[Subby]

Hey there, I'd appreciate if some exercise oriented people could look over this approach I am taking to get to "base one" of better physical conditioning. Over the years I have tried many things and had setbacks for a few, specific reasons. I'd like to try again and see if I can forge through.

I'll try and set it out logically to show how I got to where I am. Sorry if this is boring, it's the only way I can think to get to a useful point here.

First: What am I trying to achieve with exercise?
Better health. From most important to least:
- better metabolic conditioning (for better absorption, better sensitivity, less tendency to fluctuate rapidly) This is a huge issue. I take over twice the TDD I "should", according to estimates. I slip around like an ice skater all day long.
- weight loss, I am 93kg and 188cm tall, making my BMI in the middle of "overweight". I used to be comfortable at 83kg. There is too much around the belly, plus high cholesterol.
- Rehabilitate my left shoulder/back. Been a problem for years, I can strain it very easily and this brings on all manner of headaches, TMJ, strange head effects. I have an osteo who can alleviate it but attempts to rehabilitate it usually end in exacerbating the problem.
- Mental positives, physical stamina etc, all important.

Second: What are the issues I need to deal with?
CFS. I have had energy and fatigue issues ever since getting diabetic 15 years ago. I have been diagnosed with CFS when 20 and again at 28. I have worked hard with lifestyle, diet, gentle exercise like walking etc to improve this: it has improved, but I still "hit a wall" very very easily that leaves me exhausted for days.

The good news is I am very aware of that wall and am in the habit of being "just behind it" when exercising. Still, it means buildup must be very slow and cautious.

Diabetes. I have always had very brittle diabetes. Absorption, sensitivity, etc all vary greatly day to day. It also interacts with the CFS, I believe, making it sometimes seem an impenetrable unbalanced system. I am very sensitive to fluctuations, I feel lousy as soon as I am out of range. (which is multiple times, daily, despite best efforts). The pump has shown that a lot of this problem is due to strong, shifting, basal requirements through the day, and possibly dramatically different I:C ratios through the day. The pump has also helped me divide my CFS symptoms from my fluctuation BG symptoms. Hooray for progress

In particular with exercise, though, I get extreme fluctuations if the exercise pushes me. I need to try as hard as I can to have presence of mind and be prepared to aggressively lower my basal beforehand, boluses nearby, and have lots to correct with on hand, etc. This problem has often given my "regular exercise" efforts the death knell, especially as I bounce to the other extreme, so easily.

Left shoulder. Whenever I use it repetitively or with any strain it "goes", causing flared up pain, headaches, fatigue etc. I find it hard to predict when it will go. It seems mainly the muscles you feel on the shoulder blade when you begin a shrug. It is incredibly annoying because I have so much I want to do that depends on my arms!

continued... thanks for reading, it won't be much longer

[Subby]

So I am first trying to just get my body used to some heightened activity, without overdooing any one thing, and hopefully contributing to the 3 issues of dealing with (and hopefully improving) my fatigue situation, dealing with and improving my insulin usage and stability, and dealing with and improving my arm, which seems to lack muscle tone and has a susceptibility to tear or inflame.

So this is the approach I have come up with to start to get somewhere, trying to be as softly softly as possible.
- 2 x 30 Skipping. Just get puffed then. This will go up pretty dramatically I predict, But I aim to keep it light.
- 5 minutes exercise bike, just behind the "pushing" wall.
Arm with 1.5 kg weight:
- 3 x 10 weight dumbell curves. (this is max before feeling tearing)
Arm with about .5 kg weight:
- 3 x 10 overhead tricep extensions
- 3 x 10 lateral pull ups I think they are called - arm outstretched
Anything more than these weights and reps I feel straining.


I am thinking of doing this 1 hour before evening meal, if BG within reason, I have tried to do it after a meal and it seems to require so many corrections. Hoping the meal (mid-carb at this stage) will allow a cushioning impact for my BG.

I know all this seems so paltry but do remember my CFS condition and the fact that my BG reacts so strongly to exercise, even this level can cause extreme variations which hits me like a brick! Otherwise, I do a few hours a week of walking which doesn't "rock the boat" too much, but frustratingly doesn't seem to condition my metabolism much.

