In this episode I give you suggestion on how to handle situation when you experience acute on top of chronic pain of fibromyalgia.

Episode 45: What does the pain relief in fibromyalgia really come down to?   Hello friends! So Excited to be here, brining you episode #45.   The focus of today’s episode is zeroing in on what is the pain reduction really about. I had an epiphany very recently and realized that I have to share it with you because it just may help some of you to think of pain relief in fibromyalgia and other chronic pain conditions differently.   While I was still working on this episode, 2 days ago, I was in a car accident, I rear-ended a truck. I got distracted while in slow traffic, the line of cars stopped at a light and I did not realize this soon enough. The reason I am mentioning this is that I had yet another re-inforcement of the concept I am talking to you about!   So the question is: what does the pain relief in chronic pain and fibromyalgia really come down to? In a nutshell, the pain relief comes down to finding evidence for and focusing on all the ways our nervous system and brain ARE working FOR US as opposed to looking for evidence of how they do not. That’s it.   Let me explain.   If you listen to enough of my episodes or videos you know I view the process of recovery from chronic pain in 3 main steps or strategies: Understand and embrace the concept of neuroplasticity – meaning – accept that the brain/central nervous system generate the pain (and as result can take it away because the neuronal connections are born and severed /deleted every day based on our practices and habits) BELIEVE the pain relief is possible AND available to you Lastly, engage the relaxation response that makes our primitive brains feel SAFE.     I notice that often, even myself, being an experienced pain coach that I am, I tend to first think of the worst case scenario when I experience worsening of pain. Basically, my brain offers the following thought: “You see?? It is NOT working! Your pain cannot and will not get better!” And in the past I would succumb to that thought which would lead me down the spiral of doom and would not lead to anything good, seriously.   The good news is that this is normal, Our brains, our lovely brains that want to keep us safe and comfortable and love familiarity above all else, even it is not serving us, will offer us that thought. And our job is to say, well, dear brain, how about focusing on ways this DOES work?   The way to achieve this, is to sit down with a pen and paper, and think of all the times your body DID do something that may have delighted or surprised you, or may not have even registered in your attention, basically you took it for granted. I will give you some examples:   Think of one activity that you enjoy doing that you can actually forget a little or completely about your pain. Meaning, when you think about the pain then you may feel it but in the moment you are completely lost in the flow of things and you are blissfully unaware of any pain. This is a proof our nervous system is working as designed and intended. It takes away from the pain because it is focusing on something pleaseant and the pleasant and joy neurotransmitters temporarily win over the pain inducing ones.   Think of ANY time your pain was clearly worse when you were stressed out or under enormous pressure – whether in personal life or in a workplace. Your pain was worse, you did not sleep well, you were more tired. This is a proof that the system is working. The stress response is resulting in increased production of stress related chemicals that make us feel worse.   Have you ever felt excited about something, super excited, either an event you were going to go to, or a new movie, or a concert or a vacation you dreamt up and paid for, and transiently you could feel less burden of a pain? How about being excited about some project at home or at work where you were applying yourself creatively or in a leadership position – have you felt a jolt of energy, life force, energy to live and enjoy? The research has shown that when we feel good about ourselves, we feel better physically.   At the time of my accident this past week, within moments of hitting the truck ahead of me, I started experiencing almost immediate sharp pains in my neck and upper back. Then as I moved my head the pain was worse, and I could feel my upper back spasming. It was fascinating how fast that happened. After calling 911 and securing my car out of traffic, I started actively communicating with my tight muscles and brain. I was still shaking a little but I was safe. I slowed down my breathing and actively relaxed my muscles of my neck and shoulders. And I was telling myself the words: “stay calm, breath, stay calm. This will be ok. Stay calm, breathe, you are safe, this will be ok”. It was incredible that it helped in the moment. I engaged this technique multiple times in the next 48 hours as I was dealing with the fallout of the accident and taking care of all the things. My pain was gone within 24-36 houts in my neck. I kid you neck. I get chronic pain by my right shoulderplain that flares with stress and it was still there but it subsided too.   To me that’s a clear evidence of how our nervous system and pain generators in the brain LISTEN and RESPOND to what we feed them. The words we tell ourselves matter because our primitive brains, and the structures in the brain whose sole purpose is to look for danger are looking and listening. And we can direct them.     So I invite all of you to think of ways how the “system” meaning our central nervous system, IS working right, is working for us.   Above all, I wish you a very happy and prosperous and safe and HEALHTY new year of 2023.    

