Arthritis

I woke up this past Monday morning with pain and swelling in my left wrist and by Tuesday, when it had not dissipated, it was time to have it checked out by a doctor. X-rays revealed mild radoiocarpal joint arthritis (also see this Cleveland Clinic article for a clear explanation of arthritis), which prompted me to see an orthopedist on Thursday. The end result is a left wrist splint cock-up and a 10-day prescription for 800mg of Motrin taken 2 times a day to mitigate the swelling and pain.

I am intrigued by this diagnosis as it is yet one more look into my body, and am not fully surprised because having turned 63 recently and knowing that my Aunt (my Mom’s sister) has arthritis, it is something that is not foreign to me. Age sometimes brings with it interesting challenges, plus I have been practicing yoga for over 12 years and a favorite pose has me balancing on my arms in an egg shape.

Thankfully, this appears to have been a mild occurrence, with my arm not currently in the splint as I type. By the end of this coming weekend, if not sooner, wearing the splint will have been  phased out. I am now only wearing it while at school due to teaching in a makerspace; the splint ensures that my left hand is not pressed into inappropriate use for the types of activities that cause the pain, mostly lifting or pushing if my hand is in a certain position.

So what does arthritis look like?

A trained eye can distinguish the arthritis as well as the mild tendonitis identified by the orthopedist. Arthritis occurs when there is an inflammation between the joints, a joint being the place where two bones come together. In a healthy joint cartilage allows for smooth movement between the bones at the joint. Tendonitis refers to inflammation of a tendon, tendons being fiber that attaches muscle to bone. Essentially, the arthritis and tendonitis together have sent a signal that something is amiss and should be tended to!

Being an avid yogi, practicing and also teaching, it is no surprise that yoga is also recommended for people with arthritis. (See these articles from Johns Hopkins and the Arthritis Foundation.) With that said, I suspect an errant move on my part while doing yoga may have exacerbated this instance! Nonetheless, there are two useful books for assisting people with arthritis thru the practice of yoga:

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Our Nervous System, explained

I am taking the online course Being Well in a Digital Age – The Science and Practice of Yoga, which partially explains why it has been two years since my last post on this blog. During the first half of 2016 I was studying for my 200-hour yoga teacher certification and blogging at my other web home, Yoga ~ Dance ~ Music ~ Movement. And for large portions of 2015, 2016, and the summer of 2017, my son, daughter-in-law and grandchildren were living with us. Spend time blogging here or with my family; easy decision!

My yoga blog has been the recipient of all yoga-related writing and below is a cross-post of my most recent post, written earlier today. It deals exclusively with the nervous system and how stress impacts and is dealt with by the nervous system. The post is reprinted below.


The lectures by Catherine Spann and Stacy Dockins from Being Well in a Digital Age – The Science and Practice of Yoga have explained the basics of what happens when stress manifests in the human body. A little bit of stress is manageable; a lot of stress begins to break down our capacity to effectively deal with the stress, and that in turn can manifest in the malfunctioning of other body systems.

Our nervous system consists of two parts, the central nervous system and the peripheral nervous system. I use the word “central” to help remember what the central nervous system consists of – it consists of our brain and spinal cord, the part of our nervous system that runs center or central in our body from our head to the bottom of the spine and is housed in our axial skeleton.

The peripheral nervous system is the communications conduit between the central nervous system and the rest of the body. The word “peripheral” means outlying items or those not centrally located. Again, this helps me remember what the peripheral nervous system deals with – the parts of our nervous system peripheral to the brain and spinal cord, the parts of our nervous system that run through our appendicular skeleton.

The peripheral nervous system consists of the somatic nervous system, which are our voluntary actions, and the autonomic nervous system, which are our unconscious actions such as our heart beating (though we can control that to some extent), and the regulation of digestion, respiration, to name a few of the systems.

