Is neural/limbic retraining (DNRS) a treatment for ME/CFS or not?

[Wayne]

my voice is strong, my sense of humor mostly intact, and my energy level 'seems' fine.

Hi @hapl808 -- That sounds a lot like I was for many years. That's the case even today, though I'm better today than I was for many years, and can avoid most of the crashes I used to experience after little to no exertion at all. Mental PEM was almost worse than physical PEM.

I also realized I had been dismissive of people who had more severe conditions or different symptom clusters than I did.

I very much appreciated your entire post, but this comment stuck out for me. I too had been dismissive of my younger sister who also has ME, and I couldn't understand why she couldn't push herself to the degree I could, It wasn't until it took me 1-2 hrs to get from my bed to the bathroom in the mornings that I realized how difficult it can be for some people in ways we can barely comprehend.

 

[hapl808]

Mental PEM was almost worse than physical PEM.

For me it's definitely worse, partially because I just don't do much physical activity anymore. But I can't accept that there's no way to improve my mental PEM more. Seems impossible that enjoyable mental activity brings days of extreme physical symptoms.

I very much appreciated your entire post, but this comment stuck out for me.

Thanks. I also think about it a lot in relation to doctors. I couldn't even understand someone with more severe ME/CFS type symptoms when I myself was moderate. How do I expect a doctor to understand, let alone friends, loved ones, etc.

 

[ljimbo423]

I don't present like that at all - which is quite frustrating because even in a wheelchair my doctors think I'm fine because my voice is strong, my sense of humor mostly intact, and my energy level 'seems' fine.

Of course they don't understand the imminent PEM crash no matter how much I describe it. The stimulation of going to a doctor's appointment putting me in bed for a week or two seems incomprehensible to them, and really to me as well because I actually enjoy getting out of the house immensely and each time think maybe I'll avoid the crash…but I never do.

This is one of the cruelest things about this illness. It seems we get "punished" with PEM for enjoying ourselves. As I said above, I was severe for 6-8 years. I struggled to take a shower every 4-5 days. When I was in a significant flare, I would be unable to get something to eat, which was terrifying.

I remember laying in bed, wondering when I'd be able to eat. I rarely missed more than a meal or two at most, but I was never sure that would be the case.

This illness is a nightmare, even more so for those of us that are severely affected.

 

[Living Dead]

I've been doing it for almost 4 weeks and have very noticeable improvements in most or all of my worst symptoms. My pain has gone down significantly, my energy up noticeably, ear popping in my right ear is 99% gone. IBS has improved. I'm happier and have better focus and concentration, and I continue to improve.

I have been spending 2-3 hours a day doing his meditations, visualizations and Amygdala retraining exercise. I have a ME/CFS diagnosis by a doctor and fill the criteria of ME/CFS by the International Consensus Criteria.

I've had ME/CFS for 45 years. I got it when I was 17, and now am 62. I was severe for several years, but through diet and supplements, I was able to improve to the point where I can do several hours a day of light activities.

Thank you for sharing, it is reassuring that someone can improve after such a long time.

 

[JES]

I previously searched for DNRS and hit another conversation where I learned about Gupta. I made it through all of his free sessions and was hesitant to buy the series when I learned about Joe Dispenza. I bought and am making my way through one of his series and starting on reading Becoming Supernatural.

My takeaways, clearly our challenges are real, but even in cases of actual physical damage, there is energy greater than any pharmaceutical to be tapped to improve our condition. One of the challenges with chronic illnesses is that we mentally imprint and reinforce the illness through every fiber of our being, such that no amount of good food, nutriceuticals, drugs or stimulations can overcome it. We can, however, learn to release it. And there's data to prove it.

The Unlimited series I bought was worth every penny. This is the only real hope I've had for decades.

There is no good data for these methods. If there were, they would already be widely adopted by the healthcare systems because almost nothing is more cost-effective from service provider perspective than solving chronic illness with a few therapy sessions when you compare that against the money needed to come up with biomedical treatments.

While there may be some reinforcement of illness going on for a fraction of the people with ME/CFS, I don't think there is any evidence that is the maintaining factor for most of us. I have managed to "hack" my body to feel perfectly fine at times, which is evidence that this is not true at least in my case. Unfortunately all my remissions have been temporary and short-lived, but it's evidence that there is nothing in the mind going on preventing me from recovering.

