The Double Whammy Of An Everyday Illness On Top Of A Chronic Condition

Today's post from practicalpainmanagement.com (see link below) highlights a problem that many people living with a chronic illness such as neuropathy face and that is the double whammy that an everyday illness such as cold or flu can bring. Because you're already sick from an illness that causes inflammation and attacks your immune system, the arrival of something relatively simple such as the common cold can be just too much for your overloaded system and you feel much worse than you normally would. Beyond that, these illnesses can last much longer and send you into a spiral of depression that people around you don't appreciate. It seems logical but is often underestimated and this article usefully explains what is happening to you and provides tips to help you deal with the extra pressure.

Getting a Cold or the Flu When You Already Have Chronic Pain
By Rosemary Black Updated on: 01/28/19


Being sick, on top of having a chronic condition, can weigh you down. Here’s how to pick yourself up and get better fast.

Barby Ingle of San Tan Valley, Arizona, and her husband, Ken, both came down with a bad cold recently. Her husband took some over-the-counter medication and was completely recovered within a few days. Barby, who suffers from central pain syndrome, as well as a rare form of epilepsy, she got much, much sicker.

Because the prescription medication she takes for her pain already contains acetaminophen, Barby was unable to take any typical pain relievers that could have eased the aches brought on by the cold. So she had to put up with the pain from her chronic condition, as well as all the respiratory symptoms of a bad cold, which seemed to last forever, she recalls.

“Before my car accident in 2002, I was hardly ever sick, but the accident left me with central pain syndrome, and then I got epilepsy,” says Barby, who is president of the International Pain Foundation. “Now, I have a team of doctors to treat me. I do okay, but my immune system is bad, so I get sick often.”


 
When you live with chronic pain, catching a cold or the flu can make your suffering seem endless, but there are ways to get through and emerge a healthier you.

Whiles her husband got over his cold “fast and easy, I still feel like I pulled a muscle between my ribs from coughing so hard,” she adds. “I have increased full body pain and fatigue and difficulty taking full breaths.” Typically, when Barby comes down with a cold, she says she will have pain and increased fatigue for up to four weeks afterward.

To try to avoid everyday illnesses like colds and influenza, Barby steers clear of people whom she knows are sick. If she has to get on a plane, she wears a mask. She washes her hands often, offers air hugs or elbow touches rather than a full body hug or a handshake, and when friends visit, she puts out a separate candy or snack dish for herself in order to avoid germs.

During cold and flu season, in particular, people living with chronic pain conditions often face the same challenges described by Barby. “When you have the physical aspect and the psychological aspect of the chronic pain, and then you have an illness on top of it, your coping mechanisms may decline and become less effective,” explains Mohab Ibrahim, MD, PhD, an associate professor of anesthesiology and pharmacology and director of the Chronic Pain Management Clinic at Banner—University Medical Center South in Tucson. “You become more susceptible to emotional trauma. It’s like you are a balloon filled to the maximum. All it takes is one little poke—and you explode.”

Why Everyday Illnesses Are Worse When You Have a Chronic Condition

There are a few reasons for this hypersensitivity. If you take medication for your pain, it may not be quite as effective when you are sick, for example. “Pharmacologically, inflammation alters the body’s ability to metabolize medications,” explains Ming-Chih Kao, PhD, MD, CIPS, FIPP, Pain Clinic Chief and assistant professor of pain medicine at Stanford University in Redwood City, California. “In fact, the body’s ability to metabolize medications can vary from day-to-day.” In addition, if you are on any medications that suppress your immune system, you are more likely to develop a cold or flu in the first place.

Individuals who have chronic pain have more inflammation in their bodies than people who are not in pain, adds Ann Marie Chiasson, MD, interim director of the Fellowship in Integrative Medicine at the University of Arizona Center for Integrative Medicine. “So when a cold or flu shows up, it can appear worse because they already have so much inflammation,” she explains. “They feel worse than someone who gets the same illness because their body tends to respond to the illness in a different way than someone who does not have chronic pain.”

