Blog Posts

Pregnancy and Fibromyalgia: An Interview with Doctor Ginevra Liptan Fibromyalgia Specialist

Pregnancy and fibromyalgia is one of those weird information voids. Having been pregnant three times, and gathering all of the (limited) research together as best as I can for the past several years, something was still lacking. This blog post is the gold mine I was missing. A doctor who has fibromyalgia and has experienced pregnancy herself!

I am so thankful to be able to share this interview with Doctor Ginevra Liptan, a fibromyalgia specialist, who has fibromyalgia. I love her work and have followed it for a long time, so I was super excited when I got up the courage to ask her to do an interview for this blog and she said yes.

pregnancy and fibromyalgia interview with a fibromyalgia specialist

About Dr Liptan

Ginevra Liptan, M.D. is a graduate of Tufts University School of Medicine, board-certified in internal medicine, and trained in functional medicine, a holistic approach that blends both western and alternative medicine. After developing fibromyalgia as a medical student, Dr. Liptan spent many years using herself as guinea pig to find successful treatments, and has fine-tuned her approach by treating thousands of patients. 

She’s one of the few clinical specialists in the world to focus solely on fibromyalgia, and directs The Frida Center for Fibromyalgia in Portland, Oregon. She is the author of The FibroManual: A Complete Fibromyalgia Treatment Guide for You and Your Doctor and The Fibro Food Formula: A Real-Life Approach to Fibromyalgia Relief.

In your experience, do you believe fertility is an issue for those with fibromyalgia?

Clinically my patients with fibromyalgia do seem to have more fertility issues, and I think there are a few reasons for this 1) higher levels of inflammation 2) hormone alterations caused by the chronic fight-or flight response and 3) myofascial restrictions around the uterus and fallopian tubes. All of these factors can have a negative influence on fertility. However one study from Turkey found no difference in pregnancy or birth rates in women with fibromyalgia compared to healthy women Most of my patients have ultimately conceived even if the road to conception was a bit bumpier or longer.

Most of my patients have ultimately conceived even if the road to conception was a bit bumpier or longer.

Do you have recommendations for women prior to trying to conceive with fibromyalgia?

I encourage my patients to boost their nutritional status as much as they can prior to conception, as growing a fetus takes a lot of nutrients! In particular I recommend checking iron, B12, Vit. D levels and supplementing to ensure these nutrients are all at optimal levels. And while you are doing bloodwork I also check for the MTHFR genetic mutation. This sounds scary, but it simply reflects how efficiently your body can activate and use folic acid. If you have this mutation you can counteract the inefficiency by simply supplementing with an already activated form of folic acid called methylfolate or L-5-MTHF. Both Thorne Research and Pure Encapsulations, my two favorite supplement companies, offer great prenatal vitamins with this form of folic acid. 

To optimize fertility in fibromyalgia we need to reverse the three inhibiting factors I mentioned. First reduce inflammation by making dietary changes to avoid triggering foods, or adding a medication like low dose naltrexone (see below). Lowering inflammation can improve hormone balance, as can supporting our adrenals, because any component of adrenal burnout will drag down all the other hormone systems. Learn more about treating adrenal burnout in my blog.

 Finally myofascial release therapy (www.myofascialrelease.com) can break up the myofascial restrictions around the uterus and fallopian tubes. 

Do you have any general recommendations for women during pregnancy with fibromyalgia?

The most common question I get asked is “ Are my fibromyalgia symptoms going to get worse during pregnancy?”  and what I tell patients is most most often the answer is yes. In fact in a study of 26 women with fibromyalgia who had a total of 40 pregnancies, all except one women described a worsening of their symptoms during pregnancy, with the third trimester being the worst.  The good news is that none of these women reported fibromyalgia having a negative outcome on their pregnancy outcome or on the health of the baby. I personally found my fibromyalgia symptoms were worse during pregnancy. I do have some patients- especially those with both fibromyalgia and an inflammatory/autoimmune illness like rheumatoid arthritis or lupus, that feel much better during pregnancy. Pregnancy does alter immune system functioning in a way that can give a temporary remission for autoimmune illnesses.

As far as managing symptoms during pregnancy, fatigue, low back and pelvic pain are common in most pregnant women. In fact one study found that 26% of healthy pregnant without fibromyalgia had widespread pain and fatigue severe enough to be diagnosed with fibromyalgia!

Another study found that 60% of healthy pregnant women reported fatigue during the last trimester and 75% complained of disturbed sleep.

So the addition of even more fatigue and pain due to pregnancy can be extremely challenging when added on to what someone with fibromyalgia is already dealing with. It is especially hard because in pregnancy our pain management toolbox shrinks due to medication safety concerns. This is where the importance of self-care comes in– saying “no” and protecting your time, pacing activities and taking good care of your muscles with gentle stretching and movement. Gentle prenatal yoga- whether in classes or videos at home- and myofascial release self-treatment can be a life-saver for lowering back and pelvic pain during pregnancy. 

Are your food recommendations (from The Fibro Food Formula book) any different during pregnancy and nursing?

Generally my food recommendations are the same during pregnancy such as eating frequent protein and trying to avoid foods that you know you don’t tolerate still apply. But pregnancy is also not a time to try any strict diets or major dietary changes and due to nausea you may need to eat more carbs compared to protein. And pregnancy food cravings can be fierce. So my recommend is to eat what makes your pregnant body feel good. And if the baby demands donuts, eat the donuts!

Do you have any experience using low dose naltrexone during pregnancy? Do you have any resources/tips/ideas around this?

Side note: I (Melissa) personally used LDN in my third pregnancy and it was such a better experience for me (my first two dramatically worsened my pain and fatigue levels) and I am coping with the first year better than before and have managed to breastfeed successfully where I couldn’t maintain supply previously. I could never find any place to share my experience (like a register) or others experiences. I based my choice off Dr Phil Boyle’s work

Among practitioners that prescribe LDN it is considered safe in pregnancy, and in fact is used as a treatment for fertility. As you mentioned, anecdotally Dr. Phil Boyle has found LDN safe in his clinical practice. There haven’t been any studies looking at LDN in pregnancy. In animal studies for naltrexone, the safety data is conflicting, with some showing that naltrexone had negative effects on growth and behavior and others showing positive effects. The few human studies we do have looked at outcome of pregnancies in women taking higher doses of naltrexone as treatment for opioid abuse. These studies showed slightly higher rate of pregnancy complications, but the dosage of naltrexone is important to keep in mind.

