Low Dose Naltrexone (LDN), Fibromyalgia & Me

Low Dose Naltrexone (LDN)Low dose naltrexone came on my radar last year and after consuming all of the research and anecdotal evidence about its impact on Fibromyalgia, I earmarked it for my major experiment post-baby (I had baby W last December).

Donna Gregory Birch, a well-known Fibromyalgia writer who explains how LDN works: “in low doses (typically 1-4.5 mg), naltrexone enhances the body’s immune system by boosting the production of endorphins, which in turn promotes healing and lessens inflammation.

Research has been showing promising results. Dr Jared Younger started with a tiny study and found positive results, approximately 65% of patients experienced clinically significant results. He’s doing a bigger study this year.

As a member of an active group about what works for Fibromyalgia and two groups about low dose naltrexone on Facebook, I have seen many testimonies from people with Fibromyalgia experiencing changes due to LDN ranging from mildly beneficial to miraculous. There are also those for whom it does not work or they do not try it for long enough – this is not a quick fix for most.

Further information on how LDN works is well explained in this article, which includes many links to research.

If I could experience a 30% (this is considered clinically significant and therefore as success) decrease in pain and fatigue, my life would change! I could be a mama, a wife, do my work and have some form of a life outside that and not pay with such significant levels of pain, fatigue and other side effects of the Fibromyalgia.

I can only share research and what works or doesn’t work for me. We are all unique and react differently. If you’re interested in LDN then read the research/information and then discuss it with your doctor.

My updates

Low Dose Naltrexone: An Experiment
Low Dose Naltrexone: Update 16 Weeks

Now

I have been reluctant to post this update, I was waiting for something solidly quantifiable but in lieu of that I’ll give you my anecdotal evidence that it is working.

Around 8 months ago I began taking low dose naltrexone and have slowly titrated up to a dose of 4 milligrams. It took me about six months to get to 4 milligrams as previously my body couldn’t cope with that level, I experienced vivid dreams and flare ups of ulcers and cold sores each time I tried to titrate up too fast. I may try 4.5 milligrams later on.

 

For now the effects that I have noticed are:

slightly more stamina
slightly better sleep
slightly less fatigue and
slightly less neck pain – from an average (which changes over a day as well as the week) of 4-7/10 down to about 3-5/10

Anyone who has been following my blog for a while would know that my neck is the area I struggle with the most. With that a little more in check, the fatigue is a close second.

I don’t think my functionality has increased however the quality of my life while performing all that I do has increased. When I do overdo it or have a bad night’s sleep the pain will increase. The heatpack is still my best friend, the computer is still my neck’s nemesis and I can’t hold it for too long in one position – but it’s better than before.

I still have hope that as we edge toward the one year anniversary that I’ll experience more miraculous effects. For now it is definitely worth the $30 a month I pay for the perscription.

This combined with meditation and gentle exercise, paying attention to what I eat and trying to limit stress have been the best things I could do. I hope that when I start working I will be able to maintain half-time hours and not return too much closer to the previous pain levels.

I’d love to hear your experiences with LDN. I’ll write an update when we get closer to a year.

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Night School: Wake up to the Power of Sleep – A Review

Night SchoolAfter reading The Whole Health Life I have decided to look into specific areas of my health in more depth, one at a time, at the moment it’s insomnia. One book recommended by Shannon Harvey is Night School: Wake up to the Power of Sleep by Richard Wiseman.

The research on sleep is fascinating. Based on answers around when we like to go to bed, get up and do our best work there is a table to sort us into chronotypes – larks or owls, (p41) I’m a “moderate lark”. Apparently larks are more likely to be introverted, logical and reliable while owls are likely to be extroverted, emotionally stable, hedonistic and creative. These would mostly hold true of my husband (an owl) and I.

What is also interesting is that I appear to follow the usual circadian rhythm, my body will start waking up at 7am, peak at 11am, decline to the lowest point by 3, climb and peak again around 7 with my body seeking sleep from 9. So I assume I just have slightly weaker ability to wake and sleep than others, while still following the natural pattern. I’ve filed this away for future follow up!

