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Incontinence and Bowel Management for Women, Men and Children.
Women’s Health Physiotherapist Brisbane, Australia.
Pelvic Floor Dysfunction Treatment.

Christmas Nuggets: Some thoughts to minimise your stress and anxiety

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We are well and truly into December and they don’t call it The Silly Season for no reason!

It’s hot in Australia, so everyone is sweaty (unless you have solar panels and you leave the air on 24/7) and a little tesky. And the main topic of conversation is “It can’t possibly be Christmas already, I just took the Christmas lights down like yesterday”.

But whilst the romantic view of Christmas is that it’s a happy, joyous time, for many people, Christmas can be really, really stressful.

  • Families are under financial pressure and it’s a time when you need heaps of money to feed the masses and buy all the pressies.
  • Families can be estranged and this can be highlighted at a time when it’s all supposed to be peace and goodwill.
  • People can be missing having passed through the year and Christmas just brings home the loss and the sadness that brings.

And did I mention it’s very hot?

Every week for the pain/ relaxation class, I write some nuggets about chronic pain or about stress and anxiety and spend five minutes chatting about whatever this weeks topic is with the clients attending. Most of this information is taken from the brilliant text Explain Pain by Dave Butler and Lorimer Moseley, but also from other different sources. So we are not just doing breath awareness and stretches, but also educating about chronic pain and anxiety management.

explain pain book the protectometer book

As we had dived into December, for this week’s nuggets, I thought it appropriate to do some research into coping strategies for Christmas. One of the great educators about managing chronic pain from the UK, Pete Moore, (who wrote the Pain Toolkit) actually sparked this idea because he asked quite a few of us on Facebook, who treat lots of chronic pain patients, about our best idea for managing with the stresses of Christmas.

I also often ask patients in December what will be happening for them for Christmas and just about everyone has some reservations about it and faces this time with a certain amount of trepidation. So what follows is from a couple of sources (1.2) and there’s some good hints on how to manage Christmas stresses and how to diffuse some difficult situations.

Set realistic expectations

Christmas might not be the fabulous family reunion you hoped for. Plan how you will manage any feelings of anxiety or  depression that may arise.

Put the kids first

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If you have children, or children are attending the function consider putting aside ongoing adult conflicts in their interest. Think about Christmas as a day for the kids and focus on enabling their happiness.

Drink in moderation

It may be tempting to drink too much during the festive period, but alcohol can contribute to stress, anxiety and depression. Alcohol may be a problem if you’re drinking to cope.

Avoid known triggers

If your family has a history of arguing over a certain topic, don’t bring it up.

Stay healthy to avoid Christmas anxiety.

Recognising and changing behaviours that contribute to your stress will help you get through the Christmas period. Remember to stay healthy – eating wellexercising and getting enough sleep can help you cope with Christmas stress.

Tips to prevent holiday stress and depression

 When stress is at its peak, it’s hard to stop and regroup. Try to prevent stress and depression in the first place, especially if the holidays have taken an emotional toll on you in the past.

  1. Acknowledge your feelings. If someone close to you has recently died or you can’t be with loved ones, realise that it’s normal to feel sadness and grief. It’s OK to take time to cry or express your feelings. You can’t force yourself to be happy just because it’s the holiday season.
  1. Reach out. If you feel lonely or isolated, seek out community, religious or other social events. They can offer support and companionship. Volunteering your time to help others also is a good way to lift your spirits and broaden your friendships.
  1. Be realistic. The holidays don’t have to be perfect or just like last year. As families change and grow, traditions and rituals often change as well. Choose a few to hold on to, and be open to creating new ones. For example, if your adult children can’t come to your house, find new ways to celebrate together, such as sharing pictures, emails or videos.
  1. Set aside differences. Try to accept family members and friends as they are, even if they don’t live up to all of your expectations. Set aside grievances until a more appropriate time for discussion. And be understanding if others get upset or distressed when something goes awry. Chances are they’re feeling the effects of holiday stress and depression, too.
  1. Stick to a budget. Before you go gift and food shopping, decide how much money you can afford to spend. Then stick to your budget. Don’t try to buy happiness with an avalanche of gifts.

