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09/Feb/2022

You don’t really notice your thumbs until something makes you take notice. You whack one with a hammer, jam it in a door, or you get arthritis.

You then realise how often you use your thumbs every day 😖.

Your thumbs are more flexible than the rest of your digits. They can rotate, flex and touch the tips of your fingers. This allows you to perform all sorts of simple and complex movements.

So when something happens that impacts your thumb’s ability to move smoothly and painlessly, it gets your attention very quickly.

Arthritis

Many types of arthritis can affect your thumbs; however, osteoarthritis (OA) is the most common. OA occurs when the cartilage that covers the ends of the bones in a joint becomes brittle and breaks down. Healthy cartilage acts like a slippery cushion that absorbs shock and helps your joints move easily. When it breaks down, bone rubs against bone, causing pain and restricted movement. Your body tries to repair this damage by creating extra bone, called bone spurs. They may also cause pain and limited joint movement.

Other conditions such as rheumatoid arthritis, psoriatic arthritis, gout and lupus can also affect your thumbs.

This article will focus specifically on OA and thumbs.

Who gets OA in the thumbs?

You’re more likely to develop OA in your thumbs if you:

  • are female
  • over the age of 40
  • have had trauma or damage to the joints in your thumb
  • are obese
  • do work or activities that put stress on the thumb joints.

Symptoms

The symptoms of OA in the thumbs are:

  • pain
  • stiffness or limited movement of your thumb
  • joint swelling (inflammation)
  • grinding, rubbing or crunching sensation (crepitus)
  • loss of thumb strength.

Diagnosis

If you’re experiencing pain in your thumb that’s affecting your ability to do everyday activities, it’s important that you discuss this with your doctor. Getting a diagnosis as soon as possible means that treatment can start quickly. Early treatment will give you the best possible outcomes.

Your doctor will:

  • take your medical history – this will include finding out about your symptoms, how long you’ve had them, what makes them better or worse
  • examine your thumb – this will include feeling for warmth, listening and feeling for grinding or crunching (crepitus), and moving your thumb through it’s range of movement.

Your doctor may also request x-rays of your thumb to get a better look inside the joint and check for bone spurs.

Treatment

There’s no cure for thumb OA, but it can be managed effectively using self-care, splints, medications, and in some cases, surgery.

Self-care

  • Exercise – as with all musculoskeletal conditions, exercise is one of the most important things you can do to manage your pain and keep your joints moving. A study published in the BMJ Open from researchers at The University of Sydney found that hand exercises, when used with pain relief, splints and education, increased hand function and decreased pain in people with thumb OA. In Appendix 2 of the article, you can access the exercises used in this study.  You can also see a hand therapist, a physiotherapist or an occupational therapist for exercises specifically tailored to you.
  • Heat and cold – cold packs/gels can help reduce inflammation, and heat packs/gels can loosen stiff muscles, both providing temporary pain relief.
  • Aids and equipment – such as jar openers, book holders, tap turners, button hook and zipper aids and easy-grip utensils can make tasks easier and more efficient by reducing the stress on your thumbs and eliminating tight grasps. You may need to speak with an occupational therapist about what equipment is best for you.
  • Avoid repetitive or repetitive activities that strain the thumb – e.g. hand sewing.

Hand therapy
A hand therapist is an occupational therapist or physiotherapist who has undergone advanced training to become experts in assessing, diagnosing, and treating upper limb problems (shoulder to hand). They can provide advice on joint protection and energy conservation (e.g. splints) as well as recommendations for adaptive devices/equipment to improve thumb and hand function. You can find a hand therapist via the Australian Hand Therapy Association website or talk with your doctor.

Splints
A splint can support your thumb, reduce your pain, protect your thumb while you do your everyday activities, and rest the joint. A hand therapist can give you advice on splints.

Medications
Your doctor may suggest medications such as analgesics (pain killers) and/or non-steroidal anti-inflammatory medications (NSAIDs) for temporary pain relief. Topical creams and gels are preferred over oral NSAIDs because less medication is absorbed into the bloodstream. Your doctor or pharmacist can advise you on the best medication to use for your specific health needs.

Your doctor may recommend a cortisone injection into the joint if other strategies such as medications, the use of a splint, and self-care activities haven’t reduced your pain. These injections can reduce pain and inflammation for several weeks to months. However, you can only have a limited number of injections into the same joint in the space of a year.

Surgery

If conservative treatments haven’t helped and arthritis in your thumb is causing significant pain and distress and impacting your quality of life, surgery may be an option. A referral to a specialist hand surgeon is usually required. https://muscha.org/surgery/

The most common types of surgery for thumb OA are:

  • Joint fusion (arthrodesis) – involves fusing two or more bones together. This essentially turns them into one bone and relieves pain because the joint no longer moves. However, you do lose flexibility in the thumb.
  • Osteotomy – involves cutting, shaping and repositioning bone to help correct joint alignment.
  • Trapeziectomy – involves removing one of the bones in your thumb joint (trapezium) to relieve pain.
  • Joint replacement (arthroplasty) – all or part of the affected joint is removed and replaced with an artificial implant.

Osteoarthritis in the thumb can be a painful and distressing condition. But the good news is that there are many things you and your healthcare team can do to manage your pain and keep you doing the things you love to do. The important thing is that you seek treatment early and follow your treatment plan.

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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19/Jan/2022

by Anne Lloyde, MSK Help Line Manager

We’re well and truly into summer, so we need to think about ways to stay safe, keep cool but still have fun in the warmer weather.

Taking care of your skin in the sun – it’s a balancing act

We all know the ‘slip, slop, slap, seek, slide‘ message and the importance of protecting ourselves from the summer sun. After all, the sun’s ultraviolet radiation (UV) is the primary cause of skin cancer, and Australia has one of the highest rates of skin cancer in the world. But sun exposure is essential for bone health. Sunlight is our best source of vitamin D, which helps us absorb calcium for strong bones.

