Simple pathway to ketosis

 After my low carb day on Monday I fasted in anticipation of my Over 60s cricket match. I tested and was in ketosis at 0.5mmol/L by 11am. At 6pm, after playing cricket, eating two biscuits and drinking  orange and mango squash, it was 1.1mmol/L

No M issues in the match and no stiffness yesterday morning, despite a 40 ball innings and a lot of chasing in the field...

The added benefit is I was back to 85KG when weighing in.

Cricket Lovely Cricket

My father was an excellent all round sportsman. Good enough for a professional football trial and a renowned all rounder in the  Bristol area in the days where cricket was actively covered in the Green'un. I inherited his passion for sport and his love of cricket. Sadly fate would have it that I also inherited M and, so as a young boy, while I had the desire I never had the capability. Football and then rugby at school were hard...I wanted to run but always struggled. Athletics saw me hide around the shot putt area, simply to avoid having to run.

Cricket was my saviour. Even with M, unmanaged and undiagnosed, I had the skill to be selected for the School team and to Captain my House team. A reflex catch, honed through constant practice, allowed me to be seen as a reliable short leg fielder, something that stayed with me through University. I had M issues of course, and was once run out as I inexplicably ground to a halt mid pitch...it was a 3rd run and I had simply exhausted ATP. Those watching said I looked like I was running in porridge...I had no explanation and no thought other than to try and get fitter.

Cricket meant I had a place where I could hold my own and, at an all boys school, that was important. The below are extracts from my 1st secondary school reports:

Autumn Term 1973

P.E. His determination is fitful but his enjoyment is nice to see.

House Master 

He is a pleasant, courteous and willing boy, perhaps a little shy. He ties hard at rugby but it is likely that his main contributions will not be on the games field.

Summer Term 1974

P.E. He tends to opt out much too early when faced with new, physical, challenges.

House Master

The advent of the cricket season has revealed a new dimension to him: enormous confidence. He has performed well in this sport for the House and the school and I hope this will lead to a continuation of this present exuberant attitude.

Of course until I found ketosis, in 2014, I always had M on my mind. In nets after a few balls my arms would become heavy, in matches if I ran a 2 then I'd be thinking about defending the next ball simply to avoid having to run again, fielding where I would have to chase has always filled me with dread. But I loved the game and kept coming back hoping somehow that I would break through. Of course we only know our own bodies and so I was unaware that how I felt was not normal. It was after all normal to me. Diagnosis in 2005 at the age of 43 was a huge relief as it explained so much. It did not though give me a solution.

The solution came after a fast in 2014, when, deep in ketosis, I found energy levels I had never experienced before.

Now at 64, playing County level Over 60s cricket I finally feel that M does not hinder my ability to compete. I simply have to fast and walk to make sure my body is in Ketosis. Then I can focus on the ball, and not M, while otherS at our age all have their own issues to deal with !!

Ketosis is the key - how to get there? is the important question.

It is now clear that people with M benefit from being in ketosis, it also seems anecdotally true that it is easier for us to get into ketosis than for the general population. My suggestion is that a strict Ketogenic Diet is not a necessity, and there are simple changes we can make to get into ketosis regularly.

 

A low carb diet and consistent fasted morning exercise may be a relatively simple way to help people with M lead a better life. To this end I will document my food intake and exercise this week and check my levels of blood ketones to test the theory.

 

I played cricket on Saturday and at 64 opened the batting, batted for nearly 20 overs and then kept wicket for 36 overs (glutes have been feeling it since) and as I was in ketosis I had no M issues whatsoever.

 

I started today at 86.2kg, so up a little on my post Samui return weight...a couple of beers post cricket on Saturday no doubt contributing. Playing again tomorrow so today is key in my preparation. Plan to cut the snacks and have a late brunch and then an evening meal with a modest carb intake. Tomorrow I will fast until my participation in the match is done. I will also arrive early for a good long warm up walk/jog and then test my ketone level.

