Sunday, August 19, 2018
A Little Review
I can count on one hand the number of times that I have directed a new Lymphedema warrior to this blogged book. Likewise the times that I've given the print copy to someone. That may not seem like much impact but there are other ways to measure success. Writing this was good for the patient and for the writer. I have received a few comments as my words reached them. I am glad for that. I will continue to leave Liz's Lymphedema Logbook online so that whatever good it can do will be done.
Tuesday, February 14, 2017
Liz's Lymphedema Logbook Introduction Chapter 1
Introduction
Some things come
to you with the force of a mission. So
it was that I was inspired to write Liz’s Lymphedema Logbook. I didn’t expect to be doing this. I had made my decision in 2007 that I
wouldn’t write about my journey through breast cancer, the treatments and
beyond. FYI Breast cancer treatments, specifically surgery and radiation, are
risk factors in the development of lymphedema.
And yet…
One day, I got a
call from a beloved Aunt. She had just
learnt she has lymphedema and she turned to me.
I would be able to give her guidance.
I, in her mind, was an expert.
I’ll give her one thing; I’ve been in her shoes. However, I wasn’t there any longer. Oh, don’t leap to the conclusion that I no
longer have lymphedema because I do.
Lymphedema is a chronic condition. In my mind chronic meant severe, or
serious, but it actually means forever.
Within her bit
of flattery was a truth. I had been
diagnosed with lymphedema in 2008, and at that time became motivated to change
my life.
“I became an active self-manager and my lymphedema
responded favorably. I was fortunate,
but I worked at it.”
The second
indicator, that this was my book to write, came in the form of a casual book
loan. I had happened on the subject of
‘blogging a book’ and I was freshly inspired by the words inside. I had spent a few days considering potential
non-fiction subjects when my Aunt called.
It was at that moment that I knew I would write about my journey with
lymphedema. See what I mean about my
lymphedema logbook being an ‘inspired’ choice.
Chapter 2 - Lymphedema Strikes
Lymphedema Strikes
Not me! Not this!
I didn’t feel
this way about cancer. My cancer
diagnosis was a blow, certainly a big one, but my reaction was more like – okay
it’s my turn to take the cancer journey.
In my heart I worried but I also believed that my journey included
survival. All I had to do was go through
treatments and move on. I knew the
cancer statistics; I understood my risks, hereditary and lifestyle alike.
Cancer came with
faces, faces of survivors; that were my friends, and neighbors and
associates. People came to me with words
of encouragement and experience; they came to me with tips and support. Cancer was a scary place, but it was filled
with kindness. It was horrible but it
was good.
Lymphedema was
more of a challenge and a fearful thing than the cancer had been. This thing, this chronic condition was truly
an unknown in my experience. It was
faceless. It was the big dangerous thing
that could happen. I had been in the
cancer patient two hour workshop about the subject but I ignored the
information. Lymphedema wouldn’t happen
to me. The fates had dished up cancer
and that was enough.
Cancer is
unfortunately common. There are
organizations and fundraisers and public education and we know cancer.
Lymphedema seems
rare – and uncommon. It is neither. It is mine.
It is yours. When you develop
lymphedema, it’s not just a detour on the road; it is the road from here on
in.
Grief 101
The diagnosis
and reality of lymphedema is never a welcome thing. To put it bluntly, I had to take time out and
howl at the injustice of it. I know that
life is never exactly fair, and I know that there are people who are dealing
with much more than I was, but damn it anyway.
I needed to
grieve the downturn in my health. My
lymphedema developed six months after my last cancer treatment. I was alive but that oh joy, the cancer is
gone, and this is the rest of my life time, was going to be spent with a new
burden. My get of jail card had been
abruptly torn out of my hand.
My cancer
diagnosis came after I acknowledged the lump in my breast. I realize now that I was in a bit of
denial. I had gone to a mobile mammogram
unit the year before, accepted their ‘all clear’ as a fact and ignored what my
fingers were telling me. It’s a funny
trick of the mind, I guess, but those irregularities I felt were ‘how my breast
feels’. Then I would add, that’s normal
for me.
