Podcast: Battling Back: Veterans & Arthritis

Full Transcript:
Released 11/14/2023

PODCAST OPEN:            
You’re listening to the Live Yes! With Arthritis podcast, created by the Arthritis Foundation to help people with arthritis — and the people who love them — live their best lives. If you’re dealing with chronic pain, this podcast is for you. You may have arthritis, but it doesn’t have you. Here, learn how you can take control of arthritis with tips and ideas from our hosts and guest experts. 
 
MUSIC BRIDGE 

Dan Hill: 
Welcome to the Live Yes! With Arthritis podcast. My name is Dan Hill. I'm going to be your guest host today. I am a military veteran, and today's episode is about veterans and arthritis. Arthritis affects service members at a disproportionate rate. In fact, 1 in 3 active or military veterans have doctor-diagnosed arthritis. Often, it's osteoarthritis, which may result from the hard physical toll that military service takes. And the chronic pain that arthritis creates can lead to or amplify other problems, including mental health issues. 

In this episode, I'm going to talk with Dr. Kimberly Fountain, and we're going to discuss military service and how it can lead to arthritis. Dr. Fountain works at the VA, the Department of Veterans Affairs. 

I am an exercise physiologist in Maryland and a 20-year veteran as I mentioned. I am also the Maryland president of a nonprofit called VEToga. You can find more information at vetoga.org. What we do is provide free yoga and other movement practices to veterans and their families worldwide. What we do through fundraising is we fund… pay for the education, the training, of veterans to become yoga teachers. 

Today's guest is Dr. Kimberly Fountain. Dr. Fountain, welcome to the podcast. 

Dr. Kimberly Fountain:  
Thank you. 

Dan Hill: 
Please tell us about yourself. 

Dr. Kimberly Fountain:  
I'm Dr. Kimberly Fountain, originally from Atlanta, Georgia. I've had different experiences with different patient populations, including the indigent, under-served. I've worked with inmates, and I've also worked in the private sector as well, and also with veterans. 

I'm grateful for the services you all provided. And my father also, he's no longer with us, but he also was a Navy veteran. So, again, I have a personal preference with taking care of veterans. And my medical interest lies in primary and preventative care. 

Dan Hill: 
Awesome. Thank you so much for all that you do for veterans. Why is arthritis an important focus to you and your patients? 

Dr. Kimberly Fountain: 
Arthritis is very common, but it's also a very debilitating condition. And I see that, you know, because there's no cure for it, we have to find best ways for patient management. And that varies on a case-by-case basis. And the treatment and management,it varies also from vet to vet, based on their background and history. Arthritis can affect other medical conditions, including mental conditions. My job is to make sure that that I treat patients with arthritis, but also validate their concerns and provide education for them. 

Dan Hill: 
I read in our show opening that 1 in 3 service members has arthritis. Osteoarthritis is a lot more common among service members than the general population, and it occurs at a younger age. What do we know specifically about post-traumatic osteoarthritis in the military? Why is it so common? 

Dr. Kimberly Fountain: 
There is a lot of repetitive motions that can contribute to trauma. And we see that a lot. And so, it's very common. Because a lot of the drills and not the exercises that service members have to undergo, it's more intense than that of the lay public or just a common person. The only other group of people I can attribute it to will be athletes, whether, you know, college athletes or professional athletes. 

So, overuse and trauma. Those are the number two causes that make it worse. And then, of course, over time, your people, even those who have not had these extenuating circumstances, can eventually develop arthritis. But it seems to exacerbate and come on early for those who undergo intense physical activity. 

Dan Hill: 
And I like that you related it to athletes, because as a strength and conditioning coach, repetition is very important. That's why it's called conditioning, you know, strength and conditioning. And athletes, whether it's in the gym or whatever their sport is, they do a lot of repetitive, you know? They do the same exercise, the same drills, over and over again. Because they need to become proficient at those specific exercises and drills. 

And it's the same in the military. You know, we train, whether it's push-ups, sit ups and run and pull-ups, which I have my own input on those. Or whether it's jumping in and out of a deuce-and-a-half, which is a personal transport carrier. Jumping in and out of those with 80-pound rucksacks on. We have to jump out of them and do it 100 times so we know how to do it the right way. But nobody really teaches us the right way to do these exercises, you know? Do you ever hear things like that from vets that you work with or patients? 

