Muscle gain. how?

[tiredandthirsty]

Hello all,

i am back with another question.  i saw myself in the mirror yesterday and i was disgusted by what i saw.  i look like (no offense intended but i don't know how else to phrase it) one of those little babies in africa with bloated bellies and really skinny everywhere else.  i used to weigh 140-142, pretty fit.  i lifted weights 5 days a week for at least an hour if not more.  yesterday i weighed 118.8.  i am disintegrating.  i am trying to eat all the protein i can.  i eat seafood every other day.  i get a shot of liquacel (actually just started monday) at the clinic. 

what else can i do to put some muscle back on?  i understand i may not be able to get all of it back just now, but at least some.  a little bit.  my legs have gotten so skinny i feel like they might crack any day.  and they were pretty darn good from all the cardio and running and tae kwon do i used to do!  any suggestions, tips, advice?  i felt so down yesterday and still feeling a bit lousy after that picture. 

[SteveK87]

Are you still lifting weights on a regular basis?  If not the protein won't do anything for you.  Eating good amounts of protein will just maintain the muscle that you currently have and help build more when doing intense training.  I think what you really need is a high calorie high fat diet to help gain weight back.  Seafood will actually help you loose weight because it contains fatty acids like Omega-3's.  Omega 3's are good for heart health along with many other benefits so continue to eat that but it''s not going to help you gain weight.  Try eating more fatty foods like hamburgers or steaks.  A simple way to get your leg muscle back is to do different variations of leg squats.  I'd recommend looking into the P90x DVD called "Plyometrics".  That'll get your legs back in shape in no time.  If you're looking for an excellent, but intense, workout program try the rest of the P90x series.

[tiredandthirsty]

steve:  hi steve, thanks for your response.  no i am not doing any kind of weight lifting right now for a couple of reasons.  i am still working full time and it's not a 9-5 job either so it bloody never ends. also M-W-F i am at the clinic from 3:30-7:30.  i am working while i am hooked on the machine as well.  managing all these things has turned into a massive challenge.  i don't know how you guys do it.  you lot deserve an award. 

also, i don't think i have the kind of energy or the strength anymore to do the P90 type of workouts.  i have gotten significantly weaker physically from what i used to be.  getting tired easily, less strength in the arms, legs etc.  i am thinking about buying some kettlebells and starting back up.

[Whamo]

Try that 10 minute exercise program that the same guy who sells PX-90 sells.  Tony Horton, I think his name is, and don't tell us you don't have 10 minutes.  You might try reading a book about the right diet for your blood type.  Good luck.

[tiredandthirsty]

whamo;  its not about having ten minutes.  trust me, i will be the last person to complain about not having enough time.  but its about the lack of energy at the end of the day after all this. 

[Desert Dancer]

Belly dance works for me. You can get a pretty intense workout without ever moving from one spot.

[boswife]

it is horrably sad/scarry.  I mean not to make you feel worse, but i do know the destress of seeing that in yourself.  WEll, for me it's my hubby.  I look at him and silently cry.  It hurts me so much to see him so droopy and lack of mustle.  We are going to start back on the protien supplements and hope that does something for his albumin and mustles.  I think this has been one of the hardest things to deal with.  My poor man went to pull a weed from the ground the other day and the weed won.    Pulled him right down to the ground   Made him so sad...  Me too..  Danged crap this is 

[tiredandthirsty]

so sorry to hear this boswife.  i know exactly how he feels.  i am starting a whey protein isolate regimen from today.  just bought a small can as an experiment to see if it makes any difference.  my albumin was 2.7 when i started dialysis.  it is now up to 3.1 after 7 treatments.  the target is 4 they say.  so i am going to make sure i do everything on my part to make that target.  hopefully this protein therapy works.


SteveK87:  btw, just wanted to add another note to my response to your post.   regarding hamburgers and steak, I was told to stay away from red meat!  so i try to eat white meat all the time.

has anyone else been told this?

[cassandra]

probably, eat everything in moderation. When I nearly fainted seeing my body in the mirror, I got myself an exercise-bike which helped a tiny little bit. My albumin is fine. Sorry but have you actually ever seen someone on D looking muscular? Or happy with the look of their body? Just do what you can, and I actually enjoy the cycling, if I remember to do it.

good luck Cas

[tiredandthirsty]

you are right cassandra.  i know it is very unlikely that i will be back to the 140-142 range anytime soon but i am just trying to get back whatever i can.   

i wish i could post a picture or two of mine of what i was before.  sorry just feeling a little sad...hence the rambling..

[Traveller1947]

Hi, t&t!  Just wanted to add a few words of encouragement.  You're on the right track trying to eat as much protein as you can.  I wouldn't worry about whether the meat is red or white, as long as it's lean.   You don't want to add hyperlipidemia to your other troubles, common in dialysis patients anyway.  Extra calories will add weight, but they don't have to be fat calories.  Try to be patient in building up your strength.  Walking, tame as it sounds, uses all your muscles and will make you FEEL stronger.  Swimming does too.  I like cassandra's idea of an exercise bike, although I've never used one myself.  It stands to reason that it would strengthen your legs and improve stamina.  It would be helpful to keep track of your monthly lab results too.  You're already bringing your albumin up because you have a goal to aim for.  Other lab values, like hemoglobin and iron, are not in your control, but also affect your ability to exercise.  Talk to your nephrologist about them if you see them go out of range.  With patience and reasonable goals, you may just find that you've regained strength, stamina,  muscles and your normal weight over time.  All the best to you, as always. 

