You have Osteoarthritis and now what?

 

Dear Bloggers,

A few years back in the summer I first felt it: some painful morning stiffness in my fingers. The first signs of osteoarthritis. I resemble my father in many ways. We both went gray when we were 25. He developed osteoarthritis in his fingers around the age of 50 and had deformed, painful fingers and hands 20 years later. Other joints also gave pain complaints over the years. I am a bus driver now and would like to keep doing this until my last day. So, no arthritis for me.

You have to learn to live with osteoarthritis, GPs say and 15 years ago I went to the hospital and the Rheumatologist said it must be Fibromyalgia as there is nothing to find in your blood and you are still young. To keep performing in my job at sea. I had to try things out. They gave me a device that gave electric shocks to ease the pain. After a while it didn’t work out. So, I was getting pain medication and through the years I was on the highest possible dose. This summer the pain was getting back to me, and I became ill of it.

I went to my doctor about it. I thought I knew what he'll say: "There's little you can do about it, just learn to live with it." I have heard from many people around me that this is the message they came home with. Or I'm on the doorstep with drugs that won't address the cause. On sites such as the rheumatoid arthritis fund, osteoarthritis is referred to as “this chronic disease” and the treatment consists of drugs such as painkillers and anti-inflammatories, which the doctors have to prescribe for you according to their protocol. To my surprise, I was immediately referred to the Rheumatologist Dr Baudoin in Lelystad. This doctor is not in favor of numbing people with painkillers and other drugs. This is better than just getting a diagnosis in which you are immediately labeled as a "patient" and the "cure" turns out to be an expensive medical treatment that is not yet available. I don't enjoy these kinds of things. First thing I had to do he said was stopping the painkillers and go back to Panadol and solve the hardest moments. My body was totally in distress as it needed to go back to work again. I have been sick of it for three weeks getting fever and diarrhea and as my immune system was totally on the floor. Surprise surprise I ended up with a pneumonia. Isn’t life wonderful.

No one is responsible for my body. That's just me. I have the task of taking care of this as best as possible and that starts with informing myself well. Fortunately, we live in a time when you can keep yourself well informed. I started researching osteoarthritis and what I could do myself to ensure that I can still do my favorite job somewhat decently at 65. Then what I read made me happy and I want to share this with you.

Osteoarthritis is a disease of joints. These can be fingers, but also knees, elbows or hips. It is a form of inflammation that usually ends in wear and tear. It is therefore important to be there early before the wear occurs. This usually only happens after the age of 40, but it is very common. Women are ten times more likely to develop osteoarthritis than men. Wear and tear occurs in the cartilage of the joints, making the cartilage less elastic. The bone outgrowths, together with muscles and tendons, compensate for this reduced function of the cartilage. This is what causes stiffness at first and pain later. Overloading the joint (sports) can also lead to (extra) wear and tear.

Osteoarthritis says something about your overall health

Osteoarthritis seems to be a local condition, but it says something about the health of your entire body. This has to do with that inflammation that it starts with. Osteoarthritis is in fact a signal that the body is deficient in nutrients. The body uses the nutrients present for your essential organs such as your heart and liver. Just like in a panic situation your heart and muscles get blood to take action instead of your stomach which "only" has to take care of digestion. That is equally less important in a panic state. Your joints are “low” on your body's priority list, as are your skin and hair. You can survive just fine with some wear and tear on skin, hair and joints. So they get less nutrients. Osteoarthritis has everything to do with how you feed yourself. Like almost all chronic diseases, by the way. It is therefore important to ensure good nutrition and therefore sufficient nutrients. This is not to say that it is always preventable.

As we age, we become more prone to inflammation. It is therefore important to delay this process as much as possible. Osteoarthritis also has to do with the balance between free radicals and antioxidants in your body, or the oxidation process. This too cannot be prevented, but it can be kept in balance. Eating like our ancestors did before agriculture and livestock were invented is the best thing you can do to fight inflammation like osteoarthritis. In particular, a good balance between omega 6 (vegetable fats) and omega 3 fatty acids (oily fish) is important. Not too much omega 6 but plenty of omega 3 is the advice. Bit of trouble when you are allergic to seafood like me.

