11 Steps For A Better Night’s Sleep

If you ask someone how they slept last night, chances are you’ll get one of two answers – “fantastic” or “not at all”. It seems like a lot of people have trouble getting a good night’s sleep. The reasons can be many – having young children, an uncomfortable bed, too hot, too cold, too much stress…the list goes on.

When you live with Chronic Pain, it’s an entirely different story. Pain is usually the main factor in keeping us awake, and the likelihood of a good night’s sleep is generally not to be expected.  Read on to find out more about what it takes for a good night snooze. 

man sleepless in bed

 

Sleep And Your Immune System

Without sufficient sleep, your body makes fewer cytokines, a type of protein that targets infection and inflammation, effectively creating an immune response. Cytokines are both produced and released during sleep, causing a double whammy if you skimp on shut-eye.  Chronic sleep loss even makes the flu vaccine less effective by reducing your body’s ability to respond.

Stock Up on Naps

To stay healthy, especially during the influenza season, get the recommended seven to eight hours of sleep a night. This will help keep your immune system in fighting shape and also protect you from other health issues including heart disease, diabetes, and obesity.  If your sleep schedule is interrupted by a busy workweek or other factors, try to make up for the lost rest with naps. Taking two naps that are no longer than 30 minutes each —one in the morning and one in the afternoon—has been shown to help decrease stress and offset the negative effects that sleep deprivation has on the immune system.  If you can’t swing a half-hour nap during the workday, try grabbing a 20-minute siesta on your lunch hour, and another right before dinner.

Other Healthy Tactics

Person washing their hands

Of course, there’s more to boosting your immunity and guarding against illness than getting ample sleep. It’s also important to practice smart stay-healthy strategies such as washing your hands with soap regularly, avoiding close contact with people who are obviously under the weather and talking with your doctor about getting an annual flu shot.  And remember: Even if you do come down with a case of seasonal sniffles, you’ll be able to bounce back faster if your body is well rested. 

11 Tips For A Better Sleep

  1. Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
  2. Set a bedtime that is early enough for you to get at least 7 hours of sleep.
  3. Don’t go to bed unless you are sleepy. If you don’t fall asleep after 20 minutes, get out of bed.
  4. Establish a relaxing bedtime routine. Use your bed only for sleep and sex.
  5. Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
  6. Limit exposure to bright light in the evenings. Turn off electronic devices at least 30 minutes before bedtime.
  7. Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
  8. Exercise regularly and maintain a healthy diet.
  9. Avoid consuming caffeine in the late afternoon or evening.
  10. Avoid consuming alcohol before bedtime.
  11. Reduce your fluid intake before bedtime.
  12. Take your medications on a regular basis. If you take sleeping meds, take them on a regular basis as directed instead of just hit and miss each night. 

Some Items to Help with Sleeping

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Yolmina 3D Contoured Eye Mask for Sleeping

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ZzzQuil Pure zzz’s Sleep Aid

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Contoured Heating Pad for Neck and Shoulders

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White Noise Machine

Conclusion

Good sleep is available to all of us, but it can take some work to achieve it. Just think of the benefits at the end though…those zzzz’s are worth it!

There is always hope

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25 Inspirational Quotes

From time to time, I like to share quotes that I think are beautiful, to help inspire my readers or just make you think. Here are 25 of the most inspirational quotes I’ve found lately to share with you today. 

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  1. Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. We ask ourselves, ‘Who am I to be brilliant, gorgeous, talented, fabulous?’ Actually, who are you not to be?
    Marianne Williamson.
  2. Most of the important things in the world have been accomplished by people who have kept on trying when there seemed to be no hope at all.
    Dale Carnegie.
  3. Anyone can give up; it’s the easiest thing in the world to do. But to hold it together when everyone would expect you to fall apart, that’s true strength.
    Chris Bradford.
  4. Life is full of screwups. You’re supposed to fail sometimes. It’s a required part of the human existence.
    Sarah Dessen.
  5. Hard times don’t create heroes. It is during the hard times when the hero within us is revealed.
    Bob Riley.4
  6. When you have exhausted all possibilities, remember this: you haven’t.
    Thomas A. Edison.
  7. You can play it safe, and I wouldn’t blame you for it. You can continue as you’ve been doing, and you’ll survive, but is that what you want? Is that enough?
    J.M. Darhower.
  8. Fairy tales are more than true: not because they tell us that dragons exist, but because they tell us that dragons can be beaten.
    Neil Gaiman.
  9. Far away there in the sunshine are my highest aspirations. I may not reach them, but I can look up and see their beauty, believe in them, and try to follow where they lead.
    Louisa May.
  10. Be grateful for what you already have while you pursue your goals.
    If you aren’t grateful for what you already have, what makes you think you would be happy with more.
    Roy T. Bennett.5
  11. It’s not about perfect. It’s about effort. And when you bring that effort every single day, that’s where transformation happens. That’s how change occurs.
    Jillian Michaels.
  12. Reach high, for stars lie hidden in you. Dream deep, for every dream precedes the goal.
    Rabindranath Tagore.
  13. Limitations live only in our minds. But if we use our imaginations, our possibilities become limitless.
    Jamie Paolinetti.
  14. When you get into a tight place and everything goes against you, till it seems as though you could not hang on a minute longer, never give up then, for that is just the place and time that the tide will turn.
    Harriet Beecher Stowe.
  15. You may be the only person left who believes in you, but it’s enough. It takes just one star to pierce a universe of darkness. Never give up.
    Richelle E. Goodrich.7
  16. You never know what’s around the corner. It could be everything. Or it could be nothing. You keep putting one foot in front of the other, and then one day you look back and you’ve climbed a mountain.
    Tom Hiddleston.
  17. If one dream should fall and break into a thousand pieces, never be afraid to pick one of those pieces up and begin again.
    Flavia Weedn.
  18. Just because you fail once, doesn’t mean you’re gonna fail at everything. Keep trying, hold on, and always, always, always believe in yourself, because if you don’t, then who will? So keep your head high, keep your chin up, and most importantly, keep smiling, because life’s a beautiful thing and there’s so much to smile about.
    Marilyn Monroe.
  19. Don’t let something make you miserable if you can do something about it. If that’s what makes you happy, go for it.
    Kate Brauning.
  20. A boat is always safe in the harbor, but that’s not what boats are built for.
    Katie Couric.
  21. Twenty years from now you will be more disappointed by the things that you didn’t do than by the ones you did do. So throw off the bowlines. Sail away from the safe harbor. Catch the trade winds in your sails. Explore. Dream. Discover.
    Mark Twain.
  22. Your complaints, your drama, your victim mentality, your whining, your blaming, and all of your excuses have NEVER gotten you even a single step closer to your goals or dreams. Let go of your nonsense. Let go of the delusion that you DESERVE better and go EARN it!
    Steve Maraboli.
  23. I don’t believe in failure, because simply by saying you’ve failed, you’ve admitted you attempted. And anyone who attempts is not a failure. Those who truly fail in my eyes are the ones who never try at all. The ones who sit on the couch and whine and moan and wait for the world to change for them.
    Sarah Dessen.
  24. Even the darkest night will end and the sun will rise.
    Unknown.
  25. Every great dream begins with a dreamer. Always remember, you have within you the strength, the patience, and the passion to reach for the stars to change the world.
    Harriet Tubman.6


