A huge step forward, and why steel toe capped wellington boots seem to be really making a difference...

 An hour ago I stepped off the treadmill, puffing and panting, but delighted with my 1st session of the year and now needing to consider whether my 2023 goals may need upward revision.

A 30 minute jog in which I covered 2 miles was not what I would have predicted back in December but it is reward for some consistent effort and encouragement to continue to push as I approach 61!

 The secret weapon I now believe is a pair of steel toed wellington boots. Late last year my prior pair of boots finally became unusable and so I went to buy a new pair. Green Dunlop boots seemed a good price and it was not until I went for a walk the next day I realised a mistake may have been made. The heavy toe caps  made me question the purchase. Since then I have worn the boots on each of my 16 dog walks year to date, across muddy fields and with plenty of uphill walking. I have averaged 5.4km a day in around an hour and I have felt the weight of the boots working my quad muscles, not enough to cause a problem but sufficient to notice. My diet has been fairly low carb and with a walk 1st thing in the morning I've been feeling very good M wise. Today I walked a little later and a little faster and decided when I got back to treadmill. The results were beyond my expectations but very welcome. That is my 1st 30 minute jog since 2016 and had it been essential I could have continued. It wasn't so I didn't and I have left some goals to reach but delighted with my start and with the boot purchase!!

Ketones at 0.7 mmol/L at the end of my session. 

Time for 70/20/10

 2 months on and I remain somewhat disappointed with Test day 5 and indeed with my ability to stick to a regime I had intended to follow as below

"having broken my fast its I had intend to push on and see what I can achieve with:

A ketogenic diet

A minimum of 5 50 minute treadmill sessions a week

A minimum of 3 30 minute static bike sessions a week.

Modest dumbbell for arm exercises

Aims:

To jog 

1st target 10 minutes   achieved 6th November second session of day 40-50 minutes

2nd target 20 minutes

3rd target 40 minutes

4th target 50 minutes

Final target 60 minutes

Not sure yet, target for the bike as I have never used the one we have. Will assess once its working!

Start on 1st November though diet continues from now. No point wasting existing ketogenic state.

After a couple of days of modest eating weight settles at 85kg, 5kg below starting point but at least 5kg from where I would like to be. Work to be done."

Pre Christmas and after a sustained period of following diets I could not follow the regime as I had hoped. I now intend to start again come 1st January!!

Koh Samui -October fast and Copenhagen testing

 12 October

I had not planned to start my fast today but its 2pm and I have not felt the need to eat so perhaps I shall. A coconut water and a black coffee after a 2 hour stroll this morning are so far more than sufficient. 

Since my last visit clearly Koh Samui has been impacted by the pandemic. Lots if businesses closed and units empty and crumbling in the centre of Lamai. Elsewhere though investment has clearly been made. The detox spa I first came to in 2007 is one such, from a rambling series of wooden structures a modern sleek resort has emerged...sadly the old trusted open all hours steam room is no  more and I have yet to test its replacement. The menu looks delicious and I will probably allow myself one or two items from it before I return to Singapore, but only once I am feeling deeply in ketosis.

Day 2

Early morning swim. Two lengths only as arms  began to struggle. So sustained by coconut water  a black coffee and water. Off for a walk shortly....2 hours and a coffee. Checking on coconut water and seems not ideal so will be dropping that from my fasting protocol...4 lengths in the afternoon and news from Copenhagen that they are able to test me again on 25th October consequently decide to break this fast and sample a small amount of Samui delicacies. Will be back to full on water fast with renewed vigour from tomorrow evening.

Day 3

 in Koh Samui and a day of preparation. Visit to the barber shop for a No 3 and a shave (hope that was not too big a Covid risk) to get me in the boot camp mood. Local SIM acquired so I can track my walking accurately the food I am likely to crave eaten in moderation, have kept it low carb, and a multi-vitamin with minerals acquired. Ready to go anew.

Day 4

The new day 1 of what is now a 10 day water fast. I will allow coffee and I may choose to add butter to is as I did this morning. Otherwise my intention is just water. A rainy start but then the son came out and I walked 7.4km with 40m of elevation in 1hr 29mins  according to Strava. Back at base I then managed 20 lengths of the pool quite comfortably. A good morning so had a pedicure and  now have a short nap as I was up late last night unable to sleep..so far feeling so much better than at any time on the carb protocol. Long way to go.

