Pain Relief Complex Archives - GrandmaBetsyBell

surgery for arthritis

Posted on June 12, 2016

Gentle Reader,

There comes a time when surgery for arthritis makes sense. I have reached that time. I began blogging at www.NoWheelchair.wordpress.com in 2004, to share strategies a person with arthritis could use to avoid taking medication or having surgery. My posts have been about my own journey to manage increasingly severe osteoarthritis and spinal stenosis, and more recently a condition known as listhesis, or the collapsing of vertebra to the left and to the right. As my Feldenkrais practitioner keeps telling me, “You’ve got a complicated spine.”

It has been an interesting process to dedicate this year to a protocol of my own making. I have gone to a physical medicine specialist, Dr. Ren, at the Polyclinic who suggested physical therapy for eight sessions. The PT exercises did nothing to alleviate the weakness in my legs, nor the pain, lovely as it was to show up to the attention of admiring young men twice a week.

I decided to take Dr. Ren’s offer of an injection of steroids in L5 and L4 and I had a good four pain free weeks. With less pain, I was able to pay attention to my gait and realized I was so unstable on my right side that my right hip was swinging out with every step. I decided to go back to Becci Parsons, my Feldenkrais practitioner for help getting symmetrical again. Walking everywhere with hiking sticks helps with symmetry. My strong upper body lifts my weaker legs up and the hiking sticks keep me parallel. They are less for balance than for lifting weight off the collapsed vertebra.

Nerve pain came back after a short time. Dr. Ren thought I might be a good candidate for surgery. Becci has had two operations for very similar conditions so I went to her neurosurgeon, Dr.Peter Nora. Dr. Nora has twenty years of back surgery under his belt. When I met him, I looked at his hands which are small and delicate. A good sign. He put me through the diagnostic paces where you resist pressing your knees together and then apart; your feet in and then out; your knee lifting against pressure; all of which I passed with flying colors. It seemed obvious this 79 year old woman showed no sign of weakness. He tried one last diagnostic tool: I stood against the wall pressing my heals, my back and my head against it. The test: stand for ten minutes in that position. I lasted 5 seconds before my legs gave way.

I so appreciated Dr. Nora’s willingness to listen to my experience. When I stand around for a while, the right leg loses feeling and will not support my weight. Think about when standing around is what we do as humans: hanging out in the kitchen with family while we cook; looking at a painting in the museum; holding a drink at a cocktail party or reception; singing in the choir at church; waiting in line at Starbucks, at the airport, at the bank. All of these scenarios result in weakness and the sensation of getting ready to fall over. Dr. Nora heard me and kept trying moves so he could reproduce my experience in a controlled clinical setting. Thank goodness. I once had an orthopedist kick me out of his office after I told him I walked to Broadway and Madison from the 3rd Ave bus stop, a distance of about a mile, most of it up a steep hill. I was using my sticks so I could do it.

Dr. Nora explained the surgery by showing me the MRI of my spine from the bottom to the top as if you were looking up a tube in which the spinal cord runs. Between L3, L4 and L5, the poor spinal cord disappeared completely. He will carve off the bonein those areas to stop the pinching of the nerves. It could be a big change for the better. Since I have been avoiding surgery for so many years, there is no guarantee all the nerves will come back, but the pain should reduce considerably.

You would think I would get in for surgery for arthritis as quickly as possible. But my calendar is full this summer with harvesting the raspberries (bending, lifting and twisting), camping with family, traveling to Hawaii with a granddaughter and several graduations. The first stretch of time when I could commit to no bending, no twisting and no lifting for a month begins August 16th. So that is when the surgery is scheduled.

In the mean time, Dr. Ren’s Assistant, Diana Ferdana, who calls me pharmaceutically naive, meaning I have little experience with drugs, prescribed Gabapentin. This drug prevents seizures and also blocks nerve pain. Side effects bother me as I am a little loopy, a little sleepy, but the benefit of the smallest possible dose is considerable. I still take Shaklee’s Pain Relief Complex to keep other arthritis under control, like my thumbs and fingers and shoulder. She also gave me an industrial sized back brace which I wear when picking raspberries, doing laundry, emptying the dishwasher, sweeping the floor. You get the idea, bending, lifting and twisting.

