Dr. Paul Anderson on Retraining After an Illness: Pathways to Recovery

In this episode, Dr. Paul Anderson discusses strategies for retraining the body and mind after an illness. He explores:

• Understanding the Impact: How illnesses can affect physical and mental health, and the importance of acknowledging these changes during the recovery process.
• Physical Rehabilitation: Techniques and exercises to rebuild strength, flexibility, and endurance, tailored to individual needs and specific conditions.
• Cognitive Retraining: Methods to enhance cognitive function and mental clarity, including brain exercises, neurofeedback, and lifestyle changes.
• Nutritional Support: The role of nutrition in recovery, with recommendations for foods and supplements that can aid in healing and rebuilding health.
• Emotional Well-being: Strategies to manage stress, anxiety, and emotional health, which are crucial components of a holistic recovery plan.
• Integrative Therapies: The use of complementary therapies, such as acupuncture, massage, and meditation, to support the retraining process and overall well-being.
• Personalized Recovery Plans: How to create a customized retraining program that addresses individual needs and goals, and the importance of regular monitoring and adjustments.

Dr. Anderson provides a comprehensive guide to retraining after an illness, offering practical advice and holistic strategies to support a full and effective recovery.

Episode Transcript

Speaker 1 (00:01):
Go Dan, Welcome to Medicine Health. We're back in our
Muscle is Medicine series, and now we want to talk
about retraining after you've been sick, after you've had surgery,
after some sort of trauma in your life. And so
in a previous section we talked about the concept of
graded exercise tolerance, which can be used especially is useful

(00:23):
if you are out of shape, untrained, et cetera, and
you're trying to get back into some kind of shape,
but you don't want to fall over with a hypoxy
or a cardiac event or something like that. You want
to get your body working again. So this becomes more
of an issue if you've recently had a physical trauma.

(00:44):
So that could be a car accident, that could be surgery,
that could be a recent illness, it could be a
chronic illness. Any number of things can happen, and so
one of the things, and you know, our practice is
really focused on the chrome ill patient and then patients
with cancer, and both are really have a lot of

(01:06):
crossover and both are really chronic illnesses. So in those
settings we often get the question, well, geez, you know,
I just got done with chemotherapy and you want me
to start to move my body and work out. You
know what, what are you? What do you got in
mind there? Or you know, gee, I've got a chronic
illness and I'm I'm you know, my treatment really wears

(01:30):
me out, and I I'm very fatigued, and I'm not
doing well and uh, you know, and I just I
haven't felt good in so long. I can't remember when
I felt good the last time. And so how am
I supposed to start to do any exercise or move
my body, et cetera. And those are really really good things.

(01:51):
And the idea behind it is not that it's an
all or nothing thing. Very few things are all or nothing.
But the more moor ill your body is, and the
more traumatized your body is, the more that you need
to think about. A muscle is medicine, and it will

(02:11):
help on my road to recovery if I build up
some muscle and get it working. B I am not
currently doing very much in that respect. Then I'm very
out of shape and c you know, maybe the way
that I just feel every day is so bad that
I know I'm not very motivated start doing things. So

(02:33):
the thing that you need to consider in recovery either
during a chronic illness or after a bad illness, or
after surgery or whatever is you kind of have to
let go of your past athletic prowess and how well
trained you are or whatever, because the new trauma, whether
it's infectious or surgery or car action or whatever, kind

(02:56):
of knocks you back a number of pegs. Now, what
about the chronic ill patient. Have this conversation a lot
with chronically ill people where they'll say, well, I was
able to do this, you know, I was able to
do this length of a hYP or this whatever, and
then I had a flare of my chronic illness, and

(03:16):
now I can't. It's like it's like I'm untrained almost already.
What happens when you're chronically ill or sometimes in patients
in the cancer journey, they get a new therapy. As
I said, it's sort of like a new trauma, like
an infection, acute infection or surgery or something. It knocks
your feet off from under you. And so do chronically

(03:37):
ill patient who is really having trouble wrapping their head
around why they can't, you know, just go out and
do what they were doing last month. If they've had
a flare the reason is is the flare is sort
of like a new stressor it's a new trauma on
your body, and so you cannot expect your body to
go right back to that place that you were prior

(03:59):
to the flare. It's the same idea, it's the same
logic as I was moderately trained, I was doing this
amount of exercise, and then I had a big surgery,
or then I had chemotherapy, or then I had COVID,
or then I had whatever, and it just knocked me
down and I can't get back to where I was.
This is another place where the idea of graded exercise

(04:22):
tolerance can be very helpful. So what you can do,
depending on your prior level of fitness and training, etc.
Is if you were trained to a certain point before
this new trauma or the flare up in your disease
or whatever, you can look at what that was and

(04:42):
then you can restart your exercise with a portion of
what that was and see if you can handle it
or not. And so if you were a regular, you know,
ten mile a week in total hiker, you know, let's say,
and you were doing fine doing that and then you've
got COVID or you got real sick or you had

(05:04):
a flare up of your chronic disease or whatever, and
now you know you tried it and like you were,
you were not well for days afterwards. That's too much,
So you could dial it back. You don't have to
go and become a sedentary and non active, but you
can do the first week and try maybe a mile

(05:25):
twice during the week. You used to do ten total miles,
so two miles. If that goes really well, then the
second week, go up to four miles or whatever you
can do. But for a lot of people, especially our
COVID patients where they're recovering, they might have been super
trained before and now you know, we're having them get
out and do just fractional amounts of the workouts they did,

