#31 Celebrate!

Sunday afternoon, I'm sitting in Samuel's sofa in Gothenburg after what has been the most amazing weekend I can remember.

We were more than 30 people, plus 2 dogs, who made our way through the snow up to Studenterhytta in Nordmarka yesterday. A place with many happy memories, especially with my childhood friend Eli who lived there with her family and ran it for several years. This time it was really cold, and we had to hike up 5 kilometers up the mountainside to get there. Everybody had brought food, drink, delicious cakes and homebaked bread, there was music, a big warming fireplace and giggling kids.

We were there to celebrate my dear friend Sanna's 25 year birthday (again) with champagne, cakes and everything that goes with it, and at the same time saying goodbye with a solemn going away party to wish her a happy journey as she is leaving Norway and moving to Morocco.

There were stories, games, cake and more cake (I'm sure cake is good for my health and getting rid of pain... ehem... somehow...), midnight sauna and rolling in the snow, fireplace chats and spontaneous cooking, presents and warming words.

And I thought.... just a few years ago, I wouldn't have been able to do this. I would have been too tired, I probably would have wanted to go, and accepted the invitation, but most likely I would have had to cancel at the last minute, because my body hurt too much and I just didn't have strength to go. And yes, the thought arose several times the last few days "Am I really strong enough to go on this trip now? Do I have the energy? Will it make the pain worse?" but my enthusiasm and wish to be with my old friends won against the fear and thank God for that.

Because it is so important to celebrate. Celebrate life, celebrate friendship, celebrate progress, change and new beginnings.

We should celebrate more often:)

# 30 Timebox


Timeboxing is something we practice a lot in agile project management, and is really great for overcoming perfectionism and getting things done.

Try it out, and you may find it will change the way you live... in a productive way.

The concept is simple: plan an amount of time, a "timebox", for a specific activity, and in that timebox, focus only on doing that one thing, do as much as you can, and stop when you've reached the end of the timebox.

A timebox should be short, from 5 minutes for small activities (like making a phone call) to maximum 2 hours for a work process that requires some time. Remember CANI: every little step forward is a step in the right direction:)

If, for example, you feel your home is a mess, but just can't get round to cleaning it... Maybe you've been in pain for a long time and haven't had strength. You're trying to cope with everything while the health problems are eating most of your energy and gradually things have just gotten out of control. There's so much to catch up on, bills, dishes, laundry, things that need to be mended etc etc that you just don't know where to start and end up feeling awful about the mess and being hard on yourself for not doing anything about it.

So start with writing a list, what need to be done? Group thing stogether in things you can do on your own, things you need more information to do (how are you going to get it? What is the first step?), things you can do from home and things you need to go somewhere to do. What is the most important thing on your list? If it's hard to prioritize, always put your own basic physical needs first. Have you eaten today? Drank enough water? Are you warm and relatively comfortable? 

Then you are ready to timebox. Look at your day, and fit in a 30-60 minute block of time to get started on doing the stuff on your list, NO MORE! I know it's tempting to be ambitious, but trust me, if you focus for 30 minutes on doing just one thing, you will really get somewhere and it will feel great!

Start with the smallest or easiest thing on you list so you get rolling, and then just keep working without distraction for the set amount of time.

The comes the hardest part: when the timebox is over:

what you're doing... even if you're not really done, you got further along, and you can put in another timebox tomorrow... remember max 2 hours!

And then: pat yourself on the back, put a big grin on your face, and go do something relaxing and fun to celebrate your awesomeness :)

# 29 Gentle warm ups

For those who suffer from RA and other rheumatic diseases, doing mild physical exercise in the morning is a must if we are to function at all.

I've found that starting the day with a short 10 minute warm-up sequence really lowers the pain and helps me function much better through the whole day.

The one I use is really simple and is used in Chinese Guoshu (kung fu) classes in the Wutan lineage of Grand Master Su Yu Chang. I´ve practiced with Sifu Paolo Castaneda at Oslo Wutan.

The warm ups are basically a system where you go through each of the major joints in the body starting with your feet and rotate every joint in a circular motion, 10 times to the left, 10 times to the right. You can try out and find your own way of doing this, one that works well with your specific condition, and possibly find some guidance in this amateurish description:

Start by standing straight, feet together.

Lift left heel off the ground and rotate the ankle joint by making small circles with your heel: to the left 10 times, then change direction and make circles to the right. Repeat with right foot.

Knees: feet together, hand on knees, bend your knees and keeping them together make small circles, both to the left and right. Here's a video showing what it looks like (by a school that practices kung fu for health).

Hips: stand with feet shoulder width apart, knees slightly bent, hands on hips.  Rotate hips in circles first to the left then to the right.

Hands: stand straight, arms in front of you, rotate hands from the wrist, first to the lefts then right.

Elbows: arms out to the side, hands pointing up. Let your hands fall out sideways and down while keeping the elbow in the same place, and rotate underarms in circles like a windmill.

