exercise


Friday Link Love for 03.05.10

It’s back!

At least for this week, anyway :)

I found a couple of interesting articles. The first one is particular compelling…

Here’s what I’ve got this week

Futurity.org: Probiotics prime immune system to fight – Scientists have long pondered the seeming contradiction that taking broad-spectrum antibiotics over an extended period of time can lead to severe secondary bacterial infections. Now researchers may have figured out why.

We suggest that if the immune system is on idle, and you treat someone with broad-spectrum antibiotics, then you turn the system off. The system is deprimed and will be less efficient at responding quickly to new infections.

NPR.org: How Revving Up Your Heart Rate, Even A Bit, Pays Off – I know a lot of people with Lyme struggle to exercise. They want to bike, run, hike or do whatever they did before getting sick. Sadly, they hit the wall quickly and are wiped out for days afterward.

This article and accompanying podcast show that even just a little bit of activity can be beneficial. According to the researchers involved, even as little as 72 minutes a week (that’s just over 10 minutes a day) can deliver an increase in your health.

I wrote an article many months ago about how I used targeted heart rate training to help me restart my running. Check it out here.

Oh, and a side benefit to the cardiovascular improvement is that exercise increases blood flow to the prefrontal cortex. This helps with cognition, attention and overall mood. Who couldn’t use some of that?

Lymenaide: Paining This May Lyme Green – May is Lyme Awareness Month! Who knew? The ladies of Lymenaide do and they are all over it.

They’re putting together a multichannel PSA campaign to help raise awareness about the disease. On their blog post they’ve listed several ways that you can help, but if you just want to give some cash, check this link. Good luck!!

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Friday Link Love for 01.22.10

Damn, it’s cold out!

Just got back from running with a group I’m coaching. This involves running just enough to work up a sweat, but then standing around on the side of the road watching their form. I was freezing!! Fortunately it’s beautiful out. A nice, crisp winter day.

So what’s up this week? Not much. Found a couple of interesting things for you.

Here’s what I’ve got this week

FitnessSpotlight: How to Set Up the Simple Home Gym Fitness Program – One of the sites I regularly follow, FitnessSpotlight, is in the middle of a 30-day challenge to better health. If I had known about it before the first day I might have tried it, but it all caught me by surprise and I missed the gun. It’s a rather arduous undertaking – a new life-changing thing every day for 30 days – but interesting none the less. Check out the introduction if you’re curious.

Anyway… yesterday’s post was about setting up a simple home gym. I know many people with Lyme are trying to get back into exercise and the suggestions in this article on equipment could be helpful. I know many people think they need a lot of gym equipment or gadgets, but the truth is all you really need is your body weight. If I didn’t use the sauna at my gym as much as I do for detoxing, I would cancel my membership.

Mark’s Daily Apple: Sweet and Salty Primal Trail Mix – I’m a big fan of Mark’s site and I just started reading his book. He has tasty recipes from time to time and this now one of my favorites. It’s hearty, healthy AND gluten-free. I made a batch this morning and it’s great.

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Recovery Update – January 2010

Time for an update

It’s been a long time since I’ve done any sort of recovery update, but seeing as it’s the New Year and all, I figured now would be a good time. Here’s what’s up.

Basically… same old, same old. That’s the main reason I haven’t felt the desire to post an update. There’s nothing new to say. I’m still foggy 24/7 with moderate cognitive issues, have light and diffused tingling in my hands and feet, feel a baseline tiredness that fluctuates from day to day, see floaters and have a short list of other minor things.

Treatment

All of the above is to be more or less expected, I suppose. I’ve been off abx – as well as any other treatment or supplements – for just short of six months. I detailed why in a previous post (I changed LLMDs).

For a short time I was on an herbal treatment that my new LLMD gave me – SpiroNil, a Teasel Root tincture, and Biotox Elim, its Berberine, Hydrastine and Artemisia annua-based partner. The two are designed to be a sort of a wrecking ball and cleanup crew combo. The SpiroNil blows up Borellia and the Biotox Elim mops it up and helps you clear the herx toxins.

Historically, I’ve not had a whole lot of success with herbals. I tried a variety tinctures from the Witch Doctor several months ago, but didn’t experience much of a herx or a real improvement. It was with this in mind that I recklessly jumped from a test dose of three drops a day after two days all the way up to nine drops. By the afternoon of the morning I jumped up I was in bed asleep, totally exhausted and with a rockin’ headache. Apparently this stuff actually works.

