Chronic fatigue

Re: Chronic fatigue

alphavet — Fri, 05 Apr 2013 01:03:26 GMT

As far as any psych or counselling support goes, just go to www.vetlife.org.uk A well qualified & experienced (with vets!) counsellor will call you back, and if need be arrange to see you or talk to you as often as needed for as long as needed. They know what life in practice is like, and what vets are like (Often take much better care of their patients than themselves!) Personally I've found it a lifesaver (literally) and still check in with my counsellor every few months - after a nasty episode of anxiety & depression 10 years ago. They also have contacts/links to VBF & independent advisors if finances are a stress. Personally I managed to simplify my life, work less and spend less but it was a huge change of mindset & lifestyle which I didn't think I'd be able to manage at the time.... But it is actually possible for us vets to work "part-time" and still survive! At one time, my husband was a "full time" civil servant doing 32.5 hours a week, while I was working "part time" 30 hours a week.... If I finished on time! Take care of yourself :)

Re: Chronic fatigue

An On MRCVS — Fri, 08 Mar 2013 17:30:15 GMT

Anon 2

Thought situation sounded very familiar

Email me? epididymides@gmail.com (anon account)

If you're not comfortable with that, happy to talk on here, just it's a bit public and I don't come on here very often

If nothing else - make sure your ferritin has been checked lately as Fe-def anaemia very common in IBD, even if no frank blood loss...constant micro haemorrhages lead to lots of blood loss even if not obvious. If you do have anaemia, do NOT let them give you oral iron. They try to get away with it as its cheap, but its awful for IBD as it gives you D+. You need infusion.

Similarly, they don't like to give you mAbs..actually don't know why I'm telling you all this, like me you've probably looked it all up!

Sorry if that sounds patronising. As a fellow vet you may be aware, but just checking as my experience even gastros aren't as up to speed as I would like. I've shopped around and see one on Harley Street now.

Re: Chronic fatigue

An On MRCVS — Thu, 07 Mar 2013 13:59:59 GMT

Thank you all for your feedback - it helps to know other folk have worked through this sort of thing. Some of you I have PM´d and thanks for all info passed on. I think OOH only work would be very difficult as I suspect I would just end up sleeping all the time. We currently work shifts anyway, and my sleeping patterns are far from routine which i am sure does not help, neither does it help my eating habits. As for exercise I get very frustrated by my inability to do this - like Jane I was a regular runner but some days I am unable to climb a flight of stairs without becoming dizzy at the effort. Am seriously starting to think that I may have to cut my hours. Yes I have eprmanetn medical insurance, but it takes 13 weeks to kick in, not sure how it would work with any cut in hours. Think I need to sit down with my practice manager, financial advisor and colleagues but not necessarily in that order. It is just not like me to give up but I worry that I will be letting down my clients if I am not 100%.

Anon2 - I have Crohns which does put me in a fairly similar position to you. What coping mechanisms have you found work?

Re: Chronic fatigue

Helen Wallace — Wed, 06 Mar 2013 21:39:29 GMT

I had chronic fatigue after getting glandular fever at uni. The signs lasted around 3 years and it was hell but now I'm at the stage where I only have 1 or 2 bad days a year. I was lucky enough to see a specialist unit but treatment conisited of a mix of counselling, weight loss and a very very gradual exercise program (Day 1 swam 1 breadth- took 10 min to recover :) ) but I did improve eventually.

I honestly don't think I could work the hours I do now with it. A good nights sleep is really important which means on call is tricky. Stress made me worse and we all know how relaxing life as a vet is... Would part time be an option for you. If you could work evenings that might fit well with someone with kids. Just a thought.

Do PM me if you want to talk or ask more details.

Re: Chronic fatigue

Sylvia Wilson — Wed, 06 Mar 2013 18:12:04 GMT

Whoops! Have just re-read my post. I wasn't implying that Liz should find an alternative use for her degree, just that the OP might want to look at other jobs!!

Re: Chronic fatigue

Sylvia Wilson — Wed, 06 Mar 2013 17:55:15 GMT

Liz, you are quite right. So long as their condition is likely to last for more than a year, the OP is covered by the Equality Act and their employer is required to make "reasonable" adjustments to enable them to continue to work. As ever, with these problems, the question becomes, what is reasonable? The answer will depend on the size and resources of the practice and the exact needs of the OP. Unfortunately, it is reasonable for an employer to reduce salary in proportion to reduced hours, and from reading the original post, it appears that this may be an issue.

You may want to look at alternative ways of using your vet degree. There have been several recent threads about jobs for vets other than practice.

