Do we know what ‘self care’ actually is?

Self care seems to be a hot topic amongst FMS patients at the the moment. There isn\'t a day that goes by where I haven\'t seen a blog or Facebook post about it.  But how do we get to the point where self care is actually possible. It is well understood that healthy diet, regular physical activity, pacing, planning and prioritising,  reducing stress and good sleep hygiene can reduce and even prevent the symptoms of Fibromyalgia. But what do these terms actually mean and how do we know that we are getting the right information. I really thought I knew what I was doing until I started a pain management programme. You can see my reviews for each session on my website.

In order to be successful, personal motivation and good professionally led education packages are essential. It is no good talking about self care for fibromyalgia or any other chronic condition, if you don\'t know or understand the basics.  Professionally led education aims to allow people to take an active part in the management of their fibromyalgia. Structured programmes are distinct from simple patient education or skills training. They are structured programmes, which if Successful, can improve quality of life, improve symptom  management, reduce flares, improve feelings of well being and coping skills. Importantly they can provide greater independence and maybe reduce risks or complications of  depression and anxiety. Find out if there is a pain management programme in your area. They are normally run in conjunction with pain clinics. So ask your GP if you can be referred. Your GP can also look up pain clinic services under the \'choose and book\' service, so if there isn\'t one in your area there may be one in another area close by. 

As a nurse practitioner, when a patient comes to see me about  their chronic  condition, a common  question I would ask is \" are you looking after yourself?\" I have regularly heard other clinicians asking the very same  question.  My own GP asks me! Now, what they are actually asking is \"are you  trying to reduce cardiovascular  risk\" or maybe \"are you doing what I told you to do last time I saw you?\" or it may simply be\" what are you doing to reduce your symptoms?\".  What we think they are asking us about, maybe something very different in their mind. This is a very common problem. Therefore it is important to question the question. Ask your GP what they mean. I know how hard this may sound, but once you have asked once, it will break down any invisible barriers and give you more confidence in the future to ask more questions.  

Every FMS  patient has different coping strategies which are influenced by their own health values and personal beliefs. In the past, people were expected to fit in with the routines and practices that health and social services felt were most appropriate Gill (2013). Thankfully we have moved away from these paternalistic models of care, but there is slow progress. Clinicians need to understand you as a person in order to give you the best service possible. 

In general practice, knowing the patient, their family and social situation is a fundamental to providing effective patient centred care for self-management of any chronic condition. The five year forward view (2014) which can be found here  emphasises strengthening the voice of patients by advocating patient centred care.  It is vital that your GP understands you, understands your symptoms and understands the goals you are aiming for. It will also allow your GP to support you in your self care.