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02/Jul/2020

We’ve been noticing an increasing number of posts on social media and calls to our Help Line from people with musculoskeletal conditions, autoimmune conditions or with weakened immune systems who are feeling really anxious and vulnerable at the moment.

In the general population there’s a giddy exhilaration about restrictions easing. Unfortunately this seems to have led many people to forget all of the good things they’ve been doing over the past few months to flatten the curve. People are gathering in large numbers and forgetting all about physical distancing and giving others plenty of space.

That’s scary because most of us are still susceptible to the virus. And if you’re more at risk than others, it can make you feel really helpless and exposed.

So what can you do to look after yourself?

Acknowledge your feelings

It’s a crappy, crazy time, so recognise that and allow yourself to feel frightened or anxious, cry, have a freak out, and then move on. Don’t bottle these feelings up or pretend everything’s fine. All of our feelings are valid and important – you don’t have to put on a happy face or turn that frown upside down. You need to acknowledge how you really feel.

However if it feels like these feelings are taking over and they’re all you can focus on, talk to someone – your partner, a trusted family member or friend, your doctor or a mental health specialist.

Talk to your doctor

Make sure you keep your healthcare team up-to-date with how you’re doing – both physically and mentally. Continue to follow your treatment plan as prescribed, and if you have any issues contact your team immediately. If attending health appointments in person feels unsafe, use telehealth if you can. Obviously there are some appointments that will require you to attend in person – for example blood tests and scans – however there are many appointments you can attend from the comfort and security of your own home.

It’s also important that you don’t change or stop your medications without talking to your doctor, regardless of what you may see online or in the news. A recent survey of more than 500 patients attending Monash Health’s Rheumatology Department found that over half were concerned that their medications would increase their risk of getting COVID-19, and more than 75% were concerned that their medications would increase the severity of the disease if they did get it. There’s a lot of misinformation floating around about medications and COVID, so if you’re worried, contact your doctor and get their expert advice.

Stay home

If you’re able to stay home, do it. The best way to avoid contact with someone who may have the virus is to stay at home. This is the advice of our health officers, especially if you’re in an area that has outbreaks. And quite frankly it’s so cold in parts of the country at the moment, it feels much better inside than out!

So stay home when you can. Use telehealth to access your health professionals, go online to order your shopping and have it delivered (or have a family member/friend pick it up for you and leave it at your door), stay in touch with your people using video chat and phone calls, use exercise apps or online videos to keep active. Technology allows us to stay connected while staying home.

Work from home if you can

This will help reduce your risk of coming into contact with someone with COVID and other contagious illnesses like the flu. However if you can’t work from home, your workplace is required to have in place safeguards to protect you including physical distancing measures, access to soap and water and/or hand sanitisier, and clean and disinfected work spaces. For more information visit the Safe Work Australia website.

Keep practising good hygiene

This is just something we need to live with from now on. Wash your hands regularly and thoroughly (for at least 20 seconds), use hand sanitiser when you don’t have access to soap and water, cough or sneeze into your elbow, throw tissues into the bin after use and wash your hands immediately, clean and disinfect your surfaces with soap and water and a disinfectant. It’s important to clean before disinfecting because organic matter and dirt can reduce the ability of disinfectants to kill germs.

Wear a mask

When you do have to venture out, consider wearing a mask, especially if you have to catch public transport or you need to go to a location where physical distancing may be difficult. Read our updated blog about face masks for more info.

Get vaccinated

We’re all being urged to get the flu vaccination this year. This pandemic is overlapping with our flu season and while flu numbers in Australia are low due to our physical distancing measures, this may change. So see your doctor (if you haven’t already) and get your flu vax.

Ask for help

People living with health conditions are tough and resilient. We want to be able to do everything ourselves. However sometimes that’s not an option and we need to ask for help. This can be really hard and can feel like we’re giving away our independence. However this is a global pandemic – so asking for help when you need it is the smart thing to do – especially if it helps you look after your physical and mental health.

Get support from others who understand

There are some great peer support groups who meet online. You can chat with them, share your worries and concerns, get useful info and gain support from people who understand exactly what you’re going through. Being a part of these groups also give you the opportunity to give back and provide support to others.

Contact our free national Help Line

If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealthmanaging your pain 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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02/Jul/2020

Updated 8 July 2020

This article was written a week before Melbourne and Mitchell Shire in Victoria resumed Stage 3 restrictions from 11.59pm 8 July 2020. The advice from the government about wearing face masks has not changed at this stage, however if you’re concerned and would like to know more about wearing face masks, and how to make your own, read on for more info.  We’ve included new links in the More to Explore section from The Australian Medical Association: Masks an option for COVID-19 hotspots and The Conversation: Victorians, and anyone else at risk, should now be wearing face masks. Here’s how to make one.

 

Just as restrictions began easing across Australia, Victoria started recording outbreaks of COVID cases. For more than two weeks the number of Victorians infected has been in the double-digits 😯 And on Wednesday many suburbs in Victoria were locked down to stop the spread of the virus.

So if you’re immunosuppressed and feeling really vulnerable no one can blame you. This is a scary time, and having a condition or taking medication that makes you more at risk of getting ill from any contagion or infection, adds another level to this.

Although, we’re being advised to stay at home as much as possible, sometimes we just have to go outside the house. Some of us can’t work from home, or we have an appointment that can’t be done online or via video chat, or we have to use public transport.

So how do we protect ourselves when we have to go out?

Three months ago we wrote a blog about face masks. We thought it was timely to revisit this blog in light of the latest evidence, and advice from the Australian Government.