Dr. Kimberly Fountain: 
That's a very common story, very, very common scenario. It's not unique to any one particular branch. And it's common among women as well as men. 

PROMO: 
Whenever you need help, the Arthritis Foundation’s Helpline is here for you. Whether it’s about insurance coverage, a provider you need help from or something else, get in touch with us by phone toll-free at 800-283-7800. Or send us a message at https://www.arthritis.org/helpline. 

Dan Hill: 
I found my love for exercise, for movement, for helping others, after I was injured in 2003. I broke my back and both of my feet, as well as sustaining two traumatic brain injuries. I was told I would never walk again. And, of course, I didn't want to accept that news. So, I started self-studying at home because I was on convalescent leave for nine or 10 months. 

And during that time, I self-studied. I did as much reading and self-studying as I could, to learn about our physiology and to learn about exercise. And eventually I became an exercise physiologist.  I heard about this through my sister. I heard about Bikram yoga, which is basically a hot yoga, hot, humid yoga. 

I was like, "That's a great idea." It was 90 minutes in this sauna, basically, doing these physically demanding, exhausting poses. And at the time, I was like, "This is a great way to condition myself to move in this environment." So that's how I found yoga to begin with. And I just fell in love with it from there and decided to become a teacher. 

A lot of veterans, especially the men, you know, you mention yoga and they're like, "Oh, no, I'm not going to do that." And so I stopped really kind of using the word yoga, and I just use the word movement now. So, I have a lot of older male clients who do yoga. They just don't know it. And they love it. They benefit from it. They're like, "When do we get to do the stretching and the mobility stuff?" We always start with the foundation, and usually that involves yoga and breath. 

So, yoga hasn't only, you know, changed my flexibility, my strength; my calm and focus has also changed. Have your patients shared with you how they deal with arthritis, especially mentally and emotionally? 

Dr. Kimberly Fountain: 
I think for a lot of them, they just suck it up. They just kind of suck it up and keep going because they've been told that they're… 

Dan Hill: 
That's what we're taught to do, right? 

Dr. Kimberly Fountain: 
Right. Suck it up. And you don't want to appear to be weak. I've never had anyone tell me that they've been advised that, "Oh, if you continue doing this, you may have arthritis." Or "Oh, if you continue to do this, we need to have you do this, maybe jump out of a plane. Or do this drill in such a way that we protect your knees." 

It sounds like, from what I gather, the experience is such that to get through the moment at that time, or get through the drill at that time, or whatever at that time, with no thought or consideration for what future ailments may come as a result of this. 

Dan Hill: 
I agree. I think the Department of Defense needs to hire some kind of exercise physiologist or a movement coach or somebody that can revamp some of these exercises. Or at least help us learn how to do them more safely. What do your patients tell you about their biggest challenges from arthritis? What do they say is the hardest? 

Dr. Kimberly Fountain: 
The biggest challenge is this, too. It's just a debilitation and, you know, limited range of being able to move. And also the pain. And it really becomes an issue when I'm dealing with a patient who maybe has some other comorbid conditions, such as diabetes or high blood pressure, high cholesterol. These are patients for whom I'm always recommending that they exercise. A lot of times they're dealing with obesity. 

One of the main things I'm trying to do is get them to do some sort of exercise to help with the weight loss. Well, that's very difficult to exercise if you already have joint pain at baseline. And so, a lot of them feel like they're in a Catch 22 as far as doing those modalities that I recommend to help with weight loss and weight maintenance.

Another issue is this: Many of them may have other advanced disease, such as kidney disease, for which we can't… It limits what we can do for treatment. What I mean by that: There are certain medications that are non-steroidal medicines, such as aspirin, to treat their pain. Or medications I can't give because this person now has kidney disease. 

I have to work on making sure we make… We try our best to maintain the kidneys. And so, there are a lot of complications that come from that. So, a lot of times I cannot treat with the basic modalities. Now we deal with the frustration and the mental anguish that comes behind that, which is also the depression. Now we have baseline depression, but there is assessing as the depression associated with a baseline medical condition. And I see that all the time. 

Dan Hill: 
If you're a veteran listening to this, you can probably relate that, you know, being in the military is stressful. And we don't have a lot of patience. And everything has to be done at a certain time in a certain way. It’s hard to unlearn these things. It’s hard to recondition your physiology, let alone your neurology and your brain, and how to do something when you've been trained for X amount of years, 20 in my case, to be a certain way, to do a certain thing. 

