Yet another gem from the brilliant Albert Einstein
If I can’t explain the complexities of bladder, bowel, pain science and pelvic floor dysfunction simply to patients then basically I haven’t done my job very well.
One of my sayings when doing talks to health professionals and the public is:
“What we teach is science-based but it’s not rocket-science”.
What that means is sometimes what we teach can sound very complicated and difficult – and health professionals can be really bad at making things sound complicated and sometimes to even bamboozle the patient. But it is really important to break down into key points and tackle things one at a time – and one of the things that we use at Sue Croft Physiotherapy (Amanda, Jane, Kristen and of course myself) to help make the message clearer are analogies, similes and metaphors.
I have often spoken about the three Explain Pain courses that I have attended over the years and Dave Butler and Lorimer Moseley are the masters of metaphors when teaching their Explain Pain courses. Lorimer has written a fabulous book – called Painful Yarns– which brilliantly outlines some stories to simplify pain messages. Metaphors and similes may help patients remember some of their treatment strategies rather than simply trying to recall a whole lot of information. (Of course we give extensive literature to read so there is no need to have to remember everything at the first session).
Goldilocks provides a useful analogy. We all know the Goldilocks fairy tale about the porridge not to hot, not too cold but just right; the chair too hard, the chair too soft and the chair just right. I often say we want the Goldilocks stool consistency- not too hard, not too soft but just right– firm but with form (otherwise it can be too difficult to evacuate completely if too soft).
Another saying I often use with kids and adults, mostly women, with regard to voiding (urinating) is:
“If you make the time to do a wee, you must take your time.”
So many kids and women rush when they go into the toilet and it results in an incomplete empty of the bladder (and the bowel). So teaching them to listen for the message, is your bladder actually full? (If you chronically defer the bladder message you can in fact over-stretch your bladder). If you are going in, don’t hover! Sit with the correct posture and wait till the flow is finished – no straining, no hovering.
When I want to teach a transversus abdominis contraction (the fourth layer of the abdominal muscles), I say to pull in at the pubic hairline “like a mouse”. Everyone is always going to try exceptionally hard with their physio – doing a much too strong contraction, so exaggerating the image of gentleness (like a mouse would do it) helps to explain to the patient the intensity required and then often that word springs into their head when they repeat the contraction.
When teaching pelvic floor and abdominal muscle relaxation I ask patients to think of a knob of cold butter sitting on a plate in the warm sun, and imaging the slow melt that would happen – now try and relax and let go of your tense muscles as though they are melting. There are so many analogies for muscle relaxation: eg a jelly fish in the water; the ripple effect of throwing a stone in the water.
Patients over the years have come up with their own little sayings such as one little gem from a patient: ‘Gas means go’.
All too often men and women pass gas, but if the stool is too loose it can mean there is some soiling and my patient’s little saying is easy to remember. I use it all the time with children when teaching them “the poo messages’. Parents are often mystified why children don’t feel their poos sneaking out and almost always believe it’s a behavioural issue – but it almost always isn’t. Young children can get what I call stealth constipation. It sneaks up on everyone. They might be doing a little bowel motion every day but there is in fact significant constipation, with stretching of the rectum (mega-rectum) and colon (mega-colon), stock-piling bowel motion until the child cannot feel any bowel motion messages and the motion comes around the bulky firm stool and soiling happens regularly. They can also get constipated if they have a significant pain incident which then leads to stool with-holding.
So teaching them the poo messages which are:
- the poo is knocking at the back door;
- fluffs (farts);
- gripes or grumbly tummy
and telling them to answer the poo message by going straight to the toilet will help with soiling (faecal incontinence). While we are on toddlers and toilet training, please always give foot support for them so they are able to sit in the correct position, with good bottom support with a toddler seat and achieve good relaxation of their tummy and their pelvic floor muscles. Much angst can be prevented with effective education regarding this.
Finally a little plug: some patients have found such help from my books they have been known to call them The Bathroom Bible – now I do love that – not to be disrespectful to the real bible but for the patients to treat the information in my book with a certain reverence makes me happy – because I know they are going to follow the rules and listen to their body and their bladder, bowel and pelvic health will be better for it.
