Mindfulness

I said a while back I was going to do something on mindfulness, and it’s taken this long because I hit a few hold-ups along the way. First computer issues, then health issues, and then there’s just so much stuff out there about mindfulness, and some of it is. . . not contradictory exactly, but it seems to have become a bit like yoga: some of it has become ‘popularised’, and then there are a lot of different methods. This being the case, I fell back on a few go-to sites.

The NHS has a page on mindfulness (here) which gives a basic description as well as links to find out more. It describes mindfulness as “knowing directly what is going on inside and outside ourselves, moment by moment.” In other words it means being aware of yourself and the world around you, and taking time to notice both. The idea is that mindfulness encourages an appreciation and enjoyment the world. It can also help with stress and depression both through the fostered connection between person and environment, and by helping people to notice the signs of stress or depression and deal with them.

In addition to the general introduction – which is one of the clearest and most reasonable I’ve seen for mindfulness – I really liked that toward the end there was this comment:

“Mindfulness isn’t the answer to everything, and it’s important that our enthusiasm doesn’t run ahead of the evidence,”

My next visit was to Wikipedia, which had the same basic definition: mindfulness is a process by which people focus their awareness on internal and external experiences taking place in the present moment. It had a lot more on the psychological aspects, its origins and links to Buddhism, and how it can be used in different settings. It added that clinical studies have come up with results suggesting there are both physical and mental health benefits to practising mindfulness, and it be of benefit to healthy people as well as those with various medical conditions.

The final site I visited was Be Mindful, which had something of the same definition but presented in a way that instantly put me off. (Don’t ask me why because I don’t know, but a lot of the mindfulness stuff just makes me want to cringe/laugh, then run away while wishing desperately never to hear anyone talk about it ever again) Be Mindful advocates the use of mindfulness techniques as tools to manage your wellbeing and mental health. This includes its use to alleviate stress, anxiety, and depression by helping people manage difficult experiences and situations. There is information on evidence and research, finding a teacher, learning online, and FAQ’s. They also do an online stress test.

The two most common link-ins with mindfulness are meditation and yoga, I guess because both of these skills promote taking a bit of time out of a hectic day to slow down and breathe. And there’s the whole self-awareness and breathing techniques aspect.

I’m not going to go into any of this any further right now because a) I don’t want to bore anyone not interested even if those people stopped reading after the title, b) I’m sure most people reading this blog are more than capable of typing in a search term and finding these things for themselves, and c) I don’t see much point in merely repeating information that’s already out there.

As always, let me know if I’m wrong!

Questions for A Doctor – Part 3

A couple of months ago I went to see my GP (Questions for a Doctor) and was referred to an ME/CFS clinic. I phoned to set that up and was told I would then need to wait for them to contact me – the consultant had to review my case. Fair enough. While waiting to hear back I received three letters saying I hadn’t taken up my referral and could I please do so. I also had my GP asking if I had done anything about it. I phoned the clinic again and was told I had to wait. Apparently not only is there a long waiting list but their system doesn’t mesh with the NHS system, which is why I kept being sent letters I had to ignore.

I waited some more.

Yesterday I received the letter:

“We would like to welcome you. . .”

Yes! Even better the phone interview is the end of this month, and my appointment at the clinic next month. Very impressive considering I was told the waiting time to get an appointment, which you only got after the phone interview, would be several months. It’s nice when things work out like that isn’t it? Unless the consultant took a look at my file or whatever and decided I was a sad case indeed – get this person in as soon as possible!

Anyway, I now have that to look forward to: a half-hour phone interview talking about my condition when I have a phone phobia, followed by a visit to a clinic I’ve never been to before where I’ll have to talk about it some more. (Am I nervous? No, I’m not nervous. Of course not. Why would I be nervous? Or anxious. Or worrying. Or starting to think about what they might ask and how I might answer and what if I don’t explain it very well because it can get quite complicated and sometimes I forget things and–)

Ok. It’s all good. Because this is a good thing. Right? Yes. So, phone, appointment, oh, and I have to fill in a nine page questionnaire plus two pages for ‘describe a typical weekday’, ‘describe a typical weekend day’. Wonderful. All those strongly agree/strongly disagree type questions on something that can range right from one end of the spectrum to the other depending on if it’s a good day or bad.

