Improving cardiovascular fitness with asthma?

[PeterPan]

I want to make a game plan to improve my cardiovascular fitness/endurance, but I need some help to think through the factors. Or is there a medical professional who would be the right person to talk this through with? I like my family practice doc and see him annually and he'd be good with any referrals.

Background-Used to lift and workout regularly, got stressed and bogged down with covid, have had pneumonia, RSV, flu, you name it too many times the last few years, and just generally don't see to be able to get back on track. I start to, then I get sick again, on antibiotics, and am knocked down again waiting to recover. Asthma is well controlled. Even before I started getting sick so much, I really was not a paragon of cardio stamina. I think (and can check but I'm pretty sure) I have fast twitch muscle fibers. I'm much more comfortable with things that are heavy/hard/brief rather than long. So I'm more comfortable with 30 minutes of cardio broken up by intervals of weight lifting than doing 30 minutes straight. 

Things I've done-I've been working on my iron levels, b1, etc. that get depleted with covid and other viruses. I haven't redone the labs but getting my iron up has helped with next day fatigue. I've been trying to some shorter things, like biking 10 minutes a day or doing this sprinting type pattern I saw in a youtube video (yes, feel free to laugh). So you take any exercise and do 2 minutes, then 20 seconds at max exertion, repeat that cycle till you've done 9 minutes total. That actually helped my ability to do things like go up stairs without being out of breath, etc. Before I tried that alternating approach, I did just a really basic warmup biking 5-7 minutes daily but increasing the tension to build muscle. This definitely helped with stamina.

Things that probably factor in

-thyroid levels-checked, appropriate

-inspiration amounts. I think this has gone down dramatically because of my last few recent rounds of infections. I'm wanting to learn about home use of an inspiratory device to see if that could help.

-weight. Elephant in the room, I'm attending to it, and obviously that's part of why I'm wanting to get my endurance on track, so I can do these things more comfortably. I'm also taking some steps with my diet. I don't think it's the whole issue.

-iron levels-Again, I'm working on it.

-breath awareness/regulation-I read Running on Air and use the principles. I think what I've got going on is beyond that. I've just had pneumonia, infections, etc. a lot at this point. If my insurance covered HBOT I'd go get more, sigh, as it's the bomb for breathing and healing.

-access-I have access to a stationary recumbent bike, treadmill, elliptical, and a gym if I want. There's a level track for walking and some gentle paths 5-10 minutes away. 

-inflammation-At this point EVERYTHING I try to do results in increased inflammation, body pain, and frankly tendency to injury. And I'm not joking about the everything. If I play ukelele, my wrist and fingers hurt. If I walk, all kinds of tendons in my feet hurt. (I went to the doctor, they put me in a boot for one foot and not the other but it all just comes back, multiple spots.) Shoulders, lower back, etc. It feels like it's just moving up my body and happening more and more. It's sort of a (whine whine) pit, because every time I try anything, something goes wrong. If I did the 100% exertion of that 2 minute/20 second for 9 minutes thing, it sets off pain (from the inflammation/tendinitis) that varies with what machine I was on or what the activity I was doing. Even the treadmill can hurt me. I can usually walk on level ground without a problem but I don't know why that's different from the treadmill.

-gardening is out. Don't even say it. I end up with rashes just book going near the landscaping, lol.

-Running is out. Doctor says I must not and at this point with the inflammation/tendinitis I don't think I could. That ship sailed about 3-4 years ago as the pain started. I tried thick Hokas but it has just gotten worse. 

-swimming is out. Way too complex for my level of motor planning ability. 

So sorry that was like a book.  What am I missing here? What is the most logical way to get this on track? I'm going to get sick again, though I have super thorough medical care now that nabs it right away. It used to be that I'd end up down for 3 months. Now it's a week, very mild, and some basic recovery time (1-2 weeks). 

I think I need:

-inspiratory therapy (self or professional). I could make new data to see if my O2 is going down with exertion. I don't know if it is or not.

-some sensible plan that avoids injury but has me moving enough in a way that is evidence based to improve cardiovascular efficiency. 

-weight bearing activity resumed (because it makes me feel good, is good for my bones, etc.)

When people can walk 10 flights of stairs without being out of breath (I'd settle for 7), usually they say they're runners. So what else can I do if 10 flights is my goal? I also want to be able to go on gentle hikes of 2 hours (go see a glacier, up a sensible hill, etc.) without being the last one or back with the 80 year olds, which is what happens to me.

So what can I do on the exercise or breathing front to get things back on track? What is my missing piece here? What is currently evidence based for improving stamina? I know the saying is either decrease the load or improve the motor. I'm trying to figure out how to improve the motor, lol.

[Arcadia]

25 minutes ago, PeterPan said:

When people can walk 10 flights of stairs without being out of breath (I'd settle for 7), usually they say they're runners. So what else can I do if 10 flights is my goal? I also want to be able to go on gentle hikes of 2 hours (go see a glacier, up a sensible hill, etc.) without being the last one or back with the 80 year olds, which is what happens to me.

For me it’s swimming but that’s not an option for you. Walking flights of stairs can be trained. I used to lived on the 24th floor and had to use the stairs every time there was a power outage or elevator breakdown. Then I lived on the 10th floor and my stair climbing stamina declined to that many flights of stairs. Now I live on the 3rd floor and try to use the stairs instead of the elevators. Your description of hiking seems to be more on speed than just endurance. I can hike longer than my teens but they can hike faster and then need more rest stops. Have you tried a full height stepper machine at the gym? Those are good for improving stair climbing stamina and speed. 
e.g. 

