Flare-ups (aka Flares) are a part of living with Autoimmune Disease or Fibromyalgia. Though they can be frustrating, discouraging and uncomfortable, remember you can help yourself through them.
Although you will be miserable, flare-ups are usually invisible to those around you.
If specific facors that clearly aggravate your Autoimmune Disease and/or Fibromyalgia can be identified, you can gain some control over flares by avoiding or limiting the cause, or by taking preventive measures. Develop a personal flare-up management plan that keeps you in charge and reduces your sense of helplessness.
To avoid flare-ups, learn to pick your battles. Decide what is most important to you. During a flare, simplify your tasks and save your energy for what must be done. You may have to revise your idea of "what must be done."
A flare-up of symptoms can often be associated with weather changes, stress, interrupted sleep, depression, postural strain, etc. Usually, one or more activities or stressors triggers flares. The stressor could be a virus, a severe yeast infection, or a traffic accident. It might be as complex as a divorce, or as simple as a very hot day. Some people can go into flare because of a major argument, or even a sudden, very loud noise. It isn't unusual for someone with an Autoimmune Disease or Fibromyalgia to suffer a severe flare after an upper-respiratory infection or an allergy attack. Anything that interrupts or disrupts sleep can be a flare instigator, such as an injury, new addition to the family, visitors, holidays, a time change, jet lag, travel, vacations, etc.
Overdoing exercise, housework or other physical activity leads to a worsening of symptoms. People with Autoimmune Disease and/or Fibromyalgia tend to have muscles that may not be in optimum condition. Their muscles are prone to micro-trauma or small tears in the muscle fibers that do not mend effectively because the repair process occurs during the deep, restful sleep that is often lacking.
Sometimes a flare-up can't be attributed to anything that we are able to identify and can contribute to a feeling of frustration and lack of control over our health.
Flare is a temporary condition. It's a sign that you have perpetuating factors that have gotten out of control.
Feeling of Flare-Up:
Flare is a time of high-intensity pain and grief; an overwhelming episode of symptom intensity that can either creep up slowly or hit like an express train barreling down on you. Autoimmune Disease and Fibromyalgia are disorders of sensory perception, not just pain. Your entire body is hypersensitive, like a raw nerve, and when you are in flare, that nerve is dragged over hot coals. Your whole body screams for attention. When you are in flare, you may experience new symptoms and the old ones may worsen.
Disconnected:
You body/mind system shuts down in response to sensory overload. When people have been traumatized in some way, they feel disconnected. It's a defense mechanism to prevent further emotional pain.
Slurred Speech and Stuttering:
You may experience slurred speech, and stuttering. This may make you sound stupid, drugged or drunk. Your body is warning you to cut down on stimuli because it is having difficulty functioning. Your muscle strength may become unreliable, and you may drop things more often than usual.
Weakening of Movements:
Weakness during certain movements, such as when pouring liquids, turning a doorknob, or opening a can of pet food.
Spatial Disorientation:
Spacial disorientation is another symptom of an approaching flare. You can bump into walls and fall over curbs. Along with or instead of these symptoms you may have disturbed weight perception. All food becomes finger food when you are in or approaching flares, as nothing will stay on your fork. You may need to use a straw to raise a drink to your mouth without spilling it.
Noise and Confusion:
If you suddenly have much less tolerance to these kinds of stimuli and they irritate you way out of proportion to what is your usual tolerance, your body may be telling you that a flare is approaching.
Tolerance limit can be reached with conversation, too and the shutoff can come abruptly. It is as if you have reached your absolute limit, and your mind needs time to process what you have heard. You may need to lie down in a quiet, dark room for a bit, or go for a quiet walk.
Some of us avoid parties, department stores, malls, because of the confusion and noise. Others can't abide the frantic pace and sounds of cartoons. Any staccato repetitive sound, like rap music, may be an intense stressor.
Even at the best of times, some of us with Autoimmune Disease and/or Fibromyalgia cannot tolerate the sound of a child crying, or of phones ringing, or of vacuum cleaners. You may be sensitive to noise of a certain frequency, or the chatter of radio & tv news.
If you are in an airplane or any public place and wish to block out "noise", use earphones and a player. Don't rely on reading to be able to "block out."
Be aware that when you are stressed by flare, you may be tempted to reach for high-carbohydrate "comfort food." This food may cause you to feel better temporarily because it will send more glucose to your brain. But eventually you will get a rise in insulin, which suppresses glucagons and increases cortisol which will stress your body and mind even more.
Carbohydrate-rich foods will lengthen your stay in Flare City. Decide whether you want to set up permanent residence there, or find a way out as fast as possible.
Adjust medication, especially sleep and analgesic medication. (I usually take 800 mg of ibuprofen, and find it helps quite a bit. For some reason pseudoephedrine helps also, especially if the flare is accompanied by an unbearable internal heat sensation.)
Use heat or cold, whichever brings the best relief. (With me, cold brings relief. In winter I'll step out into the snow, or into the cold garage; in the summer I'll take an ice-cold shower.)
Get plenty of rest. You will be more sensitive than usual to pain during a flare-up. One form of protection is to get more rest than usual. Unfortunately, your sleep will be more disturbed, cutting short the very sleep you desperately need. If your sleep is disrupted, you'll need to spend more time in bed to get enough sleep.
Eliminate noises or other disruptions when you sleep. Because medications can lose effectiveness, a change in medication or dosage may be warranted. Pain will usually decrease when sleep quality has improved.
(see also page on Pain)
Cancel unnecessary appointments, trips, chores.
Try to make activities of daily living as easy as possible.
Watch or read something that makes you laugh.
Check muscle tension throughout the day - are you tensing your shoulders, holding your breath, or clenching your teeth?
Try to isolate the worst areas and focus on them.
Wear loose, comfortable clothing during a flare-up. Comfortable, cushioned shoes help support feet that hurt.
The tasks that you truly need to get done should be tackled one at a time. Do not start a second project until you have finished the first.
It is important to set boundaries, understand your limits, and not allow inappropriate behavior, as a matter of self-preservation.
Pleasant activities will soothe and distract you from pain, and create feelings of positive well-being.
Change the sheets on your bed, use as many pillows as you need, use a heating pad or an ice pack, have your favorite drink by your side, put on relaxing music, suck on ice chips, place a cool cloth on your forehead, or use aromatherapy.
Surround yourself with your most pleasant and favorite things. Pamper yourself with flowers or whatever makes you feel good. Give yourself permission to take care of your health.
Above all, love yourself through the flare-up. Maintain hope. You will come through it and feel better again.