People with chronic illness - how do you push through to get stuff done?
June 1, 2020 2:01 PM   Subscribe

I have many chronic illnesses, and some are flaring up right now. I need to work, I need to do my physical and occupational therapy, I need to eat and take medication. But I'm really struggling to do anything more productive than laying in bed watching Netflix. Please tell me your tips, tricks, and hacks to push through flare-ups to get things done!
posted by The Almighty Mommy Goddess to Health & Fitness (13 answers total) 19 users marked this as a favorite
If major depressive disorder counts...

I make realistic to do lists, and I vigorously and physically check them off when done. It's a great reward. No task is too small to be listed. Reward yourself for every one complete with an internal hug.

Pomodoro the fuck out of critical tasks.

Recovery-community tip: it's easy to get overwhelmed. Reduce it to "do the next right thing".
posted by j_curiouser at 2:28 PM on June 1 [3 favorites]

From a current housemate with much lived experience with flares:
1. Don't beat yourself up about not being able to "productive" The extra pain from a flare-up takes up a lot of energy.
2. Eating and medications are important - prioritize getting those done. Hydration too.
3. Do PT and OT as you are able - your therapists should understand. Prioritize the ones that you know help most with pain reduction.
4. As for work, if you can take a few sick days to recoup, I recommend it. If that's not an option, talk to your co-workers, let them know you are in a temporary situation where you need a little extra slack.
5. Be kind to yourself. Laying in bed may be what you need for your mental and physical health. If you push yourself too hard, you will make the flare last longer.
6. You are not alone!! There are other people who know what you are going through. A flare will pass.
From one chronic illness warrior to another - I see you!
posted by metahawk at 2:30 PM on June 1 [6 favorites]

.I have checklists, some written, some mental. When I'm lethargic, I'm not going to independently think I need vitamin B12 and more water, but my checklist includes B12? (when did you last eat meat) and Have a glass of water or a cup of tea.
.Make sure the freezer is stocked with healthy food, so a nutritious meal is only minutes away. When you have limited energy, and must get work done, it's like having deposits in the energy bank. Likewise, limit the crappy food in the house; when you have no energy, sugar seems like a good idea, but it's not. Maybe a square of good chocolate if you need a motivator.
.Music. I finally got an Amazon echo dot speaker and I love asking it to play my music. Futzing with cds or firing up spotify isn't hard, but once you define what music you like, it's a shot of joy and rhythm.
.If you can, get up and dance or walk for 5 minutes to get your heart rate up.
.Organization. Even though you're under pressure, take the time to prioritize the tasks, calls, meetings, accomplishments for the day. Every time you check off a task, it feels great.
.Be fierce about not allowing interruptions and unneccessary distractions; there's a cost to them.
. Be good to yourself.
posted by theora55 at 3:16 PM on June 1 [2 favorites]

In addition to the above, more frequent long, hot showers are of some help to me. Ginning up the energy to go take one right now.
posted by The Underpants Monster at 3:31 PM on June 1 [3 favorites]

Do the absolute minimum. One good day of calm rest = one good productive day > two days of crap productivity and no rest.

I have a daily list with phone reminders for flare ups. I shower, brush teeth, take meds, etc. Then I have my actual to do list which I write on a sticky note from a computer todo list that is very Long. I pick what has to be done and fit it on a sticky note so I can't do too much.

Are there other people in the house who can help with things like making a cup of tea, making cereal (perfectly fine as lunch and breakfast on Low-energy days) and tidying up? Or taking over the daily chores so you do the weekly ones saved for high energy days?

It helps a lot to do something while watching Netflix. I knit, but you could sort paperwork, write postcards, draw silly cartoons - whatever Low-energy simple things you can do so at the end of a sick day in bed, you have a little something that is pleasant to look at.

Be kind to yourself. Being sick takes a lot of energy.
posted by dorothyisunderwood at 3:39 PM on June 1 [3 favorites]

My very first step, when I'm struggling, is to systematically check in on my body/self care and change all of the things I can change.

