Costo and the benefits of exercise

Diagnosis
I was diagnosed with costochondritis in October of 2015, but had symptoms on and off for long before this. Up until July of 2015 I was working out regularly. Around August or September is when life got too hectic and working out and eating right were the first things I dropped from my list of priorities. Combine this with two stressful, sedentary jobs and it was the perfect storm for costo to fully rear it's ugly head.

After being diagnosed (which consists of the doctor asking specific questions and pushing hard on and around my ribs) I had my first costo flare - meaning the symptoms increased sharply as did the pain. For the next few weeks and months I had to learn about what costo was and how it affected my body, about what I could do and couldn't do, and about how much I could handle. I was in a proverbial "survival mode" while trying to manage this, work, home and kids. Exercise seemed impossible and out of the question at this time. Luckily this changed over time.

What if Feels Like
I often get asked what costo feels like. It's so difficult to explain because the symptoms can vary day to day and the pain can move not only day to day but throughout one day. For me, most of my pain is on the right side of my body and only sometimes on the left. But when it moves to the left I get heart palpitations; shortness of breath; anxiety; and pain throughout the left ribs, sternum and down the left arm. Yes, it sounds (and feels) like a mild heart attack.

Costo also feels like you have a leather belt being wrapped around your torso and it is being pulled as tightly as possible around your body. Not fun. On better days I just have swollen, sore ribs that feel like I have been punched. Yes those are my better days! The heart attack feeling and the belt feeling are, for me, the worst physical part of costo.

Photo credit: Jami Lynn of http://www.jamiswords.com/

In addition I have on "flare days" general lethargy, malaise, and a feverish feeling with no fever. I also have shoulder, wrist, lower back, and knee pain. I sometimes also have headaches, "brain fog", emotional sensitivity, insomnia, restless legs, sensitive skin, and have felt off balance at times. To this day opening doors hurts (heavy doors at stores and restaurants are nearly impossible), bending down to pick something up or tie my shoe brings on a wave of pain, holding anything against my torso (even crossing my arms) feels like I'm bruising myself, and wearing a bra with a wire and carrying a purse are not allowed.

Why exercise?
I have a fitness tracker that I continued to wear throughout the early months after my costo diagnosis. It quickly became my enemy as it reminded me to get up and move around both at work and at home. At work all I wanted to do was go home and at home all I wanted to do was lie down. Yes, I could have shut off the hourly reminders to get up and stretch and walk but I didn't want to throw in the towel 100%.

Anyone that knows about physical fitness, health conditions, or physiology knows that movement, any gentle movement, is better than no movement at all. I knew this too, but couldn't get myself to consistently move. I had days where I would consciously make an effort to walk more at work or at home. I had days I would try some gentle yoga. But it all hurt and I couldn't torture myself more than I was already being tortured.

Finally I met an amazing physical therapist (a special thanks to my hubby for finding her) who specialized in the spine and was very familiar with costo. Throughout having costo I keep hoping for "the miracle solution" that will finally heal me from this condition. I need to let that thought go. Because while my physical therapist didn't heal me from costo she did help put me on the path to getting physically active again.

Easy walk on the beach aka my happy place

Baby steps
Our first sessions were very slow and steady, just seeing what my body could handle. Laying facedown on her table was my first challenge! Laying on my ribs was a no go for a bit. She manipulated my ribs with her hands, trying to get some gentle movement back into my torso. I had muscle imbalances and could only rotate my torso so many degrees on my right side. We worked to get that back in balance. I added gentle chest stretches (still my arch nemesis) and eventually I was able to lift my arms a few reps and started strengthening my shoulders and side body.

The prescribed exercises from the physical therapist spawned a new outlook on exercise for me. I began to learn when I could push through the pain and when to not. I learned how to safely exercise and when I needed to rest. I had to learn that change and growth comes at a much slower pace than ever before in my life but that if I am patient with myself and my body I will make progress. I had to remember not to overdo anything so as to not have a major setback or more pain. I have learned to love the gym again.

