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    Lisa Bywaters
    04/Jun/2020
    Health InformationMSK articles

    COVID reflections from the MSK Help Line

    As COVID-19 restrictions came into force at the end of March, life as a Musculoskeletal Help Line Nurse began to change. Like many who were lucky enough to be able to work from home, I packed up my office, put it in the boot of my car and set-up my new workspace at home.

    Work looked a little different now – face to face meetings became Zoom meetings, COVID-19 health news dominated our searches and we began recording videos to keep consumers updated. But most importantly one constant remained – we were still on the end of the phone or email for when a consumer needed some help or advice.

    While the usual enquiries kept coming, there were also stories of personal struggles during the lockdown. People shared their feelings of anxiety surrounding social isolation, their vulnerability and how all too often their exercise routine had diminished, and their pain had increased. We talked over ways to try and overcome this – meditation, mindfulness, online exercise, pain management strategies etc – but sometimes it was just enough to have someone to talk things over with, and to feel like someone was really listening.

    While the struggles were evident, it was also lovely to hear reports of some positive experiences that emerged. Social isolation forced many of us to slow down, to reflect on how much we try to squeeze into a day/week, and perhaps allowed us to reflect on the simple things in life that make us happy. For some it was spending more quality time with their immediate family, others enjoyed time to potter in the garden, clear out the cupboards, do some DIY or simply relax with a good book. In a hectic world, pressing the pause button seemed to bring a little light relief in one form or another.

    As a nurse I am privileged to be able to share in peoples life experiences, including their ups and downs, and as we all get used to the ‘new normal’ I hope that I can continue to provide a friendly ear to make the COVID-19 journey just that little bit easier.

    Clare

    And some feedback from one of our recent callers:

    “Thank you so much for your caring, helpful time with me, giving me very important vital information that I truly need in this very big, busy, fast city…I have received your email with excellent advice in all possible ways and hope for a better way of going along this painful journey with chronic conditions…in which I may be able to benefit and try…and not to feel so alone. I truly hope that things will change for the better. Thank you again Anne, have a gentle relaxing evening and keep warm. Can’t wait to see and read all the goodies inside the email you sent me. With best wishes and kind regards, VC”

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain 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.

    CONTINUE READING
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    Lisa Bywaters
    28/May/2020
    Health InformationMSK articles

    Saying goodbye to iso – easing restrictions

    As we come to the end of May 2020, more and more restrictions are easing all over the country. And we’re being told more restrictions will be lifted in June and July. Yay!!

    While we’re all understandably excited at the prospect of doing the things we took for granted pre-COVID, there are things we need be aware of. The fact is we’re not out of the woods. And we won’t really return to anything resembling the old ‘normal’ until we have a vaccine. 

    So as you make your way out of the front door, blinking into the bright lights of the outside world, make sure you’re ready for it so you and your family stay safe, and you help keep the rest of the community safe.

    What’s up with your hair? And what are you wearing?!?

    OK so this is a little silly, but for many of us it’s been MONTHS since we’ve had a haircut or had a professional give our hair some TLC. So we’re looking a little wild and woolly. Add in the lack of access to beauty salons and we’re a weird, hairy mess – picture Cousin It from the Addams Family. And for many of us we’ll need scissors and a crow bow to get the trackies and slippers off, because staying at home and trying not to spend too much on the heating bill has led to comfort and warmth winning over style and fashion. So maybe check yourself in a mirror before you venture out.

    But seriously apart from sorting out our general dishevelment there are some important things to be aware of as our COVID isolation starts winding down and restrictions continue to lift:

    Hygiene

    It’s still incredibly important. Wash your hands thoroughly and regularly, use hand sanitisers, cough and sneeze into your elbow and avoid touching your face. For a refresher read our hygiene 101 blog for more info.

    Physical distancing

    We’re able to go to more places and see more people, however physical distancing is still vital. Most of us are still susceptible to this highly infectious virus, so we need to maintain at least 1.5 metres between ourselves and others when we’re out in public. This can sometimes be a bit tricky. With the loosening of restrictions, and because people have felt cooped up for so long, LOTS of people are going out. So you need to ask yourself when you pull into the shopping centre carpark and it’s full, or you can see a line of cars heading to the park you’re aiming for. Ask yourself if you’ll really be able to maintain a safe distance between yourself and others. And if the answer’s no, can you go somewhere else instead? Or do something else? Or come back at another, less busy time?

    Gatherings

    We’ve missed our family and friends, and although it was helpful, technology – with all the drop outs and weird pauses – can only do so much. We want to BE with our people. And we’re now allowed to do that in greater numbers. But you need to do a few things if/when your gather:

    • Know the relevant guidelines for your state/territory. It’s different all over the country, so it’s easy to get confused. So check the COVID-19 website applicable to where you live.
    • Only visit or have visitors if you’re healthy and well. Even if you’re chomping at the bit and you’re pretty sure it’s only a sore throat because of your allergies, or you think you’re feeling fatigued because of a late night/your MSK condition/home schooling, don’t take the chance. There may be a slim possibility that you actually have the virus and spread it to others – so don’t be that person.
    • No hugs, kisses or handshakes. This is a tough one, especially if you haven’t seen loved ones in ages, but resist the close contact. And it may seem lame but try the elbow bump or foot tap greeting. Better still, make up your own family greeting. Get the kids involved and make it something fun and uniquely yours.

