Natural Treatments for Fibromyalgia: Healing Your Digestive Tract

natural-treatment-for-fibromyalgia-healing-the-digestive-tract

I’ve just started a new naturopathic protocol, focusing on healing my digestive tract.My naturopath wants to start with the digestive tract for a couple of reasons. First of all, my IBS and pelvic pain symptoms suggest that my G.I. tract is inflamed. One cause of digestive problems is “leaky gut syndrome” – a colourful name for a condition in which the the digestive lining becomes too permeable, or “leaky”, allowing partially digested proteins and harmful substances/microbes into the bloodstream. These foreign particles are attacked by white blood cells, causing inflammation and overtaxing the immune system. Inflammation like this can prevent absorption of necessary nutrients and energy, which can in turn aggravate chronic illness symptoms. This might also affect my ability to absorb other supplements that I need, so it seems like a good place to start.

Secondly, the digestive tract is a critical part of the immune system. Inflammation, microflora (bacteria and other microbes) imbalance, and yeast overgrowth are probably all issues that I need to address. Having my immune system all tied up addressing these problems could be significantly impairing my body’s ability to function in other ways. Fatigue, pain, poor tissue repair, susceptibility to infection and other fibromyalgia and chronic fatigue symptoms can be aggravated by immune dysfunction. Freeing up my immune system from dealing with digestive inflammation and microbe imbalance could enable healing and re-energizing down the line. Here I want to share research on supplements that can help heal the digestive tract lining – an important step to help manage fibromyalgia symptoms. If you are interested in additional steps, I’ve written about the benefits of Probiotics and Fibro in a separate post and avoiding  foods that you are sensitive to, based on food sensitivity testing and/or an elimination diet.

  • L – glutamine is an amino acid (protein building block) produced in the body, stored in muscles and the lungs.* It has a number of functions in the body, including eliminating excessive ammonia waste, helping to provide nitrogen and carbon ‘fuel’ to cells, and helping in the synthesis of other amino acids and glucose, among others. Although the body usually produces adequate amounts of glutamine, in times of stress or illness the body’s production may be insufficient. Glutamine is included in this supplement in order to supply a source of fuel and precursors for growth to the rapidly dividing cells of the intestinal lining”.
  • deglycyrrhizinized licorice (DGL) licorice has been traditionally used in many cultures to promote health. This form removes an element in licorice called glycyrrhizin which can cause water retention, edema and hypertension issues. DGL is effective for treating gastric irritation, ulcers (one study found it to be as effective as a common over-the-counter medicine), heartburn, and other digestive problems. It also may be helpful for treating adrenal gland problems and reducing fatigue.**
  • aloe helps to heal inflamed intestines and can promote the integrity of the digestive lining. Aloe has a few properties which ease this process, which include balancing the pH of the G.I. tract, and antimicrobial properties which aid in healing.*** This may counteract leaky gut symptoms.

 

These ingredients are all included in a supplement called Metagenics Glutagenics. My dose is 1/4 teaspoon two times daily (of powder mixed into water).

*http://umm.edu/health/medical/altmed/supplement/glutamine

**http://www.huffingtonpost.com/julie-chen-md/dgl-supplements_b_2976260.html

***http://www.crohns.net/Miva/education/aboutaloe.shtml

http://www.webmd.com/digestive-disorders/features/leaky-gut-syndrome

Treatment Burnout

Do you ever feel overwhelmed by all the ‘shoulds’ that come with adding new treatments to your pain management plan?
Do you ever wish there was a willpower booster to get you through treatment fatigue, information overload, and the frustration of feeling like you’ve tried everything, but nothing has worked?

This past month I’ve had a patch of insomnia that has prevented me from making any headway in the various treatments I had been trying. In the spring I started meditating, I have physio exercises, recommended supplements, a capsaicin application regimen for pelvic pain, prescription pills, weekly acupuncture … I also need to do something everyday that has nothing to do with my health conditions, or I go crazy (online courses, going to the museum, audiobooks etc.).