It’s important to expose your hands, face and arms to the sun every day. The amount of time you need to do this depends on where you live, the time of the year, and your skin’s complexion. Healthy Bones Australia has developed a chart to help you work this out.

It’s also important to be aware of the dangers of sun damage and how you can expose your skin to the sun safely. SunSmart has a free app to help you determine the safe times to expose your skin to the sun. You can find out more about the app and download it here.

Sun sensitivity can affect people with various musculoskeletal conditions, including lupus and dermatomyositis. For people with sun sensitivity, sun exposure can cause rashes and lesions, flares or aggravation of their condition.

Medications can also cause the skin to be sensitive to sunlight, including some antibiotics, disease-modifying anti-rheumatic drugs (DMARDs) and some nonsteroidal anti-inflammatory drugs (NSAIDs). For more information about medications that can increase your risk in the sun, read this article from The Conversation.

If you have issues with sun sensitivity and limit your time in the sun, you may be deficient in vitamin D, as the main source of vitamin D is sunlight. Talk with your doctor if you think this is an issue for you, as you may need vitamin D supplements.

How to take care of your skin:

  • Check daily UV levels by visiting the Bureau of Meteorology or the weather page in newspapers and online.
  • Use the Vitamin D and bone health map to guide you about the amount of time it’s safe for you to expose your skin to the sun.
  • Clothing, hats, sunscreen and shade are the best ways to protect your skin from UV light. You should use sunscreen with a sun protection factor (SPF) of 30 or higher on skin that can’t be covered by clothing. Choose your clothing carefully as not all fabric provides the same sun protection. To block more of the sun’s rays, choose clothing that has a thick, dark material with a tight weave. The Cancer Council has some useful information to help you know what to look for in sun-protective clothing.
  • Keep a scarf or sun umbrella with you during the summer, just in case you’re out in the sun unexpectedly.
  • Wear a hat that shades your whole face, neck, ears and head. Broad-brimmed hats with a brim of at least 7.5 cm provide excellent protection.
  • Try to stay out of the sun between 10am and 2pm (or 11 am and 3 pm daylight saving time) when UV levels are at their highest. Avoid highly reflective surfaces such as sand or water.

For more information on protecting your skin, visit the Cancer Council website. They have lots of very helpful resources.

Staying active

One of the best ways to manage your musculoskeletal condition is to exercise regularly. But in the warmer weather, you need to consider the weather conditions. Your regular exercise program may not be appropriate for an Australian summer and may need to be adjusted. If you’re unsure where to start, talk with a physiotherapist or an exercise physiologist for information and support.

Some general tips for exercising safely in summer:

  • Don’t eat before you exercise. Your body uses energy when it’s digesting food, creating more heat. That’s the last thing you want when you exercise, so give yourself plenty of time between eating a meal and exercising.
  • Drink plenty of water – before, during and after exercise. You sweat more when it’s hot and when you’re exercising, so you need to replenish the fluids you lose.
  • Wear loose-fitting, sun-protective clothing that allows you to move freely and for sweat to evaporate quickly.
  • Change the time you exercise. Avoid the hottest part of the day, so exercise earlier or later in the day. Or, if that’s not an option, change the way you exercise on very hot days. Exercise indoors using apps, online videos or DVDs. Or visit your local pool or beach and exercise in the water.
  • Recognise that there’ll be days when it’s not safe to exercise outdoors. And if you don’t have adequate cooling indoors, that applies to indoor exercise as well. Australia is a land of extreme temps, so on those really hot days, give yourself a break 😎.

Storing your medications in hot weather

You need to take special care with your medications in hot weather, and they need to be stored correctly in cool, dry places away from direct sunlight.

Avoid bathrooms, as they’re often humid. Avoid cupboards above the stove or oven as they can get hot.

People on certain biologic medications may need to store medications below 8ºC, and you may need a cool bag to keep them at the correct temperature when bringing them home from the pharmacy and when traveling on holidays. Pharmaceutical companies will often provide special travel packs. Talk to your pharmacist for more information.

Preparing meals in summer and for special occasions

We tend to gather more regularly in the summer to enjoy good company, good food and good weather. However, this can cause stress, especially if it’s a big event or if you put pressure on yourself for everything to be ‘perfect’. And when the temps are high, as they often are in summer, this can add to your fatigue and discomfort.

Here are some simple steps to help you create and enjoy meals in a way that saves you energy and frustration, leaving you with more time to enjoy your family and friends:

  • Separate your tasks into small steps so that you can plan ahead and prepare things over time rather than in a rush.
  • Consider ordering your food and groceries online and having them delivered. Check out the websites of your local traders for more information.
  • When buying groceries, consider the pre-cut or pre-packaged fruit and vegetables. This will save you time and effort when preparing meals.
  • A range of kitchen utensils is available, including knives and peelers with wide easy-grip handles that make things easier when you’re cooking. Check out our online shop to see some gadgets that can make life easier
  • Remember that vegetables are easier to chop after they’ve been cooked.
  • If you have difficulty carrying saucepans and draining the water when cooking pasta or veggies, use a metal colander or wire basket slightly smaller than the saucepan. Put the food into the colander and place it in the saucepan. Once the food’s cooked, simply lift the colander out of the saucepan. Or ask someone to do this for you.
  • Share the load and have people bring a plate. You don’t have to do everything. And it gives everyone a chance to bring their favourite new recipe 😊.
  • When you head to the park or the beach, be on the lookout for outdoor tables where you can comfortably sit to enjoy your picnic, rather than having to sit on the ground or carry portable chairs.