The advice from our government

“In Australia the routine use of face masks in the community is currently not recommended, while the rate of community transmission of COVID-19 is low.” (1)

“However, some members of the public may choose to wear a mask in situations where it is not feasible to maintain physical distancing e.g. on public transport and/or if they are at increased risk of severe illness if infected (e.g. because of their age or a chronic medical condition). This may provide some additional protection in these circumstances.” (2)

This advice takes into account the fact that restrictions are easing, and people are going out more. And with the opening up of our communities, the risk of coming into contact with people who have the virus, whether they appear to have it or not, is increased.

The advice also reinforces the message that masks aren’t a substitute for all the other things we’ve been doing: staying at home as much as possible, physical distancing, washing/disinfecting our hands regularly, not touching our face, coughing/sneezing into our elbow and staying home when we’re sick.

The evidence

A recent article published in The Lancet reported on a systematic review and meta-analysis that investigated a range of measures used to prevent person-to-person virus transmission. It looked at physical distancing, eye protection and the use of face masks.

Researchers analysed hundreds of studies involving SARS-CoV2 (the virus that causes COVID-19), as well as SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome), across 16 countries in health-care and non-health-care settings, including more than 25,000 people.

They conclude that “wearing face masks protects people (both health-care workers and the general public) against infection by these coronaviruses”. (3)

However the authors also state that “none of these interventions offers complete protection and other basic protective measures (such as hand hygiene) are essential to reduce transmission.” (4)

While there were several limitations with this study, it does provide some reasonable evidence for the use of masks by the general public.

So if you choose to wear a mask there are some things to keep in mind:

  • Don’t let it give you a false sense of security. Masks will provide some level of protection – depending on what they’re made of, how porous the fabric is, how well you use them – but they’re not a magical, virus-repelling shield (though how cool would that be?)
  • Use it correctly:
    • Wash or sanitise your hands thoroughly before you put a mask on and when you take it off.
    • Only touch the mask by the straps.
    • Make sure it covers your nose and mouth and fits snugly under your chin, over the bridge of your nose and against the sides of your face.
    • Don’t touch the front of the mask when you wear it. That means no pulling it down to talk to someone, to eat or drink or to smoke a cigarette – seriously!
    • And don’t touch the front of the mask when you remove it. If you do accidentally touch it, wash or sanitise your hands immediately.
      Basically imagine the front of your mask is covered in something messy or gross – like paint or a virus (!) – that you don’t want to get all over yourself and the things you touch (e.g. your phone, your kids).
  • If it’s a disposable, single use mask, only use it once and then dispose of it properly.
  • If it’s a cloth mask, wash it thoroughly in warm, soapy water and allow it to dry properly before you use it again.
  • Don’t wear a mask if you have breathing difficulties or when you’re exercising.
  • Don’t put a mask on a baby or small child.
  • Replace the mask if it gets damp or wet, or if you sneeze inside it.

The World Health Organization (WHO) has some great videos to help you learn how to use a mask correctly.

Contact our free national Help Line

If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealthmanaging your pain 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

References

(1-2) Use of masks by the public in the community
Australian Government Department of Health, updated 11 June 2020

(3-4) Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis
The Lancet, 1 June 2020

 

Photo by visuals on Unsplash


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02/Jul/2020

An article in the news this week caught my eye and really struck a chord. I don’t know about you, but the period of isolation has seen me gain a little more weight than I’m happy with 🙄

Having more time to cook and create, stress eating, the return of Masterchef 😁 (Go Poh!) and not being as physically active as we were before COVID…not to mention the snacking, cocktail hour and a whole bunch of other factors has caused many of us to gain weight during iso.

Apart from the many health issues associated with being overweight (e.g. heart disease, diabetes, high blood pressure) it’s also linked to increased pain and joint damage due to the increased stress on your joints. It can also affect your ability to be as active as you’d like, which can lead to more pain, musculoskeletal issues and weight gain. We also know that fat releases molecules that increase inflammation throughout your body.

Clearly maintaining a healthy weight is important.

So if, like me, you want to lose some of the weight you’ve gained during the last few months, we can do it! We can turn this around. It may be a challenge and take some time, but we can lose the COVID kilos 😊.

