What Does Acceptance Truly Mean in Living with a Chronic Condition With Cheryl Crow

being a good problem solver and being stubborn and optimistic and saying, I'm going to fix this, I'm going to get this figured out. Those are traits that are really helpful for solvable problems. But your health is not always a solvable problem, right? And that's, I think, with autoimmune or chronic illnesses like what you and I are dealing with, it's very tricky to— the $100,000 question is, okay, how do you differentiate? What parts of my condition are solvable and which are going to be perpetual.

Welcome to Crafted to Thrive, the globally ranked podcast for entrepreneurs living with chronic illness. I'm your host, Nikita Williams, and after being diagnosed with multiple chronic illnesses myself, I figured out the surprisingly simple missing links to growing a profitable business without compromising my health. Since then, I've helped dozens of women just like you learn how to do the same. If you're If you're ready to own your story and create a thriving business that aligns with your health and wellbeing, you're in the right place. Together, we're shifting the narrative of what's possible for entrepreneurs with chronic illness. This is Crafted to Thrive.

I'm so excited to have Cheryl. Crow on this show. We are going to be talking about all things chronic illness, life, business, and all the things. But please tell us where you are, what you do, where you're from, and welcome.

Thank you so much for having me. I am from Seattle, Washington, the West Coast of the USA. And, um, yeah, I, I am trained as an occupational therapist. I got my Master's in Occupational Therapy. If you don't know what that is, I like to say it's like if a psychologist and a physical therapist had a baby because we are trained in both the mental health aspects of daily life functioning and the physical aspects. And so our whole goal is improving your ability to function in your everyday life during your activities of daily living, whether that's in the case of chronic pain, being able to take care of yourself, make your food, be able to the simple minute. Daily activities and also the larger ones, like being able to maintain your emotional health and stuff like that. But long story, short story long, I also, yeah, I've had rheumatoid arthritis since I was 21 years old. So half of my life. I just turned 42. And I run a patient education and support organization called Arthritis Life.

And that's me.

I am so excited that you shared that. I didn't realize it was that you did occupational therapy. For some reason, I I thought you were doing— what is the other one?

R-A—

no.

Physical therapy?

Yes.

Yeah, yeah, yeah.

I thought it was physical therapy. I didn't realize it's occupational therapy, which I do think is such a huge— it's a great description to talk about it between the psychology and the physicalness of dealing with those things. It's such a huge thing that I've learned just living with chronic illness to be a powerful tool to see how those two worlds collide. I don't know why there's not more. Like, I feel like that is the thing that should be—

I so— yeah, I mean, you're preaching to the choir. But yeah, if I could rename— I think the name is confusing for people. And because of that, they just kind of lump it into physical therapy, but they think it's the same as physical therapy or like a junior physical therapist. But I would rename it life skills therapist because life skills kind of, to me at least, encompasses, like, there are life skills that are in the emotional and cognitive domain, right, of being able to sustain focus and attention and be able to maintain your emotional regulation. And then there's life skills related to, like, physical tasks, right? Like being able to— if you have, like, let's say, a severe deformity from rheumatoid arthritis, can you still put your hair up in a ponytail, or can you still do the things you want and need to do in your life? And so we are really like— I like to think of us as, like, life skills detectives, and we'll look at what is it Like, if I'm seeing a client one-on-one as an occupational therapist, that one of the first questions I ask is like, can you walk me through a day in your life? What's going well? What's not going well? And then we try to analyze what are the root causes like? And then are they remediable? Are they going to be able to be remediated? Let's say you can't cook very easily and we determine that it's because of weakness. Okay, well, you can gain strength to a certain degree. That's a remediation. But there's also cases where you can't, where you say, you know what? This thumb isn't going to move any more than it can move right now. We're not going to regain that range of motion. So can we adapt and adjust? Can we use a gadget or a life hack strategy? And then again, am I falling apart in my ability to take care of myself on a daily basis because of the more emotional domain? Like, do I need coping skills and stuff? So, yeah, I think it's a great— I mean, the problem with the field, it's amazing, but it's also like jack of all trades, master of none. I think the devil's advocate would be, can you really be an expert in both the mental health and the physical, but I think we do a pretty good job. So again, totally unbiased opinion here.

Yeah, at all. I think, I think to your point, I get that whole thought about Jack, you know, like that being both worlds. But I think if you are specific, and specifically like in your work, especially in your, in your, in your business as well as in your life, like RA is a very specific lane to kind of own and to know. And there's lots of commonalities and crossovers that I'm sure that you have seen for yourself and for your clients and patients and things like that. So, yeah, I'm thinking about this and I'm thinking, man, that should be like a thing.

Yeah. And they are. And I think for better or for worse, a lot of times if you are having a hard time taking care of yourself or performing your daily activities, That's the kind of the magic word to ask your doctor, whether it's your primary care or your specialist. If you say, I'm having problems functioning in my daily life, taking care of myself, then I think it would be helpful for me to meet with an occupational therapist. Would you be able to refer me? That's something you can ask your doctor. For better or for worse, they don't always think about it. I even asked my doctor, why aren't more rheumatologists referring to occupational therapy? She was, oh, well, nowadays with the treatments being so much better, so many of our patients are doing better that they're not struggling as much. And I was like, But my experience with running the support groups I do and running the educational programs I've run is that a lot of patients don't even know to tell their doctor the things that they're struggling with because they almost seem too small. Like, literally, in occupational therapy, a goal can— I'm not kidding. This is literally in our training manuals and stuff. It can be help turn a page in a children's storybook to read to my grandchild. That is a goal that Insurance actually, depending, because of course you can never for sure get— insurance might reimburse for that. And yeah, they do tend to like to reimburse more for the things that are directly related to safety and stuff like that. But it's a shame that doctors don't know. They don't even know. They give you this little sheet at the beginning, at least for me, that it's like, can you turn the faucet? Can you dress yourself? Those are really basic activities. And nowadays, with the medicines being a lot better for rheumatoid arthritis, Sorry if I'm rambling, but you're not always having a difficulty with those really basic tasks, but you might have difficulty with the more complex tasks like taking care of children, taking care of pets, getting working, being able to work full time.