I am writing my final holiday blog from my lounge back at home. The 25 hour flight has been survived and the clothes unpacked and even washed and the only thing left to complete is this blog. We arrived in Milan around 10 am after a three-hour train ride on the Milan express from Monterosso al Mare. (We also had the best coffee of the trip at the Monterosso train station – a very unlikely occurrence). We stood in a taxi line in Milan and inhaled a few more passive ciggies while watching the military and Carabinieri keeping a close eye on the comings and goings at Milan Central Station. It is a very grand building with thousands of people milling and it was the first time this trip that I became aware of tight security.
This was also present at the major tourist attraction in Milan – it’s very spectacular Duomo. It’s a little unnerving to see the soldiers in their army fatigues with big machine guns casually walking around the outside of this enormous architectural marvel.It took 600 years to complete and from the top of the roof one can only imagine the skill and bravery of the artisans who constructed this masterpiece.
If you are into shopping (I am not) then Milan is a great place to visit, but otherwise it is a big (very dirty) city with an airport which is 100 euro cab/limo drive away. So next time I would definitely not fly out of Milan. We did like the Brere district of Milan with its nice eating areas and we did the hop on/ hop off bus tour which cost 25 euros for two days per adult and you can utilise all three lines which cover three different areas of Milan, so by the end of the 3 day visit we felt we had ‘done’ Milan. The highlight of the Milan trip was the visit to La Scala – the opening night of Giselle.
La Scala from the outside- a tad ordinary, but once inside a true spectacle. These are my real photos from inside La Scala of the seating and the orchestra pit
The artists from Giselle taking a bow at the curtain call
As per usual when travelling, it is often the people you get talking to who make the trip more interesting. It is pretty tight seating at La Scala and it was only polite to say hello to the lady, whose lap I was almost sitting on. She had come to Milan for a three-day visit and to go to the opening night of Giselle from Belgium and she apologised for her ‘terrible’ English (which I thought was wonderful), but explained she was fluent in Lithuanian, French, German, Italian and Russian…..There are times when you feel very inadequate.
Just for your future reference, if you aren’t in the front row of each seating area (like a little cubby) then you cannot see anything. Bob had to stand for the whole 2 hour performance to see anything and we were in the front row. But hec, the seats only cost $350 for 2, seeing the show would have just been icing on the cake! Still again, it’s been done, the tick on the bucket list has occurred and no need to do that again.
The lead male ballet dancer Roberto Bolle was a real star in Milan and when he made his first appearance on stage there was a thrilled, audible gasp from all the ladies in the audience and wild applause and I too was truly gobsmacked at the fantastic sculptured definition of his gluts. We spend many hours in a day as physios pointing out the inadequacies of people’s gluts, and giving exercises to improve them, but Robert’s gluts were masterful and a true lesson in anatomy to say the least. To be honest I couldn’t stop staring…..
This trip has been wonderful, so very well-planned by Bob and a fabulous way to celebrate my 60th year on this planet. Travel is so important, if not only to make you realise how amazing Australia and our clean fresh air and beaches and cities and weather (cept perhaps Melbs in winter…) are. Until our next trip it’s back to pelvic floor blogging.
Panorama photo Old Monterosso Classic Vernazza
It’s so good to be back at Cinque Terre – but everyone else in the world had the same idea! Tourism is thriving in Italy. The crowds at Venice and Cinque have been amazing and with plenty of Aussies here too. We managed to head deep into Venice and down to the Giardini and Arsenale where the crowds tend to not venture and found some incredible places avoiding the crowds, but here in Cinque it’s harder to escape the madding crowd so to speak because it’s just too small. When you’re hiking on a very narrow path and you have to let people pass and there’s a steep drop down, it isn’t easy! It is certainly much busier than the first time we came here.
Yesterday we did the less travelled path between Volastra and Corniglia. We caught the train from Monterosso to Manarola and then a local bus up to Volastra (1.5 euro from the Cinque Terre Tourist office rather than 2.5 euro if you buy it from the driver). The views are spectacular up at the top of this walk…….in fact breath-taking and the changes in types of trees wonderful. Olives, figs, lemons and plenty of grapes in the initial part of the walk, transitioning into cypress trees giving wonderful shade just when you need it to cool down.
And suddenly there was shade- cypress pines made it feel cool and shady
The climb down to Corniglia was very steep and rocky (I can’t remember that it was quite as difficult the last time we did this) and again my trusty sticks saved the day. I’ve decided my quads must be in pretty good nick giving my knee lots of stability on those great big downward steps. I have to say that Bob is faring very well with his new hip – it’s holding up brilliantly. When we arrived in Corniglia there was a threat of rain and I didn’t want to tackle any more walking as these tracks would be quite difficult in the wet, so we caught the train back to Monterosso.