One other slight problem: what’s a typical day? Typical day when I’m well, when I’m ill, typical day at the moment. . .? Typical day in summer? A rainy day? And who has ‘typical’ days anyway?

Enough of the rant – apologies for that! – The point is I’ve got the letter, the appointment, and I’m hopefully on my way to getting some answers/advice. Since they have to re-diagnose me before they go any further, I don’t know whether to hope for the ME/CFS diagnosis or not. Either way will mean a string of appointments with no guarantee of any treatment or improvement. Still, even if I just get told I’m doing an okay job and to carry on, at least it’ll be some reassurance that I might be doing the best I can.

Manual Therapies

Manual therapies (so I have recently learned) are those that use the hands to treat disorders of bones, muscles and joints. In this post I’ll look at physiotherapy, chiropractic, massage, and acupuncture. Although acupuncture is not a manual therapy (no direct use of hands) it fits in quite nicely with the others! It should be noted that although only physical symptoms are treated with these therapies, they can also promote mental and emotional wellbeing.

Both physiotherapy and chiropractic work with all ages of people. The treatments are most effective when the patient is actively involved in the process – when they listen to advice given and act on it. This means (for example) if you’re told to do certain exercises, then do them. If you don’t do the work you won’t see an improvement, and if you’re not going to follow the advice you’re given then why go?

“Physiotherapists help people affected by injury, illness or disability through movement and exercise, manual therapy, education and advice.” The Chartered Society of Physiotherapy.

Physiotherapists work in various settings including hospitals, health clinics, and sports centres. They help patients with various health conditions, including those affecting bones, joints and soft tissues; brain or nervous system; heart and circulation; lungs and breathing. Main approaches used are education and advice, tailored exercises, and manual therapy.

“Chiropractors are trained to diagnose, treat, manage and prevent disorders of the musculoskeletal system (bones, joints, and muscles), as well as the effects these disorders can have on the nervous system and general health.” British Chiropractic Association.

Chiropractors use a range of techniques to treat patients, focusing on gentle manipulation of joints and massage. Treatments can also include advice on diet, lifestyle, exercise and posture; assignment of exercises to do at home; use of ice, heat, ultrasound, and acupuncture. Because chiropractic is seen as a complementary/alternative medicine, it isn’t looked on favourably by the medical profession and is not commonly available on the NHS. This means you’ll probably have to pay for treatments privately.

Massage: “the rubbing and kneading of muscles and joints of the body with the hands, especially to relieve tension or pain”Google.

Massage is often viewed as an indulgence, but it can also be of benefit to your health and wellbeing – if done properly a good massage can significantly reduce pain and tension, and improve your mental state. It can be offered as part of other therapies, such as the Chiropractic, or it can be a treatment in itself – e.g. a sports massage. There are also different levels of treatment ranging from gentle and relaxing to a deep tissue massage that will probably leave you with a bright red back.

“Acupuncture is a treatment derived from ancient Chinese medicine. Fine needles are inserted at certain sites in the body for therapeutic or preventative purposes.” NHS.

Although acupuncture is a complementary/alternative therapy, it is becoming more accepted by the medical community and is available in some circumstances on the NHS. There are differences between Western uses and the traditional Eastern methods, and so you may wish to find a traditional practitioner to visit. Acupuncture is most commonly used to alleviate pain, although it also helps a variety of other symptoms. (A consultation will be required to determine the best course of treatment) As well as improving specific symptoms, it can produce a feeling of wellbeing.

A few words of warning:

  • If you seek treatment from a practitioner of any of these therapies it is up to you, the patient, to check their credentials. Look to see if there are certificates displayed (what for and where are they from), ask about their qualifications, do a bit of research on the practice beforehand. You are trusting these people and it’s not out of place to ask a few questions.
  • You may experience some pain after a treatment, however it shouldn’t last much beyond that day. Speak to the practitioner or a medical professional if you’re concerned.
  • Not all practitioners work in the same ways, even within a single discipline, so you may have to try several different practices before you find one that suits you.
  • Although physiotherapy and chiropractic sound similar in some ways, they are not the same.
  • Most of these treatments will require an initial consultation followed by a series of appointments.
  • Treatment can become expensive, especially if you go regularly.

