6
September
The Many Faces of Arthritis

Back2BackARTHRITIS

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The Many Faces of Arthritis

My invisible illness is Back2BackArthritis – OA/RA, Sjogren’s Syndrome & more actually, but that is enough to mention for my elevator speech. Yes, with a chronic illness you need to come up with an elevator speech, just as you do with your profession. My story is that I’m a Doctor of Physical Therapy, former athlete, empty nester of 3,  and I seriously want to get a mini-house & take a gap-year of sorts! My happy place is the beach…by the ocean with my feet in the sand and the wind in my hair or me entirely in the water… It used to be skiing in the winter when I was younger and without knee issues & OA, & sailing in the summer, until I discovered windsurfing. But one’s aspirations and need for peace and happiness get modified with a chronic illness, even if it is one that is deemed invisible.

The BEACH – my HAPPY PLACE – is where I would like to spend

most of my time during my year of R&R&R

Rest & Recuperation & Regeneration & Repair &

Recovery & Relaxation & Rejuvenation & Renewal &

Recreation & Repositioning & Re-inventing & Visit/Re-visit &

So on & So forth: as few or as many R’s as necessary!

Pain is nothing compared to what it feels like to quit. Author Unknown

Just like skiing, at first, windsurfing was…PAINFUL!! Not unlike OA, RA, Sjogren’s, all these autoimmune diseases and chronic pain problems. As their name implies, they are 1 – chronic: they do not go away; & 2 – painful: they hurt – there is no getting around that. However, there is a way, in fact there are countless ways to manage this thing called ‘chronic pain’. Let me count the ways…

But before I do, you need to know my story, where I came from– why I am writing about this – what gives me the right – what do I know about it – what is my herstory – what is my motive – anyone can write a Blog on the internet these days, true – what makes mine, Back2BackARTHRITIS, different, unique, worthy of a read.

I remember my very first day of skiing very vividly. I was 5 years old when I went out to a hill. OK, it was a bump in Groton Massachusetts. In those days –yes, the olden days y’all- I’m old & this disease makes my body feel older than my mind quite often, but I won’t let it get me down! I digress (Note: I can do that often, but will do my best to keep it at bay or at least save things for another Blog) In those days, the equipment was not the fancy stuff that we use today. It took what seemed like days to tie the double layers of laces on my boots, which of course felt too tight, and my feet were cold and then these binding things that looked like a slingshot, and I was sure that I would be shot into a tree or the sky. So my Dad, bless his heart, brought me over to the base of the bump. I was the youngest. The instructor spent what seemed like the entire lesson having us learn how to twist and torque those long, long skis so that our feet were pointing in opposite directions. We were not in ballet class even though he was trying to get us all into fifth position, but with skis!

Correct me if I am wrong here, but wasn’t the point to keep the skis together and pointed in the same direction? This guy was totally mixed up if you ask me, but then no one seemed to care what the 5-year-old with the frozen tears on her cheek was saying. Of course I fell down. “Oh good,” he said, “Now you can learn to get up.” This gets better and better I’m thinking. I cannot even recall if we did any skiing on that first day. Those memories were too overwhelming. However, it DID get better, albeit slowly. And the cold weather and the time-consuming equipment and the frozen eyelashes and the early mornings – nothing could keep me from my LOVE of skiing. Yes, I did say LOVE!! The crisp air, the wind in my face, my hair flying (sometimes – before helmets), making fresh tracks in the snow (if you went on the sides or off the groomed trail (I lived in New England after all), seeing how many runs I could get in each day (no time for meals). My passion grew and grew, and I lived for the weekends and started to ski on another little hill and took up racing. Who would have guessed if you saw me that first day in Groton? Not unlike our chronic illnesses at first, oh so very difficult, but at some point along the way, sooner, but often later – we learn to manage our pain and symptoms & life becomes our own, if not even pleasant at times. I know, don’t push it too much yet – don’t worry. Remember:

Pain is nothing compared to what it feels like to quit. Author Unknown

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My experience with windsurfing was quite similar to that of skiing, except that I started when I was 18, not 5. My family had gone on this great vacation on Nantucket Island before I went off to college (where I planned to ski by the way). I saw people windsurfing and had to try it. I took a lesson. I do not think my arms had such a good workout in a long time: stand up, fall down, in the water, get up, pull up the sail, try to sail, fall down into the water, repeat over and over and over. I think that my parents and brother were on the shore getting a great laugh out of the whole thing. Their stomach muscles were likely as sore as the rest of my muscles that night! But with time and persistence and moving to California, things progressed, albeit slowly. The worst part was the beginning. Lugging that heavy sail up every time you fall is terrible and is a killer on your back, good body mechanics or not. They don’t tell you at the beginning how much more simple it is when you can do the water starts. Oh my gosh, it’s like night and day and the rush and the wind in your face and hair flying (when it’s not wet) and skimming over the water that glistens on the horizon. Oh, it does not get better than this! It’s like combining the best of skiing, but with my love of water and the ocean and sun and not needing to put on all that equipment (although there is the wetsuit thing). My true passion had been found. When I could windsurf on SF Bay and the Hood River, although not as good as those amazing people there, I felt I had made it, I was in my happy, happy place 🙂

What is your happy place? Then? And now?

Pre- & Post-ChronicLife?

Are they the same?

Does it matter?

Can it be the same, yet you do different things?

At your Happy Place 

What is my more involved narrative? Everyone has a story, and it is important, no quite necessary that you be able to share your story with others, with someone, in order to feel more connected in general and to those sharing a similar story, maybe validated with your illness or issue(s), and possibly feel less isolated. In addition, you can become part of a group or community that truly understands what you go through on a daily basis, whether that is stiffness, pain, severe fatigue, weakness, numbness, decreased balance, incoordination, mental fog, lack of focus, or just the fact that you have a diagnosis that may or may not result in symptoms at some later date for you or maybe you are worried about your future family.