    Your mental health

    It’s been such a crazy time, and we’ve been isolated in our own cocoons for so long, many of us may be a little anxious or scared about going out. That’s completely understandable. But we do need to go out – for work, groceries, social connection, exercise, healthcare appointments – we need it all.

    However if you do feel anxious about heading out into the world, it’s important to understand why you’re feeling this way and then look for ways you can manage it. For example if you’re freaked out by the crowds at the supermarket, try and do your shopping at quieter times. If you’re concerned about using public transport, follow the capacity restrictions for the specific mode of transport, wash your hands after using it (or use hand sanitiser if you have it) and avoid touching your face.

    The important thing is to start easing your way back into the world. But if you’re having real issues getting out, talk with your doctor. You may need some professional support. You can do this via telehealth from the comfort of your own home.

    There will be outbreaks

    That’s inevitable, but we can all do our best to reduce the risk of an outbreak with good hygiene, physical distancing and staying home if you feel unwell.

    Exercise venues

    Pools, indoor and outdoor gyms and fitness centres are also reopening. This’s great news. We all need a variety of exercises for our general health and wellbeing, and to help us manage our musculoskeletal condition and pain. There are strict guidelines for all public venues about maximum numbers, physical distancing and hygiene that exercise facilities will need to be following. So if your venue hasn’t contacted you to let you know how they’re keeping their clients and staff safe, contact them and ask.

    Staying safe with a musculoskeletal condition

    If you have arthritis, back pain or osteoporosis, you may need to be careful about a few other things.

    • With more places opening up, venue owners are trying to find ways to enforce physical distancing and capacity measures. However some of the makeshift barriers being used may cause a trip hazard for some of us – because they’re low and not very brightly coloured – for example the humble milk crate or cardboard box. They seem to be a handy partition used in many places to limit the number of people in a space and to direct the flow of traffic. But they’re not always easy to see, especially if there’s poor lighting or you’re hurrying – so be careful of trip hazards and other obstacles when you’re out and about to reduce your risk of falling and getting hurt.
    • You may need to stand in queues, at the supermarket, hardware store and other public venues that are reopening, as they all have a maximum number of people they can let in at one time. This can cause or exacerbate pain and fatigue for many people with musculoskeletal conditions. So wear comfy shoes (including orthotics if you have/need them), grab your walking aid, your shopping list (a foggy brain makes remembering almost impossible) and your shopping buggy/bags. And be kind to yourself as you may feel tired and exhausted for some time after your trip. If your battery was already low before you tackled this, it’s may take some time to feel yourself again.

    With restrictions lifting all over the country, we’re getting excited about broadening our horizons beyond our own front doors. But we need to take responsibility and be careful. We’ve done really well at minimising the impact of this virus on Australians – and we don’t want to slide backwards.

    So stay informed, follow the guidance of the government health officers, and we’ll get through this next phase of the COVID journey.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain 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.

    CONTINUE READING
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    Lisa Bywaters
    28/May/2020
    Health InformationMSK articles

    The hidden dangers of iso – home injuries

    It’s a good thing iso is starting to ease around the country. Did you know people have been injuring themselves with all this time at home? Who knew taking time to get fit, being creative with exercise or tackling some of the DIY jobs around the house could be so dangerous?

    So here are some tips to help you stay safe at home:

    Exercise

    We’ll soon be able to go back to our gyms, pools and fitness centres – but the number of people who can be in these spaces at one time will be strictly limited. So you’ll probably still have to make do with home exercise. To keep safe we suggest you:

    • talk with your doctor, exercise physiologist or physiotherapist – in person or via telehealth – if you’re concerned that you’re feeling more pain than usual when exercising or after exercising. They can also tailor a home exercise program to suit your specific needs and health conditions.
    • book an appointment to talk with an instructor at your fitness centre. They can run through your exercises and give you feedback about your exercise technique.
    • before using online exercise videos, classes or apps, check the qualifications of the instructor. Do they have the expertise to provide these exercises safely? And for people with musculoskeletal conditions? Read our blog about evaluating online exercise.
    • warm up before you exercise, and cool down when you finish. Many of us skip this because we don’t feel like we have the time or just can’t be bothered. But it’s an important part of exercising and may help reduce injury. Warming up increases blood flow to the muscles and gives you the chance to get in the right headspace for exercise. Cooling down helps your body return to the resting state it was in before you started, allowing your heart rate to lower and your body to cool down.
    • don’t push yourself too far too quickly. Many of us saw iso as a chance to jump in and get fit. Yay – all this time to exercise, nothing can stop us. Until you hurt yourself or do too much. That’s why it’s important to build up slowly and progress over time. But you do need to challenge yourself, so ensure that your exercise gets more difficult over time.
    • if your joint/s feel particularly painful after exercising (for longer than two hours after an exercise session), reduce the intensity of your next session. And if an activity causes you pain or increases your pain beyond what’s normal for you, then stop this activity. Get advice from a professional to ensure you’re doing the exercise correctly or to modify it for you.

