SEPTEMBER 2021 - 1
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Feature Intro: Living with Arthritis: Less Pain and More Freedom for the Life You Love OutreachNC readers have long appreciated the columns provided by physical therapist Dr. Sara Morrison of Total Body Therapy and Wellness in Lillington, NC. Dr. Morrison has written for ONC on the benefits of physical therapy for issues such as migraines, lymphedema and correcting posture. This month, Dr. Morrison’s new book, Heal Your Arthritis, Live Your Life, arrives on shelves and in the hands of many who live with arthritis or have a loved one living with this painful condition. Dr. Morrison’s decades of experience as a physical therapist enable her to share with patients, readers and the community her insight and professional experience with arthritis, giving readers hope for improving quality of life and living fully with a diagnosis of arthritis. We appreciate Dr. Morrison’s perspective, experience and advice for treating the whole body and person. We so often focus on one spot of pain, but as Dr. Morrison explains, the whole body must adjust when one part is out of balance. Dr. Morrison helps us find hope after a diagnosis of arthritis and explains how we can keep engaging in our lives, doing the things we love and managing arthritis in ways that keep us active, lessening pain and building strength along the way.
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CONTENTS
ASK THE EXPERT: DEMENTIA CARE THERAPIES FEATURE: LIVING WITH ARTHRITIS FAITH: WHO NEEDS SOME TAPE?
LETTER FROM THE EDITOR
Amy Phariss, Editor-in-Chief, OutreachNC | editor@outreachnc.com
SEPTEMBER 2021 - 2 September is here and in full swing. I can hardly believe it. The summer flew by, one hot, rainy, muggy day at a time. Suddenly, we’re thinking about apples, leaves turning color and the possibility of sitting outside without mosquito bites and the size of our hair tripling in under five minutes. It’s still a few weeks off but hope springs eternal. This month we sat down with Dr. Sara Morrison, a Harnett County physical therapist who has recently written a book on living (and thriving) after an arthritis diagnosis: Heal Your Arthritis, Live Your Life. Dr. Morrison gives ONC readers hope for the possibility of less pain, more activity and richer lives with an arthritis diagnosis. Dr. Morrison has treated hundreds of patients over the years, giving her a unique perspective about how to treat arthritis, potentially avoiding shots, surgeries and limited mobility. Care Management Associate Ashley Seace answers a reader’s question regarding Dementia therapy in this month’s Ask the Expert. Seace explains the differences between therapies and how therapeutic interventions can strengthen independence for not only clients but also caregivers. Colette Bachand takes us back to our preschool days with a story about a snail, the power of tape and the role of God in helping fix our own proverbial booboos in life. As we say goodbye to summer and welcome fall, I think of L.M. Montgomery’s words:
“ It was a lovely afternoon - such an afternoon as only September can produce when summer has stolen back for one more day of dream and glamour.” Here’s to one more day of dream and glamour.
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ASK THE EXPERT: DEMENTIA CARE THERAPIES
Ashley Seace, Care Management Associate | ashleys@aoscaremanagement.com
SEPTEMBER 2021 - 4 Question: I am a healthcare professional and work with a variety of different Dementia patients. I am looking for more information on the types of Dementia, what to expect and which therapies may be beneficial to the individuals I work with and their families. Any information you can share would be helpful. Answer: This is a great question! The different types of Dementia may exhibit differing behaviors and respond better to particular types of therapies. During a recent webinar with the Dementia Care Alliance of North Carolina, Latoya Galberth of Galberth Health provided some information that may help you determine the best course of action for the individuals you work with. Understanding the language and acronyms of Demential treatment options is a great first step. The difference between therapy and rehabilitation, for example, is key in understanding how best to treat Dementia. Therapy is used to remediate a health problem that follows a medical diagnosis. Rehabilitation is used to help an individual become as independent as possible in their everyday activities through education, work, recreation, and meaningful life goals. There are different acronyms used for different types of therapies. Each therapy covers a specific challenge or area. The most commonly used therapies are physical therapy (PT), speech-language pathology/speech therapy (ST), and occupational therapy (OT). Physical
