The Depths of Illness - Exercise-Induced Fatigue

December 2013

A friend and colleague had been asking if I wanted to joint him mountain biking for over a year.  I loved mountain biking - got into it during college on the trails that crisscrossed South Mountain between Lehigh's three campuses - but I had not been mountain biking in years due to an irregular onslaught of aches and ailments that rarely gave me pause.  One week, however, when Ari again invited me out for a ride, I was having a good week and decided to give it a try.

The morning of the ride, I did not feel nearly as good as when I had accepted.  Nevertheless, I hopped on my bike and took off to meet Ari and his friend Alex in a parking lot not too far from my house.  "Adam," Ari said with the drawn ease of a life-time Californian, "you excited?"

"Nervous,"  I replied.  "You all are gonna take it easy on me, right?"  Ari and Alex smiled.

We took off, following some railroad tracks for a short while till coming to the drop in point for Rose Canyon.  It was less than a mile, but I was already winded and struggling to keep up.  I wasn't in the best shape, which was part of the problem, but I also knew that this feeling was different.  For years, after moderate to severe expenditures of energy - everywhere from a short run to playing volleyball to going for a hike in the mountains - my body would shut down.  This was how it always began.

After a few miles of riding over moderate terrain, we stopped at the top of a side trail that ended at a cul-de-sac near my neighborhood.  I was dizzy, shaking, and unable to breath.  "Guess I'm in worse shape than I thought," I said to Ari and Alex.  "I'm going to head on out and stop holding you two back."  Unsure if I was going to pass out, throw up, or maintain my feeling of being on the verge of something worse, I walked my bike to the cul-de-sac, hopped on and rode home.

"You're back so soon," Ingrid said, surprised.  "How was it?"

"Miserable." I said.  "I feel like crap."  I lay down on the carpet in the living room and turned on the TV.  I did not have enough energy to get up.  My head felt heavy.  Eyes closed.  Unwillingly, though blessfully, sleep came.  Not refreshing sleep, though.  When I awoke, my head and limbs remained heavy and difficult to command.  I was not surprised.  This had happened many times before and would undoubtedly happen again. 

Oxygen Therapy - A Plausible Theory (Part I)

The shortened story goes like this...  A number of years ago I started to research hyperbaric oxygen therapy (HBOT) during discussions with Dr. Kurisu regarding natural treatments for herniated or bulging disks.  In HBOT, a patient is placed inside of a container that is pressurized with air that has a much higher oxygen concentration than normal air (normal air is mostly nitrogen, approx. 78%, and oxygen, approx. 21%, with the remaining percent going to various other gasses).  To be clear, Dr. Kurisu recommended swimming or sitting in Jacuzzis (a therapy that reduced the pressure on the ailing disk thanks to the buoyancy effect of water), not HBOT.  I made the connection between the buoyancy of water and the buoyancy of pressurized air in HBOT.  My research at the time was not particularly interested in the oxygen aspect and resulted in the following conclusions: (1) HBOT was not covered by insurance for back injuries, (2) HBOT would be expensive out of pocket, (3) there was significant risk to health if not done properly (e.g. wrong pressure, wrong oxygen content, etc.).  With those hurdles, I put HBOT out of my mind.

In the intervening years, the oxygen aspect of HBOT flickered in my thoughts as something that might help correct whatever was ailing me - though it was a dim thought.  I knew that oxygen was prescribed to those with certain medical conditions and that oxygen bars were popping up in certain cities as the latest craze, but testing out an oxygen therapy on my own condition didn't take hold until I met a colleague for lunch a few months ago at the Seaside Market in Encinitas.  Instead of talking shop, as I had intended, we chatted illness and therapy, as his wife had recently been diagnosed with a mitochondrial disease.  "Your symptoms sound strikingly similar to mitochondrial disease," John (pseudonym) told me. 

The mitochondria are the powerhouses of the cells - they create the energy that the body uses to function.  Energy is produced in one of two ways: (1) aerobically - with oxygen and (2) anaerobically - without oxygen.  In mitochondrial disease, the mitochondria are unable to absorb enough oxygen to maintain aerobic energy production, resulting in the body moving much more quickly into anaerobic energy production.  The result of moving into anaerobic energy production is fatigue.

The theory that my fatigue was caused due to oxygen deficiencies in the cells was fascinating.  I immediately started looking for more information.  I found the following two blog posts (the titles say it all) by Cort Johnson:

Poor Oxygen Uptake May Be at the Core of the Exercise Problems in Chronic Fatigue Syndrome

Are Oxygen Starved Tissues Causing Pain and Fatigue in Fibromyalgia and Chronic Fatigue Syndrome (ME/CFS)?

These blog posts review current medical studies that suggest that oxygen deficiency may be a cause for both the pain associated with Chronic Fatigue Syndrom and Fibromyalgia and a particular symptom of exercise-induced fatigue - a symptom that I was thoroughly familiar with (see blog post - The Depths of Illness - Exercise-Induced Fatigue).  The Cort Johnson blogs, though fascinating, offered little in the way of treatment and/or therapy outside of a few drugs (that may or may not work if you can get your doctor to prescribe them).  

The notion that oxygen deficiency leading to anaerobic energy production and fatigue matched my experiences too closely to ignore.  Uninterested in pursuing the suggested drugs, I wanted to know if any alternative therapies could help - the leading suspect, oxygen therapy (any therapy that would supersaturate my body with oxygen).  A brief mention of oxygen therapy in the comments section of one of these blogs noted that anecdotal evidence showed that oxygen therapy was helpful for some people but not for others.  More hours of internet research confirmed the same sentiment - all anecdotal evidence, all inconclusive.  However, oxygen therapy sounded both promising and plausible - almost without hesitation, I decided to give it a try...  

Click the links below to read other posts in the Oxygen Therapy Series:

Oxygen Therapy - A Plausible Theory (Part I)
Oxygen Therapy - Finding an Oxygen Source (Part II)
Oxygen Therapy - Trials and Tribulations (Part III)
Oxygen Therapy - Massaging the Truth (Part IV)
Oxygen Therapy - Cardio for a Day (Part V)
Oxygen Therapy - Strength Training (Part VI)