Wednesday, April 4, 2018

Managing Chronic Illness: 04 - Medication And Exercise.

Oh, the catch 22 of exercise. Being fitter will make you healthier, but exercise itself makes you sicker. Is there any greater bane to the chronically ill? Possibly people saying: 'You would be healthier if you exercised more'.

How To Exercise When Chronically Ill:

First, you know better than anyone else what you are capable of. And if anything, most chronically ill people are prone to push themselves TOO hard and make it much worse for themselves. So be realistic about your goals and be realistic about how much you can do.

First, define why you want to exercise. For me, it is about promoting blood flow and keeping myself as physically able as possible. I don't want to get weak joins and I don't want my stamina to drop so low that I can't do things on the days I am well enough to go out. I'd also like to lose weight, but more about that later.

Secondly, once you have decided WHY you are exercising, you must choose exercises that are suitable for you, and suitable for your goals. It might be slow, low impact exercise like slow walking is best for you. Or maybe short bursts of high intensity. You know what is best for me? Swimming. Medium intensity, but most importantly, I can't overheat. Which is my biggest problem with exercise. You know what I don't have easy access to? A pool or the beach. I drive to the beach when I can, but that is much, much less often than I would like.

Thirdly, think outside the box. Can you lift cans of food while watching TV? That's exercise. Can you do leg lifts? Squats? If some parts of your body don't work, how can you isolate and exercise the other parts? What can you do in your living room with a small amount of space. Can you do a dance routine? I promise youtube has hundreds more exercise tutorials on it than you could ever complete if you dedicated your life to trying. You don't need fancy equipment or a trainer and you don't need to exercise the parts of you that don't work well.

Fourthly, did you do ten squats and give up? That's okay. Do ten squats tomorrow. Maybe build up to 11. Then 12. Move slowly. A tiny bit of exercise is still doing you good. Don't beat yourself up because you can't do what a 'healthy' person can. I hate to break this to you, but you aren't healthy.

When Your Doctor Wants You To Lose Weight:

I am going to talk about weight in this blog post, but there will be no fat shaming. And I hope most of you know me well enough that you thought this was a given.

The biggest problem with being overweight and chronically ill, is that doctors, nurses and random people with no right to an opinion will blame many of your symptoms on your weight. It is, of course, more likely that the reverse is true. Being chronically ill makes it almost impossible to eat as well as you want or exercise as much as you want. And in some cases, your illness may be the direct cause of your weight, particularly if you have POS or any kind of inflammation or sleep disorder, along with a lot of mental illnesses.

There are, however, some benefits to weight loss I want to talk about. Two of these, I don't WANT to be true, but however horrible, they are true and until society changes, we are going to have to live with them:

1. It's easier on your joints.
Carrying around a lot of excess weight, regardless of if the weight is part of you, or not (boxes, books etc) is hard on your joints. As is repetitive use of said joints. I know a lot of writers with bad hands and wrists, I know a lot of removalists or warehouse workers with shot backs and I know a good number of overweight people with shot knees. And, of course, if you have bad knees, it's going to be harder to move around and you will gain more weight, and the terrible cycle continues.

2. It's easier to exercise.
There are some amazing overweight athletes and all of my healthy overweight friends can run rings around me. However, it’s a lot easier to exercise when you are carrying less weight. At my heaviest I was over 90kgs and dragging myself up a hill was a nightmare. It still is, but with a 20kg back pack on, I probably wouldn't make it now.

3. It's easier to make doctors take you seriously.
Being fat could kill you. Not because of the fat, but because some asshole doctor is doing to blame your fatal condition on your weight. It happens ALL THE TIME. As in, daily. I have no stats on how many people die per day from treatable conditions that were misdiagnosed because they were overweight, but I do have enough stories just from friends to terrify me. Find a good doctor who isn't a fat-phob, warn people away from the fat-phob doctors you do meet. But also accept that in an ER, your great GP isn't going to save you.