I have worked as a physical therapist for over 30 years. I knew that I wanted MD, PT, DDS, or something along those lines in the health fields. I chose to go to an undergraduate liberal arts college where I could ski, my passion. But that all changed my freshman year when I was hit by a car while crossing in the crosswalk when returning from chem lab. That was the beginning of the knee problems, surgeries, OA, physical therapy, total knee replacement, and ultimately my choice in a profession. My ski racing ended. Eventually I was able to take up swimming and joined the swim team doing the 500yard race. And much later I even started bike racing and sprint triathlons. I learned to manage and live with OA even though there was daily pain.

It has taken me just about a year, 1 year, to get this onto my website. I find that quite unbelievable. For a type A person who slowly became the person, the family, that was always running late. It became the joke – when would we arrive? However, it all makes sense now. I was not just your average working mother of 3 trying to do it all, to be everything for everybody. I was fighting against my body every step of the way, and I was not listening to what my body was trying to tell me. It’s just fatigue. We are supposed to get by on little sleep in this country, right?! I can do it. I will make up for it at some point. How many of you have had those thoughts? Even though I knew better, my children and family had needs, as did my patients and students, came first. There were only so many hours in the day…

I truly started to realize that it may be more than OA when I had difficulty making hand splints for my patients. I could not cut the pieces of material with the scissors without significant pain. I did not have the control that I previously had..Therefore I started to steer away from doing those types of treatments. I could still work with the people having dysfunction with their hands; for the most part, however, if they required a splint, I could not make that myself. I asked one of my staff members if she could make it instead. But at that point I had not said anything more regarding my health, which seemed to be a mounting pile of issues.

The other red flag was fatigue. But that is a tough one now isn’t it? What working mother does not have fatigue, now really?! That becomes a normal part of life. However, as a nation and health providers there is finally evidence indicating that ‘sleep’ is important – Hallelujah!!!! The body is meant to rest a certain amount of time and it is then that it recovers, rebuilds and gets ready for the next day…but more on that in a later Blog.

I was working 4 jobs. Now I know that sounds like a lot and it was and I was not super keen on it, but needed to do so in order to help to make ends meet with 3 in college, even with excellent scholarships. Yes, of course there is a story attached – when isn’t there one? Let’s just say that I have more Blogs ready to go (now that I have actually started to write) than you can imagine. It was taking that first step that was the most difficult. As far as my 4 jobs were concerned, I had a full-time job, an on-line teaching job, an online consulting job, my private practice, and professional association volunteer work for starters.

Was I quitting? Was I giving up? Was I failing? Or was I finally listening to my body? Sure, there have been times when I have not wanted to do everything because I was in pain. But I just chalked it up to OA or fatigue or work or life or motherhood or a combination of those things. My time was not my own at work. Add some stress in there and our high tech world with almost 24/7 availability and sure, one can have aches and pains, who was I to complain?! I slowly weaned down letting 1 job go at time, very sadly. When I have more autonomy, I am better able to coordinate and manage my time and balance it all out as needed.

However, the fatigue became more and more overwhelming. All that I could do was work and recover from work. And even then I was not recovering enough. The thought of doing anything fun or athletic, which was my previous go-to for fun, was out of the question. Any social event sounded like torture because I knew that I could not handle it, much as I wanted to go. I was tired of giving excuses, and I know that my friends were tiring of hearing them. I could not understand what was going on, why should they?

I needed more flexibility. It seemed progressively that I was more involved than many of my clients. I could work with them, but it completely wiped me out. I could not keep up like this. I had to face reality. It was time to call it as they say in the OR. Time of death with work as I knew it…0800hours.

I have spent the past year plus in and out of hospitals, clinics, doctor’s offices, blood labs, infusion centers, had MRIs, CT scans, x-rays, testing for breathing, allergies, vestibular dysfunction, and immunology deficiency. I have tried different biologics, had adverse reactions to other medications, am currently on monthly infusions, plus a full Vera Bradley bag full of other medications. I should have stock in CVS, my favorite store these daysJ Y’all know what I mean, right?! When you feel like crap, so when you pick up your medication, you shop for a few key items, dinner and breakfast and maybe a few drinks, but they have to be gluten and lactose free, so it can be a challenge. I used to just be another customer, but now I am the one who gets a zillion prescriptions and also buys stuff with it AND uses coupons. I’ve become one of those people, all because I have Back2BackARTHRITIS.

 

It’s taken me almost a year to get back to writing this Blog. I have not felt well. There has also been the question of exactly what was going on with me. I did not want to write as an imposter. However, we are all diagnoses in process. Things are changing continuously. I have Sjogren’s Syndrome. I am being treated for Rheumatoid Arthritis and have all the signs and symptoms. When I was in school with the medical students we were taught, if it walks like a duck and looks like a duck, then it is likely a duck. I have other symptoms and may have other things going on as well, but for simplicity’s sake for now, we’ll call it OA, RA, Sjogren’s – the top 3.

Yes, my life has changed significantly. And yes, there has been a lot of pain even as I type these words now. I have never ever thought of quitting. I have thought, “ How the heck am I going to make this work?” on several occasions. However, I continue to get up every day and do the best that I can on that day, even if my best is not very much as it was today. Today was not a good pain day, it was a high fatigue day, but I made it through, and hopefully tomorrow will be better. All that I can do is my best on every single day!