We know that low-dose naltrexone has very different physiologic effects on the body than high doses so can’t assume that LDN would have the same effects in pregnancy as full dose. Also the patient populations in these studies have a history of drug abuse which puts them at a higher risk of pregnancy complications and poor prenatal care.

fertility, pregnancy, delivery and nursing with fibromyalgia

Have you come across any good guidelines for delivery/labor with fibromyalgia?

I have not found any good guidelines, but here is what I usually tell patients- and I admit it may be biased by my own experience, which is to have a low threshold to get an epidural. In fibromyalgia we experience so much pain over our lifetime, if there is a chance to experience a pain-free delivery, then I say go for it. Of course, many women with fibromyalgia have natural labors with no epidural and do beautifully. Our bodies really are built to do this! But I personally had a brutal pregnancy with severe hyperemesis gravidarum with daily nausea and vomiting for 9 months that required multiple hospitalizations. So when it came time for delivery I happily got an epidural and had an enjoyable and pain-free birth. But of course, epidurals have risks so this is a very individual decision

In fibromyalgia we experience so much pain over our lifetime, if there is a chance to experience a pain-free delivery, then I say go for it.

In your work have you found nursing to be difficult for people with fibromyalgia? Do you have any tips? 

I do see nursing being an issue for women with fibromyalgia. For some women the challenge is milk production. I think the chronic fight or flight response we experience in fibromyalgia affects the hormones of lactation. The other issue is pain caused by awkward or prolonged positioning associated with nursing. One study examined this issue and in interviews with 9 women with fibromyalgia found frequent reports of fatigue and pain interfering with the breastfeeding process and concerns about insufficient milk supply.

I initially had no issues with milk supply but at 3 months I had to go back to a very stressful hospital rotation and my milk supply dried up really quickly and I was not successful at pumping and had to quickly transition my daughter to formula.

Want to read more about breastfeeding with fibromyalgia? Check out this post.

Do you have anything else you’d like to say about women either trying to conceive, pregnancy, nursing or parenting with fibromyalgia? 

Well the other question I get asked the most is whether having fibromyalgia increases the risk of birth defects. The short answer is no it does not. The longer answer is that having fibromyalgia does slightly increase risk of intrauterine growth restriction and smaller birth weight babies. This is likely due to the effects of the overactive fight or flight (stress response) as it is also seen in women with pregnancies experiencing external stressors such as war, poverty and intimate partner violence. But in those cases also see higher rates of preterm or early delivery, and that is not seen in women with fibromyalgia.

Well the other question I get asked the most is whether having fibromyalgia increases the risk of birth defects. The short answer is no it does not.

Dr Liptan has two highly recommended books that you might like to check out

Affiliate notice: Please note that some of my links are affiliate links and if you make a purchase using one of these links I may make a commission at no extra cost to you.

The FibroManual – this is my go-to, I recommend it to everyone with fibromyalgia!

The Fibro Food Formula – the best book about nutrition and fibromyalgia, it takes into account how hard it is to enact some of the general recommendations out there and helps us to make the best choices possible.

If you want an actual book about pregnancy and fibromyalgia, mine is only one of two existing!

Thanks for reading this post. Please feel free to share it with those who need to read it. Let’s close this knowledge gap!

If you want community to do considering, trying to conceive, pregnancy, nursing and parenting with fibromyalgia – come and join our team over in the Facebook group.

My Top Five Self-Care Plans for 2020

Have you thought about your self-care plans for this year yet? Self-care is as vital as it is undervalued. Especially for busy women juggling multiple priorities. Add in chronic health issues and it should be compulsory.

Accidental multi-tasking is one of my favourite things – a two for one on your energy levels. When self-care doubles as something that also manages my health, I’m pretty stoked.

Here are my top five self-care plans for 2020 that also double as part of my chronic illness management plans.

Meditation


If you’ve read my blog for any amount of time, you will know that meditation saved my life. I do it every single day, and if I must miss a day it’s very rare. It gives me deep rest my body doesn’t even achieve during sleep. It tops up my energy levels for the afternoon. It calms my central nervous system. It is just for me. 15-30 minutes of pure self-care.

Try it: I have a free challenge for you to try it out for five days.

Do you meditate? Tell us about your practice in the comments!

Yoga


Ya’ll know I LOVE Yoga. Yoga is simultaneously mindful movement (gentle exercise), relaxation, stretching, strengthening, pain management and a sleep aid (for me). It balances the central nervous system which has been key for me.
I have shared extensively how I use it to help me. Here’s the short of it: One off poses, “micro yoga” formal practices (of 10-20 minutes) and a bed time class I made to help me wind down for sleep.

Try it: I have a five minutes a day for five days free challenge so you can see how the tools of yoga can fit into your life.

yoga for chronic pain and fatigue challenge
Join us for the FREE five minutes a day for five days yoga for chronic pain and fatigue challenge

Have you tried this challenge? Please tell me if so!

Getting to bed on time


Sleep is way too underrated. Seriously, lack of sleep will kill you (slowly) and make you feel terrible. I’ve written extensively about it. Going to bed around the same time each night is a key part of good sleep hygiene aka practices that help you sleep.

Try it: Check out this post on sleep and how you can improve it.

Treat yourself


(Who just went, “What? I can’t treat myself. Ain’t nobody got time or money for that! It need not take much money or time!)

What is something that makes you feel super special that doesn’t cost the earth? This year I’d like to attempt something different each quarter: a manicure, a massage, a weekend away with the husband etc. With three kids 5 and under we’ve been snowed under and going to the physiotherapist every month has been the extent of it for me.