Day 5

And the first morning I have struggled. Slept very poorly, could have been the pain of watching Bristol City slip to another disappointing defeat. In any event today will be less active unless two strong coffees change the mood.

The coffee worked and after a couple of hours of admin I took advantage of a break in the rain to swim 40 lengths in around 40 minutes. Could comfortably have continued but as the rain got a lot heavier decided to stop...

Day 6

Another night of tossing and turning. One benefit of carbs that I had underrated. Up at 7:15 and pushed a little harder on today's walk of 10km, with 64m of elevation, completed in just under two hours with some short uphill jogs thrown in. 

Beginning to form some fairly key conclusions from the last 2 months of trials, both formal and my own informal repeat fast, as follows:

A diet low in carb has served me well since 2006 and I need to continue to follow it.

A diet with anything like 40% carb would see me exercise less, sleep more and drift toward depression. It would leave me lifeless.

Fasting offers me the opportunity for rapid improvement in exercise capacity and the energy motivation.

I need to establish a routine of regular 1 day fasting, exercise and, at least while I seek to lose weight and get fitter, a keto diet. 

Day 7 

Another night of little sleep. But it seems I somehow need less as I don't feel tired. No walking today, a swim instead, a coffee first priority of the day though. 20 lengths with a lower back issue preventing more...a little jaded and less enthused today but will crack on.

While I never quite felt like it I did manage 40 lengths in the afternoon and as I leave Samui tomorrow that will be my last swim. Significant progress since day one and easy!

Day 8

Relaxing today before flying back to Singapore with a long steam. Sleeping a lot less than normal but so far continue to feel good as I reach the half way point of fast two.

Have to confess having a tray put in front of me on flight was too much temptation and I ate 4 small shrimps and had a taste of the curry sauce. Confident it won't impact anything and will add 10 minutes to my treadmill session at Singapore Cricket Club tomorrow. Have also been craving their cheese cubes, simply a cube of cheese, small onion and green chilly on a cocktail stick. Will try hard to resist.

Plan now to check my ketone levels when I am home and perhaps have the odd small piece of cheese to supplement the fast. 

Off the plane and I cover the ground as fast, if not faster, than anyone else actively making the choice not to use the moving walkway...the joys of ketosis.

Day 9

Marching around Singapore at pace, with no sign of any M issues, absolutely none. Getting a few jobs done before I fly back to UK tonight.

Feeling a little light headed so decide to eat a small portion of tuna.

Day 10

Back home after comfortable flight. Ketones level 6.4 mmol/l, which I am very happy with and which allowed me to fast march through the airport upon arrival with not a hint of M. Allowing myself 20g of cheese, 1o g of Hellman's mayo and 8g of ham in celebration.

Day 11

Fasting at home is hard but at least I managed 11 hours undisturbed sleep last night. A full fridge and such a high ketone level tempted me with a small selection of treats yesterday. A small piece of bread, some leftover cauliflower cheese and some more ham. Will see how my resolve is today. Certainly yesterday I lacked not for energy and will see how I go on the jogging machine.

A little light headed today and fridge proved irresistible. However, only nibbled with small amounts of cheese ham cauliflower cheese and a very small amount of bread. Will test ketones tomorrow.

Day 12

1st treadmill session since May best since 13 December when Covid struck. Able to start at 6.3kmph. Very happy with that. Now for final push and 2 days on simply water.

Day 13

Largely compliant some cheese, taramasalata and a very small amount of bread my only real deviations. Now heading for Copenhagen, actually quite excited to get on the bike tomorrow. Hopeful the effort will show a demonstrable in keto improvement. If not weight loss will have to be sufficient consolation.

Testing Day 5

Awake at 5am local time and not meeting the team until 9am. Such a stark contrast to my last visit when I could have slept all day. Again able to fast march everywhere yesterday while journeying here and to climb stairs without much issue. 50 steps a little thigh pain at the top but immediately able to march on, no shoelace tying requited. Must be nice for that to be the norm....have probably over done the pace of walking as shins a little sore but hey ho!!! Did consume a small amount of cheese yesterday.

