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» LymeNet Flash » Questions and Discussion » Medical Questions » Why no aerobic exercise per Dr. B?

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Author Topic: Why no aerobic exercise per Dr. B?
one4islands
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Over the past two months I have done no exercise whatsoever except one day of lifting weights which made the pain in my hands/wrists severe.

I want to get back to exercising and read that Dr. Burrascano says no aerobic exercise except for a brief warm-up until recovered.

What is the reason for no aerobic activity until recovered?

Thanks

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Keebler
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Aerobic exercise while dealing with infections can damage the heart. It also further stresses the HPA, the hypothalamus-pituitary-adrenal axis (detailed in links to follow).

Aerobic exercise can also further increase toxicity levels from pushing the liver too much.

There are plenty of other ways to exercise: casual exercise - just walk, dance a little bit to a song a couple times a day,

Formal methods: Tai Chi, Qi Gong or Pilates are the top three methods.

If you don't have joint problems, weight training is also good. Do not further stress irritated joints, though.

Rebounding gently on a mini-trampoline is good.

Stay in touch with your LLMD, as when you are ready, you may be able to do more.
-

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Keebler
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http://www.ilads.org/lyme_disease/B_guidelines_12_17_08.pdf

Dr. Burrascano's Treatment Guidelines (2008) - 37 pages

Joseph J. Burrascano, Jr., M.D.

* Page 27 for SUPPORTIVE THERAPY & the CERTAIN ABSOLUTE RULES

* Pages 31 - 32 for LYME DISEASE REHABILITATION and specifics in coordinating a rest / work-out schedule and Physical Therapy.

==========

http://www.ilads.org/lyme_disease/B_guidelines_12_17_08.pdf

Treatment Guidelines, 16th edition, October, 2008
Joseph J. Burrascano, Jr., M.D.

Page 20:

. . . If treatment can be continued long term, then a remarkable degree of recovery is possible.

However, attention must be paid to all treatment modalities for such a recovery - not only antibiotics, but rehab and exercise programs, nutritional supplements, enforced rest, low carbohydrate, high fiber diets, attention to food sensitivities, avoidance of stress, abstinence from caffeine and alcohol, and absolutely no immunosuppressants, even local doses of steroids (intra-articular injections, for example). . . .


* Page 27 for SUPPORTIVE THERAPY & the CERTAIN ABSOLUTE RULES


Page 31:


LYME DISEASE REHABILITATION

Despite antibiotic treatments, patients will NOT return to normal unless they exercise, so therefore an aggressive rehab program is absolutely necessary. It is a fact that a properly executed exercise program can actually go beyond the antibiotics in helping to clear the symptoms and to maintain a remission.

Although the scientific basis for the benefits of exercises is not known, there are several reasonable theories.

It is known that Bb will die if exposed to all but the tiniest oxygen concentrations. If an aggressive exercise program can increase tissue perfusion and oxygen levels, then this may play a role in what is being seen.

Also, during aggressive exercise, the core body temperature can rise above 102 degrees; it is known that B. burgdorferi is very heat sensitive. Perhaps it is the added tissue oxygenation, or higher body temperature, or the combination that weakens the Lyme Borrelia, and allows the antibiotics and our defenses to be more effective.

Regular exercise-related movements can help mobilize lymph and enhance circulation. In addition,there is now evidence that a carefully structured exercise program may benefit T-cell function: this function will depress for 12 to 24+ hours after exercise, but then rebound.

This T-cell depression is more pronounced after aerobics which is why aerobics are not allowed. The goal is to exercise intermittently, with exercise days separated by days of total rest, including an effort to have plenty of quality sleep.

The trick is to time the exercise days to take advantage of these rebounds. For an example, begin with an exercise day followed by 3 to 5 rest days; as stamina improves, then fewer rest days will be needed in between workouts.

However, because T-cell functions do fall for at least one day after aggressive exercises, be sure to never exercise two days in a row. Finally, an in intermittent exercise program, properly executed, may help to reset the HPA axis more towards normal.

On the following page is an exercise prescription that details these recommendations.

This program may begin with classical physical therapy if necessary. The physical therapy should involve massage, heat, ultrasound and simple range of motion exercises to relieve discomfort and promote better sleep and flexibility.

Ice (vasoconstriction) and electrical stimulation (muscle spasm and trauma) should not be used!

The program must evolve into a graded, ultimately strenuous exercise program that consists of a specific regimen of non-aerobic conditioning- see below.

Have the patient complete a gentle hour of prescribed exercise, then go home, have a hot bath or shower, than try to take a nap. Initially, patients will need this sleep, but as they recover, the exercise will energize them and then a nap will no longer be needed.

