In American cities, the life style is the opposite of what our bodies need. We can live day to day with hardly any exercise. The most common activity of most people in the city is watching TV, often while eating junk food. This has lead to over half of all Americans being overweight!

Many city folks stop exercising when they leave high school. In most grade schools in Chicago, children only have gym class once a week. Exercise is not an easy thing to do in the city.

So, how does an HIV positive person who has developed a long habit of being a couch potato, start to exercise? Most lower income people cannot afford to join health clubs or hire personal trainers like the celebrities do. One inspiring example of a person who started exercising is Mr. M.P., a patient at the Core Center. In 1997, he was 40 years old and had AIDS Wasting Syndrome, PCP pneumonia, thrush and was very weak. Today, in the year 2000, he is about to start on his 2nd time on the AIDS Ride, which is a fund raising bicycle trip from Minneapolis, Minnesota to Chicago, Illinois. The trip is 500 miles through the steep hills of Wisconsin, and takes 6 days to complete. Mr. M.P. accomplished this bike ride the first time in 1999. To learn about his amazing change from being very ill with AIDS to a long distance bike athlete, he shared his story.

How did you get involve in the 500 mile AIDS ride?
As a young person, I was very involved in sports. I was a sports fanatic. After high school, I became involved in drugs and I left sports and exercise behind. I got married at 21 and had children. Occasionally, I played basketball. The main problem was my continued use of drugs, not my family life. Drugs didn't leave time for anything.

Then, in the summer of 1996, my weight went down from 160 pounds to 130 pounds. I had white spots in my mouth which I was thrush. I went to an emergency room and was told by the doctor that I should get tested for HIV. But I didn't.

In February, 1997, I was sicker and had to be hospitalized. I had PCP pneumonia, thrush, severe AIDS Wasting Syndrome, diarrhea for months, TB exposure and around 125 pounds. I got tested and found out I was HIV positive.

After I got out of the hospital, I got involved in the Chemical Dependency Program here at the HIV Clinic at Cook County Hospital. I learned about HIV. I decided that my best hope for survival was to stop using drugs.

What did you learn in the drug treatment program?
I learned that HIV makes you lose muscle. You just don't get skinny, your muscles get smaller. Right after being in the hospital, in February, 1997, I had been clean, not using drugs. I was sitting at home and I felt my arm and leg muscles. They felt like mush, just meat hanging on bones, not muscles! I was astonished. I had begun to gain weight but the weight gain was not in muscle, it was fat.

What did you do then?
What I did, without anyone telling me, I started doing push ups. The first night, I couldn't do even one. I was shocked. In high school, I could do push ups forever.

So I kept trying to do push ups, and sit ups. I decided when I had to go out, if I could walk, I would. I took stairs instead of elevators. At first, stairs were a huge problem. I couldn't even walk up 2 flights of stairs. It felt impossible, and I was very short of breath. But I kept doing it anyway.

Were you still very sick with HIV?
Yes. I felt tired all the time. In February, 1997, I was started on 2 HIV medicines. But my HIV viral load was sky high. In July, 1997, I was put on 3 anti-HIV medicines, including indinivir or Crixivan. Within a month, 30 days, I began to feel a big improvement in my strength. I could walk up stairs and do more push ups. Within just 30 days, my HIV viral load was under 500.

So, between July and December, 1997, I basically did push ups, exercise at home, and I tried jogging. In the spring of 1998, a friend encouraged me to be in a 5K race, so I tried it. I was surprised to be in the top 20 in my age group.

How did you decide to do the AIDS Ride?
I was visiting a friend who lives at Chicago House, which is a residence for people with HIV. I saw a poster on the wall about the AIDS Ride. To me, it sounded like the ultimate physical challenge. It was not a race, but a 500 mile bike trip would force me to do a lot of exercise and training. It meant I had to make a long term commitment to getting fit. I had not been on a bike since I was a kid. I felt very unsure, but got a registration form anyway.

How did you know what to do to get ready for the 500 mile ride?
A few of the people I work with had done a 100 mile bike ride and they gave me tips. They told me about bike safety.

First, I had to get a bike, in April, 1999. When I rode home from the bike shop, which was downtown, that first mile, I wondered if I had made a mistake. I felt very doubtful on that 10 mile bike ride home.

I decided to work past the doubt, and not let doubt stop me. I decided to keep pedaling. I still have that doubt when I ride during the first 10-15 miles. But I keep pedaling. In May, 1999, I started riding 8 miles to work and back. After work, I rode my bike to the lake, and rode 10 miles north, and back home. That was 40 miles a day. At the end of May, I increased my riding to 60 miles on both Saturdays and Sundays. I continued to exercise at home, doing 300 sit ups and 200 push ups a day.