Dairy, bread and too many fast carbohydrates can also cause joint problems, so it is important to reduce them. This also applies to red meat.

Soon I am starting together with my wife on a program where they learn us hopefully more to live a happier and healthier lifestyle. I will suffer from pains as I will go to gym again and having a few muscles being not in the best shape. The best is yet to come and the holiday season is on it’s way.

I will try to blog a bit more again although it is painful to my wrists and fingers.

The Old Sailor,

Sick and tired of the Corona virus

Dear Bloggers,

I have been away for a while again as most of my family members are still suffering from the Corona virus that has struck the planet. Well I had the feeling that we were the lucky ones that we only got the mild symptoms. On the evening of the 12^th of March Ifound my wife in bed being feverish 38,4 degrees Celcius (approx 101 degrees Fahrenheit) She had this for 2 days and some pressure on her chest. We are not that quickly surprised as she lives with Asthma for more than 20 years. The second night she had respiratory problems and her lips turned blue for a little while when I phoned to the doctors office her breath stabilized. After these two days she was still a bit short of breath and quickly tired. I called my boss and the medical advisors of the country and they told me to stay home and self isolate with our family.

The house is alway stocked up for a four weeks survival as we do only do shopping for fresh things like vegetables and fruits. Meat and Bread we have standard in the freezer. No need to panic as toilet rolls are always on stock as well. Next victims were our oldest daughter (who works in Kruidvat a health,beauty and Pharmacy shop) and me. Practicly the same things but with a sore throat and a dry cough and tremendous headache. Our youngest daughter only had a cough for a few days and was feeling a bit weak.The advises of the government were a bit shady as one office said 24 hours after the fever you could go back to work as the other office said to stay at home for 2 weeks after the fever????? My Boss (I work as a driver on commuter busses) ordered to stay at home for the 2 weeks and so I did.I went to work again and I actually felt fine although after work I was totally wasted.

And I kept going with this dry cough. After the second week I came home being short of breath and had the cold sivers. I measured 34 degrees Celcius (93,2 Fahrenheit) and called the doctor again. My daughter stayed feverish with high and low temperatures. The doctor came to our house fully covered up due to Covid-19 and checked me out. I have no fever anymore and a mild pneumonia in my left lung. My daughter is admitted to the Hospital to check on other causes than the Corona virus. Still there is no testing on Coronavirus.

Now in the weekend on the 17^th of April my wife is having a massive asthma attack and gasps for help as she turns blue in the face the paramedics arrive and rush her of to the hospital. With hardly any chance to say goodbye to her. There is no way to visit or join a patient who is a suspected case of Covid-19. Late in the evening the Hospital calls that she is pretty much stabilized and I can come and collect her. As I am coughing I am not allowed inside and the nurse is bringing her in a wheelchair to our car.

Well let me explain a bit of this silly symptom called a dry cough it is a bit like the heavy smokers among us will recognise. That hurling sound that you make and goes away with first smoke. This is all explained by a medical doctor as this one of the symptoms of Covid-19.

A dry cough is a cough where no phlegm or mucus is produced (known as non-productive). A dry cough is irritating and usually associated with a tickly throat. Dry coughs are often caused by viral illnesses such as colds and flu, but they can also be caused by allergies or throat irritants.
Specific treatment for a dry cough will depend on the cause of the cough.
How long does a cough normally last?
Coughs associated with a cold or the flu tend to last a week or 2, most clearing up within about 3 weeks. A post-viral cough may persist for several (up to about 8) weeks after a viral illness, while some coughs persist for longer and are usually a sign of an underlying problem.
In adults and children, a cough is described as acute (short term) if you have been coughing for up to 2 weeks. In adults, a cough that lasts for more than 8 weeks is described as a chronic (ongoing) persistent cough. In children, a cough that lasts 2 to 4 weeks is called a prolonged acute cough. A cough that lasts more than 4 weeks is considered to be a chronic cough.

