SHOULDER IMPAIRMENT SOURCE OF PAIN, LIMITS MOBILITY

During the past five months I have experienced lingering discomfort, low to moderate level pain associated with my upper right arm and shoulder.

OCTOBER 

FIREFLY VARIATION

I recall feeling a slight pressure in my upper right arm documenting the above challenging variation of the Firefly asana - the evening before my 11th Yoga Anniversary.

It took several attempts to position my feet and hands in the appropriate position to execute the movements from a deep squat (Malasana) within a ten second exposure delay using my cell phone camera.

Being able to open up both palms, fingers compromised by Dupuytren's Contracture, my pelvic girdle and back while supporting full body weight as elevating both legs was exciting.

ASSESSING MY MOBILITY

A decade of focused yoga activities made it easy to 'listen' to my body, to know when whole body asanas were compromised, limited: being able to perceive a source of pressure, discomfort or possibly pain.

 

Despite the arm discomfort, it was encouraging being able to easily move my right arm, shoulder daily each morning:

• circular arm rotations in both directions

• yoga strap motions from (a) abdominals to overhead to lower back, (b) doing Figure 8 movements in both directions 

I contacted my Primary Care Physician on October 27th online about discomfort in the upper right arm soft tissues.

Dr. Faucher responded: "It could be shoulder related, rotator cuff possibly." ... and added some suggestions about limiting shoulder activities, to consider using ice, possibly taking Tylenol for pain and providing an update.

NOVEMBER

Discomfort in my right upper arm continued throughout the month.

I also began to experience uncomfortable neck and shoulder strain at times walking wearing a winter jacket with hood.

Morning and evening yoga sessions continued but which asanas were done, the sequence of movements depended on how I felt.

Little or no benefits were perceived in my upper arm using ice, a heating pad, various analgesics, even Tylenol on several occasions - these treatments were deemed ineffective and all discontinued.

DECEMBER 

As during the previous six weeks, I continued both daily yoga sessions and further modified the sequence of selected asanas.

Movements done easily over many years became limited: for example, in Gomukhasana -the clasping of hands behind my back with the right elbow moved towards  a vertical position; in a standing forward shoulder asana - moving arms parallel to my yoga mat.

Not doing specific movements in some cases (see below) reduced the likelihood of possible arm, shoulder trauma.

ALSO

• Local walks wearing a heavy winter jacket with a hood led to increased pain in my neck and upper right arm

• Obtaining restful sleep became more  difficult given the pain associated with my right arm and shoulder. 

On December 21st I contacted Dr. Faucher: providing an update on my status and asked about obtaining a referral to have imaging on my upper right arm.

X-Rays of my right humerus (2 views) and right shoulder (3 views) were taken at St. Vincent Hospital on December 22nd.

At my request, I was able to obtain a copy of the Radiologist report shared below: 

FINDINGS

• Osseous mineralization and alignment are normal

• There is no evidence of fracture or dislocation

• There are mild degenerative changes to the right acromioclavicular joint

&

• The right glenohumeral joint is well-preserved

• Images soft tissues are unremarkable

• Visualized lung parenchyma is clear

IMPRESSION

No acute osseous abnormality of the right shoulder or humerus

Mild degenerative changes of the right acromioclavicular joint.

A

 FUTURE 

MRI REMAINED AN OPTION

Details of possible soft tissue trauma including tissue tears would be disclosed with this diagnostic imaging.

JANUARY 

After reading the comments prepared by the Radiologist, my request for a referral to see a physical therapist (PT) was approved leading to a first session on January 19th.  

As during the last week in December, experiencing pain at night in my upper right arm made sleeping difficult, at times impossible.

Uncomfortable pain in my right upper arm, neck at times continued while walking - the pain became worse when I walked with hands in my coat pockets.

INITAL 

PHYSICAL THERAPY

 MEETINGS

I first met PT Jennifer Dietz, affiliated with St. Vincent Hospital Grove Medical Associates in Auburn, MA.

My initial assessments included inquiries into medical history along with evaluations of arm & shoulder mobility (range of motions).

Also evaluated were muscle strength and weakness in various positions (standing, sitting prone). 

