Teach me to convalesce!
June 20, 2020 9:26 AM Subscribe
After contracting probable-covid two months ago, I'm now dealing with lingering post viral fatigue. I've learned from online resources that the key to recovery is not only to restrict physical exertion, but also to try to limit thinking, stress and worry. I have absolutely no idea how to do the latter. More inside.
I'll try to keep this as concise as possible (not my strong suit!). I'm a chronic worrier and over thinker. Long term anxiety issues ramped up a couple of years ago after a series of unfortunate events, scaled up again with the start of a new job at the beginning of the year that I was finding stressful, and then went into overdrive in lockdown. And then! Then I got the suspect-virus. Not badly enough to need hospitalisation, but badly enough to be in bed for three weeks and very, very frightened at its peak, when I was unable to do anything for about six days but lie still and breathe.
A very gradual recovery after that evolved into post viral fatigue. I'm wary of this developing into CFS, which I think is a concern given the prolonged stressload in the run up to this (plus my body's propensity to manifest stress physically). I've read that the best way to aid recovery now is to restrict physical exertion, and to cut out as much thinking and worrying as possible - to try to empty my head.
But... I don't know how to do this! Really, at all. My head is constantly running with worry, as is its default state - it's always trying to puzzle things out and fix things, which isn't fixing anything at the moment. My best techniques for dealing with this normally are getting enough exercise to break a sweat, going for a long walk (which allows my thoughts to sink into a rhythm and flow, rather than being skittish and fractured as they are when stressed), and, when things get really bad, jumping on a plane to sit on a sunny balcony and stare blankly at passers-by for a week or two, which helps reset me a bit. These are currently all off the table, so I'm not sure what to do.
After positive signs of progress I attempted to return to work last week (on reduced hours) to an in-person job that resumed while I was ill, but it triggered a worrying relapse, and I've spent a week straight feeling tired to my bones, barely able to sit up, and breathing hard if I manage to get myself out for a short, slow walk. I've been off work again since. This is really disheartening after gradual (if back and forth) progress that had made it possible to start living a bit more normally, and again is making me worry that this is going to be a long term issue that I've just managed to exacerbate.
I'm thinking I should not be considering returning to work over the next few weeks to minimise additional stress (which is, gladly, a possibility). But, how do I switch my head off? How on earth do I stop worrying? It feels like beginners' meditation may be in order, but they all seem to focus on breathing, which has an adverse effect at the moment since all I did for weeks was lie there panicking about my raggedy-ass breathing. Other relaxation techniques may be available, but I'll need you to point me to them.
I'm doing my best to distract myself with some light hearted TV (Parks and Rec, B99) absorbing, but not too perilous PS4 games, and audiobooks. But apparently even this counts as a stimulation that should be rationed during recovery. I think 'no thinking' really means 'no thinking', which really is uncharted territory to me. Like, science fiction stuff.
I'm doing the other things pretty right (minimal news/social media, eating healthily, sunshine when there is some, regular sleep schedule etc.) but I have no clue how to quiet my overactive head.
Please, hive mind, help my mind stop buzzing and teach me to quiet my thoughts.
I'll try to keep this as concise as possible (not my strong suit!). I'm a chronic worrier and over thinker. Long term anxiety issues ramped up a couple of years ago after a series of unfortunate events, scaled up again with the start of a new job at the beginning of the year that I was finding stressful, and then went into overdrive in lockdown. And then! Then I got the suspect-virus. Not badly enough to need hospitalisation, but badly enough to be in bed for three weeks and very, very frightened at its peak, when I was unable to do anything for about six days but lie still and breathe.
A very gradual recovery after that evolved into post viral fatigue. I'm wary of this developing into CFS, which I think is a concern given the prolonged stressload in the run up to this (plus my body's propensity to manifest stress physically). I've read that the best way to aid recovery now is to restrict physical exertion, and to cut out as much thinking and worrying as possible - to try to empty my head.
But... I don't know how to do this! Really, at all. My head is constantly running with worry, as is its default state - it's always trying to puzzle things out and fix things, which isn't fixing anything at the moment. My best techniques for dealing with this normally are getting enough exercise to break a sweat, going for a long walk (which allows my thoughts to sink into a rhythm and flow, rather than being skittish and fractured as they are when stressed), and, when things get really bad, jumping on a plane to sit on a sunny balcony and stare blankly at passers-by for a week or two, which helps reset me a bit. These are currently all off the table, so I'm not sure what to do.
After positive signs of progress I attempted to return to work last week (on reduced hours) to an in-person job that resumed while I was ill, but it triggered a worrying relapse, and I've spent a week straight feeling tired to my bones, barely able to sit up, and breathing hard if I manage to get myself out for a short, slow walk. I've been off work again since. This is really disheartening after gradual (if back and forth) progress that had made it possible to start living a bit more normally, and again is making me worry that this is going to be a long term issue that I've just managed to exacerbate.
I'm thinking I should not be considering returning to work over the next few weeks to minimise additional stress (which is, gladly, a possibility). But, how do I switch my head off? How on earth do I stop worrying? It feels like beginners' meditation may be in order, but they all seem to focus on breathing, which has an adverse effect at the moment since all I did for weeks was lie there panicking about my raggedy-ass breathing. Other relaxation techniques may be available, but I'll need you to point me to them.
I'm doing my best to distract myself with some light hearted TV (Parks and Rec, B99) absorbing, but not too perilous PS4 games, and audiobooks. But apparently even this counts as a stimulation that should be rationed during recovery. I think 'no thinking' really means 'no thinking', which really is uncharted territory to me. Like, science fiction stuff.
I'm doing the other things pretty right (minimal news/social media, eating healthily, sunshine when there is some, regular sleep schedule etc.) but I have no clue how to quiet my overactive head.
