Tag: chronic fatigue

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Tips for Sleeping Well from The Fatigue Book

sleep

The following is an extract from ‘The Fatigue Book’ by Lydia Rolley and looks at the importance of sleeping well in managing the effects of Chronic Fatigue Syndrome.

It would seem to make logical sense that, if you suffer from fatigue, at least you would beable to have a good night’s sleep, right? Well, as you have no doubt discovered by now, the fatigue does not play by the normal rules of life, and what your body is craving from a good night’s sleep is sadly often denied.

As humans, we spend approximately a third of our lives sleeping. That is quite a lot of time. Sleep is essential for our mental and physical wellbeing. Sleep contributes to the proper functioning of our body’s systems. Lack of sleep, therefore, has negative health consequences.

I have worked with many chronic fatigue sufferers who, although they sleep a lot, struggle to sleep well. From my experience, people either tend to over-think sleep issues, which can lead to increased anxiety about getting to sleep, or not to think enough about these issues,
which can lead to disordered sleep habits. Chronic fatigue sufferers who have sleep difficulties usually wake feeling unrefreshed. Some may not be waking until late morning or even into the afternoon. Often it is hard to get out of bed, as the body feels weighed down and heavy. The heavy feeling and sleepiness can continue throughout the day. Some people report feeling more alert for a few hours later on, often in the early evening. Almost a small window of hope, but this can be followed by difficulty switching off at night and not being able to get to sleep.

Changing your sleep pattern does not happen by chance. It does take a lot of patience, being intentional and very consistent. Concentrating on your sleep and developing healthy sleep hygiene habits together make the biggest difference to your overall health and ability to function and cope well. I have seen countless people transform their sleep habits and have witnessed the benefits. The change started when they chose to try something different.

Sleep difficulties can be complex and multi-faceted, but most can be solved. Ignoring sleep issues, and hoping they will go away, does not work. Trying to sleep for a few extra hours to fill the gap only tends to prolong the problems rather than solve them. When sleep is disordered, our bodies need to be retrained to know when it is time to sleep and when it is time to wake up.

What I have learnt over the years is that, even though some of these tips seem obvious, they almost need to be exaggerated, repeated and magnified in order to have an effect. Please keep that in mind as you start to put into practice the following tips, which will give you some useful starting points.

I have full confidence that you will benefit from healthier sleep habits.

Tip 21: Separate Day and Night Clearly

sleep

This is probably not your present reality and that is okay for now, but please keep this fact clearly in your mind as a goal for your future sleep pattern. The boundaries between day and night can get very blurred with disordered sleep. The more disordered your sleep becomes, the more unrefreshing will be your experience. Reintroducing clear boundaries will prevent further deconditioning.

This is the direction we are heading towards to regain a healthier sleep routine. For now, just be aware of your current day and night sleep routine by drawing a line on the chart below where you think your sleep pattern currently is.

sleep

In the weeks and months ahead, be aware of how your current line gradually changes position and consider what has contributed to that shift. If you are sleeping excessively in the daytime and want to start changing that habit, see Tip 23.

Keep a Reflective Sleep Diary

The reason for keeping a sleep diary is to understand your current sleep situation and give greater clarity to what may need to change. This sleep diary is more of a reflective diary rather than a scientific measurement of your sleep cycles (such as on a sleep app). A reflective diary can be more useful in empowering you to make some changes.

In your reflective sleep diary (see Appendix 2, page 276) consider the following questions:

  • What was I doing an hour before bedtime?
  • How was I feeling in the evening?
  • What time did I get into bed?
  • How long did it take me to fall asleep? Why? Any reasons?
  • Did I wake in the night? How often? Why? Any reasons?
  • What time did I wake up?
  • What time did I get up?
  • How did I feel?
  • How would I rate my night’s sleep out of 10? (10 being excellent.)

I would recommend only doing this for a week or two, no more than that. That is enough time to recognise any patterns of sleep and highlight any particular areas that need concentrating on.