NOTE: a cardiac stress test may be necessary prior to exercising to ensure safety.
-------------

Page 32:

LYME REHAB-PHYSICAL THERAPY PRESCRIPTION

. . . (there is a P.T. prescription all set to fill out here) . . .

Excerpt:

PROGRAM:

1. Aerobic exercises are NOT allowed, not even low impact variety, until the patient has recovered.

2. Conditioning: work to improve strength and reverse the poor conditioning that results from Lyme, through a whole-body exercise program, consisting of light calisthenics and/or resistance training, using light resistance and many repetitions.

This can be accomplished in exercise classes called "stretch and tone", or "body sculpture", or can be achieved in the gym with exercise machines or carefully with free weights (see cautions above).

3. Each session should last one hour. A gentle hour is preferable to a strenuous half-hour. If the patient is unable to continue for the whole hour, then decrease the intensity to allow him/her to do so.

4. Exercise no more often than every other day. The patient may need to start by exercising every 4th or 5th day initially, and as abilities improve, work out more often, but NEVER two days in a row. The nonexercise days should be spent resting.

5. This whole-body conditioning program is what is required to achieve wellness. A simple walking program will not work, and simply placing the patient on a treadmill or an exercise bike is not acceptable (except very briefly, as part of a warm-up), as aerobics can be damaging and must be avoided. . . .

- Much more at the link.

==============

To help support body functions:

http://www.lymepa.org/Nutritional_Supplements.pdf

Nutritional Supplements in Disseminated Lyme Disease

J.J. Burrascano, Jr., MD (2008)

====================

Why no aerobics during infections? In addition to explanations above, heart and brain are two reasons. With infection, aerobics can damage the heart.

www.ott.zynet.co.uk/polio/lincolnshire/library/uk/post-me.html

or http://tinyurl.com/33rxy8

From Dr. Bruno's "Fainting and Fatigue" in the Spring 1996 CFIDS Chronicle

Post-polio expert Dr. Richard Bruno points out that physical over-activity is the biggest cause of post-polio symptoms. [3]

Excerpt:

``when mice infected with Coxsackie B3 were forced to swim in a warm pool, the virulence of the virus was drastically augmented.

In fact, viral replication was augmented 530 times. This did horrendous things to the animals' hearts. We all know that to play squash with the flu can lead to heart attacks.

Much the same danger can be courted by undertaking hard exercise with M.E. (CFS).'' - End quote.

==============

See the post about brain hypoperfusion (and how aerobic exercise making that worse for CFS patients) from the SPECT details from the Nightingale group. This thread also talks about POTS, etc.:

http://flash.lymenet.org/ubb/ultimatebb.php/topic/1/77325

Topic: To everyone with cardiac symptoms please read !

==============

In the book, The Clinical and Scientific Basis of Myalgic Encephalomyeltis/Chronic Fatigue Syndrome

authors: Byron M. Hyde, M.D., Jay Goldstein, M.D.
and Paul Levine, M.D.

The Nightingale Research Foundation reprinted
p. vii which shows three sets of SPECT scans. (1993, I think.)

Taken in resting, post-exercise and 24 hours post-exercise, the images show an immediate post-exercise effect with perfusion and

``illustrate the severely decreased brain perfusion of the same patient 24 hours after the brain has been stressed by physical exercise."

This is a most remarkable piece of paper. You can see the marked impact upon the brain in the nine photos from the SPECT.

I can't find a copy of the page on the web, but you could request a copy from the Nightingale Research Foundation at

http://www.nightingale.ca/

Dr. Goldstein, Addendum I, shows common stress pathways, and might also be available upon request.

==============

http://tinyurl.com/2agvt28

Can Exercise ``Pollute'' Your Body?

Health News - By VRP Staff

Believe it or not, toxic free radical molecules and oxidation by-products are produced whenever you exercise. . . .

==============


GOOD MOVES:

Tai Chi, Qi Gong, some kinds of Yoga and Pilates routines . . . strength training . . . walking . . . maybe slow biking . . . water movement (Tai Chi in water is very nice) . . . whatever brings you joy of movement while safely supporting your body. Do what you love. Dancing can be good. Just not at top speed.
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Keebler
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MITOCHONDRIA - another piece of the puzzle

Mitochondria get damaged from lyme. Mitochondria are the tiny energy centers in very one of our cells. When they are damaged, pushing with aerobics makes things much worse.

More about the complexity of mitochondrial damage (and ATP) - and what can help in the next two links:
--------------------------------------------

PDF: http://www.cfids.org/sparkcfs/working-out.pdf

HTML version - without photos for easier printing: http://tinyurl.com/4qevgl

WHEN WORKING OUT DOESN'T WORK OUT

By Dr. Christopher R. Snell, Dr. J. MarkVanNess and Staci R. Stevens, et.al.

