When Less Is More
I have a tad bit of trepidation writing this post. The last thing I want to do is tell people with CF to take it easy when it comes to exercise, but this is indeed what I am about to do. It may be a controversial topic…and that’s ok.
Despite being a nerd who never did anything but read as a young girl, the last thirty-eight years of my life have been marked by a pronounced exercise addiction. As such, both good and not-so-good things have occurred. The good is clear: Somehow, I’ve beaten back the CF monster time and time again, and I honestly believe that my fitness level has been a huge contributor to this bit of good fortune. It’s been known since the early days of CF research that fitness level corresponds very well with survival in CF (Nixon, 1992). I certainly didn’t know anything about this at the time I started running in order to be the skinniest girl in my high school class (thank God I didn’t win that competition), but the consequent addiction to fitness has certainly paid off. The need to be skinny turned into the need to be in control (thank you weight-lifting), which morphed into the need to combat stress (thank you medical school), which then turned into the need to get out of the house (thank you two toddlers). It wasn’t until my CF began to really let it’s presence be known to me in more serious ways that exercise became my need to (literally) run away from reality.
It was only when out for a run, or when strutting around in the gym looking (and actually being) strong that I forgot about those pesky malfunctioning genes that took my sister and brother’s lives, and would likely take mine. Taking on fitness challenges and training for them was a way to beat CF, and forget about it at the same time. This is how I coped, and it worked really well.
Until it didn’t. The wake up call for me was last spring, when I lost my mind and decided to train for, and pass the RKC. You can read about that little escapade here. So, at 50, I proved that I could train myself so hard that I could end up in the hospital with pneumonia. Sure, it was a great experience (the RKC, not the pneumonia…that sucked), it was very good for my ego, and I think I even surprised a few people, but was it really worth the blow to my immune system, the chronically elevated cortisol levels, and the resulting scars in my lung tissue which are permanent?
Here is my point. If you have CF, exercise. Heck, if you don’t have CF exercise. That is what our bodies need…what we are made to do. Everyone is healthier when they move frequently. But overdoing it is not a good idea. Over-training is a serious stressor to the body. It causes hormonal chaos, as the body thinks the stress is never going to stop and keeps on pumping out cortisol like crazy. Cortisol is the body’s version of a drug we commonly have to take to dampen inflammation in the lungs, prednisone. Remember the last time you had to take prednisone? The shaky feeling? The mood swings? The elevated blood sugar? The yeast infections? Elevated cortisol over a long period can lead to these things and worse . It not only turns down the inflammatory response in the lungs, but it also turns down the immune response to infections, resulting in….trips to the hospital with pneumonia.
So what is a cyster (or fibro) to do? Moderate. It is the best course of action. Here is how I do it now (at age 51). I walk every day, at least 30 minutes, usually more like 60 minutes. This is at a moderate pace, and is usually a pretty low key event. My heart rate is never more than 50-60% of my maximum (although this is a guess since I never take it). There is a little bit of an upper body workout component as I am always accompanied by two dogs, one of which almost outweighs me, is horribly leash-trained, and constantly looking for squirrels.
Three days a week, I pick things up and put them back down (weight lifting). This consists of a heavy day, a medium day, and a light day each week. The “heavy” day means heavy (for me) weights, which means fewer reps. This day usually consists of deadlifts and bench presses, with some ab work thrown in for good measure. The “medium” day means not heavy, but not too light weights. It’s a Goldilocks day. The exercises are usually squats, military presses and rows, and the rep range is 8-10. I may “play” with kettlebell exercises this day–but nothing hard. The “light” day is just that–light. I go back to deadlifts, but just practice form, and work on my pull ups. This is the day I will “practice” my kettlebell favorites, like the Turkish Get Up or the snatch. Again, the focus is on practicing and playing. Currently, my weight workouts are limited to 45 minutes. I’m trying to get them down to 30 minutes, but this is tough for me, because I always think of “just one more thing” I want to do.
I can hear you now. “What about cardio?” I know, I know. Running has saved me from the CF beast. I can’t give it up…the beast might get me.
I’ve been experimenting with limiting my “run” days to two a week at the most. And they are not runs anymore. They are interval workouts, where I either run fast (I would say sprint, but that’s sort of stretching it) for short periods (15-30 seconds) and walk to recover, repeating for as long as it feels right, OR I walk uphill fast wearing a 20 lb weighted vest, and then slow way down (and decrease the incline) to recover, again repeating the work:rest intervals for as long as seems right. Because interval training is hard, these are short workouts; 20 minutes maximum.
So, let’s think about this: walks daily…at such an easy pace they don’t really count. Weight lifting 3/week at 30 minutes (that’s the goal anyway). Interval training 2/week at 20 minutes. Not much time, right? Now trust me, in order to get the work done, and make it worth your time, those short workouts have to be pretty fast pace and intense (except the easy weight lifting day…don’t even consider “intense”). This is what I’ve been doing this year. And guess what? I’m going on seven months with no infections and no IV’s. My weight is up. My mood is up. My numbers are up. Life is good. Compared to the times in the past when I’ve been working out like crazy, one to two hours-a-day, this is a much more sane, and healthy (I think) approach to fitness.
Here’s my final point: This isn’t a lot of time. So the next time you try to convince yourself that you don’t have time to exercise because you are so overwhelmed by the CF regimen, ask yourself if you have 20-30 minutes. That’s not even a sit-com!
Lastly, an important caveat: If you are just starting to exercise, or just coming back to exercise after being sick, start with the daily walks. Get those down first, building up an aerobic base. Next, add the lifting. When you feel strong again, start in with the intervals. At first, intervals may look like this: 30 sec walk fast, 1:00 walk normally. Then maybe build up to a jog for the work intervals…then a run…then a sprint….then a sprint uphill (ok so maybe this won’t happen until the Magic Pills are approved). Go VERTEX!