Posted in Uncategorized

ARE YOU Ready to CHANGE?

Photo by Glen Carrie on Unsplash

Day 40 of the world’s New Normal. I’m not even sure if that is the correct number. It may be lower. It may be higher. Regardless of the length of time since COVID-19 we can agree our lives have changed significantly since COVID-19.

Some of us have adapted well to this change. Some of us have died. And some of us believe this is hoax. I shake my head in disbelief.

In my job (I’m fortunate to work from home) I talk to people daily – regular folks like you and me. Some tell me bluntly their loved one died last week due to COVID-19. Others tell me quietly that their loved on passed this morning. Some walked into the ER and never walked out. Others contracted the disease from other people socially. And still others contracted the disease because they didn’t believe it was ‘real,’ and they didn’t wear a mask.

Healthcare professionals including doctors, nurses, physical therapists, and more have seen the horror up close and personal. They’ve worked non-stop helping people with this disease – subjecting themselves to the very real possiblity of contracting the disease themselves. But they put their health needs aside, to help others.And still people believe this is a hoax.

Photo by Mick Haupt on Unsplash

But, whether you believe it’s a hoax or not, the real truth is that our lives have changed due to COVID-19. Remember when we shopped the grocery store with everything at our fingertips? And when one item was not available? We complained to the manager. Now? We are happy to find any brand of our favorite foods and humbly ask when the next shipment of toilet paper is expected to arrive.

Lunch dates with friends, night dates with partners, play dates with neightborhood children are obsolete. Now? We come together as a family and cook at home, discover new recipes, and pull out old board/card games to teach our children.

Some are very creative in helping others. When they heard elderly neighbors were unable to go to the store, one couple began a neighborhood pantry. Food/paper products are placed on the wooden shelving unit made by the husband and using the same concept similar to neighborhood Book Lenders – Take what you need and give what you can. Landlords are waiving the monthly rent for their tenants in an effort to lighten the bills of those who are unemployed. Many people are still sewing masks for friends, family, healthcare professionals, and patients.

There is an abundance of ‘goodness’ in the world today…

Need proof?

Just Google “positive news during the pandemic.” There are pages and pages of articles, posts, and stories reflecting postive acts of kindness and GOOD NEWS! Take a moment and check out those sites. Sign up for daily positivity. Share the good news with others. And know in your heart, change is a comin … is here, and we are ready for it.

Remember: Wear your masks, Wash your hands, Cover your mouth when you cough, Practice Social Distancing!

Bless you and yours,

Carolyn

Posted in Uncategorized

CoronaVirus (COVID-19)

Photo courtesy cdc.gov

Thank you for stopping in! Grab your coffee and relax a bit. Today’s post serves as a public service announcement for everyone concerning the Coronavirus (COVID-19). I know. I know. By now you are sick and tired of reading about the Coronavirus or (COVID-19). This will be my first and last post (I hope) on the topic. It’s a short read, I promise!

Per my primary care physician’s suggestion, I signed up for updates from the Center for Disease Control on their website – CDC.gov. (Click underlined words on this post to go directly to the website.) My doctor checks this site along with government officials nationwide and locally. The CDC’s information updates daily with tips, guidelines, and information about COVID-19. Also, information is available on the worldwide, national, state and local venues. Signing up is easy or bookmark the page on your favorite device.

In addition to the website, the CDC’s toll-free number is 800-CDC-INFO (800-232-4636), TTY: 888-232-6348 and is open 24/7 for COVID-19 questions. Be sure to check the website FIRST for answers to your questions about the virus before calling the helpline. This courtesy allows callers who may be experiencing symptoms get information without delay.

The about CoronaVirus page of the cdc.gov website provides information on the virus, how it spreads, symptoms, and more. The Fact Sheets at the bottom of the page are informative, simply written, and available in English, Simplified Chinese, and Spanish.

