Emily Bland

Habits & Health episode 48 - Emily Bland

Habits & Health episode 48 with Emily Bland, a Clinical Exercise Physiologist treating patients with OI, POTS, CFS/ME, persistent pain, Fibromyalgia and hEDS. She specialises in education and energy management for patients with these health conditions, in order to help them stabilise and manage their symptoms.

She specialised in this area because of her passion for helping people and also because she lives with POTS, CFS/ME and Endometriosis.

We discuss awareness some of these conditions, on things people suffering can get relief, sources to find out more and many other areas.
Links:
Website: exphysem.uk (coming soon)
Resources mentioned by Emily:
Article on spoons mentioned by Emily
I’m a “Spoonie.” Here’s What I Wish More People Knew About Chronic Illness
Recommended book:
Explain Pain
David Butler, G. Lorimer Moseley
Favourite quotes:
“Chronic illness isn’t about missing out, it’s about living life a little differently”
“Doing nothing often leads to the very best of something”
Winnie The Pooh

Don’t forget, there is a transcript of every episode (scroll down the page)

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The Emily Bland interview link:

This video is related to an older episode featuring Tommy Berrabe

Jingle 0:00

habits and health episode 48. Welcome to the habits and health podcast, where we believe creating healthy habits should be easy. Brought to you by an educator and coach for anyone who wants to create a healthier life. Here's your host,

Tony Winyard 0:18

Tony Winyard. Welcome to another edition of habits and health. My guest today, Emily Bland. She's a clinical exercise physiologist who treats patients with OI, POTS, chronic fatigue syndrome, persistent pain, fibromyalgia, and many others. And we're gonna hear a lot more about how Emily does that and what some of those conditions are, you may not even be familiar with some of the ones I just mentioned. So we're gonna find out a lot more about that in this episode with Emily. And if you do know anyone who would really find some of the information valuable, please do share the episode with them. Hope you enjoy the episode.

habits and health my guest today, Emily Bland, how are you, Emily?

Emily Bland 1:04

Good. Thanks, Tony. Thanks so much for having me here.

Tony Winyard 1:06

Yeah, it's great to have you here. And you've wondered quite a way from where you're actually from.

Emily Bland 1:12

That's right. Yep. So recently, in the last six months, moved to Cornwall, and I'm actually from Melbourne, Australia. So a little bit of travel to get here.

Tony Winyard 1:21

And do you plan on adopting a Cornish accent?

Emily Bland 1:24

Everyone's asking me that. So we'll wait and see what happens.

Tony Winyard 1:29

You're from Melbourne?

Emily Bland 1:30

That's right. Yeah, down the bottom of Australia there.

Tony Winyard 1:33

So how does Melbourne compared to... where in Cornwall are you?

Emily Bland 1:37

So we're in Truro, if you know where that is? Yeah, it's pretty far south.

Tony Winyard 1:42

How would you compare Melbourne to Truro?

Emily Bland 1:45

Ah, Melbourne's a lot busier, that's for sure. I'm sure it is a lot quieter. But that's really up my alley. I do prefer the country life over the city life.

Tony Winyard 1:55

But as I discovered before we started recording you're not a surfer, which is what people presume

Emily Bland 2:01

No. Everyone says that we're in the perfect place on the coast for surfing. But funnily enough, neither myself nor my partner have ever been surfing before. So classic Aussi stereotype which is fine.

Tony Winyard 2:15

So what how is it that you help people? What is it that you do?

Emily Bland 2:19

Yeah, so I'm a clinical exercise physiologist. And basically, I specialise in treating people with chronic fatigue syndrome or CFS me I think over here in the UK, it's referred to more as me, which is my LG encephalitis. A syphilis myelitis, though is a bit of a tongue twister, that one. And so that's one category of people that I treat. I also specialise in people with dysautonomia as well, in particular, orthostatic intolerance, so things like Postural Orthostatic, tachycardia syndrome, or pots. And again, I need to take that a little bit for the UK because it is called just postural Tachycardia Syndrome over here. So, yeah, I work with patients who have these sorts of conditions. And persistent pain is one that I didn't mention. So things like fibromyalgia. And it's interesting, because these conditions tend to have a big overlap as well. So it does work really well, especially in all of those areas. And the main thing that I do is use education around the symptoms and how to manage them. And I use a lot of energy management as well. So helping people to manage where they put their energy so that they can be sustainable and reduce their symptoms.