We decided to try the restaurant that Rick Steves recommended on his show on Monterosso called Miky. We got the last table available and sitting in the front outside but under cover on a wet evening, we sat next to a couple from Melbourne who were having their first visit to Italy to meet the husband’s extended Italian family. It’s funny how you instinctively start chatting when in restaurants overseas, when you hear an Aussie accent. We started looking at each others meals and comparing whose dessert was better (my pineapple creme brulee definitely won I think!)
Things to remember:
- Buy your train tickets in advance because the ticket machines take time to master;
- There are huge crowds trying to organise Cinque Terre hiking passes which you can buy for one, two or three days which include hiking through the region and unlimited train travel also -the best part about this is not so much the special prices, but just having the tickets pre-purchased so no lining up to buy them;
- The individual day passes for Cinque Terre and no train travel is 7.50 euros; travel to most of the towns is 4 euros per person one way; the walk from Volastra to Corniglia is free.
- Always remember to put your train ticket through the machine to validate it, which date stamps the ticket- there apparently can be big fines for not doing that;
- There are virtually no public toilets (the one at the ferry at Monterosso was closed because the lady who mans it couldn’t make it there with the train strike- so thousands of people trying to catch ferries and the toilets were locked……)
- All the cafes allow you to use their toilets if you buy a drink (frizzante water often is 1 euro);
- Sometimes these walks are too hard for some people – we saw some who were struggling and it can be quite dangerous, so do assess your fitness – there is a lot of up for some of the walks but mostly it’s the down that can be difficult with dodgy knees and balance.
- Try the Walk to Sestri Levante leaving from the other end of Monterosso near the beach – it is 3 hours and you would need to catch a train back after. (It would appear that it’s free).
- Most restaurants in Italy have a service charge which can vary from 1.5 euro to 5 euro each which routinely includes a basket of bread. Even if you’re starving control the impulse to fill up on bread as you may not have room for Tiramisu🙂
- At all the beaches the hire of 2 lounges and an umbrella is between 15 and 18 euro which also includes use of the bathroom facilities (toilet and shower). Spritzer 4-5 euros, Birre 3.5 euros, Pina Colada 6 euros.
It’s a tough gig but someone’s got to do it.
Milan and then home and seriously back to work.
Sunrise hits the Dolomites from our hotel room in Cortina
In my excitement to post about Venice, I forgot to write about Cortina and our visit to the other side of the Dolomites. As you know the hiking has been a highlight on this trip. With my trusty hiking sticks purchased in Cortina, (speaking of purchases – to any family members reading this blog, there has been a blanket decision made- no presents this time😦 just too heavy to cart around except for Beau who can’t read yet- he has a small pressi) we tackled some of the harder walks of the trip. We caught a gondola up to the top of the mountain (Mt Falzago) and then walked down via a new walk called Dolom Eu which has panoramic views into the valley where Cortina sits. They are so panoramic that I could hardly bare to look over the edge at the view (I am quite scared of heights).
Up the top where the gondola arrives is a building which features in the Sylvester Stallone movie called Cliffhanger – it certainly is aptly titled. Many of the places we have visited this holiday have had movies filmed at them and we will enjoy Netflixing them when we get home.
Up the top of Mt Falzago where the movie Cliffhanger was filmed.
The very scenic Dolum Eu walk (212 route)
The panorama from the Dolum Eu walk
The sticks really do make a difference and I would never have made it to the top of some of the walks without them, (especially today after the Cinque Terre walk). To get back to Cortina we followed the number 206 trail until we reached the halfway spot for the gondola and we were able to catch the last one down. I was pretty exhausted by this time – so Bob working out where to find the gondola was a godsend.
What I’ve come to realise this holiday is, that what matters most when you are trying to keep in touch with your business when you are holidaying overseas is good wi-fi. We’ve had some excellent wi-fi at a few hotels (A Tribute to Music in Venice, Jungfraublick, Wengen Hotel Tyrol, Val di Funes) and some ordinary wi-fi (Hotel Europa) and some shocking wi-fi (La Villa degli Argentieri, Monterosso). In this day and age where a good internet connection means you can work from anywhere, it’s really a pretty basic requirement of any hotel.