Mary Shomon, in her book ‘Living Well with Chronic Fatigue Syndrome and Fibromyalgia’, says “You probably feel confused, as I was, by all the conflicting. Information, and overwhelmed by all the options you have and the choices you have to make” (p. 3). After a year of trying to get better, this about sums up how I feel.

In addition, my Mom has recently expressed an interest in getting involved in my treatment, and wants to help pay for me to try Dr. Teitelbaum’s SHIN protocol (pay for supplements like d-ribose and so on). This seems like a good idea in theory, but she has all of the enthusiasm and none of the experience of treating chronic pain. That is, she’s looking for a cure and not a management plan; a magic bullet rather than a balance of different approaches. We’ve been on hold about starting because of summer vacations, but I find I’m nervous about discussing it further. I already feel overwhelmed by all the things I should be doing, and can’t imagine starting a whole new protocol on top of it all. But there’s the seduction of ‘but what if this is what finally works!’. And the SHIN (sleep, hormones, infections, nutrition) protocol is an exhaustive list of every naturopathic and mainstream medical supplement or drug you can incorporate to address the different domains. I went to see a naturopath to help implement it, but she has a lot of experience, and of course has her own ideas about what to try.

I think I’m going to take a 2 week treatment vacation. I need to focus on having fun for a little bit. Before that, I’m going to work on making a list of the different treatments that I feel help me most. I’ll work on incorporating them back in one week at a time – or longer – until I have a workable routine that makes me feel I have some control over my situation again, rather than feeling overwhelmed. I’ll have to think about how to incorporate the new ideas and protocols, but I feel they will have to get to the back of the line in some cases (or bud in front in some cases)!

Better treatment at Starbucks than from your GP … something’s not right

Today I went to see a new family doctor. I have been putting off going for way too long. Ever since I got accepted to the pain clinic in my hometown and moved back from grad school to be treated here and live with my partner, I just haven’t bothered to get myself a GP. I feel like all I do is go to appointments – therapy, physiotherapy (physical therapy), accupuncture, pain clinic. It’s hard to volunteer for yet another one.

Anyway, I finally did it out of necessity. I can’t sleep. I’ve tried melatonin, valerian, magnesium, alone and in combo, plus progressive muscle relaxation, sleep music and sleep hygiene. It’s not working and my regular meds aren’t cutting it, so I keep resorting to nytol/benedryl at 1 am.

At her office, the GP came in wearing leggings for pants and a white blouse. She didn’t smile and only stared at the computer. She addressed the sleep problem by saying I need to find the underlying emotional issue and deal with it. She reluctantly said she’d write me a temporary Rx for zopiclone. No mention of any alternative supplements or mind/body suggestions. That’s not surprising but you’d think she’d say something other than if the Rx doesn’t work and I still can’t sleep there’s nothing else she can do.

And honestly, I sincerely don’t want more meds, and I don’t appreciate being treated like I do. You also don’t need to tell chronic pain patients that there aren’t magic bullet cures. I know – I’m still in pain.

I’m also very careful to manage my stress with meditation, some tricks from my old cognitive behavioral therapy group (challenging negative self talk by asking how true or rational it is), – and I’m in therapy. So believe me when I say the only stress I’ve had is a flare up of pelvic pain two weeks ago.

What I wanted to talk about is whether I’ve habituated/developed a tolerance to my meds and if they should be tweaked (like sub something for my flexeril). Finally, sleep disturbance is a SYMPTOM off my illness! Therefore it might be set off by something other than stress, and isn’t like insomnia in healthy people.
But no referral to a sleep specialist was forthcoming.

Her suggestion – see the pain clinic. My problem is that they are so overwhelmed with patients that you get in only every 3 months or so. For urgent issues the recommend that you see – your GP.

At the end she tried to rush me out. I wanted blood work to check iron and B12 (and vit D and thyroid, but I didn’t get that far). She asked me if I eat the right food and said I should continue to supplement. No point getting checked. This is in opposition to everything I’ve read saying you should make sure there are no underlying deficiencies contributing to fatigue and pain.
What a relief to walk into starbucks, get a smile, and receive what I asked for. If the barrista can do it, why can’t my Dr.?

Fibromyalgia…it’s all in your hands?!

