This is the last day of the month and a close to Pain Awareness Month. Not a big small business event? You’d be surprised. Thousands of small business owners are taking steps and making accommodations to help employees living with chronic pain stay productive.
Fibromyalgia affects more than five million Americans and is one of the most common, chronic widespread pain conditions, yet it is often called an invisible illness. The disorder is one of the most common chronic widespread pain conditions in the United States.
This short streaming video reveals some of the ways small business owners and entrepreneurs are making changes to help the millions of Americans living with chronic pain.
Please follow me on Twitter to learn more about small business trends and events to give you a competitive edge in business at http://twitter.com/danitablackwood
I didn’t intend to get into a theme this week, but this paper arrived in my inbox this morning, and given both the prevalence of fibromyalgia, and the often ‘fuzzy’ management that can be provided, I thought it might be worthwhile taking a look at it. The paper itself is a pre-print, but has been revised earlier this year and is probably the final version.
The outline of the paper covers diagnostic criteria, and briefly discusses the place of neuroimaging (if only we could get that done readily here!), but notes that many other conditions overlap or mimic FM such as hypothyroidism, tendonitis, ankylosing spondylitis, as well as chronic fatigue, suggesting some sort of common pathway in either the peripheral or central nervous system, raising the possibility of some common treatment approach. So far though, it’s not clear – and it’s important to rule out these other conditions that all have their own management approach before deciding that FM is what the problem is.
The next section of the paper reviews the current state of knowledge around pathophysiology as a basis for treatment and rehabilitation. Both peripheral and central sensitisation seem implicated in FM, leading to amplification of sensory impulses that alter pain perception. Increased excitation of various peripheral structures can in turn lead to neuroplastic changes in the central nervous system – winding up the whole experience for the person in the middle of it!
Imamura, Cassius & Freni, the authors of this paper, briefly review some of the factors thought to play a role in the reduced threshold for neuronal firing, including elevated levels of substance P, calcitonin gene-related peptide, bradykinin, and so on. Included in their review are CNS factors such as the altered non-REM sleep of people with FM – and that this is associated with the severity of symptoms; the association between depression and FM; and neuroimaging studies showing a change in regional cerebral blood flow to pain-related structures in people with FM.
If these aspects of FM can be explained to people with the pain problem it could make a significant difference to their own attitude toward their pain. For many people, it can take several years before a diagnosis of FM is made: during this time the beliefs and approaches of many practitioners can influence their understanding of their pain – and sadly, some practitioners are not empathic and can take a somewhat pejorative approach to people with the disorder. Knowledge can lead to understanding – and understanding can lead to a sense of empowerment.
Moving through the paper, the authors indicate that treatment needs to be based on the proposed model of fibromyalgia. That is, it needs to address central mechanisms rather than peripheral ones (so, no more NSAIDs, opioids or corticosteroids!), and the overall approach needs to be ‘rehabilitative’ – I’d suggest biopsychosocial as the model! The shift is from curing the problem to improving health status and health -related quality of life.
There are two arms of management for fibromyalgia:
(1) pain relief through medication and ‘physical’ strategies to reduce peripheral and central sensitisation
(2) cognitive behavioural approaches to manage sleep, fatigue, mood, cognitive problems, headache, migraine and other problems associated with FM.
Although the authors suggest ‘education’ as a cornerstone – I’d rather suggest helping the person to reconceptualise their problem as one of pain processing. Education can be seen as simply providing information – reconceptualising is about helping the person see themselves and their pain problem as something they can manage, something only they can do – and something they can do.
The remainder of the paper looks at pharmacological approaches and the rationale for using tricyclic antidepressants and/or serotonin/norepinephrine-reuptake inhibitors, and tramadol because of their effect on reducing afferent transmission at the dorsal horn or increasing the activity of the descending inhibitory pain systems.
It should be noted that even these drugs don’t always reduce the pain and all have their own array of side-effects – so they need to combined with self management.
Nonpharmacological approaches are then reviewed. This is where the interdisciplinary team can take the lead because these approaches are both effective – and once learned, don’t consume health resources in quite the same way as medications can.
Exercise gets the nod – remembering that exercise can include enjoyable daily activities such as walking, gardening, dancing and playing with the dog, not just going to a gym!
Electrical stimulation – this is suggested, although as far as I know, it’s not readily available – Imamura et al. indicate transcranial direct current stimulation as an effective approach, but I haven’t heard much of this as a strategy available in New Zealand. (If anyone has, let me know). I’m also not entirely comfortable with this as a self management strategy – it sounds pretty invasive and requires health care input, at least initially.
Acupuncture – this is less well-documented, and results are, as these authors say, ‘controversial’. They suggest that ‘clinical benefits seem to be of small magnitude and of short duration’ – my main concern would be that unless the person can ‘do it themselves’, it will involve more appointments, so I’d not be comfortable with it as a self management approach. I hold a similar view of injections – Imamura et al suggest that ‘concomitant myofascial pain, along with instruction in relaxation techniques, may benefit some patients with an associated mysfascial pain component.’
The final area reviews, very, very briefly, cognitive behavioural therapy. The authors indicate its use for ‘associated psychological and psychiatric comorbidity’, but I’d be inclined to challenge this. The perception of pain involves thoughts and beliefs about the meaning of pain – and the effect of reconceptualising fibromyalgia as not being a ‘life sentence’ or a ‘constant struggle’, and understanding what some of the mechanism are, will bring about changed perception. Distress reduction, increased sense of self efficacy and more effective approaches to activity, relaxation, cognitions, as well as effective communication skills and working on relationships - these are all integral to living a good life despite pain.
Overall – this is a nice, brief review especially of some of the pathophysiology of fibromyalgia and the rationale for the treatment approaches suggested. There are plenty of good references, and while it’s not an ‘easy’ read, it’s quite brief and contains the essentials.
From Imamura, M., Cassius, D., & Fregni, F. (2009). Fibromyalgia: From treatment to rehabilitation European Journal of Pain Supplements DOI: 10.1016/j.eujps.2009.08.011
Egoscue Portland comments on an article in the New York Times.
The best way to improve children’s performance in the classroom may be to take them out of it.
New research suggests that play and down time may be as important to a child’s academic experience as reading, science and math, and that regular recess, fitness or nature time can influence behavior, concentration and even grades.
A study published this month in the journal Pediatrics studied the links between recess and classroom behavior among about 11,000 children age 8 and 9. Those who had more than 15 minutes of recess a day showed better behavior in class than those who had little or none.
DAY 30: I choose to appreciate my naps since much healing occurs while I sleep.
I really resent having to sleep much of my afternoon away. A real indicator of health for me will be increased endurance and restfulness so that I will not have to stop and sleep. I hate this gradual loss of stamina during the morning so that by Noon I am struggling and finally after lunch I surrender and go for a nap. On some stronger days I resist the fatigue and attempt to miss the nap. Unfortunately, by supper I am ready to collapse. Therefore, I almost resist the growing body of evidence that suggests that everyone should have a nap in the afternoon!
