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Spring-perfect recipes from ‘Eat Well to Age Well’

Spring has officially sprung so what better way to celebrate than by trying out some delicious and healthy recipes perfect for this season? Taken from the recently launched cookbook, ‘Eat Well to Age Well’ by Beverly Jarvis.

King Prawn Noodle Salad Bowl

Serves 2

This is a great fish dish with Oriental flavours. It is easy to prepare and speedy to cook – a tasty and nutritious meal, which looks pretty too.

INGREDIENTS:

1 tbsp sesame seeds

150 g wholegrain noodles

3 tbsp olive or rapeseed oil

250 g shelled raw king prawns

1 rounded tbsp red curry paste

2 tsp runny honey

2 tsp fish sauce (I like Blue Dragon)

1 tbsp light soy sauce

1⁄2 lime, juiced

1 tbsp freshly chopped coriander

1 carrot, shaved into ribbons

2 radishes, sliced

4 baby sweetcorn, sliced thickly

2 spring onions, chopped

 

EQUIPMENT:

You will need a chopping board and knife, a large saucepan with a lid, a large frying pan or wok, a dinner plate, vegetable peeler, citrus juicer, tablespoon, and teaspoon, a small bowl, a wooden spoon and 2 shallow serving bowls.

NUTRITIONAL NOTE:

The prawns make a valuable contribution towards your RDI for protein as well as providing vitamins A, B6 and B12 plus calcium and iodine. Prawns contain quite high levels of cholesterol but a 1996 study, compar- ing a low-cholesterol diet with one that included eating prawns every day, found that the prawn diet increased HDL (‘good choles- terol’) and significantly decreased triglycerides while only slightly increasing LDL (‘bad’ cholesterol). Prawns also have a good balance of essential fatty acids with almost three times more omega-3 fatty acid than omega-6 fatty acids (see page 17). The vegetables contribute fibre and antioxidants.

INTRUCTIONS:

  1. In a clean, hot frying pan, over a medium heat, toast the sesame seeds for about 1 minute, stirring frequently, until golden, then transfer to a plate and set aside.
  2. Cook the noodles according to the packet instructions, normally about 5 minutes. Drain.
  3. Meanwhile, heat 1 tbsp oil in a wok or large frying pan over a medium heat. Add the prawns and stir-fry for a minute or two until pink all over.
  4. Add the curry paste and stir-fry for a minute.
  5. Add the honey and fish sauce, with about 4 tbsp water, and stir and heat for 2 minutes.
  6. In a small bowl, make the dressing by combining the soy sauce, lime juice, remaining oil and coriander.
  7. Combine the drained noodles with the carrot, radishes, sweetcorn and spring onions.
  8. Pour the dressing over the noodle mix and toss everything together.
  9. Serve the noodles, divided between the two bowls, with the prawn curry poured over, and topped with the reserved toasted sesame seeds.

 

Vegetable Risotto With Roast Tomatoes

Serves 2 – 3

Risotto makes a filling and truly delicious main course, which is easy to cook if you use this largely baked-in-the-oven method. It is a great complete meal, with bags of flavour in both the risotto, which is cooked in vegetable stock and the tangy tomatoes. I usually prefer using brown rice for extra fibre and vitamins. However, there are times when a creamy, satisfying risotto just has to be made with arborio rice. You will find it in supermarkets, alongside long-grain rice, sometimes just labelled ‘risotto rice’. However, don’t stress if you can’t find arborio risotto rice; just use long-grain white rice instead. It won’t be exactly like an Italian risotto but it will still taste great, I promise!

INGREDIENTS:     

1 tbsp rapeseed or olive oil 1 medium-size red onion finely chopped 1 stick celery, finely chopped

1 medium-size carrot

sliced 125 g sweet vine tomatoes, quartered, or halved if using cherry tomatoes

Salt and freshly ground black pepper 150 g arborio risotto rice, or long grain rice, rinsed and drained

1 tsp freshly grated root ginger

1 clove garlic, crushed

650 ml hot vegetable stock

3 tbsp white wine, or dry cider, optional, or use water

5 tbsp frozen peas

1 small red or yellow pepper, de-seeded and chopped

EQUIPMENT:

You will need a chopping board and knife and a large frying pan with lid which is both hob- and oven-friendly. (If you are worried about the handle, triple wrap it in tin foil, before transferring the pan to the oven.) Also a teaspoon, tablespoon, wooden spoon, roast- ing tray, measuring jug and cheese grater.

NUTRITIONAL NOTE:

The rice makes a valuable contribution towards your RDI for carbohydrate. The tomatoes and bell pepper add fibre, antioxidant polyphenols and vitamins A and C.

TO SERVE:

50 g vegetarian parmesan cheese, freshly grated. Handful basil leaves, chopped. The oven-roasted tomatoes.

INSTRUCTIONS:

  1. Pre-heat the oven to 210°/190°C fan/gas 6.
  2. In a large frying pan, heat 1⁄2 tbsp oil over a medium heat, until shimmering.
  3. Stirring frequently, over a medium heat, fry the onion, celery and carrot for 5-7 minutes, until softened.
  4. Meanwhile, put the tomatoes onto a roasting tray. Drizzle them with the remaining oil, season with salt and pepper, then roast for about 15 minutes.
  5. Stir the rice, ginger and garlic into the pan with the vegetables.
  6. Increase the heat and add 300 ml of the stock, with the wine or water. Stir well and bring to a rapid boil.
  7. Cover with a lid and transfer to the oven, above the tomatoes
  8. Bake for 15 minutes.
  9. Remove the risotto from the oven and transfer it back to the hob.
  10. Gently, stir in the peas and the red or yellow pepper, with the remaining stock.
  11. Cook uncovered, stirring, over a me- dium-high heat, for 5-7 minutes or so, until the rice is al dente and the peas and peppers are just cooked.
  12. Remove from the heat, adjust the sea- soning if necessary, then serve, sprinkled with the basil, and the parmesan cheese, accompanied by the roasted tomatoes.

 

 

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10 reasons why you should exercise when you have bowel cancer

Blog written by Sarah Russell, author of The Bowel Cancer Recovery Toolkit.

When it comes to bowel cancer, exercise could well be one of the most powerful tools in your armoury.  It helps you manage the side effects of treatment and it might just save your life.

We need to start thinking about physical activity as the 4th treatment option for bowel cancer (alongside chemo, surgery and radiotherapy).

Being active during and after your treatment will help you overcome many of the debilitating side effects from chemotherapy and radiotherapy, such as fatigue, muscle loss and weakness. It can help your body tolerate the treatments better and there is emerging evidence that exercise can help your body fight the cancer cells.

Some studies show that being active after a diagnosis of colorectal cancer can improve your chance of survivorship by around 30%.

But above all, being active gives you a sense of wellbeing and control and boosts your psychological health.

It helps you feel that you’re doing something for yourself. And it just makes you feel better.

Yet I also know that exercise is one of the most difficult things to do when you have bowel cancer.

