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How and why I came to write ‘Yoga for Cancer’

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Blog written by Vicky Fox, author of ‘Yoga for Cancer’

Where it all began

I trained as a yoga teacher in 2008 and felt so lucky to be doing something that not only I enjoyed but I felt huge benefit in. I was always fascinated by the therapeutic application of yoga and how yoga could support people and in 2013 Laura Kupperman came over from Colorado to teach her “Yoga For Survivors” training which focused on how to support people diagnosed with cancer.

I had started studying with her when one of my best friends was involved in a tragic accident which meant that whilst learning how to adapt practices for side effects of surgery and treatment for cancer I also learnt how to hold space, be present with pain and not to be able to fix it. I think this was a huge learning for me just being fully present with someone with all that they were experiencing and with no judgement but just to be. This made my first few classes of yoga for cancer less frightening, remembering that these were just wonderful people coming into the room to have some space where they were nurtured and protected, practice yoga and maybe start to get connected to their bodies again.

What inspired me to write the book

The yoga classes gave them chance to switch from being a patient to being a co-crafter of their well-being and I started to meet the most fabulous people who shared with me what they were going through and I learnt to adapt so that everyone could participate in every bit of the class no matter what they were bringing with them on that particular day.

I volunteered to teach at Paul’s Cancer Support Centre which was a fantastic charity offering support for people living with cancer. The room I taught the yoga in was a shared space room that was used for other activities and it was not uncommon to go into the room, move furniture around and pick up the odd crisp that had escaped under a table. I loved teaching there but I also wanted to give my students the chance to experience what I felt when I went to triyoga, my local studio for a class. A dedicated space just for yoga with all the props you could possibly need and not a crisp in sight.

At the same time one of my friends worked for a company that had a charitable trust and they were thinking of sponsoring me to teach a free class for people impacted by cancer. As a result I approached Jonathan Sattin the owner of triyoga with this idea. We were negotiating room rates when I found out that the trust had voted for a different charity and so I had to contact Jonathan to tell him that I couldn’t teach the class as I didn’t have the funds for the room. He immediately responded that I could have the room for free and I agreed to teach the class for free and there we had it, the free class of yoga for anyone living with cancer started in April 2014. The “free” aspect was really crucial to both myself and Jonathan. It can be expensive being diagnosed with cancer. You might need child care, you might not be able to work, you might need to take taxi’s or have overnight stays in hotels. All this costs money and I wanted the classes to be as inclusive as they possibly could and being able to make them free meant we could do that.

 

 

 

How and when the book started to take shape

When we went into lockdown in March 2020 it was imperative that I got these classes online as soon as I could because I knew that community was a hugely important part of the class and suddenly we were all being told to stay at home and I knew this would be so challenging for some of my students. Triyoga immediately put a class on their online platform, on a Sunday, which quickly grew and I taught more classes from my home. If you knew anyone who was considered “vulnerable” during the first wave of covid you will know why the support of a community was so incredibly valuable. Some students were told if they caught covid they would not be able to be treated for cancer and other students had trials they were on cancelled as a result of covid. This online community became hugely important because students were unable to see physiotherapists or to get advice on certain side effects and so they started being discussed more widely in class.

The more I taught online the more I got to know my students, the more they asked for yoga poses that might help with a side effect. I wonder if it was that people felt more able to open up in this online format or whether it was just that they didn’t have as much choice. Students that only came once a week to class now were showing up to every class and I realised that what everyone needed support with was not cancer but the side effects of treatment for cancer.

I started creating little, short videos which I either put on Instagram or on my website with some ideas on poses that might help with cording, lymphoedema, scar tissue, peripheral neuropathy and other side effects that people needed support with. I had already started writing a book on yoga for cancer but teaching online helped me find more focus for the book and the idea of A-Z of side effects for treatment for cancer started to take more shape.

What I am most grateful for

I could not have done this book without the sharing and honesty of my students who have emailed me, spoken to me, opened up to me about what they are experiencing and asking what might help. They have trusted me and I am hugely grateful to them for this. My students really need all the credit for this book because it wouldn’t have happened if it wasn’t for them.

Anybody who is fortunate to work in a job where you contribute and others benefit will know how much purpose this gives you in life. I am so lucky to be able to do what I do and meet the most amazing people that I meet. By being forced into online teaching (which is now in a hybrid format of live studio and livestream) it enabled me to reach out to more people and where I had been unable to teach people that lived on the other side of London to me, I was now able to teach people anywhere in the UK or even abroad.

