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Conserving Spoons

If you aren’t familiar with “spoons” in the context of disability, take a few moments to read Christine Miserandino’s landmark piece on Spoon Theory before reading this post.

Spoons, by nature, are a limited resource. They’re replenishable, but not on demand. Sometimes we get a new supply each day and sometimes we have to ration out spoons over many days before our supply is restocked. And there’s no spoon store, so forget going out to buy some if you unexpectedly run out.

Conserving spoons is an essential skill. The most obvious way to conserve is simply to ration. More things to do today than you have spoons for? Eliminate some stuff!

That works fine when your day has lots of padding. It’s relatively easy to cut out things like “go out for lunch with officemates” or “participate in 500-comment Facebook conversation.” You probably won’t miss them much. But what happens when you’ve got your daily schedule down to only the most essential items–literally just the things you need to do to make it through your day without getting fired, flunking out of school, or starting to grow exciting new cultures in the kitchen sink?

Not only do you have to start choosing among cutting out essential activities, but life can start to look pretty grim. Extreme rationing is not a viable long-term strategy.

Understanding Where Your Spoons Go

It can help to think about how spoons are getting used up. For example, spoons are disability region-specific.

We have social spoons and language spoons and physical activity spoons and all sorts of other spoons. Here’s how I envision my spoon drawer looking:

Depending on our disability and how life is going at the moment, each of our spoon drawers is stocked a little differently. In general, however, most people are going to have more spoons in some areas and less in others.This is why someone who doesn’t have the spoons to go to a movie with their family might have the energy to stay home and build an intricate scale model of Narnia out of popsicle sticks.

Not all spoon reserves are created equal.

Having an idea of what your spoon drawer looks like on a given day can make it easier to conserve spoons without randomly eliminating everything that feels “nonessential.” For example, I can look at my spoon distribution above and conclude that an hour-long run in the morning isn’t going to impair my ability to work afterward. An hour-long meeting first thing in the morning will.

I have physical activity spoons to spare. My language and social spoons are precious commodities.

Recognizing this has helped me structure my days smarter. Sort of. I’m still on the fence about which strategy works best: using up essential spoons early in the day and then mostly avoiding that section of the spoon drawer for the rest of the day or conserving essential spoons for as long as possible and then burning through what remains of them at the end of the day.

For example, if I write in the morning, I know that I’ll be fresher for that task but mentally sludgy afterward. If I do non-language-intensive work in the morning, I know that I’ll be less fatigued throughout the day, but when I get around to the writing task in the afternoon, it will be more difficult. Spoons don’t entirely exist independent of each other.

Which brings me to the problem of leaking spoons. There are activities that sneakily steal essential spoons, a little at a time.  For example, I was shocked to discover recently that a fun 45 minutes of IMing could leave me exhausted. Was typing silly gossip and “LOL” and 🙂 really that demanding? I wouldn’t have thought so. I was enjoying it! Aren’t spoons supposed to be used up by challenging, or at least productive, activities?

It turns out that unexpected things drain my spoons via a slow-drip leak. The sound of hammering all day as my neighbor’s house is getting a new roof? Sensory spoon leakage. Sitting in one position for too long? Physical activity and sensory spoon leakage. Listening to a radio program while I work? Language spoon leakage. Cursing out the bank’s confusing phone menu? Executive function spoon leakage.

Even activities that seem passive or low-intensity can drain spoons in the way that the battery drains even when you’re not using your mobile phone.

To some degree, leakage can be stopped or slowed by fencing in your spoons. (Yes, now we’ve got metaphors running amok, but bear with me.) I’ve found that explicitly stating, even if it’s only to myself, that I can do X but I can’t do Y or Z helps plug chronic leaks. If I don’t clearly state up front what I can and can’t do, I’m more likely to talk myself into “just one more hour” or “just one more time”, raiding my spoon drawer without consciously noticing.

Unfortunately, there aren’t a whole lot of rescue strategies if you find yourself short of spoons early in the day. Resting is a good one, of course, but sometimes that isn’t an option. As Christine Miserandino pointed out to her friend, sometimes you don’t have enough spoons to make dinner and eat it too. That’s not an exaggeration. I’ve been there too many times. One strategy that I think sometimes autistic people forget exists is borrowing someone else’s spoons by asking for help.

Asking for help is strangely difficult at times. Maybe because we want to prove that we’re competent independent people. Maybe because we don’t want to bother anyone or be a nuisance or some other useless, deeply ingrained belief about our impact on our loved one’s lives. But asking for help is an important self-care tool, especially when the spoon drawer is looking barren.

In the long term, identifying the cost of activities becomes a crucial conservation strategy. I know that a social activity will cost more spoons if I have to wear uncomfortable clothing or can’t take a break when I need to. A similar activity may have a lower social spoon cost if I attend with someone who can run interference for me. In a sense, accommodations are like getting a spoon discount and situations filled with triggers carry a spoon tax.

When you’re low on spoons, stopping to think about the cost of an activity is critical. If the cost is high, what kinds of discounts (accommodations) might bring the sticker price down into a range that you can afford?

Sometimes, emphasizing quality over quantity is a way to avoid cutting out activities entirely. I used to read the New Yorker cover-to-cover each week. Obsessive, yes, I know, but I love the writing and I was hyperlexic so it was enjoyable. Now that reading has become harder, I page through and choose a few articles to read that look interesting. If I start one and it’s not grabbing me, I move on.

This may sound like a minor change to make, but the mental shift required was wrenching. I used to be the kind of person who would finish a book even if I hated it. It was as if I’d started it and now there was no choice but to finish it. Weird, right?

It was only when The Scientist pointed out that my stress over being 5 weeks “behind” in reading The New Yorker was completely avoidable that I realized how counterproductive my brain was being. Trying to make my spoons go further than they realistically can unnecessarily increases my stress, which causes further spoon leakage. Allowing myself to make new mental rules–and in turn shifting my self concept from hyperlexic to slow reader–allows me to spend my language spoons wisely.

Admittedly that feels like a silly, trivial example to share, but sometimes what appears trivial is freighted with hidden meaning and symbolic weight.

And finally, the hard one: let go. Sometimes, no matter how elaborately I structure, change, accommodate, plan and think about conserving my spoons, I’m forced to admit that something important will still have to go. This is really tough to face. I don’t like to lose and giving up things I like doing because I can’t do everything feels like losing. Which is silly, because there is no losing at life.

While it’s hard to say “I can’t keep doing this thing I really enjoy,” I’ve learned that it’s a lot harder, in the long run, to keep pushing myself to do something when I’m spoonless or on the verge of running out of spoons. Hopefully, if all goes well, the letting go combined with all of the other conservation strategies will lead to that day when I discover an extra spoon or two has appeared in my drawer.

106 thoughts on “Conserving Spoons”

  1. Great post as always! (Sorry I haven’t been around much – TL;DR I’m on my year abroad)

    Asking for help is a real issue of mine (which often means I use more spoons than I “gain” from it anyway) – not only is there the wanting to seem independent, there’s having to formulate the panic into words and then futilely attempt to reassure myself that they won’t think I’m silly, that they won’t judge me, that this is totally a Normal Thing(TM) that Normal People(TM) encounter too… I know I shouldn’t worry about passing for neurotypical, and yet I do. It’s just so ingrained. :/

    1. I hope the year abroad is going well!

      Good point about asking for help being a spoon stealer in itself. I agonize a lot over asking for help and then just don’t. The other day my husband saw how frazzled I was and helped me do some problem solving and then said, “why didn’t you just ask me to this thing for you?” It was a thing that he could easily accomplish and I was having trouble finding time to do and I didn’t even think of asking him. So I guess we add not realizing that someone can help with something to the list too.

      1. The spoon idea is something I need to think about in more detail given recent not-good head-developments. What really strikes me on re-reading this post is the idea of having different spoon levels for different activities; it would make my inconsistencies make more sense if that applied to me, but I’m not sure how exactly it does, so I think at some point I should actively look at what drains me most and least and try and figure out the contents of my drawer.

  2. I feel borderline silly saying over and over again, even just in my own head, how timely a post is, how relevant a particular set of survey questions is… Just last week I realised that it wasn’t excessive enthusiasm on my part – this is how it feels to be understood. Everything, or nigh on everything, feels relevant, feels like it was aimed right at me. In the last survey, one of the questions was about how things have changed since diagnosis, and I think I said something vague about understanding myself, but that is to dismiss how life-changing feeling understood has been to me. It has got to the stage where I now understand why some people might not put a priority on professional diagnosis, might be perfectly satisfied for any number of reasons (and indeed practical circumstances) with self-diagnosis or unofficial diagnosis from various professionals. I always felt the need for external validation, and that may have been because I was hoping that someone else would be able to provide the understanding of myself that I as yet couldn’t and that I had as yet failed to receive from any other external source. Now that I am well on my way to understanding, and – miracle of all miracles – accepting, who I am, how I am, and how I work, other people’s opinions do not hold quite the same sway. This is not to dismiss the very real support and understanding that might be made available through a professional diagnosis, and there is nothing wrong with having that extra validation. I’m just happy to realise that I am also capable of validating myself.