When I started "Operation Me!" at the end of June (see this post for more info) incorporating physical fitness was one of my primary objectives. I started walking, both at the gym and outdoors, in order to build up my endurance (at that time I had none!) in preparation for traveling in August. At first walking added some pain to my lower ribs, not unbearable, but it would take me a day or two before I could walk again. My first walks were 20-30 minutes at a slow, comfortable but steady pace. Even though the cartilage of the ribs doesn't have any blood flow, I think that movement and cardio help heal the area somehow.

Day 1 of Operation Me included yoga

Moving on up
Eventually I added the elliptical machine to my day and quickly realized that the machine itself felt good, but that using my arms on the arm poles was what caused pain. At first I could only do about 15-20 minutes of the elliptical but with slow and steady progress I can now do 45 minutes. I still cannot use the arm poles.

The biggest excitement for me is that I can now do arm/shoulder/chest exercises for 15 minutes after cardio! I have a real gym routine! I also do leg exercises on alternating days. I will share the arm exercises I do, but not as a prescription for others. Each of our bodies is different and will react different to exercise so please don't start any new exercise without being overseen by a medical professional.

When I started arm exercises I couldn't use any weight and I could only do 2 sets of 5 reps. Now I can use 5 pounds of hand weights and can do 3 sets of 8-10 reps! I do the following exercises: bicep curls, hammerhead curls, overhead tricep extensions, tricep dips, overhead shoulder press, lateral deltoid raises, one arm dumbell rows, and one arm tricep kickbacks. I sometimes add in 3-5 wall pushups, but this still gives me pain. I still occasionally try yoga, which is my first love, but the pain in my ribs moves and is unpredictable so I only do yoga when I'm feeling really good.

For more about the above exercises please google them, but again do not try these without being under supervision of a medical professional. I have found that they help me to build up arm, shoulder, chest and back strength but they can cause pain so please be careful.

Here are two pictures from my fitness tracker app that show some of my walking progress. On average now I walk about 6,000-7,000 steps a day. Walking around various cities catching Pokemon for the Pokemon Go app has helped keep my steps up :-)

June 16 step victory 4,994 steps

July 28 step victory 12,498 steps! 

One of my favorite things to do is go the gym to watch Jeopardy or HGTV while working out. The time flies and my mood improves immensely after.

Two somewhat unexpected benefits of working have been moderately improved sleep and a much improved resting heart rate. I started slowing incorporating exercise before I started Operation Me but after just 7 days of consistent exercise my resting heart rate improved and continues to do so! This alone is motivational! 

Questions? Comments?
Do you have costochondritis or another chronic pain condition? How are you doing with physical fitness - what are the challenges? Do you find anything particularly helpful? Comment below!

Five things I have learned about having costochondritis

Well, here I am, almost 10 months after receiving a diagnosis of costochondritis and five weeks into my more intensive health care journey that I named, "Operation Me." My intention on this journey was to devote time, energy and resources into healing from costochondritis in order to be ready to travel to Iceland in August with my husband and children.

Along the way I have learned a lot, some that I will share here in this post. While writing is therapeutic for me, my goal is to help others suffering from costochondritis (as it is a relatively rare condition) as well as other chronic pain or health conditions.

Beaches are my stress relief

First and foremost: I have learned that this journey will continue well past August. I had two thoughts when I started this project. The first one was that I would maybe, just maybe, be fully healed from costo by now. Sadly, this is not the case at all. The second thought is that this project would be too difficult to maintain while traveling and even more impossible once I'm back to work.

I have decided that the above is not the case. With the help of some of my medical providers as well as my own experiences drawn from this journey, I now know I can continue on this path of healing while traveling and while returning to a crazy schedule in the fall. I would like to continue to share how this journey unravels while traveling in a few weeks. I am hoping this may inspire others with pain to not be afraid to travel with a little extra planning.

The second thing I have learned is to not give up. We know our own bodies best and while many of the medical providers I have encountered have been extraordinarily helpful to me on this discovery, some have been completely baffled and a small minority have been close-minded. From chatting online with other costochondritis sufferers around the globe, I have heard horror stories of doctors ignoring symptoms or believing the symptoms are psychological and not physical.

