Hospice care

When you say hospice, most people assume that the care is for people with cancer. I did.

On hearing that nurses from a local hospice were visiting my dad, a question came my mind.

Did he have cancer? I knew that he had pulmonary fibrosis, which means that lung function gradually deteriorates. But was there something else?

The answer was no. The hospice team were doling their daily work, caring for people who are at the end of their life, whatever the reason.

I have worked in healthcare for my whole career — 28 years this month. Yet I had made the assumption that hospices exist to look after people who have terminal cancer. Why had I never considered end of life care to be for all?

That is what this short blog is about. Simply because I wanted to share the right message in case other people were thinking the same. And I know some are from the responses I have had when talking about my dad.

Taboo

Death and dying remain taboo in our society. There is much fear, mainly due to the unknowns.

We don’t talk about death as a part of life, despite it being inevitable for all of us. We will all experience the passing of people we know and love, and we will pass ourselves.

In some cultures, death is openly discussed and meditated upon to accept it as the cycle of life. In particular, Buddhism comes to mind. One of the tenets of Buddhist life is impermanence.

Impermanence refers to the fact that nothing stays the same. This is what makes life possible and can of course give great hope. For instance, no matter how you are feeling right now, it will pass.

Easing the discomfort of the discussion about death is possible by shifting the focus to living well. This is the view taken by Death Cafes that exist to widen our thinking and reduce the fear.

End of life care

Perhaps this is something we only consider when necessary. By the time it is, the importance is clear.

Each experience is unique. Everyone has their own set of needs and version of events.

Fortunately mine was positive. Having said that, losing a parent was surreal. The last few weeks and then days were accompanied by a knowing that the end was near, but never really knowing when. Time was suspended.

The one thread of consistency came from the hospice. The attention to caring, the frequency of contact with dad, and the little touches all made a difference.

Essentially, the staff use all their knowledge, skills and experience to make the journey as comfortable as possible. It sounds like a cliche yet what else would you ask for?

I became incredibly aware of the need for such care. I wondered how many people receive this attention? How many don’t? Everyone should.

This is the because, the reason for running the SDW this weekend (in just over 12 hours). Raising money is always a bottom line and I’m so grateful for all those who have donated so far. I know there is more to come too. We will exceed the target. But….

….there’s more

To me, what is more important is having this conversation. Raising the awareness of the work that the hospice staff do each day for people who need care at the end of their life, whatever the reason.

Raising awareness I think will result in more donations and funding as people will organically realise the importance. That’s my hope anyway.

If you agree, then you may like to support St Wilfrid’s, Eastbourne. Whatever you can spare would be much appreciated, a few quid, a tenner, £20, £50 or £100. It all helps.

See here for Richmond’s Just Giving page.

On the trail

I’ll be heading off from Winchester about 8/830am tomorrow morning. If you see me, give me a wave. If you fancy trotting along for a few miles, do.

On we go.

Tapering

I used to think tapering meant feet up, hardly any running and lots of eating for a week or so before the event.

Wrong!

For pro advice, you can read about tapering with coach David Roche here. For anecdotal experience, read on.

How I used to taper

I looked forward to the tapering week, sometimes two. Take it easy, occasionally run a few k’s. By a few I mean 3-4. So very little.

It meant a week or so of eating whatever I wanted. Awesome!

Days of sitting around, usually reading. That’s not so bad. There’s always something to learn.

But there was something that quite right. Reaching race day as I did in May this year, I felt heavy. Heavy legged.

My overall programme, which could be named hit and miss at best, was ending with a slothful period.

What was I thinking?

To put on a positive spin, it was a learning experience that has led to something much better.

How I am tapering now

Good training is sustainable training

David Roche

Tapering is part of the programme. With a measured, gradual approach to building fitness, speed, resilience, quality movement, stability and more, I have no need to spend a week or two resting to recover.

Been there…..

The week before SDW 100 miler, my training now looks like this:

  • Saturday: 20k easy on trails, hilly not steep. Run down hills with brakes off (building courage and skill)
  • Sunday: 10k easy + 4 x 30 sec hills (fast & smooth)
  • Monday: rest day, stretching/mobility, breathing
  • Tuesday: 10k easy, core/stability training
  • Wednesday: 8k easy
  • Thursday: 5k easy
  • Friday: 5k easy
  • Saturday: SDW

Feeling rested, ready, and relishing the opportunity to hit the trail next Saturday.

Now that is tapering.

Daily practices

Several times a day I stretch with micro practices dotted through the day – balance, stretch, mobilise, massage gun, roll, yoga pose, mindful breathing.

