Monday, March 28, 2011

Question of the Week: Are you struggling with making changes?

exercising on Benidorm beachImage via Wikipedia
I write a lot about strategies that I've used to make a lot of changes in my life in response to the challenge of living with multiple chronic illnesses. Even though I've had a lot of success, I'm not perfect. There are still some aspects of life of chronic illness that I struggle to get a handle on.

Like you, I put a lot of effort into following the advice of my healthcare team and implementing their suggestions. One suggestion that I've heard over and over again is, 'You need to make exercise part of your fibromyalgia self-care plan.' In trying to implement this suggestion I've run into a lot of problems, with a major stumbling block: something called post-exertional fatigue.

What is post-exertional fatigue? It is an intense state of exhaustion brought on by physical exertion. It begins anywhere from an hour to 24 hours after exercise and can last up to 72 hours. Post-exertional fatigue is actually one of the hallmarks used to diagnose chronic fatigue syndrome, although in my case this could also be related to my chronic hepatitis C infection.

Prior to 2004, I used to work out on average three times a week for 30 to 45 minutes a session. Since living with fibromyalgia and chronic fatigue, I have found that walking a block can wipe me out for several days. It boggles my mind that so little exercise can wreak havoc in such a big way. And perhaps getting stuck on the absurdity of my current situation has created a stumbling block preventing me from overcoming this obstacle.

I came to this realization after my consultation for dysautonomia at the Mayo Clinic in Arizona. When Dr. Goodman
suggested that exercise needs to be part of my self-care plan, he gave me detailed instructions. First, he handed me a pamphlet with specific exercises geared towards persons living with autonomic dysfunction. Then he asked me to start with a few of these exercises. The first goal was to work towards completing them all on a daily basis. Then, after a month of doing all these simple stretching and strengthening moves, he recommended that I try adding some cardio exercise for just three minutes three times a week. He acknowledged that this may be very difficult for me to do initially, so he further advised me to take it slow and easy. He also said that it might take quite a long time for me to build up to longer exercise sessions.

So as I work with this new way at looking at exercise, I feel a great sense of appreciation for how Dr. Goodman approached the subject. I can tell you that it really made a difference when he gave me specific instructions while at the same time acknowledging how difficult exercise is for someone like me. In validating my experience, he helped me see that there may be a way to work around my obstacles to exercise.

In light of this experience, I'm wondering what changes you are struggling to make. I'm also wondering what you think you might need to help you move past struggling to success.

To get this discussion going, I invite you to leave a comment here or on the OMA&P! Facebook page. In addition to sharing with us the areas in which you are having problems, feel free to offer your suggestions about what has worked for you to others who are struggling in areas you feel you have mastered.

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Felicia Fibro said...

I find that, for me, setting a reasonable deadline of a start date helps me. I've been considering taking probiotics for my IBS since December, but knew I wouldn't have time to do the research I wanted to do before March. I set a deadline, and shared it on Twitter, that I would be on probiotics by the end of March. I finished up my research this weekend and was going to buy the probiotic I'd chosen yesterday. I forgot to buy it when I was at the store though, so I have a few days left to get back out and purchase it!

Good luck as you ease into exercise. I'm glad your doc gave you more realistic advice. The Arthritis Foundation has published lots of charts for easing into exercise too.

Mo said...

Selena, This doctor you saw seemed reasonable and understood your limitations. We all need doctors like that. These are great hints on starting to get active again. I'll be watching your progress!

ashpauls said...

I'd love to see some of these exercises. I used to work out 3 hours a day, 7 days a week... just bc I enjoyed it! Now going from the apartment to the car wears me out sometimes all day!!! It's nice to see a doctor who understands the meaning of taking it slow, bc every physical therapist thinks a 30 minutes walk a day is a good start off for a potsy with fibro!!!

Emily said...

As a parent I don't know if I will ever reconcile that I am not able to give to my child the things a healthy parent can do...a house, help with college, a vacation!

Therapy and medicines have helped, but looking at a Disney World commercial can still make me cry.

One think I have come to terms with is the fact that I will always be sick. Time and logic helped to figure that one out. I have about 10 things wrong with me and have not had a decent day in over three years, a great day in around ten years.

I'm not trying to make anyone feel bad for me, it just is and I have accepted it.

Rachel said...

To find a health care professional who listens to concerns and offers realistic suggestions on trying to work around obstacles, that is definitely a time to be thankful.

Duby said...

i would also love to see the exercises that the Doc recommended you to start with ...
any chance you can upload them?