    That was a digression I didn’t intend… 🙂 I meant to start here, with saying that after the day I had yesterday, this post about spoons has really hammered home a very important point about how to better progress with my life as an ASD adult. I was familiar with the spoon theory and have been sharing it with a few people, though I never thought about the drawer before. I am definitely going to try and draw up one for myself, see where my energy is spent, and how it might be better spent.

    The post helped me stop beating myself up about getting ‘nothing’ done yesterday. You know, nothing except go to a job interview for the first time in over five years… It was ‘just’ a part-time job I told myself, and ‘only’ for a job that my unfortunately quite classist background taught me is supposedly far ‘beneath’ me and my intelligence. Yet, it took up my whole day. There was the getting ready i.e. preparing for battle. Then there was the interview, which went so well that I was there for an hour chatting with the lovely manager. An hour. An hour of trying to keep suitable eye contact, trying to impress, trying to pass, trying to show my very best side and not even sure what that it is: after all, some of my (in my opinion) best traits come straight from an ASD handbook. Even though I was told then and there that I got the job, I then spent the next three hours at home analysing everything I had said and done during that hour. What little of the day remained, I spent panicking about how i was going to cope in my new job, and how I was going to cover up my autism effectively. I didn’t even have the energy to cook or go on my usual long evening walk (I managed a short one). I even started biting my nails again. I went to bed for a while, and later I watched Sherlock on Netflix, which turned out to be a fantastic, though temporary, distraction from my circular thinking. I had stress dreams about not being able to manage my workload, both at home and at my new job.

    I see now that that one hour used up the majority of spoons I had in the drawer and feeling bad about not having more energy/spoons used up most of the rest. Now that I’m going to plan out my spoon quota (I love making budgets…) I am not nearly so worried about how I am going to cope or that there is even any need to cover up my autism. By recognising my limits, I can actually go a lot further than if I just assume I have absolutely no boundaries.

    I am glad I wasn’t diagnosed when I was a child because there would have been no help available to me where I was from and the stigma back then would have been too great. In fact, it’s my personal belief that it was only by denying that there was anything wrong with me (when it had been flagged by a medical professional that there was) that my parents could go about providing me with the same life chances as my siblings. However, I have thirty-odd years of shame to cast off at not being exactly as my parents, my teachers, my peers might have expected of me. At being ‘less’. I also feel like I’m not supposed to use my autism as an ‘excuse’, that I should be even better than everyone else to spite it. It’s what people want to hear, isn’t it? I’m disabled but I’m exactly the same as everyone else, no one has to make any allowances for me/understand me in any way, limitations are all in my head… It’s been a very unhelpful way of thinking. I would venture to say that, globally, we as a species still struggle epically with the idea of ‘different but equal’. Another thing I don’t understand. It always seemed obvious to me.

    1. Congrats on the job and well done for getting through the interview.

      I thought I was about to start job hunting too today, but I just got a call from a previous client for some more work so that was a relief.

      I’m just beginning to understand how ASD means I sometimes mess up in interviews – info dumping, going into too much detail, messing up greetings/goodbyes, total inability to answer ‘personal strengths and weaknesses’ type questions due to alexythymia – but I’m not sure I’ve formulated my solutions yet.

    2. Contratulations on the job interview! I’m actually impressed that it only used up one day’s worth of spoons and I’m not joking about that. When I did the radio interview that was “only” a 40 minute phone conversation, it took me a full 48 hours to get my language spoons back. I was worthless the rest of that day, and the next day I felt so sick that I thought maybe I was coming down with the flu. It wasn’t until later Saturday afternoon that I started to feel “normal” again. And of course I spent all day Friday silently judging myself for not getting more done and being more focused and getting so behind on my to-do list. Looking back now, I see that was silly and I should have just taken a nap instead. So I completely understand how a seemingly “simple, short” task can take up days’ worth of spoons and lead to lots of self-flagellation. Hopefully we’ll both better at nipping that in the bud now. 🙂

      1. Thanks. I’m very heartened by all the congratulations and by everyone sharing their own struggles with conserving spoons. It probably did take me a bit more than just the one day to fully get over the interview, because it was about so much more than one hour. My whole life has shifted in the last six months and now my whole way of thinking about myself and my life has had to shift too as I come to accept my autism and learn more about how I am autistic: my abilities and needs.

        Yesterday, I felt the full weight of thirty-two years of not really understanding myself, and not having anyone else fully understand me either, and that made me desperately sad. However, thanks to this post, I did not beat myself up about my lack of productivity. I pretty much gave myself the day off to feel sad and slowly adjust my perspective on who I am and how I need to start living my life. I only ran a few errands and those only because my husband needed some things. No matter how tired, I can nearly always find a spoon left in the drawer for my husband and our home. I’m getting a whole lot better at asking for his help too.

    3. Congratulations on the job interview! I am right now using up quite the bunch of “mental capacity-“spoons over the question whether to disclose in the application for an internship.

      1. I am only just trying to wrap my head around the idea that I am autistic and as I am, thus far, self-diagnosed that is my excuse not to disclose to anyone but my husband and one of my best friends. However, I am preparing myself for the time when I might be able to ask for accommodations off people, when I might need to, and I did imagine what it might be like to say to my new boss that I am autistic. Sometimes I need to imagine things for a long time before I can do something; other times, I just go for it, deliberately not thinking it through in case I never do it at all. There’s got to be a balance in there somewhere… 🙂

        Good luck with your internship application whatever you decide.

    4. Yay you! Well done, that’s fantastic!! 🙂
      And even without getting the job I think you deserved not to have to do anything else in the same day. I certainly wouldn’t have tried. With a job offer under my belt I’d have been dancing round the kitchen with any of my furry family silly enough to venture close enough!
      Let us know how you get on with it in due course!

      1. I absolutely love that image of dancing in the kitchen, possibly with furry friends as witnesses. I really wish I had a furry family but for now I shall just be happy to accept my husband’s offer of a celebratory cocktail this weekend. He’s a lot easier on me than I am and is really pleased for me.

  3. I’ve never seen the spoon theory applied this way, but it makes sense! Many days I’m running low on social, sensory, and concentration-on-uninteresting-stuff spoons, so while I have to keep myself from reading a hundred pages of nutrition science instead of doing my job I have spoons to spare for physical activity. I’d rather go to capoeira class each morning (sadly not an option since they don’t offer morning classes) than do my few hours of annotating texts, not to mention this master’s thesis I’m supposed to be writing. There are some days on which the distribution is the other way round – no chance to get me out of bed, but I could spend all day snuggling (often a problem due to sensory issues) and thinking about complicated theories. I should add a spoon check to my morning routine.

    1. Oh, and wearing my (long, wavy-tangly, very annoying) hair open means a really bad leaking of sensory spoons. It’s something I can only do on good days – or if I have the resources and energy to transform a social or executive function spoon to replace the leakage. I can’t think clearly when my hair is flying into my face while there is a lot going on in terms of noise and social activity.

        1. In my teenage years I got a really short pixie cut, but when I started to grow it out again the sensory issues were nastier than they are now, as I couldn’t put it in a ponytail or anything. Then I met a lady with a really long braid some years ago and decided I wanted this. Easy to maintain (brush and braid just once a day, if at all), easy to completely get it out of the way (bun and done), no need to see annoying hairdressers. Now I would feel naked without it – and playing with a braid is a pretty accepted form of stimming ^^

          1. I wish that my hair was thick enough for a long braid! The longest that I can grow my hair is just past my shoulders before it starts to look too thin and ratty. I think long hair is sooo pretty though, even just a braid. 🙂

            1. Ha, my hair is pretty thin right now (my one braid is thinner than most people’s braids when they wear two of them!), but that doesn’t stop me. I’ve been dealing with hair loss for at least two years now and recently a circular bald patch appeared on my forehead in a place I can’t hide … so much for ratty 😀

              1. That’s interesting. My hair has been falling out on and off for the last few years. After lots of tests for thyroid and iron levels I’ve realized that it’s stress (and autumn because I suspect I’m part tree and each fall I always lose a good handful). It’s funny the things that I hadn’t made the stress connection about before diagnosis. My hair loss, poor digestion, acne. Right now my hair is bobbed so that I don’t clog the drain! 🙂

    2. I just started thinking about spoons this way recently when I realized how much discrepancy there is in my capacity for different types of tasks. It’s definitely helping me understand why some days I feel so wiped out by lunch time and others I feel fine.

