If you never thought of cleaning as exercise, I’m about to blow your mind. So we all know that movement is important. And when you have a chronic illness, even getting some light exercise in daily can be extremely beneficial to your health and overall wellbeing. Cleaning is a great way to do that. Sweeping, mopping, scrubbing, taking out the garbage…you’re literally moving your whole body while you do these chores. This is one of the places where changing our outlook on something can really help us! If you’re feeling a bit hopeless about where to start or about whether you can do some cleaning for exercise, check out this podcast episode on creative hopelessness.
Hopefully you can get your body moving this week and keep making the most of it!
Did you know most animals do not get ulcers? Or suffer these kinds of physical ailments from stress? To be honest I never really thought about this before reading this book. If you’re not familiar with Why Zebras Don’t Get Ulcers by Robert M. Sapolsky, I can’t say I’m surprised. I only heard about the book when I was taking an 8-hour online course during my practicum. But it sounded interested. The subtitle is The Acclaimed Guide to Stress, Stress-Related Diseases, and Coping. If you have a chronic illness then this may be a good read to get some more understanding.
I bought it off of Amazon, but it should be available at your local bookstore or library as well.
What I liked about the book: To start off, the subject matter is interesting. We hear a lot about how stress is involved with chronic illness, but how exactly does that work? That’s what this book aims to explain. It also gives anecdotes from the animal kingdom in every chapter, explaining how different animals react to stressors. The primary focus of the book is certainly on the physiological responses to stress, so there is a lot about the brain in their, with a touch of psychological responses (I would’ve preferred more). Overall it uses the biopsychosocial approach, which I definitely stand behind. There is also a chapter on stress-management, which is helpful. The chapters are as follows: (1) Why Don’t Zebras Get Ulcers? (2) Glands, Gooseflesh and Hormones, (3) Stroke, Heart Attacks and Voodoo Death, (4) Stress, Metabolism, and Liquidating Your Assets, (5) Ulcers, the Runs, and Hot Fudge Sundaes, (6) Dwarfism and the Importance of Mothers, (7) Sex and Reproduction, (8) Immunity, Stress and Disease, (9) Stress and Pain, (10) Stress and Memory, (11) Stress and a Good Night’s Sleep, (12) Aging and Death, (13) Why is Psychological Stress Stressful? (14) Stress and Depression, (15) Personality, Temperament, and Their Stress-Related Consequences, (16) Junkies, Adrenaline Junkies, and Pleasure, (17) The View from the Bottom, and (18) Managing Stress. If any of this sounds relevant to you, it may be worth checking out this book.
One of my stress management techniques (since childhood).
What I Didn’t Like About the Book: There are a few drawbacks to the book in my opinion. First, it’s pretty sciency. He does try to make it readable for lay people, but even with my masters in counselling psychology, I got a little overwhelmed by the neuroscience aspect of the book, which was a lot of it. So be prepared to wade through if you want to read it. The other thing I didn’t like was his use of language, which was very outdated. For example, he constantly referred to people with depression as “depressives,” which is stigmatizing and just not right in my opinion. He did this with other conditions as well. It brings up with the people first vs. illness first argument, which I’m not going to get into here, but it bothered me, as a person (and as a mental health professional).
Would I recommend it? Yes. Look, overall I think there is a ton of great and interesting info in there. Will it make you feel better? Not necessarily, but I’m all for having a better understanding of what’s going on in my body, that way I can take appropriate steps to help myself. For example, mindfulness has a large evidence base of helping with stress, and I therefore, practice meditation and other mindfulness techniques on a regular basis.
A mindful moment.
As I keep reading, I’ll keep sharing. And I hope you all keep making the most of it!
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In this practice we are working on developing the “noticing self,” “observer self,” “self-as-context,” or whatever you would like to call the part of you that notices everything. Many people find this type of awareness to be very beneficial in many areas of their lives. This was adapted from Russ Harris’ ACT made simple. The noticing self is something that I have found to be very important in my own life, and in the lives of my clients.
