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<\/p>\nSINGAPORE \u2013 Doctors recommend exercise to manage chronic health conditions and for prehabilitation before surgery, to make it easier for patients to return to health. <\/p>\n
Yet how do you exercise when ill or facing other challenges to physical activity? This is how three people worked around their conditions.<\/p>\n
Exercise used to be a way of life for Ms Fatima Megala Nathan Arokianathan, a research manager at a local university. She used to swim regularly and do high-intensity workouts like CrossFit.<\/p>\n
\u201cI was passionate about exercise,\u201d says the 40-year-old. <\/p>\n
Her life changed in 2022, when she woke up one day with legs swollen to three times their usual size. She felt a burning sensation in her lower limbs and could barely get out of bed, let alone walk.<\/p>\n
\u201cThere was no known cause for this,\u201d she says. \u201cI was a very healthy individual. I don\u2019t have any other chronic conditions.\u201d<\/p>\n
Apart from the inflammation and pain, she developed gut issues and could not digest solid food. Her weight dropped from 55kg to 35kg. She is 166cm tall.<\/p>\n
Daily life became a challenge. She found it difficult to walk and take the stairs. Her legs were so stiff that it was hard to move. She had issues maintaining her balance as well.<\/p>\n
Multiple rounds of hospital tests could not explain what caused her symptoms.<\/p>\n
Her condition is rare. She was given a diagnosis of undifferentiated connective tissue disease, as some of her symptoms and blood test results suggested systemic autoimmune disease, says her doctor at Tan Tock Seng Hospital.<\/p>\n
However, adds associate professor Madelynn Chan Tsu-Li, the results are insufficient to define a more specific connective tissue disease, such as lupus.<\/p>\n
\u201cAt present, it is not clear what the cause of her weight and muscle mass loss is, and we are still investigating this,\u201d says the senior consultant at the hospital\u2019s department of rheumatology, allergy and immunology.<\/p>\n
It may seem counterintuitive, but exercise is recommended for people like Ms Nathan. Strength training can maintain muscle mass. Exercise can also help manage pain and fatigue.<\/p>\n
Ms Nathan knows this, and took up yoga to improve her flexibility.<\/p>\n
In 2025, she signed up with a gym that has experience training people with different physical conditions.<\/p>\n
\u201cI knew I couldn\u2019t exercise on my own,\u201d she says.<\/p>\n
Indeed, Dr Chan recommends that patients consult a physiotherapist or other health professional to design an exercise programme that is safe and manageable.<\/p>\n
Mr David Hoi, an exercise physiologist at UFIT Singapore, says when Ms Nathan joined the gym programme, she was unsteady while walking and easily fatigued.<\/p>\n
He and the physiotherapist work together to help her maintain muscle mass without exacerbating her symptoms. On days when her legs are swollen or stiff, the physiotherapist works on flexibility and pain-relieving techniques. She can take a rest day or switch to upper body exercises.<\/p>\n
This approach has helped her. She now has 16.6kg of muscle mass, compared with 15.9kg when she started. She can do lunges, rows and walk while carrying weights.<\/p>\n
Ms Nathan recalls: \u201cWhen I started, I couldn\u2019t even do a lunge properly. Lifting anything overhead left me dizzy. Anything with weights was an issue.\u201d<\/p>\n
She is now able to squat with a weight of 20kg and deadlift 30kg.<\/p>\n
Best of all, she can climb a flight of stairs without tripping. She can walk for longer distances, and do things like shop for and carry groceries. <\/p>\n
\u201cAll these things are much more achievable now,\u201d she says. \u201cPreviously, I could barely get out of bed.\u201d<\/p>\n
She aims to do yoga three times a week and strength-train twice a week, subject to her body\u2019s limits. <\/p>\n
\u201cI know there are days when it\u2019s okay to not be okay,\u201d she says. \u201cThis disease has taught me when I can do things and when I can\u2019t.\u201d<\/p>\n
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Madam Nancy Lim walking with her surgeon Edward Cheong, who removed a benign tumour in her chest.<\/p>\n
ST PHOTO: JASEL POH<\/p>\n
In 2024, Madam Nancy Lim Mui Luang, a homemaker, found it harder to breathe while singing in church. She consulted a general practitioner, who said her symptoms were part of ageing and recommended that she exercise more.<\/p>\n
Her weekly routine then included at least three sessions of physical activity such as swimming, playing squash, doing pilates or brisk walking. \u201cI would get chest congestion during exercise, but it came and went. It wasn\u2019t painful,\u201d recalls the 56-year-old. \u201cI thought it was stress-related.\u201d<\/p>\n
In 2025, she found it unusually hard to catch her breath while hiking in Melbourne. <\/p>\n
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