Fibromyalgia isn’t all in your head…It’s in your hands.

Wait. What?

A breakthrough study has found a clear tissue differentiation in the hands of women with fibromyalgia. Researchers took biopsies of palms and found an increased concentration of a type of nerve fibre that regulates blood flow through specialized shunts, found only in hands and feet (Fig. 1). **

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This study is important because it provides a biological test that physicians in the future will be able to use to diagnose fibromyalgia, rather than relying on subjective measures. It also firmly proves all the skeptics and naysayers wrong. Secondly, the research points to an explanation for what causes fibromyalgia.

So, what causes it? We need to start with a short biology lesson to understand. Arteries carry oxygenated blood to our tissues, moving from large artery vessels to smaller arterioles and finally to capillaries. Capillaries supply the local tissue with oxygenated blood and collect de-oxygenated blood which they carry to veins (via small vessels called venules). In the hands and feet there are specialized shunts (think valves), which can redirect blood flow towards or away from the capillary beds in the palms and soles. As Dr. Frank Rice, the leading scientist at Integrated Tissue Dynamics LLC (Intidyn), as part of a fibromyalgia study based at Albany Medical College, explains, “The AV shunts in the hand are unique in that they create a bypass of the capillary bed for the major purpose of regulating body temperature…Under warm conditions, the shunts close down to force blood into the capillaries at the surface of the skin in order to radiate heat from the body, and our hands get sweaty. Under cold conditions, the shunts open wide allowing blood to bypass the capillaries in order to conserve heat, and our hands get cold.” * The shunts are controlled by nerve fibres that open and close as needed. Fibromyalgia patients have an increased concentration of the nerve fibres which open the shunts. This picture does a better job of explaining how it works:

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So what does this mean? It turns out that the hands and feet act like a reservoir for blood. When blood is needed by other tissues in the body, such as active muscles, it can be diverted where it’s needed. If the blood flow is mismanaged because of the distinct tissue pathology found in the fibromyalgia patients, it could cause the muscle pain and achiness which characterizes the disease.* Furthermore, the researchers believe mismanaged blood flow could cause fibro fog and sleep problems. Dr. Rice says this research “appear[s] to fit with other published evidence demonstrating blood flow alterations to higher brain centers and the cerebral cortex of fibromyalgia patients”.*

This research really shakes up the conventional explanations for what causes fibromyalgia. It’s exciting, but I’m not quite sure what to make of it. How does it fit with recent research demonstrating immune dysfunction at the cellular level in FM patients? Or previous studies which have found altered levels of neurotransmitters like serotonin, dopamine, and substance P?

Personally, I don’t experience extreme sensitivity in my hands and feet, which Dr. Rice suggests is common for FM patients. I do find the sensation of cold objects painful when they shouldn’t be. In addition, my hands and feet are always icy cold. I’ve caused quite a few shocked yelps from my husband when my feet inadvertently touch his, or when I try to hold his hand!

Overall this is an exciting step towards finding the cause of FM and it will be interesting to see where it leads.

References:

Albrecht PJ, Hou Q, Argoff CE, Storey JR, Wymer JP, Rice FL (2013). Excessive Peptidergic Sensory Innervation of Cutaneous Arteriole-Venule Shunts (AVS) in the Palmar Glabrous Skin of Fibromyalgia Patients: Implications for Widespread Deep Tissue Pain and Fatigue. Pain Medicine, May 20. doi: 10.1111/pme.12139 [Epub ahead of print].

Posted at the National Library of Medicine (PubMed): http://www.ncbi.nlm.nih.gov/pubmed/23691965

A description of this study for the general public can be found at: http://www.intidyn.com/Newsroom/Fibromyalgia Pathology for lay people 2013-06-24.pdf

Freedom from Bra Pain

If you have fibro and you’re like me, bras can sometimes feel more torturous than supportive. I have large trigger points all around my upper back/shoulders/neck. Sometimes I just can’t stand my bra straps digging into the muscles. I found a couple of great solutions!
One is silicone bra strap cushions that go under the straps and distribute the pressure, like these ones: http://www.amazon.com/Flirtzy-Silicone-Cushion-Shoulder-Discomfort/dp/B002BZXMCU/ref=pd_sim_hpc_1

