Health Journey From A Novice

I thought I would share with you all what has been keeping me busy the last few months. To that, I apologize for not posting as often as I once had. Hopefully, this post will help clarify some of the reasons as to why.

March 19, 2021 was when I received the call that changed the direction of my life. I was waiting on test results and standing in line at a pharmacy picking up my high blood pressure medication when my primary care doctor called to talk to me. Not expecting anything rough, I told him I could talk. Thankfully I had to sit down to wait for my medication to be ready, otherwise, my knees may have given out. Being told that I had liver disease was not the call I was expecting.

Since that diagnosis, I have had multiple tests and procedures. I have found out that I have non-alcoholic cirrhosis and gotten my high blood pressure under control. Since December, I have lost just shy of fifty pounds. I can tell you it hasn’t been easy. It forced a lifestyle change that I talked about previously(link for article). Along the way I have learned a great many new things and have had to change my life a lot. Losing weight has been the biggest change that I constantly work on.

Medical Student looking through a microscope
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Medical History

I come from a family where liver disease is common. I mentioned in past articles that my mother, oldest brother, and my sister all have/had liver issues. We all are/were on the larger size and that constitutes part of the problem. Obesity is a leading factor in what is called NASH (Nonalcoholic Steatohepatitis) If left uncaught it moves to fibrosis and from there can lead to cirrhosis. This is where my diagnosis presumably comes from. Drinking alcohol to any degree, does not help this condition along, add to that the fact that I frequently over medicated for pain I constantly have dealt with my whole life and I probably sped up the issue more.

The rub here is that liver issues rarely cause large symptoms that people may recognize. Fatigue and mild pain in the upper right of your chest are the biggest. There is also leg swelling and drowsiness as symptoms. The problem is those Sam symptoms are also symptoms of a lot of other diseases and can cause many missed diagnoses.

Regardless of where I started, my journey had to change.

Lifestyle changes
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Lifestyle changes

My specialist advised me that the first thing I needed to do was lose weight. Sounds simple enough, but liver disease also can affect many other things, musculature is one of them. Liver issues can cause the body to waste protein. This causes the body to lose muscle mass, which is needed for exercise and weight loss. If your protein levels are monitored, it can lead to a reduced survival rate.  For me, personally, my doctors told me to keep my protein intact to 20g four to five times a day. I try to keep it at 100g or slightly more.

Protein is important if you are trying to build muscle, for any reason. It is the key ingredient in fueling protein synthesis. The flip of this is that you need a caloric surplus, mostly from protein, to build muscle. Doctors tell you that you need a caloric deficit when you are trying to lose weight. This is where I teeter totter all the time.

My daily routine for losing weight is cardio or aerobic exercise six to seven times a week. Three to four times a week I also work on strength training. Strength training combined with the protein intake allows me to work to keep the muscle mass I have and start to build on it. It’s a delicate balance of calories, protein, and conditioning.

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The rub of cardio on the body

Cardio does help burn calories and will in turn help you lose weight, due to creating a caloric deficit in your body. To burn more fat, you need more muscle. Muscle tissue is more metabolically active than fat. The more muscle you have the higher your resting energy expenditure is. This leads to more calorie burn while doing nothing.

But this is also where most people say it is associated with burning muscle. Having fewer calories means that you have less fuel for your muscles to grow. Cardio can be bad for muscle growth and fat loss.

Too much cardio can cause you not to gain muscle as fast or big as you would like. Instead, many trainers suggest that you should limit cardio to 1-2 times a week for about 20-30 mins, especially if it is higher intensity workouts. You can implement low impact workouts to go longer and achieve the same results.

High-Impact cardio requires both feet to be off the ground at the same time, these are things like running, jumping, and high knees. These things can have big impacts on losing weight but also negative side effects on your body. These high impact activities slow down our recovery time and can inhibit muscle growth.

Rest and recovery is an important part of muscle growth. Not having enough recovery time means you aren’t as ready for the next time you go out. It’s harder on your joints and body, which means you aren’t as ready to take on your next workout. High impact workouts are great for cardiovascular endurance, but you can achieve similar results by switching to low-impact results for longer periods of time,. Low-impact workouts would include stationary exercise bikes or outdoor cycling. And dont discount the benefits of walking,

All of the weight loss I have achieved so far has come from a combination of dietary changes, stationary bike, and walking.

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When to weight or strength train

Would you be surprised to know that when you strength train can have a direct affect on how you grow muscle mass? Honestly, I didn’t until recently.

My specialist made it a point to tell me that I needed to watch protein and my muscle mass, since my disease is known for wasting. She advised that I should also, immediately, start strength training. I decided to do it three days a week. After a biking, walking, or hiking session, I would lift weights and do other types of exercise to build muscle. I started noticing smaller gains than I remembered from my youth.

