Trapped in fight or flight

When we are in a chronic state of stress, it causes a physiological and psychological response called survival mode. This means the MIND AND BODY are focused on one thing and one thing only: danger ⚠️

This mode involves the release of stress hormones and the activation of our stress-response systems.

Here’s the thing: this mode is essential, it’s life or death because our bodies NEED to be able to detect a threat and know the difference of when to fight, or flight

Now, imagine not being able to make your way out.

That is what life with an adrenaline secreting tumor is. Your body is trapped in this state, regardless of how calm your mind is. The TUMOR(s) are producing or rather secreting these stress hormones in excess. You can’t shut it off, you can’t control it, and so your body is constantly feeling like there’s a threat even when there isn’t

Someone who’s lived with this disease, even the trauma of it, will catapult the system into a survival state. Just as any disease or trauma can.

What I’m talking about is a little different… but still intertwined. I’m referring to a forced physiological impact from an over production of stress hormones SECRETED by these tumours. Still with me? Our bodies are withstanding a physical trauma every single day. Pretty wild huh?

You will often hear pheo para patients explain this disease as being chased by a predator all their life. Like a lion is running after them that never quite catches them… but is always on their tail

I want to empower you with information that can only be understood from a lived perspective. I want to show you how you can fight back – by not fighting at all

I don’t think we can ever fully explain to someone who doesn’t have this disease quite what it feels like or what it does, but I try my best. Why?

I feel it’s important for us to understand (to the best of our abilities) how this impacts our daily life.

To be able to differentiate how much is the disease and what it us. How much we have control over, and what we cannot. Allowing ourselves and our loved ones to better manage the impact of a longterm chronic state of stress.

I am approaching 32, which means I have been actively living with pheochromocytoma for over 13 years. That is almost unreal to think my body has been in a chronic state of stress for that long and it has been able to survive. Even when it was so close to the end

Let’s take a moment to honour the absolute incredulous miracle our bodies perform every single day. Pause here to feel those vibes!


I’ve explained a pheochromocytoma attack hundreds or thousands of times, but when you hear it from a stress response perspective it’s so different. When we truly understand the impact on our entire system… we can take back some control

A control we are often left feeling isn’t possible or simply cannot exist. How we take back control is by learning to shift back into the parasympathetic nervous system when we’re not actively in attack

Your parasympathetic nervous system is a network of nerves that relaxes your body after periods of stress or danger. It also helps run life-sustaining processes, like digestion, during times when you feel safe and relaxed

If we are constantly trapped in fight or flight, (which many of us endure for years with this disease – and years AFTER removal!) our entire system begins to misfire and that is what we call survival mode. Where we can’t function properly because our body will never relax and feel at ease

Medically, they use medications called ‘blockers’ to protect our system from the output of adrenaline hormones. It allows us to withstand a higher level of adrenaline and can protect us from having a heart attack or stroke.

With metastatic disease, we go through different forms of treatment such as surgery and radioactive therapies like MIBG or PRRT to try and shrink and/or reduce metabolic activity from the tumor. You can click to learn about my personal experience with these, but….

Something I wish I’d known early on is how all of this impacts the nervous system. How it’s crucial to understand this impact and do what’s in our power to protect it. We can’t simply turn it off, but…

Making a conscious effort to shift back into the parasympathetic system helps– you notice I say effort. It’s not a guarantee that we can control or fully combat the effect the hormones are having on our bodies. But I know from experience – it’s better to try. Especially when treated palliatively, it helped to extend my life.

The reason I’m sharing this and will continue to talk about it is because this disease is all consuming. We deserve to know more than how to barely survive – we deserve to know how we can live a life that is balanced and feel safe in our bodies

I’m not quite there yet, but I can promise that the ways I’ve learned and incorporated different efforts into my day to day life has helped. Each day I feel I take a little piece of me back. I feel I learn to cope more effectively, and most importantly – I feel a little more calm and able to come back quicker from the attacks. I will even go as far to say that the attacks are less aggressive right now with the combination of both my efforts and the medical intervention. Keep in mind I am not on active treatment – other than pharmacological blockade.

I will never say for certain what is specifically made the biggest impact or what will work for you. We are all different and these disease is impacted by a number of things. I just share what I know and what I do with the hope that even one thing can help ease some of the pain.

15 things to incorporate into your daily routine:

This isn’t something we learn at the doctor unfortunately, so take notes my friends! In no particular order, I am constantly updating this list.