The views from your windows? – you pretty much know what you are getting from the photos on the hotel website and how much you have paid for the tariff; all the pillows in Europe are shocking ……..fullstop; the beds are all two king singles joined so cuddling in bed is along quite a solid gap; and the breakfasts ?- well good luck if you are a coeliac because it’s cereal, bread, cheese and ham wherever you go. But one thing you can never be sure of is what is the wi-fi like when it says free wi-fi available! I do hope as a trend our Australian hotels generally supply a good service for our overseas tourists.
Another thing to beware of is, you could possibly come home with a new smoking habit that you didn’t have before you left, due to the enormous amount of passive smoking you will do certainly in Switzerland and Italy (for goodness sake Switzerland and Italy, get your act together and get Nicola Roxon as a consultant and reduce your cancer rates in 20-30 years). The cigarettes are way too cheap here and there’s one thing never missing from the hotel rooms and verandas is an ash tray – in fact the photo below is the biggest ash tray I have seen in my travels and the one beside it was ‘planted’ in the a very picturesque garden.
Back to the hiking – in Cinque Terre the hiking can be harder because it tends to be much hotter here and the trails can be in poor condition. They are often closed – if there has been rain there can be land slides or the paths just too treacherous. But after today I have worked out that it is easier (in my opinion) to walk from Venazza to Monterosso rather than the other way around now having done it both ways. To get to Venazza, we had to catch the ferry from Monterosso to Venazza, as there was a national train strike today.
At the end of the Venazza back to Monterosso walk.The sticks really do make a difference and I would never have made it to the top of some of the walks without them.
As a reward for another day of hiking a magnificent dinner at L’Ancora della Toguga – really takes the prize as the best value, spectacular setting and gorgeous food.
L’Ancora della Toguga, Monterosso, Cinque Terre
Sadly the end is getting closer……..
The iconic images of Venice never cease to thrill. As the aeroport bus (the slowest boat in the world) brought us to Arsenale, the closest station to our hotel – A Tribute to Music – I still smiled with pleasure and sort of felt like I was coming home. It is my fourth visit to Venice – my first was in 1984, when we were DINKs (double income, no kids) and you can imagine the thrill then of seeing such an architecturally significant city. We had to bus (boat) it over from the camping ground and I believe we only stayed a day, but I still captured the spirit of Venice and longed to return one day. We come now because every two years the Architectural Biennale is held here and it is an opportunity for Bob to be immersed in the trends and concepts from architects in different countries around the world.
I never tire of walking around the streets of Venice and getting lost – eventually you do always make it back to your destination. We have walked for miles and miles this time and I am even starting to recognize the right direction to go. On Sunday night we experienced a different version of the Barber of Seville, when it was performed to an intimate audience in a Venetian palace, Palazzia Barbarigo, apparently built in 955. Each act was held in a different room and the whole audience had to relocate for the next act. The opera singers were spectacular and the quartet equally so. It was to put it mildly one of those tremendous surprises. I had wanted to go to an opera in La Fenice, the Venice Opera House, (as I had read a novel set in La Fenice) but when I googled La Fenice- that concert at Barbarigo Palazzo was the first thing that popped up (and I didn’t notice) and I went ahead and booked. When we went to look at the venue, it looked very dodgy, no signage, no one there two hours before – I thought ‘I’ve been done!’ But when we arrived and the opening overture commenced we knew this was the real thing. The pianist, Roberto Barrali was so entertaining to watch with his expressive playing – well it was bellissimo!
We have eaten twice now at a fabulous restaurant called Vinaria– which does wonderful variations on the typical Venetian menu. (In case you are wondering I am highlighting these places and activities for my own reference, so I don’t forget them – I am not receiving any rewards for their endorsement….although I am happy to discuss any offers…..!). One of the big shocks after we sat down, gazing at the view of the gondolas out the picture window was when a Venetian mother, father and baby with pram …and the Labrador all sat down in the best table in the restaurant. We have noticed dogs are welcome anywhere in Venice, but I was very surprised in this slick, modern restaurant. Mind you both the baby and the dog were incredibly well-behaved. Last night, we were sitting next to an Austrian couple who were arranging for their wedding to be held at the restaurant in two months time. They live and work in Austria but come to Venice every 3 months and stay for a break, so Venice is their second home, like Noosa feels to us.
There is a mystery and a complaint that I need to disclose and get off my chest.