Pain is nothing compared to what it feels like to quit. Author Unknown

 

My plan and goal with this Back2BackARTHRITIS Blog is to talk about various aspects related to arthritis and life with arthritis coming from the perspective of a Doctor of Physical Therapy who has practiced for over 30 years. In addition, my 2nd arthritis arrived just about when I was planning my long awaited empty-nest after raising 3 great children. I will also be chatting about what it’s like to reinvent yourself when –

Life is what happens to us while we are making other plans.

We need to keep the good, but always be moving forwards with our lives.

 

Life is a balance of hanging on and letting go.

 

So, let’s have some fun, share some stories, maybe answer some questions, definitely create more questions, and go through this thing called life together. We all have an invisible disease of some type, an autoimmune disease, maybe arthritis, maybe something else. Or possibly you are caring for someone or living with someone with such a disease. It’s a marathon and we are all in it for the long haul, so let’s make the most of it!

Cheerio,

 

DocMAW_Co @Instagram

DrMaryAnnWilmarth@Back2BackPT @Twitter

www.Back2BackPT.com

Back2BackARTHRITIS

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What is your happy place?

Then? And now?

Pre- & Post-ChronicLife?

Are they the same?

Does it matter?

Can it be the same, yet you do different things?

At your Happy Place 🙂

 

Post Your answers to any of the above-mentioned

Regarding your HAPPY PLACE

On any or ALL of the following:

www.Back2BackPT.com

DocMAW_Co @Instagram

DrMaryAnnWilmarth@Back2BackPT @Twitter

My 1-minute This is Me Speech 

My invisible illness is Back2BackArthritis – OA/RA, Sjogren’s Syndrome & additional autoimmune diseases. My story is that I’m a Doctor of Physical Therapy, former athlete, empty nester of 3 awesome young adults (yes I’m biased!), and I seriously want to get a mini-house & take a gap-year of sorts! My happy place is the beach!…by the ocean with my feet in the sand and the wind in my hair or me entirely in the water… It used to be skiing in the winter when I was younger and without knee issues & OA, & sailing in the summer, until I discovered windsurfing. And I always try to ‘keep calm & look on the bright side of life’ because…it sure beats the alternative and if it worked for Monty Python, then by George, it must be good, right?!

 

 

 

27
May
The Best Something of Everything

kids_backI spent over 30 years being Everything to Everybody – Except ME. Now it is my turn! This does not mean that I will not still be there to assist others, I will be. However, I need to take care of myself first, finally. I had been meaning to for years. You know how it goes, and then one thing or person after another needs you or something and before you know it months and years go by. I got to the point where the mind was willing, but the body was no longer cooperating. I knew that something had to change, but what would the change be, that was the question.

My profession is one of taking care of people of giving of oneself. Some might argue that it consists of pain and torture as the PT suggestsJ It may be a little bit of both. It is rehabilitation, which means doing what it takes to be able to get a person functioning to the best of their abilities after an injury or illness. When I first started working I would worry about patients over the weekend if they were inpatients and really involved. I had to learn to let go so that I could have a break and come back refreshed on Monday morning. I never did lose that level of concern for my patients though.

I had the same level of investment with all of the students that I taught over the years as well. I challenged them to think and work outside their comfort zones. For many that meant that they were not completely happy in the moment, but they understood once the course was complete. Some did not. However, I have had many former students contact me months or even years later to tell me that they now understand why we did what we did in the class and that it has helped them in their work and life going forward. Those comments mean more to me than anything. The fact that these people understood what we were doing and connected the dots and ultimately had the grace to make the effort to contact me and thank me speaks volumes to their character as human beings. It does not matter to me when or how one of my students comes to understand something, but rather the fact that it happened at all. These are the moments that make all those late nights and early mornings on the computer and with the books worthwhile!

Some of my students, and others, who have met my children have asked, “How have you raised three such great children?” I have heard this not once, but repeatedly over the years. One, I am blessed. Two, I give unconditionally. Three, we all work hard, we have goals, we respect each other, and I don’t put up with any crap. How’s that for putting it succinctly? I am friends with my children, but before that I am their parent. I think that too many people these days try to be only friends with their children and it does not work that way. You have to be their parent. Each child is looking for that and they need it first and foremost.

I offer the same respect and friendship to those that I work with; however, not all reciprocate. If you disrespect me, tell non-truths, or do other things that go against the grain as noted above, it becomes more and more difficult for me to give unconditionally….

I found myself in a position where my health was not optimal. I tried to work things so that I could have flexibility in order to continue on, but this did not come to be. I enjoy working with patients or clients very much and find it difficult not to give 100%+, therefore when I was working, I was working. Normally, you would want to take breaks when you work. That is a good thing to do both physically and mentally. However, I had such a difficult time getting myself going in the morning that if I stopped during the day for a break, I might not have been able to continue on. That meant that I had to keep working until the end of the day at which point I literally collapsed. I would sit down at my computer and proceed to fall asleep on the keyboard. Not just a light sleep, but the deepest sleep you can imagine. I was absolutely exhausted. And I was not even done with my work for the day. I still had hours of computer work to go. And then I got little sleep and had to wake up and do it all over again with a body that felt less than optimal.

We have to take care of ourselves before we can take care of others.

I am finally getting a chance to take care of me. My youngest is through 4 years of college, so I feel that my job is done. I have worked every possible physical therapy job and then some in order to be with my children and still bring in an income to adequately support three children through college and some of grad school. I also facilitated their ability to receive scholarships in high school, college, and graduate school to make it possible for us to live and eatJ For most of their high school and college years I was working 3-4 jobs with teaching, editing, and my main PT work. I would be on the computer every time I had a free moment and then some. In one sense I truly hated it because it made me look like I was anti-social, but I was really just trying to make ends meet.