Shoulders: Both arms pointing up. Let one arm fall forwards while the other falls back, continue arm swings in circular motion. 20 repetitions on each side.

Twisting back massage: Stand with arms shoulder width apart, knees slightly bent, twist your body left and right from the knees up, letting your arms swing around your body, slapping your torso as you move rhythmically move from side to side. gently massaging the body as you do.

All done, pat yourself on the back and smile :)

PS... is this too complicated? Maybe I should just make a video...

#28 Overcome perfectionism!

I have met many professional patients in my time, and one thing I often find is that they are very often wonderful people who set extremely high standards for themselves.

And if they set high standards in their working and private lives, you can be sure that they set high standards for their healing too. This can mean that the burden of trying to "be a good patient", with all the guilt and shame and immense pressure to heal, or just cope with, a disease in a constructive way becomes such an immense load that they in the end buckle from the stress and strain.

I have had a serious burn-out as a professional patient. It was hard to understand at the time, I didn't have a job, other than taking care of my health, no family placing great demands on me, but my own demands at managing to "WIN over my health problems" was pressure plenty. The constant inner stress of knowing that there was something I could do to get well, not knowing what, trying everything, and all the while feeling my health gradually deteriorating was just too much to handle. The burn out started gradually and got to the point where it was physical, I could hardly move a limb, lift a full glass of water to my mouth or chew solid food. I could only stand up short periods at a time and had very little motoric control. My short term memory was gone and I couldn't even read.

This was 6 years ago.

In getting back to health the first thing I had to do was let go of my perfectionism.. or.. at least tone it down 10-12 sizes. And the funny thing was, once I gave up being perfect as a patient, I started to find all these small solutions that really helped my health. Little by little, practicing this way of thinking and using the tools I have picked up on the way has allowed me to live the life I have today, where health is no longer a major issue. I have a job, I'm writing my second book, and I have a wonderful boyfriend, and good relationships with all my loving family and friends.

That's everything I wanted when I was striving to be perfect, but it seemed like my struggling was just pushing it further away.

Perfectionism is the anti-thesis of wellness, and come on, you owe it to yourself to feel good :) Whatever your life looks like today, and whatever problems your are struggling with, I promise, it can get better. Remember, whatever you dream, you can have, right?

Do you set high standards for yourself and others? Are you very goal oriented and want to succeed? Has you wish for perfection sometimes led you to give up before you even begun? If you think you may be a perfectionist you can take this quiz to find out more... it's actually rather funny...

And then read this advice, from Lance Armstrong's Live Strong Foundation... and be sure to check out the tips in this blog post on Overcoming Perfectionism – 5 Ways to Stop Trying to be Perfect by The Adventurous Writer.

#27 Power Nap

It's time to applaud the benefits of the Power Nap.

Apart from it's obvious benefits for overall well being, a short rest, where you gently ease into semi-consciousness and then come back gradually, lowers stress hormones, which aggravate your sensory perception of pain. For those of us with muscular pain, it's a great way to hit the "reset button". Your muscles relax and up to 60% of the pain may disappear as you come back to alertness.

Dr. Sara Mednick, a scientist who is leading the way in napping research (hihi...) says that napping in general benefits heart functioning, hormonal maintenance, and cell repair. She says that a power nap, meaning a 20 minute nap, maximizes these benefits. Check out her book "Take a nap!" if you want more tips, or check out some of the myriads of pages on "how to power nap".

It make take some training to go into controlled deep relaxation when you want to, especially if you are stressed or in pain, but it's an ability you can practice and improve.

PS: Napping makes you smarter too: Researchers at Nasa found that a 30-minute power nap increased cognitive faculties in people participating in controlled tests by almost 40 percent!

#26 Wear good shoes

Especially if you have back pain you will notice tremendous difference in the severity of the pain just by changing your footwear. Many other musculoskeletal conditions also improve, and I notice it really affects my neck pain and head aches. Well cushioned weight distribution with good support is the thang, and now if they can merge that package with snazzy design, it will be worth the investment for any chronic pain patient.
Exactly what shoes to get is a very individual question, and I recommend you get professional advice. Most bigger cities have specialized shoe stores where they actually test your walking by filming you on a treadmill with and without specialized footwear before advising you on what shoes to buy, and they have physiotherapists working there. Well, that's the place you want to go to.

If you can't find such a place, or won't be able to get to one for a while, find the best place you can and request their help. For excellent shock absorption and support, aerobic shoes can actually be really good, though they tend to wear out quicker than other more sturdy outdoor shoes. It may be worth getting a new pair every year if it helps your pain. I used to get special shock absorbing orthotic inserts and got good help from those, but recently I tried out  MBT's and they definately changed the way I walk, and help the pain a lot.

If you have herniated discs, shock absorption makes such a huge difference I would recommend you to go out and buy new shoes right away. And girls, forget about the high heels. It's just not worth it. Some beautiful sequined ballerinas with shock absorbing heel inserts will allow you to move freely (maybe even hit the dance floor?) without provoking a pain spike.