Causes of dry cough

A dry cough is often the result of:

• a viral illness, such as a cold or influenza (the flu), or Covid-19 the disease caused by SARS-CoV-2 – the novel coronavirus; or
• a post-viral, or post-infective, cough (cough that persists for weeks after a viral illness).
  

However, a dry cough may be a result of other problems, such as:

• Asthma
• smoking;
• Hay fever due to inhaling substances you are allergic to, such as pollen, dust or pet dander;
• certain types of lung disease known as interstitial lung disease; or
• a side effect from a medicine (for example, cough is a possible side effect of most ACE inhibitors – often prescribed for high blood pressure).
  

Other, less common, causes of a dry cough include like heart failure and lung cancer
A dry cough can be aggravated by:

• breathing cold, dry air;
• air pollution;
• inhaled irritants such as dust or smoke;
• exposure to tobacco smoke;
• excessive use of your voice; or
• a change in temperature.
  

Complications

Can I hurt myself coughing?

When a cough is severe, pulled chest muscles and even fractured ribs are a possible complication.

Diagnosis and tests

Your doctor will ask about your cough and any other symptoms you may have, and perform a physical examination. Depending on your age, history and examination, your doctor may order tests such as:

• a chest X-ray;
• a throat swab (sample of secretions from the back of your throat which can be tested for infections);

Dry coughs are often related to a viral illness and in most cases special tests are not needed.

When should you seek medical advice about a dry cough?

You should you seek medical advice if:

• you start to cough up blood or copious amounts of mucus (phlegm);
• you are short of breath or wheezy;
• the cough is mainly at night;
• you have associated chest pain;
• you have a fever;
• you are a cigarette smoker;
• you have a hoarse voice;
• the cough is associated with vomiting or a choking sensation;
• you have other symptoms such as an ongoing headache, sore ears or a rash;
• you have recently lost weight or have general muscle aches;
• the cough is in an infant aged 6 months or younger;
• the cough has lasted longer than 10 days, with little or no improvement; or
• you have high blood pressure, a heart complaint, respiratory illness (such as asthma), gastrointestinal problems or are taking other medicines.
  

Treatments for dry cough

Dry coughs that are caused by a viral infection such as a cold usually get better on their own within a week or two. Self-help measures can help make you feel better in the meantime, and cough medicines may provide some short-term relief to adults with a dry cough.
Other treatments for dry cough will depend on the cause.

Self-help for dry cough

There are some simple things you can do to provide relief from a dry cough.
Honey can help treat a dry cough by coating and soothing the back of the throat (pharynx), and relieving the irritation that triggers a dry cough. Try drinking warm water containing honey and lemon, or taking one to 2 teaspoons of honey 30 minutes before bedtime. Note that honey should not be given to children younger than 12 months of age due to the risk of infant botulism (a rare bacterial infection).
Drinking plenty of liquids can help, and warm broths or teas may help soothe your throat.
Gargling salt water (in older children and adults) may also help with a dry cough associated with a cold and sore throat.

Dry cough can be a side effect of some medicines such as ACE inhibitors and beta blockers (used to treat high blood pressure and heart problems). Your doctor may recommend stopping any medicines that could be causing your cough and replacing them with other suitable medicines for your particular condition. Talk to your doctor about alternative medicines if you are having this problem.
Repeated coughing from any cause can irritate and inflame the larynx (voice box) and upper airways. So the coughing itself makes your airways more sensitive, leading to more coughing. Strategies that can help you reduce the urge to cough and help stop this type of self-perpetuating cough include:

• taking a sip of water with a hard swallow when you feel like coughing or clearing your throat; and
• avoiding any triggers that you know tend to aggravate your cough, such as overuse of your voice, cigarette smoke, or excessively cold, dry air such as from air conditioning.
  