Try: Schedule something right now!
A manicure? Book one once a month, schedule a time to do it yourself, or swap with your friend to do each other.
Massage? Book one once a month, swap with your partner, or get out that lavender oil and give yourself a hand and foot massage.
A Saturday morning lie in? Negotiate with the partner if you have kids, or send them to grandparents/aunts/uncles and grab at least one a month.

Journaling


I am an analyst, a thinker, a written processor. So taking the time, even just five minutes to process with my pen is helpful for me to work through things. Even if you’re more of a talker, research shows journaling to be useful. You can have free reign to vent. To get things out of your head. Write down memories. Whatever works.

Try it: You can make a habit of giving yourself 1 or 5 minutes a day, a gratitude journal of just three good things or maybe you could draw in your journal.

Do you journal? Tell us how you do it in the comments.

Want to jump in and get some real, concrete help with your self-care in 2020?

Restorative Yoga for the Chronic Life Workshop is open for registrations now! Check out what restorative yoga is, what the benefits are, why we should care, practice an actual pose and learn how to practice restorative yoga. It opens on the 28th February.

So these were my top five self-care plans for 2020, I’d love to know what are yours?? Tell us in the comments below.

My top five self care plans 2020

Do you enjoy this work? Want to help me ensure people with fibromyalgia receive the tools, encouragement and hope that they deserve? When you join the team to support my work in the pay what you can (starting at just $5 per month) Melissa vs Fibromyalgia membership you will immediately access an exclusive members library of resources and tools.

What Does it Mean to “Do” Yoga, What Can it Look Like?

I am super passionate about sharing the tools yoga offers with people with chronic pain, chronic fatigue, fibromyalgia. The thing that often gets in the way is what people think it means to “do” yoga.

Today I am going to share with you all sorts of raw pictures of me “doing” yoga because I want you to start to get a sense of the fact that “yoga” has been usurped by the perfect poses on Instagram. If you have a teacher who gets your situation, then they can help you adapt yoga to your needs.

A visual representation of the below points:

  • Yoga can be adapted for almost anybody (if you have been cleared to move gently and the teacher “gets” your needs)
  • Breathing is a central part of yoga (and many of us don’t do it optimally)
  • Meditation is my favourite part of yoga (yoga Nidra guided meditation is my jam, I do it in bed with my heat pack)
  • You can do one pose
  • I have several poses I enacted whenever I need them during the day
  • Chair yoga is a great way to make yoga more accessible
  • You can do yoga in bed
  • Classes can be 5 minutes, 10 minutes, 15 minutes, 20 minutes or more
  • You don’t need to be super bendy, in fact, I am not

For the benefits of yoga, why I do it and more check out my post about Yoga for Chronic Pain and Fatigue here.

Breathing

Me simply breathing, in hero pose (with a baby about to climb on my back, life). Breathing is one of the most accessible parts of yoga and really helps me to calm down when feeling overwhelmed.

A little more challenging

Me at the very beginning preparation phase of maybe one day doing crow pose (where you lift your feet off the ground)

Relaxation and meditation

This is the final relaxation of many classes, or an excellent standalone pose. This is complete rest. You can add all sorts of things to make it more comfortable, usually I have a blanket or cushion under my legs to help my low back.

If you are curious about restorative yoga (a passive, very gentle practice) then come and check out this free workshop Restorative Yoga for the Chronic Life, it’s available from the 28th February until the 6th March.

One that can be done in bed

You can do this on your bed (I like to do it as part of my bedtime routine)

A multi use tool

I am known to do this pose all the time. It is child’s pose, it rests the lower back and calms the mind. You can do it facing up on your bed (hugging your knees), with a bolster between your legs under your chest/abdomen to make it restorative. When the kids are overwhelming me or I’m feeling really tired, then I’ll drop where I am and do it. Often the kids follow!

Adapting to my needs

Using a block to bring the ground closer to me. I am not super bendy!

#notabouttheperfectpose

This is my son doing this pose not at all correctly but he is enjoying it and not in danger of hurting himself so I encourage him to play with me when I do yoga.

Using the chair

Me doing a chair sequence. I love using a chair because it means I don’t have to get on the floor. It also means I can do some of the poses in the car when I am not feeling so nice and on the edge of my bed if I am awake in the night.

My all time favourite that can be done almost anywhere

Me doing seated cat and cow – I do cat and cow all the time, in my favourite chair, on the side of the bed, in the car, on the floor and in my classes

I hope this gave you a sense of how “yoga” can look and hopefully hope that, if you want to, you could try it in one way or another.

Show me how yours looks

In Foundations of Yoga for Chronic Pain and Fatigue, I have students who take one or two of the poses in the opening module and use those as a “class” to start. There are two full class options in module three, chair and a flow class. Many students choose only the chair class.

For the first time I’m in a yoga class that I feel like I’m actually going to get it…I really can do this and I love how it feels.”

– Student of Foundations of Yoga for Chronic Pain and Fatigue

I’d love to see how your yoga looks. Comment below, tag me on Instagram @melissanreynolds or come and join the inner circle on Facebook.

yoga for chronic pain and fatigue challenge
Join us for the FREE five minutes a day for five days yoga for chronic pain and fatigue challenge – it’s open now for you to see how you could “do” yoga.

How to Spend Less on Physical Treatments for Chronic Pain and Decrease Your Pain at the Same Time

I ask group members regularly what topics they would like me to share about, “how to save money on physical therapies” was the top request on the last post where I asked for suggestions. So here I share how you can spend less money on physical treatments for chronic pain and strategies for decreasing your pain at the same time.

What a whopper! As soon as I read the comment, I was formulating ideas. As a person who has tried physiotherapists (many different ones), Eastern practitioners, massage therapists, osteopaths, chiropractors, personal trainers (who did not get it) and more, I know the costs involved here. We run a public system here in New Zealand so none of these private physical treatments are funded at all.

When I was at my worst I was going weekly, paying $50 or $60 a session to very little benefit. As I have finally put these things into place I have reduced to three or four weekly – this is a saving of $150-200 per month! That adds up!

These are the things that you can do to reduce the amount of treatments you need from physical therapists (physiotherapists, massage therapists, osteopaths, chiropractors, etc.). If they are not necessarily easy, when are they ever?

