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Do you feel like your diet has gotten away from you? Have you spent the first part of winter eating yummy, warm and kilojoule dense foods? Are your clothes starting to fit a little more snugly than you’d like? Now may be a good time to review your eating habits to make sure you’re eating as well as you can to improve your health, energy levels and mood.

Here are some handy hints to help you get started.


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A PBS News Update

Ref: ** Pharmaceutical Benefits Scheme (PBS) | Closing the Gap (CTG) PBS Co-payment Program **

Expansion of the Closing the Gap Pharmaceutical Benefits Scheme Co-payment Program – Information for First Nations People

What is the Closing the Gap (CTG) Pharmaceutical Benefits Scheme (PBS) Co-payment Program?

The CTG PBS Co-payment Program improves access to affordable PBS medicines for First Nations people living with, or at risk of, chronic disease.

Under this program, eligible First Nations people who are registered on the CTG PBS Co-payment Register and who would normally pay the full general PBS co-payment amount, pay the concessional rate when obtaining PBS medicines from their local community pharmacy, approved medical practitioner, or private hospital. Eligible patients who would normally pay the concessional rate receive their PBS medicines for free, without having to pay a co-payment.

What is changing?

From 1 July 2024 the CTG PBS Co-payment Program has been expanded to apply to all PBS medicines dispensed by community pharmacies, approved medical practitioners, and private hospitals.

Read more

Answers to Frequently Asked Questions and further information for First Nations people, community pharmacies, hospital pharmacies, prescribers and Aboriginal and Torres Strait Islander Health Practitioners are provided at the links below:

** Ref: Pharmaceutical Benefits Scheme (PBS) | Closing the Gap (CTG) PBS Co-payment Program **

Call our Helpline

If you have questions about things like managing your pain, your musculoskeletal condition, treatment options, telehealth, or accessing services be sure to call our nurses. They’re available Monday to Thursday  between 9am-5pm on 1800 263 265; email (helpline@muscha.org) or via Messenger.

 


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MeTeOR2 Clinical Trial

The MeTeOR2 Clinical Trial compares meniscal allograft transplant surgery to a type of physiotherapy for people who experience post-meniscectomy pain.
Clinical trials 

Clinical trials are an important part in improving healthcare outcomes. If you are not familiar with what a clinical trial is, you’re not alone! Clinical trials are research studies involving people like you and me, to evaluate if a treatment is safe and helpful. The new treatment under testing may be a medicine, procedure, technique, vaccine, device, or lifestyle/behaviour. Clinical trials are carefully designed and must undergo a thorough review to ensure the procedures have merit, are safe and ethical. Ultimately, clinical trials are essential to help us improve the management of health conditions! 

People participate in clinical trials for various reasons. Some people who are aware of clinical trials understand their participation helps inform how to manage health conditions. However, many may not be aware of the other benefits. These benefits include playing an active role in your healthcare, receiving treatment from leading medical practitioners, and accessing treatments for your condition which may not be possible otherwise. One clinical trial is the MeTeOR2 trial, which compares meniscal allograft transplant surgery to a type of physiotherapy for people who experience post-meniscectomy pain.  

What is a meniscectomy? 

The meniscus is a c-shaped cartilage that distributes loads at the knee joint. A torn meniscus is common, especially among young people engaged in sport activities. Conservative treatments are available including activity modification, medication (e.g., non-steroidal anti-inflammatories, paracetamol), and physiotherapy. Some tears may be surgically repaired depending on the location of the tear. Other tears cannot be repaired, so the torn parts are removed with a keyhole surgery called arthroscopic partial meniscectomy. Although this procedure can improve pain and locking symptoms in most people, some patients may still experience pain and functional limitations after the surgery. This scenario can be very disabling and emotionally distressing, particularly at a young age when people are expected to be active, healthy, and free of disability. When this is the case, only a few treatment options are available. 

Treating pain and functional limitation after a meniscectomy 

For people with considerable pain or functional limitations after meniscectomy, surgical and non-surgical treatment options are available. One surgical option is the meniscal allograft transplant (MAT), which involves inserting a donated meniscus into the injured knee. The MAT surgery is thought to improve symptoms by restoring normal load distribution within the knee, along with the rehabilitation after surgery. Non-surgical management, such as personalised rehabilitation – which consists of many different types of treatment, including exercise, weight management, and lifestyle and activity advice – is also a viable option. Although the mechanisms of how personalised rehabilitation reduces symptoms are unknown, improvements have been observed in people with post-meniscectomy pain. However, it is still unknown which treatment option is better, in terms of safety and cost-effectiveness, to improve health-related outcomes. 

The MeTeOR2 study 

MeTeOR2 is a clinical trial designed for people suffering from pain and/or functional limitations after partial meniscectomy. This study aims to compare two knee treatments – meniscal allograft transplant (MAT) surgery and personalised knee therapy (rehabilitation) and evaluate if one treatment is superior to another in improving knee pain and function. 

How to participate/who to contact 

If you are interested in the study and consent to participate, you will have a 50% chance of being put into one of the two groups. The first group will receive the meniscal allograft transplant (MAT) surgery, while the second group will receive personalised knee therapy (rehabilitation). Participants in both groups will be asked to complete a series of questionnaires at baseline and 3, 6, 12, 18, and 24 months following randomisation. 

 You may be eligible to participate in this study if you have: 

 Inclusion Criteria: 

  • Pain and / or functional limitation from the knee, severe enough to warrant potential meniscal allograft transplant. 
  • Previous meniscectomy ≥ six months ago. 

 Exclusion Criteria: 

  • Symptomatic ligament instability, not previously corrected, as determined by the assessing clinician. 
  • Coronal limb alignment that requires surgical correction, as determined by the assessing clinician. 
  • Age < 16, or if ≥ 16, open growth plate at the proximal tibia as judged by the clinical team on imaging as part of standard care. 
  • Full thickness cartilage loss (exposed bone) > 1 cm2, on routine clinical MRI, prior to surgery, or any other form of clinical imaging or evaluation. 
  • Inflammatory arthritis affecting the study knee as determined by the assessing clinician. 
  • Unable or unwilling to engage in rehabilitation. 
  • Unable to adhere to trial processes. 
  • Previous randomisation in the present trial, (i.e., the other knee). 