Every few days, respond to the following statement:

sleep

 

Tip 23: Set an Alarm

This tip is not always popular but it is of the utmost importance. When you are exhausted and perhaps have no particular reason to get up, it may seem sensible to rest for longer, but this is counterproductive. Staying longer in bed does not help poor quality sleep. Sufferers frequently report feeling worse for going back to sleep. Seeking balance and retraining your body to learn a sleep-wake cycle goes hand-in-hand with managing your activities, pacing and rest.

sleep

I recommend that you try the following method to create an ordered sleep-wake cycle:

  • Decide what time you would like to wake and get up, for example 8.00 am.
  • Use a simple alarm clock with a silent tick.
  • Place the clock somewhere that requires you to move to switch it off.
  • Check your reflective sleep diary and set the alarm for the average weekly time you currently wake and get up – for example, it maybe 11.30am.
  • Set your alarm at this time for a week, so that you get used to waking up with the alarm.
  • Avoid going back to sleep – open the curtains, turn the light on, sit on the edge of the bed, put your pillows on the floor, etc.
  • The following week, set your alarm for 30 minutes earlier.
  • The following week, set your alarm for another 30 minutes earlier.
  • Do this consistently for a few weeks, until you are waking and getting up at your preferred time.

If the 30-minute chunks are not successful, try 15-minute chunks of time.

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

book display

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

books

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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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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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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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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Thunder Dragon Half Marathon in Bhutan: A recap by Max Tuck

Finish line Thunder Dragon

This post was written by Max Tuck, author of The Fatigue Solution: my astonishing journey from medical write-off to mountains and marathons, published by Hammersmith Health Books. 

“It’s all perfectly runnable.”… or so I was told in the pre-race briefing. And I’m sure it would have been – right up until the time that the Indian tectonic plate smashed into the Eurasian plate 50 million years ago and created the Himalayas.

I consider myself to be a reasonable runner, and I’d put in a hard winter of training in the lead-up to this race, the Thunder Dragon in Bhutan. A week earlier I was competing in a half marathon on the Great Wall of China – 5126 steps into history, and I felt every one of them. I somehow came second in my age category, despite it taking me nearly an hour longer than pretty much every other half marathon I have run, with the 30 degree temperature sapping my energy like you could only imagine.

But the Thunder Dragon – this was something entirely different. At 11 miles, my pace had slowed to a crawl. Perfectly runnable? It might have been for the organiser, a former London Marathon winner in a time of 2 hours 9 minutes. But for me, a recreational runner who 28 years ago had been deemed incurable by the medical profession – this wasn’t running, it was survival. I was at 2500 metres, feeling sick, dizzy and gasping for breath. I poured water over my head so that my mouth could focus solely on the act of breathing. It didn’t help.

My pace slowed to a walk. I faced a long uphill on a stony track at 8200 feet. Hard enough at lower altitudes, the sharp stones particularly cruel for a barefoot runner like me, whose only acclimatisation had been a hike to the famous Tiger’s Nest monastery at 3600 metres two days previously.

Yet somehow I finished, even managing to run the last mile (mainly, I’m sure, because it was downhill). It was the hardest half marathon I had ever done, reflected in my very slow time.

A major surprise came later that day at the prize-giving ceremony. An American runner was announced as the winner of the over 40 age category. “That can’t be right, Max,” she said as she went up to collect her prize. “You were about half an hour ahead of me!”

I smiled and congratulated her. Immediately afterwards, I was announced as the winner of the over 50s age group. We were both amazed – I because I had won my age category in that savage race, and she because she thought I was about 42, not 55. This anti-ageing lifestyle certainly has its benefits!

Max Tuck was in China and Bhutan raising money for Dogs Trust.

See www.justgiving.com/fundraising/maxagainstthewall to donate.

Max’s latest book The Fatigue Solution: my astonishing journey from medical write-off to mountains and marathons, is published by Hammersmith Health Books.

