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The Bowel Cancer Recovery Toolkit published in Chinese – a first for Hammersmith Health Books

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

Over a decade has passed since I had my own stoma surgery. And if someone had told me that 10 years later I would have a book translated into Chinese and I would be training ostomy nurses in China on Zoom, I would never have believed them.

Life really does take an incredible path sometimes. Here’s the timeline of how I went from ‘patient’ to ‘global expert’…

11 years ago

I went through abdominal surgery to remove my bowel and have a stoma formed, after suffering a life-threatening bowel perforation. I would need to use a colostomy bag fo

r the rest of my life. In most cases stoma surgery is life saving and life changing, and that was certainly true for me. I underwent 5 major operations over 18 months and it would be fair to say it was a difficult time. I had 2 young children and was a competitive athlete at the time. The surgeries floored me and I remember wondering if I would ever be able to go cycling or running ever again.

Lying frail in my hospital bed I asked about exercise, abdominal rehabilitation and whether I could run and do sports again now I had a stoma. My questions went unanswered. Nobody seemed to know what to do.

9 years ago

I managed to rehabilitate myself, get fit, retrain my abdominal muscles and return to running, cycling and the life I loved. To date I’ve completed 37 marathons and have just run a 50 mile ultra-marathon in the UK.

But in doing so realised there was a huge gap in patient support, nurse/surgeon education and knowledge about rehabilitation and exercise after stoma surgery. Despite my best efforts this hasn’t changed much, and we are still very much scratching the surface.

 

6 years ago

I started working with ConvaTec as their global exercise specialist and through our research in the UK, found that people who had their stoma due to cancer were reluctant to return to exercise and had very low levels of physical activity. I then trained in cancer rehabilitation to add to my MSc in sport/exercise science and 20 years of fitness rehabilitation qualifications.

 

4 years ago

I was working with a colorectal cancer patient (who was a keen runner and triathlete) and wanted to find an inspiring book for her to read about returning to exercise. I looked and couldn’t find one. So thought ‘Oh I’ll write a book then. That won’t be too hard’.

I contacted Hammersmith Health Books who took it on without a moments hesitation and then patiently waited whilst I wrote and re-wrote the book. It turned out writing a book is quite hard.

 

2 years ago (in 2019)

The Bowel Cancer Recovery Toolkit was finally published.

Let me tell you, if you’ve never published a book, it’s a terrifying process. Waiting for the first reviews on Amazon is utterly nerve wracking.

I hoped that people would find it comforting, useful and helpful. Which thankfully they have. Not only that but nurses and doctors have given it rave reviews and recommend it to their patients. That’s all I wanted and it makes me really happy to be able to help others. Read the reviews here.

During this time I continued to work with ConvaTec as a consultant and we developed an innovative nurse training course and the me+recovery training programme for patients.

For the first time patients could access professional advice on rehabilitation after stoma surgery and nurses could attend an RCN accredited (the only one of it’s kind in the world) course to teach them about abdominal exercises and safe activity for their patients. To date we’ve trained 350 UK nurses and many more around the world.

 

And so now today..

My book has just been translated and published in Chinese (a first for Hammersmith Health Books). I honestly find this mind blowing, but probably unsurprising. As it’s clearly something that’s desperately needed.

Each year there are around 380,000 people diagnosed with colorectal cancer in China (with a population of 1.3 billion) and cases are rising quickly in people under the age of 30.  It’s not a dissimilar picture in the UK, with around 45,000 cases each year and a sharp increase in younger people being diagnosed.

Even since publication of my book, the role of exercise in bowel cancer is becoming more and more important. Evidence is building to show that physical activity has a huge part to play in both prevention of cancer in the first place, but also in the role of recurrence. We now know that being physically active could reduce the risk of developing cancer (and it recurring) by around 30%.

If there was a pill that could offer the same thing, everyone would have it prescribed as a miracle treatment.

The exact mechanism as to why exercise is so effective isn’t yet fully understood, but it’s thought the anti-inflammatory effects of exercise combined with faster transit time through the bowel are the key physiological factors.

Having worked with thousands of patients, healthcare professionals and nurses over the last 6-8 years, I’m now hugely passionate about exercise and movement at all stages of bowel cancer prevention and diagnosis:

  • As part of a healthy lifestyle to reduce the risk of developing bowel cancer
  • As ‘pre-hab’ – getting fit for surgery
  • As rehab – after surgery – aiding recovery and reducing risk of parastomal/incisional hernia
  • As part of a healthy lifestyle AFTER a diagnosis of bowel cancer – improving mental wellbeing, confidence, physical strength and lowering risk of recurrence
  • For people with terminal bowel cancer, potentially prolonging life and helping with symptom control

All of this is covered in the book, along with advice on diet after surgery and specific abdominal exercises after stoma surgery.