Guesses were
brushed aside when I felt a pain in my breast.
My fingers could push on the very same bumpy spot that was maybe not
normal and I could increase the pain. I
kept quiet for a month; one more option for denial had to play out in my
mind. Perhaps this pain was related to
my menstrual cycle. It wasn’t. I had a lump in my breast and that could be
cancer.
There was one
remarkable thing that I noticed. I would say, I have a lump in my breast and
everyone knew that meant the possibility of cancer. I found myself the recipient of a remarkable
range of reactions. I received support
that was truly supportive. I received
support that missed the mark completely.
Remarkably I was avoided, as though cancer were an insurmountable barrier. Those people, who should have stepped up to
the plate with their support and didn’t, or whose actions and words added to my
discomfort were given my forgiveness. Perhaps I represented cancer in a hurtful
personal way. Perhaps they were ignorant
of how to be supportive. As I write this
and remember how it was, I realize that I have to forgive them again.
But with a
cancer diagnosis, I didn’t have to explain what that meant. Also like a lot of people, I thought that once
my cancer treatments were over, I could go forward. My big challenge was
over. Cancer had not convinced me that
bad things could happen to me, or maybe I thought it was my insurance
policy. I had cancer, beaten it, so I’m
good now.
Upon my
lymphedema diagnosis, I could count the factors involved in its development,
like surgery and the radiation that I needed to battle the cancer. But I had
ignored things that I should have paid attention to. There had been special exercises we were
shown as post cancer treatment patients.
There were numerous indicators that I was at an unhealthy weight. I never did a stretch exercise and I never
concerned myself with my overeating. There
is an unconfirmed possibility that I also had an underlying injury in my arm
that I wasn’t treating properly with rest and care. Consequentially my body was
taxed beyond its limits and I ended up with lymphedema.
Now I felt
guilty too. The only thing I knew for sure, these negative
emotions would pass, especially if I did not dwell on them. I certainly couldn’t add discouraged and
defeated to the emotional burden I faced.
Learning that
this condition is chronic was one of the first hurdles I had to face. Forever is quite a bit to get used to. My life is over – is how the first words came
out. Only in time was I able to modify
that to be ‘my life as I knew it was over’.
Then after much
more time and huge efforts both mentally and physically I have been able to say
that ‘my life is so much better now’.
Not with any qualifiers concerning lymphedema, but simply and absolutely
better and that directly because of my lymphedema.
“When I was first diagnosed with lymphedema I was scared. I didn’t know my future and my present had
been altered beyond recognition.”
Lymphedema
Strikes - continued
The face of
lymphedema was that of a stranger. I
looked around my community and could only find one person who obviously had
lymphedema – the wearing of the garments being the most visible clue and her
history of breast cancer quite well known.
I reached out to her, needing advice and empathy, feeling
overwhelmed. She was polite and
distractedly responded to my questions.
“I tell myself
that it’s just a sore arm.” She said.
Could I really
argue with her? I almost did.
“No.” I
said. “This is huge.” Then I could say nothing more than
thanks. I realize now that she was in a
totally different place in her lymphedema journey. It is also likely that her lymphedema
experience hadn’t cut such a huge swath through her life. Or she adjusted to difficulties better than I
did.
My lymphedema
was preventing me from enjoying many of my pastimes that would have eased my
stress. The bandaging that was the first
avenue of treatment made me a visibly different person and the object of
intrusive curiosity. Even a simple pastime of browsing in a store became an
emotional challenge. Stares, questions
and often, believe it or not, friendly pokes on my bandaged arm. My reaction was an angry hurt withdrawal that
few understood.
It seemed
lymphedema, with the hurt involved, both socially and physically, had changed
my personality. Yet, I tried to maintain
the image of a well-adjusted patient. No
one, after all, enjoys listening to someone who whines. I tried very hard to fill my days, to
distract myself within the pages of any book and to do ‘anything’ that might
help my arm.
I believed that
I would have had a community of supporters with my lymphedema diagnosis, just
the same as I had with my cancer diagnosis.
