It’s the Long Promised Sulfa Blog!

Since I mentioned sulfa drugs in a blog a few weeks ago, I’ve been asked some questions, including one wanting to know if these drugs could have caused a particular reader’s CKD.  Although I used the British spelling, I also wrote about my experience with sulfa drugs in What Is It And How Did I Get It? Early Stage Chronic Kidney Disease (page 90):

I knew I wasn’t feeling well at all, so I called my primary care physician for an appointment.  Her medical assistant  [M.A.] told me my doctor was out of town for a Book Coverweek and to go to the urgent care center near my home since, as a CKD patient, I should not wait.  When I told the receptionist at the urgent care center that I had CKD, she sent me to the emergency room at the local hospital in case I needed blood tests or scans for which the urgent care center was unequipped.  The hospital did run a scan and blood tests.  This way, they were able to see if I had an infection, blockage or some imbalance that might not only make me feel sick but worsen the CKD.

I already knew I had a higher than usual white blood cell count from my previous fasting blood test for the nephrologist about a month before the emergency room visit.  He’d felt it was not significantly high enough to indicate an infection but was, rather, a function of a woman’s anatomy.  Women have shorter internal access to the bladder, as opposed to those of men.  Looked like my nephrologist might have misjudged.

However, he quickly picked up that the medication prescribed by the emergency room physicians, despite my having reiterated several times that I have CKD, was a sulfur based drug.  He quickly made a substitution, saving possible further damage to my kidneys.  The hospital insisted I only had Stage 2, so this was a safe drug for me.  I was nervous about this as soon as they became defensive about prescribing this medication.  You need to stick to your guns about being taken seriously when it comes to CKD.

All right, let’s go back to basics, first.  The Medical Dictionary at http://medical-dictionary.thefreedictionary.com/sulfa+drug defines sulfur drug as

“Any sulfur-based antibiotic, in particular sulfonamides.”

sulfaGreat. Now we just need to know what sulfonamides are.  The same dictionary tells us these are

“medicines that prevent the growth of bacteria in the body”

and that they are frequently used with urinary tract infections. Yet, there’s also a warning that people with kidney disease should be sure to warn their doctors about their kidney disease should one of these drugs be prescribed.

Well, why do you need to avoid such medications with CKD? As you already know, compromised kidneys don’t do the job they were meant to do as well as they did before we had CKD when it comes to eliminating drugs from our bodies.  The kidneys are the organs that clear this particular drug from the body, not the liver (which is another organ that can clear drugs from your body). That means the drug may build up… and cause problems.

Here’s one of those problems from MedicineNet.com at http://www.medicinenet.com/sulfonamides-oral/article.htm#what_are_the_side_effects_of_sulfonamides,

“Other rare side effects include liver damage, low white blood cell count (leucopenia), low platelet count (thrombocytopenia), and anemia. Formation of urinary crystals which may damage the kidney and may cause blood in the urine. Adequate hydration is needed to prevent the formation of urinary crystals.”

We are already prone to anemia since we’re not producing as many red blood cells as we could (another job our kidneys have). Sure, adequate hydration may prevent these crystals, but just how much is adequate.  After all, as CKD patients, we do have fluid restrictions.

As for actually causing kidney damage, yes, sulfa drugs can do that. As The National Kidney Foundation phrases it at http://www.kidney.org/atoz/content/kidneysnottowork.cfm:NKF-logo_Hori_OB

“Other things that can damage the kidneys include kidney stones, urinary tract infections, and medications or drugs.”

 An allergic reaction to sulfa drugs can also cause kidney damage.  Allergies.About.Com at http://allergies.about.com/od/medicationallergies/a/sulfa.htm reports:

“People with sulfa allergy may also develop a type of hepatitis, and kidney failure, as a result of sulfa medications.”

However, they are careful to point out that this is an uncommon reaction, occurring in less than 3% of users.

The antibiotics Bactrim and Septra are two of the most common sulfa drugs prescribed today.  Most often, they’ll be prescribed for a urinary tract or bladder infection.  What makes it harder to pinpoint which drugs are sulfa drugs is that they don’t always have ‘sul’ in their name.

That’s also what makes it so important for you to impress upon your physician that you

the medical alert plate1. do have CKD and

2. will not be taking any sulfa drugs

Wearing a medical alert bracelet might help you remember to be downright insistent that you will NOT be taking any sulfa drugs.

The emergency room doctor did try to speak with my nephrologist before prescribing the drug for me, but couldn’t get through… a situation we’re all familiar with.  He was not a specialist and made a judgment call that sulfa drugs would be all right for me.

