Winter 2013

www.arthritiswa.org.au

ArthritisToday

Gentle Yoga for Arthritis

On Empathy, Stigma & Chronic Pain

Pathology Testing for Biologics

The Importance of Stability

with

The original Rose-Hip Vital™ with GOPO® imported fromDenmark is a powerful anti-oxidant and may help:

4. From the Desk of the Executive6. Latest News7. Feature Story: Pathology Testing and the New Biologics10. President’s Report13. Feature Story: On Empathy, Stigma and Chronic Pain16. Events21. AO Youth: The Kope Programe20. Volunteers21. Health and Lifestyle: The Importance of Stability Gentle Yoga for Arthritis Kirsty’s Recipe25. Upcoming Events27. AJ Smith Society30. Country Rheumatology31. Support Groups

Contents

22. The Importance of Stability

FEATURED THIS ISSUE

7. Pathology Testing and the New Biologics

13.On Empathy, Stigma and Chronic Pain

facebook.com/ArthritisWA twitter.com/ArthritisWA

with

The original Rose-Hip Vital™ with GOPO® imported fromDenmark is a powerful anti-oxidant and may help:

Arthritis & Osteoporosis WA

Arthritis Today is published by Arthritis & Osteoporosis WA.

Address: 17 Lemnos Street, Shenton Park, WA 6008

Postal Address: P0 Box 34, Wembley, WA 6913

Tel: (08) 9388 2199 Fax: (08) 9388 4488 Toll Free: 1800 011 041 (Country Callers only)

Website: www.arthritiswa.org.au Email: general@arthritiswa.org.au

President: Dr J Edelman MBBS FRACP Executive Director: Mr R Forlano CPA BCOM AICD Copyright: Articles appearing in this publication may be reproduced subject to written agreement from Arthritis WA. Arthritis WA retains editorial control over its content.

Board

President: Dr J. Edelman MBBS FRACP Vice President: Dr I.D. Froyland PhD(Crim), MA(Psych), Dip Ed Hon Treasurer: Ms Silvia Caratti B Com FCA MBA Members: Prof. R. Prince BSc MB ChB Birm.; MD Melb, FRACP, MRCP(UK); Dr B. Langlands MBBS FRACP; Dr Margaret Mazur MD FRACP; Mr Brad Gordon SA (Fin.), Fdn DFP, MAICD; Ms Debbie Borshoff BA (UWA), Dip Ed

Production

Arthritis Today is published by Arthritis & Osteoporosis WA. This magazine is designed by kembercreative. This magazine is printed by a “Level 2 Green Stamp” environmental accredited printer, using petroleum free vegetable based inks and 33% green electricity generated from solar panels. The paper is sourced from FCC accredited sustainable and well managed forests and is 100% recyclable.”

Mission Statement

The objective of Arthritis & Osteoporosis WA is to reduce the incidence and disabling effects of arthritis, osteoporosis and related conditions in the people of Western Australia through programs in Care, Education and Research.

Advertising Policy Statement

Products and services advertised in Arthritis Today are not necessarily recommended by Arthritis & Osteoporosis WA. Some readers may assume that anything that is advertised in these pages has been cleared, vetted or in some way approved by the charity. This is not so. Arthritis & Osteoporosis WA is not equipped to test and approve products and services that are available to the general public. Please exercise your own judgment about whether the item or service advertised is likely to help you personally and, where appropriate, obtain professional advice from your doctor or specialist before purchasing.

Welcome to our Winter Edition of Arthritis Today. I hope you find much that is informative and helpful in managing your condition.

In this issue, our leading article talks about pathology tests, something we all do with some degree of regularity. But if you are being treated with one of the new biologic agents to better control one or other of the many auto-immune diseases, these tests take on an added dimension.

Pathology testing is critical not only to ensure your treatment regime is working effectively but that your general health is maintained. You should read it with interest.

Less technical, is the article about yoga and the beneficial effects this form of exercise can give you. The

Gentle Yoga for Arthritis article talks about how this kind of gentle exercise has been shown to help people with arthritis by soothing their bodies and promoting a positive outlook.

And then there is this article… Why do I get annoying ‘niggles’ of pain when I increase the distance I run? …and no, it’s not simply a case of running too far too soon. The issue is quite complex and deserves a read even if you’re not about to run a half marathon or walk the Bibbulmun Track.

Welcome then to our Winter issue of Arthritis Today, packed with information by our Rheumatologists and our Health Professionals plus news from both here and abroad, news of coming events, of upcoming seminars and so much more.

As I said, there is much of interest. Enjoy.

Ric ForlanoExecutive Director

From the desk of the

Executive Director

4

5Arthritis Today | WINTER 2013

Latest New

s

Australian-first solution for osteoarthritis sufferers Millions of Australians battling

with osteoarthritis and joint pain

will benefit from an easy-to-use

website which offers people a chance

to help gain control over their pain.

MyJointPain.org.au was developed as a result of a unique collaboration between Arthritis Australia and the Bupa Health Foundation. Olympic basketball star and Australian Opals captain, Lauren Jackson understands the importance of taking action to manage joint injuries which can lead to osteoarthritis. “My journey through injury has been extremely frustrating and I know what it’s like not to be able to walk. The support of my health care team has been so important in helping me cope and recover. The MyJointPain.org.au website is like having your own dedicated team there to develop a personalised plan that can help manage pain and other symptoms.”

“Whether you’re living with osteoarthritis or joint pain day-to-day, or dealing with it through sport injuries, having an action plan and support is extremely important,” said Jackson.

The website and online tools are based on the combined knowledge of a committee of medical and scientific experts in key areas of surgical, scientific, allied health, medical and consumer advocacy to provide leading advice for osteoarthritis care.

MyJointPain.org.au offers three major support functions. Firstly, the user will answer questions about their situation, they then receive a summary of their risk of hip or knee osteoarthritis along with management options for osteoarthritis in any joint. In addition they receive regular updates and ongoing support to keep them on track with managing their joint pain.

www.myjointpain.org.au

Olympic basketball star & Australian Opals captain, Lauren Jackson

Having an action plan and support is

extremely important

“

In partnership with Telethon, Arthritis & Osteoporosis WA is producing a ‘Bones and Joint’ E-learning site within our website.

The intent is to create a virtual and interactive information centre to educate children, parents and teachers on the basic elements of a healthy family lifestyle to develop good habits in childhood.

The site aims to increase the awareness of modifiable risk factors in chronic conditions. The long term objective is to reduce the incidence and disabling effects of arthritis, osteoporosis and related conditions in the people of WA.

The site will incorporate a special login for teachers, allowing them access to a wealth of information to help with preparation of appropriate lessons.

Along with the website, there are plans for a Project Officer to visit schools, including regional and low socioeconomic areas. During these visits the Project Officer would deliver a lesson to middle and upper primary school students, as well as providing teachers and school nurses with professional development, including information of the specific diseases, training on how to navigate the site and how to effectively implement the extension activities and events which will reinforce the topics covered.

The Bone and Joint website will be officially launched at the end of June.

New ‘Bone and Joint’ online tool in development.

Arthritis Today | WINTER 2013

Pathology Testing and the New BiologicsFrom Lab Tests Online Au

Feature Story

Biologics, also known as bDMARDs reduce inflammation by intervening in the immune system process. The aim is to stop potentially irreversible joint damage and where possible, induce remission.

Having blood taken for pathology tests is a regular experience for many people with an autoimmune condition but for those being treated with one of the new biologic agents, testing takes on an added dimension.

