How to Engage in Macro Self-Care

I was listening to a podcast called Therapy Chat, on an episode about therapist self-care. The guest talked about 2 different types of self-care: macro and micro. While this certainly applies to me and other healthcare professionals, I think it also applies to everyone else, including my fellow Chronic Pain Warriors and Spoonies. Self-care is important and I’ve talked about it on the blog many times before. More recently the self-care posts have been about Activities of Daily Living. This post (and the next one) is going to broaden the definition of self-care beyond our ADLs (though I still firmly believe that ADLs is the best place to start).

What is Macro Self-Care?
As an adjective, macro means “large-scale” or “overall.” So we’re looking at big ways to engage in self-care. These ways tend to be more time consuming and more expensive that micro self-care. They are usually things we can only do for ourselves on occasion – a few times a year, maybe once a month depending on your income. Though they tend to be fewer and further between, they have the ability to really help us reset. Sometimes we need to fully disengage from other parts of our life in order to come back to our problems and difficulties feeling refreshed.

Examples of macro self-care include going on a vacation, getting a massage or having a “spa day.” Spending a weekend away with a partner. Taking a class that’s of interest to you (like an art or music class). Going on a retreat. Recently I went on an 11 day trip to Turkey and Egypt with my parents and a good buddy of mine. I hadn’t taken a vacation (other than my brother’s wedding) from work in a year. I also hadn’t travelled outside the country since 2019. It was much needed macro self-care. I also spent a “long weekend” (as in we both took off Friday and Monday) with my partner in a cabin. Another great way for me to get some macro self-care in. I definitely do try to prioritize some of this. Again, sprinkled throughout the year in different forms. It decreases my stress overall and helps me reconnect with the people who are important to me.

Istanbul, Turkey November 4, 2022.

All of these things require planning and some money. This is what makes macro self-care important but unsustainable. Which is why next week I’ll be writing about micro self-care and how we can engage in that throughout our every day lives.

Video: What is Spoon Theory?

If you haven’t heard of Spoon theory, it’s definitely a great metaphor for chronic pain and illness. It can help you understand yourself better, and prepare to do helpful things like pacing. It can also serve as a great way to educate your friends and family on what it’s like to have a chronic illness or pain so that they can understand and support you better.

Keep making the most of it!

Lessons Learned Travelling While in Remission

My AI disease has more or less been in remission for about 6 months (the doctor officially gave me that status in July). As such, I was very optimistic about my travel plans to Turkey and Egypt for November. I mean, I would have gone on the trip regardless, there was just less planning around how to manage than there would have been before (I almost wrote worry instead of planning, but truth be told I am able to limit my anxieties around travel because it is a values-based activity for me). Travel for me, means going on adventures – doing as much as I can, eating whatever I want, and just having as amazing an experience as I possibly can…

Great Pyramids of Giza

And I did. I ate my way through Istanbul. Did 2 walking tours, climbed a tower, went on a boat ride down the Bosphorus, had drinks on a rooftop patio looking out at the Galata Tower. In Egypt I went on a Nile dinner cruise, saw the Great Pyramids of Giza, had an authentic night out with friends (1 of which is a local) in downtown Cairo, went to the Citadel, the Egyptian Museum, Temple of Karnak and Luxor Temple, Valley of the Kings and Queen Hateshpsut’s Temple, and did a hot air balloon ride over Luxor. Literally packed so much in. And then came home to some body aches and pain, an upset stomach, and a cold.

To be fair, the cold could’ve been (a) because there is one going around that I’ve been told about many times, or (b) because I was up for almost 36 hours (minimal plane sleep due to crying infant) and had to run through an airport in order to catch my last flight home. However, what is important for me to remember is that remission could go away if I’m not careful. So, here are three lessons I’ve learned when travelling while in remission from AI.

1. Getting enough rest. Sure, if your vacation is all about laying on a beach, it’s easy to pace, get enough rest and enough sleep. If you’re like me and prefer an adventure vacation, then it’s important to not overdo it. To be honest I think I overall paced well. Only 1 (maybe 2) activities per day – until the last day, in which I crammed more in. I struggled with the sleep part, again, particularly at the end of the trip. Being awake for 23 hours before boarding my first flight was perhaps not the greatest idea. And while I don’t regret the activity I did that sacrificed sleep, I think that squeezing in some rest/nap time, as impossible as it seemed, would have helped me a lot. So don’t forget to (a) Pace your activities, (b) rest between activities, and (c) get 8ish hours of quality sleep every night (and don’t stay up too long!)
2. Watch what you eat. I had cut out dairy and gluten and meat last fall, which has really helped me a lot. On the trip I ate a lot of dairy, gluten and meat. It is possible to have limited some of this (the gluten would have been hard). And I did have days where I limited the meat and dairy in particular because I could tell it was rocking my body in all the not good ways. While I think it’s important to always be flexible (including with diet), flexible doesn’t mean swinging to the opposite extreme. Lesson learned.
3. Keep stress low. Theoretically my vacation was relatively stress free. At least the vacation part of the vacation was. The travel part was not. Pretty much every plane was delayed, and/or we were running through airports to catch flights. Much of this was out of my control, of course, and yet taking more time to meditate, ground or recharge (on the flights for example) would likely have helped me get my stress levels back down much faster. I did keep up my meditation practice (for the most part) throughout the trip, which was likely helpful as well.

