Mindfulness HEALS during a pandemic Vidyamala reflects on how she's handled the increasing difficulty of managing pain during lockdown, and explains her approach with an acronym: HEALS. I used to idly wonder how I’d cope with my pain in a catastrophe such as flooding, an earthquake, or war. I never imagined it would be a global pandemic where my life changed overnight and suddenly I couldn’t access my usual supports such as swimming, osteopathy and acupuncture. Soberingly, it became obvious quite early on in lockdown just how dependent I was on a balanced cocktail of exercise and therapies to keep my pain under control, and my back and leg pain quickly spiked. I’m sure this was the case for many of us living with chronic pain and other long-term health conditions. Inevitably I felt anxiety (“will the pain ever settle down?”) and low mood; but luckily, I have a long-standing mindfulness practice which made it a little easier to ride the waves without plunging too far into a mental and emotional downward spiral. I brought to mind the acronym HEALS which I have developed to help me remember that pain management needs to operate across a broad front, taking in key aspects of life and behaviour. As the pandemic continues to impact our lives I try to live by the following principles and hope you find them helpful: H is for Health eating. I make sure I have three healthy meals a day, even when it’s the last thing I feel like when the pain is bad and makes me nauseous. E is for Exercise. I recall the 3 S’s of exercise: Stretching, Strengthening and Stamina. Stretching is covered with my daily exercises based on Pilates and yoga. Strengthening is more challenging with the gym closed (where I usually do a simple weights programme), so I’ve learned to adapt by doing basic strengthening activities such as lifting tins of baked beans. Stamina was also problematic initially in lockdown as I couldn’t do the cardiovascular exercise of swimming and I can’t run or walk fast. Luckily my husband likes a good challenge and he adapted an old push bike to build a hand cycle in the back yard. It’s amazing and I can get properly puffed and always feel better for 10-15 minutes, even when it’s the last thing I feel like doing. A is for Awareness and this is the keystone of the whole acronym. Awareness is mindfulness and means I can try and make wise choices and follow through on good intentions, as well as maintaining perspective even on tough days. L is for Love and I try to make sure I stay connected with friends and family. I need to pace this carefully when I’m tired, but it usually lifts my spirits. S is for Sleep and reminds me to try and go to bed at a regular time and practice ‘sleep hygiene’ such as turning off digital devices a good period before going to sleep. Taken together HEALS has helped me negotiate lockdown and manage a nasty flare up. I know I’ll need to stick to it in the months to come. I hope it helps you too.