Dr. Gregg D. Jacobs writes in an article called the ”Benefits of Naps” that “because the urge for a nap is appreciably weaker than the need to sleep at night, it can be suppressed (or masked by caffeine) but at the cost of increased sleepiness and reduced mood and performance.” He also states that “sleep itself may not be the crucial factor in the positive effects of afternoon naps on improving mood; what may be important is an afternoon period of relaxation common to both resting and napping.” (http://www.talkaboutsleep.com/sleep) Others who promote naps actually suggest that a power nap will give us more patience, less stress, better reaction time, increased learning, more efficiency and better health. These sleep advocates even suggest how long a nap to take in order to enjoy specific benefits. For example, a 20 minute nap increases alertness and motor skills; a 40 minute nap increases memory; and a 90 minute nap increases creativity! Apparently, it is unnecessary to have a nap longer than 90 minutes since it merely means that the cycle of sleep begins again. However, I haven’t found any research to determine whether some of those numbers may change for someone who is ill.
What this information does suggest is that if naps are that beneficial to healthy people how much more to those who are ill. The necessity of sleep was reinforced when I read A Stroke Of Insight by the brain scientist Jill Bolte Taylor, who had a stroke at 39 years of age. She writes, “When it comes to the physical healing of cells, I cannot stress enough the value of getting plenty of sleep. I truly believe that the brain is the ultimate authority on what it needs to heal itself . . . I remain a very loud advocate for the benefits of sleep, sleep, sleep and more sleep interspersed with periods of learning and cognitive challenges.”
Obviously, I need to positively approach my naps so that negative emotions don’t hinder the benefits of this afternoon rest! I need to imagine how my cells are healing and how my immune system is getting stronger while I sleep. I need to trust my body’s wisdom and know that when I no longer need long naps I will no longer sleep as long as I do! And apparently, I am in good company as I nap since the following were self-proclaimed nappers: Albert Einstein, Leonardo Da Vinci, Thomas Edison, Winston Churchill, Johannes Brahms, and Eleanor Roosevelt. If naps were good enough for them, I guess they are good enough for me too!
We are therefore Christ’s ambassadors, as though God were making his appeal through us (II Corinthians 5:20-21 NIV).
Our pastor recently preached on this passage. I usually associate this verse with foreign missions, but as I listened, I was impressed with a new thought.
He mentioned that the word “ambassador” means having a mission or assignment to carry out. This verse does not say that Christ’s ambassadors are only the healthy, the strong, the mobile, or the mentally alert. It says that we – all believers – are on this mission for God.
Many days I may feel I don’t have any “assignment”– I may not be able to physically “do” anything from my perspective. I then thought about ambassadors to other countries. I’m sure there are times when every day is not packed with activity, yet they still remain as a constant presence, ready and prepared to represent their country.
I can do the same. There may be long periods where I feel there is no “mission” I am capable of carrying out for God, yet His Word says otherwise. We are God’s only vessels on this earth. He has chosen us as well as the healthy and strong to represent him. If nothing else, our continued perseverance and faith is an assignment which may have significant effects in someone else’s life.
Our pastor also reminded us that an ambassador’s home is not where he is serving. He is living their temporarily until his mission is accomplished. I am actually doing that now on earth, and some days I am ready for my assignment to be ended because I just want to go home. But the Lord knows what only I can do for him, and until that is finished, He will keep me here. One glorious day, I will be able to say, “mission accomplished”. May I also hear the Lord say, “well done thou good and faithful servant”.
Prayer: Heavenly Father, thank you that you choose not only the whole and healthy but the weak and infirm as your vessels, for when we are weak, then you are strong. May we look on every day as an opportunity to represent you and do it well. Amen.
ABOUT THE AUTHOR
Bronlynn Spindler is a wife and mother of three grown daughters and lives in Fredericksburg, VA. God’s grace and strength give her the ability to deal with chronic back pain, depression, headaches, and fibromyalgia. You may contact her at spindler@cox.net.
originally posted on August 4, 2008; Re-posted 9-22-09
Complex Regional Pain Syndrome (CRPS), commonly referred to as reflex sympathetic dystrophy or RSD, is a syndrome in which pain, usually burning type, is out of proportion to the injury (either nerve or no nerve involvement). The pain may spread through the entire limb and/or to other parts of the body. Examples of precipitating events that may cause CRPS include the following: fractures, surgery, frostbite, soft tissue trauma, burns, MS, tight cast, strokes, heart attack and amputations. The symptoms are characterized by autonomic dysregulation such as swelling, vasomotor instability (skin becoming pale/cool/cyanotic or red/warm/dry), abnormal sweating, trophic changes (course hair, thick rigid or brittle nails, skin may become coarse or thin, smooth, and tight), hypersensitivity, abnormal motor activity, and decreased bone density.
Medically, CRPS is managed by a variety of medications aimed lowering the rate of nerve firing, reducing inflammation, reducing anxiety, and reducing pain. More invasive measures include sympathetic nerve blocks in the spinal column or ganglion blocks, implanted dorsal column stimulation or decompression, all of which carry the same risks of any invasive procedure.
The main reason for this entry is to share a positive treatment outcome for CRPS using IMT. In general, the physical therapy treatment for CRPS includes reduction of pain to allow the pt. to maintain function. Traditional forms of exercise such as aerobic, pool therapy, ROM, joint mobilization/soft tissue mobilization, exercise emphasizing compression and distraction, functional ex. and exercise that increases blood flow to the extremity or increase proprioception to the spinal cord may be beneficial All exercise must be extremely gentle and nonaggressive especially if not initiated during times of sympathetic blocks.
My past experience with CRPS includes most patients unable to tolerate any manual techniques and very minimal exercise resulting in extremely slow progress. It has been shown in research that early intervention with physical therapy is extremely important to minimize loss of function. The earlier the intervention the more likely to reverse the dysfunction.
Recently I evaluated a pt. with CRPS onset following a bunionectomy. The pt. presented 3 months post op with extremely antalgic gait, inability to bear more than 30% weight on the affected foot, and requiring a walking cast boot to tolerate being on her feet. The patient’s foot was swollen, reddened, and there was no active mov’t in the big toe. Within 5 treatments of IMT including light touch on areas of the body specific to affecting the autonomic nervous system and indirect myofascial release (vs. more aggressive direct techniques) the patient is able to bear 50-50% body weight, ambulate w/o the walking boot with more normality. Gait quality still consisted of slight antalgia, decreased push off and mild trunk shift but the patient is able to walk further and have more energy throughout the day to function. The skin has returned to a more normal color and edema has decreased resulting in less smooth/shiny appearance. The slough and calluses which persisted on her incision long after surgery fell off naturally within 1 week and active ROM has returned in the big toe. Range of motion home exercises are being performed in a warm bath and also passively to isolate different joints of the toe. Ankle ROM exercises are also completed in the bath. In no way is this patient healed or pain free but the quality of the toe/foot appearance, gait quality and tolerance have progressed more rapidly than I have ever seen in the past.
I know I’m more than a little biased towards IMT but I want people out there to know that there is gentle, effective treatment out there that can make life a lot easier and functional if you have CRPS. Please spread the word!! www.missionhillspt.com and http://missionhillspt.com/index.php?page=chronic_pain for success stories of patients who recovered from chronic pain issues.