What I hope to achieve with my book

I hope this book will be an extension of these classes and empower anyone impacted by cancer that although you can’t control life you are able to control your response.

Remember, you can read the first chapter for free!

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Author Q&A: Rohini Bajekal, co-author of ‘Living PCOS Free’

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Over the last few years, there has been a shift in narrative about women’s health, especially topics surrounding reproductive health. Renowned MD Obstetrician-Gynaecologist Dr Nitu Bajekal who has decades of experience in this field has worked with her daughter, expert nutritionist, Rohini Bajekal on the much-anticipated book ‘Living PCOS Free’. The book is all about Polycystic Ovarian Syndrome. PCOS is one of the most common endocrine disorders worldwide, which affects at least one in ten women or anyone assigned female at birth. Hammersmith Health Books is proud to be publishing this book, which aims to give those going through PCOS an insightful and inspirational guide. This blog is written by Rohini Bajekal, who gives a personal account of why she worked with her mother and co-author to write the book and what they hope to achieve with it.

‘Living PCOS Free’ launches on 28th April and can be purchased here.

What spurred you to write ‘Living PCOS Free’?

They always say you write the book you wish you had on your bookshelf. As Rohini had personal experience of Polycystic Ovary Syndrome (PCOS) and Nitu has 35 years of experience helping patients, we both had a clear vision for our first book together. We had never come across a book on PCOS written by qualified health professionals that highlighted proven lifestyle approaches alongside western medicine and felt that this needed to be addressed as soon as possible. Nitu had wished to write a book for years but it took a pandemic and several lockdowns to be able to carve out the time to sit down and write it together. The initial idea was to write a general women’s health book but Rohini felt that since Nitu is an ObGyn, a general book would not do justice to the complex nature of these conditions as we would only be able to dedicate a few pages to each condition such as fibroids, endometriosis, painful periods etc. and that would not really help people to address their issues.

Could you tell us a bit more as to why PCOS is more than a fertility issue?

PCOS is often simplified as purely a fertility issue as it is the leading cause of infertility worldwide. However, PCOS and its other short-term and long-term complications are woefully underrepresented both in scientific research and mainstream conversations. It is estimated that as many as three-quarters of those living with PCOS remain undiagnosed.

PCOS is a complex condition that affects the way the ovaries function, resulting in a wide range of reproductive, metabolic, and psychological symptoms that affect women differently.  Societal stigma (due to patriarchal beauty standards) often associated with common symptoms, such as weight gain, scalp hair loss, acne, irregular periods and excess hair growth, means many women are unable to talk about it openly or seek the help they deserve.

In addition, many women are told that losing weight is the only solution to improving their PCOS with little guidance or support on how to follow a “healthy lifestyle”. In fact, 20% of those with PCOS have lean PCOS and are within the “healthy” BMI range, yet still struggle with the symptoms.

As people with PCOS have a higher risk of endometrial cancer, type 2 diabetes, heart disease and other long-term chronic conditions, it is critical to introduce sustainable nutrition and lifestyle changes as early as possible. All national and international guidelines recommend lifestyle interventions to be the first line of management for PCOS, even before medications. PCOS is a condition that is heavily influenced by our lifestyle — how we eat, sleep, move, stress, interact and so on. The book is packed with information on how to make lifestyle changes, including following a plant-based diet pattern, moving regularly, managing stress, getting restful sleep, nurturing positive social relationships and avoiding use of risky substances such as tobacco and alcohol.

What do you both hope to achieve with the book in terms of awareness and change for those suffering from PCOS?

Our hope is to reach anyone living with PCOS, a complex condition that does not receive the attention it deserves. We especially want to reach those from marginalised communities, including people of colour who are not always able to access the best medical care and support for a number of reasons that we discuss in the book. We have tried to be inclusive as PCOS also affects trans men and non-binary folk. We also hope that family members, partners and friends of those living with PCOS read this book to better understand it and to support the person they care about. Since a staggering 75% of people with PCOS remain undiagnosed, we also hope to reach those struggling with the symptoms such as fertility issues, irregular periods or excess hair growth, but for whom the dots have not yet been joined.

Advocating for PCOS is political and we hope this book is a stepping stone for greater change and awareness around reproductive health. The economic burden of PCOS was previously estimated at approximately $3.7 billion annually in 2020. Even more strikingly, this figure only considers the costs of the initial diagnosis and of reproductive endocrine morbidities, without considering the costs of pregnancy-related and long-term morbidities.