[wathe]

Weight-bearing low-impact outdoor exercise: Nordic walking.   If you can walk, then you can do this.   The technique engages arms and core, and unloads lower limb joints.   You can vary the intensity as appropriate.  There are loads of how-to videos on youtube.

I don't use special nordic walking poles; I use inexpensive adjustable trekking poles from costco.  They come with an accessory pack that includes rubber road tips.  They work very well.

Quite a few public libraries around here have pole sets available for loan.  Maybe yours might?

[PeterPan]

17 minutes ago, Arcadia said:

Your description of hiking seems to be more on speed than just endurance. I can hike longer than my teens but they can hike faster and then need more rest stops. Have you tried a full height stepper machine at the gym? Those are good for improving stair climbing stamina and speed. 

I hadn't thought about speed! You're right, something is going on because my whole system has been slowing down. It happened after one of my concussions pretty dramatically, and I don't know if it's connected or must my age or what. Not like I'm antique, lol, but I'm no longer 20 either. I just seem to move at turtle speed these days for EVERYTHING. 

Yes, you're right the gym has one of those stair climbing machines. That makes sense that working it directly might be the ticket. 24 flights!! Wow, that would be enough, lol. 

[PeterPan]

1 minute ago, wathe said:

Weight-bearing low-impact outdoor exercise: Nordic walking.   If you can walk, then you can do this.   The technique engages arms and core, and unloads lower limb joints.   You can vary the intensity as appropriate.  There are loads of how-to videos on youtube.

I don't use special nordic walking poles; I use inexpensive adjustable trekking poles from costco.  They come with an accessory pack that includes rubber road tips.  They work very well.

Quite a few public libraries around here have pole sets available for loan.  Maybe yours might?

That could be a winner! Yes, that fits the parameters of needing to engage more while not doing anything so extreme that it sets off the tendinitis and hurts me. Poles I can make happen, and it uses trails and paths I have nearby. And it replicates motion I want for some travel goals, so that's especially good! And it's weight bearing to boot? Super good. I still haven't made that dexa scan happen and my doctor blew me off, saying I was too young, not past menopause, not sure what his logic was. 

Thank you, this definitely looks like a potential winner, something I can do.

[PeterPan]

5 minutes ago, wathe said:

Weight-bearing low-impact outdoor exercise: Nordic walking.   

How many days a week are appropriate for this? Is there a minimum necessary?

[PeterPan]

7 minutes ago, wathe said:

The technique engages arms and core, and unloads lower limb joints.  

I found this on the wikipedia link "The range of arm movement regulates the length of the stride. Restricted arm movements will mean a natural restricted pelvic motion and stride length. The longer the pole thrust, the longer the stride and more powerful the swing of the pelvis and upper torso."

My stride tends to be short, and I had no clue arm movement was affecting that or could help improve it. I did PT for my walking after they put me in a boot, and the PT wanted my stride to lengthen out but we couldn't get it all done. So if this nordic walking will lengthen my stride a bit, that could be good. Nuts, it might be part of why I wear out, because I just flat take more steps than other people.  

[Arcadia]

2 minutes ago, PeterPan said:

I still haven't made that dexa scan happen and my doctor blew me off, saying I was too young, not past menopause, not sure what his logic was.

For dexa scan, my insurance would pay for people who had chemotherapy or people over 50 who have family history of osteoporosis. So it could be that your doctor knows insurance would decline paying. 

[prairiewindmomma]

When I have had to build back, I start with just regular walking.  How is your regular walking endurance?  Can you walk 3-5 miles without getting winded or wiped out the next day?  Can you check your peak flow now and see where you land on the height/weight chart? Are you average or below average?  If you take your peak flow and then take albuterol and check again 15 minutes later are you seeing a significant boost?  If so, you might just want to start with simply taking your inhaler before you exercise, and then go walking.  See if you can gradually bump your speed or distance.  I let my apple watch set my goals for the week, and go off of that.  Once you are comfortably walking briskly for a few miles every day, then I'd step up into nordic walking or using the rowing machine at the gym.  I suspect that the rowing machine might provide some sensory input you enjoy.

[prairiewindmomma]

For your tendinitis, are you stretching appropriately and wearing good shoes?  My tendinitis tends to flare when my hamstrings are tight or when I don't have appropriate arch support in my shoes.  I'm prone to the things you mention--but if I remember to stretch and replace my shoes every 500 miles or so, I'm good to go, generally.  Your allover flares are kind of fibromyalgia-y sounding.  I have them too. The key to managing overall fatigue for me is to keep moving, but at a lower impact level.  I can't do high intensity stuff every day without consequences.  I can go low and slow like a turtle, but keep on going.

[PeterPan]

Just now, Arcadia said:

For dexa scan, my insurance would pay for people who had chemotherapy or people over 50 who have family history of osteoporosis. So it could be that your doctor knows insurance would decline paying. 

Yeah, that's pretty much it. I'm creeping closer to 50 but not quite there. It wasn't that $$ so I should just get it done when we have some money in the HSA. If 50 is the magic number, it won't be that long. That's part of this whole get my walking better while I can thing, because I want to do something marvelous to commemorate turning 50, haha. No really I am taking the trip early (if I book it) because I'm not sure I can keep moving the way I want past 50 the way this inflammation keeps increasing. 

2 minutes ago, prairiewindmomma said:

rowing machine at the gym.  I suspect that the rowing machine might provide some sensory input you enjoy.

