Weight and Pain

http://www.arthritis.org/about-arthritis/types/fibromyalgia/articles/obesity-fibromyalgia.php

I recently wrote a blog piece about my lowered pain levels, or remission state, from my fibromyalgia pain. In that piece, I concluded that a year-long illness I went through, which resulted in a large weight loss was the contributing factor, so I have decided to follow it up with some actual research into this connection. And indeed, losing weight has had medical validity in pain intensity for many years now (see above link). My doctors always told me to lose weight, and to exercise. The discussion of  exercise also been a popular thread among my peers in online support rooms. Most stating it as helpful, if not with weight, at least with a healthier, happier state of mind.

I was always conflicted about this idea. I would come away from the doctors or the thread feeling shame and anger. It’s easy to tell someone with constant pain that they should get out there and walk, or swim, but it’s not so easy for that person to do. I know that just walking the dog could trigger pain for the entire next day; a very large price to pay! I want to interject here that while that is “not” occurring for me right now, it is apples to apples that it will start happening again soon (I have never experienced a remission of pain for this long, not in all my 17 years of living with fibromyalgia). Another point, in my current relief condition, is that I do still have medium pain every several days and a flare-up of pain large enough to send me to bed for the day every 7-9 days, so as I write this I am clear that this piece on weight and exercise applies to me as well as my peers. I felt shamed because I simply couldn’t create a routine of regular exercise, not with the pain threshold I live with. Anger followed because it was easier to project this feeling onto the doctors and my peers then it was to look deep inside myself and take personal responsibilty for my choices.

After losing all the weight and feeling the relief of waking up everyday at a pain level of 4 instead of the years of 5-6, I now feel ashamed that I didn’t try harder a long time ago. Lately I walk my dog farther every day then I did before, even when my pain level is at a raging 8. I make time to walk a slow three miles at least once a week. I am getting a donated recumbent exercise bike for the winter and will be applying for a low-income monthly membership to my local YMCA where I intend to use the swimming pool, take water aerobic classes, and indulge in some gentle and light weight lifting.  I am also looking into finding a free, local Tai Chi group.

I have not turned into an overnight super athlete, far from it. With the evidence of research and my own, personal experience it is obvious that the adage, “no pain, no gain” is true.  I certainly can not do all of these items weekly, but I can integrate them into an alternating monthly schedule. I will need to start slowly! My upper body is triggered very easily, simply driving the car for more than hour creates triggers in my shoulders, neck, and then head muscles (just typing this is aggravating my trapveious muscles). I am planning to begin exercising in chunks and in no more than 20 minute intervals. I will track what I actually do in my journal and then track how I feel immeaditely after, that night, and the next day. After a month or two of alternating exercising styles and journaling the resulting pain or no pain increase, I should be able to create a program that is tailored to my needs. Losing weight has definitely helped both my pain and my attitude, I am sure my seretonin levels are higher than they were, what a blessing it is for any of us to gain this important nuerotransmitter back. Despite the gift of this gain, losing so much weight has left me with wasted muscle mass (as we age we “useit or lose it”). I am keenly aware  that if I don’t start now, I may never start.

I try to share healthy, successful, positive living ideas in this blog. It would be hypocritical for me to share them and not live them myself. Besides, I love the hope of staying in a state of less pain! Try to find your weight loss path. Decide which exercise routine fits for you. Then, start tomorrow. XX

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When You Get a Break from Pain

you-are-my-sunshine-4

https://thecandyperfumeboy.com/tag/sunshine/

During the last eight weeks I have experienced less pain than I have in years. In the 16+ years I have lived with fibromyalgia, this is only the second reduction in pain I have had the pleasure to be in. Despite many other medical issues during this time, emergency gall bladder surgery, stomach flu, the flu, and migraine headaches from my experience of being rear-ended, my chronic pain is at a low of 3-4 on the pain scale! Well, except for a once a week flare up of pain that keeps me bed ridden, but, hey I will take this exchange anytime!

