Thursday, April 18, 2019

Getting Fit Is Dangerous to CFS

No, I didn't get to make to the skiing #3. The mountains had plenty of snow -- snow pack was 150% of the normal when the storms were done -- but the resorts jacked up the price after the storms so I gave up on skiing for the rest of the season. But I did go on a bike ride. The weather finally broke on the last day of March and temperature went up to 75F. I took advantage of it and went for the next segment of the river trail.

The trail undulated more as it approached Folsom and I had to pedal harder than usual a few times. Yet, by the time I remembered to take break, I was already 3.5 miles along. I ended up doing 7.5 mile ride with only one break. It was meant to be 6 miles to Folsom Outlet Mall, but I missed the turn and went way past on Willow Creek trail.  The way back after a long rest in the mall was pretty much the same: I took only one break when I got near Nimbus fish hatchery. In all, I did 15 miles only with 3 breaks when it should've been 12 miles with 5 breaks.

The outcome was predictable. I wallowed in the "worsening of CFS", aka PEM, for almost 3 weeks. Taking 5000 steps in a day was a struggle and then I had to lay off the next day, when as I was able to take 6000 steps several days in a row just prior to the biking. The CFS limit is still alive and well.

It must've been the skiing. I was cramping all over after I was done, and doing it that twice in a month must've put me back in a shape, enough that I could pedal on without remembering to take the break when I was supposed to.

And that is the danger of getting fit. You get fatigued quickly enough after a half a mile walk or 1-2 mile biking, that you don't forget to stop and rest when you are out of shape. If you are in shape, on the other hand, it's easy to forget and go on past your limit. It's better to be out of shape or depressed when you are a CFS patient, as that will help you and prevent you from over-doing

Strangely enough, I did not pay the same huge price after the skiing #1. It was the hardest exercise to date and I was cramping and aching all  over when I was done. But I was back on my feet after my condition bounced up and down for a few days. I think that was because skiing forces you take frequent breaks: you have to sit on the lift for 5-10 minutes to get back up the slope after skiing down for one or two minutes. As hard as the skiing was, the forced break must've prevented me from crossing my CFS limit. Biking slow on flat terrain is a much milder exercise in comparison, but I did it without enough break. So I ended up crossing my limit and pay the price.

The "ordeal" bike trip did not cause 3 weeks of struggle either.  It was also the hardest exercise to date at the time, but I took millions of breaks on that trip.

Graphically, the safe vs dangerous exercise zone for CFS patients looks like this:

You can either do high intensity exercise for a very short period of time or do a very low intensity exercise for a longer time. Skiing down a short bunny slope is the former and slow walking or biking on flat terrain is the latter. Either one should incorporate enough rest before repeating. When you get fit, you end up doing safe exercise at a higher intensity or for a longer duration, ending up in the danger zone. When you are atrophied or depressed, you do the reverse and get back in the safe zone.

So, if you have a moderate/mild CFS, it may be safer to stay out of shape. If you get fit, you must become extra vigilant and disciplined to force yourself to take frequent breaks. It's no different to the situation that serverely ill patients are in. For them, no activity is safe at any speed and therefore they have to be disciplined to pace themselves.

Tuesday, February 26, 2019

Curcumin Doesn't Work

It's been almost 3 weeks since I returned from the 2nd skiing trip. And I have settled into the familiar one-day-up-one-day-down pattern once again. Carry 20 lbs laundry or walking to the coffee shop craps me out the next day and I can't do much other than minimal ADL or Web surfing on my phone lying on the couch. It may be that I'm still under the weather from the last skiing. 3 weeks in the penalty box should be over in a few days, so maybe there is a light at the end of the tunnel.

In any event, that means curcumin did not help. So I'm calling the curcumin trial a failure.

I'm still waiting for a break in the weather for my next skiing expedition. It did break last week  but no lift deal was available. So I'll have to catch the next break. The atmospheric river is running again and we'll be wet into the next week.

Tuesday, February 19, 2019

Skiing Aftermath, #2

There was no bouncing up and down this time. The elevation lasted 4 days and I held up remarkably steady.  After a day of rest I was on my bike pedaling 2 x 1.5 miles fast enough to slightly run out of breath at the end. Another day of rest, and I took care of 20 lbs laundry without struggling.  It sure felt like a recovery. So much so that I was imagining hiking up Angel Island and biking 20 miles.