I used to like it a LOT, yes!! It's really hard on my back these days, sigh. But you're right, I used to do it as one of my 10 minutes of cardio things. I'd bike, do the elliptical, row, do the stair master, any of them for 10 minutes and do weights between. 

4 minutes ago, prairiewindmomma said:

When I have had to build back, I start with just regular walking.  How is your regular walking endurance?  Can you walk 3-5 miles without getting winded or wiped out the next day?  Can you check your peak flow now and see where you land on the height/weight chart? Are you average or below average?  If you take your peak flow and then take albuterol and check again 15 minutes later are you seeing a significant boost?

So I've been doing some trips where I've been able to walk quite a bit and I built it back up doing laps throughout the day. Yeah, I would say I can now do 3-5 miles without being wiped out the next day. I'm just slow. We did a bike tour in Washington DC last month and I made it through but was so tired/slow by the end. 

You're right, I can get out my peak flow meter and see where the numbers are. For a long time, I was kind of weird. Before I got my asthma under control, I had "normal" peak flow output per the charts. After I got my asthma under control, it almost DOUBLED. I have no clue but I must have unusually big lungs or something. But you're right, data is always the answer. I just got lazy with it because the asthma had been so under control. I always take my inhalers with me when I travel, but I use them maybe 3 times a year, nothing major anymore. But I'm obsessive about vit C, turmeric, cleaning, etc. So yeah, let me see my data. Maybe that's part of what is going on. 

9 minutes ago, prairiewindmomma said:

gradually bump your speed

When I try to walk faster, even brief distances, I have increased pain with the tendinitis. It's pretty bad, on a level that makes it uncomfortable to walk. That's why I'm trying to figure out some smarter, not harder things, because anything I do with bravado definitely backfires at this point. 

[prairiewindmomma]

How flexible are you? If you do yoga with Adrienne on YouTube, can you do most of what she does?  Can you touch your toes? Are heel raises comfortable? How is your wrist flexion--can you make the traditional "stop" sign with your hand and then do an ulnar deviation and then a radial deviation (flex right, flex left)  and also flex back towards your body without it being uncomfortable? Like, I'm wondering if you're really tight but you're not aware that you're really tight.

[PeterPan]

15 minutes ago, prairiewindmomma said:

fibromyalgia

Yup, I have LDN for it. I don't tolerate it all the time but I can take it in super low amounts for a while. I watched some of the videos but the lupus doctor lady on youtube and am trying to up my plants and watch to see how much animal proteins are correlating to the inflammation. When I was on steroids last it was the bomb, but obviously I can't do that all the time.

16 minutes ago, prairiewindmomma said:

 I can go low and slow like a turtle, but keep on going.

That's what I've been doing, but it's going to make some of my goals hard. I'm looking at a 2 week hiking/travel trip and I'd like to be middle of the pack. I'm willing to work but I just need to find ways that are smart that I can work without hurting myself. I think if I do the nordic walking SLOWLY, the arm movements could increase my stride, decreasing the strain on my ankles and feet. So it could be a super win if I can start it, as you say, in sort of turtle fashion. Or I could even try swinging my arms without the poles to see if that lengthens my stride. Less steps is less banging on the tendons, so lengthening the stride could be a big help. And it's sort of inverse of speed, because to go faster you usually kind of pump your arms close to your body. 

I think like you say I'm going to have to play around with it carefully. It will require some coordination to do walking poles while walking, haha, but I might be able to get it. I did dancing last month on a cruise and needed 3-4 times longer than everyone else to learn things. Even then the motor planning wasn't automatic, but I could at least do it. And I would SWEAT, oh I would sweat!! Nobody else looked like me, drenched and hair up like I had been digging ditches or something, lol. And that was just something mild like a rumba or cha cha in a beginner class, nothing fast or fancy at all. The dancing was actually really good for my feet, which is the opposite of what I expected.

22 minutes ago, prairiewindmomma said:

hamstrings

I've been waiting on stretching a bit. I was crossing a street in the city and went to fast and strained my calf. Like I said, everything is just falling apart on me, bit by bit! I literally heard/felt a pop and then had pain. I got through the trip but I've been coddling it for weeks, just resting and letting it heal. My achilles tendon was hurting on that leg and I thought I'd be genius and stretch, and nope that just made that strain spot hurt agin. 

Right now I'm tolerating normal walking in moderation. Not fast, not crazy.

25 minutes ago, prairiewindmomma said:

replace my shoes every 500 miles or so, I'm

I'm going to replace my Keens before my next trip. My Altra sneakers I need to see. My feet did some changing and the size changed. The store worker wanted me to move over to men's for the Altras and I didn't and I don't think they're quite right, meaning he was right. My Keens I bought after that, at a different store, and the clerk put me in men's which indeed give me just a bit more width and fit better. They're the bomb but like you're saying I'm close to wearing them out. At this point it's happening in spite of good shoes, sigh. 

[prairiewindmomma]

8 minutes ago, PeterPan said:

 

When I try to walk faster, even brief distances, I have increased pain with the tendinitis. It's pretty bad, on a level that makes it uncomfortable to walk. That's why I'm trying to figure out some smarter, not harder things, because anything I do with bravado definitely backfires at this point. 

Increasing your speed, increasing your stride length, greater ankle flexion all increase the load on your Achilles tendon. If this is true, squats and dead lifts and calf raises should also be terribly uncomfortable for you.  

