How a 'Later List' Can Help You Manage Chronic Illness

Before pain dominated my life, I devoured productivity books. I constantly focused on getting more things done, setting goals and accomplishing them, doing things people said would be impossible for me to do (and the more they said it, the more it egged me on).

Now that pain is a constant reality for me, I’m applying those same productivity principles but for a different purpose. I want to be able to manage my condition well, to have some level of output even if it wasn’t my old level.

I probably will write about productivity and illness other times, so this time I will focus on one tool only: the later list. Simply put, a “later list” is where you write down things you might do in the future but not committing to right now. You write it down so you know that you won’t forget it, which gives you peace of mind. David Allen, in his book “Getting Things Done,” calls it a Someday Maybe List, emphasizing that you might do it someday maybe, but not for sure.

The later list was groundbreaking for me because by default, I feel like everything has a deadline of Now. I have to get it all done right now, or so my thinking goes. If only I can work a little bit harder or a little bit longer, I can do all the things weighing on me and then I can rest. But of course, once I finish those things, I get bored and commit to other things and so the cycle continues.

With a later list, when an idea pops into my head, I can evaluate whether I want to do it ever (if not, I can safely discard it), and if I do want to do it, is it something I want to do now or would it be better to put on my later list? As long as I have a regular routine of looking at the later list and deciding whether I want to do some of those things now, it’s been very freeing. I don’t have to get everything done right now.

With health conditions in the mix, that’s a whole new category of things I feel like I have to do right now: see all the specialists, do all of the PT exercises, try all of the meds. The problem is, my schedule doesn’t allow for doing all of the things all at once. In the case of meds, doctors usually like trying one or a few at a time so they can see how it affects you (good or bad) and so they can isolate the cause. But with a later list, I don’t have to feel like I’m failing because I can’t do everything, nor do I have to worry about forgetting that a particular treatment exists. I can write it all down. Once I finish trying one treatment, I can look at the list and maybe add another.

One example for me was physical therapy. There are only so many new exercises I can handle at once — not only would too many new ones possibly present the chance for overdoing it and injuring myself, I also can’t keep track of all of the exercises. If I’ve been doing an exercise for a while, it’s part of my normal routine. If I add a couple of new ones, I can feel excited and motivated to watch the progress. If I’m given too many new ones to do, I get overwhelmed. Hence, the later list.

Another example was people suggesting diet-related changes, thinking it would help with my autoimmunity. I always brushed it off and eventually realized I already had plenty of things I was trying, I didn’t want to add another treatment to the mix just yet. So, it went on the later list.

As I look back to my pre-illness days and the way that I viewed productivity, I realized I wasn’t driven by a desire to succeed or to accomplish, but rather a sense of responsibility: if I said I would do something, then I ought to follow through on it. The problem was, I wasn’t very discerning in what I committed to doing. If something seemed like a good idea, I’d commit to it right away without looking at how it would impact my life as a whole. I didn’t have a later list then and therefore no concept that I could wait on something.

But now, my health forces me to take a broader perspective. I can’t make individual decisions in isolation. Each decision I make affects other parts of my life. If I push myself too hard to accomplish a work task, I might pay for it with pain. On a bad pain day, I might have to decide between dishes or laundry and do the other one the next day, even though I planned on doing both — which is more of a short-term later list.

Productivity is supposed to serve what you value. Like my pre-illness days, I do value responsibility, but now I’ve expanded that responsibility to include my health. If I accomplish something but at the cost of flaring my symptoms, the ones closest to me in my life are going to bear the brunt of that, whether in irritability or brain fog or them having to do extra chores because I can’t. Taking good care of myself is a responsibility I have to myself and to those I love.

If you want to start your own later list, it’s pretty easy.

• Pick a place you know you will be able to easily access. Not sure where that is? Whatever place you thought of first, that’s probably the place you’ll think of first in the future, so do it there.
• It doesn’t really matter whether your list is digital or paper, as long as you know you’ll be able to access it whenever you need it. I keep mine digitally so it’s across all of my devices and is with me at all times, but also know that if the pain is bad, I might not be able to take good notes on my phone, so I’ll leave a little voice message for myself and put it in my computer when I’m back at it.
• Once you know where your list is, put a few things on it. Think of things that you don’t want to do right now but might want to do in the future, whether health or otherwise. Write them down.
• As you go throughout your day and week, you might think of other things that should go under the later list. Pull it out and write them down.
• Make a regular rhythm of reviewing your later list. This depends on how much you have going on in your life, how regularly you want to add new things, how much you like structure vs. variety, things like that. Early on, I might recommend weekly, that way you’re pretty consistently reminded that this list exists, even if you don’t actively do any of the things on it right away. Once you have a stronger habit of looking at it, you could tweak the frequency as needed.
• Keep updating your later list. Over time, you’ll take some things from that list and start working on them. Some things might stay on your list for a while but you still want to keep them there. Some things, you might decide you don’t think you’ll do them at any point in the future and so you delete them from the list. This is completely normal.

A later list is just one productivity tool you can use to help manage your illness. You and I don’t have to get it all done today. Taking the rest you need is not laziness or procrastination, it’s making sure actions align with values — including valuing your health. Present You should make decisions with Future You in mind because today isn’t all there is.