Lupus Recovery Mode: The value of doing nothing

In my book, Despite Lupus, there's a section about learning to compromise, a must when it comes to living well with lupus, in my opinion. Specifically, I talk about the ability to indulge every once in awhile in an activity that might be a little outside of your normal "lupus" routine, as long as you're willing to put in the extra downtime to allow yourself to recover. We're not talking about anything that would be dangerous to your health, or one that puts you at risk. Rather, we're talking about deliberately choosing to do something that might be a teeny bit taxing, but puts a smile on your face. Here's the excerpt:

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Indulge, but wisely

A friend of mine was struggling with the sacrifices that lupus was forcing her to make, like reducing her sun exposure and restricting her activity level. She had a chance meeting with another woman who had grappled with the same things, but who had come to the following conclusion: indulging every once in awhile in an activity that is deemed “off limits” is okay if you allow yourself ample time before and after to recover. This woman happened to be an avid tennis player and it was causing her more stress and anxiety to miss out on a match than to deal with the effects of playing one. Given that her body was more fragile and prone to exhaustion with lupus, she realized that if she took it easy the day before and after she played, she could enjoy her pastime and not put her health at risk. As long as you’re willing to compromise, you can enjoy doing just about anything.

Keep in mind that a compromise like this one should be viewed as an indulgence, not an invitation to develop a routine. Don’t let the thrill of the experience convince you otherwise. Just like eating a cookie on a diet, it’s not the one cookie that does you in. It’s getting a taste for it and wanting a second, if not a third. 

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Along these lines, I decided to indulge this past weekend, by throwing a dinner party. We haven't had friends over for dinner in a long time, for obvious "flare" reasons, but I decided I was up for trying. I promised Johnny (and a few of my guests) that we'd order take out or cancel if I needed to at the last minute. But I ended up feeling fabulous leading up to the big night, and the evening went off without a hitch. It was relatively stress-free - the house cleaners had come the day before, I'd casually prepped the sides and dessert during the week, and Johnny took care of making the main dishes. We all had a fabulous time.

But, as expected, the extra hours on my feet, and even the minimal amount of prepping, serving and "hosting" took its toll. By the end of the relatively early evening, my knees were swelling by the minute. I felt fabulous, but my knees and ankles said otherwise. We said our goodbyes, and even though we had a mountain of dishes to tend to, I went straight up to bed. I even coerced Johnny to come up and lay next to me so I wouldn't feel like I was missing out on our typical chit chat as we tidied up after a party. The next morning, my knees were better, but I felt the effects of a long, yet fun evening. So I took it easy. All. Day. Long. I stayed in my pajamas, drank plenty of tea, and did a lot of lounging. Johnny, superstar husband that he is, cleaned up every last pan, filled and ran the dishwasher twice, and left the whole place looking good as new. All the while, I leisurely read books to the girls, sipped hot beverages, and allowed my body to recover the way it needed to.

When I woke up on Monday morning, feeling fabulous, without a shred of symptom activity, I turned to Johnny and declared the weekend a success, due in part to all of his help and assistance. In fact, I asked him if he thought it was fair that I'd scheduled the get together, asked people over to the house, just to have him end up cooking and cleaning and running the whole thing. He said he had a swell time - and that he would do it again in a heartbeat.

We'll wait a few heartbeats, of course. After all, it was an indulgence, not an invitation to go crazy!

Back to the basics, a.k.a. what I can do, now that my prednisone has kicked in!

Relief at last! Per my post on Friday, not only did my doctor add Cellcept to my medication regimen at my most recent appointment, he changed up my prednisone a bit, giving me instant relief in the mornings. He suggested we add 2.5 mg to my daily dosage, and that I take that 2.5mg at nighttime. I'm to continue administering the 5mg I've been taking daily in the morning. It seems to be just the right combination to get me through until my Cellcept takes effect. We're taking it one day at a time, but things are looking good!