We may still need to make ends meet, but if I do not have my health, then it is for naught. So, it’s time to take some deep breaths, if I can – working on that. Get myself feeling better – my best friends seem to be all my doctors these days. My goal is to have a few weeks without any MD appointments. And get out in the fresh air to do some walking – it’s going to be one step at a time to get back on track. It has been a long 30 years and an even longer winter surviving the worst snow on record. So, it’s time to get some sunshine! I want to be Everything to ME before I can be The Best Something to Others. And if I do that then you will be getting The Best Something of Everything & it will work out for Everyone 🙂 .

Don’t shortchange yourself while thinking of others.

Nova_Scotia

You cannot water the flowers if the pot is not full.

HAPPY MEMORIAL DAY!

Enjoy your weekend and the start of your summer!!

Dr. Mary Ann

 

14
April
The Carrot, the Egg or the Coffee Bean

westpalmApril 14, 2015 (My birthday 🙂 )

When I was the President of the Parents Association of the private school that my 3 children attended, I used this story as part of my speech to the parent body at the fall supper. I am sure that many were familiar with it. However, I believe that it is has a very strong message that is worth repeating and doing so at various times throughout the course of one’s life. There are many ups and downs in each person’s lifetime and how you respond to the low times is what makes you the person that you are today. It is simple to be happy and pleasant when things are going well. But how do you pick yourself up when things are at their worst? That is the true question.

“A young woman went to her mother and told her about her life and how things were so hard for her. She did not know how she was going to make it and wanted to give up. She was tired of fighting and struggling. It seemed as one problem was solved a new one arose.

Her mother took her to the kitchen. She filled three pots with water and placed each on a high fire. Soon the pots came to a boil. In the first, she placed carrots, in the second, she placed eggs and the last, she placed ground coffee beans. She let them sit and boil; without saying a word. In about twenty minutes she turned off the burners. She fished the carrots out and placed them in a bowl. She pulled the eggs out and placed them in a bowl. She ladled the coffee out and placed it in a bowl.

Turning to her daughter, she asked, “Tell me, what do you see?” “Carrots, eggs, and coffee,” she replied. She brought her closer and asked her to feel the carrots. She did and noted that they were soft. She then asked her to take an egg and break it. After pulling off the shell, she observed the hard-boiled egg. Finally, she asked her to sip the coffee. The daughter smiled, as she tasted its rich aroma.

The daughter then asked, “What does it mean, mother?” Her mother explained that each of these objects had faced the same adversity – boiling water – but each reacted differently. The carrot went in strong, hard and unrelenting. However, after being subjected to the boiling water, it softened and became weak. The egg had been fragile. Its thin outer shell had protected its liquid interior. But, after sitting through the boiling water, its inside became hardened. The ground coffee beans were unique, however. After they were in the boiling water they had changed the water.

“Which are you?” she asked her daughter. “When adversity knocks on your door, how do you respond? Are you a carrot, an egg, or a coffee bean?”

Think of this: Which am I? Am I the carrot that seems strong, but with pain and adversity, do I wilt and become soft and lose my strength? Am I the egg that starts with a malleable heart, but changes with the heat? Did I have a fluid spirit, but after death, a breakup, a financial hardship or some other trial, have I become hardened and stiff? Does my shell look the same, but on the inside am I bitter and tough with a stiff spirit and a hardened heart? Or am I like the coffee bean?

The bean actually changes the hot water, the very circumstance that brings the pain. When the water gets hot, it releases the fragrance and flavor. If you are like the bean, when things are at their worst, you get better and change the situation around you. When the hour is the darkest and trials are their greatest do you elevate to another level? How do you handle adversity?”

I take my coffee and aromas seriously and surround myself with unconditional love and happiness in the form of dogs named Java, Chip and Cappuccino – and my previous dog was Mocha Latte. Now, that’s some coffee bean fragrance for sure 🙂 🙂 🙂 in triplicate. No matter how difficult my day may be, they are always there to bring the happiness factor and take things back to the basics of food, walking and love. What more do we need? Maybe a chew toy!

I challenge myself and all of you on a daily basis to change the water, the very circumstances. If you cannot do that, then maybe it is not about the circumstances for you, but rather what you are made of. Maybe the water softened you and this might have been a good thing. Either way, it’s all good.

Read this story of The Carrot, The Egg, or The Coffee Bean with a grain of salt – pun intended, or not?! Salt put into the water, or not?! So many questions…The important thing is to take a look at yourself, move forward, do not let things keep you down, & smile every day.

I am always happy to meet at the coffee shop to talk, share, listen, do a One-on-Won, or just have some good coffee 🙂  Get in touch and we can meet there or online. See you at the coffee shop…

 

Dr. Wilmarth

Back2BackPT

Starbucks

8
March
What is Your Road Not Taken

IMG_4806The Road Not Taken by Robert Frost has been one of my favorite poems, if not the favorite, since grade school when we had to memorize it and say it every day for some time. You would think that I might have had my fill, but I actually wanted to learn more about Robert Frost. As luck would have it, I ended up at Middlebury College in Vermont where Frost had quite an influence.  For forty-two years Frost spent almost every summer and fall teaching at the Bread Loaf School of English at the mountain campus of Middlebury. Robert Frost is also credited as a major influence upon the development of the school and its writing programs. And even though I spent most of my time in the biology labs and art studios as a biology and art major, I was able to take in some of what Frost might have felt when he was in Vermont and at Bread Loaf.

photoEven though our roads are still covered with ice and snow in March, we can still make choices and go off into the woods to do so if necessary. And no matter how long the weather remains,you cannot change that. Warmer weather and sunnier days will come. You can make choices that will make all the difference. I am doing just that. I challenge you to do the same in your life. You have my support.