Anyway, I hope you have some success with these programs. If you already went through the free sessions, do you feel like your condition has improved as a result now compared to before you started?

 

[YippeeKi YOW !!]

I have tried the Gupta programme. Do not buy unless you are sure you don't have ME/CFS. It is a treatment for normal burnout and health anxiety.

Limbic retraining is not a treatment for ME/CFS.

But the various purveyors of the many versions of DNRS will be happy to take your money anyway. Cause, you know, it's an ill wind that blows no good ....

 

[Artemisia]

I've been doing it for almost 4 weeks and have very noticeable improvements in most or all of my worst symptoms. My pain has gone down significantly, my energy up noticeably, ear popping in my right ear is 99% gone. IBS has improved. I'm happier and have better focus and concentration, and I continue to improve.
.

Is the program still helping you, about a month later? I hope you will update this thread as you hopefully continue to make progress! This gives me hope.

 

[mbunke]

It's been awhile since I posted anything, and I've learned a lot. A member reached out to me recently to ask more about my experience with brain retraining, and I wrote quite a bit of a response, so I thought I'd share it here as well in case it can be useful to anyone else!

Here it is:

After three years of trying many different ones, seeing what worked and what didn't, and talking with experts about the research, I have come to these conclusions, which I am always tweaking as I learn:

You do not need most of the stuff they teach you in DNRS and other programs. I say scrap the stuff that's upsetting you!! Your life is hard enough as it is! The intended purpose of the visualizations and "rounds" and all the hubbub (or at the very least, the thing that makes these WORK for some people) is that it gets you to start DOING slightly more than you're currently doing. That is what allows people to get better. Plain and simple. Let me explain.

This does NOT mean I'm suggesting simple "graded exercise." Normal Graded Exercise Therapy (GET) for ME/CFS usually can't account for the complexity of the illness, and can obviously make people worse because it can lead to them pushing themselves too hard. A better name for the practice we're aiming for might be Graded Exposure Therapy, which is what is used to abate anxiety. One of the biggest breakthrough I've had in getting better is recognizing that although CFS is not a psychological illness--it's very physical (obviously)--it is created and un-created the same way anxiety is. They are the same processes.

I'll tell a story to illustrate. A year and a half ago I was 27 and still mostly housebound and single with no friends in the area (I had to move from MN to TX where my parents lived when I became ill). So I had not left the house to interact with humans in a very long time. I decided I wanted to start practicing little ways to "dip my toes" in the dating and social world, in ways I could. So I got on dating apps and for about 3.5 months, all I did was chat with people online. Leaving the house to go on a date was WAY beyond my scope; I did not think I would get that far until I was much healthier, maaaany months or more likely years down the road.

But all that practice talking to people online gave me confidence over time, and eventually I did go out with someone. We met at a pub a quick 5 min drive from my house, and he had dated someone with ME/CFS, so it felt less scary if I needed to rush out because of a crash. But I did it! We chatted for 3 hours! No crash. This was completely new territory for me, I had not even thought about doing anything remotely close to this since getting sick. And here's what happened when I was at that pub:

My subconscious brain looked around at my surroundings, took in all the context of the situation--I am with a stranger, I am on a date, I'm in public, I'm without my backpack full of meds and emergency "crash" equipment, I drove here, I'm without my parents, etc.--and it took note of the state of my body, which was OKAY, no symptoms! And then it took notes on all of that, and changed its predictive coding just a little bit, because it realized, "We can do this apparently."

After that, I kept going out slightly more often for slightly longer and kept meeting more people and eventually ended up in a relationship that really pushed me forward because of the increased levels of activity that led to. I am doing better than I ever have since getting sick, and I have unlocked the process for how to get better: get myself out of my normal context, into a context where I am motivated to engage in new activities, and do this gradually, while resting in between so I don't push too hard.

Let's break this down:

1. Get out of your normal context: The problem with being in the same place all day every day (your house, your bed, or just A bed, etc.) is this: Your brain works based on predictive coding, MEANING, your brain is constantly creating and then updating its model of the environment. This is to create efficiency. If it treated every new bit of sensory input as completely new every time, you'd be overwhelmed. When something in the environment contradicts your mental model, your brain re-calculates and updates that model, which changes the way your brain (and therefore body) responds to the environment. When you stay in the same environment every single day with the same patterns, you fail to give your brain the opportunity to challenge its assumption that "exertion always leads to crashing."