Despite the research, the messages from medical professionals about exercise are mixed and contradictory. There is very little encouragement to be active, and not much in the way of supervised exercise classes or groups. The ‘rest is best’ message is unfortunately very pervasive in medicine and society, so people aren’t getting the encouragement they need. If the Doc says to rest, then that’s what you’ll do.

Some research I did in 2018 (on behalf of medical devices company ConvaTec.co.uk) found that 90% of people who had bowel cancer said they didn’t do enough exercise for good health, as recommended by the World Health Organisation (150 minutes of moderate activity per week).

Statistics like that keep me awake at night.

If you’re not meeting guidelines for exercise, you increase your risk of other co-morbidities – diabetes, heart disease, depression, arthritis etc and fall into a vicious circle of inactivity and worsening quality of life. And we know that around 70% of people with cancer have at least one other chronic condition.

So basically we need to get moving and change this statistic, and fast.

People with bowel cancer need to get moving and feel confident around exercise, not to be scared of exercise or allow the barriers they face to prevent them being active.

 

But where to start?

But it’s hard to know where to start, or what’s safe. What sort of exercises should you do after surgery? Can you exercise with a stoma? How much exercise can you do when you’re having chemo? What if you just don’t feel like it? And how are you meant to get active when you feel exhausted and sick?

You might be sceptical, uninterested or just too unwell to think about exercise, or think that the notion is crazy when you can’t even get out of bed.

But you CAN do it. It’s going to require a shift in mindset and to think about ‘exercise’ in a very different way. It’ll need you to dig deep into your resilience and find a support crew and specialists to help you.

Try to think about what you can do rather than what you can’t.

But first, here are 10 reasons why exercise is so great for people with bowel cancer:

Reason 1

It is completely safe to be active when you have bowel cancer. In fact, not only is it safe, but it should be viewed as part of your treatment and recovery plan. Some studies have shown that being active after diagnosis, you can reduce the risk of recurrence of colon cancer by around 30%.

Reason 2

Being active when you’re having chemotherapy and radiotherapy can help to combat some of the side effects and long-term consequences of treatment such as muscle loss, weakness and fatigue. Even short 10-minute walks will make a huge difference. Little and often is best.

Reason 3

Rest is not best for anyone, even when you have bowel cancer. By resting too much, you risk become even weaker and losing muscle… which results in loss of confidence and loss of fitness. Get the balance right between movement and rest instead. After surgery you do not need to ‘rest’ for 6-12 weeks, instead gradually start to become more active, walking more and doing core exercises.

Reason 4

Even if you have advanced cancer, bone metastases or a complex condition it’s still ok for you to be active. You may need to make some adaptations or work under the supervision of an exercise specialist or physio, but some sort of movement is one of the best things you can do to help you cope with cancer treatments and for quality of life.

Reason 5

It might seem counterintuitive, but research has shown that exercise is a great way to overcome cancer related/chemotherapy fatigue. Studies show that doing some gentle exercise (short walks to start with or some stretching, pilates or cycling) can actually help you feel more energised and reduce your feelings of fatigue.

Reason 6

But you don’t have to go to the gym. Being ‘active’ really means just sitting less and moving more. It doesn’t have to be hard and it definitely does not have to hurt. Exercise needs to nourish you, not punish you.

Reason 7

If you’re an athlete or already do a lot of activity, you can continue to exercise throughout treatment if you feel well enough. There are examples of runners, rowers and competitive athletes who can still train when they’re having chemotherapy or other treatments. You may need to adapt your training level or certain exercises for a while, but if you feel well there is no reason why you should stop exercising completely. You just have to listen to your body.

Reason 8

The mental and psychological effects of exercise are immeasurable and incredibly powerful. Using movement as a way to recover after surgery and treatment will help you to rebuild your body, your confidence, self-esteem and energy levels. In fact I think the mental aspect of exercise is the most important of all, giving you a sense of control and positivity.

Reason 9

You don’t have to feel 100% well to exercise. It’s ok to start feeling tired or even quite unwell. Just moving a bit, going for a walk, doing some gentle stretches or something like yoga can actually help you feel better. You may have to push yourself to get started, but once you’re going, you’ll realise your body can do more than you thought.

Reason 10

And finally… after abdominal surgery for bowel cancer and especially if you have a stoma, you absolutely must do core/abdominal rehab exercises. You can start them within a few days after your operation. It’s essential to strengthen the muscles and restore the function of your core. Even though some doctors and nurses are cautious, clinical nursing guidelines advise that it’s safe to start 3-4 days after surgery with appropriate exercises. You’ll find these exercises in my book ‘The Bowel Cancer Recovery Toolkit’ and also online in my rehab exercise

classes and videos at www.theostomystudio.co.uk

 

There is a huge gap in patient care after bowel surgery. Too often people are told what they can’t do, and there’s very little support to tell them what they can do.

The Bowel Cancer Recovery Toolkit, aims to fill this gap, with expert advice, support and encouragement to help you exercise and remain active during and after your diagnosis.

So go out there and challenge the statistics (and help me to sleep at night!). Sometimes you will need to give yourself a push to get going when it might be the last thing you feel like doing. Showing up and getting started is always the hardest part, but you can do it.

‘When it comes to exercise, something is always possible, and something is always better than nothing’.

 

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Celebrating International Women’s Day

This blog post was written by Hammersmith Health Books founder, Georgina Bentliff.

In honour of this day that internationally celebrates women’s achievements, we would like to make a special mention of these brilliant authors of 2021-2022 Hammersmith Health books. All write, based on great expertise in their chosen field, to improve the health of others and are dedicated to achieving a healthier future for women and for all.

Dr Sarah Myhill, MB BS

Dr Myhill qualified in medicine (with Honours) from Middlesex Hospital Medical School in 1981 and has since focused tirelessly on identifying and treating the underlying causes of health problems, especially diseases of civilisation’ with which we are beset in the west. She has worked in the NHS and independent practice and for 17 years was the Honorary Secretary of the British Society for Ecological Medicine, which focuses on the causes of disease and treating through diet, supplements and avoiding toxic stress. She has recently deregistered from the UK’s General Medical Council and is not registered as a Naturopathic Physician with the Association of Naturopathic Practitioners. She has particular expertise in treating CFS/ME. Visit her website at www.drmyhill.co.uk

 

Beverley Jarvis

Beverley has been teaching and writing about cooking since she qualified as a home economist and cookery teacher in the late 1960s. Her guiding principles have developed through many years of working as a home economist, including a stint as head of home economics for the Nestle company, and through writing about food and teaching cookery. She has presented a series on microwave cookery for the BBC and appeared on Food and Drink plus morning TV shows. She has previously published 23 cookbooks under the name Beverley Piper, starting out with Microwave Cooking for Health, published by Penguin.