How would you feel about deep water aerobics? I had to do this for a time.  I float out in a deep pool with a floater belt on, and do all of my exercise out there, non weight bearing. I don't have to be coordinated enough to swim. You can watch some videos of classes on youtube and see what you think.

[prairiewindmomma]

Keens tend to run narrow also.  I hike in Keens, but my shoe fitter makes me use slip in orthotics in them to get things right. They also add a bit of stiffness which seems to help my achilles tendonitis a lot. I have also been gradually shifting over to men's shoes.  My fascia in my mid foot has been giving up the ghost, and I've got some bones that are starting to deviate out a bit, so having a super wide toe box helps. Shoes for women tend to have a narrower toe box for some stupid reason, but if I go up to a women's wide, then I get heel slip.

[PeterPan]

6 minutes ago, prairiewindmomma said:

How flexible are you? If you do yoga with Adrienne on YouTube, can you do most of what she does?  Can you touch your toes? Are heel raises comfortable? How is your wrist flexion--can you make the traditional "stop" sign with your hand and then do an ulnar deviation and then a radial deviation (flex right, flex left)  and also flex back towards your body without it being uncomfortable? Like, I'm wondering if you're really tight but you're not aware that you're really tight.

I tend to be over flexible and the only reason I don't present as crazy low tone is because I continue to do enough weights (in between pneumonia bouts, haha) to keep it tamed. But that, as you know, results in oddball random tightness. I have the PT exercises for my back, for my feet, etc. Yes, the calf stretching helps the foot stuff, but I can't do that right now till this strain I got heals. And that's the bigger aggravation, that everything I do these days results in some new injury, new strain, new problem. It's like my whole body is fritzing. 

But yeah, I'm not circus/EDS level, but I'm pretty flexible. My dd is crazy loose, loosey goosey level loose. 

I did finally get some folinic acid to try and I can't remember why I'm not taking it now. I don't think I found the right dose. I don't know if it helps with that tone stuff or not. I have the heterozygous MTHFR defect but also COMT, so the folinic might be the right form. When I tried it last month I don't think I found the right dose because it was good for a while and then not good. I set it aside to fiddle with later. 

[PeterPan]

5 minutes ago, prairiewindmomma said:

If this is true, squats and dead lifts and calf raises should also be terribly uncomfortable for you.  

Bingo. All gone. And it's a crying shame because it made me feel AMAZING and was good for my weight, bones, everything. 

7 minutes ago, prairiewindmomma said:

How would you feel about deep water aerobics? I had to do this for a time.  I float out in a deep pool with a floater belt on, and do all of my exercise out there, non weight bearing. I don't have to be coordinated enough to swim. You can watch some videos of classes on youtube and see what you think.

I did it in high school. Not my favorite thing. Not terribly convenient either, but just generally not my preference. Maybe when I retire from homeschooling and have less on my plate, haha. Not that you don't, but just saying I'd have to have so much free time that it would be one more nifty thing to add rather than the high priority, preferred add.

[Arcadia]

11 minutes ago, PeterPan said:

. Or I could even try swinging my arms without the poles to see if that lengthens my stride. Less steps is less banging on the tendons, so lengthening the stride could be a big help. And it's sort of inverse of speed, because to go faster you usually kind of pump your arms close to your body. 

Brisk walking. I do tend to swing my arms and that propels me forward. 

[prairiewindmomma]

Ok, based on what you've shared, I'd: 1. Sort out the shoe situation, pronto.  Get two pairs of good shoes, swap between them. 2. Foam roll your calves and hamstrings, gently, daily. 3. Do the toe pointing flexion exercises. 4. Walk low and slow, stopping when you start to hurt. If you can only do a mile right now, do a mile. Very slowly ramp up.  Ice and elevate it when you get back from your walk.  5. Work on building back your stretching routine. I'm hyper mobile also, but I have to stretch my calves and hamstrings or I do get injured. It sounds like you may have had a small calf muscle rupture when you heard that pop.  Stretching  can be simple to start with. Use a theraband while seated and build your way back up to the other exercises.

[wathe]

I try for 3 days a week, because that's what fits into my work-life-family balance.  I would like to do more. 

If you feel you need professional guidance to manage deconditioning, then a consult with a physiatrist or physiotherapist might be wise.

Otherwise, your local running store might run couch-5k walking programs that focus on building fitness.  My local outdoor shop also runs occasional nordic walking clinics. 

[TechWife]

I would start with a visit to a pulmonologist and then ask for a referral to an exercise physiologist and possibly a registered dietician. An exercise physiologist can help you set up an exercise program that will help you meet your goals. They are more educated and experienced with body systems than a trainer in a gym might be. 
Have you seen a rheumatologist about the inflammation?

Edited May 22 by TechWife

[kbutton]

3 hours ago, PeterPan said:

-inspiration amounts. I think this has gone down dramatically because of my last few recent rounds of infections. I'm wanting to learn about home use of an inspiratory device to see if that could help.

I haven’t read replies, but I will go back and look.

Get a pulmonologist on board to measure this with pulmonary function testing. You could have more going on.

Depending on how much trouble you have exercising, you could qualify for pulmonary rehab. It’s been life-changing for my kiddo, and the exercises incorporate short bursts of everything you want.

A referral to a cardiologist might be appropriate, and cardiac rehab is nearly identical to pulmonary rehab.

3 hours ago, PeterPan said:

swimming is out. Way too complex for my level of motor planning ability. 

Do you have to do normal strokes? As long as you don’t hurt yourself, something you make up that is gentle and comfy is good!!!