Please, hive mind, help my mind stop buzzing and teach me to quiet my thoughts.
Best answer: From a guided meditation, some terms to consider: "Body Scan" (instead of focusing on the breath, you're focusing on different parts of the body) or "Metta" or "Loving Kindness" (where you channel loving thoughts towards your thoughts and others... I know it sounds a bit "woo" but it can make a difference). And if you're having trouble falling asleep, I really like "Yoga Nidra" where it is super relaxing and helps me drift off especially when I am feeling anxious at night. A meditation app I like to use is Insight Timer, which allows you to find different meditations categorized by these different areas and from different speakers. Most of the content is free.
Can you do gentle stretching or yoga? Or, is there a repetitive craft like thing you can do, like knitting or crocheting?
I've also found the book "Worry Cure" to be helpful (and was recommended somewhere else on the Green). There's a section on health related worries, so that might be particularly relevant for you. Some of the guidance include, setting a side a time for worries, challenging the worries you do have, allowing yourself to feel the "fear" associated with the worry (vs. worrying to... displace feeling the fear).
Wishing you the best. This sounds like a tough time.
posted by ellerhodes at 9:48 AM on June 20, 2020 [4 favorites]
Can you do gentle stretching or yoga? Or, is there a repetitive craft like thing you can do, like knitting or crocheting?
I've also found the book "Worry Cure" to be helpful (and was recommended somewhere else on the Green). There's a section on health related worries, so that might be particularly relevant for you. Some of the guidance include, setting a side a time for worries, challenging the worries you do have, allowing yourself to feel the "fear" associated with the worry (vs. worrying to... displace feeling the fear).
Wishing you the best. This sounds like a tough time.
posted by ellerhodes at 9:48 AM on June 20, 2020 [4 favorites]
How about light and non-worrying podcasts and audiobooks? I like to combine audiobooks with crocheting to keep both my hands and brain too busy to think if I'm feeling anxious!
posted by euphoria066 at 10:00 AM on June 20, 2020 [2 favorites]
posted by euphoria066 at 10:00 AM on June 20, 2020 [2 favorites]
Best answer: Breathing is a very useful way to focus while meditating, but the important part is focusing. You could tap your finger to a regular beat and as long as you are able to be there, present, with your finger tapping you will be training your brain to be in a simple place. Or, far more often, training it to move back to a simple place after it has wandered off again. Don’t get angry with yourself when it does, just redirect — the same thing happens to the Dalai Lama, it’s part of the process.
I strongly suggest investing in a meditation app that will ring a bell on a regular basis to remind you what you’re doing.
Also, if you haven’t seen The Good Place now would be a great time to experience some extremely thoughtful and funny TV.
posted by Tell Me No Lies at 10:05 AM on June 20, 2020
I strongly suggest investing in a meditation app that will ring a bell on a regular basis to remind you what you’re doing.
Also, if you haven’t seen The Good Place now would be a great time to experience some extremely thoughtful and funny TV.
posted by Tell Me No Lies at 10:05 AM on June 20, 2020
Video games/app games will eat hours without complex thinking and also drown out a lot of general world-stress. I recommend solitaire-type games, mah jong, tetris, pinball, bejeweled and related, crush-style games, light sudoku, Zen Koi, Two Dots. If you're into it, world-building or farming games (Stardew Valley has gotten me through two family deaths, a pandemic, and curfews so far this year), city/community/park-building and Sims-type. Other commenters may have personal favorites to recommend.
I can't play most defense/fighting video games on my best day because I find them too stressful, but the original Plants vs Zombies is still a go-to game for me, and the only video game I've ever "finished", much less subsequently played through several more times.
Puzzle games are kind of on the bubble, but many of them are engaging but not complex-thinking exactly. There probably are puzzle games that are too hard, but I generally find ones like Monument Valley (also has super soothing music and graphics) and the Room games do not exhaust me further when I am tired.
posted by Lyn Never at 10:20 AM on June 20, 2020 [6 favorites]
I can't play most defense/fighting video games on my best day because I find them too stressful, but the original Plants vs Zombies is still a go-to game for me, and the only video game I've ever "finished", much less subsequently played through several more times.
Puzzle games are kind of on the bubble, but many of them are engaging but not complex-thinking exactly. There probably are puzzle games that are too hard, but I generally find ones like Monument Valley (also has super soothing music and graphics) and the Room games do not exhaust me further when I am tired.
posted by Lyn Never at 10:20 AM on June 20, 2020 [6 favorites]
BTW, I just checked on Steam and the original ("GOTY Edition") Plants vs Zombies is $0.99, and the entire PopCap Party Pack (PvZ, Zuma Deluxe, Chuzzle, Peggle, Bejeweled 3 - all good timesinks, a deal even if you only like 2-3 of them) is $8.74. I highly recommend PvZ on desktop/laptop or very large tablet, but I prefer mousing to tapping for shoulder/elbow/wrist health.
posted by Lyn Never at 10:25 AM on June 20, 2020
posted by Lyn Never at 10:25 AM on June 20, 2020
what about painting with watercolors? not actively trying to learn, but soft, wet-on-wet, abstract painting. just losing yourself in the colors. it can be incredibly meditative.
posted by changeling at 10:26 AM on June 20, 2020 [3 favorites]
posted by changeling at 10:26 AM on June 20, 2020 [3 favorites]
I'm doing my best to distract myself with some light hearted TV (Parks and Rec, B99) absorbing, but not too perilous PS4 games, and audiobooks. But apparently even this counts as a stimulation that should be rationed during recovery.
