Seeing the Bigger Picture

My practice is incredibly busy. In addition to my Garden Room Clinic, I still hold a low cost clinic on Tuesday afternoons/evenings in its town centre location at Quay Place www.quayplace.co.uk, where the 30-minute appointments are idea for those with limited time or resources, or who happen to work close by.

Interestingly though, I find more often than not that patient prefer to come for longer sessions at my Garden Room Clinic www.jobanthorpe.co.uk. I am increasingly aware that patients really want to be listened to, and indeed they have a lot to say. Many do not have the opportunity o the appropriate circumstances in which to tell their story and to feel that they have been heard - a practical impossibility in a 10-minute GP consultation.

I am also aware that more and more people working in the medical profession are looking beyond drugs to help with their mental and physical health. I already treat a number of healthcare professionals who have turned to acupuncture in preference and/or in addition to the western medicine approach of drug therapy, and have recently been invited to explore the possibility of delivering acupuncture to the staff at my local hospital as part of their wellbeing regime.

Whilst I have utmost praise for the NHS and think they deliver an excellent service the majority of the time in acute cases, where I think they could do better is in the long term management of patients whose medical conditions require them to access multiple departments. There can be a very apparent lack of joined-up thinking, a lack of continuity with no one clinician overseeing the treatment and with a strong tendency to quickly escalate the strength and quantity of medication. Patients are left highly medicated, often with complications and side effects which require additional medication, but are in receipt of very little, if any emotional support.

In my practice I have come across a great number of patients who are living with extremely complicated and debilitating conditions. Many have been prescribed a cocktail of powerful drugs but increasingly they experience little, if any respite from their symptoms despite dutifully taking their medication.

If a patient is willing to take the time to research their condition and treatment options in order to make an informed decision, and is willing to pay for private alternative therapy, then why wouldn't the NHS embrace an action that would take the onus off a system which is on its knees. In a struggling health service which is stressed and over-stretched, we are now in an environment which acknowledges the connection between emotional wellbeing and physical health.

I can understand a clinician's reluctance to allow patients full autonomy in view of the blame culture in today's society, and fear of legal action. On the other hand however, I find this surprising and rather narrow-minded as many patients are very keen to take responsibility for their own physical and emotional wellbeing, and I feel they should be applauded rather than reprimanded for wanting to do so.

Some of my recent experiences involve patients who have turned their back on conventional medicine in favour of acupuncture, on finding that they experience little or no lasting benefit from their meds, and in some instances when the prescribing has been nothing short of heavy handed. Where a patient has taken it upon themselves to explore a different route, their actions have often been severely frowned upon by their medical practitioners.

A recent patient suffering with alopecia totalis came to me after she was due to be prescribed a powerful immunosuppressant drug (usually given to transplant patients to prevent rejection), purely on the basis that one of its side effects was excess hair growth. She decided against taking the drug and is now doing very nicely after a course of acupuncture treatment. She is much less stressed and anxious and is now more accepting of her current reality and less impatient with the wait for hair regrowth.

Another patient had a very painful non-malignant melanoma in the brachial plexus of nerves in the shoulder area. She was told it was inoperable due to the proximity of nerves and was prescribed very hefty painkillers, which made her feel lousy. She was scheduled to undergo radiotherapy in an attempt to shrink the tumour. The patient realised that the medication side effects far outweighed its benefits and made the decision to reduce the medication, despite strong reservations from her consultant. Since receiving treatment, she has been able to cease all medication, has made significant lifestyle changes and is pain free. She is also refusing the radiotherapy, much to the disgust of her medical team.

Most recently I treated a young teenager who has a connective tissue disorder which leaves her with many symptoms including constant, severe joint pain. This has severely impacted her ability to attend school and has had a very negative effect on her emotional wellbeing. She had been subjected to innumerable tests over the years and was prescribed some very heavy duty medications, requiring fortnightly blood tests. All of this has left her feel low in energy and spirit, and utterly exhausted but with very little respite from her symptoms. Her parents made the decision to withdraw from treatment in favour of a less invasive, alternative therapy approach and were threatened with legal action by the hospital if they did so! I saw her  for treatment and she says she feels so much better now that she has stopped taking the drugs. She loved the acupuncture treatment and felt very calm and relaxed afterwards.