WAF Episode 44: The first of its kind, Winning at Fibromyalgia online course is born! https://www.martinaziegenbeinmdcoaching.com/course-pre-sale-landing-page https://www.martinaziegenbeinmdcoaching.com/offers/mgeMgobJ/checkout Hello friends!   Today is a special day. First of all, I am recording this from my “studio” in England and when it airs, I will still be in England!  Of course, I don’t have a studio in England, I am visiting my sister and she lives in England, about 30 minutes southwest from London and so temporarily my recording studio is here   Second, today is day 3 of my new Winning at Fibromyalgia online course going live, meaning being available for purchase. This course is basically the labor of my study and research and seeing patients over the past 12 months and my desire to let the knowledge know the large swaths of people with fibromyalgia and other forms of similar chronic pains.  What triggered me to get myself into high gear action was the culmination of events. I mentioned to you in one of the prior episodes I am working on a tedx talk about this new way of handling and reducing pain in fibromyalgia. I have continued seeing many women in my office with fibromyalgia and one of them literally told me she has felt crazy in medical offices when she would talk to physicians and other health care providers about her pain. Because she looks well, she did not feel believed, even dismissed. She felt she was viewed as a drug seeker when all she wanted was feeling better, feeling NORMAL.   If health care makes people feel crazy, something is very wrong. We can do better. I can do better.  So I have put together an online format of material that I normally teach my patients in person, over the course of several sessions. It is an online program that teaches you everything about fibromyalgia and how to help yourself. It includes scientific information that I dissect into small digestible pieces. You learn at your own pace. From the comfort of your home.  I am offering it for a super discounted price of 249 USD to a small number of participants who are eager to take advantage of this opportunity and realize this is a rare opportunity. This small group of learners we ask for your feedback on the course.  t will only be available for purchase at this price tag until this coming Thursday. We will then close the cart and reopen in December at probably doubled price.8  So why is it such a big deal? It is first and only course of its kind at the moment in this space. You will not find another course geared toward humans suffering from fibromyalgia, not of this quality and not at this price. When you purchase my course, you will have the advantage of learning from the Comfort of your home, even your PJs! Price tag of 249 USD – I do not exaggerate when I say the courses of this kind, containing the type of information I cover are worth THOUSANDs of dollars. Thousands. I am making it available at this price so that it can become available to as many people with fibromyalgia of you as many are willing to learn and find out. I have a unique combination of skills that were crucial for putting this course together – I am a rheumatologist so I have been seeing patients with fibromyalgia for over 15 years, I have the condition myself, and last but not the least I took special interest in understanding and trialing the tools to help – and proofed them on myself. The information included in the course is the magic sauce: Scientific information I gathered over the course of many years as a rheumatologist and put it in small easy to digest bites. Examples of such information is how we know the pain in real in Fibromyalgia and what kind of factors affect it. I also summarize prior research done in the area of how our thoughts and beliefs affect our experiences of pain. I review, step by step, the WAF method to reduce the pain. It includes somatic experiencing of the pain, being able to be present in the moment and being able to be compassionate with and loving to ourselves.   I am obviously biased and I believe this is a great deal.   I say you jump in and see for yourself.   And until next time       

Today's guest: Dr. Robyn Tiger Physician | Trauma-Informed Self-Care Coach | Podcaster Dr. Tiger shares so much good stuff it is hard to know where to start. Robyn Tiger, MD is on a mission to empower busy humans with self-care tools backed by science and research. She does a lot of work with physicians on the verge of burnout or coming out of burnout but the tools she discusses in this episode are literally for EVERYONE. At the beginning of the episode i asked her how she got to do the work she does - and she shares her OWN journey, how terrible her body felt while she was still working as a breast imaging radiologist. Her symptoms included body pain reminiscent of fibromyalgia and HOST of other symptoms that were ALL related to stress but nobody could diagnose it for her! The signifcance of this episode that MOST of our chronic stress symptoms are completely reversible! IF and WHEN we are ready to start implementing simple, effective and ancient tools that old cultures thousands of years ago before us knew. Dr. Tiger is certified in yoga therapy, meditation and life coaching. She offers innovative CME accredited courses, private coaching, and podcast that focus on complete physical, mental, and emotional well-being and resilience When she’s not busy supporting her colleagues, Robyn can be found enjoying her own self-care through hiking, paddle boarding, meditating, yoga, playing with her dog, husband and kids in the mountains of Asheville, NC. SHe is a host of Stress Free MD and her website is: https://www.stressfreemd.net/  