  1. Guided meditation. I simply cannot stress how important this is. This is something that is free to access, can be done as much as you want, and has proven scientific benefit dating back thousands of year. If you’re skeptical, just try 5 mins a day. You don’t have to sit cross legged, your mind isn’t too busy, you are simply listening along with a voice that is instructing your body how to relax from a subconscious level. I wouldn’t make it through my most painful procedures without years of meditation practice. Fact: meditation/hypnosis used to be used as anaesthesia! Search on YouTube for free meditations specific to your mood and schedule. The mindful movement and Michael sealy are some of my personal favourites.
  2. Deep breathing: too obvious? Most of us don’t mindfully breathe from the belly. Next time you’re feeling stressed, pause, take 3 deep breaths by inhaling through the nose expanding the belly and then exhaling by the mouth. You can also follow along with breathing exercises through certain apps like ‘aura’ or ‘headspace’
  3. Noise + Light: if you’re feeling reactive or triggered, dim the lights, ask those around you to speak quietly or leave the room and go to a safe place. This is especially important while in hospital since health care workers are trained to speak loudly, and the lights are very harsh.
  4. CBD: always check with your doctor first as it can counteract with other meds. I’ve had amazing success as of recent with CBD oils. I have tried both THC therapy and pure CBD, the THC aggravates my tumours + symptoms. CBD on its own alleviates and calms my system during the day and helps me sleep at night. Do your research for quality & safety! Sleep has been my biggest struggle over the years with all the residual adrenaline. However it’s so essential for our healing, if you can find something that works for you it’s such a blessing. I use a specific sleep compound that includes melatonin and CBN, this has helped with pain and sleep quality which has in turn helped me to calm my nervous system by being able to heal through the night.
  5. Zero gravity position: raising your legs above your heart. NASA puts astronauts in zero G before take-off to equalize their weight and ease the stress on their bodies as they are launched into space. Cool right?! It is said to benefit digestion, breathing, and provide proper blood circulation. They have beds with this technology, wedge pillows that offer this ability. Or you can prop your legs up against a wall, or build a pillow fort. Whatever works for you
  6. Gentle movement, walking, light stretching, anything you’re able to do. My husband and I have been enjoying Justin Agustin fitness videos. They are designed for a true beginner and can be incorporated while in active treatment. They can be modified to both of our disabilities and are mobility focused. Thai chi, and other forms of gentle movement can be incorporated as long as you have approval from your doctor and are comfortable. With pheo paras this is tricky as anything can set it off, but keeping in mind that muscle atrophy and pain is worsened when not moving at all. The idea being not to elevate your heart rate at a spike is key. Physio movements can also be done in bed with assistance from a caregiver.
  7. Red light therapy: only 10 mins to see incredible benefit for mood, pain, and anxiety. I recently invested in a home setup because I needed the access safely and consistently for what I’m looking for. Laying in the warm red light is calming in itself, but it’s proven to have benefit for a host of other things. The idea behind red light therapy is that it’s healing the body from a cellular level. It’s actually healing the mitochondria which helps with SO many functions in the body. Don’t take my word for it, just look at the science. There’s plenty of clinics, spas, and salons that have red light therapy. There is also a wide range of options + sizes for home. This is the company I used.
  8. Vagus nerve toning: a device I’ve been enjoying is called ‘sensate’. I was first just trying it out but am now a firm believer it has an incredible impact on my overall well-being. It’s a necklace that uses is infrasonic technology to stimulate the vagus nerve. It vibrates against the sternum paired with calming sounds on an app through your phone. You choose how long you want your session to be and select the music and just enjoy. It’s scientifically proven to ‘tone’ the vagus nerve with continued use. I love when I find things like this and they actually work. Again, just the 5 mins of calm is beneficial BUT with built in deeper benefits. Absolutely phenomenal and has helped many others see the same benefit! Very promising
  9. Nutrition plays a role in everything. I’ve talked about this before and if you have pheo or para you probably follow a low tyramine diet. If you’re wondering what that is – the MAIN no no’s would be fermented/pickled foods, processed foods, and soy. Having MCAS I can’t eat foods high in histamine either or else my system goes haywire. Being mindful + learning what triggers your body’s stress/anxiety helps a lot! I will never recommend any specific way of eating, because we are all individual. I think knowing what not to eat can be pretty life changing to our system.
  10. H20, If you are dehydrated, your body is not functioning properly, and therefore may cause increased levels of stress. Ever notice your heart rate increases or feels like it’s skipping beats when you don’t have enough water? There are many many tricks to stay hydrated, this isn’t something to skip on.
  11. Journaling: a daily self care practice that can release so many thoughts and emotions. You don’t have to love stickers or even like writing. However it can be used as a way to ‘brain dump’ whatever emotional storage you’re bringing around with you. Think of a journal as your safe space to say whatever you want without being judged or have to think about how it sounds. Just write it out, let that shit go!
  12. Trauma coaching: at the beginning of this year I made it a goal to begin treating my PTSD. It’s no secret that the body stores trauma, this was one of my ways to try and get it out. There are many forms of healing therapies that exist now Vs traditional talk therapy. I personally wasn’t a fan of that – but doing whatever feels safe and comfortable to you is key. I just happened upon a trauma coach during a cancer support conversation and it’s changed my life. We are doing a focus called ‘internal family systems’ or ‘parts work’. It’s been close to 6 months, the most notable difference I’d say is being able to slow down. When you’re stuck in survival mode, we will often not want to just ‘be’. We always have to be doing something or distracting ourselves or else it feels too overwhelming. This is what I wanted to get away from, and am proud to say is starting to happen for me. I feel I have the tools to manage my triggers and reactive states. Click here for more information regarding trauma coaching
  13. Self care: this is meant to make you set aside the time to care for yourself. It’s amazing what an hour or two of doing something just for you can impact our mood and peace. When I’m feeling particularly stressed, I may take a bath, or maybe I’ll sit and listen to music while doing my skincare routine. The point is to be intentional and really set aside the time to take care of you and you only.
  14. Gratitude practice: it may sound silly at first, but I’d recommend reading this book if you’re new to gratitude practice. It shows how at its simplest form being grateful can change how our bodies feel. If we’re only grateful when things are going well – it’s easy to get caught off guard during hard times. I recommend writing down 3 things you’re grateful for each day, this simple exercise when added to a daily routine completely changed my ability to cope. Which in turn helped me return to my baseline state of calm.
  15. The art of doing nothing: there is so much power in this one. I won’t explain much further, this comes with time. I haven’t fully achieved this ability yet, but I try every day to just be with myself and do nothing for even 1-2 mins. You may be reading this and saying “well doing nothing isn’t hard?” Yet in survival mode, this can seem like an impossible task. If you know you know

There’s no one formula to magically shift out of survival mode. As you can see, it’s an ongoing daily effort to help relax our system. It’s a combination of emotional, physical and spiritual needs. It is grounding ourselves, reminding our brains there is more to life than suffering, it’s living – not surviving

I hope wherever or whenever this finds you, it reminds you that our bodies are capable of incredible things. We are never broken, we are healing. We can take pieces of ourselves everyday. Each one of these practices has its own unique way of helping us to return to our baseline state of being.

I’m here to remind you that no matter how hard it tries, pheo cannot take away your ‘fabulous’. I hope these practices offer the gentle reminder you needed to feel more like you.

If you want peace, stop fighting

@pheovsfabulous

you are the lion.

“Listen to your body”…?

Hello? Body? I’m listening! you did WHAAAAT?!

I’m sure you’ve heard this phrase, probably hundreds of times. Although it is great advice – what does it actually mean?!

There’s a lot of different ways this phrase is interpreted, most of us associate it with rest. When your body is sending you cues to slow down or some time for self care. That’s all true, but what about all the other important aspects of it?

There’s a lot more to it than you’d think. Most of us with chronic disease are in tune with what’s normal and what’s alarming.

Your body will let you know”

Most people when recalling a diagnosis story, they’ll tell you that golden advice. They will say “your body will let you know, you just have to listen to it” so what does that really mean? What are we listening to or looking for? Do we run to the doctor each time we have a funny pain?