Age is a factor in muscle growth, to some degree, but a bigger part is when you do strength training in relation to other exercises. If you are wanting to gain muscle and fuel growth, you need to do your strength training before your cardio, according to Doing it before could be hindering your growth due to tiring yourself out before you even begin. If you are tired, you may not be able to lift as much as you could before cardio. What drives you to gain more muscle is what is called, progressive overload. In order to gain muscle you must challenge your body to work harder over time. If you are tired from your cardio, this becomes harder.

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Weighing importance

This is the question of the hour. What is more important, losing weight or gaining muscle. Roughly 57% of people answer that, to them, losing weight is more important than building muscles. The good news is that in general the body shouldn’t naturally lose muscle first, if you are doing weight loss correctly.

Some things to consider is general nutrition and activity volume, those are key in losing fat over muscle. If you are attempting to lose weight by not eating, the body goes into a type of system shock where it will start losing muscle first. You may wonder how that happens, the answer is science. When the body is exercising, it needs energy. It’s first option is to burn carbs or glucose. If there isn’t enough of those, the body will resort to burning glycogen. Glycogen is glucose that has been stored in the liver and muscles. Thereby, burning muscles instead of carbs.

Duration of physical activity is dependent on burning fat and you can train your body to burn fat as its primary source of energy. Considering a healthy diet should consist of 45-65% carbs, 15-35% protein, and 20-35% fat. Restricting types of food to lower levels, in a diet, leads to an imbalanced diet.

For me, weight was the factor to lose first. However, I also need to keep my muscles in the forefront of my mind. This is to counteract muscle wasting due to cirrhosis.

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Five ways to burn more calories

1. Train Hard – Hard exercise and intense effort is an effective way to increase energy expenditure. The harder you push your larger muscles, the more energy that is consumed each minute. Challenging exercise routines increase your energy consumption before and after your workouts. This is because your body has to work to restore itself and prepare for the next challenge it has to go through. This is called the afterburn effect.

2.Train Slow and Long – The good news is that your exercise routines dont have to be super strenuous, you can also do low-intensity workout and be just effective at burning calories. Here is a surprising fact, there isn’t a huge difference in energy expenditure in whether you do a 5k run or walk briskly for the same difference. Lower intensity workouts burn a higher percentage of fat than carbs. The big difference is that your afterburn effect is lower. Remember to select the activities you enjoy. This allows you to keep burning week in and week out, while maximizing your consistent benefit. 

3.Be active – Guess what, your muscles don’t know you if you have running shoes or gym pants on. All physical activities increase the calories you burn. Remember that “little strokes fell great oaks.” Small things like taking the stairs instead of the elevator, playing with kids instead of watching TV, or walking to a local store instead of driving all add up. Find something fun and get to it. 

4.Build Muscles – Remember protein synthesis? That is how muscles grow and is one of the most energy consuming processes in cells. Building muscles consumes energy and burns calories from the workout and the growth of muscle tissue. Muscle tissue is metabolically more active and burns more calories than fat tissue. And the more muscle you have, the more resting energy expenditure you have. To put it simply, your body will burn more calories, while doing nothing. Short answer is the more strength training you do with your workouts, the more calories you will burn. Don’t cut back on calories too much or your muscles won’t increase their mass

5.Relieve stress and get some sleep – You can’t push yourself to make sweeping lifestyle changes if you are stressed or sleep deprived. The grand trinity is at play here; stress management, good sleep habits, and good nutrition all go hand in hand. Small stress can cause a loss of appetite and body weight, larger stress episodes can cause you to eat too much and also pack on weight. Denying yourself sleep leaves you tired the next day and your body will react by wanting more energy to get through the day. Exercise is a great stress reducer, which leads to better management of your sleep cycles, and will also help in losing weight.

Long Hard Road

The truth is that getting healthy isn’t easy. All to often we are distracted by diets and fads that simply don’t give the results they promise or we want. We have to change the way we look at out lives and how we relate to it. It is about creating a more healthy lifestyle through smarter choices and correct methods. Its not easy and its not quick. I seriously started my journey in April of this year. In December I weighed 293 and by April I was down about 15lbs. That was 15lbs in four months but the only change I made was to my diet.

In April, I started adding in cardio and strength training and changed my eating habits to be vegetarian/pescatarian. No sugar drinks, no alcohol, watching carbs and calories and exercising five to six days a week. As of today, I am at 238 pounds. That is forty pounds down since April. A lot of sweat, hard work, and changing my old lifestyle. Its a commitment but I am in better shape and getting better every day.

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