 

 

Dr Shireen Kassam, MB BS, FRCPath, PhD, DipIBLM

Dr Kassam is a Consultant Haematologist and Honorary Senior Lecturer at King’s College Hospital, London, with a specialist interest in the treatment of patients with lymphoma (cancer of the lymphatic system). She is also passionate about promoting plant-based nutrition for the prevention and reversal of chronic diseases and for maintaining optimal health after treatment for cancer. In 2018 she founded Plant-Based Health Professionals UK (https://plantbasedhealthprofessionals.com/), a community interest company whose mission is to provide evidence-based education and advocacy on plant-based nutrition. In 2019 she became certified as a Lifestyle Medicine Physician by the International Board of Lifestyle Medicine.

 

Dr Zahra Kassam MB BS, FRCPC, MSc, DipABLM

Dr Kassam is a Radiation Oncologist at the Stronach Regional Cancer Centre in Ontario, Canada and an Assistant Professor in the Department of Radiation Oncology at the University of Toronto. Her areas of clinical practice are gastrointestinal and breast cancers and she has published peer-reviewed papers on these malignancies as well as in education and mentorship. She is a certified Lifestyle Medicine Physician with the American Board of Lifestyle Medicine and has completed the eCornell certification in plant-based nutrition and the Plant-Based Nutrition course at the University of Winchester. In 2019 she co-founded Plant-Based Canada (www.plantbasedcanada.org/), a not-for-profit organisation with the goal of education the public and health professionals on the evidence-based benefits of plant-based whole food nutrition for individual and planetary health.

 

Carolyn Garritt, MSc

Carolyn Garritt is a cancer rehabilitation personal trainer and Exercise Lead for the West London Maggie’s Cancer Support Centre. She has been working in this relatively new field for more than eight years and is a qualified personal trainer and instructor in running, boxing, sports conditioning, chair-based exercise and Nordic walking. She has trained hundreds of people recovering from or living with cancer. She also has personal experience of cancer – she helped both her parents become more active after their cancer diagnoses and in 2020, while she was writing this book, was diagnosed with breast cancer herself. Visit her at: https://getyouroomphback.wordpress.com/

 

Sandra Hood, RD

Sandra Hood is a specialist NHS dietitian with a degree in dietetics from Leeds Metropolitan University. She is also Honorary Nutrition Advisor to the Vegan Society. Her first book, Feeding Your Vegan Infant – with confidence, was published by the Vegan Society in 2005 and she has had articles published in magazines and contributed to many clinical publications. Sandra worked closely with Plamil Foods Ltd (the first UK soya milk company) in the 1980s to produce Infant Case Histories to prove the efficacy and benefits of a plant-based diet for infants. She has been vegan for over 40 years and enjoys running, cooking and caring for animals including her rescue dog.

 

 

Magnolia Cardona, MB BS, MPH, PhD

Dr Magnolia Cardona is a former GP, public health practitioner and current associate professor of health services research. She is a passionate advocate for the rights of older people dying of natural causes to not be over-treated with low-value care and instead have a dignifying end of life through aligning treatments with patients’ values and planning in advance. She arranged her own first advance care directive before the birth of her child by elective caesarean, as she envisaged the possibility of things going wrong and had the urgency for planning what clinicians and her family should do if she couldn’t decide. She now conducts research with patients, families and clinicians on ways to improve the end-of-life experience for all.

 

 

Ebony Lewis, BN, MIPH

Nurse Ebony Lewis is experienced in emergency medicine and geriatrics, a skills combination that has made her highly aware of the needs of older people to be treated compassionately at a place of their choice, including their own home rather than in the emergency department environment or the intensive care unit. She loves talking to older patients, visiting them at home for their health assessments and helping them express their values and preferences before they become critically ill. She was awarded an international prize for her research into advance care documentation and is now undertaking her PhD studies on frailty.

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Breathe, stretch, swing, lift. Exercise, and cancer-related lymphoedema

This blog was written by Carolyn Garritt, author of ‘Get your oomph back, a guide to exercise with a cancer diagnosis’ and Vicky Fox, author of ‘Yoga for cancer, an A to Z’.

Lymphoedema is the term given to swelling that can occur as a result of fluid building up within our lymphatic systems. These systems can be disrupted by cancer surgery and/or radiotherapy, or by cancer cells that are in the lymphatic system itself. Normally our lymph nodes take waste fluids and move them on to be expelled by the body as urine, however if these nodes have been damaged or removed through cancer treatment, the fluid can become blocked as its transport system isn’t working properly.

Physical activity can help

Many people, both those experiencing lymphoedema and those who know it’s a risk for them, don’t realise that exercise can really help – both in reducing our risk of developing lymphoedema, and in helping to manage symptoms. In particular, we want to recommend three types of exercise to you – yoga, Nordic walking and strength training.

Breathe. Stretch. Yoga for lymphoedema

Yoga is beneficial to the lymphatic system as it focuses on breathing fully. When we are breathing fully and using our diaphragm (our main breathing muscle) to breathe, this helps to move the lymph fluid towards the heart. The lymphatic system is one-way (from the periphery of the body to the centre) and the lymph doesn’t have a heart to pump it, so it functions better when it has this help. Well we all function better when we are supported, don’t we? Our diaphragm moves up and down when we are breathing fully, and this massages our system and encourages fluid to move.

Gravity is also a fabulous support that we don’t often think of. Anytime we raise our arms or legs above our heads we help the movement of lymph fluid back towards the heart. You don’t need to be super bendy to do this though – we normally work on elevating the legs when we are lying down on our backs. You can access gravity and use it to your advantage by, literally, putting your feet up.

In yoga we often work dynamically, moving the limbs in and out of poses, to also create a kind of pumping action so parts of our body get slightly squeezed (muscles contracting) and then released when we come out of the pose. This internal pump encourages movement inside the body of blood and lymph fluid, so it helps to move fresh blood into an area of the body and take toxins and dead cells away from an area.

Yoga poses also look at releasing scar tissue or areas of tightness in the body that may be as a result of surgery or radiotherapy. Scar tissue can act like a gate restricting the movement of fluid in the body. This is especially important if lymph nodes have been removed and there is a sort of “dead end” where the fluid is no longer being filtered by the lymph node. By stretching and releasing out these tight and restricted areas we help fluid like the lymph flow and not get stuck. This may just help to reduce some of the pressure felt in the arms or legs affected by lymphoedema or it may just make those areas of the body easier to move and less uncomfortable.

Vicky’s favourite pose to get everything moving

Lie on your back, legs and arms reaching towards the ceiling and then make a fist with your feet and hands (so you make them as small as you can) then widen your feet and hands and open them up to make the biggest foot/hands that you can. Repeat a few times to stimulate the hands and feet and encourage movement of fluid from the outer edges of the body back towards the centre of the body.

Then try adding onto this flexing and pointing the feet and hands. This creates a pumping action which helps to move fluid back towards your heart. If you do it you will feel the muscles in the forearms and shins working and these muscles are really important to help with movement. Muscles squeeze and then release which stimulates movement of blood and fluid and can be really helpful with lymphoedema.