Trouble was, I was neck-deep in work. I had just picked up two really big projects – one that required a lot of travel to Washington DC – and couldn’t afford to be down for the count. I stopped the herbs right away.

But now I’m back on. My projects have either finished or fallen into a slow period and I can afford to take it easy and deal with some herxing. We’ve also been down in Florida for a two-week vacation over Christmas and New Years. That makes life a little easier too. Over the last eight days I’ve worked up to seven drops of both tinctures twice a day. I’m definitely herxing, but it’s all manageable… more or less.

Exercise

My recent running experiences have been rough. In December, I ran 87 miles and biked 34 (easy cross training days on the trainer), but it’s been hard to keep up with even this moderately reduced volume. There were days when I simply didn’t feel like going, but I did it anyway. I always know that two miles into it I’ll be glad I did, and for the most part this was true, but there were still times where the whole run sucked a lot. Legs feel heavy and slow; very tired. I try to write it off to the cold and having to wear tights, a windbreaker, hat, gloves and other motion-restricting gear, but I know there’s more to it.

Being down in Florida has been a little better. I’ve run 30 miles, swum dozens of laps in the pool and been to the gym 3 or 4 times to lift a little in the last eight days. I’ve also played (if you can call it that) a bunch of tennis. There have definitely been days where I over did it. Last Wednesday, 3 hours of tennis, a 5 mile run and 30 mins in the gym, did me in for a couple days, but I’m back to “normal” now.

What’s Next?

I have an appointment with my LLMD, Dr. M, on the 18th. The plan was to only do the SpiroNil and Biotox Elim until I got my new insurance sorted out and can get on some pharma treatments. I should be good to go with that by February so I’ll be discussing that with him.

The plan was to start shooting my ass up with some Bicillin. I’m so not into doing this, but it seems to be the next step since orals didn’t do much for me. People say it’s rather painful, but my LLMD said that I only have to shoot up two or three times a week. I suppose that’s better than painless pills three times a day everyday.

That’s all for now. Hope everyone is doing well.

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Training With Lyme Disease: Part 1 – Focus on today, train for tomorrow

Photo: Athlete Director Dave via Flickr.com

Photo: Athlete Director Dave via Flickr.com

This is the first in a short series of posts that I introduced a few weeks ago. These posts are essentially my tenets for training with Lyme. I’ve had to change many aspects of my approach to exercise in order to be able to maintain a consistent level of activity. These posts will detail what I do. I don’t imagine for a moment that they will help everyone, but if they help someone (hopefully you) that’s great.

Introduction

Before I get into it, let me say three things…

First, it should be plainly obvious that I’m not a doctor or even a health professional, but if you haven’t figured that out let me say it now, “I’m not a doctor of a even a health professional.” I coach a little and work in a running store. I know a lot about running and biking, but please… take what I say with a huge grain of salt, do your own research and talk to a real doctor before you make a major change in your routine.

Second, I write these from experience. They’re my thoughts based on my experimentation over the last year and a half of dealing with Lyme. I know some doctors say that exercise is bad for Lyme patients. Some says it’s good. I don’t care. My experience is that it’s been a key part of my recovery plan. That’s good enough for me. You decide for yourself. Or, if you don’t want to take my word on it, take Dr. Burrascano’s:

“Those with long-standing tick borne illnesses end up in poor physical condition. Even with successful treatment of the infections, chronic Lyme patients will not return to normal unless they pursue a formal program of therapeutic exercise…”

~ Dr. Burrascano

Lastly, when I say “exercise”, “training” or “activity” I’m basically talking about running, biking, elliptical or other similar cardio-type workout. I’ve never really done much yoga and my weight-training experience comes from reading my coach’s book. That said, if you’re not interested in these activities, or are unable to participate in them, I still think that you can benefit from reading this. You’ll just have to adapt what I’ve put together for your preferred activity.

The First Step, Acceptance

If you’ve been struggling with chronic Lyme, especially neuro-Lyme like I am, you’ve probably already become acutely aware of this — everything is different. Your body, your relationships, your entire life, your everything is not what it once was. This can change through treatment (so I hear), but while you’re in it, life is a whole new game whose rules you’re constantly relearning. It can take several month or years to get through it, but for now, life is different.

