Category Archives: Adapting to chronic disease

If you know you get stressed here are some things you can do to learn to be less stressed

This is the fifth post in a series about stress. Previous posts are:

You might want to actively take action to prevent stress or learn techniques that will help you manage stress. Here are eight commonly available ideas to get you started

  1. Try out a few local Yoga classes and attend the one that suits you the most
  2. Look for a meditation class
  3. Learn relaxation techniques
  4. Learn assertiveness / mental toughness
  5. Confidence
  6. Talk to someone you really trust
  7. Learn time management techniques
  8. Work off your stress with physical or mental activity

You might be stressed if…

This is the second post in a series about stress. The first post can be found here. The other day I described some physical signs of stress, but sometimes stress manifests itself more noticeably in your behaviour.

The following list describes typical behaviours that are associated with stress. The impact of stress on chronic disease is varied but important to recognise as it can exacerbate your symptoms or lead to further health problems. If you find that you are exhibiting these behaviours you might want to find ways to destress and unwind or talk to your Doctor about other ways of managing your condition.

  1. You need nicotine, alcohol or drugs to unwind or feel relaxed
  2. Your sleep patterns change – you need more sleep, can’t get to sleep or wake up in the night
  3. You feel lethargic and disinclined to do anything
  4. You are short tempered for no particular obvious reason
  5. You tend to argue with people rather than discuss things with them
  6. You often feel angry with yourself, sometimes because of the other behaviours on this list
  7. You often feel angry with other people for no particular reason, or for insignificant reasons
  8. You stop doing things you enjoyed doing before
  9. You withdraw from society, for example staying at home all the time, declining invitations to go out with friends
  10. You become paranoid about the people aorund you
  11. You become weepy for no reason

Am I stressed? Symptoms of stress

This is the first post in a series about stress. If you have chronic disease, it is important to understand stress because  it can make many chronic diseases worse, and can lead to other symptoms un-related to your original condition.

 

 

These symptoms can be confusing, can be confused with other ailments, and can increase / decrease depending on what is happening in your life.

You might not have the mental machinations of stress and anxiety such as thinking about a situation all the time or feeling stuck, but you might be experiencing it all the same.

The following list is a range of symptoms which might be related to stress and can be used as signs from your body that you need to make some changes to become less stressed.

If you experience any of the symptoms below you should get in touch with your Doctor to discuss them immediately, as they could be a major emergency:

If you experience any of the following for longer than a few days it is worth talking to your Doctor about management / treatment options:

The following are mental rather than physical symptoms:

What symptoms do you experience when you get stressed?

Second draft of the medical history proforma – so you don’t have to repeat yourself over and over

One of the most frustrating things about Crohn‘s (especially if you have blockages and adhesions) is that you can unexpectedly end up in hospital all over the place. I had a period of a few years where every holiday was doomed to end up with me in hospital somewhere – eventually the problem was found.  It turned out that there was a grapefruit sized abscess wrapped around my bowel which led to exciting impromptu re-enactments of ‘that scene’ from the exorcist.

I now have an outline of my medical history to give to medical staff on my ‘travels’. The aim of the outline is to help me remember key dates and events, which can be forgotten in the begging for morphine confusion of admission.

I have attached a draft version of the outline here to share with readers: Summary of medical history (Draft 2) in order to get some comments from you about it.

  • Is there anything I have missed?
  • Is there about the right amount of space or do you want more?

Medical staff often ask you to repeat your medical history as a way of:

  • building rapport
  • checking you are compos mentis (composed mind)
  • checking that you are not suffering any ill effects of medication
  • checking for delirium that comes with fever

So having an outline to hand won’t necessarily reduce the number of times you are questioned but it will make a difference when it matters.

It is also useful to have to hand so that a carer, friend or relative can give all the important details to medical staff if you are not able to coherently communicate. This can happen if you have a fever or are in considerable pain.

So do let me know what you think about the second draft version, here it is:Summary of medical history (Draft 2))

and then I will upload a final version for you to write your own outline.

Joint mobilising series

This collection of movements is a multi-purpose series designed to:

  • warm up some of the major muscles of the body
  • warm up some of the major joints of the body
  • develop your physical awareness of some of the major muscles and joints in your body
  • help transition from the stresses and strains of the day towards a calming Yoga practice

It is also a very useful sequence to do if you are confined to bed, or the sofa, but are feeling achy and in need of doing something.

