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.
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….
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.
I used to think tapering meant feet up, hardly any running and lots of eating for a week or so before the event.
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
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.
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)
Feeling rested, ready, and relishing the opportunity to hit the trail next Saturday.
Now that is tapering.
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.
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.
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.
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.
There is a purpose for my ultrarunning, and it is mainly to share hope.
You may have seen the tagline I was using for the September upandrun: ‘ultrarunning to understand pain and share hope’. Here is why.
Ultrarunning to understand pain
Running for long distances means being on your feet for hours, moving along. On the journey, you discover much about yourself — you find out what is under the hood.
Under normal circumstances, we use our resources to deal with challenges as they arise. Life is full of uncertainty (more than certainty), twists and turns. That is the way.
What we can do is to focus on controlling the controllables. What can we control? Our approach and attitude.
Suffering comes from the way that we think about any given situation. Prior to this, it is merely a situation. This has long been realised by philosophers and others.
Life is a journey — cliche yet true. How do you approach the journey? How do you deal with things when they don’t go your way? The style that you use will determine whether you see it as an opportunity (to learn) or an obstacle?
Ultrarunning is the same. You set out on a journey that will be full of unknowns. When you are trotting along and feel great, it is wonderful. What about when you are in pain, feel sick, are hit with fatigue and hunger and thirst and more? How do you respond? How do you keep going?
The concept of the pain cave describes the place you can go. It is dark.
But, there is ultimate learning about oneself in the pain cave to the point that many embrace the experience.
Pain is inevitable on an ultra.
You become your own experiment (n=1) as you examine your perceptions and thoughts shaped by the very actions you are making. When you change the way you move, your thinking changes — embodied cognition at work. Thoughts are very much grounded in the state of our body, and the state of our body is determined by the focus of our attention. Expectations also play a significant role — we see the world that we expect to see.
As inevitable pain emerges, the opportunity arises to closely examine the sensations and how they change. Different perspectives and different language all shape the experience. Noticing a shift in running pattern, perhaps leaning forward or the head dropping, one can lift and be taller to notice the change in perspective.
What is the story I am telling myself in these moments? If I alter the words, what happens? I notice how attached I am to that particular narrative and how easy or hard it is to let it go. Bringing my purpose to mind, or a loved one and there can be a sudden transformation of state.
Heavy moments are normal. Body, legs, head suddenly feel like sacks of wet sand — have you ever tried to move one? But you know that this will pass, like all perceptions. Nothing is permanent. This insight alone pulls me back from the mire of thoughts.
Our perceptions and bodily sensations are dynamic — always changing. Life is not static, instead fluid and moving onwards. It is the story that stays the same. The one we have been conditioned to believe is true.
Then you realise that there are infinite stories and possibilities. Freedom.
Ultrarunning teaches you about freedom.
I can examine my own experiences under duress and elucidate my resources my journey continues. The finish line is of course the beginning of the next.
My message is one of hope.
Both the knowledge of pain and what we can do to guide, support and encourage people to live fulfilling lives has grown enormously.
We have much better answers to the questions (start here):
what is pain?
why do we feel pain?
what is the purpose of pain?
what can we do to improve our lives?
Many of the strategies, practices and techniques to transform and overcome pain are taken from the skills of being well, peak performance and strengths based coaching. Over the past 10 years or so, I have called this Pain Coaching.
There is a simple principle. The more you focus on the pain and try to treat it, the worse the outcome. The more you focus on the person and how they want to shape their life, the better the outcome.
Focus on what you want, not what you don’t want. As soon as you are saying, ‘I don’t want this pain’, we focus right back on the pain.
Instead, re-focus on your picture(s) of success and the steps you can take right now in that direction. This is an approach and an attitude. You will need some help, it will be up and down, but
I first met Adharanand in 2019 when I went on a writing and running retreat in Devon that he was co-hosting with Richard Askwith.
We kept in touch.
A few weeks ago I took the opportunity to whizz down to Dartmoor for a one day running camp: The Way of the Runner. This time it was co-hosted by Adharanand and Barefoot Joe. It was a great day, as I expected.
As we said farewell, getting ready to head home from the car park, we mooted the idea of a conversation.
And here it is. Eau naturale. Anecdotes about and idiosyncrasies of ultrarunning.
Much is said about recovery. This is largely because there is no single way to recover after a run. Each person must find what works for them: the art of recovery.
I’ll share some brief thoughts in the form of top tips, off the back of September’s upandrun along the North Wales Path. But, bear in mind what I have just said about the individual nature of recovery.
1. Recovery stops during an ultra
When I run, I now always opt for normal foods rather than gels and the like. This can include any of the following, depending upon the stage of the run: fruit, pasta, sweets, ginger beer, nuts, seeds, flapjacks, a bagel, samosa, coffee, water.
On the longer runs, rest and recovery stops are important for me. On solos, they are fairly brief, but nonetheless, there is relief in sitting down for a few minutes and having a bite to eat.
This is in keeping with my running philosophy that is just for me: finish line, not finish time. I want to fully experience the journey, enjoying the ride as much as I can. There is no rush for me. I am not interested in times, instead just building my belief that ‘I can’ in life.
2. Immediately at the end of an ultra
I enjoy a pizza and a beer.
The most memorable was ending up in Bath one evening, having run down from Gloucester along The Cotswold Way. It had been a pretty foul day and off the back of a period of serious rain in the UK. You can imagine the state I was in….
They were most welcoming in Pizza Express despite my appearance. I was served quickly. Looking back, this may have been so that I left promptly!
3. Recovery takes a little while
The things you do to recover span a period of time. It is an on-going process until you feel back to normal: homeostasis is the goal.