  4. I came across the spoon theory when I was researching my Fibromyalgia years ago…I never thought of applying it to being Autistic…so I guess my spoons would be lower because they are used for two things?
    Sometimes I don’t know if I have more social spoons than physical or physical than sensory….ect. Because I don’t really have a stronger area…perhaps a bit in Language…. but executive functioning, sensory overload and Physical spoons are probably all very weak areas. Social too…and language but…the other three are probably my ultimate weakest. Sigh.
    SO yesterday I took all three kids to the Optometrist. I homeschool for many reasons but the best is my mornings I can do what I want and take it slow otherwise I get very physically ill. So I had an easy morning, chatted on the phone with my best friend for an hour, chatted with the kids, made sure they were ready, husband made lunch and we had an hour before the Optometrist to chill. I decided not to do any schoolwork because of the ONE appointment. Then my stomach got sick and getting through the Optmotrist with all three kids was a feat. They all needed glasses so then we spent half an hour choosing those while being watched by three hovering attendees. They were all nice but at the end I came home and flopped on my bed and could not muster the energy to get up for half an hour. Then I forced myself up and took a shower…and couldn’t get out of the shower…so stayed for an hour till my husband got home and helped me get out…Which is weird because I HATE getting wet and prunish and I was water logged and miserable…but facing being cold and wet out of the shower was something I just couldn’t seem to do. I had company coming after supper so I forced myself to clean and help with supper, we ate, company visited for an hour, I was exhausted, watched a show and stayed up till 2 in the morning because I felt awful about my incapability to do such an easy day! I realize that my stomach off compounded everything and pre period hormones…but STILL! The kids had a great “off” day of magical play and chore time but still…

    Some days though I clean our whole house including all the big jobs like mopping, educate the kiddos, have internet time, have social time, do errands, and arrange schedules/budget ect…with energy to spare to watch some shows…So I really baffle myself.
    I’m still figuring out how many spoons I actually have every day. If I wake up in a Fibro flare it’s basically one. If I wake up before 9 am its cut in half…after nine I have however many I am supposed to have. It’s really confusing. I actually can’t weigh it in my brain with the spoons…it’s like math to me…and I have dyscalcula. I like the idea of the theory but I wish there was something that would be more accurate to me as a metaphor because I don’t really completely get how to measure in spoons.

    1. Oh my gosh, just reading about your day was super stressful! A doctor visit for 3 kids plus helping them all choose glasses . . . yikes. Going through with having company for dinner after all that was heroic, to say the least.

      Maybe some sort of color scale would work better for you? Like visualizing how you feel in terms of red (bad), yellow (neutral), green (do all the things!)? Or something else that doesn’t involve numbers?

  5. “Asking for help is strangely difficult at times. Maybe because we want to prove that we’re competent independent people. Maybe because we don’t want to bother anyone or be a nuisance or some other useless, deeply ingrained belief about our impact on our loved one’s lives. But asking for help is an important self-care tool, especially when the spoon drawer is looking barren.”

    And sometimes there is no one to ask for help. I ended up depleted without enough spoons to feed myself after not eating for several days. I live alone. There was no one here to ask for help. I was unable to use the phone, so I couldn’t call for Chinese food. I got my boyfriend on Skype and tried to get him to order Chinese for me, but it was time to eat his dinner so he didn’t have time to call and order food for me. He suggested I call an ambulance (how does one call an ambulance when unable to speak?) and ask them to feed me at the emergency room. (I didn’t even consider that option, out of fear that showing myself to be that incompetent would get my freedom taken from me. I’ve already had to go before a judge once to keep from being institutionalized for my own good.)

    I sat a long time and wept. I came close to going to bed without eating — a choice that I knew might turn out to be fatal. Finally I figured out that I could order pizza online by typing. So that’s what I ate. It made me pretty sick (I have celiac) but enough nourishment stayed in me to keep me alive another day.

    Sometimes we don’t ask for help because there is no one to ask. All I had was one person and he couldn’t help me. I might ask if there were more people who are safe to ask. But there is another reason why we sometimes fail to ask for help — who would we ask?

    1. This is such an important point, Sparrow. Thank you for sharing an example so people can see how dangerous it can be to run out of spoons when you don’t have someone who can step in to help. And how low spoons is such a vicious cycle.

      I wish there was some sort of “online help bank” where you could have asked someone for help in brainstorming how to get a meal in that situation. I’m thinking of something like the Trans Housing Network on Tumblr, but for autistic adults who need or can offer help in spoon or executive function rescue-type situations.

      The fear of losing independence is one that I think lurks in the shadows for so many of us (perhaps even more so as we get older?).

    2. I confess to not even having considered the possibility that some people don’t have anyone to help them out – how utterly naive of me. Thank you for opening my eyes, though I am sorry that you had to go through this. I get upset just thinking about how someone might think ‘less’ of me if they knew I had disabilities; I cannot imagine the fear one must feel at the idea of having one’s independence taken from them.

      I think a practical support network would be wonderful too. Even before I realized I was autistic, I’ve often thought there should be more ways to access people who can give you exactly what you need when you need it. Not everyone has the time, the energy, or the circumstances to develop a large circle of reliable relationships that can sustain them through a lifetime of ups and downs. I am lucky to have my husband, but I’m thousands of miles from anyone else who I can trust to help me if something goes wrong, and that does weigh on my mind occasionally. Yet, I’m not going to force myself into interactions just in the hopes of meeting someone I like enough to ask for help off of in five years time, or someone that I’m willing to help out should they require it.

    3. And sometimes we don’t ask for help because when we did before we were ignored or made to feel crap…
      I’ve just started a second Master’s degree (in one of my very special interests 🙂 ) and it’s online (otherwise I wouldn’t be doing it). But… our first tutorial is tomorrow and is one where you’re supposed to all be online at the same time and interact by speaking (microphone on your pc, headset etc). Well there’s no way I can manage that. I got seriously stressed just thinking about it. I originally thought it would just be typing responses in real-time and I figured I could give that a whirl because I can read pretty fast and so I’d at least keep up with what was being ‘said’ even if I didn’t contribute much. But nooooooooo. It’s speaking. So I emailed my tutor first thing Tuesday morning to explain about having Asperger’s (having already disclosed it to the University) and struggling to keep up with auditory input, and the fact that while I’d give listening a whirl I definitely wouldn’t be talking. And emailing took a few spoons out of the drawer. But he hasn’t even acknowledged my email let alone anything else. So now I feel even more crap because it’s like rejection on top of not being able to do what the others are doing. I feel like I’m leaking spoons in a big way every time I think about it.
      And it seems like on the few occasions I have asked for help in the past it’s always been the same. So now I don’t bother.
      But venting here helps 🙂

      1. That’s awful. To just not respond is very frustrating and downright unprofessional given the circumstances. It almost denies you right of reply. I hope there’s a very good excuse behind his silence and he feels obliged to share it with you very very soon.

        If our experience is that we will be made to feel invisible or shirkers or something else bad when we ask for help, then eventually even thinking about asking for help is going to cost a lot of spoons. Hope is the thing that powers me through a tough situation. If I don’t even have that, life just gets a whole lot more exhausting. Best of luck with the tutorial. And your Masters. That sounds exciting – a very special interest subject. You’re living the dream 🙂

        1. Right now it feels like a slightly unpleasant dream but hopefully it’ll improve. I’ll get through the tutorial, even if I end up giving up on it and switching off the pc, and I can battle through the degree on my own if needs be. I’m damn well going to enjoy it 🙂
          The tutor doesn’t seem to be that communicative generally so maybe it’s not just me and he’s a bit of a numpty. And even if it is just me, well he’s still the numpty! He’s not nicking my spoons without a fight…

      2. When people don’t respond its the worst for me too. I feel rejected. I would rather they said no or said something I did not like instead of silence. I hate being ignored. Apathy is the worst kind of hate. I am sorry you both have had to experience no help or silence when asked for it:(

    4. It is awful when there is no one to ask. Sometimes there just is no one at all.
      I like that you mention “who are safe to ask”. I think this is very important.
      Sometimes there might even be people around (sometimes even people who are “supposed to help”, as, for example, in hospital), but when asking not only doesn’t result in help but makes the situation more difficult or even dangerous … not good.
      This picture on my mind now of trying to peel a potato, having no peeler, and getting handed another potato. And the too-often-heard “If you don’t want to accept the offered help, no one can help you.”

      And I don’t like the “But it was your choice (…you should have known better…)” or the “You should have thought about the consequences.”

      Often it is A Very Good Thing to have an option left at all, on the list of possible solutions to a problem. Any option. Even if it is not a ‘good’ option. Like the ordered pizza that gives trouble for a celiac’s bowels – a lifesaver.

