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Is there Positive in an Exacerbation?

Ask yourself this: is there anything good that comes from a chronic illness exacerbation? The obvious answer is no. The hidden answer is yes.

Exacerbations do a number on our bodies and psyche. They are physical and mental setbacks that leave us feeling stuck in place until they are over. They can cause long-term damage or help progress our disease farther along.

Stating that an exacerbation can be “good” is unconscionable. As people coping with a chronic illness, we want to avoid them at all costs. Absolutely. But that isn’t always possible. I am aware that I could become a Zen Master and banish all the stress I feel in life, and still get hit by an MS exacerbation without warning. That is the very problem with a chronic illness: the unpredictability.

The key is to find a silver lining in the middle of each exacerbation as much as possible. There will be moments where maintaining optimism is near impossible, and that is fine. But in the moments we can find a ray of sunshine, we should embrace positivity.

The Frustration of an Exacerbation

Exacerbations slow us down. They can land us in the hospital for treatment, and they can leave us searching for more answers on how to best approach our treatment.

I hate exacerbations because of how much they set me back. Before I managed my MS, I would be in the middle of an important project, and an exacerbation would slow me down for several weeks while I recovered. My usual MS symptoms, like fatigue, often cause me to take a day “off,” while I recover in bed.

I often wonder if my body coordinates the timing of the exacerbation as a form of self-sabotage. I get ahead, and my exacerbations/symptoms pull me back.

There might be some truth to that conspiratorial belief. I am pushing myself so hard that I do not listen to my body, so my body has to get my attention. Fatigue, L’Hermmittes Sign are red flags that I am not taking care of myself.

And if I continue not to listen, the exacerbation comes along to stop me in my tracks and take a break. But by then, it’s usually too late, and I may not know the extent of the damage done by the flare-up.

Gratitude in the Lowest Moments

We know that exacerbations are annoying, we know that they can be damaging, so how can I find the positive in these adverse chronic illness events? What follows is what works for me, so your own experience may not reflect my own.

I learned that an exacerbation is an excellent opportunity to practice gratitude. Sometimes the flare-up affects my depression, so finding appreciation might be impossible. Literally, because the exacerbation is the source of a mental block. If this happens to you, try to remember not to feel discouraged because it is out of your control.

But in the moments where this isn’t the case, where the exacerbation impacts your body, where you can recognize what is going on, we can practice gratitude. This isn’t something you will be able to whip out on the first go, it will take practice. A lot of practice. Gratitude and positivity are hard to be the first thing we reach for in our lowest moments.

What would gratitude during an exacerbation look like?

Take time reflecting on the points I’ve listed below and try to find gratitude in at least one of them. If one of the points don’t fit or bring on further negative thoughts, move on, and find another aspect that can help.

When you find a point that works, take time to examine it thoroughly. Reflect on each part that you are grateful for, each positive experience you’ve had relating to it. This will serve as a healthy distraction from your exacerbation.

  • Your medical team. How quick are they to listen to you and respond to your needs?
  • Your support team. This might be your family, professional nurses/helpers, and beyond.
  • Your social network. Both online and offline. How well do they listen, respond to your needs, and help you through your tough times?
  • Your financial situation. Is it favorable or not? Do you have the means to care for yourself?
  • Your overall health outside of the exacerbation. What are you usually able to do and looking forward to once this resolves?
  • Your professional situation. Are you satisfied in your professional life, and do you find validation there? Are they supportive of your case?
  • Overall survival security. Do you have a home, food, ways to clothe and take care of yourself? Ability to get around, even if it’s less than ideal?

Hopefully, you’ll find plenty of things to be grateful for running for this list or have a starting point for your own gratitude list. It’s essential to find things you do have in your life, despite this low point, and focus on them as a means of distraction. The idea is to help uplift you until you recover.

Searching for Positive

I will acknowledge that it’s privileged to say that there can be a silver lining in almost every situation. Certain fundamental conditions need to be met before taking a step back and look for the positive. I am sure a number of my readers are in that position of privilege, but I won’t make a sweeping generalization.

