 So, how many people here were at the Sweden Conference? Okay, you're allowed to leave for half an hour, because I'm going to repeat myself. This is the talk that I gave in Sweden, because after, and it was pretty short orders, we did this research project with no money, all volunteer, and we tried to make it as scientifically valid as possible, and the people involved with it were myself and Tamara Russell from King's College, and I recruited a statistician from Stony Brook University who was a wizard. But here's the fibromyalgia, being a muscular pain problem, and it affects about 2% of the population, and women are nine times more likely to have it than men. But the reason it was chosen for this topic was because the symptoms of fibromyalgia match the benefits of flotation, the perfect match, and also because at the moment fibromyalgia is very poorly understood, many doctors don't even believe it exists, and they treat the patients that way too, rolling their eyes, and so the only treatments that they have are pain meds, and the other is that I had seen fibromyalgia patients respond very well to this technique. Now here you see the benefits of flotation and the symptoms and characteristics of fibromyalgia. So both fibromyalgia has a strong link to stress, and some believe that it begins with some stressful or traumatic event, and stress triggers the pain episodes. It's muscle pain, it's characterized by trigger points throughout the body, which are little muscle knots, very painful. It's linked, and this is why many doctors think that it's a psychosomatic, it's linked, one of the symptoms is depression and anxiety. So these aren't happy people, and one of the characteristics is that they cannot get restful sleep. Interesting thing is that they don't really sleep that much less, but it's not restful to them. And there's one study that I came across that said that people with fibromyalgia have a deficiency of magnesium. So these all correspond really nicely to what they can get out of flotation. So that's why we picked it, and we had people, this was the study. So we was in five different countries. In Germany, Netherlands, the United Kingdom and the United States, there was one flotation center in each one. In Sweden, there were several. Unfortunately, because of the data collection, we don't know how many. But this is the data we got. This was all paper, pencil, the people were given, we translated the questionnaires and they were given questionnaires before and after, each asking them about these particular symptoms. How much pain they had, how much they were bothered by pain, how much, how their muscle tension, how the freedom of movement, how stressed they felt, how much energy they had, their level of sadness, their well-being, relaxation, and how much anxiousness they had. This was on a scale of zero to ten. And they checked off how they felt before each session and how they felt after each session. So these, the research questions that we were asking were, was there an immediate effect of the intervention? Meaning did these symptoms change when they floated for an hour? Were there any longer term, we floated each one three times, remember. So was there any longer term change? Did it change over time or did it stay the same? And was there any interaction between them? Meaning that over time did they tend to have more effect or did they have less effect as they went on? Now, the results were that without exception, the immediate interventions were highly significant. Now, significance is measured mostly by statistical test, which gives you the probability that this is just by chance. And it's considered significant if it's less, the chance is less than 0.05, right? That's the level. It's preferable to have less than 0.01 as we go on. I'm telling this because we're going to show you how significant these things were. With a couple of exceptions, energy, well-being, and relaxation were the exceptions, there were changes over time so that from session to session, their pre-scores got less each time or they changed in the positive direction depending on which it was. It was well-being increased. And the last one was the interaction, the magnitude of the change that occurred over time did not significantly change except for a couple of the ones, muscle tension, stress, and relaxation, became less pronounced as time went on. So, let's look at the data. Here's the pain. Now, the way it's set up here is that here's your pain estimate on the left-hand side and then each float has a pre- and a post. So, one and two measurement times are ones before the float, ones after the float. So, you can see it nicely that there was an effect for each float. It had about the same amount. If we look down here, the pre-to-post change, that's for all three sessions, was less than 0.001, which is pretty extraordinary. The other changes were a little less. There was no difference in... They were always getting the same amount of change as it went on. Bothered by pain is measured separately because people can report pain and it doesn't bother them. So, these people, it's about the same. Pain bothers them. And the results are pretty much the same. Muscle tension. Here it's pretty much the same except for you have significance in the pre-to-post difference in the very bottom one. It's less than 0.05 anyway. But I think it's because we're bottoming out here. We're getting to... How free of tension can you get? We're getting down to the limit. Ease of movement, this