Staying in remission is a delicate balance. I got here through a change of diet, consistent exercise, and stress reduction, so it makes sense that changes away from those things that have helped me could lead back to AI flares. As Alanis Morrissette once said, you live you learn and that’s all any of us can really do. I’m going to continue to pay attention to and honour my body in anyway I can (at home and while travelling) – and I hope you do too – so that we can keep making the most of it!

Video: Daily Mindfulness – Embracing Pain

Acceptance is hard. Embracing pain is hard. Especially for those of us who experience chronic pain. And yet, there is a lot of research that shows acceptance practices can help us manage pain much better. I have used many meditative (and non-meditative) acceptance practices on myself over the past several years and it has really helped me cope.

I hope this also helps you to keep making the most of it!

How to Practice Deep Breathing for Chronic Pain

I recently wrote a post on my meditation teaching blog about deep breathing and how to do so in a way that will stimulate the vagus nerve. This is really important for chronic pain as well. The Vagus Nerve, and specifically deep breathing to affect it, activates the parasympathetic nervous system, putting us in “rest and digest” mode. This often leads to a decrease in sensations of pain. (And if you also have anxiety, this may mean a decrease in both anxiety and pain for you). Check out the blog post here.

I’ll be back from vacation with some new posts next week! Keep making the most of it!

What to Know About Hugs, Chronic Illness and Mental Health

On my professional blog I wrote about how hugs can benefit mental health, and basically, why we can always use more hugs. (If you don’t like being hugged, self-hugs also totally count, as do cuddles with pets). There are a lot of physical health benefits I outline in the post as well, including decrease in blood pressure, improved heart health and decreased pain.

Check out the post here.

I’m just on vacation right, but I promise I’ll be back with some new posts soon! Until then, keep making the most of it!

Video: Psychoeducation – Illness Grief

Illness grief is a type of disenfranchised grief that is common amongst those of us with chronic pain and illness. Loss of who we were before, what we could do, relationships, careers, etc. that are associated with pain and illness. Disenfranchised grief is grief that isn’t well understood by the larger population.

If you have questions please reach out.

Keep on making the most of it.

Why Walking is Beneficial for Your Chronic Pain & Mental Health

I LOVE WALKING. Truly. I aim to walk 10,000 steps every day (give or take 1000) and will often end up on a hike that pushes me past that. Walking is something that I believe has really helped me move from being in a lot of pain and more ill, to being in remission. It’s not the only factor of course, but it is a very big part of my lifestyle. The easy part for me is that I actually enjoy walking. I’d rather walk than take transit (if I’m going somewhere “walkable” – 45 minutes or less). I even have friends that live nearby – transit takes 30 minutes to get there, walking takes 35 – easy answer for me. That being said, I know that not everyone actually enjoys walking. However, if you can get yourself to do it (or any other mild to moderate exercise), especially if you have pain, you also might start to see the benefits.

Selfie with headphones (and/or a hat, and/or sunglasses) = me on a walk.

There is a lot of researching showing that the greatest benefits of exercise, including walking, on chronic pain are mid- to long-term. So we can’t expect immediate results (as with many things). These benefits include reduction in pain, improvement in quality of life, less fear avoidance, and a decrease in disability. Some of the reasons that these results occur are due to movement promoting healthy nutrition of the cartilage (connective tissues) in our body, and engaging with the endogenous opioid system and other parts of the brain known to decrease pain. Basically all of our bodies natural pain killers are activated, which I think is pretty cool. Walking and exercise also decrease stress, and stress is a trigger of chronic pain and illness flares for many people.

As far as mental health goes, in addition to decreasing stress, study after study shows that walking and especially aerobic exercise (like jogging) can decrease anxiety and depression/improve mood. There are some other benefits such as improving self-efficacy (our belief that we can do things), improving social interaction (especially when walking with others), increasing our self-esteem (we feel better about ourselves), improving our overall cognitive functioning (memory, concentration, etc.), and improving sleep (being outdoors and exercising are both on sleep hygiene recommendations). A benefit that is good for both physical and mental health is weight reduction – though this certainly doesn’t have to be the goal/intent. There are a few reasons all of this happens: walking and exercise can serve as distraction from thoughts and feelings, and I think more importantly, it gets a lot of those natural happiness boosters activated, like serotonin.

Of course, make sure you talk to your doctor before starting any new exercise plan, including walking (and your physio/physical therapist, etc. as well). Start slowly and work your way up – even if this means just walking around the block once! Make sure you have comfortable shoes, possibly a friend to go with, and water to drink. And try to make it fun! Take different routes, listen to music or a podcast, or try some mindful walking. With all the benefits, it’s worth at least giving it a shot so that we can all keep on making the most of it!