stress - Musculoskeletal Australia (MSK)

07/Dec/2022

Travelling can be an incredible adventure, but it can sometimes cause anxiety and stress if you have a chronic condition. When you’re out of your normal routine, it can be impossible to know how you’ll feel each day and how this may affect your trip.

Here are some tips and tricks to help you get the most out of your trip and have a fantastic time.

“I wish I had never gone travelling.” Said no one ever.

Plan your trip

Take time to plan your trip carefully. Being proactive before you go away allows you to plan around your condition rather than have your condition disrupt your trip. You know how your condition affects you – using this information when planning will put you in control.

Give yourself plenty of time to pack and complete any tasks or household chores you need to do well before the day you leave.

Rest up. Even though you may be going on a holiday for rest and relaxation, try and get some rest before you leave. That way, you’ll have more energy to do and see what you want when you arrive at your destination.

Make your itinerary realistic. When you’re on holiday, it’s tempting to pack as much as possible into every single day; however, this can often lead to increased pain and fatigue. Plan rest days or less active days and create an itinerary that’s flexible depending on how you feel each day. It’s better to do less and prevent flare-ups than do too much and end up unwell.

Minimise long journeys where possible. Living in Australia, we know long distances are a part of life, whether travelling overseas or within Australia. However, try to avoid packing your itinerary with long plane, train, car, or bus journeys if you can. Make a list of the key sights you want to see, plan your travel around them and be realistic. If you will be travelling for long periods, plan rest stops and consider layovers to make it more achievable.

If you’re travelling by plane or train, ask for an aisle seat and take strolls up and down the aisles. This’ll help reduce stiffness, and muscle and joint pain. You can also do leg and foot stretches and other gentle exercises while seated.

Consider informing the airline of your medical condition. With advance notice, the airline should be able to:

provide you with wheelchair assistance and early boarding, if necessary
have airline personnel carry your luggage for you and/or lift it into the overhead bin
accommodate you with special shuttles and elevator platforms for boarding.

Talk with the transport operators before you leave. Contact the companies before your journey to see what assistance and services they can provide. This goes for all planes, trains, coaches, ships, boats – basically any form of transport operated by someone else. Let them know if you require help and if you have any mobility aids. Have the specifications of your mobility aids handy in case they need this information. Doing this before you go means the operators can be ready for your arrival and save you any potential stress or inconvenience.

Booking accommodation. When choosing your accommodation, always consider walking distance to other services, the number of stairs and the availability and location of lifts. Make sure you can drop your luggage off at your hotel if you arrive early – you don’t want to carry heavy bags any longer than necessary! Consider booking accommodation with a heated pool or spa, so you can exercise or relax in warm water to loosen sore muscles and ease painful joints.

“Oh, the places you’ll go.” — Dr Seuss

Packing for your trip

Pack light. Packing can be one of the hardest parts of travelling – what to take, what to leave at home – so if in doubt, leave it out. Lifting heavy bags on and off trains, buses and through airports increases your risk of injury and fatigue. When you travel, you also end up carting your luggage around more than you may realise. So packing light is essential. Check out some of the travel websites, articles, and blogs if you need tips and advice on packing.

Use lightweight luggage if you have it. If you’re buying new luggage, think lightweight and durable. Look for luggage with good wheels and handles that allow for easy manoeuvrability. A suitcase you can push rather than pull places the load squarely in front of you and means you don’t have to twist your wrists. If you don’t own lightweight luggage, see if you can borrow some from your family or friends.

Don’t forget to pack any special equipment or aids that help make life more comfortable, such as:

supportive pillows
lightweight hot/cold packs
orthotics, splints or braces.

Consider wearing a mask and using hand sanitiser when you’re on planes, trains and other public transport. Although many of us have gotten out of this habit, COVID is still around. And nothing spoils a holiday faster than getting sick 🤒. Masking and sanitising are the best strategies to reduce your risk of this occurring.

Separate your medicine. Keep your medicine in separate pieces of luggage to ensure you don’t lose it all should a piece of luggage become lost or stolen. Only carry enough medicine that you need for your own personal use. Pack in your hand luggage any medicine you may need access to quickly so you can get to it when needed.

Organise your medicines. Being away from your usual routine can make it easy to forget to take your medicine/s at the appropriate time. If you take medicines every day, consider using a pillbox with separate compartments for each day (but keep the original packaging with you). More information on travelling overseas with medicine and medical devices can be found on the Therapeutic Goods Administration website.

Check size restrictions on luggage and mobility aids with your travel agent, airline or other transport operators.

“Once the travel bug bites there is no known antidote, and I know that I shall be happily infected until the end of my life.” Michael Palin

Medical preparation

Get advice well in advance. Ensure regular blood tests and doctor visits are done before you leave. Discuss any concerns you have about travelling with your doctor (e.g. whether you need to adjust your medicine schedule if travelling to a different time zone).

Talk with your doctor about vaccinations, especially if you’re going overseas. This protects your own health, but also some countries, airlines and cruise lines require proof of certain vaccinations before entering or boarding. The Smart Traveller website has more information about vaccinations and overseas travel. Note: Some vaccines should be avoided if you have an autoimmune condition or take medicines that suppress your immune system. Your doctor or rheumatologist can advise you on this.

Check that your medicines are legal and not restricted or banned where you’re going. You can do this by contacting the relevant consulate or embassy; a list is available on the Smart Traveller website. Carry a letter from your doctor listing your medicines, the dosage and what they’re for, as well as your doctor’s contact details. Keep medicines in their original packaging, or if you’re using a pillbox, keep the packaging with the pillbox.

For more information about medicines and travelling, read Travelling with medications: A guide by the International Association for Medical Assistance to Travellers.

Stock up. Make sure you have enough medicines (for your personal use) to last until you return home. You may not be able to get the same medicines elsewhere – especially if you’re overseas.

Store your biological medicines properly. If you’re taking biological medicines (biologics or biosimilars), they may need to be stored at a specific temperature in a special travel wallet. Seek advice from your rheumatologist and the pharmaceutical company about this. Check with your airline/s to see if they can assist you, for example, with ice for the travel wallet or placing your medicine in the aeroplane’s fridge.
Make sure your container is clearly labelled with your name and contact information, or attach your boarding pass. And make sure you don’t leave your medicine on the plane!

Don’t place your medicines in with your checked luggage. The baggage compartment gets extremely cold while the plane is in flight, and your medicine may freeze and be ruined.

Fridges away from home. Once you’re at your destination, you should be able to use the mini-fridge in your hotel room to store your biologics. You should check that the fridge is adjusted properly to a suitable temperature. Also, in some countries, the power in a hotel room turns off when you leave the room. Ask the hotel staff about this upon arrival.
Contact the pharmaceutical company that makes your biological meds before you travel. Most have a customer support line and are an excellent source of information on the correct storage of medicines.

“Once a year, go someplace you’ve never been before.” Dalai Lama

Travel insurance

Know what you’re covered for. You can get travel insurance if you have a pre-existing condition such as arthritis, but it’s vital that you understand precisely what your coverage provides and whether it’s adequate for your needs. Different types of travel insurance will have different limitations on what’s covered, so shop around. A medical declaration form may be required in some instances. To learn more, check out our information on travel insurance for people with a chronic illness.

Coming home

Rest up. After your trip, take a day or so to unpack and rest before returning to your normal routine. Contact your healthcare team if you have to reschedule any medical appointments or have symptoms that need attention.

Extra tips and references

Look after yourself. Even though you’re travelling, you should continue to do the things that help you manage your condition and pain at home, such as regular exercise, eating a healthy diet and getting enough quality sleep. They’ll contribute to good physical and mental health and wellbeing and help you keep pain and fatigue in check.

