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The Return to Education: A Guide for the Student Recovering/Recovered from CFS/ME

When returning to school, college or university after suffering from chronic fatigue syndrome/ME the student should avoid both mental and physical over-exertion. On some days even the minimal mental or physical effort can be deleterious and the student has to learn to accommodate during what may be a long process of recovery.

With CFS/ME in school children much information can be found on The Tymes Trust website here.

With CFS/ME and fibromyalgia all cases are different, with students all requiring unique requirements which makes the education plan and management more difficult. The dysfunction in the hypothalamus and the disturbed autonomic nervous system affect different systems and parts of the body and mind. Often there is a problem in getting up in the morning to be in time for school or lectures due to a disturbed circadian rhythm.

The other problem with all patients is the waxing and waning nature of the illness and this has to be understood by educational establishments, with students sometimes having to take off days when their symptoms worsen even though they seemed pretty healthy. They may occasionally look healthy and attempt to fit in with the educational system and school/ university student life but are often in a much more serious state of health then they let observers believe.

Unlike some psychological illnesses, CFS/ME patients retain their motivation but struggle with post-exertion malaise. The student will often try their best to carry on but their symptoms worsen with continued attempts to over-exert themselves.

As the Tymes Trust says on their information page: ‘Most children and students with CFS/ME are able to make some progress academically if education is suitably modified. However, they may be unable to follow the usual timescales for Key Stages and examinations etc. Therefore, it is important for schools to plan for the long term.’

Home tuition and/or online lessons are often needed in severe cases, reducing the extra strain that any examinations will inevitably place on the student.

It is imperative that both in school and further/higher education the relevant teachers and lecturers know about the students health problems even if they are in the past, just so there is a level of understanding for not pushing too fast and empathy if the condition deteriorates.

Recovering patients need to pace themselves, even if they are virtually symptom free. The student requires as much extra time as possible in their course work and to be given regular rest breaks during any examinations with the maximum extension to the time period allowed when sitting for any examinations.

I always advise rest breaks and small snacks and water when they take their examinations to reduce the symptoms of dehydration and hypoglycaemia which are common in CFS/ME and FMS.

Patients well enough to live in student accommodation should try as much as possible to find the quietest and least stressful environment to live in and, even if completely recovered, should avoid too much alcohol and too many late night events etc, making sure that their fellow students understand that they are not just being party-poopers.

Other measures that usually help are the use of a rest/recovery room when needed plus the student should be given easy access to lessons or lectures such as parking spaces near to the college/university entrance, and use of elevators rather than having to traipse up and down many flights of stairs all day.

Blog post written by Raymond Perrin, author of The Perrin Technique. Discover more about the upcoming Second edition here. 

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Giardia and its Complications to Coronavirus

This week is National Hygiene Week. Susan Koten, author of Irritable Bowel Syndrome and Giardia  explains how important it is to keep washing your hands or you could get giardia as well as coronavirus…

Giardia is a very common microscopic parasite that can affect the general health of the recipient in a short space of time by interfering with the whole digestive system.

This in turn gradually weakens the body and lowers the general immunity. The signs and symptoms of an infection are varied but diarrhoea and/or constipation, lethargy, bloating, nausea, headaches, and iron-deficient anaemia are but a few of these markers.

This makes those infected very vulnerable for other pathogens to invade the body and respiratory diseases are no exception.

In my book Irritable Bowel Syndrome and Giardia, I mention that the key herb for treating this parasite is Artemesia annua, (Qing hao) (sweet wormwood), a Chinese herb which in ancient times was used to treat fever, and has been used for centuries in the treatment of malaria. Not only is it effective but it has shown few adverse reactions in toxicology studies in long term use.

Covid-19 patients were reported to have a very high iron content in their cells[1]. The Artemesia annua-derivative, artemisinin, takes advantage of the fact that infected cells accumulate iron in large amounts – artemesinin is sequestered in cells where iron is high and this releases two oxygen molecules forming free radicals which kill the cell, leaving normal cells intact.

Cancer cells also have a high dependency on iron for growth and accumulate large amounts of iron. Artemisinin is used in the treatment of all cancers[2] and it has the effect of destroying cancer cells leaving normal cells untouched.

An infection of Giardia can create iron-deficient anaemia; by treating it with sweet wormwood, as described in Irritable Bowel Syndrome and Giardia, the patient’s health can return back to normal.

Iron appears to be a very important element to consider in any inflammatory condition and looking at the way sweet wormwood is attracted to these sites of excessive iron and destroys them this herb is definitely one to review.