Have you considered a water-based class that is not swimming? They have PT in the water as well as more aerobic-style classes that (from my observation) don’t seem to require as much coordination and motor planning as regular aerobics (I am a flunky at regular aerobics due to coordination).

Yoga?

When I did PT, I needed a PT that would break things down into smaller, gentler component exercises because I would get hurt so easily, but when they did that, it was really helpful. The pulmonary rehab my son did was similar to the broken down gradual PT but without the bursts of cardio. ETA: pulmonary rehab HAS the cardio—typo.

Edited May 22 by kbutton

[kbutton]

Oh, if you end up with DIY options after seeking a pulmonologist, see if you can find old Lisa Westlake videos. Start with the pregnancy ones. Seriously. Then move on to harder ones if you outgrow those. She is an exercise physiologist, and her stuff doesn’t require extraordinary coordination. They are mostly on an exercise ball though if that matters.

[Terabith]

I’m having issues with walking myself, not from an out of breath problem but because of tendinitis.  I saw a podiatrist who suggested that I not use walking as my main form of exercise like I did during the pandemic.  Normal life walking is fine, especially if I’m wearing shoes, but my feet really do hurt when I walk a ton.  It’s not terrible but not ideal.  I do deep water aerobics 2-3 days a week, lift weights (aim for three times a week), and swim laps another 2-3 days a week. It helps my trapezium that hurts if I slack.  If I do too much, though, my knees start to hurt, so swimming more than 3-4 days a week or more than a 75 minutes or so isn’t ideal there.  
 

I think we’re the same age, and it really is daunting.  I can walk a long time, but yeah, ten flights of stairs continuously would be rough.  We did close to that on one of my daughter’s college visits, and I was definitely huffing and puffing but definitely in better shape than some of the kids, which was a bit heartening.  
 

You might take a look at DDPYoga.  I did it last summer, and it’s solid.  It might be your jam.  I bailed because I felt like I was getting more benefit from swimming and weights, but I really did like it.  
 

Why are you getting covid and pneumonia so often though?  That would concern me that your immune system is compromised or something.  

[kbutton]

1 hour ago, PeterPan said:

I did dancing last month on a cruise and needed 3-4 times longer than everyone else to learn things. Even then the motor planning wasn't automatic, but I could at least do it. And I would SWEAT, oh I would sweat!! Nobody else looked like me, drenched and hair up like I had been digging ditches or something, lol. And that was just something mild like a rumba or cha cha in a beginner class, nothing fast or fancy at all. The dancing was actually really good for my feet, which is the opposite of what I expected.

Someone in my family is double-jointed head to toe, has RA and fibromyalgia, and thrives on ballroom dancing. It keeps her pain free and active.

1 hour ago, PeterPan said:

And that's the bigger aggravation, that everything I do these days results in some new injury, new strain, new problem. It's like my whole body is fritzing. 

You may have some damage from not knowing how to move your hypermobile body when you were younger. I am mildly hypermobile, and I definitely have things that hurt from not knowing I should do things differently. My stride length is a casualty of this—I walked crazy fast with long strides when I was younger, and I had no idea it was possible because I was constantly hyperextending my knees. Now I am paying.

1 hour ago, PeterPan said:

You're right, I can get out my peak flow meter and see where the numbers are. For a long time, I was kind of weird. Before I got my asthma under control, I had "normal" peak flow output per the charts. After I got my asthma under control, it almost DOUBLED. I have no clue but I must have unusually big lungs or something. But you're right, data is always the answer. I just got lazy with it because the asthma had been so under control. I always take my inhalers with me when I travel, but I use them maybe 3 times a year, nothing major anymore. But I'm obsessive about vit C, turmeric, cleaning, etc. So yeah, let me see my data. Maybe that's part of what is going on. 

You might not even have asthma. People with non-asthma breathing issues can be labeled as having asthma for years before being diagnosed correctly. Peak flow ended up being meaningless for me, and I need to find out what’s really wrong because it really doesn’t seem like asthma. It’s on my list after some genetics come back on my other kid—one of the likely things that could be going on with that one has a lung component in about 1/3 of patients, and they often get an asthma diagnosis before finding out it’s something else.

[happypamama]

I didn't read everything, so ignore this if I'm way off base, but with my exercise-induced asthma, my doctors have recommended using my albuterol inhaler before exercise. I am not big into exercising, mostly walking if that, but I do tend use the inhaler beforehand, and it does seem to cut down on wheezing for me. 

[PeterPan]

4 hours ago, TechWife said:

exercise physiologist

Is this a thing? I've been trying to figure out for several years now who I could see who would be helpful. There are PTs who move into the exercise world, but regular PTs, even though they have the knowledge, aren't allowed to for billing purposes. 

3 hours ago, happypamama said:

exercise-induced asthma,

You're right I can just make some data and see if that is a part. For a while it was but I thought I had it under control enough. I will make some data to check it.

4 hours ago, TechWife said:

a rheumatologist about the inflammation?

I need to get a bit more pushy with my doc when I see him next. It's been creeping up on me, sigh. 

4 hours ago, Terabith said:

suggested that I not use walking as my main form of exercise like I did during the pandemic.

Yeah, it's not that I'm not game, but like you say that everything I do backfires.

4 hours ago, Terabith said:

I do deep water aerobics 2-3 days a week, lift weights (aim for three times a week), and swim laps another 2-3 days a week. It helps my trapezium that hurts if I slack.  If I do too much, though, my knees start to hurt, so swimming more than 3-4 days a week or more than a 75 minutes or so isn’t ideal there.  

