Tuesday, April 29, 2008

This stream fulfilled its promise of trout.
Tucker time.
Mother Kangaroo with a Joey in her pouch.
It's not a caravan. It's a mobile kennel.

Saturday, April 26, 2008

Capsaicin (chili) cream breaks down substance p and eases the pain of CRPS/RSD.

Over the years I have had pain due to CRPS. Things have improved greatly for me but at times when burning returns I use chilli (Capsaicin) cream. I rub the chili cream in until it disappears. I make my own cream as I'm allergic to something in prepared cream. The active ingredient in chile is Capsaicin which breaks down substance p. Substance p is a neurotransmitter . Nerve cells communicate using neurotransmitters. so substance p's basic function is to cause pain. As the body continues to make substance p you need to keep applying the cream.

Science links Japan have reported results that a trial of Capsaicin cream was successful for use as supplementary pain control for patients suffering from trigeminal neuralgia and CRPS.
Medline also reports on the successful use of topical agents including Capsaicin cream for the treatment of neuropathic pain. http://www.medscape.com/viewarticle/431465

Wednesday, April 23, 2008

Physical therapists "consider adapting practice in the light of emerging evidence."

Medical News Today, had an article on a special report in Physical Therapy Reviews featuring an editorial by Professor Jennifer Klaber Moffett of the Institute of Rehabilitation, University of Hull, UK. The Professor is reported to have said that understanding the new science of pain will cause therapists to think carefully when treating pain patients and "more importantly consider adapting practice in the light of emerging evidence."

If you click on the tag "physical therapy" below this post you'll find what physical therapy has helped me. Sharing our experiences helps to pave the way to better understanding

Embracing the new science of pain - physical therapists lead the way.

Research has proven with MRI results that the brain changes with chronic pain.

More recently we've learned that changing the inputs or messages to the brain, which is known to have plasticity, causes the brain to change. These are not emotional responses to fragile egos. This is real science showing the pain and symptoms of Complex Regional Pain Syndrome can be managed and possibly resolved using simple, inexpensive, practical methods. This is treating the source and not just band aiding the symptoms. This is very good news for sufferers.

Mirror Visual Feedback, or mirror therapy is based on the finding that visual input from a moving, unaffected limb re-establishes the pain-free relationship between sensory feedback and motor execution in the affected limb.

"Explain Pain" by David Butler and Lorimer Moseley discusses "smudging the neurotag". Persistent or chronic pain leads to changes in the brain. Our brain changes all the time and is dependent on input for information. We become more sensitive to pain, and the area of pain in the brain, the virtual body becomes more "smudged" or less clearly defined. This means that instead of pain being confined to an area, eg the shoulder, the pain spreads beyond the original site. (see Noi Group link to the left of this blog) Dr Lorimer Moseley (physiotherapist and co-author of "Explain Pain") employed a motor imagery program which entailed "two weeks each of hourly performance of hand laterality recognition task, imagined hand movements followed by mirror therapy." (from 8th International Physiotherapy Congress).

It is physical therapists who are embracing this new science of pain. They are involved in the research, practicing and training of therapists around the world.

Mirror therapy is simple to do, inexpensive and really works!

Monday, April 21, 2008

Getting the balance right is like walking a tight rope.

Getting the right balance between doing therapy and family, work or social activities is almost like walking a tight rope for people with chronic pain. One of the hardest things is accepting our situation and sometimes letting go of our pre-pain identity. (I found that really hard.) Often the reality is that we cannot do all that we managed to do before. We need to redefine what is the new normal for us. Pushing on when our body is telling us we've done enough can set us back in the long term so that we "pay for it" later. Above all, I think that we need to believe that we deserve to give ourselves the time to work at helping ourselves. That's especially hard for those who have always seen themselves as helping others.

Although sometimes the direction in which life takes us impacts on our sensible life choices, pacing and keeping stress to a minimum is our basic survival plan. It's easy for me to say pace, a little and often but in a practical sense how do you do this?
I believe the secret lies in HTCwP's posts on changing a habit.