We know that ‘Pinterest’ is about to release a trend report which shows that searches for menstrual cycle are up as younger people wish to empower themselves with knowledge about their cycle – how do you feel about this and how it links in with your work?

We think it is so promising that young people are empowering themselves with knowledge and raising awareness of what a normal menstrual cycle is. Dr Nitu Bajekal is active on TikTok where there are a lot of menstrual educators creating content. We bust a lot of myths in Living PCOS Free around menstruation – we even talk about menstruation in non-human animals! So many people who menstruate struggle with irregular, painful, or heavy periods, not realising that these are not normal because of societal conditioning and lack of menstrual education. As a society, we have to do better at educating everyone around menstruation from a young age and doing so in an inclusive way. We also talk about the importance of tracking your cycle in Living PCOS Free and bust myths around issues such as seed cycling for hormonal health.

Since announcing you were releasing this upcoming book, what has been the reaction from you friends, family, clients and followers?

The reaction has been wonderful. We have been incredibly touched by the support we have received from our followers on social media, by our close friends and family and by many people we admire and look up to in the medical, lifestyle medicine and plant-based communities. Most of all, we have been honoured to receive a few especially moving messages from those who have PCOS themselves and who are especially excited about the release. We are definitely a little nervous about the reaction as we inch closer to the publication date but we are so proud of what we have created. We really hope Living PCOS Free will help many people and stand the test of time.

Could you share with us, a PCOS friendly recipe – (either from the book or one you like to make yourself!)

We have over 30 plant-based recipes from our family kitchen in Living PCOS Free which are incorporated into our 21-day plan.

One of our favourite quick and easy recipes in the book is our Paprika Hummus. Eating legumes (beans, lentils, tofu, tempeh, peas) every day is great for short-term and long-term hormonal health as these foods are full of fibre, protein, minerals and vitamins. Hummus is such a versatile dip and this homemade version takes minutes to prepare. It can be enjoyed with a baked sweet potato or potato, on a salad or as a dip with raw vegetables. The recipe also uses aquafaba, the viscous water in which legumes such as chickpeas have been cooked. Aquafaba can be used as an egg replacer as it mimics egg whites in cooking, for example in meringues and marshmallows.

Recipe: Paprika Hummus by Rohini Bajekal and Dr Nitu Bajekal

Serves 4
INGREDIENTS:

1 can of chickpeas, drained and rinsed but set the aquafaba aside
1 can of cannellini beans, drained and discard aquafaba
4 cloves of raw garlic
1/2 tsp of black pepper
1/2 tsp of salt
1/2 tsp of cumin powder
Juice of 2 lemons
2 tbsp of tahini
1/2 tsp of paprika
1-2 tbsp of premium quality cold-pressed extra virgin olive oil (optional)

A sprig of fresh herbs such as parsley (optional)

METHOD:

  1. Drain water from cannellini beans and rinse.
  2. Save the water from the chickpea BPA free can (aquafaba) and use as much of it as you need to blend to a smooth consistency with all the other ingredients in a good quality blender.
  3. Use most of the aquafaba water if you prefer a runnier hummus. Add as you go along to reach desired consistency. Taste and adjust seasoning as preferred and garnish with a few herbs such as fresh parsley if you like and a sprinkle of paprika for colour. Refrigerate and enjoy within 3-4 days.

If you make this recipe, tag us @rohinibajekal and @drnitubajekal and use the hashtag #LivingPCOSFree

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Be aware of allergies as the root cause of many problems including fatigue

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Blog written by Sarah Myhill, author of Diagnosis and Treatment of Chronic Fatigue Syndrome, Ecological Medicine, and The PK Cookbook

Allergy is the inflammation which results from response to substances (called antigens) from outside the body. Some of these present no threat to the body. Examples include pollen, house dust mites, animal dander and foods. Some antigens do pose a threat in high doses, such as metals (lead, mercury, arsenic, nickel), toxic chemicals (pesticides, solvents) or electromagnetic radiation (wi-fi, mobile phones, cordless phones etc).

Allergy has been known about for centuries. For example, 5-10 per cent of people with asthma are also allergic to sulphites. Pliny the Elder wrote of this when he reported the case of an asthmatic patient (rare for his times) who died from a bronchospasm in 79 AD after the eruption of Mount Vesuvius. The patient had lived a ‘normal life’ but for this ‘one incident’.

