I recently asked my new client, Ruth, what her goals were in working with me. She said, “I just want to be…myself…again.” She blurted it out and seemed surprised with what she had said. But there it was, the essence of her greatest loss, what chronic illness had taken from her. Years of illness had “destroyed” her, causing profound fatigue and brain fog, taking away her sense of who she was as a vibrant, active, capable human being. While she wanted my help to figure out why she was sick and to guide her onto a path of recovery, what she wanted most was to reclaim who she truly was.

All of my clients say this same thing in a variety of ways. Overcoming illness always comes down to recovering lost energy, vitality, and function. This is the true devastation of illness. Loss of energy is the common denominator. Restoration of energy is what we ultimately aspire to with all of our efforts at healing. Our energy and vitality are who we are at the most fundamental level, strengthening us, supporting our highest potential, and making life worth living.

"A great hallmark of mental wellness is the ability to be in the present moment, fully and with no thoughts of being elsewhere." - Wayne Dyer

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The heart of healing is our essential energy and vitality. The bones of this work, and of our healing, is in what we learn to do for ourselves, what we show up for every day—in our reverent self-care.

We Are Energy

Anyone who has ever experienced fatigue, myself included, knows without a doubt that it overshadows everything. There is no way to feel inspired or even happy when there’s no gas in the tank. Especially if we have to keep going—raising the kids, going to work, doing our chores. Life calls and we need to answer.

Energy underpins everything that makes life worth living: our inspirations, passion, and connection to everything in our lives. Every thought, experience, and emotion that supports us, motivates us, and moves us forward is sustained by energy. We are energy. Energy is the very essence of who we are. It’s our life force. And it’s what we lose when we are ill. The greatest blow of chronic illness is this loss of vital energy and its impact on everything that makes us who we are.

My Close Call With the Devastation of Energy Wipe Out

A few years ago, I had to have surgery for a major shoulder injury that I just couldn’t get to heal in spite of my very best efforts. I’ve been highly active my entire life and didn’t recognize that I had hyper-mobile joints that could easily become unstable and were unusually injury-prone. The inevitable traumas, aches, and pains occurred—back, shoulders, knees—you name it. I worked hard to rehab, did everything I was supposed to do, but could not heal my shoulder without surgery.

So be it. It promised to be a big challenge: immobile dominant arm for six weeks. I could manage that. Extensive rehab. No problem. There was a goal, a definite end point. I knew I would be back and better than ever. I accepted and even looked forward to the challenge. I would have to do everything with my clumsy left arm and hand. Good brain training, right?

"The heart of healing is our essential energy and vitality. The bones of this work, and of our healing, is in what we learn to do for ourselves, what we show up for every day—in our reverent self-care."

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But there was a snag I had not anticipated. Once the initial crisis of postop pain subsided and I began to come out of the haze of opiates and post-anesthesia toxicity, I found myself weirdly sick. I had planned to be back on my feet within a day or two and at least walking around my neighborhood, taking care to keep my fragile post-surgical shoulder safely tucked away in its sling for the prescribed six weeks. But I couldn’t move. I couldn’t get up and stand in my kitchen. I was so sick. I felt weak, wimpy, short of breath, fuzzy headed, nauseous. Completely shackled. Whoa.

Initially I thought, okay, I just failed to anticipate the challenge of clearing out the anesthesia and the normal and necessary inflammatory and repair process that occurred after having my body cut open and manipulated. I’m just impatient and I must surrender to this and go with the flow. I’ll be just fine. I am strong and healthy.

Rehab was going well—right on schedule. No apparent infection in surgical site. All healing well: but the exhaustion and illness persisted. So what is this?

Thank God I took several weeks off work. I’ll be fine, I thought, I’ll be just fine when it’s time to get back to work. But I wasn’t. Weeks and weeks went by. My illness persisted. The illness and exhaustion felt like a harness wrapped around my body, trapping me, holding me back, keeping me in place, clouding my mind, stomping on my spirit. I worked very hard to persevere. I told my doctors and therapists what was happening but no one could figure out what was wrong with me. “It just takes time.” I did my best to meet the demands and challenges of my life. I cut back on my usual schedule. My husband picked up all of the household chores and responsibilities (without a single complaint—my angel!). My support team was in place but I still felt so curiously sick and exhausted. I was totally side lined.