 

Also doing some video on Instagram https://www.instagram.com/mcardlesandme2026/?hl=en

Cricket has begun but not as I had hoped...but ketosis working well

Yesterday was my 1st Over 60s match of the cricket season Berkshire 2nd XI away to Sussex. Preparation started on Monday, eating low carb and fitting in a good 50 minute treadmill session. Dinner was again low carb and then I fasted until after my contribution to the game was done. So as we batted first that was at the end of the game. Had we fielded first it would have been when I finished batting. In ketosis I very rarely think about M and am able to focus totally on the ball, and playing Over 60s I feel I am competing on an even playing field with M, simply because most everyone at our age has some ailment they are combating.

I prepared perfectly to get into ketosis, which is key to playing without worrying at all about M. I fasted, walked a lot before the match, had two coffees and felt great. Went out to bat, felt good, played back to my first ball, missed it and it scraped the top of off stump ending my innings rather prematurely. That's cricket, at times the most frustrating of sports but also the sport that has saved me from the worst of M, more to come on this latter point.

The only thing to do then was  extra steps.....managed 10k steps for the day without including any during our 26 overs of fielding, where I moved quite a lot. No M issue at all and this morning not even a hint of soreness. When I was younger the next few days after playing I was as stiff as a board. Ketosis saves me from that.

2026 Fast the day by day account

Leaving UK at 90.5kg, my heaviest in a good while, trousers tight and uncomfortable, belt 2 holes over from recent normal, and appetite for sugar almost insatiable. Hopefully 14 days away can sort me out!

1st 3 episodes of Rabbit Hole and some sleep helped speed the journey. Lucky to have a brother who is a pilot, which tends to make planned travel more possible.

Arrived in Singapore and enjoyed dinner at the Cricket Club. Salmon tikka, dahl and a rather nice red wine. Returned to the hotel and caught myself in the bathroom mirror.

Took a photo as it told the sorry tale and prompted me to immediately commence my fast a little earlier than planned.

 

Start time 9pm Sunday 12th April.

 

Day One

So far this morning has been spent walking around Singapore stopping for a black iced coffee (allowing myself one a day for now) and a lime soda at, probably my favourite global venue, Singapore Cricket Club. By 11pm having walked most of the day, and a good chunk of Singapore, with my brother clocked 45, 000 steps. Drank plenty and so far feeling pretty good. Day one done.

Off to bed then Samui tomorrow....

 Day two

A night of a thousand pees....no worries about dehydration as there was clearly sufficient liquid in my system. Despite a disturbed night I feel quite fresh this morning and at 8:06 am already on MRT to the airport....very few signs of yesterday's exertion which is welcome news, and so far none of the fog I have experienced on past fasts. Long may that continue.

10,000 steps completed, mostly around the vast expanse of Changi Airport and somewhat surprisingly our flight departed 20 minutes early...unfortunately the taxi driver meeting me at the airport seemed to be relying on mystic powers he did not possess. Not that the 40 minute wait mattered and once I decided to call the hotel we were swiftly connected. So far day two passing well.    

Samui has mixed emotions for me. Fasting is sometimes no fun at all, the infrastructure has not really kept pace with building and, while the smells of cooking are uplifting, other aromas are far less so. Importantly though it is the place where I cracked the code and found ketosis, a real life improving eureka moment if ever there was one. Hoping to renew and refresh, shed 5kg and find the energy that deep ketosis brings.

First book completed to help keep my mind off food.

Day 3 

After a broken night of sleep feeling quite calm and wholly committed. The hotel has a breakfast buffet at the pool and while it looked very appetising temptation to break was quite easy to resist. Started the day, as I plan to every day with some stretches on the mobility board, brought with me from home, and then 10 lengths of the 25m pool. A good start. Calves are quite stiff from the last two days of walking so may ease back a little.

Well the swim and mobility board meant I felt sufficiently loose to manage over 13,000 steps and the smell and sight of food did not tempt me at all. 

I met with Patrick, at Spa Resorts, and have my programme for the supervised element of my fast. Starting with some testing this evening of pH levels in saliva and urine. I took a 90-minute massage during the hottest period or the day, and then thought a buzz cut was appropriate, went a little further than I had initially intended so I won't be seeing my barber any time soon.

Stretches in the pool and an exquisite 30 mins in and out of the steam room completed my pre-testing day. Will test shortly then plan to read and sleep.