 

 

 

The Road Not Taken

BY ROBERT FROST (1874–1963)

Two roads diverged in a yellow wood,

And sorry I could not travel both

And be one traveler, long I stood

And looked down one as far as I could

To where it bent in the undergrowth;

Then took the other, as just as fair,

And having perhaps the better claim,

Because it was grassy and wanted wear;

Though as for that the passing there

Had worn them really about the same,

And both that morning equally lay

In leaves no step had trodden black.

Oh, I kept the first for another day!

Yet knowing how way leads on to way,

I doubted if I should ever come back.

I shall be telling this with a sigh

Somewhere ages and ages hence:

Two roads diverged in a wood, and I—

I took the one less traveled by,

And that has made all the difference.

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27
January
Shoveling

ShovelingHappy Snow Day!

I am writing this during a snow day in the middle of the Blizzard of 2015 – Winter Storm Juno. The snow total right now has topped 2 feet and we are anticipating approximately another 8 hours of heavy snowfall. Winter Storm Juno is pounding locations from Long Island to New England with moderate to heavy snow, high winds and coastal flooding.

Our last big storm was the Blizzard of 2013 – Winter Storm Nemo, which brought with it approximately 30 inches of snow. That was the last time that I mentioned shoveling in my blog. The snow then had been nice and light and fluffy when it came down, but then rain made the snow wet and heavy.

Regardless of whether the snow is light and fluffy or wet and heavy, it is important to be careful of how you shovel and how often you shovel. You need to be mindful of proper postures and body mechanics. There is a lot of shoveling to be done and it needs to be done with care.

SHOVELING DO’S & DON’TS:

  • Use a shovel that is not too large (Very important that the load is not too large)
  • Try one of the new ergonomic shovels (This can make things easier for you if you want)
  • Bend your hips and knees
  • Keep the load close
  • Pivot with your feet (Not your back!)
  • Do NOT twist with your back
  • Take frequent breaks
  • Pace yourself (Do NOT do too much shoveling at one time – Your body and heart are not used to it)
  • Try this extension exercise for your back (The extension-in-standing exercise noted below)
  • And only shovel if you are healthy!
  • Finally, Get someone else to shovel for you if you are not able to do it yourself

You can see additional information at www.moveforwardpt.com

Snow Shoveling – Move Forward PT with APTA

Snow Shoveling

So, do your shoveling carefully, and then maybe make a few snowballs, and snow angels, and possibly even a snowman. Have some fun! IF you can manage to get some sledding or skiing in, even better! Snow days like these do not come by that often. EnjoyJ

Dr. Wilmarth

Back2Back PT

15
October
We all have a TRIATHLON in us – What’s Yours?

140804_Ironman-World-Championship-Kona-HawaiiThis weekend I was following my cousin Chris Cassidy as he completed the Ironman Triathlon in Kona Hawaii. How exciting to watch as he went through the 2.4 mile swim, then the 112.0 mile bike, and finally the 26.2 mile run for a total of 140.6 miles. Of course, I was watching on my computer through an application as we were driving to Philadelphia to visit my son (sometimes I really love technology!). I would have loved to be in Kona myself…I was last there for my honeymoon…maybe one of these days I will be there for the Ironman (I am not saying in what capacity 🙂 ).

Chris Cassidy from NASA & Luca Parmitano from the European Space Agency (ESA) were part of TeamAstro. This is a team of 2 astronauts/athletes who competed in the Ironman approximately 1 year after returning from a 6-month stay in space.

 KUDOS to both of you Chris & Luca!!

http://www.ironman.com/triathlon/news/articles/2014/10/kona-week/astronauts-in-kona.aspx#axzz3Fxpj22H4

You can imagine how curious I have been about how the body responds after being in space and particularly how Chris did after his time in zero gravity and having to basically learn to walk all over again. My physical therapy brain is always on. Just as it is when we are at the airport or the beach, it is tough for me to not analyze the gait of those walking by me. Now, all you other PTs out there…you know it’s true. Maybe we don’t do a full blown biomechanical analysis, but a dropped hip here, an adducted knee and pronation there sometimes cannot be helped. It just happens – I cannot make it go away! I cannot always turn the analysis off 🙂 Well, Chris came through with flying colors! He works really hard day in and day out and the results show with his 10:15:11 total time for the Ironman Triathlon in Kona this year in 2014.

Chris and Luca had a goal and then planned their training to reach that goal of completing the Ultra-Distance Ironman Triathlon. They had some time to make their plans while circling the earth for 6-months. But whether circling the earth, or walking the earth, or driving to work – you too can make plans to achieve goals.

I used to do Triathlons. They were primarily the Sprint and Intermediate Distance Triathlons and this was approximately 30 years ago. WOW. OK, it did not seem like it was that long ago and now that I put it into writing, I am feeling a bit mature (AKA old) here. They were fun, although I do recall that for the first one I had trouble with stairs and sitting for at least a couple of days after the race – sore quads. I had done bike racing and had been on the swim team in college and done the distance events, you know, the 500 and such – orange cards (everyone else goes for a break 🙂 ). And although I had many knee surgeries from a car accident, I could, or did, keep running, but the running was not my strong leg since I did not have a strong leg to stand on, literally.

In my first Triathlon I remember the craziness of the start of the swim. All those limbs moving at once. It was all in at once in those days and you just tried to jump to the front of the pack, if you could, or the back – somewhere where you could keep your head above water. The bike was familiar to me, however, there were many a bike race where I had a flat tire, so I just hoped for no flats for this first race. And then the run – should I wear my big clunky knee brace or not? Do you know that now I cannot recall whether I did or not, but I did finish the race. It was about where I expected to be for my time and honestly, my only goal was to finish, and it was both the best feeling mentally, and the worst feeling physically with lots of DOMS (delayed onset muscle soreness), but that was fine by me! I had done it once and that meant that I could do it again. And I did.

