Daily Activity Ratio
Please list the number of hours spent in each of the following categories for an average day, a ‘good’ day, and a ‘bad’ day during the past month (total for each should add to 24 hours).
Activity Average ‘Good’ ‘Bad’ Day
a. Total hours sleeping: ______ ______ ______
b. Rest but not sleeping: ______ ______ ______
c. Light activity while sitting or
lying down: (reading, TV, etc.): ______ ______ ______
d. Moderate activities in house
(light cleaning, desk work, etc.): ______ ______ ______
e. Moderate activities out of house
(work, walk, drive, shop, etc.): ______ ______ ______
f. Vigorous activities (exercise,
heavy cleaning, sports, etc.) : ______ ______ ______
TOTAL 24 hrs 24 hrs 24 hrs
How many days of the past month would you consider ‘average’? _____
How many days of the past month would you consider ‘good’? _____
How many days of the past month would you consider ‘bad’? _____
____________________
What is very interesting about this method of activity rating is the constancy of the activity of a person with CFS over months and years.
I think this constancy is more diagnostic of CFS than any description of a very bad day. Even with the ups and downs characteristic of CFS, the activity level rarely goes up to normal.
Most healthy people have 12 hours of inactivity (sum of a, b, and c) and 12 hours of activity during the average day (sum of e, f, and g). But:
• People with severe CFS have 1 to 2 hours of activity (e + f + g);
• People with moderate CFS have 4 to 6 hours of activity;
• And people with mild CFS have 9 to 10 hours of activity.
It is important to communicate to your physician not just the presence of the symptom fatigue, but the importance of this symptom on your life. Whether "fatigue" is the right word or not, it is the effect of this symptom on your life that is important. It is this effect – the activity restriction – that seems to mess up a day.
But using the inappropriate word ‘fatigue’ may also mess up a day.
Don’t be pushy with your doctor. Do not expect that on the first visit the physician will understand CFS fatigue.
It is difficult to comprehend the complexity of this illness or any other with a single visit. But over time, the seriousness will become clear to your physician and the diagnosis understood. So lighten up, and give your doctor a break.