EXERCISE

[jdat]

Speaking of that .. what is the best way to make a fistula stronger?

Or should I make a new post in the fistula section??

I have never had a fistula so what I am about to say is just repeating what I have heard and read.

Basically you need to make constant repeated open and close motions with your hand ( arm where your fistula is ) throughout the day, preferably with an anti stress ball or something that offers some form of resistance.

Anyone correct me if I'm wrong.

[SpeedFleX]

I usually do something on my BMX almost broke my wrist the other day still hurts

Play a little soccer, basketball.

When I wake up in the morning I do some push ups and sit ups then I lift some weights.

thats about it.

[goofynina]

I dont know about anyone else but i just broke out in a sweat READING what you do... I wish i had the energy to do half of that...    As Bajanne says:   Keep on Keeping on...... (i just love that saying)

[angieskidney]

I lack so much energy and last time a friend paid so we could exercise at a gym together she stopped going and they continued another year on me without my permission and I couldn't afford it

I would rather just go for walks with a good friend.

[Zach]

I have finally started on my exercise regimen.   I go early mornings - M, T, F - my dialysis days.  I do 25 mins treadmill; 5 x 8 reps - ad machine; 5 x 12 reps - leg lift and 3 x 12 reps leg press. Then 5 mins arc trainer (I hate this), then 25 mins treadmill.
I plan on going on Tuesday and Thursday also, but just to do the treadmill.
Top class body, here I come!!

That's a great workout!

[tamara]

Well, I thought it was time.

Started back at the gym this week,need to lose my winter weight If  I ever get the chance of getting a transplant.

I have always put weight on over winter but this year seems worse than normal.

So off to the gym I go, went tonight did 1/2 hour treadmill then a class, very tired tonight and knowing that I have to set up my machine for treatment tonight not looking forward to it, might do a double session of dialysis tomorrow    lol !!!- it would be nice if we could do that, oh I will do all my dialysis on Sunday this week leaving the rest of the week free hehehehehee.

Please someone out there care for all us people on dialysis and create something that will suit human beings!!!!!! 

Sorry a bit sooky lala tonight but thats what the site is for right?

[Zach]

Hey, if dialysis were easy, everyone would want to do it!     

It's great that you got up the energy and courage to go back to the gym.

I also need to go back to the gym ... it's been a while for me.
No excuses but, work always seems to get in my way.
Yes, dialysis is part time work!      

[BigSky]

I have always put weight on over winter but this year seems worse than normal.

So off to the gym I go, went tonight did 1/2 hour treadmill then a class, very tired tonight and knowing that I have to set up my machine for treatment tonight not looking forward to it, might do a double session of dialysis tomorrow    lol !!!- it would be nice if we could do that, oh I will do all my dialysis on Sunday this week leaving the rest of the week free hehehehehee.

Probably average gain for a dialysis patient.  One problem with dialysis is that it puts people into a catabolic state.  Which really sucks because it makes it easier for a person to put on fat while they are losing the muscle.

Eventually you will not be as tired after doing the treadmill.  It can take a while to build up stamina.  Took me a couple months where I could work out for an hour and not be dead tired the rest of the day.  Just keep chipping away at it.

[Black]

Me too. I am thinking of joining Curves, which is an exercise place for women. There is one a few blocks from my work.  Maybe if I schedule exercise the way I schedule dialysis, I will do it twice a week.

I loved Curves but my Doc has made me quit for a while.     I have untreated and undertreated hypothyroidism and adrenal fatigue which started almost 30 years ago.  I finally found a new Doc last month who is actively treating me.  I look forward to going back to Curves in a few months.  I'm already feeling much better and have lost 6 pounds since I quit going to Curves and gotten the right meds.  It really is a great place; I love the atmosphere and the machines.

BTW, anyone with fatigue, low body temp, elevated cholesterol, dry skin and hair, and weight gain should be checked for adrenal fatigue and have their thyroid hormones checked -- Free T3 and Free T4.  My previous Docs were checking only the TSH and then telling me I was fine and just needed to change my diet and get more exercise.  That's why I started going to Curves!!  I want to go back to them, show them my lab results and tell them, "I TOLD YOU I WAS SICK!!". GRrrrrrr

[Sara]

Sorry a bit sooky lala tonight but thats what the site is for right?