But only a few people were even aware of lymphedema. If people knew what it was, and how it
affected patients, it would have been different. I could have led the way, if I knew what lymphedema
was going to mean for me. But it was all
an unknown. There was little
understanding so there was little support.
Even those closest to me had only a glimmer of what I was going
through.
Eventually I
came to understand that the pain I experienced was not the average lymphedema
experience. Lucky me, I was the one in a
thousand patient with the level of pain that I had. I realize now that I should have sought
professional help to deal with everything, but the pain kept me from thinking
clearly. I didn’t even think to mention
the level of pain with my physiotherapists and because I presented well, they
didn’t ask. However I am grateful. The pain became a huge factor in motivating
me to change my life around.
I remember my
reaction to my lymphedema diagnosis. Now
some 8 years later, I wonder at that reaction, but I know now that I have been
able to successfully manage my condition, first by will and now by confident
habits.
I’ve learned to
live well with lymphedema, something I didn’t know I could do. I have been fortunate to have reduced the
symptoms of lymphedema to a point where my life is pretty average. But in the beginning, all I knew at the time
was ‘This was huge’. I doubted my
ability to cope.
“Little did I know that meeting the challenge of
lymphedema would set me on a path that included wellness in my whole life.”
Chapter 3 - Gaining the Knowledge Needed
Gaining the Knowledge Needed.
Among the people
who became aware of my lymphedema are those who tried to help. I thank them for their concern and efforts
but I was very wary. A well-meaning
untrained individual does not always have the knowledge base to be truly
helpful, and unfortunately an ineffective or harmful suggestion can lead to a
worsened situation. I had learnt from
my reading that any downturn in my condition might then become the new
standard. Lymphedema is
progressive. Unfortunately, I did not
have the knowledge base that I needed to discern if an idea was good or
not.
As an example,
massage therapists were one direction that I was pointed to. I didn’t know how to assess their
qualifications, so I never sought their help.
Other tips and recommendations came my way but again, I had questions
and concerns.
The answer was
to become more educated and one of the finest resources I have discovered is
Canada’s Lymphedema Magazine ‘Pathways’ (Empowering patients and
professionals). Eventually I found a
copy of the magazine at one of my physiotherapist appointments. Pathways is published four times a year on
behalf of the Canadian Lymphedema Framework and its provincial affiliates. I joined the Alberta Lymphedema Association
and began reading my own Pathways magazine.
It was one of the smartest things I have done. Within the pages, I found practical tips,
solid information and more than enough facts to figure out the help from the
hype.
Notes from
Pathways Fall 2012 – ‘the majority of
massage therapy graduates across Canada do not receive enough education to be
qualified to treat lymphedema patients.’
Having said that, the same article outlines what training is required
and how massage therapists have been pioneers in lymphedema care. It’s good to know.
Massage therapists
who have been trained with the original Dr. Vodder method of Manual Lymph
Drainage and Combined Decongestive Therapy for Edema management have a
lymphedema specific knowledge that other massage therapists may not.
Surviving isn’t
the only thing.
While I was busy
dealing with my new diagnosis of lymphedema I found that many around me were
still hung up with my cancer story.
Wasn’t I glad to have survived?
It’s a prevailing train of thought around cancer survival. As though the
mere fact of being alive is the only thing that matters. This is true.
I’m glad to be alive and I am a cancer survivor. But this is also false. I am alive, but I am also altered by
cancer. I can no longer assume that
cancer will happen to someone else. I
cannot assume that I will live as long as the average person. But for many people I now bear the label of
cancer patient. People treat me
different when and if they know I’ve had cancer. So let me set the record straight.
I’m not a cancer
information resource. I do not need to
know of every new diagnosis of cancer in the community. I don’t have all the answers about cancer, I
cannot even tell you with absolute certainty why I became a cancer patient.
In a perfect
world I would put cancer behind me, and just get on with it. I would walk anonymously as I went about my
day. I could do that, but lymphedema changed that.
