Managing fatigue - any tips?

Hi. I have post concussion syndrome after an accident 5 months ago. I'm working half days, 3 times a week. When I'm at work I definitely know when it's time to stop, but I'm having difficulty knowing when to rest when I'm at home doing housework etc. The fatigue creeps up slowly. Any tips on managing activity/rest? Has anyone tried using a wearable activity tracker like a Fitbit?

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  • I set timer on phone or microwave now depending on where I am in house and had a little travel alarm clock I took everywhere for a while (until I lost it)!

    Don't have a Fitbit so can't comment on that.

    The difficulty is listening to the alarm and stopping when whatever device tells you too. Easy some days, extremely difficult on others.

    Start really low activity wise until you find your balance. I started 5 minutes activity and minimum 20 minutes rest. Over years I've found about 20 minutes on is max I should do followed by at least 10 minutes off.

    Not pushing it the days you are feeling you could do more is hard.

  • Would it work for you if you wrote down your jobs for the day. If you made a list in the morning and then broke it down into, say, 10 minute blocks could you work like that? You could then mix jobs needing energy with ones that are very simple: ie dust the bedroom, sit down for a while whilst you tidied up some paperwork, then have a cup of coffee doing nothing, clean the bathroom, sit down and phone a friend and so on throughout the day. If you wrote it down and stuck to it you would not be thinking 'oh, while I have the duster out I'll do the whole house and then sit down'. You could then adjust the timings to suit how much you feel you need to rest. No housework is ever so important that it cannot wait another day if you have a tired day. If you are a fairly organised person, this could work for you. Good luck.

  • I have a gizmo that is set to beep at regular intervals throughout the day. This is my STOP gizmo and it has that written across it. It was originally designed to help me not lose track of time and when it goes off I am supposed to stop what I am doing and check what time it is, consider whether I need to be doing something else or if it is okay to keep on with whatever I am doing. It requires me to actually turn it off so it is not one to be ignored.

    When you are at home, it is easy to get stuck into something and perhaps a similar gizmo may help you manage time so you don't get too exhausted. I was given my gizmos at the memory aids clinic but I think you can get medication reminders that work in a similar way. Its just something to give you a prod to take stock of how you are doing and to consider what you need to be doing... including taking a break/rest.

    Of course if you are good at following a written plan/schedule then that is a simple option too.

    Hope you find something that works for you.

  • Here is a whacky idea...try starting in bed. Wake with alarm at 8am, eat. Do exercise. Go to bed. Sleep for as long as you need. That includes the doze - shall I get up - no I'll just stay and snooze - time. No alarms, Wake up. When you get up, eat some fruit. Do some chores. When tired, finish chores. Go to bed. Sleep. Wake up. eat some fruit, do some chores. Sleep. ETC. Always have window wide open when sleeping for oxygen. Plan to sleep. Give yourself what your body needs while negotiating with yourself energy output for parts of chores or all of small chores. Chores = exercise. Eat an apple to wake the system up. Sleep for an hour, wake for an hour, sleep for an hour, wake. Try different rhythms. See what you need. Indulge! Until you have spoilt yourself with all the sleep you need without alarms, you wont know what amount you ACTUALLY need. Try it! You might be surprised how lovely it feels to ask yourself, what do I need....and then give it to yourself.

  • I wish I could do that (Ask yourself what do I actually need?) I'm sure it would solve a lot of my problems :) What a great post x

  • Hi Lizum,

    I suffer the same and it took me a while to recognise it then accept it but I now know when its going to creep up on me. Nap time helps me instantly just 5-10 minutes works every time. In my truck or at home and I have to do it.

    The trick is to accept it and know the signs then get a nap in before its to late and you start feeling restless and then angry (well they would be my symptoms).

    Hope this helps and Happy Napping. Nick Xx

  • When I first got struck down with neuro symptoms Fitbit wasn't really out there, and so I mapped myself into submission with written activity & symptom daily planners. I then translated these records into red/yellow/green time maps on a spreadsheet. That quite quickly identified that the exacerbations in my symptoms followed hot on the heels of any intensification of activity, and that (initially at least) a mere 20-30 minutes of being up and about was my max- out point.

    Fortunately I am currently in remission from my underlying condition, but my recent brain op has left me with fatigue and related cognitive difficulties and my experience of my illness these last 6 years tells me there are only 2 ways of dealing with it: pre-emptive management or boom and bust.

    Sometimes it will be the latter - if my day has to be long, because I am spending it out somewhere with the family, for example - and the answer there is to do whatever, plough on, and then come in and collapse in a heap - and simply acknowledge that you will need extra time to recover; i.e. maybe a day or two of go-slow, not just an extra few hours kip. The psychological benefits of doing something you enjoy and pushing what you do to the limit outweigh the risk of crash and burn on occasion.

    But even on such long days, and on my normally quieter days when I can pace myself better, all that early monitoring has instilled in me a different rhythm, somewhat akin to what RecoveringH says (only I never sleep in the day as mucking about with your circadian rhythm is a no-no if your HPA axis is already befuddled, as mine is).