Biologics, also known as bDMARDs (biologic disease-modifying antirheumatic drugs), reduce inflammation by intervening in the immune system process. The aim is to stop potentially irreversible joint damage and where possible, induce remission.

They do this by targeting specific molecules that play key roles in triggering and maintaining

inflammation. Some are antibodies that stick to the surface of immune cells such as white cells removing the signals that drive them to cause disease. Other medications bind to chemical signals (cytokines) in the blood and have a similar effect.

bDMARDs include infliximab, golimumab, etanercept, adalimumab, certolizumab, abetacept, tocilizumab, and rituximab. They are often given in combination with another medication, methotrexate; this is because in some instances together they give better results. Methotrexate also decreases the risk of a reaction against some

of the biologics. However, both methotrexate and bDMARDs alter the immune system and as a result can increase the chance of developing infection. They need careful monitoring.

If you are having this type of treatment, pathology testing is critical not only in ensuring that it is working effectively but that your general health is maintained. It is important you have pathology tests both before starting the drugs and then at regular intervals during treatment. The tests vary depending on the combination of drugs being given, but some are common to all therapies.

8

Here are the tests that you will most likely see on the pathology request forms from your doctor. They are all performed on blood samples that will be investigated by the pathologists and scientists in diagnostic pathology labs specialising in any one of a variety of fields such as biochemistry, immunology, microbiology and haematology.

The Tests

Erythrocyte sedimentation rate (ESR) and/or C-reactive protein (CRP) These tests give a measure of the level of inflammation activity and they can help your doctor decide whether the drugs are working. Your doctor will also use standardised clinical assessment scores to help with this.

ESR Inflammation increases the amount of fibrinogen, a sticky protein found in blood. When the blood is taken out of the body the red blood cells clump together. This occurs in the blood collection tube after a blood sample is drawn – the red blood cells start to fall to the bottom of the tube. The rate of fall is termed the erythrocyte (red blood cell) sedimentation rate. It can be measured in an ESR test. It is a non-specific sign of inflammation and is affected by many processes and medications. Its use is mandated in some instances to gain access to biologics in Australia though there is little scientific evidence for this practise.

CRP CRP is C-reactive protein, made in the liver and blood vessels and is part of the ‘acute phase’ immune system response to damage or infection. It is present in the blood in low amounts even in healthy persons. A high or increasing

amount of CRP in your blood suggests that you have an infection or inflammation - many infections and types of inflammation result in CRP levels above 10 mg/L. A fall in CRP level in your blood tends to mean inflammation is decreasing.

FBC The Full Blood Count is one of the most common tests requested by doctors because it gives a good general picture of someone’s health but it plays a particular role in monitoring bDMARD treatment. The FBC is performed by sophisticated instruments that count the cells in a blood sample and determine their types by measuring physical characteristics including size and shape. Thousands of white blood cells, red blood cells, and platelets are counted and measured and compared against established normal ranges. As with many types of pathology tests, results are interpreted according to their relation to a predetermined reference range. When monitoring treatment with bDMARDs, the FBC used to check if blood cell production in the bone marrow is being depressed by the drugs.

Electrolytes and Liver Function tests (E/LFT) E/LFT is an abbreviation for a combination of tests used to evaluate kidney and liver function. More than 20 tests are performed on a blood serum sample that collectively gives a good assessment of multiple body systems. They give important information about the kidneys, liver, and electrolyte and acid-base balance, as well as blood sugar and blood proteins, in order to evaluate organ function and check for conditions such as liver and kidney disease.

Tests for infectious diseases If you have had an infectious disease in the past, it can be reactivated during bDMARD treatment. Your doctor will request tests if you could be at risk.

• Hepatitis B and C serology

Testing prior to starting biologics is necessary as these diseases may complicate biologic therapy.

• QuantiFERON assay or Mantoux test

Some biologics can reactivate latent (hidden but controlled in the body) tuberculosis. Excluding this is important prior to many biologic therapies.

• HIV screening

HIV infection may complicate bDMARD therapy.

Antinuclear antibody (ANA), antibody to ds-DNA (Anti-dsDNA), rheumatoid factor (RF), anti-citrullinated peptide antibody (anti-CCP) This is the series of pathology tests routinely used to diagnose and monitor rheumatoid arthritis (RA). They measure the key autoantibodies associated with the condition and help in evaluating the effectiveness of bDMARD treatment. Testing for markers associated with lupus (SLE) are carried out from time to time as rarely some biologics can cause a lupus like state.

Immunoglobulin G (IgG) Rituximab can depress levels of immunoglobulin (antibodies) – proteins in the blood that block infection. If these were to be lowered, the risk of infection may rise. If you are having rituximab IgG will be tested periodically.

Many of these tests need to be repeated at intervals ranging from a few weeks to months (ESR, CRP, FBC, E/LFT) to six monthly for IgG.

Arthritis Today | WINTER 2013

www.labtestsonline.org.au is a free, not-for-profit, Australian website, delivering independent information written by working pathologists and scientists.

Knowing what your pathology tests do and why they have been requested by your doctor can be an important advantage in understanding just what is going on in terms of your health. Lab Tests Online Australasia is an award-winning website that explains pathology simply and clearly.

Their aim is to help you understand the pathology of your condition so you’ll be better equipped to have productive conversations with your doctors and health professionals and that you’ll be able to make informed decisions in managing your health. Research around the world has repeatedly shown that people who are personally involved in their healthcare decisions have better outcomes.

They believe it is essential you have access to accurate, non-commercial and trustworthy information on the internet. Information on Lab Tests Online AU has been written by some of Australia’s leading pathologists and scientists. The website has been developed by one of pathology’s peak bodies, the Australasian Association of Clinical Biochemists (AACB) with support from the Royal College of Pathologists of Australasia (RCPA). It has been funded by the Commonwealth Government.

At Lab Tests Online you’ll find:

• information on hundreds of laboratory tests, cross-linked to the diseases and conditions they are used to screen for, diagnose and treat

• feature articles that interpret complex scientific concepts to make them easy to understand

• a general overview of pathology laboratories, the way they work and the people who work in them

• r egular news updates from the world of pathology and laboratory medicine

A free app is available through iStore and Google Play Store.

Visit www.labtestsonline.org.au

10

I am pleased to report that the staff and volunteers of Arthritis & Osteoporosis WA continue to work as hard as ever in assisting those people with bone and Joint disease. We concluded 2012, our 40th year, with a small surplus of approximately $60,000 on an income of just over $2.3 million.

Arthritis and Osteoporosis WA (AOWA) is the only organisation in Western Australia that is solely dedicated to helping those with bone and joint disease. AOWA has a record of offering quality health promotion and service programs to the consumer with arthritis, osteoporosis and related conditions, throughout the state of WA.

41st Annual President’s ReportDr Jack Edelman, MBBS FRACPPresident, Arthritis and Osteoporosis WA

Presidents Report

11Arthritis Today | WINTER 2013

Major programs conducted throughout the year...

40th Anniversary Year CelebrationsTwo functions were held to celebrate our 40th Anniversary:

• A lunch for past and present volunteers, staff and branch members held at the Wyllie Arthritis Centre on Friday 9th March.

• As part of World Arthritis Day his Excellency Mr Malcolm McCusker, Governor of WA, attended the Wyllie Arthritis Centre to unveil a plaque recognising the important contribution made by our early founders.