I have been paying attention to the decrease in my normal achey body and wondering, why? Could it be that my gall bladder was taken out; that seems whacky as most fibromites experience surgery as exacerbating their pain levels (I have blogged about this before, explaining the need to discuss this phenomenon with doctors prior to surgery). I experienced this after my knee surgery two years, so that doesn’t feel right. Perhaps it is my mood, which has been better in general since my gall bladder surgery. Or, maybe it’s the fact that I lost an incredible amount of weight over the last year because I was so scared to eat anything! Let me explain this further; I was misdiagnosed with gastoparesis a year prior to the surgery, which led the doctors down the wrong road. Every time I went into the emergency room it was reinforced that my diet was causing the problem. The pain was off the charts and if it was caused by eating, then I wasn’t going to eat, at least not much! Definitely not the best way to lose weight.

Losing the weight finally allowed me to walk without a cane, to use the stairs with one leg at a time per stair, and to walk three miles at a time for the first time in three years. This leads me to think that possibly losing the pounds is the reason for less daily pain. I gained 60 pounds when I was pregnant with my daughter, 27 years ago. I never really lost that weight and gained a bit more over the years. Since my surgery I have been complaining of needing to buy a entire new wardrobe, two sizes or more, smaller than I previously wore. This has caused others in my life to politely ask me to stop whining as they are still trying lose their own weight, a reasonable request.

Still, it bothers me that I lost soo much weight so quickly; it can’t be healthy. However, if there has been two shining gifts from the loss; my usual 6+ daily pain (at least for now) and my ability to walk normally,and even drive my own car again. I thought I would never be able to do these things again. While I have decided that losing the pounds is the reason I am in remission, I am still caught in the thought process of fear that all chronic pain suffers seem to loop in. I find that I am frequently holding my breath for the other shoe to drop. The shoe of the fall and winter season. It’s glorious to be in less daily pain, don’t get me wrong, but I can’t help noticing that the season is changing. I am doing fairly well at pushing the negative thought away by breathing in the freedoms I am experiencing. So, for today I will remember to use my positive tool of just breathing.

Words of Wisdom for “Creating Better Health” and Less Stress by Toni B.

Hi Peers

I read this yesterday and it fell right into my belief system when it comes to doing my best while living with chronic pain. Toni’s choices are the same as mine, her articles always serve to affirm and remind me to keep striving towards my best.

Enjoy:

https: //www.psychology today.com/blog/turning-straw-gold/201604/when-you-re-chronically-ill-giving-versus-giving-in

Accepting my Limits, Creating New Strengths

It is very difficult to accept limits on living your life. I have gone through this process before; during the first three years of my diagnosis of fibromyalgia. These last few years I have had a much harder time. Maybe it is because I am older now. Maybe it is because there are more than limits now. Or maybe I am just not willing to let go of my dream that I spent ten years creating. At the end of the day, none of this matters, I have to accept my new limits and create new strengths.

Just like the first three years of living with this chronic pain, my loved ones are tired of me being limited. They are tired of hearing about it. Tired of watching it and tired of helping me. I can not say I blame them as I am tired of it all as well. The disconnect that worries me the most is that they want me to fix it “now” and I am not capable of spinning a magic spell that will get there tomorrow. I am able to begin to plan steps to follow that will get me there, and, it is time to start.

Sure, they could go on and assist me indefinitely and I could continue to feel guilty and disempowered. But my mental health is on the line now. I need to affirm my new strengths. To start this process I need to know what they are. Just thinking about starting over again in this planning, journaling, and finding the new me is overwhelming. This makes taking even the first step daunting.

As daunting as it may be, I am beginning to take that step. I have begun to reorganize my home life in order to function within better. That is the first and most important step we all can take. Once we are able to feel empowered to handle at least some of our lives in our world, we can begin to find more hidden strengths.

I am beginning to realize that spending those ten years following my passion for social work, to assist persons in physical and mental distress, was not entirely a waste. I may not be able to do all that I learned, heck, I may be only capable of doing a small amount of it, but, I can still do it! I have started here, on this blog. I am beginning to branch out from this blog to more on social media. I have recently thought of what I might be able to create or offer to agencies out in the brick and mortar world.