And finally, a patient who was, according to her GP, addicted to the painkillers she had been taking for many years for her constant severe headache. She was told to stop taking all medication completely and to  'ride the storm' of withdrawal, having been offered no back up or support. When I saw her she had been struggling enormously after only a few days without drugs, but this was very quickly resolved with a simple de-tox treatment and nourishment for her constitution. When she came for her next treatment she looked a different person - lighter, happier and had felt well enough to wear make up.

I am at times horrified to hear of the over-prescribing of drugs and the seemingly heavy-handed approach by the medical profession, who often do not take kindly to being questioned, and often take umbrage should a patient show a desire for autonomy. I think patients should be applauded for wanting to take responsibility for their own health and for being willing to explore different treatment options. I think one of my roles as an acupuncturist is to support them in their decision, but certainly not to influence them in any way.

I am delighted to have been able to help these patients with some very simple Five Element treatments and to give them the encouragement they need to find their own treatment path. I feel both honoured and humbled to be asked to accompany them along their journey to recovery. 

Alopecia - My Six-Pronged Approach

So, despite my best efforts at upping my self-care, my old friend alopecia has now taken a firm hold once again.

Whilst I'd been aware of the signs for a while now, I guess I'd still held an element of denial - hoping that it would resolve by itself and quietly disappear. Not so - clearly there was room for far more work to be done, and I needed to take this much more seriously.

It's not that I'm stressed or anxious about the bald patches though, as I feel I've fully embraced and reconciled the emotional impact of the hair loss. The fact is that my hair is falling out at a rate that is not normal, and whilst I feel fit and well in myself, my body is clearly in distress and is shouting for help. 

The body is very good at telling us when things aren't right by giving us symptoms and/or pain. However, we're not always very good at recognising or heeding the warnings, and have the habit of pushing through and carrying on regardless. 

Time then to make a step change. I decided to pay close attention to my body - after all, I'd be a fool not to listen to what it is telling me. 

So time to up the ante.

Whilst I've always maintained regular acupuncture treatment with Caroline Shepherdson www.purelyacupuncture.com every two months, I have to admit the daily guided meditations (Headspace www.headspace.com) have gone a bit by the wayside. But I have been doing weekly HIIT sessions with Ted www.vitalexercise.com for the past year and just LOVE my monthly reflexology/massage treatments with Tracey www.facebook.com/tracey macrae wellbeing. 

It was time to pay a visit to scalp and hair loss specialist Cheryl www.cmhairloss.co.uk, whose late colleague Peter Bannister had first treated my scalp back in 2016, with excellent results. Cheryl uses gentle and natural products to improve the condition of the scalp and promote hair growth.

Her analysis of my hair concluded that whilst some follicles had been affected by hormones and stress, by far the greater problem was malnourishment - my remaining hair was thin, weak and malnourished. As it happened, I'd already made the decision to see a nutritionist, Fiona www.thenutritiondetective.co.uk, as I'd become aware that something wasn't quite right with my digestive system. Knowing that gluten and dairy are common culprits, I'd tried avoiding these in the past but felt I needed more expert guidance on this.

Fiona concluded that my bloating was a result of low stomach acid - the initial digestive process was inadequate so that food was passing out of the stomach only partially digested. This was remedied by a simple hydrochloric acid supplement taken with each meal.

My floating stools were a result of poor fat absorption, possibly as a result of compromised liver function due to Hepatitis A infection in childhood and long-term antibiotic use after rheumatic fever in early adulthood; not to mention low birth weight and failure to thrive as an infant, and four pregnancies (including twins), all of which hammered my body at the time. 

This has all lead me to better understand my alopecia. Predominantly it tends to be stress related, but I knew that mine had happened at a time when I had very little stress in my life and I felt (and still feel) very calm, so I was rather puzzled as to why it happened when it did.