If you are interested in being part of this important and exciting clinical trial, please contact the study facilitator: meteor2.study@sydney.edu.au 

Contact our free national Helpline

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issuestelehealth, or accessing services. They’re available Monday to Thursday between 9am-5pm on 1800 263 265; email (helpline@muscha.org) or via Messenger.

 


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It’s 2am and you’ve been tossing and turning for hours. You’re so tired, but you just can’t sleep. You lay on your left side, but your neck hurts too much in that position. So you roll on to your back, but your lower back aches. You turn on to your right side, and success (!) that feels ok. But now your knees hurt, your brain’s counting down the hours until you have to get up for work, and you need to go to the toilet. Sigh.

Sound familiar? We’ve all experienced the dreaded ‘painsomnia’ – or insomnia caused by persistent pain.

Without the distractions of our daily activities, the dark of night can become a long, painful expanse of time. Even when we’re exhausted, sleep can be elusive. It might take longer to fall asleep, we can’t get comfortable, we wake frequently, or we just don’t get enough sleep. Or all of the above.

When you add anxiety about sleep into the mix, it becomes a vicious cycle. Poor sleep lowers your pain threshold which affects the quality of your sleep. Pain can affect your ability to be active – which affects your sleep quality and your pain levels. This can make you anxious or stressed – which again will affect how well you sleep and the amount of pain you experience.

And when you’re stuck in this cycle, exhausted and in pain, it affects your mood, your ability to concentrate and it’s very easy to become depressed. So it’s important that you act quickly as soon as you start having issues sleeping.

The good news is there are many things you can do to break the cycle. The not-so-good news is they may not work immediately. And they’ll require some effort on your part. But they’re all tried and true ways to develop good sleep habits and get the good night’s sleep you crave.

  • Acknowledge your painsomnia. Although it’s tempting to pull the covers over your head and ignore the problem, that won’t make it go away. Actually acknowledging the situation, and that there are things you can do to change it, is the first important step.
  • Develop a sleep routine. There’s a reason we do this with babies and small children – it works! As often as possible, go to bed and get up at the same time each day. Your body will become used to this routine and you’ll find it’s easier to fall asleep and stay asleep.
  • Manage your pain. You can’t have painsomnia if your pain is under control. Check out our A-Z pain management guide for simple, practical ways you can take control of your pain.
  • Try some relaxation techniques. There are as many ways to relax as there are stars in the night sky (well, almost) so there’s bound to be something that suits you. Try a warm bath before bed, reading (though nothing too engrossing!), deep breathing, listening to music, mindfulness, or visualisation. These techniques will help you become more relaxed so that when you go to sleep, you sleep well.
  • Exercise and be active during the day. As well as the many other benefits of regular exercise, it’ll help you fall asleep and stay asleep longer.
  • Don’t look at the clock. Constantly checking the time can make you anxious, which makes it hard to sleep. Try removing your clock from the bedside, or cover it up at night.
  • Manage your thoughts, all of the pesky voices in your head that are focusing on the things you need to do tomorrow, or the current state of the world, or the latest stress of the day. One way to deal with them is to write them down and get them out of your head. Put them down on paper and tell yourself you’ll deal with them tomorrow when you’re rested and have the brain power to deal with them.
  • Get out of bed. Don’t lie in bed tossing and turning. Have a warm drink (e.g. milk, no caffeine), do some gentle stretches or breathing exercises and go back to bed when you feel more comfortable.
  • Avoid tech before bed. It’s easy to get caught up in news, social media and emails, and before you know it you’ve lost a few hours. Also the blue light on our devices suppresses the hormone (melatonin) that makes us sleepy at night, so be sure to stop screen use at least one hour before bed. That being said, there are some useful apps that may help you with your painsomnia – including sleep diaries, apps that provide soothing sounds to help block out other noises (like traffic or snoring), and apps that help you relax so you fall asleep more easily.
  • Consider cognitive behavioural therapy for insomnia (CBTI). This is a therapy that aims to challenge and change unhelpful ways of thinking about sleep. It also changes your behaviours when it comes to sleep. Find out more about CBTI in this article from the Mayo Clinic.
  • Evaluate your environment. What’s your bed like? Too hard, too soft or just right? Do you need to make some changes to your mattress, pillows and/or linen that will make your bed as comfortable as possible? Is there too much light or noise? Can you control that with simple fixes such as eye masks or earplugs? Is your room too hot? A slightly cool room is the best for a good night’s sleep. Consider all of these things as you take a long, hard look at your bedroom.
  • Get professional help. If pain is constantly keeping you awake at night, talk with your doctor about other things you can do to manage your pain and get some decent sleep.

Call our Helpline

If you have questions about things like managing your pain, your musculoskeletal condition, treatment options, telehealth, or accessing services be sure to call our nurses. They’re available Monday to Thursday  between 9am-5pm on 1800 263 265; email (helpline@muscha.org) or via Messenger.

More to explore


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Not just a fashion statement from the 70s!

From time-to-time many of us experience a flare, when symptoms like pain, inflammation and fatigue are worse, or more intense. This is a flare.

Flares are temporary, but can be frustrating and painful while they last. We don’t always know why they happen – and sometimes they seem to come out of the blue.

So it’s important that you have a plan for how you manage a flare when it happens.

Your flare plan

  • Write down what you were doing before the flare as this can help you identify potential triggers.
  • Talk with your doctor about what you should do when you have a flare. You may need to adjust your medications, or alter the dosage during a flare.
  • Have a plan in place for how you will deal with your commitments – family, work, social activities – when you’re in the middle of a flare. Can you alter your work hours, work from home, get your family to help out?
  • Prioritise your tasks and activities. This can reduce the risk of overdoing things.
  • Pace yourself. If the flare is the result of overdoing things, think about getting people to help you, or spread the activity over a greater period of time, e.g. if you want to clean your house, get the family involved and give each person a room or zone that they’re responsible for; or spread the job over a few weekends and assign yourself a room, a zone or a period of time to clean that’s achievable for you. When you’ve cleaned that area, or reached that time limit, stop. You can go back to it later.
  • Manage your stress, it can increase your pain levels. If you feel yourself becoming stressed, try relaxation techniques such as meditation, breathing exercises and visualisation.
  • Pull out all of your pain management strategies. Use heat or cold packs, get a massage, go for a walk, distract yourself…use all the things you know help you manage your pain.
  • Rest when your body needs it – but not for too long. Going to bed and not being active during a flare can make your pain and fatigue worse. Continue to exercise, but at a lesser intensity than usual. Listen to your body.
  • Use aids and other gadgets when your joints are painful and swollen. This will help protect your joints, and reduce some of the pain you feel when doing everyday tasks.