Yet, when I finally got a response to my own calls to the nephrologist, he was horrified.  This guy was not an emotional man so this really put me into a panic, especially since CKD was so new to me and I didn’t really know the rules yet.

Some blogs just flow and some are hard to write.  This was one of the hard ones.  I spent more time trying to tease information from the internet and my source books than writing.  I gather this is neither a popular topic nor one that is usually visited.  That makes me even more hopeful that I’ve answered your questions about CKD and sulfa drugs.NYC

I left NY in 2002, but we’re going back for a visit soon.  Nima, my NY daughter, will be taking me to High Line and The Urban Museum.  Are there any other new places you think we should visit?  While I lived there, the city was our playground… but it’s been a dozen years.

Until next week,

Keep living your life!

How I Connect Coyotes and CKD

Sunday evening is the Sustainable Blues dance lesson at the Blooze Bar.  When Abby teaches, I go and then I do some marketing on the way home.blues

When Bear was helping me unload the groceries from my car last night, he pointed out a coyote casually walking down the street.  We’re only a quarter of a mile from an arroyo and often see wild life there, but other than bunnies and Gambrel Quail, not in front of the house.

This means Bella needs to stay in the house from before dusk until after dawn since those are prime hunting times for the coyote.  Her dog door was closed last night.  While she is a medium sized dog, I wouldn’t be surprised if a pack of coyotes could devour her… and that’s why IMAG0269 (1)they’re on our block.

These creatures are hungry and they want red meat.  They’re adaptable and will eat anything when they’re hungry enough – even garbage – but 90% of their diet consists of red meat when they can find it.  Notice I’m not citing any websites here.  This is common knowledge when you live in the desert, something I’ve done for the last dozen years.

The coyote sighting got me to thinking.  They eat red meat.  Humans do, too.  Yet, as Chronic Kidney Disease patients we’re urged away from this practice.  I accept it, but I’ve forgotten why and thought you might have, too.coyote

As usual, let’s start at the beginning.  Precisely what is ‘red meat’? According to the Bing Dictionary, red meat is “meat that is red when raw: meat that is relatively dark red in color when raw, e.g. beef or lamb.”

I don’t eat lamb and never have due to some childhood questioning as to why a child should eat another child. (Okay, so I was a deep thinker even then.) Red meat was the staple of the family’s diet when I grew up and no meal was considered complete without it. That’s not the case now.

red meatWebMD has a truly illuminating three page article debating the merits and demerits of red meat at http://www.webmd.com/food-recipes/features/the-truth-about-red-meat. Most of it deals with the protein and fat content.  That is something that should concern us as CKD patients.    (It also explains why pork is considered a red meat rather than a white meat as a former colleague at Phoenix College tried to convince me.)

Okay, so fat – and hence, cholesterol – is something that could adversely affect your heart, not great for anyone including us.  But, as CKD sufferers, it’s more the protein content of red meat that concerns us right now.

In What Is It And How Did I Get It? Early Stage Chronic Kidney Disease, protein is defined as “Amino acids arranged in chains joined by peptide bonds to form a compound, important because some proteins are hormones, enzymes, and antibodies.”  That’s on pages 134-5 for those of you with a print copy of the book.  Those of you with a digital copy, use the word search function.

That definition says a lot.  Let’s take it bit by bit.  Amino acids, simply put, are “any one of many acids that occur naturally in living things and that include some which form proteins.”  Thank you, Merriam Webster Dictionary.  Did you notice that they may form proteins?  Keep that in mind.Book Cover

So what are peptide bonds, then? This is a bit more complicated, so I went to Education Portal at http://education-portal.com/academy/lesson/peptide-bond-definition-formation-structure.html#lesson for the most easily understood definition: “Peptide bonds are the key linkages found in proteins. These bonds connect amino acids and provide one of the key foundations for protein structure.”  Again, proteins.  This is a bit circular, but the important point here is that both are involved in the production of protein.

The renal diet I follow restricts my daily protein intake to five ounces a day, but why? Back to What Is It And How Did I Get It? Early Stage Chronic Kidney Disease, page77 this time:

So, why is protein limited? One reason is that it is the source of a great deal of phosphorus. Another is that a number of nephrons were already destroyed before you were even diagnosed. Logically, those that remain compensate for those that are no longer viable. The remaining nephrons are doing more work than they were meant to. Just like a car that is pushed too hard, there will be constant deterioration if you don’t stop pushing. The idea is to stop pushing your remaining nephrons to work even harder in an attempt to slow down the advancement of your CKD.  Restricting protein is a way to reduce the nephrons’ work.