    Cycling

    Wow that’s really taken off! And it’s great to see so many people and families out cycling together. But if you’re not used to riding a bike regularly you can get hurt. So:

    • be realistic. We’ve all heard the saying “it’s just like riding a bike” so we assume it’s simple, but if you’re not riding regularly, start small. It’s easy when you have the wind in your hair and the sun on your face to just ride and ride and ride. But remember, you need to return to where you started. So plan a bike route that’s easy, flat and achievable. You can increase this over time.
    • make sure you have all the right bits and pieces to keep you and others (like pedestrians) safe. So wear a helmet, use your bell when approaching others and have a light fitted just in case you get caught out when the light begins to fade. And wear comfortable, high visibility clothes so you can be seen.
    • use a bike path if there’s one nearby. Especially if you’re starting out or fairly new to riding. Riding in traffic can be scary and intimidating, and if you’re not confident it can be dangerous. So build up your confidence on bike paths.
    • read our blog for more tips about riding a bike.

    DIY

    Like getting fit, iso was going to be a time when we got all those odd jobs and repairs done around the home. But this has seen people falling off ladders and injuring themselves with power tool – yikes. So before you tackle that DIY job:

    • ask yourself – does it require a professional? There are some jobs – like electrical work and larger plumbing repairs or installations – that should only be done by someone with the necessary skills and qualifications.
    • do a risk assessment. Most of the time we just want to get the job done – the gutter unclogged, the new towel rail hung. But are there any risks involved? Do you have the right tools and equipment? Do you know if there are electrical cables behind the wall? You don’t need to write up a full risk assessment report, but just take some time before you get started to make sure you have everything you need to proceed safely.
    • be careful if you use a ladder. This is one of the biggest hazards for the DIYer – falling from a ladder or stepladder. And you can really hurt yourself. So if you’re using one, make sure you have someone around to help you move it and to ensure you’re safe. Move the ladder when you need to – don’t lean over or stretch to reach something – that’s when you can overbalance and fall.
    • whatever DIY job you’re doing – dress for it. Wear suitable clothing, footwear, gloves, and a mask if there’ll be dust or fumes.
    • don’t do anything if you’re not 100% – so if you’re tired, you’ve been drinking or you’re affected by drugs (including prescription meds) – don’t do anything. The job will still be there tomorrow.

    Mental health

    As well as physical injuries we may have suffered during this time, our mental health may have also taken a hit. There’s been a rise in the number of people experiencing anxiety and depression from being cooped up in iso and the loss of normal life and routines. And there’s also the stresses of working and schooling from home, financial pressure and general worry about the future. These issues are no less serious than falling from a ladder or stacking your bike, so if you’re struggling talk with someone. Whether it’s your partner, family member, a close friend or a professional, talk with someone. Don’t ignore these feelings. There’s a lot of help available.

    Get help

    Finally, if you do hurt yourself seek medical advice. Many people are putting off going to see their doctor or the emergency department for fear of COVID-19. However medical facilities have measures in place to keep the general public and their staff as safe as possible. So if you injure yourself, don’t ignore it or soldier on – make an appointment to see your doctor, or if it’s serious go to the emergency department or call an ambulance.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain 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

    Check out some of our health articles and blogs for more info.

    CONTINUE READING
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    Lisa Bywaters
    21/May/2020
    Health InformationMSK articles

    Treating COVID-19

    Note: This blog was written in 2020, and so much has changed since then, including the availability of medications and vaccinations for COVID. For the most up-to-date info about treatments for COVID-19, visit the Australia Government, Department of Health website. 

    At the moment there’s no treatment for COVID-19.

    Wow, that was blunt. I probably should have eased you into it, but unfortunately that’s the truth. Regardless of what you may see on social media, or what a certain President might say at a press conference, we just don’t have a treatment for COVID-19 yet.

    Doctors can treat many of the symptoms people are experiencing, but there’s no specific treatment for SARS CoV-2 (severe acute respiratory syndrome coronavirus-2), the virus that causes the disease we know as COVID-19. There’s also no specific treatment for the severe complications that some people experience which has led to thousands of deaths worldwide

    The reason for this is that it’s a new virus, one we’ve never encountered before. That’s why it’s referred to as novel coronavirus – it’s brand new so we have no immunity to it.

    We have nothing in our medicine cabinet specifically designed to deal with this virus. Antibiotics don’t work – because it’s a virus and antibiotics only work against bacterial infections.

    What we do have in our favour are the efforts of the world’s scientific and medical community working tirelessly to find ways to safely treat this disease. We also have the work that was done at the time of the previous coronavirus outbreaks.

