Finding and Staying Within My Limits
By Kathy Mero
Note: Pacing involves first finding your limits and then adapting to them. In the article below, Kathy Mero explains the different strategies she has used for these two tasks. Kathy is a CFS patient from Texas. She has been a member of our community since 2013 and a class moderator since 2016.
Finding my limits has been a real challenge! I haven't found them all yet, but I am making progress and monitoring my heart rate has been a big help.
[Note: An elevated heart rate triggers an intensification of symptoms. See the article Pacing By Numbers: Using Your Heart Rate to Stay Inside the Energy Envelope for instructions on how to find your heart rate threshold.]
The first monitor I used showed me when my heart rate was over my threshold, so I knew when I needed to stop. This prevented many crashes. And I learned how it feels when my heart rate is too high, which was very useful for times when I was not wearing the monitor.
Since I got a FitBit, which I wear all day and all night, I have been able to go way beyond just monitoring my heart rate. Now I track it, graph it, and analyze it every day. As nutty as this sounds, it's kind of fun, and takes only about 5 minutes a day.
I find knowing my resting heart rate [explained in article mentioned above], which I calculate every day, to be very useful. When my resting heart rate goes up by 2 or 3 points above normal, I label the graph with what I did that caused it.
Usually, after a big overdoing, my resting heart rate goes up by a few points each day for 3 days, then it slowly comes down, one point every day or two. It takes a lot longer to come back down than it does to go up. By watching my resting heart rate, I can rest a lot before the worst crash day, and avoid a really bad relapse.
Logging, Experimentation and Rules
Along with all this tracking and graphing, I log the big items for the day. This gives me the information I need to figure out where I went wrong! So logging is another strategy I use to find my limits.
Experimentation is another way I find my limits and, once I know them, I translate the limits into rules which cover both everyday life and special events. My biggest potential for overdoing is when I visit my folks. I have some basic rules, such as afternoon appointments only, no big shopping trips, no cafeteria style lunches where I have to stand in line.
And, I need to leave their house before the afternoon commute traffic picks up. It's a 6 hour day for me, so I need for it to be as easy as possible. My internal rules are to remain calm, breathe deeply, and sit in the car while Dad runs his errands.
Through trial and error, I’ve found that my tiniest energy envelope is physical activity, walking in particular. It is about 90 steps to my parent's apartment from the elevator.
My heart rate increases before 90 steps, even when I walk slowly. Enlarging this envelope would greatly reduce Post-Exertional Malaise (PEM) for me. [Note: PEM is the intensification of symptoms caused by overdoing.]
I crashed once after going to a movie. It was because the walk between the parking lot and the theatre was more than 150 steps, and we walked too quickly.
Knowing that 150 steps without a rest pushes me into PEM, the next time we went to the theater I stopped a couple of times along the way, looking at the movie posters, and walked more slowly. That was all I needed to make the ‘trip’ without harming myself.
I used my heart rate to figure out most of my little limits, except for the mental limits. I can tell when my brain is tired, because I can no longer think straight. I rarely get physical symptoms of PEM from mental exertion, but I think I get ‘brain PEM’, or brain fog, for a couple of days after overdoing.
Some other causes of PEM surprise me. For example, through experimentation, I learned that my limit for doing paperwork, like filing and bill paying, is only 30 minutes, once per day.
Finding my limits has been an ongoing challenge, but well worth the effort because of the relapses I am able to avoid. The tools I have used to find my limits include heart rate monitoring, logging, experimentation, and observing my symptoms. Based on my limits, I am often able to establish rules, which are especially helpful for my more difficult tasks.
If I use my rules and honor my limits, I can usually stay relatively symptom-free.