To cycle or to row… That is the question!?

21/05/14

So, in my last post I stated what a poor patient I was to myself as a Physio, and that I intended to improving my pacing.

Well, the following day (Tuesday) I had a day off work to go to my rheumatology clinic appointment ( the hospital being a 2 hour drive away). Of course that was a good day… But why? Because I got up, had breakfast, cleared the kitchen, and went upstairs for a shower… No rush, no haste. That extra long shower eased so many aches, I then attended my appointment had a good chat with the doctors and a management plan was created for the coming 6 months, I was happy. I had their number if there were any problems. I drove home.

After having a bit of food, I took my own advice and by 15.30 I was out in the sunshine on my bike. I only did 30 mins, two short laps of the local village, but I loved every minute! The wind in my hair, the sun on my skin, the muscles in my legs working. Yes my knees hurt a little, and my wrists and fingers made changing gear and braking a little tough… But that’s what exercise does to you, you don’t focus on the pain, you feel the enjoyment… Granted if it had been a miserable day and I was on an exercise bike in the gym, I don’t think it would have had quite the same effect, but thankfully it wasn’t and I wasn’t!

So, Tuesday was a good day, why? (Oh I also took the dogs to agility, but that was pushing it a little too far, so Andrew did the running around for me! I’m not superwoman… Yet!)

Was it because:
1) I was off work? It certainly relieves a little of the stress of a morning, even if I don’t feel stressed most mornings
2) I had a long shower (10 mins-ish, but I wasn’t clock watching because of 1)!!!
3) My clinic consultation felt worth while, I had a plan, and felt supported
4) I paced my self through the day, not overloading myself with ‘to do’s’
5) I got out on my bike and released all those endorphins that have lay dormant in me for so long
6) It was sunny

It could have been any of the above, and more likely a combination of all of them, but, that’s not a typical day for me, 5 out of 7 days I’m in work, the luxury of pacing such as the above isn’t afforded to me. But, what I am making a mindful effort to do, is give myself time, don’t stress about things that aren’t getting done (they will do eventually… I hope), and drip feed in a little more exercise here and there….

So what happened today, Wednesday…. Well, the first difference is, I have started a short descending course of Prednisolone. 10mg today and for the next 3 days, descending by 2.5mg until nothing, 16 days in total (following on from the clinic appointment on Tuesday).
I also retuned to my usual 8.30-5(ish) job on the ward. No huge changes to pain early in the day, but definitely an improvement as the day progressed, which can be very normal for me, as moving does help enormously, until i stop!!
It has been a glorious sunny day all day, so I have been dying to get into the garden… But I also felt I aught to do something exercise wise. I could have convinced myself, that as I am pacing myself, there would be no shame in resting today, and returning to it tomorrow, however, I am 29 with a previous level of fitness that means I could easily do a little something (stop talking yourself out of your own advice!).

To cycle or to row? It’s been hot, the rower is in the gym… It is stifling in there… Back on the bike it is… GOOD GRIEFE my bum hurt! I had to do the first quarter in standing! But it eased, it got easier, I could sit for short periods, but I decided I’d only do one short lap of the village…. My knees felt better, my wrists felt ok (still twinging), but I was determined not to over do it. The joy I got was still the same though 🙂

Since my sore bum shortened my ride, I decided to do a short burst on the rower too… My aim is to maintain strength and tone in my arms and back, not to become the next Mathew Pincent, therefore I did 50 rows in pronation and 15 in supination (to get my biceps… I had aimed for more, but my right wrist has been so bad I seem to have lost range in supination, and I found it particularly awkward, something else to monitor and work on).

But… As any poor pacer/patient would do, why stop there?! The garden is getting wild, so I whipped out the mower and did the grass, then hung out the washing and put on a white load…… Well, in one sense it’s pacing, they are all different activities using different muscles and different postures, not one of them took longer than 30 mins in total…. Let’s see how I go for the rest of the week!

So, on reflection, what has changed….

Yes Prednisolone does work wonders for me, and always does, there are side effects possible when pregnant, but they are small, and on the whole better than other medications, plus a mobile, stress and pain free me must be kicking out more favourable hormones for mini me?! – But could Prednisolone really have worked so quickly…. I look at my joints and I’m inclined to say yes, I guess we will see in 8plus days time when the dose reduces to what I have found in the past to be non therapeutic for me.

Is it my determination to act? To take a stand and do something active about this pain that limits me? I know pacing itself doesn’t ‘work’ after two days! So how much of the change about me is psychological? I’m afraid to say it is probably a pretty huge proportion, again, we will see in a few short days as my Prednisolone reduces, if I gradually get worse it’s the drugs, if I remain well it could be the drugs, it could be my mental attitude and my mental state. Only time and effort will tell. I don’t doubt there will still be tough times ahead no matter what, but there will be good times too.

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