What’s a Syndemic daddy??

According to our friends at Wikipedia “a Syndemic or synergistic epidemic is the aggregation of two or more concurrent or sequential epidemics or disease clusters in a population with biological interactions, which exacerbates the prognosis and burden of disease”. The term was developed by Prof. Merrill Singer in the mid 1990’s. it was recently bought to my attention by the author and lecturer Ben Brown.

Now let’s imagine we introduce a virulent viral pathogen into a sickly, ageing population, the multiple co morbidities would turn the disease into something which may kill well in excess of 100,000 people and cripple the country for months on end. Sound at all familiar??

Don’t expect either the Government or anyone connected to the Health Service in the UK to start talking Syndemic any time soon as this would mean acknowledging the monumental failure in the management of the country’s health policy.

A brief look at some of the latest statistics tell us all we need to know:

Obesity – NHS figures published May 2020 (for England) – 67% of men and 60% 0f women are either obese or overweight. 20% of year 6 children (aged 10 – 11) are obese. The “best guess” estimate for the UK is that 30 % or 22 million people are obese.

Diabetes – Even the 2015 stats from Diabetes UK show that at least 3.5 million people have diabetes with at least an extra ½ million having the condition as yet undiagnosed. The vast majority of these cases are type 2.

Respiratory Illness – The British Lung Foundation inform us that “surveys of the general population suggest that approximately 12.7 million people in the UK have a history of asthma, COPD, or other long standing respiratory illness”

Cancer - Cancer Research UK statistics show 367,167 new cases of cancer 2015 – 2017 and 166,533 deaths 2016 – 2018 with 38% of cases being preventable (2015)

Heart/Circulatory disease – The British Heart Foundation state that a quarter of all deaths in the UK (over 160,000 deaths each year or an average of 450 per day) are due to heart or circulatory issues.

Dementia – Alzheimer’s Research UK tell us there are 850,000 people with dementia in the UK and that 1 in 3 people born in the UK this year will develop dementia in their lifetime.

In my opinion it is nothing short of a National disgrace that the only health advice we hear from all politicians is the more and more incessant mantra of vaccines, social distancing, hand washing and mask wearing. Important as these things maybe if we addressed the “elephant in the room” of the underlying health decline each individual would be much better placed to possibly avoid serious illness or even death.

I am fully aware that susceptibility to the virus does come with a large genetic component and that some young, very fit people have lost their lives but on average, improve systemic and particularly immune health and you are on the way to a better outcome.

The normal total reliance on pharmaceuticals is also worrying, there has finally been an official confirmation that vitamin D deficiency may have an effect on immune health but, par for the course, the likes of vitamin C & A, Zinc, Selenium, probiotics et al have all been ignored despite the amount of research showing the potential benefits.

However, before laying the total blame at the door of the authorities there is another problem, many, dare I say a majority, of people who simply don’t care about taking pre-emptive action for the sake of their long term health and as long as there is a perception that the NHS will get them out of any hole which they dig for themselves with a plethora of pharmaceuticals they will accept illness, infirmity and living in a disease state for the last 10 or 20 years of their lives as totally “normal”.

As I have said on many occasions “normal” may be a nice place to visit but I wouldn’t want to live there!!

Outside of this (large) group there are those who do care sufficiently about their health and are prepared to invest some money in their future health of that of their loved ones. Most people however need to rely on the mass media and conventional health outlets for their information which at best is often confusing and often simply plain wrong.

For those of us with a degree of knowledge of the benefits of eating “real” food, exercise/activity, mindfulness and the small lifestyle tweaks that can prove so beneficial there is a real opportunity to reach out and help those who want to be helped.

Looking beyond the current crisis, SARS-CoV-2 is now among us and will remain to be so. Arguably the more man destroys natural habitats the greater the likelihood of new Zoonotic diseases being spread among populations becomes and we still have all of the other chronic diseases of the 20th and 21st centuries to protect ourselves against.

Given previous track records Governments are effectively clueless, the NHS is great at trauma care and “sticking you back together again” but is historically very poor at anything preventative. We therefore are perfectly placed to help people become the CEO’s of their own health and guide them to a future where it is accepted to remain robust, healthy, vibrant and cognitively alert into our 70’s 80’s and beyond.

Paul K Ehren

February 2021

Mindfulness & the turning of the year

This piece was inspired by a recent webinar from the ladies at The Chrysalis Effect (TCE) who specialise in long term care and recovery from Chronic Fatigue Syndrome (CFS)/Myalgic Encephalomyelitis (ME) and who have been quoted before on modules of the CISN Post grad course.