Finally, the autonomic nervous system is further composed of the sympathetic nervous system and the parasympathetic nervous system. These two have alliterative words to quickly and easily describe their functions. The sympathetic nervous system triggers the fight, flight or freeze response, which Catherine likens to putting a lead foot on a gas pedal.  The parasympathetic nervous system invokes the rest and digest response, which Catherine equates to putting on the brakes. All of these systems interact with the hypothalamus in the brain, which along with the pituitary gland and the thalamus are part of the endocrine system.

The last piece of this puzzle is the vagus nerve, the longest nerve of the autonomic nervous system. Its role as part of the parasympathetic nervous system involves regulating the heart, lungs and digestive tract.

Now we come to stress and how it impacts our nervous system. Stress can be of a short duration, known as acute stress, or it can be chronic stress meaning it is ongoing over a long period of time or simply recurring over and over and over. Our nervous system has a “set point” where it is relatively in balance; this is called homeostasis. Each time our body undergoes some form of stress, our nervous system makes adjustments to return to homeostasis. This adjustment process is known as allostasis. If we are frequently engaged in allostasis it leads to allostatic load, which is the wear and tear on our body systems that often leads to an autonomic imbalance, meaning our sympathetic and parasympathetic nervous systems are out of whack.

Eventually allostatic load causes a cycle that over time makes it difficult to reset our nervous system and find our way back to homeostasis. This is where yoga comes in! Yoga can calm the nervous system and strengthen the ability to self-regulate. A calm nervous system can begin the process of allostasis and correcting for the growing internal imbalances.

One way of calming the nervous system is by stimulating the relaxation response as described by Dr Herbert Benson. Deep, slow breathing stimulates the vagus nerve, which then positively triggers the parasympathetic nervous system. As noted in a prior post, the combination of movement (the physical part of yoga), breath, mindful attention, and relaxation lead to improved mental health. This combination makes for a powerful self-regulation tool that lets you consciously partner with allostasis to reset your body in homeostasis.

Jon Palfreman’s Brain Storms

Just this morning I finished reading Jon Palfreman’s highly accessible 2015 book, Brain Storms – The Race to Unlock the Mysteries of Parkinson’s Disease. I wrote the following review of it for my Goodreads book shelf.


Thank you to whoever recommended this book – not sure if it was Palfreman’s opinion article The Bright Side of Parkinson’s in the NY Times Sunday Review or Dance for PD. I am glad to have found and read it.

 
Palfreman writes with grace and with a story teller’s eye, demystifying the complexities of brain science and pharmaceuticals. He traverses the history of Parkinson’s research all the way from its initial discovery by James Parkinson to the many scientists currently working on myriad approaches to preventing, curing and reversing the disease.

I highly recommend this book to anyone who has any connection to Parkinson’s or Alzheimer’s or any of the other neurodegenerative diseases that abound. I found myself breathing a curious sigh of relief just knowing that there are so many people who are trying to resolve these diseases, and there are many more people trying to live with these diseases. My Dad was one of them, with the double whammy of Parkinson’s and Alzheimer’s. Not knowing what my future will hold, I take solace and advice from books like this one. And I leave you with two of the most interesting facts that Palfreman shares.

How a person with Parkinson’s chooses to live may be as crucial to his well-being as which medicines he takes. Research supports the idea that patients who exercise regularly (as I explored in chapter 7) and who keep a positive attitude and remain socially and mentally engaged do much better than those who withdraw from the world. Whether this is because of the neuroprotective effects of exercise and engagement or a robust placebo effect is still to be determined.

Everything, and I mean everything that I have ever read about promoting a healthy aging brain states the same results: EXERCISE and SOCIALIZE. And engage in novel, challenging activities.

The second highly interesting fact that Palfreman mentions is the placebo effect, which I find amazing and suggestive of the human power of optimism and determination. Hmm, those last two sound like the “positive attitude” noted in the first interesting fact!