  6. Sometimes even conserving spoons ends up costing spoons. Sometimes when you’re decompressing or taking time out, even though half of your brain knows that’s the rational, right and necessary thing to do, the other half is going “you’re just being lazy and pathetic, why can’t you just be normal?” – and boom! You’re losing spoons you never even knew you had.

    1. This is a good point. Sometimes the mind can use up a lot of spoons involuntarily, automatically, due to destructive psychological thinking patterns.

      I have a related (I think) problem: I tend to get extremely fixated on some questions I can’t solve / situations witl lack of closure, e.g. something went wrong and I didn’t realise it until it was too late to fix, or someone did something unexpected that bothers me, and I don’t know why, or I am not sure if an important situation went wrong or not. My mind will keep evaluating all potential explanations over and over in an endless loop, eventually arrive on a tentative conclusion, then reavaluate everything in that frame, then conclude that I can’t be sure if that is the right explanation, then chose another potential explanation tentatively and reconsider everything in that perspective, then conclude that I can’t be sure if that is the right explanation, and so on… an endless loop that ruins my focus on the present and inevitably leads to depression. I know that but I can’t control it, I need the explanation (with reasonable certainty) to let it go, and sometimes (mostlly) that isn’t a real option, especially if the issue bothers no one but me. Loops like that can go un running for many months, years or even decades (if the latter is the case, then they don’t run constantly, and sometimes I can’t even clearly remember what the questions were… “Mind loops” of the past just pop up now and then, with vague animations and scenes playing out in my head and a dreadful sense of uncertainty, lack of closure)… and use up a lot of energy without being able to solve the problem (hence depressions).

      1. ‘Mind loops’ – that’s a very good phrase. I have a ton of them and they are indeed exhausting. I am terrible at letting go of things that don’t make intuitive sense to me. I am terrible at letting go of past hurts if I feel that there is even the smallest chance I could be hurt in a similar way again. And trying to explain any of this to anyone else can sometimes just not be worth the energy it would take. The last time I saw a therapist, my opening line to him was ‘It’s a full-time job just being me’. In light of the spoon theory and my autism, this sentence takes on a deeper meaning.

      2. To Anna:
        These postings are a couple of years old….but I hope I may post a comment to it anyway, hoping someone will read it. I have the same problems over and over like you Anna. And a lot of negativity added to it. My mind is almost constantly nagging me with all sorts of (negative) thoughts and what you call “mind loops”.
        I’ve found a great book about “matters of the mind” especially the negativity in thoughts and blaming your self etc…
        The title of the book is “There is nothing wrong with you” by Cheri Huber.
        Maybe some of you find some help in it. It opened my eyes about the “workings” of the “thinking” mind.

        To Cynthia:
        Talking of “words” and or language problems. Besides stress, maybe the load of posts and comments to be answered is becoming somewhat like a burden. It’s quite a responsibility you can feel. If i’m in such a situation…I can begin to stutter and sometimes can’t find the correct words. Lately I’m typing lots of wrong words or just mistyping them. (Stutter whilst typing?)
        Pressure of responsibilities I have to cope with. When you’re getting older they can weigh a lot heavier than when you where younger. People “expect” more of you when you are older and (maybe even) wiser. Unconsciously one can build up a stress level thats not recognized by your conscious brain. Until it’s to late. Just my idea of how things work for me or my explanation of it. Forgive me my grammar, I’m Frysian (and proud of it) english is my second (third?) language these days.
        I wish you all the best Cynthia and everyone dealing with these problems. Our path is not always flowered with roses….

        1. Thank you for your reply:-) I will have a look at the book. Psychological topics like this one never become too old, but unfortunately Cynthia does not seem to be active here anymore, due to a health problem as I understand it. However, she probably does not mind that her posts still generate conversations.

          1. I hope she doesn’t mind conversation going on. I’m still reading and re-reading this blog post every now and then. This one, and the executive functions, out of all the posts, it is still what I ponder on, a lot.
            And somehow I am still in the “mind loop” about why asking for help costs me such a tremendous amount of spoons. I am not sure the “mind loops” thing is always just something negative or related to depression. It does give me a new angle to look at things, every now and then, kind of a new train of thoughts (that has to run through the loops) that can eventually lead to a new idea on how to tackle the ever-same spoons drain or how to try and reduce the costs and up the effectiveness. What to change, how to, and what to work on… So, yes, exhausting, but not all bad I’d think. Or maybe I am too deep in depression to see the all-bad of it? But as long as I don’t have a better way of working towards ideas or (possible) solutions, maybe I better not beat myself up over too much thinking even if in loops.

            1. I imagine that Cynthia is just happy about the ongoing activity, it is in the spirit of this blog to inspire & facilitate community and self-help (and if I am wrong, she would probably have disabled comments or in any case presumably has that option). All the great effort that has been put into the blog is like an investment that keeps generating a return for the community.

              Re. mind loops: I agree that mind loops are not necessarily negative.
              I have concept development fantasies that keep evolving and generating new add-on concept ideas. The main one has been running in my head for years, like an idea factory building on a particular core idea. It has a strong inertia and consumes a lot of attention and energy of course, but some of the ideas are actually pretty good, so essentially I consider it to be mainly a resource, but one I find hard to connect with the real world. I hope that over time I may be able to convert some of the ideas / some modified version of them, into reality. During the last year I have been numbering my ideas and writing them down whenever I’m near my notebooks, and the idea (heh…) is to make a big concept plan for the main idea using a business plan template as frame, with a potentially indefinite number of appendixes to detail all the sidebranch-ideas, the website texts that are writing themselves in my head etc… and then use the concept plan as an idea bank to remember and pick great ideas suitable for implementation, and execute them. (Most of the ideas are unrealistically ambitious of course, and overall there are way too many to make it realistic to carry out the whole main idea).

              My problem is that my mind is hyperactively generating lots of ideas (and/or worries, if that is what’s on), but I’m not very good at captivating and executing them, I get stuck and then my mind just keeps adding more branches onto the idea phase. I haven’t found a way to harvest all that energy and integrate it into the real world

              My point is, that this is also a kind of mind loop mechanism, but not the kind that generates depression. On the contrary, potentially a highly productive force but so far only potentially (from a result-orientated perspective).

  7. Interesting, I wonder if that is why many people myself included wear the same or similar clothes, besides the sensory issue with certain materials etc.
    For me, taking the need to choose out of a situation would conserve spoons, I do many things or not do them for the this reason I just never thought of it in this way.
    And asking for help, I really hate trying to explain myself, very few people will just help without asking questions, which for me anyway just makes the situation worse.

    1. I always used to wear the same 2 or 3 t-shirts and never the rest. Now I’ve made the decision to rotate my wearing but, instead of having to decide, I wear the next one in line and when it’s been washed and goes back in the wardrobe it goes on the far end so it’s last to be worn again. No thinking required and I get to earn a bit of a spoon with the happy glow that comes from knowing I’m wearing all my tops. I do the same with shirts & everything. In case anyone thinks ‘but what happens if you pick a shirt that doesn’t go?’ – it’s not a problem cos I only wear black / navy trousers / joggers and all my tops go with my shorts. And I’m not exactly fashion-conscious 🙂 Actually, most of my t-shirts are either grey or navy so there’s not much variety. But it is so much easier than worrying because my favourite t-shirts are in the wash and I can’t decide what to wear.
      I love routines – the spoons stay in the cutlery drawer 🙂

    2. I definitely do! I got through this past summer wearing the same 4 t-shirts and 2 pairs of shorts and 1 pair of jeans. The transition to cooler weather has been annoying because every day I have to figure out weather appropriate clothing. Some days are sweater weather and others (like today) are still t-shirt weather. I think there’s a post in that.

      1. I’m still in shorts for dog-walking regardless of the weather. I’m not ready to think about putting trousers on – it seems like hard work.
        (Definitely post!)

      2. Yes! Please write a post on that! I do that too and the seasonal changes throw me for a loop and almost make me depressed until I can get in a groove again…and I have to check the weather constantly and ask my husband what is appropriate.

  8. This is great stuff! Excellent metaphors with the spoon drawer with different sections, and the leakages! This is very useful.

    I think my drawer looks quite like yours, just with more language spoons and fewer sensory spoons, and some more sections.

    I often get inexplicable exhausted in the middle of the day, and when I can’t lie down and totally check out / have a nap (like I couldn’t when I worked full time / didn’t work from home) then I just can’t wake up my brain properly, but feel I’m stuck in sleep-walking zombie mode for the rest of the day. I’m now getting the suspicion inspired by your news paper example that it could have to do with my habit of constantly reading things. I never stop reading for very long… When I eat cereals for breakfast I read what is on the package, I look up info on the Internet a lot, read articles in my feed, whereever I am I read stuff I see in the surroundings, relevant or not. Text and images in the surroundings is what I notice first (but that’s quite normal anyway, isn’t it?), before I notice even big things that stand out. E.g. I would almost certainly notice a sign that says “car” before I would notice a car. I think my language & visual spoons sections if large, but I also have a large daily consumption most of the time without even noticing.