#25 Reach out and touch ... ehm.. something...

Today's tip is about the marvelous pastime called "stretching". To stretch is a verb, which means it's something you should DO, not just think about.

Stretching increases flexibility, improves range of motion of your joints, improves circulation and blood flow to your muscles (which can speed recovery after muscle injuries) and last but not least: Stretching can relieve stress.

Stretching in itself is a good help for muscle pain of varying kinds and is often part of the treatment of fibromyalgia and arthritis. 

My tip is to find some good stretches that feel right for your body, and practice them in moderation after a gentle warm up. Build your own little arsenal of specific excercises that fit your aches and pains, so you can increase circulation where you need it, without placing strain on areas that will hurt more if they are subjected to stress.

If you suffer chronic pain for extended periods and your muscles get the opportunity to gradually tighten up, this may cause for secondary pain when the muscles become too tight, so find fun opportunities to work on your flexibility... like on the couch in front of your favourite TV-show.... ooops... I mean... that is of course if you haven't already trashed your TV...

The best way to stretch is in series, just like many other exercises, find the right position and hold a 20 second mild stretch, then relax for a minute, 20 seconds stretch again, then relax half a minute, and finally a whole minute slow stretch.

Remember, muscles are highly mouldable, living, breathing tissue. They want movement and exercise!

# 24 Detox

While we're on the "back to nature" track: Ok, so this is not my favourite topic, but well... I know it's worked for a lot of people so it's worth writing about.

What do I mean by detox? Well, here's a very basic intro from about.com:

"A growing body of research suggests that many of the chemicals we ingest daily through food, water, and air can become deposited in fat cells in our bodies. A diet that lacks certain nutrients may also impair our natural ability to detoxify chemicals, which further leads to their build-up in the body.
The cumulative load, called the "body burden", is thought to lead to illness and has been linked to hormonal imbalance, impaired immune function, nutritional deficiency, and an inefficient metabolism. Signs are thought to include indigestion, bad breath, fatigue, poor skin, and muscle pain."

So a natural detoxifying diet is meant to cleanse out build-up that may be causing or aggravating muscle and joint pain. Though medical doctors usually question the effects and challenge the scientific basis of this theory, many natural clinics that work with rheumatism and muscle pain place great emphasis on detoxing. 

I have done it several times but not for many years now, so - ouch - have finally decided another round, two weeks on herbal detox supplements, no processed food or sugar but loads of water, fresh fruit and veggies.

It's another one of those things that just feel intuitively right for my body, but which are kind of hard to include in a normally hectic daily life.

Especially when you are on heavy meds, it can be really beneficial to do a mild liver detox once a year, and you may experience much greater effect of your medication afterwards. Proceed with caution, and only if you feel that this seems right to you.

PS: I have to admit that I did the "putting planks on my feet" thing again yesterday and went skiing. Ouch. I think it was worth it. Maybe. Ouch. Or maybe my Norwegian genes are just trying to trick me into enjoying it?

#23 Commit to CANI

I CAN.... backwards is CANI: an acronym for Constant And Neverending Improvement (yup it's misspelled)

This term is a translation of the japanese KAIZEN, a way of thinking that allegedly leads japanese companies to great success, and can also be used in your personal daily life.
The concept is simply: in stead of focusing on the need for big resource-demanding changes, you commit to Constant And Neverending Improvement, ergo incremental small steps in a positive direction.

It's a concept that is easily adapted to health problems. It may be easy to focus on all the things we don't have, and think that everything would be, and will be, better once we just have all that money, or lose 20 pounds, find a cure for this disease, can afford that operation, etc etc... In effect setting the goals unrealisticly high, so we don't actually have to DO anything about them.

So instead we decide which parts of our lives we would like to improve and commit to make constant and never ending improvement in those areas, doing a little bit better every single day.

If you want the whole explanation of CANI I recommend Tony Robbins "Lessons in Mastery" audiobook, it seems rather overpriced on amazon, but I'm sure you can find a better deal.

#22 Wear natural stuff

Natural fibres are good for us and good for the environment. Many auto-immune diseases come with the bonus of allergies or just increased sensitivity to chemicals and pollution. That means that if you have an auto-immune condition, you might be increasing your symptoms by wearing stuff that provokes immune reactions..

So check the tag on your favourite sweater, and take special note of the material in the clothes you wear closest to your skin. And next time you go shopping, look for natural, organic fibres, like the supercool shirts in organic cotton and bamboo that Lynnea and Brian at the Squid Ink Kollective make!

#21 Try something new

Following yesterdays topic about TV, my tip today is to try something new.

This is me being held in the air in a "one sided warrior" acro yoga pose in a workshop I was at 6 weeks ago.

Before I got Rheumatoid Arthritis I danced classical ballet 3-5 days a week. When the RA set in the doctors told me I might get lucky and get a remission, which I did. After my third spinal surgery I have been working hard to rebuild strength and flexibility for 4 years now, and last summer I wanted to give yoga another try, so I went to the international yogafestival at Ängsbacka.

