I have never been one to set, or when set, achieve fitness goals. When I was in the Navy, my fitness goals were to pass the required Physical Fitness Tests so I didn't have to do extra PT to get caught up. After the Navy I would get the occasional wild hair and start a Couch to 5k program. Note I said start. I gained weight and at my heaviest weighed 289 lbs. That was too large even for me, so I did a couple of the normal diet cycles. I lost and regained a ton of weight, but still, my focus was never on fitness.
Then I required a lung transplant to live, and was told I was to heavy to even be considered for the procedure. That'll sure change your outlook quickly.
That is when I found the Primal Blueprint and started the 21 Day Total Body Transformation, it just made sense. My fitness goals pre-transplant were to be strong enough that if I was fortunate enough to be listed, I would be strong enough to survive the procedure. The clinic prescribed pulmonary rehabilitation and I found one that had experience with IPF patients. I attended pulmonary rehab and purchased a recumbent bike. I also went for walks around the neighborhood. I ended up having to purchase a high flow regulator to do my walks, but I still did them.
As you know, I did lose the weight and was listed. On January 1st 2015, I received my new lungs. Nine days later I was released from the hospital and sent home. Working towards my pre-transplant fitness goals was a large success.
My first fitness goal following the transplant was to be able to take a shower, dry off, and get dressed without having to take long rest breaks in between each step. Post transplant rehab found me surprisingly weak. I have since found studies that show IPF and lung transplant both can lead to long term muscle weakness for various reasons. That is a topic for another post, but if you are feeling weaker than you thought you would, there is a good reason. I worked hard during rehab and tried to walk a little further each day outside of rehab. I graduated rehab with the second furthest Six Minute Walk Test that they had performed on a lung transplant patient. Hard work did pay off.
All exercises and fitness goals following a lung transplant have to be approved by the transplant team. It takes up to 18 months to fully heal following the procedure, and you can do yourself harm by doing the wrong, or too heavy, exercises.
The procedure to perform a bilateral lung transplant involves cutting the patient from armpit to armpit, and opening the chest up like a clam shell. It takes a long time for the sternum, the pectorals, the nerves and blood vessels to heal properly. Remember, the meds a transplant patient are on slow healing.
Here is an illustration of the incision:
There are very strict weight and exercise type limitations for a good long while after the procedure. Be patient, follow your teams instructions, and do something every day.
As I mentioned previously, I started with walking and using my recumbent bicycle. When cleared, I started using light exercise bands for arm and leg exercises. This did not include push or pull up type exercises or progressions towards those exercises. Push ups and pull ups are two body weight exercises that really involve the chest and need to be taken slowly. When I was approved to start working towards push ups, I started with doing them from the kitchen counter. When I was comfortable from the counter, I moved to a chair, then to the edge of the tub, then the fireplace mantle, then the floor. My goal at that time was a set of 10 push ups from the floor. It took awhile, but I got it, and then some. At each progression I ended up with a bruise along my incision. It cleared up in a couple of days. My team indicated that this was a normal part of the healing process and to just keep an eye on it and let them know if it became painful, got darker, or lasted longer than usual. The same thing happened when I started progressing towards my first pull up, another fitness goal. I still feel it in my chest when I do push up and pull up type exercises.
Every patient's fitness goals are going to be different depending on how they are recovering from the procedure and where they were at prior to the transplant. You have to work closely with your team to set achievable goals and progress towards those goals every day.
I started doing a Beginners Body Weight Program, my goals at the time were to just make it through the circuit as written. The first tine I tried it, 10 Jumping Jacks seriously kicked my rear. I progressed until I could complete the full three sets and progressed to harder variations of the movements.
Then I found kettlebells, and fell in love. I did the other exercises because I knew I needed to get into shape. I have received an awesome gift from my donor family, and I need to cherish that gift. One way to do that is to give these lungs a fit body to reside in. I really didn't enjoy doing the exercises very much though, and often had to talk myself into doing the workouts.
This all changed when I swung my first kettlebell. Pavel's Simple & Sinister has changed my outlook on exercising and getting fit. I was hooked on my first kettlebell swing. I very slowly worked through the progressions without using weight as the book recommended. I made very sure my form was correct before even purchasing a kettlebell. I was, and still am, very conscious of the effects of hurting myself in training. The best way to avoid injury is to use good form. My first kettlebell swing was just awesome, it felt great. My first set of kettlebell swings was a set of 5 two handed swings with a 20 lb kettlebell. It took what felt like forever to reach the point that is considered an "Average Strength Gentleman" by the StrongFirst community. An average strength gentleman should be able to do the Simple and Sinister workout doing one hand swings with a 24 kg kettlebell and Turkish Get Ups with a 16 kg 'bell. I am a little stronger than that now.
Her I am at the top of my 10.000th kettlebell swing.
That's a 24 kg cannonball being swung one handed by a bilateral lung transplant patient. Makes me feel kind of bad ass.
Now back to fitness goals. My current goal is to meet the Simple standard of S&S. That is to one hand swing a 32 kg kettlebell 100 times in 5 minutes, followed by one minute of rest, followed by 5 Turkish Get Ups from each side with the same 32 kg 'bell in 10 minutes.
Following the S&S program has never bothered my chest, as a matter of fact my core and back are stronger than ever and my chest and lungs are very well protected. I blew a 5 liter + FEV1 and FVC the other night and I attribute a large part of my lung capacity to the breathing techniques used in the Hardstyle swings.
Back to fitness goals. The Simple goal is a pretty major goal, reaching for it has gotten me to where I am now. I hope to meet this goal by my birthday in November. In November I'm going to start including training for a competition next Spring called the Tactical Strength Challenge. The TSC is a worldwide challenge that includes deadlifts, pull ups and kettlebell snatches. I will be able to maintain my strength and endurance gained in S&S while training for the TSC. After the TSC I will begin a kettlebell program called the Right of Passage which will add more KB movements and end with me one hand pressing a KB of half my body weight.
Long term epic goals? I want to do a pull up all the way to my transplant scar, and I would like to become a StrongFirst certified kettlebell coach.
Right now though, my goal is the Simple standard, and as Pavel says, "The goal is the goal".
If you would like to follow along with my kettlebell workouts, I keep an open log here.