The key to managing chronic pain and the inevitable fatigue that goes with it is making choices. I can only speak from the fibromyalgia perspective. People with other chronic pain conditions have to find their own keys to live life to the fullest without hurting themselves. Fibromyalgia, pain does not equal injury. Therefore, the key to living life to the fullest is to make reasonable choices to do the things you really want to do knowing there will be consequences – but not necessarily injury. Key word – reasonable. If I go jogging, I will injure my knees, feet, and ankles. If I go bungee jumping, I’m pretty sure my spine would rip right out of my back and then I’d have to have someone there to do a quick cleanup. Not that I’m catastrophizing or anything. But I can go to the Renaissance Festival in the fall, cheer on the jousters, people watch to my heart’s content, eat very well (i.e. badly), and stay on my feet from dawn to sunset. I will wake up the next morning (maybe, probably afternoon) and wonder when I wandered out on the highway and got hit by 3 pickups, a sedan, and a semi, and why am I not in traction. It may take me a few days to get fully back on my feet. My choice. My consequences. Mine. No one else’s. Mine.

There are times, however, I don’t have that control. For example, the last few weeks. While we all thought 2020 was a PTSD year, 2021 hasn’t been particularly kind either on a personal level. I’ve ended the year with my octogenarian parents deciding to suddenly become…. less young. I’ve had to request my mother to no longer drive on the highway; my father just had open heart surgery and has not been able to drive on the highway for some time. I am the chauffeur for them both. I sit in on appointments with them to be sure everything is understood and questions are answered. I help with decision making and am an occasional referee. At the same time, I have to work. Retirement to care for my parents (who are actually very young for their age, don’t get me wrong) is not an option. At work I have 25 residents and a fellow to care for, and several faculty including a program director and associate program director. And I care about every single one of them, what happens to them, how they are managing the stresses of their roles, and how I can help them with all of it. Home and work have converged to consume… me. Not just my time, but my energy, physical and emotional.

The choice is not really in my hands, because walking away from any of the people in my life that I care for is never an option. Everyone always says, self-care. You can’t care for other people without properly taking care of yourself. It’s true. But it’s a struggle.

I think of my energy and ability as finite. Like a beehive. It grows and shrinks, takes on more bees when it can, and hopefully produces something good at the end. But if wasps move in or a bear comes in and starts to steal out of the hive, there’s destruction I can’t control. The choice is not mine. However, I can choose to accept the destruction and simply work on rebuilding or rail against that which is not in my control.

So I can remember to take my antidepressants. I can be mindful of the moments that are my own. I can go to bed on time and get a full night’s sleep. I can eat properly. I can forgive myself when I don’t do any of these things – when my brain is rushing too hard to sleep, when I have to have dark chocolate covered salted caramels because it’s the holiday, when I zone out with a video game instead of rest. I can also get up and work when I feel like I have the flu and stay up throughout the whole day. I can do that, and when I have time, I can tell myself I’m doing a good job, and I’m doing the right thing. I’m doing what needs to be done, and I can do it. Gotta run :o) Thanks for listening.