Nobody expects a person beginning an exercise regimen to run a marathon or to enter a bodybuilding contest. Setting impossibly high standards only guarantees failure. But if a person starts with easy goals and works her way up, she is much more likely to make exercise part of her daily routine.
A good beginning regimen might include ten to twenty minutes of aerobic exercise, followed by a few weight-bearing exercises, three times a week. Everyone should work at her own pace until she is working out daily or at least three to five times per week. But even if a person can exercise only for a few minutes at a time, there is no need to despair. Doing a little exercise is better than doing none at all. It will get easier as time goes on.
When a person is in an acute phase of hepatitis or is experiencing a severe exacerbation or relapse of disease, any form of intense exertion should be avoided. There's no need for enforced bed rest, however. A person should listen to her body. If she is exhausted, then it's time to rest. If she's up to physical activity, then by all means she should be active. But, she must be aware of her personal limitations and know when it's time to call it quits. The liver has only so much energy to distribute to the rest of the body, so it's never wise to overdo it. Again, it is essential to consult with your doctor prior to commencing any exercise program.
Weight-bearing exercises build up both bones and muscles. For many reasons, it is important for all people with liver disease to incorporate weight-bearing exercises into their daily exercise routines. First, people with liver disease need good strong bones because they are prone to osteoporosis. Weight training is the best way to fight against this, as stronger muscles equal stronger bones. Second, in advanced stages of liver disease, the body is forced to recruit muscle as a source of energy, and people are at risk of developing severe muscle wasting and greatly diminished strength. However, if a person has a reserve of muscle built up on her body, it will take a much longer time for this complication of liver disease to develop. Third, people who have too much fat on their bodies are at risk of worsening their underlying liver condition by developing nonalcoholic fatty liver disease (NAFLD). Weight training reduces the amount of fat on the body and increases muscle mass. Therefore, the chance of developing NAFLD will be reduced. Finally, since muscle weighs more than fat, weight training is the perfect means of gaining lean healthy weight for those people who are underweight. One exception to weight training should be mentioned. People with cirrhosis complicated by esophageal varices should avoid weight training. This is because wall tension in the esophagus may drastically increase with weight training which puts this group at increased risk for esophageal variceal rupture and hemorrhage. Once again, there are lots of self-help books and videotapes that describe how to create a personalized weight-bearing exercise routine. It's a good idea to hire a personal fitness trainer, who can design a personalized routine specific to an individual's needs. It is important that the trainer be aware of the client's liver disorder, and that consequently, the client will not always be able to exercise to her fullest capacity. A person with liver disease should never push herself excessively, nor should she allow herself to be pushed by a trainer. If she feels too tired or if a body part feels strained, she should stop exercising until she feels better. Fitness training has become a field that requires certification, so make sure that the trainer is certified. It is important to remember to work out every part of the body evenly. Did you know that there are eleven distinct body parts to work out! In that way, the chances of injury are decreased. A few stretching exercises should always be performed first to warm up the muscles before doing weight-bearing exercises. The amount of weight being lifted should allow for eight to twelve repetitions. Each repetition (rep) is defined as one full and individual execution of a particular lifting exercise. A set is a distinct grouping of repetitions, followed by a brief rest interval. Three sets of a given type of exercise should be performed. Aim to work out each body part at least once a week. Twice a week is ideal.View Thread
Aerobic exercise trains the heart, lungs, and entire cardiovascular system to process and deliver oxygen more quickly and efficiently to every part of the body. It's the kind of exercise that gets the heart pumping. As one becomes more aerobically fit, the heart won't have to work as hard to pump blood to the rest of the body, including the liver. The pulse will begin to slow down, making it easier for the liver to send back to the rest of the body the blood it has just filtered. The benefits of being an aerobically fit person include an overall improved energy level, which translates into decreased fatigue. Fortunately, a person does not have to purchase high-fashion workout clothes or go to a fancy gym to get aerobic exercise. Walking briskly, bicycling (either stationary or regular), swimming, or using a treadmill all provide solid aerobic benefits. Many people start off with something easy, such as walking around the block. A helpful hint is to start by walking up and down the street close to home. In that way, if a bout of fatigue suddenly occurs, it won't take long to get home.View Thread