You too can do Triathlons even if you are not doing them now. And if you are currently doing Triathlons, then focus on making it to the next level.

Chris and Luca did a lot of things that were very good, but let’s just talk about a few here, namely, Triathlons, setting goals, and training with a partner.

  1. Triathlons

I particularly like Triathlons because they encourage cross training, which is great for the body. The swimming, biking and running are also some of the initial straightforward aerobic exercises that people use for training in general. The other basic exercise is walking. As noted below there are various levels of Triathlons starting with the sprint level.

Triathlon races vary in distance. According to the International Triathlon Union, and USA Triathlon, the main international race distances are:

  1. Sprint Distance; 750-meter (0.47-mile) swim, 20-kilometer (12-mile) bike, 5-kilometer (3.1-mile) run
  2. Intermediate (or Standard) distance; commonly referred to as the “Olympic distance”: 1.5-kilometer (0.93-mile) swim, 40-kilometer (25-mile) bike, 10-kilometer (6.2-mile) run
  3. Long Course; commonly referred to as 70.3 (total distance in miles, equivalent to 113.1 km) or the ‘half-Ironman’; 1.9-kilometer (1.2-mile) swim, 90-kilometer (56-mile) bike, and a 21.1-kilometer (13.1-mile) run (half marathon)
  4. Ultra Distance; commonly referred to as 140.6 (total distance in miles, equivalent to 226.2 km) or the ‘Ironman’; 3.8-kilometer (2.4-mile) swim, 180.2-kilometer (112.0-mile) bike, and a 42.2-kilometer (26.2-mile) run (full marathon) http://en.wikipedia.org/wiki/Triathlon
  1. Goals

I challenge any of you to make a goal and start training towards that goal. Choose your own Triathlon. It can be the traditional Triathlon with swimming, biking and running. Or you can substitute other sports or activities that fit with your level of fitness or health at this very moment in time. And you can maybe build up, one step (literally and figuratively) at a time, until you can reach your next level and goal.

There are many nonstandard variations on the standard Triathlon. I want you to think way outside the box if you need to do so. My personal Triathlon right now includes Walking-Work-Sleep. Now, I know that this sounds really ridiculous and maybe so, but I am in the middle of dealing with chronic inflammatory issues. Work is my given. I am trying to increase my steps and walking on a regular basis as much as possible and as much as my body will tolerate. I am learning how much that is on a daily basis and some days are better than others. And I do not get enough sleep. Sleep is an important part of what the body needs to recover and rejuvenate for life every day. If you do not get enough, then you and your muscles and systems are not adequately ready to function. I am working towards/trying to make sleep more of a priority so that my body can better take care of itself. Once I get better with these things, then maybe I can get back to swimming, and next biking, and who knows, maybe even running again…we will see…one step at a time.

  1. Training Partner

The final thing that helps is to have a training partner or buddy. You cannot do it on your own. You need help, especially on those mornings when you do not want to get up. Getting up is the hard part – training feels easy once you are up (well – sort of). You need someone to push you and vice versa. You want to be able to bounce things off someone else. Some people just like a training buddy. Others decide to join a team and there are many out there. You also want to get good information as you are training in order to avoid injuries.

So, we all have a Triathlon in us – What’s Yours?

Dr. Wilmarth

Back2BackPT

 

 

2
September
Start where you are. Use what you have. Do what you can. (Arthur Ashe)

Happy Labor Day!

US Open 2014Just as I said on Memorial Day Weekend, it’s the long weekend – Be active – The body loves movement!

However, I do not know where this summer went?! I know that I say this every summer, but I truly think that this summer just disappeared in a wink. It went by faster than I can even say – and it does not seem like I am the only one who felt this way.

Were you able to get started with your exercise program? Or reach your new goals? Or did you try some new activities? Summer is always a good time to do that! Fall weather is conducive to new outdoor sports and activities too.

I have been continuing to wear my FitBit and monitoring my steps and sleep. These are the two things that I have looked at the most thus far. I have managed to get over 10,000 steps on the weekends for the most part. However, during the week when I am working my steps tend to be more in the 5-10,000 range. I am up and moving while working with my clients and not that often siting at a desk, but the actual number of steps are not that high. And I am not up to doing extra walking or workouts when I get home late at night, at least not yet. Ironically, I often get more steps when I have to go to MD appointments because I walk back and forth all over the hospitals – at least that is a silver lining I guess?!:-) We have to look for those when we can…

I have found some interesting things with my sleep. I am often quite tired and may not get a large number of hours of sleep. But it seems that my time falling asleep on my computer may be adding up to more than I realized! Thus more sleep time. Now, I do not recommend sleeping with your head on your laptop, for starters, the ergonomics are terrible, and I doubt that REM sleep occurs. However, if you are desperate for some zzz’s, it is a start…
Family at US OpenFor my family, Labor Day Weekend has meant the annual pilgrimage to Flushing Meadows in NYC to the US Tennis Open. We have been heading there as a family for the past dozen years or more. It is the best time to go because there are fabulous tennis matches happening on every court around the vast grounds. The matches start in the morning and continue all day until the wee hours of the morning – a tennis lover’s dream!

 

We had 4 of our 5 family members here this year at Arthur Ashe Stadium. My son who is not such a stellar tennis fan ‘suffered’ (as he says) through many years and is now old enough to be doing his own thing. His years of our trips involved game boys, trips to the NY Zoo, the Mets across the street, and various other diversions. He may not love tennis like we do, but he knows the game, can play it, and who knows, some day may even choose to come with us!

