Chapter 18

Staying in control

Throughout this book you’ve read about different ways to help reduce your pain and improve your quality of life. Perhaps you’ve already begun to incorporate some of these changes into your daily routine — maybe you’re socializing more and walking daily. But perhaps you worry about maintaining the progress that you’re making. What happens when you’re confronted with a very stressful day? What happens when your pain intensifies and getting tasks done at work or at home becomes difficult?

No doubt, you’ll have difficult days on occasion. And there may be times when you catch yourself reverting back to old habits. You can lessen the effects of these occasional setbacks by developing strategies that help keep you focused on your pain management goals.

Getting through bad days

Difficult days will happen! Holidays can be stressful. Then there’s bill time or an unpredicted 10-inch snowfall. A visit from relatives also may qualify. Bad days can and do occur.

Whatever the reason for your bad day, you can get through it. One of the best ways to minimize the disruption of a tough day and quickly get back to your usual activities is to plan for it. And the time to plan is when you’re having a good day — not a bad one. On a bad day, it may not be easy to think of ways to cope with the problem at hand. In fact, it can be challenging to concentrate on much of anything except the day’s souring effect.

Here are some ways to plan ahead for difficult days:

Know your warning signs

Do you get a warning sign when a bad day is beginning? Maybe it’s a headache, excessive fatigue or an onset of the blues.

Identify common triggers

Knowing the most common reasons for your difficult days can help you better prepare for them. Think about some recent bad days. Was there a reason for your increased pain? Could it be from too much stress, overdoing it on the weekends, or getting a visit from a particular friend or relative? Or, perhaps, are your difficult days the result of things you’re not doing, such as relaxation exercises, a daily walk or getting enough sleep?

Develop a game plan

When you know a difficult day is coming or you get a warning sign, you often can lessen the negative effects by structuring the day with activities and diversions. Having a written plan can help. Your game plan may include:

• Maintain a normal schedule. A difficult day is not a time to overdo it — or to do nothing. Lying around won’t help your pain improve or the day go by any faster.
• Get out of the house. When you’re hurting, it’s natural to want to be alone and tend to your wounds. But this only gives you more opportunity to think about your pain. Go shopping or visit a friend who can keep you occupied. But steer your conversations away from your pain.
• Seek other diversions. Laughter helps. Read something enjoyable. Watch a funny movie or call a friend who has a good sense of humor.
• Try to relax. On a difficult day, spend more time relaxing. Practice your deep-breathing exercises. Use guided imagery or meditation techniques or do some journaling.
• Keep away from medication. If you’ve weaned yourself from medication, don’t let a bad day tempt you into using it again. Remind yourself that it’s only a temporary solution and that you’re better off without it. If you’re taking medication, don’t change the dose in an attempt to reduce the pain. You only increase your risk of side effects, and the increased dose may not help your pain.
• Say, ‘This will pass.’ It will. It’s easy to think the worst on a difficult day, but oftentimes you feel better in the morning.

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What about support groups?

Support groups can provide a depth of help and advice that you might not find anywhere else. That’s because they put you face to face with people who share many of the symptoms and feelings that you do. But not all support groups are the same. Some are mostly educational and feature discussions led by informed guest speakers, while others are more social and unstructured with meetings viewed mostly as a time to visit.

What support groups offer

Benefits of a support group vary depending on the group, but they often include:

• A sense of belonging, of fitting in. There’s a special bond between people whose lives have been disrupted by the same problem. Once you experience how others accept you just as you are, you begin to feel more accepting of yourself.
• An opportunity to meet people who understand what you’re going through. Family, friends and doctors can sympathize with your problems, but they often can’t empathize because they haven’t experienced what you have. Support group members generally know what you’re feeling and experiencing.
• A place to exchange advice. When group members talk, they speak with first-hand experience. They can inform you about helpful coping techniques.
• A venue to make new friends. A group member may become a listener when you need to talk or a companion to exercise with.