Getting around airports. Websites for all Australian international airports and domestic terminals have accessibility information, as do the individual airlines. Check these out before you go.

Give yourself plenty of time to make flights and connections and deal with your luggage. That way, you’re not rushing, which leads to stress and anxiety. Rushing can also make you push yourself too hard and lead to increased pain and fatigue.

Choose your meals carefully. Most airport and rest stop food choices are high-fat, high-salt, highly processed foods that promote inflammation. Carry healthy snacks, drink plenty of water, and drink alcohol and caffeine in moderation.

Check out the blogs of other travellers with special needs. Stories of other people who’ve visited the places you want to go to and who have accessibility needs are often great resources to help you plan your journey.

Take it easy, and have a great time! Remember, your trip is meant to be fun. Travel can be associated with both physical and mental stress that can be magnified if you have a health condition that causes you pain. So when planning your trip, factor in a plan B – just in case your original plan needs to be altered to allow you time to rest or take it easy. For example, if you’d planned a walking tour of a place you’re visiting, look into alternatives such as hop-on/hop-off bus tours or riding a bike. Build enough flexibility into your holiday to allow for these alterations so that you’re relaxed and not stressed about staying on schedule.

By planning your trip carefully, being flexible with your schedule, and taking your condition into account, you can have a fantastic holiday.

So get out there and enjoy yourself!

“We live in a wonderful world that is full of beauty, charm and adventure. There is no end to the adventures we can have if only we seek them with our eyes open.” Jawaharial Nehru

Contact our free national Help Line

Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

More to explore

10 tips for pain-free travel with osteoarthritis
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International Association for Medical Assistance to Travellers
Nearly two-thirds of arthritis patients say they take fewer vacations because of their disease
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Therapeutic Goods Administration

Lisa Bywaters

31/Aug/2022

Are you like me and find supermarkets ridiculously cold? It doesn’t matter what season it is outside; inside a supermarket, it’s Arendelle, and Elsa has just turned everything into snow and ice ❄⛄.

This can be really uncomfortable, especially if you have a musculoskeletal condition. And if you have Raynaud’s phenomenon, it can make your extremities – especially your fingers – turn white and numb.

What is Raynaud’s phenomenon?

Apart from having a really cool name – it’s a phenomenon, for goodness sake! 🙃 – what is Raynaud’s??? First, it’s named after the French doctor who originally described it, Maurice Raynaud, and being French, it’s pronounced ‘ray-nose’ (with a silent D).

Raynaud’s phenomenon causes the blood vessels to the extremities, usually the fingers and toes, to constrict more than usual in response to cold temperatures or stress. When this happens, the blood flow is restricted, causing the extremities to become cold and turn white, then blue. When blood flow returns, the skin becomes red and returns to its normal colour.

Raynaud’s phenomenon can occur on its own – this is primary Raynaud’s phenomenon. Or it can occur alongside or ‘secondary’ to another disease or condition – this is secondary Raynaud’s phenomenon.

Both primary and secondary Raynaud’s phenomenon episodes can last from a few minutes to hours.

Other parts of your body, such as the nose, lips and ears, can be affected too.

Fortunately, Raynaud’s phenomenon rarely causes permanent damage.

Maintaining a balance: vasoconstriction and vasodilation

Your body protects your internal organs (your core) by maintaining a stable core temperature – it’s not too hot, not too cold, but just right 🐻🐻🐻.

One of the many ways your body maintains this stable temperature is through vasoconstriction and vasodilation. This essentially means that your blood vessels (vaso) narrow (constrict) or widen (dilate) as needed.

In the cold, blood vessels constrict to reduce blood flow to your extremities, such as the fingers and toes. This keeps your core warm. In the heat, blood vessels dilate, and blood flow increases to your skin, moving the warm blood away from your core.

These processes help your core remain at a constant temperature, usually around 36-37°C.

For people with Raynaud’s phenomenon, for some unknown reason, blood vessels constrict, not to keep your core temperature stable but in response to cold, stress or emotional upset.

Blood vessels in your extremities narrow quickly, and your skin changes colour due to a lack of blood supply. During a Raynaud’s episode or attack, you may experience pins and needles, tingling and/or numbness in your fingers or toes. You might find it difficult to do things with your hands, as lack of blood can make them clumsy and stiff. And when the blood returns to the area, you may feel slight discomfort or stinging pain.

These changes occur in the extremities, most often the fingers. Circulation in the rest of the body is generally normal.

Primary Raynaud’s phenomenon

This is the most common form of Raynaud’s phenomenon. It’s also called Raynaud’s disease. Women, generally under 30, are more likely to develop primary Raynaud’s phenomenon than men. It can also run in families, so if you have a family member with primary Raynaud’s, you’re more at risk of developing it.

Secondary Raynaud’s phenomenon

People living with conditions such as scleroderma, systemic lupus erythematosus (lupus) and rheumatoid arthritis may develop secondary Raynaud’s phenomenon. This usually occurs later in life but can happen at any age, depending on the underlying cause.

Other risk factors for secondary Raynaud’s phenomenon include:

mechanical vibration – for example, using a power tool for extended periods
medicines – e.g. beta-blockers, some migraine or cancer drugs, amphetamines
smoking.

Diagnosing Raynaud’s phenomenon

Your doctor can determine if you have Raynaud’s by talking with you about your symptoms. It can be helpful to take a photo of your hands if you experience a Raynaud’s episode so you can show this to your doctor.

Although it’s generally not too difficult to diagnose Raynaud’s phenomenon, it can sometimes be hard to tell whether it’s primary or secondary Raynaud’s. Your doctor may use a range of methods to work this out, such as:

taking a complete medical history, including asking about family members who may have Raynaud’s phenomenon
a physical examination
blood tests
examining fingernail tissue with a microscope.

Living with Raynaud’s phenomenon

Most people with Raynaud’s phenomenon can manage it effectively with self-care and lifestyle changes. In some cases, medicines may be necessary.

Self-care

To prevent a Raynaud’s episode, the best thing you can do is to keep your body and extremities warm. Dress appropriately for the cold with gloves, thick socks and warm layers. It can be helpful to keep a spare pair of gloves or hand warmers in your car or bag that you can use if you’re caught out in a cold or stressful situation (e.g. a trip to the supermarket! 😱).

If you’re outside and your extremities start feeling cold and numb, go indoors and soak your fingers or toes in warm (not hot) water. Or you can warm them with a heater. Just be very careful of the heat – it’s easy to burn yourself when your skin is numb.

If you can’t go indoors, try these things to increase the circulation to your extremities:

Wiggle your fingers or toes.
Rub your hands together.
Make circles with your arms.
Massage your hands or feet.
Place your hands in your armpits. However, if you’re like me, your armpits aren’t always warm enough, and you may need to ‘borrow’ someone else’s warmth! Make sure it’s someone you’re close with – random strangers won’t appreciate your ice-cold fingers in their armpits! 😂
If a stressful situation triggers the attack, remove yourself from the situation, take some deep breaths and try to relax.

Medical care

Talk with your doctor if your Raynaud’s isn’t controlled by these simple measures. You may need to use medicines that widen your blood vessels and improve circulation.

For secondary Raynaud’s phenomenon, it’s also essential that the underlying condition (e.g. lupus) is treated effectively.

Tips for avoiding triggers

There’s no cure for Raynaud’s phenomenon, so avoiding things that trigger a Raynaud’s episode is key.

