Winning at Fibromyalgia

My patients often ask me: How do I know whether what I feel is my old fibromyalgia or something new and serious? in this episode I share my own recent experience after developing new symptoms of numbness tingling in R hand and R foot, how it freaked me out and what helped me feel better. The story is still evolving :-)

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: concept of neuroplasticityBELIEVErelaxation response 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: 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? first and only course of its kindComfort of your homeunique combination of skillsmyself 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...

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. 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. 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. 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.

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 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: 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 admin@martinaziegenbeinmdcoaching.com facebook name: martina lenartova

You might wonder why we need to talk about self-compassion in pain reduction in fibromyalgia. What does it have to do with alleviating physical pain? Well, it turns out, a lot. Self-compassion is a way of soothing the over-agitated nervous system, that is amplifying our pain sensation on constant basis. We may not be directly to the part of our nervous system that amplifies the pain. WHen we practice self-compassion, we are addressing our suffering, whatever is the circumstance, and that soothes the nervous system as a whole - including parts that cause or amplify the pain. enjoy, leave me a review or comment, appreciate hearing from you :-) Martina www.winningatfibromyalgia.com

Today we talk about somatic tracking as one of the core techniques on pain reduction.

in episode 32: I talk about embracing the concept of neuroplasticity - the fact that the brain can determine what hurts, how much and can also make it better/we can rewire the brain neuro pain pathways. ONe of the hallmarks of neuroplasticity is also the fact that the brain is wired for any sign of threat/danger. When it finds it, it can increase the sensitivity to pain and the pain perception itself. It does not have to stay this way, and it never does. The pain can increase, or decrease, depending on our ability/on our brain's ability to increase or decrease activation of messages that turn off the pain. enjoy :-)

Episode 31: Winning at Fibromyalgia podcast Well hello my friends! It has been a while! I have been MIA a little bit, for a good reason and I am back  I met someone special, his name is Greg and he has swept me off my feet, that’s all I will say for now. I am coming on today to introduce you to my new, simplified version 2.0.1 of my Winning at fibromyalgia method. It is very powerful and I am very proud of it. For those who don’t know me, I am a board-certified rheumatologist and work almost full time at the Rheumatology office in Cape Cod. I am an expert fibromyalgia coach where I teach women with fibromyalgia tools to reduce their pain, and win at fibromyalgia. The principle 4 steps are: Rinse and repeat  I want to start with the power of Belief today. I cannot stress how important belief is. I truly cannot. Believing my women can achieve pain reduction is #1 item I work on with my patients and clients alike. I want to tell you why it is so important. I want to tell you this because I found out the hard way. I LACKED belief myself – until I took the Whole health medicine institute course led by Dr. Rankin. Going through her program made me realize I lacked belief in my body’s ability to heal. I was able to uncover where it was coming from, and then changed it around. It did not happen overnight. But I did it. And I now am sharing it with you, my listeners and clients. I want the same for you. SO first of all – why do I even talk about Believing? There is an undeniable body of research supporting the notion that our thoughts and perceptions affect our physiology. That our mindsets can MEASURABLY affect physical healing. In research studies it is called placebo effect – meaning, taking a sugar pill has positive, measurable physiologic and physical effects (improvement in depression, mood, or asthma). There is even such thing as placebo surgeries! – when doctors opened up a patient/made an incision but did not do ANY instrumentation on patients knees and people felt better!!!! Can you comprehend this? Fascinating research from Yale – IDENTICAL milkshake given to TWO groups of people with TWO different labels – one that suggested more “indulgent” or calorific drink triggered REAL body responses suggestive of having consumed more calories!! But they have not! That’s all our brains/minds at work! Neurobiological research has shown that the placebo effect, which stems in part from individual’s mindset and expectation to heal, triggers DISTINCT BRAIN AREAS associated with ANXIETY and PAIN that activate physiological effects that lead to healing outcomes. The placebo effect is mediated by the release of neurotransmitters, consistently impacts certain areas of brain and even mirrors the action of of pharmaceuticals on human physiology. In clinical trials it is actually NOT uncommon for the placebo to BEAT the active drug, especially in the studies on anti-depressants! Do you know what this means?? This means that our minds can produce the effects of a medication as powerful as an antidepressant! This means that the mind is capable of great feats in healing the body. This should not come as surprise given that the body is an infinitely intelligent organism. Humans have been healing themselves long before the invention of modern medicine techniques. Indigenous shamans have been facilitating healing for thousands of years. They gave patients hope, and through expectation, the mind initiated the changes in physiology for the body to heal. The question is not whether there is placebo effect (power of belief in healing) but WHAT CAN WE DO ABOUT IT?? How can we consciously deliberately harness that affect?? We don’t seem to know how to produce it on demand in health and medicine. We spend enormous amount of money developing meds trying to OUTPERFORM the placebo affect. How silly! Mindset about treatments SHAPE treatment outcomes (antihistamine prick and cream test) Placebo effect is...