In a lot of ways, that affects our arthritis, too, you know? Working within these movement patterns that are not natural for our body, but we were told that we have to conform to. And yoga changed my life, opened my eyes, not just physically, like I said, but mindfully, emotionally. I became a lot more calm. I became a lot more patient. I became a lot more, you've heard the word, “mindful.” It gets thrown around there a lot, but that's really, you know, being mindful, being focused, being patient, present, calm in your body. 

Yoga is so good at creating that flow state. Because you are so involved in the posture or the pose or the movement that you're doing that you're not thinking about anything else. And that is the whole point, in my opinion, sometimes, of finding a good movement practice for therapeutic reasons. One of my mantras is “movement is medicine,” but it's hard to move when moving hurts.  

Dr. Kimberly Fountain: 
That's right. 

Dan Hill: 
We’ve got to figure out other ways, you know? Start with more gentle movements, like a rope flow, or yoga, or anything that you can do from a seated position also helps. But how did they deal? How do your patients deal with these challenges that you mentioned, and what medical or other advice do you give them? 

Dr. Kimberly Fountain: 
Very good question. That's why I say this is a case-by-case situation. There's no set cookie-cutter to patient management with these issues. So fortunately, if I have a patient who's healthy enough to tolerate chronic pain medication, we will use it as needed. But even before that, I try to tell them that, ironically, like you said, “Movement is medicine. We got to get you moving. The longer we keep you sedentary and not moving, the worse this condition is going to get.” 

And when you think about something that's chronic, this is something that's ongoing. So, I'll tell them, just like medicine that you're taking for any other illness, this is something that you’ve got to do for the rest of your life. And the irony of it is, I think, the easy thing is to pop the pill. That's easy to do. Anybody can get up in the morning and, if you remember it, take a pill. But a lot of times, the other part of this component for treatment is physical therapy. 

You'll be surprised at the pushback that I get from some veterans or patients in general who think, “Oh, that's physical therapy. That's not going to help me.” And the problem with that is, because I tell them, “This is a chronic disorder. You did not get here overnight. You're not, we're not, going to fix this overnight. And so, you will not see instant gratification with physical therapy. But it is part of the ongoing process that is necessary to get you through a baseline where you can deal with this for the rest of your life.”  

And then, as we get older, there are other conditions that we acquire, such as obesity, such as high blood pressure, diabetes, that further complicate some of these chronic issues and make it that much more challenging. But it's not impossible. And that's why it's very important for patients to realize that. But also to have a support system to help them get through it. 

Dan Hill: 
Other issues also, such as depression and anxiety ... and PTSD. 

PROMO: 
If you’re a military veteran or active service member, we’ve got support, tips and resources that can help you take control of arthritis symptoms and challenges. Get the help you need from experts you can trust at https://www.arthritis.org/veteran. 

Dan Hill: 
I feel like veterans, male veterans especially, have a hard time advocating for themselves. And with all of this physical pain, of course, that translates to mental health fitness as well. And men, I'm just going to say it: Most of us are stubborn, and we're not going to show any signs of weakness. We're not going to advocate for ourselves. Do you see that being a recurring issue with your patients? 

Dr. Kimberly Fountain: 
Yes, I do. It’s a very real issue. A lot of times, they almost get to where they only do something about it when it just gets absolutely unbearable. And another issue when I think about arthritis and depression, for example. Because it's not things that people can physically see. A lot of times, people don't… Now, I won't say they don't take it seriously, but for lack of a better term, that's the case. 

Other than the X-ray, a lot of times you can't just see arthritis on someone. A lot of times the pain goes way deeper than what we can see. You can't even always see depression. Many times, people will suppress their depression or pretend not to have it because of the reason they don't want to appear weak. And so, a lot of times you're right, if a person is not advocating for themselves, it makes it hard for someone else to advocate for them. And then the culture, like you said, being in the military, you're taught to just suck it up, just deal with it. 

Dan Hill: 
Yeah, you don't want to be the weak link. 

Dr. Kimberly Fountain: 
Mm-hmm. And the irony of it is, you're most likely not the only one dealing with it. And maybe if someone else spoke up, they may allow for the service people to speak up. But no one, you're right, wants to be the first one. 

