Syndrome (PFPS) and Iliotibial Band Syndrome (ITBS).

The deep hip external rotator muscles need to work along with the hip abductors (such as the gluteus medius) to insure proper lower extremity positioning when the leg is in full weight bearing. (Particularly, in a single leg stance.) One leg bears the full weight while the opposite leg is in the swing phase while walking, running or skipping.

The deep hip rotators (also known as the short external hip rotators) are a group of muscles including:  the superior and inferior gemelli muscles; obturator internus; quadratus femoris; and the piriformis. This group of muscles is extremely important for stability of the body, pelvis, and leg as the leg/foot initiates full ground contact.

The clamshell exercise is a commonly prescribed exercise designed to target the hip abductors and hip external rotators. However, this exercise is often performed incorrectly or ineffectively. 

In the following video, I demonstrate my preferred method of performing the clamshell exercise in order to insure optimal effectiveness.

In order to engage the deep hip rotators, you should feel the muscles working deep into the buttocks and directly behind the greater trochanter (the hard bone that pokes up at the top of the hip).

This exercise should be performed very slowly. I advise a count of 5 seconds up, a 5 second hold, and then a 5 second slow return to the starting position for at least 10 repetitions.

If you aren’t feeling the deep hip rotators activate, then you may need to reposition your legs. Usually, repositioning the knees and moving them up toward your head into a more fetal position will do the trick.

CLICK HERE TO WATCH NOW

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

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How to Improve Your Sleep Quality

The ability of the human body to heal and recover is nothing short of amazing. The body has an innate way of healing and thriving. Sleep is one of the most important aspects to thriving and aging well. Your body thrives on a routine, so preparing for bed shouldn’t be any different than your other daily routines.

Although I am not a sleep expert, I have regular discussions with my physical therapy clients regarding sleep quality and hygiene. Adequate sleep is one of the most important components to a person’s recovery post illness and injury in addition to thriving and aging well. Continue reading for tips on how to get a better night of rest.

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A Core Stability Exercise that Anyone Can Do

Proper core and lumbar extensor strength is the key to preventing an episode of low back pain (LBP) as well as an important component to treating LBP. Low back pain is estimated to affect nearly 80% of the U.S. population at one time or another. In general, most of us don’t spend enough time properly strengthening our core muscles. In this video post, you will learn how to engage your abdominal muscles with a simple ball exercise that I recommend to all of my patients initially in my LBP rehabilitation program.

The core muscles are part of the body’s natural method of stabilizing the spine. The core muscles, along with intra-abdominal pressure, help to form the round cylinder that is utilized to support the spine. Ligaments and boney articulations are also important in spinal stabilization. Most people don’t realize that the core actually consists of two separate groups of muscles, the inner and outer core muscles, and neither group involve the rectus femoris muscles (the six pack).

The Multifidus Muscles

  • The inner core consists of the muscles of the pelvic floor, the transversus abdominis (TVA), diaphragm, and the multifidus muscles (which span the vertebrae along the back side of the spine as shown above). The TVA wraps all the way around the stomach and attaches to the spine. This is what helps to form the cylinder. When contracted (in conjunction with the pelvic floor and diaphragm), it helps to increase the intra-abdominal pressure to support the spine.
  • The other muscles that help to support the spine are known as the outer core muscles. These muscles are responsible for movement of the trunk and spine as well as aiding in stability. The inner core muscles do not actually produce any trunk or spine movement. The outer core muscles consists of the following muscles:  lumbar paraspinal muscles; the quadratus lumborm; the internal and external obliques; and the psoas major and minor (hip flexors). Some may also include the glutes (buttocks muscles), hamstrings, and quadriceps as part of the outer core muscles.

Those working on core strength may not be performing the correct exercises. Performing proper core exercises (and particularly, lumbar stabilization exercises) are the primary treatment modality for LBP.

In this video, I demonstrate an easy and effective way to actively engage the inner core abdominal muscles. This exercise is typically safe even early on during the rehabilitation process for low back pain. 

For more information on how to effectively exercise and work the core muscles in order to prevent or treat LBP, be sure to check out my book, Treating Low Back Pain during Exercise and Athletics. You will learn how to address specific causes of LBP as well as the best practices on how to prevent and self-treat when you experience an episode of LBP. In this step-by-step LBP rehabilitation guide (complete with photos and detailed exercise descriptions), you will discover how to implement prevention and rehabilitation strategies to eliminate pain and get back to training and exercise sooner.

AVAILABLE NOW ON AMAZON!