    My drawer also have a spoons section for being in unfamiliar surroundings with unfamiliar people around and dealing with the unpredictability of other peoples’ decisions and behaviours. I have very limited spoons in that section, and they leak heavily even if there isn’t much interaction – for example just sitting in a waiting room without talking to anyone can be draining, or, more important: sitting in an open plan office, even if it isnt noisy and people don’t talk much. When I worked full time in an office plan office, I was run down before lunch almost every day and could barely keep my eyes open in front of my computer (luckily no one could see me since my place was a bit secluded). The office was mostly quiet, my co-workers didn’t talk a lot during work hours, and my work was easy and boring.Yet it totally drained me in relatively few hours. I think that was a leaking spoon-problem… I leaked a lot of energy without producing output that felt like an achievement.

    1. I’ve always been a constant reader too. I think it might be a kind of stimming? Or maybe a way of using a special interest as a calming/centering technique. I definitely realized some months ago that my language consumption was extraordinarily large and even with all of the cutting back, it’s probably only fallen off to average. I mean, most people don’t even read books, right? (I’ve always found it hard to believe those surveys that reveal that the majority of people haven’t read a book in the past year.)

      Your description of working in an office is very much how I imagine I would cope with working in an office as well. Being around people, regardless of how quiet or well mannered they are, is somehow exhausting in itself.

      1. Thanks for bringing up the idea of reading as stimming. I am glued to my phone because of all the news sites I read. I check them constantly, hoping for new articles or even silly pictures. I feel like it would be much better to read a few pages of a book but sometimes that is just too much commitment and reading something, anything, is comforting and if it’s a piece of easily digestible news I can access from my phone which I always have with me, then I can get that comfort almost immediately. It’s become a bit of a problem though because the news upsets me. I hate humanity sometimes…

          1. I was trying not to sound TOO cynical 🙂 I do tend to prefer animals on the whole. I’m not in a position to commit myself to having a cat or a dog right now but I desperately want one. I used to look after an outdoor semi-feral colony of cats and they learned my routine so that I would find them pressed up against the glass door of my old apartment block whenever I left in the morning to run errands. They used to team up and position themselves at different entry points to the complex so they could accost me for food and a limited amount of belly rubs when I returned. I miss them every single day.

            1. I couldn’t live without mine (1 dog, 2 cats). They’ve been life-savers and if it wasn’t for my dog I’d rarely leave the house! Love them to bits.

  9. Asking for help costs me a lot of spoons. As does communicating my needs (or trying to).
    I don’t see my supply of spoons in little boxes in a drawer, and I don’t have the same supply of spoons for the different areas of activity every day, something could be difficult-but-doable today and impossible tomorrow or vice versa.
    Different things definitely do need different amounts of my spoons. But it is not the same each day (although certain things tend to always cost a lot of spoons and others are easier). Also, sometimes it depends on time, situation, or maybe “the right moment” (or on being well prepared) – like when my focus is already on some thing, those (or related) things might be a bit easier. It seems the quickest way for me to waste my spoons is to try and jump too fast between different tasks or forcing myself through a task when my mind is still working to solve something else.
    Maybe that is what/where my leakages are. I need to think more about this.

    1. I can definitely see how being forced to change tasks too quickly could cause spoon leakage. Stopping, starting and changing tasks are all executive function areas, which means they aren’t free, even though they’re often treated as incidental actions.

      1. Thanks! I never thought of starting/stopping/changing as a “functioning” of its own. So maybe that is also why I’ve always had such a hard time falling asleep at night and waking up in the morning (no matter how many hours of sleep).

  10. Hi Musings – not a spoons comment – just to say I left some new quiz question suggestions over on the Melange survey page and I have a feeling they have just merged into the long list of other answers. They are about 3/4 way down the comments. Apologies if you have already seen and deemed inappropriate or triggery – I was trying to save you some ‘content generating’ spoons!

  11. I love this update to the Spoon Theory, so much so that I created a gif of my own spoon drawer. I almost always have enough language and EF spoons, but my levels of sensory and physical-activity spoons are always very low, and my social spoons vary based on how many sensory and language spoons I have available. It’s rare that I lock up and have to say “Words not coming!” and if that happens, I’ve almost always exhausted my EF spoons, not my language ones. EF is part of speaking, for me. Language doesn’t always need me to verbalize – I can still write down what I need just fine, usually, or sign it, if I can’t get my mouth to function.

    This is an amazing way to verbalize how there are different kinds of spoons and how they only work for specific needs.

    1. I’m really enjoying hearing about each of us thinks about our spoons. It’s interesting that you lose language when you are out of EF spoons and that you have different spoon levels for different types of speech.

  12. I have the same problem in feeling that I have to read books all the way through. Even if I’m really not enjoying it I’ll feel like I have to carry on. And it is crazy – it’s wasting time that I could be spending reading something that I love.
    I didn’t know previously what everyone was going on about with spoons so this post has been enlightening, and, as always, thought-provoking and just what I needed. Mrs T was completely right with what she said about it and about being understood. This is like a safe space where I can be myself, say what I really mean without having to think too much, and feel like ‘yay, me too’ which doesn’t exactly happen much anywhere else 🙂
    I’d have to rearrange your spoon drawer though – 6, 5, 4 on the left, 3 and 2 on the right. It just doesn’t look right otherwise 🙂

    1. Yeah, it’s definitely crazy but also obsessively compelling? I guess I cured myself of it finally by recognizing how unproductive it is when I can barely get through a book now, let alone a bad one.

      I’m glad this shed some light on spoons for you. I was mystified by it at first as well.

      Also, yay for “yay me too”! ❤

  13. The issue with this is that it seems as though you need to be very aware of your strengths and limitations in order to put your spoons in the right piles, so to speak. If you can’t even do that, what then? (Asking genuinely, not being pessimistic or rhetorical.)

    1. I definitely think that’s true and it was only recently that I realized where my strengths and weaknesses lay because the gap between them has become so wide and I’ve had to start experimenting with some extreme spoon conserving measures. In the past it had always seemed like I had a general bucket of resources to draw from, so I get what you’re saying.

      A starting place might just be to read through what others have said here about their strengths and weaknesses to see which statements you identify with and try to sketch out some general thoughts based on that. I often find that “me too” feeling is a good starting place for me in understanding myself better because while it’s hard to start from scratch and identify characteristics in myself, I can instinctively relate to things that I have in common with others when I read their experiences.

  14. I’ve been re-reading this post and mulling it over. I think that some of my spoons are wedged in the couch cushions and a few others are lost in the drawer next to the cutlery drawer and maybe some of them have been left in the basement by negligent cereal eaters.

    I find it difficult to organize my spoons because of the randomness of having other people in my life. I love my kids and husband very much but have been struggling to get my spoons in one basket… I mean drawer, for a while now.

    I find that organizing other people makes it really hard to take stock of my spoons and I’ve run out unexpectedly a few times lately.

    I need to find a way of retrieving the lost spoons without running out of spoons.

    I need to restructure… somehow.

    1. I like this story of lost spoons and would like to add some special spoons for special, not everyday tasks that live in a drawer of their own as well as the silver spoons that live in a hidden drawer and need to be polished before use – and then they will sparkle and feel just right in my hand!
      This week I had an appointment to learn something useful and I knew I would run into many of my inabilities learning what I wanted to learn, I just did not know which exactly. After the one hour, I was exhausted even though I had taken along one of the special spoons. Right then, I was aware that one afternoon would not be enough to recover so I allowed myself even the next day.
      Now, evening of the third day, after lots of rest, I feel like I have found a sparkling silver spoon, one of my feelgood sparkling silver spoons, because I have managed to integrate the lesson of two days ago with the rest of my system. The result is that I may not be able to do things like the majority but I have something to add that is equally worthwhile and often overlooked by said majority.

    2. This is a great analogy. Other people are probably the biggest drain on my spoons, especially when it comes to being a sneaky, hard-to-pin-down kind of drain. It’s especially hard when you’re the mom because people just expect moms to somehow have infinite resources for caretaking.

  15. What a timely post! I’d started blogging about how stressed I was becoming at school, and I think it’s because I used up all of my spoons, social, executive and sensory every single day, leaving very little time to recharge. It doesn’t help, either, that the new school I’m in has far too many people.

    Yeah, social activities will drain me if there are FAR too many people all at once. It’s easier to ease into it when I get to a party early enough, but if I can’t get out? Immediate stress. I’m learning to not be 110% enthusiastic about everything, because it makes me super exhausted. I’m also learning to find the places no one visits (but still in a safe spot where people are still around, they just don’t talk to me) so I can enjoy nature.

