SMART Goals and Chronic Pain: What are your goals?

Welcome, @abujan. It is nice to meet you. I'm happy you found SMART goals helpful. Living with fibromyalgia for over 35 years has no doubt made you stronger than I bet you ever thought you'd become. Resiliency comes to mind, along with flexibility.

The way you describe still learning how to live with the ever changing fibro after all these years, but still looking at the manageability, is so valuable for success. I've learned through my own chronic pain management journey and mistakes, that the more I shift mindset by replacing negative thoughts with positive, and find gratitude, the more rewarding life can be.

Ah yes, you are not alone in the fixers, planners, doers, leaders category. Being stable, moderate and flexible is a work in progress for folks like us. It takes practice to pull those natural traits back for the benefit of our health, doesn't it? I'm glad to hear that you recognize push/crash cycles and listen to your body, knowing when to allow grace and gentleness. This is why I love SMART goals, because they help with accountability.

I'm wondering if you have explored other conversations on Connect about fibromyalgia? Here are a couple you may be interested in:

- Have you found anything to successfully treat fibromyalgia pain?
https://connect.mayoclinic.org/discussion/dealing-with-fibromyalgia-pain/

- Want to talk to others with fibromyalgia: What symptoms do you have?
https://connect.mayoclinic.org/discussion/firomyalgia/

Thanks so much for sharing your thoughts, experiences and insight. We are here to help each other, and you have inspired and encouraged me today!

Thank you for the links. My name is Janice. All of my grand kids call me Abu!

I am new to these conversations. I happened to stumble on all of Mayo clinic connect links while googling loosing weight after 60. It's such a struggle for me. Anyway I still can't find a site or app that I don't have to pay for. But I'm grateful for this info. Having chronic/autoimmune disease can be horrifying for many people and I know the value of being able to talk to others & be encouraged. It's not a "misery loves company", I don't wish this on anyone! Rather, it's nice knowing you are not alone or crazy when suddenly being hit by symptoms that can change daily.
Many blessings to you.💕

I am so sorry you are in this much pain! Kudo's for your attitude on it could be worse. Be gentle & patient with yourself and rest.
About 10 years ago I was in MX, visiting my daughter for awhile. While talking to a random woman on the beach one day, she told me she could see I was in pain and how much it was affecting my body stature. Ends up, she was a licenced acupuncturist and offered me a free session. I was a bit sceptical, but then amazed how much it helped! I stayed for 3 months just for continued acupuncture therapy. I don't know if you have the ability to try, but it might be worth it. Also a good massage from someone who has experience with chronic pain is often helpful, ask questions before just going to anyone. I had a couples massage at a spa once. Felt good at the time as she dug deep & hit those pain spots that hide, but I ended up black & blue afterwards for weeks.
I truly hope you find relief and that 1 day you will share your story of being upright again!

I have to admit that structures like "SMART goals" just don't work for me. They are prescriptive and subjective, and I found that once I fell into specialist territory everything got worse. I don't know what's wrong with me, I have no idea if it's permanent or temporary, and a lot of doctors don't care about (or even remember) what your goals are. Even gentle reminders of what the visit is supposed to be about don't always work, and I end up more dispirited than before.

I know that I have primary responsibility for my health, but since I chose a different career path, I don't know HOW to get better. I'm smart, but I have no delusions about being a doctor (though I bet I could hold my own on some medical topics, after all these years).

My goals are simple and clear. I want to be able to walk for an hour. I want to be able to eat healthy food without days of gut pain and nausea afterwards. I want to feel something other than fear and sorrow. I want to regain my ability to see beauty. I want to be able to pleasure read again.

Sorry to be negative, but I've been handed so much prescriptive stuff like this, and I've diligently engaged to find that nobody wants to engage back. The SMART goals feel like something a teacher has ready for the substitute to hand out to keep the kids busy and quiet.

But if it works for you, I say go for it. I just fail to see how it helps with anything.

@greenacres - Thanks for the podcast tips. I learn a lot from podcasts - it's where you often hear of things for the first time, which makes it possible to research them. I added them to my spotify list.

Cherip, in some ways I agree. A structured plan might help but it helps when you try. In the old days of basic med 101 they used the 5 typical cycles of patients and it was originally written for terminal patients but in ways applies to all patients with disabilities
#1 Denial #2 Anger #3 Bargaining #4 Depression #5 Acceptance
No I’m not a MD but in my past life a Paramedic for 32 years before my injury. I admit I went through all 5 steps, some multiple times.
It never hurts to try something new and maybe it might work for you. The moderators work hard to help everyone here. Keep an open mind. …David

@dabbs - I hope I didn't sound judgmental. I try to not be.

