THE FIBROMATES JOURNAL

By Guest Blogger Laura Erdman

When I first became ill, I was working as a gardener. I had quit my go-nowhere corporate job to pursue a more joyful, authentic life. I became a full-time gardener in training. I should have been the healthiest I’ve ever been. I was enjoying the sunshine and the activity. I loved caring for plants and their soil, and I delighted in the creature communities of bugs and birds and fungus that I met every day.

I met the nicest people in the garden. Kind, gentle people who with sensitive fingers and eyes, carefully cultivating the conditions where tender organisms could thrive in the harsh Canadian climate. I made friends. I was happy. I was renewing my life in a good way, so I don’t know why my body chose that moment to revolt.

It’s a prolonged grief, the grief for what I used to have. I used to be able to get up at dawn and dig in the soil for hours. Since that time, 5 years ago, my life has gotten smaller and smaller. I am continually giving ground as I adjust to my new lack of capabilities; I can’t drive to town like I had hoped. I can’t shop at the greenhouse because it is too large to walk through. I just can’t keep up with the weeding and watering, so my lovely plants wither where they were planted.

The grief is profound and prolonged, so how can I celebrate the coming of spring?

I will try, of course; I can’t not try.

I’ve learned to break goals into tiny steps. Just the smallest possible task, done today or tomorrow. No pressure. No striving. So today or tomorrow, I’ll take a poke around and find my gloves and shears. Then today or tomorrow I’ll go out and look at the shrubs. On one of the next few days, I’ll set my timer for 10 minutes and gently clip the winter kill. Then, judiciously, I’ll clip off twigs and ends that appear to be healthy, but will choke the plant of its space and sunlight if allowed to grow. In the first days of my gardener training, this horrified me, excising perfectly healthy tissue from a perfectly healthy plant. Now, with experience, I am wise enough to see that these particular limbs are choking the plant from the inside out by using precious resources that inhibit its growth. Clipping these parts allows the emergence of fresh new leaves ready to soak up the sun and beautiful blossoms primed to fruit.

I prune this little bush as I know I must lovingly prune myself. I can’t continue to be the person whose beliefs and behaviours led to this collapse. Losing my capabilities has had the advantage of exposing what’s really important. The tiny bit of energy I have must need to be allocated to the thoughts and behaviours that sustain me, the things I love, the things that uplift me, and that help me to feel good. The better I feel, the more I can do.

What is keeping me from thriving?

I see the gnarly pieces that are choking my potential to thrive; adjusting myself to suit someone else’s preferences, failing to speak my true feelings for fear of being rejected, obsessively ruminating on one bad interaction, allowing my mind to dwell on the same negative thought over and over again, sinking away from the will to take positive action into sucking hopelessness and self-hatred.

These, too, I must trim away. I must make space for healing with intentional small steps that support my well-being. I must become my own gentle gardener by using my inner voice to cheer me and direct my wise actions, making safe space for feelings to be felt, honouring my authentic needs, learning what my boundaries are and defending them. For the sake of feeling good, for good health, as good as it can be, I owe this to myself. I deserve it. If nothing else, it is necessary—to balance out my grief, loss, and pain.

Just try to be okay.

Wishing you a gentle, slow, and hopeful spring. May you cultivate the space to help yourself thrive.

Laura Erdman is a 45-year-old artist living in British Columbia. Originally from the prairies, she was diagnosed with fibromyalgia in 2020. She explores creativity, self-care, and the challenges of building a meaningful life while managing chronic illness.

by Irene Roth, Blog Editor/Writer

Cultivating a Spring Mindset

As winter loosens its icy grip and the first signs of spring emerge, nature reminds us of its incredible resilience. For those living with fibromyalgia, the transition from cold, dark months to warmer, brighter days can be both physically and emotionally challenging.

However, just as nature awakens and blooms, we too can harness the energy of the changing seasons to shift our mindset from hibernation to blossoming. By embracing a mindset of renewal, growth, and self-compassion, we can step into spring with a refreshed perspective.

Winter often encourages us to slow down, rest, and conserve energy. While this can be a necessary form of self-care, it can also lead to feelings of stagnation, isolation, and even depression.

Spring, on the other hand, invites movement, renewal, and optimism. Recognizing this natural rhythm allows us to align our mindset with the season’s themes of rebirth and possibility.

Instead of dreading the transition, view it as an opportunity to cultivate a new outlook. Just as the earth shakes off winter’s dormancy, you too can shed the heaviness of the colder months and gently welcome fresh perspectives.

