Getting exercised

[Al]

I want to start a new thread on a subject that fascinates me, in regard to possible interactions with ANCA diseases: exercise, as in how much is a good thing; how much is too much; and what kinds of are appropriate.

Up front I will say that I believe in staying active, except when the activity brings about further stress and--especially--relapse. But how to do this? I like to hike and climb, but is this a good idea?

To be blunt, even the professionals I have consulted come up with differing answers. (The first one I asked was one of my hospital nurses, Jeff. Jeff is an avid biker and rock climber, interestingly, he said no one had ever asked that question before, and he had never heard a doctor discuss real exercise [for the patient] either. The assumption was that patients aren’t feeling good enough to exercise.] There are, to be sure, hundreds of articles on exercise and cytokine production listed on PubMed, but, so far as I can tell, few if any discuss it in the context of autoimmune diseases. The best inference I can make so far is that mild-medium exercise is good; heavy aerobic exercise is questionable, even without the matter of getting fatigued. (Exercise releases both pro-inflammatory and anti-inflammatory cytokines, though usually only at the local site of the muscles involved. Systemic cytokine production seems to happen only with heavy exercise.) Of course, a certain amount of resistance work helps prevent prednisone-induced bone loss.

Anyone know more about this subject?

Al

[Dryhill]

This is purely my own thoughts on the matter.

Doing some exercise if you are feeling upto it should be alright as long as you do not go for "the burn". chose a non-strike exercise (ie swimming or cycling) over soemthing like running or weight lifting. Just doing something will probably help you stop feeling like a "sick old man" (of course then you will have to go shopping or to those parties you do not want to go to). Hiking is probably still ok but do watch for stress to the knees and hips.

I used to belong to a running club and during training for a double marathon (52 miles) I sustained an injury, like an idiot I still entered a very hilly marathon the next week and was in the cross-country team the following week. Many months and hundreds of £'s later I was able to walk more or less normally! It is interesting to note that all my running buddies are now having knee troubles.

[elephant]

Al, I often thought of the same question about exercise and Weggeners or autoimmune diseases. Right now I walk 20 miles a week, sometimes less depending how I feel. I was weight training but ended up straining my spine. I do have osteopenia.

[dutch]

My son's rheum said "do everything you can until you can't." The doc put no limitations on his workouts, only those that his body signals. The side effects of the high dose steroids, muscle inconsistency, limit my son.

[Al]

Al, I often thought of the same question about exercise and Weggeners or autoimmune diseases. Right now I walk 20 miles a week, sometimes less depending how I feel. I was weight training but ended up straining my spine. I do have osteopenia.

The walking should help a lot, and feel good, too. Maybe you can do some light lifting?

[Al]

My son's rheum said "do everything you can until you can't." The doc put no limitations on his workouts, only those that his body signals. The side effects of the high dose steroids, muscle inconsistency, limit my son.

Exercise does indeed send important chemical messages throughout the body. The problem for those used to a vigorous workout is in not picking up on the return signals that enough is too much. How do we deal with this? Steroids are a problem, as you say. I tend to cramp up from the prednisone. That's boring, and I don't mean in the good way.

[Rose]

Exercise does indeed send important chemical messages throughout the body. The problem for those used to a vigorous workout is in not picking up on the return signals that enough is too much.

Certainly something to this in my experience over the years. When I push myself to do a bit more I invariably suffer some form of relapse which could take me weeks or months to get over. The line is invisible and my body only lets me know a few days later that I have crossed that line. I just have to plod along on an even keel and no matter how well I feel I have to remind myself to hold back with the exercise.

[Rose]

When I push myself to do a bit more I invariably suffer some form of relapse which could take me weeks or months to get over.

Just want to clarify that statement. The relapse is not usually in the form of muscular aches or pains from over exercised muscles. More a general ill feeling. fatiqued, energy levels much less than before the exercise and gut ache when I have really over done it.

[Dryhill]

Exercise does indeed send important chemical messages throughout the body. The problem for those used to a vigorous workout is in not picking up on the return signals that enough is too much. How do we deal with this? Steroids are a problem, as you say. I tend to cramp up from the prednisone. That's boring, and I don't mean in the good way.

"How do we cope with this?" Now that is a really hard question and the answer is probably going to be different for each individual.

When I used to run there were a few times when I was not able to run due to an injury. My osteopath would tell me when I could resume running and would also give me a training schedule that would slowly bring me back to full fitness. Basically it was always the same, start gently and short distances for a week and then pick up the pace for the same distance then the third week add some distance at the same pace. Each week alternating between increased pace and distance.

I do not know how far you are walking at the moment but my suggestion is to take a nice gentle pace and add say half a mile and do this three or four times a week. After a couple of weeks add another quarter or half a mile and so on. BUT you MUST listen to your body and not overdo things.

[Sangye]

In general, exercise as much as you can. Caveats and cautions:
1) If you're on pred, it's very easy to tear tendons and ligaments. Don't do weightlifting or put high stress on your joints. Stretch very gently. If you're on pred and an antibiotic in the fluoroquinolone category (eg. levaquin) your risk of tearing a tendon or ligament goes quite high.
2) Another caution with pred: High doses will make you feel stronger than you are. Anything other than mild to very moderate exercise while on high dose pred is actually depleting the adrenal glands and will come back to haunt you later.
3) A good way to tell if you're over-exercising is to check how you feel 1 hr, 6 hrs and 24 hrs post-exercise. If you feel very sleepy, you've depleted your adrenals. Emotional irritability is another sign of overexertion.
4) Remember that your body is recovering and dealing with tons of toxins (from drugs and inflammation). That uses a LOT of the body's resources. Don't exercise so much that your body can't heal. You can cause a flare or delay remission.
5) It's best to go for time, rather than intensity or speed.