Medical cooling concessions and rebates

These concessions provide a discount on summer electricity costs for concession cardholders who have specific medical conditions that affect the body’s ability to regulate temperature.

Visit your state/territory website to find out if you’re eligible for this concession:

Tips for surviving the summer from our volunteers

  • Exercise in the morning when it’s cooler.
  • In very hot weather, go for your daily walk in air-conditioned shopping centres, rather than outside in the heat.
  • Don’t forget to protect your feet. Put sunscreen on any exposed skin and wear supportive shoes.
  • Drink plenty of fluids to keep well hydrated.
  • Maintain a healthy diet with lots of light salads.
  • Prepare and pre-cook meals in the morning when you have more energy and when it’s a bit cooler. You can then reheat it in the evening.
  • Have your air conditioner serviced so that it’s more efficient.
  • Take ice packs when shopping to keep perishable goods cold.
  • Think about doing your shopping online and having it delivered.

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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19/Jan/2022

Working with a musculoskeletal condition can be a real struggle. Some people find that no matter how many accommodations or adjustments they make in their job, they can no longer perform their work duties to the required level. Or the job has become too taxing on their body, causing constant pain, fatigue and stress.

This can be a devastating blow, especially if it’s a job that you love. It can also be an extremely scary time as you contemplate a new future, with a different job.

The good news is that there are resources and organisations to help you through this process.

Job Outlook

Job Outlook is a great website and a good place to start when contemplating your next career move. It has a range of very helpful tools including:

  • Skills match – this tool helps you find new jobs that use your existing skills. You simply add your previous jobs, including unpaid or volunteer work, and it’ll give you alternative jobs that use your skills.
  • Career quiz – this simple quiz gives you a range of work scenarios. You choose the ones that appeal to you the most. The quiz provides a range of career paths that may interest you based on your answers.
  • Explore careers – provides all the relevant information about different occupations including tasks associated with the job, salary, future growth, skills and knowledge required, and the work environment (including physical demands of the job).
  • Links to training courses, job vacancies and other useful resources.

JobAccess

JobAccess is the Australian Government’s one-stop shop for information and resources for people with disability, employers and service providers. The section for people with a disability has a wealth of resources, especially on the Available Support page including:

Australian Job Search

Australian Job Search is Australia’s largest free online jobs website. Lots of useful info and resources for job seekers.

Job Jumpstart

Job Jumpstart provides articles and tools to help you find jobs that suit your interests. Information is tailored to your stage of life:

Department of Education, Skills and Employment

The Australian Government, Department of Education, Skills and Employment, provides information and support to help you with training and learning new skills.

  • Career Transition Assistance – designed to help people over the age of 45 build their confidence and skills when it comes to finding a job, and becoming more competitive in their local labour market.
  • Help with the cost of training – find out if you’re eligible for free or subsidised training.
  • Skills and Training Incentive – for people aged 45-70 years of age, it provides up to $2,200 to jointly fund training to help you remain in the workforce longer.

My Skills

My Skills is the national directory of vocational education and training (VET) organisations and courses. It provides info on:

Careers counsellors

You can also get professional help making decisions about your career choice by talking to a careers counsellor. They provide information, advice and guidance to help you make realistic choices about work, including further training or upskilling. They can help you identify jobs that match your skills and interests, create a resume, provide info on where to look for jobs and more.

Visit Career Development Association of Australia (CDAA) to find a private career counsellor who can help you work out your best career options. Note – these services aren’t free. The CDAA advises that ‘all members are in business, they charge a fee for the services they provide. You are encouraged to contact 2-3 members and discuss your needs to make an informed decision about who could help you best.’

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.


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09/Dec/2021

Did you know that 52% of Australians are putting off their healthcare due to concerns about COVID-19? (1)

This alarming figure has prompted the Continuity of Care Collaboration (CCC), a network of more than 35 peak bodies, industry and healthcare organisations, to create the #DontWaitMate campaign.

The campaign aims to reassure people that attending their GP, dentist, pharmacist, allied health professionals, and specialists is safe. That it’s safe to get blood tests, skin tests, scans and all other pathology tests.

It’s essential that anyone with chronic or complex health conditions, the elderly, vulnerable communities and people who are immunocompromised have continuity of care so that they’re able to live as well as possible. And that any changes in their health are picked up as soon as possible.

#DontWaitMate campaign also urges anyone who’s been putting off their tests or has noticed urgent and/or new symptoms to pick up the phone and make an appointment today.

Your health is the priority.

CCC explains that there are measures to help you feel safe to access health care needs remotely, e.g. through telehealth, e-prescribing of medicines and home delivery of medicines. If you need to go to a clinic or hospital, personal protective equipment, regular cleaning, and distancing measures are all in place.(2)

It’s all about keeping you safe while managing your ongoing healthcare.

So Don’t Wait Mate. If you’re like me and have a pathology form stuck on the side of your fridge or a poo test in your bathroom drawer, go and get it, pick up the phone, and make that call. Don’t let them expire like I did ?. It just adds to the time you’re waiting to ensure everything’s ok.

Or, if you’ve noticed some changes in your health or body that concern you, make an appointment with your doctor to discuss them.

Because your health is too important to neglect.

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

Reference

(1-2) Continuity of Care Collaboration
https://continuityofcare.org/


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18/Nov/2021

Ever notice how much governments love acronyms?? Unfortunately, this article is full of them, but we’ll explain what they mean and try to clear up the murky area of chronic disease management (CDM) plans, formerly called Enhanced Primary Care (EPC) plans.

Note: The primary sources for this article is the Australian Government, Department of Health’s chronic disease management resources. Unfortunately this information has not been updated since 2014. Please treat this as general information only, and discuss your specific needs with your GP.