Now that I have the functionality of my joints back (particularly my hands) between the hours of 8am and 1pm each day, there are a few things that I need to tend to. Granted, I won't be engaging in any four-hour calligraphy sessions - just getting back to the basics of my day. Here's what I'm going to tackle: 

Sewing: My family's garments appear to have gone downhill since my joint pain flared! At last count, Bernadette's winter coat had all three snaps missing (both sides of each snap, in fact) - leaving her with absolutely no way to close her coat. Eek! Thank goodness she has a heavier coat that's been able to get her through. One of the three snaps fell off earlier this winter, so I seized the chance to sew it back on during the end of my 10mg taper. (I had three days when I was completely pain-free, before I went down to 7.5 mg, so I tackled it then). Unfortunately, two weeks later, it came off again. At that time, I was knee deep in steroid withdrawal, and couldn't find a pain-free moment to work on it. Sure, between 5-8pm I was feeling pretty nimble...but sewing was the last thing I could tackle during the dinner/bedtime routine, as you can imagine. But now - I have my needles and I'm ready to sew. Bernie's coat, along with a couple of items for Deirdre and Johnny, will be back in action, just in time...for Spring. 

Eating my choice of breakfast: My favorite cereal, Oatmeal Crisp, has had to take a back seat during the last month or so. Most mornings, I was waking up with terrible joint pain in my jaw, and the crunchy, albeit delicious cereal was just too much for my jaw to handle. I'd resorted to pancakes, smoothies, and eggs, which aren't bad alternatives. But I was craving my fave cereal and the ability to crunch away. Now I can!

QC'ing my Pillbags - While the ease of the zipper pulls makes the pillfolds ideal for arthritic hands, I found that doing efficient quality control on 150+ pillfolds wasn't quite so easy! I had a huge shipment of inventory arrive just after Christmas, but I haven't had a chance to check them because of my joints. Even checking 10 of them adds up to 80 zippers at a time - which can be too much for really swollen digits. But now that my fingers are up to it, I'll be checking those bags in no time, and getting the Pillbags stocked and ready for Mother's Day.

Buckling the car seat - I temporarily offloaded the buckling of Bernadette's car seat to Deirdre, and it was wonderful of her to step up to the plate. It usually added 5+ minutes to our departure time, however. The girls would get to giggling, or Bernadette would want to do half of the buckle, or any number of distractions would occur, so it wasn't quite as seamless as it could have been. I figure I'll let Dee and Bee continue to help now and then, but it will be nice to resume the responsibility and make an attempt to leave on time. (Note that buckling a 5-point harness car seat could have been the single, most painful action required of me each morning. It was murder on my joints. I'm sure many of you can identify!) 

Doing hair - The hair styles of the Gorman girls have probably taken the biggest beating during this flare. I haven't used the flat iron on my hair in a long time, and the few times I have, it was conveniently before going out for the night, during my prime pain-free slot of 5-7pm. And Dee and Bee have had to forgo what they call their beloved "Elsa" hairdo - a side winding french braid that ends in a bun. But my magic styling fingers are back, so the ladies of the house will look ravishing once again! 

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There are a few things that we actually won't be going back on. Here are the workarounds that are worth keeping, among others:

Dee and Bee will continue making their lunches - I would never force the girls to make their own sandwiches, but they really seem to enjoy eating their own creations. And, given a little guidance, they do a pretty darn good job. I've started doing it more often than I was, but I'll continue to take a back seat as long as they'll let me. Watching Bernie spread peanut butter is one of the cutest things ever! 

Going to bed at 10pm - A ten o'clock bedtime really seems to work well for me. It does cut short our evening a bit, but we've pretty much adjusted to doing all we need to between by 10pm. It really has been an improvement in my routine, so the early bedtime stays.

Back on Cellcept. Hooray!

In Wednesday's post, I told you how emotionally prepared I was to accept my doctor's recommendation to start Methotrexate. I was ready and willing to go big-gun when I arrived for my appointment...but before we moved forward, my doctor wanted to hear details of what had transpired in the two months since I'd seen him. (Note that my appointment wasn't scheduled for a month later, but because I was in such pain every morning, and my attempt at a second prednisone taper was clearly failing, I called and moved up my appointment.)

I told him about the joint pain every morning, that didn't subside until 1 or 2pm, or sometimes as late as 6pm. I told him about the swollen lymph nodes, the tingling sensation in my hands, my light headedness, and my fatigue. I told him about the swollen joints, the hot-to-the-touch joints, and the sensitive elbow and foot nodules. He then told me about my lab results, which showed a drastic increase in disease activity. In conclusion, he and I deduced that I was in an all-out flare - and it was time to make a move.

