Category: exercise

(Not so) fun times with Endometriosis. (Part Two- advice for pre-op.)

I started series of posts with Part One being a description of my experience with surgery. This part (and so far, I’m not sure how many parts it will be!) is going to be my tips for preparing yourself mentally and physically for surgery and for the post operative time. This is aimed towards surgery for endometriosis, but some of the tips will be useful for other surgeries too.

Obviously, not all of these tips are going to work for everyone. Some people have children, or work or have other health conditions that will change their needs. I really shouldn’t have to say this, but if any of your health care professionals tells you to do something different to this advice – FOLLOW THEIR ADVICE!! I don’t know your body or your other health conditions. I only know mine!

1. Pelvic floor exercises

You are about to undergo a surgery that is going to poke around in your pelvis. If you make that area as strong as you can, it will heal faster. There will be a healthier vascular system – this will both assist in controlling blood loss from incisions and improving blood flow to the area afterwards to assist healing and removal of toxins.

Don’t just do kegels though. Your pelvic floor is basically a big sling for your internal organs (a simplified explanation), and you need to work on all of it. Your body alignment, your pelvis, how you sit and stand all have an affect on your pelvic floor. I did the pelvic floor exercises from healthymoving.com, but I had already signed up for her coaching and challenge program so it didn’t cost me anything extra. Alternatively, an exercise physiologist or physiotherapist can give you specific exercises to help strengthen your pelvic floor.

The other great bonus to this, is that a strong pelvic floor can help with bladder or bowel incontinence, reduce the risk of prolapse and improve your sex life! There is basically no down side to improving your pelvic floor strength.

2. Good nutrition

Although today’s anaesthetic drugs are really quite safe in comparison to days gone by, they are still drugs that your body has to process and remove. For the most part, once you wake up and have breathed out the last of any gaseous anaesthetic you might have had, this will be done via your liver and kidneys and excreted via your bladder and bowel. (Don’t be surprised if your motions smell strange for a few days!)

Unless you have a liver or kidney dysfunction, removal of those drugs will happen no matter what you eat. However, your body is busy doing an awful lot post surgery. It has incisions to heal, hormones to regulate – especially if your ovaries were involved, pain to manage and pain relief medications to process.

If you give your body good nutrition in the weeks leading up to your surgery your organs will be in a better state to deal with this. You will use less ATP (the molecule that cells use for energy) and the process will be easier. Good nutrition is vital for managing the FibroTroll, and is especially important both pre- and post- surgery. I’ve written quite a lot about this, you can find some of those posts here, here, here and here.

If you can, make food for the freezer. If you have a couple of weeks, this can be done by doubling your normal recipes and then putting half in the freezer. If you don’t have that sort of time, see if you can get a friend or family member to help you and spend a day or afternoon making meals for the freezer.

Make sure you have high fibre appealing snacks available. It is not unusual for anaesthetic and pain relief drugs to make you nauseated and/or constipated. You might not feel like eating, so making sure there is something tasty to eat will help. The high fibre will help prevent constipation. Trust me on this, constipation following pelvic surgery is not something you want to try if you can avoid it.

3. Prepare post surgery entertainment.

If you are like me, you will get bored when you can’t get up and move around easily. I tend to think I’m better than I am, and do things too soon and delay my healing. To avoid this, it is good to find some things to do that you will enjoy and that will stop you doing other things.

Find some good books, re-read old favourites or try new titles from authors you already know you like.

If you like to knit or crochet, find a simple but appealing pattern to try. Get the yarn and needles or hooks together, put them in a bag or basket or box with some scissors, the pattern, stitch markers, darning needle and anything else you might need.

Indulge in a game on your phone or tablet if you enjoy that sort of thing. Remember that blue light will interfere with your sleep, and you need sleep to heal, so try to avoid doing that in the evenings.

Watch a new series, or re-watch an old favourite. This is a perfect excuse to binge on Buffy the Vampire Slayer or Dr Who or something similar. Again, remember not to do this in the evenings.

4. Do a spring clean.

I know it’s hard to keep on top of housework when you have a chronic illness. But it is going to be worse post surgery. So doing as much as you can now, will save on things to do afterwards.

Make sure you have plenty of clean pyjamas and loose fitting pants. If the weather is cold, make sure there’s plenty of clean warm clothing. If the weather is warm then loose fitting dresses can me your friend. Anything that avoids putting pressure across your abdomen is good.

Change the linen on the bed, so you have lovely clean sheets post surgery.

