Off To The Gym

Today is my first appointment with the physio-therapist at the ALS Clinic. For me, and most most ALS patients, physical exercise is a double edged sword. You want to stay in shape, but exercising the atrophied muscles doesn't help them. Not only that, exertion is not recoverable and simply leads to exhaustion.

ALS destroys motor neurons in the nervous system. Your brain, or mine in this case, needs those motor neurons to send messages to the voluntary muscles in my body; those are the muscles you can move or stop at will. Leg and foot muscles are controlled by motor neurons in the lower spinal cord. Arm, hand and finger muscles are controlled by motor neurons in the upper spinal cord. Speaking, swallowing and chewing are controlled by motor neurons in the brain stem. Respiratory muscles are controlled by motor neurons in the upper and mid-section of the spinal cord.

Exercise will not strengthen muscles that have been weakened by ALS. Once the supply of motor neurons that control a particular muscle has degenerated, it cannot be regenerated by exercise or anything else; at least not until someone comes up with a treatment that restores motor neurons. According to the ALS Manual (yes, there is a manual for this disease) the purpose of exercise for people with ALS is:

• To maintain or improve the flexibility of muscles not affected by ALS
• To maintain the flexibility of muscles that have been affected
• To maintain the flexibility of joints in the neck, trunk and limbs

In my case, it will probably help in minimizing the "success belly" that I am collecting around my waist. I am about 20 pounds heavier than I would like and according to those nasty charts I could stand to lose about 25 more pounds after that.

Unfortunately the weight loss will come whether I want it to or not. One of the things that happens with ALS is that you ultimately lose your ability to eat. Diet and nutrition become a real problem. People with ALS end up skinny no matter what, unless they die from something else beforehand.

So off to the gym I go, to explore the whole new world of exercising just enough to keep fit but not so much that I wear myself out.