Pacing progress update

The aim of pacing is to find the approximate length of time that I can work at something without causing a flare up in my symptoms. The principles of pacing are to avoid a cycle of boom and bust and to stop before you need a break. A few months ago I worked out my starting baselines for various activities. I’m working on gradually increasing my baselines by one minute a week for two activities at a time.

Pacing:

Overall I’m starting to see benefits from pacing my activities to reduce flare ups in fatigue and pain. I still struggle with some of the drawbacks. For example, I can’t get into a ‘flow state‘ when I’m only engaging in something for a maximum of 8 minutes at a time. And it’s taking a lot of time, thought and energy to implement pacing in my life.

I’ve been doing some problem solving around the various issues as they arise which makes things a little easier. I can also see an improvement in terms of how comfortable I am as I’m aggravating the pain and dizziness less. This is particularly noticeable towards the end of the day. I have to go to bed less during the day to sleep. Though I still have scheduled rest breaks where I lie down to relax or meditate and I still do to bed at the onset of a migraine.

The changes:

Flow:

I’ve experimented with grouping tasks into sets of 4. I have a 3 minute break after each task to check in, and a longer relaxation period of around 25 minutes after each set of 4. I’m aiming to group activities so I keep some continuity in where my mind is at throughout each set, and variety in how I use my body from one task to the next. Pairing activities that I do regularly reduces the planning and decisions that need to be made each day.

  • Planning (computer) / Balance exercises
  • Reading or dictation / housework
  • Writing (computer) / dictation or thinking

Frustration with the timer:

Each morning I have started breaking down tasks I plan to do that day into smaller steps that match the time I’m allowed by my pacing strategy. This seems to reduce the frustration that comes from constantly being interrupted by the timer when I’m in the middle of something. Hopefully as time goes on I’ll get better at estimating the time needed for different tasks.

New baselines:

  • Housework
    • I’ve settled at 8 minutes at a time for general housework. I did try a week at 9 minutes but was getting very tired sometimes so reduced it back to 8 minutes. I’m planning to leave housework at this level for now.
    • I noticed I was getting very sore muscles after jobs involving stirring or scrubbing despite keeping to my time limit. I’ve made a separate category for housework involving intensive/ repetitive movement. This category has a starting baseline of 1 minute.
    • I’m alternating housework with reading or dictation which can be done with my feet up and head supported so I don’t overuse muscles. This allows me to process what I’m thinking about while doing the housework and to give my muscles a break while I read or record my thoughts.
  • Computer
    • Using wrist splints reduces pain.
    • Currently up to 8 minutes. I’ll see how that goes this week.

You can see how long it’s taken me to get to this stage in the pictures of my record sheets below. On the one hand, I’m happy that I have doubled the amount of time I can spend at the computer in two months. On the other hand, it’s taken two months and I can still only do 8 minutes which is a long way off what I want. This is where my self-compassion course, and the support of a health professional in setting and persevering with the pacing process has been so valuable. I’ve also appreciated encouragement and support from the people around me. I’m not sure I could have persevered without it.

Baseline Record Sheet: Computer
Baseline Record Sheet: Housework

Mindfulness:

  • More aware that I do need to pay attention when doing housework.
    • Thinking about how I’m going to lift something and if it’s a good idea
    • Noticing any muscles or joint aching or fatigue
    • Thinking about whether to continue with a plan or stop and change to another activity or rest.
  • I much preferred it when I could do housework on autopilot with my mind on something more interesting.

Finally – I can see some progress with pacing!

The aim of pacing is to find the approximate length of time that I can work at something without causing a flare up in my symptoms. The principles of pacing are to avoid a cycle of boom and bust by stopping before you need a break. A few months ago I worked out my baselines for various activities. I’m working on gradually increasing my baselines by one minute a week for two activities at a time.

The activities I have been working on are housework and using the computer. At the start of this week I increased the time spent on housework to 9 minutes, and time spent at the computer to 7 minutes

Using the computer is still comfortable, as long as I wear my wrist splint. This means I can increase the time allowed for the computer to 8 minutes. I do need to make sure I alternate using the computer with something away from my desk and making very light use of my hands. Dictation, reading, or using my whiteboard could all be good activities to alternate with the PC so I can keep my train of thought going while not aggravating any one particular symptom for too long.

I really want to increase time allocated to housework to 10 minutes as it’s a round number, but I felt tired few times after the 9 minutes this week. I also need to take care during the 9 minutes if I’m doing repetitive actions like stirring a saucepan or scrubbing or cleaning the bath. Several times doing activities like these within the 9 minutes has produced aching muscles and painful joints.

So I’m going to leave housework at an untidy 9 minutes. I’m also going to make a new category in my pacing list for repetitive housework tasks. I’ll start this at a baseline of 1 minutes and build up slowly from there.

Pacing like this is still frustrating although I am more accepting of it and it’s becoming a habit. I can see some benefit though. I’ve less pain in my hands particularly and while I’m tired at the end of the day, I’m not sleeping as much in the daytime.