Ok, I'm laughing here because yes this is reality, lol. I can do something a bit, then too much is too much. And you're right I'm so b&w that I tend to do one thing ALL THE WAY. I hadn't thought about some moderation. I'll start thinking about the water thing. Maybe if I get it in my mind I'll do it. I'm not sure why it wasn't on my top radar. I like things that feel heavy and water doesn't. And something is wrong with my shoulder that makes certain movements in water extremely problematic. Doc thought it was tendinitis and gave me the referral for PT but I ran out of time to get started. I'm not totally convinced it's tendinitis only either, because I have exquisite pain with certain movements, just not the ones he tried. So that would mean going to the orthopedic first which is the reason I delayed trying the PT, sigh. 

Told you I have fallen into some kind of cess pit, lol. 

4 hours ago, Terabith said:

Why are you getting covid and pneumonia so often though?  That would concern me that your immune system is compromised or something.  

Some combo of a ridiculous amount of exposure and my immune system not being hot. I know how I got it this past time and it was so stupid. I had been dancing each day with this group and the one girl (I say girl, she was like 75) disappeared for several days. She reappears and I rush up i my enthusiasm to hug her, only to realize she had been sick with a "bad cold" sigh. Too late and that was all it took. And yeah, if you've got the magic immune system boost, I'm all ears, because it's literally that pathetically direct. I saw someone on youtube talking about NAD but I haven't had a chance to look into it. I got RSV at christmas after someone showed up at my house overly sick (grr) and gave it to my ds who gave it to me. It's pretty ridiculous at this point.

4 hours ago, Terabith said:

I was definitely huffing and puffing

The sprint workouts actually were really helping with this. Now as long as I go slow and steady I'm not out of breath. But I'm going to be a lot slower than someone 10-15 years older than me, lol. 

4 hours ago, Terabith said:

DDPYoga.

I found this workout with a thing online where you subscribe and use a step and bands. It was a good starting point for me and gave me good input, but then I got sick. I was also thinking too either/or, like do that a lot or do something else a lot. I think you're spot on that maybe I make some kind of rotation plan. I could do water aerobics one day a week, that stair workout one day a week, lift 3x a week, etc. Then I'd have some variety and not be doing so much on any one part. 

 

4 hours ago, TechWife said:

a visit to a pulmonologist

I had one and they were so bored with me, lol. I think if I were doing it again I'd go to a NP kind so they wouldn't be in such a rush, you're boring, you're not technical enough to interest me mode. The dude I saw was good for a scrip but not much else. I clearly bored him, lol.

Ok y'all thank you. I have a hit list to get started with here.

 

 

 

[TechWife]

4 hours ago, PeterPan said:

Is this a thing? I've been trying to figure out for several years now who I could see who would be helpful. There are PTs who move into the exercise world, but regular PTs, even though they have the knowledge, aren't allowed to for billing purposes. 

…

They are. In my area they work at gyms owned by health systems or do independent consulting. Gyms owned by health systems here usually have cardiac rehab and other rehab programs but are also open for memberships from the community. They do thorough evaluations and really help build a program that works for you. I’ve been to one that includes an initial evaluation & designing an exercise program when joining with an update every six months included in the price. We could add additional consults when needed/wanted. Otherwise it works like a regular gym with the exception that the people working the floor are exercise physiologists, available for questions, to address problems as they arise. It’s the best exercise environment I’ve ever been in. 

[Melissa in Australia]

Would bed exercises help? 

[scholastica]

18 hours ago, PeterPan said:

Yup, I have LDN for it. I don't tolerate it all the time but I can take it in super low amounts for a while. I watched some of the videos but the lupus doctor lady on youtube and am trying to up my plants and watch to see how much animal proteins are correlating to the inflammation. When I was on steroids last it was the bomb, but obviously I can't do that all the time.

That's what I've been doing, but it's going to make some of my goals hard. I'm looking at a 2 week hiking/travel trip and I'd like to be middle of the pack. I'm willing to work but I just need to find ways that are smart that I can work without hurting myself. I think if I do the nordic walking SLOWLY, the arm movements could increase my stride, decreasing the strain on my ankles and feet. So it could be a super win if I can start it, as you say, in sort of turtle fashion. Or I could even try swinging my arms without the poles to see if that lengthens my stride. Less steps is less banging on the tendons, so lengthening the stride could be a big help. And it's sort of inverse of speed, because to go faster you usually kind of pump your arms close to your body. 

I think like you say I'm going to have to play around with it carefully. It will require some coordination to do walking poles while walking, haha, but I might be able to get it. I did dancing last month on a cruise and needed 3-4 times longer than everyone else to learn things. Even then the motor planning wasn't automatic, but I could at least do it. And I would SWEAT, oh I would sweat!! Nobody else looked like me, drenched and hair up like I had been digging ditches or something, lol. And that was just something mild like a rumba or cha cha in a beginner class, nothing fast or fancy at all. The dancing was actually really good for my feet, which is the opposite of what I expected.

I've been waiting on stretching a bit. I was crossing a street in the city and went to fast and strained my calf. Like I said, everything is just falling apart on me, bit by bit! I literally heard/felt a pop and then had pain. I got through the trip but I've been coddling it for weeks, just resting and letting it heal. My achilles tendon was hurting on that leg and I thought I'd be genius and stretch, and nope that just made that strain spot hurt agin. 

Right now I'm tolerating normal walking in moderation. Not fast, not crazy.

