Monday, January 7, 2013

What it's like to live with a chronic illness-The Spoon Theory

(The story I share here is incredible and so helpful. Please take the time to read this and share it with anyone you think might benefit from it. It helps people who do not have a chronic illness understand what it's like to live with one. It really is the best way I've found to help explain what it's like to live with a chronic illness, and how tasks that most people don't even think about become so difficult and tiring to us who do have a chronic illness. The story I share is called The Spoon Theory by Christine Miserandino. I hope this helps you understand more!)

Please read this first and then I'll comment on it at the end!

The Spoon Theory

by Christine Miserandino

"My best friend and I were in the diner, talking. As usual, it was very late and we were eating French fries with gravy. Like normal girls our age, we spent a lot of time in the diner while in college, and most of the time we spent talking about boys, music or trivial things, that seemed very important at the time. We never got serious about anything in particular and spent most of our time laughing.

As I went to take some of my medicine with a snack as I usually did, she watched me with an awkward kind of stare, instead of continuing the conversation. She then asked me out of the blue what it felt like to have Lupus and be sick. I was shocked not only because she asked the random question, but also because I assumed she knew all there was to know about Lupus. She came to doctors with me, she saw me walk with a cane, and throw up in the bathroom. She had seen me cry in pain, what else was there to know?
I started to ramble on about pills, and aches and pains, but she kept pursuing, and didn’t seem satisfied with my answers. I was a little surprised as being my roommate in college and friend for years; I thought she already knew the medical definition of Lupus. Then she looked at me with a face every sick person knows well, the face of pure curiosity about something no one healthy can truly understand. She asked what it felt like, not physically, but what it felt like to be me, to be sick.
As I tried to gain my composure, I glanced around the table for help or guidance, or at least stall for time to think. I was trying to find the right words. How do I answer a question I never was able to answer for myself? How do I explain every detail of every day being effected, and give the emotions a sick person goes through with clarity. I could have given up, cracked a joke like I usually do, and changed the subject, but I remember thinking if I don’t try to explain this, how could I ever expect her to understand. If I can’t explain this to my best friend, how could I explain my world to anyone else? I had to at least try.
At that moment, the spoon theory was born. I quickly grabbed every spoon on the table; I grabbed spoons off of the other tables. I looked at her in the eyes and said “Here you go, you have Lupus”. She looked at me slightly confused, as anyone would when they are being handed a bouquet of spoons. The cold metal spoons clanked in my hands, as I grouped them together and shoved them into her hands.
I explained that the difference in being sick and being healthy is having to make choices or to consciously think about things when the rest of the world doesn’t have to. The healthy have the luxury of a life without choices, a gift most people take for granted.
Most people start the day with unlimited amount of possibilities, and energy to do whatever they desire, especially young people. For the most part, they do not need to worry about the effects of their actions. So for my explanation, I used spoons to convey this point. I wanted something for her to actually hold, for me to then take away, since most people who get sick feel a “loss” of a life they once knew. If I was in control of taking away the spoons, then she would know what it feels like to have someone or something else, in this case Lupus, being in control.
She grabbed the spoons with excitement. She didn’t understand what I was doing, but she is always up for a good time, so I guess she thought I was cracking a joke of some kind like I usually do when talking about touchy topics. Little did she know how serious I would become?
I asked her to count her spoons. She asked why, and I explained that when you are healthy you expect to have a never-ending supply of “spoons”. But when you have to now plan your day, you need to know exactly how many “spoons” you are starting with. It doesn’t guarantee that you might not lose some along the way, but at least it helps to know where you are starting. She counted out 12 spoons. She laughed and said she wanted more. I said no, and I knew right away that this little game would work, when she looked disappointed, and we hadn’t even started yet. I’ve wanted more “spoons” for years and haven’t found a way yet to get more, why should she? I also told her to always be conscious of how many she had, and not to drop them because she can never forget she has Lupus.