Allergy is the great mimic and can produce almost any symptom. Furthermore, one can be allergic to anything under the sun, including the sun! Allergy is also common – at least 30 per cent of the population are allergic to some foods. However, by the time allergy has produced fatigue (the major focus of my work as a doctor) it has usually caused other problems beforehand. Suspect an allergy problem if any, or a combination, of the following are present:

* The onset of fatigue is pre-dated by, and/or there is a long history of:

* asthma, sinusitis, rhinitis, eczema or urticaria

* irritable bowel syndrome with wind, gas, bloating, abdominal pain, alternating constipation and diarrhoea

* migraine or headaches

* joint (arthritis) and muscle pain

* mood swings, depression, anxiety, PMT

* almost any unexplained, recurring, episodic symptom.

  • Childhood problems – This would include being a sickly child with recurrent ‘infections’, such as tonsillitis (actually probably allergy). Indeed, a colleague who is a consultant paediatrician considers it medical negligence to surgically remove tonsils without first doing a dairy-free diet. Rhinitis, sinusitis, catarrh and colic are typical dairy allergy symptoms.
  • Symptoms change with time – Often the allergen is the same, but the symptom changes through life. Allergy to dairy products typically starts with colic and projectile vomiting as a baby, followed by toddler diarrhoea, catarrh and glue ear, recurrent infections (tonsillitis, croup, middle ear infections) and ‘growing pains’. Teenagers develop headaches, depression, irritable bowel syndrome, PMT and asthma. In adult life, muscle, tendon and joint pain (arthritis). Any of the above may be accompanied by fatigue.
  • There is a positive family history – I have yet to find a patient who is dairy allergic who does not have a first-degree relative (parent, sibling, child) who also has symptoms suggestive of allergy to dairy products. Allergy to gluten grains also runs in families.
  • There is a tendency to go for a particular food – One of the interesting aspects of allergy is that sufferers often crave the very food to which they are allergic. This was illustrated by one patient who told me that when he died he wished to take a cow to heaven with him. It was dairy which was his main problem! If wheat appears with every meal, then allergy to such is likely.
  • There are symptoms of fermenting gut – Microbes from the gut are minuscule and easily spill over into the bloodstream. This is called ‘bacterial translocation’. These bacteria do not cause septicaemia (blood poisoning), but they may cause allergy reactions at distal sites. I suspect many clinical pictures can be explained by this, including irritable bladder, interstitial cystitis, intrinsic asthma, chronic urticaria, chronic venous ulcers, polymyalgia rheumatica and arthritis (osteoarthritis, rheumatoid arthritis, ankylosing spondylitis and so on).

How to identify your personal food allergies

I never do tests for food allergy because they are unreliable. False negatives are common – so, for example, many people who are intolerant of gluten will test negative for coeliac disease. Often, when the test is negative, they are told by their doctor that it is safe to eat that food – not so! There are many tests for food allergy on the market, but again I find positive results can be misleading, not least because the patient believes absolutely in the accuracy of tests and ends up avoiding foods unnecessarily or eating foods which are causing them symptoms.

The only reliable way to diagnose food allergy is by an elimination diet. The key is to cut out those foods that one is consuming daily. The reason that reactions may be prolonged or delayed is that daily consumption masks the link between exposure and symptom. Western diets include daily consumption of grains, dairy products and often yeast. If in addition one is eating other foods, such as potato, soya or tomato, or drinking regular tea, coffee or whatever on a daily basis then this too should be excluded. One should stay on this diet for at least one month before reintroducing foods to the diet – this should be done cautiously since reactions can be severe. Dr John Mansfield developed a practical, easy-to-follow elimination diet that is described in his last book, Six Secrets of Successful Weight Loss.

The Stone-Age or Paleo diet is a ‘best guess’ diet and a useful starting place, hence my recommendation of the PK (Paleo-Ketogenic) diet as explained in our book Paleo-Ketogenic: the Why and the How. If it transpires that there are multiple allergies, then these days I do not put people on a more restricted diet – that is because some people get completely stuck on two or three foods and are unable to bring in new foods because of the above severe reactions. Instead, I put in place the interventions I recommend for a general approach to inflammation together with specific desensitisation techniques to switch off allergy (see our book Ecological Medicine).