I presume that the OP has discussed the question of infections while immunosuppressed with their medical advisors. The owners are probably more of a risk than their animals, but you do need to protect yourself. I got an infection while immunosuppressed by chemotherapy a couple of years ago and, believe me, it wasn't fun.

If Anon 1 would like to PM me, I can advise on getting your employer to make reasonable adjustments.

Re: Chronic fatigue

Liz w — Wed, 06 Mar 2013 16:57:25 GMT

[quote user="Robin Grimmer"]

[quote user="Liz white"][quote user="Liz white"]I guess he has to work out whether the benefits of choosing when to work would outweigh the security of having a permanent job. I would have thought that becoming self-employed may not work in his favour if his health deteriorates.

[/quote] This was meant to be in reply to Robin's post

[/quote]

Locum work is not for everyone - some people prefer the security of a regular job. However, from a stress point of view I can honestly say I'm much happier locuming. You can plan ahead and take longer holidays for extended trips. In full-time employment I always felt more stressed because of the long hours.

[/quote] I guess I thought that if he already has a job, then is the employer not duty bound to try and work around the illness, with the option presumably of being signed of sick for periods if necessary, whilst still being able to return to work when able. It just seems a lot riskier to me to pack in the job, especially if they are not sure how well they'd manage locuming - presumably if you have to cancel a locum job at short notice through chronic illness it would be harder to get work at that practice in the future. (Disclaimer- don't really know legally what I'm talking about)

Re: Chronic fatigue

An On MRCVS — Wed, 06 Mar 2013 15:36:09 GMT

Anon 2

There seems to be confusion here. Anon 1 said he/she has a disease that requires immunosuppressants (so an immune-mediated disease) that makes her chronically fatigued. This is completely differnet to CFS or ME.

I am in the same position as Anon 1, with ulcerative colitis. Curious to know what Anon 1 has, can't see harm asking as anonymous?

Re: Chronic fatigue

Robin Grimmer — Wed, 06 Mar 2013 13:59:13 GMT

[/quote] This was meant to be in reply to Robin's post

[/quote]

Re: Chronic fatigue

Thomas Johnson — Tue, 05 Mar 2013 09:33:35 GMT

[quote user="Michael Woodhouse"]

I have no real advice other than to look after yourself. I honestly thought that these chronic fatigue syndromes were physical rather than mental, so not sure how CBT/NLP could work. If they do it may alter the aetiology somewhat.

[/quote]

I think the jury is very much out on the cause of CFS/ME, but having seen the dramatic improvement in my wife over the 3 days of the course, and she had been unwell for 3 years, and with no recurrence 18 months later, I can't see how there isn't at least some mental component to it. And yes I know this is anecdote rather than data!

Re: Chronic fatigue

jd2008 — Tue, 05 Mar 2013 01:27:10 GMT

[quote user="Michael Woodhouse"] Stick 2 psychologists in the same room that subscribe to different theories and they will argue black is white. [/quote]

Well, not if they've kept up with the research. Modern psychology is evidence based. It is a lot closer to a pure science than you think, especially when you look at recent work in neuropsych and neuropharmacology. The days of Freud, Jung et al are long gone thank god.

[quote user="Michael Woodhouse"] I can see no [sensible] reason why stimulants could be a bad thing[/quote]

No - controlled use of stimulants is not a problem. Likewise controled alcohol consumption is not a problem. But you wouldn't suggest someone with liver disease has a drink on a regular basis would you? Trouble is longterm use alters brain chemistry. Besides that, repeatedly stimulating your sympathetic nervous system has lasting effects on not only your endocrine system but also your brain. Again, there's a mound of peer reviewed evidence to support this. Ibuprofen is not a stimulant, neither is sodium alginate, sodium bicarbinate or calcium carbonate. You're comparing apples with oranges.

[quote user="Michael Woodhouse"]

not sold on blue lights!]

Funny which bits of popular psychology people latch on to

[/quote]

And again, there's peer reviewed evidence

Can provide abstracts on request

Sorry for the thread hijack!

Re: Chronic fatigue

Michael Woodhouse — Tue, 05 Mar 2013 00:52:15 GMT

[quote user="Jane Adams"]There's a lot of really bad self-help advice out there! And I'm afraid NLP is amongst the worst (sorry Michael . It's not evidence-based and has been debunked as pseudoscience by those who really do know what they're talking about (i.e. not me!)[/quote]

Well that is a bugger. To be fair I have made no attempt to keep up with the psych literature and there are some papers that support that viewpoint from a quick pubmed search. The sheer concept of metacognition and thinking about your own thinking is fantastic. If you can get to the very bottom of what 'gets' to you then you are in a position to control it. I do think with all the 'touchy feely' 'sciences' [not really sure any of this should be lumped in with pure science, because it really isn't - far more of a humanity] that some of these things are hard to prove and all we are trying to achieve is make people feel better. Stick 2 psychologists in the same room that subscribe to different theories and they will argue black is white. I suspect the truth is somewhere in the middle (not actually convinced you ladies are all suffering from penis envy, but the ability to urinate standing up is marvellous, especially for farm animal work).

