Just off the treadmill, a lunchtime session after a long walk with the dogs, the luxury of lockdown means little else that has to be done. Today's session was my 41st this year and accompanied by Stiff Little Fingers in my ears and Tottenham vs Liverpool from last night on TV. I started looking for a modest session but ended up unexpectedly jogging for 10 minutes at 7.5kmph at the end of the session. Ketone levels checked and blood level of 0.6mmol/L post session. Bit of a breakthrough and achieved through:
Daily treadmill sessions
Seeking gradual improvement
Low carb diet
Exercising pre food and fasted since the evening before
This is what works for me and why I feel a low carb diet is helpful for those of us with McArdle.
How did I get here?
Back in 2005 I was lucky enough to visit Dr Slonim in New York and to get from him an exercise prescription and a recommendation to reduce carbs to a low level in my diet. The intention of his exercise prescription, he explained, was to train my body to operate in ketosis as he felt that to be optimal for M. I followed the low carb diet and exercised regularly, at times I experienced an odd taste in my mouth, which I could not explain and once or twice I found myself able to jog at the end of sessions, much like today. I had not paid that much attention to his explanation and had not looked into ketosis - I should have.
Concurrently I was trying to keep my weight in check and so had undertaken an annual fast in Koh Samui. For several years these were monitored and I took supplements and a drank juice daily on the fast at regular intervals. In July 2014 I found the juice was making me nauseous so on Day one of my fast decided to just take water, toward the end I supplemented that with a very small amount of cheese and some natural yoghurt. With little else to do I walked a lot and started to swim. Toward the 6th day of the fast I noticed I was able to get up and go for a long walk, even up some steep hills without pause. I was able to swim 50 lengths of a 25m pool, without pause. I had never been able to do either before in 52 years. Excitedly I called Andrew Wakelin to discuss with him and he mentioned ketosis. This time I determined to take a closer look at how I might stay in ketosis for longer, since permanently fasting was clearly not a sustainable solution. I continued to fats for a further 3 days and on my return to Singapore I was able to jog for first 20 and then 40 minutes without issue, and, also for the first time in my life to play cricket unconcerned about M.
Having chanced upon this I was keen to share with the M community - a few others had been experimenting with a Ketogenic diet and as this was an obvious way of staying in ketosis so did I. At the time this was controversial and there was considerable debate about whether the diet was safe and whether it should be shared in the main McArdle's Facebook Group. Fast forward to today and there's a dedicated group for ketosis discussion with 900 members so I am pleased we persisted. For some it does not work and is not possible. For me it is once again allowing me to achieve things I thought impossible - I am probably now less high fat and more low carb. I continue to fast if I want to get into ketosis to enable exercise and ketosis works for me and given this energy pathway works as well in M patients as in the wider community makes sense, where people are able to try and use it.
For those that want to follow how I get on this year. Target if 365 treadmill sessions of 50 minutes please look out for the blogs and I hope they will offer hope and encouragement to the M community.
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