Help dealing with chronic fatigue

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  • #54641
    JeremyG
    Participant

    Hello all, I’m hoping to gain some insight into what has been a frustrating year for me. Sorry for such a long post; I’m trying to be thorough.

    I am a wildland firefighter, which means I start my consistent training after fire season is over in the fall (usually starting at 6-7 hours a week) and my fitness peaks in early summer with 12-13 hours a week. I’ve been training using the TFTNA mountaineering model for 4 or 5 years now with most of my aerobic activity consisting of backcountry skiing and running. I usually use a heart rate monitor and keep a journal of my activity.

    Starting around March, 2020, I started feeling off. I didn’t have my usual energy and didn’t have motivation to exercise. I was missing workouts or stopping workouts early because I felt spent. I basically felt like I was either dancing with overtraining or about to get sick. In the past when I’ve felt like this it’s usually right before I get a cold. I take a couple days off or more if needed, then slowly get back into the routine and all is well. However, I never could get back into the routine. I still had a decent base built up so I pushed through the summer but I couldn’t exercise like normal and was basically limping along. Most noticeably my HR was significantly higher (10-30 bpm) for a given activity and level of perceived exertion compared to previous efforts. I would run as slowly as possible and my HR would still be right at my AeT. I would end what should have been an easy run completely exhausted and feel that way for the rest of the day, or even multiple days. My level of fatigue during the day was as if I hadn’t slept the night before. I was basically wrecked.

    Fall 2020 I had some pretty bad sub-sternal chest pain and my work commitments lightened up, so I finally got a primary care doctor and started trying to figure out what was going on. Fast forward to the present and I’ve seen a cardiologist, infectious disease doc, hematologist, endocrinologist, rheumatologist, neurologist and sleep doctor and they all have given me a clean bill of health. I’ve had a bunch of bloodwork done and it’s all normal. The best they can come up with is some kind of post-viral chronic fatigue. I never had a positive COVID test, although I didn’t get tested until the middle of July. After basically not exercising at all for several months I’ve started to slowly try and start again, but it’s baby steps. It’s so easy to over do it and get exhausted for several days. It seems like anything over 2 or 3 miles at the slowest possible jog is too much. I can bike for an hour but I’m pushing the granny gear most of the time and it’s so easy to get my HR up crazy high.

    I’m not looking for a diagnosis here, but am hoping to gain some insight into how I can try and rebuild some fitness while dealing with chronic fatigue. It seems like some days I feel great and can perform ok, and some days even minimal activity is too much. It’s very frustrating and confusing. I tried to find a correlation between my activity and how I feel but it all seems so random. I understand I am very deconditioned, but even so it seems like my body isn’t responding to gentle exercise appropriately. Any ideas? Thanks in advance.

  • Participant
    Shashi on #54643

    Jeremy,

    I would recommend going through the posts related to Overtraining –
    https://uphillathlete.com/forums/topic-tag/overtraining/

    Scott has responded to similar questions in the past and you might find these discussions helpful.

    Also check out this article on Overtraining –

    Overtraining Syndrome: The Elephant in the Ultrarunning Room

    Participant
    JeremyG on #54659

    Shashi- Thanks for pointing me towards those posts and article. I had considered overtraining as the source of all this early on, but figured (perhaps naively?) that it wouldn’t last this long after some serious rest. Is it possible to still be dealing with OTS after all this time (7ish months of serious rest) ? I’ll admit that most of the symptoms line up. If I haven’t recovered yet, what are the odds I ever will? I didn’t ski at all last winter and it’s really hard to imagine a life without long runs, hikes and skis.

    Participant
    Shashi on #54660

    If I haven’t recovered yet, what are the odds I ever will?

    I don’t know. In this post, you can read about examples of severe cases of overtraining and how it has impacted them. Scott recommended “a very gradual introduction of aerobic base training.”

    Can you share what kind of exercises you are doing now? Are you doing short 20-30 min jog/runs?

    Moderator
    Thomas Summer, MD on #54665

    Hi Jeremy!

    Sorry to read about your struggles!

    As your docs came up with post-viral chronic fatigue: Have you been tested for COVID antibodies? This way you could find out if you had COVID.

    Chronic fatigue has always a big mental component. Ask yourself what stress factors you have in your life. Family? Job? Friends? Fears? … maybe you find something there. Anyway, I would recommend talking to a psychologist.

    For exercise: I’m a big fan of changing the routine completely. Do something different. Something playful. Shift away from endurance training. Maybe some ball games? Dancing? Climbing? Short but heavy strength training… walking in nature, without thinking about training…

    Do you meditate?

    I hope you find some suggestions useful!?

    take it easy! Everything will be fine:-)
    Thomas

    Participant
    JeremyG on #54685

    Thanks ya’ll, I appreciate the feedback. I did get a COVID antibody test over the winter with negative results. I currently am jogging at the slowest possible pace for 2-3 miles once a week and going for an easy bike ride once a week. I’m doing pilates twice a week along with pushups and pullups. I’m tolerating this training fine but am hesitant to do any more since I still don’t have any energy and my legs still feel very very fatigued.

    I’m trying to be patient and take the long view on this but if I’m seeing any improvement it’s on a glacial pace. Anyways, thanks again.

    Moderator
    Thomas Summer, MD on #54692

    Hi Jeremy!

    I think it shouldn’t be about training at the moment, but about doing something you really enjoy. Try something more playful!

    Participant
    SophieS on #69503

    It’s been a year so I hope you have found some answers and gains since when this was posted, but I wanted to weigh in as a fellow post-viral chronic fatigue patient. ME/CFS is a huge umbrella term, and there’s still so much that isn’t known about the underlying factors. What you’re describing is a common experience for our patient population. If you look up GET (graded exercise therapy) for ME/CFS recovery, you’ll see that there is a lot of discussion about the potential harm of too much physical activity during recovery. The new NICE guidelines recommend no GET at all. I personally found that I could do what you’re describing and keep my activity low (pilates has been great!), but I had to tune in to my body. The trick for me has been the pacing: not doing so much physical activity that it results in an energy crash, and taking time for recovery between sessions. And yes, shifting from “training” to things like walks, pilates, paddle-boarding, etc. Equine-assisted rehab was a big win! It’s worth noticing if your hr and bp is behaving normally, as dysautonomia is a common comorbidity. And shout out to you for figuring out how to take it slow: it takes a lot of mental toughness not to push too hard and play the long game.

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