A Different Approach to Fibromyalgia
“The effects of not getting good blood flow to your brain, joints and muscles?…. Fibromyalgia” – Vital Motion
Erik Hiester D.O., is not your ordinary doctor. He’s an interesting blend of engineer and doctor. Hiester’s first love was biomedical engineering (B.S. and M.S.). Wanting more contact with patients, he became a Doctor of Osteopathic Medicine. After encountering so many people in pain during his family practice residency, he took another left turn and became probably the first biomedical engineer and family practice physician to receive a fellowship in interventional pain medicine at Emory.
Has a bioengineer / doctor created something that could help FM, POTS, ME/CFS and others?
Then he put it all together to help produce a machine he believes could help people with fibromyalgia and others with pain, fatigue and other symptoms. The machine resulted from a bit of the serendipity which leavens so much of science. One of Hiester’s neighbors, a bioengineer, had developed a device which increases the circulation in the body. He planned to use it for osteoporosis but Hiester, overwhelmed with the many FM patients he was seeing, saw an opportunity in fibromyalgia.
After a trial produced good results the team was expanded, the Vital Motion company was borne, the device was improved, patents were registered, and the FDA approved it as a Class I Medical Device. Last year, Vital Motion’s Hummingbird Machine won a Production Innovation Award from Frost and Sullivan.
The Exercise Conundrum in Fibromyalgia and ME/CFS
Exercise is important for cardiovascular health, cognition, mood and pain relief but how to get the benefits of exercise without getting hammered has been one of the great questions for many people with FM, ME/CFS and allied disorders. When even mild activity can bring pain, how to get the blood flowing without producing a symptom flare?
The Hummingbird appears to be able to increase blood flows across the body while sitting down.
Vital Motion may have found a way. Their Hummingbird machine triggers a reflex that gets the blood flowing in the lower and perhaps even the upper body – while you’re sitting down. It presents the possibility of getting some of the benefits of exercising while not actually exercising.
Instead of pounding away to get one’s blood flowing during what, to be honest, is going to be a very limited walk anyway (and is likely going to leave one in pain), Vital Motion’s Hummingbird device purports to gets the blood and fluids in your body moving without your ever leaving your chair.
Activating “The Second Heart”
The device – which one plugs in and then steps on with the front of your foot – produces a vibration detected by sensors on the front of foot called Meissner’s Corpuscles. This in turn activates something called the postural reflex arc at the front of the foot.
That reflex then stimulates the soleus muscle in the calf which plays an important enough role in our circulation as to sometimes be called “the second heart”. Activation of that soleus muscle returns pooled blood and interstitial fluid back into the circulatory system, increasing blood flow to the body and hopefully reducing symptoms.
Put your foot on the machine while sitting and it does the rest.
Plantar stimulation may sound like science fiction, but the medical literature suggests it may work. Back in 2005, plantar stimulation was shown to increase both peripheral and system circulation. Calf muscle pump stimulation substantially improved sleep in one small study. It reversed the resting tachycardia that eleven women experienced after 20 minutes of sitting. It’s been shown to increase blood flows in the legs, and it reversed the blood pooling in the legs of almost 50% of women in one study.
The Hummingbird is somewhat similar to the Avacen 100 device developed for fibromyalgia which uses microprocessors and heat to enhance microcirculation of the hands and hopefully the rest of the body. Both machines attempt to improve the circulation, increase oxygen delivery, reduce sympathetic nervous system activation and relieve pain.
Fibromyalgia Study
“Without a specific therapeutic agent for disorders like fibromyalgia, this device offers a reasonable way to improve a patient’s daily life,” Dr. Charles Lapp, creator of the Hunter Hopkins Center in North Carolina.
One small, unblinded fibromyalgia study in 2014 using an older, prototype device involved 23 patients with moderate FM. Thirteen dropped out (six because of increased pain, four because of time concerns; others for a variety of reasons). The increase in pain appeared to occur in sicker FM patients who couldn’t tolerate the vibration of the older, more primitive device. (The new device uses a smartphone app which allows one to control the amount of vibration present.)
For sicker patients, Dr. Hiester starts lower and goes slower. I’ve communicated with a couple of people who have negative results – one whom had VERY negative results. I suggest that everyone not use the default setting but start quite a bit lower, try it out for only a few minutes at first, and only then, if everything is OK, slowly increase the setting. The physical sensation I had is of a low/medium vibration on the bottom of my feet.
Dr. Hiester reports that the adverse events that occur early usually resolve themselves as the body gets adjusted to new circulation.
The results suggested that some of the dropouts may have really missed something. Over 12 weeks, the ten participants reported a 33% improvement in symptoms – equal to moving them from the moderate case of FM to a mild case – plus a patient reported outcome study showed an almost 60% increase in activity.
A statistical analysis suggested that longer may be better with the Hummingbird. The more a person used the device, the better they did. Given that some people in the study only used it five minutes a day, the results were encouraging, indeed. (A minimum of 15 minutes twice a day is suggested and 30 minutes twice a day is probably optimal.) If you get the device, give it some time; it may take up to 6 weeks before you see benefits.
Hiester reported that his own anecdotal experience suggests that up to 75 – 80 % of FM patients are getting relief. As some people use it for hours a day without negative effects, the potential for side effects – except for the very hypersensitive – appears to be low.
Interestingly, the study also found the FM patients exhibited low diastolic blood pressure while sitting – a sign of reduced blood flow to the tissues. (Anecdotal reports suggest that lower blood pressure may be common in ME/CFS as well. ) The fact that the low blood pressure levels were positively correlated with symptoms suggested that the Hummingbird’s ability to induce small elevations in blood pressure may be helping.
Cindy Leyland, an editor at Prohealth and person with fibromyalgia reported on her experience with the Hummingbird. It was not a cure – it’s not supposed to be – but it did help.
The results are truly quite amazing. I still have insomnia, fatigue and pain. But I find my overall wellness improved, with less life interruption because of pain and fatigue, and I credit the Hummingbird with some of that improvement. I will continue my flight with this Bird.
POTS / ME/CFS / Dysautonomia and Others
The Hummingbird was developed for use in fibromyalgia but it’s hard to believe that if it works, it wouldn’t also help out in chronic fatigue syndrome (ME/CFS), postural orthostatic tachycardia syndrome (POTS) and other allied diseases. The evidence rests on the notion that problems with the circulation in the lower body are impeding blood flows back to the heart, brain and tissues.
