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    Michael L. Aaronson, MD
    Kidney Doctor and High Blood Pressure Specialist
    7401 O Street Lincoln, NE 68510
    Phone: 402-484-5600

    Saturday, May 4, 2019

    Bike Quietly and Save Space on Zwift with Power Pedals. Use Biofeedback to Workout

    Dr. Aaronson biking up a mountain in Zwift. Notice how he is generating 113 watts of power (upper left) but only biking at 4 miles per hour. Why? It takes power to ride up a mountain. Zwift correctly interprets the power you generate to interact with the program and respond accordingly. Notice at 12 o'clock: Dr. Aaronson is biking at an elevation of 212 feet.
    After successfully setting up running on Zwift on Android, I decided to invest more in the program and set up biking. After extensive research and time, I learned there are several ways to set up Zwift with biking, given the compatibility options available to the consumer.

    Sunday, April 28, 2019

    Using Zwift for Android You can Chromecast to Your Television for the Big Screen experience

    With your Android device you can chromecast to your television and enjoy a big screen experience.
    Full disclosure: when I Zwift, I like the smaller Android phone screen and the smaller footprint of the Android Zwift companion app. That said, some like to immerse themselves in the virtual reality of Zwift using a larger TV to enjoy a more realistic experience. Can only those with Apple television enjoy such luxury? Do you have to spend the big bucks to do this? The answer is no, you do not.

    Today's blog by Dr. Michael Aaronson will show you how to chromecast your Android screen to a chromecast device and enjoy your run / biking experience on the television. Just for the sake of comparison: The Google chromecast is 35 dollars. The lower cost Apple TV in 4K is 179 dollars.
    "The rich must profit and get richer. And the poor must stay poor. Oh no, you poor little fool - oh no, you fool." -- Morrissey 
    Once you have Zwift set up and working, connecting to a television using a chromecast is easy. Here is how to do it:

    • Download the Google home app.
    • Make sure your chromecast is correctly connected to your phone and to your television. Make sure everything is in sync.
      • If you have more than 1 chromecast, you want to make sure you connect to the right television. In this case, we will connect to Dr. Aaronson's office TV:
    • Next click "Mirror device." It is the 4th choice down.

    • You may now enjoy the experience of using your TV to use Zwift as shown above and here:

    • Yes, it is that easy. Both sound and video is cast via chromecast to the Television.
    • When done please remember to disconnect your device from the chromecast.

    Saturday, April 27, 2019

    Connect to Zwift on Android Using the Runpod.

    Zwift on Android Using the Runpod

    Zwift is a exercise virtual reality. It is a way to exercise at home, connecting if you wish to a community of runners and bikers, using the internet. It allows you to track your power, heart rate, and more. Zwifters enjoy the virtual environment provided by the program. I will show you how to connect to Zwift using Android and a Runpod.

    Why is this important information? Zwift is a great, cost effective program that can keep you healthy and motivate you to exercise. In my humble opinion, the problem with Zwift is the cost of entry. Some spend thousands of dollars to start. My goal is to help get more people on the platform without having to endure the high cost of entry.
    "I've always been true to you." -- Morrissey
    Why am I doing this? My mission is to promote health. Exercise over time is hard to achieve. It can be done. I'm here to help. Let's get connected.

    • Get connected at the Zwift website. If you wish, you can create an account from the android application as well. 
    • If your Android phone / device is compatible, you will be able to download Zwift from the Google playstore.
    • For simplicity, download the Milestonepod app from the Google playstore.
    • Optional: if you are interested in measuring your heart rate (and more to come) purchase a Wahoo TICKR and download the TICKR app (officially called the Wahoo Fitness: Workout Tracker).

    The wahoo TICKR: this device not only measures your heart rate, but it does a lot more with respect to the Zwift application.

    We are about to unbox the Zwift RunPod

    • The Zwift RunPod device, in all of its glory:
    The actual Zwift RunPod device unboxed
    • The Zwift Runpod requires a Lithium CR 2032 3 V, volt, Lithium battery which is included. Shown:
    • Use the quick start instructions to help you set up your device:
      • Insert the battery into the RunPod
      • Place the holder under the laces, between the second and third eyelets up from the toes.
      • Twist the RunPod clockwise onto the holder until it clicks.
      • Download Zwift and calibrate your RunPod.
      • Lace up and start Zwifting. 
      • Zwifting, used as a verb, means to start running.
    • Dr. Aaronson demonstrates the positioning of the RunPod holder using his Berkshire Hathaway running shoes he purchased at the shareholders meeting in Nebraska.

    • Remember to insert the battery before attaching the Runpod. I used a butter knife to open the case because I didn't have a screwdriver handy. A quarter might work as well.
    • The battery goes "plus" side up as shown:
    • Twist the RunPod clockwise onto the holder until it clicks. This is an important step. You don't want to lose your device.
    Berkshire Hathaway special edition Brooks running shoes with the RunPod attached.