In addition, check out this sample video, Segment 2: What are the Core Muscles?, taken from my Treating Low Back Pain (LBP) during Exercise and Athletics Video Package which you can purchase HERE.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

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Epigenetics: Choose to Optimize Your Aging Process

How you age will in part be determined by genetic forces. These forces are strongly influenced by the lives we have led and the choices we continue to make. The key to successful aging is to be prepared and intentional as to how you want the journey to unfold.

With the sequencing of the human genome, we continue to learn more about epigenetics. Epigenetics is the science of how the modification of gene expression (rather than the alteration of the genetic code itself) can lead to vastly different outcomes in disease processes or a successful aging process.

What this new scientific field has really taught us is that nothing is known for sure. How we treat our bodies, effectively the choices we make, will potentially lead to different outcomes. In other words, we get to have a say in how we age. Our genetics are not set in stone, but instead can be influenced by our lifestyle choices. With this knowledge, we can choose to optimize our aging process. Continue Reading

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Osteoarthritis vs. Rheumatoid Arthritis

What’s the Difference?

By Dr. Matthew Crooks

Arthritis is a condition involving tenderness and swelling in your joints, and it’s often coupled with inflammation as well. With over 100 different types of arthritis, the two most common forms are Osteoarthritis (OA) and Rheumatoid Arthritis (RA). Both of these involve inflammation in the joints; however, learn how these conditions differ.

Breaking Down the Differences

The main differentiator between Osteoarthritis and Rheumatoid Arthritis is that RA is an autoimmune disorder while OA is a degenerative disease. Another major difference between the two is that RA is a type of polyarticular arthritis meaning that it affects multiple joints as well as different sides of the body. Osteoarthritis affects only a few joints and just one side of the body.

Autoimmune

An autoimmune disease is one that causes your body to think there is an issue in a particular area. As a result, it attacks and damages healthy tissue. In the case of RA, it causes your body to attack the tissue surrounding the affected joints. Your immune system will produce antibodies that will attach themselves to the joints. Your body will then attack these joints which then cause inflammation, swelling, and pain in the area.

Degenerative

Being a degenerative disease, OA is one that affects you as you begin to age as well as prolonged wear and tear on your joints. Over time, the protective cartilage that pads and protects the ends of your bones begins to wear down. As this cartilage begins to wear down, the bones within the joint will start to rub together, resulting in pain and stiffness.

Osteoarthritis Symptoms:

Pain and stiffness within the joints are the most common symptoms of Osteoarthritis. These two symptoms typically appear in the morning or after a period of rest.

Some other symptoms that you will notice with OA: 

  • A limited range of motion or stiffness that tends to go away after activity.
  • Clicking or cracking sounds when bending a joint.
  • Mild swelling in the joint area.
  • Tenderness to touch.
  • Pain in the joint that gets worse with activity and at the end of the day.

The most common areas that are affected are hands, fingers, knees, hips, and spine. Over time these symptoms will increase and build up rather than show up suddenly and out of nowhere. However, if the stressors that are causing the wearing and breaking down of the joint cartilage are continued, you may notice a sudden increase in the symptoms.

Rheumatoid Arthritis Symptoms:

Like Osteoarthritis and other forms of arthritis, pain and stiffness will be associated with Rheumatoid Arthritis. Besides this, RA will bring with it: swelling; tenderness; and more than one joint that is affected or the same joint on either side of the body is affected. Fatigue and loss of appetite can also be symptoms of RA.

Other areas of the body can also be affected when dealing with RA besides your joints. The prolonged inflammation that comes with the disease can cause the following:

  • Dryness, pain, and redness in your eyes.
  • Dry mouth.
  • Gum irritation.
  • Small lumps under your skin called rheumatoid nodules.
  • Shortness of breath.
  • Anemia.

Osteoarthritis Prognosis

The prognosis for those with Osteoarthritis will vary from person to person and case to case. There are some cases where patients will not be adversely affected much at all by OA while others are severely affected. The fact that it’s a degenerative disease carries the assumption that the condition will continue to get worse over time.

While this is the case with some patients, other times the disease tends to stabilize at a certain point. While some patients will eventually need to undergo some sort of joint replacement surgery, it’s rare for the condition to progress enough for this to be the recommended course of action.

Osteoarthritis is not a condition that can be reversed. However, it is a condition that can be treated. When experiencing symptoms of OA, limiting the activity in those joints and the amount of stress you put on them will help. The most effective strategies you can take are to maintain a healthy weight and exercise regularly.

Rheumatoid Arthritis Prognosis

In the past, Rheumatoid Arthritis carried a more negative prognosis than it does today. Typically, patients can now live a productive and healthy life while continuing to go to work, school and partake in social and physical activities.