    In 2003 we saw an outbreak of SARS (severe acute respiratory syndrome) and in 2012 we saw MERS (Middle East respiratory syndrome). These coronaviruses are closely related to SARS CoV-2.

    While a treatment for SARS or MERS didn’t make it to large, human trials, there were promising results in labs tests, animal studies and small clinical trials. These drugs were some of the first to be studied for use in COVID-19.

    Medications currently used to treat other conditions, for example hydroxychloroquine which suppresses an overactive immune system in people with lupus and rheumatoid arthritis (RA), are also being investigated. If we can repurpose an existing drug it’s hoped that we may have a treatment sooner rather than later.

    So let’s have a quick look at some of the treatments being investigated

    Anti-virals

    Viruses, like the one that causes COVID-19, have only one job – to make more of themselves. They get into the cells of bacteria, animals and people, hijack them, and turn the cells into virus making factories.

    Anti-virals stop them from making more copies of themselves.

    Researchers are currently investigating several anti-virals including those used to treat viruses such as Ebola and HIV (human immunodeficiency virus).

    There have been some early trials, using small numbers of people with COVID-19, that have had mixed results.

    For example, remdesivir wasn’t effective against Ebola, but it had been effective against SARS and MERS in the lab and in animal studies. However we don’t yet have enough information to know if it will work in humans with COVID-19 or not.

    Repurposing other drugs

    As well as looking at ways to disable the virus and prevent people getting sick, researchers are also looking at medications we currently use for other conditions, to see if they’ll help people manage complications of the infection, especially those that affect the lungs and other internal organs.

    The most widely talked about drug, hydroxychloroquine, works well to suppress the immune system in people with RA and lupus. However there’s limited evidence that it works for people with COVID-19. Trials are ongoing, including COVID SHIELD, a new trial being conducted at the Walter and Eliza Hall Institute in Melbourne.

    Other drugs that suppress the immune system are also being investigated including the RA drug baricitinib.

    The focus on immune suppression is to help manage the “cytokine storm” that some people with severe COVID-19 experience. This is when the immune system releases too much of an immune protein (cytokine) into the blood. This causes a high fever and inflammation, and in severe cases it can lead to multiple organ failure.

    However there’s concern that treating people with an immune suppressing drug when their body is fighting an infection may be dangerous. We need more information from large, randomised controlled trials before we know if these drugs will help or harm people.

    Other therapies

    As well as going through our medicine cabinet and looking at old drugs to treat a new virus, researchers all over the world are looking at other ways to treat COVID-19.

    They include plasma therapy, a process that involves taking the blood plasma from someone who’s recovered from COVID-19 and transferring it to someone who has the disease; stem cell therapy to treat people experiencing acute respiratory distress and the gene-editing technology CRISPR to find antibody targets for the disease.

    These are just some of the innovative therapies that are being investigated to treat COVID-19.

    Lots of work to be done

    While a lot has been achieved in a short amount of time, we need to remember that with all of these trials we’re still very much in the early stages. We just don’t have enough data to know if the drugs or therapies work and if they’re safe.

    We can feel confident though that the world’s scientific and medical communities are making great progress in their efforts to find safe and effective ways to treat COVID-19. But it will take time, both to come up with a vaccine and to find a treatment that we can produce in sufficient quantities to deliver on a global scale.

    So we need to continue with our physical distancing, maintain good hygiene, stay active, eat well  manage our mental health and follow the restrictions that are in place where we live. This will eventually pass, but it will take some time.

    More to explore

    CONTINUE READING
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    Lisa Bywaters
    21/May/2020
    Health InformationMSK articles

    New virus, new language

    Have you noticed how many new words, acronyms and phrases have entered our vocabulary since rona arrived?

    We thought it was timely to have a quick look at some of the more common ones, so you’re up-to-date in iso.

