The "Baby Steps" Workout

I just did 6 wall push-ups and 6 sit-ups.  This is week 6 of my "Baby Steps" workout regimen.  Each week, I add one more incremental wall push-up and sit-up to my daily quota.  This way, I don't overdo it, my body can handle the very gradual change, and I get to enjoy the (eventual) benefits of doing mild, muscle-building exercise on a daily basis.

Back in "the before time" (before I had Fibromyalgia) I started this workout regimen for myself to build up my strength and stamina, little by little.  I did regular, floor push-ups instead of wall push-ups back then, too.  I got as far as 22 per day in 22 weeks and was so proud of myself for being able to do 22 push-ups at once!  Then I got an awful flu bug that made me violently ill and made me lose 10 pounds of water in one week.  It was not fun, to say the least.  Needless to say, I was unable to continue my workout routine during my week of constant fluid expulsions from various orifices.  My gradual return to health after that week also was not inspiring me to get back on the wagon so I had essentially quit and forgot about it all while recovering... until now.

I've been especially ill for the past 5 months now with what today appears to be gastritis and biliary dyskinesia, along with daily headaches on top of the bellyaches, bloating, cramps, and general discomfort.  I have spent many days home from work, vegetating in bed or on my easy chair ("the nest" as Don likes to call it), trying to gain some comfort or distract myself from my symptoms with journaling, reading books, watching television, or playing computer games or blog reading.  I have also been very unhappy with my recent thirty-pound weight gain and all the problems associated with that.  While lamenting that I was stuck between a rock and a hard place about being unable to lose weight or exercise for my own good, it finally came to me that I had already invented a great way for a Fibromite like myself to sneak in something good without upsetting my body too much and causing a flare-up.  I'm a genius!

So, with some minor adjustments from my original version, I am back on the slow, rickety, but reliable (little red) wagon (being pulled by a baby goat) of gaining back lost muscle mass, losing some weight by burning calories and increasing my metabolism, feeling a daily sense of accomplishment and progress, and looking forward to less frequent flares, better tolerance for activity, and reducing stress.  Although it will be a slow journey to reach these goals, I am determined to remember the lesson I learned the first time around and make sure I stick to the program no matter how I'm feeling.  It's a relatively small amount of time and effort, especially in the first week, so I know I'd feel much worse if I were to skip.  (How lame would I be to determine I can't do one single wall push-up and one single sit-up today, right?)  

So, I'm very proud to report that I've accomplished 5 full weeks of daily baby steps workouts, in addition to any other exercises I might happen to squeeze into my day while I'm feeling up to it, like walks and climbing stairs and doing chores.  I'm not going to fall off THIS wagon, damn it!  That would be so, so lame of me.  I will continue and just enjoy the slow, scenic route to feeling better.

Look at Me; I'm SUPER*

* SUPER to a Fibromyalgia patient is not unlike a regular-sized person being called a "giant midget" in some ways, but it is a temporary and fleeting phenomenon and is an event to be celebrated as a major victory.

Today I woke up, earlier than I usually like to, and I was actually ready to get up and start the day. That's rare for me, as I am usually really ready to sleep lapse into a coma when morning comes.  This was my first clue that something was different.  Besides, it's Monday.

So I got up, all bright-eyed and bushy-tailed, and announced to Don my sudden realization: "I don't feel terrible today!"  I wasn't feeling cured, by any means, just not as awful as the past few weeks or even months.  Hooray!

I'm taking a daily antacid prescription first thing in the morning these days, to see if it helps my gastritis and abdominal pain problems I've been having since August.  I am supposed to wait 30 minutes before eating breakfast after popping this pill, so I busied myself while waiting.  

First, I got my new "baby steps" workout regimen out of the way for today.  I'm on week 4, which means that I need to do 4 wall push-ups and 4 sit-ups every day this week.  I'm adding one increment each week, and hope to build back some lost and much-missed muscle.  Doing those took only a couple minutes of my time, so I went to the basement and hopped onto my elliptical machine for a bonus 4-minute (slow) cardio workout.  It was not too bad and I'm feeling very proud of myself for having done it, since I don't usually get enough exercise.  Yay me!

