Tuesday, May 27, 2008

The Exercise "Cure"

I don't know whether the Editor of the Glasgow Herald will afford me the amount of space I'm asking for this larger than usual response to an article promoting Mickel Therapy (link below my signature) but, worringly, advocating defying listening to your body and taking exercise. Still, I think it's worth a shot.

There are quite a lot of comments under the article online and the majority seem to be in favour of Mickel Therapy.

May I suggest that, as many as can manage, send a response - shorter than mine - to the letters page, letters@theherald.co.uk For economy of effort, just before you send the e-mail copy it and paste it in the online comments and, if you want it to appear on our website, whether they publish it or not Bcc it to info@mefreeforall.org or to my e-mail address. Same applies if you want to send any discussion point, without writing to the paper.

I think that if they receive a good number of letters, especially with a variety of views and experiences, there is more likely to be a good follow up.

I have copied mine to Dr David Mickel. If you want to, his e-mail address is drdavid@mickeltherapy.com

Although this is a therapy that has been developed in Scotland, there are Mickel Therapists practising throughout the world, so opinions and experiences from abroad are equally welcome as those in the UK.

Cheers John drjohngreensmith@mefreeforall.org

*Letter to the Editor of The Glasgow Herald, Charles McGhee*. Cc: Martin Greig, Sports Writer.

I hope - in the interests of seeing all sides of an argument and because the consequences for M.E. sufferers could be so serious, even potentially harmful - that you will allow the same space and prominence to my response, as you did to Martin Greig's article, promoting Mickel Therapy and the talk to be given by it's inventor, Dr David Mickel, in Glasgow, on Saturday 17 May 2008 (*My body told me to rest: I got better by doing the opposite, Glasgow Herald, 11 May 2008*), which prompts it.

Before embarking on any course of treatment - including Mickel Therapy - M.E. (*Myalgic Encephalomyelitis*) sufferers would be well advised to weigh up what is known about the therapy being offered and learn from other areas of medicine in order to better understand any possible risks or consequences.

It is a quite legitimate, understandable, early step in any scientific enquiry to set out with a theory. The traditional approach is to test a hypothesis and, once it has been proved valid and reliable, with a high degree of probability of repetition, usually 95% or 99%, accept that the suggested treatment is appropriate and safe. Often, treatments are tested thoroughly under laboratory conditions, or on animals, before they are given to patients, to maximise safety.

In M.E. research, the approach has too often been to skip the testing and expect M.E. sufferers to be guinea pigs (for example in the PACE -* Pacing, graded Activity and Cognitive behaviour therapy: a randomised Evaluation*and FINE - *Fatigue Intervention by Nurses' Evaluation* - trials, which are being carried out on patients before the results are in and have been assessed, a practise which would be unethical in some drugs and animal experiments).

No one, as yet, has a cure for M.E. but some people claim to have treatments which "help" people with M.E., though the ways in which this help are clearly observable, such as a return to some measure of a previously healthy life, like returning to work or school, are not always obvious.

When people have been ill for long periods of time and have tried everything suggested without success, they tend to be less critical of and take bigger gambles with, more radical treatments. There is, undoubtedly, an opportunity for charlatans but, even when the practitioners are well-intentioned, reputable and honourable, they only have a theory. Interestingly, the advocates of different radical treatments advance different theories of M.E. with equal firmness that theirs is the correct one - the hypothalamus (Mickel Therapy), amygdala (the Gupta Programme), adrenaline (the Lightning Process) - yet they all remain unproven theories.

No one - not even the practitioner - knows how they work. There is no scientific evidence for them. They are not approved by any medical organisation. They have not been independently reviewed and rely only on recommendations from people, who claim it has helped them, not balanced by any dissatisfied customers, who may be too ill to speak out or fear the consequences if they do. They are often, quite secretive, pyramid-sold treatments, practised by an assortment of people with disparate, indefinite, qualifications, such as 'life coach'. There are no follow-up studies, or statistics available, to check whether M.E. sufferers relapsed; anecdotal evidence suggests that many do. A single session often costs as much as some people, on benefits, have to manage on for a week. They rely on faith and put the responsibility to get better squarely on the patient. Thus, if the M.E. sufferer says they feel better, success is claimed for the treatment but if they say they have not improved, it may be said the patient was somehow negative or not ready for it.

In other areas of medicine, treatment is given even when the causes of an illness are not fully understood and the scale of possible side effects of treatment is unknown. The stakes are high. For example, we are now seeing some of the undesirable after-effects of chemo- and radiotherapy; I'm sure that the people behind Thalidomide had nothing but good intentions; frontal lobotomies seemed a good idea at the time. This is not scaremongering. We know, for sure, these things happen; we do not know, for sure, how many cases there are of damaged M.E. patients and whether any improvements would have been achieved without any treatment at all.