From the Vital Motion Website
Fibromyalgia Device for Pain Relief | The Hummingbird by Vital Motion
That problem – which is called reduced preload – is precisely what Dr. David Systrom found in a large study of people with idiopathic exercise intolerance. This group, which includes people with ME/CFS, FM, POTS and others who have difficulty exercising but have no detectable heart issues, have been a mystery. Systrom’s invasive exercise tests suggest that circulatory problems that prevent sufficient venous return of blood to the heart are one cause.
The insufficient venous return results in blood pooling in the lower body which then causes in a reduction of blood flows to the heart, brain and muscles – potentially accounting for some of the problems with exercise, gut issues and cognition found in these diseases.
Vital Motion is primarily marketing the Hummingbird to FM patients, but if it works in FM, it’s hard to believe that it will not be helpful for people with ME/CFS/POTS. (Those with other circulatory problems such as diabetes, peripheral neuropathy and the elderly might conceivably benefit as well.) The University of Tennessee is assessing the Hummingbird’s effectiveness in chronic pain patients.
I wondered about the bedbound. Getting the blood flowing better seems like a great idea for the bedbound. I asked Dr. Hiester if the Hummingbird could provide enough of a boost to help people to move more without relapsing. No studies have been done but Hiester thought it might be possible.
Cost-Effective
Compare the potential cost-effectiveness of devices like this, which, if they work, require only one-time purchase (not covered by insurance) with drugs and their never-ending costs.
The device is not a cure but used consistently it appears to have the potential to ameliorate the symptoms in FM/ME/CFS, POTS, etc. while the search for the cure goes on.
Note that if you have uncontrolled blood pressure (UBT) or deep vein thrombosis, this machine, since it can elevate blood pressure a bit, is not for you. If, on the other hand, if you have FM and/or related diseases, particularly if you experience dizziness or low blood pressure, the Hummingbird might be worth trying.
Getting the Hummingbird
The Hummingbird sells for $395 (or $495 with a package which includes a Fitbit 2). It comes with a risk-free guarantee. Pay for it now and if it doesn’t produce results over the next 45 days, return the device and get your money back with no restocking fee.
Find our more about purchasing it here.I f you have questions they have a chat feature and a phone number ( (888) 885-6686.
If you use this coupon code – HealthRising – you can get $25 off.
The Vital Motion website states that 75% of those buying the device have kept it.
I haven’t tried the Hummingbird yet but both I, with my ME/CFS/FM/MCS, and my partner, with her ME/CFS and POTS, are going to try it. The Hummingbird and Dr. Heister were introduced to me by Nancy McGrory Richardson, a long-time ME/CFS supporter, whom I trust and have known for years.
Health Rising is not affiliated with Vital Motion and does not receive benefits from the sale of the device.
Enhancing Blood Volume
Enhancing blood volume is another way to increase blood circulation in these diseases. Find out ways to do that in Enhancing Blood Volume for Chronic Fatigue Syndrome (ME/CFS), POTS and Orthostatic Intolerance found in Health Rising’s resource section.
How does this differ from using a Chi machine, please?
I had never heard of a Chi machine and looked it up.
https://en.wikipedia.org/wiki/Chi_Machine
https://smile.amazon.com/Daiwa-Felicity-Original-Exerciser-
From what I can tell they both attempt to do the same thing – increase circulation in the legs (and hopefully elsewhere)- but they do it differently. The Chi machine uses wave-like motions at the ankles to do that (while you are lying down) while the Hummingbird uses a specific frequency to activate a reflex which then activates the calf muscles while you’re sitting.
We currently have a Confidence Fitness whole body vibration plate trainer machine which seems to be based on the same basic principles. The cost is about $50 less than the Hummingbird but the Hummingbird might be easier to use, particularly if you suffer from bouts of dizziness, because you’re sitting when using the Hummingbird instead of standing on the vibration plate as with the Confidence Fitness. The Hummingbird might also alleviate PEM symptoms from standing on the vibration plate. Thinking of trying it.
Interesting all these different devices that are attempting to increase circulation! I had no idea.
If I’m reading it right the Confidence Trainer does appear to be trying to activate the same reflex as the Hummingbird but in a slightly different way.
https://www.amazon.com/Confidence-Fitness-Vibration-Platform-Machine/dp/B00COGQ9IK
Confidence Trainer – The vibration plate creates a high frequency vibration which causes a stretch reflex within the body. The Frequency Range 50-60Hz.
Hummingbird – maybe because it’s being offered as a medical device it has a more specific range. From the website:
https://www.vitalmotion.com/how-it-works/
“The Hummingbird is actually FAR more than just a vibrator on your feet. Clinical studies show that the stimulation must meet certain key criteria in order to activate the “calf muscle pump”—which reverses the pooling of fluids in the body: 1) correct frequency (44 Hertz); 2) correct amplitude (30-70 microns); and 3) proper positioning. You can find those details by reading the scientific studies on which we created The Hummingbird.”
Thanks for the detailed information, Cort.
I’ve an oscillating machine that is supposed to do something similar, but given how tiny my home is and that it’s a stand-up machine, I’ve nowhere to put it where I’d remember to do it. Also, standing for that long is difficult. If I’m ever well enough to stand on it for long, I’d do it for lymph movement alone.
Hummingbird isn’t sold in the UK. I’ve purchased a Revitive and am giving that a try. The handbook at least identifies what is considered a low range.
Vibration machines of any sort, even the ones you use lying down, trigger a post exertional malaise crash in me, so the Confidence Fitness wouldn’t work for me. Even passive muscle movements from a TENS unit cause a crash. So for me, something which increases circulation without working the muscles would be preferable.
I have the same problem. Any muscle movement causes not only PEM-but can easily cause me to ‘crash’ for extended lengths of times. But I have been bedridden for over 8 years now, and am scared of strokes, etc.
My Doctors in my Southern State are not knowledgeable about Fibro, ME or POTS. Add to that-I began having back surgeries at age 13 for severe scoliosis. Correction for scoliosis was not good in the 60’s and early 70’s. I am completely fused from my neck to my sacrum. I became sick with Fibro and ME after my 14 hour surgery to try to correct a quickly failing spine in 1998.
My current doctors don’t take me being bedridden seriously at all !?! It’s all up to me to figure out what to do.
I wonder if my insurance would cover all/any of this device? Does anyone have any experience with this? Thank you ??
