PEM and Pacing: The Traffic Light System for ME/CFS

Does your PEM have different levels to it based on how much you over-do it?

When I was still able to hold a part time job back around 2003, my boss needed me to come up with a way to communicate where I was in my cycle of PEM.

The system I came up with was based upon the traffic lights – red, yellow and green. When I was green, I was feeling my best and had the greatest capacity for activity but still within the limits of needing to be mindful and to be much less active than normal people- like a green traffic light it meant I was good to go as long as I obeyed the green level limitations of MECFS. Yellow meant warning, be prepared to stop if needed. This was a mild PEM. And I knew if I didn’t slow down and rest that I could end up at red. Red meant if I didn’t stop everything, including all sensory input and go to bed, that I would crash and end up in bed for, days, weeks or months.

So then, I could tell my boss, who had fibromyalgia and so was very accommodating, that I was orange heading for red, and she knew what that meant, and I could lighten my activity level correspondingly, thus avoiding a full on crash.

At other times I would be orange heading for green. This meant I was still needing to be careful, but that my carefulness was paying off and that I was heading in a good direction. I rarely got to green, but when I did, that was a good day. Green was essentially my best, but still very limited place.

I also began to identify and recognize the symptoms associated with each level. To make this long story shorter I’ll just mention the three main signals my body would give. First is an increase in the volume of the tinnitus. Second is an increase in quantity and intensity of headaches. Third is the arrival of insomnia.

With increased tinnitus I was heading for red, if I didn’t cut back on my activity level appropriately. With an increase in headaches, I was firmly in orange and still heading for a serious crash if I didn’t slow down and rest. By the time the insomnia started I was definitely red heading for a crash of epic proportions – completely bed ridden with earplugs and an eye mask with my only option for activity being calm abiding meditation in order to be as calm as I could be while waiting for my body to settle.

This system has helped me to navigate my activity and rest levels enabling me to have my best life possible with this horrible debilitating illness. Currently, I am mostly homebound and can only work for myself. But this traffic light system has remained relevant in helping me to navigate my day to day existence. Such as whether I can take a shower or not. Whether I can wash my dishes or not. And, when I need to stay in bed and do nothing, etc.

That’s enough about that for now. It has been, for me, a very helpful metaphoric practice enabling a more successful navigation of activities relative to symptoms.

🙏🕊️🙏