Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

WHAT IS ME/CFS?
1.A short introduction explaining ME/CFS file Introduction to ME-CFS.pdf [pdf] 461KB
2. Getting started with ME/CFS GETTING STARTED for CFS pts 2nd Section.pdf [pdf] 418KB
3. A detailed biological explanation of ME/CFS
4. A comprehensive ME/CFS Service leaflet on understanding ME/CFS
5. What we offer What we offer.pdf [pdf] 490KB

Energy management
1. Pacing and grading activity file Activity Management- Pacing and Grading Activity.pdf [pdf] 710KB
2. How to complete and calculate an activity diary (with template) How to complete an Activity Diary v1.pdf [pdf] 677KB
3. Weekly planner template Weekly Planner (w) 2020.pdf [pdf] 217KB
4. Planning and baselines Planning and Baselines (w) 2020.pdf [pdf] 586KB
5. Rest What is Rest (W).pdf [pdf] 303KB
6. Sleep handout Sleep.leaflet.2.pdf [pdf] 791KB
7. Value based goal setting Value based goals and goal setting 2009 (w).pdf [pdf] 416KB
8. Relapse management Relapse & resource list.pdf [pdf] 622KB

Energy conservation
The following links contain energy conservation tips for a variety of daily tasks:
- Energy Conservation at Work.pdf 311KB
- Energy Conservation in Cleaning .pdf 515KB
- Energy Conservation in Gardening .pdf 446KB
- Energy Conservation in Infant Care pdf 427KB
- Energy Conservation in Laundry pdf 415KB
- Energy Conservation in Meal Preparation pdf 267KB
- Energy Conservation in Personal Care pdf483KB
- Energy Conservation in Shopping pdf 413KB
- Fatigue Management - energy conservation techniques.pdf 704KB

