support - Musculoskeletal Health Australia (MHA)

25/Jun/2020

This strange time we’re living through has forced us to live smaller. SARS-CoV-2 is going to hang around for quite some time, so our way of living will likely remain on the small scale for the foreseeable future.

And as we’ve seen with the spike in active cases in Victoria, restrictions can be eased and they can be tightened again. Trips overseas are out and trips interstate are dependent on state borders being open. Even travelling across our own state may be subject to restrictions if outbreaks continue.

It’s easy to feel a little despondent about the whole situation. It’s been a hard slog with no end in sight.

So it’s important we take some time to sit back and take stock. We’ve adapted to isolation and the massive changes in our world. We’ve been creative and done things that we couldn’t even imagine we would’ve done this time last year. We should give ourselves credit for that and continue to discover the small joys in life.

Like having a jigsaw on the go on the kitchen or coffee table that everyone adds to as they walk past. I can’t tell you how many people have told me they’ve been doing this…and how much satisfaction they get when they complete a tricky 1,000 piece puzzle.

Or discovering the parks, paths and until now unexplored areas in our neighbourhoods. Foot power and pedal power has us discovering many hidden treasures we never knew existed before COVID.

We’ve enjoyed cooking and creating meals together. Discovering an interesting recipe, trying new ingredients, and taking time to sit down together and talk, laugh and have fun. With the change in our routines, and the lack of social/sporting/school/work gatherings, we have a little more time to break away from the mundane meals of the past, at least occasionally. Turn the TV off, put some music on, enjoy the company and the meal.

We’ve hauled the dusty board games out of the back of cupboards and spent hours playing and enjoying time together…unless it’s Monopoly. It always seems to start well, then ends in tears. We’re reading, planting vegie gardens, catching up on new TV shows, enjoying a cup of tea in the garden, doing the crossword together – basically living much more simply.

We’re catching up with friends and family with long phone calls and video chats. I think this’s been one of the best things that has come out of the pandemic. Without the distractions of work, social obligations, kids sports and the busyness of pre-COVID life, we have a bit more time to catch up and really talk. This has been wonderful.

And for those of us with a chronic condition, being able to stay home has allowed us to feel safe from the virus, but has also given us the time to reevaluate how we’re travelling. For example, how’s our pain management? Do we need to tweak something, try something new? Are we looking after our mental health? Should we try some mind-body techniques such as mindfulness or guided imagery? This pandemic has paused the world in some ways, but it’s given us an opportunity to check our health and wellbeing.

This time will pass. It’s going to take a while, but we can adapt. We’ve been doing it for months, and we can continue to do it. And rediscovering the small joys in our world will help us get through.

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

Saying goodbye to iso – Easing restrictions
Musculoskeletal Australia, 28 May 2020
Sick and tired of iso? Hang in there!
Musculoskeletal Australia, 30 April 2020
Does your self-care plan need some TLC?
Musculoskeletal Australia, 22 April 2020
Some inspiration for isolation
Musculoskeletal Australia, 8 April 2020

Lisa Bywaters

18/Jun/2020

As a species we’re social creatures. We need our tribe – whether it’s a large extended family group and lots of friends, a small intimate group of nearest and dearest, or somewhere in between. We need our connections.

I think that’s one of the hardest things we’ve had to deal with during this pandemic. We’ve been forced to change how we connect with others. We kept away from our people for months, and now that we can gather, we’re told to keep a distance, don’t touch, hug or shake hands. It feels so unnatural.

That’s the insidiousness of this virus. It’s infiltrated our world and affected the very fabric of our connectedness.

I need to make a confession – I’m incredibly sad as I write this blog. My aunt died today. She was a beloved mother, sister, grandmother, aunt and – like me – a crazy cat lady. She’s been unwell for quite some time, and I haven’t been able to see her for months. With isolation and the very real risk of spreading the virus to someone who was already so unwell, it was not a risk we could take.

And so she died, this wonderful, kind, most incredibly well-read woman. Without all of her family around her. And I’m so very sad.

I know I’m not unique in this situation. So many people have died during this pandemic – due to COVID-19 as well as the many other reasons people leave our world every single day. But sitting at home on a cold Sunday afternoon, I can’t help but reflect on how terribly sad this whole situation is.

