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Coronavirus – what you need to know

coronavirus

By Dr Sarah Myhill

Introduction

It now seems inevitable that sooner or later we will all be exposed to coronavirus. This is because people can be carriers of this new virus without showing any symptoms. The strategy to slow and treat therefore is FIRST slow the rate at which the epidemic grows so that medical services are better able to cope. SECOND, reduce the loading dose of infection so that the viral numbers take longer to build up in the body and so not overwhelm the immune defences. THIRD, start to improve the body’s immune defences now before you are exposed to the virus. FOURTH, kill the virus directly with vitamin C (well known for its antimicrobial actions as it is used widely as a food preservative) and iodine (a disinfectant with long pedigree)

We know that coronavirus, like the flu virus, will kill some people. However, the vast majority will live – survival is determined by good immune defences. So:

  • Act NOW to improve the body’s immune defences (our standing army)
  • STOCK UP NOW with ascorbic acid 500 grams (at least), Lugol’s Iodine 15% (30 ml) and salt pipe

Before you show any signs or symptoms of illness

The severity of any infection partly depends on the loading dose of infection. Take action to keep this loading dose low so that it takes longer for the numbers of viral particles to build up in the body. This gives the immune system time to generate an effective immune response. At this stage do not suppress symptoms with medication since this inhibits inflammation – the very tool the immune system needs to fight infection.

Make sure you have this package in place:

What Why
Eat a low carbohydrate diet, ideally paleo-ketogenic High blood sugar encourages all infections (diabetics are especially susceptible to infection)
Take a good multivitamin/mineral supplement The immune system cannot function without raw materials
Vitamin D at least 5,000 iu, ideally 10,000iu daily We get more infections in winter because we are at our most deficient then
Vitamin C at least 5 grams daily This vitamin contact-kills all viruses – the key is the dose – you have to take heaps!

For more detail see– ‘Groundhog basic’ in my book The Infection Game: life is an arms race

If there is any hint of possible exposure, keep the infectious load down with:

  • Good hygiene – wash hands regularly. After washing rub iodine oil into your hands. You can make an iodine oil yourself using 10 parts of coconut oil to 1 part of Lugol’s iodine 15%. Iodine contact-kills all microbes, as I have said; it is the best disinfectant – ask any surgeon – this is what is used before surgical incision and to prevent post-operative wound infections. Yes, your hands will be stained slightly yellow but then you will know the iodine is there.
  • Sniff and inhale Lugol’s iodine 15% 2-3 times a day using a salt pipe. I suggest 2 drops in a salt pipe sniffed up into the nose and inhaled 15-20 times. Iodine is an effective topical disinfectant. It is also volatile so when inhaled kills or substantially reduces the numbers of all microbes threatening to enter the airways.
  • And/or …possibly use a face mask, drizzle 2-4 drops of Lugol’s iodine 15% on to the lining. for the same reasons as above. Re-apply Lugol’s three times a day.
  • And/or …smear iodine oil (made as above) round the nose and upper lip three times a day. Yes, it does stain the skin yellow temporarily but it slowly evaporates from the skin to generate a disinfectant cloud of iodine. This is good for kids who may not be able to use a salt pipe or tolerate a mask.

For much more detail see my book The Infection Game: life is an arms race

At the first sign of any infection (runny nose, sore throat, cough… you know!):

Strike early and strike hard with…

What Why
Take 10 grams of vitamin C (as ascorbic acid powder) in 500 ml of water every hour until you get diarrhoea – this is called ‘bowel tolerance’ This is of proven benefit – see references below.

You must take enough vitamin C – you can only fail by under-dosing. Vitamin C is completely safe and you can do no harm with it. As one of my comic patients put it ‘Premature crapping is preferable to premature croaking.’

Inhale Lugol’s iodine every two hours. I suggest 2 drops in a salt pipe sniffed up into the nose and inhaled – this may slightly stain the inside of your nose – but then you know the iodine is present. You will know the iodine is in the right place because you can smell it. Iodine is non-toxic to humans and all mammals (but if you are allergic to iodine then you should not use it)
Good nursing care – go to bed, wrap up warm and allow the body to run a fever Heat kills all microbes
Tell everyone that you are ill so that… …they can put in place all the above to reduce their loading dose and deal effectively with the virus
To quote the poet Dylan Thomas ‘Do not go gentle into that good night….’ Fight hard and stay alive!

For more detail, see ‘Groundhog acute’ in my book The Infection Game: life is an arms race

Advice for children

  • The principles are exactly the same.
  • And no-one has ever had serious side effects from vitamin C – perhaps use 5 grams every hour to bowel tolerance – or less depending on size.
  • Use vitamin D at proportionate body weight – use the 10,000 iu but perhaps every other day or every third day – the capsule can be chewed in the mouth.
  • Really important to use topical iodine oil over the nose and upper lip as this reduces the infectious load when inhaling and exhaling
  • What is interesting is that the Chinese babies whose mothers have had coronavirus have survived fine. I suspect this is about the immune system – with very high viral loads, the immune system over-reacts and it is this over-reaction that kills. It is called a cytokine storm. This is why the very sick patients are treated with anti-inflammatory drugs such as paracetamol, NSAIs and steroids (which you would think counterintuitive. There is a place for these drugs but not with mild symptoms). My guess is these Chinese babies do not have the immune reserves for a cytokine storm and so have survived well.