So although we started the appointment with the intention of adding Methotrexate to my medication regimen, after he reviewed my symptoms, asking for my input along the way, we decided that CellCept would be the best option at this time. And I jumped for joy, primarily because I've taken Cellcept before and I know how well it worked the last time. But I was also relieved because I know what to expect with the drug - I know how it's administer, have a firm grasp on the side-effects, and have a good idea of how I typically respond to the drug. Knowing what to expect makes all the difference!

As soon as we settled on CellCept, I felt as if my doc was throwing me a lifeline. Immediately, a burden was lifted. The burden of waking up morning after morning, completely overcome with pain. The difficulty sleeping, the challenge of pushing off the sheets first thing in the morning, having to choose certain pajamas that were easy to remove. The silver lining was that throughout the day, the pain did subside. But waiting the four, six, or eight hours until that relief occurred was taking its toll. But with Cellcept on my side, I felt like the world was opening up again. Not only did I see visions of pain-free breakfasts and unrestricted morning activities, I saw the possibility of the return of a happy, flare-free lifestyle. One where we can travel when we want to, make plans when we need to, and simply return to the "living well" lifestyle I'd become accustomed to, one which is relatively void of symptoms. (I still have the afternoon fatigue to contend with - but I can manage that.)

You never realize how your outlook on life changes when you're sick. After hearing that Cellcept would be added to my list of medications, I realized that I'd put a ton of plans in the "up in the air" category for the coming year: the speaking engagements I have scheduled for the spring, and the trip my husband and I have planned for this fall. Even the Girls' Spa weekend I have coming up next weekend. In the back of my mind, I wondered how, make that if, I was going to be able to make them happen. Now, with Cellcept in my pillfold, I feel confident that I'll feel good enough to fully participate in each one of them.

But don't worry - I'm not going to go crazy. I will continue on the path to wellness by getting my sleep, monitoring my activity level, and not overdoing. And there's always the possibility that my disease has changed such that Cellcept won't be the cure all it was before. But I don't believe there's any harm in hoping for the best!

While Cellcept is a welcomed addition, it's not without slight trepidation that I start the drug. It does have its own set of side-effects. But this article I posted last year about there being no clear link between lupus and lymphoma eases my concerns.

Next week, I'll continue with details of my appointment and changes in my medication.  Now more than ever do I need a Pillbag to keep it all straight!

My lupus decision making process, better known as R-E-L-D!

When I'm faced with a big decision regarding my health, as I feel I am now re: the choice of starting a big gun medicine like Methotrexate, I tend to follow a pattern. In fact, my modus operendi looks something like this: Resist, Educate, Listen, Decide.

Step 1: I "resist" the change to begin with, be it a new drug, a lifestyle change, or an alteration to my routine. Whatever "it" is, I don't like the sound of it the first time it's suggested to me. Sometimes, I reject it outright, like I did years ago when it was suggested that I order my groceries online. I was sure online ordering was only for the sick and disabled...and it wasn't until I wised up a few months later that I realized having my groceries delivered was designed exactly for people like me (the sick and disabled!) Other times, when faced with a new suggestion, I turn up my nose at the idea, but reluctantly agree to consider it. Either way, an immediately welcomed change, it is not.

Step 2: I decide to "educate" myself about whatever change has been suggested - forcing myself to research, talk about, or explore the pro's and con's of said change. I used to not enjoy this research part very much...but now I actually find it very empowering. The longer I have lupus, the more comfortable I am probing other people for information, be it patients who've experienced the same thing, or medical professionals who could weigh in on the situation. If I think someone might have a morsel of information that could teach me something about the subject, I ask.

Step 3: I open myself up to "listen" to signs and signals that point me in the direction of a decision. I will myself to become more attuned to coincidences, and make an effort to make connections that I might otherwise dismiss. Like the time I happened upon a story in a magazine where a woman was talking about her struggle to decide to go part time at work. I was, at that very moment, struggling with my own decision to take a part-time position at my office. I could have just brushed off the occurrence, convincing myself that the circumstances surrounding her deliberation were surely different than mine. Instead, I read the entire article, and took it for what it was: a sign that if this random woman in a magazine could muster up the courage to go part time, so could I. In instances like these, I attempt to embrace the coincidence - chalking them up to fate, divine intervention, or what have you. I figure I can use all the help I can get! (Here's another example of acknowledging the signs around me - in my decision to start Cellcept years ago.)

Step 4: I "decide" on a course of action, based upon the process above. By the end, the choice to be made has usually become so crystal clear that I have very little difficulty making the call in the end.