I'm going to replace my Keens before my next trip. My Altra sneakers I need to see. My feet did some changing and the size changed. The store worker wanted me to move over to men's for the Altras and I didn't and I don't think they're quite right, meaning he was right. My Keens I bought after that, at a different store, and the clerk put me in men's which indeed give me just a bit more width and fit better. They're the bomb but like you're saying I'm close to wearing them out. At this point it's happening in spite of good shoes, sigh. 

If you heard and felt a pop, and were in lots of pain after, you need to get that checked out. That can be a tendon tearing off the bone. 

[PeterPan]

1 hour ago, scholastica said:

If you heard and felt a pop, and were in lots of pain after, you need to get that checked out. That can be a tendon tearing off the bone. 

I've had this happen in my hand, so I know what you mean. (told you I'm getting prone) I looked it up and the amount of pain correlated to something in the middle. It made me limp but I could still walk. It has been four weeks since the incident and the range of healing for what I think happened when I googled was 6-8. So I've been doing modest activity but nothing assertive at all. I suspect if they had gone in right away they would have put me in a boot, which might have been preferable in the long run as it would have helped the achilles issue too. I dno't know why I didn't, except well I've done the boot on my other foot and it's not fun. 

6 hours ago, Melissa in Australia said:

Would bed exercises help? 

That's an interesting term I hadn't heard before. Googling it let me to some intriguing things like butterfly situps that I hadn't seen before, thanks.

10 hours ago, TechWife said:

They are. In my area they work at gyms owned by health systems or do independent consulting. Gyms owned by health systems here usually have cardiac rehab and other rehab programs but are also open for memberships from the community. They do thorough evaluations and really help build a program that works for you. I’ve been to one that includes an initial evaluation & designing an exercise program when joining with an update every six months included in the price. We could add additional consults when needed/wanted. Otherwise it works like a regular gym with the exception that the people working the floor are exercise physiologists, available for questions, to address problems as they arise. It’s the best exercise environment I’ve ever been in. 

I did some googling and started looking through lists on a certification site. As you say, there seems to be a range of how these people are employed, from company gyms to rehab programs to research. Many of the certified physiologists in the big city near us used that certification as a springboard to other things and aren't even practicing in it. There were two levels of certification so I can look at the next level down. I just wasn't finding anything in a reasonable drive (under 40 minutes) that looked like the right fit. I'll keep looking though. Was this a service your insurance covered or were you private pay?

[PeterPan]

I was looking at some youtube videos out the breather device you can find on amazon, etc. For the singer version it said the instructions were to inhale QUICKLY and exhale QUICKLY to build strength. I'm playing with that using the amounts they specified (2 sets of 10 twice a day) without the breathing device as that's probably a better starting point for me. Those inspiratory muscles are very fatiguing when you work them! Just doing that a bit is getting me some of that feeling of being able to take a deeper breath I was looking for. 

Do hormonal changes of perimenopause affect tendons? I've sort of assumed that's factoring into being so prone the last year or two. I would say I'm in perimenopause (if I understand what it is). If there's something to combat those tendon changes, that might be smart. If I get my breathing better again and can be kind to my tendons, I'd be able to do things more consistently, lol. 

My body has become like whackamole, where you're whacking at this problem or that one and they keep popping up, lol. I may have to break down and see some practitioners for some of the things (shoulder, inflammation, etc.). What usually happens though is I go in, I don't describe much pain (because that's how I am), I don't say what they expect to hear on the motion tests (because that's how I am), and they get bored with me or finally do imaging and do something. It's tricky when you are complaining but can't tell them the things they expect to hear. It makes you look like a hypochondriac. And literally that's how it goes, with an orthopedic going "does it hurt when you do this movement" and I do it and he's thinking how can you do that, that should hurt... And I'm like well I don't *like* it (as in I feel something there, not sure what). So they do imaging and put me in a boot. It's vague and aggravating like that with ALL this stuff because that's how my body is. I don't describe things with the red flag words they expect to hear, so they don't know what to think. I asked my doc about my shoulder, he picked one motion, said nope not rotator cuff it's only tendinitis. Sorry, but there's impingement just in a slightly different type of motion. 

That's part of how I get in these pickles with not treating things, because I'm not SURE and don't give them quite clear enough signals. Like on the leg, did I hear it or feel it? I don't know. It was so fast, but it was something and it was definite. But you're right, I haven't been taking care of myself. At this point on the leg I'm not sure the calf strain thing matters as it is slowly healing. The achilles thing is definitely affecting my motion.

So I've got two outstanding things that probably still need attention (shoulder and achilles) and the question of the overall connector/cause of the inflammation. And I've got arthritis probably this point in my wrist from the prior injury and occasional pain and slowness from multiple concussions. At this point my theory is each spinach and play hard before my body gives out. I just don't know what's left. I can go to doctors, but it's still happening. The system is reactive and will pay for PT but not anything proactive to keep you on track (physiologists). Or maybe my insurance will cover exercise physiologists? I think it would be easier for me to call them directly and ask. Then at least I'd have names on their list. That's what blows my mind, how reactive everything is rather than preventative. 

[Carol in Cal.]

Have you ever had Cipro?  It can cause tendon problems like that—it happened to me.  I would suggest avoiding it.

[PeterPan]

12 minutes ago, Carol in Cal. said:

Have you ever had Cipro?  It can cause tendon problems like that—it happened to me.  I would suggest avoiding it.

I haven't been on cipro, but you're right I've been on antibiotics way too much the past couple years. I hadn't even thought about the connection. I'll look into it, thanks.