Like most conditions though, the prognosis will vary from case to case. In some patients, the symptoms will go through periods of dormancy while others will experience chronic symptoms. In some severe cases, life expectancy can decrease but this is not as common.

Common prognoses associated with RA include: persistent joint inflammation; a decline in mobility/range of motion in the affected area; and pain and stiffness that does not improve with treatment.

Like OA, it can affect other areas of the body as well, outside of the joints. Some patients will experience psoriasis; heart disease; eye inflammation; osteoporosis; anemia; respiratory complications; and depression. Patients with RA will need constant medical care and should be in contact with their primary care physician as well as a rheumatologist regularly.

Treatment

While both of these conditions are chronic and neither can be cured, both are treatable. Treatment can make living with the disease more comfortable (and in some cases, normal).

Reducing inflammation is an important part of treatment. A doctor may suggest anti-inflammatory drugs which will also alleviate the pain and stiffness in the joint. Other forms of treatment are physical therapy or injections depending on your specific area of pain.

Increasing the mobility and range of motion in the affected area will help slow down the progression of the disease. It’s important to be in contact with your doctor if you are experiencing any of these symptoms. There are always options to improve your quality of life.

For more information on RA and OA, please refer to Q and A: Exercises Beneficial to Managing Rheumatoid Arthritis and 4 Key Strategies for Preventing and Treating Osteoarthritis.

About Dr. Matthew Crooks

Dr. Matthew Crooks is a double board certified, fellowship trained interventional pain specialist. He has had the distinction of training with leading experts in pain medicine at two of the nation’s top hospitals, with extensive training in acute and chronic pain management, completing residency in Anesthesiology at Johns Hopkins Hospital. While at Johns Hopkins, he had the honor of being selected Chief Resident of the Department of Anesthesiology and Critical Care Medicine for the 2008-2009 year.

 

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Is Resiliency the Key to Aging?

Resiliency is defined as an object’s ability to return to an original form or position after being bent, compressed or stretched. When this definition is applied to a person, it gives us a clue as to why some people recover quickly after illness or injury. It can even help describe why some people age well while others do not. This more scientific definition helps us understand why resiliency is nothing more than your own margin for error in life. The greater margin for error you have, then the less likely something catastrophic will occur.

However, for this definition to be useful, we must have an understanding as to what makes a person resilient. Are there tried and true methods in making a person more resilient? Discussing resiliency in an object is quite easy. You just have to understand the characteristics of the object in question. Understanding what make a person resilient is a very complicated discussion because of the multifaceted nature of being human.

Resiliency in humans is not just a physical characteristic. It’s comprised of emotional (psychological), mental (cognitive), social (relationships), and spiritual characteristics.

Each characteristic of human resiliency impacts the others. Understanding the interplay of the five different aspects helps in understanding a person’s true resiliency. The patterns of resiliency in others can offer valuable clues on how we can all become more resilient and age well. Continue Reading to discover how to improve your resiliency.

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Getting in Shape while Avoiding Overuse Training Syndrome (OTS)

New Year…New You! With the beginning of a new year comes the drive to want to do something different and better than the previous year. Resolutions, new changes, new outlooks, and new workout routines are on the top of many people’s resolution list for the new year.

Getting in shape is important for your physical and mental health, but as with everything, you can do too much. As we get into our new routines with fresh motivation, we push ourselves harder–we run faster, swim further, and lift more. Yet while our new workouts may seem outwardly healthy, we may actually be doing ourselves harm in the long run.

Why? For some of us, the exercise routines we have been inspired to take on have turned from ‘healthy’ to ‘unbalanced’. It may be that we progressed too fast or our volume or intensity of training is too high for our present conditioning.

More commonly, there was not enough attention put into the recovery portion of training. In other words, as we’ve pushed ourselves on the court, in the pool or on the bike, we’ve lost track of our personal limits. We’ve fallen prey to what is generally called Overuse Training Syndrome (OTS). It’s also referred to as Overtraining Syndrome.

Overuse Training Syndrome is pretty much exactly what it sounds like: it occurs when the body is pushed too far during exercise and/or training–over and above its limits for too long–thereby causing it to lose its ability to recover in a sustainable and safe way. For obvious reasons, this wreaks havoc on both your health and your training routine, not to mention to your mental endurance. The training cycle should consist of a balance of training, recovery, and then adaptation. Too much training and not enough recovery means no adaptation and in the case of OTS, a regression of health and training status.

Overtraining typically leads to worsening performance and results. Unfortunately, the most common reaction to OTS is an even greater commitment to training harder, faster, and more often. The effects typically end in disaster.