Some of the suggestions listed here are easy, however others involve a bit of thought, as well as input from others. But taking the time to work out a plan that works for you will help you manage your flares better, and with less disruption to your life.

Get advice from your doctor, and others in your healthcare team. Or, contact our free helpline on 1800 263 265 and speak with a nurse or email us at helpline@muscha.org

MORE INFORMATION

NPS MedicineWise: Managing Your Flare

 

 


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Tips for preventing falls

The 80’s song ‘catch me I’m falling’ could have been my family anthem. We’re clumsy, uncoordinated, and with two left feet, always slipping, tripping, and falling. 😁

It‘s just the way we are. I’ve even gotten to the point of doing a ‘ta-da’ after a trip, extending my arms over my head like a gymnast at the end of a routine.😀

But now, as I’m getting older, it’s not so amusing. I’m conscious of the more serious repercussions of falling. In fact, just last week, I tripped over my cat, whacked the side of my head on the kitchen counter and broke my glasses. Fortunately, I wasn’t seriously injured. But it made me take stock, stop thinking about falls as something I have to put up with and start being more proactive in preventing them.

Because the good news is that falls aren’t inevitable. They can often be prevented, or at the least, any injuries that occur can be minimised.

Let’s start with some facts

Data from the Australian Institute of Health and Welfare shows that falls are Australia’s largest contributor to injuries that require a stay in hospital and are a leading cause of injury deaths.(1) More than half of the hospitalisations were due to broken bones – often hips, vertebrae and wrists.

Falls can happen anywhere and to anyone, but a fall that lands you in hospital is more common in older people and most likely to occur in the home.

The stats are alarming, and like me, you may think these were falls from a height or down stairs. But the truth is, ‘over half of all falls leading to hospitalisation occurred on a single-level surface (for example, by slipping), and only 7% of falls leading to hospitalisation involved stairs or steps.’(1) 😱

And if you have osteoporosis and your bones are already fragile, the risk of breaking a bone due to a fall is much greater.

So to avoid becoming one of these stats, we can’t see falls as an inevitable part of life and getting older. They’re a serious problem, and we all need to take steps to prevent them.

We know that falls can result in broken bones, but they can also cause:

  • Dislocated joints (e.g. shoulder)
  • Head injuries
  • Bruises, scrapes and sprains
  • A loss of confidence which can lead to restricting activities due to the fear of falling. For example, avoiding walks in the park or going into places that are unfamiliar, crowded or have stairs/steps due to fear of falls,

What causes people to fall?

Health issues

  • If you’ve fallen more than once in the past 6 months, you’re more likely to fall again.(2)
  • Medical conditions that lead to reduced strength and endurance (e.g. arthritis), loss of sensation (e.g. diabetic neuropathy), impaired balance (e.g. Parkinson’s disease) and cognitive impairment (e.g. dementia).
  • Medicine side effects, especially if you’re taking several medicines.
  • Poor eyesight and vision problems.
  • Incontinence. Rushing to the toilet can increase your risk of falling, especially at night.

The environment

  • Trip hazards in your home and the community, e.g. clutter, cords and cables, wet and/or slippery floors, uneven footpaths, and pets.
  • Poor lighting.
  • Inappropriate or ill-fitting footwear and clothing.

Reducing your risk

Falls are usually caused by a combination of factors. Changing some of these factors can lower your chances of falling. Or, if you do fall, reduce your risk of serious injury.

Exercise regularly

Australian physical activity and exercise guidelines recommend that all adults be active most days, preferably every day, for 30 minutes or more. Exercise is vital for good health, maintaining independence, and lowering your risk of falls and fall-related injuries. Physical activity helps to maintain and improve your mobility, strength, posture, coordination, balance and flexibility.

People with better posture, better balance and stronger muscles are less likely to fall or be injured. On the other hand, people who aren’t very active are more likely to fall and be injured than those who are more active.

Talk with your doctor, physiotherapist or exercise physiologist for information and advice about how you can safely become more active.

And read Exercise for preventing falls by The Royal Australian College of General Practitioners for more info.

Look after your health

  • Talk with your doctor about your medicines. Some medicines can help reduce falls, such as pain-relievers that decrease your pain and allow you to move more comfortably and be more active. However, some medicines or combinations of medicines can cause dizziness, drowsiness or confusion, which increases your risk of falling. Understanding your medicines and how they affect you is an important strategy for reducing this risk.
  • Eat a healthy, balanced diet with regular meals throughout the day to avoid feeling lightheaded, weak or dizzy. Stay hydrated and drink plenty of water each day.
  • Limit alcohol intake as it can affect your balance and coordination and increase your risk of falling.
  • Have your eyes tested regularly by an optometrist. If you wear glasses, keep them clean. If you have different glasses for different situations, e.g. reading or distance glasses, make sure you use the appropriate ones for the task. Be careful when going up and down stairs if you wear multifocals.
  • Wear sunglasses outside to minimise glare and squinting and to protect your eyes from UV damage.
  • When moving from a light to a dark space, or vice versa, allow time for your eyes to adjust.
  • See a podiatrist if you have problems with your feet that affect your balance or how you walk; for example, pins and needles, pain, swelling, or poor circulation. They can help you address these issues. They can also give you advice about appropriate footwear.
  • Take time to regain your balance after lying down or standing up after sitting.

