Posts from — October 2009

photo credit: SummerTomato

When I first met my husband, he was living on a strict diet of McDonalds, Taco Bell, Wendy’s, and frozen pizzas. The first time he cooked for me, the meal centered on cheddar cheese-flavored powdered mashed potatoes. Our first date was to Fudruckers. ’Nuff said.

Then he told me that heart disease runs in his family. Big time. So, I started to worry. I told him to shape up gently suggested he consider a healthier diet. It’s been three years, and I’ve learned a thing or two about healthy eating from The Man.

First off, you can’t change the way you eat overnight. Not even if you really, really want to. Not if your heart starts to flutter in your chest on occasion. Not if you have high blood pressure and high cholesterol—and you’re only 28. Not even if your wife begs and pleads with you to break off your fling with ol’ McDonald’s.

Next, the more you do it, the better you feel. The Man started eating healthier, and that scary little pitter-patter in his chest faded away. His formerly high cholesterol and blood pressure have normalized. And now when he eats from the Evil Empire he feels it in his body, a clear warning sign that something’s not quite right with those patties. Even more surprising, he’s started to like some healthy foods. That’s right, like. As in he actually said once, “I feel like a big salad tonight.” Aside from the time he spontaneously wanted to clean the entire house, hearing him say that was my proudest moment as a wife.

According to The Man, here are six foods you should start to love:

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photo by ucumari
This is how I feel. Minus the fur.

I’m a little peeved. Last night, I was sidelined with a killer caffeine-resistant headache that grew stronger as the night went on. It was so bad, I broke down and popped some Excedrin, a big no-no during PRP thanks to the drug’s anti-inflammatory property. It wasn’t a migraine—my migraines are way more interesting than that—but it was almost as painful.

So you can imagine why I’m a little annoyed to learn that researchers at Brigham and Women’s hospital in Boston say people who get migraines are at an increased risk for stroke.

Especially if you’re a woman. Check.

Especially if you experience auras. Check.

Especially if you take birth control. Check.

During my first migraine, I was sure I was having a stroke. (So, yeah, I get the connection.) It started in my eyes. Suddenly, my peripheral vision was taken over by crazy disco lights that flashed without rhyme or reason. Soon, the flashing turned to zigzags and worked its way across the main part of my vision. At this point, I was severely freaking out. And then my left hand started going numb, working its way from a tingle to full-fledged numbness. My freaking out became more intense. All I knew is that I was dying and was going to miss The Notebook. I didn’t even care. I was dying. Then the left side of my face went numb. My lips went numb, my tongue even went numb. And then—a lightening bolt of pain splintered my skull (or so it felt like that). The flashing lights and numbness faded away and I was left with a massive ache pounding around in my head.

Every other time I’ve had a migraine—and I’ve only had about four in the past five or six years—it’s the same routine. My eyes start getting all freaky. I think I’m going blind. Zigzags appear and I realize what I’m in for. The left side of my body shuts down. A headache closes the show. And every single one of those times I seriously considered the fact that I might be having a stroke. Seriously. I’m sure I’ll think that next time too. Especially after this new study.

So, on to the basics …

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Yesterday, in a comment to my post, Tomas Anthony of Everyday Athlete made a good point about the way our bodies work. It’s advice I wish someone had told me back when I was 22 and sprightly and durable. But I’m not holding a grudge against those good-for-nothing docs who whipped me in and out of their offices faster than you can say malpractice. Really, I’m not.

But, the point. Right. Our bodies aren’t a bunch of independent parts that happen to share a few important organs. It’s more like a string of Christmas lights that works as a whole—and when one light burns out, the entire string is kaput. The next step is infuriating: inspecting the strand one bulb at a time until you discover which shorted out first. You probably have a clue which body part gave up first (for me, the throbbing pain in my knees was a dead giveaway), but finding other culprits is a little trickier.

Here’s something I knew yesterday: My legs always have been weak. As a teen, I rarely (read: never, ever) worked out, so any muscle mass was from general horsing around. Since I started physical therapy—that’s PT to you—I’ve focused on strengthening my quad muscles so they bulge in a Lance Armstrong kind of way. I have special exercises to strengthen my inner and outer thighs, and work my hamstrings every other day.

But I think I’ve neglected my butt.

