Thursday, 11 September 2014

"Play-Up & Lay-Up" not "Boom & Bust"

Early in my ME encounter I was told to avoid "Boom and Bust" and to aim for day to day consistency.

I was also given the advice:
"Do only 60% of what you can sustain without producing symptoms".

Now these two bits of advice are excellent, but not at all easy to achieve.  After all, if I really DID do so little, as to never produce symptoms, then how would I know if I was starting to improve?

I was thinking about this dilemma recently, and being a science teacher (prior to ME) I couldn't resist a few graphs to help me think all this through!  Perhaps they'll help you too?


1. PACING ZONE.  In an ideal world our daily activities would fluctuate very little.  The wiggly blue line on this graph shows only minor day to day change. I aspire to this!  I am told this gives my body the best chance to heal itself.

Click any image to enlarge

2. BOOM & BUST!  We all recognise this one!  Something comes up that we want to do - and we do it!  The thrill of the "doing" releases some adrenalin - so we keep on doing that activity.  It's the classic BOOM scenario.  I often hear folk talking about getting as much done on their good days as they can.... 

However, once we come down off this high we experience a big crash downwards, and for several days or more we are in the BUST ZONE and totally unable to do our normal activities!   If lucky, we can BOOM & BUST and not loose any long term ability.

3. BOOM, BUST AND DECLINE....  This scenario is much more frustrating.  Sadly it seems to be the one I find myself in.  Any incursion into the BOOM ZONE, not only causes a crash into the BUST ZONE, but also changes my boundaries - apparently permanently..... (I called it a lowering of my glass ceiling in a previous post.)

The incentive to avoid BOOM AND BUST is therefore much higher, than if I could simply do a week's payback to recover previous levels.  

4. PLAY UP & LAY UP.  This is my compromise for those special moments.  It is a very cautious move away from the PACING ZONE, involving voluntary LAY UPS  both before and after the activity.

The "PLAY UP" moment is controlled as tightly as possible.  I stop the activity while I still feel able to do more and start the Post Activity LAY UP no matter how well I feel.   It is not easy.  If I've got it right then I should have almost no symptoms.  Ironically, it also might seem to others that my condition is not so severe - because I tend not to enter the BUST ZONE!


THE RANDOM FACTOR.  This is something that we might all encounter.  A life event, or a viral infection or other wild card, can change the best laid plans.  We can't control everything, but I feel we owe it to ourselves to treat our bodies as best we can.  

TESTING BOUNDARIES?  Obviously each time I succeed in "playing up" with out problems, I learn some-thing about where my boundaries lie.  Further, by noting any small symptom responses, I can better judge how much to attempt next time. 

SELF DISCIPLINE is key, because often I'll have to back out of something that I feel well enough to attempt.  Friends are also likely to say things like, "Sorry you weren't well enough to join us...." and this makes me feel frustrated, because they are probably imagining me much more unwell than I actually am.  Yet the concept of Laying Up is hard for well folk to grasp.  

GOING FORWARD?  I'm hoping that careful PACING with a little bit of Play Up & Lay Up will help me sustain my current levels and ultimately give my body the chance to heal itself... 

I no longer expect recovery to be anything other than a slow process!


Post linked in this article:  The Exercise Catch22!

Links to more of my thoughts here:

Managing Illness through Pacing;
Do you STOP soon enough? March 2015
Pacing and Unpredictable Events Sept 2014
"Play-Up & Lay-Up" not "Boom & Bust" Sept 2014
The Exercise Catch 22! Jul 2014
ME Awareness - Why NOT Exercise? May 2014
Thoughts on Travel and ME Mar 2014
The Dilemmas of Exercise and M.E.  Dec 2013

Monitoring Activities for Pacing:
Monitoring ME: Part 1 - Fitbit Sept 2014
Rhythm+ and Endomondo: HR monitoring for ME Aug 2014
A few notes on using a HR Monitor for Pacing Feb 2014


  1. Yes! I find this very helpful. I can also relate to the boom-bust-decline pattern, sadly. I'm doing better at pacing than I was, and resting well, and spending a lot of time lying down, which is really helping.

  2. This is very useful. Thanks for explaining it so well.

  3. I find the idea of Play Up and Lay Up quite helpful. It's a useful way of looking at how to break the boom and bust cycle, which I admit I'm still struggling with, though getting better. I have been doing pre-emptive rests for a while now, though it doesn't always work - sometimes I'm still unable to take part in that thing I was planning to. But it works more often an not and I like the idea of pre and post event Lay Up. Thanks for sharing.

  4. Nice description of what I have found works for me. I push the envelope till I sense a shift then back off and rest up, inbetweens go steady and keep my HR below 120.
    It becomes intuitive if I stick to my routine but if I step out of that then still I risk a crash

  5. Glad this was reposted. Another tricky element is that the 'pacing' level, how much energy is available to use without causing harm changes daily, even throughout the day.

    This is one of the reasons I find using the heart rate monitor, and paying attention to recovery time, so useful. When I see my HR increase with less exertion, or when my HR takes longer to go back down, and when it doesn't return to resting rate - I know my safe pacing level has dropped and I have to act accordingly.