  • Start with a goal. It really does help if you have a clear goal in mind. Just the idea of losing weight isn’t a goal, but a specific, measurable plan – for example – losing 5 kilos in 8 weeks is. So make sure your goal is SMARTspecific, measureable, achievable, realistic and has a timeframe. Read our blog on setting goals for more info. When you’ve created a goal that suits your specific wants and needs, write it down and put it somewhere prominent. It’s a great visual to help you stay on track, and remind you of why you started.
  • Keep track. It’s helpful when you’re trying to get back into a healthy routine to write down what you’re eating. You can use a simple notepad or download an app. Whatever format you choose, make sure you use it. Add every little thing you eat and drink, how much you’re consuming and when. Keeping track of your food intake really helps you see if your diet is balanced and it can help you spot any trends as far as snacking, serving sizes etc. That’ll help you adjust things if you need to.
  • Eat a balanced diet that includes a colourful variety of foods, such as fruits, vegetables, whole grains, dairy products, proteins and healthy fats. This gives your body the energy and nutrients it needs to work properly, helps you maintain a healthy weight, helps protect you against other health conditions and is vital for a healthy immune system.
  • (Re)Establish a routine. If you had a healthy diet and exercise routine pre-COVID, reestablish it. It may not be exactly the same, but if you had it once, you can do it again. Look at what’s changed for you over these last few months, how it’s affected your diet and exercise, and what things you need to do to get things working again for you in this new world. If you didn’t have a good routine before COVID, now’s the perfect time to get one. Think about your typical weekday (weekends will have a slightly different routine), what you need to fit into your day including your family, work and other commitments. Write it all down and think about how you can establish a routine that works for you. Think about when you’ll work on creating healthy meal plans, when you’ll shop for ingredients, when you’ll cook, and when you’ll exercise. If you break it down into the small tasks, it makes it easier to fit into your schedule. This may take some trial and error, but it’s worth the effort.
  • Get the family involved. Whether you have family living with you, or they’re in another location, get them involved. They’ll be your cheer squad, but they may also benefit from a little TLC when it comes to their diet and exercise. You can support each other, work through problems together, share recipes and ideas.
  • Exercise. Obviously. Make sure exercise is part of your everyday routine. It’s important to help manage your musculoskeletal condition, pain, mental health, weight, sleep – and so many others things.
  • Get a good night’s sleep. Research has shown a clear link between not getting enough sleep and weight gain. Poor sleep is also linked to difficulties losing weight. As many people with musculoskeletal conditions struggle with sleep, this is yet another reason to really look at how you can improve your sleep quality and quantity. And if you need help, talk with your doctor.
  • Eat mindfully. This involves taking the time to be aware of what you’re cooking and eating – savour the tastes, the smells, the textures. Be present while you eat, and try not to be distracted by things like the work, TV and other devices. Don’t hurry, eat small bites, take your time and enjoy.
  • Distract yourself. Sometimes we eat not because we’re hungry, but because we’re bored, sad, lonely or upset. Before you eat something outside of meal times, ask yourself why you’re reaching for that food. Do you actually feel hungry? Or is there another reason? If you’re not hungry, distract yourself with a walk, call a friend, drink a glass of water (not wine! – many of us are overdoing that too – see below).
  • Choose snacks wisely. I’m not a chocoholic, but somehow it’s been finding its way into my cupboard on a regular basis 😁. It’s easy for this sort of thing to become a habit, so be mindful of what you’re snacking on and how often. If you’re snacking on less healthy options like high fat, high sugar or high salt treats, substitute them for healthy options such as fruit, vegetables, nuts, yoghurt. But be aware of the serving size and the frequency. You can have too much of a good thing! And save the treats for when you can really savour them. When you only eat them occasionally you’ll enjoy them even more 😉
  • Acknowledge that you’re not perfect and you may eat some things that aren’t part of your healthy eating plan. That’s OK, you’ll get back on track. Don’t let it trip you up, or allow the negative self-talk to sabotage your weight loss. Go back to your goal, remind yourself why you’re doing this, and move on.
  • Don’t deprive yourself but don’t ‘treat’ yourself too often either. Find that balance of enjoying your food, but don’t use it as a reward or to make yourself feel better if you’re feeling down or stressed.
  • Get help. If you’re struggling with your weight and you need professional help, talk with your doctor or dietitian. They can help you with practical information and strategies that are specifically tailored to you.
  • Be careful with alcohol. Reports are showing that many of us are drinking more during these stressful times. If that sounds familiar, cut back on your alcohol intake. Substitute other drinks that you enjoy instead of alcohol, though be careful of drinks high in sugar. Try different teas and infusions, add lemon and other fruits to your water, give kombucha a go (maybe? it can be an acquired taste 😉), make a mocktail (again be careful of the sugar content).

Contact our free national Help Line

If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain 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

Photo by Heather Ford on Unsplash


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25/Jun/2020

The last week has seen a large number of new cases of COVID-19, particularly in Victoria. With this large increase in the number of active cases, should we be worried?

Well – yes and no. Let’s explore some of the issues.

We’re dropping our guard

SARS-CoV-2 (the virus that causes COVID-19) is like a mythical beast. It’s caused so much damage and devastation – both here and globally – but most of us haven’t faced it. It’s hard to stay vigilant against something that seems so elusive.

So we drop our guards and our standards along with them.

It’s absolutely understandable – it’s been a long road so far, we’re sick of being isolated, we want life to go back to normal.

“I wish it need not have happened in my time,” said Frodo.
“So do I,” said Gandalf, “and so do all who live to see such times. But that is not for them to decide. All we have to decide is that to do with the time that is given us.”
J.R.R Tolkien – The Fellowship of the Ring

But because most of us haven’t been exposed to the virus, we’re still susceptible. And some people are more at risk than others of becoming very ill if they develop COVID-19, including people with immune issues and certain other health conditions.

So we need to maintain our vigilance.

Community transmission

Most of the new cases can be linked to people returning from overseas and specific clusters where the origin of the virus transmission is known.

However there are some cases where we have absolutely no idea how/when/where a person became infected. This is known as ‘community transmission’ – a person becomes infected with the virus but they’ve had no contact with a known case.

They may have been in contact with someone who’s asymptomatic (infected but don’t feel unwell or show any symptoms) or someone who’s pre-symptomatic (infected but not yet showing symptoms). Or they may have come into contact with someone who thinks they have a bit of a cold, or even someone who suspects they have the virus but isn’t self-isolating 😪.

The issue of community transmission is why we need to remain on guard against this virus. Just because restrictions have been easing doesn’t mean we can ease up on our physical (social) distancing, washing our hands as often as possible, using hand sanitiser if there’s no access to soap and water, sneezing and coughing into the elbow, staying home when we’re sick and getting tested if/when we develop symptoms, however mild.

Remember, symptoms of COVID-19 are:

  • fever
  • chills or sweats
  • cough
  • sore throat
  • shortness of breath
  • runny nose
  • loss of sense of smell.