I used a vibrating machine you stand on, many regular folks swore it helped them, but it made me get sicker every time. Anything which moves lymph and muscle in this body makes me sicker. Acupuncture, only a few needles tolerated. Massage, just five minutes.
Still tempting to try this
The good news is that you can get your money back if it doesn’t work.
I used a vibrating machine you stand on, many regular folks swore it helped them, but it made me get sicker every time. Anything which moves lymph and muscle in this body makes me sicker. Acupuncture, only a few needles tolerated. Massage, just five minutes.
Still tempting to try this as we still want to believe we can improve, if I owned it, and was very careful deploying….
At first, I thought a TENS machine was a miracle because using it settled my system so nicely. Otherwise, at times I can feel like I’ve got my finger stuck in a low voltage outlet. But eventually I had the same problem you had. I’m glad I had the awareness to see the problem because it can be tempting to use the “solution” to fix the problem the “solution” created. The relief of a few days wasn’t worth the consequences.
I have found relief and able to walk again. I go to a swimming pool 3 or more times a week. The water helps so much, people don’t have to swim just being in the water helps circulation
Yes, indeed. Probably the best exercise for ME/CFS and FM.
Unless you crash every time you attempt pool exercise. I feel wonderful in the pool, but even doing a session with my ME literate physical therapist, I still ended up with severe PEN.
Yes. Even the pool can be too much. Totally recognize that.
Janet, Water’s amazing but a pool can be hard to come by. Especially if you have severe fatigue. Just the shower afterwards, never mind the trip there and back is a big turn off for me. Plus this seems different somehow than aerobic exercise.
I noticed that quite a few people said if used without distraction it is almost meditative and many said it is quite relaxing. People seem to actually look forward to using it because they feel good during and after.
I’m not a sales rep, lol! I just read a lot of reviews on Facebook.
I wonder how us with HyperPOTS and higher blood pressure that may also have to thick blood, Reducing smooth blood flow and volume…..if this would help? Movement of my legs, for sure helps. I fidget all the time. Not that I’m nervous, but movement helps – both sitting and standing.
I have a chi machine and it definitely increase blood flow and makes your legs feel great. It also gives a sense of energy to the body and the mind.
I use a shake plate with infrared, at my gym, and that too is a huge benefit. That also helps improve lymph drainage. Initially you may have a detox response with this. And because its rather warm and you have to stand, could trigger mast cell. But going low and slow is a big help.
Issie
I use a vibrio plate to help with muscle tone and circulation and Slendertone for muscle tone in abs and upper arms. This seems like a gentler version of a vibro plate.
It’s amazing all these different possibilities (that I never heard of :)) Thanks for sharing.
Pricey apparatus. I’ve been using support stockings, some even have a little style to them. The swelling in my legs has gone down and my energy levels have gone up. Way less cash.
I had been considering giving the Hummingbird a try – now I’m going for it. It is pricey but if it works even moderately it will be worth it. Thanks for the discount code Cort.
Good luck! You do have a 45 day risk free window to return it if it doesn’t work out 🙂
Can patients with a spinal cord stimulator use the hummingbird? Is it strictly vibration?
I used to have a High Tech Health circulation booster which I used to use throughout the day. I’m guessing it would be similar? They also did socks which attached to a battery pack.
And in hospital I found the air compression leg massagers very soothing.
The High Tech seems to be attempting to do something similar. Looking at the specs it has, if I’m reading it right, a more widely defined frequency range – 1-50 Hz. The Hummingbird has only one frequency – 44Hz with a specific amplitude amplitude (30-70 microns)( whatever the heck that means…:)) – https://www.vitalmotion.com/how-it-works/
I have recently begun treatments for OI, andother ME/CFS issues with Theresa Dowell, FNP. The OI (or POTS) leg compression and sipping salt water all day do make a difference! I have osteoporosis, and am mostly bedbound, and tried a Marodyne Liv device. It is very low intensity, and seemed the only potentially effective treatment for my bones. But, I am one of those highly sensitive types, and after weeks of trying to cope, I had to return it. 🙁 I think it would be great for most people.
So I read at the begninning of the article, that the initial target was osteoporosis patients? I wonder if the Hummingbird will also help them as well? It would be great to use it sitting down. Standing for a while is hard, but was necessary for the whole body to benefit for osteoporosis. Now that I am finding some help with circulation, perhaps I will be able to walk a little again… and the Hummingbird might get me there — IF it isn’t too strong a vibration for my nerves, sensory overload and FM. How long will the sale and discount code be available? Thanks Cort, as always.
Hi Denise, I’ve looked into the “Liv” device also for benefit to my bones (I have osteopenia and am only 42) and being bedbound most of the time. Could you tell me what happened, why you couldn’t tolerate it? I’m very sensitive also. Thanks!
Is there anywhere in Canada where this device can be purchased?
would it be also for severelly ill ME/cfs patients that are 98% bedridden?
Just putting my feet on it for 5 minites?
Does somebody know that?
Also I have heard that such devices do not need such enourmous tests like for medication by the FDA. I do not know if that is true?
Or is this device more for FM patients? Or less severe cases of cfs?
In my experience lying too long flat does cause as much or more blood flow and pooling problems in the brain compared to the legs. And I am not even bedridden so I can shift to sitting or standing a bit when desired.
Reducing pooling in the legs when lying down and staying that way (or only able to alter position for a very short time) may yield hard to predict results, it will alter blood flow and pooling body wide.
Without the ability to sit or at the very least lie raised this should improved blood flow to the brain but when the returning capillaries and arteries do not improve fast enough that may cause worse blood pooling in the brain and hence higher CBF pressure.
On the other hand, this device may have a trickle down effect to blood flow in the rest of the body and slowly improve the return of blood from the brain. But that could take weeks to months IF it worked out that way. Therefore:
So for bedridden patients at the very least I would go *very slow*, way below 5 minutes at first, observe a lot and increase time very slowly. Just my 5 cents.
I tried to order the device but they don’t ship to Europe yet.
I have used the Hummingbird for about 4 or 5 months now. It has been astounding how much better I have felt. I used this in tandem with compression stockings. The two things together is what makes this work for me. No more oral rehydration for me though. My quality of life is so much higher. I can plan for things now and know that I’ll usually be able to make it. Now, when I have an off day, I know it might just be for a day instead of weeks or months in bed. I have some sort of dysregulation of the autonomic system…whether I have POTS or orthostatic intolerance, I’m not sure. I just know that I failed the TILT table test when my heart rate dropped 40 beats, not my blood pressure.
