Festive Flare Ups

Top Tips for Holiday Flare Ups Pt 1: Preparing for the Pain

The Holiday season is great for many reasons (time off work, summer sun here in Australia, evenings are warm so outdoor events abound, the wine is cool and the mornings warm) – it really is my favourite time of year.

But there’s no denying, for those who experience chronic pain, it can be a mine field.

Poor eating, too much drinking, being under slept and extra busy, tension can run high perpetually, as we fight shopping crowds, traffic and social engagements back-to-back……that’s a recipe for pain flare ups.

But, if you’ve read or hear much of my view on chronic pain issues, you’ll know that I believe all those external things can aggravate the problem – absolutely – but they are not the cause of chronic pain issues.

The cause lies with our internal environment.

What is the internal environment? 

What I mean by “internal environment” in this….. all the thinking, believing, feeling and attitudes that go on inside your head.

We all hold a plethora of these, about everything in life, and they form our general emotional and psychological state. For instance, people with depression tend to have thoughts, beliefs, feelings and attitudes that are negative and despairing; people who suffer with anxiety tend to have thoughts, beliefs, feelings and attitudes that are worried and fearful.

With chronic pain sufferers, the internal environment will be one of self negativity, often undergirded by a strong sense of unworthiness, not-enough-ness and usually a good deal of socialised fear (that is, fear of being socially rejected, thought poorly of or shamed).

Now, it’s hard to find a woman (and I suspect a man, also) who doesn’t have some of these kinds of self deprecating thoughts, beliefs, feelings and attitudes. In western societies we’re kind’ve raised to have them.

But my experience with those suffering chronic pain issues such as fibromyalgia, migraines, joint and muscles issues, IBS and other digestive conditions, arthritis (specially early in life) is that they have a deeply rooted harshness in how they think, believe and feel about themselves, which leads to some pretty negative attitudes toward the self.

This internal environment, over time, creates the reality of the body.

Why prepare for the festive flare ups?

While preparing for the worst can be a great way to reduce the effects once a pain flare is underway, I also believe preparing for pain flare ups means you can divert them at the first sign, often avoiding them altogether – if you’re committed to self care as a primary goal through this season.

A quick note on self care commitment

Given what I wrote, above, about the cause and development of chronic pain issues, it’s no surprise that I’m a big believer in self care as your number one goal. Turning your internal environment to point in the direction of caring for your health first often means some significant changes in how things are done, what gets done and how the other people around you are going to feel about your choices! But if you truly want healing, it will take that kind of commitment because the root problem is the very things you’re choosing to do or not do, and why.

So while these tips for preparing for festive flare ups might seem time consuming and cumbersome at first, and may mean you have to change some patterns in your own life and that of those around you, the longer term benefit will make it all worthwhile, I promise!

Preparation Tip #1: Know your triggers 

You’re probably already doing some of this instinctively, and possibly even very consciously. But at this time of the year, when parties and social events abound, it’s all too easy to let our good habits drop.

There are four areas of your being – body, mind, emotions, spirit –  that can contain triggers for pain flare ups and my suggestion is that you take the time to write down what the triggers are in each of these four areas. Bringing them to mind clearly can help reinforce our will power to avoid them.

Area One: Your physical body. How we use and treat our body can create stress and tension, which can trigger flares.
What foods or alcohol increase your chances of flare ups (for me, sugar and too much wine will really mess with my gut and sense of brain fog, which can lead me to tension, which leads to migraines)?
What scents affect you?
What physical movement, or lack thereof, can affect you? (walking for hours around shopping centres, or siting too long, standing too long)?

Area Two: Your mind. What we think about creates physical responses in our body that can trigger flares.
What are you thinking about as you approach family and social events? Are those thoughts causing stress, tension, anxiety or fear?
Are you playing the “tapes” of previous arguments, grievances or the things you wish you could say to someone?
Are you judging yourself or others, being critical or mean in your mind?
Are you making assumptions about other people’s motives, meanings or feelings that you do not know are true but which make you angry, bitter, judgemental, hurt or withdrawn?

Area Three: Your Emotions. How we feel about the Holiday season and family, the emotions these things can raise in us, can trigger flares.
How do you really feel at Christmas time? Lonely? Grieving? Sad? Questioning the meaning of your life? (these are very common!)
How do you really feel when you’re around your family? Is there shame? Embarrassment? Unworthiness? Put down or ignored? Child-like patterns? (again, these are all very common, even when we also feel positive things)
Do you feel negatively toward or about yourself? Do you compare yourself with other people, your siblings, cousins or other “more successful” family members? Is there any sense of being a “loser,” a “failure” or “someone no one likes”? These can all be deeply embedded in our Holiday-related bag of experiences.

