MO Arthritis

Sustainability Toolkit - Growth Action Plan Worksheet Updated

The Growth Action Plan worksheet within Missouri's Sustainability Toolkit has been updated based on feedback from users over the past year.  The Toolkit, published on March 31, 2012, remains the same in content.  The formatting of the Growth Action Plan Worksheet appendix was modified to be more user friendly.  All documents on the Missouri Arthritis and Osteoporosis Program's Sustainability page have been updated with the new document.  In addition to the electronic version of Missouri's Sustainability Toolkit, there is now a print version of the Growth Action Plan worksheet, as well as an electronic version of the Growth Action Plan Worksheet.

Success Story: "Attend more than one program"

“This is your opportunity to learn how to do this.  You get to be in charge now.”  Marcia Rippe of St. Joseph, Missouri, Buchanan County, shares her experiences as a leader of self-management programs.  Rippe works for the Heartland Health (St. Joseph) Arthritis Community Services office.  Rippe has served as a nurse educator for at least the past 25 years, and she provides patient education through her job.  She also volunteers with the Red Cross, with Disaster Preparedness, and in teaching CPR.  The Arthritis Community Services office provides many self-management programs.  Rippe is a leader and trainer for the Chronic Disease Self-Management Program (CDSMP) and for the Walk With Ease (WWE) program. 

With her experience with the program, and her organization covering 12 counties in northwest Missouri, Rippe has had the opportunity to get to know many Missourians in the northwest area of the state.  At the end of the CDSMP programs, Rippe and her co-leaders ask participants to talk about what they’ve gotten out of the program and to talk with the group about how the program has made a difference for them.  One memorable response came from a participant in her 80s.  This participant told the group, “I think I have finally learned how to make decisions” through brainstorming activities.  This success, and others, “really touch my heart,” says Rippe.  “This [program] is their opportunity to learn how to do this – they get to be in charge now.”  Rippe travels from county to county and gets to interact with many rural Missourians.  Rippe states that individuals who live in rural communities are special to her because she knows oftentimes they will travel in town from a farm or to another city to attend these programs.

The CDSMP is a group format course that is offered by trained leaders in six-week increments, meeting once per week for 2.5 hours.  Participants are either persons with a long-term health condition (like asthma, arthritis, diabetes, and heart disease) or a caregiver for an individual with chronic health problems. This program which was researched and designed by Stanford University and is now an evidence-based intervention, discusses techniques to deal with health problems associated with chronic conditions; appropriate exercise; appropriate use of medications; communicating effectively with family, friends and health professionals; nutrition and setting goals.

The Walk With Ease Program is a group or individual format course.  The group format is offered by a trained leader in six-week increments, meeting three times per week.  This class, which was researched and designed by the Arthritis Foundation to be joint-friendly, includes warm-up, stretching, and cool-down exercises.  It teaches participants to learn how to safely pace themselves and how to monitor their progress while building up to walking at least 30 minutes at a time.  The individual format course is done independently, but follows the same structure as a group course.

Rippe also experiences personal benefits from leading the CDSMP and WWE programs.  The WWE program has started her on a regular walking program and she feels she can provide better support to friends taking care of themselves through her experiences with CDSMP.  To find out more information about CDSMP, WWE, and other self-management classes being held in Northwest Missouri, contact Northwest Regional Arthritis Center coordinator Debbie Braby at 816-271-7057 or 1-800-443-8858.  If you are interested in participating in self-management programs elsewhere in the state, you can find a class near you by visiting www.moarthritis.org/classes.html or calling toll-free at 1-888-702-8818.  Rippe says these programs are “a good healthy jump start to getting organized and to doing something you’ve always wanted to do.”

Success Story: "The leaders empower you."

"I don’t know if I can do this.”  Sheila Murphy, 54, of Poplar Bluff, Missouri, wanted to regain her independence and also to take care of herself after the loss of her sister whom she had cared for over 12 years.

(Image: Sheila Murphy, when she first came to the Independent Living Center of Southeast Missouri in July 2012)

When Murphy first heard about self-management programs being offered through the Independent Living Center of Southeast Missouri, her life slowly began to change.  Murphy started slowly participating in the Arthritis Foundation Aquatics program, just a few times each week.  Murphy has now built up to participating about three times each week.  She also enrolled as a participant of the Chronic Disease Self-Management Program (CDSMP).  One of Murphy’s greatest motivators to continue taking control of her health was her family: “I felt like I owed it to them.”

