greenleo94

My next post in honor of Fibromyalgia Awareness Month will be about Exercise Intolerance.

What is Exercise Intolerance?

Exercise Intolerance is a term used to describe the worsening of symptoms after physical exertion. Many patients with FM will experience this as it is one of the major symptoms of the disorder. The worsening of symptoms could be as mild as general malaise, or as severe as a full blown flare up.

What causes Exercise Intolerance?

Unfortunately, Fibromyalgia is a condition not heavily researched. To this day, there are people in the medical community who simply don’t believe this condition exists. The exact cause of this is relatively unknown, but some studies suggest that that people with FM experience disturbances in peripheral micro circulation.

Per the NIH:

“The key point to note is that ischemia associated with a modest decline in tissue oxygen causes muscle fatigue. It has been shown that have been found low muscle levels of phosphates and abnormalities in microcirculation in fibromyalgia. Based on several novel data, production abnormalities of nitric oxide level might lead to symptoms of fatigue as a long term effect. There a vicious cycle concerning impairment of microcirculation in FM. The cycle is firstly initiated decrease of production of nitric oxide in the endothelial level by some trigger factors. Changed level of nitric oxide may cause microcirculation abnormalities in the tissue levels, muscular region. At the end of these phases, muscular fatigue and exercise intolerance may progressively develop in the FM. It is possible that this theory appears to provide a physiopathological explanation for decreased exercise capacity in patients with fibromyalgia.”

https://pubmed.ncbi.nlm.nih.gov/16412581/

What does this actually feel like?

It feels awful is what it feels like!!! I can be going about my usual physical activities, such as weeding, walking my dogs, etc, and suddenly my body feels weak, slightly numb, and absolutely exhausted. It’s like suddenly a switch was flipped in my body, and I need to stop whatever I’m doing and rest. It can make doing physical things very scary, and that anxiety used to prevent me from doing physical things at all. I’ve thrown myself into many full blown flares because I’ve overdone it on accident.

Just today I was trying to do my physical therapy, and could only do 15 minutes of my normal 30 minute routine. I had to stop, take some medication, and lie down for an hour. Thankfully, the nausea stopped, but I’m still feeling a little loopy and tired.

What is the treatment for Exercise Intolerance?

The treatment is exercise 😂 I know this may seem counterintuitive, but it’s important for people with FM to *slowly* build up their endurance through physical activity.

Per the Mayo Clinic:

“Appropriate exercises include low-impact aerobic activities, such as walking, swimming, biking and water aerobics. A physical therapist familiar with fibromyalgia can help you develop a home exercise program. This is especially important if you've become significantly deconditioned. A good goal is to work up to at least 30 minutes of aerobic exercise three times a week.

Strength training, also called resistance training, may be helpful but hasn't been as extensively researched. Resistance training is a type of exercise that may involve lifting weights, using resistance machines or using elastic resistance bands. Strengthening exercise also appears to reduce pain and improve quality of life and muscle strength.”

https://www.mayoclinic.org/…/fibromyalgia-and-…/art-20093376

The key point to takeaway from this is to build up endurance *slowly.* I deconditioned when I first developed this condition because I was basically bedridden for months. I started Physical Therapy about a year after my FM developed, and I’ve been in PT ever since. I’ve made fantastic progress, but it’s important to note that I’ll never be able to be as physically active as I once was. Progress is fantastic, but pacing is important to reduce flare ups and symptoms of exercise intolerance.

In honor of Fibromyalgia Awareness Month, I’ll be telling the story of how I developed the condition.

I used to be an intensely physical person. I’ve done 4 Ragnar Relay Races, used to work at a very physical job, etc. I was suffering from a lot of anxiety, though, so in the summer of 2016 I sought medication as a treatment.

At this point, I had already tried things like SSRI’s, and they didn’t work for me. They put me on Propranolol, a beta blocker that lowers blood pressure. In small doses, propranolol can reduce the physical symptoms of anxiety. I tried it, and it worked amazingly! I was excited, and started taking it more regularly.

One evening, I was sitting at home and this weird feeling hit me like a ton of bricks. I dissociated and became intensely suicidal out of literally nowhere. It was scary. We called the crisis line, and they urged us to go to the ER. They treated me like a psych patient, lied to me, and got me to sign away my right to refuse treatment.

