 Welcome to Happiness Isn't Brain Surgery with Doc Snipes. This podcast was created to provide you the information and tools Doc Snipes gives her clients so that you too can start living happier. Our website, docsknipes.com, has even more resources, videos and handouts, and even interactive sessions with Doc Snipes to help you apply what you learn. Go to docsknipes.com to learn more. Welcome back to part three of Happiness Isn't Brain Surgery with Doc Snipes, practical tools to improve your mood and quality of life. And we're continuing to talk about living with pain and chronic illness. In this, the final segment, we're going to review medical and non-medical interventions for pain. Remember that any pain intervention should be cleared by your doctor or care team before you undertake it. So, medical interventions for pain, and I'm not recommending any one of these. I'm just telling you what's out there. Tylenol and your NSAIDs. They're over-the-counter medications like ibuprofen and naproxen. Those are out there, and people use them, but it's important to understand that they are not 100% effective for some people, and they're also not necessarily 100% without side effects. So you need to weigh the good with the bad when you're deciding how to address your pain. Opiates provide relief by attaching to opioid receptors, and when we're talking about opiates, we're talking about hydrocodone, Percocet, Vicodin, Lortab, those medications that you may get from your doctor after you have maybe an inpatient, outpatient procedure or surgery or something. They provide relief by attaching to opioid receptors. When that happens, the body stops making or cuts down on making your natural opioids when it's flooded with the prescriptions. So, you know, okay, that's fine because you're taking the prescription anyway. Over time, the body reduces the amount of opiate being let through, so you develop a tolerance. Your body says you're only supposed to have so much opiate, which is what the normal amount is that your brain would make, and you're flooding it with opiates right now. You're flooding it with painkillers, and after a few days, the brain goes, you know what, I don't think we need this much going through. So it starts shutting some of the doors, if you will, that the opiates are going through. This happens after only a few days. It is not hard to develop a tolerance to opiates, which is why they're so dangerous and so easy to get addicted to. When you stop taking prescription opioids, the body takes a few days to start making its normal level of natural opioids again. So your pain threshold may be markedly decreased. So you may feel achier. You may feel a little bit more lethargic. It's important to understand that that will likely improve in a couple of days. If you have concerns, call your doctor and ask. There are other interventions depending on what's causing your pain or your condition, such as muscle relaxants like flexoril and soma, gabapentin, which helps with nerve pain, SSRIs, your antidepressants. Remember I said in the prior presentation that serotonin is one of those neurochemicals that's involved in your perception of pain. Low serotonin means a lower pain tolerance. So sometimes people are given antidepressants, such as Simbalta, to help them feel less pain, to help them feel less achy. Also a side effect or a symptom, if you will, of depression is actually pain. So and Simbalta is not the only SSRI. It's just one that is commonly prescribed when there is pain that needs to be addressed. Nerve blocks, acupressure and acupuncture are also some techniques that can be used, prescribed by your physician to address pain, in addition to physical therapy and massage. Non-medical interventions for pain and chronic illness. So if your chronic illness doesn't cause pain, that's awesome. But it's still a chronic condition that is impacting your life. So what can you do on days that maybe your energy is really low because you've got chronic fatigue or your blood sugar is all over the place and you're having difficulty stabilizing it? Aside from doing the medical things that your care team tells you need to do to address those issues, you can use guided imagery, color imagery. Think of a color that you associate with pain or the condition or fatigue and picture the painful area of your body as red or if we're talking about fatigue, you may picture your entire body is that color and then imagine that color shrinking, fading or dispersing. So imagine it kind of pixelating and leaving your body and what's left behind is an image of you, a colorful image of you. So that's one way you can use color imagery to imagine fatigue lifting or pain going away. Symbol imagery. Think about what it feels like, what your condition feels like. If it feels like a knife sticking into your joint, imagine you're pulling the knife out of your joint and throwing it away. If it feels like an elephant sitting on your chest because of the anxiety and you don't feel like you can breathe, imagine the elephant getting up and walking away. Symbolic imagery can also be used to help you feel more calm. So imagine a place that's calming to you using all of your senses. How does this help? Well, number one, it gives you something to focus on besides the condition itself because when you're focusing on the pain or you're focusing on a feeling, you tend to feel it more intensely. If you've ever been sitting in one of the hard pews in church and you know, you're sitting back and forth and you're rocking back and forth and you're focusing on how uncomfortable you are, you're going to notice it a lot more than if you focus on what the preacher is saying or even what's in what's in your hymnal or something. So scenic scenic imagery can help you distract your attention. The key is really getting your mind to go there. So you want to use all your senses. What