 

External links:

Questions for a Doctor – Part 2

I went in for my blood test results and, surprise surprise, everything is fine. Which is only what the doctor suspected of course and these blood tests are only being done because the ME/CFS clinic she referred me to wants them done. . .

In fact I did have two borderline results. One was vitamin D (Uh, it’s the end of winter and we’re in the UK, most of the population probably has slightly low levels right now) and the other was iron. What was done? I was told to “get out more, you have to get out!” and given a prescription for iron tablets because “someone as young as you shouldn’t have levels that low.” The woman is obsessed with my age!

And she wasn’t done with me yet. “What changes have you made to your lifestyle since I saw you last?

To put it politely, I was flabbergasted. (An excellent word don’t you think?) What changes was I supposed to be making exactly? As far as I could remember, she hadn’t told me to do anything except go for the blood tests. And get a job. Was I supposed to have done that within the last few weeks, while I’m only just recovering from the effects of a Christmas cold that lasted over a month? As it happened I’d also had an infection under a tooth which was leading to an abscess and had been in agony and taking painkillers by the dozen the last week or so, along with antibiotics prescribed by my dentist.

You’ll be amazed to hear I hadn’t felt up to doing much. Not that I knew I was meant to be doing anything in particular anyway.

When I explained about the toothache (such a poor description!) she nodded understandingly and asked if something like that set me back. Set me back. I had barely eaten for days and nearly called emergency services (not that she knew because she didn’t ask) and she wonders if that sort of thing sets me back.

I’ll admit I was a touch annoyed by this point, and my temper wasn’t improved by her conclusion that the next step was to have the ME/CFS clinic re-diagnose me so that they could sort me out.

I could almost hear the suggestion of, ‘therapy for a start, to correct your wrong-thinking and get you up and out into the world, because you’re too young to be malingering and wasting your life like this.’ For clarification, this wasn’t said aloud, but it’s certainly the impression I got.

Oh, and after I’ve been to the clinic I’m supposed to make another appointment to see my doctor to ‘give her feedback’. Does anyone else think this would be a waste of resources? I’m sent to the clinic because they know (hopefully) what they’re talking about and how best to help me. Why then do I need to report back to my doctor? Aren’t doctors able to contact the clinic directly anyway? If that sort of thing is happening a lot, it’s no wonder the NHS is struggling.

I can only hope I have a better time at the clinic, because this doctor really isn’t doing much for my faith in the medical profession.

Web-View: NHS

The first link I chose when looking for information on ME/CFS was the NHS website, assuming it was going to be trustworthy, up-to-date, and have plenty of information.

The condition can be found in the Health A-Z (or use the link above) under Chronic fatigue syndrome or ME. Both take you to the same pages, titled ‘Chronic fatigue syndrome’ which then offers various sections:

  • Overview – divided further into an introduction, symptoms, causes, diagnosis, and treatment.
  • Clinical trials
  • Community
  • At the right-hand side are lists of useful links, both within the NHS site, and external

On the Overview the information is reasonably well laid-out and easy to understand, but it’s pretty general: gives the basics and little else. (Which I guess is kind of the definition of an overview)

The clinical trials tab offers a database search of trials currently taking place. You can filter by whether or not they’re recruiting, trials for children, and which country they’re taking place in. Selecting a link takes you to further details of that trial.

The community has a forum for questions and blog posts, although I’m assuming you need to join/sign up to participate. As you might have guessed from my lack of detailed knowledge, I haven’t been active here, only peeked at the initial page.

Overall I found the website has good basic information which I trust to be accurate at the time of posting (Somewhere on the page should be a ‘last reviewed/next review due’ date) and it seems to be checked every couple of years. I guess a slight concern is, is that often enough to count it as up-to-date? Then again, there haven’t been any major changes in the basic understanding of symptoms, treatments, or causes, and presumably if there were the people who maintain the site would know and update accordingly. Although it doesn’t have masses of detailed information, it offers links to places where there is more: more details of the condition, more support, more information on research.