I know this is a bold statement, but honestly it’s not one that I’ve come up with. It’s one that’s been studied, and it came to my knowledge through the form of a book – When the Body Says No by Gabor Mate. Now, I have done a whole post giving my review of that book awhile back, so that might be something you want to check out before or after reading this today.
First things first, I want to reflect on my own life. As an adult I wouldn’t say I repressed my emotions. Well, sometimes, when I was in my 20s, I would repress anger until it boiled over and spilled out like. Then I was accused of having ‘anger problems’ but really, looking back I was just not expressing it as it came about. On the other hand, sadness, joy, etc. all seemed to come out appropriately. Diving further back, I know there was a time between the ages of 8-13 that I repressed emotions – again, usually anger. Through those 5 years I had a group of friends at school, and one girl in particular was good at manipulating the others into not talking to me for periods of time. Like I mean I had no one to hang out with at school when they did this. It started as just being a day, then a few days, then a week, sometimes a month. It was honestly unpredictable of when it would happen and how long it would happen for. I never knew what ‘I was doing wrong’ and was always only told by them, “If you don’t know, then I’m not going to tell you.” I think this was actually a traumatic experience for me. Actually, my therapist told me it was. However, this post isn’t about that trauma, it’s about repressing me emotions. I think the only way I could get through 5 years of elementary and middle years schooling was to repress. Not show any emotion about it at school. I remember crying myself to sleep at night, but certainly not every night. Luckily, I was enrolled in a ton of extracurricular activities which probably helped me too.
I think I was 6 in this photo.
What does repression of emotions have to do with chronic illness? Well, in When the Body Says No, Gabor Mate explains that repression of emotions – particularly anger – has been linked to several illnesses. These include autoimmune diseases, cancer, and ALS. Now, this doesn’t necessarily mean EVERYONE fits the bill, but certainly, in my conversations with others, people readily admit they have difficulty expressing anger in an appropriate and healthy way. Very interesting.
I was first diagnosed with autoimmune in 2016.
Why does repression of anger cause chronic illness? Well, in and of itself, it does not. However, when we look at illnesses from a biopsychosocial standpoint (this is the mostly widely accepted view in the medical community – both Western and holistic), it is a contributing factor stemming from the “psycho” portion. Bio stands for biological – so any genetic or epigenetic (meaning our genes were changed by our environment) – contributions to illness. Psycho stands for psychological contributors, which can also include personality, management of emotions, how we handle stress, and so on. Social usually relates to the environment, which often includes factors like traumatic events.
What can we do with this knowledge? For me, the best thing I’ve learned to do is appropriate and consistent expression of emotions. This means I don’t ‘boil over’ with rage but rather can notice and accept the feelings of anger, expressing them through words. This is sometimes referred to as emotional regulation, and in my practice it definitely falls under acceptance. There are many ways to learn to do this. The most effective would be going to see a therapist. There’s also the self-help section of the bookstore or library. The practice of mindfulness. Just to name a few. Will doing this help heal our illnesses? Well, not exactly, but it can help lessen the severity and impact of our symptoms on our lives. I think it is a part of the healing process we often neglect, but really shouldn’t. This week’s episode of the podcast talks about acceptance (find it here). If you have questions about it, feel free to DM me on Instagram (@chronically.living_)
Learning to express our full range of emotions – anger, sadness, joy, nervousness, etc. – is important to our overall well-being (just watch the movie Inside Out if you’re not convinced).
Chest openers are among my favourite yoga poses because I am always tight in my chest, really noticing it under the shoulders, near my armpits. And I always feel good during this stretch. Stretching is super important when managing chronic pain, and something most of us don’t do enough of, which is another reason I’ve incorporated yin yoga into my daily routine. Please consult with your healthcare team before starting any new exercise routines. I am not a professional yoga teacher, just giving your some education on what has worked well for me! Yoga is also a great way to contact the preent moment, which is the topic of this week’s podcast episode, avaiable here.