    Sidebar: I kiss the soil. I hug the soil. I eat the soil. -- Morrissey
    • Now we are ready to pair the RunPod to our Android Phone. I'm using a Pixel because I love Google! Notice you can choose to run or to ride a bicycle. For the purposes of this demonstration, we are going to run. 
    It's time to pair (via bluetooth) the Android phone to the Zwift Runpod
    • Optional bluetooth pair: connect a heart rate monitor such as the TICKR 43B9 61. I don't want to hurt myself. I want to measure my heart rate during my exercise routine so I am safe. I do this now. By the way, I can connect other devices to bluetooth later if I want to.
    Pair your hardware to the Android phone using bluetooth at this point. If you want to add bluetooth devices later you can do that too.
    • Up to you: if you have access to a treadmill, you can calibrate your RunPod. The device calibrates your different running speeds to improve accuracy. It is a smart move on Zwift's part. They want to be right. They test slow, medium, and fast running speeds. The figure shows Dr. Aaronson holding a steady pace on a treadmill, running at a gym, the Y, at 3.1 mph for 40 seconds. The calibration of the device can be helpful for accuracy.
    An important step of the setup process is calibrating the Zwift RunPod. 3-Point device calibration will improve your accuracy. 
    • Optional but worth it step: upgrade the firmware on the RunPod. This is done by opening the Milestone app, connecting to the device, and upgrading the firmware. Sidebar: If you decide that Zwift is not for you, you can still use the RunPod to track your exercise, or determine how many miles you have run with your shoes -- helping you determine when it is time for a replacement pair of shoes. 
    • Here's what impresses me about Zwift as a company: they are universal. Their software works on every platform. And their hardware does as well. I'm a subscriber to Zwift because it is so great. But I can cancel at any time and still have a workable, usable "hardware" device. They have confidence in their product. And it is deserved, as you will see.
    Dr. Michael Aaronson, Kidney Specialist in Lincoln NE, upgrades the RunPod firmware so he is up to date and can use his RunPod on Zwift with no worries.
    • Using the RunPod outside of Zwift. It can be done, but once you immerse yourself in the program, you will want to stay.
    It is possible to use the RunPod using the Milestone app without using Zwift. But once you start using Zwift, you will want to stay.

    • Once connected you can use the Zwift app to run or walk. (You can also bike.) You can run on a treadmill or walk around your house. It is great! Here is a pic of me running in the virtual environment. Notice the bikers. Notice the other runners / bikers nearby.  Notice all the information on the screen. 
    • From time to time, they give you pointers to improve your performance. 
    • Helpful hint: For more information, consider downloading the Zwift companion app. Full disclosure: I use 2 phones during my workout: one for the following view and one for the information provided from the companion app. It is spectacular!
    Dr. Aaronson runs in Zwift on Android. He is using the Tickr to record his heart rate. The RunPod records his cadence and his miles per hour. This is very motivating!
    • A screenshot of the Zwift companion app. It helps visualize the target speed goal. Notice that at 5.3 miles per hour I am running at my goal speed. As a newbie, my heart rate is 107. That's not bad, but I need to be careful. I don't want to hurt myself. My cadence is 112. What's great: Zwift gives you pointers during the run. For example: "tempo is defined as 80-85 percent of your total effort, known as the lactate threshold pace." The goal is to get healthier without hurting yourself. They get it.
    Zwift companion app

    "Spent the day in the bed. Very happy I did, Yes! I spent the day in bed."  -- Morrissey on Facebook.

    • Once you are connected you don't necessarily need a treadmill to "run." You can walk around your house. Just don't forget the cost of the monthly membership.
      • As of April 2019, the RunPod is $29.99.
      • If you want the TICKR you will spend around 50-100 dollars. I would suggest you purchase the more expensive one. You can do more with it. To be clear, this device is not required.
      • As of today, the monthly cost of Zwift is 15 dollars a month.

    In conclusion, we have shown you a way to interact with the Zwift community for cheap using your current Android phone and a RunPod that costs 30 dollars. If you want to upgrade from your pedometer and utilize both running and biking (more blogs to come regarding biking on Zwift and you need a setup to use biking on Zwift), consider my instructions to get starting using the product and get started Zwifting. Enjoy!
    "No bus, no boss, no rain, no train." -- Morrissey.
    Update: I have removed my comments using Zwift with a rebounder because a recent update lessened the experience. 

    Follow Michael Aaronson on Zwift

    Dr. Michael Aaronson believes in a healthy you! He has joined Zwift to get healthier, upgrading his exercise regimen from the 10 dollar pedometer/ 10,000 steps a day paradigm.

    [Read more: A Simplified Approach to 10,000 Steps a Day - Your Daily Exercise Requirement]

    Feel free to follow his progress on Zwift and/or run and/or ride your bike with him. How do you do it? What's the easiest way to follow Dr. Aaronson on Zwift?

    I think the easiest way is to download the Zwift companion app:
    Click on the "hamburger" in the upper left hand corner and select "Find Zwifters."

    Type in: "Michael Aaronson." Select his name, and you are done!
    "Why don't you find out for yourself?" -- Morrissey, Rockabilly Version
    Interested in cost effective ways to use their product? Stay tuned. I'm going to facilitate. I am interested in your health and well being without breaking the bank.
    There's a place in the sun for anyone who has the will to chase one, and I think I found mine. Yes, I do believe I have found mine. -- Morrissey

    [Read more: Connect to Zwift on Android Using the Runpod.]

    Kidney Disease and Constipation. What is Your Best Option?

    Use the cap as a measuring cup.

    Constipation can be a major problem for many people whether they have chronic kidney disease or not. Many bowel remedies have on their labels a request that patients ask their doctors for permission prior to use.

    Some medications for slow bowels have been shown to cause kidney failure requiring renal replacement therapy or dialysis. If you have kidney disease and are constipated, you need to make sure your approach to treating constipation is not affecting the body's electrolytes or risking kidney injury.

    Sidebar: acute phosphate nephropathy or acute kidney injury can be caused by enemas containing sodium phosphate. Avoid these products if you have kidney disease. If an enema is going to be considered, you might want to try a warm water enema instead.

    So what should you do if you fall into this category and prefer a less invasive approach? In other words, you want to avoid the enemas!