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"The Spoon Theory" - Read this, you'll be glad you did!

7 Recommendations

The Spoon Theory
by Christine Miserandino www.butyoudontlooksick.com
My best friend and I were in the diner, talking. As usual, it was very late and we were eating French fries with gravy. Like normal girls our age, we spent a lot of time in the diner while in college, and most of the time we spent talking about boys, music or trivial things, that seemed very important at the time. We never got serious about anything in particular and spent most of our time laughing.
As I went to take some of my medicine with a snack as I usually did, she watched me with an awkward kind of stare, instead of continuing the conversation. She then asked me out of the blue what it felt like to have Lupus and be sick. I was shocked not only because she asked the random question, but also because I assumed she knew all there was to know about Lupus. She came to doctors with me, she saw me walk with a cane, and throw up in the bathroom. She had seen me cry in pain, what else was there to know?
I started to ramble on about pills, and aches and pains, but she kept pursuing, and didn't seem satisfied with my answers. I was a little surprised as being my roommate in college and friend for years; I thought she already knew the medical definition of Lupus. Then she looked at me with a face every sick person knows well, the face of pure curiosity about something no one healthy can truly understand. She asked what it felt like, not physically, but what it felt like to be me, to be sick.
As I tried to gain my composure, I glanced around the table for help or guidance, or at least stall for time to think. I was trying to find the right words. How do I answer a question I never was able to answer for myself? How do I explain every detail of every day being effected, and give the emotions a sick person goes through with clarity. I could have given up, cracked a joke like I usually do, and changed the subject, but I remember thinking if I don’t try to explain this, how could I ever expect her to understand. If I can’t explain this to my best friend, how could I explain my world to anyone else? I had to at least try.
At that moment, the spoon theory was born. I quickly grabbed every spoon on the table; hell I grabbed spoons off of the other tables. I looked at her in the eyes and said “Here you go, you have Lupus”. She looked at me slightly confused, as anyone would when they are being handed a bouquet of spoons. The cold metal spoons clanked in my hands, as I grouped them together and shoved them into her hands.
I explained that the difference in being sick and being healthy is having to make choices or to consciously think about things when the rest of the world doesn’t have to. The healthy have the luxury of a life without choices, a gift most people take for granted.
Most people start the day with unlimited amount of possibilities, and energy to do whatever they desire, especially young people. For the most part, they do not need to worry about the effects of their actions. So for my explanation, I used spoons to convey this point. I wanted something for her to actually hold, for me to then take away, since most people who get sick feel a “loss” of a life they once knew. If I was in control of taking away the spoons, then she would know what it feels like to have someone or something else, in this case Lupus, being in control.
She grabbed the spoons with excitement. She didn’t understand what I was doing, but she is always up for a good time, so I guess she thought I was cracking a joke of some kind like I usually do when talking about touchy topics. Little did she know how serious I would become?
I asked her to count her spoons. She asked why, and I explained that when you are healthy you expect to have a never-ending supply of "spoons". But when you have to now plan your day, you need to know exactly how many “spoons” you are starting with. It doesn’t guarantee that you might not lose some along the way, but at least it helps to know where you are starting. She counted out 12 spoons. She laughed and said she wanted more. I said no, and I knew right away that this little game would work, when she looked disappointed, and we hadn't even started yet. I’ve wanted more "spoons" for years and haven’t found a way yet to get more, why should she? I also told her to always be conscious of how many she had, and not to drop them because she can never forget she has Lupus.
I asked her to list off the tasks of her day, including the most simple. As, she rattled off daily chores, or just fun things to do; I explained how each one would cost her a spoon. When she jumped right into getting ready for work as her first task of the morning, I cut her off and took away a spoon. I practically jumped down her throat. I said " No! You don’t just get up. You have to crack open your eyes, and then realize you are late. You didn’t sleep well the night before. You have to crawl out of bed, and then you have to make your self something to eat before you can do anything else, because if you don’t, you can't take your medicine, and if you don’t take your medicine you might as well give up all your spoons for today and tomorrow too." I quickly took away a spoon and she realized she hasn’t even gotten dressed yet. Showering cost her spoon, just for washing her hair and shaving her legs. Reaching high and low that early in the morning could actually cost more than one spoon, but I figured I would give her a break; I didn’t want to scare her right away. Getting dressed was worth another spoon. I stopped her and broke down every task to show her how every little detail needs to be thought about. You cannot simply just throw clothes on when you are sick. I explained that I have to see what clothes I can physically put on, if my hands hurt that day buttons are out of the question. If I have bruises that day, I need to wear long sleeves, and if I have a fever I need a sweater to stay warm and so on. If my hair is falling out I need to spend more time to look presentable, and then you need to factor in another 5 minutes for feeling badly that it took you 2 hours to do all this.