  
  
  
  

Still I think that I have only mild symptoms and they are though and yes the ones that are

Hospitalised are in a severe condition being on oxygen is scary. The ones that are ending up on ventilators are the ones to pray for as many of them will not make it back to their loved ones and that is the worst thing in live that can happen to you. Stay as much as you possibly can away from other people. When it hits you it might destroy you and everyone you love. This virus will get the biggest guys one there knees it even kills very healthy people.

Stay safe and stay healthy.

The Old Sailor,

Surviving the heatwave with Diabetes

Dear Bloggers,

When temperatures start to get out of control, so can you’re blood sugar can get out of control.. Both hot and cold weather extremes can harm your testing equipment and your medications and have a negative impact on your body’s ability to produce and use insulin.

Research shows that when it’s hot out, more people with diabetes end up in the ER and are hospitalized because of heat illness. The number of deaths in diabetes patients due to heat illness also increases in summer. Low temperatures can be an issue for people with diabetes as well.

But you don’t have to let the environment have the upper hand. Taking a few smart precautions can help you outsmart Mother Nature. Here are the adjustments to make depending on where you live and the weather forecast.

 

Managing the Summer Heat

Take these steps to keep your diabetes under control when the temperature soars:

Stay hydrated. “The problem is that in the heat, people tend to get dehydrated easily. When you’re dehydrated, you have higher concentrations of blood sugar because less blood flows through your kidneys. With less blood, your kidneys don’t work as efficiently to clear out any excess glucose (blood sugar) from your urine.” When it’s hot, be sure to drink plenty of water or sugar free beverages. Don’t wait until you are thirsty to replenish fluids.

Store your medications properly. High summer temps can affect your diabetes medications, glucose meter, and diabetes test strips. “When it’s hot out, it’s easy for insulin and other drugs to become degraded,” Be sure to store your medications properly out of the extreme heat. Never leave them in your car on a sweltering summer day, for instance. “It could get up to 50 degrees inside your car."

If you’re traveling, don’t forget to take your diabetes medicines with you. You may need to carry them in a cooler with an ice pack. Just be sure they’re not sitting directly on ice or the ice pack.

Stay out of the heat of the day. Exercise is an important part of diabetes management and blood sugar control. But you don’t want to be outside exercising during the hottest part of the day. “Get in your exercise first thing in the morning or once the sun goes down,”. Another option is to work out in an air-conditioned gym.

Know the signs of low blood sugar. Some of the symptoms of heat exhaustion are similar to those of low blood sugar, or hypoglycemia. These include sweating, light-headedness, shakiness, and confusion. “You may think it’s the heat and not recognize that your blood sugar levels have fallen to dangerous lows,” Be aware of the warning signs of low blood sugar and keep some carbohydrates with you to eat if you need to raise your blood sugar. Have a plan for a medical emergency.

 

Test more often. You may need to test your blood sugar levels more frequently so that you can adjust your insulin and your diet as necessary. Talk with your diabetes educator about guidelines if you're unsure of the best schedule.

Mind your feet. People with type 1 diabetes and type 2 diabetes are susceptible to problems with their feet. In the summer you face the temptation to go barefoot or wear open sandals that expose your toes … to trouble. Always wear shoes that fit well, even in warmer months. And at the end of the day, check your feet for any cuts, scrapes, blisters, or bruises. Don’t ignore injuries to your feet. Get medical treatment right away.

Surviving the Winter

Freezing temps and inclement weather can make it more challenging to stay on top of your diabetes. Here’s what to watch for during the colder months:

Keep your supplies out of the cold. Just like extreme heat, extreme cold can affect your insulin and cause your glucose monitor to stop working. Don’t leave supplies in a car when temperatures outside are below freezing.

Do your best to avoid getting sick. When you’re sick, you’re stressed, and being under stress can raise your blood sugar. Also, when you don’t feel good, you’re likely to not eat properly. Wash your hands with soap and water often so that you don’t spread germs. “We recommend diabetes patients have a sick-day kit at home. Fill it with soup, sugar-free cough drops, tea things that will make you feel better and that you can access easily,”

Avoid packing on the pounds. Managing your  type 2 diabetes during the holiday season can be tricky. Many seasonal treats are loaded with carbohydrates that cause your blood sugar to rise. Plan your meals and pace your special treats so that you don’t greet spring a few pounds heavier. Even a small weight gain makes it more difficult to control your diabetes and blood sugar levels.

