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15/Sep/2021

This is the third in our series exploring the different groups of health professionals and therapists who’ll help you live well with a musculoskeletal condition.

Managing a chronic musculoskeletal condition – or multiple conditions – can be complicated. To help you get the best health outcomes and maintain (or improve) your quality of life, you’ll probably see a variety of different health professionals and therapists.

Who you see and how often will depend on your condition/s, symptoms and how they affect your life.

What is a specialist in healthcare?

A specialist is exactly what it sounds like. A person – in this case, a medical doctor – who has undergone additional training to become a ‘specialist’ or an expert in a specific area of medicine.

Specialists work in clinics and in hospitals, both in the private and public health systems. To see a specialist, you’ll need a letter of referral from your general practitioner (GP) or another specialist doctor.

As far as musculoskeletal conditions go, the most common specialist that people will see is a rheumatologist. But many other specialists help people manage their condition. Let’s explore each of them.

Whether you see any of these specialists will depend on your condition, symptoms, and their effect on your overall health and wellbeing.

Seeing a specialist

To see a specialist, you’ll need a referral letter from your GP or another specialist doctor. This will include information about your symptoms and test results.

You can visit a specialist in a clinic or a hospital. Depending on various factors such as where you live, the number of specialists available, the urgency of your situation, and if there’s a waiting list, you may see a specialist quickly, or you may have to wait.

Talk with your GP about the costs involved when discussing your referral. Medicare will cover part of the fee to see a specialist but not all of it. Specialist fees can be high, and depending on your circumstances and eligibility, this may influence whether you see a specialist at a bulk-billing hospital or in a private clinic. If you have private health insurance, this may also cover some of your costs. However, it’s essential to ask about fees and your choices before seeing a specialist.

The Better Health Channel suggests asking the following.

Does the specialist:

  • work within the public or private health system?
  • bulk-bill via the Medical Benefits Scheme (MBS)?
  • require gap payments?
  • have a payment plan?
  • accept my private health cover?

Before your first appointment

When making your appointment, ask what information or test results you need to bring with you. The specialist may already have access to all or some of this information via your health records, but it’s a good idea to double-check.

You can also be proactive and create a file containing all of your results, records, medications and other treatments. Take it with you when you visit the specialist. That way there’ll be no potential delay in your assessment and treatment if your specialist can’t access some of your information. And make sure you include your referral letter.

Write down a list of questions about the things you want to know. This may be about diagnosis, treatment options, the benefits and risks of different treatments, costs, things you can do to manage better etc. Put them in order, with the most important questions at the top of the list. That way, if you run out of time, they’ll have been answered first.

Make sure you have an up-to-date list of your meds to take with you. This can be extremely helpful if your specialist hasn’t been able to access this information through online channels. You may want to use an app to keep track of your medicines so you always have this information with you. The MedicineWise app from the National Prescribing Service is free to download. You can create a list of your medicines by scanning their barcodes, set reminders for when to take medicines, store your test results and much more.

Consider taking a family member or friend with you. Healthcare appointments can be stressful, and having an extra set of eyes and ears can help you take it all in. They can also provide emotional support before, during and after your appointment.

During your appointment

The specialist will ask you about your symptoms and examine you.

Be open and honest when answering their questions. The specialist needs all the relevant information about you and your health to have an accurate idea of what’s happening and how best to treat you. They’ll need information about your medical history, other health conditions, treatments (both conventional and complementary) and lifestyle factors (e.g., how often you exercise, if you smoke, your diet etc.).

You may have one or more visits to your specialist before they have all the information they need. They may also send you for further tests. Once they have all the necessary information, they’ll explain your condition to you and what treatment they think you should have.

If you don’t understand what they’re suggesting, or you need more information, ask the specialist to explain further. Don’t be embarrassed to ask for this. Musculoskeletal conditions and treatments are complicated, so the more you understand, the better. And don’t be afraid to ask them to write things down for you.

After your appointment

Follow the treatment plan that you and your specialist have agreed upon. If they’ve requested you have further tests or book more appointments, make sure you do this as soon as possible.

If you’ve been prescribed medication, take it as instructed. If you can’t remember, or you’re not sure how to take it, talk with your pharmacist or call your specialist.

And for information and support between visits to your healthcare team, call our national Help Line on 1800 263 265 weekdays.

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

More to explore


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15/Sep/2021

Ever had a moment when you’re so enraged you feel like you’ll explode?

I was watching the news recently, and something made me furious. It flicked a switch in me, and I wanted to throw my glass at the wall. Such an OTT soap opera moment 😂. Fortunately for my wall and my glass, I didn’t follow through. But it was a close call.

Many of us are angry at the moment. We may put on a happy face, but it’s simmering just below the surface. And it only takes a tiny thing to release it, leading us to do or say something impulsive we’ll regret later.

Where’s this anger coming from?

The last 18 months have been exhausting. We’ve been living with constant stress, anxiety and frustration. And there’s no end in sight yet. This has had a significant impact on our mental health. And one of the ways this can manifest is as anger.

What’s changed?

Last year we were all in it together – sort of.

But now, it seems like it’s every person for themselves. Us against them. State vs state. Community vs community. Politicians who can’t work together, constantly fighting 😤.

We’re so over everything that we’re losing empathy and tolerance for others.

So it only takes something minor to make you lose it 😤 😡 – someone cutting you off in traffic, unsolicited text messages from MPs, another appointment/event/freedom cancelled because we’re STILL in lockdown, or just stubbing your toe against the bedside table – ARGH 😤!

And when it happens, we often take it out on those least deserving of it. Our loved ones who’re in the wrong place at the wrong time, or the retail/hospo worker just doing their job.

Apart from the negative impact our anger has on ourselves and those around us, being angry all the time, or not addressing this anger, affects our physical health. It can cause high blood pressure, headaches, anxiety, depression, insomnia and digestive issues. It also makes us unhappy, and no one wants that. So here are some tips to help you manage your anger before you have an OTT soap opera moment.

13 tips for managing anger

1.Breathe

Pause and take some calming breaths. If you can, close your eyes and focus on your breathing. Slowly take a deep breath. Fill your lungs to a capacity that’s comfortable for you. Then slowly release this breath. Don’t release it in a sudden exhale, but control it so it’s slow and smooth. Continue to take slow, even breaths…in and out. You’ll feel your muscles start to relax, and your mind will begin to calm.

2. Step away from the situation or put away your phone.

Our reactions when we’re angry can be out of character, and we can regret our actions once we’ve calmed down. So if you can, physically remove yourself from the space until you calm down. And put away your phone. Text messages or phone calls made in anger are the worst. And you can’t take them back.

