Wednesday, 25 April 2018

managing (chronic) pain

Tomorrow's my 11-year-anniversary with my chronic headache, so what could be more appropriate than another little post on chronic pain? An alternative title for this post I had is "managing pain and how I fail at it" because like any human bean, I have periods of time when I don't do well with the things I know I should be doing, others when I'm managing much better and sometimes I don't even know what I should be doing to feel okay. And, honestly, I'm currently living through a larger patch of having struggles. So, even though when I began writing this it was with informing and helping others in mind, maybe I'm really trying to help myself along the way, too.

Managing pain is obviously something that can be very personal and different to each person, and these are just some quite basic tips. Most of them are just common sense and things that have specifically worked for me. And although, for me this is about managing my chronic pain, these are basically self-care tips that anyone can apply to their life. Personally, having a routine that I try to stick to is really quite important. But the emphasis is on try because I do struggle with routine and therefore some of my worse days are somewhat self-inflicted. But it is what I know I should be doing, and something I'm trying to be better at. So maybe these will be of help to someone!

Having a consistent sleep schedule is in the top3 things I and everyone else needs. And it's also one of the things I'm the worst at. Getting too little or too much sleep noticeably affects my headaches, yet I cannot for the life of me keep to a set bedtime. At the moment it's because I don't have a schedule for school/work and I can sleep during the day and stay awake all night if I want to. Which is not healthy. My alarm is at 8am most mornings regardless whether I've gone to bed at 11pm or 5am, so that's not good either (I don't necessarily get up at that time, but it's when I start waking up). Don't be like me, though! Sleep is so important - get enough of it!

Also, a top3 thing. At least three meals (breakfast, lunch, dinner) a day is what I think is recommendable. I know if I skip a meal, there's a 95% chance I'll get a migraine. Yet I am forgetful, and this happens far too often. (I am literally the worst!) Sometimes I am able to get myself feel better by simply eating something salty, but with the migraine nausea I also have times when I can't eat anything for days, or can have the two things that I can stomach - which for me are bacon and gherkins (mostly gherkins). Finding out what you can and cannot eat is basically just trial and error and might take a fair bit of time, but it is worth it in order to actually be healthy.

Just as you need to eat enough (and proper food), drinking enough (water) is crucial. This is something I've actually gotten better at within the last year or so, and always have a jug of water on my desk and always carry a water bottle with me. Extra tip; if you're like me and don't like the taste of water, add some lemon, herbs, fruit, anything into your water. It makes life so much better.

Also, I'm currently on the low FODMAP diet as I read it can be helpful for people with migraines and headaches. Diets are definitely not the first thing I'd recommend, but eliminating certain foods or food groups from your diet can give good results. If you know of or suspect there's something that triggers your pain or symptoms, get rid of it and see if it makes a real difference. It can be just one thing like coffee that is your trigger or it can be a whole food group like dairy, gluten/grains or legumes that aren't good for you. Specifically to migraines and headaches, coffee, cheese, chocolate and wine/alcohol are the most common triggers, so starting with eliminating those one at a time might be a good place to start. If you want to try out a diet you read about on the internet, you might want to consult a doctor first, though!

Again, in the top3, but also very person-specific. Especially with migraines and headaches, there's different types, out of which some might be helped by exercise, others worsened. Recently there was headlines in the Finnish news that basically made it sound like exercising was the holy grail cure for migraines, and I talked about this with my mum (who's also suffered migraines most of her life) and both of our reaction seemed to be to roll our eyes at the ignorance. Like I said, there's so many types of migraines and headaches that saying something works for everything is like offering a plaster to all injuries you see. It might work for someone but definitely not everyone. But exercise is also something I've tried to add to my routine, and is something that is helpful to most people. Although, you need to know yourself and your body enough to know what kind of exercise is good for and will help you. Whatever it is you do, exercising will be good for your body, mental health, overall health and can really help with managing your pain.

Get out of bed
Although sleep is important, it shouldn't be the only thing you do in life. Or lying in bed in general. If you're not having an absolute nightmare of a day, get out of bed. Sounds simple, but it isn't always. But try. When possible, getting out of bed, getting dressed, whatever it is you can get done, can make you feel so much better.

Go outside
Getting fresh air, even for 5 minutes can make you feel so much better. It doesn't have to be exercise (although why not kill two birds with one stone?), but just being outside if possible can uplift your mood and make you feel better in every way. Get that oxygen!

Take a shower
Another really basic thing that everyone knows about, but it can be really helpful and it isn't as easy for everyone. Taking a bath obviously works as well, and is something I view as more relaxing and comforting perhaps. Plus warm/hot water can actually relieve some chronic pain, relax your muscles, and not having to stand up in the shower can be easier. I know if I am having a bad day, I do not have the energy to shower, but could possibly benefit from a bath (don't live in a house with a bath, though, how sad!). Although, a shower isn't going to miraculously cure anyone, it does have the tendency of making one feel more refreshed, more on top of things, generally better. For me, a hot/warm shower isn't something I ever want if I'm feeling poorly, usually heat makes me feel worse and sometimes dizzy. And this is headache specific again, but what I've been doing a lot more frequently nowadays is cold showers. Not necessarily even showers; sometimes I'll genuinely just run ice cold water over my head, get my hair wet, especially get the spots of my head and neck that are the worst that day. It's a rather temporary relief, but is working for me at the moment.

