Tuesday, 22 September 2015

Graded Exercise Therapy? No Thank You!


I have created a slide series (below)  to give a quick over view of the problem with graded exercise advice for ME patients given in NICE guidelines (UK).

M.E. patients & the problem with NICE advice on exercise from Sally Burch

Update 2016 - This paper  by Mark Vink shows that data from the PACE trial itself, shows that there are no real benefits to either CBT or GET:
The PACE Trial Invalidates the Use of Cognitive Behavioral and Graded Exercise Therapy in Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome: A Review

Live links for the slides:

Other posts I've written in relation to exercise and ME:

"Play-Up & Lay-Up" not "Boom & Bust" Sept 2014
Rhythm+ and Endomondo: HR monitoring for ME Aug 2014
The Exercise Catch 22! Jul 2014
ME Awareness - Why NOT Exercise? May 2014
A few notes on using a HR Monitor for Pacing Feb 2014
The Dilemmas of Exercise and M.E.  Dec 2013


Saturday, 12 September 2015

"The Use of Patient Blogs as a Care Resource"

QUB ePatients Conference 12th September 2015

Today a video of the audio PowerPoint that I've been working on over the summer was shown at the QUB ePatient Conference in Belfast.

My own health was (& is) not sufficient to cope with actually presenting this live, so I was delighted when Dr Steven Wilson  the organiser of the event agreed to me presenting remotely.

I am also hugely indebted to Joan McParland and Martina Marks, my co-Trustees for Hope 4 ME & Fibro Northern Ireland, for attending the event and answering questions after the presentation on my behalf .

This is the presentation:

To watch in full screen, start video then click on the
word YouTube in bottom right corner.

I stayed at home and was delighted to be able to follow the event on Twitter using the tag #QUBept  and there were many ideas and concepts discussed that will require further thought on my part!

Altogether a fascinating event.

I look forward to further discussions online on some of the issues raised.


***********

Links to material shown in my presentation:

Media Articles: 
"ME: fear of exercise exacerbates chronic fatigue syndrome, say researchers" The Telegraph
"Exercise can help with ME, scientists say" BBC

ME Association Links:

Forward-ME Minutes of meeting at House of Lords 25 June 2014
Our CBT, GET and Pacing Survey calls for major changes to therapies offered for ME/CFS | 29 May 2015

NICE Guidelines for ME [Edited to add this link on 16th Sept]
Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy): Diagnosis and management of CFS/ME in adults and children
NICE guidelines [CG53] Published date: August 2007
It is the assumption of "increase" that I find problematical with the GET programmes.

Sites that influenced me:
The World of One Room - Face Book page
Stonebird website
Invest in ME website
Let's Do it for ME (fund-raising for Invest in ME)

Canadian Consensus Criteria for ME (online pdf)

Paper referenced by Prof VanNess during his Feb 2014 visit to N.Ireland
Discriminative Validity of Metabolic and Workload Measurements to Identify Individuals With Chronic Fatigue Syndrome Christopher R. Snell, Staci R. Stevens, Todd E. Davenport and J. Mark Van Ness (2013)

Our Charity webpages:
 Hope 4 ME & Fibro Northern Ireland
Facebook page for Hope 4 ME & Fibro Northern Ireland

Links to Just ME posts mentioned:
Living Death Disease
Well Enough to Drink Coffee
"Play-Up & Lay-Up" not "Boom & Bust"
Circles of Influence & ME

Other related material:
Recent video of Jessica Taylor and the work she does with her charity Share a Star
Link to Greg Crowhurst's book: Severe ME: A Carer's Guide 


14th Sept: Edit to add a link to Greg Crowhurst's review of my video on Stonebird:
This video could save your life !
Thank you Greg.  A review, like this, from you means everything!

Sunday, 30 August 2015

Circles of Influence & ME

Click to enlarge
Part of coping with ME, I think, is about drawing circles around the things we aim to influence.

When I was well, I once attended a staff development session where we were asked to list all the things in the world we'd like to change.

Then we were then told to place each thing either:  inside our "Circle of Realistic Influence" or outside of it.  The take-away message was that we were to forgive ourselves for not tackling those things outside of our personal circles.

Now that I think back on this session, it makes me realise just how much ME sufferers must draw tight circles around their lives - often pushing more and more things outside of that circle of influence.

In fact even looking at what we can cope with on a daily or weekly basis, shows how we need to "Let Go!" of some things that, before illness, we took totally for granted.

I expanded the concept of having a single circle and did this one for me and my ME.

The innermost circle shows the things that are basic essentials for life, and in truth probably represent the sum total that the very severely affected can manage.

The next two rings are more personal, and could change over time depending on current circumstances. The "Less than Daily" circle looks a good list, but doing one thing on the list, is likely to mean that others must be abandoned.  So some items will be very infrequent. I created the graphic a few weeks ago - I might make some changes were I to re-do it today.

