Putting 'Pacing' to the Test

Denys and I have been quite busy recently with my birthday, and we had two sets of family come up for a visit, which means there hasn't been a lot of time to relax. 

I'm a social person, but that has become harder since developing M.E. as it wipes me out much faster than before. With illnesses like M.E. you have to find your new limits in terms of socialising and pushing your body; it's not just about learning to live with pain everyday, or what you can and can't do physically anymore, even things like sitting in a room with someone and talking uses up more energy than before. Then there's also the added factor that what uses up more energy one day, is different the next, it is so changeable and those limits fluctuate. 

Pacing 

If you have a chronic illness like M.E., you'll more than likely be aware of 'pacing', or will have at least read about it somewhere. The idea is that by adapting and making small changes in everyday life, you will be able to keep going for longer, or get more done, without pushing too far and ultimately crashing. 

How do you do it?

It's different for everyone because we all have our own set of symptoms and what I find taxing might not bother you at all. For me, walking slowly and standing still for long periods causes me a lot of pain in my ankles, all the way up my knees to my lower back. Because of this, I now try to sit down whenever possible to try and avoid causing myself too much pain. I make sure that when my pain levels are starting to increase, I take the pressure off my legs and I can usually feel the pain starting to decrease again. 

I also pace myself when socialising, but as everyday, and every situation is different, it can be hard to manage. I get sensory overload much more easily when in a social environment, especially if there are several conversations happening around me at once, my brain struggles to pick apart the individual conversations, which then usually leads to overload. I sometimes try to remove myself from the situation if possible to give my brain a chance to relax and regain focus. If I can't do this, or it doesn't work, that's when I usually need to put my headphones in and listen to music until it passes. 

Using your anaerobic threshold to help with pacing

The anaerobic threshold is the physiological point during physical activity and exercising that lactic acid starts to accumulate in the muscles. 

The theory in the M.E. community is that if you keep your heart rate under your anaerobic threshold when being physically active, you lessen your chances of going into PEM (post exertional malaise). Keeping an eye on your heart rate can help you with pacing. 

To calculate a very rough number, you need to know what your maximum heart rate is, and this can be calculated easily by subtracting your age from 220. For example, mine is 220 - 29 = 191.

From there, you need to know what your resting heart rate is. To get this number, check your heart rate before getting out of bed in the morning, and do this for a few days in a row. I use an activity/fitness watch so I'm able to check it using that. Mine ranges between 82 and 100 bpm (a lot of people with M.E. and other illnesses have a faster heart rate), so I will go with 90. 

You then do 220 - 29 (your age) - 90 (resting heart rate) = 101 (your rough estimate). 

This number is your 'cushion' known as the heart rate reserve. Going beyond this number regularly is thought to bring on more PEM and M.E. symptoms and so you should monitor your heart rate when being active to stay below this figure. 

If I am doing something like housework, or something quite physical, I will keep a close eye on my heart rate and sit down if it is hitting the reserve number in the hope of keeping PEM, pain, fatigue and weakness at bay. 

Have you tried pacing? Do you have any tips for those who are new to the concept? 

Thanks for reading. 

That ME Girl