I'm a disabled artist with CFS/ME, a complex nuero-immune metabolic illness that causes me to be limited to my house and often my bed. Explore my life making art with CFS/ME through my blog and videos!
Feb 24, 2019 | Posted by Zeraph
What IS the optimal level of risk-taking when someone is trying to heal or improve their health? What can we learn from other fields that study risk-taking? And perhaps most importantly, how can we improve our odds of success?
I talked with a friend today about something we have in common. Both of us tend to be risk-takers. And, both of us sometimes struggle to know which risks are going to be good for us.
I think a lot about risk-taking behavior lately, as one possible lens to understand how to manage and heal chronic conditions.
With ME/CFS, there are many possible treatments, and each of them is a risk.
Sometimes that risk is financial, sometimes physical, sometimes emotional. Often, it is all three.
Yet these risks also might yield rewards. We sometimes hear of someone who has gotten well through one treatment or another. Some people relocated to a mold-free environment, living out of a tent or RV or moving to the desert, on the basis that their illness was caused by an inflammatory overreaction to even small amounts of mold. Some people have tried one of the often-controversial cognitive rewiring programs. Others had big improvements from more common approaches, like low-dose naltrexone (LDN).
Yet often, we also hear of people who have not gotten better or have been harmed. These stories can be scary. For some patients, the fragility of their health combined with the lack of satisfactory options has made them risk-averse. They take few or no risks in order to conserve the level of heath they do have.
Personally, I want to take the right number of smart risks with my health in 2019. These risks might be medications, programs, even new mental frameworks. I know that some risk-taking is necessary if I want to improve. But how can I determine which risks to take? And how often should I try something new?
As I explored this question, I began to wonder if there were answers waiting in the science and mathematics of risk-taking. After all, risk is a concept that is studied in several fields, and surely someone had put plenty of thought into these very questions.
As I began to research, I recalled a phrase I’d heard used in the sciences: Risk tolerance. It seemed like a good place to start.
Risk tolerance is the amount and type of risk that someone (or something) is willing to take to meet their objective. As a concept, it can be studied in human beings, in animals, and in organizations. (Pretty much anywhere decisions get made!) It’s a common framework for making decisions around financial investments, for example.
When risk tolerance is high, losses don’t cause much panic; when it’s low, any loss can feel catastrophic.
Juni Daalmans, author of Human Behavior in Hazardous Situations, writes that humans evolved to have a moderate risk tolerance. Though risks do lead to problems sometimes, and even death, it was necessary for our ancestors to take some risks to acquire enough food to survive.
Crucially, they also had to take the right risks, by observing the world carefully to notice patterns.
Of course, not every human, nor every animal in a species, has the same risk tolerance. As with many other things, diversity means that different individuals prefer more or less risk. Linnér et. al (2019) reported on 124 genetic variants associated with risk-taking behavior, but also noted that the environment plays a significant role. Though some of your risk tolerance is established before birth, you can influence your risk-taking behavior.
From my perspective, it’s essential to take some risks on a regular basis to improve my health. And my risk taking tolerance is reasonably high, even with the risk-averse part of me that has been formed by years with ME/CFS.
Currently my health is in a very slow improvement. That’s great, but if I want to recover faster, I should take a good number of risks in 2019— maybe even as many as one per month. That’s a lot of opportunities for improvement, but also a lot of cumulative risk.
Businesses face risks all the time, too, and luckily for us, they have made a science out of evaluating and minimizing them. Two of their risk-minimization strategies are relevant here: Transfer and mitigation.
Transfer is when you cause some other entity to bear some or all of the risk. For example, if I choose to try a new supplement, I can find a reputable company that offers a money-back guarantee if it does not work, or free product to try. In this way, I force the company to assume the financial responsibility if the supplement turns out to be a bad investment for me.
Mitigation is a way to lessen a risk. If there is damage from a risk, mitigation will limit that damage. If a new supplement may cause a side effect, is there a way to limit the damage from that side effect? If I have to travel in order to access a new treatment, how can I make that travel as easy as possible? Often, people with chronic conditions are very creative in mitigating risks.