Episode 30: With Dr. Saloni Sharma on Solutions for back pain I was so excited to talk to Dr. Sharma about back pain. Back pain is one of the most common problems of humans in general, and it does frequently bother patients with fibromyalgia. Dr. Sharma is a dual certified in Physical Medicine and rehabilitation (PM&R) and Pain management. She is medical director of the Orthopedic Integrative Health Center at Rohmans Orthopedics and specializes in the NON-operative care of musculoskeletal pain and dysfunction. She recently wrote and published a BOOK on back pain called THE PAIN SOLUTION and she CAME TO MY PODCAST TO TALK ABOUT IT! You are in for a treat. In addition to the above qualifications, she studied Lifestyle medicine, Functional medicine and Integrative medicine through the Andrew Weill program at the Univ of Az. She had studied yoga and meditation, mindfulness and acupuncture! We talked about: IN a way ALL OF THE THINGS THAT MAKE US BETTER ARE ALL COMMON SENSE https://www.amazon.com/Pain-Solution-Relieve-Prevent-Medication/dp/1608687937 https://www.salonisharmamd.com/ https://www.instagram.com/salonisharmamd/ https://rothmanortho.com/oihc

Episode 29: why losing hope can torpedo your efforts at reducing pain from fibromyalgia Well hello there my friends! It has been a few weeks since I talked to you from my office in person  I brought several guests to you and I hope you loved the episodes. Today I want to touch upon something that has been weighing on my mind last few days. I had a patient told me recently: “Doctor Z, I already DID ALL OF THAT. I tried EVERYTHING. I already did meditation, physical therapy, and more meditation and I am not better!”. This happened when I explained the neuroplasticity concept and how nervous system and our magnificent brain can produce pain. She has had fibromyalgia for over 25 years and also suffers from chronic low back pain. I know it was frustration speaking. And also – to me anyway, it sounded like she may have started losing hope. Hope that her pain can get better. She had already tried all of the meds that are out there for fibromyalgia. Many of you may have already. They gave her side effects or did not help. Water aerobics have been beneficial but her pool is currently closed so she did not feel she could do that. Here is what I want to tell you. The words matter. Language we talk to ourselves matters. And I have a science-y explanation for you, it is not just motivational speak that I am here to tell you  There is a small structure, or should I say, a conglomerate of cells in the brain stem/right underneath the brain and at the top of the spinal cord referred to as RETICULAR ACTIVATION SYSTEM. Its sole job is to filter through millions bites of information our nervous system registers every second and only deliver to our cortex of our brain the relevant “stuff”. And how is it related to what I am talking here? The cells of this reticular activation system (or simply RAS) comb through an ocean of information our nervous system is flood with. And by nervous system I mean input from eyes, mouth, touch and ears (the input from our smell goes somewhere else). What information gets to our conscious mind rests solely on this RAS guy! RAS regulates our wakefulness, flight or fight AND focus. If the message we send to our brain (aka, the thought we think and words we say) is: I have already tried everything, this is pointless, nothing is working”, the RAS will look for information that confirms this thought. It will find all the ways we have already tried and failed in our efforts. It will emphasize how our pool is closed and will not let us think about other options. It will allow us to think that not moving is the best course of action, day after day, because what’s the point. Please know I do not argue resting when it is warranted and when the body needs it. I do just that when I need it, when my body needs it. I absolutely 100 percent endorse the idea of listening to our body. What I am talking about here is indulging our primitive brain into thinking that we cannot do something or should not do something because it is not safe. Our brains want to keep us safe. That’s their primary role. So if we feel we already tried everything, movement is not safe, there is no point in not trying anything else, the brain will say of course, don’t do anything new, stay where you are because you already know it is safe (eventhough you are miserable). A good day in the office, from brain perspective, is to stay dormant, and save energy. If on the other hand, our thought is: ”Well this sounds weird and interesting at the same time, I wonder what is up with this neuroplasticity theory”, or “well this sounds interesting, I am not super excited but I am curious”, the RAS will filter through and lets in information that allows your curiosity and willingness to learn be satisfied. So, to go along with the scenario I presented, the patient might say to herself: ”let me read the book the Dr. Recommended or let me try this somatic tracking thing – I am going to give it a try, it can’t hurt since I already tired...

Episode 28: Recovering from Traumatic brain injury (TBI) and chronic pain with dr. Susan Hughes Dr. Susan Hughes is a board certified currently non-practicing family medicine physician who survived and recovered from traumatic brain and other body injuries 8 years ago. She reveals: - how it was to get through trauma of a car accidents, subsequent fall out including difficulty reading, speaking and remembering things and people and inability to continue practice medicine. - Recovery is not linear - She was not being the person whse wanted to be so At one point she had to make a decision to grow into a person she wanted to be – she poured herself into professional development Website bouncehighest.com