I... don't know how literally you should take the advice you found. As a person with chronic health issues that have variously been diagnosed as fibro/cfs, I can say that sometimes if I can spend a few days just lying around, reading whatever I want, watching whatever I want, and sleeping whenever I want, that helps me feel functional again at least as well as trying to just relax, and often much better. Like you, I often find trying to not think about things stressful in itself. I try to avoid things that will get me emotionally worked up - material that makes me cry or feel anxious is the opposite of helpful (to me at least, ymmv). But funny things? Exciting things? Nice and interesting things? Those are great, and if they're engaging so much the better.
That said, there are various low-key things you could do, like listen to music (maybe make your room dark if you really want to just focus on the sound and nothing else); talk with friends or family; do something productive but easy like join one of those volunteer transcription efforts (random example). Maybe watching nature videos, or just having something like a six-hour train video on in the background, might help quiet things down a bit.
If you really do want to try the no-thinking approach, though, I remember reading (maybe here) about a Japanese therapist (I think) who developed a system for dealing with chronic stress or trauma (I think...) that involved, as a first step, something like spending 5 days in your room and forcing yourself to do nothing. If I can remember his name (or if someone else can, or knows of a similar approach) maybe articles on that would be a source of some details.
tl;dr: focus on what seems to work for you, not on one-size-fits-all health advice that may or may not just be the fad of the day.
posted by trig at 10:31 AM on June 20, 2020 [11 favorites]
I... don't know how literally you should take the advice you found. As a person with chronic health issues that have variously been diagnosed as fibro/cfs, I can say that sometimes if I can spend a few days just lying around, reading whatever I want, watching whatever I want, and sleeping whenever I want, that helps me feel functional again at least as well as trying to just relax, and often much better. Like you, I often find trying to not think about things stressful in itself. I try to avoid things that will get me emotionally worked up - material that makes me cry or feel anxious is the opposite of helpful (to me at least, ymmv). But funny things? Exciting things? Nice and interesting things? Those are great, and if they're engaging so much the better.
That said, there are various low-key things you could do, like listen to music (maybe make your room dark if you really want to just focus on the sound and nothing else); talk with friends or family; do something productive but easy like join one of those volunteer transcription efforts (random example). Maybe watching nature videos, or just having something like a six-hour train video on in the background, might help quiet things down a bit.
If you really do want to try the no-thinking approach, though, I remember reading (maybe here) about a Japanese therapist (I think) who developed a system for dealing with chronic stress or trauma (I think...) that involved, as a first step, something like spending 5 days in your room and forcing yourself to do nothing. If I can remember his name (or if someone else can, or knows of a similar approach) maybe articles on that would be a source of some details.
tl;dr: focus on what seems to work for you, not on one-size-fits-all health advice that may or may not just be the fad of the day.
posted by trig at 10:31 AM on June 20, 2020 [11 favorites]
There's a reason a lot of religions use moving strings of beads between one's fingers and repetitive prayers. A string of costume pearls will do, and any quotes, lyrics or poetry that are pleasant for you. The rhythm of it is soothing to the convalescent lack of focus and the words and manual sensations keep the brain busy.
posted by I claim sanctuary at 10:41 AM on June 20, 2020 [1 favorite]
posted by I claim sanctuary at 10:41 AM on June 20, 2020 [1 favorite]
Sorry to comment again, but this just occurred to me: you could also experiment with using background sound.
Here's a few. And another. Youtube is full of these kinds of things.
posted by aramaic at 11:34 AM on June 20, 2020 [2 favorites]
Here's a few. And another. Youtube is full of these kinds of things.
posted by aramaic at 11:34 AM on June 20, 2020 [2 favorites]
One old convalescence idea was to take to the seaside. I wonder about going to pretty natural spots nearby and simply bring a blanket, nice treats, a beachy book, and simply being out in nature a bit. Walk gently a little if you feel up to it, but mostly just sit in front of a pretty view and allow yourself to watch that. Could be combined with the watercoloring or meditating or music listening mentioned already.
posted by shadygrove at 12:04 PM on June 20, 2020 [4 favorites]
posted by shadygrove at 12:04 PM on June 20, 2020 [4 favorites]
Best answer: FifteenShocks, I've had myalgic encephalomyelitis since 2004 and have been varying gradations of bedridden because of it since 2007 - because I didn't get good advice on the need to limit exertion. I'm a worrier too, and ME, as it does, has triggered anxiety issues I didn't have before being ill. You are right to do all you can to limit exertion, including mental exertion, and you're right that it is quite hard.
For anyone who happens by this question and wants to know more about post-viral fatigue and the need to limit activity, here's an excellent handout intended for a general audience. ME Association INFORMATION ON Post-viral fatigue (PVF) and Post-viral fatigue syndrome (PVFS) following coronavirus infection. You'll note that in the management section, watching TV and computer work are noted as mental activity.
What's important is figuring out where your personal limits are - which will shift over time, partially but not entirely depending on what you do. Being more aware than average of your physicality, you're probably in a good place to cultivate a sense of what is okay for you and what is not.
What's vitally important is to *not* find the limits by hitting them. The way to approach this is to find them by determining what level of activity results in improvement. What makes this harder is that because of how post-viral fatigue works, which is like ME in this respect, you probably won't get negative consequences immediately - they may be delayed by a day, or two days, or even three.
To stay within limits, a lot of people with ME do something called pacing. This is limiting exertion by using a heart rate monitor to stay below a heart rate threshold, and keeping an eye on consequences by recording daily activities and tracking heart rate, blood pressure, and temperature on awakening and retiring. (You may want to include O2 sat.) Then they know, when their HR, BP, and temp go up a little the day after or two days after an activity, that their body is saying "no" and "rest more." There's much more about pacing at How to Get On.
For things you can do while minimizing exertion, my favorite list of bedbound activities is this three-part one from Sarah Stanton: The Severe ME Bedbound Activity Masterlist. There are low-stimulation mental ones and ones that involve some limited physical movement.
