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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by alexandra_k on February 28, 2005, at 4:10:42
Ok.
So the weight wasn't water weight and it is getting a bit late in the year to justify it as the inevitable expansion that happens fairly briefly every year around christmas time... Time to do something about it...
I hurt my legs / feet quite badly a couple of years back. Spent close to a year in a wheelchair and then on crutches. But it has been in the year since then... I used to walk a lot. But I can't walk more than a couple of k's at a fairly average pace. I can't do any impact. I tried to swim but I can't point my toes to kick for freestyle and I can't do the leg movement required for breaststroke. Well. I can do a sort of deformed movement but I worry that that is reinforcing the bones setting / hardening funny. I don't want to end up with bodybuilder arms. And the pool isn't heated and summer is drawing to a close soon anyway. I also hate biking...
Anyway, the point is that I can't really do much with respect to increasing my exercise. And I guess that because I am not walking etc as much as I used to I require less calories now.
So I have decided to eat healthier.
Replace things...
Lots more vegetables and fruit
No more potato chips and the hardest thing for me is cutting way back on the carbohydrates. I don't really crave sweet things. But carbodydrates. Bread, pasta, and potatoes really were my staple diet. I have managed a couple of days without any problem. Wish me luck.
Posted by saw on February 28, 2005, at 7:51:33
In reply to change in eating habits..., posted by alexandra_k on February 28, 2005, at 4:10:42
This sounds EXACTLY like me except that I did not injure my feet and legs.
The hardest, very hardest thing to cut from or lessen in my diet has been the carbodydrates. Bread, pasta, and potatoes aswell as dairy and cheeses etc.
Proteins just do not stop the growling tummy the way a good fresh cheese sandwich does.
Sabrina
Posted by alexandra_k on February 28, 2005, at 15:24:39
In reply to Re: change in eating habits... » alexandra_k, posted by saw on February 28, 2005, at 7:51:33
Posted by alexandra_k on March 7, 2005, at 2:27:08
In reply to change in eating habits..., posted by alexandra_k on February 28, 2005, at 4:10:42
Moving in to the start of the second week now...
Have been doing ok. Not perfect, but pretty good. Healthiest eating I have ever done (volountarily) in my life. Not perfect... But much better. Might be my imagination but I think I have lost a little tiny bit of weight. See how I go over the next couple of weeks...Feel healthier too. I swear I do.
The next step will be switching from coke to diet coke. I used to drink diet coke and was okay with it. Coke tasted too sweet. But when you are used to coke diet coke tastes kind of bitter and watery. You do adjust though. I'll do that later this week. I drink maybe 8 or 9 litres a week so probably good to change...
:-)
Posted by Damos on March 15, 2005, at 14:53:51
In reply to change in eating habits..., posted by alexandra_k on February 28, 2005, at 4:10:42
Hey Kiddo,
Sorry I didn't see this before but you know us Aussies are bit slow :-) With respect to your exercise difficulties 2 possibilities come to mind. If you liked walking but any kind of impact is out of the question then an elliptical trainer might be the go. The motion is similar to cross-country skiing and they work the arms as well, but because you never lift your feet off the machine there is no impact transmitted to the feet and legs eventhough they get a great workout. So they're better than a walk or even a treadmill from that respect. The other possibility if the knee and ankles are okay with linear up/down movement might be a rowing machine. If it's not too rude to ask, do you experience much pain when standing for extended periods or when bending?
From your diet you sound like a girl after my own heart, love my pasta and taters :-)
Hope the diet's going okay.
((((alexandra_k))))
Posted by alexandra_k on March 19, 2005, at 20:53:36
In reply to Re: change in eating habits... » alexandra_k, posted by Damos on March 15, 2005, at 14:53:51
Ah. I think the elliptical trainer might be out.
I shattered most of the smaller bones in my feet and my ankles. Broke both the main bones in my legs and my right heel bone was shattered too. I have pretty restricted ankle movement and too much movement leads them to swell and ache because the joints aren't smooth anymore. There is no way I can stand on tip toes even. And I don't walk properly by transfering my weight to the ball of my foot.
