The ME. Tips Collection (text only website)

Introduction

Myalgic Encephalomyelitis (M.E.) is a disabling long-term illness affecting an estimated 150,000 people in the UK. It affects many systems of the body, particularly the immune system and nervous system but the exact mechanisms are not yet fully understood.

Some people recover relatively quickly (in a year or two), others remain ill indefinitely. Although data is limited, perhaps around a quarter of people with M.E. are severely affected, mostly confined to their homes or beds. In children, M.E. is the most common cause of long-term sickness absence from school. *

M.E. is often called Chronic Fatigue Syndrome (CFS) but this term is disliked by many patients who consider the word ‘fatigue’ misleading and the definition too broad. The illness, its research and treatment remain surrounded by controversy and confusion.

These tips are a product of the ingenuity and experience of countless members of the M.E. community. We regret that it has been impractical to name them individually, or to trace the original ‘inventors’. For years practical tips have been passed through our community by word of mouth and pen. It is our hope that ‘The M.E. Tips Collection’ will make this easier.

As a general rule we have aimed to include tips on ‘living with’ the illness, and to exclude those on ‘treating’ it, although there is no real distinction. The individual tips have not been checked by an M.E. specialist and are not specifically endorsed by us or by any M.E. organisation. However, we do hope that you will find some of the ideas useful. We have also included addresses of relevant organisations, but these have not necessarily been recommended by anyone with M.E.

A big thank you to everyone who has made this compilation possible; to all our volunteers who made phone calls, typed and read drafts; to those who encouraged, supported and made constructive criticism; and to everyone who sent tips.

The M.E. Tips Collection is available on the Internet at www.metips.co.uk Extracts, or the full document, can be freely photocopied or printed in newsletters, but please include the website details.

If you have any comments, corrections or additional tips write to us at THE M.E. TIPS COLLECTION – C/O ACTION FOR M.E., Third Floor, Canningford House, 38 Victoria Street, Bristol BS1 6BY or E-mail: Zoe@metips.co.uk with ‘Tips’ in the subject heading.

Further copies of this booklet can be obtained by sending stamps to the value of £1 to:
* ACTION FOR M.E., Third Floor, Canningford House, 38 Victoria Street, Bristol BS1 6BY or
* THE M.E. ASSOCIATION, 4 TOP ANGEL, BUCKINGHAM INDUSTRIAL PARK, BUCKINGHAM, MK18 ITH.

The cartoon illustrations are by Graham Kennedy and Zoë Beveridge.

The M.E. Tips Collection is presented in memory of Alison Hunter.

Zoë, Trevor and Pat Williams and Zoë Beveridge


* DOWSETT E.G, COLBY J Long Term Sickness Absence due to M.E./CFS in UK Schools: An Epidemiological Study with Medical and Educational Implications Chronic Fatigue Syndrome 1997; 3:29-42


How to use this booklet


Words in italics refer to other parts of the booklet e.g. under Reading you will find Talking Books. Look up Talking Books and there will be more information. Pages 2 and 3 (‘Where to look for more information’) are also relevant to many sections.

References like AfME Pain Control mean that there is a relevant document available from one of the M.E. organisations. AfME information sheets are free unless otherwise stated and are available from Action for M.E. Articles which have been previously published in their magazine InterAction, can be ordered from the AfME Information Service at Wells free to members of AfME (please quote your membership number), non-members send 3 first class stamps. YAO documents are available on the Young Action Online website or by post (send 3 second class stamps for one leaflet or 5 second class stamps for six leaflets). TYMES magazines and information packs can be obtained from the Tymes Trust address below. Write to AYME at the address below for their booklets and videos.

* ACTION FOR M.E. Membership costs £15 per year, P.O. BOX 1302, WELLS, BA5 1YE Tel: 01749 670799 Website: www.afme.org.uk
* M.E. ASSOCIATION. Membership costs £15 per year, 4 TOP ANGEL, BUCKINGHAM INDUSTRIAL PARK, BUCKINGHAM, MK18 ITH Tel: 01280 818960 Helpline: 01375 361 013 Website: www.meassociation.org.uk
* TYMES TRUST AND YOUNG ACTION ONLINE, P.O. BOX 4347, STOCK, INGATESTONE, CM4 9TE Advice Line: 01245 40 10 80 (11am-1pm & 5-7pm Mon-Fri) E-mail: jane@youngactiononline.com Website: www.youngactiononline.com
* AYME (Association of Young People with M.E.), BOX 605, MILTON KEYNES, MK2 2XD Tel: 01908 373300 Fax: 01908 274136 E-mail: info@ayme.org.uk Website: www.ayme.org.uk

When writing to people or organisations mentioned in this booklet, please include a stamped addressed envelope. Some of the information will go out of date. Directory Enquiries (Tel: 192) may be able to give up to date telephone numbers. Please let us know about any errors.

M.E. varies a lot in its symptoms and severity; none of the tips will be suitable for everyone. Take care when trying new things, pace yourself and use your own judgement as to whether you are up to it. Where a service has been mentioned, the organisation concerned may provide other services as well.

Where to look for more information:

* THE DISABLED LIVING FOUNDATION provides information about equipment specifically for people with disabilities. 380-384 HARROW ROAD, LONDON, W9 2HU. Tel: 020 7289 6111 Helpline: 0845 130 9177 Minicom: 020 7432 8009 E-mail: advice@dlf.org.uk Website: www.dlf.org.uk
* There are also local Disabled Living Centres where you or an assistant can try out equipment to assess its suitability. THE DISABLED LIVING CENTRES COUNCIL can provide details of your local centre. FIRST FLOOR, WINCHESTER HOUSE, NO. 11, CRANMER ROAD, KENNINGTON, LONDON, SW9 6EJ
* RADAR. Pan-disability campaigning organisation that gives advice and information on non-medical issues. 12 CITY FORUM, 250 CITY ROAD, LONDON EC1V 8AF Tel: 020 7250 3222 Minicom: 020 7250 4119 E-mail: radar@radar.org.uk Website: www.radar.org.uk


* THE GLOUCESTERSHIRE HEALTH INFORMATION SERVICE (THE GUIDE), FREEPOST SWC 4299, GLOUCESTER GL1 2ZZ Tel: 01452 33 11 31 E-mail: enquiries@guide-information.org.uk Website: www.guide-information.org.uk provides information about illnesses and treatments, self help groups, complaints procedures, the Patients’ Charter etc. They may be able to give details of similar services in other areas.
* Local disability information lines, contact DIAL UK, ST CATHERINES, TICK HILL RD, DONCASTER, DN4 8QN Tel: 01302 310123 for your local number. E-mail dialuk@aol.com Website: www.dialuk.org.uk
* CITIZENS ADVICE BUREAUX can provide information about many things including benefits, local services and legal matters.
* THE SAMARITANS provide confidential emotional support for anyone in distress or at risk of suicide. Local branches (details on the website and in the phone book) also have phone numbers of local helplines and counselling services. Postal service: CHRIS, P.O. BOX 90 90, STIRLING, FK8 2SA. Tel: 08457 909090 Textphone: 08457 90 91 92 E-mail: jo@samaritans.org Website: www.samaritans.org
* REMAP’s volunteer engineers, craftsmen and occupational therapists design and construct otherwise unavailable equipment for people with individual needs due to disability. Projects undertaken by the charity’s local panels are varied and include designing a hoist for lifting shopping to an upstairs room, arm supports, a computer keyboard support to be used lying down, and wheelchair adaptations such as ‘sand wheels’ for beach trips. There is no charge to the person supplied with the equipment though a donation towards materials is welcomed. REMAP, HAZELDENE, IGHTHAM, SEVENOAKS, KENT, TN15 4AD Tel: 0845 1300 456 Website: www.remap.org.uk


How To find out more about M.E.
* ACTION FOR M.E. can provide details of LOCAL M.E. GROUPS or individual local contacts. Write to ACTION FOR M.E., Third Floor, Canningford House, 38 Victoria Street, Bristol BS1 6BY or ring 01179279551
* THE M.E. ASSOCIATION, 4 TOP ANGEL, BUCKINGHAM INDUSTRIAL PARK, BUCKINGHAM, MK18 ITH and ACTION FOR M.E., Third Floor, Canningford House, 38 Victoria Street, Bristol BS1 6BY both have a range of leaflets and a quarterly magazine, among other services.
* Action for M.E. and some local M.E. groups have libraries from which members can borrow books about the illness and sometimes tapes, relaxation tapes or videos. Local libraries also lend books on M.E., and may be able to order books not on the shelves or out of print.
* CO-CURE (Co-Operate And Communicate For A Cure) list and website has up to date news and many medical references. Website: www.co-cure.org
* AXFORD’S ABODE includes links to international sites. Website: http://freespace.virgin.net/david.axford/me.htm


The Role of Social Services
* Social Services provide things like home helps, meals on wheels/frozen meals delivery, home care, respite care, assistance with getting up or bathing. Eligibility depends on an assessment of your needs. It is worth thinking carefully about your needs beforehand, as the person assessing you may not be familiar with the often profound but invisible effects of M.E. There is a charge for services, which varies depending on your financial circumstances. Self-referral is possible.
* One of the roles of Occupational Therapists (OTs) is to provide suggestions about what equipment might be useful for your needs. They are able to provide some equipment on long-term loan.
Benefits; Carers; Doctors; Education; Young People
InterAction 30; 1999; pages 14-15 Social Services – a rough guide


A-Z of Tips

Bed - There are contoured pillows that hold the head and neck in a better position. But Robin McKenzie in his book ‘Treat Your Own Neck’ recommends pillows that you can adjust to your shape as being the best. He writes ‘ideally feathers or kapok, with rubber or foam chips as a second choice. Make a hollow for your head and bunch the edge to form a thick support for your neck. If the pillow does not provide adequate support for your neck, use a supportive roll in addition. Make a soft foam roll of about 8cm in diameter and 45cm long. Place this inside your pillowcase, on top of the pillow and along its lower border. Alternatively, use a small hand towel of about 50cm long and wide. Fold this in half and roll it loosely, then wind it round your neck and pin the ends together in front. The measurements are a guide, each person needs to experiment for himself.’
When lying on your side, it may improve comfort to have a pillow or cushion between your knees. Try bunching a duvet around your head, neck and back; you can change its shape to support you in different ways. You may find a small towel helpful sometimes to give extra support for your lower back. An unsuitable mattress can cause much discomfort. If you have the opportunity to try different types in a shop or when you stay somewhere else this may give you some idea of what you need. Joint pain may mean that the surface of the mattress is too hard, and back pain that it is too soft. The ideal is a good level of support with a soft surface. Mattress overlays can be obtained which may help if the mattress is too hard. Pressure relieving measures can be beneficial for painful muscles or joints and for general comfort, as well as for prevention of sores (see Pressure Sores).
A bed cradle keeps the weight of the covers off your feet, or you could try a pillow by your feet. You may need to use a double duvet or a blanket on the end to reduce draughts. If you are at risk of falling out of bed, consider getting a bed guard. Don’t be embarrassed to lie down in company or to have visitors when you are in bed. Use lightweight drawers, tidy pockets, shelving systems and containers to keep frequently used items organised and within reach. One person with M.E. attaches her watch to a table light instead of her wrist. Although some parts of the room are likely to be visually busy, have a specific area for work/clutter and try to include other areas which are more peaceful to look at, in order to avoid an over-stimulating environment. Drawers are less visually over-stimulating than shelves, or you can have a piece of material attached to the front of shelving systems so that you don’t have to look at everything.
* FOAM FOR COMFORT, UNIT TWO, WYTHER LANE INDUSTRIAL ESTATE, WYTHER LANE, KIRKSTALL, LEEDS, LS5 3BT Tel: 0845 345 8101 Fax: 0845 345 8102 E-mail: info@foamforcomfort.co.uk Website: www.foamforcomfort.co.uk Foam For Comfort sell mattresses, pillows, cushions and are happy to discuss individual needs.
* SPENCO soft mattresses overlays can be obtained from SPENCO HEALTHCARE INTERNATIONAL, 45 LONDON ROAD, HORSHAM, WEST SUSSEX, RH12 1AN Tel: 01403 321900 E-mail: sales@spenco-healthcare.co.uk Website: www.spenco-healthcare.co.uk These are sometimes available through district nurses or occupational therapists.
Clothes; Environmental Control Systems; Nature; Over-Stimulation; Pain; Passive Physio; Plugs; Pressure Sores; Resting; Severe M.E.; Sitting; Sleep; Stairs; Temperature Control; Tray; Wheelchairs

Benefits - Make sure you know what social security benefits you may be entitled to. Some forms are complex and M.E. doesn’t fit easily into the boxes. Work out what to say about your illness and somehow fit it into the form. Keep photocopies of forms and other documents. Make a note of when your sick note runs out; you will need to see your doctor then and the DSS doesn’t send out reminders until the date has almost arrived.
* BENEFITS ENQUIRY LINE Freephone: 0800 882200 (0800 220674 in Northern Ireland).
* DISABILITY ALLIANCE, UNIVERSAL HOUSE, 88-94 WENTWORTH STREET, LONDON E1 75A Tel: 020 7247 8776. Welfare Rights line (Mon Wed 2-4 pm) 020 7247 8763. Disability Rights Handbook £11.50 inc. p&p (£7.50 for people on benefits).
AfME A guide to benefits; AfME Incapacity Benefit – Personal Capability Assessment £1.50; AfME Personal Capability Revisions and Appeals £2.50; AfME Disability Living Allowance – Filling in the form £1.00; AfME Disability Living Allowance – Revisions and Appeals £2.50; AfME Therapeutic Earnings – The New Rules; AfME Benefits for Students; AfME Disability Living Allowance for children under 16 £1.00; InterAction 34; 2000; pages 30-32 Benefits – DLA guide; InterAction 35; 2000; pages 36-37 Benefits – DLA appeals guide; InterAction 30; 1999; page 17 Money matters – private health insurance; InterAction 36; 2001; pages 20-21 Housing issues and benefits
Buzzers - There are various types of buzzer, with and without an intercom, to enable people to call their carer/P.A. A doorbell intercom, portable doorbell, or baby intercom monitor (e.g. from ARGOS or MOTHERCARE) may be useful for this purpose. Some carers carry a mobile phone or pager so that they can be contacted when they are out.
* Emergency buttons are available which are worn around the neck. For more information contact AGE CONCERN AID CALL Tel: 0800 772266 Website: www.aidcall.co.uk
Carers; Door; Environmental Control Systems

Carers - If you rely on carers/Personal Assistants and are often too ill to explain what you want them to do, develop a system so that you can leave instructions when you do have the energy. Some people use index cards, with each card having instructions about a particular job. Having detailed instructions written out also makes it easier when there is a new carer/PA. Another possibility is to leave a recorded message on a dictaphone or tape recorder. Having a routine can also help. Local authorities now have the option (although not the duty) to make Direct Payments to people with disabilities as an alternative to the client using social services own care provision. This gives the client more options to enable them to purchase suitable care, although it also involves taking on extra responsibilities. RADAR has a pack of information about Direct Payments Tel: 020 7250 3222. There is also an article about Direct Payments on our website.
* INDEPENDENT LIVING ALTERNATIVES, TRAFALGAR HOUSE, GRENVILLE PLACE, MILL HILL, LONDON, NW7 3SA Tel/Fax: 020 8906 9265 Wed/Fri 10.30-4.00 Website: www.ILA.mcmail.com Provides support and information and personal assistants, including advice about Direct Payments.
* ACTION FOR M.E. has information about holidays and respite care, send an SAE plus 50p in stamps to AfME, P.O. BOX 1302, WELLS, BA5 1YE.
* MEACH TRUST, 25 TURNPIKE WAY, ASHINGTON, WEST SUSSEX, RH20 3QG Website: www.meach.org Raising money with the primary aim of setting up care homes specifically for people with severe M.E.
* CARING FOR CARERS HELPLINE Freephone: 0800 100 000 can give information on benefits and support networks.
* CROSSROADS-CARING FOR CARERS, 10 REGENT PLACE, RUGBY, WARWICKSHIRE, CV21 2PN Tel: 01788 573653 Website: www.crossroads.org.uk Provides trained care attendants for the benefit of the carer.
* THE KILORAN TRUST, 157 BLYTHE ROAD, LONDON, W14 0HL Tel: 020 7602 7404 E-mail: kiltrust@aol.com Website: www.kilorantrust.org.uk Provides supportive breaks for carers.
* THE CARERS NATIONAL ASSOCIATION, 20-25 GLASSHOUSE YARD, LONDON, EC1A 4JT. Carers Line Freephone: 0808 808 7777 Mon-Fri 10am-noon and 2-4pm.
* DOGS FOR THE DISABLED, THE FRANCES HAY CENTRE, BLACKLOCKS HILL, BANBURY, OXON, OX17 2BS Tel: 01295 252 600 E-mail: info@dogsforthedisabled.org Website: www.dogsforthedisabled.org supply trained dogs to help disabled people
* CARELINK Tel: 0845 762 6536 have a database of organisations and counsellors. They arrange short-term respite care with volunteer families.
Coping Strategies; Pacing; Parenting; People; Writing; Young People (see also page 3: The Role of Social Services)
InterAction 33; 2000; pages 22-23 Caring for carers; Is Direct Payments for M.E. (on our website)