For more information on the methods used at Mission Hills Physical Therapy please visit these sites
One problem that arthritis patients have in getting an affirmative arthritis diagnosis is that many forms of arthritis imitate one another, and even mimic other conditions. This makes it a difficult task for doctors to diagnose certain types of arthritis, and can often lead to frustration in patients, as well.
For one thing, there are over 100 types of arthritis. Additionally, some forms, such as Rheumatoid Arthritis, share many common characteristics with other diseases – specifically chronic and invisible autoimmune illnesses.
With so many symptoms overlapping and so many coexisting conditions, it is no wonder that patients and doctors are sometimes left in a state of confusion over the actual cause of the problem, or problems, at hand.
Conditions such as Rheumatoid Arthritis, Lupus, Fibromyalgia, Sjogren’s Syndrome, and Multiple Sclerosis, for example (just to name a FEW!) have many of the same symptoms: aching joints, muscle tenderness, overall pain and discomfort, stiffness, severe fatigue, headaches, a feeling of weakness, and so on. Many patients with these symptoms have an elevated rheumatoid factor and coexisting symptoms such as vision/eye problems, gastrointestinal issues, etc. Additionally, many of these conditions’ symptoms lull and flare, and are not consistent on a day-to-day or even hour-to-hour basis, which makes it a hit-or-miss situation when visiting a doctor to try to “show” them your symptoms upon physical exam. All of the above conditions are autoimmune in nature, causing a weakened immune system that attacks itself, and that can cause other illness, as well. In fact, many medications and natural courses of treatment overlap for all of the above-named conditions, too. Even more perplexing is that these conditions often coexist in the same patient, at the same time!
With all of this being said, you may wonder why it matters to get an official diagnosis, if many of the symptoms, outcomes, and courses of treatment are the same. Getting an official diagnosis is important because, although many aspects of these illnesses do overlap, each has its own exclusive set of symptoms, as well. For instance – someone with RA may have swelling – but no swelling or inflammation is typically present in fibromyalgia by itself. Depression, while a common factor in any chronic illness, is more closely associated with MS than any of the other aforementioned conditions. Likewise, patients with MS and RA may have vision issues, while someone with Lupus may not. People with Sjogren’s deal with severely dry eyes and mouth, which isn’t always common to the other conditions. Rheumatoid Arthritis is closely associated with certain forms of cancer, heart disease, low-grade fevers, and thyroid problems; and MS is associated sometimes with musculoskeletal issues and food allergies. Lupus patients typically get a red butterfly rash on the face, as well as occasional edema in the lower legs. As you can see, it is important to treat each illness on its own, in order to take care of each individual symptom, despite so many of them overlapping.
All of the similar traits of these types of illnesses can often lead to misdiagnosis, or, a “missed” diagnosis. This is why it is important to share EVERY symptom or change in your health – even if you think it is irrelevant – with your health care professional, so that they can make a reasonable assessment and an accurate diagnosis. The one symptom that you neglect to tell your doctor may be the key in proper diagnosis of your condition.
So how DO they know what you have? In diagnosing forms of arthritis and related conditions, a doctor usually couples a physical examination with bloodwork. Additionally, they also factor in the patients’ personal description of ailments. In many cases, the lab work is used to rule out other conditions, and a diagnosis is often made using a “process of elimination” of sorts. Unfortunately, people who have one form of arthritis (for example, RA) often have another co-existing form (i.e. osteoarthritis or fibromyalgia.) Likewise, patients with one autoimmune condition typically have more than one – often, three, overlapping conditions at once.
Other reasons for coexisting conditions and overlapping symptoms in arthritis patients include medications and lifestyle. Arthritis patients with a more sedentary lifestyle are more prone to obesity which can then lead to diabetes or heart problems. Additionally, many medications can cause nasty side effects ranging from partial blindness to neurological and gastrointestinal problems – and even cancer.
It is important to stay proactive in your health. If you are unsure “what you have” – see a doctor. A helpful tip is to keep a health journal, and, before your appointment, document every symptom that you have – even if you aren’t sure it is a concern. If you are unsatisfied with a diagnosis, seek a second or even third opinion until your issue is resolved. Do not ever write anything off. If you have these types of conditions, you need to be aware of everything that is going on with your body. Educate yourself on your disease. For instance – if you have arthritis, do you know what type you have? Is it rheumatoid, which is autoimmune in nature? Or, is it osteoarthritis, which is more mechanical; more “wear-and-tear”? Is it another rheumatic condition – bursitis, myositis, gout, Sjorgen’s, Still’s Disease, ankylosing spondylitis? Make sure you understand your illness and the array of symptoms associated with it. If anything new pops up, let your doctor know – it is better to be safe than sorry.
For your information, here are a few quick facts and tips to keep in mind:
There are 117 types of arthritis. You can read about them from the Arthritis Foundation here: http://www.arthritis.org/types-arthritis.php
There are over 100 known autoimmune diseases – many of which are also considered – you guessed it – forms of arthritis and rheumatic disease.
A symptom common to all of these conditions is severe, debilitating fatigue. Another is widespread weakness and pain.
Another attribute common to all of these types of illnesses is the fact that they are chronic. A chronic illness is one that is ongoing, long-standing, and typically, permanent. Often, chronic illnesses may be treatable to an extent but have no cure.
If you have a chronic illness like arthritis, be certain not to neglect the needs of your spouse/partner, family, and loved ones. It is sometimes all too easy to concentrate on yourself and your symptoms and overlook the needs of others.
People with these types of diseases are prone to anxiety and depression. Be on the lookout for any signs of mental or emotional distress.
An accurate and official diagnosis is often needed in order for health insurance to cover your condition and provide benefits.
The Arthritis Foundation provides brochures and literature on the 117 types of arthritis. Contact us if you need any types of resources or support.
Keep in mind that all of these illnesses CAN AFFECT CHILDREN, too! If your child’s pediatrician gives you a diagnosis you disagree with, keep tabs of his/her symptoms and seek out a second opinion.
Please note, too, that we will not be airing a new episode of Arthritis Radio this week, due to the G20 Summit being in town here in Pittsburgh. However, in correlation with this blog, we encourage you to go back and browse our archives – you will learn a lot from episodes 1-8 about rheumatoid arthritis, osteoarthritis, juvenile arthritis, fibromyalgia, and overall wellness.
Check it out here: http://arthritisradio.podbean.com or search, “Arthritis Radio” on iTunes!
“A good friend is a connection to life – a tie to the past, a road to the future, the key to sanity in a totally insane world.” —Lois Wyse
1. Understand that she lives in a constant state of making decisions for which there is no guarantee that she is making the right choice.
2. Put meals in disposable containers and attach a note saying “This doesn’t need to be returned.”
3. Add stickers to envelopes for a cheerful touch.
4. Arrange for your friend’s kids to have a night with your children.
5. Don’t make a person into a project.
6. Ask, “Would you be willing to talk to a friend of mine who has recently been diagnosed with a chronic illness and offer her some encouragement?” It makes one feel good to know that her experience can offer someone else hope and that God still has a purpose for her life.
7. Wash his car and put a little note inside for him to find later.
8. Remember important anniversaries, both the good and the bad. No one else will.
9. Ask, “Do you want company the day that you wait for the test results? I could come over for a couple of hours.”
10. “No matter how little you have, you can always give some of it away.” ~Catherine Marshall. Just listen . . . until it hurts to not say anything. And then listen some more.
