Your doctor has probably told you that stress will cause flare ups.  Regardless of the chronic illness, stress is an easy (and valid) scapegoat.  Stress gets you agitated. Stress raises your blood pressure.  Stress causes flares and inflammation and pain.  Stress is stressful to think about it.

Before it turns into a cyclical mess, what can you do about stress?

Was your first response nothing? That there’s nothing that can be done about stress.

Or did it feel more like a joke with yourself? “Oh gee, I guess I could quit my job and be less stressed.”

These responses really imply the same root feeling.  Hopelessness.  When you feel like you lack control in your daily life, whether your internal monologue is matter-of-fact or sarcastic, that’s a pretty sad place to be.  Think about it, what you’re saying is that you’re not in control of your life or your path. And that’s crazy.

What CAN be done about stress is a change in thinking.

Take responsibility. You can’t control what other people think, feel, say or do. But you do have control of all of those things for yourself.  Meditation is a remarkable practice for learning to tame your own mind.  Similarly, actions and words (i.e. what you say) are certainly within your direct command – simply take a breath and you’ll find you have more time to say or do the right thing.  In the space between, there are decisions you’ve made that have lead to where you are (professionally, interpersonally, etc.) and mishaps along the way, but own those too.  It’s part of life.

Take action. While you can’t control what others think, feel, say or do.  You do control your relationship to those others. If you reach the conclusion that a situation you are in is not serving you personally, if it’s causing you more stress than benefit, if it’s leaving you feeling agitated, tired, or especially flared up, make a change in your relationship.  Whether it’s a personal or professional matter, remember that you do control your relationship to it.

Accept the rest. It is really easy to get worked up and stressed out about things completely outside of your personal control.  In fact, it can be very fun to talk about what that one person did or what’s going on next door, as if the gossip somehow makes up for being outside of the situation.  However, for your own sanity, accept what you cannot change.  And remember that acceptance is also a decision (to take responsibility for).

In a way, it comes back to the serenity prayer:  ”…grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference.”    I omitted the God-piece because I find it easier to take this prayer as a sort of intention.

How do you manage stress?

Last week, I traveled to California for a yoga workshop. It was a fun and playful experience. But because of the nature of the type of physical practice, I found that I needed to share the details of my disease with the organizers and a few participants.

Generally speaking, everyone was very supportive. The instructors leading the workshop were kind in making modifications to the practice as needed. One of my colleagues, one who in the few days of the workshop had become rather close, said something surprising.

When I talk about rheumatoid arthritis, I usually reference “my disease,” “my RA,” etc. Talking about my illness, as though it belongs to me, as though it’s a part of me that isn’t going away any time soon. He suggested that I would be better served to not use the pronoun in describing my relationship to the disease, that it somehow described an attachment to the illness that may lock it into being.

An interesting thought. Though at the moment, I was a bit offended. “Let me take responsibility for my shit,” I remember thinking. It is something I will be dealing with, for better or worse, for the rest of my life.

Or is it?

The friend that brought this up is a follower of Abraham Hicks (LINK). To over simplify, he subscribes to the “if you can dream, it you can be it” philosophy

But for a chronic, is this type of hope valuable, or simply insane idealism to the point of delusion? Discuss.

A few things have become clear to me in the past few weeks:

1. I have a general aversion to pain.
2. I get quite pissy when I’m agitated.

At first glance, these both seem obvious and potentially experiences that are universally human.  So let me explain.

Pain Aversion

Rather than feeling pain, physical or emotional, I tend to change the subject, start a conversation or look for someone to talk to, walk away from things that are too painful to do or deal with, or eat.  Rather than actually feel the pain, I intellectualize it or drive my mind to distraction.

Pain is agitation.  That brings us to pissy.

Quite Pissy

So here’s the deal. When I actually feel pain, my emotional response can be unfortunately predictable.  If left unchecked, pain turns to agitation, agitated turns to pissy, and then we arrive at a helpless, angry feeling that turns cyclical.

Cyclical anger and self-pity is a big problem. It’s all judgement. Why do I feel this pain? Why can’t I do the things that other twenty somethings can?  Why can’t I just be normal?

Inflammation Awareness

Mornings are painful.  The pads of my feet swell up.  This makes walking generally uncomfortable.  However, when I’m aware of the inflammation, where it is and how much stiffness there is, I can better support my body.  I make better choses around footwear or morning activities (for example, I don’t practice hot yoga before 10am now as a rule).  In part because of this disease, I’ve created a life around flexibility.  That wasn’t a joke about yoga, that was to say that my days are not structured around 9-5 business hours or a more traditional Western ideal largely because it doesn’t work for my body.  Frankly, I don’t think it actually works for anyone, but I digress…

Point is: You have to be able to feel the pain, learn what your body is asking for and respond appropriately.  Otherwise, you’re just contributing your own stress and inflammation levels by playing into the judging response.

My Google alert continues to bring me odd information about my disease.

Yesterday, I came across this article over at DrCutler.com discussing the results of a study at the Georgetown University Medical Center.  According the article, “Researchers studied 76,643 women between the ages of 50 and 79 for their results. They found that consuming any amount of tea carried a significant risk of developing RA and women who drank four or more cups of tea per day had an increased risk of developing RA compared to those who drank none.”

At first glance, in plain Englsih, that seems to say that tea causes RA.  After reading the article, I had to remind myself of something my high school science teacher liked to tell us at any opportunity:

Correlation does not mean causation.

It would definitely appear that this study found a correlation between tea and RA.  However, there are so many other variables unaccounted for here.  For example, are tea drinkers generally more stressed than non tea drinkers?  Stress has been linked to RA time and time again.  We know RA is first and foremost a genetic condition.  Perhaps these tea drinkers used tea to destress, but have already reached their anxiety peak point to trigger RA. 

Regardless, these types of studies don’t do too much for those of us who already have the disease.  Will tea drinking aggrevate our condition?  Who knows.  But I’m going to keep drinking it because it’s soothing.

Pretty much every time I visit my rheumatologist, he tells me, “you look good. You’re in remission.”

Unfortunately, by the time I get to his office, I’ve usually been awaken for about three or four hours minimum and the worst of the “morning stiffness” is over.  My body has had time to adjust to itself. Sometimes I wonder if the pain stops or if I just adjust and don’t notice it as much…

So he says I’m in remission.  But when I think of remission, I think of cancer.  I think gone.  No more.

So you say I’m in remission.  But I wake up stiff.

So you say I’m in remission. But I don’t want to get up to walk to the bathroom because the pads of my feet are painfully swollen.

So you say I’m in remission.  But I swell up teaching a heated yoga class.

I want remission to mean gone.  Isn’t that what it means?  Guess not.  RA has different rules.