Tag Archives: Arthritis

Lymphedema Tied to Obesity? Exercise helpful too it seems

Greetings… Part 3a of 3b.

Dr. Halligan, surgeon, Doctor’s Clinic Silverdale, saved my life/legs when he checked to see if the deep lesions on my left leg could be treated without surgery….and wanted a daily cleaning –debriding – and rewrapping of the leg. The doctor ultimately did it himself – everyday in the hospital.

Back home my husband, trained by Doctor’s Clinic Silverdale took over the leg lymphedema wrap.

Restless Leg Syndrome (RLS) – now called

Willis-Ekbom Disease (WED) Foundation www.willis-ekbom.org – was my biggest hindrance to healing.

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“Lymphedema Tied to Obesity

By Todd Neale, Senior Staff Writer, MedPage TodayPublished: May 30, 2012

“Obesity may contribute to the development of lymphedema, a small study showed.

Among 15 obese patients with enlargement of the legs, the average body mass index was significantly greater for those with confirmed lymphedema (70.1 versus 42.0 kg/m2, P<0.001), according to Arin Greene, MD, of Children’s Hospital Boston, and colleagues.

“Our findings suggest that obesity … may be a cause of lower-extremity lymphedema,” they wrote in a letter to the editor in the New England Journal of Medicine.

“As the amount of adipose tissue increases in the lower extremity, lymphatic vessels may become dysfunctional (possibly because of compression or inflammation), thereby reducing proximal lymphatic flow,” they explained.

“Alternatively, elevated production of lymph from an enlarging limb may overwhelm the capacity of a normal lymphatic system to remove the fluid from the extremity,” they continued. “Although lymphedema is typically progressive, we speculate that

http://www.medpagetoday.com/Endocrinology/Obesity/32986

Steven Gardner, political reporter at the Kitsap Sun, will have Bariatric surgery at Swedish Hospital in Seattle probably in the April time frame. Steven tells his story here: http://fieldofsteve.com/

“Obesity is known to be a major lymphedema risk factor” Part 3a of 3b

Fitness and Exercise:

It is very important for individuals with lymphedema to be physically fit and maintain a healthy weight. A safe form of exercise is an essential part of a fitness program for people with lymphedema. Fitness and exercise are not the same. Exercise includes many different types of physical movement. The three main types of exercise are: aerobic, strength, and flexibility.

These three types of exercise, along with Lymphedema Remedial Exercises, are addressed

in this paper. There are many other types of exercise that have health benefits such as Pilates, yoga, Tai Chi, Qigong, aquatic exercise,1trampoline rebounding, breathing exercises, and relaxation exercise that have not been adequately studied in people with lymphedema. However, the person with lymphedema can use the benefits of any system of exercise if he/she follows the general safety principles of exercise with lymphedema, seeks medical guidance, and uses caution in starting any new exercise program.

Exercise and types of lymphedema:

Lymphedema has many causes. The type of exercise that is best for an individual depends upon the severity and cause of lymphedema and other co-existing medical conditions (e.g. heart disease, diabetes, arthritis, etc).

Exercise for breast cancer-related lymphedema is the most studied lymphedema condition. Many conclusions about exercise and lymphedema are based on studies of breast cancer survivors that may or may not apply to other forms of lymphedema.

Lymphedema Remedial Exercise:

Lymphedema Remedial Exercise is a part of treatment for lymphedema when reduction of size of a limb is necessary. Lymphedema Remedial Exercise involves active, repetitive, non-resistive motion of the involved body part.

Exercise in Phase I and Phase II Complete Decongestive Therapy (CDT) (see Position Paper “Diagnosis and Treatment of Lymphedema” http://www.lymphnet.org/pdfDocs/nlntreatment.pdf) is performed with compression as an essential part of the total (complete) reductive phase of lymphedema therapy.

3-5

Lymphedema exercises, used with compression, help the body’s natural muscle pump to increase venous and lymphatic fluid return to the circulatory system and out of the swollen areas. Remedial Exercises for lymphedema are similar to some movements of low impact Tai Chi and Qigong, but are different in that lymphedema Remedial Exercise is used with Phase

I treatment of lymphedema to reduce size of the body part.