1. Shoulder mobilising sequence from this post

2. Leg stretch

Have your knees bent and feet on the floor/bed. Draw your right knee in towards your belly and hold the back of your right thigh with both hands. As you breathe in (inhale) straighten your leg as much as you can and as you breathe out (exhale) bend your knee back to the starting position.

Draw your left knee in towards your belly and hold the back of your  left thigh  with both hands. As you breathe in (inhale) straighten your leg as much as you can and as you breathe out (exhale) bend your knee back to the starting position.

Recommendation: repeat up to five times, building up to ten times.

Extension 1: Extend your leg, and hold the stretch for up to 10 breaths.

Extension 2: repeat the movement using both legs

Extension 3:extend both legs and hold the stretch for up to 10 breaths

3. Ankle twirls

Have your knees bent and feet on the floor/bed. Draw your right knee in towards your belly and hold the back of your right thigh with both hands. As you breathe in (inhale) straighten your leg as much as you can. Twirl your ankle around one way and then twirl your ankle around in the opposite direction. As you breathe out (exhale) bend your knee back to the starting position.

Have your knees bent and feet on the floor/bed. Draw your left knee in towards your belly and hold the back of your left thigh with both hands. As you breathe in (inhale) straighten your leg as much as you can. Twirl your ankle around one way and then twirl your ankle around in the opposite direction. As you breathe out (exhale) bend your knee back to the starting position.

Recommendation: repeat up to five times, building up to ten times.

4. Hip openers

Gently rest both hands on your right knee and move your knee in a circle by pulling it towards you. opening to the side, pushing it away from you and then taking your knee over your left hip.

Repeat with your left knee.

Recommendation: repeat up to five times, building up to ten times.

5. Reclining cobblers pose

Start with knees bent and feet on the bed / floor. when you are ready, drop your left knee out to the left side, and then drop your right knee out to the right.. Bring your soles together. If you want to you can place cushions underneath your thighs to help support your legs. You may wish to put your hands on your thighs to help increase the stretch. Just do what feels right.

Recommendation: hold for between 5 and 10 breaths.

3 gentle moves to alleviate discomfort from being in bed – mobilising your shoulders

This series of movements focusses on the shoulders. These movements can be done lying in bed or sitting up. See which position your prefer by trying them both. If you decide to practice these lying down in bed, scoot down the bed a little and make sure you have plenty of space above your head – you’ll need to freely be able to move your arms above your head.

 

Make sure your read the guidelines first.

1. Shoulder mobilising A

Start in the lying on your back, knees bent position with your arms by the side of your body, palms down. This is your neutral position.

a) Slowly bring your right arm up over your head as you breathe in.

b) As you breathe out, return your arm back to the neutral position.

c) Slowly bring your left arm up over your head as you breathe in.

d) As you breathe out, return your arm back to the neutral position.

Recommendation – repeat five times, building up to ten times on each side.

2. Shoulder mobilising B

Start in the lying on your back, knees bent position with your arms by the side of your body, palms down. This is your neutral position.

a) Slowly bring your both arms up over your head as you breathe in.

b) As you breathe out, return both arms back to the neutral position.

Recommendation – repeat five times, building up to ten times on each side.

3. Shoulder mobilising C

Start in the lying on your back, knees bent position with your arms by the side of your body, palms down. This is your neutral position.

a) Bring your right hand across to your left shoulder and try to pull your arm across as far as you can, feeling a stretch at the upper back.

b) Release and return to neutral

c) Bring your left hand across to your right shoulder and try to pull your arm across as far as you can, feeling a stretch at the upper back.

b) Release and return to neutral

Recommendation – repeat five times, building up to ten times on each side.

Round off the routine by stretching both hands up over your head and having a good stretch.

3 gentle moves to alleviate discomfort from being in bed – mobilising your neck

This series of movements is all about mobilising your neck muscles. These movements can be done lying in bed or sitting up. See which position your prefer by trying them both.If you decide to practice these lying down in bed, scoot down the bed a little and make sure you have plenty of space above your head. Remember to read the guidelines first!

1. Mobilising your neck A

Start by tucking your chin into your neck and then:

a) Roll your head towards your right shoulder

b) Roll your head back to centre

c) Roll your head towards your left shoulder

d) Roll your head back to centre

Recommendation: Repeat between 5 and 10 times to each side.