I have chosen to
manage my lymphedema by being compliant and wearing the compression
garments. My garments attract attention
and questions. People stare. People poke at my arm. People go out of their way to make jokes,
expecting me to respond with a funny story.
I would love to
have the words that turn this aside. The
best I option I have found is to say ‘This is not an injury. I am dealing with a condition.’ Sometimes I will add a condition of the
lymphatic system.
Sometimes I turn
the joke back on them, and while that often is the best way to deal with this,
I am left to undo the damage that has done to my day. None of this is easy or pleasant to do. I do not want to be a curiosity. I do not want to be reminded of my
problems. I certainly don’t want to be
explaining lymphedema to everyone who knows nothing of it. I don’t want to be teaching manners. I don’t want to be rude myself.
It takes the
Wisdom of Solomon to figure out what answer is appropriate to the
situation. I could refuse to talk about
it entirely. However there are golden
moments as well. I’ve been approached by
a lymphedema patient (who wasn’t wearing the tell-tale garments) and I was able
to share my pain management successes including weight lifting exercises. Another patient was thrilled to hear about
the silicone grip band that kept my sleeve in place. I responded one time by calling my lymphedema
and the trademark garments ‘a souvenir of my cancer treatments’. I quickly found that I touched a troubled
heart that had just received a diagnosis of cancer.
“It’ll be your
job for a while, but you’ll be fine.” I
said, just as someone else had said to me about my cancer.
“Let me say this to you about your lymphedema. You’ll learn to manage what you can and to
accept the rest. It’ll be okay.”
Monday, February 13, 2017
Chapter 4 - In the Meantime
In the Meantime
The diagnosis of
lymphedema was just the newest of my problems.
I had extremely tender feet, the result of chemotherapy induced nerve
damage. I had fatigue. I had fears of the cancer returning. I had difficult relationships and emotional
problems, and I had losses and disappointments.
Now I had lymphedema. To top it
all off and to be the straw that broke the camel’s back. Shit.
I quickly found
out that basically I was on my own. I
took my swollen arm to the Dr. twice. He
prescribed a diuretic on my second visit because the first appointment we
discussed if the swelling might not be the result of an insect bite. I realize now that I knew that this was
lymphedema but I was fighting that knowledge, I was hoping against hope that I
would be mistaken.
I remember
during the second appointment, when the doctor asked me why I was so
upset. Then he asked me, “Why are you so
concerned about the possibility of lymphedema?”
This was my
first clue that lymphedema is a misunderstood condition. It certainly was not in his radar. I didn’t expect that the medical system that
had served me so well during my cancer treatments would be such a poor resource
with lymphedema.
By the time a
month went by, the swelling had travelled from my arm into my hand. My fingers looked like fat little sausages. I was in significant pain.
I knew that my
cancer hospital had a physio department and that they helped patients with
lymphedema. I phoned them. They told me that I couldn’t just come up and
get help; first I needed a referral. I
didn’t book another appointment with my local doctor; I simply phoned in and
told his nurse that he was to send the necessary referral. To his credit, he did. Then I contacted the physio department again
and luckily I caught an appointment within the week. Someone had cancelled, or it would have been
three weeks. I shudder to think of what
might have happened in three weeks.
Later someone
pointed out to me that it is too bad that I didn’t get the help I needed before
my hand was involved. Too true. That delay cost me dearly, but I realize that
my own reluctance to face lymphedema played a role. A person can’t look back, and I did as best
as I could at the time. I didn’t know
how strong I really was.
The words haunt
me still. Right on the top of the page
it said ‘Do not knit’. It pains my heart
to this day to remember how that felt when I read this advice concerning
lymphedema management. I had become
enthralled with the ancient art. I was
passionate about yarns. I devoured books
about knitting; I dreamt of knitting projects and my needles were always
clicking. I was devastated. Simply crushed. You might think I’m being extreme here, but
it was like I had been parted from my love.
I couldn’t knit.
Knitting was
considered the worst of the small movement, fine motor skill, lymphedema
aggravating activities. Then I learnt
that most of my list of favorite activities matched the list of things I should
not do.