Try these alternatives:

  • Donate to a charity in someone’s name.
  • Give homemade gifts
  • Start a family gift exchange.
  1. Plan ahead. Set aside specific days for shopping, baking, visiting friends and other activities. Plan your menus and then make your shopping list. That’ll help prevent last-minute scrambling to buy forgotten ingredients. And make sure to line up help for party prep and clean up.
  1. Learn to say no. Saying yes when you should say no can leave you feeling resentful and overwhelmed. Friends and colleagues will understand if you can’t participate in every project or activity. If it’s not possible to say no when your boss asks you to work overtime, try to remove something else from your agenda to make up for the lost time.
  1. Don’t abandon healthy habits. Don’t let the holidays become a free-for-all. Overindulgence only adds to your stress and guilt.

Try these suggestions:

  • Have a healthy snack before holiday parties so that you don’t go overboard on sweets, cheese or drinks
  • Get plenty of sleep
  • Incorporate regular physical activity into each day.
  1. Take a breather. Make some time for yourself. Spending just 15 minutes alone, without distractions, may refresh you enough to handle everything you need to do. Find something that reduces stress by clearing your mind, slowing your breathing and restoring inner calm.

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Some options may include:

  • Taking a walk at night and stargazing.
  • Listening to soothing music.
  • Getting a massage.
  • Reading a book.
  1. Seek professional help if you need it. Despite your best efforts, you may find yourself feeling persistently sad or anxious, plagued by physical complaints, unable to sleep, irritable and hopeless, and unable to face routine chores. If these feelings last for a while, talk to your doctor or a mental health professional
  2. Take control of the holidays. Don’t let the holidays become something you dread. Instead, take steps to prevent the stress and depression that can descend during the holidays. Learn to recognise your holiday triggers, such as financial pressures or personal demands, so you can combat them before they lead to a meltdown. With a little planning and some positive thinking, you can find peace and joy during the holidays.

Here are some apps to help you further:

ReachOut Breathe

http://au.reachout.com/reachout-breathe-app

Smiling Mind Meditation

http://smilingmind.com.au/smiling-mind-app/

High Res – A Self-Management and     Resilience Training

https://at-ease.dva.gov.au/highres/#!/home

Take all of the ideas and implement, or maybe just use one.

But whatever you do, work hard to reduce stress and anxiety if Christmas tends to be a difficult time.

And always remember to breathe…….

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  1. http://www.mindhealthconnect.org.au/beating-christmas-stress-and-anxiety
  2. http://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20047544

Farewell and thanks Bec!

Bec S and Liss at 194 Gladstone

Bec Stacey

I consider that I am very lucky to have wonderful staff -physios and secretaries alike. Today I am here to talk about my secretaries for a very important reason. Sometimes my recruiting methods for the secretaries could be considered dodgy, (Facebook, bakeries, friends of the other girls- well that’s not dodgy) but I have to say so far they have worked very well. Many of you will have had communications with one of my longest-serving secretaries, Bec Stacey and the sad news is- Bec is flying the coop. Bec has been on the other end of the phone to my patients for almost four years. I recruited her from Baker’s Delight, (as you do) where she used to serve me white Hi-fibe bread and 2 litres of milk with the odd chocolate Danish thrown in for Mike. Every time I went there she was very cheerful and I decided that her friendly manner was just what I needed as my secretary.

When we were at the old rooms, the reception desk was in the kitchen. It was pretty primitive, but Bec efficiently made it work and happily greeted the patients and made the appointments, putting all the callers at ease. As we have expanded and employed more girls to cover the day completely, and then progressed to needing two girls on per shift, Bec has been involved in the training of everyone and turned the office into a smooth running engine room.

When we bought the new rooms, between Bec and the other girls, they efficiently created the office in the new building with the last patient being farewelled at 3pm on the Friday at Gladstone Rd and the doors opening at the new premises at Hampstead Rd, Highgate Hill at 7.30am on the following Monday morning. An amazing feat (which may have been helped along with some pizza, Coke and chips…….)!

img_9189   reception   waiting room of the new rooms at 47Hampstead Rd Highgate Hill.2jpg,

Just like your kids, who you want to grow up to be independent and fly the coop, when your secretaries are Uni students, you know they are there for a finite time and will eventually move on to their different future careers. So it is with sadness but resigned pleasure, that I wish Bec all the best in her future in developing her career in healthy nutrition and catering and thank her for her dedication, reliability, happy demeanour and complete integrity with all my patients and for keeping the office of Sue Croft Physiotherapy so efficient and a happy work environment.