For information about protecting your family and yourself from the COVID-19 click on this link. Detailed information can be found under the following tabs:

PREPARE YOUR FAMILY

PROTECT YOUR HEALTH

WHAT TO DO IF YOU ARE SICK

However, my PCP told me there will be cases of the virus in YOUR area. The key is DO NOT PANIC!

Remember these three tips:

1- WASH WASH WASH your hands throughout the day and especially when shopping at stores, visiting the doctor or hospital and restaurants.(Many fast-food restaurants offer drive-thru service only as a precaution and protective measure for their customers and employees.) Follow the 20-second rule for washing your hands and share it with every family member. (Video and detailed information can be found at cdc.gov.)

2- PREPARE your home and family for the virus.

3- CHECK OUT the cdc.gov for daily updates. This is a great source of information! Sign up for daily updates with your email.

As most of you know, empty shelves are growing in the grocery stores and pharmacies. The homes of hand sanitizer, disinfectant sprays, toilet paper, bottled water, and medicines have vacated. Preparing for enough supplies for at least one or two months makes sense. However, pictures of stockpiled supplies for 3-6 months is just plain selfish.

Would you consider providing this one simple act of kindness? When purchasing items for your family grab one or two extras for your elderly neighbor, the person who is homebound, or a family without the means to purchase these items. This simple action will go a long way during this virus crisis and the future.

Since it looks like staying home is a definite I should be able to crank out more posts about chronic pain and all that entails! Again, be safe, take care of each other, and thanks for stopping by!

Writing my next post!

All my best,

Carolyn

03/16/2020

Posted in Uncategorized

PAIN ISSUES IN THE 2020s

Happy New Year!!! It’s a brand-new decade (the 20’s), a brand-new year, a brand-new opportunity to commit to change (your lifestyle, your job, your body)… again.

I hope you celebrated with a BANG! or enjoyed a nice quiet celebration with your honey! Either way, I hope you had fun!

So……What are YOU DOING different this year?

Better question…WHAT AM I DOING different this year?

So far, nothing. I made resolutions still waiting to be carried out, kept pushing the start day later in the month and changed the resolutions repeatedly.

For this first post in 2020, I thought about tradition. Every country, race, nationality, family, and even individual celebrate at least one tradition during the Holiday season. One of my favorite traditions is BAKING cookies over the holidays. Lots of cookies and sweets! In past years special cookie packages for the postman, UPS driver, neighbors, friends, and favorite retail workers were delivered with smiles and excitement. That warm, fuzzy feeling fills your heart when sharing your favorite recipes with others!

However, Rick and I haven’t met many people since moving to Savannah and our gifts of sweetness were few this year – one to our postal carrier and one to our family. But, it’s ‘tradition’ and I baked sugary goodies regardless of my shortage of friends, shortage of time or my ever-present chronic pain.

Before we get into sugar vs chronic pain here is a mini-history paragraph about the tradition of baking cookies for the Holidays.

Christmas cookie recipes trace back to Medieval Europe. The introduction and hefty price of special ingredients: dried fruits, cinnamon, nutmeg, almonds, and ginger were added to favorite recipes by all families, regardless of social status. During Christmas celebrations the addition of sugary treats matched the excitement of the Holiday. By the 16th century cookies were baked into the different sizes and shapes of Christmas. The most famous of Christmas cookies, gingerbread, came from Germany. Although it has changed into a cake-like texture, gingerbread dates as far back as the crusades when soldiers brought spices home to Europe.

Now that we have an idea of its origin, the tradition of baking cookies seems to be more important than ever! However, not to burst the holiday bubble, sugary sweets bring their own problems to those of us suffering from chronic pain.

  • SUGAR ESCALATES PAIN AND INFLAMMATION

After baking comes eating and I did my share of eating! I noticed that my RA and chronic back pain increased lasted longer and traveled to other joints including my hands, elbows, knees, and ankles. The pic below shows how I feel inside when those flares occur.

