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Fatigue - Fighting the Battle
Episode 5919th July 2020 • The Axial Spondyloarthritis Podcast • Jayson Sacco
00:00:00 00:11:24

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Welcome to this week's episode of The Ankylosing Spondylitis Podcast. This week's topic is something has been a huge challenge for me this week fatigue.

But first, I want to welcome the new listener from Guatemala, which marks the 95th country that the show has been downloaded in. And also, don't forget to head over to to sign up for the Whenever I feel like it newsletter. I'm hoping to get one sent out next week. And check out the T-shirts and stuff available on the website. The items are at this time available in the United States and Europe, with more countries coming soon. Also check out the new facemasks I made available. I also wanted to thank a couple of companies that I've partnered up with to bring some great CBD based products. The first is Joy Organics. They're an awesome company that makes CBD based products made from 100% hemp from America that has all been organically grown. Also wanted to welcome Foria which makes an amazing CBD based intimacy oil. These two companies are fantastic partners with the show and I can attest to the benefits of each company's products. 

So let's talk fatigue. This week has been just quite the challenge. I've been just tired and worn out all week regardless of the amount of sleep I get. I do wear part of the night of C-pap machine when I sleep in my bed, but there's times when I get up and I go out and sleep in the recliner that I have. So I don't have a C-pap to wear out there. But I'm looking at like a mobile travel c-pap option, a smaller machine that I can keep in the living room so that I wear when I'm sleeping in the recliner. And it's just been an amazingly challenging week, even to the point where the thought of recording the podcast has just been really hard. Part of it is probably being cooped up from the COVID stuff and top that off with some fatigue and it's just been really a rough week. And I noticed that I'm not alone in those thoughts. I was going through the different boards on Facebook. And I noticed there's a lot of question about how do I deal with fatigue? What do I do? I can't get any energy to do anything. And so I was thinking about that and I came across this article on tips for beating Ankylosing Spondylitis fatigue. Some of these we may be doing as a collective group. Others might be something new for you to try. So let's see what we got here. 

Ankylosing, Spondylitis and fatigue. Well, Ankylosing Spondylitis is known for all the complications related to inflammation, the spine, the hips, you know, basically any of your joints that it can affect but primarily spine and hips. Well, the pain and discomfort may disrupt our daily activities. You could be contending with another debilitating side effect, which is fatigue. According to the National Ankylosing Spondylitis Society, fatigue is one of the most common complaints among AS patients. Excessive tiredness can be attributed to AS, but it can also be a side effect. 

Inflammation and Fatigue. The biggest culprit behind AS related fatigue is the inflammation. Inflamed tissues, whether it be in your hips, your spine, ribs wherever release a small protein based chemical called cytokines. Considered to play a major role in fatigue, pain, psychological disturbances, these cytokines are produced by cells in your immune system react in your body similar to those produced when you have a cold or a flu. This is why you may feel like you have a viral illness when you really don't it's just the fatigue. Treating inflammation with medications can help to reduce the excessive fatigue, but keep in mind that prescription drugs that contain opioids or coding may increase tiredness. Aim for sound sleep. In some cases, fatigue isn't exactly related to the inflammation. You know, the pain and discomfort can make it difficult to fall asleep at night, adding fuel to the exhaustion. Your pain may also cause you to wake up during the night. Here are a few ways you can ensure more a restful night's sleep: 

·      Try to go to bed at the same time every night. 

·      Take breaks throughout the day, instead of naps. 

·      Do relaxing pre-bed activities such as deep breathing exercises, meditate, I've found that I like to do some stretching, if I can, anything to try and get the blood flow moving a little bit before I lay down for the night.

·      Some people like to take a warm bath before bed. 

·      You could try adding curtains to your bedroom so that the sunlight is less likely to awake you. 

·      And then you could also try to regulate the temperature in your bedroom. That's a big one from my bedroom just it never heats up in the winter and it never gets cold in the summer. So it's always a bit of a challenge there. I tend to wake up sweating and all covered, you know, a mess because I just can't regulate the temperature in that room. 

·      Also, check for anemia. You know, inflammation from the as increases your risk for anemia. 

I'm always borderline anemic, so I have to make sure to take a lot of vitamins. My multivitamin every day and the anemia is a condition that is marked by a lack of healthy red blood cells, we know that these cells are responsible for transporting oxygen to the organs. Fatigue is one of the first signs of anemia. Other symptoms of anemia include frequent headaches, dizziness, shortness of breath, and finally pale skin. Anemia is diagnosed with a blood test. If you're diagnosed with anemia, your doctor may prescribe an iron supplement to help restore your red blood cell levels. Your doctor will also want to make sure you don't have ulcers or bleeding from non steroidal anti inflammatory drug use. 