3. Acknowledge how you’re feeling

Don’t suck it up. It’s okay to not feel okay. When you’ve had a chance to calm down, examine why the situation/person/event made you angry. Was it a rational response? Or was it an overreaction? Think about other ways you could handle the situation if something similar occurs.

4. Write it down

This can be really cathartic. Write down how you’re feeling in a journal or on a piece of paper. This lets you get it out and then reflect on your feelings, which can help you understand why you react in a particular way. It can also help you get a better handle on your emotions.

5. Then let it go

In the end, holding on to anger only makes us and those close to us unhappy.

6. Be kind to yourself

Use simple strategies to reduce stress; try exercising, talking with a friend, meditating, making a cup of tea, doing something creative. Whatever relaxes you, do it! It’ll help you put your stress and anger behind you and make you feel more energised and positive.

7. Be kind to others

Nothing makes you feel better than being kind to others…letting someone in front of you at the checkout, holding the elevator, complementing a colleague on their work, thanking the delivery person, hugging your kids. These small acts of kindness are easy to do and go a long way to making us all feel better and less angry.

8. Create a daily routine to increase feelings of control

A regular daily routine gives you control in a time when so much is out of our control. Separate work and non-work time. Prioritise your connections with others, healthy eating, sleep and exercise. Have a work/school week routine and a weekend routine.

9. Focus on what you can do, not what you can’t

At the moment, many of us can’t visit our friends and family. We can’t travel or have a meal in a restaurant. We can’t celebrate together. And that all sucks. But we can call our friends and family. We can travel through books, virtual tours, revisit past travels and plan future trips. We can send cards, presents and tokens to celebrate milestones and occasions. It’s not the same, but it is still doing something. So focus on the things you can do.

10. Agree to disagree

Don’t let your differences affect your relationships with others. We’re all feeling heightened emotions, and we’ve all got our opinions. A lot has been thrown at us in the last 18 months! But if there’s tension or anger when discussing certain viewpoints, agree to disagree, and move on.

11. Monitor your social media use and limit your news intake

Too much media can increase feelings of frustration and anger. It certainly did for me! So I now skim through the paper once a day, and instead of watching the evening news, I’m watching old episodes of Friends (it’s on all the time 😊). With this routine, I’m in control. I’m aware of what’s happening in the world, I’m avoiding the most sensational stuff, and I’m enjoying spending quality time with old friends 😉. I’m also limiting my time on socials and spending the time doing other things that are more enjoyable and relaxing.

12. Be careful with drugs and alcohol

While it might seem like an easy way to unwind when you’re stressed or angry, drugs and alcohol won’t solve the issues that make you angry. So just be careful here. It’s an easy habit to fall into and a hard habit to break.

13. Seek help from a professional if your anger becomes overwhelming or feels unmanageable

Talk to your doctor about how you’re feeling and ask them for help.

Anger is an important emotion, but if you start to feel it more and more, it can be detrimental to your health and wellbeing. So next time you start to get worked up, try these strategies to get you through. It’ll take practice, but it’s worth the effort.

For every minute you remain angry, you give up sixty seconds of peace of mind. Ralph Waldo Emerson

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

More to explore


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15/Sep/2021

Guest blog written by: Polly Bongiorno and Mathew Richardson

Have you heard people talking about myotherapy but don’t know what it is?

You’re not alone. Myotherapy is a relatively new treatment method for pain which has been rapidly growing in popularity in recent years.

What is myotherapy?

Myotherapy is a health care profession that focuses on assessing, treating and managing pain associated with musculoskeletal conditions.

Myotherapists are known for being hands-on with their treatments, and one of their great strengths is their soft tissue skills.

The treatment skills of a myotherapist can be classified broadly as either ‘active’ or ‘passive’.

Passive treatments are those that are ‘done to you’, providing short-term relief of pain to restore preferred movements. These can be incredibly helpful when working to change protective muscle spasms, movement patterns, fears and stress.

Active treatments are longer lasting, and involve you changing behaviours that will lead to long-term health benefits. These include exercise, education, lifestyle modifications and exploring the many different contributors to your pain.

In essence, myotherapy helps people in pain move better and live their best life. A myotherapist will foster a relationship of respect, care and trust with you to form a unique plan to get you back to doing the things you love.

So, what sets myotherapy apart from the rest?

Myotherapy treatment sessions are often longer than those of other allied health providers. This gives the therapist time to develop and implement a comprehensive, individualised plan for care and recovery and still have ample time for strong hands-on therapy and exercise rehabilitation. It also allows time to nurture the relationship with you.

Myotherapists are uniquely placed to offer a wide range of personalised treatments that can help to reduce pain and get you moving again. Myotherapists understand that no two people are the same, and so no two people should be treated the same when it comes to pain.

What does a typical session with a myotherapist look like?

One of the greatest benefits of a myotherapy session is longer treatment time. Time that is essential to ensuring your myotherapist will listen to you and your personal pain story. The myotherapist will ask you lots of questions to get a complete picture of your medical history and to understand your expectations and treatment goals.

They’ll listen carefully to understand the nature of your problem and its impact on your life. This will include all aspects affected by your pain. These can be:

  • physical – e.g., work, exercise, lifestyle
  • psychological – e.g., anxiety, stress, beliefs
  • social – e.g., access to health care, support system, family relationships.

The myotherapist will then assess your body – muscles, tendons, nerves, ligaments, joints – and movements, to rule out serious conditions that may require referral to another healthcare professional, before moving ahead with treatment.

They’ll use a range of interventions, tailored to you and your goals. This may include soft tissue therapy to calm an over-protective nervous system, as well as exploring lifestyle and stress reduction strategies, exercise and movement interventions. They’ll also help you find ways of getting back to doing the things in life, that pain may have disrupted or affected.

Finally, they’ll help you make sense of why you hurt, and what to expect on your journey of recovery. Understanding what’s happening to you and why, can be a powerful pain reliever.

How is myotherapy different from physio or osteo?

By definition there isn’t a lot of difference between musculoskeletal health professionals. Myotherapists use many of the same orthopaedic assessment techniques as physiotherapists and osteopaths, and many of the same treatment techniques. Apart from minor differences in approach, the differences mainly lie in the scope of practice, rather than the quality of treatment.

For example myotherapists commonly treat general musculoskeletal pain and movement dysfunction, whereas physiotherapists also extend their treatment to cardiovascular and serious neurological pathologies.

Accessing a myotherapist

You don’t need a letter of referral from your doctor to see a myotherapist.

They typically work in settings such as private clinics, sporting clubs or community health services.

Myotherapists may work closely with other allied health professionals, general practitioners and specialists to get the best outcomes for people living with pain, regardless of the complexity of their problems.