Well that depends, first, you need to get to know your body.

no one knows your body better than you”

Not all of us are in tune with our bodies, especially if you’ve never had a major health condition. We can brush off a lot of symptoms because we’re unsure of their importance. So I’m going to give you some tips and explain a bit more of what to be looking for

In order to get to know your body, you have to start listening to it. If you have a normal every day pain level of 2, take note of that. If you’re someone who has no pain at all, take note of that too. If you’re a woman, take note of what your breasts feel like, on and off your period. Get to know your smells, if you normally don’t have a perspiration smell or do. Do you often get headaches or is it unusual for you? Do your eyes twitch when you’re tired, or all the time? Is your skin very dry? Always or just sometimes? How’s your mental state? Are you a very anxious person or very calm? Always tired or full of energy?

These are just random examples, but you get the idea. We have to get a baseline idea of what our bodies normally do in order to know when it’s giving us cues. Or in some cases, alarm bells.

It’s pretty normal for most people to have the odd symptom here and there, it’s typically nothing to be alarmed about.

When I start to become more alert is when I experience a new symptom that I’ve never had before or haven’t had for a very long time. I take note, and I follow it to see if it’s getting worse or becoming consistent.

I break down the urgency by persistent or consistent. If you’re experiencing the same symptom over and over again, that’s when your body is really trying to tell you something.

If I’m experiencing a symptom that’s worsening, that’s when I’m making a trip to the doctor.

Why is it important to listen to your body?

If not you, then who will?

Going back to when people are diagnosed, later when they recount their story, they remember certain cues or things that were off. They recall things their body was doing that perhaps didn’t seem like such a big deal at the time. I can’t tell you when something is urgent, because everyone is different. I can tell you to listen and try to judge with the best of your knowledge.

I can also tell you that if something impairs your daily life or capabilities, it’s not to be ignored.

I’ll give you some examples of things I personally take note of and how I deal with them.

Symptoms

If my headaches become more frequent, I start to take note. It’s not for nothing, but it can be due to lack of sleep, or stress. If they become more frequent and severe, that’s when I’ll bring it up at my appointment.

Energy levels and fatigue: if I’m sleeping well, and doing all the right things – yet I’m still exhausted… I’ll take note of it.

Perspiration: if it changes or has a different smell, I take note of it. Hormones can change the way your body smells, so it’s good to know the differences.

Abdominal pain: There can be so many different types of pain, I for one experience pain on a daily basis for numerous reasons. So I take note of the level, the location, and the frequency. Is it linked to an activity? A food? Is it the same pain? How would I label it?

Skin changes: I used to think this wasn’t a big deal. “My skin is just dry because of winter”, or “I just have dry skin”. That may sometimes be the case, yes, but I’ve also had major skin changes to alert me of my thyroid changing, and my cortisol levels depleting. Many issues in our body lead to a hormone imbalance, so it’s important to be aware of the trends.

Hair loss: it’s normal to lose a few strands of hair in your brush, and in the shower. However when you’re losing clumps, getting bald spots, and it just falls out without brushing or washing, it’s a cause for concern.

Brain fog: some of us can get a bit foggy when we’re overwhelmed or not sleeping enough. However, brain fog is also a major symptom of many illnesses. It can also be caused by medications. For me personally, I take note and try to link it to a specific cause so I can deal with it IF possible.

Bloating: this can be a major issue for some of us, it can be something that needs to modified in your diet. That’s the first thing I try to take note of by trying to link it to a food intolerance. Next I will make note of the severity, does it happen after eating? Does it happen out of no where? Is it painful? Does anything help it?

Mood changes: first thing I ask myself is if it falls under my normal reaction or trends. I label the feeling, try to link it to something, and if not I ask myself if it’s related to lack of self care. If it’s really an irrational random reaction, I take note because it’s typically linked to something more important.

I could probably go on for a while with the types of symptoms I feel, but you get the picture. First take note of what it is, then try to keep an eye on the trends. Frequency, severity, and description. If you’re someone with a lot of different symptoms, it’s best to take note of the ones that stick around or are particularly painful.

Once you have your baseline of what’s ‘normal’ to you, you can then start listening for the alarm bells and cues.

Remember, often it IS a gentle reminder to take it easy, slow down, get some rest. However the only way to know is to be in tune with your body, that’s when you can begin to really listen to what it’s trying to tell you.

When I make note of all of these things, I generally try to make changes in my control to see if anything helps. If nothing changes or it becomes worse, I will talk to my doctor, get some labs done, and see what kind of plan we can come up with based on the results.

You can read how to best prepare for a doctor’s appointment here.

Sending love, unicorn magic, and a whole lot of fabulous your way 🤍✨

Pheo VS Fabulous

@pheovsfabulous

How to conquer ‘Scanxiety’

Friday, September 10th

Another day, another hospital, another scan.

It

Will

Be

Okay

I can call myself an expert by now, I would estimate in my short time on this earth… I’ve had at least 70 scans. Probably more, but I don’t keep count.

All types of scans, CT with contrast, CT without contrast, MRI, PET scans, MIBG, Octreotide, bone density scans, Gallium 68, and that’s not including your average ultrasounds and x rays.

So, I will hold the title of expert level, I might as well get something out of it. I’m going to give you the best tips I have to be prepared. I find the best way to remove the fear, is to know what’s coming. So hopefully by me sharing what to expect, the things we can control, it will eliminate some of the anxiety leading up to it.

Yesterday’s scan was an MRI, not my favourite type of scan. But then again, they all have their woes.

A lot of people ask…

“what is the best type of scan to get for a Pheochromocytoma?” but here’s the thing… it is so specific to your case.

Specific to the timing, is it diagnostic OR prognostic? Is it a follow up after surgery? Is it to see the tumor size or is it to see the tumor activity? Is it to see if you’re eligible for future treatment?

See, there’s no one size fits all answer.

But since this isn’t going to be about all the different types of scans, I will focus on the one I had yesterday: the MRI

I’m normally a CT girl, not because it’s the best, or because it’s easier – quite the opposite. A CT is normally best for diagnostic imaging, it’s less detailed than an MRI, but gets a good overall view of the body. But I’m deathly allergic to iodine, which is the injectable solution used to light up your insides. So when I do a CT, I have to go through an exhausting allergy prep in order to safely get imaging. I can’t help but giggle, having a rare cancer that requires constant imaging but being allergic to the process. Awesome.

Salt in the wound, am I right?

So because earlier this year we discovered the link between my pheo and mast cell disease, making it no longer ‘just an allergy’ but a life threatening anaphylactic condition, we switched to MRI.

Still with me?