[Carol in Cal.]

39 minutes ago, PeterPan said:

I haven't been on cipro, but you're right I've been on antibiotics way too much the past couple years. I hadn't even thought about the connection. I'll look into it, thanks.

Cipro specifically and the oxycin family of antibiotics in general are associated with tendon damage.  (Also with detached retinas.  Nasty stuff.). I have not heard of that with other antibiotic families though.

[kbutton]

2 hours ago, PeterPan said:

Do hormonal changes of perimenopause affect tendons? I've sort of assumed that's factoring into being so prone the last year or two. I would say I'm in perimenopause (if I understand what it is). If there's something to combat those tendon changes, that might be smart. If I get my breathing better again and can be kind to my tendons, I'd be able to do things more consistently, lol. 

I think I’ve been told hormones do affect them, but I don’t have chapter and verse on that.

2 hours ago, PeterPan said:

The system is reactive and will pay for PT but not anything proactive to keep you on track (physiologists). Or maybe my insurance will cover exercise physiologists? I think it would be easier for me to call them directly and ask. Then at least I'd have names on their list. That's what blows my mind, how reactive everything is rather than preventative. 

My PT was willing to give me maintenance exercises, but she was also astute about the hypermobility spectrum and was not the first PT I tried in the group.

1 hour ago, Carol in Cal. said:

Cipro specifically and the oxycin family of antibiotics in general are associated with tendon damage.  (Also with detached retinas.  Nasty stuff.). I have not heard of that with other antibiotic families though.

Yes, fluoroquinolones do this. They can also cause aortic changes, especially in older people and people prone to aneurysm formation. They are not good for people with the kinds of connective tissue disorders that cause aneurysms.

[TechWife]

4 hours ago, PeterPan said:

I've had this happen in my hand, so I know what you mean. (told you I'm getting prone) I looked it up and the amount of pain correlated to something in the middle. It made me limp but I could still walk. It has been four weeks since the incident and the range of healing for what I think happened when I googled was 6-8. So I've been doing modest activity but nothing assertive at all. I suspect if they had gone in right away they would have put me in a boot, which might have been preferable in the long run as it would have helped the achilles issue too. I dno't know why I didn't, except well I've done the boot on my other foot and it's not fun. 

That's an interesting term I hadn't heard before. Googling it let me to some intriguing things like butterfly situps that I hadn't seen before, thanks.

I did some googling and started looking through lists on a certification site. As you say, there seems to be a range of how these people are employed, from company gyms to rehab programs to research. Many of the certified physiologists in the big city near us used that certification as a springboard to other things and aren't even practicing in it. There were two levels of certification so I can look at the next level down. I just wasn't finding anything in a reasonable drive (under 40 minutes) that looked like the right fit. I'll keep looking though. Was this a service your insurance covered or were you private pay?

I was private pay. My husband's cardiac rehab program was covered by insurance.

 

[PeterPan]

Ok, I'm looking into this, and the antidote for the antibiotic-induced tendinitis is collagen plus therapy exercises. I like jello so this could be workable. I'm going to do some thinking about this achilles tendon. What's weird is it actually seems WORSE than it was before, even without injury. It makes me think the antibiotics, etc. are just slowly adding up to this damage and propensity. I just feel stupid going into an orthopedic and complaining about pain when I can't say when/why it happened. The weird part is the *lump* on it is gone. I had that knot/lump thing on both sides and the one side cleared up with the boot. The other was still present and now it's gone but I actually have MORE pain. That mystifies me. And if I massage it it hurts worse, not less. 

Yeah, I could have antibiotic induced jello deficiency disease. I would buy that.

1 hour ago, kbutton said:

aneurysm

I'm just gonna hold that thought for another day because I definitely don't like it.

[PeterPan]

5 minutes ago, TechWife said:

I was private pay. My husband's cardiac rehab program was covered by insurance.

 

That makes sense. Maybe what I'll do is make a move on the tendon thing. I had thought that maybe my heavy bed blankets were pushing my toes down at night, contributing to shortening, leading to some of the funky foot problems. I decreased the weight of my blankets radically and the remaining knot on my achilles is gone but the pain is worse. It's actually the worst thing affecting my walking right now, and it doesn't feel like a stretch and it feels better thing. That's why I'm thinking the antibiotics and steroids causing tendonitis makes more sense. Well I say that and while I was on the steroid I felt GREAT, oh my. No tendon pain then, haha, just woo woo walk walk. Then they were gone from my system and it was payback, rebound, revenge of the foot. 

I'm going to look into this more. I don't know if that tends to go away or might improve with jello. Sure would be a nice outcome if it's literally just a collagen issue. 

Well I'll work on it. I can eat jello while waiting for some appointments.

[kbutton]

1 hour ago, PeterPan said:

 

I'm just gonna hold that thought for another day because I definitely don't like it.

If you have no family history, you are probably low risk, but I think people need to know this generally.

For those at risk, I think the risk is also still time-limited.

 

[PeterPan]

I went ahead and made an orthopedic appointment for my foot. Ate jello last night too, made extra stiff. It actually made me feel better, which is weird when you think about it. I may pick up some collagen to make it easy as there's data that taking collagen alongside PT improves outcomes. We'll see what the doc does to me, therapy or a boot. And I'll try to keep doing the breathing exercises 1-2x a day to get my breathing stronger again. I'll wait on any exertion (stairs, etc.) till I've seen the doctor. 

Self care is moving up the priority list, sigh. Sometimes I amaze myself with how slow I am to make connections.