Area Four: Your Spirit. Not fully expressing who we truly are can create inner tension which can trigger pain flares.
Are you ignoring who you really are, to fit in and play along during Christmas functions?
Are you “lying” or hiding the truth about yourself because you think it wouldn’t be appropriate or acceptable?
Are you saying “yes” to events or tasks you’d rather say “no” to?
Are you checking in with your deeper self to ensure she gets some time to do what makes her happy, even amid the rush of a full Christmas schedule?

Preparation Tip #2: Recognise your warning signs and establish your “Point of no Return”

Now that you’re more consciously aware of the things that might set off a pain flare for you, it’s useful to spell out (i.e. write them down) exactly what your early warning signs are.

For me, I know a migraine has started its process when a certain muscle in my shoulder and neck starts to feel stiff. I know that if I get up and move my body – do something very physically different – when I feel that early stiffness, I can avoid a migraine.

I have long encouraged clients to develop a very clear Traffic Light System (TLS). It’s a simple way of categorising early symptoms and late symptoms (those that are the last signs you get to respond to before you cross the point of no return and a pain flare is inevitable).

The Green in the TLS is when things are generally ok. I know what symptoms I can “ignore” or respond to “later” and I know what ones indicate I’ve moved out of the green zone. While it’s always best to respond to every symptom immediately, knowing your limits and your windows of opportunity are critical.

The Orange in the TLS is when I need to respond. That muscle in my shoulder and neck getting stiff starts in the green zone, and I have roughly 45 mins to remain doing what I’m doing before my body ups the ante and pushes me to the orange zone. That’s when I have to act if I want to avoid the red zone. In rare situations, this is when I will take pain meds, if I know I can not change what I’m doing. While I consider this a last resort, sometimes it is simply the most kind and self-caring thing to do to not let the body get into too much pain before resorting to medication.

The Red in the TLS is the “Immediate Action Required”. Usually this is beyond the point of being able to avoid the flare up altogether, but I can still take definitive action to lessen the impact. Drugs are not enough once I’m here, but usually necessary. This is the point at which I accept I must cancel on social events I could attend, but I know if I do I’ll be completely ravaged by the end of it. I no longer accept that path of self treatment. Once I’m in the red zone, the only action I have is to go home to bed.

I consider the red zone to be the point of no return. There’s probably no avoiding the pain flare. My goal is to never get to the red zone. But this isn’t a perfect science, it’s a life we’re living and sometimes the red zone happens.

After the red zone is the “I wont get out of bed for days” place. It’s not even a “zone” in the TLS because I never want anyone to think they can go there. It’s the black unknown at the other side of the red zone and it’s really a “No Go Zone”. Letting yourself get to that place is not an option for the person serious about self care.

Know your symptoms and “zone” them.

Write up your own list of symptoms and sort them into the green, orange and red zones for your own TLS.

Be specific AND include the action that should be taken at the first experience of each symptom.

For instance, my neck and shoulder stiffness starts as green zone. I should get up and move around for at least an hour.
Next that stiffness turns to sore muscles that I start to massage, and stretches up my neck and over the base of my scalp. I consider this the movement to the orange zone. I must get up and move, probably not returning to what I was doing, for the rest of the day, at this point. If I know that’s not possible, I will consider some light pain medication, because I know for sure that if I don’t move at that point, a migraine will come.

Write out your symptoms and actions for your TLS and know the drill. When you hit a symptom, the earlier you act, the better the chance of avoiding a full flare up.

Preparation Tip #3: Have a morning and evening routine

You may have heard this before but it bears special repeating over the festive season. A routine that creates physical, mental and emotional peace and love not only makes you start and end each day feeling better but your create a link between the practical things you do as part of your routine and the feelings. This means, when you need to create some peace and calm (ie in the middle of stressful family get togethers) you have a few things you can do that will help you connect to greater peace and calm, quickly.

I use to a meditation app called Insight Timer. It has ambient sounds you can listen to while meditating. I encourage meditation but if you’re not that into it, having the sounds of waterfalls or beaches or crickets or monks chanting “Om” playing while you simply sit and drink your morning cup of tea, and repeat “I choose to feel love. I choose to feel peace. I am grateful for life” and other such mantras, will do the trick.

When stressful moments arise over Christmas, repeating that mantra, or playing that background track, can instantly take your body back to the calmness of the morning routine.

Want more tips?

Next week’s blog will be full of tips to help you once  your flare up is in full festive swing. So be sure to check that out.

I’m also doing some FB Live Lunchtime Learning on this topic on Thursday December 14th and 21st, at 12.30pm Sydney time (use this site to easily find what time that is for you). This Live Lunchtime Learning will stay up on my FB Site indefinitely, so you can check it out at any time.

As part of that Learning program, I’m developing a hand out to cover the things we’ve talked about here and a few more tips I’ll include in the Live session. If you’d like to have that handout emailed to you just before we go live, on the days of the session, you can sign up for that here:

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