I realise now that nutrition plays a hugely important role. I was convinced that my diet was very healthy - which indeed it is - but if my digestion wasn't up to scratch then it was obviously leaving my body depleted and wanting.

A regime of supplements and slight tweaks to my diet has already improved my skin, which was prone to dryness and itching. The scalp treatments are optimising the condition of my hair follicles and hair is beginning to grow back at the edges of the bald patches. And my amazing hair dresser Lucy www.facebook.com/joshua c constantly comes up with styles which are kind to my hair and keep it looking edgy. 

As an acupuncturist myself, I have come across practitioners who frown upon patients who have treatments with several different therapists at the same time. I agree that it's not easy to determine whether any one therapy is making a difference as the waters can become rather muddied, but I feel that sometimes a broader approach can be beneficial, as long as the therapies undertaken compliment each other, rather than duplicate or contradict.

   

I will continue to look after my general wellbeing with good diet, exercise, relaxation and acupuncture. It's very easy to become complacent when things are going well but it's important not to let self-care slip. If we do, we will regret it and pay the price.

The Wanderer Returns

We've all said it. Usually through gritted teeth, with a fake smile and a sinking feeling in the stomach.

'How lovely to see you!'

Extending that insincere welcome to a distant relative or the 'not quite a friend', to whom you've said, 'Do pop in when you're next in the area', but secretly wishing and hoping that they won't. In fact, knowing that you'd really not be bothered at all if you never see them again.

You know how it is - they turn up unannounced, stay too long, make seemingly unreasonable demands and whilst we try our utmost to accommodate them and make them feel welcome, we  heave a huge sigh of relief when they've gone.

Great Aunt Alopecia has been threatening to pay me a visit for a while now. She's been knocking on my door since before Christmas but I've managed to avoid her up until now by hiding up and pretending to be out.

Her last visit two years ago turned my world up-side-down. I'd always thought of myself as a tough cookie who could cope with most things hurled at me, but I wasn't quite prepared for Auntie's surprise invasion, her vicious tongue and completely uncompromising manner.

She hung around for about nine months in the end, and I'd resigned myself to the possibility of her staying for good. But then I was pleasantly surprised (and relieved) when she packed her bags and left - just like that. 'Do come again - anytime,' I heard myself saying, 'You're always welcome.' (In my head 'NOT!')

After she'd left two years ago, I spent some time reflecting on her stay. Not being one to hold back, and being renowned for calling a spade a spade, she'd picked holes in my life, criticised some past life-choices I'd made and positively laughed at my paltry attempts at self-care.

Charming! I felt indignant. I didn't need some stuffy old bat coming into my life and telling me things that I already knew!

And that's the point. 

She wasn't telling me. She was FORCING me to take a good look at my life, and at all things that I did indeed already know.  I'd had my head in the sand and was ignoring all the warnings and red flags. I wasn't doing anything different to make changes or improvements - and Auntie wasn't going to budge until I'd addressed all of those things in question.

And so Great Aunt Alopecia took it upon herself to make me stop in my tracks and take heed. So slowly, gradually I did indeed make changes and really, really paid attention to my self-care. And guess what - it paid off! At long last Auntie took her leave - hooray! But not without that final, warning glance over her shoulder which seemed to say 'I'll be watching you.'

So yep - I hold my hands up - guilty as charged. I started to let things slip and the changes and improvements have been slipping out of the window. And so, true to her word Auntie came back, wagging that finger at me.

But I find I've changed my tune as far as my relationship with her is concerned. Despite her rather commanding presence, I've realised that she means well and actually talks a lot of sense. She encourages me to be more mindful of my boundaries, to make time for my family and friends - and above all, to make time for myself.

I actually have a lot of respect for Great Aunt Alopecia. I wouldn't say that I particularly enjoy her visits, but I have an increased tolerance towards her and so will always make time for her and listen to what she has to say. Just hope she doesn't hang around so long this time.

Alopecia - Journey's End and a New Chapter Begins

December 2016

May 2016

I can always remember my late Father's wise words. 'Give it time,' he would say. 

