conversations about medicine and life

The Big Red Ride: a community bike programme

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Annie Tredray

For the past ten years, I’ve been a physiotherapist at Mineral Springs Hospital in Banff, Alberta; Canada. Witnessing long term care residents live a mostly sedentary life did not resonate well with me. I saw the effects repeatedly: deteriorating functionality and simple lack of satisfaction with daily living. Some people would beg me to take them outside and, once there, they would lament that they were no longer able to walk around and enjoy their surroundings. Despite often severe disabilities, it was obvious that residents still craved opportunities to be active outdoors.

In 2015 I attended an Exercise Prescription and Aging conference. There I learned some hard data about Canada’s fast-aging population. According to Statistics Canada, the number of 85-year-olds will more than double between 2016 and 2036. By 2036, 62 percent of all healthcare spending will be on those aged over 65. Furthermore, while many adults are healthy in their later years, there is also an increasing number of seniors living with fraility. Frailty comes with more complex health challenges. Both social connectivity and physical activity are necessary components for healthy aging for any adult over 65 years, whether or not they are frail.

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“With Them Through Hell”

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Sue Wootton

With Them Through Hell11 November 2018 will mark one hundred years since the official end of the First World War. Over 18,000 New Zealand combatants were killed in the conflict, and many more were wounded or fell ill. Their experiences were so harrowing that most survivors, even years after returning to civilian life, would never speak of what they had endured during the ‘war to end all wars’.

Serving alongside them in that hellish world were the men and women of the New Zealand medical corps. A century on, Anna Roger has written a comprehensive history of this ‘other army’, which was charged, not with ending lives, but with saving them. The result is a rich tribute to the courage and compassion of those who worked “in appalling, perilous conditions and for inhumanely long hours” to alleviate the suffering of others.

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A Box of Bones (Part 2)

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Sue Wootton

femurThis essay continues from Part 1, which you can read here.

At some point most evenings I would put down my pen and pull the box of bones towards me. The lid had a small brass hook which fastened to a matching brass eye on the base. I tapped the hook edgeways and, as it fell free of the eye, felt the box give, as if I’d unbuttoned a tight corset. Apart from the foot and the hand, whose bones had been wired together, the bones lay separated and higgledy-piggeldy. I might pick up whatever happened to be lying on the top, a rib perhaps, or the femur. At other times I needed to look more closely at a specific part of the body, and so I would fish around for that particular bone.

The knocking sound of bone on bone and bone on box comes back to me as I recall this. With practice I became good at fishing blind, my eyes on Gray’s Anatomy and one hand in the box, delving. The scapula is like a large empty scallop shell. The humerus and the fibula are long sticks. The humerus is thicker, and knobbled top and bottom. The fibula is more like a giant’s toothpick or knitting needle. A patella sits comfortably in the palm of the hand, and has a satisfying contoured shape, like a large limpet. I noticed, too, the patella’s heft, its stone-like solidity. Most of the rest of the bones in the box didn’t feel this way. They were very light in the hand, almost like holding sticks of chalk. Had they been buried, or cremated, of course, they would be less than chalk by now. They’d be dust. Perhaps beyond dust: loam, clay. Shakespeare has Hamlet imagine Alexander’s bones fully recycled in the earth, becoming clay to stop a bunghole. To what base uses we may return, Horatio.

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A Box of Bones (part 1)

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Sue Wootton

How Tom Beat Captain NajorkSearching recently for a good read-aloud children’s story, I pulled from the bottom of the bookshelf  How Tom Beat Captain Najork and his Hired Sportsmen by Russell Hoban. Young Tom lives with his aunt, Miss Fidget Wonkham-Strong. She’s no soft-hearted dearest Auntie Fidge. She is aways, strictly, Aunt Fidget Wonkham-Strong, a woman who “wore an iron hat, and took no nonsense from anyone.” In Quentin Blake’s illustrations she’s a big-beamed human battleship wearing a rivetted-on grey dress and a high grey helmet. Tom – colourful, cheeky, cheerful – is clearly dancing circles around her. Readers naturally side with Tom. He’s all risk and movement. He’s teetering and testing, nimble, flexible, curious and persistent. He’s full of life. Poor old Aunt Fidget Wonkham-Strong makes flowers droop and trees shiver. Ridiculous in her rigid posture, bound tight by her unbending rules, she represents a fatal stillness of the soul, a kind of living death.

When I was eighteen, I found myself in the presence of a someone very like Aunt Fidget Wonkham-Strong. She taught anatomy at the school of physiotherapy where I was enrolled as a first year student. Wide-hipped and waistless, with an imposing ledge of a bosom, whenever she walked into the room we tender blossoms drooped. She stomped, each footstep an insult to the floor. I would eventually learn to figure out where a person was hurting by watching them walk: low back, tummy, ribcage, shoulder, neck, head, hip, knee, archilles tendon – the site of pain always lends a signature adjustment to the gait. But even as-yet untrained, I could tell that Ms Anatomy Wonkham-Strong was through-and-through sore. Some long-ago irritation had lodged within her, had spread through her entire body, and vibrated out into any environment through which she moved.

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Polio Survivors in 21st Century New Zealand – “We’re still here”.

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Gordon Jackman

Elvis Presley Salk Vaccine 1956
Elvis Presley receiving the Salk Polio Vaccine in 1956

New Zealand hasn’t had a case of live and wild polio infection since 1962, so people would be forgiven for thinking that was the end of it, we beat that one. Indeed, thankfully the world is on the brink of eliminating the wild polio virus, with only 14 cases globally reported this year. But the late effects of polio continue to affect thousands of New Zealanders, most of whom are now in their sixties or older.

The “Late Effects of Polio” or “Post-Polio Syndrome” affects most polio survivors. Symptoms include fatigue, muscle weakness and muscle and joint pain, shortening of tendons in polio-affected limbs, difficulty sleeping, difficulty breathing, and psychological stress. These symptoms can be debilitating and may compromise health and independence. A recent systematic review of the incidence and prevalence of Polio worldwide suggests that there may be close to 10,000 polio survivors alive in New Zealand today, including a significant number who caught it overseas more recently than their New Zealand-born counterparts.

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