I started off with the smallest amount of vibration for 10 or 15 minutes and worked my way up in time and to the maximum vibration. I also started off doing it three times a day. I can go twice a day, but have found once a day is not enough. Some days I need to go three times a day. I have been able to interrupt a really bad day where I feel like all I can do is lay flat by getting my feet on the Hummingbird. Most times that really awfully sick feeling goes away after about 20 minutes. Once in a while, it will make me feel better, but still feel I need a day in be. The investment is well worth the return. I still use a mobility scooter to leave my home, but maybe there’ll be a time when I can use it less.
I am quite a believer we FM/ME patients do have our share of circulation problems. Part of my improvement is by trying to improve my blood flow, but due to physical circulation exercises.
For me, I believe it provides part of the benefits of exercise with less of the downsides of exercise and do experience it as such. So this device certainly has similarities with what works for me.
I however also believe that our bodies try to cut back circulation on purpose in order to avoid extensive (inflammatory) damage. At the very least I tried a more forceful approach before, trying to boost my circulation a lot, and that did cause a large flare up of symptoms every single time I tried to do this.
I come to believe that part of the success I have with circulation exercises is because I improve the conditions for more *appropriate* blood flow rather then by increasing blood flow. In my case I believe that is reducing tension in my muscles and reducing stiffness of blood vessels by doing these very small series of circulation exercises. Then the body can better adapt (increase and/or lower) blood flow to specific requirements.
So for those caring about potential side effects I would suggest:
* Start really slow.
* Listen to your body. Getting worse at first may be a sign of detox / Herx reaction, but while getting from about 5% to 25% of functionality I never needed a Herx reaction once. Starting slow and upping slow produces IMO as much or more results but with lower risk and fewer side effects.
* I would consider any increase in stiffness, local leg pain and a changed mental status (not in the positive sense) to be warning signs.
@Cort: maybe it could be good to also create a page on the forum for people who buy and try this device to share their experiences both short and long term. Having a link to such page now may increase people reporting results. Often people having no or moderately beneficial results don’t report having tried it, which is really a shame to estimate the potential of a new approach. Only people reporting very good or very bad results is too inaccurate.
Hi dejurgen,
Could you give a quick overview of the circulation exercises that work for you?
Many thanks 🙂
I have 2 classes of circulation exercises that do work for me:
* exercises improving circulation of the legs with some attention to the feet, much to the lower legs and some to the upper legs. These also have an indirect influence on much of the abdomen area.
=> I WON’T give a description of the actual exercises as they have to be done well and in a certain order if they are to benefit you. Any experienced physical therapist willing to take your limitations into account should be able to provide you with those. Just cut the initial intensity and amount a lot even if they take your weakened situation into account and work up from there.
* for me the most important (probably more so for ME then FM): gentle circulation exercises dealing with the neck, shoulders and upper back. I’m working on ideas why circulation exercise on this region do far more then just improve oxygen and nutrient supply to the brain. More on that later.
-> Again I WON’T detail exact exercises. Doing them wrong may damage key nerves in the neck. Again, any good physical therapist listening to your limitations can help you with that.
* I tried circulation exercises of the hands and arms, but those are less important to me.
The exact type of circulation exercise is not that important IMO. It’s the region they focus on, having them done in a good sequence to optimize results plus the lack of intensity and numbers done that counts.
With “having them done in a good sequence” I mean that some exercise shift pooling blood from A to B, some from B to C, some from C to the hart. You don’t just do them in random order.
With lack of intensity I do mean: do ask your therapist the ones with the very least intensity he knows, even if others are more effective. Cut even then the suggested numbers. Better do a few tiny series spread over the day then one more intense series. Then see where you go from there.
Note: my PT easily adapted the leg exercises to be lying down. It is possible for the neck IMO but not convenient if not needed as a mattress restrains movement.
It is not unwillingness to explicitly not state what the exercises are exactly but my strong believe doing so rather then pointing patients to a good PT with the information I gave would be harmful. It doesn’t require a precise set of exercises, just a systematic set for this two regions and going very very slow and easy at first. More is NOT better. Pain is NOT a sign you are doing well. Listen to your body. Having other particular problems may make things that are good for me harmful for you and reverse. That is another reason to not state specific exercises.
I hope this helps. I’m also writing on my “Me current improvement” series on the blog, but things go slower then I wish. There I won’t go into detail of what exact exercises I do for the same reason however.
Note to cost: I do talk about a few sessions with a PT learning you the basics, not a few sessions a week forever.
If it works out well you can decide to return and learn to be more efficient at it as I did, but that is no requirement.
As towards “doing exercises wrong” let me give this example:
As a young guy I read about the advantages of belly breathing in a book. That appealed to me and looked simple enough so I decided to give it a go. After half a year of regular training I got the hang of it. Or so I believed.
Reality was I had nearly no control over my diaphragm for more then two decades thereafter while I mainly used belly breathing as my method of breathing. I just had developed a sort of “contradictional breathing” where one movement countered the other making breathing effort high and efficiency low.
The funny thing is it may have been even a bit more efficient then how I was breathing before that. But it certainly was far of the breathing efficiency I get now. If I would have had my current breathing technique two decades ago my health may have evolved quite differently.
Now breathing took me a year of practicing and a meeting with my PT every 2 to 4 weeks, just for getting only a single breathing technique wright. That was a lot more difficult to me then the circulation exercises.
With what I know now is that learning to belly breath from a book probably didn’t work for me as it did not took into account the very poor state of my gut. My brain probably blocked many sorts of movement in that region due to the high amount of pain and damage when doing so.
Apparently there is quite some work available on the effect of neck/shoulder/chest muscle on brain blood flow and brain to body nerve compression. Getting the wright search terms to find out is often the major bottleneck to know it even exists.
The first 1.5 pages of working-well.org/articles/pdf/rsi_related.pdf provide a good overview. It starts by saying “In this article we will discuss Repetitive Strain Injuries that affect both the nerves and circulation.”
Also en.wikipedia.org/wiki/Thoracic_outlet_syndrome provides some good quality information. “Thoracic outlet syndrome (TOS) is a condition in which there is compression of the nerves, arteries, or veins in the passageway from the lower neck to the armpit.[1] There are three main types: neurogenic, venous, and arterial.”
