New study on alexander technique for back pain - BMJ report

What is already known on this topic

Combined manipulation and physiotherapy-supervised strengthening exercises helps functioning moderately (1-2 activities no longer limited by back pain)

Preliminary evidence suggests that massage and lessons in the Alexander technique might help in the short term

What this study adds

Six sessions of massage, prescription for exercise and nurse counselling, six lessons in the Alexander technique, and 24 lessons helped with back pain and functioning at three months

Lessons in the Alexander technique still had a beneficial effect on pain and functioning after 12 months

Six lessons in the Alexander technique followed by exercise prescription are nearly as effective as 24 lessons

Link:http://www.bmj.com/cgi/content/full/337/aug19_2/a884

I am tired.

This is how I feel, except that I am not so cute.

RA party is in town again.

Enough said.

Recovery- post massage

I blew some real money on a good massage, and now I ache less, and feel more energetic. A throat infection had thrown things off balance, leaving me totally drained and in pain.

Weekend is my recovery time. There is lots of work to catch up with, I brought home my work.

Sardine curry: Very simple and cheap curry recipe

This is what I cooked for lunch. It is a perfect flare day food.

Curry and sardine is a delicious combination and provide two great ingredients for RA patients like me. It is particularly useful when I have a flare, and too tired to cook.

Here is another recipe of cheat's curry - sardine curry

Here is what you need:
1 table spoon of tom yam/ Thai curry paste (see my chicken curry page for photo)
1 can of sardine (or mackerel). It is alright to use whether in brine, sunflower oil or tomato sauce. Personally I prefer in brine/sunflower oil.
Milk - about 50 ml- 100 ml, depending on whether you want it dry or hot
1 small onion-sliced into rings, or diced (optional)

Methods:

1. Heat a small non-stick pan, turn to medium heat.
2. Add a few drops of oil- i normally use the sunflower oil from the canned fish
3. Brown onion, until it is soft.
4. Scoop in 1 tsp of curry paste, fry it for 2-3 minutes, until fragrant
5. Add fish. Fry for less than a minute. Mash it with fork/spatula.
6. Add milk.
7. Bring it to boil.

How to eat

• With BREAD: If dry, (use less milk), this will be a good consistency as a sandwich filler. Add a few slices of cucumber if you like.
  
• with rice or pasta: If more wet, it will be perfect as a pasta sauce. Can also scoop this over a plate of rice and serve with a few pieced of cucumber. Perfect.

Time taken: Less than 5 minutes if no onions are used.
Cost: REALLY really cheap!!! A can of supermarket brand sardine is probably the cheapest item in the kitchen cupboard.
Nutrition: High in omega-3 (anti-inflammatory), and contains lots of turmeric. Perfect food for those RA flares.
Challenge:Cutting and peeling the onion. Opening the can of sardine.

RA/fibro tips: I like to use it as a sandwich filler, with sliced bread. I cook more and eat this over two or three meals. Keep in fridge and reheat before eating. 1 can of sardine fills about 3 sandwiches nicely.

What to do when you have a fibromyalgia/rheumatoid arthritis flare?

A flare is not fun. No, there is nothing much you could do. You are sore and painful in many places, fatigue, and perhaps even having some brain fogs. Typing, like what I am doing now, may be quite limited too.

For me, a flare days means I move from bed- sleep or trying to sleep, to getting up to make myself some food (important - hunger creates more fatigue and fog, in my experience), doing something to kill the boredom - read, watch television etc and most importantly, my self-healing rituals. I call them rituals, as there are no scientific basis to most of these. This is the list of things I do

1. Take my medications - NSAIDS. This helps to lessen the pain and swelling.
   
2. Rest a lot - sleep.
   
3. Keep comfortably warm/cool. Sometimes I feel very hot during flares, and I will try to keep cool.
4. Take a hot bath/shower. The hot water relieve the stiffness.
5. Use hot towels - put it at places where there are taut bands/points. See my earlier post for details.
   