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photo credit: tranchis

I have a case of the Mondays. As if going back to work after a too-short weekend weren’t bad enough, there’s The Question. “What’d you do over weekend?” For people (like me) who limp around in pain every day, the weekend is a time to finish weekday chores left undone thanks to aches and pains. But that’s no fun to hear about, so I keep my weekend recaps vague. “Oh, not much,” I’ll answer instead of giving a play-by-play on how I did three (count ’em: three) loads of laundry on Sunday.

Today, the answer was modified a little: Oh, I just went apartment hunting. Just went apartment hunting? Just went? It’s more like: I had a huge weekend and pushed myself more than I have all month. I went apartment hunting!

The thing is, for the average person, that’s a boring weekend chore. A huge weekend is something like scaling a mountain or shopping for six hours straight or going to a concert. It’s climbing Mount Kilimanjaro barefoot while juggling bowling pins lit on fire. All right, maybe not that crazy.

So as pathetic as I feel for saying this was a big weekend, it was. My husband and I went to see six apartments in two days, standing in the elevator, walking around each unit, strolling to the garages and mail rooms and business centers until I could barely stand. I think I even heard my knees plead with me, Pleeeease … Just pick one!

In the end, I’m not sure if this was a good knee weekend or bad. My knees were screaming, but would they have been screaming more without the PRP treatment? Or are they hurting more because of the PRP? The world may never know.

Finally, as you may have guessed—at least I hope you’re perceptive enough to have guessed—we’re moving. That’s right, we’re packing it all up and moving out from under the giant beast that lives upstairs. No, he will not be missed. How we’re going to deal with all of the packing and moving (without giving my husband a hernia) is still a mystery to me (though my mother’s signed on as Moving Man No. 1). I’ll keep you posted as the move gets closer.

photo credit: cosmo flash

Remember the Great Echinacea Craze of the late ’90s? Freezing temps rolled in and everyone was popping Echinacea to prevent the sniffles. Fervent believers in the Chinese herb faced cold and flu season with a sense of calm: “I’m not going to get sick, I’m taking Echinacea. It cures runny noses and stops the flu in its tracks! It even tackles world peace!”

And then? Some studies came out saying, “Hold on there just one minute! Echinacea doesn’t really work. Suckers.” People went back to fortifying themselves with diligent hand washing and into-the-arm sneezes as the popular pill slowly faded out of the spotlight. (There are still ardent followers who are probably wagging their fingers at me right now.)

Anyhow, that’s the first thing I thought of when I heard about the latest research on glucosamine. A recent study says it doesn’t work. Bummer.

Here’s the deal on the supplement: Runners, cyclists, and anyone else who wants to prevent debilitating knee pain and a future diagnosis of osteoarthritis have been popping the pill to keep knees cushy. I take a vitamin with a mix of glucosamine and its knee-loving brother chondroitin sulfate, on a daily basis with hope that it will minimize my cartilage damage—or reverse it.

But researchers at the American College of Rheumatology’s annual scientific meeting, going on this week in Philly, have burst that bubble. They presented findings from a recent study that say the supplement was no better than a placebo at preventing knee joint damage in a group of middle-aged men and women. The researchers randomly split 201 participants into two groups: One received glucosamine while the other got a placebo. At the end of the six-month study, the researchers scanned all of the participants’ knees with an MRI, then compared the final images with the “before” pictures. Disappointingly, there was no difference in joint damage between the two groups.

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When it comes to minor injuries—the kind that hurt but don’t require a blood-curdling scream, some sort of snap-into-place move, or paramedics—a doctor’s first line of defense is something called Wait and See. The main goal of this approach is to put exercise on hold until you see improvements in pain. There’s a lot of doing nothing involved, some icing, elevating, and plenty of wondering whether the Wait part of the whole thing is over.

During my first go-round with knee pain, I tried this technique. I stayed off of my knee as much as a normal human can without hiring a personal assistant. I waited and waited, and followed a printout of leg-strengthening exercises for a few weeks until I was healed. Wait and See was a success!

The third time my knee started quitting on me, I started to wonder if this whole Wait and See thing (with some self-taught physical therapy thrown in for good measure) was really worth being the go-to treatment. That’s because once Wait and See was over, a smaller, less talked-about wait and see started … wait and see if your pain will come back.

It did. Every time. So I started to wonder whether I should be doing something instead of waiting—like, you know, strengthening my muscles. Over the past six years, I’ve had fewer relapses into Knee Hell when I’m training than I ever did as a couch potato. Younger me, I’m sorry no one told you this.

