Bone Health in Corona Times

Time heals, it is said, but today, ironically we are living in a time which itself needs the healing!

Welcome to corona times. We are going through the toughest and the most puzzling time of our generation. We are living an experience unprecedented and unparalleled.

We the Doctors have earned the new epithet of CORONA WARRIORS, one which we didn’t need, and certainly do not cherish. It is, in a way, a snide, as there wouldn’t be Corona Warriors without Corona patients, who would not have existed had there been no Covid 19 virus.

Hence it is all a conundrum – a complicated circle little understood on a path never chartered before.

It is heartening to see my friends in critical care medicine fight it out by the side of the afflicted humanity, in an uphill battle with ever changing protocols and tweaking doses of modern medicine, rejoicing in small conquests, only to realize that the peak is but a small plateau with a steeper climb of an unanswered and puzzling array of questions.

We as Orthopaedic surgeons, adept at replacing joints and handling road traffic accident traumas, suddenly find ourselves getting phone calls asking for advice on problems like sore throat and fever. We, the Doctors, have become the voice that can allay the concerns of a society living in fear of the Covid affliction. People sleep lonely and locked up, by design and destiny.

Purely from an orthopaedic point of view, two important aspects which need care and attention in times of Covid are:

• Easing of an existing pain
• Preventing home accidents

Easing out the Malady

A large section of our citizenry has allowed the fear of getting afflicted if they as much as step out of their homes, to override their other serious health concerns. However, they need to understand that Covid penetration in our society as per ICMR is only about 0.7 %. In simpler terms, this would mean that in a crowd of 120 people, one might be covid positive and that too may not be in the infective stage. Weigh this statistic against a more damaging scenario where neglecting debilitating arthritic pain, ignoring a twisted ankle or avoiding a searing back pain consult might lead to permanent disability or sure-shot surgical intervention in 3 to 4 months.
After three months of locking ourselves and our aches and pains behind closed doors, it is now perhaps time to reach out to the Doctors. If fear keeps you from visiting the Orthopaedician in his chamber, or at the hospital, it would be wise to at least do a tele-consult.

Talk to your Doctor!

Please remember that though we at Medica are offering you the option of on-phone consultation, arthritis pain can be crippling and your Doctor may find it difficult to give you treatment advice without physically examining you. In extreme cases, a visit to the Doctor may become necessary. If the fear of infection is keeping you from visiting the hospital, please be reassured that the hospital and your Doctor are taking all precautions to keep you safe.

As far as the home care of moderate or mild pain of arthritis is concerned, there are 3 cornerstones of care.

First is exercise and mobilization of creaking and stiff joints in moderation. One needs to remember the more one sits in a particular position the more the joints revolt to any movement from the position of ease they adopt. This causes permanent fluid compression in the discs and joints and leads to permanent changes in the joint surface causing erosion of the areas under constant pressure. It leads to the aggravation of arthritic pain, more in the already degenerating joints in the elderly. Hence it is imperative that one keeps walking and doing gentle exercises for strengthening of core muscles and mobilization and stretching of back and hips, strengthening exercises of the knee and stretching of ankles. Pranayama is an excellent way to ventilate the lungs, particularly in these Covid times. A daily moderate walk will ventilate your lungs and strengthen the heart.

Second is warm or cold compress as per the need. Warm compress is useful in mild pain with stiffness, to thaw and ease the joint movements while excruciating pain with swelling is well taken care of by cold packs 3 to 4 times a day, along with adequate rest and mild exercises.

Third is a medication which helps to boost immunity and bone health. Vitamin C is the immune booster and Vitamin D is the bone healer. Taken in adequate amounts these are beneficial in fighting the dual battle – with Covid and bone pain.

Preventing Domestic Accidents:

It is an anachronism that we are trying to prevent an incidence which by definition is something we never know would happen, and if and when it happens we rarely are able to pinpoint a reason. But still, the preventive aspects of home accidents in orthopaedic injury need to be kept in mind, particularly in these times.

Doing away with carpets and rugs at home would have the twin benefits of reducing the fomites carrying bacteria and viruses while also preventing inadvertent falls leading to broken hips, twisted ankles and knees. This would be a small step towards making your home largely accident safe for the elderly in the family.

It is important to keep the walkways and floors dry, with particular attention to areas like bathrooms and kitchens. This step becomes even more important if there are elders at home, as with age the need to get up at night to relieve overactive bladders or go to the kitchen for a cup of water increases. Keeping handrails near the toilet commodes is a very thoughtful adjunct for the elderly as it can prevent falls that may make a midnight rush to emergency imperative.

As we live through these difficult times, trying our best to preserve our sanity and mental equilibrium, it is important to remember that a healthy human existence depends as much on our skeletal framework of bone and joints, as it does on our mental health. It is our sacred duty to do everything in our power to preserve these pillars of our body which protect the other life-sustaining organs and make our lives worth living.

STAY SAFE BUT SEEK HELP if you need it! It is important to be wary of the monster lurking around the corner, but it is mindless to raise one right in your backyard by neglecting the avoidable.

(Dr. Vikash Kapoor is Senior Consultant Orthopaedic Surgeon & Group Director, Medica Institute of Orthopaedic Sciences)