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

book

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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Celebrating International Women’s Day

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

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

Dr Sarah Myhill, MB BS

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

 

Beverley Jarvis

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

 

 

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

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

 

Dr Zahra Kassam MB BS, FRCPC, MSc, DipABLM

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

 

Carolyn Garritt, MSc

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

 

Sandra Hood, RD

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

 

 

Magnolia Cardona, MB BS, MPH, PhD

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

 

 

Ebony Lewis, BN, MIPH

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

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Kindness within the Community

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

Sara Challice – Author of ‘Who Cares?’

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

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

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

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

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

 

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

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

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

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

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

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

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

 

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

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

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

 

Sandra Hood – Author of ‘Feeding Your Vegan Child’

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

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

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

Love Underdogs needs to be recognised for its wonderful work.

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

 

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

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

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

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

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

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A sneak preview from upcoming release ‘Green Mother’

We have something a little different but equally as visually stimulating for you on our blog. A sneak preview of some beautiful illustrations from upcoming release ‘Green Mother’ by Dr Sarah Myhill and Michelle McCullagh with Craig Robinson. Launching later this year.

A family watering the garden
A mother breastfeeding
Children splashing in a puddle
A child splashing
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Giardia and its Complications to Coronavirus

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

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

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

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

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

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

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

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

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

 

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

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

 

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The Perrin Technique Second Edition – Coming Soon…

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

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

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

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

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

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Vitamin D and Covid-19

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dementia

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

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

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

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

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

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

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

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

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

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

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Exercise in Lockdown for Osteoarthritis

Knee

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

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

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

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

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

Knee squats

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

Heel to butt

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

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

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

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How to start exercising after recovering from scoliosis surgery (or any other surgery)

Scoliosis Handbook

At its simplest, scoliosis is an abnormal curvature of the spine. It looks like an ​S shape​. There are four common types:

  • Right thoracic curve – curve to the right (thoracic) upper back.
  • Right thoraco-lumbar curve – curve bends to the right of the thoracic down to the lumbar (lower back).
  • Right lumbar curve – curve bends to the right of the lumbar.
  • Double major curve – usually a curve to the right at the thoracic and left at the lumbar.

Diagnosis includes bending over to touch the toes and checking to see how symmetrical the spine appears plus X-ray, CT scan and MRI.

Signs of scoliosis as advised by the NHS include:

  • A visibly curved spine
  • Leaning to one side
  • Uneven shoulders
  • One shoulder or hip sticking out

Scoliosis HandbookTreatment for scoliosis includes wearing a brace to help straighten the spine which can work, depending on the stage of the curvature, or surgery. If the spine develops a severe curve, this can cause pain, while also putting pressure on the heart, lungs and other organs. Physiotherapy, exercise and massage can also alleviate pain before and after surgery.

Starting to exercise again after scoliosis surgery can be daunting for many people. How far do you push your body and how quickly? It is easy to have lost confidence in your ability to judge your body especially if you have been out of action for months.

My guidelines for returning to exercise are based on recovery after scoliosis spinal fusion surgery but the general principles can be applied to anyone who has had fusion surgery, for example damaged discs, or indeed any other condition.

The idea after scoliosis surgery is to build up back muscles gently.

According to the surgeon from my third surgery, the general rule is to lift no more than 5 kilos with free weights.

Starting back to exercise

PAIN

You should not feel pain during exercise at all. If there is any pain in the joints – back, neck, hips, knees, shoulders, elbows, wrists – stop what you are doing immediately. Gentle muscle pain after two days is normal in, for example, the quads (thighs), glutes (bottom) and abs (stomach). It is not normal not to be able to walk, or to have terrible neck and shoulder pain or to be in agony. If this happens, either the exercise was performed incorrectly or you have overdone it, or that exercise is definitely not for you. Do not over-push yourself at any time after scoliosis surgery. Initially, fatigue sets in quickly, so always make sure there is a rest time when the session is finished. Chill out for at least 30 minutes afterwards.

Always be aware of your posture and body alignment. Head, neck, shoulders, spine, hips, knees, ankles and toes should follow each other. A tip is to look down or check yourself in the mirror. Are your knees pulling together or your toes positioned inwards? Knees should be front facing or slightly outwards and toes positioned between 11am and 1pm OR 10am and 2pm.

With my clients, I operate what I call ‘exercise allergy awareness’

EXERCISE ALLERGY AWARENESS

  • Start with one gentle exercise
  • Start with low repetitions
  • Wait for two to three days
  • If you feel no pain at all after two to three days, continue with the first exercise and add a second
  • Wait another two to three days
  • If you feel no pain at all, add a third exercise to your routine
  • Wait another two to three days
  • If you feel no pain at all, add a fourth exercise, and so on … If you do feel pain, which at its maximum should be no more than gentle muscle pain, you will now be aware that a particular exercise is to be avoided – just like a food allergy.
Caroline Freedman
Caroline Freedman, author of The Scoliosis Handbook

Regular exercise will really help to stretch and strengthen the muscles around your spine, keeping them strong. As a result, posture will improve and you will look and feel so much better. It is a case of listening to recommendations from the consultant, physiotherapist and your body as to what may be comfortable to do.

Always consult your GP, consultant or physiotherapist before starting to exercise again.

Blog post written by Caroline Freedman, author of The Scoliosis Handbook, coming soon to Hammersmith Health Books. For more information about Caroline or the book, visit her website: https://www.scoliosishandbook.com/ or follow her on Facebook or Instagram.