there is always hope

 

 

20 Quotes To Reduce Stress When You Have An Invisible Illness

Having Fibromyalgia, or any Invisible Illness is hard to live with. People can’t see your pain like they can with other conditions, and we often have to put up with the platitudes of “but you don’t look sick”, or “oh, I get aches and pains all the time too”. Hearing these comments over and over can lead to depression, frustration and resentment. Stress builds and makes you hurt even more, and so a vicious circle begins. 

It’s time to read something more positive, words that you can cling to and keep close at heart. These quotes are from a variety of different people who seem to have a handle on anxiety and stress. I hope their words help you. Thanks to Live Purposefully Now for the list:

Ocean with giant rock and the words Stress Free Zone

Quotes

1. Anxiety’s like a rocking chair. It gives you something to do, but it doesn’t get you very far. Jodi Picoult

2. You don’t have to control your thoughts. You just have to stop letting them control you. Dan Millman

3. Anxiety does not empty tomorrow of its sorrows, but only empties today of its strength. Charles Spurgeon

4. I promise you nothing is as chaotic as it seems. Nothing is worth diminishing your health. Nothing is worth poisoning yourself into stress, anxiety, and fear.  Steve Maraboli

5. You can’t always control what goes on outside. But you can always control what goes on inside. Wayne Dyer

6. When you change the way you look at life you literally shape a different life for yourself. Elle Sommer

7. I just give myself permission to suck. I find this hugely liberating. John Green

8. Stress is an ignorant state. It believes everything is an emergency. Natalie Goldberg

9. Don’t try to force anything. Let life be a deep let-go. God opens millions of flowers every day without forcing their buds. Osho

10. Breath is the power behind all things…. I breathe in and know that good things will happen. Tao Porchon-Lynch

11. You must learn to let go. Release the stress. You were never in control anyway. Steve Maraboli 

12. If the problem can be solved why worry? If the problem cannot be solved worrying will do you no good.  Shantideva

13. The key to reducing anxiety is to let each situation be what it is, instead of what you think it should be. Elle Sommer

14. One of the symptoms of an approaching nervous breakdown is the belief that one’s work is terribly important. Bertrand Russell

15. Many a calm river begins as a turbulent waterfall, yet none hurtles and foams all the way to the sea. Mikhail Lermontov

16. The greatest weapon against stress is our ability to choose one thought over another. William James

17. Stress is the trash of modern life we all generate it but if you don’t dispose of it properly, it will pile up and overtake your life. Danzae Pace

18. Rule number one is, don’t sweat the small stuff. Rule number two is, it’s all small stuff.  Robert Eliot

19. Today I refuse to stress myself out about things I cannot control or change. Anonymous

20. If you are distressed by anything external, the pain is not due to the thing itself but to your own estimate of it; and this you have the power to revoke at any moment. Marcus Aurelius

Living A Stress-Free Life

Stress-Free

Re-examine Your Values

Or examine them for the first time. Your values will always make it clear to you what you want in life.

Once you are clear on your values, you can begin to identify the things you could do away with. Those things will probably be your stressors, so this tip helps to clear your mind and prepare for the changes ahead.

Forgive Yourself

You can’t begin to live stress-free if you can’t forgive yourself. If there are issues from your past you haven’t dealt with, you are likely to be filled with stress over them. Living with regrets is also stressful. 

Life is meant to be enjoyed. And it’s a journey, not a destination. Just because you took a detour to the wrong side doesn’t mean you can’t find your way back to the right path. Work toward becoming a better person. Let your mistakes be life lessons. Everyone makes mistakes, remember that. And put the past in the past where it belongs.

Forgive Others

This goes hand in hand with forgiving yourself. Just as it’s important to forgive yourself, it’s equally important that you forgive others for the wrongs they’ve done to you.

Others are just as worthy of forgiveness as you are. Forgiving others frees you more than it frees them and the extra baggage you’ve been carrying around is liberating to let go of as well. 

Accept Your Life Just The Way It Is

No one is promised a perfect life. Though we all strive to achieve happiness and contentment in our lives, it doesn’t always turn out that way. The key to acceptance is to accept it just the way it is. Accepting it doesn’t mean settling in it. It means consciously acknowledging it instead of running away from it in denial.

Whatever your life circumstances, accept them. Only when you accept your life circumstances can you begin to take steps to improve them. This will definitely help you to live stress-free.

Think The Best Of Every Situation

Whatever the situation is that you’re going through, be it divorce, disease, failing at school, getting fired from work, etc., you can still find some good in it. I know that sounds simplistic, but there are always reasons to be grateful as long as you don’t play the victim and accept the circumstances for what they are. 

You still have the power to change things. That power is what leads to a stress-free life. Acceptance can be liberating. 

Be Present In Everything You Do

It’s easy to be preoccupied with other things while we are doing one thing, and this elevates stress. If you are washing dishes, but now you are worried about paying the bills and the kids’ tuition, and the mortgage, then stress is bound to overwhelm you.

Instead, learn to be present in what you are doing. You can teach yourself to think of only washing the dishes. You can compartmentalize everything so that you don’t let your stressors dominate all your time. This way you don’t let stress prevent you from being productive. 

Declutter Your Life

And do this in every way imaginable if you want to live stress-free. People have a lot of stress because they have a lot of material, mental, emotional, financial, intellectual and social clutter. If only they could declutter their lives.