 

[1] Cavezzi A, Troiani E, Corrao S. COVID-19: hemoglobin, iron, and hypoxia beyond inflammation. A narrative review. Clin Pract 2020; 10(2): 1271.  doi: 10.4081/cp.2020.1271

[2] Zhang Y, Xu G, Zhang S, Wang D, Prabha PS, Zuo Z. Antitumor Research on Artemisinin and Its Bioactive Derivatives. Nat Prod Bioprospect 2018; 8(4): 303–319. doi: 10.1007/s13659-018-0162-1

 

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It’s National Read-a-Book Day!

In honour of National Read-a-Book Day this Sunday 6th September, we asked our authors to recommend the best books they’d read during lockdown. This is what they told us:

 

Dr Sarah Myhill, independent GP and author most recently of Ecological Medicine, says: ‘The Shardlake series by CJ Samson – brilliant!  Also the Cicero trilogy by Robert Harris.’

 

Craig Robinson, mathematician and co-author with Dr Myhill, most recently of Ecological Medicine, says: ‘For me it would be The Diamond as Big as the Ritz by F Scott Fitzgerald.’

 

Sue Koten, herbalist and author of Irritable Bowel Syndrome and Giardia, says: ‘Company of Liars by Karen Maitland was very interesting as it was about a group of people travelling through the time of the plague.’

 

Julie Sullivan, author of The Gallstone-friendly Diet, says: ‘The best book I read in lockdown was Reasons to Stay Alive by Matt Haig.’

 

Frances Ive, health journalist and author of One Step Ahead of Osteoarthritis says: ‘I’d like to recommend two because they were so good: The acclaimed Normal People, by Sally Rooney, which I read in three days before watching the TV series which was equally good.

Where the Crawdads Sing by Delia Owens – brilliantly written with outstanding description of the wildlife and swamps in N. Carolina (and has sold 5 million copies).’

 

Barry Sears PhD, research scientist specialising in inflammation and author most recently of The Resolution Zone says: ‘I read a lot of history and philosophy during these times to put things in perspective. History doesn’t necessarily repeat itself, but it usually rhymes. Ancient Roman history especially provides a sense of balance. That’s why I am rereading Gibbon’s The Decline and Fall of the Roman Empire. I recommend co-reading a more recent book, Twilight of Democracy by Anne Applebaum, as a companion book.

‘Philosophy (especially Roman Stoic philosophy) lets you make better choices with the current fate you are dealing with. A book that I can recommend is Philosophy for Life and Other Dangerous Situations by Jules Evans.’

 

Erica Crompton, independent journalist and author of The Beginner’s Guide to Sanity says: ‘My mood has been low during lockdown which means concentration is poor. So I read Paragon art books as they’re succinct and easy to read. The last one in the third week of lockdown was called The Life and Works of Constable. It made me notice and appreciate the trees on walks after reading. Next up, Dear Life – short stories by Alice Munro, brought for me as a birthday gift.

 

Professor Stephen Lawrie, Erica’s co-author, says: ‘I would say Fiction: Girl, Woman, Other by Bernadine Evaristo.

 

Associate Professor Antonina Mikocka-Walus, health psychologist and author of IBD and the Gut-Brain Connection, says: ‘Boy Swallows Universe by Trent Dalton and The Ten Thousand Doors of January by Alix E Harrow are my latest favourites.’

 

Jo Waters, health writer and author of What’s Up with Your Gut? says: ‘I read all 880 pages of Hilary Mantel’s The Mirror and the Light  during lockdown – it seemed topical too as there was talk of plagues and tyrannical leaders and civil unrest. It was a great book to hunker down with in dark days, but it reminded me that dark days pass – although not alas for Thomas Cromwell. I read it in eight weeks and can’t wait to reread it.’

 

Nat Hawes, health researcher and author of the Nature Cures books and website says ‘The last intriguing book I read was Glittering Images by Susan Howatch.’

 

Dr Raymond Perrin, osteopath, specialist in neuro-lymphatics and author of The Perrin Technique, about to be published in a greatly enlarged second edition says: ‘I managed to dab onto a wonderful collection of short stories by Stephen King, Bazaar of Bad Dreams, which has the usual Stephen King twists from the master story teller.’

‘And a sort of health book I enjoyed during the past few months was The Reality Slap by Dr Russ Harris to understand how ACT Acceptance and Commitment Therapy helps people through life’s stresses and as a useful aid to helping some of my CFS/ME patients cope better with their illness.’

