Antibiotics, sepsis and lingering fatigue

Hi,
I had the missfortune to get sepsis following double inguinal hernia surgery. It was pretty messy and i was on a mix of antibiotics for almost 5 weeks. As we all know antibiotics do screw up good gut bacteria and i have since transitioned to a diet of no processed foods, lots of veg and fish and occasional meat. I amn not carb deficient. I walked a minimum of 12000 steps every day to keep active and have returned to easy 1h z2 rides 3-5x a week for last 3 weeks. My problem is fatigue which seems to come on far too quickly and seems disproportionate to effort!. I am just wondering if this is to be expected or not. FWIW i have asked my consultant and he says that the sepsis would have hit harder if i was like most of his patients unfit/overweight. And recovery, from the operation and infection would be much longer for them too.
Does anyone else have experience of recovery from sepsis and if so what was your experience of returning to exercise. I appreciate i have needed to take it easy at first but want to introduce more varied workouts, even a bit of HIT.
Thanks.

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I don’t have any experience with sepsis, but just a small side note.
You said you are doing 1h z2 rides 3-5x a week → are you sure that z2 is still z2?
After such a major/traumatic event it is very likely your FTP has dropped substantially and you may in fact be working in z3.
I’d say this is one of those ‘less is more’ scenarios. Reduce the intensity and duration until you are no longer feeling fatigue coming on and/or a disproportionate effort. In this situation, trust RPE over your power meter or hrm.

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Good point. My FTP was 255 at 73 kilo’s. I estimated a drop to 200 and have limited most of my riding to 130ish watts, occasional bursts. Perhaps i should go lower still.

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Umm…so…a fairly major surgery, followed by significant illness (sepsis is no joke), followed by five weeks of AB, and you feel your fatigue from this level of effort seems “disproportionate”?

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Would suggest you not compare current post-surgery/illness you to pre-surgery you, and cut yourself some slack. I’m thinking your fatigue level is fully justified.

:wink:

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Have you looked at your heart rate response during the rides? Is there a lot of cardiac drift?
How do you do with a Z1 heart rate effort?

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:grinning: :+1:

If i remember to put my fan on then very little drift at all. Unless i drop a sneaky 5s sprint in.
FWIW at 59y old i have a low resting HR of 38-40 and post operation its only in the last week that RHR has fallen to 40.
I think @CPT_A CPT_A has quite rightly reminded me i am only human and not some uber athlete able to bounce back from injury or sickness. Thanks all.

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We old(ish) guys have to stick together…

:fist:t2: :fist:t4: :fist:t6:

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Lots of good information here. You might want to try HM after all of this and see how you react to the harder level efforts in it. There is a controlled section that will give you a good idea where you are at. Sepsis, like COVID-19, is no laughing matter and puts your body under a great deal of prolonged stress. Read through some of the ‘Long COVID’ threads as well to get a great idea on what to do for recovery.

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12000 steps may even have been too much. I had sepsis early 2020, one month after brain surgery and it really hit me. I’m still on the mend. recovering at home at the time and doing quite well and if I hadn’t been so active it would have turned out a lot worse. also, recognising the symptoms and calling back into hospital (Saturday morning, this stuff tends to always happen on weekends or doesn’t it?) saved my life. I had emergency surgery on Sunday evening to clean out the infection in my brain that caused it. there’s still a long way to go. mind you, brain surgery plus another four revisions might be a bit worse than hernia but what I’m trying to say is that sepsis is a life threatening condition that really needs time. do stuff too soon and you’ll pay. take pain for discomfort and push on cos you’re a Sufferlandrian and you’ll pay. listen to your body. eat well, sleep as much as you can and stay in your comfort zone when you train, i.e. you should happily be able to to talk constantly without getting out of breath. doing HM to see where you are and then adjust is a good idea but be aware that afterwards you may need a while (i.e. more than 1-2 days but perhaps even a week) to recover. then when you train, proper pacing is the best tool you have. finish your rides on a high note, even if that means you didn’t finish. feel great with another 10 minutes to go but not quite sure what these are gonna feel like? get off, be proud of what you just accomplished. I took the hard road to learn and still do. finished an outdoor ride I had last done before my tumor was diagnosed, took 10 minutes longer and wasn’t happy even though I probably should have been proud of being able to ride this far again.
take your time to recover and you’ll get there in the end, however long it will take. I wish you all the best

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Hi Bob, sorry to hear about that, but hope you are well on the mend now. After that amount of time off the bike it is expected to lose not only some fitness but also some resistance to fatigue. As a result, not only do relative power levels drop, but also your ability to recover from Z2 even with the new number. Although not having the surgery or antibiotics period you have had, I’ve had long periods off the bike for various reasons and even after reducing zones and working at the correct relative intensity, I have found fatigue more of a factor. Keep riding, progressively build at a sensible rate, and both fitness and fatigue resistance will return

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@IsiSchneider_KoS What you have been through is extraordinary. I am in awe of your struggle and return to form. Be proud of your achievement. Mine is and will be easier. Thanks for posting and the sage advice.

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I totally agree with Bob. I would be incredibly proud if I went through what you did and was able to do what you can do now.

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Firstly, and although i am no Doctor (of Medicine) I can say sepsis is quite dangerous and in my understanding you are lucky as it could have been worse. So I wish you a speedy recovery. Secondly listen to your body, build back slowly as the sepsis could have caused damage which you can’t see. Take it easy and listen to the triggers of your body.

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I am one of the few who watched, from the sidelines, what happened in your case. This was extreme but I’ll state that sepsis is NO JOKE. It totally involves your body and completely takes you over. You have GREAT comments, Dame Isi. Just to put this in perspective you are STILL recovering, two or more years later. I stand in awe that you can ride what you do, let alone get on a bicycle.

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thank you Sir @jmckenzieKOS for your kind words, I’m trying to hang in there as good as I can

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You are doing a great job and are a great inspiration for the nation.

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