What are CDM plans?

In a nutshell, these plans are a proactive way for you and your general practitioner (GP) to manage your chronic, complex or terminal medical condition/s. The Department of Health defines a chronic condition as ‘one that has been (or is likely to be) present for six months or longer’.

Chronic musculoskeletal conditions fit under this definition.

These plans are prepared by a GP to help eligible people manage their condition/s. The plans set goals to help people manage and hopefully improve their health and wellbeing.

There are two types of CDM plans:

  • GP Management Plans (GPMP) and
  • Team Care Arrangements (TCAs).

GP Management Plans (GPMP)

A GPMP can help people with musculoskeletal conditions by providing an organised approach to their care. It’s a plan that you’ve worked out with your GP that:

  • identifies your health and care needs
  • sets out the services to be provided by your GP
  • lists any other health care and community services you may need
  • lists the actions you can take to help manage your condition.

For example, if you have osteoarthritis in your knees that’s causing you lots of pain, and you’re no longer able to comfortably play tennis or go bushwalking, you and your doctor might decide that losing some weight will improve this situation. However, rather than just agreeing that weight loss is a good idea, a GPMP is an action plan that sets out your clear aims and objectives.

Once this plan has been developed, you should receive a copy to take with you.

Team Care Arrangements (TCAs)

If you need help from other healthcare providers to achieve your goals, your GP may also suggest a TCA.

TCA’s include 5 visits per calendar year to other health care providers. These 5 visits can be to one healthcare provider or spread between several providers.

On the first of January you become eligible for 5 new visits. You’ll need to see your GP about this.

You should also receive a copy of this plan.

Eligibility

This is one of the areas that’s a little complicated, so if you think you might be eligible, it’s best to speak with your GP directly. When you call to make an appointment, let the receptionist know that you’d like to discuss a chronic disease management plan. You’ll need a longer appointment for this.

The Department of Health states that while there’s ‘no list of eligible conditions…these items are designed for patients who require a structured approach and to enable GPs to plan and coordinate the care of patients with complex conditions requiring ongoing care from a multidisciplinary care team. Your GP will determine whether a plan is appropriate for you’. (1)

Costs

Also a tricky area. If a healthcare provider (e.g. dietitian) accepts the Medicare benefit as full payment for the service, you’ll be bulk billed and there’ll be no out-of-pocket costs. However if they don’t, you’ll have to pay the difference between the fee charged and the Medicare rebate. This is often called the ‘gap’.

When you’re making an appointment, be sure to ask what your out-of-pocket costs will be. If the cost isn’t something you can afford, discuss your options with your doctor.

Reviewing your plan

Your plan will need to be reviewed regularly. These reviews allow you to see how much progress you’ve made. If you’re meeting your goals – e.g. losing weight, increasing your fitness – that’s great. If you’re not getting there or having difficulties, a review will allow you to discuss this with your GP and work on solutions or adjust your goals.

Help!

It can seem overwhelming, but your GP and the practice nurse are there to support you on this journey.

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

More to explore

Reference

(1) Chronic Disease Management Patient Information, Australian Government, Department of Health, 2014.


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18/Nov/2021

Written by Rachel Lea

During the 32 years of living the life of a Lupus Warrior, I’ve come to liken the feeling of battling lupus to the principles of the board game Snakes and Ladders. When the dice rolls, you take the number of steps forward that the dice dictates. Literally one step at a time. When you’re feeling well, and your lupus is under control, you may even land on a ladder and climb up the board a little bit further. When that’s happening, you feel truly happy, as you’re able to maintain a sense of balance and stability. It just feels good.

But then the game can change without warning, and the dice can roll towards a snake. When you hit a snake, it boldly raises its head and hisses at you. Taunting you. Because you know what’s coming. You’ve suffered another setback, another lupus flare. And so you begin to slide. You slide all the way down the back of that slippery snake, sometimes to the bottom of the board. That soaring happiness dissipates as you realise you have to begin the game all over again, and fight your way back up to the top of the board. This is how the game of lupus is played each day. Over and over and over again. At some point, you’ll always fall back down. Why? Because lupus always wins.

So the never-ending tweaking of medication takes place, whether it be increased steroids or methotrexate. This’ll require months and months of tapering back to the dose at which I was originally controlling my lupus. Before that flare took me down. My symptoms of extreme fatigue, joint and muscle pain, fevers, migraine-like headaches, mouth ulcers and hair loss are being treated by these medicines. It’s draining. And bloody frustrating! Particularly when I felt I was managing my lupus and overall health really well, and then, boom!

After thirty-two years of experiencing such flares, I’ve grown to realise that the only way to fight back is to simply let go. Let go of everything. Place myself in a protective bubble and focus on me. Hope that the drugs kick in quickly and move with the pain and discomfort the best way I can. I’ve grown to learn that it takes strength to surrender and put trust and faith in the universe. That even when I’m struggling like this, I’m exactly where I’m meant to be. I know this because when I’ve been too stoic, trying to rise above the pain and fatigue, the resulting flare has been longer and more challenging to overcome.

I grew to learn very early into my diagnosis the benefits of being very gentle and kind to myself. If that means having a teary and a good sook, so be it. If that means I’m in bed for days or even weeks, I’ve no choice but to give in. If it means I’m back on the higher doses of medications, with all of the nasty side effects that come with them, then that’s just the way it is. I just have to roll with it as best I can. I need to let go so I can get back on the game board again and keep rolling the dice.

I’m a kinder, more considerate and less judgmental person because of lupus. I’m more patient and adaptable when faced with new challenges. I’ve recognised that being able to persevere and be resilient in the face of uncertainty is a gift. Self-acceptance cultivates much inner peace, but when my acceptance of life with lupus is tested, I’ve learned to respect what this disease is and what it can do. If I wage a war against myself and push through without enough rest and respite, I’ll be causing more inflammation, more damage, and undo all the good I’m trying to nurture within my body. And that’s no good for me in the short or long-term. I’m managing a disease without a cure, one that’s unlikely to leave me anytime soon.

