Episode 82 - Listener Q&A: Pacing, Muscle Wastage, Keto Problem Solving, Increasing Exercise and Managing PEM

This is a guest expert interview with Zoe McKenzie where we discuss her book which has recently been published. Although the book title suggests it is for Autoimmunity, the pages are filled with wisdom on how to exercise if you have chronic illness, fatigue conditions included. We have a wonderful conversation where we discuss the work that I did with Zoe as her 1-1 client, belief systems about exercise, exercising with fatigue, exercising with pain, finding your baseline, adjusting your baseline when life happens and everything in between (plus plenty of analogies!). Zoe McKenzie is a Physiotherapist, Exercise Coach and Clinical Pilates Instructor who created, Actively Autoimmune, an online exercise platform for those with chronic conditions. After experiencing health issues herself from a young age, Zoe has specialised in supporting clients around the world to find a way to move their body that works with them. She works with clients 1:1 as well as with an on-demand virtual Pilates studio. She has also recently published her book ‘Exercise Well with Autoimmunity’.  Useful links: Website: https://www.activelyautoimmune.com/ Instagram: https://www.instagram.com/activelyautoimmuneBuy the book: https://www.amazon.co.uk/Exercise-Well-Autoimmunity-Zoe-McKenzie/dp/139970852X/ Previous episodes on exercise: Episode 27 - Building Exercise Tolerance and Capacity with Chronic Fatigue Episode 26 - How to Exercise with Chronic Fatigue

Often in our practice we see autoimmunity come hand in hand with chronic fatigue. Not every case is an autoimmune case, but for those who do have autoimmunity, we want to consider how a dysregulated immune system is contributing to the picture of fatigue and how we can manage it. In this episode Anna gives a high level view of the autoimmune management strategy that she uses in her practice which includes both simple and more complex strategies to support outcomes and improve quality of life.  Useful links: Website: http://annamarsh.co.uk/ Instagram: https://www.instagram.com/anna_marsh_nutrition/ Apply for 1-1 Support: https://annamarsh.co.uk/1-1/ Additional Resources:

Many women experience crashes, flares and setbacks around their menstrual cycle. The natural fluctuation in hormone levels can be destabilising to sensitive and unstable symptoms. Although we want to keep the whole picture of imbalance in mind, there are some tricks we can use to support the body around this unstable time. In this episode Anna covers her 3 top considerations for reducing symptoms, crashes and flares around menstruation Useful links: Website: http://annamarsh.co.uk/ Instagram: https://www.instagram.com/anna_marsh_nutrition/ Apply for 1-1 Support: https://annamarsh.co.uk/1-1/ Episode 35: https://annamarsh.co.uk/podcast/episode-35-how-to-have-better-periods-with-cfs-me-part-1-what-does-a-healthy-cycle-look-like/ Episode 36: https://annamarsh.co.uk/podcast/episode-36-how-to-have-better-periods-with-cfs-me-part-2-testing-your-hormones/ Episode 37: https://annamarsh.co.uk/podcast/episode-37-how-to-have-better-periods-with-cfs-me-part-3-supporting-your-hormones-naturally/

This week's episode is a guest interview with Harry Leeming the founder of the Visible app, an activity tracking tool to help people with chronic illness use data to empower their recovery and pace better. Harry was a young, healthy active individual who caught a “virus” and has never been the same since. He has turned his pain into purpose, using his background in engineering to build out an activity tracking app that is more appropriate for people with chronic illness than some of the traditional fitness trackers. He is doing incredible work in the world to progress the research in this area and you can get involved by downloading and using the app. But first, listen to the episode! Useful links: Get Visible: https://www.makevisible.com/

What is Heart Rate Variability (HRV)? How is it measured? Is it useful for Chronic Fatigue and can you improve it? These are all the questions that Anna answers in this week's episode where she shares her personal experience and clients’ experience with different devices and interventions.  Useful links: Website: http://annamarsh.co.uk/ Instagram: https://www.instagram.com/anna_marsh_nutrition/ Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

If you have been experiencing a chronic illness, energy crashes and flares are familiar territory. What can make these events so distressing, especially early on in your journey, is not understanding what is happening and why. In this episode Anna explains the biochemistry of what is happening in an energy crash. She shares almost everything you need to know for fatigue recovery in a nutshell including the most important things to consider to make sure your energy crashes are few and far between.  Useful links: Website: http://annamarsh.co.uk/ Instagram: https://www.instagram.com/anna_marsh_nutrition/ Apply for 1-1 Support: https://annamarsh.co.uk/1-1/

All healing journey’s have their ups and downs and we need to make mistakes so that we can learn. Here are eight mistakes, which led to eight fantastic lessons that Anna experienced in her journey recovering from Chronic Fatigue Syndrome.  Useful links: Website: http://annamarsh.co.uk/ Instagram: https://www.instagram.com/anna_marsh_nutrition/ Apply for 1-1 Support: https://annamarsh.co.uk/1-1/Nurturing Resilience Workshop: https://annamarsh.co.uk/nurturing-resilience

In this episode Anna answers questions from you, the listener! Anna covers the topic of proper pacing and how to prevent muscle wastage and if bodybuilding supplements are worth it. We do some problem-solving for those exploring the ketogenic diet and discuss the best time to work on exercise. We wrap up with a discussion about what to do to manage bad PEM. Useful links: Website: http://annamarsh.co.uk/ Instagram: https://www.instagram.com/anna_marsh_nutrition/ Apply for 1-1 Support: https://annamarsh.co.uk/1-1/ Nurturing Resilience Workshop: https://annamarsh.co.uk/nurturing-resilience Thyroid Blog: https://annamarsh.co.uk/screeing-for-underactive-thyroid-in-chronic-fatigue-and-how-to-address-it/ Ketogenic Diet Blog: https://annamarsh.co.uk/ketogenic-diet-chronic-fatigue/ Blood Sugar Mini Course: https://annamarsh.co.uk/courses/ Revive Electrolytes: https://getrevive.co.uk/discount/ANNAMARSH

Stability is the foundation of healing. As humans we are self-organising, self-healing human beings. Yet, in chronic illness the body has become increasingly disorganised and increasingly unstable over time as a consequence of having to cope with multiple and ongoing stressors of life. In this podcast Anna talks about the disorganisation in a “syndromal system” and how we can support the body to become more stable and organised again. This podcast will help you reflect on where you are in your journey and areas of your life that you can prioritise to support greater stability in your chronic illness and/or fatigue recovery journey.  Useful links: Website: http://annamarsh.co.uk/ Instagram: https://www.instagram.com/anna_marsh_nutrition/ Apply for 1-1 Support: https://annamarsh.co.uk/1-1/ Nurturing Resilience Workshop: https://annamarsh.co.uk/nurturing-resilience-special/ Nervous System Workshop: https://annamarsh.co.uk/workshop/ Blood Sugar Mini Course: https://annamarsh.co.uk/courses/

In this episode Anna answers questions from you, the listener! Anna covers the topic of building capacity and shares some of her own experience having a sensitive nervous system. She talks about the challenges of managing acute infections, especially when you are a long hauler. She shares things to think about if you are waking feeling unrefreshed. How to prepare for surgery and a conversation about her experience working with clients and their medications.  Useful links: Website: http://annamarsh.co.uk/ Instagram: https://www.instagram.com/anna_marsh_nutrition/ Apply for 1-1 Support: https://annamarsh.co.uk/1-1/ Nurturing Resilience Workshop: https://annamarsh.co.uk/nurturing-resilience-special/ Nervous System Workshop: https://annamarsh.co.uk/workshop/