11. Ask her, “How do you feel God is working through-or despite-this illness in your life? I’m interested.”
12. Ask, “What do you wish people understood about your illness?”
13. Don’t make her feel guilty about things that she cannot do.
14. Treat her to a gift of movie rentals via postal mail through a service ($7-15 a month).
15. Ask, “Would you be comfortable with having your name on a prayer list, so that others can pray for you?” Don’t assume.
16. Instead of saying, “I will pray for you,” say, “I’d like to pray for you right now, if that’s okay.”
17. Mop the floors.
18. Ask if she would be interested in writing something for the church newsletter, maybe even about the subject of living with chronic illness.
19. Buy a brightly colored umbrella as a gift.
20. Ask, “Do you have an errand I can run for you before coming over?”
21. Ask her to do spontaneous things, like go to a concert in the park, or just for a picnic. She may be more likely to participate since she knows if it’s a good day or a bad day.
22. Don’t say, “So, why aren’t you healed yet?” or “I wonder what God is trying to teach you that you just aren’t learning!”
23. For a unique gift, provide brightly colored paper plates, napkins, and utensils in a gift bag with a note that says “For when you don’t feel like doing dishes.”
24. Get her a pretty box to keep all of her notes of encouragement. Remind her to get it out and read things when she is feeling down.
25. Be her advocate. If you are at an event and walking/seating is an issue because of her disability, ask her if she’d like you to take care of it. If she says you can, be firm but not rude. Don’t embarrass her by making accusations of discrimination or by making a scene.
26. Ask, “Would you be interested in a prayer partner from our church?”
27. Purchase matching coffee mugs for you and your friend, and then commit to pray for one another each morning while using them.
28. Say, “While you’re in the hospital I’d be happy to take care of your pet.”
29. Don’t tell her about your brother’s niece’s cousin’s best friend who tried a cure for the same illness and. . . (you know the rest).
30. Find out which charity is most important to her and then give a donation in her honor.
31. Ask, “What are your top three indulgences?” and then spoil her soon.
32. Hold the door open for her. They are heavy!
33. Don’t tease her and call her “hop along” or “slowpoke.” Comments you mean in fun can cut to the quick and destroy her spirit. Proverbs 18:14 says, “A man’s spirit sustains him in sickness, but a crushed spirit who can bear?”
34. Say, “I know you must need someone to just vent to occasionally. I may not fully understand how you feel, but I’m here to listen anytime.”
35. Ask your church youth group to come over and clean up the yard during seasonal changes.
36. Don’t ask her, “How are you able to make it financially?” If she wants to share a burden she will.
37. Ask, “What would you advise me to look for in a new doctor?”
38. If your friend has a disabled parking placard and you are driving, allow her to tell you where she wants to park. If she’s feeling particularly good that day, she may not want to park in the “blue space.” Don’t be disappointed that you’ll have to walk farther.
39. Don’t gossip about others. She’ll wonder what you say about her. “Do not let any unwholesome talk come out of your mouths, but only what is helpful for building others up according to their needs, that it may benefit those who listen” (Ephesians 4:29).
40. Proverbs 25:11 says, “A word aptly spoken is like apples of gold in settings of silver.” Be kind, gentle, and respectful.
41. Accept that her chronic illness may not go away. If she’s accepting it, don’t tell her the illness is winning and she’s giving in to it.
42. Don’t say, “Let me know if there is anything I can do.” People rarely feel comfortable saying, “Yes, my laundry.” Instead pick something you are willing to do and then ask her permission.
43. Ask her to share her testimony at an event.
44. Buy a magazine subscription for her on her favorite topic.
45. Plant a rosebush to view from a window.
46. Understand that you don’t need to know all of the details about the illness in order to be helpful. He’ll share with you what he’s comfortable with you knowing.
47. Don’t ask, “Why can’t the doctors help you?” or insinuate that it must be in her head. There are millions of people who are in pain with illnesses that do not have cures.
48. Avoid having gifts be “pity gifts.” Just say, “I saw these flowers and their cheerfulness reminded me of you.”
49. Send tapes of church services your friend misses to her with a copy of the bulletin and a note.
50. If she doesn’t have a cordless phone, get her one. Phone headsets are also nice.
Reprinted from Beyond Casseroles: 505 Ways to Encourage a Chronically Ill Friend by Lisa Copen.
The worst thing in the world is to try to sleep and not to. ~F. Scott Fitzgerald
DAY 23: Continue to find strategies that will improve my sleep.
It has been frustrating to have a conversation with someone and I would mention how my body is always hotter than anyone else’s and how I often get very feverish. Immediately, I would get a knowing nod, “Yes, doesn’t menopausal hot flashes suck.” Well, yes as a matter of fact they do. But try adding heat that is constantly there and then gradually as the afternoon progresses and turns into evening that heat increases to the point that my husband has commented, “You could heat a room.” I like to think I have saved us considerable money on heating our house since I often don’t often need to put on the furnace even on our cold winter days. My family comes home and they tell me they are freezing!
Finally, my current doctor has explained that my thermal regulator has been compromised and it won’t get better until considerable amount of mercury and lead is pulled from my body. In the meantime, I am always experiencing sleep deprivation. Greg laughed last night when he read that many people have sleep disorders so that they can’t sleep past 6 a.m. We both long to have that kind of sleep. Yes, I have given Greg a sleep disorder since he often wakes up throughout the night due to what he calls “the Furnace” sleeping beside him.
A common sleep pattern for me is to wake up every two hours until around 4 or 5 a.m. when I finally can’t fall back to sleep. Needless to say, this lack of sleep is a huge component to the pain that I experience. However, I have tried many different sleeping pills but none can compete with the heat that wakes me up! They merely make me feel very groggy the next day!
Well, last night I incorporated various strategies that I have done individually before. First, I stood in a cold shower waiting for my body to be uncomfortably COLD. Secondly, while I stood in the shower, I practiced some acupressure points while I made some affirmations about my sleeping. I know that I have some negative emotions around this sleeping problem so that I admitted those emotions but finish with positive statements. For example, I said, “Even though I I will never get over this sleeping problem, I know I will get healthy.”. I added, “Even though I will never get over this sleeping problem, I deeply and completely love and accept myself.” I concluded with “Even though I will never get over this sleeping problem, I know that God wants me to have a good rest tonight.” Then I took a Tylenol to see if that would lower my fever. I also took 3 Melatonin which helps put a person into a deeper sleep. When I lay in bed, I began focusing on the statement, “I am sleeping until 6 a.m. tomorrow morning.” Amazingly, I woke up once last night with the heat, took a cold cloth to cool my arms and legs , ran water on my wrists and then washed my face with cold water. I returned to bed and fell asleep until 6 a.m.!!!
Needless to say, I am trying these strategies again tonight!!
DAY 21: Put a pitcher of water in the fridge to ensure that I am drinking 10 glasses of water.