1. Water: have I been drinking enough water? Do I have a full bottle/cup nearby to drink from?
2. Food: do I need to eat something? What can eat that's absolute minimum effort (if that's just plain lunch meat, do that)? Do I have easily accessible snacks for when I inevitably get hungry later?
3. Bladder/GI: do I need to go to the bathroom and/or use a laxative?
4. Temperature: am I too warm or too cold? Do I need to turn on the AC or put on a sweater?
5. Medication: have I taken all my medication and supplements today? Do I need to take a Tylenol or Ibuprofen?
6. Hygiene: do I need to wash my face, brush my teeth, take a shower?
7. Mood: am I upset about something? Do I need to talk about it or journal with someone? Do I need to take half an hour to an hour to do something that brings me joy?
8. Noise: is it too loud or too quiet? Do I need earplugs or to close doors/windows? Do I need to put on background music for some energy/stimulation?
9. Body/posture: am I in a comfortable position? Do I need to get up and move around? Do I need to stretch anything out?
10. Environment: is the chair/bed/etc. I'm in comfortable? Do I need to get a pillow or footstool? Do I need to clear off my desk to make it easier to do work?

My second step is to figure out what's hard about being productive.

1. Do I know what to do? This is what I maintain a to-do list for. Anytime I think of something and don't do it immediately, throw it on the list. Even the smallest things go on there.
2. Do I know where to start? Try breaking it down into smaller steps. Try starting with just gathering the resources I'll need. "Gather resources" may need to be broken down into smaller steps.
3. Does it make anxious? Figure out what I'm afraid of. Do some thought-challenging. Figure out if there's a part I can do that doesn't make me anxious (can I write the e-mail but not send it yet?).
4. Am I getting stuck on the parts I can't do? Try and figure out if there are things I can do right now, whether in terms of physical/mental effort or I'm waiting on a person or tool.

The final step: if you've gone through all of that and are still struggling, give yourself permission to give up. Beating myself and trying to force myself to do things just means I'm less able to do things later. I try really hard to not spend three hours attempting and failing to do work. If after going through all those steps, I've been struggling for half an hour or more, then I give myself permission to give up and zone out for as long as I need to, which might be all day. That said, I try and pick something to zone out with that I actively enjoy, rather than just "filling up my brain." So, a video game I've been wanting to play, a book I've been wanting to read, etc. Sometimes, though, all I can do is mindless TV or internet browsing and that's okay too. Better to conserve my energy for the next day than continue to wear myself out trying to be productive and failing.
posted by brook horse at 4:12 PM on June 1 [11 favorites]

You need rest. Cut anything you don't need to do. Stock up on frozen microwave meals, paper plates, plastic forks, etc. so that you don't have to cook or do dishes.
posted by Jacqueline at 4:20 PM on June 1 [1 favorite]

I have the bad habit of over-promising what I'll get done today. I try instead to set priorities (must get done, would like to get done, get done if I'm up to it). I congratulate myself on meeting goals and remind myself that I got goals A and B done, at least, so C can wait until tomorrow.

Let yourself stop and rest. I have another bad habit of speeding up as I do a chore; I'm trying to finish before I run out of energy. Don't be me; try instead to slow down and take breathers when you need to.
posted by SPrintF at 4:47 PM on June 1

Modafinil is a stay-awake drug that I use occasionally to help push through. It doesn't help with pain, but makes pain less exhausting.
posted by metasarah at 6:28 PM on June 1

Prioritize things that will make you functional or keep you functional and only do the other stuff when doing them will not knock your functioning back appreciably.

This means peeing, drinking fluid and eating come before paying bills or washing dishes, and washing dishes so you can eat comes before paying bills. Never wash the dishes if it means you will end up not eating and will be worse off the next day than you are today. Being too run down to do self maintenance is a vicious circle.

Use pissing as a forcing function. When you get up to pee grab a few gulps of water, or bring the phone back with you so you are ready to make a necessary call, or pull something out of the freezer to defrost or do one of your occupational therapy exercises.

Try to do two things whenever you are functional enough to do one. So if you are functional enough to get down to the kitchen and nuke something to eat try to extend that effort to continue long enough to pay a bill on line, or throw in a load of laundry in the machine during the time the microwave is going. Keep in mind that if you can either heat up some food and eat it, or heat up some food, pay a bill and then not have the energy to eat the food you just heated up, you need to eat instead of pay the bill.