Celine, Jose, Maddie, Ellie and sometimes Liss are there to continue to answer your calls and I can assure you, have the same cheery disposition and confidentiality when taking your calls.

Farewell Bec from us all, but especially Bob and I.

xx

 

Studio 194: Our little community is growing!

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I felt very daunted about starting our little pelvic floor safe studio.

Before we even bought our new property in Hampstead Road, which then gave birth to the studio, the proposition of completely handing over responsibility to other physiotherapists for treatments of my patients, was inconceivable to me. But when I first found my two talented locums, (one of whom, Jane, continues with me to this day) who allowed me to keep my practice open, while I went to Melbourne in 2015 to see my first beautiful grandson, the first big hurdle had been overcome.

But then to branch out into a formal exercise studio – that made me feel completely out of my depth. But I have been blessed with my instructors – Amanda, Monique, Nicoletta and Alison (with help also through that time from Lori, Michaela and Emily) who have such dedication to helping women find their potential with exercise in a safe way and a pain-free way.

Our studio is growing and when I was in dance yesterday I suddenly realised I feel like we have created a little community at 194 Gladstone Road, Highgate Hill. I have a whole group of new pals – my dance buddies – yes we tear up the floor to Beyonce, Michael Buble, Ricky Martin plus many other fabulous artists and their tunes. And we do it safely – knowing no one will laugh at us, criticise us or belittle our body shapes or coordination. We are all there for the same purpose… to have fun, to keep our brains alert and firing (laying down complex moves, renewing neural circuits every class), to get a good cardio workout, strengthen muscles, free up ageing joints and improve our bone density.

dance class photo

The Mums and Bubs class is also an opportunity for new mums to exercise together with their babies and perhaps exchange some sleepless nights stories that maybe make you feel you aren’t the only one that’s sleep deprived. There are definitely some group dynamics going on such that when someone had been away for quite a few weeks everyone was worried about what may have happened to that person and when she returned from her illness there were soothing words from the ladies in the class to make her feel welcome back.

mums and bubs class

We were all strangers to start with, but we all know each other now and enjoy our chats before the class starts and what I have found is that everyone is very welcoming to new arrivals at Studio194. In these times of increasing isolation for many people, I love that our studio is providing a space where people can come together and feel positive and happy for a period of time.  I like to feel it’s a safe zone in turbulent times.

ailsadancing class

Ailsa, my completely devoted supporter of Studio194, who takes as much pleasure in seeing our numbers grow as I do plus some of our dance stars!

Our latest class, our new Barre class at 10.30am on Fridays with Alison Spink, who is also doing some one-on-ones before the Barre class, is becoming a favourite with our Studio194 members. Alison tailors it to your ability and it certainly helps with flexibility and strength. Don’t feel worried about it – give it a go.

With Christmas upon us in a flash, if you are looking for a most worthwhile pressie for someone, we are selling gift vouchers at various price points which are gift wrapped and with a gift card and the prices are even slightly cheaper than if you bought the classes on-line! So if you are sick of nighties or chocolates for Xmas make sure you drop some big hints or better still ring my secretaries yourself on ph: 3848 9601 and you can pay over the phone and it will be posted out free of charge. Then don’t forget to tell your loved ones how much they owe you!

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In the meantime in case you haven’t realised it’s only 5 weeks to Christmas so to avoid that last-minute rush and struggle with the carparks – pace yourself and start getting organised!

PS If you are feeling stressed and anxious or have pain issues, don’t forget the Pain/Relaxation class on a Monday night with myself at 6.15pm – it really sets you up for a happier, more relaxed mindset for the week.

 

 

 

Who is ready to run again?

jane finishing the Gold Coast marathon

Jane Cannan in charge of our new running clinic

Every day at our clinic we chat to women who are keen to get back to their beloved running, but because of circumstances surrounding the delivery of their baby, it may be necessary to caution women about an early return. Other women may have pelvic floor dysfunction or other musculoskeletal problems and just need help in how to start running having been inspired by friends or relatives or the Olympic Games! Whether it be prolapse, urinary incontinence, nerve damage or significant abdominal separation or a myriad of other reasons, whether a woman gets back to running and when that should happen, requires careful consideration.