One morning I was planning to attend a workshop on yoga and meditation for stress reduction, but forgot my mat and was late for the beginning of the class. I came panting into the training hall after everyone else had sat down in a circle and quickly grabbed a mat and sat down with them, when this funny looking guy says;

"Hello and welcome to this class in Acro Yoga for beginners..."


Wrong class...

Of course I should have got up and left right then and there, but I was too self-conscious. I figured I'd stick around until a quiet moment allowed me to sneak out silently. We did the warm ups and that was ok, then we were paired up, and the instructor showed us some beginning exercises, where one person lifted the other in the air on their legs and it looked completely crazy and utterly impossible for me with my health conditions.

But my assigned partner was really friendly and it was hard to leave her high and dry, so I played along with the exercises without actually having to try any heavy stuff. (I try to never excuse myself and not participate because of health problems anymore, as I find it just limits me so much to draw attention to the things I can't do. It's better to just silently nod and work around it.)

Then we were asked to pair up again, and I find myself eye to eye with this blue eyed goddess who asks me "Have you been flying yet?" ("flying" in acro yoga means being lifted up in the air) and I say "...noooo", and she says, "well you're going to now!" and like it's the easiest thing in the world, she gives me a radiant smile, takes my hands in hers and just picks me up on her feet and lifts me into the air...

... and you know what? It wasn't hard at all, and it didn't hurt, and before I knew what had happened, I was flying!!

I laughed and cried that day, I was so overjoyed to have found some kind of physical training that was almost as fun as classical ballet, but actually involving two people who help each other. Dear Anne Mette, the blue eyed goddess, became a good friend and we flew together several times and I will never forget the moment we met, or her beautiful smile.

I decided to join the same instructor in a weekend course in acro yoga a few months later, and after a few sessions I could do fun stuff like the sideways warrior and the bat:

I choose to believe that this means anything's possible... I've heard the saying "when pigs can fly..." and I haven't seen that happen yet, but when back-broken, RA-riddled whiplash-patients can fly...? That truly is a miracle :)

Sometimes we need a little help, or a mistake like entering the wrong room at the wrong time to dare to try new things... but wow... how fun it is!!!

#20 Turn off the TV

How many hours a day do you spend in front of your TV?

Any idea what you could do with that time?

Statistically, the average American spends 4 hours and 45 minutes a day in front of the TV, that's 33 hours a week, almost as much as a second job. If you have health problems and spend a lot of time at home, chances are you end up spending even more time feeding your brain with stuff from the little box. Yes, I know it's an easy way to relax and slip away from your worries for a while, but imagine what it would do to your health if you spent half the time you spend in front of the TV on learning something new, exercising, or hanging out with people that are good for you?

What would you rather be doing?

Growing fat and dying young, or trashing the TV set and finding a new hobby?

#19 Go Balmy!

Some of us can´t help ourselves, we just have to rub it in.

Rub in ...  the ointment that is... the good, all natural pain relieving ointment.

Like Badgers, or one of the less natural ones, like Tiger Balm, or Bengay, or the absolutely not natural ibuprofene cream that works really well on many muscular aches and pains. And while you're rubbing it in, you get the benefit of closing that neural gate and improving circulation, so it works three different ways at the same time!

Might not feel heavy duty enough when you're over level 6 on the pain scale, but it will often bring down the pain a notch or two if you use it earlier.

#18 start your day with a cold shower

Oh yes. You know you want to:) Just 15 seconds in a cold shower first thing in the morning will jump-start your noradrenaline and dopamine production, giving you a blissful rush and boosting your energy levels for several hours. It also boosts your immune system, increases circulation, and is a well known natural remedy for mild depression.

In my experience a cold shower is the quickest way to significantly alter you perception of pain, save by hitting yourself in the head with a frying pan, and so much less painful :D

I learnt this from an amazing lady, Elisabeth Engqvist, who is a yoga instructor specializing in Kundalini Yoga and stress management. Together with her husband, she runs Yogabolaget, and hosts classes, workshops and teachers' training courses all over Sweden and many places in Norway. She advices cold showers to treat burn out and prevent stress, but I found it works really well for chronic pain too. And you can always turn up the heat a while after you've had that initial rush.

But of course, you should avoid cold showers if you have a heart condition.

#17 Hang out with people that are good for you

Today's tip is very very simple.

I'll say it once, I'll say it again: good people are good news.

If you have friends who drain you, who always leave you feeling upset or confused, or drag you down in any way, that's totally OK. It happens. But maybe you don't need hang out with them in those periods when you yourself have enough on your plate?

When we struggle with chronic health problems, it's easy to feel a lot of empathy and also recognition with others who have serious problems of some kind. Somehow we don't feel so "weird" if we are with other "weird" or dysfunctional people. But this might just end up draining you even more, which can increase depression and also the subjective experience of pain.