I would like to get to the stage a gym membership is cost effective for me. At the moment it seems to me that I am better of trying to get basic conditioning going first, so that I can do a reasonable workout. Fair attitude to take?

As a starting point, can anyone recommend additions or replacements that may serve me better? I would really appreciate feedback.

[HelenM]

I don't know much about weights but I don't think that theres anything in your programe for abdominals or for flexibility. I try to do some pilates exercises most days and have found it excellent for both. Because it can be done at different levels people of all ages and states of fitness can manage it. Theres a woman of seventy in a class I go to.
Unfortunately its often thought of as simply a form of exercise for women, this article might sell it to you
Pilates For Men
another quick google found this set of exercise on video. I think the abdominal one in particular could be a useful adition to your workout. Some of the other execises (eg arms) might be an alternative to the weights if they prove too difficult for your shoulder problem.
Pilates: How To Achieve Great Abdominals (Sports & Fitness: Pilates)

[Dimes]

I think you have the right idea Subby, just ease yourself into it. I find exercise really has a positive effects on my #'s. More than 2-3 days without some form of good exercise and I start to swing a lot more easily.

[Subby]

HelenM I will definitely look into adding some pilates type resistance exercises, I know exactly where you are coming from and thanks for pointing out the lack of core strength/flexibility.

The problem I have about pilates and yoga is that those usually "whole body" exercises (in my experience) seem to particularly tire me and bring on whole body aches. I have tried before and they knock me right around and easily bring on the CFS. I agree progress must be made with core strength though, and I suppose I will just have to be very choosy in what pilates exercises I do, aiming for easier and more localised ones. Thanks for hunting down the links.

Dimes, thanks for the encouragement, it's good to think I might get a little more stability through being more active. My challenge is not to think too big too soon - this always gets me.

[morrisma]

Subby,
Good job looking to get rebuild some stamina and fitness.

I started swimming years ago to begin my "rehabilitation". At first it was just a few laps at a time (I got winded and nauseous at first) but gradually I was doing a mile or more each morning. Just be sure that shoulder isn't stressed.
Machines like the ellipticals are "self-paced" so you set the tension, speed & incline and stay on for as long as the music or tv moves you. I love csi & time my cardio on the elliptical to cover a 1 hour show start to finish. You also can limit the arm motion.

Yoga is very good. The instructor I have always allows us leeway to prevent overworking a sore or damaged area. I don't like to not keep up with the class but part of a session was always better than no session.

Good luck,
Mike

[Alice]

I'm a reasonably fit person who decided to "step up" my exercise level. Don't make the same mistake I just made a couple of weeks ago...don't overdue the impact exercise.

I joined a bootcamp class (which was excellent)...I did well during the cardio and hand weight segments...but the running just killed me. Thought it was a pulled ligament...ended up a stress fracture. I've been on crutches for two weeks and am encouraged to go to therapy...which I don't feel I need....but will probably go since I'm a "good girl"...

We ran on pavement which is terrible unless you are really in top condition and your muscles can absorb most of the shock.

I was thrilled I was running...but the excitement gave way to pain!

Take it easy on your joints and you will be able to exercise much longer!

[shiftzor]

I would exercise after eating, that way you give your body the energy and insulin to do the exercises. You can reduce the quantity of insulin pre-exercise by 20% (change this number to fit your body) to stop you going low mid exercise. Take something to eat like fruit and something to get you out of a hypo like Lucozade sport. Test regularly. Good luck

I think you should keep up the cardio until you get into your ideal weight before increasing your free weight exercises. That way you will be able to see the definition the weights give you . One step at a time.

[Scratch]

Originally Posted by Alice

I'm a reasonably fit person who decided to "step up" my exercise level. Don't make the same mistake I just made a couple of weeks ago...don't overdue the impact exercise.

I joined a bootcamp class (which was excellent)...I did well during the cardio and hand weight segments...but the running just killed me. Thought it was a pulled ligament...ended up a stress fracture. I've been on crutches for two weeks and am encouraged to go to therapy...which I don't feel I need....but will probably go since I'm a "good girl"...

We ran on pavement which is terrible unless you are really in top condition and your muscles can absorb most of the shock.

I was thrilled I was running...but the excitement gave way to pain!

Take it easy on your joints and you will be able to exercise much longer!