Another issue of timing is “social jetlag” for example during the week the owls will be tired from getting to work while their body wants to be sleeping. On the weekend (or any night for me!) When my owl of a husband wants to socialise I’m ready for bed. Causing each chronotype to suffer fatigue.

Wiseman references a lot of research. For example, in 2006 it was “estimated that around sixty million Americans suffer from a chronic sleep disorder” (p57) and approximately a third of Americans now get less than seven hours of sleep per night. In a British study more than 30% of participants had insomnia or another serious sleep problem. With this setting the scene, Wiseman goes on to explain what happens when you don’t get enough sleep – spoiler alert, nothing good.

“Belenskys’s study reveals the highly pernicious nature of even a small amount of sleep deprivation. Just a few nights sleeping for seven hours or less and your brain goes into slow motion. To make matters worse you will continue to feel fine and so don’t make allowances for your sluggish mind. Within just a couple of days this level of sleep deprivation transforms you into an accident waiting to happen.” (P67)

After all the bad news around not sleeping enough, Wiseman shares his secrets of super sleep and they include include:

1. Create a bat cave
Dark and silent room, right temperature, safe, only sleep and sex in the bedroom.

2. Set up during the day
Nap right, exercise but not too close to bed time unless it’s gentle yoga, use your brain and energy, know when you’re tired (don’t ignore sleep cues, unless you are tired all day, then don’t ignore your bedtime).

3. Prepare for bedtime
Warm shower/bath, write out your worries, snack right, lavender (unless it gives you a headache!).

4. At bedtime
Counting sheep, happy thoughts, fake a yawn, try to stay awake (reverse psychology on your brain!), set up some sleep cues (I have an eye mask, the dark and gentle pressure on my eyes now cues me to rest).

5. In the night
Get up (unless you physically can’t), don’t panic – apparently we get more sleep than we think, relaxing in bed is good rest and the closest the list comes to recommending meditation is to suggest progressive relaxation (I do a body scan meditation when I wake).

Nothing here is new to me, but it is presented in easily actionable chunks, if you want a list of sleep hygiene to follow, this is a good one. I would add meditation, I can’t nap and even if I do it’s only after a long time of trying and I feel gross afterward. So I meditate. Sometimes, if all the stars align, after a 20-30 minute meditation I’ll nod off for 5-10 minutes and wake up feeling nicely rested (very unusual). I use guided meditation during the day, at bedtime and in the night I do a body scan meditation (I visualise each body part individually relaxing, sometimes I’ll imagine it’s warm and tingly and relaxed, other times I’ll just imagine each part in turn).

Again as I delve into the research around sleep I am flummoxed at the lack of worry the doctors I have come into contact with have shown for my sleep. They should know how desperately humans need it, let alone people with chronic pain and fatigue already. I’ll keep you updated if I find anything useful in my research and experiments.

Fibro Mama Pregnancy Diaries Weeks 31-33

fibro mama weeks 31-33I am sharing these posts from my pregnancy with baby W last year to provide a sense of what it’s like for a mama with Fibromyalgia to do pregnancy. Unfortunately it’s taken me nearly a year to edit and post these. Find my Pregnancy Diaries page here

I was in a period of waiting. Of feeding my family, cleaning my home, organising my stuff. Of resting and stretching and trying to be well despite sleeplessness and the pain of carrying an extra 9kgs.

Despite all the difficulties of pregnancy and Fibromyalgia, I was trying to mindfully inhabit the present. To enjoy the moments of sitting on my couch and hearing the birds play in the trees. To enjoy snuggles with Nu. To embrace this period of slow.

12 minute pregnancy yoga clips helped me to stretch and open my cramped back and hips. Meditation helped me to rest and relax and make it through the afternoon. My physiotherapy appointments became a little more frequent to help support my neck and shoulders.

Baby’s movements became more painful as he stretched the limits of his shrinking (relative to his size) home. He seemed particularly busy at rest time, bedtime and once Nu went to bed (and I sat down).

I was lucky enough to try biofeedback therapy after being on the waiting list since my pain clinic appointment earlier in the year. I love having tools that I can call on to help myself (stretching, meditation, trigger point work etc.) And so this furthering of my meditation work was useful.

