My recent health/fitness hiccup
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Transplant meds suck, prednisone's downsides are well known (though I seem to be fine with it), tacrolimus (prograf) destroys your kidneys over time to the point where many end up on a dialysis/transplant path, and mycophenalate (cellcept) wreaks havoc on your intestines. This is a story of the latter.
Cellcept can cause direct injury to the intestinal lining, to the point where it mimics celiac disease when biopsied. This is because the same mechanism by which it inhibits lymphocyte synthesis (a type of white blood cell) can block intestinal epithelial cell development.
I've lived with this to some degree or another for 10 years, which is why I buy loperamide (Immodium AD) by the gross. But I've gone through several episodes where it goes crazy, leading to the loperamide being ineffective, then chronic diarrhea leads to malabsorption issues which leads to significant involuntary weight loss.
My weight the week of 9/29 to 10/4 averaged 178. On the 24th of February I weighed 149lbs. That was at the end of the day, in the morning I was probably at 146-47.
The entire month of February I was counting calories, and averaged over 3000 calories a day, and was still shedding weight. I just couldn't absorb the nutrients I was consuming.
It took just a couple days after pausing the cellcept for my BMs to stabilize. My weight then started a pretty decent upward trajectory. Here it is in pictures:
(That low point is north of 150 because these are weekly averages)
Anyway, when I showed that to my transplant team last week there was little doubt that the cellcept was the cause.
In the last 7 days my weight has averaged 165 (at night) and I have consumed, on average, 4000 calories daily.
I hope to get back to 175 by sometime in May.
Then I need to wean myself back onto Cellcept. Starting with a lower dose and moving up from there. Welcome to transplant. But as LuFin would say, it beats the alternative.
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I should add that, with the exception of the second half of December when I was traveling and sick (lovely combo), I never stopped my 7 day a week gym routine. Yet I lost lots of muscle mass and experienced a material reduction in the weights I could push-pull-bench whatever. It doesn't matter how much protein you ingest if your intestines won't put it in your damn blood stream.
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Yeah, I wondered about the travel. Makes it tough.
I generally try to keep up my exercise when traveling. For example with the boy on the west coast, I purposely chose hotels over Airbnbs so I could have gym access (I don't always do this but given the weight loss I wanted to this time). Of course their gyms sort of suck usually, but they're better than nothing.
Tomorrow I'm off to Thailand and my Bangkok hotel has a gym. We'll spend four days at a resort in Krabi that doesn't but they do have bikes and I'll go for long brisk walks in the morning.
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I will never understand the compulsion for travel, but I grant that women have it in general. Even while I was traveling in Florence, I did stay at a hotel with a "gym", but what a waste of space. One treadmill, dumbells that went to 50, maybe an elliptical. I purchased a day pass at a gym within walking distance instead. Walking distance from one part of Florence to another means that both points are within florence, but this gym was a 4 minute walk.
The girl at the front couldn't have been more dismissive, as she spotted me as a tourist. Of course everybody in Florence is a tourist. It was a decent gym. Hot as hell on the top level with the free weights.
I ended my workout on the treadmill on the first floor and sweated a fire hydrant as I do. Asked if they had water and she said no. I was aware of a store nearby and asked about it, just to see if I was dealing with someone who wanted to help. She said she didn't know. I went to get water from that store and she went outside to smoke. Eurotrash.
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In my experience in the US most hotel gyms (of the chain type) have dumbbells up to 50, a lonely bench or two, a tall pulley machine for doing the myriad things you can do with one of those, and a long line of treadmills. I usually see most people on the treadmills, maybe me and another middle aged guy using the weights. Unless I go in the afternoon, then it's just me.
Some of the higher end hotels that are huge AND near large city conference centers have really impressive gyms. They look like a regular gym without the barbells (must be a liability issue). Vegas hotels also have some impressive gyms.
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