[SteveK87]

I understand intense physical activity may be too much but if you want to start off slow just do some pushups and squats every morning before work.  One exercise that you'll only be able to endure for about 30 seconds at a time is to put your back flat against the walls and squat down until your legs are at 90 degrees and just hold that position for as long as possible.  You'll feel the burn real quick.  Just keep doing that with little breaks in between and that'll work your quads pretty good.

[ChrisEtc]

Hi, I was kind of in the same situation but overweight in my late 30's.  The anemia reallys kicks your butt and you're always lethargic.  I still work as well so you don't feel like doing a whole lot after a full day's work and 4 hours of dialysis.  Basically I decided to get a trainer.  lt's probably the hardest thing I've ever done in my life.  Your muscles just don't respond the same way as I'm sure you know and it's a long, long road just to get to a "normal" strength level.  It's definitely possible though.  At first when I started working out I would throw up basically every single time and have fainting spells.  It's really incredible how the kidneys affect your entire system when you exert yourself.  After I worked out I would be done for the day basically, would have to lay down for a few hours to get my strength back.  You work through it though and you will get stronger if you keep at it.  Right now I take protein shakes two to three times a day and eat plenty of chicken and beef, enough to get about 200g of protein per day.  I am working out probably an average of 4 days a week with weights/cardio/basketball, non-dialysis days, and I am gaining muscle and strength.  It takes real perserverence and patience though, it's very slow to gain muscle with this condition.  Good luck!

[ChrisEtc]

One more thing!  There is an over the counter product called Beta Alanine.  My nephrologist cleared it for me so it's safe.  It basically counteracts the build up of lactic acid in your system so that you can do more before your muscles get tired.  It has really worked wonders for me.  I probably can workout an extra 20% longer when I take it.  I highly recommend it.  It's like $12 for 250 capsules.  I usually take 3-4 caps about a half hour before working out. 

[billybags]

Boswife that really made me laugh, about the weed. I have to keep chuckling. My husband and I have  problems opening jars, we save them and ask the gran kids to open  them. Even pill bottles, I have to ask the pharmacist to loosen them. Daft every day things are a challenge. He is also on protein supplements,, the muscles are gone, they are replaced by saggy skin and I doubt if they ever will come back. O well.

[cassandra]

BB the jars, and bottles might be easier to open if you use a dampish tea-towel around the lid. I found myself feeling like super-woman after I discovered that tip. There's also some really handy gadget (uhm it's white plastic, sort of a handle that goes under a jar-lid. Don't remember the name its from Jarkeys) Anyway, they'll make you feel better in a very practical way, so to say.

love Cas

[boswife]

oh billybangs,,i KNOW!!  It's so awful but danged its a picture of reality for sure..  and thinken a itty bitty weed could do that to them..  well, i can see why you chuckle..lol   

and hum,,, a damp tea towle seems a good idea.. gonna give that a try

[MooseMom]

I was thinking about Shad Ireland.  For those who don't know his story, read this:

http://www.shadirelandfoundation.org/about/shad-ireland/

Now, what I want to know is how did this young man go from a 75 weakling to an Ironman athlete, and how can the rest of us learn from him?  After he decided that his goal was to become an athlete, what did he do the very next day?  Did he talk to his neph?  Did he ask his neph to come up with a "muscle restoration" plan?  Did he consult with a physical trainer?  Did he buy a set of free weights and come up with his own training plan?  I know that many kidney patients have comorbidites that will prevent them from becoming Ironman competitors, but surely there is SOMETHING we all can do to restore some modicum of muscle strength to our bodies.

Does anyone have any specific knowledge on exactly how Shad began his road to renewed athleticism?  I doubt very much that he does standard inclinic D...

[Whamo]

Anyone who wants to put on muscle should use the finest protein they can find.  I like pure egg protein, but "Bioactive Whey Protein" is supposed to be the best.  And Dr. Stephen Langer's Glutathione Precursor Complex is supposed to increase training energy as well.  I pumped iron and ran in my 30's, but at 59, with CHF, liver disease, and kidney failure, my "mind over matter" training mindset isn't enough.  I never felt healthier than when I ran and worked out a lot, and my surfing skills improved quite a bit too, because of the training.  At this point it's a struggle just staying alive, as Barry Gibb used to sing (God bless him, RIP).   I don't think you can build muscle without working out.  There is no magic supplement that can replace it, except, perhaps, steroids, but that's not the way to go...or really good genetics. 

[MooseMom]

Whamo, has your medical team ever spoken to you specifically about exercise?  Should someone with your health issues avoid exercise altogether, or can you benefit from a tailored exercise program?  Is there any exercise program that could strengthen your heart without endangering you?  "Working out" can mean anything you want it to mean, even if it is working with light free weights.  Or am I just being naive (entirely possible)?

