Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group 1st Phys. Therapy session

Had my first PT today and they decided to start on my wrists. They are both acting like they are fusing. I didn't think it would be bunnies and flowers but HOLY MOLY that was freaking painful!!

My left wrist seems to be fusing via "fibrosis" while the right seems more like a bony fusion to the Dr.

Pretty darn amazing though, just by pushing, rubbing and slightly torturing the ligaments in my forearms, my wrists actually loosen slightly. Very cool.

I am a strange one, I have zero evidence in my SIJ's still, but wrists are fusing. I read an article yesterday that said for those of us AS-ers who have hand/feet problems (not back, SI) it is more than just tnf that needs to be blocked to control inflammation.
"TGF transforming growth factor-β (TGF-β), is also important in the inflammatory process by leading to fibrosis and ossification at sites of enthesitis.8"

entire article http://emedicine.medscape.com/article/332945-overview

So maybe they will roll out a new line of biologics tgf-blockers for those of us who experience enthesitis as our biggest complaint.

Thanks Donette, that is a really good summary article!
It even takes seriously the papers on Klebsiella involvement, providing relevant references. It also mentioned an animal study that I haven't heard of before, which also supports bacteria as a triggering environmental factor:

"HLA-B27 –positive transgenic rats that are raised in a germ-free environment do not develop clinical disease. Once introduced into a regular environment (ie, non–germ-free) and exposed to bacteria, the rats develop clinical manifestations of spondyloarthropathy."

Hi Donette, glad your PT went well. How many days a weeks will you be going and what's the next step? Thanks for the article.
Cindy

Dear Done
this is very fortutious to my current expeirnce.

Agape'
Lon

Glad to hear that you were able to get some range of motion back!!

Hi Cindy,

I have no idea how long I will be going. I had two therapists, one was a Dr. and one was a student. The Dr. said "you can come in as often as you want, when the student works on you, it is free, and I will check in often."

That was awesome because the med student seemed very mature and knowledgeable and they both were really good listeners. My AS is nothing like what either of them are familiar with, (no SIJ probs, back just starting to stiffen, major hand/feet probs, easily dislocated joints). The Doc said he is going to do some research and when I see them tomorrow he will have a better idea of how to help me. That is a first for me, having a Dr. say he is going to research on my behalf. Amazing. And they were such good listeners. I have done ALOT of learning about this disease, and they wanted to know everything I knew. Double amazing.

So for now 3x per week is the plan. They said their job is to get me moving, my job is to keep me moving. Hee, easier said than done. I know nothing about PT though, I am still amazed at how what they did helped.

How are you feeling, Cindy?

It is torture, Lon. When I stood up off the exam table I appologized for sweating on it. The med student said, "That's OK. Its a normal response for someone under any kind of distress."

And I said, "Oh good, that means you did your job."

Take care, Lon. How is your chest today?? Keep up the good work. You are fighting a good fight.

-Donette

Thanks Craig. How have you been? I found some new comfy shoes and they come in Men's too. Sketchers Shape-Ups. They look goofy but feel like walking on marshmallows. Heavenly. I tried my mom's on and have now ordered my own.

Take Care,
Donette

Donnette,
My mind is clear about some things.
And I know where I am headed, I will see you there!

My physical pain therapist my help a bit????
They keeps saying I should not be able to do the things I do, If I felt that bad, etc, x-rays show some damage, etc....

thanks my friend,
Lon

It sounds like you've had a really positive visit, Donette.

Both the doctor and the student sound fab - Good listeners are hard to find.

Long may it continue

Hugs