Relaxation
1. Relaxation introduction
2. Relaxation leaflet Relaxation leaflet 5th.pdf [pdf] 568KB
3. Breathing techniques Breathing Techniques for CFS Symptom Control.pdf [pdf] 510KB
Narrator:
Sit or lie down comfortably. Uncross your legs, and have your arms at your side. Take a couple of deep breaths in…and out…And on the out breath notice a sense of comfortable heaviness. It’s beginning in one hand and arm. Repeat to yourself: ‘My hand and arm are comfortably heavy. My hand and arm are comfortably heavy’.
And now allow your attention to pass to the other hand and arm, and repeat: ‘My hand and arm are comfortably heavy. Both my hands and arms are comfortably heavy’.
Again, taking more deep breaths now turn your attention to one of your lower limbs. Repeating to yourself: ‘My leg and foot are comfortably heavy. My leg and foot are comfortably heavy’. And now turn your attention to your other leg. Repeating to yourself: ‘My leg and foot are feeling comfortably heavy, my leg and foot are feeling comfortably heavy’.
‘My arms, legs, hands, and feet are comfortably heavy…and I am feeling quiet inside’. And now just spend a few moments mentally scanning the whole of your body for any signs of stress or tension, and should you find any just allow it to float up and away, to leave you with a sense of peacefulness and calm.
As you go deeper now…each easy breath relaxing you…calming you…you can be aware of how comfortable and peaceful you are becoming…as your body relaxes and your mind relaxes with it…all tension…all anxiety and fear just draining away now and calm filling your completely. I would like you to imagine that you are in a sailing boat, all alone, floating on a lake…all around are mountains, their steep sides covered with forests of pine trees…their peaks snow-capped. You have sailed to the very centre of the lake, enjoying the fresh crispness of the air and the scent of the pine forests carried on the breeze that drives the boat…filling the sails at a gentle but exhilarating pace…the splash and gurgle of the water as the boat cuts through the gentle swell…the creaking of the rigging and the crack of the sails as they fill with each gentle gust of air.
You can be aware of how good you feel…alone with your own thoughts…alone with the sounds of nature all around…a calm natural peace that knows no concerns or troubles…nothing disturbs that peace…nothing bothers you at all.
Now the wind drops to almost nothing…the sails flap limply as they empty of the wind that drives the boat forward…the surface of the water becomes calm…still…flat as a mill pond.
You feel the sun warming your skin…comfortably warm…soothing and relaxing you…the quiet surrounds you now, broken only by the gurgle of water beneath the hull…the faint sounds of bird-song…the occasional splash as a fish rises to take an insect…calm…peaceful tranquillity surrounds you and envelops you.
You lie down on a soft cushion on the bottom of the boat, unconcerned at the lack of wind…knowing that the engine is there in perfect working order when and if required. You look up at the crystal clarity of the blue sky…small clouds perfect and white hang above and around the tops of the mountains visible where you are so relaxed and comfortable.
The boat drifts…rising and falling with the almost non-existent swell…you are looking now at the very tip of the mast as it sways gently…it appears to touch the clear blue sky above…the air is so clean here…you can taste it and you feel the calm tranquillity…absorb that gentle peace…and you drift too with thoughts that are pleasant and calming…you breathe in peace and calm with every gentle breath…breathing out anxiety and stress.
Here you have time to reflect on those things that have caused you stress…you have time now to assess carefully and with a clarity never before available to you…the importance and the relevance of so many different things. You realise that you have fallen into a habit of reacting in a manner which has proved stressful for you. You resolve now to ignore the red flags and to calmly reflect and decide on the most peaceful and effective way to live your life…calmly…confidently…in control…knowing that you are in control of you and of your life.
Things that are stressful are so because we allow them so to be…and you are now that person who is aware that you do have the choice…you choose to be calm and unaffected by the rush and hurry…to make unhurried and calculated decisions that are the right ones for you and those who are important to you.
You can be aware now of the peace…the calm…the confidence that fills you…expanding within you…and you enjoy the stillness…the warmth of the sun…the subtle sounds of nature all around…the sights and the scents that can allow you to be aware of the larger world…the depth of water beneath you…the natural world at peace with itself…as all troubles and cares fade into unimportance…insignificance. You feel so much stronger now…aware that the strength comes from deep within you…it was there all the time…hidden for a time beneath turmoil and stress, but now no longer shrouded within a veil of negativity and lack of confidence, it shines through…and you recognise the strength that is yours and resolve now to use that which is yours to your highest benefit.
As the boat drifts you know that it can be so easy to allow the prevailing winds to take you wherever they will…but in your vessel you have the power when winds blow, to tack and to steer, using the winds as you choose to guide which is the right way for you…and you can have in reserve, too, that engine…that power which can mean to you that you have complete choice in the way you go…but it can be pleasant to drift…knowing that you can choose freedom…calm…confidence and you will, will you not?
If ever you feel burdened and stressed…you can choose to get into your boat and drift whenever you need to, whenever you want to…using the strength that is yours, and so growing stronger and stronger with every day.
Enjoy this wonderful sense of calm and peacefulness and then when you are ready, open your eyes slowly. Become aware of your surroundings and then slowly when you are ready sit up or stand….slowly move on with the rest of your day. Aware of the wonderful sense of calm within.
Narrator:
Sit or lie down comfortably. Uncross your legs, and have your arms at your side. Take a couple of deep breaths in…and out…And on the out breath notice a sense of comfortable heaviness. It’s beginning in one hand and arm. Repeat to yourself: ‘My hand and arm are comfortably heavy. My hand and arm are comfortably heavy’.
And now allow your attention to pass to the other hand and arm, and repeat: ‘My hand and arm are comfortably heavy. Both my hands and arms are comfortably heavy’.
Again, taking more deep breaths now turn your attention to one of your lower limbs. Repeating to yourself: ‘My leg and foot are comfortably heavy. My leg and foot are comfortably heavy’. And now turn your attention to your other leg. Repeating to yourself: ‘My leg and foot are feeling comfortably heavy, my leg and foot are feeling comfortably heavy’.
‘My arms, legs, hands, and feet are comfortably heavy…and I am feeling quiet inside’. And now just spend a few moments mentally scanning the whole of your body for any signs of stress or tension, and should you find any just allow it to float up and away, to leave you with a sense of peacefulness and calm.
As you go deeper now…each easy breath relaxing you…calming you…you can be aware of how comfortable and peaceful you are becoming…as your body relaxes and your mind relaxes with it…all tension…all anxiety and fear just draining away now and calm filling your completely. I would like you to imagine that you are in a sailing boat, all alone, floating on a lake…all around are mountains, their steep sides covered with forests of pine trees…their peaks snow-capped. You have sailed to the very centre of the lake, enjoying the fresh crispness of the air and the scent of the pine forests carried on the breeze that drives the boat…filling the sails at a gentle but exhilarating pace…the splash and gurgle of the water as the boat cuts through the gentle swell…the creaking of the rigging and the crack of the sails as they fill with each gentle gust of air.
You can be aware of how good you feel…alone with your own thoughts…alone with the sounds of nature all around…a calm natural peace that knows no concerns or troubles…nothing disturbs that peace…nothing bothers you at all.
Now the wind drops to almost nothing…the sails flap limply as they empty of the wind that drives the boat forward…the surface of the water becomes calm…still…flat as a mill pond.
You feel the sun warming your skin…comfortably warm…soothing and relaxing you…the quiet surrounds you now, broken only by the gurgle of water beneath the hull…the faint sounds of bird-song…the occasional splash as a fish rises to take an insect…calm…peaceful tranquillity surrounds you and envelops you.
You lie down on a soft cushion on the bottom of the boat, unconcerned at the lack of wind…knowing that the engine is there in perfect working order when and if required. You look up at the crystal clarity of the blue sky…small clouds perfect and white hang above and around the tops of the mountains visible where you are so relaxed and comfortable.
The boat drifts…rising and falling with the almost non-existent swell…you are looking now at the very tip of the mast as it sways gently…it appears to touch the clear blue sky above…the air is so clean here…you can taste it and you feel the calm tranquillity…absorb that gentle peace…and you drift too with thoughts that are pleasant and calming…you breathe in peace and calm with every gentle breath…breathing out anxiety and stress.
Here you have time to reflect on those things that have caused you stress…you have time now to assess carefully and with a clarity never before available to you…the importance and the relevance of so many different things. You realise that you have fallen into a habit of reacting in a manner which has proved stressful for you. You resolve now to ignore the red flags and to calmly reflect and decide on the most peaceful and effective way to live your life…calmly…confidently…in control…knowing that you are in control of you and of your life.
Things that are stressful are so because we allow them so to be…and you are now that person who is aware that you do have the choice…you choose to be calm and unaffected by the rush and hurry…to make unhurried and calculated decisions that are the right ones for you and those who are important to you.
You can be aware now of the peace…the calm…the confidence that fills you…expanding within you…and you enjoy the stillness…the warmth of the sun…the subtle sounds of nature all around…the sights and the scents that can allow you to be aware of the larger world…the depth of water beneath you…the natural world at peace with itself…as all troubles and cares fade into unimportance…insignificance. You feel so much stronger now…aware that the strength comes from deep within you…it was there all the time…hidden for a time beneath turmoil and stress, but now no longer shrouded within a veil of negativity and lack of confidence, it shines through…and you recognise the strength that is yours and resolve now to use that which is yours to your highest benefit.
As the boat drifts you know that it can be so easy to allow the prevailing winds to take you wherever they will…but in your vessel you have the power when winds blow, to tack and to steer, using the winds as you choose to guide which is the right way for you…and you can have in reserve, too, that engine…that power which can mean to you that you have complete choice in the way you go…but it can be pleasant to drift…knowing that you can choose freedom…calm…confidence and you will, will you not?
If ever you feel burdened and stressed…you can choose to get into your boat and drift whenever you need to, whenever you want to…using the strength that is yours, and so growing stronger and stronger with every day.
Enjoy this wonderful sense of calm and peacefulness and then when you are ready, open your eyes slowly. Become aware of your surroundings and then slowly when you are ready sit up or stand….slowly move on with the rest of your day. Aware of the wonderful sense of calm within.