therapy is comprised of movement experts use to enhance mobility and function through prescribed exercises, hands-on care, and patient education. This could include mobility activities, home assessments, or movement coordination skills. Speech therapy is devoted to preventing, assessing, diagnosing, and treating speech, language, communication, cognitive, and even swallowing disorders. This could include diet modifications, word-finding tasks, or impulsivity control. Occupational therapy works to build and/ or restore the ability to perform day to day activities, and develop, recover, improve, and maintain those skills. This could include self-care tasks such as bathing and dressing, home safety assessments, or behavior management. As you have probably experienced, individuals living with Dementia have some characteristics and behaviors that may be helped by these different therapies. You may have noticed behaviors including slowed movement, story repetition, impaired recall, difficulty with self-care (bathing, dressing, toileting, grooming), poor balance or fall risk, or a decrease in social participation and community outings. In order to determine what therapy would best suit the individual, you will need to look at their Dementia diagnosis. Based on the specific dementia diagnosis, the individual can benefit from different therapies. For instance, someone living with Alzheimer’s Disease will respond differently to therapy than someone living with Frontotemporal Dementia because their brains are affected differently. If both of these individuals are having trouble with communication, someone with Alzheimer’s may respond better to a speech therapist and not an occupational therapist like someone with Frontotemporal Dementia
SEPTEMBER 2021 - 5 might. Or certain behaviors in Alzheimer’s, Vascular, and Lewy Body Dementia may be managed with help from a physical therapist or occupational therapist, but a speech therapist could be of help to someone with Frontotemporal Dementia. What does the individual need? Transfer capabilities? Communication enhancement? Help with self-care tasks? Or does the family need handson training and education? There are therapists for each of these issues! Regardless of the diagnosis, seeking out a professional can yield positive results. The different therapists can provide education, skill support, and resources to the caregiver as well. Professional therapists can provide support for the caregiver who is working on these tasks outside of the sessions with a therapist. A care manager is another professional who can help with maintaining autonomy as one ages. Care managers can provide social services, care planning, coordination of care and resources, and advocacy for the individual. The benefits of therapy in Dementia Care can far outweigh any negatives. Therapy leads to an improved quality of life through building strength, increasing the
ability to communicate, or maintaining the necessary skills for daily living. Not only is a patient’s physical quality improved, but they can also maintain their dignity and independence, which is something everyone desires as they age. The caregiver’s burden is decreased as the individual’s quality of life improves. The caregiver may no longer feel the burden from having to do every task for the individual.
Therapy does not just relieve the burden of the caregiver; it relieves the individual’s feeling of being a burden to their caregiver because they are able to complete different tasks for a longer period of time and maintain their independence. Overall, working with your client or family member to regain independence back through therapeutic means, regardless of the type of therapy, will strengthen the relationship you have with them. Building that relationship is one of the most important and beneficial things you can do for someone during the aging process.
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SEPTEMBER 2021 - 6
LIVING WITH ARTHRITIS: Less Pain and More Freedom for the Life You Love by Amy Phariss This interview has been edited for length. OutreachNC: Thank you for sitting down with us. We’re excited to chat with you because you have a new book! Tell us about your book: Heal Your Arthritis, Live Your Life. Sara Morrison: I’ve been a PT in Harnett County for 19 years. In my clinic, we’re really into getting people back to normal, doing their normal activities without medicine, shots and surgery. With this new book, I am just trying to show people there are other options besides medication, shots or surgery. Sometimes, people don’t know all the information, and I feel like helping people get that information means they can make better choices when it comes to their health.
an injury and know it can get better; they don’t see arthritis the same way. They see arthritis as a dead end. No matter what you think about natural healing, a lot of people think arthritis is in a different category and there is no hope for that. They don’t see the possibilities for healing and improvement when it comes to arthritis the same way they see healing knee pain or back pain, for example. ONC: How do you see that hopelessness affecting lives?
When people hear arthritis, they feel like there is no hope. They think they’ll have it the rest of their life, that they won’t be able to do what they love, that they have to give up what they love.
SM: I think a lot of people start out being really active. They go to the gym or are active in their yard. Then, they let one thing slide. They don’t feel like going to the gym or gardening. Then, it’s easy to let another activity slide. One by one, the list gets longer. Over time, they’re sitting on the couch. For a lot of people, the activities they limit are the things that gives them joy. So, the arthritis is not only limiting what they can do but taking those joyful and social activities away.