Today I actually enjoyed the 30 minutes cycle. Little pain and only issue was not going too fast ! I did not beat my keto protocol max of 110w but this was a hugs contrast to just two weeks ago.

Now to maintain a ketogenic diet for the next 3 months and a regular exercise programme both treadmill and static bike and then see how I am.....

Still weight to lose so will be eating very modestly for the next few days at the very least.

Copenhagen trials - proof enough for me that carbs make my M much, much worse......

I write sitting in a cafe in Koh Samui, where my keto journey started with a water fast in 2014. Tomorrow I shall commence another 10 day water fast and this time with the added incentive of testing the impact with specialists in Copenhagen next week.

Those that have read this blog, or know me on FB, or otherwise, know very well that I am an advocate of a low carb diet for McArdle disease, so to be able to participate in a clinical trial in Copenhagen, over the last few months, has been a privilege. I was the last patient to go through the trial and so my blog now will not prejudice it in any way. 

 The trial in a nutshell looked at 2 diets. One ketogenic and one a "placebo". The placebo being higher in carbs, and much higher so than the diet I have followed since 2006, when I visited Dr Slonim, and particularly, since 2014 when I learned about keto. The food on each diet is the same the only difference is in the 4 times daily 250ml of drinks that need to be consumed.

 I was tested on 4 occasions on a static bike with 30 minutes at a level pace and then a build up in watt output 10w per minute until a maximum was reached. Heart rate monitored and blood samples taken. The study was blinded so I did not "know"  which protocol I was on until both diets and testing had been concluded. Suffice it to say though that my body quite quickly revealed which was which.

 Post diet I planned this fast as, at 60, I find myself overweight, with elevated blood pressure and high cholesterol (have known this for a long long time). I want to be in the best possible shape for the 2023 cricket season so this is my chance to press the reset button and start the long road back to better fitness with a bang. I am delighted the team in Copenhagen will test me again in just over 10 days and excited to see what my body can achieve when deep in ketosis. I have fasted many times before so I know what lies ahead but the added incentive of testing will, I am sure strengthen my resolve, while I am keen to demonstrate what deep ketosis can do for McArdle patients.

 I started the 1st diet, shortly post testing day one in Copenhagen on 9th August, everything below is contemporaneous:

8th August

Up early and excited to be heading to Copenhagen today 8 years on from returning from Koh Samui, exuberant after a fast and my new found exercise capacity. Since then keto has become a patient advocated "treatment" for McArdles so being part of the current clinical study both excites me and has me a little nervous. I have found a good balance between a low carb diet and fasting which enables me to be at my best for playing cricket. With 3 League matches left for me this season I hope I am doing the Keto diet first and nervous that the higher carb placebo diet will leave me jaded. Keen to get to Copenhagen and get the full details.

 All a bit of a rush, as I only found out about the opportunity to be part of the trial last Wednesday and deadlines mean I need to start the diet this week. I need a diet without question, not sure though I am quite ready for what lies ahead. The two diets are:

Ketogenic: 80% fat, 15% protein and 5% carbs

Placebo : 45% fat, 15% protein and 40% carbs

 Last minute bookings meant a flight via Zurich so its already been quite a long day...not looking forward to an exercise test at after 8pm....a 15 minute cycle at 9pm is not often in my plans. Tonight I managed it without too much issue. Only problem  being I may have set the bar a little higher than I should have and tomorrow's test is likely to be harder as a result....time for sleep.

 7am showered and ready for 9am report. The stark reality of the dietary requirements is dawning. Post cricket evenings will not be quite the same for the next month that is for sure.  I do though need to lose weight and I will need to regularly remind myself that this study is important....other stark realities appear....cholesterol is high and needs attention and for the first time ever my blood pressure was also high. Need to get both checked when home.

