Aggressive Rest Therapy: My Experience

[trishrhymes]

Good for you Sasha, good luck. Let us know how it goes.

I'm still mentally gearing up for this. I haven't quite decided how I'll manage it.

I listened (or half listened, with concentration wandering) to a radio program about rest recently where they did brain scans with the mind focusing on one thing/task compared with letting the mind wander. The latter seemed to use more of the brain and more energy. I suspect I'll end up using this as an excuse to let me listen to radio or CD's while I rest!

I don't think I'd cope with 20 minutes rest / 20 minutes up and active. I'd end up feeling like a jack-in-a-box, and it would be more activity than I can manage. How about:

20 minutes up and active - meals, shower, chores etc
20 minutes bed rest
20 minutes bed activity such as reading or TV
20 minutes bed rest

so it's actually 20 minutes up then an hour in bed, but broken into rest/active/rest

and if I need to be up and active for longer any time, I could make the following rest period equally long.

I think I might find that more manageable. Except I can never stick to anything. Great at planning, rubbish at execution.

 

[Cheesus]

Wondering if people have ARTed successfully by resting in small bits frequently or in huge chunks?

I tried the "small bits frequently" method yesterday (20 mins active, 10 mins rest) and never felt rested - and couldn't stick to it completely because you can't eat a meal in 20 mins. Wondering whether to go for some epic stints in the middle.

I think it can be worth getting some epic stints in. It can sometimes take the body time to settle. Do you know how to meditate? If so then this is a good opportunity to settle down and do some concerted meditation. If not then it is a good opportunity to learn.

In my mind the real goal is for you to feel that you are resting an unnecessary amount. As I mentioned before, a good way to do this is to rest until you feel like you're ready to stop resting, then push on for at least another 10 or 15 minutes.

I am feeling motivated to give this another go now that you guys seem so keen. It will be good to get a break from my feverish use of the internet and obsessive discussions of Jeremy Corbyn on Reddit.

 

[Sasha]

I do know how to meditate but assumed it would be burning up fuel - so @trishrhymes's comment that it uses less energy than letting your mind wander is interesting.

I think the programme you mention might be one I've got recorded to listen to while I'm resting! I've had the radio on but haven't been concentrating. Maybe I should!

Boredom is the enemy of rest. I need to get my act together!

 

[TiredSam]

Trouble is, it's hard to shorten a social visit, unless you can arrive, chat etc, then lie down in a quite room for 20 minutes, then get up and have the meal, so the visit is still enjoyable, but broken up with rests. Does this make sense?

That's do-able, I have friends who offer that.

 

[Cheesus]

I do know how to meditate but assumed it would be burning up fuel - so @trishrhymes's comment that it uses less energy than letting your mind wander is interesting.

I think the programme you mention might be one I've got recorded to listen to while I'm resting! I've had the radio on but haven't been concentrating. Maybe I should!

Boredom is the enemy of rest. I need to get my act together!

I've been practising for a number of years now and I can quite comfortably rest by just watching the breath gently, but earlier on meditation did sometimes take up more energy because I could get quite intense about it.

Boredom is the anti-rest. I find if I can push through a wave of boredom my mind sometimes starts to wander I forget I am resting.

 

[Sasha]

I'm thinking I need to have a core three-hour epic-rest period every afternoon while I'm doing this. That's the time I most feel the need of rest, most enjoy resting, and it's neither too soon to rest nor so late that it would interfere with my sleep, I think.

I'm going to treat it like a daily hospital appointment!

I'm going to get my radio etc. stuff all recorded and ready. I can record radio and play it through the TV via Freeview on my HD TV recorder and can play YouTube videos and podcasts through my laptop (and both are in my lounge, where I have a Z-bed flop-out foam mattress where I can lie down properly).

 

[Cheesus]

I'm going to treat it like a daily hospital appointment!

That sounds terribly depressing

 

[Sasha]

That sounds terribly depressing

It will shift my baseline for misery so low that three hours of rest will seem great by comparison to actually being in a hospital!

 

[Cheesus]

It will shift my baseline for misery so low that three hours of rest will seem great by comparison to actually being in a hospital!

Lower your expectations and you can never be disappointed. Good tactics.

 

[Spoons]

I think I'm going to try this too. I feel like I've plateaued the past couple of years & it's definitely not helping me mentally to feel stuck.

Not sure how I'm going to do it yet, I don't think a set schedule will work for me, but will try to bear in mind that I should rest more than I want/need to. I like @Cheesus' idea of pushing for an extra 10/15 mins after you're done. Will download some podcasts & see how it goes!

 

[Spoons]

Also, I got a Fitbit recently to monitor sleep, and I've noticed my heart rate goes into "fat burn" zone when I do anything physical. (I know they're not the most accurate things). Anyone else use monitoring devices? I'm going to try and incorporate it into working out how much rest & when, and seeing if ART makes a difference to that too.

 

[Snowdrop]

I'm very interested in knowing what would be a good tool to use in aid of ART that monitors heart rate (or anything else that matters)

 

[Mij]

I find I need ART in the mornings and early afternoons so I don't do too much during this time. When the evenings come around I feel quite well for the most part and this is when I cook, shower, talk on the phone etc.