So I guess it is movement as well as impact... I don't think I could bend my ankles well enough for a rowing machine. Biking is okay because the peddles rotate so I don't have to actually move my ankles very much at all. Even standing is painful because my arches have collapsed and the undersides of my feet (especially the right heel) aren't flat surfaces anymore. Step aerobics would be too much. I have to 'tip' off the edge of steps rather than bend my ankles. They just don't bend like they used to. I also have to bend my ankle quite severely to the right (as much as I can really) just to have my right foot flat on the ground. The ankle couldn't set straight.
So basically my legs / feet are f*cked.
They said I'd never be able to walk without crutches but I can. I can.
But I guess I shall have to try the diet thing....
I guess it is hard because I used to have quite firm legs / backside from all the walking I used to do. But not any more. Not any more. Just need to eat better I think. But that being said I have been eating better (much better) for a couple of weeks now and haven't noticed any difference at all.
Posted by Damos on March 19, 2005, at 22:17:44
In reply to Re: change in eating habits... » Damos, posted by alexandra_k on March 19, 2005, at 20:53:36
Well, they do say if you're gonna do something, do it well. And it sure sounds like you did a pretty good job on your legs.
So now the problem with focusing on diet alone is that it does nothing for strength and muscle tone, which with any form of imobility issue become a vicious circle - I can't do much because I'm imobile so I eventually end up more imobile. If I can come up with a series of exercises that you can do lying down or sitting in a chair which don't involve impact or ankle rotation/leverage do you want me to just post them here for you? The calf muscles are a poblem having no ankle leverage but I think I should be able to manage most of the others okay.
You should be very proud of the fact that you can walk without crutches, so let's see if we an't get a bit of tone and strength happening for you as well hey.
Take good care okay.
Posted by alexandra_k on March 20, 2005, at 14:12:14
In reply to Re: change in eating habits... » alexandra_k, posted by Damos on March 19, 2005, at 22:17:44
Thanks.
I probably should give something like pilates or yoga a go. But I can't face the thought of a gym or of exercise classes. I am far too self conscious. Yeah. If you can think of some exercises I would be grateful if you could post them.I wasn't sure whether exercising through the pain would actually be good for them. Should I try to practice standing on tip toes etc? Will that make the muscles / ligaments (whatever) stronger?
Or will it just make the pain worse as the bones rub against each other? They said that they will disintegrate over time. I'll be back in a wheelchair again as I get older. Would I be hastening my demise? Or helping? Nobody seemed to know.So I don't know either...
I think I can feel the difference between general pain and the pain of the bones / joints having had enough. I got a script for some anti-inflamataries but I never got it filled. I thought that if I took them before a long walk it may help with the joint / bone pain and especially if the pain is due to the swelling.
I can actually walk pretty far.
But then they are really stiff and sore over the next two or three days.
It isn't so bad because it means that if I really do want to do something (go for a short bush walk), go for a longer walk by the river or round town then I can do it. It is just that there are consequences for the next couple of days...
Posted by Damos on March 20, 2005, at 15:17:00
In reply to Re: change in eating habits... » Damos, posted by alexandra_k on March 20, 2005, at 14:12:14
> Thanks.
Hey it's no problem at all, it's a pleasure actually :-)
> I probably should give something like pilates or yoga a go. But I can't face the thought of a gym or of exercise classes. I am far too self conscious. Yeah. If you can think of some exercises I would be grateful if you could post them.
Great minds. A number of the exercises I was going to recommend are 'core' Pilates so work the mid section pretty hard. I can understand the gym thing too. I joined a Pilates and Yoga only place in Sydney back in May and have never been for the similar reasons.
> I wasn't sure whether exercising through the pain would actually be good for them. Should I try to practice standing on tip toes etc? Will that make the muscles / ligaments (whatever) stronger?
This is always a difficult question. My guide is that if the pain you are working through is from stiffness due to lack of use/mobility and not from joints actually rubbing on each other or nerves then it's okay. The problem with not doing load bearing exercise e.g. walking is that it is important in preventing osteoporosis. So any that you can do is a good thing. Given the problems you have it would be best to do it on soft grass than paths/roads etc as the soft surfaces with reduce the shock transmitted to the joints. They also make gel filled innersoles now that can help a great deal with heal strike. An appointment with a podiatrist might also be a good idea to get some thoughts on whether orthotics of some description might help.
