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Activity Adjustments

Part of pacing is changing how you are active. You can improve by integrating the following activity adjustments into your life. (For more detail on each strategy, see the Pacing Tutorial and the series Pacing: What It Is and How to Do It on the self-help program website.)

Putting Limits on Individual Activities

One common pacing strategy is to set limits on particular activities. This can mean that you stop doing some things entirely or that you reduce the amount of time you spend doing an activity ("stop before your drop"). Activities often targeted include:
  • Computer use
  • Phone calls
  • TV viewing
  • Housework
  • Standing
  • Driving
  • Shopping
  • Exercise
  • Times outside the house per week
To put limits on individual activities, follow a two-step approach. First, find your limits through experimentation. For example, try different lengths of time working on the computer, taking note of your symptoms during and after, then gradually adjust your computer sessions to fit within the limit you found. You might use a timer to enforce your limit. 

For an example of limit setting, see Bobbie Brown's article The Many Reasons Why I've Improved. The article describes how she increased her functional level from about 15% of normal to about 35% or 40%.
Practice Activity Shifting

Another strategy for getting more done with lower symptoms is to shift frequently from one type of activity to another, for example switching among physical, mental, and social activities. If you find yourself tired or confused after working on the computer for a while, you might stop and call a friend or do something physical like preparing food. 

Another way to use task switching is to divide your activities into different categories of difficulty (light, moderate, and heavy), switch frequently among different types and schedule only a few of the most taxing activities each day.

Use Short Activity Periods

You can also affect your symptoms by adjusting how you are active. Two short periods of work with a break in between can produce more and leave you feeling less symptomatic than the same amount of time expended in one block. For example, you might do ten minutes of housecleaning, rest for five minutes, then do another ten minutes of cleaning.
The same principle can be applied over longer periods of time. You may find, for example, that your overall symptom level is lower if you spread activities through the week, rather than trying to do many things in one or two days.

Use Devices

Your efforts to pace yourself can be aided by using devices of various kinds:

Pedometers and Heart Rate Monitors
We'll begin with pedometers and heart rate monitors, two devices we recommended you use to find your limits. Both can be used also to help you adjust to your limits.

You can use a pedometer (step counter) to limit your physical activity. FIrst, determine your current activity limit by wearing it for several days, noting the connection between your number of steps and your symptoms. Then, knowing your limit, use the pedometer to stay within your limit. For more, see the article Pedometers: A Tool for Pacing.

One trigger for relapses is a heart rate above a limit called the anaerobic threshold (AT). Some people with CFS and FM exceed their heart rate threshold with everyday activity. A heart rate monitor can help you determine and then stay below the threshhold. The article Pacing By Numbers:: Using Your Heart Rate to Stay Inside the Energy Envelope will show you how to determine determine your AT. Knowing your threshold you can use a monitor to stay below it. 

You can use timers to enforce activity limits. For example if you know that 15 minutes is the longest you can work on the computer without getting fatigued or brain-fogged, use a kitchen timer or the timing function on a watch, cell phone or computer to set the timer a short time before your limit.

Stools, Scooters and Other Devices
If you often feel faint while standing, consider sitting down whenever possible, for exampe use a stool while preparing meals or a plastic chair while showering. Similarly, if shopping is tiring, use a scooter or motorized cart. Use wheelchairs in airports and a cane for balance, grab bars in the bath, and handicap parking tags to park close to your destination..

Use the Rule of Substitution (Pigs at a Trough)

It's easy to do just "one more thing", but that approach often leads to higher symptoms. The solution: think of substitution rather than addition. In order to add a new item to your schedule, drop one.

For example, if your Enveope allows you to leave the house three times a week and something new arises, find a way to postpone one of the usual outings in order to honor our limit of three. The new activity squeezes in by forcing another activity out, just like pigs at a trough.

Delegating, Simplifying, and Eliminating

The overall idea of pacing is to reduce your overall activity level so it fits without your limifs. You can think of this as a two-step process. First, you determine how much pruning you'll have to do. For example, you can list the activities you do currently in a typical week, making an estimate of the time each takes. 

You then add up the times and compare them with the limits you established using the Rating Scale from the Self-Appraisal or the Energy Envelope form from the Finding Limits page. If the items on your list take more time than your limits allow, you will have to make some adjustments to stay inside your limits.

In the second step, you reduce your activity level using a combination of delegating, simplifying, and eliminating. Delegating means finding someone else to do a task that you used to do. For example, have other family members do the grocery shopping or hire a cleaning service. 

Simplifying means continuing to do something, but in a less elaborate or complete way. For example, you might clean house less often or cook less complicated meals. Finally, you may decide to eliminate some activities entirely.

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