For more information about symptoms and to see if you or someone you care for may have the virus, use the healthdirect Coronavirus (COVID-19) Symptom Checker. Answer a few simple questions to find out if you need to seek medical help or be tested. Or call the National Coronavirus Helpline on 1800 020 080, 24 hours a day, seven days a week.

Winter is here

And for most of Australia there’s is a bit (or a lot) of chill in the air 😱. Which means we’re staying indoors, huddling close together to stay warm, keeping the windows closed to keep the cold out and the warm in. Unfortunately all of these things make it easier for germs to spread. We’re close together and there’s little ventilation. Perfect to help the little buggers move from person to person.

Along with the cold weather, we’re seeing more people gather together as restrictions ease and as boredom well and truly sets in. This’s a big problem. On a recent trip to the local shopping centre I was shocked by how many people I saw –most weren’t allowing 1.5 metres between themselves and others, people were hugging, coughing into their hands, not using hand sanitiser when entering stores…all of these things allow germs to spread through the community. Needless to say I hightailed it to the closest exit and went home 😑

It’s cold and flu season

This pandemic is overlapping with our flu season. Yay 😒 Currently flu numbers in Australia are low due to our physical distancing measures. However, this may change for the same reasons we’ve seen increases in COVID-19 cases.

There’s also the potential that people may become infected with the flu and COVID-19 at the same time, which, to put it mildly, isn’t ideal. While we don’t know if this leads to more severe cases of both infections, the immune system will be weakened by fighting two infections. And if a person’s immune system is already weak due to another health issue, this has the potential for very serious outcomes.

Finally if flu numbers do increase as we continue through our flu season, it will have an impact on our healthcare system, which is already working overtime because of the pandemic. It seems like so long ago, but the 2019 flu season was our worst flu season on record.

So for all of these reasons we’re being urged to get our flu vaccination this year.

This is also a time of year when many of us succumb to colds. Coughing, a runny nose or sore throat may be symptoms of cold, allergies, the flu or COVID-19. If you experience these symptoms, don’t just assume it’s a cold or your allergies flaring up. The same goes with muscle soreness and a fever. For some people with musculoskeletal conditions, this may be a symptom of a flare. Or it may be your body displaying signs of COVID-19. The best thing you can do is stay home and contact your doctor – and if recommended – get tested.

So should we be worried about these COVID outbreaks?

We should be concerned because most of us are still susceptible to the virus, and some of us are at risk of becoming seriously ill if we become infected with COVID-19.

So stay at home if you’re unwell, know the symptoms of COVID-19, wash your hands often and thoroughly, cough/sneeze into your elbow, maintain physical distancing measures and continue to follow the advice of our health officers.

But we shouldn’t become so worried that we don’t get out (safely and responsibly), that we don’t live our lives. We were able to keep the numbers down for months. We can do it again.

Contact our free national Help Line

If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealthmanaging your pain 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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25/Jun/2020

Living with a chronic musculoskeletal condition costs us physically, mentally and emotionally. But what many people don’t understand are the substantial financial costs associated with having chronic conditions. They’re expensive 😒

Healthcare costs

These are the most obvious. Medications, lots of trips to your doctor, your specialist/s, allied health professionals, tests, exercise classes, surgery, orthotics….they all add up. A lot!

People who don’t have a chronic condition may assume that a lot of this is covered by government subsidies, GP Management Plans, health insurance, the Pharmaceutical Benefits Scheme, with a little sprinkling of magical fairy dust to cover the rest. Depending on a person’s situation some of this may be covered. But much isn’t.

There’s significant cost in seeing allied health professionals such as physiotherapists, podiatrists, occupational therapists, hand therapists, dietitians and psychologists. While GP Management Plans assist with the cost, there’s mostly only five visits provided and these are used up very quickly. There may also be a gap payment over the Medicare Rebate. And there are also often considerable out of pocket expenses to see a specialist privately or longer waits when you see them publicly.

This can put a significant strain on a person’s finances.

Employment

Living with a chronic musculoskeletal condition is varied and episodic. That means you often don’t know how you’ll wake up. Your pain and stiffness may have been under control and manageable for some time, but then one day you wake up feeling crap. Your joints are swollen, it hurts to move, and you’re soooo exhausted. This makes it difficult to get up and move around, let alone get to work and put in a full day, as well as all the other things you have going on – family, friends, studying, chores, and a social life.

This may lead to time off work, and using up all your sick and personal leave. But if the situation (or workplace) becomes unmanageable it may result in someone having to permanently reduce their hours, change jobs, become unemployed or retire early.

Any of these things will obviously affect your everyday finances. However it can also affect your future finances as superannuation is impacted by reduced or lost income.

Wow. This became really depressing really quickly 😒.

The good news is there are services to help you if you need to change careers, or need financial assistance while you re-evaluate what you can or can’t do. We’ve added a bunch of these to the More to Explore section below.

And while we know none of these services are perfect, they can provide you with many of the tools and resources to help you through this tough time.

Hidden costs

Lost employment and medical costs – check. They’re probably the most visible costs. But there are many hidden costs. We’ve listed just a few.