Arthur Ashe has been an influence for my children who admire his work ethic and humanitarianism. In honor of our trek and his stadium and this weekend, I believe that his quotes say it all.

Read, and reread carefully. Listen and make them your own (as he would have).

-ENJOY-

 

Arthur Ashe Quotes:

http://www.cmgww.com/sports/ashe/quotes.htm

  • You are never really playing an opponent. You are playing yourself, your own highest standards, and when you reach your limits, that is real joy.
  • One important key to success is self-confidence. An important key to self-confidence is preparation.
  • Start where you are. Use what you have. Do what you can.
  • The ideal attitude is to be physically loose and mentally tight.
  • A wise person decides slowly but abides by these decisions.
  • Trust has to be earned, and should come only after the passage of time.
  • Every time you win, it diminishes the fear a little bit. You never really cancel the fear of losing; you keep challenging it.
  • You’ve got to get to the stage in life where going for it is more important than winning or losing.
  • Success is a journey, not a destination. The doing is often more important than the outcome.
  • True heroism is unremarkably sober, very undramatic. It is not the urge to surpass all others at whatever cost, but the urge to serve others at whatever cost.

“From what we get, we make a living; what we give, however, makes a life.”

These quotes bring us back to a key lesson…

“Start where you are. Use what you have. Do what you can.”

That is all that you can do…

I did manage to get my 10,000 steps in even when watching tennis at the US Open for long hours over the Labor Day Weekend. Lots of walking in between matches does the trick! ‘Start where you are. Use what you have. Do what you can.’

If you want to get moving, but maybe you are not good at getting yourself out to go walking every day. Get a walking buddy. It makes it easier to get you going, it keeps you accountable, and it’s fun. It can always be with a friend or significant other or family member or even a favorite pet dog. Just look to your left or right, and there will be someone that wants to walk as well.

Now, I am going to record the US Open Tennis so that I can take my dogs for a walk and then watch it later while I am doing my work. Thank goodness for all the high tech electronics!

Most of all – Have fun!

Dr. Wilmarth

Back2BackPT

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28
July
Healthcare Provider by Day – Patient by Night…No Wait, It’s 24/7

My journey as both a healthcare provider and patient

MAWBeachI have been working with patients as a physical therapist for 30 years. That is quite a milestone. I love what I do, still learn new things every day, and am so lucky that I have the opportunity to be a part of the lives of the clients that I work with, if even for only a short time. I consider it a privilege. I am honored to be able to do what I do and hope to be able to continue my work for another 20-30 additional years.

As Harvey MacKay says, “Find something you love to do, and you’ll never work a day in your life.”

Steve Jobs took things a step further than Harvey MacKay and said to find what you love, but also to be satisfied, you must do what you believe is great work. In order to accomplish this, you must love what you do.

You’ve got to find what you love and that is as true for work as it is for lovers. Your work is going to fill a large part of your life and the only way to be truly satisfied is to do what you believe is great work. And the only way to do great work is to love what you do. If you haven’t found it yet, keep looking and don’t settle. As with all matters of the heart, you’ll know when you’ve found it.

Steve Jobs, Stanford Commencement Address, 2005

 

Physical Therapy – The Beginning

Let me offer a very quick recap here so that you can see where I am coming from with my career. When I was a freshman in college, I was hit by a car as a pedestrian. The car accident occurred in the middle of ski season. The car accident was devastating. I had been so excited to be on the ski team and training at such a great college. Fast forward 4 years, and I had undergone 3 knee surgeries and spent most of my college career on crutches. I wasn’t able to keep skiing after the car accident, but I joined the swim team. I was grateful that I could do anything.

After college, I was considering a number of health professions for graduate school, namely physical therapy, medicine, and dentistry. After doing internships in dentistry and PT and having lots of physical therapy as a patient during college, I decided that PT seemed like the perfect fit for me. So off I went to graduate school for my Masters in PT. I thought that my knee problems were behind me.

PT school is extremely challenging with lots of highly motivated type A students taking all the same classes pretty much all day long. Most students then tend to go off running or doing some other type of high energy sport to exercise and burn off stress in between intensive studying. I ended up undergoing 2 more major knee surgeries during my 2 years of graduate school, which made it challenging at best to keep up with studies and impossible to be a part of the runs and fun sports. But I managed to make it through and even was a student trainer for the football and rugby club sports teams. If I could survive those intense, injury prone sports teams, I thought that I would be able to survive almost anything.

Years of PT Practice:

Until now, I have rarely discussed my chronic pain issues. My focus has always been on my clients and their pain and dysfunction. I focus on enabling my patients to achieving their goals and returning to their desired level of function, whether that be walking around the block, running a marathon, or competing in the Olympics. However, I want to take a moment to share my own health experiences and to connect with everyone who may be going through similar challenges.

It was really tough working full time, raising 3 children, getting my doctorate, and even having a time when I was working 3 jobs and raising the children on my own. It was impossible to be everything to everybody. Especially as a healthcare provider who gives of oneself all day long, there comes a point where there may be little left to give. Now add to that chronic pain with Crohn’s, colitis, autoimmune arthritis, and fibromyalgia and the day-to-day schedule becomes much more challenging.

Mornings are generally hellish. I have to set the alarm hours in advance just to wake up to take medications and allow the meds to take effect and then get my body in motion. In addition, I have to do my basic morning exercises that permit my joints to move enough to function for the day. Once I get moving, I feel better, but as y’all know, you never know from one minute to the next. That is part of the frustration! You could be ready to do something socially and then have to cancel because your body flares up for no apparent reason, or as I write in my notes, NAR.