I was admitted to a psychiatric ward for 3 days (4 days total including the ER). On top of being mentally unstable, I got intensely sick and feverish during this time. As if I wasn’t feeling bad enough, they held me against my will and forced me to cooperate with treatment. It was an intensely traumatic experience, both physically and mentally. The only good thing to come out of that is that they identified that I had a terrible, rare reaction to the propranolol that put me in this state.

After being released, I tried to return to life as I knew it before, but after a few weeks I started feeling run down. It wasn’t anything specific at first - it started off fairly mildly. Soon, though, I started getting INTENSE full body pain after exercising. I thought I was just overdoing it, but even light stretching would bring it on. Then the fatigue really set in. I wasn’t sleeping well no matter what I tried, and even after 9 hours of sleep I would wake up tired. If I exerted myself even slightly, like trying to go to my college classes, I would get a low grade fever and intense full body pain. Eventually, the pain never left. I was at a constant 7-8/10 daily.

After far too long suffering like that, I went to the doctor and was diagnosed with Fibromyalgia. They did the tender point exam, and ruled out any other cause of my pain.

This condition has completely taken over my life unlike any of my other health problems. It is my most disabling condition currently. I’m on a slew of medications to control the pain and sleep disturbances, but there’s nothing I can take for the fatigue. It still hits me like a ton of bricks, despite taking years to build up my endurance from scratch through intensive physical therapy.

It’s a hard condition to deal with, and very lonely. I’m often stuck at home unable to do things because I’m so goddamn fatigued. It’s more than just being tired. It’s like all your strength drains away. You get shaky, and even simple things like standing up are extremely difficult. Even your brain gets tired, so you can’t even do fun things at home like paint, read, etc. I equate it to not having eaten for a week (been there, done that - it’s the same feeling).

I really hope you’ve made it this far, and I hope you can start to understand and have compassion for people with this condition. It’s not just being tired. It’s not just being achy. It’s Fibromyalgia, and it’s a real bastard.

In honor of Fibromyalgia Awareness Month, my first post will be about what, exactly, this condition is.

Fibromyalgia (FM) is a condition that affects the Central Nervous System (CNS), which includes the brain and spinal cord. This makes FM a condition with a LOT of various symptoms, however, the two hallmarks of the condition are widespread pain and fatigue. Other symptoms include sleep disturbance, mood disturbances, numbness / tingling, headaches / migraines, painful menstrual cramps, problems with urination, and irritable bowel syndrome (IBS). There are many other symptoms that comprise this complex disorder due to it affecting the brain.

Fibromyalgia is brought on by trauma, either physical or mental -

Per the Mayo Clinic:

“In some cases, fibromyalgia symptoms begin shortly after a person has experienced a mentally or physically traumatic event, such as a car wreck. People who have post-traumatic stress disorder appear to be more likely to develop fibromyalgia, so your doctor may ask if you've experienced any traumatic events recently.”

https://www.mayoclinic.org/…/fibromyalgia-symp…/art-20045401

I can't believe I wrote 30 poems in 30 days! I don't like all of them, but I did it lol. I'm very proud of this accomplishment, especially considering that as of March 31st I hadn't written any poetry in years. I wanted to say thank you to all the poets who have supported me in this endeavor. Thank you to li0nfart , writingbubble, IntelligentZombie, EnzymeDevice , MozartsNemesis , Ceratomia , Yuukon , Medoriko , camelopardalisinblue and the rest of the wonderful members of NaPoWriMo 's Discord group server.

I also wanted to give a shoutout to my amazing mentor LadyLincoln! She is a wonderful writer, extremely supportive, and has helped me with romantic poetry so much.

Congratulations to the rest of the poets who have participated, even if you didn't complete all 30 poems. Writing anything is an accomplishment, and you should be proud of yourselves.

To wrap everything up, here are my 30 poems for the month of April:

I wanted to say thank you to SingingFlames for the Daily Deviation on my piece "I Shall Not Want." I am stunned and honored by the decision to feature this poem. I am so elated that someone loved one of my pieces this much!

I also wanted to say thank you to all of the people who fav'd my works due to this, and I'm very grateful to all the people who have watched me as a result. Thank you! I hope you continue to like my poetry and art.

Alex