Episode 40: You experience an acute jolt of pain – now what? Welcome to episode 40 of WAF Podcast! I am recording this episode exactly on my podcast first anniversary! I launched The Winning at Fibromyalgia podcast exactly a year ago, October 15th 2021. It is now October 15th 2022. This is the 40th episode. I could choose to be upset over not giving you 52 episodes – one per week. But instead I am choosing to be grateful and excited. Grateful for all of you who listen and have found some form of helpful information, in one shape or another. I get excited when I get feedback that something I talked about or mention was helpful. I am also excited because a year ago I did not think I would do this, that I would be able to produce 40 episodes. It means putting my thoughts into words, on paper/computer screen, then recording it. It means picking and inviting guests on my podcast, recording the interview. Then listening to it and helping to edit. Hours and hours of work. So, I am celebrating. This entire weekend. One of the questions I have for you – what are you celebrating when you look at the past year? I don’t think we should only reflect on the past year at the end of the year. I feel we can reflect any time of the year, especially if there is an anniversary. It was also recently an anniversary of 8th year of my Mom passing. And I am not quite ready to talk about that on my podcast.  I am so excited to be back. I have shared with you I have been going through a rather difficult time of accepting a dissolution of a romantic relationship. I am doing better and deeply appreciate all the messages of support and encouragement and love from you. It feels like I am almost over the hump  Today, in addition to this being a celebratory podcast of one year anniversary  I am choosing to share another personal experience, intimately related to my story of fibromyalgia. Before I get to it, I do want to say one thing – aimed at all of you, my lovely women who suffer with pain every day, who wonder whether it can ever change, whether YOU can ever change it. I am here to tell you – YES YOU ABSOLUTELY CAN! It is within your power to reduce your pain and turn the entire course of your fibromyalgia story around! I see it on myself, I see it in my patients, rewiring of the pain pathways, the pain neural circuits CAN be rewired, NEW neural connections can be created! Every minute. Every hour of every day, we have an opportunity create these new neuronal connections! That will translate in less pain and more enjoyment, and you doing things that you cannot imagine right now because you cannot see beyond the current moment  My fibromyalgia back pain has been flaring through this break up time (and coming and going anniversary of my Mom’s passing). I have been doing somatic tracking every day and it is really good in the evening when I am relaxing and definitely flares up during the day when I am at work. But it has been tolerable. Now I decided a break up would be a good time to go to my old crossfit gym here on the cape. I was a member for several months last year but quit last September and joined more of a regular globo gym. I felt I was too destroyed after each workout back then, and my joints were sore after – I do have rheumatoid arthritis and I just did not feel it was right.  So with this break up I decided to return to the crossfit. And there the second day I went, we were doing push press and split jerks. That’s a movement when you push the bar above your head while you catch it below – with your legs slightly apart, as if in a lounging position. And I overdid it, too enthusiastic, I put on too much weight. ON the way down, as I was receiving the bar with weights, I felt a pop/sharp pain in my R shoulder, followed by a temporary weakness, to the point of not being able to lift the arm for a few moments. My first though was “no! I hurt my shoulder again!”, I do have a history of R shoulder injury/partial rotator cuff tear, from 10 years ago, that responded to PT but would flare every time I overdid things in Crossfit – lifting things above my head. And my first thought went to – OMG, I MUST HAVE NOW COMPLETELY TORN it, that’s why I have weakness and sharp pain, why else would the pain be there so sharp??? I was in a pure panic mode. And this is where something magic happened and the reason I am sharing this episode with you. I WAS ABLE TO PAUSE. I was able to put a pause, a break between the trigger (the movement that I believed re-injured my shoulder) and my spiraling out of control, the dooms spiral. I already put the bar back on the rack.  I went to the coach. I told her what happened/that I was worried about re-injury. Then I tried and succeeded in calming myself down. Two main things happened: I focused on the pain and realized two areas were involved – my right mid back by the R shouldblade, that has had chronic flare over the last few weeks. It was on fire and super sore and the R shoulder – top/posterior, searing pain. Almost like somatic tracking but I don’t recommend somatic tracking in acute severe pain. Second thing I did was that I told myself messages of reassurance – in my case it went like this: Martina, ok, so you MAY have torn the shoulder cuff, you MAY have. If you did, you know where to go – you will solicit help of one of the surgeons you are familiar with at your work place. You will be taken care of.   But right now you DON”T KNOW FOR SURE that you torn it. You just know that it is hurting. Can you TRY to calm your breathing and mind down, and see whether it helps? The coach came by in the meantime seeing I am trying to stretch and gave me a ball that they refer to as “Chinese torture” in my gym  She said I could try to use that to loosen up my muslces.  