Increasingly I am finding that one does not have to be perfect to reduce allergy and allergy symptoms. Simply reducing the total load is helpful – attention to the general approach is as important as specific desensitisation. However, the key steps are:

  • The PK diet
  • Extinguishing the inflammatory fire with my Groundhog Chronic regime (see any of our books) including antioxidants, especially vitamin C
  • Identifying possible causes, not forgetting micro-organims in the upper gut that should not be there, and eliminating or avoiding them
  • Detoxing to reduce the factors that cause inflammation
  • Reprogramming the immune system with probiotics, micro-immunotherapy, enzyme potentiated desensitisation (EPD) and neutralisation – all explained in detail in Ecological Medicine.
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Breathe, stretch, swing, lift. Exercise, and cancer-related lymphoedema

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

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

Physical activity can help

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

Breathe. Stretch. Yoga for lymphoedema

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

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

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

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

Vicky’s favourite pose to get everything moving

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

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

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

Swing – go Nordic walking

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

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

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

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

Lift. Strength training is safe

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

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

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

What do we mean by strength exercises? Carolyn says

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

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

Before you start

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

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

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

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

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

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

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

And now to relax


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

 

More support for those with lymphoedema

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

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

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

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

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

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

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

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

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

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Get Your Strength Back After Cancer

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

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

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

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

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

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

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

 

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

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

 

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

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

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

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

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

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

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

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

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

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

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

 

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

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

What doctors learn about mitochondria

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

Power, Sex, Suicide by Nick Lane | Waterstones

 

Professor Nick Lane’s book

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

 

The Sinatra Solution

 

 

Dr Stephen Sinatra’s book

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

 

Look after your mitochondria and they will look after you.

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Dr Raymond Perrin’s Voyage of Discovery

Blog post written by Dr Raymond Perrin, author of The Perrin Technique 2nd Edition and The Concise Perrin Technique.

 

The background to The Perrin Technique

In 1989 a cyclist came into my clinic complaining of back pain. He also told me that he had been suffering with myalgic encephalomyelitis (ME) for 7 years and had been out of cycling for all of that time. I explained to him that, as an osteopath, I could help his back problems but couldn’t do much for his ME/chronic fatigue syndrome (CFS), which in those days was also known by the terribly derogatory name of ‘yuppie flu’. We were trained to believe that ME was very much a psychological disorder and that, with tender loving care and more exercise and time out of the office, the young upwardly mobile professionals so often affected would return to their healthy former selves. How wrong we were!

With treatment to the cyclist’s postural problems, his back pain diminished but amazingly so too did his ME symptoms and within a few months he was totally symptom free and able to return to his beloved bicycle.

 

The Perrin Technique: The theory

After helping this patient, I embarked on over three decades of clinical research into ME/CFS, including a doctoral thesis into the cause and treatment of this disorder that continues to baffle most clinicians, scientists and patients. In the early days of my research, I came up with a theory that formed the basis of my PhD thesis and my first book, The Perrin Technique, published by Hammersmith Press in 2007; this theory was that ME/CFS was due to a physical disturbance of the lymphatic drainage of the brain and spinal cord. This, I hypothesised, led to a build-up of toxins within the central nervous system, leading  to a disturbed autonomic nervous system (the nerves that control automatic functions of the body such as blood flow, the heart and gut function).

At the time, my theory that this autonomic dysfunction caused a reversal of lymphatic flow from the brain and spine, leading to toxic overload of the brain, went completely against medical and scientific thinking, as according to all the main authorities there was no lymphatic drainage of the central nervous system to go wrong in the first place. It was recognised that we had the lymphatic system to take away larger molecules that could not drain directly into the blood, but this was deemed unnecessary in the brain as the there was a natural protection, known as the ‘blood-brain barrier’, that stops large particles entering the brain, and so blood vessels in the brain were thought to be sufficient to flush any small particles away. We know very differently now!

 

The Perrin Technique: The facts

Join me in my voyage of discovery in The Perrin Technique 2nd Edition in which I describe how scientific breakthroughs over the past 14 years have  finally caught up with my original theory; we now have irrefutable proof of the existence of the lymphatic drainage of the brain (AKA the ‘glymphatic system’) and masses of evidence showing how  this drainage can be disturbed by a combination of physical, emotional, immunological and/or environmental stressors, leading to ME/CFS and fibromyalgia (FMS), and how a reversal of neuro-lymphatic  drainage can lead to physical diagnostic signs. In my 2nd Edition I include many references to the supporting scientific papers and to my own published research.

The Perrin Technique 2nd Edition also explains why every patient with ME/CFS or FMS is different and detail over 100 symptoms with an explanation of why patients suffer from each of these, such as :

Hyperosmia (changed sensitivity to smell): This is a common symptom of ME/CFS and FMS. The olfactory pathway is one of the main neuro-lymphatic drainage points in the cranium. The increased neurotoxicity and/or inflammation in this region will result in irritation of olfactory nerves leading to a heightened sensitivity to smell in some patients, with others finding a lessening of their senses and in some a total loss of smell and taste (see anosmia).