Celebrations - Life with M.E. can be monotonous. One idea is to turn some days into gentle celebrations. For example, on 14th July (Bastille Day), how about wearing a Breton T-shirt and eating croissants, on 4th July (American Independence Day), maybe listen to a bit of American music and have apple pie; for Hogmanay; tartan, bagpipes and shortbread. Other possibilities include Chinese New Year, Bonfire Night, World Vegan Day (1st November), and National Poetry Day. If you would like to see in the new year, but can’t stay up late without ill effects, try going to sleep at the usual time on New Year’s Eve and getting woken up just before midnight. Birthdays and Christmas can be emotionally difficult. Re-prioritise your Christmas, choosing which traditions suit you and your illness, and dumping those that don’t. Try to do activities such as shopping, cooking, writing and wrapping up in advance so that if you are ill you won’t be worrying that there is so much to do. If you want to put a letter in with Christmas cards, writing just one and getting it photocopied saves energy (also good for thank you letters). Keep a supply of suitable cards, small presents and wrapping paper handy and use a birthday book or list. To avoid having to find the end of the Sellotape every time, use a dispenser (which can be used one-handed).
You may find it more enjoyable to celebrate your birthday or Christmas over a two or three-week period e.g. stagger visitors or telephone calls and open cards and presents on different days. Use other people’s arms to open cards and presents if it’s easier for you. Presents are easier to open if they have the minimum amount of sticky tape, and tissue paper is easier to rip. Envelopes don’t always need to be stuck closed. Depending on the illness, it is possible to include people with M.E. in events such as weddings and parties which they are unable to attend. For example they may be able to look at photos, watch or listen to a video or cassette of a wedding, receive a phone call from a party or enjoy a piece of cake or buffet. Even a simple message or note to show that they were remembered can mean a great deal, and if the illness is severe this may be all they are well enough for.
* CRAFT CREATIONS, INGERSOLL HOUSE, DELAMARE ROAD, CHESHUNT, EN8 9HD Tel: 01992 781900 sell recycled paper bags in different designs. This makes wrapping presents easier and avoids the difficulties presented by particular shapes.
Computer; Coping Strategies; Funerals; Games; Holidays; Pacing; Quality of Life; Writing
Virtual Holidays (article on our website)

Chemical Sensitivities - If you have become sensitive to chemicals, make sure that you, and if necessary those around you, stick to unscented, non-aerosol deodorants, toiletries, and cleaning products. Try to find ‘natural’ alternatives. Bicarbonate of soda can be used as a cleaning agent, (it can be bought more cheaply from a chemists) and table salt as a scouring powder. White vinegar mixed half-and-half with water can be used to clean glass or remove scale and stains. Certain plants help to clean the air. New clothes might need a good soak and/or washing a few times to reduce the chemicals. Printed material, especially on shiny paper, can cause problems, but may improve after an airing. Open post in a different room so that you can get away from it if it causes symptoms. If your skin reacts, try wearing gloves. Read second-hand books instead of new ones, as some of the chemicals will have been released. If you react to other people’s perfume, deodorant etc. it may be possible to get a letter from your doctor stating that you have allergies or chemical sensitivities and listing problem substances. This can be photocopied and sent in advance to people who are visiting your house, asking them to avoid these things. It may be worth going to stay somewhere else if you or a neighbour are having work done. Some materials release chemicals for a short time and then stop, others continue off-gassing.
* Multiple Chemical Sensitivity – A Survival Guide by Pamela Reed Gibson ISBN 1-57224-173-X £12.99 This book contains lots of information on living with multiple chemical sensitivities.
* THE ALLERGY SHOP, 2 MOUNT PLACE, LEWES, EAST SUSSEX, BN7 17H Tel: 01273 472127 Sells non-allergenic and biodegradable cleaning products, toiletries, vitamins and minerals.
* THE HEALTHY HOUSE, COLD HARBOUR, RUSCOMBE, STROUD, GLOS. GL6 6DA Tel: 0870 331 33 33 Fax: 01453 752216 E-mail: info@healthy-house.co.uk Website: www.healthy-house.co.uk This company supplies things like filter masks, air purifiers (including one for cars), paints and water purifiers.
* THE NATURAL COLLECTION, ECO HOUSE, MONMOUTH PLACE, BATH, BA1 2DQ Tel: 0870 331 33 33 Fax: 01225 469 673 E-mail: info@naturalcollection.com Website: www.naturalcollection.com Sells E-cloths (which clean with just water), and cleaning products as well as a range of other environmentally considered products.
* THE SOIL ASSOCIATION, BRISTOL HOUSE, 40-56 VICTORIA STREET, BRISTOL, BS1 6BY Tel: 0117 9290661 E-mail: info@soilassociation.org Website: www.soilassociation.org Can supply information about organic produce. Their guide ‘The Organic Directory’ (£5.95 including p&p) has a comprehensive list of outlets and organic box schemes.
* HONESTY COSMETICS, LUMFORD MILL, BAKEWELL, DERBYSHIRE, DE45 1GS Tel: 01629 814888 Fax: 01629 814 111 E-mail: info@honestycosmetics.co.uk Website: www.honestycosmetics.co.uk Sells household cleaning products, deodorant stone, and unscented beauty products.
* AURO NATURAL PAINTS, UNIT 2, PAMPHILLIONS FARM, DEBDEN, SAFFRON WALDEN, CB11 3JT. Tel: 01799 543077 Fax: 01799 542187 E-mail: sales@auroorganic.co.uk Website: www.auroorganic.co.uk
Doctors; Drinking; Dust; Nature; Pain
InterAction 31; 1999; pages 18-19 Chemical Sensitivities

Child Protection Procedures - Although designed to protect children from abuse, there have been some cases where the law has been used to try to enforce controversial treatment on children with M.E. Tymes Trust and AYME can put people in touch with professionals who may be of help in such a situation.
Young People
YAO Social Services & Children with M.E. - Misunderstandings, Child Protection Procedures, Ways Out of the Nightmare; TYMES Magazine Issue 26 £1.50 (includes coverage of recent cases) ; InterAction 29; 1999; pages 30-31 Care orders and the Child Protection Act by Nigel Speight

Christian - Many clergy are happy to bring Holy Communion to people who can’t get to church. Some churches are able to make tape recordings of services and talks.
* CHRISTIAN M.E. PRAYER FELLOWSHIP E-mail: carolyn.jowett@ouvip.com There are two telephone groups and a postal group, a fortnightly list, and a monthly newsletter.
* CARELINK Tel: 0845 7626536 have a database of organisations and counsellors. They arrange short-term respite care with volunteer families.
Meditation; Special Interest Groups

Clothes - If lying down for long periods, avoid garments with pockets or bulky seams. Jumble sales and charity shops sell clothes more cheaply, which is especially useful if you have difficulty finding clothes that are comfortable. Try out different types of garments to see which cause you the least pain or discomfort. You may be surprised and find that, for example, a lightweight silk shirt is better than a nightie or T-shirt. Slippery material slides easily over the skin and may irritate your muscles less; slippery clothes and sheets can also make it a bit easier to turn over in bed. Cotton clothes may be best for sensitive skin. Socks that would usually be considered too big might be better than a close-fitting size. Well-cushioned trainers may be more comfortable than slippers. There is no need to get changed in the morning and evening as long as you wear clothes that are comfortable enough to sleep in – change when you are well enough. Try not to be embarrassed if you are better off wearing nightclothes. You may be able to find some in a ‘daytime’ style, or try elasticated trousers and a T-shirt. Trousers which are loose around the waist can ease abdominal pain. Front fastening bras are easier to take on and off and cardigans are easier than jumpers. Fasten shoes by bringing your feet up on a chair or step rather than putting your head down. If you have difficulty with zips and buttons replace them with press-studs or Velcro (bear in mind that Velcro catches on some materials). A carer could do up most of the buttons before you get dressed, leaving the top one undone so that you can slip it over your head. Fleeces are warm and lightweight. Wearing several layers of thin clothes is more flexible for temperature control, or use blankets and a duvet. If you can’t wear long sleeved tops and don’t mind looking unusual in order to keep warm, try cutting the sleeves off a sweatshirt, hem the top of each sleeve with some elastic (not too tight) and wear the sleeves with a top you can tolerate. Alternatively, use leg warmers or a loose tubigrip bandage. Another option is to wear a shirt back to front – it is easier to take on and off while lying down and shouldn’t irritate your back muscles. Soft padding can be sewn into sleeves to give pressure relief for elbows. If it is difficult to get things washed, it may be worth having extra garments, sheets etc.
* KIWI SLIPPERS, ST MARGARET, HARLESTON, NORFOLK, IP20 0TB Tel: 01986 783333 E-mail: sales@kiwislippers.com Website: www.kiwislippers.com sell sheepskin slippers.
Pain; Pressure sores; Temperature Control

Computer - There are several ways of making computers easier to use. A type of adjustable armrest is available. You rest your arms on them and then you can move your arms more freely (although it takes a bit of time to get used to). This can be used in combination with a computer keyboard that can be split and a foam pad to rest your wrists on. If you find using a mouse difficult you can get a large track ball where you use the whole hand. Alternatively you can use a small square pad where you point with your finger or a special pen instead of a mouse. A strong trolley that can slide over the bed may enable you to use a computer in bed. Some keyboards are specially shaped to reduce fatigue. Tilt the screen so that you can use the computer in a more comfortable position. Software is available which is voice responsive, enabling the user to dictate into their computer and operate all functions, including E-mail, by voice. You can use a combination of voice, keyboard and mouse if you want to. You can create your own macros – such as your address or a standard paragraph, and call it up by saying a certain word. However some types are better than others. One individual with experience of these programs is Barry Brooks and he is willing to tell people with M.E. more about them, Fax: 020 8286 4774 E-mail: bbatlarge@yahoo.co.uk Some programs can minimize the number of letters typed by guessing the word or phrase as you type it (e.g. newer versions of Word for Windows). Others give you the option of having text read aloud by the computer (e.g. TextHELP! Read and Write). If you can’t sit in front of the PC, print out your incoming E-mails and write E-mails to send on paper and ask someone else to type them. Computers can be used for organising lists, appointments etc. Energy can be saved by using standard letters that can be sent to more than one person, and printed labels for addressing envelopes.
* ABILITYNET, P.O. BOX 94, WARWICK, CV34 5WS Tel: 0800 269545 E-mail: enquiries@abilitynet.co.uk Website: www.abilitynet.co.uk AbilityNet provide an advice, information and assessment service on computing for people with disabilities e.g. communication aids, highly ergonomic workstations and voice input computers.
* NEIL CONN, 434/2 LANARK ROAD, EDINBURGH, EH13 ONJ E-mail: Nwildrover@aol.com Neil will post questions about M.E. on the Internet for people who are not able to use the Internet (for a small donation). He will send any answers by snail mail.
* Anti-radiation screen filters are available by mail order from THE GREEN STATIONERY COMPANY, STUDIO ONE, 114 WALCOT STREET, BATH, BA1 5BG Tel: 01225 480556 E-mail: jay@greenstat.co.uk Website: www.greenstat.co.uk
* Computerised jigsaws can be played lying down and with less need for movement and co-ordination. They can be downloaded from www.jigzone.com
* A ‘Page Up’ is a small gadget which holds a piece of paper (or several) www.mypageup.com
Education; Headaches; Memory; Reading; Speech Difficulties; Writing
TYMES Magazine Internet Special £1.50 InterAction 37; 2001; pages 14-16 Computers and M.E.

Cooking - Food processors, electric can openers, lightweight mixers, electric knife sharpeners and electric knives can make cooking a lot easier, but not all are practical or suit your particular needs. Take any opportunity to try them before buying. If knives are kept sharp it takes less force to chop food. Organise your kitchen so that the things you use most often are within easy reach. Make as few movements as possible when cooking a meal. Using a small jug to carry water to a kettle or pan, avoids lifting a whole pan full of water. Kettle tippers, available from disability catalogues, hold the weight of the kettle or jug to make it easier to pour. Eat simple meals requiring minimum effort to cook and prepare. Sit down wherever possible; potatoes can be peeled in an armchair. Keep a tall stool or office chair in the kitchen. Cooking vegetables in a wire basket in a saucepan saves lifting a heavy pan. When able, prepare extra quantities and freeze some for a later date. Portions of casseroles, mashed potato, cooked rice, ham, sauces for pasta, and fresh cream in ice cube moulds can also be frozen. Find out which fresh foods and vegetables freeze well. Keep a supply of convenience foods for bad days. A microwave is useful for re-heating. You may be eligible for social services help such as: meals on wheels, frozen meals delivery service, or a carer who will cook for you. If you are having visitors, think about getting a takeaway, preparing food in advance, asking guests to bring a dish or getting them to do the cooking. Paper plates and disposable knives and forks save washing up if you don’t have a helper.
* WILTSHIRE FARM FOODS deliver a wide range of frozen meals. Brochure request line: 0800 773 773
* EISMANN Tel: 01536 275100 deliver frozen foods and prepared meals to some areas of the country. Nutritional information leaflet available on request
Drinking; Eating; Grip; Household; Pacing; Shopping; Sitting

Coping Strategies - Different people have different ways of coping. It is up to each individual to find out which strategies suit them best at that time. Be patient with yourself, you are living with a very difficult illness; it is natural to feel frustrated and angry sometimes. It is common to feel guilty for being or staying ill, but try not to blame yourself; it’s just bad luck. Sometimes it will be appropriate for you to grieve your losses and feel sorry for yourself. Have a good cry when you feel the need to. At other times it will be appropriate to try and pick yourself up emotionally, and distract yourself from your problems. It can help to remember that there are other people suffering too; people who are going through similar problems and people who are suffering due to other reasons such as hunger or war. Take one day at a time, and look after your emotional well-being. Remember that you are no more or less valuable than anyone else. Identify small pleasures and take time to do things that you enjoy (see Quality of Life). Where possible avoid situations which make you feel stressed or unhappy. Things which are difficult but necessary can sometimes be less stressful if you break them down into more manageable chunks and tackle them before they become urgent. Try to balance demoralising tasks with activities you will find enjoyable or relaxing. Although you can’t have a day off being ill, you might still be able to have regular breaks from ‘jobs’. It is difficult to express emotion with very limited energy. Here are some possibilities: Express it by talking to someone, in poetry, art or writing, or in prayer. Listen to music appropriate for your mood. Squish a whoopee cushion; pop bubble wrap; throw a soft toy on the floor; or play with Playdough. Tear up scrap paper (thin paper such as tissue paper takes less energy); scribble all over scrap paper or write down angry words and then rip them up. Watch a candle, use relaxation or meditation (see Resting).
* MIND mental health promotion booklets cost £1 each, £3 for 5 or £4.50 for 10 plus 44p postage. Titles include ‘How to assert yourself’; ‘How to cope with loneliness’; ‘How to look after yourself’ and ‘How to recognise the early signs of mental distress’. MIND PUBLICATIONS, GRANTA HOUSE, 15-19 BROADWAY, LONDON, E15 4BQ Tel: 020 8519 2122 Fax: 020 8522 1725 E-mail: publications@mind.org.uk Website: www.mind.org.uk
* THE SAMARITANS provide confidential emotional support for anyone in distress or at risk of suicide. Local branches (details on the website and in the phone book) also have phone numbers of local helplines and counselling services. Postal service: CHRIS, P.O. BOX 90 90, STIRLING, FK8 2SA. Tel: 08457 909090 Textphone: 08457 90 91 92 E-mail: jo@samaritans.org Website: www.samaritans.org
* Membership of the M.E. ASSOCIATION costs £15 per year and has a listening ear service for members. 4 TOP ANGEL, BUCKINGHAM INDUSTRIAL PARK, BUCKINGHAM, MK18 ITH Tel: 01280 818 960 Helpline: 01375 361 013 Website: www.meassociation.org.uk
* ‘Surviving M.E. Practical Strategies For Coming To Terms With Chronic Fatigue’ by Joyce Fox. ISBN 0 09 181472 3 £8.99. This book offers guidance on coping with the emotional impact of M.E. At the time of publication, it was out of print, but you could try your local library or M.E. Group.
* BRITISH ASSOCIATION FOR COUNSELLING AND PSYCHOTHERAPHY, 1 REGENT PLACE, RUGBY, CV21 2PJ Send an SAE for details of counsellors in your area. Counsellors can also be accessed by their website www.counselling.co.uk
Celebrations; Holidays; Nature; Pacing; Parenting; People; Quality of Life; Resting; Young People
InterAction 37; 2001; pages 35-37 Counselling – telephone service for M.E.; InterAction 22; 1996; pages 9-10 Counselling and Psychotherapy guide; InterAction 29; 1999; page 32 Depression and M.E.; InterAction 26; 1998; pages 26-27 Abuse, Trauma and M.E.; InterAction 24; 1997; pages 33-34 Loneliness; InterAction 34; 2000; pages 36-37 low self esteem; InterAction 38; 2001; pages 6-8 Recovery – making the adjustment; InterAction 36; 2001; pages 24-25 Stigma; InterAction 28; 1998; page 26, also issue 31; 1999; pages 28-30 Suicidal feelings

Doctors - Work out what you want to say before a doctor’s appointment and write a list as a memory jogger. It might be worth taking a tape recorder and asking if you could record important consultations, in case you’re not well enough to take everything in at the time. If travelling is likely to be bad for your health do ask (and keep asking) for a home visit or contact by phone, letter or E-mail. You might be able to send a representative, such as a well-briefed friend or carer, and get it tape recorded in your absence. Find out what you can about M.E., as your doctor may not know very much about it. Doctors, as well as patients, find this illness frustrating and difficult. Information sheets are available from M.E. organisations. See page 3 ‘How to find out more about M.E.’. Action for M.E., and possibly your local M.E. group, have a lending library for members. If you want to ask a specific question of a doctor with experience of M.E. some of the M.E. magazines have a ‘Dear Doctor’ column. The ‘Professionals Referral Facility’ is a network of professionals, including doctors, available to Tymes Trust members, who will advise families direct (see Young People for details of Tymes Trust). You could ask your local group or contact if they know of any understanding doctors in your area. If you are very unhappy with your GP, you should be able to change. You can ask for a preliminary appointment with prospective new doctors, either for yourself or a carer to attend. Keep a handout of your medical history, your known allergies, what drugs you are on etc. as you never know what emergency might crop up.
* For confidential advice about medical complaints procedures contact THE GLOUCESTERSHIRE HEALTH INFORMATION SERVICE (THE GUIDE), FREEPOST SWC 4299, GLOUCESTER GL1 2ZZ Tel: 01452 33 1131 E-mail: enquiries@guide-information.org.uk Website: www.guide-information.org.uk
* A video of a talk given by Dr David Bell is available from AYME, BOX 605, MILTON KEYNES, MK2 2XD priced £8.50 (including p&p).
* MEDICAL ADVISORY SERVICE, P.O. BOX 3087, LONDON, W4 4ZP General Medical Helpline: 020 8994 9874 6-8pm Mon-Fri Covers all general medical queries: how to change your G.P.; explanation of operations and surgical procedures; insomnia etc. Advice from M.A.S. nurses and referrals to specialist organisations and helplines.
Pain; People; Page 3; Prescriptions; Visitors
AfME Guidance on the management of CFS/M.E.; YAO Polling Your New Consultant; YAO What is M.E./CFS? (short introductory leaflet for doctors); Tymes Trust M.E. in Children and Young People (by and for doctors) £1; Tymes Trust GPs pack £2; InterAction 36; 2001; pages 6-15 Hospitals and M.E. – Special focus on inpatient care; InterAction 37; 2001; pages 8-9 NHS: how to make a complaint; InterAction 38; 2001; pages 16-17 Doctors with M.E. ; AYME Getting the best out of your doctor £1.50