Most sources consider the effect of poor blood flow on the limbs and arms, but when searching further some go more into detail on brain blood flow. Problems with that seem to be deemed more rare, but it is associated with:
* sometimes being caused by whiplash; common initial onset cause for FM and ME.
* in very severe cases: can cause passing out (reduced consciousness more extreme then in ME) or in compression of the brain stem.
There seems to be recent indications that plenty ME patients have brain stem compression:
forums.phoenixrising.me/index.php?threads/20-patients-now-found-positive-for-cci-aai-there-must-be-many-more.62893/page-2#post-1026789
http://www.mechanicalbasis.org/
IMO compression of brain to neck veins should also be a mechanical cause of increased CBF pressure, also a common thing in ME/FM:
http://www.healthrising.org/forums/threads/the-link-between-idiopathic-intracranial-hypertension-fibromyalgia-and-chronic-fatigue-syndrome.6101/#post-34698
http://www.healthrising.org/forums/threads/is-it-a-common-symptom-to-stop-breathing.6110/#post-34721
As FM an ME patients are known for very often having tense muscle and quite likely muscle inflammation creating further local pressure and also have plenty of pain spread throughout the body increase risk of poor posture we have plenty of chance to stack this muscle based compression of blood vessels and nerves on top of our already chemically (lack of NO) constricted vessels and on top of poor blood flow to the brain due to combined poor blood volume and poor cardiac output.
I believe furthermore that poor blood flow between brain and body messes up the entire bodies temperature regulation, leaving the brain too hot exacerbating brain inflammation (too few cooling of the brain) and cold limbs and poor muscle biochemistry due to cold limbs (too few heat transferred from brain to body plus need to keep blood temperature sufficiently low in order to sufficiently cool the brain despite poor blood volumes).
=> So I truly think circulation exercises in this area can benefit plenty of us.
=> Despite this I am very reluctant to give an overview on the exact type of exercises I do. When reading the above links it will be clear what types of severe damage doing these exercises wrong can do. Good PT instruction can avoid plenty of harm, even if it is but a few sessions.
=> When seeing examples a few days ago how ridiculously high medical costs are in the US I can understand the desire for free online tutorials. I tried and looked to see if I can find a good quality online tutorial that is fitted for *most, not all* FM/ME patients. Despite many of them being better then whatever I can write down, I haven’t found one yet I deem sufficiently safe to just post online. Helping 5 against risking to damaging 1 is not good enough for me. I’ll keep an eye out.
This sounds similar to EECP, enhanced external counterpulsation. My cardiologist had me do the treatment for dysautonomia but I read on the Onward through the Fog blog that it was part of Dr. Enlander’s protocol for MECFS:
EECP Treatment: EECP (enhanced external counter pulsation) therapy is an outpatient treatment used to improve blood circulation and increase cardiac output. It is normally used for angina and heart failure. In ME/CFS the treatment sessions are 30-45 minutes and are given once a week. During the treatment, the patient lies on a comfortable treatment table with large blood pressure-like cuffs wrapped around the legs and buttocks. These cuffs inflate and deflate continuously at specific times between heartbeats, a continuous electrocardiogram (EKG) set the timing so the cuffs inflate while the heart is at rest, in diastole, when it normally gets its supply of blood and oxygen. The cuffs deflate at the end of that rest period, just before the next heartbeat, systole. When timed correctly, this will decrease the afterload that the heart has to pump against, and increase the preload that fills the heart, increasing the cardiac output.
Sounds really interesting. Definitely want to increase preload…Did it help?
I’ve found taking small amounts of Sildenafil (aka Viagra) helps open up the small capillaries in the peripheral areas like arms fingers legs feet. The drug also increases blood flow in the brain, improvement cognitive impairment (my subjective opinion only).
I break a 100mg pill into 5 = 20mg and take 5 times a day.
It worked better for me than isosorbide mononitrate.
I would prefer Cialis due to its 36 hour action, but unfortunately that’s still under patent and is too expensive.
I also take a slow release low dose aspirin to thin the blood and propranolol to stop the heart unnecessarily exerting itself.
Plus I wear grade 3 medical compression tights. And drink heaps of water.
But all that said, the best improvement was either (or both) from the 16/8 fasting or taking ibuprofen immediately after any exertion that I thought would trigger a PEM relapse. And taking it (to the recommended directions) for 24 hours after over exerting (that includes social and cognitive exertion)
During the fast period a gastric surgeon recommended I take Omeprazole (aka Prilosec and Losec) with any NSAID like ibuprofen if taking it without food as omeprazole protects the stomach from bleeding that NSAIDs can cause
Really interesting. A UCLA professor years ago had a Viagra study going on ME/CFS in hopes that it would boost blood flows and oxygen levels but it was apparently never completed. Thanks for the suggestion with Ibuprofen. Check out some more PEM/Flare busters here – https://www.healthrising.org/forums/resources/crash-flare-busters-for-chronic-fatigue-syndrome-and-fibromyalgia.391/
20 years ago my heels started cracking till they bled. I started taking Gingko biloba to expand the capillaries, 1200mg. It worked, I still take it.
My small intestine has permanent damage: scarring and ulcers, from ibuprofen use. Plus I have chronic bleeding from the small bowel and need iron infusions ever 6 weeks. Small bowel injury is at least as common as stomach bleeding as a result of NSAID use but it is much less well known. This is because the small bowel can’t be seen with normal GI endoscopy studies, either from above or below. However, studies show that even a single dose of an NSAID increases small intestine permeability (a sign of injury). Omeprazole and other proton-pump inhibitors don’t prevent this injury, and they may actually exacerbate it. Unfortunately, I knew nothing of this in the months I took I max dose ibuprofen around the clock, with omeprazole to prevent stomach irritation. I miss the ibuprofen. For a while I switched to celecoxib, thinking it would be less prone to causing small bowel damage (as a study suggested), but I ended up needing blood transfusions because of my (not visible but persistent) bleeding from the gut. My blood loss has slowed after over a year off of all NDAIDs, but it’s still happening. So, I feel compelled to warn others about this little known devastating effect of NSAIDs.
I had quite a lot of rectal bleeding in the past. A colonoscopy did not reveal the origin. I have been low on NSAID use all my life but I did take some. So our problems are probably different in origin.
However I did find that diet was the cause of it in my case. It’s part of how I discovered I have plenty of food sensitivities and what they are.