I mentioned my long, decade plus active yoga practice and several movements I had been doing for years easily and safely that were now more restricted and a source of discomfort and pain.

Two examples of compromised movements are shown below:

TORTOISE

Entering this asana requires the joints of arms, shoulder to move in a way that was usually comfortable but now, at times, a source of pain.

Likewise, twisting my torso and  fully extending my right arm outwards away from body to a position parallel to the floor was compromised.

REVOLVED

 HAND FOOT ARM EXTENSION

BOTH INVOLVED

ABDUCTION  

DEFINED

AS 

MOVEMENTS 

  AWAY TO SIDE

 FROM THE MIDLINE OF THE BODY

The supraspinatus, deltoid, trapezius and serratus anterior muscles are involved in arm abduction at different times.

Jennifer responded to my inquiries and  suggested a shoulder impairment involving a  rotator cuff muscle (supraspinatus) was a reasonable explanation for the referred pain experienced mostly in my upper right arm based on the assessments.

We also addressed issues with my posture as noted below.

BACKGROUND

For many years I referred to several yoga anatomy books, online articles and videos to obtain a better understanding of the biology related to my mobility.

Ray Long's book THE KEY MUSCLES OF YOGA was a useful reference source to visualize the complex association of the arm, shoulder joint: bones, ligaments, muscles and tendons along with excellent illustrations of diverse asanas.

THE SHOULDER GIRDLE

The shoulder girdle is compromised of the following structures (Long, p.17):

• Scapula (shoulder blade)
• Scapulothoracic joint
• Clavicle
• Sternoclavicular, Acromioclavicular joints
• Humerus (upper-arm bone)
• Glenohumeral joint

SIMPLIFIED ANATOMY

UPPER ARM, SHOULDER

&

SUPRASPINATUS

AREA OF ILLUSTRATION

FROM 

ONLINE ARTICLE BY TIM MORRISON

The above image is an enlarged view of the shoulder joint that highlights the supraspinatus muscle, tendon attachment to the humerus and relative positions of the joint bursa and the scapula (shoulder blade) projection known as the acromion.

SUPRRASPINATUS

(Long, p.175)

"This muscle originates from the back (dorsal) surface of the scapula and inserts on ... the humerus ..."

This muscle "initiates arm abduction"

'It is ... frequently injured, due to impingement of its tendon ...  (by) the acromion process of the scapula." 

IMPINGEMENT

(LONG, p. 184)

"The subacromial bursa is a sac-like, fluid-filled structure that facilitates the gliding of the rotator cuff under the acromion."

"Impingement involves compression of the subacromial bursa between (the supraspinatus tendon attachment) of the humerus and the acromion."

" This can result in shoulder pain."

It is likely the acromion has been causing inflammation to the bursa, tendon of supraspinatus.

 

ROLE OF POSTURE 

Jennifer and I also spoke about my compromised posture, the forward position of shoulders resulting in 'rounded shoulders' - a condition I have been aware of for many years.

I mentioned a suspicion of the reconstructive thoracic surgery (pectus excavatum) in June, 2001 to address a debilitating structural deformity compromising breathing may have contributed to this poor posture. 

Our conversations noted the difference between the greater muscle strength of my chest (pectoralis major, minor) and weaker back muscles. 

Use of a shoulder harness as a reminder to adjust posture was discussed and considered an reasonable option.

Walking with a lighter jacket, with shoulders upright and arms at sides significantly decreased my neck, right arm referred pain.

😊

FEBRUARY

FOUR

PT SESSIONS

Jennifer continued to manually move the right shoulder joint during each session, to use different props to help address shoulder issues, reduce pain.

Photos of my whole body movements from 2013 to the present, demonstration of selective asanas led Jen to better understand how I moved yet express caution: that some of the shoulder movements I was capable of doing could have a negative outcome.

I acknowledged her comments and indicated my approach to yoga mobility for over a decade was guided by "less is more" to avoid trauma, potential injury.