Image by Camila Quintero Franco
  • MOOD CHANGES

Instead of being jolly, happy and almost giddy while baking, I became irritated with the amount of time it took to bake the simplest of recipes. This led to depression. Once again my ‘new normal’ interfered with those activities I loved to do before chronic pain became my middle name.

  • LEFTOVERS CAN WARP YOUR GOOD SENSE

I planned to start the Keto Diet on January 1st but instead pushed it out to the end of January. Why? Because there were still tins of cookies and candy in the house…and freaking sugar is expensive!

  • WAKE UP!

Now the goodies are gone, and I’m left with an indescribable craving for sugar and I’ve finally awakened to the fact that those ‘goodies’ increased my pain along with my weight. So, today, January 29, 2020, I’m beginning my low-carb, a whole lot less sugar, high-protein, high-fat diet!

  • UNNECESSARY TRADITIONS??

Junk food traditions do not equal a happy, family-oriented holiday. Food is an important part of the holidays, but it isn’t the central point of the festivities except for the weekend before Christmas, Christmas Eve and Christmas Day – okay it IS a central point of focus. But so is enjoying time and sharing traditions with family and friends. Food definitely has a part and I need to focus on the part food plays.

For next Christmas, my baking will be limited to decorated Sugar Cookies – exactly what Rick urged me to do this past Christmas. Our new tradition of decorating sugar cookies with our grandkids fills our hearts with joy, laughter, and love. Watching their imaginations come through with their designs and color combination were priceless! And they did most of the work themselves! THIS is our new tradition—combining holiday baking with special family time.

Realizing something hurts you more than helps you is a difficult pill to swallow, especially when you think that something is harmless. Experiment and see if you feel a difference in your pain levels when you add more sugar into your diet than normal. And share your findings! We are in this pain journey together!

Thank you for taking the time to read and I’d love to hear your family traditions! Until next time,

Take care of you!

Carolyn

Posted in Uncategorized

Options for Chronic Pain Relief

PART 1

Exploring NSAIDs, Acetaminophens, and Antidepressants 

If you suffer from any form of BACK PAIN, you know (or maybe you don’t) there are numerous options to help relieve your back pain. These options are placed in one of these categories:

Medications     –    Injections  –    High-Tech Treatments    –    Surgery

Because the research on these different options is extensive, I plan to cover each category over the next six to eight posts. Today, I’ll begin the first part of MEDICATIONS by talking about the first two categories: NSAIDs & Acetaminophens, and Antidepressants. These medications are used for treating pain and chronic pain in the back and other parts of the body.

Medications:

This category appears to have the highest percentage of usage for treating back pain –temporary or chronic. I found five categories of medications:

1) NSAIDs and Acetaminophen,

2) Antidepressants,

3) Anti-seizure or (Anticonvulsants),

4) Muscle Relaxers, and

5) Opioids

 

NSAIDs or Nonsteroidal Anti-inflammatory Drugs encompass a wide variety of medications that may be found OTC (over-the-counter) or may need a prescription from your doctor. In either form use caution when taking anti-inflammatory drugs. Be sure to administer the drug precisely as directed by your doctor and/or the package instructions.

There are numerous articles online for OTC Anti-Inflammatory medications and I urge you to surf the net for more information. I always look at the most recent article – try to avoid older articles because there is constant change in this industry. However, one site (Healthline.org) is beneficial and includes a guide to OTC Anti-Inflammatories.

This guide lists the common NSAIDs, how they help with pain, the side effects, and comments regarding drug interactions. Before using any of the medications listed in this post, please contact your doctor first. Your doctor needs to know your history and the drugs (you are presently taking) before deciding the best NSAID for you. Some drugs interaction with NSAIDs will make the NSAIDs less effective.

Note: If you’ve had chronic pain for more than six months, call your doctor’s office. Your pain may be chronic and this list of medicines may not be suggested by your doctor.

In the Guide to OTC Anti-Inflammatories … Aspirin (Bayer, St. Joseph), ibuprofen (Advil, Motrin, Midol) and naproxen (Aleve, Naprosyn) were noted as common NSAIDs.