When support groups aren’t the answer

To gain the most benefit from a support group, you have to be willing to share your thoughts and feelings. You must also be willing to learn about and help others. People who are severely depressed and don’t want to talk or who have poor social skills are generally less likely to benefit from support groups.

In addition, not all support groups are beneficial. You want to be in a group where the mood is upbeat, the message is positive, and the focus isn’t on your pain and symptoms. Group meetings that aren’t carefully monitored can become settings in which to vent and share only negative feelings that feed on themselves. That isn’t the type of group that you want to be associated with.

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10 ways to maintain your gains

To stay in control of your pain, use the pain management strategies outlined in this book: daily exercise, moderation skills, relaxation techniques and positive-thinking strategies. The more you use them, the more beneficial they’ll become. Here are some other suggestions to help you maintain your progress and avoid relapses.

1. Don’t forget your goals

Select your areas of greatest concern, then set specific, measurable and realistic goals to help you deal with those issues. You might be worried, for example, that you’ll slip back into your old pain behaviors, such as moaning, complaining or limping. Or maybe you’re concerned about keeping up your exercise program. Create a list and check off each goal you reach. To strengthen your motivation, periodically review your checklist.

2. Pull out the contract

Some people find making a personal commitment to improving their lives and managing their pain helps them follow through with their plans. More than just a goal, a contract becomes a pledge, like other binding agreements you’ve made throughout your life. If you have a contract, put it where you can see it.

3. Monitor your progress

Keeping track of your accomplishments helps motivate you to continue to strive for your goals. Use charts or some other method to display your progress.

4. Plan your day

When you specifically schedule time for something that you want to do — such as exercising or going to a movie — you’re more likely to do it. Also use to-do lists or notes marked on a calendar as a way to remind you of your priorities.

5. Keep it positive

Look around your house and get rid of things that might lure you back into unhealthy habits. For example, is your bed still sitting in the living room to avoid having to walk upstairs to your bedroom? Are the drapes pulled to keep your rooms dark? Make your house feel like a home, not a hospital. When you walk around your house, you want to see evidence of a person who lives a happy and active life.

6. Say, ‘yes’

Accept help from others. It doesn’t mean that you’re failing. The fact is, you need support from others to keep you on track and to help you during difficult days. People who have supportive people around to help them often fare better than do those who don’t have support. In addition to asking for support from family and friends, you might consider joining a chronic pain support group.

7. Team up with a professional

If you’re having difficulty following your pain plan, make an appointment to see your doctor. Your doctor, or another health care professional, can be one of your biggest advocates. You might also consider seeking help from a counselor or life coach. Keep this person updated on your progress and obstacles you may encounter. He or she can often help you overcome those obstacles.

8. Talk yourself up

List as many positive statements about yourself as you can and say them to yourself when you’re feeling discouraged or in danger of slipping back into some of your old patterns of unhealthy behavior. If you do have a relapse, accept that it happens and move on again, positively.

9. Prepare for challenges

Make a list of situations that could disrupt the positive changes you’ve made. Prepare a response plan that you can use when needed.

Perhaps you’ve been walking for 30 minutes each day, but you know the weather will soon be changing and you don’t like being outside in the cold. How do you still fit in your walk? One option might be to walk indoors. Or perhaps a local school or mall allows indoor walking during certain hours. Another option is to buy a treadmill or get a gym membership.

Another example might be a change at work. You know you’ll be taking on new responsibilities, and that worries you. One way you might make the transition easier is by developing a list ahead of time. Write down all of the new things you’ll need to learn. Prioritize the list and decide what steps you need to take to learn each task. Knowing ahead of time exactly what you need to do and how you’re going to do it can make the transition less stressful.

10. Reward yourself

Rewards are a great way to reinforce positive change. When you reach a goal or successfully execute a pain strategy, treat yourself to something enjoyable.