When you're lying in bed and can't keep food down, muscle metabolizes first.
Dr. Zhaoping Li, my UCLA clinical nutritionist, says the rate is two to three pounds of muscle wasted for every pound of fat. Bug-eyed and big-bellied with fluid after four months' hospitalization for liver failure, I had legs and arms like matchsticks. I could walk no farther than one block. Me, the lifelong athlete, former aerobics instructor and dancer -- now wait-listed for a transplant.
My diagnosis seemed unbelievable: An ultra-rare disease, Budd-Chiari Syndrome.
Two years later, not yet dead, not yet given a liver transplant, I'm told by Li that I must increase my muscle mass. If I am hospitalized again, I'll lose even more muscle and might not survive.
And so I find myself one foggy Tuesday morning at a low-impact aerobics class. The instructor is world-renowned, a fitness leader. A volley of words echoes around the studio: "Oh, isn't her body amazing?" and "Look at how toned she is." I squish down memories of days when I looked that toned.
My shoes are flexible, lightweight, cushioned in the right places and ready for rebound, thanks to advanced cantilevered technology. My full-length pants and long-sleeved pullover, neither stylish nor new, are oppressively hot. I don't want anyone to see the purple bruises on my legs and arms, will not bare my scarified, herniated belly and kangaroo-mama pouch.
No one in the class knows me, and though my mind tells me I should feel grateful to be alive, I feel ridiculous and vain.
I approach the instructor with a smile, saying, "I might need to modify some of the moves." She looks at me blankly and turns toward the mirror, starting the warm-up: Shoulders roll, backs curl and straighten, knees bend deeply.
My own thighs burn. Five minutes in, I gasp. My heart rate exceeds 200 beats per minute, well over the "training" zone for my 45-year-old body. I put a smile on my face that I do not feel -- some say if you smile you actually make yourself feel happy -- and keep moving my feet, dropping my arms to take the intensity down and relieve my heart.
The instructor picks up the pace, moving into choreography without cuing ahead. The canned music grates.
My head throbs from pills I took the night before, and my face flushes crimson, as veins and capillaries struggle to open, impeded by blood clots in my liver. To keep myself from the creeping onset of a dizzy spell, I slow down, count the beats and cue to myself.