is important for people with fibromyalgia because the pain restricts their movement and sometimes it completely disables them. And so, again, it's getting better with each one. The feeling stressed. Again, we have... I think we may be reaching the limits because you have less effect as it goes on with each one. But it gets better each time. Here's one where you don't see a lot of change. There is change and it is significant, they're not getting a boost in their energy. Yeah. Between each one, they were floating once a week. Right after they floated. Yeah. So they would fill out the form before and right after they floated. Sadness. Also very significant. So we're working on the depression part there. The opposite of that, well-being. We're getting a nice improvement. Interesting that we don't have them progressing up quite as much, it's not significant. From the pre-tests, from one pre-test to the next pre-test. They're getting more relaxed. This is actually supposed to go up to 10, so we're not really topping out on this one, but that's as relaxed as they're getting. The amount of anxiety also. Okay, so those are the main measures. We looked to see, one of the things that we had originally in designing the study, I had made up an audio program which was designed to be listened to while they floated with some pain reduction suggestions on it. It was in English, we put it up so that the script and all the music that was in the background were available, but nobody translated it. Remember we were doing it with five different countries, only two of them speak English, so it wasn't used in the non-English speaking countries. So we wanted to know, was there any difference between countries in terms of, and while there was some difference between countries, it was still all very significant in terms of having the effect for each float session. Now, we had 81 subjects in this who participated, but not all 81 stuck with it. We had some dropouts. Nine of them only did the first session. Seven did sessions one and two, and 65 did all three. So then the question was, okay, maybe the people who dropped out weren't getting anything out of it. So we looked at that. And the blue ones are the ones who only did it once, and you can see they had a significant effect from it. The yellow ones did it twice, and they also had a significant effect, but the interesting thing there is that the yellow ones didn't get the longer-term reduction. They were getting a benefit from it, but they weren't getting a long-term benefit. So there wasn't a difference. It wasn't because they weren't getting something out of it. They were getting something out of it. Another way to look at the data is more personal to look at what people said. And just looking at some of the comments because they were given a chance to make comments on how they felt afterwards, and this was recorded at the beginning of the next session so that they could say how things had gone afterwards. So the sleep was better, better able to relax, felt balanced. I'm not going to read them all because you can read them. Can you? Better concentration because I'm not bothered by pain anymore. There's a second German participant. I just sampled a few of them. It's an interesting first comment, feeling so much of a burden to your family and then finally being able to go back and participating in the family after a float, after one float. Oh, and these were set up so that float one, float two, float three, these were when they were taken. This person felt more tired afterwards, which is often the case. But when relaxation can make you feel really tired, if you've been running on pure stress energy and just keeping yourself going, you relax, you're exhausted. Here we're into the Netherlands and here at the bottom. If I am floating to cure long-term pain, I will have to float more than three times. And that is, I think, very true. So it doesn't always make you feel better. Now, one of the things that we also measured in was sleep. But we had some problems with sleep. Part of it was my fault in the wording of the questions. My statistician pointed out to me that I was not consistent in the wording of the question from the initial evaluation when everybody filled out a form at the beginning and the later one was asking in general how much do you sleep and it doesn't compare to how much did you sleep last week or how many hours. So it's not quite as valid because we needed to rephrase the words. Here's the wording of the questions that differed. How many hours of sleep do you get on an average night versus how many hours did you sleep the night after float? And he said, that's not valid. You can't have, because when people say, when people respond to a question on average, they don't give you the same answer when it's specific about this particular instance. So he said, you have to change that. And we've done that for the next stage. But anyway, the results still showed this is sleep duration. So that with the follow-ups, baseline on how much they sleep, they were asleep. And you can see that they're sleeping a reasonable amount of time. This isn't hours. This is almost seven hours. There was an increase in how much they were sleeping. But we also measured the quality. And that also increased. But we can't say that with great confidence because of the way it was worded. But sleep, one of the symptoms, we had to wait to measure that afterwards. So this study shows some compelling evidence that that flotation can produce