What would you do if you were given a prescription that could:
• Give you more energy
• Improve your mood
• Fight depression
• Lower your blood pressure
• Reduce your risk of heart attack and
• Make your muscles and bones stronger?

Would you take your medicine? Most people would certainly jump at the chance to improve their physical and mental health. Ironically, this treatment is not prescribed often enough and, even when it is, not enough people takethe “prescription.”

So, what is this treatment?
It’s EXERCISE! Don’t think just because you have renal disease you can’t or shouldn’t do it. In fact, it is even more important for you to do it! Unfortunately, the exercise prescription often takes a back seat to everything else.

Physical fitness decreases continuously with chronic renal failure. The end result is decreased flexibility, decreased muscle strength, coordination disturbances and decreased endurance. There is a greater risk for bone disease and loss of muscle mass. Renal disease puts patients at increased risk for heart attacks and strokes and, to no surprise, at an increased risk for depression.

Research supports the “use it or lose it” theory. There are numerous studies examining the effect of exercise in renal disease. It appears no matter what
phase of renal disease you are in- from newly diagnosed through transplantation - there can be a positive impact! Almost all the studies show some type of physical improvement, no matter what type of exercise was pursued.

Chronic disease is not necessarily a barrier to exercise. If you are new to exercise, you should check with your doctor first. If you have cardiac issues, you may require cardiac rehabilitation. Those with musculoskeletal problems may benefit from a physical therapy evaluation. People with diabetes can benefit
immensely from an exercise program, but may need to increase the monitoring of their blood sugars. Diabetes patients may experience a blood sugar decrease for up to 24 hours after exercising. Most people with diabetes quickly learn how they react to exercise and can adjust accordingly.

Once you have the thumbs up from your physician, you can start exercising. There are
three distinct types of exercise and they all have their benefits. The three components are: 1) endurance, 2) strength and balance and 3) flexibility. While this statement will make many people want to throw down this article, ideally, you should do all three in some form several times a week. No, you do not have to turn into a gym rat to do this!

Endurance exercise may also be called cardiovascular or aerobic. It is anything that increases your heart rate and makes you breathe harder. If you improve your endurance, you will improve the health of your heart, lungs and circulatory system. With that, you will lower your risk of diabetes, colon cancer, heart disease and stroke. Increased endurance also decreases death and hospitalization rates. Some classic examples are running, biking and swimming.

The second component of exercise is strength and balance. This type of exercise builds your muscles and helps strengthen your bones. Having muscle strength can make the difference between being able to carry in your groceries instead of paying for delivery. If you have muscle strength and balance, you are more likely to catch yourself if you trip. Examples of strength exercises are lifting weights, resistance bands or even just lifting your own body parts. Don’t be fooled into thinking you have to join a gym to do strength training. You can incorporate strength training into everyday life with things as simple as lifting canned goods or doing leg lifts in your chair. Try to do strength exercises at least two times a week.

Balance exercises can be done anywhere and anytime! The next time you are waiting for someone, try standing on one foot. Change feet. Try it with your eyes closed. (Until you are comfortable doing this, it may be helpful to hold onto something such as a railing or chair back.) Keep track of your time and try to extend it!

Flexibility exercises are the last component of an exercise program. These may include general stretching or Tai Chi. You should feel a mild pulling, but NO PAIN. Flexibility is important to keep your body limber and avoid being a “Tin Man.”

The hardest part of any exercise program is getting started! The second hardest part is to keep it up. You need to pick activities you enjoy and can fit into your schedule. Joining a gym that does not have convenient hours or is intimidating will not help you reach your exercise goals. Having an exercise buddy that meets you every morning for a walk will help. The buddy can be your spouse, a neighbor, the person in the dialysis chair next to you or even your dog! Just having someone who is counting on you to be there will help keep you motivated.

There is nothing more discouraging than getting injured from doing too much too soon! It is important to start slow to avoid injury and make sure you include a gentle warm-up.

Setting a goal can be very helpful in staying motivated. It may be to complete a 5K charity walk or to swim to the end of the pool without stopping. A good way to measure your progress is to note where you start from and then measure your progress every month.

Many people find it helpful to keep an exercise journal. It can be very motivating to see on paper the improvements you have made. A pedometer is a very useful tool and can be fun for a friendly competition with your friends or at your workplace.

There are many resources available for you and some are just a click away on the Internet. Give it a try. The only way you can fail is if you don’t do anything at all.

Kathy Howard, RN, BSN, CCTC, CCTN, is a registered nurse with 27 years of experience, most of those years in the transplant or dialysis field. She now works for St. Louis University Hospital as a transplant coordinator. She is also Vice President of the American Board for Transplant Certification.

For more advice from Kathy Howard, visit the AAKP Web site, www.aakp.org. Ms. Howard was a guess speaker in our AAKP HealthLine series under the topic, Understanding Anemia and the Importance of Exercise. The archived call is in the “Educational Program & Events” section of the Web site.