2. Get into a context where you are motivated to engage in activities that are slightly outside your envelope: My story would not have turned out well if I had not been motivated to start dating. My thought was, "I'm 27, I never leave the house, if I don't get on these apps now, I might never get the chance at having a family." I was very motivated. What's more, when I met someone I liked, I was very motivated to hang out with them in person--romantic attraction is a super strong motivator! This will be one of the most challenging things you've ever done, because it will not come without its ups and downs and crashes and adjustments--so you need to find something you're very motivated to do. For me it was getting in a relationship. Now I'm focusing on career goals and sports. Maybe for you it's swimming; maybe it's cooking. Whatever it is, it needs to have a physical aspect. (If you're motivated to do computer programming, that won't help as much because you can still do it in bed without doing anything physical. Doing physical activity is what your nervous system believes is dangerous, challenging it with physical activity is the only way to change its predictive coding.)

3. Go gradually and rest in between: Some people can take big leaps. Most people can't. Go slow, listen to your body, but not so much that you're in total submission to it. Rather than seeing how my body FEELS, a good rule of thumb for me is asking myself, "Have I been doing a lot these past few days or mostly laying low?" If I've been doing a lot and my body feels shitty, I'll rest. If my body still feels shitty but I haven't really done much, I'll say, "Okay time to violate my brains expectations!" And I'll go do something. For you, maybe you start as slow as sitting on the edge of your bed for a few minutes. You want to challenge yourself to go slightly outside your normal envelope, and then rest. Keep doing that until your envelope has increased, and then take the next step. If you're extra sensitive due to Covid right now, go extra gently.

The good news is, you don't need visualizations or memories to do any of this! The reason these things work for some people who do these programs is because they believe so strongly that the process they've been taught will work, that their new confidence allows them to try new things and put themselves in new situations that they would have previously avoided. Avoidance is the best way to stay exactly where you are, or even get worse.

You just need motivation. Find that thing that motivates you.

 

[frozenborderline]

I'll tell a story to illustrate. A year and a half ago I was 27 and still mostly housebound and single with no friends in the area (I had to move from MN to TX where my parents lived when I became ill). So I had not left the house to interact with humans in a very long time. I decided I wanted to start practicing little ways to "dip my toes" in the dating and social world, in ways I could. So I got on dating apps and for about 3.5 months, all I did was chat with people online. Leaving the house to go on a date was WAY beyond my scope; I did not think I would get that far until I was much healthier, maaaany months or more likely years down the road.

But all that practice talking to people online gave me confidence over time, and eventually I did go out with someone. We met at a pub a quick 5 min drive from my house, and he had dated someone with ME/CFS, so it felt less scary if I needed to rush out because of a crash. But I did it! We chatted for 3 hours! No crash. This was completely new territory for me, I had not even thought about doing anything remotely close to this since getting sick. And here's what happened when I was at that pub:

My subconscious brain looked around at my surroundings, took in all the context of the situation--I am with a stranger, I am on a date, I'm in public, I'm without my backpack full of meds and emergency "crash" equipment, I drove here, I'm without my parents, etc.--and it took note of the state of my body, which was OKAY, no symptoms! And then it took notes on all of that, and changed its predictive coding just a little bit, because it realized, "We can do this apparently."

After that, I kept going out slightly more often for slightly longer and kept meeting more people and eventually ended up in a relationship that really pushed me forward because of the increased levels of activity that led to. I am doing better than I ever have since getting sick, and I have unlocked the process for how to get better: get myself out of my normal context, into a context where I am motivated to engage in new activities, and do this gradually, while resting in between so I don't push too hard.

Let's break this down:

1. Get out of your normal context: The problem with being in the same place all day every day (your house, your bed, or just A bed, etc.) is this: Your brain works based on predictive coding, MEANING, your brain is constantly creating and then updating its model of the environment. This is to create efficiency. If it treated every new bit of sensory input as completely new every time, you'd be overwhelmed. When something in the environment contradicts your mental model, your brain re-calculates and updates that model, which changes the way your brain (and therefore body) responds to the environment. When you stay in the same environment every single day with the same patterns, you fail to give your brain the opportunity to challenge its assumption that "exertion always leads to crashing."

This just sounds like you were doing unintentional mold or toxin avoidance. I can absolutely do more activity in areas with clean air , but it has nothing to do with predictive coding or dnrs principles.

I would agree people should try different contexts but with the caveat that they should do it based on things like good air etc. Probably would widen many people's energy envelope.