Because running is a high impact sport, it places a greater burden on the pelvic floor – but what if the physical act of running has a profound positive effect on the mental and emotional state of that patient? If we look at the patient holistically, then encouraging and supporting her return to running could be a saviour for her if she has some post-natal depression or other anxiety issues. Should we just say a blanket no because of the state of her pelvic floor, when fitting her with a pessary could facilitate enough support to protect her from prolapse or stop her urinary leakage? Should we say no to a woman if by assessing her running technique we could tweek her running style and decrease the impact as she runs?

Well at Sue Croft Physiotherapy we have recognised the importance of this and we have started a running clinic conducted in the main by Jane Cannan, but also assisted by Amanda Quinn (nee Lee), where patients are assessed…….their whole body is assessed and exercises prescribed, adjustments suggested, pessaries fitted by myself or Kristen if necessary, and encouragement to return to running in a body-safe way. Jane and Amanda are both keen runners and with their strong musculo-skeletal background and special interest in women’s health, they will advise you as to the risks versus benefits and how to return to jogging / running safely.

In the past we have been always looking at the needs of the patients with respect to running and advising them on any injuries they have had, but now we are looking at it in a more structured way and seeing if a change to their running style or strengthening key muscle groups can reduce or stop the leakage/ reduce the impact on their prolapse, their pelvic floor or another joint and therefore prevent an injury. If you would like to be seen in the clinic specifically for running advice, please ring the rooms on 3848 9601 and tell our gorgeous secretaries that you would like to book in with Jane (initially) even if you are currently seeing one of my other physios including me.

The initial appointment is 45 minutes and you need to come dressed for running (joggers, bike pants or shorts and T-shirt) and you may see Jane dressed for running also as she means business.

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Jane and her running team mates showing us how it’s done 

 

Guest Blogger: Dietitian Jocelyn Hunter Clark on IBS and FODMAPS

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It is just over 12 months ago that I received a welcome call out of the blue from Dietitian, Jocelyn Hunter Clark asking whether I had any space in my new building for her to rent, as the rooms she was using were no longer available. I strongly believe in referring patients on to a dietitian to receive expert, specialised advice about dietary modifications for a whole raft of conditions I see every day and to have Jocelyn at my premises to me would be so convenient for my patients. So Jocelyn has now been at 47 Hampstead Road, Highgate Hill now for over a year and she has been a pleasure to work with. As such I have asked Jocelyn to contribute some blogs on a regular basis to help unravel the mystery surrounding some gastro-intestinal conditions.

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Jocelyn is an Accredited Practising Dietitian and Accredited Nutritionist with a Degree in Science and a Post Graduate Diploma in Nutrition and Dietetics. She has over fifteen years’ experience in variety of roles and was a Registered Nurse for 10 years before becoming a dietitian. She has a special interest in gastrointestinal disorders, food intolerance and children’s nutrition. She has a particular interest in Functional Gut Disorders such as irritable bowel syndrome, and regularly attends the Monash University Department of Gastroenterology research seminars.

Before opening her private clinics, Jocelyn was a lecturer at Queensland University of Technology in the School of Public Health.  She has also been a guest lecturer at Griffith University and involved in the supervision and tutoring of Nutrition & Dietetic students completing their Masters degree. Jocelyn is a member of the Dietitians Association of Australia (DAA), is committed to a program of continuing professional development and remains up to date through the Accredited Practising Dietitian program.  She is currently an active member of the professional mentoring program with the DAA.

Her blog today is on IBS and FODMAPS (1).

Irritable bowel syndrome is a common gastrointestinal disorder with symptoms including bloating and distension, erratic bowel habits, abdominal discomfort and excessive wind. There is good scientific evidence for use of diet to manage symptoms but it’s important to get good advice before you start modifying your diet.

The first step is to have a chat to your GP about your symptoms to rule out any possible causes for your symptoms such as Coeliac Disease.

