An old friend was nearing retirement and drew two circles. In one she made a pie chart of what her actual day looked like. The other was a pie chart of what she wanted to do with her days. She also counted her projects at home and had about 20. She chose five and worked on them for a year in her "spare" time and finished three. She says that it is very satisfying.

I have been using her circles in clinic, but I have added a third circle. I ask people to draw the first two circles at home. Homework from your family doctor. Then they are to think about the third circle for a few days and draw what their body wants to do.

Is it only type A people who get chronic fatigue? In chronic fatigue the theme is "I used to have all this energy and now I have nearly none and it's horrible and I want to be like I used to be." None of us stay eternally 18. From an emotional standpoint, I thank the Beloved for that. But many chronic fatigue patients seem to be in a war with their body: I want it to be different.

Last week I did my idiot swim, 400 yards when I had not swum for a year and a half. Partly I was jealous of my daughter going to state in swimming. They swim 3-5 miles six days a week. However, it was also a test: can I ski this winter? If I can't swim, skiing is unlikely. The results were clear: no swim, no ski. I went to my Armour Suit massage person yesterday and said that my legs were doing well, but my neck and shoulders were awful.

This proved true. My legs were less locked up and range of motion was better than it's been since I started this body work a year and a half ago. My shoulders and neck were a mess. He unlocked the muscles and I felt AWFUL afterwards and exhausted. Funny how I can ignore pain and stiffness entirely but when those muscles are unknotted, the creatine kinase undoes me too.

I asked if he thinks chronic fatigue is an adaptive response to protect and recover. I have been reading and apparently up to 10% of systemic serious infections can lead to a chronic fatigue response. It isn't EBV or CMV or Lyme or strep A. It's any of them. If that is what I have then I am lucky so far, because I can work half days. Some people basically nearly faint when they sit up. I am exploring the envelope, what can I do and what can't I? It is annoying to my type A parts but it also interests the scientist part of my brain. And I am aware that it can get worse, so I do want to pay attention. Also nine out of ten patient visits are complaining that something has changed: my right knee didn't hurt LAST year. It is sort of hard to believe that one's physical body will stay the same.

Anyhow, my Armour Suit person said that he thinks it's postural. According to Somatics, many people get locked either into a head thrust forward, toes clenched and holding on the ground posture: fight. Or flight, where they are curled to protect the central organs and abdomen. I was definitely fight. He says that the brain over time experiences that as always being about to fall forward. Fall on your face. So the brain and body are in a constant hormonal state of "AUGH! WE ARE FALLING!" High cortisol and adrenalin. And then we wonder why so many people complain of "adrenal fatigue syndrome". It is not really measurable by allopathic mainstream standards, but I think that it's real. At the conference I went to in March, the diagram that sticks with me is that cholesterol gets metabolized to thyroid hormones and sex hormones normally. But if we are too stressed, that pathway shuts down and we make cortisol and adrenalin. Ah. Those would be the many patients who say, "I am exhausted all the time and I don't want sex." Right.

So Armour Suit Remover thinks that I can swim but I will have to relearn how to swim the way I have been relearning to walk. And same with skiing. I grumped: oh great, I can swim in another year and a half and ski in three years. He laughed at me and said that maybe after learning to walk without locking into my old Armour Suit, I can transfer some of that experience to swimming and skiing.

At this point I think I have mild chronic fatigue and do not really care if we formally diagnose it or not. I still get to work half days, do lots of writing and have more time to do some other things. I will start to exercise again, but with caution. Swim 40 years with a very lot of attention to what my body wants and what it doesn't like: no automatic pilot. It doesn't seem so odd after all that our bodies might go into an adaptive defensive mode if we push and push and push and ignore them for years on end.

What does your body want?

Somatics by Thomas Hanna: http://www.amazon.com/Somatics-Reawakening-Control-Movement-Flexibility/dp/0738209570
The Somatics website: http://hannasomatics.com/
American Academy of Family Practice: Chronic Fatigue Syndrome Diagnosis and Treatment: http://www.aafp.org/afp/2012/1015/p741.html
American Academy of Family Practice letter: Article on CFS Does Not Reflect Current Best Treatment Practices http://www.aafp.org/afp/2013/0401/ol1.html
CDC continuing medical education on chronic fatigue http://www.cdc.gov/cfs/education/index.html
World Health Organization: The Hummingbirds' Foundation for M.E. http://www.hfme.org/thewhoandme.htm

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