The four ways of how to spend less on physical treatments for chronic pain

1. Remove or reduce the things that perpetuate the physical issue the physiotherapist/massage therapist/chiropractor etc. has to work on.

This might be a tough one as you may not be willing or able to do the things. For example, working full-time on a computer really exacerbates my neck and shoulders. I cannot, no matter the steps I take to mitigate it, experience less pain and keep doing it. Do you engage in something that aggravates your tricky spots? Is your bed and pillow correct for your needs? Check your breathing!

Let yourself brainstorm as there might be lots of things that come up.

2. Work on the whole of life things

So a lot of our physical issues are related to our overall health. When the fibromyalgia was worse, I needed to see the physical therapists for in search of relief (which never came).

When I changed my entire life – reducing work hours, cutting my commute, moving to a warmer climate, learning to rest (and later meditate), gentle exercise (which for me meant cutting back!) etc. – the amount I needed to see the physical reduced.

3. Finding the right treatment

This alone halved how often I had to go. For severe, recurrent trigger points in my neck – for which I’ve spent at least $1500 per year for over 10 years trying to get some relief from – I have the right practitioner and treatment at last. It’s a physiotherapist who places acupuncture needles into the trigger point, leaves it to relax and then performs gentle traction and stretches. The amount of time and money I spent on massage therapists, physiotherapists, osteopathy and chiropractic is insane.

Ask yourself, does that massage or chiropractic session actually help enough to justify the cost? Does the benefit hold long enough to be justifiable?

4. Learn to do things yourself

This might be the most important and the easiest!

For me, this is copious amounts of stretching/yoga.

I can show you how to “do yoga” in Foundations of Yoga for Chronic Pain and Fatigue, this is a four week beginners course especially for people who have tried the whole stretching and yoga thing and found it near impossible! It is an actual dream come true to be able to share these tools, that have helped me so much, with others.

for the first time i feel like i can do yoga

Restorative Yoga for the Chronic Life Workshop is available now! Join this special, free workshop and learn about restorative yoga, its benefits, why we should care and practice a super helpful restorative yoga pose.

restorative yoga for the chronic life workshop

Meditation is also helpful, especially guided meditations for pain relief and relaxation. You’ve heard me talk about this for years. Insight timer free app.

I also use a Theracane trigger point massager and foam roller. You could self-massage or buy a personal massage aid. This post talks about inexpensive items I use to fight chronic pain.

Always ask a practitioner you see to give you suggestions for things you can do at home and DO them.

So these are my top four ways to spend less on physical treatments (and reduce your pain at the same time). Are you working on any of these areas? What is your favourite way to cope with physical pain?

Do you enjoy this work? Would you like to join the mission to ensure people with fibromyalgia receive the tools, encouragement and hope they deserve and get yourself into the exclusive Melissa vs Fibromyalgia membership library? Become a patron using the pay what you can membership option from just $5 a month today.

It’s a Wrap 2019: What Were You Looking For? Plus grab your free You vs Fibromyalgia course invite

It is a wrap 2019! It is that time of year! Time to recap 2019 and look ahead for 2020. A new decade and a new year at the same time. It is full of promise.

Here I share the top posts of 2019 so that you can recap the key things we have been looking at in our journey fighting chronic pain and fatigue.

Ways to make money with fibromyalgia.

ways to make money online with fibromyalgia

In this post I shared genuine, micro business ideas. Not get rich quick ideas. These are ways that you can look to make an income from home on your schedule.

Post Exertion Wipe Out

This is a surprising one, this is a post from the very beginning when I was writing diary-like entries to share my journey while pregnant with no knowledge or resources available.

6 Practices for calming the central nervous system

In this post I share six very helpful ways to calm down after a stressful situation. I used these when a car drove into the back of us when me and my tiny baby were in the car!

My daily log, why I track fibromyalgia symptoms

In this post, I shared why and how I track my symptoms. It has been really helpful and I suggest finding a way that suits you to track patterns.

What works for me now 2019

what works for me now 2019

In this post I updated the first post I wrote about what works for me – hint: it is mostly the same but I provide more detail. This is my protocol!

My low dose naltrexone one year experiment

My life has irrevocably changed thanks to this off-label, low-side effect medicine. I am so grateful for the past two years. This post shares the five ways it has helped me so much.

Inexpensive items I use to fight fibromyalgia

In this post I shared 9 inexpensive items I use to fight fibromyalgia. The first I use almost every day!

So there you have it, the key posts people were searching for this year. I hope they help you as you consider what you will tackle in 2020 for your journey toward thriving with chronic pain and fatigue.

Free live talks

In 2020 I have big plans to keep supporting you with this blog, the Facebook group, more live trainings and of course, adding to Yoga and Meditation for the Chronic Life virtual mindful movement studio.

Do join us for the free training on the Facebook page “My Top 5 Self-Care for 2020” on the 5th February.

For more information:

Hello friend, are you new here? I’m Melissa and I am on a mission to see that everyone receives resources and encouragement to thrive with fibromyalgia. Please come and join my free You vs Fibromyalgia micro course by signing up to my newsletter. You will receive access to a free resources page too!  If you are curious about me and my journey you can have a search through the archives. Check out the What I Offer Page for all of the resources here.

Yoga for Chronic Pain and Fatigue

I have been dabbling with yoga for chronic pain and fatigue for more than 10 years. For the past five I have progressively become more enamoured with it.

In this post I will share some research, the benefits (in brief), the thing I love most about yoga, it’s multiple uses for chronic pain and fatigue, specific ways I use it, and how you can learn more about incorporating it into your well being journey.

Let’s be clear right out of the gate. Yoga is not a panacea. It is not a cure all. It is one useful tool that can be a part of a holistic plan for wellness.

yoga for fibromyalgia infographics

Type “yoga for fibromyalgia” or “yoga for myofascial pain syndrome” or “yoga for pain” etc. And you will find a wealth of search options to delve into.

There is research specifically for using poses for myofascial pain syndrome, fibromyalgia and more. Taking a more macroscopic view, mindfulness for chronic illness is just as much of a buzz topic at the moment.

