Actively Autoimmune: How Zoe Uses Exercise to Manage Multiple Chronic Conditions
It’s probably a familiar scenario: you’ve been looking forward to going out all week, and then your illness messes up your plans, again. One of the characteristics of chronic illness is that symptoms can flare up at any time. Of course there’s never a good moment to feel sick, but it’s especially discouraging when you have something fun or important planned.
When you’re generally healthy and you come down with the flu, you just call in sick and reschedule. But when you live with chronic illness, you’re tired and in pain pretty much all the time. If you would stay home every time you’d feel bad, you’d probably never leave the house. So how do you decide when to push through and when to stop and rest?
I used to struggle with this question a lot. Cancelling plans and letting people down sucks, especially if you can’t be sure if you’ll be able to make it next time. But pushing through isn’t always an option, and even if you do, it overshadows your experience. Plus, you’ll likely pay for your persistence the next day(s).
Deciding if you should push through depends on so many variables – and they’re all personal and constantly changing:
1. How you’re feeling
What kind of symptoms are you experiencing and how severe are they? For example, aching joints may be easier to deal with than passing out in public. But even if you have mild symptoms, could it harm your health in the long run if you push through? At the same time, your mental wellbeing matters too. Will sticking to your plans make you feel better emotionally even if you’ll crash physically afterwards?
2. The plans you’ve made
It’s never fun to cancel plans you’re excited about, but there’s big difference between having to miss your best friend’s wedding and skipping a weekly dinner at your mom’s house. Also, are people depending on your presence? And how accessible is the event you’re attending? Can you easily manage your symptoms or are you forced to walk a lot/sit still/do something that’s challenging for you?
Another important determinator: how easy is it to get to your destination? Lots of people with health problems have mobility issues. I tended to focus so much on getting somewhere and being at my appointment or date, that I would forget to save enough energy for the way back home.
3. The possibilities to crash afterwards
Unfortunately, pushing through is usually followed by a crash. When you force your body to do something it isn’t prepped to do, you’ll be rewarded with a flare-up of symptoms or post-exertion malaise. And that’s ‘ok’ – some things are worth the payback, from studying for your final exams to making that important doctor’s appointment.
But that does mean you need time to rest up and recover afterwards. When I was a teen and young adult, push-and-crash cycles where my way of making my goals and dreams come true. I could manage my own schedule and my loved ones were there to (practically) support me during rest days. But now that I’m a mom running my own business, there’s little room for staying in bed after a tiring day. That’s something I have to take into account when deciding if I should push through or stay in.
And still, even if you keep all these factors in mind, it can be so hard to know what’s the right call to make. And it’s a decision only you can make, putting a lot of responsibility – including the accompanying guilt – on your shoulders. One thing that helped me to make the decision process easier, was to create my own ‘health heuristics’.
How Heuristics Can Ease Your Decision-Making Process
A heuristic is a simple but efficient rule you can fall back on when you’re faced with complex problems or uncertainty. Wikipedia calls heuristics “a mental shortcut that eases the cognitive load of making a decision.” And that’s exactly why it worked for me: having self-made rules reduced the emotional turmoil of second-guessing myself, feeling guilty and wondering whether cancelling plans would upset people and make me a ‘quitter’.
So what is a heuristic exactly? Well, it’s any rule-of-thumb that simplifies your decision-making process. For example, during my internship I suffered from severe ‘painsomnia’. Every time I’d lay awake at night, I would worry about how to survive the next workday and when it would be ok to call in sick. After a few months of going through all the emotions each morning, I made a deal with myself. If I’d have less than 3 hours of sleep or severe symptoms, I could cancel or reschedule appointments if needed. If I had more than 3 hours of sleep and ‘only’ my normal symptoms , I’d stick to my plans. No more internal debates, no more hard feelings, a lot more peace of mind.
Only you can decide which specific heuristics work for you. But here are some ideas to inspire your own rules:
5 Health Heuristics You Could Use
- You’ll push through ‘once-in-a-lifetime’ events, like a bachelorette party or the concert of your favourite band in your hometown. Of course you’ll always plan plenty of real rest beforehand and afterwards to prevent serious health setbacks.
- It’s ok to say ‘no’ to invitations or obligations that aren’t a priority to you. Being clear about your boundaries could save you and the people in your life from feeling guilty or let down.
- You stop to rest when pushing through puts your long-term health at risk. Maybe you really want to attend a party, but that would set off an upcoming migraine. Don’t feel guilty if you don’t want to spend the rest of the weekend in bed with painkillers.
- You push through certain symptoms, but not others. Perhaps you’re used to getting things done with pain and fatigue, but cope less well with dizziness and nausea.
- If you doubt you’ll be able to commute to your appointment (and back!) without hurting your health, try to reschedule if possible.
Creating your own rule-of-thumbs for recurring situations in your life – from taking a sick day to cancelling plans with family and friends – reduces a lot of emotional stress when you’re chronically ill.
I’d love to know: How do you decide when to push through and when to stop and rest with chronic illness?
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