I think that for everybody, understanding and accepting this fact is an important first step in getting better. However, if you were any sort of athlete prior to becoming ill it’s a critical one. If you harbor even the slightest dream of returning to your previous form you need to come to terms with the fact that you’re past achievements are truly in the past. Dealing with this difficult and painful reality should be your top priority. I, for a long time, made it my last and I suffered for it.

Relearning Everything

After my initial illness, I was out of action for over three months. I barely ran or did any exercise at all. I thought that rest and relaxation would help me bounce back. Later, as I realized I wasn’t going to get better any time soon, I started to test the boundaries. I began to inch back in to running.

It didn’t go well. I would endeavor to run an easy three to five miles, but be wiped out for the rest of the day and into the next. Unaccustomed to my body failing me like this, my mind started to fail me as well. I began to be nagged by the idea that “this” could be my last run ever. The fear would chase me down the road and I would endure to make my final run a memorable one; something that I could look back on and feel good about as I sat on the couch watching The Biggest Loser. I’d run hard and bury myself. I was in an unsustainable cycle of self-destruction.

The epiphany

Long-time readers may remember — a year ago I wrote about a run I did during which I caught a falling leaf in my hand without breaking stride. Previous to this run I was struggling. Struggling to hold on to my pre-Lyme mindset of training to improve, race and excel at every level of competition. Fortunately, the touch of that leaf landing in my hand started an avalanche of thought on my passion for endurance sports. It forced me to look deep into myself and as I did, layer after layer slid away and the true nature of the mountain beneath was revealed.

For the first time in a very long time I was reminded why I so love endurance sports and what, at the end of the day, is really, really important for me in athletics. It’s not racing, or even competing, it’s the pure beauty of the effort. The question of how far or how fast is inconsequential when compared to the to the question of “can I go at all?” Just getting out the door, moving my body and experiencing life in motion is the gift that exercise gives me. I realized it was time to go back, way back to basics. Both in my mind and with my body.

What I do now

Freed from having fear as a motivator and the self destructive cycle of trying to maximize my every “last chance”, I’ve become a different athlete. When exercising now, I’m still focusing on today, but I’m no longer evaluating everything by my performance. Everything is done with tomorrow in mind.

I still strive to make every workout a quality one, but I never (okay, almost never) take it to a level of intensity or duration that threatens my being able to function on a day-to-day basis. Being released from the pressures of performance and improvement allows me to manage things in a more sensible manner. It frees me to run for myself instead of the watch. It allows me to bike for myself instead of the wheel of the other guy. It allows me help my body to become healthy instead of punishing it because it isn’t.

New Perspectives In Action

As part of my new approach to training I created a series of guidelines to keep me on track. I would suggest that if you’re considering starting to exercise or you’re struggling with your current activities that you follow them.

1: Be conservative

When beginning any new activity, provide your body with at least one day of rest between sessions — even if you feel good on the day after. If you need more than three days, you did too much. Cut back and try again.

Sometimes it can be hard to tell how you’re doing. You may wake up and feel bad, but later feel better. Does that mean you’re recovered from your previous activity? One way to objectively observe whether you’re still recovering is through tracking your resting heart rate (RHR). This is easy and doesn’t require a heart rate monitor.

To do this, simply take your heart rate for 60 seconds every morning. Do it when you’re still in bed, before you move around, turn on the TV or wake up too much. Also, try to do it while laying on your back and not your side — the weight of your body and internal organs can cause your heart rate to fluctuate.

Write down the results for one week and then average the numbers together. This will give you your target resting heart rate (TRHR). Next, take your TRHR and add 3 beats in either direction to get your target resting heart rate zone (TRHRZ). For example, my TRHR is 49. So my TRHRZ is 46 to 52.

Now that you have your target and zone, continue to keep track of your heart rate each morning. On mornings that you fall outside of your zone (generally it will be too high), take the day off from exercise. After while, you should start to get a sense of how much is too much by comparing your RHR with your exercise schedule. This should aid you in finding a healthy balance of rest and activity.

2: Build slowly

Whether increasing duration or intensity, you should be careful.