Not being well enough to continue my beloved vocation of working as a VCE secondary school teacher, I’m currently on another journey of personal growth and acceptance. In addition to having lupus, I’ve also been battling fibromyalgia for 8 years. As I became sicker, teaching became more challenging than usual, even when working part-time hours. I was also working within a combative, negative work environment. I was constantly asking myself, ‘how can I keep moving forward, finding hope and purpose as a chronically ill person in a toxic work environment like this?’ One where people strongly resisted the opportunity to invest more time and effort into creating greater goodwill and positive change that everyone could benefit from. How long could I endure the frustration of working like this and be in the best health possible? And ultimately, the question which intrigued me the most, ‘how do other people, like me, who have invisible chronic illnesses, cope in stressful, challenging workplaces? How do they find their way in the world when their pain is invisible to those around them? ’

With too many lupus flares to bounce back from and a working environment that wasn’t likely to improve, I resigned from my teaching job. It’s been a very isolating, extremely lonely and sad time for me. However, over time I’ve been able to reflect on the challenges of having lupus and working in a difficult work environment. This has resulted in my book ‘Lupus = Lift Up, Persevere, Use Strength’.

I’ve written my book in 3 parts. The first part, ‘Lift Up’, examines the 3 long years it took to diagnose my lupus. I was symptomatic at age 14 and diagnosed at 16. I describe the social, emotional and physical impacts of being ill as a teenager, its effects on my parents and family, and the stress of misdiagnosis and experimental treatment along the way. In part 2, ‘Persevere’, I discuss the struggles of having lupus while finishing school, university and the fear of entering the workplace as a secondary school teacher with a chronic illness. In the final part, ‘Use Strength’, I share the challenges of life in the workplace with an invisible illness and how I’ve tried to maintain hope and perspective.

It’s my greatest hope that my book can offer companionship and unity to fellow Lupus Warriors, chronic illness fighters, their carers and loved ones. I also hope to generate greater understanding and awareness of lupus, and cultivate more compassion and empathy for the challenges of living with a chronic illness. In all of the teachings that having lupus continues to bring, I know I must keep putting into practice what I’ve learned in being able to surrender and embrace the unknown with more courage, grace and acceptance.

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.


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28/Oct/2021

22 February 2022 – This article was written in October 2021. In December 2021, the Australian Government approved and recommended booster shots for all eligible people aged 16 and over. You can find the latest advice on booster vaccines on the Department of Health website.

There’s been a lot of talk in the media recently about boosters and third doses of the COVID-19 vaccines. And the nurses on our Help Line are certainly taking lots of calls about it! So we thought we’d answer some of your questions about this next step in the vaccination rollout.

Honestly, most of us thought that once the majority of Australians were double vaxed, it was smooth sailing ahead. That everything was sorted. Job’s done. Time to ‘get on the beers’ and return to normality. 🍻

But this virus is tricky, and we’re still learning so much about it. Including how to protect ourselves from it.

Fortunately, we can look overseas for information. With Australia’s vaccine rollout months behind countries like the UK, US and Israel, we can learn a lot from their experiences and the data they’re collecting.

We know that after two doses of the vaccines, healthy people have a greatly reduced risk of developing severe COVID or ending up in hospital. Which is fantastic news. Yay for vaccines!

However, we’re seeing that some people with weakened immune systems (immunocompromised) have caught COVID, even though they’re fully vaccinated.

Although we don’t know exactly why this happens, it appears that people who are immunocompromised have a varied response to the vaccine. They do gain immunity, but it’s generally not to the same extent as the general population. And how much immunity they gain depends on their underlying health condition and the medications they’re using.

That’s why the Australian Technical Advisory Group on Immunisation (ATAGI) has recently recommended a 3rd dose of the vaccine to severely immunocompromised people so that they can reach a level of immunity that’s protective. You can check out their list of immunocompromising conditions and therapies here. The Australian Rheumatology Association has also updated their COVID-19 information to include information about third doses. And if you want to know if you need to get a 3rd dose – because the information can be a little confusing – talk with your GP or specialist about your situation.

It’s worth pointing out that the use of additional doses to increase the vaccine’s effectiveness in immunocompromised people isn’t a new thing. It happens with other vaccines, for example, the annual flu shot to boost immunity to the influenza virus. Instead of one flu shot, some people require two.

When it comes to the general population – again using overseas experiences and data – we’re seeing that about 6 months after the 2nd vax, the protection from the vaccines seems to be waning.

A booster shot may be needed if immunity to the virus does start to decrease. The Therapeutic Goods Administration (TGA), in consultation with ATAGI, has assessed the Pfizer vaccine for safety and effectiveness as a booster. As of 27 October 2021, it was provisionally approved for use in those aged 18 and over. The first in line to get it will be those who received their vaccines firsts – way back in February 2021 – so that’s aged care residents, frontline health and quarantine workers. The government is waiting on further advice from ATAGI as to when the rest of the population will receive boosters.

Booster shots may also be required in the future as we see different variants of the virus emerge. Again, as we see with the annual flu vaccination, it’s tweaked each year to keep up with changes to the influenza virus. This may be what happens with the COVID vaccine.

At this stage, the Pfizer vaccine is the only one put forward as a booster. So what does that mean if you received a Moderna or AstraZeneca vaccine for your first two doses?

We’re not sure. Several studies are investigating this very question. It’s possible that mixing different vaccines might broaden your protection. But the research is ongoing, and it’s just too early to say. So it’s a matter of ‘watch this space’.

