Many of you would have been told that you need to pace yourself, don't do too much in a short space of time and give yourself as much rest as possible. All of this is very easy to say, but how do you do it?

Take Mary for example. Mary has myasthenia gravis and she has been told by her nurse that she has to learn to pace herself during the day.

During the week, Mary tends to be very active in the morning and sleeps every afternoon for a variable length of time. She experiences a major burst of activity on Tuesday afternoons when she looks after her 3-year-old grandson after playgroup. As a result of this, Mary is generally tired by the time her husband returns from work and her sleep in the evenings is generally broken and unrefreshing.

Pacing yourself is a balancing act between using your energy in the most efficient way and maximising the energy that is available to you. You need to know when to prioritise activities and when to delegate them. This will help you in the long term because you will have set a time to do certain activities. This will mean that you will know what you are going to do and when. This will save you doing too much as you will be able to rest in between activities.

To avoid being exhausted in the afternoons and evenings, Mary should spread her jobs out during the day so that she does fewer jobs in the morning, come back home to rest, and then complete her remaining jobs in the afternoon.

Prioritising and planning your activities will ensure that you are using your available energy effectively. Planning and prioritising also ensures that you will be getting enough rest in between activities. You should take regular rests during the day. Micro-breaks are also important, these are frequent short breaks of varying length.

Saturday is another day of excess for Mary. In the morning, Mary and her husband go to the local supermarket to do the shopping for the week. She then goes into town with her sister to do some shopping and have a coffee. It is because of this activity that Mary is exhausted on Sunday and tends to be in bed for most of the day.

Mary has voiced her concerns about being in bed all day to her nurse and she has been advised to share Saturday's jobs with Sunday. The weekly shop can be done on the Sunday, meaning that Mary has more time to rest before meeting her sister on Saturday afternoon.

Giving yourself enough time to rest will help you to manage your symptoms better and will make you healthier. It will also mean that when you come to do your planned activity, you will have maximised the energy available to you, meaning that you will feel less tired after you have completed your task.

Part of pacing yourself is finding your activity limits. You must know how much and what kinds of activity you can do without intensifying your symptoms. You may notice that you become tired if you spend too long shopping, for example, whereas you may not notice that you have done too much of something and the effect this can have on your myasthenia symptoms. The most effective way to stop yourself becoming too tired is by slowing down. You should take short frequent rests during the day to help maximise your output. If you are out shopping, stop to take a rest after each aisle. It might take you longer but you'll benefit from it later or even the next day.

Caroline Carmichael, Specialist Nurse