The results are in, very quickly, with messages from Patrick moments after I submit photos of the strips:

 

“Clearly in ketosis Andy

Specific gravity is good. Hydration

Saliva pH is good ( alkaline)

Urine pH is acidic is influenced by the fast as it’s already day 3

For the other parts of the urine pH all good”

 

Day Four

It's HAPPENING

 

Another night where I slept in short blocks and was awake for a good deal of time in between. Left knee troubling me a little but stiffness now gone.

Awoke at 7am tested and, sure enough, in deeper ketosis. Headed for the pool and whereas yesterday my 10 lengths were in 2 blocks of 4 and a 3rd of 2, with rest in between, today I reeled off 20, quite easily, with no stops. As I have not been swimming in a long time this was a surprise. Being in fairly deep ketosis was not. Supervised fast starts today.. 

Check in with Patrick and scales show 88.4kg so progress already,  weigh in was mid morning. First cucumber and lime detox drink with added psyllium husk and bentonite is just the right side of tolerable. Needed to provide nutrients and help cleansing process. Massage booked for 1pm so will read and dose until then and save my walking for this evening.

Not sure if its coincidence but feel very lethargic post my first drink. Test strips did show I was less hydrated than yesterday so will drink more and try the fasting broth.

Day 5

After a massage and a steam and my first visit to the colema room I slept, woke briefly, slept, woke briefly on repeat from around 7pm until I woke for the final time at 5am. At 6am I left my room for a walk 14,000 steps later back in the room. Felt better than I expected so included a very sweaty 30 minute treadmill session, my 1st in a long time. Managed to jog slowly twice for 90 seconds. Good to be back trying again.

As day 5 draws to a close I feel good and happy to have reached half way. My regime is now set with the morning for exercise  and the afternoon at Spa Resorts for a massage, a bucket, and a steam. Evening relaxing in my room at Poolsawat villas. 

Reaching some early conclusions. 

• I needed this fast and will be much better for it. 
• Dr Slonim was 100% right in 2006 when he advised training to get the body to use ketosis as an energy source. 
• Daily life and exercise are so much easier in ketosis.
• Ketosis helps weight loss

·         I can and will get back to jogging.

 

 

 

Day 6

Wake at 3am with sleep elusive, finally drift off at 5:30am for two restful hours. By 7:50am I am in the pool for 40 lengths in 50 minutes. To the me before 2014 this would have been incredible, swimming without any muscle pain at all for 1,000 metres is something I would never have dreamed of, or imagined was possible. 

Today I feel a little disappointed that neck and back stiffness slowed me down. I guess I also need to accept that I'm 64 not 52! A short walk rest and reading are the order of the day. 

Visited Patrick for daily blood pressure check and he offered a weigh in, which happily showed I have dropped 2 kilos since my 1st weigh in here so 4 kilos in total at just over half way. I may have a celebratory coconut juice later! Decided on a treadmill session and managed 3km in 35 minutes before the machine timed me out. Gradually built speed today to 5.8km and then walked and did 60,90,105 and 120 second jogs at that pace. Something to build on.

Rather than rest I walked into town for a pedicure and that coconut juice. 8k steps good enough on top of everything else.

Day 7

Bristol City kept me up late, ultimately delivering disappointment, despite a very good 1st half performance, which but for the incompetence of the lino would have seen us 2-0 to the good at the break. 2nd half collapse unexpected.

Slept undisturbed until 6:30am, my 1st undisturbed sleep since arriving in Samui.I intend to have a day of exercise and sleep uninterrupted by detox drinks supplements or buckets. A day of water an iced lemon tea perhaps, and walking/swimming/resting. Time to push.

11am and relaxing by Spa Resorts pool. 13,000 steps and 10km covered so far today. Plan another walk later once its cooled down a little. Blood pressure today 120/80 which is very good for me.

Finish the day on 17,000 steps and am now enjoying the Spa detox broth. Planning a swim this evening and will then see how long Gloucestershire can keep me awake.

Day 8

Surprisingly long was the answer. Slept only when the age defying Sir Jim engineered a collapse. Nevertheless, a decent last day in prospect, which will keep me entertained this evening. Slept a good 7 hours and woke around 5:30am. Morning walk 90 minutes 10k steps 7.6km followed by 20 lengths. A little light-headed today but finish line is in sight.