    • BCV – before corona virus. This is self-explanatory. Those heady days before we’d even heard of COVID-19 or SARS-CoV-2.
    • blursday – seriously what day of the week is it today? They really do all blur together in isolation.
    • corona moaner – we love rhyming don’t we? We all have our moans and complaints about iso and this strange situation we’re living through, but the corona moaner is the person who never stops complaining. You know who I’m talking about.
    • coronials – corona + millennials = a new generation, born about 9 months after isolation began. Lots of time at home together, a few quarantinis and whoops, we have a baby boom.
    • covexit – like Brexit – it’s the strategies for getting out of isolation and the economic issues associated with it. Let’s hope it’s smoother and quicker than Brexit!
    • coronacation – working or schooling from home. Though I’m a little perplexed by this one because it hasn’t felt like a holiday or vacation at all. It’s feels a bit like hard work, right??
    • covidiot – again fairly self-explanatory. Just as we love rhyming, we love joining words together to create new ones. A covidiot is someone who ignores physical distancing, ignores all the restrictions and thinks life can continue as usual, as if it was BCV.
    • covid-kilos – refers to the slightly curvier shape some of us have developed after making endless batches of banana bread or trying to make the perfect sourdough loaf or experimenting with quarantini recipes.
    • flattening the curve – this phrase entered our vocab very quickly. Basically it means limiting the spread of COVID-19 to reduce the impact on the health system. Sadly it’s not a quick fix to covid-kilos or pandemic padding.
    • iso – short for isolation. Der.
    • magpieing – this refers to the covidiots who created a toilet paper/hand sanitisier/flour/cake mix shortage for a time by buying up more than they could use in 10 lifetimes.
    • my corona – showing my age here, but this one always makes me laugh. It’s just a take on the 1979 song My Sharona by The Knack.
    • pandemic padding – see covid-kilos.
    • quarantini – a martini/cocktail you consume during quarantine. Going by the recipes and images on socials it now seems to be anything you want it to be. But it’s essentially an alcoholic drink you create using whatever you have on hand. Enjoy!
    • rona – our short, ‘affectionate’ name for coronavirus. Shortening it somehow makes it seem a little less scary.
    • sanny – short for hand sanitiser. Have you noticed how the world (or every public building you enter) is beginning to smell like sanny?
    • social/physical distancing – social distancing is used more often, but we prefer physical distancing. It simply refers to us staying physically distant from others to stop the spread of rona.
    • WFH – working from home, with all the joys of tech issues, fighting for space with the family, home schooling, pets and kids interrupting video chats. Yay.
    • zoombombing – the intrusion of covidiots you don’t know into your Zoom meeting. This can be for entertainment purposes – can you say bored covidiot? Or it could be for malicious reasons. Make sure you use the waiting room feature of Zoom so you can see who’s wanting to enter before they disrupt your meeting.

    That’s it – you’re up-to-date. For the moment. It’s inevitable that new words and phrases will appear as we continue on our iso journey towards covexit.

    Until then, go and fix yourself a quarantini, sit back and contemplate your coronacation. And as the sweet smell of sanny wafts through your home on this blursday in iso, take heart that we’re flattening the curve and we’ll soon be looking at ways to covexit.

    More to explore

    CONTINUE READING
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    Lisa Bywaters
    21/May/2020
    Health InformationMSK articles

    Pain – persistent, chronic, always there

    For many of us our pain is always there – sometimes in the background and at other times it’s very much in the front of our minds. It’s a constant – just like taxes. Even with a pandemic causing so much chaos and uncertainty, our pain persists, it’s always there.

    And quite frankly it’s a pain in the arse. It hurts. It’s exhausting. And it’s invisible.

    The Australian Institute of Health and Welfare last week released their latest report Chronic pain in Australia. It highlights that 1 in 5 of us lives with chronic pain. So next time you’re standing in a physically distant queue at the shops or taking a walk around the park – consider the fact that 1 in 5 of the people see you around you is also living with pain. It’s a massive problem, but there are things we can all do to manage our pain effectively.

    Know your pain and yourself

    It’s so important when you live with a chronic condition that you understand it. Learn as much about your condition as you can so that you can take an active role in managing it, including the pain associated with it. For example, what makes your pain better? What makes it worse? Do you tend to overdo things when you’re feeling great and end up paying for it over the next couple of days with increased pain? Or when you’re experiencing a flare and your pain is worse – do you get anxious, and everything becomes negative and too hard?

    Knowing these things – really understanding how your pain affects you physically, emotionally and behaviourally – will help you manage your pain and your condition better, even in this time of crazy COVID.

    Tackle the big three – exercise, eat, sleep, repeat

    I don’t know about you, but I’m finding my exercise, diet and sleep have all taken a hit due to the pandemic and iso. Not being able to get to the gym, changes to work and my normal routine and stress has really impacted how and when I’m eating, sleeping and exercising. And not in a positive way.

    This has had a very noticeable effect on my pain levels. If you’re experiencing this too, acknowledging it is the first step to changing things. So I can’t get to the gym – there are other ways to be active. So my routine has changed and as a result so has my diet. I can manage that. Stress and pain is impacting my sleep? I’ve managed that before – I can do it again.

    It’s all about finding the right mindset. This is a strange, new normal we’re living in. And it’s going to change and evolve as we continue through 2020. We have no roadmap for what’s been, and what’s to come – so we need to do the best we can to change and adapt to the constantly shifting landscape.

    Get help

    OK, that all sounded sooooo easy, right?? Nope.

    We may be able to change and adapt to some things but there will be times when we need to ask for help. From our family and friends, from our doctor, physio, psychologist. Whether it’s medications or physiotherapy to directly manage the pain, or asking a family member to carry the heavy laundry basket to the clothesline, or talking with a friend about your frustrations – whatever it is, there’s help available. You just need to acknowledge the fact that you need it and reach out. And remember the nurses on our Help Line are just a call or email away.

    Use your mind

    It’s a powerful tool. You can use it for distraction, mindfulness, relaxation, visualisation and guided imagery. None of these things will take your pain away completely, but they can provide temporary relief while you do a painful task, try to fall asleep, or wait for your pain medication to kick in.