Keep an eye on your feet. Diabetes can cause a loss of feeling in your toes and feet. Protect them with the right winter footwear, especially in snow. Apply moisturizer to your feet to keep your skin healthy. Inspect them regularly, and if you notice an injury that doesn’t heal, seek medical attention. Don’t wait. Also important warm your hands. “If your hands are cold, you may have to warm them up to get a good blood sugar reading,” Wash them in warm water before testing.

Don’t skip your workouts. It can be hard to get motivated to exercise in winter. But exercise is an important part of diabetes blood sugar control. It helps if you dress in layers when you’re exercising outdoors in the cold. Or join a gym where you can work out indoors. Another option: Work in exercise at home by taking the stairs, lifting weights, and exercising to videos.

At this moment I have to deal with the summer heat and my type 2 diabetes

When the hottest days of summer hit, people with type 2 diabetes need to pay close attention to their condition. Here's how to savor the season without health worries.

Summer conjures up images of backyard barbecues, pools and beaches, street festivals, stargazing, and more. But summer heat can add to the problems faced by people living with type 2 diabetes. In fact, studies have shown that during a heat wave, emergency room use by people with diabetes increases. And while most people with diabetes are aware that extreme heat poses a danger, they may not always know when to take precautions..

If you have diabetes, the high heat and humidity of summer can be difficult for your body to manage. The problem with hot weather is the combination of temperature and humidity.

Elderly people are at particular risk, but people of all ages with diabetes should be aware of summertime dangers. These include dehydration, heat exhaustion, and foot problems.

Dehydration is your enemy

Everyone, regardless of their health status, should make sure they drink enough fluids during the summer. People with type 2 diabetes, however, face an additional challenge because when their blood sugar levels are too high, they may be passing more urine than usual which means they are losing fluids more quickly. Add sweating into the mix and you have a recipe for speedy fluid loss. Certain medications, such as metformin (Glucophage), also increase the risk of dehydration.

If you are out and about on a hot summer day, make sure you have enough of these beverages on hand to stay hydrated:

• Water or seltzer
• Sugar-free lemonade or other drinks

Also, avoid alcoholic drinks and caffeine. Alcohol and caffeinated drinks are usually okay in moderation but too much of either one can cause you to lose more fluids. And remember to bring along snacks in case your blood sugar drops.

Diabetes and Heat Exhaustion If you’re going to be outside, be alert to these symptoms of heat exhaustion:

• Dizziness
• Fainting or near-fainting
• Sweating to excess
• Muscle cramping
• Cold, clammy skin
• Headaches
• Rapid heartbeat

Check blood glucose levels often. Aim for checking four times each day and before you drive.

With the proper precautions, people with type 2 diabetes can get through the summer and enjoy summer activities with no worries.

The Old Sailor,

I had no idea asthma could be fatal.

Dear Bloggers, 

I let my thoughts go when I think up a worst case scenario as my wife is diagnosed with the final stage of Asthma. Something that was told at the doctors office a couple of weeks ago. 

Somehow it is waiting untill things go terribly wrong. I imagine it like this.
At 7.50am, my wife left for work in her car as usual, dropping off our youngest at the day care centre on he way. I had to start earlier and do my rounds with the bus.

She texted me: “Can you take care of diner today?”she tapped.

I phoned her back and we chatted about the plans for that evening. We ended the ­conversation as always by saying: “Love you.”

A couple of minutes later, she was dead.

She’d driven into the side of a lorry after suffering a fatal asthma attack.
For us the rest of the family of four, her death came as a bolt from the blue. Shocking are the  statistics as they show that one person dies from asthma every eight hours.

But a new review, that will investigate the cause of asthma deaths, is hoping to reduce that number to two or three every year so that cases like my wife’s will become few and far between.

