Confused by Dr. re: postexertional fatigue

Discussion in 'Fibromyalgia Main Forum' started by justjanelle, Sep 23, 2006.

  1. justjanelle

    justjanelle New Member

    I've got FM. I've been seeing the same rheumy for 4 years and I find him generally helpful.

    The problem is that I've recently returned to work part-time (about 10 - 12 hours a week) and I've found my pain and fatigue levels to have skyrocketed.

    The dr. is OK with me increasing slightly on some of my meds for the pain, but says the reason I'm so fatigued now is not because of the work (teaching) but because I've just gotten out of shape and need to work on conditioning. Once my stamina is built back up again, apparently I'll stop needing the 12 - 15 hours sleep and 2 hour nap I need following each 3 - 4 hour shift. (I work no more than 3 afternoons a week.)

    He wants me to add physical therapy for cardio exercise several times a week, and also for me to try (ack! can't remember what it's called -- where you exercise in a pool).

    It just seems to me that if I'm this tired under my current schedule, adding all this additional exercise is just like asking for a crash.

    The doctor says I may feel worse for a few weeks, but then as I become better conditioned I'll start to feel better than ever.

    What do you think? Anyone ever been in this situation?

    Best wishes,
    Janelle
  2. Slayadragon

    Slayadragon New Member

    Well, "cardiovascular exercise" doesn't have to mean jogging for 30 minutes on a treadmill. For a lot of people, it means 10 jumps on that trampoline thing, or a slow 3-minute walk down the street, or 10 minutes doing just a few movements (not a whole strenuous half-hour class meant for well people) in a pool.

    I'd suggest doing a little bit of mild exercise and see how you feel. If it helps (or at least doesn't hurt), you can work up gradually. If it causes you to crash, then you certainly should do less.

    Your doctor may be right and the exercise may help you. (Well, he may be sort-of right....this idea that you're going to feel "better than ever" if you're taking on a bigger workload is just naive). You also can tell him honestly that you are working on conditioning at the level that you can, so that hopefully he'll be more willing to give you the meds you need.

    Not that I'm one to talk.....my own exercise is totally hit-or-miss, depending on how I'm feeling and if there's anything I need to be doing (like walking somewhere). Maybe it's better to adjust according to those circumstances, maybe not, I don't know.. I certainly should at least go back to doing yoga every day though. And maybe getting one of those trampoline rebounder things everyone seems to like so much. I hate few things more than adding clutter to my house, but perhaps that one item would be worth it.
    [This Message was Edited on 09/23/2006]
  3. lenasvn

    lenasvn New Member

    I suspect you have to listen to your body. Even the best doc can be wrong. You may not be able to work, only time will tell. I am no expert by any means, but if I felt the way you do, I would rest, rest, rest. Maybe you have CFS also? In that case, following his advice may make you worse. Just my 2 cents.

    Sometimes we are diagnosed with FM, only to find out we have CFS, vice versa, or how about both?
  4. butterfly8

    butterfly8 New Member

    If you can afford it financially, could you build up your stamina first and then return to work??????? Teaching is VERY draining, physically, emotionally, etc. and can be very stressful.

    Otherwise, only time will tell. You'll either build up stamina and be okay or you will crash. I really hope the former will happen but I tend to think the latter is more likely - but probably a lot depends on the understanding your doctor has of your specific condition.
  5. Marta608

    Marta608 Member

    What I think is that this doctor doesn't have FM.

    Marta
  6. Marta608

    Marta608 Member

    "Checking my records, I discovered that times of increased symptoms were often associated with days I did laundry, housecleaning, grocery shopping, cooking or some combination of those activities. All of them required that I be physically active while standing. This led me to state a rule for myself: “All physical activity is exercise.”

    Yes! This is beautiful, Hayley. Thank you for sharing it. You always seem to know what I need to read!

    Good advice here, Janelle.

    Marta
  7. justjanelle

    justjanelle New Member

    you've all given me good advice and helped me think through the things my doctor said.

    Based on this, I think I will start keeping a log of my current schedule including exercise/activity of all kinds, plus my sleep requirements and notations of pain and fatigue levels.

    I think I'll start this now and keep up with it for a couple of weeks at my current activity levels, and then call to get into the physical therapy he has told me to get. Then I'll have "before and after" documentation to help me see if I'm getting better or worse.

    It would be great if the physical therapy works, but if it doesn't at least I can show him I tried. My next apt. with him is in 2 months. I should know results by then.

    Thanks, everybody!

    Best wishes,
    Janelle