If you’ve read part 1 and part 2 hopefully you are feeling more positive and motivated about moving forward. It’s important to keep in mind that it is normal to have exacerbation and it is a part of the process – in fact, it is one of the most important parts to move forward. I say this meaning every last part of it – If we learn our limits, we learn what threatens our nervous system and we learn what provides safety to our nervous system then we then are able to develop a viable plan to begin moving forward. Understanding these elements is going to play a big part in helping you start taking more steps forward then you do back. The more we can plan for those backward steps, or times in our lives where we know we will have more threatening stimulus, the more we will develop the tools to reduce the intensity and duration of the exacerbation as well as the frequency.
By this stage you will hopefully have identified a good number of things in your lifestyle that lead to your symptoms being worse. These may be activities, movements, stressful situations, sickness and so on. You will also hopefully have identified a number of safeties - things you know feel good, allow you to relax and may decrease your symptoms. If you haven’t already this is a great activity to complete so that you have a list of both. Some activities may fall under both columns. This is normal, include those as well.
These following 9 rules are helpful to have on hand if you know you will be experiencing a greater number of activities/experiences from your threats list, i.e. Work dead lines are coming, or you feel a flu coming on;
1. Find time to relax, meditate and breathe. This will help 'down-regulate' your nervous system. Relaxation can help increase GABA levels in your brain, the neurotransmitter that tones down sensory signals - meaning it'll help turn down your pain.
2. Identify activities in your safeties list that are easy to do and make time for them.
3. Don’t avoid exercise, just limit it’s intensity and duration. “Motion is lotion”. A nice saying to remember is “to it, not through it”.
4. Pace your stressful activities. If you don’t need to do it all at once, plan how you can do it incrementally.
5. Rationalise your pain – the pain you experience isn’t indicative of tissue damage – you are sore, but you aren’t in danger.
6. If you need to rest, do it, but try and keep moving – bed rest for long periods can make things worse. More frequent rests but shorter duration has been shown to be a more effective strategy.
7. If you have a number of items that help you cope with exacerbation, keep them in one place to make it simple to access and use.
8. Do what makes you happy that doesn’t take a huge toll emotionally or physically.
9. If you believe something helps – it probably does. We know that the mind is your most powerful asset.
If you feel worried it is always fine to contact your GP, Pain specialist, Exercise Physiologist or Physiotherapist. They may be able to assist in helping you with any of the above rules or if there is anything else you should consider.
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