Due warning, I am going to explore some quite deep philosophical arguments which the hard-bitten scientists among you may find a bit left field but for those who get off on this kinda stuff, draw up the comfy chair, pour a glass of good red and we’ll jump in!!

The webinar was a discussion on healing protocols used by TCE and how they integrate with nature, the changing of the seasons and traditional remedies. It was presented by Heidi Bamford, a Natural Physician, Doctor of Chiropractic and Kinesiology practitioner who herself suffered years of CFS before using TCE to effect a cure. She is now a practitioner at the centre.

There were a number of things contained in the presentation that resonated with me and I thought worthy of a little debate.

Firstly, the mere fact that the presenter had herself succumbed to this all-embracing malaise is a reminder to us all that even though we may have a certain knowledge of nutrition, exercise, therapies etc we are not immune from falling sick. Indeed, I would argue that those at the front line of caring for others and regularly taking other people’s problems on to their shoulders may well be more at risk. The more empathic you may become (which Pete Williams argues is the corner stone of a good practitioner) the greater the possible risk of ignoring your own health. The classic irony!!

Turning now to the main thrust of this piece, the use of nature in healing protocols.

First question, why do I and many others place such faith in the power of nature, its rhythms and its energies to not only heal us but more importantly to prevent us from becoming sick in the first place?

For years I have considered myself something of a Pagan, I feel more alive in green or blue spaces even though I was bought up every part the “City kid”. Although necessary, I find grey concrete “sucks your soul” after a while and that a recharge in the woods or by the coast is very much part of my life. This is not purely an intuitive thing as the more I learn of integrative medicine and nutrition it sets to confirm my thoughts that natural seasons and rhythms underpin so much of what we do.

A quote that I have used many times before goes to show it was ever thus:

2500 years old and possibly the greatest 100 words ever spoken on the integrative nature of Nutritional Therapy, Strength and Conditioning, Sports Nutrition and Functional medicine. Relevant to this article “……when proper attention is given to the season of the year, the changes of the wind, the age of the individual and the situation of his home…….”

Notwithstanding ancient Greek thought, this view of nature would have been completely alien to my parents and for many generations who proceeded them. Now, why might this be? Here’s my own theory for better or worse and this is where we start to get really deep.

Friedrich Nietzsche famously stated “Gott ist tot” - “GOD IS DEAD” - in both “The Gay Science” (1882) and further expanded upon the theme in “Thus Spoke Zarathustra” (1883 – 85)

“God is dead, god remains dead and we have killed him. How shall we comfort ourselves, the murderers of all murderers? The holiest and mightiest of all that the world has yet owned has bled to death under our knives: who will wipe this blood off us? What water is there for us to clean ourselves? What festivals of atonement, what sacred games shall we have to invent? Is not the greatness of this deed too great for us? Must we ourselves not become gods simply to appear worthy of it?”

One interpretation of this, and one I tend to agree with, is that after the Scientific revolution of the 16th century, the Age of Enlightenment of the 18th century and the Industrial revolution of the 19th century many learned minds where far less able to accept scripture, tradition or other incomprehensible divine forces as a basis of beliefs in favour of reason and evidence.

This itself can take us in 2 directions, either we can see hard science as the answer to all questions and that everything can be explained in a laboratory experiment or by way of some mathematical algorithm or we can look towards the natural world and attempt to harmonise our place within it. The answer, as ever, I believe falls somewhere in between.

The Chrysalis Effect use a 6-step program in their natural healing protocol:

• Consider the season and what nature is doing at the time. Acknowledge you are part of the rhythm.

• Spend more time engaged in nature.

• Consider a more seasonal based diet.

• Integrate ancient wisdoms into your life and how better to understand and use the seasons.

• Use Zen Yoga to better prepare for transition through seasonal change.

• Get involved with us at traditional wisdoms.

I have absolutely no argument with the first 3, the 5th I would personally say is too restrictive, there are many forms of mindfulness we could use to achieve the same goal. The 6th is merely a plug for their services. Its number 4 that I have some issues with.

Heidi expands at some length on traditional wisdoms from Australia, New Zealand, Mexico, China, Thailand/Myanmar, Bali, North America, The Amazon and Japan, and how she has used these to promote her own healing process and what she now recommends for others. Far be it from me to discourage something that has appeared to be successful but let me throw out a theory of my own.

Going back some years now when I first heard Ian Craig lecture, he started the presentation with a basic principle of Functional Medicine/Nutrition that we all incorporate within our practices. The fact that we are all bio chemically/genetically unique and that the world is full of shades of grey rather than black and white.

