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.

6 Ways I’m Managing a Weather-Caused Flare (+ 5 More Ways I Could)

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.

1. 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.
2. 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.
3. 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.
4. 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!
5. 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.
6. 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.

Image from: https://www.medicalnewstoday.com/articles/323144

So those are the 6 things that I am doing, but what are the 5 things that I’m not but probably should be?

1. 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.
2. 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.
3. 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.
4. 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.
5. 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!

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Convos and Massages

I can never express enough how beneficial I find getting a massage. For someone who has all over body pain, spending 45, 60 or in today’s case, 90 minutes having a RMT deep tissues massage you can completely change how your body feels. Normally, I have a massage very 2 months, for 45 minutes to an hour. Because of Covid, I haven’t had a massage since February. I also normally feel good but sore after a massage. Today I just feel amazing. My body needed it, and needed it more than I could imagine. Luckily, I have insurance that covers it. If I didn’t, I know I would find a way to work it into my budget. Finding an amazing RMT is also something I can’t emphasize enough. I told mine about my hip tear, explained what type of tear it was and how it was giving me referred pain in my leg. She not only worked the hip and the thigh, but made them feel so much better. I know it’s a bandaid of sorts but sometimes that is enough to get you through, when you have chronic pain (or rather I should say ME because I can’t speak for everyone).

Image from: https://www.wellness-within.ca/massage-st-albert

I also always have interesting conversations with my RMT. I know some people like to go and just chill and relax and not talk at all during their services. I get that, and I’ve been like that. I do strongly believe in relaxation and relaxation techniques. However, my RMT is hilarious, engaging, and a great conversationalist. So, I know that when I go for a massage, we will talk the whole time and it will be about very diverse topics. We covered a lot in our 90 minutes today. From systemic racism in the police force and amongst white people in general, to anti-maskers, to Hamilton as seen on Disney+, to the Netflix documentary disclosure and how trans actors should be cast in trans roles. (There were a lot of other subjects by the way, but I feel like this gives you a general picture).

Image from: https://rogersmovienation.com/2020/06/25/documentary-review-disclosure-charts-the-evolution-of-trans-representation-on-film-and-tv/

What I’ve found is that because she’s intelligent and does research, we have these amazing intellectual conversations that are good for both of our minds. I’ve been talking a lot of about self-care in school. I’m taking a group counselling course in my master’s program. Last week, a partner and I ran a group on self-care for a few of our classmates, and this week one of the group’s I’m participating in is on self-care. One of the aspects of self-care that can easily be overlooked is the psychological. We need to engage our minds, whether through reading or good conversation, in things that we don’t normally engage in. It helps with our overall well-being. Reading, writing, watching a documentary, going to therapy, or having these types of conversations can fuel your mind, taking care of it. So, we can say that today I have already done some physical and mental/psychological self-care and it’s only 1pm.

Image from: https://bccampus.ca/2020/06/18/why-self-care-isnt-selfish-caring-for-yourself-during-covid-19/

If you’re looking at increasing your self-care, look at these different areas:

Physical – healthy eating, taking your medications and going to appointments, exercise, massages, physical intimacy with your partner.
Psychological – listed in the previous paragraph!
Emotional – hobbies, pets, social activism, volunteering, being in tune with your emotions
Spiritual – mediation, yoga, forgiveness, church, being in nature.
Personal – setting goals, family time, reading, learning something new, spending time with friends
Professional – not taking work home with you, taking appropriate breaks, taking mental health days, taking vacation time, setting boundaries

Reference:
https://crmhs.org/mental-health-self-care-2/