I didn’t argue
with the instructions. My hand and arm
were in severe and constant pain and I knew I couldn’t live like this. I was right when I thought lymphedema is a
life changer in the way that the cancer wasn’t.
I grieved
knitting. I resented my knitting friends.
It wasn’t fair. Those people who knew I
was a knitter would ask after my activities with yarn and were surprised to see
me tear up.
I have
lymphedema. I would say and then I have
to explain. I didn’t have the
words. My friends didn’t understand but
I couldn’t explain further. I felt alone
and sorry for myself. I suffered through
my days struggling to fill my empty hours, time that I would have spent
knitting. Then I would retire frustrated
and sad. Occasionally I would have
lovely dreams where the soft lovely yarn knit into beautiful garments. I’d wake up crying.
I had to give up
knitting but what was also evident that I had to give up thinking about
knitting. I packed up all that I owned
that related to knitting. I stopped
haunting those sections of the library and the book stores, despite how
unconscious my feet might lead me. I had to stop. I learnt to avert my eyes from knitted
garments, lest my hands fondle the textures, lest my interest lead me to
question the owners if they had knit the item themselves. I grieved some more.
When life hands
you lemons…and it will. Challenges come
up all the time, for everyone. Have you
noticed that some people rise quickly to face their challenges while others are
sunk by every single little thing? I’ve
been in both boats and I’ve learnt some things while I was there.
The absence of
choice is part of the struggle to meet a new challenge. To realize that life has dropped another
lemon in your lap is never met with ‘Oh goodie, I can make lemonade!’ Eventually the challenge has to be accepted
and met.
I may not have
chosen my restrictions concerning my lymphedema, but I’ve traded hobby work as
my main creative outlet to a focus on writing.
I grieved my losses, especially the knitting, but with that behind me, I
have come realize my restrictions have given me an element of freedom. Yarns are no longer an irresistible temptation
and the knitted projects are not waiting for my spare moments.
I am free of
that and that is a huge advantage. I
have that time and energy to write and I love it. I’m grateful now that my limitations
empowered me to choose this version of lemonade.
“I learned to talk to myself with compassion, with
courage, and as time passed, with confidence.”
Take Hope
I cannot skip around
the fact that lymphedema is serious and the adjustments can be huge. But while I am serious, I do not want to be
grim. Lymphedema is life-changing but
not life-ending.
My lymphedema
journey is and continues to be a challenge, but I am healthier now and more
adjusted than any other time in my life.
I believe lymphedema gave me the wake-up call. Good can come out of some pretty tough
situations and I have proven that to myself.
Sensing the possibility of good gave me hope. I took that hope and I held on to it. Do the same.
Chapter 5 - After Lymphedema Perspectives
After Lymphedema Perspectives
Early in my relationship
with lymphedema, I realized that I would have to keep my perspective. I could not ignore lymphedema but it was
equally important that it not dominate my life.
That, as many things are, is easier said than done. Everything that had been my life was affected
so how could lymphedema not dominate my life?
During the first months of dealing with lymphedema, I was in pain and my
ability to use my right hand was extremely limited. I could do practically nothing.
Things had to
change.
The definition
of insanity; if you continue to do the same things, you cannot not expect
different results. While I hold that to
be true, and I certainly believed it when lymphedema struck me, it isn’t
exactly clear what a person does instead of the same thing they’ve done in the
past. What exactly am I to do? I had to find the answers to that.
One of the
hardest things during my initial adjustment period was learning what I could do
and what would create difficulties. It
was trial and error, with the errors producing significant pain and potential
long term damage. My bullheadedness
wasn’t the best ally, and I made some mistakes.
I was in a hurry to get on with my life.
I was always pushing to the edge of reasonable activities and often
overdoing it.
It was a dark
time when my therapist gave me a splint to put my hand in and the explicit
order to ‘do nothing’. If this was going
to be my future, I really wasn’t going to adjust. Luckily the rest gave my body a chance to
recover. I know now that I was going to
return to an almost normal life, but at the time the future looked grim.
