What?
I have realised that routine "coaching on pacing" is rather a broad topic, and for the majority of my professional journey I have been having these discussions with people who are systemically well, with a view to improve on a sedentary lifestyle. With the emerging population of service users recovering from Covid-19, it has become clear that routine coaching on pacing isn't particularly helpful to those suffering from severe clinical fatigue
So what?
Discussions limited to "taking it easy" aren't really sufficient when fatigue is so severe that ADLs are a struggle or even impossible to achieve independently. From personal experience, this is not particularly helpful advice, and runs the risk of alienating service users who feel like their fatigue is somewhat forcing them to "take it easy". I distinctly remember my most severe struggles surrounded not being able to to basic tasks without feeling too exhausted to do anything else, like not being able to wash my hair and go to the shop on the same day. Its important to avoid this disengagement from how service users might be experiencing the sequelae of their illness, and be able to offer advice that is personal, meaningful and helps them to increase their quality of life
What now?
Over the course of completing the Covid-19 Recovery and Rehabilitation module, what stuck with me the most were the "three P's" of fatigue management: Planning, Prioritising and Pacing. I had unknowingly used some of these techniques in my own recovery from fatigue and found them to be incredibly helpful in coming to terms with a slowed down pace of living. Whilst this may be reassuring for me, more importantly it gives a helpful way to structure conversations with service users, particularly with regards to being able to strike a balance between exerting yourself enough to elicit improvements and engage in meaningful activities, whilst not overdoing it and risking the progress of recovery. Having gone through the frustrations of coping with such severe physical limitations, I was interested to see if there was a way to positively frame such a distressing concept, and explain it easily to others. Further research led me to the discovery of "Spoon Theory", a fantastically simple, elegant and relatable metaphor for explaining limited energy or capability. I look forward to using Spoon Theory to frame the discussion of planning, prioritising and pacing activities with service users whom this may benefit, particularly those who present to FCP clinics with conditions such as fibromyalgia, PMR and MS.