In addition, I discuss many other conditions that can occur together with ME/CFS and FMS and consider other therapies that may be of benefit together with The Perrin Technique as part of the jigsaw-puzzle of recovery.

 

Two Perrin Technique books

With the publication of The Concise Perrin Technique this month (August 2021) there will be two up-to-date books describing how to reverse problems with neuro-lymphatic drainage using manual techniques. The core of both books is a comprehensive game plan for helping patients return to health plus a step-by-step guide for manual practitioners to carry out the required treatment. Both books also answer many practical frequently-asked questions such as: What are the dos and don’ts for patients with ME/CFS and FMS?

However, I am acutely aware that ME/CFS and FMS can badly affect the cognitive ability of sufferers and that many of my patients find reading and comprehension difficult or impossible tasks, especially when it comes to long texts. Consequently, I have written The Concise Perrin Technique as a short, more focused guide to the Perrin Technique aimed specifically at patients who simply want to know the key facts about ME/CFS and FMS, how to diagnose these conditions and how to treat the underlying problem, without using scientific and medical language and long explanations.

Both The Perrin Technique 2nd Edition and the new The Concise Perrin Technique show how successfully to beat ME/CFS, FMS and other similar, emerging conditions, including Long-COVID. Correcting neuro-lymphatic drainage may also help many other neurological disorders – further research is underway.

If you wish to comprehend the underlying science and gain an in depth understanding of issues related to ME/CFS and FMS, then The Perrin Technique 2nd Edition is waiting to be read; if you want just the basics of the Perrin Technique and how to put these into practice, then The Concise Perrin Technique is for you.

 

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5 Ways to Prevent or Reverse Hypertension

Blog post written by Dr Eugene Kongnyuy, author of No Pills, No Needles, launching 25th May.

 

10 years ago, I was diagnosed with high blood pressure (hypertension). As a physician and researcher, I decided to self-experiment. My aim was to find out what could successfully reverse my hypertension so that I could stop taking blood pressure (BP) medicine. I tried over 70 different things including salt restriction, meditation, stress management, different dietary regimens, weight loss, walking, etc. After 5 years of self-experimenting, none of the things worked for me and I felt disappointed.

In order to keep fit, I decided to run or jog for 1 hour every morning. Six months after I started this programme of 1 hour per day of regular exercise, I took my BP and it was very low. I stopped the BP medicine and the hypertension was gone.

One hour of regular moderate to high intensity exercise per day may be what you need to reverse your high blood pressure. Over the years, I have kept with 1 hour of exercise per day while tracking my BP and I have learned a lot more. Here are some of things that I have learned that can help you either prevent or reverse hypertension.

 

  1. Exercise regularly

Exercise is the centrepiece for the prevention or reversal of high blood pressure. Experts recommend 150 to 300 of moderate exercise (or 75 to 150 minutes of vigorous intensity exercise) per week. This is what you need to prevent hypertension. In order to reverse hypertension, you would probably need a lot more. To reverse hypertension, I had to do 1 hour of moderate to vigorous exercise per day (or 420 minutes per week).

First, aerobic or ‘cardio’ exercises cause repetitive contraction of large muscle groups which in turn forces the heart to work hard and pump blood to the muscles. Regular ‘cardio’ workouts, such as jogging, brisk walking, running, cycling, swimming, yoga, dancing, football, golf, hiking and basketball, increase the heart rate and train the heart muscles[1]. You need to train your heart muscles to pump blood more efficiently and this takes time. The longer the duration of each exercise, the better the results. Cardio training over several months causes a significant fall in blood pressure.

Second, exercise causes the endothelium (inner wall of blood vessels) in exercising muscles to produce nitric oxide and prostacyclin, both of which promote enhanced vasodilatation by relaxing the smooth muscle cells in the blood vessel walls[2].

Third, exercise blocks the renin-angiotensin-aldosterone system (RAAS), a hormone system that, when stimulated, raises blood pressure by increasing vascular resistance and causing sodium retention by the kidneys. This causes the blood vessels to widen and the kidneys to flush out sodium.

