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Routine, Reminders, Rules

This page is about the three R's of pacing --routine, reminders and rules-- plus a bonus fourth R: records. But first, a general guideline.
 

Make Changes Gradually

You may feel overwhelmed at times when you think of all the adjustments you have to make to reduce symptoms and regain control. The solution: focus on one thing at a time.

One person described how she changed by saying, "The transformation into a more disciplined person was a long-term process. The changes have been introduced gradually over time. And I make sure I find the right one before Imove on to adding the next."
 
Routine

Developing routines is one way to increase consistency. Doing things in a regular and customary way reduces energy expenditure, because you are living by habit rather than continuously confronting new situations.

Living your life in a predictable way can help reduce relapses, because routine is less stressful than novelty and because it increases your chances for living within your limits.


Your ability to do this depends on your developing a detailed understanding of your limits and then creating a schedule of activity and rest that honors those limits.

The Daily Schedule worksheet gives you a way to translate your understanding of capabilities and limits into a daily routine of activities and rest. Developing a daily routine means doing things in a regular and customary way.

As one person said, "Developing a routine and sticking to it have been helpful because the familiarity reduces the number of surprises and lowers the attention that I have to spend on unexpected happenings." 

For more on planning, including a page on daily plans and a page on weekly plans, go here. For a personal story, see the article How I Use Routine to Successfully Manage Fibromyalgia
 

Reminders

A technique that works together with the daily schedule is the use of reminders, such as notes posted in prominent places such as the refrigerator, bathroom mirror or computer. Also, devices of various sorts can give you reminders.

For example, you can use a timer to limit the time spent on the computer or housecleaning. Also you can use a pedometer to help you keep your activity within limits and a heart rate monitor to stay within your heart rate limit, as described in two articles on the self-help program website.
 
Rules

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. Some people have just a few rules to guide them. For example, one person with fairly severe FM or CFS has three rules for herself: 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.
 
Other people develop a set of rules covering different situations. For example, they might establish rules for how long to stay on the computer, how long to talk on the phone, how much exercise to do, how far they drive, when they go to bed at night and get up in the morning, when and how long they rest during the day, how long they 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: 
  • If I’ve been on the computer for 20 minutes, then it’s time to take a 10-minute break
  • If it’s 11 am, then it’s time for my morning rest.
  • If it’s 9 pm, then it’s time to start getting ready for bed
  • If I feel short-tempered, then it's time to take a rest
Still other people write down their strategies for symptom management and carry them with them on a card or post them on the refrigerator or bathroom mirror.
 
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.

Records

Keeping a health log, which should take no more than a few minutes a day, can help you gain consistency in three ways.

First, records help you get a clearer picture of your limits and reveal connections between what you do and your symptoms. Using records, you can discover how much activity you can do safely in a day and a week, and whether there are delayed effects. Also, a log can show the effects of mental and emotioinal events, as well as physical activity.

Second, a log can help you hold yourself accountable. Reviewing your records is like looking yourself in the mirror. One person said, "Logging brings home to me the reality of my illness."

Third, records can motivate you by showing that staying within limits pays off in lower symptoms. Records of progress provide hope.

Work with a log occurs in three steps:
  1. Write: make entries in a log
  2. Analyze: review the log to gain insights 
  3. Act: use your insights to make changes
You make daily entries, which usually takes no more than a few minutes. Periodically, say every few weeks, you review your records to learn about your limits. Then, you use strategies such as those in this and the next page to change how you live (the hard part!).


For more, see the article Heath Logs: Big Payoff on a Small Investment on the self-help program website. Sample logs are available for download on the Logs, Forms and Worksheets page on the site.

Note: Think "Sustainability"

The key to pacing success is to find the level of activity you can sustain over a period of time without worsening your symptoms and then gradually adjusting your life to live within that limit. You can find your sustainable activity level through experimentation. 

Many people are helped by asking themselves the queston "What level of activity can I susgtain for a week without making my symptoms worse?" As one person said, "Just asking that quetion forced me to pull back some from the amount of activity I could do in a single day." 

If you can sustain a consistent activity level for a week without intensifying your symptoms, congratulations, you are living within your Energy Envelope!
 

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