Advice to a New
Patient: 2005
By Bruce Campbell
What are the most important things to
remember in coping with Chronic Fatigue Syndrome or fibromyalgia?
We asked that question recently of about 50
participants in our self-help program, telling them to imagine that a
newly-diagnosed patient approached them for advice, asking them what two
or three things they had found to be the most helpful in coping with
their illness.
Their answers may surprise you. No one
mentioned any specific medications; rather, their advice focused on
three points: 1) the importance of making psychological adjustments to
long-term illness, 2) the need to play an active role as a patient, and
3) the usefulness of experimenting to find what works in individual
situations
(Note: This is the third time we have asked
this question of people in our program. You can read results of the
earlier inquiries by following the links at the end of this article.)
Accept Your
Illness
Both
CFIDS and fibromyalgia are long-term illnesses that impose limits and
require adjustments. Some of the adaptations are practical, but, for
many people responding to the question, the psychological adjustments
were, if anything, more important. Without an acceptance that life has
changed on a long-term basis, people find it difficult to start making
the practical changes that can improve their lives. One student wrote:
"Life
has just changed. Just repeat that to yourself and start the process of
acknowledging this. Find the new ‘normal.’ [You] cannot go back to
the old ways of living; have faith you will find new ways in time." Another
said: "You didn't cause the illness
nor are you imagining it; it's real and you have to adjust to the
reality. It is not amenable to mind over matter!" Several
people sounded a cautionary note, saying that they believed people could
avoid long-term damage by accepting their limits and doing financial
planning early on. One wrote: "My unwillingness to lose income
resulted in my continuing to work even though I was way too sick to do
so. I'm certain that it's because I did this that I'm virtually house
bound today."
Grieve Your Losses
Part
of adjusting to long-term illness is mourning all the losses brought by
illness: loss of good health, loss of friends, loss of financial
security, and loss of the future you had envisioned for yourself. One
respondent wrote: "You
will need time to mourn your loss. The fact is you are now not the same
person you were…you cannot do the things you once did." Another
said: "I had to go through the entire grief process before
I could learn to manage my illness with any kind of success."
Educate Yourself
About Your Illness
Long-term
illness challenges you to take on a different and more active role as a
patient than you may have had with previous illnesses. Many respondents
spoke of the importance of understanding your diagnosis and the many
treatment options available. One wrote: "Educate
yourself. Read the books recommended by [other patients], the CFIDS
association, the Arthritis Foundation --anything that does not promise a
fast cure, because that would be rare. Then listen to your doctors,
weighing what your doctor says against what you have researched
yourself. Then be an active participant in designing the treatment plan
that works for you."
Get Support
Having
your life turned upside down is a disorienting and often isolating
experience. Support in various forms can help. As one person wrote,
"[Create a] support network.
This network should ideally include their healthcare providers, family,
spiritual leaders and friends who are committed to be there for this
person."
Many
respondents mentioned the support offered by fellow patients and patient
support groups, saying things like "realize that you are not alone,
there are people who understand what you are going through." Others
emphasized the helpfulness of one-on-one support, whether from a
therapist specializing in long-term illness or a special friend or
confidant. One person said: "If
possible, find someone else who has a chronic illness that you can talk
to. I have two close friends with MS and they both played huge roles in
my acceptance of my illnesses and in learning to live with them."
Find a Helpful
Doctor
Even
though living with long-term illness means much more than managing
symptoms, a doctor can be an important part of your response to illness.
Respondents advised looking for someone who believes that your illness
is real and who is willing to experiment to find the treatments that are
helpful in your individual situation. But they also voiced various
cautions. One said: "Get a good, proactive doctor who understands your
illness and isn't fixated on his/her own approach. You need a supportive
doctor aware of his or her limitations." Another wrote: "Listen to
their advice, but decide for yourself what suits you best. You will
become your own expert on your condition." A third said: "Speak up
if their treatment isn't working after a reasonable amount of time and
change providers if you feel they are not meeting your needs."
Experiment with
Treatments
There
are no widely effective medical treatments for either CFIDS or
fibromyalgia. This fact has two implications for patients’ efforts to
feel better. First, it means that treatments have to be individualized
for each patient. Second, most patients have to experiment before they
find what works for them. Working with a doctor, they usually try
various medications, but they many also experiment with alternative
practitioners and approaches as well. Many reported using a variety of
strategies, not just a single approach. In addition to trying
prescription medications, respondents mentioned using yoga, acupuncture,
nutrition, supplements and hypnotherapy. One student’s response is a
good summary of this process:
A
friend of mine, who also has FMS, said to me, "You have to find
your own way. It may take a year or so, but you are the one to have to
do it." I was really angry and upset [at] such an unfeeling
comment. I was in pain! How could I possibly do that by myself? In
looking back, that was great advice. It made me mad enough to look for
alternative treatments, do research, and in the process, gather my
support people, find the [self-help program] and many other things.
Trial and error has made me find what works for me.
Various
kinds of lifestyle change were also mentioned frequently, especially
pacing and logging. Pacing means finding the right balance of activity
and rest to control cycles of push and crash. A common theme was the
idea of learning to listen to one’s body and the signals it sends. One
person said "For a long time, I told my body to shut up; that was a
mistake." Another said: "My first piece of advice would be ‘listen
to your body’. Getting well requires a shift from trying to override
your body's signals (in order to continue what you were doing) to paying
attention when your body tells you to stop or slow down. By heeding
these signals at an early stage, you may forestall the development of
even more severe symptoms."
A
third person explained how she had come to live by the idea that all her
actions have effects on her symptoms. She advises asking if you can live
with the payoff, if you are willing to accept the consequences. Several
people mentioned that they found logging helpful. By keeping records,
they learned what works for them and what doesn’t.
Have Hope
Finally,
respondents stressed that it is possible to have a good life with
long-term illness. Several people observed that they had learned how to
manage their illness. One said: "You can improve or at least live
better with your illness." Several others said that they had found it
possible to live a good life with long-term illness, though they
stressed it was a different kind of life than they had before and
different from the life they had planned for.
One
said: "It is possible to find a new life, one that is joyful and
rewarding." A number of others said they liked their new lives better.
One wrote: "I don’t want to go back to the driven person I used to
be. I like the person I am becoming much better." Others stressed the
importance of attitude, especially how you view your situation. One said
she found it important to be compassionate toward herself rather than
blaming herself for getting ill or feeling guilty.
Conclusion
Patients
in our program believe that learning to live well with chronic illness
is based on several principles: 1) accepting that life has changed on a
long-term basis, 2) educating yourself about your illness, 3) getting
support, including the help of a sympathetic doctor, and 4)
experimenting to find what combination of treatments and lifestyle
adaptations work in your individual situation. Respondents also stressed
that a life with long-term illness can be rewarding. As one person said:
"You can have a good life with FM or CFIDS, but it will be different
than life was before."
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