Move around safely

  • If you’re unsteady on your feet or have painful feet, hips or knees, you may need some support to get around. A physiotherapist or occupational therapist can help you decide if a mobility aid (e.g. a walking stick or walker) is appropriate for you. They’ll also help you learn how to use it correctly and adjust it to your requirements.
  • Plan your outings to fit how you’re feeling. For example, if you’re at the shopping centre and feel tired or your feet begin to hurt, you might need to sit and rest for a while. Or, avoid going for a long walk if you’re having a day when your pain and fatigue levels are high. Take a shorter walk instead.
  • Be aware of the weather and how it can affect your environment. For example, footpaths are often slippery when wet, especially if there are wet leaves on them. Or, on sunny days, sun glare can make visibility more difficult, and you may not be able to see as clearly as usual.

Choose your clothing and footwear carefully

  • Avoid long trousers or skirts that may get caught underfoot or on furniture.
  • Wear well-fitting, supportive shoes with non-slip soles. Avoid high heels, floppy slippers, shoes with slick soles, and walking around in your socks.
  • Hip protectors may be an option for people with osteoporosis or those who fall often. They’re plastic shields or foam pads that fit into the pockets of specially designed underwear and reduce hip fractures from a fall. Your doctor can give you more information about hip protectors.

Reduce the hazards in your home

  • Make sure mats, rugs and carpet edges are lying flat on the ground and well secured. If they’re loose or curled up, they can cause you to trip.
  • Clean up spills from the floor immediately. If you have balance issues and bending over is a problem, ask someone else to clean the floor or use a light mop.
  • Ensure your walkways are clear of clutter, and you have plenty of space to walk between furniture without anything getting in your way.
  • Remove cords and cables from walkways. Secure them to skirting boards or close to the wall.
  • Install non-slip mats in the bathroom.
  • Pets can be a trip hazard (as I learned the hard way), especially if they like to be close to you or it’s meal time. 😼 So be aware of where they are when you’re up and about. 🐶
  • Make sure your home is well-lit so you can always see where you’re going. If you get up in the night frequently to go to the toilet, make sure you have a bright bedside light or use a torch so you can see clearly. Motion sensor lights are also handy and can be plugged into power points on the way to the toilet.
  • Consider installing a handrail on at least one side of any stairs and next to baths, showers and toilets.
  • Safety strips on the edges of outdoor stairs are also a good idea. They provide additional grip and help you see exactly where the edge of the step is.

What to do if you fall

Sometimes, no matter how careful you are, you can still have a fall.

So if you have a fall, it’s important that you try not to panic (easier said than done 😑). And although your first reaction may be to get up quickly, especially if you’re in public, because you’re embarrassed (been there, done that), take a moment.

  • Assess the situation. Are you hurt? Is it safe to get up? Have you damaged your glasses? Or lost your walking stick?
  • Make a decision whether or not to try to get up. Factoring into your decision will be whether you’re safe where you are, e.g. have you fallen onto a footpath or the road?

If you can get up:

  • Take time to recover. Sit and let yourself get over the shock. Drink some water. Take stock of your injuries.
  • Tell someone you’ve had a fall and/or seek medical advice. Don’t just brush it off. Falls can signify that something’s wrong – e.g. medicine side effects, balance problems, or a new health issue.

If you can’t get up:

  • Try sliding or crawling to seek help.
  • Use your phone or personal alarm, call for help or make a loud noise to attract attention.
  • Make yourself as comfortable as possible until help arrives
  • Seek medical advice/or call an ambulance.

Services to help keep you safe

If you’ve done all you can to prevent falls and are still concerned about your risk, there are services available to help you.

  • Falls and balance clinics provide multidisciplinary assessment and management planning for people who’ve had falls and have mobility and balance problems. People receive information on making their homes safer and are referred to physiotherapy, occupational therapy, exercise classes and other allied health professionals. Talk with your doctor about whether this might be an option for you.
  • Personal alarms. There are two basic personal alarm options; a pendant you wear around your neck and a smartwatch worn on your wrist. Pressing the button on the alarm will trigger contact with the service company, who’ll then contact your nominated relative, friend, neighbour or a response service. Some people can access free or reduced-cost personal alarms through government schemes such as the Commonwealth Home Support Program, National Disability Insurance Scheme (NDIS) and Department of Veterans’ Affairs. Visit their websites or speak with your doctor to see if you’re eligible. A variety of private companies provide this service for a fee if you don’t qualify for the free service.
  • Red Cross Telecross is a free service offered by the Australian Red Cross. It aims to provide people who live alone and are at risk of illness or accident the peace of mind that someone is looking out for them. Each morning, every day of the year, trained volunteers make a short call to people’s homes. If the call goes unanswered, Red Cross will take action to make sure that the person is OK. For information about accessing Telecross, call Red Cross on 1300 885 698.

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issuestelehealth, or accessing services. They’re available Monday to Thursday between 9am-5pm on 1800 263 265; email (helpline@muscha.org) or via Messenger.

More to explore

References

(1) Falls, Australian Institute of Health and Welfare, 2022.
(2) Falls and the elderly, healthdirect, 2020.

 

Originally written and published by Lisa Bywaters 2022.


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Budget-friendly tips for staying warm this winter

Sadly winter is more than just lazy Sundays when you can stay at home, warm on the couch with a loved one. Reality means we need to eventually (and reluctantly) head out of our cosy homes and face the cold, wet winter. And when we’re at home, because of crazy energy prices and rising living costs, we have to make hard decisions about how to spend the household budget. Heating is one of the more significant costs in winter, so many people are forced to reduce it to save money.

For those of us with conditions like  fibromyalgialupusosteoarthritisrheumatoid arthritisback pain, scleroderma, and Raynauds’ phenomenon, this can be a painful problem. We often feel the cold more keenly with increased joint and muscle pain or lack of blood circulation to the extremities.

So, how can you stay warm and keep the costs down this winter? We’ve got some suggestions for you to try.

Dress for the weather.

Let’s start with the basics. You need to dress for the temperature and wear layers. It can sometimes feel cumbersome and bulky, but it’s one of our best defenses against the cold. So put on the warm pants and jumper, embrace your inner Wiggle and wear a skivvy, pull on your thick socks and/or tights and appropriate footwear. If you’re still cold, consider adding thermals to your layers.

When you head outdoors, add more layers – including a coat, hat, gloves, and scarf. You can also buy a fantastic range of heated vests, socks, scarves, and gloves. They can be a little pricey, but they may be worth that initial outlay if you’re outdoors a lot. Check online or in-store at outdoor suppliers.