 

Hanna Purdy, nurse practitioner and author of Could it be Insulin Resistance? says: ‘I am hoping to read Dr Sarah Myhill’s Ecological Medicine next, about PK diet, sleep, exercise etc. It sounds similar to what I think about these things, so I am always very keen to learn more. I haven’t had time to read anything whilst finishing my own book, so I am only planning, but would like to name this book.’

 

Bridget Sheeran, independent midwife, homeopath, women’s health activist and author of colouring book Preparing for Birth, says: ‘I’ve been reading books that tell me how to do things and think A Taste of the Unexpected by Mark Diacono is brilliant – it tells one everything one would want in a holistic garden. And I’ve been revisiting Sally Fallon’s Nourishing Traditions to make fermented foods. Otherwise the only reading I’ve been doing is for a course but I’ve found Interpersonal Psychotherapy  by Scott Stuart and Michael Robertson fascinating and highly readable.’

 

Mary Jordan, author most recently of The ‘D’ Word, says: ‘I did enjoy The Infection Game by Sarah Myhill – everything she says is so sensible. I also really enjoyed Pale Rider  by Laura Spinney about the Spanish Flu of 1918. I read it to convince myself that this would all pass as it did 100 years ago and was amazed to learn that the effect of hysteria caused by the media is unchanged.’

‘For escapism you cannot beat Jane Austen and I reread her novels and then enjoyed reading Jane and Me by her great niece, Caroline Jane Knight, about the last days of Chawton House (JA’s brother’s house) as a private residence.’

 

Sara Challice, teacher, motivational speaker and author of Who Cares? says: ‘I read two great books this summer for my Mindfulness Teacher Training course, both on health and wellbeing. They are Ageless Body, Timeless Mind by Deepak Chopra, which shows we have more freedom and power than we realise, and Essential Spirituality by Roger Walsh, which will have something to offer you wherever you are on your spiritual journey.

‘I’ve also listened to Michael A. Singer’s The Surrender Experiment as an audiobook, about the author living a quiet life of meditation and solitude but agreeing to do what he was asked by others and how this helped him to evolve and grow… and turned into a huge business.’

 

Fleur Brown, author of Beat Chronic Disease, says: ‘The books I have most enjoyed reading during lockdown are: A Gentleman in Moscow by Amor Towles, Girl, Woman, Other by Bernadine Evaristo, Circe by Madeline Miller, Love is Blind by William Boyd and The Remains of the Day by Kazuo Ishiguro. If you want my favourite three, these are A Gentleman in Moscow, The Remains of the Day and Circe.

 

Caroline Freedman, specialist personal trainer and author of The Scoliosis Handbook of Safe and Effective Exercises Pre and Post Surgery, says: ‘I love reading and have always devoured books and any I have read during ‘Lockdown’ have had to really hold my attention. For a quick-dip-in-and-out book I’ve found Dr Sarah Myhill & Craig Robinson’s The Infection Game fascinating and has made me re-think about how I approach infections.

At The Pond is a bunch of essays by writers including Margaret Drabble and Deborah Moggach, describing their experiences of Hampstead Ladies’ Pond.  I walk on The Heath most weekends with my two dogs Tillie and Oscar and have never dreamt of swimming in the freezing cold outside. The trauma of having to emerge myself in my school outdoor unheated pool at the start of every Summer Term in April probably has something to do with this. Nevertheless after reading these memoirs I am really tempted to have a dip ‘At The Pond’… once ‘Lockdown’ is truly over.

The book I loved reading during ‘Lockdown’ and was really quite upset when I finished it was The Seven Husbands of Evelyn Hugo by Taylor Jenkins Reid.  Every page was a pleasure to read. The story unfolded beautifully and the Hollywood glamour painted so well, I could see the words in colour.  Each chapter was a surprise and I could not guess where the ending was going.  I can usually work out how a novel will finish… not this one.

 

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The Perrin Technique Second Edition – Coming Soon…

We have some exciting news to share about The Perrin Technique. This was first published in 2007 and since then has sold over 11k copies, helping very many people with CFS/ME (including the HHB publisher’s son) back to health. Author Dr Raymond Perrin has been working on a new edition for some years but had found clinical commitments plus invitations to lecture and train abroad worked against his completing this major work. Now with lockdown he has been able to finalise the second edition of his book and this will be available towards the end of the year.