 

ACETAMINOPHEN (Tylenol) is one of the most common pain medicines used for fever reduction and pain.

Acetaminophens are used for arthritis pain, common aches, or headaches. These drugs have good results except in the cases of pain lasting more than six months. If this is the case you may have ‘chronic’ pain and require a prescription for a stronger pain reliever. Check with your healthcare provider for more information.

Keep in mind acetaminophens do not reduce inflammation.

 

ANTIDEPRESSANTS

In the world of searching for drugs to help alleviate chronic pain, some drugs developed for other diseases have become the most effective and commonly used ways to treat chronic pain.

Case in point: antidepressants, which were developed for the treatment of depression. And although depression may not be a condition of the patient, antidepressants have become a pillar in the treatment of chronic pain conditions. Although it isn’t understood the connection between antidepressants and their treatment of pain; it is believed neurotransmitters in the spinal cord are increased by antidepressants which would reduce pain signals.

This type of medication must be taken daily – regardless of a low or non-existent pain level. And the relief isn’t experienced immediately. It can take several weeks to feel the effects of an antidepressant. Moderate relief has been reported by most patients who take antidepressants. If this medicine does not effectively lower your pain, your doctor may pair your antidepressant with an anticonvulsant.

There are three groups of antidepressants due to how they work and their chemical structure. Considered one of the most effective group for pain relief is the tricyclics.

A few Tricyclic Antidepressants (TCAs¹):

  • Amitriptyline
  • Amoxapine
  • Clomipramine
  • Desipramine
  • Doxepin
  • Nortriptyline

Side effects include:

Blurred vision, drowsiness, dry mouth, lightheadedness upon standing up (due to drop in blood pressure), weight gain, constipation, heart-rhythm, difficulty urinating, and difficulty thinking clearly.

To help prevent or reduce these side effects, you will begin with a lower dose and your healthcare provider will increase the dosage as needed. Ironically, the lower doses tend to be more effective for pain than the doses used for depression.

Serotonin and norepinephrine reuptake inhibitors (SNRIs) are the second group of antidepressants. Often, patients with chronic pain will develop depression. Drugs in this group help treat depression at the same dosages used for treating chronic pain.

Medicines in this group include duloxetine (Cymbalta), venlafaxine (Effexor), and milnacipran (Savella). Side effects are drowsiness, insomnia, nausea, dry mouth or elevated blood pressure. If your doctor suggests one of these medications, be sure to check the specific side effects by searching the drug online.

The third group of antidepressants, Selective serotonin reuptake inhibitors (SSRIs), include the drugs paroxetine (Paxil) and fluoxetine (Sarafem, Prozac). As medications for treating depression with chronic pain, these medications work well. However, they do not relieve pain on their own. Fluoxetine may be prescribed along with other tricyclic antidepressants to boost their painkilling agents.

Then there are antidepressants that are considered “atypical antidepressants” because they don’t fit into their own category. Atypical antidepressants are bupropion, trazodone, and mirtazapine.

Like most antidepressants, the side effects of atypical antidepressants include nausea, fatigue, dry mouth, diarrhea, nervousness, and headaches. Again, ask your healthcare provider questions about these drugs and their side effects. You can also go online and read reviews by patients who have taken or are taking these drugs.

 

(Please note: Slightly increased risk of suicidal thoughts or actions are associated with antidepressant medications. Please talk to your doctor before accepting these medications if you have entertained suicidal thoughts.)

 

[¹] Published April 13, 2016. Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ.

Posted in Chronic lower back pain, chronic pain, Uncategorized

Keeping a Pain Diary or Journal

Cheers to a rainy Friday! (Rather a rainy day where I live.)

Lately, I’ve read several articles about the need for keeping a journal or diary of chronic pain levels. At first, I skipped the articles and went to my business of writing. However, the more I read, the more I decided this activity would be beneficial in many ways.