Cost

The cost to see a myotherapist may vary, so ask about costs when you’re making enquiries about booking an appointment. You may be able to claim your treatment through your private health insurance. Check with your health fund to find out if myotherapy is covered, and if so, how much of the treatment is covered and how many sessions you can claim.

In summary

Myotherapy treatment aims to help you become confident that you can return to moving your body in ways that best support your lifestyle and what you value. It’s all about you.

Consider myotherapy the next time you’re in pain. Myotherapists are health professionals with a deep understanding of the human body and can help you on your journey to wellness and vitality. If you’re in pain and want to try myotherapy, contact your local myotherapist or visit www.myotherapy.org.au to experience the difference.

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

More to explore


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26/Aug/2021

This is the second in our series exploring the different groups of health professionals and therapists who’ll help you live well with a musculoskeletal condition.

Managing a chronic musculoskeletal condition – or multiple conditions – can be complicated. To help you get the best health outcomes and maintain (or improve) your quality of life, you’ll probably see a variety of different health professionals and therapists.

Who you see and how often will depend on your condition/s, symptoms and how they affect your life.

Mental and emotional support professionals

Being diagnosed with a musculoskeletal condition can be overwhelming. You may feel a range of emotions such as fear, anxiety, stress, loss, worry and anger.

And living with a condition that causes ongoing pain and fatigue, and has the potential to change the way your body moves and functions can cause you to feel an array of emotions too.

If you feel these ups and downs, you’re not alone. Many people living with musculoskeletal conditions find that their emotional and mental health is affected from time to time. In fact, anxiety and depression are more common in people with musculoskeletal conditions than in the general population.

It’s important to recognise signs of these conditions and seek help as early as possible. Together with your healthcare team, you can develop a treatment plan that fits your needs physically, emotionally and mentally.

Your support team

Depending on your needs and whether you’ve been diagnosed with a mental health condition such as anxiety or depression, or you’re seeking support to help manage your emotions, you may see one (or more) of the following professionals:

Your general practitioner (GP) – is usually the first person you see when you have a health issue. As well as helping you manage your musculoskeletal condition, they coordinate your care and help you access other health professionals and services. If you require specific support for your mental health, they’ll work with you to create a mental health treatment plan. This plan entitles you to Medicare rebates for certain mental health professionals and care via the Better Access initiative.

A psychologist – can help you work through your feelings, particularly if you’re feeling anxious, stressed or depressed. They can also help you set goals and work through any problems that may be preventing you from achieving your goals.

A psychiatrist – is a medical doctor who’s undergone further study to specialise in diagnosing and treating mental illness. They tend to treat severe and complex illnesses. They’re able to prescribe medication, such as anti-depressants, if appropriate.

A mental health nurse – is a registered nurse who’s undertaken additional training to care for people with mental health issues. They work in the community and hospital settings to support people in managing their mental health and treatment.

A mental health occupational therapist (OT) – OTs help people learn better ways to do everyday occupations (or activities). Those working in mental health help people lessen the impact their condition has on their quality of life and their ability to do their everyday activities.

An accredited mental health social worker – specialises in assessing, treating, and preventing mental health conditions. They help people manage their condition and its impact on their family, friends, work, and education.

A counsellor – is someone you can talk through your problems with. They can help you find clarity and solutions. A trained counsellor has usually spent three or more years studying counselling; however, there’s no requirement in Australia that counsellors have any qualifications or experience.

Wow, that’s a lot of support! How do you choose who to see?

Several factors will influence your decision:

Your mental health issues/condition. It can be challenging to know what to do or where to go when you’re struggling with mental health issues. This is where your GP comes in. They’re trained to help people with their mental health issues. By talking with you about your situation, they’ll be able to refer you to the appropriate specialist to get the care you need. They can also assess whether you’re eligible for a mental health treatment plan.

Your history. Have you seen a mental health professional before? Do you have a good relationship with them? Have you experienced good outcomes from your sessions with them? If so, you may decide to go back to them. If not, discuss your options with your GP.

Cost. If you’re able to access subsidised treatment via the Better Access initiative, you’ll be able to see a mental health professional at a reduced cost. However, health professionals set their own fees, so be sure to ask about out-of-pocket costs when you’re booking your appointment. If these costs are an issue for you, even with Medicare rebates, talk with your GP.

Access. If you live in a rural or remote area, you may not be able to see a mental health professional in person. In this case, you may be able to access them via telehealth. Telehealth enables you to consult with your health professional over the phone or through a videoconferencing app (e.g. Zoom, FaceTime, WhatsApp) on your smartphone, tablet or computer. You can choose phone or video consultations, depending on the technology you have available, and how comfortable you are using it.

Treatments

There’s no ‘one size fits all’ when treating mental and emotional health issues. Treatment will be tailored to your unique situation and the goals you have. But treatment will commonly include:

Lifestyle factors – regular exercise, eating a healthy diet, getting enough good quality sleep, managing your stress and limiting your use of alcohol and drugs are practical things you can do to improve your physical, emotional and mental health.

Psychological therapies – also called psychotherapy or talk therapies – explore the feelings, thoughts and behaviours that are distressing you, and work towards changing them. It can be used by people with mental health conditions and people who want to understand themselves better.* There are many different forms of psychological therapies, including:

  • cognitive behavioural therapy (CBT) – this helps people learn to identify and change negative or unhelpful thoughts that have a harmful effect on behaviour and emotions, and replace them with more objective, realistic thoughts. People learn practical coping strategies such as goal setting and problem-solving that they can use in the current situation and in the future.
  • mindfulness-based cognitive therapy — combines cognitive behavioural therapy and mindfulness strategies.
  • acceptance and commitment therapy – focuses on acceptance to deal with negative thoughts, feelings, symptoms, or circumstances. It also encourages a commitment to positive, healthy attitudes.

Medication. For some conditions, such as moderate to severe depression, you may be prescribed anti-depressant medication. This will work alongside treatments such as lifestyle changes and psychological therapies. Find out more about anti-depressant medications.

Other support is available

  • Your family and/or close friends can be a great source of support and understanding.
  • Peer support groups, or people in similar situations, can also be a valuable resource. Talking with someone who really understands what you’re going through and has lived experience and practical info is priceless. Groups meet in person and online. For specific mental health groups, check out this list by the Black Dog Institute. https://www.blackdoginstitute.org.au/resources-support/support-groups/
  • Mental health organisations provide a considerable amount of information and support to help you manage your mental and emotional health. See the list below for details of these groups.
  • Online therapy. There’s also a lot of information online that you can access whenever and wherever you want. Healthdirect has some information to help you find out more about eTherapy, including links to useful sites.

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

More to explore

Mental health organisations and resources

Reference

* Psychotherapy, healthdirect, September 2019.


