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A Fibromyalgia Doctor's Advice for Dealing with the Physical Tasks of Daily Life

  [ 195 votes ]   [ 4 Comments ]
By Dr. Mark J Pellegrino, MD* • www.ProHealth.com • April 21, 2010


A specialist in musculoskeletal function and pain (Physiatry), fibromyalgia doctor Mark Pellegrino suggests many “basics” that can help those with FM and other painful conditions to approach daily chores in ways that are kinder to the muscles. An FM patient himself, he knows that ‘every little bit helps.'

_______________

Whoever invented fibromyalgia never had to vacuum!

Chores can be a difficult challenge for someone with fibromyalgia. I always ask my patients if their fibromyalgia interferes with activities in the house and they almost always tell me “yes” (even the men!). The bending, reaching, lifting, and pulling required of these tasks causes increased pain and often leads to painful flare-ups. The fibromyalgia homemaker/maintainer is faced with the dilemma of wanting to have a clean home, but not having the physical abilities to complete these tasks without pain. What can you do?

1. Stop doing housework altogether. Yes, just go on strike! See if the work gets done by others. Watch as nothing gets done and your house becomes a health hazard! You can’t stop everything, but daily or weekly tasks can be analyzed to determine if they can be done less frequently. Consider a rotating system where different parts of the house are cleaned on different days and not all at once. Instead of doing one heavy task in one day, spread it out into several mini-tasks over the course of a week.

Your whole house may not be perfectly clean all the time, but parts of your house are perfect every day!

2. Have someone else do it, with you supervising. This is a good way to teach responsibility to your children (or your spouse, the biggest kid of all). The shared housework concept divides the responsibilities among the entire family, and you do the share of tasks that you can comfortably handle.

The heavier tasks (vacuuming, carrying laundry loads) should be delegated to other family members. You supervise - and be sure to look busy at all times!

3. Pay someone else to do it, if you can afford it. Try to have the paid person come weekly or every other week to do the major cleaning, scrubbing and vacuuming. You can do the minor “touch-up” work in between visits. Bribe your kids to work cheap!

4. Modify the way you are doing particular tasks. This allows you to continue doing the homemaking, but do it in a way that is kinder to your muscles. Since homemaking chores are done with your body in unusual and awkward positions that aggravate your fibromyalgia, proper attention must be paid to "fibronomics."

Four Rules of Fibronomics

1. Arms stay home.
2. Unload the back.
3. Support always welcome.
4. Be naturally shifty.

Probably a combination of these options works best for each person. New strategies can be learned and used successfully. Sometimes unusual projects cause flare-ups. For example, one patient described how she spent several hours decorating cakes for her boy’s basketball team and had severe pain in her shoulders and arms. Another woman had a flare-up in her back when she was lifting heavy bird seed bags into the trunk of her car.

Both ordinary and unusual homemaking tasks and projects can cause flare-ups, so you must be constantly on guard to try to prevent them. Wear your mental seat belt and follow fibronomics. Following are some tips for handling usual tasks - plus special strategies for conquering grocery shopping and cooking with fibromyalgia.

* * * *

1. Problem: Vacuuming
Vacuuming is Housework Enemy Number 1. It can aggravate pain in the back, shoulders and arms because your arms are reaching out to push and pull the heavy vacuum, and you are bending forward while pushing, which puts stress on the back.

Solutions:
a. Obtain a lightweight vacuum cleaner to minimize the load on the arms and back.

b. Hold the vacuum cleaner by holding arms down against the side and lightly holding the vacuum handle but not squeezing hard. The handle of the vacuum cleaner rests against the upper thigh and hip area. Walk forward with back maintaining a normal curvature and push the vacuum cleaner forward, and then backing up, squeeze the handle harder and pull the vacuum backwards with steady force. Repeat these steps to cover different areas of the carpet. Be sure that the arm does not reach out away from the body, but that the whole body moves forward along with the arms.

* * * *

2. Problem: Washing Dishes
Standing at the sink washing dishes hurts your lower back because you have to lean forward.

Solutions:
a. Alternate leg on a low stool or inside the under-sink cupboard [open door & rest foot on cupboard bottom] to unload the back and decrease the pain.

b. Use disposable paper plates, paper cups, and paper cereal bowls. (Don’t hurt your back throwing them away!)

c. Do a few dishes at a time, do something else, then do more dishes. The alternating methods helps reduce prolonged back strain.

d. If the sink is too short for your height, place a large plastic dispan on the counter top and wash dishes in this.

e. Use one of those sponges that have dish detergent in the handle. You can rinse and wash dishes easier.

f. Cook and eat from same dish. Use a microwave bowl to cook and then eat out of it. If you’re eating alone, just eat out of the pan.

g. If cooking for your family, serve from the stove so you don’t have extra serving dishes and spoons to wash.

h. If using a dishwasher, have family members load their own dishes, and assign the job of unloading clean dishes to children or spouse.