Tony Winyard 3:37

What led you into doing this?

Emily Bland 3:39

Yeah, really good question, Tony. And I've actually got chronic fatigue and POTS. And I've also got endometriosis myself. So I have a little bit of the trifecta of fatigue, orthostatic intolerance and persistent pain. And at the time, when I first developed these conditions I was actually studying in the exercise field. And in Australia, when he's studying that you can actually go on to specialise in the clinical side of things. And for me, it was an absolute no brainer that when I developed these conditions, and I was unchecked with my studies that I was 100% going to go and specialise in this field so that I could give back to people with these conditions, while also being really empathetic to what they were going through.

Tony Winyard 4:28

You mentioned about various conditions you had So how did they did they limit you in any way? How was it affecting you?

Emily Bland 4:36

Yeah, so a lot of these conditions so if anybody listening to this know someone with these conditions or husband themselves, they would know that they're very spectrum based. So you can get people who have very minimal symptoms and then you can have people who have very debilitating symptoms as well. And when I first became unwell after an infection I was right off the end of the scale of being very debilitated. And I was housebound for about a year. How old? Are you? 21 years old? Yeah. So it was about seven years ago for me now, seven, eight years. So obviously, that had huge impact on my life, you know, everybody else is going out celebrating 21st Birthdays, and I'm just hanging out at home hoping that things will get better. And, again, for people who are familiar with these conditions, you would know that it's not something you could ever expect is that one day you become ill and then the next day, you don't get better, because normally we get sick with something we recover, we go back to normal. So I was kind of waiting for things to pick up and just go back to how they were. And it wasn't it took a couple of years, we'd actually get any sort of diagnoses with my health. So it was definitely a long journey. And not until I had those proper diagnosis that I could find the right help and therapy to actually start to improve my health again.

Tony Winyard 6:01

A couple of things come to mind when you when you say that. So I'm wondering, so what was the initial? What did you first notice? What was the first sign that there was something not quite right. And, of the things that you mentioned that you had, what was the initial thing that they said you had? Or did they say you had all of those at the same time? And I just wonder how that developed?

Emily Bland 6:20

Yeah, no really, really good question. Because this is something that there's usually a lot of overlap with experience, as sorry, experiences that people have with these conditions, in terms of diagnosis, but then there's some real differences as well. So I always stress that this was my experience, and it's, you know, a personal one. So it's not going to be the same as everybody else's. But the first thing that I particularly noticed was a lot of shortness of breath, and intolerance to being upright. So I couldn't stand for long periods of time. And I was unusually fatigued. So

Tony Winyard 6:55

when that first started to happen, what did you think was going on? Did it just suddenly come out of the blue?

Emily Bland 7:01

Yeah, yeah, it was pretty sudden after the infection. So you know, I gave the infection maybe a month, and when things didn't improve after that, I was like, something's wrong. So working in retail, you know, I was doing a four hour shift. And I just couldn't stand up at my register anymore. And I was like, What? What is going on? I must be crazy. I must be making this up. And people use the The L Word, which we call a bit of a swear word in my field of work. And that's lazy. Like she's being lazy. And yeah, it was really hard, because I couldn't explain to people what was going on, because I didn't know myself. But the other part of your question there, Tony, was that the doctor that I was seeing at the time said that I had anxiety that like you are struggling with anxiety, and you need to go on antidepressants, anti anxiety medications, and you need to go see a psychologist. Just finally to talk

Tony Winyard 7:53

to you again, but okay, my I imagine, and by no means an expert in this. I imagine this is the kind of thing that would be easily misdiagnosed quite early 100% 100%.

Emily Bland 8:04

And particularly with parts orthostatic intolerance anxiety is a very go to diagnosis from doctors that don't understand. And yeah, it was it was very conflicting for me at the time, because I had already been diagnosed with anxiety. And I've had anxiety for most of my life, childhood teenage years. So when they said you've got anxiety, I was like, This can't be right, because these symptoms are on me. And the it's not the same. Yeah. So it's very interesting. And unfortunately, it's a story that I hear a lot from my patients now.

Tony Winyard 8:40

So what happened from there? So once you you realise, no, I don't think this is simply anxiety. So what how did it progress from there?