Door - If you have difficulty answering the door, consider getting an intercom. This is also good for security purposes. You might like to give a front door key to some friends or neighbours. An automatic door opener has a buzzer and speaker grille by the front door connected to a ‘phone’ by the bed. You can speak to the visitor and then press a button, which releases the door catch, if you want to let them in. If you sit or lie in other rooms sometimes, you can have more entry phones fitted there too. It is also possible to have a switch fitted in the phone to enable you to turn the buzzer off when you do not want to be disturbed. There is another type of lock, where visitors can let themselves in if they know the code. However, this type doesn’t give you as much control over who enters your home. If you choose a combination lock, make sure you change the number initially as all locks of that model come fitted with the same code. Both these locks may be available through an Occupational Therapist.
Buzzers; Environmental Control Systems

Drinking - Kettle tippers, available from disability catalogues, hold the weight of the kettle or jug to make it easier to pour. Use a small jug to carry water to the kettle rather than carrying a full kettle. Lightweight china or plastic cups take less energy to lift. Drinking straws enable you to drink lying down or without holding the cup, and a long straw can be made by taping two straws together. Warm drinks can be drunk through a straw as long as they are not too hot. Wide straws are useful for thick soups. A cup with a spout may be helpful as they spill less, are lighter and can hook over your hand if grip is a problem. Some bottles have a nozzle lid - the liquid comes out slower and more controlled, so you can drink lying down. Keep a bottle of water next to the bed or chair (perhaps with a kettle tipper) so that you can refill the cup more easily. Thirst is a symptom of M.E. It may be worth taking water with you when you go out. Many people with M.E. find it better to avoid caffeine and alcohol. You might also decide to drink filtered or mineral water.
Cooking; Eating; Tray

Driving - Power steering and an automatic gearbox may be advantageous.
* THE DISABLED DRIVERS’ ASSOCIATION, NATIONAL HQ, ASHWELLTHORPE, NORWICH, NR16 1EX Tel: 01508 489449
* DISABLED DRIVERS’ MOTOR CLUB, COTTINGHAM WAY, THRAPSTON, NORTHANTS, NN14 4PL. Tel: 01832 734724
* TRIPSCOPE, THE VASSALL CENTRE, GILL AVENUE, FISHPONDS, BRISTOL, BS16 2QQ Tel/Minicom: 08457 585641 (local rate) Fax: 0117 939 7736 E-mail: enquiries@tripscope.org.uk Website: www.tripscope.org.uk Provides information about travelling and transport (including car adaptations) for people with a disability or chronic illness.
* THE RESEARCH INSTITUTE FOR CONSUMER AFFAIRS (RICABILITY), 30 ANGEL GATE, CITY ROAD, LONDON, EC1V 2PT Tel: 020 7427 2460 Fax: 020 7427 2468 Textphone: 020 7427 2469 E-mail: mail@ricability.org.uk Website: www.ricability.org.uk researches and published unbiased information on products and services to enable older and disabled people to live more independently. They have a guide “Ins and Outs of Choosing a Car” including getting in and out and adapting a car.
Chemical Sensitivities; Parking Concessions; Travelling
Dust - Dusting with a wet cloth rather than a dry one causes less dust to get into the air.
* THE HEALTHY HOUSE, COLD HARBOUR, RUSCOMBE, STROUD, GLOS. GL6 6DA Tel: 01453 752216 Fax: 01453 753 533 E-mail: info@healthy-house.co.uk Website: www.healthy-house.co.uk supplies products to reduce dust mites such as dust mite proof bedding covers

Eating - A thermos flask can be useful to keep drinks, soups or food in, because they can keep things hot (or cold) for several hours, which can save you or your carer time and energy. Plates with a lip are available which make it easier to eat certain foods with one hand (e.g. lying down). There are also non-slip mats to stop the plate sliding around. If eating a complete meal is difficult, try to eat little and often. This could be better for anybody, particularly if low blood sugar is a problem; although it’s not so good for teeth. Make sure you always have some food with you especially if you often feel faint. Keep an overnight snack by the bed. It might be worth taking water to drink when you go out. Soft food can be very helpful when recovering from a collapse, saving energy for something big or if you are too ill to chew. Wide straws are useful for soups. Plastic cutlery, plates and cups are lightweight and also quieter than metal and china. A variety of adapted cutlery can be obtained some of which is bent at a particular angle. Others have built up handles for people with weak grip, although they may be heavier than standard cutlery. If you need an assistant to feed you, the long handles of knickerbocker glory spoons may save them having to lean over you. If you have a willing assistant and not too many allergies, food can play an important part in quality of life, especially if you spend a lot of your energy eating. Try out new foods and recipes, use an attractive bowl or cup, have sandwiches cut into interesting shapes. If you want to eat cornflakes but find them too crunchy, leave them in a bowl of milk until they get soggy. Heated meusli also loses some of its chewiness. People with very severe difficulty eating may benefit from liquid oral feeds or naso-gastric tube feeding.
People on restricted diets may have a higher chance of developing an intolerance or allergy to that food, so try to eat as varied a diet as possible. Wheat and dairy products are the two most common intolerances, and many people with M.E. find it better to avoid caffeine, sugar and alcohol. If you suspect you may have food allergies or intolerances it might be worth seeking advice. A GP can refer you to a dietician.
* ‘Soft Options – for adults who have difficulty chewing’ by Rita Greer ISBN 0-285-63447-X. This book has recipes and advice on how to adapt foods to make eating easier. Here are some tips from the book: A bowl and spoon are easier to manage than a plate with a knife and fork, but there is still quite a long way from the table to the mouth. If the bowl is held near the mouth then the problem is not so great. A spoon of a size between a teaspoon and a dessert spoon with a matching fork will probably be of most use. Some people who have difficulty chewing, require extra liquid with their food. This can be in the form of a sauce, gravy or a drink with the food. ‘Soft Options’ eaters should be encouraged to savour the non-chew food by holding it in the mouth and moving it around with the tongue if possible. It is important to lubricate the food with saliva that contains enzymes to start off the digestive process. There is a knack in feeding someone else with food. It needs to be done at the right pace, with the correct-sized spoonful. The food needs to be put into the person’s mouth, not just to the lips, with a large napkin to catch the inevitable spillage. Sitting facing someone to feed him or her is more difficult than at their side. The temperature of the food should be appropriate for the person being fed. If feeding takes a long time due to difficulties, divide hot food into two amounts and keep one half warm while you feed the first half. Food that is puréed or finely chopped will go down to half its original size. Bear this in mind when dishing up, as it is very easy to overestimate the portion and give people far too much. It is always worth taking trouble to present food attractively, especially if it is of a new kind.
* A subscription magazine for people with food allergies/intolerance is available from: BERRYDALES PUBLISHERS, 5 LAWN ROAD, LONDON, NW3 2XS Tel: 020 7722 2866 www.inside-story.com
* THE SOIL ASSOCIATION, BRISTOL HOUSE, 40-56 VICTORIA STREET, BRISTOL, BS1 6BY Tel: 0117 9290661 E-mail: info@soilassociation.org Website: www.soilassociation.org Can supply information about organic produce. Their guide (£5 inc. p&p) has a comprehensive list of outlets and organic box schemes.
* The book “E for additives” by Maurice Hanssen, £6.99 has information about different additives.
Chemical Sensitivities; Cooking; Doctors; Drinking; Faintness; Sitting; Tray
YAO Diet in M.E.

Education - M.E. often has a dramatic effect on children’s education and is the most common cause of long term sickness absence from school in the UK*. Education must be tailored to the needs of the individual and care should be taken not to commit the child to too much work; it is better to enjoy doing one subject than to struggle with three and end up more ill, frustrated and demoralised. There is no legal requirement for a child to attend school, only to be educated, although some children are too ill for any form of education. Depending on the illness, a variety of methods can be used such as home tuition, part time school or college, correspondence courses and tuition by phone, fax or E-mail. You may find talking books or educational TV programmes more accessible than text. AYME has an educational advisor and a video teaching pack for schools (priced £20). Tymes Trust has documents to give to professionals or to use yourself (listed below). The ‘Professionals Referral Facility’ is a network of professionals available to Tymes Trust members, who will advise families direct e.g. exams officer, home-tutor co-ordinator, educational psychologist, social worker and specialist doctors. The ‘Tymes Trustcard’ can be carried by pupils with M.E. to show that they are entitled to make use of special facilities. (See Young People for details of AYME and Tymes Trust). Appropriate exam concessions (such as rest periods) should be available but need to be applied for in advance. There is no age limit for taking GCSEs; loans may be available for people of any age. A Dictaphone can be used to tape lectures at school or university.
Anna Grace Lidstone writes in the Young Action Online document YAO Learn and Live – A guide to the Open University: ‘Be organised. There is an awful lot of paper and it looks much scarier if you don’t file it promptly. If possible have a space specifically for study, away from distractions, so that you don’t have to waste valuable energy transporting course material from shelf to table. Learn to spot the early signs of ‘brain fatigue’ and act accordingly - it’s far better to take lots of short breaks than to work yourself into relapse. ALWAYS put your health and well being first’.
* ADVISORY CENTRE FOR EDUCATION (ACE), 1C ABERDEEN STUDIOS, 22 HIGHBURY GROVE, LONDON, N5 2DQ Tel: 020 7354 8318 Freephone Helpline: 0808 800 5793 advice line Mon-Fri 2-5pm. E-mail: ace-ed@easynet.co.uk Website: www.ace-ed.org.uk
* HOME EDUCATION ADVISORY SERVICE Tel/Fax: 01707 371 854
* EDUCATION OTHERWISE, P.O. BOX 7420, LONDON N9 9SG Tel: 0870 730 0074 Website: www.education-otherwise.org exists to support families who wish to educate their children outside the school system. For general information send A5 SAE.
* LEARNING DIRECT Helpline, Freephone: 0800 100900 Website: www.learndirect.co.uk Confidential and impartial information and advice on learning and career opportunities for adults in the UK.
* THE NATIONAL ASSOCIATION FOR THE EDUCATION OF SICK CHILDREN, REGUS HOUSE, HERALD WAY, PEGASUS BUSINESS PARK, CASTLE DONNINGTON, DE74 2TZ Tel: 01332 638 586 E-mail: naes1@aol.com Website: www.sickchildren.org.uk Works exclusively to improve educational opportunity across the UK for all children whose education is disrupted by illness. Have an online tuition service – satellite school.
* SKILL, NATIONAL BUREAU FOR STUDENTS WITH DISABILITIES, CHAPTER HOUSE, 18-20 CRUCIFIX LANE, LONDON, SE1 3JW Tel: 0800 328 5050 Minicom: 0800 068 2422 E-mail: info@skill.org.uk Website: www.skill.org.uk
* ICS - (International Correspondence School) LEARNING SYSTEMS, CLYDEWAY SKYPARK, 8 ELLIOT PLACE, GLASGOW, G3 8EP for people of any age. Freephone: 0500 303333 Website: www.icslearn.com
* BBC Learning Zone: E-mail: edinfo@bbc.co.uk Website: www.bbc.co.uk/education/lzone/Links to search for specific topics. BBC Learning Website: www.bbc.co.uk/learning/
* Channel Four Learning: www.channel4.com/learning
* SCIENCE LINE Tel: 0808 800 4000 answers questions from the general public about anything to do with science (but they can’t give medical advice). 1pm-7pm Mon-Fri
* ‘Zoë’s Win’ by Jane Colby ISBN 09537330 0 9 price £7.95 contains a section for teachers.
Computer; Headaches; Memory; Over-Stimulation; Pacing; Paperwork; Reading; Talking Books; Television; University; Writing; Young People
Interaction 30; 1999; pages 18-19 Studying with M.E.; YAO Students & M.E.; YAO School Examinations & M.E. Special Assessment Arrangements; YAO Guidelines for Schools; YAO M.E. & Learning; YAO Your M.E. Assembly £3.50 (a pack for pupils and teachers); YAO Learn & Live - a guide to the Open University; TYMES Education Special £1.50; TYMES Internet Special £1.50 (features experiences of computer learning); InterAction 35; 2000; page 35 Schooling and M.E.; InterAction 30; 1999; pages 18-19 Studying with M.E.
* DOWSETT E.G, COLBY J Long Term Sickness Absence due to M.E./CFS in UK Schools: An Epidemiological Study with Medical and Educational Implications Chronic Fatigue Syndrome 1997; 3:29-42

Emergencies - Keep a handout of your medical history, your known allergies, what drugs you are on etc. as you never know what emergency might crop up.
* Emergency buttons are available which are worn around the neck. For more information contact AGE CONCERN AID CALL Tel: 0800 772266 Website: www.aidcall.co.uk

Environmental Control Systems - These systems aim to make it easier to operate things like lamps, curtains, buzzers, door and telephone from a bed or chair. The Department of Health may fund equipment for people who are severely disabled. These companies supply them:
* POSSUM Tel: 01296 481591
* RIDLEY ELECTRONICS Tel: 020 8558 7112
* RSL STEAPER LTD Tel: 01634 226 161
Household; Plugs

Faintness - Eat frequent meals and always have some food with you.
Eating; Pacing

Funerals - If you are unable to attend a funeral as you would like, it might be suitable to have a small ceremony of your own at home, perhaps at the same time as the main funeral. Light a candle (making sure it is safe), and remember the person who has died. A hymn, poem, photo, music and/or bible reading may be appropriate.

Games - Using a playing card holder takes the strain off your hands. Other players can roll dice or move pieces on your behalf. For games with several people playing, if you are not up to playing yourself, you could team up with another player and take as active or inactive a role as is appropriate. This also enables you to leave at any time. Games of pure luck can be played wholly or partially in your absence, with a counter being allotted to you. Games such as ‘snakes and ladders’ and ‘beggar your neighbour’ are also good if your brain isn’t up to a more skilful game. A time limit can be set for many games that would otherwise be too long, with the person who is winning at that moment being the winner. There are various forms of ‘patience’ which you may be able to watch another person playing. Being in the same room as other people while they play a game can be a pleasant, undemanding form of company (wear a blindfold and ear plugs or ear defenders if needed). Some games involve more skill for one player than the other so the ill person can take the easier role e.g. ‘mastermind’; ‘I spy’; ‘animal, vegetable, mineral’. Sensory guessing games can be fun – the person with M.E. wears a blindfold and has to guess the taste, or an object in their hand. Pencil and paper games are entertaining and some are quick. Gift shops sell ‘executive’ toys, bubble mills, mobiles, lava lamps and sand pictures. Charity shops sell jigsaws and games, and they might welcome an offer to check whether these items are complete.
* A playing card holder (£4.69 ref. LE 2010) and large print playing cards, which are good for playing in low lighting (single pack £4.69 ref. LE2020), are available from KEEP ABLE LTD. UNIT 38C, TELFORD WAY, TELFORD WAY INDUSTRIAL ESTATE, KETTERING, NORTHANTS, NN16 8UN. Tel: 01536 525153 Fax: 01536 515077
* Computerised jigsaws can be played lying down and with less need for movement and co-ordination. They can be downloaded from www.jigzone.com
* JUCY TRADING LTD, 43 SELWOOD ROAD, GLASTONBURY, SOMERSET, BA6 8HW Tel: 01458 830554 (after 6pm). A small timer costs £5.40; a large timer costs £11.20
Celebrations: Computer

Gardening - Consider keeping a chair outside so that you have somewhere to sit down without moving furniture. A raised flower bed enables one to do gardening from a wheelchair or seat. Think about how your garden might be adapted to reduce the amount of work, for example using paving slabs or gravel beds. A garden kneeler or seat might be useful. Pace yourself carefully and don’t be tempted to finish a job just because you started it. Consider having a tap in the front and back gardens.
Nature; Pacing

Grip - Taps can be replaced with a long handled design. Tap turners from disability catalogues are a cheaper but generally less effective alternative. Some pens are designed to be easier to grip (see Writing). Handles can be built up using padded racket tape from a sports shop. There is also cutlery with built up handles which are easier for some people, although they may be heavier than standard cutlery. Rubber gadgets for opening jars are available. Using a towel gives more grip than just using your hands. Kettle tippers, available from disability catalogues, hold the weight of the kettle or jug to make it easier to pour. Use a small jug to carry water to the kettle rather than carrying a full kettle.
* Disability catalogues sell adhesive handles to stick to plugs, making them easier to pull out of sockets. BETTERWARE Tel: 0845 125 500 E-mail: csd@betterware.co.uk Website: www.betterware.co.uk have a good design.
* A device called a ‘baby boa constrictor’ makes opening jars much easier, it costs £5.95 from BOA (UK), UNIT 1, ADDINGTON BUSINESS CENTRE, VULCAN WAY, NEW ADDINGTON, CROYDON, CRO 9UG E-mail: info@boa-uk.com Website: www.boa-uk.com
Drinking; Eating; Games; Plugs; Washing; Writing

