Managing the Holidays with Chronic Pain

Cars swarm the parking lot at 40 miles an hour. The lines at the checkout counter are endless. Houses are stuffed with people. Everyone is in a hurry. People are feeling anxious about the things they feel they need to accomplish and guilty about the things they have failed to accomplish. This must be the holiday season. The crazy, busyness of the holidays can take its toll on anyone, but it can be especially hard on people with arthritis, predisposing them to fatigue, flare-ups, and pain. Fortunately, with a little bit of planning, “thinking outside the box,” and the right attitude, you can not only get through the holidays — you can enjoy them!

Plan ahead: Don’t be list-less

The first step toward a sane holiday season is to plan as much as you can ahead of time. This means marking your calendar and keeping lists. You can use a desk calendar to keep track of events you want to host and deadlines for buying and shipping gifts. If you’re planning to host a gathering, mark the date you’ll be hosting. In the week before the event, you might want to mark things like “decorate tree” and “shop for food.” If you’ll be shipping gifts to someone halfway across the continent, mark a deadline for shipping the gifts at least a couple of weeks before they are supposed to arrive. And mark a deadline for buying the gifts a week or so before that.

Also get in the habit of making lists. Gift lists, for example, are a great tool. On a notebook page, you could write down the names of everyone you want to buy gifts for, separated by at least several lines. Then write down gift ideas beneath each name. Once you buy a gift, you can cross that gift (and possibly the person) off the list. Also make lists of shopping you need to do — such as for decorations and groceries — in preparation for any event you might be hosting, and cross the items off the list once you buy them.

Sometimes lists like these can seem so overwhelming that we actually put them aside and try not to think about them. The trick is to take the list in bite-sized pieces. Try tackling one or two tasks at a time, especially those with deadlines approaching. Once these are accomplished you can cross them off the list and consider taking on a couple more. You may also be able to accomplish some of your tasks by “stealing time.” This means, for example, that while sitting in the doctor’s waiting room, you can address at least some of your holiday cards. And some of the tasks on your list, you may start to recognize, really aren’t worth the bother. Cross them off!

Another trick is to make a list of tasks you’ve already completed and then cross them off. This may sound crazy, but it feels good to see, in black and white, what you’ve already accomplished.

Shopping: far from the madding crowd

The holiday crowds at shopping malls can be daunting for everyone, but they can be particularly unpleasant for people with arthritis. Finding a decent parking place and standing in long lines can quickly become tiresome for anyone experiencing pain. Here are some measures that can make the task a little easier:

  • Consider shopping online. It’s easy to compare products and prices over the Internet, and no legwork is required. If you don’t know the Web sites for your favorite stores, you can often try running a Google search to find them, using the store’s name.
  • Whenever possible, use catalogs and order by phone.
  • If you must go to the mall, try to get most of it done months in advance — in August or September — so you don’t have to deal with the holiday crunch. And instead of doing your shopping all at once, you might want to spread it out over several trips to avoid wearing yourself out. Try to shop when there are the fewest people at the mall. Make a list of which items you intend to buy at which stores. It may be helpful to call the stores in advance to find out whether they have the items in stock and are willing to put them aside for you.
  • Remember that it’s the thought that counts. Some families buy so many gifts they practically need a dump truck to deliver them, and they essentially bury themselves in presents — and in debt. If you’re worried about holiday gift-giving draining your checking account, consider more “thoughtful” and personalized gifts, such as photo albums with mutually cherished photos, I.O.U.’s for babysitting, handmade crafts, brownies, or books of pressed wildflowers. You could also arrange a gift exchange, where each family member picks the name of another family member out of a hat and buys a gift only for that individual.
  • Some people love wrapping gifts, but you might not be among them, especially if arthritis affects your fingers. Consider having the gifts wrapped when you purchase them. (Many companies also have gift-wrapping available when you buy gifts online or through a catalog.) Or consider bribing (for instance, with brownies) a friend or family member to share the task.

It’s in the cards…

Writing out and addressing holiday cards can seem like an endless task, especially if you have an abundance of friends and family members — or if arthritis affects your fingers or wrists. Here are some ways to smooth out the bumps:

  • Don’t consider holiday cards a “must-do.” If you really don’t like writing out and sending holiday cards, consider just picking up the phone and calling your favorite friends and family members over the holiday season.
  • Instead of handwriting dozens of envelopes every year, consider making computerized sheets of labels that you can peel off and paste on envelopes every year.
  • One picture is worth a thousand words. You could personalize your holiday cards by running off multiple copies of photos of yourself, your family, your close friends, and/or your pets. These can be as personal as lengthy messages.
  • Also consider using your computer to write generic notes about what and how you and your family are doing. Make as many copies as you need, and then handwrite personalized messages at the end.

The hostess with the mostest

Hosting holiday gatherings is not a recognized Olympic sport, so resist the temptation to “go for the gold.” Chances are that hosting is more tiring for you than it is for someone without arthritis, so one of your top priorities should be finding ways to make it easier on yourself. Here are some ideas:

  • Start cooking well ahead of time. Many foods, such as sauces and casseroles, can be made at a leisurely pace in the week preceding your gathering and then refrigerated or frozen in freezer bags. That way you won’t be overwhelmed with cooking on the day of your event.
  • Consider a “potluck” meal. Why should you do all the work? You could offer salad and/or a variety of beverages and have guests make and bring their favorite dishes. In fact, contributing to the party makes guests feel more “invested” in the party, and it gives them the opportunity to compliment each others’ dishes and share recipes.
  • Consider serving food buffet-style so you won’t need to carry around heavy plates of food.
  • You might want to use paper plates and plastic eating utensils. These are much lighter to carry, and it is much easier to throw everything away than to wash and dry a mile-high pile of dishes.
  • Order out. You could order food from your favorite Chinese restaurant, pizzeria, or other restaurant, so that you can focus on something other than food preparation. You can preorder fully cooked holiday meals (such as turkey with all the trimmings) from some grocery stores. If you have the money to spend, consider having your holiday gathering catered.
  • Consider hosting a postholiday gathering. An event the day after Thanksgiving, for example, can actually be more relaxing than one hosted Thanksgiving Day. People can bring leftovers to cut down on the cooking you’d otherwise have to do.
  • Don’t sweat the decorating. Some people throw themselves into decorating, with candles, elaborate holiday scenes, and even neon-lit Santas replete with sleigh and reindeer. That doesn’t mean you have to follow suit. You can keep it simple, especially if tinkering with tinsel and silver balls is not at the top of your wish list. Consider inviting friends and family members to come over and help you decorate, especially before any big gatherings. Small children in particular enjoy decorating Christmas trees, so why spoil their fun by doing it yourself?

O’er the hills we go!

Traveling from one gathering to the next can be the most exhausting aspect of the holidays. Consider these options for making travel a little easier:

  • One reasonable travel option is not to travel — or at least not to accept every invitation that comes your way. Otherwise, you might wind up spending more time on the road than socializing. Consider hosting this year’s family gathering in your own home so you won’t have to travel.
  • If you do travel, get plenty of rest in the days before your trip. Traveling can be exhausting enough as it is.
  • Pack for success. Use lightweight luggage with wheels and a handle that you can extend and lock. This way, you can push or pull your luggage and give your joints a break.
  • Avoid having to carry a lot of gifts with you. When ordering online or by catalog, you can have the items shipped directly to your destination. Or you can arrange to ship the items from your nearest post office or UPS office well in advance of your trip.
  • If you are flying, try to make your reservations well in advance so you can have more options in terms of when you fly and what seats you get. If you need a wheelchair, ask about that when you make your reservations. Keep your medicines in their original packages in case you’re approached by airport security, and pack them in your carry-on bag in case your checked luggage gets lost. (Check the Web site of the Transportation Security Administration for up-to-date information on medicines in carry-on bags.) It’s helpful to walk the aisles periodically during your flight to keep your joints mobile. If walking is not an option for whatever reason, you can exercise in your seat by rolling your shoulders and flexing your feet, hands, and fingers.
  • When traveling by car, give yourself plenty of time to make it to your destination. That way, you’ll have time to stop, walk around, and stretch every hour or so. If possible, have someone share the driving with you.
  • Even if your hosts enthusiastically invite you to spend the night, consider getting a hotel room. That way, when the chaos of a large gathering starts to wear you out, you can retreat to your own space.
  • Eat ahead of time. If you eat a healthy snack before going to a party, you’ll be less likely to fill up on less-than-healthy foods like cookies, brownies, and high-fat appetizers.

Lighten up!

Finally, your attitude and behavior can make a big difference in how you experience the holidays:

  • Maintain realistic expectations. As much as you may envision a picture-perfect holiday, realize that people and situations don’t always live up to your expectations. Some family members may be downright annoying, travel plans may get interrupted, and meals may not come out as planned. Above all, have reasonable expectations for yourself: Don’t try to keep up with the Joneses or beat yourself up over all the things you should be doing but can’t (or really don’t want to). You can’t meet everyone’s expectations, and you may find that your harshest judge is yourself.
  • Don’t be afraid to ask for help. Most people are willing to accommodate — or should be.
  • Give yourself plenty of time to do what you need to do.
  • Prioritize. Distinguish between the things you really want and need to accomplish versus pointless, soulless rituals you simply perform every year out of “tradition.” Traditions were meant to be broken and often you can replace them with new ones that are just as rewarding, if not more so.
  • Remember that not all planned activities are a “must-do.” No concert, sporting event, or other activity is going to be any fun if you’re feeling achy and exhausted. If others get on your case about being a party pooper, remind them that your arthritis is a real condition that needs to be treated with respect.
  • Focus on the positive. Forget the petty squabbles between those who don’t get along and concentrate instead on the feelings of warmth that come with seeing family and other loved ones. Focus on the meaningful rituals like Christmas dinner or lighting the Hanukkah candles.
  • If you start feeling sad because of the absence of loved ones who have passed on, try not to dwell on their loss. Rather, remember the good things about them and swap fond memories and anecdotes about them.
  • If you’re feeling lonely, make a special effort to reach out to others. Invite old acquaintances over or become involved in an arthritis support group, religious group, or community service organization.
  • Avoid overindulging in food and drink. Overindulging in alcohol can bring you down, especially if you’re a little blue to begin with. Overindulging in food can leave you feeling bloated and listless.
  • Take time out to laugh with funny books or movies. For irreverent holiday-themed fun, try reading David Sedaris’s Holidays on Ice or watching “A Christmas Story” or “National Lampoon’s Christmas Vacation.”
  • Try to maintain a healthy routine. Sometimes the busy-ness of the holidays can sidetrack our best efforts to live well. Don’t forget to take your arthritis medicine or to engage in your usual exercise routine.
  • If you find family gatherings overwhelming, feel free to slip away for some private time. Sometimes all it takes is a walk around the block.
  • While doing all the things you feel you have to do, be sure to set aside time for the things you like to do, such as reading, walking, or soaking in a hot tub.

As the holiday season approaches and the pace of life picks up, remember to inject a little dose of sanity: Plan ahead, prioritize, and try to keep a healthy perspective on what’s truly important.

Robert S. Dinsmoor is a medical writer and editor based in Massachusetts.

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