I still go to the Xgym every week. My trainer has talked to Becci and together they have a workout plan that stabilizes my core while building upper body strength. These exercises don’t ask much from my weak legs other than stability although I am doing controlled lunges with hiking sticks. Staying fit is important when heading for major surgery. The guys at Xgym will help me get back on my feet when the surgery is over.

I am still walking most days although forty minutes to an hour is as long as I can go without sitting down to give my back relief. So no hiking with my group. This is the hardest loss for me as I have been in the wilderness nearly every week since 2004, summer and winter. Happily there are plenty of parks nearby with old growth forest and trails, but there is nothing like deep wilderness. I miss it and my hiking buddies.

I share all this personal experience with the hope that you or someone you know will take heart in their own struggle with arthritis. Don’t give up and sit down. We have to keep moving to avoid further damage and disability. At this point for me, I can do damage by over-doing so I have to learn to listen to the signals that say, enough. Most days at least a mile of walking works. I begin each day with tiny Feldenkrais movements to activate the core, the psoas and the multifidae that go up and down my spine to stabilize it. Just half an hour of that careful “exploration”, as Becci calls it, makes the difference for movement all day.

So, Be well, Do well and Keep Moving.
Feel free to share this. And don’t forget to like me on Face book.

Comments and questions are encouraged.

Betsy

206 933 1889

Pain Management

Posted on January 29, 2015

Last week I questioned the wisdom of masking pain, asking if I might be missing a diagnosis by taking my Pain Relief Complex. Following up with you after 72 hours of no herbal pain tablets, I can tell you that taking them alleviated discomfort. Not taking them left me with the discomfort of aching hip joints, sore knee and ankle. The numbness in my right leg came and went, mostly went. I experienced a tough workout at the hands of JR at the Xgym, walked four miles up and down the hills of West Seattle, sat at the computer, drove the car, and attended meetings all without debilitating pain. I was happy at the end of the experiment to take a Pain Relief Complex before going to bed to insure a pain-free sleep.

I visited my chiropractor, David Kirdahy, during this hiatus. He found the usual pelvis miss-alignment, clicking and prodding everything back in place. He wondered if I might have a neuropathy in the right leg and foot. I was not able to give him specific cues as to the center of the numbness. It is hard to help with pain management when I can’t identify exactly where the pain is.

In answer to the questions, is there anything you can’t do because of numbness or pain? I had to answer, no.

I am left with the annoying unanswered question, in spite of advice from a neurologist and a nurse who read my blog post, if my activities are not impaired, why seek further diagnosis? I did that already in May of last year and have the report from the sports medicine doctor at the Polyclinic. Clearly, taking Pain Relief Complex is not covering up a condition that may need attention. I seem to be able to handle my pain management with all the measures I already use.

I wanted to show you a schematic of the COX 1 and COX2 pathways, but the pictures and science is too complicated for me to introduce here. I don’t understand it well enough to comment scientifically. I do remember the schematic the Shaklee scientist used to describe how Pain Relief Complex works. You can explore this for yourself if you are interested.

My intention here is to look at the more typical medications prescribed and over the counter that people use for pain management. The wisdom in the alternative world is that pain medication masks conditions and that pain is an indicator of something that needs medical attention. I agree with that, hence my experiment. What I have been taking for pain did alleviate discomfort. Stopping it did not reveal a condition that seems to require immediate attention.

Type of pain

Every one experiences pain differently. Some of us push through. Others of us want to eliminate the slightest hint of discomfort. Pain is a communicator from the body to us, telling us something is amiss. Pain management is different for each of us. If it weren’t for pain, we wouldn’t know to take our finger off the hot stove, or to rest with our foot elevated after spraining an ankle.

Pain can be categorized. Acute pain typically comes on suddenly and has a limited duration. It’s frequently caused by damage to tissue such as bone, muscle, or organs, and the onset is often accompanied by anxiety or emotional distress.

