Pacing

Split tasks into small manageable chunks and do a bit at a time. Think about how each activity might be done in a more energy efficient way; for example many things such as ironing and teeth brushing can be done sitting rather than standing.

Decide which jobs actually need to be done and do any vital things first in case you run out of steam. Try to leave more than enough time and energy to complete each task. Hunting for scissors or keys wastes valuable energy, so have homes for different items and try to keep organised.

Use equipment that will save your energy, such as a wheelchair. Use other people’s energy and try not to feel shy about asking for help. If finance permits, employ people to do domestic jobs. You can be selective, for example employ someone to dig the garden but you may be able to do some of the lighter work, such as planting out bedding plants.

Alternate activity and rest. You may well find that you can do more of if you do an activity in short bursts. For example it is better to listen to a talking book for fifteen minutes then have a rest before listening to a bit more, than it is to listen to half an hour in one go and feel very ill. A countdown timer or alarm clock will remind you to rest and may help you to avoid doing too much, especially when doing something you enjoy or want to complete. Alternate different types of activity, particularly physical and mental tasks, so as not to overuse your brain, legs, arms or whatever.

Many people find it helpful to keep a diary of their activities. Use it to learn about your individual illness, how much you are able to do, and what things make your M.E. worse. Listen to your body and respect what it is trying to tell you. Never be afraid to decline an invitation or visitor or to refuse a request if you are not feeling well enough. Try to be flexible and change plans according to how well you are. Plan big events carefully, preparing things in advance so that you can manage your illness as well as possible. Sometimes it is worth feeling really ill as a result of doing too much, in order to do something special. It is up to you (and nobody else) to decide whether a certain activity is worth the recovery period. Learn to be assertive about your needs. It is easier for those around you if you recognize and respond when you need a rest.

Energy can be thought of as being a bit like money; it is possible to go into ‘energy debt’ but you will have to pay it back with interest and will feel really ill. Sometimes this will be unavoidable, but it is a good idea to live within your ‘energy budget’ most of the time. Continually spending more energy than is available is a common cause of M.E. relapses. Steadily increasing activity regardless of symptoms can cause long-term deterioration.

When trying out a new activity, start by doing it for a short time that you know you can manage. If it is OK, experiment with doing it for a bit longer next time, cautiously testing your limits. Be realistic about your limitations and don’t over-estimate what you can do. It is sometimes recommended that people with M.E. should do only about 80% of what they think they can do. This leaves a bit of leeway for unpredictability and may actually give the body a better chance of improving. Although pacing is very important for living with M.E., no-one paces well all the time - don’t be too hard on yourself when you don’t manage it as well as you had hoped.

Pacing Yourself; AfME Rest, Pacing and graded exercise; YAO Graded Exercise - does it really work?; TYMES Energy Management Pack £1.50; InterAction 27; 1998; pages 18-19 Pacing

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