You may find as you track your activity that some video is okay for you, but when limiting exertion in a low-energy state it definitely counts. I have had difficulties with video since 2007 - sometimes some has been possible within my energy limitations, sometimes it's all been impossible and has made me worse. Audiobooks are right out for me because trying to get all the information from that one sense is even more difficult somehow, but they work for other folks with ME. I couldn't listen to music at all for more than a decade. Things moving in my visual field trigger dizziness, which knocks out video games. And it's very difficult not to be able to distract oneself from one's suffering *somehow*. So I really sympathize.
I know it's no fun to work within scary new limits, but it's a lot worse to have to do it for the rest of your life, so I encourage you to continue to do your best now to give yourself the best outcome down the road. MeMail me if you like.
posted by jocelmeow at 12:07 PM on June 20, 2020 [14 favorites]
For anyone who happens by this question and wants to know more about post-viral fatigue and the need to limit activity, here's an excellent handout intended for a general audience. ME Association INFORMATION ON Post-viral fatigue (PVF) and Post-viral fatigue syndrome (PVFS) following coronavirus infection. You'll note that in the management section, watching TV and computer work are noted as mental activity.
What's important is figuring out where your personal limits are - which will shift over time, partially but not entirely depending on what you do. Being more aware than average of your physicality, you're probably in a good place to cultivate a sense of what is okay for you and what is not.
What's vitally important is to *not* find the limits by hitting them. The way to approach this is to find them by determining what level of activity results in improvement. What makes this harder is that because of how post-viral fatigue works, which is like ME in this respect, you probably won't get negative consequences immediately - they may be delayed by a day, or two days, or even three.
To stay within limits, a lot of people with ME do something called pacing. This is limiting exertion by using a heart rate monitor to stay below a heart rate threshold, and keeping an eye on consequences by recording daily activities and tracking heart rate, blood pressure, and temperature on awakening and retiring. (You may want to include O2 sat.) Then they know, when their HR, BP, and temp go up a little the day after or two days after an activity, that their body is saying "no" and "rest more." There's much more about pacing at How to Get On.
For things you can do while minimizing exertion, my favorite list of bedbound activities is this three-part one from Sarah Stanton: The Severe ME Bedbound Activity Masterlist. There are low-stimulation mental ones and ones that involve some limited physical movement.
You may find as you track your activity that some video is okay for you, but when limiting exertion in a low-energy state it definitely counts. I have had difficulties with video since 2007 - sometimes some has been possible within my energy limitations, sometimes it's all been impossible and has made me worse. Audiobooks are right out for me because trying to get all the information from that one sense is even more difficult somehow, but they work for other folks with ME. I couldn't listen to music at all for more than a decade. Things moving in my visual field trigger dizziness, which knocks out video games. And it's very difficult not to be able to distract oneself from one's suffering *somehow*. So I really sympathize.
I know it's no fun to work within scary new limits, but it's a lot worse to have to do it for the rest of your life, so I encourage you to continue to do your best now to give yourself the best outcome down the road. MeMail me if you like.
posted by jocelmeow at 12:07 PM on June 20, 2020 [14 favorites]
This sounds like advice that is similar to that given to people recovering from brain injury, where even listening to music or thinking a lot lead to serious neurofatigue. I’ve been there and it’s hard to just *not* really think or do anything, but you might find some good strategies by searching for advice about recovering from brain injury, concussions or neurofatigue.
posted by heurtebise at 12:32 PM on June 20, 2020 [2 favorites]
posted by heurtebise at 12:32 PM on June 20, 2020 [2 favorites]
Three things that help me in stressful situations are singing, swimming, and reading aloud -- all because they call on me to regulate my breathing, but the breathing is a side-effect and not the primary focus. Swimming is probably out for now, but if you have access to a tub, you might try letting yourself float and bob, above and below water, based on your breathing. Singing - there are probably YT videos that offer free easy voice lessons that might be distracting. And if you have a smart phone or computer, could you read to others online? Or record yourself reading kids books and share them with friends or family?
posted by cocoagirl at 12:36 PM on June 20, 2020
posted by cocoagirl at 12:36 PM on June 20, 2020
I think of myself as pretty empty-headed during the day, and I hum a lot as outer manifestation of the elevator music inside my head. Could try that if it doesn't annoy anyone?
posted by batter_my_heart at 3:14 PM on June 20, 2020
posted by batter_my_heart at 3:14 PM on June 20, 2020
I don't have chronic healtj issues or general nxiety butI did go through post-viral fatigue after a mild to moderate COVID19 infection. I didn't know to expect it and so it was a confusing time. The infection had depleted my reserves so, say if I skipped lunch because I was busy with work I would be sinking badly by around 4pm.
So you have 2 things to deal with, building your strength back and keeping anxiety at bay. You could channel the anxiety into restoring your health. Meal planning, making things that require low energy and perhaps ordering out a bit to change it up. Nap whenever you feel like it if your situation allows that. A few days of much needed indulgence will get you going atleast physical health wise.
If anxiety is part of your pathology, other people's suggestions will go only so far. Eating regularly and binge watching tv restores me when I'm sick, and when you're physically depleted there's not much else you can do, and perhaps that's contributing to your anxiety. The upside is that Covid is behind you.. the deal with the general anxiety perhaps you could reach out to a tgerapist, perhaps CBT, if you havent already.
All the best, feel better.
posted by whatdoyouthink? at 3:37 PM on June 20, 2020
So you have 2 things to deal with, building your strength back and keeping anxiety at bay. You could channel the anxiety into restoring your health. Meal planning, making things that require low energy and perhaps ordering out a bit to change it up. Nap whenever you feel like it if your situation allows that. A few days of much needed indulgence will get you going atleast physical health wise.