Very sick patients

Very sick patients will of course need hospital treatment with anti-inflammatories (for the cytokine storm), oxygen and respiratory support (for respiratory failure). The Chinese doctors are currently treating severe cases of covid-19 with additional intravenous vitamin C and seeing excellent results.

Support for the use of high doses of vitamin C

Follow the links below for more information about the science and clinical experience behind using high-dose vitamin C:

From 1943 through 1947, Dr Klenner reported successful treatment of 42 cases of viral pneumonia using therapeutic doses of vitamin C. This was administered by mouth, intravenously and intramuscularly. See:

And there is lots more good science and practical detail at Ascorbate Web

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Using Pro-Resolution Nutrition To Control the Coronavirus

Virus

This post originally appeared on DrSears.com. It is written by Hammersmith Health Books author, Dr Barry Sears, author of The Mediterranean Zone

Viruses and bacteria were here long before we were and will definitely outlast us. So, when a new pathogen crosses from its natural animal reservoir to infect humans, what are you going to do? One choice is the ancient approach to quarantine infected individuals until the disease runs its course. That method was used in fighting the Black Death that started in 1348. Actually, the first appearance of the Black Death occurred about 800 years earlier when it was known as Justinian’s Plague and is estimated to have killed between 30 to 50 million in the Roman Empire. When it re-emerged in the fourteenth century it killed about half the population in Europe or approximately 75 million people. However, it didn’t immediately disappear as it continually reappeared in Europe until about 1660. The most effective interventions against the Black Death were draconian measures ranging from closing the borders, use of quarantines in both international trade (i.e., preventing ships from entering ports) and in domestic travel, and finally in keeping citizens confined to their towns to await their fate.

Newly emerging viruses can even be worse. According to the Centers for Disease Control (CDC), the first appearance of the influenza virus in 1918 infected about 1/3 of the world’s population, killed between 20 to 50 million worldwide including 675,000 in the U.S. between 1918 and 1920 (1). There were no vaccines, no antibiotics to treat secondary infections at this time, just quarantines and good personal hygiene.

Today, the modern way to treat pandemics of bacterial or viral infection is to simply surrender to the power of pathogens and use vaccines and antibiotics and modern medical care (i.e., ventilators, etc.) for the infected until the patient either survives or dies. According to the CDC, we are still not doing a good job in the U.S. as in the 2018-2019 flu season, it is estimated that more than 35 million Americans were infected (about 9 percent of the total population) with the flu, and 34,000 Americans died even though we had vaccines and antibiotics (2). While those numbers are definitely better than they were in 1920, but don’t bode well for future new viruses.

So, how are we handling the current coronavirus since we have no vaccine? The Chinese are using the ancient method of strict quarantines. It is highly unlikely that type of iron-fisted population control will work in the United States and Europe. And without a vaccine, the spread of this virus into an immunologically naïve population can rapidly expand. Is there another approach?

I believe the answer to that question is a definite yes. I call this the immuno-nutrition approach. The body has a powerful internal system to fight viral and bacterial infections. It’s a combination of both the innate and adaptive immune systems. The innate system is ancient and primitive as it reacts quickly to chemical structures. It works as our first responder to any type of microbial invasion. The adaptive immune system is more sophisticated in that it uses immune cells that digest the microbial invader and hopefully remember its structure when it might return. The adaptive immune system is slow to response (especially to a new biological invader) because it needs the innate immune system to prime it. However, unlike the adaptive immune system, the innate immune system is under strong dietary control and that’s where immuno-nutrition comes into play.

Immuno-nutrition is not simple advice to eat a healthy diet, but requires following a highly defined nutritional program to optimize the innate immune system to make the adaptive immune system more responsive to all microbial invaders. The key feature is your ability to optimize the Resolution Response™. The Resolution Response is your body’s internal healing response. It is composed of three distinct dietary interventions to reduce, resolve, and repair the damage caused by an injury including those caused by microbial (i.e., viral and bacterial) infections such as the coronavirus (3)

Without going into great detail in this blog, any injury causes an initial inflammatory response to alert your immune system that you are under attack. The more inflammation you have in your body, the less likely you can optimally activate your immune system to respond to this microbial challenge. This is why your first goal is to reduce excess inflammation in the body, not by taking an anti-inflammatory drugs (which are also anti-resolution drugs that inhibit the next step of the Resolution Response), but by following an anti-inflammatory diet such as the Zone diet (4-6). That is only the first step. Next you have to resolve the inflammation induced by the microbe by increasing the production of a group of hormones known as resolvins (7,8). This can only be done by consuming high levels of omega-3 fatty acids in the diet to maintain a low AA/EPA ratio in the blood. What is the right dose of omega-3 fatty acids? Your blood will tell you. If your AA/EPA ratio is between 1.5 and 3, then you are taking enough (3). Most Americans will require at least 5 grams of EPA and DHA per day to reach that ideal AA/EPA range since the average AA/EPA ratio for most Americans is about 20. Finally, you have to optimize the innate immune system using high-dose polyphenols that are water-soluble so they get into the blood to activate the gene transcription factor known as AMPK. How many polyphenols? Enough to keep your levels of glycosylated hemoglobin (HbA1c) between 4.9 and 5.1 per cent. This will take about 1 gram of water-soluble polyphenols per day with delphinidins being the best choice (9).