While Murphy has assuredly had great success in the programs she has participated in, a success that has been observed by staff at the Independent Living Center and the Southeast Missouri Regional Arthritis Center, she feels like the greatest success is the instructors of these classes.  The instructors are “all winners in my book because they keep going.  My goal is to become like them.”  The instructors in Murphy’s CDSMP course taught her to brainstorm and to problem solve.  The ability of these individuals to relate to Murphy and her health helped her realize the importance of the class and her health.  She stated that her health is getting back on track thanks to “those women and men [in her classes]; their stories have been the success”.

The Arthritis Foundation Aquatics Program is a group format course offered by trained leaders.  The program is a warm water exercise program shown to reduce pain and improve overall health.  Murphy stated of the program that “a heavy person can feel like a ballerina in the water; it gives you hope.”  The CDSMP is a group format course that is offered by trained leaders in six-week increments, meeting once per week for 2.5 hours.  Participants are either persons with a long-term health condition (like asthma, arthritis, diabetes, and heart disease) or a caregiver for an individual with chronic health problems. This program which was researched and designed by Stanford University and is now an evidence-based intervention, discusses techniques to deal with health problems associated with chronic conditions; appropriate exercise; appropriate use of medications; communicating effectively with family, friends and health professionals; nutrition and setting goals.

(Image: Sheila Murphy, in May 2013 with her completion certificate for becoming a Certified Leader for the CDSMP classes.)

The impact of Murphy’s leaders on her commitment to take back her life is apparent.  Murphy has recently gone through the process to become a certified leader for CDSMP classes.  And, now that Murphy has begun to feel that she has positively impacted her health, including improving her mobility, lessening her pain, and increasing her confidence, she has a goal for the next year.  Murphy will be working on taking steps to get back to working at least part-time. 

To find out more information or to register for Arthritis Foundation Aquatics programs, please visit www.arthritis.org/resources/community-programs/aquatics.  If you are interested in participating in a Chronic Disease Self-Management Program in southeast Missouri, contact the Southeast Missouri Regional Arthritis Center, Heidi Dunn, toll-free at 1-888-216-3293.  To find a CDSMP class elsewhere in the state, call toll-free at 1-888-702-8818 or visit www.moarthritis.org/classes.html .  Murphy’s advice to individuals considering participating is to “be brave. Be courageous.  Put yourself out there.  It’s scary and those things control you, but they don’t define who you are.  You define who you are.”

Success Story: "We have fun!"

When Russell Otte, 65, of Edina, Missouri (Knox County) registered for his first physical activity course, he was fearful that he would not succeed with the program.  Being the only man in his class didn’t help this fear.  However, the instructor of his Walk With Ease class encouraged everyone to walk at their own pace, to realize it wasn’t a competition, and to encourage one another.  As Otte says, “We cheered one another on.”  When considering taking a self-management or physical activity course, many people have similar fears. 

Otte pushed through his initial fears and continued taking the Walk With Ease course.  He stated that “the class isn’t about keeping up with the crowd – it’s about keeping up with yourself.”  He realized that others in the class had similar problems to his.  Otte has arthritis, diabetes, Meniere’s disease, and suffered a stroke in 2009.  The stroke in particular limited his mobility and range-of-motion on the right side of his body.  In describing his improvements made through taking the Walk With Ease course, Otte said, “The first day I only walked 5 minutes, but by the end of 6 weeks, I was able to walk 45 minutes with more ease than the 5 minutes had been at the start. After the 45 minute walk, I felt energized and ready to meet the day, instead of exhausted and overwhelmed with pain.”  Since Otte felt he had improved so much in this program, he chose to also enroll in the Arthritis Foundation Exercise Program. 

The Walk With Ease Program is a group or individual format course.  The group format is offered by a trained leader in six-week increments, meeting three times per week.  This class, which was researched and designed by the Arthritis Foundation to be joint-friendly, includes warm-up, stretching, and cool-down exercises.  It teaches participants to learn how to safely pace themselves and how to monitor their progress while building up to walking at least 30 minutes at a time.  The individual format course is done independently, but follows the same structure as a group course.

The Arthritis Foundation Exercise Program (AFEP) is a group format course offered by trained leaders in six-week increments, meeting two to three times per week.  Some sites choose to offer the program year round to participants with long-term health conditions (like asthma, arthritis, diabetes, and heart disease) or individuals just looking for a regular exercise routine.  This class, which was researched and designed to be joint-friendly, includes activities to improve range-of-motion, flexibility, balance, strength and to build endurance.  All of the exercises can be modified to meet participants’ needs.

