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Symptom Management

Symptom management

Pacing

Symptom management

Ideally you should be experiencing few, if any symptoms.  If you are, it is important to discuss these with a health care professional who knows you, i.e your GP, practice nurse, cardiac rehabilitation team etc.  Especially if the pattern of symptoms has changed significantly in the last couple of weeks.
They will want to know:

  • The nature of symptoms you are experiencing (e.g. chest discomfort, shortness of breath, dizziness, palpitations or ankle swelling) 
  • They type of activity that provoked the symptoms (e.g. ordinary or extraordinary activity)
  • How long the symptoms last
  • What makes the symptoms go away (e.g. rest, GTN spray, sitting up in bed etc.)
  • How many times you've experienced this/these symptom/s (e.g. only occasionally or every time you attempt something)

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Pacing

When you have no symptoms, you might be tempted to get as much done as you can. But doing too much often leaves you feeling fatigued with little energy. As a consequence, you might then cut back to doing virtually zero for a few days to "get over it". As a result you then feel guilty, so once you feel better you try to make up for lost time.  The end result of this over-activity on a good day is almost certainly increased symptoms.  So the cycle starts again, leaving you with the feeling that your life is out of control. If you repeatedly get caught in this cycle, your mood gets lower and you lose fitness. This happens not just because you may have been unable to keep active but also because of the amount of time you find yourself resting and recovering.


Pacing means finding the right balance of activity and rest for you. It offers an alternative to the repeated cycles of boom and bust. With pacing, you can manage your symptoms, reduce the number of bad days and live your life, rather than the symptoms controlling you. 


Finding your baseline, means knowing the amount of activity you can do without getting any symptoms and using that level to set realistic daily goals or targets of what you want to achieve. Some people find it helps each day to estimate how much you think you can accomplish, then divide this in two and aim to do this lesser amount. Rather than challenging your limits, you limit yourself to a comfortable level of activity. You will probably find that you can achieve more and have fewer symptoms if you break your activity into two shorter periods with a break in between rather than trying to do the same amount all in one block. You may also find that your symptoms are lower if you spread out activities through the week, rather than trying to do many things in one or two days.

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