Ostheopathy and Chronic Fatigue

I have given you an account of my adventures into acupuncture, and now I have taken a leap into another homeopathic discipline.

I was raised a true ‘science person’ and so anything that isn’t traditional medicine I am naturally suspicious of. However I have spoken to many people who have had good experiences with chiropractors, and so I started looking into it. I found osteopathy to be more appealing than my original topic of chiropractors, as it seems a bit more all round and used lots of science words.

My first visit was very similar to my first acupuncture session, we spent the entire time combing through my entire life and medical history. What was my childhood like? What was I experiencing emotionally at the moment? How about physically? The big difference came in how much of a two way process this was. My osteopath, Josh, would often pause and lean back, before repeating back something I said, suddenly bringing my attention to a flaw in my thinking. Josh is very good at this, he can say something very simple and suddenly I’m thinking “really? Is that how I said that? I am looking at that so wrong!”.

For example the biggest revelation of my first session was that I was referring to my body as “it” not “me”. I had a huge disconnect between brain and body. I saw myself as my brain inhabiting a body that wasn’t doing what I wanted. Seeing that made me start to look at things in a different light, I’ve always considered managing my CFS as working in partnership with my body, so what does this mean for that?

Josh explained it as: your body senses things and then the signals are passed to your brain, so your body is always a step ahead of your mind. This means I’m now working on trusting my body and it’s reactions instead of analysing everything endlessly. I’m a bit tired? Rest. It feels good to stretch a muscle? Do it!

I know it’s sounding a bit like therapy from how I’ve described it so far, and sometimes it feels a lot like it too. The key difference is that we focus on the physical a lot of the time, although sometimes that leads us in to bottled up emotions as they cause a lot of tension in the body!

My main take away so far that I’d like to share is that with CFS we often take pain or fatigue as a sign to completely stop, but it is worth taking the time to play around with whatever you are doing. If you are standing and you get tired is there another way to stand (maybe introducing some leaning?) that could alleviate some of that? When sitting, is there an adjustment to posture that changes your aches and pains?

Josh calls this “being creative with movement” and I’ve found particularly with activities that involve a lot of standing, I am able to prolong my endurance and reduce symptoms the next day by making sure I move about a bit rather than standing totally still. It seems counterintuitive as I’ve always though more movement = more energy used = more symptoms, but actually mixing things up makes a big difference.

So would I recommend osteopathy to others with chronic conditions? Yes, it seems to help connect the dots of what you are experiencing emotionally and physically to find ways to improve symptoms. I wouldn’t expect drastic results, but new coping mechanisms are always welcome!

Side Effects – Do I want to know?

Magicians who work with hypnosis and suggestion will often say that some people are more susceptible than others. The same is true of the placebo effect and it’s antonym – the nocebo effect.

I first heard of nocebo through a youtube video, it started out by pretending to be about frequencies of noise, and stated that it would play a sound that was beyond human hearing but caused ear pain and headaches. As soon as the sound was played I covered my ears, such pain! My husband looked at me like I was mad. He felt nothing. He was incredibly smug moments later when the video announced there had been no sound. I was shocked, but I had felt it! How could I have had pain in my ears at that exact moment if there was no secret pain sound? The answer was simple, nocebo. The idea that by telling someone “this will hurt you” it will hurt them.

I was not surprised that I was susceptible to the nocebo and my husband was not. I am quite a gullible person generally whereas he is always the sceptic. When I’ve walked into work and someone has asked “Are you okay? You look a bit ill” I will quickly think “actually I don’t feel that good”, whereas moments before I would have said I was fine. My husband however is ever the contrarian, “you’ll like this film” almost always ends up with “this is rubbish”.

So armed with this new knowledge that I am susceptible to negative as well as positive suggestions I have taken to avoiding things that will negatively bias me. A major one is that I do not read the side effects leaflets when I get a new medication. How will I know if I am really having a side effect or just experiencing a nocebo? There is no way to know, so by avoiding reading about them I guarantee that anything I feel is real. It’s a weird feeling questioning your own reality and I try to avoid it wherever possible.

