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Crohn's Disease Forum » Diet, Fitness, and Supplements » Fitness and Exercise » Medications that give you a false sense of energy - is exercising in this state bad?


02-08-2014, 09:21 AM   #1
UnXmas
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Medications that give you a false sense of energy - is exercising in this state bad?

I'm extremely underweight and had major surgery a few months ago, so my "exercise" consists of slow-walking with my dog, once a day, sometimes just ten minutes, sometimes more like forty-five minutes depending on how I'm feeling. Obviously I'm not trying to lose weight, and I have no real hopes of building up fitness as my health is just too poor to have those kind of aims. I just like getting outside with my dog, and want to make sure I don't become too sedentary - I do make myself walk even though I often don't feel like it because I don't want to get into the habit of just always staying still because I feel exhausted.

I get codeine prescribed regularly by my doctors, and it always gives me the feeling that I have more energy; it stops my body aches, and walking is far, far easier when I've had codeine. I came off it for a while but was recently prescribed it again, and as usual it's making me feel a lot better, and I've found walking is often not the enormous effort that it was when I was off the codeine.

My question is, is it possible that I'll do more exercise than is good for me because of the "fake" energy and sense of well-being that the codeine gives me? I used to think about this even more when I was on prednisone, because prednisone gave me an absurd amount of energy. In my natural state, without any meds, walking on hilly ground is exhausting. On codeine, it's still an effort to get started, but it's ok. On prednisone, I could walk all day. It was scary the amount of energy prednisone gave me.

But I am extremely underweight to the point where it could be dangerous, and I have absolutely no muscles. Is it a good thing to make the most of the energy codeine gives me, as it certainly makes my day easier and I enjoy walking? Or could this be a problem because I might not realise if I am doing far more than my body can cope with? E.g. would it stress my heart or be bad for my muscles to walk more/faster than I'd be able to without codeine?

(I did discuss this briefly with a doctor once, but that wasn't any use because she said codeine was a sedative and couldn't understand why it gives me energy.)
02-08-2014, 03:44 PM   #2
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Do you feel any worse after the exercise with codeine than you do if you donít use it or donít go walking at all?

I know where you are coming from in asking but if the answer is no then I donít see it is doing you any harm.

I assume the codeine is for pain, not for faecal management? If iso then the aim of effective pain management for someone like you is to not bomb you but give you enough freedom from your pain to make it manageable and in doing so allow you to go about your daily activities, including things like walking.

Dusty. xxx
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02-08-2014, 04:24 PM   #3
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I find no matter how well I feel, it's not the 1st day but the day after (and the day after that) I feel the side effects (whether its aching or pains). With this is mind I always start off slow and do maybe 25-50% of what I can do, then give it a couple of days to see how my body responds before trying again. It's much easier and better to do it this way then to overdo it and take weeks out getting better
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02-08-2014, 04:30 PM   #4
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My question is, is it possible that I'll do more exercise than is good for me because of the "fake" energy and sense of well-being that the codeine gives me? I used to think about this even more when I was on prednisone, because prednisone gadve me an absurd amount of energy. In my natural state, without any meds, walking on hilly ground is exhausting. On codeine, it's still an effort to get started, but it's ok. On prednisone, I could walk all day. It was scary the amount of energy prednisone gave me.