 

Bp 106/65 so quite low for me. Scale shows a slightly disappointing 85.5kg but with 3 days to go I am hoping now to be below 84kg when I finish here, to then target 80kg and below when I get home.

Afternoon on the plan including a steam. 13.5k steps and 10km covered. 2 days to go.

Day 9

BP133/ 76 immediately post exercise.

1pm as I write and I am still a little shocked by today. I woke early and felt, as I have been these last few days, a little disappointed that, despite adhering strictly to this fast, I had yet to feel a real change in energy levels as I had in the past. On reflection I think this was more to do with expectation than reality. 

This fast has so far been quite easy, none of the retching, headaches and nausea of prior attempts. I've slept well and got into a good exercise routine but given my prior experience the exercise part was expected, as I know, without any single iota of doubt, that when my body is in ketosis I am at my best. I had I think hoped that I'd suddenly feel a bit extra when in reality 10 days ago doing what I have done would not have been on the cards or anywhere near them.

In any event, that all changed this morning a 5k brisk walk at 11mins/km, a stop for lemon tea......and then a thought to jog down my favourite Samui hill. I started, it felt good, and much like Forest Gump, I just kept going all the 4.17km back to my hotel. Some of it was slow, slower than my walk, but two sections were between 7.5min and 8.5mins/km. Incredibly elated by that and grateful that I had the opportunity to be here. 

Rest of the day followed a familiar pattern until I added in 20 lengths in the pool, which was very comfortable.

 

Day 10

So it’s finally here and I am pretty delighted with the way this has gone. Urine tests this morning reveal a high level of ketones within, which means I am producing a lot more than my body is using, even with these levels of exercise. Currently midway on my morning walk sipping an iced lemon tea (no sugar) 56 mins for 4.67km. 

Subsequently started immediately on a quite steep 400m hill and at the top repeated my jog of yesterday without any issues, toward the end I began to feel a little dehydrated so I stopped at 3.7km in 24 minutes and had another drink. I thought I'd then jog back to the hotel. My thighs immediately told me otherwise. Will head out no later than 6:30am tomorrow. It was nice though that google fit titled this as a run and not a walk.

 

This was scheduled to be my last day fasting but I have now decided to carry on the fast and review on a day-by-day basis. After all I have done the heavy lifting. If I am feeling good, then I'll go to Sunday evening at 9pm to complete 14 days. But I'll be very much listening to my body.

BP126/75

 

The rest of the day followed the script. I made the "mistake" of telling Khun Ae, the massage therapist, that my quads were quite sore. She suggested Thai massage and I thought why not? As she joyously inflicted pain, with her elbow, and through various contortions stretching various muscles I certainly felt it a mistake. However, once she stopped my body felt a whole lot better.

 

Actually, enjoyed my broth this evening, who would have predicted that?

 

By tomorrow morning I will have finished my supervised fast here. I have done my last bucket so it’s just two probiotic drinks and a probiotic syringe implant tomorrow. Plus the tale of the tape with Patrick.

 

Day 11

 

Awoke early and planned a walk, a stop for the google fit to reset, and then a jog. Hopefully 5k back to the hotel. In the end google fit treated the whole thing as one exercise so, only post exercise, could I calculate the jog at around 4.3km.

Throughout my quads were sore, not M pain as arms, calves, etc all totally fine but more I think normal muscle soreness from exercise. Slightly disappointed but not in the context of where I was two weeks ago.

It’s then time for the tape which reveals I have lost an inch from my waist and now weigh 83.8kg near my lowest of last year. Patrick guided me through the process of breaking the fast with fruit and then steamed vegetables and then discussed the importance of the body's pH. I'll get a printed report later. The contents of a probiotic syringe were duly implanted and the formal part of my fast is done. 

 

BP was 99/76 and I am still feeling fine so think we'll carry on. I did sneak a spoonful of curry gravy as they cleared the breakfast buffet so I have had a taste of Thailand at least. The rest of the day spent reading and relaxing.

 

Day 12

 

This will be my last full day I think. Plan to rest this morning and then travel back to Singapore, where I am meeting friends this evening. This has been 10 days of solitude so it will be nice to get back to being social. I then plan to get on the treadmill at SCC tomorrow and see what I can achieve before breaking the fast. A little breakfast gravy and a final broth soup prepare me for the day.