Evidence of this was indicated by my daily modification of asanas during both morning and evening sessions - for example: either modifying or not doing a specific movement (tortoise, firefly variation, balance with arm abduction movements) 

MOVEMENTS 

TO 

STRENGTHEN

SHOULDER, BACK MUSCLES

Suggested movements introduced by Jen during physical therapy sessions and done daily at home have included the following:

[1]

> ELASTIC BAND Use (At Door), Standing<

[1] Rows, parallel to floor

[2] Lat Pulls: downward motions

[3] Scapular Retractions with Mini Shoulder Extensions, at quad level, arms straight

[2]

> ELASTIC BAND Use (On Mat, Use Mirror)<

[1] Bilateral Horizontal Arm Abduction

[2] R & L Diagonal Arm Stretches

[3]

> SCAPULAR RETRACTION, PRONE<

ON MAT, EXERCISE BALL

Raising Shoulders At Four Arm Positions (with and without 2 pound barbell)

[4]

> *SNOW ANGELS, SUPINE<

On FOAM ROLLER, MAT 

[5]

>EXERCISE BALL PRONE WALKOUT<

SEVERAL VARIATIONS

* Snow Angel movements resulted in most discomfort, lessened by elevating right arm

KUDOS

 TO

JENNIFER DIETZ, PT

I was fortunate to interact and to receive excellent professional services from Jen during our six sessions.

Jen's skills were apparent in the various manipulations I benefitted from during each meeting, the specific exercises and props selected to address my right shoulder mobility, upper arm pain issues.

Being able to share photos of my whole body yoga mobility abilities during the past decade were appreciated, facilitating her understanding of what were normal, safe movements for me. 

As a source of knowledge and effective communicator, I would highly recommend Jen to anyone seeking professional physical therapy assessment and treatment.

I remain grateful for Jen's contributions to my ongoing recovery.

AMONG

 CURRENT

PROPS  FACILITATING MOBILITY

A 65 cm exercise ball, a long foam roller, various sized yoga blocks, a yoga strap, wrist supports, an abdominal/back support belt, sandbags, several elastic bands of different resistance, two pound dumbbells and a tennis ball were some of the props I have used for years, recently to address my whole body mobility. 

HIGHER QUALITY SLEEP

My ability to sleep better at night during February has been a significant, positive and welcomed consequence of doing all of these various movements suggested by Jen.

Adjusting to sleeping differently: on my back with the right arm in a pain neutral position, at times using a cushion under my right shoulder, instead of on my sides has been effective to significantly reduce shoulder discomfort and pain.

A shoulder harness has been ordered to help remind me to maintain a better posture.

OPTIMISTIC WITH PROGRESS TO DATE

Incorporating the movements identified above, others I have examined in online videos will continue moving forward.

I anticipate making future additional adjustments to both morning and evening yoga sessions in response to what I can do safely.

ANTICIPATING

A

FUTURE MASSAGE 

WITH

 RAY HOYT

Looking forward to an opening with my former talented hatha yoga instructor and Tui-Na bodyworks massage specialist.

Using a tennis ball, foam roller to massage my arm, shoulder and back muscles are no substitutes for the hands of a skilled practitioner.

SHARE YOUR THOUGHTS

I will provide an update of my status next month on my 70th birthday.

BOB CROWTHER - NUTRITION - YOGA

AS A NEW YOGA DECADE BEGINS

 Bob Crowther (69, 116.6 pounds)

I highlight improved yoga mobility, several health status updates including weight, nutrition and announce a book project.

DOCUMENTING 

YOGA MOBILITY PROGRESS

'BIRD OF PARADISE' PREP

3 October 2020

DEMONSTRATING

BALANCE

AND

ENHANCED

HIP JOINT, PELVIC & LEG MUSCLES

 RANGE OF MOTIONS

&

GUILLOTINE POSE

20 SEPTEMBER 2020

 

 

DEMONSTRATING

EXTENSIVE

WHOLE BODY LENGTHENING

WITH

LEGS TOWARDS VERTICAL

&

DEEP OPENING

OF

SHOULDER  & PELVIC GIRDLES

Both of the above asanas and those below were documented in my condo yoga studio during the past month after morning and evening yoga sessions - using my cellphone camera with a ten second exposure limit. 

