My Top 5 Relaxation Tips for Stress (and chronic pain)

So many of us struggle to relax. To actually induce feelings of relaxation in our bodies and minds (which typically go together). And yet relaxation has been found to be very helpful for chronic pain. When the nervous system is dysregulated, the immune system goes into overdrive, causing inflammation, which causes pain, which then further dysregulates the nervous system. While there are many ways to break this cycle, relaxation is one.

Social connection can help with relaxation.

Relaxation is different from mindfulness. While many people do feel relaxed after meditation or some other mindfulness practice, the goal with mindfulness is not feel present and aware (relaxation is a common byproduct). The goal of relaxation practices is literally to relax. And so, mindfulness can be done pretty much anywhere, whereas relaxation needs to be done somewhere safe and comfortable. All that said, from my experience with chronic pain, here are my top 5 relaxation tips:

  1. Deep breathing – sending the breath into the belly activates the parasympathetic nervous system (rest and digest) moving us out of the sympathetic (fight or flight response). Closely related is sending the breath to areas of the body that need help relaxing. This is quick, easy and technically overlaps with mindfulness so it can be done in more places than some of the other suggestions. Check it out.
  2. Progressive Muscle Relaxation – PMR is done when we tense and then relax different muscle groups in our body. I have been practicing PMR for years (former therapist taught it to me) and have always found it helps to relax me and often decreases pain. Check it out.
  3. Yoga Nidra – newest one on my list as I’ve only more recently started practicing it. It sends you into a deep meditative state that is extremely relaxing. There is some evidence that the use of a sankalpa (resolve) can also help to promote healing. Check it out.
  4. Exercise – believe it or not but exercise often helps with our emotions and can help us feel more relaxed. It can be more intense to less intense depending on what you need in that moment. I’ve found when I’m anxious, for example, going for a walk can ease a lot of it.
  5. Social connection – in person is better, though any type of connection with a friend, partner, family member, etc. – especially one that is regulated – can help us move back into regulation because our nervous systems like to co-regulate with each other. Sometimes when I hang out with certain people, even if I was tense or stressed or anxious before, I feel calm and chill during and after the hangout.

There are many more ways to get ourselves into more of a relaxed state. These are just some of my personal faves. I hope that helps you to keep making the most of it!

My Experiences of Lifestyle Changes for Chronic Pain

I feel a little bit of unease writing this post because I don’t want to give the impression that I think it’s completely possible for everyone to do this. In fact, prior to my own personal experience, I thought this was highly unlikely if not nearly impossible even though I’ve read about others doing similar things (reducing ANA, reversing illness, stopping illness progression, etc.) through a lot of the same methods I’ve used. I only started with lifestyle changes in order to reduce symptoms and general distress so that I could do more values-based activities. All of what I did was with the guidance, help and advice of amazing holistic healthcare professionals – my naturopath, my psychotherapist, my physiotherapist(s), my chiropractor(s), and my massage therapist(s). My primary care/general practitioner/family doctor (however you want to say it) and my rheumatologist(s) supported my lifestyle changes but never advised me on them. They deal with medications, and frankly that’s fine. I also want to say, my intention has never been to go off any medications. I like an East-meets-West approach to healthcare. All that said, here’s what I did (in order of appearance):

  1. Stress Reduction – I learned a lot of coping skills to reduce my stress from my psychotherapist and have had regular acupuncture sessions with a naturopath for several years (minus 1 year where I didn’t have benefits).
  2. Tied in with the above, regular meditation and eventually yoga practice. I continued to reduce and manage stress through these means. Mindfulness in general can really help with anxiety, depression, and has been shown to reduce pain in many, many people, across many, many studies. I currently meditate 20 minutes (minimum) per day and do yoga 4-5x/week (between 20 minutes to 1 hour each day).
  3. Exercise – my exercise routine began with some work with a personal trainer who worked with autoimmune disease in the past, and then going to the gym 3x/week. When the pandemic hit, I began working out at home with some basic body-weight strength training exercises. I currently alternate strength-training with exercises given to me by my physiotherapist and chiropractor. On top of that I walk around 10,000 steps per day. I find that it works best if I pace by splitting it up with breaks and doing the same amount of activity each day. My physiotherapist and I are working on building up my strength so I can do more and longer hiking (currently I can do up to 1.5 hours, once or twice/week).
  4. Stretching – I’m giving this it’s own category because it’s not ‘exercise’ and yoga, while can be a great stretch, is much more than that. I do several stretches daily that have been given to me by personal trainers, naturopaths, physiotherapists, chiropractors, and massage therapists. I stretch every part of my from my jaw to lats to wrists to legs to back to toes. I probably spend about 15 minutes just on stretches each day.
  5. Diet/nutrition – this is something I struggled with for a very long time. I was recommended paleo diets and AIP protocols and this and that and I struggled to stick to any of them. So I made my own protocol/diet by just paying attention to how I was feeling after eating different foods. Then I eliminated what doesn’t make me feel good. I describe my current diet as “gluten-free pesca-vegan” because I mainly eat fish/seafood and then a vegan diet (no dairy) and gluten-free. (I probably should cut down sugar more and reduce alcohol a bit more but I’m getting there). I’ve been on this “diet” since last November. What’s made it easier for me to stick with is actually that I’m cognitively flexible with it. What I mean is, if I’m out and there are no (or very limited) options for this way of eating, I just eat whatever. If I’m at someone’s house and they serve meat or gluten or whatever, I eat it. This happens at most once/week and often less than that.