    ‘P’ yourself – plan, prioritise and pace

    We’re often our own worst enemy. We do too much when we’re feeling great, and end up feeling rubbish for hours/days afterwards. Something ‘simple’ we can do to prevent this from happening time and again is to plan, prioritise and pace ourselves. First plan – what do you need to do today? Write it down. Now prioritise. How much of those zillion things do you really need to do? Often things we see as hugely important aren’t. And do you need to do them yourself? Can someone else do it? Now pace yourself. It’s not a race – so be generous with your time, spread your jobs over the day and build in space for rest breaks.

    Look after your mental health

    Living with persistent pain can sometimes be a roller-coaster of emotions. It’s perfectly natural that from time to time to feel sad, worried, angry, anxious, depressed or frustrated. Add a pandemic, and it’s no wonder many of us are feeling as if our worlds have turned upside down and inside out. It’s important that you acknowledge these feelings. You may want to write in a journal, talk with a family member or close friend or talk with a counsellor or psychologist. Don’t ignore these feelings or keep them bottled up.

    Your GP can refer you to a psychologist if needed on a GP Mental Health Management Plan. At the moment because of COVID-19 you can arrange to speak to a psychologist via telehealth (over the phone or a video call).

    Be kind

    To yourself and to others. It’s an unprecedented, really strange time and we’re all doing the best we can. So be kind to yourself – you’ll experience ups and downs, stumbling blocks, and barriers that get in your way. And some days you’ll need to work really hard just to keep moving. So give yourself a break. And remember 1 in 5 people are living with invisible chronic pain. And even more people are dealing with all kinds of stuff we can’t even imagine. So be kind to the people you encounter. It makes us all feel so much better than the alternative.

    More to explore

    Our nurse Clare discusses some simple things you can do to manage pain while at home in isolation, including pacing activities, exercise, getting a good night’s sleep and heat and cold packs.

    We also have some great blogs to give you more tips and info about managing pain:

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    Rosie.jpg
    Lisa Bywaters
    21/May/2020
    MSK articles

    A pandemic can’t stop me volunteering!

    Written by guest blogger Rosie

    Most of my adult life I’ve been fortunate to have been involved with not-for-profit organisations and I’m well aware of the important role of volunteers in our society.

    After I retired as an allied health professional, it seemed only natural to seek the opportunity to volunteer. I had heard of the enormously supportive role that Musculoskeletal Australia (Arthritis Victoria as it was then) played in the community. So I contacted them. The rest is history! I’ve now been volunteering with them once a week for over 6 years.

    I work most closely with the nurses on the Help Line doing data entry. I’ve been able to continue to do this from home during the pandemic. I know this has been helpful for MSK as it helps them see trends and look for ways to improve the service. But it’s also kept me occupied and sane during lockdown! Data entry may sound a little boring, but I find it satisfying as I know it’s important work. You need to have attention to detail, computer skills, and be accurate with the information you enter the database. So that really engages the old grey matter.

    Volunteering gives me great personal satisfaction. I’m able to contribute to the community and I have the chance to meet and work with like-minded staff and volunteers.

    MSK is a forward thinking organisation and has staff who are enthusiastic and friendly. I have felt privileged to be part of its continuing growth.

    In this picture I’m standing with some of my fellow volunteers as we attended the 50th anniversary morning tea at Government House in 2018. I felt fortunate and thrilled to attend this function with staff, volunteers and other supporters. It was such an honour.

    Rosie

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    vaccine.jpg
    Lisa Bywaters
    13/May/2020
    Health InformationMSK articles

    A vaccine for COVID-19

    Just the shot in the arm we need?

    It’s seems crazy when you think about it, COVID-19 has had such a life changing effect on us, but unless you’re a healthcare worker, you probably don’t even know someone who’s had it. Yay for the success of our pandemic plan, but it also means most of us are still susceptible to it.

    But we can’t stay in iso forever. Apart from all of the obvious reasons, we’ve run out of jigsaws, eaten all of the banana bread and we’re over video chatting to our friends about doing nothing.

    It appears that the only way we can get back to our normal lives is if there’s an effective vaccine against COVID-19. So far the info we’re hearing from scientists developing vaccines these vaccines is encouraging. We’re even hearing that one may be available as early as September this year! But what are vaccines, how do they work and what are the chances we’ll have a vaccine for this virus any time soon?

    Your immune system

    To understand how vaccines work, it’s important to understand a little about your immune system. It’s designed to protect you against harmful diseases and infections caused by foreign bodies (also called pathogens) such as viruses, bacterium and other microbes. When your body detects the presence of a pathogen, your immune system mounts an attack to try to defeat it.

    Side note: For those of you who have an autoimmune condition like rheumatoid arthritis, lupus or ankylosing spondylitis, your immune system has gone a little bonkers and has attacked your own body instead of a potentially harmful pathogen. This really sucks. But we can help. Contact our Help Line on 1800 263 265 weekdays.

    Vaccines

    Vaccines work by introducing your immune system to a virus or bacteria. This allows it to learn how to protect you from the pathogen before you meet it out in the world. A vaccine is a weakened or inactivated version of the pathogen. It causes your body to create antibodies – these are the soldiers in the battle against the foreign invader. They have one target and one target only…the specific virus or bacteria that you were vaccinated against. If it ever encounters it, it latches on and destroys or disables it.

