Renal dialysis can be draining, both physically and emotionally, but Duncan dialysis patient Lois Cossar refuses to let four hours a day of treatment, three days a week, dampen her zest for life. In fact, during her dialysis sessions and in spite of arthritis in her joints, Cossar is determined to pedal as quickly as she can on a recumbent stationary bicycle.
“I’ve noticed that my legs are stronger since I started pedalling,” she says. “I try to pedal at a rate of around 25 kilometres per hour and do short sprints where I’m pedalling 30 kilometres per hour. I can keep a sprint up for about a minute.”
Cossar is one of 15 participants in Island Health’s Intradialytic Exercise Program, an innovative pilot project spearheaded by Central Island Renal Services Vascular access coordinator, Calais Gionet, in collaboration with Nanaimo nephrologist, Dr. Michael Garfinkle and dietitian, Eileen Carolan. The program, inspired by similar projects in other parts of the country, encourages patients at the Duncan Community Dialysis Facility and Nanaimo Regional General Hospital renal unit to pedal their way toward wellness.
“This really was a no-brainer from a program perspective on how can we improve outcomes for our patients,” says Anna Hill, Island Health director of Renal, Trauma and Oncology Care Strategy. “At the end of the day, it’s really about maximizing the wellness of our patients by boosting their energy and physical fitness levels, empowering them, and focusing on what they can do rather than what they cannot.”
As one of Cossar’s renal dialysis nurses, Lynda Findlay witnesses the benefits of the exercise program for her patients first hand.
“Dialysis is exhausting and the exercise program gives our patients something to look forward to while they are getting their treatments,” says Findlay. “It’s also great that they have been setting distance goals, starting with a virtual bike ride from Victoria to Cape Scott. That goal was met and then exceeded pretty quickly. Now they are excited and motivated to set new goals.”
The 16 bicycles used by patients are funded through the BC Renal Agency — eventually, hand pedals will also be provided for amputees who don’t have use of their feet. While some patients are too fragile to participate, most others are capable of pedalling short and long distances. Cossar started her journey at five minutes of pedalling — she can now pedal for more than an hour at a time.
“Something I have noticed is that I have to be very careful with my morning insulin dose. When I pedal, it knocks my blood sugar readings down a couple of points, which means I take less insulin with breakfast,” says Cossar.
It’s no surprise to Island Health staff that the exercise program is having positive effects on dialysis patients and their health.
“Pedalling helps with cleaning and moving the blood of our patients on dialysis — it also increases their strength and stability, decreases blood pressures and stabilizes blood sugars,” says Hill. “It’s been fantastic to see this program become more vibrant based on the enthusiasm of our patients and staff.”
For her part, Lois Cossar intends to keep pedalling during her dialysis treatments, setting new distance goals as she shatters previous ones.
“After we achieved Victoria to Cape Scott, our group pedalled to Kamloops,” she says. “If we can do that, we can keep going. Cape Spear (the easternmost point in Canada) is only about 8,000 kilometres, so why not? It could take us to Christmas but it’s a neat goal.”
While the community dialysis facility in Duncan is considered the flagship location for the pedalling initiative, eventually Island Health intends to implement the program in all seven community and hospital based dialysis facilities across Vancouver Island based on input from current program participants and staff.