This is just my experience. I’ve been able to go off of one medication entirely, one medication was reduce to “as needed” (granted I supplement CBD instead daily – 10mg), and my rheumatologist reduced one medication a few weeks ago from 2000mg/week to 1400mg/week. Despite my lower ANA I do still have some symptoms – a bit of inflammation, some pain, but overall it’s a lot better than it used to be.

Have any of you found a difference with lifestyle changes?

Keep making the most of it everyone!

Always seek help from qualified healthcare professionals before making any lifestyle changes.

How I Stay Healthy in the Summer

Love it or hate it, summer comes every year. I personally love the summer. I’ll take heat over cold any day (I grew up in Winnipeg which is hella cold). I find the heat takes a slightly less toll on my body than freezing temperatures. And though I live in Vancouver now, where winter has more rain than snow and extreme colds, the changes in the barometric pressure are never fun for my body either. All that said, I know a ton of people who prefer winter over summer, because they don’t like being hot and/or their illness symptoms worsen in the heat (which I’ll admit when it’s really hot, mine aren’t superb either). Even without illness, we need to prioritize staying healthy in the summer. And though summer is coming to an end, any time left does need us to consider a few things.

I’ll admit that I sometimes take off my hat before taking pictures (especially if I’m going to post them on Instagram).

The first thing I do is dress appropriately. I try to go for outfits that are cooling, regardless of whether I’m working or lazing about. Probably most importantly in how I dress for the summer is always having a hat on (ball cap or brimmed hat) while I’m outside and always having sunglasses. That way I can help prevent heat stroke, symptom flare ups, and my eye health. Also, it requires basically no effort to grab my hat and sunglasses when I go out. I’m always a little shocked when other people aren’t wearing them to be honest.

Second, I put on a lot of sunscreen – and reapply as needed. I typically use SPF50 on my face (it’s built into my moisturizer) and SPF30 on my body. I’d rather use “too much” (because that’s not actually a thing) than not enough. Not to mention skin cancer doesn’t sound fun, and I once read that being sun burnt even once in your life greatly increases your risk of melanoma.

Third, I stay hydrated. I always have a water bottle with me. I always make sure there is a bunch of ice in it as well (it’s also an insulated water bottle which helps). I drink a ton of water while working and even just in my apartment. Constantly drinking water because, well, we know that water has a ton of health benefits, plus dehydration is not going to help me feel physically or mentally well.

Fourth, I try to make sure my sleep is as good as possible. I don’t have A/C currently and it gets hot. So I keep windows open, fan on when necessary – even if that means I have to wear earplugs to bed. I have an east facing bedroom window, and while I do need to invest in some blackout blinds, I often wear a sleep mask to bed so that the light doesn’t wake me up. I also ditch most of the blankets and sleep under just a top sheet to try to keep my body temperature down.

Finally, I still get all my movement in. There is a tendency to want to avoid exercise due to heat (trust me, I know firsthand I’m less inspired to workout when it’s hot). I do still make it a priority. If I go for a walk, it’s earlier in the day or later in the day and I try to stick to the shade. My strength training routine is done with a fan blowing at me (though I’m tempted to invest in a gym membership again just to have a cool workout facility), and I do yoga (also with the fan blowing at me). And while I do vinyasa and yin, I find that yin can be a bit better in the heat because you hold poses longer.

So, that sums up how I stay healthy in the summer. What do you do?

Take care & keep making the most of it!