Check what sort of energy or motivation you might have and look for tasks that will fit your current abilities. If you need to get up and eat and you only have some brain to plan with, but can't find the strength to get up and make it as far as the kitchen don't let the fact that you don't eat keep you from jotting some things down in a journal.

Don't just do the absolute essentials. Doing nice things or fun things are also critical. Sometimes it is better to find a fun video to watch than to put a load of laundry on.

Skip non critical responsibilities without guilt. You don't need to fold laundry. You don't need to wash more than enough dishes to get you through the next meal. You don't need to wear a clean shirt but you do need to wear clean underpants. If you skip some of these supposedly non-negotiable things but pass an evening smiling and listening to your kids from the couch so they go to bed relaxed and cheerful you absolutely did not waste the evening. Your morale and mental health and the family's morale mental health are the priorities that comes immediately after survival.

Try to set up some routines that keep things going, such as a day to order groceries, or picking up the kids' laundry whenever you wander into their room. Mindless routines that can be done automatically and which don't require more than a miniscule amount of calorie-burning are very helpful to get your through days when the brain fog makes you unable to remember what your kids' names are let alone what day it is. You can drift through the house not sure what you are doing or what you need to do, and with routine habits like this end up with a household that can still function. Another example of a routine that helps keep everything from collapsing around you is to keep rebooting the laundry. If you have a habit of pausing, remembering laundry exists and going into your home laundry area and moving what is in there to the next stage you are much less likely to discover that nobody has had clean clothes for two weeks and the clothes in the washer are covered in black mold. It's completely sufficient if all you do is take the clothes out of the washer, shove them into the dryer and start it and then not think about them again for the rest of the day.

Come up with some micro tasks you can do that keep you or your household running for when you have a little bit of energy but not much brain. Make a list of these and post it somewhere you will see it so that if you are on your feet you remember to wash the dogs water dish, or change the garbage bag and put the old bag in the garage, or squirt a shot of shampoo into the toilet and give it a quick polish.

Keep cleaning supplies very close to every where you clean. If you have a two story home have a broom and dustpan and brush and paper towel and a bottle of spray cleaner on every floor greatly increases the chances that you will be able to clean up a glob of dog vomit without ending up back in bed for the rest of the day.

Have containers for dirty items. If you are not going to be able to do the dishes having a bunch of dishpans to stack the dishes in means that you will be able to clear the kitchen table much more easily than if everything that doesn't fit in the dishwasher is piled higgledy-piggledy on the kitchen table, and if you have dishpans for the dirty dishes it will help prevent items that are not dirty dishes disappearing into the mess.

Give yourself as many points for good moods as you do for chores done.

If you have enough energy use the pomodoro technique, remembering that the reward part of a pomodoro is an essential part of it. If you don't have enough energy for a standard forty-five minute pomodoro, a ten minute or even a five minute pomodoro is still enough to do a surprising amount of work, especially if you can fit in several of them. Five ten minute pomodoros will get more work done than one forty-five minute pomodoro so try that out if you dread the idea of committing to anything for a full forty-five minutes. Sometimes you get a lot more done with the five ten minute bursts of work, more than you would doing a fifty minute pomodoro.

Take some time at the end of the day, or before falling asleep to think of three things that went well that day, and the reason why they went well. Sometimes your things-that-went-well may be as pathetic as "We haven't been evicted because we still have time to get the rent cheque in before they can send us an eviction notice," but that is a much better thought before sleeping than, "We're about to be evicted because I can't motivate myself to pay the rent." The first thought might be a better motivator to pay the rent when you wake up than other one which can turn into self loathing.

Do some different things. If all you can do is schlep around on the property and you can't motivate yourself to get dressed and you have done nothing but net surf and cobble together minimal food for three days you will feel better if you do things like go sit on your balcony and eat some food while listening to the birds, or lie on the couch and read a book.