Emily Bland 8:47

Yeah, so after a couple of years, I got to a point where I was like this, there has to be more to this. And I didn't give up and again, a very relatable thing is you get thrown around the healthcare system a lot and you go from person to person, until I eventually ran into a gastroenterologist who said, I think you've got pots, which I'd never heard of. And so I was very fortunate that she referred me to a cardiologist who specialise in that area, and then they yesh on that diagnosis. And it just kind of snowballed from there. And I was actually referred to see a clinical exercise physiologist myself, and it was all the work that I did with them. That completely changed my outlook and I started showing some improvement in my health then. So very inspiring to go into that role after that kind of help.

Tony Winyard 9:37

And would you say the level of awareness around POTS and CFS and so on? Is it much different here to Australia? Or how would you what would you say? Do you know

Emily Bland 9:47

I was still I'm still developing my own concept around that at the moment. Because in Australia, it's still missed, but now that I've started working with patients over in the Okay, I've had some similar feedback from them as well, explaining that it is something that it's really hard to get helpful. So I think from what I can tell so far, it seems like a bit of a universal thing. Ironically, just yesterday, I did go to the doctor's office for something. And the medical student that I was seeing had never heard of my conditions. And I was like, that's okay. Like, that actually doesn't affect why I'm here. But they had to go and get another doctor to come in and help with the consult. And that senior doctor had never heard of any of the conditions either. So it was okay, because I'm educated enough that I can advocate for myself, but it still was a challenging situation, and probably a surprising one to the extent of it as well.

Tony Winyard 10:46

So if anyone listening to this may well, I wonder if there could be people listening to this, who, similar to what you were told, I've been told are you've got anxiety, they've got some kind of issue. They don't really know what it is. Yeah. And they may just be told it's anxiety. What kind of things could people be looking out for to realise maybe this is more than what you've been told that? Yeah.

Emily Bland 11:09

Yeah. No, really good question. Again, Tony. And symptoms, like shortness of breath, intolerance to standing up high heart rates for seemingly no reason. Those are some really big signs that you might have a condition like orthostatic, intolerance, or pots. And I would actually encourage people that if they thought maybe they fell under that bracket to check out the POTS UK website, because this is a charity run initiative. And they provide a lot of help to people who think that they might have these conditions or know that they have these conditions. So not just information, but they also have recommendations of specialists that you can see in this area as well.

Tony Winyard 11:53

And so once someone has one of these sort of issues, how easy or difficult is it to treat it to live with it, and I realise there's a spectrum, as you said,

Emily Bland 12:07

it's very subjective, it really is. So it depends on the individual. It often depends on the age, how long they've been living with the conditions, what sort of treatment they've actually sought out, or they've had the opportunity to seek, because that there is a lot of treatments out there. And it's important to remember that we need to take a well rounded approach because of how unique everybody is. We can't just focus on psychology, or we can't just focus on pharmaceuticals or lifestyle, it needs to be a combination. And that's where a lot of the work that I do is I'm adjusting lifestyle and energy management. But I'm also working closely with people's specialists, their doctors, their psychologist to make sure that we're all on the same page as well.

Tony Winyard 12:58

So you mentioned some of the things so endometriosis and CFS and so on how it sounds from what you were saying there's a lot of connections between some of these conditions.

Emily Bland 13:09

Yeah, yeah, that definitely is, and it's one of those things where it's not, it doesn't have to be cause and effect. So we don't know, if just because someone has this that they will develop. This is one of those things that they're still doing a lot of research into, because even with CFS ma they actually don't know, what causes it. So to say cause and effect, we don't know, but we do know that they tend to be comorbid a lot of these conditions. So when we do treat someone, say with chronic fatigue syndrome or me, then we're always just being careful that they don't have symptoms of Ra, because if they do we want to pick up on that and help them to manage that as well.

Tony Winyard 13:55

Is that the same? Do they know what the causes of endometriosis?

Emily Bland 13:59

Um, again, it's something that I would actually have to do more research into myself to give you a proper answer on. But we do know that with conditions of the nervous system, so when our body is under a lot of stress that we have, so people with me and parts, they have more symptoms when their body is under stress. And we also know that their reproductive system, the digestive system, all those functions that automatically regulate themselves in the body, that sometimes they're not regulating as well as they could because of the levels of stress adrenaline and cortisol that are affecting their systems. So, again, I can't say if it's cause or effect, but that tends to be something that we see.