It is greatly expanded and now includes all the latest research that sheds light on the importance of the lymphatic system and lymphatic drainage in health. While in 2007, the connection between cranial lymphatic blockage and chronic fatigue was a ‘hypothesis’ that was supported only by the results of treatment with the Perrin Technique; now the science exists to transform hypothesis into knowledge and to explain the diverse symptoms of CFS/ME.

Because the second edition, with the new sub-title  ‘How to diagnose and treat chronic fatigue syndrome/ME and fibromyalgia via the lymphatic drainage of the brain’, is greatly expanded (it will be around 500 pages) we will have to increase the price considerably but will ensure there is a more reasonably priced eBook as an alternative.

We are announcing the second edition now because copies of the first edition have run out and we can no longer offer it for sale. You may be able to find it online from some vendors and the author also has some copies remaining and can be contacted via info@theperrinclinic.com for anyone who can’t wait for the second edition – and the eBook continues to be available here. 

If you wish to leave an expression of interest with Hammersmith Health Books regarding a pre-publication special offer, please contact us via info@hammersmithbooks.co.uk and you can pre-order from Amazon and other booksellers. Please bear with us while we complete work on this large, complex and highly illustrated book. We can’t wait… but we have to get it right!

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Vitamin D and Covid-19

Blog post written by NH Hawes, author of Nature Cures: Recovery from Injury, Surgery and Infection

Many studies have concluded that low levels of the ‘sunshine vitamin’, vitamin D, in the body could play a part in reducing the immune system’s ability to fight off the Covid-19 virus. Vitamin D is manufactured in the skin from the sun’s rays and then stored in the liver for up to 60 days. It only takes 15 minutes of sunshine on the skin, a few days a week, to produce the vitamin D the body requires. Low levels will affect the immune system and can be caused by various factors, as follows:• Working or staying inside buildings during daylight hours.
• Covering the skin when going outside.
• Using sunscreen on all exposed skin before venturing outside.
• Being over the age of 60 as the body’s ability to manufacture and store vitamin D begins to deplete.
• Consuming too much alcohol.
• Having a compromised or damaged liver.
• Kidney disease.
• Gastrointestinal conditions such as Crohn’s, coeliac and non-coeliac gluten sensitivity or IBS.
• Skin disorders.
• Some medications.

Also, in the northern hemisphere of planet Earth, where most human beings reside, the sun’s rays are too weak to allow this process to take place from 1st October until 1st April every year. As the body’s stores of this vitamin become depleted, after 30-60 days, humans become prone to infections in the winter, especially viral and bacterial infections of the respiratory and sinus tracts. Therefore, there are far more outbreaks of viral colds, influenzas and pneumonia from November until April.

Vitamin D deficiency is on the rise because people have become aware of the risks of skin cancer caused by exposure to the sun’s harmful rays and either use sunscreens or cover up or avoid the sun completely. Sunscreens with a sun protection factor (SPF) of 8 or more appear to block vitamin D-producing UV rays, although, in practice, people do not apply sufficient amounts, cover all sun-exposed skin or reapply sunscreen regularly. Therefore, skin likely synthesises some vitamin D even when it is protected by sunscreen as typically applied.

Those with dark skin have less ability to produce vitamin D as over 90% of the sun’s rays cannot penetrate the skin This is also applicable to those who maintain a deep suntan over a period of time. This may explain why BAME people have been hardest hit by the Covid-19 virus.

Fifteen minutes of midday sunshine on bare skin can provide all the body needs. It is not the same as sunbathing; the skin simply needs to be exposed to sunlight a few days a week. UVB radiation does not penetrate glass, so exposure to sunshine indoors through a closed window does not produce vitamin D. Over-exposure to the sun’s rays can be dangerous for the skin but no exposure at all can be equally detrimental to our health. Complete cloud cover reduces UV energy by 50%; shade (including that produced by severe pollution) reduces it by 60%. This may also explain why the Covid-19 virus seemed to be especially prevalent and dangerous in polluted areas.

Vitamin D also protects against vascular disease via several different mechanisms, including reducing chronic inflammatory reactions that contribute to the pathology of the disease. Vitamin D also improves blood circulation throughout the body, which is essential for the heart to function properly. This helps reduce the risk of blood clots causing heart attacks, heart failure, strokes and other problems. Therefore, deficiency of vitamin D may also be the cause of these outcomes in the more serious Covid-19 cases.

