Thursday 30 September 2010

The Hard Truth

My previous post focused upon the dilemmas involved in managing an illness that is still so poorly understood. Moving on from that, I want to now address my Grand Plan of Action. Okay, so maybe the capitalisation is overdoing it ;)

The past week has contained some challenging days. Days where I've seriously wondered whether I have the desire and strength to persevere for the long haul. To clarify, I don't mean I am suicidal or depressed (although I naturally have periods of low mood, as anyone in this situation would). I mean from a more pragmatic point of view. If my life for the foreseeable future is to be led from a sofa/bed and I am unable to retain enough energy and concentration to do meaningful things that stimulate my mind then how much quality of life is there?

Part of my journey has been to learn as much as I can about my illness and how best to manage it. I now feel I have a reasonable grasp of what I'm up against and have digested the views of many different leading practitioners who have been working with M.E. patients for some time.

The first thing my knowledge has provided is a dose of realism. It's natural that people will tell me I'll get better soon etc. Even I still sometimes refer to myself as being temporarily unwell. But let's be realistic and use real data involving real people. The likelihood of me making a full recovery and being the person I was before I got ill is around 5%. Which of course means there is a 95% chance I won't ever be the old me again. Amongst that 95%, it is roughly split in half between the probability of having periods of remission and relapses (boom and bust in economic terms!) and the probability of getting progressively worse before I stabilise.

Now, I'm not being a doom and gloom merchant here and I'm not giving up all hope of a recovery. Rather, I am merely being realistic in gathering comprehensive data as opposed to anecdotal tales of individual outcomes. So, what about the stories of 'magical' recovery using techniques such as the Lightning Process or other 'mind over matter' approaches?

Undoubtedly the mind is a massively powerful tool and plays a huge part in how we feel physically. I completely accept that. However, if I do indeed have M.E. then there are various things going wrong within my body at a cellular level that positive thought or determination cannot possibly cure. I mentioned in my previous post that the landscape of understanding of M.E. is a rather unruly mess. To expand on that a little, I think I now have a better grasp of why M.E. and CFS should not be used on an interchanging basis.

Chronic fatigue is a symptom rather than a diagnosis. Yes, I have fatigue but it is only one element and probably not even the main one. I have had post-viral fatigue before and I can say with absolute certainty that this is way different. In fact, this all probably started with post-viral fatigue (I was sleeping lots and lots in the early period) but it has developed into something much wider. I'm still not totally convinced that M.E. (as defined by the World Health Organisation) is the correct term for whatever is wrong with me but I must accept that there is currently not an adequate clinical definition at this stage. It is my belief and hope that this will change in the future and that a better understanding of my condition will lead to a more appropriate clinical definition. It's not an easy task as every time I try to pin a description on it I am reminded that I am describing symptoms rather than disease itself.

I am therefore convinced that there needs to be a separation of those who have chronic fatigue syndrom/post-viral syndrome from those who have what we currently know as M.E. in order that clinical diagnostics are more readily definable. It might sound like I'm saying I am more ill than someone with post-viral fatigue syndrome or more deserving of research/sympathy/compassion but that isn't it at all. The waters are murky because a whole load of conditions are being lumped together under the M.E./CFS bracket and that makes the task of classifying, researching and treating the conditions almost impossible.

So, now that I've dipped my toes into these politically charged waters and risked the wrath of those in the community who disagree with me, what next?

Independent research is still the way forward, I feel. I've been able to build up a comprehensive understanding of what different treatment methods are being used in various specialist clinics (not NHS ones, i'll come to that in a minute!) and of the theories surrounding what is going on within my body. I am still of the view that nobody has yet uncovered the full picture and therefore I must approach each theory with a healthy dose of skepticism. However, impressive track records exist in various countries, including my own, in terms of managing similar conditions and I should not ignore that.

I mentioned the NHS. The current NICE guidelines worry me a lot and the more research I do the more I am convinced that I should retain control of my own treatment plan. Graded Exercise Therapy is a key tenet of those guidelines and is something I will be encouraged to partake in. There is overwhelming evidence that suggests to me this increases the likelihood of a severe worsening of the condition and I will be refusing that particular method of treatment.

So, now I've mentioned all that is wrong - what is right? Well, I will make use of this blog to cover in detail the treatments I am going to be relying on. In fact, my next post will begin that process in earnest. I say this with a full understanding that I am merely 'managing' my illness. There is no cure (yet!) but my understanding of what is going wrong within my body, and the clues afforded by various pioneering souls in the medical community, does allow me to make some pragmatic choices about how best to lessen symptoms. That in itself would have a major impact on my daily life. Imagine if I could have a shower without feeling like I'm going to pass out afterwards or walk to the bathroom without feeling like my heart is going to burst out of my chest or without breathing like a breathless old man. Yes indeed, managing symptoms and reducing their severity even a little will benefit me greatly.

Take care,

Barry

Thursday 23 September 2010

Rest or Treat?

The focus of this post is a dilemma I have been wrestling with for some time now.

To illustrate this dilemma I will begin by stating what I KNOW and what I DON'T KNOW.