TIME-RESTRICTED EATING

&

MAINTAINING

ADOLESCENT WEIGHT

Daily weight values have remained relatively stable since June 2020 by continuing nutrition practices started late last August, early September, 2019.

I have continued to combine calorie restriction, intermittent fasting and time-restricted eating approaches with positive outcomes: regaining high school weight values with relative ease.

Limiting food consumption each day, from approximately eight  to ten hours, was easy and effective towards reaching short and long term objectives.

My October average daily weight was 117.1 pounds - my lowest values in over 50 plus years.

As noted in earlier posts, my mobility has improved as weight decreased to adolescent levels.

Daily yoga mobility, relatively good nutrition choices and getting rest, limiting stress have all contributed to maintaining strength and mind-body balance.

LOCAL

 NUTRITION 

OPTIONS

THE ROSE ROOM

JESS & BILL SABINE

(4 E. MAIN ST., WEBSTER, MA)

508-461-5344

Jess and Bill use locally grown ingredients in their many creative and diverse offerings updated daily. 

 

TWO OF MY RECENT SELECTIONS:

ONE MORNING OFFERING

GREEK YOGURT, MOCHA LATTE

 INCLUDES

 ALMONDS, OATS, COCONUT, HONEY 

AND

AN AFTERNOON SELECTION 

WILD MUSHROOM VEGGIE

A GENEROUS, ENJOYABLE COMBINATION 

WITH

ALFREDO SAUCE ON FLAT BREAD

 

UPDATING

HEALTH STATUS

[1]

VITAMIN B12, D2

Evaluation via blood assays indicate both vitamin concentrations have been elevated significantly since being consumed in mid-June, 2020.

Measured values of each vitamin are now within medically recognized 'accepted as normal' ranges.

I continue to take both vitamins and anticipate monitoring blood levels of each in the future.

[2]

DENTAL EMERGENCY

Receiving timely access, informed professional input in response to an extremely painful tooth was fortuitous and facilitated by the professional and helpful office manager Lima at Great Expressions in Auburn, MA.

Opting to have a root canal procedure,  excellent technical services were provided by Dr. Ping Zhang and assistant Bobbi for which I remain grateful.

Not being able to eat as usual for several days led to a weight decrease to 116.6 pounds. 

FIRST PART OF ROOT CANAL

[3]

EYE ISSUES

My Geriatric Specialist Dr. Jarrod Faucher approved a referral request to see an Ophthalmologist in Worcester, MA to discuss several issues.

It was suggested the optical migraines I had been occasionally experiencing (but not currently) may have been a consequence of  low vitamin B12 levels - a future evaluation of my optic nerve has been scheduled.

The Ophthalmologist suggested a return to Boston and meet with the retinal specialist I had last seen ten years ago at Massachusetts Eye and Ear while employed at the Shriners Hospital.

Visual examinations, photographs and a sonogram of an existing choroidal nevus determined there was a decrease in its size - positive observations for the presence of pigment (in their words "an eye freckle") - a condition that could become a melanoma. 

[4]

FLU SHOT

I was administered Fluzone High-Dose Quad 2020-21 (PF) 240mcg/0.7mL IM syringe flu shot on October 13th at St. Vincent's Hospital in Worcester - as a precaution to potentially mitigate the impact of viral exposure to flu strains during our current COVID-19 pandemic.

It is possible wearing a mask, social distancing may reduce exposure to these viral threats this Fall and Winter.

[5]

DUPYTREN'S CONTRACTURE

IMPACTING

PALM & FINGERS IN BOTH HANDS

I have made significant progress since 2018 and especially during the past twelve months to counter the negative impact of this connective tissue disease compromising my hand mobility.

My daily customized morning and evening yoga sessions have included frequent inclusion of movements to safely, gently open both wrists and hands.