Levels of vitamin D can be replenished marginally by consumption of vitamin D-rich foods such as:
o Krill oil
o Eel
o Maitake mushrooms
o Rainbow trout
o Cod liver oil
o Mackerel
o Salmon
o Halibut
o Tuna
o Sardines
o Chanterelle mushrooms
o Raw milk
o Egg yolk
o Caviar
o Hemp seeds
o Portabella mushrooms

However, often vitamin D levels drop too low and enough of these foods cannot be consumed to correct it. It is then that vitamin D supplements are required. It must be vitamin D3 that is consumed as the body cannot absorb vitamin D2. Plus, as it is a fat-soluble nutrient, it can only be absorbed into the body with some oil; consequently, vitamin D3 in oil capsules is the best way to ensure absorption.

The optimum level of vitamin D in the blood should be 50-70 ng/ml and up to 100 ng/ml to treat cancer and heart disease.

It is particularly important to have a blood test to determine vitamin D levels, especially if any of the following health issues are present:
• Abdominal pain
• Age-related macular degeneration
• Anorexia
• Autoimmune disease
• Bacterial infections
• Bone disorders
• Burning sensation in the mouth and throat
• Cancer
• Chronic fatigue
• Colds and coughs
• Confusion
• Constipation and diarrhoea
• Dehydration
• Dementia
• Depression
• Diabetes mellitus
• Dry eye syndrome
• Fibromyalgia
• Fungal infections
• Hypertension (high blood pressure)
• Influenza
• Irritable bowel syndrome • Insomnia
• Kidney disorders
• Liver disorders
• Loss of appetite
• Lower back pain
• Multiple sclerosis (MS)
• Muscle weakness or pain
• Nausea and vomiting
• Obesity
• Osteoarthritis
• Osteomalacia
• Parasite infections
• Peripheral neuropathy
• Polyuria (producing large amounts of diluted urine)
• Polydipsia (abnormally high thirst)
• Poor appetite or loss of appetite
• Rheumatoid arthritis
• Seizures – can be fatal
• Skin disorders (eczema and psoriasis)
• Systemic lupus erythematosus
• Tetanus
• Viral infections including Covid-19
• Visual problems
• Weakened immune system

In conclusion, the evidence that vitamin D may have an influence on the Covid-19 pandemic and should be tested for is as follows:
• Covid-19 became prevalent from November 2019 to April 2020, peaking in March 2019 when levels would be particularly low.
• Became more prevalent in polluted areas.
• Higher numbers of the BAME community had serious, and often fatal, outcomes.
• Persons over 60 were hardest hit.
• Persons with underlying health issues, often made worse by vitamin D deficiency, were hit harder.

If you feel you may have low levels of vitamin D, get a blood test done by your doctor as soon as possible. Also make sure that in November 2020 you get your levels checked again. This is important to help you fight off all viral infections, including colds and influenzas and especially the Covid-19 virus.

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An Attempt to Prevent the Death of an Old Woman

A poem by Glenn Colquhoun, author of Playing God – poems about medicine

 

Old woman, don’t go, don’t

go outside into dark weather

Out into the night’s wet throat

There is cooking on your stove

Old woman, don’t go.

 

Don’t go old woman, don’t go

Down beneath that deep sea

Down onto its soft bed

There are still fish to be caught

Old woman, don’t go.

 

Don’t go old woman, don’t go

Bent into that slippery wind

Listening for its clean voice

There are songs still left to sing

Old woman, don’t go.

 

Don’t go old woman, don’t go

Walking beside that steep cliff

Watching where the sea flowers

There are daisies on your lawn

Old woman, don’t go.

 

Don’t go old woman, don’t go

Lifting in those strange arms

Caught against that dark chest

There are people left to hold

Don’t go, old woman, don’t go.

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Trying to provide the best environment for someone with dementia in the present crisis: the three ‘Ss’

Dementia

It’s a difficult time for all of us – and particularly so for anyone with dementia. We are all being urged to stay at home and people in care homes are no longer allowed even to see visitors. How can those of us caring for people with dementia provide an environment that gives them the best experience in these circumstances?

First, it is important that the environment is supportive. Life does not always run smoothly and those of us who still have plentiful cognitive reserves learn to cope with that fact. We can acknowledge the need to limit our social contacts and our outings in the present circumstances. We can accept that we may feel anxious, bored and annoyed and we all hope to ‘come out the other side’ when life resumes its normal path.. Someone who has little cognitive reserve, for whom even following a routine is difficult, will find any change or complication doubly difficult. People with dementia need support. They need support from those around them and it is doubly important that those they rely on for support continue to give calm and consistent care.