If you’re at home and still feeling the cold, grab a blanket for your legs as you sit at your desk or on the couch. You can use any warm blanket, doona or heated throw. Whatever you choose, just be careful you don’t trip on it when you get up.

Shop around.

Don’t assume you’re on the best energy plans for your gas and electricity. Take some time to see if there’s a better deal. If you live in Victoria, visit Victorian Energy Compare. For all other parts of Australia, visit Energy Made Easy.

Deal with draughts.

When the wind’s howling outside, you know it’s trying to find a way indoors 💨. So cover the bottom of your door with a door snake or an old towel, or add some door seals. Pull your curtains and blinds over the windows at night and during miserable days to keep the warmth inside. If you have floorboards, consider putting down rugs (just be careful they don’t become a trip hazard).

If you can safely do so, close or cover air-conditioning vents, exhaust fans, and unused chimneys. However, it’s important to be aware that some gas appliances require a certain amount of ventilation or fresh air, or they can be unsafe. They should also be serviced every two years or sooner if you notice anything unusual. If in doubt, speak with a licensed gas fitter. Energy Safe Victoria has lots of useful info about heating your home with gas and what to look for when searching for a licensed gas fitter.

Sustainability Victoria also has helpful information on draught-proofing your home. You can also watch these handy DIY draught-proofing videos from the City of Port Phillip (Melbourne).

Turn down the temperature.

While it’s tempting to crank the heat up, the most efficient temperature to set your heater to (if you can select the temp) is 18-20 degrees. While that may not sound particularly warm, we’re often outside during the warmer months wearing short sleeves when it’s 18-20 degrees. It’s just a matter of perspective.

And only heat the areas you’re using. If you can turn the heating off in unused parts of your home, do it. Shut the doors and use a draught stopper to prevent the warm air from the rest of the house from escaping into these areas. And turn the heating off when you go to bed or leave home.

Install heavy curtains.

Thick curtains made from heavyweight, tightly woven fabrics can prevent heat from escaping your home. For the best results, curtains should be fitted as close to the window frame as possible, extend below the sill and well over the sides of the window frame, and a pelmet fitted over the top. This acts to seal the window from the rest of the room and prevent heat loss. Curtains will also keep the hot air outside in summer.

Let the sun shine in.

Open your curtains and blinds on sunny days to let the sun shine on your windows. Even with a chilly wind, the sun will bring wonderful warmth into your home.

And remember to close them when the sun starts to go down. As someone who goes for walks when it’s dark in the early morning and evening, I’m always amazed by how many people have their windows uncovered. You can practically see the heat escaping through the glass. So close them to keep the warmth in and the gaze of the sticky-noses (like me) out 😉.

Cool down at night.

You sleep better when your body can cool down, so turn the heater off at night. It’s also safer to sleep with the heater off. You can remove the chill from your bed using a hot water bottle or an electric blanket. Just remember to turn your electric blanket off before sleeping.

Winter-proof your bed.

There’s nothing like slipping into a deliciously warm bed on a cold night, especially if there’s soft flannelette involved! So swap out your lighter, everyday bedding for heavier winter ones. And add layers – a top sheet (if you don’t already use one) and extra blankets. Finally, if you have floorboards in your bedroom, adding a rug under your bed can prevent draughts from making their way to your bed.

Get active.

When the weather allows, go for a brisk walk outdoors, wearing appropriate clothing, and you’ll warm up in no time. Save on pricey petrol and walk to the shop/school/post office instead of driving.

When you’re at home, exercise indoors using an online program, a DVD or an app. Play with the kids. Clean the house. Do anything that gets you moving, and you’ll feel warmer than if you sit in one place for hours.

However, if you’re having a flare or experiencing a lot of pain, be as active as you can within your limits. And use your heat packs to help relieve muscular pain.

Shorten your showers (if you can).

Many of us use our shower to warm up sore joints and muscles so we can get moving. However, hot water uses a lot of energy; even a few extra minutes will add to your bill. If you can, shorten the time you spend in the shower. Aim for four minutes or less. You can use a timer or sing your favourite song. Hunter Water has a great playlist of four-minute(ish) songs to get you inspired.

Give your heater some space.

Anything that blocks a heater will prevent the warm air from flowing around the room uninterrupted. So move clotheshorses and other obstructions away from the heat source.

Hot air rises, so if you have ceiling fans, flick the reverse or winter mode switch and turn the fan on low. This will pull the cooler air towards the ceiling and push the warmer air down to you.

And to stay safe, fire authorities say you should keep clothing and other fabrics at least one metre from your heater. Never place them on heaters.

Snuggle up.

Get comfy on the couch with your partner, kids, and pets. Grab a warm blanket or doona, share your body heat, and enjoy being together.

Use heat packs and hot water bottles.

If you’re feeling stiff and sore, heat packs or hot water bottles can provide temporary pain relief and help you get moving. But you need to be careful when using them.

If you’re using a heat pack or wheat bag, let it cool completely before you reheat it. Don’t sleep with your wheat bag or smother it behind you in your chair or bed. This can cause it to overheat and catch fire. Always carefully follow the manufacturer’s instructions and never overheat them in the microwave.

If you’re using a hot water bottle, use hot water from the tap, not boiling water. Wrap it in a cloth or use a cover so it doesn’t come into contact with your skin.

Always examine your hot water bottles and heat packs before use, and toss them out if you notice signs of wear or damage. And always check their temperature before use to ensure they’re not too hot.

Warm up from the inside out.

Many delicious winter recipes bring comfort and warmth on the most miserable days. So crack open the cookbooks and get cooking! Or go online for inspiration for yummy, warming curries, soups and stews. We’ve got some great recipes to get you started! Can’t be bothered cooking? Simple. Grab a cup of hot chocolate, tea or coffee. It’ll warm your insides and your hands. Perfect! ☕🍵

Choose energy-efficient heaters and hot water systems.

If you’re in the market for a new heater or hot water system, make sure you’re buying one that’s energy-efficient and best suits your needs. Read Canstar’s guide to energy-efficient heaters and Choice’s article on buying the best hot water system for more info.