Tony Winyard 14:49

So someone who may be does have endometriosis and my feeling and I could be very wrong in this is that it seems that there's a lot of doctors who aren't that knowledgeable on it? Certainly From experience I had in my, with my daughter's mother and so on, because my daughter's mother had endometriosis. And her doctor had very little knowledge about it, it was very clear from some of the things he was saying. So I wonder for people who do have that, what advice, what kind of things can they do to alleviate it to help

Emily Bland 15:24

with the symptoms themselves? Don't Yeah, yeah. So it's one of those things that a lot of people with endometriosis will have done a lot of research into this as well. But things like hate packs, 10s machines, nourishing foods at different times of the month are good ways to manage it. They're also things that the individual needs to decide if it works for them. So no, with 10s machines, it's one of those things that if you want to use it great, if you don't, that's fine, but the research is mixed. And, but I do know people that love it, people that hate it, it's like compression tights in pots, some people love it, some people hate it. And I think just making sure that you're seeking the right care for it as well. So finding websites, like pots UK can point you in the right direction, because I think they have a section in there on endometriosis as well. Because you don't want to spend that time and that money seeing someone who's not specialised in that area. And it's like I always say to people, if you're having renovations done on your home, and you're having someone come in to pull up the carpet, you usually have two or three people come in and give you a quote on that you don't just go with the first person that you meet. It's exactly the same with our body is we don't have to go with the same this one specialist that we meet straightaway. We can have a look around and see what's out there and what is going to be the best fit for us in our body.

Tony Winyard 16:52

So when when people come to you, what are they? Usually they have one of the conditions that you've mentioned, or how do clients find you? What is it they're looking for when they come to you?

Emily Bland 17:04

Yeah, no good question again. They have usually been struggling with these conditions for a while. So the reason for that is because like I said, with my experience, that took a really long time for me to actually know what was going on. So by the time people are like, Okay, I've got CFS or I've got fibre, or I've got pilots, they've been living with it for a while. And in some cases, normalising the symptoms, because they didn't know any difference. And they're like, this is my life, this must just be what it is. So yeah, those people who find me it's usually through Instagram, and LinkedIn, and my website as well. And they usually ask you questions to start with. They're like, Hey, I'm living with this. And you know, this, this, and this is stopping me from living my life, do you think that there's any chance that you could help? And for me, it's actually really important, because I don't know if you've seen my website yet, Tony. But it's very simple. And that's because I actually want to have a chat with people before I booked them in and make sure that they are a good fit for what I do. Because for some people, they do need some further care. And long COVID is a really good example of that. So they need to make sure that they've had all the correct care and all of those things checked first before I would take them on as a patient. And it's the same with the other conditions.

Tony Winyard 18:24

And is this are these things that you can do over over zoom? Or is it the need to be face to face?

Emily Bland 18:30

Yeah, so all of my work is done through telehealth because I actually treat worldwide so most of my patients at the moment are in the UK and Australia. And for me, I thought that was great, because I didn't want to say goodbye to all of my patients in Australia when I moved over, they definitely didn't want to say goodbye to me. And living in Cornwall, I'm a little while away from the busy busy London where you know, a lot of health care is for these conditions. So I wanted to be able to reach everyone everywhere. And the added bonus was that I do have a lot of patients who have a lower capacity. So it means that they actually don't have to leave the house to have the appointment and we can tailor the appointment to them. So one patient I've got at the moment, we have 10 minute appointments with the other 20 minutes of that appointment is filled in with recordings because they can't actually be on the phone for more than 10 minutes. So I find out everything that they are challenged with. And then in the next 20 minutes I spent that educating them on what we would have gone through if I'd seen them face to face through zoom. And then yeah, again, 30 minute sessions and 45 minute sessions as well. So I try and accommodate to everyone at every level.

Tony Winyard 19:49

And prevalent are these things, isn't it more than many people would imagine or is it quite rare?

Emily Bland 19:56

Yeah, I couldn't give you a number but it's a lot more prevalent than people would realise. particularly, because, like I said, if it's spectrum based, there are people out there who are quite functional living with symptoms, who don't realise it. And we never actually see I never see patients until their symptoms become limiting. Because if your symptoms weren't limiting, why would you go out of your way to try and fix something? So? Yeah, it's definitely a lot more prevalent than we realise. And, you know, you can say that on social media and the support groups, it's quite overwhelming actually, how many people out there are talking about it, which then kind of conflicts with the fact that we've got doctors out there who don't know what it is.