Through his participation in the Arthritis Foundation Exercise Program, Otte was inspired to become trained as a leader, a move his doctor supports.  “My doctor was really pleased.  He sees that my life has improved, and tells me to keep on doing the activities.” Otte especially wants to encourage more men to participate in similar programs.  He will be starting a new Arthritis Foundation Exercise Program course this fall in September at the Community Center in Edina.   

To find out more information, please call the Northeast Regional Arthritis Center at 1-866-626-2878 x2049.  You can also find out more information about other self-management and physical activity programs being offered in the Northeast Missouri region.  If you are interested in participating in a Walk With Ease or an Arthritis Foundation Exercise Program course elsewhere in the state, you can find a class near you by calling toll-free at 1-888-702-8818 or by visiting www.moarthritis.org/classes.html. 

Otte especially encourages you to “find a program and experience it”!

Success Story: "We're all in it together!"

“You really don’t understand something until it is in your own backyard.”  When the grandmother of Paula Moore, St. Louis City County, had a stroke, she thought she understood what her grandmother was going through.  However, it wasn’t until three years later, when Moore had an ischemic stroke, that she felt she could actually understand where her grandmother was, what she was going through, and how she dealt with her stroke.  Following Moore’s stroke, at the recommendation of her health care team, she began rehabilitation at SSM Health Care in St. Louis.  While at SSM, the director of social services recommended to Moore that she should contact the Eastern Regional Arthritis Center (RAC) to enroll in the Chronic Disease Self-Management Program (CDSMP).

Moore enrolled in CDSMP in the fall of 2012. As she participated in the program, she realized she was in an environment where others were experiencing the same or similar things that she had been experiencing following her stroke.  One of the things Moore learned through the CDSMP was that the leaders of the program were not trying to make anyone feel guilty – “we’re all in it together”. The physical, emotional, and cognitive aspects that were covered within the CDSMP helped Moore with her development and recovery overall.  She ended the class feeling like she was more aware of resources she could reach out to when needed.  Prior to taking the program, Moore didn’t like to think of herself; she would instead think of others.  Now, as a completer of CDSMP, Moore feels a greater desire to be more aware of her own needs.  As she says now, “I choose to think about me”.

Taking this self-management course has helped Moore to look at illnesses differently.  Many of us can relate to Moore’s feelings that she didn’t want to become a burden or a hindrance to her family following her diagnosis.  Having been put in the position of experiencing pain, emotional stress, and physical stress associated with health problems firsthand, Moore can now look at individuals who have health problems differently and understand what they’re going through without treating them as if they are a burden.  Looking back to her relationship with her grandmother following her grandmother’s stroke, Moore felt that once a similar problem to her grandmother’s was “in her own backyard,” she could understand how her grandmother felt.  “Unless you’re sitting in it, you don’t know the depth of it,” says Moore.

The CDSMP is a group format course that is offered by trained leaders in six-week increments, meeting once per week for 2.5 hours.  Participants are either persons with a long-term health condition (like asthma, arthritis, diabetes, heart disease, and stroke) or a caregiver for an individual with chronic health problems. This program which was researched and designed by Stanford University and is now an evidence-based intervention, discusses techniques to deal with health problems associated with chronic conditions; appropriate exercise; appropriate use of medications; communicating effectively with family, friends and health professionals; nutrition and setting goals.

If you are interested in participating in a Chronic Disease Self-Management Program in eastern Missouri, or would like more information on the program, contact the Eastern Missouri Regional Arthritis Center coordinator, Duana Russell-Thomas, at 314-286-1625.  To find a CDSMP class elsewhere in the state, call toll-free at 1-888-702-8818 or visit www.moarthritis.org/classes.html .  Moore’s advice to individuals considering participating in a self-management program is to “try to get into a program if you can.  You can give yourself something and feel a sense of community by participating.”

May is Arthritis Month

The start of May kicked off National Arthritis Awareness Month, also known as Arthritis Action Month!  With arthritis being the number one cause of disability in the United States, it's important to raise awareness of what arthritis is and how it affects us, our family members and our friends.  Many organizations, including the Centers for Disease Control and Prevention (CDC) and the Arthritis Foundation (AF), are encouraging the nation to take action to help manage arthritis and reduce it's negative effects.

The CDC encourages walking to ease joint pain.  As identified in their May 3 Morbidity and Mortality Weekly Report (MMWR), State-Specific Prevalence of Walking Among Adults With Arthritis - United States, 2011, adults with arthritis nationally can improve upon the number of minutes spent walking each week.  To learn more about this MMWR and walking in Missouri, view the Missouri Arthritis and Osteoporosis Program's (MAOP) Press Release on Arthritis Action Month, released May 7.  You can also read the CDC's feature on Arthritis Awareness Month.