Finally, it’s essential to recognise that being vaccinated doesn’t stop people from getting COVID. But it significantly reduces the risk of severe disease and hospitalisation. That’s why we need to be vigilant and do all the COVID-safe things we’ve been doing since this whole thing started:

  • wash your hands
  • cover your coughs and sneezes
  • wear a mask (when required)
  • physical distance
  • check in
  • stay home when sick
  • get tested
  • and stay safe.

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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28/Oct/2021

Photo by AUSVEG

Caitlin, a fifth-generation farmer from the northwest coast of Tasmania and Australian Apprentice of the Year 2020, shares her story about living with arthritis.

I was diagnosed with arthritis when I was 12, turning 13, and in grade 7.

I remember my first attack very well. We were on the Spirit of Tasmania heading over to Werribee for the 2011 Interschool Nationals (Equestrian) and on the boat I had a really sore hip. By the following night, the pain had become unbearable, so mum took me to the hospital. The staff took x-rays but couldn’t find what was causing my pain.

I was then transferred to the Royal Children’s Hospital, where I spent the next three days. After a series of ultrasounds and an MRI, they found a heap of fluid on my hip and diagnosed post-viral arthritis. Even with this diagnosis, I went on to compete and hobble around on crutches at Nationals!

When I got home to Tasmania, I went to my GP and was referred to a rheumatologist. It was then I was diagnosed with severe idiopathic rheumatoid arthritis. Then the journey began…???

Has your condition or living with pain impacted your social life, work, friends etc?

It had a huge impact on the rest of my high school years. I took prednisone daily for two or so years, which made me extremely puffy in the face. The people who knew what was going on were kind, but there were also some unkind people. It affected my confidence, I became depressed, moody and I didn’t even want to ride my ponies for a while.

Also, because I usually competed every weekend and rode a lot, I never really felt that I belonged with a particular group at school. And so, towards the end of school, I was quite happy to do homework in the art rooms at recess and lunch. I had some friends, but none who understood what it was like for me, or my lifestyle with the horses and farm, except for my best friend, who lived an hour away.

Since grade 12, life has been on the up and up. I’ve found my ‘people’ by developing greater friendships through horses, joining Rural Youth and getting involved with local agricultural networks where I fit in with like-minded people. Sometimes I’m exhausted and not up to some activities, but I know how to balance my life to keep myself healthy (most of the time! ?) and to be honest with how I’m feeling and when I need to take a break.

Work-wise, working for myself and my family is very handy as I can be more flexible around workload and how I do things. My family is super supportive and will help me in any way they can if I get sick, have an attack or need to go to appointments.

What’s life like living with arthritis?

Every day is different! When I was younger and trialling a lot of different medications, it was a rollercoaster to say the least! I would be nauseous all the time if I was on methotrexate, and tired to the point where I would fall asleep not long after getting home from school. Touch wood, it seems to be somewhat under control now.

I’ve found Actemra (tocilizumab) to be the best medication for me so far. I have an infusion at the hospital once a month. However, I’m starting a new medication next week due to the worldwide shortage of Actemra as they’ve been using it to treat people with COVID. So we’ll see how that goes, as it requires me to go back on to methotrexate.

I could’ve opted for a different medication, such as a daily tablet or self-injection, but I wasn’t a fan of those options. I self-injected twice weekly for a few years, and in the end, I couldn’t mentally do it anymore. I’d get worked up about having to do it, and I found the medication wasn’t working as well. With my busy lifestyle, sitting down in the hospital for a couple of hours once a month actually suits me quite well!

How does your condition impact working and running a farm?

Hydraulics were invented for a reason! Don’t get me wrong, it’s still a very physical job, but I enjoy it as it helps me stay fit and active.

When I’m fitter, I find I don’t get as sore, or I’m at least able to handle more exercise. I also find it helps me with my mental health too. I’m lucky to be able to run two of my own businesses. One through coaching dressage and beginner riders and creating freestyle music. The other is the farm with my partner that we lease from my grandparents. I find that long days in the tractor and very repetitive movements make me stiff and sore, but I’m sure many others find that as well.

Does horse riding help?

It helps in the fact that it takes my mind off the pain while I’m riding. I do feel it afterwards though! On the days I’m in so much pain that I struggle to walk, I can ride, and the horse can become my legs for an hour. When I was younger, I was graded as a para-athlete due to the effects of my arthritis. This wasn’t a bad thing as it allowed me to make so many connections with other para-athletes. I realised that I didn’t have it bad at all, and those I felt had it worse than me were often more determined and more able than some able-bodied riders I know! The only barrier is our mind and what we think we can do. So that really allowed me to push myself to be a better rider and then pass that on when teaching children or adults with learning or physical disabilities.

How important are strong connections – e.g. family, friends, partner – when you have arthritis and chronic pain?

Having a supportive team around you is essential. I’m lucky to have a very supportive family, and my partner Owen is amazing.

There can be days when I need help with basic things like getting undressed, getting into the shower and putting my hair up or the like. For the most part, I’m totally independent, but I know that when I am going through an attack, it won’t be pleasant, and I’ll need to rely on that support.

I also have Hashimoto’s disease and fibromyalgia, so it all hits my immune system hard. From restless legs to feeling pain for the smallest of things, it can be really frustrating. So to have people to comfort you when it gets too much is really important. Sometimes we all need a hug and to be told it’s all ok to get us through the day. ?

My best friend for the last 10 years has seen me go through everything, from being really sick to the healthiest I’ve been and everything in between. We’ve travelled overseas and look forward to more adventures, hopefully soon.

I first told my story publicly on Landline earlier this year. I had messages from people from all over thanking me for sharing my story and inspiring them to go for their dreams too. So to know that my story has helped others makes me so happy!