Of course, the more closely you follow the Zone diet, the fewer water-soluble polyphenols or omega-3 fatty acids you will need to optimize your internal Resolution Response (3). Such water-soluble delphinidins that can activate AMPK are found in low levels in blueberries or in far higher concentrations in delphinidin extracts. Once AMPK is activated by these water-soluble polyphenols, then it begins to orchestrate your immune system to attack and neutralize the microbe. This is definitely a team approach. If any one of the three steps (reduce, resolve, and repair) is not working at optimal efficiency, your ability to control the outcome of the microbial infection (in this case the coronavirus) will be inhibited.

This could mean the difference of either having runny nose or being on a ventilator because the likelihood you will be exposed to the coronavirus is great due to globalization. The choice of the outcome of that coronavirus exposure is yours.

References

https://www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html
https://www.cdc.gov/flu/about/burden/2018-2019.html
Sears B. The Resolution Zone. Zone Press. Palm City, FL (2019)
Sears B. The Zone. Regan Books. New York, NY (1995)
Bell SJ and Sears B. “The Zone diet: An anti-inflammatory, low glycemic-load diet.” Metabol Synd and Related Disord 2:24-38 (2004)
Hotamisligil GS. “Inflammation, metaflammation, and immunometabolic disorders.” Nature. 542: 177-185 (2017)
Serhan CN. “Pro-resolving lipid mediators are leads for resolution physiology.” Nature 510: 92-101 (2014)
Morita M et al. The lipid mediator protectin D1 inhibits influenza virus replication and improves severe influenza. Cell 153(1):112-125 (2013)
Jin X et al. “Delphinidin-3-glucoside protects human umbilical vein endothelial cells against oxidized low-density lipoprotein-induced injury by autophagy upregulation via the AMPK/SIRT1 signaling pathway.” Mol Nutr Food Res 58: 1941-1951 (2014)

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How to Cope with Family Gatherings When No One Understands Your Illness

family dinner

The holiday season can be filled with moments of love and joy, but it also can be stressful for those of us living with chronic illness. This is especially true if your family doesn’t understand what you are going through day to day. If you are worried about managing the holiday season with your family this year, here are five do’s and don’ts to help you navigate family gatherings when feeling misunderstood.

  1. Let people know what to expect. If you don’t tell your loved ones what you need, they won’t be able to help give it to you. A close friend of mine keeps a live Google Document with a current health status, a list of foods she can eat, and a couple tips on how to best support her. Try making a guide like this of your own and share it with you family before you get together – more often than not, when people know how to support you, they will.
  2. When it comes to food, make something you know you’ll enjoy. One of the most challenging things about navigating the holiday season with a chronic illness is sorting out dietary restrictions. Before you get together with your family, spend some spoons on preparing a dish you know you can eat and will enjoy. This ensures that you aren’t left out of the family meal. If you aren’t able to make something for yourself, ask a friend to help you prepare before you connect with your family.
  3. Find an ally. Whether this is someone in or out of your family, find someone you can touch base with through the day. Family gatherings can induce anxiety for those of us battling illness and having a friend or ally checking in with you can make a real difference.
  4. Decide on a safe space to rest before you arrive. This is a big one. Make sure you have somewhere quiet and calming that you can retreat to. This might be a guest room, a study, even your car. If you have somewhere safe and comfortable to rest, you may have more stamina for the day.
  5. Try not to over-extend yourself. Family gatherings are exhausting even for able-bodied folks! Try not to give more of yourself than it is healthy to give. Does it make sense for you to come in before a meal and hang for an hour before going home? Do it! Even if they don’t understand your day to day life, most families want to love and support each other. By making choices that take care of YOU, you’ll be able to better invest in moments of positivity throughout the gathering.

Every family is different, and every illness experience is different – some are shaped by more toxic support relationships than others. But if you can communicate clear expectations, find support where and when you need it most, and be able to take yourself out of the situation when you need to – you’ll be able to manage your next family gathering with grace, positivity, and strength.

Blog post written by Allie Cashel, expert patient featured in the book Lyme Disease, medical myopia and the hidden global pandemic. Available from Hammersmith Health Books. 

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My Journey to Managing Osteoarthritis

Osteoarthritis

One Step Ahead of OsteoarthritisIt crept up slowly with a little niggle here and there, and a bit of stiffness in the joints and then I wondered why my knee seemed to hurt when I played tennis. So I went to the doctor and was referred for an MRI, worried that I might need to have an operation. So it came as some relief to be shown the scan and see that it was osteoarthritis, no damage, and no need for an operation.  I was told to carry on playing tennis and do other exercise.

