It’s been a tough day, not because anything dramatic has happened but simply because I’ve been feeling lousy.

This isn’t a one off– I’ve been struggling with chronic pain, nausea and fatigue for months.

I’ve got used to feeling ill, to waking up overwhelmed by nausea, to constant nagging pain in my back and hips, and to fatigue muddling my thoughts.

We’ve all been making changes to try and make things easier – my workload’s been reduced and I’m resting for several hours each day. I’m used to adapting and pushing on, but today I started to ask myself if I’m too ill to be at work. It’s a question that made me feel sad and frightened because I love my job and feel motivated by every part of it.

I’ve never been great at judging when not to work, but if I had a cold or an infectious bug I’d probably stay at home. But with a chronic condition it’s much harder to judge.

I’ve been thinking this over and I’ve come up with a checklist of questions to ask myself:

• Have you slept for more than four hours?
• Have you been able to eat?
• Is your pain under control?

If the answer to any of these questions is ‘no’ then I think I need to think seriously about cancelling meetings and allowing myself to rest properly.

Contemplating this is deeply upsetting to me but if I’m honest with myself I know that the current situation is not sustainable.

Now all I have to do is be honest when I answer the questions!