Chair of Musculoskeletal MedicineAOWA remains committed to the establishment of a Chair in Rheumatology and Musculoskeletal Medicine. We have achieved our fundraising target of $1.5 million in pledges. These funds will be solely used for the professorial position. Unfortunately we were unable to make an appointment in 2012, however we continue with our search, advertising worldwide in the middle of 2013.

Arthritis Awareness WeekDr David Hunter, Professor of Medicine at University of Sydney was invited to visit Perth to conduct several seminars to both the public and Health professionals. Dr Hunter provided an update on the prevention and management of osteoarthritis.

Department of Health WA FundingAOWA successfully negotiated a three year funding agreement with the Dept. of Health WA. The total value of the

agreement is for just over $1M spread over three years.

Services to be provided are:

• Coordination of Regional Clinics - In 2012 we provided over a 150 Day Clinics throughout regional WA at 15 different locations.

• Building workforce capacity to meet projected demand – AOWA will train health professionals in metropolitan and regional areas to deliver disease specific self-management programs on Osteoarthritis of the Knee, Rheumatoid Arthritis, Ankylosing Spondylitis and Osteoporosis.

• Provision of these self-management programs for consumers in metropolitan and regional WA.

Bone & Joint E Learning ProgramAn innovative website linked to the new Australian Curriculum funded by Telethon, this web based program is all about maintaining healthy bones and joints in children. It will be packed with information for kids, parents and teachers to help our young people understand the skeleton, joints, exercising, diet and why we should look after our teeth.

Musculoskeletal Health NetworkAOWA continues to take an active role and to date the projects completed by the network are:

• Elective Joint Replacement Service Model of Care

• Inflammatory Arthritis Model of Care

• Osteoporosis Model of Care

• Rheumatoid Arthritis Clinical Guidelines

• Spinal Pain Model of Care

12

• Consumer Guide to managing Lower Back Pain

The network is now focusing on the development of an overarching policy for musculoskeletal health.

JIA CampCamp Freedom was held at Forrest Edge Recreation Camp in Waroona. 31 children attended coming from as far afield as NT and Kalgoorlie. Camp Freedom gives kids the opportunity to enjoy a number of activities along with gaining tips on how to self-manage their disease. I would like to thank LotteryWest for partly funding the camp along with the many volunteers who gave their time to ensure the camp was a success.

Pain Information InitiativeAOWA has moved to offer practical education programs for health professionals whose work puts them in face to face contact with people in pain along with offering education and support for those people in pain.

Furthermore, we continue to provide our high quality range of programs for the consumer and health professionals including;

• Arthritis Today Magazine Three times a year with a circulation of approximately 12,000

• Monthly electronic newsletter to over 2,500 people

• Telephone Advisory Service for information and support

• A range of seminars and workshops for the consumer and health professional

• Support groups and a telephone befriending service

• Hydrotherapy/Warm Water Exercise. We have over 300 participants that use the hydrotherapy pool weekly

• Exercise classes, which include Tai Chi, Nordic Pole Walking, Pilates and an Osteoporosis Exercise Program, with approximately 120 participants weekly

• A range of booklets and fact sheets covering most of the 100 bone and joint diseases

Public Relations & FundraisingOf course the services we provide would not be possible without our major fundraising activities of

• Direct Mail

• Raffles

• Bequest Program

• Bingo, run by the Mal Atwell Group on behalf of AOWA

Special Events• The Great Gatsby Ball at Government

House

• HBF Run for a Reason

• Blue Illusion Fashion Show

• Great Wall of China Trek

• Abbotts Solution Arthritis Golf Classic held at Royal Fremantle Golf course

• Fremantle Portrait Prize Exhibition

13Arthritis Today | WINTER 2013

SummaryUnfortunately during the year we lost one of our most dedicated and hardworking board members, Mr Bill Robertson, who passed away suddenly in August 2012 after serving the on the Board for over 20 years. Bill made an enormous contribution to AOWA and will be sadly missed.

Other Board changes include the resignation of our Treasurer Mr TJ Spooner who retired in December after approximately three years of

service. Our Thanks go to TJ for his contribution and support.

We welcome three new board members, Mrs Debbie Borshoff, Mr Brad Gordon and Ms Silvia Caratti as Treasurer.

The success of AOWA is a direct result of many hours of hard work by a team of dedicated staff, volunteers, board and committee members and of course not forgetting our loyal supporters.

INCOME 2012

EXPENDITURE 2012

FundraisingInterest IncomeFee for ServiceDividend IncomeGrantsOther

Community Support GroupsHealth ServicesEducationFundraising & PRAdministrationResearchImpairmants on InvestmentsOther

$113,501

$338,943

$180,471

$672,609

$853,680

$57,187 $45,399

$4,398

$1,493,398 $204,000

$358,308

$51,335

$204,906 $13,698

INCOME 2012

EXPENDITURE 2012

FundraisingInterest IncomeFee for ServiceDividend IncomeGrantsOther

Community Support GroupsHealth ServicesEducationFundraising & PRAdministrationResearchImpairmants on InvestmentsOther

$113,501

$338,943

$180,471

$672,609

$853,680

$57,187 $45,399

$4,398

$1,493,398 $204,000

$358,308

$51,335

$204,906 $13,698

On Empathy, Stigma and Chronic Pain

Have you ever wondered why people with chronic pain can be stigmatized in our society when we know from surveys that one in five of us experience this problem?

The proposition explored in this article is that the clinical behaviour of doctors and other health professionals can, at least in part, be held responsible for such stigmatization.

Empathy is a quality highly prized by health professionals as being a positive attribute to be conveyed by them to their patients. Defining empathy is difficult but essentially it conveys the capacity of the health professional to sense the emotions

and feelings of the patient. Derived from the Greek empatheia for “in suffering or passion,” empathy implies a process of sharing whereby a person is able to both accept and understand the expression of another person’s experience because it reflects his or her own experience.

Empathy functions as a foundation for other social behaviours (e.g. compassion, altruism) that allow one to enter the experience of the other person in an intuitive manner without the necessity of having to share that same experience, as is the case for sympathy. In clinical practice, the patient’s lived experience of pain forms a common ground for understanding empathy. However, empatheia includes the sharing of

strong negative emotions. Such emotions arise when one’s very existence is under threat (which is a not uncommon experience of those in chronic pain) or when the legitimacy of the person’s distress is being doubted. These emotions are powerful and can even challenge the health professional’s inclination to remain in the same room as the patient!

The simulation theory of empathy proposes some form of mapping process from one person’s situation to another. Such mapping occurs automatically at an unconscious level. At the conscious level, rule-based reasoning then takes over in order to decode the experience of the other person. Obviously this reasoning process requires that a

EmPatHy allows one to enter the experience of the other person in an intuitive manner without the necessity of having to share that same experience.

Dr John Quintner

Feature Story

Arthritis Today | WINTER 2013

frank and honest discussion takes place between clinician and patient.

Brain imaging studies support the existence of this reciprocal process, suggesting that the act of observing others who are experiencing pain triggers activation of the very same neural networks that have been implicated in the lived experience of pain.

Importantly, these networks also include those that have been found to accompany the observation of strong negative emotional expressions in others, such as disgust, fear, anger and sadness. Empathy may then change into a projection of negative emotion and judgment towards the other person, and even a conscious avoidance of compassion. When empathy is thus extinguished and compassion disappears, this process could be called “negative-empathy”. “Negative-empathy” leaves a vacuum that allows community-based stereotypes of chronic pain sufferers to enter and colour the clinical encounter. As such stereotypes often contain negative values (e.g. “putting it on,” “all in the mind”), “negative-empathy” on the part of their health professionals may then contribute to the complex process of stigmatisation of chronic pain sufferers.