After a couple of months I was back to playing tennis with a support on my knee and that was eight years ago, and I haven’t had to stop since.  But then my thumbs started hurting, and the joints in some of the fingers felt swollen.  I was wary of arthritis in the hands as I’d seen my mother’s gnarled fingers and didn’t want the same to happen to me.  So I had them X-rayed and sure enough it was osteoarthritis.

I am a health journalist and I follow a natural lifestyle, so that seemed to be the way to go. And to be honest the doctor didn’t really offer any alternatives. They tell you to take Ibuprofen if the pain is bad, but strong drugs are reserved for chronic pain and due to the side-effects they certainly don’t hand them out to anyone who has a bit of osteoarthritis.

I also take the view that with many health issues there is so much you can do yourself that it’s not necessary to suffer.  So I started researching the subject and found out that I needed to make my diet more alkaline and much less acidic as acidity in the body is a problem for osteoarthritis (and many other conditions).  This simply involved some adjustments to what I ate, but no major changes.  I almost cut out certain foods  like tomatoes, aubergines and potatoes, and decided to drink much less wine.

I was already exercising quite a lot – tennis, tai chi and yoga – but I added some specific exercises for knees and hands and made sure I did some every day.  Tennis clubs are full of “older” people wearing knee supports yet doctors seem to think that it’s a good idea to continue with any exercise that you are used to doing.  Tai chi and yoga are both very good for osteoarthritis, and classes are often manageable for the less mobile.

I experimented with different supplements, that are known to be good for osteoarthritis (glucosamine, chondoitrin, rosehip, and more) but settled on turmeric and (no-blush) Niacin or Vitamin B3).  I took cider vinegar in water every day and gradually things began to improve, although I should emphasise that you can’t actually cure osteoarthritis but you can reduce inflammation and pain.

By not taking my thumbs and fingers for-granted, as I had done all my life, and trying to avoid putting undue pressure on them,  I have found that they don’t cause me many problems any more.  In fact, and this is quite amazing, they are straighter and stronger, and the knuckles are far less inflamed – happily they are not now very noticeable to other people, which is a good thing.

It’s important for me to keep my weight down as a few pounds extra can make all the difference with my knee and it can start hurting.  I also need to avoid too many stairs downward,  so often take the lift just to avoid them. I can walk down steps perfectly well but it puts unnecessary pressure on them.

Once it becomes a way of life to manage osteoarthritis, it is easy to do and prevents too much pain or discomfort.  My own experience and my background as a health journalist made me decide to write One Step Ahead of Osteoarthritis, so that others can benefit and take a positive approach rather than feeling downhearted about it.

Blog post written by Frances Ive, author of One Step Ahead of Osteoarthritis which is now available from Hammersmith Health Books!

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Are you One of the Billion Migraine Sufferers?

woman-migraine

There are one billion people in the world like me (and most likely like you too, since you are reading this blog): people who suffer from migraine. Although you already knew it was so common, you still probably feel (as I do!) that you are the only person in the world who suffers this much, and in a way no-one else can understand.

This is called the paradox of living with chronic pain disease. It is so much easier with flu: during the flu season most people around you are also sneezing, coughing and moaning, at workplaces or at home in bed. It helps to know that you are not alone. It makes suffering tolerable. When ill, you may enjoy being pampered by healthy family members. You may even update your Instagram with a photo of you on a couch in front of the TV with a blanket and a bowl of chicken soup. Post #sickasapuppy and empathetic faces, thumbs and hearts will fill the screen.

During migraine attack, there is no-one but you and the pain inside your head. The excruciating pain grabs all your attention, unplugs your power cords, shoots you with a taser, holds you to ransom. It allows no people in sight. Pillow adjustments by the loving spouse make no difference. Selfies do not even cross your mind. The only thing you care about is to get rid of the pain. You count the minutes.

Migraine is one of the most severe and disabling neuropathic pains one can experience. That is a solid fact. When, where and how migraine affects people varies considerably between people, and also within each individual. A billion people means several billion variations of migraine attacks. Not every attack is identical, nor are the triggers always the same. The pain-free periods between the attacks also differ. For the lucky ones, it is 24 months; for the unlucky ones, it is 24 hours.

A billion people is a massive peer group. That said, it is still only you who knows your migraine and only you can find the best ways to live a good and meaningful life with this disease. Despite this disease.

You don’t have to figure out everything by yourself, though. So much scientific evidence, and understanding of good practices, has emerged during recent years on effective ways to treat migraine attacks – as well as prolong pain-free periods – that all the tools you need for your own toolbox are already out there. You just need some easily digestible information, some perseverance, some help from skillful healthcare professionals…  and some support from the billion peers, of course.

Written by Dr. Helena Miranda, pain physician, chronic pain sufferer (including migraine), and author of the new book Rethinking Pain – How to live well with chronic pain.

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Irritable Bowel Syndrome & Giardia – A Q&A with Susan Koten

What was the inspiration behind your book?

Experiencing the trauma and desperation of my life being turned upside down with the sudden onset of IBS symptoms fifteen years ago, and the lack of help available. This experience stayed with me and when I started to see and treat patients in my clinical practice who were going through the same experience, I knew I would one day write a book about it and Irritable Bowel Syndrome & Giardia is the end result of all that experience.