You don’t need all those other things outside of your basic needs. Stop hoarding stuff because managing it means stress. Simplify your life in the best possible way.

Be Grateful

Don’t underestimate the significance of gratitude if you want to live stress-free. Most people can’t get out of stress because instead of being grateful for the good things in their lives, they are busy whining about the bad things in their lives.

Sometimes they whine even about the good things because they’ve become blind to how lucky they are. If you are like that, it’s time to change. Gratitude is the best antidote for stress, so take a spoonful and live stress-free.

Using Vitamins To Help Treat Fibromyalgia

Fibromyalgia is a difficult condition to treat because no one seems to present with the same set of symptoms. Every person describes their pain in different ways (aching, throbbing, burning) and their pain can manifest in different parts of the body than where you may experience it. One treatment option is to use Supplements to help the body where it may be lacking in a certain substance.

Picture of various vitamins

How Do Vitamins Work?*

A vitamin is a small molecule that your body needs to carry out a certain reaction. Your body has no way to create vitamin molecules itself, so the vitamin molecules must come in through food that you eat. The human body is known to need at least 13 different vitamins:

In the body, proteins, carbohydrates, and fats combine with other substances to yield energy and build tissues. These chemical reactions are catalyzed, or accelerated, by enzymes produced from specific vitamins, and they take place in specific parts of the body.

The vitamins needed by humans are divided into two categories: water-soluble vitamins (the B vitamins and vitamin C) and fat-soluble vitamins (A, D, E, and K). The water-soluble vitamins are absorbed by the intestine and carried by the circulatory system to the specific tissues where they will be put into use. The B vitamins act as coenzymes, compounds that unite with a protein component called an apoenzyme to form an active enzyme. The enzyme then acts as a catalyst in the chemical reactions that transfer energy from the basic food elements to the body. It is not known whether vitamin C acts as a coenzyme.

When a person takes in more water-soluble vitamins than are needed, small amounts are stored in body tissue, but most of the excess is excreted in the urine. Because water-soluble vitamins are not stored in the body in appreciable amounts, a daily supply is essential to prevent depletion.

Fat-soluble vitamins seem to have highly specialized functions. The intestine absorbs fat-soluble vitamins, and the lymph system carries these vitamins to the different parts of the body. Fat-soluble vitamins are involved in maintaining the structure of cell membranes. It is also believed that fat-soluble vitamins are responsible for the synthesis of certain enzymes.

The body can store larger amounts of fat-soluble vitamins than of water-soluble vitamins. The liver provides the chief storage tissue for vitamins A and D, while vitamin E is stored in body fat and to a lesser extent in reproductive organs. Relatively little vitamin K is stored. Excessive intake of fat-soluble vitamins, particularly vitamins A and D, can lead to toxic levels in the body.

Many vitamins work together to regulate several processes within the body. A lack of vitamins or a diet that does not provide adequate amounts of certain vitamins can upset the body’s internal balance or block one or more metabolic reactions*.

Why Do I Need Vitamins?

Optimal nutrition creates a body that is strong and healthy. When you live with Fibromyalgia, you may be at risk of poor nutrition, due to various factors. Some reasons contributing to your fibromyalgia nutrition problems can be:

1) lack of nutrients in the food you consume
2) lack of nutrients in the soil in which your food is grown
3) a spasm in the artery leading to the muscle
4) poor digestion
5) lack of exercise
6) stress (which increases your demand for nutrients)
7) chronic fatigue
8) hormonal imbalances
9) viruses and toxins
10) chronic pain, which makes it difficult to eat

Which Vitamins Are Best For Fibromyalgia

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The above chart can help you determine which vitamins might be best for you. Where possible, it’s always best to get your vitamins from a natural food source, but supplements are fine as well. Talk to your doctor so that the two of you are working together to find a plan that fits with your current medications and lifestyle.

In particular, pay attention to the B Vitamins, Vitamin C, Vitamin D and Magnesium. These four are the powerhouses for Fibromyalgia, working on bones and muscles as well as nerves. Since Fibromyalgia is thought to be a condition in which the messages between the brain and the nerves to the spinal cord are messed up, good nerve function is critical to the care of your Fibromyalgia. Magnesium can help with the heavy muscle pain that Fibromites often feel. The B Vitamins are crucial for maintaining your overall good health, including that of the muscles and nervous system.

Other Supplements That May Help

SAMe

S-Adenosyl methionine, more commonly known as SAMe, is a synthetic form of a compound the body naturally produces.

We need it for proper immune function, and it plays a role in forming cartilage and our DNA.  As we age, our bodies produce less of it, which may explain the increased aches we feel after each new birthday. Taking a SAMe supplement not only lessens chronic pain, but it also can boost your spirits, as it assists in the production and breakdown of neurotransmitters, such as serotonin, norepinephrine and dopamine – brain hormones that influence and regulate moods.

Fish Oil

Because of its omega-3 fatty acids, fish oil has terrific anti-inflammatory properties, which can help reduce fibro pain.  It reduces the body’s production of inflammatory hormones (prostaglandins) and that may mean less stiffness or fewer tender joints.

The recommended dosage is 1 or 2 capsules (or 1 or 2 tablespoons) daily to reduce inflammation and boost your immunity. But check with your doctor first – especially if you take blood-thinning medications, such as aspirin or warfarin (Coumadin).

Ribose

Tight muscles are a common cause of fibro pain. To relax and release, muscles need energy and that’s where ribose supplements come in.

Ribose, a simple sugar, can increase energy by an average of 61% – and cut the pain experienced by fibromyalgia sufferers by an average of 15.6%, according to a 2012 study published in The Open Pain Journal. The author of the study recommends a 5 g dose three times a day.

Brown Seaweed Extract

You may not be familiar with these capsules, but this supplement is one to look for. It’s showing great promise in the fight against chronic pain.

In fact, taking 1,000 mg of brown seaweed extract daily can reduce joint pain and stiffness by 52%, according to a 2011 study from Australia’s Centre of Health and Wellbeing, published in the journal Biologics.  Even better: These benefits kicked in after just one week, so you don’t have to wait long to find out if it’s working for you.

Conclusion

There are many options available to you in regards to Vitamins and Supplements when it comes to treating your Fibromyalgia. Check with your doctor for more information and find the ones that may work for you.