Vicky says: ‘Yoga can give you a sense of being empowered because yoga is something you do for you. No one can do it for you. You are in control and can explore what works for you, so you are the co crafter of your wellbeing’

Swing – go Nordic walking

Nordic walking – using poles similar to hiking poles, is a clever and likeable form of exercise. As you walk, you swing your arms and pump your fingers, and these actions are believed specifically to reducing swelling.

There’s good evidence around its efficacy: Jonsonn (2013)[1] found that swelling (in the arm) ‘was significantly reduced after an 8 week programme of Nordic walking 3-5 times a week’. Di Blasio[2] went further and recommended that Nordic walking ‘should be prescribed to prevent the onset and to treat light forms of upper limb lymphoedema’.

Carolyn’s personal experience mirrors the evidence: she has mild lymphoedema, swelling that comes and goes. It is normally much less noticeable, and feels less tight, on days that she has used her Nordic poles. She teaches it to all of her clients.

Nordic walking is also a highly sociable outdoor activity that you can do surrounded by nature. What’s not to love?

Lift. Strength training is safe

It is emphatically recommended that people experiencing cancer related lymphoedema use exercise to build strength in the area affected. Until relatively recently the advice given was frequently to the contrary, and people with symptoms would be advised to avoid lifting completely.

Dr Kathryn Schmitz, previously Chair of the American College of Sports Medicine led the field in understanding the impact of strength training on lymphoedema. She[3] challenged traditional thinking by conducting a trial in which women with lymphoedema followed a progressive weightlifting training programme. Yep, weight lifting – heavy ones. The trial found that, contrary to some expectations, progressive weightlifting didn’t make swelling worse. They also found that participants had fewer flare ups, reduced symptoms, and increased strength.

Later Nelson[4] reported ‘strong evidence that resistance exercise produces significant gains in muscular strength without provoking lymphoedema’.

What do we mean by strength exercises? Carolyn says

‘Your best bet is a combination of moves that use several of our big muscles together – squats, lunges, climbing up steps. Then add exercises that work the limb or area affected. So, for breast related lymphoedema, I’d recommend using a resistance bands or hand weight to do shoulder press, triceps press, bicep curls, etc.’

Part of the benefit of exercising, of course, is around how it can make you feel, how it can improve your mood and make daily life feel better and more manageable, both physically and mentally.

Before you start

There are, of course, some precautions to bear in mind. Although they’re not the most comfortable, if you have a compression garment for the area that swells (sleeve, tights, vest etc), you are encouraged to wear it during exercise. It’s also recommended that you stay well hydrated before, during and afterwards, and that you look out for any changes in the affected area.

If you were given exercises to do by your clinical nurse specialist or oncology/surgical team, then do refer back to them to look for any specific advice that you were given personally.

If you become tired while exercising, stop. It’s one thing to work hard and push yourself, but another consistent message that we both hear in our chosen fields is that being active after a cancer diagnosis, and especially with lymphoedema, is best done slowly, gently, progressively.

Avoid exercise if you have cellulitis. Avoid strength exercises if you’ve had surgery in the last 8 weeks.

If your affected limb/area becomes heavy or more swollen quickly, or if you are experiencing pain, do seek the advice of your specialist nurse, physio or doctor.

Whatever exercise you’re going to do, our best advice is to

  • Restore your range of motion first before building back strength
  • Learn good technique so you do it well. This is essential to prevent injury and so that you can feel confident in what you’re doing
  • Take baby steps so that you build back strength slowly
  • Be progressive. Keep a note of what you’re doing and how it makes you feel. Allow yourself to build up gradually
  • Be kind to yourself. It’s easy to judge and to look at what you used to be able to do and feel frustrated. Notice even your frustrations with a sense of a smile. Vicky says ‘Being kind is practicing yoga.

And now to relax


Vicky’s favourite pose to relax into is lying with legs up the wall or legs over a chair. This is a splendid example of how you can achieve something by doing nothing. Just by elevating the legs gravity helps to move fluid back towards the heart. You can relax and be a human being (not a human doing) and let gravity do all the work.

 

More support for those with lymphoedema

Check out the Lymphoedema Support Network as an excellent place for well-qualified, clinical advice on all forms of lymphoedema.

If you have lymphoedema in a place that you can reach, you may find some relief by learning appropriate self-massage techniques. Dr Kelly Reed is an oncology specialist physical therapist and lymphoedema guru. She has a richly-stocked YouTube channel called Cancer Rehab PT that you may find helpful.

Importantly though, if there’s anything that is currently concerning you about your own symptoms, please talk to your specialist nurse, or oncologist.

‘Yoga for cancer, an A to Z’ by Vicky Fox will be published by Hammersmith Health Books in May 2022

Carolyn Garritt’s ‘Get your oomph back, a guide to exercise with a cancer diagnosis’ is available through Hammersmith Health Books now.

[1] The effects of pole walking on arm lymphoedema and cardiovascular fitness in women treated for breast cancer: a pilot and feasibility study, Jönsson & Johansson, 2013, Physiotherapy Theory and Practice Vol 30, 2014 – Issue 4

[2] Nordic walking and the Isa method (2016), Di Blasio, Breast Care 2016;11:428-431

[3] Weight lifting for women at risk for breast cancer-related lymphoedema: a randomized trial (2010) Kathryn H Schmitz et al JAMA 2010 Dec 22;304(24):2699-705

[4] Journal of Strength and Conditioning Research, Volume 30, Number 9, September 2016,2656-2665

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Get Your Strength Back After Cancer

This blog was written by Carolyn Garritt, author of ‘Get Your Oomph Back’.

Cancer treatment can leave you feeling tired and weakened. Each of the treatment modalities (surgery, chemo, radiotherapy, hormones, immunotherapy) can, in one way or another, result in fatigue, and in us feeling like we do not have the strength that we did before diagnosis. Most people find that they need to move less, and rest more, during treatment and that can lead to the muscles becoming ‘deconditioned’ as they have had a period when they worked less.

If you’ve been out of action for a while, the chances are you’ll have lost some of your muscular strength and this can be why simply climbing the stairs or getting out of a chair feels harder than it did. Resistance training can help to rebuild our functional strength.

Alongside muscle loss, cancer treatments can leave us with stiff or painful joints and with a reduced range of motion, and exercise can be used to help diminish pain and to build strength in the connective tissue – the tendons and ligaments that support the joints and help them to remain mobile.

Strength, or resistance, training is therefore a key component of cancer rehabilitation. It is my belief that everyone who has had a cancer diagnosis would feel the benefit from it and should plan to be doing activities to that end for the rest of our lives. There is a full programme of relevant exercises that you can tailor to your individual situation in my book Get Your Oomph Back but, in honour of World Cancer Day, I am providing here for-free a guide plus short film to the 10 most universally useful exercises for anyone with a cancer diagnosis. These will help you with lung capacity and lower-body strength.

Try this. The exercise I perhaps use more than any other: sit to stand

Sit in a hard-seated chair that’s either heavy or resting against a wall (so it can’t slide backwards). Looking ahead, rather than at the floor, stand up without pushing yourself off with your arms. Try to avoid stamping the floor – keep your feet flat, firm, hip-width apart. Sit back down again, trying to control your downward motion so that you land on the seat gently.