Avoid being out in the cold for long periods, especially if you’re not dressed warmly.
Make sure your whole body is kept warm, using several layers of clothing to trap body heat.
Keep your extremities warm with gloves, woollen socks, earmuffs and/or a beanie.
Use hand warmers. These small, often disposable products produce heat on demand and are helpful when gloves aren’t enough; you can buy them from supermarkets and chemists.
Remember, hand sanitisers often have a cooling effect, so when using them, be prepared to warm your hands quickly.
Avoid smoking cigarettes or drinking caffeinated drinks as nicotine and caffeine constrict blood vessels.
Review your medicines with your doctor; if they’re causing the problem, discuss possible alternatives.
Be aware that holding something cold, such as a can of drink, can trigger symptoms.
Learn to recognise and avoid stressful situations.
Keep a journal of when episodes or attacks happen, as this may help identify triggers.
Look after the skin on your hands and feet – with our frequent hand washing and use of hand sanitiser, it’s easy for our hands to become dry and cracked. Cracked skin is an opening for germs to get in and potentially cause an infection.
Exercise regularly to maintain blood flow and skin condition. Being active also has many other health benefits.

Complications

For most people, Raynaud’s phenomenon is uncomfortable and a nuisance but is basically harmless, with no lasting effects. However, in rare cases, loss of blood flow can permanently damage the tissue. This may lead to skin ulceration, tissue loss and scarring.

Talk with your doctor if you notice any changes in your symptoms.

Contact our free national Help Line

Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

More to explore

Patient education: Raynaud phenomenon (Beyond the Basics)
UpToDate
Put your hands together and applaud … your hands!
Musculoskeletal Australia
Raynaud phenomenon
Australasian College of Dermatologists
Raynaud’s disease
Mayo Clinic
Raynaud’s phenomenon
American College of Rheumatology
Raynaud’s phenomenon
Cleveland Clinic
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National Institute of Arthritis and Musculoskeletal and Skin Diseases
Raynaud’s phenomenon
Versus Arthritis

Lisa Bywaters

16/Jun/2022

“Welcome, winter. Your late dawns and chilled breath make me lazy, but I love you nonetheless.” Terri Guillemets.

Winter is well and truly here ❄. And for many of us with conditions like fibromyalgia, lupus, osteoarthritis, rheumatoid arthritis, back pain and Raynauds’s phenomenon, we feel the cold more keenly with increased joint and muscle pain or lack of blood circulation to the extremities.

As much as I’d like to be writing this to you from a toasty warm room, with the heat cranked high, there’s just too much pressure on the household budget to be so careless. And I know I’m not alone in feeling anxious about rising costs – food, petrol, mortgage/rent – everything seems to be going up. Except for the temperature outside, that’s stuck in a downward spiral 😨.

So what can you do to stay warm and keep the costs down this winter? Here are some strategies to try.

Dress for success

Let’s start with the basics. You need to dress for the temperature and wear layers of clothing. It can sometimes feel cumbersome and bulky, but it’s one of our best defences against the cold. So put on the warm pants and jumper, embrace your inner Wiggle and wear a skivvy, pull on your thick socks and/or tights and appropriate footwear. When you head outdoors, add more layers– including hats, gloves, scarves and masks (if required/desired).

If you’re working from home and still feeling the cold, consider using a blanket over your legs as you sit at your desk. I can tell you from personal experience it’s very cosy. And my cats love it 😺. Just be careful you don’t trip on it.

Deal with draughts

Cover the bottom of your door with a door snake or add some door seals. Pull your curtains and blinds over the windows at night and during miserable days to keep the warmth inside. If you have floorboards, consider putting down rugs (just be careful they don’t become a trip hazard). And check out these handy DIY draught-proofing videos from the City of Port Phillip (Melbourne).

Turn down the temperature

While it’s tempting to crank the heat up, the most efficient temperature to set your heater to (if you can set the temp) is 18-20 degrees. While that may not sound particularly warm, we’re often outside during the warmer months wearing short sleeves when it’s 18-20 degrees. It’s just a matter of perspective.

And only heat the areas you’re using. If you’re able to turn the heating off in unused parts of your home, do it. Shut the doors and use a draught stopper to prevent the warm air from the rest of the house escaping into these areas.

Let the sun shine in

Open your curtains and blinds on sunny days to let the sun shine on your windows. Even if there’s a chilly wind, the sun will bring some wonderful warmth into your home. And remember to close them when the sun goes down.

Snuggle up

Get cosy on the couch with your partner, kids, pets. Grab a warm blanket or doona, share your body heat and just enjoy being together.

Install heavy curtains

Thick curtains made from heavyweight, tightly woven fabrics can prevent heat escaping from your home. For the best results, curtains should be fitted as close to the window frame as possible, extend below the sill and well over the sides of the window frame, and a pelmet fitted over the top. This acts to ‘seal’ the window from the rest of the room and prevent heat loss. Curtains will also keep the hot air outside in summer.

Turn it off at night

You sleep better when your body has a chance to cool down a little, so turn the heater off at night. It’s also safer to sleep with the heater off. You can remove the chill from your bed by using a hot water bottle or an electric blanket. Just don’t forget to turn your electric blanket off before you go to sleep.

Winter-proof your bed

There’s nothing like slipping into a deliciously warm bed on a cold night, especially if there’s soft flannelette involved! So swap out your lighter, everyday bedding for heavier winter ones. And add layers – a top sheet (if you don’t already use one) and extra blankets. Finally, if you have floorboards in your bedroom, adding a rug under your bed can prevent any draughts from making their way to your bed.

Get active

Go for a brisk walk outdoors – wearing appropriate clothing – and you’ll warm up in no time. Save on pricey petrol and instead of driving, walk to the shop/school/post office etc.

When you’re at home, exercise indoors using an online program, a DVD or an app. Play with the kids. Clean the house. Do anything that gets you moving and you’ll feel warmer than you would if you sit in one place for hours on end.

However, if you’re having a flare or experiencing a lot of pain, be as active as you can within your limits. And use your heat packs to help relieve muscular pain.

Shorten your shower, if you can

Many of us use our shower to warm up sore joints and muscles so we can get moving. However hot water uses a lot of energy, and even a few minutes extra will add to your bill. If you’re able to, shorten the amount of time you spend in the shower, even if it’s just a little.

Move clothes horses and other obstructions away from the heater

Anything that blocks a heater will prevent the warm air from flowing around the room uninterrupted. So move them away from the heat source. And to stay safe, fire authorities say you should keep clothing one metre from your heater.

Use heat packs and hot water bottles

If you’re feeling stiff and sore, heat packs or hot water bottles can help get you up and about and provide temporary pain relief. Always follow the instructions when using them. Don’t overheat or smother them under blankets or clothes, and let them cool down between use. It‘s also important to let your skin temperature return to normal before using them again. To avoid burns, wrap your hot water bottle in a cloth or use a cover, so it doesn’t come into contact with your skin. Always examine your hot water bottles and heat packs before use, and toss them out if you notice signs of wear or damage. Finally, check their temperature before use to make sure they’re not too hot.

Warm up from the inside out

Many delicious winter recipes bring comfort and warmth on the most miserable days. So crack open the cookbooks and get cooking! Or go online for inspiration for yummy, warming drinks, curries, soups and stews.

Choose energy-efficient heaters

If you’re in the market for a new heater, make sure you’re buying one that’s energy-efficient and best suits your needs. Read Canstar’s article ‘A guide to energy-efficient heaters in 2022’ for more info.

Working from home

If you run a home-based business, Energy.gov.au has some simple tips to reduce your energy costs. Many of these tips are also applicable if you work from home because of the pandemic and have changed your working arrangements.

Billing and payment help

If you’re struggling to pay your energy bills, Energy.gov.au also has some information about support for Australian households, including info on potential rebates that may be available for you.

We’ve also put together lots of info to help you if you’re struggling with financial stress.

Insulate

If your house isn’t adequately insulated, this is something you can do for long-term benefit. Obviously, there’s a substantial upfront outlay, but it may be an option for some households. Find out more about insulation, including the different types available and how to install it, from the Australian Government’s website ‘Your home’.