Lymphedema Remedial Exercise has been studied and shown to reduce limb swelling.3-5

It is unknown whether Lymphedema Remedial Exercise alone can prevent

lymphedema in at-risk individuals, or whether they can maintain reduction of swelling without compression.

Flexibility or Stretching Exercises:

Flexibility exercises include a wide range of activities that stretch muscle and connective tissues to increase and/or preserve range of motion. Flexibility exercises can minimize skin scarring and joint contractures that may lessen lymph flow. Flexibility exercises should be performed slowly and progressed gradually. Flexibility exercises are not a treatment for lymphedema, but are a part of optimal lifestyle management for reducing the complications of lymphedema. Lymphedema has a tendency to restrict motion of muscles and joints.

Optimal lymphatic function requires full mobility of muscles and joints. Lymphedema from cancer treatment can be associated with tight muscles and connective tissues due to fibrous adhesions from surgery or radiation. Tight muscles and scars from surgery or radiation may require Physical or Occupational Therapy to treat before attempting to do self-stretching.

Specific stretching exercises for cancer treatment-related scars and joint restrictions in an area at risk of lymphedema should be prescribed by a provider familiar with the management of lymphedema. A specialized form of stretching exercise may be required for Axillary Web Syndrome (AWS) or axillary cording, a condition that can occur in cancer survivors who have had axillary (armpit) lymph nodes removed.6

AWS may benefit from treatment by a certified lymphedema therapist and specific home stretches taught by a therapist.7

Resistance or Weight-Lifting Exercise:

Resistance exercises are usually thought of as weight-lifting. Resistance exercises may involve lifting body weight (such as push-ups) or lifting objects (such as dumbbells, weight machines, etc).

Resistance exercises can be performed without moving a joint (isometric) or by moving the joint through a range of motion (isotonic). All of these types of resistance exercise may be utilized by individuals with lymphedema, but should be done cautiously, starting with low weights, low repetitions, and gradual progression. Resistance exercises are performed against an opposing load to enhance muscle power, stamina, and tone. Resistance exercise may reduce limb volume when used as an adjunct to compression therapy8

One study showed that guided participation in resistance exercise, as a part of a total fitness program, did not increase the risk of developing lymphedema in breast cancer patients at risk over the group who did not exercise.9

Lymphedema did occur in both groups. No increase in lymphedema development was noted between the exercise and the non-exercise group. There have been many studies on resistance exercise in breast cancer-related lymphedema that show no harmful effect on lymphedema and beneficial effects for overall health.10-20

Aerobic Conditioning or Cardiopulmonary Exercise:

Aerobic conditioning exercise is often referred to as “cardio” exercise. Aerobic exercise involves activity that uses large muscle groups to increase the heart rate to 60-70% of an individual’s maximum heart rate. This type of exercise, when progressed gradually, increases the heart and lung capacity while also improving muscle conditioning.

Aerobic conditioning enhances cardiovascular fitness, effective weight management, and overall health and well-being, all of which are very beneficial to people with lymphedema from all causes.10-21

Walking, jogging, cycling, and swimming are examples of aerobic conditioning exercise. Aerobic conditioning has not been studied formally as a treatment for lymphedema. One study showed no adverse effect on lymphedema from aerobic exercise.17

Resistance Exercise plus Aerobic Exercise:

Studies of combined resistance and aerobic exercise have shown no adverse effects on lymphedema.21

No studies have specifically evaluated resistance plus aerobic exercise as a stand-alone treatment for lymphedema. One study in breast cancer-related lymphedema showed that the individuals who performed aerobic conditioning and weight lifting had better control of their lymphedema and had fewer flares of lymphedema than those who did not exercise. However, individuals with lymphedema still had to utilize standard lymphedema therapy techniques for flares.

Another study about women at risk for breast cancer-related lymphedema showed that aerobic conditioning and weight-lifting reduced the risk of developing lymphedema.

Considerations for Designing an Exercise Program:

A number of studies have shown that aerobic and resistance exercises are safe and beneficial for people with lymphedema or at risk of lymphedema if they follow the guidelines for progressing slowly, use recommended compression, and report any adverse effects to a professional who can help them adapt their exercise regimen.9,16-21

Most studies on lymphedema and exercise have been done on breast cancer survivors, but the principles may guide exercise in other forms of lymphedema. Individuals with or at risk of lymphedema must report other health conditions that need to be considered in developing a personal exercise regimen (diabetes, heart disease, neuropathy, arthritis, etc).

