After meeting with Tim my biggest prevailing problem – which is likely to extend to next trimester – is trying to manage my time and be flexible around my physical health. The very nature of it is very unstable and is very reactive to events that can be out of my control; for example just recently an abusive argument at home completely ruined my thoughts for two days and living in a tense environment isn’t helping. Trying to get around my ‘flare ups’ is going to be my biggest obstacle.
I’ve done some research on this and a paper by BMC Public Health had a few good insights;
Barriers and facilitators for self-management have been described in a large body of research. For example, male sex , high social position [4, 5], social support , high self-efficacy , and good psychological status  are related to performing more self-management (both in terms of frequency and types of behaviors), while belonging to an ethnic minority [8, 9], being in a financially vulnerable position [4, 10], co-morbidities , low self-efficacy , and demanding social obligations [6, 12] are related to performing less self-management.
So some of the things I can do is try to minimize these. One of these is already in motion; I’ll be moving out soon away from toxic room-mates and closer to family and other friends instead of being heavily isolated up north. Also during my trimester break I’m going to get another sleep study done to see if I can at least improve my sleep apnea because that is a physical problem that can be more easily treated.
One of the patients in this study pretty much reflects my outlook:
Well, then [in a stressful situation] that enormous tiredness reappears so I like… can’t do anything more, must go and sit down or put myself to bed. Then it is impossible to think, you can’t do anything. Or if you go to town… before [the MS] you could have a long list of things you should do, but I have stopped doing that. Now I go and then I do what I have time for and can. It’s not possible to get stressed, it’s hard to explain, it [the body] just shuts down. You have to go [to town] without preconditions.
In this trimester all I can do is take on smaller tasks and do what I can, when I can. This blog post might be the only thing I have energy for today but at least it was one thing on the list. Better than nothing right? (Apparently there’s a name for this called ‘spoon theory‘ which is less funny than it sounds.)