 

Repeat this for as long as you can – 10 or 12 stands might be enough for now. As you get into a rhythm, try to dig your heels into the floor when you’re coming up to stand, as this activates the glutes (the big muscles in your buttocks). Gently squeeze your bum as you come to stranding straight. Build this up – it’ll really help. See if you can get to a point that you can sit-to-stand for a whole minute.

Then try speeding up and work on how many you can fit in – with good technique, mind – during that minute. Eventually, it can be done holding a weight, or on one leg.

 

Client story: How sit-to-stand got Hima fit for surgery

Hima was diagnosed with lung cancer, and although surgery was the best treatment option, her surgical team felt that she would find it difficult to tolerate. So, aged in her mid-eighties, she was advised to get fitter, so that she could safely have her surgery. She started coming along to the gentle exercise class that I run. I don’t think she had done anything like it before in her life.

At the end of each class, the whole group does as many ‘sit-to-stand’ as they feel they can. This exercise gets you properly out of puff, sends the heart rate right up, and is helpful for building strength in your lower body and confidence in your own ability. It is the one exercise, more than any other, that I urge people to do at home as well as in the class, and Hima did her home study with considerable gusto. She just got completely into doing them, and would bob up and down, grinning. The number she could do increased massively over the weeks until she reached the magnificent point that she outdid everyone else in the room, keeping going longer than any of her classmates, most of whom were 20, 30, 40 years younger than her. She was able to stand up out of a chair and sit down again more than 60 times. The average for her age is 9-14.

And then she disappeared from the class. Her family got in touch a little later to say that she had had her surgery.

From ‘Get your oomph back’ – 10 lower body strength exercises to do at home

This routine will work the large muscles around the legs, hips and buttocks, and therefore could help to improve strength that you will notice in everyday activities. Provided it’s safe for you to exercise (it’s always worth checking with a GP or one of your cancer team), this can be performed at home. You just need a firm chair that won’t roll away or tip back, and a resistance band.

Follow this short film, which illustrates the lower body strength routine that is in the book.

Try to do 10 to 12 of each move, then have a rest. You could do the routine every other day – this is regular enough but still allows the muscles their time to repair. Build up so that you can do the routine, have a rest, then repeat it a second time.

‘Get Your Oomph Back’ by Carolyn Garritt is available directly from Hammersmith Books, and from all major booksellers.

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Groundhog regimes for Groundhog Day

Blog post written by Dr Sarah Myhill and Craig Robinson, co-authors of Green Mother and The Infection Game.

We are what we repeatedly do.

Excellence, then, is not an act, but a habit.

Idiomatic translation by Will Durrant in

The Story of Philosophy of the Ancient Greek

 

 

 

I first introduced what I call the Groundhog regimes in our book The Infection Game: Life is an Arms Race. I gave them this name because I constantly refer back to this basic approach which is fundamental to the treatment of all infections, and by inference to the avoidance of the major killers (cancer, heart disease, dementia) which are all driven by chronic infection.

In the film Groundhog Day the protagonist is caught in a time loop where the same day is repeated again and again until there is a shift in his understanding; my Groundhog regimes represent another sort of loop that bears constant repetition. The point here is that these regimes done well will do much to prevent acute illness developing and chronic disease getting a foothold. It is also the case that Groundhog will change through life as we are exposed to new infections and as our defenses decline with age. The key principles are:

  • All should do Groundhog Basic all (well, most) of the time
  • All should be prepared to upgrade to Groundhog Acute to deal with unexpected and sudden infectious challenges – get your First Aid battle box stocked up now!
  • We will all need to move to Groundhog Chronic as we age and acquire an infectious load.

In summary, we use the Groundhogs like this:

 

 

 

 

 

 

 

 

 

Read our books for more detail and the ‘why’ but the key ‘to do’ list is:

Groundhog Basic

  • The Paleo-Ketogenic diet (see Paleo-Ketogenic: The Why and the How)

* high fat, high fibre, very low carb

* probiotic foods like kefir and sauerkraut

* herbs, spices and fungi in cooking

* no dairy or grains

* two meals a day with no snacking within a 10-hour window (fast for 14 hours)

– A basic package of nutritional supplements – multi-vitamins, multi-minerals and vitamin D

– Vitamin C to bowel tolerance

– Sleep 8-9 hours between 10:00 pm and 7:00 am

– Exercise at least once a week when you push yourself to your limit

– Heat and light (sunshine is best)

– Use your brain!

Groundhog Acute

At the first sign of any infection, you must immediately put in place Groundhog Acute:

* You will feel much better very quickly.

* Your immune system will not be so activated that it cannot turn off subsequently

* The shorter and less severe the acute infection, the smaller the chance of switching on an inappropriate immune reaction, such as autoimmunity

* The shorter and less severe the acute infection, the smaller the chance the microbe concerned has of making itself a permanent home in your body. Many diseases, from Crohn’s and cancer to polymyalgia and Parkinson’s, have an infectious driver.

At the first sign of the tingling, sore throat, runny nose, malaise, headache, cystitis, skin inflammation, insect bite, or whatever…

  • The Paleo-Ketogenic diet
  • Consider a fast – this is essential for any acute gut infection
  • Drink rehydrating fluids – that is, Sunshine salt 5 g (1 tsp) in 1 litre of water ad lib
  • Vitamin C to bowel tolerance
  • A good multi-vitamin
  • 1 dsp hemp oil
  • Take Lugol’s iodine 12%: 2 drops in a small glass of water every hour until symptoms resolve. Swill it round your mouth, gargle, sniff and inhale the vapour
  • With respiratory symptoms, put 4 drops of Lugol’s iodine 12% into a salt pipe and inhale for 2 minutes; do this at least four times a day.
  • Apply a smear of iodine ointment inside the nostrils
  • Apply iodine ointment 10% to any bite, skin break or swelling
  • Consume plenty of herbs, spices and fungi
  • Rest: listen to your symptoms and abide by them; sleep is even more important with illness
  • Heat: keep warm
  • Light: sunshine is best
  • Use your brain: do not suppress symptoms with drugs

Groundhog Basic

As we age and/or we acquire stealth infections, we all need Groundhog Chronic. It is an extension of Groundhog Basic. Most people will end up doing something between the two according to their health and history, but as you get older you have to work harder to stay well.