MRI also requires an injectable solution, called gadolinium. But the chances of having a reaction to it are very low. I still prep, and I’m cautious, and I still feel the aftermath of it in my body for a couple of days. But nothing life threatening, phew.

An MRI is a more detailed image, so as previously mentioned, for me it makes sense as we already know I have cancer. We’re not looking for it, or diagnosing it, we want to see all the gory details. We want to see detailed imagery if it has metastasized further, if it’s grown or perhaps shrunk, or if it’s magically disappeared? A girl can dream.

Before I go into explaining what an imaging day looks like, and what to expect DURING an MRI… I want to talk about what the before, leading up to it.

In the weeks leading up to my scan, I get a nervous energy that I don’t even realize I have. I get very fixated on certain tasks, I get a bit scattered, foggy, yet I can’t settle down or rest. I feel the need to always be doing something, planning something, or helping someone else. It’s my way of not focusing on what is about to happen.

In the days leading up to my scan, I allow myself to realize the impact of what’s about to come. What this scan will mean to my future. My brain tries and tries to acknowledge both outcomes, but I don’t allow that.

I refocus my mindset to the impact of hearing the good news, I only focus on the good news. This may seem like blind hope, but to me, why focus on the things we can’t change?

Until there IS a problem, why create one?

I used to always go in with the attitude of expecting the worse but hoping for the best. It was a way of protecting myself and not having my world shattered if I heard bad news, and let’s be real… I heard a lot of bad news. So it became a routine, I’d go in, do my scan, and deep down knee what was to come.

Only in the last few months did that start to change, my life has changed. Well, my quality of life I should say.

Feeling hope to this magnitude, it’s a tricky thing. As previously mentioned, hope can be the hardest thing to have. In fear of it being ripped away, which has happened to me quite a few times.

But I can’t live a life expecting misery and feel no hope and dream no dreams, because that wouldn’t be a very nice existence. So I reframe my mindset to feeling hopeful, manifesting healing, dreaming of what’s to come, and praying for another miracle.

I figure, no matter what the outcome, I will deal with that when the time comes. I can’t control the outcome, but I can control my feelings leading up to it. A-ha! See?

With cancer, or any chronic illness really, we often feel so helpless. Not in control of our own bodies, our minds, our future. So I like to be in control of anything I can. In my mission statement I wrote ‘holding onto my fabulous is the one thing I can control’ and that’s still true.

Except I realized my ‘fabulous’ is much more than just lipstick or hair. It’s who I am, it’s everything that makes me, me!…

So if I had one piece of advice to those of you who are experiencing scanxiety – it’s to acknowledge the possibility of both outcomes, but put your focus on the one you want. It’s okay to quickly consider the alternative, but don’t allow it consume you. Ask for prayer, ask for love, good energy, ask for support. Do what you need to do to feel hopeful.

Set your intention on the good, and in the days leading up to your scan… live your life as normal. Go about your day, clean your house, exercise, bake, talk to your friends and family, make homemade pizzas with your kids, shop till you drop. Do whatever makes you feel good, and most of all, normal.

I can’t tell you just how many sugar free cookies I baked, and how many celebratory outfits I ordered. Yes, celebratory. Because I fully intend to be celebrating the outcome. That’s the intention I set, and every day leading up to the scan, I meditated about it, I sang about it, I cried about it.

And now I’m writing about it. I’m putting it out into the universe

It

Will

Be

Okay

When I began writing this blog today, I wanted to explain the process of an MRI to take a bit of the unknown out of it for others. But I’m happy it turned into something different, because I love sharing my heart with you. Let’s be real, we don’t come to pheovsfabulous for the science 😉😂


Let’s walk through what the day looks like, and some practical tips to prepare!

Confidence comes from being prepared

First step, we drive 3 hours to get imaging, so you’re going to want to be comfortable. I said comfortable, not boring. There’s nothing boring about us, we need to feel cute! Look good feel good, am I right? Ladies AND gents!

Me, Gallium, and my ‘hospital bag’

1. Choose your outfit, and make it a good one. Something that makes you feel like you can take on anything. An outfit that makes you feel POWER, and confident!

2. Prepare your hospital bag, yes, you need this! Even if your hospital is close by, you need to have certain essentials to get you through the day. Since my hospital is out of town, I always bring a small bag of toiletries just INCASE anything unexpected were to happen.

Medications, maybe a book, a good luck charm, lipgloss, you know, the essentials. I always bring my fighting pretty gloves for strength, and a stuffed animal for comfort. This time, I brought gallium. He’s my scanner buddy. More importantly, your medical resume. This is your road map for emergency protocols, allergies, history. I show you how to create that here. If ever you were to have a reaction or go into crisis and couldn’t speak, this is going to be their guide.

3. Create a playlist that pumps you up, gives you happy vibes, and passes the time. You can even listen to an encouraging podcast or whatever you’re into.

4. Prep food and drinks for your trip, takeout is hard when you’re following a low tyramine/histamine diet and allergic to nuts. This is a fasting MRI, so you’re going to be hangry. I suggest bringing at least protein bar to devour the moment you’re done the scan. We bring a small cooler and prepare for the day. We didn’t used to do this and since we have, it’s made such a difference.

5. Pillows, blanket, neck pillow. Anything that’s going to make your road smoother. If you experience chronic pain, sitting in the car for long periods can be tough. I always have a neck pillow in the car as a minimum.

6. Bring slippers! You will have to completely strip down and get into that sexy blue gown, and you don’t want to have to shuffle around in the hospital paper booties too. So bring a pair of slippers to walk around in until your scan.

7. If you wear a wig, you will have to remove it during the scan. (Magnets) I like to bring a bandana or some sort of head covering to be comfortable before and during the imaging. I sometimes sweat quite a bit in reaction to the loud noises and vibrations, and I don’t like coming out with my hair drenched. So I cover my natural hair with a bandana and it helps absorb some of the perspiration.

8. Speaking of noises and vibrations, this is something that bothers quite a few of us. You may want to speak to your doctor about taking something to relieve the anxiety or claustrophobia. Just make sure you’re able to stay awake, as there’s work to do in there!

The MRI:

So now that we’re fully prepared, what should we expect for the MRI?

Our prayer ritual before the scan

You will check in, wait a little in the waiting room, I was allowed to be accompanied by my husband as he is my caregiver. With my conditions, I can need life saving care at any time. I can’t go wandering around alone. If your condition requires special attention or sudden medication, tell them this at the door so that your caregiver can be present up until the actual scan.

