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Mommy moments come in all forms of days at the park, backyard BBQs, or meetings at the pool. They are a great time to get to know other mothers and share activities as well as advice. But as the number of women who live with chronic illness such as chronic fatigue syndrome and lupus continues to grow, so does the spontaneity of the fun of these mommy moments.

For example, according to the National Fibromyalgia Association, fibromyalgia (FM) experts estimate that about 10 million Americans and approximately 5 percent of the population worldwide suffer with FM, one of the fastest growing auto-immune diseases in the USA. I recently attended an adoptive mom’s playgroup and within this niche group, three out of the six of us had chronic illnesses. Being aware of a friend’s limitations and challenges, acknowledging them, and just asking questions, can make a huge impact in their ability to participate and feel comfortable with their peers.

[1]. Ask what time of the day is good for play-dates or activities. This can vary from season to season (weather affects it a great deal); and also from one illness to another. For some moms, mornings are good and afternoons are exhausting; for others it’s the other way around.

[2] Be adaptable and don’t make her feel guilty if she must cancel your plans. When one lives with a chronic illness, one never knows what may change moment to moment. For example, last week I just took a normal step, but it resulted in my knee being locked up for four days. Despite all the medications and therapies, all my plans had to be cancelled and my husband tried to pick up the pieces of my son’s schedule while he also worked from home.

[3] Ask her to clarify what she’s comfortable doing. For example, you might say, “How far do you want to walk today?” and try to accommodate. Even though you can see the park from your house two blocks away, she may not be bale to make it. Stairs may be impossible, and I won’t even take escalators any more because of my knees, so take the elevator with her. Walk at her pace, recognizing that she may have to take rest stops every few minutes even though you’ve only walked fifty feet. Do her a huge favor and chase after her kids for a few minutes. Standing for longer than a couple minutes may also be a challenge. Despite the pain of walking, it’s better for me than standing. Even though the line at the carousel looks like it’s only five minutes, she may need you to offer to stand in line and then let her jump in beside you at the last minutes.

[4] Show some interest in what she deals with but ask politely. For example, say, “What is your greatest challenge?” Avoid sharing with her about the many cures you’ve heard about on TV and in the magazines for her illness; don’t try to sell her products from your trunk that will cure here overnight; and don’t think that it will encourage her to hear about your mother’s cousin’s sister who has the same illness but still manages to raise four children and work a midnight shirt at the local hospital because she “refuses to give in her illness.”

[5] Remember that simple things may be difficult for her. For example, if you go to the beach, ask her if she would like to be dropped off while you find a parking spot. Many people are unable to plop down on the ground, so bring a few lawn chairs so she isn’t the only one two feet above everyone else. Sun and heat can bother her so she will need to find shade. Don’t expect her to carry three lawn chairs, a cooler and your fourteen-month old daughter, even though you can carry all that and the dog. You don’t want to make her feel helpless, and she doesn’t want a fuss, but be aware that she may need a few extra considerations.

[6] Don’t presume that she can watch your children diligently, even for five minutes, unless she volunteers. Taking care of kids is exhausting and caring for her own may be draining the little strength she had left. Plus, if your kids are run out into the street, keep in mind that she may not physically be able to sprint after them as fast as you could.

[7] Plan things that she can participate in. Even though you may think nothing of inviting her to your stroller exercise group, and mommy and me aerobics classes, these are not likely options for her. Discover what kinds of things she likes to do and then see if you can join her. And don’t try to set a record for the longest outing. Keep the activities under three hours or at least let her know that she’s welcome to go whenever she wants. You may like six hours watching the elephants, but she’s going to need to get home and recover from the outing. Don’t try to encourage her to stay longer by saying “A little more exercise might really help you feel better!”

[8] Lastly, tell her what every mom longs to hear: “I don’t know how you do it. I really admire your perseverance and strength. You’re my hero.