Of course each person will interpret the advice and information differently, exactly as they should. But the ethos of the book is for each individual to focus on their own recovery and develop the confidence to exercise safely in their ‘post cancer body’ regardless of wherever they live in the world and wherever they are on their cancer recovery journey.

 

And finally…

The most recent part of this story (and it’s certainly not over yet) is the most incredible and ambitious project put together by ConvaTec to deliver the me+recovery training programme to a global audience.

In August 2021, we delivered online training (via Zoom) for stoma nurses in China, Japan, New Zealand, Australia, Singapore, Malaysia and South Africa – all at the same time.

It comprised 4 x 3 hour sessions to a group of 60 nurses with simultaneous translation into Chinese and Japanese. With me sat at home in my little studio in East Sussex. And due to the time differences, some of the nurses were up in the middle of the night. That’s commitment.

It was incredible. The cultural differences and the clinical approaches were fascinating and so very different. But the outcome was that every single nurse involved wanted to do better for their patients. They wanted to learn how to help them rebuild their confidence, return to exercise and know how to do safe abdominal exercises after their surgery.

I didn’t think it could work.  But it did. I’ve never experienced anything like it and it was an honour to be part of it.

In the book I write ‘My goal in writing this book is to try and help people, and to support, educate and encourage, and to start to change understanding and practice’.

And thanks to both ConvaTec and Hammersmith Health Books, that’s starting to become a reality.

Little by little we can start to change clinical practice around the world, give people better advice and enable people who receive a bowel cancer diagnosis to recover with confidence and live their best life.

 

For more information about me+recovery from ConvaTec Your home of stoma care advice, support and lifestyle tips. (convatec.co.uk)

For more information about my private practice www.sarah-russell.co.uk and my clinical Pilates www.theostomystudio.co.uk

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Raising awareness of Polycystic Ovarian Syndrome (PCOS) for PCOS Awareness Month

Blog post written by Rohini Bajekal, co-author of upcoming release ‘Living PCOS Free’, launching in February 2022.

This September is PCOS Awareness Month. Despite PCOS being the most common endocrine condition to affect women of reproductive age and those AFAB (assigned female at birth), with at least 1 in 10 affected, most people have never heard of it. Depending on how hard one looks for the condition, up to 3 in 4 of those with PCOS remain undiagnosed.

PCOS is the number one cause of anovulatory infertility and those with the condition are at greater risk of a number of long-term conditions, including type 2 diabetes, gestational diabetes, cardiovascular disease, metabolic syndrome and endometrial cancer.

PCOS is a chronic condition so, while there is no “cure”, making positive lifestyle changes can go a long way in managing PCOS and its symptoms, including insulin resistance, both in the short-term and longer term. Lifestyle modifications can tackle the underlying insulin resistance. All national and international guidelines recommend lifestyle and behavioural changes as the first line of management for PCOS, even before medications.

Knowledge is power and education is key. Raising awareness of what to look out for allows those with PCOS to access early help, support and advice. This may be through campaigns such as PCOS awareness month, workshops and education in schools or even by opening up the conversation between friends, family and colleagues.

Living PCOS Free is a practical guide which shows readers how to manage PCOS using proven lifestyle approaches alongside conventional medicine. Dr Nitu Bajekal, AKA ‘The Plant Based Gynae,’ dispels misinformation and tackles irregular periods, infertility, acne, weight gain and more.

For the diagnosis of Polycystic Ovarian Syndrome, any two out of three of the criteria below have to be met (Rotterdam criteria, 2003).

  • Ovulatory dysfunction (oligo- or anovulation: not producing eggs on a regular basis)
  • Clinical symptoms or biochemical (lab) evidence of androgen excess: (Increased levels of androgens including testosterone)
  • Polycystic ovarian appearance in one or both ovaries on pelvic ultrasound scan (specific features such as number of follicles, volume of ovary)

There are some common symptoms of PCOS, but it is important to mention that not everyone with the condition will have all the symptoms and vice versa (these symptoms may have other causes) so it is important to get a proper diagnosis:

  • Infrequent periods or missed periods are the most common sign of PCOS (oligomenorrhoea/amenorrhoea). NB: Pain is not a feature of PCOS. Painful and/or heavy periods or painful sex may be signs of endometriosis, fibroids and/or adenomyosis, all of which can affect fertility. Missed or infrequent periods could be a result of other conditions such as hypothalamic amenorrhoea resulting from calorie restriction (disordered eating, for example, or over-exercising).
  • Excess facial/body hair (hirsutism)
  • Acne (often adult and/or cystic)
  • Scalp hair loss (alopecia)
  • Unwanted weight gain
  • Insulin resistance
  • Fertility problems