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26/Aug/2021

Have you noticed how much more fun and rewarding exercising is when you do it with others? Whether with family or friends, in a team or in a class, in person or online, exercising together has many benefits.

It motivates you.
It’s much easier to hit snooze and roll over in bed if you’d planned to go for an early morning walk on your own. But if you’re meeting a friend for a walk or a workout, knowing that they’re waiting for you can give you the push you need to get up and pull on your workout gear. If you’ve paid for a class or gym membership or you’re part of a team, the same goes. You don’t want to waste your money or let the team down.

It’s a way to connect with others.
Exercising together is a way to spend quality time with people who are important to us, or share our interests. It’s also a great way to meet new people. And this interaction often extends beyond the gym, sports field or walking trail with pre or post-exercise catch-ups.

It provides support and encouragement.
This is particularly important when feeling tired and sore, but we know exercise (at a reduced intensity) can help us manage these symptoms. Our exercise buddy can provide encouragement to start exercising or to keep going.

It can challenge you to push yourself harder.
When you’re exercising with others, especially if you’re similarly matched in terms of fitness levels, you’re more likely to push harder and spur each other to increase the intensity of your exercise or the distance you walk/run/cycle. This continual challenge provides the best health outcomes over time.

Fitness leaders provide structure and form.
Exercising with a qualified instructor – in person or online – ensures your workout has a proper structure. That includes a warmup, workout and cool down. The instructor can also make sure you’re doing the exercises correctly to get the most benefit and make sure you’re not going to injure yourself.

It’s fun and makes you feel good!
When you exercise, your body releases chemicals such as endorphins, serotonin and dopamine into your bloodstream. They’re sometimes called ‘feel-good’ chemicals because they boost your mood and make you feel good. They also interact with receptors in your brain and ‘turn down the volume’ on your pain system. Combine that with the company of your bestie or your partner/kids/neighbour, and it can be a fun time for all 😊.

Finding an exercise class, group or centre that suits you

OK, so you’re motivated and want to join an exercise group. How do you find one that suits you?

First – you need to be COVID safe and follow the specific rules in your state or territory.

If in-person classes aren’t possible at the moment, you have other options.

There are lots of free exercise apps, YouTube channels and websites with free online exercise programs. These can be especially helpful when you need or prefer to exercise from home. There’s a class or group to suit all fitness levels and tastes. Read our blog about online exercises for more info and links.

If you can exercise together in person, try these sources to find an exercise class, group or centre that suits you:

  • Neighbourhood houses and community centres are ideal starting points to find exercise options close to you. Visit the Australian Neighbourhood Houses and Centres Association Members page to find your state or territory’s website, where you can then search for local houses or centres and find exercise programs they offer.
  • Local councils are also a good source of information about exercise programs. Go to your local council’s website and search ‘exercise classes’ to see what they offer.
  • Some larger gyms and physio centres have heated indoor swimming pools where you can swim laps or join a warm water exercise class. You can also search online for classes held at community swimming centres.
  • Walking groups are a fun way to get active, meet new people and socialise. The Heart Foundation has over 1200 walking groups around Australia, you can search for one close to you here.
  • parkruns are free, weekly community events are held all around the world with 5km walks and runs in parks and open spaces on Saturday mornings. Everyone is welcome, there are no time limits, and no one finishes last!
  • Fitness Australia has an online directory of personal trainers and businesses. If you’re looking for an exercise class in your area, select Find a Business, click on Group exercise classes and type in your suburb. It’s that simple!

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

More to explore


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05/Aug/2021

The thought that you might need surgery one day because of your musculoskeletal condition can be a frightening one. The good news is that most people can manage their condition with the usual treatments of medical care (e.g. GP, specialist, medications and allied health) and self-management (e.g. exercise, weight management, relaxation, aids and equipment).

Surgery is usually only required when all other treatments have failed to bring any relief.

Reasons for surgery

For some people, surgery may be an option to:

  • relieve pain that’s no longer controlled with treatments such as medications, heat and cold, massage or exercise
  • improve joint movement
  • improve mobility and independence
  • correct the position of joints that have become misaligned
  • improve their health and wellbeing if joint pain affects their sleep, mental health, ability to work or take part in other important activities or events.

Is surgery right for you?

That’s something only you can answer, after consultation with your doctor and an orthopaedic surgeon, and weighing up the benefits and risks. In the end, it’s your choice whether you have surgery.

If you’re not sure or don’t feel comfortable about the information you’re receiving from the surgeon, ask your doctor to refer you to another surgeon for a second opinion.

Types of surgery

There are many types of surgery that people with musculoskeletal conditions may undergo. Your surgeon will discuss which one is right for you. We’ve focused on the most common and provided links to websites with information on others in the More to Explore section.

  • Arthroscopy – allows surgeons to look inside the joint and see any damage. The surgeon makes a small cut (or incision) into the site (e.g. your ankle) and inserts the arthroscope. It has a tiny camera that provides images from inside the joint. The surgeon can then diagnose the problem (e.g. damage to the ligament or cartilage) and/or treat the problem. Arthroscopy is most commonly used for conditions affecting knees, shoulders, elbows, ankles, hips and wrists. It’s important to note that arthroscopy is not recommended to treat osteoarthritis (OA) of the knee. Evidence shows that it’s not effective in improving OA knee pain.
  • Joint fusion (arthrodesis) – involves fusing two or more bones in a painful joint together. This essentially turns them into one bone and relieves pain because the joint no longer moves. Joint fusion is often done in the ankles, spine, feet, fingers, thumbs and wrists.
  • Joint replacement – is exactly what it sounds like. A damaged joint is replaced with a metal, ceramic or plastic device (prosthesis). The entire joint may be replaced (total joint replacement), or only a section (partial joint replacement). The replacement is designed to replicate a healthy joint and allow you to move it freely and without pain. The most commonly replaced joints are the hip and knee; however other joints such as shoulders, elbows, fingers, ankles, toes can also be replaced.
  • Joint resection – involves removing part of the bone from a joint, or the entire joint, to improve the range of motion and relieve pain. Resection is often done in toes, thumbs and shoulders.
  • Joint revision – involves a prosthesis from an earlier joint replacement being removed and replaced. This may occur because the joint has worn out (most modern prostheses last 15-20 years), an infection has developed at the site, or the replacement has become unstable.
  • Osteotomy – is surgery that involves cutting, shaping and repositioning bone. This may be done if, for example, a knee joint is wearing unevenly, and there’s more pressure on one side than the other, causing pain and instability. The surgeon will cut and reshape bone in the knee so that pressure is distributed more evenly across the joint. Osteotomy is most commonly used for knees and hips but can also be helpful in other areas such as the spine or jaw.
  • Synovectomy – is the removal of tissue (synovium) from the inside of a joint. In inflammatory forms of arthritis such as rheumatoid arthritis, the synovium can become inflamed and excessively thick. This causes pain and may limit joint movement. A surgeon can remove some of this synovium, relieving pain and improving joint function. This surgery is often performed using an arthroscope. The most commonly treated joints are ankles, knees, hips, elbows, shoulders, wrists and fingers.