Beyond that, there’s probably the biggest way to minimize potential risks, which is research. Research can help us take the right risks. But research is also complex: There are many voices speaking. Some are applicable to our unique bodies and some are not.
Some, unfortunately, just want our money.
The research I do now is very different from the research I did when I first got this condition. The average person’s casual research skills just won’t cut it when it comes to navigating a medically unsolved condition. There is a learning curve, and it can be both steep and treacherous for the beginner.
I admit, I was looking for a solid answer. I was hoping that mathematics had some wisdom for me about the optimal number of risks to take in order to persevere in the end. I wanted some clear-cut numerical wisdom. I haven’t found anything quite that definite about this complex issue.
What I learned, however, was that the optimal number of risks to take in the modern world depends on the situation, but if the risks are reasonably good risks, it’s often good to take many. One’s cumulative chances of success rise with each risk— as long as you can weather the negatives. And that will come down to your individual body, bank account, and risk tolerance.
What is your risk tolerance when it comes to your health? Is your risk tolerance changing over time? Would you change anything about how you approach risk?
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Feb 03, 2019 | Posted by Zeraph
Yesterday was one of those days I didn’t feel like doing anything. I felt crappy and headachy and lazy and tired.
I was recovering from a minor ME/CFS crash and my body was focusing energy inward, on recovery and repair. The energy I needed to rebuild from the crash was depleting my immune system, and I had a sinus infection.
Everybody has those days, chronically ill or not. There are different degrees, of course, but everyone feels off sometimes. It’s a good reminder to allow your body some rest time, to “lean in” to the slow times and let them restore you so you can get back on track sooner.
Today, I woke up feeling different, better. I wanted to get back on track. I was ready to start doing positive things for myself again.
When I need to know what to do to get back on track, I like to turn to a reference that will remind me of my goals. I used to have a tendency to flounder around, feeling guilty I wasn’t doing what I should be, but not quite making it to the “action stage.”
Instead, I was just making myself feel bad all day by thinking vaguely about things I was supposed to be doing.
I’ve been using the Streaks app (iOS) to build habits for several years, but this year I kicked it into gear and have been making huge progress. I want to share with you what I’ve learned and what I think is key for creating daily habits that actually help, and sticking with them permanently.
Habit-building is about creating daily and weekly habits. Rather than a to-do list, which changes all the time, daily and weekly habits will mostly stay exactly the same. Therefore, it’s a good idea to choose them carefully.
Here are the criteria I use to choose good daily habits:
1. Choose tasks that are always a good idea. A daily habit should be something that would be good for you— body and mind— pretty much any day. If you have severe ME/CFS and you set a habit to get dressed every day, what if on some days it would actually hurt your health to get dressed because it is too difficult? Then you would have to choose between achieving your goal or “failing” and protecting your health.
Choose a habit that will pretty much always be helpful. I like to shoot for several rest periods per day as a daily habit, for example. I also include things like taking my medication and drinking my medicinal tea.
2. A daily habit should be achievable. Don’t shoot too high. If you currently get one rest period per day on most days, then make one or two rest periods your goal for a while.
Don’t immediately decide that because five rest periods would be ideal, that should be your goal. You’ll be more motivated to create habits if they are achievable.
3. Make sure your habits will always be possible to complete. Perhaps it goes without saying, but a daily habit has to be something that is possible to do every day.
If you set a goal to go for a walk (and I’m assuming you don’t have ME/CFS here…See #6) and sometimes there is bad weather, you’ll fail to reach your goal due to factors outside of your control. Instead, make your goals more general (“Get some exercise”) or time-based (“Exercise 15 minutes”).
4. Throw in some easy tasks. I like to make some of my goals very easy to achieve. The streaks app gives me 12 goals per day, so a range of difficulty is possible. One of my goals is “listen to my audiobook.”
I can check it off even if I only listen for a minute. I’ve found this still helps me a lot, as it’s something that gets me into a calm state, and often I want to keep listening. Easy tasks will keep you motivated and help you segue into more difficult ones.
5. If you have ME/CFS, don’t choose exercise-based goals. If you have ME/CFS, I recommend that none of your goals are exercise-focused, even if you normally exercise. Use your goals to track habits that are always going to benefit you even if you are unwell that day. If you choose to exercise (while being aware of the risks!), of course you still can, but it should be a separate decision, not linked to completing your goals.