My doctor gives a series of lectures that he wants his patients to attend to enable them to do all that they need to do to get well. These lectures also help them better understand the types of treatments he gives them. When I became one of his patients, I began attending the lectures. Unfortunately, my health continued to worsen and I wasn’t able to attend all of them. Since then, he has also expanded on each of the topics. I had hoped that I could take his whole series again and the first lecture was on Saturday. I got ready to go, but minutes before I was to leave, I conceded that I had too many symptoms especially dizziness and I needed to stay home. Therefore, I decided this week to look at my notes from the first time I attended and review what I learned from his first lecture.
This first lecture was a general overview of the 7 things the body needs:
Adequate fluids
Rest
Oxygen
Nutrients
Sun – Vitamin D and Serotonin
Exercise
Germs
He spent quite a bit of time discussing how the body cannot function without enough water since all of our cells and organs depend on water. Water acts as a lubricant, forms the base for saliva, forms the fluids that surround the joints, regulates our body temperature, helps to alleviate constipation, regulates metabolism, and plays a key role in the prevention of diseases such as colon cancer. Interestingly, he mentioned the book Your Body’s Many Cries for Water whose author maintains that “Unintentional Chronic Dehydration (UCD) contributes to and even produces pain and many degenerative diseases that can be prevented and treated by increasing water intake on a regular basis”.
After discussing the benefits of water, he proceeded to explain that tap water can actually contribute to other health problems since the water treatment plant cannot filter all of the chemicals found in the water. It was rather unsettling to contemplate how all the antidepressants, hormone replacements, contraceptives, and industrial sewage still exist in our water. He believes that one of the reasons for the increasing trend of males developing breasts and females having periods at a younger age could be attributed to the increased estrogen that people are drinking! Obviously, he wants his patients to drink water that has either been distilled or to use Reverse Osmosis since these systems better filter out those agents.
We actually have had a Reverse Osmosis System for a few years . However, we have learned that since our system is older, it is most likely not as efficient filtering all of the toxic materials. As part of my program of optimizing my healing environment, we may need to investigate this matter further to determine whether we need to upgrade our system.
Most importantly, I need to begin the practice of putting a pitcher of water in the fridge to ensure that I am really drinking ten glasses of water. I am continually thirsty so I assume I am drinking that amount but I need to know definitely. Just imagine if I drink consistently enough water some of the pain might lessen and I would experience more energy!
Your shoulders and knees are throbbing with pain, so intense you can’t even cover up with a sheet, but there’s no explanation as to where the pain is coming from. The only thing the doctor can tell you is that it isn’t originating from your shoulders or your knees. Well, thanks a lot doc. Another doctor, a different doctor, tells you it’s all in your head. “We’ve conducted test after test, and we just can’t find anything wrong with you. It must be psychological. Here’s the number for…” You’ve heard it all before, and it’s getting rather monotonous.
Let me tell you something. You are not crazy. Your pain is real, no matter what anyone else says.
The first step of diagnosing Fibromyalgia, (FMS), is to rule out every other illness on the face of the planet, everything from the flu to Lupus. Yes, this can take months, even years. But you can’t give up. You can’t go on letting the pain determine what you’ll do, (or not do as the case more likely is), day-to-day. Don’t let it take control. You take control.
One of the most difficult aspects of this chronic illness is dealing with the brain fog. I’m not making that up; it’s a real symptom. Brain fog feels exactly like it sounds – like you’re trying to find your way through the fog, but the fog is only increasing with every step you take. The harder you try, the more confused you become. Try talking coherently when you feel like you just got whopped upside the head with a basketball thrown by Michael Jordan. It ain’t easy. In fact, it’s impossible. Anything you do manage to get out of your mouth sounds like it’s been filtered through….well, fog. This only assures the doctor that he’s right, you’re crazy, and you need mental help.
Still, don’t let it stop you. Go home, and do your best to get some rest. When you feel better, (it does happen, believe in that), either call that doctor back or find another one who will listen. Tell him or her, (don’t ask, tell), that you want to go ahead and begin working toward a diagnosis, whatever it takes.
It took me about 18 months, and an extreme amount of patience, to find the right doctor and obtain a diagnosis. Not to mention that my family suffered greatly. My husband couldn’t understand why I, the active, social woman he met only four years earlier, could not get up off the couch even if he told me there was baklava in the next room. My sons, toddlers at the time, wondered why I wasn’t down on the floor playing with them. I scarcely remember family events because I wasn’t truly there.
The first doctor I saw about my pain was one of those who was certain I must be imagining it all; either I was a hypochondriac, or a drug addict trying to score some narcotics. He didn’t even order blood work. It took me no time at all to start looking for a new doctor. After a few months and three or four more doctors with much the same opinion I got lucky, or, more accurate, blessed. A co-worker noticed that I’d been hobbling a lot lately, running into walls, cringing at every noise, etc, etc. She asked me if I was okay. I never have liked to talk to anyone about my health problems, but for some reason I opened up to this woman and just spilled my guts. I told her all about the pain and fatigue I’d been experiencing, and about not being able to find a doctor who believed me. She recommended her own doctor, a general practitioner who was kind and caring. I scheduled an appointment. It saved my life.
The good doctor, as I’ve come to refer to her, ordered blood work first, to determine if it might be arthritis, or diabetes, both of which run rampant in my family medical history. It was neither, (though there was bursitis in my knees and tendonitis in my shoulders), so we took the next step; she ordered another blood test to check for Lupus. That was also negative, but the test for Lupus, ANA it’s called, runs a 50/50 false positive result, meaning only 50% of the test results are accurate. Because of that, over the course of about nine months, the doctor ordered two more ANA tests. They were negative also. I had two MRIs, a cat scan, and nerve testing done. Finally, upon conclusion of those tests being negative, the doctor decided I must have Fibromyalgia, and she sent me to a rheumatologist to confirm that theory. While I wasn’t too fond of the rheumatologist’s bedside manner, (or lack thereof I should say), he did confirm that I had Fibromyalgia. Finally, I began to accept that I was not insane, that I was not a hypochondriac, but that I was truly ill. As hard as it was to hear I had this terrible illness, it was also a blessing, simply to have a diagnosis. That diagnosis led to the next step, treatment.
There is no cure for Fibromyalgia. So, what can be done? The most important part of treating Fibro is also the most challenging, for me at least. I was told that I must first and foremost change my lifestyle. The fact that I was always going, going, going was the main contributing factor to my illness. How in the good Lord’s name are you supposed to slow down when you have a husband, two school-age children, and a full-time job that consumes your entire life? Good question, and not one that I can answer with confidence. The most important thing I’ve learned over the years is that I can’t possibly do it all, and worrying about it does nothing but make the pain and fatigue that much worse. So I put a stop to the worrying, or at least I slacked off as much as possible. It helped.
Keep in mind that you must exercise, but not too much. When I was in high school I was captain of the auxiliary corp, and acted in plays with the speech and drama team, among other pursuits. When I moved out of my parent’s home I held down three jobs at once. In other words, I was always on the move. It never occurred to me that I should sit down and relax now and then. Therefore, I had no idea how to do just that – sit down. I had to train myself to take breaks, stop myself from speed-walking at the park, and refrain from breaking out in a run when my sons rode their tricycles. Yes, it is easier said than done. But it can be done. You just have to stick with it. And don’t make the mistake of thinking you only need to take a break if you’re not feeling well. You must ensure you’re getting enough rest, even when you feel great and wonder how in the world you could’ve been diagnosed with a chronic illness. That’s a mistake I’ve made over and over, and I’m sure I’ll do it again. When I’m having a good day, I feel like I need to “hurry up and get it all done” before I start to feel a flare coming on. Well, guess what. That’s exactly what leads to a flare, (or one thing that does anyway).
