Staying activePatients with myeloproliferative neoplasms (MPNs) may feel that exercise and staying active is the last thing that they want to do, especially with the extreme fatigue reported by up to 80% of MPN patients. However medical carers in this field have observed that staying active keeps you mobile, improves circulation and reduces fatigue. Here are some recommendations contributed by Professor Ruben Mesa, MD (Medical Doctor). Prof Ruben Mesa is board certified in internal medicine, haematology and medical oncology and is director of the Acute and Chronic Leukemias Program in the Division of Hematology-Oncology at Mayo Clinic in the United States. Dr. Mesa is also a professor of medicine. Studies have found that fatigue is by far the most common problem faced by people with MPNs. Physicians don’t always appreciate just how fatigued MPN patients can feel and often overlook or undervalue the symptoms that MPN patients report. In future, better treatments may hold the key to overcoming symptoms, but exercise is a great way to feel better today. Professor Mesa suggests the following approach: Define your goals Writing down your objectives will build your motivation. Your goals can include improving muscle tone, sleeping better and feeling less fatigue. It’s useful to define a specific goal that you can measure, such as walking to the bottom of the garden every day or running a 10km race. Ramp up slowly “The classic error in any exercise programme is doing too much too soon; it’s the ‘New Year’s resolution phenomenon,’” says Prof Mesa. You will need to increase activity very slowly over time to avoid exhausting or injuring yourself. Team up with your GP “People with MPNs cover a broad range, so it’s important to create a bespoke programme for your particular situation,” explains Prof Mesa. You should develop a reasonable and modest plan with your GP, taking into account any limiting factors such as a history of clots. MPN medications are not a major hurdle to physical activity, but do check with your physician before you begin. Gather your tools “It can be a challenge to implement a programme at home,” says Prof Mesa. New tools can help you get started. Use a pedometer to record the number of steps you walk each day. Keep track of your progress in a logbook. Invest in a comfortable pair of walking shoes and comfy, loose-fitting exercise clothing. Measure gains over time You may need to wait many weeks or even months to see an improvement in your energy level and physical condition. That’s the case for healthy people and it’s equally true for those with MPNs. Increase your level slowly and then gradually measure your progress against your goals every few months. Push the limit “The net change over your baseline has the biggest impact. Over time you can push the limit further and further out,” says Prof Mesa. Check back with your GP and haematologist and redefine your goals when you feel ready to take on some new challenges. Enjoy your new energy It’s clear from the latest research that even a very modest exercise programme can yield tremendous results; you can reduce fatigue, become more mobile, improve circulation and get more oxygen to your tissues. You may never feel quite as good as you did before you had an MPN, but you can feel a whole lot better. Visit our real life section for stories of people who have enjoyed getting their fitness under control.