If anxiety is part of your pathology, other people's suggestions will go only so far. Eating regularly and binge watching tv restores me when I'm sick, and when you're physically depleted there's not much else you can do, and perhaps that's contributing to your anxiety. The upside is that Covid is behind you.. the deal with the general anxiety perhaps you could reach out to a tgerapist, perhaps CBT, if you havent already.
All the best, feel better.
posted by whatdoyouthink? at 3:37 PM on June 20, 2020
Best answer: Hey, I'm in the same boat, with prolongued post-probably-corona symptoms (about 2.5 months since I had the virus now), though not as severe as yours at this point by the sound of it. jocelmeow's answer is great and includes all the things I've picked up so far about managing it. I found Recovery from Chronic Fatigue Syndrome a helpful read (as long as you can focus on the advice, rather than the fact it took him a long time to recover!). The main tools I've taken from it are:
* Living within your energy limits rather than pushing at them. For me right now that's a slow 10 minute walk and 15 minutes of gentle yoga a day. I was walking a little further but since I cut back to give me the spoons to pick up a little yoga, my body's much happier (I know that maybe doesn't sound like post viral fatigue compared to being bedridden, but I used to run long distance, so it's still very noticeable as a sudden change). Sounds like you probably shouldn't be doing that much right now, but FWIW, I did the Yoga With Adriene Yoga for When You're Sick a lot, and she has a whole playlist of Restorative Yoga which is the term for yoga that's more about relaxing than working hard. But that sounds like you're maybe not quite there yet and need to rest more.
* Keep a diary of symptoms (including mental health, brain fog etc), physical activity, healing activities (rest, sleep, meditation, medications) and it makes it easier to see cause and effect, such as there is.
* Use these observations to stay within your energy limits, because, as jocelmeow says, the signals your body gives you in the moment may not tell you when you need to stop - the negative consequences will probably only come 1 to 3 days later.
* Keep your heart rate down.
* Rest before you need to - build in more, longer, regular rests than you think you need and have them even if you feel fine. Helps prevent symptoms. Keeping the diary helps me stick to this, because it becomes obvious if I haven't done it.
For times when I need to rest, I go with the Body Scan meditation, which gives you half an hour of very calming activity focusing on the sensations of different parts of your body in turn. I also listen to audiobooks/podcasts that you can dip in and out of, like Bill Bryson's A Walk in the Woods (no matter what point you zone out or rejoin, they're still walking in the woods, doesn't matter what you've missed), and the Ramblngs podcast with Claire Balding, which is hundreds of episodes of people chatting while strolling through pleasant British countryside - I listened to so many of these when I was ill! I'd nod off to someone going up a hill in Dorset and wake up to some dog walkers taking in the view at Loch Lomond. I'm trying the Stephen Fry in America audiobook at the moment, which is also pleasant and doesn't require you to follow a plot, though some of it is feeling uncomfortably dated given the pace of change in the US since it came out. Basically, stuff that has enough chatter to occupy my mind a little, without being demanding enough that I feel like I have to concentrate. Even if it's just background babble that you're not listening in to, it somehow helps to pass the time.
Best of luck. And heartfelt thanks to jocelmeow and all the others who went before us with post-viral symptoms that didn't come with a headline-grabbing catalyst virus. Your open-hearted sharing of the lessons you've learned through quiet patience and - too often - despite lack of medical support or public sympathy, is seen and massively appreciated.
posted by penguin pie at 4:58 PM on June 20, 2020 [4 favorites]
* Living within your energy limits rather than pushing at them. For me right now that's a slow 10 minute walk and 15 minutes of gentle yoga a day. I was walking a little further but since I cut back to give me the spoons to pick up a little yoga, my body's much happier (I know that maybe doesn't sound like post viral fatigue compared to being bedridden, but I used to run long distance, so it's still very noticeable as a sudden change). Sounds like you probably shouldn't be doing that much right now, but FWIW, I did the Yoga With Adriene Yoga for When You're Sick a lot, and she has a whole playlist of Restorative Yoga which is the term for yoga that's more about relaxing than working hard. But that sounds like you're maybe not quite there yet and need to rest more.
* Keep a diary of symptoms (including mental health, brain fog etc), physical activity, healing activities (rest, sleep, meditation, medications) and it makes it easier to see cause and effect, such as there is.
* Use these observations to stay within your energy limits, because, as jocelmeow says, the signals your body gives you in the moment may not tell you when you need to stop - the negative consequences will probably only come 1 to 3 days later.
* Keep your heart rate down.
* Rest before you need to - build in more, longer, regular rests than you think you need and have them even if you feel fine. Helps prevent symptoms. Keeping the diary helps me stick to this, because it becomes obvious if I haven't done it.
For times when I need to rest, I go with the Body Scan meditation, which gives you half an hour of very calming activity focusing on the sensations of different parts of your body in turn. I also listen to audiobooks/podcasts that you can dip in and out of, like Bill Bryson's A Walk in the Woods (no matter what point you zone out or rejoin, they're still walking in the woods, doesn't matter what you've missed), and the Ramblngs podcast with Claire Balding, which is hundreds of episodes of people chatting while strolling through pleasant British countryside - I listened to so many of these when I was ill! I'd nod off to someone going up a hill in Dorset and wake up to some dog walkers taking in the view at Loch Lomond. I'm trying the Stephen Fry in America audiobook at the moment, which is also pleasant and doesn't require you to follow a plot, though some of it is feeling uncomfortably dated given the pace of change in the US since it came out. Basically, stuff that has enough chatter to occupy my mind a little, without being demanding enough that I feel like I have to concentrate. Even if it's just background babble that you're not listening in to, it somehow helps to pass the time.
