A profound feeling of no energy plus nagging aching pain

that turns into sharp pain when joints are moved.

Pain and loss of energy are the classic symptoms of RA. Fatigue-like energy loss is caused by inflammation in the body. No amount of rest will relieve it.  Cytokines, chemicals produced by the inflammation process, are a major factor. As inflammation is reduced with RA DMARDs, such as methotrexate and the biologics, the overwhelming fatigue  may also be reduced.

Sometimes the lack of energy seems like a permanent fixture in our life. Those of us who have few commitments can head for the couch with pillows, heating pad, and chocolate for the duration. Then we can happily carry-on when this flare is over. It works.

Then there are the rest of us. We have work commitments, young children, older children who need to be carpooled to soccer or tutors, husbands and elderly parents that need to be fed, business deadlines to meet. And on it goes. Time out is a luxury we don’t have.

Many have come up with concepts on how to manage this chronic condition plaguing those of us with autoimmune diseases. I can never remember them. I simply use the technique of pacing. Old. Tried and true.

For example, today we made a trip to Costco. I like to push the cart as it helps keep my arms strong. I am tired when we get home.  I refrigerate or freeze those items that need immediate attention. Then I sit down for a while with a cup of coffee and read.

I am currently reading a Pendergast story by Preston and Child. They are marvelous writers and Pendergast is a favorite character who has introduced me to many new concepts over the years.

I return to the kitchen and put away other items. But my pacing isn’t limited to managing groceries. I use pacing when I cook, do my laundry and even dress. Short bursts of activity followed by a rest.

I think we all do this to some degree. A little change in our activity level. We just need it to be deliberate when we have RA.

When we are unable to find a solution for our severe RA fatigue, it is easy to slide into a feeling where we are discouraged. It is easy to become depressed. It happens when we feel we are no longer able to cope with the demands of our life.

Pacing is one technique to add to our toolbox. It is something to practice while knowing flares will eventually pass at least for a while.  Yes, we have a miserable chronic disease. One idea will not solve our problems. But one idea will ease our way. And if we can patch together enough ideas, our lives will become hopeful, and we can carry on.