It is probable that there are many more M.E. sufferers, who have been badly affected by a particular treatment than we know about because the victims are too ill, after it, to speak out; some are daunted by the energy required to respond publicly; some fear threatened litigation, even bullying. We simply don't know the figures because the work hasn't been done. Furthermore, claims of success for M.E. patients do not take account of later relapses, again because follow-up studies have not been done and the statistics are not available.

It is also possible that the success doesn't belong to the therapy claiming it because the patient may not have had M.E. at all but some other illness misdiagnosed. Or, credit may, instead, belong to some other intervention taken simultaneously, which has not been considered, in a multivariate analysis. Or, improvement may be due to the passage of time, during which resting and gentle pacing has had an ameliorative effect. Indeed, pacing is recommended as the treatment most likely to show a beneficial effect by most M.E. sufferers, though it does require discipline and is easier said than done.

For some, it's too late once the damage is done. Patients considering any exercise treatment, even in clinics with recommended therapists, should take note of the experience of M.E. sufferers who had well-meaning advice from GPs to exercise and finished up in wheelchairs, or bed bound, from which they have not recovered their previous level. There is also experimental evidence, in this country and in Belgium, that even the more orthodox recommended treatments have no lasting benefit for people with M.E, or leave some irrecoverably worse than before.

The advice of this Research Psychologist and 20-year M.E. veteran is that it is better to have no treatment at all than one which does you no good, or leaves you worse after it. Remember, the burden of proof is on those recommending the treatment, not for patients to acquiesce for any other reason than firm evidence.

At ME Free For All. org we have a reputation for even-handedness and welcome contributions of all shades of opinion to our discussion groups at http://www.mefreeforall.org/Mickel-Therapy.212.0.html<http://www.mefreeforall.org/>

Yours sincerely drjohngreensmith@mefreeforall.org Dr John H Greensmith ME Free For All. org


My body told me to rest: I got better by doing the opposite MARTIN GREIG April 28 2008 Comment | Read Comments (35)

I remember the morning. It is seared in my memory. It was a beautiful summer day, the first of my holiday. A world of possibilities lay ahead - only I was struggling to open my eyelids. Swinging a leg out of bed seemed like an effort. I looked at my alarm clock: 9.15am.

I showered and had breakfast. The tiredness hung over me like a storm cloud. My girlfriend phoned to make plans; I said I didn't feel up to doing much. I could feel my eyelids getting heavy again. I put down the phone and looked at the clock: 11am. I wanted to crawl back into bed.

I wasn't overly concerned. I had started a new job three months previously and had been working flat out. It was August 2004. Around March or April that year I had picked up the flu, which I believed initially to be the start of my problems. I tried to work through it but never quite shook it off.

I moved to my new job as a sports writer at The Herald at the end of May, but as the months passed I felt increasingly under the weather. So I took a holiday. And here I was - sun shining, exhausted, but confident that a break would re-charge my batteries. I was, after all, 25, physically fit and had never been ill in my life.

By the third day, my best-laid plans had fallen by the wayside. I phoned in sick the following week, by which stage I was suffering from deep fatigue. I began to worry, so I went to my doctor and she sent me for blood tests. They came back clear. She could see I was drained and signed me off again, but there was little improvement. Thankfully, all my colleagues at The Herald, to my eternal gratitude, were very understanding.

I went back to the doctor. "We could be looking at something like malaria," she said. My jaw dropped. I sought a consultation with another doctor who diagnosed it as "post-viral symptoms", which was at least more likely than malaria, but even she could offer no remedy.

I was off for three months. By then, I had recovered enough to make a phased return - two days at first and then gradually building it up. After six months I was working normal hours, but still not back to where I had been before. I still felt more tired than I should have done and regularly experienced other symptoms - muscle tightness, pin pricks in my feet and light-headedness.

It was clear that physical exertion exacerbated my symptoms so I was worried that any form of it would lead to a relapse. The only real advice from medics and support groups was "pace yourself".

I tried other things. I ate more slow energy- releasing foods; I went to my bed early. The differences were minimal. I became increasingly concernedthat I would never fully recover. By then, I had realised that orthodox medicine did not have a clue what was wrong with me or how to treat it.

Hope came from an unexpected source. A friend was suffering from a similar condition and found it even more debilitating than I did, having had to stop work completely. She had been researching the series of interrelated conditions commonly referred to as ME, chronic fatigue syndrome and fibromyalgia, and her trawl of the internet threw up something called Mickel therapy. The explanations it offered - see panel below - struck a chord so she booked an appointment. I dropped in to see her one night, as usual feeling under par.