At week 32 my immune system seemed to go on hiatus, I got another bad cold that I couldn’t shake and turned into an infection requiring antibiotics.

As my sleep worsened further, I found it harder and harder to get up in the morning. Much of the day was spent dragging. Somehow I perked a little in the afternoon and after dinner.

I found myself getting really riled up when people suggested that my third baby would be a girl or that I “had” to have a third so I might have a girl. I knew I could not do this again. My back would probably hand in its notice. My emotional well-being couldn’t survive it. I had plans for my health, for my work, for my life that are on hold. I can’t try any new medicines (herbal or otherwise) until I finish trying to nurse the baby.

In order to support my rest I finally started watching Grey’s Anatomy season 12 (not actually a good idea as I cried in most episodes) and rereading Middlemarch (George Elliot). I find comfort in rereading my favourite classics, I also got out my worn copy of Pride and Prejudice to begin my annual (sometimes biannual if I need the perking up!) reread of that.

Something about seeing my baby again and learning that he was perfectly average in size at week 33 enabled me to relax into the last weeks. The fundal height measurements had been placing him in the 20th percentile which was much smaller than his big brother and I had worried I had done something to cause this. Knowing he was 2.1kg made me feel proud and even more excited that my baby was growing and coming soon! With escalating back, neck and shoulder pain it was a nice reminder of why I was doing it all.

I am sharing these posts to provide a sense of what it’s like for a mama with Fibromyalgia to do pregnancy. Find my Pregnancy Diaries page her

The Whole Health Life – A Review

whole health life

Image from GoodReads https://www.goodreads.com/book/show/32885166-the-whole-health-life?from_search=true

In The Whole Health Life Shannon Harvey shares her learning from a ten year journey as a 20-something journalist diagnosed with an autoimmune illness living a fast-paced life to a 30-something healthy mama of two.

Of course this appealed to me, it’s a blend of research and personal story. It is an easy to read, compelling, evidence-based case for following the steps in The Whole Health Life.

Being healthy in this crazy, busy, modern world is not easy.

For journalist Shannon Harvey, finding a solution to this problem became personal when she was diagnosed with an autoimmune disease that had no known cause and no known cure. After being told by her doctor that she could end up in a wheelchair, she realised she had to take action. – synopsis from Goodreads

I loved this book! As a person who has been fighting Fibromyalgia for over ten years and has done a lot of research, I had previously found most of the lessons outlined in the book, but also further avenues to explore.

The chapers are the key steps in the Whole Health Life, these are all the main concepts in coping with Fibromyalgia, other chronic illnesses or just living healthily in general.

Stress

This step discusses the effect that modern life has on our body, chronic activation of the fight or flight response, and how meditation and mindfulness can help counteract this. Like the author, I have found meditation to be enormously helpful in my journey, not only for catching up on some deep rest from lack of sleep, but for calming my nervous system. I used to get anxious so much more easily and it would be more difficult to relax. Now I have the tools to calm down – breathing, focusing on the moment, and checking in with my body.

Belief

This is an interesting area of study. Our beliefs, positive or negative can effect our physiology – if we believe a medicine will work, there is evidence that this enhances (or creates) the benefit. I firmly believe that a realistic but hopeful mindset is key for coping with a long term illness. If we were to have our hearts broken with every new change or medicine we tried, we’d become pretty hopeless and this would in turn effect our health. If we have realistic hope that we can change our life, that we have control, then we will get much further in our journey to wellness.

I love her suggestions such as set your mindset positively (for example, I can walk 20 minutes, rather than I can’t walk 30 minutes); pay attention to negative expectations and be wary of them; meditate to lessen the effect of worry about our illness; make a ritual around treatments to allow something called classical conditioning to take place (p93); adhere carefully to treatment plans as this aids the expectation response.

Food

Food is a minefield at the moment. There are many recommended eating plans – but research suggests the only “best” eating plan is one that we will stick to. Personally, I agree with the author’s conclusion that a diet rich in whole, plant-based foods is the way to go (p102).