A flare is what I call “couch days” – days when you couldn’t pull yourself up off the couch if your life depended on it, when you feel like you have the flu and have just been startled, never being able to let go of that tension that being startled causes; all the while someone, or something, is stabbing flaming needles through your fingertips, your toes, your eyelids, just wherever they feel like partying at the moment. There have been times when I was certain I was dying. That’s how bad the pain can get. You’d think the memory of those times would cause me to be more careful when I do feel well enough to “get it all done”, and in some cases it has, but for the most part I ignore those memories and set forth to do it all anyway. Take it from one who knows – don’t do it!
Another thing that must be done, but is also difficult, is to not let yourself get stressed out, over anything. Long before I was diagnosed with Fibromyalgia, I was diagnosed with chronic depression. One theory is that FMS is caused by depression. Another theory is that depression is caused by FMS. I tend to agree with both. I’m certain that my depression was a major contributing factor to the FMS, but I’m also certain that the FMS causes me to be depressed. Think about it. Who wouldn’t be depressed when they have to lie on the couch watching their children play instead of being able to get up and play with them? This is why it’s so important to properly maintain your stress level. Just like forcing yourself to take breaks on those good days, you must do something for yourself that will make you feel good, that will make you smile, that will make you laugh. Read the comics, watch your favorite episode of I Love Lucy, listen to your children laugh, whatever it is that lifts your heart and makes you feel like you’re walking across fluffy clouds, do it. Put it on your calendar if you have to.
Something else you can do to ease the pain is to make sure you’re getting the proper kind of rest. I stress “proper kind” because it means something entirely different than “enough”. You could sleep for twelve hours, but not feel any better if that sleep was interrupted by nightmares, pain in your legs causing you to toss and turn, etc, etc.
It’s important to have a specific bedtime ritual, and to go to bed and get out of bed at the same time each day. About an hour before you want to go to sleep, prepare yourself to go to sleep. Think of the things that help you relax, and use them. There are many different methods for this of course, and what works for some won’t work for others, but I’ll tell you mine.
I am a reader, maybe too much of one, (that, according to my husband). I take a book to bed with me every night. Sometimes, not having read the book before, I don’t realize that it’s going to get so exciting that the story ends up waking me up, wide-eyed, instead of putting me to sleep. Well, I’m not one to preach on the subject, but if you realize this is happening you should put the book down. I would never do that, but it’s what you should do. Then pick up something else, something you’ve read before and know won’t excite you, and read it.
Before I begin to read though, I turn on my noise machine, (one of those doo-hickey’s that make nature noises you can buy at any Wally World), to the sound of ocean waves. Then I pull the covers over me, and position my two pillows to cradle my neck and shoulders just so, close my eyes, imagine myself lying on the beach, at night, alone, and take ten deep breaths, very slowly, in, out, in, out. By the time I open my eyes back up to read the boring book I’m already halfway to dreamland. My muscles are relaxed. I’m calm as a newborn kitten. Then my husband storms into the bedroom to tell me about the exciting play on the Steelers game he’s watching, and I have to start all over. I don’t let it irritate me; I just start all over. It works. Usually I sleep peacefully for eight hours, or until the hubby has to push me out of bed to get me going the next morning. Getting that type of rest, the peaceful kind, will do wonders for ensuring your fibro pain is not as great as it could be otherwise.
These are just a few tips for controlling some of the pain associated with fibromyalgia. It doesn’t begin to touch on how many symptoms there are. Fibromyalgia can cause, or be associated with, a wide variety of phenomenon. See Fibromyalgia for more information. At the risk of sounding like a commercial, if you’ve been experiencing any of these symptoms, and are having trouble getting a doctor to help you, or even believe you, just keep on keeping on until you find the right one. They’re out there, I promise.
The fact that it is pretty. The cooler weather I could do without. This morning it wasn’t even a balmy fifty degrees. Now that makes for a rough morning. But the leaves are changing color and when you look outside it’s a colorful world. A tantalizing tease before winter hits with its gloom. I have grown to despise winter and cold and snow. Finny how this happens as we get older. I remember being a kid and you couldn’t keep me inside in the winter now it’s a struggle to get me out of the door!
Yesterday I got my trigger point shots from my doctor – they are not steroids (don’t bother w/steroids because if it is truly Fibromyalgia the steroids will not help) – they are numbing shots. My trigger point injections are used to numb just the worst areas where I have hard knots – sort of like marbles or in some cases golf balls under my skin that can not be broken up with massages (I have much to say about massage therapy but not today). The injections also temporarily break up the knots. Sometimes it lasts for a couple of months, sometimes just a couple of weeks but they offer true relief even if just for a bit. The knots always come back but any relief is good for me. However the day after I get the shots is not always a good day. Sometimes it is even the worst of days because every spot where the shots were injected HURTS – it’s like my body is rebelling. Thankfully that usually only last for that one day after – so today I was woken up by the pain – and today nothing could touch the pain – at some points I thought cutting my left arm off would be preferable to dealing with it any longer. So I thought “great…fabulous…a really bad day…yee haw!”
But then I won an online contest for an ARC (Advanced Reading Copy) of a new book from a series I have really been wanting to read. And that little thing…a note in my inbox from an author (just getting any email from a published author is awesome enough)…it changed my day. I went over to twitter and told my book blogging buddies about it…did the Twitter equivalent of jumping up and down and was flooded with warm wishes and congrats and teasing jealous comments. All of it lifted my mood. Then one of the other bloggers commented on how she loved my review of the Julie & Julia movie from my BookObsessed blog and an amazing thing happened, a whole bunch of other people started sending me notes about my reviews and how they enjoyed them and started pushing me to put out the post for a book they knew I finished earlier this week but hadn’t reviewed yet. The pain didn’t go away. I spent most of the day with an ice pack and some of it laying down but I did work on the review after the little push they gave me…their support helped me to do something instead of nothing. Nothing good was expected from the day but I was surprised to find good beyond, through and outside of the pain. I didn’t finish the review but it was more than I’d hoped to do today and for me that too changed my day.
I know this is a bit rambling-ish but I hope the point came across regardless. Sometimes it’s not a good day or a bad day but bits of both and you should grab that good and hang onto it because it make the bad not quite so bad. Ahhh…good night, Heather
Today is World Suicide Awareness Day. Now I don’t know about you, but I’ve generally found that the topic of suicide is one that is danced around, and talked about more in hushed voices than normal ones. But it’s the topic of my post today. And here’s why:
The leading cause of death from fibromyalgia is suicide.
This is not because fibromyalgia patients are depressed (even though chronic pain does frequently cause depression), but because their symptoms are inadequately managed. The pain is so bad and so constant that death is preferable.