Tamara, what does sooky lala mean?  Sounds cool but I have no idea LOL. 

[angieskidney]

One problem with dialysis is that it puts people into a catabolic state.  Which really sucks because it makes it easier for a person to put on fat while they are losing the muscle.

Eventually you will not be as tired after doing the treadmill.  It can take a while to build up stamina.  Took me a couple months where I could work out for an hour and not be dead tired the rest of the day.  Just keep chipping away at it.

I did not know that. I was wondering if what I was going through was normal. Thank you. Is there any documentation on that? I am tired all the time even though my hemoglobin is good and when I started back to work last week I was surprised how fast I get tired out. I used to be able to handle more than this ..

Plus I had lost a lot of muscle last year when I had Peritonitis and went from 140 lbs down to 112 lbs in one month's time (I had become malnurished).

[sandman]

I haven't been to a gym in a very long time because they usually cost so much to maintain a membership and I have been out of the racing seine so long, I don't really have a good reason to train.  I know this may sound a little backward from the norm but during the winter months for me, I change my eating habits and I don't get much exercise and because of that, I loose weight.  But come summer when I go back to my normal job, I gain my weight back.  I guess pushing motorcycles is beneficial.

[tamara]

Sorry a bit sooky lala tonight but thats what the site is for right?

Tamara, what does sooky lala mean? Sounds cool but I have no idea LOL.

Sara, just means being a bit of a cry baby.

[BigSky]

I did not know that. I was wondering if what I was going through was normal. Thank you. Is there any documentation on that? I am tired all the time even though my hemoglobin is good and when I started back to work last week I was surprised how fast I get tired out. I used to be able to handle more than this ..

Plus I had lost a lot of muscle last year when I had Peritonitis and went from 140 lbs down to 112 lbs in one month's time (I had become malnurished).

It has been documented.  Dialysis washes out protein.  This is why dialysis patients are to eat lots of high quality protein to keep their albumin up. 

\From the first paragraph of a article in JCI.

Malnutrition: a frequent misdiagnosis for hemodialysis patients
Precision in the use of words is necessary in any discipline, and this holds true for physicians and investigators dealing with patients who have chronic kidney disease. Specifically, malnutrition is often used to describe a group of abnormalities — fatigue, loss of body weight with muscle mass being replaced by fatty tissue, declining serum proteins — present in many such patients.

As to exercise, short term studies show it is beneficial to patients.  I haven't read any long term studies on exercise and dialysis patients though.

Some studies even suggest patients get better dialysis if they do light exercise while hooked up to the machine.  (pedaling type exercise)

[angieskidney]

It has been documented.  Dialysis washes out protein.  This is why dialysis patients are to eat lots of high quality protein to keep their albumin up. 

\From the first paragraph of a article in JCI.

Malnutrition: a frequent misdiagnosis for hemodialysis patients
Precision in the use of words is necessary in any discipline, and this holds true for physicians and investigators dealing with patients who have chronic kidney disease. Specifically, malnutrition is often used to describe a group of abnormalities — fatigue, loss of body weight with muscle mass being replaced by fatty tissue, declining serum proteins — present in many such patients.

As to exercise, short term studies show it is beneficial to patients.  I haven't read any long term studies on exercise and dialysis patients though.

Some studies even suggest patients get better dialysis if they do light exercise while hooked up to the machine.  (pedaling type exercise)

I was never told I was malnourished but figured it out myself when I was trying to figure out why I was suddenly losing 2 handfulls of my thick nice long hair since Oct 2005 all the way til Jan 2006. I had to cut my hair off real real short because long hair when you are losing it doesn't look good. Not unless they start a new fashion of long stringy hair with Bald patches

I had them make me an appointment with the dermatologist but it took them so long to do so that I didn't have the appointment til June when I already had stopped losing my hair. So what I did instead is did research online where I discovered that with the Peritonitis I had become so sick that I had become malnourished but the body shows signs after the fact. I had Peritonitis in July 2005 but didn't start losing my hair until Oct.