Do you have any tips for other people who have arthritis or other musculoskeletal conditions?

The biggest piece of advice that I can give is finding what makes you happy. When I’m focused, the rest seems to blur out. Get to know your body and what you can handle, find people in similar situations and ask them as many questions as you can, and then be that person for someone else. We are all in this together and shouldn’t feel alone! There’s no reason we can’t do the things we wish to do most in today’s world.

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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28/Oct/2021

When you live with persistent or ongoing pain, it can sometimes feel like it’s taking over your life. And the usual things you do to manage your pain don’t seem to have the same effect.

This can significantly impact your ability to do your daily tasks, work, be social, and be active. It can also affect your sleep quality, your emotions and mental health. This can then exacerbate your pain and become a vicious cycle.

The good news is that there’s lots of support available to help you break this cycle.

Breaking the pain cycle

There is a range of different health professionals who can work with you to manage your persistent pain. You may see them on an ongoing basis, or you may visit them from time to time as needed.

Your general practitioner (GP) is central to your care and will help you access other health professionals and services. Make sure you have a doctor who knows you, at a practice that can see you when you need to be seen. Having the same doctor, rather than moving from one doctor to another, means that your care will be consistent and organised. This will lead to the best possible outcomes for you.

Physiotherapists (or physios) use a variety of techniques (e.g. exercise, massage, heat and cold) as well as education and advice to reduce pain to allow you to gradually increase your activity levels. They can also show you how to increase mobility, strength and functioning by developing an exercise program for you. Find a physio.

Exercise physiologists can help you improve your health and fitness through clinical exercise programs tailored to your specific needs and support to live a healthy lifestyle. Find an Accredited EP.

Occupational therapists (or OTs) help you learn better ways to do everyday activities such as bathing, dressing, working or driving. They can also provide information on aids and equipment to make daily activities easier. Find an OT.

Psychologists, psychiatrists and other mental health professionals can help you work through your feelings, particularly if you’re feeling anxious or depressed. They can also assist you with goal setting, prioritising activities and coping strategies.

Pharmacists can help you with information and advice about medications – both prescription and over-the-counter.

Pain specialists are doctors who’ve undergone additional training to diagnose and treat pain. They come from a variety of different medical specialties such as psychiatry, anaesthetics and general practice. They often work with a team of other health professionals to treat all aspects of your pain, from the physical, to the mental and emotional aspects

Pain management services and multidisciplinary pain clinics provide a holistic and coordinated approach to managing pain. Their programs are designed to specifically address the range of factors affecting your recovery, including:

  • physical factors
  • psychological issues, including your mood, stress or poor sleep
  • social factors including how you manage your activities at home and how you can return to work safely.

You’ll learn from health professionals such as doctors, physiotherapists, psychologists, occupational therapists and nurses how to manage your pain more effectively with the least side effects.

Talk with your doctor about whether a pain management program would be helpful for your situation. And check out the National Pain Services Directory by Pain Australia. It provides more information about the different types of pain services and a handy search function to find a service near you.

Family and friends can be a great source of support and encouragement, so keep them involved. How much or how little you tell them about your pain issues is up to you, but just knowing they’re there if you need them can be a great source of comfort.

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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07/Oct/2021

The people in our lives bring so much colour and richness to our days. Our family and friends, work colleagues, local baristas, intimate partners, food deliverers, healthcare providers, neighbours, fellow gamers and dog walkers – all of the ordinary and intimate relationships we have are important and connect us to our world.

Apart from the warm fuzzies we get from having these people around us, healthy relationships are good for our physical and mental health. They help us feel less stressed, reduce feelings of loneliness, distract us from pain, boost our immune system and make us feel happier and more optimistic. They’re practically a tonic for all that ails!

And that’s why it’s so important that we nurture these relationships.

This is the first of two articles exploring ways we can tend to our close relationships, to ensure they remain strong and supportive. We begin with the relationship with a partner, spouse, or significant friend.

Physical vs emotional intimacy

When we think about intimate or close relationships, we often think of physical acts of intimacy – holding hands, cuddling, kissing, hugging and having sex. They’re an essential element in our romantic relationships. But we also need emotional intimacy for deeper connections with those we have or hope to have a committed relationship with.

Emotional intimacy involves each person opening up to the other, allowing their vulnerabilities to show, and sharing their deepest feelings and thoughts. To do this, each person needs to feel safe and supported to be themselves, ‘warts and all’. This level of intimacy takes time. And it requires open, honest communication and ongoing work.

“Intimacy is the capacity to be rather weird with someone
– and finding that that’s ok with them.” Alain de Botton

Emotional intimacy occurs not only within committed, romantic relationships, it can also happen within platonic relationships, for example, with your bestie, BFF, a sibling, or with someone else you have a close bond.

The following strategies are focused on nurturing romantic relationships, however most can be used for platonic relationships as well 😊.

Strategies for nurturing your relationship

Share your deep, inner thoughts, feelings, beliefs, fears, needs, pain and worries – not just the superficial stuff.
To really develop that deep connection and understanding of each other, share the things that make you ‘you’. We’re all so different and have had different experiences, challenges, traumas, victories and lifestyles. This shapes who we are, and we tend to keep much of this to ourselves.

However, sharing these things with your partner over time creates intimacy as your relationship grows and deepens. This has to be a two-way street. You both need to be open and honest about what matters to you, as you feel comfortable and safe to do so.

“Never idealize others. They will never live up to your expectations.
Don’t over-analyze your relationships. Stop playing games.
A growing relationship can only be nurtured by genuineness.” Leo F. Buscaglia

Share how much they mean to you.
We all like to hear how much we mean to someone – especially when it’s out of the blue. Try not to become complacent with your relationship or take your partner for granted. Tell them how much you appreciate them and how much they bring to your life. Show them how much they mean to you – buy the book they’ve been wanting, prepare a picnic full of their favourite things, give them a hug, fold the laundry, place little love notes or tokens in unexpected places. Be creative and be honest 🧡.