 

[frozenborderline]

Avoidance is the best way to stay exactly where you are, or even

Sounds like victim blaming likemost dnrs stuff. No me/cfs doctors have ever told me its the fault of Amy behavior that made or keeps me sick. There's no scientific evidence for any dnrs stuff. Anecdotal only. Now I agree anecdotes are the first step in science and with enough promising anecdotes we should eventually study a given treatment , but given the existing etiokogical theories of me/cfs dnrs would be low on the list. It also seems like the existing anecdotes are possibly biased due to the sort of pyramid scheme structure of the companies. We can never ask for scientific evidence or much detail about how this works in the context of me/cfs or proof the limbic system is a major driver of me/cfs, but we have to actually buy the course and try it out before dismissing it... Sounds like a good way to dismiss criticism or dismiss people asking for proof.

 

[Revel]

You just need motivation. Find that thing that motivates you.

Ouch! ME/CFS has robbed me of many things, but "motivation" to be well again certainly isn't one of them!

This reminds me of when my POTS consultant wanted to refer me for GET at the local "fatigue clinic". I expressed my reservations based on the known harm GET can cause pwME. He replied "Well, it won't work if you don't believe in it".

Every potential treatment I have tried so far has been undertaken with a belief that it might help. That's why so many of us continue to "self experiment". So far, for me, all to no avail. I guess these days I'm looking for more proof than scientifically unverified hope.

 

[frozenborderline]

Ouch! ME/CFS has robbed me of many things, but "motivation" to be well again certainly isn't one of them!

This reminds me of when my POTS consultant wanted to refer me for GET at the local "fatigue clinic". I expressed my reservations based on the known harm GET can cause pwME. He replied "Well, it won't work if you don't believe in it".

Every potential treatment I have tried so far has been undertaken with a belief that it might help. That's why so many of us continue to "self experiment". So far, for me, all to no avail. I guess these days I'm looking for more proof than scientifically unverified hope.

So much this. When I think of me/cfs patients and their experiments and attempts to get well, I think of sisyphean , huge attempts and struggles upstream against all odds... when they occasionallywork, like some type of biohacjing or niche treatment that's great, but they often fail and it's through no lack of will. Maybe there are lazy me/cfs patients but I haven't meant them. We are all working too hard to get well if anything .

 

[frozenborderline]

The OP may tbink what I posted is too harsh. Maybe the OP may think or say that it's unfair to say anecdotal evidence isn't enough when we use anecdotal evidence for justifying trying other treatments ., like supplements or things like that.

I tbink the difference is that the risks of supplements and drugs are widely known and also that there is at least more theory why many of these drugs or supplements may work. If someone has pots and takes fluodrocortisone this is maybe not fda approved treatment but it's based on very simple theory , that many people with pots and me/cfs have low blood volume, borne out by much research.
Proponents of psych treatments or , sorry, "neuro retraining " treat these treatments as if they are totally lacking in side effects.
This is actually a problem in the field of psychology in general. Even therapy for people who need it can have side effects. Meditation can have side effects and Buddhists know this.
The worst thing of all that I see proponents of brain retraining do is suggest a) that people with me/cfs avoid activity because of fear based conditioned responses, and not bc it is bad for their body... nobody would dare do that to a congestive heart failure person avoiding activity bc it makes them sicker... and b)psychoanalyze their opponents in online conversations, often to destabilize their sense of self since we are often insecure due to stigma about our illness , using things like suggesting our distrust of these treatments is bc of defensiveness that is psychologically pathological. This is common, even if OP hadn't done b) in the conversation so far, which is nice, OP had certainly done a), which I'm not sure if crosses a line rule wise but is certainly unethical.

There is no evidence, anecdotal or other, that me/cfs patients try any less hard to get better than people with any other illness. If anything many of us push ourselves thru insane regimens of research, don't pace ourselves, don't sleep enough, all in pursuit of a cure. Or for those of us who decide pacing is more effective than doing research on other types of treatments and biohacking , they pace meticulously, meditate , and do all sorts of stress reduction things... I've seen no evidence this illness is perpetuated by catastrophizing or behavioral and mental patterns

