How I Use Routine to Successfully Manage
Fibromyalgia
By
Joan Buchman
Editor’s
Note: Joan Buchman, a fibromyalgia patient from California, is a support
group leader and moderator for the CFIDS/Fibromyalgia Self-Help Program.
During the 12 years
I have had fibromyalgia, I have found that having a routine lifestyle is
crucial to moderating my muscle pain, optimizing my energy and enjoying
my life with FMS. I know that my daily patterns will sometimes be upset,
but I have learned that if I am sensitive to my symptoms and willing to
adjust my routines, I can have a full and happy life with fibromyalgia.
Developing a
Routine Lifestyle
When my symptoms of
FMS started in March 1991, I had no idea what was going on. It took 18
months to get a diagnosis. Only when my symptoms had a name, was I able
to start learning about and come to terms with this illness. Through
reading about FMS, through a lot of trial and error, and by taking the
CFIDS/FMS Self Help Course in 2000, I gradually learned that having a
daily routine was the key to keeping my symptoms manageable. I also came
to recognize that I have to adapt my routine from time to time to fit
new circumstances.
This routine that I
developed works well for me during stable periods of my life. This
routine includes exercising three times a week doing aerobic exercise
and weight training, taking a weekly tai chi class, walking three to
four times a week, and resting once a day for at least one hour. I have
a social life which includes phone calls and outings with friends, and
activities with my husband. I have time for my artistic hobbies of
rubber stamping and calligraphy. By sticking to this routine, I maintain
good symptom control and enjoy many satisfying activities.
I arrived at this
routine by asking myself a number of questions. For example: What are my
present pain and fatigue levels? What have I learned so far about
minimizing these symptoms? Are my social interactions satisfying? Am I
allocating my time optimally to perform health maintenance, do home
chores, have a family/social life, and engage in satisfying hobbies? The
answers to these questions helped me arrive at the routine I described
in the previous paragraph.
I have to remain
open to making minor adjustments to my routine. For example, on a day
when my pain is stronger, I may need to modify my exercise program. Or
if my fatigue during the day noticeably increases, I may rest for a
longer period or go to bed earlier that night. Sometimes increases in my
symptoms are just vagaries of the illness. But from my many years of
experience, I know that usually symptom increases are signals that I am
off routine. Then I have to step back and see where I have deviated from
my routine and decide what I need to do to get back on track. I may need
to stop doing an activity altogether or simply pull back a bit.
Life Changes
Calling for a Completely New Routine
Sometimes, I am
pulled out of my routine by a one-time event, such as a family
gathering. I make a choice to attend even though I know that I will be
very tired when it is over and my other symptoms may increase. Since I
make this decision consciously, I can plan down time afterward to
re-establish my balance and get back to my routine.
But some life
changes upset my routine in a more lasting way. Examples include leaving
my job because of FMS, taking care of a terminally ill relative for six
months, unexpected major surgery and moving four times in eight years.
Before I started this routine lifestyle plan, when one of these events
occurred, I would resist my new reality and continue the changes in my
life without making many adjustments. That added more stress to my life
and worsened my symptoms. After taking the CFIDS/FMS Self Help course, I
learned that I needed to adjust my daily routine to cope with these
events so I wouldn’t have a total relapse of FMS.
The strategy I
devised is to create a new routine out of my new situation as soon as
possible. For example, when I had major surgery in 2002, my carefully
crafted routine disintegrated. While recovering from the surgery, I had
to drop all exercise except walking. For the next two months, I walked
daily, working up from five minutes to 30 minutes at a time. I was
unable to do my other normal activities, because I was so weak. So my
new routine became walking and resting. As I became stronger, I was able
to gradually add back my other activities such as tai chi, going to see
friends, catching up on correspondence, doing art, etc., eventually
re-establishing my former routine.
Other times I have
made a conscious choice that will cause a major change in my routine. An
example of this is the many moves my husband and I have made in the last
12 years. Once we moved because of termites. A year and a half later, we
moved again to lower our monthly living expenses and establish residency
for tax reasons. Then last year, we decided to move from Northern to
Southern California to be closer to my family. These moves were all
conscious choices to disrupt our lives.
When we decided to
move over 500 miles to Southern California, I realized that this
long-distance move would require a lot of planning and a long period of
preparation, so I created a new routine. Starting six months before our
move date, I reduced my time with friends, still keeping in touch by
phone, stopped doing my artwork and put that time into purging and
packing. I continued with the exercise portion of my routine.
The Value of
Pacing
My knowledge and
experience with pacing was very helpful during this time. I found that I
could pack four boxes a day and not be totally worn out, as long as my
husband took those boxes out to the garage. If I pushed those four boxes
onto the hand truck and moved them to the garage, I was so worn out that
the rest of the day I could do nothing else. I kept this “packing”
routine going for several months. By the end of that time, we had sorted
through our possessions, purged unneeded items and packed the rest.
After selling our
house, we put most of our furniture into storage and moved to Southern
California. We rented an apartment for three months while we found and
purchased our ‘dream’ retirement home. With all our belongings now
at our new house, I have developed a new routine very similar to my old
one, exercising, unpacking and creating a new life in our new town.
Adjustment Is a
Continual Process
Even with all my
years of adjusting to new situations that arise, managing FMS is a
continuing learning process. Overall, the adjustment to our new home has
gone well. My pain and fatigue levels have been manageable. But I
developed sleep problems. I had trouble getting to sleep and woke up
many times during the night. Looking at my routine, I realized that I
was doing too much. So my husband and I came to an agreement that we
would pull back on the unpacking, giving me more time to relax and rest
during the day. Almost as soon as I changed my routine, my sleep
improved dramatically. Now most nights, I fall asleep very quickly and
only wake up once during the night, which was my pattern for many years.
It was amazing to me how quickly and easily I was able to see
improvement.
Conclusion
Some people may
think that having a routine-driven life is boring, but for me it has
been liberating. My illness is not running my life, I am. By being
realistic about the illness and my symptoms, I am taking conscious steps
to feel as well as I can.
There will always be
unexpected events and situations in my life. But I feel confident that I
will be able to change my daily living to cope with these changes and
re-establish an equilibrium. This is key for me in living my best life
with FMS.
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