Ways to Engage in More Self-Care as a Spoonie

The difference between the media’s version of self-care and healthcare’s version of self-care is huge. In the media we see bubble baths, spa days, “me time,” wine nights, and girls trips. In healthcare we talk about activities of daily living – showering, getting dressed, eating nutritious meals, doing light exercise, etc. I mean, I’ll admit that I definitely engage in all of the media’s version of self-care as well (well, I prefer solo trips to girls trips, just sayin’). And that’s fine. It’s totally all well to do all of that. As a person with a chronic health condition, I find it more beneficial to make sure all of my ADLs are done on a regular basis. Why? Because it helps not only my physical health (I’m literally more mobile when I do them), it also helps my mental health (mood is better, anxiety is less). Yet it can be hard to do these activities when we’re feeling low, when we’re super anxious, when we’re in a lot of pain. The thing is, doing them can help with all of these things.

Read more here:

https://www.kelseylharriscounselling.com/post/5-ways-to-practice-self-care

Getting out for a walk (I prefer one with a view).

Keep making the most of it!

How to Have a Better Attitude Toward Fitness (When You Have Chronic Pain)

We all know that the majority of the research says exercise = less pain. Honestly, I’m a supporter of this idea. Why? Because it has literally worked for me. I’ve managed to get off one medication, which happened when the only major lifestyle changes I had made were daily exercise (strength and cardio/waling) and daily meditation (plus yoga 2-3x/week). No more Lyrica for me! Now that doesn’t mean that I no longer have pain. It’s just more manageable. I notice that when I don’t exercise, my pain actually increases. Of course, this all seems totally backwards to our brains., mine included. When exercise was initially presented to me as an option for reducing pain, I was like “no way I’m going to do that! I’ll be in more pain.” Then I tried it and the rest is history.

yoga!

The thing is, even if you believe that exercise will help (and I’m aware that some of you don’t believe it, and that’s okay)the problem becomes, how do we reframe our minds so that we can actually start to engage in some physical activity? There are a way different ways we can approach this (or use all of these ways, depending on what you need). The very first thing I do is connect with my values. Why is this important to me? What values will I be living by? For me, when it comes to exercise this is often aligning with values of health, self-care, and independence. They might be the same for you, or totally different. The second thing I do is to just looking at my thoughts. I ask myself, are these thoughts helpful or unhelpful? Are they taking me toward the life I want to live or away from it? Then it’s helpful to create some distance from them. This can be anything from naming the story I’m telling myself, to speaking the thought aloud with the phrase “I’m noticing I’m having the thought that…”, to placing the thought on a leaf in my mind and watching it float down a stream.

At this point if I notice any sensations of anxiety or another emotion, I try to make some room for those. Maybe I send my breath into that area, or remember it’s normal to have anxiety, or drop an anchor which involves allowing my emotions to be there. By this point, I can usually do whatever activity it is I’ve decided I need to do (so in this case, exercise). While exercising there are a few more things I do so that I can improve my attitude. Firstly, I make sure my movement is mindful. I stay with the sensations of the movement, the smells in the air around me, what I can see and hear, all while exercising. This can be done on a walk or while doing strength training. You could also try yoga as a form of mindful movement that allows for stretching and exercise as added benefits. All my stretching in general is also done mindfully. I also make room for sensations while exercising. DO NOT exercise if it’s actually causing you extra physical pain. A little discomfort though is completely normal. I might do a quick body scan to check in with myself and make room for physical discomfort. I definitely use my noticing self to step back and just notice if it’s actually pain I’m feeling or if it is just discomfort that comes from exercise.

Lastly, I commit. I started out just going to the gym 3x/week. During the pandemic I built it up to strength training at home and going for walks to get fresh air and yoga a few times a week. The point is, you can start slow. And it’s probably better to if it’s a big change. You can also work with a physio/physical therapist, kinesiologist, occupational therapist, or personal trainer to help you get started (I worked with my physiotherapist, chiropractor and a personal trainer when I started). Here’s a podcast episode about exercise for chronic pain. So hopefully, this gives you some ideas on how to improve your attitude toward fitness with chronic pain. Until next week, keep making the most of it!

How to Use Your Body’s Natural Pain Killers More Effectively.

The other day I was walking into work and there was an older gentleman, probably in his late 70s, looking for the hearing clinic. Honestly, I don’t pay attention to the dozens of businesses in the building, so when he asked I said I wasn’t sure where it was. He ended up not following me into the building. When I went in, I quickly looked at the directory, and then ran back outside and down the street to get him. I went with him to the hearing clinic, before going down to my office. He was very grateful, and I felt good. I also had been in a lot of pain that day (my hip) and I noticed (awhile later) that the pain had drastically reduced. Why did this happen? Because my body released endorphins when I performed an act of kindness.

