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You are here: Home / Stop Feeding Fatigue / Module 1: How Fatigued are You? / Lesson 1-1: Putting a Number on Fatigue

Lesson 1-1: Putting a Number on Fatigue

There is no shortage of proposed ways to treat fatigue.

But how do you know you’re getting better?

What does improved energy even look like?

And how the heck do you measure it?

Have you heard of something called the peak-end rule?

The peak-end rule helps to gain a little better understanding of the way your brain works. Your brain doesn’t calculate an average for a given experience.  Instead, according to the peak-end rule, the way in which you judge an experience is largely based on how you feel at the experience’s peak (the most intense point) and/or at its end.

Consider the following two experiments that better illustrate the peak-end rule in action:

In patients undergoing a colonoscopy (an incredibly uncomfortable procedure), researchers consistently found that patients rated the experience based on either the worst part (most painful part) of the examination or at the end of the examination. If researchers prolonged the experiment by three minutes but caused little-to-no discomfort for those three minutes, patients rated the procedure as far better than the patients that experienced a shorter exam.

Another study had a group of participants first place their hands in cold water for one minute. Then, the same participants had to place their hand in cold water for another one-minute interval. But at the end researchers raised the water temperture by one degree celcius (a neglegible amount) and instructed participants to keep their hand submerged for another thirty seconds.

When researchers asked participants which trial they’d rather repeat, the overwhelming majority selected the second version. Even though the second trial had their hand submerged for an additional thirty seconds in cold water. The particpants brain remembered that one degree celcius increase as a positive expereince. This colored their entire experience. And this is the peak-end rule in action.

A similar phenomenon happens with fatigue. When asked to rate your energy levels, your brain will remember a time when they were at their best. Or, a time when they were at their worst. And that one experience will color how you interpret your “average” energy levels.

In reality, your energy levels fluctuate throughout every hour of every day. There will be days/times when you have more energy. And other days/times when fatigue can feel unbearable.

This is what makes questions about your energy levels so inaccurate. The intensity at which you rate your fatigue/energy is entirely dependent on how you’re feeling when you’re asked the question.

How will you know that you’re making progress in treating your fatigue? 

Your energy could be improving but your brain keeps remembering the time when you were at your worst. Your brain could (secretly) be sabotaging your success. A change in your nutrition, supplements, exercise, etc. could be helping to improve your energy. But your brain is stuck remembering the time(s) when you were so fatigued you couldn’t walk up the stairs!

To combat this, you’re going to take a detailed fatigue inventory this week. This will serve as your fatigue number. It’s what you’re going to use every 3 months to evaluate whether (or not) your energy is improving. Tracking in this systematic fashion will ensure you’re on the right track!

How should fatigue be evaluated?

After fatigue is diagnosed, it then needs to be evaluated.

If you’re in this course, it’s safe to say that you’d like your energy to be higher, right?

To properly evaluate your fatigue, you’re going to use 4 medical questionnaires used to evaluate the intensity and quality of your fatigue. These will form your baseline readings.

Check your email inbox for the questionnaires. I’m going to email a new one to you each day this week.

  1. Lesson 1-1
    • Standford Sleepiness Questionaire
    • This simple survey uses a 1-7 scale to rate your fatigue levels throughout the day. It’s done on 5 separate days.
    • This allows you to see patterns of when your energy is at it’s highest and lowest during the day.
    • Knowing this information can empower you with information on how to best treat your fatigue.
  2. Lesson 1-2
    1. Multidimensional Assesment of Fatigue
    2. This 1-10 scale questionnaire allows you to determine exactly where fatigue is most interfering with your life.
    3. It creates a perfect baseline measurement.
  3. Lesson 1-3
    1. Modified Fatigue Impact Scale
    2. This 0-4 scale helps you to determine the frequency with which you’ve felt tired in the past week.
    3. It also helps you identify what aspect of your life fatigue creates the most harm – physical, cognitive, or psychosocial.
  4. Lesson 1-4
    1. Checklist For Individual Strength (CIS scale)
    2. The Checklist Individual Strength (CIS) measures four dimensions of fatigue: Fatigue severity, concentration problems, reduced motivation, and activity.

On pgs 19 & 20 of your workbook, you’ll be able to write in your totals for each of these questionnaires. Keep track of this page. You’re going to want to refer back here after you’ve created and implemented your personalized diet. This way you’ll be able to see just how much your energy has improved!

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  • Stop Feeding Fatigue
    • Introduction
      • What is Fatigue?
      • Course Overview
      • Why You Need This Course
      • How to Use this Course
      • Welcome To The Course
    • Module 1: How Fatigued are You?
      • Lesson 1-1: Putting a Number on Fatigue
      • Lesson 1-2: Fatigue Scale One – Stanford Sleepiness Scale
      • Lesson 1-3: Fatigue Scale Two – Multidimensional Assessment of Fatigue (MAF) Scale
      • Lesson 1-4: Fatigue Scale Three – Modified Fatigue Impact Scale (MFIS)
      • Lesson 1-5: Fatigue Scale Four – Checklist For Individual Strength (CIR)
      • Lesson 1-6: Your Personal Fatigue Score
    • Module 2: Blood Sugar & Fatigue
      • Lesson 2-1: Get Familiar with Your Blood Sugar
      • Lesson 2-2: How to Track Your Blood Sugar
      • Lesson 2-3: Analyzing Your Results
    • Module 3: Food and Fatigue
      • Lesson 3-1: Meal Tracking
      • Lesson 3-2: What foods are causing your fatigue?
      • Lesson 3-3: Your First Step Towards Personalized Nutrition
      • Lesson 3-4: How to Create Your Anti-Fatigue Diet
      • Lesson 3-5: Carb Chasing
      • Lesson 3-6: Fat Is Where It’s At
      • Lesson 3-7: What Now?

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Eve Paraschuk, MSW, RSW
Jane Prescot, FMCHC
Mark Volmer, R.Ac., FMP
Sheena Huculak, RHN
Steph Perryman, RMT

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