Finally, I thought long and hard about what to call the outer circle.  I didn't want to call it "Beyond My Ability" - even though that is really what the stuff there represents.  So I thought "Aspirations" would be much better.

I think perhaps for some-one newly ill with ME an exercise like this might help them to let go of certain things without guilt.  I remember early in my illness deciding that I had to totally let go of what happened to my garden.  I could no longer tend it myself, nor could I ask family to keep it up they way I wanted.  So I let it go.

One day perhaps I will be well enough to spread all my circles out again, so that my garden once more is tended as I would wish.


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Other thoughts about coping with an energy-restricted life:

Managing Illness through Pacing;
Do you STOP soon enough? March 2015
Pacing and Unpredictable Events Sept 2014
"Play-Up & Lay-Up" not "Boom & Bust" Sept 2014
The Exercise Catch 22! Jul 2014
ME Awareness - Why NOT Exercise? May 2014
Thoughts on Travel and ME Mar 2014
The Dilemmas of Exercise and M.E.  Dec 2013

Saturday, 8 August 2015

What is ENOUGH?

Today is Severe ME remembrance day when we think of those too ill to leave their darkened, and eerily quietened, rooms.

Today once more, patients, families, carers and friends will try to alert the world and the medical establishment to the travesty of the "living dead" - those who are most severely ill and largely forgotten.

Last year I wrote a blog post called "Living Death Disease" to try to highlight this incredibly mis-represented and misunderstood situation.

A quick look on social media today under the tag #SevereME will bring up scores of blogs, videos, tweets, links, and messages. (Please look, like and share as much as you feel able.)

Yet advocates have been campaigning for change for decades.  The history of how some ME patients have been treated by the establishment makes for harrowing reading.

A short quote from MAGICAL MEDICINE:HOW TO MAKE A DISEASE DISAPPEAR (Hooper 2010) illustrates a pervasive attitude:

"In 1992, the Wessely School gave directions that in ME/CFS, the first duty of the doctor is to avoid legitimisation of symptoms; in 1994, ME was described as merely “a belief”; in 1996 recommendations were made that no investigations should be performed to confirm the diagnosis and in 1999 patients with ME/CFS were referred to as “the undeserving sick”. "

So how can we do ENOUGH to tip the balance in our direction? 

What do we need to do, so that the rest of the world will look on in horror and shout "ENOUGH!" on our behalf?

How can we persuade ordinary doctors, who receive inadequate training on how to cope with ME, to champion our cause?

I don't have ready answers.  

Physically, I may not be up for placard waving or protest marching but I can blog, I can use social media, and I can work with others to push for change in my own area.

I am proud to be a trustee for Hope 4 ME & Fibro Northern Ireland  and I will continue to campaign for change in whatever way I can.

Please join me and others, in highlighting this situation - because surely, by now, we've all HAD ENOUGH!!

It's time for change!


Severe ME must be validated as the devastating physiological illness that it is.  Substantial research funding must be secured to investigate its etiology, and the psychiatric premise for ME treatment must be fully discredited and discarded.

What the medical authorities currently regard as enough, is simply NOT enough!


*****

PS Yesterday a fellow blogger asked me if I was going to publish something today.  I replied that I was in a bit of a dip, and wasn't sure that I would.  Yet last night when I read what he had written, I knew I had to say something!

Please read this piece by Henry Anderson:
A blog about my cousin for Severe M.E Day – 8th August 2015

Edit to add:
Two more powerful stories illustrating exactly why we need change:
Limited Capability: Severe ME Day 2015
Living with Severe ME and Random Things: Severe ME Awareness #SevereME

Wednesday, 29 July 2015

Green spaces for ME

 I keep reading articles about how studies have shown that having access to gardens and other green spaces helps people to cope - and I agree.

Yet, when I read some ME articles, these comments are usually intertwined with our need to remove stress from our lives so that we can recover! That is less easy to agree with.

Take this recent conversation - I was told;

"If you would just take time to appreciate the goodness in your life, your recovery would quickly follow." 

I suspect this lady, was allowing her pre-conceived notions about ME to cloud her impressions of me.  She certainly didn't know much about my life.

Anyway, I'm proud to say, I was very "zen" about this interchange.  I was not up for a debate in that moment, so I took a deep breath and then let it go!

You see I love green spaces and am very appreciative that my personal situation allows me so much access to nature.  Indeed, one of the main reasons I took to using a scooter so early in my illness, was to be able to get outside more.

But neither the "appreciation" nor the "green spaces" are going to cure me of ME!

It's just that being outside is such a nice place to be.


Immersing ourselves in nature allows us to leave some of our struggles behind as we just lie back and watch:

- the wind
- the clouds
- the trees
- the birds
- the bees
- and all the rest of nature

. . . as nature carries on  regardless of us, and our struggles.