“Love is a two-way street constantly under construction.” Carroll Bryant

Share, learn and explore sexual desires, so you both feel satisfied.
This adds to your emotional connection. However, sometimes our condition, pain, anxiety and the madness of life in general can impact our desire to be physically intimate. Check out our blog on sex, intimacy and musculoskeletal conditions for tips to help you get your groove back.

“Sex without love is merely healthy exercise.” Robert A. Heinlein

Share time together outside of your day-to-day routine.
Remember the excitement when you first met? The first thrilling time your hands brushed, when you couldn’t wait to see each other? Try to rekindle some of this excitement, so you get to be together as lovers, partners, and friends – not as mum/dad/worker. Make the time to check in with each other, even when it feels like the world is taking over. This can be really challenging – we’re all so busy. So you may need to schedule time for this (not sexy, but often necessary). And make sure you unplug from all technology and put your phone away. It’s worth the effort. Take this time as a loving couple to talk about your day, feelings, needs, hopes and dreams, and just connect.

“A dream you dream alone is only a dream.
A dream you dream together is reality.” John Lennon

Share the difficulties, and where possible, work on solutions together.
If you have problems or difficulties that relate to your condition, job, other people, etc., share them. Don’t keep them bottled up. Having someone to discuss your issues with can help bring clarity. Or at least help you feel your emotions are important and validated.

If the problems relate to your relationship or home life, this can be tougher. Especially if you both have strong feelings about the matter. In this case, it’s really important to be respectful to each other, listen, and work together to come up with a solution. And be prepared to compromise so the solution feels fair to both of you. Remember, we’re all different, and we do and see things differently. This is a good thing (how boring would it be if everyone saw things the same way?), but it can sometimes be really frustrating. So if you become angry, take some time to breathe, reflect on the situation, and come back to it when you both feel calm.

However, sometimes it can be hard to get past an issue, and you may need external help to resolve it. See the section below on managing conflict.

“Nothing is perfect. Life is messy. Relationships are complex.
Outcomes are uncertain. People are irrational.” Hugh Mackay

Share the load.
We like to think of ourselves as superhuman at times and try to do it all without asking for help. Even when it may be needed 😫. But this isn’t sustainable. We’ve all ended up in a heap doing this.

Again, it comes down to open, honest communication. Someone who doesn’t have a musculoskeletal condition can’t fully understand what it’s like and how frustrating it is to be fine one day and thoroughly shagged the next. If there are things you’re struggling with – all the time or just occasionally – discuss these with your partner. Look for ways to share the load – with your partner, children, housemates, other family members, or even hire someone to do the chore/task.

“Being deeply loved by someone gives you strength,
while loving someone deeply gives you courage.” Lao-Tzu

Share fun times.
Make time for having fun, being silly and finding (and celebrating) the joy in life. This can be challenging when you live with pain, the uncertainty of living through a pandemic, work stress and household craziness. But it’s so rewarding. Watch a silly movie, dance in the back garden, share funny memes during your day, go skinny dipping after dark 😍. Laughter and shared fun create another level of intimacy, as well as a twinkle to the eye and a healthy glow to the skin (especially if the water is cold 😉).

“We’re all a little weird. And life is a little weird.
And when we find someone whose weirdness is compatible with ours,
we join up with them and fall into mutually satisfying weirdness
– and call it love – true love.” Robert Fulghum

Have outside interests (and share yourself).
In case you’re starting to feel nauseated by all the saccharine togetherness 🤢, it’s also essential that each person has independent interests. There are often things that make us really happy but are of no interest to our partner – think sports, book clubs, crafts, parent groups, community gardens, study groups, cooking classes, gaming etc. Instead of dragging your partner along, take that time for yourself. It helps you pursue the things that make you feel fulfilled, and you can share your experiences and happiness with your partner. When you both have these opportunities, life is more exciting and rewarding.

“A great relationship is about two things:
First, appreciating the similarities and second, respecting the differences.” Unknown

When it isn’t always smooth sailing: managing conflict

All of the suggestions we’ve provided require commitment, time and ongoing work. But sometimes, you can work and work hard, but arguments and conflicts still arise. Especially when you’re living with the stress of unpredictable health issues, COVID-19, family commitments and all the other complicated things adulthood brings with it.

If you’re both committed to working through these issues, but feel like you can’t resolve them on your own, consider talking with someone you trust about it. This may be a close family friend or family member, or it may be a professional.

Getting help
Family Relationship Advice Line is an Australian Government service that helps families affected by relationship or separation issues. It can also refer callers to local services that provide assistance. Call 1800 050 321.

Relationships Australia provides a range of counselling services delivered face-to-face and online. Find out more about the counselling services available on their website. Or call 1300 364 277.

Ending a relationship
If you’re not committed to resolving relationship issues and want to end it, read ‘Fourteen ways to break up better: How best to minimize the pain in a painful situation’.

Abuse or violence
Using power, abuse or violence against another person is never ok. If you need help, it’s available. For safety and support, call 1800 RESPECT (1800 737 732) for confidential information, counselling and support. They operate 24 hours, 7 days a week.

Read the second instalment of this series: Nurturing relationships: Family and friends

“Maybe you don’t need the whole world to love you.
Maybe you just need one person.” Kermit the Frog

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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Musculoskeletal Health Australia (or MHA) is the consumer organisation working with, and advocating on behalf of, people with arthritis, osteoporosis, back pain, gout and over 150 other musculoskeletal conditions.

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