Research around Yoga, Pain and Fatigue

Take this 2010 study that found, “pain was reduced in the yoga group by an average of 24 percent, fatigue by 30 percent and depression by 42 percent.” The yoga group participated in a holistic program for eight weeks – gentle yoga poses, meditation, breathing exercises, yoga-based coping instructions, group discussions and a daily diary assessing their progress. The control group received standard medication treatments.

This was followed up three months later: “Follow-up results showed that patients sustained most of their post treatment gains, with the FIQR (Fibromyalgia Impact Questionnaire Revised) Total Score remaining 21.9% improved at 3 months. Yoga practice rates were good, and more practice was associated with more benefit for a variety of outcomes.”

This study was small, just eight participants completed the study on the effect of yoga on myofascial pain syndrome in the neck. It comprised two weeks of breathing and relaxation practices and two weeks of asanas (poses), breathing and relaxation. The poses were Trikonasan (triangle pose), Tadasan (mountain pose), Vakrasan (twisted pose), Balasan (child’s pose) and Vajrasan (thunderbolt pose).

However, let’s not lose sight here – Vajrasan is a more advanced pose, the ability to do this pose indicates a pretty high level of physical ability to me.

The results were that this program “led to significant improvement in the quality of health, physical capacity (strength), cervical range of motion, and pressure threshold of the trigger points, and decreased the disability and pain.”

Perspectives on Yoga Inputs in the Management of Chronic Pain describes the benefits: “This consists of decreased metabolism,[24] decreased rate of breathing, decreased blood pressure, decreased muscle tension, decreased heart rate and increased slow brain [alpha] waves.[25] As the neural discharge pattern gets corrected, the habitual deep muscle hyper tonicity and thus the static load on postural muscle also slowly come down. The function of viscera improves with the sense of relaxation and sleep gets deeper and sustained. The fatigue level comes down.”

woman doing yoga

Benefits of yoga for chronic pain and fatigue (or anyone)


• calms the autonomic nervous system
• help with sleep
• reduced fatigue
• reduced pain
• increased physical capacity
• decreased myofascial pain
• less anxiety
• reduced depression
• relaxation
• mindfulness of movement
• awareness of proper alignment

What I love the most about yoga for managing chronic pain and fatigue:

Ease of adapting to my current abilities -Whatever my symptom level on any given day there is an option for me to practice yoga.

yoga for chronic pain and fatigue picture of toolkit

Let’s talk a couple of key things here:
Yoga is a tool, a multi use tool, but a tool nonetheless. I will use any tool at my disposal to help with the symptoms I live with. In much the same way I use low dose naltrexone- it was not designed for fibromyalgia or myofascial pain syndrome but it helps anyway.

If some parts of the spectrum of yoga practices don’t resonate with you, ignore them. If you want to look at it as a purely physical practice, then do so.

In terms of the spiritual side, I shy away from much if it. My belief practice is Christianity and I have never felt a conflict. In fact, there is a great Christian yoga channel on YouTube.

Some of the options in yoga

Asanas (poses): one or two gentle poses (like child’s pose and forward bend), a flowing sequence of 5, 10, 20 or more minutes, chair yoga, bed yoga or restorative yoga.

Pranayama (breathing): breathing is always useful when you are managing a chronic illness. Simply focusing on your breath and helping your exhale to be slightly longer than your inhale will cause a relaxation effect. Breathing through pain, fatigue, stress, anxiety and overwhelm can help centre your thoughts on something else, release tension and help to ease the symptoms. Synchronising movements with the breath makes you more likely to be mindful of your movement and less likely to overdo it or injure yourself.

Meditation: I began using meditation specifically to achieve rest where sleep provided little. It was a means to an immediate end. After a few years I realised it was helping me much more profoundly in the form of turning down my central nervous system overdrive. There is nothing better than the comfort I feel after a 20 or 30 minute yoga nidra meditation. I cannot achieve it another way.

Day to day my practice changes but I usually practice in one way or another.

Meditation is my top tool for managing fatigue and pain. I very rarely miss my daily meditation.

I have never completed a 60 or 90 minute class or resembled a pretzel in any way. Because that is not the point.

Strengthening, calming, being mindful and moving is.

When my first son was young I had a yoga instructor come to my house for a private session to ensure my posture was correct and craft a sun salutation sequence suitable for my physical abilities at the time.

Sometimes I do the sequence with several breaths for each pose, one breath for each pose or a mix. If I feel a particular benefit from one of the poses I will engage in that one longer. Forward bend is a particularly good one for letting the neck gently stretch.

Cat and cow pose is a great tiny sequence for the pelvis and back. I did this multiple times a day during my pregnancies. I teach cat and cow pose in my free challenge, Five Minutes a Day for Five Days Challenge, sign up here.

When my pelvis was unstable due to pregnancy and I could hardly walk, I could still do half sun salutations (standing) or chair salutations.

The key is to be mindful of your body on any given day. Pay attention to what you need and can reasonably do.

Learn the many options- these tools have a place in our natural pain relief toolkit.

The complexity in yoga for chronic pain and fatigue

When we have extra challenges to think through, we need to be extra mindful. 

There is some complexity involved in practicing yoga when you have chronic issues. This is why it can be helpful to see a teacher privately – either for some initial guidance or ongoing personalised work. 

There are several types of yoga, many asana (poses) to choose from and we need to choose sequences that make sense for our current context. The other bonus is that you can create a homework plan so that you can continue your work between sessions, equipping you further.

As an example of the complexity – I have severe, recurring trigger points in my neck and shoulders. Holding poses that activate these muscles for up to five minutes (yin yoga) is not a good idea for me. I have a heat intolerance so hot yoga isn’t for me. The fibromyalgia and poor tense fascia responds well when given a chance to gently release.  So I gravitate toward slow flow and gentle yoga. 

I trained to be a yoga teacher because I got so frustrated with doing “beginner” classes that we out of my reach physically and for the time frame. I also wanted to share these tools to show you that “yoga” doesn’t mean 90 minute classes getting into very bendy positions. 

This is also why I created the below challenge!

Learn how we can use the tools of yoga in just five minutes a day?