My experience is that if you have problems with chronic pain, choose to spend the time you can (your "out and about time" is very limited, I know) with people who are good for you, people who make you smile, people with whom you can feel happy, energetic, optimistic, lively and healthy. Don't have too many of those right now? Well then it's time to find some new friends, or reconnect with old ones you haven't seen in a while.

#16 Listen to self help audio books

Yayy, it's Saturday, maybe my favourite day of the week. The sore ski-muscles are softening up and my body is slowly returning to normal. Pain level? Mhhhm... 2. That's pretty amazing for a cold winter day!

Today's pain-free tip is to listen to self help audio books; an excellent activity for those periods when you're so worn out that you can't bring yourself to exercise or go out and meet people.

The pain relief foundation has a bunch of good titles here, and this one by Dr. Arnd Stein is a complete program that uses well tested techniques like deep relaxation and autogenic training.

#15 Build muscle

Many inflammatory diseases (like rheumatism and MS) weaken you doubly, because while the pain and inflammation are consuming your energy, the inflammatory process is actually feeding on your muscle tissue.

This is something my good old rheumatologist taught me quite early on in my career as a patient, and she told me it meant that I would have to eat a lot of protein and make sure I got plenty exercise that built muscle, because my muscle tissue would be continually depleted by the inflammation.

This has a double benefit, because every pound of muscle burns 300% more calories than a pound of flesh (some people say it's much more, but the science is really shady), so you increase your metabolism drastically by building muscle.

And if you train wisely, you can build muscle that will support your spine in a way that drastically reduces back pain, by lifting the weight of your body and relieving herniated discs.

PS: and oh, I definitely built some muscle on that ski trip... in places I didn't even know I HAD any muscles... ouch...

#14 Accepting ups and downs

Life has its ups and downs. Some days I have a lot of energy and everything feels sweet, I can handle any number of unforeseen circumstances and laugh at the future. And other days, well... it's just not that sweet.

If you've lived with chronic health problems for a while, chances are that your good days are few and far between, and there are many days with very little energy, where you hardly seem able to tackle even the everyday challenges of normal life.

I find that just knowing this, and accepting it, can be very liberating.

Sometimes I have a lot of energy, other times I don't. The trick is to not identify too much with your perceived problems when you are in a low, because they always seem bigger then, and lacking the energy to deal with them, you may think that you will never be able to cope. But you can. Just recognize that you are low, you need to rest and do things which build you up, and don't make any big decisions based on how you're feeling at that stage.

Then get ready to surf the next wave.

#13 Get some fresh air

Ok, I admit, the research for this entry got a little bit out of hand. Since I am in the mountains this week, and I really want to be a good Scandinavian, well...have you heard the old saying that "All Norwegians are born with skis on their feet"?

No? Well, that is a very well known saying hereabouts, and let me just say here and now that it is NOT TRUE!
I am Norwegian. I was NOT born with skis on my feet, and honestly, I have never been able to understand the fascination. Where does this crazy idea come from, that people should put planks on their feet and drag themselves outside in the snow to run on top of frozen cold fluffy stuff? It´s completely unnatural!

And then again... I´m here... at a ski resort. It´s very beautiful outside... And the skis I got for christmas some years ago that have been standing in their vacuumed plastic wrapping in the attic, were finally approached.

My swedish colleague and friend Siri, apparently thought that we could just "go skiing"... but she had to show me how to put the darned things on my feet. And she was very patient when it took me 10 minutes to hobble the 100 meters down the road (I only fell once!!!)

At first of course it was horribly hard, I was scared (of falling and hurting myself), brutally humbled and it was cold. Then when we hit the actual ski tracks, it got much better, and well.. what do you know... it was actually really beautiful.

My pain-reducing activity tip for today was supposed to be "get some fresh air" because of course that´s one of the good and simple things that helps chronic pain: just go outside, move, breathe fresh air, get some oxygen to your lungs, brain and muscles. I didn´t mean that you should run a marathon or go skiing or anything...

Now I understand that I´ve probably gone and caused more pain, at least some really sore muscles... but right now, fresh from outside, with rosy cheeks and a good tired feeling in my body, I still think it was worth it.

#12 Bed of nails

What can be better, when you are in pain, than to voluntarily subject yourself to MORE pain? Yes, those ancient underfed yogis were right: a bed of nails is the best bed to lay on!

Now this thing - The Yantramat - has been overexposed in Scandinavia the last year or so, but still... despite the hype, I actually find that it works quite well.

I guess, once again, it's because the endorphins (God, I love those things!!!) that are released by laying on the more than 8000 sharp spikes on this thing. They say it's acupressure, but I don't actually believe that, because acupressure works by pushing the synapses in the muscles, and this doesn't go as deep. I actually imagine that a real bed of nails, as in one with metal spikes customed perfectly to your body, would be even better because of the magnetic fields and energy lines in the body that are activated by metal, but I haven't had the time to make one yet;)

If I'm at level 4-6 it can actually take my pain all the way down for a while. And even if I'm on level 7-9 it always helps, and takes me down a few notches in pain intensity if I can just manage to stay on it for about 20 minutes and breathe slow and deep.