Modifications of aerobic and resistance exercise that are commonly recommended for individuals with lymphedema are:

1) Allowing adequate rest intervals between sets; 2) Avoiding weights that wrap tightly around an extremity or clothing that cause constriction; 3) Wearing compression sleeves or bandages during exercise; 4) Maintaining hydration; 5) Avoiding extreme heat or overheating; 6) Exercising in a circuit that alters the type of exercise and body part within the exercise session.

Exercise and Compression Garments:

Lymphedema Remedial Exercise as a part of CDT requires compression garments or bandages.3-5 There are no studies on the use of compression garments when performing stretching or flexibility exercise alone.

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Thanks for reading… Sharon O’Hara

Continued…in Part 3b

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Dear Kitsap County Commissioner’s – a Coordinated Trail System and the Physically Challenged

Sharon O'Hara

Dear Kitsap County Commissioners:

As a physically challenged person and cycling fan, I am writing in support of the Kitsap County Non-motorized Trails Coordinator and our need of one person to coordinate the entire trail system. The present hodge podgy fingers in the same pie method are not working. We need one person to oversee the entire trails plan for our county and no interest other than that. Nothing else makes sense.

We need to fully fund the creation of this position and have it directly under the Commission as planned.

A planned trail system throughout our county would bring tourists here in droves – more importantly, it would be a massive boost to our own citizens – all of us.

Only a small portion of citizens uses the huge taxpayer outlay of funds you approved for the Howe Farm off Lead Dog Park in South Kitsap yet we all paid. All Kitsap County citizens would benefit from the balanced and planned trail system overseen by a coordinator.

I am learning how to get around as a physically challenged person. The hand cycle recumbent trike is useful because the bone on bone left hip causes too much pain pedaling a regular recumbent trike. I am not yet able to pedal a regular recumbent trike.

The physically challenged in this county NEED the kind of trail system one coordinator would put together as one piece. Our service men and women are coming home, many of them, with physical challenges the trail system would help address.

The timing is now for the future of our county in an ever-increasing awareness that physically fit and active people live healthier lives.

Let us turn Kitsap County from being an unsafe place to be into a safe place for the NMT fans and the best place to go.

One coordinator would have one job and that is the trails – no special interest would cloud the picture. I am guessing the cost to put in that one dog park was far greater than the cost of a trails coordinator benefiting all.

Respectfully,

Sharon O’Hara

Now all I need is find a large flat area to practice and someone to give me a lesson or two and get it road ready with a headlight and stuff. This hand trike turns by leaning the handlebars and post over to whichever direction you want to go..really neat.

Malin’s first ride on a recumbent trike tadpole… they’re not just for the physically challenged.

Please contact our KC County Commissioner’s if you understand the need for one coordinator to oversee the project. Contact them if you don’t understand and thank them for doing a difficult job. We live in a superb county – let’s make it work better. Please.

Thanks for reading… Sharon O’Hara

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Lymphedema, Bone on Bone Arthritis, COPD – Prayer, Predisone, Water Workouts Help Heal this Patient

Sharon O'Hara

Regular rehab is fabulous. But? It doesn’t go far enough – long enough – it hurts and it isn’t challenging enough.

Years ago, before beginning a concentrated physical exercise routine I asked my pulmo how high I should allow my heart rate to go and he sincerely and thoughtfully said I probably shouldn’t let it get over 100 at the beginning. I laughed and told him it shoots to 100 just getting up from a chair! I’ve not asked anyone since.

I’ve had a few really outstanding rehab technicians and I’ve learned from them. They have to follow rules though and I don’t. I’m a patient and I’m through coddling myself when I feel sick because I have a goal and it has to happen this year.

Except for one day when I was in Harrison and couldn’t make my swim session…we haven’t missed one swim session since we began 1 February 2011. No matter what, my legs can ooze, my lungs labor and wheeze or burn with a fever – nothing stands in the way of a swim session.

Marilyn Grindrod is my swim coach and a miracle worker. The only thing she said when we met and she asked if my doctor approved of what we planned to do and I told her I believed they did but I would not ever ask my doctors to give me a written note guaranteeing my fitness to exercise. They couldn’t. Nobody could. Marilyn nodded and said, “get in the water, let’s get started.”