Even patients I’ve had in the past who know they have
The more they limit, the more they end up staying on
SEPTEMBER 2021 - 7 the couch. Then, the more by themselves they are, the more isolated they feel. Then we have loneliness and depression symptoms coming in.
A treatment is about 10 minutes. Usually after that, your pain is cut in half. So, if you were at an 8/10 pain when you came in, you would be around a 4/10 after using the deep tissue laser.
ONC: So, it’s like a connected circle?
It’s also safe for everybody. It’s safe for people with diabetes, if you have a metal implant, if you have or had cancer in the past, or if you have a heart condition. If you have one of those issues, you often can’t get certain treatments. If you have heart issues or diabetes, for example, treatments can be restricted, but the laser is good for anyone. It’s good for new pain or even old pain.
SM: Exactly. I have a chapter in my book called “The Vicious Cycle.” It starts with having pain, so you move less, so your joints get stiffer, and your muscles get weaker. The cycle keeps going. And then you throw in the psychological and mental components. It ends up spiraling out of control. Suddenly people don’t know where to go or what to do. They think I have arthritis. I can’t do this.
We have a lot of folks with old injuries, and it works fantastic on those. We have a lot of veterans in the area or people who’ve been active their whole lives. Farming for example. It’s a great treatment for chronic pain, even if that pain has been ongoing for quite some time.
ONC: What things do you see people most often avoiding?
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ONC: What is a deep tissue laser? SM: It’s a laser light. It’s not a cutting laser. It’s a light that shines in your body and targets your “T-cells” or healing cells. It helps your T-cells grow bigger and multiply, so it’s increasing your body’s natural healing ability. It doesn’t block the pain like medicine does. It increases healing capacity.
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SEPTEMBER 2021 - 8
What does
DEEP TISSUE THERAPY help with?
Enhanced relief of pain and inflammation associated with: Muscle Knots / Tears Carpal Tunnel Syndrome Shin Splints Tendonitis Plantar Fasciitis Disc Injuries Strains & Sprains Lower Back Pain Shoulder Pain Bursitis Soft Tissue Damage Patellofemoral Syndrome Sports Injuries Sciatica ...and much more!
ONC: What do you think is the biggest myth about arthritis? SM: I think the biggest myth is that there’s no hope for arthritis. There’s this myth that once you have it, the pain is going to stay and there is no hope. But once we can start to improve your pain, we can get those muscles working. Then we can get your strength back and get your pain down. What usually happens with arthritis is that you get into that vicious cycle. So, all of the pressure gets put on the bones when you don’t have muscle to help you. Once we can get the pain down, we can build your strength. Then, there is muscle to absorb some of that pressure. This places less pressure on the bones, less pressure on the arthritis. So, we can’t necessarily get rid of arthritis, but we can take the pressure off the bones so that when you move it doesn’t hurt. Also, one of the other myths relates to control. People think: I can’t control when I hurt. This is usually very frustrating. You are going to have good days and bad days, but physical therapy can teach you to prevent those bad days from happening. We can also teach you what you should do on good days and bad days. These are little changes you can make, small things you can do daily to make bad days better. We can help you understand what you should do on good days and what you should do on bad days to make sure you don’t get worse. You also want to prevent yourself from having more bad days. ONC: What is an example you can do on a good day, for example, to keep your pain at bay? SM: Taking breaks. If you have to clean your whole house, clean for 20 minutes and then sit down for five minutes. Take a big task and break it up a little bit at a time. By doing this, you’ll be able to do more throughout your entire day. But sometimes if you just try to clean the whole house, you’re in so much pain, you’re done doing any activity for the rest of the day. If you take breaks, you will actually be able to get more work done by the end of the day and still feel good.