significant temporary relief to symptoms of fibromyalgia. The findings were consistent. They're robust across all 10 of the variables. So in addition, they experienced increase that the effects lasted over time. The carryover of the variables moved progressively in the direction of improvement. And the amount of improvement was the same for each flotation session. So naturally, this raises the question, what would happen if we went longer? Well, so looking back at fibromyalgia, the current thinking about fibromyalgia is that it's a central mechanism in the brain where there's a oversensitization to pain, that a trauma or some stressful event or an illness has made this person more susceptible to pain, giving them a lower pain threshold. Now, in addition, another hypothesis comes out of the magnesium literature that the deficiency of magnesium changes the way your nerves respond, that they'll respond to less stimulation. They're more sensitive, they're hypersensitive. So you may have both going on. You may have a brain mechanism going on, and you may have a nerve problem going on. So the question is, would it be possible to reset this? You know, the thing with pain, you have a pain sensation, and what happens when you feel pain? Well, there's an increase in your arousal level. It's how they, I'll tell you a story, I used to work in prison, and I was teaching. And one of the things my students taught me was how do you overcome a lie detector test? You know, a lie detector test measures how aroused you feel at any particular time, the amount of stress you're under, and they said, all you have to do is create some pain for yourself when they ask you the questions that they know the answers to. They would either stick a needle under their thumbnail and then just touch it every time or they would jab their heel of their shoe into their ankle to create pain when they ask them what's your name, you can tell them your name, and the machine's going wild like you're telling a lie. So when we feel pain, we have an increase in arousal. And that increase in arousal causes an increased perception of pain. With fibromyalgia, you have the pain, the stimulus of pain, an increase of arousal, which is probably more because they're over-sensitized, and then an even vastly greater increase in the perception of pain. So if you compare the pain experience with a decrease in arousal repeatedly, then hypothetically we should be able to create a decreased perception of pain and in this way reset this sensitivity. Now, so I just finished proposing this in Sweden when this woman got up after me, Mark Freckle had arranged for this woman to come from England and tell her story. Now I'll read this one because it's pretty small. This woman named Tina Graham got up and she said I could use her name, and she gave her a story which was that she was chronically tired, bedridden much of the time and suffered pain that felt like body-wide bruising. It hurt to have one touch her. She was depressed, anxious, unable to work and continually stressed about providing for her two sons. The doctors of the National Health Service could not tell her what was wrong with her. She went to a rheumatologist outside of the system and was diagnosed with fibromyalgia and chronic fatigue syndrome. And it was linked to a car accident that she'd had in 1998. Fibromyalgia led to Tina losing her friends, her job, her ability to enjoy her life. She had to consider her physical condition at all times and try to adjust her life to it. Always anticipating some new symptom, new pain, or flare up of the familiar pains. She was taking a prescribed cocktail of diazepam, neproxine, ibuprofen, tramadol, and fentanyl patches. But even this was not able to control the searing pain that she had. After she nearly overdosed on fentanyl, she decided she would go visit some friends who lived in Phoenix, Arizona, and there was a flotation tank nearby and she was studying for a doctorate in psychology. And she was interested in relaxation in states of healing. So she'd read about flotation and she went at 43 years old. She tried her first float and described it as being like stepping into a warmth that was hard to describe. I felt held, secure, safe, enveloped and surrounded by this wonderful water that was so good to feel against my painful body. I had immediate relief and no breakthrough pain for 17 hours after my first float. After that, she tried to do it every two weeks. But sometimes it was hard because the nearest one was 55 miles away. After seven floats, she estimated that her pain was reduced by about 90%. And if she were able to float more regularly, she thought she'd be down to nothing because the relief seemed to be cumulative. With each float, she experienced progressively deeper relaxation as well as longer lasting pain relief. Gradually, she was able to hang on to this relaxed feeling and return to her normal life. She finished working on finishing her PhD. I don't know if she's done that yet. And then Anu, is Anu here? After Tina, Anu who runs a float center in Sweden, she said that one of her patients, Bergita, had done the same thing, that she had gone through the three floats of the fibromyalgia project. And she liked it so much that she continued. Now, she was diagnosed with fibromyalgia at the age of 45 and had much pain for many years before that, before she was diagnosed. The pain was in her neck, shoulders, legs, and back. And she frequently suffered from dizziness and had very little energy. She