She doesn’t say I can’t do something. She leads the way and I follow as best I can. Gradually I’m improving to a physical fitness I haven’t had in years and is proving out what Anna Marx, PT, DPT at Kitsap Physical Therapy in Silverdale proved to me: the right machine/exercise WILL help my left hip get better and manageable.

Marilyn also, by changing my work-outs and her focus on breathing, must be getting oxygen to areas that have suffered without the oxygen they’ve needed…such as the Lymphedema in my lower legs.

Melissa will be surprised when I have to go in to be measured for another set of support stockings. Lower leg muscle will meet her measuring tape, not the flab of yesterday.

My legs (left leg mostly) occasionally still need and get the Old Guy’s expert spiral and padded wrapping when the skin gets too painful and I know if we don’t catch it, the skin will crack and lymphatic fluid will again ooze out. This is the longest stretch I’ve not needed to see a doc or Melissa at NW Orthopedic and Lymphoma rehab in Port Orchard for another outbreak! Melissa’s patient education works.

My ideal week is four, one hour or longer sessions in the warm pool water. The work-outs are nonstop, smooth and I can feel my locked body become more flexible, more agile and I’m beginning to feel muscle again.

A couple weeks ago working out close to the diving board I impulsively reached up and grabbed the end of the board and began doing ‘chin ups’- shooting myself up out of the water and above the board to my chest, lowered myself and repeated 15 times. That was a lot of weight I pulled up – the point is I did it easily – the first twelve anyway.

So, you can’t live a life in the water can you? No. What I can now do on land is lift my left leg about a foot and flex my left ankle. They’ve been – sort of – frozen. When something hurts we have a tendency to back off and it becomes a spiral into a body that doesn’t work and eventually gets dumped into a wheelchair.

My patient opinion is that physical rehab works best, is most effective in the water. The warm pool water resistance gets us further faster with less pain.

I believe in miracles.

In a Pulmonary Function Test two months ago, 16 February 2011 my FEV 1 (Gold Standard for COPD) sats had dropped across the board: 35% – 31% – 29%.

Last week 6 April 2011 across the board they were: 56% – 50% – 48%

Christopher Goss, MD at the University of Washington Medical Center was amazed and doesn’t need to see me again for five or six months.

What made the difference? The longer non-burst of Predisone he extended? A miracle? Prayers? Serious water work-out by a professional swim coach?

My sister lives in a small town in Kentucky and goes to a Revival church. She and her companion each stood up and asked the minister and congregation to “pray for Karen’s sister, Sharon in Washington” and Karen says they do!

Kristin Okinaka, a reporter at the weekly CK Reporter AND a runner recently came out and wrote an article and took a photo that shows some of my recumbent trikes… http://www.pnwlocalnews.com/kitsap/ckr/news/119501909.html

The following article is what prompted this post today: If Great Brittan can do it – we can too!

“Exercise pilot is successful for rheumatoid arthritis

People with rheumatoid arthritis (RA) in Portsmouth reaped the benefits from an exercise pilot, which was the first of its kind in the UK.

Volunteers took part in a 10-week programme to get exercising in the local area. They had tried various activities, including yoga, tai chi, walking and circuit-based exercises.

‘Appropriate, regular exercise is very important for people with rheumatoid arthritis, even when they are experiencing a flare of their symptoms,’ said Colin Beevor, matron and service manager of musculoskeletal outpatient department services at Queen Alexandra Hospital, where the pilot was launched. ‘Being more active helps to control joint swelling and ultimately can reduce the pain, stiffness and fatigue a patient may experience.’

Rather than hospital-based exercise, local facilities were used to encourage participants to become accustomed to working out in a familiar environment. By learning the basics of a variety of activities, participants were also able to discover which forms of exercise they enjoyed the most, with a view to continuing with the exercise after the pilot ended.

Around 700,000 people in the UK have RA, and while many recognise the importance and benefit of exercise for their condition, obstacles such as the prohibitive cost of classes or feeling stigmatised or embarrassed in group classes can stop people with RA regularly exercising.

Local firms such as private gyms and sports centres are now being encouraged to offer discounts to people with RA to enable the participants of the pilot to continue their exercise programme….”