==========================

Cardiac Issues - and Energy / Endurance - addressed here:

http://flash.lymenet.org/ubb/ultimatebb.php/topic/1/77325

Topic: To everyone with cardiac symptoms please read !
-

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Keebler
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ADRENAL LINKS:
------------------------

To help repair adrenal function so you can have better endurance.

This book is specific to lyme and other chronic stealth infections. The author discusses the endocrine connection and effects of STRESS on a person with such infections. You can read customer reviews and look inside the book at this link to its page at Amazon.

http://tinyurl.com/6xse7l

The Potbelly Syndrome: How Common Germs Cause Obesity, Diabetes, And Heart Disease (Paperback) - 2005

by Russell Farris and Per Marin, MD, PhD

==================

Remember that lyme really messes up the HPA axis (Hypothalamus/pituitary/adrenal network). The pituitary has much to do with weight/growth. Mess up any part of the endocrine system and other parts suffer, too.

http://www.ilads.org/lyme_disease/B_guidelines_12_17_08.pdf

See page 4 where Dr. Burrascano describes a bit about the considerations of the dysfunction with the HYPOTHALAMIC-PITUITARY AXIS

===============================

Cordyceps is recommend here:

This is included in Burrascano's Guidelines, but you may want to be able to refer to it separately, too:

http://www.lymepa.org/Nutritional_Supplements.pdf

Nutritional Supplements in Disseminated Lyme Disease

J.J. Burrascano, Jr., MD (2008)

========================

Great information about treatments options and support measures, including those to help adrenal/endocrine function:

http://tinyurl.com/6lq3pb (through Amazon)

THE LYME DISEASE SOLUTION (2008)

- by KSn, MD

You can read more about it here and see customer reviews.

Web site: www.lymedoctor.com

=========================

http://webhome.idirect.com/~wolfnowl/thyroid7.htm

Get To Know Your Endocrine System -by Lauri M. Aesoph, N.D.

Excerpt:

(section on) Adrenal Glands

. . . Your body reacts to these hormones with a "flight or fight" response: pounding heart, dilated pupils and high blood pressure. . . .

=========================

http://www.prohealth.com/ME-CFS/library/showArticle.cfm?libid=14383&B1=EM031109C

http://tinyurl.com/detwtt

Underactive Adrenal Gland - Stresses and Problems with the Body's 'Gear Box' - by Dr. Sarah Myhill, MD

=======================

Many libraries carry this book and you can read 95 customer reviews here (average 4.5 star out of 5) AND see inside the book:

www.amazon.com/Adrenal-Fatigue-Century-Stress-Syndrome/dp/1890572152/ref=sr_1_1?ie=UTF8&s=books&qid=1263516913&sr=8-1

Adrenal Fatigue: The 21st Century Stress Syndrome

~ James L. Wilson, ND, DC, PhD, Johnathan V. Wright, MD

About $10. And qualifies for free shipping with a total $25. Purchase at Amazon

======================

http://www.cpmedical.net/newsletter.aspx?newsdate=11-1-2009#6511

3/4 of the way down page:

Curcumin Prevents Some Stress-Related Changes (By CP Staff)

Excerpts:

A recently published study investigated the effects of curcumin, a constituent of the botanical turmeric, on changes in cognition and memory caused by stress. . . .

. . . In this new study, researchers investigated the effect of curcumin supplementation on stress-induced learning defects in mice. . . .

. . . In addition, curcumin reversed the stress-induced increase in the levels of serum corticosterone, the primary hormone secreted during the stress response. . . .

. . . The researchers concluded, ``Thus, curcumin may be an effective therapeutic for learning and memory disturbances as was seen within these stress models, and

its neuroprotective effect was mediated in part by normalizing the corticosterone response, resulting in down-regulating of the phosphorylated calcium/calmodulin kinase II and glutamate receptor levels.''

===========================

This is not a lyme book.

This book has only one reference to lyme (in the historical use of sarsarparilla for another spirochetal infection). However, it is a vital first book to read - or a reference - for anyone interested in understanding nutritional methods.

Search for Ashwagandha; Cordyceps; Siberian Ginseng in this book:

http://oneearthherbs.squarespace.com

The One Earth Herbal Sourcebook (Tillotson)

Graciously, much of this book is on line. It can also be purchased from this site or through Amazon where you can look inside the book and see many customer reviews.

Amazon link to this book: http://tinyurl.com/6zapeh

=====================

The Rhodiola Revolution by Richard P. Brown, MD and Patricia L. Gerbarg, MD, et.al.

See this at Amazon.

[But note that Rhodiola by itself, especially at first, can be a bit too stimulating for lyme patients who are often very sensitive. It's best to start with others - or with rhodiola as part of a formula.]