Recently though I had a genuine side effect. I have recently made a change from citalopram, my antidepressant since 2016, to mirtazapine as after 3 years I wasn’t getting much of an effect anymore so I made the long and stressful change over. This transition meant weaning off of one and onto the other across a couple of months. After a week of the full dose of mirtazapine I started having an insatiable hunger. This was around the time I posted about trying to lose weight, so at first I thought my cravings were a reaction to trying to eat less. However no matter how much I ate I was still ravenous. One day I literally ate until I was sick. It was awful!

When I went to the doctors for my fortnightly check in I mentioned that I was having issues with eating as I was worried I had developed an eating disorder (I have previously had issues with food as a teenager). The doctor was surprised and we talked about possible causes and then suddenly she said “AH HA! It’s the new drugs!”, it turns out the group of drugs that mirtazapine belongs to are known for causing ravenous hunger, particularly cravings for carbs (something I did not need help with as I am already a pasta addict).

This caused me to reflect, when I had approached the doctor about changing antidepressants, we had selected mirtazapine as it helps with sleep, and I had been having bouts of insomnia. Would I have gone with it if I had known this side effect though? Probably not. So should I have done more research into the options available and what potential pitfalls I might experience? I don’t know is the honest answer. As someone who is highly suggestable reading all the side effects would have meant I was looking out for them and potentially willing them into existence. However the trade off is I am now having to work around a very unhelpful side effect because I wasn’t educated in the risks.

Is ignorance bliss? Or does being armed with the facts alway help, even if, like me, you might end up experiencing a nocebo effect?

Acupuncture and CFS

As the child of science teacher and an engineer I am a big sceptic about homeopathy. I am of the opinion that if something works it becomes medicine, so alternative medicine must not work. However when struggling with a chronic health condition you try anything.

My encounter with acupuncture was before I was actually diagnosed with CFS, when I was stuck in the horrible limbo of feeling awful and not knowing why. My CFS initially presented as chest pain and a fatigue I put down to struggling to breath comfortably. I was desperately trying to continue my normal day to day life but my body had other ideas!

That was when someone at work who I respected and thought of as a very logical person suggested acupuncture. Immediately I was incredulous, how could someone I thought of as very smart be suggesting such a silly thing? A week later I booked an appointment. Funny how desperation overrides being stubborn!

The first session we spent 90% of the time going over why whole life, every illness, every trauma. The practitioner was very nice, she seemed to know what to ask, and was very interested in the whooping cough I’d suffered from as a child as she felt my current pain was linked back to previous experiences and traumas.

Then came the part I was dreading, I had to undress and lay on the table ready for the needles. I have had a phobia of needles since I was a child so it had taken a lot of courage to try acupuncture (okay more desperation than courage but whatever gets you through!).  I braced myself for each tiny sting as she put needles into my wrists and ankles. Inwardly I rolled my eyes, my chest hurts so you are stabbing my feet and hands? after about 6-8 needles were in place she stopped. Is that it? I’d assumed I’d be a full hedgehog.

She moved next to me and placed her hand on my sternum. Now at this point in my CFS I could not stand any pressure on my bestbone, even the tension of breathing hurt it. The doctors had been considering costochondritis, an inflammation of the connecting tissue either side of the sternum, as the potential diagnosis (later disproved by an ultrasound that showed no swelling). So when she pushed down I braced myself and tried not to whimper… but it didn’t hurt. I was in shock.

“That didn’t hurt!”

“Yes” She nodded, this is what she had expected.

“No, it really didn’t hurt!”

I have inadvertently let my shock show, revealing that I thought this was bollocks up until a moment ago. She looks mildly annoyed by hides it well.

“It actually doesn’t hurt!” I double down on insulting her profession with my shock. Usually I am much more tactful, but it’s like I’ve just seen a magician turn a skyscraper into a rabbit. How can pins in my wrists and ankles stop my chest hurting? It is so bizarre and illogical I cannot compute it, but it works. Undeniably it works.

Further research has shown that scientists agree with me, they don’t really understand why acupuncture is effective at pain relief, but it is. I’m sure all the practitioners out there would explain it’s to do with energy flow and blah blah, but my understanding of the nervous system and my experience having acupuncture just don’t line up. Does it matter? Not really, if something works for you that’s the important part, the why is just for interest.

I continued having acupuncture once a week for a few months, and found that it would relieve my pain for a few days at a time. Not a permanent solution and in the end too costly to keep up, but I will never get over the feeling of wonder I had that first session when it worked.