  • Home and car modifications – so that you can continue to do the things you want and need to do as easily and pain-free as possible you may need to make changes to your home and/or car. They may be simple and relatively inexpensive – e.g. adding a swivel seat to your car to help you get in and out, or more complicated and pricey – e.g. installing a chair lift to help you get up and down the stairs in your home. An occupational therapist can help you work out what modifications will assist you, and can also advise you of any available schemes or assistance programs you may be eligible for.
  • As well as changes to your home or car, you may also need to buy various gizmos and gadgets that: protect your joints (e.g. tap turners, pick-up reachers), help you manage your pain (e.g. heat packs) and generally make life a little easier (e.g ergonomic mouse for your computer, walking aids). Again these can range in price.
  • Getting out and about if you’re in pain, or dealing with serious brain fog, can be tricky if you don’t feel up to driving. It’s only made worse with the COVID pandemic, when many of us feel vulnerable catching public transport. So you might have to resort to catching a taxi or using a rideshare company. But over time this does add up. You may be eligible for a taxi subsidy – each state/territory has their own scheme – so it’s worth checking to see if you can access this.
  • Food, glorious food 😋. Let’s face it there are many times you feel flattened by your condition and cooking is the last thing you want to do. And now with the convenience of delivery apps, you can get almost anything delivered to your door. Unless like me you live in an outer suburb in which case it’s fish n’ chips, pizza or burgers – yum, but not the healthiest options 😁 These deliveries can be a lifesaver, but the cost can also very quickly add up.
  • Events and holidays. This’s a tough one. Because of the nature of chronic conditions and often not knowing how you’ll feel from day to day, you can pay for future events and then have to cancel or change at the last minute. Like tickets to a concert (remember those??) – you often buy them so far in advance and you’re excited for literally months! And then the night comes and you know you can’t go – you’re too tired, too sore, too whatever. So you have to forfeit your ticket, or give it away to a friend. Or you’re on holiday, but you end up having to pay to make changes because you’ve had a flare and you need an earlier flight home, or you need to catch more taxis than you’d planned to, or you need to buy a pillow because the one at your hotel is a rock. It’s the crazy, unpredictable stuff like this that’s hard to plan for and adds to financial stress.

Pandemic pain

And then came COVID.

Many of us are having to manage to do more on less, with fewer hours, less pay, or no pay. It’s the unpredictability of this pandemic that adds to financial stress, especially if things were already tight before COVID came along.

The best thing to do if you’re feeling anxious about your financial situation is to be proactive and sort it out ASAP. Ignoring the problem won’t make it go away, and may make the situation worse. Choice has written a useful article that provides lots of handy info and tips: Making the right financial moves during the COVID-19 coronavirus outbreak.

And check out the More to Explore section below for more resources to help you.

Contact our free national Help Line

If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealthmanaging your pain 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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25/Jun/2020

This strange time we’re living through has forced us to live smaller. SARS-CoV-2 is going to hang around for quite some time, so our way of living will likely remain on the small scale for the foreseeable future.

And as we’ve seen with the spike in active cases in Victoria, restrictions can be eased and they can be tightened again. Trips overseas are out and trips interstate are dependent on state borders being open. Even travelling across our own state may be subject to restrictions if outbreaks continue.

It’s easy to feel a little despondent about the whole situation. It’s been a hard slog with no end in sight.

So it’s important we take some time to sit back and take stock. We’ve adapted to isolation and the massive changes in our world. We’ve been creative and done things that we couldn’t even imagine we would’ve done this time last year. We should give ourselves credit for that and continue to discover the small joys in life.

Like having a jigsaw on the go on the kitchen or coffee table that everyone adds to as they walk past. I can’t tell you how many people have told me they’ve been doing this…and how much satisfaction they get when they complete a tricky 1,000 piece puzzle.

Or discovering the parks, paths and until now unexplored areas in our neighbourhoods. Foot power and pedal power has us discovering many hidden treasures we never knew existed before COVID.

We’ve enjoyed cooking and creating meals together. Discovering an interesting recipe, trying new ingredients, and taking time to sit down together and talk, laugh and have fun. With the change in our routines, and the lack of social/sporting/school/work gatherings, we have a little more time to break away from the mundane meals of the past, at least occasionally. Turn the TV off, put some music on, enjoy the company and the meal.

We’ve hauled the dusty board games out of the back of cupboards and spent hours playing and enjoying time together…unless it’s Monopoly. It always seems to start well, then ends in tears 😁. We’re reading, planting vegie gardens, catching up on new TV shows, enjoying a cup of tea in the garden, doing the crossword together – basically living much more simply.

We’re catching up with friends and family with long phone calls and video chats. I think this’s been one of the best things that has come out of the pandemic. Without the distractions of work, social obligations, kids sports and the busyness of pre-COVID life, we have a bit more time to catch up and really talk. This has been wonderful 😊.

And for those of us with a chronic condition, being able to stay home has allowed us to feel safe from the virus, but has also given us the time to reevaluate how we’re travelling. For example, how’s our pain management? Do we need to tweak something, try something new? Are we looking after our mental health? Should we try some mind-body techniques such as mindfulness or guided imagery? This pandemic has paused the world in some ways, but it’s given us an opportunity to check our health and wellbeing.

This time will pass. It’s going to take a while, but we can adapt. We’ve been doing it for months, and we can continue to do it. And rediscovering the small joys in our world will help us get through.

Contact our free national Help Line

If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealthmanaging your pain 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


vitamin-D-cap.jpg
18/Jun/2020

Most of us know that vitamin D is important. It’s like the other things we ‘know’ – when to use the word literally, which fork goes with which course, and what Pi is 😂. We sort of know vitamin D is good for us, but maybe not as much as we’d like. So let’s do a quick vitamin D refresher.

