Weekly Live event replay- 20200701
Trying to thrive in a world of heightened uncertainty by focusing on:
Chicago Arthritis and Regenerative Medicine- Weekly Live
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Discussing relevant issues regarding state of the care for arthritis, tendinitis, injuries, and back pain.
Hello everyone, this is Siddharth Tambar from Chicago Arthritis and Regenerative Medicine. Welcome to our weekly Live event. It’s July 1st, 2020. I hope everyone’s doing well. This feels like the beginning of summer, even though that started a couple of weeks ago. Here in Chicago, we’ve started to enter phase four of the coronavirus response, which generally means that certain retail establishments, including restaurants, I believe bars, are now allowed to allow something like 25% of their normal volume of patrons. That’s a nice small win for us here in Chicago, since we had so really clamped down pretty hard for a couple of months, we’ve been able to start slowly easing into, you know, this new normal. At the same time we have other parts of the country that weren’t quite as… I don’t know if I want to say diligent or aggressive when it came to precautions when they were reopening. And now they’re in a position where they have to start kind of pulling back as well. My sense is that this sort of cautiousness and variability that we’re seeing throughout the country is something we’re going to be dealing with for at least the next several months. Meaning as some places are able to reemerge a little bit, more steady, other places may need to retract, and there’s going to be a bit of give and take, and pull and push as we, you know, as we grow into what this new world is.
And in that kind of world where you have so much uncertainty and volatility, I want to touch base on how can, how can we as individuals, still thrive in a world with heightened concerns? So it goes without saying that for folks that have active medical issues that require treatment or are being delayed because of COVID-19, those are really harsh things that obviously need to be addressed in a hardcore medical way. A lot of the things I’m talking about are more about, you know, how should we be approaching, how should we be approaching things from a mental and emotional standpoint with some of the heightened concerns that we have, and volatility that we have in this world. And so there’s two things that I think of, number one is being able to focus on small wins. And number two is really a concept that I believe in which is falling forward.
So in terms of small wins, I think it’s critical that we really appreciate when we do take those baby steps, when we are, when we are actually moving forward and when we have wins. So as an example, phase four in Chicago, that’s a big deal. I mean, we really were pretty clamped down and shut down from a business standpoint throughout, you know, our, the Metro Chicago economy for the last, for the last few months. And so to see restaurants starting to open up a little bit is a big deal. This past weekend, my family, we were able to go to the Chicago Zoo. And then the next day we were able to go on a picnic with some friends and we maintained appropriate precautions in terms of mask, as well as social distancing. But you know, that, those are small wins, and that’s important to recognize.
So in a professional component, when I think of how do we get small wins for our patients who have arthritis, tendinitis, injuries and back pain, there’s a few things that I think of. The first is, small wins help out in a couple of ways. For example, they help out with maintaining forward momentum or forward progress. In addition, small changes sometimes can equal bigger, bigger wins longterm as well. So as an example, maintaining forward progress, I think physical therapy is a great example of where small wins on a day-by-day basis go a long way. In particular, small gains in strength, small improvements in range of motion, go a long way in terms of improving a person’s function, a person’s pain relief, and a person’s quality of life on a daily basis. So key because small changes in strength, small changes in stability make a huge difference in quality of life. Regenerative medicine sometimes has a similar effect, for example, improving stability, which is a lot of what we’re doing when we’re treating ligaments, soft tissue structures, tendons, muscles, labrum, meniscus, that even just a small amount of improvement in stability and strength in those tissues goes a long way in terms of improving function as well. So that classic sort of example would be a patient who says, “Look Doc, I’m doing okay when it comes to my knee, when it comes to rest, and I can do some basic activities okay. But now when I’m walking about four blocks is when my knee is causing problems. I start to feel fatigue and pain and it starts to feel a bit loose.” Well, improving some of that stability with physical therapy, but also with the regenerative medicine techniques, whether it’s injecting your own platelets, dextrose, bone marrow stem cells, that that goes a long way in terms of taking somebody from walking four blocks to walking eight blocks. Quality life improvement there is pretty big. The original prolotherapy, dextrose prolotherapy, where you’re injecting sugar water, which has been going on for decades as a treatment modality for arthritis and tendinitis, that worked by improving that tissue integrity of ligaments. And by improving that function just a little bit, made a huge difference in terms of functional improvement, and quality of life, and pain relief as well. So small changes, small wins, when it comes to things like physical therapy and regenerative medicine, help to maintain forward progress, and help to push forward a person’s abilities.