Now I will say, finally, that some people may be helped by dnrs. A very small amount of people. Less thsn are helped by mold avoidance., which is already considered controversial to some. Less than are helped by surgery or vitamins or saline infusions. But some people. Maybe these people spontaneously remitted. Maybe they didn't have me/cfs but had a rare functional disorder. However I don't want to focus in number two since we can't know and I'd like to extent the courtesy I'd like to be extended of not being psychoanalyzed. So number 3, they are accidentally doing mold avoidance and don't know it. One of the prominent UK pro wessely cfs people , actually had been going to all these nature areas and doing more activity and saying he's mostly cured , by increasing his activity. I think he just accidentally did mold avoidance. Mold isn't just visible stuff in people's houses. It's in outdoor air , and it's shorthand for a nasty brew of stuff in various indoor and outdoor areas that makes people very sick but also can be in one area and then not be in an area that's very close by ... it changes quickly. So there...

 

[frozenborderline]

Get into a context where you are motivated to engage in activities that are slightly outside your envelope: My story would not have turned out well if I had not been motivated to start dating. My thought was, "I'm 27, I never leave the house, if I don't get on these apps now, I might never get the chance at having a family." I was very motivated. What's more, when I met someone I liked, I was very motivated to hang out with them in person--romantic attraction is a super strong motivator! This will be one of the most challenging things you've ever done, because it will not come without its ups and downs and crashes and adjustments--so you need to find something you're very motivated to do. For me it was getting in a relationship. Now I'm focusing on career goals and sports. Maybe for you it's swimming; maybe it's cooking. Whatever it is, it needs to have a physical aspect. (If you're motivated to do computer programming, that won't help as much because you can still do it in bed without doing anything physical. Doing physical activity is what your nervous system believes is dangerous, challenging it with physical activity is the only way to change its predictive coding.)

Do you think pwME are not generally motivated to get better?
How do you explain people recovering from physical treatments or having tests , like abnormal mris and a abnormal tryptase, histamine, immunoglobulins levels, two day exercise tests being abnormal, mitochondrial function being ab.ormal ? Are these all things with the simple explanation of limbic system affecting rhem all? Stress affects every disease but what makes you think this works for me/cfs and not, say, MS or a mito disease.. both have physical findings

Do you think it's possible you had a different illness tban others on this board given how dissimilar your experience is?

 

[Iknovate]

@mbunke

Your sharing of your experience was heartfelt and helpful. Take confidence in that.

As I tried that journey briefly, I took different paths, just to get me to survive new challenges (returning to part-time work after COVID).

What I learned from my journey is the healing benefit of being recognized for your talents and efforts and even your own pride of accomplishment in taking steps forward.

In further discovering the unusual, I've found (with real data from my monitor), that a shower and dressing looks like a marathon, but I can teach a low impact exercise class 3x/week and it barely registers. But many of the people in my class have tremendous physical challenges and they continue to report how much they are helped by the class.

I think there's just something to finding meaningful purpose.

 

[GlassCannonLife]

Do you think pwME are not generally motivated to get better?
How do you explain people recovering from physical treatments or having tests , like abnormal mris and a abnormal tryptase, histamine, immunoglobulins levels, two day exercise tests being abnormal, mitochondrial function being ab.ormal ? Are these all things with the simple explanation of limbic system affecting rhem all? Stress affects every disease but what makes you think this works for me/cfs and not, say, MS or a mito disease.. both have physical findings

Do you think it's possible you had a different illness tban others on this board given how dissimilar your experience is?

@Martin aka paused||M.E. mentioned he knew a girl with really bad markers who was very sick (not sure if as bad as him? But severe IIRC) that recovered to mild using DNRS.

I find it all very interesting, if you look at those rat studies with the amygdala (I think in this thread?) it all makes a lot of sense. It's more like why don't we all respond to it?

It seems that there's a certain amount of stressors that have to be overcome and then the brain is ready to improve gradually or something? And it's impossible to know how many stressors one can take while remaining health vs someone else - prior to flicking into the ME state that is.

How can something like Abilify fix very severe people within weeks to massively higher capacities..? It also doesn't address mitochondrial issues or infections etc.. There's something weird there that we just haven't been able to figure out I think.

 

[YippeeKi YOW !!]

How can something like Abilify fix very severe people within weeks to massively higher capacities..?

The problem with the Stanford experiments with small doses of Abilify is that it seems to work ..... until it doesn't.

Not much has been heard recently from the handful of members who were benefited early-on in their experimentation with Abilify ....

 

[GlassCannonLife]

The problem with the Stanford experiments with small doses of Abilify is that it seems to work ..... until it doesn't.