#11 Steam it up

Having retreated to the Swedish mountains for a week with our crew of 18 young project managers in training, I am very relieved to find that there is a sauna in our cabin.

Some facts about the trip:
We are in Branäs
It was minus 25 degrees celsius this morning and my eyelashes froze shut when I went outside
We are going to be working 10-14 hours a day for 4 days

The objective of the trip is to have a creative and fun start up of 12 new projects simultaneously, while my colleague Siri and I are leading the process and coaching the students. Driving for hours, and sitting most of the day, lots of work, heavy concentration, frosty trees and beautiful crisp mountain air. This is not the kind of activity that is very flexible when it comes to back pain, so I'm doing my best to keep mine in check.

Which is where the Sauna enters the picture: Ta DAAA!!!

A little room of luxury, just 4 square meters, but crammed with 4 giggling girls and heated up to 65 degrees celsius...we filled it with steam by pouring water on the heater until it got too hot for comfort, then we ran out and roll in the snow under the starry dark skies, and rushed back into the saunascreaming and shivering.


As I return after the second roll in the snow my back ache is melting away, and the muscles relax. Aaaaah... Wish I could fit one of these in my closet back home...

Here´s Joanna and me, mellowed after the trips between sauna and snow..

#10 Eat Dark Chocolate

Now this won't come as a surprise to anyone out there, but yes, it's true, dark chocolate has a natural pain relieving effect.

Apart from the obvious feelgood effect of sugar which often comes as part of the package when you eat dark chocolate, it's the phenylethylamine (PEA) in the cocoa beans that is the reason for this. Also known as the bliss chemical, PEA is otherwise released by the brain when people fall in love and stimulates release of those feel-good endorphins. Dark chocolate also contains magnesium which can ease aches and pains because it helps muscles to relax.

Apparently cocoa also has good preventive effect on migraines by stimulating anti-inflammatory proteins in the brain, eases emotional stress, and reduces risk of heart disease.

But of course this effect won't come by eating the low grade chocolate you get at your regular convenience store, which has hardly seen a cocoa bean on it's way to the candy shelf. You need the kind that has 70% + cocoa solids in order to get the beneficial effects.
My favourite kind Divine is organic and fairly traded, and I buy it at the local health food store.

Enjoy in small amounts of course :)

#9 Create your own Pain Scale

Have you learned how to use a pain scale yet? If so: GOOD! If not: you're in for a treat:)

Doctors usually ask you to define your pain according to some scale, and if you actually make your own system and learn how to use it this can really help you deal with your pain in a more constructive way that the regular *pain increase = PANIC = pill popping* way.

I use the model that is used at the Mayo clinic, which is a numerical scale from 0 to 10. My pain clinic in Oslo used a similar one, and my back surgery clinic in Sweden uses the VAS scale: Visual Analog Scale (pain marked by placing mark on a line ranging from 0 to 10)

The visual version can look something like this:

This is the model used at the Mayo Clinic:

0-1 No pain
2-3 Mild pain
4-5 Discomforting - moderate pain
6-7 Distressing - severe pain
8-9 Intense - very severe pain
10 Unbearable pain

My personalized version looks like this:

1-2 I am A-Okay!
3-4 May need to take a couple Ibuprofen or Paracetamol. My glance is unfocused, I'm getting nervous.
5 Pain alert.. Its getting harder to concentrate, I should probably get home ASAP and cancel any plans.
6 Bad pain: I need to take prescription pain killers and lay down
7-8 Agony: I hate my life... Focus on breathing, anything that can distract me from the pain is welcome
9 I am very weak, can hardly breathe
10 There is nothing but screaming pain. Suicide is an option.

Thankfully, these days I am rarely above 5 because I've learnt how to prevent it from getting out of hand.

The key to learning that is to identify the different stages, and to know which strategies to implement at every level.

So: What does your pain scale look like?

Start by drawing it, and write out the symptoms at each separate stage to analyze your own pain behaviour. What are your strategies today, and how can you improve them to decrease the pain at an earlier level?

Have fun:)

#8 Balance

Strengthening your core and stabilizer muscles will change the way your nerves function and help decrease pain.

Something happens in the body when we manage to activate the very small fibrous muscles that hold and sustain the larger muscles in the body. It creates circulation and support in a way that is very good for us dealing with chronic health problems, who are often weakened by years of pain.

That's why it's good to work on your balance. When you balance, you are training the inner supporting muscles.

One very simple way to do this is to train on standing on one leg. Do it gradually, try 20 seconds on each foot the first time, then aim for 40 seconds. You can lift your foot higher as your balance get better. Often one leg is way weaker than the other: good! Now you know what to work on. Always try to train your body to be as evenly strong as possible. If the left side is weaker (it often is) focus extra on that side and aim to become more symmetrical.

