chronic conditions care courage consistency coaching

Care, Consistency, Courage and Coaching

Chronic Conditions

Care, consistency, courage and coaching are my “4 Cs” of chronic condition management.

Care

There are different types of care. Top of the list is great medical care. You must have a good relationship with your primary care provider (general practitioner, GP). I’m not suggesting you be family friends who go out for dinner (that could be difficult) but you should feel comfortable that your GP “gets” you and that you trust their level of care. This is the medical professional on your team that herds the cats (your specialists) and keeps the information flowing, in a sense the gate-keeper.

Self-care is extremely important. Self-care isn’t all bubble baths and scented candles, although those are nice. Self-care includes doing the things you MUST do to maximise your health, minimise your pain. Making the time to do stretches, walk, swim, lift weights, sleep, eat well: “doing the hard yards” as my father would say. Yes, the other sort of self-care, the time-out, rest, relax: also very important.

Mental health care is extremely important. As I have written about that in “We Need Mental Health as well as Physical Health, I won’t say more here. Reducing stress is part of mental health care.

Being careful is also a form of care. One example I have written about before is changing exercises where necessary. My own example is I no longer do dumbbell chest press because getting off the bench irritates my spine.

Being careful with our body weight is important – for many, weight gain can mean increased pain levels.

breakfast
Breakfast

Consistency

Consistency is paramount. When we were healthy, our bodies could recover from a week or two of no exercise, a night on the booze or day of crap food. Sure, we may have suffered a hangover or the scales may have jumped a kilogram, but we easily recovered from the damage.

Once we have a chronic condition/illness/disease not only are our bodies not as resilient, we are likely on medications that, while doing very good things for us, may also compromise other aspects of our “internal workings”. My own example is my rheumatoid arthritis (RA) medication suppresses my immune system – logical when you think about it, of course, given RA is an autoimmune condition, my own immune system attacking me. This means I have to be super careful not to catch bugs/viruses, as I recently did. I ended up in ED with what felt like a ping-pong ball in my throat.

Exercise, such as stretching and resistance training, will stop your body deconditioning and greatly assist with pain management. However, the gains we make can be lost VERY quickly once our bodies are unwell. Consistency is vital to ensure we maintain our gains and keep building on our achievements. I have discussed exercise in more detail in Doctors and Exercise, so please click that link for a more comprehensive presentation about the importance of exercise.

de-conditioning

During a consultation with my endocrinologist he asked, “Do you take your meds?” Frankly, I was shocked – what a strange thing to ask, I thought, of course I take my medications! He asked because my thyroid was misbehaving again and my blood tests were not within the reference range – again. Clearly some patients don’t take their medications as prescribed.

Most medications for chronic conditions require consistency to be effective. If you feel the dose or the medication isn’t working as it should, TALK TO THE SPECIALIST before changing anything. You may do more harm than good. If the problem is remembering, set alarms in your phone. Some medications can take three or more months to reach the required level of effectiveness.

Be consistent. With medications, exercise, diet, rest, sleep, hydration.

consistent exercise
Consistent daily steps

Even if you have to dance to get there!

Courage

Yes, courage. It takes courage to start AND to keep up the fight. “The cave you fear to enter holds the treasure you seek”. The treasure is maintaining quality of life for as long as possible. For some, the cave is MOVEMENT! It can be hard to think about movement when we are in pain. Or we feel we can’t “keep up” in the gym. Today is my swimming day. The predicted high is 13 Celsius. Do I REALLY want to get into my bathers and hit the pool, or would I prefer chocolate cake and a nip of Bailey’s Irish Cream? Consistency! Courage! Just do it!

leg press

The benefits are worth it. I have avoided a knee replacement and radiofrequency denervation of the lumber spine. Yes, I MAY need both some time in the future (distant future, I hope) but for the moment, I’m good. I’m on no pain medications.

Four years ago I started with four x 5 minute walks a day.

Now a gym session looks like this:

  • 4 sets leg press
  • 3 sets chest press
  • 3 sets shoulder press
  • 1 set body weight squats
  • 3 sets Smith Machine squats
  • 3 sets tricep extensions
  • 3 sets bicep curls
  • 3 sets lat pulldowns
  • 3 sets leg extensions
  • 3 sets pec dec
  • 8 minutes on the rowing machine

I got VERY annoyed recently when I lost muscle strength and had to drop my leg press weight down from 160 kgs. While we still don’t have a medical explanation, I am building back up again, so perhaps it was just a temporary glitch. We have temporary glitches.

I didn’t get to where I am now without care, consistency and courage.

Coaching

Professional athletes all have coaches. They have goals. WE also have goals (hopefully SMART goals)!

Perhaps we need to look at ourselves as endurance QOLs –  Quality of Life is the goal we strive for, not necessarily running 3,100 kilometres in 45 days! Our mental challenge can be just as extreme, even if our physical achievements are not. 8 Steps to Retain/Regain Quality of Life

People are all different, conditions vary greatly. Even so, the sooner you start managing your condition instead of your condition managing you, the better your chances of retaining your quality of life for as long as possible.

Sometimes all that is needed is help to get started. Sometimes a patient may prefer longer term support and encouragement.

Coaching helps the chronic condition patient take control. There is a fifth “C” – Control!

Too often patients feel they are “OK for the moment, I’ll worry about all this later” (when my job is not so stressful/the kids are older/the house is paid off). My advice is don’t wait. Start now to protect your future.

Contact me for a confidential chat as a starting point.

Note this article is intended for chronic condition patients who have a medical clearance or medical advice to exercise. This can be at any level from beginner.

too much chocolate is not self-care

We Need Mental Health as well as Physical Health

As a movement/exercise trainer I write a lot about benefits of physical movement for chronic illness. It is my area of expertise. I am well aware that mental health will affect clients’ motivation to enhance their physical health. Recently I wrote about the financial aspects. As I am a CPA, I’m qualified to write about dollars too.