On to the test and 35 minutes of static bike, gradually increasing resistance after 30 minutes. Followed the classic McArdle pattern and after rising rapidly heart rate and pain levels began to decline after 8-10 minutes until levels were increased from 50 watts to 60, 70 80 & 90 where I had to call a halt after a minute of cycling. No issues after the test except saddle soreness...cycling shorts now a priority before my next trip. The diet begins tomorrow with a short escalation period before its full steam ahead on Friday.....

 21st August

 Am convinced I am on the Keto protocol this block, not just because of the way I feel muscle wise but also because of the aroma of my urine and the taste in my mouth. The diet is by no means easy with the prohibition of alcohol tough given planned social events, including 2 days at Lord's and, of course, post cricket matches.

 Yesterday I played cricket totally unhindered, kept wicket for 40 overs then opened the batting and batted 25+ overs, with lots of running between the wickets and, for once, total focus on the ball. No M concern, indeed it only entered my mind when thinking how good I felt. Thankfully skill level was up to physical level..

28 August

 My last League match of the season today - fasted, morning walk done and one drink consumed, so confident am I that I am on the keto protocol. I can taste it and this morning I got up and walked the dogs straight away. A short incline consumed at pace, where normally I would stop at least once....Captain for the day and may bowl....let's see how we go......thankfully a win, bowling not required but felt great in the field. 

30 August 

 Certain I am on the ketogenic protocol now. Went for a dog walk this morning and set off with a friend at a really good pace with not a hint of an issue...looking forward to the trip to Copenhagen and testing on Thursday...

1st September

Test day 2 and I felt a lot better than on the prior visit. Managed a significantly Higher watt level at the end of 35 minutes and felt much more comfortable throughout the ride, and not just because of the padded shorts! Plenty of blood taken and data to analyse but hopeful I was on the keto protocol and improved performance was significant enough to show in all the data. Good to have no dietary restrictions for a little while and to sample the delights of Copenhagen....cycle lanes a permanent danger...

12 September 

After 10 days of not dieting I am back in Copenhagen for testing prior to diet 2. Feeling fine M wise, know I am in need of a weight loss regime, and hoping the next 3 weeks will not be quite as bad as I fear. Luckily cricket is all but over for the season and as the regime requires no more exercise than normal I expect to be fine. Testing day tomorrow to get through first!

13 September 

 As expected this session was truly awful. 10 days of post diet excess, including a great wedding, where I did not hold back, meant I was in worse condition than for the first test a month ago. Had to stop at 4 minutes before restarting and nothing was easy, low level muscle pain throughout and maxed out at 60w....boy do I need a good fast! When I say i had to stop I mean it was an absolute necessity, as, had I tried to go on, I am sure I would have left the exercise room on a hospital trolley...

 19th September 

Diet 2 and everything seems harder. Only a few days in but just carried a box of paint etc. Up a small flight of stairs - struggled and am finding I need to go slowly. 

30th September 

Diet has become quite painful. I have felt fatigued and have taken to my bed twice in the afternoon  in the last 3 days. Not only tired but distinctly fed up. Convinced this is the higher carb leg and wonder if, at times in the past when I have equally exhausted, diet was a driving factor. Certainly keen to get this diet finished, the last test done and then to head to Koh Samui for a much needed fast.

 5th October

Wandered through Heathrow in a zombie like state heading to Copenhagen feeling exhausted and glad this dietary nightmare will soon be over. 

 That come Saturday I will be on my way to Koh Samui for a much needed reset.  

6th October 

Despite 10 hours sleep I still felt as if I could lie down and sleep for several more hours. No surprise then that bike results were poor. It was hard just to see through the 30 minutes and at no stage did it feel easy. It most certainly had post the keto diet when I managed 35 minutes, today just getting to 30 minutes required me to dig quite deep. Nothing left at the end to try and increase watt level..NOTHING 

 Conclusion

 It's very clear to me that low carb or keto is the best diet for me and this last few weeks has cemented that conclusion. Fatigue and feeling fed up is no way to live and that is what the placebo, higher carb, diet gave me.

Performance wise my in keto max was nearly double what I was able to achieve this time, with so much less pain, and the struggle throughout the session is not something I would want to regularly endure. It's clear to exercise comfortably and at my best I need to have a low carb diet and ideally to exercise fasted from the night before and after black coffee. Next step for me is to get the carbs out of my system and reset completely

If I felt like I felt today every time I tried to exercise then I would give up.

