This information about VIRAL LOAD was passed on by some medical colleagues, currently fighting on our behalf, is the key to how coronavirus affects each person. I found it helpful in explaining some of the issues we are now faced with and good reason to have as little physical contact with as few people as possible. It also gives a clue how to manage the virus. Perhaps the government could have explained this earlier.

VIRAL LOAD, why is this so important?

With this particular virus, the amount in your blood at first infection directly relates to the severity of the illness you will suffer. This isn’t unusual – HIV management is all about reducing viral load to keep people alive longer. BUT it is very important in COVID-19.

If you are in a pub, religious building or entertainment venue with 200 or more people and a large number do not have symptoms, but are shedding, breathing in lots of droplets per minute and absorbing a high load of the virus. Then you will likely become ill over the next 48 hours. Three days later you may wonder why you struggle to breathe, then end up in hospital. Perhaps you may have thought you are young and healthy, not a problem, WRONG!

Fortunately, but unfortunately, because the elderly are isolating quite well, the initial UK data suggests that all age groups above 20 are almost equally represented in ICU’s in England. Most cases are in London at present but the wave is moving outwards.

This means that being under 60, fit and well doesn’t seem to be as protective as we thought. Why? VIRAL LOAD.

This may be skewed simply by the fact that too many Londoners didn’t do as asked and congregated in large numbers in confined spaces, receiving a large initial viral load. They then, went home and infected their wider families. Which is why London is probably overwhelmed. We need to shut everything down to save all of the UK. The rest of the country is roughly one week behind London.

How does the Viral Load affect us?

Scenario 1

If I sit with one person and catch the virus, I receive a small viral load. My immune system reacts and starts to fight it, hopefully by the time the virus begins replicating, I am ready to kill it.

No medicines will help this process meaningfully, hence no “cure” for the virus as yet. All the hospital can do is support you with a ventilator until you immune system plays catch up.

Scenario 2

I sit in a room with 6 people, all shedding, now I receive six times the dose of the virus. The rise in viral load is faster than my immune system can cope, it is overrun. I then become critically ill and require specialist medical treatment and support to deal with it. Or I could have stayed at home and been OK after a few days.

Important

If you are a large family group, remember that by being ill and in the same room, you will make each other ill or “more ill”. If you do get sick, isolate yourself to one room and stay there. Don’t all sit in one room coughing. This will increase the viral load for everyone reaching the survival rate.

A family of six people may produce double the amount of droplets as a family of three in the same space, mathematics is important!

If one of you is symptomatic, assume you are all shedding and make sure you keep some space between you all.

Parents are getting it from their kids because no parent is going to stop comforting their child (nor should they) so the parent gets a big hit as well as the child. This cannot be helped.

Please keep washing your hands, even if you don’t venture out wash hands after opening envelopes or packages, food shopping etc. If you go out, leave shoes at the door or carry them through house and wash the soles.

This virus is encased in lipid (fat) which dissolves in soapy water or alcohol and destroys it. The virus cannot pierce the skin, but will get in through nose, mouth and eyes.

REMEMBER: Think about VIRAL LOAD

It could save lives.

This is one of the most comprehensive articles on the current Coronoviris, Covid-19, Sars-Cov-2 pandemic. From the Prospect magazine.

 

Social distancing, self-isolation, city-wide lockdowns—they can only do so much. In order to stop Covid-19 in its tracks, we need a vaccine. So, how long will we have to wait?

Source: Shot of hope: inside the race for a coronavirus vaccine

To all patients

In the interest of all during the current situation the clinic will be temporarily closed.

I will be available, as always to discuss any concerns and offer advice where possible. As I anticipate high volumes of calls please use either Text, Email or WhatsApp.

Thankyou in advance for understanding.

