Chronic illness - a view from the other side

Physiotherapists regularly interact with patients who have a range of illnesses and conditions and thus are, arguably, more aware than the general population of both the preciousness and fragility of good health. However, personal experience of illness can reveal the shallowness of that knowledge. We, the authors of this Editorial, are physiotherapists from disparate areas of practice, with chronic, non-life threatening illnesses (chronic fatigue syndrome and seronegative spondyloarthropathy respectively) that have had life changing effects. We are at quite different stages of our illnesses – one of us has been ill for over 16 years and has experienced periods of improvement after a variety of interventions, followed by prolonged plateaus, while the other is at a comparatively early stage with a less clear clinical pattern. We met as a result of these illnesses and, while we do not claim to have had unique or special experiences, or to be experts in chronic illness, our experiences and reactions to them have been very similar and we share some common symptoms, including fatigue and musculoskeletal pain, that fluctuate from day to day. This Editorial provides some personal insights into the impact of chronic illness and how we have learnt to cope with our conditions. These insights may be relevant to the way you interact with patients in your professional practice, or they may resonate with you personally now or in the future. Remember, you too could end up viewing chronic illness from the other side. In our experience, the development of an illness is accompanied initially by a period of physical and emotional chaos. We have found that learning to cope with and accept chaos is important as we have often revisited this period of crisis during recurrent or unexpected relapses. Once the initial turmoil had passed and our illnesses had taken on an element of chronicity, learning to manage the condition effectively became an ongoing, challenging, and essential process. We needed to develop and continue to look for strategies to cope both with flare ups and our baseline levels of impairment. To assist in the development of our coping strategies we used personal resources, medical and other health practitioners, and family and friends. We found, particularly in the early stages of illness, that the need for consultation with various medical professionals contributed to our feelings of bewilderment, especially if differing and conflicting diagnoses and treatment options were given. A supportive general practitioner who was able to provide some consistency and orchestrate referrals and management was very important. Although such conflicts did not happen frequently, we found it particularly frustrating when health practitioners dismissed or ignored signs or symptoms because they did not fit the usual pattern of presentation, at times seeming almost to ‘blame’ us for this. We certainly preferred it when those we consulted were open-minded, non-judgemental, and curious, acknowledging the limitations of medical knowledge and understanding. Not