Movement

We know movement had to be included, it is vital for good health. We also know we don’t need to run a marathon or climb a mountain, especially if we’d hate the attempt. Let’s chose something we can stick to. I choose yoga and, incidentally, it hits all the aspects that research identities as useful for us: “a vinyasa yoga class can get your heart pumping, your muscles stretching and strengthening, and your mind-body connected (that’s neuromotor exercise).” P131

Environment

This chapter delves into nature vs nurture and the idea of epigenetics (that your environment can change your genes). It teaches you some ways to set up your environment for better health. Can you cut the commute? I did and it saved two hours of time, energy and stress per day, Harvey writes of the same experience. Something as simple as putting a nice looking fruit bowl in a prominent place can assist you in your healthy eating goals.

Sleep

Ah sleep, the thing I try to get all night and spend all day trying to set up well! Yes the research shows how important sleep is for our health, yes there’s a heap of sleep hygiene that may help. I have ordered one of the books on her recommended reading list for sleep – Night School: The Life-Changing Science of Sleep by Richard Wiseman.

Emotions, Healthcare and Relationships are the remaining sections.

This is well worth the read if you are facing a chronic illness or just want to invest in your health – don’t get dragged into ill-health by our culture’s fast paced, burn out risking standards. Start meditating, prioritise sleep, go for a walk, have a snuggle with your partner or have an apple at morning tea time today, just start!

Biofeedback Therapy, Another Tool

If you have read through my blog a little, you will see I have found meditation to be immeasurably useful. Especially in my second pregnancy.Biofeedback Therapy

The thought of furthering my meditation practice was a highly appealing one. In addition, receiving some assistance after doing this (mostly) alone for most of my life, was a nice emotional boost.

Having a tool that can help my body and mind relax so thoroughly has been a lifesaver. I have spent many many hours miserable, exhausted, sore and wishing I could sleep. When Nu was small and I was desperate for sleep, my body still refused to nap. And when I lay down, exhausted, hoping I’d pass out, I’d not only not sleep but become upset that I couldn’t. Now I can lie down for 15, 20, 40 or 45 minutes, depending on the mediation I choose, and feel rested and calm. Sometimes I fall asleep for 10 minutes at the end. This is one tool I seek to utilise every day.

In addition to this, I have found, through biofeedback therapy that I am able to effect my central nervous system through my meditation. As a person with Fibromyalgia, a central nervous system disorder, my parasympathetic nervous system needs some support. The emerging research around heart-rate variability is shedding light on just how important teaching our parasympathetic to activate is.

My two plus years of practice has made a big difference. Through deep breathing, visualisation and meditation I am able to activate my parasympathetic system (rest and digest) which I believe leads to less pain and more energy. I am definitely in a better place than I was prior to beginning my meditation practice.

So when I was offered biofeedback therapy with a health psychologist at the pain clinic after a non-event follow up with a pain specialist, I jumped at the chance.

A biofeedback therapy session involves having a heart-rate monitor placed on your thumb that sends your heart-rate to a laptop. The newer systems have fancy graphs and many things to look at, at it’s simplest, it provides beeps to let you know how high or low your heart-rate is.

In two sessions I tried two types of guided meditations led by the health psychologist and employed deep breathing and visualisation on my own. I was able to conquer the medium setting on the machine (apparently they don’t usually tell people with chronic pain that there are higher settings than low because without practice it can be very difficult).

I do need to practice relaxing my shoulders and neck as my heart-rate obviously kicked up when we got to those parts in the relaxation meditation. This is unsurprising as these parts are tight and sore all day, every day. A physio can make them relax a little through neck tractions and acupuncture needles in key points, heat can help too, but nothing makes them feel nice. So this is my homework, I’ll keep working on visualising and relaxing these body parts.

Biofeedback therapy has provided a useful check in with how my meditation practice is going and provided some areas to work on. I feel so empowered to have a tool that can not only initiate short term relief, but has long term effects (which are only just starting to be researched).

Has anyone else had experience with biofeedback therapy? Does anyone else find meditation to be so helpful?