People with liver disease should take up both aerobic and weight-bearing exercises, as they each play a different role in fighting liver disease. It is fortunate that there are an abundance of books, videotapes, and television programs that teach, step by step, both types of exercises. It is important to use these self-help materials prior to starting any exercise regimen. Other helpful ideas include scheduling a few appointments with a personal trainer to design a fitness routine that personally meets the needs of a person with liver disease. Many fitness trainers will even work in their clients' or the trainer's homes. And recently, one-on-one fitness training facilities have become widespread. They offer both privacy and personalized attention. This is important, as many people are too self-conscious or too shy to exercise in a crowded gym, and/or lose self-motivation after the first few sessions at a gym. A welcome development has been the appearance very recently, of gyms geared specifically to individuals who are not in good shape. In these facilities, embarrassment is mitigated and the convergence of similarly situated clientele creates an environment akin to a combination support group/health club. Finally, the likelihood of success is increased if a person adopts an exercise program that she already enjoys and that can easily be adhered to with consistency at least three times a week. Timing is also important. It is fine to exercise at any time of the day that is personally convenient. However, by the end of the day, most people are usually too mentally and physically tired to do anything, least of all, run on a treadmill! That is why most people with liver disease find that they need to do their exercises first thing in the morning. While some people may find it difficult to get up in the morning in the first place, once they get started with an exercise regimen, it will become easier and easier. And people usually find that exercising in the morning helps give them an extra boost of energy to make it through the day. Finally, don't overdo it. It's more important to maintain a regular routine than to set any records. Aerobic Exercises Aerobic exercise trains the heart, lungs, and entire cardiovascular system to process and deliver oxygen more quickly and efficiently to every part of the body. It's the kind of exercise that gets the heart pumping. As one becomes more aerobically fit, the heart won't have to work as hard to pump blood to the rest of the body, including the liver. The pulse will begin to slow down, making it easier for the liver to send back to the rest of the body the blood it has just filtered. The benefits of being an aerobically fit person include an overall improved energy level, which translates into decreased fatigue. Fortunately, a person does not have to purchase high-fashion workout clothes or go to a fancy gym to get aerobic exercise. Walking briskly, bicycling (either stationary or regular), swimming, or using a treadmill all provide solid aerobic benefits. Many people start off with something easy, such as walking around the block. A helpful hint is to start by walking up and down the street close to home. In that way, if a bout of fatigue suddenly occurs, it won't take long to get home.View Thread
Exercise is essential in order to decrease the incidence of potentially detrimental bone disorders. Osteoporosis is a bone disorder frequently associated with liver disease. It results in decreased bone density, thereby leading to fragile, easily fractured bones. While osteoporosis is a disease that most frequently affects postmenopausal women, it can also affect premenopausal women and men with liver disease. Postmenopausal women are particularly susceptible to osteoporosis because, as estrogen production stops, bone loss accelerates. Furthermore, women naturally have a lower percentage of muscle and bone mass than men. This further increases their risk of developing osteoporosis. Other risks for osteoporosis in people with liver disease include excessive alcohol use, primary biliary cirrhosis, advanced cirrhosis from any liver disease typically resulting in muscle wasting, and the use of prednisone. Fortunately, people can reduce the likelihood of developing osteoporosis by making exercise and a healthy diet part of their lifestyle. Just as muscles grow in response to muscle contractions, bone strength and density increase when the muscles attached are contracting. Studies have shown that muscle and bone growth promoted by frequent weight-bearing exercise is vital to the prevention of osteoporosis. Supplementing the diet with at least 1,000 to 1,500 milligrams per day of calcium in combination with vitamin D is also important. If a person already has osteoporosis, it needn't keep her from exercising, but she will have to use more caution so as to keep from breaking any bones. High impact aerobic exercises, which involve jumping and twisting, can increase the risk of injury and should be avoided. Low impact exercises, such as swimming and walking, are the safest choices for aerobic exercise. Weight-bearing exercises with light weights can generally be safely performed. Close attention should always be paid to proper form. Running on a hard surface, such as concrete pavement, should be avoided. Soft surfaces, such as specially designed running tracks, a treadmill or a sandy beach, are preferable.View Thread