Best of luck. And heartfelt thanks to jocelmeow and all the others who went before us with post-viral symptoms that didn't come with a headline-grabbing catalyst virus. Your open-hearted sharing of the lessons you've learned through quiet patience and - too often - despite lack of medical support or public sympathy, is seen and massively appreciated.
posted by penguin pie at 4:58 PM on June 20, 2020 [4 favorites]
I agree heartily with the people urging you to live within your energy envelope. I've heard the analogy of a budget: you have $10 you can spend today. If you spend all of it every day, you'll never have enough for a rainy day emergency. It's better to spend a little less than you have and save up.
The suggestions for meditation are great. If you've never done it before, try a 5 minute guided meditationc and see how you go. Do it twice a day if you're up for it. Once you feel comfortable with that, try 10 minutes and just gradually increase.
I highly recommend the book The Happiness Trap. It's more of a short course where you read a chapter a day and do the related exercise. It has a lot about how to deal with stress and worry. It's helped me a lot.
posted by mosessis at 3:36 AM on June 21, 2020
The suggestions for meditation are great. If you've never done it before, try a 5 minute guided meditationc and see how you go. Do it twice a day if you're up for it. Once you feel comfortable with that, try 10 minutes and just gradually increase.
I highly recommend the book The Happiness Trap. It's more of a short course where you read a chapter a day and do the related exercise. It has a lot about how to deal with stress and worry. It's helped me a lot.
posted by mosessis at 3:36 AM on June 21, 2020
The Headspace app has a free introductory course called The Basics. It's a great way to learn meditation if you haven't done it before.
posted by mosessis at 4:29 AM on June 21, 2020 [1 favorite]
posted by mosessis at 4:29 AM on June 21, 2020 [1 favorite]
Best answer: +1 to all the suggestions about learning to live within your energy envelope. Hopefully this will just be temporary, and learning to do that is the best way you can help that right now.
With respect to TV, podcasts, etc., it's something you can experiment with to find your boundaries. Like others suggested, it's probably best to slowly expand up to those boundaries, because over-extending may have more negative effects. e.g. I find shows like Parks & Rec, The Good Place, etc. are fun because they're engaging and I get involved. That may not be what you want right now. When I was sick, I watched (and re-watched) a ton of very trashy reality TV because it demanded a lot less of me - the voice-over constantly re-told me what was going on, and there was no long-term plot, so I could let my attention fade in and out without being stressed about following things. There are other options, too, like live cams of wildlife, people who record their local birds and squirrels, ambiance videos that are just sounds and a little movement in a natural setting, videos of people making things, etc.
posted by pie ninja at 4:32 AM on June 21, 2020
With respect to TV, podcasts, etc., it's something you can experiment with to find your boundaries. Like others suggested, it's probably best to slowly expand up to those boundaries, because over-extending may have more negative effects. e.g. I find shows like Parks & Rec, The Good Place, etc. are fun because they're engaging and I get involved. That may not be what you want right now. When I was sick, I watched (and re-watched) a ton of very trashy reality TV because it demanded a lot less of me - the voice-over constantly re-told me what was going on, and there was no long-term plot, so I could let my attention fade in and out without being stressed about following things. There are other options, too, like live cams of wildlife, people who record their local birds and squirrels, ambiance videos that are just sounds and a little movement in a natural setting, videos of people making things, etc.
posted by pie ninja at 4:32 AM on June 21, 2020
Response by poster: Thank you everybody for your excellent input. The responses offering encouragement that I'm doing the right thing have made me feel very supported, so thank you especially for those.
I think I've figured out that at this stage it's key to try to empty my head as much as possible for at least parts of the day, rather than add in different stimulation to try to distract, and that's why historically I've found sitting on a balcony empty-headedly people watching more genuinely restorative than netflix binges - it gives the necessary time and space for frantic thoughts to sort and refile themselves, and start to release. I think the guided meditation links are going to prove helpful for this, with other great ideas like watercolour painting giving a way to reach more of a calm flow during the day without using up too much brain capacity. I'm looking forward to checking out Lyn Never's game suggestions when I'm starting to feel slightly more put together (and thank you for looking them up on Steam for me).
The podcast and audiobook suggestions will be good for some low key stimulation when my brain refuses to sit still, and aramaic's background sound suggestions in a dark room will work in times when I need to double down on rest. It reminded me of a suggestion I picked up elsewhere on the green to use Gregorian chanting as a low key, soothing stimulation when in bed with migraine, and that migraine rest is in some ways a comparable scenario, where overstimulation and too much sensory input is counterproductive to real rest and recovery.
One of the things that's been hampering recovery (that maybe I should have mentioned before) is the repeated bouts of insomnia that have been a feature of the illness. For some reason, regardless of exhaustion levels, I've been completely unable to nap at any point (probably the overactive head, though at the peak of the illness I became slightly scared to go to sleep because it felt like I had to keep myself breathing sometimes, which maybe got me into bad brain habits). So the nights I haven't managed to fall asleep (like last night! Hello Sunday) have been lost forever, and my energy debt is a little worse than it might have been (it also has a big impact on my heart rate, both resting and while doing anything even basically active, like making food). I'm hoping the meditations could help with the insomnia too, and I'm thinking that doing some gentle yoga and stretching might help my body feel like it's done something that day in a way that still keeps my heart rate down and energy expenditure low, but might encourage sleep at the end of the day, and help with the achey legs that get restless at night. Any other input on this is welcome.
I'm glad the importance of pacing has been repeated, and I'm going to get a heart rate monitor to start to give me some data and parameters. That should hopefully also help me feel a bit more in control of my circumstances too, which is a helpful side effect.
I think trying to bring my attention back to where I am and celebrating the small victories (like, being able to sit in a chair in the garden listening to birdsong) instead of ruing the things I can't yet do will help re-centre me and help shrug off some of the anxiety noise. Shadygrove has made me realise that my last minute trips away to deal with overwhelm were in fact a bit of old fashioned convalescence, and that sitting somewhere quiet with a nice view closer to home will still be good medicine for this. I also remembered this morning the value in just lying flat in the grass looking up at the clouds, which helped slow my thoughts.