[quote user="Jane Adams"]Avoid stimulants as much as possible. (I'm hoping Michael's Red Bull comment was tongue in cheek ) [/quote]

Honestly no. If I feel tired I consume caffeine and I perk up. Just like if I have a headache I take ibuprofen and feel better. Or indigestion I take some Gaviscon......... I can see no [sensible] reason why stimulants could be a bad thing (obviously not before bed) if feeling fatigued. Avoiding them sound more 'self help' science than everything. You missed out avoiding gluten and dairy products...........

Without coffee I wouldn't function.

[I can believe that (some) TV stimulates the mind but not sold on blue lights!]

Funny which bits of popular psychology people latch on to

Re: Chronic fatigue

jd2008 — Mon, 04 Mar 2013 23:57:49 GMT

I'll apologise in advance for the long post

I'm currently in a sort of similar situation myself so I can speak from my own experience (recently diagnosed with a dysautonomia, the main symptom is marked hypotension which leaves me feeling permanently exhausted)

First off I hope you have the support of a good GP or specialist. We can all offer advice but we're not medical professionals or psychologists and we don't know your individual circumstances. I'm going to suggest a few things but please don't take my advice as gospel, they're only suggestions - speak to your GP/specialist about them if you feel anything I suggest might be helpful.

First off I'm probably suggesting something you've already had checked out. Have you had ferritin and vitamin D levels checked? Low levels of either will contribute to fatigue. Beware having supposedly 'normal' ferritin. Having a result at the low end of normal means you have essentially no iron stores. This is especially important if you are a menstruating female for obvious reasons.

Some 'normal' Vitamin D ranges are too low/conservative. Ideally you want Vit D >75nmol/ml.

Sleep is vital but quality counts. Having a set sleep routine where you go to bed (even if you don't always fall asleep straight away) and rise at the same time every single day is important. Sleeping in, even if you feel exhausted, disrupts this.

Needless to say shift work is arguably the worst thing for any chronic illness! I have no choice 'cos it's my job but I am knocked for six every time I work nights and I know my recovery would be much, much better if I were working normal hours.

Avoid blue light for 2 hours before bedtime. This means no TV, no looking at mobile phone screens and no computers unless you use this nifty bit of freeware: http://stereopsis.com/flux/

Avoid stimulants as much as possible. (I'm hoping Michael's Red Bull comment was tongue in cheek )

If you really enjoy coffee then don't deprive yourself but try and limit your intake. Likewise alcohol and refined sugar.

Exercise is important to avoid deconditioning but needs to carefully moderated. (One of my husband's good friends is a fitness coach for a football team, chronic fatigue and dysautonomias are similar in many ways to overtraining syndrome in athletes so his advice for me has been very helpful) Ideally you want exercise that keeps your heart rate between 120 and 140 bpm for 30-40minutes three to four times a week. But this one you really should check out with your GP.

For me it's been brisk walking, gentle resistance work and yoga. As an avid runner I've found this very difficult to stick to but it has been worth it for my recovery.

Do think about seeing a good psychologist. There are well documented psychological effects from chronic illness which will hamper recovery if not addressed. Best to avoid going it alone on this as you may do yourself more harm than good. There's a lot of really bad self-help advice out there! And I'm afraid NLP is amongst the worst (sorry Michael . It's not evidence-based and has been debunked as pseudoscience by those who really do know what they're talking about (i.e. not me!) I'm extremely lucky that my husband's a psychologist. He's not my therapist but he does monitor my moods and attitudes and helps me avoid ruminating and getting stuck in negative thought patterns. As well as having my hubby to help I see a psychologist regularly and view this as just as important as sorting out the somatic stuff. The most recent psychology research shows that a practice called mindfulness based therapy consistently produces excellent results (even more so than CBT). There are a number of books on this I can recommend but ideally you should learn at least the basics of mindfulness with a psychologist first.

Sadly the NHS has a long waiting list for psychologists. If you can afford it, go private. Contact the BPS http://www.bps.org.uk/. They will give you the names of psychologists near you who can help your particular problem.

Apologies again for the very, very long post. You really do have my sympathies and I hope some of what I've said is of some help.

Please PM if there is anything else I can do.

