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by Lourdes Salvador
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The easiest way to understand pacing is to imagine starting the day out with a handful of cards and each time energy is expended, a card is lost. When the cards are low, the day is over and sleep is required. Each activity of the day requires a card, including getting dressed, bathing, cooking, and visiting with someone. If too many activities exhaust the supply of cards, a deficit ensues and one nights sleep is not enough to recuperate.
Most of us start the day with unlimited cards. Certainly we have enough to get through until bedtime. For people with chronic fatigue syndrome, they have few cards to begin with and must pick and choose how they expend their energy so that they don´t run out of cards and collapse. This forces them to prioritize, establish routines, schedule extra rest, and keep activities short. This is known as pacing.
People with chronic fatigue syndrome also engage in shielding, which was
rated as highly helpful by 96% of study participants. Shielding
involves surrounding oneself in quiet and, in some cases, darkness.
People with chronic fatigue syndrome are often sensitive to light and
sound, which expends their limited supply of energy by stimulating the
central nervous system.
One of the most misconceived treatments recommended by the medical profession is graded exercise therapy, yet 79% of the participants experience deterioration as a result. It stands to reason that with such limited energy to expend, using too much on exercise leaves woefully little, if any, energy for tasks of survival such as fixing meals, eating, paying bills, and bathing.
"Patients´ experience is important in this context," says Bjørkum and
colleagues, "Graded training may cause deterioration of the condition in
many patients."
Another failed treatment was cognitive behavior therapy, yet this is
also widely recommended despite the scientific knowledge that chronic fatigue syndrome is a serious neurological disorder
which can not simply be "thought" away.
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