Here are six of my habits:
My “hot bath” habit is actually a weekly habit that can be completed at any time during the week, ideal for less frequent tasks where you have to pick days that work for you as you go. “30 minutes handsfree” is a partial rest period when I don’t use my hands for anything and might include watching videos or listening to an audiobook.
I love tracking things, and I love apps. Maybe you do too (or maybe you don’t)! The key is to find what works for you.
Personally, I like to track my goals in the Streaks app according to percentage of completion. Streaks lets me see how often I completed my daily habit in the last 7 days and the last 30 days. I set a percentage completion goal for the month and make sure I reach it. For January, my goal was 40% for all 12 tasks; for February it is 50%.
I actually totally disregard the “streaks” aspect of the app. Think about it this way: It’s much more important to your body if you complete your goal most of the time than if you have a “streak” of 20 days. Frequency matters, but streaks are just a number. Use them if they help you — if not, ignore!
Rather than using streaks, percentage goals give me an ongoing emotional investment in my own success. If I complete tasks, I can push my percentage up and reach my goal.
Different apps will have different ways of tracking, reminding and rewarding you for completing daily habits.
I’d love to hear about tools you use to build positive habits! If you’ve tried Streaks app, did you like it? Do you prefer other apps, journalling, pen and paper charts or reminder alerts? What tools would you consider using to improve your health in 2019?
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Nov 25, 2018 | Posted by Zeraph
For the second time this year, I challenged myself to blog daily about my experience with ME/CFS, while also trying new things to improve my symptoms every day! I did this over at my Instagram, under the tag #14DayMEChallenge. You can view my posts here.
“Challenges,” whether 7, 14, or 30 or more days, are popular right now. They often involve doing something every day for a period of time, and they can be a good way to improve a skill, build a habit, or improve yourself or the world in some way. Some people take photos daily, or draw something daily like in #Inktober; other people focus on self-care or health.
My goal in doing a ME/CFS challenge was twofold: I wanted to create a form of accountability for myself, and I wanted to benefit from a focused attempt to rest more often, which is one of my self-care goals. If you don’t know, I follow a strategy of resting throughout the day and also taking periodic rest days in a patient-developed treatment protocol called aggressive rest. Aggressive rest just means that you rest before you’re forced to by your illness.
One of the biggest changes I implemented throughout my 14 Day Challenge was to get serious about completing my daily checklist. I use an app called Streaks to manage 12 daily self-care tasks. Streaks is an iOS (iPhone/iPad) app developed by the folks at Crunchy Bagel, who by the way are super nice and have had meaningful email exchanges with me about how to improve their app. The app is a one time fee of $4.99 (I get it, that’s steep for an app) but it’s really helpful to me and it does exactly what I want it to do.
I also started using Downtime on my iPhone and other Screentime features meant to help you manage and limit your phone use.
However, I found quickly that these features don’t work that great. Screentime is super inaccurate and Downtime (a scheduled time when your phone stops letting you use apps) is just too inflexible for me. Currently, I only use the feature that limits my time on game apps and social media apps, as these seem to work well enough.
The next idea I started exploring was this idea of doing “10% better” at resting and self-care. I generally had been pushing myself to do a lot better with resting, and to be honest, I was failing… or felt like I was failing… often.
Spending time doing nothing is super hard, even if it sounds nice to think about. And I’m a very motivated person with a lot of projects going on, too.
When I was younger I was actually a trained volunteer HIV and sexual health educator, and among people who do that sort of education, there’s this idea of harm reduction. That means, basically, “We understand that human beings are gonna be human beings, and probably do things that might cause them some harm. So instead of telling them to just stop, which won’t work, we’ll give them tools to do it more safely.”
So what if we apply this idea of harm reduction to resting and pacing with ME/CFS? That’s where I came up with the idea of doing “10% better” in my efforts at healing. It’s a series of little improvements that I hoped would add up over time.
But I would have to see what happened over the course of the challenge.
This kind of led into thinking about new ways to rest that weren’t so drastic and weren’t so impossible-feeling for me. I know that resting works for me already— but I just couldn’t MAKE myself do it!