Hot/cold compress
If you don't want to be as extra as me and basically dip your head into a bucket of ice water (also something I've been known to do), just a regular cold/hot compress will do. I respond to cold, but it can be either or both for others. For chronic headaches, having a small wet towel on your forehead is the easiest thing to do and while working as a cold compress will also double as a block for light sensitivity. I also have a microwavable grain heating pad that I usually use unheated and just the pressure of this on my pain area can make such a difference (also good for period pain!).

Talking about and having people who understand your pain is a big thing. It can be difficult but it is important. If you have friends and family you can talk to, that's great. If you don't, there's plenty of other people you can reach out to. Even if people in your life are there for you, listen to you and support you, unless they have the same condition or similar symptoms as you and even then, it can feel like you're alone, nobody understands you and it's easier to isolate yourself than not. Finding people online or finding support groups can definitely be helpful in sharing with and supporting others. And sometimes it is easier to talk with strangers. Having people in your life who truly listen to you on your good days and your bad days will not lessen the physical pain but it will make it easier to cope mentally. And in addition to having those people, getting professional help is something I'd recommend. Whether it's a psychologist, therapist, counselor, whoever you think will be relevant, these are people who are there to help you with whatever you're feeling, experiencing, going through. Finding someone who you're able to have a good relationship with might take some time (or you might find someone great on the first try!), but it's worth it. And finding someone who has experience in ~your situation~ might also take time or not be possible, but I'd look into that as well. Personally, I've seen a psychologist, and although at first I was not keen on it (I was shipped to her when my other doctors didn't believe my pain, which is another fun story..), it was really helpful, I really enjoyed having someone "from the outside" to talk to and being able to talk about my pain or other things when I wanted to. I saw the same person for years, and although I've not been seeing anyone for quite a few years now, getting a new psychologist/therapist is something I've been thinking about doing for a while now and will probably bite the bullet and contact someone this year (because asking for help isn't easy - I know!). If you aren't ready to talk to a professional or someone you know, try and find someone (you can holla at me, for example) so that you don't have to carry everything on your own. And if you aren't ready to reach out, write things down or get those feelings out in some other way!

First things first: consult your bloody doctor. Don't eat whatever pills you find at the pharmacy or whatever your aunt says worked for her coworker's son's pal. If regular painkillers work for you, that's good. But if you're popping them pills like my favourite TV physician House, in the long run that's not good. Honestly, however much research you do on your own on drugs you can get without prescription, on supplements, on vitamins, on anything, medication is the one thing I would trust doctors on and leave it to them (and I have a serious dislike and distrust of doctors). Even with doctors, finding something that will work for you can take forever and it can be disheartening. But you might just find something that will considerably better your quality of life. I've tried numerous preventive pills, migraine meds of different type, I've been on drug detoxes, I've had things that have worked for a while that I've then built a resistance to, I've taken multiple pills a day, I've stopped taking drugs. I currently only take something for my worst migraine attacks and have prescription painkillers that I can take at other times, but am on one of my "not relying on meds" phases. And I would say that relying entirely on medication isn't the best thing, but also that taking the right medication to you is the best and surest way to manage pain.

Know your triggers
Knowing what causes or increases your pain will make it easier to navigate life. You cannot avoid everything in life but you can have some control over how much exposure you have to certain things. Certain foods, smells, noises, movements, whatever it is, can make you feel worse and when you know this you can either avoid them completely if possible or at least be prepared for them. Certain positions, like sitting in one place for a long period of time or walking a certain distance, can cause pain and if you know this you can avoid them. Cucumber used to be a migraine trigger for me (although it's not a strong one anymore), so I would not eat cucumber, I would not be in the same room with cucumber if it was possible not to. I'm sensitive to light and heat, so I wear sunglasses, hats and in the summer I try to keep to the shade. If I have to sit somewhere for an extended time period, I try to make sure I don't have my neck and head turned in a weird pose, or I get up at times if possible. If I know I'm going to be spending quite some time somewhere with strange lighting, lots of constant noise, lots of people, lots of those people wearing perfume (basically when I'm in public), I mentally and physically prepare myself for this and the very likely possibility that I'll feel worse afterwards. It's easier to identify some of your triggers and it's easier to avoid some. And you do what's possible, because it's not always an option to avoid everything.

Know your limits
Similar to triggers, knowing yourself, what you're capable of and where your limits lie will make it easier to live your day to day life. Only you know how much energy you have each day and each moment, and only you have the power to either carry on or call it quits. If you're exercising, you probably know your body well enough to know the difference between 'this is something I can absolutely not do', 'this is hard now but I can try better next time' and 'this is the best I can do (now)'. If you have to cancel plans, cancel plans. But if you cancel plans just because it's easier to stay home, maybe reconsider. It's possible there are things that you can never do, but it's more certain that there are things you can do and can get better at doing. Like with everything, it's easier to stay in your comfort zone, but there just might be better things outside of it. If you know you can't do x, you can still do y, z and so much more. And even if you know you can't do x, you can still do all the things leading up to x. Obviously don't push yourself when you know something will make you feel worse and increase your pain, but you can push yourself to the limit - and maybe next time the limit is a bit further away. Just as important as knowing your limits, is knowing not to let your pain or illness limit or define your life.

These are just some rather irrelevant photos from a little nature trip from a few years back that I never got around to posting. This little northern blue sitting on my mum's finger for a good ten minutes was a highlight, though. And maybe there's some kind of a dumbass metamorphosis metaphor to be found here.

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