Yeah.

So stuff like that, we can help.

No, I don't think it's rambling at all. I think there's a lack of education in a lot of sense of the word when it comes to who do you advocate to see? Right? Because that's such a challenge because doctors aren't necessarily forthcoming who you should be asking for. And so you sharing that, like, this is what it could look like and what type of help you might be looking for. Here's what it's called. I know you know Lauren Freeman, who is the podcast host of Uninvisible Pod, which you guys know I've had her on the show and all that kind of stuff. She has— I don't know if she still has this on her website, but she has, like, a PDF document that talks about Who do you see for what? Like, what's the name of all of these different specialists? And she describes like what kind of things you might want to see them for in the context of what you're talking about. Like, yeah, I can't turn the page of a book to read to my grand— you know, things like that, as well as the bigger things, right? And so I do think the more we can educate our audiences in general around who you should be asking for is more power to all, to us all. So thank you for sharing that. Yeah, yeah. So tell me a little bit about where you came upon this journey. So I know you, you shared a little bit about what you do and your passion, but did you like grow up saying like, I want to be an occupational therapist? Like, yeah, how did that happen?

Yeah, well, what's interesting, I, I grew up knowing I wanted to be in a helping field and I wanted to be At that point, when I was a child, I wanted to be a teacher. I wanted to be a special education teacher, which is the phrase that it was called back then. I think there's people advocating for that phrase to be changed because it can be a little paternalizing, or I don't know if that's the right word, but to say special needs, but working with children with developmental disabilities. I grew up alongside a cousin my same age who had autism. Back then, children with autism weren't integrated into the general ed classroom, so they were just kind of taken off to this mysterious room. Like, what is he doing there? I was just fascinated by it. So I worked a lot and volunteered a lot in special education. And then I worked at a very— anyway, long story short, I worked in a private school for children with severe behaviors, meaning kind of violent towards people. And it's a really tough setting. And that honestly, I thought to myself at that time as a 21-year-old or 22-year-old, I was like, I don't know if I'm actually cut out for this. And I also had just got my rheumatoid arthritis diagnosis and I'm like, I can't even physically make sure I'm safe. Safe in this job. So I got a little— I was like, what if I— anyway, I ended up working in nonprofits for a little while, but I came back full circle to occupational therapy because a good friend of mine unfortunately had gotten in a car accident and he had a head injury. He was a friend of mine from swing dancing. And the occupational therapist taught— it was like, this literally sounds like a metaphor, but it's true. The physical therapist taught him to walk again and the occupational therapist taught him to dance again because it's all about what is a meaningful activity to you in your life. And I was like, oh, occupational therapy. And I remembered back when I worked in the school for children with disabilities, some of the kids would say, like, I want to go to OT. I want to go to OT. And there was this one that was like, OT Sarah, OT Sarah. He had Tourette's. He had Tourette's, and one of his tics was OT Sarah. And I was like, what is this OT Sarah? And I remember going to check out the OT room thinking, this is cool. You can work one-on-one, so it's not as intimidating as the whole classroom. And so, okay, sorry, this is a long, long version. So I went to occupational therapy school. And so the funny thing, the reason I'm saying these reasons I went is it was for the physical disabilities that were like severe, like cognitive and developmental disabilities. Like my friend who had— he had— sorry, he had a brain injury if I didn't say that earlier. So his car accident, he got hit by a car while on his bike and he had brain injury. So he had a lot of memory problems, cognitive problems, and he grew a lot. I saw his rehabilitation. It was amazing. And then I went back and volunteered with the children within the special education program and I was like, this is a cool field. I'm going to go into this.

Okay.

And everyone's always like, oh, did you become an occupational therapist and help people with arthritis because you knew that's what— because you had arthritis. Actually, no. My entire— sorry, this is a little soapbox. You can tell me, getting on my soapbox.

No, it's fine. Go ahead, girl.

Just like we were just talking about, I had never been referred to occupational therapy as an arthritis patient. And I didn't even know that occupational therapists could do so much to help people with arthritis until school. And actually, during my schooling program, when I learned about strategies for fatigue, strategies for pain reduction, I was like, why did I not know this stuff already? Right? So that planted the seed that became my business, Arthritis Life, in 2019. But I ended up— because I had my blinders on of like, okay, I went to school to help. I want to work in pediatrics. I want to work in special ed. I ended up working in special ed for a while. And then on the side, I started my talk show, my YouTube talk show about Arthritis Life in 2019. And then the pandemic, I pivoted to making it an actual business.

That is so interesting. Oh my goodness.

I know. Sorry, I have so many directions.

No, no, no. I was just like thinking like how it's so interesting that the reason why you're doing what you're doing has— it was like kind of like, man, nobody told me that. Again, nobody told me that this is something I should have been doing or it was even something I should have access to or been even referred to. I feel like that happens so much with so many of us. I remember when someone told me about a urogynecologist, and I was like, what is that? And they're like, it's a urologist that specializes in the girly parts. And I was like, why didn't anybody tell me this? Like, that exists? And it does. Yeah, it was just like, wow, that makes a lot more sense, right? So to your point, went into that place of supporting people and was like, why didn't I have this? So it's so interesting how our paths kind and lead us in different ways to different places. But I want to kind of go back to, like, you were saying you were diagnosed at the age of 21 with RA. What led to that diagnosis? Like, how did— did you kind of see this happening before then? Or like, just tell us a little bit more about that journey.