He would say it very often in his daily practice as a Vet, to anxious owners who wanted to know how long before their sick or injured pet to make a full recovery. He would say it to us kids when we were being impatient and expectant. 

There were occasions when I thought this to be an avoidance tactic when my Dad didn't have the time, energy or motivation to engage (and I'm sure this was the case more often than not). However, it taught us kids a valuable lesson in the virtue of patience, though I'm sure we weren't aware of this at the time, and probably didn't appreciate it.

I remember hearing his very words ringing in my ears last May when I made the decision to embrace my alopecia and shave off my remaining damaged hair. Initially I felt the need to find out the cause and a way to fix it, but I soon came to realise that I may never find out why it happened, and there may not be a way of fixing it - and I was OK with that.

Like my Dad said, I knew I just needed to give it time. 

We tend to assume that the GP will have all the answers - after all, they have a pill for most things, and if there isn't a cure then at the least they can usually offer an explanation.

We humans seem to need to have a reason/diagnosis/treatment or plan of action. It serves the purpose of putting our minds at rest,  it can allow us to apportion blame, or it reassures us that it's not all our own fault, Above all, it gives us hope and empowerment - we feel we are able to do something constructive, and we are given back some semblance of control.

However, often when investigations draw a blank, rather than being relieved that nothing sinister has been uncovered, some people can become frustrated and even disbelieving of the medical profession, and can feel that they have been let down.

What we're not terribly good at is sitting back, doing nothing and accepting something for what it is without knowing the reason why. It is the element of control, or lack of, which can really mess with our emotional well being because being able to exercise autonomy is one of our essential emotional needs.

Along with my Dad's words, I have held on to some other expressions during my journey with alopecia, and they have been my inspiration along the way. 

'Let Nature take its course'; 'Wait patiently for what time brings', and especially the words of the Serenity Prayer;

God grant me the serenity to accept the things I cannot change;

the courage to change the things I can;

and the wisdom to know the difference.

I feel that the most important part of my recovery has been emotional rather than physical. I have been extremely fortunate in being able to give myself the gift of time in order to do a lot of introspection and reflection, and to implement changes where needed.

Most importantly, I have been able to focus on ensuring that my emotional needs are met as fully as possible - and I still make this a priority. I see this as not by way of any selfish need, but as an absolute necessity - because if I don't look after myself, then I cannot give my best to those that I care for.

I am convinced that my sound emotional health has been my mainstay throughout my journey and has undoubtedly helped me to accept the loss of my hair and the prospect of it not returning. Of course I feel immensely lucky to find that it has regrown, but I was mentally prepared for this not to be the case - and I was OK with that.

Sadly, I know there are hundreds who live on a daily basis with the anguish, embarrassment and low self-esteem that accompanies alopecia. To those who are suffering in this manner, you may find it useful to consider the following: 

It is not so much WHAT we experience, but HOW we experience it. It's not what we go through that determines our ability to cope, but how we deal with the stress, and how we still manage to meet our needs as best we can, retain hope and feel empowered.

Most people will accept us for who we are with or without hair - those who feel the need to poke fun or are unkind are generally acting out of  ignorance, and these are not the people we need to associate with right now. Much of our criticism comes from within, so it is vitally important that we learn to love ourselves and to ensure that as many of our emotional needs as possible are met on a daily basis.

You might find the following links helpful :www.suffolkmind.org.uk and  www.clinical-depression.co.uk

Alopecia - Nearing my Journey's End

May 2016 - immediately after the chop!

August 2016 - with added blonde!

It is now five months since I shaved my head (and 14 months since discovering my first bald patch) and I'm delighted to report that my hair is growing back!The patches are closing up and there is new (dark) hair growth clearly visible in their centres.

I have attributed this recovery to a very simple, yet powerful Five Element acupuncture treatment given to me by my tutor and mentor, Nora Franglen http://norafranglen.blogspot.co.uk/, whom I consider to be the authority on Five Element Acupuncture in the UK. 

The treatment she gave me was to clear a CV/GV block. This protocol is primarily used in Five Element acupuncture, but less so by practitioners trained in the more widely available Traditional Chinese Medicine (TCM) acupuncture. 