Then the struggling followed. Walking 4 blocks to Starbucks was enough to bring about a nasty ache and fatigue the next day.  The struggle lasted for 5 days.

I will back to skiing next week  if I can find another $30 deal. This time I'll stick to 3x5 bunny runs and see if I get the elevation without the ensuing struggle. The weather may not cooperate though. The "atmospheric river" has stopped running, but they are still forecasting snow next week. This has been quite a wet season and the snow bases were over 10 feet before this storm. It must've been a delight to skiers. Me, I'm just delighted to be back on the slope.

Friday, February 8, 2019

Skiing #2

Soon after Colfax snow started to appear on the ground.  By the time I got to Kingvale, the walls on the sides of the road were 6 feet high and then turned into 10 feet in Soda Springs. The storm must've really dumped.

I woke up yesterday with ache from 2 x 50 m run I did three days before. It was the tail-end of a post-exertional malaise. But the lift ticket was already paid for, so I went on. And
my score this time: 5 bunny run; 2 x ( bunny + blue); 2 x (bunny + blue) + blue + 3 bunny run. 

It was about twice as much as I did the last time, and almost as much as I used to manage on the first day of the season when I was healthy. Yet I didn't cramp this time. And I stayed up all evening when I got back playing with the phone that arrived from a eBay dealer. Today I'm wallowing in a happy fatigue just as I should, unlike the last time when I was phlegmatic rather than wallowing. Don't know yet what coming days will bring. I think a funk will set it tomorrow when happy chemicals dissipate and then everything will be back to the routine after that. We'll see.

Saturday, February 2, 2019

Curcumin Trial

I bought curcumin phytosome from Amazon and started on it a few days ago. This is the same brand used in the CFS trial for its anti-inflammatory property in reducing fatigue. The trial resulted in 15% improvement, so it's not much to write home about. I am not trying it for anti-inflammatory property though. I am more interested in microglial deactivation via TLR4 receptor inhibition and curcumin is supposed to be one of the antagonists.

This paper  claims that curcumin significantly deactivated microglia in concussion fatigue patients after in vivo injection.  Taking orally is not the same thing obviously. Curcumin is famous for low absorption rate and it's not clear how much of what's absorbed actually gets to the brain. But I figure it's worth the try. If nothing, 15% improvement is still nothing to sneeze at.

Back on My Feet Already

Well, that wasn't too bad. I struggled for only a few days, not 3 weeks. The struggle was over by 1/31, 7 days after skiing. Today I went out for a morning ride to the river and ended up pedaling fast in the shower on the way back. And that was on top of 1.5 mile walk yesterday.

Amazing that the struggle was over so quickly given that the intensity of skiing was way more than biking. I was cramping all over for crying out loud. Maybe it's got to do with the fact that skiing down the bunny slope takes less than a minute and then you get to rest for 5 minutes on the chair. It was an interval training.

So I'm going back to skiing next week after the storm is over. It is supposed to dump 8 feet of snow by the time it is done. Not that it matters since I'll be on the bunny slopes mostly. But fresh power will be nice still.

I went back to my log for the Oregon trip last August to see if I struggled long like the trip to So Cal in 2016. I didn't. I was biking 4 days after we returned and I did the "ordeal" 6 days after. And they were comparable trips.  So, I''m concluding that I am making a progress indeed.

But the cross-country trip in 2017 did result in a couple of 3 week post-trip struggles, one in NYC and another when we returned. And so did the trip to Paris. So the post-trip struggle is still alive and well; it's just that the exertion threshold went up.

Wednesday, January 30, 2019

Skiing Aftermanth

It's a deja vu all over again. And this post-trip struggle may go on for 3 weeks.

Day 1 - Fatigued but calm and awake.
Day 2 -  Ran errands and biked 2 miles. Crapped out in the afternoon till the next morning.
Day 3 - bounced back and free from fatigue and ache. Ran errands and then rode bike for 5 miles in the late afternoon. It felt like a recovery.
Day 4 - struggle begins..

It's as if whatever was keeping elevated lasted for another 3 days before the struggle set in, just like in Mesquite. Back then, walking up 2 flights of stairs was enough to bring about crash once the elevation faded. Now it's carrying 20 lbs laundry up one flight.

I could lay low for another 2 weeks till this post-trip struggle passes over. Or I can go on another trip, another skiing perhaps, to postpone the struggle. I still haven't figured out a way to soft-land from a hard elevation, other than relying on Sudafed or Bronkaid to temporarily prop up.