Hair - Two in one shampoo and conditioner reduces the amount of washing to be done, or just use shampoo. Diluting shampoo with warm water makes it lather up more easily. An energy saving technique for washing hair is to sit on your bath/shower seat, bend forward and lean your arms and the weight of your upper body on your thighs. This way you can reach your head without having to hold your arms up. If you wash your hair in a shower, do it first so that it can be rinsing while you get washed. Dry shampoo can be sprayed on to hair and brushed out, making unwashed hair look a bit more presentable. Try rubbing flour into greasy hair as a dry shampoo. Alternatively, just wash the fringe, and perhaps tie it back if you have long hair. Short hair is easier to wash. Having someone else wash your hair saves energy; don’t deny yourself the pleasure of clean hair for the sake of false pride; even healthy people have help at the hairdresser. There are several designs of trays to enable an assistant to wash hair more easily at a sink or in bed. The ones for use in bed can be solid plastic or inflatable. Ask an Occupational Therapist, who may be able to provide one, or buy one privately from a disability catalogue. Another method which you may find less uncomfortable than using a tray is to lie on your front with your head over the edge of the bed. Place a pillow under your chest with plastic on it so it won’t get wet. Put plastic on the floor and a big bucket on the floor under your head. An assistant can then pour water over your hair with a jug. A hair dryer can be stuck in a toothbrush and mug holder so that you only need to move your head when drying and don’t have to hold up the dryer, but don’t use electrical appliances in the bathroom. Leave hair to dry naturally to save energy, putting a towel on your pillow or round your shoulders. It is quite possible to live happily without having a hair-wash at all. Some hairdressers do home visits. If sitting up to have it cut is a problem, have a style that will look fine if it doesn’t get cut for a while. It may be worth pacing a hair cut by having a short rest halfway through. You could ask the hairdresser not to chat and to place more importance on speed than perfection.
Sitting; Washing

Headaches - A cold flannel or ice pack may help, or alternatively a hot wheat pack. Eye masks (containing blue gel), which are available from The Body Shop (Tel: 01903 731 500), can be cooled in the fridge or heated. Putting one hand on your forehead and the other behind the back of your skull can be soothing for headaches or use a bandage for a similar effect. Look for things that might be triggering the headaches such as mental activity (Pacing; Reading; Television), noise, sleep disturbance, over-stimulation, stress or particular foods (commonly cheese and chocolate).
* THE MIGRAINE TRUST, 45 GREAT ORMOND ST., LONDON, WC1N 3HZ, Helpline: 020 7831 4818 Mon-Fri 9am-5pm. Fax: 020 7831 5174 E-mail: info@migrainetrust.org Website: www.migrainetrust.org
* Eye masks which can be cooled in the fridge are available for £6.50 from THE BODY SHOP Tel: 01903 731 500
* MIGRAINE ACTION ASSOCIATION, UNIT 6, OAKLEY HAY, LODGE BUSINESS PARK, GREAT FOLDS ROAD, GREAT OAKLEY, NORTHANTS, NN18 9AS Tel: 01536 461 333 Fax: 01536 461 444 E-mail: info@migraine.org.uk Website: www.migraine.org.uk
* A ‘Hot Bot’ can be heated up in a microwave or frozen. They don’t stay hot for as long as a hot water bottle but they are much more comfortable. They are available for £11.95 and £16.95 from: WAYS AND MEANS (formerly from CAVERILL LTD.), UNIT 2, PADDOCK ROAD, CAVERSHAM, READING, RG4 5BY. Tel: 0118 984 3142 Fax: 0118 946 1176 E-mail: info@caverill.co.uk Website: www.caverill.co.uk
Doctors; Light Sensitivity; Noise Sensitivity; Over-Stimulation; Pain; Reading; Sleep; Television.

Hiccups - A low-energy hiccup cure is to drink water while very gently pinching your nose, but take care not to block off all the air or you’ll make your ears ‘pop’.

Holidays - Packing in advance when you are well enough reduces the pressure. Make sure the accommodation is suitable, for example you may need adequate heating, nearby parking, wheelchair access or a lift. You may feel worse than usual after a journey and so be less able to tackle stairs, walking and general activity. Travel at off-peak times to avoid predictable traffic jams. Self-catering accommodation or a camper vehicle enables you to rest and get up when you like. Enlist help so that you can take most of your food with you to avoid using up energy shopping. Your holiday destination may be quieter if you go at an off-peak time of year.
If travelling is difficult, stay somewhere close to home or have a virtual holiday at home. You might like to base your virtual holiday in a particular place. Look at pictures of that place and eat appropriate foods (such as croissants, baguettes, garlic and cheese if you ‘go’ to France). Having decorations or pictures put up in your room changes the scene if you are up to the stimulation. Another possibility is to have a project holiday where you could spend a week at home learning about a particular topic, or doing something you enjoy. Short ‘holidays’ of a day or two may be easier to arrange and can be spread throughout the year. It is harder to switch off if you are still at home, but treat it as you would any other holiday. Although you can’t get away from your symptoms and limitations, you may be able to have a break from other difficult things.
* ACTION FOR M.E. has information about holidays and respite care. Send an SAE plus 50p in stamps to ACTION FOR M.E., Third Floor, Canningford House, 38 Victoria Street, Bristol BS1 6BY.
* CANBEDONE LTD, NO 11 WOODSTOCK HILL, HARROW, HA3 OXP Tel: 020 8907 2400 Fax: 020 8909 1854 E-mail: holiday@canbedone.co.uk Website: www.canbedone.co.uk has a free brochure of accessible holidays in the UK and abroad.
Carers; Celebrations; Eating; Games; Parking Concessions; Quality of Life; Toilet; Travelling; Wheelchairs
Virtual Holidays (on our website); YAO How To: Go Places and Meet People; Travel and Severe M.E. (on our website); InterAction 33; 2000; pages 28-30 Holidays – M.E. friendly ideas

Household - Consider getting a dishwasher, if funds permit. One person with M.E. finds a hand-held sewing machine useful. Long-life energy-efficient bulbs need replacing less frequently. If you are thinking of moving house, look at bungalows, ground floor flats and houses with a downstairs toilet, which could enable you to live downstairs most, or all of the time. When decorating it is worth bearing in mind that busy wallpaper will be more stimulating (see Over-Stimulation).
* THE RESEARCH INSTITUTE FOR CONSUMER AFFAIRS (RICABILITY), 30 ANGEL GATE, CITY ROAD, LONDON, EC1V 2PT Tel: 020 7427 2460 Fax: 020 7427 2468 Textphone: 020 7427 2469 E-mail: mail@ricability.org.uk Website: www.ricability.org.uk researches and published unbiased information on products, including household appliances, and services to enable older and disabled people to live more independently.
* ROYAL SOCIETY FOR THE PREVENTION OF ACCIDENTS, EDGEBASTON PARK, 353 BRISTOL ROAD, BIRMINGHAM, B5 7ST Tel: 0121 248 2000 Website: www.rospa.co.uk provides information on home safety.
Cooking; Environmental Control Systems; Ironing; Plugs; Stairs; Telephone; Television and Radio
InterAction 36; 2001; pages 20-21 Housing issues and benefits


Ironing - Look in the local press to find out whether your area has an ironing service that will collect things from your home to be ironed. Sitting down to iron takes the strain off your legs. If you have plenty of space, consider leaving your ironing board up. Buy non-crease clothes and don’t iron anything that doesn’t really need it.
* THE RESEARCH INSTITUTE FOR CONSUMER AFFAIRS (RICABILITY), 30 ANGEL GATE, CITY ROAD, LONDON, EC1V 2PT Tel: 020 7427 2460 Fax: 020 7427 2468 Textphone: 020 7427 2469 E-mail: mail@ricability.org.uk Website: www.ricability.org.uk researches and published unbiased information on products, including household appliances, and services to enable older and disabled people to live more independently.

Light Sensitivity - Many sunglasses let in light at the sides; if this bothers you look for a ‘wraparound’ style. Prescription sunglasses can be obtained. There are also wrap-around sunglasses that fit between your glasses and eyes (ask an optician), and others which will go over the top of glasses.
A baseball cap or sun-hat shades the eyes (preferably with a dark coloured peak which reflects less light). Blindfolds/sleep masks are available from some chemists (e.g. SUPERDRUG), or if you know someone who is travelling, airlines give them out on long flights. They can also be improvised or home made using several thicknesses of cotton folded with aluminium foil. Some lampshades (e.g. ‘up lighters’) diffuse the light more than others. Several lamps with low watt bulbs are easier on the eyes than one bright one. Dimmer switches (which buzz a little) and different coloured bulbs may also be worth a try. Bulbs can be bought with a silver coating, which reflects the light upwards so it is more dispersed. If your light sensitivity is severe, you may find indirect light best, perhaps from an electric night light, candle, torch or illuminated globe. Blinds reduce the glare of the sun without making the room dark. Blackout curtain lining and blackout blinds are available. Some specialist blackout blinds are sealed at the edges and can be used to make the room pitch black, but new blinds release chemicals for over a week after installation. The father of one girl with M.E. turned her bed into a four-poster. She uses the curtains when the light in her room gets too bright.
* ACS WINDOW TREATMENTS, 73 MANOR ROAD, BRACKLEY, NORTHAMPTONSHIRE NN13 6ED Tel: 01280 701 275 Install blackout systems and specialist window films.
* Tinted window film can be fitted which reduces some of the light. It is available from SECURITY AND SOLAR WINDOW FILM Tel/Fax: 01242 523 912 Mobile: 07976 268 922
* Coloured overlays to place over text when reading have been found to reduce visual stress and increase reading fluency in about 20% of school children. In M.E., light sensitivity may contribute to reading difficulties and overlays may reduce the effects. Website: www.essex.ac.uk/psychology/overlays Tel: 01206 872 130 or send A4 S.A.E. to COLOUR AND VISUAL SENSITIVITY, DEPT PSYCHOLOGY, UNIVERSITY OF ESSEX, COLCHESTER CO4 3SQ
* ‘Sunglasses Huts’ sell a wide range of high quality sunglasses.
* There are light shades designed to stick on car windows available from ARGOS and other sources.
Chemical Sensitivities; Games; Headaches; Opticians; Reading; Sleep; Television

Meditation -
* STILLPOINTS is a self-help forum for M.E. sufferers to share experiences and information on meditation and Buddhism. No need to be a Buddhist, they have a range of interests and background including beginners. To join, please ask for an application form and send a postage stamp plus a cheque for £5 payable to J Marlow. E-mail: stillpoints@onetel.net.uk (please allow for delays)
Christian; Resting

Memory - Write lists and notes to yourself and keep them in a place where you won’t lose them. A computer, dictaphone, personal organiser or Filofax might help. Small photo albums are good for storing flat items you want to have at hand such as notes to yourself, stamps and address stickers. Try having a pen and paper in each room. Before making a phone call write a brief memory jogger to say who you are ringing and what you want to say. This is also a good idea for doctor’s appointments or any situation where you might forget something important. You could also ask to tape record a consultation so you can listen to it again afterwards. Make sure you keep a record of all appointments in a diary or calendar. If you have difficulty keeping track of time, try a watch that beeps regularly. Set a timer to remind you to stop an activity before you do too much. Set an alarm for your favourite television programme or other time you want to remember (if necessary, write a note of what it was for). If you tend to forget where you are going and get lost, write out directions to frequently visited places. Pillboxes can be obtained with different days and/or times on the lids, so that you can tell if you have taken your tablets (ask a chemist).
* Several types of Casio Databank watches are available from ARGOS, these have features such as multifunctional alarms, countdown timer, pages of memory for telephone numbers and appointments and even the ability to record a 30 second message.
* JUCY TRADING LTD. 43 SELWOOD ROAD, GLASTONBURY, SOMERSET, BA6 8HW Tel: 01458 830554 (after 6pm). A small timer costs £5.40; a large timer costs £11.20
Computer; Writing
YAO Brain Problems in M.E./CFS

Menstruation -
* THE WOMAN’S NUTRITIONAL ADVISORY SERVICE, P.O. BOX 268, LEWES, EAST SUSSEX BN7 1QN TEL: 01237 487 366

Nature - A bed, mattress (on a ground sheet) or sun-lounger set up outside may enable you to enjoy some fresh air for a bit (see Light Sensitivity; Noise Sensitivity; Stairs; Walking; Wheelchair). Here are a few ways to experience the great outdoors inside: ask people to bring autumn leaves, conkers and fir cones; a bit of snow, hail or ice; or a shell or pebble if they visit a beach. Spend time looking at a photograph or painting of a landscape, a postcard or a picture book. Some relaxation tapes use imagery and recording of appropriate soundscapes and can provide an atmospheric background to a picture of the sea, a wood or a rainy day. Use nature programmes on TV or radio. Grow some seeds (with help) on windowsills, and ask a friend or relative to plant them out. If you grow bean sprouts or cress, you can eat them as well as watching them. Flowers are nice if you’re not allergic to them. You may be able to ask someone to bring a snail, ladybird, worm or caterpillar to visit.
* A small seasonal range of artificial flowers and plants are available from LAKELAND LIMITED, ALEXANDRA BUILDINGS, WINDERMERE, CUMBRIA, LA23 1BQ Tel: 01539 488100 E-mail: net.shop@lakelandlimited.co.uk Website: www.lakelandlimited.co.uk
* There are recordings to enable you to identify bird songs and calls, available from the RSPB Tel: 0870 606 6333 Fax: 01283 506 301
* GARDEN BIRDWATCH, BTO, FREEPOST, NORFOLK, IP24 2BR, Tel: 01842 750050 Fax: 01842 750030 E-mail: gbw@bto.org Website: www.bto.org Some 15,000 volunteers watch and record the numbers of birds visiting their gardens. The information is used to understand how birds use gardens and how this use changes from one year to the next. Free enquiry pack.
Bed; Gardening; Pets; Quality of Life; Stairs

Noise Sensitivity - Try earplugs, headphones or cotton wool. Ear defenders are available from building suppliers or gun clubs, and may be more comfortable than earplugs. Prices range from around £5 to over £100, some of which have a built in radio. If you need to wear ear defenders a lot, you may end up spending much time lying on your back, in which case watch out for pressure sores. Sundays tend to be quieter than weekdays so it may be a better day to do things like going outside. There is also some predictable variation of noise level over the course of the day; quietest in the middle of the night and never quiet during the rush hour. Many electrical appliances hum so it might be worth thinking about this when buying a new appliance. The literature about some appliances includes noise levels during operation. Consider turning off plugs or central heating while you rest if they disturb you.
Properly sealed double-glazing cuts out more noise than single. Apparently, up to a point, the bigger the space between the two panes of glass, the more the noise level will be reduced. It is worth seeking professional advice from someone who knows about noise reduction if you are considering replacing windows. You may choose a window with a large opening section so that you can have a change of air quickly with the minimum of exposure to outside noise.
It may be worth trying to escape temporary severe noise by going to stay somewhere else. Write a respectful letter to your neighbours explaining that your illness is affected by noise and asking for their help in one or two specific and realistic ways. For example, ask if they might be able to let you know beforehand what dates they expect to use noisy machines.
Plastic cutlery is quieter than metal. A ‘Do Not Disturb’ or ‘Quiet Please’ sign can let other householders know when you particularly want quiet. You might find that some rooms in your house tend to be noisier than others; it may be worth using the quietest room as a rest room. Other family members may be willing to use headphones when they are watching TV if the noise affects you. Some people with M.E. watch television with the sound off (some sports and nature programmes are suitable for silent viewing), although the high-pitched noise may still be too much. Try subtitles on Teletext page 888. Using a tape-head cleaning cassette reduces the buzz from the tape recorder. M.E. groups may like to try an idea from the Deaf Community and use waving as a quiet alternative to clapping.
* Earplugs are available from JUCY TRADING LTD, 43 SELWOOD ROAD, GLASTONBURY, SOMERSET, BA6 8HW. Tel: 01458 830 554 (after 6pm). £3 for a pack of 7 pairs.
* THE GLASS AND GLAZING FEDERATION Tel: 020 7403 7177 Website: www.ggf.org.uk
Headaches; Holidays; Resting; Tinnitus

Opticians - Some opticians provide home visits for people who cannot visit the practice due to illness or disability. Flexible metal frames (‘Flexon’) are expensive, but more comfortable to wear lying down.
Doctors; Light Sensitivity

Over-Stimulation - With M.E. it becomes difficult for the brain to process information and to filter out excess stimuli. If you often find yourself over-stimulated and unable to rest properly, observe when this happens. Are there any particular things which tend to trigger it, or any activities which help or which do not trigger it? Television, noise, caffeine and clutter are all stimulating. Some activities are more stimulating than others. I find skim reading particularly bad as my brain can’t select only the words I want to see and gets overloaded (see Reading for tips on this). You may find gentle physical activity, such as having a wash, less over-stimulating than mental activity; it may help to alternate the two. Try to pace your activities carefully and do only one thing at a time (See section on Pacing). Stress can contribute to the problem of over-stimulation, so look at ways of reducing and managing stress (See Coping Strategies). Practice relaxation techniques to help you rest as deeply as possible (Resting). Wearing a blindfold and earplugs or ear defenders during rest periods minimizes the stimulation reaching your brain. Blindfolds are available from some chemists (e.g. SUPERDRUG), or if you know anyone who is travelling, airlines give them out on long flights. Once over-stimulated you may need a long rest to give your brain time to wind down. Frequent short rests may help you to avoid becoming over-stimulated. The place where you spend the most time should be as visually peaceful as possible. You may be able to position mess so that it is out of sight or cover it with a sheet. Bookcases are visually busy so they do not calm the overactive brain. Putting a piece of material in front can be enough to make it more restful (choose a quiet design). This can be put on a curtain rail or attached to the bookcase with Velcro or hooks. When decorating, it is worth bearing in mind that busy wallpaper can be over-stimulating. You might also prefer plain bedding. If you are sensitive to touch and find showering difficult, see if it helps to bounce the water off your hand onto your body.
Bed; Pacing; Paperwork; Reading; Resting; Shopping; Visitors

