Advance Praise for How to Feel Better

‘Every patient – and every patient’s supporters, be they relative, partner or friend – will find help from this book. From the start of a phase of medical intervention, right through to the struggle to get out of it and back on with life, Frances and Lucy have broken the entire process into understandable sections, and demystified the process. By giving a structure to feelings that you might other wise only be dimly aware of, or not at all until too late, it informs and guides the reader through the complex geography of appointments, illness, treatment and recovery. As a succinct guide to the journey through illness, it has the makings of a classic. I warmly commend Frances and Lucy on a sympathetic and above all practical guide’

Professor Justin P Cobb, Chair, Section of Orthopaedics, Imperial College London

‘This book is a great companion for people living with long-term conditions and their families. It gives simple, practical advice for those faced with the challenges of illness, such as dispelling their worries and giving coping strategies for managing stress. I like the examples from people who have experienced illness and these will be inspirational to others. I would recommend this book to anybody with a long-term condition and their families, as it shows it is possible to put quality back into life after a diagnosis’

Dr Barbara Conway, British Heart Foundation Cardiovascular Specialist Nurse, Doctor of Nursing, County Durham & Darlington NHS Foundation Trust

‘For doctor and patient alike, those familiar with serious illness recognise that the associated mental struggle, stress and uncertainty are at least as great a challenge as the physical illness and its aftermath.

How to Feel Better is a detailed, practical guide that understands these problems and provides practical evidence-based solutions. The insight and experience of Dr Goodhart are easily apparent through the many thoughtful tips and strategies, whilst the key themes and ideas are related by the authors in a style that is accessible, without being patronising. The authors draw on many patient vignettes that resonate with my own clinical practice. Indeed, the handbook is as helpful to the thoughtful doctor as to his or her patient. This is an important, well-balanced and serious contribution that will provide the interested patient, carer and professional with new perspectives, tips and insights’

Robin P Choudhury DM FRCP Professor of Cardiovascular Medicine, University of Oxford & Consultant Cardiologist, Oxford Heart Centre

‘It is extraordinary that no one has written a book like this until now. It is designed to help you take off where the medical profession left off. Inventive, practical and authoritative, this book will help with the obvious and unexpected challenges of recovery after illness’

Dr Suzy Cleator BM BCh MRCP FRCR PhD Consultant Clinical Oncologist and Honorary Senior Lecturer, St Mary’s and Charing Cross Hospitals, Imperial Healthcare NHS Trust, London

‘This is a really timely book. It puts together much if what I have gleaned over the years and try to tell my patients in a rush in 8 minutes! The advice is sensible and manageable, and phrased in a way that doesn’t make you want to give up before you have started. A great resource to dip in and out of as you come across different hurdles in convalescence’

Rosie Haining, Edinburgh GP

‘This book is a joy – thoughtful and funny, practical and realistic. It takes the whole potentially terrifying process of medical investigation and treatment and breaks it down into manageable pieces, with well-researched tactics and tips to help at every stage. Designed to help both patients and carers, it avoids jargon and highlights the all-important psychological issues which are so often underestimated. Having a long-term illness brings many challenges, emotionally as well as physically. With this book comes the promise of feeling just a little less overwhelmed’

Dr Sarah Jarvis, GP and medical broadcaster

To our parents: Celia and William Goodhart, and Sue and Peter Atkins

COPYRIGHT

Published by Piatkus

ISBN: 978-1-4055-1576-4

Copyright © Dr Frances Goodhart and Lucy Atkins 2013

The moral right of the author has been asserted.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of the publisher.

The publisher is not responsible for websites (or their content) that are not owned by the publisher.

Piatkus

Little, Brown Book Group

100 Victoria Embankment

London, EC4Y 0DY

www.littlebrown.co.uk

www.hachette.co.uk

Dr Frances Goodhart is a consultant clinical psychologist with twenty years’ experience of working with individuals and families who are coping with life-threatening illnesses. She worked for several years as an NHS Macmillan Consultant Clinical Psychologist in Oncology and Palliative Care. Dr Goodhart’s patients include men and women of all ages, and she supports not just the patient, but their families and carers too. She also provides psychological consultation and supervision to medical and nursing colleagues. Dr Goodhart’s work has been published in academic journals and presented at national and international conferences. She has a BA (hons) in Experimental Psychology from the University of Oxford, an MSc in Clinical Psychology from the Institute of Psychiatry, London University, and a doctorate in Clinical Psychology (D. ClinPsych) from City University. Dr Goodhart lives in London with her husband and three children.

Lucy Atkins is a well-known health journalist. For the past fifteen years she has written health features for the Guardian, the Weekend Telegraph and the Sunday Times, the Sunday Express, The Times, Red, Woman and Home, Grazia and the major mother and baby magazines. She is also the author of Blooming Birth (Collins, 2005) and First-Time Parent (Collins, 2006 and 2009). Lucy has been a media commentator on health and family issues, online, in podcasts, and on radio and on television. She currently lives in Oxford with her husband and three children.

ACKNOWLEDGEMENTS

Enormous thanks to: Anne Lawrance and the fabulous team at Piatkus; The British Heart Foundation – in particular, Kevin Fitzpatrick, Darlington Coronary Heart Club, Gordon Wilcock, Dr Barbara Conway, Adrian Hurley, Dr Melissa Sanchez; The Stroke Association – in particular, John Hillman, Ealing Stroke Club, Pat Badger, Tewin Over 50s Social Club; Professor Nadina Lincoln, Dr Anna Sorensen, Dr Catherine Hood, Dr Michelle Kohn and Kelly McCabe at the London Oncology Centre’s Living Well programme. Huge thanks also to Bungie Snow, Trilogy Boot Camp, Zina Sabovich, The Wellcome Trust, Jothy Rosenberg and Francis King. Above all we are grateful to the many other people who so generously gave up their time to tell us about their experience of illness, injury and recovery, whether in person, by email, phone or even twitter. Finally, thank you – as always – to our families: Jim, Josie, Beatrice and Kitty, and John, Izzie, Sam and Ted.