================================

Medical abstracts for the most common adaptogens (adrenal support):

http://www.ncbi.nlm.nih.gov/sites/entrez

PubMed Search:

Ashwagandha - 369

Cordyceps - 531 abstracts

Rhodiola - 297 abstracts

Eleutherococcus senticosus - 93 abstracts (also called Siberian Ginseng)

Siberian Ginseng - 228 abstracts

Panax Ginseng, adrenal - 65 abstracts

===========================

This is the supplement that works best for me, suggested by my ND:

http://www.naturalhealthyconcepts.com/adaptocrine-k2-p-endocrine-system.html

Adaptocrine (by Apex)
-

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Keebler
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Now, I know all this is a ton of information. If you copy and paste it to your study file, you may find all these links to be good reference sources for a wide range of self-care questions.

About the hour long sessions suggested, even with non-aerobic exercise, some have to work up minute by minute.

Seriously, walk 2 minutes today. In a couple days, go for a little more - what your body can do. Increase gradually.

And that's why I like gentle dancing around my living room. As soon as my body says it's had enough, I listen. And I know I'll be able to do some more a little later or tomorrow.

If you go to www.hsn.com or Goggle and search "Gazelle" - get an idea of a "glider"

I have a much sturdier one called "HealthWalker Plus" by Fitness Basics. Craig's List often has these as they are no longer made. Excellent construction. The best of this type ever made. Totally silent. No motor, no oil, no breakable parts at all.

I LOVE mine. No need for bells and whistles. Just enjoy at your own pace.

It really helps and you can stick to a gentle pace. It's not full body, but it is still very good for getting circulation going, helping the lungs works, etc.

I suggest getting a P.T. or Balance Ball. NOW - while you can keep your windows open and let it off-gas. Best: buy a used one from a friend. Ask your LLMD for a good LL PT who can give you some guidance.

If your balance needs help, ask for a LL PT who is trained in vestibular rehabilitation. Tai Chi and Qi Gong are also excellent to strengthen balance. Again, start slowly. It's better to do a minute than none at all.

For some, massage - or the LMT or PT doing passive exercise - is the only exercise they can get. Breathing exercises are always good, too. Work with your body. Honor where you are at this point in time and you'll soon be enjoying moving a bit more.
-

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Rumigirl
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Dr. B in his guidelines also says to do strengthening exercises for 6 months, and then begin aerobics. But it all depends on what state you are starting from.
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one4islands
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Thanks all-much appreciated:)
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sixgoofykids
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Moving to medical questions

--------------------
sixgoofykids.blogspot.com

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Keebler
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http://entropyproduction.blogspot.com/2009/08/chronic-infection-theory-of-heart.html

The Chronic Infection Theory of Heart Disease

================================

www.cpnhelp.org

Cpn Help - C. pneumoniae (as discussed in above article)

===================================

http://flash.lymenet.org/ubb/ultimatebb.php/topic/1/77325

Topic: To everyone with CARDIAC symptoms please read !
-

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Keebler
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At your own speed, something like this can be FUN. Dance along with the four-minute VIDEO from YouTube. It works for me by holding every other move or skipping some or just going more slowly.

http://www.youtube.com/watch?v=pMnZTkTTRZ4

Bollywood-style "Flash Mob" Dance for Diversity at OSU

Oregon State University faculty, staff and students participate in a choreographed Bollywood dance to promote diversity awareness on campus.our-minute VIDEO from YouTube=

http://www.youtube.com/watch?v=pMnZTkTTRZ4

Bollywood-style "Flash Mob" Dance for Diversity at OSU

Oregon State University faculty, staff and students participate in a choreographed Bollywood dance to promote diversity awareness on campus.

They trained as a class for 3 months but kept the "flash" event tip-top secret from everyone.
-

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one4islands
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I did buy a mini trampoline for rebounding.

I will only use it for several minutes at a time and without much intensity for now.

Just a soft bounce to help the lymphatic system.

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Chronic Triathlete
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I've run regularly for 3 years while fighting Lyme including 2 sub 01:30:00 half marathons.

I've been to 2 different well known LLMDs and they've both encouraged me to "do whatever you can as long as it doesn't set you back."

Through my blog I've also met several athletes still living an active life while dealing with Lyme. In fact, I talk to a woman who, this year, trained and ran a sub 03:00:00 Boston Marathon and then got her PICC line two weeks later.

There are endless guidelines and scientific research, but what's most important is your personal experience. Trial and error will tell you what works.

--------------------
10.24.07 Sick
03.31.08 Diagnosed IGeneX WB with Bb
04.08.09 Fry Bart

Updated 02.06.10 On an ABX break since July 09, gluten-free, lots of exercise.

My blog: http://www.chronictriathlete.com/wordpress

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