Fourth, exercise blocks the sympathetic nervous system (SNS). This causes the blood vessels to relax and widen, which in turn reduces the blood pressure. The SNS is one of the two main divisions of the autonomic nervous system (the other being the parasympathetic nervous system – PNS) that is responsible for our ‘fight or flight’ response among other things. The autonomic nervous system is a control system that acts largely unconsciously and regulates bodily functions, such as heart rate, digestion, respiratory rate, pupillary response in the eyes, urination, and sexual arousal. The SNS activation causes BP to rise. Once activated, the system fires electrical signals that lead to the release of the hormone adrenaline by the adrenal gland. Exercise blocks the SNS and therefore lowers the BP.

 

  1. Get active

Exercising plus being physically active throughout the day is more effective than exercise alone. I realised that each day when I came back from work, I did between 1000 to 2000 steps. I spent most of the day sitting. I decided to change my desk to a standing workstation. I remained standing while working, reading emails, writing, and I held standing meetings. The number of steps I did per day increased from 1000-2000 to 4000-5000 steps. I observed that my systolic BP was about 10 mm Hg lower during the day than it would otherwise be when I wasn’t physically active. I also find gardening, cooking and cleaning very helpful in keeping me physically active. There are many other ways to be physically active and each person can figure out what he or she can do to avoid a sedentary lifestyle.

 

  1. Get sweaty

Sweating lowers blood pressure by causing the dilation of blood vessels under the skin as well as loss of water and salt. I found that exercise that caused me to sweat was more effective in lowering my BP than exercise that didn’t. With sweat-inducing exercise, my systolic BP was about 10 to 20 mm Hg lower than exercise that didn’t cause me to sweat. Sweating is a natural method the body uses to control body temperature. When your body starts to heat up, whether because of exercise or outside temperature, it releases sweat from the more than 2-4 million eccrine glands spread out across your skin, pouring liquid through pores to lower body temperature. Sweating induces a ‘diuretic’ effect by causing increased loss of salt, including sodium, and this lowers blood pressure[1]. For those who can afford it, having a sauna at home could be an easy way to get sweaty.

 

  1. Keep warm

I found that my BP was generally lower in warm weather (such as summer or being in a hot country) than in cold weather (such as winter or a cold country) independent of sweating. Numerous studies have found a correlation between temperature and blood pressure, and have also generally shown higher blood pressure during winter. The explanation is that cold weather activates both the sympathetic nervous system and the renin–angiotensin-aldosterone system. Warm weather does the reverse as well as inducing sweating[1]. Therefore, following the sun when booking holidays can therefore be a good way to manage your hypertension.

 

  1. Lose weight

Weight is important if you want to say ‘goodbye’ to your antihypertensive pills. Studies have shown that by losing 5 kg (8.8 pounds), your systolic and diastolic blood pressure can drop by 4.5-3.2 mm Hg respectively[3]. If you have mild high blood pressure, weight loss alone can be sufficient to control it. Weight loss improves blood pressure, although exercise has a greater impact. This is the reverse of what I found for type 2 diabetes. Diabetes is affected more by weight loss than by exercise. In my case, I estimate that my BP was treated 80% by exercise and 20% by weight loss and my diabetes 80% by weight loss and 20% by exercise.

 

In conclusion, by combining regular exercise with being physically active throughout the day, doing something what makes you sweat, keeping warm and losing some weight, you can prevent or reverse hypertension. In this article, I decided to focus on my experience. But it’s important to note that there are other ways which, although they didn’t work for me, could work for other people. These include salt restriction, healthy diet, quitting smoking, moderating alcohol intake and managing stress.

One of my self-experiments was to find out the effect of altitude on my BP. It’s well known that the higher you climb, the higher the BP. However, I found that the effect of exercise and sweating was so strong that it completely overrode any effect of altitude on my BP.

These are just a few of the lessons I have learnt self-experimenting which helped me reverse both hypertension and type 2 diabetes. After hesitating for several years, I finally decided to put my experience in writing because I felt it could help many people, or at least the methods I used could be applied by anyone to find out what works for them. I have written down all my lessons in a book No Pills, No Needles which is coming out in May 2021.

 

[1] Rosenthal T. Seasonal variations in blood pressure. American Journal of Geriatric Cardiology 2004; 13(5): 267–272.

[2] Nystoriak MA, Bhatnagar A. Cardiovascular effects and benefits of exercise. Frontiers in Cardiovascular Medicine 2018; 5: 135.

[3] Fortenberry K, Ricks J, Kovach FE. How much does weight loss affect hypertension? Journal of Family Practice 2013; 62(5): 258–259.