The benefits of exercising are numerous. First, exercise gives people a general sense of well-being and an improved self-image. It is a known fact that if a person feels well mentally, her immune system will be stronger and give her that extra edge needed in the fight against disease. Second, as previously discussed, exercising gives a person a boost of energy. Fatigue is probably the most common as well as one of the most bothersome symptoms that plagues people with liver disease. Many people with liver disease frequently feel like they don't have enough energy to make it across the room, let alone around the block. However, the best way to fight this seemingly relentless exhaustion is to exercise. Yes, the notion of exercising when you are fatigued may seem counterintuitive- like a vicious cycle, but most people find that it actually works. In part, fatigue may have to do with the fact that both the heart and the liver are working overtime to keep a good supply of filtered blood circulating throughout the body. Adding a regular exercise routine enables both organs to work more efficiently. Over time, this will boost energy levels. While most people find it tough going at first, they eventually realize that the benefits make it well worth it. Third, exercise improves cardiovascular function. As the body gets stronger and more aerobically fit, the cardiovascular system will be able to work more efficiently. Less effort will be required of the heart to pump blood to the liver and other body organs. Less effort on the heart equals stronger cardiovascular function and an increased overall energy level for a person with liver disease. It is extremely important to attempt to do some exercise while on interferon treatment, as this will decrease the fatigue, irritability, and depression often associated with this medication. Fourth, exercise results in a reduction of total body fat. While nearly everyone knows that being overweight places a great deal of stress on the heart, most people don't realize that it also makes it harder for the liver to do its job. When total body fat is reduced, fat content in the liver is simultaneously reduced. This often results in a significant reduction of elevated liver enzymes, no matter what the underlying liver disorder is. Eating right and getting plenty of exercise is undoubtedly the slowest way to lose weight known to humanity, but it's also the safest and surest. This is especially true for people with liver disease. Even intermittent exercise has been shown to be beneficial in obese women. Combining a healthy diet with regular exercise is also the best way to keep from regaining the weight.View Thread
Regular exercise is an important component in the fight against liver disease. This isn't something that can be found in any medical textbook or that is taught in medical school classrooms. This may explain why most liver doctors don't realize how important exercise can be to maintaining their patients' health. But I've seen the benefits over and over again in my practice. People who are in good shape and who exercise on a regular basis not only feel better, but often respond more positively to medical treatment. People do not have to do a lot of exercise in order to reap its benefits. Nor does it make sense to overdo it. The main thing is simply to get going. Regular exercise will increase energy levels, decrease stress on the liver, and, in many cases, even delay the onset of certain complications associated with liver disease. For people with liver disease, it is crucial to consult with a doctor before beginning any type of exercise program.View Thread
I'll be appearing on Sirius Radio, channel 114 (on XM, channel 119) on Monday April 14, from 9-9:30 A.M. discussing the new protease inhibitors telaprevir and boceprevir for hep C. Please tune in and ask questions live!View Thread
HBV is 100 times easier to transmit sexually than HIV ( the virus that causes AIDS). HBV has been found in vaginal secretions, saliva, and semen. Therefore, it doesn't matter if a person's sexual partner is of the same or the opposite gender. If one partner has hepatitis B, the other one can get it. Oral sex and especially anal sex regardless (whether it occurs in a heterosexual or homosexual context), are possible ways of transmitting the virus. It is not transmitted by holding hands, hugging or even dry kissing on the lips. The chance of transmission with deep kissing is unknown, as no infections have been definitively documented after exposure to infected saliva. Yet, since HBV has been found in saliva, the risk of transmission with deep kissing probably exists and the risk increases if one partner wears orthodontic braces or has open cuts or sores in the mouth. The likelihood of becoming infected with HBV grows with the number of sexual partners a person has. Thus, promiscuous individuals are more likely to get HBV. Also, men who have sex with men are 10-15 times more likely to catch HBV than the general population.View Thread