A CV/GV block can occur as a result of major trauma (recent or historical) or after surgery in child birth, and can leave the patient with chronic, low energy (eg ME, MS), infertility and auto-immune deficiencies. If a CV/GV block is suspected, it is vital that it is cleared as this energy flow is responsible for supporting all the other energy meridians and officials.

In Nora's eyes, my sudden and dramatic hair loss pointed clearly to a major energy block and a CV/GV block clearance was indicated.

The procedure involves clearing blocked energy in the Conception Vessel or Ren Mai (CV) and the Governing Vessel or Du Mai (GV) by needling the following points;
CV1 (located at the centre of the perineum); GV1 (located between the tip of coccyx and the anus); CV 24 (located on the chin in the mentolabial groove); GV28 (located inside the mouth, on the frenulum).

In reality, many acupuncture practitioners avoid clearing this block because of the intimate nature of the needling, but it can be done very discreetly with minimal embarrassment. Whilst it is important that the needling is carried out with intention, any discomfort is short-lived and the benefits far outweigh this.  

I have been reflecting back over my own past to try to think of a root cause to my hair loss. I know I am not alone in having experienced several traumas and losses in my life. Undoubtedly the most traumatic event was the sudden and unexpected home birth of my second child, who arrived two weeks before term, and was delivered before the ambulance arrived with just my husband to help. Sadly my son only survived for two days as he was born with congenital hypo-plastic left heart ie the left side of the heart had failed to develop, and so it was a fatal defect. 

This happened 29 years ago - but I didn't allow myself to grieve at the time as I had a 13 month old toddler to look after. I blocked out my grief to enable me to take on the role of supporting my young son, husband, parents and in-laws, who were all naturally absolutely devastated. 

I know now that I was clearly in shock and possibly suffering from PTSD, but certainly felt closed off emotionally for many years subsequently. I spoke very rarely of my loss and hid it from my children and others - in my mind I thought I was protecting them from hurt, but the fact was that I didn't know how to initiate the conversation or to answer potentially difficult questions. As coping mechanisms, I became an expert at avoidance and compartmentalisation, and adopted a frenetic life-style, absorbing myself completely by looking after family, home and work. 

Could it be then that my alopecia was indeed a very delayed response to this and other traumas?

My conclusion is that finding the exact cause doesn't really matter, but I believe that my own regular Five Element acupuncture treatment over the past six years and my understanding of how trauma affects the Five Elements, have helped me to finally reconcile past events, and to let go of unresolved emotional issues, unrealistic expectations, grief and guilt. 

Perhaps losing my hair was symbolic of this process of letting go? Certainly it has felt like quite a journey, and has really made me take a good hard look at myself and our society, and at the importance we place on looks, hair and imperfection. It made me realise that, hair or no hair, I am the same person on the inside and actually it really doesn't matter to me what I look like or what people think of me.

 
I feel that this experience has allowed the real essence of who I am to emerge. For the first time in my life I feel that the real me has arrived. 

I like the person I have become and feel very privileged to be here with a wonderful family, home and good health. 

Alopecia - My Continuing Journey and the Rise of the Brave Shavers

I have great admiration for all those who are Braving the Shave for Macmillan - bravetheshave.org.uk, the hugely worthy cause for an organisation which does tremendous work in very difficult situations. 

The decision to shave one's head is not an easy one, for many reasons. One practical reason being that it does get rather nippy around the back of the neck. I slept with a bobble hat on for the first few nights.

I decided to shave my head after 9 months of significant hair loss through alopecia. I had got to the point of considering options - headscarves, hats or even a wig, before I questioned my reasons for hiding my condition. I came to the conclusion that, having made the decision to shave my head, I no longer had a problem with my hair loss. However, I realised instead that I wasn't sure how to deal with the prospect of my acquaintances struggling with knowing how to act and what to say.

This was highlighted when I went into my local greengrocers with my newly shaved pate. Neither of the two young female assistants were able to make eye contact with me and acted as if nothing had changed. My day was saved when their boss took one look at me and said "What's with the hair then?"

