Fit, Fat and Chronically Ill

posted in: chronic illness | 11
After Munch #11 © 2012 Jane Waterman
After Munch #11 © 2012 Jane Waterman

I wrote this post back on January 6, 2013. I suppose like anyone who is considered medically obese, I get nervous giving an audience ammunition. However, I’ve let that fear go enough to believe this needs to be said. This post began as a quiet plea – now it is a call to action to anyone who organizes gentle fitness classes for other people, especially the chronically ill.

I’ve struggled with obesity pretty much ever since I became ill, or rather, I did at first and then accepted that no matter how much I walked, cycled or did circuit training, I would remain fat, but fit. I was never going to be my slim adult self again. I’ve made my peace with that, especially at a time when pain and other symptoms mean I’m eating less than ever. Food preparation is something that doesn’t appeal when you feel like you’ve been kicked in the side – all day, all night.

Like most people with chronic illness, setting aside the chorus of non-ill people telling us we’d feel better if we exercised, I know that it does feel good to be fit (even if fat). It never cured my Sjogren’s syndrome, and my depression was never aided by the promised rush of endorphins, but I did appreciate the way I showed self-care through daily exercise.

Times change.

The day I wrote this post, I went to a gentle yoga class. It started off very well, but then morphed into a set of exercises that, while moderately gentle, concentrated all my weight on my knees and folded wrists for at least an hour of the class. It was very difficult, this ‘gentle yoga’ class, and at one point I found myself pushing down silent tears at the torture of a class that had promised a way back to fitness. At least, my tears were mostly silent until my nose decided to run, and then I had to contend with silent, sniffling, tears. I felt like a failure.

I spent the afternoon after that in awful pain. It was beyond contemplation doing anything else with my day, but immobilizing myself and trying not to hurt my screaming muscles or joints. Not only that, said joints were injured for 3 days afterwards. If I can’t get through a gentle yoga class without 3 days of pain, why would I go back? It’s a shame because in matters of fitness, I’m a fairly social animal. I need the encouragement of other people working alongside me to maintain the (well, if not enthusiasm) commitment to improve my fitness. If I can’t start with the bar at the bottom, than where do I start?

It felt like a great blow, as I’d had a long, happy association with yoga in the past. At one of my workplaces, between 1995 and 1999, we had a hatha yoga teacher/naturopath visit our workplace and lead us in an hour class at lunch. I was a regular attendee from the start, and fairly soon found myself as the de facto organizer, emailing the staff when it was time for yoga, and encouraging everyone to come along. Not bad for an introvert. I got a lot out of the practice, including some tips for my particular health issues, which at that time included an inordinate number of sinus and throat infections.

Times change.

Life sends us more challenges, more pain, and more complications with our illnesses. I moved to another country, and left behind that one day a week practice. I kept cycling, but by 2005 I was walking most of the time with a cane.

Of course, the chronically ill don’t think about doing more realistic, manageable classes because no-one, nowhere caters for obese people with autoimmune disease, fibromyalgia, depression and other challenges where the class must not only be low-impact, but the ‘workout’ part must not last more than 20 minutes. No one caters for that market, which is a shame, because there are quite a few of us out here.

I find it constantly confounding that the basic mechanics of the human body, especially the obese body, escapes even the most caring and intelligent teachers, except those who specialize in ‘heavyweight’ yoga (only to be found in the DVD section on Amazon, as far as I know). I presume we’re expected to exercise at home where no one can see us. Just as people don’t choose to have invisible illnesses, such as autoimmune diseases and mental health challenges, they don’t always choose to be obese.

There are a couple of reasons this happens. Of course, there is the component that the non-ill eagerly recognize, which is we do less because doing more means pain. We shrink back because going out is either exhausting, painful or terrifying with our challenges. We stay inside our comfort zones. In doing less, the only way we maintain weight is to eat less, as so many of us do.