    1. I’ve been reading your posts. It sounds terribly stressful and draining!

      Places no one visits are a blessing. I recently moved to a town that triples in size during the summer and I can’t ever remember being so eager for Labor Day to arrive. The quiet that fall has brought to town is like a big sigh of relief.

  16. Thanks for a very meaningful post.

    Spoon leakage is a very good point. I often take ages to notice a leak eg. too much time on the iPad or too much planning for an upcoming event.

    I find that if my spoon draw gets totally empty it takes ages to re-fill, but if I’m careful to keep a reserve it gets topped up again much faster.

    The asking for help thing is interesting. I understand the wanting to manage and appear capable, but I think I have another problem with it too. If I’m mostly ok but am struggling with one thing I can sometimes ask for help. But if I’m running out of spoons or feeling stressed or overwhelmed I usually can’t. I’m lucky if I can work out what I need let alone communicate this to someone else. It generally takes less spoons to muddle through on my own rather than formulate the words to ask for help that would make things easier. I don’t know if this is purely a language thing or an executive function thing, but it is a strong barrier to getting help.

    1. It takes me a long time to find leaks too. I just finished up a post for tomorrow and in the process realized that I’ve been leaking sensory spoons for weeks without knowing exactly why.

      I totally get what you’re saying about asking for help. It seems like a mix of EF and language things. I think there’s also (for me) an element of tunnel vision. As in “I started doing this thing and I’m going to finish doing it no matter what” where I don’t realize that I’m in over my head and should probably stop and seek out help.

  17. This just makes so much sense. Most of the things you write, or at least another person’s take on it (found in comments) make so much sense. I think I may have found the diagnosis that fits me, and with the diagnosis comes a whole host of solutions, as well as the acceptance that there are some things I just can’t do, and that this is okay.
    Thank you, not just for this article, but for the whole blog.

    (Also, would dictation software help you with the blog, while you’re struggling with typing, and language, or is vocalisation affected as well?)

    1. You’re very welcome.

      Regarding the dictation software, you read my mind! Just yesterday I decided to order Dragon to try it out (the older version is only $30 on Amazon, which made it an easier decision). I think it will help specifically with the spelling problems that have become a huge nuisance recently. Not sure what it will do to my overall language spoons because I’ll have to speak to use it, but I’ll likely write about it at some point.

  18. I just read this post today and thought it was wonderful. I also read the linked article about spoon theory and how it was created to describe lupus. It works well with any chronic condition. I don’t consider being diagnosed with Aspergers as an illness, but I do consider having Sjogren’s Syndrome to be. Of course the combination puts a serious strain on my spoons, but now that I can think of things this way, I think it should help.
    Of course I also need to add in that my HFA adult daughter is living with me as well.

    1. I had to Google Sjogren’s syndrome because I had never heard of it before. It sounds like a challenging condition to live with. I think that the spoon theory applies well to both chronic illness and disability or any combination of the 2. As you pointed out, having a chronic illness in combination with Asperger’s can be doubly challenging. I’m glad you found the original article and my thoughts on it helpful.

  19. This post and especially the comments has been the most useful thing I’ve read in a long time. I’m currently in what you might call the discernment part of a diagnosis journey – it’s been highlighted at work that there’s a fairly serious issue and my suspicion that I might be autistic has been lent, at least in my mind, weight by the situation. So many things everyone is saying here chime with my own experience that I hadn’t even realised were connected to autism! I figured I just had a load of different unusual quirks and maybe they’re actually all tied up in one big bundle of a neuro difference. Thank you all, so much.

    1. So glad you found it helpful. The commenters here are the best. 🙂

      Good luck with your journey – having a label can be an incredible relief and it opens a door to all sorts of realizations and sensemaking discoveries.

  20. … I found this topic because I waz scanning the catagories for any subject on ‘collections’ because I have a few things I collect – most of the things … well … THIS subject is not about that … so I read your intro … then I went to the story of the girl with lupis … and I must tell you, I personally could have read with much more clarity if the words ‘time’ & ‘energy’ had been used in place of every use of the word ‘spoons’ …
    I can get a metaphore usually – but … I battled thru the reading bc I primarily kept picturing real spoons, and things that people do with spoons and ‘spooning’ and the game ‘spoons’ and also forks and knives because they are in the drawer beside the spoons …

    Meanwhile, I too run out of time and energy every single day bc I have a great many jobs I HAVE to do, and then there are things I NEED to do and then there are things I want to do that do not benefit the former two at all and cause me to be further behind … for example, reading and replying on this site … and typing topics of interests to 2 friends in email, and watching movies …
    The lists of things in the necessity column, the imperative column, and the wish column are full enough that even at age 52, mathematical calculations show I will likely die of natural causes within the average lifespan age. With age comes less energy anyway. I can only pray for Jack LaLann-type stamina …

    his diet is on one of my lists …
    … { ‘:¬•

    1. It is a bit disorienting when you think of it literally, isn’t it?!

      I hear you on how full the three columns are and how it becomes harder to apportion energy between the two. There’s a constant tension between doing what we have to do and yet not using up all of our energy on necessities and then having none left for the enjoyable stuff. :-/

  21. I’ve only just discovered your blog, so I’m coming in on this post very late! I’ve familiar with the Spoon Theory for years from having M.E. and fibromyalgia, but strangely I’d never really thought of applying it to my Asperger’s as well. Although actually, managing three conditions that leave you physically and mentally exhausted is so tough that I don’t have the brain power to make the links, I rely on other people making them for me! Thank you, you’ve lent me a good number of spoons today. >;o)

  22. I had a hard time following the spoon metaphor- but I know the nature of not having enough resources. For example, I can handle one or two minor upsets, changes in plans, disruptions, sensory bombardment, etc. but reach that threshold and I can become far more likely to meltdown, withdraw or simply be a grumpy-gus until I either sleep or find some rejuvenating activity(such as engaging in one of my “special interests”)
    with such limited resources, especially under stress or pressure, I find myself constantly on edge… I do like the concept of being able to “borrow others’ spoons” but I find that I have, in most cases, no one to ask for help.
    it’s not that I don’t have friends at all, I just feel like no one is there when I know I need to ask for help. I feel as though even though I put my heart and soul into supporting my friends when they need me- this doesn’t get reciprocated very often in return. I feel worse about myself when that happens, wondering, “am I a jerk?” why don’t they reflect the same willingness to “be there” for me as I do for them?

    1. I know the feeling but I’ve come to the conclusion that it’s just that a lot of people are basically fairly selfish in their attitude towards others (it’s that whole me, me, me culture) and I’m not good at asking for help so the decent ones end up not getting that I need something from them.

      1. It’s terribly frustrating, its no mystery why I tend to be solitary.
        To have to deal with people and their “me first” additude… I realize that isn’t spelled right- but if it wasn’t for auto-fill this whole reply would be a string of gibberish. My language skills just walked out the door… I need a vacation… *sigh* see, there went the last of my language spoons. (Thanks to modern technology this made some sense at least) leave it unedited and this is what it looks like: sometines I cant gey a songle wrof spelled right. My unedited version is so terrible… I am beginning to realize how much I rely on spell check. Rabbit trail.
        My original point was that I find that the effort of trying to associate with other people can be downright unbearable, not to mention that the more stressed out I get the more likely I am to lapse in basic language skills.

  23. Thank you for this post! I am completely exhausted all the time, and it feels like I am never able to replenish my spoons to what they can be. It’s hard to figure out things to let go of – partially because I’m not sure what is taking up my energy at all. It feels like what is necessary takes up so much energy, I don’t have many or any spoons for anything I really really love – I split up with my boyfriend because it all of a sudden felt like I was unable to maintain a long distance relationship. I want to go back in – I wasn’t ready to end it, truly. I want to be able to do it more efficiently and use fewer spoons on small things, because it feels like walking 5-10 miles a day to school, making food and planning a long day of work I don’t like eats up everything.

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Friday, January 29, 2016

Update Rollup 9 for System Center 2012 R2 Data Protection Manager is now available!

Update Rollup 9 has been released and for all the DPM-admin out there. Here is the fix we all have been waiting for:

  • No production server restart is required when you upgrade from DPM 2012 R2 Update Rollup 6 or later versions!
"We have performed an extensive review of the DPM architecture to avoid production server restarts when you upgrade the DPM Agent. There were a few cases in which the Agent update was flagging for restart, and these are fixed now. Therefore, if you already upgraded to DPM 2012 R2 Update Rollup 6 or a later version, you will not experience a restart when you upgrade to this update."

There are more features and a lot of fixes that prevent issues in UR9 so go ahead and start upgrading: Update Rollup 9 for System Center 2012 R2 Data Protection Manager

Have a great Friday and a lovely weekend!

