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Over time, I’ve become aware of several different ways I make my symptoms worse, but I’ve also learned strategies for avoiding some relapses and getting myself back on track in other cases.

 

One way I sabotage myself is simply doing too much, going outside my Energy Envelope. This can happen when I carefully do each little thing in my day, with a short rest between activities, but in total it adds up to too much.

Over time, I discovered that if I am paying attention to how I feel, I can observe that the little tasks become harder and harder. If I can catch myself before I am exhausted and call it a day, I can usually avoid a relapse.

 

Another way I sabotage myself is when I talk while walking or walk too fast, or hurry to do anything at all. All these things quickly push me beyond my energy limit. So if I get a phone call, I immediately sit down to talk.

My walking energy envelope is tiny, measured in steps, not minutes, and going over that limit causes Post-Exertional Malaise (PEM) rather easily. [Note: PEM is the intensification of symptoms triggered by overdoing.] I don't avoid walking, but I am very careful to go slow and stop often, and I monitor my heart rate.

 

Adrenaline is also my evil companion. I can sabotage myself by getting exuberant about anything. Before CFS, I found showering very refreshing and exhilarating. I would come out of the shower with more energy than when I went in.

Now showering is one of the hardest things in my day. I have to constantly remind myself to stay calm in all situations. When I am having fun with friends, it's especially hard to stay calm, because I tend to forget the consequences of acting normal. 

 

Of course stress is very harmful, and adrenaline rushing stress is even worse, like the time my Dad passed out, and they called and told me had had a stroke. He hadn't - he was just dehydrated from drinking too much coffee and little else. My heart rate immediately climbed to 135 from a huge adrenaline rush and it stayed abnormally high all day.

 

 

Once I have overdone it and sabotaged my pacing, my only solution is to stop overdoing and start resting. I check my resting heart rate every morning, and I also check in on how I am feeling. [Note: See the article Pacing By Numbers: Using Your Heart Rate to Stay Inside the Energy Envelope for instructions on how to determine your resting heart rate.]

 

I often cannot tell how I feel until I have been up for an hour or so. Sometime when I think I feel really good my resting heart rate is a bit elevated (like 3 points higher than average). I can quickly tell then that I am adrenaline mode and my heart rate goes up too much with any activity.

As a friend says, “Feeling good is dangerous.” This adrenaline mode is kind of a pre-crash state, but if I spot it and respond by resting, it is my opportunity to avoid a crash.

 

 

It has not been easy for me to learn how to stay within my Energy Envelope, and I can still sabotage myself if I exceed my limits. Any time I do too much, even in small chunks, I can go beyond my Energy Envelope.

Other things that cause me to go outside my limit are stress, rushing around or doing anything fast, and getting excited or exuberant. 

 

But I have discovered that the sooner I recognize the signs of overexertion, the smaller are the consequences. The earliest sign, and the one I find most useful, is my heart rate (resting and while active).  

If I wait until I am tired, then it might be too late to avoid PEM entirely. If I ignore my fatigue and keep going, it may take many days, even weeks, to get my body back to its ’normal’. The longer I ignore my symptoms, the longer it takes me to recover. Conversely, the sooner I get back on track, the better!