There are several less well-known symptoms including:

  • Eating disorders, especially binge eating disorders without purging, unlike bulimia. (This may be missed, especially in those from different ethnic groups or those with excess weight. Referral to a therapist, dietitian specialising in medical nutrition therapy or another specialist, such as an endocrinologist or dermatologist, may be needed.)
  • Excessive daytime sleepiness
  • Breathing problems (sleep apnoea, snoring)
  • Acanthosis nigricans (darkened skin: behind the neck, underarms, groin).
  • Psychological issues such as depression and anxiety, which must be addressed.

 

Lifestyle matters and nutrition is the cornerstone

A plant-predominant dietary pattern

Given the commonality of PCOS among those with type 2 diabetes, and the higher risk of other serious health conditions, people with PCOS should be advised to focus on predominantly whole plant foods, including whole grains, beans, fruit, vegetables, nuts and seeds, herbs and spices. These foods are full of fibre and micronutrients that are nourishing and absorbed slowly, helping to normalise blood sugars. We know this works very well in people with type 2 diabetes and metabolic syndrome. Living PCOS Free is packed with tasty and nutritious plant-based recipes with gluten-free and oil-free options.

Exercise

Regular movement in a form that you enjoy is key. Aerobic exercise and resistance training, including high intensity interval training (HIIT) are all recommended to help improve insulin sensitivity in women with PCOS. Aim for 300 minutes of exercise per week (approximately one hour a day) and try to exercise outdoors in natural light.

Sleep

Ensure a regular sleep routine with seven to nine hours of restorative sleep.

Stress management and reduction

Consider exercise, meditation, mindfulness, community work, psychotherapy or yoga to help manage stress and lower cortisol levels which make insulin resistance worse.

Positive social connections

Build or join a community, whether online or offline; ensure you have a support network or a friend you can trust and confide in. Loneliness is a source of chronic stress and is associated with an increased risk of heart disease, high blood pressure and type 2 diabetes.

Avoid or limit risky substances

Eliminate risky substances such as drugs and tobacco and limit alcohol (people with PCOS are at higher risk of non-alcoholic fatty liver disease), which has no health benefits.

Living PCOS Free features an easy-to-follow 21-day plan by Nutritionist Rohini Bajekal, illuminating case histories and plant-based recipes.

https://nitubajekal.com/pcos/

https://nitubajekal.com/pcos-nutrition/

 

Dr Nitu Bajekal MD FRCOG Dip IBLM

Consultant Obstetrician and Gynaecologist

Lifestyle Medicine Physician

 

Rohini Bajekal Nutritionist and Lifestyle Medicine Professional

 

About the authors

Dr Nitu Bajekal, MD is a Senior NHS Consultant Obstetrician and Gynaecologist in the UK with over 35 years of clinical experience in women’s health. Her special interests include Lifestyle Medicine, PCOS, endometriosis, period problems, menopause, precancer, complex vulval problems and medical education. She is a keyhole surgeon with experience in laparoscopic procedures, including robotics.

Rohini Bajekal MA Oxon, MSc Nutrition, Dip IBLM, is a Nutritionist and Board-Certified Lifestyle Medicine Professional based in London. Rohini is passionate about PCOS and has personal experience of living with this condition.

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Mental Health Awareness Week Blog Special

Blog post written by Dr Trevor Griffiths and Dr Marian Langsford, authors of Emotional Logic. Available for pre-order now, launches 27th May.

The authors of Emotional Logic: Harnessing your emotions into inner strength have been married for nearly forty years. Marian still practices medicine under her maiden name of Langsford. They both now teach internationally the Emotional Logic method of preventing stress-related mental and physical illnesses, which Trevor developed while in medical practice. The best compliment they have received, they say, was from a medical student in Bulawayo, Zimbabwe, who stood up after a training session and said, “I have learnt today that it is really cool to be old, and married, and still together, ‘cos you get to travel the world and inspire people like us!” We don’t look very old; we received that as the honour it was intended to convey in that culture.

Learning to activate your inbuilt Emotional Logic helps to build more responsive relationships in any new situations you face. And it can be learnt at any age. An active schools programme in the UK has a wide range of age-appropriate materials, such that a five-year-old boy took an emotion leaf from a ‘Talking Together Tree’ they had made in the classroom, and took it to the teacher saying, “I would like to tell the class why I am feeling angry about something.” Imagine the difference that ability to talk sensibly about emotions rather than only act them out, or regulate them, might have.