Endorphins are literally our bodies natural pain killers. We produced around 20 or so different types of endorphins, and they are all released by two parts of our brain – the hypothalamus and the pituitary gland – when we are stressed or in pain. Endorphins bind to our body’s opioid receptors which then gives us some pain relief. Opioid medications basically imitate endorphins when they enter our bodies, also clinging to the opioid receptors. And actually, when we take opioid medications, our body produces few endorphins because it doesn’t think it has to produce as many anymore (part of the reason it is easy to become addicted to opioid medications). Now, you might be saying, if these endorphins are so good, why am I in so much pain? Why would I need pain medications, including opioids, if these endorphins actually worked?

Here’s the thing, endorphins do work pretty well. There is a reason our bodies evolved to have them. Chronic pain is weird though and can affect many areas of our lives, which can increase pain (biopsychosocial approach) that make it more difficult for endorphins to work. Also, when we have chronic pain, we end up doing a lot of things that are the opposite of what would be helpful. We lie in bed all day, we withdraw from others, we become depressed making it hard to laugh for example, we stay inside, etc. Doing a lot of the opposite actually helps to produce more endorphins. Here are some examples of activities and practices that cause our bodies to produce more endorphins naturally:

  • exercise – particularly moderate exercise. I find I always feel good when I work out. There is an uphill walk called the Coquitlam Crunch when I live and I swear it is an endorphin boosting activity (probably why a lot of locals do it). However, if you struggle to exercise, any activity to start will likely get some endorphins going.
  • acupuncture – I get acupuncture at least once a month because it reduces my stress, so it makes sense that it produces endorphins (a lot of people find it helps to reduce pain as well)
  • meditation – I’m a big meditator, if you follow this blog you know that. This is another activity that I always feel good after.
  • Sex – I mean it’s physical activity and an enjoyable activity so it totally makes sense this would produce endorphins.
  • Music – singing, dancing or playing an instrument gets the endorphins going. So, if you’re in the kitchen, blast some tunes and take a few moments to dance! (I love kitchen dancing). Every time I play the piano I feel really good.
  • Laughter – as I mentioned, if you have a low mood this can be difficult, but perhaps turning on a funny movie or calling a friend who always makes you laugh might be helpful. As a therapist, I try to utilize laughter in client sessions as much as possible (and appropriate).
  • Sunshine – yep, getting outside, even if it’s just to sit on your deck or balcony, or sit in a park for awhile. In the winter, investing in a UV light. All of this can boost our natural pain killers.
  • Aromatherapy – particularly scents of lavender and vanilla. I often use lavender in my diffuser, which I always have on when I do telehealth counselling sessions at home. It’s a scent that is meant to help you feel more relaxed, and understanding how this work (endorphins!) is helpful for me at least.
  • Altruism – so my opening story is one about doing a kind act for a stranger. Likewise volunteering (I used to volunteer at a children’s hospital, and then at a crisis lines for kids and teens) also produces endorphins. Honestly, while I love volunteering, I find that even holding the door open for someone feels good. And this is why!
  • Chocolate -it actually contains a type of endorphin within it, which is why it helps to produce more. While I’m not saying you should eat a chocolate bar every day, the occasional chocolatey treat might be a good idea!

Okay, so I’m not saying that doing all of these things will mean you don’t have to take any pain medications anymore. What I am saying is that it can (a) reduce your need for some meds (I went off one from honestly exercising and meditating), or (b) can make you feel even better, while you still take medication. And look, none of this is a guarantee, everyone is different, and there are a lot of factors that affect our pain levels, but I’m always looking for what can help. That way we can all keep making the most of it!

Ways to Determine Acts of Self-Care From Acts of Health Care

First off, the media’s portrayal of what is self-care is VERY different from what mental health care professionals think of as self-care. Self-care in the media is bubble baths and spa days and bottomless brunches. I am not against any of this! In fact it all sounds quite fabulous. Counsellors and therapists such as myself think of self-care more in terms of activities of daily living (ADLs) like getting showered and dress and eating meals, etc. And then there is this weird grey area of overlap. For example, I see meditation as a form of self-care. It’s not an ADL, and the media would categorize it as self-care, and yet it can be extremely beneficial for mental and physical health. So I see things like that really as acts of health care.

Relaxation and meditation.

Here are some activities that I see as health care (that are sometimes categorized as self-care):

  • meditation and mindfulness – contacting the present moment to be here-and-now
  • self-compassion – taking a moment to be kind to yourself through touch or words
  • massage therapy – having a registered massage therapist do deeper work (than just purely going to the “spa”)
  • acupuncture – it has been around around for thousands of years and sessions are usually between 20-45 minutes
  • swimming and other forms of exercise – water therapy, strength, cardio
  • baths – more water therapy!

