Boom and Bust ?

[Jill777]

Could someone kindly explain what the boom and bust reference is . I've seen it a few times now and i don't know what it is. many thanks . Jill x

[Chat2U]

Hi!You do more than your body/ brain can take on good daysand pay for it later.

Google Spoon Theory.

Ax

[RogerCMerriman]

Hi it’s how you deal with being tired after the brain Injury, ie Fatigue.

And how it’s easy to overdo (boom) and then suffer the next few days (bust)

Very easy to do, and even if it’s been years most folks will at times do it, sometimes deliberate ie going to a party etc, know it’s going to hurt!

[Chat2U in reply to RogerCMerriman]

Yep! 8 years. Just had weekend away with family. Love it. (Boom) But paying for it severely now! (Bust) Expected. But still a struggle! Pain levels through the roof and really struggling to breathe.

I huuuuuuuurrrrrt!

Spent last 2 days in bed but not improved yet.

Feel like I've been kicked by a horse from head to toe and he's then sat on my chest and stayed there!

Can't up the pain meds anymore (hernia/throat inflammation - literally choking me), can't sleep, can't focus enough to read for more than 2 min and head killing me with TV noise.

The last place I want to be is inside my head but that is all that's available.

Did a load of grounding work to counteract disassociation recently. Think that therapist has never been in bloody pain! I want to dissasociate right now!!!

[Chat2U]

Sorry - I get selfish when in pain. I've loads of stuff on this, will share later if that's OK.

[Pairofboots in reply to Chat2U]

Hi, the symptoms you mention, are these similar to previous times, following a period of excess? It's just under current circumstances, you say about throat inflammation, and struggling to breathe, with little or no improvement. Have a checked out if you might have caught covid? Can't be too careful 🍀

[Chat2U in reply to Pairofboots]

Hi! Actually the throat inflammation/closed throat are new (and a little scary to be honest!), but I'm asthmatic so the breathing issues are not new, just worse at the mo. Had Covid in Dec20 but not since. Usually lateral flow twice a week.

Have you had it?

Ax

[Pairofboots in reply to Chat2U]

No I have managed to avoid covid, probably more by luck and isolation, than judgement.

Look after yourself x

[Plenty]

The bust stage can take longer to recover from. First time I went through it, I really felt I’d gone back in my recovery by 18 months, back to being in bed resting, word finding difficulties increasing, lack of interest in everything and everyone, panic attacks, no tolerance to noice, incontinence of bowels and bladder, extremely low energy, social isolation, memory issues exasperated etc….

To be honest I now avoid certain activities, just to keep me in a better mood and avoid that slippery slope.

[Painting-girl]

Hi Jill, as everyone said - it is when you have a day when you feel 'normal' or close to it, and rush around - catching up with jobs, for example - only to find yourself barely moving for the next few days, or indeed the rest of the week - this is the 'bust' phase, when you are suffering badly from fatigue (and when memory, and all the other glitches we can get, like poor sleep,seem to get worse also).

The second part of this 'boom and bust' cycle is that having crashed out for a few days, or more, that you then feel better, you see all the stuff that 'needs' to be done, and have another 'boom' day, but then go back to where you started.

I was told by all my rehab team that the aim is to smooth out this up and down activity pattern, and instead aim.for gradually increàsing manageable activity over time, including daily exercise. Indeed my neuropsychiatrist put it more strongly and said that fatigue is the last symptom to go in post concussion, and that staying in a boom and bust pattern meant I could actually get worse over time. My neuropsychologist said to be aware of my mood deteriorating in a bust phase and making it last longer - at that point when I'm almost not able to move, and the misery thoughts add to a downward spiral.

Personally, I am beginning to think that being in a bad crash makes it harder to re-establish steady activity again, so re-enforcing a downward (instead of upward) spiral of activity level overall - perhaps made worse by the predictable worsening of mood triggered by the energy slump (don't know what everyone else thinks on that one?)

Am currently feeling crummy from christmas, and a lovely UK holiday break in January - complicated a bit by a hopefully non covid virus - so am actually trying to work out how to drag myself out of this one, so this post is slightly less than theoretical.

The physio and neuropsychologist advised regular brain breaks initially every hour to manage fatigue, and then a half hour break from tv/ reading/ screens/ noise etc in the afternoon and evening. They, and the neuropsychiatrist emphasised that the way to start managing fatigue is to identify what you can do on a 'bad' day and stick to that level of activity on a 'good' day, only increasing your level of activity cautiously and steadily by perhaps half an hour a week. Work out how many hours you spend watching tv, exercising, preparing meals on a bad day - and stick to that level of activity on a good day - just increasing what you do by half an hour on a couple of days a week -and, once you can maintain that, add another half hour, and so on. Fatigue diaries are also useful for spotting patterns - log your fatigue levels out of 10 three times a day, and note what you've done in-between.

This is what people with ME/ CFS sometimes call 'living within your energy envelope' - as they and other groups face similar challenges.

My team also agreed that doing nice but tiring stuff shouldn't be ruled out - but to manage that by planning to rest up a day or two before, and a day or two after. My neuropsychologist identified from my fatigue diary that I didn't have much control on what happened over the weekend, so suggested having quieter days on Fridays and Mondays for example.

All this is very sensible, and really does help, and overall I did increase my activity levels - actually helped by the original lockdown,when I found that my fatigue levels overall just plummeted, which made it easier to work out what caused bad energy drains, and what didn't.

But in recent months, despite having paced myself better in the run up to Christmas (back to regular breaks, and spreading out tasks) I think I overstepped my energy envelope too many days/ weeks in a row, and am suffering a bit now.

That said, I think that it's really easy to slip back into doing 'too much' and to maintain a constant background of fatigue - but again - perhaps that's just an individual choice?

[Jill777]

Thanks to all that contributed to my question i hope you can realise how helpful you all are especially the ones that discribe my days when writing what they have been doing. x

[Braininjurysurvivor]

I was told I’m doing this the boom and bust as I do way to much and then end up absolutely exhausted