Contact our free national Help Line

More to explore

Recipes
Check out our tasty recipes! They’ve been created by our volunteers including an Accredited Practising Dietitian, a Master of Dietetics student and a Registered Clinical Nutritionist. Enjoy!
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Lisa Bywaters

23/Mar/2022

Written by Buffy Squires, with input from Mikayla O’Neill

Note: the names of the completion certificates vary across the country, e.g., VCE in Victoria and HSC in NSW. In this section, we refer to them all collectively as SSCE.

Wow! You’re heading into your final years of secondary school! Congratulations! It’s a really exciting time for you.

But perhaps you’ve heard from friends and others who’ve already gone through it, that it’s a lot of hard work. This may be making you a bit worried about how your body’s going to hold up. It’s ok to feel like this, but we’ve got plenty of tips and resources so that you can deal with the challenges and get on with your studies. And in doing so you can make your final years of secondary school as successful and enjoyable as possible.

Keep in mind that there are lots of different options for completing your SSCE. You may choose to do it over 3 years rather than 2 or do less subjects or an ungraded SSCE. It’s a matter of talking with your parents and your school and working out what works best for you.

All students should have the opportunity to sit their exams on as level a playing field as possible. This means that your arthritis or musculoskeletal condition shouldn’t put you at a disadvantage to your peers.

So, as exam time approaches, it’s important to remember that you may be eligible for special consideration. This could include extra time to do your exam, take breaks, use a keyboard instead of handwriting, access your medication, heat and cold packs and more. The process differs depending which state or territory you live in so check out the Curriculum and Assessment Authority links below for more information. Your school will help you with this, and they’ll lodge the application on your behalf.

Tip 1 – Start early

Special exam arrangements aren’t just for your final exams. If you live with a chronic condition (like arthritis), you can apply to have them in place right through your schooling to cover things like NAPLAN. But many students first apply for special exam arrangements as they approach their final school years.

Some students will be doing a final year subject in year 11, so if that’s you, you’ll want to start thinking about the process of applying for special consideration at the end of year 10. Speak with your rheumatologist about it, as they’ll have to write a letter supporting your need for special consideration. It might also be a good time to make an appointment with the hospital’s occupational therapist. They can do a writing assessment to see if you’d benefit from a laptop/keyboard and recommend other aids to help you. In the public hospital system, you might need to wait a few months, so again, start the process early!

Speak with the head of senior school or find out who is responsible for managing special exam arrangements in your school. Make sure they’re aware of your limitations and ask them for a list of anything they need you to provide.

Tip 2 – Have a support system in place

Make sure you have a support system in place at school. If you feel comfortable in doing so, it’s a great idea to talk openly with your teachers and the head of senior school so that they know your needs and limitations and are able to offer help around test or exam time. You may also want to have one particular teacher who’s your main “point of contact” so that, if you’re unwell or need to take time off school, you can deal with any issues through them.

After significant appointments it may be helpful to take into school a doctor’s letter or organise a quick meeting with teachers to keep them in the loop. You may also find that by keeping your teachers updated regularly, they’re better able to understand your condition. Then, when exam time comes around, you’ve already got that support system in place which makes it easier to organise the help you may need.

Tip 3 – Manage stress

Yes, it’s easier said than done, but if you put some plans in place and find some strategies that work for you, year 12 really doesn’t have to be that stressful. In a few years you’ll look back and wonder what all the fuss was about! Check out our A-Z pain guide (link https://msk.org.au/pain-guide/) and the pain section of our website (link https://msk.org.au/kids-pain) for tips on dealing with pain. Find things you enjoy that make you feel great. It might be something active like a walk with a friend or a game of soccer, or perhaps you enjoy meditation, music, gaming or colouring in. Whatever it is, have some options you know work for you, and use them as soon as you feel the stress starting to build.

Tip 4 – Check, and check again

Once you’ve got the paperwork in place, check with your school to see if there’s anything else they need from you. If you haven’t had confirmation to say your special consideration has been approved, don’t be afraid to ask them to follow it up. The creaky gate gets the oil!

Things may change as you get closer to exams. Perhaps you have a flare-up and find that you can’t sit for long periods. Keep the lines of communication open with your contact person at school and make sure they know what’s going on. They can always make later applications for amendments to your plan – for example, a stand-up/sit-down desk to help manage back pain.

Got any tips you’d like to share? We’d love to hear from you. Send them to buffy@msk.org.au

More to explore

Disability Standards for Education 2005
Australian Government, Department of Education, Skills and Employment
Disability standards for education: A practical guide for individuals, families and communities
Australian Government, Nationally Consistent Collection of Data on School Students with Disability
Responsibilities of schools and educators
Royal Children’s Hospital, Melbourne

State and territory resources

Australian Capital Territory
Equitable assessment and special consideration, ACT Board of Senior Secondary Studies
New South Wales
Disability provisions, Education Standards Authority
Northern Territory (see South Australia)
The Northern Territory Certificate of Education and Training is based on and administered by the South Australian Certification of Education.
Queensland
Students with disability, Queensland Curriculum and Assessment Authority
South Australia and Northern Territory
Special provisions in the SACE, SACE Board of South Australia
Tasmania
Reasonable adjustments, Office of Tasmanian Assessment, Standards and Certification
Victoria
VCAA Special Provision, Victorian Curriculum and Assessment Authority (VCAA)
Western Australia
Special provisions, School Curriculum and Standards Authority

Lisa Bywaters

19/Nov/2020

I’ve just taken a week off from work. I was struggling mentally and physically, so I decided it was important to take time to pause, reflect and reconnect.

But it was really tough to do.

I think part of my problem was I felt like I needed permission to feel how I was feeling and to take a break. It felt self-indulgent to feel sad when there are people in a ‘worse’ situation than I am; who are working so hard just to make ends meet; who are facing relationship issues. How dare I feel this way? I have a loving partner, a home, a job, and wonderful family and friends. I can now move around freely outside of my 25kms and enjoy the spring weather.

I have all of these things, so I felt selfish for feeling sad and for worrying those around me.

But while catching up with friends and family last week, I found I wasn’t alone in feeling this way.

So for anyone out there who needs to hear this, it’s ok.

It’s ok to take a break or to rest. You’re not a machine. You need time to recover – physically and mentally – from the things that are affecting you. That way when you do return to what you were doing, you’ll feel refreshed and more able to deal with everything.

It’s ok to say no. We all want to please others, so saying no can be a challenge. But you need to weigh up all the things you have going on and decide whether you can take on something else. If you can’t, then say no. And don’t feel you have to apologise for doing so.

It’s ok to listen to your body. In fact it’s a necessity. Living with a chronic condition means that you need to be self-aware of how you’re feeling. If you’re tired, rest. If your back hurts, move. If you’re feeling sluggish, get some fresh air. Whatever your body is telling you, listen and take action.

It’s ok to be kind to yourself. Our inner critic can be really loud at times. If yours is giving you grief, ask yourself – would you say those things to someone you love? The answer is probably no. So quiet that inner voice by making a list of three things you like about yourself and stick it on the fridge or bathroom mirror. Remind yourself of these things regularly.

It’s ok not to be perfect. No one is, no matter how they appear on social media.

It’s ok to let go of the things that drain you. For me, that was the news. I was watching it constantly and getting more and more depressed by the state of the world, and how people treat each other. So now I read the news highlights, get more detail on the things that matter to me, and discard the rest. Think about the things that drain you (and this may include people) and if you can, let it go. Or at least limit your exposure to it.

It’s ok to put yourself first. Sometimes we need to make ourselves our top priority – whether that’s physically, mentally and/or emotionally. You’ll be more able to help others when you’ve taken time to look after yourself.