 

I am feeling full of energy and mentally very sharp. So much so that I have spent my time at the airport and on the plane editing the above and writing a substantial summary and conclusion piece, that ultimately will sit at the top of this blog.

Day 13

 

Unlucky for some, and as I write at 7:45am at Singapore Cricket Club I think this may be the last  few hours of my fast. I slept well, though was back to a two hour cycle of sleep and pee so I am clearly hydrated but I feel a little light headed. Will find a coconut water and then reassess. 

 

Always love being back in Singapore 20 minutes after landing and I was already in a taxi headed to The Cricket Club. Lime soda with friends and then a journey back to stay with them, catch up conversation and then bed Today will be catching up with lots if people on the Padang, one of the top cricket fields anywhere in the world. Walked for 90 minutes and then walked with friends around Fort Canning, something I had not done while living here. This was interesting as we encountered a long block of steps...ketosis or not I needed a stop midway up. To me this was the fact that anaerobic exercise where we rely on muscles in a more explosive way is eased somewhat by ketosis but not fully. I was better than I would have been unfasted but no as free as I am with aerobic activity.

Back at there flat the fast was broken with some absolutely delicious pomelo so it lasted 12 days and 15 hours. Further modest amounts of fruit later in the day at SCC and plenty of hydration has me feeling less lightheaded after 27,000 steps in 30 degree heat.

Intend plenty of exercise the next two days and indeed when I am back in UK.
Day 14

A real joy to be able to get up, open the door and go for a 10k walk. No need to stop, no need to worry about when to turn back, freedom to just walk. A swim a relax and then an evening meal of dahl and chickpea salad washed down with a glass of red wine complete my day.

End the day with total steps if 26,000.

Day 15

Slept like a baby, awake refreshed. Breakfast included in my hotel stay so enjoy fruit, salad, scrambled egg and curry sauce then head for the 6k walk to see my GP here. BP after an iced black coffee 120/80. Ask for CK, PSA and a glucose blood tests, apparently ketone blood test not available in Singapore and head to SCC to see what I can achieve today on the treadmill.

BOOM !!!!!
Strangely I felt this was inevitable today. While I took a little time to get fully comfortable I managed a 4k jog at around 6 to 6.6kmph without much trouble at all. Max heart rate was 160 and was mostly between 140 and 155. The only unfortunate part was I ran too close to the emergency stop and that ended my session when 5k was comfortably in sight.

As trips go the cake was iced a long time ago, it now has a cherry tree on top!!! Closed the day with over 20,000 steps in addition to the jog. Did rather overeat this evening but plan now not to eat on the plane home and have a very light meal tomorrow evening before a final weigh in on Wednesday morning on home scales.

After an overnight flight home and a good night's sleep I weigh in at 85.5kg 5 kilos lower than when I started and more importantly ready to work hard to get where I want to be. A couple of days now catching up at home and then come Friday a first attempt at home at 5km jog.

Time for another trip to Koh Samui and a fast - The summary

 Summary

My fast started at 9pm on Sunday 12th April and was broken on 24th at 12 noon with a small amount of pomelo. My main aim was weight loss with a target of at least 5kg

And this was comfortably exceeded.

In that time I ate nothing, except 2 spoons of dahl at Lau Pa Sat.

I exercised every day, walking, swimming and towards the end jogging. Over 200,000 steps in two weeks

I came off my blood pressure medication (for high bp) as bp was quite low when I arrived in Samui and stayed at a very good level throughout my stay.

Starting weight 90.5kg end weight in Samui post supervised fast 83.7kg. I also lost 1" around my waist.

Blood work

Before leaving for Samui I had a letter from my GP warning I was pre-diabetic. Testing when back in Singapore showed normal, while my CK level was only 447 a very low level for anyone with McArdle's and after a lot of exercise.

Conclusions

Ketosis is absolutely the key to living well with McArdle.

In 2006, Dr Slonim explained to me that his exercise prescription and proposed lower carb diet was aimed at training the body to get into ketosis.

For the next 8 years I exercised quite consistently, and once or twice, looking back, I managed to jog, for longer than I ever had, and was in ketosis (the taste in my mouth and my ability to exercise were the tells I did not then recognise).