Because it takes science eons to confirm simple things patients already know, Dutch researchers just confirmed that physical therapy is better for people with patella femoral pain syndrome than Wait and See. Go figure.

The study, published online yesterday in the British Medical Journal, enrolled 131 participants in either a six-week supervised physical therapy program or a Wait and See plan of the same length. (No joke: they really called it “wait and see.”) Both groups got the same handout on their condition and a sheet of at-home exercises. After three months, the exercise group reported less pain and better function than those who took it easy. And after a year of follow-up, the exercisers still reported less pain, but were about equal with wait and see-ers when it came to physical function.

Before you mumble under your breath something about those lazy people deserving another year of knee pain, remember: They were doing physical therapy. But instead of getting guidance from a physical therapist, they were following an illustrated sheet with exercises. The problem is, those take-home sheets don’t account for progression or accountability … two major keys to rebounding from an injury.

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I have some good news and some bad news on this chilly October evening.

The good: It’s been 12 days since my last PRP treatment, and I’m walking like a normal human—if that’s possible. What I mean is that I’ve ditched the dip-and-drag swagger, where my left leg is semi-straight and makes a half circle as my right leg propels me forward. This is a good thing because my back was starting to contort in all the wrong ways. It’s also good because my right knee was taking a beating. But it’s really a good thing because I have to get around at work, which means people—real people who don’t get the whole needles-in-the-knee thing—watch me do the shuffle a dozen times a day.

The bad: I’m still not fully recovered, which means I need to use my hands when sitting down. Sure, I can flop onto the couch without bracing myself, but smaller seats are a bit harder. Like the toilet. But that’s a story I’ll spare you…

In other news…

Since this is my second time around with PRP, I’ve learned a thing or two that I missed last time. Alright, I really learned only one thing: Buy a journal. See, three months ago when PRP was all new and weird, I’d get all neurotic on my husband each night. Is it supposed to feel this bad? Shouldn’t I be healing faster? What about this ache—is it normal? Why is my tendon still swollen? Is that normal? Should this be happening? Am I behind? And on and on.

This time, you’d think I would know exactly what to expect. You’d think. But then you’d realize I didn’t take any notes about my first PRP, and my memory of the experience has somehow been wiped over the past 11 weeks. This time around, I’m bugging my husband with other questions. Didn’t I get better faster last time? Are you sure I wasn’t walking without a limp sooner last time? I don’t remember it hurting for this long … are you sure I’m OK? Is this normal? Am I behind?

A stupid little pack of papers could have cured my self-doubt. But since I flunked that test during my first go-round I’ve gotten smarter. So next time I get PRP I’ll scroll right to this entry. I’ll remember I wasn’t exercising at the two-week mark, and feel a whole lot better about my sorry state.

I’ve been going on and on and on about my recent treatment that I’ve barely had a moment to get down to the nitty-gritty. So if you’re sitting there, scratching your head, wondering if PRP is some sort of voodoo, read on. Today, I’m laying out the facts.

PRP is an easier-to-type acronym for platelet-rich plasma, a type of injection therapy that, in a nutshell, uses a person’s own blood platelets to heal an injury.

What the heck are platelets?
Your blood is full of platelets, particles that aid in clotting. Platelets are packed with growth factors, which are involved in wound healing and tissue regeneration.

How does PRP therapy work?
Before your body becomes a pin cushion, you’ll donate a small amount of your own blood for the treatment. Once the blood is drawn, it’s rapidly spun in a centrifuge so that it separates. Light particles like red blood cells float to the top, while heavier blood platelets fall to the bottom. Your doctor will fill a syringe with those separated platelets suspended in a teensy amount of blood plasma, and inject them into your injured area.

The idea is that the high concentration of platelets jump starts the body’s self-healing and spreads growth factors to areas otherwise untouched by blood (like ligaments, tendons, and joints). When the platelets are done doing their thing, the body will have repaired damaged muscle or tissue.

And because PRP uses your own blood, there’s no risk of rejection. In other words: The treatment is more or less risk-free. (OK, OK, there’s always a slight risk when it comes to injections. Even if you’re shooting cortisone in your body, there’s a chance of infection. Consider yourself warned.)