Choose your fuel and sources of hydration according to your needs. It can be a bit up and down after an ultra.
For instance, I will feel hungry and eat. Then feel a bit queasy. And then hungry again and so on.
Whatever you do to recover then, be complete and see it through. This could of course include all of the elements I discuss.
This might just be the most important one.
Understanding sleep as arguably the keystone of wellness, creating a good habit is vital for recovery and performance at all levels of participation.
Unfortunately, in the modern era, sleep has taken a back seat. For some reason, a lack of sleep has been championed as some kind of machismo feat: I can work for 23 hours a day….how incredible am I? I can be out all night and then carry on….
But it is not. What that is, is a one way ticket to poor performance and health. And probably a shorter life. There are some brutal facts. But we know that people don’t always like to pay attention to the facts.
Bottom line. Try to get the best quality sleep (7-8 hours) as many nights as you can.
5. A special ingredient
When we pay attention, we can realise that there might just be one ingredient that makes a difference. On that, I have made a recent discovery.
CBD oil and balm.
Having had a good chat with Celine from Wholy Me, I was happy to try the drops and balm as part of my daily routine and recovery.
Acknowledging that it is a case study of one, me, I have been taking the drops each day, and massaging the balm as required into sore bits.
I finished the ultra on Monday evening, having started the previous night at 1030pm. My watch told me that I had been going for 18 and a half hours, covering some 120k.
It was time to recover.
Yesterday I was running again, albeit an easy pace and concentrating on form. I like to do this anyway: a slow run (speaking pace), focusing on being relaxed and tall.
I am fortunate to recover seemingly quickly after an ultra. Perhaps because of my monthly jaunts since May 2019.
But this appeared to be quicker than ever. Was it the CBD routine? One cannot say for sure. Expectations also play a significant role, and I do expect to be moving almost normally by day two.
So, I will continue with the CBD as part of my daily rituals alongside other habits: cold shower in the morning, various supplements, mindful practice, movement, attendance to fuel and hydration, and sleep to name a few.
For it is the small things behind the scenes, accumulating their effects each day that make the difference.
Just in case you are wondering, I do believe that the CBD is making a difference to me.
6. Bonus: motion is lotion
It is tempting to stay still and rest. But it is movement we need to nourish the muscles, joints, nerves and more.
Easy movements, getting up, changing position, trying to maintain best form, and being regular are all important for recovery.
They are also vital day to day because the way we use our body will shape its form. And it is that form you take into running and other activities.
If you sit for long periods, parts of your body will tighten. You will then try to move those parts vigorously in sports causing adaptation and excess strain. This is one of the major reasons for the gradual onset of pain and sensitivity.
The body also keeps a record of every emotion and experience you have. We must look after ourselves as a whole if we want to perform.
Preparing for an ultra requires planning. It is also a time to take it easy and eat.
Update on the route
I am now planning to start at the Menai Bridge.
Having looked at the path along the North Wales Coast, it became apparent that an acknowledged leg runs from the Bridge to Chester. Or vice versa, which is the way that I am travelling — East to West.
This extends the route a little to 131k.
In the meantime…
I am looking at the maps to build in my sense of the journey and to arrange the rest stops. Here I will meet Jo and Chico for fuel, fluids and any other bits and bobs that help me to keep going. Perhaps a change of socks.
Jeff is joining me for the last 30-40k.
Ffynnongroyw or Mostyn.
This week is an easy week: a few relaxed runs help to keep moving, plenty of sleep and nourishing food.
I’ll gradually be pulling my kit together. It maybe chilly running through the night. Perhaps it will rain. Must be prepared.
This month sees the return of the 100k + distance as I trot along from Bangor to Chester.
For some time I have been chatting with Jeff, an UP ambassador, about running together. So, I am delighted and excited to say that Jeff is joining me for the last leg — I will be on my last legs, that’s for sure!
Jeff is a great encourager. He is a coach, a facilitator, a writer and much more. Jeff has a book coming out soon, which I know will be superb. I am going to ask him to write a blog about it.
I also have crew for this one. Jo, my wife, has agreed to drive along the route and keep me supplied. She will be ably assisted by Chico.
Here’s the plan:
Drive up to Anglesey on Sunday. Set off around midnight, wrapped up and be-torched.
Make my way along the coast line through the night. Meet Jo and Chico at dawn with fresh supplies.
Have a beer and a pizza.
Lie on the back seat and be driven home.
To raise awareness: pain is one of the largest global health burdens affecting millions and costing billions.
There is much we can do as a society.
It starts with understanding pain. From there, people can feel educated, empowered and enabled to move on and shape a positive future.
This is the purpose of Pain Coaching, an approach I began pioneering around 10 years ago.
Recently I started using Wholy Me organic products: the drops and the balm.
The drops I use each day, morning and evening. The balm I apply, using self-massage, as needed. This is quite often as I usually have some aches and pains from training and running.
I have no other me to compare, however, my own experience is certainly one of overall calming and soothing on a day to day basis. The balm relieves my local soreness. It is a great combo.
Recently, I had a chat with Celine from Wholy Me on Instagram Live. I shared my thoughts and experiences. The Wholy Me Instagram page is here.
Here’s the blog that Wholy Me wrote about our conversation.
I will certainly be taking my drops and balm with me!
Please share so that we can give hope!
Over the past 5 years there has been a significant increase in the understanding of pain as a perception. This enables us to offer a wide range of practices, exercises and ways to help, guide and support people along their journey to improve their lives.
See the Resources tab on the site for articles and talks, and more on the Specialist Pain Physio site; podcasts and blog (Richmond’s clinic site)