Aerosure Launches in Australia

Great news, Aerosure has launched in Australia. See the TV advert below:

This is really great news because 1 in 10 Australians has some form of lung disease, and associated breathlessness and dyspnoea is a significant component of reduced quality of life in most lung diseases.

See the full statistics here: Lung Disease Australia

Aerosure can be purchaed in Australia at the outlets or pharmacies below:

Actegy

ChemMart

Amcal

Revitive: Circulation Booster

This post I would like to talk more about the work we have been doing with electrical foot stimulation (Revitive: Circulation Booster)initially in healthy populations, but the work will continue in diseased groups such as those suffering from diabetes. Diabetes is an awful condition in which the sufferer loses control of blood sugar regulation. The disease basically comes in 2 forms, Type I and II.

Type I diabetes is a genetic condition where insulin is not produced so patients experience rises in blood glucose and need to take regular insulin shots to keep things under control. In type II diabetes it is kind of the opposite problem that patients become insulin resistant so they over produce insulin and can experience hyper (high) as well as hypo (low) glycaemia (blood glucose).

Well high or low blood glucose doesn't sound so bad until you realize that high levels of blood glucose combined with poor circulation (low oxygen levels) can damage tissue in the body and low blood glucose can cause dizziness and fainting.

The majority of diabetics are inactive and therefore a common disease progression is tissue damage. Nerve damage (diabetic neuropathy) is all too common and combined with immobility can lead to blood stasis and swelling of the limbs. This blood pooling eventually leads to microvascular injury (damage to the small blood vessels) which doesn't heal and can eventually lead to amputation.

So what can be done to prevent this terrible disease progression? The most important factor in slowing or preventing this spiral is to create increased flow out of the swollen limb, normally a job done by the muscle foot pump during movement, but if movement is compromised then this creates an issue. Compression stockings have been used with limited success, pneumatic compression devices which rhythmically squeeze the tissues and force the blood back toward the heart have also been effective. Both forms of compression have issues though, the stockings can restrict blood flow when not moving, and the pneumatic pump is large and technical and not easily used.

Our preferred idea was to use electrical stimulation to cause muscular contraction, similar to when you point your toes and foot the floor. This involves placing electrodes over the muscle and stimulating with safe amounts of electrical current, causing the muscles to contract. The elicited contractions are not quite the same as voluntary contractions but they are good enough to squeeze the blood out of the lower legs and back to the heart, mimicking the muscle pump. When the muscle relaxes new fresh blood and nutrients flow into the lower legs keeping the environment healthy and helping to prevent swelling.


So electrical stimulation seems to tick all of the boxes for creating the muscle pump and maintaining a healthy flow of blood through the legs. But most forms of electrical stimulation are also difficult to use. Generally stimulation pads are stuck onto the skin over the muscle but getting the right position of the electrodes can be difficult. This is why we were so excited when we discovered Revitive: Circulation Booster as all that was required was the user popped their bare feet on to the device footpads and switched it on. It is really impossible to get this wrong.

If you have diabetes and are concerned about foot health issues (even if their are no physical symptoms yet) then speak to your consultant and try Revitive: Circulation Booster. This sort of thing is always worth doing in advance of problems, especially if you are not leading an active lifestyle. Over the next few post I will cover how we helped to develop Revitive even further, making it the most efficient and powerful circulation booster on the market.

Microfracture Surgery

So I had some long standing cartilage damage to my left knee. I went to the surgeon at the BMI Runneymede and had Xrays and MRI's taken which showed that I had medial cartilage damage from poor liftng technique, a small cyst and a lateral femoral tear that seemed to go down to the bone. The surgeon informed me that he could tidy up the torn cartilage and remove the cyst without any problems, but if the lateral tear did indeed go to the bone that he would like to do some microfracture surgery to repair.

I hadn't heard of microfracture before so I started reading around and although it has been around since the late 80's it is still a work in progress. It was actually developed by Richard Steadman, founder of the Steadman Clinic. The basic idea is that if you can make bone bleed the blood is rich in mesenchymal stem cells that can become a number of tissues. So special tools are inserted into the bone to create a rough, broken surface, deep enough to cause bone bleeding. A super clot or blastema then forms over the damaged bone, the bone heals and also new cartilage grows to cover the operated area.

Although new tissue will be formed in 6 weeks there is a long process of tissue remodelling that is required to cause the tissue to become what is required. Articular cartilage that covers the ends of bone is strong and elastic so it can last and absorb the impact forces it is subjected to. Unfortunately the new cartilage that formed during the early years of this technique was fibrocartilage, a much stiffer and less robust cartilage. It seems the great progress in the last 20 years has not been in surgical technique but in rehabilitation. Actually doing the right things to tell the tissue what it needs to become is the main focus of rehabilitation. Unfortunately the physio dept. at the Nuffield Woking seemed only to want me to be walking again and that was the limit of their care.

So post surgery I was non-weight bearing on the left leg for 6 weeks. Not a pleasant experience but it certainly grew my respect for those who use crutches on a daily basis. I was told by my consultant only to do mobilisation exercises for the 6 weeks. This didn't seem consistent with what I was reading so I decided to take control of my own rehab. For 2 weeks I only did mobilisation to get the full range of motion. After that I bought a cycle exerciser from ebay (an exercise bike is fine but place no resistance through the wheel) and started doing 5 mins of cycling twice per day as well as my mobilisation exercises. I very slowly and carefully and watched how my body responded to gauge what was too much. Any swelling or discomfort I took as my limit, when I could complete that without any symptoms I increased the duration. Eventually I built up to 40 mins of unloaded cycling per day.

Another technique I used was Revitive: Circulation Booster. This is a device I have worked on and I had one so I thought I know it improves circulation so it should speed my recovery. I used this 2x per day for 20 mins each time. Again building up the intensity as I got used to it. I would perform my mobilisation exercises after using Revitive: Circulation Booster as I found that I could get much larger ranges of motion after my leg was warmed up. Within a month I had full range of motion back in my leg. I did suffer from swelling in the leg and Revitive: Circulation Booster quickly removed this.

I also kept using my aerosure: youbreathe training device to keep my lung performance up to speed and this helped a lot especially whilst on crutches.

So 6 weeks came and went and when I went back to the surgeon he was very happy with the condition of my knee, full ROM and no pain or swelling. So he took my crutches away and sent me back to physio. I decided to move physio to a team I had used before, Balance Physiotherapy in Clapham North. I saw a knee specialist Paula Coates and she started me on a programme of knee strengthening and flexibility. I cannot jog till next year but I am back swinging my kettlebells which was the main aim for me. I am getting stronger and fitter by the day and knee feels great, very smooth and little discomfort. One important thing Paula added to my rehab is stretching as the quad had shortened from lack of use, getting the muscle back to normal length has been hugely helpful.

The links to some interesting research are here:

Pulsed ultrasound

Pulsed ultrasound observational study

LIPUS in rats

Microfracture rehab 1

Microfracture rehab 2

In my next entry I will describe my nutritional and supplement strategy.

Tune in!