That said, try and look for the positive even in the middle of your exacerbation. Finding the positive does feel futile at times, so don’t feel pressured if you can’t find it. There are going to be good moments, and there are going to be bad. When you first start off, there will be more bad moments until you get more practice.

The key is to retrain your brain to not focus on the negative, but be receptive of the positive. This will be an uphill battle, as our biology steers us towards the negative. We are no longer running from other apex predators when we walk in the woods, so take time to retrain the primitive brain.

Exacerbations, while overall, are not a positive experience, they can give us a chance to find the positive in our lives separate from the negative experience. They give us a chance to slow down, appreciate what we do have, and find a way to retrain our brains to focus on the positive aspects of life. It’s not ideal, it never is, but it’s one way to cope with an uncontrollable situation.


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Learning through Painful Experiences

On the Adult Swim show, Rick and Morty, there’s a minor character named Mr. Meseeks. In a moment of extremely dark humor, something the show is famous for, Mr. Meseeks admits that “existence is pain.” When you live with a chronic illness, there’s a lot of truth to that phrase: life can be literally and figuratively painful at times. But there’s something we should know: we can learn through the painful experiences.

While the Mr. Meseeks character can “poof” away after fulfilling its purpose, we cannot leave. We are stuck trying to find a healthy way to manage our physical and emotional pain.

What Pain Teaches

Pain comes in many forms.

It can be physical, mental, or emotion. Often, we find it’s a combination of these three: if I am in physical pain, I might feel it emotionally as well. One leads into the other in a domino effect.

Physical Pain

When pain is in a physical form, it can teach us what we are capable of handling. If it’s an expected pain, one that we can mentally prepare ourselves for: an outpatient procedure, exercise, or giving birth, it reminds us that we are strong.

Often, after these moments pass, we recognize we’ve become stronger because of the pain/discomfort endured. Scar tissue heals tougher, muscles build up, or we have a beautiful little one to show for the struggle. We endure, we grow stronger, and we have something positive to show for it.

When the pain is unexpected, such as an undiagnosed chronic illness, it can be discouraging. Even if we expect the pain due to our illness, it’s often coupled with the uncertainty as to when it will end. When we willingly put ourselves through a physically painful experience, we have an expectation of knowing it will eventually end.

Exacerbations and chronic pain do not adhere to such a timeline.

But this pain can still teach us what we are capable of enduring, even in the moments we feel like we’re barely tolerating it.

Emotional & Mental Pain

Emotional pain is harder to grasp. It’s so nebulous that when we think we’ve caught it, rooted it out, and dealt with it; it pops up in some other form in another part of our life. Emotional pain is a constant game of “whack-a-mole.”

The scars are harder to see when we’ve endured emotional abuse. Anything can cause our emotional pain to grow out of control. Even the slightest look from a stranger can turn our positive mood into a dark space. It might take hours to days before we get back into a balanced state.

Mental pain can be equally difficult to deal with. It may be out of our control, requiring chemical intervention. Please continue to follow your healthcare professionals recommendations if you require chemical intervention to manage your mental pain.

These types of pain also provide important lessons: emotional pain teaches compassion, while mental pain teaches us to honor and nurture our fragile nature in a healthy way.

I found that these three forms of pain, physical, emotional, and mental, all teach me one thing: I can endure, and I grow into a stronger person because of it. Without pain to push me, I stay within my comfort zone and do not develop into the person I have the potential of becoming.

You can’t Stop the Pain…

As much as we’d like to, there’s no quick fix to handle our pain. We can abuse medication or find other unhealthy ways to escape it, but that isn’t handling the pain as much as it’s kicking the can down the road. This form of avoidance can deepen the pain, making it more difficult to manage, which turns into a negative cycle.

Please note: I am not referring to using prescribed pain medication as directed by an ethical healthcare professional. I am referring to the intentional abuse of prescriptions or illegal drugs as a means of escaping physical, emotional, and mental pain. If you, or someone you know, is abusing medication, please seek help now. You can break the negative cycle.

Pain will always be a part of our lives. We cannot escape it; we cannot avoid it. When we try to run from it, like “checking out” or procrastinating, it can exacerbate the pain, specifically mental, and make it feel more overwhelming. It’s often a struggle to confront it, which is what we must do if we are to move forward.