None of this will occur tomorrow. It might take me a year, it might only be six months. I have put these ideas down in the section of my journal entitled, “Important Thoughts”. I use this journal daily. I will continue to take the time to work on my new strengths and stop focusing on my limits every day. We can all do this, I know we can..

Similarities Between Fibromyalgia and Mood Disorders Some Research Points out the Links

Link to Research/Presentation by NCBI on Fibromyalgia and Spectrum Proposal of Other Co-Existing Disorders

Hello Peers,

I have been having a distressing, verbally attacking posting conversation about Fibromyalgia and the link to mood disorders these last few days. Unfortunately, this has occurred in a “safe” post forum, where discussions like these are not productive or helpful for the general needs of Peers. I believe I started this problem by stating that there was no empirical research that connected these disorders. I generally point out items I think lead Peers down a road that may increase either disinformation or fear of new and different symptoms. I don’t do this to be a know-it-all and this time I was called out onto the posting “mat” about my statement by the original poster. I was informed that I was wrong and that as someone who is a therapist, I should check out my DSM-IV book. I apologized for the second time to the other Peer and posted I would not engage in this on this space anymore. All this did spark my interest and I Googled the research available on this topic.

I did indeed find some research. One was a research article that was empirical, from 2008, another was always the always reliable information from the NCBI and a general jargon piece on PyschCentral’s site. The other two research articles I found on Google, not in my professional peer-reviewed journals, are simply about depression in general. Here is what I gathered from the 2008 article and the generally similar information from the NCBI (NCBI offers up-to-date information about Fibromyalgia, this focused on the topic I researched tonight). People with Fibromyalgia and Mood Disorders both have similar problems with their neuroendocrine and autonomic systems responding as normal, along with possible genetic factors, environmental factors and social factors that can trigger any one of these conditions. The problem with the 2008 article is this; the p= numbers are very low. A normal empirical connection is considered .05 in research. There has also been much debate about how the DSM is used in general since the newer DSM-5 came out, with opponents contending that, among other disorders, even normal sadness can be pathologized. That does not mean the DSM-IV does not have important role in understanding mental health; it is the best empirical data in one place for mental health therapists to begin with in determining mental health issues that are currently beyond what their peers are experiencing.

I definitely can see a connection in his hypothesis. And, I do use the DSM-IV but the starting diagnosis should be cautionary as the person’s situation may change as their sadness clears up; without medications. *(This is only my opinion). As a Peer with chronic pain I have discussed depressed days and stated that depression can cause physical pain. We can all think of many co-existing syndromes and/or illnesses, beyond Fibromyalgia and Mood Disorders.  An example would be depression combined with overeating and pain in the persons knees. A person could have arthritis and a mood disorder, heart problems and Fibromyalgia.

As time goes on we may find that there is a strong connection to these two syndromes/disorders. This is why there is always a reason to have your doctor take your full history when you experience any syndrome or illness. Just because you suffer from A doesn’t mean you don’t also have B and C. A person who begins to experience any new symptoms should always seek medical attention, not advice from this blog, a forum or from Google only! We should work closely with the doctor, creating a relationship that lends itself to weeding in/out all possible issues.

I also was called out on the DSM-IV and whether I knew my diagnosis; I do. I have seen many depressed, hospitalized persons with Fibromyalgia. But, not a high number of both in one person. Just like a General practitioner or Pain Management Specialist, I take a full history of the patient, current and past social background and their family history. I have discussed that each of us is unique in our symptom presentation. I found that during my year in the hospital and I find a large difference in one Peer and others in their posts, blogs and in person. Our experiences as we journey towards living Well are unique.

It has been previously posted in my blog that new, empirical research shows dysfunction in our brains, central nervous system and muscles. I was surprised by this post attack to hear that mood disorders were strongly linked to Fibromyalgia. There were two components mentioned in the 2008 research, the neuron receptors in our brains and our autonomic system, that are the same in both syndromes. Fibromyalgia survivors have an additional dysfunction,  our central nervous system. Also discussed in both resources were genetics, social and environmental factors.