NOW, while I have never really considered suicide myself, I do have a confession to make. A few days ago I was in a lot of pain and had been lying awake for hours. I had gone to bed at eleven thirty and was still awake at four in the morning. I seriously considered getting up to take more painkillers. “If two make me drowsy, how many will it take for me to fall asleep?” Please don’t lecture me; I know how dangerous that is, and what a slippery slope it can be. Immediately after that thought, I stopped myself firmly. I don’t want to start abusing painkillers, or using them to escape my problems. I don’t want to be the victim of an accidental overdose, or even make some mental connection that taking painkillers to fall asleep is an acceptable thing.
It may also be said here, though, that I come from a family history of depression. My grandmother attempted suicide, and, when I was around three or four, my mother seriously began considering and planning a suicide attempt. I don’t know what I would have done without these two wonderful women. I am constantly amazed by their strength, to keep living even when they felt so strongly that they didn’t want to.
In him we were also chosen, having been predestined according to the plan of him who works out everything in conformity with the purpose of his will, in order that we . . . might be for the praise of his glory (Ephesians 1:11,12 NIV).
I recently read the book Images of the Blue Ridge Parkway by George Humphries. Taking more than twenty years to accumulate perfect photographs for the book, the author succeeded in creating a glorious work of art and beauty.
I’m sure the author traveled at all hours, in all kinds of weather, and in all seasons of the year to acquire such perfect pictures. He probably had some days that were not successful and some photos that were disappointing. Perhaps when he first began taking pictures, he didn’t even know that the end result would be this beautiful masterpiece. It was an accumulation of hours, days, months, and years of perseverance and effort.
I began thinking of my own life. Lately I have been struggling yet again with my purpose here and asking God why – why do I have to deal with these limitations when so many others I know are leading such full, active lives? Just when I think I have come to total acceptance, I enter another round of questioning.
I realized that my life is like that book. I have had seasons full of activity and accomplishment – some nice photos. Now I am in a place where that doesn’t seem to be the case. Yet the entire sum of my life is producing a work of art for God’s glory. He’s producing a masterpiece in me and in all believers, but it is one that takes many years and experiences to complete.
When I wake up in the morning and have that old familiar feeling of “why another day Lord?”, I want to think of that lovely book and what it took to produce it. I’m traveling on my journey with God, and need to ask myself how I can live another page of glory to Him today.
Prayer: Lord, give me the strength and desire to make your glory reason enough to answer all my “whys”. Amen.
ABOUT THE AUTHOR
Bronlynn Spindler is a wife and mother of three grown daughters and lives in Fredericksburg, VA. God’s grace and strength give her the ability to deal with chronic back pain, depression, headaches, and fibromyalgia. You may contact her at spindler@cox.net.
This post will be coming at you in list form due to lethargy and brain fog
This week’s positives:
Trusty sidekick has been promoted to partner in crime, I am no longer alone in the search for solutions!
I have started a journal of symptoms, diet, exercise etc etc to try and figure this whole mess out.
I have started to take Magnesium and Calcium which is meant to help me sleep better and my muscles hurt less.
I finished my first TAFE subject!
I got a love letter in the mail:)
This week’s negatives:
Extreme fatigue, weakness, pain and brain fog.
Onset of new weirdy symptoms that are not welcome here!
The spooty symptom award winner has gone large with me experiencing the nauseaus-dizzy-spinning symptoms both day and night when I am ‘tired’ making it very difficult sometimes to walk and do things. I feel very off balance and like i’m going to ‘fall off’. I have to hang on to things to get about and walk very slowly to stop the spinning feeling and falling down. Being ‘tired’ makes me feel like i’m going to throw up and pass out.
Feeling completely worn out after the most minor exertion eg: huffing and puffing, having difficulty catching my breath, heart thumping and racing, deep breathing after doing something as simple as getting out of bed, getting a glass of water, walking slowly up the back steps or checking the mail.
Crazy pain, not just the usual ’sore’ type but this week I have experienced a whole new bunch including ’stabbing’ ‘pin pricking’ ‘prickling’ as well as ‘aching’ and ‘twinging’. Pain intense enough it keeps me from sleeping, scares me in the dark of the night and feels like my nerve endings are exploding.
Lonliness, frustration anger and sadness. Wanting to give up.
On May 30, 2008, a little over a year ago, I thanked God for my health. I remember very specifically writing the words and in fact, I pulled out my journal just to prove that it happened. I wrote, “Thank You for today. Thank You for my health and the fact that I can get up in the morning and walk.” I do not know what prompted this. Moreover, I cannot remember a single time before this that I specifically thanked God for my health and mobility. I should have been praising Him daily for it, but I hadn’t been. I think that I considered health more of privilege than a blessing. But on this day in May, beneath the Roman sun, I was convicted that I did not have a right to my health, that the Lord blessed me with the ability to walk, and I was so grateful.
Today, I woke up at 8:30 for class. I made myself presentable and rode my bike to the quad. I made it through all my classes, even Logic and Reasoning, which is excruciating. Between classes, I had a quiet time with the Lord. I rode my bike home.
These are normal, basic college activities. But again, on this day in September, I find myself praising the Lord for the body He has given me and the ability to walk. The fact that I can ride a bike shocks me. I am amazed that I can function in a classroom. Because three weeks ago, I couldn’t even walk.
The day after I wrote my journal entry in Rome, I had a seizure that most likely set in motion a number events that left me with a chronic illness called fibromyalgia. Never before have I had a seizure and to be honest I couldn’t even describe it if I wanted too. One minute I was talking with friends and the next thing I remember, I cannot hold myself up. My bones are liquid; I have no strength. Two people sit beside me literally holding my limp body upright and magically a bowl appears in front of me so I can vomit. When I hear someone on the telephone, apparently talking to the hospital, say, “We have a girl who just had a seizure and we need an ambulance,” I protest. In my head, I think, “Are you even kidding right now? What an exaggeration! I am just nauseous” but my mouth can only manage a slurred, “No. No. I’m fine.” In fact, I do not even believe the seizure took place until, lying in the ambulance stretcher, the nice Italian paramedic, pulls down my lip. I had bit through it.
I haven’t been the same since the seizure and after a long and serious process of doctors, tests, more doctors, I was officially diagnosed with fibromyalgia. It’s a long strange word that some people know about and others don’t. I never really know how much or how little to tell people but in this blog, I want to be real. I want to glorify the Lord and one of the ways He is working in my life is through this disease, so I have to explain it.
Here is what happens: after a traumatic even (like a car accident, pregnancy, or…oh wait, a seizure), the stress of the event causes the body to overreact to protect itself from further stress. The spinal chord sends messages to the brain of pain, throughout the body, even though there is no stimuli for the pain. There are a lot of unknowns when it comes to fibro. Everyone is a little different with varying degrees of pain. For me, fibro means constant, chronic pain. There were times I can’t walk or move because of the pain. Some days I can’t feel my legs or move them, for that matter. Because my brain is dealing with this constant influx of pain, it retreats into itself to hide. I have memory problems and holding conversations with people can be brutal. A lot of the time, I just don’t feel like myself.
This summer, instead of going on a mission trip to Rome, I was home, dedicated to getting better. I told myself (and God) that by the time the school year started, I would be back to normal. But the summer didn’t go as planned, because I am not in charge. A week before school started, I had a flare up. It was some of the worst pain, I’ve ever had.
