Positive work – understand pain

My work as an oncology physiotherapist ~ Hannah Leach

September 1, 2020Richmond Stace | The Pain CoachLeave a comment

My career to date

Since becoming a physiotherapist, I knew I wanted to work in oncology. This decision was shaped by various experiences in my teenage years, including watching my Granny go through ten years of cancer treatment before she died when I was 16. I sometimes think about the sliding doors that led me to the job I’m in now – and how close I was to choosing an entirely different career path. I know somehow my Granny led me into my dream job and I’m grateful every day for it.

Working in oncology is different every day; cancer can affect any part of the body, so for every patient I work with, I may see any combination of cardiovascular, orthopaedic, respiratory, neurological, musculoskeletal and holistic problems. For this reason, I must be flexible, creative and patient-centred, in order to provide my patients with the best possible care.

I am a huge advocate for the NHS, and extremely proud of the work I have done and continue to do within our incredible national treasure. I am currently working full-time in a hospice, while also doing bank shifts in an oncology intensive care unit. It is such rewarding work but, as someone who is made up of both a scientific and creative mind, I found the strict structure of the NHS curbed my visions for better ways of providing care.

The current situation in oncology rehabilitation

Currently, physiotherapy and other allied health professions are hugely under-utilised in oncology. With only 30% of the people needing cancer rehabilitation receiving it, it’s clear we have a long way to go.

Thanks to incredible research and trials, we are seeing better outcomes in cancer; there is now an average ten-year survival rate of around 50 % across all cancer types. The flip side of the coin is that we are seeing more long term side-effects resulting from more advanced cancer treatments. I have met people who are in remission, but have

accepted living with a compromised quality of life because they believed this was the cost of being cancer-free. This is not true!

Physiotherapists and allied health professionals can work with people to manage the side effects of cancer and treatment, allowing them to live fulfilling, active lives. My vision is to use physiotherapy to help as many people as possible to enjoy a meaningful life after cancer. Is this not why we go through the treatment in the first place? We must get more people talking about cancer and rehabilitation.

My vision

In the face of our uncertain future in healthcare, I feel passionate about providing those going through cancer with the highest quality support. When seeing outpatients in the hospital, I found there were patients travelling from outside of London to see a specialised oncology physiotherapist. Since a majority of these people were experiencing fatigue and pain, this felt so backwards to me and I knew there must be a better way to deliver high-quality advice – without the financial, time and physical implications of a hospital round-trip!

I knew the solution was to take my expertise online, to reach as many people as possible, regardless of geographical location and local services. I spent most of 2019 thinking about my idea, unsure of where to begin. Then, on New Year’s Day, while on a flight home from New York, I decided I had to just go for it (I always do my best thinking on planes and trains – anyone else?).

The very next morning, I set up my website and STRONGERTHAN was founded!

What do I offer?

I offer 1:1 online physiotherapy appointments to those living with and beyond cancer., to help them stay strong in body and in mind. I love to work with a diverse range of people of all ages, backgrounds, cultures and abilities. There are countless reasons that someone may seek physiotherapy; from exercise and lifestyle advice, to managing peripheral neuropathy or breathlessness. My role is extremely versatile and I am constantly learning from my patients, about the realities of life with cancer.

Some examples of the people I may meet and work with are:

● A young athlete, recently diagnosed with cancer, who is aiming to complete treatment and return to competing as soon and as safely as possible.

● A busy mother, who wants to improve her shoulder function following a mastectomy, so she can play with her children comfortably again.

● An older person having chemotherapy, who wishes to maintain their strength and manage their fatigue, to continue living independently at home.

● A business-professional, who would like to be able to return to their cycling commute to work, following abdominal surgery and radiotherapy.

● A person receiving palliative care, who wishes to improve their exercise tolerance in order to comfortably attend an important wedding.

● A young person in their 20s, who has poor body image following extensive treatment and wishes to maintain their weight and muscle mass.

The patient is the centre of my work – I wouldn’t have a job without them! I listen very closely to what they have to say and I want to know their story. This is something that can be done very easily by video consultation. Research has found that more people feel comfortable opening up to health-care professionals during video appointments, compared with face-to-face. This is likely due to the security that being in the comfort and privacy of their own homes brings.

I always ask myself: if it were me, ‘would I follow that advice?’. If I felt my health-care professional heard and understood what I had told them and felt excited about my goals with me – I would feel more confident to make adjustments to my lifestyle and change my habits, to better my quality of life.