I think she was starting to understand when she theoretically didn’t even get to work, and she was left with 6 spoons. I then explained to her that she needed to choose the rest of her day wisely, since when your “spoons” are gone, they are gone. Sometimes you can borrow against tomorrow’s "spoons", but just think how hard tomorrow will be with less "spoons". I also needed to explain that a person who is sick always lives with the looming thought that tomorrow may be the day that a cold comes, or an infection, or any number of things that could be very dangerous. So you do not want to run low on "spoons", because you never know when you truly will need them. I didn’t want to depress her, but I needed to be realistic, and unfortunately being prepared for the worst is part of a real day for me.
We went through the rest of the day, and she slowly learned that skipping lunch would cost her a spoon, as well as standing on a train, or even typing at her computer too long. She was forced to make choices and think about things differently. Hypothetically, she had to choose not to run errands, so that she could eat dinner that night.
When we got to the end of her pretend day, she said she was hungry. I summarized that she had to eat dinner but she only had one spoon left. If she cooked, she wouldn’t have enough energy to clean the pots. If she went out for dinner, she might be too tired to drive home safely. Then I also explained, that I didn’t even bother to add into this game, that she was so nauseous, that cooking was probably out of the question anyway. So she decided to make soup, it was easy. I then said it is only 7pm, you have the rest of the night but maybe end up with one spoon, so you can do something fun, or clean your apartment, or do chores, but you can’t do it all.
I rarely see her emotional, so when I saw her upset I knew maybe I was getting through to her. I didn’t want my friend to be upset, but at the same time I was happy to think finally maybe someone understood me a little bit. She had tears in her eyes and asked quietly “Christine, How do you do it? Do you really do this everyday?” I explained that some days were worse then others; some days I have more spoons then most. But I can never make it go away and I can’t forget about it, I always have to think about it. I handed her a spoon I had been holding in reserve. I said simply, “I have learned to live life with an extra spoon in my pocket, in reserve. You need to always be prepared”
Its hard, the hardest thing I ever had to learn is to slow down, and not do everything. I fight this to this day. I hate feeling left out, having to choose to stay home, or to not get things done that I want to. I wanted her to feel that frustration. I wanted her to understand, that everything everyone else does comes so easy, but for me it is one hundred little jobs in one. I need to think about the weather, my temperature that day, and the whole day's plans before I can attack any one given thing. When other people can simply do things, I have to attack it and make a plan like I am strategizing a war. It is in that lifestyle, the difference between being sick and healthy. It is the beautiful ability to not think and just do. I miss that freedom. I miss never having to count "spoons".
After we were emotional and talked about this for a little while longer, I sensed she was sad. Maybe she finally understood. Maybe she realized that she never could truly and honestly say she understands. But at least now she might not complain so much when I can't go out for dinner some nights, or when I never seem to make it to her house and she always has to drive to mine. I gave her a hug when we walked out of the diner. I had the one spoon in my hand and I said “Don’t worry. I see this as a blessing. I have been forced to think about everything I do. Do you know how many spoons people waste everyday? I don’t have room for wasted time, or wasted “spoons” and I chose to spend this time with you.”
Ever since this night, I have used the spoon theory to explain my life to many people. In fact, my family and friends refer to spoons all the time. It has been a code word for what I can and cannot do. Once people understand the spoon theory they seem to understand me better, but I also think they live their life a little differently too. I think it isn’t just good for understanding Lupus, but anyone dealing with any disability or illness. Hopefully, they don’t take so much for granted or their life in general. I give a piece of myself, in every sense of the word when I do anything. It has become an inside joke. I have become famous for saying to people jokingly that they should feel special when I spend time with them, because they have one of my "spoons".
© 2003 by Christine Miserandino Butyoudontlooksick.com