Get on the scale. A lack of energy can lead to decreased activity and trigger weight gain. You know in this last month, I'm down about six pounds, but I still have 50 to go and I'm hoping that if I can lose some of this additional weight, even other 20 pounds, that that'll help with this sleep apnea and make that issue start to rectify itself and help to fight off some of the sleep apnea induced fatigue but being overweight presents many long term health concerns and can also make your AS symptoms worse. Extra fat adds more stress to your spine and worsens inflammation. Being overweight can also make everyday tasks more difficult to complete. So if you're still gaining weight despite eating right and exercising, you don't talk to your doctor, there could be something else going on there. You may also need further testing, like thyroid function tests to get to the root cause if you're just not able to lose any weight. Also, our medications can be notorious for either adding weight or keeping weight on I take a lot of gabapentin on a daily basis around 2400 milligrams and that I know can really add to the weight gain along with some other items. Dietary considerations weight gain often calls for changes to your diet. But when it comes to battling AS related fatigue, dietary changes mean much more than just cutting calories. Our focus as somebody with ankylosing spondylitis should be on eating nutrient dense foods, you know that will help you have a high energy all day. That's why I did if you look back at my first episode, I’ll have a link in the show notes. I did an episode with Vinnie Tortarich on the No Sugar, No Grains Diet, which is just getting rid of a lot of the bad stuff that we eat any given day and focusing on the right foods that will help us throughout the whole day. A big thing is if you drink a lot of soda. Try to swap that out with just water, you can pick up these different flavorings at the grocery store to add to your water so you can make it taste like whatever you want. Some of them have caffeine in it. So if you want to continue to add that boost from caffeine, they're all available so that's a great option instead of drinking sodas. Also consider if you're a coffee drinker, if you're putting all those you know creams and sugar and everything into that coffee, you're just adding extra calories that may be better used other spots and look at maybe drinking just a black coffee. I do know that Vinnie Tortarich talks about in the morning, adding a pad of butter and some MCT oil to the coffee to give you a nice sustained energy throughout the morning and into the afternoon. 

And finally, Some exercise tips. When you're on your last thread, you know, working out is likely the furthest thing from your mind, you're completely fatigued and just thinking about getting that energy up to do something is very difficult. You have low energy levels, and you just don't want to do it. But if you do, that little bit of exercise you can start off doing and increasing as you go along can help with future energy levels, and flexibility over time. Exercise is important for keeping your bones strong so that we don't get osteoporosis,  a disease AS patients are at an increased risk of developing later in life. So start with a short walk if possible, work your way up to longer higher intensity exercises. If you can swim swimming is a great exercise for people with AS. Also, you may find it easier to fall asleep at night if you've worked out that day. Just make sure you're not exercising too late in the evening, as it can actually disrupt your sleep. One of the things I do, or try to get done is, if I'm watching TV, when the commercials Come on during the day, do 10 quick push ups, and then get back up on the couch, watch my TV and next commercials, push ups, and so forth. So there's little ways to work that in. I also have a link in the show notes to some videos on beginner yoga. It doesn't matter what your mobility level is, if utilized, for example, the yoga for seniors, it starts off a lot of them in sitting positions that are very simple and allow you to at least start the exercise. So basically, the outlook for this is because there's no cure for AS. You know, we always are fighting these related symptoms, and you've got to really be diligent about that. If you frequently don't have enough energy to make it through the day, it may be time to reanalyze your current treatment plan with your doctor. You know, let him or her know what you're doing and they may have have additional options that you had thought of a different approach to treating as may be enough to keep fatigue at bay, above all else, you not try to remain positive and calm, you know, stress only as to the feelings of tiredness. So cut yourself some slack, try to get some more rest. Consider meditation and that yoga on top of food considerations. And, you know, we may be able as a collective group to fight this. 

So, thank you for listening. Check out the show notes again for links to spondee podcast calm to sign up for the newsletter. Also, don't hesitate to check out the Instagram page. If you're on Instagram, go to as_podcast and like the page and follow. So again, I hope you all have a wonderful week. I can't wait to interact with everybody and hear from you online. And your feedback means the world to me. So thank you for listening and have a wonderful week.

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