Track and React the Impact of Arthritis

I get Arthritis Today, the magazine published by the Arthritis Foundation, and I generally read it cover to cover. The July/August 2013 issue has several things I plan to share here. The first is an online tool called 'Track and React'. As the magazine says, "Track which daily activities impact your arthritis with the push of a button". When you register to begin using the tool, it asks if you have arthritis, then gives you a long list from which you choose the one type that affects you the most (tough decision for those of us with multiple issues).
In the 'Profile' section, besides basic identification, this is the place to enter all your meds, so you can keep track of taking them. There are fill-in-the-blank fitness goals, and a space for other goals.
 The 'Track' section is the the meat of the tool. There are six pages, for nutrition, fitness, sleep, meds, your day, and symptoms. On each page are several questions, with slider bars to give your responses from low to high. Each page also has a space for your own input. There are also links you can click on for more information about each topic.
The 'Results' page creates graphs, showing the relationships between what you do, and how you feel. You can choose a graph based on nutrition, fitness, meds, your day, or all of these combined. You can also choose a single day, or a span of any number of days to be calculated into a graph. The graph is fairly basic, with just a bar representing how well you are caring for yourself, and a line indicating your symptom level. Over time, you may notice trends in how the bar and line fall. The 'Track and React' tool can't tell you how a specific food or activity is affecting you, but it can indicate if things are going smoothly or if you might need to change your diet or exercise routine, or see your doctor.
I think this is a useful tool for keeping tabs on how you are doing. When I first read about it in the magazine, I thought the graphs would be really informative, and the reason I would use this tool. Now I think the real benefit of this tool is the 'Track' section. It is a quick and easy way to check in with yourself in multiple areas on a daily basis, the graphs are an added bonus.
Give 'Track and React' a try at www.arthritis.org/trackandreact.  It is also available as an app, so it can go with you anywhere. When you are done with that, explore the rest of the Arthritis Foundation website.They have so much useful information, and so many useful tools, it can keep you occupied for hours.

Better Choices, Better Health

For the past five weeks, I have been participating in an online workshop called 'Better Choices, Better Health'. I don't remember how I found it, but I am glad I did. On their home page, their tag line is 'A Stanford University Workshop to help you manage your health: a service of the National Council on Aging'. It is a six week workshop for people living with chronic conditions that teaches/encourages you to make lifestyle choices that will maximize your health.

When you enroll in the workshop, you are put into a group of about 20 people who will be your classmates for the six weeks. Each week there is a lesson to read online, and opportunities to post problems and action plans. An action plan is like a goal, only more specific. After reading the lesson and writing your own action plan, you are invited to read what others have posted, and post your replies. Classmates and volunteer group leaders give each other suggestions, validation and encouragement. Topics covered include ways to deal with pain, fatigue, and stress, healthy nutrition and exercise choices, and communication with family and doctors. You are instructed to 'log on at your convenience 2-3 times per week for a total of about 2 hours per week.' I have found that I am spending closer to 4 hours on the website each week, and some of the others in the group have also commented that it takes more than 2 hours to get through all the site has to offer. I like to be thorough, and want to read everything, though there is no requirement to do that.

In addition to the discussion center, where the posts are located, there is a section of the website titled 'My Tools'. In it, there are many tools such as the Fitness Zone, where you can post a fitness goal and log your progress; a Health Profile, where you can track your weight and blood pressure, among other things; a Nutrition Zone; Relaxation Zone; Web Resources and an Online Journal.

And that's not all. They also send you a book titled Living a Healthy Live with Chronic Conditions, by Lorig, Holman, Sobel, Laurent, Gonzales and Minor. This book is itself a wonderful resource, with chapters on self management, symptoms, exercise, communication, sex, advance directives, nutrition, medication and planning for the future. There are separate chapters on living with chronic lung disease, heart disease, arthritis and diabetes. Chapter 20, the last chapter, is titled: 200+ Helpful Hints. Each week there are optional readings in the book to go along with the lesson.

Setting goals is easy. The hard part is following through. This workshop not only shows you how to divide your goals into very specific steps, or action plans, but also provides the social support and camaraderie needed to encourage you to stick with it. One of the main changes I have made is to keep a food journal. It is making me more aware of what I eat, and reminding me to make better choices. I have started to jot down pain levels as well as highlights of the day's activities, to see if there are correlations.

So what does this whole program cost? Nothing. It is totally free, except for the time and effort you put into it. I highly recommend it. To get started, go to the Better Choices, Better Health home page and click on the button that says: Not Enrolled? Learn More.