Most days I will sit and meditate. Other days are micro meditations of a few minutes. I am lucky because I get to practice with people most days as well in the clinic when we look at different ways to change state, create calm and clarity to help overcome persistent pain.

Walking. I walk everywhere.

Standing. At home I stand to work. In the clinic, I get up and move around often as a matter of course.

Our mind’s are embodied. Thinking emerges from the body state and the body state can depend upon what we are thinking. There really is no separation. We have just the one experience.

Hence, movement is a fundamental part of being at our best.

Upandrun.

Onwards.

RS.

PS/ If you would like to support the work of St Wilfrid’s Hospice, please donate here. We are over half way to the target, so your help is much appreciated.

The team looked after my dad and us so well in his final days. To help them continue this vital end of life care is so important to our society.

Thanks

Easy running

I would never have imagined that a monk would teach me to run.

Over the past three months or so, following my DNF in May, I have been getting it together by following a training programme.

This was a programme put together by record breaking ultrarunner Damian Hall. He bases much of his coaching on the approach by David Roche. David is a great advocate of easy running — you can run as easy as you like.

Easy running makes you quicker. Didn’t you know? I am not going to explain to you how, because David can here.

I can tell you that it works from my own experience.

I was pretty broken after two years of non-stop ultras. The pushing, straining, mile after mile initially worked, but the stress on my body caught up. You can’t keep going at that intensity without something giving. I see these folk in the clinic — the ones who are stuck.

So easy together with consistent and regular movements, stretches, stability and strength with have built me a base. What’s more, it has brought the joy back and the confidence to keep going. Perfect timing too with the SDW 100 miler next Saturday.

Thich Nhat Hanh

A great advocate of mindful walking, Thich Nhat Hanh encourages us to slow down, be in the here and now and cultivate a peaceful way.

I used to try and practice mindful running, but somehow had put this way to the back. Instead, I became over-focused on the feelings in my body and trying to work them out. This was part of the reason for the DNF. It is unsustainable because every little ache and pain becomes amplified.

Together with the easy running, I thought I would listen to Thich as I trotted along. To be able to listen to someone or a podcast whilst running means that your pace is easy — not stressful.

Thich guides many meditations, but the one I was listening to resonated. It also worked in as much as I became calmer and calmer, running relaxed and easy. Perfect!

This is the kind of practice I share with people who come to see me. Most if not all benefit from creating a calmer embodied mind having been dealing with many different challenges at the root of their suffering. Persistent pain in particular and the consequences.

The beauty of the practice is that it is so simple. Whilst it may not be for all runners, if you are someone who wants to master the easy run to become quicker, you may find it helpful.

Here are the words. I will share a recording soon.

Try this if you like.

The practice

Run easy, which means with flow, smoothness and upright, using your body as a guide — no strain. Notice your breathing, but do not try to change it or control it. One way is to place your attention at the end of your nose and become aware of the air flowing in and flowing out.

With your awareness now upon the flow of your breath, silently say to yourself: breathing in, I am aware I am breathing in. Breathing out, I am aware I am breathing out. The shorten to breathing in, breathing out.

This brings your attention to your breath in the here and now. If your mind wanders, simply start again. This is a practice.

Some people enjoy the presence and rhythm that this brings, somehow becoming part of the overall movement of running.

A further mantra that I use to remain present and at ease is: breathing in, I calm my mind. Breathing out, I run easy. Then shortened to calm mind, easy running.

Of course, you can create your own as well. Choose words that give you gentle direction that you can follow.

Notice what happens.

Let me know if you like. I’d love to hear.

Next time, some thoughts on nose breathing — because that is what it is there for.

Happy running!

RS

PS/ If you are up on the South Downs Way next Saturday-Sunday and see me or want to join me for a few miles, let me know. I am running to raise £ for St Wilfrid’s Hospice in Eastbourne and in memory of my dad: https://www.justgiving.com/fundraising/richmond-stace11

upandrun 21

Brick Richmond from Brickrunners

Back on the trail tomorrow for upandrun 21

Tomorrow is my birthday. My present to myself is to run from home to where I was born for upandrun 21.

21 is not my age.

The idea came from the Pegasus Ultrarunning guys. They have created an Ultra Marathon Birthday Hall of Fame.

Of course, the primary purpose is to raise awareness of the problem of chronic pain that besieges so many people across the globe.

It is also to share hope as our knowledge and understanding of pain advances at a rapid rate. As a result we can help people shape positive futures.

Further, ultrarunning is a way to experience one’s own pain and learn — blog here.

The route

It is a mixed bag. A good amount of the trail will be along the South Downs Way as I head from Ditchling Beacon to Eastbourne.

From there I will find my way along the coast to Hastings, where it all began. I don’t remember that day, but I know it happened.