Sociologist Erving Goffman described stigmatisation as a process by which the reactions of a community to specific personal characteristics reduce a person’s identity “from a whole and usual person to a tainted, discounted one”, causing that person to be discredited, devalued, rejected and socially excluded from having a voice.

In our society, it is not uncommon for chronic pain sufferers to be the bearers of stigmatic labels, such as whiplash, repetitive strain injury, chronic fatigue

the act of

observing

others who are experiencing pain

triggers activation of the very same neural networks that have been implicated in the lived experience of pain.

Dr John Quintner

Empathy may change into a projection of negative emotion and judgment towards the other person, and even a conscious avoidance of compassion.

syndrome, fibromyalgia, and even non-specific low back pain. These labels can denote that their motives are suspect and/or the legitimacy or reality of their symptoms is in doubt. They are also at risk of being placed in “moral jeopardy” should they fail to validate the therapeutic effectiveness claimed by their health professionals, or should they challenge their health professional’s power to control the relationship. The term “heart-sink” has been coined to describe patients in this situation.

A remedy for these potentially disastrous consequences of “negative-empathy” might commence with an examination of the “either/or” terminologies that are readily found both in health professional teaching and clinical practice: they include objective/subjective; normal/abnormal; and body/mind. Recognition of how these dualistic frames can work against patients’ best interests would be integral to a program that seeks not to perpetuate them. The stage would then be set for the emergence of pain

theories with greater explanatory power

than those that are currently being employed by health professionals.

Such theories would rise above the body/mind dualistic frame attributed to René Descartes, the 17th century French philosopher, whose influence still pervades pain theory and practice. They would incorporate the findings from neuroscience as they compel clinicians to accept empathy in all its connotations as being of fundamental importance to the understanding and management of patients presenting with complex pain states.

A new model of clinical engagement will emerge, one that is both scientifically and ethically obliged to discard conceptual frames that perpetuate negative stereotypes. There must be no hidden rules of the consultation (such as those governed by power imbalance) that might hinder a harmonious engagement taking place between clinician and patient.

When proposing what might be termed a social neuroscience

paradigm, we invoke the concept of the intersubjective or “third space” which allows for many different ways of communication. In this space, the positive and negative experiences of both patient and clinician can be shared and negotiated, neither being an “expert” compared with the other, thereby resisting the entry of socially or culturally determined stereotypes. Inadvertent stigmatisation of their patients by health professionals would cease.

If the proposition advanced in the article is close to the mark, there is much work to do!

Adapted from: Cohen ML, Quintner JL, Buchanan D, Nielsen M, Guy L. Stigmatization of patients with chronic pain: the extinction of empathy. Pain Medicine 2011; 12: 1637-1643.

Arthritis Today | WINTER 2013 17

Events

Rottnest Channel SwimOn the 23rd February, two teams battled huge swells and pushed their bodies to the limit during the 19.7km Rottnest Channel Swim. Their amazing efforts were achieved in the name of AOWA. The Wood Kenny Group, a Perth engineering company, entered a team of four into the swim for the first time and impressively came second out of all the charity

swim teams. The second team participating for AOWA was “Berley Up”. The team’s leader Michelle Bistrup was diagnosed with Rheumatoid Arthritis several years ago, and took up swimming to manage her pain and maintain her fitness. This year was Michelle’s second year in the Rottnest Channel Swim, although she found it challenging

due to the unfavourable weather conditions, her goal for next year is to participate in a duo. We would like to thank both teams who participated in the swim this year and for their incredible efforts in fundraising over $3,000 in total for AOWA.

19.7km

18

JIa Sausage SizzleOn Sunday 5th May AOWA hosted a sausage sizzle for families who have a child with bone and joint diseases such as Juvenile Arthritis, Ehlers Danlos Syndrome, Juvenile Osteoporosis and Osteogenesis Imperfecta. It was a perfect day for a BBQ with clear blue skies and a gentle breeze blowing through gorgeous Kings Park. It was a great opportunity for families to meet and mingle and we were also joined by some Camp Freedom leaders who came along to introduce themselves and get to know the kids better. A fun morning was had by all with great chats, footballs flying, kids playing and delicious sausages, onions and rolls dripping in tomato sauce goodness!

AOWA host regular talks and meetings for parents to connect and receive information from Health professionals

on Juvenile Arthritis. The BBQ was one of the many meetings we host, those meetings being mainly on the last Tuesday evening of every month. Parents please come along and feel free to invite anyone else whose kids have JIA.

Also, besides our monthly catch-ups we have Camp Freedom coming up! This is an annual camp event held for children with Juvenile Arthritis. The next camp will be held in October this year and everyone is looking forward to catching up with old friends and making some new ones. For more information on Camp Freedom or any of our JIA meetings please call us on 9388 4409 or email kirstyi@arthritiswa.org.au

National Pain Week 2013 22nd – 28th July

A committee of volunteers at AOWA has been planning a series of events to mark this week. These will include workshops on Mindfulness Meditation for Pain, Gentle

Yoga for Pain, and a unique Research Forum for Consumers.

Details of times and venues will appear on the AOWA website calendar

www.arthritiswa.org.au/events and on our Facebook page: National

Pain Week 2013 – WA Events.

19Arthritis Today | WINTER 2013

Jane Muirhead

Persistent (chronic) Pain in children and teenagers is far more common than many people realise, with estimates that as many as 25% of young people are affected at some time, with the most common complaints being headaches and migraine, chronic abdominal pain, and musculoskeletal pain (including juvenile arthritis, and other inflammatory conditions).

Persistent pain in young people can significantly affect their quality of life and if left untreated can lead to a greater risk of chronic pain, anxiety and depression in adulthood, according to an increasing number of studies.

Arthritis and Osteoporosis WA in partnership with Curtin University are therefore very pleased to have received Telethon Institute funding to pilot a brief educational self-management programme for children and adolescents with persistent pain conditions and their parents. This will be the first educational programme to specifically address the needs of young people with pain in Western Australia.

Kids Overcoming Pain Education (KOPE) will offer a one-day workshop for two age groups, with a half day follow-up workshop held 2.5 weeks later to enable children and their parents to report back on changes made. At this time participants will be provided with encouragement to maintain the skills learnt on the programme in their home and school environment.

Age groups:

• Children 8 – 12 years

• Adolescents 13 – 17 years (Big KOPE)

• Parents of the child/adolescent in pain

Parents and children/adolescents will attend together at the start of the first day and then split into two groups – one for the young people and one for parents.

Children and teens will learn the reasons why pain sometimes becomes a longer term problem as well as practical coping strategies to assist them to gain confidence in managing and reducing the effects of pain on all aspects of their lives. The skills will be taught in an enjoyable and interactive way, using mediums such as art, music, yoga and relaxation.

Having a child who suffers with a pain condition can be a very stressful experience for parents. The aim of the co-current workshop is to provide support and education to parents about the nature of persistent pain conditions and equip them with the skills and confidence to help their child to cope better with the pain and resume more consistent activities including school attendance.

The groups will be run by an occupational therapist, psychologist and physiotherapist, with extensive experience working in pain management and young peoples’ health. They will be assisted by two co-facilitators; a young person and an adult who themselves live with a persistent pain condition and manage it well.

The KOPE programme will by evaluated by a professional researcher from Curtin University

School of Physiotherapy.

The workshops, 2 for children and 2 for adolescents in total, will be conducted between August and November 2013 at Arthritis & Osteoporosis WA in Shenton Park, with intake interviews being held in June/July 2013.

