Month

February 2019

February 26, 2019

What You Can Change – Part One

So, two weeks ago I posted an article about making changes if you have an autoimmunity or an invisible illness. If you haven’t read it yet check it out here.

Maybe you’re ready to change, but where do you start? Over the next several weeks I will be releasing different things that you can start changing. Even small habit/lifestyle changes can make big impacts in your daily living. Below is our first topic to target:

Sleep Hygiene

Screen Time

Exposure to screens can disrupt the hormones that help regulate our sleep cycles. Melatonin, a major hormone responsible for preparing the body for sleep, is suppressed when exposed to screens. Consider limiting phones, tv, tablets, etc. before bed in order to improve sleep time and sleepiness at night. Even 30 minutes can make an impact, but 1-2 hours is more ideal.

Blue-Violet Light  

This is part of the reason that screens suppress melatonin. Maybe you can’t totally give up screens before bed. So what do you do? You can turn on night mode or the color/nighttime mode in order to reduce exposure to the blue-violet light. This turns on a reddish-orange tint that can help prepare your body for sleep.

Red Lights

This is the opposite of blue-violet light. White light contains all colors of light, including blue light. If you switch out one or two light bulbs to use at night that are pure red light it can do wonders for helping you feel sleepy before bed. They’re super cheap on Amazon and it’s a really easy adjustment. All you have to do is flip a switch before bed and let the light do the work.  

Room Temperature

We sleep better when the room is cold. Your body starts to recover if your body temperature drops. If you’re hot, your body won’t rest. Your body also won’t rest if you’re too cold. The goal would be to sleep with the air between 60-67 degrees Fahrenheit. If you wake up sweating at night that’s not good. So unless you have a medical condition that causes night sweats think about making this adjustment to get more restful sleep.

Light Exposure

I just spent 2 weeks in the Arctic Circle, in February, and it was very dark. This can have an affect on my hormones that influence my sleep (melatonin and cortisol being the two big players). Consider light alarm clocks or black out curtains in these situations. Our mood isn’t the only thing affected by light. You can also use eye masks while you sleep to block out light from street lamps or other lights that may disrupt your sleep.

White Noise

Fans, air humidifier, white noise machines, anything that can create a dull noise can allow you to block out any sounds that may keep you awake – a noisy roommate, a snoring partner, a dog barking, birds chirping, a garbage truck, etc. Fans and air humidifiers have other purposes as well (temperature and air quality). Another way to block out annoying sounds are a simple purchase of ear plugs! These can be uncomfortable or fall out though, but it is a simple adjustment and small storage.

Air Quality

I live in California. Sunny and beautiful and mostly clean air, except when we have fires. This year we had some of the most destructive fires in the history of the state. The smoke drifted hundreds of miles and clogged the entire Bay. This made breathing extremely difficult. Thankfully we had an air purifier and an air humidifier to help with this. Our world is polluted. So, especially if you live somewhere with poor air quality, consider investing in something that helps not only your sleep quality, but the overall quality of your health.

Head position

When was the last time you evaluated your pillow?The shape of our neck should dictate the shape of our pillows. Firm, soft, and everything in between should depend on what’s comfortable. I actually switch based off of the stress I’ve had that specific week. Stress, airway, and head posture can all be related (see more below) and that can affect how your neck feels and looks and thus the pillow that will help your body relax.