 

*http://cyber-north.com/vitamins/work.html

10 Things I’ve Learned About Chronic Pain

If you’ve read my blog before, you know that I live with Chronic Pain and Chronic Fatigue. My pain comes from Fibromyalgia, Osteoarthritis in all my major joints, Myofascial Pain, a condition called Trigeminal Neuralgia, Diabetes (and Neuropathy that comes from that), Pelvic Adhesions, a spinal condition called Forestier’s Disease, aka D.I.S.H. which stands for Diffuse Idiopathic Skeletal Hyperostosis, Gastroparesis and several other medical conditions.

The author showing various pictures of her face in pain

My many faces of pain

I’ve been living with Chronic pain for over 30 years now, from the time I was a teen, and I’ve learned a few things in those years. I’d like to share 10 of those things with you now.

1. THERE IS ALWAYS HOPE

No matter how long I’ve been in pain for, I’ve never given up hope that things are going to get better. Some days I have are pure agony. Some days are pure delight. I cling to the good days as a reminder that things can be better and often are. There is always hope.

2. A GOOD DOCTOR IS TO BE TREASURED

Doctors have a hard time treating patients with chronic pain because they haven’t been trained well. They’re trained to diagnose a problem and solve it, so chronic pain is frustrating for them as well. If you don’t have a sympathetic doctor who is doing everything they can for you, find another doctor. When you do find one, be honest with them. Share everything…your depression, your anger, your worries. A good doctor wants to help you, but if you can’t share with them, you’re not giving them the chance to do all they can.

3. SUPPORT GROUPS AREN’T RIGHT FOR EVERYONE

Some people thrive in a support group. Others tend to get tired of the constant back patting and “Oh my gawd, I’m so sorry” conversations. Some are in the middle. I think a support group can be a great thing, as long as it’s the right fit. You want a group where you can feel heard and valued while offering support to the others as well – not just a one-way street. I also think it’s important to not jump into every group you hear about. That just becomes confusing and almost like a competition, to see how much sympathy you can drum up. You have to be willing to give back and you can’t forge honest relationships with people when you’re in a dozen active groups in my opinion. Unless that’s all you do all day long. And if that’s the case, I feel sorry for you, because you’re obviously not getting something you truly need.

4. CHRONIC PAIN IS ALMOST IMPOSSIBLE TO EXPLAIN TO OTHERS

Despite having great tools like the Spoon Theory and the Battery Analogy to talk about how much energy it costs us to live with chronic pain, it’s almost impossible to get others to understand what it’s like to live with chronic pain day in and day out. Here’s the thing…THE PAIN NEVER GOES AWAY. I can’t make it any more clear than that. No matter what I’m doing, or not doing. I’m hurting. Sometimes I’m in agony, like when I get a Trigeminal Neuralgia Flare up. Try to imagine the last time you experienced brain freeze from eating/drinking something cold…do you remember that sensation? That agonizing pierce of pain in your brain?  Now try to imagine that same feeling but in your cheekbone…for 12 hours in a row. Can’t imagine it?? Go try and get brain freeze as a reminder. That’s what my TN flare-ups are like. They start in my cheekbone and spread to my sinus cavity and my eye, then down to my jaw, and to my esophagus. I get spasms in my throat and often I get chest pain as well. For 12 hours.

My Fibromyalgia pain feels like my limbs are in concrete…it’s a heavy throbbing sensation in my arms and legs that make them impossible to move. The Neuropathy I feel in my feet is like pins and needles that never go away. My back pain is so intolerable that I can’t sweep my floors for more than 5 minutes without my lower spine seizing up.

5. DID I MENTION, THE PAIN NEVER GOES AWAY.

Sometimes it lightens up a bit, maybe after I’ve had a rare good night’s sleep, but if I’ve done too much on a particular day, the next day will be agony. Every day is different, and I’ve learned that there is no rhyme or reason as to what might cause a flare and why some days are better than others. Even as I’m typing this, my hands and wrists are throbbing and I’m making more mistakes typing than I normally do. When I sleep, I have to make sure my fingers aren’t curled, or I’ll wake up and won’t be able to move them.

6. COMFORT ROUTINES FOR FLARE UP DAYS ARE LIFESAVERS

In order to combat chronic pain, you need to have an arsenal of weapons at your disposal. This can include medications, therapies like massage or chiropractic care, acupuncture, heat, cold, stretching, yoga, and other items that help you when your pain is flaring up. Warm fluffy blankets and socks, a TENS machine or massaging unit, a roll-on pain medication – whatever you find works for you is part of your comfort routine and it’s important that you use these items when needed before your pain becomes even worse.

Kitten resting in a fluffy blanket

7. PACING REALLY DOES WORK

One of the important things you learn when you have chronic pain is that you have a limited amount of energy and you have to pace yourself throughout the day/week, etc. in order to stay ahead of the pain. Pacing is critical in helping to prevent flare-ups or in helping to reduce the number of flare-ups you may experience. There comes a point when you may have to consider outside help for chores because you can’t do them all. Perhaps a teenage neighbour can help with cleaning or laundry or care in the garden. Maybe you decide to hire a cleaning service twice a month for a deep clean that you can’t get to. Whatever you need and whatever you decide, my best advice is to lose the guilt. It’s not your fault you have chronic pain. You do what you need to, in order to make your home a happy one again.

8. SLEEP IS A VERY GOOD THING

Most people with chronic pain struggle to get good sleep, just by the very nature of being in pain. Take the time to establish a good sleep routine and don’t be afraid to nap during the day if that’s what your body requires. Just sent a timer for no more than 90 minutes (one sleep cycle) and do it early enough that it won’t interfere with bedtime. If you need to ask your doctor about sleep medications, then ask. Don’t be afraid of them, but perhaps try the more natural solutions first, like melatonin. Your doctor can give you the best advice.

9. WE ARE ALL WARRIORS

Just by the mere fact you are reading this and identifying with it, you are a warrior. Living with chronic pain is no picnic my friend and those of us who do it struggle every single day of our lives. Some days are good, some days are bad and some days are too difficult to talk about. It takes a special kind of strength to manage chronic pain and life at the same time and I admire every single person out there who is doing it. You are a warrior.

