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Trusting the Numbers 7: The simple heart rate is more useful than I once thought

Tracking the heart rate has amazing power!

In the beginning, I knew that I should try to keep my heart rate below my anaerobic threshold. But beyond that, I didn’t know what my heart rate really could show me. I spent more time looking at HRV, which seemed more interesting and useful. And it is interesting and useful, but I was underestimating the power of the simple heart rate.

As it turns out, the heart rate itself offers a lot of insight into what is going on with my body and what it can tolerate.

Here’s what I wish someone had told me about tracking my heart rate through the day. (I've been wondering if everyone else already knows all this—but just in case, I'm putting it here.)

If I had known this from the beginning, I think I would have made more progress on my road to stability. Some of this I only got into my head in the last few weeks. Pretty much all of it comes from what I have learned on the Facebook group "ME/CFS - Pacing with a Heart Monitor #2." (But this is my understanding only, and it's definitely incomplete.)
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Some of these things you can do just by counting your pulse manually, or with a device that you use at specific moments through the day. But for the most insight, you need a device that tells you your moment-to-moment heart rate. Ideally, you will also be able to see a graph of your HR history—even more ideally, one that doesn’t average the heart rate out over time. Averaging will conceal things like brief spikes.

  • Find your resting heart rate (RHR) daily. To do this, when you wake up in the morning, stay in bed. With as little motion as possible, wait quietly at least five minutes to allow your heart rate to stabilize a bit, since your heart can be irregular when you first wake up. Then measure your heart rate. (In my case, this is now combined with measuring HRV.). Record this. Measure it the same way every morning. The RHR may vary from day to day, but over time you will learn your typical RHR.
    • Some devices calculate a RHR for you. Different devices use different methods for this, and the result may or may not be accurate for this purpose.

  • As much as possible during the day, stay below 15 beats per minute (bpm) above RHR. If your RHR is higher today than usual, try to stay with 15 bpm of your normal RHR. If your RHR is lower today, it’s safer to stay within 15 bpm of that lower number. This is best because both a raised and (especially) a lowered RHR are generally a sign that you need more rest.

  • It’s a good idea to check throughout the day to be sure that you can get back to RHR. Whenever you lie down throughout the day, you should be able to get back to RHR, except maybe right after a meal. Not being able to return to RHR, or dropping below RHR, signals a problem for you to investigate. (Healthy people can be at RHR while sitting, also.)
    • Food sensitivities and overexertion both can keep you from returning to RHR. (It usually takes about 40 minutes for food sensitivities to show up for me.). Serious overexertion may cause your heart rate to fall below RHR.

  • During the day, when you exert yourself, use your heart rate to tell you how long to rest.
    • As soon as you stop your exertion, start timing while watching your HR. When your HR returns solidly to your RHR, stop the timer. Rest for about 5-6 times as long as you timed.
    • I find it easiest to use the stopwatch timer on my phone. I start the timer as soon as I stop my exertion. Once my HR hits my RHR, I click “lap.” Then I wait, watching my HR, until I know whether my HR is going to bounce around, above and below my RHR (more than it would if I hadn’t just exerted).
      • If my HR doesn’t bounce or go low, then I can take that Lap 1 time as my rate of recovery; the Lap 2 time shows my rest time.
      • If my HR does bounce or go low, then I click “lap” again once I actually achieve my RHR, and I have to calculate my rate of recovery: Lap 1 + Lap 2. I then use Lap 3 to time my rest time.
    • If it takes longer than 10 minutes to return to RHR, that exertion was too much for you. (I like to keep my recovery rate to 2 minutes when possible.)
    • This is not enough for pacing all by itself! It’s still quite possible to overdo in a day, even if you rest like this after every exertion. But it definitely helps.

  • Keep track of your maximum HR for the day, and try to keep it as low as possible.
    • A high HR, even for a moment, has more of an impact than we would think. (I hypothesize that this is about alarming the autonomic nervous system.) I try to plan my exertions so that my HR never gets too high. It’s generally better to have an activity go longer than to let the HR go high. (I’m sure there are extremes where that wouldn’t be the case, of course.)

  • If you lie still for too long, your HR may begin a steady rise. This lets you know how long your body can tolerate stillness.
    • In my case, I can only tolerate about 20 minutes of lying still before my HR starts a steady rise. I try to remember to change position around that point. (That's hardest to remember when I'm using my laptop!)
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Comments

Skim read some of this but sounds very helpful. Will have to come back later and do are re-read to absorb more. Hopefully my brain will be cooperating then. :)

Thank you!!
 
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It took me months to get all of this straight! I wrote it out because I have never seen it all written out in one place.
 
I was just eating something and my heart rate alarm went off. Yikes. No wonder chewing is so tiring for me.

As soon as I finished eating, it dropped back down by 16bpm so I know it isn't a reaction to the food but the actual act of eating. :(

I once asked a non-ME friend if she ever wished we didn't need to eat. She said, "Noooo" in a voice that implied I was crazy to ask that question.

Not crazy when it takes so much energy to do it. :xpem:

edit:
If your RHR is higher today than usual, try to stay with 15 bpm of your normal RHR. If your RHR is lower today, it’s safer to stay within 15 bpm of that lower number. This is best because both a raised and (especially) a lowered RHR are generally a sign that you need more rest.

This is good insight because when my RHR goes really low sometimes, I can feel just as bad or even worse than when it is too high but like you said either is not ideal.

edit #2: You can see I'm just now working my way though your post. It's good stuff. I may come back and comment some more once I get through more points.
I also want to read it a couple times to get the info to stay in my brain. :)

Thanks for taking the time to post it.
 
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I once asked a non-ME friend if she ever wished we didn't need to eat. She said, "Noooo" in a voice that implied I was crazy to ask that question.

This has been my main wish lately—to be able to just skip eating. Partly because it's hard on my husband to have to feed me regularly, but mostly because it seems to be one of the hardest things on my body.
 

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