First, as you build endurance (struggle less) and want to start increasing the duration (exercise longer), begin reducing the interval between sessions BEFORE you start increasing the duration or intensity of each session. If you want to do more, try doing two short activities on the same day instead of one longer one. This approach was very helpful in getting me back to running longer distances. I sometimes ran to work and back (two miles in each direction) instead of doing a single four–mile run. Other days, when coaching, I would run a slow mile to meet my groups, rest for 15-20 minutes while we talked and then run three or four miles and then rest again for another 15 minutes before I did another slow mile home. I wasn’t able to run a full six miles, without over doing it, but with breaks in between I was able to increase

3: Go easy

Keep the intensity low and aerobic. I normally council new or beginning athletes to forgo the use of a heart rate monitor. It adds unneeded complexity to the activity and distracts from the experience. However, this is an instance where using a heart rate monitor can be advantageous. This is a good, cheap monitor if you’re going to get one.

To do proper HR zone training involves a lot of math and mental juggling that even pre-Lyme I had trouble keeping up with. There’s a pretty detailed article on it here, but do your self a favor and simply use the charts below. The left is for men, the right for women. They were created for non-Lymies so don’t get caught up with the “optimal heart rate” and “maximum heart rate” labels. They’re for the healthy. You’ll be one of them soon, but for now, the blue section is your optimal zone.

Max heart rates for men and women

Max heart rates for men and women

When starting out, keep your HR in the blue zone. It’s best if you can find a flat area of road or sidewalk since hills will tax you unnecessarily and drive your HR up. If it does start inching into the white, back off. Walk if you have to or sit down even, just don’t let it stay in the white zone.

Experiment with this level of effort and see how it goes. If you’re not exhausted afterward and your resting heart rate (see #1) is healthy in the morning, try upping the frequency (see #2). Then, if you’re able to do things more often, try upping the distance.

Only when you’re fully able to exercise  on a normal cycle of five days a week should you start experimenting with the white zone. To do this, incorporate some intervals of increased activity into one of your weekly workouts. For runners this could mean mixing in alternating hard and slow efforts into a run. For example, try a cycle of three minutes of running at your regular pace and then a throw in a minute of  hard effort. Be sure to watch how you feel for a day or two after to ensure you didn’t over do it.

Now Get Started

So there ya go… everything you need to begin. I know… easy for me to say, right? Yes, I’ve been lucky enough to be able to continue a pretty active lifestyle while fighting my illness. I realize and appreciate the fact that for some going 1/2 a mile is equivalent to my doing a 1/2 marathon. However… and this is really important… you need to do something.

There are countless studies which prove that exercise is highly beneficial in the battle of everything from a cold to cancer. Lyme is no exception.

So, you see, it’s important that you be active as much as you possibly can. You can do it. Just be realistic, honest with yourself and maintain the outlook that exercise, along with the many other things that you’re probably already doing, is helping your down the path to wellness. While today you might not able to get out and pound a new personal best or go farther than you have in the past, keep in mind that someday you’ll get there.

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The Price of a 5:23 Mile

Roger Bannister breaking the four-minute mile

Roger Bannister breaking the four-minute mile

My coach runs a series of spring and summer speed training sessions at the local track. I use to go religiously every Tuesday night and I credit these efforts with turning my running into Running. I learned so much about pacing, refining my stride and increasing my efficiency. Over two summers I probably cut a full minute off my mile time.

Sadly, last year I was resigned to standing on the infield and serving as an assistant coach for the season. I would actually run from my office in Manhattan to the track in Brooklyn with my work clothes in a backpack, but the full-tilt effort of a track workout was too much for me. I’d feel the power draining from my body with every lap. It just wasn’t worth it.

This year is a little different. With a better base of miles in my body from training for the Brooklyn 1/2 Marathon and more strength in my legs from the many miles of recent cycling, I decided a couple of weeks ago to show up at the track.

From bad to better to almost best

Week one was a disaster. The nagging hamstring issue that I acquired during the 1/2 marathon — an issue that I thought was long since healed — started stabbing me again. I could only do 2/3rds of the workout.

Week two was slightly better, but I could still feel weird fireworks shooting off in my legs. I ran the whole thing, but took it easy. I’m generally the fastest of the group, but I forced myself to run at the back of the frontrunners and pace off them.