Chronic pain lasts longer than acute pain and is generally somewhat resistant to medical treatment. It’s usually associated with a long-term illness, such as osteoarthritis. In some cases, such as with fibromyalgia, it’s one of the defining characteristic of the disease. Chronic pain can be the result of damaged tissue, but very often is attributable to nerve damage. See WebMD. A third type of pain is psychogenic, the emotional side of physical pain.

The WebMD article classifies pain in a couple other ways: tissue damage or nerve damage; type of tissue or part of the body affected such as back pain or chest pain, muscle or joint pain.

Drug Therapy most often prescribed for acute or chronic pain

Milder forms of pain may be relieved by over-the-counter medications such as Tylenol (acetaminophen) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen. Both acetaminophen and NSAIDs relieve pain caused by muscle aches and stiffness, and reduce inflammation (swelling and irritation). Topical pain relievers are also available, such as creams, lotions, or sprays that are applied to the skin in order to relieve pain and inflammation from sore muscles and arthritis.

If over-the-counter drugs do not provide relief, your doctor may prescribe stronger medications, such as muscle relaxants, anti-anxiety drugs (such as diazepam), antidepressants (like Cymbalta for musculoskeletal pain), prescription NSAIDs such as Celebrex, or a short course of stronger painkillers (such as codeine, Fentanyl, Percocet, or Vicodin). A limited number of steroid injections at the site of a joint problem can reduce swelling and inflammation.

In April 2005, the FDA asked that Celebrex, an anti-inflammatory drug, carry new warnings about the potential risk of heart attacks and strokes, as well as potential stomach ulcer bleeding risks. At the same time, the FDA asked that over-the-counter anti-inflammatory drugs — except for aspirin – revise their labels to include information about potential stomach ulcer bleeding risks. [WebMD article on pain management]

A couple hundred milligrams of aspirin, or other NSAIDS, Tylenol or other acetaminophens for a short period of time, say 48 hours, is fairly safe. However, one of the most well known risks of painkillers is liver damage from acetaminophen. “Although [acetaminophen] has been used for years and overall is extremely safe, liver toxicity can occur with use of more than 4,000 milligrams in a day,” says Dr. Glaser. “This would be eight 500-milligram pills, which is the dosage of extra-strength Tylenol. Liver damage or failure may also occur at lower doses in those who drink alcohol regularly or who have pre-existing liver disease, such as hepatitis C.”

Because acetaminophen is often incorporated into other drugs, you may not be aware of exactly how much you’re taking, which further compounds your risk. “It’s also included in multiple other remedies for colds or sinus symptoms and is commonly paired with other stronger painkillers in medications such as Vicodin and Percocet,” says Glaser. “If an individual is not aware of this fact, he may unintentionally expose himself to amounts of acetaminophen in the danger zone.”

NSAIDs and Ulcers

Taking ibuprofen and naproxen doesn’t pose as great a risk to liver function as acetaminophen. However, some damage to the stomach lining is a possibility, which can lead to blood loss from the irritated area, stomach pains (gastritis), and even ulcers. This is also true of aspirin, which is related to NSAIDs and has many of the same properties. And if you use aspirin along with ibuprofen or naproxen, the risk to your stomach is even greater.

“Any of these pain drugs alone can cause ulcers, and using them together only increases the risk,” says Glaser. “All three of these medications reduce pain through their effects on the prostaglandin pathways.” Unfortunately, those same effects are what lead to an increased risk of gastritis and ulcer formation.

The prostaglandin pathways carry the pain signal to the brain. What these drugs are doing is interrupting the COX 2 pain pathway. Unfortunately these drugs also affected the COX 1 pathway, which resulted in stomach bleeding. Celebrex was the miracle when it came out because it did not cause damage to the stomach. Unfortunately for patients and for the drug company, Celebrex was implicated in heart attacks. [for further understanding of COX 1 and COX 2, go here.]

NSAIDs and Kidney Function

Though it’s rare, some people could risk kidney problems from using ibuprofen or naproxen. “A less common but severe complication related to these medications is kidney failure, which occurs more commonly in patients who have co-existing risk factors, such as diabetes or high blood pressure,” Glaser says.