Dan Hill: 
There's a common quote that says, “Not all wounds are visible.” And that's what we're talking about, right? Depression is not visible. You know, not all wounds are visible. A lot of people fake being happy to cover depression. But I've never met anyone that faked being depressed. You cannot judge someone by the outside or, you know, socially. 

Dr. Kimberly Fountain: 
Agreed. And unfortunately, those who are depressed enough to be suicidal and those who are unfortunately successful at their suicide attempts, that's when the first thing you hear people say, "Wow, I didn't know he was that depressed." Or "Wow, I didn't know she was that depressed." Well, no, she's not wearing a tattoo on her forehead saying, "I'm depressed and suicidal." Most people don't want to advertise that. 

Dan Hill: 
My mantra is, “Depression has a hard time with a moving target.” So, keep your bodies moving, and that keeps your mind, or your mental health, your mental fitness, that keeps that strong, too, because movement is the best medicine. 

One of the things I always start with when I have a new client, especially one with arthritis, is breathing techniques — how to calm the mind, how to just be mindful and present in your own body and realize what's going on. Just being mindful. Half the time, people don't know there's a problem until somebody else points it out, you know? 

Do you ever mention, or do you know anything, about breathing practices, breath exercises?  

Dr. Kimberly Fountain: 
Honestly, not as much as I should. I've never even considered my breathing exercises as a mode of therapy. And part of the reason why: It's because, you know, I really wonder if I tell a veteran, “Well, let's do some breathing exercises. Let's try...” I can see somebody laughing at me or just being totally non-receptive to that. Like, “I know how to breathe. I don't need any help breathing. It's not my breathing that's the problem. It's my knees, that's the problem. It's my feet, that's the problem.” 

But it's funny you mentioned that. I was working with a psychiatrist for myself. And it's been brought up: Did I want to do some yoga, or do some training? And the first thing I remember telling her, “Ma'am, I don't have time for that. I don't have time to be doing all that. I’ve just got to get better, I’ve got to take care of my patients.” 

Well, you know, and she's trying to convince me. “Well, maybe this will be something that helps you.” And in my mind, I'm just thinking of all the million and one things I have to do. And so, I honestly, because I cannot… I have not done that for myself, I find it hard to convince my patients to do it. Because it's hard to convince people of things that you haven't done for yourself. And so, I have not even pushed that as an option. And perhaps that's something I need to consider. 

Dan Hill: 
That makes me think, too… I'm out here trying to help all these veterans by teaching them how to move, teaching them how to breathe, teaching them how to do yoga. And, of course, just like you said, they're not too receptive until the doctor says, "Hey, you're going to die if you don't start exercising." That's when they start hiring personal trainers. And unfortunately, too late. 

Dr. Kimberly Fountain: 
Right. 

Dan Hill: 
Maybe I should stop targeting, or looking for patients, the veterans, the arthritis sufferers. Maybe I should start teaching the doctors and the other advocates how to breathe and how to do yoga and how to do controlled articular rotations, you know? Because, like you said, you don't feel comfortable talking to your patients about it because you have not been through it yourself. So, you don't feel like… But then, of course, like you said, too, doctors don't have the time for an extra 10 or 15 minutes a day, but learning how to breathe… 

And it doesn't only just change your physical, your physiology, but it changes your mental health as well. Learning how to breathe is the first thing I teach people, whether it's now, before we start moving, or before we start meditating. It is the gateway to just taking control of your own mind/body, as they say. 

Dr. Kimberly Fountain:  
I recently attended a VA-sponsored conference at the VA in Orlando, where they talk about physical therapists as part of the basic PAT team for patients. And one of the things that they talked about is… They had it set up where, you know, physical therapists could be easily available for primary care providers with respect to helping patients. 

So, when they were talking about how good it is and how they can convince their patients to do physical therapy, I'm like, "Well, I guess you can, if, within their 15-minute encounter, there's a physical therapist two doors down the hall for whom you can get them face-to-face with that patient, to just discuss whatever modalities you recommend." I don't have that luxury. 

It's kind of hard when it's remote, and they can't see visually how this is going to help them. A lot of veterans and people in general, before they just buy into what you say, you’ve got to convince people. 

Dan Hill: 
Yeah, I mean, the hardest part is always just getting people to follow through. If someone comes into my gym, I can give them a great workout, but if they don't have the discipline to come back, they're not going to come back. It's the ones that have done it repetitively for a couple of months that now are conditioned, now are addicted to working out, to fitness, that are going to keep coming back. So, that's the hardest part, I think, is getting people started, you know? Getting people to have the discipline or the accountability to actually start. 