Investing in physiotherapy, your health and your future is an important decision for anybody. Working with a health-care professional will provide someone with support, encouragement and accountability to ensure they are able to make the changes they need, to live their life the way they want to.

In summary…

With cancer treatments advancing, it is essential that we provide innovative after-care to match. To reach as many people as possible living with and beyond cancer, we must continue to re-think how we provide specialist physiotherapy advice.
I will continue to shout about online physiotherapy, because I strongly believe that having expert rehabilitation a few clicks away, is the path to a brighter future for those

living with and beyond cancer. So, to anyone reading this post now, who thinks you or a loved one might benefit from this support – book your appointment now and thank yourself later!

Hannah Leach

www.strongerthan.co.uk

Why I have gone vegan

December 30, 2019December 30, 2019Richmond Stace | The Pain Coach

Undoubtedly, choosing the way of the vegan is gaining momentum. Each person will have their reasons. Here are mine.

There’s little doubt in my mind that I have chosen a vegan diet over the past couple of months to test the effects in me. It is likely I have been influenced by notable ultrarunners such as Scott Jurek and Capra Corbett.

(Being slightly philosophical for a moment, any decision that we make is the culmination of a range of beliefs, most of which are hidden away from our conscious awareness).

So how has it gone? It’s been interesting, that’s for sure, including other people’s responses. All in all, I can summarise by saying that I feel more energised, my running times appear to have improved (maybe I’m pushing harder?) and my digestive system seems to be working better (less bloating, discomfort, lighter). It is early days.

At the end of the blog are some of my favourite vegan things to eat

Initially being vegan meant a very different shopping experience. I had to really think about what I was going to eat and hence what I needed to buy. It has become easier with new habits of where to look, such as knowing where the oat milk is located.

Then there is the challenge of being vegan and eating a healthy diet. The two do not have to co-exist. It would be easy to go for processed vegan food, all neatly packed at the end of one aisle in my local supermarket. When you look, there are plenty of vegan options, replacing day to day foods: cheese, sweets, biscuits, chocolate, bacon, sausages etc. I have had some scrumptious vegan sausages!

A recent trip to Liverpool meant finding places to eat. I was pleasantly surprised to find that this was rather easy, with plenty of vegan options. I even saw a vegan chicken burger ad on a huge billboard from a well known fast food company — not my thing, but an interesting shift.

Beyond being curious and seeking to build wellness, there is also the positive effect upon the planet. Each person doing what they can adds up. This could be reducing plastic, easing back on animal products, or less travel.

From a scientific perspective much more research is needed. The recent film Game Changers provoked controversy with opponents claiming that the studies used were poor quality. However, if the reaction is to reduce the consumption of meat, this can only be a benefit. Many of the people who adjusted their diets subsequently were probably ready for change for different reasons. Whilst some of the quoted research may be inconclusive or lack certainty, it is pointing us in a particular direction.

Veganism is growing. And with the increasing numbers of people choosing this approach, there must be further research to understand the consequences. For instance, are there risks that need countering with vitamin supplements?

Only a couple of months in, I am unable to make any concrete claims about my case study of one. However, I will stick with it for now. Besides, much of the food is so delicious!

Some of may favourite dishes so far…

Vegan Indian food with jackfruit, soya, tofu and vegetables

Roasted vegetables with tofu

Coffee with oat milk

Sauerkraut

Avocado & green vegetables

Fruit smoothies with chia seeds

Granola with oat milk or soya

Vegan sausages for breakfast with beans and mushrooms

Bean burritos with home made guacamole and salsa, plus vegan cheese

Lentils — spiced and seasoned

Quorn chilli and rice

Peanut butter on toast

Sweet potato and carrot soup

Green soup — beans, peas, broccoli and more

Humous as a dip or in a sandwich

Beetroot

And there’s so much more to try!

Opioid painkiller prescriptions increase

September 9, 2017September 9, 2017Richmond Stace | The Pain CoachLeave a comment

A report from the Public Health Research Consortium (PHR) has shown the increase in use of opioid medication over the past 15 years. This is despite the fact that our understanding of pain and what we can do to overcome pain has advanced enormously in that time. There is a clear mismatch between the pinnacle of pain knowledge and what is known and practiced in society. The gap must close.