The other reason that most people don’t consider (or consider a cop-out) is that the pharmaceuticals we rely on for control of our symptoms or pain (which is the case for many illnesses where there is no cure) almost always cause weight gain. This seems true of a lot of psychiatric medicines. This is my experience. In 1987, when I was 21, I weighed 119 pounds. A year later, I started on a triphasic birth control pill. In 1990, I weighed 152 pounds. That was the year I became chronically ill. In 1991, I started on the first of many psychiatric medications. I also sought out a doctor about recurrent sinus problems and difficulty breathing while swimming. He told me (not addressing my other complaints) that I needed to lose weight. At the time, I weighed 178 pounds. By 1995, after years of different (and often poorly prescribed) psychiatric medications I weighed  229 pounds. In 8 years, my adult weight had nearly doubled. I consulted an endocrinologist. His scientific wisdom? “It likely would have happened anyway”.

It’s now 2013, and I weigh 233 pounds. I know it’s not good, hence the gentle yoga class. My pain is worse than ever, and most yoga poses cause piercing pain that takes my breath away. That’s not conducive to any kind of exercise. Obviously the mass borne by my weight-bearing joints is high. It’s a factor I wish those slim, fit yoga teachers would keep in mind when they design a gentle class. I’m not asking for a class designed for marathon runners with ‘dodgy’ knees or circuit trainers who injured a muscle and have to take it easy for a week. I’m talking about classes for the chronically ill, who aside from the difficulty of finding someone to take us to a class if we can’t drive, can’t afford to be discouraged by the pain of exercise from balancing on our knees or wrists for too long.

There are many numbers bandied about, but a popular one is that a pound of weight equates to four pounds of stress on the knee joint. Therefore, it stands to reason that my 233 pound self is in deep trouble compared to my 119 pound self. That extra 114 pounds is putting 456 pounds of stress on each knee.

I put this out there in the hope that more progressive teachers will do the math the next time they ask someone in a gentle class to kneel continuously on a thin rubber mat for an hour. Help us to stay fit, even if we have to be fat.

Blessings,
Jane

11 Responses

  1. Lorna
    | Reply

    Great post! I would love to be able to participate in a "gentle" form of yoga. I've yet to find one. I try and ride my exercise bike, it was required after my knee replacement. I run out of energy fast! Walking is about the only exercise I can do and that is on the days I can stand upright, am not dizzy, weak, tired, in a flare etc. Maybe we should campaign online for a new wave of exercise? I can't even count how much weight I have gained and lost over the years due to medication, probably my body weight several times over. The whole thing is silly! I guess while we wait for someone to help, we can type? I wonder how many calories typing burns? *Hugs*

    • Jane Waterman
      | Reply

      I could only hope that typing would burn calories! Wheee! Like you, walking is the main option open to me. I have to accept that walking often means a required "shutdown" nap of 2-3 hours. It's so frustrating! I used to love cycling. Then I got dizziness issues with the Sjogren's. That's when I started using the cane a lot. It's improved quite a lot, but still, I don't know I'd risk my fragile self with a potential bike accident. I have been looking longingly at 3 wheel trikes, but I don't know if I'm just being impractical. I can't afford one anyway, but maybe I could loan or rent one sometime and see if it's truly out of reach. I'd gladly nap for a little bike ride again. :)

      I've never been one to get excited about exercise, but I do know it's important. It's just so difficult. I often see our local rec centre promote "new and exciting" ways to exercise. The latest is some South American dance inspired thing. But how about really slow and really gentle? It doesn't seem to happen. Even the seniors are expected to do these classes!

      Thanks for writing and making me feel not so alone in this experience! *hugs* <3

  2. anet37
    | Reply

    I'll send your post to my friend, the physiotherapist at The Arthritis Society. Maybe she'll be inspired.

    I do arthro-pilates and Lori, who teaches it, comes to my house every 3 weeks if neither of us is sick or operated on recently. She has PsA so some similar problems.