The pilot, run by Portsmouth Hospitals NHS Trust, Solent Healthcare and UCB Pharma Ltd, received positive feedback from participants. http://www.arthritiscare.org.uk/NewsRoom/Latestnewsstories/Exercisepilotissuccessfulforrheumatoidarthritis

More later…thanks for listening… Sharon O’Hara

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Patients Need to be Educated. Are Some Physicians too Ignorant?

Sharon O'Hara

The other day I was shocked to run into a friend I hadn’t seen recently and to see this formally physically fit verbal person limping gingerly with the help of a walking stick sickened me as I listened to the story – and PERFECT example why communication between patient and physician is paramount to that patients well-being.

A few years ago my bone on bone left hip needed a bone doctor. Before I could get to the local appointment with a bone doctor, the pain sent me to a Prompt Care after a call to my primary physician, Karen Eady, M.D. The doctor ordered x-rays – yes, arthritis and didn’t do anything further since I had an appointment with a local orthopedic doctor in a few days.

The orthopedic doctor didn’t say much of anything but talked in terms of an operation and suggested several over the counter meds for the pain. I take meds for my lungs and other medical conditions and know non-prescription drugs can counteract with each other the same as prescription drugs can and cause huge problems. I’m leery. That said and after a non-informative brief discussion, he walked away and I called after him, “Doctor, what do I have?”

“Arthritis” he called back then disappeared around the corner. Okay. But I had expected him to tell me what I didn’t know and give me the type of arthritis – there are more than 100 different kinds of arthritis.

Sometime later I complained to another doctor about the encounter and he laughed and said orthopedic docs never communicate – sort of a ‘rule’ and laughed again. I grinned but told him that’s wrong. By then, I had visited one of the University of Washington Medical Center’s orthopedic surgeons and he educated me what I had and what it was doing and what we could do about it.

I told my laughing doctor the U surgeon DID inform me what was going on and gave me options. He seemed surprised that any orthopedic doc spoke more than 10 words to a patient. I shrugged it off and decided that the performance in the operating room must be all that counted.

Seeing and listening to my friend the other day though made me realize that the problem with doctors who do not/can not communicate with their patients is that they must not DO NOT LISTEN to their patients either! Her complaints were ignored by her doctor and it seems to be a big surprise to him that she now has serious medical problems, not just the replaced hip and another operation to fix what should never have happened had he listened to her!

I suggested that my friend run, not walk to the University of Washington Medical Center for a through exam and get things resolved. That she not waste any more time – that she not do what I did all those years ago.

Do not waste one moment on an ignorant physician, folks.

Without exception, every doctor I’ve met at the UWMC is a communicator…they listen.

Orthopedic doctors who can’t communicate with their patients? Let them operate on themselves. A physician who can’t respect their patient enough to communicate with them is not one who listens to them either – in my opinion as a patient.

More later…thanks for listening… Sharon O’Hara

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COPD, Professor William MacNee Clicked for this COPDer

Sharon O'Hara

FLASH

Ref: Early detection public COPD Spirometry, World Spirometry Day and World COPD Day

I called our health district yesterday and spoke with Cris Craig, Kitsap County Health District Public Information Officer. She couldn’t answer my question about the health department offering free spirometry to the public. She did say in a cheerful voice she would call in about three weeks with a response. THAT is good news and she didn’t ask what COPD was – even better.. A hopeful sign and may mean that Spirometry will be offered and made available to the public. I believe in miracles.

Professor William MacNee and the Royal Infirmary of Edinburgh Scotland, UK website has superb graphics – the best explanation of COPD (Chronic Obstructive Pulmonary Disease) I’ve seen in one place. His ‘The Latest Trends in COPD Research’ graphically shows why early detection Spirometry is important.

For many of us COPD is an ongoing magnet for other disease, including some really difficult stuff. COPD and lung disease can be the beginning of a long list of personal medical challenges expanding the patient’s medical disease library. Whatever needs to happen to avoid COPD in your life get tested for early detection and do whatever is needed to get it done.