One of the things you learn with chronic illness, and with life in general, is that you can’t fight your body and win. You also can’t fight your mind. It’s kind of a “flow-with” situation. How can you accept and flow with your current mind and body in a way that supports your eventual goals?
Out of these thoughts came a new strategy of resting that I call 1/2 Hour On/Off. This means that after doing any activity for 1/2 hour, I rest for 1/2 hour. Both activity and rest are defined by me, the individual.
For me, activity might mean typing, light cleaning, using my phone, and any kind of work.
Resting meant listening to an audiobook, watching videos, or lying down doing relaxation or meditation. I found it was really helpful to give myself options. When I get antsy during a planned 1/2 hour rest period, I can switch activities as much as I need to.
For someone who is more mildly affected with ME/CFS or more severe, the meaning of rest and activity will change.
Toward the end of the challenge, I started using Flaredown app, which is a multi-symptom tracker for iOS and Android. It allows you to graph different variables against each other, including symptoms, treatments and special factors that may come up in day to day life. It’s for a huge range of chronic illnesses and conditions.
For me, the jury is still out on Flaredown. It very much feels like it will be what you make of it. It’s up to you to make sure you’re tracking the right variables and that you’re accurately recording your symptom severity.
I am always pretty unsure if I’m recording things correctly, as they may change throughout the day and I can only enter my answers once per day.
Short answer: Yes.
The challenge actually helped more than I thought it did. I had hoped to use it to build good habits and find new ways to manage my illness, but I also had a secret hope that I didn’t say much about: I wanted to improve my baseline. This is a really elusive and important goal, and one of the hardest to achieve. But without changing the baseline itself, recovery is not possible.
Mostly, I have moved my baseline through medication. I’ve stabilized declines simply through my behavior, but it’s rare to raise my baseline permanently just through my own actions. I hoped that the challenge would actually help me do that. After all, if I am going to recover, I need my baseline to improve regularly.
Through the gradual and small improvements in the challenge, I gained new tools that helped me do a little bit better every day,and over time these changes added up. In the few weeks since I did the challenge, I’ve had more energy than I have had in the last year. I’ve become accustomed to having productive time every day, and it doesn’t build up fatigue until I crash. Instead, I am mostly still fine. This is a great indicator of a shift in the baseline.
I still need to stay attentive and keep doing “10% better” (harm reduction) and doing 1/2 hour on/off days (aggressive rest). But I’m feeling more energetic than I have in a long time. I’ve had days where I’ve cleaned, organized, painted AND worked on the computer in the same way — an impossibility for over a year now.
Thanks for following my healing effort – by following my blog, Instagram or Facebook, you’re literally a part of my healing team. It wouldn’t be possible to do the 14 Day Challenges without a community of people caring, encouraging, and learning along with me.
If anything I tried in my challenge appeals to you, let me know! I’d love to know what you are trying out for yourself.
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Nov 18, 2018 | Posted by Zeraph
It’s the most magical time of the year: First snowfall (here in New England, anyway) and the start of the Christmas season! However, it’s also time for lots of cold and flu bugs, and those come on top of the extra symptoms that many of us with ME/CFS experience year-round.
If you have ME/CFS like me, or many other chronic illnesses, you’ve probably noticed constantly-shifting symptoms of illness and infection, like chest congestion, sore throat, stuffy nose, sinusitis, candida issues, and more. Often doctors can’t do much to help and you’re left to pick yourself up on your own.
For people with ME/CFS, minor infections and inflammation can easily lead to profound crashes, with their even more disabling symptoms like difficulty moving, breathing, eating, drinking, and speaking.
I thought I’d share one of the things that helps me avoid crashes from infection symptoms and immune dysfunction. I struggle personally with chest congestion and sinusitis, especially when I’m tired or have overdone it, and this remedy is very helpful. Two or three cups a day puts me back on track and often limits infection-related crashes to one day rather than an endless string of days.
Super Ginger-Lime Immune Tonic
What you’ll need:
Optional: Your favorite immune-boosting and/or antifungal tea (Ex: Pau d’Arco, Echinacea, etc.)