Explore topics in this discussion:

Pain Lupus Bruises Fever

13 replies

Wow Teeteeme,
That's pretty intense, straightforward and an interesting perspective on Lupus, Sarc. or any other 'autoimmune' disease we have. Yesterday my husband needed to run to the Office Depot to get another power supply for his computer, but whenever I go shopping or run errands for a few hours, it completely drains me and then I'm basically useless the rest of the day. He doesn't understand.....like our friends and other family members. But, I like your 'spoon analogy'. You and TheGardener, should both write books. Do you have Sarcoisodis too, or just Lupus?
Mbeth059

I've seen this on here a while back and enjoyed it then and again now. I don't remember if I passed it to my children so I made sure I did this time.
Thank you for sharing.

It is how I felt yesterday. I saved 1 spoon Sunday and used all my spoons yesterday so I could be with my grandbaby, do a couple of errands, dine and see a foolish dr, 2 hr ride each way. Was asleep before 9pm, woke at 4am and will go back to bed 10-11am for a nice rest.

This was awesome! Can I share this?
http://content.sweetim.com/sim/cpie/emoticons/000202C7.gif

Lynn

That pretty much sums it up. :)

Even during my "recovery" I have to think about what I can do and what should do to keeping going all day. Some days I feel like Superwoman and have all the spoons all day, and others I hibernate on the couch - fatigued and achy without a spoon in hand. Thanks for sharing this one.

I couldn't even have thought that way. Thank you. You said it all. creative Linda

I wish I could take credit for writing it, but a woman named Christine Miserandino wrote it. You can find it on the web site Butyoudontlooksick.com I have Sarcoidois for 15 years with a 21/2 year remission in between. I came back with a vengence. I have it in my lungs, heart, nervous system, joints and I found out two days ago, in my eyes, both. I have been on remicade for about 3 months. This disease sucks. Last Saturday, I wanted to go to a store down the street from me. By the time I got dressed, I was too tired (no spoons!) My Husband said "Your not going?" I told him I was too tired now, and started to cry. I turned around went and lied down and fell asleep for 4 hours. Such is my life. Tee

P.S. The Spoon Theory can be copied just make sure you give credit to the author.

Tee,

Can you tell me about the sarc in your eyes? I have some eye issues and the doctors are looking into them. ;-) My problems are with both eyes and are in/around the lens (calcification) and on the eye lids (not sure what the bumps are yet) and I feel constant pressure in my left eye. I see white as gray with my left eye (constant) and have pain daily in my left eye. The tingling is intensified on the left side of my face.

Joe

Big joe,
It started with gunk on my eyes when I woke up like two weeks ago. I thought I had pink eye. the inside corner of my right eye and the lower lid was all red and itchy. Then my right upper lid got all swollen. Then it went away. Then it came back last weekend.
but worse and I had a headache in my right eye and stabbing pain. and sensitivity to light. a little in the left eye. the right upper lid very swollen. I went to the opthomologist on Tuesday and she (the DR.) looked in my eyes and said there was inflamation from the sarcoid. She said the upper lid was swollen because the oil glands get "clogged" and to put hot wash cloths on it several times a day. She gave me steroid drops to put in my eyes for two weeks and said to come back in 6 months unless It gets worse or doesn't improve. The headache in my eye is the worse. luckily I don't have any major vision changes. The only other weird thing is that for the past year, on and off, my right eye, only at night, will tear non stop. but it hasn't happened lately. strange. How long have you had the tingeling on the side of your face? It makes me think of bells palsey or shingles. I haven't had the former, but I have had the latter 3 times and once on my face and tingling is a symptom. do you have any lesions, breakout of any kind on the one side? or numbness? tee

Greetings.

I use the Spoon Theory (and when doing so always mention the source), but change spoons to a currency that the people I'm speaking to will understand -- usually the British pound sterling or American dollar. Spoons tend to confuse them but they can understand money.

Deb
London

My partner started remicade for skin sarc in November and it has worked wonders on the lesions; they're basically gone except for the discolorations. It does leave him VERY tired, especially from 3-8 days (plus or minus a day or two) after the infusion.

He finally got to see someone at the Sarc Clinic at Johns Hopkins and between that doc and the dermatologist he has, we think he can be justifiably put on 8-week regimen of remicade infusions for a year. Now I don't know how effective remicade is on other forms of sarc like yours. Please let us know how you are doing with this treatment, though.

So far the remicade is working great for me!, it doesn't necessarily help the pain, but it does help that awful sick/hungover feeling that I used to live with everyday, and that initself is worth its weight in gold!! (well actually it already costs almost that!! :) ) I hope it starts doing more though, my pulmonary doesn't think it is doing enough and wants to pull the plug, thankfully my rheumy has the final say, and after me pleading my case, that it was my body, my life and I wanted to stay on it and it should be my say. he kept me on it. My fingers are crossed. Tee

Wow! Thanks for posting "The Spoon Theory" . I wouldn't have guessed such a great and simple explanation could be found except for having read back through the old posts.

That was a great story. It is something my husband should read. He doesn't understand and thinks I read too much about this disease and doesn't understand when I can't go out or walk the stairs to do laundry, or push the sweeper to sweep. Sometimes can't open a jar. Thanks for putting this "Spoon Theory " on!!!

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Sarcoidosis and the Body
Sarcoidosis is a "multiorgan" disease - meaning it almost always involves more than one organ. It's unpredictable and affects different people in different ways.

You can learn about the ways in which sarcoidosis affects the body in FSR's Sarcoidosis and the Body brochure.

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