I agree, codeine gives me extra energy and pred even more so too. I am used to having little sleep, what with emptying the bag and generally crap that follows in the months after major surgery. When on pred I could live on a few hours a night and when I had to get up to go to work at around 6 am I found it easy to spring into life. Now I'm not taking either sometimes I have to drag my sorry arse out of bed. I can understand with the pred as all side effects point to being more awake however with codeine I think it was more in my mind. Mainly it made me feel better all round, took the edge off the aches and pains.
If you are exercising more and burning more calories than you are putting in then I would say it could potentially be doing more harm than good. It does take a lot of walking to burn calories though , an hour of walking uses approx 250 calories (based on a 70kg individual) in turn to lose a 1lb of body fat you need to burn 3500 calories. Now I know you are a touch on the skinny side unxmas but I should nt think you would burn many more calories in walking because of your weight. You do need to realise though your body is already using extra calories every day trying to repair itself from surgery and for those of us with ongoing illnesses, crohns etc, we use more calories for that too. Put all this together with a bit of malabsorption and its a fat persons dream and our worst nightmare. Just make sure you are trying to put in the calories if you are going out with the dog. On the days when eating isn't so good, stay at home and watch the chase instead
It took me a good six months after surgery to start putting on weight and has been so slow since then. If I get dehydrated I can lose 2-3 kg in a week, I never would have thought it possible and sometimes it breaks my heart to be going backwards again. Dioralyte and loperamide help lots with that.
I know you are being tortured with your weight at the mo and my heart goes out to you but you need to give yourself time for your body to turn the corner since having Surgery, three months is no time at all! I would keep on exercising but don't bust yourself in the process!
I doubt also your other organs are in danger through walking, no more than being at home. The positive mental wellness walking gives you is probably as equally important as sitting at home stuffing in the doughnuts

How's the output now btw? mine didn't thicken until month 4, I came out of surgery emptying 20 times a day and that lasted for months. Even now its 50/50
Of water and something that looks like soup! Try not to let it get you down!!!
02-09-2014, 09:05 AM   #5
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Do you feel any worse after the exercise with codeine than you do if you donít use it or donít go walking at all?

I know where you are coming from in asking but if the answer is no then I donít see it is doing you any harm.

I assume the codeine is for pain, not for faecal management? If iso then the aim of effective pain management for someone like you is to not bomb you but give you enough freedom from your pain to make it manageable and in doing so allow you to go about your daily activities, including things like walking.

Dusty. xxx
I feel fine after walking. I used to be on codeine for pain, but this time it has been prescribed to slow my stoma output. They're not sure what is causing my stoma to be working so quickly all of a sudden, and I have an appointment with my stoma nurse next week to try and figure it out. If the high-output is a temporary thing, I'm not sure if I'll continue with the codeine. I haven't discussed that with a doctor yet. I really want to stay on it, because I just feel so much better, not just in terms of physical energy but because it stops me aching all the time, and I do get a slightly more relaxed, happy mood when I take codeine, which I know is probably not a good reason to take it, but it certainly feels like one at times.
02-09-2014, 09:13 AM   #6
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I can understand with the pred as all side effects point to being more awake however with codeine I think it was more in my mind. Mainly it made me feel better all round, took the edge off the aches and pains.
This described very well the effects I felt too.

If you are exercising more and burning more calories than you are putting in then I would say it could potentially be doing more harm than good. It does take a lot of walking to burn calories though , an hour of walking uses approx 250 calories (based on a 70kg individual) in turn to lose a 1lb of body fat you need to burn 3500 calories. Now I know you are a touch on the skinny side unxmas but I should nt think you would burn many more calories in walking because of your weight. You do need to realise though your body is already using extra calories every day trying to repair itself from surgery and for those of us with ongoing illnesses, crohns etc, we use more calories for that too. Put all this together with a bit of malabsorption and its a fat persons dream and our worst nightmare. Just make sure you are trying to put in the calories if you are going out with the dog. On the days when eating isn't so good, stay at home and watch the chase instead
I haven't been too concerned about the calories burned, as I walk very slowly and for less than an hour a day, so I don't think it will burn that much off.

I've also been thinking that at best it's going to be many many months before I can hope to gain enough weight to be considered healthy, and that's a long time to go without doing anything involving much movement. After six weeks of nearly total bed rest following the surgery (first two weeks in hospital then another month or so at home) I was getting a bit crazy with staying still and inside for so long.
02-09-2014, 05:32 PM   #7
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I think asking your doctor is the best first answer. Past that, listen to your body. I think exercising is always better than not. Exercise does nothing but good for the body. I usually struggle with feeling lethargic and just getting off the couch and finding the energy to work out is always the hardest for me. I would utilize the energy you have, medication-induced or otherwise. Way to go!
02-10-2014, 05:34 AM   #8
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Exercise does nothing but good for the body.
But that's the thing, it's not always a good thing. If you have an injury, it's often not good to exercise it. If you've just had surgery, you're often not supposed to exercise. I was on nearly complete bed-rest following my surgery - there was no way that exercising would have been good for me in that state. And I'm wondering whether being severely (and I mean very severely) underweight is in the same category. I've known girls with anorexia who were forbidden to exercise because, when very underweight, it does more harm than good. So I'm not sure. Of course it does depend on how you define exercise - I'm only thinking of moderate walking, not working out for hours, which would be impossible for me right now, and definitely not good for my health.