As much as possible carers should keep to the habitual routine. There is no need to force the person with dementia to stay indoors, for example. If the rest of us are allowed outdoor exercise then so are they. ‘Social distancing’ can easily be maintained simply by walking in quieter areas or gently directing the person you care for in the right direction.

Secondly, the environment should feel safe. Note that I am not saying here that the environment should be safe but that it should feel safe to the person with dementia. Naturally, we should aim for a clean home environment – but becoming over-protective about touching surfaces or cleaning areas is not going to help someone with dementia to feel more safe and secure. It is more likely to cause extra stress as they cannot understand the need for such precautions. And bear in mind that most people with dementia confronted with a person wearing a mask and gloves are likely to feel terrified rather than safe.

Thirdly, the preferred environment for people with dementia should be stimulating to the senses and provide an opportunity for social interaction. Now that day centres and dementia cafes have been forced to close many carers are finding it quite challenging to provide activities for people with dementia and even more challenging to provide social interaction.

The fact is that without stimulation any of us may become bored and doze off. How often has this happened to you whilst watching a boring TV programme? People with dementia are frequently bored because many of the occupations with which they passed the time previously are now closed to them. Boredom can lead to difficult behaviour and restlessness, but often it just results in sleepiness. Simple tasks can be enjoyed – think sorting books by size, pairing socks, ‘tidying’ shelves, dusting and polishing. And remember that an impaired memory can be an advantage. If you ask someone to dust a piece of furniture more than once they are unlikely to remember that they have just completed the task. Outdoor jobs like watering plants, raking up leaves, and carrying trimmings to the compost heap combine fresh air and exercise as well as passing the time and ‘tidying the shed’ can occupy a good few hours even if the result doesn’t live up to the job description! Watching visitors to a bird table can be absorbing and this can be done through a window if the weather is not so good.

Providing social interaction is more challenging. Today we are being urged to use technology and social media to keep in touch with others but this is not an acceptable alternative for people with dementia who progressively lose the ability to work even simple devices such as a remote control. Many people with a cognitive difficulty will also be unable to associate screen pictures with the ‘real thing’ and may even find them frightening.

Telephone calls are often still acceptable as this is a method of communication that is still familiar so ask your relatives and friends to use the telephone to make contact.

You can also talk to neighbours ‘over the fence’ or whilst keeping an acceptable distance on a walk. Carers from care agencies are still allowed to visit to provide personal care or companionship if this is necessary so don’t cancel your regular care and remember to give them tips about chatting to the one you care for.

Blog post written by Mary Jordan, author of The Essential Carer’s Guide to Dementia

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This is What I am Doing for My Scoliosis During the COVID-19 Lockdown

Written by Caroline Freedman, author of The Scoliosis Handbook

Depending on whether you are working or running around the house cleaning, our daily routines have changed dramatically.  My Personal Training classes, like many people’s work, have all changed to Zoom or FaceTime.  I am not moving around as much as I used to. Usually I am demonstrating and then walking around a client checking their posture and positioning, now I am sitting on my exercise ball closely watching the screen to check the exercises are being done correctly.  My clients say they are working harder than ever but what about me?  After the first week, I found I was stiffening up quite a lot, after three Zoom sessions, my legs and glutes went to sleep and cramped.  The same problem applies if I am sitting writing.  Speaking to clients, the huge change for many people working from home is that they tend to sit for hours in one position once they have got into deep concentration and have become focused.  Time also appears to just run away so it is easy to eventually glance at the time and realise most of the day has just disappeared and you still need to fit in cleaning, the washing, shopping, some voluntary work, cooking and…exercise….and don’t forget socialising on HouseParty to catch up with your friends. I also cannot visit my physiotherapist or book a home visit massage.

I have found the following changes to my day have really made a difference since the first two weeks of lockdown.

SITTING/WORKING/WATCHING TV/LAPTOP  etc

Set an alarm on your phone to remind you to get up and walk around and do some stretches.  Keep hydrated and if you have a garden, get some air.

CLEANING

I found that I was using my right arm to clean which is the same side as my curve.  Using one side repeatedly can result in an imbalance of the muscle build up, especially if you are cleaning every day.  One night I woke up with a spasm on the right side of my spine.  After a few stretches to release the back muscle (Lats) I was fine.  I have switched arms to do the cleaning. Yes, it does feel a bit weird at first but I found I became used to it quite quickly, with the exception of ironing, which I am definitely not bothering with.  Mopping for example, use your weaker side to do the work.  Anything heavy –  like lifting the vacuum up the stairs – ask someone else to help you if they are around. Try and delegate jobs. Note: if you run the home this can be a challenge and that whole discussion is probably for another blog!