If you are physically capable of it do some range of motion exercises even if you are not up to doing anything that counts as exercise. Just getting into different positions and holding them, such as squatting instead of always being in a chair sitting, or sitting cross legged on your bed or bending over to do a comfortable toe-touch type of stretch is very helpful for you body. When you are in zombie mode you may never raise your hands unless you are bringing them to your mouth, much less raise them above your head, and your body suffers like a child not allowed to play. Do easy things that you never do to bring some variety into the monotony of being a housebound zombie. Lie down on your balcony floor if you have a balcony, or on the living room floor if you do not. Getting up and down from the floor is something that most adults don't do and sometimes starting around sixty they begin to discover they can't do it any more. Range of motion and variety are very good for a depressed or healing brain.

Figure out if there are any of your PT or OT exercises you can do in places where you tend to collapse. If you collapse in bed, figure out if you can do some exercises in bed and maybe you can motivate yourself to do half your exercises there instead of none at all. If you are spending all your time glazing at the computer bring your exercise bands to where you sit looking at the computer. That way if you get any motivation you can grab them and don't have to maintain the motivation long enough to go to another room. Even if you are going to do most of the exercises in the centre of your living room, keep the bands where you sit, so that you can grab them if you stand up. If necessary get a second set of bands or print out a second set of exercise instructions and put it in the living room so that you can at least do some of the exercises at whatever location you are in.

Try to live by crip time. Your schedule is not the clock, the year, the due dates on your bills or the suggestions your therapists have made for you. Your schedule is when your body is capable of it. Learn your body so that you know its rhythms. If your therapist tells you to do forty reps every day and your body allows you to do thirty reps three times a week, then know that your body overruled your therapist. Your body knows what it can do. Wait patiently and do your thirty reps when you can. Don't give up because you can't do forty reps every day. You are not your physical therapist's imaginary example of a typical patient. If your therapist is good they will say, "Aim for forty reps every day,"and appreciate what you can do and you do do. The body that only lets you do thirty reps three times a week is the body that you and your therapist are trying to help.
posted by Jane the Brown at 6:32 PM on June 1 [5 favorites]

i pick a single thing that needs to get done one day and i do the fuck out of that thing. then i take a nap. sometimes that thing is just "take a shower" or "eat an entire meal that a normal person would consider a full meal". under current life conditions i am less concerned about "sleep normally" bc i will just pass out eventually when my body gets super mad about that.

i'm not going to pretend that any of that is so-called good behavior for managing chronic pain but it's the best i have right now.

the main thing that makes my life easier is that i absolutely fucking refuse to cook for myself, ever, at any time. i will gladly reheat things in the microwave, or even in a single pot or the oven, but anything that requires any kind of preparation other than "put this in the oven and set the timer" is not going to happen, ever, in my home, for any reason. if this is something you can afford to do then it is my strongest possible suggestion.

but also i end up eating a lot of fancy beef jerky and dried fruit.
posted by poffin boffin at 7:03 PM on June 1 [1 favorite]

I bet you in fact do more than lying in bed watching Netflix, but you don't consciously realize it or give yourself credit for it. Acknowledging what you already do can make you less depressed and even give you a slight boost in energy.

j_curiouser's point about giving yourself credit even for small tasks is really important! I have depression and low thyroid and my energy levels vary from lower-than-average for my age to abysmal. When things get bad, my inclination used to be to feel like "I didn't accomplish anything today" when really, if I gave myself credit for all the chores I did, it was not nothing. So I sometimes will include even daily routine chores on my list, especially if I'm feeling particularly self-condemning. Making dinner is a thing! Taking the trash out matters! Scooping the litter box counts! These all require effort and contribute towards a functioning household.

Also, you say you "need to work". Make sure that you don't do more work than you need to do. If you are any sort of perfectionist, you may be requiring yourself to work perfectly, or work more than adequate, rather than just work. If you are used to being a high performer, investigate being merely competent and see if you can get some energy back that way.
posted by nirblegee at 10:04 PM on June 1 [1 favorite]

And please remember, Voltaire, the French writer, said, “The best is the enemy of the good.” Confucius said, “Better a diamond with a flaw than a pebble without.” And, of course, there's Shakespeare: “Striving to better, oft we mar what's well.”
posted by theora55 at 8:28 AM on June 4

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