does it look like? That's obviously where we start. What do you see? And all the way down to the smallest detail, you know, if you're imagining a forest scene, it's more than just trees and a babbling brook. You know, you may see a little chipmunk and you may see a bird flying by. So you want to notice what you see, what you hear and pay attention. If you go outside right now, you hear more than one thing. If I walk outside my office, I will hear people talking. I will hear the construction that's going on at the other end of the complex. I will hear the traffic on the outside road. And there's a little mockingbird that is as loud as loud can be that hangs out outside my office and I will hear him. And on the mornings that I don't hear him, you know, it kind of startles me because he's always there and he's always singing. So you want to notice everything you hear. So be as in-depth as possible. What do you smell? You know, what do you smell in the air? What do you smell around you? And what do you feel? When you go outside, you'll feel the breeze or lack thereof. You may feel the sun. You may feel, you know, I don't know what else you would feel. But pay attention to all the different sensations that you're feeling. The more you can focus on that, the more you can really get down into the details, the less you're going to focus on the other stuff, the more immersed you will be in the situation, which can help you temporarily escape or get away from whatever condition is causing you pain or anxiety or depression. Mindfulness, you can choose alternate focus. Instead of thinking about the pain and how to relieve it or the condition and how to make it go away, think about something else. Choose to think about, you know, what you're going to do this weekend or focus on a picture that you've got on your desk. And remember as clearly as you can, what that time was like. Focus on everything in that picture. I find, unfortunately, when I focus on pictures, I usually find something that was out of place in the background. And I'm like, oh, I really should have cleaned the house better before we took the picture. But I digress. Alternate focus encourages you to just say, you know what, I'm not going to think about this right now. I am going to intensely think about something else. Deep relaxation and breathing through the pain. Sometimes pain comes and goes. I do this a lot when I stretch because I don't have really good flexibility anymore. And when I start stretching, it hurts. And so breathing through until my muscles start to relax is important. The same thing is true if you're having a bad headache or, you know, whatever symptom you may be having, especially if it's pain involved, breathing through it instead of starting to breathe shallowly and triggering a stress response in your body. Deep breathing also works against a stress response. So you're reducing your stress at the same time. Distractions, find them. If you can't change a situation, if you can't change whatever your symptoms are that day, distract yourself, find a book, start, you know, pick up a hobby, go do something else, go to a movie, whatever it is you can help yourself do to not focus on something you have no control over. And focus on one moment at a time. Instead of getting caught up thinking about three hours from now or next week, just stay in the present moment and focus on what you're doing. Hopefully it's something positive and distracting from your condition. So, you know, if you're watching TV, focus thoroughly on that television show. If you're reading a book, really get immersed in that. Anything you can do to keep your mind from wandering, especially to those negative places. If it wanders, that's okay. Just say, you know what, nope, I'm not going to think about that right now. Bringing my attention back to whatever I'm doing. Radical exemptance means understanding that life can be worth living even with painful events. Rejecting reality doesn't change reality. So, if I can say I really don't want to have this condition or I really don't want to hurt today, well, that's nice, but it doesn't change reality. So, throwing my little temper tantrum is not going to do any good. Changing reality requires first accepting it. So, I've got to accept that this is how it is. So, I can either choose to stay miserable and fight with it or I can choose to improve the next moment. Pain can't be avoided. It's nature's way of signaling something is a little bit wrong. If you go to the gym and you work out hard, you're going to hurt the next day. Does that mean that something's wrong that you need to go to the doctor? Probably not. You know, you need to use your best judgment with that. But it's your body's way of going, yeah, you worked out hard and you built some muscle yesterday. So, just because you have some pain doesn't necessarily mean it's an all hands on deck emergency. You need to know your pain and use good judgment about when to contact your providers. Rejecting reality turns pain into suffering. Remember I said throwing that temper tantrum does no good? Well, if I'm throwing that temper tantrum and I'm not getting my own way and it's not making the condition go away, it's not making the symptoms any better, then I'm going to start to suffer. I'm going to start to feel miserable and hopeless and helpless. So again, accepting it is what it is. How can I keep going forward is a lot more useful use of your energy. Refusing to accept reality can keep you stuck in unhappiness, bitterness, anger, sadness, shame and other painful emotions. Once you've accepted reality, then you can figure out how to deal with it. So you've accepted that whatever this condition is, it is what it is. You've got it. You've got to figure out how to deal with it. There are some other non-medical interventions you can do to help yourself relax and not experience