Insulate.

Insulation keeps your home warm in winter and cool in summer by preventing heat from escaping or entering your home. This keeps your home at a more consistent temperature and reduces the need to crank up your heating or cooling.

If your home isn’t properly insulated, this is something you can do that’ll have long-term benefits. There’s a substantial upfront cost, but it may be an option for some households. Find out more about insulation, including the different types available and how to install it, from the Australian Government’s website, Your home.

Billing and payment help.

If you’re struggling to pay your energy bills, Energy.gov.au also has some information about support for Australian households, including info on potential rebates that may be available.

We’ve also put together lots of info to help you if you’re struggling with financial stress.

Contact our free Helpline

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issuestelehealth, or accessing services. They’re available Monday to Thursda between 9am-5pm on 1800 263 265; email (helpline@muscha.org) or via Messenger.

More to explore


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24/Apr/2024

Did you know that back pain is the leading cause of disability in the world? (1)  In 2017-2018, 1 in 6 Aussies reported having back pain – that’s almost 4 million people.(2)  And these stats don’t take into account people who have back pain caused by conditions such as osteoporosis.

With so many people affected by back pain, it’s likely that you’ve experienced back pain or you know someone who lives with back pain. Or both.

So it’s crazy to think that people with back pain are still having to deal with disbelief or suspicion about the reality or extent of their pain and the impact it has on their lives.

We saw this reflected in the responses we received to our 2023 national survey from people with back pain.

Why is this? Why is there so much stigma attached to back pain and back injuries?

Well, for one thing, like most musculoskeletal conditions, back pain is invisible. And it can seem to come and go for no particular reason. For someone who’s never experienced back pain, it may seem like a convenient excuse to get out of work or to receive sympathy. This is untrue and unfair.

It’s time to shine a light on the very real issue of back pain.

How your back works

To understand back pain, it helps to have a basic understanding of the structure of your back. It’s an amazing feat of engineering that provides support for your whole body.

The spine is made up of bones (vertebrae) stacked together to form a loose ‘S’-shaped column.

Each vertebra is cushioned by spongy tissue called intervertebral discs. They act as shock absorbers and give your spine its flexibility. Pairs of small joints (facet joints) connect vertebrae to one another. Ligaments, tendons and muscles, provide further support to your spine and help protect it from injury.

Your spinal cord runs through the centre of the vertebral column and connects your brain to the rest of your body.

Why do people get back pain?

The cause of back pain is not always clear. The good news is that most people with back pain don’t have any significant damage to their spine. The pain comes from the muscles, ligaments and joints.

Causes of back pain include:

  • non-specific back pain – this is the most common type of back pain. It has no ‘specific’ cause, such as a disease or infection.
  • arthritis – osteoarthritis and ankylosing spondylitis are two types of arthritis linked to back pain.
  • osteoporosis – is a condition where bones lose density and strength. Vertebrae can become so porous and brittle that they break easily, causing pain.
  • stress – a side effect of stress is increased muscle tension. This can lead to fatigue, stiffness and pain.
  • sciatica – is a painful condition that develops when the nerve that runs from the lower back into the leg is compressed or squeezed.
  • lifestyle factors – such as lack of exercise, obesity, lack of sleep and smoking can cause back pain.
  • accidents – including car accidents, workplace injuries, falls, sports injuries – can damage your back, leading to back pain, which may be acute (only lasting for a short time) or chronic (lasting for more than three months).

Diagnosing back pain

Because most people with back pain have no underlying condition or damage to their back, diagnosing will involve lots of talking with your doctor. Together you’ll discuss your back pain, including potential causes or triggers, if you’ve had back pain before, things that make your pain worse, things that make it better. Your doctor will then check out your back to see if there are any obvious causes or issues.

Your doctor may also refer you for some tests, especially if they think there may be a more serious cause for your back pain.

However, imaging (e.g. x-rays, CT or MRI scans) isn’t useful or recommended in most cases of back pain. Scans may seem like a reassuring thing to do so we can rule out anything scary. But unnecessary tests can be expensive, and some involve exposure to radiation that should be avoided unless absolutely essential.

A thorough examination by your doctor will decide whether more investigations are appropriate or helpful in developing a treatment plan that’s right for you.

It‘s also important to know that many investigations show ‘changes’ to your spine that are likely to represent the normal passage of time, not damage to your spine.

For more information about questions to ask your doctor before you get any test, treatment or procedure, visit the Choosing Wisely Australia website.

Managing back pain

Most cases of back pain get better on their own, and you won’t need to see a doctor. The following tips may help relieve your symptoms and speed up your recovery.

  • Understand your back pain. What makes it better, what makes it worse? Knowing as much as possible about your condition means that you can make informed decisions about your healthcare and play an active role in managing your condition. And remember, the good news is that most back pain isn’t caused by anything serious. It’s painful, but it will get better.
  • Rest your back (temporarily). Avoid strenuous activity but where possible, continue light activity (e.g. walking). Bed rest for more than a day or two isn’t helpful and will worsen your back pain.
  • Get back to your normal activities. Try to be as active as possible and get on with your day-to-day life, including work and exercise. If you’re returning to heavy manual jobs, this may take longer.
  • Move. Don’t stand or sit in the same position for too long. Get up and stretch, go for a walk, move about. There’s a reason physios say ‘motion is lotion’. Moving keeps your joints and soft tissues more flexible and less painful.
  • Learn ways to manage pain. There are so many strategies you can use to deal with your pain. Knowing what works best for you is essential when living with back pain. Read our A-Z guide to managing pain for tips and techniques you can use to relieve your pain. And check out the More to Explore section below for links to great videos on managing pain using your brain.
  • Try to manage emotions such as stress, anxiety and frustration. While it’s completely natural to feel these things when you’re in pain, they can actually make your pain worse. That’s because pain involves your perceptions, feelings and thoughts. The worse you think your pain will be, the worse it feels. This can become a vicious cycle. Talking with a family member or a close friend, or a health professional about how you’re feeling means you can start dealing with these feelings and break this cycle. Strategies such as breathing exercises, meditation, massage, heat, cognitive behavioural therapy (CBT) and gentle activity like tai chi may also help you keep your stress and anxiety under control.
  • Apply heat and cold therapy. Hot and cold packs applied to the area of pain may help relieve pain temporarily. Make sure you protect your skin from the heat or cold (e.g. wrap your ice pack in a tea towel). Only leave on the affected area for a maximum of 10 to 15 minutes then allow the skin temperature to return to normal before reapplying as needed.  The Australian Clinical Care Standard for low back pain recommends using heat wraps as a first-line approach alongside other treatments, such as regular physical activity, to relieve back pain.
  • Eat a healthy diet and manage your weight.
  • Get a good night’s sleep. Not getting enough good quality sleep can have an impact on your back pain. Read this article by The Sleep Foundation to find out ways you can sleep better with back pain.
  • Quit smoking.
  • Medications may help in the short term to get your back pain under control. Your doctor may prescribe a short course for you, or you may purchase some meds and/or liniments over-the-counter. Talk with your doctor or pharmacist for more info.
  • Seek advice. If you’re concerned your back pain isn’t improving, make an appointment to discuss it with your doctor so you can develop a plan tailored to meeting your specific needs and goals.

