Fatigue can be measured in many ways. Mostly, though, fatigue is a subjective experience, and such, is hard to measure in an objective analysis. What I want to impart to you is the fact that, in many cases, fatigue is not an object to be measured at all, but a process that involves many facets of living.
I attended the Functional Capacity Evaluation (FCE) ordered by my insurance company in January 2011. I found it very interesting, and educational. My evaluator was very nice and patient with me, and explained that I was to do my best, but that I was to stop myself if I felt I could not do something safely. I explained to him that it was not in my nature to stop myself if I felt I could go on. I did try to really pay attention to how I was doing things and do each activity properly without too much pain. It was harder than it looked!
At the end of the evaluation, although I wanted to ask questions, I waited until I received the report from my doctor. I found the report fascinating. I was amazed at how weak I was, yet also surprised that we did not do more with the sedentary activities, as that was the final word on the evaluation. The FCE focused only on my muscular abilities. I have never said I cannot walk, although I do use a cane at times and like to try to keep active. I have never said I cannot lift at times, or stand for a bit. The FCE gave what I consider to be a very accurate, yet limited estimate of my abilities.
I say this is a limited estimate because there is so much more to fatigue than muscular activity. If I sit, for example, at a desk with a computer, within 15 minutes, my shoulders start to hurt, the tendonitis in my wrists acts up, my lower-mid back begins to spasm, and my legs begin to stiffen. If I sit for 30 minutes or more, I must get up very slowly, as straightening my legs and lower back can be very painful.
I do sit for an hour or so in my recliner, sometimes, but there I can move my legs often and I usually adjust the way I am sitting every few minutes.
Fatigue of the muscles from moving is harder to measure when I move just to keep the muscle spasms and stiffness in check. When I worked as a clerk, I could get up and move as needed and sit as needed. It worked for me for years, and I loved my job. I could take breaks when I needed, visit the restroom as often as necessary, eat or drink as needed, and still do my job. In fact, I battled fatigue for years with medications and by altering my daily schedule to fit my needs. Then I got sick.
When I stopped working, it was with absolute conviction that I would be back to my job in a few days. I just had a viral sinus infection and a bacterial ear infection. I had medication, and would be back in no time at all. In my family, if you are not dying, you are fine. I was fine. I had just worn myself down enough that I could not get up, and these infections were the cause.
That is what we all thought. Three weeks later, and against my doctor’s best judgment, I stumbled back to work part-time. Trying to do a 40 hour a week job in just 20 hours a week, with little to no help, was stressful, but I was determined to knock myself back into shape and I kept going. Four weeks later, I went back to my doctor. She said that I was over my infections, but that I was to go home and go to bed. I did not tell her that basically, that is what I had been doing for the last several months. Instead, I said, “Ok, so I will work and sleep, and that is it.” She said, “No. You go home, go to bed, and don’t go to work.” That was the end of it. She wrote another note to work saying that I was not released to work again until further notice.