Low Dose Naltrexone: An Experiment

There are three little letters that are causing a craze in the world of Fibromyalgia at the moment – LDN (low dose naltrexone). This is the last (for now) major experiment I can engage in.

Research has been showing promising results. Dr Jared Younger started with a tiny study and found positive results, approximately 65% of patients included experienced clinically significant results. He’s doing a bigger study this year.

How LDN works is well explained in this article, which includes many links to research.

It is meant to help with so many issues, including Fibromyalgia, chronic fatigue syndrome, gastrointestinal troubles and more.

If I could experience a 30% (this is considered clinically significant and therefore as success) decrease in pain and fatigue, my life would change! I could be a mama, a wife, do my work and have some form of a life outside that and not pay with such significant levels of pain, fatigue and other side effects of the Fibromyalgia.

I can only share research and what works or doesn’t work for me. We are all unique and react differently. If you’re interested in LDN then read the research/information and then discuss it with your doctor.

Key things I learnt:

  • It works best for me when taken at 9 (not earlier).
  • My main side effect was vivid, crazy dreams.
  • Titrating up 0.5mg at a time with four day gaps between increases, until 2.5mg when it was beneficial to wait a week or more.

I’ll update on this experiment when I’m closer to the four month mark – this is when most people I’ve read about in the LDN groups on Facebook find it shows the best effects.

Have you tried LDN? Any success?

What Works: A Roundup

I love research and reading about potential treatments for fighting Fibromyalgia. But there are so many options and so many variabilities that it’s hard to have a sense of what may work for me. I have managed to glean a list of what works for me and of things I would like to try. There are also some great blog posts outlining what other chronic illness fighters do. In this post, I wanted to share a few examples.
What Works-
I have written extensively about my experiments, my whole of life change and what I hope to try.
  –
Essentially, I have found that in order to be well (or the most well I can be) with Fibromyalgia is what any good health guidelines advocate:
  • Sleep as well as you can
  • Exercise gently
  • Eat healthily
  • Rest, meditate, pace
  • Practice safe posture on computers
  • Find your work/life balance
  • Nurture your passions
Donna from February Stars has recently written about what she is doing to counteract her three worst symptoms.
Bonnie Wagner-Stafford from BClear Writing wrote about how clean eating has helped her symptoms, including a serious gut cleanse. On the flip side of that, she posted about the six worst foods for Fibromyalgia.
 –
Veronique Mead writes about her top 10 Under-Utilized Tools for Treating Chronic Illness, I particularly like #5 Making Room for Resources and Pleasure, and #8 Meditating.
Donna Gregory Birch at Fed Up With Fatigue wrote about her Six Favourite Things For Fibromyalgia Relief (this blog is where I first read about low dose naltrexone, which I’m currently trying).
 –
Katarina Zulak at Skillfully Well and Painfully Aware wrote the Top 3 Things I Do Every Morning to Manage My Fibromyalgia, the stretches she provides are delicious!
 –
Hannah Radenkova at Superpooped: Adventures for the Exhausted wrote about her diet for managing ME, including a daily meal plan.
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What are some of the best ways you have found to cope with the myriad of symptoms that come with Fibromyalgia?