You ask, “How will keeping a pain diary or journal help me?”

I’m glad you asked! Keeping a journal or diary of your daily pain activity chronicles your “ups and downs” with pain. For example:

  1. your pain level is higher on rainy days 
  2. your sleep is disrupted because your pain woke you up 
  3. a change in medication dosage may lower or increase your pain

These are a few of the actions you can chronicle with a pain diary. Over time, you’ll have a detailed report for your personal needs and for your doctor to review. Depending on Your pain results help your doctor manage your pain more effectively. He will see the symptoms of your pain and how it varies depending on the time of day.

There are “apps” specifically for tracking your pain levels. But after reading Jo Young’s article, “How I Started a ‘Pain Diary” (and Why I Think You Should, Too) I created my own diary with columns specific to my needs. Using Excel or a spreadsheet of your choice,  below are sample column headings you may find beneficial:

  • DATE
  • MORNING  (Pain level 1-10)
  • AFTERNOON  (Pain level 1-10)
  • NIGHT  (Pain level 1-10)
  • DOSAGE OF MED-X (Dosages and frequency can affect your pain level.)
  • DOSAGE OF MED-Y
  • DOSAGE OF MED-Z
  • WENT OUTSIDE? (Sometimes we just don’t feel like going outside, like today)
  • MENTAL STATE   (Bad, Very Bad, Neutral, Good, Very Good are some suggestions)
  • HOURS OF SLEEP  (Hours of uninterrupted sleep, not including naps.)  
  • EXERCISE   (Amount of, type, time spent)
  • NOTES:  (Put anything here as additional info for yourself or your doctor)

Your entries offer valuable information to help you cope with your pain. In addition, your pain diary helps your doctor’s decisions to manage your pain more effectively. And remember – start a pain diary if you were just diagnosed or experienced pain for years! After a few weeks, you’ll begin to see a pattern of your pain levels and what appears to affect it.

Would you mind letting me know when you start your pain diary or journal? And would you share your findings? I won’t share your personal information but may use your findings (along with other readers) in a blog post!

Thank you for stopping in to read! I appreciate your time and look forward to your comments!

Blessings sent your way,

Carolyn

webmd_rm_photo_of_pain_journal

Posted in Uncategorized

Part 3 – Chronic Pain and Depression

First, an apology. This third part of the series, “Chronic Pain and Depression,” should have been written and posted a long time ago. Unfortunately, LIFE got in the way and I’m just now writing and posting it! There are so many events coming up that have kept me from posting on this blog in the professional manner that I should. Therefore, I’m committing to writing something on this blog at least weekly and then move it up to every day. The next post will give more details about what is going on and how it is affecting my Chronic Pain.

But now, let’s finish our series on Chronic Pain and Depression…

As you begin your relationship with your therapist these are items to consider after your meeting(s). If there is ever a question in your mind about the therapy you are receiving, stop and seek out a new therapist – for peace of mind if nothing more. Your mind will give you warning signals if:

37.  During the session, your therapist answers his phone. (Not professional! This is time you are paying for!)

38.  As you talk about your culture or religion, your therapist throws insensitivity comments your way.

39.  Denying or ignoring the importance of your spirituality is another warning signal from your counselor.

40.  Your therapist tries to push her thoughts or convictions regarding spirituality or religion onto you.

41.  You find your therapist doesn’t empathize at all.

42.  Or, your therapist empathizes too much.

43.  As you talk about your problems, your counselor appears overwhelmed. You begin to feel like you are abnormal with so many problems. Not true! It’s time to start looking elsewhere.

44.  Your feelings or issues make your therapist overly emotional, affected or triggered. 

45.  Against your wishes, you are pushed into highly vulnerable feelings or memories.

46.  Or, you find your therapist avoids exploring your emotional or vulnerable feelings.

47.  Your permission is not asked when your therapist begins using various psychotherapeutic techniques with you.

48.  Without helping you to appreciate and resolve the underlying causes, your counselor tries to get you to exert overt control over your impulses, compulsions, or addictions.