The second is reusable adhesive silicone cushions that cover the nipples (preventing embarrassing nipple-itis) on days when I just can’t stand to wear a bra at all, like these: http://www.amazon.com/Nippies-Skin-Reusable-Silicone-NON-ADHESIVE/dp/B001O482W4/ref=sr_1_1?s=apparel&ie=UTF8&qid=1372098771&sr=1-1&keywords=silicone+nipplies+cover

I buy the brand at my local drugstore, so these links are just to illustrate. Enjoy the freedom!

Meditation Journal

I thought I would post some reflections on my attempts meditating in the last couple of weeks. So far, I’ve been able to meditate every day (except weekends), which is the longest period of time I have ever been able to keep it up. I’ve noticed a few subtle changes in that time. I was definitely able to focus on my breath without getting distracted for up to a few minutes. This is pretty good for me, because I am always jumping around to different thoughts in my mind. I think I was able to notice intervening thoughts more quickly, like evaluations of how I was doing, or thoughts about the past or future. When I notice them, though, I still have to work on just noting the content of the thought and then escorting my attention back to the breath, without being judgey on getting distracted the first place. The thoughts I find most slippery are thoughts about meditating while I am meditating – like thoughts about making a nice meditation corner in my apartment, thoughts about building my practice into a lifelong habit, thoughts about becoming less stressed and more Zen, etc. Of course, none of those nice things is going to happen if I’m thinking about them instead of actually meditating!

I like Jon Kabat-Zinn’s explanation on his disk (meditation for pain) – that meditation is a journey exploring yourself and your relationship to pain, with no destinations promised, such as ending up having less pain or becoming enlightened. Dr. Jackie Gardner-Nix promises more – less stress and reduced pain. I think that Dr. Jackie is probably trying to give hope to chronic pain patients, as well as feels supported by recent research, whereas Kabat-Zinn is coming from a more traditional meditation background which emphasizes nonattachment and impermanence/changeability. I think both perspectives give a good balance; the first gives you hope and reason to keep practicing, while the second reminds you that being judgmental or frustrated, because you aren’t where you want to be yet, defeats the purpose of the exercise. I think that over the last two weeks I got better at understanding that each day is different and that I can’t expect a certain result every time I meditate.

One of the phrases on my guided meditation track asks you to reflect on “accepting being in the here and now”. While I was meditating last week, I found a strong internal resistance to those words. When I looked around my living room, I felt sad and resigned to be there, then. I realized that these feelings came up because I feel unhappy with my current lot – being at home, on disability, without any concrete plans for the future. This week I made more of an effort to get out and spend my time doing the things that I enjoy. I went to an interesting talk at the library, watched lectures from my online course at a café, and went for lunch with my godmother (this is part of my philosophy of living like I am a retiree – don’t people wait all their lives for time to pursue their hobbies?). Then I had another, more interesting, revelation: I have been feeling guilty for enjoying my life again. Remember the superwoman overachiever tendencies? Part of me thinks that, until I have ‘solved’ the problem of my fibromyalgia, I have no right to have fun. Wouldn’t that be tantamount to shirking my responsibilities as a grown-up, and flaking out on life?

Wow, writing that down makes it seem even more crazy. It seems obvious that it would be hard to heal if I keep pulling myself down into a pit of despondency. So, this week I’ve been challenging that voice by saying that my life is pretty good, actually, thank you very much!

Mentally Mindful

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In the past two weeks I finally moved into my new apartment and it is starting to feel like home. The silence and the space are so much more conducive to learning mindful living then the construction zone I lived in before. I did not feel very Zen during the move or unpacking, but that’s what I’m working on now. No time like the present!

The second part of chapter 2 in The Mindfulness Solution To Pain by Dr. Jackie Gardner – Nix talks about mental attitudes related to mindfulness. (I’m going to keep summarizing the key points that jumped out at me, and connections I made to my own life; I don”t want to put citations everywhere). Attitudes can be enabling or harmful to our well-being, and awareness about these attitudes can help us to strengthen positive ones and change negative ones.