If you are wheelchair bound you can train core balance on a balance ball, and strengthen inner arm muscles by small weight training. But I sincerely hope that if you are wheelchair bound, you have a good physiotherapist who is working with you on this already.

#7 Envision your future

Did you dare to dream lately?

If not, then I think it's time we did a little exercise...

If someone told you ten years from now that they could not believe you ever had any health problems, because you look and seem so wonderfully fit, how would that affect you?

Can you see yourself in that future? What do you look like? How do you move your body? How do you speak? Try closing your eyes and make that image as vivid as possible.

Then look at your life today and just notice the differences. Now, what do you imagine you need to do in order to get closer to that future?

Can you even imagine a life without health problems?

Let's just pretend that it's this easy that if you can dream it, you can have it.
So it's time to start practicing dreaming. Just how healthy do you want to be? Just how happy do you want to be? See beyond the doctor's appointments and the new treatment you're trying out. Try to imagine yourself 100% well, fit, energetic and bursting with vitality. What are you going to look like then, and how will you feel?

6 years ago I was pretty much horizontal all the time, and could hardly leave my appartment. Today I practice acro-yoga and kung fu, and people I meet do not believe that I ever had a health problem. I still have pain, but it hardly ever shows (and only to people who know me well). I remember laying on my bed one evening about 7 years ago dreading another night of excruciating back pain and just being so tired of it all I didn't know what to do with myself. That's when I got this image, like a dream I saw myself in a healthy future, laughing, dancing, surrounded by friends and family, where health wasn't even an issue for me. That image gave me strength, and somehow it lit my way and helped me make the right decisions in the years that came, and one day I looked at my life and and saw I was actually living that dream, only it was even better than I imagined it....

I believe that to go where you want, you need to know where you're going. Haha, that's a tricky one. It means you have to sit down and define what you want, put it in words and create pictures that go with it. Start creating the road map, don't drift along. Problems you have now won't necessarily be there for ever.

#6 Smile

Yep, it's true: smiling reduces pain!

The buddhists have apparently know this for a very long time: when you smile, your brain releases chemicals that make you feel calm and happy.

Aha, you thought it was the other way around, that when your are happy, you smile? Well so did I. Apparently this is one of the things that falls into the "tricking your brain" category.

But when you are in pain and your life sucks you may not feel like smiling, it actually might feel like the most difficult thing to do.

Yesterday I was at the airport in Frankfurt, flying back to Norway from Christmas holiday with my sister in Austin. Sitting in an airplane seat for 9 hours had really got my back and neck aching, and the neck pain was quickly approaching the level where I have problems functioning and can't see straight. I was too tired to get up and do much about it, my otc painkillers hadn´t worked and I didn't have anything else with me. I remembered this tip, and vainly tried fake-smiling for a while but really couldn´t get very into it.

Then when I was going through security, this friendly man was searching my bag for security hazards, and he came across the bottle of "Texas Roadkill Barbecue Sauce" I'd got for my father in Houston. The security officer (who looked sort of like Santa Claus) wiggled his finger and tried to look very stern; "Now this is an explosive, young lady, I can't let you bring this on the plane" and then I started laughing for real. He let me off (thankfully he didn't open the other bag, that had the slightly naughtier present for my boyfriend in it), the roadkill sauce was history, but I just thought it was all so funny I couldn't stop grinning.

And what do you know? A little while later the pain was gone.
Thank you Frankfurt Airport Security!

That experience sure helped me understand this theory, and now I've looked it up again and found lots of information about how smiling (even fake smiling!) releases endorphins, natural pain killers and seretonin, which helps you relax, it also lowers blood pressure, boosts your immune system and makes you look younger.

So Why wait?

Can´t even imagine smiling? Here's How And here is some inspiration :)

#5 Wear wool (or hang out with furry animals)

I don't know why, but wool helps muscle pain.

When I have really strong back pain, I lay on a sheepskin and it has good effect. If you don't want to hang around dead sheep, option #2 is lambswool directly onto the skin. They have really good soft lambswool stuff out there to wear under your other clothes, but the prickly stuff can be great too because it has double effect, it stimulates and tricks the sensory signals (as mentioned in post #4)at the same time that it warms.

In other countries, I have heard them say that cat...skin is supposed to be very beneficial to muscle pain :& but if that means you have to kill and skin a cat, I'm not going to try it...

But... I would imagine that this should probably work even better if the cat is alive, warm and furry...?

Which would mean that putting a purring cat on your aching body is excellent medicine, how about that for a feel-good cure?

Yayyy :D

#4 Trick your sensory signal system

Hypersensitivity means that the same health problem hurts more the longer the problem persists, and is usually the reason why chronic pain patients can fall into a negative spiral.

Technically, a doctor can describe this way better than I can, but I usually explain it this way:

Imagine that you hit your knee against a sharp corner.

It hurts.

