My expectation is that there will not be an earthquake today. That all my family, friends and community members that are healthy today will be healthy tomorrow. That I will not flare today. The ground, mountains, and buildings seem unmovable.

But life doesn’t work that way. In fact, the only thing I can be certain of is change, and that one day I will have an ankylosing spondylitis (AS) flare and it will disrupt my world just like an earthquake. And it’ll be both shocking and unnerving  when it happens.

More Than an Ounce of Prevention

Let me pay forward the advice I got from one of my health care providers, who’s also a cancer survivor. Take time to take care of yourself. Your disease will demand attention. Your disease will get that attention on your terms or its terms. It’s far better to spend time taking care of yourself, even if it seems inconvenient. If you don’t, your disease will certainly make things inconvenient for you.

Rather than putting off self-care, I follow a flare prevention list that includes eating healthy food, exercising, taking breaks, and practicing yoga. I also check in routinely with a person on my “AS support team” such as a friend, family member, clergy, therapist, nutritionist, rheumatologist, or yoga instructor.

Manage Flares by Managing Stress

If you’re anything like me, a flare will happen during a time in your life that’s already highly stressful. There certainly seems to be a connection between stress, inflammation, and flares.

When I poll the room at an education/support group meeting with a question like, “Do you think stress causes a flare?” The answer is usually a universal yes. People vividly recall highly stressful times that coincided with terrible flares, like losing a job, taking care of a hurt or dying loved one, moving to a new home, or taking school finals or the bar exam. Even blessed events, such as getting married or having a newborn, can be stressful.

In addition to managing stress, I’ve learned that I need to balance diet, activity, and rest. I’m pretty confident that I can periodically take liberties with stress, diet, activity, and rest. But not all at once. If three are off, then I can pretty much expect a flare.

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