10. I’VE FINALLY ACCEPTED MY BODY THE WAY IT IS

For all my bravado and positive spirit, it took me a long time to learn to love this pain-filled body of mine. When I was forced to leave my job at the top of my game in 2009 I was devastated. I didn’t think I’d ever be useful to anyone again and I sank into a deep depression over how my body had let me down. It took several years before I was able to accept that this truly was my “new normal” and that returning to work wasn’t going to happen for me. When I found myself in a place where my health had improved somewhat, and I felt I had something to give back, I started volunteering for the Patient Voices Network and that really helped me get back on my feet. I am able to take part in committee work again, but at a pace that works for me and my health. I’m better able to accept my body and all it’s medical failings because I’ve found ways to contribute again.

I’ve also been able to get involved in hobbies again such as crafting and reading. I’m learning how to crochet and do needlepoint, all things I didn’t have time for when I was too busy working. So accepting my limitations also opened the door to new things for me to try, which has been a blessing. Perhaps you’re in the same place now, ready to accept that this is your new normal, and it’s an okay place to be. If you’re going to be in pain anyways, doesn’t it make sense to accept it and find ways to make the best of it.

CONCLUSION

I’ve been blessed with a positive nature that has helped to get me through a lot of difficult situations in my life. Chronic pain and my medical conditions are part of that. I believe in God and trust Jesus every day to be there for me. I have wonderful family and friends who have been so supportive of me. I belong to a great support group online that genuinely cares about me. More than anything though, and as my first point says,

There is always hope

Chronic Pain and Travelling

When you live with Chronic Pain and Chronic Fatigue, travelling for business and/or pleasure can become a real challenge. In the course of my volunteer work, I sit on 4 different committees and one working group, and of those, 2 of them require travel from my home in Langford, BC (just outside of Victoria) to Vancouver on the Mainland. It’s a short flight, only 30 minutes from runway to runway, but with everything that goes into it, it can end up being quite exhausting by the time the trip is over.

Plane and images of travelling

On my most recent trip to Vancouver, I came down with what was either food poisoning or a severe case of gastroenteritis on Thursday evening before my all day Friday meeting. I was in the bathroom every hour all night long, plus I had the stomach cramps and nausea, along with feeling extremely cold yet having the sweats. I haven’t been that sick in years!!!  On top of all that, I had a flare-up of my Trigeminal Neuralgia which combined to make me a very, VERY miserable girl.

I survived to the next day, made it through the meeting still having the shakes and sweating and still with facial pain from the TN, and all I wanted to do was get home as soon as possible. I arrived at the airport for my 7pm flight, only to find out it had been cancelled!!  The next flight was for 8pm so I had no choice but to wait. Then there came notice of a delay for that flight. Then another delay and another delay and still ANOTHER delay. In total, there were five delays for the flight and I didn’t get home until just before 11pm by the time it was all said and done.

I was so wiped out from being sick, from the travel, the intensity of the meeting…just everything. I went to bed immediately and didn’t wake up (except for pee breaks) until Sunday at 8am. I completely slept through Saturday!!

Chronic Pain And Travelling

Travel, in general, is not easy when you have Chronic Pain and being sick makes it worse. If you do have to travel, for business or pleasure, I’ve gathered a few tips to help make YOUR travels a bit easier the next time you’re flying or on the road:

General Considerations:

  • Plan a realistic itinerary.
  • Allow plenty of time.
  • Keep a small, lightweight, hands-free bag with essentials handy and check your main bag if traveling by air.
  • Ask, “How accessible are handicapped accommodations?”
  • Pack for all temperatures and environmental fluctuations. I get hot easily, so I pack clothing that is easy to layer. With careful coordination, I can make many outfits from fewer articles of clothing and lessen the load.
  • Make your bed as close to your bed at home as possible. Ask for extra pillows or blankets. (I always check the closet when I first arrive for these).
  • Use earplugs and a sleep mask.
  • Stay as close to your usual routine as possible, but also adjust with the local time to avoid jetlag.
  • Throw in an extra pair of reading and sunglasses from the dollar store so if you lose them, you don’t mind so much. A book light comes in handy and serves as a light that is easy to access when your unfamiliar hotel room is dark.

Medical-related

  • Carry a medical letter or a medical history summary that includes diagnoses with your physician’s contact information. This letter is handy and often available from your doctor. Ask if they might have such a thing or create your own.
  • Carry your medications with you and follow the tips for traveling with medications.
  • If you need a wheelchair, contact your airline and arrange to have one available.
  • Carry your insurance cards and identification at all times.

In the air, over the rails, and on the road

Amtrack Passenger Train

  • Take advantage of rest stops. Move about and stretch every chance you get. If you are traveling in America, Google has a map of rest stops across the U.S.
  • If you are confined to an airplane seat, keep blood and lymph moving by flexing and relaxing your joints every 20 to 30 minutes. Compression socks are helpful for circulation too.
  • Avoid alcohol and stay hydrated. Dehydration stresses the body as a whole.
  • Carry a healthy snack bag with fresh fruit and non-perishable foods, like protein bars, in case of a delay.
  • Dress for comfort in loose non-restrictive clothing and a pair of comfortable fail-safe shoes. This is not the time to try out those new sandals you bought!!
  • Make sure your plane, train, or bus is on time before leaving home – sign up for notification alerts when offered.

Travel comes with challenges for everyone, but especially those of us who live with conditions that cause chronic pain. But, if we respect our limitations and listen to what our body tells us, we can enjoy our time away from home.

Remember, there is always hope

 

Overcoming Depression With Fibromyalgia And Invisible Illness

If you are a patient with Fibromyalgia or another Invisible Illness, chances are you’ve felt depressed at some point. Depression is prominent in fibromyalgia patients with the risk of getting depressive symptoms at least once being about 90% and getting major depressive disorder (MDD) being about 62–86% in fibromyalgia patients*.
Depression Is a Big StormBy following an appropriate fibromyalgia treatment plan and getting the support of family and friends, you can take control of your fibromyalgia. You can also get control over your symptoms of depression and improve your quality of life.

What Is Depression?

Sadness is a normal reaction to loss or life’s struggles.  Depression surpasses sadness and becomes a problem that affects your whole life. People who are depressed commonly experience:

  • Loss of interest in activities you used to enjoy
  • weight loss or gain
  • thoughts about death
  • Irritability and guilt
  • Anxiety that won’t go away
  • Insecurity and a feeling of helplessness
  • decreased energy
  • difficulty concentrating or making decisions
  • uncontrollable tearfulness

These thoughts, physical changes, and feelings interfere with daily life.

What Is the Link Between Fibromyalgia and Depression?

