health and fitness with dialysis
keep your legs straight!
Does your unit have a cycle/pedal attachment on the chairs?
Renal-y Relavant Workout programme
This is the basis for my journal of exercise. Having dialysed for 6 years now (dec '09. Anniversary is September. In case any-one is interested, best treat as a day of mourning!, or a holiday). As I watch my condition gradually deteriorate. Having spent my time in depression thinking what a time consuming, debilitatingly draining illness. And while every-one tries to tell me I'm still young with my life ahead of me. I'm decidedly too young to be ill. The why me's, the can something be done?, are the medical people missing things? The answer seems to be yes.
If the physicians knew everything surely there would be a cure! Unless you think there is and it is being hidden to make money for an elite few. Perhaps the truth is out there in the cosmos or gubpages. We just haven't found it or didn't realise to do it when we read it. And again separating fact from fiction is a hard process.
I'm no official expert. Unless you consider that 6 years is a long time to not know anything. Please bear in mind I have and do listen carefully to doctors etc., and find out all I can. Though I find doctors don't like saying much. All I know is that finding dialysis is now affecting me, gradually more and more over time. I, like many cannot take the speed of the pump when it is increased beyond 300, even that is a struggle. (350 plus is said to be called "high flux")
I know that exercise is beneficial for all (see: video. Active Treatment, available from nkf (national kidney federation) helpline. 0845 601 02 09. www.kidney.org.uk) A worthwhile organisation that has been helpful in the past. Its magazine has enlightened me on many things over the years. The latest being that there is such a thing as overnight home haemodialysis, not to be confused with pd (peritoneal dialysis) and that this gentler form besides freeing up the day helps reduce the tablets a patient requires, and as the flow required is lower and the time on can be, is longer (8 hrs, instead of 4hr.) this gentleness may lead to a longer lifespan. So I am currently looking into that as it will also help my attempts to exercise and keep fit.
Inertia is the first hurdle to get over. Not easy as there is so much that can get in the way. I do all my own housework, shopping etc. I find I sleep several hours after dialysis. And with the exception of yesterday (friday 11 December 2009) where I was "full of beans" and feeling so energetic I went to the gym early morning. I stayed about an hour which is good, not least because something is always better than nothing.
It may help to get over the initial inertia by working out your reasons for wanting to set up and take part in a good exercise program. A list of reasons may occur. 1. Dialysis has a way of wearing people down over time and exercise is shown to resist this. 2. There are many side effects with all the treatments. Only homehaemo (not to be confused with PD or CAPD) seems to reverse the need to be on so many tablets. Even so exercise is still recommended as with healthy people. Althougfh workouts may be less arduous. One linked side effect is renal-osteoparosis, certain exercises, and not losing too much "water" weight may prevent or delay its onset. Consider the following blog: The Benefits Of A Trampoline For Exercise
Maxim 1. "Doing Something is better than doing nothing!!!"
Even if you / I only do 5 minutes, it is still 5 minutes that may not have been done. It may even promote the urge to continue. Fair enough as there is a need to improve strength and stamina for dialysis which is said to be like running a marathon. This is renowned, I heard it a lot among patients and drivers in my early days on dialysis.
I've often considered that this is a drinkers disease. I remember spending long hours in pubs just drinking, mainly with my dad who has developed it as something of a fine art... I was sixteen when he first took me drinking to his local, where he spent many a night in an often solitary lock in. Getting his own pints and being trusted enough with the bill. He's now got renal complaints of his own including diabetes. The question is why have I got the troubles first? I would put this down to fizzy drinks being much more readily and relatively cheaply available when I was growing up, and in the now compared to in his day. So in a way I've been drinking longer.
Some background information on the illness
I don't think the body is designed for fizzy drinks. I have two words or phrases to back up this point. 1. If God had meant us to drink fizz he would've carbonated the water for us! And if you wish to avoid religion and look on it as science. We have evolved over many years drinking still water. Which in essence is pretty similar to point one. So if both factions agree then surely it is most likely to be true!
Of course the medical profession have their own reasons for its onset. I did have two bladder infections where I was passing blood as a child. And did not dare say anything for a fair while. The doctors didn't look at even my current diet, let alone the fact that I was drinking a lot of fizzy pop upto and at that age of the infections. And I seemed to drink more of it as the years went on, as well as some junk food replacing a proper diet.