A fast in 2014, after which I was able to jog for 50 minutes without stopping, for the first time in my life, and a discussion with Andrew Wakelin pointed toward the explanation being ketosis.

So I wanted to keep my body in ketosis as much as I could and decided to pursue a ketogenic diet. Gradually I became less consistent and, as M did not really cause me too many problems, I developed a routine of exercising in the late morning before any food. 

Also 18 hours before playing cricket I always stop eating and have been able to play without worrying about M since. I have also walked regularly with friends and only when I have had too many carbs do I need to ask for a pause.

The last 6 months I had exercised less, given in to sugar cravings and let myself go.

This visit to Koh Samui has once again affirmed the benefits of ketosis. Also how quickly I am able to get into ketosis, which surprised Patrick who supervised my fast. I ate a good curry meal with red wine and naan on Sunday evening, by Tuesday evening, after fasting for 2 days I was in fairly deep ketosis and obviously stayed there for the rest of the fast. In truth I was no doubt already in ketosis on Monday walking around Singapore.

The benefits of the fast were, weight loss, clarity of mind, lower blood pressure and hugely increased capacity for exercise. 

I am, of course, not recommending such a fast to everyone but to all those with McArdle please consider seeking ketosis, ask your medical practitioner. A low carb diet, modest consistent exercise and fasting from your evening meal until you exercise, as late in the morning as you can, perhaps after a black coffee, should do the trick. See how that makes you feel.

If you want to walk with friends, have more energy and improve your health then do the research and give it a go. 

Let's define ketosis:

"Ketosis is a natural metabolic state where the body, lacking sufficient carbohydrates (glucose) for energy, switches to burning fat as its primary fuel source. The liver converts this fat into fatty-acid compounds called ketones, which are used to power the body and brain. This process is commonly achieved through a ketogenic (keto) diet, fasting, or prolonged exercise. 

Key Details About Ketosis:

• How it Works: When carb intake is very low (typically under 50g/day), glucose stores (glycogen) are depleted, forcing the body to rely on stored fat for energy.
• What are Ketones: These are water-soluble fat-derived molecules—acetone, acetoacetate, and beta-hydroxybutyrate—produced in the liver during fat metabolism.
• Synonyms/Related Terms: Nutritional ketosis, fat-burning mode, keto, physiological ketosis (non-pathological).
• Usage/Benefits:
  • Weight Loss: By burning stored body fat.
  • Management of Chronic Disease: Used to help manage/reverse Type 2 diabetes and metabolic syndrome.
  • Therapeutic Use: Historically used to reduce seizures in children with epilepsy.
• Symptoms: Common signs include increased thirst, dry mouth, frequent urination, and decreased appetite.
• Difference from Ketoacidosis: Ketosis is a safe, natural metabolic state. It is vastly different from Diabetic Ketoacidosis (DKA), which is a dangerous, fatal condition where insulin is too low, causing dangerously high levels of ketones and glucose. "

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.

26 miles is a long way

 8 hours walking alongside the Thames on the hottest day of the year, to that point, without M impacting me was a strong endorsement of the benefits of regular and consistent exercise. At the beginning of the year my purpose in setting a 365 treadmill session goal was somewhat nebulous, trying to use the time provided by Covid to some positive effect. Regular long dog walks with a mate helped prepare for this specific challenge, while having lived, and walked, in Singapore, the heat was less of an issue for me than most. It is now clear to me though that to be able to function at my best, whether walking with friends, or continuing to play cricket the treadmill sessions are a vital part of daily life henceforth. 

I have only done one session since the walk, circumstance and a short holiday the cause, but 198 sessions year to date mean I am currently 10 sessions behind my target. Starting on Saturday I will look to close that gap so I am back on track by the end of August. 

The sessions mean I am able, almost for the 1st time, to play cricket, which has always been a physical challenge, without thinking much at all about M, that for me is a huge benefit and one which I will not let go readily. While the thought of walking 26 miles did not concern me and was a hugely enjoyable experience, chatting and walking with those I met along the way. For someone who used to avoid walking with anyone that's another large tick in the plus column.