Coping with the emotional impact of ME/CFS
1. Local psychological support services Local services contact sheet - AKH.pdf [pdf] 433KB
2. Mindfulness Mind Mindfulness Booklet.pdf [pdf] 466KB
3. Obstacles to making changes Obstacles to making changes.pdf [pdf] 464KB
4. Self-compassion Self compassion and ME.pdf [pdf] 412KB

Healthy eating
1. Diet Diet.pdf [pdf] 619KB
2 Nausea advice sheet Nausea general advice on diet.pdf [pdf] 594KB
3. Nutrition Nutrition.pdf [pdf] 281KB

Useful links
1. Post-viral fatigue: a guide to management BACME Post Viral Fatigue A Guide to Management May2020.pdf [pdf] 681KB
2. Flu jab advice Flu jab advice ME CFS.pdf [pdf] 292KB
3. ME/CFS Awareness ME Awareness Booklet.pdf [pdf] 719KB
4. Memory and Concentration Memory & Concentration.pdf [pdf] 370KB
5. Travel tips Travel recommendations KW.pdf [pdf] 402KB
6. Resources Additional Resources for FSS and Web 2020.pdf [pdf] 529KB
7. Advice for students Advice for Students with CFS.pdf [pdf] 274KB
8. Pregnancy ME _ pregnancy.pdf [pdf] 152KB
9. Work resources Work Resources & links.pdf [pdf] 462KB

Useful organisations
1. NICE guidelines myalgic-encephalomyelitis-or-encephalopathychronic-fatigue-syndrome-diagnosis-and-management-pdf-66143718094021.pdf [pdf] 539KB
2. ME/CFS Helplines file ME CFS Helplines.pdf [pdf] 563KB
3. Talking therapies in Surrey file Surrey-IAPT.pdf [pdf] 17MB
4. British Association of Clinicians in ME/CFS https://bacme.info/