Start by observing the small signs of renewal around you—the budding trees, the return of birdsong, and the longer daylight hours. Let these natural cues serve as reminders that transformation is always possible.

Fibromyalgia symptoms often fluctuate with the weather, and seasonal transitions can bring new aches and pains. Rather than viewing these changes as setbacks, reframe them as opportunities to listen to your body and make mindful adjustments.

Perhaps the longer days encourage you to spend a few extra minutes soaking in the sunshine, which can boost your vitamin D levels and improve your mood. Maybe the milder temperatures make gentle outdoor stretching or walking more inviting, providing a natural way to reduce stiffness and increase endorphins.

When setbacks arise, remind yourself that just as nature adapts, so can you. Adopting a growth mindset—one that focuses on possibilities rather than limitations—can help you navigate seasonal changes with resilience and hope.

1. Renew Your Routine – Spring is an excellent time to assess your daily habits and make small, positive changes. Consider incorporating more fresh, seasonal foods into your diet, adjusting your sleep schedule to align with natural light patterns, or engaging in light movement such as stretching, yoga, or tai chi.
2. Connect with Nature – Studies show that spending time outdoors can improve mood, reduce stress, and increase energy. Even if mobility is limited, sitting outside, gardening, or simply opening a window to let in fresh air can have profound benefits.
3. Set Gentle Intentions – Rather than overwhelming yourself with drastic goals, focus on small, manageable shifts. Perhaps you set an intention to embrace gratitude, engage in a new creative hobby, or prioritize self-care in a way that aligns with your needs.
4. Surround Yourself with Positivity – Seek uplifting books, music, or conversations that inspire you. Spring is a time of renewal, so why not refresh your mental environment as well? Let go of negative thought patterns and welcome in affirmations that encourage hope and self-love.

One of the most beautiful lessons nature teaches us is that growth happens at its own pace. Not every tree blossoms at the same time, and not every flower opens on the same day. Your journey with fibromyalgia is unique, and it’s important to honor your personal rhythm. Some days will be filled with energy and optimism, while others may require rest and introspection. Both are valid, and both are part of the cycle of growth.

As the season shifts, give yourself permission to embrace change in a way that feels right for you. Celebrate the small victories, whether it’s stepping outside for a few moments, trying a new activity, or simply allowing yourself to dream of possibilities. Just as nature awakens after months of dormancy, you too can bloom—one gentle step at a time.

By aligning your mindset with the renewal of spring, you can transform this season into an opportunity for personal growth, resilience, and hope. Fibromyalgia may present challenges, but just like the changing seasons, there is always a chance for renewal and a fresh beginning.

by Dr. F. Perry Wilson, Guest Article

Reprinted Article with Permission

Welcome to Impact Factor, your weekly dose of commentary on a new medical study. I’m Dr F. Perry Wilson from the Yale School of Medicine.

I’ve been thinking about Dune a lot lately. I think I might be the only person in the world who prefers the bizarre and grotesque David Lynch movie version to the elegantly crafted Villeneuve oeuvre, including David Lynch himself. We lost a real artist with his passing, and a rewatch of Twin Peaks is very much on my to-do list for this winter.

But back to Dune, because one of the pivotal scenes in the novel and both movie versions is one where young Paul Atreides is tested by the Machiavellian Bene Gesserit. Atreides has to put his hand in a box. What is inside? Pain. Ever increasing pain. He must keep his hand in the box, despite all his instincts telling him to pull it out to prove his fundamental humanity — his ability to exercise control over his own instincts.

Because, as the Reverend Mother points out after the ordeal, his hand is unharmed. The pain is a fabrication — pain by nerve induction, she says. There is no physical damage. It’s all in his mind.

And, of course, that’s true of all pain, isn’t it? It’s not your toe that hurts when you stub it. Signals are sent from your toe, up a nerve to your spinal cord, up another nerve to your thalamus, and then onto the cortex to give it context, emotion, intensity, reality. If that chain is broken, pain simply does not occur. It’s all in your mind.

That’s what makes pain so difficult to treat. It is fundamentally subjective. I’ve had patients with wounds that would make me scream for my mother, yet they sat stoically silent while we worked on them. And I’ve had those who, well, seemed like they were hamming it up a bit.

But right now our best tool to get a window into someone’s level of pain is a tool like this. A pain scale. How much does it hurt?

Given that the answer may lead us to prescribe some ice or some Tylenol or some morphine, well, the answers aren’t always reliable. Or even consistent. To quantify pain, to put a non-subjective number on it, we’d need to read someone’s mind. Well, maybe we can.