If you cannot stop the pain, what can you do?

…But you don’t have to Accept it

Exactly that.

You do not have to accept the pain. You have to endure it, yes, because it will always be present. But you don’t have to give into it and let it “win.” Rather, you can find ways to manage it so you can put it in proper perspective.

For physical pain, you can learn meditative techniques to manage the pain. You can speak with a healthcare professional about a healthy way to chemically treat the pain or referral to physical therapy. The pain may be telling you to slow down because you’ve done too much, so take some time to rest. You can look at it as a challenge to test your abilities to endure and flip it into something positive.

For the emotional and mental pain, find a competent therapist or qualified accountability partner to help you work through it. Figure out why you are in this pain, what triggers it, and how you can healthfully manage it. Use healthy distraction techniques to keep you moving in a forward direction and minimize getting “stuck” in one place.

Learn to work with, through, and around the pain so it no longer holds you back. It is just one more hurdle to overcome in life, with or without a chronic illness.

Learning Through Painful Experiences

Pain gets a bad rap for being negative. To be fair, it can be negative most of the time. But remember the planned pain, like with exercise? That pain can bring on positive growth. It teaches use we are strong by making us stronger.

Try to view the unplanned pain from illness or injury in a similar manner. It is teaching us something about ourselves: what we can do with it, how we can handle it, and possibly how our lives are better because of it. There are plenty of people out there that lose part of themselves, enduring pain from trauma, to come back stronger than before.

Pain teaches us a lot about ourselves, we just have to be willing to listen to what it has to say.


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Illness as a Positive, Part II

In November 2018, I surprised myself when I wrote about how I was grateful for my MS diagnosis. Before writing it, I thought about the benefits of my diagnosis, in light of all limitations. I was healthier, mentally and physically because of it. I made and achieved personal goals since my teenage years. Can an illness be a positive? I asked myself.

As I wrote, I found the answer was “yes.”

This isn’t a case of the dreaded “inspiration porn,” that plagues people with chronic illness. I am not saying that chronic illness is some test that brings enlightenment to its sufferers meant to inspire others.

I was talking to Ash a few weeks ago about how my MS isn’t “sexy” enough to be inspirational. I’ve temporarily lost leg function before, but never to the extremes that other people with MS experience. There’s nothing inspirational about my diagnosis and disease-management story.

What I am saying is that, for me, getting ill was the wake-up call I waited for all my life. The call rang in the background, but I kept ignoring it. Getting the “all clear” from my neurologist on my brain lesions shook me out of complacency. I reached my “rock bottom” and needed to work towards the person I dreamed of becoming for so long.

I absolutely have my moments where my MS is a negative thing. I hate my brain fog, when objects slip out of my hands, or I struggle to get out of bed due to fatigue. There are days where I wish I could trade places with someone who isn’t chronically ill just to feel “normal.” I will admit: this daydream occurs at least once a week.

Taking a mental tally of the benefits my illness brought me versus the negative, I’ve found that the positive outweighs the negative. This won’t be the case for everyone, my MS was never that bad, to begin with, but making the decision to be positive is one form of disease management.

How? It gives me a more realistic view of the severity of my illness. Before, I had a hopeless view of my future. I waited until I progressed to Secondary-Progressive. I now see that the MS does not limit me as much as I thought it did.

Deepening Appreciation

My perspective on my illness is evolving. Rather than re-publish the post in November with some edits, I wanted a separate post to reflect on everything I’ve learned about myself and my MS in the last eight months. Life is a classroom, and I’ve learned a lot more about myself since November.

In childhood, I was taught adversity was a good thing: it’s what shapes us into stronger adults. It’s one of the reasons why I chose the lotus for MS Awareness on the blog. Through the mud does the beautiful lotus flower bloom: a perfect metaphor for what it’s like to live with a chronic illness.

We sit in our dark moments, in the middle of an exacerbation, unable to see the internal growth taking place. When the exacerbation is over, we blossom into a more resilient person, wiser from the experience.

I just passed my second anniversary since my last major exacerbation, but I still live with a fear that I will wake up with blindness in one eye, or unable to lift my leg to walk.