To enquire about participating in KOPE please contact:

Jane Muirhead Occupational Therapist KOPE Project Leader Jane@easpain.com.au Mobile: 0402 277 098

Please also cc your email enquiry to: Mary Roberts Psychologist Project Officer MaryR@arthritiswa.org.au

Details of enrolment and intake interviews are available at www.arthritiswa.org.au

The Kope ProgrameHelping young people and their families “cope” with a persistent pain condition.

more common than many people realise, with estimates that as many as

CHRonIC PaIn of young people are affected at some time.

in children and teenagers is far

25%

Arthritis and O

steoporosis

Youth

21Arthritis Today | WINTER 2013

Volunteer Spotlight

Volunteers

A couple of editions ago we featured an article about the Albany Branch and all their volunteers. In this edition we wanted to let you know about the Bassendean Arthritis Group (formerly the Bassendean Branch) and one of our longest serving volunteers, Myrtle Brammall.

Twenty-two years ago, Myrtle read an article in the local paper about the Arthritis Foundation’s Bassendean Branch and, wanting to find out more, she went along to a meeting. Within a couple of months she was asked to be the secretary and has never looked back. In the early days the branch raised funds holding street stalls. As time went by, the Branch decided to become a support group and to focus on providing support and passive exercise to its members.

The group meets every week at the Bassendean Community Centre

where they spend 40 minutes doing passive exercises which are led by another volunteer, Susan Lowe. Afternoon tea follows when members can catch up and share news. In recent months the group has grown in size and all that attend really enjoy the support and friendship that is on offer, as well as keeping fit.

Myrtle co-ordinates the group and makes new members welcome. In her spare time she enjoys outings with a local group and swimming once a week. When approached about being featured in the Arthritis Today Magazine her comment was “it gives a lot of pleasure to let people know how successful the group has been”.

Arthritis & Osteoporosis WA thanks Myrtle for all her effort and support over the last twenty-two years – keep up the good work Myrtle!

Volunteer Position Available Community SpeakersDo you enjoy speaking to groups? We are looking for Community Speakers who are happy to deliver talks to groups in the community on arthritis and related conditions and the services that we provide. Training on the talk content will be provided, however you need to have a clear speaking voice, the ability to learn and share basic arthritis information, good communication and listening skills and transport to get to the group presentations.

All volunteers receive training both formal and informal, on-going support, volunteer reimbursement and are covered by insurance. If you are interested in either of the positions and would like to be part of our team, please call Margaret on 9388 2199 for further details.

it gives a lot of pleasure to let people know how successful the group has been”

L-R Volunteers Mrytle Brammall and Susan Lowe, serving tea after their exercise class.

22

Health &

Lifestyle

With the HBF ‘Run for a Reason’ and Cancer Council’s ‘Relay for Life’ recently taking place, many people may have taken up training to participate in these worthy events.

By following a sensible training programme, gradually building up your running distance, it stands to reason that your body will gradually adapt to the new workload without any problems.

However, commonly this is not the case. You may find increasing from 5km to 10km attainable, but as you increase the distance beyond 10km, you may start to notice twinges of pain in your

knees, hips and/or back. To quote Professor Julius Sumner Miller, “Why is it so?”.

Firstly, we are all built differently. We are not robots made mechanically perfect. However, the human body is very robust – it can compensate for many biomechanical anomalies. But there comes a time when the additional strain or overload can no longer be compensated for - it’s literally a case of the straw that broke the camel’s back.

A common postural problem is over-pronated feet or ‘flat feet/fallen arches’. Since our feet are the foundations, any abnormality here can cause a domino effect throughout the rest of the body. A crucial phase when walking/running is heel strike – the moment the foot/heel makes contact with the ground. Following this, there is an immense force transmitted. In fact, the foot must pronate for shock absorption. The problem is many people experience excessive pronation due to their fallen arches which creates an unstable platform for propulsion. Flat feet are commonly linked with knee or hip pain. This is because when the foot strikes the ground it causes

excessive internal rotation at the knee and hip which may overload the muscles contributing to repetitive overstrain of soft tissues causing inflammation. Some common complaints include (but are not limited to); shin splints, plantar fasciitis (inflammation of the small muscles on the sole of foot), achilles tendonitis, ITB syndrome (ilio-tibial band – on the outside of the knee), patello-femoral pain (underneath the knee-cap) and low back pain.

Another cause of pain with higher intensity exercise is instability of the pelvis. Most people have heard of ‘core stability’. Many people interchange with the term ‘core strength’. This is not correct. To put it simply, to improve stability, the core muscles must be retrained at a low intensity so it is not a case of working harder to increase strength (as in performing abdominal crunches while holding a weight to your chest). It is more a case of retraining the timing of the particular muscle groups, at low intensity (workload) progressing to exercises that challenge balance, are functional and sports-specific.

The crucial aspect regarding management of any new

The Importance of StabilityMs Melanie Galbraith (BSc. Physio) APAM, Project Officer AOWA

“The human body is very robust – it can compensate for many biomechanical anomalies. But there comes a time when the additional strain or overload can no longer be compensated for.

23Arthritis Today | WINTER 2013

The Importance of Stability Why do I get annoying‘niggles’ of pain when I increase the distance I run?

pains since increasing your running distance, is to consult a registered Physiotherapist (or Sports Physiotherapist) or other reputable health professional (eg. Chiropractor). They should spend time conducting a thorough and accurate biomechanical assessment. They should be able to determine what is most likely responsible for your pain, whether you require orthotics (and/or referral to a podiatrist) and the appropriate

treatment and exercises. If you are not satisfied with the initial assessment, you should inform the health professional. You are not obliged to continue seeing that particular health professional – you can choose to go elsewhere. A referral from your GP is not required. It is very important to catch it early – before it becomes chronic and more difficult to manage.

EXPRESSION OF INTEREST

Rheumatoid Arthritis for Physiotherapists e-LearningAs part of a PRF funded project in 2011, WA physiotherapists completed a survey about their professional development needs in the clinical area of rheumatoid arthritis. As a direct result of responses received, a series

of five on-line learning modules has been developed. Now nearing the evaluation phase of development, we are seeking physiotherapists interested in undertaking these modules.

This is a fabulous opportunity to learn more about RA specifically for your physiotherapy practice, free of charge. Please note, while

participation is voluntary, it is part of a research project so you will be asked to complete short pre and post questionnaires in order to advise the developers on any required modifications and the effectiveness of the modules. To express your interest in participating, please visit this link https://curtin.asia.qualtrics.com

Useful Websiteswww.ahpra.gov.au Health Practitioner Regulation Agency

www.physiotherapy.asn.au Australian Physiotherapy Association

www.chiropractors.asn.au The Chiropractors’ Association of Australia

Gentle or restorative yoga has been shown to have positive benefits for people with arthritis, including improved joint health, flexibility and balance as well promoting a positive outlook, reducing symptoms of depression and improving overall quality of life.

There are many styles of yoga, however not all are suitable for people with arthritis. For example, Ashtanga yoga which involves a series of strenuous poses and Bikram yoga which takes place in a hot room are not recommended.

So what is gentle yoga? Gentle yoga uses modified poses with an emphasis on breathing, deep relaxation and meditation to reduce pain. In a gentle yoga class poses will be modified for individuals so they can be performed effectively and safely. Often props are used such as chairs, bolsters and blocks to provide additional support and all poses can be done seated on a chair if this is more comfortable.

