Friday, November 24, 2017

You don't need the whole city, or state. You live within the diameter of a mile most of time, all you need is the neighborhood. Cafes and restaurants and some shops, I have most I need in this neighborhood of Midtown. For everything else, I can hop on the car and drive down to the mall  or big box stores. I'm good for a year or two, I think. Then I'll think about where to settle for the final resting place.

Today I hooked up the TV and the audio and then the bedroom furniture got delivered. In between I went out to shop for a kitchen cart and a space heater and charge the car. It was as if I was healthy, only out of shape. The last crash appeared to be the last of the post-trip struggle. That would make it about 3 weeks since we returned from France, the same amount of time it took in New York.

Life will be fine if I can stay this way all the time without getting sick. But there will be more sickness before I fully recover, I'm sure, especially if I get into biking. I'm buying a bike nonetheless, and I'll tootle around the Midtown on it. It'll be only a couple of miles at a time and I may be able to get away with it.

Tuesday, November 21, 2017

Settling In

In SF, I've never turned on the heater. The first night in Sacramento, I borrowed a space heater from the landlord and had it run all night long. Its a little colder in winter and the old building with hardly an insulation didn't help. I don't see staying here too long, though we chose it knowingly because of the midtown location. I don't need the location, but wife who doesn't drive does.

And all that moving didn't help my health. This second story walkup has a narrow and steep stairs in the back and carrying a few stuff on the first day was enough to throw me into a post-exertional sickness for 4 days. It's always the quads -- a few squat used to be enough to trigger the sickness so I stopped it long time ago. Apparently it hasn't improved. And the triceps still ache when quads over-work.

Why is it that the triceps ache when quads over-work and vice-versa? It's as if they are somehow connected. With what, I'm  not sure. One possibility is the inflammation. Though the muscular inflammation is supposed to be local, the inflammation the day after may not. The cleaning up of cellular debris has to be global since the debris are circulating in the blood stream. That global inflammation could trigger the ache in the triceps. And why triceps and quads? They may have gotten sensitized by the years of judo, perhaps by sprouting more inflammation receptors. Anyway, these are all speculations. All I know for now is that use of quads triggers the sickness and quads and triceps are highly sensitive.

Coming back to the walkup, having to go up and down stairs everyday will reduce my margin of error. Managing CFS can only be done statistically -- there are so many unknowns and measurements are imprecise -- and not having enough margin of error will make the post-exertional sickness more frequent if I don't reduce stress elsewhere. I'll have to pace more carefully and keep it below 90 steps per minute all the time. Distance probably won't get effected -- it's always the sustained speed/intensity that  triggers the post-exertional sickness.

Monday, November 13, 2017

Back at Home

The air feels just different here. It's fresher and crisper. That's what I feel every time I come back to the Bay Area. And the blue sky too. Paris was swell, but the air wasn't much better than Korea that constantly suffer from smog blown over from China.

Anyway, I slept 9 hours, then was fed and pooped. Now I feel like a million in bucks, the day after the ordeal of 18 hour flight.  And my pace was up to 98 per second this morning on my way to retrieve the car from the garage. No jet leg for now, it seems. Will I be suffering from the post-trip struggle again? I already paid the price in Paris and this leg of the trip from Paris to SF lasted only one day really. So, I'm thinking I shouldn't get another one. We'll see.

Saturday, October 28, 2017

Rethinking Post-Exercise Fatigue vs Post-Exertional Sickness


I've been classifying the fatigue lasting less than 48 hours as post-exercise fatigue rather than post-exertional sickness. I reasoned that a day of fatigue after a heavy activity is normal even for a healthy person. It is a happy fatigue flush with endorphin. But the fatigue on 10/3 was not a happy fatigue even though it lasted only a day; it was a sick, wallowing fatigue. That made me wonder if the duration was the correct criteria for the distinction, or if the distinction is meaningful at all.

Frequent post-exertional sickness means  that you are over-reaching. And knowing that is imperative in managing CFS. So the duration and frequency of post-exertional sickness must be measured and recorded. But the normal post-exercise fatigue should not be included in it because, well, it is normal. More importantly, post-exercise fatigue is not disabling; my mind actually works better when I'm having post-exercise fatigue. So the distinction between post-exertional sickness and post-exercise fatigue is still meaningful and useful.