David

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Preparing for the weekend lecture day on Cervical Spine Risk Assessment. Hoping to take onboard lots of new and updated information to add to the current library

Looking forward to the weekend and joining the course on Headache Skills at the University College of Osteopathy. For those who are aware this is one of my favourite areas of treatment. I have spent many hours recently refreshing the Third edition of International Classification of Headaches- (ICHD-3). The breadth of understanding and classification has come a very long way in the last 15 years. We are very capable of affecting many of the sources of the Tension type -headaches both primary and secondary. However it is of prime importance as an Osteopath to be fully aware of all the classifications and work with a multi-disciplinary approach. I hope to produce an updated review sometime soon for the headache section of the website.

Further to the evolving situation regarding the COVID-19 outbreak and in line with Public Health England and other informed sources, I would like to assure patients that I am taking measures to reduce the risk of infection by implementing the following:

1)       Pre-screening patients prior to visiting and advising to postpone appointments, stay indoors and avoiding contact with other people if you’ve travelled to the UK from:

• Hubei province in China in the last 14 days, even if you do not have symptoms
• Iran, lockdown areas in northern Italy or special care zones in South Korea since 19 February, even if you do not have symptoms
• other parts of mainland China or South Korea, Hong Kong, Japan, Macau, Malaysia, Singapore, Taiwan or Thailand in the last 14 days and have a cough, high temperature or shortness of breath (even if your symptoms are mild)
• other parts of northern Italy (anywhere north of Pisa, Florence and Rimini), Cambodia, Laos, Myanmar or Vietnam since 19 February and have a cough, high temperature or shortness of breath (even if your symptoms are mild)

2)       Asking patients to postpone appointments if they have symptoms of flu, even if they haven’t travelled

3)       Continuing to maintain a high level of cleanliness and hygiene in my clinic both in public areas and in-clinic rooms, in line with the health and safety legislation

In light of the virulent nature of Coronavirus, I hope you can understand the importance of implementing the above measures.

If you have any questions, please feel free to email or call and ask.

David Isherwood BSc Hons. Ost. FSCCO

Why do I need to Stretch?

In today’s world the nature of our lifestyle is much less active. We have, over the last few years become much more sedentary.

This is mainly due to the advances in technology. Sitting becomes the most commonly performed action. We no longer need to stand up and take down files or even go to the fax and copy machines. We do it all on our PC and more than ever our smart phones.

When we sit with our knees bent, the three hamstring muscles relax, they attach on our ‘sit bones’ (ischial tuberosities) and partly the back of the Femur. At the other end they attach below the inside and outside of the knee. They are, in essence a postural muscle responsible for controlling the strong quadriceps on the front of our legs. They need to remain in a state of constant readiness, called resting tone. If shortened for any length of time, small receptors in the muscles called ‘muscle spindles’ measure their length, send messages via the spinal cord to the cerebellum to reduce the actual resting tone length.

This is why after being seated for any length of time at a desk or in a car, plane, train or sofa, the act of standing become difficult as the muscles have become shortened. Stretching helps to re-set the resting tone to be longer again and also improve speeds and stride length when training.

Does Stretching Help?

Many patients ask about the benefits of stretching and whether or not it may help with their back problems. We will attempt here to explain the various benefits and disadvantages to be aware of within yourself, that may make Stretching part of your daily activities.

Recommended Daily stretches

Hamstrings, Hip Flexors, Gluteals, Calves, Neck muscles. For more details visit the following five pages on differing body areas for stretching.

Other muscles commonly shortened

In the side of the neck when holding the telephone for long calls regularly, ladies check out the raised muscles when trying on that nice summer dress that always slips of the shoulder. The back of the neck when slouching on your chair gazing at the lap top or screen that is too far away from you. A classic for developing that headache that comes on later in the day! Those Psoas or Hip flexors that attach fom the inside of your upper leg, head through the and under your tummy vessels to a fix to the front of the lumbar veterbrae, when you stand up they are tight and create a bigger dip in your low back, this can make your tummy look larger and bloated. Wearing High Heals shortens the calf muscles making wearing flat sandal painful in the achilles tendon.