The stress from fibromyalgia’s pain and fatigue can cause anxiety and social isolation. The chronic deep muscle and tender point pain can result in less activity. That causes you to become more withdrawn and can also lead to depression. It is also possible that anxiety and depression are part of fibromyalgia, just like the pain.

Depression and fibromyalgia can greatly interfere with the way you manage your activities at home or at work. So it is important to openly discuss any symptoms of depression you have with your doctors.

Does Stress Increase Depression With Fibromyalgia?

The stress of living with chronic pain and relentless fatigue can put a person into “overload.”  This results in near catastrophic levels of nervousness and anxiety. Doctors aren’t certain yet whether stress brings on Fibromyalgia or if Fibromyalgia brings on stress. All we know for certain is that it’s a vicious circle and that stress adds to problems of anger and irritability. Most patients feel their pain and fatigue worsening over time.

Is Depression Common With Invisible Illness?

Feelings of depression are common with all types of chronic pain, including headache, back and neck pain, hip pain, shoulder pain, and the pain of fibromyalgia. For example, the prevalence of major depression in people with chronic low back pain is about three times greater than in the general population.

Continuing that vicious circle, being depressed also increases the risk of developing chronic pain. Patients describe greater disturbances because of pain and display more pain behaviours than other pain patients who are not depressed.

One of the worst things that happens is that people with chronic pain such as fibromyalgia start to isolate themselves from family and friends at a time when they often need them the most. They become more focused on their pain, which causes further withdrawal which then causes more depression and round and round it goes.

Ways to Ease Depression With Fibromyalgia

It’s important to understand that fibromyalgia is more than the deep muscle pain and tender points you feel. It encompasses everything about you — your feelings, emotions, and attitude; the way you respond to stress; and the way you communicate with others.

The good news is, though, that while there is no cure, the fibromyalgia pain and symptoms of depression can be successfully treated.

  • Cognitive Behavioural Therapy

One of the most effective treatments for fibromyalgia and depression is a program called cognitive behavioural therapy (CBT). CBT is a type of treatment that helps patients understand the thoughts and feelings that influence behaviours. CBT is commonly used to treat a wide range of disorders, including depression, and anxiety.

This negative self-talk can fuel a sense that negative experiences are catastrophes, which further increases stress, anxiety, depression, and pain.

Your doctor can refer you to a CBT program offered individually (often online) or in a group format.

  • Mindfulness-Based Stress Reduction (MBSR)

This program, which teaches mindfulness to patients, had demonstrated remarkable benefits for reducing fibromyalgia pain as well as anxiety and depression. “Mindfulness is an awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally,” according to Jon Kabat-Zinn, a pioneer of mindfulness in medicine.

Being mindful means intentionally being present with your breath, thoughts, feelings, and sensations. You can practice mindfulness through meditation, body scans, mindful eating, or mindful movements like yoga or Tai Chi.

You can find an MBSR program offered in your community through your doctor.

  • Music for Pain Management

Music has a powerful effect on the mind – listening to music is associated with the release of dopamine, a feel-good neurotransmitter that is known to have a role in the body’s natural pain-relieving mechanisms. It also produces relaxation, which in turn can help to lift your mood and ease your pain.

A study published in Science Daily found that, when people with chronic pain listen to music for an hour a day, they experienced up to a 21 per cent reduction in pain and a 25 per cent reduction in depression. Additionally, they found that listening to music made participants feel less disabled by their condition and more in control of their pain.

Music that you find relaxing is likely to be the most effective for improving mood and pain levels. However, music doesn’t have to be soft and soothing to be effective. Whatever type of music makes you happy is the best kind to listen to, so go ahead and turn on Rock & Roll, Grunge, Heavy Metal or Classical…it’s your choice.

  • Medication

Medication does have a role in treating depression in people living with Fibromyalgia or other Invisible Illnesses. Only your doctor can know for sure if you require medication so it’s important you seek medical care if you are experiencing the symptoms of depression.  The goal is to help you feel better and often a short course of medication might be an option in conjunction with one of the above treatment options as well.

As you can see, depression can wreak havoc on the body already plagued by Fibromyalgia. Don’t let it isolate you from your family and friends. If you’re experiencing signs of depression, seek help. The sooner you start, the better the chances are of decreasing your pain and suffering and getting you back on track to better health.

There is always hope

*https://www.news-medical.net/health/Fibromyalgia-Depression-and-Anxiety.aspx

Interview April – Terri Sutula

Readers, thank you for checking out our final Interviewee – the fabulous Terri Sutula. 

TerriSutula

Introduce yourself and tell us a bit about you…

Hi, I’m Terri Sutula, and I currently live in the state of Virginia, USA. I’ve been married to the love of my life for the last 21 years, and I’m the Mom of a fabulous grown son. I served 20 years in the Air Force, and after I retired, I went back to school and received my degree in Religion (emphasis church ministry), then obtained my certifications in Personal Training and Health Coaching with the goal of developing a whole-person health ministry. Those plans took a bit of a turn in 2011…. Now I consider my blog to be my ministry, and I hope that by sharing my journey, setbacks and all, I can let people know that there is still life – a great life – after diagnosis, and help them avoid the hopelessness I felt at one point during my illness.

One fascinating fact about me is:

I don’t know if I’d call it fascinating, but it’s something my family loves to tease me about…. I’m constantly making up silly songs to popular tunes. I just can’t seem to help myself haha.

Chronic illness(es)/disabilities I have…

My main issue is fibromyalgia, though I’ve suffered from migraines my entire life, and have also lived with endometriosis, early osteoporosis (probably from the endometriosis treatment), and irritable bowel syndrome for years.

My symptoms/condition began…

Around 2011, my primary fibromyalgia symptoms began after a “snowball” of illnesses, accidents, and a stressful move. I got the flu and soon after that, was diagnosed with subacute thyroiditis, which resolved after about a year. During the same period, I had a couple of bad falls which ended with me doing a face-plant on the pavement. My second fall ended in a trip to the Emergency Room and pain in my ribs for months afterwards. Then, about a year later, we moved to another city, and everything that could go wrong did. I became extremely stressed out, my abdominal symptoms got worse and worse, and the fatigue and whole-body pain became overwhelming.