tried all kinds of treatments. Some of the things that had helped her were physical therapy and warm baths and exercise. When she entered this study, she was 70. And she felt such an increase in pain relief and in mood relief that she felt better in her body and her soul. She says at age 72, she's floating once a month and will continue to do so as long as it keeps her feeling so good. It's not completely gone, but it's significantly less as she's had many days without pain. So a couple of examples of people who have been able to carry it on longer. So this was the impetus to say, okay, let's do it for longer. And let's do it in the same format because we still don't have any money to do it. So we've created, we want to do larger numbers. We had 81 down to 65 who completed the whole study, which is pretty good for a flotation study. That's a lot. We want larger because this is not a controlled, randomized study, where you can really say to get the scientific community and the medical community to perk up and say, oh, look at that. But if we could come up with a few hundred people from all over the world, and give them longer times of doing it. So we created this website, and this is thanks to Graham and Ian. The website is up and it's functioning. And so the whole research will be based on the web so that you at your center can participate in this. It's designed so that people, if a fibromyalgia sufferer comes across it and we want to get them the word of this, they can register. It'll help them find your center. You can register. You've got to meet certain criteria. One of those criteria is we want them to float ten times. And so we're asking you to give them the first four floats for free. After that, you can choose, but for the next six, you can charge them 50% of what you usually charge. So we're asking something from everybody. This person is supposed to give their data, and the data will be collected on the website. After that, what you charge is, you can go back to your normal rates, but these people are likely to be long-term users of flotation because it keeps them functioning. And with this, oh, so the way that it will work, people will sign up for it. There's a number of steps to go through. They have to get clearance from their doctor. So there's a form on the form that they have to get their doctor to sign off, which makes us know that this person does, indeed, have diagnosis of fibromyalgia. And it also informs the doctor about flotation, which is part of what we wanted to do. This is for PR in the medical community. We want the doctors to know about this. So that's part of the reason for signing off, but also because we want to know this person really has fibromyalgia. And then all the forms. We're trying to maintain privacy on this. So the person doesn't give their name in to the website. They get a code. They get a code number, and the flotation center gets a code number. And whenever they fill out their stuff before and after a float, both codes have to be present so that we know that this person actually had the float. You can't just fill it out from home so that we know that. There's a few tweaks that we're going to have to do in this yet, but it is up and running. So we're looking for 10 treatments. The weight list control, this is still up in the air, thinking about because it's going to take some time for people to get their doctors sign off on this, that we use each person as their own weight list so that while they're waiting to start the flotation, that they fill out the symptom checklist each week so that we allow them to do that for four weeks in a row. They're their own controls. We're trying to make sure we have scientific validity on this thing. So as much as we can in this kind of clinical study. And then if at any time anybody drops out and this is something that was missing from the last study, we don't know why they dropped out. We didn't have a questionnaire for termination. So this time we will. Whether they go through the whole thing, we ask them questions, or whether they drop out sometime earlier. And that's something that we can ask them. They don't need both codes. They can do that from home. So things to talk about. The privacy, I think we've got pretty well covered, is scientific validity. Someone mentioned from Manhattan. Sorry, are you here? What's your first name again? Rob. Rob mentioned utilizing a standardized activity function test, which I think is great for the initial, so that we've got using some standardized forms in addition to just these scales for symptoms that will help with scientific validity. The other part with the controls, you know, we can only go so far and how much we can ask people to do. But we're trying to get as much scientific validity as possible. Whether there's any other variables, we should look at translations. Now we need to have this translated. You saw the map of Europe and how many flotation centers there are there. Well, we've got Otto and Benjamin here to help us get with the German and with the Swedish, you know, there's the Netherlands. So we're going to reach out to have this website translated into as many languages as possible so that people can do it all over the world. So what we also need to discuss and from you is how to outreach this, how to reach out to fibromyalgia associations and let them know about it, perhaps even get them to link to this particular website and reaching out to your community to let people know that this is a possibility.