By Jane J. Lee mercurynews.com
You'd think five kidney transplants would give someone a good excuse for skipping the gym.
But for Tiffany Van Alst, "There are no excuses."
Each week, the 44-year-old Los Gatos woman runs laps, does push-ups and lifts weights with fellow organ transplant recipients.
The three-hour boot camp aims to improve the quality of life for kidney, lung and liver patients through exercise. Transplant physicians haven't always encouraged their patients to exercise, but that has changed in recent years.
Now the boot campers attack their cardio workouts with such vigor it's hard to believe that many of them couldn't breathe without a ventilator before their surgeries.
"We have to work twice as hard for half the benefit," said Anabel Stenzel, of Redwood City. She and her twin sister, Isabel, are boot camp members who received lung transplants.
As they do push-ups, clenched teeth and grunts interrupt the flow of conversation among the group, which also includes family and friends of the transplant recipients.
Van Alst had her first transplant at age 17, and the six-time medalist at the National Kidney Foundation U.S. Transplant Games helped start the organ transplant boot camp at Stanford's Cobb Track and Angell Field with some of her teammates.
It was either get a transplant or get your affairs in order, said Brett Barker, a 29-year-old lung transplant patient and one of the newer members of the group.
Although exercise is the focus, the patients also act as a support group for one another. They chat excitedly about gaining weight and compare lung function scores, which indicate how healthy their lungs are. Some drive in from Sacramento to participate.
The Stenzel twins, Tom Martin and Lara Borowski were all lung transplant recipients who trained together with Van Alst for the competitions. Borowski died in May while waiting for a second set of lungs after her body rejected her first set.
They wanted to keep exercising in Borowski's memory, so they formed the boot camp and opened it up to anyone who wanted to participate.
Anabel Stenzel is one of the few survivors of two double-lung transplants. About 25 percent of them survive, Van Alst said.
Van Alst attributes her survival and health to exercise. Working out builds up their muscles and helps the lung patients clear their new organs of bacteria. It also builds up a fitness capital that the patients can fall back on if they get sick again.
"We're becoming increasingly aware of how beneficial exercise is for these patients," said Dr. David Weill, director of the lung and heart-lung transplant program at Stanford University. "I think transplant physicians in the past had simple survival in mind. But now they're taking into account quality of life, and exercise helps with that."
The benefits of exercise for regular people apply to transplant patients as well. An added bonus for organ recipients is that it can help to counteract some of the side effects of the immunosuppressant drugs they take, such as loss of muscle mass, said Patricia Painter a researcher at the University of Utah who ran a transplant exercise rehabilitation program for kidney and dialysis patients at UC San Francisco for five years.
But not all transplant patients are so fired up about working out. "They're scared of damaging (the organ)," Painter said. She explained that the patients consider it a gift and they don't want to screw it up.
The boot camp attendees admit they worry about getting hurt, because a broken leg or infection would quickly undo all their hard work.
Before her surgeries, exercise for Anabel Stenzel consisted of just getting out of bed because she was so weak. The thought of being laid up again with an infection is anathema to this group of people determined to stay healthy.
"They're either very sedentary or they're absolutely wound up and they exercise a lot," said Weill, describing the willingness among his lung transplant patients to exercise.
Barker wanted to get back in shape after his lung transplant surgery April 1, but he wasn't sure what to do. His doctors gave him advice about exercise, "but I've gotten a lot of useful information here," he said about the boot camp.
"I used to hate to exercise," said Anna Modlin, a lung transplant recipient. But now her sister, who is not a transplant patient, is teaching her how to run properly, starting with laps around the track in bare feet.
Van Alst credits the organ donors who saved her life, and exercise that kept her healthy, for giving her the chance to start a family -- she wouldn't have been able to give birth to her son, now 5, without them. "When you donate an organ, you're helping someone to live, not just survive," she said.
To become a donor
The boot camp attendees are grateful for their new organs, and would like to see more people choose to become donors.
Though California drivers can attach those little pink stickers to their license indicating they're a donor, people can also sign up at http://donatelifecalifornia.org.
To join the organ transplant boot camp, email firstname.lastname@example.org.
- Step 1: The group begins with stretching.
- Step 2: Next comes a walk -- or jog for those who can -- around a track for several laps.
- Step 3: A series of arm exercises follows, which may include weights or push-ups.
- Step 4: The group then climbs the stairs on the bleachers about 10 times.
- Step 5: Finally, a 5-pound Pilates ball is thrown around for more upper-arm exercise.
THE 'BOOT CAMP' WORKOUT
Because health challenges differ, the transplant boot camp doesn't have a set workout. But here's a typical routine: