Thursday, July 24, 2014

Was it a lifesaver? Or was it a small curse?

Remember back a few years when I was dealing with debilitating headaches that it seemed like no one would be able to figure out? (April and May of 2009, to be exact.) After a relatively short period dealing with the unbearable pain (about a month…but it felt like an eternity!), I finally saw an ENT that diagnosed me with Cluster Headaches.

After the diagnosis, I was prescribed a drug called Propranolol, as well as given some pain meds that go right to the source of the pain and knock it out when it attacks, and life moved on relatively pleasantly.

The propranolol was the key, though. It’s a beta blocker that acts as a prophylaxis to my headaches. For some unknown reason, it keeps them from happening. And for that, I've been very, very grateful! (They don’t know what causes Clusters. Whether it’s a stress thing, or a tired thing, or a food thing. So it makes it tough to treat them, I guess.)

One of the “side-effects” of propranolol is a lowered heart rate. I don’t want to get all medicalish and shit in this post, but this is an important fact to note. I have been taking 160 mgs of propranolol every day for the past 5 years, because when I try to back off and take less of it, it’s not long before I start having regular headaches again…and not long after that before they become debilitating.

Since that time, I have been gaining more and more weight. However, I work out regularly. I eat pretty well a majority of the time. But I continue to get bigger and bigger. I wrote a post recently  about how frustrating it can be to be in a body that just doesn't seem to respond to anything I try to do to make it healthier. I've written posts like that several times throughout the years that I've been blogging, hoping I can help make a small difference, I guess. But also, they’re a little cathartic. ::shrugs:: Meh.

I've been thinking a LOT lately that my propranolol might not be helping. So I tried looking it up online…checking to see if there’s any info out there about how propranolol affects the standard workout for an otherwise healthy adult. And I found NOTHING. Lots of articles and tidbits about how it will affect your heart rate, obvs, and even questions from people wondering if they can workout while they take the drug. (The answer is generally, yes…depending on why you’re taking it, of course. Some people take it for blood pressure issues, and hypertension. Those folks should totally consult with their doc before they start a workout regimen!) But nothing about how a standard workout for an otherwise healthy individual might be changed by the drug.

Apparently, I was going to need a heart rate monitor in order to see what was happening, specifically, during my workouts. I asked my personal trainer for suggestions, and he said he had a couple of clients that used a model from Polar that had worked pretty well for them, so I went ahead and got one of those babies for myself.

Everyone has a maximum heart rate they should be keeping in mind when they’re working out. We all start at 220, for some reason. It’s based on something called the Karvonen formula. I don’t understand where it came from, and Google isn't entirely helpful with it, but it’s what a lot of gym-goers use as their basis for calculation, so I’ma stick with that for the purposes of this post. So we subtract my age from 220, and we come up with a max heart rate of 180.

Technically, according to some genetic testing I've gone through the trouble of having done (I've gone to great lengths to try to figure out how to deal with this weight issue in as natural of a way as possible!), I should be working at 70 – 85% of my max heart rate 40% of the time, and 50 – 65% of my max heart rate 60% of the time. Since I work out with my personal trainer twice a week, we count those as the 40%, and then the rest of my workouts (3 – 4 times on other days of the week) are the 60%. They mostly consist of a great deal of walking, but can also include some tougher yoga or Pilates classes/videos.

Looking back at that math up above, the targets are as follows:
40% of workouts = working towards a heart rate of 126 – 153
60% of workouts = working towards a heart rate of 90 – 117

Unfortunately, with the propranolol in my system, my max heart rate I could reach during a heart rate test on the treadmill was 128.

128. That was IT.

My first training appointment when I wore the monitor, I worked out for 44 minutes, and burned a total of 173 calories.

That? Was depressing.

But it was a step towards figuring shit out. I set the monitor to work for Leo one day, so he could see how high his heart rate was getting during his workouts with his personal trainer. I was on the treadmill at the gym while he was doing that, and when he was done, he came over and said, “So, is this right?”, showing me the results from the monitor on his arm. He had worked out for 41 minutes, and burned 384 calories.