Yeah, and I'll preface this by saying I have a 45-minute YouTube video on just my diagnosis story. Saga, only to say that it is a saga like many of us. And I want to acknowledge first, I had basically every privilege you could have other than being a white male. I'm a white female, but also came from a family, a super supportive family that had the financial resources to really try to get me my diagnosis. They knew I was sick and I still— it took a long time and I'm still emotional about that because it was basically experienced like medical gaslighting. So the story is that I was a really athletic, really healthy kid, went to college, was the captain of the college soccer team, really strong, really healthy, everything going great. And then all of a sudden, my sophomore year of college, I started feeling like I was wasting away. My appetite went away. I started losing muscle mass, and I started losing weight unintentionally. I hope it's obvious that I was not trying to lose weight. I was trying to maintain weight to be an athlete., and it was so bizarre. Just came out of nowhere. And I had this sprained finger. I'm making quote marks for those listening. So to me, as somebody who's used to pushing through a certain degree of pain as an athlete, it was not a big deal. My pain— I'm not saying this to minimize anyone else's pain from rheumatoid arthritis, but literally the pain to me, it didn't register as a big thing to mention to doctors. The bigger problem was the digestion issues and the losing weight. I barely even mentioned it to them that I had this finger pain. But it turns out that was the first sign of rheumatoid arthritis. Specifically, interestingly, just a teaching moment for anyone else who's either undiagnosed or knows someone with rheumatoid arthritis, that uncontrolled inflammation from rheumatoid arthritis directly causes muscle wasting. And it's a phenomenon called rheumatoid cachexia. Again, something I didn't learn about until I went to— in a healthcare field. I never even knew that that actually was what happened to me. But anyway, I went to gastroenterologists. Everyone kept saying, you're not sick, you're just anxious, or accused me of having. So trigger warning for eating disorders. But they told my parents they thought I was faking and hiding an eating disorder, that I was doing this to myself. And first of all, if I had an eating disorder, I would deserve the most compassionate care, right? But it felt to me like, how do you prove to someone you don't have an eating disorder? I felt like in a really difficult position. All I could say was, I want to eat. I want to feel like how I felt a year ago. None of this makes any sense. I kind of kept thinking I must have stomach cancer or some sort of health problem. But of course, if all their quote unquote tests are normal, which they run, whatever blood tests that they did, and then you're saying you feel really sick and like you might have cancer or something else, they're like, well, then the next step for them logically is you're just anxious, you're just a hypochondriac, and you're losing weight because you're stressed. So I'm like, yeah, I'm a little stressed. It's a little stressful.

You're not listening to me. You're adding to it, by the way.

Yeah. The way I like to describe it is it was like my body was a house. The house was on fire. I called the firemen and they're like, there's no fire. Like, who do you call? So my parents, again, putting the privilege in here, I want to acknowledge that they had the financial privilege to say, we're going to hire a concierge doctor, which back in 2003 was a really new concept. Concierge medicine is a a little bit more common now, but concierge at that point meant it's someone that's available 24/7. It's not like I was a celebrity with a private doctor. They had other people, but they did pay out of pocket for this. And even her, the concierge doctor, first said, I think you're hypervigilant about your health. You need to stop stressing out so much. And then I got diagnosed really quickly in a row with gastroparesis, which is basically paralyzed GI tract, which explained my slow gastric gastric emptying and everything, but it still didn't explain. There was not a lot to do about it. And then I got diagnosed with rheumatoid arthritis. So I had also started because I started having panic attacks. So to mention the mental health again, the chicken or the egg to me is I didn't really have any, not to sound like defensive, but I didn't have any preexisting real consistent mental health issues. I would say that I had signs of anxiety off and on from a young age.

Like being normal people.

Yeah, normal amounts of like functional amounts of anxiety. Yeah. But then I started having panic attacks thinking like, no one's going to help me. What's— how do I do— you know? So yeah. And then I started anxiety medicine. So it all kind of swirled around, right? It's not a very linear story, but I woke up one morning and every single joint in my body hurt, especially the fingers and the toes. I couldn't even open like a container of milk. And so that's when we called the concierge doctor and she very quickly ran the blood tests for rheumatoid arthritis and sent me to rheumatology. And I was like, I'm like, that's funny. You kept telling me you ran all the tests and everything's normal, but you didn't run the rheumatoid arthritis test, so I guess you didn't run all the tests. So I'm still salty about that.

If you can't— No, I think many of us who have been gaslit like that or have gone through those things, that is a common thing. Like that result. Oh, we ran all the tests and it's like, when you get the diagnosis and it was actually something that could be confirmed by a test, you're like, so you didn't run that one? Like, I totally get it. I, I am with you on that. I would probably be salty and still upset about that too. It's like, why didn't you run that test? Like, just exhaust all the tests you have at this point, because at this point my life is wherever it is. Like, go ahead. But yeah, no, yeah. So what I will do though is have a link to your your YouTube channel about this specific one so they can hear all of the juicy— I'm sure, like, there were even more, yeah, more things in there. But I wanted— no, no, no, it's okay. I want the audience to kind of know a little bit more about, like, how you had a diagnosis and how you came to this place. But the thing I really wanted us to talk about is acceptance and commitment. And I think we don't talk about this enough, I feel like, in the world of chronic illness in general, the difference between acceptance versus— I never say this word right, so you guys bear with me. It's like me saying synonym versus— anyway, acceptance versus resignation. There you go. Yeah, what she said.

What's your—

there's such a huge difference in, in that. And I know for me and my journey and a lot of my clients acceptance, the true feeling, authentic acceptance, living with something, chronic illness, is such a game changer for being able to choose to thrive even though you're dealing with chronic illness. So—

Yep, 100%. Yeah. Oh, sorry.