Airway

  1. Airway: This is a really lengthy topic. There are lots of ways that your airway may be limited. If your airway has any limitations (nasal, oral, etc.) then it will affect how much air you can inhale, how much air you can exhale, the strain you need in order to breathe, neck and head posture, etc. Believe it or not, forward head posture may not only be from staring at a screen. Forward head posture can actually be related to the development and structure of your airway. If you have a limited airway then it will affect how your breathe when you sleep and an avalanche of other factors that affect your biochemistry, hormonal function, and quality of sleep. This may not be something you can change though, but it is something worth being evaluated. If you wake up feeling tired and not rested even when you sleep 8+ hours a night you should probably see a sleep specialist who understands the airway. Other people to consider finding are oral maxillofacial surgeons, ENT’s, airway focused dentists, myofunctional therapists, and airway focused physical therapists.
  2. Sleep apnea: Directly related to airway. When you have sleep apnea you literally stop breathing and your body jolts you awake to resume breathing. This puts stress on your cardiovascular system and your central nervous system. Addressing this is very important for sleep quality. If you wake up tired every morning you may want to dive deeper in to this. Even mild sleep apnea can have a significant impact on your quality of sleep. If you wake up multiple times throughout the night due to a stressful event like not breathing it can put a lot of stress on the system that the body doesn’t recover from. Something to consider as well is that simply addressing sleep apnea with a CPAP machine may not be enough. Check out this research paper. You might need to address the actual airway itself to breathe better instead of forcing air in to your ribcage. CPAP machines help you feel more rested, but it’s just masking the symptoms, it’s still not solving the issue of your limited airway.
  3. Nasal breathing: This again is related to the structure of your airway. If you have a deviated septum, a narrow nasal cavity, a blocked nasal cavity, etc. this can lead to mouth breathing. Mouth breathing can lead to dehydration, change in blood pH, change in heart rate, and can expose you to more infections/allergies that make you sick and can actually continue this loop of difficulty in breathing.
  4. Snoring: this is a sign of sleep apnea and lack of nasal breathing. If you snore consider seeing a sleep specialist to be further evaluated. This may tell you a lot about the structure of your airway and if you need to see a specialist about possible interventions (myofunctional therapy, orthodontistry, or oral maxillofacial surgery).

Meditation and Breathing

This may directly impact how quickly you fall asleep and the quality of sleep that you get. Getting your body ready for bed also means shutting your mind off from the day. When you are stressed out at work or because of the kids or because of the argument you got in to with your friend your mind and nervous system is a stressed, or it’s ready to fight state. This does not equate rest. This will make it harder to fall asleep even if you’re tired. You may not be able to fall asleep and you just lay in bed tossing and turning with your mind racing. Breathing and meditation are two ways to help your system relax and start the process of preparing to rest. If you’re interested in what specific breathing exercises to look in to I have several resources you may be interested in so leave a comment below and we can talk further.

Timing

Sleep duration and the time that you go to sleep seem really obvious and yet it’s one of the biggest things that people don’t change. Most people need more than the amount of sleep that he or she gets. So 6 hours of sleep really isn’t enough. Especially when you add in the fact that the sleep is interrupted and the quality is poor because she is breathing through her mouth and she had been staring at a screen for over 8 hours today at work and then 2 more hours once home. Even if you claim to be a night owl you do have the ability to change certain habits and go to bed at an earlier time. Think about going to bed earlier so you can actually get an appropriate amount of sleep. 8 hours of interrupted sleep are better than 5 hours of interrupted sleep so even if you can’t change anything else about your sleep you can at least give yourself more time to try and recover.

Keep an eye out for next week’s post in order to see what you can’t change about sleep. If you want specific advice on where you can improve your sleep hygiene let’s talk.

Also check out these resources on sleep:

Why We Sleep by Matthew Walker

Lucy Hendrick’s has a really good article

Lance Goyke has a really good article

February 18, 2019

The Front Line

How many times a year do you see your doctor? Maybe once for your physical or to renew medication. Sometimes more if you get sick. Maybe frequently because you have some type of illness. Maybe not even once a year. And when you do see your doctor, how comfortable do you feel around him or her? Do you confide in them about your work stresses, or the thing your kid said to you the night before? Do you talk to them about your relationship or tell them about the amazing dinner you had last night? You may, but most likely not.

Now how many times a week do people come in and work with their personal trainers? Probably at least once a week, maybe even four or five times a week. As a coach, I interact with my clients sometimes daily. We send messages back and forth, we see each other frequently, and I learn a lot about every single one. I know what foods they like and dislike, I know about their jobs, and their relationships, how many kids they have, their insecurities, the name of their dog. I have very strong relationships with all of my clients and I’m sure most personal trainers do as well.