The distance will end up around 80k I would suspect. Time? No idea. I always get that wrong.

One of the beauties of heading off on a long bimble is the loss of a sense of time. I often have no idea of the hour. There is only this moment. Truly present.

As ever, pics will be on social media.

Instagram | Twitter | Facebook

RS

UP on the road in South Africa

The end of a successful roadshow: Neil Wright (TensCare), Juan Schaerer (Adcock Ingram), me, Nick

I was very pleased to be asked to speak at the Adcock Ingram Sports Science & Rehabilitation division launch roadshow — a whistle-stop tour of South Africa.

Innovative TensCare CEO Neil Wright asked me whether I would give a series of talks in South Africa (Johannesburg, Durban and Cape Town). He had heard that I bring an ‘edge’ to the topic of pain. I like to think so, but only in terms of challenging out-dated thinking that holds us back. What a great opportunity, I thought. A chance to spread important messages via Understand Pain (UP) and to learn about how chronic and complex pain is addressed in South Africa.

The new Adcock Ingram division was being launched to local physiotherapists, chiropractors and biokineticists, and the theme of the events was pain. How could I resist? Adcock Ingram are engaging with therapists and clinicians in a new way that is generating a great deal of excitement. This is based on creating great relationships and distributing high quality products that compliment rehabilitation, including the range of devices from TensCare.

Both the team putting on the roadshow and the attendees were buzzing! The feedback from the people in the audience was very positive. There was a thirst for quality pain education, and it would be great to follow up with full Pain Coach workshops.

Richmond giving Pain Coach talk
Johannesburg audience

TensCare and TENS

TensCare is an employee owned company, distributing TENS and electrotherapy machines all over the world. One of the main reasons to use TENS is for pain relief, in both acute and chronic pain. It is probably best known and most used in maternity care.

In my experience, TENS is under-used for chronic pain. Whilst TENS will not solve the problem, it can offer relief that helps the journey forwards. As an inexpensive and simple form of self-treatment, it is a good option. The key is that the user understands how it works and how to best use the unit. This can take some time and practice, but with instruction, discovering the right parameters can be found more swiftly.

 

Nick & Richmond selfie in Durban

I shared the stage with Nick Martichenko from Canada. Nick spoke about the use of tape and the understood mechanisms, whilst I focused on pain and pain coaching. I entitled the session ‘The Challenge of Pain’ as a doff of the hat to Pat Wall, the founder of modern pain biology, who wrote a book of that name. It was Wall’s work that resulted in the development of the TENS machine.

Three days, three events

On the road…

The roadshow put on by Adcock Ingram was very high quality from start to finish. They really wanted to make sure that every detail was covered. This was appreciated by the attendees who were most enthusiastic about the event. There was a new precedent being set, and the beginning of a new engagement between Adcock Ingram and therapists/clinicians.

I was particularly impressed by the way that the sales team approached their work. Selected and led by Juan Schaerer and Sheila Keshav, this group has come together in a short period of time. There was a great deal of positivity within the team, supporting each other, and getting jobs done from start to finish. I was privileged to be able to hear some the individual stories about how they came to join the team.

Richmond Stace The Pain Coach in South Africa
Cape Town Team

From a pain education perspective the roadshow was a great opportunity to talk about ways in which we can help people understand their pain and move on to improve their lives. That’s the purpose of UP. I hope that everyone else enjoyed their time as much I did. This was a super start and I will be very interested to learn how this story unfolds.

RS

 

UP heads to South Africa

UP in South Africa
Photo by Tim Johnson

Talking tour March 2020

In a week’s time I head off to South Africa to deliver a series of Understand Pain talks. This is a great opportunity to connect with clinicians, therapists and others who work with people suffering pain. Invited by TensCare, we will be working together on this tour to educate, enable and empower people to provide best care for pain.

TensCare: We provide drug-free pain relief for the long-term treatment of chronic pain conditions and the relief of the acute pain during childbirth

One of the main issues and reasons why pain is such an enormous global health burden is the misunderstanding of what it is and how it arises. The predominant approach remains biomedical despite the fact that this model does not deliver solutions. Society needs us to build on our knowledge about pain and offer person-first care: it is the person who feels pain, not the body part.

In brief, I will be talking about the purpose of pain, why it persists and what we can do to help and encourage people to move on and live fulfilling lives in their own unique way. This is using strengths based coaching together with the latest pain and related sciences, focusing on meeting the person’s needs. This is the essence of Pain Coaching, which is a skillset and way of delivering care that sees a person first, not a patient or a list of problems. Instead, we see someone with strengths and the potential to improve their life. We guide and facilitate this growth in a positive way.

My hope and aim as ever, is to bring the latest understanding and thinking about pain to society in a practical way.

Understand pain to South Africa

Towards the end of the trip I plan to run #upandrun 13 in and around Cape Town, taking in Table Mountain. This is the awareness raising part of the Understand Pain social enterprise work, as I continue with monthly ultramarathons.

You can follow my projects here on the UP website and blog, and on Twitter (@painphysio), Insta (@paincoach) and Facebook (Specialist Pain Physio).

RS

Free Pain Coaching for Osteoarthritis

Richmond Stace pain coaching
Richmond Stace | The Pain Coach | Pain Specialist | Chartered Physiotherapist

A new project for UP: FREE Pain Coaching for people suffering pain from osteoarthritis

Osteoarthritis is a leading cause of pain and disability, estimated to affect 8.5 million people in the UK. This being the case, UP is offering a free Pain Coaching programme for sufferers.

Your free place here

In a project supported by GSK, you will receive 4 Pain Coaching sessions with Richmond Stace, co-founder of Understand Pain (UP) and pioneer of Pain Coaching. This can be face to face if you are able to attend one of the clinics, or Skype/Zoom if you live afar (UK or abroad). There will also be some small group sessions with 4-5 people).

The aim of both Pain Coaching and this project is to help you understand your pain and give you tools and practices to improve your life.

We are also studying key moments in the coaching conversations and will be voice recording the sessions to create transcripts. These will be anonymous and securely saved according to GDPR regulations.

What is Pain Coaching?

Pain Coaching is a blend of strengths-based coaching and pain neuroscience. Results-focused, we work together to clarify your picture of success and then design the steps in that direction. The steps consist of a range of ways to overcome pain and live your best life. This is a continuous process meaning that once you have the knowledge and skills, you are able to build momentum and seek sustained improvements.

Coaching is increasingly being used in the NHS as it is the primary way we can encourage effective self-care and independence. Strengths-based coaching has been pioneered by Mike Pegg. Mike sums up strengths-based coaching as a means of ‘…how we can encourage people during our time on the planet. It looks at how we can help people to build on their strengths and achieve their picture of success’. This approach is one of the predominant forms of coaching that we see in successful business organisations and sport.

Getting the best of you so you can live your best life

Key features

  • Free Pain Coaching sessions for OA pain
  • 1:1 (in person or Skype/Zoom) or small group
  • Understand your pain and symptoms
  • Learn tools and practices to improve your life
  • Build momentum for sustained improvement

Next steps…

Start your Pain Coaching today by visiting the Project page and arrange your first session.  

CLICK here to start

RS

Why I have gone vegan

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.

Vegan mince pie

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!

Beetroot juice

RS


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!

#upandrun 10 Hampton Court to Henley

Setting sun coming into Marlow

#upandrun 10 Hampton Court to Henley

76k along the Thames Path taking in Shepperton, Chertsey, Staines, Windsor, Maidenhead, Marlow and finally the home of one of the most famous regattas

The final ultra of the year for Understand Pain saw me running along the Thames, finishing at Henley-upon-Thames bridge. It’s a flat route meaning that most of the strides were similar, making for monotony as a challenge. The only variation was traversing fields, featuring uneven ground — tyre tracks, mole hills, divets etc. This was especially interesting in just the light of my head torch. Patches of fog provided additional fun.

Now it is time for some planning: monthly races and solos for 2020. There are so many to choose from! My thinking is to go for a 100-miler and another mountain race. I have some unfinished business on Snowdon, but perhaps Europe.

The UP workshops will have a different look in 2020. There are a couple of new projects afoot, which I will announce in more details once the details are finalised.

Exciting times ahead!

Meanwhile, here are some photos from #upandrun 10.

Runnymede

River Thames

Windsor Castle

RS

#upandrun No.8

Richmond Stace co-founder of UP running for #upandrun

It is time to think about the October #upandrun ultramarathon now that I have recovered from the Snowdonia adventure and am back to running around locally.

There are several choices, both of which are solos. That is when the runner heads off on his or her own, unsupported, making their way from A to B.

The one I shall go for is Richmond to Oxford along the Thames Path. Previously I ran from Hampton Court to the Thames Barrier, so this will be going the other way; out of town so to speak.

The route is 100 miles. I will chunk this into two days, finding somewhere to stop overnight. Any suggestions are welcome. Preferably somewhere quiet, with nourishing food where I can dry out and put my feet up for a few hours before setting off again. All I will carry is what I can fit in my backpack.

So that’s the plan. I will confirm the dates soon.

If you are interested in sponsoring this run and the October UP workshop, or sponsoring/associating with #upandrun do get in touch >> richmond@specialistpainphysio.com