Having a regular daily schedule or routine, as described in the Planning section, eliminates a lot of decision-making. As one person says, “Instead of having to ask whether something is or is not within my envelope, I try to stick to a schedule I know is safe.”

 

You might also use reminders, such as notes posted in prominent places. Alternatively, you can use devices like a timer to limit the time spent on an activity. And you can use a pedometer or heart rate monitor to help you stay within your limits, as described in two articles on the self-help program website.

 

Another way to change behavior is to create and use a set of personal rules, which are planned responses to various situations. Living by a set of rules reduces the power of spontaneity to overwhelm good judgment. Rules show you how to substitute new ways of doing things for old habitual behaviors. Over time, the new behavior becomes a habit.

 

Rules can take several forms. First, you might state a few rules crucial to controlling symptoms. For example, a person with severe FM or CFS might have three rules: no more than three trips outside the house per week, no driving beyond 12 miles from home, and no phone conversations longer than 20 minutes. If you are bothered by brain fog, you might consider taping rules in some prominent place, like the refrigerator, the bathroom mirror or your computer.

 

Second, you may create a set of rules covering different circumstances. For example, you might establish rules for how long you stay on the computer, how long you talk on the phone, how much exercise you do, how far you drive, when you go to bed at night and get up in the morning, when and how long you rest during the day, how long you spend in social situations and so on.

 

If you develop specific rules, you can simplify your illness management program into asking yourself two questions: What situation am I in right now? What is my rule for this situation?  Personal rules have an if/then structure. For example: 

Third, you might write down your strategies for symptom management and carry them with you on a card or post them on the refrigerator or bathroom mirror.

 

For example, for managing fatigue, people in our program often mention taking daily rests, getting enough sleep, limiting the number of times they leave the house each week, breaking up tasks into small chunks and limiting the time spent standing up. For managing pain, common strategies include pain medications, exercise, adequate sleep, daily rests, massage and heat and/or cold.