ALPIMS Flare & Event Planning Toolkit
Adapted from relapse and event planning methods used in ME/CFS and fibromyalgia care, this version is designed specifically for individuals living with ALPIMS-related conditions. ALPIMS stands for Anxiety, Laxity, Pain, Immune, Mood, and Sensory dysregulation.
This toolkit contains two parts:
- ALPIMS Flare Reflection & Response Worksheet
- ALPIMS Special Event Planning Worksheet
1. ALPIMS Flare Reflection & Response Worksheet
A. Flare Triggers by Domain Record factors that intensify symptoms within each ALPIMS domain. Examples:
- Anxiety: conflict, overstimulation, uncertainty, overstretching expectations
- Laxity: overuse of hypermobile joints, skipping supports/braces, posture strain
- Pain: overactivity, poor sleep, weather changes, prolonged screen time
- Immune: exposure to allergens, food sensitivities, infections, poor diet
- Mood: lack of routine, emotional invalidation, negative self-talk
- Sensory: bright lights, noise, textures, chemical smells, multitasking
B. Warning Signs by Domain List early indicators that you’re heading into a flare. Examples:
- Anxiety: racing thoughts, shallow breathing, muscle tension
- Laxity: joints feeling “loose,” instability, clumsiness
- Pain: head/neck/thoracic soreness, flaring nerve pain
- Immune: sore throat, flushed skin, nausea, histamine-type symptoms
- Mood: flatness, irritability, internal shutdown
- Sensory: light/sound sensitivity, disorientation, aversion to touch or food
C. Responses to Warning Signs Plan actions that support recovery when warning signs appear. Examples:
- Lie down with legs elevated (autonomic reset)
- Switch to audio-only input (reduce visual strain)
- Apply cold or heat to calm mast cell or nerve flares
- Text someone for co-regulation
- Use noise-canceling headphones
- Take a break in a low-sensory zone
- Hydrate, eat a simple snack, or take stabilizing meds/supplements
- Engage in a gentle grounding practice (rocking, humming, weighted wrap)
D. What Helps Prevent Flares? Daily stabilizers across domains:
- Anxiety: predictable routine, DBT skills, breathing exercises
- Laxity: braces, ergonomic seating, joint pacing
- Pain: warmups, microbreaks, scheduled rest
- Immune: clean diet, safe environment, pacing after exposures
- Mood: emotional validation, pleasure routines, journaling
- Sensory: sensory diet, environmental controls, tech filters
2. ALPIMS Special Event Planning Worksheet
Event: ______________________________________
A. Before the Event
- Reduce output by __%
- Increase rest periods to ___ per day
- No extra appointments or errands in the ___ days prior
- Confirm safe foods/environment/clothing for event
- Communicate limits in advance
B. During the Event
- Limit activity to ___ minutes per hour or ___ hours total
- Set timer for pacing and sensory reset
- Use comfort aids (fan, wrap, shaded glasses, headset)
- Scheduled rest breaks or quiet zone access
- Have an exit plan if flaring begins
C. After the Event
- Plan post-event rest days: ___ days of limited activity
- Avoid new obligations during recovery window
- Use calming rituals to decompress (bath, journaling, nature)
- Reflect using Flare Worksheet if symptoms increase
Reflection Notes: What helped most? What will you do differently next time? How did each ALPIMS domain respond?