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!

Spoonie Stress

It’s not really a surprise that Spoonies have more stress than healthy folks. Chronic illness and chronic pain warriors just have a lot more to deal with. Coming up with ways to relieve stress is important, and something I try to pay attention to. As stress accumulates it can lead to mental health problems, and quite often, especially with autoimmune diseases, flares. Today I thought we’d focus on some causes of stress and I’ll give some ideas (that work for me) for you to try out to see if they help at all.

Stress is an evolutionary response.

First, I thought we’d start off with a few definitions. The reason I want to give these is that often as a therapist-in-training, I see that people don’t really understand the meanings of the words they use, nor are they aware of the difference appropriate emotional responses and ones that don’t fit the situation.

• stress – normal, physiological reaction caused by the fight-flight-freeze response in our brains, alerting us that something needs our attention. It’s neither good nor bad, but is a signal telling us that we need to act on something. podcast
• anxiety – “an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure” (American Psychological Association). Anxiety is also not inherently good or bad. It’s another natural response of the fight-flight-freeze part of our brain. It’s also normal and part of what makes us human. There is no way to be totally free of anxiety. Fear, on the other hand can be extremely protective and it can be easily confused with anxiety. podcast
  • Anxiety disorder: anxiety that is out of proportion with the situation, and is long-lasting and severe can indicate an anxiety disorder. Someone with an anxiety disorder has “recurring, intrusive thoughts or concerns” (APA)
• depression: an emotional disorder that can include feelings of sadness, loss of interest in pleasurable activities, and low energy and motivation. Sadness is a common emotion that is important to our functioning. Depression occurs when sadness doesn’t just “go away” on its own. Both anxiety disorders and depression are helped with psychological treatments. blog, podcast
• trauma – “an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea” (APA). I’ve heard this one be misused often, so just be aware of whether you’re actually experiencing trauma. This can also be helped with psychological treatments.

Understanding mental health concepts can be helpful for managing it.

Okay, now that we’ve got that out of the way. What are some common causes of stress in Spoonies?

• physical symptoms – flares, pain, and basically any other annoying and/or debilitating symptom that comes with your chronic illness. blog
• medical gaslighting – when a doctor or healthcare professional dismisses your pain and/or symptoms. podcast
• interpersonal relationships – difficulties with your partner, family, or friends often stemming from a lack of understanding of your illness. blog
• finances/insurance – even with insurance there is a cost of medications and other treatments that may not be covered or give you as much coverage as you need. blog

Side effect from my hip arthroscopy that definitely caused me some stress.

These are of course, just a few, and you may experience a lot of other stressors depending on your illness and overall life situation. The point out reducing stressors like this is to improve your overall quality of life. So, here are some suggestions that I’ve found to be helpful for each of these (I’m going to link some of my other posts and podcast episodes in case you want more in-depth information).

• Mindfulness, exercise, sleep, and diet. This means daily practice of whatever way you stay present. Getting whatever type of exercise is accessible during the day (even if it’s a short walk). Practicing good sleep hygiene. And eating as healthy a diet as you can. podcast, podcast, podcast, podcast (yes, one for each of these).
• Being a self-advocate when it comes to your health and knowing your rights. The medical gaslighting podcast episode I mentioned earlier goes into being a self-advocate. For disability rights check out this podcast.
• Effective communication and emotional regulation. We can’t control other people but we can definitely control ourselves, even if our emotions are high. podcast
• Budgeting, budgeting, budgeting. I am without health insurance for the first time in many years. And yes, I live in Canada where healthcare is “Free” (with the exceptions of medications, dentistry, and adjunct care such as physio/chiro/naturopath/massage/etc). Yet I’ve seen the chiropractor twice in the past 3 months (with another appointment today) and gone for a massage. I’ve very meticulously budgeted these in because they are so helpful. The blog post mentioned for finances incorporates budgeting.

There are lots of ways to decrease stress. I enjoy some light exercise in nature.

On top of all this, practicing self-care (podcast) is very helpful. If you don’t like the term “self-care” because it’s been waaaay overused in the media than maybe think of it is as “ways to improve my overall health.” It includes domains of : physical, emotional, intellectual, social, spiritual, and work. It is also incredibly helpful in reducing stress levels. I’m going to be hosting a self-care challenge starting on April 24 on the premium blog. To sign up for the challenge it is only $5 and you get 4 weekly premium posts, motivation for the challenge, ideas and help with the challenge, and an opportunity to be featured on the blog and/or podcast! Stay tuned for more!