I am more aware of a lot of things in life.

I’ve become more mindful of my time, choosing to live in the moment more, rather than focusing on the future fear of an exacerbation. I appreciate each day I get exacerbation-free. I am aware of my aging, and what my elder years might look like with MS. I recognize my mortality more, not because MS might kill me, but it might take my ability to function away from me, so I have to wait for years to die in a hospital bed.

This is unlikely to be my situation, but this disease is so unpredictable that I cannot rule it out entirely.

That is something the MS taught me: the unpredictability of it all. Everything. Each time I go out to exercise, I play with Jai, I interact with Ash, or love on my cats; each of these moments is so precious because I do not know what I will wake up to in the morning. If I am lucky, MS won’t get me, but MS did make me aware that anything can. MS taught me that every day is a gift and you never know when it is your time to go.

I know that’s morbid, but it’s why I developed a more positive outlook. If we are given a brief chance to look back at our lives at the end, will I leave feeling positive about my life overall, or negative?

The Importance of a Positive Outlook

I am speaking from a place of acceptance with my illness, so it’s easy to maintain a positive outlook. We are not all there yet, as we work through the stages of grief post-diagnosis.

Once you reach a space of acceptance, try to look at life more positively. Look not at the series of moments of what you cannot do, but at the moments of what you can. You may be surprised that you can do a lot more than expected. Now re-examine the things you think you can’t do and see how you can adapt to make things happen.

I never thought I could be a runner, before MS and especially after my diagnosis. I did not think I could be a mother. I never anticipated getting into a positive space with my more adversarial acquaintances.

I never thought I could improve as a person, especially after my diagnosis.

And yet, here I am. If I had the opportunity to go back ten years to interact with myself, past me would not recognize present me both physically and in personality. I am a completely different person.

It started when I stopped looking at what I couldn’t do and adapted myself, so I could “do.” Embracing a more positive outlook, I started to say “yes,” to more opportunities to grow. I don’t know if that would have happened without my MS.

The Grace of Chronic Illness

Having a chronic illness is awful. This is never in dispute.

There are difficult days where we can’t get anything done. Where we are so miserable, physically, and emotionally, that we just wish it could be over. But the grace of the chronic illness is this: it teaches us compassion towards ourselves and to others in similar situations. We can share our knowledge and experiences with others who are struggling to navigate their chronic illness.

Another reason why we should view ourselves as lotus flowers: the lotus flower represents compassion and courage. We are reborn in our illness and able to cope in ways we previously wouldn’t expect.

The illness teaches us how much we can endure, and we are capable of enduring a lot. You might discover one day that a friend experiences the same pain you do, but cannot manage it without external help. Meanwhile, it’s a pain you experience daily but manage through mindfulness and perseverance.

It’s not about comparing pain or experiences, but acknowledging that our perspectives and thresholds differ from person-to-person. It’s also about acknowledging what you are capable of doing.

Who you are and who you can be.

It would be nice to have a cure for our illnesses in our lifetime. But that may not be on the horizon any time soon. Waiting for a cure and rehabilitation to change our lives is something we may not have the luxury in doing. Shifting our perspective towards our illness, no longer looking at it as an entirely negative force in our life, can help get us on the path of self-discovery and self-appreciation.

The grace of our illness teaches us to appreciate our lives as they are now and the value of life itself.


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Featured photo credit: Michelle Melton


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Focusing on the Positive

I struggle with the idea of focusing on my positive qualities. It became so ingrained that I am a bad person, that the idea of having positive qualities can be physically painful at times. When asked by others to name something I appreciated about myself, I often balked at the exercise, trying to find the most superficial, least offensive thing I could name: my laugh?

In an awkward couple of seconds between the question and my response, I often have a tightness in my chest coupled with intense shame for seriously considering the idea that there is something good about me. I struggle to take a compliment, and I am known to self-sabotage an opportunity if I know I will succeed.

When I recognized the unhealthy relationship I had with my positive qualities, I realized I needed to not only examine it further, but I wanted to learn to celebrate the stuff I loved about myself. If I were to heal my painful internal narrative, I would need to start countering it with some facts about myself: I am a decent person, and it isn’t arrogance to say that.