Pacing - Split tasks into small manageable chunks and do a bit at a time. Think about how each activity might be done in a more energy efficient way; for example many things such as ironing and teeth brushing can be done sitting rather than standing.
Decide which jobs actually need to be done and do any vital things first in case you run out of steam. Try to leave more than enough time and energy to complete each task. Hunting for scissors or keys wastes valuable energy, so have homes for different items and try to keep organised.
Use equipment that will save your energy, such as a wheelchair. Use other people’s energy and try not to feel shy about asking for help. If finance permits, employ people to do domestic jobs. You can be selective, for example employ someone to dig the garden but you may be able to do some of the lighter work, such as planting out bedding plants.
Alternate activity and rest. You may well find that you can do more of if you do an activity in short bursts. For example it is better to listen to a talking book for fifteen minutes then have a rest before listening to a bit more, than it is to listen to half an hour in one go and feel very ill. A countdown timer or alarm clock will remind you to rest and may help you to avoid doing too much, especially when doing something you enjoy or want to complete. Alternate different types of activity, particularly physical and mental tasks, so as not to overuse your brain, legs, arms or whatever.
Many people find it helpful to keep a diary of their activities. Use it to learn about your individual illness, how much you are able to do, and what things make your M.E. worse. Listen to your body and respect what it is trying to tell you. Never be afraid to decline an invitation or visitor or to refuse a request if you are not feeling well enough. Try to be flexible and change plans according to how well you are. Plan big events carefully, preparing things in advance so that you can manage your illness as well as possible. Sometimes it is worth feeling really ill as a result of doing too much, in order to do something special. It is up to you (and nobody else) to decide whether a certain activity is worth the recovery period. Learn to be assertive about your needs. It is easier for those around you if you recognize and respond when you need a rest.
Energy can be thought of as being a bit like money; it is possible to go into ‘energy debt’ but you will have to pay it back with interest and will feel really ill. Sometimes this will be unavoidable, but it is a good idea to live within your ‘energy budget’ most of the time. Continually spending more energy than is available is a common cause of M.E. relapses. Steadily increasing activity regardless of symptoms can cause long-term deterioration.
When trying out a new activity, start by doing it for a short time that you know you can manage. If it is OK, experiment with doing it for a bit longer next time, cautiously testing your limits. Be realistic about your limitations and don’t over-estimate what you can do. It is sometimes recommended that people with M.E. should do only about 80% of what they think they can do. This leaves a bit of leeway for unpredictability and may actually give the body a better chance of improving. Although pacing is very important for living with M.E., no-one paces well all the time - don’t be too hard on yourself when you don’t manage it as well as you had hoped.
* JUCY TRADING LTD. 43 SELWOOD ROAD, GLASTONBURY, SOMERSET, BA6 8HW Tel: 01458 830554 (after 6pm). A small timer costs £5.40; a large timer costs £11.20
* A booklet called ‘How to Assert Yourself’ costs £1 from MIND PUBLICATIONS, GRANTA HOUSE, 15-19 BROADWAY, LONDON, E15 4BQ Tel: 010 8519 2122
Cooking; Coping Strategies; Eating; Over-Stimulation; People; Quality of Life; Resting; Stairs; Wheelchairs
Pacing Yourself (on our Website); AfME Rest, Pacing and graded exercise; YAO Graded Exercise - does it really work?; TYMES Energy Management Pack £1.50; InterAction 27; 1998; pages 18-19 Pacing

Pain - Heat or cold can help with pain. Try an electric heat pad, wheat pack such as a ‘Hot Bot’ (which can be used hot or cold), hot water bottle, cold flannel or ice pack. If you get attacks of chest pain, look for possible triggers such as exposure to chemicals. Some people find a bath soothing and a foot spa may relieve aching feet. Try cold (or hot) drinks for nausea or sore throats. Pressure relieving measures can be beneficial for painful muscles or joints and for general comfort as well as for prevention of pressure sores. Alternate different types of activities to give different parts of your body time to recover. For example if sitting up causes pain, do it for short periods at a time, interspersed with rests or activities you can do lying down. If, after an activity, the pain is bad or you feel more ill, try doing it for a shorter period next time. You may well find that you can sit up for longer altogether, if you do it in short bursts, than if you sit up for long enough to cause a flare up of symptoms. Sleep disturbance can exacerbate pain, and vice versa, so strategies and treatments aimed at minimising sleep problems may indirectly help with pain. Pain clinics have helped some people (they need a GP referral). T.E.N.S. machines give a small electrical stimulation which masks some types of pain. Much of this booklet is relevant to M.E. pain management, especially the sections listed below in italics.
* PAIN CONCERN, P.O. BOX 13256, HADDINGTON, EH41 4YD Tel: 01620 822 572 Fax: 01620 829 138 E-mail: painconcern@btinternet.com Website: www.painconcern.org.uk
* The College of Health in London has put together a directory of NHS specialists around the UK specialising in treating different types of pain and includes a list of local support groups around the country. Send a cheque for £12 payable to College of Health at COLLEGE OF HEALTH, SAINT MARGARETS HOUSE, 21 OLD FORD ROAD, LONDON E2 9PL.
* THE PAIN SOCIETY, THE BRITISH CHAPTER OF THE INTERNATIONAL ASSOCIATION FOR THE STUDY OF PAIN, 9 BEDFORD SQUARE, LONDON, WC1B 3RE. Website: www.painsociety.org
* Electric heat pads (which are like miniature electric blankets) are available from BOOTS, ARGOS and other sources.
* A ‘Hot Bot’ can be heated up in a microwave or frozen. They don’t stay hot for as long as a hot water bottle but they are much more comfortable. They are available for £11.95 and £16.95 from: WAYS AND MEANS (formerly from CAVERILL LTD.), UNIT 2, PADDOCK ROAD, CAVERSHAM, READING, RG4 5BY. Tel: 0118 984 3142 Fax: 0118 946 1176 E-mail: info@caverill.co.uk Website: www.caverill.co.uk
* ‘Heateze’ and hand, foot and body warmers (which can only be used once) are available from MYCOAL WARM PACKS LTD, UNIT 1, IMPERIAL PARK, EMPRESS ROAD, SOUTHAMPTON, SO14 0JW Tel: 023 8021 1068 E-mail: enquiries@mycoal.co.uk
Bed; Chemical Sensitivities; Clothes; Doctors; Headaches; Light Sensitivity; Noise Sensitivity; Over-Stimulation; Pacing; Pressure Sores; Resting; Sleep; Temperature Control
Pain Relief through the Mind (on our website); AfME Pain Control £1.00; InterAction 32; 2000; pages 6-7 Pain relief

Paperwork - If possible keep papers in a place where you will not have to look at them when you are trying to rest. Try to file things promptly so they don’t get lost. A4 tidy trays are useful if you can’t lift files. Write to organisations that keep sending junk mail, and ask for them to remove you from their mailing list. A Filofax or computer may help you to keep lists and notes organised. It may be easier to have regular bills paid direct from a bank account (standing order or direct debit).
Using a letter opener saves energy and fitting a cage to the letterbox means you don’t have to pick up mail from the floor.
* Minimise unwanted post by sending your address to THE MAILING PREFERENCE SERVICE, FREEPOST 22, LONDON W1E 7EZ Tel: 020 7291 3310. Sales telephone calls and faxes can also be minimised, see Telephone
* A ‘Page Up’ is a small gadget which holds a piece of paper (or several) Website: www.mypageup.com
Education; Memory; Over-Stimulation; Pacing; Reading; Writing

Parenting - Parents with M.E.
* ACTION FOR M.E. has a pregnancy network for people with M.E. and their partners who are thinking of having a baby, who are pregnant or who have a baby or toddler. U.K. Annual subscription £10. Ring 01749 670799 for details.
* DISABLED PARENTS UK, DISABLED PARENTS NETWORK, P.O. BOX 5876, TOWCESTER, NN12 7ZN. Tel: 0800 018 4730 Textphone: 0800 0189 949 9.30-5 Mon-Fri E-mail: information@disabledparentsnetwork.org.uk Website: www.disabledparentsnetwork.org.uk
Parents of Young People With M.E.
* AYME has a magazine for parents of young people with M.E. (see Young People)
* TYMES has a network of carers’ contacts (see Young People).
Childlessness
* MORE TO LIFE, 114 LICHFIELD STREET, WALSALL, WS1 1SZ Tel: 01922 722 888 Fax: 01922 640 070 E-mail: info@moretolife.co.uk Website: www.moretolife.co.uk Aims to foster a self-help network and to provide a greater understanding of the issues surrounding childlessness, so that people who have a life without children will not feel isolated and alone.
TYMES info packs ‘The Child, the Family and the Professional’ and ‘Time to Care’ £1.95 each; InterAction 22; 1996 pages 5, 16 and issue 23; 1997 pages 28-29 Parenting: M.E. and having children; InterAction 30; 1999; pages 20-21 Parenting with M.E.

Parking Concessions - The Blue (formerly Orange) Badge Scheme provides a national arrangement of parking concessions for people with severe walking difficulties who travel either as drivers or passengers. The main purpose of the scheme is to allow people with disabilities to park closer to their destination. People on the higher rate of the mobility component of Disability Living Allowance automatically qualify for a badge. Those not on DLA may also qualify if they have difficulty walking and can get a doctor’s letter. It can save a lot of energy that would have been spent walking, or being wheeled, to and from distant car parks. The scheme does not apply in Central London. Ask Social Services or, in Scotland, the Chief Executive of your Regional or Island Council.
Chemical Sensitivities; Driving; Shopping; Travelling

Passive Physio - Careful passive physiotherapy with the aim of keeping joints mobile and maintaining the angle of foot to leg can be worthwhile for some people who are bed bound. When lying down or sitting, the Achilles tendon shortens. The foot can be propped up with a bolster pillow in bed in order to lengthen the tendon. A physiotherapist may be able to advise carers on how to move the M.E. sufferer’s joints passively. Splints may be used for contractures in the hands.
Bed; Pressure Sores

People - Practice being assertive about your needs, this involves communicating clearly and respectfully. It is easier for those around you if you recognise and respond when you need to rest. Try to be patient with people, many don’t know how to treat people who are ill or disabled. They may not be willing or able to face the changes in your life. Learn about how to look after your health and be realistic about your limitations. Don’t let anybody persuade you into trying any treatment which you are not happy with. M.E. can be very isolating. It might be worth looking out for others locally who are also isolated for whatever reason. Many people with M.E. appreciate having contact with other M.E. sufferers, either through their local group, by phone, letters, E-mail or talking letters recorded onto cassette. It may be easier to explain about your illness to friends and relatives in writing, in your own words, or using leaflets, articles or books on M.E. Keep a handout of your medical history, your known allergies, what drugs you are on etc. to help with communication in an emergency.
* Contact ACTION FOR M.E. for details of your local group or individual local contacts.
* There are pen-pal services for people with M.E. details of which are available through many of the M.E. organisations (see page 3 and Young People).
* If you are well enough, joining a club or class is one way to meet people. There are also various special interest groups for people with M.E., conducted by post, phone or E-mail (details in M.E. magazines).
* WRITE AWAY, 1 THORPE CLOSE, LONDON, W10 5XL Tel: 020 8964 4225 Fax: 020 8964 3532 E-mail: info@write-away.org Website: www.write-away.org This organisation puts people, some with a disability or special need in touch with pen-friends, using whichever type of communication they prefer (e.g. Audio tape, E-mail, fax, pen and paper).
* MIND mental health promotion booklets cost £1 each, £3 for 5 or £4.50 for 10 plus 44p postage. Titles include ‘How to assert yourself’, ‘How to cope with loneliness’ and ‘How to look after yourself’. MIND PUBLICATIONS, GRANTA HOUSE, 15 – 19 BROADWAY, LONDON, E15 4BQ Tel: 020 8519 2122 Fax: 020 8522 1725 E-mail: publications@mind.org.uk Website: www.mind.org.uk
* THE HANDIDATE INTRODUCTION AGENCY, FREEPOST, THE WELLINGTON CENTRE, 52 CHEVALIER STREET, IPSWICH, SUFFOLK, IP1 2BR Tel: 01473 226950 Fax: 01473 254 030 E-mail: handidate@btinternet.com Website: www.btinternet.com/~handidate Specialises in helping people with or without disabilities make friends or find partners.
Cooking; Coping Strategies; Doctors; Pacing; Telephone; Visitors; Writing; Young People
YAO HOW TO: Set up a Social Group; TYMES Education Special £1.50 (includes HOW TO: Educate Everyone Else about M.E.); TYMES Issue 29 £1.50 (inc HOW TO: Be a Good Friend to someone with M.E.); TYMES TRUST Friends Pack £1.90; AYME Friends, Relationships and M.E. £1.50; InterAction 19; 1995; pages 28-31 Relationships and M.E.

Pets - ‘Furry therapists’ are great companions and pets are known to reduce stress (as long as you are not allergic to them). One person with M.E. likes to break the good news to her dog when it is time for him to be fed or taken for a walk. A friend may be able to bring their animal to visit you, or you could perhaps have a ‘part time pet’ – looking after an animal when its family are away or at work. Cats take less energy to look after than dogs.
* DOGS FOR THE DISABLED, THE FRANCES HAY CENTRE, BLACKLOCKS HILL, BANBURY, OXON, OX17 2BS Tel: 01295 252 600 E-mail: info@dogsforthedisabled.org Website: www.dogsforthedisabled.org supply trained dogs to help disabled people
Carers; Nature; Quality of Life
InterAction 27; 1998; pages 16-17 Pets as therapy


Plugs -
* Disability catalogues sell adhesive handles to stick to plugs, making them easier to pull out of sockets. BETTERWARE Tel: 0845 125 500 E-mail: csd@betterware.co.uk Website: www.betterware.co.uk have a good design.
* If you buy a strip of sockets with individual switches you can leave several things plugged in and choose which to turn on. If the sockets are on an extension lead it can enable you to choose where to put the switches. Try a local electrical shop or ARGOS.
* Adaptors exist which enable you to turn electrical sockets on and off by remote control. They cost around £20 (ref KK73) from MAPLIN ELECTRONICS SHOPS (mail order) Tel: 0870 264 6000 Website: www.maplin.co.uk
Environmental Control Systems

Prescriptions - People who have lots of prescriptions may be able to buy their medicines more cheaply by using a Prepayment of Prescription Charges certificate (approx £90 per year – ask at the pharmacy, Health Centre or Post Office). Some medicines can be bought more cheaply over the counter than on prescription. Some people are entitled to free prescriptions (e.g. those who are unable to go out without help from another person or who receive Income Support or Disability Working Allowance), for more details contact:
* THE GUIDE Tel: 01452 33 11 31
Doctors

Pressure Sores - Pressure sores can occur when the cells in the skin and tissues become damaged by insufficient blood supply. This usually happens when a person has been in one position for a long time. They can also be caused by friction or shearing, for example sliding down in bed. Pressure sores can lead to pain and infection, but fortunately they can often be prevented.
If you are able to get up briefly sometimes (e.g. to walk to the toilet), this will help to prevent sores. Otherwise, try to change position every hour or two, perhaps using pillows to redistribute the weight away from bony areas. If sitting in a chair, rock from one buttock to the other for a short time. A pressure-relieving mattress, mattress overlay or a special cushion can be useful to distribute your weight more evenly and may also be more comfortable. When moving try to avoid dragging your skin across the bed or chair. If this is unavoidable, consider different techniques such as using a transfer board or hoist.
Watch out for feelings of numbness or a reddening or darkening of the skin (especially if it stays red when pressed). If this happens, take the weight off that area to give it time to recover.
Crumpled sheets and crumbs can cause problems, so it's good to have the bed re-made. Keeping clean is also helpful, if you're well enough, especially if you have incontinence or are sweaty. A healthy diet and plenty to drink with enough rest and sleep are all recommended.
If you think you may have a pressure sore, contact your doctor or district nurse.
* TISSUE VIABILITY SOCIETY, GLANVILLE CENTRE, SALISBURY DISTRICT HOSPITAL, SALISBURY, SP2 8BJ Helpline Tel: 01722 415069 (Mon, Wed, Fri, 9am-3pm) Fax: 01722 425263 E-mail: tvs@dial.pipex.com Website: www.tvs.org.uk
Bed; Clothes; Drinking; Eating; Resting; Sitting; Sleep; Washing

Quality of Life - Being ill is very hard and it is important to do what you can to look after yourself emotionally (see section on Coping Strategies). Maintaining your morale will always be a juggling act, and you should expect to feel down some of the time, especially if you have insufficient support or are severely ill. Here are some ideas which might help in the battle for a reasonable quality of life.
You will probably have lost many of the things you used to enjoy, but over time people do find they develop new interests and hobbies which fit in with the limitations imposed by their illness. Creative pursuits can be particularly satisfying such as making greetings cards, sketching, painting, embroidery, tapestry, or photography. Pastels, pencils and crayons need no water so they can be used in bed.
Hug a teddy, a pet, or a person. Learn a foreign language by tape, or find out more about science, stamp collecting, birds, religion, or anything else that interests you. All sorts of writing are popular with people with M.E. (letters, poetry, articles, diaries). You might fancy compiling a book of family history, photograph album or story of your life. Genealogy (family history) can be conducted by post, at least back to 1837. Make use of your sense of humour, with cartoon books and comedy on radio or TV. Listen to talking books or music. Having a wash and changing into clean clothes can boost morale, as can bathing with aromatherapy oils or bubble bath.
Cultivate your senses – take time to quietly observe: notice the feel of a cup in your hands, its texture, its temperature, how the light hits it. Hold a smooth pebble. Spend time looking at something beautiful: a flower, reproduction of a work of art, landscape photograph, the clouds or the stars. It might be possible to change rooms to get the best window view in the house.
Think about improving your living space. If your only journeys are to and from the bathroom, these will be more pleasant if there is a nice plant on display rather than shampoo bottles.
If you have a willing assistant and not too many allergies, food can play an important part in quality of life, especially if you spend a lot of your energy eating. Try out new foods and recipes, use an attractive bowl or cup, have sandwiches cut into interesting shapes. Have a virtual holiday (see Holidays) or celebrate a special day (see Celebrations).
Here are some ideas for very low energy levels: watch someone else blow bubble mixture; wear a temporary tattoo; use an aromatherapy burner; practice meditation or relaxation techniques (see Resting); have a helium balloon to watch; close your eyes and imagine a nice place.
Celebrations; Coping Strategies; Eating; Education; Games; Gardening; Holidays: Nature; Pets; Special Interest Groups; Talking Books; Telephone; Television; Tray; Washing; Writing
InterAction 33; 2000; pages 24-26 Beating the Blues – ideas to lift your spirits

