I’ve written a lot recently about how I’m adapting to experiencing chronic pain.

While this isn’t straightforwardly related to Tourettes, I’ve started to appreciate that my motor tics have put a lot of physical pressure on my body for a long time, so it’s probably not surprising that as I get older the cumulative effect of this could start to have longer term physical implications.

I’m slowly adjusting to this new situation. I’ve made a number of practical changes to my home, I’ve scheduled regular rest breaks into my working day, and I’m slowly developing new language to explain my changing circumstances.

But one thing I haven’t quite got my head around is how to balance my energy levels and the physical consequences of pushing myself too hard. I’m used to being on the go and squeezing a lot in, it’s how I’ve worked for years. Sure, I’d get tired but I’ve always been able to power through and recover quickly afterwards.

This is no longer the case. If I do too much (and how much is too much seems to change day to day) the physical consequences are significant. My pain levels increase and my energy plummets, and my tics, as always, intensify when I’m tired, making it harder to rest.

Last night I arrived home after the second busy day in a row, broken. The pain was excruciating and it was impossible to find a comfortable position. The consequence of over doing things is that now I can’t do anything. I need help with stuff I’d normally expect to do by myself, like transferring in and out of bed, changing my position, or just turning the light on.

Where once I could push on I now have no choice but to stop and recover, sometimes for several days. I know this bodily boom and bust isn’t sustainable, but I’m finding it really hard to adjust my way of doing things until it’s too late.

I need to get better at pacing myself, and I recognise this will have to involve more than just scheduling in naps – I need to change my assessment of how much I can fit into a day. I hadn’t really realised before how inbuilt these physical parameters are. Adjusting what I can expect to do is taking time and in the process I’m getting it wrong a lot!

I don’t want to keep repeating this excruciating boom and bust cycle so I’ll have to find ways to adapt and to learn how to slow down.

Today you’ll find me in bed.