The last fatigue flare: why you won’t know it’s the last one at the time

This is a quick blog that’s relevant to anyone with a fatigue challenge really, but particularly for those of you who are in the final bit of your journey.

Quick sidebar here! I should say that I help people with fatigue for all sorts of reasons, including those living with longer-term health conditions where ‘recovery’ might not be the right word, or even the goal. Indeed, even when I’m helping people with chronic fatigue type challenges, such as Long Covid or ME/CFS, I don’t tend to use the word ‘recovery’ very often — because, as you might already have realised, defining when you’ve actually ‘recovered’ isn’t as straightforward as you might think!

Instead, I tend to talk about achieving your ‘fatigue rescue’ mission, and ‘getting back to where you want to be again’.

Even if you have a medical reason that means it’s unlikely your fatigue will ever completely be a thing of the past — such as a lifelong thyroid imbalance or some autoimmune conditions — I’d still encourage you to aim to get your fatigue as well-managed as possible. I’ve guided many people to build a much steadier life and reach a point where those horrible, sizeable crashes become far less frequent, and sometimes stop altogether. So there’s still plenty in this blog that’s relevant if that’s your situation.

Anyway, sidebar over! Back to the main topic of this blog…

I’m into my eighth year of fatigue coaching now, and over the last few years I’ve naturally found myself supporting more and more people with chronic fatigue who are clearly in a much better place and, hopefully, in the latter part of their journey. I don’t tend to talk in percentages, but if I did, it would probably be the final 10–15% of their journey.

I hope that those of you who are earlier on in your fatigue challenge will take huge inspiration and hope from the fact that I see so many people get to that place. Indeed, you might be envying them somewhat! And it’s true that it’s a lovely place to get to — but it isn’t one that’s completely free of challenges, physically or emotionally. Indeed, in some ways it can actually feel a little more difficult to deal with the impacts of your (improved, yet still there) fatigue challenge.

I’m writing this today because I’m supporting a couple of people tackling fatigue journeys who are having to really dig deep to deal with a flare-up of symptoms. They’ve been in a much better place for a considerable while now, and had hoped that this was a thing of the past. But nope, here they are having to figure out how to cancel everything from their to-do lists for the next few days, and trying to remain calm while their mindset wants to take them back into those horrid worst-case-scenario thoughts.

Because the thing is, dips and flares can continue right the way through this sort of fatigue journey. It’s how you know you’re still ON your journey! If you weren’t having them, you might well be able to consider yourself over the line and just working on getting your full conditioning back again.

It’s just that by that final bit of the journey, these symptomatic spells are usually so much further apart. Sometimes months apart!! And although that probably sounds like a wonderful concept to those of you who are early in your fatigue challenges, it can actually be pretty tough to cope with a symptomatic spell after several weeks or months of daring to hope that you’re clear of it.

Added to which, there’s the tricky situation where you don’t necessarily know if it actually is a fatigue flare — or whether you’re poorly because you’ve picked up some sort of bug. Many of you will be familiar with that. I remember it very clearly myself…I’d be delighted when my husband got ill too (poor thing!) because it meant that what I was feeling wasn’t a disappointing fatigue flare, it was simply a virus that had got through my immune system’s defences. And hey, everyone succumbs to that at some point, don’t they?!

So this message is for those of you who might, at some stage, find yourselves dealing with a symptomatic episode that you REALLY had hoped was now in the past. First, my heart goes out to you. It’s horrible.

BUT please remember that these episodes do pass, and there’s every reason to hope that you’ll get back to where you’d been again once it has. I can’t promise that, of course, as I don’t know the individual circumstances around why someone might find themselves in that situation. But what I can reassure you about is that, for the vast VAST majority of people who reach out to me with a later-journey stumble, they get back to their previously lovely level of wellness quite nicely — assuming, of course, there’s not a medical reason why this isn’t possible.

So here’s a very simple list of things to focus on if and when you find yourself in this situation:

1. Remember, this happens to all of us. Goodness I remember those final flares well - but now, all these years later, I can see it was all part of the journey. And they didn't stop me achieving a fully successful fatigue rescue mission! But I wish I'd known that at the time.

2. Try not to worry. As we learn with these journeys, worrying about a less-good day doesn’t tend to help…indeed, it can often compound things further.

3. Cut back as much as you can. Your system needs some wiggle room to recalibrate and figure out how to get back to a steady place again.

4. Look after yourself. Stay hydrated, eat if you have an appetite, and get lots of healthy proteins and immune-supporting foods in (just in case it is a virus after all!).

5. Be patient. Give your system the time and space it needs to settle again.

6. Be honest with yourself. Have you perhaps been pushing things a bit too much lately? By this stage of the journey you can often ‘get away’ with that for a while…but sometimes it does eventually catch up with you (see my blog about Cumulative Onset Fatigue). Or have you gradually dropped too many of the helpful things that got you here in the first place? Perhaps you’re not taking enough time out, your bedtime has started slipping, or you’ve stopped doing some of the calming/nervous system practices that used to be part of your routine. It’s completely understandable that we loosen some of these things as we get better — indeed, I think we should! But a flare can sometimes be a useful nudge to check whether you’ve loosened a few too many at once. And let’s face it, most people would probably benefit from doing some of these things anyway, health challenge or not!

7. And remember…one day this will be the very last flare you ever go through!! The tricky thing is that we don’t know at the time that it was indeed the final one. So be ever hopeful that this time could be it!

   
   

I occasionally run a live webinar called ‘Crossing the Fatigue Finishing Line’. I don’t have one scheduled at present, but if you’re in that final part of your chronic fatigue journey and would like to hear my guidance on how to manage the challenges of this stage (and how to know you’re doing enough of the helpful things to actually get over the line) drop me a message. If there’s enough demand, I’ll happily schedule another one in.

Take care! ✨

Pamela

One day your fatigue flares will be behind you.