“Miranda?” Your name will be called, and you will be escorted into the injection area. The hospital I went to was lovely and had a private bed to wait in. I appreciate these details with being in so much pain and fighting to keep my eyes open.

The gadolinium injection won’t take place until during the scan, so you’ll need an IV placed. (Hydrate a lot before!) so that your veins will be ready.

The technician will insert the IV, and you will be asked to wait a bit until your turn to be scanned.

You will again be escorted into another room, this time where the MRI scanner lives.

(This is just a sample image to show the scanner)

The MRI is a big white tube, and yes, you’re going in head first. This is why I like to know what to expect, it makes you less nervous when prepared. You will lay on the hard narrow table, there will be a blanket underneath, and if they don’t have a leg wedge set up, ask for one! Thank me later. You will want that elevation to take pressure off your back, the scan will most likely last at least 20 mins, mine was about 30.

They will place a large plastic contraption over the area that’s being scanned, for me, that was my abdomen. This device will be what captures the images, and they will gently secure you to the table with some straps so you don’t have to be worried about positioning.

Before sending you into the MRI, they will place some headphones on you. This will allow the technician to speak to you throughout the test, and you will also hear a voice prompt you when to breathe and when to hold your breath.

My technician was super kind and explained to me to listen to the voice as soon as she says to breathe in, GO. Don’t wait until the instructions are finished, this was really helpful to me so that we didn’t have to repeat the photos.

**Super important tip**

For me, I don’t want to feel like I’m in a tube. So I close my eyes before I go in. I never ever open them, that way I won’t panic. Everyone is different with this, my husband likes to keep his eyes open and then close when he’s ready. It depends if you’re claustrophobic.

Everyone will leave the room, and you will move into the machine. You will begin to hear the prompts almost right away, “take a deep breath in, now hold your breath” and you will have to hold for about 30 seconds. (I counted)

How do you stay calm during the scan

I practice guided meditations every day, and I learned breath work to calm my nervous system periodically throughout the day. This can all be done through YouTube, type ‘guided meditation’ and you will see a whole bunch of meditation types. Ranging from stress relief, sleep aids, ptsd healing, etc. Doing this on a daily basis allows me to stay calm during ongoing stressful circumstances. During the scan your mind will be used to travelling to your happy place, while still listening to the breathing instructions.

This is our favourite daily meditation

About half way through the scan, the gadolinium will be injected electronically into your IV. Like any contrast, you will feel the ‘warm feeling’. AKA you will feel like you just peed yourself. It’s not AS aggressive as the iodine contrast during CT, but you do feel it. This is normal, don’t panic! You didn’t pee! I promise.

The hard part is over, kind of. You will be guided back into the injection room to have your IV removed, and you can be on your way. Go take care of your hanger, eat that protein bar, and drink LOTS of water to flush your kidneys of the dye. And I mean lots! You’ll feel better quicker.

Although the physical part is over… now the mental part is going to take its toll. Leading up to the scan, all that nervous energy you experienced, it’s going to be the opposite now.

You will most likely be drained, exhausted, mentally and physically. It’s time to rest and recover. I slept a few hours the moment I got home, and I’ll be honest – experienced a lot of pain. Have your heating pad ready, and whatever you do to control your pain levels. As I’m writing this I’m still pretty stiff. For me, the noise and vibrations of the machine makes my body tense up. Leaving me feeling like I did an extreme an workout when the whole day is done.

Speaking only from my personal experience, once the scan is done, I feel too drained to worry about the results. I did enough of that leading up to it, now it’s time to just be and let be.

Worrying will not change the results, but it will make you feel like crap. As we all know, stress is the worst thing for our bodies with this disease.

So now it’s time to rest, and do something that really brings you peace. For me, it’s doing exactly this. Writing.

This is my therapy, helping others by sharing my experience.

What’s yours?

Let’s Connect:

Tiktok & Instagram: @ pheovsfabulous

#pheovsfabulous

🤍🦄💫

Caregiver Chats: our story

www.instagram.com/tv/CTV0qRilPhD/

If you’d like to watch the replay of our LIVE chat, I interviewed my husband for the first time ever about our journey.

He shares some incredible insight about how you can support your loved one and respond to crisis and attacks.

He also talks about the importance of language and wording, and encouraging the person to stay feeling like who they are.

We talk about palliative care, what terminal illness means, there’s a lot of valuable info In here!

I hope you watch with us and if you do, make yourself a warm drink, and just connect with our words, our story.

You may even learn some tips about how to keep your loved one comfy at the hospital, surgery, we tried to hit all of the points you asked us about!

So let us know if you watch, and let us know your favourite part or something you took away from it

Sending our love,

Pheovsfabulous & Drcupcakes

Let’s talk about: pain management

In this post I’m going to give you a road map of how I manage with pain with different techniques for severe flare ups AND daily prevention.

I’ve dealt with my fair share of pain, I remember living day to day at a pain scale of 12+ and couldn’t quite get it under control. I truly suffered for years and pain was my primary issue.

I remember not being able to stand because my feet were so sore, I couldn’t sit because my tailbone hurt so much, and I couldn’t comfortably lay down because my skin literally hurt to the touch. I was miserable. But there were things that we learned along the way that helped significantly, so I’m going to share them. But not before I explain WHY 👇🏼

Please always consult your team before making any changes. Integrating new techniques into your daily routine is okay, but removing something without your doctor’s knowledge can be dangerous.

If you didn’t already know, we heavily advocated for a diagnosis of mast cell disease this year. There was a lot of symptoms not adding up with my primary illness… and a lot of red flags over the years for MCAS.

Part of having mast cell disease is a chemical and medication intolerance. Your body doesn’t like a lot of stuff. So the regular pain management approach that was being used for me at that time, was unknowingly making me worse. Much worse

When you have pheochromocytoma or metastatic disease, pain relief can already be tricky since there’s medications that can make the same hormone expression in our bodies as the tumors. Sometimes making us more symptomatic and in more pain.

If you mix mast cell disease into the equation, it’s a recipe for disaster.

So what did I do? Well first, we had to evaluate if I was on the right medications… or on the wrong ones!

Emergency reference guide for mast cell patients

This is a quick emergency reference guide of medications to avoid and that are better tolerated in most cases of mast cell disease. This is from the mast cell society.

So once I fully detoxed from the bad medications on the list, and began life saving treatment for MCAS, I could now begin my healing journey. It saved me, I could now begin to manage my pain.