The AF encourages individuals to explore the Faces of Arthritis gallery.  This interactive website allows us to learn more about the facts of arthritis, to put a face and name with the disease, and to use tools to help/to act now!  The Faces of Arthritis gallery also allows individuals to submit their own picture and story and to really become the "face of arthritis". 

Closer to home, the AF Heartland Region office is offering webinars throughout the month of May featuring topics about arthritis.  Registration and log-on information is available for each webinar.  Contact Jazzmin at jmckay@arthritis.org with questions.

• May 15th: The Anti-Inflammatory Diet     Register Here
• May 22nd: Get Physical with Arthritis     Register Here
• May 29th:  Pain Management     Register Here

The National AgrAbility Project is also offering a webinar on Wednesday, May 29 at 1:00 pm CDT.  It is called Gardening with Effective Arthritis Management.  To participate in this free webinar, register here by Friday, May 24.  You can contact AgrAbility at 1-800-825-4264 or email if you have questions.

Self-management and physical activity classes are available throughout the state of Missouri.  These classes can be a great first action toward improving your health. 

For more information, contact your local Regional Arthritis Center (RAC).  Throughout the month of May, on Tuesdays and Thursdays, success stories from around the state will be highlighted on the MAOP website (www.moarthritis.org).  These stories, which come from a variety of participants and leaders, help to showcase the different classes offered throughout the state.  We hope that one or more of these stories will encourage you to take action to be our next success story!

MAOP Press Release - Arthritis Action Month

FOR IMMEDIATE RELEASE                                    Contact: Missouri Arthritis and Osteoporosis Program

May 7, 2013                                                                 (888) 702-8818

Take Action to Improve Your Health!  Increase Your Awareness of Arthritis and Jump Start Your Summer by Staying Active During Arthritis Action Month

 The month of May marks Arthritis Action Month nationally.  Throughout the month, individuals are encouraged to make personal actions to change the course of their arthritis.  May is also a great time to raise our awareness of this chronic health condition.  Adults who have arthritis can use physical activity as a step in their self-management plan to help reduce pain and increase their mobility. 

While there are many forms of beneficial physical activity, the Centers for Disease Control and Prevention (CDC) recommends walking.  According to the CDC, walking has been shown to improve arthritis symptoms, physical function, gait speed, and quality of life.  Friday, the CDC released information in their MMWR report that over half of adults with arthritis in all states walk less than 90 minutes per week.  In fact, among adults with arthritis in 38 states, over 50% did not walk at all.  In Missouri, 75% of adults with arthritis walk less than 90 minutes per week with over 56% of those adults not walking at all. Make it a priority in May to help change the statistics!

One thing you can do to take action to improve your health is to join an existing walking event or program.  In Missouri, the Arthritis Walk®, the Arthritis Foundation’s (AF) signature event, helps to raise funds and awareness of the nation’s leading cause of disability – arthritis.  If you live in the St. Louis area or didn’t make the May 4^th Kansas City walk, the 2013 Arthritis Walk – St. Louis will be Friday, May 17^th at 6:30 pm at the Logan College of Chiropractic in Chesterfield, Missouri.  For more information on this event and how to participate in St. Louis, visit www.arthritis.org/programs-events/arthritis-walk/. 

Through its seven Regional Arthritis Centers (RACs), the Missouri Arthritis and Osteoporosis Program (MAOP) offers two physical activity programs locally around the state. 

The Arthritis Foundation Exercise Program is a group format course offered by trained leaders in six-week increments, meeting two to three times per week.  Some sites choose to offer the program year round to participants.  Topics covered include: range-of-motion, flexibility, balance, strengthening and endurance-building activities; relaxation techniques; and health education topics.

The Walk With Ease program is offered in group or independent formats.  In the group course, trained leaders work with participants three times a week over the course of six weeks.  For the independent course, individuals use a workbook three times a week over a six-week period.  Topics include pain management; walking routine development; stretching, warming up and cooling down.

All courses are offered year-round and are designed for individuals with risk factors for or with chronic health conditions, such as arthritis, diabetes, heart disease, and high blood pressure.  Courses meet participants at their personal level – whether newly diagnosed, with a controlled condition, or not yet diagnosed.  Individuals with multiple chronic health conditions may find additional benefit from these courses as they learn how their conditions interact and can impact their overall health.  Self-management courses can also be beneficial for caregivers or family of those with chronic conditions.

For a complete schedule of courses offered and to learn more, click on your region at: www.moarthritis.org/regional-arthritis-centers.html.  If a course isn’t listed in your area, contact your RAC by calling the toll-free line at 1-888-702-8818 or via the website at www.moarthritis.org to begin a group or get added to a waiting list.  You can also contact your RAC to find out more about becoming a program leader. Find out more about MAOP programs by checking out our Facebook page at www.facebook.com/MOArthritis.