2. Mobilising your neck B

Start in a neutral position and then:

a) Drop your head to your left, as if you are trying to bring your left ear towards your left shoulder

b) Keeping your chin tucked in, roll your head to centre and then towards the right, finishing with your right ear towards your right shoulder

c) Keeping your chin tucked in, roll your head to centre and then towards the left, finishing with your left ear towards your left shoulder.

Recommendation: Repeat between 5 and 10 times to each side.

3. Mobilising your neck C

Start in a neutral position and then:

a) Keeping your chin level, turn your head to the left

b) Return to neutral

c) Keeping your chin level, turn your head to the right

d) Return to neutral

Recommendation: Repeat between 5 and 10 times to each side.

My chronic career – Teresa’s story

‘My Chronic Career’ is a (often) weekly feature here at WorkLifeSpirit, featuring interviews with people who have chronic health problems. The interviews focussing on not just their medical experience, but also the impact of their health on their life and career.

Teresa from Norfolk in the UK has agreed to be interviewed. Thanks Teresa!

(Please come forward to be interviewed if you work and have a chronic health problem by contacting me)

Can you tell me a bit about your medical history?

I have been diagnosed with Crohn’s disease in May 2005. It was thought I had appendicitis , but had an operation and they saw the Crohn’s. I then had another operation two weeks later as the medication wasn’t working. I then got peritonitis and nearly died, and so they gave me an ileostomy for a few months which was reversed in November 2005.
I was then diagnosed with arthritis and fibromyalgia. I had two operations on my elbows. I then had issues with adhesions and have had 3 further operations to try and get them to settle, but they haven’t, and so even now I am being treated.
I am on Methotrexate for the arthritis, having tried MP3 and Mercaptopurine, which didn’t work. I was on steroids for a long time and put on a lot of weight which made me feel terrible and so took antidepressants.
My last operation was November 2010 there were adhesions again, but this time it made it worse rather than better, and now I am being treated and looked at with St.Marks Hospital where I have been referred to as they are more specialist than my local hospital. I am tired all the time, and I suffer with fatigue a lot and am on a lot of opiate pain killers.

And how about your working life? What career path have you taken?

Although I was off for a while, I have been a police officer for nearly 15 years, and am now on a back to work recovery programme and now working full time hours.

Did you know about your condition before you were diagnosed?

Nope, no clue at all.

How did you find out further information about your condition when you were diagnosed?

I looked on the internet as staff at the hospital

Finding information is different now with the internet, which sites do you find useful in terms of information / support and advice about your condition?

I find the National Association of Crohn’s and colitis to be helpful. I also have a couple of books on the disease, and also look on crohnszone.org for information as well as other friends who have the disease.

Thinking about working and having your condition – what do you find / have you found most difficult to manage / cope with in the world of work?

The fatigue is the biggest issue for me, and where the nearest toilet is!

What is your top tip for employers – what could they do to support people with your condition?

They need to be empathetic in relation to your working space, and also where the nearest facilities
are.

What is your top tip for employers with your condition?

You are covered under the DDA and so if there is something that is troubling you then you do have the support of the disability discrimination act.

When you have a flare up of symptoms – what is your ‘coping mechanism’?

I am normally in bed early with a hot water bottle and my medication.

Do you think you have developed any personal skills or qualities as a result of having your condition? 

I have developed more skills in finding the toilets, how to ask and explain in places when toilets aren’t public, to ask where they are.

What advice would you give people who have just been diagnosed with your condition?

I would suggest that you look at the DDA to see what your entitlements are, and also, find out where the facilities are at your place of work.

What advice would you give to the family and friends of someone who has just been diagnosed with your condition?

It is not that bad – there are going to be some bad days, and there are going to be some good days, some bad. Don’t wait around for the bad ones and make the most of the good ones.

Do you have a chronic health condition and a career? If so please come forward to be interviewed by contacting me!

3 gentle moves to alleviate discomfort from being in bed – lower body

Sooner or later after surgery, the novelty of a morphine pump will wear off, and horror (@.@) you realise that the nursing staff will actually take it away from you so you will have to retire from your career as an opium eater. You aren’t quite ready to get out of bed let alone go for a walk, but you are starting to want to move about a bit. As you are weaned off pain relief, aches and pains related to being immobile and in bed will present themselves to you.

This sequence of movements is aimed at mobilising the lower body and back, and you should be able to do them whilst in bed.

This series of movements is fantastic to do at any time, at any point. I use them all the time as warm up or cool down before my Yoga practice and also if I have back ache, it’s an excellent first aid treatment for getting rid of aches and pains.