    That being said it still takes some recovery time though on the day of I feel great.. She's thinking of doing a dvd.

    • Jane Waterman
      | Reply

      Thanks, Annette – I'd be interested to hear her feedback. I'm sure part of my problem is being in a smallish town and lack of options. I also hate exercising alone. It's so boring. I will send it to my favourite yoga teacher too. <3

  3. Carmen Waterman (@Ca
    | Reply

    Jane this is a brilliant request for some much needed changes to programs available. I really enjoyed the yoga we attended for a while when I was given options to do some of the poses using a chair. It made all the difference in the world to my ability to participate and still feel part of the class.

    My challenge as you so well describe is that exercise of any sort exhausts me and even walking I need to rest later. It is so hard to be able to find time to do these things when you know you are going to have to add hours of rest afterwards before you are able to continue with your day or the things you so wish or need to do.

    I think it would be wonderful for all centres to recognize the need for specialized programs and adjustments or options for larger people and/or those with pain or illnesses that restrict the ability of the participants.

    Bravo for speaking up for so many of us.

    Carmen

    • Jane Waterman
      | Reply

      Thanks, Sweetie – I know you know these challenges all too well. I said to a good friend just now that what most people don't realize is that chronically ill people don't have 24 hour days. On a really good "day", we usually have about 6 hours without needing to rest or sleep. If you do an exercise that requires you to then sleep through half of your "day" that leaves 3 hours, which is nothing if you have to work a part-time job.

      I hope if nothing else it makes people think about the other end of the spectrum – not just the super fit end that is looking for the latest craze.

      <3 xxxx <3

  4. Skye
    | Reply

    Hi Jane,

    I agree with you regarding the yoga classes. I bought a yoga CD for beginners and cannot do the simplest movements due to too much pressure on my wrists for too long a time. Bending my ankles forward when doing a certain pose is also painful. I have adjusted all poses to suit my limitations. With doing it at home I feel comfortable doing it my way not do I feel embarrassed when unable to keep up. I have also purchased a Zumba CD that I absolutely love. (Better than yoga.) It has multiple levels and dance movements. I do it when I can, and for as long as I can breathe and my body lasts. Again no embarrassment. Also I can do it as many times a week as I am able or as little. No paying for expensive classes or driving long distances to get there on that ONCE a week program. We have a pool so in the summer months I get to exercise in the water everyday if and when I have the energy to walk there… I swim as many laps as my arms will tolerate and may do this a few times in one day. Then again in a couple of weeks. I can also just walk/march around the pool or do leg lifts with ease. Moving my arms up and down in the water also helps keep them limber.

    I know of your struggles with ways in which to lose weight. It has nothing to do with not liking who you are or in what size. It's all about why it won't shed the weight that suddenly appeared. As I mentioned regarding the information on cortisol levels – and hyperglycemia, it's the way the body processes food no matter how little you eat, and won't allow you to lose it. I eat less than my children and still have trouble losing weight too. I have lost 6 inches around my waist with mild exercising when I can. If I cut out all wheat it would work better. Really didn't think it was all that bad at first. What a shocker.

    Good luck with any progress. Love you and gentle ((hugs))

    Namaste'

    Skye

    • Jane Waterman
      | Reply

      Thanks for your sweet thoughts, Skye. I have always loved yoga, so it's disappointing not to be able to do it. As I said, there is also the motivating part with having company while exercising. I think I may have found my perfect class in a gentle stretching/meditation class. I hope I can keep going. You're right that going out, especially when you have kids like you, is very challenging with an illness. I have a qigong DVD that I love. I need to clear a spot in the floor and do some. I find qigong so graceful, no matter where my health is at. I don't think I've ever been a good dancer. I looked up Zumba a few weeks ago, and know I would look awful LOL.

      I'm hoping to get to the pool again soon. Hopefully as our grandkids grow up we will be doing more of that.