INTRODUCTION

‘The end of an illness is not always in sight when the doctor’s visits cease. Very often the weeks of convalescence which follow the turning point of a malady are almost as trying to the patient and his family as the illness itself, and they are certainly, although in a different way, quite as critical.’

British Medical Journal, 1911

A serious health problem is like an earthquake with you at its epicenter – it’s frightening and noisy, it rocks your foundations and shakes you up, familiar structures collapse around you. You make it out of the wreckage – health professionals bring you to safety and patch you up … but then they leave. You’re supposed to be ‘feeling better’, you’re meant to be ‘getting your life back’, but your landscape has changed – the landmarks and structures look different, possibly even unrecognisable. You know you’re supposed to rebuild it all, but you’re still shaken up. Even when the physical symptoms are under control, it can take a while to really feel better. You need help, but your rescue team has gone. You feel very alone. What now?

Well, that’s where this book comes in. If you have had a heart attack, a stroke, cancer, surgery of any kind, or been hospitalised for a serious illness such as pneumonia, or something out of the blue, like a car accident, then this book is for you. It is for anyone whose health has unexpectedly taken a blow. It provides the tools and strategies to help you rebuild yourself.

In days gone by, there was a whole phase between illness and recovery, called convalescence. For at least three centuries this was taken very seriously indeed. Scientific papers – sometimes entire books – were written about it. There were convalescent spas and rest cures, ‘wellness’ regimes, bath chairs, water cures, tonics, sanatoria in the Swiss Alps. Doctors, nurses and carers debated the tiniest details of convalescent care, right down to how to lay the dinner tray. Nobody was expected to just ‘bounce back’.

In today’s quick-fix, high-tech world, the notion that feeling better takes time has somehow been lost. Nowadays, we are meant to ‘Get Well Soon’, pick up where we left off, move on, get our lives back, be our ‘old selves’ … The Victorians and Edwardians may have enjoyed hanging around in bath chairs, but we have jobs to hold down, mortgages to pay, households to run – and no domestic staff. We also have the benefits of modern medicine: effective pharmaceuticals, state-of-the-art scans and blood tests, follow-up consultations, physiotherapists. When our bodies are fixed – or at least stabilised – we are expected to feel ‘better’.

If only it were this simple. The truth is that when your body takes a serious knock, so does your mind. Even if you look fine you may feel, deep down, as if your foundations are cracked. You may feel worried, confused, lonely, depressed, unsupported or overwhelmed. You may be grappling with ongoing physical challenges such as disability, pain, the side effects of treatment, sleep problems, fatigue or muscle weakness. You may have practical concerns about finances, work or plans. Or you may simply be trying to ‘adjust’. If any of this sounds familiar, then you are far from alone. Countless people struggle, often in silence, long after the physical symptoms of their illness or injury have been controlled.

In 1927 an American doctor called John Bryant wrote in his book, Convalescence, that ‘most of our large hospitals display in their corridors direction signs, some of which bear the legend THIS WAY OUT. But these signs too seldom tell the patient whither the hospital portals lead.’ This sense of disorientation is just as strong today as it was in 1927: those hospital ‘portals’ still lead us into the unknown. We may be given information leaflets, follow-up appointments and rehab instructions, but we don’t get bespoke, in-depth, ongoing care or a crash course in rebuilding our lives.

That is why we wrote this book. It is about understanding what happened to you when the ‘earthquake’ hit. It is about learning simple, practical ways to cope with the tricky emotions that surface. It is not about turning back the clock, creating a society of invalids or re-opening the sanatoria. Nor is it about navel-gazing and feeling sorry for one’s self. It is simply about finding a path through what Dr Bryant called ‘the space between illness and health’. It is about understanding what has happened, and learning ways to cope. This is the ‘modern art of convalescence’ – for convalescence is just as vital today as it ever has been.

All the strategies in this book are evidence-based (that is, they are backed up by rigorous scientific studies). They don’t always make their way into rehabilitation courses or leaflets but they are essential if you want to survey the damage, sift the ‘rubble’ and rebuild yourself – from the inside out. Your life may never be exactly the way it was, but take the strategies in this book seriously and you won’t just ‘cope’, you’ll thrive.

A word for carers

You may have been catapulted into a role that you never imagined, and certainly didn’t ask for. You may not feel entirely confident about this. In fact, the whole ‘carer’ thing may seem completely daunting right now. Your life has changed too – and this can throw up a lot of different emotions. The truth is that it’s perfectly normal for you to go through many of the emotions that your loved one is experiencing: to feel stressed, anxious, depressed or simply exhausted.

If you can read the whole of this book, please do. The techniques here can really help you to cope too. Otherwise, look at the ‘Notes for Carers’ sections at the end of each chapter. It might also help if you tell yourself – right now – that you don’t need to be the perfect carer, just a ‘good enough’ one. Caring for someone is a learning process. You are bound to have ups and downs. You’re likely to make mistakes. And there will almost certainly be days when you think, ‘I just can’t do this any more.’ You, too, need practical ways to cope with tricky emotions – whether they are yours or those of the person you are caring for. This book, in short, is for you too. For once, your needs are not being overlooked.