Here's what works for me. I had to get in the habit of doing this by practising every day. I divide the day into the number of therapy sessions I can manage.
At present I do five a day.
  • Before I get out of bed I breathe in for 4 and out for 6-8 with a pause in between. On the first day I do this I'll do 12 sets of in/out breaths which is about 3 minutes in total. I increase the time by one set occasionally. I then stretch whilst lying down and finally do some exercises sitting on the bed.
  • About morning tea time I do breathing again followed by some different exercises (usually either with weights or a band).
  • Before lunch I breathe again and do a different exercise and
  • again in the afternoon and
  • in bed at night I do muscle relaxation and breathe again.
My exercises don't take long and I vary what I do each time. The breathing is calming and is mindful if you focus on what is happening as you breathe. HTCwP has good posts on "mindfulness".
Allow yourself time to practice and develop a routine whether at home or at work. (It's in their own best interest to allow you time for therapy and rest at work.)

The other things I do are to notice and correct my posture if I am in more pain or tired and to try and move "normally". The more we move normally the more we reinforce the "OK" message in the brain.

Above all else I believe we should listen to our body,
I encourage you to alter and enhance your life style to accommodate your needs and feel empowered by knowing you are helping yourself.

Sunday, April 20, 2008

Great 2020 summit blog by Cristen Tilley, senior producer ABC online.

If you're interested in an inside observer's view on this hopefully ground-breaking summit then take a look at Cristen Tilley's blog. Read the section Agenda: productivity and get a "sneak peek" at what won't be televised. Take a look at the bionic eye: 2020 vision by 2020. Share the summit through Cristen's astute eyes.

Thursday, April 17, 2008

Promoting awareness.

This is my post for HTCwP's April Blog Carnival.
The April Pain-Blog carnival will be up soon.
How to Cope with Pain is now offering a monthly Pain-Blog Carnival during the last week of every month, to include each month's best posts. New bloggers are always welcome to contribute.
As some are aware I am devoting this year to promoting awareness and gaining interest in educating and funding for research. In Australia we have been given a unique opportunity to have our say about future directions for our country. This weekend there will be a 2020 Summit http://www.australia2020.gov.au/about/index.cfm
I took the opportunity to join a local 2020 Summit at which I gave a submission. This will be taken and considered with other submissions at the summit this weekend in Canberra.
Due to my recent accident I was not able to forward my submission in time to be placed on the government website. For that reason I've decided to post it here. People often ask me how to spread awareness. Sometimes I think you need to grasp the opportunities as they present themselves.

Submission for 2020 Summit

Re Topic 5 – Long term health strategy

It costs nothing to think smart.

There are numerous low cost treatments that are well documented but infrequently used. Two of these with which I am familiar are a simple exercise to fix some cases of Benign Positional Vertigo (BVP) and new brain science treatments for pain. Importantly also, I am aware of protocols which, if used, can prevent a chronic pain syndrome after surgery.

I met an elderly woman who had been given the drug Stemital for benign positional vertigo for over two years. She had signs of Parkinsonism as a side affect of Stemital and was never given the option of an exercise to correct the cause. If her doctors or therapists were educated about this simple non-drug, effective treatment and had used it, then she could have been saved years of nausea, dissatisfaction with the health system and the government would have saved over $1000 in treatment costs. BPV is more common as people age.

I have a chronic pain syndrome which I am successfully treating at home with a mirror. The human brain has multiple mirror neuron systems that specialize in carrying out and understanding not just the actions of others but their intentions, and their emotions and pain. The brain decides if we experience pain. Retraining the brain with the “it’s ok” message using a simple mirror stops pain at its source.

Mirror Therapy is very successful and is not just mind over matter but a measurable change in neural activity. Australia’s high cost of pain alone reveals a $34 billion price tag. With an aging population this is set to increase. Mirror visual imagery, once taught can be done at home for the cost of a mirror. There are other low cost, non-drug, non-invasive treatments which retrain the brain.

