Summary Bio

I have a long list of illnesses (see it here). In 1995 at age fifteen I was diagnosed with ulcerative colitis (a disease of the large intestine), and I lived with it for seventeen years. In 2010, it spread and advanced to a severe diagnosis. I spent a year on a roller-coaster of intensive immunosuppressive drug therapies, only to end up requiring surgery to remove my large intestine and replace it with a j-pouch. After surviving three surgeries, I developed Myalgic Encephalomyelitis, the most debilitating illness of all. (Read "Myalgic Encephalomyelitis" and "The Spoon Theory" to understand more.) Below are the detailed accounts of my ups and downs on this journey.

Sunday, April 8, 2012

Getting Back in the Game

  UC = ulcerative colitis     GI = gastrointerologist     BM = bowel movement  

"It's hard to beat a person who never gives up."   -Babe Ruth

Regardless of how determined we are, we all hit roadblocks sometimes that cannot be avoided.  Whether it's due to injury, illness, work or family emergencies, holidays, stress, lack of motivation, etc., we all end up having to take breaks from our workout routines at some point or another.  This does not mean, however, that we are giving up; when the roadblock has passed, it's time to get back in the game.  But we can't just pick up where we left off, or we risk injuring ourselves.

A few weeks ago, I had taken a couple weeks off due to my UC symptoms and initial Imuran side-effects.  I was not back into my workout routine more than two weeks before I had to take another week off (last week) due to the high fevers and a bad reaction to the Imuran.  As I am waiting for my new medication to get approved by my insurance, I have a two-week window where I am not on immunosuppressants, which means I've been feeling better than I have in many weeks.  This week I have thought a lot about maximizing my return to my workout routine.  Since I am illness and injury prone (think mega shin-splints), I have to be careful about how I go about it... as we ALL should when coming back after a break.

Where to pick up is going to depend on how long the break lasted.  If it was a week or less, you can probably just pick up where you left off without much problem.  However, if it was more like two or three weeks off (or longer), you will have to ease back in to things.  You need to get your body used to working out again, re-build that foundation, and trigger your muscle memory.  Whether you're talking about weight-lifting, running, or any other type of sport, a good rule of thumb to go by is to return at between 50% - 75% of where you left off, depending on how long you were gone.  If it was a week or two, you can probably jump in around 75%, but if it was longer, you want to drop it down to 50% and build from there.  The good news is that you can increase much more quickly than if you were starting from scratch.  If you have repeated an exercise many times before, your muscles will remember those motions and re-build the muscle there much more quickly.

I wish there was a formula for how fast to increase mileage or weight, but the truth is that if there is one thing I've learned from all my years of research and expereience in health and fitness, it is that everyone's body responds differently.  Therefore, the biggest rule to always live by is listen to your body.  You should obviously expect some soreness when returning to your routine, but during and after your workouts you want to pay close attention to your body and watch out for any fatigue, twinges or stiffness in unusal areas or any acute pain.  If you notice any of these, dial it back a notch.  If you feel strong and good to go, increase your recovery pace a bit.  On Tuesday I was feeling a bit weak during my run, and my energy ran out quickly, so I only ran 2.6 miles, which is about 75% of what I was running during weekdays before my break.  Same with my leg work-out yesterday.  However, Thursday I felt strong and energetic, so I ran about 4 miles.

By the end of that run, though, I noticed a bit of a twinge in my shin-splint areas.  So when I got home, I made sure to RICE my legs for twenty minutes.  RICE = Rest, Ice, Compression, Elevation.  This is a routine I do quite often after workouts to both treat and prevent shin-splints, but you can use it to treat any type of minor injury or to prevent overuse injuries to trouble areas.  Immediately after my workout I take two re-useable cold packs out of the freezer and wrap them tightly to my lower legs with ACE bandages and then prop my legs up on some pillows for twenty minutes.  This hits all four points of RICE treatment and reduces inflammation to the area.  You can also use NSAIDs such as ibuprofen for the same purpose, but only AFTER your workout.  You never want to take a pain-killer before your workout because that pain is an important signal from your body telling you to slow down, and you need to listen to it; otherwise you risk further injury and longer set-backs.

Another thing to keep in mind is to give your body adequate time to recover.  While you're getting back in the game, do not do the same exercise type two days in a row.  This will give your body a chance to re-build muscles, joints, tendons, and ligaments between workouts.  However, it is a good idea to cross-train on your off days to keep up with strength and endurance.  Doing different types of exercises will strengthen different areas of the body and not only improve your progress in your sport of choice but will also help prevent injury.  (This is actually a rule I live by all the time anyway for exactly those reasons.)  Additionally, you don't want to do any heavy or intense programs while you're re-building your foundation.  High intensity interval training (HIIT) is all the rage right now as the best way to increase strength, endurance, perfromance, etc.  I love HIIT and highly recommend it, but if you're coming back from a break - especially if it was due to illness or injury - you should stick with slow and steady workouts until you have built a solid base.

I know I personally have an extremely difficult time reigning in my enthusiasm and motivation to go faster and do more when I'm coming back from a break, but it is an important skill to learn unless we want to end up setting ourselves even further behind with overuse injuries.  However, if you are careful and learn to listen to your body, you can recover from a break pretty quickly and maximize results.  I'm looking forward to getting through this recovery time so I can really throw myself into my workouts and start seeing some great progress.

T H I S   W E E K ' S   H E A L T H   L O G

My Condition:  mild/moderate ulcerative colitis since 1995, severe pancolitis since 2011.

Current Symptoms:  no cramping, loose BM 2-4x/day, tiny amount of mucous, miniscule amount of blood, small amount of gas.

Prescription Meds:  prednisone (30mgs), Asacol HD (4800mgs), mesalamine enema, Prilosec.

Current Side-Effects: weakness, shakiness, occasional fatigue, slightly elevated heartrate, arrhythmia, slight insomnia, increased appetite, moon-face, ultra-sensitive teeth, thinning skin, anemia/low hemoglobin count (carries oxygen from lungs to rest of body).

Supplements:  creatine, BCAAs, CLA, L-glutamine, glucosamine, whey protein (post workout), casein protein (before bed), Omega-3, calcium, vitamin D, vitamin C, biotin, multi-vitamin.

Diet:  Breakfast - 8oz. Odwalla Superfood, spinach/bell pepper scramble topped with salsa.  Lunch - 1c teriyaki chicken/veggie stir-fry, 0.5c rice.  Dinner - large spinach salad w/ diced chicken and hard boiled egg, low-cal dressing.  Snack Choices - (two per day) sugar-snap peas with hummus, wheat thins and cheddar, a couple handfuls of cashews, an apple and peanut butter.

Exercise:  Mon - none (messed up my meds and had a REALLY crummy day).  Tue - ran 2.6 miles.  Wed - 60 mins weight-lifting (legs).  Thu - ran 4 miles.  Fri - 60 mins weight-lifting (upper body "pull"). Sat - ran 6.4 miles.

Stats:  height 5'7", weight 146 lbs, body fat 16 %.

Have Tried:  Imuran, Lialda, Endocort, Prednisone (dependent), Canasa, Cortico-foam, probiotics, L-glutamine, licorice, various other supplements, Specific Carbohydrate Diet, FODMAP diet, various other dietary changes.

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