If I leave out fructose, FODMAPs and many fiber rich vegies (some are perfectly OK) and gluten containing grains (wheat, rye… even when a gluten intolerance test shows up negative, maybe it’s the FODMAPS in them) that my stool normalizes and rectal bleeding ends.
In my case I have to be low on fructose but also make sure I eat no single meal with more fructose then glucose in it (fructose malabsorption?). With bread I do tolerate organic spelt wheat bread made with sour dough fairly well but not perfectly well. Spelt wheat has similar properties to wheat but to a lesser extent. Sour dough bread is known to be often easier to digest then yeast bread.
It took however quite some time to achieve so. A few weeks for bleeding to become rare, a few months for it to be gone. Stool is getting close to normal in about half a year time now but still needs lots of tweaking diet. Hope it might be of some help.
Perhaps you could try turmeric instead of an NSAID to lessen PEM. It seems to work for me to some extent.
Thank you Vlynx, I’ll look into it. I’m surprised to hear the Omeprazole is problematic as my friend who is a gastric surgeon suggested I take it when I told him how well ibuprofen stops the PEM flare ups. Maybe he’s been brainwashed by big pharma.
I think I’ll ask another doctor about it. And investigate further.
Also thank you Cort for the flare up link
Another alert about NSAID’s and other anti-inflammatories!
I have asthma and it is triggered by several things, among them, anti-inflammatories.
I tried Turmeric as it was a ‘natural’ anti inflammatory. I ended up on steroids as the asthma reaction was just as bad and it took me a while to realise what was causing it!
Now I have to avoid ALL anti-inflammatories, whether medicine or natural. I even had to give up my favourite chai as it was full of anti-inflammatory spices such as ginger, pepper, nutmeg etc. A tiny bit in a baked egg custard is OK, but not regular consumption.
I’m currently wondering about other anti-inflammatory foods such as blueberries, which I eat every day. I have low level asthma symptoms still since a chest infection in early January. So I may need to cut them out, at least for a while. 🙁
So this is a warning – just because something is natural, doesn’t mean it will be without side effects.
A glass (1,2 or 3) of (red) wine everyday could also help for many patiënts if you can tolerate alcohol. There is a subgroup of patiënts who feel complete normal after drinking wine. That is also very interesting. We know alcohol is not good for the longer term but drugs too.
I can tolerate a few glasses of wine once in a while too. One should be fine every day.
When healthy I loved a good glass of wine and would open up a bottle. Now I never feel the desire to drink alcohol anymore but appreciate a glass or two if someone opens a good bottle. Just like before alcohol does cause some fatigue, but in the sleepiness sense rather then exhaustion.
There are a few interesting properties of alcohol:
* Some studies find that moderate consumption of alcohol protects against IBS. That’s close to protecting the gut. IMO that could be due to the fact that bacteria use chemicals like alcohol, acetic acid, lactic acid… to reduce growth of competing bacteria that have their growth slowed down by those products.
* Red wine contains a fair amount of anti-oxidants.
* Some researchers believe much of the toxicity of alcohol is due to alcohol being converted to too much NADH too fast (non mitochondria process). As we lack NADH production it could offer an alternate route for energy production with it’s own advantage/disadvantage trade offs that fit some patients when “supplemented” in moderation.
Beer however is not good for me, even 0% ones. Probably because I do poor on wheat (and maybe on yeast, but wine has yeast too but maybe it’s more alive in beer due to lower alcohol %).
Thank you so much for posting this great article, Cort! I’ve been diagnosed with FM, ME, and POTS back in 2014. In these five years, I went from being an athlete to becoming bedridden. I’m a patient of Dr. Klimas office, and have tried every treatment in the book, to no avail. I’m one of those super sensitive patients, but got excited about trying the Hummingbird ( love the name!). I plan on starting with 2-3 min at the most, but feel a bit hopeful. Something that hasn’t happened to me in quite some time. Thanks again for all you do!
Good luck to you Patricia and please let us know how it goes. Glad you are seeing Dr. Klimas. Stick with her – I have an interview with her coming up shortly.
Patricia, how long have you been seeing Dr. Klimas? I only learned of her through this website (thank you, Cort). Her work is fascinating, but it sounds like you got no benefit from being treated at her clinic. I have been contemplating calling her office for an appointment. Like a lot of us here, I just feel desperate for answers. I hope the Hummingbird gives you some relief.
Terri,
Everyone’s story is different. I live in Miami and soon after getting sick started looking for local support groups. I hadn’t even been officially diagnosed with any illness, but knew that I was terribly ill. In my case the onset wasn’t gradual, it was acute. I ended up in the ER after profuse vaginal bleeding in Jan 2014, and after passing out, was admitted for blood transfusions. A month later, I had a partial hysterectomy and felt great soon after the procedure. However, about 3 weeks later I developed a real nasty kidney infection, which was misdiagnosed by my doc as a simple UTI. By the time he started treating me for the actual infection, it was too late. I felt severe body pain, and could hardly move around. Then, I found out about Dr Klimas from the support group. She no longer accepts new patients, but I see Dr. Vera, who works in her clinic and is also an excellent professional. Unfortunately, she doesn’t have Dr. Klimas experience. I scheduled a visit with her 7 months after the pain started, and was very hopeful I’d be able to recover. I’ve always been a type A ( unfortunately!), and kept on working for the first 2 yrs, even though I could hardly breathe or even stand up. So gradually pushing myself made my health decline very quickly. Also, my circumstances were never favorable to a recovery: my husband has MS, has been on disability since 2007, and I was his caretaker. I also took care of my mother, and young daughter. My life was very stressful, even when I was healthy. I tried every treatment u can imagine, but it turns out my levels of inflammation are too high. I can’t even eat most foods bc they cause severe pain. I’ve on the AIP diet since 2015. So, as u can see, I’d say it’s reasonable to assume that anyone with less stress/pressure in their lives would have a better chance at recovery, or at least improvement. Dr Klimas office is the only one I’ve ever been to where I feel understood & respected. It’s also easier for me bc Dr. Vera is the dr who treats all of my conditions. It’s a one stop shop. She is extremely knowledgeable. I highly recommend. Good luck! Are u also in FL?
Patricia, I am in Calif. but it would be worth it to consult with Dr. Klimas if it would do any good. I am especially intrigued by her research in Gulf War Illness. I consider this my real condition even though I did not serve in the war, but my illness onset was through prolonged chemical exposure. I’ve been diagnosed with FM and chemical sensitivity. In a recent lecture I saw online, Dr. Klimas speaks about a treatment designed to “reset” the system and she is undergoing clinical trials with gulf war vets. I’m really hopeful on this one.