    So a quiet day goes a bit like this: I get up, let dogs out, make a cuppa, then I sit and watch the world go by for 20 mins. A bit like a car idling...Then I wake the children, get them up and out or occupied, then make my breakfast, eat it and sit there and watch the world go by for 20 mins...then I make a list of anything I think I 'need' to do and, accepting I will probably only achieve half of them, I alternate between physical and mental tasks and intersperse it with idling throughout the day. I normally go to bed early - not long after the boys - and even if I can't sleep I relax, actively wind down and rest. I am awake very early, so let myself catnap to catch a few extra zzzzs and then am usually up again by 6.

    It has become a habit and I don't have to think about it so much now. I used to feel guilty about stopping, always had to be on to the next thing, now these downtimes happen at least half a dozen times every day. I think of it as plugging myself in to my charger - usually it involves a comfy seat and cup of tea, or a prayer journal, or a yoga mat, depending on where I am and what is appropriate at the time. There are no distractions allowed - so phone goes off onto charge too, TV and radio are not usually on anyway in my house but if they were I would switch off. It is just quiet time. Thinking time. Slow down time. Everything slows even more than it is already....

    I think that what has probably happened (alongside a marked remission of symptoms these last few months) is that along the way I have got adept enough at managing my condition to give the appearance of it almost having disappeared. The long days and my reaction to them show that my fatiguability is actually still very impaired - it may never 'normalise' - so to maximise what I can do I need to manage activity well and take advantage of all energy saving options, which at times can and does include my mobility scooter, my high stool (for peeling potatoes and for doing the ironing), my bus pass/car and the help of others - even when I don't think I need them. And that is what has kept me and still keeps me plodding on with my plodding on, even when my symptoms are at their height.

    It is not life lived as most people do, nor is it life lived as I used to live it, but I like my slow lane these days. I find I see much more, enjoy more fully, experience more deeply. It does require a total shift in mindset though. If you want to manage your fatigue effectively you have no choice but to accept that you will need to do less in order to accomplish more in the long run. And unfortunately you won't find a gizmo that will tell you accurately when it is time to stop so you don't overcook... although my 10 year old has promised to invent one for me when he is older! Pacing and pre-emptive action are as close as you will get.

    Hope it helps!

    Blessings x

  • I do wish I could offer some better advice than 'remove yourself from the situation'. As my mobility has increased and my appearance mostly returned to pre accident state - my life has developed into one daily round of trying to be normal, then collapsing/uncontrolled tears or laughter. The secret seems to be to stop in time. I don't have that opportunity so the crazy roller coaster continues. A Fitbit seems like a great idea, or the 'gizmo' mentioned above - excellent.......might try this too. I'd say you're doing fabulously to be back at work, so we'll done and wishing you luck with finding a solution. Off to the gizmo shop now - have a good day :) x

  • Fatigue take many forms, however the two simplest forms are physical and mental fatigue. I would work out what it is this that is causing fatigue. Sometimes by doing this you may discover the underlying cause to the fatigue - even though you had a concussion sometimes the impact can also affect the eyes and ears.

    I used to find putting the vacuum on used to make me really tired. However, when I had the balance corrected in my ears, that particular aspect of fatigue eased. The brain is obviously working quite hard, processing information from your ears and eyes as you move forward and backwards with the vacuum. If the information from either of these is slightly out then the brain has to work a lot harder.

    I found that breaking the day into chunks around the traditional breaks worked for me - breakfast, mid morning, lunch, mid afternoon, tea time, evening etc. Each break time I would normally shut down (nap) for a few minutes.

  • Hiya, something that helps me no end & I know it has helped several people on here....

    The good old power nap. People often say 'won't work for me' and don't bother even trying. They're right, it won't work for them. Other's don't do it properly & then say 'it doesn't work for me.

    Anyway, close your eyes, & relax completely. Keep those eyes closed & if U have to open them, start again. Try & let your mind completely wander, ideally falling asleep, but if not, not really essential.

    Before U close your eyes set an alarm for 20 minutes. Apparently after about 26 minutes U go into a different stage of sleep so 20 minutes seems to be ideal for myself.

    Make sure U get up & about after 20 minutes cos otherwise you just go back to sleep for a couple of hours & you're no more refreshed than if U had got up after 20 minutes.

    All I can say, is give it a go & hopefully you'll rave about it as much as I do, cos it is ideal for people who have had a head injury baring in mind sleep patterns are usually inconsistent & it's such a good way to recharge your batteries.

    If I don't have a nap my eyes glaze over, I go very quiet & just can't concentrate, whereas after a nap I'm generally full of life ;o)

  • & if U do feel sleepy 2 or 3 hours later, have a 2nd power nap.

    I never have more than 2 but if U feel sleepy a little while later, have another.

    Even 5 minutes makes a lot of difference (they actually say a 6minute nap but I just close my eyes & count to 300 (5 minutes) & get up refreshed. That is only good for a couple of hours for me but good if the 20 minute nap doesn't last til bed time ;o)

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