Overuse Training Syndrome (OTS) Symptoms:

  • OTS makes you tired–not in the traditional ‘good workout sense’, but fatigued in a way that throws your training and muscle wellness off balance. This type of exhaustion is often confused with a sense of demotivation or laziness, thus leading many people to push-through and push harder. Sadly, this approach does a lot more harm than good as it delays recovery for longer periods which places even more stress on your overall health, stamina, fitness, and body. This is typically due to over fatigue in either the sympathetic or parasympathetic nervous system depending on your most common form of exercise/training.
  • OTS feels a little like the flu: a dull aching in your muscles and joints, lightheadedness during exercise, slight nausea, and overall grumpiness follows its onset. In general, OTS leads to the lessening of enjoyment during exercise as your goals aren’t met and your motivation declines. OTS is thus mentally and physically debilitating. Yet apart from fatigue and an overall dampening to your exercise routine, OTS and its resultant drive to push harder and faster may actually lead to a number of serious and harmful consequences.
  • Exercising too much and pushing certain areas of your body to the brink and beyond often leads to disturbances which may cause short and long term damage. Examples of these types of injuries include: tendinitis; carpal tunnel syndrome; plantar fasciitis; and patellofemoral pain. Indeed, if the names don’t scare you away, then the pain associated with these conditions will.
  • Perhaps more common when it comes to OTS are symptoms you may in fact already be experiencing. These include insomnia, elevated heart rate, appetite loss, decreasing muscle mass, dwindling performance, and muscle soreness. None of these symptoms are particularly enjoyable. While you may think that exercise may actually alleviate the symptoms, the truth is that increased activity will only worsen them exponentially.

So, what can you do? You love training, your routine is magnificent, and you’ve finally mastered the art of waking up early enough to get the right amount of activity in before work. How could you possibly change anything at this point?

It’s time to start being very honest with yourself. Exercise is wonderful for you, but too much of it may actually be putting you at a disadvantage. The key is–as with so much in life–balance. It’s very important to balance the duration, type, and pace of your routines in order to make sure that no one part of your body is constantly under fire.

Although it may be difficult to accept at first, rest is just as important as exercise. It’s absolutely crucial that you give your body time off to recover and rest. This will allow your muscles to repair themselves, your joints to heal, and your endurance to be prolonged. The training cycle should consist of the right balance of training, recovery, and then adaptation.

Working out is as much about the ability to listen to your body as it is to push it to be its best. Adding a rest day (or two) to your week will actually be more beneficial to your workout than skipping them. As an extra bonus, you can sleep a bit later on those days! Balancing exercise and rest is the most effective way of staving off the risks associated with Overuse Training Syndrome. Knowing how to do this is, however, tricky for many of us.

For more information on overtraining, be sure to check out my 12 Tips to Prevent Overtraining Syndrome and 10 Tips to Self-Treat Overtraining Syndrome. In addition, you can find more recovery tips in Muscle Cramping & Spasms – Treatment Options.

AVAILABLE NOW ON AMAZON!

If you are interested in a more thorough look at Overtraining Syndrome and how to use overreaching as an effective training tool, be sure to check out my book on Amazon, Preventing and Treating Overtraining Syndrome. I show you how to recognize the risk factors and symptoms of OTS. You’ll learn how to utilize prevention strategies to help you develop a personal training strategy that will allow you to push past your limits and prior plateau points in order to reach a state of what is known as overreaching (your body’s ability to “supercompensate”). This will speed up your results, so that you can train harder and more effectively than ever before! In addition, learn how to use the foam roller (complete with photos and detailed exercise descriptions) as part of a health optimization program, recovery program, rest day or treatment modality.

Nothing can derail your best laid training plans and goals like an injury or suffering from OTS! If you develop OTS, you will need to take specific steps to speed up your recovery in order to prevent injury and return to a normal training schedule. Be sure to check out my book today in either paperback or on Kindle!

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Aging Well Takes Initiative

Successful aging is a worthy goal for all of us to strive toward. To be successful in the aging process, great initiative is necessary as we are solely responsible for our health. Each person’s journey will be different. Those who choose to rely on others or our modern day healthcare system will likely miss the mark and unfortunately, the opportunity for a wonderful journey of aging well.

Differences in backgrounds, life experiences, upbringings, and genetics are what make us all so unique and wonderful. It also means there is not a set path to aging well, but instead options to do it differently (to do it your way). In order to age successfully and well, be intentional and take initiative. Although each person’s path is different, consider the following in order to insure a successful process. Continue Reading