Dr. Klimas has gotten excellent funding from the DOD and it’s paving the way for ME/CFS too. Stay tuned a report on the several clinical trials she has underway..
Want that I had $395.00 If I did, I would have to use it for essentials – you know, groceries, meds etc. My Long Term Disability was stopped with only 30 days notice and then SSD hasn’t been recieved for 2 months – Politics? Shutdown?
Hi Cort, here’s another being flogged in Australia 🙂
https://www.revitive.com.au/our-products/
My mother has the revivitive. I should give it a try.
Hey guys, i bought one of these revitive medic devices today. have used it twice so far and will continue to use twice a day. I’ll try to give an updated comment in a week or two as to if i find any improvement with cfs/me.
Does anyone know how much EMF the Hummingbird emits or tested one with an EMF meter? I am trying to reduce harmful EMF exposure as much as possible and normally close proximity to electrical devices puts them in the hazardous radiation range.
Hi Michael, I was worried about the same thing. decided not to purchase when I wrote the company and found out you cannot disable the wireless function. (see my post below). Too bad!
Thank you Cort for all of your hard work!
Just to note that when I entered the coupon code “HealthRising” for the $25 discount, it registers a discount of only $6.33.
Looks like you selected the payment plan, so your $25 discount is applied over 4 payments, $6.33. The total discount will actually be $25.32 after your 4th payment 🙂
Thanks for this, as I hadn’t intended the payments route. Will try again.
If this puts out an artificial magnetic field, it is not great for anyone. Artificial magnetic fields cause calcium ion problems.
Does it? Put out an artificial magnetic field? Thanks.
I don’t know about a magnetic field specifically, but I am sensitive to EMF’s, so I wrote the company to find out whether the wireless connectivity (higher frequency em fields, used by cell phones, etc, which are more electric than magnetic) could be disabled. It can’t, so, unfortunately, it’s a no-go for me.
I’m disappointed- I’d have thought that a company focussed on the needs of folks w FM and CFS would have some awareness of the not-infrequent co-morbidity of EMF and other sensitivities. It’s not hard to design a way to turn a feature off!
Hopefully the next version….Everything seems to want to have wireless!
I wonder, how do the results of using these kinds of circulation devices compare with results from the yogic practice(s) of inversion?
Thank you so much, Cort, for bringing us yet another potential “tool” for us to use to possibly reduce our symptoms. This machine looks good! I really appreciate Dr. Erik Hiester for his unique medical path and willingness to pay close attention to his patients’ symptoms.
Just FYI for others, Vital Motion does offer a payment plan, which I would be interested in since I’m on Social Security; and as someone has stated above, the Health Rising discount still applies to a payment plan.
Their Clinical Resources page has important information, and you can click on a link in each study to see the actual study report. I found the Binghamton University of NY report, which IS NOT a study using the Hummingbird, but rather a review of a rocking exercise one can do with their feet while sitting that produces similar results; it’s included because BU suggests “Studies utilizing the Hummingbird…are warranted.”
This from that section:
“Results:
Rocking with plantar flexion using the calf muscles increased blood pressure and enhanced cerebral perfusion; subjects demonstrated significant symptom improvement.
Application:
Subjects who experienced calf muscle stimulation showed a decrease in pain medication and improvements in balance and symptoms of depression and anxiety. Studies utilizing the Hummingbird as an intervention in nursing homes with elderly and Alzheimers patients are warranted.”
I occasionally do these foot rocking movements while watching TV. I learned them from one of my physical therapy sessions way back. I’ll try doing them consistently twice a day for a couple of weeks and see if I notice any difference. I may still purchase the Hummingbird because of its exact setting(s) that work based on science and studies. But, hey! If the foot exercise can do almost the same thing, it’s an option for people who either absolutely cannot afford it, or who don’t want to pay for yet another “thingie” in their arsenal.
Good luck to those who do try it. Cheers! Judith
I would be lost without you, Cort. Thanks so much for all your incredible work. It’s hard to fathom that you have ME/CFS…
I don’t have POTS. I do have Vasovagal Syncope, Fibro and moderate to severe ME/CFS. I’m wondering if The Hummingbird would be of benefit. I don’t want to get my hopes up too high.
I would contact Vital Motion. I looked up vasovagal syncope and it is associated with low blood pressure and with blood pooling in the legs – which the Hummingbird might be able to help with. I don’t know, though, f the blood pooling is there all the time or if its suddenly triggered by something. If it’s there all the time my guess is that it might help; if it occurs suddenly it might not…That’s my laymen’s guess!
Thanks Cort & everyone; I’ve been considering this machine. As I think has been covered on this site, one model of FM is that an inflammatory or autoimmune process damages the peripheral nerves (Peripheral Neuropathy–tested with a skin punch biopsy by labs like Therapath). This model views FM as more of an inflammatory neurodegenerative disease than about “trigger points” or “non-restorative sleep” etc., and suggests IVIG therapy. So I’m wondering if this machine would still work (or maybe work with increased use) if the nerves in the calves are damaged (supplement consumers beware of vitamin B6 toxicity–one lesser-discussed cause of nerve damage). If blood flow to the brain helped in the simple manner suggested by Vital Motion, patients might feel better after a night’s sleep–instead of half dead…
I was all set to buy one of these and then discovered they are only available in the US. I live in the UK. I contacted them and they confirmed that it is only US. Pity.
They say they are working towards international sales, hopefully within the year.
Thank you Cort for this post & for your work. We just trialed the Hummingbird. My 16 year old has been ill for 2 years. Diagnosed with HyperPOTS, ME/CFS and Amplified Pain (from unrelenting chest pain), potential MCAS. Corlanor/Ivabradine has been the only treatment that has helped with pain & some symptoms. Severe PEM if he doesn’t manage exercise & study envelops. Sleep is always greatly affected & a huge issue. We tried the Hummingbird to help with sleep & to hopefully “calm down” his autonomic nervous system. Unfortunately, even at 1 minute at 30 (lowest level); he could not tolerate the stimulation. In the past, we tried PEMF (BEMER), TENS unit, acupuncture /acupressure…all too stimulating. Increased chest pain, weird “tingling” during session. Increased malaise after.
Having said that, Vital Motion is a great company to work with. They have been incredibly supportive. I hope this technology works for others.