Tony Winyard 20:37

So it makes me wonder if is there? Are there more people being diagnosed right now simply because there's more awareness of what it is? Or is this always been around for a long time? Or is it more because in the last, so of last 50 years, there's more environmental toxins and various sub stresses? Why this is maybe happening more? Yeah, it's kind of chicken and egg thing.

Emily Bland 21:00

In my opinion, I think it's because there's more awareness around it. So the the younger generations of doctors, and I'm not saying that there's anything wrong with the senior doctors. But from my personal experience, I've noticed that the younger generation of doctors are actually learning more about this central sensitization in their education, and my studies were quite similar. Is that right? As I was about to finish my studies, people started talking about central sensitization and a biopsychosocial, all rounded approach. And that was at the end of nine years of study for me, and I was like, Where was that for the other eight years?

Tony Winyard 21:41

So you mentioned in your title, I forget the exact words see if something physical exercise, but what was your What was it you said before?

Emily Bland 21:49

So clinical exercise physiologist, that is my official title.

Tony Winyard 21:54

And the word exercise seems to scare a lot of people, it seems Yeah,

Emily Bland 21:58

yes. So that's a really tough one, because it is my official title. But particularly over here in the UK, there used to be called something called graded exercise therapy, or G T. So exercise became a bit of a swear word, because we know that g t is actually no good for people with CFS, or pots, or Fibro. Because what that was all about was giving people fixed incremental changes to a movement programme. And that's a very linear approach that doesn't take into consideration the individual. So if someone had CFS, and you tried to give them di t, you'd be telling them okay, this week, you're doing five minutes of walking. And then next week, you're doing 10 minutes of walking, and then the week after you doing 15 minutes of walking, and it's just making them increase by increments, regardless of whether they're tolerating that or not. So what you really want to do with people is talking about energy management. And this is completely backed by the the NICE guidelines here in the UK, is that when we talk about energy management, we make sure that it's patient led, so we're not giving fixed increments, we're listening to the person as a whole person. And whenever we make alterations to the activities, itself, driven by the patient, and it's actually taking into consideration how they are, what symptoms they're experiencing, and you know, what levels they can tolerate at the moment. So yeah, it has been a really controversial topic. But the main takeaway with that is graded exercise was fixed incremental stuff, whereas energy management is patient driven, and you're actually listening to them. So you know, if they're having a bad week, or you know if something's going on there, instead of just assuming that they're okay to keep moving forward.

Jingle 24:01

We hope you're enjoying this episode of the habits and health podcast where we believe creating healthy habits should be easy. If you are looking for deep support to create the health and life you want, we invite you to consider one on one coaching sessions with Tony. coaching sessions give you personalised guidance to fit your unique goals and life situation. Only a limited number of spots are available, but you can easily get started by booking a free introductory call at Tonywinyard.com. Now back to the show.

Tony Winyard 24:30

It's very difficult for someone with CFS for example, it must be very difficult to to do exercise in first place because they're just so tired. But then it sounds like it's essential that they do do some form of exercise. Otherwise, is it going to get much worse?

Emily Bland 24:46

Yeah, so the nice guidelines it's the National Institute of Care Excellence. I believe it's a bit of a tongue twister again that one in the UK. They have Condra indicated but graded exercise therapy and avoidance. So they don't want people to just completely rest and not move. But they don't want them using fixed increments either. So I actually, ironically enough, despite my job title, I don't talk about exercise, I talk about movement. And I see movement as being spectrum based. So I might have a patient who comes to me and they're like, I want to work on my energy management, so that I can work towards brushing my teeth. And that would be that patient's goal. Whereas I might have another patient come to me, and say that their goal is being able to work on energy management so that they can walk their dog each day for 20 minutes. And those are two very different ends of the spectrum. But what we do with someone's energy is a relative to their goals and what they're wanting to achieve.

Tony Winyard 25:58

And would a sport, such as swimming be easier or not? Would it be again, very dependent on on the person,

Emily Bland 26:07

extremely dependent on the individual? So for some people, you know, swimming just would be completely out of the question. I know, there are some published studies actually saying that it's not recommended for me just because it's considered a danger to their health if they become unwell in the water. But then there's studies out there for people who just have pots, I shouldn't they just have hot pots, but they have pots. And they, they tolerate it really well, because they get compression from being in the water. And then when they're in that flatline position, it's actually easier for them to regulate their blood pressure. So it would be something that you'd have to assess with the person. And also with people that have fatigue is, it's not just swimming, it's getting to the pool, it's getting changed, then having a swim and getting out having a shower getting changed and having to get home. So it's one of those things you do need to tailor and talk to the person about first.