It’s important for our health. Among its many benefits vitamin D:

  • regulates the amount of calcium and phosphate in our body, necessary for healthy bones, teeth and muscles
  • helps protect us against osteoporosis, a condition that causes bones to become weak and lose their strength, making them break more easily than normal bones
  • supports our immune system
  • can reduce the risk of falls, important for all of us, but especially those with fragile bones or another musculoskeletal condition.

There are two types of vitamin D:

  • D3 (cholecalciferol) – formed in the skin by the action of ultraviolet (UV) light
  • D2 (ergocalciferol) – produced by UV light on plants and obtained through our diet.

In Australia our main source of vitamin D is sunlight. It’s important to expose our hands, face and arms to the sun every day. The amount of time needed to do this depends on where you live, the time of the year and the complexion of your skin. Because we also need to be careful that our sun exposure is safe and we don’t risk skin cancer, Osteoporosis Australia and the Cancer Council have developed a useful chart to help you work this out.

Vitamin D can also be found in small quantities in foods such as fatty fish (salmon, herring, mackerel), liver, eggs and fortified foods such as low fat milks and margarine. For most us though, it’s unlikely we’ll get enough vitamin D through diet alone.

Vitamin D – whether it’s from sunlight, food or supplements – is stored in our fat cells until it’s needed.

Why should we care about vitamin D?

First, for the reasons we mentioned above. And second, in case you haven’t felt it, it’s getting cold. Winter is upon us and we’re not exposing as much of our skin to the sun in most parts of Australia as we did earlier in the year – at least not without risking frostbite 😨

So we need to make sure we’re doing everything we can to get enough vitamin D during these colder months.

Most people, through every day exposure to the sun in the warmer months, will have created enough vitamin D to make it through the winter without becoming deficient. Yay!

For others however, it may take a more concerted effort to get enough vitamin D during winter. The best way to do this is to be active outdoors – e.g. going for a walk, working in the garden. You can also include foods that contain vitamin D in your diet. A dietitian can help you with this. They can also ensure your diet is healthy so that you get all the other nutrients you need.

Finally there are some people who aren’t able to get enough vitamin D through sunlight or diet, which puts them at risk of vitamin D deficiency. This includes:

  • elderly people – especially those who are housebound or in residential care
  • people who wear concealing clothing for religious or cultural reasons
  • people with certain health or medical conditions who need to avoid the sun
  • people with dark skin as their skin contains higher amounts of melanin, which inhibits the creation of vitamin D
  • people in occupations where they have limited exposure to natural sunlight throughout the day – e.g. taxi drivers, factory workers, office workers and nightshift workers
  • people with diseases that make it difficult to absorb enough vitamin D – e.g. cystic fibrosis, coeliac disease and renal disease.

If you‘re concerned that you may be deficient in vitamin D, it’s important to discuss this with your doctor. They can do a simple blood test to check your vitamin D levels. If you are deficient, it may be necessary to take vitamin D supplements for a period of time.

It’s important to note that if you’re not vitamin D deficient, there’s no reason to take vitamin D supplements. It’s possible to have too much vitamin D, so only use these supplements as prescribed by your doctor.

What does vitamin D have to do with COVID-19?

There have been reports that vitamin D may be useful in our fight against COVID-19, however the results of these studies haven’t been conclusive.

We know that vitamin D plays an important role in supporting our immune system. And in some recent studies people who’ve developed COVID-19 have been found to be vitamin D deficient. However these studies involved literature searches, analysis and observational studies – which are useful and provide valuable information – but can’t say with any certainty that vitamin D can help prevent people who are vitamin D deficient from catching COVID-19.

That’s because they can’t eliminate other important risk factors such as age, obesity and socioeconomic status (e.g. level of income, education, access to healthcare, housing).

However when researchers looked at the data of half a million people from the UK Biobank and adjusted for variables such as age, race, socioeconomic status and obesity, they found that ‘people with lower vitamin D have a higher risk of COVID infection, but it looks like this is explained by other risk factors and not by the vitamin D itself…our findings do not support a link between vitamin D concentration and the risk of COVID-19 infection.’ (1)

Professor Mark Morgan, Chair of the Royal Australian College of General Practitioners Expert Committee – Quality Care (REC–QC), has also been quoted as saying ‘at the moment, I’ve not seen any evidence that using vitamin D could prevent or treat COVID-19…I know that there’s a number of controlled trials that are being commenced to look into that, but we’ll have to wait for the results of those trials before we have any information.’ (2)

So at the moment, it’s a watch and wait situation when it comes to vitamin D and COVID-19. We need more information from randomised controlled trials that are able to tell us conclusively if vitamin D can protect at risk people from catching it.

And remember if you’re concerned about your vitamin D levels, discuss this with your doctor. Don’t start taking a supplement without their expert advice.

Contact our free national Help Line

If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealthmanaging your pain 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

References

  1. Exploring the links between coronavirus and vitamin D
    The New York Times, 10 June 2020
  2. Do vitamin D levels affect risk of infection and severity of COVID-19?
    newsGP 15 May 2020

Photo by Michele Blackwell on Unsplash


garden-gnome.jpg
18/Jun/2020

With our neighbours across the ditch resuming life in an almost pre-COVID normal – abandoning physical distancing and restrictions on gatherings – it’s hard not to feel a little envious 😏. They’ve recorded zero new cases of COVID-19 in more than two weeks. That’s longer than the incubation period of the virus, so they’re feeling pretty confident that SARS-CoV-2 (the virus that causes COVID-19) has been eliminated in New Zealand.

In Australia some of our states and territories have also recorded zero new cases in over two weeks or are getting close to this magical number. So can we expect Australia to follow in NZs footsteps and lose all restrictions any time soon? And does this mean we can get rid of this virus once and for all?

