I'm back to normal, but it took 5 years. I had the severe fatigue - 60 visits with my doctor of physical therapy made a dramatic difference. I was shaky and weak the first session and had to sit down and rest for 15 minutes after one test.
Dr. Joe had me do a Bruce protocol of which I lasted a not very impressive 7 minutes the first time. I complained the entire 120 hours (each session lasted 2 hours). It was so hard. I did an hour of resistance training and 45 minutes on the treadmill, and a generous dose of therapeutic rest. I would come home after the first sessions and crash - literally fall asleep from exhaustion. I was worn out and struggled the first 2 months (about 20 sessions). I was skeptical that exercise was going to make a difference.
The next block of sessions we saw a dramatic difference. I was tired, but not painfully exhausted. My memory started improving (Dr. Joe has worked with cognitive injuries and used music and conversation too). I started to feel, well, more normal. Daily life was not such an effort.
We were able to get an additional 20 visits approved by the insurance company over the standard 40 visits. By the end of the program I was buff and fit. I felt better than before cancer, amazing. Dr. Joe had me do the Bruce protocol test again on the treadmill and I was only his 2nd patient to ever finish the test, and I was coming down with a cold at the time. The only other patient to finish was a Navy Seal! The doctor was so proud.
He wanted to get me above 10 METS because of a study on exercise and reduction in recurrence rates. I found some information that explains about METS. Using METS to avoid mets, isn't that ironic?
Quote:
The patient walks on a moving treadmill while EKGs and heart rate are continuously monitored.[12] As tolerated by the patient, the speed and incline of the treadmill is gradually increased in stages according to whatever protocol is being used. Permanent records of heart rate, blood pressure and EKGs should be made at least once during each stage, and is usually done during the last half minute of a stage before change is made to the next higher stage. If possible, the patient continues exercising until at least 85% of their predicted maximal heart rate is reached.
MET stands for metabolic equivalent and refers to the amount of oxygen used by the body. One MET means the body uses 3.5 ml oxygen/minute/kilogram of body weight, and is about the amount of oxygen required by the body to just sit. METs allow exercise capacity to be standardized, so that a given physical performance on an cardiac exercise test indicates a certain level of fitness. About 5 METs are required to do very light work. People who don’t exercise regularly and lead a very sedentary lifestyle often can’t do more than about 7 METs on an exercise test. Healthy people who get regular exercise can reach higher MET levels.
The patient walks on the treadmill through successive stages until maximum exercise capacity is reached or the test has to be stopped for medical reasons. Each higher stage involves increasing the speed and/or grade of the treadmill. When a treadmill is set for 1.7 mph and 10% grade, a person walking on it for 3 minutes has completed close to the 5 MET level. Such a speed and grade is Stage 1 of the frequently used standard Bruce protocol. Each standard Bruce protocol stage lasts 3 minutes. Some other protocols have 2 minute stages, which is about the minimum duration needed required for the body to reach physiological equilibrium at that to a level of exercise.
There are numerous types of treadmill stress testing protocols that use different speeds and grades, but the Bruce protocol is the most common protocol. Stage 2 of the Bruce protocol is 2.5 mph at 12% grade, and requires about 7 METs. Stage 3 requires about 9.6 METs at 3.4 mph and 14% grade. Completion of Stage 4 at 4.2 mph and 16% grade requires about 13 METs. Stage 5 (5.0 mph/18% grade), Stage 6 (5.5 mph/20% grade), and Stage 7 (5.5 mph/22% grade) require about 15, 18 and 20 METs respectively. Even most normal people cannot reach the higher Bruce protocol states, with the exception of athletes and those who perform regular intense exercise.
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