How to Actually Pace Yourself With RA
Lene Andersen breaks down how to keep yourself from ending up with an RA flare because you overdid it … again. by Lene Andersen, MSW Patient Advocate
“Pace yourself.” This is the magic solution to all my woes of trying to live my life while managing rheumatoid arthritis (RA). At least, it’s presented as such by a miscellany of doctors, nurses, friends, family, and random articles on the Internet. When the solution comes wrapped in a nice little bow, but lacks an actual instruction manual, how are you supposed to implement this?
With everything that needs to get done in life, most of us end up exhausted and in pain on a regular basis, wondering yet again if we are missing something obvious. I have spent decades trying to work this out (usually while nursing a flare from overdoing it yet again) and this year, it finally clicked. This is what I learned and how I put it into action.
I learned to identify my obstacles. Whether you are repairing a leak in your bathroom or trying to improve how you live your life, it’s a good idea to identify the problem before you try to fix it. The way I see it, there are two obstacles to pacing yourself when you have a chronic illness. One is how bananas our lives have become. Along with work, taking care of your family, and being involved in your community, it seems we all need side hustles now as well. Realizing that my healthy friends were just as exhausted and burned out as me was really helpful—instead of “failing” because I have a chronic illness, I saw that we are all weighed down by trying to do too much.
The second obstacle is RA itself. We often have less energy than the average healthy person and simply can’t do as much. This, however, does not prevent us from trying! I have spent literal decades tangled up in my own expectations of what I “should” be doing, combined with the guilt I feel about not being able to be do it. Repeatedly getting sick from pushing too hard did not register. Or perhaps my denial was influenced by the grief of what I had lost and guilt that I didn’t—couldn’t—“measure up.” Somewhere along the line, I forgot how to say ‘no,’ to others, but especially to myself.
I started making hard choices. The obvious solution to being overwhelmed is to remove some of the many tasks you are juggling on a daily basis. But when everything seems essential (it’s not just me, right?), choosing what to take away is not so clear. Last fall, I got very sick because I’d kept pushing through my limits—so ill, in fact, that I had to step away from everything for five weeks. That’s a really long time, but guess what? The world didn’t end. This emphasized the truth of that wonderful saying: “Believing you are indispensable is the first sign of a nervous breakdown.” I have promised myself to remember this so I won’t have to get sick to regain my perspective.
Start with some deep thinking about what actually is essential. In a very difficult year, we’ve all had to reevaluate our lives and focus on what really matters, which has been a valuable pandemic-induced practice in prioritizing. When you’re making your weekly “to-do” list, for example, try putting a few things that may be less essential at the very bottom. This usually means that you don’t get there at all by the end of the week. If you never check these items off and the world is still turning, perhaps they weren’t crucial after all. Then repeat the exercise with another few less-essential items the following week, and keep whittling away until your life feels more balanced.
I let my body decide my day. Taking care of your life and the people in it starts with taking care of yourself. As you might imagine, I have not excelled at this. My go-to solution has always been to ignore everything my body tells me and keep going until it calls me nasty names and makes me sit still. But I have been gradually changing that approach through my #3Things system, a gentle way to improve your life with chronic illness. By choosing small things you want to try to do most days in a particular month, it’s possible to sneak in some pretty profound life changes. One month, I decided to let my body choose what I did each day. It meant taking a bit of time the night before to create three to-do lists—one for a good day, another for a medium day, and a final list for a bad day. I then started each morning by checking in with my body and letting it decide which list I followed.
The results were revolutionary, both physically and mentally. Because I wasn’t mindlessly pushing through no matter how I felt, I had much less pain and fatigue. Having a plan B and C meant I could get something done every day, even if it was the smallest, easiest task, and helped me feel really accomplished, even on the worst days. As a bonus, it also made it much easier to shrug off what didn’t get done because I was very conscious of having made the deliberate decision to prioritize my needs over the needs of The List. And guess what? By putting my body in the driver’s seat, I was doing things at a slow and steady rate instead of the usual push-and-crash cycle.
In other words, I paced myself.
And in that moment, I came to understand a topic I have done a lot of thinking, reading, and talking about over the years. Pacing yourself isn’t just about energy conservation (although it is that, too). It’s about finding a rhythm that allows for happiness, not just efficiency, and enjoyment of activities, not just execution of a to-do list. In short, pacing yourself is about finding the speed that lets you live your life to the fullest.