Check out the guidelines first!

1. Pelvic tilt

In addition to helping you to engage with your abdominal muscles, this practice has the added benefit of stretching your lower back as well as activating your abdominal muscles.

a) Start by lying on your back and if possible come to a position where your knees are bent and your feet are on the floor or the bed. Put your hands on your hips and begin by pressing the back of your waist into the bed. When you first start doing this, this might be as much as you can do, and that is absolutely fine.

b) To move on, as you press the back of your waist into the bed, try to draw your navel in towards your spine.

c) For the third stage try to tilt your pelvis towards you as your press the back of your waist into the bed.

d) Finally you press down through your feet in order to lift your hips slightly off the bed.

Recommendation – start with 5 repetitions and gradually build up to 30 repetitions

2. Hug knees to belly

This is a movement which complements the pelvic tilt very well. This stretches out the back of the body and can be very helpful in starting to restore your mobility. The action of bringing your knees up on to your belly helps you to get to know your insides again after your surgery.

a) Begin with your knees bent and feet on the floor / your bed. If you can, use your hands to draw your right knee towards your belly and hold this position for a few breaths and then release.

b) Keeping your knees bent and feet on the floor / your bed. If you can, use your hands to draw your left knee towards your belly and hold this position for a few breaths and then release. notice if this side feels different to the first side.

c) If you want to you could repeat this movement on each side, but this time pull your knee in closer to your belly. You should feel a stretch in your lower back and the back of your hips along with gentle pressure on your abdomen.

d) Once you have become familiar with the movement on each side, try bringing both knees on to your belly, one at a time. Hold for a few breaths and then release.

e) If you want to you could repeat this movement with both knees on your belly, but this time pull your knees in closer to your belly. You should feel a stretch in your lower back and the back of your hips along with gentle pressure on your abdomen.

Recommendation – start with 5 repetitions and gradually build up to 30 repetitions

3. Supine Twist

a) Come to knees bent and feet on the bed or the floor, if you are doing this on the floor. Have your knees and feet together. Use your folded towel and both hands to apply gently pressure on your abdomen. Very gently drop your left knee to the left until it is resting on the bed / floor. If your knee won’t go that far, then use a pillow to support the knee at whatever height is comfortable for you. Then drop your right knee to the left knee so that the right knee and ankle are resting on the left knee and ankle.

b) Rest here for a few breaths feeling the stretch along the right side of your body.

c) Come back to the starting position. Have your knees and feet together. Use your folded towel and both hands to apply gently pressure on your abdomen. Very gently drop your right knee to the right until it is resting on the bed / floor. If your knee won’t go that far, then use a pillow to support the knee at whatever height is comfortable for you. Then drop your left knee to the right knee so that the left knee and ankle are resting on the right knee and ankle.

d) Rest here for a few breaths feeling the stretch along the left side of your body.

Recommendation – start with 5 repetitions and gradually build up to 30 repetitions

Finish the sequence with a couple of repetitions or the pelvic tilt or the knees to chest.

Draft medical history proforma – so you don’t have to repeat yourself endlessly

One of the most frustrating things about Crohn‘s (especially if you have blockages and adhesions) is that you can unexpectedly end up in hospital all over the place. I had a period of a few years where every holiday was doomed to end up with me in hospital somewhere – eventually the problem was found.  It turned out that there was a grapefruit sized abscess wrapped around my bowel which led to exciting impromptu re-enactments of ‘that scene’ from the exorcist.

I now have an outline of my medical history to give to medical staff on my ‘travels’. The aim of the outline is to help me remember key dates and events, which can be forgotten in the begging for morphine confusion of admission.

I have attached a draft version of the outline here to share with readers: Summary of medical history_Draft in order to get some comments from you about it.

  • Is there anything I have missed?
  • Is there about the right amount of space or do you want more?

Medical staff often ask you to repeat your medical history as a way of:

  • building rapport
  • checking you are compos mentis (composed mind)
  • checking that you are not suffering any ill effects of medication
  • checking for delirium that comes with fever

So having an outline to hand won’t necessarily reduce the number of times you are questioned but it will make a difference when it matters.

It is also useful to have to hand so that a carer, friend or relative can give all the important details to medical staff if you are not able to coherently communicate. This can happen if you have a fever or are in considerable pain.

So do let me know what you think about the draft version (here: Summary of medical history_Draft) and then I will upload a final version for you to write your own outline.