Reaching - There are devices called ‘grab-sticks’ or ‘helping hands’, which have a claw on the end to help pick up things which would otherwise be out of reach. Some versions have a magnet for picking up small metal items. They come in two lengths; the longer ones often have a supportive wrist cuff.
Reading - Large print may be easier to read. Some companies will send bills in large print, or on cassette, on request. Try a large magnifying glass for small writing. A reading aid can be made out of a piece of plain card. Cut a slit in the card and place it over the page so that only one line of print is visible at a time. This cuts out the distraction of all the other words on the page. Or simply hold a bit of card under the line you are reading to help stop you jumping lines. Read small manageable chunks – listen to your body; don’t push through the symptoms (easier said than done, of course). You may find short stories, children’s books, comics, cartoon books or poetry more manageable than a novel, or try books on cassette (see Talking books). There are computer programmes which can speak text from the screen. (e.g. ‘Text HELP! Read and Write’). Ask other people to read aloud to you. Letters can be sent on tape. When reading through a text it is sometimes useful to highlight important passages for ease of future reference. You may find it easier to read while lying down, and printing text onto coloured paper can also be helpful. I find skim reading particularly over-stimulating, as my brain can’t select only the words I want to see and gets overloaded. To avoid skimming when looking at an index, focus on one word then jump to another word and read it properly, rather than scanning lots of words. Keep jumping until you get close to the word you are looking for. When searching for a particular page number in a book, keep your gaze on the numbers only; take care not to look at the rest of the page until you get to the one you want. Instead of skimming lots of pages of The M.E. Tips Collection, look at the contents page to locate what you are looking for. If holding a book is difficult there are many designs of bookstand, which vary in their effectiveness for different sizes of book. Some local libraries operate a delivery service for housebound people and they may have large print books and also books on tape.
* MONUMENT TAPE SERVICES Tel: 01823 662104 records documents onto cassette.
* ADA READING SERVICES Tel: 01722 326987 records small documents such as leaflets and booklets onto cassette.
* A ‘Page Up’ is a small gadget which holds a piece of paper (or several) Website: www.mypageup.com
* Coloured overlays to place over text when reading have been found to reduce visual stress and increase reading fluency in about 20% of school children. In M.E., light sensitivity may contribute to reading difficulties, and overlays may reduce the effects. Website: www.essex.ac.uk/psychology/overlays Tel: 01206 872 130 or send A4 S.A.E. to COLOUR AND VISUAL SENSITIVITY, DEPT PSYCHOLOGY, UNIVERSITY OF ESSEX, COLCHESTER CO4 3SQ
Computer; Education; Headaches; Over-Stimulation; Pacing; Paperwork; Talking Books; Tray; Writing

Resting - Resting is part of pacing (see section on pacing.) You may well find that you can do more altogether if you do an activity in short bursts and stop to rest before the symptoms flare up.
Your need for rest will be individual so experiment to find out what works best for you at your current level of health. Some people benefit from having rest periods at set times every day (including good days). This could be in form of one long rest in the afternoon, or many shorter ones spread throughout the day. If well enough, you might be able to rest adequately sitting quietly in a comfortable chair with your feet up, or you may be better off going to bed to rest, especially if you live in a busy household. When in other people’s houses ask to lie down if you need to. Listening to the radio, talking, reading and sitting up, all take energy; remember that M.E. brains need rest as much as M.E. bodies.
Rest will be more effective if you relax as deeply as you can. Turn off the phone or use an answering machine to avoid being tempted to jump up in the middle of a rest. Also turn off central heating and electrical appliances if they disturb you. A ‘Quiet Please’ or ‘ Do not disturb’ sign can let householders know when you particularly want quiet. If it is noisy, try earplugs or ear defenders (see noise sensitivity). A blindfold/sleep mask or a darkened room may be helpful. Blindfolds are available from some chemists (e.g. ‘SUPERDRUG’) or if you know anyone who is travelling, airlines give them out on long flights.
Make sure you are warm or cool enough, lie down flat and close your eyes. Try to get as comfortable and fully supported as you can, perhaps using extra pillows or rolled up towels by your sides, and under your arms, knees, or legs (slightly raising the legs relieves tension in the lower back).
Learn meditation or relaxation techniques to improve the quality of rest and help you cope with the frustration. To find an approach that suits you, try listening to several different guided relaxation recordings. In time you will be able to practise relaxation without needing a tape and you may find silence less energy consuming. If you are too ill to listen for more than a couple of minutes, you might like to play short pieces of relaxing music before a silent rest. Some people find recordings of rain and other soundscapes easier than those containing music or speech. You may find familiar pieces of music take less energy than pieces that are new to you. It may also be easier to listen to a recording of one or two instruments, rather than many different parts.
* Members of ACTION FOR M.E. can borrow relaxation tapes from the AfME library.
* Relaxation Techniques – A Practical Handbook for the Health Care Professional by Rosemary A. Payne ISBN 0-443-06263-3 £23.99. This book describes lots of methods, many of which are suitable for people with M.E. (but avoid those including exercise or muscle tensing unless you are confident they are within your limits).
* ‘The Little Book of Calm’ by Paul Wilson ISBN 0 14 028526 1 £2.50 contains lots of ideas to help combat stress and find peace. It is written in bite-sized chunks.
Bed; Coping Strategies; Light Sensitivity; Meditation; Noise Sensitivity; Over-Stimulation; Pacing; Pain; Sleep; Travelling
Diaphragmatic Breathing and Autogenic Training (on our website); Free Your Mind (article on our Website);

Samaritans - The Samaritans provide confidential emotional support for anyone in distress or at risk of suicide. Local branches (details on the website and in the phone book) also have phone numbers of local helplines and counselling services. Postal service: CHRIS, P.O. BOX 90 90, STIRLING, FK8 2SA Tel: 08457 909090 Textphone: 08457 90 91 92 E-mail: jo@samaritans.org Website: www.samaritans.org

Severe M.E. -
* 25% M.E. GROUP, 4 DOUGLAS COURT, BEACH ROAD, TROON, AYRSHIRE, KA10 6SQ E-mail severeme.group@btinternet.com Website: www.btinternet.com/~severeme.group A support group for people who are almost or completely housebound or bedbound.
* CHROME (Case History Research On M.E.) asks people with Severe M.E. (defined as those who cannot leave the house unaided) or their carers to fill in a questionnaire each year. This is the first project to be looking at the progress of the disease in people severely affected. CHROME, 3 BRITANNIA ROAD, LONDON SW6 2HJ E-mail: secretary@chromesw6.co.uk Website: http://ds.dial.pipex.com/comcare/chrome

Sex -
* SPOD (Sexual and Personal Relationships of the Disabled) 286 CAMDEN ROAD, LONDON, N7 0BJ Tel: 020 7607 8851 Fax: 020 7700 0236 Provides a list of publications and a telephone counselling service. E-mail: info@spod-uk.org Website: www.spod-uk.org
InterAction 18; 1995; pages 14-16 Sex (intercourse) and M.E.

Shopping - Some major stores have a first aid room where people with M.E. can rest. Ask for help; for example shop assistants may be willing to carry things to the car for you. A shopping bag on wheels saves carrying, and some designs have a seat on the top. It is possible to borrow wheelchairs at some large shops, and also an assistant to push you.
* SHOPMOBILITY schemes enable people to borrow electric and manual wheelchairs and scooters in some shopping centres, Tel: 020 7689 1040 E-mail: nfsuk@lineone.net Website: www.justmobility.co.uk/shop
There is a lot of sensory information for the brain to process in a supermarket; you may find smaller shops less exhausting. Make a standard shopping list for regular items and photocopy it, then you can just add other items you need. Some shops will deliver to people’s homes and others are willing to put together your order so that you only need to get it collected. Have heavy items delivered or collected for you. Buying in bulk is cheaper, and reduces the number of times you (or your helpers) have to shop. If you have milk deliveries, they may also deliver drinks, eggs and potatoes. Many things can be bought by mail order, including food. Some high street shops are able to take orders over the phone using a debit or credit card and then send it to you by post. Write down details of your order so that things can be chased up if necessary. Some large stores have magazines that can keep housebound people up to date with new products. Many shops can now be accessed via the Internet. When ordering food over the phone, it is not always necessary to struggle with a catalogue; if you explain your disability some people are very willing to help.
* The ‘Pay as You Shop’ card works like a top-up card for a mobile phone, enabling people to shop online without giving out their credit card details over the internet. To top up your card, ask someone to take the card to one of the many top-up shops around the country (see their website for a list) and give the cashier money to put on the card holder’s account, ready to be used online. E-mail: customerservice@splashplastic.com Website: www.splashplastic.com
* Many shops provide a delivery or mail order service including: ICELAND Freephone: 0800 328 0800; TESCO, Website: http://www.tesco.net; SAINSBURYS Tel: 0845 301 2020 or ring your local stores to ask.
* For a list of Fair Trade catalogues contact ASSOCIATION FOR FAIRTRADE SHOPS, BAFTS, TDA HOUSE, 211, CLAPHAM ROAD, LONDON SW2 02H Tel: 020 7737 5156
* A mail order stationers: THE GREEN STATIONERY COMPANY, STUDIO ONE, 114 WALCOT STREET, BATH, BA1 5BG Tel: 01225 480556 E-mail: jay@greenstat.co.uk Website: www.greenstat.co.uk
Chemical Sensitivities; Driving; Parking Concessions; Telephone; Travelling; Walking; Wheelchairs; Writing
InterAction 35; 2000; page 17 and issue 22; 1996; pages 13-14 Shopping from home guide

Sitting - If you are able to do jobs like ironing or cooking, these will take less energy if you sit rather than stand. Sit to brush your teeth, wash etc. Walking sticks with a built in seat are available; many people with M.E. use these for going out so that they can sit down when they need to (see Walking). Keep a chair in every room, so you are able to sit down while you are doing things. A tall stool or office chair can be very useful in the kitchen. An electric riser-recliner chair is a help to some people. Putting your legs up, perhaps on a high footstool, aids the circulation. It may also help to have a little walk around occasionally. You might find it easier to sit on the floor than on a chair, and this has the advantage of always being at hand. Some people with M.E. find beanbags more comfortable than chairs, or try sitting or lying on cushions on the floor. An inflatable armchair is lightweight and easy to move around.
When sitting, try to get your body as fully supported as possible on either side, behind and underneath, by using a few extra cushions or a V shaped pillow. V-pillows (which are available from disability catalogues and ARGOS) are often recommended but you may find that they push your head forward awkwardly. A solid foam wedge is another possibility for use in bed. It keeps your back straight when you sit up only slightly. Some catalogues also sell these, or you might be able to obtain one more cheaply from a shop which cuts foam shapes. An inflatable neck support pillow is good for some people. They are often sold as travel pillows. If you can use your arms but have difficulty manoeuvring to sit up in bed, a rope ladder bed hoist may be of use. This consists of strong nylon rope and plastic rungs. It fastens to the legs of the bed and lies over the top enabling you to pull yourself up into a sitting position. They can be obtained from disability catalogues. There are electric mattress raisers (for single beds) or electric inflatable pillow lifts, which enable people to sit up in bed by pressing a button. A bed, mattress (on a ground sheet) or sun-lounger set up outside may enable you to enjoy some fresh air for a bit without having to sit up (see Light Sensitivity; Noise Sensitivity; Stairs; Walking; Wheelchair).
A lot of people with M.E. have great difficulty sitting up even if they are very well supported. As with other activities, sitting up needs to be carefully paced if the M.E. is severe. People with M.E. may get an overwhelming need to lie down urgently which can be difficult if there are lots of pillows to get rid of. Be alert for warning signs if you are liable to get this symptom.
There are a number of pieces of equipment designed to aid transferring from a wheelchair to a bed or chair. If you are able to stand a little with assistance, there are turntables to put under your feet. Alternatively a transfer board may be useful if the seats are of compatible height. One end of the board goes on the wheelchair seat, the other on the bed or chair, creating a continuous surface to manoeuvre along. A cushion may be used to make a low seat higher. There are specially designed chair or bed raisers which can be put under the castors if you find it easier to rise from a high seat. Some chairs have an electric seat which moves to assist you into a standing position. A hoist may be required if you need a lot of help with transferring.
* Beanbags are available for around £100 from TFH SPECIAL NEEDS, 5-7 SEVERNSIDE BUSINESS PARK, SEVERN ROAD, STOURPORT-ON-SEVERN, WORCESTERSHIRE, DY13 9HT Tel: 01299 827 820 Fax: 01299 827 035 E-mail: tfh@tfhuk.com Website: www.tfhuk.com
* JOOLS INTERNATIONAL LIMITED, 22-23 RAYNHAM ROAD INDUSTRIAL ESTATE, BISHOP’S STORTFORD, HERFORDSHIRE, CM23 5PD Tel: 01279 465 000 Fax: 01279 465 444 E-mail: info@jools.co.uk Website: www.sofabeanbag.co.uk Sells beanbags in four sizes including sofa size which is like a bed (but not very easy to get up from).
Bed; Nature; Pacing; Pressure Sores; Toilet; Travelling; Walking; Wheelchairs

Sleep - If you find a bath relaxing, the evening can be a good time to have one, to help you unwind before settling to sleep. Having a small supper (preferably complex carbohydrates such as wholemeal bread) may avoid a blood sugar low in the night. Keep a snack such as a banana by the bed in case you get hungry during the night. Comfort is important and poor sleep may mean that the bed or mattress needs replacing. Avoid anything stimulating for a couple of hours before settling to sleep (e.g. bright lighting, tea, coffee, coca cola, TV – especially exciting or distressing programmes).
Earplugs may help you to sleep through noise. Using a commode at night may be less likely to keep you awake than walking all the way to the toilet.
Spending time awake in bed can contribute to difficulty sleeping, but this cannot be helped when you have M.E. and need good quality rest. Having two beds – a ‘day bed’ and a ‘night bed’ gets around this problem; or if this is not possible try sleeping with your head at the foot of the bed so that you are in a different position from the daytime. With luck your brain may come to associate the night bed or night position with sleep. Opinion is divided about lie–ins and daytime naps – some doctors advise avoiding them and others feel that people with M.E. should sleep whenever it comes. Experiment to find out which is better for you. Try settling at a similar time every day; with M.E. one late night can be enough to disrupt sleep patterns for weeks.
If you can’t get enough sleep because of light, these tactics might be worth trying. Try wearing a blindfold/sleep mask, which are available from some chemists (e.g. SUPERDRUG), or if you know anyone who is travelling, airlines give them out on long flights. In the long term, consider getting a blackout blind or blackout curtain lining. Some specialist blackout blinds are sealed at the edges and can be used to make the room pitch black, but new blinds release chemicals for over a week after installation. Blackout material can be fixed to the window frame with adhesive Velcro (not suitable for sunny daytimes as the glass might heat up). During light evenings wear dark glasses and, if necessary, blackout your room and use low level artificial lighting. Try using a very dim light, or a torch at night, perhaps with a red coloured bulb.
If sleep does not seem imminent, a personal stereo can help to pass the time during the night, although listening to anything too stimulating may keep you awake. Choose a light programme or talking book, or relaxing music. If you are kept awake by thoughts or worries, set aside a time earlier in the evening to think, write things down or make lists. Relaxation techniques can be helpful (see Resting). A Dictaphone may be the least stimulating way to jot down thoughts in the middle of the night.
* The Website: www.sleepnet.com/links.htm Has many links to different sites about sleep.
* THE BRITISH SLEEP SOCIETY, P.O. BOX 247, COLNE, HUNTINGDON PE28 3UZ Website: www.british-sleep-society.org.uk
* ACTION FOR M.E.’s information sheet on Sleep Disturbances. Send £1 to ACTION FOR M.E., Third Floor, Canningford House, 38 Victoria Street, Bristol BS1 6BY Tel: 0117 9279551 Website: www.afme.org.uk
* ‘Sleep Sound’ costs £12.95 on CD and £7.95 for a cassette including p&p. DAWN AWAKENING MUSIC LTD, FOXHOLE, DARTINGTON, TOTNES, DEVON, TQ9 6EB Tel: 01803 864866 Website: www.dawn-awakening-music.ltd.uk
* ACS WINDOW TREATMENTS, 73 MANOR ROAD, BRACKLEY, NORTHAMPTONSHIRE NN13 6ED Tel: 01280 701 275 Install blackout systems.
Bed; Celebrations; Chemical Sensitivities; Doctors; Light Sensitivity; Noise Sensitivity; Over-Stimulation; Pain; Resting; Talking Books
AfME Sleep Disturbance in M.E. £1; InterAction 25; 1998; pages 26 – 28 Insomnia and sleep disturbances; TYMES magazine Issue 38 has features about sleep disturbance

Special Interest Groups - There are a number of special interest groups for people with M.E., details of which can be found in the magazine of Action for M.E. or by contacting Action for M.E. One of these is the WRITERS’ M.E. GROUP. They circulate folders of members’ work for other members to read. There is a general poetry group and a Christian poetry group.
Christian; Parenting; University