Hopefully the extended trough of the last week or so is just a blip brought on by a bad decision to return to work too soon, and I'll take heart that I was on an upwards trajectory before then thanks to trusting my instincts in the early stages to scale things up very slowly, and keep my heart rate down. I'll make sure to keep giving my limits the patience and respect they need - mental and emotional now, as well as just physical.
Apologies for the chat filter response - I really just want to convey my gratitude to you all, for the suggestions, support, and for giving me different perspectives on how to approach this. This has been very helpful.
posted by FifteenShocks at 7:21 AM on June 21, 2020 [3 favorites]
I think I've figured out that at this stage it's key to try to empty my head as much as possible for at least parts of the day, rather than add in different stimulation to try to distract, and that's why historically I've found sitting on a balcony empty-headedly people watching more genuinely restorative than netflix binges - it gives the necessary time and space for frantic thoughts to sort and refile themselves, and start to release. I think the guided meditation links are going to prove helpful for this, with other great ideas like watercolour painting giving a way to reach more of a calm flow during the day without using up too much brain capacity. I'm looking forward to checking out Lyn Never's game suggestions when I'm starting to feel slightly more put together (and thank you for looking them up on Steam for me).
The podcast and audiobook suggestions will be good for some low key stimulation when my brain refuses to sit still, and aramaic's background sound suggestions in a dark room will work in times when I need to double down on rest. It reminded me of a suggestion I picked up elsewhere on the green to use Gregorian chanting as a low key, soothing stimulation when in bed with migraine, and that migraine rest is in some ways a comparable scenario, where overstimulation and too much sensory input is counterproductive to real rest and recovery.
One of the things that's been hampering recovery (that maybe I should have mentioned before) is the repeated bouts of insomnia that have been a feature of the illness. For some reason, regardless of exhaustion levels, I've been completely unable to nap at any point (probably the overactive head, though at the peak of the illness I became slightly scared to go to sleep because it felt like I had to keep myself breathing sometimes, which maybe got me into bad brain habits). So the nights I haven't managed to fall asleep (like last night! Hello Sunday) have been lost forever, and my energy debt is a little worse than it might have been (it also has a big impact on my heart rate, both resting and while doing anything even basically active, like making food). I'm hoping the meditations could help with the insomnia too, and I'm thinking that doing some gentle yoga and stretching might help my body feel like it's done something that day in a way that still keeps my heart rate down and energy expenditure low, but might encourage sleep at the end of the day, and help with the achey legs that get restless at night. Any other input on this is welcome.
I'm glad the importance of pacing has been repeated, and I'm going to get a heart rate monitor to start to give me some data and parameters. That should hopefully also help me feel a bit more in control of my circumstances too, which is a helpful side effect.
I think trying to bring my attention back to where I am and celebrating the small victories (like, being able to sit in a chair in the garden listening to birdsong) instead of ruing the things I can't yet do will help re-centre me and help shrug off some of the anxiety noise. Shadygrove has made me realise that my last minute trips away to deal with overwhelm were in fact a bit of old fashioned convalescence, and that sitting somewhere quiet with a nice view closer to home will still be good medicine for this. I also remembered this morning the value in just lying flat in the grass looking up at the clouds, which helped slow my thoughts.
Hopefully the extended trough of the last week or so is just a blip brought on by a bad decision to return to work too soon, and I'll take heart that I was on an upwards trajectory before then thanks to trusting my instincts in the early stages to scale things up very slowly, and keep my heart rate down. I'll make sure to keep giving my limits the patience and respect they need - mental and emotional now, as well as just physical.
Apologies for the chat filter response - I really just want to convey my gratitude to you all, for the suggestions, support, and for giving me different perspectives on how to approach this. This has been very helpful.
posted by FifteenShocks at 7:21 AM on June 21, 2020 [3 favorites]
I'm glad this has been useful! It's really important to fix that insomnia, as you've seen in its effect on your heart rate. You can't heal if you're not getting good rest. Given what a whack from inflammation your body has taken, I wager the sleep problem is probably not entirely psychological.
Sleep is the #1 thing my ME specialist works on, because problems with it are universal in ME and finding a solution that works is so crucial to stabilizing people with it...and, admittedly, there's so little else that can really be readily fixed. There are lots of non-prescription and prescription sleep aid options out there - give your doctor a call.
I *totally* understand the need for brain filing. I used walking/running and repetitive culinary prep (vocational and avocational) for this when I was well, and those have been hard to replace. One hobby I've picked up that's worked for me is sending postcards. I have a few dozen junior pen pals, and writing a few lines each day has helped with that needed time for synthesis.
And I agree having data really helps with feeling one has a basis for making good decisions and not feeling so adrift.
As additional encouragement: A friend of mine got a bad case of pneumonia several years ago and got knocked down in a way looked post-viral and had features that worried me it was going to turn permanent. But she was wisely very, very gentle with herself. She's a data person too, so she kept spreadsheets along the way about how she was functioning that were useful to her. Full recovery took two years, but she's back to normal now.
Our current world system's ideas about how long healing takes are not always well-aligned with how long it actually takes, and the body knows nothing about and is not influenced by that system. The body only heals at its own pace.
posted by jocelmeow at 8:44 AM on June 21, 2020 [1 favorite]
Sleep is the #1 thing my ME specialist works on, because problems with it are universal in ME and finding a solution that works is so crucial to stabilizing people with it...and, admittedly, there's so little else that can really be readily fixed. There are lots of non-prescription and prescription sleep aid options out there - give your doctor a call.
I *totally* understand the need for brain filing. I used walking/running and repetitive culinary prep (vocational and avocational) for this when I was well, and those have been hard to replace. One hobby I've picked up that's worked for me is sending postcards. I have a few dozen junior pen pals, and writing a few lines each day has helped with that needed time for synthesis.