The problem is, again, there are one-day fatigues that are not happy post-exercise fatigues: the one-day-up-next-day-down pattern during a post-trip struggle is not post-exercise fatigues even though they last one day. So the duration-base classification can end up with false negatives (for post-exertional sickness) and under-register the struggle. I could remedy the problem by adding the happy/sick feeling as a criteria, but that is yet another subjectivity that I don't need.

Since post-exercise fatigue usually last one day and post-exertional sickness usually multiple days, the current classification by the duration is probably still useful enough. I'll stick to it for now till I find a better way to cull out the post-exercise fatigue from the post-exertional sickness. For post-trip struggles, enough multi-day post-exertional sickness also occur, so ignoring one day sickness may not be a big problem.



Post-trip Struggle in Paris, Over

We went to Louvre yesterday evening, after doing the Rodin Museum the day before. And today I'm still up and writing this blog after registering 10,000 steps, two days in a row. I only have a happy post-exercise fatigue for now, though I may crash in the evening when the 24 hour probation of post-exertional sickness is up.


This week has been fairly trouble-free even though my activity is up -- I already registered 48,000 steps and I still have one more day to go. As such, I'm declaring the post-trip struggle in Paris over. That makes it the struggle of 3 weeks, about same as the one in NYC or maybe a little shorter.

By now, there is no doubt that the elevation effect of traveling and ensuing post-trip struggles are real. I know that not only from the repeated observation, but because I predicted the effect before this trip started and the trip proved it correct. That makes it more than anecdotal. What I still don't know is whether the exercise tolerance threshold after the post-trip struggle is higher than the pre-trip one. For now, the trips doesn't seem to have lowered the tolerance, as I have feared before I started out on this experiment. So, I can at least continue with this "travel treatment" and see if I can eventually cure myself.

Sunday, October 15, 2017

Post-trip Struggle in Paris, Not Over Yet

The battery died on me again. I went out to Place de Bastille and Rue St-Antoine and the camera gave up after take a dozen shots. The battery is so small that I have to keep recharging it every night and I keep forgetting it.

I had to go out despite the post-exertional sickness in the afternoon. Yesterday was the first sunny day in Paris since we arrived and it felt like summer. People were sunbathing in Place des Vosges in shorts. I felt like walking on and on following the St-Antoine till it ends. But I knew better; I turned around when my fitbit pedometer hit about 5000. This morning I feel OK. and I don't think I'll crap out this afternoon either since I reined in on the distance.






And, yes, I did crap out in the afternoon of 10/13 as I thought I would. I felt worse yesterday afternoon, making it a post-exertional sickness, not post-exercise fatigue. So, it seems, the post-trip struggle in Paris is not over yet.

You can't really tell if the struggle is over until it is well over. I figured it is over if I could walk 2 days in a row. But the struggle means frequent post-exertional sicknesses. So, the end of the post-trip struggle should really be defined as when the normal post-exertional sickness frequency returns. And I wouldn't know that till at least one month has past from the end, since my normal pre-trip frequency is currently one a month. (In Paris, I had 2 so far).

Back to Paris. I keep thinking Paris has a lot in common with Seoul. You forget historic and architectural difference, and the street scenes looks much much the same. The bus ride to Place de Bastille was no exception. It looked just like alley ways in Sinchon or Sang-il dong with millions people coming and going in narrow streets with shops on both sides. Add to that the Norman demeanor,  it has more more commonality with Seoul than, say, Chicago. (I was going to say New York, but New York is so multicultural, it has a little bit of Seoul and Paris mixed in it).

Friday, October 13, 2017

Is the Post-trip Struggle in Paris Over?

This isn't the Paris I knew. When I was here some 25 years ago, there were only a few guards in front of the gate of Elysee Palace. I even took a picture with one of them.  Now there are a slew of them all around it, in military fatigue and armed with Uzis. The alley ways around it was block off and I had to track back to Marigny to get to Champs-Elysee Clemenceau station. The recent terror attacks must have had some effect.

Ave. Marigny

On the health front, the post-trip struggle in Paris seems to be be over. I went out for two days in a row and I'm OK today, though I'll probably crap out this afternoon.  We'll have to wait and find out.