One day, about two months into this saga of mine, on just a whim (of genius) I decided to take my blood pressure (they don’t do that in shoulder clinic). I was sitting at the table in my kitchen and pulled my husband’s blood pressure monitor out of the drawer. First reading: 80/50 (normal blood pressure is 120/70). Whoa, what’s this? I took it again while sitting. The same: 80/50. Then I stood up and took it: 70/35. Oh my gosh! My normal blood pressure is 100/60. No wonder I felt this way! I hadn’t felt light-headed but I certainly had all of the other symptoms of low blood pressure. It had never occurred to me. I was too sick to be my own doctor. I didn’t have enough blood flowing to my brain or any part of me. I was running on fumes.

Though I had been hydrating and eating well all along, I immediately started aggressive fluid and electrolyte replacement to get my blood volume and blood pressure up. I did this by drinking coconut water, which is naturally high in electrolytes, as well as a medical electrolyte solution. I added more salt to my food and I increased the total volume of my fluids. I went in to the lab immediately for a blood draw to check a few things out, like adrenal hormones and electrolytes (which were all “normal”). I started myself on high dose licorice root, another very effective strategy to elevate blood pressure by modulating hormones that support it.

In my moment of discovery of what was wrong, after my two-month saga of an illness that I did not recognize, I rounded up my team—I called my acupuncturist, Alice, and she got me in the next day. Alice had known me for many years and understood my constitutional tendencies and needs. When I explained my story to Alice she knew exactly what to do and went right to work. I lay prone on her table and she very strategically placed her needles. I am always able to sense the lively effect of acupuncture on my body and I immediately felt a deep change begin to take place. I experienced what I can only describe as a central core of warmth and sense of energy flow that started in my solar plexus and gradually grew, expanding outward into my whole body. After resting with the needles in place for thirty minutes, she took them out and I slowly got up and cautiously observed. Relief washed over me. I was back, revived, recovered. By the skin of my teeth. A reprieve—by grace.

I continued on this regime based on my understanding of basic human physiology with the insights of Chinese medicine. I recovered and kept my organs happy with a good supply of oxygen and nutrients. My brain came back on-line. My energy recovered—and in that I recovered myself.

Self-Care Was My Salvation

In retrospect that was one of the scariest experiences of my life. Two months of completely debilitating illness is nothing compared to what so many of my clients have gone through, but long enough for me to taste deeply the experience of being shackled and not knowing what the future held for me. I can tell you with certainty that I struggled with hope. I felt despair. Every day took enormous courage and strength. It was a lonely journey of not knowing if I would ever feel like myself again. In retrospect I was incredibly lucky because I had already been on an intensive healing journey of self-care. I ate well, slept well, moved a lot, tended to my mind and emotions and worked hard to stay in balance in my life. Had I not been on such a path of self-discovery and self-care I would not have recovered so quickly. That surgery would have triggered a much larger and more complex saga of repair and recovery.

I feel incredibly blessed. And I learned about myself. I learned what it has to take to keep me well. I know what my vulnerabilities are and I am completely committed to the essential self-care that I know I need to stay well and to protect my precious vital energy. Perhaps most importantly, I learned that emotional survival in these challenging circumstances of illness must be a dedicated practice—another essential aspect of self-care. Perseverance, hope, optimism, grit, and grace are all choices that I had to make every single day. And through practice these qualities expanded and I was able to face each day with a bit more strength.

The self-care roadmap that I use for myself and teach to my clients is what I call the Nine Domains of Healing. My personal strategy doesn’t look exactly like anyone else’s—we’re each unique and need to work on different things. But what we all share in common is the need to show up for ourselves every day, practice, and stay true to ourselves and what we need to thrive.

As my yoga teacher tells me, “Hug in first, then extend out.” This is my mantra and my renewed commitment to a life of daily essential self-care practice. I’ve met fatigue and illness up close. I know what’s at stake. I know how to recover.

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Karyn Shanks, MD is a physician and writer whose work is inspired by the science of Functional Medicine and body-mind wisdom, which honors the power of individuals’ stories, their inner wisdom, and innate healing potential. She believes that the bones of healing are in what we do for ourselves. Visit her work here and contact her via karyn@karynshanksmd.com. Subscribe to her weekly articles here.