To explore this issue we need to understand some of the terminology that’s being used when we talk about getting rid of the virus – suppression, elimination and eradication. They’re sometimes used interchangeably in the media, but they’re quite different.

Suppression requires everyone in the community to physically (or socially) distance themselves. It also requires people who have COVID-19, and the people they live with, to socially isolate themselves from the community – that is, stay at home and don’t go out – until they’re COVID-free.

This is what we’ve been doing in Australia. It aims to flatten the curve so that our health system isn’t overwhelmed and we minimise the spread of the SARS-CoV-2 until a vaccine is developed.

On the 12 June 2020, a media statement from the PMs office stated that “National Cabinet recommitted to a strategy of suppression of COVID-19”. (1) This means that we’ll be continuing as we have up until now – testing and tracing, controlling outbreaks as they occur and slowly easing restrictions as active case numbers drop.

Elimination means that there are no cases in a specific area – e.g. a state/territory/country – for a specific period. The aim is to reduce any chance the virus can spread from person to person. NZ achieved this by putting in place strict lockdown measures for about 5 weeks early on in the pandemic, and gradually relaxing restrictions when active cases greatly decreased.

The incubation period – or the time from when you’re exposed to the virus to the time you start showing symptoms – is two weeks for SARS-CoV-2. NZ declared they had eliminated the virus after there were no new cases in 17 days.

It’s important to note that elimination doesn’t mean everything’s back to normal. The borders will still remain closed to overseas travel and testing and surveillance will continue to occur so that the virus hopefully doesn’t gain a foothold in the community again.

It also means that after a vaccine is developed for SARS-CoV-2 we’ll need to vaccinate people regularly, as we do with other infectious diseases such as measles or the seasonal flu. We don’t know yet if people who are exposed to this virus remain immune. We just don’t have the long-term data on this new virus. So we may need a national vaccination program (as we do with measles) or an annual vaccination (as with the flu) and continue to monitor for any emerging cases.

Finally, eradication means there are no cases anywhere in the world. This is what happened with smallpox. It took a worldwide effort to identify ALL smallpox cases, then vaccinate everyone who could have been exposed to it. It took many years but in 1980 the World Health Organization declared smallpox to be eradicated.

However eradicating COVID-19 may not be possible.

As Adrian Esterman, Professor of Biostatistics, at the University of SA wrote recently, “to be eradicated, a disease needs to be both preventable and treatable. At the moment, we neither have anything to prevent COVID-19 (such as a vaccine) nor any proven treatments (such as antivirals).” (2)

He also went on to say that “even if a vaccine does become available, SARS-CoV-2…easily mutates. So we would be in a situation like we are with influenza, where we need annual vaccinations targeting the circulating strains. The other factor making COVID-19 very difficult if not impossible to eradicate is the fact many infected people have few or no symptoms, and people could still be infectious even with no symptoms. This makes case detection very difficult… So while we may well be on the path to elimination in Australia and New Zealand, eradication is a different ball game.” (2)

Contact our free national Help Line

If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealthmanaging your pain 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

References

Photo by John Bussell on Unsplash


connections-lego-figures.jpg
18/Jun/2020

As a species we’re social creatures. We need our tribe – whether it’s a large extended family group and lots of friends, a small intimate group of nearest and dearest, or somewhere in between. We need our connections.

I think that’s one of the hardest things we’ve had to deal with during this pandemic. We’ve been forced to change how we connect with others. We kept away from our people for months, and now that we can gather, we’re told to keep a distance, don’t touch, hug or shake hands. It feels so unnatural.

That’s the insidiousness of this virus. It’s infiltrated our world and affected the very fabric of our connectedness.

I need to make a confession – I’m incredibly sad as I write this blog. My aunt died today. She was a beloved mother, sister, grandmother, aunt and – like me – a crazy cat lady. She’s been unwell for quite some time, and I haven’t been able to see her for months. With isolation and the very real risk of spreading the virus to someone who was already so unwell, it was not a risk we could take.

And so she died, this wonderful, kind, most incredibly well-read woman. Without all of her family around her. And I’m so very sad.

I know I’m not unique in this situation. So many people have died during this pandemic – due to COVID-19 as well as the many other reasons people leave our world every single day. But sitting at home on a cold Sunday afternoon, I can’t help but reflect on how terribly sad this whole situation is.

We’ve missed, and will continue to miss, our celebrations and milestones. Weddings have been postponed. Babies have been born with far less fanfare than would normally happen. Special birthdays have been and gone without the usual fuss. Students have finished courses, aced exams or have mastered a difficult skill without the jubilant gathering of family and friends to celebrate. And funerals have occurred with only a small number of mourners allowed to attend in person.

And it’s not only the milestones and celebrations we’re missing. It’s the small events, the little encounters that go to the very heart of who we are. The big events are important, but the small things, the everyday incidental stuff with workmates, neighbours, friends, family – they’re the things that make our lives rich.

So we need to find ways to ensure our milestones, gatherings, phone calls, video chats and every day encounters carry as much joy, love, sadness, real emotion and connection as they possibly can.

Celebrate and bask in the little things. Share your day – the highs and lows with your partner/kids/closest friend – and really listen as they do the same. Take time to sit and reflect on what’s been happening in your life and those close to you. Even though it may feel like life is moving slowly at the moment, it’s moving quickly – can you believe it’s almost the end of June? – and so much can happen in a day, a week, a month. Don’t let these moments pass you by.