(05:46):
but still something. And so another thing that comes up
in people with you know, retraining and you know post activity,
et cetera, is you have to let go of your
expectations of your body and realize it's had a shock
or a trauma or an infection, or you've flared up
your chronic illness. An you got to give it a

(06:08):
little grace, a little bit of a break so you
can come back. And part of that can be if
you're at the gym, and I think about this a
lot when I'm at the gym, you know, especially if
you're there kind of at the same time, you know,
and there's people around that know you. You might be
doing a lower amount of you know, weight reps and
whatever else you do in your healing process, and you

(06:32):
may be at the gym a shorter amount of time,
or maybe with rest breaks a longer amount of time.
And so you have to let go of the expectation that, well,
I've got to go back in and save face and
you know, really be able to work out and all
this stuff. That's that's not going to serve you in
trying to get over something. Now, based on your underlying
condition and the level of trauma on your body, you

(06:57):
may be able to get back into shape an online
much faster, okay. And then if the injury trauma flare
up of your disease whatever was bigger, your road to
getting back to where your training was before maybe a
lot slower. Now, why is this idea of retraining an

(07:18):
extra graded exercise tolerance? Why did it you know, why
does it come up as a you know, a controversy
in the world of say, chronic fatigue syndrome or CFSME.
And the reason for that is not so much that
the concept is bad. It's that, in my experience in
working with hundreds, if not thousands of people with chronic

(07:39):
fatigue and fibromileogy, et cetera, A, you don't feel well.
B In chronic fatigue specifically, you have an intolerance to
movement and exercise, and that's part of the disorder. So
the way that we have found to deal with that
is chronic fatigue has any areas of the body where

(08:02):
it is affected. It's not just triggered by one thing.
It's not like getting an infection or something. And so
when we think about that, what we try and do
with people is say, look, you know, yes, walk around
your house as much as you can and do what
you can. Don't push yourself to the point of being
unable to move the next day, but move as much

(08:23):
as you can. But as we work on these other
underlying areas of your chronic illness, your body will get
more reserve and be able to respond to the exercise.
And then we will do more of this, you know,
little baby steps great exercise tolerance. The problem at least
in the papers I've read where they're really down on

(08:46):
exercise tolerance and chronic fatigue patients, etc. Is largely because
they're not doing anything about the other parts of the
body and the other areas of the body that are
being stressed. And if you don't do that with a
chronic ill person, then their body will never recover. And
so just as an aside, well, what areas are you

(09:09):
working with? Well, the big areas that we look at
in chronic illness or recovering from cancer or whatever are
going to be self function, which includes your nutrients and
your mitochondrial function, and all of that exposure to toxic materials,
environmental exposures, resistance factors for common chronic infections that you

(09:32):
may not even know you have. Getting your immune system
as functional as possible. Some of our chronically ill patients
actually have immune disorders and you have to work around that.
Some just have such a beat up immune system it
doesn't work very well. Then your hormonal system in any
trauma or chronic illness can be thrown way off. Your

(09:57):
psychosocial interactions. How well are you doing with people around you?
How do you feel inside? We need to work on that.
Your function of your digestive tract, which is so terribly important,
and also what are you putting in it, what are
you eating? And then physical and structural things, because sometimes
people have been sick for a long time, may have
a lot of trigger points, they may have a lot

(10:19):
of muscular skeletal problems, they may have other things that
go along in the physical realm that are important. So
what I would say about the controversy around great exercise
tolerance and specifically chronic fatigue syndrome is we've never really
had a problem with it, but that's because it was
a part of working on all these other areas for

(10:42):
the chronic fatigue patient or the fibro patient or a
bad autoimmune case or something like that. So the person
is having the other areas of their health attended to,
and we're, as I said, getting more margin for their
body to be able to do the exercise. But the
other thing that's real critical is in someone who has

(11:04):
say chronic fatigue or five mile ja or they've really
flared in a chronic illness. They may have to start
with almost nothing and do it for not a week,
but like a month, and then month two they go
to a little more than almost nothing, and month three
they go to a little bit more. We've had people recovering,
you know, after chemo or in a bad flare, you know,

(11:25):
with a chronic illness, and the first thing was just
standing up and down out of their chair more times
a day, or walking, you know, one more trip to
the kitchen, not to get any food, but just that
was the only trip they made during the day, kitchen
and bathroom usually, And so just a little bit more,
just a little bit more, and then they'll say, well,

(11:47):
but you know, next week's I can do more. Well,
if they're really really sick and their metabolism is really suppressed, no,
we might do it for four weeks and so that
extra trip, you know, the kitchen, you might do two
of them or some thing. But then the next month
you see how they're doing, you see how they're tolerating
all of that, and then you say, okay, I think

(12:07):
we can go to here. You know, what do you
want to do? Do you want to add a walk
around the block. Do you want to add going up
down the stairs a couple of times? What do you
want to do? And we just keep building it. But
the idea is a little longer step. So they're baby
steps with their wider, longer steps, and they're little steps
each time. It's not like when you were fifteen years
old and went out for track and you were sore

(12:28):
for the first week and then you're running like a gazelle.
It doesn't work that way anymore. It's all elongate. We
have chronic illness. And I will put in the show
notes some of these studies just so you can take
a look at them if you want to anything else
of interest we put down there in the show notes.
I do want to thank everybody, all the subscribers on

(12:50):
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(13:10):
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(13:31):
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have notifications on all. Right, well, we're out of time
for today, Thank you so much and our helpful therapy
as muscle as medicine was our subtopic today. And I'll
see you all on the radio next week.