I rubbed the palm of my left hand with my right thumb. Circle after circle after circle. I could barely focus on what everyone was saying through the pain. If I moved, I might throw up.

I was sitting in small group  (back when we squished on couches in the same room — remember those days?), and we were discussing something from Genesis. I think. I was a little preoccupied at the time. 

But the guy sitting next to me noticed my rubbing (which was getting more frantic), and put his hand on me. “You okay?” 

I glanced over at his whisper and shook my head. I wasn’t okay. Eventually, I made it to the bathroom, knelt on the floor and cried for a while, and administered the treatment that calmed the adrenal issues I was having at the time. But it stuck with me that he’d even noticed.

If you know a chronically ill person, I have a small tip that will make everything smoother. It’s not complicated. It will just take some paying attention. But it will make a difference, and it’s a huge way you can support your chronically ill friend or family member.

Pain signs can come in many different forms, and they tend to look different for each chronic illness warrior. There are obvious, universal ones. For example, crying. Or making sounds of pain. But often, spoonies will have unique, subtle signs that they are in pain or that their pain is increasing. 

It also might not indicate pure pain, but organ issues or a chemical reaction or rising nausea — some kind of discomfort, whether it’s pure pain or not. 

Learn to identify your spoonie’s pain signs. Doing so will help you gauge how they are doing and when they need your support and help. Especially in social situations where a spoonie is unlikely to verbalize their needs in front of everyone. 

Also — this might sound strange to someone who has never experienced a chronic illness — but sometimes spoonies will exhibit their pain signs but won’t even notice their pain is rising yet until it reaches a certain threshold unless you call their attention to it. 

Some spoonies might not even know what their pain signs are, others will be distinctly aware of them. When you recognize a pain sign, check on them! Don’t ask them every thirty seconds how they are doing. But pull them aside (or whisper to them) and see if there is anything you can do to help. (Even if that means leaving them alone.)

Pulling them aside is crucial, especially if you’re in front of a lot of people — most chronically ill people tend to prefer to not make a big deal out of something in front of everyone.

That night, I made my way to the bathroom, dealt with my issue, wiped my eyes, and came out bubbly and cheerful like nothing had happened. Afterward, several people in the room came up to ask how I was, but I was glad that I didn’t have to explain it in front of everyone. 

It will take some time, but learning to recognize your spoonie’s red flags and pain signs (and respond appropriately) is such a big way to support them.