Alright everyone, for now, take care and keep making the most of it!
Long title, I know. But nonetheless I thought I’d share some of my tips with you, plus a few other evidence-based ones I found online as I’m trying to get through this. I’m writing this exactly one week before it will be published so fingers crossed that it’s over by the time you’re reading it, but if not, then I’ll just have to accept it as it is. My flare is likely caused by a few things. First, I recently moved and moving is stressful (even a relatively easy move like I had) and stress can cause a flare. Second, I moved from a dry climate in the interior of British Columbia to the wet, lower mainland of BC. I always notice my symptoms, especially pain gets worse when it rains… but then I knowingly moved to a rainy climate (*face palm*). All jokes aside, my symptoms are increased pain, increased fatigue, really bad jaw pain, my left foot is super veiny and sore (my calf is fine though so unlikely anything super serious). How the heck can I manage all of this?
Even on a flare I’ve managed to explore my new neighborhood.
Acceptance. Yes, I know some of you are rolling your eyes or saying that this is ridiculous or unlikely to work. But I find it does. I accept that my pain is here, while knowing that the intensity changes hour by hour, sometimes even minute by minute, and I know that when my flare is over I’ll go back to baseline. Acceptance is helpful. I’ve been doing body scans and other mindfulness activities to help with the acceptance, but honestly just acknowledging my experience without getting wrapped up in it is helpful. Check out this acceptance practice.
Exercise, Movement and Stretching. If you read this blog regularly you know that I like to exercise. And I still pace myself by trying to stay consistent with what I do. I definitely increase my stretching during flares. Particularly I focus on the areas that seem to hurt or need it the most. For example, my jaw is the worst today as I write this, and I’ve made sure to do jaw stretches throughout the day. For more on jaw pain specifically, check out this podcast episode with Dr. Shirazi.
Warm Baths. I LOVE my baths. I literally take a bath 4-5x a week in the winter months. And with the rain, I’m definitely needing them. They help relax my muscles, keep me warm, and are very relaxing. Trust me when I say I could never (and would never) live in an apartment without a bathtub. Knowing what is vital to your self-care is essential to dealing with a flare. Check out this podcast episode on it.
Dressing Warmly and in Layers. Vancouver, if you’ve never been, is a city where everyone dresses in layers. It will likely rain at some point during the day, though you never know exactly when. It could also start off cool and warm up, or vice versa. So I’ve been making sure to put on 3 layers when I go out, and have a pair of mittens on me. I need to remember a hat and/or an umbrella, but I’m working on it!
Hydration. I tend to drink a lot of water. Admittedly more when I’m working. Staying on top of my water intake is so important to managing my flares and really my health! I’m trying to drink 5 full glasses of water a day minimum. I basically keep a glass of water next to me all day and every time it’s empty, I refill it. Listen to my podcast conversation with Beau Berman about gut health and how important drinking water is to him.
Omega-3’s and Vitamin D. I typically try to get these from the foods I eat. Lots of fish mostly (rich in both), as well as mushrooms, spinach, avocado and tofu and really a variety of others foods are rich in vitamin D. These are really important for reducing inflammation naturally and honestly are just really good for you! Also, Vitamin D is a way to combat with the “winter blues” (which I often get) and the more severe, Seasonal Affective Disorder.
So those are the 6 things that I am doing, but what are the 5 things that I’m not but probably should be?
Acupuncture. This is actually an evidence-based and recommended treatment for chronic pain. I’ve had it in the past and I’m hoping to start back up with bi-monthly sessions next month. Listen to the podcast episode on recommended treatments for chronic pain for more info.
Massage. I miss getting massages. It’s been nearly a year since I had one, and this is also a service I used to get bi-monthly. I’ll likely also start these back up soon as well. Clearly I need to. The benefits of massage can be heard in the podcast episode with Danielle Potvin.