The subject of Mickel therapy came up and she said that it had started to make a real difference to her. After three sessions, she felt less tired and more confident about the future. I was delighted for her. I left feeling much more positive and e-mailed my friend's therapist for an appointment that night. I instinctively felt that this was something which could help me. In particular, two things I liked were that it did not involve any medication and was not psychotherapy. I attended my first session a few weeks later with a Mickel therapist called Lynda Carnochan.

The theory is that the symptoms of the "energy disorders" - currently labelled variously as ME, post-viral fatigue syndrome, chronic fatigue syndrome, fibromyalgia, and many more besides - are caused by a malfunctioning hypothalamus gland. Treatment involved a series of one-hour sessions during which I learned why my symptoms were there and how to work with them to regain my health.

What struck me was how practical Mickel was. It required dedication and decision-making, but I was prepared to do anything to improve my situation.

Like my friend, after three or four sessions I noticed a difference. I would still have bad days or weeks but the length between them was increasing. I started to build things back into my daily routine that I would never have contemplated previously, like physical exercise and socialising.

The process reminded me of an episode of the sitcom Seinfeld. In an episode called The Opposite, Jerry's best friend George Costanza attempts to turn his life around by doing the opposite from what his head tells him to. Instead of being intimidated by beautiful women, he approaches them. Instead of being subservient to his boss, he challenges him. As a consequence, his life turns around for the better.

When experiencing symptoms my head had always told me to rest. I realised, through Mickel, that doing so only caused my symptoms to escalate. So I did "the opposite", exciting, life-enhancing stuff that sparked positive emotions. I was apprehensive at first, but I soon started to feel like I had a life again and gained confidence from not suffering setbacks.

One night out in particular sealed it for me. It was my friend's birthday. The drink was flowing and all seemed right with the world. At one point, I looked at my watch and noticed that it was 5am. I had been partying all night and felt great. I went to my bed for a few hours, woke up early afternoon and still felt fine (apart from a bit of a sore head). In the past, I would not have gone out at all, expecting to have experienced tiredness for several days at best afterwards. I was getting better.

That was last year. The symptoms have continued to diminish. Even if they do raise their ugly head, I now know how to respond to them so that my body no longer needs to create them. Seven sessions later and six months on, I am back living the kind of active life that a 29-year-old should. It is all thanks to Mickel Therapy.

It was developed by a Scottish doctor: so what is Mickel therapy?

Mickel therapy is a ground-breaking new treatment for a wide range of chronic health conditions including chronic fatigue syndrome (CFS), myalgic encephalomyelitis (ME), post-viral fatigue syndrome (PVFS) and fibromyalgia (FMA). Developed by Scottish medical doctor Dr David Mickel, pictured, the treatment involves no medication, dietary change, supplements or psychotherapy of any sort - Mickel therapy is unique, in a genre all of its own. Treatment involves a series of sessions during which clients learn why their symptoms are present and, crucially, how to work with them to regain their health.

What does Mickel therapy believe causes CFS/ME/FMA and related conditions?

Mickel therapy is underpinned by the hypothesis that the conditions of CFS, ME, PVFS and FMA are created by a dysfunction of the hypothalamus gland. However, Mickel therapy recognises the conditions of CFS, ME, PVFS and FMA as being purely physical and not psychological in nature.

How does Mickel therapy work?

Until Mickel therapy's hypotheses and process are studied properly then the answer remains unclear. However, the results show that it does. Dr Mickel believes a whole range of chronic health conditions are created, and subsequently maintained, by the effect of negative primary emotions such as anger, fear and boredom on our physical cells. These are primal, instinctive emotions that are being created spontaneously in our mid-brain without cortical or "thinking brain" activity. Unfortunately, in our modern world, increasing numbers of people have stopped responding to these negative primary emotions, which ultimately manifest themselves in physical symptoms. Mickel therapy reunites clients with these emotions and coaches them in the constructive handling of them, to leave them symptom-free.

What does Mickel therapy involve?

# Trained practitioners meet sufferers in a series of face to-face-sessions lasting one hour. All practitioners are supervised following each and every session, thus ensuring a high standard of therapy across the board. What proof exists that Mickel therapy works? Mickel therapists point to the testimony of more than 1000 clients who report a full return to health - a 92% success rate. This, of course, requires validation by approved research. The Mickel team would welcome such research, and want to have Mickel therapy properly studied. To find a practitioner in your area visit www.mickeltherapy.com

* * *

If you improve with exercise you DONOT HAVE CFS. A hallmark symptom is exercise intolerance. I find that whenever I exercise/overdo, I get worse, and not just for a few hours, it lasts for days/weeks. There’s your proof that what I have is not depression, it’s CFS.

Whatever this patient actually had that was cured with exercise, it’s not CFS.

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