CKD, Fistuala and exercise

[barbara55109]

I'm 60 and have CKD for around 3.5 years. The medicos thought I'd be on dialysis by now so I have an unused brachiocephalic fistula in left arm. It is just above the elbow crack. The transplant folks wanted me to lose weight. I started Wegovy, go to the YMCA 5 nights a week and eat once a day. I got below their magic 200. But I've floated above it now. I switched from Wegovy to Mounjaro last week. Since I am moving from the highest dose of one me to the lowest dose of the new one, I am hungry all the time. It will take 6 months to taper up the Mounjaro.

I'm trying to spend more time using the weight machines. Meanwhile I'm having twice a week PT for my back. I have deterioration in the facet joints. The PT says I shouldn't be doing any weight work with my fistula arm. I searched far and wide for information about that. There was one study showing no problems with 6 lbs weights and below - but that was for active AV fistulas. I'm not lifting weights, but there are five machines I use with my arms. I can't set them to just 6 lbs for my left arm and more for my right. It doesn't work that way.

I see my nephrologist next month and will ask. But I don't think he will know. Nobody studies unused brachiocephalic fistulas! I see inspirational stories with CKD folks losing massive amounts of weight going to the gym. How is that possible with a 6 lbs weight restriction?

Any suggested sources of info about this?

[Bassetmommer NKF Ambassador]

It is true..... do not lift weights, I heard over 5 pounds with the AV fistula.... Think about it. You have a major artery and vein SEWN together. Rip them apart and how fast do you think you will bleed out? and you may not even know you split them open. Don't screw with it just to lose weight.... You do not want to have to use a chest catheter if you had a kidney emergency.

Is weight lifting better than cardio?

A cardio workout burns more calories than a weight-training workout. However, your metabolism may stay elevated for longer after weights than cardio, and weight lifting is better for building muscle. healthline.com/nutrition/ca...

[barbara55109 in reply to Bassetmommer]

If I don't get back under 200 they will kick me off the transplant list. I ride recumbent bike and stepper for at least an hour a day, but it isn't really cardio. I can't go fast. Its more like mall walking at my place. The black dog is really back since I started gaining weight. I've tried so hard for the last 4 years. I've been busy dying for over 45 years. I'm sick of being sick. My metabolism is so very, very slow. That's why I need to do weights to try and increase it.

[Bassetmommer NKF Ambassador in reply to barbara55109]

I so understand what you are saying. Believe me. I too have been fighting the fight to lose weight my whole life. And for active as I am, it is an awful struggle. I get it. I spoke with my cardiologist last year about it and he was the first doctor who said, certain people have a set point and a slow metabolism, and they will never lose weight without surgery. Well, I was denied the surgery so,....there ya have it. My transplant people are letting me accrue time even though I am overweight for their normal surgery. They have something call the Davinci machine that they use for larger people. The issue is they only have one surgeon trained. I think it is rubbish, but that is what they said. So, I am on a list for 6-7 years. I will be over 72 then, and I think their cutoff is 72. Its all crap to me.

There are other places that have more relaxed weight restrictions. The issue is being multiple listing is prohibited if they are in my state. I would have to cancel the local list and start over. It's such garbage.

My only suggestion for you is you need to change your diet. Eating once a day is not good. It stops your metabolism. Any time you diet for a prolonged period, and I am talking years, you mess with your metabolism. Mine is so slow, I look at food and gain.

Have you seen a renal dietician or had someone review your food? When I did lose 50 pounds, it was on a renal diet. I did and still do intermittent fasting, but I eat twice a day and have a snack midday. If I go to my aerobics, I have two rice rollers and coffee in the am, like at 9:30am. After class, or most days, Lunch/brunch is oatmeal and fruit. Snack is fruit and sometimes some crackers with hibiscus tea to fill me up. Dinner is often salad or pasta and veggies. We eat at 4pm so we are done with food by 5:30. I have done this for over five years now so although I was maintaining my weight loss, I stopped losing. (I also relaxed some of my restrictions) And yes, I am diabetic, although my A1c has been 5.6 for over two years. I am on the lowest dose of Ozempic. I had two flares of pancreatitis and that was at only .5 mg dose, so I am on the low dose only for my diabetes.

I know the guilt that comes with dieting that somehow, this is your fault. Well, it isn't. And science and the medical community is finally waking up to see this. But it is a long way off. Discrimination for people of size is the last bastion of blatant discrimination, sanctioned and approved by society.

[barbara55109]

I've got a great update! My vascular surgeon got back to me. He said I am free to exercise with my arm! Since my fistula is unused it isn't at risk like one that is used 3x a week. It isn't as if I'm lifting, I'm just using two armed exercise machines set between 12-40 pounds, depending on the machine. I'm so glad I can reset my machines at the Y to match my strength test instead of just 6 pounds. All the machines use both arms, so the weight is distributed too.