Join us for the challenge!

yoga for chronic pain and fatigue challenge
Join us for the FREE five minutes a day for five days yoga for chronic pain and fatigue challenge

Join us for five minutes per day for five days and see how the tools of yoga might be of service to you.

If you are curious about restorative yoga, a gentle and relaxing practice, come and checkout my free workshop only available from 28th February to 6th March. 

restorative yoga for the chronic life person doing poses

I’d love to hear from you – have you found benefit from any of the tools of yoga? 

Mindset and Steps for Improving Fibromyalgia

Tackling fibromyalgia is a mammoth task. It is a complex illness requiring a holistic approach. Getting our mindset right is key for helping us to improve.

If we want to get better we must truly believe we can.

mindset for improving fibromyalgia

The tools for a cure do not exist yet. But I do believe we are close.

In the absence of a cure, we do need to ask ourselves two questions:

  1. Do I believe I can improve?
  2. Am I willing to do the (hard) work to achieve this?

You need to believe you can improve and you need to do the work. Or you’ve sabotaged yourself from the beginning.

Take some time and play with these questions. Write them in your journal, or a blank piece of paper and write through all the thoughts that come up with them. When you’ve worked through that, perhaps you could write yourself an affirmation like, “I will decrease this pain and fatigue.” Or if that seems too far for you right now, “I will take one small step each day to improve my life.”

There is no magic pill. Nothing a doctor can dispense will eradicate symptoms or stand alone.

It will more than likely be a multi pronged attack in the broad areas of:

  • Sleep
  • Pain management
  • Pacing and energy management
  • Perpetuating factors
  • Nutrition and food intolerances
  • Gentle exercise
  • Central nervous system/meditation

It is a big task that will take time.

You need someone on your team who:

  • Gets it
  • Listens
  • Helps you look at the big picture, holistic management
  • Enabling you to focus on small, sustainable changes
  • Can provide accountability and support

Whether that is yourself, a coach, a family member or another suitably experienced person – you need support. PS. I offer coaching, check that out here.

It sounds hard, right? Like perhaps you could never do all of this while in such pain and so exhausted?

Let me encourage you. Because I did it. Over several years I have halved my pain and fatigue levels and improved my quality of life – far exceeding my expectations.

How did I do it? One step at a time with the belief I could improve just a little more.

You can read about some of my journey in these posts:
What works now 2019
Fibro framework sleep
Low dose naltrexone one year experiment

if you believe

What are the mindset shifts for improving fibromyalgia?

Not I can’t…but how can I?
From I’ll never be cured…to I will improve.
Not this is so overwhelming…but what area can I tackle right now?

A positive mindset is not going to cure us but it sure as heck will keep our hope kindled and keep showing us the way forward. One step at a time.

What can help us cultivate a positive mindset?

Gratitude!

Each day try to find three things you are grateful for. Track your progress, however small and be thankful for it. Some days you might only find gratitude for the fact that you survived it. On others you might notice that you felt so nice for a few minutes in the hot shower. Or how sitting in the sun on your deck was so calming.

For some things that might make you feel nice see this post.

Let me know, do you have a gratitude practice? Do you believe you can improve?

Do you want to join a community working toward wellness together? Come and join melissa (you) vs chronic pain, fatigue, fibromyalgia Facebook group.

Christmas Gift Ideas for Chronic Illness Fighters to Give and Get

When you are dealing with chronic pain and fatigue the last thing you want is to spend hours being jostled around in a busy mall trying to figure out what to get those on your list. This list that I have compiled gives you some ideas to add to your Christmas gift list and for others to give those of us with chronic illness.

I am sharing 16 Christmas gift ideas for you!

christmas gift guide

Affiliate notice: Please note that some of these links are affiliate links. If you make a purchase using these links, I may make a small commission at no extra cost to you.

An Energy Friendly Creative Hobby – Paint by Numbers Canvas

Winnie’s Picks – Paint by Numbers canvas. These are very cool packs with everything the recipient needs to create their own canvas. It’s great as a meditative practice and just plain fun. This is really great for both a chronic illness fighter and a special gift for others. It’s creative without requiring bucket loads of creativity!

my paint by numbers kit
This is the kit that I received, it was so fun to unpack it!

Reading – without having to go to the library or store

I am a massive reader. Without a fantastic library system I wouldn’t be able to maintain this perfect hobby for the chronic illness fighter. Second to the library is Amazon Kindle Unlimited – reading and listening! They offer 6, 12 and 24 month membership options which gives unlimited reading of over a million ebooks. A book lovers dream!

Audio books – without going to the shop

If audio books are more you or your person’s speed then Audible gift membership will do the trick! You can choose 1, 3, 6 or 12 months and for each month they receive three titles from a vast number of options.

Adult colouring books

Coloring is a great hobby that we can pick up and put down as needed. I have a few coloring books and my Faber Castell coloring pencils. Coloring is a great gateway to meditative practices.

Essential oil diffuser


I have written about using essential oils a few times. I particularly love copaiaba essential oil. Lavender and peppermint are really great beginner oils. Lavender is good for creating a relaxing massage oil, dropping under your pillow for sleep and more. Peppermint is good for nausea.

Fruit infusion bottle

When I created the healthy habits challenge my first area to tackle was hydration, the second was nutrition. This is a nifty way to tackle both! Add some fruits and/or herbs to your water as you hydrate.

A simple cookbook with nourishing, easy prepare meals

Ways to get into utilising the slow cooker, pressure cooker or both are always useful for us. Quick and nutritious meals that you can easily double up are perfect.

A subscription box

Do you have a local subscription box that you could set up for three or six months? The gift that keeps on giving! This website has a whole heap of options that would suit any giftee.

A potted plant

Flowers are a beautiful treat, but a plant continues to give well beyond the bouquet. I have a beautiful pink and white cyclamen in my lounge – as featured in the below image.

10 nice minutes with chronic illness

A herb for their windowsill to use

You could choose parsley, chives, micro greens, coriander, rosemary, thyme etc.

Hot chocolate mix

Make your own and put it in a pretty glass jar or purchase one (make it decadent).