NSAIDs. I’m not a fan of these drugs to be honest. They can cause stomach problems when on them long term. I’ve drastically cut back on them and only take them to supplement the more natural medications I take (i.e., CBD). If you’re aware of the risks and find them helpful then this can be a helpful solution.
Natural supplements. The only natural supplement I currently take is magnesium bis-glycinate which is a muscle relaxant (and I mainly use it when I’m menstruating). Other recommended supplements are fish oil, ginger (which I sometimes have in food and/or tea), turmeric (which I sometimes have in tea), and gingko. These are definitely worth checking out to use in addition to some of the other suggestions.
Limit Stress. Oh I can’t wait until I’m passed the stress of the move and starting up new counselling practices. The truth is there is always some kind of stress in our lives and it really comes down to how we manage stress. I typically do a good job with mindfulness, meditation, yoga, and relaxation practices. So this might just be a reminder to do a bit more of that. And also, if you are able to avoid stress then that’s a good plan (I do not plan on moving again for quite some time!).
Taking it easy on Halloween. Needed some time to relax after the move.
So that’s it! 11 ways in total to manage a flare. Keep making the most of it everyone!
These are some exercises that I use to make sure I’m getting sufficient movement in my elbows and wrists, especially when they feel tight and/or sore. Remember, exercise isn’t always about strength or cardio; for chronic illness warriors it’s often about getting different types of movement because it is helpful in keeping our bodies going. However, if you want some more information on weight loss, check out this podcast episode (with Dr. Francell Hamilton). And please consult with your healthcare team before starting any new exercise.
Happy moving, and keep making the most of it everyone!
This is it! My final post about this year’s World Pain Summit (put on by the Alberta Pain Society) and all that I learned. Make sure to read parts 1 and 2 if you haven’t yet because there is great info in them. Once again, the summit/conference was a 3-day event for (1) physicians, (2) allied healthcare professionals (like me!), and (3) people with lived experience (also like me!). This summit had such amazing info, so here’s what the third day looked like, and some of my key takeaways from it!
If It’s Not Inflammation, Why Do I Hurt? 2 Rheumatologists did presentations, and as someone with an autoimmune disease that sees a rheumatologist, this was a great session for me to attend (with my person with lived experience cap on). Lots of really interesting info. Like first rheumatologists hate ANA tests because they are highly sensitive and not at all specific (in other words, they don’t work). You can also have an autoimmune disease without meeting the classification criteria because even though classification is often used for diagnosis, it is only meant for research. They noted that an absolute answer to the causes of pain isn’t always possible, and that pain should be managed with lifestyle (reduce stress, improve sleep, avoid triggers, and exercise) not just medication. Finally, what they said to the other rheumatologists out there was that they should always help their patients manage pain regardless of diagnosis (is this hope for the field?).
I don’t always get inflammation, which is why I have a secondary diagnosis of fibromyalgia.
Evidence-Based Tips for Coping with the Emotional Impact of Chronic Disease and Persistent Pain. This was a presentation by a person with lived experience who is also a researcher. After going through all the sciencey mammalian brain stuff (which is important but too long to summarize here), she gave 4 tips for managing emotions and pain: (1) charge your frontal lobe so you can feel more energetic at the end of an activity then when you started (sleep hygiene, healthy eating, hydration, physical activity, nature, social connection); (2) use your “battery” wisely – this refers to the frontal lobe of our brains that controls our behaviours (asking for help, and most importantly pacing – which is keeping activity the same regardless of whether you’re having a good day or a bad day); (3) psychological flexibility (using problem-focused and emotion-focused coping); and (4) build a village (family, friends, technology, healthcare providers, etc. – but only trusting relationships). Also, remember the physical body and psychological body influence each other!
I like to charge my frontal lobe in nature.