To illustrate the point Ian used 2 images of extremely different cultures which I have shamelessly stolen for my own presentations:

Ian posed the question can we expect these two individuals, given their heritage and backgrounds, to respond to the same diets, supplements or healing protocols?

I am simply taking this argument one stage further, can we expect the traditional wisdoms of the Aboriginals, Maori’s, Amazon Shamans, or Far East philosophies to resonate with the soul of somebody who’s roots are firmly in Western Europe? We can of course argue about common ancestry going back hundreds of thousands of years but to my mind we have enough of this green and pleasant land engrained in our being to respond better to our own ancient wisdoms rather than having to search for somebody else’s.

Eastern philosophy in particular requires a completely different way of thinking about the world and our place in it.

I am however a great believer in using whatever may bring you comfort whether that may be Zen Buddhism, Jesus Christ or the animal spirit beliefs of a Witch Doctor from the rain forest. It just seems counter intuitive to search the world for a wisdom that you can find some resonance with when we have our own both within us and surrounding us. Your local wood, country park or beach may not at first view appear as esoteric as some far-flung exotic part of the world but this I think is missing the point. Nirvana is within and you can tap into this as the sun rises and mist spreads over an English forest enveloping a scene that our fore fathers have experienced for millennium.

Paul K Ehren - November 2020

NB: None of this article is intended to be any form of criticism of The Chrysalis Effect or its practitioners. They carry out immense work and have my full support and respect.

Using their webinar as a springboard however as a generator of my own thought processes opens up some fascinating lines of discussion.

Life – are we a participant or a spectator?

I’m writing this on the afternoon of Tuesday 21st December, winter solstice, a time seen throughout the ages as one of death and re birth. The shortest day, when nature seems at its lowest ebb, leaves withering, losing their essence and disappearing from the trees leaving mere skeletons behind. Most flowers now long gone leaving apparently frigid earth behind. Many birds and animals emigrating to more welcoming environments or preparing to sleep through the worst that the harsh months of January and February may throw at us.

However, the shortest day heralds the slow expansion of the daylight, imperceptible as it may be initially. The flora and fauna is simply gathering its reserves, taking stock, pausing for breath and readying itself for the turning of the seasons which in a few short months will once again spread warmth and light and the rush of life which will follow.

For our-selves the allegory of the shortest day is quite apt. After a year like none of us can remember the latest body blow was announced on Saturday that with a new strain of the SARS-CoV-2 virus tearing swathes through London and the South East Christmas is effectively cancelled, many of the European countries have closed their doors to the UK and we return to a form of house arrest never before seen.

I consider myself fortunate with my own personal circumstances but hardships have still existed, my Mother at the age of 94 has been without human contact from any of her family for months due to the restrictions in hospitals and care homes.

However, as human beings and in our case as practitioners we need, once again, to use nature as our template for life. To use this darkest hour as the pause before the re birth into a brighter future in 2021. Whatever your feelings on the vaccines now being given emergency use authorisation or the government’s handling of the situation there may now be a way out of this current cycle and if nothing else the way the scientific community has been galvanised by the greatest need has been remarkable.

It is a nature of the jobs we do, whatever our chosen speciality, to care for others sometimes more than we care for ourselves which can, in the long term, particularly given current circumstances, leave us even more open to maladies of the body and mind than those we call clients. Whether those clients are elite athletes or weekend warriors who also hold down responsible jobs few of them realise or appreciate the amount of work we put in behind the scenes on their behalf. Just looking at my own practice this year, and I’m far from exceptional, I’ve had clients win world titles, recover from serious surgery, battle chronic disease, come to terms with personal tragedy, contract the current virus and learn to deal with the effects of “long COVID”. As a practitioner with any degree of empathy we live these triumphs and disasters with the client.

Many years ago, I was given a piece of advice from a very old school and very successful coach “never become emotionally attached to your clients as at some point they will let you down”. This is inevitably true but something I find almost impossible to put into practice. I know that I am far from alone in this particularly with the ethos and training of organisations such as CISN.

At this point I refer back to the title of this article, how often do I, or you, simply “go with the flow” of our day to day lives. We are drawn and pushed from situation to situation like a broken branch in a river, swirling in the currents, in free flow when in open water or spiralling, caught in an eddy before cascading down stream again.

What if we could apply some mindfulness techniques to help us regain control, to experience our working and leisure time rather than simply observing it in some kind of out of body experience.