And I agree having data really helps with feeling one has a basis for making good decisions and not feeling so adrift.
As additional encouragement: A friend of mine got a bad case of pneumonia several years ago and got knocked down in a way looked post-viral and had features that worried me it was going to turn permanent. But she was wisely very, very gentle with herself. She's a data person too, so she kept spreadsheets along the way about how she was functioning that were useful to her. Full recovery took two years, but she's back to normal now.
Our current world system's ideas about how long healing takes are not always well-aligned with how long it actually takes, and the body knows nothing about and is not influenced by that system. The body only heals at its own pace.
posted by jocelmeow at 8:44 AM on June 21, 2020 [1 favorite]
I found a book that might be useful, but note that I have not read it myself: Out of My Head. It popped up on Recomendo.
posted by aramaic at 10:43 AM on June 21, 2020
posted by aramaic at 10:43 AM on June 21, 2020
Best answer: I find Eckhart Tolle's videos on YouTube very relaxing. He has a calm manner. It's basically the Buddhist stuff of Being Here Now, but he communicates so well. Here's one. I do think that's the key: practicing just Being in the present. Also the body scan stuff, although when your body is scaring you, it can be anxiety-producing to focus on any of it specifically. See what works for you in that regard.
Most important is to keep reminding yourself that THIS is what you're supposed to be doing now: relaxing, healing, feeling whatever you're feeling at the moment, nothing to be concerned about, nothing to be worried about, just allow yourself to notice: where in my body am I feeling tense? legs? arms? am I clenching my jaw? what's tight? and just exhale as you allow the tension to leave your body slowly, gently. (can you tell that I have to practice this myself all the time?)
Also I have people in my life who have gone through this post-COVID period, and they were worried too, but it DOES get better. Try not to tell yourself e.g., oh my god I didn't sleep last nght!! I'm not healing! what am I going to do?? etc. If you don't sleep one night, there is another night. (of course, if there are sleep aids that help you, don't deprive yourself! I'm talking about your feelings about what you're "supposed" to be doing. Try to let it go; none of it matters. Allow yourself to just Be there in the space you're occupying, and look around, and if that's too exhausting (and I know how that feels too, just close your eyes and let yourself float in there.)
It will all evolve, change, and you don't have to do anything to make it so. It just will, all by itself. You're also allowed to feel happy sometimes that the worst is over. You don't have to feel happy, or anything, but if you want to sneak in a little feeling of relief, you're allowed,, it won't jinx anything! You're here, in all your exhausted glory, it's okay to be just as you are. Have a good night!
posted by DMelanogaster at 5:52 PM on June 21, 2020 [2 favorites]
Most important is to keep reminding yourself that THIS is what you're supposed to be doing now: relaxing, healing, feeling whatever you're feeling at the moment, nothing to be concerned about, nothing to be worried about, just allow yourself to notice: where in my body am I feeling tense? legs? arms? am I clenching my jaw? what's tight? and just exhale as you allow the tension to leave your body slowly, gently. (can you tell that I have to practice this myself all the time?)
Also I have people in my life who have gone through this post-COVID period, and they were worried too, but it DOES get better. Try not to tell yourself e.g., oh my god I didn't sleep last nght!! I'm not healing! what am I going to do?? etc. If you don't sleep one night, there is another night. (of course, if there are sleep aids that help you, don't deprive yourself! I'm talking about your feelings about what you're "supposed" to be doing. Try to let it go; none of it matters. Allow yourself to just Be there in the space you're occupying, and look around, and if that's too exhausting (and I know how that feels too, just close your eyes and let yourself float in there.)
It will all evolve, change, and you don't have to do anything to make it so. It just will, all by itself. You're also allowed to feel happy sometimes that the worst is over. You don't have to feel happy, or anything, but if you want to sneak in a little feeling of relief, you're allowed,, it won't jinx anything! You're here, in all your exhausted glory, it's okay to be just as you are. Have a good night!
posted by DMelanogaster at 5:52 PM on June 21, 2020 [2 favorites]
In case these haven't made it across your radar, I thought I'd add them here for the "not alone" factor. Paul Garner is a professor of infectious diseases at Liverpool School of Tropical Medicine.
For 7 weeks I have been through a roller coaster of ill health, extreme emotions, and utter exhaustion
Covid-19 and fatigue—a game of snakes and ladders
Covid-19 at 14 weeks—phantom speed cameras, unknown limits, and harsh penalties
posted by jocelmeow at 1:33 PM on June 23, 2020 [1 favorite]
For 7 weeks I have been through a roller coaster of ill health, extreme emotions, and utter exhaustion
Covid-19 and fatigue—a game of snakes and ladders
Covid-19 at 14 weeks—phantom speed cameras, unknown limits, and harsh penalties
posted by jocelmeow at 1:33 PM on June 23, 2020 [1 favorite]
Response by poster: Thanks, jocelmeow. The 7 week recovery article was the last I'd read from him! It's good to have affirmation at this stage, and the last article made me laugh - when I spoke to my Dr after the return to work triggered this relapse I was also told "it's just anxiety", and dismissed. (Yes, I am switching GPs!)
Here's hoping the media spotlight on this now will bring wider attention to the issues faced by ME/CFS sufferers, and motivate a greater medical interest in tackling it.
posted by FifteenShocks at 2:56 AM on June 24, 2020 [1 favorite]
Here's hoping the media spotlight on this now will bring wider attention to the issues faced by ME/CFS sufferers, and motivate a greater medical interest in tackling it.
posted by FifteenShocks at 2:56 AM on June 24, 2020 [1 favorite]
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posted by aramaic at 9:45 AM on June 20, 2020 [1 favorite]