The three challenging asanas below were selected among others to highlight current abilities to support my full body weight

FIREFLY VARIATION

18 OCTOBER 2020

DEMONSTRATING

EXTENSIVE

PECTORAL MUSCLE INVOLVEMENT,

OPEN 

PALMS, FINGERS & WRISTS

STRENGTH

AND

MOBILE

BACK, PELVIC GIRDLE, LEGS

&

EIGHT ANGLES POSE

11 OCTOBER 2020

DEMONSTRATING

WHOLE BODY

STRENGTH & BALANCE,

TORSO FLEXIBILITY

AND

CONTROLLED BREATHING

&

HANDSTAND

PREPARATION

10 OCTOBER 2020

DEMONSTRATING

MOBILE

 WRISTS, HANDS

&

FLEXIBLE SPINE, BACK

It is especially exciting to be able to engage in whole body movements like my Handstand  Prep for the first time since 2017.

Progress in opening my restricted lower spine, back muscle mobility has occurred.

However, their association with the pelvic girdle and, in particular, my thoracic region requires daily stretching and frequent practice of diverse asanas - often using various props.

Issues with my lower back and spine are a constant reminder of how yoga can be a humbling experience. 

MASSAGE

WITH

 RAY HOYT

Ray offered me an opportunity to experience his skilled hands that facilitated my yoga mobility progress these past ten years.

Before my TUI NA bodywork session I was able to show Ray some of the photos taken recently to document my overall mobility progress since my las group class in 2017 including the image shown below.

It was encouraging listening to Ray's positive comments about my home yoga practice  during the past three years, my mobility progress.

COMPASS POSE

1 OCTOBER 2020

DEMONSTRATING

EXTENSIVE

SHOULDER & PELVIC MOBILITY

AND

ENHANCED

LENGTHENING OF LEG MUSCLES

NEW PROJECT

WRITING  BOOK

DECADE

OF

 YOGA & NUTRITION 

LIFESTYLE CHOICES

Individuals are being notified of my intent to write a book of positive yoga and nutrition experiences during the past ten years.

I will tell a story of how my overall health and mobility have and continue to improve with age, approaching 70. 

Our yoga community led by the inspired instruction of Ray Hoyt and others will be one focus of my presentation and highlight gradual progress experienced year by year.  

Including members of our yoga community I encountered will occur in my story with their permission.

Over 100 images of my current mobility abilities and limitations have been documented by me at home during the past month.

More asanas will be taken in the weeks and months ahead - for possible inclusion in the book along with earlier photos from my yoga experiences.

FUTURE BLOG

 ON

 NUTRITION PUBLICATION

 COMMENTS WELCOMED

#BOBCROWTHER #NUTRITION #YOGA

ENCOURAGING 2020 LAB DATA, OFFICE EVALUATION

 69, 118.6 Pounds 
AN

OVERVIEW

OF 

ANNUAL MEETING 

WITH

 Dr. Jarrod Faucher

BAKASANA
(CROW POSE)

IN

THE YOGA LOFT
[2016, PHOTO BY PATTY TREMBLAY]

THIS ASANA IS ONE AMONG OTHERS I PRACTICE DAILY TO MAINTAIN MY HAND MOBILITY
FROM
DUPUYTREN'S CONTRACTURE
 COMPROMISING
 BOTH PALMS, FINGERS
(A CONNECTIVE TISSUE DISEASE)

PAST & CURRENT HEATH DATA 
WILL INFORM 

FUTURE ACTIONS

My fifth annual meeting on June 17th with Geriatric Specialist Dr. Jarrod Faucher provided a welcomed opportunity (1) to discuss health issues since our last office evaluation and conversation on April 26, 2019 and (2) to identify health action items during the next year.

During the past 13+ months I addressed a number of important health matters:

• had the second recommended pneumonia (Pneumovax 23) vaccine

• received both injections of the recombinant Zoster (Shingrix) shingles vaccine 

• obtained a seasonal influenza vaccine

&

• evaluated my inflammation status via a c-reactive protein blood analysis (<1 mg/L)

• scheduled, remained awake during a colonoscopy evaluation resulting in no polyps, inflammation of large intestine 

• remained proactive, monitored my dental health with cleaning, evaluation appointments

• evaluated eye status resulting in the purchase of new glasses

 DURING April, 2019 - June, 2020

 EMPHASIS 

ON

 IMPROVING HEALTH RISK FACTORS

BY

 TWO PRIMARY LIFESTYLE APPROACHES

[1]
FOCUS ON NUTRITION

VIA

CALORIE RESTRICTION

INTERMITTENT FASTING

TIME-RESTRICTED EATING

I continued to experiment with the what, when and how I ate by customizing features of calorie restriction, intermittent fasting, and time-restricted eating starting in late August, 2019.

