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Post Viral Fatigue

I’ve been intending to write this as part of my triathlon series of posts, and noticed on my recent bathroom post that it was my 99th post. It seems fitting that my 100th post be related to what was happening when I first started this blog.

I think I’ve mentioned already that I was diagnosed with post viral fatigue in March 2014, just before my rowing National Championships. I feel like this is something I should write more about, mainly to raise awareness of this but also just to get it off my chest.

I first started having problems in December. I was very tired physically, but also not coping particularly well mentally. December is always a pretty tough time in our training as it’s when the workload really ramps up, plus the intensity goes up, and the pressure comes on as the serious testing (trials and racing) starts to happen. I talked to my coach, we thought I was possibly overtraining a little, and generally stressing about my performance – I’d done surprisingly well the previous year so now there was more pressure to perform this year. He sent me off on a holiday. A week off training and completely away from all things rowing.

I came back refreshed and re-energized, but still not quite on top of things. I went to a training camp at the Australian Institute of Sport (Canberra) in January – a week long with a very heavy training load. I survived the week very well but never recovered when I got home, even after a few days off. It all went downhill from there. I was struggling to complete training sessions at full intensity and was also increasingly unstable emotionally. We reassessed my training, and had some more time off, but I was coping just well enough to not call everything off. It was pretty unpleasant though.

I was tired all the time. Walking was hard work, with my feet scuffing the ground a lot of the time because lifting them up was too much effort. I struggled to hold proper posture (sitting upright) in the boat, let alone actually rowing well. When I did have to do something at intensity (eg sprint work) my legs would give out after about 30 seconds. As in, I’d try to exert effort and it just felt like there was nothing there . . . like when you’ve just done a huge amount of hard exercise . . . but this was when I was fresh. I was crying a lot, when training was so hard, when I was forcing myself to go to training, when I couldn’t do it . . .again. I was having panic attacks, hyperventilating at the thought of a trial, or sometimes just at the thought of a training session. At my worst I struggled to hold a conversation. I just could not put the right words together in the right order.

(To make matters worse, I was eating more to try to keep my energy levels up, which meant I couldn’t lose weight and was struggling to make the weight limits for trials and races)

All this time, there was nothing obviously wrong. Was I just not good enough? Was I not cut out to be an elite athlete? Was I just weak, being soft on myself? Was I not trying hard enough?

Finally, towards the end, I had decided that there was definitely something wrong. What I was feeling, and how my body was failing me (simply not responding, or failing during intense efforts) was not normal. I went to the doctor and had some tests done. Every test they could think of actually. It didn’t really matter – I was sure by this point that there was something physically wrong. Luckily the tests came back to indicate that I’d recently had Glandular Fever (despite not showing any symptoms) so there was a probable (but inconclusive) diagnosis that I had “Post Viral Fatigue”.

There is no cure, or even any treatment, other than to rest and recover. After Nationals (you can read about that experience, here, especially the fatigue bits here and here) I rested. Not completely, because I wanted to keep in touch with rowing, and also because rowing was the most useful indicator of my condition. Other things could feel fine, but rowing is where the fatigue really showed up. I rowed about 3 times a week, and only for about 8km. We used to do 20+km in a session. It was 3 months before I completed a whole session without feeling tired. That was a very exciting morning for me.

I had trouble getting back into training properly. Sometimes I’d start to feel tired when I hadn’t done much work and I couldn’t tell whether it was fatigue (in which case I should back off), or my head playing tricks on me. Had I got so used to feeling fatigued that my head and body now automatically shut down at the slightest sign of work? Sometimes I just didn’t want to push through it anymore. It had been so hard for so long, and I couldn’t be bothered fighting it.

I didn’t know how to deal with this but I didn’t want to give up so I went to see a sports psychologist. He gave me some useful tips, the main one being contingency plans, or giving myself lots of little goals to re-assess ie “I don’t know if I can do it. OK, I’ll get to there, then assess how I’m going. If I’m still not feeling good, I’ll finish off with this. If I’m OK, I’ll keep going to there and reassess again”. This helped me deal with getting back into training, even if not at full intensity, while still being sensible and sensitive to my recovery.

I also felt like I’d failed, or that I was being soft, or that people would think I was weak . . especially if I was giving up because of my head – because I didn’t want to push through it. The sports psych reassured me that what I’d been through was actually a valid thing and that how I was feeling was actually normal and justified. And that my mental recovery might take just as long as my physical recovery. Just like the relief of actually having a diagnosis, to be able to say “this is wrong with me”, it was comforting to have someone validate how I was feeling and tell me it was OK.

Some six months after Nationals, I finally did some intense work and didn’t feel fatigued at all. I just felt normal tired. Wow. What a revelation. I had been fatigued for so long that I’d forgotten what “normal” was. I rowed at intensity, and my legs didn’t shut down. I got puffed, and my heartrate was up, and it was hard, and it hurt, . . . . but I could keep going. Wow. This was another reminder that it hadn’t all been in my head. There had actually been something wrong and what I’d been feeling wasn’t “normal”.