In Chapter 1, Trevor comments on Marian’s story about a misunderstanding with a friend who had offered to help tidy her garden one autumn. She had told how understanding the emotional logic of her many loss reactions that followed helped to avoid a break-up. Here is an extract from Trevor:

As the eldest daughter in a Devon farming family, Marian grew up on a mixed dairy and horticulture farm overlooking rolling hills, surrounded by buckets of early flowers that needed bunching each evening for market the next day. They were not rich. She loved it. She has a wisdom from nature that I had missed, having been brought up in the London suburbs. For example, she once said, “Gardening isn’t all about pulling up weeds. You have to plant something in the earth in its place, and care for it.” A comment like that can leave me fixed into a garden chair for ages while I watch her getting her hands covered in earth and planting. Something simple like this can lead me to a lot of thinking, which I consider is my core skill.

So, what do I think about? I think a lot about human nature. I think things like, ‘Seemingly small things that break out on the surface of people’s lives can have deeper roots than we realise at first.’ It took me a few decades to realise that it did me a lot of good to listen to Marian. I think many men discover the same at some point in their married lives…

Emotional Logic was born out of years of experience in general medical practice, and out of a disrupted family background that Trevor experienced as traumatising. With a depth of emotional memories to draw upon, Emotional Logic harnesses the language of emotions into the inner strength needed to come through times of trouble stronger and healthier. Post-traumatic growth is encouraged as a way forward from post-traumatic stress. As a senior Community Psychiatric Nurse who uses Emotional Logic in her work said, “Emotional Logic heals the broken heart behind mental illness.”

Once learnt, people can share their new trauma-responsive conversational skills in their daily encounters with others. This prevents isolation following hurts. It reduces the risk of illness by building greater resilience and a realistic hope for recovery into relationships. Even if setbacks and disappointments occur, knowing how to activate one’s inbuilt Emotional Logic provides a world of constructive options to talk about. And where is there better to talk and to explore new ways forward than in nature, where the seeds of something beautiful in life can take root and grow.

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Corneal Grafts and Vaccinations

Blog post written by Nat Hawes, author of the Nature Cures series of books.

Nat Hawes shares important information for anyone having the COVID-19 vaccine who has had a corneal graft. There is a risk of graft rejection if ameliorating action is not taken. This means you can have the vaccine but must take special care of your eyes at the same time.

Corneal grafts are also referred to as corneal transplants or keratoplasty. They are used to correct problems caused by medical conditions or injury e.g. from infection.

Nat tells us:

‘Anybody who has had a corneal graft should be aware of the possible risk of rejection of the transplanted cornea following vaccination because vaccinations enhance the immune system. They should contact their eye consultant to be prescribed steroid eye drops to administer four times a day, or they may be advised to increase steroid drops if they are already using them. They will also need to have their eyes checked two weeks after they have had the vaccine. This is appropriate for both the influenza and the COVID-19 vaccines.

‘Although, as yet, there have been no confirmed cases of rejection due to the COVID-19 vaccine, there has been some documented from flu vaccinations.[1] It is still early days though and most people have only had the one dose of the COVID-19 vaccination so far in the UK. Rejection can take place up to 2 months after the influenza vaccination and is potentially reversible.[1]

‘Corneal rejection is caused by CD8 and CD4 T cells (defensive white blood cells) fighting to eradicate the foreign body (transplanted cornea) from the body and it is these very same T cells which are boosted by the COVID-19 vaccines so it is a distinct possibility that corneal rejection might occur.[2]

‘This may be much more of a risk after the second dose of the vaccine so it is important that corneal graft patients are made aware of this so that they can take the appropriate steroid drops to counteract it, and have their eyes checked. They should still go ahead with having the vaccine, but cautiously.’

 

  1. Wertheim MS, Keel M, et al. Corneal transplant rejection following influenza vaccination. Br J Ophthalmol 2006; 90(7): 925-926. doi: 
  2. Pluddemann A, Aronson JK. What is the role of T cells in COVID-19 infection? Why immunity is about more than antibodies. The Centre for Evidence-Based Medicine. 19 October 2020. 

 

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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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Reporting Harm – The Development of New Vaccines

The development of new drugs, and especially new vaccines, is very much in the public eye at the moment. This development is hugely costly not least because most potential products have to be rejected during development as not sufficiently safe and/or effective – this means the successful products have to carry the costs of all the failures as well as their own. It also means that once a product has made it through to official approval and general use there is inevitably huge reluctance to find fault with it as long-term problems emerge – very few drugs and vaccines are withdrawn at this stage. This makes it particularly important that any one of us who experiences a problem with a drug or vaccine reports it so the side-effect/bad reaction/failure can become part of official statistics about the product.