My son, Al and I were visiting family in Northern Norway in1997. I didn’t know then my 40 year smoking habit was almost over. And so was I. I was beginning to feel sick. The day after this picture was taken, I had to see a Norwegian doctor. She examined me and prescribed medications for Pleurisy and Chronic Bronchitis. The medication worked, the pain receded and we were back on schedule. Within a couple weeks after this picture was taken and five days after returning home, I was in the hospital.

Life as I’d known it was over.

COPD is a friendly disease. For me, once Emphysema (COPD) got settled in my lungs and got comfortable, she began to invite her Other Stuff Disease buddies for a sleep over. Trouble is, they stayed over and didn’t go home. They joined COPD trying to play Havoc with my health and life.

Following COPD was an open lung biopsy and Sarcoidosis – Sleep Apnea – RLS – Psoriasis – Venous Stasis Dermatitis – Cellulitis – High Blood Pressure – Lymphedema – and bone-on-bone Arthritis, left hip followed – to name a few.

Early detection Spirometry can stop COPD early – before it’s too late. Ask your doctor.

This is where it gets tricky. Health care is a huge problem. COPD generally takes twenty years developing before a person mentions symptoms to the doctor and by then about fifty percent of the lungs are destroyed….leading the patient to a long slow smother and the taxpayer choking form the cost.

Offering free Spirometry testing for early COPD detection gives the individual warning. If the problem is not genetic, it can be turned around. Telling isn’t enough – SHOW people what COPD can do to them and their families. Let them meet willing patients who can show and tell… a real reality show.

Exercise works and muscle utilizes oxygen better than flab. We can breathe better and move easier. Exercise and understanding COPD gives us a quality of life back – to be the best we can be. The recumbent trike takes us places we couldn’t easily go without one – fun stuff, building muscle at the same time. We must keep moving … ask your doctor.

I did not qualify for lung reduction surgery or I would have opted to get it ..not enough good lung and I heard rave reviews from patients who had had one. One COPDer told me the lung reduction surgery restored his life back to ‘normal’ and lasted about five years before time and COPD danced ahead. Ask your doctor about it.

Pursed lip breathing training is a must for COPDers – it keeps us out of the panic mode and out of the hospital. It has for me…and I tested it with my oximeter.Talk to your doctor about pulmonary rehab. It is never too late to get better through our own efforts…what does your doctor say?

Photo taken by the photographer who traveled with the Trek. This photo shows me on my recumbent trike flying the COPD/EFFORTS safety flag and pedaling over Deception Pass with the American Lung Association of Washington’s three day bike ride – the Trek Tri Island.

It was the first time I had been away overnight from my house in seven years – since Harrison Hospital in 1997. A slow trike rider, it is thanks to the wonderful volunteers who hop scotched me and my trike ahead of the other 200 plus bike riders time after time that enabled me to pedal 50 miles of the 137 mile trip. I felt free again.

Key motivators were the Shortness of Breath Study at the University of Washington Medical Center that I was lucky enough to qualify for and my online support group, EFFORTS. Proof to me that educating COPD patients work.

Stroke patient, Mary Griffith and her butterfly and gold star fingernails caught my eye the other day – more about Mary and husband, Doug later)

Kitsap County Health District … Will you be the first county health district in the nation to see the fiscal benefit of early detection Spirometry to protect citizens of ALL ethnic background.

The Kitsap County taxpayer and COPD future could rest in your hands.

Thank you Professor William MacNee for a great COPD informational website and allowing me to use it here.

http://www.efanet.org/activities/documents/WMcNeeLatestTrendsinCOPDResearch. pdf

More later… Sharon O’Hara

Part 4 of 4

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New NIA Senior Walk Study

Sharon O'Hara

The National Institute on Aging wondered ‘What Can Prevent Walking Disability in Older People’ and awarded $29.5 million to the University of Florida’s Institute on Aging to find out.

To be a part of such a study is the greatest opportunity for us…person, patient or senior to be a part of something important for future generations, meet the most amazing people and have fun at the same time…such as the University of Washington’s Shortness of Breath Study https://www.managesob.org/RS/StudyII/

Unfortunately, our own close-by University of Washington in Seattle isn’t one of the eight sites for the study but for those seniors close enough to one of the sites of the new “Lifestyle” – get your feet wet and get involved. I’ve been lucky enough to have been part of two COPD studies and can’t recommend them highly enough.

This six year “Interventions and Independence of Elders “(LIFE) study involves about 200 people, from 70 to 89 years at each of the eight sites around the nation.

