How to Pace with
Chronic Fatigue

Pacing with Chronic Fatigue

Pacing is probably the best way live with, and manage your Chronic Fatigue.  If you live with chronic fatigue, you’ll understand that it isn’t an illness and that it’s  best defined as a symptom of numerous illnesses and conditions.

Pacing in itself, is a skill that needs to be learned. Here I’ll discuss how to pace properly and a few hints and tips as well as a few tools that will making pacing for chronic fatigue easier.

Table of Contents

About Chronic Fatigue

What is Chronic Fatigue?

Chronic Fatigue  hasn’t really been defined, and can have different meanings in different circumstances. The  problems with the definitions are covered quite well here.  The Oxford English Dictionary defines fatigue as `lassitude or weariness resulting from either bodily or mental exertion’ (Oxford English Dictionary 1989).

For the purposes of ME and maybe Long Covid I’d modify the definition to;  Mental and physical lassitude or weariness resulting from mental, physical or psychological activity or stress on a body that has lost the ability to recover or cope due to illness. (this is a work in progress and I will probably refine it).

What Causes Chronic Fatigue?

Chronic fatigue is on a lot of peoples minds at present, as it is one of the main symptoms of Long Covid. There are numerous reasons for Chronic fatigue,

  • from easily investigated ones like diabetes
  • serious illnesses such as cancer. 
  • medication reactions
  • any organ system in your body, for example heart and circulatory problems can cause chronic fatigue.
  • It’s also possible that your diet and other lifestyle factors can lead to chronic fatigue.

The point of this mini list is to illustrate that there is no one cause, and if you’re not sure of the cause, then you may need to get it investigated as some reasons are easily treated. You’re better off getting the cause treated or managed if possible  than trying to live with the consequences.

How to live and pace with chronic fatigue

The best way to live with Chronic fatigue is to learn to pace properly. The best instruction I have heard on how to pace was from Raymond Perrin, who says, “Think about what you can do and then do half”

Practical Ways to Pace

A good example of a practical way of pacing is to try and break tasks up.  For example If you want to vacuum a room, the end task is a clean vacuumed room with the furniture back where it’s supposed to be. This could be broken in to steps that we could rest and recover inbetween.

  1. Pick up anything you don’t want to vacuum up. (clothes and rubbish that’s too big or will block the vacuum)
  2. Carry the vacuum cleaner into the room
  3. Move furniture you want to clean under out of the way
  4. Vacuum
  5. Move furniture back
  6. Vacuum where the moved furniture was.
  7. Put the vacuum cleaner away.

This is quite a long list for something we would normally consider an easy task, but you have to adjust and compensate for your fatigue. As Paul Garner recently said about managing his Long Covid linked chronic fatigue, “Don’t try to dominate this virus, accommodate it”. There are many other activities that we could also manage in this way.

An old patient of mine also suggested you don’t have to do the full task, the example they gave was ironing. In the past, they may have tried to do the whole ironing pile, now they’ll only iron what’s needed for now and follow the step approach to getting the iron, ironing board and ironing together.

With the tips so far we’ve looked at breaking things down to make the tasks  manageable. Here we’re going to consider making them bigger (sort of!).

Good home cooked food, where you can control the ingredients and make recipes to your preferences, can often help as part of making you feel better. The trouble is that cooking every meal from scratch can be very fatiguing.

It taxes in every way. You have to concentrate on the recipe. Making sure of the ingredients, timings and heat. You have to stand there preparing and cooking it (do you have a bar type stool that you could maybe site down on?) There’s also the stress of how it will turn out too.

To cope with this you can try batch cooking and freezing (you can even freeze grated cheese or chopped onions). Make a larger amount than you need and split it into individual or family sized portions before freezing. This will mean you have food ready to heat and eat at at later date where most of the effort has already taken place.

You could also try making a basics, like mince and onions. This could later be a cottage/Shepard pie, bolognese, a chili, or a moussaka, it could even be the start of an Indian dish. Imagination and a good cookbook would help you with more of these.

I’m sorry if these don’t help with all aspects of your life. Dogs still need walked and children still need parents and these are the things that can’t be batched or cut into handy steps, but by making use of the time when kids are at school or nursery to rest and recover, we stand a chance of having the energy for when they’re at home. By batching and doing things in steps it also means we stand a chance of surviving our life.

Tools to Help You Pace

We can use our heart to assess how well we are. One of the easiest ways of measuring how well or how well recovered you are is to take your resting heart rate. This is usually taken when you’re sitting down resting. Any increase in your resting heart rate, potentially means you’ve overdone it, or maybe you’re coming down with something and you should back off or rest more.

All this really need is a something to count the seconds and an ability to find your pulse. Also something to mark it down. Lots of sports watches now have either the ability to take your pulse or the option to add a sensor to measure it. Some will even alert you if your pulse goes above a preset point. This can also be done with mobile phones too.

If we’re considering mobile phones it would also be good to look at HRV or heart rate variability. There are some great apps and sensors that can be used for this. You can even use the light on your phone, shining through your finger as the sensor  for this.

HRV really needs a post of its own, but for now the short answer is, it’s measuring the neurological control to and from your heart to assess how well you are rested from a whole body approach. If you want to read more about HRV try this. It’s worth remember though, that as a way of monitoring and managing your fatigue, it doesn’t work for everyone.

If this was helpful please let me know in the comments section below. If there’s any more information, or if you think I’ve missed anything out I’d be delighted to hear too.

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