Posted by: Abby Caplin, MD | February 19, 2012

Chronic Illness and Exhaustion

My own energy varies from day to day, but with good amounts of consistent rest, well planned, I’m thankful to live a full and creative life.

For many years, though, I functioned in a deficit range, leading to illness and exhaustion. I believed then that it was normal to push myself beyond capacity. I’d done it for such a long time, and I was good at it. Why not keep going?

I didn’t listen to my body as it “talked” back to me through symptoms.

A great method that I use to help myself gauge my stamina is to check in with my body during the day. I like to think in terms of “energy coins,” like a stipend that I have been given, and one that I must spend wisely. In my mind, when my energy bank is full, it has ten coins. As I go about my day, I pay out to the world, slowly or quickly, depending on my circumstances.

If I drift down to about five coins, I reassess my plans and make appropriate adjustments. Four coins, and I know I’m headed for at least a day in bed. It’s hard making those adjustments and even after all these years, I can still sometimes feel guilty about letting others down. But the sooner I make those changes, the sooner I recover. Make it a habit, like taking medicine, to closely watch your energy. If your energy bank is low, take the appropriate action. You have my permission!



  1. This is so hard to do sometimes, but very important! My husband and kids are really good at knowing that it’s time to reassess. Sometimes we don’t do the things we had planned, but that’s life. I feel badly for my children, but I think they are learning an important lesson about caring for their bodies, even if they aren’t chronically ill.

  2. Thanks for your great comment, Karen. It’s really helpful when everyone in the family is on the same page. You are serving as a wonderful role model!

    • Fortunately (and unfortunately) I had a good role model myself. My mom has carpel tunnel syndrome, Rhumatoid Arthritis, and Lupus. She was diagnosed when I was in high school. I grew up knowing that we have to make allowances for those we love but that “down time” could be just as special.

  3. I wonder how your mother was able to make “down time” in a way that made it special. It would be helpful, I think, for others to know how, if you are comfortable sharing.

    • We often had quiet activities at home that allowed my mom to be a part of what was happening but didn’t require a lot of energy. We had jigsaw puzzles and board games that were calm activities. We would watch movies together or watch a TV show then discuss what we thought. My brother and I learned how to express ourselves and form opinions through many episodes of Oprah and Phil Donohue. Family time didn’t always have to be something big and exciting. We just learned to enjoy life TOGETHER, no matter what the energy level was.

      With my own girls I do many of the same things. With the invention of the Wii I can sit and watch them do active games or I can join them for more “brain games.” We like to read, sometimes together, sometimes all in the same room but with different books. We have discussions about the books we’ve all read. It’s really a matter of readjusting thoughts on what “quality time” looks like.

      • Thanks for sharing this, Karen. It’s quite a gift that you kids got, and that your own kids are now getting—intellectual growth, guidance, wisdom and your presence.

  4. After reading the following,” If Howard Hughes can direct his empire from bed, so can I,” I repainted and re-imagined my bedroom to make it feel more like a sitting room and library. So I don’t feel as if I’m leaving the world to rest, just being in a smaller albeit just as rich world.
    thank you for your blog, dear Abby

    • I love that idea Alison! My husband put a futon in our bedroom so I could go in there and relax without being in bed. I really enjoy that because it gives me a different point of view, too. I hope you are enjoying your library and sitting room when you need it!

    • Yes, it’s a wonderful idea, Alison. You’ve created a healing space/environment that feeds your soul. Good job! Please share any time. 🙂

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