  • Groundhog Basic, especially the PK diet, PLUS
  • Glutathione 250 mg daily
  • Iodine 25 mg weekly
  • Vitamin C to 90% of bowel tolerance, little and often throughout the day dissolved in mineral water. Remember this will change with age, diet and circumstance
  • Lugol’s iodine 15% 2 drops daily in water
  • Make sure your First Aid box is stocked (see The Infection Game)
  • Sleep 8-9 hours between 10:00 pm and 7:00 am with a regular power nap in the day
  • Exercise within limits. By this I mean you should feel fully recovered next day. If well enough, once a week push those limits, so you get your pulse up to 120 beats per minute and all your muscles ache. It is never too late to start!
  • Take supplements for the raw materials for connective tissue such as glucosamine. Bone broth is the best!
  • To address energy delivery take the mitochondrial package of supplements daily vis: CoQ10 100 g, niacinamide slow release 1500 mg, acetyl L carnitine 500 mg. D ribose 5-10 grams at night if you have really overdone things
  • Check for sources of toxins including electromagnetic pollution
  • Review any prescription medication: they are all potential toxins! The need for drugs is likely to be symptomatic of failure to apply Groundhog
  • Consider tests of adrenal and thyroid function since these glands fatigue with age and chronic infection

You may consider that doing all the above amounts to over-kill, but when that next ‘flu or coronavirus epidemic arrives, as it surely will, you will be very happy to have been prepared. Stock up your Groundhog Acute First Aid box now. As Lord Baden Powell wrote in Scouting for Boys, ‘Be prepared’; and heed the wisdom of Benjamin Franklin (17 January 1706 – 17 April 1790): ‘By failing to prepare, you are preparing to fail.’

To find out more about Groundhog principles, check out Green Mother and The Infection Game.

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Clinical studies in minors: The largest abuse in medical research since the Tuskegee trial

Blog post written by Dr Klaus Rose, author of ‘Blind Trust’, now officially launched.

 

My new book, Blind Trust, deals with a topic that many in the health and pharmaceutical world would prefer to ignore and many journalists have proved nervous about covering. Which is why I would like to reach out directly with this blog post and tell you a bit about it and why so many find this topic uncomfortable. If you have a sick child, if you raise money for a paediatric charity or for paediatric research, if you are a doctor seeing child, and especially adolescent, patients, you need to know what is in my book.

The picture on the cover is an old illustration of the fairy story, Hansel and Gretel. These children, abandoned in the forest and starving – a metaphor in my book for being desperately ill – come across a house made of ginger bread and other treats and can’t resist eating it; the temptation is too great. The owner of the house is an old woman who seems friendly and welcoming (she represents the authorities running and sanctioning unnecessary research to boost their careers), but we, familiar with the story, know her sugary house is to tempt children in so she can exploit them. Just as you know the story of Hansel and Gretel, I would like you to know the many stories in Blind Trust so that you can be on your guard in these situations too.

The background is laudable enough. Clinical studies evolved with modern drug development. When penicillin was first produced industrially, during World War II, complicated studies were unnecessary as the benefits were so clear – patients with bacterial infections were literally snatched from their deathbeds by this new drug. The development of new pharmaceuticals then accelerated, and the range of treatable  conditions expanded to include pain, insomnia, diabetes, birth control and much more. At this time, a German company developed and marketed a drug whose name is probably familiar – thalidomide – for all sorts of ailments but including insomnia, nervousness and nausea in pregnancy. In the late 1950s, it was discovered that it had caused thousands of severe birth defects worldwide. This became a turning point in drug development. From 1962 on, US law demanded studies for all new drugs.

Separately, back in the 1950s, toxicities had been reported in babies, and especially premature babies, treated with antibiotics. To avoid lawsuits for damages in the litigious US, pharmaceutical companies began including ‘pediatric warnings’ with information about their products. This, in turn, led to the idea that all children were ‘therapeutic orphans’ though they were being successfully treated for an increasing range of problems, including many cancers.

Legitimate concerns for babies became the narrative that all drugs were dangerous in all children if not tested separately, based on the concept that ‘children are not small adults’. This mantra invaded medicine, science and politics. Confidence in science was high. US lawmakers decided to reward pediatric pharmaceutical studies by extending drug patents. Companies could sell drugs longer at a higher price if they funded research. And here the big challenge began.

No need to be a doctor to know that 15-year-old teenagers who are bigger and stronger than mom or dad are physically mature. No need to be a shrink to know that emotional and mental development usually lags behind. The FDA defined ‘children’ first as being below 17; today the cut off is below 18 years. But drugs treat the body, not the legal status. ‘Pediatric’ studies in minors, including physically mature adolescents, became big business for researchers. All scientists complain about a lack of funds. For ‘pediatric’ research, a bonanza started. It became worse when the European Union (EU) expanded the obligation for ‘pediatric’ studies in Europe. Yet many of these studies were futile in adolescents and massively exaggerated in young children. Minors don’t remain as vulnerable as newborns until they come of age. Today, thousands of questionable ‘pediatric’ studies are being performed worldwide with the young people participating, and their parents, sadly assuming they are contributing both to their own chances of recovery and to the future health of others. The reality is, many may be receiving placebo treatments to satisfy the regulatory authorities when it is already clear what active treatments are safe and effective.

The opinion that most pharmaceutical studies in children and young people are excessive is not shared by most medical and  pharmaceutical professionals worldwide. In fact, I am one of very few. But I know what I am talking about. I am a medical doctor and was global head of pediatric drug development at two large international pharma companies. I am independent now, and can publish papers and write books about this challenge. In this position I can say categorically that the definition of children as under 18 is a legal, not a medical one. There are no drugs that work in adults but not in children. Kids are not another species. The focus of research in children who are not physically mature should be dosage and safety, not efficacy that is already known. A further issue is drug toxicity in babies. Dosage studies and safety observations are much less demanding, expensive and testing for participants than complex international ‘pediatric’ studies that repeat in young people before their 18th birthday what we already know to be the case after they turn 18.  Studies in minors can save lives, or can harm. Blind Trust shows you how to tell the difference. I also offer online seminars for pharmaceutical companies in which I explain how to push back against potentially harmful studies demanded by the FDA and the European Medicines Agency (EMA) so that research funding can be focused where it will genuinely make a difference.

 

To  read the first chapter of Blind Trust for free, click here.

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Kindness within the Community

As it is the season for giving, caring and community, we want to celebrate all the kind things our wonderful authors do, not just at Christmas, but all year round. In our latest blog post, a selection of our authors tell us about the incredible organisations they work with to encourage you to spread kindness this Christmas.

Sara Challice – Author of ‘Who Cares?’

Whilst I cared for my husband, I found great support in the community from local charities offering a variety of services – for both of us.

One charity, INS (Integrated Neurological Services), based in Twickenham, not only gave my husband, Neal, one-to-one physiotherapy, which was a Godsend due to his waning mobility and falls, but they supported me as a carer. I realised how vital local charities were and within six months I had become a trustee on their board – offering my graphic design skills, along with giving a carer’s insight to improve services.

It didn’t stop there. The charity continued to give to me in return, as I gave to it. I learned many things, not just about the charity, but of supporting those with neurological conditions.

During this time, I joined their Mind Body Spirit group, enjoying the meditations and learning of books to empower and improve health and wellbeing. Five years on, I now take this group myself, having become a mindfulness instructor. There is always a great turnout to this supportive and nurturing group, discovering ways to help yourself, even if you have a neurological condition, such as Parkinson’s, Multiple Sclerosis, stroke, or if you are a carer.