The potential savings in pain costs alone is millions.

I developed a chronic pain syndrome after a wrist fracture (37% of people with a wrist fracture develop this). Scientific studies have proven that this syndrome can be prevented by taking 1 gram of vitamin C for 50 days after the break. A high percentage of people with orthopaedic surgery develop this syndrome. Protocols including pre-emptive analgesia and vitamin C have been developed to prevent this syndrome which causes intractable pain and a huge drain on the health system. The economic impact of my case alone is estimated to be close to a million dollars.

My recommendation is to think smart by utilizing what is already known in the first instance and researching and teaching what is known but not well documented.

I suggest this is done by:

  • Compiling a document of non invasive, non-drug treatments proven to work.

  • Distributing a hard copy of this document to doctors and providers for easy reference.

  • Providing training to support the document and also training about legitimate alternative options.

  • Identifying treatments known to work but needing further research.

  • Educating stake holders to the advantages of funding research into what is known to work but not rigorously researched. Share the burden.

  • Being pro-active in creating culture change towards living physically and mentally healthy.

  • Developing performance review guidelines for providers including their provision of lowest cost, lowest impact options.

  • Addressing Indigenous health issues with empowerment and respect.

Let’s review health in terms of obtaining the best outcomes, wisely, compassionately and cost effectively. Above all let’s educate our providers with what is known and fund further research into what is known but not published or adopted. Let’s bring our health system to the cutting edge towards 2020.

Sunday, April 13, 2008

RSD patients deserve fair treatment.

On Monday I had an accident where my left leg went out to the left with a loud cracking sound. The pain was sudden and very severe. We were bush camping in our caravan so didn't reach the local small town hospital for several hours. In small towns in Australia local general practitioners service the hospital. My leg was strapped with a wooden spoon, a ruler and two sturdy sticks.

As is mostly the case in these small towns, the nurses were wonderful and the doctor seemed kind and thorough in his examination. I explained that I was not in much pain if I kept still but that my leg collapsed if I tried to walk. My knee did not feel stable and I'd collapsed with extreme pain 5 times. At this stage my leg looked normal, swelling came later. I told the doctor I have RSD. He said he knew the condition and that it involved weak muscles from not using them. He told me both my quadriceps were weak and I should see a physiotherapist. I explained that I understand the neglect symptoms RSd patients often have but that I have had on going physiotherapy for 10 years. He bandaged my knee and offered me pain medication. I explained that I do not take pain medication and was not in much pain as long as I didn't weight bear. With that he left the room.

I wondered if this doctor had preconceived ideas about RSD patients. Clearly he did not listen when I explained I had an accident where my leg went unnaturally sideways with a loud click. He did not listen when I said I could not weight bear. If he had no knowledge of the pain syndrome would he have treated me with the same arrogant disregard for what I said?

The nurses were concerned and asked me how I was going to manage. I stubbornly said that as he seemed to think I was fine then I would get up and walk which I did and promptly collapsed in severe pain. The nurses strapped my leg in a steel brace and called the doctor back. He suggested I come back the next day for an x-ray. I was then told to go home, two days' drive away and see my own doctor.

It's Sunday here today. The gross swelling has gone down considerably. I am having conservative treatment of laser acupuncture, anti inflammatory cream, vitamin C to prevent CRPS complications and passive exercise. My leg remains in a brace except for several times a day when I do passive movements. Today I have improved range of movement with my leg but cannot weight bear. I do not have CRPS symptoms in my left leg. I followed Professor Scott Reubin's protocols for prevent CRPS after orthopedic injury and I am taking vitamin C which deals with inflammation. If I continue to be unable to weight bear then I'll have further tests.

The real downside for me with this accident is that it has caused a recurrence of cardiac symptoms. My immediate problem when my leg gave way wasn't the pain. It was trying to remain conscious as my blood pressure plummeted. I was halfway up an embankment with a river below. I'm hoping that in time Yamamoto Acupuncture works its magic again.

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