For me, fatigue has been a huge issue since my injury. I have no problems sleeping 8-12 hours a night plus 2 or more hours every day and still I'm dragging around exhausted all the rest of the hours I'm awake.

Clearly I'm getting lots of sleep, but it still doesn't seem like enough. I no longer remember what it feels like to be well rested.

I've worked with an OT for many hours on various pacing strategies. The doctors like to just tell me to "do less" but that never really helps. The only strategy that's really helped at all so far is a points based energy system similar to weight watchers, but for activities.

Basically you are allotted so many "points" per day of activities (as determined by my OT) and every activity is assigned a point value. Everything from getting dressed to doctors appointments to making meals to feeding my animals to getting groceries, etc.

Then its up to ME how I want (and need) to spend my allotted points each day. Some days you HAVE to go over because maybe a doctors appointment is worth almost your whole day's worth of points, so then you borrow from the next day and then you do less the next day.

Its common sense, obviously, but has been helpful to make sure I'm not over doing it too many days/weeks/etc in a row... as I am inclined to do.

As my OT has pointed out, I have 2 settings, asleep and full steam ahead.

My rehab doc also prescribed ritalin for me. It works and does make me less tired, but then I'm also more likely to overdo it. So I don't take the ritalin regularly. I use it occasionally if I know I have a day where I really need to be "on" and more awake and miss my nap. But if I use ritalin ONE day, I can count on needing 4-5 days to recover from it.

If it wasn't for the overwhelming fatigue and the headache that has been my constant companion for 2.5 years, I could probably deal with the other symptoms from my injury. But those two are the brutal ones that make me wonder how long I can do this.

Starr