In Mid June, 1999, on a Saturday, I got up early and road to South to Hammond, Indiana, and then rode North to Evanston. then I rode home. That was a total of 100 miles, round trip. I felt really proud of myself.

But, I also realized that I would have to ride 100 miles a day all 6 days of the AIDS ride. So, the next day, on Sunday, I rode 100 miles again. That's when I found out how stretching helps me keep having sore muscles. It prevents pulled and stiff muscles when you stretch before and after exercise, and gets you ready for the next day's ride.

It's amazing that the day after you first rode 100 miles, you got up and rode 100 miles again!
Well, it was a big mental boost for me. I began to think I could actually complete the 500 mile AIDS ride. I have a competitive nature, and I felt pressure to do well because I was asking lots of people to support me (donate money). Riding 100 miles the next day helped me believe that I could do the 500 miles without being picked up by the support truck. After that, I rode 100 miles every Saturday and Sunday. And, I got up at 6am and rode 30 miles before work, and 40 miles after work, so about 80 miles Monday through Friday.

Did you feel ready?
Yes. I flew to Minneapolis on Sunday and the ride started on Monday. I zipped through the first 50 miles, but tired out toward the end of the first day, which was 103 miles. The second day was tough in the last 40 miles, but I completed it.

The 3rd day was called the hill day. It was only 70 miles, but what they called hills felt like little mountains to me. I thought probably I wouldn't be able to make each hill, that I'd have to walk my bike up and I told myself I wouldn't feel bad. But I was able to ride up the first hill. Then it became a challenge to me to ride up all the hills.

After that 1st hill day, I felt remarkably stronger. I ate really well, lots of fruits, greens and starches.

The 6th and last day was really remarkable. It was raining for 90 miles, and it was cold, so my body temperature was low from McHenry County to Chicago. When we got to Grant Park, out of 200 bike riders, there were only 70 ahead of me. So, I finished in the first 100 riders. Because I arrived at the finish line early, I was cheering the other riders as they finished.

Nutrition is important for people with HIV and for people who exercise a lot. Did you change how you ate when you started exercising and training for the AIDS Ride?
I changed how I ate a lot. When I used drugs, I ate brownies and a can of Coca Cola for a meal.

When I found out I was HIV positive and started exercising, I began to be really conscious of what I ate. My goal on the days I train a lot is to eat 4000 calories. Other days, say 60 mile days, I eat 3000 calories or more. I need this much to keep up my weight and build muscle. This amount of calories is twice what the average human not in training would eat. I became conscious of the nutritional content of foods, of vitamins, carbohydrates, proteins, and fats. I learned to read nutrition labels. With this amount of food I feel energetic. I have to plan when I eat and where I will get food during a long ride. I also have to drink a lot of liquids, like gatoraid and water. When you exercise, you sweat and lose liquids. You have to replace those liquids or you will lose strength. When I am on a long ride, I keep 30 oz. of ice water and 2 16 oz. gatoraids with me on the bike.

Most athletes say they feel tired or fatigue at times. How do you deal with fatigue?
There are days when I feel unwell and not motivated, even though my HIV seems well controlled. My CD4 or T cell count never increased greatly, so maybe that's why I feel this way sometimes. Sometimes I wonder if its emotional, a bad mood. Depression can make you feel physically fatigued, and physical fatigue can bring on depression.

When this happens, I try to read more and find out what the source the fatigue is. Is it not enough or poor food intake, is it emotional? Then, I try to work past that feeling, and keep on exercising. Usually, if I distract myself, like at my job, it goes away.

What kind of advice would you give a person with HIV who is going to start exercising?
I would share my personal experience. They should talk to their doctors to see if it's o.k. Since I've been exercising, the difference in how I feel physically and emotionally is huge. It has had a huge impact on increasing my self esteem. At first, I had all the changes in body fat that are common with protease inhibitors: the fat belly, and the lipodystrophy. In the past 3 years of exercising, there has been a reversal of how I look due to exercise even though I have been taking protease inhibitors all this time. It is due to the exercise. I was able to combat the body changes you get with HIV and the protease inhibitors through exercise.

Starting exercise is a matter of starting to exercise, and setting goals. Listen to your body, and start slow. It helps to have a work out partner to keep you motivated. When you meet your exercise goals, you can feel really good.

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