Fibro Mama Baby Diaries: The First Month

I fell in love the moment they put him on my chest. Despite the doctors dealing with my excessive bleeding and then stitching me up, I was lost in my son. He calmly laid on my chest and looked at me as I drank him in. fibro-mama-baby-diaries-month-one
I didn’t get that with Nu because he had been taken for some medical attention immediately.
I was blown away by these first precious moments. My boy, who I had worked so hard to meet, was here. After some time cataloguing all his fingers and toes and marvelling at this creature, we managed a full first feed. I thought things would be easier this time.
But again I found that after nearly 39 weeks of pregnancy and 32 hours of labour, breastfeeding is a real kick in the pants!
The second day cluster feeding led to a mangled nipple on one side, so I had to feed the baby from one and express from the other from day three.
It didn’t fully heal and the other side got very sore from overuse, so by week two I was expressing exclusively.
My energy levels and pain didn’t help production, so baby outgrew the amount I could produce per feed by three and a half weeks. Far from being stressed, I knew that it didn’t have to be all or nothing. I had the tools to mix feed so that he could continue to have breastmilk for as long as I could produce any.
Far from being the “easy” baby I’d hoped for after Nu and his being hospitalized for week three, W didn’t like to sleep in his Moses basket and only slept in my arms or on my husband’s chest for the first couple of weeks. By week three we did manage to get him to sleep in the basket after his last feed and until his 4am feed (when he wanted to stay with mama).
My body coped really well until both my husband and I hit the wall at three and a half weeks. Baby had a few days of extreme fussiness, hungry but gassy is not a good combination.
But I persevered with my coping mechanisms – quick meditations whenever I could, heat pack, ibuprofen, stretching and hot showers.
In addition to the Fibromyalgia, general post-birth pains and sleeplessness, I received a name for the severe low back and pelvis pain I had been experiencing: symphisis pubis disorder. Basically, my pelvis spread a little too far, probably due to the prolonged labour and having to use the stirrups. This made things difficult as I couldn’t spread my legs very far apart – no squatting, no stepping over things, keeping my legs together when getting out of bed etc. I had been so looking forward to being able to sleep on my back again, but this wasn’t possible yet. My physio suggested pelvic tilts and to see my doctor if it hadn’t gotten better by six weeks.
Nu adjusted really well to being a big brother. The sleep habits we instilled in him saved us as he slept from 7.30pm to 7am and then had a nap in the afternoon. Our constant refrain was “quieter!” As he speaks so loudly and gets very excited. He gives many kisses to baby and likes to help to feed him.
Pregnancy, labour and the first weeks seem much like rugby…You can plan all you like and utilise all the tools at your disposal, but in the end you have to put your head down and run in! I’m just super thankful for Husband and his help, because I don’t know if I could have coped without him.

Second Trimester, The Second Time

The second time around I truly found a distinction between the first and second trimesters, a real diminishing of symptoms. The nausea vanished, the more extreme fatigue receded and my low back pain eased. For a time.

second-trimesterThe relative lack of stress, limited work hours and the totally different place in my health journey all helped immensely. I had my coping mechanisms well in place. I already had a plan for coping with the third trimester, labour and the first weeks.

Sleep, of course, was difficult as my neck and shoulders hate (with a capital h!) lying on my sides. Every time I changed position, which was often, I woke. But meditation around lunch time for 20 or 30 minutes really helped me to cope.

Nu was really excited and shared the journey with me day to day, so that was really special!

Here’s what I did to be well:

  • Energy Revitalisation Formula – a general multivitamin to support nutrition for those with Fibromyalgia, any pregnancy multi is a good idea
  • Making better food choices – once I wasn’t so sick
  • Exercise as I could – this meant walking 20 minutes several times a week, being generally active (using 8000+ steps a day) and some gentle resistance work (superman, pelvic tilts and lots of pelvic floors)
  • Stretch – often!
  • Heat pack – not only does it ease pain, but I had to sit or lie down with it for it to stay on my neck or back.
  • Sleep and rest – bed at a good time, meditation about lunchtime
  • Journaling – taking time to write “mama notes” documenting the toddler and the pregnancy
  • Physio – every 2 weeks

As the trimester progressed and sleep deteriorated (due to worsening back pain) it did become more of a slog. But a heavy dose of acceptance helped – pregnancy is a trying time for any body, it is finite and I do all I can to help myself.

It also helped to be able to say things like, “these are my last first kicks,” “this is the last time I will have to cope with pregnancy-caused backache” and “this is my last second trimester”!

Fibro Mama Tools for Managing Early Pregnancy Symptoms

fibro-mama-tools-for-early-pregnancy-1Motherhood for a person with Fibromyalgia and Chronic Fatigue Syndrome is not a short sprint, it’s an epic marathon spanning pregnancy, labour and baby’s first year. So it’s really important to get your pregnancy wellness plan underway fast.

Here are some things I have learnt for tackling the early pregnancy symptoms:

Sleep – I tried as best I could, but I had a lot back pains which made lying down difficult. I needed pain relief to get to sleep and woke often either in pain or to go to the bathroom. I had pillows to alternate and utilised brief body scans to encourage certain parts of my body to relax. I found that the Chronic Fatigue was greatly flared up and the amount of sleep I got was almost directly related to my nausea levels.