Of course, sometimes I wish this little ritual of mine wasn't quite so predictable. I wish I could break away from the structure of my decision making process and just spontaneously come to a good, solid conclusion within moments. But it doesn't work like that. And it probably shouldn't, if I'm to make prudent, well-thought out decisions. And so I've learned to expect my ritual. I know the steps to take, and I know how the process is going to go.

And so it went with my decision on whether or not to start a big gun drug like Methotrexate: I resisted, then researched, then randomly picked up a book club book, only to read about one of the main characters being on, drum roll please, Methotrexate. Thus, I decided that everything was pointing me in the direction of starting the drug, including the fact that my prednisone taper wasn't working. I went back to my doctor, and confidently told him that I was ready to start Methotrexate. It just took about two months for me to realize it. Not bad in the grand scheme of things. I'm just glad the book I read was THIS month's book club book...rather than our casual summer reading!

In an upcoming post, I'll tell you in detail the plan that came from that most recent doctor's appointment. Never a dull moment in lupus land, I know that!

Guest Post - Dr. Donald Thomas, Author of The Lupus Encyclopedia - due out this year!

GETTING THE MOST OUT OF YOUR DOCTOR’S APPOINTMENT - Guest Post by Donald E. Thomas, Jr., M.D., FACP, FACR, RhMSUS, CCD. 

A few years ago, I ran across a very interesting book called, “Say The Magic Words” by Lynette Padwa. It was eye opening in that it talks about the inside language, policies, and procedures of different professions. Each profession has its own “secret” language, and if you have an inside knowledge of this “secret” language and use it, you can really gain a significant advantage when dealing with these different specialties. This book goes into how to speak to attorneys, car dealers, doctors, hairstylists, hotel reservation agents, landlords, nannies, mechanics, real estate brokers, therapists, teachers, and many more.

It got me thinking that the exact same thing occurs between doctors and patients. Doctors go to school for many years to learn and refine their skills on how to take care of patients, but in the end, they end up speaking a highly technical language that is “foreign” to most people. Yet, since we are completely immersed in that language and processes most of our lives, we can easily forget what it is like to be a nonmedical person. This unfortunately, can lead to a clash between some doctors who forget how to connect and the patients who need our help. We actually do not want to be a “secret” language, but it often ends up being that way. Many doctors are very good at learning to communicate to the patient (i.e. interpret things in layman’s nor nonmedical persons’ terms), but unfortunately, some never reach this important point.

As the patient, though, you do have it in your power to turn things in your favor. If you know the right things to do and say, it can actually help communicate what is wrong and what you need to the most mechanical, scientific physician. If fact, I feel that this is such an important topic, that I devoted an entire chapter in my upcoming book, The Lupus Encyclopedia, to this topic. In the meantime, at the kind request of Sara Gorman, I’d like to present some of the “secrets” on getting as much out of your doctor’s appointment as you can in the next few paragraphs with some “do’s” and “don’ts”.

1) DON'T go in with 4 pages of single spaced, 2000 word list of all the symptoms that have occurred since your last visit unless you are prepared to see your doctor's eyes roll and try to compose him or herself. On the surface, it is easy to convince yourself that you are doing the right thing; you are being very comprehensive, and you are making it “easier” for the doctor to know exactly what has happened. But you must remember, that your doctor has many patients to see that day, plus has many other duties (reviewing labs, reading x-rays, discussing cases on the phone with other doctors, studying the most up to date research articles) and he or she only has so much time in a day to do everything. This sort of list will only overwhelm him or her and will most likely not even be read, or will be skimmed at best.

     - Do write down 3 questions or problems that are most important to you and write them down very briefly; be short and concise; maximize your description efficiency.

2) DON'T say... "Oh by the way...." when your doctor is about ready to leave the room. He or she probably has rooms full of other patients and was mentally prepared to go onwards.

     - Do give your list of 3 questions or problems to your doc immediately at the beginning of the visit so he or she can maximally devote appropriate time to your concerns and address them. Also, make sure to let him or her know what medications need filled at the very beginning as well (it does take some time to write prescriptions).