As with Christmas time – it is in the giving that we receive – and similarly, after I received from this wonderful charity, I have been giving to it, and still continue to reap the benefits. Kindness is truly all-encompassing.

 

Dr Eugene Kongnyuy – Author of ‘No Pills, No Needles’

The United Nations Population Fund (UNFPA) is the lead UN agency for sexual and reproductive health and rights. In the past 12 months, my work with UNFPA involved supporting fragile health systems in Mali and the Democratic Republic of Congo (DRC) to enhance access to contraceptives, skilled birth delivery and assistance to survivors of gender-based violence.

File:UNFPA logo.svg - Wikimedia CommonsBoth countries are affected by humanitarian crisis and the health systems are very fragile and weak. Due to the high level of insecurity caused by non-state armed groups, transporting contraceptives, medicines, medical supplies and equipment to reach the last mile is a major challenge. The weak health systems were equally hit by the Covid-19 pandemic, epidemics (including Ebola in the DRC) and natural disasters (including the Nyiragongo volcanic eruption in the DRC).

Despite these challenges, my colleagues and I successfully reached millions of women with contraceptives in both countries. We also supported in-country contraceptive logistics (warehousing, distribution and inventory management) and trained healthcare providers on contraceptive counselling and provision.

We also renovated and equipped maternities and where no health maternities existed, we installed prefabricated maternities to enhance access to skilled birth attendance. We recruited midwives where there were no midwives to ensure that each maternity provides skilled birth delivery. We equally supported midwifery training schools by updating their training curricula to meet international standards, trained midwifery tutors and provided training equipment to midwifery schools. While obstetric fistula has virtually been eliminated in developed countries, thousands of women and girls develop fistula in Africa due to lack of skilled assistance at birth. In both countries, we supported obstetric fistula repair by providing surgical repair kits and training doctors to repair fistula.

Due to the humanitarian crisis, gender-based violence is a big problem in both countries and is sometimes used as a weapon of war. The violence takes several forms including sexual, physical, emotional, economical, domestic etc. Our job was to provide assistance to survivors of violence and to ensure safeguarding for women and girls affected by crisis. We set up one-stop centres in hospitals to provide comprehensive services for survivors – medical, psychosocial, judiciary, police and socioeconomic reintegration. The one-stop centres ensure that survivors do not need to be referred elsewhere as they receive all services including access to the police and a lawyer in a single centre.

While responding to the immediate humanitarian needs, my work also involved working closely with the Government to build national capacity and systems including policies so that the Government can eventually take over – we recognize that it’s the primary responsibility of Governments to provide the basic social services and to respect, protect and fulfil the human rights of its citizens.

 

Sarah Russell – Author of ‘The Bowel Cancer Recovery Toolkit’

One of the things I do in terms of community and ‘giving back’ is the work I’ve been doing with my local hospice. I’ve volunteered with Hospice in the Weald for 4 years as an exercise specialist and work with the physio and OT team. I run exercise groups for palliative patients under hospice care and since the beginning of the pandemic I’ve been doing them on zoom. Which has worked brilliantly as people have been at home and needing to shield and keep themselves safe, but we’ve still been able to keep them active and mobile.

People often wonder how exercise can help palliative patients, and if it’s really safe.. but the benefits are amazing. It helps people to stay strong, mobile and independent for longer, in some cases extending life. But the most important aspect is that people feel they have a little bit of control over their lives, they are doing something to help themselves, even when they are really unwell. For that short time when doing their exercise class they don’t feel like a patient, and it gives them positivity and encouragement and a little bit of normality. It really is wonderful that we can give that to people through the power of exercise, even at the end of their lives.

 

Sandra Hood – Author of ‘Feeding Your Vegan Child’

In 2020 I took on Pixie who was an ex-street dog from Macedonia. Due to her nervousness and Houdini abilities, Pixie had had a number of homes in the UK before finding her way to Love Underdogs.  Love Underdogs is a charity that does amazing work with stray unwanted street dogs, mainly from Romania, and took Pixie on to find her a home.

I had a dog flap fitted and the garden was, I believed, escape proof. After having Pixie for a couple of weeks, I had to go into work early in the morning. My phone was switched off at work but when I checked it at lunch time there were numerous messages. Pixie had been found, some 11 miles away. She was eventually trapped in a driveway.  The police took her in, got details from her ID tag and contacted Love Underdogs and me.

When I collected Pixie she was absolutely exhausted and very pleased to see me. It was only the next day that a neighbour told me he had seen her jump out of the upstairs bedroom window to chase my car. Someone submitted the story to the paper and she made page 3!

Love Underdogs needs to be recognised for its wonderful work.

I would also like to mention Goole RSPCA Cats which I support. My sister and niece are volunteers for the charity and they do amazing work with rescuing cats that can be in terrible states. For example, my niece Georgina fostered Marigold in December last year, a cat that was found in a field, severely underweight, one-eyed and with a distinctive crinkled ear. Most likely abandoned due to her pitiful state, she wasn’t expected to make Christmas last year as she was so ill.  No one has been interested in giving Marigold a permanent home, so now Georgina is going to adopt her.

 

Dr Raymond Perrin – Author of The Perrin Technique 2nd Edition and The Concise Perrin Technique

This is the story of how the research that led to my doctorate and then to my book The Perrin Technique came about – with a little help from above…

Medical research comes with a hefty price tag even for relatively small projects, so when I embarked on my research project at the University of Salford in the early 1990s, I needed to establish the FORME charitable trust in order to attract other trusts to donate the £100,000 needed to test if my osteopathic techniques could help ME/CFS. We appealed widely through the media but to no avail. We had a few thousand pounds – enough to buy a computer or two but not to run a controlled clinical trial involving at least 60 participants. So, the trustees of the charity decided to hold an emergency meeting to discuss closing down the charity and donating our meagre funds to a national ME Fund for Osteopathic Research into ME - FORME charity, ending my dream of undertaking this research.

The meeting was scheduled for a Thursday evening but just two days before I received a phone call that was to change everything. It was from a Mr Barclay who said he had read about our appeal and wanted to know if he and his brother could meet me at his hotel. When I inquired where his hotel was he replied Monte Carlo! Two days later I was sitting with Frederick and David Barclay in the Mirabeau in Monaco, one of the many hotels that they owned around the world. They wrote a cheque then and there for £50,000 and said the rest would be sent in a few months. An hour later I was heading for my flight home at the same time as the trustees were meeting to disband the charity – a meeting I interrupted to tell them of the Barclays’ generosity to the surprise of all.

Thirty years on, with a few more research projects completed, all funded by charity and supported by volunteers, we have provided much evidence to support the importance of lymphatic drainage in ME/CFS and we are now just about to embark on a new study at the University of Manchester, together with the NHS, into Long Covid, again funded by generous organisations from the public. I shall never forget the generosity of all concerned without which this research would never have begun.

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What does Get Your Oomph Back include?