Til this day I was never diagnosed as Malnourished but I know I was because of the signs my body gave. I became malnourished because I was in so much pain that I couldn't even stand up straight much less actually eat anything! The only reason I didn't lose more than I did is my friend Dave started coming over and feeding me Cream of Wheat. He would put the bowl on the floor and I would eat there.

I know exercise is extremely important for all dialysis patients and read a report where 20% more toxins are removed from the body during dialysis if you use the bike.

The report was posted on D&T City. But since D&T City has no search ability I had to do a search and found it here incase you want to read it!

[sandman]

Good post Angie, very informative.  Thank you.

[Zach]

Here's another important link about the need to exercise.


http://www.imakenews.com/ckdupdate/e_article000556048.cfm?x=b11,0,w

[angieskidney]

Oh good read!

[Zach]

Information on the positive affects of exercise for dialysis patient has been around even before I started hemo in 1982.

As patients, we always hear our "Dialysis Team" tell us don't.
"Don't eat this, don't hold your arm like that, don't scream when I stick you!"     

Here's something we should be told to do.

[sandman]

Information on the positive affects of exercise for dialysis patient has been around even before I started hemo in 1982.

As patients, we always hear our "Dialysis Team" tell us don't.
"Don't eat this, don't hold your arm like that, don't scream when I stick you!"     

Here's something we should be told to do.

Ummm, are you saying that your dialysis team tells you NOT to exercise?  Or is it that something they fail to tell you period?

[Zach]

I was being a bit sarcastic ...

But in general, as dialysis patients, we hear a lot about what not to do.

It's always good to have a positive, encouraging comment, such as "I'd like you to try to exercise."

[thom]

i swim 3 or four times a week.

[stauffenberg]

The problem with the data showing that dialysis patients who exercise are healthier and live longer is that the effect may not be due to exercise at all.  Rather, it could well just be that patients who are already doing better, who are already healthier, and who are already going to live longer, are the only ones who feel energetic and strong enough to exercise -- so the exercise is just an effect of their health, not a cause of it.

Before I started dialysis my hemoglobin values were regularly measured in the 150 to 160 range (for males the normal range is 140-170).  After dialysis, largely because of the exaggerated fear of EPO among most nephrologists, I was kept at a hemoglobin level of between 100 and 120, which left me profoundly anemic all the time by normal standards,  Now no doctor in his right mind would tell a patient with that degree of anemia to exercise!  On top of that, in the non-dialysis population, anemia in men is treated starting in the 130 range, and yet most dialysis patients treated with EPO are not even allowed to reach that range!

A further problem with dialysis and exercise is that the high level of toxins left in the body by dialysis often interferes with the pituitary gland's ability to send messages to the testes to produce testosterone.  This means that testosterone levels sink drastically, with the result that muscles disappear, no matter how much you exercise.  So exercising simply wears down the remaining muscle mass instead of improving it.

[sandman]

Anyone know WHY dialysis patients hemoglobin is kept at or below normal levels?  I have been hearing this a lot and I don't know why.

[BigSky]

Anyone know WHY dialysis patients hemoglobin is kept at or below normal levels?  I have been hearing this a lot and I don't know why.

Well besides the cost savings.   Epo and Aranesp have an increased risk of various types of clots etc. when given to patients with hemoglobin levels over 11. 


As to muscle loss and exercise.

This is all my opinion from what I have gathered on it. 

It has to do with intensity.  Healthy people exercise at the recommended intensity level and are able to burn fat and little muscle.  Because dialysis patients have low Hb levels if they exercise at the same intensity that is often recommend to healthy people it will tend to burn more protein/muscle.  This is because in order to burn fat the body needs an adequate amount of oxygen.  If it is not present the body turns to using protein as its fuel.   Low Hb levels prevent dialysis patients from maintaining the proper oxygen level to exercise at such intensity levels.

In order to perserve the muscle to some degree I find it best to exercise at a lower intensity level ,but for a longer time.  Also I found it best to take in 20 grams of protein before and 20 grams of protein after exercise to help perserve the muscle and build it up.


However this all could be alleviated if the doctors would prescribe what was needed to eliminate the muscle wasting from dialysis in first place but that isn't likely to happen anytime soon.