3) DON'T be rude or demanding to staff, phone people, office manager, then be all nice to the doctor.... you will only sabotage your image at the office and things will happen that you don't want (it shouldn't, but people are people, and they react certain ways to impoliteness). Upfront I will say that the vast majority of patients are wonderful and nice to everyone, but I am occasionally surprised to find out that someone who I thought was very nice is actually rude and demanding to the rest of my staff and have a bad reputation. This ends up causing friction between the staff and the patient and only ends up making it difficult for that patient when they are not in the room with the doctor.

     - DO make that extra effort to make ALL staff your best friend, always smile, be courteous; brownies work great. If a staff person is impolite or rude to you; smile, back off, write down the person's name, and don’t confront the person. Then when your visit with the doctor is over, ask to see the office manager, and very tactfully let him or her know what happened. We only want the best staff... any rudeness or unprofessionalism is bad... and we may have a staff person who we not know is behaving that way and needs extra attention/training. You, the patient, are the most important person to us, and we want you to be treated courteously and professionally at all times.

4) DON’T ramble on and on about a symptom and all of the circumstances around it including what your aunt was doing at the time and how you were on vacation because of such and such and such and such and such and such (you know what I mean... we all know those people). Some people are great talkers and they view themselves as great communicators not realizing that they take up way too much time with their descriptions. By the way, people who tend to do this are usually incredibly nice people, and view themselves as good communicators. They often get upset when they are “cut off” and not allowed to finish their stories; they often feel that “no one listens to me”. That may be a good clue, as many people who tend to “ramble on” do not have the self-awareness that they do so.

     - DO write down your symptoms succinctly. Writing it down and rehearsing your symptoms can be good practice at how to verbalize your symptoms in a concise manner. If you have pain in your back... write down when it started, where in your back, did it come on gradually or abruptly, does it come and go or is it constant, do any body postures/activity/meds/heat/ice make it feel better, does it radiate anywhere, what have you taken for it and did it help, have you ever had the problem before, and have you had other symptoms such as fever, weight loss, trauma, etc. Describe the problem chronologically from the moment it happened (get rid of all the extra fluff) to the present moment, is it better/worse/or the same at the present time. Anywhere from 80% to 90% of the time, doctors know what is wrong with a person simply from getting an excellent, concise history.

Here is a good website, the Pain Resource Center, that lists a succinct way to describe pain. It can also be used for other problems such as nausea, tingling sensations, depression, cough, etc. This list may seem very mechanical, but if I had someone simply answer these questions each time they described a symptom, they would be way ahead of the game and make my diagnostic job much easier (and hence, make a correct diagnosis quicker and help my patients get better quicker).

5) DO always take a list of your meds/allergies/med problems, keep it up dated at all times. When the nurse takes your med list, don't even answer anything... just hand over the list... this can keep huge mistakes from occurring in the med list. In fact, this recently happened to me. I only take one medicine, I answered the nurses question about my meds, not realizing she did not ask me everything. The list the doctor actually saw was different. If I had simply handed her my list of 1 medicine, she would have easily deleted the incorrect medicine that she had on her list.

This is absolutely one of the most important habits to get into. Every day, at least several times a day, I run across incorrect medication lists. The patient “assumes” that the doctor’s list is always the same as what they are taking. This does not take into account possible errors from the pharmacy, older prescriptions accidentally getting refilled instead of newer ones, medicine changes not being noted correctly in the chart, other doctors’ medication changes/additions/deletions. Protect yourself. Keep a list on your computer, update it immediately after any change, print out the new list (at least 2 copies, one for you and one for any health professional), throw out the old.

6) DO be honest with everything you tell your doctor and other medical providers. The only way you can get proper medical care is if you tell the complete truth. For example, we know that 50% of our patients don’t even take their Plaquenil (hydroxychloroquine) regularly or use their sunscreen religiously every day. These are the two safest therapies for lupus. If I have a patient who is flaring up, and I assume they are taking their Plaquenil and using their sunscreen, my next step may be to add a stronger, and potentially more toxic immunosuppressive medication when this step may not be even necessary. If that person puts on their med list “Plaquenil, 200 mg tablets, 2 tablets 4 days a week” instead of “daily”, that lets me know immediately that we don’t need to discuss more aggressive therapy, we need to discuss compliance and how to help that person learn to take his or her medications more regularly. On your medication list, don’t write down what you are “supposed” to be taking, but what you are really taking. Another example would be the person who doesn’t have enough money to pay for their CellCept. He or she may only be taking it half the time due to expense and may feel too embarrassed to let us know. If your lupus is not under good control and this is the reason, we need to know. This honesty can lead to more productive discussions such as could there be a less expensive alternative, or could we put you into contact with some drug assistance programs.