What was the most challenging part of writing the book?

This is my first book and when I started the project 10 years ago, I had no idea the amount of work that lay ahead to finally get it published.  This book has the potential to change people’s lives for the better so it was important extreme care and research went into writing it. With a busy practice to run, I would often start writing at 10pm and finish at 2am – this has always been my quiet time and I could concentrate with no interruption.

What has been the most satisfying part of the writing process?

My aim is to pass my knowledge on to those who need it and as I delved deeper into the subject matter, to understand how and why the clinical observations and patterns of my patients were presenting themselves, I have found writing it down and putting all this information together in a manuscript, has allowed me to achieve this.

Did anything surprise you while writing IBS & Giardia?

About seven years ago I changed my treatment strategy to a more gentle approach and the results surprised and amazed me which is reflected in the book.

What sort of people would benefit most by reading your book?

This book is for anyone who is struggling with the health of their digestive system and other related disorders. It is also aimed at health professionals, both allopathic and alternative, who are treating these patients.  It is my hope that the information contained in this book, and the personal testimonies of my patients who were suffering with what is currently a chronic and untreatable diagnosis, (IBS), will bring hope and healing to those who are unwitting hosts to the Giardia parasite. Of course I appreciate this parasite is not responsible for all digestive issues but in my experience a Giardia infestation is very often overlooked as the cause of digestive problems and this then leads to misdiagnosis and a life of misery for those affected.

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Five Questions with Richard Shaw, author of Conquer Type 2 Diabetes

CRAB & RADISH STACK (VARIATION) PAGE 83

Type-2 diabetes doesn’t have to be a lifelong condition; for many people, especially those who have been recently diagnosed, it’s possible to reverse the symptoms of this malignant disease.  But how can that be done? Inspired by results obtained from research done at Newcastle University, Richard Shaw decided to try and kick the disease by following a carefully structured, low-carb, whole-food diet and starting a modest exercise regime. Conquer Type 2 Diabetes describes what he did to lose 31 kilos and all his diabetes signs (high blood sugar, high cholesterol, high blood pressure) and symptoms. We caught up with Richard to ask him a few questions about his new book and his amazing recovery. 

What was the inspiration behind your book?

When I started this I really wanted to talk to someone who’d managed to put their own T2D into remission: not a doctor, not a dietician, not a medical professional but someone who had had first-hand experience of doing it for themselves.  I couldn’t find anything that really told me what it was like from the patient’s point-of-view, so I thought it might be worth writing my own. Plus, because I like food so much, I really wanted to write some decent recipes to make the point that it’s not all about bland salads, tasteless soups and intermittent fasting.

CRAB & RADISH STACK (VARIATION) PAGE 83
Richard’s book is full of amazing recipes, like this crab and radish stack.

What was the most challenging part of writing the book?

It can be tough to write a book and hold down a full-time job.  I did it by getting up every morning at 4am, writing for 2 hours and going back to bed for a while before heading into work. I wrote it as I went through the process and there was a part of me that worried that if it didn’t work it might all be a bit of a wasted effort.  In hindsight, I think writing the book probably gave me motivation to keep going and made me even more determined to see it through.

What has been the most satisfying part of the writing process?

I’ve collaborated with other writers on books about food and cooking in the past so, to be honest, it was amazing to finally produce something that had my name on the cover. And even a slim book like this goes through so many versions, eventually having your editor tell you one day that it’s finally done is an enormous relief. I also took huge satisfaction from my GP agreeing to write the foreword, she was incredibly generous with her comments.

FRENCH OMELETTE WITH GRUYERE
French omelette

Did anything surprise you while writing Conquer Type 2 Diabetes? 

I spoke to dozens of other people as I was writing it and I was surprised to find so many people attempting to come off the meds and resume a normal life.  Putting T2D into remission is a very active and passionate grass-roots movement but it hasn’t really translated into mainstream medicine yet.  By and large much of the medical profession is treating this disease in exactly the same way, as it was 30 or 40 years ago, with lame public health advice, generic exhortations to adopt a healthier lifestyle and by prescribing a raft of meds that treat the symptoms rather than the underlying cause.  So finding other people doing exactly the same thing all over the world provided enormous encouragement to keep going.

What sort of people would benefit most by reading your book?

Professor Roy Taylor’s work from the DiRECT trials tells us that the earlier we attempt put T2D into remission after diagnosis the greater the chances of success. And for many people this doesn’t have to be a ‘forever’ diagnosis, – something I took at face value for several years. It’s a story for people who want to take a shot at reversing their condition and testimony that (if addressed soon enough) it may not have to be a lifelong, meds-dependant, progressive illness. And if someone who’s as hopeless at exercise as me, who likes food as much as I do and who’s as much of a slacker as I am can do it, then so can many others.

For more information about Richard’s new book,  go to  his website here,  or join the conversation on Facebook.

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Five Questions with Antonina Mikocka-Walus, author of IBD and the Gut-Brain Connection

What was the inspiration behind your book?