I do try. I've been trying for years, and I'm honestly exhausted from trying. I've swum through the "5 steps," which don't always happen in order, hundreds of times. The last three years have been especially difficult, and I experience all of these, often on a daily basis. It's disheartening, exhausting... it's a fight every day.

Sometimes new things do hurt. Each dashed hope is a new wound and another step towards giving up.

I'm tired of being told what to do when the directives don't actively help. I am not a "halfwayer" - if I do it, I do my best, all the way. I believe in giving things truly fair shots. But there's a point where it all feels (to me) more like "heal thyself" rather than "let me help you heal."

I just need someone to help me heal. Instead I'm "too complex," or too fat, or my condition is not in their wheelhouse (specialist siloing is a disgusting move in medicine, IMHO). My best medical resource is my psychiatrist - that is not how it should be. She helps me because nobody else will, connecting me to doctors other patients of hers have had good success with.

Interestingly, so far, none of them have been in big medical systems. The bigger the system, I theorize, the less likely you are to find the doctor who is able and willing to help you. At least that's how it is in my neck of the woods.

Everyone is willing to cut out my stomach, though. I may be too fat for surgery, but apparently that doesn't apply to slicing away half of a critical organ, nevermind I don't even eat 800 calories a day right now, and haven't for a very long time. Yet it is nearly every specialist's first suggestion, before we even talk about what I'm there for. When you get 15-20 minutes with a doctor, rehashing the "cut your stomach out" issue is a waste of my time. It can take 6 months to see a specialist - and I think many are more focused on their hospital's goals rather than the patents' goals and needs.

Cherip, by all means I’m not being judgmental. I for one can easily see how patients can feel the way you do. I’ve learned a lot since being on the patients side of the fence. Since I’ve “retired “ I’ve gained at least 20-25 pounds for lack of exercise which I no longer can do. Yes, if that’s the first thing they say then yes it works on self esteem which isn’t right. Your MD first should diagnose your pain and then tactfully after giving your treatment plan refer you to a nutritionist Unfortunately yes, weight is a factor especially in joint health BUT should not be the deciding factor on how your treatment goes. Secondly ALL patients should be treated with respect! NEVER let anyone take your self esteem! If they mention your weight just say yes I’m working on it which will satisfy them and then let them find the problem. It helps when you get thick skin and won’t let them bother you with those remarks. Yes, counseling will help with your self esteem! I’ve been here for a week or so and trust me when I say that you’ve found a great site which is nonjudgmental! Hang in there my friend, there is light at the end of this journey!….David.

@dabbs - that's very kind. Thank you.

I cannot grow a thick skin. I am intensly sensitive to emotions around me; if I could have, I'd have learned 40 years ago. All I can do is roll up like a pillbug and hope some bounces off. I was born an emotional sponge.

My PCP is a doctor I like. She gets 12 minutes per patient, though she changes mine to 30 minute "extended" visits.

Hospitals undervalue GPs and therefore undervalue patients. There is no realistic way she can help me.

Large hospital systems beat their GPs into the earth. I think GPs are worth much more than a specialist, who only keeps one tiny, deep slice of knowledge and seems unable to make connections. GPs need a broad base of knowledge to diagnose and treat, but they are no longer able to practice their art.

And diagnosing is an art.

I won't bore you with all the details, but all these experiences (over 20 doctors so far, in 3 years) have left me with a pretty serious case of medical PTSD. Every appt makes me feel ill. Heat flushes, jitters, heart rate, blood pressure, a desire to flee or hide... and yet when the next Dr says I'm a liar, or that they don't help cases like mine, all I can do is freeze. I am not a fighter, or a confronter. I did once, the first time a specialist called me a liar and then put in an Rx I'd explained I didn't want. She ignored me. It got uglier when I complained, and the "investigator" of my complaint was that units head nurse.

That's when I realized that patients are not the priority in medicine, and god forbid you rock the boat and call BS.

I wish I'd never tried to get help in the first place. I had an old idea of what medicine is. Now I have a new understanding of how medicine can quickly ruin your life.

Hi Janice, checking in as it's been a minute. How are you doing these days in the management of your chronic symptoms? Have you found any small wins lately through SMART goal setting?