This isn’t my way of saying that personal trainers are better than physicians because we know more about our clients than doctors do about their patients. That’s not true at all. What I am saying though, is that it’s our job to recognize when something is wrong. Here’s my anecdote to illustrate this point:

I’ve been seeing a client for a couple of months now. He has very high levels of stress. He’s a very sweet guy, very kind, works hard on his exercises he does independently, and his main goal is to gain some mobility. We’ve done some stretches and breathing (I had him do an entire session of just breathing and he gained over 15 degrees of shoulder flexion), but our most recent session he opened up a little bit further. I began to ask him questions about how he’s sleeping and he told me not very well. He said he’s stressed at work. Okay, that’s pretty normal for Silicon Valley. But, I asked some more questions. “How much sleep did you get last night?” he said he had about 9 hours. That’s a decent amount of sleep, so why isn’t he sleeping well? I inquired further and found out not only has he not felt rested after sleeping, but he doesn’t want to get out of bed in the morning. He’s been feeling incredibly depressed and doesn’t have the strength to get up in the morning. My heart sank. Here’s this awesome, happy, nice guy who can barely get up in the morning. From what it sounded like he also has not sought help or guidance for this yet. He hadn’t told his doctor because he doesn’t think he needs to make an appointment for this issue. Yet, his depression is so crippling that he is barely functioning. So what is my responsibility as his personal trainer? I’m not equipped to take him through a screening, or counsel him, I’m not a licensed therapist. But, he’s confided in me. I’m his first point of contact with this issue in his medical care team. He’s been working with an acupuncturist and a massage therapist, but his reason for treatment is stress, not depression. There’s a very good chance I’m the first person to receive this information just because I see him enough and I happened to ask the right questions.

So what did I do? I told him I was here to help him and to listen. I told him that everyone at our clinic cares about him and we are there to help improve his standard of living. And finally, I referred him. It’s not my job to treat depression, I am not trained on how to handle depression, but it is my job to recognize when there is a problem and to refer appropriately.
Which brings me full circle to the title of this article. Personal trainers are generally the first point of contact for people; we are on the front line of healthcare. This is something Brendon Rearick taught me. We generally have the most time with people throughout a year of sessions. We may not treat disease or do rehab, but we have the most reps with clients/patients. So while it’s not our jobs to do medical procedures or treat and diagnose, it is our job to recognize and refer accordingly for the best interest of our clients. We are part of their medical care. The services we supply are to improve performance and health for every type of client, whether you play professional basketball, or you’re a 65 year old woman who wants to walk up the stairs without holding on to the railing, my primary purpose in your life is to improve your life. So if I ignore or overlook things like depression or other medical issues, I’m failing at my job. Recognize, identify, and refer – it’s in your job description.

February 10, 2019

What Does a Plane Crash and an Autoimmunity Have in Common?

Before I started writing this article I was speaking with a friend and I asked him the same question that I titled the article with: “what does a plane crash and an autoimmunity have in common?” He bluntly answered: you can die from both. Which is 100% accurate. You can die from both. So even if that’s not the point of this article it’s still relevant.

When a plane crashes it doesn’t happen because of one large system failure. This is called the Swiss Cheese Model. This model states that there are many layers of defense between dangerous hazards and catastrophe. However, these layers of defense have flaws, or holes (picture slices of swiss cheese), that if aligned properly, an accident will occur.

Swiss Cheese Model: https://en.wikipedia.org/wiki/Swiss_cheese_model

Aviation has regular check ups and policies to make sure there are no major malfunctions (large equipment failure, dangerous weather, pilot sleep schedules, etc.). However, sometimes error still happens, and when these mistakes lineup, a plane crashes. This one article explains a recent crash very well using this model.

An autoimmunity is the same way. You don’t just contract an infection and then magically have multiple sclerosis. You don’t just have a genetic mutation found with ALS and then turn 40 and begin to lose muscle strength. There is a progression, a list of systems that intertwine, and when enough little things line up your body’s system of checks and balances fail and your body begins to attack itself.