I’m going to see if my son’s PT can incorporate some exercises that stimulate his soleus muscle. Even slower/gentler may be needed. Appreciate everyone’s posts. They are very informative.
Sorry to hear that Vickie. Thanks for passing your son’s results along and good luck with finding something that works!
Have you tried high THC cannabis? A paste I use works great for calming my system down and allowing me to sleep. It’s really something…
Vickie, do you know the source of your son’s chest pain? I’m asking because acupuncture seems to have precipitated some (never before) chest pain for me. Thank you.
Wow,
I’m going to purchase a Hummingbird. I have a continuous dull ache in and around the popliteal fossa region, to include posterior bilateral medial gastrocnemius muscles and the muscles that border the opposite sides (can’t remember their names). I also supplement with L Citrulline and L-Arginine daily. For years, I have suspected a circulation problem as contributing to the pain associated with my Fibromyalgia. The scope of data that is disseminated by Cort on Health Rising is amazing! I love the wide range of diverse data that covers every angle! This blog is a godsend!
I bought a Hummingbird and used it for two weeks. The first week, I set it at an intensity of 30 for five minutes. The pain in my legs went away, my brain fog went away, and I felt better overall. The second week, I set it at 40 for eight minutes, and my symptoms came back. Now, I’m going back to five minutes and 30. Hopefully, that will work.
Worst experience ever with this device. It activated every nerve in my body giving me burning pain and pins and needles pain all over. Even my tongue was burning. Brain fog got really bad and ears were ringing so loud. Please proceed with caution. The last thing those of us with fibro want is more pain. This is the worst I have felt in a long, long time.
Ouch…On the bright side – which I admit is not bright at all in your case – it’s clear the product is doing something. I’m not being glib. My question was whether that vibration could really do something – apparently it can! Unfortunately it made things much worse in your case. It’s clearly tweaking your systems…
What setting did you have it on? I recently spoke with a Hummingbird rep and they said some people are having to start far lower than the default setting.
The default setting – which is I think a middle setting – is apparently too high for some/many. I just made an amendment to the blog to suggest that everyone start a lower setting.
Day 21 and I can definitely say the Hummingbird does “something” although I’m not sure yet whether it’s good or bad. I worked up very gradually from once a day to twice and from 10 min on level 40 to twice a day for 30 min on 50 with no noticeable effects of any kind. I even threw in a trial of 20 min on 60 and then dropped back to 30 min on 50 for 2 days with no results. No sleep improvement. I’m not in much pain thanks to CBD and LDN it’s the CFS/PEM that’s the worst. (I have Lyme/Bart? and had Anaplasmosis.) So on day 10 I did 30 min on 60 in the am. I knew when I stood up from the table that I had overdone it because my legs felt like jelly. It took 4 days at 20/50am and 20/40pm before I wasn’t feeling it in my legs and I upped it to 30/50am and 30/40pm for 2 days. I used it the next am 30/50 and was too tired to use it at dinner. The next 2 days I decreased it to 30/on 40 then I upped it to 30/50 and had jelly legs again. The next 3 days I did 30/50, 20/40, 20/40 in am only. Yesterday and today I did 10/30am & pm. I’m still more tired and more sore. Yesterday I started with my more classic (for me)Lyme flare symptoms. I’m not saying that the Hummingbird provoked the flare as I also could have been exposed to the current “bugs/flu” going around, I’ve changed doses on herbs, and any number of other confounding issues but this is just a warning that this DOES provide “exercise” for your legs (my reason for trying it) and not to overdo it even if you think it’s not do anything, because it is!
This post is long after the original article appeared here. I ordered the Hummingbird device today, June 22, 2019, but be aware that as of latter March this year, shipments have essentially stopped due to a backorder on an electronic piece that goes in the Hummingbird. Some may have received orders placed before then in April 2019. Their Facebook page has a lot of negative comments, especially regarding getting refunds. It seems they were not prepared for unforeseen circumstances! It’s great to invent things, but putting them into production, running the business and keeping up inventory are another thing altogether. Will keep fingers crossed!
I bought the Hummingbird soon after Cort wrote this blog post. I didn’t have to wait long to receive it, so I avoided the issue of the long backlog that others have mentioned.
In any case, the device is very basic. It is a hard plastic “platform” that weighs maybe 3-4 lbs. It comes with a basic wall-wart power supply. Maybe a lot of research went into the Hummingbird, but it doesn’t have the feel of a high tech medical device. Instead, it has the look and feel of something that should retail for maybe $35 at Bed Bath & Beyond.
There is no on/off switch anywhere on the device. You are supposed to download the Hummingbird app onto your Android or iOS phone or tablet, and use the app to set the timer (10-50 minutes, in 10 minute increments), and the intensity of the platform’s vibrations. However, I have found it is difficult to obtain a Bluetooth connection between the Hummingbird and my phone.
That doesn’t really matter, because you can use the device without the app. Just plug it in and put your feet on the platform for 20 minutes. While on, the platform vibrates ever so faintly, at a frequency that seems similar to that of a Sonicare toothbrush. After 20 minutes, just unplug it to stop the vibrations.
I haven’t noticed any difference from using the Hummingbird. In fact, I stopped using it consistently because it didn’t seem to make any difference with my leg muscle issues. Then again, my diagnosis is ME/CFS, with significant worsening of leg muscle pain and fatigue over the last year, not FM. Maybe it works better for FM sufferers.
Sorry it didn’t work for you but thanks for relaying your experience.
Has anyone tried the Avacen 100 first mentioned in 2015?
I have a secondhand Hummingbird for sale. The company Vital motion is out of business, so this is a unique and rare chance to get your hands on one!
When interested, please email me at kellysiebers@gmail.com. Do NOT reply to this comment, I do NOT get a notification of it and thus will not see it.
PS: please implement this option Healthrising, it’s such a basic and incredibly useful function in comment sections to be notified of replies.
I have a secondhand Hummingbird for sale. The company Vital motion is out of business, so this is a unique and rare chance to get your hands on one!
When interested, please email me at kellysiebers@gmail.com. Do NOT reply to this comment, I do NOT get a notification of it and thus will not see it.
PS: please implement this option Healthrising, it’s such a basic and incredibly useful function in comment sections to be notified of replies.
As a suggestion: I’m interested to know what the research says about whole body vibration (WBV). Becky Chambers has written books about it and sells them as well.