 

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Coping with osteoarthritis during Covid-19

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

 

The Covid-19 pandemic is the number one health issue everywhere, but despite that we still have to manage osteoarthritis. According to a recent article in the British Medical Journal, Covid impacts on osteoarthritis in a couple of ways:[1]

  • There is more likelihood of being hospitalised when suffering from the virus if you already have osteoarthritis.
  • OA sufferers are likely to have additional pain in the joints when they contract Covid.

A key recommendation in the BMJ article is that physical activity is extremely important, regardless of age. Although this would seem to be difficult during a severe outbreak of the virus, it is feasible if the symptoms are mild. Also, all activity keeps us healthy and more able to fight illness.

I emphasise the importance of exercise in One Step Ahead of Osteoarthritis, in order to keep us active and mobile and enjoying a good quality of life. A glowing statement from Professor Sir Sam Everington, GP in Tower Hamlets, Chair of NHS Tower Hamlets Clinical Commissioning Group, and a board member of NHS Clinical Commissioners, who wrote in his foreword for my book: ‘This book should be prescribed on the NHS by all doctors. It can’t be, but if you have osteoarthritis or want to live a happier and healthier life, buying this book is the best investment you could ever make.’

Professor Sir Sam’s involvement in the social-prescribing initiative increasingly being adopted by GPs (pre-Covid) would account for his enthusiasm. The main message in One Step Ahead of Osteoarthritis is taking responsibility for your own health through:

  • exercise
  • weight management
  • healthy eating
  • supplements
  • complementary therapies
  • practical tips (shoes, keeping warm, bathing, etc.)

Even in lockdown we can walk locally and there’s no limit to how long you can stay out. If you are used to doing yoga, Pilates or other classes, there is a wealth of sessions being provided online either free of charge or for a nominal sum under £10. For those people who find exercise very hard due to chronic arthritis or other conditions, Chair Yoga provides a good alternative and that too is available online.

Finally, try not to overeat when confined at home and stick to the Mediterranean diet with plenty of fruit and vegetables. Recognised by doctors as the best diet for all conditions, it can also help us to keep our weight down, an important factor for reducing pressure on weight-bearing joints. Both Vitamin C and Vitamin D are essential for supporting the immune system, helping all conditions and giving us a fighting chance against Covid.

 

[1] https://ard.bmj.com/content/80/2/151

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What Survivors of Major Illness can Teach us

Blog post written by Dr Jerry Thompson, author of newly released Curing the Incurable: Beyond the Limits of Medicine.

Could we have underestimated our ability to heal ourselves from even the most serious of diseases? Could our innate powers of recovery be far greater than we realise?

This book examines healing from an unusual angle: it looks at those remarkable people who have recovered against the odds? I believe they have something absolutely crucial to tell us. Whether we have a serious illness or we just want to keep illness at bay they have information that can make a profound difference.

But how did they succeed? What did they do after their doctors told them they had an incurable disease?

I have been fascinated by these people that I call “survivors” for years. This book explores their stories and what they did. Recovering from a life-threatening illness is no small feat and you can be sure they did not get better by chance. They achieved it by following certain fundamental principles of health. And it is these fundamental principles of health that this book explores.

They used four main strategies, typically in combination. The book covers each one.

Few will be surprised that one of those principles, eating healing foods and avoiding harmful ones, was a popular and successful strategy amongst survivors. Combining information from case studies, research on the effects of food extracts on cancer cells and population studies this section gives us a useful guide on using food to heal.

Many know that our minds can powerfully impact on health but can mind power cure a life-threatening illness? In fact it can and there are many examples using many methods. We can use our mind to up-regulate our immunity, to go into healing mode or to create health. The case histories in this section are some of the most extraordinary in the book. The methods may surprise you and many are simple to use.

Mainstream medicine largely ignores toxicity but survivors cannot afford this luxury. How many carcinogens and neurotoxins do we meet in an average day and where do they come from? Which are the most dangerous? How can we reduce our and how can we excrete our accumulated chemical load. All this is covered in the book.

Changes in our energy field precede disease. They also precede healing. So understanding energy makes sense.

Again the stories could surprise: cancers the power of groups to bring about extraordinary healing, how lethal cancer can be cured from thousands of miles away, cancers disintegrating in minutes, and energetic blocks to healing that could prevent a good treatment working.

What emerges from these many remarkable accounts of recovery from major disease are basic and powerful principles of health and healing. Using them can make the difference between health and disease and many of are surprisingly easy to put into practice.