My diagnosis process was… 

Surprisingly enough, my diagnosis process was pretty quick and easy. I went to my Primary Care doctor, explained my symptoms and my accompanying illnesses, and he checked me for tender points, did some bloodwork, and confirmed what I suspected – that I had fibromyalgia.

The hardest part of living with my illness/disabilities is…

The hardest thing for me to come to terms with is my physical limitations. As I mentioned earlier, I was in the military for 20 years, stayed mentally and physically strong, and was capable of doing pretty much anything I put my mind to. Learning to work within my revised capabilities has really been a challenge, but it has also been a time of growth. It’s given me greater empathy for others and I’ve discovered a new sense of purpose.

 A typical day for me involves…

I’m not sure I have a really “typical” day – I just do whatever needs to be done on a given day. I do try to do some blog work most days, and I break my cleaning chores into different days so I’m not trying to do everything at once. We’ve started picking up groceries for a few days at a time rather than doing a “big” shopping trip once a week. It gets me out of the house and helps me work with my energy levels. It’s a lot easier to run into the store for a few things than to spend a long time shopping. I guess I’d say I do all the “normal” things others do, just on a smaller, more relaxed scale. I’ve learned that pacing my activities is key to keeping flares at bay.

 The one thing I cannot live without is…

 I have to say that there are actually two things I can’t live without, my faith and a sense of humour. Both of these are my keys to not just surviving, but thriving, with fibromyalgia and any other adverse event or circumstance that comes my way.

Being ill/disabled has taught me…

This illness has taught me that it’s okay to ask for help, and it’s okay to not be okay sometimes. I’ve learned that I don’t have to be strong all the time; it’s okay to share the load with others and asking for help isn’t a sign of weakness; it’s actually a sign of strength.

 My support system is…

My absolute biggest supporter is my husband, and I’m so grateful to have him. I’m very fortunate to have a really supportive family in general, but he’s my day-by-day, minute-by-minute supporter. He sees what I go through many days and is always willing to do whatever I need him to do.

If I had one-day symptom/disability-free I would…

I would go hiking on one of the beautiful trails we have around here. My hubby and I used to love to pack a picnic lunch and go hiking, and unfortunately, my pain and energy levels don’t allow us to do that right now. My goal is to work my way up to at least some of the easy trails.

 One positive of having a chronic illness/disability is…

You find out what’s really important to you when you have a chronic illness/disability. When you aren’t in such a place of “doing” all the time, as I was before I became ill, you can concentrate on the things that really add the most value and joy to your life.

One final thing I want people to know is:

There is hope, and there is a fulfilling life after diagnosis. Your life might not look exactly the way you imagined and you might have to learn to adjust to your “new normal” but this new phase of your life might open up even greater opportunities for you to live a life of joy and purpose.

My links are:

Blog: https://reclaiminghope.blog

Facebook: https://facebook.com/hopereclaiming

Twitter: https://twitter.com/hopereclaiming

Pinterest: https://pinterest.com/reclaiminghopeblog

Interview April – Ellie Trinowski

Let’s meet our next Guest (with the gorgeous smile), Ellie Trinowski, and find out more about her:

EllieTrinowski

Introduce yourself and tell us a bit about you…

My name is Ellie Trinowski, and I live in Cleveland Georgia. I’m a wife, mother, and Grammie.

Before I stopped working, I was an event planner and coordinator for weddings in the Northeast Georgia Mountains. I worked with wineries and catering companies to create memorable events in picturesque settings. I loved my work. Now, I am a full-time grandmother of a talented little gymnast named Violet. I love this gig, too!

Chronic illness(es)/disabilities I have…

I have psoriasis(PsO), psoriatic arthritis(PsA), fibromyalgia, epidermolysis bullosa acquisita(EBA), and bullous pemphigoid(BP).

Beyond these autoimmune diseases, I have also survived multiple bilateral pulmonary embolism, and I live with a supraventricular tachycardia.

My symptoms/condition began…

I was 17 years old when the psoriasis begin. It wasn’t until I was 44 years old that I was diagnosed with psoriatic arthritis. Within the next year, symptoms of fibromyalgia began.

In the summer of 2017, I began realizing symptoms of a rare skin disease called epidermolysis bullosa acquisita. By the end of the year, I was diagnosed with bullous pemphigoid.

My diagnosis process was…

I have been very fortunate in the duration that it took for my disease processes to be diagnosed by medical professionals. The largest obstacle was the pain and limited mobility that came with PsA initially. It did take almost two years of suffering before I found the right doctor to diagnose me with PsA. Dr. Jatin Patel also diagnosed me with Fibromyalgia and recognized the symptoms of my rare skin disease. He was expeditious in getting me to a dermatologist, Dr. Carmen Julian, for evaluation. After several biopsies and blood work, I was diagnosed with EBA. Finally, it was determined that I also had BP at Emory in Atlanta by Dr. Ronald Feldman, who is the professor of dermatology at the clinic for blistering diseases.

The hardest part of living with my illness/disabilities is…

I do not appear sick. It is incredibly frustrating to have people judge me when I use a mobility cart in a grocery store and have people ask me why. I’m 50 years old. Once I had an elderly woman walk up to me, while I was on a mobility cart, and she asked me to get off because she needed it more. Of course, there was no way for her to know that I had a flare of all of my diseases at the same time. I was in a lot of pain, I couldn’t walk well and my skin disease was causing ridiculous itching. I was feeling frustrated and embarrassed because she did this in the middle of the pharmacy area of the store. I relinquished and gave up the cart to her.

A typical day for me…

Involves a lot of driving!

Now that I am a full-time Grammy, I drive my granddaughter to school, and I pick her up every day. I take her to gymnastics practice, and we might go to the park if there is no gym. She helps me pick up groceries and we head home.

If I am not flaring, I plan dinner most days, and if I’m doing really well dinner actually gets made! I try to do one thing that contributes to house cleaning every day, like vacuuming the living room or cleaning a bathroom. I find that things don’t get too out of hand that way. Violet always helps me out with chores, as well.

By early evening, I am typically on the couch because I’m toast! I will make it into my room, take my medicine and fall into my bed by 8pm, where I watch Netflix.

The one thing I cannot live without is…

The support of my family! I am blessed beyond measure! My husband works full-time and still does the laundry for me and anything else that I can’t handle that I would have done before my disabilities. My mother and father live right next door, and they are incredible when it comes to anticipating my needs. Dad gave me a cane when walking became difficult. Besides checking on me often, my dad brought a walker over before I admitted I needed it. My mother randomly shows up with leftovers or muffins, and a smile to cheer me up. My little Violet fetches things for me, and helps me in the kitchen, or when I need to tidy up the house.