Until next week Spoonies, keep making the most of it!

Surgery & Post-Op World

First of all, I’m going to say that I’m pretty impressed with myself for writing a blog post just 24 hours after coming out of surgery. Also, this was my first ever surgery, so I thought I’d share some thoughts and feelings about the whole experience. If you’ve been following me for awhile you are probably aware that I was diagnosed with a labral tear in my left hip back in March (MRI was back in January). Of course, with Covid-19 any kind of surgical consult, let alone treatment was pushed back and back (also I was floated around to 3 hospitals because very few surgeons specialize in hip arthroscopy apparently).

My sexy hospital bracelet.

I didn’t choose the surgical route lightly. Actually, I took advice from several physicians and healthcare professionals before making the decision. My rheumatologist (actually my rheumatologist was on mat leave so it was the one covering for her) diagnosed the hip tear and sent off for a surgical consult. She also told me to start physiotherapy for the tear as it is often helpful. Because things closed down because of the pandemic, I started virtual physio with my regular physiotherapist mid-April. Though exercise helped a bit, it was minimal. I added chiropractics, and massage back into my routine care (because of my undifferentiated connective tissue disease as well) in July, and then most recently started seeing the naturopath again at the end of September. All helpful, but not enough to take away the excruciating discomfort cause by the tear. They all also offered opinions, some differing, on whether I should have surgery. At the end of the day, with research done on my own, I decided that as my naturopath put it, surgery was really the only option to fix the problem.

And my sexy post-op selfie.

Now, I actually wasn’t nervous about the surgery, especially after finally meeting with the surgeon mid October, and literally being booked for surgery less than a month later. He was confident, read me off the risks which were minimal, and again, I did some research on long-term outcome studies. Yesterday, after I had been checked in, and then taken into the pre-op area for some vitals and questions, I started to get nervous. However, the amazing healthcare team (all the pre-op, op, post-op nurses; pre-op and op anesthesiologists and assistants; and of course my surgeon and surgical team) made me feel at ease. According to my surgeon after surgery, it went “perfectly.” Also a relief.

Image from: https://www.floridaortho.com/specialties/hip-thigh/hip-arthroscopy/

Post-operatively not so fun. I wasn’t actually nauseous at first and the pain in my hip I rated at a 6-7 (for which they had me on morphine) after about 30-45 minutes later (really was out of it and couldn’t keep track of time) I rated the pain about the same, so they gave me oxycodone, which then made me nauseous. It took another 2.5 hours for me not to feel “as nauseous”… basically the least amount for me to go home (and my pain was also down to about a 4 at the time). Long day. Probably longer for my amazing friend, Mike, who picked me up from my appointment and then took care of me at home (even brought groceries, and Starbucks!). The nausea stayed until like 7:30pm. Honestly, I think food helped. And I was pretty out of it all day. Oh yeah, they gave me Gravol for the nausea which totally made me drowsy. But we had sushi, and watched Netflix until like 9, when I passed out in bed.

Is everyone else singing, “Vanilla Ice, Ice, Baby…”

At this point I’m more annoyed about the post-op complications I guess? First, sore throat which apparently is common after coming off of general anesthesia, but I didn’t know that. I’m trying to drink a ton of liquids to help! Second, I have numbness in the groin area… maybe I’ll share more about that on a later post but let me say, not fun. Finally, living alone and trying to get around on crutches post-op is not fun. I have to ice my hip constantly, and then it took me forever to get coffee/breakfast ready for myself this morning. If it weren’t for the pandemic, my mom would’ve flown out to help me. Oh well, I suppose this is Chronic Pain Warrior life.

I’m quite impressed with my breakfast abilities this morning!

That was mostly thoughts… as for feelings, I’m tired and sore and frustrated (about the numbness) but also relieved to have the surgery over with, and hopeful that I will have significantly less pain in my hip. I mean, if I’m going to be a practicing therapist soon I need to be able to sit for long hours without looking like I’m in discomfort, so I can be present on focused on those future clients of mine!

If anyone else has an op/post-op experience they’d like to share, I’d love to hear from you. And remember, keep making the most of it. 🙂