While downstairs, I noticed some laundry in the dryer, so I unloaded into the basket and - get this - I carried the clean laundry upstairs into the bedroom for folding.  I know, it's unheard of.  I haven't been able to deliver a load of laundry up or down the stairs in months!  I brought up the basket and told Don "Look at me; I'm SUPER!" with a bit of a dumb grin on my face.  He immediately warned me, "Don't over-do it."  He's right, I need to remember to curtail my enthusiasm and pace while I'm feeling well, so I don't feel like crap tonight or tomorrow.  Thanks, Don.

After folding up the laundry, I am ready for breakfast and munching away on my cereal as I type this post.  I'm hoping my day continues to be at least a good day, if not great.  Hope you're having a great one!

The Vicious Circle of Rare Disease Diagnosis

Warning: I need to rant a bit here.

When you have been diagnosed with a multitude of health conditions that includes Fibromyalgia Syndrome, as I have, you may find the need to dig deeper and see if there is a more reasonable diagnosis lurking behind the myriad symptoms - something that ties at least some of the symptoms together and makes more sense.

After being diagnosed with Fibro in February of 2008, I thought I would find some relief, thinking "okay, we know what this is, now we can treat it." Today, almost three years later, I'm not feeling much relief. Although having some diagnosis for all the things that seem to be malfunctioning in my body was at first comforting, I have realized some things.

Fibromyalgia is merely the name of a syndrome, which means it is merely a short way of naming a collection of symptoms that occur together. It isn't actually classified as a disease or condition. Saying one has Fibromyalgia is just a way of saying that a certain (long) list of non-fatal symptoms is occurring in the person's body. Having a doctor declare to me that I am experiencing a collection of symptoms is really not very helpful, really. Tell me something I didn't already know! There is no way to treat the core problem because the core problem is simply not yet known. Treatments currently focus on relieving whichever symptoms cause the most distress to the patient, and many are ineffective or only mildly helpful at best.

Many doctors tend to shy away from things they don't understand. The medical journals and conferences tell them what the official word is on how to diagnose and treat patients, and they tend to follow protocol. That's good much of the time, but sometimes this pattern is not very helpful to the patient. If it looks like a duck and sounds like a duck, it's probably not a horse, right? But when patients have symptoms that greatly affect the quality of their lives, they want a little more than standard protocol from their doctors. Why are we dealing with so many systemic problems? Why does the list of symptoms continue to grow despite our best efforts at improving them? Why does coping reasonably with these symptoms while still searching for real answers seem to spell "hypochondriac" to doctors who hear our best guesses for investigating conditions with similar symptoms and decide we aren't sick enough to pursue those tests?

Here's the thing. Once upon a time, all the health conditions that are known today were unidentified. Over the centuries, humans have observed and recorded health problems and treatments. When patterns emerged, conditions were named. As the collection of health conditions amassed, new, albeit rare, conditions began to be named and documented. You know the saying "there's a first time for everything" right? It's true for named health conditions, too. Every condition we know about today was once new... and rare.

We have always had a collection of rare health conditions. Only a very few of the patients seen have been diagnosed with these rare conditions. Some of them have become less rare as more was learned and diagnosing methods were narrowed down. Today, we still have a great many "rare" diseases and conditions out there. Statistically, very few people have been diagnosed with these conditions - but there are some out there.

So, when I ask a doctor to consider the possibility that I may have a certain health conditions and the reply is "no, it's not that; that's very rare," I propose that that reason for coming to a dead end on figuring me out is bullshit. Doctors: If you fail to test people for conditions, you will have contributed to the "rarity" of those conditions by reducing the statistics - the very reason you have provided to me for failing to pursue investigation of the possibility that such a condition could make sense of my problems.

Another reason I have been given was that if I had such a condition, I'd be much sicker than I am. Again, logic fails. Whatever happened to the great advice of getting diagnosed early for conditions, so it can be treated and possibly cured before it progresses to a point where nothing helps? If I'm "not sick enough" to be considered for a condition, does that mean that doctors don't want to diagnose early? Will they consider the condition if I wait until I suffer much more? Is this humane??