Jane

Re: Chronic fatigue

Michael Woodhouse — Mon, 04 Mar 2013 22:22:49 GMT

Hello Helen

We buy trays of Red Bull from the cash and carry and that gets me through the mad days. Just stocked up on the stuff as lambing starting to kick off.

NLP does work nicely has no great scientific proof, but may make you feel better. A good book if anyone is interested:

http://www.amazon.co.uk/NLP-Workbook-practical-achieving-results/dp/0007100035/ref=sr_1_2?ie=UTF8&qid=1362435513&sr=8-2

This is an easier to read over-view

http://www.amazon.co.uk/Introducing-Neuro-Linguistic-Programming-Joseph-OConnor/dp/1855383446/ref=sr_1_14?ie=UTF8&qid=1362435513&sr=8-14

[I did an A Level in psychology and find it absolutely fascinating]

Re: Chronic fatigue

Liz w — Mon, 04 Mar 2013 20:52:24 GMT

[quote user="Liz white"]I guess he has to work out whether the benefits of choosing when to work would outweigh the security of having a permanent job. I would have thought that becoming self-employed may not work in his favour if his health deteriorates.

[/quote] This was meant to be in reply to Robin's post

Re: Chronic fatigue

Liz w — Mon, 04 Mar 2013 20:51:00 GMT

I guess he has to work out whether the benefits of choosing when to work would outweigh the security of having a permanent job. I would have thought that becoming self-employed may not work in his favour if his health deteriorates.

Re: Chronic fatigue

hswift — Mon, 04 Mar 2013 20:00:27 GMT

Hi anon,

I developed CFS/ME a few years ago and would be happy to tell you about my experience and offer advice if you want to PM me. I agree with many of the above comments and think OOH work is a definite no-no!

Re: Chronic fatigue

Robin Grimmer — Mon, 04 Mar 2013 13:21:52 GMT

I agree with Clive, having worked OOH work for 2 years I would definitely not recommend it for anyone suffering from chronic fatigue! Human beings are not evolved to work nights! Have you considered locum work anon? You can then get a better work/life balance to suit yourself and perhaps take a bit of a break beforehand.

Re: Chronic fatigue

Thomas Johnson — Mon, 04 Mar 2013 09:36:11 GMT

My wife suffered with chronic fatigue syndrome for 3 years after a particularly bad 'flu infection. What made the difference for her was a course called 'The Lightning Process'. We were both very sceptical initially as it does appear to have some of the trappings of alternative medicine, and it was over a year after first hearing about it that she booked to go on the course. I took her, and sat in on the sessions, and while I am still a little unsure about the mechanism suggested for causing chronic fatigue, the treatment itself has been very successful, it draws on both CBT and NLP. The website is:

http://www.lightningprocess.com/live-a-life-you-love/

If you want more information then feel free to private message me.

Re: Chronic fatigue

Pippa de Chassart — Sun, 03 Mar 2013 08:29:10 GMT

Hi Anon I have also had some health challenges and the stress of the job certainly doesn't help. Sometimes a good break will help - away from work, and the expectations.There is little room for underperformance in our job, and as you have noticed, it can undermine your confidence in the long run. I would suggest a decent break, at least 2-3 weeks, away from the profession and your work mates.Try to ask for better suited hours if you can - one day a week away from work can make all the diffierence. Its very important to have some daily exercise, and a proper diet ,with regular meals. Sounds obvious, but its not common when you're doing long hours! Good luck , if you want to mail me privately I may be able to help. Best of luck.

Re: Chronic fatigue

Clive Ansell — Sat, 02 Mar 2013 14:02:57 GMT

[quote user="Bob Russell"]

Perhaps look into shorter hours. A few nights with an out of hours provider may give similar pay to a day job (no experience of this though!). Sleeping could be done during the day.

[/quote]

I no longer work nights in OOH clinics, but I used to find it more tiring and more stressful than daytime work, plus the pay is often poor given the number of hours worked (Last time I worked for a large national OOH provider they were offering £180 for a 15 hour shift, which is pants. They would often negotiate at the 11th hour though). I used to find that daytime sleep was never as good.

Anon - sounds like you need a nice holiday for some decent R&R. can you work fewer hours? if you are ill, you could some time off sick and/or take some annual leave. Don't want to teach Granny to suck eggs, but good nutrition and light gentle exercise may help too?

Re: Chronic fatigue

Bob Russell — Sat, 02 Mar 2013 11:20:54 GMT

Perhaps look into shorter hours. A few nights with an out of hours provider may give similar pay to a day job (no experience of this though!). Sleeping could be done during the day. I am assuming you have no form to permanent medical insurance!

Sorry not able to be particularly helpful!

Tough one.