The first attitude associated with mindfulness is being nonjudgmental. This is something that I have a long way to go to achieve! On Monday I was listening to Dr. Jackie Gardner – Nix’ guided meditation (more on this in a moment) and my practice was not going as well as last week. Every other breath I caught myself thinking things like “my breathing is too fast and shallow”, “why can’t I stay focused today?”, “I don’t think I’m ever going to get this right”. In the book, the authors point out that judgments about whether something is positive or negative are very black and white, and often miss the ‘gray’ nuanced part of experiences. Bad experiences can have silver linings, and good things aren’t always what they seem. Negative judgments can begin a domino effect of reactive emotions, tension and increased pain. Given the changeability and impermanence of things, judgments can really be a waste of time. I’m going to have to work on this in meditation practice and in the rest of my life too! Being off work on disability leave, as I’ve mentioned before, definitely leads me to be very judgmental about the lack of accomplishment, purpose, etc. I think they called this the inserting “superwoman overachiever cycle” in the last chapter!I really liked the observation made in the book that it can be freeing to experience situations or encounters with people and not judge them.

The second attitude associated with mindfulness is the beginner’s mind. To achieve this mental stance, you have to try to overcome your own biases, prejudices and preconceived notions, and not bring them to present situations or encounters. This reminds me of what my anthropology professors called ‘reflexive thinking’. Anthropologists believe that it’s impossible to cultivate a purely objective stand point, but by being aware of your own subjective point of view, you can still produce valuable insights and new knowledge about the culture you are studying. So this mindful attitude sounds to me like being an anthropologist studying yourself!

The third and fourth attitudes to cultivate are trust and patience. Trust that developing awareness will lead to change over time, and patience regarding how long that will take.

The next chapter (chapter 3) is about beginning a formal meditation practice. The authors define this as “intentionally setting aside a specific period of time… In your day to systematically cultivate mindfulness by focusing your attention moment by moment on some particular aspect of your experience, and actively noting when your mind wanders – as it always will – and then bringing it back to the focus” (Gardner-Nix and Costin-Hall, 2009). Usually breathing is the focus of mindfulness practice. I decided to buy Dr. Gardner-Nix’ CD of guided meditations, called ‘meditations for the mindfulness solution to pain’, which is available on iTunes. I thought it would be best to go with this one because it is designed to specifically accompany the book. The authors also recommend Andrew Weil’s “meditation for optimum health”, available from Sounds True (Google for website).  I also really like John Kabat-Zinn’s disc of guided meditations called “mindfulness meditation for pain relief”.  I’m not going to give a detailed summary of how to meditate because I think these resources to a much better job than I ever could. I did just want to mention the advice given at the end of this chapter to pace yourself while incorporating meditation into your daily routine – start with 5 min., slowly work up to 10, then 20, and so on. I’m at 10 minutes right now. I’d like to work up to 20, eventually without the guide, but for now I like listening 😉 p.s. I don’t sit cross-legged in serene white while meditating. I have to lie down with pillows under my legs on the couch or on the floor – fibrostyle. My body wouldn’t put up with that kind of sitting!

image courtesy of photostock at FreeDigitalPhotos.net

Trying to Digest

Stomach Pain

I thought that I would blog about something that is very close to my, …er, stomach. During the course of the last year, I’ve had to come to terms with adding irritable bowel syndrome (IBS) to my list of conditions. This isn’t all that unusual; according to the Chronic Pain Research Alliance, several chronic pain syndromes often co-occur in patients, and these include chronic fatigue syndrome, endometriosis, fibromyalgia, interstitial cystitis, irritable bowel syndrome, temporomandibular disorders, and vulvodynia. The CPRA points out that none of these conditions are understood well, and the relationships between them are equally unclear. Consequently, many physicians are inadequately trained to treat chronic pain syndromes, resulting in the misdiagnosis or incorrect treatment of patients.