Guys That’s what did the trick – I was leaning against the ball against the wall on the SOREST spot on my R shoulderblade, to the point it was taking my breath away, that’s how sharp the pain was. YET I was successfully releasing the tension in my shoulders, I let the shoulders drop down, while staying calm and telling myself to stay calm, with my breath, with the pain, and applying the pressure. I did NOT go to push press that gym session. Over the next 48 hours, my pain went down from 9/10 down to 2-3/10. The pain was really severe that evening and I had trouble even just doing dishes – any motion with my right hand INCLUDING brushing teeth was flaring the pain. But I continued to breathe through all of it, and did not lose the sight of the fact that I would know what to do if the pain was not getting better. The pain was better the next morning. I went back to the gym the next day but did NOT do any overhead activity. I did stretching at home and in the gym for the next few days. Then over the next several days the pain went almost back to baseline. SO why am I talking about it? For the following 3 reasons: Tense muscles can totally lead to acute muscle strains and acute pain. I clearly have myofascial pain and that underlying kind of baseline pain was there when the acute pain happened – and you need to know that this can happen. Acute pain does NOT mean automatically acute trauma or tear. It DOES or MAY mean injury, but there is a scale and degree to injuries. What I experienced was most likely minor muscle/tendon strain from overloading and not stretching enough or not having my shoulder muscles ready for the load I put on that bar. You can improve your pain experience by staying calm and knowing you have control over the physical experience of the pain. The main thing I did was to halt my anxiety or panic that I started feeling at the moment of the acute pain. I literally did not allow myself to go there. You can do it too and in fact you need to, in order to stay in control. The second thing I did was I BELIEVED I COULD HANDLE things EVEN IF I HAD TRAUMA IN FORM OF TEAR> I never for a moment steered away from that though. And you can too – even if you are not a physician, you can have faith that you are able to seek help if the pain does not get better after the initial steps outlined above, or if it is getting worse in the first 48 hrs after injury.

Episode 39: The pain of a break up is both emotional and physical   Hi! Welcome to episode #39!   Today I am going to talk about the pain of a break up! It is something I first heard about a year ago when I was taking pain reprocessing courses and at that time I found it fascinating. I was recently dating and it did not occur to me I would be “testing” on myself    Break ups hurt. NO matter how many times you have thought about breaking up with the person or questioned whether your relationship was going to last – when it actually happens, and you like, loved them, it hurts.   So first, I met a great man, after not dating for almost 6 years, and he swept me off my feet and now we are broken up.  That’s the short story.   There is a study, believe it or not, that explored what happens when people are shown pictures of someone they loved/someone who broke up with them. Brain MRIs were done at the same time. They recruited 40 people for this, all of them had experienced a recent unwanted break up. The other part of the experiment was stimulation of the left forearm with a hot probe. Auch. And what they found is that the signal that is picked up at the time of looking at a picture of your ex overlaps significantly/almost identically with area in the brain that processes physical pain! Isnt’ this fascinating?   These findings give a new meaning to the sentence “break up hurts”. Because it does. And you can even prove it on the functional brain MRI!   But joking aside, these findings basically shed new insight into how emotional experiences lead to development of physical pain. They are consistent with the research on “embodiment” which means that emotional experiences are closely intricately and intimately connected to the physical sensation and processing of pain.   This explains why people may experience an uptick in pain after a breakup or whenever they are going through a difficult time that is accompanied by some kind of social rejection.   So the next question is what to do, can you make it better?First of all, heart break is always hard and I am not here to tell you will make the pain go away. Break up means a loss of a relationship and no matter how bad it was, you still have to mourn the good and beautiful and wonderful things that you had experienced together. However, I do claim that what I am about to say will make YOU feel better about the whole situation and in turn, may improve the pain.   First, acknowledge the pain you are feeling, the heart ache. The pain can be all consuming and excruciating. If you are anyone like me, who falls hard and experiences everything intensely, you will feel the pain intensely. trying to run away from it does not help. Acknowledge It is there and that it is ok.   Allow yourself a lot of grace and love.   You may cry, and feel intense sorrow, that may make it hard to function – let yourself feel it is ok. Love on yourself. Try to think of what gives you sense of love and reassurance. Then feel it, imagine it. I have been imagining a picture of me being a small girl, feeling sad and lost, and giving that little girl a huge loving warm and reassuring hug. Telling her it is going to be ok.   Know you are NOT alone. Remember many other people have gone through this and you will get through this too. Almost anything we experience in life, and especially a break up, other humans have overcome. So can you. So can I.   Accept the decision. If you are the one who was the recipient of the break up news, like me in this particular situation, accepting the decision is extremely important. For whatever reason the other person decided it was best for them to break up – that means it is best for you too. Because why would you want to be with someone who cannot see the same about you?   Try to learn from this experience – are there any ways you were not true to yourself in the process? If so, why not?   Know that you are going to be ok.