Understanding your surgery

All surgeries have an element of risk and the potential for complications. That’s why it’s essential that you know as much as you can before you have surgery. And while it can sometimes be intimidating asking questions, it’s your right as a patient to be fully informed.

You should discuss the risks of your specific surgery with your surgeon and anaesthetist before you decide whether to go ahead with it. And if you don’t understand something, ask them to explain it some more.

As well as understanding the procedure and what to expect, don’t forget to ask your doctor about any rehabilitation required, the costs involved with surgery and for an idea of how long you may be waiting for your surgery. Both may factor into whether you decide to go public or private (if you have private hospital cover with your health insurance).

You should also find out if you can do things before surgery to minimise these risks – for example, lose weight or quit smoking. Knowing and understanding potential risks enables you to make an informed decision about surgery.

Finally, it can be helpful to take someone with you to these consultations. There can be a lot to take in, so an extra set of eyes and ears can help you make sense of it all. They can also provide you with support if you feel anxious or stressed (which is completely understandable!).

Getting ready for surgery

Once you’ve made the decision to have surgery, you need to get ready. You’ll have the best outcomes from surgery if you’re at your healthiest and fittest. Your GP and healthcare team (physio, dietitian, exercise physiologist, psychologist) can help you do this safely. Depending on your own circumstances, you may need to:

  • Meet with your surgeon and healthcare team – they’ll give you information and advice so you know what to expect during and after surgery. Depending on your surgery, you may need to undergo an assessment before you have surgery.
  • Exercise – to strengthen your body and help you manage your pain and mental health before surgery. An exercise physiologist or physiotherapist can provide you with an exercise plan to suit your needs.
  • Lose weight – if you’re overweight, losing some extra kilos will aid your recovery. Eating a healthy, well-balanced diet is the best way to lose weight and get the nutrients you need for good health. Talk with a dietitian for a dietary plan to help you lose weight, or join a weight loss group.
  • Quit smoking – as smoking can increase your risk of complications during and after surgery.
  • Have some meals prepped in your fridge and freezer – so you don’t have to worry about cooking healthy meals when you come home after surgery.
  • Prepare your home – remove any trip hazards (e.g., rugs, loose cables, cords), ensure your lighting works in all areas, and if necessary, install handrails in your shower, beside the toilet and beside any steps or stairs to provide you with extra support.
  • Get your family or friends involved – you may be in some discomfort when you return home from the hospital and may need help. Enlist the aid of your family and/or friends to help with things such as taking you to medical appointments, running errands, getting dressed, doing housework, or cooking.

After surgery

  • Monitor your wound as instructed by your surgeon.
  • Talk to an occupational therapist about aids and equipment – depending on the surgery you’re having, you may require some aids to help you out in the short or long term, such as walking aids, shower stools, tap turners etc. They can also give you information and advice about things such as your bed and chair heights and ways to save your energy while recovering from surgery.
  • Stay active – exercise is essential after surgery, especially those prescribed by the physiotherapist at the hospital. Perform these exercises as instructed and check in with the physio as required. This will ensure you get the most benefit out of your surgery.
  • Take any medication as prescribed.
  • Look after yourself – eat healthy, balanced meals, drink plenty of water, sleep well, don’t smoke and deal with your emotions. It’s ok to have some ups and downs after surgery, so acknowledge how you’re feeling.
  • Write down any questions you have for your surgeon, doctor and allied health team, so you don’t forget them when you get to your appointments.

What are the costs of surgery?

If you’re a public patient having your surgery at a public hospital you don’t pay anything for your medical treatments.

Costs for many private treatments are also fully covered by Medicare and private health insurers.

However, you may have to pay out-of-pocket costs if you have medical treatment as a private patient in a private or public hospital. This can include costs for:

  • doctors or other health care providers
  • hospital charges such as accommodation and theatre fees
  • costs incurred outside a hospital, for example for appointments or diagnostic tests.

For more information on out-of-pocket costs visit the Department of Health Website.

If you have health insurance and you plan to go through the private health system to have your surgery, contact your health insurer to find out if your procedure is covered by your level of cover, and if you’ll be facing any out-of-pocket costs and waiting periods. We’ve listed different levels of cover and what they include on our website.

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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05/Aug/2021

Humans have evolved to be an incredibly social species. That’s why our connections are so important to us – with family, friends, work colleagues, teammates, walking buddies, fellow book clubbers and staff at the local coffee shop. They all play a role in shaping who we are and how we get on in the world.

So when we can’t see these people in person due to lockdowns, restrictions, quarantine and the general chaos of COVID, it’s really hard on us.

The last 16 months have been so wearing – both physically and emotionally. We’re living with heightened feelings of anxiety and stress – what will the case numbers be today, when will I be able to visit loved ones, how long will we be homeschooling, when will life go back to ‘normal’??

Unfortunately, there aren’t any simple answers for any of these questions – especially the last one.

But there’s a simple thing you can do to combat the loneliness, lethargy, emotional fatigue and general feeling of ‘meh’ that COVID is causing us to feel. And that’s staying in touch with your peeps and extended community.

How to stay connected when you have to stay apart

First, we should never forget that restrictions and social distancing measures are all about physical distance. We need to remain separate from others so that the virus can’t spread. But that doesn’t mean we have to be socially separated or isolated.

Even before the pandemic, we used technology to remain connected. COVID has just put that on the fast track, and we’ve become familiar with video chats, long phone calls, and messaging.

So what else can you do to ensure you remain connected with the people and places important to you?

Check in. And no, there’s no QR code involved in this one 😀! Take time daily to check in with yourself. How are you doing? If you’re feeling anxious or lonely, or overwhelmed, reach out to others for support. If you’re feeling fatigued or in pain, what can you do to deal with this? Taking a few moments to check in with yourself each day helps you deal with any issues before they become significant problems.

Take time to connect with those in your own home – your partner, kids, parents, siblings, housemates, pets, plants🌷😊. How’s everyone doing? Share your experiences and feelings about the day. And if you want to go beyond the small talk, try these ‘36 questions for increasing closeness’ from The Greater Good Science Center at the University of California, Berkeley (USA).

Phone a friend. Make a regular time to call/video chat with those important to you. And make that day/time sacred – nothing (other than an emergency) should get in the way of this contact.