Disciplined, daily practice and monitoring were required to realize my short and long term objectives.

Including time-restricted eating (at times ranging from 5-6 to 10+ hours) was important, critical - resulting in achieving my short term weight objective with relative ease.

EXCEEDED 
WEIGHT GOAL OF 120 POUNDS
(TEN POUND LOSS IN TEN MONTHS)

My average daily weight during August, 2019 was 129.2 pounds.

I was able to gradually and safely lower my weight to 119.4 pounds on November 29th, to 118.8 pounds on January 7th - gradually becoming significantly leaner by reducing adipose storage in my torso, abdominal areas.

Maintaining a relatively narrow weight range during January to June, 2020 was facilitated by keeping daily records of my weight and maintaining a semi-log of what I ate.

I WAS INFLUENCED & INSPIRED BY WRITINGS

 OF
MICHAEL POLLAN

EATING REAL FOOD
MOSTLY PLANTS
IN SMALL AMOUNTS

Daily, diverse selections of vegetables, fruits, nuts, seeds, legumes, beans, spices, herbs, some dairy and seafood prepared mostly at home and eaten in moderation all contributed to both acquiring and maintaining a 'healthy' microbiome - as indicated by my positive colonoscopy evaluation, outcome.

No meat was eaten to reduce likely exposure from antibiotics, hormones, pesticides and microbe contamination from Big FOOD, INC sources.

At no time did I have any sense of being malnourished or experienced any fatigue, loss of strength at these teenage weight values.

Likewise, I had no sense of sarcopenia (muscle wasting) or loss of strength based on my daily yoga sessions.

[2]

YOGA MOBILITY
ADDRESSING
STRENGTH, BALANCE, FLEXIBILITY
BREATHING, MINDFULLNESS
  ACKNOWLEDGING CONTRIBUTIONS
OF
 RAY HOYT, PATTY TREMBLAY, JEN GENDRON
&
MANY YOGA CLASS COLLEAGUES 

Currently in my 10th year of hatha yoga activities, customized daily morning and evening yoga sessions in my condo studio provided my primary form of whole body mobility.

My loss of weight to adolescent values significantly facilitated asanas - like the FULL LOTUS VARIATIONS I practice daily.

Keeping hydrated was a high priority and facilitated movements.

AND

WALKING

Being able to walk outside on both relatively flat and inclined roads for durations over thirty minutes and up to three hours at times provided cardiovascular benefits complementing my yoga practice.

I was successful in maintaining full range of muscle, joint motions and avoiding muscle aches by stretching well after each walk, keeping hydrated and maintaining good electrolyte levels.

OXYGEN SATURATION At 99%

Undoubtedly my local walking contributed to better respiration and improved oxygen saturations levels - 99% was my best value in the past five years.

My approaches to nutrition and mobility also kept my blood glucose levels, electrolytes (sodium, potassium, chloride) and calcium within ranges deemed desirable for maintaining optimal biological functions.

IMPACT
OF
NUTRITION & YOGA, WALKING
ON

BLOOD PRESSURE

115/69 in 2019; 127/68 in 2020 

Both of these systolic and diastolic values were improvements from previous office visit blood pressure readings during the past five years and achieved without any prescribed medications.

My readings indicate how blood pressure measurements are taken is important to obtain accurate values - failure to follow guidelines likely will result in misleading readings.

Blood pressure values follow circadian rhythms and will be lower or higher at different times during the day - possibly explaining variations of my numbers.

Home monitoring of blood pressure at specific times each day would provide more accurate and useful information to modify my actions, behaviors to achieve long term benefits.

I have begun and will continue to evaluate recommended blood pressure monitors during the next several weeks.

