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!

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!

How to Improve Your Health through Sleep

So I write a lot of blog posts for my clinics that are really relevant to all of you as well. As a counsellor I specialize in working with people with chronic pain and chronic illness and concussion. As someone who has chronic pain and illness I know how difficult having these conditions can be. I also know how difficult it can be to get a good sleep… but also how important a good sleep is to improving our health. Quite a conundrum. Check out this post I wrote about sleep hygiene and its benefits for our overall health, as well as some sleep hygiene tips that are totally applicable to spoonies (I use them myself!):

https://www.advancehealthandwellness.com/why-proper-sleep-hygiene-is-good-for-your-health/

Why Zebras Don’t Get Ulcers: A Book Review

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).

Image from: https://theconversation.com/putting-nigerian-neuroscience-research-under-the-microscope-101396

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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Sleep & Relaxation: A few products to try

If you’re a regular reader of this blog, then you know that I’m always looking for new ways to improve my overall health (and that I love to share my findings with all of you)! This week I want to explore a few items that can potentially help with sleep and relaxation. Sleep is incredibly important for your physical and mental health. Good sleep hygiene, in particular, can impact the quality of our sleep and improve our day-to-day functioning. However, what happens if your sleep hygiene is good but you’re still not getting a good sleep? Additionally, relaxation is important for Chronic Illness Warriors because if our mental health deteriorates, our physical health will as well (the body-mind connection). Pain increases with anxiety and depression, and there are lots of studies to support that, so relaxing (which helps anxiety) is another piece of the puzzle.

My parents dog was very relaxed there (and having a good sleep!)

I’m going to start with a product that I am currently using, which is the memory foam pillow. I first used one when I was visiting a friend awhile back and she had one. I found the pillow to be much more comfortable than what I was currently using. A few weeks ago I bought a memory foam pillow off of Amazon. Now, there are a ton of them on there. I bought a shredded one (again, going with what my friend had) but I imagine they have similar effects.

My memory foam pillow

• What I like about it: It is extremely comfortable when lying on your back and the right balance between soft and firm for me.
• What I don’t like about it: I’m a toss-and-turn sleeper, and it is much less comfortable when sleeping on your side and stomach (yes, sleeping on your stomach is bad and I try not to)
• Would I recommend it?: Definitely if you sleep on your back, otherwise I’m 50/50 on whether it improves sleep.

The second product I want to talk about is the body pillow. I don’t have one but I’ve done reading on them and I’m convinced I want one. Also sometimes I line my spare pillows up next to me and use them as body pillows. They are apparently good for side sleepers, help back pain, and possibly release oxytocin in your brain (according to one article I read but I’m not 100% convinced by that). Apparently you have to be careful and get one that is the correct height for you. If someone uses one, please comment and let us know what your experience is!

Image from: https://puffy.ca/products/puffy-body-pillow

The third product is weighted blankets. This is another product I haven’t tried but have heard amazing things about. I know a few people who use them and describe them as a “hug” and report that it does help their sleep. The thing to consider here is the weight of the blanket because you have to get one that is appropriate for your height/weight so you don’t get crushed but is also not just like a normal blanket. My former roommate had one that was too heavy for her so she gave it to her brother, whom it worked well for. Not only are they supposed to be helpful for sleep but also stress and anxiety, as they have some relaxation effects. If anyone uses a weighted blanket, a comment on this would also be lovely.

Image from: https://www.bearmattress.com/products/weighted-blanket

I have a birthday coming up so I’m likely going to buy myself either a weighted blanket or a body pillow (I’m not sure which one yet), so I’ll keep you posted on what I find. For now friends, 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!

Integrating Health with Mental Health

Recently I read an article in a psychotherapy magazine put out by the BCACC (British Columbia Association of Accredited Counsellors) about how therapists can and perhaps should integrate health promotion into their clinical practice. Being interested in health psychology anyway, and wanting to work with people with chronic illness as well as mental health problems, I devoured the article. Then I did a quick google search to see what others are saying. And while there are not a ton of journal articles on the subject, there are a few, all pointing to the same thought – this is something therapists should do. What makes it difficult is that psychotherapists, whether they hold a Masters or PhD (or not, depending on where you live they may not need either), typically don’t have a lot of training in health outside of mental health (always a little bit as it relates but rarely a large amount). This makes me curious as to what everything thinks about therapists encouraging health promotion, in some way, during counselling.