I know that I am not well enough to live a 'normal' life. I know that a bunch of the everyday bodily functions we take for granted have become faulty within me. I know that I cannot seem to produce or restore energy for my body to use. That is pretty much all I know.

Then we get onto what I don't know. I don't know what exactly is wrong with me. I don't know how exactly to get better. I don't know what exactly is going on within my own body (at a micro level).

As this illustrates, I'm pretty much clueless still. Despite all my research and time spent considering different theories I am probably no closer to understanding my own lack of health. From the beginning I have wrestled with establishing the best approach to looking after myself and helping myself get better. I have no energy so I try to rest a lot. This seems sensible as surely my body is telling me that's what I need? On the other hand, I feel I should be doing something specific to help my recovery. The NHS is even more clueless than I am on this subject, it seems, so that's not an avenue of help for me. I research supplements and alternative treatment options and begin filling my body with various things that might help.

Which approach is correct? Rest and recuperate or actively treat the illness? This is where things get a little circular. Let's go back to something I DON'T KNOW..... I don't know exactly what is wrong with me.

This is the fundamental source of frustration for me and makes my recovery plan a bit like pissing in the wind. None of the explanations my medical advisors or the community were providing were satisfying my mind as they were vague and, in some cases, downright illogical.

For the purposes of having a label attached to my illness I say I have M.E. or Chronic Fatigue Syndrome. Dig deeper into these terms however and it's a mess of contradictions and poor logic. 'Experts' no longer seem to be able to explain the difference between M.E. and CFS and patients have come to use the terms on an interchanging basis. The World Health Organisation classify M.E. as a neurological condition. The neurologist I saw pretty much said there was nothing wrong with me. M.E. in pure terms is an inflammation of the brain stem and/or spinal cord as far as I can tell.

Do I have M.E.? Is my spinal cord and/or brain stem inflamed and causing neurological problems? You'd think that'd be an easy question to answer but it seems not.

Then we have Chronic Fatigue Syndrome. Again, none of the 'expert' explanations were satisfying my mind. There is much talk about the viral link now and this has never seemed right to me. I'll state again for the sake of clarity that I am glad it is getting positive media attention but it seems to be missing the point as far as I can see. Chronic fatigue is, in my eyes, a symptom and nothing more. Any viral infection we might have, be it XMRV or anything else, is another symptom. This does not explain the root cause. Of course people with messed up immune systems are going to be susceptible to catching a virus. Of course people with messed up bodily functions are going to suffer fatigue. There is surely a bigger picture here that we are missing.

So, with all this in mind, what do I do? My approach thus far has been to mix rest with supplementation. I'm sure none of the supplements I am taking are doing me any harm but are they helping? Who knows. What I do know is that I am spending a considerable amount of money on them without knowing if they will help. I'm effectively housebound and am earning very little so spending money is limited.

All of this frustration and guessing doesn't sit well with me. I am the sort of person who needs clarity and definite answers. A clear path to follow. By chance, that path is becoming a little clearer now my research has taken me in a different direction. This post is already long enough so my next update will focus on what I now know and how I am going to use that knowledge to formulate a treatment plan for myself.

Take care,

Barry

Monday 13 September 2010

Decisions

I should begin my reassuring any readers that I'm not going to be wallowing in self-pity this time around. My previous update showed a very unattractive aspect of how I'm coping with being ill and I know it didn't paint me in a very good light. However, I wanted to acknowledge that there are days when I feel exceptionally sorry for myself and get angry with 'fate' for bestowing this on me. Writing about how unfair life is becomes a pointless task and it helps nobody to read it so I will be avoiding such posts in future.

Today I want to focus on some great work being done on M.E./CFS in the form of an upcoming documentary. Please visit this link for more information. Part of the pre-production work is asking those impacted by the illness to post their personal stories in the form of videos. Seeing an intelligent, determined woman be reduced to only being able to speak in a whisper and hearing a story of a child with the condition who wasn't believed and was taken away from his parents by social services then thrown in a swimming pool to force him to swim allows me to once again be thankful that I am not in the grasp of something much worse than my current condition. I will try to post more information on this documentary as progress continues.

Also, over the past week or so, I've made decisions about my future and taken action. I have now contacted my University to confirm I am unable to attend this year. And, I have sold my car. I was avoiding making both of these decisions as they are confirmation of my current loss of independence but it was unrealistic for me to hope against hope that I would make a miracle recovery and I actually feel inwardly calm now the decisions have been made.

I had a period recently where I was achieving sustained bursts of feeling mentally alert (although obviously not too alert as I managed to scald myself with hot tea and knock my laptop over, busting the hard drive!). I was having period of 4 or 5 hours at a time when my mind felt light and clear and I was able to concentrate on tasks. This was bliss and I mistakenly took it as a signal I was recovering after 4 months or so of illness. Needless to say, it was only a temporary thing and I am back to being zonked again and having long period of having to stare into space or sleep. It's disappointing to feel back at square one again but I think that is just the nature of the illness and I will in future just be grateful for those brief periods of lucidity.

Take care,

Barry