Maxim 2. "eat -AND DRINK- healthily"
No good putting in all that effort making the fire if the fuel is going to be damp and short lasting.
That's not to say cut out everything that's delicious. What do you call delicious? Don't deprive yourself only wait until the end of your day. (and try to have less) In the meantime use a healthier or more time consuming option. For example I use cola bears, because I like cola but the fizz blows me up and tires me out. (I try to save the chocolate for the evening. I don't punish myself if I fail, but say to myself "there, only kit-kat, I could be having that Yorkie/Dairy Milk now if I had waited") Also boiled sweets take awhile to finish in the mouth. The blogger who said fruit has a good idea if you like fruit and can be bothered with the peeling or the juice going everywhere.
Also for motivation, a personal trainer is a good idea to get you started so that you know the best or right way of doing things. Mine have taught me a lot. These can be found in gyms though not so much at my local leisure centre. Have a set time to go, and stick to it though it may take a bit of tweaking initially. If you miss one don't give up on the idea, look at your reasons for not going, find another if you need to but try to keep going and keep your next appointment.
Whose going to lose out if you don't? Only yourself ...And those who instead of meeting the positive energenic and vibrant and healthy you see only a negative tired even disinterested shadow of your self that you know you could be!
Maxim 3. "Keep on keeping on".
If You've asked the question "Where do I get the willpower?" you obviously want, & need/ed to know -And DO! But don't just wildly go about exercising. Dig into all relevant information. I'm still looking but a couple of good books and things I've found so far are as follows.
Fitness Walking, L.Snowdon & M.Humphreys
Stretching, Bob Anderson (US)
Strength Training Over 50, "stay fit and fabulous", D.Cristine Caivano
(Note: Though I'm only 34, health condition is a factor so I needed something Gentle.)
There is something to be going on with from Warm Up through to strength and stretching. At school I learned 5 's' elements of fitness. These Are Suppleness, Speed, Strength, Stamina, & skill. Suppleness is in the warm up & post training stretch as well as the post training stretch which is recommended to do by experts who say it is beneficial after strength training as well. Speed brings an Aerobic element to the training, that is not the same as strength. Stamina requires slow movements and holding for lengths of time. Skill, in sport is to do with winning. In training though for FITNESS & HEALTH is to do with how well you / I perform each task, therefore amounts to not getting injured. And part of that is in gaining knowledge and keeping up to date but with knowledge knowing the waffle from the wisdom, know what is right for you.
Maxim 4. "Knowledge. Know what is right for you!"
As my physio at Fitness First pointed out. "Some programmes are counter productive to others." and that says everything. My role here is not in playing 'expert', but to point out that I, we all would be lost without the kind help of experts. So, I must hereby take the opportunity to thank Sammy & Dan at www.evolvefitnessandphysio.com I've seen myself leap forward in the short time I've been undertaking treatment with them. And find FITNESS FIRST to be a very capable gym environment for improving my general fitness.
Part of knowing what is right for me is in deciding the path to take. I decided against supplements and steroids etc. For the reason that my intention is not to go too far with it all. I am interested merely in exercise for getting and staying reasonably healthy and fit to enjoy a happier lifestyle, with a certain amount of freedom from illness and injury. My aim or wish or dream is not in entertaining others with a developed physique, such as found in entering contests and competitions. Nor is it out of some frett that if I don't get big I will be more susceptible to getting picked on etc. I find this just perpetuates violence etc. So we can add to maxim 4. ...And know where you're going with it.
I cannot pass by the subject of knowledge without the advice. Know what is available, and what is possible. Renal (AKA. Kidney) failure/disease can be a very stressfull thing to cope with, and overcoming the issues and problems faced can be a very steep learning curve. Especially when it becomes about time to dialyse for the first time. Doctors like to have us ready, and a fistula prepared by the time Creatinine levels reach 800+. Knowledge includes and incorporates knowing how to look after this, with exercises and protective equipment.