SEPTEMBER 2021 - 9 ONC: What about on a bad day? SM: On a bad day, the most important thing is your safety. It’s okay that you could do something yesterday but can’t today. You need to listen to your body. When people try to push themselves, they will often have a flare up of pain or even fall. If you listen to your body, and you don’t think you should do something that day, scale it back. Take a break. However, it’s important to move and stretch even on bad days. If you usually do 10 repetitions of an exercise, you can try to do three. Even a little movement will really help with that pain. Patients will tell me: I want to go to the beach! I haven’t been in so long. I want to see the ocean. I tell them: you can go! You may not be able to run along the water, but you can still go. You can still be there. You can have that community with your loved ones.
ONC: For someone who has arthritis, what is the best-case outcome? SM: There are a lot of people who don’t have to stop doing their activities. We can help them get on an exercise program that allows them to stay at the activity level they are at. They can still golf, do yard work and play with grandkids. Once you learn how to manage your lifestyle, you can still do what you love. It’s never too early to start. Once you get diagnosed, you can see a physical therapist and begin working on a program for your lifestyle and your needs. If you have been suffering for years and you’re stuck on the couch, we can get you back up. We just start little by little. If you talk to anybody and think, wow, they’re doing well for their age, I guarantee that they’re doing things to keep themselves healthy and active. It doesn’t happen by accident. That person has made a choice to make functioning a priority. Anybody can make that choice.
ONC: How much of managing pain and thriving is mental? SM: A lot. There’s a lot. What we have to do is help get people motivated. We have had patients who may have had a poor attitude or lack of motivation. Physical therapists are trained in helping people understand the importance of therapy and build buy-in, change the attitude. There’s a part the person has to do themselves, but we’re used to dealing with people with various attitudes and emotional states. If you’re not there yet, we can help you get there. I tell people: all you have to do is come in. You just have to show up. We can’t get you here, but once you’re here, we can help.
ONC: Why did you write this book? SM: You know, I wrote this book because I see a lot of people who were active and were very optimistic, and once they get diagnosed with arthritis, they just feel hopeless, they feel like it’s a dead end. I wanted everyone to know there is hope for arthritis. It’s not a dead end. There’s a lot you can do to keep living and to enjoy life.
ONC: What would you say is the biggest barrier to treatment? SM: The biggest barrier is usually someone who doesn’t want to get better. Everybody says they want to get better, but sometimes people are used to being sick or not getting around well; they don’t believe they can get better, so they don’t try. Although we can help you quite a lot, it has to be a two-way street. It’s amazing when you have a patient who does everything you tell them; it’s amazing how quickly they get better and the level they can get to! Whenever anyone comes in, I never think: this is hopeless.
SEPTEMBER 2021 - 10 There is always something to help you function better. Even if you’re someone who ends up needing to get a shot or having surgery, if you have tried the natural route, you’re going to be very secure that you know that’s the road for you. You’ll know you tried. You’ll feel more secure about it. Also, a lot of surgeons, even if they want you to have surgery, are having you start PT before surgery because it makes rehab after surgery so much less painful.
ONC: Are there any surgical options for arthritis? SM: There are plenty. There are a host of injections to get, and there are joint replacements. We see a lot of people with knee, hip or shoulder replacements.
ONC: Can you avoid these surgeries with PT? SM: Yes, many times you can. There are always cases where you need the surgery, but there are a lot of people who avoid these surgeries through PT. Injections are helpful to avoid pain medications, but you often can only get them a few times a year. There are reasons they don’t want to put that medication inside your body too often. There are always side effects. So, physical therapy can help avoid those.
For example, if you’ve had knee pain for years, you’ve been walking funny for years. That affects a lot of your body. Your hips and back are affected and the pain can spread. If this is the case, putting an injection into the knee won’t help those other parts of your body that compensated for that knee pain. By the time symptoms get out of control and we seek help, we have several issues. It’s important to understand that when this happens, there isn’t one magic fix. You have to have someone who is going to look at you as a whole person and not just one little spot. It’s not just the knee. It’s the whole person. The knee arthritis is throwing off your walking pattern, which will affect the knee, the hips, the back. So, even if you have the knee replacement surgery, you still have to treat the walking pattern and the other areas that have been affected. So, people think that if they have a knee replacement, everything will be fine, but that’s not necessarily true. And then people think the knee replacement didn’t work. If you have three problems and we only fix one, you’re not going to be better.