    Well that’s the immune system and vaccines in the smallest of nutshells. Watch this short video How do vaccines work? for more info.

    Now it’s time to look at COVID-19 and the efforts to create a vaccine against it. You may be wondering why a vaccine rather than a treatment? That’s a good question, and there’s a LOT of work going into finding effective treatments for COVID. But to treat someone, they already need to be infected. And because this virus is highly infectious, that person can go on to infect many others. So it’s preferable that we prevent this and any subsequent spread of disease is prevented altogether.

    We know a lot about COVID-19

    Even though there are still so many unknowns, we do know a lot about this virus. If you compare it to other new viruses or disease outbreaks, we’re so much further ahead, which is really good news. We knew the genetic makeup of this virus within a couple of months of the outbreak. Researchers used this info to develop tests for diagnosing COVID and to start working on potential vaccines and treatments. So we’ve come a long way in a very short time.

    Types of vaccines

    Just as there are different types of pathogens, there are different types of vaccines. The type of vaccine developed will depend on characteristics of the pathogen and how it affects people

    Types of vaccines include:

    • A weakened, live version of the virus. We use this type of vaccine to prevent diseases such as measles, mumps, chicken pox and rubella. Note: people who have suppressed immune systems can’t use live vaccines.
    • An inactivated vaccine (e.g. flu vaccination). Chemicals are used to destroy the virus before being injected however it’s not as effective as a live vaccine, which is why we have regular boosters.
    • Vaccines that target specific parts of the virus, rather than the whole thing. This is used for diseases such as shingles, whooping cough and tetanus.

    Creating a vaccine

    A great article by The Conversation (31 March) outlined the steps involved in creating a vaccine for COVID-19:

    1. Basic understanding of the virus.
    2. Scientists decide which approach to use from the list above – i.e a live vaccine, an inactivated vaccine etc.
    3. Initial safety testing is carried out in animals to help us understand how it may affect people.
    4. Clinical trials being using people. There are three phases:
      • Phase I – testing on a small number of people, to see how safe it is, and if it has any side effects,
      • Phase II – testing on several hundred people to test for efficacy – or see if it works how it’s meant to work
      • Phase III – testing on several thousand people for efficacy and safety.
        If the vaccine can show it’s safe and provides effective protection against the virus, it will then go on to the next stage.
    5. Regulatory approvals.
    6. Production. This will involve a lot of work to create the quantities of vaccine we need to vaccinate large populations, and to ensure the vaccines are produced safely and with great attention to quality control.

    For more information read: Coronavirus vaccine: here are the steps it will need to go through during development.

    And….after all that we need to actually vaccinate people on a global scale! – which will take a great deal of planning and coordination.

    So when will we have a vaccine?

    The short answer is we don’t know. Most scientists say between 12-18 months. There are some who are more optimistic and say by the end of the year. With over 100 vaccines being researched around the globe, it may well be sooner rather than later. However we need to be mindful that we can’t rush this at the expense of safety.

    So until a vaccine does appear we need to get comfortable with our new normal. We need to continue with our physical distancing, maintain high levels of hygiene, stay active, eat well, managing our mental health and follow the restrictions that are in place where we live. This will eventually pass, but it will take time.

    More to explore

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    teddy.jpg
    Lisa Bywaters
    13/May/2020
    MSK articlesMSK Kids Blogs

    We had a dress rehearsal for COVID-19

    Thanks to one of our MSK Kids parents who has written this blog for us. They have chosen to remain anonymous. 

    When our world changed rapidly at the end of March due to COVID-19 social distancing regulations and remote learning, I was amazed that my child wasn’t freaking out about all the changes taking place. I put it down to her wonderful teachers and the fact that she has dealt with a major event in her life already, a chronic health condition and immunosuppressive treatment. Here are some of the ways my child has had the dress rehearsal to COVID-19, and so have we as parents.

    Experienced at social distancing

    When you have an immune suppressed child you have already had to cancel play dates, sleepovers and extra-curricular activities. Your child has already stopped sport at some stage, and has probably missed important days at school or with friends. You have already been fearful of every cough and sneeze in the classroom and you know the times of the year when chicken pox cases increase.

    We’ve been using hand sanitiser already

    Ask any parent who has spent time with a child in hospital, and chances are they know the smell of Microshield® very well (the brand of hand sanitiser in most Australian hospitals). We’ve been used to having good hand washing habits and know the importance of alcohol-based agents to clean hands. You probably already had a decent amount of hand sanitizer at home before COVID-19, as well as alcohol-based wipes (especially if you have to administer subcutaneous injections).

    We know and appreciate our healthcare workers

    It didn’t take this pandemic for us to appreciate our wonderful healthcare workers. We’ve known this for years through our regular interactions with doctors, nurses and allied health workers. Hopefully everyone else now recognises the importance of good health in our lives and our amazing healthcare workers.