1. Thinly slice plenty of ginger (about 1/3 of a medium hand of ginger) and put in a mug. You can reuse this ginger all day and it keeps working for 2-3 cups of tea.
2. Add a teabag with good quality ginger tea, and your additional immune-boosting tea if you’re using it.
3. Fill with boiling water and cover 10 minutes.
4. Squeeze a lime slice into the tea and drink while hot. (Don’t put it in with the water— the boiling water will destroy beneficial compounds in the lime.)
This is a strong tea and has powerful effects! Drink 3x a day for best results.
*If you prefer lemon, go for it. I prefer lime because it’s seedless (meaning no seeds in the tea!) and I feel it works a bit better for me.
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Sep 29, 2018 | Posted by Zeraph
Maybe this always happens this time of year. It’s almost October; then the Saturnine period from fall to Christmas, the death time. Not only because of the season or the feeling, but because people often die during this time…
I think one year I spent several months thinking that was me, that I couldn’t possibly keep living. Not depression, exactly, but the body sending out signals that surely this can’t keep going. Surely there is some bottom to this pit. At the time I was declining slowly but steadily. I stabilized. After a while (with medication) I improved. Now I am stronger, but completely overwhelmed by sensory sensitivities. In some ways this is more disabling than anything before. To see screens, lights, to concentrate, all wears my brain out until it can’t bear to experience any more stimulation. The other night, with my eyes shut tight in a pitch dark room, I find myself thinking: It needs to be darker.
Yet I (living, breathing, alive) don’t want to be unable to talk to people, unable to look at screens that connect me to people. I can’t go outside anymore because of the sensory issues. They’re so extreme, and they cause crashes — sensory crashes. Days of lying in the dark, audiobook, brief use of phone.
I don’t know how to address this, I don’t know how to fix it or even begin to approach it. My brain is on fire, I can feel the liquid heat of it in the way the outdoor sun burns my eyes and overwhelms my brain to the point of dissociation. I start to perceive in jumbled flashes: Tree. Water. Sky. Motorboat sound. Leaves. All strobing like I’m in a crowded club on a bad trip.
I know what the outdoors is supposed to be like. I remember its embracing energy, the calmness of the forest. I want that. I want to feel it. But I don’t feel anything like that. The outdoors is here but I can’t experience it because it doesn’t feel right to me anymore. It doesn’t feel like it is supposed to. So I can’t go to it. I can’t go home.
Yeah, maybe it was last year I listened to Leonard Cohen’s last album on repeat and fell, fell fell down into a darkness, a gloomy Saturnine place, a cool crypt within the hot body. And I was afraid, sometimes. And sometimes I wanted someone to take me in their hands — When I lived on Division Street, we had bags of potatos sometimes, and they would sit in the dark and sprout, and we’d find them too late for eating. And I would take them into the garden and press them into the earth, so that though they were loose and collapsing, their life could make new life. I imagined that someone could take me in their hands, like that, and press me into the soil, and make my life count in that way. That I could be able to rest, and fulfil my final purpose.
I didn’t die, and I didn’t get better, and my body is still loose and collapsing. Is there a sprout, something green inside? Is there new life, begging to be let out, uncurling, using me for fuel? (Take it, take what you need.)
Am I still part of this? Of all of it?
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Sep 18, 2018 | Posted by Zeraph
Here is a question for you: Is your life small or large?
How do you know?
Is it possible to have a big life in a single, small room?
Or to lead a small life that is lived in many places?
Questions like these have become more pertinent to me lately. They surface when I am ensconced happily in my bed, writing, painting, designing or networking with other artists. They surface also when I am taking the comparatively hazardous journey outside, where the lights, sounds and unfamiliar vistas of the outdoors overwhelm me, sending my brain into a strobing cataclysm of sensory overwhelm.
They surface when I’m somewhere in between, too. When I’m in the living room of the house that I live in, a place I visit so infrequently that it seems like another country, taking a wheelchair ride to the shower or bath. At times like these, I may suddenly think, “My God—my world must seem to others so small—so sad!” But then that question bounces against a bigger and deeper feeling inside: “But my life doesn’t feel small or sad to me. Why is that?”
Perhaps I should explain a little about myself.