ONC: Do you see a lot of frustration in your patients? SM: Yes, in different ways. Once they finally come to someone who is going to look at their whole body, they’re thankful. Then they get frustrated and they say: why did nobody do this before? Why hasn’t anybody told me this before? We try to honor that frustration and just start from this point. We cannot change the past, but we can change your future. We just start from today and move forward. This can sound like a long process but it’s not. You think you have a lot of problems, and you think it will take a long time to get better, but once you get moving, they get better faster than you think.
SEPTEMBER 2021 - 11 ONC: And probably, by addressing them all, you can take a more holistic approach so the issues can heal together.
™
SM: Exactly. Things are all connected, so when you start working them as a group, they all start to get better. Then, people get excited. They start walking more and working in their yard more, and they get their motivation back. They see they can do more, and that makes them want to do more.
6th annual
fundraiser event!
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ONC: Is arthritis only present in the elderly?
Once we know what’s going on, we can start with | a regimen of pain control, strengthening and stretching.
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There is always a level of exercise you can do. For some people, exercise is standing up from a chair. For other people, it’s push-ups. There is always something you can do. So, we find out your starting point, where you’re at, and then we progress.
™
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For your donation of $25, we will purchase a mum in honor or memory of a loved one, local care facility, ™ caregiver or front-line worker. |
We now have diagnostic ultrasounds that we can use over the joints. With this technology we can see what’s going on inside the joints. We can see how the joint looks at rest and we can also see what happens when it moves! So, if someone has arthritis in the elbow, for example, we can do an ultrasound and see what’s going on with the joint, is there a nerve being pinched, is there a tear?
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SM: No, it’s not. There are a lot people who have arthritis in their family, so they can get it at an earlier age. There are also some kinds of juvenile arthritis, so these people can get that as a teenager. Osteoarthritis and rheumatoid arthritis are the most common types, but there are multiple kinds. It also depends on your activity level. A lot of times, military veterans or those who’ve had active, labor-type jobs, maybe an old accident as a teenager, they’ll start to notice symptoms in their 40s.
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AOS & Friends Care was incorporated and approved by the IRS as a 501(c)(3) tax exempt nonprofit in 2015. Our Mission is to raise awareness and provide direct care and community support to older adults, with a focus on those with dementia.
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The Rev. Colette Bachand | cwood@penickvillage1964.org
FAITH: WHO NEEDS SOME TAPE?
SEPTEMBER 2021 - 12 My daughter works in a preschool and recently told me the funniest story. While outside one morning with the children, they found a snail in the woods, and she suggested they bring it into the classroom to watch it. She put in on a tray, and they gathered around it. “Shhh,” she told them, “We have to be very quiet. Snails don’t like a lot of noise.” I’m pretty sure she made that part up, but the little ones were so quiet and still, watching the slimy little guy drag its big shell slowly across the tray. After some time, my daughter was called away to something else, and a few minutes later heard one of the boys say, “Don’t touch it.” When she returned to the table, the children had wandered off to do other things, except for one little boy. She noticed the tray with the snail had been turned over. She lifted the tray to find the snail had been smashed, its shell broken into lots of little pieces. “Oh,” she said, “That’s too bad.” The one little boy who had remained at the table looked up at my daughter and said, “He needs some tape.” He needs some tape. Don’t we all?
While it’s unlikely tape would have helped the little snail, her story got me thinking about the ways our faith helps keep us, literally, together when we feel scattered and broken … changes, times of grief, health challenges, separation from family, strained relationships, all can leave us feeling upended like that snail, with our outer shell scattered and broken. But time and time again, I find that God is the tape that puts me back together when things like that happen. God is the tape that keeps me intact when I think I might unravel. God nourishes and heals, and puts me back on the path I’m meant to travel. With God as my tape, I remain hopeful, able to see the big picture, and conclude that somehow everything will end up ok.
It’s so easy for me to forget that God will always, always, show up with a roll of tape… sometimes scotch tape, but other times duct tape when things have gotten really bad. It’s often hard for me to remember, like the little boy suggested, that sometimes all I need is a little tape, but then I remember, that God is always there to ask, “How big a piece do you need?”