As a scientist interested in the gut-brain links in IBD, I collect articles on the topic. There are hundreds of them scattered around my various computer drives. One particularly rainy summer, when I still lived in York, I thought I should organise these articles and collate my scribbled notes into something meaningful, so that I could use it for my future papers. However, this organisational task proved more entertaining than I initially predicted. I found some fascinating studies I forgot about, and as I read on I thought: There is so much out there. It must be hard to make sense of it when one is a patient. Many of the papers also triggered some memories from my own experience as an IBD patient, negotiating my way through the healthcare systems of the three countries in which I have lived. That’s how the book came about, though until it was finished I considered it merely my personal diary, a collection of interesting studies and anecdotes. I then showed this manuscript to a friend, another IBD psychologist, who enjoyed reading it and encouraged me to publish it. And the rest, as they say, is history.

What was the most challenging part of writing the book?

It was to move away from scientific writing, to make what I write interesting and accessible to a lay person, but also, more importantly, sharing my life story. I do not hide that I have IBD but in this book I go beyond merely admitting I am a patient as well as a health professional. I discuss my symptoms and recall a bit of my family history. I believe these snippets from my own life make the story I tell more real but as is the case when one chooses to share their private matters with the whole world I feel vulnerable, and that’s not always pleasant.

What has been the most satisfying part of the writing process?

The most difficult part – sharing my life stories – was also the most fulfilling. When I decided this manuscript would become a book, I wanted to make it different to a book about IBD written by a health professional. But I also wanted to offer my readers more than my own stories, to go beyond ‘Me and my IBD’ narrative. I reached to what I love, science, and I merged interesting science findings about IBD with something personal. I hope I found a happy compromise in combining the perspectives of a patient, psychologist and scientist.

Did anything surprise you while writing IBD and the Gut-Brain Connection? 

Not the science itself because that’s my daily bread but the amount of the data, the presence of mutually exclusive recommendations. I followed the principles of evidence-based medicine to interpret what I read for the readers without a medical background. But nothing, even in science, is completely objective. I introduced the readers to systematic reviews, a scientific technique to try to make sense of the many studies out there and being critical about the evidence which surrounds us. I hope people find this technique of filtering evidence useful. On the other hand, I decided to also include my completely subjective perspective on IBD when I shared my own stories. The truth is somewhere on the verge of science and a personal human experience, I think.

What sort of people would benefit most by reading your book?

The book is addressed to patients living with IBD, their family and friends, to people of all ages and educational backgrounds, to anyone who wants to learn more about this fascinating condition. The brain-gut links and the gut bacteria have finally become topical and I feel really privileged to be able to speak openly about the gut health. Who would dare to discuss bowel movements publicly a few generations ago? Now, it’s becoming normal and I am happy to be part of this social revolution.

If you would like to learn more about IBD and the Gut-Brain Connection, the first chapter of Antonina’s book is available to read here

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Five Questions with Paul Brice, author of COPD Innovative Breathing Techniques

Paul Brice and patients

What was the inspiration behind COPD?

I had been working with COPD patients for nearly 7 years when I first considered writing this book. Initially this was because patients kept on telling me that they felt so much better using the techniques I used, and even people who had previously undertaken pulmonary rehabilitation told me that they had not been shown these exercises before. I did not think I was doing anything special until I researched what other pulmonary rehabilitation programmes delivered to their patients.

Without realising it, the skills and knowledge I had acquired as an athlete and a high-performance sports coach had helped me recognise how to use posture and movement to modify breathing and exercise capacity. I had found a way to communicate this to my patients in what they told me was clear, simple and logical.

I had developed a series of techniques to show my patients how they could use their bodies to breathe in a more natural and relaxed state, and a system to help them become more aware of the things that made them breathe poorly.

Only once patients had become more aware of how they could help themselves to breathe and move comfortably, would I introduce them into what could be called real exercise. The style and the intensity of exercise were staged and the rate of progress depended upon the individual patient.

Patients tell me they appreciate this gradual approach to their treatment, and I reiterate the fact by threatening to break into the song: ‘It ain’t what you do it’s the way that you do it….That’s what gets results!”

I started to write the book aware of the fact that the emphasis on posture and natural breathing meant that other conventional COPD techniques I had been taught were either no longer needed or were no longer relevant. It is with this in mind that I named the programme the ‘Brice Method’. I am very much aware that my method is likely to challenge some aspects of the conventional wisdom of breathing and exercise for COPD patients.

I had to write this book as I am passionate about helping other people with COPD benefit from the simple and effective techniques that my patients have benefitted from.

What was the most challenging part of writing the book?

There were two challenging aspects to writing COPD Innovative breathing techniques.

The first challenge was to ensure that the book was written at a level that would be suitable for patients with COPD, their friends and their families and not at a level for health professionals or practitioners.

When I started out writing the book, I was aware that other health professionals might skim read the book and look for evidence, references and a bibliography at the end of each chapter, all standard practice for medical/ health books. Quickly I realised that referencing the book in this way would make it totally unusable for the people who would gain the most from the book.

I was however, aware that because some of the postural techniques used at the start of the book can so dramatically modify the shape, size and mechanics of the patient’s lungs, there are a number of breathing techniques that follow, which would challenge the standard practice, and might stir up a bit of a furor amongst fellow professionals. In truth, I now welcome that latent debate.