Your kidneys have about a million nephrons, which are those tiny structures that produce urine as part of the body’s waste removal process. Each of them has a glomerulus or network of capillaries.  This is where the blood from the renal artery is filtered.  The glomerulus is connected to a

Glomerulus-Nephron 300 dpi jpgrenal tubule, something so small that it is microscopic. The renal tubule is attached to a collection area.  The blood is filtered. Then the waste goes through the tubules to have water and chemicals balanced according to the body’s present needs. Finally, the waste is voided via your urine to the tune of 50 gallons of fluid filtered by the kidneys DAILY.  The renal vein uses blood vessels to take most of the blood back into the body.

For those of you who may have forgotten, phosphorus isn’t troublesome in early or moderate stage CKD, but can be in Stages 4 and 5.  Phosphorus works in conjunction with calcium to keep our bones and teeth healthy, but it has other jobs, too.  Compromised kidneys cannot filter out enough of this, though.  That can lead to calcification in parts of the body.

Confession time: after six years of following the Northern Arizona Council of Renal Nutrition Diet, I am not attracted to red meat.  Bear’s family traditionally has standing rib roast for Christmas and ham for Easter.  I will gladly cook them for the family – or buy them already cooked – but I’m fine with the steamed vegetables and a taste, a little one at that, of each of the meats. We don’t buy red meat when we market (except when Bear has an urge) and rarely eat it in restaurants. It wasn’t that hard to get out of the habit of always having red meat.

Until next week,

Keep living your life!

I Can Hear The Blood Rushing in My Ears

July 4thHope you had a wonderful Independence Day weekend. Ours was filled with water walking thanks to the Vlasitys, Olsens, and Artecs who all offered their pools for Bear’s physical therapy, board games after we discovered our neighbors – Linda and Mike Olsen – played our favorite domino game, a movie (Train Your Dragon, Two… oh yes!), plus dinner out at Macaroni Grill, a restaurant where I actually have choices that fit in the renal diet. We even got to the only remaining bookstore on our side of The Valley of The Sun. Quiet, fun activities.

During that time, my blog was in the back of my mind. It’s always in the back of my mind. Which is why I can’t stop writing it, by the way. This weekend, I kept thinking about the subtle connection between hearing and Chronic Kidney Disease.

The topic came about in the usual way: I complained of hearing poorly and my ever vigilant primary care doctor, Dr. Zhao of Deer Valley Family Practice right around the Arizona style corner (three and a half miles), suggested I might want to have my hearing tested by an audiologist. This was right after I passed the Medicare Annual Wellness Visit hearing test with flying colors despite my complaints.

Off I went to Dr. Kristin Wells of North Valley Audiology… for the third time in five years. Her assessment was that my hearing was just fine. Go figure, but she did applaud me for telling her I had CKD (and sleep apnea, but that’s another story…uh, blog).test

Why did I do that you ask? Well, as I wrote on my March 15th, 2011, blog during National Kidney Month:

“Research shows that hearing loss is common in people with moderate chronic kidney disease. As published in the American Journal of Kidney Diseases and highlighted on the National Kidney Foundation web site, a team of Australian researchers found that older adults with moderate chronic kidney disease (CKD) have a higher prevalence of hearing loss than those of the same age without CKD.”

You can enter hearing in the topic search to the right of this blog read the rest of that blog.

earHow moderate CKD and hearing are connected is another matter, one that apparently isn’t as well documented. Here’s what I found at http://www.hear-it.org/More-than-half-with-Chronic-Kidney-Disease-have-hearing-loss – which has an online hearing test – and not most, but all of the other sites I searched. This comes from the same study I used in my 2011 blog. That study was completed in 2010… four years ago.

“University of Sydney, said:
The link between hearing loss and CKD can be explained by structural and functional similarities between tissues in the inner ear and in the kidney. Additionally, toxins that accumulate in kidney failure can damage nerves, including those in the inner ear. Another reason for this connection is that kidney disease and hearing loss share common risk factors, including diabetes, high blood pressure and advanced age.”cochlear tissue

I couldn’t visual this inner ear tissue, so I started looking for images. You can see them all over this page.

Suddenly it became clear. If toxins are – well – toxic to our bodies, that includes our ears. My old friend The Online Etymology Dictionary at http://www.etymonline.com/index.php?term=toxic tells us the word toxic is derived directly from Late Latin toxicus “poisoned.”

Now I got it. Moderate CKD could be poisoning our bodies with a buildup of toxins. Our ears and the nerves in them are part of our body. Damaged nerves may cause hearing loss. I’d just never thought of it that way before. Sometimes all it takes is that one last piece of the puzzle to fall in place.