Essentially, when you are in chronic pain, your system is already in overdrive and on cue to overreact, Dr. Ibrahim says. “The pain circuitry in your nervous system is wound up and ready to jump once a stress - whether physical or emotional - activates it,” he explains. “So when they experience a small stimulus, say, from a cold or a flu, their system receives it as a major event and perceives it as much more painful than a person who does not have chronic pain.” Thus the symptoms of an everyday illness such as a cold or a virus are magnified in an individual who has chronic pain.

It is important to remember that pain has both a physical aspect and an emotional aspect, Dr. Ibrahim says. Everyone with chronic pain experiences the physical part of pain, but not everyone experiences the emotional part. For some individuals, pain does not keep them from enjoying life because they have good coping mechanisms. Others may suffer more. As the ancient saying goes, he noted, “pain is inevitable, but suffering is optional." If you can develop good coping skills, you may feel better equipped to deal with the emotional aspect of the pain and reduce your suffering. Some may say this is easier said than done. Below are a few tips to get through.

How to Avoid Getting an Everyday Illness

For starters, try to steer clear of people are sick, experts recommend. Wash your hands often, especially when you are around someone who is sick. This should be done before you eat or before you touch your eyes, nose, or mouth. Keep in mind that the flu virus can live on a surface like a doorknob for hours!

Other strategies for avoiding getting sick are to: 

Clean and disinfect frequently touched surfaces at home and at work
Make sure you get enough sleep
Be as physically active as possible.
Drink plenty of liquids and eat nutritious food.

In fact, an anti-inflammatory diet may be worth considering, says Dr. Chiasson, who offers the Mediterranean diet as an example. This diet emphasizes fish, vegetables, and olive oil, among other staples. According to the Arthritis Foundation, cherries, olive oil, soy, seafood, low-fat dairy products, broccoli, and green tea are also good choices if you are following an anti-inflammatory diet.

How to Feel Better Fast When You Get Sick

Even if you are very careful to avoid getting sick, it’s inevitable that, at some point, you will succumb to a cold or flu and feel miserable. So what can you do to feel better?

Distract yourself, says Dr. Ibrahim. Pain is always worse when you are thinking about it. “That is why pain is typically worse when a person is at home or is trying to sleep at night. There is nothing to distract you.” Try reading a good book, going outside if even for a short walk, or phoning a friend.

Consider integrative medicine, Dr. Chiasson says. For instance, elderberry lozenges or extract can be helpful in reducing your discomfort, she advises. If you use the extract, take 1 tablespoon 4 times a day for the first 48 hours of an illness, she says. “It can decrease your symptoms by half.” Echinacea can also be helpful in improving your symptoms, she says, as can turmeric, a known anti-inflammatory. Take a 500 mg capsule of turmeric three times a day when you are not feeling well, she recommends. (Read more about the pain-relieving benefits of turmeric )

However, taking herbs can be tricky, says Dr. Kao. Turmeric can reduce the effectiveness of several opioid medications, including hydrocodone, he says. “I would suggest not adding or stopping herbs unless discussed with a medical provider,” he says. “The safety principles I abide by are to start medications at low doses and increase slowly, and make I change at a time.”

Heating pads or gentle massage can provide relief as well, says Dr. Kao, as can acupuncture, and, adds Dr. Chiasson, guided imagery. This mind-body technique can help to “retrain the brain to attenuate its response to chronic pain,” she says. For instance, check out the InsightTimer mobile app, which offers free, guided meditations and plenty of soothing music.

While you may not want to do this when you aren’t feeling well, resolve to improve your coping skills once you are better. Enlist the help of a behavioral therapist who specializes in pain management to help you develop the coping skills you need to help lessen the impact of chronic pain in the long term, Dr. Ibrahim suggests.

https://www.practicalpainmanagement.com/patient/resources/pain-self-management/getting-cold-flu-when-you-already-have-chronic-pain?utm_source=Practical+Pain+Management&utm_campaign=a644b0b597-EMAIL_CAMPAIGN_2019_02_12_04_58&utm_medium=email&utm_term=0_4c61498ef3-a644b0b597-52662069