EXERCISE

Schedule that walk into your day and don’t miss it out.  Some fresh air and change of scenery does wonders for your mental health and I find I always come back home feeling calm and happy.  I also make sure I train every day.  You will find exercises in The Scoliosis Handbook that can be done at home.  I have floor exercises in my book you can do without the need for gym equipment.  Many of the equipment suppliers have run out, so for bands, replace them with tights or leggings and for weights, find some tins, bottles of water, books, bags filled with packets of rice/pasta.  There is also an abundance of exercise classes available online.  With scoliosis or any person with back issues you have to be careful. I have found that @yogaberry.scoliosis is really good to follow.  She is on YouTube with some free downloads or you can book into one of her Zoom classes.  I am offering one-on-one Personal Training sessions on Zoom for 30 minutes or 1 hour.  Please do get in touch if you would like to train with me.

MISSING YOUR PHYSIOTHERAPIST/MASSAGE?

Many scoliosis or back pain patients usually try to keep up regular visits.  If you have recently had surgery you may still be visiting your physiotherapist as part of your recovery.  Below are some stretches that may help you feel better.  You can also try ordering a spiky massage ball to roll up and down against a wall.  They are around £5.  For tired muscles try and order some magnesium salts to put in a hot bath. I find these salts are really great at easing aching muscles.  I find stretching really helps me.

STANDING NECK PUSH AGAINST WALLSTANDING NECK PUSH AGAINST WALL (a John Rutherford physiotherapist exercise backpainspecialistslondon.co.uk)

This movement could come under exercises OR stretching depending on how slowly it is done. I recommend super slow.

It works the neck muscles and helps with strengthening the neck and improving posture.

  • Stand with your back to the wall and your knees slightly bent.
  • Gently push your head back using your neck muscles to try to touch the wall at eye level.
  • Make the push a very small movement towards the wall making sure your chin is tucked slightly in, hold for a few seconds, then relax.
  • Repeat the pushes six times and build to 10 repetitions x 3 sets.

HAND HANGINGHAND HANGING

I find this stretch a great relief.

  • Find a high bar or top of a door you can just reach.
  • Hold with both hands. Bend your knees and try to sit, so you are dropping your spine downwards. Do not arch your back, but suck your abs in.

SEATED OBLIQUE STRETCHSEATED OBLIQUE STRETCH (a John Rutherford exercise)

This movement offers excellent release.

  • Sit on a chair, bench or Swiss ball (see the Scoliosis Handbook for guidance) with your knees at a 90° angle.
  • Cross your arms above your head with your hands on opposite shoulders.
  • Really try to sit up as tall as you can.
  • Move gently from one side to the other, lifting your hips off the chair alternately.

BANISTER STRETCHBANISTER STRETCH

This is my all-time favourite stretch. It is my go-to stretch for any client who walks into my studio complaining that they have ‘done something’ to their back, or when I just want  a lovely  waking-up stretch.

If you sit at a desk for work, the banister stretch is great for pulling out a compressed

spine, opening up your vertebrae.

  • Find a banister or fixed pole.
  • Feet one and a half hip width apart
  • Grip with your hands and squat down and outwards.
  • Keep your back flat, head in line with your body, core sucked in.
  • Do not arch your back.
  • Imagine someone is pulling your hips towards the back of the room. Sit further down to get a deeper spinal stretch.
  • Hold for a few seconds up to 60, and repeat.

Always check with your doctor/physio that these exercises are safe for you. 

Illustrations by: Dunelm Digital – www.dunelmdigital.co.uk

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Eating to Protect Your Health and Your Arthritic Joints

Fruit and Vegetables

Eating healthily is more important than ever at a time like this. Notwithstanding the problems with finding food available in the supermarkets, there are still regular deliveries of all foods to the stores.  As explained in One Step Ahead of Osteoarthritis, The Mediterranean diet is recommended for both osteoarthritis and general health and well-being.   In addition to fruit and veg, this plant-based diet also comprises pulses, beans, nuts and fish,  chicken and turkey, and the all important olive oil – best drizzled over vegetables or salad.