Kind Regards
Markus Eliasson

Thursday, January 28, 2016

Setdpmserver, errorcode = 0x80070005, error says: access is denied

So today I ran into an interesting problem when installing a DPM-agent on a Domain Controller in another trusted-domain.

The agent-installation completed successfully but when I ran:
   SetDpmserver.exe -dpmservername
In a elevated command prompt I got received the error
   SetDpmServer failed with errorcode = 0x80070005, error says: Access is denied.

My solution, after some hours of troubleshooting, was to run a Enter-PsSession to the production server, from the DPM-server in my

   Enter-PSSession -Credential Contoso\DomainAdminUser

*fill in my password in the authentication-box*

   CD 'C:\Program Files\Microsoft Data Protection Manager\DPM\bin'

   .\SetDPMServer.exe -dpmservername

I hope this can help anyone of you!

Kind Regards
Markus Eliasson

Tuesday, January 12, 2016

What's coming for System Center in 2016?

Hi everyone,

Just a quick post to update you on what new features we can expect to see in DPM 2016:

  • Protect mixed mode clusters
  • New form of change tracking to replace VSS snapshot-based backups - Resilient Change Tracking (RCT)
  • Storage Spaces Direct (S2D) support
  • Virtual TPM support for protection of Shielded VMs

How these new features will integrate with VMM 2016 and its new "VM Checkpoint support" ("Production" checkpoints in Server 2016) is going to be very interesting!

Here is a great bloggpost covering all System Center products:

Best Regards
Markus Eliasson

Monday, January 4, 2016

Microsoft recommends installing Update Rollup 8 to improve stability

Hi everyone!

Its now 2016 and we have got a whole new year of exciting new features and releases in front of us, but lets focus on our current situation for a moment.

Update Rollup 8 for DPM 2012 R2 has been out almost two months now and if you haven't already upgraded now is the time. Microsoft has received good feedback from thousands of customers and have decided to make the UR8 marked as "Important Update" on Microsoft Update.

Here is a complete list of important issues that has been fixed since DPM UR7:
  • DPM console crash issues.
  • If you try to back up a SharePoint site that uses SQL Always On as a content database, SQL logs are not truncated resulting in SQL disks to become full.
  • If you have multiple SharePoint farms hosted on the same SQL cluster, with different instances but the same database names, DPM cannot back up the correct SharePoint farm content.
  • You try to back up Hyper-V virtual machines (VM) that have a replica and both the Active virtual machine and the Replica virtual machine are managed by the same System Center VMM server. Previously, you had no control to select between Active and Replica virtual machines for backup. This frequently caused backups to fail, depending on the setup.
  • If you try to protect large number of virtual machines in a single Protection Group, and you have the VMM Helper Service enabled, some backups may fail with "System.TimeoutException".
  • In some cases, alerts that are resolved in DPM are not synced in the DPM Central Console.
  • If you are trying to recover data from an imported tape, DPM may crash with a "Connection to the DPM service has been lost" error.
  • When you try to protect a SQL failover cluster, the Data Protection Manager UI may crash for backup or synchronization operation.
  • DPM self-service recovery for SQL databases may fail with the error “Cannot connect to DPM server …”
  • End User Recovery/SSRT may not work in some cases for mirrored SQL databases.
  • You cannot protect a SQL database on an Availability Group (AG) if different AG have the same database name.

Kind Regards
Markus Eliasson


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Health Information and Tools > Patient Care Handouts >  Learning About Life With a Tissue Heart Valve
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Learning About Life With a Tissue Heart Valve

What is a tissue heart valve?

A heart valve may be replaced when it is damaged or narrowed by disease. Your doctor replaces your valve with an artificial valve made of animal tissue. The new valve controls the normal flow of blood into and out of the heart.

It's important to keep in mind that an artificial valve won't work as well as an undamaged natural valve. So even though your heart works better, it may not recover to completely normal levels. If your heart was already working poorly before your valve was replaced, you may still have heart problems.

Artificial valves wear out over time. A tissue valve will last about 10 to 18 years. As long as you have the valve, you and your doctor will need to watch for signs that it's wearing out.

Your doctor may give you a blood thinner to prevent blood clots. If you take a blood thinner, be sure you get instructions about how to take your medicine safely. Blood thinners can cause serious bleeding problems.

How can you check for problems with your heart valve?

Even though you have a new valve, you still have a serious heart condition that needs to be watched closely. And because tissue valves usually need to be replaced over time, you and your doctor will need to watch for signs that the new valve is wearing out.

These signs will be similar to those you had before your original valve was replaced. Watch for:

  • Shortness of breath.
  • Fainting.
  • Chest pain.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Where can you learn more?

Go to

Enter G601 in the search box to learn more about "Learning About Life With a Tissue Heart Valve".

Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.


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Health Information and Tools > Patient Care Handouts >  Learning About Gun Safety for Teens
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Learning About Gun Safety for Teens

Why is it important to think about gun safety?

Guns are common in our society. Even if you've never seen a gun in person, you've probably seen them in video games, TV shows, and movies. If your family has a tradition of hunting, or if you go to shooting ranges or gun clubs, you may have direct experience with guns. Whether you have used a gun or not, it's good to think about safety. And it's important to understand that curiosity about guns can lead to deadly injuries.

Wherever there are guns, there can be unintended shootings. This is more likely in households where guns aren't stored properly.

As a teen, you have more freedom than younger children. But you also have more responsibility. If there are guns in your home, make sure they're stored safely to protect you, your family, and your friends.

What can you do to prevent gun violence and accidents?

  • If you're interested in guns, take a class to learn how to handle them safely.
  • If there are guns in your house, they should be stored:
    • Unloaded.
    • Locked in a secure location. And the keys should be hidden.
    • With the safety device on.
    • Separate from ammunition. It's also important to lock up the ammunition.
  • If you're concerned that the guns in your house aren't stored properly, talk to a parent.
  • If you ever see a gun at school, tell a school official or a trusted adult right away.
  • If you ever come across a gun that is not properly stored:
    • Assume that every firearm is loaded and is potentially dangerous.
    • The muzzle of the firearm should not be pointed towards yourself or any other person.
    • Do not put your finger on or near the trigger.
    • Get someone who is trained in firearm safety to check that the gun is unloaded.
    • Follow the steps above to ensure that the gun is stored safely.

Where can you learn more?

Go to

Enter G100 in the search box to learn more about "Learning About Gun Safety for Teens".

Adapted with permission from copyrighted materials from Healthwise, Incorporated (Healthwise). This information does not replace the advice of a doctor. Healthwise disclaims any warranty and is not responsible or liable for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.


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Health Information and Tools > Patient Care Handouts >  Kidney Transplant: What to Expect at Home
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Kidney Transplant: What to Expect at Home

A healthy donor kidney transplanted into a person with diseased kidneys

Your Recovery

A kidney transplant is surgery to give you a healthy kidney from another person. The new kidney may have come from someone you know, a stranger, or a person who has died. You need only one healthy kidney to live.

Your belly and side will be sore for the first 1 to 2 weeks after surgery. You also may have some numbness around the cut (incision) the doctor made. You may feel tired while you are healing. It may take 3 to 6 weeks for your energy to fully return.

After the transplant, you must take medicine to keep your body from rejecting the new kidney. You will need to take anti-rejection medicine every day from now on. These medicines have side effects. One side effect is that your body may be less able to fight infections. It's important to take steps to avoid infections. Stay away from crowds of people and anyone who might have an infection or an illness such as a cold or influenza.

Your new kidney may start working very soon after surgery, or it may take a few weeks. If your kidney doesn't start to work right away, you'll need to have dialysis until the new kidney can take over.

Having an organ transplant can bring up many emotions. You may feel grateful and happy. But you also may feel guilty or depressed. Seek out family, friends, and counsellors for support. If you think you are depressed, ask your doctor for help. Treatment can help you feel better.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
  • Avoid exercises that strain your belly muscles and activities that make you work hard, such as bicycle riding, jogging, weight lifting, or aerobic exercise, for 4 to 6 weeks.
  • For 4 to 6 weeks, avoid lifting anything that would make you strain. This may include heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, a vacuum cleaner, or a child.
  • Hold a pillow over your incision when you cough or take deep breaths. This will support your belly and decrease your pain.
  • Do breathing exercises at home as instructed by your doctor. This will help prevent pneumonia.
  • Ask your doctor when you can drive again.
  • Most people are able to return to work about 4 weeks after surgery. It depends on the type of work you do and how you feel.
  • You may take showers. Pat the incision dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
  • Ask your doctor when it is okay for you to have sex.

