I didn’t expect the second post on TiP to be about my health journey, but it’s one of the major catalysts to some shifts in my thinking and being over the last few years. So we might as well get it on deck, even if it’s a little longer than I anticipate most of these posts will be.
In late 2024, as part of finally going to the Veterans Administration (VA) for some service-related issues I’ve been dealing with since my deployment in the mid-2000s, I discovered that I had all but one of the markers for fibromyalgia and chronic fatigue. I knew I had PTSD, hypervigilance, IBS, hip/spinal issues, hearing loss, and tinnitus, but the markers were new information to me.
It also explained a lot of the aches, pains, wipeouts, and doctor visits over the last couple of decades. I had already figured out what activities I could and couldn’t do, but I didn’t know why.
The particular way fibromyalgia and chronic fatigue show up for me creates a challenging balance: I need to work out and move a lot or I’m in pain, but if I work out too much, I can have a fatigue wipeout. I’d gotten used to working in level 4 – 7 pain – that was my normal – but fatigue makes it hard for me to do anything, including everyday tasks and working out.
You read that correctly: if I’m not active enough, I’m in pain. If I’m too active, I can get crippling fatigue and can’t be active.
The can there is important. I’m still figuring out what combination of activities I can do that lead to fatigue and which don’t. And what duration for each activity is recovering, strengthening, and/or fatiguing.
Aside from physical activity, the other major pain and fatigue trigger is stress. I’ve learned that it’s not just distress, but eustress, too. For me, though, a lot of the activities that create eustress tend to be much more moderate and include activity, nature, music, and other elements that calm my nervous system.
Prior to learning that I had fibromyalgia and chronic fatigue, it didn’t feel like there was much I could do to be out of pain and have high energy. That’s why I had just accepted the daily pain as my reality and the fatigue as a ride-along to the pain or a random “I overdid” it occurrence.
Pain is a hell of a motivator. Or, better stated, it’s a hell of a motivator when you know you can avoid or lessen it.
So I ended up with the simple goals of increasing movement, decreasing stress, and accepting that I could no longer work a “normal” schedule, let alone the hours I’d built my life and career on. What were previously productivity experiments became health imperatives.
At the top level, it was a simple math problem. But at the root level – at least in the beginning – it was an identity problem. I’ve never been able to succeed by being good enough. I had to be better to get a chance to play and to stay in the game, at least in the creative class I work in and with. I still feel this way, though with less underdog energy.
And one of the ways I’ve been better is to outwork folks and be more consistent over time. I’m rarely the smartest, richest, best connected, or most accomplished person in the room, though I’m often among the most balanced across some of those.
I can’t outwork folks in the short time slices that online careers live in. I can’t be everywhere. It’s not simply that I don’t want to – I can’t anymore. I also don’t want to.
Competitive dynamics aside, I can’t do as much as I want to do and am used to being able to do. I know this is normal as we age, but I have the normal aging decline plus this pain/fatigue condition.
The easiest way for me to adjust to these new conditions has been to think of it like a 20-lb rucksack that I can’t take off. I’ve had to do everything most folks have to do with this 20-lb rucksack and I’ll have to keep carrying it with me. Everything is harder, but with pacing, patience, and making better commitments, I can still get on down the road.
So, yes, it’s going to be one of my five projects. But now I know it’s a project and can quit pretending like it’ll go away.
I got my disability rating in late 2024. Officially being a disabled veteran is a whole other identity reckoning that I’m still working through on a lot of levels. That said, I’m really grateful to have the medical treatment, bodywork, and meds that are helping me manage pain and my nervous system (mostly) covered by the VA rather than spending nearly a grand a month for care.
As part of that care, I started taking Duloxetine in October 2025 and it’s been a godsend for pain, fatigue, and nervous system regulation, at the same time that it’s had other effects on my focus. After a year of taking it, I think I’ve figured out the focus/attention cycles and the support structures I need. Gone are the days of just getting up and cranking, as it’s now a whole two-hour uptake process.
On the work front, the diagnosis and walking away from nearly being acquired in 2024 has led to a deep reckoning about what matters to me, what I no longer can do, and what I no longer want to do. I took the fears and pre-grieving from both as signals for what I really cared about. I’m better at adding the full energetic costs of activities when I’m considering whether to do them or keep doing them. My ideas and goals have a harder time getting a Yes enough to get turned into a project.
What became ever clearer to me is that writing and advising were my unacceptable losses. It’s taken me a few years to get those recentered and you’re reading this on the other side of the void I’ve been in.
I’ll likely share more details about the changes I’ve made and where things may be headed as we go along, but this health journey has been both a catalyst and foundation for so much of my thinking and reconsiderations. It’s not something I want to be defined by, but it’s also not something that I can or want to ignore.