Supplements boost the immune system

There are several supplements that can be helpful for osteoarthritis, and which boost the immune system at a time when you need all the defences you can muster.

  • Vitamin C is reputed to fight viruses, and has been proven to be effective in reducing inflammation in osteoarthritis and impeding its progress[1] Taking high amounts (such as 1,000mg or more) of Vitamin C cannot harm you as excess is excreted out of the body, although some people find it upsets the stomach.
  • Turmeric too has a good reputation for easing inflammation in osteoarthritis and is often taken as a spice, as a liquid, or in capsules. What is lesser known is that it has antibacterial, antiviral and antifungal properties as well.
  • Vitamin D is made in the body when your bare skin is exposed to the sun a lot, but in reality after a British winter it’s likely to be low. Dr Andrea Darling and Professor Susan Lanham-New, the University of Surrey, claim, ‘Vitamin D can help prevent respiratory tract infections[2] so it is important to have good Vitamin D levels during the COVID-19 pandemic.’

Dr Rod Hughes, rheumatologist at St Peter’s Hospital, Surrey,  is convinced of the importance of Vitamin D for those with osteoarthritis, ‘About 50 per cent of the population is deficient in Vitamin D, due to lack of exposure to the sun. Deficiency can mimic arthritis providing the same symptoms. It’s very easy to take a blood test and treatment is simple with capsules or injections, and the patient gets better very quickly.’

Cider vinegar

Although not the most tasty of drinks, taking a dessertspoonful of (apple) cider vinegar in water every day is helpful for easing osteoarthritis, and it also is full of beneficial bacteria and minerals.  It’s important to buy Cider Vinegar with the Mother, which means it is not pasteurised and retains all its health benefits.

While it seems counter-intuitive to have an acidic drink, the body metabolises cider vinegar so that it turns alkaline. However, it does taste acidic so if you find it unpalatable add a teaspoonful of honey, another healthy food.

So do eat healthily and exercise regularly all the time, but particularly during this difficult period in all of our lives.  Stay home if you can and stay safe.

Blog post written by Frances Ive, author of One Step Ahead of Osteoarthritis.

[1] Chiu PR, Hu YC, Huang TC, Hsieh BS, Yeh JP, Cheng HL, Huang LW, Chang KL.

Vitamin C Protects Chondrocytes against Monosodium Iodoacetate-Induced Osteoarthritis by Multiple Pathways. Int J Mol Sci. 2016 Dec 27;18(1). pii: E38. doi: 10.3390/ijms18010038.

[2] Martineau et al (2017)

Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data.   Br Med J 2017; 356 doi: https://doi.org/10.1136/bmj.i6583 (Published 15 February 2017) Cite this as: BMJ 2017;356:i6583

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Exercise in Lockdown for Osteoarthritis

Knee

We are all facing the very real threats of Coronavirus and many of us are self-isolating now, especially the over 70s. Life as we knew it has completely evaporated.  For anyone with osteoarthritis, there are plenty of things that you can do to help the condition and keep yourself generally healthy in the face of such a threat.

What better way to spend all our cooped up time than doing some exercise, at whatever level you can manage?  It helps to have an exercise slot during your very long day so that you remember to do it and it gives you something positive to do.

If you have an exercise bike, now is the time to build up the muscles around the knee which protect arthritic joints and make legs stronger.  Just 10 minutes a day can make your legs feel good and strengthen the knee area.

There are also specific exercises for  osteoarthritis in the knees,  hips and hands.

  • For arthritic fingers: try some gentle stretching/splaying of the fingers, or make a fist with your hand and then completely relax it.
  • For knees: sit well back in the chair with good posture. Straighten and raise one leg. Hold for a slow count up to 10, then slowly lower your leg. Similar exercises can be done lying down or standing. If you are unsteady on your feet hold on to a firm surface and do a few squats bending your knees so that they are over your feet, making sure you only do as much as you can.

Knee squats

  • For hips: Hold onto a work surface and march slowly on the spot bringing your knees up towards your chest alternately. Don’t raise your thigh above 90 degrees. Also, holding on to a surface, bend each knee in turn, putting your heel up towards your bottom with the kneecap pointing towards the floor.

Heel to butt

There are more diagrams (courtesy of Versus Arthritis) in One Step Ahead of Osteoarthritis with helpful instructions.

So with all this time on our hands, do something helpful for your fitness, to keep your joints working well and avoid getting bored.  Above all, stay safe.

Blog post written by Frances Ive, author of One Step Ahead of Osteoarthritis.