The Fifty Percent Solution by William Collinge
The experts agree that lifestyle change is the foundation for recovery from CFS. According to Paul Cheney,, M.D., this is “easily the most important and often the least emphasized” part of treatment.
CFS is a cyclical disease. One important aspect of lifestyle change is how you manage your cycles. You can be “doing everything right,” and you’ll still have cycles, often for no apparent reason. You can, however, learn to reduce their severity, and even use them to your advantage. Here’s how.
“The Good Days” Waking up to one of those precious “good days” is like finding an unexpected $100 in your pocket. What do you do with this extra money? The temptation might be to go out and spend it all. You may want to “make up for lost time” and do everything you’ve been deprived of: go shopping, go for along walk, do the laundry, clean the windows, go to a movie, wash the car, shampoo the carpet, and finish those three or four other projects… knowing that this is a rare opportunity to “get a lot done.” And then, of course, you crash.
There is an alternative way to work with your cycles. You can actually use the good day to help build momentum toward healing. Think of the good day as a form of “capital” that can be invested in your healing process- rather than being spent or squandered.
“The Fifty Percent Solution” I call this “the fifty percent solution,” and it goes as follows: When you awaken to a good day, make an assessment of how much you feel you can do. For example, you might make a list of ten things you feel capable of doing and want to do today.
Now, instead of spending all your newfound capital, you would do half the things on your list, and then stop. For the next day or two, you observe your body’s responses If you crash, your assessment is adjusted downward on your next good day. If you feel fine, you may repeat this process, each time doing just half of what you feel capable of doing. As your confidence grows, your appraisal of how much you can do may increase, but you still do just half.
What do you do with the other half of your energy? This is the key. It takes some self-discipline, but here is where you have a chance to do something clever.The essence of the fifty percent solution is that you spend half your energy and invest the other half. What is not spent outwardly is used inwardly to support your body’s self-repair mechanisms. Thus, even though you don’t feel you need to, you take extra time to rest.
This piece is over 15 years old yet it rings as true now as it did when it was first published. Most ME/CFS patients – from necessity or desire – attempt to do too much. The difficulty, of course, lies in reigning in an already very reigned in life; like most ‘lifestyle adjustments’ Dr. Collinge’s recipe is easier to agree with than to follow.
The article only rings wrong when Dr. Collinge suggests that the program will “eventually lead to your recovery”. For the right person it may be able to do that but for most it will probably result in a better quality of life and health – not a bad outcome at all – but not full recovery, either. Still the article nicely presents a fundamental tenet of health managment in ME/CFS: not to overdo.
The rest that you get on a good day is of a higher quality than that on a bad day. By gaining extra “unneeded” rest on a good day, you are investing in a savings program that collects interest.
Your body’s self-repair mechanisms are what will eventually lead to your recovery. By giving them the benefit of this extra good quality rest, you build momentum toward a higher baseline of functioning.As you move further toward recovery, your assessment of your available energy will gradually rise. By managing your energy conservatively on your good days, eventually your periods of remission can lengthen, and the severity of your relapses can gradually diminish.
Let your wealth grow. Don’t spend every penny you find in your pocket. The fifty percent solution has served as a useful guideline for many former PWC’s in promoting recovery.
Cheney, Paul. Interview in “Physicians’ Forum,” The CFIDS Chronicle, March, 1991, vol. 1, no. 1, pp. 1-17.