The Rehab Saga: Goal Setting, Red Hot Chilli Pepper (Capsaicin) and Swimming

So I’m getting really close to complete my rehab stay and today was mostly about rounding up the programme and making sure I’m as prepared as possible before going out into the wide world to continue my life. I overslept this morning (I’m blaming the antihistamines) but I did get up early enough to go to the last stretch stretch class of the week. There were only a few of us so it was a nice cosy group. We finished the session and I was feeling pretty good so I stayed around to do some of my exercises rather than waiting back on the ward. I paced my exercises by chatting with some of the ladies from the ward, I’d finished my exercises by the time I was called through for the joint OT & Physio session. We were meeting in order to set my goals for the next 3 months. After some haggling and negotiation we have eventually settled on 5 goals.

1. To get up each day by 9am and do some gentle stretching.

2. To do my physio exercises 5 times a week.

3. To go swimming between 12 times before my 3 month review.

4. To cook a meal from scratch once a week (I must pace myself while doing it)

5. To use stress management techniques during stressful situations 25% of the time.

With each goal I have a worst case scenario written down as well as 2 slightly tougher development levels for each goal incase I make massive amounts of progress.

After my OT and Physio had photocopied my goals sheet we said our goodbyes and I thanked them for all the hard work and support over the last 3 weeks. I really cannot fault the rehab MDT, the therapy techs, OT’s, Physios and horticultural folks really have been amazing. I can’t believe the progress I’ve made they have totally exceeded my expectations. (I’m not just saying this incase they read the blog) haha!

I headed back to the ward for lunch, it would seem the kitchen thought I’d gone home (some kind of miscommunication) So after some fussing and a bit of a wait I ended up with a jacket potato and ‘salad’ (tomato and cucumber). I did get orange jelly tho so its not all bad 😉

The first session after lunch was ‘future medical management’. We talked about the different kinds of pain and the different meds used to treat them, we also discussed the proper way to take medicines. Proton Pump Inhibitors (like omeprazole and lansoprazole) used to protect your stomach need to be taken a few hours before the meds they have to protect against and on an empty stomach. If you take them with the offending medication they won’t do the job.

We talked about the different anti inflammatories (NSAID’s) and apparently diclofenac is being used less and less because of the increased risk of heart attacks. Naproxen, on the other hand, is being used much more commonly now. We discussed anti-neuropathic meds, like pregabalin and gabapentin and covered some of the side effects. We discussed the balance between side effects and the benefits of the medication, at what point do the side effects outweigh the benefits.

We discussed analgesia (painkillers) and the differences between various medications in the opiate category. We also touched on the new and exciting uses for Capsaicin (the chemical part of chillies that makes them HOT). One of the ladies I’ve met over the last week was in for a procedure where they smother painful areas in Capsaicin paste and it essentially burns off the nerve endings that cause pain. Sounds horrible right? well the procedure itself isn’t nice but you only have it done every 3 months and it could potentially get rid of chronic neuropathic pain! Stanmore is apparently one of the hospitals pioneering this procedure. I made a mental note to research it further!

Anyway after the medications chatter was over we had half an hour to get ready for swimming (water based exercise) I headed down with one of the ladies from the ward. It was a very small session, a lot of the rehab ladies are feeling pretty worn out and we’ve all worked really hard over the next 3 weeks. It ended up being just 3 patients plus 2 physiotherapists and 2 therapy techs (one for dry land and one in the pool) So essentially each of the patients had their own therapist!

I managed not to get PoTSy this week by doing just 2 lengths before taking a break. I still think the pool is too hot but everyone else thought it was cold compared to normal! After nearly an hour in the pool I’d managed just 8 lengths but I had paced myself and I’d kept my heart rate below 140bpm (considering the heat thats not bad). After a short rest I got out and dressed. I said my goodbyes to the therapy ladies (who have been fabulous throughout my stay and have helped me in more ways than I can count) and I headed back to the ward.

After a nice lay down and some intensive kindle reading I was ready for tea, Rice, Chicken and Peas with strawberry jelly for dessert. We chatted and laughed before I retired to bed for some internet time. I checked facebook before getting down to some research on Capsaicin.

Aswell as the nerve burning procedure done in theatre, Capsaicin is also available as a gel / cream or in patches from your GP. It would seem to work sort of like Deep Heat (but with a slight analgesic effect) The longer you use it the more of an effect it has on pain. This is all fairly new information to me but it makes a lot of sense, a few years ago I took a weight management suppliment called ‘Chilli Burn’ its chilli and green tea, supposedly it boosts your metabolism so you burn more calories while exercising. I took it for about 8 weeks for a month or so after that I took green tea tablets and Cayenne capsules separately from holland and barrett. I did lose some weight. I definitely had more energy and I was also in less pain. I put the reduction in pain down to being more active (less muscle stiffness) and to losing weight (less strain on my wonky joints) but now I’m wondering if actually it was the capsaicin? In my reading I also came across some other benefits of Capsaicin. According to google (not vouching for the peer-reviewed-ness of the articles) Capsaicin can help protect against gastric ulcers (because it hinders the development of Helicobacter Pylori bacteria) it has some anti inflammatory properties and its a great source of vitamin A. There is limited scientific documentation supporting the theory that it supports weight loss by making you less hungry, so you consume less calories. There is also research supporting the use of Capsaicin to treat painful skin complications post surgically and for nerve pain as well as conditions like like Complex Regional Pain Syndrome (Reflex Sympathetic Dystrophy). All in all it sounds like a pretty clever substance.  I’ve ordered some Cayenne capsules from Holland & Barrett and I’m going to do my own mini-study (if you decide to try it too please check with your Dr Blah Blah *generic disclaimer*)

I’m spending the rest of the evening horizontal, I think I’ve done enough for today and I’m getting quite into my current book.

Ciao for now folks!

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