This was exactly the prompt I needed - someone grabbing the situation by the horns and saying it straight. I decided at that moment that this would be the best way forward for me. I needed to prepare the ground before I walked on it by having some scripts ready at the tip of my tongue. Communication was definitely the key to managing this transition effectively.

To ensure that my alopecia didn't become the elephant in the room, it was important for me to initiate conversations. And so, just as the Brave Shavers did, I spread the word around my tribe using all the means available to me - email, social media etc - not to attract attention but to forewarn them of my radical new look, and to reassure them of my health.

Being open and honest also worked well for me. A child asked me very directly what had happened to my hair. "It fell out," I replied. Her response? "Oh, OK." My grand daughter declared that she didn't like Nanny's new haircut. I told her that I wanted to have the same haircut as Granddad and she was OK with that!

Embracing my alopecia was an incredibly liberating experience for me. It meant that I could rock a brand new hair cut and funky colour, I bought loads of new earrings and scarves, and re-vamped my make-up and spent an amazing day having a complete make-over and photo shoot at Dream On http://www.dream-on.co.uk/ . I rediscovered colour, sparkle and lipstick! It was as if the real ME had finally emerged and it made me realise how much I had been hiding behind my old mop of hair.

It is now almost 3 months since I braved the shave - and my bald patches are getting smaller! Having turned my back on western medicine's drugs and hair transplants, I just stuck to healthy eating, vitamin B12 supplements and acupuncture. Here's an account of a really significant treatment which I'm sure marked a turning point for me :  http://norafranglen.blogspot.co.uk.

My journey is by no means over but it feels like I'm coming down the other side of the mountain now. It would be wonderful if my hair returns in its entirety, but if it doesn't, then I've already initiated Plan B - watch this space!

My Journey with Alopecia

We have always been a family with good hair - and youthful hair at that. My Dad kept most of his hair until a ripe old age, and didn't turn grey until well advanced in years. My brothers all still have full heads of hair and I've always had a real mop of strong, healthy, shiny hair which was thankfully and conveniently very low maintenance.

Imagine then, my surprise when my hairdresser rang me immediately after my appointment to tell me that she had noticed a bald patch at the back of my head, which she thoughtfully hadn't want to flag up in front of others in the salon. Surprised, yes - but also relieved. I thought she was going to tell me that I had head lice! Somehow, alopecia didn't seem quite so bad at that point.

The immediate thought in cases of alopecia is that it is a response to stress. Yes of course I've had stress in my life (having four children under 5 years old was one of them) - haven't we all? - but I would say that these days I'm probably the most chilled that I've ever been. Blood screens for thyroid problems, diabetes or other auto-immune conditions all came back clear.

Alopecia is one of those mystery auto-immune conditions where there's no specific cause and no effective treatment. Alopecia areata (which is what I have) is the non-scarring variety so at least there is the potential for the hair to regrow in time.

So over the past nine months, I have gradually but significantly been losing hair from the back of my scalp. What started as a patch about the size of a £2 coin, and very well hidden somewhere in my mop - has now affected almost three quarters of the back of my head. I still had a wispy covering in the worst places but it was becoming very drafty indeed!

The remaining hair was not unaffected though. In more and more places the ends of the hair were becoming slightly crinkled, as though it had been heat-damaged. And more and more hair was falling out each time I brushed.

So today I took the plunge and had it all shaved off - short back and sides if ever there was one! Yes, it feels a bit chilly at the moment but I've still got some on top, AND I still have slightly more hair than my husband has!

This may seem rather extreme, but embracing the next stage in this way is exciting and actually rather liberating. I was more than ready to ditch the old mop and now I'm looking forward to experimenting with headscarves, new earrings and even a head tattoo!

I have pre-warned my family and close associates so as to lessen their shock, and will cover my head at times if I feel some, particularly vulnerable people and patients, may feel unsure of how to react. But ultimately, I don't want to hide my alopecia - after all, it's not contagious or life-threatening, it's just different.

At the end of the day, it's only hair (or rather, lack of) - the person underneath it all (me) is still the same.