I hope those of us who get involved will keep us posted when you can… the results of the study will help millions of future seniors maintain a quality of life and save future taxpayer dollars in health care.

“There is a lot of evidence indicating that exercise can help in preventing diseases, such as diabetes, among older people. But we do not know whether and how a specific regimen might prevent walking disability in older people who are at risk of losing mobility,” said NIA Director Richard J. Hodes, M.D.

“This research is critically important at a time when the population is aging and new interventions should be sought to keep people healthy and functioning in the community longer.””

“At eight sites around the country, LIFE will involve 1,600 people aged 70 to 89, who at the start of the study meet its criteria for risk of walking disability, defined as the inability to walk a quarter of a mile or four blocks.

About 200 participants will be enrolled at each of the study sites, which include the University of Florida; the University of Pittsburgh; Northwestern University School of Medicine in Chicago; Stanford University in Palo Alto, Calif.; Pennington Biomedical Research Center in Baton Rouge, La.; Yale University in New Haven, Conn.; Tufts University in Boston and Wake Forest University School of Medicine in Winston-Salem, N.C. Wake Forest will also coordinate the data management and analysis.”

“Limitations in walking ability compromise independence and contribute to the need for assistive care,” said Evan C. Hadley, M.D., director of NIA’s Division of Geriatrics and Clinical Gerontology, whose program is overseeing the trial. “Older people with impaired walking are less likely to remain in the community, have higher rates of certain diseases and death, and experience a poorer quality of life. A successful intervention might help prevent these bad outcomes.”

“We know that many older people have chronic health problems that affect their ability to walk,” said Jack Guralnik, M.D., Ph.D., chief of the NIA’s Laboratory of Epidemiology, Demography and Biometry and co-principal investigator of the study. “Arthritis, muscle weakness and poor balance can all affect how well and how far a person can walk. And, some older people have all of these problems. We will test the LIFE intervention in this population to see how it works in a real-world setting.”

Study participants will be randomly assigned to one of two groups. One group will follow a structured intervention consisting of walking at moderate intensity, stretching, balance and lower extremity strength training; the control group will participate in a health education program. The participants will be followed for about three years.

Researchers will evaluate whether, compared to health education, the physical activity intervention reduces the risk of major walking disability, serious fall injuries and disability in activities of daily living, and whether it improves cognitive function. They will also assess the cost-effectiveness of the intervention.

“This will be the largest randomized controlled trial to prevent major mobility disability ever conducted in older persons who are at high risk of losing their physical independence,” said Marco Pahor, M.D., director of the University of Florida’s Institute on Aging and study principal investigator. “Typically, this population is excluded from large trials, and from this perspective the LIFE study is unique.”

The NIA leads the federal effort supporting and conducting research on aging and the medical, social and behavioral issues of older people.

For more information on research and aging, go to www.nia.nih.gov.

The NIH — the nation’s medical research agency — includes 27 institutes and centers and is a component of the U. S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases.

For more information about NIH and its programs, visit www.nih.gov.”

More later…Sharon O’Hara

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Arthritis Folks Move On

Sharon O'Hara

Supervised exercise for Rheumatoid Arthritis patients can show dramatic improvement in their quality of life, according to a recent study presented in Copenhagen at the Annual Congress of the European League Against Rheumatism. ScienceDaily reported the announcement, June 23, 2009.

Led by Dr. Miguel Souse of Instituto Portugues de Phematology in Lisbon, Portugal, the three-month study revealed, “”When joints are stiff and painful, proactively taking exercise might seem undesirable for people with RA. However, our study has demonstrated that regular and supervised moderate aerobic workouts and strengthening exercises may be extremely beneficial for both a patient’s physical and mental health, with a corresponding effect on quality of life. The challenge for physicians is to provide suitable motivation and reassurance to their RA patients in order that they initiate and stick with such a programme.”

If regular bone on bone hip joints react the same as RA, it is easy to be reluctant IF the patient is worried the bones will get ground down further.

What do the bone doctors think and who leads such ‘supervised exercise’ here in Kitsap County – anyone?

The percentages of reported improvement are dramatic… such as 55% improvement in the “sit and stand test * 62% patients reported less need for steroid use * 33% improvement in daily physical functioning, such as dressing and walking. * 40% improvement in the Depression Anxiety Stress Scales is significant.