All that being said, let’s get to pain management!

With such a restriction of traditional pain management, we had to start learning different forms from of relief. I was kind of forced to do so, and I’m actually thankful for that. I don’t think I would have believed how well integrative relief worked if I hadn’t tried it myself. I think that this is something every chronic pain sufferer should know either way.

Mind body connection:

I’m not going to get too scientific, but I was told when I had my very first surgery that the brain will imprint pain.

If the brain gets used to pain, it’s difficult to find relief. Which is why it’s important to understand the link between the mind body connection.

You can’t just say “okay I’ll be really positive and believe I’m not in pain and it’ll go away!” No, it’s much deeper than that.

The more pain we endure, it can make the brain can experience anxiety and depression. Which makes pain worse.

Which is what led me to managing pain in a way where I don’t just throw a pill at it.

I know, it was hard for me to wrap my mind around this too. We are made to believe that medications are the only way of pain relief. Especially in palliative care. But please don’t get me wrong, I’m NOT saying medications are bad, I’m just saying that it takes MORE to truly control pain. Also in my specific circumstances, I didn’t have a choice. With the restrictions on the list above, pain management isn’t easy.

Pain flare:

Let’s talk about that sudden, unexpected, all encompassing type pain that makes you feel panic and pushes your body into overdrive. My list may seem extreme, but I promise the more prepared you are…. Quality of life improves significantly.

Through panic tears, squeezing headache, nausea and sharp belly jabs, it’s difficult to give the body the oxygen it needs to calm down. So there’s a few steps to a flare that I follow. Especially if chest pain is involved.

*if you’re alone, you will want to put aside an emergency pain flare setup. So things can be easily grabbed and accessed. If you’re with someone, they need to know how to respond and what measures to take. Either way, perhaps print the following information and keep it handy. I will also include a list of supplies at the end.

1. First, get to your safe place. For me, this is my bed. My bed offers me the most relief, and I can adjust to how I need to position myself.

2. Elevate your legs, I have an adjustable base, which allows me to put myself in zero gravity with 1 touch. This has been a life saver for me for many reasons, but not everyone has this. Keep some firm pillows or preferably a wedge nearby to quickly access if your bed is not adjustable. Putting your legs into what they call ‘zero gravity’ position means your legs are higher than your heart.

  • 120° angle bend at the hips puts your body in the “zero stress zone”
  • Spinal vertebrae are decompressed and muscles are relaxed
  • Airway and nasal passages are opened up
  • Elevated legs reduce stress on the heart
  • Heart and stomach are slightly below the head and knees

I can literally go on and on about the benefits of zero gravity, which is why I have an adjustable bed. In a flare, it will open your airways, reduce the stress on your heart, and put you into a reduced stress zone for pain relief. This is scientifically proven.

Leg wedge pillow example

3. Once you’re in your safe zone, your legs are elevated, you will begin to feel just a tiny bit more calm. I promise. Reducing the feeling of stress and panic to your body will already alter your pain receptors, allowing your body to be less tense, and begin to think more clearly.

4. Heat and Cold Therapy: In a flare state, most likely you will experience sweating, flushing, and added discomforts. Which brings me to my next point: heat and cold therapy.

Having a cooling band for your head will help relieve the inevitable headache you will experience, and it will also cool your body temperature. Cool therapy also can help with nerve pain. So having more than 1 cooking band is a good idea. You can even use a cold wash cloth. Whatever works for you.

Heat therapy is typically a heating pad, or some sort of heat relief. So again having it ready and easily accessible is important. I always have my heating pad rigged and ready to go in my bed. Always plugged in! The more prepared you are, the smoother these flares become.

5. Massage: most of you are probably reading this and going “well I don’t have a personal masseuse!” 😂 and I get that. I promise, I got you!

IF you do have someone able to gently rub your body to relieve the tension the pain is creating, then do so. Not all types of pain allow us to be touched, but if it’s not the yucky skin pain, then go ahead with light massage.

If you’re a caregiver reading this, the power of a light touch is incredible. Even if it’s just to say “I’m here” without words. This is dependant on your partner or loved one, but I find it very helpful to have my head rubbed lightly during this event. It’s helpful for the body to go into a relaxed state, loosens the muscles, and can alleviate some of the tremors.

So what do you do if you’re by yourself? Well you guys KNOW how much I love Amazon. (Hehehe)

Introducing the massage mat: it can even be heated! Which eliminates the use of a heating pad. So many of you have asked me if I know about a heating pad that hits all areas of the body, so I did my research, V 😉

Heated massage mat

6. Guided Meditation or sound therapy: okay, I’ll ask you to keep an open mind here. I know a lot of us hear the word meditate and think something entirely different than what it is. Meditation simply means your mind is focusing on a particular thought. Learning how to meditate is incredibly important because if we circle back to the first step, you’re much more likely to achieve a state of reduced panic if you’re able to practice mindfulness. And that’s what meditation is, practicing mindfulness. I had NO idea how to meditate, and honestly? I like to take the guess work out of it. Which is why I use a guided meditation practice. I’m sounding all fancy, but literally just search on YouTube ‘guided meditations’. For this specific circumstance, I will link the one that helps me in a pain flare. It’s short, it’s specific to pain, and it’s very good at calming me down and putting me to sleep. Sleep is the primary end goal in a flare. I will talk more about the benefits of meditation later.

*Once you are able to achieve this mindfulness, you can use this focusing technique during painful procedures, scans, and any situation where you need to disconnect.

‘The mindful movement: healing chronic pain 20 min guided meditation’

Sound therapy means that if you’re unable to listen to someone speak like in a guided meditation, you can use sound healing instead. It operates on a frequency that can offer different forms of relief for your body. Here’s an example of a pain frequency:

Search ‘pain relief frequency’ or ‘stress relief frequency’ or whatever form you’re looking for. It’s like spa music but is used as a healing method.

7. This may seem obvious but keeping your flare up emergency medications close to you in different parts of the house can make all the difference. I keep a mini medication kit beside my bed since that’s my safe place. If I’m experiencing ‘that type’ of headache, or anything flare related that can be calmed with medication treatment, I take it before doing anything else. That way it has time to sink in while I’m trying to calm my body.

If you haven’t already noticed, the primary goal of pain management during a flare is to calm the nerves, the nervous system, the mind, it’s all about the calm!