It’s ok to talk about mental health. In fact it’s really important that we do. The more we talk about mental health and how we’re feeling, the less stigma will surround it. Which will lead to more people opening up about their mental health and getting help when they need it.

It’s ok to not watch the news. Take time to unplug from the 24/7 news cycle and focus on the world around you – your family, friends and environment.

It’s ok to forgive yourself. This comes back to our inner critic. We often beat ourselves up for the smallest of mistakes. If you made a mistake – and ask yourself if you really did make a mistake or are you being super-critical of yourself – look at what you did, learn from it and then move on. Don’t keep thinking about it – it’ll only drive you crazy and make you unhappy.

It’s ok to have a messy house. Or to have a pile of laundry that needs folding. Or for the grass to need mowing. Or for pet hair to cover ever surface of your home. Sometimes things get a little untidy as we prioritise our health and wellbeing over a perfectly made bed, sparkling bathroom or fluffed-up cushions. And that’s ok.

It’s ok to not be ok and feel sad/angry/vulnerable. Your feelings are valid and they matter. However if you feel like these feelings are taking over, talk with someone. A trusted friend or family member, or a healthcare professional. While it’s ok to feel like this from time to time, you don’t want to feel like this all the time. And you don’t have to. There’s help available.

It’s ok to cry. We all have difficult days and crying can be an outlet when we feel sad, stressed, overwhelmed, scared, angry or in pain. So grab a box of tissues and let it out.

It’s ok to do more of the things that make you feel good. Love a massage? A walk on the beach? Sitting in your garden with a cup of tea and a book? Whatever it is that makes you feel good is not an indulgence, but a necessity to help you recharge your battery and make you a happier person.

It’s ok to put your phone down or away. We look at them too often anyway, so put it away for an hour, a day, a week. Be present and be mindful of the people and the world around you.

It’s ok to admit you’re struggling. And it’s ok to ask for help. It doesn’t mean you’re not a capable person. It just means that in this time and place, or for this task you need some help. And that’s fine. We all need help every now and then.

It’s ok to take your time. We don’t always have to be in a hurry. Make space to breathe and be still, meditate and be mindful.

It’s ok to not have all the answers. You’re not Google or Encyclopedia Brittanica. Saying ‘I don’t know’ is a valid and human thing to say.

It’s ok to put down your ‘to do’ list and be spontaneous. Lists can help us feel in control and organised, but sometimes it’s freeing to toss the list aside and just do something unexpected, just because you can.

So it’s really ok to sing, to dance, to walk barefoot in the park, to hug the stuffing out of your partner/kids/pets. We’re living through a global pandemic, which is affecting us in so many ways, so it’s important and very much ok to find the joy and welcome it with open arms.

And remember, it’s ok to be you.

Call our Help Line

If you have questions about things like managing your pain, your musculoskeletal condition, treatment options, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

Crisis support

If this article has raised some issues with you or you feel like you need help during this stressful time, there’s help available. Contact Lifeline Australia on 13 11 14 for 24 hour crisis support and suicide prevention.

More to explore

7 signs you’re too hard on yourself
Psychology Today
Action for happiness
Head to Health
Australian Government Department of Health
Beyond Blue
Feeling lots of….feelings? Journaling can help
NPR
It’s okay to be who you are – forget approval and show your true colors
Tiny Buddha

Lisa Bywaters

19/Nov/2020

OMG, did you know there are only 36 days until Christmas?!!

It seems like Christmas 2019 was just a few weeks ago, now Christmas 2020 is looming! Yikes!!

Ok, breathe. It’s important we don’t panic. There are lots of things we can do to prepare for the festivities without too much pain. After the year we’ve had, we deserve a wonderful Christmas with those near and dear to us.

So here are our top tips so you can enjoy some festive fun:

Shopping

Plan around your pain and fatigue. Wear comfy shoes (including orthotics if you have/need them), grab your walking aid, your shopping list (a foggy brain makes remembering almost impossible) and your shopping buggy/bags. Be kind to yourself as you may feel tired and exhausted for hours/days after your trip. If your battery was already low before you tackled this, it’s may take some time to recharge and feel yourself again.
Once you get to the store, hygiene and physical distancing is key:
- Wear your mask if you live in an area where they’re mandatory or recommended.
- Use sanitiser on your hands and disinfectant wipes on the handles on your trolley/basket.
- Keep a least 1.5 metres between yourself and others.
- Don’t touch your face.
- Wash your hands thoroughly when you get home.
Take breaks. Shopping is exhausting and stressful, so take breaks when you need them. Don’t push yourself too hard, or you’ll end up paying for that over the coming hours/days.
Use a trolley or a shopping buggy, even if you’re only getting a few things. It will do the heavy carrying for you, so you can avoid muscle and joint pain.
Use your assistive devices – walking aids, braces, orthotics. If you have them, use them. They make a big difference.
Shop online. We’ve learned through life in lockdown and iso that so many things can be purchased with a few quick clicks of your mouse. So visit your favourite stores online and save yourself some trips to shopping centre madness. Just be sure to check the shipping details to ensure your goods arrive in time.
Shop local. You don’t need to hit the big shopping centres to find unique gifts or fresh produce. Small, independent local stores often have most of what you need.
Be kind to others. Your fellow shopper isn’t the enemy. So be patient, give them space, and be tolerant. The staff at the store also deserve our kindness and empathy – they’ve been flat out all year trying to keep the shelves stocked so that we can get all the things we want or need.

Gifts

Take a leaf out of the big guy’s book – write a list and check it twice. Knowing what gifts you’re looking for before you hit the shops will save you time, energy and money.
Consider spending less. It’s been a tight year for many of us, so it makes sense to be economical and save some dollars. You don’t want to head into 2021 with massive Christmas bills.
Make your own gifts. Embrace your inner creative guru and bake, paint, draw, knit or sew your presents. Another option is to make some gift vouchers – e.g. 1 hour of babysitting or dog walking.
Embrace Kris Kringle or Secret Santa gift exchange. They’re popular for a reason. Make 2020 – the year of the ‘new normal’ – the time to try it out, and save yourself time, stress and frustrating shopping expeditions. It’s particularly good if you have a lot of people to buy for.
Give gift cards and vouchers. They’re always a great idea for the person who’s hard to buy for, or the person who has everything. And you can get a lot of them online – without the hassle of changing out of your pjs or leaving the comfort of your couch. Some companies such as Private Health Funds offer discounts online when purchasing gift cards.
Give to charity. There are so many worthy causes around and many have been struggling during this incredibly tough year. So follow your heart and make a donation instead of buying gifts this year.
When it comes to wrapping your gifts, gift bags are easier on sore hands than cutting wrapping paper and using sticky tape. They’re also a lifesaver for those of us who are hopeless at wrapping.

Decorating

Get the family involved. Put some Christmas music on and have fun with it. Decorating your tree, your home and garden for Christmas should be all about the joy of the festive season and being together.
Keep it simple. Remember what you put up you have to pack away after Christmas. So if that thought fills you with trepidation, choose the ‘less is more’ option.
Put decorations in easy reach on a table or bench so you’re not constantly bending over to pick them up.
Use a step ladder, rather than overstretching. And if you have any balance issues, ask someone else to do the high stuff.
Remember things don’t have to be ‘perfect’. That’s too much pressure. So don’t be a Monica Geller (sorry, couldn’t resist a Friends reference).