5. Pack an overnight bag.

My surgeries have always been day surgery. Meaning I have been discharged the same day and not had to stay overnight. But it pays to be prepared. If there is a complication or your surgery gets delayed due to someone else’s emergency, then there is a chance that the surgeon will want you to stay overnight.

I keep it simple. Clean underwear, change of clothes – I choose something that I am also comfortable sleeping in. Toothbrush and toothpaste, body wash and moisturiser. I find my skin gets very dry in air-conditioning, so I do like to pack a moisturiser. Sanitary pads. I don’t like the ones that hospitals supply, so I bring my own. A book or a crochet project.

Bring your own food if you have lots of dietary restrictions like I do. The last thing you want post surgery is an IBS attack to deal with as well!

6. Organise transport.

This is super important. It is simply not safe for you or the other drivers on the road to drive yourself home from hospital. If you live alone, try to organise someone to be with you for the first 24 hours at least. If this isn’t possible, discuss this with your doctor. They might be able to keep you overnight in hospital or put you on to a service provider that can help.

7. Make arrangements for important commitments.

A few days after I had booked my surgery, a federal election was called and the date scheduled for the day after my surgery. There was absolutely no way I was going to walk down and back up the stairs of my high-set house, let alone think about something like voting the day after surgery.

So, I organised a postal vote, which was great as I could sit in front of my laptop with the voting card and actually research the policies of every candidate in my electorate.

8. Mindfulness

Meditation and mindfulness can go a long way in helping your healing. If you are at all anxious about surgery, I strongly suggest talking to a psychologist if possible and practising mindfulness. Anxiety increases cortisol which can reduce or delay healing. It can also interfere with anaesthetic drugs, meaning you need more drugs to achieve the same result.

Deep breathing techniques where your exhalation (out breath) is longer than you inhalation (in breath) helps to calm the nervous system and activate the parasympathetic nervous system (the calming side of your nervous system). If you can, practice this when you are in the pre-op room. It gives you something to do when no-one is poking at you, and will make the anaesthetic smoother and easier on you (and your anaesthetist!)

But don’t just start in the hospital. Start now. Really. Even just taking a couple of moments to focus on your breathing will make a difference in the long run. I challenge you when you finish reading this, don’t just go on to the next thing you were going to do. Take a deep breath, count slowly to 5 while you do, then slowly let it out again, try and make the exhale twice as long – i. e. count to 10. You might need to purse your lips or do something else to slow your exhale down.

Then do it again. Do it 10 times. Then do it again tomorrow. You don’t have to sit for 20 minutes and meditate (although it’s awesome if you can), start with the breathing and go from there.

Good luck!

Go back to Part 1 or forward to Part 3 or skip to Part 4 and the addendum.

Seven tips for holidaying with Fibromyalgia

At the start of this month, the Knight and I went away for a few days. We had tickets to see Tim Minchin – a hilariously funny, intelligent, gifted musician, who plays piano, does a lot of political and religious satire, and swears a lot. The Knight and I are both big fans.

We missed out on tickets for his Brisbane show, so when Gold Coast tickets were released, I jumped straight at them, and decided I would figure out the logistics of travelling and hour and a half later. It worked out well, because it’s the Knight’s birthday this month, and he was very happy to have a weekend away and tickets to one of his favourite comedians as an early birthday present!

Functions and events are hard when you have Fibromyalgia. There’s the noise and lights and seats and lots of people and massive amounts of sensory input that drains your energy very quickly. Add to that, evenings are my worst time of day, and I have to make sure I plan to do nothing the next day, to try and avoid a flare.

But you cannot live your life in a bubble. It’s boring and makes your depression worse. So here are my tips for weekend getaways or travelling for functions:

1. Book a self contained apartment

I found a lovely little one-bedroom apartment, with a small but fully equipped kitchen, some comfy couches, a dining table and 2 small balconies over looking the water.
There was a place to play board games, and separate places to eat, so we didn’t have to pack up mid-game. It also meant I could go and nap, and the knight had some comfy couches to relax on without having to sneak around to avoid waking me.

2. Bring your own food

Catering for yourself, not only saves money, but keeps the IBS under control. If you do go out to eat, do your research in advance. If you have dietary intolerances, it is unfair to expect a restaurant to cater for you without any advance warning.