8. At this point we should have achieved a state of exhaustion, the pain should be dying down, but we have nothing left in our tank. So it’s time to sleep … sleep is the number 1 restorative factor in our overall health and actually helps with daily pain control. If you get a restorative night’s sleep, your body and cells regenerate and heal. If we reframe our brains and pretend like you’re going to pay 120$ for some special exclusive healing therapy, we might be more motivated to get our money’s worth!

List of pain flare supplies:

  • Leg elevation wedge
  • Heating pad or blanket
  • Cooling headband
  • Medication kit
  • Playlist of pain meditations
  • Personal masseuse or massager

Pain management VS Pain relief:

So what we just went over was mainly considered pain relief type practices, because they’re meant to reduce pain NOW. But what I’ve learned I’m trying to manage my pain? It’s a full time job!

Daily healing takes time, dedication, education, it can be expensive, and can seem daunting to do on our own. But the way I’ve explained it, I’ve used a lot of self healing methods to try and remove some of that burden.

Pain management is the practice of constant self care and prevention techniques, it’s treating your body like the precious vessel that it is. It’s self care, it’s nutrition, it’s movement, it’s mindfulness, it’s everything we discussed above and much much more.

If you rolled your eyes at any one of those things, I get it. I really do. I am NOT saying “get some fresh air and do some yoga” and you’ll feel all better.

I am not minimizing pain nor am I saying it’s a one size fits all, I’ve been exposed to chronic pain all of my life in various forms. I’ve grown up witnessing my father suffer in chronic pain from a work accident. My sister having been hit by a car and in an extended coma when I was 12… I’ve seen pain. I am a 30 year old palliative woman, I GET PAIN. I promise I have the life credentials.

But what I am saying is that… the thing they don’t teach us in the pain clinics or when people are prescribed heavy narcotics, is that our brains play a powerful role in how we feel. The mind body connection is so important, and once understood and used correctly… can be life changing.

I’ve gotten angry at people for telling me to take a walk or get fresh air. Especially when I was physically unable to do those things a lot of the time. It won’t cure you, it won’t make it go away, but in combination with other daily habits can really help us toward managing our mental AND physical well being.

My husband showed me that no matter what your circumstances, you have to continue to do the things you love. The things that bring you enjoyment and calm. So hopefully I can be that person for you.

If I couldn’t leave bed, I’d get outside in my wheelchair. Feel the vitamin d in your face for a moment, breathe the fresh air. It’s just an important note to change your surroundings and not fall victim to your illness.

My daily management road map:

You’re going to see a trend here, the main goal for management is to manage your stress, your mood, your mental well being, your body’s inflammation levels, physical activity… but overall, the mind plays a major role in pain management strategies. Let me show you:

1. Nutrition: If your condition has any link to food triggers or intolerance, get to know them. Study them inside and out and start eliminating. Don’t wait, I’m telling you! I wish I had done this sooner. Start writing down what you eat and how you felt afterwards. I knew with pheo I couldn’t have foods high in tyramine, but I didn’t really understand the impact. I knew with MCAS I couldn’t have foods high in histamine. If you’re unsure of your condition, an elimination diet could be helpful. Then once you reintroduce the foods one by one, you will see what you react to.

Understanding the role of nutrition is probably… one of the things that impacted my overall health the most.

Weight related pain caused me extreme joint pain, weakness, skin sores, inflammation, clothing discomfort. My conditions kept me gaining and incredibly inflamed, swollen, sore. Until we finally figured out what diet worked best. For me and my angry tumors, my broken mast cells, and my AI, the best lifestyle I can follow is: low carb, sugar free, low histamine and low tyramine life.

Anyone can benefit from eliminating processed foods and sugar, but it’s a personal choice and can be difficult when trying to manage everything else. Believe me, food is a great source of comfort for us. Hello, doctor CUPCAKES. But when I saw the difference in my pain and even my mood? I wish I had known sooner

These are foods that HELP lower histamine naturally

If you don’t know where to begin, just stay in the fresh part of the grocery. Whole foods are vegetables, eggs, meats, and anything that isn’t processed or canned. I know this sucks, but eliminating alcohol completely is so important with this disease. There’s really no good alcohol and it will cause an immediate reaction.

2. We talked about meditation, so if you can, incorporate it into your daily lifestyle. Like I said, start slow, and easy. Open YouTube, type ‘guided meditations’ and choose one that speaks to your mood at the moment. Anxiety, stress, grounding, chakra balance, pain, overactive mind, sleep, self love, there’s a meditation for just about anything. Tips to incorporate it into your day: wake up and do a quick 5-10 gratitude session. Mid day when taking a nap, choose one that’s a little longer to rest to. Then when you go to bed, put one on for sleep. That’s 3 right there!

3. Daily mindfulness: because I’m often asked what my daily habits are and what is self healing… I use an app called aura, it curates coaching sessions, CBT therapy, breath work exercises, meditations, all specific to your needs. It’s a quick and beginner way to learn how to connect with yourself.

Try exploring some self healing books, some topics I recommend are: PTSD recovery, gratitude practice, mindset, anxiety control, and self care. If you’d like me to share my reading list let me know in the comments and I will dedicate a post to it.

If you’re new to practicing gratitude, order a 6-10$ gratitude journal on Amazon. This would be a good place to start. Acknowledging what we’re grateful for helps dig us out of a rut, it improves our way of thinking, and it allows us to see the good even when things are very bad. Law of attraction is real y’all!

If you’re asking yourself… what does this all have to do with pain? You’re not wrong for asking, most people connect pain relief with traditional practices and physical actions. But for management it’s important to be managing your mindset, mood, outlook, and coping strategies. It’s all linked in one way or another, but I can’t do more than offer you the guidance and assurance that it works for me. It’s up to you to make the decision to include what works for you.

Another way to practice mindfulness is to listen to music, get in a habit of putting on some headphones when doing any task. Listen to whatever speaks to your mood, anything to boost your happy hormones, am I right?!

4. Movement: okay this is a big one. It’s also hard when you’re unable to move much at all. I’ve been there as well. But movement is important for circulation, for inflammation, and pain relief!

Some things you can do if you’re sedentary: physio, physio, physio.

Think of when you just get surgery, the first thing they have you do is walk and sit. Think of it like that.

You can do physio in bed, you can do physio from a chair, and it doesn’t always have to be formal. I did my own physio for months with exercise sheets provided to me by the hospital. Ask your physician for some physio exercises, or look for your own and ask if it’s okay for you.