What is wrong with Italian coffee???? I thought Italy was the home of coffee and for the last 3 visits in 2011, 2014 and 2016 the coffee has been getting increasingly disgusting. I know that one thing that ruins the flavour is the use of long life-milk and I want us to look after our dairy farmers because it’s when you come to Europe and only drink long-life milk that you realise how spoilt we are in Australia with the real thing. But I have been in training for a year now drinking black (decaf Nespresso pods) coffee to get around the milk issue, so jumped straight into black coffee, but the coffee is yuk too.
My conclusion: Australia has nailed the art of making great coffee. End of story.
We have been to a number of the Biennale exhibitions over the last couple of days. A particularly poignant one was one celebrating the life and work of Zaha Hadid, an Iraqi-born female British architect, who died in hospital in March this year, aged only 65 of a heart attack following a bout of bronchitis. I well knew of her work as she was one of my son’s favourite architects during his course and I was pleasantly surprised that she had been able to smash the glass ceiling of architecture – being a woman and an Iraqi! She was at the pinnacle of her career and was an iconic leader in architecture and role model for women in architecture and has designed many of the truly distinctive buildings around the world. There was a long BBC (Scotland) documentary on her at the presentation which I commend to you.
After a couple of days trawling the external Biennale venues we needed a rest day and took ourselves over to Lido – the beach for the Venetians. Despite it being a very hot day, most of the beaches were deemed closed, but thankfully one sole beach area was open with the obligatory beach umbrellas and lounges. I only discovered the joy of doing this on our last holiday to Italy – having balked at the idea of actually paying (a lot of) money for the pleasure of lying raised under shade on a beach of pebbles or as in the case of Lido – dirt with a touch of fine sand. It was fantastic- reading a book, eating fritto misto and sipping on a pina colada. This day we had a discount rate of 18 euro which gave you 2 lounges, an umbrella and toilet and shower visitation rights – well worth the money.
Refreshed after our day off, we tackled the main Bienalle itself today. The highlight was the Australian pavilion – a great, newly-designed building (by Denton, Corker and Marshall) in a magnificent position on one of the canals down in the Giardini.
It’s theme was the importance of ‘The Pool’ in Australian psyche. It was a cool space on a hot day and the chairs called Anerie-aneme, designed by central Australia-based designer Elliat Rich and hand-made by Aboriginal-owned business, The Centre for Appropriate Technology Ltd were a welcome place to pop the weary body for half an hour. The reflections from the canal outside through the large glass window give the walls a life of their own. I would recommend you find the Australian pavilion and seek an artistic refuge.
As a non-architect, I have found the theme this year ‘Reporting from the Front’ difficult to understand. It seems very nebulous and some of the presentations were difficult to relate to the theme. But what the name did allow for were quite a few related to war and refugee-related presentations. There was one on Blue – the UN peacekeeping buildings and camps and the feeling that these should have a more permanent feel to them, so that when the peace-keepers move out, there is some infrastructure for the remaining population.
Time to head out again for the night. We have become very decadent- many nights eating at 8.30, going to a Vivaldi concert tonight at 9pm – but Venice does that to you🙂
Until the next time….fino alla prossima volta!
We are sitting on the lounge (in that picture) at Hotel Tyrol, Funes , sipping a Prosecco and awaiting the sunset, hoping a rusty hue will descend upon the spectacular Dolomites.
I have been dreaming of this part of the holiday for 12 months. And it hasn’t disappointed. If you remember I showed Bob a photo I had seen when I googled The Dolomites and I said I want our hotel to look at that view. Well it didn’t quite include the church in the view- see our own photos below- but to me it was even more magnificent. They just dominated the skyline and the colour changes as the sun hit different angles was magical to watch.
The iconic photo taken by Bob- no google image there
View from our balcony
We arrived two days ago to spectacular sunny weather and the imposing view of the Geisler group in the Dolomites from the balcony of our hotel room. All the hotels in this region and really all through northern Italy, have spectacular petunias and geraniums adorning their facade. Bob is impressed and incredulous at their magnificence and is madly googling how to grow flowers like the Italians and Swiss.
We hiked to the church above our hotel which had even better views and a beautifully kept graveyard with family plots and names going back over 100 years.
After lunch we then headed off for a more major walk out to UNESCO Zentrum (walk 6 and returned on 35A/36). The scenery is spectacular with the Geisler group dominating every corner we turned. The trails are well sign posted and there is a map which is well worth the 9 euros it costs, as you can ensure you are heading in the direction of home when it most counts…as the legs are flagging. To get close to the mountains, there is a lot of UP. I have worked out I am excellent on the horizontal and downhill stretches of any of these walks and less so on the uphill walks.
