1. { Post Concussion Action Group: Session 3 Managing Fatigue

2. Different symptoms for different people Different symptoms for different people The result of overexertion The result of overexertion Not just feeling sleepy – can mean other symptoms emerge such as pain, pressure, inability to pay attention, low mood, poor coping, etc. Not just feeling sleepy – can mean other symptoms emerge such as pain, pressure, inability to pay attention, low mood, poor coping, etc. What is “Fatigue”?

3. Giving Credit Where it’s Due…. Many of the concepts including the Points system introduced in this slideshow are credited to Becky Moran, OT, at Parkwoods Hospital, London, Ontario

4. The energy you require each day is like the gas in your car. The energy you require each day is like the gas in your car. When you run out, you need to refuel When you run out, you need to refuel How quickly you run out depends on a number of factors: driving conditions, how fast you’re going, using additional resources (AC!), whether it was filled up to begin with… How quickly you run out depends on a number of factors: driving conditions, how fast you’re going, using additional resources (AC!), whether it was filled up to begin with… The Gas Tank

5. It can result in a crisis (stranded at the side of the road ) It can result in a crisis (stranded at the side of the road ) Or a routine stop (going to the gas station) Or a routine stop (going to the gas station) What makes the difference is how you anticipate and plan When you run out of gas…

7. Pace and plan your day, including rest! Pace and plan your day, including rest! Build in breaks (15 min per hour to start) Build in breaks (15 min per hour to start) Alternate types of activities between thinking (high cognitive demands) and doing (high physical demands) Alternate types of activities between thinking (high cognitive demands) and doing (high physical demands) Reduce activities that cause symptoms (Eg. TV, Computer, Radio) Reduce activities that cause symptoms (Eg. TV, Computer, Radio) Maintain routines, exercise, good sleep patterns, and nutrition Maintain routines, exercise, good sleep patterns, and nutrition Strategies: from Becky Moran, OT

8. Gas Guzzlers: Talking (the more people the more taxing) Talking (the more people the more taxing) Visually stimulating environments (think of a trip to a busy grocery store!) Visually stimulating environments (think of a trip to a busy grocery store!) Driving Driving Activities and environments that require “filtering” Activities and environments that require “filtering” Cognitive tasks requiring attention, concentration or so-called “multi-tasking” Cognitive tasks requiring attention, concentration or so-called “multi-tasking” Physical activity – do some, but go easy on yourself! Physical activity – do some, but go easy on yourself!

9. Rest Rest Peace & quiet Peace & quiet Relaxation exercises, meditation, yoga Relaxation exercises, meditation, yoga Sleep Sleep Healthy food Healthy food Alternating activities Alternating activities Planning activities in ways and times that reduce demand Planning activities in ways and times that reduce demand Knowing your limits and planning appropriately Knowing your limits and planning appropriately Maintaining routine and balance Maintaining routine and balance Ways to fill your tank up:

10. Look at your demands on a daily and weekly basis Look at your demands on a daily and weekly basis Identify priorities & fixed plans and arrange other activities accordingly Identify priorities & fixed plans and arrange other activities accordingly Write it down in a dayplanner Write it down in a dayplanner Don’t overload yourself all on one day Don’t overload yourself all on one day Use a “Points” system Use a “Points” system More about Planning:

11. Like “Weight Watchers “ Points – a way to keep a limit on what you do. Consider the demand of each activity and assign a point value. Put a cap on the number of points used each day. As time passes you can gradually increase the # of points each day. Considerations: Complexity (require thinking) Complexity (require thinking) Auditory & visual stimulation Auditory & visual stimulation How much talking you are doing How much talking you are doing How much filtering is required How much filtering is required Visual processing Visual processing What’s a Points System? More credit to Becky Moran, OT

12. A correct tally includes: Every task has a value (even “free time”, watching TV, etc) Depending on where you are in your recovery you can assign negative points for naps –but don’t over do this. Better to plan ahead rather than log after! Look to the day(s) ahead and lay out what you can reasonably accomplish Enlist your family members for help if needed. It also helps them to understand your limits.

13. Provide a daily reference (look at it each morning) Provide a daily reference (look at it each morning) Help to track plans & appointments Help to track plans & appointments Manage “To Do” lists and accomplishments Manage “To Do” lists and accomplishments Use as a journal to track symptoms and notice patterns Use as a journal to track symptoms and notice patterns Carry it with you at all times Carry it with you at all times Look at it often! Look at it often! Dayplanners:

14. Let your symptoms guide you – if they flare up, step back and rest, try again more gradually Let your symptoms guide you – if they flare up, step back and rest, try again more gradually Gain insight by taking note of symptoms in a dayplanner and look back for patterns Gain insight by taking note of symptoms in a dayplanner and look back for patterns Learn to manage accompanying difficulties such as anxiety, low mood, pain, dizziness, etc. with professional help. Learn to manage accompanying difficulties such as anxiety, low mood, pain, dizziness, etc. with professional help. Returning to Activity: Step by Step

15. Look at incorporating equipment or simply altering environment: sunglasses, weighted compression vests, or Look at incorporating equipment or simply altering environment: sunglasses, ear plugs, drawing your curtains, turning off background noises, weighted compression vests, or binasal occlusion glasses. Consult an occupational therapists to determine what’s right for you. The right “stuff”: The end!