No, no, no, no. I was just going to ask you, when in your journey did you come to this place of acceptance personally, and how has it affected your life?

Yeah, it is the number one most helpful thing for me in learning to thrive with a chronic illness has been acceptance. And I definitely— I like to say I was dragged kicking and screaming to acceptance because I am a recovering control freak. Or as my therapist like to say, I had two therapists. I'm going to refer to one as a he and one as a she because there are two. In case you're like, what? The first therapist I went to, I thought it was just going to be for postpartum adjustment kind of challenges. I didn't like to think of it as depression because it didn't feel like depression. It did feel more like postpartum irritability. And apparently anxiety and depression can manifest as irritability. I didn't know that. And anxiety. So they both said that basically being a good problem solver and being stubborn and optimistic and saying, I'm going to fix this, I'm going to get this figured out. Those are traits that are really helpful for solvable problems. But your health is not always a solvable problem, right? And that's, I think, with autoimmune or chronic illnesses like what you and I are dealing with, it's very tricky. The $100,000 question is, okay, how do you differentiate what parts of my condition are solvable and which are going to be perpetual? So the way that Dr. Russ Harris, which if I want to send people one resource, I'm not even going to send them to my own website because this book, Dr. Russ Harris, he wrote a book called The Happiness Trap. And it is so fabulous. It's like the one thing I'm like, if you do nothing else, read this book. I'm going to look up this— I always forget how to say the second part of it, how to stop struggling and start living. And then it's like a primer to acceptance and commitment therapy. But the way he defines acceptance is taking what's offered. It doesn't mean liking it. It doesn't mean resigning yourself to your fate. It's just saying this is what life is offering me. In the moment today. So it really is— ACT stands for Acceptance and Commitment Therapy. And that's again, what the Happiness Trap book is about. There's many other books about it too, but it's an evidence-based technique. Just for those listening who might be health professionals who need to say, is this evidence-based? Or patients who want to know, is it evidence-based? It's actually more evidence-based than traditional cognitive behavior therapy for chronic pain, specifically in chronic conditions, because it really teaches you to say it's a mindfulness and behavior-based approach. The first part, the A, is accept your thoughts and feelings and sensations, including pain, exactly how they are in the moment, and you expand and make room for them. And then the C is connect with your values, and the T is take effective action. So you say, okay, what can I do to still have a full and vibrant, meaningful life with my health condition alongside it versus making your whole life all about fighting it or trying to take it away.

Yeah, yeah. No, this is a core, core, core piece of my business coaching for folks that live with chronic illness. It's like we cannot operate in our business in silos without going through and accepting that this isn't something you are going to fix so that you can then therefore be successful. Like, this is a part of your life, and that sucks some days. That's okay to accept that. And there's some days it's not sucky. Like, you know, it's like, okay, when in your journey specifically do you have a point in time? I have a very specific time in my journey where I know that I went through this process of accepting in a completely different way, and it changed literally the way I saw and everything that I did. But not everyone has that, right? Not everyone has that. Some people go through phases of acceptance. Different things. But for you, what has that looked like for you and your journey with RA?

I think that I'm reminded of a quote by John Green, who's a young adult fiction writer. He's really great. He wrote a book called The Fault in Our Stars. And one of the lines in that book is, he fell in love like you fall asleep slowly, then all at once. And I kind of feel like that was what acceptance for me was slow, and then it was all at once. It was like I fought it. I fought it. I had so many therapy points with my first therapist, and then my second one, he is an OCD specialist, obsessive compulsive disease, and he— or disorder. It's weird. You wouldn't think, like, wait, what's the overlap between OCD and pain and stuff and chronic pain? But he somehow was able to— and I wish I could remember. Yeah, exactly. I don't think it was like it was one moment, but he was somehow able to kind of get me to accept again that fact of some problems are not going to be solvable, that I need to let go. And letting go of control could actually be freeing versus letting go of control, feeling depressing or sad. That's why I call it the acceptance paradox, because I think when you have a chronic illness, so much of like, it's comforting in the short term to think that you can control things. And that's how you see the language. I'm really fascinated by language. I look at all the language of different programs people are selling. And that's something I loved about you because I love that you have the down to earth, like, we're going to achieve things, we're going to make progress, but we're also going to accept and validate that we've got some stuff going on that's not easy and that's not fixable necessarily. And I think other programs, they try to give people hope by saying, all you have to do is this. Just follow my plan. Oh, you just got to eat vegan or you have to do XYZ. And it's like that which you hold holds you. And that's a quote from Tom Robbins, another author I really like, fiction writer. And the more you hold to this idea that the only barrier to your life happiness is your health condition and you just need to defeat that and then you're going to be able to climb the mountain of happiness. That's not how life works. Life is suffering. At default. That should be our default position, right? That's where kind of mindfulness, Buddhist perspective, where it's like life is suffering, period. We're not going to avoid it. So can you build your capacity to live alongside suffering, to tolerate it? And again, not to say to give up, that you can reduce your suffering and you can reduce the amount of impact suffering is having on your life, but you're not going to avoid it altogether. Yeah. So I guess, long story short, the second therapist, he eventually convinced me, but I still struggle with it. He has to call me out on it sometimes to be like, that's your problem solving brain. Remember, problem solving is really helpful if the problem is solvable. Right. So I guess I would say I believed in the power of it all at a certain point, but I still struggle with with remembering it because I think there's that internal optimist in me that wants to be like, but what if I just did this? Could I just feel happy and good all the time?

