Chronic Fatigue Pacing

What is chronic fatigue pacing?

Pacing is an evidence-based strategy that helps chronic fatigue patients keep as active as possible to limit the complications of inactivity while avoiding the relapses that result from over exertion.

Breaking the Boom-Bust Cycle

Many of us with chronic fatigue fall into a boom-bust cycle We have our good days, and we have our bad days. On our good days, we try to play “catch up” and tackle as many of the responsibilities we had to neglect during our bad days. What happens next? We crash! Our bodies force us into recuperation, and we can't do anything again. It becomes a one step forward, two steps back process. We end up worse off than before.

Pacing is a way to break the boom-bust cycle. Chronic fatigue pacing requires discipline and organization, but the theory is simple. Pacing is the practice of alternating periods of activity with periods of rest. The key is to listen to your body and stop as soon as you become unpleasantly tired.

The 50% Rule

A good place to start pacing is by applying the 50% Rule. Only tackle half the activities that you think you are able to. Do you think you can manage two loads of laundry today? Only do one. Do you think you have enough energy to shop for two hours? Shop for one hour only. Do you feel up to going out with friends and seeing a movie? You may have to choose between the two activities.

Balance Your Activities

The main goal of chronic fatigue pacing is to never exceed your energy limits. You can do this by balancing your activities. Divide your activities into three categories: 1. Things that require energy (such as chores, socializing, or shopping), 2. Things that renew energy (such as sleep or resting quietly in a darkened room), and 3. Things that are energy neutral (such as reading or watching TV).

Then, balance the time spent doing each activity, and make sure that your energy input equals or exceeds your energy output. Everybody has their own balance. For some, reading a book may renew their energy; for others, it may require energy. Listen to your body to find the right balance for you.

Every Hour, Every Day, Every Week

Apply pacing to every hour, every day, and every week. For every day activities, try breaking larger tasks into smaller ones so you can take frequent rests. Make sure you rest before and after more demanding tasks each day. If you have a big event coming up, plan a relaxing day before and after. Again, listen to your body's signals and be flexible. If you begin to feel poorly, rest!

Prioritize and Delegate

Prioritizing and delegating are skills that few of us have mastered prior to getting chronic fatigue. If you were like me, you were the “go to” guy with a long To Do list. It never crossed your mind to hand off responsibilities to anyone else! Although you are certainly more limited now, you can still accomplish the most important things by prioritizing and delegating to others.

Here is how I learned to prioritize and delegate.

First, I purchased an inexpensive day planner. I chose one that listed the hours of the day so that I could specifically schedule activities.

Next, I asked my family to let me know of all their activities for the week. I also wrote down all of the scheduling obligations I had.

Armed with this information, I then made a list of all the activities that were asking for my attention that week. I included my family's activities and my obligations, but I also wrote down activities that were just for fun, like reading, or that were mundane but necessary, like housework.

Looking at this list, I then rated each item on how Urgent and Important it was. For example, my pantry was bare, so going food shopping scored an 8 on both urgency and importance. Vacuuming the living room, however, scored a 3 on importance and a 1 on urgency. Reading was a 10 on importance, but a 1 on urgency.

Next, I considered the list and asked myself, “Where do I need help?” and “Who can help me with this?” I could ask my husband to pick up groceries on the way home. I could ask my children to help with the housework. I preferred to go to back to school night myself, but if I was feeling bad, I could delegate that to my husband. Preparing a talk for church, however, was something only I could do.

Finally, I began scheduling my activities. I penciled in the most urgent and important activities first. I then sprinkled in less urgent and important activities. I made sure to leave large blocks of time available between activities to rest up. And I made sure to surround my busiest and most demanding days with easy days. I also made sure I had a back up plan in case I started feeling bad again.

See? Organization and discipline! But the rewards are more than worth it!

Do Something You Love Every Day

One final word about pacing. Chronic fatigue can be severely limiting. You may find that you have very little energy to do much of anything, and you may be tempted to spend what energy you have on things you feel “need” to get done. Do not neglect the things that make you happy! Make sure to do at least one thing you love every day. You will then be able to hold on to more joy while battling this disease.

Source: “Diagnosing and Treating Chronic Fatigue Syndrome,” by Dr. Sarah Myhill, MD, updated January 2009.

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Go to Chronic Fatigue Lifestyle from Chronic Fatigue Pacing