Genetics have been a marker for a multitude of syndromes and diseases for a while now. Social and environmental circumstances as well. I am taking the time tonight to delve into this in order to inform my Peers about this thought process. The more we know the more we can learn about chronic pain, differing presentations and what may fit for our unique symptoms. Perhaps these two similar dysfunctions helped to jump-start the new research that includes all three areas and inform doctors to always closely monitor their patients health history. I am truly sorry that the other person became so distraught about it all, this is never my intention. I am grateful that it allowed me to find out about this concept and do research about depression and Fibromyalgia similarities.

One last item is the debate about anxiety and Fibromyalgia survivors. I have had some anxiety my whole life, who hasn’t? One of my parents had overwhelming anxiety most of their lives. I do not think I have ever met a person going through difficult situations who doesn’t have some degree of anxiety. I will leave this for you to think about, and, research if you desire.

Please see your doctor and do your own research. Being informed by doing your own research is the best method to decide what fits for you, makes sense to you and what tools you will want in toolkit.

Links, Information and small rant n rave for the night, (tomorrow, CDC)

Lucinda Tart, Fibromyalgia Peer Advocate/Life Skills Advisor

*This blog is never meant to replace a visit to a professional. I am in no way giving out professional advice, even if I use my professional as my opinion in a post.

Begining to Retrain your Thoughts from Negative to Positive

Hello Peers,

I stated in my post, about our need to know what items to bring with us in situations that arise unexpectedly, that I would add links above it. I was able to find a good link for basic mediation learning. Emotional retraining, not so simple. Most links I found were actually advertisements for their various learning courses; sneaky.  I understand the basics of emotions and Cognitive Behavioral Therapy, since there are no reliable links to add for your own research, I am going to post a simple process I have used with both myself and with others.

The first thing our brain does is  latch onto a thought. Negative thoughts might be thoughts such as, “I am a failure”, “I never accomplish anything”, “I can’t handle this situation”, “I am just going to give up” or worse. In using these specific examples I am trying to recreate thoughts I have had, and have, because my daily life has changed from living with Fibromyalgia. Despite my ability to live Well with chronic pain, I am not perfect, I am human.  Our brains will always default and take the most used pathways. Once a pathway is established as our usual belief, our thoughts, emotions and behavior becomes automatic.

In our situation these thought paths can effectively create behaviors where we just stop trying to accomplish it in order to not fail. We know we can’t handle it, we won’t complete it, so we don’t. This example is fairly clear; thought creates behavior. Negative behavior is based on negative thoughts. This automatic process is one that we are not conscious of. We become stuck in a cycle that hurts us.

You can begin to recreate pathways that latch onto positive thoughts, emotions and behavior. You can  retrain your brain. Start simply. Begin to notice your thoughts, emotions and subsequent actions. Drawing a circle with three headings each equally spaced around the circle; Thought—->, Emotion——>, Behavior—–>, with the circle completed when you reach Thought again. You now have a closed circle with the three key words waiting for you to use in retraining your pathways. Make the circle large enough that under each heading you can put your automatic thought, emotion and behavior. Pick one after a week of practicing noticing your automatic negative thoughts. Write them under the headings in the circle, then add a positive Thought, Emotion and Behavior under the negative ones. For instance, you first thought, “I am a failure”, now you add underneath it, “Doing the Best I can”, followed by the new emotion and behavior that accompanies it. Use this basic circle as a new tool that will begin to change your negative, self-defeating brain. Put this somewhere where you see it every day.  If that is too much right now put a note on your mirrors with the new positive thought. Watch as your behavior begins to move forward.

*Update: 10/2015. This is also a good worksheet to keep in the front of your organization binder, or, tuck into your daily reminder book/memory book.

This is a very simplified explanation of what CBT can assist people with. Right now, keeping it simple is all we need. Actually, keeping it simple is all anyone ever needs!

Lucinda Tart, Fibromyalgia Peer Advocate/Life Skills Advisor

*As always, this blog is in no way a therapy site, I am not offering professional advice and I advise anyone experiencing new or unusual problematic thought processes or behaviors to immediately contact their doctor.