The other thing is sometimes small changes can actually be equivalent to humongous gains. So two examples of that. Number one is a patient I saw recently who was having a lot of hand and wrist pains, who I think has probably early rheumatoid arthritis. You know, the next step in her evaluation is actually to check a diagnostic ultrasound of her hands and her wrists. And the reason why is I’m expecting to see some subtle changes of fluid. But really what I want to see is does this person have what’s called power Doppler uptake or active inflammation in those small joints, because if they do, that makes a big difference in terms of what our next steps would be. In particular, because if they have that small vascular change on ultrasound, it’s a sign of very significant inflammation, and it’s a very significant sign of progression or risk for progression of their condition, including actual damage in the joint as well. So identifying that small change is huge because we can actually make a difference with treatment there. If you start a person on the right kind of medication treatment who has that condition, you can reverse or actually get that inflammation signal to resolve, and that will then predict a reduction in chance of progression of their condition, and a reduction in chance of actual damage from their condition as well. So that’s humongous, making small changes, small win for that one small change can go a long way to improving that person’s condition, pain, inflammation, and longterm outcomes as well.
The second concept that I think that’s important is something that I think a lot about is this idea of falling forward. So, you know, I got this idea originally, I am a big football fan, and every once in a while, you’ll find a running back who’s in the league who is not the fastest, not the quickest, not very elusive in his movements, but he’s someone who based on his size, his agility and the way he plays, that anytime you hit him, he still falls forward. He still somehow gains yardage. So if you hit him after a three-yard gain, he gets five yards total. If you hit them behind the line of scrimmage, instead of a one-yard loss, he still somehow ekes out two yards. Falling forward. I think that’s important mainly because, in my own personal and professional life, I find that when you have to make tons of decisions, it’s hard to make all those decisions perfectly and correctly. And sometimes you just have to make a good decision that makes sense on paper. And hopefully if it’s enough of an improvement, that even if the result is not ideal, you still fall forward, meaning you’re still getting some forward momentum. You’re still inching forward, so that you’re not as concerned about, “Did I make the exact perfect decision?” You’re more thinking about, “Did I at least move things forward? Did I at least move my life forward, my business forward, the effect on this individual forward?” So that we’re still moving forward in a positive way. I think that’s key because it’s important that when you make decisions that you are learning, you’re adapting, and you’re moving forward.
This is, this is important, not only from a life standpoint, a business standpoint, I think it’s so key from a musculoskeletal standpoint as well, namely for the following two reasons, two examples. I had a patient ask me recently about what to expect after his regenerative medicine treatments. And the key for him to understand is that, that first couple of weeks are going to be a little bit up and down, that he may feel like he is, his progress is a little bit up, a little bit down, but the key is to understand that as long as you’re inching forward, falling forward, you’re making progress. And that long term, that sort of slow progress of falling forward will eventually equal big gains longterm. I think physical therapy and exercise is the same thing. There’ll be moments where you feel like you’re doing well. And there may be the moments where you feel like you have a little bit of retraction. That little bit of retraction, that can occur. And that’s okay because that’s part of the process of healing and improving, meaning that it’s not a linear straight line. A lot of times it is actually just getting small improvements and there may be a small setback, which you learn from that, you adapt from that, and then you kind of get back on that upward trajectory. Falling forward is key because I think in a world of uncertainty, we’re not going to have full visibility of what’s coming next. We’re not going to have full visibility of, are we making always good progress? But as long as we’re making micro progress falling forward, I think that’s, that’s a way to gauge that. Are we actually in the right direction?
So in this world of heightened uncertainty and concern, I think whether it comes to your own personal life, whether it comes to your own professional life, and certainly when it comes to your own musculoskeletal health, those are the key things. Are you making small wins again and again. And are you falling forward. I think if you are, then you’re heading in the right direction. You’re still growth-oriented. You’re still moving positively. I think that goes a long way.
Thank you for your time. Until we connect again next week, I hope everyone stays healthy and is safe. As a reminder again, I’m publishing two things right now. The first is obviously this Weekly Live kind of interaction. The other one is a Weekly Educational meeting that I have with my own team every week. We’re publishing that as well. Good way to kind of learn from both of them in a slightly different way, but until next week, I hope everyone stays healthy and live well. Bye, bye.
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***About this video***
In this video Siddharth Tambar MD from Chicago Arthritis and Regenerative Medicine discusses how to thrive in a volatile world- 1) Small wins. 2) Falling forward.