Priorities

Choose the most important things to work on first. You might include:

•   Leisure activities and hobbies, e.g. swimming, walking, planting in the garden, making cards.

•   Social activities, e.g. going to see a film at the cinema.

•   Household tasks, e.g. ironing clothes.

•   Self-care, e.g. styling your hair, cooking a healthy meal.

•   Work (paid or voluntary), e.g. in a local charity shop.

There are different ways to change your pacing style. Here are some suggestions.

STEP ONE

List each activity and record the time it took you on a recent good day and a recent bad day (see Razia’s Pacing Plan below).

STEP TWO

Under the ‘Everyday plan’ heading, write the number of minutes in which you could realistically carry out that activity every day, despite pain.

STEP THREE

Under the ‘Times per day’ heading, write down the number of times you could repeat the activity. It may help to break tasks down into smaller activities: e.g. ironing for 10-minute periods; or painting a wall, then having a rest break (see Razia’s Daily Activity Plan below).

Here is Razia’s Pacing Plan, as an example:

This means that Razia plans to stand and cook for 12 minutes, six times per day. After each 12-minute cooking session, she will take a 5-minute break to sit down. Then, Razia could walk around and do three specific stretches for 4 minutes. See chapter 9. She could then return to standing to cook or move on to another activity.

Razia then gradually increases the everyday plan time by 2 or 3 minutes every four or five days. For example, after a month she has increased in her everyday plan her standing activities, like cooking, to 22 minutes. She rewards herself with her favourite fruit in season, mangoes. She starts thinking about other things she could do with the children.

Now try filling in your own Pacing Plan on the opposite page.

Pacing means thinking about:

•   How often to do an activity.

•   How long to spend sensibly at an activity.

•   When to do it in a typical day.

It sometimes means reducing unhelpful activities and increasing others. For example, Razia realized her underactive pacing style meant she needed to reduce her long periods of rest in bed. She still had breaks but planned fewer and shorter rest times (see her Pacing Plan above). This helped her fitness increase steadily.

Razia’s Daily Activity Plan (see overleaf) shows how she planned parts of her days, putting in her priorities, like taking the children to school. Her plan helped her pace. At the end of the day she could see she was more active (especially with the children), getting fitter and still had some rest times. She shared her plan with Hassian, her husband, and he was very supportive and offered some ideas too.

Here is a Daily Activity Plan for your own use. There is a spare Daily Activity Plan sheet, if you need it, at the back of the book (see p. 295).

How to deal with barriers to realistic pacing

Start by trying to work out what sort of situations might stop you from pacing more effectively. For instance:

•   Having to meet a deadline at work

•   Being ill, e.g. having flu

•   Having to cope with family demands

•   Having to deal with an emergency

•   Having a good or bad pain day

In your notebook, write down any barriers that you are facing at the moment.

Then, next to each barrier, write down what you can do to tackle it (see Chapters 6, 7, 9, 10 and 16 for ideas).

Here are some tips for success in changing your pacing style:

•   Time yourself while doing each activity.

•   Don’t say ‘I’ll just do 5 more minutes’ or ‘I’ll just finish this bit’. This type of thinking leads to overactive pacing.

•   Try and do some activity on bad days, even if it’s only 5 minutes. Be aware of unhelpful negative thinking or fearful predictions on difficult pain days. This type of thinking can reduce your activity further, so experiment.

•   Steadily increase the level of your activity. For example, you could gradually lengthen the time you spend driving the car from 10 minutes to 20 minutes over a three-week period.

•   Record and reward your achievements.

CHAPTER SUMMARY

•   Pacing is an important skill that can improve all aspects of your life. Identifying your pacing style and making changes helps you balance activities and breaks.

•   If you are underactive, you need to steadily pace yourself towards a more active life. If you are overactive, you need to plan more rest times and relaxation.

•   If you have a mixed pacing style, you need to monitor your activity. Get to know the situations, times or thinking that trigger a period of overactivity or underactivity.

•   Plan each day and choose what is important to achieve. Priorities are a vital part of pacing skills. Experiment with your Daily Activity Plan, especially with finding a balance between activities and rest or relaxation breaks. Reward yourself often, especially for effort.

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