Dr. Kimberly Fountain: 
Right. 

Dan Hill: 
Whether it's a medical prescription or a workout program or even just a couple of stretches at home that are going to take five minutes. Nobody's going to follow through with that. 

Dr. Kimberly Fountain: 
It's interesting you said it because, even with my patients who, like I said, are diabetic, who have high blood pressure, who have... You know, a lot of times I say, "You are your own driver. I'm going to give you the tools. And now you have got to take these tools home and implement them." 

Sometimes, it's not enough to just say, “This is bad.” Sometimes, you have to give people a reason, and that takes education. A lot of times, patients need to have some sort of background information as to why this modality is helpful, or why they should do this as far as this training or why they should exercise. Everybody just knows in general, “Oh, exercise is good.” Sometimes, they need to realize this is what happens when you don't exercise. 

And what I try to do is educate them on that before they start having some of the ailments or the complications as the result of not exercising. And sometimes, by the time they come to me, it's too late. By that time, you've got a person with arthritis, with poor blood sugar levels. Right now, I've got a couple of veterans who need knee replacements and have talked to surgeons. But because their diabetes is not under control, they're not surgical candidates. Or they are too high a risk. 

Dan Hill: 
Yeah, same thing in the gym. I have people do all these exercises with very light weights, and we're doing all of these shoulder or hip mobility exercises that don't look very hard. But those are the ones that they usually need the most. And it's only through repetition. You know, they're like, "Why do I need to put my hands over my head? I never ever need to do this," you know, as an example. And I say, "Because if you don't, your body's going to think, 'Oh, I guess we don't need that range of motion. Let's turn it off.'" 

Dr. Kimberly Fountain:  
That's right. 

Dan Hill: 
"We don't need it anymore." And that's how you get frozen shoulder, and you lose range of mobility. And you’ve got to keep that synovial fluid moving around. You’ve got to keep all of your joints moving to keep that arthritis at bay. 

Dr. Kimberly Fountain: 
A lot of times, you get a lot of the pushback, because a lot of times people don't feel like they're in control. They feel hopeless. But it's not always a hopeless situation. They just don't realize where the power lies and what power they do have to make their conditions better. And so, what I try to do is help them realize that. 

Dan Hill: 
That’s awesome. Thank you so much. You know, what I see is: We're doing a great job trying to help people who have arthritis, who already suffer from this chronic pain. But what I see as being a bigger problem is, instead of focusing on rehabilitation, we focus on pre-habilitation, right? Preventative care, you know? 

Dr. Kimberly Fountain: 
Yes. 

Dan Hill: 
I think the military could do a better job at preventative care, to make it more acceptable, to make it more ingrained into our physiology. But I think we need to focus more on joint mobility care to prevent our veterans, and everybody, obviously, but you know, our veterans from getting arthritis. Do you have an opinion on how we could introduce or make this more acceptable? 

Dr. Kimberly Fountain: 
That's a good question. I think the one thing to make them more acceptable is to stress the statistics that we're dealing with now. To demonstrate now that, without this intervention for preventive care, this is what we deal with. Then what can we do to minimize the number of patients who are dealing with arthritis and minimize the severity to which they deal with it. 

But you're right, if there's something that we can do to prevent your arthritis from being severe in the first place, during the time you're actually doing PT or during the time you're actually still a youth in the military, why not capitalize on it at that time, so that perhaps this won't be a bigger issue for you at 55, as opposed to 25?  

PROMO: 
The Arthritis Foundation’s Live Yes! Connect Groups are empowering support groups that bring people together for informative events and engaging activities. Peer-run and volunteer-led, they offer a place of understanding and encouragement and cover all kinds of topics. Find a group that matches your interests at https://connectgroups.arthritis.org.  

Dan Hill: 
Before every episode, we post a question on social media. For this episode, we asked, "If you are, or have been, in the military, how do your challenges of living with arthritis differ from those of civilians with arthritis?" 