Yeah, it's such a good point. I like that you shared that. It's just one of those things for everyone that's going to kind of look different. Like, you're going to have times when you don't accept it or your problem-solving brain, as your therapist says, is going to kick in. Because I think that's our default, our default for our nervous system. Like, our body will naturally just because that's how we're programmed, right? We're programmed to fix, avoid, be safe, run away from bad things, right? And so that's our natural programming to a degree. And so learning how to, like, do that in a way that's actually not going to hold you back and still move forward is such a— it is a skill. Like, that's all I have. Like, acceptance is a skill. Right? It's not a one and done. It's kind of like going to the gym and saying, oh, I got some muscles because I lifted some weights. It's like, hmm, that's cute. That's cute. Yeah. It's going to take a lifelong kind of experience. But I think that in itself is an acceptance piece, is to accept that we're going to be working on acceptance for as long as we're here.

Yeah, and I have this metaphor that I learned when doing some trainings in Acceptance and Commitment Therapy, or ACT. It's the metaphor of the finger trap toy. So I don't know if you're watching the video of this, you can see, but like, you can imagine the finger trap toy is this little like paper kind of wooden thing. You can put one finger on one side, one finger the other side. If you pull apart, then your fingers hurt and it gets stuck. And then if you relax into it, they come together. So the present, you can imagine like on, let's say, your left hand, hand in the finger trap toy is like the present moment. And so you put your— and then your right hand is resisting the present moment is when you pull away from it. You're like, I can't handle this. I can't do it. I have to fix it. I have to solve it. And then the resistance is what causes our pain to some degree. And then when you relax into it and you say, okay, I'm allowing this again, I'm not changing my thoughts around whether I like it or not, but I'm going to make space for the present moment. That's when you relax and then you're out of the trap. I keep one of these literally on my desk just to remind me. Yeah, I think it's like the last thing— this is something I grapple with all the time. The last thing, especially newly diagnosed people want to do, right, is confront the possibility that this is something they're maybe going to have to live with the rest of their life. And the thing is, it's a weird thing because true acceptance in the framework of ACT is about the present. So it doesn't mean that the future— there might be a cure for rheumatoid arthritis or endometriosis.

There might be a cure tomorrow, and then we'll change our approach, right?

I'm not going to not take the cure. If there's a cure, I'm going to take it. But I need to accept not just the specific condition, but the fact that suffering and pain are inevitable in life, whether that's emotional suffering, emotional pain. It's almost like this elephant in the room. We all want to act as if we can. And I think it's part of modern culture and being able to avoid suffering from a young age. We kind of grow up thinking, oh, I guess I just I can just fix everything. It's like, actually, it frees you. That's why it's a paradox. You would think it would be so depressing, and it can be, and that's valid. But it also frees you to say, okay, given that this is going to have inevitable suffering, is inevitable, what can I still do to have a beautiful, full life even with some degree of suffering? Right? It's like, oh, let's put some brain space into that idea versus all the brain space or energy just going towards fixing. Because it's ultimately not going to fully work. We might fix your rheumatoid arthritis or your specific condition, but you're never going to fix the fact that life is going to present you other challenges. Yeah. Challenges.

Other hurdles. Yeah. I think it's to— you just bring up a point that I say all the time to my clients is like, and this is part of the reason why I talk about chronic illness, is like, chronic illness is one of the challenges that we deal with. It's not the only thing. Right. We have other life hurdles that happen to all all of us. And I think the piece of it is that some of us are not able, or we can't see it as being similar or the same because we haven't tapped in our— tapped into our own version of compassion and acceptance for the circumstances that we're in, whether it is chronic illness, whether it is, you know, family issues, whether it's money issues, whether it's, you know, some random accident. All of these things, if we don't know how to tap into acceptance as a skill, as we were talking about, out or self-compassion, seeing someone else's pain that can't be changed is really difficult. And so I think in the world, as you were talking about, like, in general about fixing things and, like, not being, like, suffering, it's like everyone's going through something. It's just not everyone's talking about how they're getting through the something, right?

So true. So true.

We're always talking about the shiny success things that we're doing. I think that happens a lot in business, especially. We hear everyone's wins, but we don't hear, like, the night before Granny died and their cat died and all these horrible things that happened along with it, right?

Yeah. And I think culturally, I would say there's a lot of stories about when you're younger, you learn stories about people maybe who might have— yeah, like someone had cancer or something, and then it's like they either overcome it or they die. And we learn when it's an acute illness, there's not a lot of good stories out there for chronic illness where as a mom, I've had to explain to my child, it's not a consistent thing. Like, I had a leg amputation and it's like, Mommy doesn't have a leg today. She didn't have a leg yesterday. She's never going to have a leg again. That's something you can wrap your head around to accept. I think accepting a fluctuating condition is really uniquely challenging because you're like, Mommy has fatigue, which, first of all, that's so ephemeral and hard to even mean. Mommy's tired. Okay, but I'm tired. I was really tired yesterday. I'm not as tired today. I might be more tired tomorrow. I might not. I might be not tired for 2 weeks and then really tired for a month. How do we calibrate our expectations and how do we explain to other people these fluctuations and the uncertainties that I don't know if I'm going to feel better. And that's, I think, what acceptance— I put a little bullet point to myself to remember to say that I think one of the hardest parts for me to accept was the uncertainty and the sometimes random nature of the flare-ups. And I've literally made little videos on— this is why social media has been so therapeutic, I think, for me and other people. But I'll make a video being like, look, sometimes you can do everything right and still get a flare-up. And I'll get all these comments from people being like, Wow, I'm so glad you said that because I always blame myself if I did something right. If I thought I did everything right and I still got a flare up, it must have been that I did something wrong. But I'm like, what if it's not? What if it's random? What if some cell in your body completely out of your control flared up everything? Not your fault. So it kind of— I don't know, it's been really helpful. Although I still— again, I don't like uncertainty. I wish someone could just give me a roadmap for the rest of my life. It feels like that would be comforting to know this is how you're going to feel. Cheryl, on October 2, 2026, you're going to feel this way and you're going to be able to do this.