Get everyone involved. Call your nearest and dearest for a group chat and…watch movies, listen to music, make dinner, enjoy happy hour, fold the washing, discuss a book, play online games. You can still do things together even if you can’t be together.

Get out and walk. Exercise is essential for our physical and mental health, so get out and breathe in the fresh air. Take the family for a stroll, or meet up with a friend in the park. If you can’t walk with your usual crew, link your fitness apps and compare how many steps you’ve done for a little friendly competition 😉. Go on a scavenger hunt. Or send pics to your network of the things you see on your walk. Walking isn’t just a good form of exercise – it can become an adventure, or a mindfulness exercise, or a chance to see other people in the flesh (and safely distanced).

Connect with your neighbours. Have a chat over the fence as you do your gardening or peg out the laundry. Or sit in your separate yards/driveways/balconies and just natter the afternoon away. Take note of any neighbours who live on their own and reach out to them. See if they need any assistance, groceries, someone to take the bins out, or most important of all, simple human interaction. It’s what we all need to get through this.

Immerse yourself. There are lots of online support/hobby/social/exercise groups that you can access from the comfort and safety of your own home. You can learn new things and meet new people without stepping out your door. And the beauty of online groups is they don’t even have to be in the same city, country or continent! Befriend Inc has created a handy guide to help you find and attend social groups online.

Send a care package. To someone you care about, or someone you know is having a difficult time. Send books, jigsaws, flowers, yummy food, a handwritten note. Anything that lets them know you’re thinking of them. It’ll be a lovely surprise and a boost for them, and for yourself. “As we work to create light for others, we naturally light our own way” – Mary Anne Radmacher.

Give thanks. Even though we’re tired, frustrated, anxious and sick of the stupid virus, there are still things to be thankful for. Taking time to reflect on these things helps us feel more positive and more fulfilled. Find out how you can become more grateful in your everyday life.

Volunteer your time and skills – from home. Volunteer work can be rewarding for yourself and your community. And there’s a lot of volunteer work that can be done online or remotely. So think about the types of things you’re passionate about, your skills, the amount of time you can give, and look around your local community to find the best match. Or visit GoVolunteer and search the database for volunteering opportunities.

Learn something new. There are so many organisations providing online learning courses, and many of them are free or low-cost. Just search online using your favourite search engine, and explore what’s available. Also, check out Laneway Learning, MOOCs (massive open online courses), TAFEs, colleges and community houses. You’ll come out of this pandemic with so much knowledge you’ll wow everyone at your next trivia night 😉. And you’ll meet a bunch of like-minded people. Win-win!

Worship. Attending churches, temples, mosques, synagogues and other places of worship with our family and friends isn’t an option for many people at the moment. The good news is that a lot of them are now online. Contact your place of worship or search online to see what events are being streamed and when. Gather with your extended family and friends virtually after worship to celebrate together.

“Invisible threads are the strongest ties.” – Friedrich Nietzsche

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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05/Aug/2021

This is the first of a series of blogs that will explore the different groups of health professionals and therapists who’ll help you live well with a musculoskeletal condition. For ease of reading, we’ll be referring to them all as practitioners.

Managing a chronic musculoskeletal condition – or multiple conditions – can be complicated. To help you get the best health outcomes and maintain (or improve) your quality of life, you’ll probably see a variety of different health professionals and therapists.

Who you see and how often will depend on your condition/s, symptoms and how they affect your life.

Physical or manual therapies

These therapies provide a hands-on approach to help relieve your pain and stiffness and improve your mobility, movement and joint function.

They’re often referred to as physical, manual, manipulative or hands-on therapies. The most common are:

  • Chiropractic – this involves manipulation and manual adjustment of your spine. It’s based on the premise that if your body, especially the spine, is out of alignment, it can affect the health and function of other parts of your body.
  • Massage – involves rubbing and manipulating the soft tissues of your body, especially your muscles. Massage can improve blood circulation, ease muscle tension and help you feel more relaxed. There are a variety of different types of massage available.
  • Myotherapy – involves assessing, treating, and managing the pain associated with soft tissue injury and restricted joint movement caused by problems with your muscles and the tissue surrounding your muscles (the fascia).
  • Occupational therapy – helps you learn better ways to do everyday activities such as bathing, dressing, cooking, working, eating or driving. An occupational therapist can also provide information on aids and equipment to make everyday jobs easier.
  • Osteopathy – is based on the premise that your body’s wellbeing depends on your bones, muscles and other soft tissues functioning smoothly together and correctly aligned. It uses physical manipulation, massage and stretching.
  • Physiotherapy – uses physical means (e.g., exercise, massage, heat and cold) as well as education and advice to help keep you moving and functioning as well as possible. Physiotherapists can also show you pain relief techniques and design an individual exercise program for you.
  • Reflexology – involves pressure applied to specific points of your feet or hands. These points are believed to match up with other parts of your body.

All of these therapies will provide additional support apart from the hands-on treatment. This may include specific exercises for you to do at home, relaxation techniques and pain management strategies. Some practitioners (e.g., chiropractors, physiotherapists and myotherapists) may also use medical devices such as ultrasound, transcutaneous electrical nerve stimulation (TENS) or dry needling alongside their hands-on treatment.

Talk with your GP and/or specialist

Before seeing any new practitioner, it’s best to discuss the treatment with your GP and/or specialist (e.g. rheumatologist). They may have some cautions about a treatment as it relates to your specific health condition/s. For example, they may recommend that you not get a treatment if you’re going through a flare or have active inflammation. Or, if you have fused joints or osteoporosis, they will likely advise against treatments that manipulate or adjust your joints or spine.

On the flip side, they may also provide you with recommendations of practitioners they’ve worked with or who have a particular interest in your condition.

Do your research

When making enquiries about a potential practitioner, ask lots of questions. For example:

  • How does the treatment work?
  • What are the possible side effects or risks?
  • Have you treated other people with my condition or health issues?
  • Do you need to see any of my recent medical tests (e.g., x-rays)?
  • How long does it take for this treatment to work?
  • How will I know if it’s working?
  • What can I expect during a treatment session?
  • How often will I need to see you?
  • How much does it cost?
  • Can I claim this treatment on my private health insurance?
  • What are your qualifications?
  • Do you receive regular training and updates?
  • Are you a member of the professional association for this treatment/practice?

You can also contact the professional association and check their list of members to ensure the practitioner is registered. Or visit the Australian Health Practitioner Regulation Agency website and search for the practitioner.

What to expect at your first appointment

Regardless of the type of practitioner, you can expect to have a detailed discussion about your musculoskeletal condition and medical history, symptoms and what you hope to get out of the treatment.