Tony Winyard 27:06

So say to, to friends and relatives, of people who have a condition like CFS, and how they can be, I don't know, sympathetic is the right word empathetic to to people, because they, I imagine that some people have no understanding of their so what kind of things? How can they help, I guess, is what I'm asking.

Emily Bland 27:29

Yeah, I think being able to have those open and honest conversations with the individual who is affected by the condition. And a big one is understanding that we don't look sick, we don't look disabled, we look like normal people. And that's really hard for people to comprehend, because they see one thing and you know, one day, we might be completely fine, and you know, go out shopping or for a walk. And then the next day, we could be completely trash. And that is why energy management so important, so that we can get consistency. But that's a very confusing concept for someone that doesn't have these conditions. One of the resources that I love is there is an individual out there on the internet, if you Google The Spoon Theory, they use a and I don't know if you've heard of this before, Tony. There is a concept of, you know, spoons being energy. So for example, you start your day with 12 spoons, you have breakfast that takes one spoon away from me. So you lose that energy. If you want to have a rate of it, please do because this is a really good insight into people with living with chronic health conditions. And how energy is sort of taken from us throughout the day. Because we don't have a unlimited supply, like someone who doesn't have these conditions. And that's something that I often share with my friends and my relatives as well so that they can see where I'm coming from with my health.

Tony Winyard 28:58

I'll make sure there's a link to that in the notes so people can,

Emily Bland 29:02

yeah, that'd be wonderful. So it's referred to a lot in social media, I think,

Tony Winyard 29:06

in the in some of the questions I asked you before we started recording, and I was talking about habits and you mentioned pacing.

Emily Bland 29:12

Yeah, yeah. So pacing is the foundation of everything that I teach. And it's also the foundation of my life to live with these conditions and do what I do. Pacing is about energy management. So it's making sure that we are breaking up our days and we're not doing big blocks of activity back to back and then having a crash without fatigue. It's about listening to our bodies so that when we do expend energy, we take time to rest and restore so that we kind of top our spoons back up. So if an activity can cost us spoons, we're trying to find ways to get some spoons back. Or to even just maintain ourselves so that we're not Having those crashes?

Tony Winyard 30:03

We've been talking a lot about, you know, chronic fatigue syndrome and more about the kind of physical side of it. But I guess there's there's a mental side of this as well.

Emily Bland 30:14

Oh, definitely. I think a lot of people overlook that. So not just friends and family, but sometimes us ourselves is that we forget that there is a cognitive side to it as well. And it's not just physical. So we can expend energy physically and cognitively. And that's something that people tend to overlook when it comes to pacing is they think that they're having a restorative, they're doing a restorative activity, I should say. But they're actually not. So they're concentrating, they're reading, they're listening to people. And that's why social activities can be so so challenging for people with these chronic health conditions. Because when you go out socially, it's physical to get there. It's physical to be present. But then it's cognitive to engage with people. Yeah, so definitely very important to consider the cognitive.

Tony Winyard 31:10

So are there any other so we've talked about the physical side, the cognitive side? Are there any other elements as well as the contributor?

Emily Bland 31:17

Yeah, so we talked about the four categories, actually. So physical, cognitive, emotional, and environmental. And the emotional ones, again, is actually something that surprisingly overlooked. Even I still do it myself. If were under stress, you know, for example, we get some bad news. So sometimes we go to a clinic, see a doctor, or we get some bad news. That takes an emotional toll on us. And the emotion takes energy. Anyone who has gone into that room pulled the covers over their head and cried for a while, would know that they pretty tired after doing that. And environmentally, that's quite a broad one. So there can be a lot of things in the environment that can take energy from us, and some common ones, bright lights and loud noises, because they're things that we can tend to be a little bit more receptive to or sensitive to with these conditions.

Tony Winyard 32:17

What I mean, one of the difficulties with not knowing so much about this, from my point of view is, so therefore, I'm very limited in the questions I can ask. Okay, what? What question is there maybe that I haven't asked that? Or what information? What thing? Would you like to say to people listening about this that question, I haven't even thought to ask you.