3. Take some extra days

We headed down on the Thursday afternoon before the show on Saturday. This gave me a full day to recover from travelling and to relax and enjoy the time away. We stayed until Monday, so that Sunday could be spent doing as little as possible to hopefully avoid the dreaded DOPEM (Delayed-Onset Post-Exertional Malaise).

4. Bring low energy entertainment

We brought a few board and card games with us, our favourite at the moment is Hero Realms. We also brought Carcassonne and Ticket To Ride (India/Switzerland) as they are both good with only 2 players. This allows us to do something we both enjoy together, and interact. So much better for our relationship than just watching hours of movies sitting on separate couches! (No judgement for those who do this, we do it too sometimes, it’s just not our favourite thing to do together.)

5. Bring your Yoga mat

View of the ocean and surf and a park with green grass and pine trees. Blue sky and fluffy white clouds.
View from one of the balconies.

Unfortunately the FibroTroll doesn’t take holidays. I find yoga and stretching to be very helpful for reducing the overall pain I have each day. The exercises might hurt a bit sometimes, but generally not as much as I hurt when I haven’t done any of them for a few days.

On the plus side, this is the view I had each day as I was doing my exercises.

I also meditated on the balcony each morning. Having the sun come up over the water and shine straight in your face is a wonderful way to wake up!

6. Pace Yourself!

As much as I get frustrated with pacing, it really is extra important to do it when you are on holidays too. Taking the time to relax and not push yourself to do “All The Things!” means that you will enjoy your break and not come home more exhausted than before you left.

7. Do a load of washing

I know this sounds boring and not at all like it belongs in a what to do on holidays list. However, if you are going away for more than just a weekend, there is going to be a lot of washing to do when you get home. If you can, do a small load of washing on your second last day. This means when you get home, you can just put all the clothes back in the cupboard. It will save a surprising amount of energy when you get home.

So those are my tips. They worked fairly well and I didn’t have too much of a flare afterwards. Unfortunately, other health issues have flared up instead, (the FibroTroll has many friends) but at least I managed to keep the FibroTroll mostly under his bridge.

Sunrise over the ocean, with pine trees in the foreground.
Sunrise from the other balcony.

The last morning, when I couldn’t sleep, the picture to the right was my view as I sipped my coffee and the Knight had a little bit of a sleep-in. Not too much of a hardship!

In the end, I can say for certain that it was worth all the effort. I laughed so hard I cried, and the Knight and I have been singing random bits of Tim’s songs to each other for a week!

Exercise and Fibromyalgia

Exercise is such an important aspect of health. Our bodies are designed to move, and to do it regularly. Aside from the obvious fitness aspect of exercise, it has many other benefits. Exercise helps keep our muscles and joints strong, it assists digestion, heart and lung function, blood flow, lymphatic drainage, liver and kidney function and even mental health! Basically every part of the body benefits from moving our bodies.

But what happens when we have a chronic illness? One that zaps energy and causes increased pain? I can tell you. It makes exercise exceedingly hard to do.

Before I was diagnosed, before I had any idea what was wrong with me – that the FibroTroll was coming to stay – and long before I had any idea how long that visit would be (spoiler alert – probably forever), I thought I was just unfit.

I decided to fix this by playing indoor beach volleyball. I enjoyed playing volleyball – I won’t pretend that I’m particularly good at it, but I enjoyed it. I also took up indoor rock climbing. Both of these activities are a lot of fun – and a lot of hard work. Even just walking through sand is harder than walking on a flat surface, so playing a sport on it, is significantly harder.

This turned out to be a bad idea. Fibromyalgia is not the sort of disease that you can force to get better. Until you learn some level of pacing, it is very common to have a push-and-crash cycle. This would happen to me. I would keep pushing until I ended up bedridden. Then as soon as I was able to get out of bed, I would try and do all the chores that I felt guilty for leaving to the knight in tarnished armour, and then relapse.

This sort of cycle continued until I basically became too afraid to push at all. Every activity or function became a source of stress. I would pretty much always flare afterwards. This was a contributing factor for my battle with depression and anxiety.

About 18 months ago, I started seeing both my psychologist and my physiotherapist. With their help I have made small but significant improvements. I have continued working with my naturopath – with her help, and metabolic balance I am back to my ideal weight! I just need to develop some more muscle and still stay the same weight and to do that, I need more exercise.

I joined up to Healthy Moving‘s Coaching and Challenge program – which if you can afford it, I strongly recommend it. If not, just sign up for her free emails and you’ll get some helpful tips anyway.

