Arthritis meeting in Amman, Jordan.

The APLAR (Asia Pacific League of Associations for Rheumatology) 2012 is on - previously scheduled in Damascus, Syria, it is pushing through in Amman, Jordan.

Many had been adamant in coming, in my case, mainly due to the extended Arab Spring phenomenon, just several hundred kilometers away, and the fact that geographically, Jordan is wedged between Israel and Iran. But in the airport I met several friends from other countries and  represented in the mix were attendees from Korea, Japan, Indonesia,  Malaysia, China, and some from western countries AND the trainees slinging poster canisters. It was a comforting sight.

Today will be the first day of meeting and I am hopeful that this Middle East meeting will still give us a good "harvest".

Some notes on the bus trip to the hotel: searing hot sun, immense expanse of red brown land, with sparse dots of palms, olive grooves, one camel herd, and one sheep and goat herd - as quick as my neck can turn. It's fantastic, given other countries that I have visited had trees and plants, asserting themselves between buildings - here it is a desert expanse, breath -taking for a first-timer. One cannot but praise God for His creation. We are in the Dead Sea - where the convention center is located, and it is 384 meters below sea level!

The "chick" - ever heard of Chikungunya fever (and associated arthritis)?

        This article is being written with a real time possibility that chikungunya fever is on the rise in Manila. It is a virus, the CHICV, that is also acquired from a mosquito bite (same mosquito as the dengue -  Aedes aegypti  and some other species). 

        This viral infection has also been described as the "neglected" infection since its course is more benign and has not hugged the lime light of public health concerns,  as say, dengue. There has been NO reported deaths from it since its first isolation in Tanzania in 1953, but the arthritis associated with it can be debilitating. The term chikungunya is from a Bantu (African) language, which means to "fold up." This is thought to refer to the patient's stooped posture due to joint pains and generalized body aches. This fever is unique since it makes its appearances in many African, Southeast Asian and even temperate countries like Italy, where it had been reported, then disappears for decades at length, then is back.

       Again, i reiterate that its course is benign.

       There is a possibility that in the Philippines where dengue is endemic, fever and rash and general body aches associated with most viral infections could miss the "chick." Since its course is benign, identification of this fever can spare many a hospitals' resources on intravenous fluids which is the main supportive treatment for dengue at this current time. Still, any infection for that matter needs increased fluid intake, and if it's the "chick", drinking water may suffice. If there is headache and vomiting, then intravenous fluids become necessary.

       Your internist, infectious disease specialist and your rheumatologist can help. Please seek any of these specialists. Testing can be done if the illness is 7 days or less in the NIH of UP Manila,  and if more than 7 days, testing is in RITM in Alabang.

Ref:
1. Alladi Mohan, DHN Kiran, I Chiranjeevi Manohar, and D Prabath Kumar. Epidemiology, clinical manifestations, and diagnosis of Chickungunya fever: Lessons learned from the re-emerging epidemic. J Dermatol. 2010 Jan-Mrch; 55(1): 54-63. doi: 10.4103/0019-5154.60355
PMCID: PMC2856377
2. Dieudonné Nkoghe, Roland Fabrice Kassa, Mélanie Caron, Gilda Grard, Illich Mombo, Branly Bikié,Christophe Paupy,Pierre Becquart, Ulrich Bisvigou, and Eric Maurice Leroy. Clinical Forms of Chikungunya in Gabon, 2010. Negl Trop Dis. 2012 February; 6(2): e1517.

Published online 2012 February 14doi:  10.1371/journal.pntd.0001517

 PMCID: PMC3279511

with permission from my daughter who came down with fever, arthritis and rash, and is being tested for the "chick"

      Updates are upcoming, and we are collecting data on this interesting cause of arthritis.

Calisthenics: when was the last time you did it?

        The Merriam -Webster dictionary defines the word as systematic, rhythmic bodily exercises performed usually without apparatus.

        Fifty years ago, I recall my Grade 1 teacher, Ms. Rose Cabaron, (any current information about her is most welcome) leading us out of the classroom in a bee line, to bring us out to the sunny, grassy school quadrangle, for our regular calisthenics. She would have an empty can and a wooden stick to drum up counts 1 - 8, then 8 -1, for the head roll up, side, down, side and up again; for arms forward, upward, sideward, down, repeat, till you are down to count 1 again. Then while arms are in sideward position, we twist to the right and left, and the tin drum goes tang, tang, tang, tang 1- 8, 8-1. Then we should march in place, "feet high up" - she would holler, and the tin drum goes, tang, tang, tang. This was repeated several times, and when we were all sweaty and in all probability, smelly- she would then herd us back to the classroom for the rest of the lessons. (Thanks Ms. Cabaron!)

      Why talk about calisthenics after 50 years? It crosses my mind now why children in elementary grades had to go through such boring routine, when they should be jumping, running, climbing and even falling at that age.

      

       This is because calisthenics is the easiest exercise routine that can be done by ALL people, age 5 -95, with arthritis or not - as in, by all.  

      It can be done in the bedroom, on waking up, even while still seated at the edge of the bed (for those with knee or hip arthritis who have pain on standing), in the bathroom before dipping the "tabo" or opening the shower. It can be done by the busy mom who needs to fix kids for school before sun rise, for the business man who is averse to the gym, by the gym buff who knows that the body needs rest from heavy gym routines, and even by the teenager who is busy with, whatever- school, iPads, fb, etc. The stay at home moms can do this before doing the laundry, cooking, potato couching and even after!

       Calisthenics are essentially range of motion exercises, and for the uninitiated, heaviness and pain may be experienced as the limbs are moved. The muscles of the arms, legs and buttocks provide the natural resistance or weight. When done slowly -no jerky motion, please, the pain eases over a few weeks and the repetitions can then be increased.

       I used to attend a nice non air-conditioned gym, where I really sweated it out. But now, with less time and the distance of the place, I reverted to calisthenics. This way, I spend less, and has no more reason at all not to do the basic body maintenance required as we age. 

       This is an invitation to do calisthenics, add on the hula-hula for the hips, and any innovations you feel will move as many muscles there are in you. Just do it slow and deliberate, and feel the stretch (and pain) and enjoy the relaxing feeling after. Don't forget a good tall glass of 

WATER with it!