I had another reminder of how bad things had been in October, when I had a relapse. I had been ramping up my training, but don’t think I was being silly about it. I started feeling a little bit tired during the week, then all of a sudden, in one day, I crashed. I went from feeling normal to being at my absolute worst of fatigue overnight. The first time this had happened, it had come on gradually, and amidst all the normal tiredness and aches and pains of an elite training load. This time it came on suddenly when I was still only in moderate training. The feelings were instantly familiar though. Heavy, dead, ‘flat’ legs (and arms too, now that I think about it). Fuzzy head that can’t think properly and can’t hold a conversation. Panic at the slightest thing. Dread of any kind of exercise. And a really miserable, hopeless despair.

I immediately backed off everything I was doing and pulled out of all the rowing trials that week. The worst symptoms (the head related ones) cleared within a week but, even doing virtually nothing, it took me 6 to 8 weeks for the physical side of things to return to mostly normal. It was very interesting though to recognise all those things that I’d put up with for so long. The feelings were so distinctive. It gave me a lot more confidence in my ability to recognise “fatigue” versus tiredness or laziness.

So now I am still “recovering”. I still don’t feel like I could tackle a proper training load. Most of the time I feel fine, but sometimes (like now) I feel a little bit flat. I don’t know whether this is just normal ‘flat’ness or whether it’s a bit of fatigue coming back in. Sometimes I decide to push through it, and sometimes (most of the time at the moment) I give myself the benefit of the doubt and back off.

One of my rower friends who is also a doctor was telling me some things about post viral fatigue. He said (this is my interpretation, so sorry if I’ve got it all wrong!) that the condition eats away at the cells in the muscles, which is what causes the tiredness and the flat, dead feeling. He then said that not only does it eat away at the muscles, but it actually eats away at the cells in the brain, which is what causes the emotional instability – panics, depression etc. My friend and I joke about my “brain eating zombie disease”. It’s nice to have some humour around what was otherwise a very horrible part of my life.

The condition is essentially unprovable, with no outward signs, and I always felt like people would think I was just being soft, or a drama queen, or making excuses. However, I’ve been surprised how many people have understood my condition (because of friends or family having it), or at least been very supportive and sympathetic. This is nowhere near as bad as many other medical conditions, and is not life threatening, but it can certainly destroy someone’s way of life. And it is very much a real thing. Hopefully this will give you an understanding of what I went through in case you ever come across it in your life.

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5 Comments

  1. I find all this very interesting, as back in 1993 ( when I was 33) I was very poorly with Glandular Fever. I ended up being off work for 3 months, but am the first to admit that it was probably a good two years before I felt fully recovered and full of energy again. I also started to get the odd panic attack every now and then. I never went to the doctor about it, but rather just struggled through it on my own. In the years since then, I have heard of all this being very common after Glandular Fever in particular, even the panic attacks.

    It did all settle down in the end, but I do have a tendency these days to choose not to do things I don’t like doing (like driving on Motorways!) rather than stressing myself out when there’s no need. Life can be hard enough without giving yourself more hassle!

    Hope it all settles for you soon. 🙂

    • Helen says:

      Thanks for sharing that. I think fatigue issues are much more well known these days, but I’m still surprised how many people have experienced them, or have friends who have. It’s not something people usually talk about so it’s easy to feel like you’re on your own with it.
      I’m glad to hear yours settled down after a few years. Mine is dragging on annoyingly at the moment – not enough to destroy my day to day life, but enough to stop me doing some things I’d like to. Hopefully the change of scenery can kick start a proper recovery!

  2. annathrax says:

    Crazy what the body can go through. Hope you make full recovery for all those scottish hikes!

  3. CJ says:

    Amazing to read your experience and the ups and downs. It really is hard to convince yourself you’re not just being a bit ‘soft’ isn’t it? And I’m not even on a physical training regime! Far from it, but I suppose a busy working Mum, I got Parvovirus last December and have just had to resign from my management position to cope with it. I’m so glad to read a story of recovery as my doctor does tell me that most people recover fully… eventually!

    • Helen says:

      Not knowing there was actually something wrong was one of the worst things about this experience. Once I realised there was, and had enough belief in that to tell other people and change my actions accordingly, it became a lot easier to deal with. It still sucks . . . but at least I give myself a break about it now! Recovery does happen, but I’ve found I need to be very gentle on myself in the meantime to give myself a chance to heal – both physical exertion and general stress levels. There are still ups and downs, but I think the downs are getting smaller and the ups are lasting longer. I can only imagine trying to deal with something like this as a working mum. At least I could come home and crash . . . . from what I know of kids, often there is very little downtime allowed! I hope you’ll be able to recover now so you can get back into work, and fully appreciating your life and kids, soon! Best wishes.
      Interestingly, I had parvo when I was a kid. Like the glandular fever, I didn’t have any symptoms. It just came up on a blood test a few weeks later. I didn’t have any fatigue symptoms then though.

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