By Kathy Howard, RN, BSN, CCTC, CCTN

Hello… Hello! Yeah, you… the one holding this magazine… this is your body talking. I know I haven’t always held up my end of the bargain, but I need your help now.

It’s simple. I need you to starting exercising me!

This is what your body would say if it could speak to you. There are many things that you can do to improve your health: adopt a healthy diet, maintain a healthy weight, not smoke and follow your medication and treatment regime as prescribed. What is often left off that list is the need for exercise.

In my years of working in the renal field with either people approaching end stage, on dialysis or post transplant, I have probably heard every excuse as to why they can not possibly exercise. I concede that it can be a challenge for some but the potential rewards will make the effort worth it.

There are scores of research on the positive effects of exercise in renal failure. The benefits are boundless. But, for so many, and not just those with renal disease, the information on exercise and its benefits are ignored.

Well, if you continue to read this article, then the time is now to listen to your body! The following is the lowdown on what you need to do to start exercising or kick it up a notch!

First, get the okay from your doctor. Unless you are in acute congestive heart failure, you will probably get the big thumbs up!

An exercise program should consist of an aerobic or endurance component, a strength and balance component and a stretching component.

When I hear that, you sound like Charlie Browns teacher... “Wah, wah, wah, wah, wah, wah.”

Yes, it is a little hard to hear but cardiovascular disease and its entourage (think heart disease, stroke, hypertension, high cholesterol) is the number one killer of kidney patients. Aerobic or endurance exercise can combat it. Think about doing anything that makes you breathe a little harder and your heart rate go up. If you are starting from zero, then a simple walk around the block may be all it takes. The opportunities are endless. Walking, running, swimming, biking are all traditional exercises but it can be walking in a pool, riding a stationary bike, dancing, taking a flight of steps instead of the elevator or doing a low impact aerobic DVD.

A minimum goal would be 30 minutes a day but you can also do it in three 10 minute segments. If you are already exercising, then push the intensity, distance or time. Throwing in several 20 second bursts of increased effort, no matter what the activity, will do your heart and general fitness level a world of good.

The second component, strength and balance training, is often overlooked but has so much to offer people with kidney disease. If you don’t use your muscles, you will lose them. Inactivity is the villain for you. If you have less muscle mass, you will find it harder to carry your body around; the more muscle mass you have, the more calories your body will naturally use just to maintain a normal weight; the normal “good stress” of working your muscles will also stimulate your bones to help keep them stronger.

Convinced yet?

Going to the gym can be intimidating but a certified personal trainer can be a good investment in setting up a program and having correct form. Is a gym too expensive or not available, then check out the DVD section of the library. There are many beginner exercise DVDs available. Resistance bands are inexpensive and there are also things around your house that can be used. A can of vegetables can be a one pound hand weight.

Your own body weight can be used. Just try sitting up and down in a straight back chair 10 times. That’s right. Sit down, stand up. Try not to use your hands to pull or push yourself up. Just use your legs and your tush. Feel it?

Now stand on one leg near that chair. Go ahead and use it for balance if you have to but if you don’t, great. Now close your eyes and try to do it. It’s harder, isn’t it?

Oh yeah, I feel it. So those can count as a strength and balance exercises? This body is starting to feel good!

You can get in a good strength session in just 20 minutes and should try to do it two times a week. When it gets too easy, then increase your weight OR increase the number of times you do an exercise.

Try to do simple stretches before and after your other exercises. Yoga and Tai Chi help keep your body more flexible, but simple stretches at home or while waiting for appointments can be equally effective. Remember that nothing should hurt when you stretch.

This all sounds great but how do I make my owner do this for me?

Great question! Motivation is the hardest part. Here are some of the tips that I find extremely helpful!
 
• Find something you enjoy doing. If you don’t like an activity, you will not keep it up. I love being outdoors with my dogs. I don’t like to swim. You can guess my preference as to what form of exercise I prefer.
• Buddy up! A spouse, a friend, a dialysis acquaintance, a dog… all will work.
• Distraction. Music, talk radio or my personal favorite, an audio book will keep your mind off the task at hand and before you know it, your exercise session is done.
• Log it! Keep track of your progress and note your improvement! My newest web find is on http://exercise.lbl.gov/index.html. It is a way do a Trans-America trip without leaving home! A pedometer is also a great motivator and way to keep track of your mileage.
• Reward yourself! Pick a goal and when you reach it, have a treat planned! Or pay yourself… as little as 25 cents for every mile walked or 20 minutes of exercise will add up. You pick your salary!
• Bet on yourself. A contest can be a great motivator. Talk to your dialysis unit about pedometer walking contest. Or as a unit, stationary bike across the country. You can use the same web site already mentioned to form a team. Consider doing something with your exercise buddy. Winner gets coffee delivered or breakfast in bed.

No matter what you decide to do, the important thing is to take the first step. So, put down this article, lace up your shoes and take that body around the block. He or she will thank you for it!


Kathy Howard is a registered nurse, certified clinical transplant coordinated and certified clinical transplant nurse with 30 years of experience, mostly in the field of renal failure and transplantation. She is employed at St. Louis University Hospital in the Center for Abdominal Transplant and is currently trying to get in as good of shape as possible to prepare for back surgery in the fall.

This article originally appeared in the September 2010 issue of aakpRENALIFE.

Posted 9/23/10.

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