 

Close but no cigar..........

 I ended 13th December with 20 sessions left to complete to reach my 2021 target of 365. Sadly on 14th I tested +ve for Covid and that, as they say, was that. While symptoms were mild I have been left feeling weak and fatigued and so have yet to get back on the treadmill.

I am sure I will in the next few days and I will do so with the added benefit of a keto diet, which I think will help me recover prior performance more quickly and then to go on to challenge my Lifetime best in 2022.

But for Covid I am confident I would have hit my goal. I had though found it more difficult in the last few sessions as I took diet a little for granted. For me it is clear to exercise at my best I need to be fasted from the night before, whether I need to be fully ketogenic or simply no carbs before exercise I will seek to discover in the coming months. For 2021 I was generally low carb and that enabled me to achieve the following:

2021 Summary
Total number of sessions                            345
Total distance covered                                1915.63km
Average distance per 50 minute session            5.55km
Average speed                                                    6.66kmph

Predictably I improved distance as the year went on, 2nd sessions were always better than 1st sessions and the more I did the more I could do. My best was 7.51km or 6th November, my 3rd session that day and only 130m short of a lifetime best. November was also my best month with 49 sessions of average 6.54km.

Overall pleased I set myself the challenge at the beginning of 2021, for 2022 I intend to try and establish a routine of a minimum of 3 double sessions each week, and to do so following a ketogenic diet, for January at least. 

Of course that will be post-Covid malaise dependent, which goes to confirm that not everything is M and M is not everything when it comes to health matters.

All best to all for the New Year and thanks for reading.

Consistency is the key- perhaps even more so than diet

As I approach the end of 2021 I am delighted that I challenged myself at its beginning to complete 365 50 minute treadmill sessions in the year. While I have some catching up to do to reach that target I have learnt a lot and feel as fit, if not fitter than I ever have. 

Yesterday I managed 3 sessions in the day and was able to start the first at 7.2kmph and easily completed 6.3km in 50 minutes. What is becoming clear is that regular exercise makes all the difference. I started 2021 with a session of of 3.46km. My best year to date has been 7.51km in 50 minutes, which is not far short of a lifetime best (7.64km set in 2016),  which is now my next target before I pass 60.....

At the beginning of the year I was very conscious about what I ate and I avoided carbs. More recently I have found that unless I eat lots of carbs I am able to exercise at a pretty consistent high level irrespective of diet. I still exercise mostly in the morning, and often fasted from the night before, but what I eat in the evening seems now to have little impact. November has been my best month so far, 35 sessions average 6.64km) after getting back to regular sessions in October (49 sessions average 6.1km). I am lucky in that I am retired and so have the time to focus on exercise and making it a priority. In truth I wish I had done this years ago! Dr Slonim told me in 2006 that regular exercise, following his "prescription", was needed. I semi complied but have not been as consistent as I need to be until this year.

I will continue until I reach my 2021 target, 53 sessions to go with 38 days left of the year. In 2022 I plan to start the year on a mission to set a new lifetime best. To do that I think I will need to be stricter with diet and get deeper into ketosis, as I was when the previous best was set. With 365 sessions behind me I think I'll have a very good chance to pass that lifetime best before I hit 60 in February. Something that very few people would have the opportunity to achieve. 

YTD Summary data

Session total: 312 Distance covered 1,705km Average speed 6.66kmph Average distance per session 5.46km

7th October 241 sessions done 124 to go

 After a slow summer post marathon walk I have only just got back to regular treadmill sessions with 2 a day so far in October. Having no kids at home and therefore access to the treadmill without concern for those still sleeping has been a help but simply making the decision to recommit to the challenge more so. Today I was rewarded with my best 50 minute session since June 6.4km felt good though I was never able to jog for more than 2 minutes today. 2 hours of dog walking, a sausage roll, coffee and a keto bar seem to have got me in the right place! Currently I am 39 sessions behind a 1 a day schedule,  year to date, so I have some catching up to do but I am pretty confident I can hit the 365 target and giving the rapid improvement so far this month that I can end the year far far fitter than I started it.