Be wary of any practitioner that doesn’t give you this time and attention to understand your situation and your needs. There’s no ‘one-size-fits-all’ when it comes to healthcare.

Keep track of your progress

It can be helpful to keep a daily diary tracking your symptoms so you can see if the therapy is working for you. Write down any changes in your pain levels, fatigue and other symptoms for a period (e.g., a month). Also include any changes to your medications, exercise routine, the amount of sleep you’re getting and anything else that could affect your symptoms. After a month of tracking, you’ll have a clearer picture of whether or not the therapy is working.

And keep your GP and/or specialist informed about how you’re going with the physical therapy.

Be careful

All treatments – from hands-on physical therapies to medications and vaccines – have benefits and risks. You need to weigh these up to make an informed decision as to whether or not the benefits outweigh the risks for you.

And if you have conditions such as osteoporosis or inflammatory arthritis, you should avoid manipulative treatments such as chiropractic and osteopathy.

Contact our free national Help Line

If you have questions about managing your pain, your musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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Professional associations


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04/Aug/2021

Written by Jenny Hill

Hi, my name’s Jennifer, but I also answer to Jen, Jenny, Jen Jen and for many years during primary school – ‘Skippy’ (as in The Bush Kangaroo!). I’m 39 years old and was diagnosed with juvenile arthritis (JA) when I was in grade 4.

My memories of my initial symptoms, diagnosis and treatments are a little hazy, given it was 30 years ago, but my mum has provided a timeline of my journey and our experiences. I suggest you read her blog before mine.

My first experience of the pain that I’d later identify as JA followed a routine sprain of my left ankle. It didn’t seem to heal properly, leaving me with permanent swelling, immobility and terrible pain. I quickly went from playing netball and water skiing to crawling to get around the house.

Despite seeing an array of GPs and other health professionals, there was no explanation as to why my joints were so painful.

When I was finally diagnosed with juvenile arthritis, I felt some relief amidst the initial confusion and shock. There was something wrong; it wasn’t in my head, it had a name, and there were treatments for it.

I spent that first year adapting to my new lifestyle.

During school recesses, I’d sit in a courtyard adjacent to my classroom, observing my friends who found ways to play close by. I read as many books as I could to distract myself from boredom and pain. I took drama classes instead of competing in my beloved netball. I learnt how to style my hair to cover my baldness when my hair fell out. Before I visited the hospital, I focused on the treat of a McDonalds burger rather than the painful examinations. I learnt how to ‘save up’ my strength and pain tolerance for special days such as excursions. When I could walk, I learnt that the only way to try and keep up with others was to re-work my limp (which made me look like a pretty clumsy kangaroo!). I don’t think that I ever believed that this could be permanent. I just took it day by day.

Looking back on these early years – despite the pain and frustrating cycles of treatments or reactions to medication – I can’t help but think that I was lucky in many ways. During primary school, I didn’t experience bullying. I had a large number of friends who took turns sitting with me when I couldn’t play. My teachers tried hard to understand my diagnosis and were very supportive. Having three siblings meant I was rarely lonely, as there was always at least one of them at home who I could torment from the couch! And I had parents who were 100% on my team, reorganising their lives around me, fighting uphill battles with doctors, sitting up with me on painful nights, and showing me patience – never frustration.

I eventually had periods of remission that brought a lot of relief but also a lot of anger, frustration and sadness when symptoms reappeared and interrupted my life. I stopped talking about my JA. It was too hard, and I believed no one could understand. Thankfully though, remission followed me into high school!

I moved onto high school, where I was in classes with a few students from primary school. It was cool having different subjects to study and getting to know new friends. By then, I found it considerably easier to walk distances and even play some netball without too much pain! It was no longer so obvious that I had anything physically wrong with me.

This made it very difficult for me when I had my weeks or days of flare-ups, when the pain would suddenly and viciously return. This was sometimes due to spending too long on my feet shopping and hanging out with my friends, or for no particular reason at all. When this happened, I grew incredibly self-conscious, angry and embarrassed and the last thing I wanted to do was try to explain myself to new friends.

I couldn’t even make sense of it myself.

I tried to hide it from friends, often socially disconnecting, spending lunch alone in the library and wagging P.E classes. I felt quite low during these periods and resorted to denial. I tried to deny the whole situation, even when a friend told me his mum saw an article about my JA experience in New Idea magazine. I flat out denied it (though I think the photos of me in the article gave me away!).

Thankfully, I was invited to attend camps for young people run by the Arthritis Foundation of Victoria (now Musculoskeletal Australia) around this time. At first, I was hesitant to go. But once I got there, I was amazed to be with people my age going through the same stuff, with the same limitations and experiences. It provided a space to let down my guard, have fun, talk about my arthritis without it being a big deal, and have space to vent and complain about things with people who totally got it.

There was no point denying my arthritis around these people or that I was feeling pretty low and angry at times…we all did.

I remember how all the young people had their cortisone shots just before camp so they could participate in the activities. And how at the end of the day, when all our joints were aching, we’d commandeer the spare wheelchairs and motor scooters for a game of wheelie basketball. This peer support didn’t entirely cure how I felt, but it did mark a change in my attitude towards my arthritis and a shift in my social life.

I was more outspoken to friends about my past experiences and current limitations. I found that most people didn’t have lots of questions anyway. We were teenagers, and everyone was wrapped up in themselves!

My pain became quite manageable over the next couple of years. I even wore high heels to my middle school formal – medication-free! However, I still struggled with depression at times and eventually left school.

I went back to school and then to university. I got my Master’s Degree and have spent over 10 years working as a youth worker and in academia.

Apart from the odd flare-ups here and there, I’ve remained in remission. I’ve enjoyed many travel adventures and weekends at music festivals (often on the edge of the dancefloor with friends who know my physical limitations!). I even went on a solo hike around an island in Japan for a month, camping out in a tent!

I’ve also developed osteoporosis, but that’s another story.

As fantastic as it is that there’s growing recognition of the physical toll that JA puts on a young person, it’s essential to consider the psychological and social impact of JA on young people (and on their incredible families). The transition from primary to high school was challenging for me. I believe I would’ve had a much easier time if I’d had access to peer support and targeted mental health support.

If you’ve enjoyed reading my blog, check out my mum’s blog.

Jenny Hill


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04/Aug/2021

Our journey of discovery with juvenile arthritis

Written by Cathy Hill

Arthritis isn’t something you expect to hear your nine-year-old daughter has, but that’s what we were hearing as Jenny and I sat in the rheumatologist’s office in 1991. We’d gone from one doctor to the next, trying to find out what was wrong with Jenny’s ankle, which we thought she’d sprained, but the swelling wouldn’t go down.