We’ve missed, and will continue to miss, our celebrations and milestones. Weddings have been postponed. Babies have been born with far less fanfare than would normally happen. Special birthdays have been and gone without the usual fuss. Students have finished courses, aced exams or have mastered a difficult skill without the jubilant gathering of family and friends to celebrate. And funerals have occurred with only a small number of mourners allowed to attend in person.

And it’s not only the milestones and celebrations we’re missing. It’s the small events, the little encounters that go to the very heart of who we are. The big events are important, but the small things, the everyday incidental stuff with workmates, neighbours, friends, family – they’re the things that make our lives rich.

So we need to find ways to ensure our milestones, gatherings, phone calls, video chats and every day encounters carry as much joy, love, sadness, real emotion and connection as they possibly can.

Celebrate and bask in the little things. Share your day – the highs and lows with your partner/kids/closest friend – and really listen as they do the same. Take time to sit and reflect on what’s been happening in your life and those close to you. Even though it may feel like life is moving slowly at the moment, it’s moving quickly – can you believe it’s almost the end of June? – and so much can happen in a day, a week, a month. Don’t let these moments pass you by.

Tell those close to you how much they mean to you. Extend that support and kindness beyond your own bubble to those you encounter at the supermarket, when you’re driving, talking with your child’s teacher, or when you’re in a work meeting. We’re all dealing with all kinds of stuff – big and small – so let’s discard the petty annoyances and frustrations.

We’re still some way from finding a vaccine or treatment for this virus. It’s vital we continue to support and care for each other in this new normal we live in.

Life is short, and although it’s changed so dramatically, we have so much to be thankful for.

Contact our free national Help Line

Crisis support

If this article has raised some issues with you or you feel like you need help during this stressful time, there’s help available. Contact Lifeline Australia on 13 11 14 for 24-hour crisis support and suicide prevention.

More to explore

It’s okay to feel sad
Better Health Channel

Photo by Hello I’m Nik on Unsplash

Lisa Bywaters

04/Jun/2020

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

Lisa Bywaters

28/May/2020

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.

Talk with the nurses on our Help Line 1800 263 265 – weekdays
Contact Lifeline Australia 13 11 14 – 24 hours/7 days
Contact Beyondblue 1300 22 4636 – 24 hours/7 days

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

More to explore

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

Lisa Bywaters

07/May/2020

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

More to explore

Managing fatigue
Versus Arthritis(UK)
No wonder isolation’s so tiring. All those extra, tiny decisions are taxing our brains
The Conversation, 1 May 2020
Why am I so exhausted? How to combat the unexpected side effects of coronavirus isolation
7News, 9 April 2020
Here is why you might be feeling tired while on lockdown
The Conversation, 7 April 2020
5 ways to wipe out winter tiredness
NHS (UK)
Does your self-care plan need some TLC?
Musculoskeletal Australia
Getting a good night’s sleep
Musculoskeletal Australia

Photo by Tracey Hocking on Unsplash

Lisa Bywaters

25/Mar/2020

Update – April 2020. This blog has been updated in line with the new restrictions on gatherings and physical distancing.

Ok, so the title dates me…I’m a child of the 80s. Olivia Newton-John was a leg-warmer wearing goddess to many.

During this crazy, unbelievable, unprecedented COVID-19 (coronavirus) time it’s important that we embrace the practice of physical distancing, also called social distancing (your choice whether to do this wearing leg warmers, but please, please, please just do it).

It’s the best option we have for slowing the spread of COVID-19 so that we protect the most vulnerable in our community (our older people, people with suppressed immune systems, people with chronic conditions, pregnant women and people with pre-existing health conditions). Obviously, this list includes many of us, so physical distance is important for protecting our own health and wellbeing, as well as the broader community.

Physical distancing also helps us to flatten the curve. You may have heard this term reported in the media and thought – “huh?? What does that have to do with me?”. In basic terms when we practice physical distancing we reduce the risk of passing on, or catching the virus and we’re helping to spread out the number of people becoming infected over a longer period of time. By spreading it out, our health system is more equipped to handle the numbers and not become overwhelmed, which would be the case if we all got sick tomorrow.

And it’s not just us – many of our wonderful healthcare workers will inevitably get sick too. Which will affect the ability of the health system to keep up with the demand. So spreading this out over a longer period of time makes a lot of sense. Read more about flattening the curve here.

