How To Train With A Debilitating Disease - PART 1
The Story Of An Active Busy Professional
HOW IT ALL BEGAN
For most people, itโs not difficult to allow the fitness and nutrition to fall lower and lower on the list of things that need to get time and attention each day. Your family, career, friends, social activities and entertainment, all somehow end up ahead of taking the time and making the effort to engage everyday in the steps that will make you healthier and bring you closer to the fitness or even physique goals youโve long since decided were impossible to achieve.
And then, the New Year comes around, and suddenly things seem just a bit more possible. The momentum swells, the confidence rises - or maybe the opposite, the momentum rises because the confidence has hit a new low. But despite the reason, here you are wanting badly to make a change and you swear off all procrastination and excuses. For the moment.
For most people, this is the annual swing of things. Fitness highs in January, lows February through May, then its almost summer so the surge is back to try to do what you can to get in shape for the beach, then back indoors come October.
LIVING WITH A CHRONIC DISEASE
If youโve ever been affected by a chronic disease which significantly affects your ability to do physical exercise, drastically limits what you can eat - including some of the most nutritious foods, and even leaves you stuck in bed on some days, then you know how hard it can be. You know how much you might wish to be in the shoes of someone who could merely make an excuse for not getting into the gym. But for you, the challenge is real.
For my client Brodi, every day brings a new face to his devastating gout. For most people, the challenges to making the time work out is truly a form of procrastination. For others however, there are real, debilitating conditions that make fitness a lifelong struggle - one of these, is gout. This is a look at Brody's struggle with fitness, gout and a busy career.
A gout attack is almost always extremely painful. Any joint can be affected, with the large toe, knee, ankle, hands and fingers being common locations.
THE SYMPTOMS
Without providing exhaustive details, the symptoms associated with gout and a gout flare or attack are due to increased levels of uric acid (UA) in the blood. High UA levels increases the possibility of UA precipitation into solid needle-like crystal particles, which may then begin to accumulate in small joint spaces, causing swelling, severe pain, limitations in range of motion, and over time, the formation of nodules known as โtophiโ or โgouty tophiโ.
In people with particularly severe presentations of gout, UA deposition result in many tophi in and surrounding affected joints, and are said to have โtophaceous goutโ.
My client Brodi, who has been diagnosed with tophaceous gout has frequent flares or attacks, and these present significant challenges to his overall lifestyle as a busy professional, helicopter pilot, spinning instructor and entrepreneur, and can be crippling to his physical activity and fitness goals.
TRAINING WITH GOUT
Given the severe physical manifestations of gout, as you can imagine, resistance weight training with gout is is predictably and unpredictably challenging. Gout and tophi limit his range of motion at some joints, notably his shoulders, elbows and wrists. His grip strength is affected by gout in both wrists and hands and some fingers, and so we focus on selecting the best exercises for him, so as to remain effective his available active range of motion.
Quite separate from these training challenges, various aspects of his nutrition are impacted by gout. It is well known that some foods predispose to gout attacks, and importantly, many food triggers are important protein sources (many beef and pork product for example). As perhaps THE critical macronutrient supporting progress on a resistance training program, we have to find creative ways of ensuring that Brodi is able to get adequate amounts of protein. In fact, meats of almost any sort and shellfish are strong triggers for Brodiโs gout and must be avoided. His protein sources are limited to small quantities of chicken, fish and plant-based proteins.
THE RISK OF Pharmacologic Treatments
As if nutritional challenges and physical training challenges werenโt enough, a number of pharmacologic treatments for gout can themselves trigger attacks, and even cause weight gain - real disadvantage when training to achieve body recomposition, as in Brodiโs case.
In part 2 of this post, I will go into the details of a recent training session with Brodi, the warmup and activation routine we go through, the exercises we chose, and why and the various small adaptations that we use, which make a difference in his ability to perform exercises.
Stay tuned!
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We all have a sense that highly-processed foods arenโt exactly healthy for us. BUT, did you know there is a classification of foods (really products) that are called Ultraprocessed Foods orUPFs?
Chances are you arenโt aware of what this specifically means and the types of additives that are included during processing.
In Part 1 of this 2 Part Blog, weโll review what ultraprocessed foods are, the top 3 reasons why you eat ultraprocessed foods in the first place, the 4 keys to grocery shopping to minimized process food consumption and how ultraprocessed foods have become a part of our culture - from the Hawaiian perspective.
Enjoy!