Not much has been heard recently from the handful of members who were benefited early-on in their experimentation with Abilify ....

Yeah true, most lose the benefit. But why can it overcome all of the problems we have to such an extent? It's like the ME switch is different for everyone (how much stress needed to set it off) and you can somewhat manipulate it external to the amount of stressors.

Eg are there people with worse infections, heavy metal toxicity, etc than what we have, who don't have ME?

And are there pwME that only have very minor problems but have ME? And they can cure it by fixing the small problem, vs others who might have many problems along with a higher level of stress required to trigger the state.

All really interesting; I guess we'll find out when I'm 80 (if I make it that long) and there's finally enough research funding to learn something.

 

[Wayne]

Avoidance is the best way to stay exactly where you are, or even get worse.

Sounds like victim blaming likemost dnrs stuff.

Hi @frozenborderline -- I can see why you might think it's victim blaming, but I would respectfully disagree. I interpret what @mbunke is saying as being similar to one of my own adages; "If you keep doing what you're doing, you'll keep getting what you're getting". In other words, it pays to "mix things up now and then".

I often try to do something different, no matter how small or seemingly inconsequential. This can be anything from what I eat, what I watch or read, how I feel about certain things, etc. Perhaps even using my opposite hand to do something I usually do with my primary hand.

In my mind, any new thing we bring into our lives has the potential to shift things. These shifts are usually pretty small and modest, but some can be significant. And sometimes a lot of little things can end up adding up to something far bigger.

To me, this is all part of being creative, which I think is an important spiritual quality that can serve us well in addressing our challenging health situations. I really do think that when we start trying something different, no matter how small, it gives "Spirit" an opportunity to step in and be of assistance. Sort of like the old adage, "God helps those who help themselves".

But I also think it's vital that we heed intuitive warnings of when "enough is enough". If we're getting a strong sense that we're in a time where we should be doing little to nothing, and letting ourselves regroup before venturing into new areas of life, then we should absolutely do that. I try to stay away from absolutes, and feel remaining flexible is another aspect of creativity. In other words, at all times, it's important we be true to ourselves.

 

[YippeeKi YOW !!]

Hi @frozenborderline -- I can see why you might think it's victim blaming, but I would respectfully disagree.

In an unusual departure from my general ongoing agreement with you, I have to side with @frozenborderline here.

One of the basic tenets of many of these predatory programs (i.e., The Gupta Program, Lightning Process (sometimes referred to as Lightning Program), ANS brain retraining, Recovery Norway, the Chrysalis Effect, The Switch, and DNRS (dynamic neural retraining systems) is that, if they fail you, it's your fault. You didnt work them hard enough, you didnt do them right, you didn't follow instructions, you didnt believe in them enough to allow them to do their work. Which obviates the promise of a " ....full refund ..." if they fail to help, improve, or cure you, because it wasn't the product that failed, it was the user ....

In my mind, any new thing we bring into our lives has the potential to shift things.

I agree. But there's a difference between an organic, well-thought out small personal change, like using your non-dominant hand to do something that you usually use your dominant hand for or making a determined effort to improve some small, almost seemingly insignificant part of your life with a new supplement, and forking over several hundred dollars for a pre-packaged, one-size-fits-all program that's often just a clever rehash of previous versions of the same thing, with a few new bells and whistles and some spiffy new promises.

I have a deeply ingrained aversion for, and general loathing of, the oleaginous, ingratiating snake oil salesmen who seek out the sick, the vulnerable, and the desperate as targets for their own financial benefit, while nimbly dancing away from any potential repercussions of their vacated promises ....

Often, all we have to keep us going thru the rougher spots is hope, and once that's been crushed by a failure that's pinned directly on us, on our own frailty, on our own inabilities, and not the product, we've lost one of the most valuable allies we have in enduring, improving, and surviving this miasmic little ass-kicker of an illness ...

And sometimes a lot of little things can end up adding up to something far bigger.

I agree. I've been preaching the value of the 10% for, like, EVER .... it was my husband DB who, after watching me beat my head bloody as I tried to drag myself out of over 5 years of bedbound hell in any way I could, would gently push at me, reminding me not to reject the 10% improvement just because it wasn't 75 or 100%.

It's important to keep looking for the 10%, and to keep building on that. But when you have to pay for 100% in that pursuit, your balance sheet is eventually going to sink you ....