Okay.

But we don't have that, so we have to be able to accept that degree of uncertainty.

Yeah, you're so right. You're absolutely right. That piece about the fluctuating condition, especially with chronic and acute things. I often have this conversation with friends who live with chronic illness too. It's just like, yeah, today I can do this, but tomorrow, I don't know, we'll see what happens. Like, I think the acceptance piece of this has been me learning to create that type of reality within my life circumstances of being able to flow in and through that kind of shift. And that's part of the reason why I'm like 100% like a person who's like, if you can have your own business, do. Because— and, and then and base it around that ability to have that fluctuation because the uncertainty is going to be there. The uncertainty is certain. That's what I would just say.

Yeah, that's the only thing for sure.

It's the only thing for sure. We know it's going to be there. So how have you been able to navigate the uncertainty? Wow, because you're a mom, you have your business. How does that look like for you? What has been some ways you've kind of flowed? With that?

Yeah, I think that I am a kind of— my default personality, like, before I got a chronic illness, was like to pack in as much as I could every day, right? I would have, like, on the weekend, I'd be like, brunch with this person, coffee with this person, dinner with that person, go dancing, do this. And that's still my inclination. I've had to learn to plan for, like, 75% of what I want to do. And so that I have buffer zones, buffer time. And it's gotten a little easier as I've gotten older, actually. Because I don't know why, honestly, maybe the pandemic made it easier too. But it's— I think I also just like, I feel the benefits of having that rest time and that buffer time. So in terms of planning a week or planning my business activities versus life, other, you know, outside life, I try to make sure, okay, like if I pick up my son from school at 3:15, like I'm going to put— I'm going to make my calendar availability stop at like 2:00. So that just as a specific example, right? So I have an hour and 15 minutes to like literally lay down or do whatever self-care I need to do at that time.. But that does take a level of acceptance and not denial because I think for a while I was in denial and I was like, I'll just do everything and it'll be fine. There's a real thin line between optimism and what's the word? Delusion. Believe me, it's taken me a long time to be like, I'm a human being. I was running an event called the Arthritis Life Hack Extravaganza with my friend Sarah, who also has RA.. And I remember telling her, I'm so tired today. I don't know why. And she goes, Cheryl, you have rheumatoid arthritis. Don't forget. I'm like, oh, yeah, we both have rheumatoid arthritis. I have a company of all about arthritis. We're talking about arthritis, but I still kind of forgot that that's the reason maybe that I'm tired. It's weird. It's human again to just have these moments. But, yeah, I think planning ahead for rest breaks is and planning. Like, my— again, my inclination, if someone's like, I have this opportunity for you, like, business-wise, like, unless it really is a time, like, oh, they want to do something before a certain date, I'll be like, okay, I'll give them a date that I can meet in, like, a month later, as opposed to that impulse control part of me that's like, I want to do everything right now. I want to say yes to everything. So that's honestly work in progress, like, for me still. Delegating, I think, is also really important that I'm not doing very well right now on. But I think that's probably a good idea.

Yeah, delegating is, it's a beautiful thing. It's one of my friendly things that I like to remind everybody about. Like, it's— yeah, I don't know, like, so this is like kind of going off topic but still topic of delegating because you brought it up, is because we can't outsource like our energy in the context of like planning. Like, we are the ones who kind of know, like, you need that hour and 15 minutes before you go pick up your son. Like, we kind of know that kind of we've created that. But I find that when we start thinking about delegating and outsourcing, people get stuck and be like, well, what do I have them do? Or what, what is it that I need to do? Or, or even the, the concept of, um, it's going to take me so much more time and effort to explain it to them. Like, that's a— that's another one. That's my control type A clients. And I'm like, yeah, but you're still not doing it right now, so it can't be that bad. Like, it can't be that bad if you have them do But what for you is that piece of like that stops you or like is like the hurdle when it comes to outsourcing?

You literally just word for word said it, that the type A client.

Yeah, like that.

I'm like, it's just faster for me to do it. But no, and so I know it's truly true, or it's having the— I think honestly the executive functioning skills, which have taken a hit in recent years for me. Like in terms— I had a car accident in 2016 where I had a concussion, and ever since then I feel like my executive functioning, which is like the CEO of your own brain, right? That helps. They conceptualize ADHD actually as an executive functioning disorder and not necessarily just an attention, because maintaining attention is only one part of executive functioning. It's also about organizing, prioritizing, planning, and response inhibition, which is my problem of saying yes to everything. You need to inhibit that, be able to say no. So I think it's a matter of accepting that I can't do it all well. I want to do it all, but I think it's not really feasible or sustainable to do it all. Also, I do have to say, just being 100% honest, that I kind of have a point of pride that I'm like, I do it all myself. Like, I'm amazing, you know what I mean? And it's like, no, it's not. I am doing a lot myself. I have started delegating. I have Lauren, who is amazing. She's an OT student who helps me like 5 hours a week with my support group programs and stuff. But it's still like the volume I'm delegating is low compared to the volume I'm still doing. So I need to get over myself and be like, it's not worth it to me to say I do it all myself. Aren't I amazing? No, it's not amazing because it comes at a cost. I'm the one at 8:00 PM, my son's like, let's get ready for bed. And I'm like, hold on, one more email. That's not good. You know what I mean? So I can logically look at it, but then when it comes to taking that knowledge and then applying it to actually making a change, that's where things seem to slow down. But I'm like, maybe I'll just make a fun video, or maybe I'll, you know, fun thing come first.

Like, yeah, no, I get it. Yeah, I think to me, I need you.

I need to book a call with you after this. I'll do that.