Pain is on my mind this week, thanks to this study “Predicting Individual Pain Sensitivity Using a Novel Cortical Biomarker Signature,” appearing in JAMA Neurology, from David Seminowicz and colleagues at the University of Western Ontario. Their goal was to use non-invasive brain studies — in this case, electroencephalography (EEG) and transcranial magnetic stimulation (TMS) — to interrogate the level of pain a person is feeling. To do that, they enrolled 150 healthy participants with no history of chronic pain. Then they needed to hurt them. And they needed to hurt them all in a very standard way. Their model here was to inject a substance called nerve growth factor into the right masseter muscle. That’s the muscle right in front of your ear that does a lot of chewing. I mean, honestly, this is so gom jabbar, right?

When you inject nerve growth factor into a muscle, it hurts. And not just for a moment. It hurts for about 4 weeks; it’s a model of acute pain that turns into chronic pain. I am quite curious how much these 150 volunteers were paid to participate in this study, and more curious to know whether they felt that pay was adequate after the fact.

Before we get to the brain, let’s talk about the effect this injection had on pain levels. The authors used a statistical technique called growth mixture modeling to identify two types of people in their cohort: those for whom this injection caused a lot of pain and those for whom it’s not so bad. Their scores, over time, are shown here.

The yellow group, people who experienced more pain, were in a lot of pain. You can see their scores were around the top, 10 or so, for the first few days of the study before coming back down a few weeks later. The blue group tolerated it better. It still hurt, they reported, but it wasn’t the worst.

So the question at hand is whether you can tell who belongs to which group from the brain alone. And the answer is yes — almost perfectly, in fact. The authors identified two brain biomarkers (measurements) that could predict quite well which group an individual belonged to. Via EEG, they looked at the sensorimotor peak alpha frequency, a measure of the rate of oscillation of brain waves, and found that slower peak alpha frequency predicted more pain.

TMS might not be as familiar as an EEG, but it’s seeing increasing use. TMS uses a targeted magnetic field to sort of “poke” the brain — give it a little stimulus in a very specific area. You then can see how quickly that stimulus propagates to other areas. In the case of this study, they looked at something called corticomotor excitability — how quickly a signal from the cortex can get to the part of the brain that controls muscles. Slower signaling? More pain.

Combining these two metrics, peak alpha frequency and corticomotor excitability, was all the researchers needed to predict who would belong to which group — the high-pain or the low-pain group. And it worked with about 90% weighted accuracy. But there’s more to the study than that. The thing that really blew my mind was the effect of including psychological information about the participants. There’s a standard survey called the “pain catastrophizing scale” that helps to quantify the psychological impact of pain. Certain individuals may tend to ruminate on pain more, or have more anxiety about the idea of pain, or feel helpless to manage pain.

But here’s the thing: The inclusion of those scores didn’t improve upon the brain measures at all. To predict how much pain someone is going to report, knowing about their psychology was essentially useless in this study, provided you know about the electrical signals in their brain.

This is an amazing way to think about and understand pain, and people’s complaints about pain. It’s not that some people react worse to the same level of pain; it’s that some people’s brains process those signals differently. Psychology is a slave to biology, not the other way around.

There is one last twist to the study that I want to leave you with. One of the two metrics assessed — the peak alpha frequency — was measured before the injection into the masseter muscle. Alone, that measurement couldn’t perfectly predict who would have more pain, but it was still pretty good.

That means this study has opened the door to two new ways to think about and deal with pain. First, a way to predict the severity of pain before you experience it. Think of this as a tool to be used before elective surgery, for example, to help physicians and patients prepare for postoperative pain and manage therapy. And second, to quantify the degree of pain a patient may be feeling acutely, in order to better dose pain medication.

There’s a dark version of this, of course. There’s a world where we stop listening to patients’ complaints and just strap something on their head that spits out how much oxycodone they should get. I don’t want that world, and I’m sure you don’t either. But there are cases where this will help — particularly those cases where the cause of pain isn’t obvious (such as fibromyalgia), and doctors might minimize the symptoms when the patient describes them. Tools like this could prove what patients have been telling us all along. And when doctors dismissively say, “It’s all in your head,” patients can accurately say, “Indeed it is. Treat it, please.”

F. Perry Wilson, MD, MSCE, is an associate professor of medicine and public health and director of Yale’s Clinical and Translational Research Accelerator. His science communication work can be found in the Huffington Post, on NPR, and here on Medscape. He posts at @fperrywilsonand his book, How Medicine Works and When It Doesn’t, is available now.