Episode 37: Weaving the threads (of Winning at fibromyalgia philosophy) together   Hello friends.   In the past few episodes I discussed individual pieces of the Core Winning at Fibromyalgia program. Today I am coming on here for a sweet short episode to recap, and emphasize the most important pieces and what I am doing about it.   I do strongly recommend listening to prior episodes to learn more about the individual steps. In summary, they include: The Neuroplasticity concept – the principle of this is that our central nervous sytem/brain can produce pain that is felt in the body, and more importantly, that it does not have to stay that way. Our brain has an amazing, incredible capacity to rewire itself, with a little bit of help.   The concept of Belief - in own’s body ability to heal, in our brain capacity to rewire, in ourselves, and our ability to get better.   Letting go of the attachment to the outcome. In short it means we can want something very much (to reduce our pain and improve our lives) but it can create a lot of pressure on our brain so it helps to feel certain lightness about our desire and journey to pain reduction. More curiousity and self compassion.   The work – mindfulness based techniques that incoude somatic tracking, self compassion, healing emotional wounds from the past.   The most important pieces, in my opinion and the common denominator in all success stories are the belief in one’s ability to get better, to heal, to be pain free or with significantly less pain AND fierce self -love.   I have found on my own journey and from listening to the many women who got better – they believe and they love on themselves. Self-love can be hard to recognize as self love because the societal norms tell us what we “should” and should not do. And we put that pressure on ourselves. Some of the examples of the opposite of self love is: Putting others’ need ahead of your own – repeatedly. Many many moms do that. Every day. I just spoke to a good friend of mine whose husband took their kids to his parents for a weekend. For the first time in a long time she had 3 days to herself. She did not know what to do with herself. It was like a vacation. ALL MOMS need that. IF we don’t get our cups filled first, we cannot be tehre for other people, our subconcious brain detects a threat and boom, low level fight or flight reaction/stress response is on.   Working long hours just to be a good employee or feeling loyal to your employer. I am guilty of this and I am working hard on resolving this issue for myself. Many physicians and non-physicians in health care suffer from this condition – feeling responsible for the patient’s outcome so putting in extra time, extra mile to get things done. And many times that is appropriate and even desirable. But not every day, not all the time. The same applies to other industries.   Staying in a toxic relationship or seemingly happy relatioinship when our intuition is screaming at us that we should get out.   We only have ONE precious life. We have to treat it like gift, we have to treat our health and our bodies as gifts.   What we feel, what we are going through matter. We should not be miserable at work or in life every day.   So here is what my team and I are doing. Starting at the end of September, I will be hosting weekly calls, For women interested in supportive community and more knowledge about fibromyalgia and what to do about it. We meet and talk about a topic each week I share ways to assess your fibromyalgia and then Prompts to do the tools Or simply answer your questions   Being part of the supportive group where everyone knows what the other might have gone through thanks to fibromyalgia is priceless.   Support is the other key factor in becoming successful at winning at fibromyalgia. Support of people who know what you are going through, who hear you, see you AND believe in you. That’s what I will be doing for you guys. There will be a small fee associated with this activity, paid monthly, it will be a close knit and private community to get us started. We will get to know each other story well, to whatever is each of you feeling comfortable, And we share our knowledge and stories and tips every week I will moderate it and it will be a positive, private, and confidential type of setting where everyone participating will feel comfortable and safe.   www.winningatfibromyalgia [email protected]   facebook name: martina lenartova