Addiction

Some painkillers prescribed by doctors can become addicting, in particular Vicodin and Percocet which contain opiates. You can explore the internet to discover how high the abuse of these drugs has become, especially among high school students seeking to numb psychological suffering. If you have unused painkillers in your medicine chest, left over after surgery, get rid of them, especially if there are teenagers in your world.

But I digress, showing my bias against the use of medications. My original blog post tells my anti-drug bias.

There are many other options. My blog posts are full of them. I am particularly unwilling to take NSAIDS given the fact that I had Hepatitis C as a young adult, communicated by a dirty needle in the hospital when I was having a D&C after a miscarriage. In and of themselves, these drugs can be helpful. It is when they are used frequently and without regard for other conditions, such as high blood pressure, stomach issues, high consumption of alcohol. It can become a stew of interacting foreign substances.

Personally, I have found that the herbal Pain Relieve Complex does a pretty good job of keeping me pain free, along with chiropractic, Feldenkrais, frequent long walks, yoga, massage, Pilates moves and strength building training sessions at the Xgym. My trainers constantly check for good posture and make sure I avoid putting stress on joints that are compromised by osteoarthritis. Pain Relieve Complex is a COX 2 inhibitor. The Shaklee scientists found plant compounds that interrupt the pain path without any damage to the stomach or heart. I plan to keep doing what I am doing until break-through pain or severe numbness stop me in my tracks. Then I will check in with the sports doc for a new MRI. I am convinced I am not increasing my risk by waiting.

To understand how Pain Relief Complex works, click here. To order some from my personal Shaklee web site, click here.

I welcome your comments. It takes a village.

Be well, Do well and Keep moving,

Betsy

Arthritis, Be Well health tips, Keep Moving: Managing Arthritis

Do I need a pain diagnosis?

Posted on January 22, 2015

Do I need a pain diagnosis?

I was standing in front of the piano along with my fellow choir members. Heading back to my seat, I realized my right leg was dangling from my hip. No feeling. Just a dead weight. While standing for rehearsal something, probably in my back, pinched off a nerve to the entire leg. Numb. If I took a step, would I crash to the ground?

This has happened before. I was alarmed by the numbness in late May of 2013. I was leaving in a few days for a writers’ retreat in southern France. While I have experience the numbness off and on during the past two and a half years, when it came on right before leaving for a 100-mile hike in England in May of 2014, I was worried. I remembered walking from Montmartre to the Shakespeare and Company bookstore on the left bank, talking to my right leg the whole way, “Lift, swing, step, lift, swing, step.”

The incident last week was much worse.

Dr. Kirdahy, the chiropractor who has been keeping me out of the operating room for years, was puzzled when I went to see him. “You have no pain?” “No” I reassured him. “I have no pain.” “How can that be?”

Maybe because I take Shaklee’s Pain Relief Complex first thing in the morning and as often as required to keep pain at bay all day long.

“What’s in this Pain Relief?”

Pain Relief contains two herbs: Boswellia and Safflower

Boswellia extract

A controlled clinical trial found that a daily dosage of 1,000 mg of Boswellia

Extract taken in divided doses significantly improved joint discomfort,

Knee flexion, and walking distance.1

In a clinical study, an extract containing boswellic acids was shown to promote

comfortable joint movement.2

Safflower extract

The benefits of the safflower are newly discovered in the West, but have a long

tradition of use in Asia.3

Kimmatkar et al. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee: a

randomized double blind placebo controlled trial. Phytomedicine. 2003;10:3–7.

Etzel R. Special extract of Boswellia serrata (H15) in the treatment of rheumatoid arthritis. Phytomedicine.

1996;3:91–94.

Hsu HY. Oriental Materia Medica. A Concise Guide. 1986. New Canaan, CT, Keats Publishing Inc. and

Oriental Healing Arts Institute, Long Beach, CA.

[From the Shaklee Product Guide, a fact sheet]

I told Dr. Kirdahy I would come back next week after 36 hours without any Pain Relief Complex.

This chiropractic visit induced a search of the literature for the answer to my question: does pain help diagnosis?