The study patients worked out three times a week for 50 -60 minutes of aerobic and strengthening exercises for three months.

I have many questions to ask at the annual Arthritis Foundation Conference next month – free to the public.

The Free Public Symposium, “Taking control of Arthritis Together” is Thursday, July 23, 2009 from 08:30 am to 12:30 pm at the Shoreline Conference Center, 18560 1st Ave. NE, Shoreline, WA.

The program includes a free osteoporosis screening by the Washington Osteoporosis Coalition and includes such notables as:

Basia Belza, PhD. RN – Aljova Endowed Professor in Aging University of Washington School of Nursing.
Julie L Carkin, MD – The Seattle Arthritis Clinic Director, Osteoporosis Services Northwest Hospital
Larry Wienkers, PharmD
Sue Romanick, MD – Rheumatologist, Private Practice
Jane Hoyt Buckner, MD – Associate Member Director, Translational Research Benaroya Research Institute
Diane Sowinski – Patient Advocate, Personal Trainer & Arthritis Veteran
Angelika Burns – Personal Trainer, Will Tree Fitness Wellness Coordinator, Bayview Wellness Center

If anyone is interested in carpooling or needs a ride, let me know.

Pre-Registration is required.
Contact Annie Rehn at (800) 746-1821 ext. 101 or arehn@arthritis.org
Have a great week – more later.– keep moving.… Sharon

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Silverdale’s Hot Time In The Old Town Coming!

Sharon O'Hara

Silverdale’s event packed Arthritis Walk 2009, is this Saturday, May 7, 2009 at the Silverdale Waterfront Park!

The Washington Osteoporosis Coalition will be there to offer a free bone health screening.

Leashed, well-mannered dogs and families are welcome to the fun-filled eventful day in recognition of the 51,000 Kitsap County citizens living with arthritis.
The Arthritis Foundation’s annual walk honors Shirley Boheme, a 40-year arthritis survivor and ‘go-getter.’ Boheme’s ability to live well with her 40-year rheumatoid arthritis challenge is something I sure want to hear about.

While The Washington Osteoporosis Coalition screens human family members for bone health and osteoporosis, Naturally 4 Paws, is likely to have a nutritious snack for the dog family members.

Anytime Fitness in Silverdale sponsored the weekly pre- Arthritis Walk practice walks and I hope they continue the walking program.
The Acupuncture & Wellness Center offers a complimentary massage and Chinese pulse diagnosis while
Abiding Homecare, Costco and the Bremerton Symphony Association round out the program. (Does anyone know how the Chinese pulse diagnosis differs)

I’ve had arthritis only 2 or 3 years and I can tell you that bone on bone arthritis is nasty stuff, yet I am only one of 51,000 Kitsap citizens living with arthritis and most far worse off than me. Too many of them are children.

Speaking from my experience, the Arthritis Foundation is proactive with super volunteers to assist folks who contact them. One volunteer I spoke with is in a wheelchair. The amazement is that she has lived with the pain of arthritis since childhood, yet there she was, a cheerful, uplifting voice on the phone giving advice and information to folks who call the Foundation. Without exception, every person I have spoken with in the Arthritis Foundation has been informative and helpful.

The festive Community Celebration party begins at 9:00 a.m. – Hat judging begins at 09:35a.m. –followed by a Scavenger Hunt, the Movement Zone, (don’t ask) and Costco offers a Mom’s Day gift to the beat of good Bremerton Symphony music and free food.

COPD & Other Stuff will be there – arthritis is one of the Other Stuff. If you happen to see a young man and woman on a recumbent trike, say hello to my grandson, Uriah, and Christine.

Its not too late. Three ways to register for Saturday’s Kitsap Arthritis Walk are:

1. On line at: www.arthritiswalkkitsap.kintera.org
2. Sign up the day of the walk – 9—10 a.m. at the Silverdale Waterfront Park.
3. Registration forms are available until Friday, May 8 at the Kitsap Arthritis Walk kiosk in the Kitsap Mall.

If anyone wonders how many Arthritis Support groups we have for the 51,000 arthritis folks in Kitsap County…ask me.

Hope to see you Saturday!

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