Your favourite book

Do you have a favourite book? Give that to a lucky person on your gift list! Here are a few of my favourites…

A milk frother for a decadent morning beverage


A way to make the morning (or afternoon) nice. Hot chocolate, coffee latte, tea latte, moringa latte. This will get a lot of use.

Nutribullet

For easy food prep try a Nutribullet– nut milks, smoothies, delicious cashew cheese sauce and more! I am obsessed with mine and it was a fun Friday when my husband bought this home for me. I would have preferred the 1200 watt, but the 800 works well too. A really good way to increase your vegetable, herb and fruit intake.

A decent heat pack

This is on my list this year! I have had the same heat pack for a few years now and it just isn’t working for me. I tried a clay one, as clay is meant to be better, but it somehow popped and then the clay was oozing out. It was bad! I would like an electric one this time.

A beautiful journal and pen

There are a lot of options for journals, a beautiful blank one or a guided one for different purposes. I always have a journal on the go and really make an effort when I have a really nice one.

The Ultimate Fibromyalgia Wellness Planner Kit

Would you or your giftee like the gift of helping you plan your journey to better wellness? My Ultimate Wellness Planner Kit is designed to help you make your pain management plans, improve sleep, choose and evaluate new treatment options and more.

ultimate wellness planner

There we have it, 16 options you or your person might like for Christmas this year.

Are there any on this list you are adding to yours? Do you have some other ideas?

Improve Fibromyalgia Now: How I Learnt the Tools to Halve My Fibromyalgia Symptoms

What is the best way that exists to improve fibromyalgia? In this post, I share the best information that exists right now. I am keeping an eye on the research being done by Dr Jarred Younger and the Neuroinflammation, Pain and Fatigue Laboratory and I encourage you to as well. They are at the forefront of the research on fibromyalgia.

I believe that everybody can improve their quality of life. Whether you are suffering from chronic pain, chronic fatigue, insomnia, myofascial pain syndrome, fibromyalgia – I believe there are steps we can take to improve our symptoms. I am not sure about complete recovery, yet, but I have personally halved my pain and fatigue levels. I have also dramatically improved my sleep – I no longer spend hours trying to get to sleep, sleep in one hour blocks or spend hours awake in pain in the night. It is just far and away better than before.

improve fibromyalgia now

How did I achieve this?

By following the advice of the authors in the following two books. And by working away at lots of little steps every single day.

I also believe if we gave these books to people as soon as they were diagnosed and their doctors were willing to work with them through them, then they would not decline as far and would begin to improve sooner.

Affiliate notice: Some of these links are affiliate links and I will make a small commission at no extra cost to you.

The FibroManual by Dr Liptan

This book was written by a doctor who has fibromyalgia herself and has dedicated her career to treating it. In a recent interview I saw with her, she said she believes herself to be around 80% better to what she was (following her own advice) and even works full time as a practicing doctor in addition to a lot of advocacy work and blogging etc. She also believes we may have the tools for complete recovery available in the next ten years!

This book is also designed to take the back portion to see your doctor and help them treat you. Especially the sleep section.

From Fatigued to Fantastic by Dr Teitelbaum

Another doctor who has fibromyalgia and who has dedicated his career to helping patients with it. A holistic protocol that begins with sleep. If you Google his name, you will find a multitude of resources, including videos and interviews and an entire website.

Both of these books are multi-pronged attacks and deal with more than just band aids for pain and fatigue.

Even if you only found one nugget in these books, you would improve your quality of life. These books are packed full of useful things to enact.

If you are able to follow instructions and try things yourself – then you will surely see results.

Dr Liptan also gives further detail about nutritional changes in The Fibro Food Formula book – so check that out!

All of these areas take time and trial and error. If you want to DIY it, write out a big list of goals or things to try from these books and slowly working through it

If you want support, then you can get some coaching (with me or another health coach). They can help you break it down into manageable chunks.

My Hypothesis

I believe if I was handed one or both of these books at the beginning (and had a doctor who would help me with their parts) then I wouldn’t have gotten so sick and it wouldn’t have taken so long to get better. The cascade of physiological flow on effects wouldn’t have occurred.

To Do List

  • Read one or both of these books
  • Write out the main list of areas (sleep, pain, nutrition etc.)
  • Fill in ideas to try under each area, including what you need to ask your doctor for help with
  • Work on each part slowly
  • If you can, engage a coach to help you with this work – it’s complex and there’s a lot to it
  • You might like to look at my Fibromyalgia Framework Series for a quick start DIY guide
  • If you want to start your own small, sustainable steps join us in Yoga and Meditation for the Chronic Life virtual mindful movement studio.
yoga and meditation for fibromyalgia

Do you think you can improve your quality of life? Have you done it? Followed one of these books, or another protocol? I’d love to hear from you in the comments below.

Do you agree with my hypothesis? That we can improve fibromyalgia now by following one or both of these two books?

Do you enjoy this work? Would you like to join the mission to ensure people with fibromyalgia receive the tools, encouragement and hope they deserve and get yourself into the exclusive Melissa vs Fibromyalgia membership library? Become a patron using the pay what you can membership option from just $5 a month today.

Ways to Make Money with Fibromyalgia

When you are fighting a chronic illness, especially one which limits your energy levels, it makes working in an office or physical job difficult. We still need ways to make money even with fibromyalgia. These are not “make a quick buck” ideas, these are “build a micro-business, it takes time and effort” ideas.

ways to make money with fibromyalgia

Affiliate notice: Some of these links are affiliate links. If you make a purchase using these links, I will make a commission at no extra cost to you. It all helps me to keep making these resources. For more information see here.

Ways to Make Money with Fibromyalgia

Etsy Store

I created an Etsy store to share the templates I had created and used for myself in my own journey – things like My Wellness Planner Kit and My Sleep Workbook. I share a lot of detail about it in this post, My Etsy Diaries. It took a lot of time – I created and fine tuned the templates, created the copy for the listing, researched keywords, created the images and then had to promote them on social media. This has created a small but constant stream of income. If you were focusing solely on it, dedicated to researching best practices and good keywords etc. then you could likely make much more.

