chronic illness coping coping with disability

Chronic illness and the art of pacing

Chronic illness and the art of pacing.png

Me: I’m going to clean the house in One day!

Body: Hell no, you’re not.

Me: Yep, getting started now.

*Does one thing*

Body: Here is some fatigue and pain for you. Price of that one thing.

Me: Damn it! 

Fact is, everything has a price and cost. And you have a couple of bucks in your body’s account to spend on what you want to do in the day. But even getting up has a cost. Doing routine things has a cost. Anything extra? More cost. So we have to spend carefully. And budget our time and energy. It doesn’t mean doing nothing at all, but it does mean carefully considering what we do and how we go about it.

  • Consider breaking up large tasks. Want to clean the kitchen? Great! But maybe do it in sections over the course of a few days.
  • Want to go out and socialize? Awesome! This is important to our wellbeing. But consider what you will be doing. The amount of rest you will need before and the recovery you will need after.
  • Want to start exercising? A fine goal! But start slowly to see where your limit is and increase at a slow steady pace to not exceed your limit.
Pacing isn’t just for Bad Days

Often we think I Have to pace on a bad day because my body limits what I can do. But on a good day, I can be far more productive. This isn’t right. Because if we do too much on a good day, we cause bad days. And it ends up with this wave of good days, doing too much, and a lot of recovery days, and we can’t do a thing. Whereas if we pace all the time, no matter how we feel, we can lessen the effects of bad days caused by overdoing it. ( See Boom and Bust cycle) Pacing is a chronic illness lifestyle, my friends. It is a coping method to be utilized all the time to manage our fatigue and pain.

Do not exceed limits by doing things in moderation

Our limits are a tricky thing in that one day we are capable of more than another day. And knowing where that limit is, is very difficult. The idea is to moderate all the time to never really exceed that limit. You can nudge it, but not exceed it. No cleaning the house in one day. But you can plan to do a certain amount of housecleaning every day, good or bad. My mom suggested the 10-minute rule. Do 10 minutes of housecleaning a day, good or bad, in different focused areas. And on days where we feel good, with our pacing considerations in place, we can do one or two additional tasks to nudge where our limit is. Any fatigue or pain that is over baseline is an indication you may be exceeding your limits. Be conscious of that fact. Sometimes it is just awareness some things cause muscle aches. Like exercise. But there is an alarm zone of fatigue and pain that warns you you are at your limit. You never want to go past that zone as it generally leads to a flare of symptoms. Spreading activities over the week into smaller more moderate tasks is a way to pace and to not exceed those limits.

Fatigue management is as important as pain management

Often we pace according to levels of pain but push through fatigue. And this can lead to excessive amounts of fatigue where we cannot do anything at all. Chronic illness is also about fatigue management. It is about taking breaks to rest during times of activity. It is about napping to give you a boost before an activity you know you will need energy for. And it is about pacing to manage fatigue as well. Activities have a cost in energy for chronic illness and we have to be aware that we have a limited amount of energy even if we are having a good pain day. This is one reason pacing every day is vital.

Pacing doesn’t mean lack of activity

On really bad pain days, yeah, self-care is far more important than activity. But doing things; exercising, socializing, general chores… all matter in their own way. I find when I lack the motivation to do things, generally due to depression, I feel guilty for my lack of productivity which feeds the depression. For my wellbeing, I had to establish a Basic Routine for the day. Get up. Get dressed. My ten minutes of cleaning. Work on writing. My exercise (which is futile at the moment with vertigo, but generally a little bit of it goes a long way). And cook dinner. On good days I’d do more, but I’d stick to my basic routine to keep up some general activity. I did a daily health journal to keep track of at least one accomplishment a day and one goal for the next day. For me, lack of activity feeds my depression and keeping to a general routine helped me with that on bad days. Because with depression… you don’t want to do anything, but when you don’t you mentally punish yourself for it. So routine is my friend.

Pacing means not feeling guilty for lack of productivity on bad days

For me, yesterday was a very bad day. And I could do nothing but endure the pain. I got nothing done. And that is fine. High pain is something we have to carefully manage with self-care, all the techniques of coping, and pain management strategies we have. That itself is hard work. Just trying to not get into a mood funk is hard work for me. High pain is something my depression loves. So I have to be careful. There is no room for guilt. This is just a fact of life. It is also the same for high fatigue days. Problematic symptom days and flares. It is a time of coping.

The art of pacing
  • Pace on the good days and the bad to prevent Boom and Bust flares
  • A basic routine is actually good for wellbeing
  • Stop feeling guilty for bad days. Those are the days you are working damn hard to cope.
  • Napping is one way to manage fatigue
  • Resting breaks during the day help with fatigue management, pacing, and pain management of the activities you are doing.
  • Pacing to manage fatigue is just as important as pacing to manage pain
  • Spreading your necessary activities through the week helps you pace
  • Moderate activities to not exceed your limits

 

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9 comments

  1. Something that I think others who are well don’t understand is that “Pacing isn’t just for bad days” – whilst hubby does get it, the rest of the family are another matter…..mind you, the adolescents are probably the best at pacing themselves all day, every day, whether they need to or not!
    Being serious though, my 3 all suffer with fatigue and the eldest (22) & youngest (15) are both really stressed by difficulties with fatigue & concentration whilst studying for exams. Tricky! Thanks for the post, Nikkix

    Liked by 1 person

    1. Pacing for me can be tricky if my fatigue is good that day. Then I think I can do so much. I have to really hold myself back from going overboard. But yeah it is harder to manage with the stress of exams.

      Liked by 2 people

  2. Pacing yourself is so very important, I have found that it is so difficult to accomplish this on your not-so-bad days. There are sooooooooooo many things that need attention, it does get overwhelming.
    Thank you for a great post.

    Like

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