as much pain, discomfort or exhaustion. Stretching can help. When we're stressed, we tend to tighten muscles throughout our body. Most of us tighten muscles in our neck and our back, which hurts, but it also uses a lot of energy, which further tires us out. So stretching and balancing exercises can help release some of that muscle tension. Ice or heat packs are great for not only pain, but if you've got muscle tension, they can help with that. Massage, TENS units, you can buy those at Walmart now, which is really nice. They're the little units that you attach that send little electrical impulses that basically bombard your nerves and confuse them so they aren't sending the pain signals. Improve your sleep. Better sleep means your neurotransmitters are better balanced. You're probably going to have more serotonin, which means you're probably going to have a higher pain tolerance and be less fatigued. And do more things you enjoy. Yeah, it's not going to fix the condition. If you've got diabetes or heart disease, doing things you enjoy is not going to make that go away. But you know what? Using your energy to do things that make you happy is probably a whole lot better use of energy than doing things that make you unhappy or just sitting and stewing about the fact that this isn't how you wanted things to be. And stress management. Stress causes digestive upset and pain. Most of us, when we get stressed out, have some sort of stomach stuff that happens. Back pain, upper back pain, lower back pain depends on the person, but a lot of us get back pain when we get stressed. Migraines, headaches and jaw pain. When you're stressed, you may clench your teeth more, which can contribute to feelings of pain in your jaw. And if you're like me, cracked teeth. So you want to be aware of the impact of stress on you and the impact of stress on your condition. We know that stress makes it harder to manage blood sugar levels. We know that stress is going to make fibromyalgia and lupus and some of those other things worse. So we know that stress is typically not your friend. A little bit of stress is necessary to get you excited to get up off the couch. But this negative stress is what I call it, the anxiety stress. That's not what we want. That's only going to make your condition worse in most cases. So things you can do to manage your stress. Some people like to meditate. Some people hate to meditate. So if it's not for you, that's okay. That's cool. Distract. Don't react. When you're feeling stressed sometimes, there's nothing you can do about it. So go through, figure out what you've got control over, what you don't have control over. You can, the things you have control over, you can work with that. But if there are a bunch of things you don't have control over, you may need to just distract yourself from whatever's going on. So you can give yourself a breather. Identify your most important values and decide for yourself when stress happens, is stressing over whatever this is, getting you closer to or further away from your goals and values. Is stressing over, you know, I can't even, is stressing over having this diagnosis, getting you closer to your goals and values? No. Because stressing over it doesn't change it. It actually makes it worse. And one of your goals and values is probably not to be sick. So stressing over this is moving you away from your goals and values. So instead, what can you do to move toward them? One of those things would be following your care plan and doing what you need to do for your body to get healthy, but also doing what you need to do to keep your mind healthy and happy. So pain is inevitable. We know this. Many people struggle with chronic conditions, including TMJ, migraines, depression, fibromyalgia and pain. Regardless of the condition, if you've got a chronic condition that sometimes makes you feel or function on a less than optimal level, it can impact your mood, your thoughts, your behaviors, what you do on a day-to-day basis, and your relationships. Now, some of that is just the consequence of a change. But some of that is the consequence of how you approach the change. If you approach it negatively, if you're unpleasant, if you're angry, if you're bitter, if you're resentful of all the people who can do the things that you can't do anymore, it's going to have a much more negative impact on you than if you are happy for them that they still have those abilities and figure out how to accept the fact. That your life has changed some, but it doesn't mean it's changed for the worse. It's just different. Addressing pain will help reduce related anxiety, depression, and anger and fatigue. There are a variety of methods for pain management when pain does arise, so it's important to know that there are medical and non-medical things that you can do. Too often, people just want to reach for a pill to make it go away. And while that may make it go away for four to six hours, it's probably not addressing the root of the problem. So long-term pain management requires non-medical interventions as well. Pain management requires a comprehensive approach, which addresses the physical causes of the pain, you know, what's triggering it, the mood issues associated with the pain. Your social supports, so you have somebody to lean on when you're having a bad day and you're not surrounded by people who are going to make it worse or make you feel guilty about it. And you need to address your sleep, because we know that inadequate quality sleep is going to probably make you more likely to experience more pain. Happiness isn't brain surgery, it's an educational podcast and not a replacement for medical advice. If you like this podcast, subscribe on your favorite podcast app or join our Facebook group at docsnipes.com slash Facebook, or join our community and access additional resources at docsnipes.com.