I've often been asked over the years what a flare is.
Well, here is my definition:
flare: a significant increase in symptoms above what is normal for you
A flare can be different for anyone. For a start, what is normal for you will not be the same as what is normal for the next person living with Fibro. And Fibro flares are often accompanied by flares of comorbid conditions (conditions you have alongside your Fibro) - so the flare of someone with Lupus and Fibro could well be very different to the flare of someone with Migraine and Fibro.
This is topical for me as I think I'm heading into a flare, my first for 18 months. I'm incredibly lucky in that my Fibro is now usually extremely well managed - I would in fact go so far as to say that I have been in remission for a few years now as, apart from a couple of very short lived flares, I have been pretty much symptom free without daily medication.
I have had a "flare plan" for years and formulating one is something I really recommend to anyone living with Fibro. It isn't a complicated process or a formal one, it is just knowing what you need to do when you think you are heading into a flare (or are definitely in one) so as to minimise the symptoms and keep the flare as short as possible.
My flare plan always looked like this:
1. Rest more. Reduce stress. Prioritise tasks - if something isn't urgent, it can wait until I feel better. Limit outings and socialising, especially if I know it is something that will tire me.
2. Improve sleep quality. Poor sleep quality is a hallmark of Fibro and in a flare or with out-of-control Fibro, it can be a catch-22 - your body can't recover until you improve your sleep, your sleep won't improve unless you get control of your Fibro! Sleep hygiene has a part to play for many people - go to bed at a reasonable time, get up at about the same time every day and make your bedroom a restful place without stimuli (taking work, laptops, games consoles or TV to bed are unlikely to help your brain switch off). Supplements, such as valerian, can help some people. But for me, medications have been an important part in improving my sleep quality and dealing with flares. Clonazepam has been a very helpful medication for this for me, as not only does it improve sleep quality (by raising levels of GABA in the brain, it reduces the over-stimulation of the Autonomic Nervous System that is a problem with FIbro), but it also has a muscle relaxant effect, so it really helps me with the myofascial pain that often accompanies my flares.
3. Pay attention to physio. Like so many people with Fibro, I can benefit from doing a simple daily routine of stretches and basic strengthening exercises (all prescribed for me by various physios over the years). And like so many people, I forget to do this on a daily basis! But flares not only remind one to do what we should be doing, but remind us exactly why we shouldn't stop doing it!
4. Spend time in water. Hydrotherapy is the complementary therapy with the best level of evidence behind it for its use as treatment for Fibro. I certainly find warm baths and showers helpful for pain, especially I incorporate some stretches with time in the water.
5. Get a massage, I am fortunate in that I have a very experienced myofascial release specialised massage therapist in my town (Sue Perry at Two Nine O Five Pain Relief Clinic). Sue has worked in me for years now and was a big help in getting my Fibro under control. Many of my flares (especially migraine, TMJ and muscular pain) are myofascial related and I've found that MFR is the best way for me to get this under control. This is something I have to pay for privately, but we've always found it's well worth it.
6. See the doctor. If the above doesn't work, then I consider whether anything else could be happening (like this week I'm going to the GP to ask to get my vitamin D levels rechecked as they have been low in the past and it is the middle of winter!) and if not, I see my Fibro specialist for a modified Myers cocktail injection (an intramuscular injection of lidocaine and various vitamins and minerals) to give my body a boost).
This is my first flare as a mother and I knew it would be harder now. Parents of young children are often the people who struggle the most with getting control of their Fibro. As a parent, you are used to prioritising your childs needs above your own and it can hard to readjust and say to yourself and your family "I need to help myself now or I can't be the parent I want to be".
Improving sleep quality and introducing medications is tough when you have a young child that wakes at night and isn't always happy to not have their Mama available. And now my working time is limited to when I have childcare, it's harder to rejig my schedule to enable me to rest more. But we're working on it and I'm confident I'll nix this flare soon.
Update: I saw my myofascial release therapist (she's done so much extra training now she's more like an osteopath than a massage therapist!) and she identified that I had put my pelvis out of alignment when carrying my daughter awkwardly one day. I had thought it was my neck that was the problem, but my pelvis was putting my back and neck under strain, which was then flaring the Fibro. After a long treatment session and a few night's reasonable sleep, the flare started to shift! It's now definitely gone...though I now have a stinking cold thanks to my daughter!