Now more than ever it’s important we stay in contact with the people we care about

Personally, I like the term physical distancing. It’s seems to me to be less isolating and now more than ever it’s important we maintain our social connections (just not physically in the same space). By maintaining our physical distance we can still chat and stay in touch with friends, family and colleagues – using technologies like Skype, FaceTime, WhatsApp, Messenger, Facebook, emails, as well as going old school and actually calling someone (insert gasp here) and even send letters (both WHO and CDC have confirmed that you can’t catch the virus through your mail).

So what do you need to know about physical distancing?

Stay informed. This is really important. Misinformation leads normally rational people to buy more toilet paper they can use in a lifetime, causing shortages for others. It leads to fear, anxiety, confusion and anger. So stay informed with accurate, up-to-date information. Go to our website, we have a dedicated section with up-to-date, reliable and practical information on COVID-19.

Maintain your physical distance. But be careful with the pinwheeling arms (if you’re not a child of the 80s look it up). I saw someone doing that today to emphasise that she had enough space around her and she almost took her husband’s eye out (clearly he wasn’t keeping the recommended physical distance).

We’re advised to maintain at least 1.5 metres between ourselves and others. As a guide if you stretch your arms out to your sides (horizontal with the floor) and imagine this amount of space goes all the way around you. Now imagine everyone you come in contact with has the same amount of space around them. This is how much distance you need to keep between yourself and others.

Stay home. We’ve now entered a period that requires us to stay at home as much as possible. The 1.5 metre space around you is a guide for when you HAVE to go out. We’re being advised to only go out when absolutely necessary – when we need to go to the supermarket or chemist for supplies. If you do have to go out, try to avoid crowds and touching too many surfaces.

Now’s the time to embrace your inner introvert! Think about all the times you said you’d like to do X if only you had the time. Well now’s the time! Learn that language, write that book, do something with all your holiday photos, clean the clutter from your cupboard/house/garage, virtually travel the world, live stream the zoo, tune in to the Melbourne Symphony Orchestra online. You’re not only doing something you’ve always wanted to do, but you’re helping to flatten the COVID-19 curve.

Public gatherings. On 29 March the Federal Government brought in restrictions to limit most indoor and outdoor non-essential gathering to 2 people. Places where more than 2 people may gather as they’re considered to be essential are: workplaces (if you can’t work from home), health care settings, pharmacies, food shopping, schools and universities (if you can’t study from home) and public transport. You need to maintain physical distance (i.e 1.5 metres between each person) during this time. Unfortunately many of our favourite places to gather are not considered essential at this time. This includes: libraries, cafes, galleries, movie theatres, markets and places of worship. But this won’t last forever – and just think how much more we’ll enjoy them when we get to go back?? Find out more about these restrictions: Limits on public gatherings for coronavirus (COVID-19).

Look after yourself. While you might be tempted to go full out couch-potato, you need to stay active, eat healthy foods and watch your weight, get plenty of sleep, wash your hands thoroughly and frequently, and generally look after yourself. Also go easy on the alcohol. These things will all help your immune system, and help you feel the best you can. And if you do become sick – whether it’s with COVID-19, a cold or some other illness, you’ll do better if you’ve been looking after your health.

Check in with others. There are many people on their own who may become isolated during this time. Call them. If you don’t know them (for example an elderly neighbour) leave them a note with your phone number and let them know you can help them out if they need groceries or other supplies. Also some people may just need to hear another voice and know someone is looking out for them.

More to explore

Why are we calling it ‘social distancing’? Right now, we need social connections more than ever
The Conversation, 24 March 2020
Is ‘social distancing’ the wrong term? Expert prefers ‘physical distancing,’ and the WHO agrees
The Washinton Post,27 March 2020
Physical distancing and other transmission reduction measures – coronavirus (COVID-19)
Department of Health and Human Services, State Government of Victoria, updated 25 March 2020
Coronavirus distancing measures are confusing. Here are 3 things to ask yourself before you see someone
The Conversation, 23 March 2020
How we’ll avoid Australia’s hospitals being crippled by coronavirus
The Conversation, 20 March 2020
These graphics help explain why social distancing Is critical
Smithsonian Magazine, 19 March 2020

Lisa Bywaters

13/Mar/2020

Having children, self-belief and acceptance

Written by Shirani Wright

Read part 1 of Shirani’s story.