The review will ask GPs and ­hospital doctors for information to identify factors leading up to an asthma death, including the ­medication a patient was taking and whether a patient had any attacks in the run-up to their death.

On the morning she dropped our daughter at day care, nothing was out of the ordinary.
“She’d taken her inhalers the night before and in the morning and she didn’t seem unwell,” just an other day. “It was only when her boss at the telecom firm where she worked called me to say that she hadn’t turned up! I really started to worry.

“I knew something terrible had happened because she was if it comes to work she’s ­always punctual. I had a broken shift and I went home during the break, worried sick hoping to find her in bed or something similair.

I rang the police to see if they knew of any accidents but they couldn’t tell me anything. Then, at 10.10am, two police officers turned up at the door.

“They told me there had been a road traffic accident involving my wife. The officers had taken their hats off and said they were really sorry. I knew then she was dead. 

It was like the whole world stopped. I went into ­automatic gear, phoning her workplace to let them know what had happened, then I went to the school to tell the children their mum was dead. It was probably the hardest thing I’ve ever had to do.”

I never thought asthma would kill her.

She first developed the condition when he was 12 shortly after she went to another school it started being allergic to many things and she got some medication to stop it, when I met her she was 23 years old and her hands were a mess because she was reacting allergic to the Christmas tree. In Januari we bought a fake tree and I took her to her Phd. The evening before she had a severe Asthma attack and her lips turned blue due to the lack of oxygen. Her doctor was a bit hardheaded to admit that this would be asthma. So I pushed him verbally in a corner and he send us of to a specialist. A couple of weeks later she got a better life by having the right doses of medication.

 “We don’t know if this triggered her asthma but from then on she started to take Ventolin and Becotide inhalers,” the lungspecialist says.
As the years passed, She became increasingly prone to chest infections and I have to admit that after the breakdown after having our first child and several miscarriages, she began to smoke 15 cigarettes a day due to a lot of stress.

“She gave up for a while when we expected our second child and no I was not very supportive during those years but then she started smoking again. I was always nagging at her to take her inhalers when she was wheezy but she didn’t always listen.”

Her first wake-up call came in 2011 when she suffered a bout of pneumonia. She spent five days in bed where i still think she should have gone to the hospital. At the time she was taking a Ventolin inhaler and Seretide 250, a steroid preventer ­inhaler. Nothing really worked. After a Prednisolone treatment she recovered.

Her second bout came in February this year, when she had an attack of coughing syncope, a ­violent coughing ­episode which caused her to pass out.
A month later, she suffered a similar attack but this time he was behind the wheel of the car. It proved to be fatal.

“The postmortem showed a massive asthma attack, which means she probably passed out and drove into the lorry,” says the report. 
“She had all her inhalers with her in the car when she died.”

The lorry driver was totally blameless and it was an accidental death.

I am thinking back at our days that we met.  “It was a strange way to meet but we bumped into each other at the station and a few weeks later I took her out. We were both separated in a bad way in a former relationship. Eventhough I did not believe in love anymore after I was stood up again, creepy but after nearly five years of being single not wanting anything to do with women, I ­totally fell for her smile and a fair sense of humour.

“Asthma was always a problem for her and it did increasingly affect her day-to-day life. Simply running around with the children made her out of breath. But we thought her condition was under control and I still find it hard to believe that asthma could kill her.

 “Thank God we did many fun things together because we now treasure those memories if we would be losing her so unexpectedly. My point is even if your not that rich live life as best as you can. This is crucial and everyone must understand how deadly asthma can be.”

This story is just the freedom of my thoughs, It is still not too late for my wife as she is still around but this might be a realistic scenario. For her there might not be that many options left but it’s not too late for other asthma sufferers. 

“I want everyone to know that ­asthma can kill, because I didn’t know until it was told to me by a physician.

“I wish we’d known how deadly asthma can be because then, I would have made absolutely sure she took all her inhalers.” Here is a simple test: If you can breathe normal just put a straw in your mouth and try to breathe through it, don’t forget to block your nostrils as well. That is how many Asthma sufferers feel when they have an attack.

The Old Sailor,