Screen Shot 2017-09-08 at 22.30.24 — PHRC Final Report: Prescribing Patterns in Dependence Forming Medicines

Chronic pain is the number one global health burden, costing society enormously whilst millions are suffering. This is a public health crisis embedded in society. Whilst doctors are increasingly prescribing opioids, society is also demanding a quick fix in the form of a pill.

There is only one person that can overcome his or her pain

In many or most cases, when someone goes to their doctor they expect to come away with a prescription for a pain killer. They do not expect to receive advice on ‘self-management’ despite the fact that this is exactly what should come first. There can be a role for medicines, but within an overall programme of care that revolves around the person’s own understanding, thinking and actions.

To overcome pain takes understanding, the formation of new (healthy) habits, lifestyle changes, practice and effort

The problem of pain can only be solved with social change. This is the reason for UP, to drive that change by delivering knowledge, skills and know-how to society. To truly understand pain is to be free from the on-going loop of suffering by using our strengths to build wellness. This is the essence of the positive strengths-based Pain Coach Programme, with each person reaching their potential by clarifying their picture of success and learning the principles to follow in order to achieve results.

Screen Shot 2017-09-08 at 23.09.52 — BBC News

UP driving social change

As a purpose-led enterprise UP has the vision of a world where pain is understood to reduce unnecessary suffering. Our purpose is to drive social change with regards to beliefs about pain because we know that people can overcome pain, build on their wellness and live meaningful lives. Understanding pain provides that opportunity together with self-coaching that gets the best out of each individual so that they can reach their potential in whatever circumstances they find themselves.

The Understand Pain and Pain Coach workshops are tailored for the different groups: e.g./ patients, healthcare professionals, schools. The key information is the same, but the workshop structure and the practices are created with the participants in mind. They leave inherently knowing that there is a choice.

The actual experience is a vital part of the process. The sessions are designed to inspire individuals and healthcare teams to learn and grow, provide practical tools that can be used straight away and to integrate their learning in their own unique way that is appropriate for their life.

UP is bound to the principle of delivering positive work to people across the globe. If you would like to partner or connect because you are interested in driving social change for a better world for all, we would love to hear from you. We all have a responsibility to look after each other and the planet and we can choose to do this in our own way. The UP and Pain Coach Programme encourages, educates and enables individuals and groups to build on their innate capacity for wellness by learning and practicing the skills of being well.

In cultivating our ‘wellness’, we create the conditions for a healthy and happy life. Forming a strong foundation of being well that includes such components as self-compassion, purpose, resilience, attention and gratitude means that we become attuned to the existing goodness in us and the world. This does not mean that we do not face adversity, because everyone does at some point. However, practicing being well means that when we do come up against a problem, we can view it as a challenge and an opportunity to learn instead, using and bolstering our strengths. You could say that in fact we are choosing the positive approach as a way onwards.

To overcome pain is not to somehow fight it or to mask the true cause by taking medication. You can’t fight yourself after all. You are your pain as much as any other part or dimension of you. The pain is characteristic of the person as much as their humour or their posturing. Pain is not about tissues or pathology, it is about a perception or prediction of possible danger or threat. To overcome pain is to face the challenge, learn about pain, learn about yourself and how the pain emerges in you, and then transform the experience using practical tools that focus on what you want: your picture of success.

It is not unacceptable for the approach to pain to revolve around medicine. We know too much about what pain really is, what it is for and why we experience persistent or chronic pain. We know that people can get better, lead fulfilling lives and build on their wellness by understanding their pain and what they must do themselves to overcome pain. There is a choice to be had and society need to know that this choice exists. UP strives for the choice to ‘come alive’ across the globe, and we will work tirelessly so that each person can reach their potential for a healthy and happy life.

UP works on a 1 for 1 basis, which means that for each paid workshop delivered, one is provided to the local community within their environment. Please contact us with the form below if you would like to arrange a workshop in your area

Helping others is distinctly healthy ~ a great story from Ghana

August 22, 2017August 22, 2017Richmond Stace | The Pain CoachLeave a comment

The Helper’s High

Increasingly we are understanding the healthy benefits of practices that we can adopt in an effort to live a long and happy life. This is highly relevant to the millions of people who suffer chronic pain across the globe.