* * * *

3. Problem: Ironing
Bending forward increases back strain, and repetitive arm reaching hurts.

Solutions:
a. Alternate leg on a low foot stool to unload the back.

b. Avoid overextending the arm; keep the elbow bent and the iron as close to the body as possible.

c. Use a drive-through dry cleaning service.

d. Buy fabrics that don’t need ironing.

e. Wash clothes at home; hang dry so you don’t have to use druer. Take them to the cleaners for pressing.

* * * *

4. Problem: Dusting
The major problems with dusting are reaching for the tops of shelves and bending to reach diffcult low area of furniture.

Solutions:
a. Use a longer handled dust mop to allow the equipment, not your arm, to reach the spots.

b. Use a hair dryer to blow dust off.

c. Store all knickknacks in glass-enclosed shelving.

* * * *

5. Problem: Scrubbing
Scrubbing the floor, furniture, or countertops is an invitation to a flare-up. You bend and reach and you hurt!

Solutions:
a. Use a long-handled mop when scrubbing the floor. Take advantage of any cleaning solvent that will perform the chemical scrubbing for you, so all you have to do is wipe up.

b. Use an electrical device that does the scrubbing for you.

c. Hire someone to clean your floors yearly.

d. Sit down to clean up spills on the floor. Or use the Ann Evans Bath Towel Method (ABT) to clean up spills. Holding one end of towel, put foot on other end and use foot to wipe up the spill!

* * * *

6. Problem: Doing Laundry
There are various components to laundry that cause problems, including gathering up dirty clothe, carrying them up and down stairs, and loading and unloading the washer and dryer.

Solutions:
a. Use dry cleaning services whenever possible, especially the drive-through or pick-up and delivery service.

b. Instead of using the laundry basket to carry clothes up and down steps, place the clothes in a mesh laundry bag and throw them down the steps. Drag them up the steps behind you.

c. Dryers that have front openings are preferred. You can get closer to the opening to pull out the clothes, making it easier on your low back and arms.

d. Do only one or two loads at a time; wash enough clothes for two or three days, instead of a week.

e. Use an assistance device (a reacher/grabber device) to reach into the washer or dryer and avoid bending over.

* * * *

7. Problem: Washing Windows
Another enemy of housekeepers and almost everybody else! Reaching, straining the back, wiping; it hurts me to write this, and I don’t do windows!

Solutions:
a. Use a long-handled window cleaner with a squeegee to clean the outside windows so you can observe proper fibronomics.

b. Don’t try to do all your windows in one day; wash only one window every other day.

c. Hire window cleaners once a year.

* * * *

8. Problem: Getting Objects In and Out of High or Low Cupboards
The reaching and lifting can hurt your shoulders and back.

Solutions:
a. Use footstools or kitchen step ladders so you can practice fibronomics when getting object out of cupboards.

b. Store your everyday pots and pans in the most accessible cupboards; the rarely used and heavy cooking items can go in the higher cupboards or less accessible locations.

c. Store all cooking utensils in a basket on your kitchen counter so they are always accessible.

d. Use a reaching device.

e. Buy a refrigerator with the freezer on the bottom. The fridge will be at a more comfortable height, and the lesser-used freezer will be out of the way. Don't forget to put a magnetic notepad (your Fibrominder!) on the refrigerator.

* * * *

9. Problem: Lifting or Moving Heavy Objects or Furniture
Every once in a while, we decide it’s easier to move something ourselves and we usually will pay the price.

Solutions:
a. Do not buy heavy objects unless they can be placed in a permanent resting spot, and I do mean permanent, forever, always, OK?

b. Do NOT lift heavy objects; leave them where they are as long as they are not bothering anything.

* * * *

10. Problem: Prolonged Writing/Typing
This might include bill paying or writing letters. Also, frequent typing on computer keyboards can increase neck and shoulder pains.

Solutions:
a. Instead of paying bills all at one time, designate two nights a week for the task.

b. Use marker pens or pens with a medium point to minimize amount of pressing required.

c. Reduce the total number of checks to be written by consolidating loans or using automatic deductions. Some banks offer online bill paying services that might save you time and effort.

d. Write or type a “master” letter and photocopies for your different friends, adding personal tidbits to the individual’s copy.