[Zach]

For more IHD reading about exercising and people on dialysis:

http://ihatedialysis.com/forum/index.php?topic=415.msg374142#msg374142

http://ihatedialysis.com/forum/index.php?topic=18814.msg322235#msg322235

http://ihatedialysis.com/forum/index.php?topic=3027.msg360814#msg360814

http://ihatedialysis.com/forum/index.php?topic=23946.msg387146#msg387146

http://ihatedialysis.com/forum/index.php?topic=18858.msg322622#msg322622

http://www.medscape.com/viewarticle/749178

 

[Zach]

According to the National Kidny Foundation (U.S.A.):

3. Management of Protein and Energy Intake

Dietary Protein Intake (DPI) in Maintenance Hemodialysis (MHD)
The recommended DPI for clinically stable MHD patients is 1.2 g/kg
body weight/d. (Evidence and Opinion)
• At least 50% of the dietary protein should be of high biological value.)
http://www.kidney.org/professionals/kdoqi/pdf/KDOQI2000NutritionGL.pdf
PDF page 41.

And for PD patients on PDF page 45:
Dietary Protein Intake (DPI) for Chronic Peritoneal Dialysis (CPD)
The recommended DPI for clinically stable CPD patients is 1.2 to 1.3
g/kg body weight/d. (Evidence)
• Dietary protein intake should be no less than 1.2 g/kg/d.
• Unless a patient has demonstrated adequate protein nutritional status on a
1.2 g protein/kg/d diet, 1.3 g protein/kg/d should be prescribed.
• At least 50% of the dietary protein should be of high biological value.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

You can include a protein drink such as Designer Whey, which provides 19 grams of protein for only 140 mg of phosphorus.  Just two Renvela tablets.

And as posted before by RightSide, a 3 oz. chicken breast will provide about 26 grams of protein, and has only 196 mg of phosphorus.

And then there is 3 oz. of shrimp, 17 grams of protein and 155 mg of phosphorus.

You can always check with the USDA National Nutrient Database search:
http://www.nal.usda.gov/fnic/foodcomp/search/

 

[tiredandthirsty]

hello folks, sorry for the MIA.  but i have been very busy with work.  this past week was super heavy with doctor appointments (3), dialysis and work.  boy am i enjoying the weekend doing absolutely nothing just sitting in front of TV watching movies.

i see a lot of you have posted some great information to my question, and i am so grateful for all of it.  thank you very much for all this.  i will read through it all when i am on the machine. 

also, besides the gas problem that i described in another thread, dialysis has been going well.  nothing out of the box.  except that i lose my voice sometimes after dialysis.  not always, but it does happen often.  anyone else experience this?  i am alright the next morning. 

i will keep checking in as much as i can and report/update on anything new.  thank you so much for all your help and knowledge sharing.  if there is anything you would like to ask, feel free.  i will try to answer it as best as i can. 

[Restorer]

My voice gets hoarse after dialysis too. People have asked me whether I was getting a cold. It clears up in 3-4 hours.

Does your center do nPCR labs? It stands for Normalized Protein Catabolic Rate. It measures your protein intake between sessions to make sure you're getting enough. It would be worth asking your nephrologist and/or dietitian about it.

[Gerald Lively]

I can only talk from my own experience.

My weight training ended with the 2008 forest fire that took out my home and everything in it.  That included my cage and powerlifting setup.  After two years of rebuilding and fighting with the insurance people, I tried to get back into shape at a gym 35 miles away.  Didn’t work.  I needed my own setup.

While lifting, I tried to take in one gram of protein per pound of body weight along with lots of water.  To gain muscle mass requires heavy duty sessions under the bar.  The mantra then was, “Eat Animals”.    I always began the day with a heavy dose of Whey protein in non-fat milk, sometimes with an egg or two.  When dialysis came along I had to cut back on the water intake and that meant cutting back on the protein.  I saw no chance of gaining muscle weight.

Now, I am in the worst shape of my life. The dialysis is over for now.  I have given some thought of finding a gym but I still have cancer and will soon be on radiation.  Everything is on hold and I am 73.  I was this week that I discussed this with my Radiation Oncologist.  He seems to have this old-fashioned idea that I should slow down because of my age.  It is true that if I could regain the strength I had just before the fire I would own several World Records. 

I still hold three California State records for the 65 to 70 age class at 242 lbs. (APA/WPA)  When the forest fire overran our place, I was squatting 420 lbs, benching 300 and deadlifting 325.  I was breaking through a plateau in my squats and was quickly moving up to 450 or more when I gave it up.  As soon as I gave up lifting, my weight zoomed up to a chunky 256.  Then with renal failure, I lost 40 lbs about.

I don’t know how one can be on dialysis and engage in meaningful weight training.  The required energy isn’t there.  Hanging on to what you have would be equally difficult.  If I had access to a gym and all of their equipment, I might maintain what I had using machines for high reps just to cover the big muscle groups. 

I know This wasn’t much help but this is what I know.

gl