According to Spine Health, because the causes of back pain can be very complex, it is often more difficult to get an accurate diagnosis for back pain than for other medical conditions. While some spinal diagnoses are relatively straightforward (such as tumors, infections, or fractures), for many conditions there is little agreement among spine specialists about a diagnosis.

However, getting an accurate diagnosis of the cause of back pain is critical, because different diagnoses will require very different treatment approaches. And the sooner an accurate diagnosis is made, the sooner the patient can find an appropriate treatment for pain relief and to improve his or her ability to enjoy everyday activities.

Pain is our friendliest enemy — it keeps us out of trouble even though it often seems to actually be the problem.

The body ‘locates’ pain near the surface quite well but has trouble indicating the source when the pain is deep. Pain from deep injuries, diseases or infections of organs, such as the heart, stomach, lungs and back may seem to come from somewhere else nearby or may radiate into multiple places. Intense pain may be more localizing but not always.

Therefore, when back pain is accompanied with other changes, fever, swelling, redness, heat, neurological problems or changes in body functions, the diagnosis may be sharper — and the back pain diagnosis may be more serious.

The milder backaches that one feels over one’s lifetime can generally be successfully managed by simple back pain treatments — rest, medication, massage, the application of salves, exercise, weight loss and learning to put up with it.

So, if the severity of back pain does not serve as a guide for when to see a physician, the question is how does one know? While there are exceptions, there are several generally accepted guidelines of when to see a doctor for back pain:

If the back pain has any of the following characteristics, it is a good idea to see a physician for an evaluation:

Back pain that follows a trauma, such as a car accident or fall off a ladder
The pain is constant and getting worse
Back pain that continues for more than four to six weeks
The pain is severe and does not improve after a day or two of typical remedies, such as rest, ice and common pain relievers (such as ibuprofen or Tylenol)
The pain is worse at night (most common forms of back pain are alleviated by rest)
Severe pain at night (e.g. pain that wakes one up from deep sleep)
Abdominal pain that accompanies the back pain
Numbness or altered sensation in the saddle area (upper inner thighs, groin area, buttock or genital area)
Neurological problems, such as weakness, numbness or tingling in the leg(s) or arm(s).

I have seen orthopedists, neurologists and sports medicine doctors for my chronic pain. Currently, I handle the pain with Pain Relief Complex, exercise, Back2Life machine every morning, and moving as much as possible during the day (sometimes a challenge as I am a writer!) So I would say I live my life pain free.

The above article persuades me that it is time to cut out the Pain Relief for a day or two to see just how bad this pain is. Before leaving for England last May, I had an MRI and a consultation with the Sports medicine doctor at my clinic. She told me I have several bulging discs, a normal condition in people my age, but that I was not at risk for hospitalization or major trauma on my hike. In fact, she assured me, the 100 miles hike would be good for me.

And it was.

The degree of increase in the numbness worries me. Doing without Pain Relief even for 48 hours worries me, too.

I’ll keep you posted. Next week, I will discuss the most common medications used to handle osteoarthritis pain, and why you might want to think twice about using them habitually. Stay tuned.

Be well, Do well and Keep moving,

Betsy

206 933 1889

betsy@hihohealth.com

Leave your comments. They help other readers and me, too.

Arthritis, Be Well health tips, Health and Fitness, Keep Moving: Managing Arthritis

4 ways to get a sore back fuctional

Posted on October 3, 2013

Gentle Reader,

Sore back? Been traveling, sitting in an airplane for hours? Did you enjoy a vigorous hiking holiday slogging miles over boulders, roots and bogs for days in a row? Maybe you had back surgery, successful but still stiff and cranky. Or perhaps, you joined a new salsa dance class (that would be my recent experience) for the first time and the instructor had you swinging your hips in directions they hadn’t gone in 50 years.

There’s nothing that slows you down more than a sore back, whether it is caused by over-exersion, chronic arthritis, or a sudden move that sets everything zinging. Here are four tips to get you moving comfortably again.