What I do early in the day often dictates how I'm going to feel later on (for the most part).

 

[Little Bluestem]

I got a Fitbit recently to monitor sleep, and I've noticed my heart rate goes into "fat burn" zone when I do anything physical.

Do you know what you anaerobic threshold is? I am guessing that ART combined with going over your anaerobic threshold while up would be counter-productive.

 

[TrixieStix]

Hi TrishaMafia,

I really sympathise with you and all your troubles. I wonder whether you can find a way of keeping up some activities but do them in tiny bursts with complete rest in between.

Trips out to the grocery store or to visit friends are great for morale, but I'm imagining each can keep you active for an hour or more at a time which can be exhausting.

Trouble is, it's hard to shorten a social visit, unless you can arrive, chat etc, then lie down in a quite room for 20 minutes, then get up and have the meal, so the visit is still enjoyable, but broken up with rests. Does this make sense?

I do hope you find a way forward. So good you have a supportive spouse.

Best wishes.

Hello my fellow Trish! That is a good idea re: resting during social events and maybe I could even do it when I have to run errands in town with my spouse. I do usually end up laying on the couch at any larger dinner party I go to where slipping away for a bit isn't so obvious. But perhaps I should do this also when having dinner with just a few friends. They have offered before but I always say no as not to be rude. Thanks for the feedback.

 

[Spoons]

Do you know what you anaerobic threshold is? I am guessing that ART combined with going over your anaerobic threshold while up would be counter-productive.

It's impossible to work out your anaerobic threshold properly without doing actual exercise, but from past experience I'm certain I'm well below it so it should be fine, but I'll keep an eye on it. (In terms of Fitbits, I think that's more cardio/peak zones which I'm never in, but it works out zones by age so aren't always accurate).

 

[justy]

Wondering if people have ARTed successfully by resting in small bits frequently or in huge chunks?

I see ART as being slightly different to this other thing which seems more about pacing rest and activity.

Those of you who've had success with this - what regime did you use? Long rests (hour or more), short rests (20 mins or less), or a mixture throughout the day?

I have to strongly agree with Tanniaaust that what is being discussed on this thread is not ART but a form of pacing. A lot of ME charities and even the NHS recommend alternating rest with activity in small chunks in order to not overdo and to cope better.

Aggressive Rest Therapy was first suggested to me by Dr Myhill and she meant COMEPLETE bed rest for a prolonged period of time. I rest for hours every day anyway (severe ME) so for me if I want to increase my functioning I need to completely rest. This will help to restore the adrenals etc, but as people with severe ME find, this will lead to a higher level of functioning eventually, but this higher level cant be sustained.

I did a prolonged period of ART at the beginning of my severe relapse 8 years ago on Dr M's advice. At first I felt much worse - this is normal. It then took around 6 months of very intense daily bed rest to start to feel better, then, and only then do you gradually and very slowly begin to introduce more activity. if you start to feel worse from activity you back off a bit.

When resting I would limit computer use, but could listen to audio books or the radio instead, and do gentle things like colouring books. I would get up to eat and sometimes to shower and occasional trips out in the car and with my wheelchair.

Now I am back into overdoing push crash cycle and the only thing that gets me out of the awful crashes is back to bed for up to a week at a time and back to audio input only, with a little TV watching (im quite ok with this).

There is no way I could alternate laying down for 20mins with activity for ten or 15 - it would not be enough rest for ART - perhaps if you are mildly affected it could be? But the idea is to completely rest the bidy and adrenals and not tax them at all.

This doesn't discuss ART, but is a general good read re resting

http://www.drmyhill.co.uk/wiki/Getting_enough_rest_-_an_essential_part_of_managing_CFS

 

[Sasha]

Thanks, @justy - I do think that people are getting confused between ART and pacing, and I'm trying to determine what ART actually is in practice. I was assuming (perhaps wrongly) that the amount/timing is different according to what level of function you've already got. I'd been hoping that three hours a day of bedrest (plus extra rest scattered throughout the day) might do it for me, but maybe not.

I'll read that Sarah Myhill thing - thanks!

 

[justy]

The ART you describe seems to be at times of relapse/crashes which I have also been forced to do; but total bed rest for days is not an option as I still have to feed myself etc.
The whole point of pacing is to try and avoid crashes.
That said, what I understand from this thread, is that ART is resting for prolonged periods of time even though you may not feel you need to.

Not just at times of relapse etc, but as a therapy to improve functioning in general over time. I would still get up to make food and do daily care for myself - I also had 4 kids at home at this time so it was just as much bed rest as I could possibly manage!

yes agreed pacing is to avoid crashes - however for some just tasks of daily living are enough to cause continual crashing. If I JUST look after myself I can feel ok, but if I try and look after the house and my kids and do daily cooking then im in a continual push crash cycle.
Yes agreed - ART id resting even if you don't feel like it. It's not just pacing.

 

[justy]

That would then (according to what you posted before) make you also 'mildly affected', as we all crash if we try and do too much, be it looking after kids or going to work.

Sorry I don't understand what you mean by this. I have severe ME. I didn't mean I felt OK overall, just that if all I am doing is resting, dressing, making myself a small meal (literally nothing else) then I can feel tolerable - that doesn't mean I have improved functioning.