 

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Missouri Arthritis and Osteoporosis Program
moarthritis@gmail.com

CDC Report on Walking Released

Last Friday, May 3, the Centers for Disease Control and Prevention (CDC) released their Morbidity and Mortality Weekly Report (MMWR).  The report contained two articles of note for the arthritis community.  First, a report on walking among adults with arthritis was released.  The report, State-Specific Prevalence of Walking Among Adults With Arthritis - United States, 2011, looks at national data from the 2011 Behavioral Risk Factor Surveillance System (BRFSS).  Second, an announcement was made in the May 3 MMWR that May 2013 is Arthritis Awareness Month.  To learn more about Arthritis Awareness Month, also known as Arthritis Action Month, please visit the Faces of Arthritis webpage.

Arthritis and Hip Implants

The hip is one of the largest joints in the body, with a ball-and-socket design— the femoral head (ball) sits in the acetabulum (socket)—connecting thigh to pelvis. The surface of the bones is covered in cartilage, which acts as a cushion and allows movement. In a healthy hip, a small amount of fluid is produced by a layer of tissue membrane surrounding the joint, lubricating the cartilage and eliminating friction.

Understanding Hip Joint Degeneration

Arthritis, or inflammation of the joints, affects at least 50 million Americans and approximately 25 percent of seniors. Over time, arthritis can cause deterioration in the joints. When weight-bearing joints are affected, such as the knee or hip, this pain is the leading cause of disability and joint replacement surgery in the United States.

Osteoarthritis, a degenerative joint disease, is the most common form of arthritis. Osteoarthritis affects the cartilage surrounding the joint. Pain may be steady or intermittent, accompanied by swelling or stiffness at particular times of the day, and some people can even hear or feel the crunching of bones rubbing together.

Rheumatoid arthritis is a chronic autoimmune disease, where the body’s immune system attacks and can even destroy healthy joints. The inflamed area is usually the tissue lining the joint, causing irritation and damage to the cartilage, pain, swelling and stiffness as well as decreased range of motion. The ability to perform normal everyday activities may be impaired.

When the cartilage is broken down by arthritis, the bones rub together causing joints to become swollen or stiff and function to become limited and painful. This inflammation is prompted by the development of bone spurs, or bone overgrowth, and an increased production of fluid in the joint, which further impairs function.

Hip Replacement Surgery

Hip replacement surgery can offer restored mobility and eliminate joint pain, and is recommended for those who have hip pain that is limiting to daily life and unresponsive to conservative treatments.

In hip replacement surgery, the damaged hip joint is removed and replaced with a prosthetic implant. A metal stem with a metal or ceramic ball placed on the top is fitted into the center of the thighbone, replacing the femoral head. The damaged cartilage of the acetabulum is removed and replaced with a socket that is secured with screws or cement. A plastic, ceramic or metal insert is placed between the prosthetic ball and socket to allow for smooth range of motion.

Particular attention must be paid to the type of hip implant being used. The flawed design of several metal-on-metal hip implants, including the DePuy ASR and Stryker Rejuvenate and ABGII, has led to serious complications. Implanted in thousands of Americans before being recalled, these hip implants can cause patients to develop toxic levels of metal in the tissues and blood stream, can cause tissue loss and bone death and are likely to fail early, necessitating revision surgery.

Patients should speak with their doctor about using an implant that contains components made from a variety of materials.

Linda Grayling writes for Drugwatch.com. Linda has a number of professional interests, including keeping up with the latest developments in the medical field.

National Minority Health Month

In April, the Department of Health and Human Services' (HHS) Office of Minority Health and their partners work to raise awareness about health disparities, especially those which impact racial and ethnic minorities.  National Minority Health Month was established to help give everyone have equal access to services to improve their health.  The three main objectives outlined in a statement by HHS Secretary Kathleen Sebelius inlcude:

• to improve minority health
• to advance health equity
• and to eliminate health disparities. (HHS News Release, 2013)

The theme for National Minority Health Month 2013 is "Advance Health Equity Now: Uniting our communities to bring health care coverage to all".  The theme represents a call to action for each of us to come together to improve the overall health of our communities for all community members.  Partnering organizations, including the Centers for Disease Control and Prevention (CDC), also have activities ongoing in April for National Minority Health Month. 

To learn more about National Minority Health Month, click here.  To learn more about health disparity reduction efforts by the Office of Minority Health, click here.