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February 27, 2002
By Virginia Haydon
A pace is just a single step. But M.E./CFS (Chronic Fatigue Syndrome) sufferers can take heart in the knowledge that ‘pace’ also means ‘a rate of progression.’ Virginia Haydon suggests planning out defined periods of rest and activity – and sticking to them.
Pacing is difficult to achieve. Forced by the very nature of the illness to do next to nothing for hours, days or weeks on end, the temptation to make a break for freedom at the very first sign of any energy is virtually impossible to resist. But pacing demands that we do just that. It’s about achieving the right balance between different types of exertion and rest periods. And it can help sufferers achieve ‘some gradual recovery’ according to Dr. Anne MacIntyre.
So how do you go about managing your precious energy levels?
Establish a Routine
One aim of pacing is to make activity and rest patterns more consistent. It’s all about staying within energy limits without over or under activity. Pacing can help sufferers avoid the ‘boom and bust’ cycle that delays recovery.
Work Out What’s Right for You
It can be helpful to plan the same amount of activity and the same amount of rest every day. For this reason it is crucial to set your initial levels within your own personal comfort zone. They must reflect what you are already doing, not what you wish you were able to do. Listen to your body, or the levels won’t be realistic. If possible, avoid doing too little, as this can lead to deconditioning.
Making detailed daily activity diaries and noting how you feel can help you on your own personal tolerances. The diary can also help highlight what level of activity if possible without suffering ‘pay back,’ which can be delayed by up to two days.
Set Clear Goals
Writing down your goals will make it easier to fix them in your mind. Specific daily targets according to your energy levels might include:
-Getting up and going to bed at the same time
-Walking for ‘x’ minutes per day
-Not taking phone calls after a certain time
It’s worth remembering that activity needn’t just be physical or mental. Emotions take their toll on energy levels, too: that’s why we feel so exhausted after a long hard cry.
It can be helpful to grade activities into high, medium and low energy. Then set down guides of how many of each grade activity you feel able to do on a daily basis. Include clearly defined rest periods.
Recognize that simple tasks like getting washed and dressed are physical, too, and should not be underestimated. And be aware that seemingly harmless deeds like watching TV, reading or chatting on the phone can drain the brain. All these things must be taken into account and rationed into your daily activity allowance. Likewise, avoid doing two things at once, e.g., watching TV while talking on the phone.
Rest Must be Restful
It is essential to achieve quality relaxation in your allotted rest times for it to be beneficial. Forcing yourself to sit down and do nothing while your mind is racing, or you’re still tense of worried, won’t necessarily replenish ‘batteries.’
Use breathing, relaxation or meditation techniques; listen to gentle music or lie in a dark room. Whatever your technique, make sure your rest is truly calm and as refreshing as possible.
Organization and Planning
These are the key words to successful pacing. Setting yourself a program of rest and activity periods throughout the day is one thing; sticking to it is the hard bit.
It helps if you plan your week ahead as well as each day, making a note of what you want to achieve and then prioritizing what matters most to you.
Remember to allow sufficient time to complete tasks. There is immense satisfaction at being able to tick off a successfully achieved task, no matter how simple. Being overambitious only leads to disappointment and frustration. If things are going well, don’t be tempted to do more than you planned, particularly on a good day. Likewise, don’t be too disappointed if you are faced with a setback. Aim for consistency.
However, it helps not to be too rigid: life always throws up unexpected situations and flexibility can help you surmount them without your schedule disintegrating before your eyes.
Don’t Feel Guilty!
Accepting your limitations is a huge step on the road to recovery. So is the ability to stop activities which, in hindsight, are wasteful of your energy. Examples might include spending time with people who drain you or feeling the need to vacuum before family come round.
However, be wary of allowing those things that give you the most pleasure to be squeezed out of your schedule to make way for more ‘worthwhile’ activities. Try to get a better balance of enjoyable activities and chores on the same day. Don’t allow yourself to be driven by guilt because you feel you’re not doing enough. But remember Dr. McIntyre’s advice: ‘Stop before you even start to feel ill, and save some energy for getting better.’
Source: InterAction issue 39 – January 2002. InterAction is published by Action for M.E. Web site: www.afme.org.uk
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