The next day we did a full day hike (starting from Waldschenke near St Johann’s Church Trail numbers 28, 34A, 34, 36, 36A, 35, 36B, 36, 33- all of this meant a 600 metre vertical climb up and down) and got very close to the base of the Dolomites- part of this is the well known Albert Munkle path (of the Geisler group of mountains) which runs parallel to the mountains.
It is a beautiful trail and because its a proper trail rather than a service road for the ‘refuges’ (which are amazing restaurants high and deep in the national park) there are rocks to clamber over and massive tree roots to step around, ensuring concentration is required to ensure safe footing.
Geisleralm Restaurant at 1996 metres
When I was telling people that I was off to Switzerland and Italy to walk and corrected them if they said the word ‘hike’, I had no idea that what we were attempting was quite so hard. I am now a fully fledged hiker (albeit much slower than the estimated times on every signpost) and I now own proper hiking sticks to prove it. I borrowed a pair from the hotel and they were so helpful I purchased my own in Cortina to tackle the enormous walk today.
The best part about hiking in such beautiful country is the high value ‘homoncular refreshment’. Walking surrounded by beautiful scenery, where it is peaceful and quiet with the only loud noises being the odd jangle of a cow bell and just the sense of achievement at the end of a 4-6 hour walk has certaily reinvigorated my senses! Plenty of times I wanted to stop or ring a taxi and say:‘Please come and get me’ . Of course ringing a taxi wasn’t possible, but I did slightly wish it. Bob just kept saying one foot after the other…not long now. Bob and the sticks got me there.
After two days at Val di Funes, we said goodbye and headed around to Cortina to see the other side of the the Dolomites. The wireless internet has been terrible where we are staying in Cortina, hence the slowness of this blog. But as we head to Venice tomorrow, with supposedly great internet, I will catch up on the absolutely spectacular vistas of Cortina then.
We farewelled beautiful (yet cloudy and wet) Switzerland and passed into Italy. The most obvious difference was as the driver announcements came on there was a lilting, musical announcement from the conductor/driver, who was also obviously a comedian because all the Italians in the compartment had a good laugh and were shaking their heads in amusement. None of that in the efficient Swiss trains!
Today was a 9 hour train journey to get from Wengen (Switzerland) to Bolzano (Italy), with about 6 train changes. I think it would be fascinating to construct a research study into comparing fitness levels and their pelvic floor dysfunction in women between the ages of 50-80 from Australia (who drive everywhere) and Swiss women, same age cohort (who commute via trains and end up walking huge distances at a very fast rate between platforms – because it’s mandatory due to the slick timing of interconnecting trains). As I said in my last blog I am really clocking up the steps and today it was up and down steps and ramps, carting luggage and hoping like crazy Mr Efficiency has got the right platform (so far spot on).
Thirty two years ago we travelled down from Cortina into Roma and felt like I had literally melted. We had been travelling around in a campervan for many weeks through freezing Great Britain (where the water had actually frozen in the pipes at one of the camping grounds); then across to equally freezing northern Europe and then through the Dolomites. Today I had the same experience. It was very cold and wet at Wengen so we rugged up accordingly and by the time we stepped out of the train it was 28 degrees. Bellisimo!
We chose Bolzano to train it to because it is the spot we pick up our car – the only driving we are doing this trip, because to see the true beauty of the Dolomites you do need a car (or a bike- I have heard of many who cycle around and through the Dolomites). As soon as we crossed the border the sun did start to shine so I am very hopeful for a warm, dry Italian experience.
Bolzano is a wonderful surprise. It has a vibrant town square where all the townsfolk of any age criss-cross on their bicycles, (helmetless and licra-less) as they get about their business. There are the mandatory geraniums and petunias adorning every building and the architecture is beautiful. There are food cafes and restaurants around the edge of the square, adding further life and colour and further in the town there were markets selling magnificent fruit and veggies. For a Monday night the whole town felt exciting and alive. I love Italy!
Markets at Bolzano
We stumbled across a funicular up to a town high above Bolzano- there are actually three villages up there and a railway that links them all – truly spectacular vistas.
Funicular up to a stunning view of the Dolomites
After all that walking, we felt we had earned dinner and ate at our own hotel’s cafe (Stadt Hotel Citta), which overlooks the town square. Yes that is a Pina Colada in the background of a very healthy dinner. Note to self – I mustn’t ever have one again because it was way too delicious.