Not gonna lie, I went to the bathroom after that and started crying. It just was not fair. I worked out longer and harder than that guy a majority of the time, and fuck if my body just wasn't going to let me see any good result from it! (And yeah, he’s a dude, and their bodies are different from a woman’s, and he’s 3 years younger than me, too, and blahblahblah…it still sucked to see those numbers, ok?)

Maintaining the 90 – 117 heart rate level during my 60%-of-the-time workouts was easier. I achieve that without issue by doing interval training on hills and with speed adjustments while on the treadmill every time I work out.

But it very quickly became clear that there was no way in hell I would ever be able to achieve that 85% of my max heart rate at 153 beats per minute! Not while I’m on the propranolol. And I’m pretty sure that without being able to work up to that number, those workouts with my personal trainer twice a week are pretty much a waste of time. (Not 100%...don’t get me wrong. I know they’re helping me to build strength and keep healthy. But as far as seeing a better result? Not gonna happen!)

So I’m weaning off of it again. I've tried this once before, but it didn't go very well. However, I’m in a completely different place with my brain now. I see my hypnotherapist once a week and we’re focusing on the headaches (as well as the hemifacial spasm) during our current sessions. My nutritionist has a supplement called “Migranol” that hopefully will help during this weaning period. And I see my chiropractor/acupuncturist every week as well. He can help with this sort of shit, too.

Western meds aren't always the answer. And I don’t wanna be stuck on a medicine for these headaches for the rest of my life, anyway! So we’ll attack them in an alternate fashion, goddammit.

As of today, I have been weaning off the propranolol for 1 week. I expect it will take 4 – 6 full weeks before I can stop taking it all together. But, surprisingly, it’s already having an effect on my workouts. The day after I skipped my first evening dose, my heart rate went up to 132 during my workout with my personal trainer. Tuesday, I worked out for 1 hour and burned 273 calories. My heart rate got up to 134 that day. The previous week, I worked out for 44 minutes, and burned only 189 cals, and only got to a max heart rate of 124. Yesterday (which was one of my 60% days), I worked out for 1 hour 22 minutes, and burned 357 cals with a max heart rate of 123 achieved.

Clearly, this heart rate thing makes a difference in calorie burn, is mah point.

For some reason, even though I’m somewhat overedumacated when it comes to my health and exercise and all that good stuff (I've been working at remaining as fit as possible, off and on, since I was a kid. I attended a fat farm/weight loss camp when I was 12. I started doing Jazzercize with mom when I got back from camp that year. I went on Jenny Craig for the first time when I was 15. It’s been a long road filled with all the info you can imagine would be related to eating healthy, working out, and living an active life), I have not made that heart rate connection with my failing to lose weight in spite of my consistent workout routine for the last 3 years.

I wanted to get this info out there so others dealing with this shit have a resource to turn to. At least a beginning to work from, if nothing else. It’s not an excuse…but it IS an explanation. A scientific one, no less! And we need more studies on this stuff, I think. More information to be able to help propranolol users maintain an optimal health level while they’re using the med. Or at least to help them realize the full impact it will have on them while using it.

In my case, the propranolol basically saved my life when I knew of no other way to save it. But it’s also keeping me from being able to burn fat, and God knows what else my body is failing to do properly without being able to reach those higher heart rate levels. (Well, and science knows, too. I’m sure science is well aware of all the things my body can be doing more optimally when I reach a higher heart rate level during my tougher workouts twice a week, right? I just don’t know how to look all that sciency stuff up. But if you happen to know it, and can tell me in layman’s terms what else it might be doing for me, feel free to share!)

Maybe I’ll always have to be on some small amount of propranolol. But maybe not. I sure hope not! In the meantime, I think I've won this one small battle. And that gives me hope for the future ones I have in store. Being positive is half of the battle, anyway, right? And now that I have that positive outlook? The war might need to just watch it’s back, honey…


Anonymous said...

I hope you'll post regularly about your workouts as you wean off it. The human body is amazing. As one who struggles with weight loss, it helps me to read of others struggles. I don't feel so alone. It's the whole "misery loves company" thing, I guess. :)

Heather said...

I have no helpful information, but I just wanted to say I really admire your ability to not just accept your status quo as "they way it has to be" and actively working to change it. Whether that be researching different treatments or whatever. Not everyone is that open to change and it's awesome so see! Keep it up, lady!