6. Acupressure and massage. I usually DIY, if my fingers are alright. I also use other objects to help. I find that the acupressure points are remarkably similar to trigger points. Acupressure is Eastern, while trigger point therapy was developed by Western trained doctor. I found this book by Clair and Amber Davies helpful: The Trigger Point Therapy Workbook: Your Self-Treatment for Pain Relief (Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief). It is less than £10 from Amazon UK, a very good investment.

7. Stretch. This keeps you supple and relieve the stiffness. I normally only do this late morning, after the hot bath, and start with simple moves.
8. Eat well. This can be difficult sometimes- loss of appetite or no energy to prepare food. I eat lots of fruits (get it delivered, or get someone to buy it), or at least drink a lot of fresh fruit juices. I know how difficult this is, especially when the flare is prolonged. Fruits are really heavy and expensive if it is delivered. I also try to make sure I maintain my omega-3 intake- through pills or those tinned mackerels!

(Note...it takes a long time to put this post together. In between, I slept, ate, stretched, and soaked my fingers in hot water. I hope it is of use to others.)

Down time

After more than 1 month of this continuous low level flare, my body finally can't take it anymore. I woke up this morning, felling much more stiff, sore and tired than in the past few weeks. I am also coming down with some throat infection. I know this is my body telling me - you to rest.

The warning signs are all there. I won't want to trigger a big one!

So today, i rest at home. Slept. Totally bored. Uncomfortable. I don't have real rest when I am sore all over. Sigh.

I hope I am well soon.

Fog, fog stay away

Just half an hour ago, I found myself analysing a scientific paper, and developing a structured argument and commentary about it.

It is so late at night, I am awfully tired after a long day, but still, my brain worked! I am a scientist. Yes, I am a scientist. This should be normal??

Yes, and No!

I had this sudden sense of "Hallelujah", "thank God", "Amitaba" "Insya Allah". Awww.. I just wished to say thank goodness/Thank God in all the manners available to the major religions on earth. That is how grateful I am.

I suddenly realised that although I have not been that well these few weeks, and fatigue is affecting my concentration, my brains are still still working! My fingers are swollen (enough to get my physiotherapist who saw me today really concerned and strongly suggested I get a proper occupational evaluation and told me my legal entitlements).

Compare my life now to the days when I faught fibro fogs daily- this is still heaven despite the pain and fatigue. Fibro fogs is the most difficult part of fibromyalgia! That is true, at least for me!

If you are some foggy brain stumbling onto my blog, do not ever give up. There is hope at the end of the tunnel. Or should I say, the sun will shine and drive the fogs away one day?

.. and ahem.. can it say it again? "I am amazing"!!

Are you well?

This question goes to other fibro and RA bloggers, whose blogs I regularly read, whenever they stop blogging for a while.

I would wonder, are they well? What kept them away from blogging?

Felt better? Discovered more energy and therefore enjoying life?
Felt worse? And therefore desperate for energy, and sanity to blog?

I hope you all are well. I regularly read some of your blogs, and let me let you know that I think of you. Sarakastic mentioned that perhaps not many people read. Well, honestly, I don't expect many people read my blog. I only find time and energy to check others' perhaps once or twice a month? That is already "as much as I can". It all really depends on my energy level.

If you happen to be down.. rest a while my friend. But remember, get well soon and come back!

Yes, I am not feeling well. My RA have been flaring for a while, making me permanently tired. Now my fibro is in town too - keeping me in pain and awake.

Bruises - is it the RA or fibromyalgia?

Before I my swelling starts, I would notice bruises on my arms and legs. Sometimes they even appear on the thighs.

What cause the bruising? Is it linked to my fibromyalgia or rheumatoid arthritis? 

Any other patients/doctors noticed the same signs ?

Will someone please do the research?

I am amazing

Yes I am. I am amazing. I have to remember that. This had been such a hectic week at work.