SEPTEMBER 2021 - 13
GRAY MATTER GAMES
ACROSS 1. Samurai code 8. Ice covering mountain peaks 15. Bromo ingredient 16. Mosque’s tall, slender tower 17. Removed from view 18. Exploitative employer 19. Flexible 20. 1969 Peace Prize grp. (acronym) 22. Method of frying 23. Disney dog 24. Grave marker 26. Boris Godunov, for one 27. “... ___ he drove out of sight” 28. Whenever 30. Charlotte-to-Raleigh dir. 31. Allergic reaction 33. Showing even less
emotion 35. Increase, with “up” 37. “Idylls of the King” character 38. Abstruse 42. 10 to the 100th power 46. 40 winks 47. Yo-Yo Ma, e.g. 49. Altdorf is its capital 50. Attracted 52. Discourage 53. Carpenter’s groove 54. Hungarian language, e.g. 56. Undertake, with “out” 57. Red Square figure 58. Information displayed on an electronic device 60. Oily, poisonous ingredient in rubber 62. Accord 63. Keel-shaped ridges
64. Less forgiving 65. Tools for raising the nap DOWN 1. Utters incoherently 2. Forget 3. Straphanger 4. Good to have around 5. Gross 6. Conk out 7. Something very unusual 8. Rude 9. Cloak-and-dagger org. (acronym) 10. Aims 11. 200 milligrams
12. Excited 13. Solvent derived from petroleum 14. Helmsman 21. “___ go!” (contraction) 24. Displayed a scornful expression 25. In the middle of 28. Montezuma, e.g. 29. “Four Quartets” poet 32. “C’___ la vie!” 34. Altar avowal (2 wds) 36. Architectural feature 38. Carries on despite hardships 39. John Singer
___, Am. portrait painter 40. Run 41. Game name 43. Purine base found in DNA 44. Fifth, e.g. 45. Disney’s Nala 48. All together 51. Dentist’s request 53. Shops selling readyto-eat food 55. N.Y. neighbor (abbrev.) 57. 100 kurus 59. Adaptable truck, for short 61. Dumfries denial
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• Pay Bills • Track income & expenses • Maintain accurate financial records • Organize tax information • Manage the administrative tasks surrounding your checkbook
We value your trust and loyalty. Our commitment to your safety remains our number ONE priority. We're excited to welcome you back to a safe We are happily accepting new patients!
"As daily money managers, we create and maintain a road map of your finances."
Anne Seline 910.683.0606
305 Page Road | Pinehurst, NC
APSeline@EDCNB.com EveryDayChecksandBalances.com
Our Practice Is Your Solution “I’m passionate about making sure my clients know about resources available to them, including legal documents that will help them maintain control and dignity as they age and experience life’s twists and turns.”
4 SIGNS YOU MAY NEED A CAPTIONED TELEPHONE 1 2
You frequently ask your caller to repeat themselves. Caller voices seem quiet or muffled, even at max volume.
3
You struggle to catch every word over the phone.
4
You avoid making phone calls.
Get your CapTel phone at
captelnc.com
Margaret “Mia” Lorenz Attorney at Law MLorenz@LorenzCreedLaw.com CAPTEL 840i
FEDERAL LAW PROHIBITS ANYONE BUT REGISTERED USERS WITH HEARING LOSS FROM USING INTERNET PROTOCOL (IP) CAPTIONED TELEPHONES WITH THE CAPTIONS TURNED ON. IP Captioned Telephone Service may use a live operator. The operator generates captions of what the other party to the call says. These captions are then sent to your phone. There is a cost for each minute of captions generated, paid from a federally administered fund. No cost is passed on to the CapTel user for using the service. CapTel is a registered trademark of Ultratec, Inc. NC Department of Health and Human Services • Division of Services for the Deaf and Hard of Hearing • ncdhhs.gov/divisions/dsdhh • NCDHHS is an equal opportunity employer and provider. • 04/2021
H STA O Y AN M E I N D LO YO SA N U FE G E R R R
SEPTEMBER 2021 - 16
910.499.0399
Your Cer tifie d Accessibilit y Spe cialist s Ser ving All of Nor th Carolina
ACCESSIBILIT Y SOLUTIONS TO FIT YOUR NEEDS
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