This is how life works, isn’t it? Anyone who is old enough eventually learns that honesty is always the best policy (even when it is painful), as it almost always results in the best outcome in the long run.

7. DO consider downloading, filling out, and taking this form to each visit with your rheumatologist - The Lupus Checklist.

I hope this information is helpful in at least giving some insight into how to make the best out of your appointment with your doctor. Of course, communication is a two way street, and doctors need to learn to be better listeners as well. Unfortunately, you as the patient have no control over how good a listener your doctor is, but it is in your power to improve your chances of being listened to and getting the best results as outlined above.

Lupus is unpredictable, so beware of the slippery slope!

In relating the events of the last few months to my mom and dad, I caught myself saying, "You know, it's hard to explain, but lupus is just unfair." In his wisdom, my dad paused, and replied, "Well, maybe it's just that it's unpredictable."

Indeed, Dad, you're right.  It's the unpredictability of lupus that's so confounding. The symptoms, the flares, the side-effects. You never know what you're going to get hit with or when. Nor do you know how long it's going to last. But I quickly reminded myself that I know this. I've known this for awhile, and I've actually learned how best to combat it. If lupus is going to be unpredictable, then I'm going to be as predictable as possible. I suppose that's why I nap for two hours every day, why I try to get to bed at the same time, why I limit the number of errands I do, and why I space out our travel, social activities, and my working gigs so that I don't overload myself. While I'll never claim to have lupus all figured out, I do try to stay one step ahead of her. If she's going to try and unleash her haphazardness on me, I'm going to hit her right back with order and method.

Sometimes, I feel like my life is a bit over-run with guidelines. But those guidelines make sure I don't unknowingly slip into old habits of running my body into the ground or skimping on rest. It's all too easy to push off a nap or stay up late. And if I do it once, it's a lot easier to do it again. Before you know it, I'm no longer resting when I need to, or taking it slow and easy as I should. It can be a slippery slope once the guidelines go out the window...and that usually doesn't turn out so well.

In fact, I was just explaining this to a new babysitter regarding the girls. As I was recounting the "rules of the afternoon" (snack only between 3-4pm, only milk or water to drink (no juice), and choice of snack being fruit, cheese, yogurt, or the like...no sweets), I found myself starting to apologize for all of the rules. But then I followed up by explaining what happened before the rules went into place while babysitters were on duty:

When there was no designated snack time, food was being consumed continuously throughout the afternoon - some snacks even creeping up toward 5:30 or 6pm, leaving the girls with full bellies at dinner time. Choice of beverage became a juice fest - with cups of cranberry and orange juice being doled out all afternoon long. And the sweets. Oh my. They were having cookies and candy to their delight. It was no one's fault except mine - since there were no guidelines to go by. It started out innocently with a cookie one day, and a cup of juice the next, I'm sure. But without any guidelines, one time became every time, and then the slippery slope began.

Today, the girls are fine with the guidelines. In fact, I find that kids like rules. It allows them to work within a certain framework with which they're familiar and comfortable. I think they like knowing what to expect, too. Of course, we're allowed to veer off the track now and again. Special days get special treats, and there are always exceptions.

Just like there are exceptions with lupus, too. A special late night here, or a busy morning of errand running there. But the way the way I see it - there's already such a fine line between one's disease activity being stable and unstable. If there are some simple stipulations that I can follow to help tip the scales in my favor, I'm all for it. The guidelines definitely help to keep me on the straight and narrow...and living well, day after day!

Be sure to stop back on Friday for a guest post by one of my favorite rheumatologists - Dr. Donald Thomas, author of The Lupus Encyclopedia, due out later this year. In Friday's post, he'll cover the patient do's and don't's during a doctor's appointment. A post that's sure to be helpful to all of us!

Health Monitor Magazine - Tip for lupus? What else could I say but "Nap!"

When you're at your next doctor's appointment, be sure to flip through the latest issue of Health Monitor Magazine. You might find my face smiling back at you! I was recently interviewed for an article on coping with chronic illness, and I think the spread turned out great. The magazine wanted to hear everyday tips for living well with your disease - and I couldn't avoid talking about my nap. It's been so essential for all these years! Click on the images below to read tips from those interviewed, or read the article here. Looks like some great advice all around.