Once I got
through the total rest assignment, I still had to figure out what my life would
look like. What could I do? Again, I returned to my normal duties with an
eye to pacing and limiting the damage to my arm. That still left a big hole in
every day. I needed time filling and
activities and I needed a purposeful occupation. I didn’t have a clue what that would be
beyond keeping my lymphedema managed and I didn’t yet know how to do that.
It seemed what I
was doing was not good, for firstly I aimed to do something different. I would get different results if I did
something different. It wouldn’t
necessarily be the ‘right’ action but I would be able to figure out what worked
and what didn’t, because either it worked or it didn’t. I realize that this is about as basic as you
can get, but I needed that basic, basic, truth to be hammered in. I might give lip service to ‘knowing’ what to
do, but since I wasn’t doing it so I didn’t know a damn thing. I just knew that I had to do things
differently because what I was doing based on my know-it-all-attitude. That wasn’t working.
Simple. No one was waving a map in my face. I had the stop sign. Stop this now, my body had spoken. Lymphedema.
Easy does it was
the attitude that I had to develop.
However, in the past I had been an all or nothing worker. The signal for housework, as an example, was
the point where I became disgusted with things and then I would housekeep
binge.
Pacing is still
a problem for me, but I have gotten better.
I preferred all-day-get-the-job- done marathons to short spurts of
anything. That had to change. I had to stop being the hare and start being
the tortious on a racetrack that was no an obstacle course. But I still wanted to be in the race.
Early days, I
kept things afloat as best I could, but mainly in respect to my mental
well-being, rather than any white glove house inspection. My desire to go forward with a normal life,
even if it was vastly different than my old life, served me well. Okay.
So my bullheadedness did help.
“Since it was my right hand and arm that was
affected and I am right handed, immediately I was cut off from a vast number of
my normal activities.”
Adaptations were
necessary in both my physical and emotional world. It helped to remember that I had certain
pastimes and activities fade out of my life in the past. I had chosen those changes while these
restrictions were forced upon me, but the end result was the same. It helped to realize that everyone had
something they couldn’t do.
I also realized
that I could no longer do everything that appealed to me. I had to choose. I was limited by lymphedema, something that
seemed a handicap until I thought of it differently. My limitations meant that I had gained
focus. Lymphedema had gifted me with
this.
My left hand got
pressed into service but it was inept and needed training. I garnered a few tips from material
pertaining to amputees who were managing their world with one hand, but mostly
I applied my own ideas.
Could I keep my
house clean? I swept with my vacuum
cleaner that I manipulated with my left arm.
I learned new methods in the kitchen and I set aside fussy recipes. I managed.
I told myself that my ‘job’ at the moment was to do everything I could
to manage my lymphedema and to adjust to my new life.
Writing is the
one thing that has endured as a source of comfort for me. Yet the physical act of writing was
challenging. There were many components
to this. Lymphedema and fine motor
skills are not good partners, so my pen and paper method was not a good
idea. It takes two hands, normally to
type. But I would continue to write as
this was an activity that I loved. I
spent time each evening teaching my left hand to write, beginning with large
figure eights and working my way to writing legibly and within the lines. I learned to type with one hand, to make
notes with my non-dominant hand and to go at composing paragraphs in five
minute segments when rest was necessary.
It wasn’t pretty but writing is something that I would fight to keep in
my life. I didn’t know what my writing
would look like but still I chose to be as productive as possible with my
writing.
I left hand
operated my new camera as well. It was
lightweight and I could hold it upside down for my left hand to push the
shutter button. My camera was a new
hobby’ one that helped me get more exercise and gave me an outlet for my
creativity.
I found things
that I could do and I found how I should think.
I chose to be grateful that I had this life to live. I certainly gained optimism as I went
along. It helped that I was making
physical progress with the lymphedema condition, reducing the amount of fluids
being retained with a combination of daily bandaging, weight loss and
exercise. My weight loss efforts are
described in the chapter – the Weight of the Weight. Why my excess weight aggravated my health
will be explained as well.
“I chose to be as healthy as possible with my
lifestyle- accepting the reality of lymphedema without grieving or become a
victim.”
