I’ve been reflecting a lot lately on the parallels between inertia and fatigue. We learned in physics that objects in motion tend to stay in motion, and objects at rest tend to stay at rest. My fatigue presents itself with the same qualities. Waking up every weekday morning I take 10 minutes or so in bed to convince myself that I can get up and make my daughter’s lunch in time to get her to preschool. I finally start puttering around in the kitchen, and I notice physical activity seems to get a bit easier with time and motion. Once I’m in motion I find it easier to stay in motion. The energy required for one activity somewhat spills into the next, so I almost feel like momentum is on my side. But I unfortunately can’t sustain that motion for extended periods, and inevitably need to lie down and rest within a few hours. At night after my daughter is in bed, I calculate where I am going to stop and lie down because I know I will be unable to move my body for at least two hours. On the weekends I let myself rest more since my husband is home to help; but usually that means rest begets more rest, and by dinnertime on Saturday I can’t seem to find the strength to sit up at the dinner table.
I find this inertia parallel is not only appropriate in describing fatigue; but also in illustrating the challenges in planning and functioning within the confines of that fatigue. For example, I have had a slow and steady loss of ground in what I can accomplish since the New Year. The medications that are supposed to help take 12 weeks to take full effect, never mind that prior authorization from insurance is still pending. I felt I needed to try to change something in order to stop losing ground, but trying anything means using more energy, and fighting to get out of the “state of rest.”
The psychological commitment required to will one’s body into action when one’s abilities are shrinking is intense. It is almost counterintuitive to launch a drastic change in the daily routine. It tends to beg the question, “What do I do when I’ve used up more energy on the intervention and the energy payout won’t be until the distant future?”
For elders and their caregivers, it takes mental and physical energy beyond what one would expect to complete actions like researching homemakers, finding a meal preparation plan, lining up transportation, or looking into alternative living situations. And after an elder’s abilities have declined is the hardest time to corral the energy and effort required to plan those interventions. This is one of the most challenging yet unspoken barriers to making changes in daily living.
I am only four days into my own planned intervention- dietary changes to help control fatigue and pain symptoms. I can’t say I’m confident I can sustain this regimen, given I don’t have the energy for a significant amount of food preparation. So I battle this new change in daily living one day at a time. Right now I am physically worse for the energy expended, but I have mental comfort in that I am actively trying to fight all the chronic illnesses that are chipping away at my normalcy.
When there is a chronic health condition and things begin to slip, change is often needed. Objects at rest need to become objects in motion. But it is equally important for caregivers and healthcare professionals to understand inertia is a powerful, powerful force that those chronically ill may not always have the strength to challenge.