Tell those close to you how much they mean to you. Extend that support and kindness beyond your own bubble to those you encounter at the supermarket, when you’re driving, talking with your child’s teacher, or when you’re in a work meeting. We’re all dealing with all kinds of stuff – big and small – so let’s discard the petty annoyances and frustrations.

We’re still some way from finding a vaccine or treatment for this virus. It’s vital we continue to support and care for each other in this new normal we live in.

Life is short, and although it’s changed so dramatically, we have so much to be thankful for.

Contact our free national Help Line

If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealthmanaging your pain 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.

Crisis support

If this article has raised some issues with you or you feel like you need help during this stressful time, there’s help available. Contact Lifeline Australia on 13 11 14 for 24 hour crisis support and suicide prevention. https://www.lifeline.org.au/about-lifeline/contact-us

More to explore

It’s okay to feel sad
Better Health Channel

Photo by Hello I’m Nik 🎞 on Unsplash


immunity.jpg
11/Jun/2020

Every day we’re exposed to millions of microscopic germs – bacteria, viruses, fungi, parasites. Our immune system protects us from them so that we don’t get sick.

But sometimes a germ (or pathogen) is able to get into our system – through a cut, from breathing in droplets from someone’s cough, or if our immune system has become weakened.

When this happens, our body launches an attack.

It starts with the white blood cells (or leukocytes). They’re our germ fighting cells. They patrol the body looking for foreign bodies like viruses. When they come across one, they immediately start to multiply. While they do this, they’re also sending signals to other immune cells to saddle up and get ready for battle.

There are two types of white blood cells: phagocytes and lymphocytes.

Phagocytes are hungry little buggers that eat pathogens for breakfast. They do this by surrounding the cell and absorbing it. When they do this they receive information from the proteins on the surface of the pathogen. These proteins are called antigens (or antibody generators). Phagocytes then send this info to the lymphocytes.

There are several types of phagocytes including neutrophils, monocytes, macrophages and mast cells. They all play important roles in the immune system.

Lymphocytes can be divided into B cells (they’re created in Bone marrow) and T cells (they’re created when they travel from the bone marrow to the Thymus).

B cells create antibodies. Antibodies neutralise the antigen by binding to it and disabling it. The antigen and antibody fit together like a key in a lock. As with a specific key working for a specific lock, there’s only one antibody that can fit each type of antigen.

T cells kill any of your infected cells. There are different types of T cells who have specific jobs in the immune response: Helper T cells and Killer T cells.

Helper T cells help…they send instructions to the other immune cells to help them get coordinated. They tell the B cells to create antibodies. They tell the Killer T cells to do what they do best – kill or destroy the cells infected by the pathogen. And they tell the phagocytes (specifically the macrophages) to join the party for a tasty pathogen feast.

When the battle is done and dusted, your body will keep copies of the antibody it created against this pathogen. That way if you encounter it again, you have a defence against it.

That’s your immune system in the very briefest of nutshells. It’s a highly complex, involved system that includes a lot of other cells, organs and body parts. Check out the More to Explore section for more info about the immune system.

Giving the immune system a head start – vaccines

Vaccines work by introducing your immune system to a virus or bacteria. This allows it to learn how to protect you from the pathogen before you meet it out in the world. A vaccine is a weakened or inactivated version of the pathogen. It causes your body to create antibodies. We have many vaccines at our disposal for diseases that cause people to get seriously ill – including measles, flu, tetanus, typhoid and polio.

There are currently more than 100 labs around the world researching and developing a vaccine for COVID-19. Read our blog to find out more.

When things go wrong – autoimmunity

Sometimes the immune system gets it wrong. Instead of attacking something foreign, like a virus or bacteria, it attacks healthy cells and tissues in the body. This is called autoimmunity. The attack causes inflammation and damage to the cells.

We don’t know why the immune system attacks its own body, but it’s thought that it may be the result of genetic factors (or things you’ve inherited) and something from the environment (e.g. a bacteria, virus or some medications).

There are many autoimmune conditions that are the result of a malfunctioning immune system. They include rheumatoid arthritis, lupus, ankylosing spondylitis, juvenile arthritis, Sjögren’s syndrome, coeliac disease and type 1 diabetes.

Stopping the spread of disease – herd immunity

There’s been a lot of talk recently about herd immunity – especially around COVID-19. But what does it mean?

Simply put herd immunity means that a large proportion of the population (or the herd) is immune to the disease. This can happen if they’ve been vaccinated or they’ve had the disease and are now immune to it. When most of us are immune to a disease, the disease isn’t able to spread as easily from person to person. The people who are immune create a buffer between the disease and those who can’t be vaccinated.

By building up this herd immunity, we not only look after ourselves (if we’re able to be vaccinated) but we help protect those who are vulnerable to infectious diseases – including babies, people with compromised or suppressed immune systems and older people.

The number of people we need to be immune to a disease to achieve herd immunity – the herd immunity threshold – varies from disease to disease. It depends on how easily transmissible and how infectious a pathogen is. For example, in the case of measles we need 92-95% of the population to be vaccinated because it’s incredibly infectious and the virus can survive outside the body for up to two hours. So even if you’re not in the room with an infected person, if you touch a surface that they’ve coughed or sneezed on, you can become infected if you’re not immune to the measles virus.

We don’t at this stage know what the herd immunity threshold will be for COVID-19. Estimates currently suggest around 60%. However we also don’t know if people remain immune to COVID-19 after they’ve recovered from an infection. So it may be that we only truly reach herd immunity if/when a vaccine is created and administered to the majority of us.

As with so much to do with this virus, we’re still learning and gathering data.

Contact our free national Help Line

If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealthmanaging your pain 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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