Monthly Archives: February 2013

Remembering to be mindful

The tendinitis that I’ve been suffering since the New Year had really set me back emotionally and physically. As well as being in pain pretty much constantly, it was also affecting the quality of my sleep. This meant that I spent daytimes feeling really low on energy and consequently low emotionally as well. Last week, I was away with my partner and noticed that a great deal of my conversation with him was dominated by me simply saying “I’m really tired”, and also “I’m so fed up of feeling tired all the time”. He reminded me that I had not meditated regularly for quite a while and that this probably meant that I was coping less well than usual.

When I thought about things, I realised that I am mostly pretty good at dealing with sporadic pain and the unpredictable aspect of my pain and fatigue. I rarely spend too much mental energy worrying about where it’s going to turn up next, or how long flares will last for. I never spend any time worrying that I’ll get worse. This is a big change from how I was when I was first diagnosed with palindromic rheumatism.

Yet the pretty much constant pain of the tendinitis and fatigue was somehow harder to deal with. It had started to grind me down physically, and that was feeding into how I was feeling and thinking. So, I decided to kickstart my mindfulness and meditation practice by reading a book that had been on my shelf for a while: Mindfulness, A Practical Guide to Finding Peace in a Frantic World by Mark Williams and Danny Penman. I also decided to try and follow the program in the book.

My first introduction to mindfulness and mindfulness based cognitive therapy was on a wonderful course for people living with a long-term condition led by Breathworks.  It really helped me accept the realities of my condition, and gave me some really useful tools for coping, not just with my arthritis but with life in general. So my own experience of mindfulness has already been a positive one. However, my meditation practice – the foundation of mindfulness – has been somewhat sporadic. Sometimes I meditate daily, sometimes even twice a day. Other times I can go days or even weeks without prioritising meditation. Even though I’m getting practised at mindfulness itself, it’s not enough on its own if you don’t meditate.

So I read the first few chapters of the book to try and inspire me to prioritise my meditation again. One of the premises of MBCT (mindfulness based cognitive therapy) is that not only can our thoughts drive our emotions, but it can work the other way as well. In my case, my low energy and tiredness was feeding into my thoughts and instead of just accepting those feelings, my mind fed off these negative and low emotions, exacerbating things and making me feel even lower.  My mind was stuck, focusing only on the pain and tiredness and not on anything else that was going on externally or internally. It was like a broken record.

Most key for me to remember, was that my mind was becoming really focused on wishing things were different. My internal narrative was basically on a loop constantly saying “I wish I had more energy”, I wish I wasn’t so tired”. It wasn’t even the pain that was the main issue. It was the fatigue and tiredness. Instead of accepting the pain and fatigue for what they were, my mind was occupied with wishing it was different. In the book, it says that focusing on the gap between “how you feel and how you want to feel” highlights that gap, and this doesn’t help things, it only makes it worse. The trouble was, just wishing my pain and tiredness away wasn’t going make them go away. And it wasn’t as if I wasn’t doing things to help myself. I was. The only thing I wasn’t doing was accepting or meditating.

Once I realised how much energy I had been spending on wishing I had more energy, and wishing it was different, the clouds lifted. Since I’ve stopped wishing things were different and accepting them as they were I actually started to feel better. I’m still tired, but I’m saving energy by not focusing on wishing I had more energy – if that makes any sense!  I’ve managed to meditate almost daily since starting the program.

The funny thing is, I know I feel better after a yoga nidra meditation – a deep relaxing meditation. And I know that regular meditation does help. And it’s not just me that thinks that. Research studies all over the world are showing how beneficial mindfulness meditation can be. Yet, I don’t always do the things that are good for me or that will help me feel better. Thanks to mindfulness, I’m not going to beat myself up over it or spend too much time on dwelling on why this is. After all, I’m human, and I’m not the only one who forgets to do the things that are good for her!  I’m just going to keep on keeping on with my practice, and to really try and meditate as often as I can (which means timetabling it in and prioritising it).

I’m also going to remember that the key to this recent shift is that spending time on wishing things are different to how they are, especially when it’s about something that you cannot change, is a waste of mental and physical energy.

thankfully, I can also report that the tendonitis is healing – slowly.  The pain is much less, and I am sleeping better.

Some meditation resources that I’ve found useful include:

  • Headspace offers a great introduction to mindfulness meditation in its free “Take 10” programme which includes ten, ten minute meditations. I paid for the full year’s programme on an app and have progressed through quite a few of the daily programmes and found them really excellent.
  • Meditation apps from Oasis: There are a few different free and paid-for apps.
  • Insight Timer app: Basically just a meditation timer for people who don’t need much leading with their meditations.
  • Breathworks: Offers CDs, books and courses (online and throughout the country) on mindfulness. Especially relevant for people with chronic illness.
  • Everyday Mindfulness: Blog and forum for people using mindfuless

A different kind of pain

This is my first blog written using voice-activated software, so please excuse me if it doesn’t always make sense or if there are some strange words in there. It is a strange program which sometimes seems to have a mind of its own!

The reason I’m using it right now is because I have been told to totally rest my right hand and arm. And therein lies a lesson in what happens when you ignore pain. In about the second week of January, I got, what I thought was, a flare in my right wrist. It was more persistent than usual flares but not at that time particularly painful. With my arthritis flares, it doesn’t make much difference whether I rest the joint in question or carry on. I mean, yes it may hurt to use it, but it won’t necessarily make it worse. And so I carried on as normal.

Yet the flare did not go and, in fact, started to get worse. I also noticed a weird swelling about a centimetre from the base of my thumb. It did not appear to be on my joint. After three weeks of constant pain, I decided that this was no normal flare and went to see the doctor. This wasn’t my usual GP nor my rheumatologist and he sent me to A&E for an x-ray in case there was a break. Thankfully there was no break, although the first doctor I saw was completely mystified by my swelling and pain. This did not inspire me with confidence. Thankfully, she called on a more senior doctor and he was able to diagnose tendinitis. I was relieved that it was something identifiable but dismayed to find out that it might be hanging around for a while yet.

The doctor gave me a splint to wear and told me that I needed to completely rest my wrist. Carrying on as normal had probably aggravated it and prolonged the condition. I now needed to rest.  No cooking. No cleaning. No cycling :-(. And no typing. The voice-activated software that I had been sporadically using suddenly became my best friend. Or at least, the type of friend who will help you out when you need it but makes a point of letting you know how much they’re doing for you, acts passive aggressively and then sometimes refuses to do what you want them to do for no apparent reason!!

Yes it’s frustrating, but it’s better than not being able to send e-mails or do any work at all.

10 days on and there still seems to be no discernible improvement to the swelling or the pain. It hurts constantly and then there’s a really fierce, sharp pain when I’m doing something I clearly shouldn’t be doing. I’m trying not to worry about how long it’s going hang around for, and yet at the same time, I’m quite disheartened and fed up of constant pain. A couple of friends have suggested I seek a second opinion in case there is more I could be doing.

I am assuming that this tendinitis episode is related to my PR because I can’t see any other cause. It’s not as if I was doing a lot of typing or using my mouse on the computer for long periods of time before this happened. mind you, these days I attributed almost everything that is unexplainable to my PR.

Thankfully, actual arthritis flares have been quite mild and short lived while I have had to deal with the tendinitis pain so I suppose there’s always a plus side to everything!