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The Fatigue Solution: From Medical Write-Off to Mountains and Marathons

The Fatigue Solution by Max Tuck

I used to like filling in forms. What could be more satisfying than taking a blank document and experiencing the joy of completing it to someone else’s exacting standards? Does this make me odd? Maybe you’re just not with me on this one. And today, I’ll confess, I’m not feeling the love either. There are so many other things I’d rather be doing on a Saturday afternoon.

The form in question is a visa application to enter the People’s Republic of China. If someone had told me 28 years ago that in May 2018 I would be embarking on my biggest running challenge in years, involving a half marathon on the Great Wall of China, followed by a race of the same distance at altitude in Bhutan in the Himalayas, I would have replied that they were clearly wrong, because I wasn’t expected to live that long. Never mind not only still being alive, but to be taking on that kind of physical challenge? Definitely a case of mistaken identity.

The reason for my disbelief would be simple. In 1990 my body was wasted and exhausted. As a vet, if I’d had a patient with as few white blood cells as I had, I would be looking down a microscope at a blood film to check, because the machine must have got it wrong. My desperately low white blood cell count was mirrored by my startlingly low bodyweight and complete muscle wastage. I was so weak that even getting into my car to drive to work involved significant effort. As for the idea of running races for charity in challenging conditions – forget it.

But here I am. In my book The Fatigue Solution, I explain how I went from medical write-off to mountains and marathons; how I rejected exhaustion and rediscovered life. It sounds like a dramatic turnaround. It certainly was.

What had happened to me? I was overworking myself, never taking breaks, cramming far too much in, never saying no, refusing to give up… and ultimately I lost my most precious possession. No, not my house, my job or my car – my health. You never fully appreciate what you have until you lose it. And at the ripe old age of 27, I lost that completely. It disappeared in a fog of exhaustion, muscle degeneration and viral attack. Hello Epstein-Barr virus and chronic fatigue. Goodbye life.

Or… so the doctors believed, based upon other patients similarly affected. Not me. I’m tough. I’m stubborn. I take huge delight in proving people wrong. As you’ll read in The Fatigue Solution, I never give up. Tell me I’m incurable? I’ll show you. Don’t tell me I can’t.

And prove them wrong I did. Not only am I still alive at the age of 55, I’m thriving. I’m fitter, stronger and have more energy than most 25 year olds (or so my personal trainer tells me anyway). My muscles all came back, and then some. Drastic turnaround? You bet. Was it easy? No. Did it take hard work, dedication and determination? Of course it did. Was it worth it? Hell yes!

The Fatigue Solution by Max Tuck

How, you might wonder, did I do it? After all, if you’re in a similar exhausted situation, running to the next lamp-post might seem impossible. Step by step, that’s how. As I explain throughout The Fatigue Solution, by upgrading every aspect of my lifestyle. By researching and implementing all the factors that are known to make a difference. Applying the information and using it to fuel my recovery, consistently, every day. By believing that I could, and that I was worth it. I did it for me. Armed with the right knowledge and a will to succeed, you can do it too.

There’s now only one thing standing between me and my tough far-eastern running challenge – that wretched visa application form.

Max Tuck’s book The Fatigue Solution: my astonishing journey from medical write-off to mountains and marathons is available in print and e-pub versions from Hammersmith Health Books.

For more information visit www.thefatiguesolution.co.uk

To support Max in her charity fundraising, visit www.maxagainstthewall.com

 

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CFS/ME: Are you sleeping too much?

CFS/ME: Are you sleeping too much

Difficulty with sleep is common for people with CFS/ME. Some people find they are sleeping too much, while others find they are not sleeping enough. If you experience problems with sleep there are several things you can do to help yourself.

There is no such thing as an ideal amount of sleep. For example, some people need 10 hours, while others only need five. An average night’s sleep is around eight hours. When the amount of sleep someone is getting is causing an increase in fatigue that is when it becomes a problem.

When people first have CFS/ME they often over sleep. People who have had CFS/ME for a longer period of time often go from over sleeping to not being able to sleep enough, despite high fatigue levels. Continue reading CFS/ME: Are you sleeping too much?