It turns out that many times people who received a placebo, instead of some of the actual treatments described in the book, wound up having a positive effect that often lasted for a considerable amount of time. The questions this raises are twofold – Why can placebos be as powerful or more powerful than actual treatment? And what does this mean for certain invasive treatments if the placebo can do as much or more good than the invasive surgery?

…the Rush University neuroscientist Christopher Goetz mentioned in an update to the Parkinson’s community the intriguing and somewhat controversial topic of the placebo effect… Goetz the clinical neurologist believes it is an effect worth keeping. As he puts it, “I use the placebo effect when I greet my patients, when I encourage them, when I tell them we’re a partnership… [I] would never want to eliminate it in the clinic.” But Goetz the scientist sees the placebo effect as a liability. “In a trial, if the patient gets just as good effect with sham surgery as having some kind of foreign cell implanted, then we have a problem.” That’s the conundrum in a nutshell.

Sit? Stand? Move!

I have a standing desk in my office. Easily adjustable, it can be lowered to function as a sitting desk, but I only use it as a standing one because directly opposite is the counter at which I used to sit. That counter is now used as a staging area or as a place to sit for lunch.

After reading a NY Times article this past November, Stand More at Work, Sit More at Home, I decided to do an experiment. Initially, my experiment was going to run for a full week, but it quickly became apparent this would not be necessary.

I tracked my sitting and standing times on a typical weekend day, in this case Sunday, November 15 (my birthday!) I tried to avoid consciously changing behaviour in order to keep the results as true as possible, and here is what the result was: 6 hours 30 minutes spent sitting, 8 hours 5 minutes spent standing.

The next day, Monday, November 16, I tracked my sitting and standing standing desk at worktime at school. When teaching, I am typically on my feet in different classrooms. My office is on the second floor of a building, requiring me to use one long and one short set of stairs to go up and down, something that I do multiple times each day. Our school campus has four buildings, and my office, where all my supplies are located, is not in the same building as the classrooms in which I teach. The result: 6 hours 32 minutes spent sitting, 9 hours 50 minutes spent standing.

I stopped my experiment at this point, because the goal was to compare a weekend day to a work day, and all of my work days are similar in terms of standing, sitting, and walking around.

Of course, all of this made me wonder WHY is it better for humans to stand than to sit. According to James Levine of the Mayo Clinic,

The impact of movement – even leisurely movement – can be profound. For starters, you’ll burn more calories. This might lead to weight loss and increased energy. Even better, the muscle activity needed for standing and other movement seems to trigger important processes related to the breakdown of fats and sugars within the body. When you sit, these processes stall – and your health risks increase. When you’re standing or actively moving, you kick the processes back into action.

His full article is available here.

The operative word in Levine’s comments above is movement. Research has shown that it is movement, not simply standing, that makes a difference in our overall health. Thus, no matter how you slice it, sitting too long is a health hazard, as artfully depicted in this Washington Post infographic.

For reference, here are some past posts related to movement:

  • Move It!  – how exercise boosts brain power
  • Exercise Lights A Spark – the first of two posts about John Ratey’s book SPARK, provides background for the second post
  • Mostly in Ratey’s Words – explains the benefits of exercise on learning, particularly the Science of exercise’s impact on the hippocampus

The Secret World Inside Each of Us

This past summer I read, with much interest and delight, Gut by Giulia Enders, and in preparing for this blog post this 20-minute interview with Giulia showed up in a search.

Enders’ book introduced me to the invisible world of my insides. This Fall, the American Museum of Natural History in NYC further opened up my insides for me to see as a result of the exhibit The Secret World Inside You. Not too long ago I scoped out the exhibit in preparation for a possible visit by the 5th graders at the school where I teach.

By now you probably know that there are trillions and trillions of bacteria living in us and on us. Around the same time I visited the AMNH exhibit, my husband and I were spending evenings watching the six episodes of David Eagleman’s The Brain. Between learning about the bacteria and the brain, at one point during a Brain episode I burst out saying “we are simply aliens with skin covering!” We are not so different in our internal look than the many aliens depicted in sci-fi movies; we simply have an outer look that we are used to while we (or certainly, I) continue to be amazed by our inner conglomeration of micro-beings.