I asked her to list off the tasks of her day, including the most simple. As, she rattled off daily chores, or just fun things to do; I explained how each one would cost her a spoon. When she jumped right into getting ready for work as her first task of the morning, I cut her off and took away a spoon. I practically jumped down her throat. I said ” No! You don’t just get up. You have to crack open your eyes, and then realize you are late. You didn’t sleep well the night before. You have to crawl out of bed, and then you have to make your self something to eat before you can do anything else, because if you don’t, you can’t take your medicine, and if you don’t take your medicine you might as well give up all your spoons for today and tomorrow too.” I quickly took away a spoon and she realized she hasn’t even gotten dressed yet. Showering cost her spoon, just for washing her hair and shaving her legs. Reaching high and low that early in the morning could actually cost more than one spoon, but I figured I would give her a break; I didn’t want to scare her right away. Getting dressed was worth another spoon. I stopped her and broke down every task to show her how every little detail needs to be thought about. You cannot simply just throw clothes on when you are sick. I explained that I have to see what clothes I can physically put on, if my hands hurt that day buttons are out of the question. If I have bruises that day, I need to wear long sleeves, and if I have a fever I need a sweater to stay warm and so on. If my hair is falling out I need to spend more time to look presentable, and then you need to factor in another 5 minutes for feeling badly that it took you 2 hours to do all this.
I think she was starting to understand when she theoretically didn’t even get to work, and she was left with 6 spoons. I then explained to her that she needed to choose the rest of her day wisely, since when your “spoons” are gone, they are gone. Sometimes you can borrow against tomorrow’s “spoons”, but just think how hard tomorrow will be with less “spoons”. I also needed to explain that a person who is sick always lives with the looming thought that tomorrow may be the day that a cold comes, or an infection, or any number of things that could be very dangerous. So you do not want to run low on “spoons”, because you never know when you truly will need them. I didn’t want to depress her, but I needed to be realistic, and unfortunately being prepared for the worst is part of a real day for me.
We went through the rest of the day, and she slowly learned that skipping lunch would cost her a spoon, as well as standing on a train, or even typing at her computer too long. She was forced to make choices and think about things differently. Hypothetically, she had to choose not to run errands, so that she could eat dinner that night.
When we got to the end of her pretend day, she said she was hungry. I summarized that she had to eat dinner but she only had one spoon left. If she cooked, she wouldn’t have enough energy to clean the pots. If she went out for dinner, she might be too tired to drive home safely. Then I also explained, that I didn’t even bother to add into this game, that she was so nauseous, that cooking was probably out of the question anyway. So she decided to make soup, it was easy. I then said it is only 7pm, you have the rest of the night but maybe end up with one spoon, so you can do something fun, or clean your apartment, or do chores, but you can’t do it all.
I rarely see her emotional, so when I saw her upset I knew maybe I was getting through to her. I didn’t want my friend to be upset, but at the same time I was happy to think finally maybe someone understood me a little bit. She had tears in her eyes and asked quietly “Christine, How do you do it? Do you really do this everyday?” I explained that some days were worse then others; some days I have more spoons then most. But I can never make it go away and I can’t forget about it, I always have to think about it. I handed her a spoon I had been holding in reserve. I said simply, “I have learned to live life with an extra spoon in my pocket, in reserve. You need to always be prepared.”
Its hard, the hardest thing I ever had to learn is to slow down, and not do everything. I fight this to this day. I hate feeling left out, having to choose to stay home, or to not get things done that I want to. I wanted her to feel that frustration. I wanted her to understand, that everything everyone else does comes so easy, but for me it is one hundred little jobs in one. I need to think about the weather, my temperature that day, and the whole day’s plans before I can attack any one given thing. When other people can simply do things, I have to attack it and make a plan like I am strategizing a war. It is in that lifestyle, the difference between being sick and healthy. It is the beautiful ability to not think and just do. I miss that freedom. I miss never having to count “spoons”.
After we were emotional and talked about this for a little while longer, I sensed she was sad. Maybe she finally understood. Maybe she realized that she never could truly and honestly say she understands. But at least now she might not complain so much when I can’t go out for dinner some nights, or when I never seem to make it to her house and she always has to drive to mine. I gave her a hug when we walked out of the diner. I had the one spoon in my hand and I said “Don’t worry. I see this as a blessing. I have been forced to think about everything I do. Do you know how many spoons people waste everyday? I don’t have room for wasted time, or wasted “spoons” and I chose to spend this time with you.”
Ever since this night, I have used the spoon theory to explain my life to many people. In fact, my family and friends refer to spoons all the time. It has been a code word for what I can and cannot do. Once people understand the spoon theory they seem to understand me better, but I also think they live their life a little differently too. I think it isn’t just good for understanding Lupus, but anyone dealing with any disability or illness. Hopefully, they don’t take so much for granted or their life in general. I give a piece of myself, in every sense of the word when I do anything. It has become an inside joke. I have become famous for saying to people jokingly that they should feel special when I spend time with them, because they have one of my “spoons”."
© Christine Miserandino