So this brings us to the end of the first lesson. The first lesson is concerned primarily with motivation to get started and keep going long enough to free oneself from the inertia. Of long time practicing sitting in front of the TV., or computer etc. This brings us to ...
Maxim 5. Discipline yourself to get out of the old routine and into the new one.
This discipline, for me started with seeking knowledge. I sought books on fitness. I didn't let the fact that in every subject known of by man there seems to be a lot of rubbish. Eventually finding some Gems along the way. (listed above), but this is only where discipline starts not the be all and end all. It takes discipline and something of a strong will to turn the TV off and start reading. (This is a good level to start at as you're still in the comfort zone of sitting down). In school the correct order was simple exercises like walking for awhile, then jogging on the spot for several minutes to warm up. then some simple stretches followed by more running around, the specific exercise we were there to do, followed by more running around for a bit, slowing down into a walk, more stretches. Spot jogging slowed into walking and then sort of shaking off at the hands and feet before putting tracksuit back on. And rest with feet up. What could be simpler? I'm still looking for things to help me with ideas to adapt this for the home. As I'm 2 floors up my neighbours won't appreciate any pounding on the floor etc. And I have to watch the space when waving my arms around so that I don't break the light shade or knock things over etc. So discipline requires much thought and carefulness in planning ahead.
First Maxim of second lessonreminds me of The Karate Kid films. Where the Master was teaching his Student. "Second lesson is First learn First lesson!". The films are appropriate to a point in that much emphasis was put on exercise and staying well. On the other hand the kid pulled his punches somewhat, I'm sure his first love eventually went back to her original boyfriend, if nothing more than for the sake of parental approval. Maybe even peer pressure? So his mistake was in not thoroughly checking the lay of the land, the way things are in his new place before barging in for the prettiest who clearly had a thing for 'Johnny come lately', (Eagles song).
I digress, while the film is clearly geared toward competing, my own reason for watching it in the first place was of a social nature. At the time it came out people I was around were watching it and talking about it. So it seemed the logical thing to do as a curiosity and to keep up with the conversations -although the latter vanished by the time I got round to seeing the video.
27 July 2010
Second maxim of second lesson
Enjoyment and Safety is paramount. Safety has more than one meaning. You need to do the exercises properly. And I can agree with those who say this should be in the first lesson, but it is a rule rather than a maxim. Note also Safety in the environment you are working out in. I can understand why they separate women and men in sport, it goes right back to tribal mating rituals! This would seriously get in the way of winning first prize if your more concerned with attracting a mate rather than competing. I tried to keep it light with this one! But Personal Security is always important to consider. If you can go out in two's or groups, keep to daylight hours, maybe take a panick alarm, any spray to the eyes will buy you some time to get away from anything tricky, it doesn't have to be mace but preferably strong smelling with a sting for the eyes.
I assume you also don't want interruptions and people looking in, so get blinds for windows, good light shades prevent a lot of light escaping through the window and so it is harder for the unscrupilous to know if your in or not!
Also, it is harder to enjoy something if you feel watched, or you feel the need to keep an eye out, just in case. Be Safe and Secure!
Now, you should be well on your way to becomming a master keep fit enthusiast? Always strive to be going forward and improving, but never rush to get somewhere...
*(from knowledge and knowing).
1. Forming a fistula. So your creatinine is creeping up it is time to consider what you need to do to help form and keep a healthy fistula. 1. from now on cleanliness really is of the utmost importance, but it is not alone. 2. Keep the area warm to encourage continued blood flow. Don't forget that night time is the coldest, and the wrist -usually the first port of call for the doctors- is quite hard to keep warm and protected. 3. Protection from prolonged pressure, like sleeping on the area. Try a throw over the arm with a loose wrapping of something like corrogated cardboard or thin but tough plastic in order to form a tunnel for the arm if rolled on. As long as the material cannot easily be squashed, is light weight, and allows the arm and hand to breathe. Consider wearing a glove when out, and particularly at night when things are coldest.
2. Some Isometric exercises are possible when on the dialysis machine, some anyway. Be careful not to break the footrail by pushing on it. And steer clear of the connecting tubes. Remember you don't always need weights to get a good workout. Most people sleep, or lie back as this is gentlest on the heart etc. It is still like running a marathon -as they say.
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