This week was much better… in fact, it was too good. It was the last session of the spring class and, as he traditionally does, coach takes us all for ice cream after the workout. Of course, ice cream comes with a price — the distance medley relay. For the DMR we break up into two (or more) teams of four with each member of the team running either a 1200, 400, 800 or 1600 meter leg (in that order).

I always get stuck with the 1600, but didn’t mind because Shane, the guy on my team who was running the 400, was a track star in a previous life. He was going to easily hand my group a half a lap lead by the end of his leg. I also knew I was faster than Carl, the guy on the other team running the 1600, so it was going to be an easy win.

Wait! Where’s my agent?!

Sure enough, after Shane’s 400, we had a nice lead that the 800 meter runner on my team easily held. But then the two team captains, who happen to be evil sisters, decided on a mid-race trade. They swapped 1600 meter runners and I was suddenly on the losing team and looking at a 150 meter deficit at the tag. I knew I was faster than the Carl, but that much faster?! I really didn’t know.

What was once a comfortable and fun run was now a rabbit race. Knowing full well that this kind of effort was exactly what I should NOT be doing, I dug in and started to chase down Carl.

I ran a screaming 1:16 for my first 400 and 2:35 for the 800. Not exactly Olympic pace, but for me that’s excellent. For the 1200 I was so in the zone that I didn’t hear my split. All my high school track memories were flashing before my eyes while my eyes burned a hole in the back of Carl’s shirt. With 300 meters to go I tucked in behind him to regroup and catch my breath. Granted, we were still moving very quickly, but need the time to find my kick.

To the line

Coming out of the last turn I moved into lane two and pushed a little to see if Carl would respond. He did. I pushed again. Carl came with me. With about 20 meters to go we’re still side by side. Determined not to lose it after all the work I’d put in to catch him I summoned up another gear.

Like the afterburner on a military jet I dumped raw adrenaline into my muscle. I really though I was already running as fast as I could, but I found something more. I found that crazy strength people talk about after they’ve lifted a car off of somebody to save their life. I just said to myself, “Body! Do it!” and it did. I beat Carl by maybe two strides. Very close.

The price of victory

I ran a 5:23 mile. Carl ran a 5:48. And while I’m very happy to know that I can still run a mile within striking distance of my personal best (5:10), I’d trade that knowledge in a second to remove the way I feel today.

Part of the reason… actually, the main reason I didn’t want to run Carl down was that I’ve just come off a week’s break from antibiotics; from everything, in fact. No supplements, no vitamins, no herbs, no drugs of any kind. I simply decided a week ago (without talking to my LLMD) that I was going to take a break just to see what it felt like. Which, surprisingly, was fairly good. Not great, not recovered, but a string of three or four days the likes of which I only get maybe once a week when on everything.

One of my training with Lyme rules (which I’ll write about soon) is to not push it during a herx. I exercise to help sweat out the toxins, but I don’t stress out my body. Chasing down Carl clearly broke that rule. Even though I’d only been back on the drugs (rifampin, minocycline, azithromycin, diflucan) for two days I could really feel their effects. I was feeling tired, tingly, foggy, depressed and overly anxious.

Today it’s even worse. I barely slept last night and got up really early. By 10am I was back in bed for an hour-long nap. Felt much better after that, but I almost NEVER need to nap during the day.

I mustered the energy to take a very easy hour-long bike ride in the late afternoon. It actually improved my spirits, but left everything else more or less the same.I expect all this will all wane over the next couple of days as the herx clears. We’re also going to Cape Cod for an extended 4th of July. Being there will chill me out and give me a chance to rest a little.

Thanks for reading. Stay tuned for more…

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Training With Lyme Disease – Introduction

Me training for the Brooklyn 1/2 Marathon

Me training for the Brooklyn 1/2 Marathon

I get a lot of email from people asking me, “How do you do it? How do you continue to exercise with Lyme?” The honest truth is, I haven’t a clue. It’s a mystery to me how I can still not only compete, but continue to excel (to some extent) while dealing with Lyme. It’s all very confusing. Even my LLMD is stumped. He thinks Bartonella is my main issue, but I can tell he’s reaching for an answer.