The first answer we have here, Dr. Fountain, is: "I dealt with chronic fatigue and pain for years, and no one in the VA system took me seriously. At best, they prescribed me Motrin. At worst, they accused me of seeking drugs. I felt helpless. And my life came to a halt this year when the pain became unbearable. My PCP didn't listen to me, didn't advocate for me and actively tried to stop me from seeking answers. I finally received a referral to a rheumatologist and received a diagnosis two months later. When my rheumatologist gave me an initial exam and told me that she believed me, I broke down in tears. Unfortunately, my story is very typical for American vets. No one should ever be shamed for seeking help.” 

I agree. Dr. Fountain, do you have anything to add to, that? 
 
Dr. Kimberly Fountain: 
I didn't gather from what you told me that this doctor validated this patient's feelings. Most of the time, you’ve got to just start somewhere and validate what they're feeling, validate their concerns. Don't just think everybody's drug-seeking. I need to validate what you're saying, to say, "Wow, this must be painful for you. This is really a real issue." And so yeah, this patient probably broke down and cried because for so long they didn't even have anybody who they could relate to, to validate what they were feeling. 

Dan Hill: 
And as a veteran, I can relate to this. I've had similar experiences, which I'll talk about in a second, but first, reading it, it gave me the impression that they were having a hard time getting a referral or having their PCP refer them to any kind of specialist. Is that common? 

Dr. Kimberly Fountain: 
Right, right. Well, I will say, arthritis in general, it's initially treated by a PCP. However, if the treatments and modalities I give you from a PCP standpoint get to the point where that's not enough, then you refer to a specialist, but a specialist is not always indicated. I don't call a specialist until and unless I offer certain modalities, and we try to give those modalities an opportunity to work. And once we get to the point where they don't work, then that's when I call a specialist. But if you're just brushing a patient off, not treating them, not validating their illness, you don't even get to that point yet. 

Dan Hill: 
Right. I know that there's a process. There's an order of steps that you have to follow. And it doesn't… It's not clear in here how long it took them to get to the rheumatologist. 

Dr. Kimberly Fountain: 
Right. And it's a case-by-case. 

Dan Hill: 
Right. We like to sum up every episode with top three takeaways. Dr. Fountain, what are your top three takeaways from our conversation? 

Dr. Kimberly Fountain: 
Mumber one is: Let the veterans know that, or patients in general know to, first of all, seek help if you need it for whatever it is, whether it's for arthritis, whether it's for depression or whether... Seek that help that you need. Because until you come to us, I wouldn't know that you have an issue. The second thing, on our part as a provider, as a doctor, is once the veteran comes to me, I need to validate their feelings and validate their concerns and try to devise a customized treatment plan for that particular veteran. And then the third thing is for us to work together as a team, the veteran and myself, as a team. And any other support, part of that support, whether it be there's other additional family members or other medicine specialties that we recruit to help, so that we can have a long-term plan for dealing with their comorbid conditions. 

Dan Hill: 
Thank you. Those are great takeaways. I would have to say my first one is: Movement is medicine. But like we talked about, sometimes, you know, moving is hard when it hurts. So, you’ve got to find something that works for you. Start where you're at, with what you have, and just learn how to move. And if any kind of gentle movement is still painful or hard, I would start with breathing. What you should be starting with breathing anyway. Breathing is also exercise. Breathing is also meditation. Breathing is mindfulness. Breathing is taking the parking brake off. That would probably be my first takeaway that I'd want listeners to walk away with. 

The second is: Advocate for yourself. No one's coming to help you. No one is. No one is just out there looking for people to help. You have to ask for help. You have to do what these people who are helping you instruct you to do. 

And third is probably a prehab. Learn how to move before it hurts. Learn how to move before you have arthritis. Learn how to move before you experience trauma that's going to make it harder for you to move when you get older. Those would be, in three nutshells, my three takeaways. 

Dr. Fountain, thank you so much for joining us today. 

Dr. Kimberly Fountain: 
Thank you for having me. This has been an honor and a privilege to have this conversation and to share some of my experiences. But also, to learn from your experience as well. And I will keep these in mind as I move forward in helping my veterans with their arthritis, as well as other chronic diseases. I look forward to other additional opportunities in the future. 

Dan Hill: 
We appreciate you. 

PODCAST CLOSE: 
The Live Yes! With Arthritis podcast is independently produced by the Arthritis Foundation. This podcast aims to help people living with arthritis and chronic pain live their best life. People like you. For a transcript and show notes, go to https://www.arthritis.org/liveyes/podcast. Subscribe and rate us wherever you get your podcasts. And stay in touch!