Jenny enjoyed playing netball and was a very proficient player. However, a few months earlier she’d tripped over a log after playing netball. Her ankle became swollen and wouldn’t improve. The usual treatments of ice, compression, elevation and rest, did nothing to ease what we assumed was a sprained ankle.

A chiropractor had successfully treated me after I’d had a similar injury, so we took Jenny to see him. After a few sessions with no improvement, he suggested we go to our GP for blood tests, as he felt the problem was ‘something internal’. Our GP refused to listen to what the chiropractor suggested and told Jenny to ‘jump up and down on the trampoline. This upset us, as Jenny had difficulty walking let alone jumping on a trampoline! Our chiropractor then recommended a GP who he felt would listen to us. This GP sent Jenny to have blood tests and then referred Jenny to the rheumatologist we were speaking to now.

We were shocked to think that a 9-year-old could have arthritis. This doctor assured us that it could be treated and that Jenny could lead a healthy and active life. He started her on Voltaren, which certainly brought down the swelling but gave Jenny stomach pains. The doctor then decided to send Jenny to a paediatric rheumatologist at The Royal Children’s Hospital where they were able to successfully change her medication. After a couple of months Jenny’s condition had improved so much that it was declared that Jenny was in remission and she was able to stop the medication.

Unfortunately, this improvement was short-lived, and after another fall at netball Jenny’s right ankle swelled up, this time even worse. Jenny wasn’t able to walk on that leg at all, and I would drop her as close to her classroom as possible so that she could virtually crawl into her classroom. Thankfully she had a very good group of friends who stayed with her at playtimes in the courtyard right outside their room. Jenny would crawl inside the house, and I would have to lift her into the bath at night. Because we’d been told that she was in remission, we decided to try another form of treatment, this time a local naturopath who had been recommended to us. That treatment didn’t work, and Jenny’s foot was not only terribly swollen, but was also sticking out at almost a 45-degree angle from where it should have been!

We didn’t know what to do, so we went back to the GP who originally referred us to the first rheumatologist. He suggested that we try an orthopaedic surgeon who told us that Jenny’s bones in her ankle had fused together, but unfortunately at an unnatural angle. He wanted to be absolutely sure that he was doing the right thing to help Jenny, so he asked us to take her into St Vincent’s Hospital where she would participate in a ‘round table’ of various doctors. The doctors agreed with the orthopaedic surgeon’s first thought that he would manipulate Jenny’s foot under general anaesthetic and put it in a fibreglass cast for 6 weeks. This was done at the beginning of 1992, and thankfully the result was that her foot was at a much more normal angle. However, the foot was still swollen, so it was recommended that we go back to see the rheumatology team at the Children’s.

So began a series of X-rays and scans, new medication, regular physiotherapy, eye check-ups, and included visits to a lady who specialised in ligament damage, and who treated members of the Australian Ballet as well as AFL footballers. I had to do exercises twice daily with Jenny, which resulted in many arguments. I had returned to full-time teaching at the end of 1991, so it was difficult enough getting four children off to school in the mornings and then getting to my own school, as well as finding the time to do the exercises with a reluctant patient! Jenny’s right leg had lost a lot of muscle tone while in the cast, and together with the fused ankle meant that she was not walking properly. It was imperative that we do those exercises, but at that time it was hard for Jenny to understand that, especially as it caused her pain.

We’d contacted the Arthritis Foundation of Victoria (now Musculoskeletal Australia) for support, and they told us about the camps they ran for children with arthritis. Jenny’s rheumatologist was very keen for Jenny to attend, as he was sometimes involved with the camps. Before she attended the first camp, he wanted Jenny to have ultrasound-guided cortisone injections in her foot, under a twilight sedative. He assured us that it was routine for the children to have cortisone injections right before the camps so they could get the most out of the camp activities. Over the next few years Jenny was able to participate in three camps, including one in Sydney with children from all over Australia. The camps were extremely beneficial for Jenny, and indeed all the participants. There were children with all different types of arthritis, some in wheelchairs, and they were offered a wide range of activities which they wouldn’t normally be able to participate in, such as scuba diving.

In 1993, in grade 6, Jenny noticed that when brushing her hair she would have clumps of hair in her brush. She was losing hair in patches. The doctor thought this was probably due to stress. We approached Jenny’s teacher and asked whether she could wear a beanie inside as well as outside, but her teacher said that as they had a policy of no hats inside, it would only serve to draw more attention to her. We could see her reason, so asked our hairdresser whether she thought she could do anything to help. She was able to tie Jenny’s hair back into a ‘half up-half down’ hairstyle, which did a pretty good job of covering the bald patches. Jenny was in a great class with generally very caring kids, so she thankfully didn’t have problems with teasing. Grade 6 also meant school production, and this is where we realised Jenny had a great flair for acting. She committed herself to learning her lines and songs and was cast in one of the lead roles – a little dog called Puddles, who had a ‘wee’ little problem! Looking back now I wonder whether the involvement in the production provided an escape from the arthritis and pain.

Secondary school had its ups and downs. It involved a new set of teachers and a new bunch of kids, mixed in with some friends from primary school. With a letter from her rheumatologist, Jenny was given permission to wear Doc Marten shoes, which gave her right ankle extra support and allowed for the orthotics that had been made for her at the Children’s. The orthotics were used to absorb shock rather than provide arch support like my own orthotics. With the fused ankle Jenny did walk quite flat-footed, but arch supports wouldn’t have helped. Later on it would affect Jenny’s driving, but eventually she found that certain cars that enabled her to sit forwards over the wheel allowed a better angle for her foot, as the fusion of the ankle meant that there was little movement up and down.

At secondary school Jenny had her group of friends from primary school as well as other new friends. However, continuing flare-ups meant that she would often go and find a quiet place by herself at school, which affected some of her friendships. At the time we weren’t always aware of how much pain she was in, otherwise we would’ve asked her doctor whether there was anything else Jenny could take for the pain.

Jenny immersed herself in the music program at school, and we went to several music concerts. She still had a great interest in drama and was enrolled in a local drama school where she took part in several productions. Jenny was able to participate in netball again, although she was confined to the goal third of the court where she became quite a proficient shooter!

When Jenny was 15, her rheumatologist considered that she was in remission, so she was able to stop her medication. She’s now 39 and has chosen to eat a vegan diet, and although Jenny can still have flare-ups of pain in her joints she’s no longer dependent on any arthritis medication.

If you’ve enjoyed reading my blog, check out my daughter’s blog.

Cathy Hill




Musculoskeletal Australia (or MSK) is the consumer organisation working with, and advocating on behalf of, people with arthritis, osteoporosis, back pain, gout and over 150 other musculoskeletal conditions.

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