Being ill/disabled has taught me…

Although I have never been one to judge, being disabled has taught me never to judge a book by its cover. You never know what somebody is going through. It has also taught me that life is short and that you must make the most of every day. After being admitted to the hospital on October 5, 2017, and being told I was lucky to be alive after blood clots had been found in both of my lungs, I tend to look at every day with different eyes. I’m incredibly grateful for my life.

It is not always easy on painful days, but it is imperative when you consider it might be your last.

What advice would I give someone recently diagnosed…

I would tell someone who was recently diagnosed with an illness or disability that they must stand up for themselves. It is so important to speak your truth and ask plenty of questions. Take notes and research responsibly. Instead of researching on Google, type in Google Scholar and utilize that platform for reliable research. Ask for a second opinion if necessary and get to know others who suffer from chronic illness. This gives you a sense that you are not alone and it is also a great resource to gather ideas to help yourself.

My support system is…

I have always believed that it takes a village to accomplish anything. As I mentioned my family is my number one support. I also value the social media community of chronically ill patients. I am grateful to the people who spend time sharing their experiences and knowledge with others to effect change in policies, as well as, suggestions for the lifestyle alterations we must make in our lives. Others who have lived our pain and challenges sharing their experience is a priceless resource I am grateful for!

If I had one day symptom/disability-free I would…

Go for a hike in the mountains with my granddaughter.  I used to push Violet in her stroller all over this beautiful place we live in. When she became a toddler, I would take her with me on hikes to wear her out and get a good nap out of her! I had no idea back then that this simple ritual would be taken away from me before I was 50 years old.

One positive of having a chronic illness/disability is…

The ability to effect change. Because of outlets like the National Psoriasis Foundation and the Arthritis Foundation, I can connect with others and use my voice to effect change in my state and even in my country. I am currently advocating for step therapy reform in the state of Georgia. I was able to bring my voice to this legislation by traveling to the Capitol on Advocacy Day and share my story with others. I love that sense of accomplishment and progress.

My social media links are:

https://www.facebook.com/grammiesdoublewhammy/

www.instagram/grammiesdoublewhammy

www.twitter.com/ellietrinowski

www.grammiesdoublewhammy.com

Fibromyalgia and Pet Therapy

Fibromyalgia and Pet Therapy

pet-therapy

Fibromyalgia can be a lonely disease. Staying connected with friends and family becomes difficult when chronic pain and fatigue make it hard to get out and about like you used to. Sometimes, having a pet can make all the difference in the world!

Not only will a furry friend give you some companionship, but it turns out that pet therapy can actually be a pretty effective way of dealing with fibromyalgia pain. Here’s how it works.

What Is Pet Therapy

Pet therapy is a guided interaction between a person and a trained animal. It also involves the animal’s handler. The purpose of pet therapy is to help someone recover from or cope with a health problem or mental disorder. Basically, it involves using specially trained animals like cats and dogs to provide comfort to people who suffer from diseases like fibromyalgia, cancer, dementia, etc. The animals provide companionship while the patient pets or plays with them, reducing the amount of stress and pain they feel.

The biggest concern when it comes to pet therapy is making sure that the animals are well-trained and vaccinated. Because pet therapy is often done in hospitals, doctors want to be sure that a dog won’t get loose and run around contaminating the area.

With that being said, pet therapy, when done by a professional, is perfectly safe and can be very effective in treating fibromyalgia pain.


What Are The Benefits Of Pet Therapy?

Pet therapy builds on the pre-existing human-animal bond. Interacting with a friendly pet can help many physical and mental issues. It can help reduce blood pressure and improve overall cardiovascular health. It can also release endorphins that produce a calming effect. This can help alleviate pain, reduce stress, and improve your overall psychological state.

How Can Pet Therapy Ease Fibromyalgia Pain?

While the idea that simply petting a cat or dog can actually help your fibromyalgia pain seems a little far-fetched, there’s some basic science that backs it up. You see, petting an animal has been shown to cause your body to release lower levels of cortisol, which is the hormone linked to stress. And cortisol levels are directly linked to the amount of pain people with fibromyalgia feel.

And in addition to helping deal with your fibromyalgia pain, pet therapy also has other benefits. Depression and anxiety are both common among people with fibromyalgia, and it turns out that pet therapy can also help significantly with those symptoms. People who engage in pet therapy report consistently lower levels of stress and anxiety than people who don’t. There’s something about stroking a companion animal that lends a level of comfort to people who are suffering.

And taking care of an animal also helps people with fibromyalgia get more involved in daily life. Taking the animal on walks or playing with them in the park are great ways to coax yourself out of bed. And that’s especially true on days when your fibro pain makes you want to just close the curtains and go to sleep. So, a therapy animal can even be a link to the rest of the world when you have fibromyalgia.

So pet therapy can not only help you reduce your fibromyalgia pain, it can help you feel happier and less anxious.

How Can You Start?

Your doctor or therapist managing your treatment will administer pet therapy. A trained handler, often the pet’s owner, will take the animal to every meeting and work under your doctor or therapist’s direction to help you reach your goals. In most cases, the handlers work as volunteers. Discussion of proper pet handling is needed to ensure the safety of both the person receiving treatment and the pet.

Or if you prefer, you can also purchase your own animal that has been trained to be a therapy animal. There are lots of different breeders and trainers. And one should be able to help you find what you are looking for. A quick google search should be enough to find some in your area.

So maybe you’re the kind of person who hates having to leave their loyal pet behind. Well, getting them certified to provide therapy means that you can get comfort from them anywhere you go. And that can be a great thing when you’re suddenly struck by a fibromyalgia flare-up during your daily routine.

Animals make great companions, and it turns out that they might actually be great for treating fibromyalgia pain too. So if you’re tired of trying side-effect riddled medications, some alternative pet therapy may just be for you.

Outlook

The success of pet therapy depends on establishing realistic goals and expectations and meeting those goals. You and your doctor or therapist will establish these goals at the beginning of your treatment. You’ll also discuss how to reach those goals and how long it will take.

Your doctor or therapist will monitor your progress and help you stay on track to meet your goals. If your progress is slower or faster than expected, they may alter your treatment plan.