Yoga connects the mind and body through the breath. The breath, used in combination with the poses, helps to relax the body and calm the mind. Deep relaxation and meditation techniques are used to enhance focus and promote a calm, peaceful mind.

Yoga is a personal practice, through movement and the breath there becomes greater body awareness. Students are encouraged to listen to their bodies and be aware of their limitations, always moving and breathing within a range that is comfortable for them in a safe and supportive environment.

While there have been many scientific studies reporting the benefits of yoga, studies on yoga for people with Osteoarthritis and Rheumatoid Arthritis are in the early stages, although these early studies are showing promising results. According to the John Hopkins Arthritis Centre, studies have shown people with Osteoarthritis and Rheumatoid

Arthritis have reported “some improvement in joint health, physical functioning and mental/emotional wellbeing” with the evidence suggesting “when combined with a program of good medical care, yoga may provide important additional physical and psychological health benefits for arthritis patients” (www.hopkinsarthrits.org/patient-corner/disease-management/yoga-for-arthritis/).

Recent studies have shown people with various types of arthritis who practice yoga on a regular basis “can help to reduce joint pain, improve joint flexibility and function and lower stress and tension to promote better sleep”. Studies have also shown an improvement in balance, flexibility and symptoms of depression (www.yoga4arthritis.com/resources/for-clinicians/).

A study conducted by Sharon Kalasinski MD on the effects of yoga on people with knee osteoarthritis reported reduced pain and joint stiffness and improved physical function (http://arthritistoday.org/what-you-can-do/staying-active/activity-types/yoga-benefits.php).

If you are interested in attending Gentle Yoga classes at Arthritis & Osteoporosis WA in Shenton Park, please call 9388 2199 or go to

www.arthritiswa.org.au

connects the mind and body through the breath.

Yoga

Gentle Yoga for Arthritis By Melanie Browne

25Arthritis Today | WINTER 2013

Kirsty – Health Education Coordinator

Moving to the USA and living in San Diego, California, as a teenager broadened my horizons in many ways – one of those was an introduction to Southern Californian cuisine. I was at first quite reluctant to try fish tacos, but once I took a bite I never looked back. They are totally delicious! I hope you enjoy them as much as I do!

INGREDIENTS

10 flour or corn tortillas

For the fish marinade5 firm white fish fillets, boneless (snapper is good)2 tbsp. olive oil¼ cup fresh lime juicePinch of salt2 tbsp. chopped coriander1 tsp. of cayenne pepper or mild Chilli powder

For the cabbage salad1 red onion, thinly sliced¼ cup coriander, coarsely chopped

2 cups freshly shredded white cabbage

For the bajar sauce1 cup light sour cream1/3 cup plain yogurt½ tsp. mild chilli powder (or to taste) 1 tbsp. lime juicePinch of salt

For the chipotle salsa Fresca1 cup chopped red tomatoes½ cup chopped red onion3 chipotle chillies, minced (or use 1 minced jalapeno)1 large clove garlic, minced½ cup chopped coriander Juice of 1 lime2 tbsp. olive oilPinch of cuminSea salt

PREPARATIONPlace the fish fillets in a large, shallow dish and brush with olive oil. Pour over lime juice, a sprinkle of salt, chopped coriander and half the cayenne pepper. Allow the marinade to infuse the fish for 30 minutes - 2 hours in the fridge. In the meantime, toss the cabbage salad ingredients together - shredded cabbage with red onion and coriander.

FOR THE SALSA Mix the chopped tomato, onion, chilli, garlic and coriander together in bowl. Drizzle with olive oil and lime juice. Add pinch of cumin and some sea salt and stir through. Set aside.

FOR THE BAJAR SAUCEIn a small bowl, mix together - sour cream, yoghurt, chilli powder, lime juice and salt.

Preheat a grill or barbeque to medium-low.

On a very clean grate, brush the grill with oil and place the fish seasoning side down to cook. Sprinkle the rest of the chilli on the top side of the fish and cook for about 2-3 minutes per side or until the fish is cooked through.

Remove the fish to a clean platter, allow it to rest 10 minutes and then slice into thick strips.

Heat the tortillas by placing them on the barbeque grill for about a minute each side.

TO SERVEFor each taco, place a warm tortilla on a plate, add a few chunks of fish, drizzle with the Bajar sauce, and add a handful of salsa and cabbage salad.

Make a small fold along the bottom edge of the tortilla and close from both sides, creating a little parcel that won’t drip out the bottom.

Recipe from www.sbs.com.au/food

FISH taCoS RECiPEGentle Yoga for Arthritis By Melanie Browne

JIA Parents Get-TogetherTuE 25 JuNE

Come along to a new social group for parents to share experiences, gain greater understanding and receive regular advice from health professionals. Guest speaker Alison Morris (Physiotherapist PMH) will talk this month on Physiotherapy & JIA.

When: 7:30pm - 9:00pm Where: Wyllie Arthritis Centre Cost: FREE

Tai Chi for Osteoporosis Instructor TrainingSAT 29 JuN & SuN 30 Do you love Tai Chi and want to share your love with others? Come and attend Dr Lam’s Accredited Tai Chi for Health Instructor Training workshops with Master Trainer Rani Hughes.

Where: Wyllie Arthritis Centre Cost: $385 per workshop, including DVD Contact: Mel Browne on 9388 4404 or visit arthritiswa.org.au/events

World Scleroderma DaySAT 29 JuN

Mandurah Marvelous Glove Design Challenge hosted by Mandurah Scleroderma Support Group. Decorate your gloves, the crazier the better and get your entries in by June 24, then join in for the presentation of prizes.

When: 2.00pm - 3.00pm Where: Bortolo Pavilion, 76 Bortolo Drive Greenfields WA 6210 Cost: Adult $5.00, children under 12 $2.00. Pay on entry to the pavilion. All proceeds will assist Scleroderma Australia

Tai Chi for Arthritis Instructor TrainingMoN 1 Jul & TuES 2Do you love Tai Chi and want to share your love with others? Come and attend Dr Lam’s Accredited Tai Chi for Health Instructor Training workshops with Master Trainer Rani Hughes.

Where: Wyllie Arthritis Centre Cost: $385 per workshop, including DVD Contact: Mel Browne on 9388 4404 or visit arthritiswa.org.au/events

Fremantle Portrait Prize - Closing date for entriesSAT 8 JulY The FiPP promotes excellence in the art of portrait photography at the same time as raising funds for Arthritis & Osteoporosis WA Visit www.fremantleportraitprize.org.au for more info

National Pain Week 2013MoN 22 – SuN 28 JulY

Events include workshops on Mindfulness Meditation for Pain, Gentle Yoga for Pain, and a unique Research Forum for Consumers. For more info visit arthritiswa.org.au/events or the Facebook page National Pain Week 2013 – WA Events

Tai Chi for Arthritis Classes (Term 3)MoN 29 Jul – 16 SEp

The movements of the Tai Chi for Arthritis program have been specifically designed to be safe for people with arthritis. The slow movements prevent injury but build muscle strength and calm the mind. 1 hour per week for 8 weeks.

Ongoing class – 11:00am Beginner class – 12.45pm Where: Wyllie Arthritis Centre Cost: $80

JIA Parents Get-TogetherTuE 30 Jul

When: 7:30pm - 9:00pm Where: Koko Black Chocolate & Coffee Shop (inside Claremont Quarter Shopping Centre). Cost: FREE

Gentle Yoga Classes (Term 3)TuE 30 Jul - TuE 24 SEp

Gentle and restorative yoga has been proven to be helpful for many chronic pain conditions, providing relief from both the pain itself and the associatedstress related to living with chronic pain. 1 hour per week for 9 weeks. Participants will need to bring a yoga mat.