Another thing that was very hard for me – and I’m sure turned out much better than the doctors thought – was having my children. I don’t think my rheumatologist was overly keen on the idea, but he knew me well enough, not to try and talk me about of it as he knew that nothing was going to stop me and nothing did!

I was advised that I had to come off my methotrexate for three months before we started trying to get pregnant. This is because it’s a category X drug for pregnancy and can cause serious birth defects, including spina bifida. This was a bit scary.

The doctors thought that, by coming off methotrexate, I might have a big flare-up and not be able to even get pregnant. I came off methotrexate and luckily for me, no flare-up. They also thought if I did get pregnant there were a lot of other possible complications that could have resulted in the baby being born early.

My doctors pretty much implied I was too sick to get pregnant and carry to full term. Well, you know what they could do with that idea!! Even if I had to sit in bed for nine months and not move, I was determined to have children and that’s what I did. I have two beautiful girls, Chloe and Jacinta. I’m not going to say it was always easy, but it was worth it. I feel extremely luckily to have my two healthy girls.

I’d like the all the parents of kids with arthritis, and children with arthritis, to know it’s possible to have children of your own if you want to, even if you do have arthritis.

Having arthritis does make looking after my girls difficult sometimes, but I wouldn’t have it any other way. I wasn’t about to let arthritis stop me from having children!!! It’s easier, now they are both at school. I’m also very lucky to have a very supportive husband who understands my health issues and does a lot with the children as well as working full time and supporting me emotionally.

I also get emotional support from my friends, and family, but I’ve found that the Young Women’s Arthritis Support Group has helped greatly, as everyone in the group knows what it’s like to be in pain, be on medication, have bad days and everything that goes along with having a chronic illness.

I believe having arthritis has made me a strong person mentally and that it has helped me develop a positive attitude towards life. It often hasn’t been easy but I’m not one to back down from a challenge. I sometimes wonder what I’d be like as a person if I didn’t have arthritis.

We all have our limitations whether we have a disability or not. There are those who might not be able to walk but they might be a terrific artist. People with a disability can have just as fulfilling a life as someone without one. We can do anything we set our mind to. It might just take a bit of extra work but we can do it.

If I can give any advice to children with arthritis I would say, we need to believe in ourselves. We need to accept that we have a disability and that we have limitations but we shouldn’t let our disability define who we are. We are more than our disability.

To leave you, I’ll finish with a thought. Never give up and always shoot for your dreams!

Lisa Bywaters

12/Mar/2020

Growing up, school and working

Written by Shirani Wright

I wake up in the early morning to go to the toilet. I look at the time – 5.00am – early enough to take my tablets. I turn on the lamp and automatically reach over and take my prednisolone, plus eight other tablets so they have time to work before I need to get up and get my girls ready for school. I go back to sleep until my alarm goes off at 6.50am and then I start my day.

Taking medication is a part of my life as I have systemic juvenile idiopathic arthritis. I was three and a half when it all began.

It started when I got bronchitis. My condition worsened and I was in hospital for six weeks. No one knew what was wrong with me. The doctors thought I had pneumonia, and although I was on IV antibiotics I just wasn’t getting better.

I was transferred to The Royal Children’s Hospital, where I had a number of investigations on my lungs and they discovered that I had a massive amount of inflammation. With this discovery and further tests, I finally had a diagnosis – systemic juvenile idiopathic arthritis or SJIA, an autoimmune condition that has stayed with me to this day. Not many people know that lung involvement, like I had, can be a part of some types of arthritis. And for me, joint involvement happened a bit later.

Since I was diagnosed at 3, I don’t remember not having arthritis. I think maybe this has made it easier for me than other people I’ve met who got arthritis at an older age, who might have been used to a certain life. I don’t remember what it’s like not to be in pain or discomfort every day or not to regularly go to the doctors, have tests, and be in hospital. It’s all just a part of my life and I’ve accepted it.

My twin sister and I had tennis lessons for a while but I remember I couldn’t run fast enough. I also did gymnastics too, so as you can see I didn’t let my arthritis stop me! My sister played basketball with a school friend for a time, I didn’t because of my arthritis. I don’t remember being particularly upset by this. I used to go and watch her team play and sometimes score for them.

At school, my arthritis didn’t affect me that much. I pretty much always joined in with PE unless I was having a particularly bad day. Sometimes if we had to walk somewhere from school my mum would organise for me to get driven by one of the teachers and I could always take a friend. Sometimes I’d be late getting to school if I was waiting for my tablets to work.