I love the way Christine explains this. One of the most frustrating things about having a chronic illness is trying to get people to understand what it's like to live with it every single day. And what I want to make sure people understand is that it's not their fault at all that they don't understand and don't know what to say or how to act. It's not your fault! Just remember that. 

It's common for me to hear, "you did this yesterday, so why can't you do it today?" Being chronically ill is very hard to deal with because it changes so much. One minute I will be fine, and the next I'll be on the way to the hospital. Our illness don't give us any warning about when it will strike. Like I said, I have been sitting somewhere (class, church, a restaurant), having a good time talking to people and all of the sudden I get really sick and either need to leave or go to the hospital. 

One of the reasons I haven't blogged much in the past month, and also this past semester, is because I've run out of "spoons" for blogging. Things such as walking to the bathroom from bed in the morning and showering are taking more "spoons" than they normally do. It's not a new problem, but I like I said, these tasks that we usually take for granted are costing me much more energy than normal. This too will pass, hopefully soon, and I'll be able to use more "spoons" for fun things like hanging out with friends instead of daily tasks that we normally do without thinking. Tonight I got to go out to dinner with two of my best friends! It was so much fun! But to be able to do that, I had to plan ahead and save "spoons" by going to bed really early last night and resting a lot today. We have to learn how to adapt to how many "spoons" we have each day, depending on how we're feeling. One day I'm able to go to a class and hang out with friends, and the next day I can barely even walk to the bathroom that's only a few feet away. I'm so thankful for the days where I have more "spoons"!

I hope this helps paint a better picture of how each day is different and that we have to choose how to spend our "spoons". Most days, I say to myself that I need to blog that night and I have a post all planned in my head, and then once that night comes, I'm out of "spoons" and am too tired. Tonight, I knew I wanted and needed to post, so I saved a "spoon" for that, so here I am! 

I am going to really try to post several times a week, maybe even daily this year. I love hearing from you and how God has used this blog to encourage you somehow. It really encourages me to know that God is using my situation to help others. If you would like for me to pray for you, I would absolutely love to! If you want to share your story with me, I would love to listen! If you would like to ask me questions about anything, I would love to answer them! Just leave a comment or email me directly (my email is on the side by my profile I think). And I apologize if it takes a little while for me to respond. I love hearing from you!!!

I will post again soon on what's been going on this past month!


  1. Hi Victoria, I am 51 years old, from Australia and have a chronic illness. I am so thankful to God for the family He has given me that help me get through life. While I am sad to see a young girl just starting out in life, struggling the way that you do, it is also so encouraging to read of your walk with God and the lessons that you have learnt through your illness. I love the story of the spoons and believe that it explains things really well. I will certainly try and use it next time someone asks. Love your blog and hope that you start feeling good again soon.

  2. I enjoyed your blog as well. Going to use the story. =)

  3. I have never read a more powerful blog post. Your explanation with the spoons is exactly what people don't understand with Lyme disease; I never know how to explain it to people. Most people do think they have a never ending supply of spoons, where as, we don't. Kudos for you and your explanation. Continue touching people through your writing.