I would expect the reason stated for many, if not most, cases of anxiety or depression is a sense of lack of control. What if we could learn to take back that control and once again become the masters of our own destinies?? Could we become better practitioners by learning to care for ourselves before turning our attentions to our clients. Burn out is a problem across the industry but we normally spend so much time looking at the “nuts and bolts” of our profession – learning as much as we can about metabolism, physiology, nutritional science, exercise physiology, programming etc, etc that the old axiom of “physician heal thyself” becomes lost.

Part 2

In 1993 a film called “The Last Action Hero” was released. It starred Arnold Schwarzenegger as Jack Slater as the Los Angeles cop hero, Charles Dance as Benedict the master criminal and assassin and Tom Noonan as The Ripper, a crazed murderer. The film is a wild roller coaster ride full of explosions, car chases, impossibly choreographed fight scenes and fire fights, impossibly beautiful women, cartoon characters inter reacting with the live actors and all actions ae played out without consequences.

We are however watching a movie within a movie.

The real twist of the film is that it is played out from the perspective of a young teenage boy, Danny Madigan, played by Austin O’Brien who is Jack Slaters greatest fan. He obtains a ticket from his local old movie house to watch the film. The ticket however turns out to be magical and Danny finds himself able to enter the celluloid world and become part of the film. Cue many crazy situations as the real and imaginary worlds interact and Danny tries to explain to Slater how the laws of nature and physics have been suspended so what is happening cannot possibly be real.

The real kicker comes when Benedict and the Ripper learn of Danny’s true nature and manage to pass from the Silver screen into our reality, closely followed by Jack Slater in an effort to prevent bloody mayhem.

Reality however, starts to pose a few problems, guns do not have unlimited magazines, getting punched and shot actually hurts, it’s not possible to jump from tall buildings without breaking bones. On the flip side kissing the girl is a lot more pleasurable and Benedict and the Ripper find huge enjoyment in what they can inflict.

Pausing for a well-earned breath, can we make the quantum leap to allegorise that we all get in the habit of living in or watching the film as we move through life rather than actually participating fully in the reality with all the pleasures and pain that entails. Do we become de sensitized over a period until our own reality comes crashing down upon us at a velocity that we find hard to withstand?

To help re sensitizing us there are many Mindfulness techniques available to assist us connect with ourselves and our environment. A friend of mine has spoken at length about mindful eating and how we can use the whole experience of eating a meal to fully appreciate the food we are eating rather than simply using it as a method of re fuelling.

Taking my own morning routine, I normally start with an early morning walk, which at this time of year still starts in the pitch dark. I use this for 2 purposes, firstly as cardio vascular exercise and secondly as a form of connection/grounding. The first mile or so and the last section are up hill and these I tend to step out, get the heart rate pumping and breathing rate elevated. The middle section however is through the local country park containing both woods and open spaces. At this time of the morning and particularly at this time of year I am normally pretty much by myself and for this part I normally slow my pace and remove hat/hoods so that my face and head are exposed to whatever the winter weather decides to throw my way. At this point I will take note of my breathing, allow my body to provide feedback on any areas of tension or discomfort, to feel the wind and any rain on my face, to listen to the bird song, to take note of the trees and other vegetation in the emerging light of a new day.

Taking this one stage further I find that “living in the moment” allows my sub conscious to work on projects and issues that I may have on the go and very often ideas and solutions present themselves without having to force the process in a similar way to a computer running sub routines in the background while your screen is filled with the priority task.

Once home the next stage is often a resistance training program but if we can shunt this to one side as the psychology of strength/hypertrophy training is another article in itself.

Hitting the post exercise shower, apart from simply washing ourselves, is another opportunity to tap into that feedback loop. After the soap and flannel thing I run a series of contrast showers with firstly hot water then as cold as possible, the difference in physical sensations is marked, from the pleasant “tropical rain storm” feel of the warm water to the immediate “cold water shock” of the opposite temperature setting, feeling the changes to skin reaction, heart rate, breathing all things to help us focus on us as a conscious aware entity.

Then breakfast, we can use all of our senses, even well before the actual meal is served up in front of us to appreciate the food and the pleasure involved in the simple act of eating.

Throughout the rest of the day taking a few movements to breath, concentrate on our thoughts and feelings and asking ourselves a few simple questions:

What am I feeling?

Why am I feeling this?

What do I want to achieve from the day/interview/client meeting?

What motivates/excites me?

How can I enhance this?

What demotivates/drags me down?

How can I control these?

Most important of all, take control, explore and understand our sensations and feelings.

Don’t be a spectator of our own lives, be a participant.

Paul K Ehren - December 2020