Key for me is always to start  each session at a comfortable pace and build slowly. Usually I exercise on an empty stomach after coffee. Second session of the day is usually much better than the first. Pushing just enough leads to progress, gain without pain, which is why I like the controlled environment of the treadmill.

Near the midway point - feeling the benefit - new challenge

Year to date I have managed 184 treadmill sessions so am on the home straight with 181 to go and still 10 days left in June. I had hoped to be a little further ahead but following a brief hiatus more consistent use of the treadmill is helping me off it. This last weekend I played a competitive cricket match, kept wicket for 30 overs( 180 plus squats) and then opened the batting, (lots of running) going on to score my highest score for a good number of years. Two days later and I have no pain other than in the front of my shins - for me that is now common but going back to my twenties and thirties, before keto and before consistent treadmill it would take me a week to be able to walk normally after cricket - just in time for the next match!!!!!

I have also been walking regularly along the Thames with a friend, for the pleasure ( my 11 year old self would not believe that possible) and in preparation for a 26 mile walk from Windsor to Henley on 17th July. The opportunity, courtesy of McMillan, appeared on my FB feed in February and I signed up as a further challenge to myself and to provide added incentive to keep up the treadmill work. As the day approaches I am looking forward to it and feeling ready. I am aiming to complete the walk in under 8 hours but of course completing it is the main challenge....

In the interim its back to building stamina and treadmill speed, while aiming to accumulate plenty more runs over the course of this cricket season.......................

Peaks and troughs...peaks and troughs

 So its been a while since my last blog and after excelling in March and reaching a PB for the last several years of 6.81km in 50 minutes I have let things slip and today was only able to do 5.4km. Disruption to my daily schedule in April meant I only did  13 sessions during the month and have as a result regressed. It has though served to emphasise how easy it is to slip up and how quickly deterioration in capability follows.

In March I did 33 sessions and averaged 6km per session. In April only 13 and my average had slipped to 5.64km. So far this month I am having to build back 14 session at an average of 5.37km. Diet has been broadly the same and I have continued to exercise on minimal food.

On the positive side I am still way ahead of where I started the year and have managed 159 sessions towards by 365 session target.

Work to do! Even more so as I am signed up to a 26mile walk on 17th July. more details in due course on that.

The above pattern is a small picture of life with M - when I have followed the regime set by Dr Slonim and exercised on the treadmill daily I have managed to improve and that helps in daily life and with weight. When I have not deterioration has followed as night follows day.

March - picking up the pace

 After a PB at the end of February March has started really well. 11 sessions so far and on four of the five days I have done two sessions the second 50 minutes has seen me cover 6.3, 6.24,6.38 and 6.35km   . The least distance covered so far has been 5.1km, while most  6.38km. Have decided I will now focus on 2 sessions a day for 3 days and then a rest day. Aim to make as many as possible second sessions above 6km.Average distance is covered this month is a whole 1km better than in January. promising signs.

6.5KM...better than a poke in the eye with a sharp stick

 Delighted to have finished the month with a new PB since September 2016 of 6.5km in 50 minutes on the treadmill. 3rd session of the day and was able to push myself without pain - jogging for short bursts and then settling back at around 7.5 kmph was how I managed this. It proved to be my last session of the year as a poke in the eye from our Beech hedge prevented any activity of the last day of February and meant I was two sessions shy of my February target:

Still a new PB and continuing progress. Diet still not where I would like it to be though. Aiming for 46 sessions in March as lockdown eases.

15 years since diagnosis - a short video on exercising with M

 https://www.youtube.com/watch?v=sfRNISq6wU8&list=PLCXW01PHd4dFa750czRaBwiZOaHOeCo8q&index=15&t=21s

5.9km but more significantly a 35 minute jog forward...

 2nd session today after a day off yesterday, following four sessions on Wednesday. Not my furthest distance but what feels like a significant step forward with, probably, my first 30 minute non-stop jog since 2016. I was not expecting it today but kept setting myself small goals. When I started jogging at 7.3kmph after 17 1/2 minutes the aim was to jog until 20 minutes. With highlights of the NZ V Lions 3rd Test of 2017 to keep my mind occupied I just kept going and was able to keep on going. After 35 minutes I decided that was enough for the session. No pain but progress.