When I was twenty-five, I was enrolled in college at the University of Maine in Orono after concluding several years of traveling across the United States. I was studying to be an ecologist, I worked as a research assistant, and I was unhappy. At the time, I was engaged with a scientific field I no longer cared about in hopes of becoming someone I thought I ought to be—a proper scientist, not an artist who would never make much money. I wasn’t so much blossoming into adulthood as I was wilting. Life kept propelling me forward, rootless and unwilling, toward some future I could not conceive of and did not desire.
Perhaps that unhappiness was why I missed the first symptoms of my illness. Or perhaps it was simply because no one expects this to happen to them, this creeping and insidious sickness that hides in the shadows, barely seen, until it’s already made itself at home in your life.
However insensitive I was to the signs, I took notice when one day, after an ordinary afternoon of classes, I was too tired to walk across the campus lawn back to my car.
What would you do in such a situation? It certainly feels like an emergency, but you cannot call 911. You need help, but no one will understand.
I had no diagnosis yet to explain my symptoms. I had no idea what was happening to me.
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Sep 17, 2018 | Posted by Zeraph
CFS/ME isn’t typically seen as a pain disorder because the fatigue aspect is so much more disabling. But many people do have pain to varying degrees.
My CFS/ME pain is mostly in my limbs and joints. I also have pain from other, non-CFS/ME problems.
When I’m in pain, I don’t manage my CFS/ME very well.
I am restless; I move too much. I try to distract myself. I don’t sleep as well.
Pain is fatiguing, and it can make other CFS/ME symptoms much worse if it gets out of control.
So what can you do to manage pain effectively when you have CFS/ME?
After having CFS/ME pain for five years, I’ve discovered 3 key tips for dealing with pain:
Here’s some more information on each of these points.
Triggers are anything that causes pain to start or to get worse. Avoiding triggers is the best method of pain relief.
Sometimes it’s not clear what the trigger is. This is one reason it can be helpful to use tools to track your pain, like a daily, simple hour-by-hour diary.
The Hourly Diary
The hourly diary is recommended by Martha E. Kilcoyne in her book, Defeat Chronic Fatigue Syndrome: You Don’t Have to Live With It (available from Amazon). She recommends making a short note every hour describing what you are doing and how you feel.
For me, diarykeeping was useful in understanding patterns that I previously just didn’t notice, even though I felt like I was pretty aware. For example, I noticed that I have an increase in pain and fatigue every afternoon and that my fatigue from exertion can be delayed as much as two or three days. As Kilcoyne explains, the diary can be as simple as one or two words per hour, so it is an accessible tool for some severely affected patients as well.
If holding writing implements is difficult for you (like it is for me) you can use a digital tool like a smartphone diary — I like an app called Day One.
Or, try one of these: 24 Of The Best Chronic Pain Apps And Trackers
For me, my top triggers are dairy, sugar, overuse of muscles, and lying down in “crunched-up” or curled position.
Start treating at the first glimmer of pain! Treat the pain adequately, not just a little bit.
Don’t try to push through pain for any length of time — it WILL get worse.
When you have CFS/ME, it’s important not to let pain slide. Often, pain comes on mildly and intensifies over time. If you wait until it’s intense, it’s probably too late to treat it well or prevent it from impacting your other symptoms.
Good pain relief often involves more than one modality or method. After all, pain is a complex, bodywide experience that affects us in many ways!
I conducted a poll in one of my CFS/ME support groups to see what pain relief methods CFS/ME patients found most successful. Here are the top 10:
There’s no need to wait to administer pain relief— I go ahead and use all my safe available modalities right away, as long as they are OK to use together. (Of course, be cautious around opiods and any other dependency-forming substances, or substances that may affect your ability to conduct yourself safely.)
If you aren’t mentally competent to determine what medicines to take or how much to take, it is crucial to get help from a responsible person or medical professional. People with CFS/ME during flares can become too confused to correctly self-administer medication, so be aware of your mental state and get help as needed.
I find it helpful to list all the things I can do for pain, so that i can refer to the list later when I am in pain and unable to process or brainstorm clearly.
What do you find helpful for treating pain?