Blog post written by Carolyn Garritt, author of ‘Get Your Oomph Back – A Guide to Exercise after a Cancer Diagnosis’,  now officially launched.

 

There are many tools described in the book. Often the best starting point is simply to walk – outdoors if possible. Walking mindfully and seeking out nature (in an urban environment as well as the countryside) can feel really soothing and, as long as the walk is brisk, it can help to restore physical fitness as well as a sense of wellbeing.

If you’re not able to stay on your feet for long, then marching in a chair, and chair-based exercises in general, can elevate the heart rate more than many people imagine. You can get properly out of puff at home if that’s what you need to do, for now. There’s a chair-based cardio routine in the book.

In the book I also talk about Nordic walking – using poles – which I boldly describe as ‘perfect exercise’. It is very clever – it elevates the heart rate, gives the lungs space to work, improves the posture, protects the joints, strengthens the bones, supports the balance (pain and numbness in your feet is a common side effect of chemo). It helps reduce the risk of, and manage, a condition called lymphoedema, helps rebuild upper body strength and uses 95% of your body’s muscles.

And yet – perhaps most importantly – it feels really nice. The poles propel you along, so walking can feel more manageable. The fact that it’s outdoors, in nature, it’s low-cost and highly sociable, just seals the deal. Possibly my most used and useful type of activity.

Strength training

In the book there’s a lot of information about strength training – often overlooked, and definitely one aspect of exercise that folks are unsure about. Strength training – using weights, resistance bands or our own bodyweight – can help us to feel less tired after cancer treatment. Most people feel they lose some strength while they’re on the injury bench, and if we’re out of action for a while we can lose muscle mass.

Building (or rebuilding) stronger muscles is known to reduce our risks of cancer returning. It can also make everyday activities seem more manageable. Many of the people I’ve worked with (regardless of their age) have found that they can’t climb stairs as easily as they could before. There’s some specific information in the book about how to tackle stairs.

Do what you enjoy

One important theme throughout the book is that we should, I believe, do what we love when it comes to exercise. If you don’t love any type of exercise at all, there are some suggestions about how you might find acceptable, even likeable forms of activity. In my mind, nothing is out of the question – I’ve trained people to play croquet and to tackle ultra-marathons. And pretty much anything in between.

There’s definitely scope to get into, or return to, team sports, such as football, rugby and/or basketball, after a cancer diagnosis, and there are now organisations that run group-based activities specifically for people with a cancer diagnosis, such as the wonderful Active Ostomates.

Parkrun

In the book I also talk about parkrun which is, in my view, community, grassroots exercise at its very finest.

Running (slowly) is without doubt the exercise I love most. There’s a ‘couch to 5k’ running or walking programme that incorporates a monthly trip to parkrun.

Boxing

Boxing features too because it is a superb stress-buster. It helps sharpen our hand-eye coordination, which can be a bit foggy after treatment, and if done properly it works the whole body. (You don’t have to spar or hit actual people – I’m talking about using pads, mitts or a punchbag.) You do have to really think on your feet and stay light on your toes, yet it can be for anyone. My oldest trainee boxer is 84.

Combining boxing with using a skipping rope is one way to push ourselves and strengthen our hearts, lungs and bones as we go.

Yoga

Yoga, particularly restorative yoga, is another tool described. It’s important for people to find ways to relax (not easy, I know) and also to stay flexible as this can help deal with some of the aches and pains associated with taking cancer drugs.

Making time

Too much? I know that the idea of exercising can feel overwhelming. Fair enough. If you know you’re short of time or energy (or enthusiasm), then the book contains several cunning ways to incorporate movement into your daily routines. It can be as simple as getting off the bus a stop early and then walking, or taking the stairs rather than the lift. These actions can all add up to a more active day.

How am I doing?

And so, 18 months down the line, how am I doing? I know I’m not as fit as I was before, but I’m working on it and I’m doing my own strength training rather relying on what I do for a job to keep me strong. I’m less anxious about the cancer coming back, for sure. The drug I’m going to take for 5-10 years (tamoxifen) does make me tired and achy but I’m figuring out ways to minimise that.

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The books that informed my diagnosis and treatment of CFS/ME

Blog post by Dr Sarah Myhill, author of several HHB works including ‘The Energy Equation’, ‘The Infection Game’, ‘Ecological Medicine’ and ‘Diagnosis and Treatment of CFS/ME’.

 

Medical practice is called such for good reasons – doctors do not know all the answers and are practising! The patients present daily with medical dilemmas and the good doctor interposes her/himself between the theory of science and the art of treatment. As the famous physician, Sir William Osler, put it: He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all.

So, what books do I take to sea with me? I determine the worth of such by the extent to which a book impacts on my clinical practice. There are two common ways – the first is to supply the intellectual imperative to put in place the necessary changes. This is vital as lifestyle changes are difficult and if I cannot inspire my patients with good science then they will not change their ways. After that it is about the road map. For me, since the 1980s the great challenge has been the treatment of patients with chronic fatigue syndrome and ME. There was no doubt they were pathologically ill, but why? What were the mechanisms? Could the pathology be biochemical and so not ‘seen’ by pathologists? Could there be something wrong with energy generation within cells?

What doctors learn about mitochondria

Medical students learn about those cellular energy generators – namely, mitochondria – during the ‘theory’ years. I was one of them. I mugged up the subject the night before, courtesy of black coffee and chocolate biscuits, regurgitated those short term memories onto the exam paper next morning and forgot. The reason to forget was simply that mitochondria appeared to have no application to the ‘practical’ years which ensued.

Power, Sex, Suicide by Nick Lane | Waterstones

 

Professor Nick Lane’s book

How wrong was that?! It is now difficult to find a pathology in which mitochondria are not involved. Professor Nick Lane’s Power Sex Suicide: Mitochondria and the meaning of life detailed the what, why and how of the role of mitochondria in the natural world. They supply energy to all living organisms such that the difference between life and death is mitochondria. No energy means no life. Lane’s book reads like a detective thriller – a real page-turner which had me enthralled as so much pathology suddenly fell into place.

 

The Sinatra Solution

 

 

Dr Stephen Sinatra’s book

The Sinatra Solution: metabolic cardiology then provided the practical reality of how to treat mitochondrial pathology. Stephen Sinatra was a traditional cardiologist using the conventional tools of drugs, pacemakers and surgery to treat heart disease, but none of these tools addressed the underlying pathology which progressed unremittingly. Sinatra now works by identifying the underlying causes of heart disease, and starts by treating the mitochondrial lesions. In doing so he has reversed pathology and cured patients. Great news for patients, bad news for Big Pharma whose mantra is: ‘A patient cured is a customer lost.’ By applying the Sinatra Solution to my CFS patients, I started to reverse their pathology. I watched their symptoms melt away. I began to see patients really recover. Not just recover but go on to live well. The really good news is that I can now also tell my patients that their best years are ahead of them – once recovered by addressing the mitochondrial lesions they are further protected against not just heart disease but cancer and dementia.

 

Look after your mitochondria and they will look after you.