* * * *

11. Problem: Yard Work
This can be especially challenging since many patients with fibromyalgia love being outdoors and working on the flowers, garden, or lawn. Rather than giving this up completely, I encourage patients to find ways to enjoy some aspects of yard work without doing work that is too strenuous or painful.

Solutions:
a. Buy a garden seat and cart to allow sitting and other proper fibronomic techniques.

b. Don’t be a yard warrior. Break up large tasks into a series of smaller tasks and spread them over a longer period of time. Cut the front grass one night, the back the next, and do the trimming on a third night instead of doing it all in one day.

c. Hire a lawn service for heavy duty tasks, like spring cleanup, edging, or mulching. You do what you enjoy.

* * * *

12. Problem: Walking the Dog
The dog jerks the leash, causing your arms, shoulders and back to hurt. Walking the dog is exercise for both you and the dog. However.

Solutions:
a. Use an extendable leash which will significantly reduce the torque and force on your arm.

b. Obedience school for your dog. (Heck, you are in “Fibromyalgia Obedience School” if you’re reading this!)

c. Train your dog to use a treadmill. I have a patient who actually did this. Now the dog gets a lot of exercise, but not my patient!

* * * *

Special Strategies - Grocery Shopping With Fibromyalgia
Grocery shopping can be a dreaded activity with fibromyalgia. The fibromyalgia homemaker should prepare some shopping strategies.

Time: One of the first steps is to choose a time to arrive at the store when no one else wants to shop. It is that simple! During early mornins or late evening, most stores are not crowded. Determine the peak shopping hours at your favorite stores and avoid those times. Those times are usually during the lunch hour, after school and work, and Saturday.

Store: It is easier to pick a small store that does not have miles of parking lots to cross just to get to the front door. Thus, the super store is usually out. Even if they have a better selection and price, what good is that if you are exhausted even before you get into the store.

Parking: Remember where you park your car. Park in the same section all the time if you can.

List and ‘Map’: A shopping list is a must. To make your shopping fast and easy, prepare a master list of all of the products that you will use and purchase. Then, in your mind, go through the store and write down the items in the order that the aisles are arranged in the store. You’ve made your grocery map from your master list. Check this ‘master map’ before you leave home, and when you arrive at the store you will be organized and can shop fairly quickly with a minimal amount of walking. Conserving your energy is important so you can get those newly purchased groceries into your car.

Other Grocery Shopping Tips
So you park close, get to the store quickly, avoid any long lines, and keep a list. What other strategies can be helpful to get your groceries into your home? Consider these tips:

1. When you enter the grocery store, look for those small plastic baskets you can carry, and put one in the bottom of the shopping cart basket. Thus you only have to bend and lift one time at the checkout to place the items on the counter, and your grocery cart is easier to unload.

2. Buy smaller amounts of groceries. Beware of quantity. It is better to make two or three trips a week than to buy jumbo sizes of laundry detergents, cereal boxes, and milk containers that are too heavy to handle on a daily basis.

3. Ask for help to get your groceries into the car. The bagger can pack them lightly and in paper bags so they are easier to handle.

4. Keep small laundry baskets in the trunk of your car. These baskets can keep grocery bags upright and prevent them from sliding to the back of the trunk where it is hard to reach. Keep a reacher/grabber (an assisting device) in the trunk to get items you can’t reach.

5. Once you arrive home, take the bags containing items that need refrigeration inside; you can unpack the rest at a later time. Or bring the bags into the house and put them away later. Or have a family member or friend carry the bags into the house. You might even pay someone to go out and get your groceries in the first place!

* * * *

Conquering Cooking With Fibromyalgia
Getting groceries is a challenge, but cooking is a true adventure. The fibromyalgia homemaker may have chosen to not work outside the home, but still have difficulty finding time, energy, or physical stamina to prepare meals. You can cook and not feel guilty in spite of your fibromyalgia.

Prepare meals that can be done quickly and do not require extensive physical labor. Choose recipes that you can rely on when you are tired and operating on very low energy reserves, and prepare meals with ingredients that you have on hand.

Avoid meals that require standing for long periods of time to cut vegetables, or standing with arms extended over a kitchen counter. Avoid hanging things over the stove or places where you have to lean or reach. Use the front burners on the stove; less reaching is involved.

You can keep it simple. Adding items to the meal directly increases the time needed for preparation, serving and cleaning up. Try to use foods that are already prepared such as salads in a bag, cole slaw, macaroni, and bean salad. Use paper plates, napkins, salad bowls, or whatever you can throw away.