When: 4:30pm Where: Wyllie Arthritis Centre Cost: $90

Osteoporosis Exercise Program (Term 3)WED 31 Jul – 25 SEp ThuR 1 AuG – 26 SEp

Physiotherapist run exercise classes designed for people diagnosed with osteoporosis or who have experienced a first “low trauma” fracture. 1 hour per week for 9 weeks.

When: Wed 8:30am, Thur 9:00am Where: Wyllie Arthritis Centre Cost: $90 Register: Call 9388 2199 or online at arthritiswa.org.au/events

Upcom

ing Events

27Arthritis Today | WINTER 2013

Exercise Information SessionJulY (DATE TBC)

Come along to our Exercise Information Session and find out more about the exercise classes we have available for people with Arthritis and/or Osteoporosis. Our classes include Tai Chi for Arthritis, Osteoporosis Exercise classes, Pilates for Arthritis, Gentle Yoga, Nordic Pole Walking and Warm Water exercise. Our instructors will each talk about their classes, and you will have the opportunity to speak with the instructors and ask questions during tea and coffee afterwards.

When: 10:00am - 12:00noon Where: Wyllie Arthritis Centre

Pilates Term 3 ClassesThuR 1 AuG – ThuR 26 SEp

Pilates combines physical exercises with breathing regulation to build body strength and generate mental calm. Run by a qualified instructor with knowledge and experience of osteo and inflammatory arthritis. Participants will need to bring a mat (all other equipment will be provided). 1 hour per week for 7 weeks.

When: 4:00pm, 5:15pm or 6:30pm Where: Wyllie Arthritis Centre Cost: $70

Ankylosing Spondylitis Education & Self-Management Research ProgramAuG/SEp

This research program is specifically for people with diagnosed Ankylosing Spondylitis. It offers a holistic approach providing disease specific education and self-management techniques and is run by health professionals. 2.5 hour sessions per week, over 7 weeks.

When: Times and dates yet to be decided Where: Wyllie Arthritis Centre Cost: FREE

Gentle Yoga Classes (Term 3)AuG/SEp

Gentle and restorative yoga has been proven to be helpful for many chronic pain conditions, providing relief from both the pain itself and the associated stress related to living with chronic pain. 1 hour per week for 9 weeks. Participants will need to bring a yoga mat.

When: Thurs 9:30am Where: Shenton Park Community Centre Cost: $90

Osteoarthritis of the Knee Education & Self-Management ProgramWED 7 AuG – 11 SEp

This program offers a holistic approach providing disease specific education and self-management techniques and is run by health professionals. 6 x 2.5 hour weekly sessions.

When: 10:00am - 12:30pm Where: Victoria Park Leisurelife Centre, Cnr Kent & Gloucester Streets, East Victoria Park Cost: $30 single, $35 participant plus partner

Nordic Pole Ongoing Walking Group (Term 3)ThuR 15 AuG – ThuR 17 oCT

Nordic Pole walking enthusiasts get together for Nordic walking followed by coffee at the nearby cafe. Anyone who has participated in the Nordic Pole walking beginners course is welcome

When: 9.30am Where: Kings Park Cost: 10 weeks @ $70 or $90 (with pole hire), 5 weeks @ $50 or $60 (with pole hire)

Chevron City to SurfSuN AuG 25

This iconic Perth fitness event has a distance to suit everyone: Marathon, Half Marathon, 12km Run, 12km Walk, 4km Run/Walk, or 4km Wheelchair. Combine taking part with helping raise money for Arthritis WA by easily setting up your fundraising page online.

For more information visit http://events.sportsnewsfirst.com.au/event/perthcitytosurf/

JIA Parents Get-TogetherMoN 27 AuG

Guest speaker TBC.

When: 7:30pm - 9:00pm Where: Wyllie Arthritis Centre Cost: FREE

Nordic Pole Walking Beginners CourseThuR 29 AuG – ThuR 26 SEp

Nordic Walking is a fun and easy form of fitness using light weight poles that allows a total body workout without the feeling of greater exertion. Participants should be able to walk at least 500 metres unaided.

When: 11.00am Where: Kings Park Cost: $75 (1 hour/week - 5 lessons)

to register for events call 9388 2199 or go online at arthritiswa.org.au/events

28

Events Calendar

Abbott Solutions Arthritis Golf ClassicMoN 23 SEp

Join Abbott Solutions and Arthritis & Osteoporosis WA for the 10th annual Classic at the Lake Karrinyup Country Club - Awarded Western Australia’s Number 1 golf course for 2012.

See advertisement on back page for more information

Inflammatory Arthritis Education & Self Management Program17 oCT – 21 oCT

This 6 week program is specifically for people with diagnosed rheumatoid, psoriatic or sero-negative rheumatoid arthritis. It offers a holistic approach providing disease specific education and self-management techniques and is run by health professionals.

Gout Public Seminar with specialist speakersSAT 12 oCT

When: Sat 10:00 – 12:00noon Where: Wyllie Arthritis Centre Cost: $5 donation

Term 4 Exercises ClassesCommence early October, call 9388 2199 or visit a arthritiswa.org.au/events for more information.

alSo ComIng uP...TUE 25 JUNE JIA Parents Get-Together

SAT 29 JUN SUN 30 JUN

Tai Chi for Osteoporosis Instructor Training

SAT 29 JUN World Scleroderma Day

MON 1 JUL TUES 2 JUL

Tai Chi for Arthritis Instructor Training

SAT 8 JULY Fremantle Portrait Prize - Closing date for entries

MON 22 – SUN 28 JULY National Pain Week 2013

MON 29 JUL – 16 SEP Tai Chi for Arthritis Classes (Term 3)

TUE 30 JUL JIA Parents Get-Together

TUE 30 JUL - 24 SEP Gentle Yoga Classes (Term 3)

WED 31 JUL – 25 SEP THUR 1 AUG – 26 SEP

Osteoporosis Exercise Program (Term 3)

THUR 1 AUG – 26 SEP Pilates Term 3 Classes

AUG – SEP Ankylosing Spondylitis Education & Self-Management Research Program

AUG – SEP Gentle Yoga Classes (Term 3)

WED 7 AUG – 11 SEP Osteoarthritis of the Knee Education & Self-Management Program

THUR 15 AUG – 17 OCT Nordic Pole Ongoing Walking Group (Term 3)

SUN AUG 25 Chevron City to Surf

MON 27 AUG JIA Parents Get-Together

THUR 29 AUG – 26 SEP Nordic Pole Walking Beginners Course

MON 23 SEP Abbott Solutions Arthritis Golf Classic

17 OCT – 21 OCT Inflammatory Arthritis Education & Self Management Program

StaRtIng DatE

With malice towards none, and charity for all…”-Abraham Lincoln

“

Arthritis Today | WINTER 2013

If you’re wealthy, and you’re writing your last Will, I guess it’s your choice to write an absurd Will. Indeed, some were truly crazy…

Some used their Will to settle a score, make a statement or correct a rumour. Some were just silly; one wrote that their corpse shall be present at meetings, another that their estate be used to develop a better alphabet. At least, they left their mark on life.

The length of a Will didn’t seem to matter. Ricky Nelson wrote a three page Will, John Lennon wrote a four page Will. Cole Porter needed twenty-nine pages to share his many and extensive properties among family and friends.