Chapter 6 - Workshop Series - Action Plans
Workshop Series
There was a
small article in the local paper.
‘Workshop series
returns to support Vermilion residents with ongoing health conditions.’
It sounded
promising. I mentioned it to a friend
and she was interested in attending and could provide transportation. We both registered. It seemed I was catching a break. It turned out to be more than that.
Action plan
basics
I’d heard of
Action Plans before, and I guess I was actually a little disappointed when the
workshop was based on them. However, I
had come to learn and learn I would. My
mission, I decided would be to become an active self-manager. I would see if this tool of action planning
was for me.
I’d love to be
able to go through my notes and produce for you a step by step record of how I
succeeded in managing my lymphedema.
Those notes don’t exist. I don’t
have a complete written account of my journey, but actually this is not important. I believe that anyone can create a pathway to
be an active self-manager. There is no
magic in the specifics of what I did.
The power is in the process.
Loosely defined the process includes
these first steps
1. A
decision of what you want to accomplish.
2. Searching
for alternative ways to achieve this.
3. Making short term goals – action plans.
And these follow
up steps.
4. Carrying
out action plans.
5. Checking
the results.
6. Adjusting the plan.
An action plan
is a basic tool, perhaps the only one you will need. Look at these notes I made – left-handed -
during one session of the workshop that introduced me to goal setting in the
action plan method.
•
Support
my healthy lifestyle – physically
•
Achieve
this by - daily walks – physio session and weights.
•
Walk
to the neighbor’s gateway before 4:00 P.M.
•
Physio
– in the morning before breakfast
•
Weights-
after supper before bed
Every day this
week for all three – bad weather walking will a timed session indoors including
the stairs. Confidence level that I can achieve these goals-7 or 8 out of 10
If you compare
these notes with the steps to action plans you will see that I have decided
what I wanted to accomplish- support for a healthy lifestyle. I had chosen some specific tasks for that –
daily walks, my physio exercise and lifting weights. Then I made those general goals into specific
ones by adding in time and place and alternate options. The confidence level was a checkpoint to make
sure that I had a chance of achieving the goals. What is left after this step is the
monitoring of actual activities and fine tuning of the plan.
The list
previous is the plan I made for one week, concerning one aspect of active
self-management. It is the blueprint
that I used in many situations.
Personally I was fairly good at making plans, but what turned the plans
into sweet reality were the follow-up steps.
“I used one page per action plan and made sure there
was enough room to keep track of my walks, or frequency of exercise or
compliance to other goals. This helped
me keep an accurate count so that I was held accountable. It was a good place to record problems as well.”
If I remember
correctly, I had committed to walking previously but this action plan involved
a bump up in frequency. The physio, as I
called it, was a set of stomach strengthening exercises and arm stretches. The weight lifting exercises helped with pain
management but were often forgotten.
I believed, and
it proved true that this action plan was doable, and that could become part of
a success story. It was not a done deal;
there were many weeks where I had to adjust my goals to the point where I was
confident that I could take on an increase in frequency. It didn’t happen the first week/month or even
for some particularly tough goals even the first year. (I had action plan journals for my disordered
eating and also for my writing goals. I forged onward, crediting myself for
progress, adjusting my goals to be realistic.
The journals
brought my goals from fantasy to reality.
They reminded me of what the goals were in very specific terms and they
served as a gauge of success.
There were other
tools that achieved the same thing.
Charts are one example. I made a chart with my weekly recorded
weight. I hung it on the side of the
fridge. I had a record of muffins ate at
meals or as snacks. The chart meant that
my actions were in plain sight.
Whatever
achievement that I desired could fit into an action plan. Whatever form I used included a track record
of my results. The information,
including details of failure that I gained, served to help me make better
plans. Through action plans I discovered
motivation keys that were custom designed for me. I made notes of my successful methods so that
I could repeat them. I’m convinced this
was crucial for me, those habits of thought and action needed time to be second
nature.
“Find daily reminders of your motivators. Find examples of success – no matter how
small. This builds self-confidence and
reinforces good actions.”
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