> Or will it just make the pain worse as the bones rub against each other? They said that they will disintegrate over time. I'll be back in a wheelchair again as I get older. Would I be hastening my demise? Or helping? Nobody seemed to know.
Unfortunately it is probably right that the joint will deteriortate further over time. But the person I share my house with has MS and refuses to do any exercise and is now paying for it badly with loss of flexibility, muscle tone and strength. Yes it would have happened anyway but just not as quickly. She now drags herself around the house with a walking frame and has to use a chair or electric scooter when she goes out.
>
> So I don't know either...I think the only answer is to listen to your body, it'll let you know when something you're doing is not good.
> I think I can feel the difference between general pain and the pain of the bones / joints having had enough. I got a script for some anti-inflamataries but I never got it filled. I thought that if I took them before a long walk it may help with the joint / bone pain and especially if the pain is due to the swelling.Okay then, that's pretty important. The thing we have to be careful of is not to load up the ankles while still ensuring the joint is exercised. So I'll suggest some things and you can just say yes or no based on your experiences
> I can actually walk pretty far.That's great!!!!!:-)
> But then they are really stiff and sore over the next two or three days.The trick is to build up slowly over time and ensure your footware etc is as good as it can be. I used to keep rigorous training logs back when I was young and silly - just so I could guage where I was at. You don't just go out and run marathon distances you have to build up slowly to avoid injury etc. If they're only stiff and sore this is also a relatively good sign, especially if the soreness is just general not specific to this bone or that bone.
> It isn't so bad because it means that if I really do want to do something (go for a short bush walk), go for a longer walk by the river or round town then I can do it. It is just that there are consequences for the next couple of days...
Good, so If I come over you can take me for a walk by the river or something to show off :-)
One question before I go to start planning your exercises, if your legs are just hanging off the bed or a bar stool etc how well can you raise/lower your feet. Sorry for all the questions, hope they're not bringing any bad stuff.
I'll write soon,
Posted by alexandra_k on March 20, 2005, at 19:02:19
In reply to Re: change in eating habits... » alexandra_k, posted by Damos on March 20, 2005, at 15:17:00
> This is always a difficult question. My guide is that if the pain you are working through is from stiffness due to lack of use/mobility and not from joints actually rubbing on each other or nerves then it's okay.
It is hard to figure out. I guess I need to take the anti-inflamateries to figure how much is due to inflamation. I know they said that the only thing that will harden the bone is impact - so I need to walk on them. That was hard. I really didn't want to stand and walk because it was so very painful. Had to go into hospital for a week when it was time and the physio had to yell and scream and coax etc just to get me to stand up.
> They also make gel filled innersoles now that can help a great deal with heal strike. An appointment with a podiatrist might also be a good idea to get some thoughts on whether orthotics of some description might help.
Yeah. I have some gel insoles made. But I have to figure out a way to get in to pick them up. They have been waiting for me for over a year now so I don't even know if they are still there.
> loss of flexibility, muscle tone and strength.
Yeah.
> I think the only answer is to listen to your body, it'll let you know when something you're doing is not good.
Yeah. But they always hurt. I just don't know whether I just need to ignore it and keep on (I have learned to tune out the pain signals pretty well) and when I am overdoing it. I have just been working on how painful it is in the next few days after having done something. If I walk a couple of k's then the next day I can hardly stand up and walk. But I make myself. But it is really hard. Don't know how much anti-inflamateries will help with that. I guess I need to go get another script to see. My Doc said it was important to get the insoles. Walking funny isn't any good for my back. Fractured that in a couple of places as well. I notice that sometimes too.
I used to like doc martins. But I couldn't wear my old ones because they had molded to the shape of my feet - but then the shape of my feet changed and they really hurt to wear. Got some running shoes cause I thought the arch support would be good. But it wasn't - it hurt. So at the moment I just wear skateboard shoes because the soles are flat and they are pretty well padded but with no arch support. I wear them out pretty quick though (not that I walk all that much!) but they wear down fast at the heel. Both inside and out.