4. I will relieve some psychological pressure.
It doesn't matter how much to love your curves, every time someone makes a negative comment, you probably die a little inside. I wish I could be there to punch every single negative person in the face before they speak, but I can't. And you're still going to be bombarded with skinny models and actors and advertising telling you to be ashamed and that you are only beautiful if you are thin. I know in this context losing weight is essentially 'giving up', conforming to make the bullying stop. And yes, that's exactly what it is. We live in a dystopian hell and sometimes you have to do whatever it takes to survive here. 

Medication Sucks

No one enjoys taking medication. Even addicts don't enjoy it, addicted or not, it something we do to cope. To hopefully make things a tiny bit better—either by keeping us alive or removing some symptom we suffer through.

It can be difficult to balance our medications, they can be dangerous, disruptive, and come with a lot of complicated feelings. Its hard to take pills of any kind without feeling there is something 'wrong' with you, even when logic argues that we need it.

Its up to you to use common sense when it comes to your medication. Logic should trump emotion. Take your pills when you should, and acknowledge your negative feelings about them. Journal about them, if it helps. Here are some other tips:

Question. Your. Medication.

At least once a year, I like to re-assess and re-trial all my medication. Depending on what medication you take, this may be dangerous, impossible or relatively easy. You can book a meeting with a pharmacist in Australia, who will meet with you and go over all your medications looking for potential clashes and interactions. They can also talk to you about side-effects you might be treating as symptoms. Symptoms evolve and change and if you have been taking a lot of medications for a long time, symtoms that are getting worse may be from the medication. EG: I took Panadol almost daily for 20 years. Recently when my headaches just would not ease, I spent a week with NO painkillers, not even Panadol. It was hell. Not going to lie. However, one of the new aspects of the migraines eased up, only to flare again when I tried the Panadol again. I can no longer tolerate Panadol and I have had to adjust my medication schedule accordingly. It used to be I couldn't take nurofen without throwing up, now I handle it just fine.

Likewise, an old migraine medication I took for ten years suddenly started giving me seizures. You change, your symptoms change and your reactions to medications change. Anything you are on long term needs to be re-assessed regularly to weed out illnesses-disguised-as-cures.

Research New And Alternative Medications.

I don't mean alternative therapies. Don't switch your Naltrexone for crystals.

Don't disregard vitamins and herbals just because they are 'simple'. Let's be honest, after years of chronic exhaustion, we would feel stupid if our condition was treatable by something as simple as a vitamin. Iron, or vitamin D, or Vitamin B. However, this is literally a best case scenario. Feeling better from taking a pill with no side effects, no prescription, no long term harm.

I'll tell you something else, a lot of 'hardcore' drugs are just complicated versions of simple things. Medications are just compounds of other things. Most of us know penicillin is derived from mould. All drugs are derived from something and sometimes the only reason a herbal supplement is not an expensive prescription drug is because pharmaceutical companies have not isolated the right compound yet.

Valerian root and turmeric are two fantastic examples. Valerian, when concentrated, is a better sleeping agent than any commercially available sleeping pills. But it also dangerous. So the valerian you get from blackmores is very mild. Because pharmaceutical companies don’t know WHY valerian makes people sleep, they can't turn it into a sleeping pill yet. But they are trying. Meanwhile, Valerian is not taken very seriously by anyone as a sleeping aid, even though we KNOW it is more effective.

Turmeric is the same. With pepper, it is proving very effective at treating certain conditions, just as Indian medicine has been saying for centuries. However, the active compound isn't known, so pharmaceutical companies have been releasing rather misleading studies claiming turmeric has no effect. Really, the specific compound in turmeric they tested had no effect. But in spreading these results, they drive people away from using turmeric and back to their other prescription products.

Remember Health Is The Goal.

Your goal is always to be healthier in the long and short term. We need to stay fit, flexible and strong enough that life doesn't become more difficult for us. But we also don't want to make ourselves sicker trying to overdo it.

Likewise, we want our pills to improve our situation, not make it worse, and that means a lot of trial, error, research and inconvenience, which can often leave us struggling in the short term, but is hopefully beneficial in the long term.

I'm not a big fan of doctors, but I hope you have one you can trust to speak to before you embark on any medication tests or exercise routines. Who knows, they might even have some good ideas.

Next week: Socialization, time management and goal setting!

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