Collectively all those trillions and trillions of bacteria weigh about as much as a human brain, which is three pounds. I teach 3rd graders about water, and there are billions of bacteria living in one tiny drop of water. Billions!

It turns out most of our cells and genes are not “human”. Rather, they are microbial, meaning they are teeny tiny life forms that we cannot see, and often only are aware of when something is out of balance resulting in our not feeling well. As Giulia states in the above interview, our microbes are necessary for digestion and most of them aid our immune system, but when they are out of balance or we harbor any of the five percent that are not good for us, we become aware of their existence.

As a result of the museum exhibit I learned there are eight characteristics of bacteria. Bacteria:

  1. are small (very!)
  2. are alive
  3. consume nutrients
  4. move
  5. communicate via chemical signals (and they live in colonies of billions!)
  6. reproduce
  7. swap genes between cells, therefore combining and recombining their DNA, which is why they can become resistant to antibiotics
  8. evolve due to their ability to reproduce and morph their genes

In the early years of an individual’s life the variety of microbes in their body train cells of the immune system to only attack bacteria that are carrying diseases. This is how a human develops immunity, in other words, protection from illnesses and unfriendly bacteria. Autoimmune diseases (such as MS, IBS, type 1 diabetes, rheumatoid arthritis) occur when a person’s immune system doubles back on itself and attacks its own cells.

As best I understand some of the practical advice that has come out of microbial studies, kids playing in the dirt, petting cats and dogs, and being given the bare minimum of antibiotics, all lead to having a healthier gut micro biome and possibly fewer allergies.

Yes, wash your hands before you eat and after going to the bathroom. But perhaps stop using those microbial foams that dry out your skin and vanquish contact with bacteria that are good for you!

Neuromovement

Given all that I have written over the years about the brain and movement (both here and at my yoga blog), without knowing more about “neuromovement” I would have guessed it described the brain and how it manages movement.

Last night I had the opportunity to attend a free talk, Neuromovement for a Vibrant Life by Anat Baniel, at the Eileen Fisher Learning Lab in Tarrytown, NY. Anat is an entertaining presenter, injecting humor and a sense of “I know exactly what I am doing, and I am doing it as it should be done” into her talk. She is also the creator of the Anat Baniel Method, a neuromovement approach to helping people of all ages who have limitations imposed by a brain that is not functioning to its fullest. From her information-packed site:

NeuroMovement® is a holistic approach to human functioning and action, based in the understanding that movement is the language of the brain. Movement provides information the brain needs to grow and organize itself. And, in return, the brain organizes all movement, thought, feelings, and action.

Anat explained that her approach utilizes The Nine Essentials For Vitality®, and used her talk to describe the first three. (The free Friday evening talk was followed by a pay-to-attend workshop the next day, which I did not attend, and where the plan was to go into the remaining steps.)

These Essentials make use of brain plasticity, which I have discussed in multiple blog posts. As Anat describes, each Essential is useful for:

…creating new connections and avoiding rigidity and automaticity when needing to overcome pain and limitation to thus reach new levels of physical and cognitive performance.

The three she explained are Movement with Attention, The Learning Switch, and Subtlety. Movement with Attention is how I practice yoga, and I immediately equated it with moving with the breath, attentiveness to my body’s messages, and awareness and then dismissing of any thoughts that percolate during practice.

The second Essential, The Learning Switch, reminded me of Elkhonon Goldberg’s talk at a Learning & the Brain conference years ago. To quote from my blog post, this is what he had to say about keeping the aging brain healthy:

Goldberg employed us to “turn neuroplasticity to your advantage” by: 1. Welcoming novel challenges. 2. Beware of being on mental autopilot. 3. Remain cognitively active.

