Get Well Golden Rules
The Get Well Golden Rules
A Basic Starting Programme for Treatment of CFS/ME
The first appointment is a patient assessment, a positive diagnosis, relevant investigations organised and a detailed explanation.
At the second appointment a programme is developed with the patient, plus partner or someone who is close.
Structure your day.
Go to bed at the same time, the time is immaterial. Take a very small dose of amitriptyline one hour before bed (half of a 10 mg tablet). Increase slowly over the following days or weeks to a dose that gets you to sleep within half an hour, and keeps you asleep all night, waking by alarm at the same time, every day, seven days a week, and doesn’t make you too groggy.
Your day starts after you wash, dress and have breakfast, say one hour later.
*Potter till lunchtime and take an hour off. Potter after lunch until dinner say 6 PM, the same time every day. After dinner and before bed you dumb down, radio, music, talking book, phone, take a bath, chill, relax, talk.
Pottering means activities like washing up, laundry, hanging out the clothes, vacuuming, tidying dusting, ironing, cooking. On a nice day go into the garden – weed. Clean a window, paint a room. Arts and crafts, watercolour, drawing are good in a relaxed mode.
Phone a friend for 10 min. Do not come back and repeat the same thing at an interval of time of less than one hour. Do a little bit and break up your day with periods of rest, sitting down during which time you might have a cup of tea, listen to radio 4, listen to radio 3, light music, light stuff, talking books, (radio music can be done for 30 min per hour. Relax and chill, recline but do not lie down and whatever you do don’t sleep in the day.
If you are already sleeping during the day, then cut it out if at all possible If it’s not possible to start with then make sure you sleep for the same time in the day and at the same time and, as you improve, cut it down and out as soon as possible.
Try to avoid doing similar things back to back such as listening to radio 4 and then talking on the phone they are the same thing. Doing the ironing and then washing up would also be the same thing you are using your right arm for both. Do something that is different to the thing that you did before and something different afterwards; break it up and rotate.
You do not have to do the same thing at the same time every day.
Your total energy output for mental and physical activity should be the same every day. You can’t legislate for everything but if you can, take control; you don’t have to go to that funeral, you don’t have to go to the wedding or the party and you can cancel Christmas.
Do less than you can achieve.
Do it everyday.
If you can’t do it every day – don’t do it at all.
Stop before it stops you.
On a bad day you do not have to do it.
If you’re not sure, do half of it.
Do it every day for two weeks before you know that you can do it – the lag effect of it catches up.
On a good day to not do any more, do not play catch up. If you do, this will lead to boom and bust.
As the days go by your symptoms will settle and this will be reflected in the fact that you will sleep better. Your sleep will improve in quality and you will begin to wake relatively refreshed.
Things to be avoided.
Doing too much either mental or physical as it perpetuates your illness.
Things to very much avoid.
Intellectual visual processing and other visual processing such as television, reading, computer, Sudoku, crossword, cross-stitch, i.e. things that require a brain.
Don’t do more physical activity then you can do every day.
Do things in short time periods say 10 to 15 min (or less) at a time then stop and rotate activity.
The longer you have been ill the longer it will take to settle.
There is one marker that will guarantee you will get better and or improve and that is when you wake refreshed or relatively so in the morning. – Wake refreshed and you are doing it right. Wake unrefreshed and you’re doing it wrong.
Wait until you have woken refreshed for approximately 2 weeks before adding another small activity to your programme at the expense of a rest time. Do something extra rather than doing something for longer.
Do not forget that this is your programme – you put into it what you want. Do things that are nice for you. You don’t have to do housework all day. Go and get your hair done, paint your nails, go for a ride in the car.
Once you’ve added this new activity, do it for two weeks before you know that you can do it and then you add something else. So, you go forward step-by-step. Don’t rush; if you’re not sure do half of it and then you will gain confidence that this illness is in your control.
Remember, chronic fatigue syndrome never ever gets worse by itself.
The whole structure of the Recovery Programme is covered in greater detail in the PDF Recovery Guidelines (60 pages)
CFS AND ITS SUBGROUPS
For a more detailed background on Dr Smith and his medical theories behind his treatment plan, the PDF Understanding and Diagnosing ME/CFS (123 pages 737KB) can be downloaded here.
We regret we cannot provide hard copies
This document outlines how the successful treatment plan was developed and how and why it works. Primarily for those in the medical profession it will be of interest to patients and their supporters.
Dr Smith will retire on 9th December 2017. After that date he will be unable to offer specific medical advice on a personal basis. However, we are still here to encourage and support you, or clarify points on the website, if you are trying to follow Dr Smith’s Get Well Guidelines.
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To date, £1000 has been sent to the ME Association.