Pacing – The second time around, I was super lucky that a work contract ended at week four so I had week five off to get into a routine of rest/errand. The first time around, I had little choice and needed to work the entire time, however I worked from home and was able to schedule lie down breaks regularly – for a while there I napped at 10am and 3pm (and my body’s a rigid non napper usually!) The work/rest cycle is really best for managing pain, fatigue and pregnancy. Sometimes it may feel as if the rest needs to be longer than the work portion, but try to allow that as best you can. Some days I was so (miserably) tired but couldn’t nap and  resting was the difference between coping and not. I actually lay down with my eyes closed and listened to Pride and Prejudice audio book which was a lovely treat.

Meditation – as a stubborn (my body, not me!) non napper and a troubled sleeper meditation was a lifesaver. It is useful first thing if you wake too early and cannot get back to sleep. It can be used midday, or whenever you need a lie down. Or it can be used right before bed. You can choose simple breath focused meditation, you can listen to guided meditation or do body scans. You can choose meditations specifically for pain or pregnancy. There’s a heap available on YouTube to try.

Exercise – walking is a big part of my usual pain management plan and this is no different in pregnancy. I had to pause my experiment to see if I could increase the amount I could comfortably walk without increasing the pain or fatigue. But I was able to continue gentle 20-30 minute walks all around our neighbourhood after the hardest weeks were over. During the worst weeks I managed about 10 minutes a day. Yoga was off the menu for me due to post exertion malaise, but this could return in the second trimester for me and may be useful for others in trimester one. Your body will tell you. Anything you did before is usually okay during pregnancy.

Here are three cool yoga poses for your entire pregnancy that I found https://m.youtube.com/watch?list=PLoLbQHZNNqOrHOyfkvlDDvKMi1Clz309c&v=5XKaDOYUpiw

Fuel – I needed smaller amounts of food more often, so I adjusted my meals to suit this and this helped stabilise my energy levels and avoid the more severe nausea. When I was the most sick and unable to eat I found that gently coaxing my tummy back to food with diluted orange juice, small amounts of milk, toast and then whatever I fancied worked. Crackers by the bed for midnight or 3am snacks was a handy hack!

Pain management plan – my doctor helped me to put together a system for dealing with the pain using as minimal medicinal input as possible. My big struggle has always been my neck, so I needed a dose of pregnancy suitable pain killers before bed. I took a combination paracetamol and low dose codiene mixture. I allowed myself one dose per day unless my back pain was severely breaking through the more natural methods of management. You may like to look into homeopathic remedies, using an experienced practitioner’s advice – my doctor is a big fan and I used Crampmed by Naturo Pharm.

There are a ton of natural pain control mechanisms that I have written about before (links) but a snapshot: heatpack, warm bath or shower, meditation, self massage or partner massage or paid massage, herbal topical relief cream (like arnica), gentle walk (seems counterproductive but often helps my neck and back the key word is gentle), a swim, distraction (funny videos, phone a pick me up friend), self trigger point, foam rolling, yoga poses (restorative poses for pregnancy), stretch (seriously, do this several times a day!).

Nausea – this is pretty much unavoidable but I have a few tricks for reducing it: 1. Keep your tummy from getting empty, 2. Don’t get too fatigued (using tools above), 3. Ginger lozenges or mints, 4. Acupuncture for nausea in the wrist point or the seasickness bands that hold pressure in the same point.

Going to the bathroom ALL the time – I can’t really help with this, but I do avoid anything other than water after 3pm and, otherwise, just go with the flow!

Plan – if you’re at all like me, you will find comfort in planning ahead. And write everything down because it may fall out of your head. Figure out potential parental leave options.

Enjoy – you’re growing a tiny human! Revel in that a little. Also enjoy the things you can do now and will have to give up later (weird fact, I do certain stretches and legs on a chair pose like crazy because I know I’ll have to give them up from week 16 or so!)

Do you have any tips for getting through the first trimester?