I also used to lift one pound weights in bed, just to move my arms around and not completely lose my muscle mass. We would do leg exercises while I was laying down, and I began slowly walking more and more.

Laughing, smiling, and bed dancing helps too.

If you’re moderate, you can incorporate movement by walking. What I like to do is give myself a daily steps goal, no I am not running a marathon so I won’t achieve 10,000 daily steps like most people, but I cried the day I hit 1000. Some days I would only get to 68 steps, so even if you increase that goal to 100, it ALL COUNTS! Now sometimes I can even get to 5000!

YouTube has a ton of free light impact workouts, physio routines, and light strength training. I love body by Amy, and I also really enjoy beach body on demand, they always include a modified version which I appreciate. I always do the super modified version!

If I’m walking – I’m dancing. I may look ridiculous, and I love it! I dance in the kitchen, I dance brushing my teeth, I dance doing my skincare. Any way to get some movement in and my blood flowing! Also, being silly helps you smile and helps others around you smile. And happy hormones offset angry hormones, well that’s what I tell myself anyway.

This may sound taboo for some but … sex! Sex is not only movement, but it’s a way for the brain to create natural endorphins. Making your body less stressed, happier, and reduces pain. Cool, right?! And remember, you don’t always need a partner for sex! Hint hint. I’ll leave you with that thought. In all seriousness, I know when we’re feeling blah and in pain the last thing you want to do is have sex. Sex can be painful for a lot of us, but it is good to keep pleasure in mind because it’s a natural way of creating pain relief and improved mood. Swearsies!

Good old walking, but make it enjoyable. Go somewhere nice, go to the water, the beach, the woods. Switch it up, let it be good for the mind and the body at the same time.

Last but not least, I try as much as I can to incorporate movement by doing everyday house tasks. I’m not able to do a lot, but unloading the dishwasher or preparing a meal can really change the way you feel about yourself. It makes me feel accomplished and it reduces my stress levels. And if you dance while you’re doing it, it’s a double movement bonus!

5. Sleep: we talked about sleep, but we have to make it a habit in order for it to be helpful and restorative. We don’t just want to pass out from a flare or when we’re delirious. (This was me for many years) once I got the proper treatment for all of my illnesses, my sleep improved. The night terrors went away, and the adrenaline panic jumps stopped.

Some things we can do to improve our sleep habits are…

-Clean sheets and comfortable bedding (you can’t beat that ‘hotel’ feeling’!) make every day like you’re on vacation in your own home

-Going to bed 1 hour earlier per night. (I have a sleep alarm on my phone that tells me when to wind down)

-meditate to go to sleep, or listen to a sleep story, or even just put on some calming sounds, I promise it works!

-if you experience sleep apnea or breathing issues, it’s important to participate in a sleep study and be treated

-zero gravity position. Yes! You can sleep this way. It’s not just for flares. Having a slight elevation opens your air ways, increases circulation, and takes pressure points off your back. It also helps with acid reflux sufferers. All of which wake us up frequently. Try it, thank me later!

Beside me you will see my adjustable remote, my headphones, my emergency pill kit, and my gratitude journal. Proof I practice what I preach!

Please keep in mind that sleep includes rest, so although we will be meditating daily, and doing mindful practices… it’s not sleeping. Our bodies need A LOT of rest, my nap time is 3pm sharp! Don’t ever feel guilt for sleeping, for resting, but I recommend really resting and not just watching tv or scrolling on your phone. Our bodies need time to restore, and yes nightly sleep is vital for this. But so is daily rest!

Especially if you’re feeling down or a depression creeping in, your body may require more resting time than normal. You will know when, just listen to the cues your body gives you.

6. Daily tracking: get used to writing things down. Download a diary app (orange diary, or diarium) or get yourself a notebook. The more you write down your symptoms, your triggers, your moods, your patterns, your activities, the more you will see what’s helping or hurting. It’s also helpful for your medical team and YOU! Think back to your last appt, Were you struggling to describe the type of pain when you were reliving it to the doctor? This is why tracking it is important, in real time. It gets to be a habit and it can be what literally saves your life.

7. What brings you joy? You guys, I can’t stress this question enough, I saved it for last for a reason. Not because it’s the least important, but because it’s the MOST important. Living with life altering illnesses can be all encompassing, most of us only go out when we see our doctors. Or for treatment, and if we’re really lucky, the grocery store. So I can’t stress this enough, what do you LOVE doing? What makes you happy?

I understand you may not be able to zip line or bunjee jump, but there’s always a way to adapt to your previous passions. And also find new purpose! We don’t lose who we are because we become sick.

Remember when I said my husband taught me it’s possible to do the things you enjoy when you’re sick? Well, it’s sometimes difficult, and comes with extra planning and help… but it’s do-able.

I’ve also found that the simplicity in life has brought me great joy compared to before, I can appreciate just about any moment or see something beautiful.

It’s all of the above daily healing practices that’s helped me with this. But we all hold the ability to see things in this way.

However we HAVE to do things that bring us happiness, it’s what gets us from one day to the next, and it’s what helps us release our minds temporarily from the pain.

Self care is a huge part of my happiness, all of the above is self care. Self care is dedicating time to YOU and your healing. So I am prescribing a big fat dose of SELF CARE to you! That’s why I share so much of my routines, my love for taking care of myself, because it brings me joy. And guess what? When we’re happy, we’re often experiencing a momentary release from the pain!

I personally love this, sharing. I love staying fabulous, and I love helping others. That’s what brings me joy.

I also love unicorns, Starbucks, writing, SHOPPING, Christmas, birthdays, chalet getaways, sunsets, selfies, massages, movie nights with friends, cooking, pedicures, manicures, skincare, makeup, my husband’s smirk, his smile, my dogs, pink things, soft blankets, my bed, fresh flowers, things that sparkle, planners, journals, writing lists, being organized, and … well, just about anything else. Not in that particular order

I’m not hard to please. My point is, think of what makes you happy. Do at least one thing per day that gives you that feeling.

So that’s all folks, that’s my pain relief guide and management plan. You have aced the course! Now you just have to live it. I bet you weren’t expecting what you just read, but living it is the best part!

I always say the best feeling in the world is having something to look forward to. Well I hope I’ve created that feeling for you, planning all the ways you will incorporate these into your life to successfully manage pain!

Pheo VS Fabulous 🤍🦄