Which injuries does it treat?
The beauty of PRP is that its application is expansive. It’s commonly used for ligaments and tendon injuries, but also treats back pain, arthritis and cartilage injuries like patella femoral pain syndrome. Most famously, PRP was used to treat NFL player Hines Ward after a knee ligament sprain. Ward left mid-game, got injected the following day, and played in the Super Bowl two weeks later.

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It’s been raining for five days here, and if next week’s forecast weren’t sun, sun, and more sun, I’d start building an ark. There are plenty of reasons to hate the rain—hello frizzy hair—and hardly a benefit to speak of. Well, OK, there’s that whole watering the earth to help plants grow thing. But aside from that…

Rainy days mean more to me than a slow, sluggish start. If you have joint pain, you know what I’m getting at. Pain is worse when it rains. Truly. And this type of weather—rainy and unnaturally cold for an October day in the Mid-Atlantic—is the very worst. For a while, I figured some sort of placebo effect was happening:

Wow, it’s raining, I’d think. Rain is supposed to make my knees hurt. You know, they’re starting to feel kinda sore. And it’s really cold out. Cold is supposed to make it even worse. And it does! They hurt! Really bad!

But then, this past winter, I’d marvel at my sudden morning stiffness while brushing my teeth in the morning. I’d get mildly depressed at my backsliding as I blow dried my hair. And then I’d walk out the door to a frigid, rainy day. Life made sense again.

So, you can imagine how excited I was to hear researchers validate my weather-forecasting ability. According to Javad Parvizi, M.D., Ph.D., a joint specialist at the Rothman Institute at Thomas Jefferson University Hospital in Philadelphia, atmospheric pressure changes—especially low pressure systems that roll in with rain—cause nerves in the joint to respond and make fluid or pressure in the joint fluctuate. With less cartilage to cushion the joints, people with “damaged goods” really notice the change. In other words: I’d make a pretty kick-butt weatherman.

My avoid-stiffness-and-stay-warm-plan for cold, wet weather? A heating pad, a cup of tea, and a good movie. The first is essential. The other two are up to you.

Thanks to my job as a health writer, I’m up on the latest medical research, including trials on omega-3 fatty acids. So when my doctor suggested I started taking a supplement to go along with my PRP therapy, I agreed.

Research on omega-3’s affect on joint pain is slim. In a 2006 study, researchers at the University of Pittsburgh Medical Center gave 250 participants 1,200 mg of omega-3 per day and asked them to rate their pain. By the end of the trial, more than half had quit the anti-inflammatories they had been taking, and 88 percent were satisfied enough with their joint pain improvement to continue with the meds. Still, when it comes to joint pain, omega-3 is better studied in rheumatoid arthritis, a chronic autoimmune disease that causes debilitating inflammation in the hands, knees, feet, and ankles.

Despite the lack of solid scientific evidence pointing to its joint-lubricating powers, I’ve been popping four fish oil pills (1,000 mg of omega-3 fatty acids) daily. The case for omega-3 is building and getting stronger. Research suggests it can reduce the risk of heart attacks and strokes, lowers triglycerides—and important factor in heart health—lowers blood pressure, reduces LDL (“bad”) cholesterol, fights depression, and reduces the risk for colon and breast cancers.

Fatty fish like salmon, halibut, and tuna are especially rich in omega-3s. (I use this fact to justify the occasional 6-inch tuna sub from Subway, by the way.) Other food sources include walnuts, flaxseeds, and canola oil. I get my plant omega-3s from ground flaxseeds that I sprinkle in my morning oatmeal. Tip: Skip whole flaxseeds; they’ll travel straight through you without doing much good. Stick with ground.

Here are a few other things you should know about omega-3 fatty acids:

1. There are three types of omega-3 fatty acids: alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic (DHA). The latter two are found in fish and easily absorbed and used by the body. But ALA, the type of omega-3 in nuts, nut oils, and flaxseeds, must first be converted to DHA and EPA—so it’s a less potent form.

2. Fish burps are a myth if you down your pills with dinner.

3. Just because a supplement contains 1,000 mg of fish oil doesn’t mean it has 1,000 mg of omega-3s. The ones I take have 690 mg in two capsules. I take four a day to hit 1,000 mg.

4. The thought of drinking a few teaspoons of fish oil makes my mouth water in a bad way. The brand I use (Nordic Naturals’ softgels) has a lemon flavor that masks all that fishiness.