For all of these, research actually supports that they are important for health and mental health. Mindfulness and self-compassion can release tension in the body, make us feel calm and centred and present. Massages and acupuncture can reduce physical sensations of pain and also create relaxation in the body. Exercise reduces pain and increases strength. Baths, swimming and in general water therapy is supported for pain because of its strength, flexibility, heat and relaxation effects (depending on what you’re doing).

Thinking in terms of how these things will benefit my health, as opposed to just being things to enjoy (I mean, these are all things I do also enjoy) makes me more motivated to do them. It’s funny, because the idea for this topic came to me as I’m having a massage later today (I write these about a week before they’re posted). Getting a massage purely for pleasure hasn’t occurred to me in the longest time. Instead I always consider my massage therapist part of my healthcare team. I’m just like, hey, it’s time to take care of those muscles, especially because I have fibromyalgia and I’ve been neglecting them recently! And honestly, this type of health care is also self-care. I think we can get pulled into all these labels, rather than just going with what we need, regardless of whether it’s real self-care or media self-care or health care or anything else. What will make your mind, body and spirit feel better today? Do that, and keep making the most of it!

Video: Daily Exercise – Hip Abductors

Disclaimer: Please consult your appropriate healthcare professionals before making changes to your exercise routine.

This is a new exercise given to me by my physiotherapist that I have found helpful for hip strengthening and pain reduction. What are your favourite hip exercises? As always, keep making the most of it with your exercise routines!

5 Easy Chronic Pain Self-Management Skills

Today I want to take a slice of Pete Moore’s Pain Toolkit and share it with you. Who is Pete Moore? He’s a chronic pain warrior who came up with this incredible Pain Toolkit to help others struggling with chronic pain. Here’s the website: https://www.paintoolkit.org/ . The truth is, we can learn to self-manage our chronic pain. Like Pete, I have also learned to do so to a point where, yes I have pain, but no it does not affect my day-to-day life (that’s not to say I don’t have bad days, heck I had bad pain the other night and had difficulty sleeping). One thing we want to do when we have chronic pain is cultivate resilience. Now, I’ve written about resilience before in the past, so I’m not going to go into detail here. For those who aren’t familiar with what resilience entails, here are a few things: optimism, self-belief, willingness, self-control, being able to adapt, psychological flexibility, problem-solving, emotional awareness, social support, and humour, to name a few. So, here are 5 ways we can learn to do this.

Doing these things helps me manage my chronic pain.
  1. Goal Setting and Action Planning I often set goals for myself, even on days that I’m not feeling great. In our third atmospheric river (basically several days of torrential downpour) since November in BC, Canada, I’m again feeling it in my body. But I know my body also needs to move. So I set a goal for how far I will walk in the rain (which is less than my goal would normally be but appropriate for the weather, my body at this moment, etc.). So, set your goals, and prepare for barriers to them. Here’s a podcast episode I recently did on that.
  2. Engaging in Activities of Daily Living – Getting out of bed, having a shower, eating breakfast, etc. All the regular stuff we do in our lives. It can be really hard to want to do them when you have an illness or pain, but doing them can also improve our overall well-being. Check out this episode of the podcast for more.
  3. Problem Solving – Problem solving can include a lot of different things. Pacing is important and I’ve done a post on that (December 1), prioritizing and planning your days, and really importantly, having a setback plan. What are you going to do when things don’t go the way you planned (in your goal setting and action planning stage). When I was recovering from hip surgery last year, I had to problem solve how to do all of my daily activities because I couldn’t put any weight on my left foot (for 6 weeks!) and I live alone. I still had to figure out how to cook, shower, dress, and even get to some appointments.
  4. Be Active – this will mean a lot of different things to a lot of different people, but it really means to move your body. It could be walking, exercise/going to the gym, stretching, yoga. Exercise itself is an evidence-based treatment for chronic pain (here’s the podcast episode). It can be light movement, as long as it’s movement. I can’t go a day without moving my body. Even when I notice I’m having the thought that I don’t want to move or I’m in too much pain, I inevitably actually feel better if I go for a walk or do some restorative yoga.
  5. Be patient with yourself – offer yourself some compassion. Change is slow. Like it’s an average of 10 weeks for someone to start noticing differences (in their minds or bodies) when they start to make any changes. If you find you’re having difficulty being patient with yourself, try this mindfulness exercise. I’m definitely guilty of wanting change to occur quickly for myself. But interestingly, when I offer myself patience and compassion instead of criticism, change seems to actually occur more quickly than when I’m only hard on myself.
Remember, change is slow.

I hope this helps you with some pain management. I know it’s things that have helped me and many others. So, just keep making the most of it!