But the Lord provides and He is good. By His grace, I’ve improved. He is helping me to get through school. He is with me when I ride my bike. He is with me when I ice my body at night. He is with me. He is with me. I pray for healing everyday but I also pray that His will would be done. I pray that as I deal with this messy, strange disease, that He would be drawing me nearer to Him.
As for that journal entry, I don’t know why God chose to lay my health on my heart the day before I had the seizure. But I know it wasn’t malicious. I know He wasn’t laughing at me, thinking, “Haha, Nina. Take that.” He is good and He loves me. He wants His best for me and so do I. Fibormyalgia is not fun to say aloud (it is a weird word) or to deal with on a daily basis. But more than health, I want Jesus. I will walk with Him even if I can’t walk.
DAY 8: I give myself permission to grumble and bellyache as much as I like as long as it is to the “right” person.
In Jack Canfield’s book, The Success Principles, he says that we have to give up complaining. In fact, in says, “Think about this . . . people only complain about things they can do something about.” He also claims that “The circumstances you complain about are, by their very nature, situations you can change – but you have chosen not to.” I don’t believe this is true in many circumstances, but it definitely isn’t true for people who are ill. However, his statements lead me to ponder the efficacy of complaining as I optimize my healing environment.
First, I thought I had better see how the dictionary defines “complain”, and I learned that “it is to express dissatisfaction or annoyance about a state of affairs or an event.” This definition seemed rather incomplete and so I looked up in the Thesaurus other words for complain: protest, grumble, whine, bleat, carp, make a fuss, object, speak out, criticize, find fault, kick up a fuss, raise a stink, bellyache, moan, snivel, beef, bitch, sound out, grip, kvetch.” Oh dear, none of those words seem to infer that complaining has any redeeming qualities.
Even though I felt uneasy about this conclusion, I felt I should respond proactively. Therefore, I became rather excited when I learned about a congregation that decided to take a pledge to swear off complaining, criticizing, gossiping or using sarcasm for 21 days. Each member wore a bracelet and whenever that person succumbed to complaining, he/she would switch the bracelet to the other wrist and would have to start again from Day One. Even though this practice certainly has its benefits, I actually felt more heartened when a psychologist was interviewed who said that sometimes complaining was helpful!
I began looking for information about the merits of complaining and I learned about a book called The No Complaining Rule. Its author says that “the goal is not to eliminate all complaining – just mindless complaining that negatively impacts our health and performance and sabotages our individual and team success.” I was just about to justify complaining since I didn’t feel that mine was mindless when I read his next statement: “ And the bigger goal is to turn complaints into solutions and positive actions”. I felt unsettled again about the merits of complaining because there aren’t always solutions and positive actions I can attempt when I am complaining about how I am feeling!
Just when I was becoming more and more confused whether I would have to completely stop complaining, I came across Bob Kalal’s article on “Creative Complaining.” He mentions that one benefit of complaining “is that it highlights what’s wrong.” However, after 12 years of being ill, I think I already know what is wrong! What I did appreciate is his recommendation to keep complaints brief. Actually, that is what I have tried very hard to practice. Sometimes I have just found it therapeutic to complain to my husband because what I am really desiring is his easily gotten empathy! I don’t expect him to be able to take away the pain. And I have found the hard way that allowing myself to complain too long just leads to self-pity and that is definitely not helpful.
Then I thought about one of Jack Canfield’s statements about complaining: “You’re complaining to the wrong person”. Now the truth about complaining and its merits was becoming more apparent to me. Complaining to another person may be gratifying when I need some empathy. However, the person I can complain to as often and as long as I like is God. As Isaiah 53:3 reminds me, I have a Savior who “was a man of sorrows, and acquainted with grief”. Richard Foster in his book Prayer reminded me that “here is the wonder: the suffering is not for nothing! God takes us and uses it for something beautiful, something far beyond anything we can imagine.” And so I can join the psalmists when they lamented to God and I can join Job and even Jonah as I complain about pain, fatigue and sometimes even worse – the lost memories due to the brain fog and I can complain about lost time. And I can have the reassurance that even when I express my anger, my doubts, my complaints, I can also rest in the knowledge that my complaints are being heard and are being taken seriously. Jack Canfield wrote, “Have you ever noticed that people almost always complain to the wrong people – to people who can’t do anything about their complaint?” It is a good thing to complain to God since only He has the love and the power and the grace to do something with my complaints!!
Have you experienced low back pain lately? There are many causes of low back pain which need to be properly and thoroughly evaluated. The obvious cause may be attributed to specific activity, especially one that has not been performed in quite some time. This may include a sports injury, gardening or yard work related injury, or, it may result from the accumulation of multiple smaller activities that you are not use to doing. Sometimes, the cause of low back pain can be obscure and difficult, if not impossible, to determine. In these cases, a thorough history is important. For example, Lyme’s disease can create the classic low back pain presentation and its diagnosis is dependent on a blood test. Don’t be fooled by the fact that the patient may not be an outdoors type of person, “…and couldn’t possibly have been in contact with a tic.” Many inactive patients have pets that can transfer the deer tic larva into a home and transfer it to a sedentary, non-active person. If the cause of LBP is difficult to determine, Lyme’s disease may be worthy of investigation.
Another cause of low back pain can arise from certain medications. In a July 2009 journal article, muscle fiber damage was found in 57% of patients taking drugs associated with lowering cholesterol, referred to as statins. Typically, health care providers rely on a blood test that is suppose to detect the breakdown of muscle tissue called CPK (creatine phosphokinase) when statin-related muscle damage is suspect. However, in their study, only one in 44 patients with muscle damage caused by statin drugs was abnormal! According to the researchers, muscle pain associated with statin drug treatment has been dismissed as a “minor” side effect by both doctors and patients. In fact, the American College of Cardiology and the American Heart Association have published guidelines recommending continuing statin therapy, “…as long as circulating levels of CPK do not exceed 10 times the upper limit of normal (1,950U/L).” To see if that is was a good recommendation, CPK was tested in 10 healthy volunteers who had never taken statins, 10 control subjects matched by age, 15 patients with clinically diagnosed myopathy from statins but had stopped the statin therapy at least 5 weeks prior to the study, 29 patients with a history of statin-associated myopathy who remained on statin therapy and 19 patients with long-term statin therapy but no muscle complaints. Significant muscle damage (>2% of the biopsied muscle sample) was NOT seen in any of the control patients not taking statins. However, it was seen in 1 of the 19 patients on long-term statin therapy who reported no muscle symptoms as well as 25 of the 44 with myopathy (57%). More importantly, all but 3 patients who quit statin therapy because of related muscle pain reported their symptoms disappeared within days of quitting the statin medication. Also, the rate of significant muscle damage was about equal in those with myopathy still taking the statin meds (55%), and those who had quit the medication 60%. The severity of muscle damage was not related to the length of time the statin med was used or, with higher doses of statins.
The point of this discussion is that low back pain may be related to causes other than an injury or trauma to the back and that a thorough history from the patient must be obtained, especially when the patient is non-responsive to typical care for low back pain.
At this clinic we strive to provide the highest quality care and follow “best practice” approaches. We look forward to helping our patients and appreciate the confidence shown by our patients for choosing our practice to help manage their health related issues.
YOU MAY BE A CANDIDATE FOR LOW BACK PAIN TREATMENT!