I definitely feel that I am a better therapist as a result of the chronic health and pain issues I have. I understand what it is like to go through the medical procedures on a daily basis. I know the anxiety. I visit the doctors. I go through the MRIs, scans, colonoscopies, endoscopies, surgeries, etc. I give myself the injections. I understand what it is like for all my patients who have to go through similar situations.

Orthopaedics and manual therapy are my specialties. With Back2Back Physical Therapy, I talk about Optimizing Function via Body Balance. This means that I utilize my orthopaedics background and look at the biomechanics of the body to get and maintain a balanced body. This most often involves some use of manual therapy initially in order to balance the body from the inside out, namely with fascia and the other connective tissues. The ultimate goal is to make function optimal whether that be at work, school, sports, or just having fun at the beach.

Website

I will continue to use this website to share information for Back2BackPT. However, I will also open it up to a dialogue regarding issues associated with Crohn’s, colitis, autoimmune arthritis, fibromyalgia & total joint replacements. We will discuss Optimizing Function via Body Balance from various angles. For example, one tool that I use and find very helpful is FitBit, which can be used to track one of the most highly underrated exercises: WALKING!

See the section on my website where you can purchase a FitBit if you do not already have one. They are easy to use, and FitBit can provide motivation for you to get out and walk or run more. The main thing is that you are getting out and about on a regular basis and moving. The body loves movement and finding a simple way to move in a regular way throughout the day is important.

So, as I head into some surgery this week, I am taking it as an opportunity to start a new chapter here on Back2BackPT, as well as in my life. I want to make new connections and share information regarding health, wellness and exercise. I will continue to Tweet and write Blogs and post articles with the latest evidence-based medicine.

Do what you can and take things one day and one step at a time, sometimes literally. If you can go for a walk, it often helps, even if it is around the house to start, then the block, then ½ mile, then 1 mile, and so on.

See you virtually on the track. 🙂

Dr. Wilmarth

Back2BackPT

26
May
TRAINING BUDDIES

Tori-JavaHappy Memorial Day Weekend!

We should all pay tribute to those who have served and sacrificed for our country.

It’s the long weekend – Be active – The body loves movement!

You may want to sleep in for what seems like forever after a very long week or month or season, but don’t stay in bed too long. The body will actually feel more stiff and get off it’s natural rhythm. You may be better off getting up, moving about and then taking a short 20-minute power nap later in the afternoon to refresh. Give it a try and see how it works for you.

I am not against sleep by any means – just the opposite! Sleep is a vital part of a healthy balanced life. However, ideally you want to try to keep a fairly regular routine with your sleep so that your body knows the daily rhythm and can function optimally. Now, truth be told, I struggle with this just as the rest of you do- absolutely! One night during the week I get little to no sleep and then I am trying to make up for it, which is not possible. So, I have to find a better work-life balance in order to make things work. It involves some tough decisions. We can do this together though. Your body and your life and family are worth it, right? I think so. 🙂

When you get up in the morning you often feel a bit stiff, right? When you are older, or more mature in years, this stiffness can be more apparent. This is because you have not been moving as much during your sleep at night. If you are a heavy sleeper and do not change positions much, then you get less movement at night. This all adds up to requiring some time to work the kinks out in the morning, maybe 15-30 minutes – to lubricate the joints and warm up the muscles.

So you want to get moving, but maybe you are not good at getting yourself out to go walking every day. Get a walking buddy. It makes it easier to get you going, it keeps you accountable, and it’s fun. It can always be with a friend or significant other or family member, but not necessarily. Just look to your left or right and there will be someone that wants to walk as well.

The next step may be to find a group of people in your town or local area that walks. Sometimes you can find this through health clubs, or various other groups that may advertise in the local paper or online. If you ‘google’ walking groups online, then you will find a lot to begin your group search.

Training buddies can turn into trios and then four and more. Groups for any cause can provide support, a sense of community, and a social network. For walking and exercise, as times goes on – you may start looking for training tips. This is when you may want to join up with a more established training group, or at least check in with them or places like this online to make sure that you are progressing well and will not hurt yourself.

Setting goals can be helpful for many people as it provides something to work towards. You can also set smaller weekly goals if you have a larger 5k road race goal at the end of the month for instance.

Triathlons are another popular way to get good cross training. You do not have to start as an ironman athlete. You can start at the beginning and work your way up with others at your level – one step at a time. Trifind.com includes beginner triathlons as well as triathlons for women only and more. USA Triathlon is an elite triathlon site. There is something for everyone out there.

http://www.trifind.com

http://www.usatriathlon.org

I used to do triathlons when I was younger and loved them. I remember my first one was quite challenging, and I spent the two days after it having a tough time with stairs and sitting down – my quads were pretty sore. It was worth it though! And it was fun AND it got easier each time. 🙂

Team triathlons where you divide up the swimming, biking and running can be good at the beginning if you have one of the three that is not your forte. It is also quite fun to be part of a team and cheer on your teammates before or after you race.

If you are doing triathlons, then bike fit is an important part of your equipment check. If the fit is not right, then it can cause knee or back problems for starters.

Two easy things to do to see if the fit is approximately correct are as follows:

  1. Sit on the seat and put the ball of your foot on the pedal, there should be about a 15-20 degree bend at your knee. Another way to do this is to put your heel on the pedal and then your knee should be approximately straight.
  2. While standing, put your elbow on the edge of your seat – the tips of your fingers should touch the stem of your handlebar.

*Remember, these are very approximate measurements to see if the bike fits you. If you are way off, then make adjustments of consider a different bike. If it is close, then you are probably ok. We will discuss more detailed bike fit in a later BLOG.

Most of all – Have fun!

Dr. Wilmarth

Back2BackPT

iTori Iron Girl