Article from Insights magazine (Spring 2017 issue)

What this article really looks at is not just physical health or mental health but all components of health. A holistic approach. Sometimes people go to therapy for things like weight loss, which in that case, health promotion and education seems necessary. Other times someone might bring it up as a secondary concern. There’s also, of course, the interrelation between things like exercise and nutrition and mental health. As well as sleep and mental health. See where I’m going with this? It actually might be almost impossible for therapists to not integrate health into counselling. So, while I usually save this kind of stuff for my premium blog, I thought I would share some health behaviours I’m going to put extra effort into this week, and I hope everyone reading thinks about some that they can as well! Body-mind connection week indeed!

• nutrition: I’m going to go with making sure I eat fruit everyday (which I typically do but sometimes stumble on the weekends)
• exercise: putting yoga back back into my routine at least 2x/week
• sleep: ensuring I don’t have anything to drink after 8pm (part of sleep hygiene!)
• other (social, hobbies, gratitude, mindfulness): playing the piano daily (I haven’t been playing as much as I would like)

As you can see, integrating health is rather inclusive and definitely extends beyond just physical aspects. Medication adherence can be another really important one for chronic illness warriors. The article I read speaks about Maslow’s hierarchy of needs, which I’ve mentioned in previous posts. We need to take care of our basic needs in order to take care of our higher needs. The three basic components of physical health I mentioned above are so important. So here’s my question (and I’d love answers in the comments), would you want your therapist to help you with aspects of health promotion that you are neglecting? Why or why not?

Family hike in the summer.

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

How has your sleep been?

I can’t overstate how important sleep is to daily functioning. For everyone, and definitely for those of us with a chronic illness. I know I’ve written about sleep before, and honestly, that is because it is that important. I wish I was one of those people who could function after 4-5 hours of good sleep. How amazing would it be to go to bed at midnight and wake up at 5. All the things you could do with the day. Alas, that is not the case for me or probably most of you, so I suppose it is not worth dwelling upon.

Spike was a pro at sleeping.

I will admit that I have not been sleeping well lately. And by lately I mean since my hip arthroscopy four weeks ago. Poor sleep is something I’ve experienced before. Waking up in the middle of the night because of pain, or not being able to get comfortable during the night because of pain. Anyone else with chronic pain experience this? I’m betting I’m not alone. The past four weeks have been slightly different. Yes, initially there was some pain from the surgery, and my hip was swollen, so it was difficult to shift around at night. I like to switch sides during the night, and occasionally sleep on my back or stomach as well. Immediately following surgery I could only sleep on my back. Then about two weeks later I could also sleep on my right side. The past few nights I can get onto my left (side that had the surgery) but only for short periods before I get uncomfortable. Technically my sleep has been improving the past few nights, but not to where I’d like it to be.

This giraffe looks like it’s in sleep mode!

Why is sleep important? Well, for one it can actually help with chronic pain. The better the sleep you get, the less pain you can experience during the day. It also helps with fatigue. That’s not to say your illness won’t make you tired during the day, but at least you won’t be starting off the day exhausted. And of course it is important for your mental health. You’ll be more alert, feel more positive, and likely have at least a bit of extra energy to do some of the things you enjoy during the day (self-care!).

Napping outside it always good! (as long as you’re wearing sunscreen).

So how can we improve our sleep, especially in situations where we are limited in how we can sleep (i..e, position)? I think the best way to go about it is just to make sure our sleep hygiene is as good as possible and that we are taking care of all of our medical needs. Sleep hygiene means we don’t drink anything 2 hours before bedtime (except for sips of water), drink caffeinated beverages after 2pm, exercise at night, do anything in our beds except sleep or have sex, and try practices such as meditation or having a hot bath in order to relax at night. As far as medical care goes, have we taken all of our medications as prescribed and at appropriate times? Have we taken any alternative medications (like marijuana or CBD oil for example) that can help with sleep? Can we sleep in if we need to? I know the last one is hard, especially if we have other responsibilities. Initially post-op I gave myself permission to sleep in (basically up until two days ago when I started setting an alarm again). Give yourself permission to do what is best for you and your health needs, because you can’t take care of your other responsibilities if you don’t!

As much as I like hammocks, I think just relaxing in them works better for me than sleep (Costa Rica throwback).

I would also add that consulting with your healthcare team might be useful as they might be able to suggest other strategies, techniques, supplements, etc to help you. Personally I would be wary of sleeping medication as it can be addictive but ultimately that choice is your own. I hope your sleep improves if you’ve been struggling. Feel free to share your own strategies, by commenting! Keep making the most of it everyone!