Having people over

Keep it COVID-safe. What you can do and how many people you can have over will depend on where you live. So visit your state/territory government health site for the latest info. Have plenty of soap and hand sanitiser available, avoid hugs (I know this is tough) and if you’re feeling unwell, get tested and stay home, or cancel your gathering. That last one will be incredibly tough, as we’re so used to soldiering on through our aches, pains and fatigue, but if you think there’s even the remotest chance you have COVID, get tested and keep everyone safe by isolating until you know you don’t have the virus. Use the Healthdirect symptom checker to find out if you need to be tested.
Keep it simple. As with decorating, keep your celebrations simple. Seriously after the year we’ve had, any celebration is epic!
Cook/bake things ahead of time. Many of the foods we enjoy for Christmas can be made days and sometimes weeks before the big day. That means you don’t have to work yourself into a cooking frenzy Christmas Eve and Christmas Day. And you’re more likely to enjoy yourself on the day.
Ask your guests to bring a plate. This shares the work, the cost and ensures those with special dietary requirements can bring food that accommodates their needs.
Pace yourself. When you’re hosting an event, it’s easy to get carried away and be constantly on the move. Gatherings can be a marathon, so pace yourself so you don’t run out of steam before the end.
Take a seat. Make sure you take time to rest and get off your feet.
Be medicine-wise:
- Over-the-counter and prescription medication may help you manage pain and inflammation so you can enjoy your day. If you’re not sure what will work best for you, talk with your doctor or pharmacist.
- Watch the alcohol. Many medications don’t mix well with alcohol, so find out if it’s ok to have a drink with your meds.
Stay hydrated. Christmas is often hot in Australia, so it’s easy to become dehydrated, especially if you’re busy making sure everyone is having a good time. So keep the water flowing – for yourself and your guests.
Give yourself a break when it comes to cleaning and packing up. Get the family and your guests involved – even if it’s simple things like folding up chairs, or bringing dishes to the kitchen. And ask yourself if you really need to do everything immediately? A lot can be done the next day after you’ve had a rest.

Manage stress

Christmas and the holidays can be a stressful time, but it’s important that you manage your stress as best as you can or risk having a flare. So pull out your best stress management strategies and use them as often as you need to.

Call our Help Line

More to explore

Arthritis and the holidays
Arthritis Foundation (USA)
6 tips for managing the holiday season with chronic illness
The Mighty
Christmas gift ideas when you’re on a budget
ABC Life
Top tips for managing pain over the festive season
London Pain Clinic

Lisa Bywaters

22/Oct/2020

And things you can do to manage

This blog was so full of info and strategies we had to split it into 2 parts. You can access part 1 here.

But here’s a recap: We know finding and keeping a job when you have a musculoskeletal condition like back pain, rheumatoid arthritis, osteoarthritis and gout can be really tough.

Pain, fatigue, medication side effects and the unpredictability of your condition can all affect your ability to work.

The extent to which this happens will depend on things such as the condition you have, how severe it is, how well it’s being managed, and the type of work you do. Physically demanding work will be impacted by painful joints or restricted movements. And any work that requires you to focus and concentrate, especially for extended periods, will be affected by brain fog, pain, and lack of sleep.

The good news is there are things you can do to help manage these issues. We’ve listed a bunch of strategies here. This is part 2 of our 2 part blog.

Note: we understand that some of these strategies may not be possible for all workplaces or conditions. However the majority of them can be adapted in some way to suit your needs.

Manage your meds. Sometimes medications cause side effects like nausea, headaches, lightheadedness, and drowsiness. This can make it really hard to concentrate at work, and may in fact make it dangerous to perform some work duties such as driving or operating machinery. If you find that your medications are causing issues for you, talk with your doctor about possible alternatives you can use.

You may also need to have a review of your medications if you find your condition’s not under control or you need more help managing pain and other symptoms. Again, talk with your doctor about this.

Get a good night’s sleep. We all go through periods when sleep is elusive. Chronic pain and anxiety are just a couple of things that can affect our ability to get enough quality sleep. But sleep is important for good physical and mental health, and to give us the ‘get up and go’ we need to get to work and work productively. If you’re having issues sleeping, don’t just put up with it. There are lots of things you can do to get the sleep you need.

Take a break. Get up, move and clear your head. We all need to take breaks for our physical and mental wellbeing. So walk to the photocopier or around the block, do some simple stretches, step outside and do some deep breathing or visualisation. Whatever helps you manage your pain, fatigue, and brain fog, do it.

Dealing with time off work. We all need time off from time to time, but for many people with musculoskeletal conditions, it may happen more often than we’d like. Attending healthcare appointments during working hours or having a flare means you may go through your personal leave quite quickly. If this is a concern or problem for you, discuss your options with your healthcare team. Are you able to attend appointments via telehealth or outside of your usual working hours? An occupational therapist or physiotherapist may have some solutions for working during a flare and to reduce the pain and strain on your joints. And if you’ve disclosed your condition to your employer, discuss your concerns with them. Together you should be able to develop a plan to help you balance time off and the work duties you need to complete. One of the silver-linings of the COVID pandemic is that we’ve discovered that many jobs can be done productively from home. So working from home may be an option. As too are aids and equipment that protect your joints and save energy, or even changing the work you do at your workplace. Being proactive and knowing your rights is key to working well with a musculoskeletal condition.

Managing changes to your abilities and functioning. Unfortunately some musculoskeletal conditions will change a person’s ability to do specific tasks. For example, someone with back pain may find sitting for long periods impossible. Or a person with arthritis in their hands may find repetitive work such as typing extremely painful. Talking with an occupational therapist or physiotherapist can help you find potential solutions to these issues. Whether it’s finding new ways to do work tasks, using special equipment and aids to support you and protect your joints, or managing your pain while at work, they’ll tailor a solution to your specific needs.

These are just some of the things you can do to manage your condition and continue to work. Feel free to share the things you do to help you manage at work with a musculoskeletal condition. We’d love to hear from you!

Call our Help Line

If you have questions about things like managing your pain, COVID-19, your musculoskeletal condition, treatment options, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

Making the invisible visible

Read the report based on our 2020 National Consumer Survey – Making the invisible visible – in which 66% of people said that their ability to work had been impacted by their condition/s.

Watch our webinar

Watch the recording of our webinar from March 2021, as Jessica Dawson-Field, Employment Associate, Maurice Blackburn Lawyers, takes us through employment law – rights and entitlements.

More to Explore

JobsAccess
Australian Government
JobAccess is the national hub for workplace and employment information for people with disability, employers and service providers. It provides:

a wide range of info and services to help people with disability find and keep jobs, get promoted to better jobs, upgrade or expand their workplace skills
advice on modifying your work area, talking about your disability, training for your co-workers, negotiating flexible work arrangements and returning to work
the Employment Assistance Fund (EAF) which gives financial help to eligible people with disability and mental health conditions and employers to buy work related modifications, equipment, Auslan services and workplace assistance and support services.
and much more.

Work Assist
Australian Government
Work Assist can help you stay in work if you risk losing your job through illness, injury or disability.

I have a job and arthritis: Now what?
Arthritis Society Canada

Fatigue
National Rheumatoid Arthritis Society (UK)

Sleep and pain
painHEALTH

Managing flares
National Rheumatoid Arthritis Society (UK)

Lisa Bywaters

21/Oct/2020

Or how to manage fatigue

We all get tired. We overdo things and feel physically exhausted. It happens to us all. Usually after a night or two of good quality sleep the tiredness goes away and we’re back to our old selves.

But fatigue is different.

It’s an almost overwhelming physical and/or mental tiredness. And it usually takes more than a night’s sleep to resolve. It generally requires multiple strategies, working together, to help you get it under control.

Many people living with a musculoskeletal condition struggle with fatigue. It may be caused by a chronic lack of sleep, your medications, depression, your actual condition (e.g. rheumatoid arthritis, lupus, fibromyalgia) or just the very fact that you live with persistent pain.

Fatigue can make everyday activities difficult, and can get in the way of you doing the things you enjoy. The good news is there are many things you can do to manage fatigue and get on with life.