Groucho Marx lost his humour when he wrote his Will. Henry Houdini did at least write a Will but said nothing as to how he’d managed to escape death so many times or whether he might escape again.

John F Kennedy died suddenly and only then did his family discover his Will had been written seven years before he became president. His brother Robert, assassinated five years later, had an even older Will, both creating immense problems given the wealth of the Kennedy family and the birth of children.

And then there was Abraham Lincoln who died without a Will despite being one of the most prominent and best known lawyers of his time.

The message is thus clear – do please give thought to what you want done with assets you have acquired over your lifetime and write a Will.

Do please think about leaving a bequest to the Arthritis and Osteoporosis WA to help us advance our efforts to fight the pain and disabling effects of arthritis and the many other bone and joint diseases. Your bequest of any amount will help secure our future and be of enormous help to generations yet to be born.

If you are interested, unsure or have questions, Trish Broderick is here to help. Trish has a background in Health Management, Nursing and Physiotherapy, has spent time as a carer, worked in Disability Services, with Funeral Services, has managed a 10 bed Retreat House and helped people walk and work through their life’s challenges. What wonderful experience she has to help people decide what and to whom they might leave their worldly assets.

Trish is available on 08 9388 4436 or 0438 250 080.

AJ Sm

ith Society

alSo ComIng uP...

Trish Broderick

3030

To help offset some of the costs Arthritis & Osteoporosis WA incurs and to receive a years subscription to Arthritis Today, here is my contribution of:

$20 $30 $40 $50 or $

Cash ChequeOR, please charge my gift to my credit card:

Visa Mastercard Amex

Exp. Date: /

Name on card:

Signature

Mr/Mrs/Ms/Miss:

Address:

Phone:

PLEASE SEND TO: PO Box 34, Wembley, WA 6913

We pride ourselves in delivering services for the many thousands who daily, struggle with the trauma and limitations imposed on them by musculoskeletal diseases. Services include access to our specialist bookshop, courses on arthritis and osteoporosis and use of our exercise and hydrotherapy facilities.

Education is just one aspect of our work as is our ongoing funding of vital research. If you can assist us by making a donation, we will be most grateful. Whether it’s to find a cure or to simply make living with arthritis or osteoporosis a little easier, we know we will do better if we had your support too.

All donors receive receive a years subscription to “Arthritis Today”, our magazine filled with up-to-date information about arthritis and osteoporosis, as well asnews on our regular presentations and events.

Thank you sincerely,

Ric ForlanoExecutive Director

Want Arthritis Todaydelivered to your door? Simply make a donation to help offset our printing costs, and we’ll deliver your own copy, three times per year.

✂

Email:

303030

Established since 1974, the Rural Clinic Program aims to provide early diagnosis and specialist treatment to patients of Regional WA.

A doctor’s referral is needed when making an appointment. Please call Arthritis WA for further information regarding each clinic area.

Toll free 1800 011 041

Country Rheumatology

Rural Rheumatology Clinics

ALBANY June, Jul, Aug, Sept. Clinic held every mth.

BRIDGETOWNJuly Clinic held every 4 mths

BROOME Sept Clinic held every 6 mths

CARNARVON Aug Clinic held every 6 mths

DERBY Sept Clinic held every 6 mths

ESPERANCE June Clinic held 2-3 times/yr

GERALDTONJune, July, September Clinic held approximately every mth.

KALGOORLIEJune, Jul, Aug, Sept. Clinic held every mth.

KARRATHAOct Clinic held every 6 mths.

KUNUNURRASept Clinic held every 6 mths.

MANJIMUP July Clinic held every 4 mths

NARROGINAug Clinic held every 3 mths.

NORTHAMJuly, Sept Clinic held bi-monthly

PORT HEDLANDOct Clinic held every 6 mths.

BUNBURY & DUNSBOROUGHPrivate Clinics - contact Specialist Rooms in Perth for clinic dates.

JUNE-SEPT 2013

31Arthritis Today | WINTER 2013

Rural Rheumatology Clinics

JUNE-SEPT 2013

Groups held at the Wyllie Arthritis Centre17 Lemnos Street, Shenton Park

Inflammatory Arthritis (IA) Support Group

Meets 1st Tuesday of the month 10:30am – 12noon. Wyllie Arthritis Centre. Dates: 4 Jun, 2 Jul, 6 Aug, 3 Sept (meets @10am if talk organised).

Joint Replacement Group

Meets quarterly on a Friday, 11am–12:30pm. Dates: 24 May, 23 Aug, 22 Nov 2013

JIA Parents Group

A newly formed group for parents of children who have arthritis. Meets monthly from 7pm. Next meeting: Tues 25 Jun (Jul-Sept dates TBA) call for details.

Suburban & Regional Groups / BranchesAnkylosing Spondylitis Exercise Group

Meets every Monday evening for hydrotherapy and gym exercise program at RPH, Shenton Park.

Evening Inflammatory Arthritis Social Group- for those of working age

Meets 3rd and 4th Wednesday of the month from 7pm - 9pm.

3rd Wed (North) Mille Café, Inglewood. Dates: 19 Jun, 17 Jul, 21 Aug, 18 Sept 4th Wed (South) Applecross area, call for details. Dates: 26 Jun, 24 Jul, 28 Aug, 25 Sept. Call for venue details.

Mandurah Scleroderma Support Group

Meets quarterly on the 3rd Tues, 10am-12 noon, Eastlake Church, 99 Lakes Rd, Mandurah. Dates: 21 May, 20 Aug, 19 Nov 2013

Albany Branch

Meets 4th Wed of the month, 1pm–1:45pm, Resource Centre, Lotteries House, 211 North Road, Albany. Dates: 26 Jun, 24 Jul, 28 Aug, 25 Sept.

Bassendean Arthritis Group

Meets every Tuesday for gentle exercise, 1:30pm - 2:30pm. Bassendean Community Centre (Main Hall), 48 Old Perth Road.

Support Groups

For more information about attending a support group, please call Arthritis & Osteoporosis WA on (08) 9388 2199 or email clarac@arthritiswa.org.au

Talks are sometimes held during support group meetings. For details of talk topics and dates, please see page 27 and 28.

Arthritis & Osteoporosis WA has a number of support groups which are led by a trained volunteer leader. If you would like the opportunity to talk freely about your experiences and feelings in a safe, non-judgemental environment; share helpful hints and practical tips; receive and give encouragement and support – why not come along to one of our groups?

Social LinesDo you have arthritis which sometimes limits your social interaction?

Perhaps you would like to make a new friend, a volunteer from Arthritis & Osteoporosis WA who will telephone you on a regular basis at a time mutually agreed upon.

If you want to talk about a hobby, a recent activity, your family or even have a grumble, they are there for you.

If you are interested in being part of the Social Lines Program or know of someone who might, please call us on 9388 2199 or email general@arthritiswa.org.au

arthritis golf ClassicmonDay 23 SEPTEMBER

Join Abbott Solutions and Arthritis & osteoporosis WA for the 10th annual Classic at the lake Karrinyup Country Club - Awarded Western Australia’s Number 1 golf course for 2012.

• Lunch• Shotgunstart(Ambroseformat)• OnCourseMassages• NoveltyGames• Post-GameBeverages• 2CourseGourmetPresentationDinner• WineWallFundraiser• LuckyWinePickFundraiser• LiveAuction

Sponsorship Packages commence at $1500, please visit www.arthritiswa.org.au or contact Ric Forlano on 9388 2199 for more information.