I felt like I had a bit of support from Musculoskeletal Australia growing up but not as much as there is available now. The Arthritis Foundation of Victoria (as it was known back then) ran camps during the summer holidays as a way for young people with arthritis to get together, meet each other etc. On these camps, they offered workshops run by doctors, massages and free time. It also gave us the chance to meet other young people with arthritis.

Up until those camps, I think I had only met one other child with arthritis; that’s why I think MSK Kids is a really great idea. It gives kids and young people an opportunity to meet each other and support each other. It also gives their parents the same thing. I’m sure my parents would have liked to have known some parents of kids with arthritis.

One thing I didn’t like about having to take medication for my arthritis is that because I’ve taken prednisolone since I was 3 (and I’m still on it 41 years later) it has stunted my growth. So when I was 15 years old, I looked 10 or younger, and that really used to bug me! I remember once I was in a shop with my mum and the shop assistant said, “are you mum’s little helper” and I got really upset. As my mum said though, it’s not her fault she doesn’t know. Now that I’m an adult, being short doesn’t worry me really from a social point of view, it’s more on a practical side when I sometimes have trouble reaching things at the supermarket, or glasses on shelves etc.

I think one thing that got me through childhood with arthritis,(apart from my mum)
is a positive attitude. Because I have arthritis there are things I can’t do. However, I try to concentrate on what I can do rather than what I can’t. This isn’t always easy, but I try and take the attitude that there’s no use worrying about what I can’t do, as that won’t change the situation. I try not to get grumpy or sad about it as this doesn’t change anything. It just gets me down and isn’t much fun for the people around me.

It’s not always easy to accept my limitations but I try and think “well everyone, including healthy people, has limitations”. Not everyone can run a marathon but does that mean they’re not as good as someone who can? I would say NO. Those people who can’t do one thing might be able to do something that another person can’t do. A fish can’t walk, but they’re happy.

One limitation I have had to deal with because of my arthritis is that I’m not working.

I left school and went to university and then TAFE. I worked in several part-time jobs over 10 years. I had to change fields of jobs from Nanning to reception/admin work as nannying was too physical. I did try working full-time for a year and a half but ended up in hospital as I often became breathless (which happens a lot with my type of arthritis).

At that stage, my doctor said I needed to cut my hours back. I found this hard as up until then my arthritis had not really limited me in a big way. But the fact that I couldn’t work full time was a big thing. It made me feel like I was sick and not normal.

One of my friends didn’t understand this. She said it was good that I only had to work part-time. What she didn’t understand was that working part-time wasn’t a choice! I didn’t choose it, I had to do it for health reasons. After some time and thought, I accepted this change and continued with my life. I no longer do any paid work as my health isn’t up to it.

Read part 2 of Shirani’s story.

Lisa Bywaters

22/Jan/2020

Written by Steve Edwards, MSc(Oxon), MSc(Edinb), BSc(Pod)

“A cortisone injection? You want to stick a needle in my sore foot?”

Your health care clinician has suggested you have a cortisone injection into your foot. As with any medical procedure, both of you are best advised to discuss the benefits and risks before proceeding. It helps to know what cortisone is, what it does, and why it’s been offered to you.

Cortisone is an anti-inflammatory medication that’s often used to treat musculoskeletal conditions. It’s a synthetic version of cortisol, a hormone that naturally occurs in your body. Injected into the affected area, cortisone can lower inflammation and pain, remove fluid, and thin scar tissue or adhesions. So if your clinician diagnoses a musculoskeletal condition affecting your foot or ankle – such as arthritis, bursitis, neuroma, or tendinitis – a cortisone injection is commonly raised as an effective treatment option.

Cortisone injections also contain a local anaesthetic. For certain conditions an injection can be painful, so the anaesthetic may be injected separately before the cortisone to block this pain.

The clinician may or may not use ultrasound technology to guide the injection. For pain relief in the foot or ankle, research finds no statistically-significant difference between procedures conducted with or without ultrasound. Interestingly, trials on cadavers injected with dyed cortisone show how it rapidly spreads from the injection-point to adjacent tissue, indicating that pinpoint accuracy is not key to effectiveness.