Exercise and being active. While this may sound like the last thing you should do when you’re feeling fatigued, exercise can actually boost your energy levels, help you sleep better, improve your mood, and it can help you manage your pain. If you’re starting an exercise program, start slowly, listen to your body and seek advice from qualified professionals. Gradually increase the amount and intensity of activity over time.

Take time out for you. Relaxation – both physical and mental – can help you manage your fatigue. I’m not just talking about finishing work and plonking down in front of the TV – though that may be one way you relax and wind down. I’m specifically referring to the deliberate letting go of the tension in your muscles and mind. There are so many ways to relax including deep breathing, visualisation, gardening, progressive muscle relaxation, listening to music, guided imagery, reading a book, taking a warm bubble bath, meditating, going for a walk. Choose whatever works for you. Now set aside a specific time every day to relax – and choose a time when you’re unlikely to be interrupted or distracted. Put it in your calendar – as you would any other important event – and practise, practise, practise. Surprisingly it takes time to become really good at relaxing, but it’s totally worth the effort. By using relaxation techniques, you can reduce stress and anxiety (which can make you feel fatigued), and feel more energised.

Eat a well-balanced diet. A healthy diet gives your body the energy and nutrients it needs to work properly, helps you maintain a healthy weight, protects you against other health conditions and is vital for a healthy immune system. Make sure you drink enough water, and try and limit the amount of caffeine and alcohol you consume.

And take a note out of the Scout’s handbook and ‘be prepared’. Consider making some healthy meals that you can freeze for the days when you’re not feeling so hot. You’ll then have some healthy options you can quickly plate up to ensure you’re eating well without having to use a lot of energy.

Get a good night’s sleep. Good quality sleep makes such a difference when you live with pain and fatigue. It can sometimes be difficult to achieve, but there are many things you can do to sleep well, that will decrease your fatigue and make you feel human again. Check out our blog on painsomnia for more info and tips.

Pace yourself. It’s an easy trap to fall into. On the days you feel great you do as much as possible – you push on and on and overdo it. Other days you avoid doing stuff because fatigue has sapped away all of your energy. By pacing yourself you can do the things you want to do by finding the right balance between rest and activity. Some tips for pacing yourself: plan your day, prioritise your activities (not everything is super important or has to be done immediately), break your jobs into smaller tasks, alternate physical jobs with less active ones, and ask for help if you need it.

Write lists and create habits. When you’re fatigued, remembering what you need at the shops, where you left your keys, if you’ve taken your meds or what your name is, can be a challenge. And when you’re constantly forgetting stuff, it can make you stress and worry about all the things you can’t remember. Meh – it’s a terrible cycle. So write it down. Write down the things you need at the supermarket as soon as you think of it –a notepad on the fridge is a really easy way to do this. Create habits around your everyday tasks – for example always put your keys in a bowl by the door or straight into your bag, put your meds in a pill organiser.

Be kind to yourself. Managing fatigue and developing new ways to pace yourself is a challenge. Like any new behaviour it takes time, effort and lots of practice. So be kind to yourself and be patient. You’ll get there. It may take some time, and there may be some stumbles along the way, but you will become an expert at listening to your body, pacing yourself and managing fatigue.

Talk with your doctor. Sometimes fatigue may be caused by medications you’re taking to manage your musculoskeletal condition. If you think your medications are the issue, talk with your doctor about alternatives that may be available.

Fatigue may also be caused by another health condition – including anaemia (not having enough healthy red blood cells to carry oxygen around your body), diabetes, high blood pressure, fibromyalgia and being overweight. If you’re not having any success getting your fatigue under control, your doctor may suggest looking into other potential causes.

So that’s fatigue…it can be difficult to live with, but there are lots of ways you can learn to manage it.

Tell us how you manage. We’d love to hear your top tips for dealing with fatigue.

Call our Help Line

More to explore

I’m a “spoonie.” Here’s what I wish more people knew about chronic illness
healthline
A great way to describe what it’s like to have limited energy to family and friends who want to understand.
Fatigue
Better Health Channel
Fatigue and arthritis
Arthritis Society (Canada)
Managing fatigue
Versus Arthritis (UK)

Lisa Bywaters

10/Sep/2020

Last issue we talked about spring cleaning our physical environment. There’s nothing like a thorough purge of your home or office, and the sense of satisfaction when everything is clean and organised just the way you like it.

But it’s also a really good time to start thinking about how you can spring clean yourself – your body, mind and spirit.

2020 has been a really tough year and it’s not over yet.

We’ve been isolated, locked down, separated from loved ones, working from home (or lost work) and home schooling. Through it all we’ve done the best we can to cope with a really difficult situation. But that takes a toll on us – physically and mentally – especially if you’re living with a chronic condition, pain and fatigue.

So let’s take advantage of the warmer days and the extra downtime many of us are dealing with and look at how we can sweep away the cobwebs and make ourselves sparkle this spring!

Unplug. We’re always connected these days, immersed in the news, social media, video chats, work/school, phone calls. We’re never far away from a phone, tablet or computer – and we need to step away. Schedule time to put it all aside: perhaps after dinner, or for an hour during your day, or for your entire Sunday. Whatever works for you and your commitments. Just make sure you take some time away from the digital world, step outside and breathe in the fresh, sweet smelling spring air.
Say no. We’re wired to want to please others, so we often find it difficult to say no. But that can make us become overwhelmed and stressed with the number of commitments we have. That’s why we need to look after ourselves and start saying no. The next time someone asks you to do something, give yourself a moment. Don’t answer immediately with an automatic ‘yes’. Ask yourself if this is something you want to do? Are you able to do it – physically and mentally? Do you have the time to do it? Will it bring you happiness? If you answered no to these questions, then you should say no to the request. You may disappoint some people and they may be a little unhappy with you. But you need to be true to who you are and stand firm. And don’t feel the need to give detailed reasons for saying no. Saying no is really hard, but it will become easier.
Change your routine. Do you feel like you’re stuck in a rut? I know it feels like Groundhog Day at times! So look at your routine. What can you change? Take your work/school commitments out of the equation for now. Do you spend your evenings on the couch? Or weekends doing the same old things? Stop and really think about what you would actually ‘like’ to do with your free time. Go for a bike ride? Take up painting? Visit a new place each week? Find things that you enjoy, and fill you with anticipation and happiness, and do them. Now think about your work routine. There may not be things you can change about work – but why not put on your favourite outfit/earrings/shoes/lipstick – even if you’re working from home. Or use some new stationary or bit of tech. It’s amazing how these small changes give us a mental boost.
Focus on the basics – eat well, move, sleep – repeat. This time of the year we have access to amazing fresh produce that’s just crying out to be made into delicious salads and stir fries. The days are getting longer and warmer so we can get outside more for our exercise. We can shed the heavy blankets and adjust our sleep habits. There’s never been a better time than now to focus on these basics and make improvements if needed. And finally, make sure you’re staying hydrated by drinking enough water each day.
Surround yourself with positive, upbeat people. Positivity and happiness is contagious. And in the midst of a pandemic – this is the kind of contagion we need. These people will inspire you, make you feel good about yourself and the world in general. Too much contact with negative people (in person and via social media) does the opposite and makes the world a gloomy place. So seek out the happy, positive people and enjoy their company. And if you can, ditch the negative people.
Take some time out to relax. Try strategies like mindfulness, visualisation and guided imagery. Or read a book, listen to music, walk the dog, create something, play a computer game, have a bubble bath or massage. Whatever relaxes you. And make sure you do these things on a regular basis. They’re not an indulgence – they’re a necessity and vital to our overall happiness and wellbeing.
Let’s get serious – sugar, fats, alcohol and drugs. Many of us have been seeking comfort in sugary and/or fatty foods more than we’d like. Or we’ve been using alcohol and/or drugs to make us feel better. Over time this becomes an unhealthy habit. So it’s time to get serious. Ask yourself if your intake of these things has changed or increased? If it has – what do you need to do to fix this? Can you decrease their use by yourself? Or do you need help from your family, doctor or other health professional? The sooner you acknowledge there’s a problem, the sooner you can deal with it.
Nurture your relationships. It’s easy to take the people around us for granted, but these people support and care for us day in and day out. They deserve focused time and attention from us. So sit down and talk with your kids about their day. Make time for a date night with your partner and cook a special meal to share together. Call or visit your parents and see how they’re really doing. Reminisce with your siblings about childhood antics and holidays. Our relationships are the glue that holds everything together for us – so put in the effort. You’ll all feel so much better for it.
Quit being so mean to yourself. You’re valued and loved. But sometimes we forget that. And the negative thoughts take over. “I’m fat”, “I’m hopeless”, “I’m lazy”, “I’m a burden”. If you wouldn’t say these things to another person, then why are you saying them to yourself? Ask yourself why you even think these things? And how can you reframe these thoughts? If, for example, you tell yourself you’re fat – are you actually overweight or are you comparing yourself to the unrealistic media image of how a person should look? And if you do know you need to lose weight, and want to make that happen, put those steps in motion. Talk with your doctor for some guidance and help. And congratulate yourself for taking action. And as you make these changes be kind to yourself along the journey. There will be stumbles, but that’s expected. You can pick yourself up and move on. Kindly.
Throw away the ‘should’s. This is similar to the negative self-talk…we need to stop should-ing ourselves to death. This often happens after we’ve been on social media and seen someone’s ‘amazing’ life. You start thinking “I should be better at X”, “I should be doing X”, “I should be earning X”, “I should look like X”. Remember that most people only put their best images on social media, so everyone’s life looks wonderful. But you’re just seeing the superficial, filtered person, not the whole, and they probably have just as many insecurities as the rest of us. Instead of thinking “I should…”, be grateful for who you are and what you have.
Be thankful and grateful. You exist! And yes, the world is a strange and sometimes frightening place at the moment, but you’re here to see it. People love and care for you. Focus on the people in your life and the things you’re grateful to have in your life. Celebrating these things – both big and small – reminds us why we’re here. To bring joy and happiness to those around us, and to make the world a better place.