The second challenge was to make patients aware that their COPD may not be the most restrictive health condition that they have. A high percentage of my patients find that once they have modified their postural habits and their breathing techniques, that their lungs are not the limiting factor when it comes to physical activity, but it is another health issue. Arthritis, chronic back or neck pain, acid reflux, shoulder immobility, and poor balance are all issues that can often restrict the patient’s ability to exercise. I believe that relaxed, natural breathing can only be done when the whole body is in a relaxed state and when it is relatively pain free. The unfortunate truth is that moving when you have not exercised in a while is going to be uncomfortable, so there is a section on identifying the difference between discomfort and pain, which is referred to at stages throughout the book.

What has been the most satisfying part of the writing process?

Having spent quite a lot of time on my own writing the book on my apple mac, taking the pictures and working with my daughter Lucy to adapt the images, the most enjoyable part of the book has been witnessing my simple word document morph into what I could recognise as being a proper book.

Before I started the project, I had a vision of how the book would look, and working with the publishing team has been a real eye opener as to the amount of work and expertise that goes into producing a completed book.

Surprisingly, having written the book, it has been particularly rewarding to search the top online book stores and see that the book is ready to order. I have searched for so many books over the years, wanting to learn things from other people, and to be referred to as an author on the likes of Waterstones, Amazon and Foyles will a take a little time getting used to.

What sort of people would benefit from reading the book?

The book is aimed fairly and squarely at the person who has been diagnosed with COPD, or a friend or family member. COPD is an overarching term that comprises many chronic lung conditions such as chronic bronchitis, bronchiectasis and emphysema, plus many more.

In reality there are a large number of people who have problems with their breathing, who might benefit from the techniques used in the book. The techniques are split into specific sections and even if a person has physical imitations that mean they cannot do the more active, later chapters in the book, most people seem to benefit with their breathing with the postural exercises and breathing techniques that make up the first half of the book.

Paul Brice and patients

Try this simple exercise to see if the book might help you.

You sit down comfortably on a dining chair and take a deep breath. If you can listen to where you feel the air going into the chest. If you feel any of the following…..

  • That you have to suck hard to get the air in
  • That the breath is short and unsatisfying
  • You cannot feel your chest expand
  • You only feel the air going in the top of your chest
  • You use your shoulders to lift the chest

…then the likelihood is you will get some benefit from the exercises and techniques in the book

I believe that breathing should be as natural and relaxed as possible, and the whole aim of the book is to help anyone with COPD breathe more easily.

How will people benefit from reading the book?

The aim of the book is to help show people with COPD how to get the most out of the lung function that they have remaining.

The book is structured so that the reader can learn what they need to do using a tried and tested step-by-step approach. They are encouraged to take things at their own pace, and only move forwards to the next stage once they feel they have mastered the section before.

Firstly the book shows the reader how they should use their lungs, and help them recognise what bad habits they might have developed that could prevent them from breathing more naturally.

I explain what they need to do to help overcome their bad habits using basic changes to their posture and make them aware of how simple body movements can be sequenced with the breath to help the body find a more natural breathing pattern.

The book explains how you can learn to maintain these new breathing techniques, using a homework plan, these are essentially micro workouts of 4 or 5 exercises that last between 3 and 5 minutes that can be done up to 4 times a day. This is how my patients overcome decade’s worth of inactivity, poor posture and bad breathing patterns within weeks or sometimes within days!

The book then goes on to suggest a range of exercises to improve the readers stamina and strength, whilst explaining what pitfalls to look out for along the way.

There is a landmark test that the reader can take at several stages throughout the book to help them monitor their progress and check that they are on the right path before moving on to the following stages.

If you would like to learn more about COPD, the first chapter of Paul’s book is available to read here

Posted on

Inflammatory Bowel Disease: The invisible illness

Inflammatory-Bowel-Disease-The-Invisible-Illness

What is inflammatory bowel disease?

Inflammatory bowel disease (IBD) is an umbrella term for diseases which cause either whole or part of the digestive tract to become sore and inflamed. It commonly starts in younger people aged 10 to 40, although younger and older people may be affected too. The two most common types of IBD are Crohn’s disease (CD) and ulcerative colitis (UC); the symptoms for both can be similar but with some distinguishing characteristics. In the 19th and 20th Centuries prevalence of IBD increased with industrialisation and the highest rates in the world are still in developed countries such as the UK, Canada, the USA and Western Europe – although cases are now increasing in China and India.
Crohn’s disease may affect the whole digestive tract from your mouth to your anus; ulcerative colitis affects only the colon. Crohn’s disease can be more serious as it not only affects the lining of the gut but can also extend deeper into the wall of the bowel and this sometimes results in severe complications. Both can be extremely painful and debilitating, leading to weight loss and fatigue, and have a great impact on your quality of life, affecting your ability to digest food and absorb nutrients from it, as well as the frequent trips to the toilet.

Why is IBD increasing?