Plane crashes are rare because the chances of all of the little things happening at once are rare, but humans have lots of errors regularly. We may not sleep enough, we might be too stressed at work, we might have sleep apnea, we might have been infected with Epstein-Barr virus back when we were 12, we might have a genetic marker for a certain disease — all of these things by themselves can be controlled with our bodies line of defenses. But, when you add up multiple different stressors or “errors” it might just be enough to break the system.

So how do we know when the plane is going to crash? We don’t. That’s why we do regular maintenance. What happens when we don’t do regular maintenance though? We don’t check to make sure the system and parts are functioning properly. It’s the same with our bodies. How do we make sure that we don’t crash? We do regular check ups with our doctors, we try to sleep 8 hours, we eat the right foods, there are many steps we can take to make sure that we don’t crash.

But, what if we crash anyways? Human bodies are much more sensitive and unpredictable than regular machinery. Airplanes use 20 million lines of code to function plus equipment and humans that needs to work correctly in order to be successful…humans have 420 billion possible sequences of DNA plus proper system function, developmental function, and we’re surrounded by billions of other microorganisms that also play a role in how we function. That’s a lot of room for error. So the chance of something going wrong is much greater for us. And it’s becoming more and more prevalent. We live in a world where people stay up past midnight, look at their phones and screens irradiating blue light, eat the easy food like chips or pizza, drink soda, sit in our houses on our couches or sit in our chairs inside buildings at work. People ignore regular check ups with physicians, refuse to take medications or change their lifestyles to stay healthy, but when we finally do crash that’s when they want to make a change. By then we’ve already crashed and we’re just left to pick up the pieces.

Now, I’m not saying that autoimmunities are preventable if you just take care of your system. We are still unpredictable. Planes still malfunction after check ups and sometimes our bodies do as well. But, by maintaining our systems we do reduce the chances that a failure will occur.

This is why it’s important to take care of yourself. This is why it’s important to get 8 hours of sleep, eat foods that are good for us, drink water, go for regular check ups, stay active, get exercise, do things to eliminate as many errors as possible. We can’t always prevent disease, we can’t always prevent stress, we can’t always choose how we develop, etc. but we can choose other things. So think to yourself before you order that pizza, how will this make me feel? Is this going to be good for me tomorrow? What choices am I making today in order to make myself better when I’m older?

You need to make healthy choices and change your lifestyle if you want to get better. Your system of checks and balances are not going to prevent you from getting sick, they’re there to warn you. So if you’re chronically tired, get stomach aches, in pain, etc. your body is alerting you of some dysfunction. We don’t have the ability to change and fix everything ourselves, we need medicine sometimes, but sometimes you can control certain factors as well. So I’ll ask you this, which is the tagline of this website, how much are you willing to change in order to get better?

Furthermore, if you’re reading this and you have already crashed, think about what you’re doing to try and maintain your system. It doesn’t make much sense to do maintenance on a plane after it crashes, but we aren’t actually planes. Even after you crash making sure to take precautions to check in with your physician, make good choices for diet and hydration, get enough sleep, take away the extra stressors in your life and try and manage you crash. If you need help building yourself up after your crash let’s talk.

February 4, 2019

Why I Won’t “Double Down”

It’s common knowledge that you don’t just tell someone with depression to “just get over it,” “get out of bed,” or “you can choose not to feel sad, it’s just mind over matter.” So why would you tell someone with Chronic Fatigue Syndrome to do more, double down, and it’s all in their head?

 

My world is centered around not having a flare up. I’m so set in my ways because if I do have a flare up I’m useless for an indeterminable amount of time. My last flare up was in July and it took me until this past month, 6 months later, to finally feel almost back to normal.

 

In order to understand how important this is you need to understand what a flare up is. I will do my best to try and illustrate what it’s like.