> One question before I go to start planning your exercises, if your legs are just hanging off the bed or a bar stool etc how well can you raise/lower your feet.Oh. I can lift my legs up okay. There isn't anything wrong with my knee joints. Just ankle movement / impact.
Posted by Damos on March 20, 2005, at 20:08:02
In reply to Re: change in eating habits... » Damos, posted by alexandra_k on March 20, 2005, at 19:02:19
> It is hard to figure out. I guess I need to take the anti-inflamateries to figure how much is due to inflamation. I know they said that the only thing that will harden the bone is impact - so I need to walk on them. That was hard. I really didn't want to stand and walk because it was so very painful. Had to go into hospital for a week when it was time and the physio had to yell and scream and coax etc just to get me to stand up.
I can understand that, it would have been an absolute nightmare for you, I can't imagine how much it hurt. I think the trick will be to get load without impact - load builds strength, impact does damage.
> Yeah. I have some gel insoles made. But I have to figure out a way to get in to pick them up. They have been waiting for me for over a year now so I don't even know if they are still there.Okay, step 1 call them and find out if they're still there. If they are can they mail them if not can they mail/email you the prescription so you can get another pair made locally. If not, then a local podiatrist is the next step or local chemist should have some generic sports ones. If you go to the podiatrist don't worry about the cost okay - this is important.
> Yeah. But they always hurt. I just don't know whether I just need to ignore it and keep on (I have learned to tune out the pain signals pretty well) and when I am overdoing it. I have just been working on how painful it is in the next few days after having done something. If I walk a couple of k's then the next day I can hardly stand up and walk. But I make myself. But it is really hard. Don't know how much anti-inflamateries will help with that. I guess I need to go get another script to see. My Doc said it was important to get the insoles. Walking funny isn't any good for my back. Fractured that in a couple of places as well. I notice that sometimes too.Boy you really did a job on yourself, and I have a sneaking suspicion that this kind of damage wasn't quiet what you had in mind at the time :-( Give the anti-inflamatories a miss if you can cause they're usually just a cortico-steriod and extended use can do as much harm as good - try RICE (Rest, Ice, Compression, Elevation) first. You might even try wearing an elasticized ankle support to as this will provide additional stability to the joint when in motion. Chinese Thousand Flower Oil is also really good for joint/muscle pain. It stinks but really works.
> I wear them out pretty quick though (not that I walk all that much!) but they wear down fast at the heel. Both inside and out.Why am I not surprised to hear you're a Doc Martens fan? I wear out all my shoes from the insides of the heals first.
> Oh. I can lift my legs up okay. There isn't anything wrong with my knee joints. Just ankle movement / impact.Sorry, wasn't clear enough. When your lower leg is hanging straight down your foot would normally be hanging slightly down from the ankle, can you raise your foot throught a vertical arc (like cocking your wrist)- the physio probably forced you to do something similar. Even 5-10 degrees of movement is important.
Pretty sure I've got quads, inner & outer thighs, hamstrings, butt, abs and obliques sussed. The response to the above will help sort out the calves. If you want upper body too I can do that as well (and you don't need to end up looking like a body builder).
Posted by alexandra_k on March 21, 2005, at 2:03:43
In reply to Re: change in eating habits... » alexandra_k, posted by Damos on March 20, 2005, at 20:08:02
> Okay, step 1 call them and find out if they're still there.
Yeah. Must do.
>If they are can they mail them
Nope. They won't. I managed to get in to pick them up but then they said I needed to make a time for an appointment and come back. That he needed to check that they were ok. But I haven't been able to get back. I had to stand in this foam box thing to make a footprint. That is how they make them. I really should 1) ring them up and 2) figure out how to get them...
> Give the anti-inflamatories a miss if you can cause they're usually just a cortico-steriod and extended use can do as much harm as goodHmm. Can you be a bit more specific about 'extended use'? It wouldn't be daily. Not even weekly. More like fortnightly or monthly. Just before I have a big walk planned. Just then. I am supposed to take asprin every 4-6 hours but I really don't find that it helps at all to tell you the truth. Even the codene didn't feel like it helped at all. The morphene did but they understandably wanted to wean me off that as soon as possible... I got a fright when they suggested methadone to help me come off it. Made them just taper it down instead.