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    tired.jpg
    Lisa Bywaters
    07/May/2020
    Health InformationMSK articles

    Why am I so tired?

    Hands up if you’re feeling tired at the moment? Or if you’re too weary to raise your hand, just a brief nod will do it. It seems like we’re a nation of tired people at the moment (?).

    Why is this? We’re not going out like we used to, to the movies, restaurants, family gatherings, to see friends, sports events, or take the kids to all of their extra-curricular activities. We should be swimming in time and feeling relaxed and rested, right?

    Ah, no.

    We’re stressed

    Stop me if you’ve heard this before but we’re going through unprecedented times. This pandemic is causing massive disruptions to our lives, our families, our work and our routines. This constant uncertainty causes us to feel stressed. All the time.

    When we’re stressed our bodies release adrenaline. It’s so we can react to a crisis, the old ’fight or flight’ response. But when the stress is constant, as many of us are feeling at the moment, this has an effect on our health – including making us feel physically and mentally tired.

    There are lots of things you can do to manage stress. By understanding what’s causing your stress, you can start to manage it. This may include things like developing a new routine (and sticking to it), exercising, talking with your family about how you’re feeling, finding ways to relax, making sure you’re eating a healthy diet and drinking enough water, getting a good night’s sleep and avoiding excessive use of alcohol and other drugs.

    We’re staying indoors more

    Because of restrictions we’re staying inside our homes more. So we’re not getting exposed to as much sunlight as we normally would. A lack of sunlight causes the brain to produce more of the hormone melatonin, which makes us sleepy.

    To deal with this, schedule time every day to go outside for a walk or stroll in your yard, open your blinds or curtains as soon as you get up and expose yourself to as much sunlight as you can. It’ll help you feel more awake and improve your mood. Just think how much better you feel after being stuck indoors when you get out into the sun. It makes you feel so much more energetic and alive! So this one’s a no brainer. We just have to make time to do it.

    We’re sleeping less (or more) than usual

    Let’s face it, since this all started our usual everyday routines have been shot to pieces. Work, home life, family, socialising, shopping – it’s all so different at the moment. When you add stress to the mix, our sleep is often affected.

    You may find you’re sleeping less than usual because you’re working long hours to catch up on work after spending the day home schooling the kids, or you’re watching more TV and spending more hours online, or stress is causing you to feel more pain and you’re having issues sleeping through the night.

    Or you may be sleeping more – trying to rid yourself of this constant feeling of tiredness, or because you’re bored, or because it’s cold outside and you’re feeling cosy and warm indoors, or because you’re feeling sad. Not enough sleep, too much sleep and poor quality sleep will all increase how tired you feel.

    That’s why it’s important that you stick to a sleep schedule – even on the weekends. Get out of bed in the morning and go to bed at night, at the same time every day. Your body needs this regularity for your internal clock to function properly, and to help you fall asleep and wake up more easily and feeling more refreshed.

    And if you’re regularly finding it difficult to sleep or get out of bed because you’re feeling really sad or down, it’s a really good idea to talk with someone about this, whether it’s family, a close friend or your doctor. Please don’t ignore this.

    We’re exercising less

    Many of us are finding we’re exercising less because we don’t have access to our warm water exercise classes, tai chi, gyms and exercise groups. Not getting enough exercise can make you feel sluggish and tired. If this continues for some time, we start to get out of shape and feel less inclined to exercise. So it’s really important to make exercise – whether it’s online videos and apps, walking, dusting off your old exercise DVDs, or dancing around the living room – an essential part of your everyday routine. And get the family involved. Everyone needs to be exercising and staying active for our physical and mental wellbeing. If you’re home alone, use a video app to call a friend and exercise together. You’ll find you’ll feel more energised and happier when you’re exercising regularly.

    We live with chronic conditions

    Apart from all of above affecting how tired we’re feeling, we live with chronic musculoskeletal conditions and other health issues. These often cause us to feel fatigued. Many of our medications and living with chronic pain can also make us feel excessively tired. When you add a pandemic on top of that, the unique issues you’re facing – how the virus may affect you, worry about being more at risk, how to safely access your healthcare team, navigating telehealth – it can heighten you’re feelings of fatigue.

    Many of the things we’ve looked at – such as establishing a routine, getting adequate sleep, eating well, exercising and staying connected with your family, friends and work colleagues will help you with some of these issues.

    You can also get help from your GP and from the nurses on our Help Line. Contact a peer support group or go online and connect with others dealing with similar things. Even just talking with others who know exactly how you’re feeling can help you feel less isolated.

    We may need to talk with our doctor

    Finally if you’re concerned that your tiredness is due to more than just the reasons listed above, it might be worth talking with your doctor about it. Your tiredness may be caused by other things like vitamin deficiency (for example iron and vitamin D), side effects of your medications, feeling sad, anxious or depressed or it may indicate another health issue. So make an appointment to discuss it with your doctor – either in person or via a telehealth consultation.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain 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

    Photo by Tracey Hocking on Unsplash

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