Goals

My most recent Chronic Illness/Chronic Pain Support group meeting was on 'Goals.'  Here is an excerpt of the handout. What is a goal?
A goal is a specific outcome to aim for. Having goals can help with motivating yourself, planning how you spend your time, and with decision making.
Why goals are important for people with chronic pain and illness
Our lives have been disrupted, we may no longer be able to pursue the plans we had made for our lives.
We may be limited in the activities we can do, it is very easy to feel discouraged and useless.
Setting goals can help us redefine ourselves and what is important to us.
Having goals can help in deciding how to use our limited energy.
(I have seen several versions of this S.M.A.R.T. method of writing goals.  Here is one:)
Setting S.M.A.R.T. Goals (From Mark Stibich, Ph.D., former About.com Guide)
S - Specific:
You must state your goal as specifically as possible.
Have your goal be like an instruction telling you what to do.
M - Measurable:
You need to have a way to measure progress.
A - Attainable:
Your goal should be meaningful to you. It should be set by you, not someone else.
The goal should be inspiring enough that it motivates you to success.
R - Realistic:
Goals should be ambitious, but not impossible. Do not set yourself up for failure.
Break large goals into smaller goals.
Create a plan to do all the steps you need.
T – Time Based :
When will you finish your goal? You need to choose a time, the sooner the better.
(We thought that the word 'Attainable' meant almost the same as the next word, 'Realistic'.  We decided to replace it with 'Aspiring', ie, something you would aspire to.)
Write your goal:
Finish the following sentence, write it down and put it somewhere you can see it:

I will [your goal here] by [how you will do the goal]. I will know I am making progress because [how you will measure the goal] [time goes here].
For example: I will lose 20 pounds by increasing my exercise to 4 times a week and cutting back on sugar and portion size. I will know I am making progress because I will lose 2 pounds a week for ten weeks.
Now really think about your goal.
I will [________________________________________________________________________] by [__________________________________________]. I will know I am making progress because [________________________________________________] [_______________________________].
(Not all goals fit this format, but it is a good place to start.)  Now evaluate your goal – is it Specific, Measurable, Aspiring, Realistic, and Time-Based? Good. Now go do it! 
Tips for achieving your goals
Don't try to work on more than three goals at a time.
Review your goals daily.
Put your goals in writing.
Use 'I will...' instead of 'I want to...'.
List benefits of reaching your goal.
List possible obstacles and how you will overcome them.
Break large goals into smaller more easily achieved goals.
Reward yourself for progress and accomplishment.
Make your goals public or have a goal buddy.
Make working on your goal a priority.
Visualize achieving your goal and what that would be like.

It can be hard to make and to pursue goals when you do not know how you will feel from day to day, or when and how bad your next flare will be.  Goals are still important.  Just recognize that disruptions are a part of life.  If you have a setback, cut yourself some slack, and pick up your goal where you left off.  You may even need to back up a bit, if you have lost strength, endurance, or whatever.  That is okay, its not your fault. As long as you don't give up, you are still on track.  

Write Your Own Obituary

I have heard about an exercise that can help put your life in perspective:  write your own obituary.  I have not tried it, but I have thought about it, and sometimes bring it to mind when I am thinking about whether or not to do something.  The idea is to think about how you want to be remembered.  An obituary is a brief summation of your life, what you have done, and the lives you have touched.  It sounds like a morbid thing to focus on, but it really isn't.

This is a chance to look at where you are in your life and compare it to where you would like to be.  What really matters in your life? Are you focusing on your priorities, or do you spend most of your time/energy on things that don't really matter?   What kind of person are you, and what kind of person do you want to be?   With chronic illness and pain, you likely aren't living the life you expected.  Pain and illness make your world smaller, but it doesn't have to disappear completely.  I found good instructions for writing your own obituary on E-How.  This person tells how to put a little humor into it, while taking it seriously as a way to keep you on track in the future.

It is too easy to feel sorry for ourselves, and to get ourselves stuck.  Be realistic about what you can and can't do, but don't sell yourself short.  Doing things you want to be remembered for may be more difficult, but that does not mean they are impossible.   The writer of the instructions suggests this as a way to motivate you and jump start your life.  As the saying goes, where there is a will there is a way.  (Pun intended.) 

After you write your obituary, pick one goal, and write out the specific steps it will take to get you there.  The more specific you are, the more likely you are to work on those steps and reach your goal.  Reward yourself, be proud of your accomplishments, no matter how small they may seem.