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.