LIPID PANEL DATA

AMONG CURRENT & SIGNIFICANT
HEALTH RISK FACTORS
 RECOGNIZED BY MEDICAL COMMUNITY

(1)

TOTAL CHOLESTEROL/HDL Ratio: 3.36  
(lowest value in past five years)

[decreased risk of a cardiovascular event]

(2)

HDL 'GOOD' CHOLESTEROL: 69 mg/dL
 (highest value to date, at 40 in 2001)

(3)

TRIGLYCERIDES: 67 mg/dL
(lowest value ever)

(4)

LDL 'BAD' CHOLESTEROL: 150 mg/dL
(elevated from 130 last year)

 (5)
APOLIPOPROTEIN B: 110 mg/dL
(elevated, first time being measured)

Collectively, these lipid vales indicate a relatively low risk of a cardiovascular event - especially considering other lifestyle factors including my weight, physical activities, nutrition, blood pressure, no smoking, drinking or drug use among other behaviors.

I still struggle with addressing my Total Cholesterol, LDL Cholesterol values - attempting to reconcile the various, often conflicting guideline recommendations by medical groups and my daily food choices.

[My preference moving forwards is to use my yoga and nutrition lifestyle focus and practices, to avoid prescribed medication use only as a last resort]

PSA RESULTS
[PROSTATE-SPECIFIC ANTIGEN]

I am aware this assay can be misleading, that some physicians prefer a manual evaluation of the prostate gland.

My current value was 3.5 ng/mL are within a "normal" range at 69.

VITAMINS 
[B12, D]

In response to my interest in obtaining a baseline value of vitamins, Dr. Faucher authorized the evaluation of two: B12 and D - both often found deficient in seniors following my nutrition practices, not taking supplements.

Dr. Faucher discussed my extremely low values of B12 (<50pg/ml) and D (6.8ng/ml) yet acknowledged I exhibited no adverse physiological symptoms associated with these current levels. 

As recommended, I purchased each and the following day began to take orally:

B12 (Cyanocobalamin tablet 1000 mcg/day)

D2 (Ergocalciferol capsule 50000 unit/week)

We agreed to have an new assessment of both vitamins in four to five weeks to determine concentration levels.

MINDFULNESS

MONITORING, REDUCING STRESS
&
GETTING RESTORATIVE SLEEP

My past success in lowering sources of negative stress remains a priority.

I mentioned my reading of Dr. Satchin Panda book "THE CIRCADIAN CODE", my earlier blog post on this topic to Dr. Faucher and how I was able to improve my sleep my reducing blue spectrum light, using amber lights to promote natural melatonin levels from pineal gland during my evening hours.

These changes, along with time-restricted eating, have significantly improved my quality of sleep.

CURRENT REFERRALS

I requested and received authorization to meet with (1) an audiologist to evaluate my hearing and (2) an ophthalmologist to examine my eyes. 

My hearing as a senior has never been tested to date - this would provide a baseline, current status.

A retinal lesion (pigment cells) in my left eye warrants a more detailed evaluation as these pigment cells can become a melanoma (=cancer).  

AND

MONITORING CONDITIONS

• A groin hernia will likely require a surgical intervention 

• Considering possible enzyme injection treatments for my Dupytren's Contracture

• Possible consultation with a retinal specialist about occasional lapses in eye focus

• Status of body pigmentation by a dermatologist

CHALLENGES MOVING FORWARD

I remain positive, overall encouraged and motivated by the outcomes contributing to my current relatively good health and quality of life.

As in the past, I will continue to read and expose myself to the various and expanding sources of information - some that could be useful as daily lifestyle choices are made.

Dr. Faucher and I spoke of my concerns, challenges about evaluating the many contradictory sources of information relating to medical, nutrition and fitness/wellness topics.

[For example, see the recent article (17 March 2020) by Rebecca M. Marton and colleagues:
"Science, advocacy, and quackery in nutritional books: an analysis of conflicting advice and purported claims of nutritional best-sellers"]

SHARE YOUR THOUGHTS ON MY POST

STAY WELL & SAFE

BOB CROWTHER -NUTRITION -YOGA