I pulled myself out of bed every morning, and took the pain on my swollen feet with a grimace. It really helped. It really helped that the workplace allow people to start work as late as 10 am.

I timed myself to get on a train which is empty and got myself a seat - to rest my feet before torturing it during the short walk. And as usual, God loved to have fun with me. So, he gave us a fire drill. I had to walk up and down 5 floors worth of stairs, trying to keep pace with my colleagues. Trying not to limp.

I typed until my fingers were so painful, that my words began to look jumbled up because the fingers were so tired, and and fatigued to respond properly.

And yes... i made mistakes. I was so tired that I made mistake. A colleague noticed it and not too pleased and made some comments which really hurt me. I almost felt that I lost this battle However, I could put myself in his shoe and think that is a fair comment. He did not know I had RA. He did not know how unwell I had been.

So, I deserve this post... to remind myself. I put in a lot just to do the usual normal things that adults do, and to let others know. It takes a lot for someone with RA to live normally, but we can live a life as full as we could if given just some small allowances to make adjustments.

Thank God it is friday, and I can now have a good rest to fight on next week.

Still swollen..........

and painful.

Reward? Any rewards for this?

Yes, an excuse to buy shoes. No one would have the hear to tell a women with swollen legs, and feet of changing sizes she had too many pairs of shoes.

It is summer, it is the sales, so pluck up all your energy and get something!

14 days since the DIP started to swell..

It had been 14 days since my DIP on my ring finger started to swell. I remember really "noticing" it on Thursday, 5th June, when it became painful at work.I was probably there since Wednesday. As usual, before any "symptoms" started, I was drinking like a parched camel finding an Oasis. When I weight myself that day, I noticed I "put" on 2.5 kg in 2 days. Clothes seemed tighter, and shoes - i need to get my "big" shoes. (I keep shoes of a few sizes. Yes, RA is a perfect excuse to buy shoes).

It was a pain. I ran out of diclofenac. My rheumatologist refused to prescribe me new ones- she said "I did not need them"- that was what the nurse told me. Well, she is the doctor, therefore she was always right. My standby supply of ibuprofen ran out on Sat and I had to go and get it from teh supermarket!

Living with Arthritis

I was pleasantly suprised by the booklets published by Arthritis Care, UK.

http://www.arthritiscare.org.uk/LivingwithArthritis

Check it out :)

Added a "subscribe" button

I have added a button for Google feed, so that any publishing from this site could appear on your Google page. I know a couple of you do pop by regularly. Thanks for your support.

I must apologise that I do not write as often as I wish. There is a great deal of energy preservation going on :) Hopefully, the button is useful.

New fibro support forum (UK)

There is a new fibromyalgia support forum for UK.

http://www.fibro.org.uk/

Hope this forum flies. Good luck. UK patients will need all the info/help in getting help from the NHS system, and understanding their rights.

A fogged moment!

It was just another day at work. My manager was going to go through with me how data could be analysed with a new software.

The alarm bells started to rang when I realised I had "blank" moments about what she said 5 seconds ago. Therefore, I tried to write down "notes", so that I could refer to it when I became blank again. I tried my best to listen, asked questions, get confirmation, and write down immediately, but there were still so many missing "gaps". It was horrible. I was so worried that I might be "found out". She must have thought that it was weird for me to write down every single instruction she gave!

The acid test happened when she asked me to give it a go-enter some data and tried a new analyses. Good grief!! So many mistakes. I could only joke about hypoglycaemia, low blood sugar and hoped that she would half believe it. When the session was over, I immediately declared lunch and hoped that the brain fog would go away!! Thankfully, I was much better after lunch.

That was a really narrow escape. I have some RA symptoms recently, swellings in the morning, and I guess the fog was part of the package. Wish me luck!!!!

Research- Fatigue(felt) related to heart functioning!

A new research published in the very respectable annals of internal Medicine showed that fatigue is related to cardiac functioning yesterday.

