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There are many things you can do to limit relapses. Some are actions to take; others are mental adjustments to make the situation more understandable or bring consolation.
Rest, Rest, Rest
The most common strategy for overcoming setbacks is to take extra rest, continuing until the flare subsides (and even beyond --see next point). Dr. Lapp recommends alternating small amounts of activity and rest in a quiet, non-distracting place such as a sofa or lounger. (He discourages patients from staying in bed.) He also advises stretching and relaxation techniques.
Take Extra Rest, Even If Flare Seems Over
Long periods of rest can create frustration, which may lead to resuming a normal activity level before the body is ready, leading, in turn, to another relapse. To avoid a double-dip relapse, return gradually to a normal activity level.
For many people, this means taking more rest than usual for two or three days after a relapse seems to be over.
Postpone, Delegate or Eliminate Tasks
Reducing activity by postponing tasks, asking for help or deciding not to do something can help speed the end of a setback.
Use Positive Self-Talk
Because relapses can be deeply discouraging, it can help to say soothing words to yourself, such as “this flare will end, just like all the others.” Reassurance can help you relax; less tension promotes recovery.
Stay Connected
Connecting with someone you trust via a phone call or email can be helpful because of the suggestions you receive, because of the reassurance you get or just from feeling connected to another person.
Prepare
Having things handy and in place can help reduce the anxiety of a crash and make it easier to weather. You might keep a large supply of food in the house, including food that your family can cook (or defrost and heat).
Learn to Identify and Respond to Warning Signs
You may be able to reduce the length of a setback, or even prevent it, by training yourself to spot relapse warning signs and to take quick action.
Warning signs that a relapse is imminent may include feeling especially weak, tired or confused or having more pain than usual. Responses may include lying down, reducing your activity level, limiting sensory input and/or limiting your time with other people.
Address Perpetuating Factors
If a setback goes on longer than usual, look for perpetuating factors and address any you find.
Sleep often deteriorates during a relapse, so attempts should be made to insure a good sleep. Eight to nine hours of sleep nightly are generally recommended, but it may be necessary to sleep longer during relapses.
Anxiety and depression often flare up during a relapse. If untreated they may perpetuate the relapse by interfering with sleep, motivation, pain tolerance, and energy. If positive self-talk is not effective, it may be helpful to increase an antidepressant dose temporarily.
Relapses can be caused or lengthened by other medical problems. Infections such as recurrent bronchitis or cystitis can both trigger and perpetuate relapses and in endemic areas persisting infections such as Lyme Disease can be the cause.
A good medical examination and some laboratory studies can identify infections as well as medical problems such as thyroid abnormalities and hypoadrenalism.
Allergies, either seasonal (hay fever) or situational (new pet in the house), may be an aggravating factor, and hormonal changes such as menopause have far reaching effects on sleep, joint discomfort, and neuroendocrine imbalances.
Finally, medications can contribute to relapses. Failure to take prescribed medications can worsen symptoms. Also, drug interactions may create problems. If you suspect medications could be a cause of symptoms, review them with your doctor and eliminate everything that is non-essential.
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