  • Follow your doctor's instructions about what to eat after your surgery. You may need to follow a special diet for your kidneys or for other health problems.
  • Drink plenty of fluids (unless your doctor tells you not to).
  • Check with your doctor before you drink alcohol. Alcohol can cause problems with some of the medicines used to prevent organ rejection.
  • You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fibre supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

  • Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
  • If you take aspirin or some other blood thinner, ask your doctor if and when to start taking it again. Make sure that you understand exactly what your doctor wants you to do.
  • Take your anti-rejection medicines exactly as prescribed. Call your doctor or nurse call line if you think you are having a problem with your medicine.
  • Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, take an over-the-counter medicine that your doctor recommends. Read and follow all instructions on the label.
    • Do not take aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve), or other non-steroidal anti-inflammatory drugs (NSAIDs) unless your doctor says it is okay.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your medicine after meals (unless your doctor has told you not to).
    • Ask your doctor for a different pain medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

  • If you have strips of tape on your incision, leave the tape on for a week or until it falls off.
  • Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
  • Keep the area clean and dry.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have severe trouble breathing.
  • You have sudden chest pain and shortness of breath, or you cough up blood.
  • You have severe pain in your belly.

Call your doctor or nurse call line now or seek immediate medical care if:

  • You have pain that does not get better after you take pain medicine.
  • You are sick to your stomach or cannot keep down fluids or your anti-rejection medicines.
  • You have loose stitches, or your incision comes open.
  • You are bleeding from the incision.
  • You have symptoms of a urinary infection. For example:
    • You have blood or pus in your urine.
    • You have pain in your back just below your rib cage. This is called flank pain.
    • You have a fever, chills, or body aches.
    • It hurts to urinate.
    • You have groin or belly pain.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • Swollen lymph nodes in your neck, armpits, or groin.
    • A fever.
  • You have trouble passing urine or stool.
  • You have pain or swelling in your lower belly.
  • You have signs of a blood clot, such as:
    • Pain in your calf, back of the knee, thigh, or groin.
    • Redness and swelling in your leg or groin.
  • You have a weight gain of more than 1 kilogram in 1 day.
  • You have any problems with your anti-rejection medicine.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

  • You do not have a bowel movement after taking a laxative.

Where can you learn more?

Go to

Enter J390 in the search box to learn more about "Kidney Transplant: What to Expect at Home".

Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.


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A doctor’s job search doesn’t begin or end with specialty. Due to the profound nature of the current doctor shortage, physicians can also choose geography. Does the new doctor want to stay in the same location as the school from which she graduated? Is the 15-year veteran willing to move away to find a better position?

There are additional geographic locations to consider as well. Some states are heavily rural while others combine rural with big-city environments. Still other states have no big cities at all. They are dominated by small and mid-size cities with populations no higher than a few hundred thousand.

Deciding on the best place to work can be a tricky proposition. To help clear things up, WalletHub conducted a study based on 2017 numbers and then ranked the states and the District of Columbia accordingly. Their study looked at 16 different metrics divided into two categories:

  • Opportunity and competition (annual wages, starting salary, job opportunities, etc.)
  • Medical environment (health system quality, malpractice awards, insurance rates, etc.).

The opportunity and competition segment made up 70% while the medical environment component accounted for the remaining 30%. Each of the metrics were scored on a point system with a cumulative total of 100 points. With all that said, some of the more interesting observations are described below.

Annual Wages

There is no denying that pay is one of the more motivating factors in a job search. It is no different for physician jobs. According to the study, Mississippi tops the 50 states in terms of annual wages. Rounding out the top five are South Dakota, Iowa, Georgia, and Tennessee. At the bottom of the list are Hawaii and the District of Columbia.

This might surprise you given the tendency for people to believe that the states with the biggest cities would offer the highest annual wages. But it’s not true. In fact, California and New York ranked 48 and 49 respectively.

Job Competition

If you are a doctor in need of a job, you might be thinking about applying in states where the competition is lowest. If so, you would want to think of Idaho, Alaska, and Nevada. They are the top three for job competition. The bottom three are Connecticut, Rhode Island, and the District of Columbia.

State Medical Boards

WalletHub looked at an interesting metric that a lot of us would probably not think of: how punitive state medical boards are. In states with the worst scores, doctors are more likely to be disciplined by medical boards deemed too punitive. The most punitive states are Delaware, Kentucky, and Wyoming. The best places to work in this regard are Maine, the District of Columbia, and Massachusetts.

Insurance Rates

This is a big one to doctors for obvious reasons. The less one has to pay for medical malpractice insurance, the more real income is generated. The least expensive malpractice insurance can be found in Nebraska, South Dakota, and Wisconsin. New York, Illinois, and Michigan have the highest malpractice rates.

This particular factor may not be so much of an issue for locum tenens doctors. Locums always have the opportunity of working with agencies that offer free malpractice insurance as an incentive. In such cases though, insurance rates are still a big factor among locum agencies.

The WalletHub study offers a fascinating look into the working environments in the 50 states and DC. As a side note, South Dakota ranked number one with a total score of 75.97. If you are physician looking for a job, you might want to give the study a look.


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On This Day- 25 March 1840 – Birth of Myles Keogh

The Little Bighorn, which sounds like a bit of a contradiction in terms, is a river in the American state of Montana. It flows through mainly flat or gently undulating plains. As a river it is unremarkable. But it is not famous for the qualities of its drainage. It is infamous for what happened there on 25 & 26 June 1876 when a flamboyant, egotistical Cavalry officer, George Armstrong Custer, led his Seventh Cavalry to the worst, and last, military defeat ever inflicted on the US Army by the Plains Indian tribes, the Lakota and Cheyenne, at what they called The Battle of the Greasy Grass. No prizes for guessing what it was that greased the grass of the river’s banks.

Five of the twelve companies of the 7th cavalry were wiped out on 25 June, including ‘I’ Company, led by Carlow-born Captain Myles Keogh, the most senior of thirty-two Irish-born fatalities in the battle.

Keogh, from Leighlinbridge, had found his way to his date with destiny by a circuitous route. He had, in 1860, as a twenty year old from a relatively prosperous Catholic family, volunteered for service in the army of the Pope. He wasn’t dressed in a striped uniform guarding the Vatican city, he was fighting, unsuccessfully, to save the Pope’s last remaining landed possessions in Italy. When the American Civil War broke out the Roman Catholic Archbishop of New York, John Hughes, recruited Keogh and a number of his colleagues, to join the Union Army. He served with distinction through most of the American Civil War as a cavalry officer, fighting at Fredericksburg and Gettysburg and rising to the rank of Lieutenant Colonel.

After the Civil War the American Army was greatly reduced in size but Keogh wanted to stay on. Like most other officers he lost his exalted war-time rank but was not demobilized. He was sent west to join Custer’s 7th Cavalry charged with keeping the peace on the great American Plains and ensuring that nations like the Lakota – better known as the Sioux – the Cheyenne, and the Blackfeet, behaved themselves and remained on the relatively useless patches of land that had been set aside for them as ‘reservations’.

Keogh was undoubtedly handsome, dynamic, vigorous and physically courageous. However, he was also described by some colleagues as intemperate, drunken and violent. Although he respected the Native Americans of the Plains as military opponents he had no time for their culture or way of life. He viewed them, quite simply, as savages who needed to be kept permanently in check.

He was part of an Army that had a huge Irish element. 10,000 soldiers were stationed in the American West, a quarter of whom were born in Ireland. The Irish influence can clearly be seen in Custer’s 7th Cavalry. The muster roll in 1876 included 126 Irish-born soldiers out of 822 members of the regiment. Keogh was the only officer. The regiments two marching tunes were the Irish airs ‘Garryowen’ and ‘The Girl I Left Behind Me’.

The story of Custer’s massive miscalculation in sending his six hundred strong force against an Indian village that contained up to 5,000 fighting men, has become the stuff of legend. He made things even worse for himself by dividing his command. Everyone who fought with Custer, died with Custer. The only survivor was Keogh’s horse Comanche. Keogh himself was killed a few hundred yards away from Last Stand Hill where his Colonel died. Although he is buried in New York state a gravestone bearing his name marks the spot where he perished, surrounded by the other members of Company ‘I’. For some reason Keogh’s body was one of the few not to have been mutilated by the victorious Sioux and Cheyenne. He wore a Papal medal, awarded in 1860 by a grateful Pope. This token may have been what saved his corpse from evisceration. The Lakota and Cheyenne, who wore pendants of all kinds to ward off evil spirits, may have been wary of the Pontiff’s decoration.

Captain Myles Walter Keogh, commanding officer of Company ‘I’ of the Seventh Cavalry was one of two hundred and sixty eight US cavalrymen to die at the Battle of the Greasy Grass or the Little Bighorn, he was born one hundred and seventy-six ago, on this day.


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Nickname Riana is registered to Рамалданова Риана Алисултанова. Issued wooden certificate id4714. Issue date 09.02.2017.

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