Finding Your Limits (Energy Envelope)
ME/CFS and fibromyalgia impose limits. Fighting against or ignoring your limits produces an intensification of symptoms called Post-Exertional Malaise. Finding and honoring limits, in contrast, offers a way to regain control and provides a path for safely increasing activity level.
Your Energy Envelope
The severity of ME/CFS and fibromyalgia varies greatly. To treat your condition effectively, you need to understand the severity of your ME/CFS and/or FM.
You can get an idea of the severity of your ME/CFS or FM by locating yourself on the ME/CFS & Fibromyalgia Rating Scale. Place yourself on the scale by answering the question "What is the highest level of functioning I can sustain without intensifying my symptoms?"
Your rating gives you an idea of the severity of your illness and of the activity level your body can tolerate at present, which we call the Energy Envelope. The average of people starting the Self-Help Program is 25, with most falling between 15 and 45. Whatever your current rating, remember that we have seen people improve from where you are.
The Little Envelopes
While it is useful to understand your overall limits, it's also crucial to understand your limits in specific areas. We suggest you focus on the seven listed below, which are described in detail in the article The Little Envelopes:
- Physical activity
- Mental activity
- Social activity
- Sensory limits
- Heart Rate
All seven areas are important and deserve your attention. By zeroing in on each area one by one, you can gradually build a detailed understanding of your limits and vulnerabilities. The Energy Envelope Worksheet is a free tool you can use for that purpose. For an example of defining the many envelopes, see the article Finding Your Energy Envelope, Part 2.
Three Places to Begin
Three strategies we recommend as you begin your work to understand your limits are:
1) Track Your Steps
To get an idea of your current limit for physical activity, use a pedometer to count your steps as described in the article Pedometers: A Tool for Pacing.
2) Track Your Heart Rate
Some people with ME/CFS and fibro are highly sensitive to their heart rate and experience relapses if the rate goes above a certain level called the anaerobic threshold (AT). For information about how to determine your threshold, see the article Pacing By Numbers.
3) Define Individual Activity Limits
A good way to understand your limits in particular areas is by trying experiments and keeping records, focusing on one specific area at a time and looking for how much you can do without intensifying symptoms. Areas that people often begin with include computer use, phone calls, TV viewing, housework, standing, driving, shopping, socializing, and exercise.