To suffer chronic pain is to be consistently in a state of protect. Pain is a feature of this state and whilst it is temporary and transient, the person experiencing chronic pain will frequently exist in such a state. Developing skills to shift into a healthier or ‘care-giving’ state (as I call it with people I work with) is fundamental to overcoming pain. With this in mind I have invited contributions from people who have volunteered to do positive work to gain insight into how it made them feel.

You may be wondering how someone with hugely impacting chronic pain could engage with such work. Indeed it would be a challenge for many and to some seem impossible. However, with some thought and planning, volunteering to help others can come in many forms. This benefits all — the giver and the receiver. And like any practice, the more it is done, the easier it becomes. We can all access the ‘helper’s high‘. So, here’s a fascinating story about a recent journey to Ghana to do positive work.

Introducing Kenny Webster

I have recently been on a journey, both physical and metaphorical. I would like to share parts of this journey with you, if you can spare a few moments and I promise to try and not be too smug about it. I am one of those people who has always worked hard and despite warnings from friends and family over the years, I almost certainly worked too hard and too long. By training, I am a research biochemist, but after several years of lab research, I became more involved in the public engagement side of science and eventually ended up working in the science museum sector – inspiring others in the beauty of science. In a working life of over 20 years, I only ever took one day off sick, never used my full annual leave allowance, started early, left late and often went in to the lab/ office at the weekends – sound familiar? Relationships with friends fell by the wayside and I essentially became totally engrossed in work, always telling myself that I was doing a lot of good for a lot of people. This might have been true (the jury is still out), but I certainly didn’t save any lives and I definitely didn’t earn a bucket load of cash that I might have tried to buy happiness with – as I perceive some other people try to do!

A couple of months ago, I was made redundant. At first, there was shock, but then the rational side of me kicked in and I acknowledged to myself that over the previous few months, I had actually been pretty miserable at work and at least this was going to be an end to that. As I thought through my options, I started to recognise just how much of my personal time was given over to work and that I would actually be getting all of that back as well – it was going to be an opportunity to start again, but without actually having to choose to start again! I decided that I was not going to panic and find a new job, any job, as soon as possible, but instead I was going to do something amazing and meaningful with the time that I now had. I was going to do something that I would have considered myself crazy and irresponsible to have done under normal circumstances. So I went to Ghana for a month and volunteered on community projects.

It really was an incredible place. The people were so friendly and welcoming as well as having the best names in the world. I don’t tend to meet people called Blessing, Comfort, Princess or Leticia very often and I certainly don’t meet many children called Alan, Norbert, Theophilius or Richlove! Just the names put a smile on my face! I didn’t once, in four weeks, hear a child cry or a parent shout at a child; it just seemed to be a country where people were content, despite the extreme poverty that we witnessed. The main project that I was working on was building a new school, but we also ran a community library that would only open if volunteers came and opened it. Every day there were around 30 children outside, waiting for us to arrive, desperate to read, practice their English or do some colouring. In this tiny, remote town in the clouds above Ghana, there was such a strong desire to learn.

One day each week we would visit a hyper-remote village, the sorts of places that you see on comic-relief with a celebrity shedding a tear. But there were no celebrities here, just mud and straw huts, dirty water and smiling children. We would install and demonstrate water filters, carry out minor first aid and dispense food, clothes and hygiene products – basic human rights types of things!

I was a fair bit older than most of the volunteers (who were largely on gap years or had just finished university) such that I effectively became the house Dad. The vast majority of these people though were remarkable in their commitment and resolve. Yes, one or two were clearly on a holiday or just wanting to have something interesting to say on their personal statement, but most were far more interesting and mature than I was at their age – and despite the Dad jokes, I felt welcomed into their community as much as the Ghanaians welcomed me into theirs.

Now that I am back home, I am of course considering my future and especially my future employment. My Ghana experience has shown me how much I personally value helping others. I think I have always been quite a nice person, willing to help others, but I now feel that I want go out of my way to try and make other people’s lives a bit easier if I can and from a career perspective, I am certainly looking at organisations whose missions are to help others. As I left employment I told my former colleagues that I was going to go somewhere and do something incredible, even creating the Instagram hashtag #smugken to let me boast about it. There was a certain amount of hope in that desire to do something incredible, but my experience in Ghana has certainly affected me in a very positive way, enriching my life and giving me a strong sense of wellbeing. It might not last, but I hope it does, because I really do think I prefer the version of me that has come back from Ghana.

Kenny Webster