For the rest of this month, I will be discussing the importance of highlighting our positive qualities, illness included, as a way to develop a healthier relationship with ourselves.

Learning to Fall in Love

You may already love yourself, and that’s a wonderful thing. No one is more deserving of your love than yourself. This month will hopefully serve as a refresher course of why you fell in love with yourself in the first place.

But if you are like me, you need to find a way to fall in love with yourself. You may be searching to do this right now, which is why you landed here, or you haven’t realized that it’s a necessary step in the self-improvement journey.

While this next step should be fun, it may be painful for you as it is for me.

That pain is part of the process of developing any new relationship. When you try to fall in love with yourself, you are fostering a relationship just as you would with a potential lover or friend. There will be awkward moments where you’ll wonder if you messed up; where you are uncertain if the other person will even like you back; or where you’ll discover something new that mildly annoys you. The comfort is that the other person in this relationship is you and they literally are not going anywhere.

So this is an opportunity to freely explore yourself, one where you can remove judgment because in the process of getting to know yourself better, there is no right or wrong way.

To get you started, take a few minutes to figure out what you are comfortable admitting you like about yourself.

Listing off our Positive Qualities

If you follow the weekly newsletter, you may have done this exercise already: list off five things you deem positive about yourself. For now, keep the list to what you are comfortable admitting to yourself.

This list can be as superficial as loving how you sneeze, or as deep as your ability to be a quality baker/cook. Make a list quickly, without overthinking it, as this will allow you to unconsciously list what is important. Sometimes when we don’t overthink something, we allow ourselves a glimpse into our deepest truths.

I find when I do these sorts of exercises, and I overthink it, I will backtrack and put down the “right” answer, thus skewing the intended outcome. When we are learning to fall in love with ourselves, we have to do the number one thing all relationship experts agree on in a two-person relationship: being honest.

Since I am also on this journey of learning to fall in love and developing a healthier relationship with myself, here are five things I came up with in my exercise:

  1. My personal drive and motivation to accomplish goals
  2. My laugh and how it can be infectious for others
  3. My cooking/baking abilities and adaptability in the kitchen
  4. My sense of humor
  5. The love that I have for others

The Struggle to Love

You may find, like me, that making these lists are the start of that uncomfortable feeling we get. Admittedly, these lists are a tad silly, but they serve a purpose. To physically manifest our positive qualities. Sometimes we have these ideas about ourselves that float around our head, but when we take the time to write the idea out on paper, we make the idea “real.”

I feel foolish admitting to these five things, even now, because of the embarrassment I feel about myself. If I allow this embarrassment to control my thoughts and actions, I won’t allow myself to feel something for myself. I will remain afraid to take steps to fall in love.

Like approaching a crush, we might talk ourselves out of an opportunity to put ourselves out there because we fear rejection. Our negative self-talk will try to reject us, but we must persevere. We want to love ourselves despite what our negative narrative tells us.

These steps, like any relationship, will come slowly. Overcome the initial embarrassment in favor of reaching out for connection. Take it slowly and see where your unconscious takes you as you grow more comfortable with the idea of loving yourself.

Celebrate Ourselves

As we hurtle through July, take some time to celebrate yourself any opportunity you get. Achieve a small goal? Celebrate by allowing yourself some kind words of encouragement. Overcame an obstacle? Allow yourself a pat on the back. Find ways to treat yourself in a healthy manner.

Be open to any and all opportunities that come your way to celebrate you.


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Mindfulness as a Coping Tool

You are probably asking yourself, how do I handle my self-doubt in a healthy and meaningful way? There must be an easy way to address self-doubt once and for all. Unfortunately, no. Remember, self-doubt can be healthy, provided it’s not preventing you from something you are capable of doing. While there is no way to removed self-doubt entirely, there are ways to cope with it, so it is less bothersome. Mindfulness works as a coping tool when it comes to our self-doubt. It can quiet our fears enough that we can take a step into the unknown.

I love mindfulness because I find it to be one of the more successful therapy techniques I’ve used on myself, especially with my MS. It helps me drop all the baggage I have in the past and about the future to focus on the moment I am “in.”