But the pinnacle for me in terms of improvement in pretty much every aspect of my life- fatigue, pain, confidence, independence, mental health – is that this morning, I went back to Tai Chi.

Tai Chi is one form of exercise that has been actually been studied in randomised control studies and has shown to be beneficial in the treatment of Fibromyalgia. Here’s the link to one such study. I used to go when I was first diagnosed, but haven’t been for a couple of years. It is gentle, can be altered for restricted movement, or even done in a chair! It also focuses on mindful movement, and is sometimes referred to as moving meditation.

This morning, the long suffering knight rode his bicycle to work and left me the car. I was quite determined that I wanted to drive myself. It’s not a long way and I feel I need to get some of my independence back.

I got myself ready – I chose not to do a full yoga session this morning, and made sure to give myself plenty of time. I fed the chickens, breakfasted, showered and meditated, then drove our little manual car to the lesson. I was pleased to recognise one of the instructors cars in the car park when I arrived. Not having to explain myself to a new person was very welcome. I got up the stairs and walked into the room, not realising how much I had missed it until that exact moment.

I managed the entire lesson. I sat down for a lot of it, but I very quickly started to remember the moves. My balance isn’t what it was, but that will come with time. I felt welcomed and valued. I met new people and caught up with old friends. And while I am definitely tired, I don’t have that bone weary exhaustion that comes when the FibroTroll has had enough.

So if you are at a place where you want to try some gentle exercise, or struggle with meditation and need a form of movement mindfulness, then I strongly recommend Tai Chi. If you are in Australia, then try the Taoist Tai Chi Society of Australia. The Brisbane branch has a health recovery class and I can vouch that it is well worth the trip up the stairs!

Self-Care Challenge

I mentioned in my last post (which I just noticed was over 3 weeks ago – gulp!) that I was about to start a “no-time self-care challenge”.

I am pleased to say that I have started it. I’ve mentioned Healthy Moving a few times and I’m pretty sure today won’t be the last time either. I should say – I don’t have an affiliation with Jen or Healthy Moving, I just really love her approach.

So the week didn’t start so well for me. On Monday morning, I watched the first video which starts with a mindset practice for the week. I found that this particular one both resonated and confronted me at the same time. This probably means that it is particularly relevant to me!

Then on Monday night I had an episode of extremely intense pelvic pain. The Knight in Tarnished Armour was threatening to carry me downstairs and take me to hospital, but thankfully the pain relief kicked in and I managed to avoid another sleepless night at the ER. Now I should point out, that our nearest Emergency Hospital is about 3km from our house, so in most cases, it would not only be quicker just to drive to the hospital, it would be a waste of the very valuable time of an ambulance service to come to us.

After a visit to my GP on Wednesday and an ultrasound on Thursday I now know my pain episode was likely an endometrioma on my ovary rupturing. Yay! Another co-morbid condition to add to my list. I really wish the FibroTroll would stop inviting friends over to my body. There really isn’t room for more! I’m on the upswing now, but I was pretty flat for a few days after this.

Which leads me back to the self-care challenge. Given that most of my week has involved me being horizontal, except for appointments, I didn’t think I would get much of the challenge done. But, I am super proud of myself. I watched the first exercise video and initially thought “Ha! I can barely stand up today and you want me to put one foot on a chair?! No chance!” But then I thought about the mindset for the week. Then I had a scroll through the Health Moving Website, and found an exercise that focused on the same muscle group, but was lying down. So I did it instead. I found the next day’s exercise easy, but the day after that was a difficult one again. So I gave myself permission to just do the really simplified version of it.

I am proud to say that I have done a variation of all 5 of this week’s exercises/stretches. This has been incredibly good for my mental health. Depression is another of the FibroTroll’s friends, and it is very much a double-edged sword. It makes it super difficult to do, well, basically everything. But conversely if you do nothing, the depression gets worse. Exercise has been proven to help, but when you have depression in combination with physical pain it is even harder to actually do any.  I have my depression mostly under control, but it does rear its ugly head from time to time, particularly when I have extra pain.

These little 2-5 min exercise/stretch videos are just the right amount for me to get the ball rolling. Some of the actual exercises take hardly anytime at all and are easy to weave in to your day – provided you can remember to do them! But the result is that I move my body more than I would have, and it gives me a sense that I have achieved something.

I am about to go and tackle the 15 min class for the week. I have to be mindful of the week I have had, and be extra careful with pacing. To that end, I have given myself permission, in advance, to just do 5 mins if it is too much. Wish me luck!