Aye yi yi. Yeah, you got to be careful with some of this stuff. You may want to review your dietary habits about calcium intake, getting a stress fracture inside of 2 weeks of high impact is pretty quick -- did the doctor who diagnosed you raise any thoughts about getting a bone density scan?

Everyone's different of course, but for many I'd recommend going with easy paced impact cardio for the first year to help build the necessary bone strength. It's also good for getting the tendons and ligaments ready to handle the stress. Muscle adapts fairly quickly, but the bones and connective tissues take much longer.

[Alice]

Hi Scratch...yes, I just had a bone density test a few months ago and everything looked normal. I'm also a milk drinker and have been told I don't need supplements until menopause.

I have always had a hard time running...it must be my short legs!

[Subby]

Ow Alice, take care of yourself I heed your story very carefully. Thanks for the suggestions guys, I'm modifying as I go and trying to add in a little core strength training somewhere... I'll work it out.

Shiftzor, I''ll try after meal with the bolus down as you suggest, I've been burnt by repeated lows but I think part of the the key also lies in getting my basal right down as well in time. On the pump, my basal has a three-four hour lag, so I gotta get that happening sooner than I have been...

Happy to report that after just a few sessions of those stupidly low weight exercises, I feel my shoulder strengthening a little and my neck feel more limber in general. Now I just have to Keep. Not. Overdoing. It. I am thinking of tattoing that to my head It is a shame I can't program my pump with a custom message to come up every few hours.

Just a question to the weight users, should the 3 exercises I am lightly doing for the arm give a general purpose strengthening for general use? Something else I should do as well or instead? Lifting things overhead is probably the worst for me... I don't know if that means I should do very light exercise overhead, or conversely avoid it.

[Scratch]

Originally Posted by Subby

Just a question to the weight users, should the 3 exercises I am lightly doing for the arm give a general purpose strengthening for general use? Something else I should do as well or instead? Lifting things overhead is probably the worst for me... I don't know if that means I should do very light exercise overhead, or conversely avoid it.

About the only way to get stronger at a weakness is to work at it. Pushing weight up above your head is a lot about the deltoids, the shoulder muscles -- that's one of the jobs of the deltoids, to be able to push things up over your head.

Light and heavy are relative terms. To make your deltoids stronger, you need to lift weights that'll make them work and put stress on them. The military press with a barbell is good for the deltoids, along with the triceps and the act of stabilizing the weight overhead also will work the core muscles because you'll need to keep your midsection stable to make the lift.

I say light and heavy are relative because they are to each person. If you have any concerns that a weight you're lifting is too light compared to somebody else, you're not thinking about it right. You need to be working at the weight which will promote strength development for you.

An easy kind of way for you to find this with something like the military press would be doing something like this even -- going with a weekly schedule of 3x a week, have your first military presses just use an empty barbell, and use a 5x5 protocol. 5x5 means 5 sets of 5 reps and give yourself a couple of minutes between each set. If that first session goes super easy, add 10 lbs to the bar for the next workout. Again, if super easy, add 10 lbs to the bar. Once you hit a weight that in the later sets begins to feel like some work, then drop down to adding only 5 lbs to the next workout session.

Using that, within a couple of weeks you'll likely have reached your training weight, in the process you'll have gotten to practice getting good form on the military press. For a good instructioin video about form with the military press, see the following at youtube --

YouTube - Overhead Press coach Mark Rippetoe

It's very important to practice good form with your lifts.

[Ronin]

Hi Subby!

I admit that I don't know a lot about Chronic Fatigue Syndrome (CFS) beyond a friend who has it, recovered and over-did and relapsed.

About exercise, the one thing that I find most important is that you like to the point of enjoyment, the exercise that you do. The program that will work for you is the one you will do willingly, not grudgingly or because "it's good for me."

Of course, you will have to moderate your levels so that you do not relapse on the CFS.

[Subby]

Thanks a lot for the wisdom and advice Scratch - I will incorporate the military press and take heed of the methods you suggest.

Ronin, agreed completely on the enjoyment factor RIght now I'm just enjoying a sense of progress but I have it firmly in mind to make sure it doesn't get grim. Also your friend's relapse... I have heard of CFS sufferers doing that, it is the last thing Iwant - I suspect I've relapsed a little a number of times pushing myself. No more of that!