Speech Difficulties - If you are able to speak, but only quietly, have something with which you can make a noise, in order to alert people when you want to speak. Some telephones can amplify outgoing (or incoming) sound.
* BT suggests in ‘The BT Guide for Disabled People’ that people with no voice might use an answering machine, fax machine, speech synthesiser or Textphone. Freephone: 0800 919 591 for more details.
It may be worth learning a bit of sign language or inventing some signs of your own. A speech therapist may be able to provide more information or equipment e.g. a computer. Computers can provide an artificial voice if you are able to use one. Some people communicate by blowing or moving to indicate each letter, while another person says the alphabet. It is more efficient if the alphabet is ordered so that the most common letter comes first. Here is one such English language ordering: e t a o i n s r h l d c u m f p g w y b v k x j q z. Other people trace letters with their finger on a helper’s hand. Alternative methods of communication include boards (bought or home made) with pictures, words, symbols or letters. The person who is ill indicates either by pointing, moving their eyes or making some signal as the helper points. However, some people with M.E. are too ill even to do the thinking required for communication.
* ABILITYNET, P.O. BOX 94, WARWICK, CV34 5WS Tel: 0800 269545 Fax: 01926 407 425 E-mail: enquiries@abilitynet.co.uk Website: www.abilitynet.co.uk AbilityNet provide an advice, information and assessment service on computing for people with disabilities e.g. communication aids, highly ergonomic workstations and voice input computers.
* There are about a hundred different voice output communication aids, for more information write to COMMUNICATION MATTERS C/O THE ACE CENTRE, 92 WINDMILL ROAD, HEADINGTON, OXFORD, OX3 7DR Tel: 0870 606 5463 Fax: 0131 555 3279 E-mail: admin@communicationmatters.org.uk Website: www.communicationmatters.org.uk
* COMMUNICABILITY – THE JAMES POWELL UK TRUST, CLERWOOD HOUSE, 96 CLERMINSTER ROAD, EDINBURGH, EH12 6UT Tel: 0131 334 0977 aims to help with the provision of communication aids, equipment and related services.
Computer; Reading; Telephone; Writing

Stairs - Think ahead to minimize the number of trips up and down stairs. Make a collection of things to take up or down with you next time you go, or ask someone else to take them. Try to keep things that you will want during the day on one level of your home. Get duplicates of some items and keep one upstairs and one downstairs; e.g. a second lightweight vacuum cleaner, a telephone and small items such as scissors and paper. Keep a duvet and pillow downstairs and something to lie on such as a travel mattress, or even a second bed so that you can rest without having to go upstairs. It might be possible to re-arrange your house in a way that enables you to live downstairs. Consider having a downstairs toilet fitted or use a commode chair. Alternatively, you could have a small kitchen area upstairs. However, you may find that some rooms tend to be noisier than others, so consider factors such as proximity to household activity (which may be worse downstairs) and the transmission of outside noise. Go downstairs slowly one step at a time sitting down, or stand and make use of the handrail. A stairlift can be very helpful, although they are expensive. Social services might be able to provide one, depending on the local budget. They can be bought second-hand through local newspapers, stairlift companies, or disability organisations. If you are thinking of moving house, look at bungalows, ground floor flats and houses with a downstairs toilet.
Noise Sensitivity; Walking

Talking Books - Talking Newspapers and Magazines. There are three main national organisations dealing with spoken word cassettes for people with disabilities such as M.E. They all require a doctor’s signature to show that the person has an illness or disability which causes difficulty in reading or holding books/magazines.
* LISTENING BOOKS, 12 LANT STREET, LONDON, SE1 1QH Tel: 020 7407 9417 E-mail: info@listening-books.org.uk Website: www.listening-books.org.uk Listening Books has a cassette library with commercial recordings of both abridged and unabridged books. Subscription costs £50 per year and postage is free. There is a children’s library, and they provide support for the National Curriculum at Key Stages 2, 3 and 4. They also supply audio equipment called an ‘easy play’ at no extra cost to people with difficulty using a standard tape player.
* CALIBRE, AYLESBURY, BUCKINGHAMSHIRE HP22 5XQ Tel: 01296 432339 E-mail: info@calibre.org.uk Website: www.calibre.org.uk Calibre is a cassette library with over 6000 specially recorded unabridged books. Membership is free; the organisation relies on donations. Postage to and from the library is also free. Full details of the books available and application forms available on the website.
* TALKING NEWSPAPER ASSOCIATION UK (TNAUK), NATIONAL RECORDING CENTRE, HEATHFIELD, EAST SUSSEX, TN21 8DB Tel: 01435 866102 E-mail: info@tnauk.org.uk Website: www.tnauk.org.uk TNAUK records many magazines and newspapers onto cassette. Subscription costs £45 (concessionary £30) per year plus postage, for up to 3 titles. They can supply details of local talking newspapers and other tape services.
If you can’t listen to very much, try tapes of short stories, children’s books or poetry. Use a tape head cleaner regularly to minimize background noise when playing cassettes. Some tape recorders have a ‘cue and review’ facility. This enables the listener to fast forward audibly and to hear when there is a change or silence. Some recordings take advantage of this possibility so that in, for example, a taped magazine you can find the beginning of the next article. Many local libraries stock talking books, which are available for anyone to borrow. Some also have a delivery service for people who are housebound. InterAction, the magazine of Action for M.E., is available on tape.
Environmental Control Systems; Headaches; Pacing; Plugs; Reading; Television and Radio; Writing

Teeth - It takes less energy to brush teeth if you lean your elbows on something, and sit down. Some people find an electric toothbrush useful. If travelling is likely to be bad for your health, ask for a home visit from a dentist. Try a mouthwash if you can’t always brush your teeth.
* You may find ‘Flossettes’ (£1.39 for 10 from BOOTS) easier to use than dental floss.
* THE BRITISH SOCIETY FOR MERCURY-FREE DENTISTRY, 221, OLD BROMPTON ROAD, LONDON SW5 0EA Tel: 020 7373 3655 Send an A4 s.a.e. for an information pack
Grip; Travelling
InterAction 17; 1994; pages 14-15 Mercury amalgam debate

Telephone - Phone calls are often unpredicted and it is easy to find yourself using up too much energy. Arranging times for phone conversations in advance can make illness-management a bit easier. It may also help to let the other person know how long you expect to be able to talk for, and perhaps to use a timer (see Pacing for details of a timer). Practice being assertive – “I’m sorry, I’m not up to talking at the moment, can I arrange a time to ring you back?” (See People for details of a MIND booklet on assertiveness). With an answer phone or the 1571 service you can receive messages without needing to answer. Rests will be better quality if you don’t leap up to answer the phone in the middle; you might like to turn the ringing off at these times, or leave only one phone audible. Answer phones can also be used to screen calls so you can choose which ones to answer. Phone 1471 to find out the last number that dialled you. There is a Caller Display service that enables you to tell who is ringing by displaying their number on the screen of your phone. There is also an automatic ‘Reminder Call’ – phone 150 and ask about ‘Select Services’ for charges. To save rushing to the phone when you are up to answering, have extra phones in different rooms, or at least one upstairs and one down. Position them so that you are able to sit or lie down while you talk. Telephone extension leads and cordless phones can be used. Hands-free operation is possible with some telephones, either by means of a headset (which can be used lying down) or a built in speaker and microphone. It may be necessary to speak quite loudly into this kind of microphone. Headsets are loaned free by BT to people with a disability. Some phones also have the ability to amplify outgoing (or incoming) sound. The telephone can be used for shopping, banking, and keeping in touch with friends (a three-way call is possible). If it is easier for you to listen to a conversation than to take part, you could listen while another person talks. With two phones or a hands free phone you can hear both sides of the conversation and participate a bit if you want to. Some carers carry a mobile phone so they can be contacted when they are out. Mobiles are also useful it you are able to go out alone, in case you need to call for a lift, taxi or breakdown service.
* BT have a free guide to their products and services for older or disabled people called ‘Freedom to Communicate’, available in Braille, large print, disk and on audiotape. BT AGE AND DISABILITY ACTION TEAM Voice Freephone: 0800 919 591 Fax: 020 8326 9339 Textphone: 0800 243 123 E-mail: disability@bt.com Website: www.bt.com
* There is a free Directory Enquiries service for people whose disability prevents the use of a telephone directory, ring 195 to apply.
* THE RESEARCH INSTITUTE FOR CONSUMER AFFAIRS (RICABILITY), 30 ANGEL GATE, CITY ROAD, LONDON, EC1V 2PT Tel: 020 7427 2460 Fax: 020 7427 2468 Textphone: 020 7427 2469 E-mail: mail@ricability.org.uk Website: www.ricability.org.uk researches and published unbiased information on products and services to enable older and disabled people to live more independently. They have a leaflet called ‘It’s Your Call’, which gives information about what services are available from the 8 largest phone companies and tells you how to get them. Also available in Braille, large print and on tape.
* TALKING PAGES: 0800 600900 is a the free telephone information service from Yellow Pages Website: www.yell.com
* Sales telephone calls can be minimized by contacting the BT PREFERENCE SERVICE Freephone: 0800 398893
* Unwanted faxes can be reduced by contacting the FAX PREFERENCE SERVICE 020 7291 3330
* Audioline Petit is a miniphone which is suitable for people who have difficulty holding the phone (although the small buttons are unsuitable for those with coordination problems). It costs under £10 from DIXONS/CURRYS. Dixons Direct Tel: 0800 068 2868 Website: www.dixons.co.uk
Headaches; Household; Pacing; People; Shopping; Speech Difficulties; Visitors

Television and Radio - A special filter fixed to the front of the TV screen may make it a bit easier to watch, as may sunglasses. A remote control saves getting up, multi-purpose remote controls can be obtained and also ones with large buttons. If you don’t have a TV with a remote control, but you do have a video with one; if you switch your TV to the video channel, you can then change channels using the video remote. Record your favourite programmes to enjoy at your best time of day, watching or listening to it in short sessions if necessary. Using a video enables you to fast forward through the adverts. Some people with M.E. watch television with the sound off (some sports and nature programmes are suitable for silent viewing), although the high-pitched noise may still be too much. Try subtitles on Teletext page 888. Use the mute button if sudden loud patches are difficult. If you are well enough, you might like to hire a video and invite a friend. Friends in different places can hire the same video and talk about it on the telephone. It might be worth buying a film guide in order to select the best films to watch. Many people with M.E. find radio or cassettes easier than television. Some radios and televisions have a timer and can turn themselves off. Other family members may be willing to use headphones when they watch TV if the noise affects you.
* WIRELESS FOR THE BEDRIDDEN 159A, HIGH STREET, HORNCHURCH, ESSEX, RM11 3YB Freephone: 0800 018 2137 In cases of need this organisation may be able to provide a free television, radio or radio/cassette player Fax: 01708 620 816
* Anti-radiation screen filters are available by mail order from THE GREEN STATIONERY COMPANY, STUDIO ONE, 114 WALCOT STREET, BATH, BA1 5BG Tel: 01225 480556 E-mail: jay@greenstat.co.uk Website: www.greenstat.co.uk
Education; Environmental Control Systems; Headaches; Pacing; Plugs; Sleep; Talking Books

Temperature Control - Have extra clothing with you when out, especially a warm light garment such as a fleece. A hot or cold drink or a warm bath can help (see Washing and Drinking). Soak icy feet in a bowl of warm water. If you are well enough, try wearing several layers of thin clothes, as it is more flexible for varying temperature. Two thin pairs of trousers, or long johns and trousers, may be more comfortable than one bulky pair. Use extra covers on the bed if needed, this may enable you to have the window open sometimes for fresh air. Duvets are lighter than blankets. Cellular blankets are warm and lightweight. A blanket can be folded and used over part of your body for localised coldness. An electric oil-filled radiator is very useful for keeping one room warmer than the others. A lot of warmth is lost through the head, so try putting on a soft hat if you get cold in the middle of the night. One person with M.E. keeps a designated kettle next to her bed. She tips water straight from a hot water bottle back into the kettle to be reheated. Wrapping a hot water bottle in a blanket or towels will keep it warm for a while until you need it. An electric or folded paper fan may be of use.
* Many people use an electric blanket or electric heat pad (heat pads are sold through BOOTS or ARGOS).
* A ‘Hot Bot’ can be heated up in a microwave or frozen. They don’t stay hot for as long as a hot water bottle but they are much more comfortable. They are available for £11.95 and £16.95 from: WAYS AND MEANS (formerly from CAVERILL LTD.), UNIT 2, PADDOCK ROAD, CAVERSHAM, READING, RG4 5BY. Tel: 0118 984 3142 Fax: 0118 946 1176 E-mail: info@caverill.co.uk Website: www.caverill.co.uk
* ‘Heateze’ and hand, foot and body warmers (which can only be used once) are available from MYCOAL WARM PACKS LTD, UNIT 1, IMPERIAL PARK, EMPRESS ROAD, SOUTHAMPTON, SO14 0JW Tel: 023 8021 1068 E-mail: enquiries@mycoal.co.uk
Clothes; Drinking; Washing

Tinnitus - Recordings of relaxing sounds can help to mask tinnitus.
* ‘Sleep Sound’ costs £12.95 on CD and £7.95 for a cassette, including p&p. Tel: 01803 864866 DAWN AWAKENING MUSIC

Toilet – Children at school may require special permission to allow them to eat, drink and use the toilet when they need to as needing the toilet frequently is a symptom of M.E. Castor chairs are wheelchairs for use indoors which require no turning circle so they can get to some places that would be inaccessible to a larger chair. There are also special chairs with a hole in the seat, which can be wheeled over the toilet and also used for showering/washing. There are cushioned toilet seats for people who find hard seats painful. A raised toilet seat with handles or a grab rail might be of use if you have difficulty rising from a seated position. Social Services may be willing to provide any of this equipment. Although there is a risk of losing muscle bulk if you walk less, as long as you are aware of this, using a commode intelligently can increase flexibility. If walking is very limited, reducing the amount used on getting to the toilet can leave more walking ability free for other things such as going into other rooms, tackling stairs or going outside. You may be able to use toilet paper while sitting down. A commode or bottle can be useful if you need to go to the toilet frequently (especially if the bathroom is occupied!). If you can’t get to the toilet, use a commode or urine bottle (male and female versions available), or ladies’ slipper urinal (£6.25 from BOOTS – these can be used lying down). People with difficulty sitting up to use the toilet/commode might benefit from having a back to front dining chair to lean forward onto, with a pillow for padding.
* The National Key Scheme provides keys for people with disabilities to around 4000 public toilets that are usually kept locked. To obtain a key, send a cheque/postal order for £2.50 made payable to RADAR to: THE ROYAL ASSOCIATION FOR DISABILITY AND REHABILITATION, 12 CITY FORUM, 250 CITY ROAD, LONDON, ECIV 8AF Tel: 020 7250 3222
* TRIPSCOPE, THE VASSALL CENTRE, GILL AVENUE, FISHPONDS, BRISTOL, BS16 2QQ Tel/Minicom: 08457 585641 (local rate) Fax: 0117 939 7736 E-mail: enquiries@tripscope.org.uk Website: www.tripscope.org.uk can provide information about accessible toilets.
Household; Sleep; Travelling; Washing

Travelling - In addition to the Blue Badge (see Parking Concessions) various schemes are run in conjunction with local councils/social services departments, which allow disabled people to use public transport for free (e.g. the Freedom pass in London) or to take advantage of reduced fares in wheelchair accessible taxis. It is generally easier to obtain these concessions if you receive the higher rate mobility component of Disability Living Allowance, though you may be able to apply with a doctor’s support. If you have a car, use the back seat as a place to rest with a pillow and sleeping bag (remember to lock the doors).
An M.E. travel kit bag might contain some or all of the following: eye mask, ear defenders, ear plugs, wrap-around sunglasses, sun cap, plastic bags for travel sickness, a damp flannel, water to drink and snacks.
Try to get as comfortable and well supported as possible before setting off. You may benefit from having padding under your legs and arms, a neck pillow and perhaps a hand-towel around your waist as a lumbar support. Reduce vibration by sitting on a pillow and putting another under your feet. Relaxation techniques such as breathing exercises can help to reduce the impact of the movement (see section on Resting). Smooth, straight roads are generally the easiest, although motorways are noisy and full of fumes. You may find air conditioning and good suspension helpful. Keeping your eyes closed when travelling reduces the stimulation. If you are able to rest in the vehicle, it can help to stop regularly, although some people find it easier to do the whole lot in one go.
A carer may be able to check out the route beforehand to minimize problems on the day. Plan routes around toilet stops or if necessary take a portable urinal. Travel at off-peak times to avoid predictable traffic jams. Some road rescue services have priority service for disabled customers. Consider taking a mobile phone if you have one. Explain a bit about your needs to the person driving; for example asking them to drive as smoothly as possible and not to chat or have the radio on. As the driver will be occupied, it may be worth having a second helper to care for you while on the move.
You may need to travel lying down or in a reclined position, although this leaves you without the protection of a safety belt. The most widely used method is to recline the front seat. You could try sitting in the back with your legs raised on a pillow on the fully reclined front seat. Another method is to lie on cushions on the back seat, or in a large car lay the back seats down flat and create a ‘bed’ with lots of padding, in the boot space. Probably the safest method of travelling in a horizontal position is by stretcher ambulance. With a doctor’s backing, these can be provided on the NHS for medical journeys. It is possible to hire one from St John’s Ambulance or the Red Cross but this is very expensive. Funding for a particular journey can be sought from local charities such as Rotary and Lions Clubs. Ambulances and Dial-a-ride services often go round picking up several people, which extends the length of the journey. If this would make you more ill explain your difficulty and request a direct route.
Bear in mind that you may feel worse than usual after a journey and so be less able to tackle stairs, walking and general activity. It’s an idea to try and organise for a room to be ready before you arrive so you can rest without delays. Packing and other preparation should be done well in advance (ideally by another person) to enable you to get plenty of rest before the journey.
It may be worth suffering for a few days in order to get a change of scene, but perhaps only if you stay for a fortnight or so to give yourself time to recover and have some quality time. Staying somewhere close to home can make a journey more manageable (even the next street is a change if you can’t normally go there). Where travelling is likely to be bad for your health, do ask (and keep asking) for home visits from doctors, dentists and therapists wherever possible. If having both a journey and an event in one day is too much, you might be able to stagger it by staying somewhere for a night or two. For example, a hospital appointment may be more possible as an inpatient than as an outpatient. If the aim in an outing is to improve quality of life, and yet you suffer so much that it has the opposite effect, you may find you benefit more from staying at home and finding other things to enjoy.
* The book ‘Multiple Chemical Sensitivity – A survival guide’ by Pamela Reed Gibson ISBN 1-57224-173-X £12.99 includes lots of ideas on travelling with chemical sensitivities.
* ‘M.E. Chronic Fatigue Syndrome: A Practical Guide’ by Dr Anne Macintyre includes a section about travel. (ISBN 0 7225 3539 2)
* Local DIAL-A-RIDE schemes offer a low cost door-to-door transport service for people with mobility problems who find it hard or impossible to use conventional public transport. Contact TRIPSCOPE for details (see below). Some volunteer bureaux run social car schemes which may also be cheaper than hiring a taxi. Contact your local volunteer bureau or Dial-a-ride.
* TRIPSCOPE, THE VASSALL CENTRE, GILL AVENUE, FISHPONDS, BRISTOL, BS16 2QQ Tel/Minicom: 08457 585641 (local rate) Fax: 0117 939 7736 E-mail: enquiries@tripscope.org.uk Website: www.tripscope.org.uk Provides information and suggestions about travelling and mobility for people with a disability or chronic illness.
* For train times and fares call National Rail Enquiries: 08457 48 49 50
* A sheepskin safety belt cover (price £5) is available from EASYRIDER COMPANY LTD. 60 MAIN ROAD, HACKLETON, NORTHAMPTON, NN7 2AB, Tel: 01604 870713 Website: www.easyrider.com
Chemical Sensitivities; Driving; Holidays; Light Sensitivity; Noise Sensitivity; Pain; Parking Concessions; Quality of Life; Shopping; Sitting; Toilet; Wheelchairs
Travel and Severe M.E. (on our website); YAO How To: Go Places and Meet People