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Nov 14, 2017 | Posted by Zeraph
Several months ago, I clued in to a therapy that I believed would help me. It was a combination of pacing (staying within the “energy envelope,” or available energy for that day) and aggressive rest therapy (ART), a strategy of planned resting.
Often people with CFS/ME are encouraged to exert themselves as much as they can by doctors, family, or simply by their own responsibilities. Over time, patients physically decline as they repeatedly overstep their boundaries in order to keep up with the demands of life, or to do what doctors ask. Others remain relatively stable, but at a level of illness that prevents them from doing most of the things they enjoy.
Pacing and ART are attempts to stabilize and reverse CFS/ME by allowing the body time to recover from reasonable exertion while avoiding excessive exertion. I believe that pacing and ART give the body space to use its natural healing abilities to heal the damage to the body that is caused by CFS/ME.
For me, aggressive rest began with a short period (about two days) of total rest – no lights, no sounds, no watching TV or using any devices. I simply lay down, slept, or relaxed.
After two days, I began a more “active” rest period where I alternated rest periods with easy activities. For me, these easy activities took place in bed, because I was already bedbound. I used my heart rate monitor to keep within my limits. (I’ve chronicled many of my experiences during this period on this blog.)
As I gained strength, I used several “rules of thumb” to guide my activities:
As the body heals, gentle motion can be introduced to strengthen muscles and increase the number of mitochondria. Such “exercise” should be gentle enough to not cause PEM (post-exertional malaise).
While performing these gentle exercises, care should be taken not to exceed the body’s abilities. A heart rate monitor with alarms can help to avoid exceeding the anaerobic threshold, commonly set at 60% of the max heart rate, which is 220 minus the person’s age.
For people with moderate to severe CFS/ME, it is best to set the threshold lower, such as at 50% – 55% of max heart rate, to start. My alarm is set at 50% or 55%, depending on my activity level and how I am doing.
To succeed at these techniques, it’s necessary to control as much about your life as possible. If unexpected challenges come up constantly, it will be hard to pace effectively. Sometimes things cannot be avoided.
Lastly, it’s important to have support in doing pacing and ART; it is hard to do. Staying still is work, and doing nothing is work, too.
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Aug 25, 2017 | Posted by Zeraph
It’s been tough lately. Sometimes I don’t want to write about that here, because I’m not sure that suffering is instructive, that it has value that can be transmitted to others. But it is sometimes the truth.
I’ve been pacing using a heart monitor for about a month now, which entails using a heart monitor to “pace “myself, that is, to stay within the energy envelope allotted to me each day by CFS.
At first, there was a clear trajectory of healing. The more I rested the better my heart rate was, and the more I could do without raising it problematically high.
However, as I started to do more, my heart rate jumped up and hasn’t come down with any consistency. I still had energy to do some things, and that meant a lot of painting and being able to express myself in ways that are often off-limits to me due to my disease. But I knew that in a way, I was on borrowed time, benefiting from my earlier rigorous resting. I knew I would run out of energy eventually, and there didn’t seem to be anything I can do about it. And that has come to pass, with the last couple days being very low energy with lots of pain.
What I find hardest to deal with about all of this is the jitteriness and anger that it produces. I am so frustrated by not being able to do things that I want to do, and my frustration has no outlet. I would love to exercise or clean or spend hours painting like I used to, because these things give me a way to work through challenging emotional energy. I’ve use these methods to cope for a long time, and CFS has mostly put them out of reach.
However I really do treasure the time that I have had recently when I have had more energy and have been able to do more. I read a book, I painted quite a bit, I talked to people. Sometimes in these interactions, there is something close to freedom. I want to have that, to have more of it, to increase it. I’m dedicated to that goal, but the path is anything but straightforward. It involves constant problem-solving, endless determination, and undying patience.
So I struggle on. In a lot of ways I’m just praying for strength, reaching out to the world around me in the hope that it will in some way fortify me. This is a struggle not just to bear up under my illness, but to actually make headway in defeating it. The scope of the struggle is so great. If I was looking for a teacher of patience, I found it.
So I keep on. I hope along the way there will be enough moments like there have been in the last few weeks, times when I’m able to do things that nourish me on the deepest levels. If I have that, it will help me keep my head steady and resolute in pursuit of what I need to have to make my life worthwhile again.
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