I'll tell you about the whole system later, but right now let's focus on the red card. It has the major things to do that I'm working on right now. Like the appointment book, it is always with me. These to-do's are the major, non-routine things that really need to get done, probably today or tomorrow. They may be steps that are part of a larger project. For example, right now I'm working on my taxes for the year. That is a major project and will take me over a month to complete. I don't have "taxes" on my red card; I have "get charity info," which is the step of the taxes that I need to do next. In order to make the red card work, I need to look at it as often as the appointment book, at least six times a day. Second, an important rule: I cannot have more than five things on my to-do list. I call this "The Power of Five." If I have more than five things there, what happens? I start to feel overwhelmed and confused. I don't know where to start. I wind up not doing anything. If that sounds familiar, you may have ADD. But there are a lot of things I need to do. Every time I turn around a new one pops up. So it's just natural that I would quickly pull out the card and add the new thing to my to-do list. Then before I know it, there are twelve things on there. Then I feel overwhelmed and confused, get stalled and I'm not doing anything.

So I've been trying to learn to actually keep the list down to five. And I'm getting better at that. If the brain decides that not feeling pain is the best way to protect you, then you will not have a conscious experience of pain. For example, what if you were running away from a tiger in the bushes, and your finger got pricked by a thorn? Your brain would likely dismiss the pain signals from the thorn injury in favour of the more pressing signals that a tiger is chasing you! Hopefully, you are beginning to appreciate how very complex and amazing your pain system truly is (and how hard it is to understand)! The next section will talk about how the message of pain can change over time. This is very important information if you live with persistent pain. Have you heard of the term "neuroplasticity"? It refers to the nervous system's ability to adapt and make changes to itself. The connections between nerve cells can increase or decrease depending on what you do and how you think. In fact, the brain, spinal cord and peripheral nerves are very sensitive to changes and can adapt at an alarmingly fast rate. This explains why the pain system can change over time as a result of injury or experience. Think about the first time you heard a new language, learned a new skill, or practiced a musical instrument. Remember how hard it was to do at first? If you kept at it, you also noticed that, with time and practice, you became better and better at whatever it was you were learning. The reason people can learn new skills and languages is because of neuroplasticity. In the case of persistent pain, the brain can adapt and become better at feeling pain in the same way you become better at anything you practice a lot. If pain persists, even after only 3 to 4 weeks, the nervous system can undergo changes that make it more sensitive to pain. Here are some of the ways the nervous system can change.

In order to do this, all you really need to do is to put the earlier part of the day behind you and to make a promise with yourself either to enjoy the rest of the day or to make it productive. Don't forget the first Golden Rule of Overcoming Procrastination: Always keep the promises that you make with yourself. During our discussions, I became more aware of why I had resisted seeing him. He helped me understand my resistance may have come from the stigma surrounding mental health. He explained how I needed to start looking at myself as a whole person, not just a caregiver, daughter, and working professional. He showed me that life was more than just the hamster endlessly running at a fast pace on a treadmill. He also provided me with reading material for total self-care and recommended that I start journaling. Since that day, I have journaled daily. I will never forget his words, which now seem so obvious but at the time were profound: You are a person with real feelings that needed to be addressed. Eventually, I opened up, realizing just how frightened I was about my health and future. I began to understand how I had swallowed my emotions from the battles I faced with my family, career, and chronic back pain. Most importantly, I wanted to learn how to take my power back, because along the way I had forgotten how important self-care was for me. When you ask yourself `Is this thought helpful?' you are not disputing the accuracy of your thoughts - maybe it was a waste of time, maybe she is trying to wind you up - but right now, regardless of their accuracy, these thoughts probably aren't helping you. They're preventing you from coming up with any solutions. Are you certain? The foundation for coping with ADD is to have an appointment book and a to-do list, to have them with you at all times, and to learn how to use them. I need to review my appointment book and my main to-do list frequently, about six times a day. And I need to keep my to-do list down to five items or I will get overwhelmed and stalled. I keep three to-do cards in my pocket: red, orange, and yellow. The red is the five things, priority.

On the orange card I put the other to-do things that have any priority or urgency, that I need to get to reasonably soon. On the yellow card I put anything that I might get to someday. I don't use this system perfectly; it requires some self discipline, which is something I don't have a lot of (I have ADD, remember?). But I'm getting better at it. It helped a lot to add the orange card. When I only had the red and the yellow, I always tended to write everything on the red, because everything seemed urgent, because I'm not good at setting priorities. Imagine that one day you come home to find that your home had been broken into and that some of your possessions had been stolen. You decide to buy an alarm system so that you and the authorities will be alerted the next time anyone tried to break into your home. Then, imagine that your home was robbed again. You would be likely to turn the alarm system up to make sure you catch the next threat. As you keep turning up the sensitivity on your alarm system, you start getting alerts whenever anyone moves around in your home, even if they are just family members or pets. Besides keeping your valuables safe, the alarm system is now picking up on any non-threatening movements! In the same way, your nervous system's "alarm" can start to react even to signals that aren't actually dangerous. Injured tissues, such as muscle or bone, can cause nearby areas to become inflamed as part of the body's healing response. This inflammation can trigger nearby nerve cells to make more "danger sensors" which will help them pick up any future "danger messages" more easily. After an injury or change in health, the body's stress response (fight/flight) is activated. The chemicals the body produces during stress can also make the peripheral nerves more sensitive to future "danger messages." When the spinal cord gets a lot of "danger messages," it adapts to become more easily excited. The spinal cord then sends a stronger message up to the brain. The more "danger messages" the brain processes, the faster these messages travel, making the brain process pain more efficiently. You can think of this as the brain's orchestra becoming more skilled at playing the "pain song." When I can cross something off on the red card, it makes me feel good, increases my morale.

I feel like I have some control and like I'm on top of things. Then I can move something off the orange card to the red, as long as there are no more than five things there. It helps to number things on the card in the order I plan to do them, and to keep it neat and easily readable. The red card, with the list of five, is the key. The three colored cards are always in my pocket. When something comes up or pops into my mind I can put it on the appropriate colored card. But things are not that simple. I have a whole card system in my pocket, and I have other lists. The next step is to confront the certainty with which you feel your thoughts are absolutely right. Remember, if you are in the habit of negative thinking, it has become your default position - your mind automatically takes and accepts a negative perspective without considering any other options. So now you are challenging your mind's automatic negative perspective and recognize that there are other possibilities. Here are some questions you could ask yourself: Am I positive that what I'm thinking is true? What evidence do I have for how I'm thinking about this situation? Do I know that for certain? For example: Think for a moment of all the Internal Revenue Service workers who depend on receiving and processing your tax forms in order to earn a living. When you file your taxes, you're helping someone at the processing center to earn wages, and that's a very good reason for making the sacrifice of the time and energy that you spend in filing out your return. Finally, perhaps the best reason for making a sacrifice is to experience the positive feeling that you'll receive from taking care of yourself. All that sitting down and tallying up of figures, the filling in of those governmental forms with their check boxes and signature lines; they all turn out to be worth do-ing after all! For persons like ourselves, it's not only the best reason for accomplishing any task, but it's especially true when it pertains to a task that we particularly dislike. Remember: Every task has a silver lining.