Tray -
* Small tables can be obtained which wheel over the bed/armchair. Some people use a non-slip tray with a beanbag base for drinking, eating, reading and writing, these can be obtained from LAKELAND LIMITED, ALEXANDRA BUILDINGS, WINDERMERE, CUMBRIA, LA23 1BQ Tel: 01539 488100 E-mail: net.shop@lakelandlimited.co.uk Website: www.lakelandlimited.co.uk
* A tray with a top that lifts and props up is useful to put books and magazines on and also for writing in bed. The Adjusting Angle Bed Tray is £16.95 plus p&p ref.: AG1008 from HOUSE OF BATH, ROOM 240, NUMBER ONE, BARTLETT STREET, BATH, BA1 2QZ Tel: 0870 6075021
Trolley

Trolley - A trolley or table on wheels can be useful to save carrying things backwards and forwards. Load it up in the morning with things you will want during the day e.g. kettle, thermos, bowl, flannel, notepad.
Bed; Tray

University - ‘Choose your subject carefully and be organised.’ ‘On a practical level, find out how many lectures a week you will have to attend plus extra work on top of that.’ ‘Plan out a work time table.’ ‘Tell your lecturers, personal tutor, Department and Year heads about the situation.’ ‘Remember, always ask these people for help if you need it.’ Think carefully about the practicalities of university life, and what assistance you are likely to need. Some Halls of Residence have special rooms for people with disabilities, which may be more suitable. The University may have a society for students with disabilities. Many students now choose a university close to home and don’t travel away.
* OPEN UNIVERSITY (OU), P.O. BOX 724, MILTON KEYNES, MK7 6ZS Tel: 01908 653 231 Fax: 01908 655 072 E-mail: general-enquiries@open.ac.uk Website: www.open.ac.uk The Open University enables people to study from home and makes use of radio and television.
The quotes in this section are from ‘Survival at University with M.E.’ an article by Catherine Foxwell, Cheers 19 p21 (Cheers is the magazine of the Association of Young People with M.E.)
Computer; Education; Over-Stimulation; Paperwork; People; Reading; Talking Books; Writing; Young People
YAO ‘Learn & Live’ a guide to the OU; YAO ‘Students and M.E.’

VAT - People with a chronic illness can claim VAT exemption on products designed specifically for people with a disability. This makes a significant difference to the cost of expensive equipment. Items which you may need because of your disability, but which were designed for general use (e.g. earplugs) are not exempt. Ask your local VAT office for details.

Visitors - It isn’t easy to ask a visitor to leave. One idea, which doesn’t interrupt the flow of the conversation, is to use coloured cards. When you are OK, have a green card on view. An orange card silently indicates to the visitor that you need to wind down the conversation, and a red card means you need a rest urgently. Rudyard Kipling had an ornamental fish, which he turned to point away from the room when he wanted the visitor to leave. If possible plan visitors for your best time of day and perhaps decide beforehand how long they should stay. It might help to use a countdown timer, which will beep after a set period. Frequent short visits are better than getting worn out once a fortnight. One person with M.E. uses a signalling system where a specific curtain is left open if she is happy for a visitor to pop in, and closed if not. If you find it difficult to concentrate when there is more than one noise, ask visitors to try and avoid speaking at the same time as someone else or over the top of an aeroplane or television. Explain that your brain has trouble filtering out excess stimuli, and if necessary ask friends to visit one at a time. Make plans to minimize the chances of the conversation grinding to an awkward halt. Look out for interesting topics, facts or jokes. Think about what you might talk about, and maybe let the visitor know in advance. You might prefer to do something together such as playing games or watching television. Use refreshments. If you are too ill to have a long conversation, a friend might be able to pop in to see you, go and talk to another family member while you rest, then pop in to you again before they go; or you might be up to having them sit quietly in the room reading a book, studying or playing patience. Some people might like to share a time of silent meditation, prayer or deep relaxation with you. If you are very ill, your family may be able to keep up some contact with your friends on your behalf. Visitors who would stay the night if you were well enough might be able to stay at a local Bed & Breakfast instead.
Cooking; Meditation; Over-Stimulation; Pacing; People; Resting; Telephone; Writing

Walking - A lightweight stick, walking frame or crutches might help. Some ramblers use ski sticks or walking poles. Wheelchairs save a lot of energy even if you are able to walk, and enable people with M.E. to go further. Walking is easier than standing for many people with M.E.; if this is the case for you, try walking on the spot or moving your legs around instead of standing still. Spreading salty sand on wet or icy steps will make them less slippery.
* Walking sticks can be purchased with a built in seat, so you can sit down when you need to. A folding seat stick is available for £26 plus £1.70 p&p from GP SPECIAL PROJECTS LTD, P.O. BOX 25, PORTISHEAD, BRISTOL, BS20 9NJ Tel: 01275 842322 However, it is worth comparing different types – the Disabled Living Foundation can supply details (see page 3). Some designs take more strength to open than others, and models with three or four legs offer more stability. The height and weight may also be important, and vary between models.
Door; Parking Concessions; Shopping; Sitting; Stairs; Toilet; Travelling; Wheelchairs

Washing - If hot baths make you ill, try one at body temperature. Grab rails can be fitted next to the bath, shower or toilet, or in other places where they might be useful. Consider getting a non-slip shower or bath mat.
A seat for the bath or shower can save a lot of energy even if you are able to stand to wash. There are various types such as a simple four-legged stool, wall-mounted folding seats, or a seat that goes across the bath (ask an Occupational Therapist). An extra wall- fitting for the showerhead could be positioned lower down for a seated position. Have a stool by the basin as well. If there is room, a castor chair can be wheeled up to the basin to save lifting (Wheelchairs). Sit down when drying yourself, brushing teeth, or having a wash.
A shower robe may enable you to get warm and have a rest before getting dressed and saves energy on drying, or wrap yourself in a big bath towel or two. Towels or clothes can be warmed on a radiator or in a tumble drier. If you are too ill for a bath or shower, try having a wash in bed with or without assistance. It may be worth washing only one part of your body per session. Plastic bidets can be obtained which fit onto the toilet
Balls of soft mesh are available from chemists (known as ‘puffs’ or ‘body polishing sponges’). These lather up soap more easily, thus reducing the energy needed to wash. A particularly good type is the ‘Ulay puff’. A flannel mitt (or two face cloths sewn together) will help stop you dropping a face cloth.
If you can’t wash every day, shaving armpits every week or two reduces body odour. You can wash hands in bed with no-water hand wash or vodka. Baby wipes can be used for keeping hands and body clean. Take care with new products if you have chemical sensitivities. If you find a bath relaxing, the evening can be a good time to have one, to help you unwind before settling to sleep.
Chemical Sensitivities; Hair; Teeth; Toilet

Wheelchairs - Using a wheelchair takes much less energy than walking, but it does take energy. Take it slowly and get someone to push you. If you are quite severely ill, try it at home without moving around first. To minimize vibration, have large wheels with pneumatic tyres and stick to smooth surfaces. Wheelchairs are a form of transport, which can enable people with M.E. to go much further than they could walk. This needn’t stop you using your leg muscles if you can walk – think about a child’s use of a wheelchair. If you are embarrassed, go at first to a place where you are unlikely to see anyone you know. People who can’t sit up for long enough to use a standard chair may be able to use one that reclines fully or partially (fully reclining wheelchairs can be used lying down). Experiment with different cushions to try to minimize pain/discomfort. A headrest which supports the sides of the head may be useful. It might be suitable to combine a short trip in an upright chair with time lying down in a car or on a portable sun bed. Some people are not well enough to use a wheelchair at all. A castor chair is a wheelchair for use indoors which requires no turning circle. Lightweight chairs are easier to lift in and out of a vehicle and to self-propel. Electric wheelchairs and scooters can increase independence for some people with M.E.
* THE BRITISH RED CROSS Tel: 020 7235 5454 Website: www.redcross.org.uk have local branches with wheelchairs for short-term loan. Wheelchairs can also be borrowed at some museums, supermarkets, airports, hospitals, and amusement parks.
* Occupational Therapists can arrange provision of various types of wheelchair for long-term loan on the NHS, if there is deemed to be a ‘clinical need’.
* The Wheelchair Voucher Scheme (which is available in some areas) enables people who would be entitled to a wheelchair on the NHS, to obtain a voucher instead, which they can top up in order to obtain a more expensive model.
Holidays; Pacing; Parking Concessions; Pressure Sores; Shopping; Travelling; VAT
A Rough Guide to Wheelchairs (on our website)

Work - If you are able to do some work, look for something to do from home and without set times of work so you can do it when you feel able.
* NEW WAYS TO WORK, 25 SHACKLEWELL LANE, LONDON, E8 2EZ Tel: 020 7503 3283 Website: www.new-ways.co.uk This charity promotes more practical ways of working such as job sharing.
* LETS (Local Exchange and Trading Schemes) Website: www.gmlets.u-net.com and Time Banks enable members to exchange skills using special local ‘currencies’. This may suit some people with M.E., as it is more flexible. To find out if a scheme exists in your local area contact TIME BANKS.
* TIME BANKS UK, C/O NEW ECONOMICS FOUNDATION, CINNAMON HOUSE, 6-8 COLE STREET, LONDON, SE1 4YH Tel: 020 7089 2849 Fax: 020 7407 6473 E-mail: info@timebanks.co.uk Website: www.timebanks.co.uk A time bank is a way for people to come together and help each other. Time banks measure and value all the different kinds of help we can give each other – everyone’s time is worth the same. Participants ‘deposit’ their time in the bank by giving practical help and support to others and are able to ‘withdraw’ their time when they need something done themselves.
InterAction 28; 1998; pages 20-21 Voluntary work; InterAction 32; 2000; pages 30-31 Working with M.E. ‘new ways to work’; InterAction 28; 1998; pages 20-21 Voluntary work; InterAction 32; 2000; pages 30-31 Working with M.E. ‘New ways to Work’

Writing - It takes more energy to write with some pens than others. A ‘2B’ pencil requires less pressure than an ‘HB’ pencil, and a fibre tip or gel pen less pressure than most biros. Experiment with different writing implements. A pencil always works and a propelling pencil doesn’t need to be sharpened. Some pens have an area of rubber or serrated plastic to make them easier to grip, or you may find a special chunky pen easier. There are pen grips available from disability equipment catalogues, which fit onto ordinary biros or pencils, or make your own by wrapping a rubber band round the pen. The ink flow tends to be better with more expensive ballpoints, which makes them easier to write with. Lean on a hard surface such as a clipboard.
Address stickers and headed notepaper save writing your address and can be obtained from many sources including some charities. Labels can also be used for messages such as ‘Happy Christmas, with love from Sophie.’ Some stationers sell cards printed with a message such as ‘Dear …, Thank you very much for the Christmas present. Love from …’ Pre-inked stamps can be made with an address or even a signature; ask a good stationers.
Standard letters, which can be sent to more than one person, can save energy. These can be done on a computer or handwritten and photocopied. Computers can also be used to print out labels for addressing envelopes. Use highlighters and different coloured pens and paper to make filing systems and lists more user friendly. Post-it notes are also useful. Writing or dictating post cards or note cards rather than letters is enough to keep in touch. It doesn’t have to be finished all in one go, but can be written or dictated a few lines each day. Some people exchange talking letters, recorded on cassette.
It may be possible to dictate into a tape recorder or dictaphone and then get someone to write it out later. A personal stereo/dictaphone, which uses full size cassettes and doesn’t need earphones, is available from ARGOS. Some tape recorders record when you speak and stop when it is quiet so there is no need to keep pressing buttons. It is also possible to dictate into a computer with the correct features. Other programs can minimize the number of letters typed by guessing the word or phrase as you type it (e.g. newer versions of Word for Windows).
Some friends might be prepared to send you postcards or letters without receiving a reply. Creative writing such as poetry can provide a means of expression and enjoyment, but it can be difficult to switch off and rest when your brain is in the middle of composing a poem. Write lists and notes as an aid to memory. Keeping a diary or journal may help express your feelings.
Some words are often shortened (and, street, road) but you can choose to shorten other words as well if you are writing notes 2 yslf, as long as you can remember what they mean! Some people use 4 instead of for, u instead of you. Shorthand is designed to be the most efficient way of writing. It takes time to learn in full but you can always use selected bits. Books are available to teach yourself ‘Pitman’s Script’. Using a letter opener saves energy and fitting a cage to the letterbox means you don’t have to pick up mail from the floor.
* KINGS AUDIO, 15 OXFORD ROAD, PENMILL TRADING ESTATE, YEOVIL, SOMERSET, BA21 5HR Tel: 01935 411322 supply cassettes of any length from 5 mins-126 mins
* Post card re-use labels are available from C.A.T. (CENTRE FOR ALTERNATIVE TECHNOLOGY) MACHYNLLETH, POWYS, SY20 9AZ Tel: 01654 705 950 Fax: 01654 702 782 Website: www.cat.org.uk
* To find a business that can type out documents for you, try looking in the phone book under ‘secretarial services’ or ‘typing services’.
Computer; Education; Pacing; Paperwork; People; Reading; Shopping; Special Interest Groups; Tray

Young People -
* ASSOCIATION OF YOUNG PEOPLE WITH M.E. (AYME) BOX 605, MILTON KEYNES, MK2 2XD Tel: 01908 373300 Fax: 01908 274136 E-mail: info@ayme.org.uk Website: www.ayme.org.uk AYME has various services including a magazine every two months, a pen-pal service, buddy scheme and library. There are three advisors dealing with medical, educational and psychological matters. Members who are well enough can attend the annual get together, which is videoed for those at home. Membership is free to people with M.E. under 26
* YOUNG ACTION ONLINE, P.O. BOX 4347, STOCK, INGATESTONE, ESSEX, CM4 9TE E-mail: jane@youngactiononline.com Website: www.youngactiononline.com YAOnline is a specialist information provider and works in partnership with Tymes Trust. All website information is free of charge.
* TYMES TRUST, P.O. BOX 4347, STOCK, INGATESTONE, ESSEX, CM4 9TE Advice line: 01245 40 10 80 (11am – 1pm & 5-7pm, Mon – Fri). Tymes Trust publishes a quarterly magazine, and information packs. Tymes Trust provides free telephone, E-mail and correspondence support services advising on issues ranging from energy management and mobility aids to liasing with health/education professionals. The organisation specialises in training education professionals, and runs day courses for a multi-disciplinary clientele in association with The National Association of Educational Inspectors, Advisors and Consultants. Parents and young people are welcome at these courses. Annual Subscription to TYMES magazine is free to people with M.E. under the age of 26, and costs £5.50 for those over 26. Jane Colby, chief Advisor to Tymes Trust, also gives individual educational consultations, lectures etc.
* ACTION FOR M.E.’s young people service Tel: 01179279551 E-mail: admin@afme.org.uk
* THE FAMILY FUND TRUST, P.O. BOX 50, YORK, Y01 9ZX Tel: 0845 130 4542 (local rate) Textphone: 01904 658085 E-mail: applications@familyfundtrust.org.uk Website: www.familyfundtrust.org.uk The purpose of the Family Fund Trust is to ease the stress on families who care for very severely disabled children under 16, by providing grants and information related to the care of the child. Further details are available from the Information Officer.
* CHILDREN’S LEGAL CENTRE, UNIVERSITY OF ESSEX, WIVENHOE PARK, COLCHESTER, CO4 3SQ Tel: 01206 873 873 Advice line: 01206 873820 Fax: 01206 874 026 E-mail: clc@essex.ac.uk Website: www.childrenslegalcentre.com
* CHILDLINE, FREEPOST 1111, LONDON N1 OBR Freephone: 0800 1111, 24 hours a day (will not show up on itemised phone bills). Website: www.childline.org.uk
* CHILDLINE FOR YOUNG PEOPLE IN CARE Tel: 0800 884444. Mon-Fri. 3.30-9.30 Weekends 2-8pm
Child Protection Procedures; Christian; Doctors; Education; Parenting; University
AfME Information for young people; YAO Action for M.E. Children’s Charter; YAO M.E. in Children; YAO Childhood M.E. £2.50 (cheques payable to ‘Tymes Trust’); YAO The Collaborative Care Management Model; AYME Research Project Speaking Up – Experiences of AYME members £1.50; InterAction 20; 1995; pages 26-30 Children and M.E: Overview by Dr Alan Franklin; InterAction 32; 2000; pages 3 and 5 Panorama on mistreatment of children with M.E.

THE M.E. TIPS COLLECTION - www.metips.co.uk - 2002