I think it's a hard thing. I was the same way until I realized that literally the I was like making me worse. Like, my— like, the thing that I actually was already like— so coaching is my, like, superpower, right? Like, my love and attention to people is my superpower. But because I was like trying to do all of these different kind of things all while during a flare-up, or, oh wow, I'm like, can't get out of bed today, like all these random things while I'm trying to prove to myself that I'm better. Yeah, I couldn't even do the thing that I was really good at well. Out. And so I realized, I'm like, I'm not creating any kind of safety in my business or even in the thing that I enjoy by trying to prove to myself that I can do it by myself, because I ain't doing it. Like, it's not, it's not happening, right? And so that's one of the reasons why I like talking about it often, probably on the show, because I, I'm totally that person. Even with a VA, like, my VA has to be like, what can I take from you? And I'm always like intentionally have to just be like, just give it to her, even though you know you can do it. Like, literally, I have to just disconnect myself from it. And then when I do it, I'm like, oh my gosh, why didn't I do that? Like, so long ago? Like, why didn't I do that?

No, that's, that's so true. That's— I did that with, with my own podcast. I did delegate out the audio and video editing. And I was like, I thought it was going to be so hard for me because I like having that control of editing.. And I actually genuinely enjoy the editing process. It's weird, but it's just like you said, once I started doing it, I was like, this is so great to have it off my plate. It's almost easier to just get it completely off your plate than to halfway be still doing it. So you're sure, right? And I also think for me, it's also like if I want to build something that's sustainable right now, the whole castle crumbles if I get really sick with my support groups since I run 4, I'm having 4 groups a week right now. And it's actually kind of remarkable that I haven't had to— oh my gosh, I haven't ever had to— I've rescheduled a couple of them, but I haven't had to massively do that yet. But it's on my list for the future to train other people to facilitate the groups because it is like a standardized process that I do. And so, yeah, there's a lot. Yeah, I think it's part of being like a multi-passionate entrepreneur person is like being so interested in so many things. And I want to do a podcast and I want to do media influencing, and I also run support groups and educational programs, and I also speak at conferences and stuff, and it's like, whoa, you're everywhere, lady. There's inevitably going to be a ceiling at just my own effectiveness unless I get more people involved. So, yeah, thank you. This is like live coaching right now.

Yeah, no, I am just with you on that. I think one of the things I believe, like, I'm sure you especially in occupational therapy, I think there's this something that I learned just in my own journey is like creating safety. Because when we have uncertainty, a lot of times the uncertainty creates this feeling of like always being in that fear-flight brain space. And I have found like my ability to access and create safety for myself within whatever containers that is, whether relationships, at home, in my business, that is what gives me more freedom and like breath and space for my random, certain, unpredictable uncertainty, if that makes any sense. Like, this sounds so like—

no, it makes sense to my brain.

So for me, I'm always like, one of the things I just like leaning into is like, how can I create safety? And when I say that, when I'm like holding against like asking for help or instead of thinking of it as help, I think it— think of it as safety. How am I creating safety for myself by outsourcing this or delegating this? And that thought, just that shift, has been amazing to me because when I think about it from safety, I'm like, oh my gosh, yeah, this totally makes sense. Because what if I— what if I am in the hospital? What if I am this? Or what if all these things that I'm constantly debating, I don't have to worry about that because now I've created kind of like this safety system. And I think that's huge for chronic illness warriors, especially our businesses, because that's a constant mindset thing that's like in the back of our head before we go to bed, thinking like, oh my gosh, what if I wake up tomorrow and I literally cannot do this thing?

Mhm. Mhm.

Right?

Yeah. Yeah. It almost reminded me when you're talking about this of the value of therapy being beyond that 1 hour a week. Like, some people would say, how much can that 1 hour a week really help you? But it's knowing that throughout the week you have that 1 hour to look forward to with your therapist. So same with, I I think it gives you this sense of ease. And I think this in the same way I'm imagining, obviously not through experience because I haven't done this yet, but delegating on a more massive scale than I have would be like, as you're falling asleep, you're like, okay, well, I know that like my VA is going to take care of those things. Yeah. Versus now being like, oh, don't forget this, don't forget that, you gotta do this, you gotta do that. Yeah. So I mean, you're definitely making the case. It's, it's totally a matter of like, it's like that exercise, diet and exercise is like, you know, it's right, it's It's just when are you gonna take the step to do it? That is the mystery.

Yeah, yeah, yeah. So think about it. No, I'm just kidding. Let's try to think about it. Yeah, think about it. Think about how can I create some more—

or commit life, commit to it. I have to— because that's the acceptance and commitment therapy. It's committing to—

yeah, commit to creating some more safety in your, in your business with your delegation. That would be awesome.

I love it.

Well, I love this. I want to know about How is it running your business with RA? Like, you're— and you're like, I feel like this is where I love talking with you when, when we talked, is thinking both of our businesses are about how we live. Like, you know, like, it's not like separate, like, oh, I'm gonna go home and like not worry about this thing that I live with. Like, this is what we live with, do for work. How does that work for you? I always have people ask me that question. They're like, how are you not like bored with it? I was like, that's my life. How is that possible? But for you, how is it all working for you?