      I tried cutting out wheat for quite a long time (some of the "gluten-free" foods were so full of additives they made me sick). I think I would find it easier now. I'm eating more vegetables than ever, and really enjoying them, just because my body is craving simple, non-greasy, non-heavy things. I wish there was such a thing as an anti-cortisol shot. I see how my body holds on to things, even fluid.

      Thank you for listening and for sharing your experiences.

      Love and many hugs – Namaste!
      Jane

  5. Massiel Barros-Torning
    | Reply

    Just wanted to send you a BIG BIG hug and thank-you for explaining it so well. I’m also Fit, Fat and Chronically ill.

    It’s not an easy life, I’m plucking away at it. I found an exercise physiologist to help me last year. He asked me “do you want to die”? Cause up to now I had been doing all the wrong exercises for my conditions putting so much stress on my body. I was flat out recovering and fatigued.

    So, a change of pace, new exercises and I did start to loose a little weight. My confidence grew, I had hope. Life was going to give me a break.

    Then I got diagnosed with breast cancer.

    Two surgeries, 6 weeks radiation, horrific burns and just got home from skin infection. My life has changed again. I’m going to dig deep and find some way of pushing forward.

    Your story helped me feel less alone. Just had to drop you a line to tell you that.

    • Jane Waterman
      | Reply

      Wow, Massiel – what a journey you have been on! I am so sorry you had to deal with yet another challenge on top of the others – I’ve recently had insight into how devastating cancer treatments are, so I know this has been a big setback to you. But you know what? Reading what you wrote, I see a lot of hope behind your words. It’s the biggest motivating force we have. I know I have days when it just seems too much and I used to dread feeling anything toward myself – pity, even kindness! Now, I am learning to take those setbacks with much more kindness towards myself, which has so enriched my life. It doesn’t make all the challenges go away, but it feels so much better when we are not fighting ourselves as well. Give yourself one of those BIG BIG hugs, because you deserve it!

      Love Jane <3

  6. Fit DreamCatcher
    | Reply

    Jane~
    You’re so right! Practicing self love is essential to our well being, as is positivity. Many people just don’t understand how important mind set really is. Sounds like you’re doing much better than when you originally wrote that post. I’m so happy to hear you’re eating well. Nutrition is vital to our mental, physical, and emotional well-being.

    What a great post. I am proud to be fit and chronically I’ll! Your writing really resonated with me. Because not that long ago I was in your shoes! I’d like to share my story with you, if thats OK.
    You see, I have MS, fibro, sjogrens and a couple of other chronic illness. When I was diagnosed I spiraled out of control and into a dark depression. Years went by and I just kept getting sicker, more relapses, more pain, more pharmaceuticals. Until last July 2014 I was facing needing another surgery to repair what my obesity had done to the previous one, and I wanted to do anything to avoid a trip to the OR. That’s when a miracle happened. A friend reached out to me and told me again (I blew her off for a good 6 months ) about the 21 day fix and shakeology. I decided to give it a shot I figured there’s a money back guarantee , so why not? I eagerly awaited the arrival of what would be the most amazing thing I’d ever done for myself. I committed 110% and fell in love. By November I had lost about 40 lbs and felt amazing! That’s when disaster struck! I ended up spending a month in the hospital and after tons of steroids, a surgery, and almost dying… The inevitable happened, I gained all my weight back plus some. I was devastated. But, I wasn’t about to let this speed bump detail my journey. I wanted my happy and healthy back. I hopped right back in with my nutrition. And when cleared I began working out again. I may have been in a wheelchair, but I got it done! Here I am 6 months later, 60 lbs lighter, and a completely different person inside and out! My pain has decreased tremendously, as has my fatigue, and my depression is nonexistant. And I feel better now at 33 than I did at 23! I am a true believer in health and fitness because of this program. I’ve even become a coach, hoping to help others the way that my coach helped me.

    Xoxo keep up the great work!

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