> You might even try wearing an elasticized ankle support to as this will provide additional stability to the joint when in motion.
Yeah... I had wondered whether they might help. Worth a try... The pressure might be good.
Chinese Thousand Flower Oil is also really good for joint/muscle pain. It stinks but really works.
Hmm. Not keen on stinky stuff ;-)
Still, thanks for that..> Why am I not surprised to hear you're a Doc Martens fan?
I don't know... Why are you not suprised??? I'd really like some dark green 10 ups but they don't seem to be able to import them anymore :-( Can't even get any black 10 ups steel caps anymore :-( They don't import very many different varieties at all... Not even cherry bump toes or nothing :-( Still... Can buy them off the internet no doubt ;-)
I wear out all my shoes from the insides of the heals first.
Hmm. I wonder what that means ;-)
> Sorry, wasn't clear enough. When your lower leg is hanging straight down your foot would normally be hanging slightly down from the ankle, can you raise your foot throught a vertical arc (like cocking your wrist)- the physio probably forced you to do something similar. Even 5-10 degrees of movement is important.Ah. I think I can manage about that much... Though it was hard for me to work out. 180 degrees in a circle... 45 in a right angle... 20 something is half of that ;-) Yup. I think I can manage bout 5-10 degrees of upwards ankle movement. Is that what you meant? I have tried stretching my calves but it is hard because of the lack of ankle movement. Can't really seem to stretch them by the exercises I know... Or maybe just a little tiny stretch... But I am more worried about my thighs than my calves to tell you the truth ;-) Though it is true that all of it really has turned to mush...
:-)
Posted by Damos on March 21, 2005, at 15:13:46
In reply to Re: change in eating habits... » Damos, posted by alexandra_k on March 21, 2005, at 2:03:43
> Nope. They won't.
Bugga! Yes I really think you should do whatever it takes to get them as they will make a big difference.
From what you've said the anti-inflamatories should be fine. Yeh, the recommended arthritis strategy here is 4 hourly paracetamol but that is certainly not going to help really strong pain. RICE is still the best treatment to reduce the swelling etc if done immediately after a walk etc.
> Yeah... I had wondered whether they might help. Worth a try... The pressure might be good.Yeah I think so, the objective is to support the joint and help minimise sideways movement and the tendency to roll over on the ankle joint, and the pressure will definitely help the tendency to swell. Just make sure it is not too tight.
> Hmm. Not keen on stinky stuff ;-)
Gee, I'd better not come visit then - just kidding ;-)I'm not either really, but I'm into stuff that works and is not full of chemicals :-)
> I don't know... Why are you not suprised??? I'd really like some dark green 10 ups but they don't seem to be able to import them anymore :-( Can't even get any black 10 ups steel caps anymore :-( They don't import very many different varieties at all... Not even cherry bump toes or nothing :-( Still... Can buy them off the internet no doubt ;-)
Hmmm, I don't exactly know why, they just seemed you. Let me know the size and I'll have a look around and I can post them over.
> Hmm. I wonder what that means ;-)
That I'm firm, confident, positive and decisive maybe? Yeah right, and the pigs will be flying by my window any minute =0).
Dear oh me oh my. You can tell the girl's a philosopher not a mathematician. 360 degrees in a circle, 180 in a straight line, 90 in an right-angle, etc. But that's okay at least you've got 1 string to your bow, all I've got is a bent piece of wood :-)Well that is good new about the ankle movement - makes a huge difference giventhe range of movements for calf exercises is kinda limited.
Do you have a yoga mat? They make the laying on the floor a lot less uncomfortable and you can also fold them in half and then in half again to stand on for load bearing. Also is there somewhere close by that has a solid handrail you can use?
I'm serious about the Dr Martens too, it's no problem and will give me something to do at lunchtime. And I just have a sneaking suspicion that you miss them. So let me know the size okay! Promise!
I'll babblemail the first exercises soon.
>
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