Imagine that you hit the exact same spot on another sharp corner the next day. What happens? IT HURTS MORE.

Now imagine that you (accidentally) hit the exact same spot on your knee against a sharp corner every single day for three months.
After just a few days even a very mild touch will hurt really bad, and after a week or two, just the sensory signal of fabric brushing against your knee is going to hurt like h%&$.

That's what living with chronic pain is like.

I imagine that the nerves are like network cables in my body. And when a certain cable has been jampacked with signals over a period of time, lets say it's been highly trafficked because I've had a lot of pain in a specific area, the brain increases the bandwith, i.e installs broadband instead of a 56 k modem connection...or ... it builds an eight lane highway, where there used to be a little dirt track through the jungle...

So, your brain and your nerves are exaggerating the pain signal, tricking you to make it feel alot more painful than it needs to be. Good thing we can trick them too.

The easiest way to do that is by stroking the skin, because the sensory signals from the skin travel by a different nerve system than the pain signals, there's some sort of "gate" into the brain which means that while the skin is being touched, the nerves want to transmit those signals to the brain, and so there
is less bandwidth left over for the pain signals!!! So simple, yet so effective.

(Btw... my physiotherapist described this in a much better way... I'm sure there are smarter explanations out there)

Anyway. It works. Try it :)

Or even better, have a loved one do it for you.

Choose a part of your body that has little or no pain, yet is quite sensitive, like the inside of your underarm maybe? You have to stroke it gently for a while before the "gate" is closed for the pain signals, and it doesn't shut out everything, but maybe 60%. Which is just about as good as many prescription drugs out there... no drugs, yet less pain = win/win :).

#3 Listen to a friend

Calling on a friend, inviting somebody over or just making a phone call.

Sometimes the best thing you can do is listen to somebody else talk about issues they are dealing with. You don't have to say much, and you don't have to tell them about your own problems, just focus on active listening. Ask questions to help them explain, and repeat things they say to clarify and show that you're taking in what they are saying.

It may help if you can identify with what they are talking about, and you might want to draw on your own experience using the "feel, felt, found" line of communication;

"I understand how you feel - I have felt the same way....(insert a situation from your own experience).... , and here's what I found...(insert what you learned - the insight you want to share)."

If your friend reaches a point where they've identified and described some kind of challenge or problem, simply ask them what they are going to do about it.

Usually they have all the answers they need, they just need somebody to listen. And for you, it's an excellent way of not having to think about your pain for a while.

#2 Learn about your condition

It's Saturday, and a great day for surfing the internet or going to the library. Welcome to the world of the professional patient, it's time to get started on those self-studies!

Knowledge is power, and if you have a health condition, knowing more about it can help you get better. If you have a diagnosis, make it a point to read different descriptions of it, and take notes. Collect information from as many sources as possible and try to understand it so well that you can describe it to others in your own words.

If you suffer chronic pain without a specific diagnosis, you should learn more about the central nervous system, about pain signals and about chronic pain.

Set aside an hour or two and start with the basics. Find websites or books that work for you, it can be good to start with an illustrated textbook if you want to get a visual understanding of what's going on inside your body. Check out the neural pathways, read about the difference in nociceptive and neuropathic pain for example, and see if you can find information written both by doctors and by patients to get different perspectives.

This can be a good place to start:
The American Chronic Pain Association
And this page is excellent for a more in-depth explanation: Basic Science of chronic pain.

#1 Get Physical!

Aerobic exercise is definately not something you're up for when you've been in serious pain for a long time, and that's why I got pretty pissed off at the doctor who told me this...

Back in 2003, I'd been through hell with my whiplash injury, when several months of waiting and getting sent from one place to the other brought me to this supposedly specialized neurologist who simply said: "There's nothing we can do for you, but you should try getting your blood pumping by doing aerobic exercise 20 minutes a day."

I was getting my blood pumping right there and then, but maybe not in a very healthy way. "Who the %&$/ is HE to tell me to exercise?? Doesn't he know what kind of hell I'm going through, I can hardly walk to the kitchen and back, and here this guy is telling me to get fit?" etc etc etc...

But a while later I got to try it out, inadvertently of course, as I would never dream of actually following the advice of a doctor I didn't get along with... but I had a good day and was walking up a steep hill, first it was just really tough and my breath was labored, but after a while I noticed that I reached that level where my breath sort of evened out and got calmer, I got more energy and the pain was completely gone, my body was warm and just felt great for the first time in a looong while. Afterwards my pain was significantly lowered for the rest of the day, very noticably so, and I came to remember that doctor and his advice...

I did some reading up and found out that getting your breath going like that maximizes the amount of oxygen in your blood. Your heart beats faster, and increases blood flow to your muscles and at the same time your body releases endorphins, natural painkillers that make you feel good for a long time afterwards. All natural and even builds some muscle.

It will always be difficult to motivate yourself to move much at all when you're feeling awful, but it's definitely worth a try. Specially since it's free and it feels great.