What about surgery?

In most cases, the evidence doesn’t support the use of surgery to treat chronic back pain. Most people can manage their back pain with education, exercise and making lifestyle changes.

If your doctor suggests back surgery as an option, ask questions so you can make an informed choice. Choosing Wisely Australia has 5 questions to ask your doctor or healthcare provider to help you get started.

Final words

Back pain is a significant issue for so many Australians. But the good news is that it’s rarely caused by anything serious. And there are lots of things you can do to manage it, so you can get on with living your best life.

Contact our free Helpline

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 Monday to Thursday between 9am-5pm on 1800 263 265 or email (helpline@muscha.org) or via Messenger.

More to explore

References

(1) Musculoskeletal conditions
World Health Organization, 2021
(2) Back problems
Australian Institute of Health and Welfare, 2020 


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08/Apr/2024

Are you like me and find supermarkets ridiculously cold? It doesn’t matter what season it is outside; inside a supermarket, it’s Arendelle, and Elsa has just turned everything into snow and ice ❄⛄.

This can be really uncomfortable, especially if you have a musculoskeletal condition. And if you have Raynaud’s phenomenon, it can make your extremities – especially your fingers – turn white and numb.

What is Raynaud’s phenomenon?

Apart from having a really cool name – it’s a phenomenon, for goodness sake! 🙃 – what is Raynaud’s??? First, it’s named after the French doctor who originally described it, Maurice Raynaud, and being French, it’s pronounced ‘ray-nose’ (with a silent D).

Raynaud’s phenomenon causes the blood vessels to the extremities, usually the fingers and toes, to constrict more than usual in response to cold temperatures or stress. When this happens, the blood flow is restricted, causing the extremities to become cold and turn white, then blue. When blood flow returns, the skin becomes red and returns to its normal colour.

Raynaud’s phenomenon can occur on its own – this is primary Raynaud’s phenomenon. Or it can occur alongside or ‘secondary’ to another disease or condition – this is secondary Raynaud’s phenomenon.

Both primary and secondary Raynaud’s phenomenon episodes can last from a few minutes to hours.

Other parts of your body, such as the nose, lips and ears, can be affected too.

Fortunately, Raynaud’s phenomenon rarely causes permanent damage.

Maintaining a balance: vasoconstriction and vasodilation

Your body protects your internal organs (your core) by maintaining a stable core temperature – it’s not too hot, not too cold, but just right 🐻🐻🐻.

One of the many ways your body maintains this stable temperature is through vasoconstriction and vasodilation. This essentially means that your blood vessels (vaso) narrow (constrict) or widen (dilate) as needed.

In the cold, blood vessels constrict to reduce blood flow to your extremities, such as the fingers and toes. This keeps your core warm. In the heat, blood vessels dilate, and blood flow increases to your skin, moving the warm blood away from your core.

These processes help your core remain at a constant temperature, usually around 36-37°C.

For people with Raynaud’s phenomenon, for some unknown reason, blood vessels constrict, not to keep your core temperature stable but in response to cold, stress or emotional upset.

Blood vessels in your extremities narrow quickly, and your skin changes colour due to a lack of blood supply. During a Raynaud’s episode or attack, you may experience pins and needles, tingling and/or numbness in your fingers or toes. You might find it difficult to do things with your hands, as lack of blood can make them clumsy and stiff. And when the blood returns to the area, you may feel slight discomfort or stinging pain.

These changes occur in the extremities, most often the fingers. Circulation in the rest of the body is generally normal.

Primary Raynaud’s phenomenon

This is the most common form of Raynaud’s phenomenon. It’s also called Raynaud’s disease. Women, generally under 30, are more likely to develop primary Raynaud’s phenomenon than men. It can also run in families, so if you have a family member with primary Raynaud’s, you’re more at risk of developing it.

Secondary Raynaud’s phenomenon

People living with conditions such as scleroderma, systemic lupus erythematosus (lupus) and rheumatoid arthritis may develop secondary Raynaud’s phenomenon. This usually occurs later in life but can happen at any age, depending on the underlying cause.

Other risk factors for secondary Raynaud’s phenomenon include:

  • mechanical vibration – for example, using a power tool for extended periods
  • medicines – e.g. beta-blockers, some migraine or cancer drugs, amphetamines
  • smoking.

Diagnosing Raynaud’s phenomenon

Your doctor can determine if you have Raynaud’s by talking with you about your symptoms. It can be helpful to take a photo of your hands if you experience a Raynaud’s episode so you can show this to your doctor.

Although it’s generally not too difficult to diagnose Raynaud’s phenomenon, it can sometimes be hard to tell whether it’s primary or secondary Raynaud’s. Your doctor may use a range of methods to work this out, such as:

  • taking a complete medical history, including asking about family members who may have Raynaud’s phenomenon
  • a physical examination
  • blood tests
  • examining fingernail tissue with a microscope.

Living with Raynaud’s phenomenon

Most people with Raynaud’s phenomenon can manage it effectively with self-care and lifestyle changes. In some cases, medicines may be necessary.