Choose meals that can be prepared the night before. Salads, desserts, and vegetables can be prepared early and refrigerated overnight. Make sure you have all of the ingredients, as nothing is more frustrating than making a mad dash to the store when you are trying to prepare a meal.

Any job can be made easier if it can be broken down into smaller tasks. Divide and conquer is a good plan. If you’ve picked a meal that is “fibro-friendly,” gathered the necessary ingredients, prepared some items the night before, all you need to do is divide and delegate the work.

If you are preparing the meal for yourself, you can take it one step at a time and rest in between. Clean-up can always be done the next day.

If you are preparing for others, divide the task so that each person has a job. Your kids make great helpers in the house (cheap too… usually). Don’t forget to get them involved. Older kids can take out the trash or run errands for you (if they drive). Younger children can help set the table and assist mom and dad in other chores. Delegate responsibilities and try to make it 'fun.' If you find out how to get your kids to work for fun, please write me and tell me what you are doing!

* * * *

These ideas and strategies... have worked for me and my patients. I hope they will help you in a few more battles against fibromyalgia... and improve the quality of your life.
____
* Dr. Pellegrino has seen more than 20,000 patients with FM and associated illnesses in his practice at the Ohio Rehab Center, and has been a fibromyalgia patient himself since childhood. This information is excerpted with kind permission from Chapter 36 of Fibromyalgia: Up Close & Personal by Mark Pellegrino, MD.* ©Anadem Publishing, Inc. and Mark Pellegrino, MD, 2005, all rights reserved. This information-packed 424-page FM coping book may now be purchased in the ProHealth.com store.

Note: This information has not been evaluated by the FDA. It is generic and is not intended to prevent, diagnose, treat or cure any illness, condition, or disease. It is very important that you make no change in your healthcare plan or health support regimen without researching and discussing it in collaboration with your professional healthcare team.




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Article Comments Post a Comment

Dealing with Daily Life
Posted by: Mishque
Apr 21, 2010
I found this article very interesting but a bit silly if you live on your own, where common sense comes into play. If something you do hurts you, then you try to find another way around it. Or if the pain is too bad for one day or for one or two weeks, you just wait until the pain is a little better for you to do the necessary house or garden work. However on some occasions life doesnt let you do that as they want bills and paperwork responded to yesterday and will not wait! As I mentioned, I live on my own, so the housework cannot be left or things not done! Two, I cannot afford to hire anyone to do the chores for me as my income on benefits is very low and I have no family to help me, and three, when I have to do the garden, I have to find ways of lifting heavy bags of mulch or bark etc., as there is no one else to do it for me! Yes sometimes I suffer but what alternative do you have when you have to live. The best thing a doctor/consultant can do for all those with Fibromyalgia is find an answer to the inflammation which in turn causes the pain. Also a pain killer that doesnt knock you out for the whole of the day so that you cannot live anyway!
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Article/ I liked it
Posted by: kb101
Apr 21, 2010
I liked the article because it provided some mental and emotional support for me. I have a hard time with daily tasks and have already been doing some of the things mentioned in the article. However, it validated my pain and fatigue and daily difficulty to sometimes just get anything done at all. It helped with my inner guilt for not keeping up with things the way I used to, and reminded me that it's okay to just take a day off and rest. Sometimes we just need some confirmation and support. kb
Reply Reply

Dealing With Tasks of Daily Life
Posted by: mazzadee
Apr 21, 2010
Even though most of this is 'commom sense', many of us don't stop to think through these everyday issues and just keep doing what we have always done. Plan, Prioritise and Pace all help. Sometimes it's about choices and knowing when to say enough is enough and take a break. Keeping elbows tucked in and taking a step to turn the body rather than twisitng are such simple things yet they make a difference. I even found that carrying the washing down the stairs caused problems, so I decided to drop the basklet over the edge of the rail and walk down unencumbered and start fresh from the bottom of the stairs!
Reply Reply

there is help
Posted by: uxordepp
Apr 21, 2010
I find Flylady.com (which is free!) very helpful for pacing myself in terms of housework, and even work-at-home work (the paid kind). Flylady breaks everything into chunks, usually 15 minutes but you can adapt that. Her reminders rotate through different parts of the house. If you get everything done (and she says don't catch up! Just do what you can) you will hit pretty much every part of every room in a year. She even approaches yard work. She also sells high quality house care products that can be labour saving for some people (because they work the first time!) And yes, get the kids working!
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