Having experienced unhelpful providers in the past, I was ready to put up a fight with providers if they tried to go down this path, but luckily that really didn't come up much this time around. But in the meantime I listened to my body, didn't try anything that didn't feel right for me, kept a detailed health journal of my symptoms, and did my best to explain myself to providers.

Help is out there, if you have not found the right people who are willing to listen and who really hear what you have to see, keep searching. Don't give up. Reach out to others who may be able to point you in the right direction. Social media outlets can be helpful in finding resources. Facebook has some well-established closed (aka private) costochondritis groups where members vent and receive support and share tips and resources.

Thing three that I learned (re-learned is a better word) is that family is everything. It is easy to get stuck in your own head during this windy road - this very long windy road. Being hyper-focused on my health sometimes was a barrier to living in the moment and focusing on what's important in my life.

I knew this already but it was hard some days because I was in so much pain and that pain hindered everything. Luckily, I have an amazing family and have truly won the "lottery of life." My family is the reason I have something to look forward to every day, my motivation to get up and push through the pain, and the reason I laugh every day (even though laughing hurts sometimes!). Whether family is your pet, your spouse, your kids, your parents, your siblings, or your best friend: cherish them, laugh with them, talk with them; you won't regret it. (Balance this time with rest and recovery if needed. Going out somewhere with family often meant laying down after with heat, pain creams, and medicine.)

The fourth thing I learned is that everything we have been taught to eat since we were kids (at least in America) is wrong, wrong, wrong. I am going to save most of this information for a future blog where I will list resources and research so you don't think I'm just blowing steam. But I thought that I ate relatively healthy (on my good days) but I really wasn't. Some of the finer details of nutrition will be different for everyone because our bodies are different, however we need much more vegetables (especially the green varieties) than we think and much less grains and protein than we think we should be having. I am still working on my nutrition and it takes a long time to heal all those years of unhealthy eating, but I am happy with the changes I am making. More to come later!

Life changing book:

The fifth major thing I have discovered is how important physical activity is. Again, I knew this and I enjoyed fitness before costo. I loved zumba, walking, yoga, light weight lifting, P90X and more. I always felt better when moving. But I also love learning and could spend hours researching, taking classes, writing, etc. I had symptoms of costo years before I was diagnosed, but costo finally kicked my butt in October after working two jobs for a few months trying to advance my career. Both jobs are stressful and sedentary. There wasn't any time for exercise, plus it hurt.

After the diagnosis I spent months trying to balance pain and physical fitness. My fitness tracker became my number one enemy. Everytime it vibrated, telling me to get up and walk around, I would feel worse and worse about my predicament, but I was afraid to move and be in more pain. There were more days than I would like to count that I needed help putting on or taking off shirts, lifting clean dishes to the cabinets, bending over to tie my shoes, and opening doors. Who wants to work out when they are in that much pain?!

One of the many symptoms of costo is shortness of breath. I had this even while lying still. Trying to exercise (even walk) was tough at the beginning of this journey (just over a month ago)and being out of shape only made physical fitness more difficult. I was hard on myself, wondering if I would ever be fit again. I am not very patient, especially with myself, so learning how to slowly (and I mean slowly) build up endurance and strength was not easy for me. I had to learn how small the increments of change and progress would be.

Looking back now, though, it wasn't all that long. It may not sound like much but when I started this project I couldn't do much more than 10-15 minutes of walking or the elliptical machine but now I can do up to 45 without more pain (I still can't swing my arms yet or use the arm poles on the elliptical). In the beginning I couldn't really do any arm exercises and now I can usually do three sets of 6-8 reps of a few traditional arm/shoulder exercises every other day without too much discomfort. I still don't have any strength in my pecs/chest and can't do more than 5 wall pushups without pain that lasts 2-3 days. But I'll get there! Most importantly I can walk 2 miles outside comfortably - Iceland here I come!!