1. A muscle relaxant for a few days won’t kill you and will give those spasms a chance to quiet down. There are a lot of over the counter medications to chose from. My personal favorite is Aleve. I can usually manage flare ups with frequent doses of Shaklee’s Pain Relief Complex, a herbal COX 2, 5 LOX inhibitor that will not damage your stomach. 99% of the time I can manage a sore back with Pain Relief Complex. It gives me peace of mind to know I am not hurting my stomach or creating any bad side effects.

2. To relieve a sore back my friend alternated between hot compresses and ice, getting the blood to move through the low back. The joints are not easy to flush with blood flow so this is an excellent therapy, especially if you have the leisure to work on the problem. The hottub is excellent for the heat. I use mine every night sending the jets on any sore muscles. In the case of acute sore back, more frequent cold/hot changes will speed the healing along.

3. For immediate relief for a sore back, rub Joint and Muscle Pain Cream or other menthol analgesic into the area. For years I relied on Arnica Montana or Icy Hot cream, but I have found that the pain-relieving effect seems to penetrate more deeply and last longer.

4. I use the Back2Life machine daily and when my back is more sore than normal, I will relief the sore back by getting on the floor with my knees over the top of this contraption several times a day. It’s gentle motion is like a Feldenkrais manipulation. The small, steady lifting and lowering motion of the Back2Life machine, relaxes and opens up the sacrum, allowing blood to flow into the irritated and inflammed area. The machine is set to do its work for about 13 minutes which is just about as long as a busy person can stand to be still, lying on the floor. Past posts about the Back2Life Machine.

In addition to these excellent sore back relieveing strategies, I like to put Peggy Cappy‘s soothing voice on before I go to sleep every night. In fact, her voice usually puts me to sleep. She takes you through a muscle relaxing meditation for about 20 minutes beginning with the eyes and facial muscles. By the time she has progressed through the entire body, you are so still and relaxed, you couldn’t move an arm or a leg. The last part of the CD takes you even deeper and she talks to your “inner mind” about the way sore and damaged joints restore through rebuilding healthy new cells using the nutrients offered by the blood stream. I am convinced that if I were to get an MRI of my lower back and spine today, the deforming and pain-causing spinal stenosis and osteoarthritis would be less evident, just because of her CD. Sound to woo-woo for you? Never mind. Listen to her relaxing CD anyway for relief from the SORE BACK that has you moaning. To read a past post about Peggy Cappy, click here.

Probably the most effective strategy of all is moving. As soon as you can tolerate even a little movement, get up and walk. It is only by getting blood flow back into the disturbed joint that healing can be accelerated.

I wish you well in your journey to a healthy back, and the end of the sore back experience.

Be well, Do well and Keep Moving,

Betsy

206 933 1889

Arthritis, Be Well health tips, Health and Fitness, Keep Moving: Managing Arthritis

4 1/2 hours of driving…Oh, my aching back

Posted on May 9, 2013

Gentle Reader,

Six hiking buddies escaped to the cabin of one of us on the Oregon coast just sound of Canon Beach. The sun shone and the sand was warm, inviting surfers, families and dogs to play even though it was mid week and basically empty of tourists or locals.

I was really hurting from the long hours of driving and didn’t want to miss a minute out doors. I had no Back2Life machine with me. But I got over my aches and pain fairly easily with a technique I’d like to share with you. In addition to several Pain Relief herbal tablets that inhibit the pain path nicely with no side effects.

Lie on the floor with your butt up against the front legs of a chair and your bent knee legs on the chair

seat. While in this restorative pose position, move in the very tiniest motions, a pelvic clock. Ten up and down movement between 12 and 6, then 10 between 1 and 7, then 2 and 8, then 3 and 9 and so on around the clock face. The pelvic tilt

is a miniscule movement using your abdominal muscles to produce a small swing from up to down. You can look it up under Feldenkrais. It works miraculously to unwind and restore balance to the lower back.

For a little eye candy, here is the sitka spruce forest we hiked in, a herd of elk crossing the dunes, the sunny beach and the wild flowers blooming their little spring hearts out.

Be well, Do well and Keep Moving.

Before you go, tell us what you have done to get the kinks out after a long drive or hours in a chair. Leave a comment.

Fondly, Betsy

206 933 1889