There are several types of cortisone. In most cases the clinician will administer a long-duration cortisone, taking effect within 1-3 weeks, with benefits lasting between 1-9 months, depending on the condition and its severity. There’s a clinical consensus that no more than 3 injections should be administered to the same body-part within a 12-month period, though there’s no research literature to clearly support this belief.

After the injection, you can quickly return to most activities. The clinician may recommend you avoid strenuous physical exertion such as gym workouts or running for a few days, so the cortisone isn’t displaced from the target tissue.

As for risk-factors, there’s been research into whether the injection may risk tearing tendons in the target area. There’s no recorded case of this in human trials, though it has occurred in trials on dogs and horses. There were cases of more general tissue damage recorded in early trials on American gridiron players, but various factors could have produced this result – the needle used, the amount of fluid injected, and the subjects receiving multiple injections within a short period.

No medical procedure has a 100-percent success rate, but a single cortisone injection administered by a trained clinician is both safe and effective in providing medium-term pain relief. Side effects are minimal, and the benefit to your musculoskeletal condition is potentially vast. And for some foot-specific conditions – such as a neuroma (pinched nerve), or plantar fasciitis (heel pain due to scar tissue) – a cortisone injection can often be a cure.

Our guest blogger

Steven Edwards is a trainee foot and ankle surgeon with the Australasian College of Podiatric Surgeons. He also teaches pharmacology and foot surgery to undergraduate podiatry students at La Trobe University.

Lisa Bywaters

12/Sep/2018

As someone who wears a lot of black you might be forgiven for thinking that adopting a ginger coloured cat was probably not the smartest thing to do. Sure, it’s a little frustrating when you’re in a hurry and you notice the fur coating your clothes. Or when your house looks like a giant fur-ball.

But armed with my new best friend – the lint roller – I know that the benefits of owning a pet (in my case two very cute cats) was one of the best things I could do for my health and happiness.

When you live with a chronic condition, you often go through periods when you’re up, and then you’re down. It’s just the nature of the beast. But sometimes those downs can be really down. You’re in pain, things can look bleak, and it can be hard to ‘turn that frown upside down’.

But I find that the crazy antics of two young cats – chasing after toys, wrestling with each other, ninja fighting something only they can see – has a great impact on my mood. Sure, the pain is still there, but the distraction they provide, and the unconditional love, has real health benefits.

Research has shown that owning a pet can:

decrease cholesterol levels and blood pressure
decrease feelings of loneliness
reduce stress
improve mood
increase opportunities for exercise and outdoor activities.

I’m sold – let’s go shopping!

Hold your horses for just a minute. If you’ve been thinking of getting a pet, and you think now’s the time, it’s important that you do your research. It’s easy to get swept up in the excitement of adopting a pet, and you want to make sure the fit is right for you and the animal. The RSPCA has several resources to help you decide on the right pet for you. Check the More to explore section below for links.

I love animals, but I can’t have a pet 🙁

Sadly owning a pet isn’t an option for everyone. They can be expensive, you may live somewhere that doesn’t allow pets, you don’t have space, or you work long hours and aren’t home very much.

If that’s the case, but you want to be around animals more, there are other options:

offer to walk a family members/friends/neighbours pet (I saw a person walking an alpaca on a lead recently!)
volunteer time at an animal shelter – there are lots of things you can do – grooming, feeding, playtime socialisation, patting cats, walking dogs
look after a family members/friends pet when they go on holidays
think outside the litter box – there are others pets you can adopt that may be an option – fish, birds, spiders, mice and rats. They may provide a bit more flexibility than the traditional cat or dog ownership
watch videos online. The internet is practically one big animal video…cute cats, playful pups, sneezing pandas. It’s all there waiting for you to find. And even though you’re not in physical contact with an animal, this connection can boost your mood and relieve stress.

More to explore

What do I need to know before I get a new pet? – RSPCA
Smart Puppy Buyer’s Guide – RSPCA
Smart Kitten and Cat Buyer’s Guide – RSPCA
Connecting with pets – Head to Health
Pets are good for your health, and we have the studies to prove it – MNN.com

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Written by Steve Edwards, MSc(Oxon), MSc(Edinb), BSc(Pod)

“A cortisone injection? You want to stick a needle in my sore foot?”

Our guest blogger

I’m sold – let’s go shopping!

I love animals, but I can’t have a pet 🙁

More to explore

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