But whatever… my Bart issues are not the point of this post. The point is how do I make it all work? Well, I’ll tell you…

This will be the first in a series of posts I’ll make covering my approach to exercising with Lyme. Of course, all of the usual disclaimers come with these posts — I’m not a doctor, everyone’s illness is different and what works for me might kill you (literally). Take what I say with an enormous grain of salt. Use what works for you and trash the rest.

My approach centers on the following concepts:

1: Focus on today, but train for tomorrow
Every workout should be a quality effort, but what you do today shouldn’t prevent you from doing it again tomorrow. Learn your boundaries. I’ll explain how I approach this.

2: Listen to your body
Right now, your brain doesn’t like your body. Your body’s keeping your brain from doing the things it wants. It’s going to tell you to flog your body for being insubordinate and that you can do more than you really can. Don’t listen. Your brain’s a liar. Your body will tell you the truth. I’ll explain how I’ve learned to shut out my brain and only listen to my body.

3: Support the effort
You body’s fighting a real battle inside. You need to support it. There are a couple of supplements that I think are key to exercise performance while dealing with Lyme.

4: Eat smart
If you’ve been dealing with Lyme for even a little while you’ve probably already cleaned up your diet to some extent. This is incredibly important, but there are a few additional things to pay attention to when working exercise into the mix. I’ll tell you what I do.

I’ll break down each of the above into separate posts for easier reading. They’ll be posted in the coming weeks so stay tuned. Now, however, I thought I’d sort of back up a bit and do quick recap of what’s happened to me over the last year and a half and explain how I’ve worked exercise back into my life.

A quick recap for those of you who just walked in

Before I was struck with Lyme back in September 2007 I was in the best shape of my life. I was a serious contender for placing in my age group in the races I was entering, I could run a mile faster than I could in high school and was running or biking more miles in a month than most people do in a year. However, after the disease struck, I could barely sit up for very long let alone swim, bike or run anywhere. I felt like I weighed 4,000 lbs. and hadn’t slept since I was born. The fatigue was crushing.

This frightening and debilitating acute phase lasted about eight days until a well meaning doctor put me on 10 days of penicillin for what he suspected was strep throat. At the time, a horrific sore throat was my greatest complaint. It felt like I had chugged a bottle of Drano to wash down the nails I had just swallowed. It was by far the worst sore throat of my life.

I improved greatly on the penicillin and we all assumed I was on the rebound, but for weeks and months I lingered in this limbo land of half health. On a good day I felt 75% of what I called baseline functioning. Meaning, take away all the exercise I was doing I was still only about 3/4ths of the way there. I was no longer in bed, but I wasn’t really gettin’ it done.

I felt like crap, I couldn’t sleep and was really starting to feel my life, as I had known it, slipping away. Previously to all this, when I felt bad or stressed, I’d go out for a run, meditate on my problems and come home feeling clear and focused. At this point, however, going for a run felt like a titanic chore and it left me feeling worse. I napped a lot.

After six infuriating months of doing the “are you my doctor?” polka I finally figured out that Lyme was my issue and got into treatment.

Where am I today?

Part of the treatment process, at least for me, is staying active. In fact, multiple doctors told me that I should stay as active as possible. I’m not exactly sure they knew what they were suggesting because, luckily for me, a lot is still possible — far more than all but a few Lymies I’ve met. Still, I’ve tried to take the spirit of what they were getting at and combine it with my training knowledge to develop a framework to work within.

So far this has worked well for me. I’ve managed to avoid suffering a relapse of my initial acute phase symptoms, keep from getting injured and find a balance of effort that keeps me from feeling too wiped out to do what I need to do every day.

I’m by no means cured or even significantly recovered from my post acute phase symptoms. My main complaints are moderate, but brutally consistent, neurological issues. Mostly brain fog, trouble concentrating, confusion and some tingling in my extremities. I also suffer from regular fatigue though it’s not exhausting. More like I was up all night… which some times I am. My sleep is often hit or miss. There are other symptoms too, but if these were to go away I’d feel “cured.”

So how do I do it?

It’s not easy and it’s often frightening. I really fear that out there for me is the workout that kicks me all the way to the back to square one. I also sometimes fear that I’ll never really beat this thing until I stop exerting myself and just take it easy. However, in my mind, not working out is as bad, of not worse, than than feeling crappy all the time. It’s because of this that I keep at it.

Thanks for reading. Stay tuned for more.

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