In my case, the first gastrointestinal problems began about two years ago when I started having severe cramps when I had to ‘go’ to the bathroom during my menstrual cycle (I’m trying to keep this as non-graphic as possible, but any post on IBS is going to have TMI). My gynecologist thought it was most likely endometriosis and put me on the birth control pill, which did significantly reduce the pain. Over the next year, my fibromyalgia symptoms blossomed, so I was put on long-acting tramadol (synthetic opioid). One of the downsides of narcotics is constipation. Other than that, I have had the regular IBS symptoms of bloating, abdominal pain and irregularity. The usual culprits are whole grains, cruciferous veggies (broccoli, cauliflower, brussels sprouts), some beans and too many citrus fruits. Finally, last summer (2012) I started having episodes that are similar to stomach flu. They typically last for about 24 hours and include frequent urges to ‘go’, sleeplessness, sweats and chills (but no fever), and skin tingling or crawling. These are probably among the worst experiences I’ve ever had. In total, I’ve had about five of these episodes. The triggers seem to be eggs and beef. A naturopath did a food sensitivity test for me once and I have a food intolerance to eggs. The beef I can’t explain.

The most relevant article I’ve found to explain these episodes is called ‘Food intolerance is linked to different disorders’ by Science Nordic. The article focuses on research by Arnold Berstad and colleagues at Lovisenberg Diaconale Hospital in Oslo. Berstad conducted a study with 84 participants who had unexplained digestive problems that they attributed to food intolerances. The research team administered a provocation test in which the patients were given a non-digestible carbohydrate called lactulose to eat. The provocation test re-created the symptoms of digestive distress experienced by the patients, proving that their complaints were not psychosomatic. Researchers suspect that the indigestible carbohydrates were not absorbed in the small intestine, but fermented by intestinal microbes in the large intestine, resulting in the digestive problems. One result of this study was that patients were observed to get chills as part of their reaction to the provocation test, in addition to digestive upset (bloating, gas, and pain). This is the only mention in all of my research to food intolerance reactions which includes both G.I. tract distress and body wide symptoms like chills. Significantly, the researchers found that all but one of the participants were symptomatic of IBS, 84% were symptomatic of chronic fatigue syndrome and 71% were symptomatic of fibromyalgia. The authors of the study suggest that an imbalance in intestinal microbes might be part of a common disease mechanism for all three overlapping conditions. Other researchers dispute the claim that the cause of the three chronic pain diseases is intestinal, but agree that it might play a role.

This article was significant for me to understand the confusing and extremely unpleasant symptoms that I was experiencing. I still believe that some of my episodes result from eggs, not only difficult to digest carbohydrates, just because often the only food preceding an episode that differed from my usual diet has contained eggs – like lemon meringue pie or ranch dressing. My solution has been to focus more on taking care of my fussy intestines. I’ve been taking a probiotic called Align which is specifically formulated for IBS. It has a patented bacteria called Bifidobacterium infantis 35624, which has been clinically proven to reduce IBS symptoms. It’s a little bit pricey, so taking generic probiotics that include Bifidobacterium might also be helpful. I think eating foods rich in probiotics are beneficial. I like yogurt the best, but some people swear by miso and other fermented soy products. You’re probably better off with supplements though if you have a sensitivity to dairy or soy. I’ve also been feeling much better eating a high soluble fiber diet. There are two kinds of fiber – soluble and insoluble. Soluble fiber creates a gel in the intestinal tract, made up of the unabsorbed fiber dissolved in water, which helps with both kinds of irregularity. It slows down the transmission time of food in the gut but also creates enough bulk to ensure passage. In contrast, insoluble fiber just pushes through the gut, and can create problems with loose digestion, and also cause bloating or gas. High soluble fiber foods include oatmeal, squash, carrots, apples, oranges, flaxseed, potatoes, some beans/lentils and (according to some) French bread and white pasta. Also Metamucil (without irritating artificial sugars) is very helpful because it contains psyllium husks that are high in soluble fiber. Of course avoiding trigger foods is also key. IGG Food sensitivity tests, although critiqued by some, can help give you an idea. For me, the test that helped identify a food intolerance to eggs was totally right on.Lastly, I eat a plant-based diet that is focused on high nutrition, created by Dr. Fuhrman, and adapted to accommodate my IBS. I’ll write more about that another time, but the focus is on phytochemicals, antioxidants, micronutrients, anti-inflammatories and all the other benefits of fruits, veggies, grains, nuts and seeds, to give my body a fighting chance. I’m also big advocate of moderation, and not obsessing too much over rigidly following supplements and diets – I love food too much (even though we have a complicated relationship) to kill my enjoyment with dogmatism!