Is it wise to see an Osteopath before starting regular stretches?

Probably a good thing as the osteopath will be able to assess the quality of the muscles and their respective functions. This allows the osteopath to advise which stretches are more beneficial and specific to you and the envirnment you are in.

The Osteopath

When visiting an Osteopath with chronic or acute problems, you are assessed and treated with a view to prevention of further injury, combined with corrective exercise. The Osteopath is empathetic to the patient’s need to establish a speedy recovery of the body and return to the achievement of intended goals.

Trapped Nerves

A ‘trapped nerve’ is a common and unpleasant condition in which a nerve can be irritated by either the chemical or mechanic effects of inflammed tissues. Symptoms that may suggest that you have trapped nerve include:

• Neck pain and stiffness with a combination of radiating pain, tingling, numbness and weakness down the arm, forearm and fingers
• Low back pain and stiffness, also, with a combination of radiating pain, tingling, numbness and weakness down the buttock, thigh, legs and feet.

A typical case history of a patient presenting with a trapped nerve may sound like this:

‘I woke up one morning with an incredibly stiff neck. I could hardly turn it. It took me a lot longer to get changed for work – brushing my teeth, putting my jacket on and reaching for things were particularly painful. I took some Nurofen which seemed to free off my neck a bit but later in the day, I started to get a pain down my arm and a couple of my fingers went numb. Although the stiffness has improved somewhat, I’m still getting these symptoms down my arm 3 days on.’

Sciatica is another example of a trapped nerve. Sciatica can be caused by a number of different injuries such as a slipped disc, arthritis, a sacro-iliac injury or a muscle tear in the low back.

Because there are many injuries that can cause a ‘trapped nerve’ it it worthwhile visiting an Osteopath to determine the root cause of the symptoms. If the Osteopath is unsure, you may be referred to have an x-ray, MRI scan or ultrasound to confirm the diagnosis.

Once a diagnosis is made, a treatment plan can be created that will firstly reduce the pain and discomfort and secondly help to prevent recurrence of the injury.

There has been some press recently on tinnitus and it’s affects on Mental health. I have been approached on several occasions to ask am I able to treat this phenomenon with Cranial Osteopathy. Here is my response to the enquiry.

I have been a long term sufferer of Tinnitus for as many years as I can remember. My mother also suffered along with sinus issues. Over the years of living with this I have yet to discover a finite “cure.” I have however using some techniques reduced the severity to background irritation. I will point out that this has not removed it but made it less noticeable.

It is irritating for that should a patient discuss their tinnitus I will immediately be aware of my own.

What would I be looking for to help? Primarily as an Osteopath and Cranial Osteopath the first thing would be to assess the function of fluid flow within the head by gently holding the cranium in the palm of my hands and perhaps the sacrum. Once I have a good feel of what is happening I will be looking for any restrictions that may be affected ting the flow, ie structure attached to the various cranial bone from the neck back and Pelvis. I would then assess all the sutures of the cranial bones and the upper segments of the Cervical Spine. Of particular interest is the Sphenoid bone in the picture which houses the Vestibular and heating apparatus.

If there are restrictions in ay of these areas it may cause reduced functionality of the cerebra spinal fluid movement, blood supply and venous drainage. All of these can contribute to increased cranial pressure in turn headaches poor sinus drainage and venous drainage.

After treating these areas we return to assessing the flow. Hopefully this will enable the body to normalise. This will enable improved movement.

There are times when I suffer, that I will concentrate on good breathing technique whilst quietly listening to gentle classical music. Improving diaphragmatic function also improves flow within the cranium as there is a large fascial attachment from the diaphragm to the Cranial base of Sphenoid and Occiput bones. If the diaphragm is restricted it can affect all sinus drainage and Cranial function.

How successful this approach can be is never a guarantee. However it is not invasive and  uses no drugs. 

Good luck and hope this is of assistance.