How Mindfulness Impacts our Lives

Mindfulness is about finding ways to be present at the very moment we inhabit. Rather than focusing on a nebulous future or an unchangeable past, we focus only on the now.

For a person such as myself, mindfulness is difficult to practice. My mind pulls in multiple directions at any given time. I am the sort of person who cannot just sit and watch a TV show or movie (at home) and not be on my phone working on something else. I live for multi-tasking. If I am sitting “idle,” I could be doing something productive with that time even if it’s catching up on the news or latest social media trend.

When I sit down to practice mindfulness, I confront all the thoughts I’ve pushed aside throughout the day. Something I said three days ago, why haven’t I started that task that’s due tomorrow? Focusing solely on the moment feels impossible sometimes. But it does not need to be a long, drawn-out meditative task that we are led to believe (unless you want it to be).

That’s where I would always get hung up on the practice. I had to sit for five to ten minutes, focusing on the moment. An exercise such as that is useful, but untenable if you need a quick mindfulness check while sitting in traffic.

Think of mindfulness as putting temporary blinders on. When your doubts get so overwhelming, take a few seconds to breathe, and push out all thoughts of your past concerns and future worries out of your mind. Remove the distractions preventing you from taking the steps you know you want to make and realize only the current moment matters.

If you are starting something new, or feeling overwhelmed by your chronic illness, being mindful will help you gain the clarity that comes from being singularly focused. It allows you the chance to take life one step at a time so you can catch your breath and say, “I can do this.”

Mindfulness as a Coping Tool

Mindfulness is an ideal tool to combat self-doubt because you have to live in the moment. Most of our doubt stems from previous experiences informing current concerns, or future worries preventing us from taking a significant leap.

Sitting within the moment, rejects past baggage or future concerns. As soon as we bring up a previous failure, we are no longer in the current moment. Or when we focus on a potential roadblock in the future, we are out of the moment.

Mindfulness creates a blank slate for us to work and build on. We have no room for insecurities or restrictions at the moment. Logistics come after the mindfulness exercise is over. If you want to walk a 5k and MS makes walking challenging, mindfulness allows us the chance to say, “I can do it, despite my difficulties.” Then we work backward from that goal to figure out how we can achieve it.

The more I live within the moment, the less I can focus on what I can’t do. I am not a grasshopper in these moments; I still keep my eye on future concerns and work hard on my time-management. But when I am focused on the task of achieving something important to me and only concentrate on it, I don’t have time to think about my doubts.

When self-doubt comes creeping in, I tell the doubt that I don’t have the mental energy to entertain it. Often, that’s enough to stop it altogether.

Self-Doubt, Chronic Illness, and Mindfulness

The exercise of mindfulness is all well and good; you may be thinking to yourself. But what about my illness? Most of my doubt stems from my illness. My illness prevents me from that skydiving adventure I wanted to take since childhood. Or, I would love to start my own business, but I don’t have the energy to begin the planning process, let alone run a business.

There may be limitations your illness places on you, but have you taken the opportunity to find alternatives or workarounds? Or has your self-doubt gone only as far as stopping you from considering anything?

For myself, I allowed my MS and self-doubt stop me from even considering an alternative life path. I assumed I would wait for the inevitable, my MS getting so bad that I would be a burden on my family. I would never teach; I would never start a family; I wouldn’t make it past forty before my body broke down.

The moment I pushed my self-doubt aside when Ash and I decided to start a family, was the moment I started allowing myself to make alternative plans from the ones I had since childhood. My teaching evolved into this blog, and I am interested to hear what my GP has to say about my overall health. I know my neurologist is hugely impressed with my progress.

Your journey will not look like mine, but it may take you in a similar direction to the one you envisioned for yourself. You may decide to work towards that skydiving dream regardless of your illness. In the process of preparing for it, you may find a useful alternative that gives you the same freedom you were looking for in the first dream.

Or you may not officially start a brick-and-mortar business, but able to sustain freelance work in the field of your choice.

You need to take a moment, focus on where you are right now in life and illness, and decide what you are capable of doing right now , rather than what you may not be capable of doing down the road. The answer and result may surprise you. Hopefully, it will be like my answer: better than I expected.


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