Acres of Diamonds

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By Bruce Campbell

When I hear people with CFS or fibromyalgia describe their quest for improvement, I often think of the story called "Acres of Diamonds." The tale describes a wealthy Persian man who dreamed of finding a great diamond mine.

Inspired by the dream, he set off on a long search, one that, unfortunately, cost him his wealth and ended in disappointment. Later, the person who took over his property in Persia saw something shining in a stream in the garden. It was a gem. Spotting it led to the discovery of a fabulous diamond mine right on the property.

Often people with CFS or fibromyalgia make valiant and sometimes expensive efforts to find a panacea to relieve the suffering of CFS and FM. They go to great lengths, sometimes pursuing treatments far from home. More often than not, like the wealthy Persian, their search, too, ends in frustration and disappointment.

Self-Management

Self-management, which focuses on adjustments to daily habits and routines, offers an alternative to the search for a magic pill, a way to gain greater control and lessen suffering by changing how you live your life. It is consistently helpful for those who use it. In the words of famous CFS/FM physician Dr. Charles Lapp, "There is no drug, no potion, no supplement, herb or diet that even competes with lifestyle change for the treatment of CFS or FM."

Below, you will find some examples of self-management strategies, some diamonds you can use to improve your quality of life. You can find many more in other articles on this site. (Note: We recommend people use both self-management and medical treatment. For the benefits of medical care, see Dr. Lapp's article How Your Doctor Can Help If You Have CFS/ME.)

Planned Rest

Rest is often used as a way to recover from intense symptoms (recuperative rest), but rest can also be used to prevent problems. Taking planned rests on a regular basis can help you control symptoms, gain stability and reduce total rest time. We call this practice pre-emptive rest. This kind of rest is one of the most frequently used coping techniques among people in our program. Here's what two people said about it:

I decided to incorporate two scheduled rests into my day and the results have been incredible. My symptoms and pain have decreased and I feel more ‘in control'. My sleep has been more refreshing and even my mood has improved.

I have been resting in between activities, sometimes only for five minutes. For the first time in the four and a half years that I have been ill, I feel that it is possible to manage my symptoms and have some predictability in my life.

Time of Day

Most people with CFS and FM have better and worse times of the day. Some people start the day ready to go; others are at their best later in the day. You may be able to increase the amount you get done, without spending more time or intensifying your symptoms, by changing when you do things, using your best hours for the most important or most demanding tasks.

For example, one person in our program was bothered by the effects of brain fog on her ability to read and retain information. When she studied in the morning, she was able to read for only a half an hour and had trouble remembering what she read. But when she studied in the afternoon, she could study for two hours a day and retain the information.

Controlling Stress

How we react to events can affect our symptoms and the amount of energy available to us. For example, if we respond to pain by tensing our muscles, the muscle tension will increase our pain. If we can learn to relax, we can break that vicious circle. One person in our program recently wrote, "Through the self-help course, I became aware of how often I'm tense. Knowing the connection, I now relax my body and breathe deeply, which helps. A bit of housework or a short walk also helps."

Another person in our program found a different path to stress reduction: changing her expectations for herself. At a party one year, she took on the role of the good hostess, moving about and worrying whether everyone was having a good time. Experiencing the party as a stressful event, she found herself tired and cranky after an hour.

At a similar party a year later, she focused on being relaxed, telling herself that people would have a good time and she didn't need to worry. Freed from the self-imposed expectation that she should make sure everyone enjoyed themselves, she found herself with good energy for more than two hours.

Using Devices

You may be able to get more done, avoid symptoms or both by using devices to help you. Some patients whose tolerance for standing is low, who are sensitive to sensory input or both find shopping easier if they use a scooter or motorized cart. Many large stores have such devices, which they make available for free.

One person in our program used to get so tired doing her weekly grocery shopping that she would lie down for two hours as soon as she returned from the store. When she started using a scooter at the store, she found that she didn't need any rest at all after grocery shopping, adding two hours of activity to her day.

The same principle applies around the house. For those who have limited tolerance for standing, using a stool in the shower or in the kitchen when preparing meals can prevent symptoms.

Relapse Prevention

Relapses are a common and often demoralizing part of CFS and FM, but by learning how to recognize relapse triggers and warning signs, you can reduce the frequency and severity of relapses.

A man who spends one or two minutes a day keeping a health log used his log to understand and then eliminate relapses. Reviewing his records at the end of a year in which he had spent a total of almost two weeks in bed due to CFS flares, he found that most of his relapses were associated either with acute illnesses or travel. He created strategies for both.

To combat relapses triggered by secondary illnesses, he started taking extra rest after the secondary illness had ended. To minimize travel-related setbacks, he limited travel to a few hours' driving distance from home and took rest breaks in route. Time spent reviewing records and devising strategies: two hours. Payoff: no relapses in the decade since.

Conclusion

Acceptance of illness and adaptation to it through lifestyle changes offers an alternative approach to medical treatments. Such change is safe, inexpensive and consistently helpful for those who use it.