Emily Bland 32:37

Oh, Tony, that's a really good one. specialisation and I know that this is the case in Australia, I'm not entirely sure what it is in the UK. But I did spend nine years of my life undergoing tertiary studies to specialise as a clinical exercise physiologist, but not once did we actually touch on these health conditions, or if we did, it might have been special populations. But there might have been one slide in there that mentioned fatigue. So everything that I have done has been alongside my studies. So I tend to PD. I seek out people through networking to learn more, and I am very proactive. So it is important, like I mentioned before, when you seek care that you go and see someone specialised in this area, because it's not something that we learn as part of our mainstream studies studies. And I know over here, physiotherapists, and occupational therapy, therapists, big areas to specialise in these conditions, but are only the ones who have gone out of their way to learn more about it. So yeah, that's definitely something that I would just be aware of, if I was thinking care.

Tony Winyard 33:56

Well, that's got me thinking about, you know, there's books on every topic you can think of. So I'm therefore wondering, are there may be the books around this, this area, there may be some to almost avoid, because they're maybe... misinformation? Is there any to your knowledge that is not actually as helpful as they're proposing to be?

Emily Bland 34:21

So the texts that I stick to or the clinical ones, and then that way, I know that they are legit, and that the information I'm getting out of them is good? Yeah. I haven't really read any, you know, off the shelf kind of books. And I think if you're going to do that, make sure you do research beforehand into who's written the book, and why it's been developed. Cuz I know for some, it's their personal experience as well. So I think that those are great that people are sharing their personal experiences. But when we share our personal experiences, like I do myself, I always just make it really clear that that was my journey and that was what worked for me. Yeah, because just because I have the label of CFS MA or pots or endometriosis does not mean that I will be the same as somebody else who has those labels. And that's something that I'm really careful with my treatment as well, is just because you have CFS and somebody else has CFS, I cannot treat you as the same person, I need to do a thorough assessment on you and make sure that I'm taking the right approaches for them as an individual. And it's the same with those books, they can be great, I'm sure. But you need to do your research and go into it with an open mind as well.

Tony Winyard 35:36

Are they are there any good information sources for people around this?

Emily Bland 35:44

Yeah, so again, POTS UK, who I'm just a really big fan of, I love their work. And I'm actually starting to do some work with them myself next year. There is the ME Association as well. And they're really big over here. They sound really fantastic. And if anybody loves a bit of a nerd out like I do, and they do enjoy reading, there's a text called Explain pain, which goes through a lot of central sensitization concepts. So explain pain, although it is about chronic pain. It's relevant to your pots and your chronic fatigue syndromes as well, because we know that the nervous system works similarly for all of these conditions. But that one's actually Australian. That's a guy called Lorimer, Moseley, and David Butler. So if you want to check that one out, Explain Pain comes in your standard layperson format, it also comes in a clinician form as well, if you're wanting to upskill your knowledge.

Tony Winyard 36:44

Well, again, I'll put links to all of those in the show notes. Look in the shownotes for more information. So I talked about we touched upon books just now. Yes. Is there a book that's really moved you in any way?

Emily Bland 36:58

Yeah, I think I was having some thoughts about this. And I allowed to swear on this, Tony, I don't know.

Tony Winyard 37:09

I know, you're gonna say

Emily Bland 37:12

it's called The Subtle Art Of Not Giving A F***, and excuse me for my language. But that one is by Mark Manson. This isn't about chronic illness at all. It's just a general, easy written book about not giving a f***. And I just applied it a lot to my life. And I really loved it. Because one, it's so easy to read. And with fatigue, it's not the easiest thing to concentrate on a book. And two, it just really outlined some seemingly basic concepts that were really helpful for me to just move on and not care what people thought about me or change my perception on things that maybe didn't matter as much.

Tony Winyard 37:54

That comment you just made I hadn't considered that aspect that is not so easy for you to read a book. So that's another whole elements are as well. Yeah, yeah. Really much shorter chunks to say then then maybe other people might.

Emily Bland 38:09

Yeah, again, depending on the individual, some people tolerate but tolerate it better than others. But yes, I don't usually read as much as I used to in one hit. But interestingly enough, jumping back to Warren Mosley's book, unexplained pain, he talks about dims, and Sims, which are things that are good on our nervous system and things that are not so good. If we read a book that we enjoy, and that's friendly, nice on our nervous system, then we're actually going to tolerate it better and be able to read more than if we were reading a journal article for uni, which seems like it's taking a bit more energy and is a bit more of a challenge on our nervous system. So.