Tomorrow…Val de Funes
We are off and racing on the 60th birthday European Vacation. Of course you all know my birthday was back in August and it will actually be Bob’s birthday (for the THIRD time) that will actually occur while we are in Italy. But August is way too hot and busy to be hiking around the Swiss and Italian Alps and it is sort of special to be able to have one of our birthdays over there.
The plane trip to Dubai was pretty good – knocking over three movies and catching 4-5 hours sleep- followed by a pleasant daytime trip to Zurich which had unfortunately had spectacular cloud cover meaning no spectacular view of the Alps.
(On a side note and I know I did promise myself and others that I would stick to travel blogging and not be banging on about bladders, bowels and pelvic floors for this three weeks, but I do want to just say I found it very disconcerting to be calmly sitting on the loo at Dubai airport (after what seemed like a very small amount of time… and you know my favourite saying to patients is: “When emptying your bladder- if you make the time to go to the toilet, you have to TAKE your time!) and suddenly, without my permission or any action on my part, the toilet starts flushing. What the??? It is also worthy of note that in the absolutely ginormous Dubai International Airport there seems to be a dearth of female toilets. Honestly architects and designers, women do use the loo and I know you are possibly right into bladder retraining on their behalf, but don’t be lousy. The queues were huge.)
After 27 hours of travelling, we still had to jump on a train and head to Wengen – 3 hours from Zurich (and about 4 train changes). If going to Switzerland, I promise it does cost and an arm AND a leg to travel on the trains. I would recommend a Swiss 3 day pass if going to the Jungfrau region as all the trains and cable cars are very exy. The 3 day pass costs 180 CHF (Swiss Francs) each which is much less than what we have forked out for all the transport over the last couple of days. We didn’t plan to do all the train and cable car travel because we thought we were walking most places, but the weather sadly failed us and we had to use the trains and cable cars.
The first morning after our arrival, we decided regardless of the cloud cover and rain, it was all systems go for Jungfrau. We missed it 5 years ago due to rain and cloud and i wasn’t going to miss it this time. There was some early morning sunshine and to get the “cheaper” (135 CHF instead of 170 CHF each) fare up there we had to be on the 8am train and leave on the 1pm train. There are plenty of picture opportunities on the way up – IF and its a big IF- the clouds and mist stay away. Once they descend, you have absolutely no idea what majesty lies out there.
Sun peeking above one of the peaks on the way up in the train.
View on the way up to Jungfrau above Kleine Sheidegg
Aletsch Glacier viewed from Jungrau- its 22 kms long and 1km deep
Jungfrau and the region around Wengen is truly spectacular and because yet again the weather has prevailed, it guarantees a return trip sometime in the future. It is so peaceful, with babbling brooks and cowbells the only sound to pierce the peace and quiet. Today one of the highlights was a walk from Stechelberg to Lauterbrunnen (I am hosing in 10000 steps on this trip).
The babbling (well it was really roaring) brook we followed on the walk.
Wearing my new Schilthorn beanie which I had to buy up there because I saw it was minus 4C on a sign!
We are off to the next set of Alps in the Dolomites in Italy at the crack of dawn tomorrow. It will be 9 hours on the train and I am mostly praying to the rain gods (to stay away) because I am breathlessly awaiting my view from our Val de Funes hotel.
I hope the view is like this
Gute nachte and abschied von Wengen (Good night and farewll from Wengen)
There’s nothing like remembering it’s World Physiotherapy Day on the 8th September at 11.55pm on 7th September. What do you do – ignore it and lie awake wishing you’d realized earlier and posted some masterpiece to commemorate your beloved profession and your mates who do good stuff around the world every day changing lives (hopefully for the better)? Or get your iPhone and type a blog one finger hoping not to disturb your hubby asleep beside . Yep you guessed it. No tossing and turning for me – fully awake and writing. In fact September is quite overloaded with “special” days, weeks and months as highlighted tonight on Gruen and many of them are incredibly relevant to what I do- but they did manage to leave an important one out – World Physio Day. September has amongst others Women’s Health Week, Prostate Awareness month and a new one for me which is very worthy- Steptember.
The theme for this year’s World Physiotherapy Day is ‘add life to years’—aligning with the World Confederation for Physical Therapy. The message builds on the findings of WHO’s World Report on Ageing and Health and a range of reports indicating the contribution and cost effectiveness of physiotherapy in healthy ageing.