Today I take a look at mental health. I am not qualified in the mental health field, therefore I refer to those who are. My own experiences may put the advice into context and help you consider whether some support may be helpful or life adjustments may be necessary for your situation.

Queensland Health published 5 steps for making your mental health a priority in 2018 (and beyond) earlier this month. I’m going to talk about those 5 steps in the context of having a chronic condition.

Understand what mental health actually is

This is important. If we don’t have an understanding of what mental health actually is, we won’t recognise when we need support. We already have a physical condition: diabetes, lupus, fibromyalgia, inflammatory arthritis…..the list is very long. Maybe we have more than one condition to manage. Our life may have slowly or suddenly changed and those changes can bring with them depression or anxiety. There can be a sense of loss if a patient has to reduce working hours or give up work entirely. The financial concerns resulting from that life change can bring considerable stress. There are times, especially in the early days, when it can feel like a downward spiral.

I remember what it was like in the early days, when I was not yet on medication as the specialists investigated and the diagnostic process chugged along. It. Was. Tough. I did have faith there was light at the end of the tunnel, but that light seemed to be a tiny speck in the distance at times. Now I can leg press 160 kg – that is a long way from the days when I walked five minutes, three times a day. Not only am I physically healthier, I am also mentally stronger. I feel in control, which I certainly didn’t in late 2014.

Just as our physical health can affect our mental health, the reverse is also true: our mental health can affect our physical health. If we reach a point where we feel there is no hope, then we may stop doing the very physical things that would give us hope and a better quality of life. Sometimes it really is the old chicken or the egg question.

Being mentally well doesn’t mean you don’t experience ‘negative’ emotions or reactions, like sadness, anger, grief or frustration. Similarly, being mentally unwell doesn’t necessarily mean that you can’t experience emotions like happiness or excitement, go to work or school, or have relationships.

Having mental wellbeing means being able to experience all the ups and downs of life and cope with them in a psychologically and emotionally healthy way.

Please read the full article for the clinical definitions and a broader explanation of what constitutes mental wellness.

Cultivate mental wellness

For physically healthy people, this may not be something they have to think about too much. There are mountains of research showing that physical exercise helps maintain mental health. Healthy people are out there playing tennis, running, cycling, gyming and swimming with gusto. Us? Maybe not so much, at least not at first.

We can usually eat right. Sleeping right may be affected by pain.

Another important aspect is finding our purpose – but this may just have been taken away from us: we have to find a new one. If we loved our job, for example, and can no longer do that job, this may affect our sense of purposefulness.

You can find more resources about looking after your mental health on the Head to Health website. This Australian Government website focuses on four broad aspects of life that can impact your mental wellbeing: physical healthconnectednesspurposeful activity, and feeling safe, stable and secure.

Find ways to decrease stress

This is something I have written about in the past.

Queensland Health says:

Stress can impact anyone and can affect your mental and physical wellbeing. While a little bit of stress can be a good thing, helping you to focus and perform well under pressure, ongoing stress is not healthy for your body or mind.

Let’s not beat around the bush – finding out we have a chronic disease IS STRESSFUL! Apart from the medical advice that stress may cause condition flares, which we don’t want, stress can impact our mental health and the vicious cycle starts. It is important for physically healthy people to manage their stress: it is absolutely vital for chronic disease patients to manage stress.

Take time out

Strongly recommend this one. With caution. For anyone with a chronic condition, self-care is critical. Brianna Wiest covers this well in This Is What ‘Self-Care’ REALLY Means, Because It’s Not All Salt Baths And Chocolate Cake. For me, I might want it to be all hair appointments and manicures. Although I did have 20 grams of Lindt chocolate today.

True self-care is not salt baths and chocolate cake, it is making the choice to build a life you don’t need to regularly escape from.

And that often takes doing the thing you least want to do.

So while we do need to take time out (have that manicure, watch a favourite TV program or enjoy a nice glass of wine), because we have to avoid the Boom Bust cycle, we need to be careful not to take so much time out that we sacrifice our very necessary self-care. We can no longer do as much in any given day as we could in the past. We can’t catch up tomorrow, necessarily.

Get help when needed

YES YES YES!!! From my personal experience I recommend talking to your GP early if you feel you are experiencing difficulty coping. Support such as Mental Health Care Plans are available under certain circumstances to help with the costs. Don’t keep soldiering on, support is out there, use it. I find just being able to vent in a safe environment immensely beneficial. Being proactive about our mental wellness is very important at any time: once we are a chronic disease patient it is absolutely critical.  

Signs it’s time to seek professional help include:

  • you’ve been feeling sad, down, angry, depressed, numb or generally ‘not yourself’ all the time, for two weeks or more
  • the way you’re feeling is affecting your ability to cope at work, school or in your relationships.

You can start by talking to your GP, a trusted friend or family member who is a good listener, or by calling a helpline like beyondblue or Lifeline. If it’s an emergency and you think your life or someone else’s life is in danger, always call Triple Zero (000) for an ambulance.

Remember that only a trained health professional can diagnose you with a mental illness and offer treatment services.

Other Resources

“You can’t stop the waves
But you can learn to surf.” ~ Jon Kabat-Zinn

The Daily Manic – corporate change consultant and advisor Jayne was diagnosed with life changing illness at the age of 44. She now uses her change management skills to help people slow down their lives, whether that be for reasons of illness or simply because they want to slow down.

If you are willing to see if physical activity will help you manage your condition/(s), do check out my current competition. You may win eight weeks free training to get you started!