Self-care

To prevent a Raynaud’s episode, the best thing you can do is to keep your body and extremities warm. Dress appropriately for the cold with gloves, thick socks and warm layers. It can be helpful to keep a spare pair of gloves or hand warmers in your car or bag that you can use if you’re caught out in a cold or stressful situation (e.g. a trip to the supermarket! 😱).

If you’re outside and your extremities start feeling cold and numb, go indoors and soak your fingers or toes in warm (not hot) water. Or you can warm them with a heater. Just be very careful of the heat – it’s easy to burn yourself when your skin is numb.

If you can’t go indoors, try these things to increase the circulation to your extremities:

  • Wiggle your fingers or toes.
  • Rub your hands together.
  • Make circles with your arms.
  • Massage your hands or feet.
  • Place your hands in your armpits. However, if you’re like me, your armpits aren’t always warm enough, and you may need to ‘borrow’ someone else’s warmth! Make sure it’s someone you’re close with – random strangers won’t appreciate your ice-cold fingers in their armpits! 😂
  • If a stressful situation triggers the attack, remove yourself from the situation, take some deep breaths and try to relax.

Medical care

Talk with your doctor if your Raynaud’s isn’t controlled by these simple measures. You may need to use medicines that widen your blood vessels and improve circulation.

For secondary Raynaud’s phenomenon, it’s also essential that the underlying condition (e.g. lupus) is treated effectively.

Tips for avoiding triggers

There’s no cure for Raynaud’s phenomenon, so avoiding things that trigger a Raynaud’s episode is key.

  • Avoid being out in the cold for long periods, especially if you’re not dressed warmly.
  • Make sure your whole body is kept warm, using several layers of clothing to trap body heat.
  • Keep your extremities warm with gloves, woollen socks, earmuffs and/or a beanie.
  • Use hand warmers. These small, often disposable products produce heat on demand and are helpful when gloves aren’t enough; you can buy them from supermarkets and chemists.
  • Remember, hand sanitisers often have a cooling effect, so when using them, be prepared to warm your hands quickly.
  • Avoid smoking cigarettes or drinking caffeinated drinks as nicotine and caffeine constrict blood vessels.
  • Review your medicines with your doctor; if they’re causing the problem, discuss possible alternatives.
  • Be aware that holding something cold, such as a can of drink, can trigger symptoms.
  • Learn to recognise and avoid stressful situations.
  • Keep a journal of when episodes or attacks happen, as this may help identify triggers.
  • Look after the skin on your hands and feet – with our frequent hand washing and use of hand sanitiser, it’s easy for our hands to become dry and cracked. Cracked skin is an opening for germs to get in and potentially cause an infection.
  • Exercise regularly to maintain blood flow and skin condition. Being active also has many other health benefits.

Complications

For most people, Raynaud’s phenomenon is uncomfortable and a nuisance but is basically harmless, with no lasting effects. However, in rare cases, loss of blood flow can permanently damage the tissue. This may lead to skin ulceration, tissue loss and scarring.

Talk with your doctor if you notice any changes in your symptoms.

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available Monday to Thursday between 9am-5pm (excluding public holidays) on 1800 263 265; email helpline@msk.org.au or via Messenger.

More to explore


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08/Apr/2024

It’s all in the hands! 

Hands…they tend to be two things we take for granted. They really do an awful lot for us. But what happens when using our hands is painful or difficult? 

Hand osteoarthritis – signs and symptoms 

Osteoarthritis (OA) is the most common form of arthritis. It commonly affects the hands, fingers, base of the thumb and the wrist. OA causes the cartilage on the ends of your bones to become thin and rough. When this happens, bones don’t move as smoothly as they should causing pain and stiffness. OA of the hand most commonly affects women over the age of 50.  

For more detailed information click here.

What are the hand signals? 

As mentioned, pain and stiffness can be the first sign. You may also notice changes in the shape and structure of the joints in your hand.  Some people will develop firm, knobby swellings on the finger joints which means the bones are trying to repair themselves but as a result there is excess bone developing. 

Thumbs up – what to do 

Unfortunately, there is no cure for osteoarthritis of the hand. So, the focus is on relief of symptoms and trying to avoid excess strain on your hand joints. As we all know, doing something that we know is going to be painful usually means we avoid it, but it is really important to exercise these joints. Other things we can do include using pacing strategies and avoiding lifting or carrying heavy weights.  

A hand therapist can help with this as well as advice on aids and other strategies.

Latest updates 

A new study using an existing drug called methotrexate for the treatment of osteoarthritis of the hand with synovitis (inflammation of the lining of the joint) is showing some promising results especially with improvements in pain. The study looked at the safety as well as the benefits of a 6-month course of methotrexate. 97 participants were randomly given 20mg of methotrexate once a week as compared to placebo. The methotrexate group had a moderate but clinically significant reduction in pain providing important evidence that it could have a role in treating this condition. This is a small study, and further trials are needed to see if the benefits continue after 6 months as well as how long treatment is needed. But it is a promising start!  

As with all medications, and as part of discussions with your health care team, you will need to weigh up any possible side effects of methotrexate.  

The lead researcher of the study, Prof Cicuttini, is planning an extension trial and hopefully answer these and other questions like can it prevent joint damage which is often quite severe in post-menopausal women with OA of the hand with inflammation. 

So…grab life by the hands 

 Whilst OA hand is very painful there are things that can help. 

  • putting less strain on the joints
  • implementing simple strategies like pacing and  
  • using practical and well researched aids to provide support and assistance can help. 

Making sure you are up to date with the latest information, support and research (through MHA of course) is essential. As well as working with your health care team about options including the use of medications like methotrexate to provide relief. 

Also, make sure you register for MHA’s upcoming webinar Understanding and managing thumb arthritis on 23rd April at 7 pm. Click here to register  

References 

https://versusarthritis.org/about-arthritis/conditions/osteoarthritis-of-the-hand-and-wrist/ 

https://ard.bmj.com/content/78/1/16 

A well-established drug can improve hand osteoarthritis symptoms: study – Monash University  

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issuestelehealth, or accessing services. They’re available Monday to Thursday between 9am-5pm (excluding public holidays) on 1800 263 265, email helpline@msk.org.au or via Messenger.

 

 


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