Of course there’s not much point in adding years to life if the quality of those years is diminished due to Urinary or Faecal Incontinence or other pelvic health issues. So seeking assistance from your Continence and Women’s Health Physiotherapist is going to add value to those extra years. Part of our daily mantra to patients is to also exercise (pelvic floor safely if necessary) and to encourage healthy eating and avoiding smoking altogether, and drinking alcohol in moderation (except if pregnant when the new guidelines say zero alcohol consumption).
Seeking help for these personal issues is never easy – pelvic floor issues can be stigmatized and associated with shame and put in the “too hard basket” for many women and men. The benefit of highlighting what we do on such a day as World Physiotherapy Day, is that one extra person may just make a phone call; Google their nearest WHPhysio or do a walk-in and book an appointment. And that prompt may just be the turning point in the quality of any extra years of that person’s life that are achieved.
Happy World Physiotherapy Day to all my #pelvicmafia colleagues, and to all Physios world wide who work hard every day to add life to years.
The next blog will be coming from Europe- get your senses ready for some visual treats!
Recently I had a patient lament that because she had been forced into early menopause due to treatment for an oestrogen dependent/driven breast cancer she would no longer be able to achieve her goal of running or even walking a marathon as her prolapse would not tolerate the pressure/effort. When I spoke to her (via social media) I cheekily called menopause ‘a thought virus’ and that I would make it my goal for her to achieve her goal and yes she will finish that marathon.
Every day in my job I try and reassure women that menopause doesn’t have to be the big bogey that it is made out to be. In fact I found menopause quite liberating- once I stopped buying pregnancy testing kits and actually believing I wasn’t going to fall pregnant at 52. There is also a certain freedom that often comes with the timing of menopause – your children start to leave the nest. Now whilst this can be sad – not having their presence there every night when you come home from work; not having the elevated washing pile; not having the mountain of washing up; being able to cook one meal a week and then just eat the leftovers every night, night after night…..yes it is sad, because you miss them. But it can be a quality time for you to ramp up your own hobbies, to cook whatever you want and eat it at whatever time takes your fancy, to reclaim your relationship (and run in the nudie between the bathroom and the bedroom, or saunter slowly even!)
Last year I attended a workshop on Women’s Health Physiotherapy and Menopause run by Michelle Lyons, one of my Irish physio friends/colleagues from Facebook, which was fantastic and she had the following two definitions of menopause.
The first definition is the one which I (and of course Michelle) would love everyone to embrace, as I think it gives more hope to women that menopause is just a natural time in a woman’s life, which may of course have varying degrees of comfort or discomfort. What also needs to happen is, we need to change the conversation about menopause to stop the risk of handing down from generation to generation thought viruses and a dialogue of negativity about this particular life stage of a woman.
The first description of menopause:
“The joy of menopause is the world’s best kept secret. Like venturing through the gateway to an ancient temple, in order to claim that joy, a woman must be willing to pass beyond the monsters who guard its gate….as thousands of women from all cultures throughout history have whispered to each other, it is the most exciting passage a woman ever makes”.
Now read the next description by Theresa Crenshaw in 1996:
“Menopause is not a natural condition; it is an endocrine disorder and should be treated medically with the same seriousness we treat other endocrine disorders, such as diabetes or thyroid disease”.
Really?!? Oh come on – we can do better than that surely?
We know there are many changes that happen (or are blamed) on menopause, but I would like us to think more positively about it as a life stage and instead of expecting all the bad things, maybe get help and address the physical changes and look forward to the positives.
Take up new pursuits which have scientific proof to be helpful for cognitive, cardiovascular and bone health such as dance.
Dance class at Studio194
So for my patient I will encourage her to take one day at a time and be focused on her recovery from chemo (which I know she totally is and with the love and thoughts of her many friends and relatives) and once she has rid her body of her cancer, she can then move her attention to the goal of that marathon. I know for a fact that she will slap that down just as she has other barriers and roadblocks that have appeared in her life.
In the meantime for all us other women, in this – Women’s Health Week – here are some worthy Facebook memes (how did we get up and start the day without some of these little gems before Facebook?)
Although I am not sure about that “make someone else’s bed”– another good thing about being an empty nester is you don’t even think about bed-making!
And finally, as you grow older, try and grow stronger – in mind and body – because the world can be a tough place and I know being strong will enable all women to embrace everything that gets thrown at them.
Happy Women’s Health Week – let’s share the conversation about embracing superlative Women’s Health in Australia.