The "Energy Crisis" of FMS/CFS: Causes and Cures

This is very helpful, thank you! I know Dr Spurlock and Dr Jacob Teitelbaum are colleagues, and had reported upon Dr Teitelbaum when I heard him do the keynote at a presentation I was invited to present at as well in 2009. He developed the SHINE protocol, with the E being for Exercise.  I asked Dr Spurlock why he omits the E/exercise and it essentially is because what he implies above related to over-exercise which drains too much energy.  (Here is the link to what I wrote about related to SHINE, when I heard Dr Teitelbaum speak www.lumigrate.com/forum/jacob-teitelbaum-md-has-come-fatigued-fantastic-0 [5]

I found with my patients when I was doing occupational therapy in an outpatient clinic prior to transitioning to outreach/education and individual shepherding of health navigation, we'd have to work really hard on the concept of 'how much exercise'. I actually prefer the word 'activity', but SHINA doesn't make a good acronym.  

We'd start on our FIRST DAY with learning how to deep breathe and do mindfulness meditation. This got people 'connected' to be able to learn to self-monitor and therefore pace themselves.  And then the next visit, we'd start on UP TO two minutes of slow to moderate activity while concentrating on monitoring and pacing, lots of kudos for stopping if there was an awareness of fatigue, just as much as if they walked or elipticalled for the full two minutes.  

They'd do some breathing and meditation, take a break to drink water and rest, then go on to another piece of equipment IF they were feeling up to it. The could do this on the first day on UP TO three pieces of gym equipment, for a total of 6 minutes actually 'moving', or 'uptime', and at least that much 'downtime' while they nurtured their cells with oxygen, water, and all the 'good things' the body does when you're meditating.  (If they opted to do more than one piece of equipment, the second had to be for the upper extremity (the UBE typically but some people weren't able to do that motion and we'd use very light dumbells and other UE exercises).  

I'd have them come back in 2-3 days ideally, and do another session and progress them to where they were doing 3 pieces of equipment with rests in between for the two minute increments and then get PT orders and transfer their exercise plan over to the PTs who were interested in working with these types of more frail patients, who would continue to work on not only building up their tolerance for activity and helping the musculoskeletal system from the activity getting the 'juices flowing', but also hands-on manual therapy for the muscles.

Many had significant problems with their spine, almost always cervical and frequently also lower, and PT done right with this population of patients can be very beneficial. The providers often have to study up a little bit about fibromyalgia and chronic fatigue, and I would encourage the patients to help them with that.  Most of my patients had been referred in the past to PT by their physicians and were 'flared up' by the well-meaning but ill-advised/uneducated (about CFS/FMS) PT staff; understanding what is going on in the muscles and with energy is key!  So I can see why Dr Spurlock dropped the "E"! And I hope my adding this on with a thorough explanation of why I keep the E, was a helpful addition! ~~Mardy

I was just looking around at the information over in the fibromyalgia forum and noticed that a year ago tomorrow, on November 4, 2009, Dr Spurlock wrote his first piece on Lumigrate, which was so 'short and sweet'/streamlined, valid, progressive, FUN, that I invited him to have his own forum (and obviously, he accepted!).  So I thought I'd copy that over here so everyone can also see it, since it's similar to the piece, above, but also a little different. AND it's 'historical', as the first piece from him. 

THANKS TO EVERYONE who come to Lumigrate to read, write, contribute financially to support our efforts, and allow us to be here doing what Lumigrate does best!  Dr Spurlock, included! ~~ Mardy

"Pain in patients with fibromyalgia/chronic fatigue syndrome may come in many different varieties.  Some patients may actually have more than one pain condition at the same time.  The core pain in fibromyalgia is due to "energy deficits"! 

Think about your fingers when you have "writer's cramp".  The fingers are drawn up (shortenened) and if you straightened one out really quick, it would really hurt!  That's how it is with fibromyalgia; the muscles are lacking energy and they shorten, and if you move against them, they hurt. 

The true goal in treating fibromyalgia is to identify the sources of energy drainage and replace/repair that problem, or those problems, so energy returns to the muscles. The pain lessens or goes away as a result. 

This particular task is not necessarily easy, it will take some definite work between the patient and the doctor/practitioner."

~~ Wm. Marcus Spurlock, MD