Medical Cannabis for Chronic Pain/Real World Evidence: Helping Canadians Navigate the Cannabis Landscape. This was 2 presentations that had a lot of overlap, and I totally attended this as a person with lived experience who uses medical cannabis. They reviewed the research they conducted through meta-analyses and studies of patients who use medical cannabis for chronic pain. They made “weak” recommendations in favour of offering a trial of medical cannabis for patients interested in trying it. Basically there is about a 10% chance of it significantly reducing pain, but when most chronic pain patients are asked if they would try it knowing there is just a 10% chance, they say yes. This was a session that was mostly directed at physicians who can prescribe. Both researcher-practitioners who presented also have done a lot of research on opioids and seem to be slightly in favour of cannabis over opioids for chronic pain (noting that opioids are better for acute pain). Food for thought!
Being in the Presence of Pain Without Losing Yourself – Kristin Neff keynote. If you’re not familiar with Dr. Kristin Neff, she is the leading researcher on self-compassion. Don’t run away though, because self-compassion has been found to be an evidence-based treatment for chronic pain. There are 3 components of it: kindness, common humanity, and mindfulness. There are also 2 sides of self-compassion that need to be in balance: tender self-compassion (nurturing, healing) and fierce self-compassion (protecting, providing, motivating). Did you know that 75% of people are more compassionate toward others than themselves? Despite the fact that s-c is strongly linked to well-being, improves our physical health (immune responses, sleep, physical symptoms). With chronic pain specifically it increases emotional resilience and coping; decreases depression and anxiety; increases relationship satisfaction; leads to fewer doctor’s visits and prescribed medications; increases acceptance of self and situation; and literally changes our brain responses to pain!! She also reviewed common blocks to self-compassion but I might save those for another post. Check out the self-compassion meditations I have on my YouTube channel (LovingKindness and The Kind Hand).
My fierce self-compassion.
Courage to Go Deeper: Meeting Suffering Through Compassion and Self-Compassion. The presenter is a person with lived experience and a spiritual counsellor. She discussed the spiritual aspects of healing, including self-compassion that Kristin Neff presented, and tied into some of Gabor Mate’s presentation on trauma. A couple of key takeaways here:
Pain x Resistance = Suffering (the more we resist pain or hate pain, the more we focus on it, which in turn intensifies the experience of it)
Pain isn’t “wrong,” it is part of the experience of being human (approaching pain and suffering as a natural part of the human experience facilitates self-compassion and eases suffering)
Spiritual distress may be understood as the loss of meaning and connection in relation to the self, others, and the Other (for healing to occur, we need to make room for and allow the full range of human feeling and experience).
I found this to be a powerful session (and though I’m not religious, I am spiritual).
Self-compassion and acceptance moves us away from suffering.
Choose Your Own Adventure: Bringing Your Values into Your Practice. This was the last session of the weekend, and was about using Acceptance and Commitment Therapy not with clients, but with ourselves as a practitioner. Obviously there is a ton of overlap with clients, but this really focused on values and values-based living. The presenter, who is the present elect of the Alberta Pain Society as well as a Registered Psychologist, did discuss using ACT for chronic pain. She stated: (1) it is cost effective as a treatment option; (2) it looks at emotional well-being and function; (3) it improves pain acceptance, values-based activity, decreases in pain catastrophizing and pain avoidance, and increases psychological flexibility; (4) it is consistent across SES categories; (5) it works with people who have higher disability, longer duration of illness, older and younger adults, people with previous treatment failures, and people who have neuropathic pain as well as other types of pain and illness; and (6) it literally changes neurobiological mechanisms in the brain – specifically pain processing. In other words, maybe find a therapist who practices this for an alternative treatment option (hey like me!).
Are you living by your values?
That’s a wrap! Whole conference in 3 long posts (I know I’m sorry, I usually don’t write so much). I will definitely be breaking some of this down more in the future for you. In the meantime, keep making the most of it!
Chronically Living 