Yeah, I mean, so my condition has fluctuated in just in the 4 years since I started Arthritis Life as a business. There's been ups and downs. There's been periods where my joint pain has been worse, period, and fatigue has fluctuated. But right now I'm at a good place with it where my medications seem to be working and I'm doing the lifestyle things that I enjoy that also have a positive impact on my symptoms, like exercise in particular. For me, exercise and sleep are like— and exercise, sleep, and stress management, I guess all three of those go together for me. Nutrition is in the mix, but it doesn't have as big of an effect on specifically my rheumatoid arthritis, just in my body. So, for example, I'm going— actually, even though I was saying I try to keep As an example, keeping time to myself, like 2 to 3 on my schedule. But on Mondays, I go to a personal trainer at 02:00. And so I'm working on exercise and weight training specifically because I made that my goal earlier this year, but I wasn't actually doing it on my own. So I don't know if that's what you mean by balancing it, but for me, it's very much like the reason I started Arthritis Life and I specifically help other people with the same condition I have is that there was this Japanese concept of Ikigai or Ikigai, where it's like the 4 overlapping circles, right? And so for me, as an occupational therapist who was equally passionate about helping children with developmental disabilities as I am helping adults with inflammatory arthritis, the reason specifically that I pivoted to this is because it's what do you love? What does the world need? What are you good at? And then what can you get paid for? But what does the world need?— in my city of Seattle, there are probably 200 occupational therapists that focus on pediatrics. There's no one else focusing on autoimmune inflammatory arthritis or even just like, generally speaking, chronic illness. There's no one that I know of. Right. So it's like, that was the exciting part for me, is being able to serve a niche that is so massively underserved. Now, some people are like, wow, you are always promoting other people that to me, Someone would say they look like they're your competitors. Like, why are you promoting, like, so-and-so else who's an occupational therapist? Because I'm like, I'm excited that there's more than one of us who care about this.

Me too.

Yeah, right. So you're like, it's abundance mindset too. But so for me, it's very exciting. I do have to have— I will say the boundaries I have to have in my head are around, like, there are times if I'm running a support group and there's something that comes comes up that's triggering emotionally for me. Not so triggering that I have to do anything in the moment about it, but something where I have to give myself a little time and space afterwards to emotionally process what happened. And it can be hard with my diagnosis story I mentioned earlier, with the medical gaslighting. When that happens to anyone in my groups, I get so upset for them. I feel that empathy. It might maybe be easier to facilitate a support group for people who have, like, a totally different condition than you have. But for me, the pros outweigh the cons for sure.

Yeah, I love that you shared that because I have some clients that are finding their alignment in that space, right, of finding, like, this affects so many pieces of my life, but also I wish I had this in my life. Like, I wish I had a net— like, you wish you had a Cheryl when you were going through all of this, like, you know what I mean? And that was the kind of journey for me. It was like, I wish I had a— and I had them, but they were like all spread out. They were— it wasn't like in a one spot, like, right, you get all of this support. And so I love that you're doing that, especially for the RA community, because it's such a powerful place to be seen and heard in the experience by someone who's not just talking about it, but has some aspects of understanding what it is like to be living it, right? And it's such a powerful thing. So what's exciting and coming up for you with your business and how can we support you?

Oh my gosh, that's so nice to you. So yeah, I've worked on— I developed a comprehensive self-management program, which is really educational program called Rheum2Thrive, spelled R-H-E-U-M, like room. Like, it actually stands for rheumatic disease. As well as rheumatoid arthritis. But it's really tailored for people to give them, like, with rheumatoid arthritis, psoriatic arthritis, and spondyloarthritis, to give them a kind of a step-by-step guide on how to manage the day-to-day of their condition and thrive. That's why it's Room to Thrive. And Thrive is like an acronym, so it stands for, like, tools for pain and fatigue and habits and all that stuff. But anyway, that's a self-paced course people can go through on their own time, or they can do the course plus a 12-week support group. That's why I was mentioning support group with an additional alumni group after that if you want to keep meeting. And it's been really wonderful seeing the transformations that occur in people who really represent— there's a diverse group. There's people like me who've had it for 20 years but never gotten any support. It doesn't really matter how long you've had it. If you've got no support or no education, then you're at the same place as somebody who was just diagnosed. And there's people—

it's open to people.

Through the country. So my website is like myarthritislife.net. That will redirect you to my website. The actual URL is kind of long. And I also yearly do the Arthritis Life Hack Extravaganza, like a free educational event that's happening in February. It's probably going to be February 3rd, and that is going to be an opportunity to just kind of come together within a webinar style event where you learn basically tips, tricks. This year I'm going to do it as like a day in the life. So walking you through again that day in the life I mentioned earlier, where are all the areas we can implement some life hacks, not just the physical life hacks like using compression gloves or I use like a tripod for my phone instead of holding my phone, for example, but also the emotional coping skill life hacks. It's a little stretch to call them life hacks, but mental shifts, they're kind of like a life hack, right? A reframe or doing a self-compassion practice to improve your quality of life. And I'm also on all the social medias. I like to make TikToks and reels.

Her TikToks and videos are awesome. If you're not following her for any other reason but to watch her be awesome and she's a huge Taylor Swift fan. I love watching your videos. I'm just like, you're having, like, the most fun.

No, it is. It's so fun.

Thank you.

Yeah, edutainment is such a fascinating concept to me where it's like educational entertainment.

Yes.

And so, yeah, I love connecting to people on social media.

Perfect.

Feel free to like and subscribe. No, just kidding.

Well, I'm going to put, of course, all of the ways for them to connect with you on social media online if you want to check out her community and her program. All of that will be in the show notes. But thank you so very much for hopping on and sharing a little bit about acceptance and your journey with RA. This has been awesome.

Thank you so much. I really appreciate you and all that you do to help the chronic illness community. So it's a pleasure to be on.

Thank you.

That's a wrap, y'all.

Thanks for tuning in to Crafted to Thrive, the podcast that helps entrepreneurs entrepreneurs with chronic illness to thrive and build a holistic business and life. Check out our website at craftedtothrive.com for this episode's show notes and all the gifts and goodies. Connect with me on Instagram @thrive_with_nikita for more tips and behind the scenes and more. Tag me to share what you loved about this episode, and I'll feature you on an upcoming episode. So Until next time, remember, yes, you are crafted to thrive.