49.  Instead of teaching you coping skills to manage your impulses, your therapist prematurely or exclusively focuses appreciating and resolving the underlying causes you have with an issue or compulsion.

50.  Your therapist is consistently late for your appointment. Signs of canceling or missing your appointment on a consistent basis is another warning sign.

Those conclude the 50 Warning Signs to look out for during your first few appointments with a therapist. Some of these signs may not show up until you are well into a therapy program. When you feel uncomfortable with the lack of progress or the overt pressure you receive from your therapist, ask your doctor for another recommendation. There is no time limit on switching therapists.

It is better to adhere to the warning signs your brain picks up on rather than do nothing and become trapped within your therapist’s expectations or program. You should not be forced into doing anything you don’t feel comfortable doing.

I hope this three-part series has given you some enlightenment and permission to move to another therapist. When I read this article online at GoodTherapy.org it helped me to understand the reasoning behind a family member’s actions. The problem is if your loved one has succumbed to questionable therapy, there isn’t anything you can do about it. It is the person’s choice to continue with the therapist and all you can do is hope he/she will eventually see the therapy given was incorrect.

Thanks for reading and if you know of other “warning signs,” please be sure to let the author know them at the link for Good Therapy.

Carolyn

Posted in Uncategorized

Part 2 – Depression and Chronic Pain

Welcome Back!!!

As many Chronic Pain Sufferers know, depression attaches itself to the excruciating pain you already suffer through. This occurs for a variety of reasons:

  • you just don’t feel well
  • you don’t feel like going out with friends
  • you may feel abandoned by your friends
  • you can’t do the things you did before the pain became “chronic”

And I’m sure there are many other reasons to spark your depression, but I found these to be the top four that hit me wth depression faster than my pain meds took effect.

We talked about the warning signs of questionable therapy and counseling to look for when you decide to go to a counselor or therapist in Part 1 and we’re going to continue with the next 18 items:

19. Without authorization, your therapist discloses your identifying information.

20. Your therapist begins to tell you the identity of another client.

21. You learn your therapist has never participated in personal therapy work.

22.You find you therapist cannot admit mistakes or accept feedback.

23.Without helping you to change, your therapist focuses extensively on diagnosing.

24.Counselor talks way too much, without giving you a chance to speak.

25.Or, your therapist doesn’t talk at all.

26.Leaving you confused, your therapist speaks in “psychobabble.”

27.Without considering your feelings and somatic experiences, your therapist focuses on thoughts and cognition at your expense.

28. At the exclusion of thoughts, insight, and cognitive processing, counselor focuses on feelings and somatic experience.

29. Acting as if they have the answers/solutions to everything, therapists spend time telling you how to best fix or change things in your life.

30. Your Counselor gives frequent unsolicited advice, makes decisions for you, or tells you what to do.

31.Your dependency is encouraged by your therapist by allowing you to get your emotional needs met from the therapist.

32. Against your will, your therapist attempts to keep you in therapy.

33.The belief factor of the therapist is that only her counseling works and she ridicules the approaches of other therapists.

34.Making you feel uncomfortable, your therapist is contentious with you or may be confrontational.

35.Your counselor doesn’t remember your name or your interactions from one session to the next.

36. Appearing to be in her own little world, your therapist doesn’t pay attention to you, listen to you, or understand you.

I’m sure you will agree these are powerful factors to take into consideration when you are paying your hard earned money to see a therapist for help and guidance. Be sure to print these items out here or go to GoodTherapy.org for the full article. Part 3 is the last blog regarding the warning signs of questionable therapy. After that blog, we will look into the positive signs of therapy.

I hope these series are helping you with your therapy if you are going to a therapist or counselor or if you are considering going to a therapist. And hopefully, you are not seeing any of these negative factors with your therapist.

Take care of YOU, and I look forward to hearing from you,

Taking pain one day at a time,

Carolyn