References:

About Bifantis. 2013. Retrieved May 7, 2013 from http://www.bifantis.com.

Chronic Pain Research Alliance. 2009. Retrieved May 7, 2013 from http://www.overlappingconditions.org.

Feinmann, J. 2010. Eating Fibre May NOT Be So Good For Your Stomach. In Mail Online. Retrieved May 7, 2013 from http://www.dailymail.co.uk/health/article-1228402/Eating-fibre-NOT-good-stomach.html.

Spilde, I. (2012). Food Intolerance is Linked to Different Disorders. In Science Nordic. Retrieved May 7, 2013 from
http://sciencenordic.com/food-intolerance-linked-different-disorders.

Image courtesy of Marin at FreeDigitalPhotos.net

Zen master, not so fast

Hello again,
I was hoping to write a little bit sooner, but my plans were foiled by the construction zone that has sprung up outside of my apartment building. Thank God we are moving next week to an oasis of quiet – at least, I hope that’s what it will be! Maybe it’s just me, but since my fibromyalgia diagnosis I sometimes dream of living in a soundproof room. Barring that, hopefully some of this mindfulness work will make me Zen enough not to get woken up by every dripping tap, licking cat and snoring husband. On that note, on to chapter 2 of The Mindfulness Solution To Pain.

Dr. Jackie Gardner – Nix defines mindfulness as “the awareness that arises when we pay attention to what is happening in the present moment, nonjudgmentally”. I was struck by the poignant message made at the beginning of this chapter that many of the people who live mindfully, live with with a terminal illness. The authors say that it shouldn’t have to come to this extreme for you to pay attention to your life as it unfolds, rather than “realizing at some point that somehow you may have missed large swathes of life while it was passing you by”. Moreover, the chapter points out that mindfulness is not just about being aware of the pleasant moments. The authors claim that ignoring strong, negative feelings can deepen their affect on your health.

This really struck a chord with me. Although I haven’t really begun practicing mindfulness yet, the previous chapter (which was about the impact of childhood stressors on chronic pain in later adult hood) stayed in my mind during the week, and led to some interesting observations. I realized that every couple of hours I say something really negative to myself, and that a lot of these things relate to how my family operates. For example, I found myself saying things like “am I ever going to do anything with my life?” or “I haven’t done anything productive today!” In my family, personal worth is attached to accomplishment, and there is a lot of suspicion about long-term illness (that it is ‘all in your head’ and really about some kind of not yet dealt with emotional problem). I often struggle with feeling like my fibromyalgia is a failing rather than a misfortune and I guess I am repeating that daily by trying to accomplish things to make up for it. I think this is also why I was resistant at the beginning of the book when the authors gave some examples of people who were healed by realizing they had emotional issues. These examples repeat what I grew up with and cast doubt on the biological realness of my illness. In fact, the authors give a more complicated explanation for chronic pain. They claim that issues from your childhood (experiences, parental deficiency, or poor parental role modeling) might well be affecting you, but right down to your gene expression, immune function, nervous system reactivity and other biological operations. In that sense, it is both “all in your head,” in terms of negative patterns of feeling or thinking that elicit the body’s stress response, and real biological dysfunction (including slow healing, activating predisposed illness and pain signals), which can occur partly as a result. I think I’m starting to be aware of some of my own negative patterns.Dr. Jackie is reassuring though, when she says that “just seeing …[destructive habits] clearly is the first step by which they can change”. And also that “this too shall pass”.

I think that I will leave it there for this week. It has been pretty heavy stuff so far, so I may have to get some treats and watch some trashy reality TV tonight (I’ll confess that my guilty pleasure is watching keeping up with the Kardashians – don’t judge!). I’m looking forward to learning more about starting meditation in the next chapter. Have a great weekend!