Mental dialysis, brain fog, preemptive rest – writing with ME/CFS

A tantalizing thought: a possible mechanism to explain how and why taking a nap clears out the brain of a PWC (Person with CFS – ie, me) so she can think – and write.

I have often wondered how a standard technique for us PWCs – resting after, and even before, energy is required – works. For me that energy translates to the possibility of writing: without a working brain, attempts to write, fiction especially, come to naught. I just can’t do it.

I can read – which is where surfing the web for SOMETHING interesting to read to keep me from going mad comes from. But I can’t write, and if I CAN write, it is usually not creative fiction.

There are higher brain functions involved in writing/creating that are not called on when doing straightforward reporting or simply clearing the mind of related ideas to write an editorial or opinion piece (such as a blog post).

If I can’t even read, sometimes I can watch TV. Other times I can do something simple and repetitive such as a game on the Nook Color.

But I can’t write fiction, and, since that’s what I want to do every day for at least a while, I get very frustrated.

Many of these times, if I will but take a proper ‘preemptive rest,’ I can restore some of that brain function to a more usable state such as acquiring the ability to go from surfing the web to blocking the web and writing for a while.

Definition of proper preemptive rest

For this purpose, a proper preemptive rest is 35 minutes, horizontal, with an eye-mask, in a quiet environment, doing nothing. It’s a strict definition because I need to be strict with myself for it to work right, and, after all these years of doing many a day, I know what works and how do get to that state when my racing or plodding mind wants to do something else.

While driving, I can sometimes do several two-hour blocks IF I will take a 35 min. rest in as close as possible to the horizontal position. When I’m going a longer distance, I actually take the seats out of the back of the van so I can lie down every couple of hours.

It can’t be extended indefinitely, to allow continued two-hour ‘on’ sessions, and I may be slow the following couple of days, but it works for me. And it’s a lot better than nothing.

However, I’ve often wondered exactly what was going on, and WHY it works.

Rest, sleep, and what happens in the brain

When I came across an article in Science News with the intriguing title Sleep allows brain to wash out junk (SN 11/16/13, p. 7), I found some interesting bits. I’ll quote them here, note that they relate to the original article in the Oct. 18, 2013 issue of Science, and then try to stitch them together into an ad hoc explanation that I find intriguing and useful for getting myself to take the rests, which I otherwise resist, since I’m not two years old any more.

“Sleep hoses garbage out of the brain”

“Sleep’s role in garbage clearance…called the glymphatic system, flushes brain and spinal cord fluid into the space between brain cells. Ultimately, the fluid and any debris it carries washes into the liver for disposal.”

From a study of awake and sleeping mice: “Brain cells known as glial cells swell and shrink to control fluid flow. When mice are awake, glial cells expand, reducing the space between brain cells and shutting off fluid flow. During sleep, the cells contract and the faucet opens.”

“The region between brain cells changes in volume by at least 60% between wake and sleep” (emphasis mine)

These results make me wonder whether, by taking a rest, and it being as close to sleep as possible (I often fall asleep, and strive for that if I can – otherwise I do patterned yoga breathing that keeps me from thinking), washes out of my brain an excessive accumulation of what the researchers called ‘debris’ – and I can think again.

I visual the process as ‘mental dialysis’ or ‘brain dialysis’ that I have some voluntary control over, because I choose the time and place and conditions, and make my brain as close to asleep as I can.


It takes time.

It requires me to take a decision to lie down and rest properly when my brain is so fogged that I’m making bad decisions right and left – the worst time to make decisions is when I’m tired.

It takes time – and my brain keeps telling me we can bull through the work instead (and rarely, we can – but I’d say that’s less than 5% of the time).

There are many places where I desperately need a nap and can’t really take one (airports and air travel are killers, for example).

While I can do shorter times, I really need 35 minutes to do a good job.

It only lasts for a couple of hours afterward.

It’s hard, psychologically, to take a nap when ‘well’ people don’t have to.

It interrupts what I’m doing.


It almost always works, at least for a while after.

I have learned to quiet my mind – which is also beneficial to my blood pressure.

It serves as a breaker when the thoughts get obsessive.

And it gives me what I need to stay sane: usable writing time.

Synergistic effect with vitamin B1, and my current working method

I am currently getting the best use out of my brain that I’ve had in a while. Considering the many things that have gone badly in the last month or so, I’m amazed that I’m funcitoning at all.

ALL the following pieces work synergistically: the more of them I get going together, the more likely my brain function will rise above the line marked FICTION:

I do the steps daily if at all possible, because I lose almost a day’s writing every time I get disconnected by a Life Event, and lose more days when the interruption is longer.

1. A good night’s sleep of at least 6 hours, preferably 7 or more (I will write a whole blog post on that sometime, but I often tell myself that I will be ruining a whole day worth of writing if I don’t get to bed, and the thought does get me moving toward sleep.

2. I use vitamin B1 as soon as I get up (I need to update with another post, but searching on B1, and reading the last one that comes up on the blog will provide a good overview of quantities) with food.

3. I leave Mail and my regularly-read blogs for later.

4. I block the internet as soon as I can make myself do it, using Freedom for the Mac, and setting is for 3-4 hours: WRITING TIME.

5. I don’t worry about having my brain significantly less functional for the first hour – I can’t change that it takes time for the B1 to start working. Plus there are many organizational and cleanup jobs I CAN do during that time – and as soon as I block the internet, I do at least try to do those.

6. If necessary (especially after a bad night), I interrupt my writing time to take a preemptive rest.

And then, magically, the mind focuses, and I get started on the next step, whatever that is.

If I do as many of these steps as possible, fiction creaks out of my brain, I feel good, I have a purpose, and the rest of the day goes much better.

If not, we’re down the rabbit hole again.


7. And then, when Freedom runs out, I take ANOTHER nap/rest to deal with the ‘debris’ in my brain from the writing itself.

Done right, I can get in a decent piece of writing in the morning, and occasionally have enough energy to do something else, too.

Wish me days like these, and I’ll get this novel finished.



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