December aches and pains

Many of us are furious that everyone keeps talking about health issues – not just some of the time but all of the time.  Casual conversations, dinner discussions, brief greetings, and telephone chats are eventually twisted into discussions of doctors and procedures and medications and rumors about all of the above. Not just us older folks…but everyone.  Boring, and I avoid it by walking away.

So…..(it is now obligatory to start narratives with ‘so…’)  Here is a summary of observations about aches and pains in the cruelest month of December, when cold and damp replace warm sunshine.  My prejudice is away from meds – even NSAID’s – unless absolutely necessary.  I am not injured, but have the same OA and creaky old body as everyone else in my age group. So I look for solutions.

Observation #1: Believe the experts on the subject of hydration. I started early in the summer on a plan to have water everywhere and drink not just the recommended minimum (eight glasses) but as much as I could. The goal was to avoid dehydration, but really test how I felt.  Simple conclusion: the more I hydrated the less aches and pains and sometimes none at all.  To the contrary, if I skipped drinking water for a half day I felt the results right away.

My apologies to the tiny bladder crowd, because I recognize the inconvenience; and my apologies to those fixated on exotic brands of bottled water (not my problem) that cost too much; and my sympathies to those often stuck in long traffic jams (try trucker’s friend) but the benefits dramatically outweigh the inconveniences.  I also recognize that some of our favorite beverages actually dehydrate when you drink, so I have adjusted (Hint:  I drink more water). The real challenge will be in the cold months, when it is not quite as natural to hydrate all the time.

Observation #2: For pain relief the solution that still works in a surefire low cost way is ice/ice packs/frozen peas or any direct application of cold with a bit of pressure.  We note that a sure sign that you are getting older is that the cooler on the passenger seat no longer is devoted to beer but now is loaded with refreezable (Velcro optional) ice packs. In a pinch plastic bags will work, or an old fashioned water bottle kept in the car to fill with ice when necessary. There is no excuse to succumb to aches and pains if you can tolerate the silly inconvenience and logistics of having ice packs plentiful and handy.

Observation #3: There is an entire industry, perhaps multiple industries devoted to convincing we the consumers to purchase pain relievers of every imaginable size shape and variety. If you watch television without fast forwarding through commercials you know there is a similar industry for surgery (see below), but the logical flaw to this approach is that taking , for example, an NSAID, is necessary and we just have to choose which one. I can report that if I did not try every single one, I tried many too many.  My conclusion is that they are all very different and work in ways that can be called ‘spotty’.  Long term and excessive use can be dangerous, and generally lifestyle variables have a determinate role in when and how well and how long they work. My concern is that there is not a lot of personal control. Various doses of ibuprofen or acetaphetamine under all those brands effect your entire system.[ I actually found a cocktail (‘script required) of arthrotec combined with limbrel that made me feel like superman.  Blood tests three months later revealed severely elevated readings on my liver chemistries.  That was the message I needed to avoid general meds.]

Observation # 4: Topical applications and products are of two catagories; those that work and those that merely irritate.  Again, I may not have tried them all, but I tried a lot both in the US and overseas (no script necessary). First, all those stinky menthol laden irritants have some value for ‘warming up’ and stretching before starting (just ask elite runners) bit IMHOP are not pain relievers by themselves. Second, many of the topical treatments combined with stretching and/or massage have quite a bit of value, albeit limited.  My favorite (cheap) example is good old Aspercreme; combined with a bit of massage and stretching it provides localized relief of aches and pains.  Limited, but useful.  The more expensive topical crèmes and gels (I am happy to send a list) are also of limited value, both the expense prescription variety (Rosiden and Voltaren) and the generic (pricey)sports rubs like Zostrix. I don’t use them anymore, but it does not mean they might not work for you.  Prepare to spend a lot of money.

Observation #4:  Two winning topical products have emerged from about ten years of wasting money. And the first is my pleasure to endorse  -- Arnicare (topical – I have not tried the ingestables), and the ingredient Boiron has worked for me and many of my friends.  Pinpoint and with some duration, the gell crème, or ointment is not too messy and not too costly.  The second product is not my pleasure to tell you about.  It works so well that it is scary, and worth the cost and the prescription if you are in pain.  There is a patch called Flector, and is technically an MSAID called diclofenac epolamine in conacentrated form.  Put the patch directly on the pain and the pain goes away no matter how acute.  Wear it while you sleep and the next morning you have full flexibility and no pain at all.  But the stuff is really powerful and you know that something has transformed your metabolism.  I cannot explain it, but please tred carefully. You have control, but not if you leave it on too long.  It is also expensive.

Observation #5: Is all that surgery necessary? We all have friends doing replacements and scrapings, and implants. The marketing is powerful.  The insurance  industry aides the promotion. Somehow I think that aches and pains are just a message that you have to slow down.

There you go; I have done my discussion of aches and pains for the year.  Now I just have to listen to everyone else.