 

My last flare up was on a Tuesday after July 4th weekend in 2018. I remember because most of my clients that I train were gone on vacation and I had finished the day early. I had been the most active I had been in over 5 years. I was eating the cleanest that I had in my entire life. My cognitive function and energy were at an all time high. Because I had finished my day early I began to start a workout. I was feeling a little tired and assumed it just had to do with something I had eaten for lunch and that if I were to do some exercise I would feel better. So I got to work. Within minutes I knew that had been a mistake. I had shooting pain that radiated from my spine down in to my legs and feet. I had a pins and needles feeling shooting up my spine and in to my head. My hands started to shake like I had tremors and my body felt so tired and weak that it felt like gravity had doubled and moving my body under that intense amount of weight was almost impossible. I went home early and didn’t make it past the living room. I dropped my backpack and laid down on the ground where I would remain for the next 4 hours before crawling up to the couch. I didn’t eat that night and went to bed. I also could barely speak. The energy required to open my mouth and to actually create words was too much. So I just laid there. Mind racing, but body drained. I did the bare minimum for the rest of the week.

 

By the following Saturday I was feeling better and thought I could go push myself and repair a flat tire that I had on my bike. So I walked my bike less than a mile to a bike repair station and worked on patching my tire. This was the worst decision I could have made. The physical and probably some mental stress was enough to drag me further down this pit of a flare up. Without finishing I laid down on the ground, shaking from tremors, my heart rate had spiked to 180, and I called for help. Somehow I walked home where I collapsed again. Covered in oil and dirt from the bike repair I tried getting in the shower. My very amazing boyfriend had to help me as I sat on the floor of our shower, unable to lift my arms to wash my hair, unable to stand without support.

 

This is how it was the next following weeks. I woke every morning with pain down my legs and that feeling of intense gravity. It would take me over an hour after waking up to actually get the energy to get out of bed. Some people stay in bed on their phones or are too tired to get out of bed and that’s not what this was. This was wide awake, but no energy to get my phone or to move or to speak. It’s like your brain is fully functioning but your body is in full paralysis and all you can feel is intense pain. I was nauseous daily, I could barely hold conversations, coaching was exhausting, and I did nothing other than work and sleep. Over time with rest it gets better and I’m sure if you’re reading this and you have some kind of invisible illness you can understand what this was like. If you don’t experience this for yourself though or see someone go through this then you have no way of really understanding this.

 

I am absolutely terrified of having another flare up. I’m terrified to feel this way again. I’m terrified to have the thoughts that I’d rather be dead than experience this again. I’m fully aware of how this fear makes me very close minded and very rigid about certain aspects of my life. Until I feel comfortable enough that I am in no way at risk for a flare up I will not push myself beyond what I feel is safe. I can push myself enough to grow, but not enough to collapse. This is a skill I’ve worked on for 5 years. A skill I developed while trying to play a division 1 sport with this illness. I have a fairly good understanding of what will cause a flare up at this point and I am not willing to risk that to get in an extra set or do that high intensity workout.

 

This does not mean that I don’t want to do that extra set though. This does not mean that I don’t wish I could go run sprint repeats. This does not mean that I wouldn’t love to eat pizza and stay up past 9:30 pm. But my desire to do these things does not outweigh the fear I have of relapsing again. It’s hard though. To tell myself not to do more. To tell myself not to eat that. To feel disappointed with the amount I can lift or to lose confidence with the way I feel about my body because I can’t do workouts I want to do. If you challenge someone on something that he or she is already self-conscious about you’re only making him or her feel worse. When people tell me that my illness is all mental it really sucks and there are days that even I question it. “One more set won’t kill you,” “it’s not a big deal to stay up and finish the movie,” “it’s mind over matter, the pain you feel is all in your head.” But then I start getting symptoms again and I’m immediately pulled back in because I can start to feel my body slipping and the memory of how much pain I go through makes me stop dead in my tracks.

 

So stop telling people to push themselves in this situation. People with real diagnoses and autoimmunities have real conditions that are exacerbated by doing that extra push. Don’t do more damage to an already dysfunctional system. There will be a time hopefully where I can push myself and where other people in my situation can as well and when that day comes I’ll be more than happy to do that extra set, but until then I won’t be doubling down.