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More to explore

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6 self-care tips to help you spring clean your soul
Thrive Global
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Lisa Bywaters

10/Sep/2020

If you live with a musculoskeletal condition, chances are you’ve had a flare at some stage. Your body turns up the dial on your pain-o-meter and wow…that hurts. As well as increased pain you may experience increased joint stiffness, inflammation and fatigue. As a result everyday activities – getting out of bed, showering, looking after the kids, working, cooking – become much more difficult.

Flares are frustrating and painful. You don’t always know why they happen – and sometimes they seem to come out of the blue. How long they last is also uncertain and can in part depend on how you deal with them.

What causes a flare?

Flares can be caused or triggered by a number of things including:

stress
changes in medications
overdoing it physically
changes in weather
poor sleep
illness, infection or injury.

Knowing the triggers that cause you to have a flare can help you be prepared and take control.

Your flare plan

Be prepared

Talk with your doctor about the things you can do to manage a flare when one occurs. This may include pain relieving medications to help you get through the worst of it, as well as self-management strategies, including rest, gentle exercise and the use of heat and cold. You may also need to adjust your medications, or alter the dosage during a flare.
Have a plan in place for how you’ll deal with your commitments when you’re in the middle of a flare – family, work, home life, social activities. Can you alter your work hours, work from home, get your family to help out with chores?
Manage your stress. Many people find they’re more prone to flares when they’re stressed. Unfortunately we’re living through a particularly stressful time at the moment. But there are things you can do to deal with stress. Try relaxation techniques such as meditation, breathing exercises and visualisation, avoid caffeine, alcohol and cigarettes. And talk to someone – whether it’s a family member, friend or a mental health professional. Talk through what’s stressing you out so you can deal with it, and hopefully avoid a flare.
Don’t overdo things. We’ve all done it. Countless times. We’re feeling great so we decide to go for the extra-long walk. Or clean the house from top to bottom. Or weed the entire garden. Afterwards we’re proud of our achievements…until we wake up and can’t move. And we tell ourselves never again. But we really need to follow through with the ‘never again’. So when you’re feeling great, pace yourself. Go for the walk – but don’t go too far, or stop for a coffee break and a rest. Do the cleaning or gardening – just don’t get carried away, and get help from others. By managing your activities, energy levels and pain, you can hopefully prevent a flare from occurring.

Take control

Even when you do all you can to prevent a flare, you can still have one. Some flares we can predict, but sometimes they seem to happen for no reason at all. Or they may be triggered by things we can’t control – such as changes in weather or changes to meds. So you need a plan for dealing with them in the moment.

Over-the-counter and/or prescription medications may help you manage the pain and inflammation of a flare. As we mentioned earlier, discussing this with your doctor before you have a flare means that you can act quickly as soon as a flare strikes. You’ll have the medications you need, when you need them. But if you haven’t had the opportunity to have this discussion, now’s the time. Make an appointment as soon as possible. Don’t try to soldier on. This will only make life miserable, and can potentially make your flare last longer and cause more damage.
Write down what you were doing before the flare. It might seem like it came out of the blue, but there may be triggers you aren’t aware of. Tracking your activities, sleep patterns, stressors, diet and even the weather each time you have a flare may help you identify potential triggers. This will help you reduce your risk of future flares.
Prioritise your tasks and activities. You still need to be able to get through your day and commitments, so you need to prioritise what’s most important. You may not be able to do everything if you’re in a lot of pain or you simply can’t focus because you’re so tired. So be realistic – what really, seriously needs to be done? Only do those things. You can get to the other things when you’re feeling better.
Pull out all of your pain management strategies. Use heat or cold packs, get a massage, go for a walk, distract yourself…use all the things you know help you manage your pain.
Rest when your body needs it – but not for too long. Going to bed and being inactive during a flare can make your pain and fatigue worse. Continue to exercise, but at a lesser intensity than usual. It’s important you listen to your body.
Use aids and other gadgets when your joints are painful and swollen. Aids include splints, walking sticks, jar openers, tap turners and pick-up reachers. They’ll help protect your joints, and reduce some of the pain you feel when doing everyday tasks. Check out our online shop to view some of the items we have available to make life easier.
Get a good night’s sleep. Not enough sleep or poor quality sleep has a negative effect on our mood, our physical wellbeing, pain levels and our energy. It can also trigger a flare. Unfortunately it’s easy to say ‘get a good night’s sleep’ but it’s often hard to do when you’re in a lot of pain. The good news is there are lots of things you can do to improve your sleep. Find out more.
Track your flares. Keep an accurate record of when you had a flare (or flares). Also note down the symptoms you experienced and rate them. For example if you have increased fatigue, how would you rate it compared to the fatigue you feel when you’re not having a flare? Do this with all of the symptoms you experience. All of this information is valuable to help you and your doctor understand how your condition is progressing, if it’s being well managed or if your treatment plan is providing the best results.
See your doctor. If your flare is lasting longer than usual, your symptoms are much worse, you’re experiencing unusual symptoms or you’re having more frequent flares, go and see your doctor or specialist. You may need your medications to be adjusted. Or you may need an assessment of your current treatments to see if there’s an alternative that will help you gain control over your condition.

Some of the suggestions listed here are easy, however others involve a bit of thought, as well as input from others. But taking the time to work out a plan that works for you will help you manage your flares better, and with less disruption to your life.