Basically, it showed that the amount of blood pumped out by the heart is lower among individuals with high reported fatigue, both at rest and in response to stress compared to low or moderate fatigue people.

The authors concluded:

"This study demonstrates that fatigue complaints may have hemodynamic correlates even in ostensibly healthy individuals".

Those were just nice and intellectual sounding stuff which means:

"There is some sort of link between the heart and blood dynamics in people who said they are fatigued! It is not all in the mind!"

I cant blame any ME, CFS or RA patients who have deal with fatigue almost on a daily basis feeling vindicated. I did!

Exercise made 1/3 of Chronic Fatigue Syndrome patients feel worse..

Saw the report about exercises prescribed for CFS patients made 1/3 of them felt worse, and resulted in some of them to be bed bound for the next couple of days.

I certainly feel a lot worse after a "good work out". The kind of fatigue and soreness, the flares in my joints I experience is not just plain after excercise sort of tiredness. I make no mistake about that. The jury is still really out there about how much is too much and how much is enough. Until then, we just got to listen to out body and get up and do as much as we possibly could. Exercises and activities, is definitely a good thing, but the amount required is really depending on the individual. That stays, until some solid research have came out we good data.

At the same time, some researchers had worked out that people who complained of high "fatigue" has hemodynamic differences compared to those arent (when they looked into the blood flow and pressure)

Getting up is hard to do..getting to work is a military plan

Getting up in the morning is not easy.

That is an understatement for someone with rheumatoid arthritis.

How would you feel, if you wake up every morning feeling stiff and sore all over the place? You might also feel like you need a few more hours of sleep. That sense of "tiredness" is completely different from the "tiredness" that most people have.

The first step of the day for someone like me is most likely greeted by pain.

Quite often it takes me a good 1/2 hour before I could take my "first step" in the morning. A good one hour or more before I could walk to the bus-stop. And I have to plan. Plan such that I could avoid the peak rush hour. Either go slightly earlier than everyone, or later. AVoid the trains which would reach the central business district between 830 to 9 am. Avoid the buses which would take people to the trains station so that they could catch these trains. Plan. Plan. Plan.

Perhaps why that is why I was awake at 5 in the morning. I woke up before the alarms rang. Probably worried about getting to work. I have an important meeting at 10 today, and I must not must not be late. I am thankful that the current employer really enforce the flexi time policy, and respect the core hours stated. No important meetings before 10 am! Hurray.

If I am stressed enough to get up at 5 for a meeting at 10, imagine what my life was when my former employer liked to have meetings at 830am, and thought a 9 am meeting a big compromise for my sake? And I remembered when traveling with her, she was unhappy that I was down for breakfast only at 7.15 am, when I should have been there at 7 (but really only need to be there at 8am?)

I believe I am not alone. As I type this, there must be thousands of others people with RA, making significant but understated efforts just to get to work. Just to work like a "normal" person. Out of all these people who made the efforts, there may be many who still could not get to work "on time", simply because the stiffness decided to last longer than usual on a particular day, or limitations in the mode of transport.

The governments should look at ways to allow some leeway for patients like me to do what we want to do. Getting to work. Most patients with RA want to work- if only we could, we would.

How frequently do I blog?

Rarely.

Someone left a comment, wondering why I do not blog EVERYDAY. This person is starting a blog about rheumatoid arthritis (cures!) and wonder why I don't blog everyday.

Hmmm... if you truly understand RA and FMS, you probably won't expect the patient to blog every single day? Only those who are very well controlled could probably do that!

I hardly have the energy to blog after a full day's work.

Keeping myself in a condition where I could just do what everyone is doing requires great efforts and discipline. Not to mention that i can only blog when hubby is not around me. That is another great effort. Today is a rare day he sleeps before me.

I have been feeling really tired after work each day. Had this "small" flare going on. So, I just have to focus on rest, and "functioning" for the time being.