Tony Winyard 38:52

So going on from that, then, I'm guessing, if you're totally engrossed in a film, and even though it may be, say, three hours long, if you're totally engrossed in it, it's from a fatigue point of view, you're going to be okay with that, I guess.

Emily Bland 39:06

Not necessarily okay. But it may not. It may not cost us as much energy or it may not perceive that it costs as much energy. So perceptions are really big word that I use a lot. It's not saying that it's all in our head, because it's not it's all in our brain. But yeah, depending on the environment, and the situation and nervous system can perceive it differently. So and we just need to be aware that when we do enjoy things, it tends to be easier to get involved. But that doesn't mean that it's not costing us energy. So we do just need to be careful of that when it comes to managing our energy.

Tony Winyard 39:42

Did you say at the beginning of this, as we started recording this that there was an element of positive psychology. Did you mention that?

Emily Bland 39:51

No, I didn't.

Tony Winyard 39:52

Okay, I must be getting mixed up with a recent present person I talked with just let me just before we went If people want to find out more about you, where where would they look? Where's your social media, your website and so on?

Emily Bland 40:05

Yeah, definitely. So my website is exphysem.uk That's got some more information on me and what I do, like I said, it's pretty simple. Because if people were seeking help in this area, I'm actually more than happy to get in touch with them and have a more individualised conversation with them. But also my LinkedIn, https://www.linkedin.com/in/exphysem/, I should come up. And also my Instagram page, which is actually my dog. So my dog is the front of all of that for a little bit of fun. And that one's called https://www.instagram.com/dog.autonomia/ And that is all about tips and tricks for people living with chronic health conditions. And also a little bit of fun and some humour in there as well. So check it out.

Tony Winyard 41:05

Cool. And just before we finish, I mean, the question I always finish on with all my guests is, is there a quote that you particularly like, or quotes that you particularly like?

Emily Bland 41:14

Yeah, there's a couple. One was actually one that I always say myself, and that's that, you know, chronic illness shouldn't be about missing out, it shouldn't be about living life a little bit differently. So I say to my patients, we shouldn't not be able to do things, but we just need to look at doing them a little bit differently. So my other favourite quote is from Winnie the Pooh, and that is doing nothing often leads to the very best of something. And when I first heard that it really resonated with me from a fatigue perspective, because sometimes we do need to stop and do nothing. We need to sit on the couch and just hang out, so that we can have the energy to do the very best of something.

Tony Winyard 42:01

We don't say actually appropriate to everyone in society, wherever they've got CFS me whatever, because too many people try to do too much.

Emily Bland 42:12

Yeah, I actually say to people that the things that I teach in my programme, so the education and the management, if people that didn't have these health conditions, actually implemented them in their life, they would be living their best life. And they would be managing really, really well. And I'm not saying that they're not. But it would really enhance their ability to, you know, be in the best place that they could be.

Tony Winyard 42:39

Emily, I'm really thank you for providing this information, because it's something that he's not probably not talked about enough. And so there's a lot of people. There's a real lack of awareness around it. So yeah, thank you for giving, giving this information to people.

Emily Bland 42:53

Oh, thank you so much for having me, Tony. It was really nice to come on here and help to raise awareness around these conditions.

Tony Winyard 43:00

Great. Thank you. Next week, episode 49 with Dr. Sarah mile, she's a former GP, who now is registered with the Association of naturopathic practitioners. She's written numerous books on many different areas around health. And she's also written some papers around mitochondrial dysfunction and some other areas. Her latest book is the energy equation, and she not so long ago did a book called ecological medicine. She she's a controversial figure is Sarah. She has very strong views. And she doesn't always agree with the way that some things are done in in the UK regarding medicine she has, she's more into the kind of integrative functional medicine type of approach or she's not a functional medicine doctor, but she's more into that type of approach. It's quite an interesting episode. She's definitely no wallflower. She has some very interesting observations and comments. That's next week's episode with Dr. Sarah Myhill. If you did enjoy this week's episode with Emily bland, please do share the episode with anyone who you feel think would get some real value from it. And hope you have a great week.

Jingle 44:12

Thanks for tuning in to the habits and health podcast where we believe creating healthy habits should be easy. If you enjoyed this episode, please subscribe and leave us a review on your favourite podcast app. Sign up for email updates and learn about coaching and workshop opportunities at Tonywinyard.com See you next time on the habits and health podcast.

Transcribed by https://otter.ai

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