The Learning Switch necessitates the brain be in a ready-state for learning. As Anat notes, “repetition, drill, and everyday stresses, as well as habitual patterns of thought, exercise and emotions, all tend to turn the learning switch off.”

Subtlety is the third Essential, and was the most interesting to me due to being the area which provided the most ideas for ways to work with children and adults. It is the concept of “less is more”. As Anat explained:

For the brain to receive new information it needs to perceive differences. By reducing the force with which we move and think, we increase our sensitivity. With the resulting increased sensitivity we greatly enhance our brain’s ability to perceive the finest of differences. These perceptions give the brain the new information it needs to organize successful action and become more alive and vital in both body and mind.

What has remained with me is the content of a short video Anat showed highlighting her work with an infant who was born with an inability to move her left arm. Typical physical therapy dictated repetitive physical movement of her arm by a physical therapist. Anat explained that this would simply train the child’s brain that in order to move the arm it needed an external person to lift it. Then came the part that astonished me – in the video Anat simply blew on the child’s palm while seeming to apply stimulation to another part of her body at the same time. (Sitting in the second to last row, it was difficult to see all the video detail.) Within ten minutes she had successfully helped the child’s brain to recognize and move her left arm. Less was more, and the focus of the “less” was as simple as could be.

Another story Anat shared had to do with a boy who was having extreme difficulty with writing, beginning with the letters of the alphabet. This story highlighted her explanation that the brain needs to perceive differences in order to rewire itself. Well-intentioned experts had been trying, unsuccessfully, to get the boy to write the letter “A”. Anat concluded that the boy had no idea what a proper letter “A” should look like, so she asked him to draw his worst version of the letter “A” and then complemented him on drawing a truly poor version. She then suggested he draw a slightly less “worst version”, and he complied. When she requested an even slightly less “worst version”, he asked if she was kidding him, and then proceeded to draw a version that was getting close to a good version of a letter “A”. His ah-ha moment came when he realized what an “A” actually looked like.

The remaining seven Essentials are: Variation, Slow, Enthusiasm, Flexible Goals, Imagination & Dreams, and Awareness, and you can read more about them here on her website.

Falls Awareness & Prevention Guide

Falling is the nemesis of older folks. Yes, falls can be an issue for anyone at any age, but for older folks it can mean broken bones – especially hip bones – that take a long time to heal, require physical therapy to be able to resume activity, and are all too often the harbinger of further problems.

The American Academy of Orthopaedic Surgeons and The Orthopaedic Trauma Association have put out a Falls Awareness & Prevention Guide that I recommend for anyone, regardless of age, and absolutely recommend to anyone living on their own, particularly if they are older (and you can take “older” to mean whatever age you feel like having it mean!)

My Mom lived alone for about five years, and in her last year of life she fell several times, the first on New Year’s Day 2010. We were getting ready to leave a family gathering at the home of a relative. Wearing shoes that were like slippers and did not offer much by way of support, she tripped on a towel that was near the front door and meant for wiping wet shoes. The shoes and towel were a nasty combination, causing her to lose her footing and fall to her left. As if it were happening in slow motion, several of us tried to reach out and catch her or lessen the impact of her fall. Alas, a trip to the ER showed a broken left humerus. This would be the first of two shoulder breaks, with the next one happening to her right humerus.

If you look at the Falls Awareness & Prevention Guide, you will notice inadequate footwear and all throw rugs and area rugs that are not properly secured (could just as easily apply to towels on the floor) listed as risk factors. It could have been anyone who fell on that rug, but I suspect my mother’s age also had something to do with it.

So, take a look at the guide and see if it provides some tips for you or for someone you know. Being a little proactive now can mean a lot in terms of later prevention.

And from the National Council on Aging, an info graphic to herald Falls Prevention Awareness Day, which happens to be September 23, 2014.

FPAD14-Infographic_full