There are some diagnostic tests that cost a lot to do or require much more reasoning and thought and time to put together, and I suspect that these are the real obstacles I'm fighting. If this is the case, I'm thoroughly disgusted. I am trying to live my life as best as I can while dealing with at least a dozen symptoms at any given time. Meanwhile, I'm working to improve my quality of life and reduce the burdens on others by searching for meaningful reasons for my body's failings. I'm motivated to do the research, though my medical knowledge is greatly limited. I need the help of medical experts to find these answers, yet the true rarity in medicine today is a doctor who is actually willing to empathize and help me find those answers.

My plea to doctors is this. Don't dismiss my hypotheses with the rarity excuse and don't use cost or effort as a reason either. My body is breaking down and I need a better diagnosis than a syndrome. Cost and effort of investigation should not play a part in my health. I need more effective treatments and I want to know if defects in my DNA or blood or other body parts could be the missing link in what I'm experiencing. If you don't want to help me improve my health, I don't need you at all. If you don't know the answers, call on a colleague who might. Don't discard me. I'm a human being. I want to live well and I want others like me to live well. If you were the one in my place, would you approach things differently? Think about it.

Bellyaching and Stuff

On November 12th, I had an EGD performed.  Gastritis was detected, but no ulcers or other abnormalities, and a biopsy test revealed no H. Pylori is present.  In the absence of any other clues, including no gallstones and no gallbladder inflammation or infection, the GI performing the EGD warned me to ease off the NSAIDs (like Aleve, which I use only for more severe headaches/migraines and very rarely as an alternative pain reliever for hip pain or joint pains that may have inflammation) and consider gallbladder removal if my pain episodes continue.  He didn't seem very tolerant of my many questions, despite the fact that my case is not clear-cut for gallbladder removal.  So I sought out another GI for a second opinion.

Last Monday I brought all my test results and questions to the new GI and he was much more helpful to me.  He listened to all of my symptoms and concerns and agreed with my opinion that gallbladder surgery seemed not to be the clear answer to my problems.  Not only that, he actually commended me for being "proactive" about my own health and bringing all my documentation with me.  This is how doctors should be!  (Special thanks to my niece for recommending him to me.)

Anyway, his best guess for a diagnosis right now is functional dyspepsia, which he explained can be quite common for people who also have IBS or/and Fibromyalgia.  It is not the same as IBS, which I have dealt with before, but much like IBS, it is a condition that turns out can be difficult to live with, but is not likely to cause permanent damage.  He is having me try some acid reducing medication (Dexilant), since my pain seems to be more on the stomach side rather than one the gallbladder side of my upper abdomen.  

I was also given a pamphlet called "Gas and Flatulence Prevention Diet" which discusses foods that can cause gas in some people, and the science of bloating, which can get ridiculously severe during my pain episodes.  There is a breakdown of various foods by groups that can be problematic, but each person is different so finding out if any of them make my problems worse is going to take some trial and error.  The doctor suggested I try to eliminate one food or food group at a time and see if there is any change either with elimination or returning it to my diet.  He made sure I understood that he was NOT suggesting avoiding all the problem foods at once, or else I'd have pretty much nothing left to eat.  Looking at the list, I see why.  It seems the only food group that isn't listed as a potential troublemaker is lean meat.  I'm documenting my diet and symptoms, so I can look for new patterns I may have missed.

Lastly, he suggested that I try to eat smaller, more frequent meals, avoiding large meals.  The reasoning behind this suggestion is that some people, especially sensitive folks like us fibromites, don't tolerate the sensation of the stretching of the stomach well, and it can feel painful.  To minimize on the stretching, I could try grazing little by little throughout the day.   It's hard to have half a meal here and there, especially if you want something hot, but I understand the logic and am glad he gave me so many options and ideas with explanations.

He left me with one last bit of advice before my next appointment: find a way to cope with stress and my annoying symptoms so I don't slip into a constant state of worrying about the next flare up.  I believe he was talking specifically about the abdominal pain, but I know this is also important to keep in mind for the rest of my Fibromyalgia symptoms and life in general.  I do what I can with journaling, blogging, and reaching out to others in need, knowing I won't always have it all under control.  There are days when the symptoms just pile on and I get downright cranky or fed up, especially when I have to miss work and get behind on my duties at the office, but the reality is that I'm stuck with much of this bad luck and need to buck up and do what I can to find my own happiness wherever possible.  I'll definitely keep working at this.