The next step is to consider your diet . Research into food triggers has focussed on the FODMAPs  and it clear that dietary restriction of these foods leads to improvement in symptoms in most people with IBS. FODMAPs do not cause IBS however they often exacerbate the symptoms and so managing FODMAP load in the diet provides an excellent opportunity for reducing symptoms.

So how do FODMAPs aggravate symptoms?

FODMAPs can have a wide range of effects in the gut because they are often incompletely digested.  Foods that are not digested in the small intestine continue on to the large intestine (the colon) where they become food for the good bacteria in your gut. This is considered quite a normal thing to occur and  FODMAPs are considered “prebiotic”, meaning they provide a good food source for the bacteria in the colon which in turn help keep the bowel cells healthy. 

However in individuals with IBS the following may occur

  • FODMAPs are rapidly fermented by gut bacteria and this results in rapid gas production which can contribute to bloating and abdominal discomfort
  • This gas production (methane & hydrogen) can slow the movement through the bowel and contribute to constipation or bowel irregularity
  • Increased water delivery into the bowel (osmotic effect of FODMAPs) may contribute to diarrhoea or erratic bowel habit

If you plan to trial a low FODMAP’s diet it is vital you seek guidance. A specialised gastrointestinal dietitian will provide accurate information and supervise the dietary trial. The diet includes a wide range of healthy foods across all food groups so it is nutritionally sound.  However if you trial this diet without supervision it is highly likely you will be more restrictive with foods than is necessary and this may jeopardise nutritional adequacy. For example, many individual mistakenly exclude gluten even though is unlikely to be a problem unless there is Coeliac Disease. Others will exclude all dairy when they could be including a wide range of lactose free dairy options. Others will make the mistake of limiting all  grains, or excluding fruit and this often means a reduced fibre intake. 

The other concern with an overly restrictive diet or an extended time on the low FOMAP diet is the loss of prebiotic effect. Recent research highlights that a low FODMAP diet causes both a reduction in the  total amount and specific types of bacteria.  For this reason the diet is designed as short-term, supervised trial  followed by a reintroduction of the FODMAPs in a step wise manner to identify tolerance levels.

The good news is that for most individuals large amounts of a certain FODMAP’s may trigger symptoms but smaller amounts may be well tolerated. So it is likely that many individuals will be able to maintain a good level of symptom control with a more liberal diet. The long-term goal of the diet is a healthy eating plan to include as many FODMAPs as  tolerated.  In other words, a healthy diet  with the least restriction necessary for symptom management. And this may mean acceptance of  some of the milder symptoms from time to time in the interests of a broader diet.

Thanks Jocelyn. This will be of great interest and assistance to many patients and health professionals who follow my blog. If you would like to make an appointment with Jocelyn, ring on 0419 673 797.

(1). What are FODMAPs? (Taken from Sue Shepherd’s website Shepherd Works)

FODMAPs are found in the foods we eat. FODMAPs is an acronym for

  • Fermentable
  • Oligosaccharides (eg. Fructans and Galacto-oligosaccharides (GOS))
  • Disaccharides (eg. Lactose)
  • Monosaccharides (eg. excess Fructose)
  • And
  • Polyols (eg. Sorbitol, Mannitol, Maltitol, Xylitol and Isomalt)

Analogies, Metaphors and How to Keep Pelvic Health Simple

second albaert einstein simple image

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

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.

jelly-fish

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 issuebut 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.

toddler-toilet-seat-and-ladder

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.

Book 1 and 2 new editions copy

 

 

The La Scala spectacle completes a magical holiday

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.

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Milan Duomo

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.

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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

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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.

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Cinque Terre Revisited

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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.

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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.

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Beach Monterosso

It’s a tough gig but someone’s got to do it.

Milan and then home and seriously back to work.

Hiking in Cortina and some tips to remember for next time

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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.

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Up the top of Mt Falzago where the movie Cliffhanger was filmed.

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The very scenic Dolum Eu walk (212 route)

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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.

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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.

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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.

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L’Ancora della Toguga, Monterosso, Cinque Terre

Sadly the end is getting closer……..

Venezia: The home of the Architectural Biennale 2016

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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!

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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.

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Messner Museum Mount Kronplatz – Plan de Corones, South Tyrol, Italy. We went very close to seeing this lookout but time went against us- another reason to come back again to the South Tyrol region. 

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.

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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.

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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!

 

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