The End-Stage Renal Disease Workout Plan for Dialysis Patients

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By: Bob Northam

Bob Northam is the author of The ABC's of the Big D: My Life on Dialysis, a humorous look at the lifestyle, personal, and work issues faced by dialysis patients.  Bob is a longtime dialysis patient who recently retired from a Fortune 500 company, where he was VP, Finance.  He and his wife Donna have two adult children and one grandson.

Being the intuitive kind of guy that I am, I sensed that I was in trouble the first time I brought up restarting my exercise routine to my doctor shortly after starting dialysis.

"You're going to exercise?" he said.

I nodded.

"While you're on dialysis?"

"Well not during treatment," I said.  "But yes.  You between treatments."

His response was very telling.

Now, I should point out, before anyone asks for this doctor's name in order to start malpractice procedures, that this was not my nephrologist, but my general practitioner.  He wasn't advocating a sedentary lifestyle, he was just shocked because from what he knew about dialysis, it didn't exactly make patients want to assault the nearest elliptical machine.  And he had a point, I mean, dialysis has a tendency to sap your strength.

Recommended Reading: CKD Patients improve Muscle Power, Leg Strength and less Fatigued by Exercising During Dialysis

Usually, a dialysis patient's idea of a vigorous workout is nose-diving into the couch in the TV room.

And, while this doctor went on to encourage me to stay physically active, his initial reaction brought out a truth that we dialysis patients have to face down.

Dialysis and exercise do not make a good mix.

But, exercise has always been an important part of my life and I was determined to get back into it despite feeling sick and tired most of the time.

Now, to say that my initial foray into returning to the gym did not go well is a gross understatement.  I talk about it in my book (how's that for a shameless plug?) but in a nutshell, I tried to get back to my pre-illness level of activity right away.

Recommended Reading: Exercises Tailored for Chronic Kidney Disease on Dialysis

Big mistake.

I was working with a personal trainer who had me do a warm-up run on the treadmill and when he turned his back, I splayed out on the mats in the back of the gym.  Imagine his surprise when he turned back around and I was gone.  He thought he was going to have to have me carted off on a stretcher.

But, not to be deterred, I went back and met with the same trainer again, and I have to say I admired his courage to keep me as a client.

"Maybe we should start out a little more slowly this time, huh?" he said.

I said, "Either that or just save some time and call in the EMT's now."

He laughed a little, but I could tell he was wondering whether he had gone into the wrong line of work.

"OK, how about we try a warm-up WALK this time," he said.  I agreed.

So, the session seemed to be going better.  I warmed up properly and was feeling pretty good.  The PT seemed to understand my limitations as a new dialysis patient still adjusting to the treatment lifestyle.

Recommended Reading: "Some Exercise Is Better Than Others for Lowering Blood Pressure"

Then I was struck by a bad case of over-confidence.  I had apparently forgotten about almost being taken out in my last trip to the gym.

I spied a healthy looking group of people working vigorously and in unison back in the matted area.

"What're they doing?" I asked my trainer.

"Circuit Training," he said.

"Hmmm," I said, still watching them.

"It's pretty advanced stuff..." my trainer said warily.

"Think I could try it?" I asked.

"Probably not a good idea," he said.  "Why don't we go get a smoothie?  The banana kiwi swirl is bitchin'."

"No no," I insisted.  "I really want to try that."

So, against my trainer's advice, I joined the group.  The lead guy laid out the agenda.

"We're gonna do squats, bench dips, sit-ups, lunges, bent-over rows, squat thrusts, then finish up with some bicep curls.  Go select your dumbbell weights out of the bin."

Recommended Reading: Walking is the Easiest Exercise to Incorporate into Your Daily Life

So we moseyed over to the weight bin.  I watched the guys before me and they were all picking out some of the heavier pieces.  When I didn't think anyone was looking, I went for the five pounders when a nice-looking young lady, all of about 100 pounds, grabbed for them at the same time.

I looked at her, embarrassed, and immediately went into improvisation mode.

"Oh, here you go," I said, handing her the dumbbells.  "I was just moving them to get to the heavier ones underneath, heh heh..."

She just rolled her eyes and walked away.

Well, to put it mildly, the circuit training routine did not go well.

When I started to do the squats, I went down once and didn't get up.  The guys on each side of me took pity and hauled me up by my arms.  The group ripped off bench dips in the hundreds.  I did three.  We were all doing sit-ups, but it felt so good in the laying down position, I just stayed there.  Lunges?  Forget it.  I attempted to do some squat thrusts, but I was thinking about the smoothie.  And when the group was doing the bicep curls, I left my pathetic little weights on the floor and headed for the shower.

Recommended Reading: Chronic Kidney Disease Patients can Prevent Burnout and Regain Peak Performance

Of course, my trainer was watching the whole time, and as I passed him by I said, "So, how do you think I did?"

He was suppressing a smile.  "Do you want me to be honest or polite?" he asked

I said, "Polite, of course."

He just laughed.  Then he said, "See you next time?"  As in forget about this circuit training nonsense.

"Yeah," I said, practically crawling out of the gym.

My lesson was:  Take it slow.  Build your way back. 

Circuit training can wait.

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