My instinct is to agree with you - I want to move! I'm just not sure my instinct is correct.
02-10-2014, 11:31 AM   #9
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UnX, since you are so underweight and presumably therefore don't have much muscle mass, I wonder if you could get a referral to a physical therapist or work with a personal trainer to get you slowly and properly going on fitness? That's how I started getting into exercise, I saw a physical therapist for my hip arthritis and she advised me that a lot of my joints were very weak and that I had very low muscle mass. I started working with her on very simple exercises, and when I got a bit stronger and was able to do those without getting tired out, we'd add some more exercises or increase the difficulty of the things I was already doing. I started working out in a gym on weight machines as well to increase my muscle mass and things just went from there. I think that as long as you take it slow, possibly work with a professional to start with, and really listen to your body, that you should be okay.

As for weight loss, unless you're working out a ton, you shouldn't really lose much if any weight from exercise. When I ride the stationary bike on a difficult hill program for an hour, I sweat like crazy and the machine tells me I've burned about 300 calories in that hour. You can pretty much make up that calorie deficit by eating a candy bar or drinking an Ensure plus. That's a pretty intense workout for me, so I know I'm burning less than 300 calories on days when I do other things like lifting weights or walking my dog. I've been working out regularly for close to 3 years now, and I really haven't lost any weight (I have shifted some Entocort flab into muscle, but my weight itself has been mostly static). So I wouldn't worry too much about losing weight from exercise - if you just do light/moderate exercise like walking with your dog, you shouldn't burn enough calories to lose weight, especially if you're mindful of that and try to get a few extra calories here and there.

In a nutshell - take it slow, and listen to your body. Good luck & have fun!
02-10-2014, 02:06 PM   #10
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Thanks Cat. Yes, my concern with my weight isn't that I'll burn off calories given the small amount of exercise I do, I just thought I should clarify that it's not my aim to lose weight with exercise given that for so many people it is. My concern with my weight is more that exercise would stress my heart or damage muscles by making my legs work more than they should... or any other possibility of harm that may affect someone who's very underweight that I've not thought of.

In a nutshell - take it slow, and listen to your body. Good luck & have fun!
I guess this is my worry - that I won't hear my body because I'll be listening to the codeine instead! My body tells me it doesn't want to get up, but the codeine makes it sound like my body is saying it's up to going out walking!

I'm not really one for organised exercise or personal trainers. I live in the middle of nowhere for one thing! Physical therapy sounds quite a sensible idea though; maybe I'll see if the NHS would cover it for me.
02-10-2014, 02:51 PM   #11
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I think these concerns should be brought to your physician but when you remain in the "walk" type of exercise I would doubt it could be problematic if your codein is masking pain only. I would pay attention to your hearth rythm. If it beats to the roof, then I would be concerned but if it's essentially regarding the pain you are not feeling while you do the effort I would not worry too much. If you have a lot of difficulty breathing then I would be cautious too.

As far as I know, exercising (not talking about benching and running marathon here) will help a lot in the chronic pain management. Tai-chi, yoga, walking, things that are smooth and do not require excessive energy. Can you be seen by a kinesiotherapist?
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02-10-2014, 03:01 PM   #12
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The codeine doesn't just mask my aches, it masks (or gets rid of?) my exhaustion. Without it, I just want to lie down all day. I still force myself to get up and walk, but it's a real effort. Even just focussing on my book or something online is an effort. With codeine, it's not quite so much an effort - I want to do things and find myself getting absorbed in what I'm reading rather than feeling blah and forcing myself.

Can you be seen by a kinesiotherapist?
That's a new one on me - going to have to look it up!
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