Here is an article with a run down for creating and selling printables.

my wellness planner kit

Online VA

One thing I haven’t done but had in the back of my mind for a long time was to be an online virtual assistant. You can choose your hours, work in the comfort of your own home and take on the type of work that interests you. It is time consuming to actually find the work and then do the work and take care of the background administration for your own company. It is the easiest way to make a full income if you can work enough hours. Here is an introductory video about it:

You could specialise in:

  • Working with small business owners
  • Helping bloggers
  • Pinterest VA
  • Social media manager
  • Bookkeeping
  • Website support
  • Transcription services
  • Ghostwriting
  • and more!

Blogging

This blog has been around for several years now, when I started, I never imagined that I could make any income from it. As it has grown and people have told me how much they love it, I have had to look for ways to make some of my income from it to enable me to keep dedicating time to it. I did everything one thing at a time. Even creating blog posts is done step by step. So it is definitely a long-term plan.

I dabbled with a free site for a long time, but now I am finally settled with a host I like I am playing massive catch up. Starting with a host from the beginning and setting it up right is actually a time and energy saver. I recommend GreenGeeks – I chose a three year subscription and got a very good price. In this blog post I share how I create posts step by step and some resources for getting started blogging.

As part of the blog I have the opportunity to do affiliate marketing. This means I can promote products and services I like and receive a portion of the cost. Like when I told you about MSM supplement for pain in this post. If you decide to try it and use my link, I make a tiny commission. Eventually it all adds up. The important thing here is that I would have written the post anyway, the potential to make a little bit of income is secondary.

Some people have made very successful blogs and make a good living from them, but that takes investment and a lot of energy. It is also usually in other niches (subject areas) because nobody goes into the chronic illness niche to make lots of money.

Online courses

Do you have a good understanding of something? Perhaps your previous profession gave you some tools you can teach other people. I have lived, researched and actively worked to fight fibromyalgia – so I have created courses to help you do that too. My courses and books and coaching are shortcuts for you so it doesn’t take as long for you to figure it out. Do you have a subject like this?

I chose Teachable to host my courses. I did a lot of research around the key players in online course software and chose this one after careful deliberation and a play with a couple of the other options. It has been easy to set up and use.

Teaching /Live Services

Do you have something to teach or a service to perform in real life? Or live, virtually? I am doing this with yoga – if you are curious about yoga or coaching or a blend with me, click here. You could do it with:

  • English lessons (can be done virtually or in person)
  • Reiki
  • Massage therapy
  • Nail technician
  • Personal training (exercise)
  • the list is endless!

The idea is for using your skills (or honing new ones) in a way that provides flexibility around your needs. Do you need to work early in the day? Have long breaks between clients/sessions? Do you come alive later in the day? Can you do a few hours over six days, or a couple of fuller days?

Write Books

One or two books doesn’t make that much money, but I didn’t write my books for that. It was a life dream to write a book. I had no idea I could achieve it while living with fibromyalgia and with two small children. With the help of my brother, I did it. My Pregnancy and Fibromyalgia book is still one of the only books written on the subject so it was necessary. I wrote my books very slowly as at the time of writing them I couldn’t sit at the computer for very long at all. They do bring in a small amount of income every month (I don’t receive it every month, Amazon holds onto the money until it reaches $100 and then they deposit into my bank account and then my bank takes $15 processing fee).

If you were able to write multiple books and focus on really marketing them – telling people they exist, then you could make much more.

Coaching

Are you an expert in something? Or do you have a passion for helping others to achieve their goals? Life coaching training gave me the framework to take my expertise to my clients. It is a process to support clients to achieve their goals.

Research around coaching for fibromyalgia is in its infancy but the initial findings are that it is enormously beneficial. This article discusses the benefits on patients receiving coaching for fibromyalgia. At the conclusion of the study it refers to, 12 months results included that Revised Fibromyalgia Impact Questionnaire scores improved by 35%. Illnesses interference in function was reduced by 44%.

I became a coach because it was a natural extension of the work I have been doing in my blog, books, courses and Facebook groups. I wish that there had been a coach capable of helping me back when I was beginning my journey fighting fibromyalgia. My purpose is to save people the time and energy I had to invest in order to learn what I needed to learn to start improving my quality of life.

Coaching is about more than the initial training, however you choose to train, it is ongoing professional development. I am constantly learning about treating fibromyalgia.

Writing articles

Freelance writer and teacher Elna Cain is a great resource for getting started in this field. She has a free introductory course. Writing articles for online businesses in a great way to make super flexible income. You do have to watch out for places that will pay appropriately for your content or you will end up writing yourself into the ground just to make a decent income. I have only written a few because I haven’t had the time to focus on finding the places to pitch to that pay well.

You Tube

I have been making videos for years, mostly as a way to add to the blog posts. In all this time I have not hit the metrics required to monetize the content, so I don’t personally make money this way. If you are prepared to focus and work at it, you can make some money this way. Gillian Perkins is a great resource for learning about using YouTube to generate income:

E commerce store

This is kind of like an Etsy store except that you host it on your own website and then drive all of your own traffic there. If you create your own products, this is a great way to do it. You can also host affiliate products in your store. It is just another way to present affiliate products to your audience. If you genuinely like the products you are recommending it is a great way to make income while serving your audience (reducing the time it takes to find a good product for a particular solution).

fibro framework book

Membership site

Have you been providing something to people for free, like a blog, YouTube channel, supportive group etc? Perhaps people have been telling you they love your work, think it’s valuable and would like a way to support you?

Patreon is a really cool way to set up a pay what you can membership model. The Melissa vs Fibromyalgia Inner Circle Membership is the way that people who love my work can sign up to support me for as little as $5 a month. They are simultaneously supporting me to create this blog, the YouTube videos, live monthly talks and run the Facebook groups. They also get access to the exclusive library of content to help them in their journey. Toolkits, videos, audios, templates and more.

You can include bonus content in the form of videos, blog posts, downloads and more. You can simply provide more access to you. Or create a private group where you help people more in depth.

I hope that something here has peaked your interest if you were wanting to start making money in a more flexible way, despite fibromyalgia. Is there something you do that isn’t listed here?

an income with fibromyalgia