Studies in the UK have found that the number of children affected by IBD has risen by 15%; in Scotland the number of childhood cases has risen by 76% since 1995, according to research by the University of Edinburgh. Experts are also worried because the average age of onset of symptoms is now much earlier in childhood rather than late teens/early 20s because, as I said before, the symptoms are more severe in childhood.
Although scientists have identified a genetic basis for IBD by pinpointing many different genes, especially the variants in a gene called NOD2 in Crohn’s disease – and a positive family history remains the strongest risk factor for IBD4 – genes are clearly not the whole story. Experts refer to IBD ‘as a complex genetic disorder that is influenced by environmental risk factors’. Certain genes may give you a susceptibility to IBD, but the prevailing theory is that IBD is caused by a combination of genes and exposure to environmental risk factors. It’s the interaction between these environmental risk factors and your normal (nonharmful) gut flora that is believed to lead to an increased immune response which results in chronic inflammation.

What are the symptoms of Crohn’s disease compared to ulcerative colitis?

The short answer is that many of the symptoms overlap (around 10% of IBD sufferers have a mixture of both and this is called indeterminate colitis). There are some key distinguishing characteristics your doctors will be able to tease out – see the table below.

Ulcerative colitis (just affects the colon) Crohn’s disease (can affect the whole gut)
Bloody diarrhoea and colicky abdominal pain, usually before passing a stool Abdominal pain and diarrhoea (sometimes with blood, pus or mucus). Pain is caused when food or faeces build up after eating in an area of the intestine damaged/ narrowed by inflammation
Some of or the whole colon is inflamed/ ulcerated, but other parts of the gut are usually unaffected Patches of the gut are inflamed and ulcers may develop but there are sections that are unaffected. It mainly affects the terminal ileum (the last part of the small intestine). Sometimes Crohn’s only affects the colon
Only affects the lining of the gut Inflammation may be confined to the bowel wall but can sometimes cause deep ulcers which also penetrate deeper through the muscle layers of the bowel wall causing fistulas (an abnormal connection between one area of the body and another). Often these are around the anus. Other complications include scarring and narrowing of the intestines, sometimes leading to blockages
Inflammation is usually continuous from the rectum Inflammation often skips segments of bowel which appear normal
 
Weight loss from inflammation

Weight loss from inflammation and reduced absorption
Tiredness and fatigue (anaemia is common) Tiredness and severe fatigue (anaemia and other deficiencies occur)
Feeling feverish Sometimes fever and night sweats can be caused by abscesses or collections of inflammation
Inflammation can involve the joints, skin, liver and eyes and cause mouth ulcers Inflammatory symptoms are similar to those of UC and may spread to other parts of the body causing mouth ulcers, red eyes, painful joints and rashes

Sources: Core charity and Crohn’s & Colitis UK

More about Crohn’s disease

Crohn’s disease affects around one in 1,000 people and in about one in five cases if you have Crohn’s disease you will have a family member who is also affected.

As discussed in the table above, Crohn’s disease may affect any part of the gut but most commonly causes inflammation in one particular area called the terminal ileum – this is the last section of the small intestine. The first part of the colon, called the caecum and the next, the ascending colon, are often involved. In many people only the colon is affected. Inflammation sometimes skips a segment of gut which is normal, rather than being continuous. Only a few people with Crohn’s will have involvement of the stomach or the upper intestine.
Mild forms of Crohn’s result in patches of inflammation – these look similar to mouth ulcers. In moderate to severe cases the intestine is damaged, and becomes thickened so it blocks the passage of digested food, causing cramp-like pain. Deep ulcers can also penetrate the bowel wall causing infection or even an abscess; this often happens around the anus. It is called a fistula when an inflammatory connection goes through the skin surface, the vagina, the bladder or another part of the bowel. When inflamed tissue heals, scar tissue may form, posing a further risk of blockages in the bowel.

More about ulcerative colitis

Ulcerative colitis is the medical name for when tiny ulcers form on the surface of the lining of the large intestine. It mainly affects the rectum and lower colon, but may affect the whole of the colon. It’s more common than Crohn’s disease, affecting an estimated one in 420 people. It seems to be more common in white people of European descent, particularly among Ashkenazi Jews who originated from Eastern Europe and Russia. It affects non-smokers and ex-smokers more than smokers, although doctors say the risks of smoking still far outweigh the possible benefits so do not take this as a licence to smoke! Men and women are affected by UC in equal numbers.

There are three types of ulcerative colitis:

  • Proctitis. This is where only the rectum is inflamed. Fresh blood in the stools is the main symptom, plus an urgent need for the loo (‘urgency’) and perhaps a feeling that you have not completely emptied your bowels. You may have normal stools, diarrhoea or constipation.
  • Left sided. This is inflammation that starts at the rectum and continues up the left side of the large intestine (the sigmoid and descending colon). Symptoms include passing diarrhoea with blood and pain on the left side of the abdomen, plus an urge to pass a stool even when your bowel is empty.
  • Total colitis. This is sometimes called pan colitis and is when the entire colon is affected to some extent. It causes very frequent bouts of diarrhoea, severe painful stomach cramps, weight loss and often fever and generalised illness.

This extract was taken from What’s Up with your Gut? By Jo Waters and Professor Julian Waters