The phases of drug development are…

  1. Discovery and development when bio-scientists look for likely candidates based on knowledge of human biology
  2. Preclinical (lab-based) research
  3. Clinical research (what we think of as ‘drug trials’ where efficacy, dosage, safety etc are assessed)
  4. Official review and approval for specific uses by the relevant national authority (e.g. FDA in the US; MHRA in the UK; HPRA in Ireland)
  5. Post-marketing surveillance and monitoring (‘pharmacovigilance’)

Those of us outside the industry can contribute to drug and vaccine safety and efficacy by taking part in clinical trials, if the opportunity arises, if we have a particular health problem or are prepared to act as healthy ‘control’ patients. However, ALL of us who receive any medication or vaccination can contribute to ongoing monitoring by reporting any negative effect. In the UK this is done via the Yellow Card system (there is a great article about the Yellow Card system on the website of Independent Living here). In the US, the FDA monitors adverse events that may occur related to receiving a vaccine through its Vaccine Adverse Event Reporting System.

How many times have you, or someone you know, grumbled that a flu jab has given you a fever and a day or more off work? Or an asthma attack? Or that an antibiotic has had strange side effects, such as loss of hearing? Or that a statin has left you constantly weak and exhausted? But have you recorded the problem so that anybody who could take this into account knows? Just as we should exercise our right to vote, we need to exercise our right to speak out about the ill effects of health products – and the Yellow Card system applies not just to drugs and vaccines but medical devices (e.g. implants) and equipment (e.g. hearing aids which are often overly complicated for those to whom they are sold) too. With the roll-out of a number of brand new vaccines developed at unprecedented speed we must not be complacent or keep problems to ourselves – it is time to exercise our pharmaco-vigilance!

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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.

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How to Survive the Stress of Caring, and Look After Your Own Health

Blog post written by author of Who Cares?, Sara Challice. Who Cares? has been shortlisted in the Non-Fiction category of The People’s Book Prize 2020/21. Click here to give it your vote.  

 

Caring for a loved one is, without a doubt, a kind and selfless act. Not only does it give another a better quality of life, it may even extend their longevity.

But whilst caring, your altruism could cost you more than your time and energy, because around 70% of carers fall either mentally or physically unwell – this included myself!

During my time out recovering, I realised I needed to make changes so as not only to survive my caring role, but also to regain my health and start enjoying life again.

So how can you overcome the stress of caring, to become more resilient and safeguard your own health?

1. Check in with yourself

As a carer, you’re often so busy being there for everyone else that you ignore your own health. And during the pandemic, this is ever more so whilst trying to talk to your GP, let alone arrange a hospital appointment – all time-consuming tasks that take even more of your precious energy and time.

You may even be suppressing your emotions, as you’re so busy tending to and protecting those around you who are almost certainly classed currently as ‘high risk’ for coronavirus. The pressure can build up, bit by bit, and go unnoticed until crisis strikes.

Do you have a good friend or family member you could check in with for a short time, once a week? This can be either face-to-face (socially distancing of course!), over the phone or via Skype. Or you could try journaling – writing down your feelings and the issues you’re experiencing. Observing what is actually happening can help lead you to making better choices for yourself, as well as for your loved ones.

2. Take a break

If you see each day as a list of chores – just doing this, just doing that – you’ll end up simply falling into bed exhausted!

Even though times are ever more challenging, you still need to have regular breaks, as well as have quality time. You’re not just here for a loved one, you are also here for you!

Try taking a short break between each chore, even if it’s 10 minutes. This will help you pace the day. You could jot down a list of things you enjoy doing during these breaks, such as reading a magazine, having a kip, or calling a good friend for a chat. You can then pick from your ‘break menu’, when you stop for a rest.

3. Focus on the good stuff

There is often a lot to deal with and carers are often in survival mode – focusing on the issues, to ensure everything and everyone is okay – but this does not make for an enjoyable life.

What are you happy and thankful for in your life? It may just be a hot shower that morning, or your comfy bed. It could be having loving and kind friends or patting your pet. If I’d had a bad day, I would climb into bed and think of five things I was grateful for that day. It always put a smile on my face and put me in a better state of mind before sleep.

Just remember to be kind to yourself and recognise all that you do. You really are amazing, being there for loved ones. Make sure you are also there for you!

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Giardia and its Complications to Coronavirus

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

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

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

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

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

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

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

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

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

 

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

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