Pacing

Both Chronic Fatigue Syndrome and fibromyalgia impose limits on patients. The severity of illness can vary greatly, but usually patients function somewhere between about 15% and 50% of normal. The limits imposed by illness means that patients have less energy. People with CFS and FM usually do less around the house than when they were healthy. They often reduce their hours at work or stop working. And, they have less energy for relationships.

The limits brought by illness require many adaptations, both practical and psychological. For many people, the bigger challenge is psychological: accepting that life has changed and learning to see life in a new way. This acceptance is not resignation, but rather an acknowledgment of the need to live a different kind of life, one which honors the limits imposed by illness. In the words of one person in our program, "Getting well requires a shift from trying to override your body's signals to paying attention when your body tells you to stop or slow down."

This process of accepting limits and learning to live a different kind of life usually takes several years. In terms of practical adjustments, perhaps the single most important strategy for controlling symptoms is for the patient to adjust activity level to fit the limits imposed by CFS or fibromyalgia. We call this "living within the energy envelope" or pacing. Rather than fighting the body, with repeated cycles or push and crash, the patient seeks to understand the body's new requirements and to live within them. Because it is not possible to do everything with limited energy, the patient and family must choose those things that are most important. Family members have an important role to play in helping the patient to adapt to limitations. The first and most significant is to honor the patient's limits, accepting that the patient can do less than before and that trying to do more than the body allows intensifies symptoms. 

Pacing techniques include keeping activity level within a person's limits, taking daily rests, using routine, scheduling activity based on priorities, and timing activity for the best hours of the day. Other stress reduction approaches include de-cluttering (for example, reorganizing the kitchen or discarding unused possessions), limiting exposure to media, limiting contact with some people, avoiding crowds, and making mental adjustments (such as letting go of outdated expectations). (from the CFIDS and Fibromyalgia Self-Help site)

CFIDS is the term commonly used in the USA to refer to CFS