Hmmm. High blood pressure is the second most common leading cause of CKD and it can also lead to hearing loss. Let’s take a look at that.

ear tissueAccording to WebMD at http://www.webmd.com/a-to-z-guides/hearing-loss-causes-symptoms-treatment “Certain illnesses, such as heart disease, high blood pressure, and diabetes, put ears at risk by interfering with the ears’ blood supply.” Of course!

I went right to What Is It And How Did I Get It? Early Stage Chronic Kidney Disease to figure out how. On page 97 (you know the drill: digital readers use the search function), blood pressure 300dpi jpgthere is a diagram from The National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health that demonstrates how high blood pressure is caused… and if you read on, you’ll read about the problems high blood pressure causes.

This is the sentence that clarified the issue for me (page 99): “Humans have 10 pints of blood that are pumped by the heart through the arteries to all the other parts of the bodies.” That would include the ears. Moderate CKD might mean that blood is tainted by the toxins our compromised kidneys could not rid us of.

I had been hoping for more recent research, but sometimes you just have to deal with what you get.

Talking about getting, Dr. Nick Held of ASU sent a long involved comment. Basically it is full of opportunities to study about Chronic Kidney Disease. While most of it is a bit too medical for me, you may be looking for just this opportunity, so here’s the address: http://www.nejm.org/toc/nejm/medical-journal. You’re looking for Vol. 371, No. 1. Many thanks, Nick, and thank you for the accolades, too.

Things are quiet here this summer. No word yet from either the radio show or the article in Medicare’s publication about when they’re going to happen. No word on SlowItDown either. I’ll bet people are going directly to DaVita.com for their Chronic Kidney Disease education. You are, aren’t you? Hey, get that CKD education any way you can.

The book lives! I do believe there may be another book about CKD fairly soon: The Book of Blogs. This blog was born when an Indian nephrologist contacted me to explain that he Book Coverthought What Is It And How Did I Get It? Early Stage Chronic Kidney Disease was just what his new patients needed, but they were too poor to even pay bus fare to keep their appointments.

I was very new to social media, but figured if I wrote a blog, he translated it and then printed it, his patients who could keep their appointments could read it and bring it back to their villages with them for other CKD patients to read.

Now I’m looking at it the other way: I have more than a few readers who are not comfortable with anything electronic. They need a book in print. I’m seeing what I can do about that, folks.

Until next week,
Keep living your life!

Life Is Just A Bowl Of Cherries

Here I was all ready to write about sulfur drugs and CKD or hearing and CKD when I received an email from  Cindy Bruggner who’d just bought some good looking bing cherries but wasn’t sure whether to eat them or not.  We all know that cherries simply don’t last that long, so – Cindy – this one’s for you.

cherries

The big issue about eating cherries when you have Chronic Kidney Disease is their potassium content. I went straight to What Is It And How Did I Get It? Early Stage Chronic Kidney Disease to see what I’d written about this. In the Glossary (on page 134) I found this definition:

“One of the electrolytes, important because it counteracts sodium’s effect on blood pressure.”

While that’s true, we’re going to need more to help Cindy out. So I turned to Chapter 8: The Renal Diet (page 75).

“Potassium is something you need to limit when you have CKD despite the fact that potassium not only dumps waste from your cells but also helps the kidneys, heart and muscles to function normally.  Too much potassium can cause irregular heartbeat and even heart attack.  This can be the most immediate danger of not limiting your potassium….

Book Cover…Check your blood tests. 3.5-5 is considered a safe level of potassium.  You may have a problem if your blood level of potassium is 5.1-6 and you definitely need to attend to it if it’s above 6.  Speak to your nephrologist ….”

I checked with the National Kidney Foundation http://www.kidney.org/atoz/content/potassium.cfm about those levels just to be sure they hadn’t changed since the book was published.  They haven’t.

That got me to wondering why cherries are considered good for the general population, but not CKD patients. So, of course, I did a little research.  Green and Healthy at http://www.greenandhealthy.info/kidneydisease.html#ckd suggests those without kidney disease eat cherries for the following reason:

“According to research from Michigan State University tart cherries contain anthocyanins [Thought you might like to know this means natural pain relieving and anti-inflammatory properties], bioflavonoids, which inhibit the enzymes Cyclooxygenase-1 and -2, and prevent inflammation in the body. These compounds have similar activity as aspirin, naproxen and ibuprofen.”

Sounds good to me since we can’t take some of those pain relievers, but cherries have the same effect.  Something was nagging at me though.  Back to What Is It And How Did I Get It? Early Stage Chronic Kidney Disease. As I read page 3, I realized why:

“The problem with unregulated minerals, such as sodium and potassium is that these minerals are needed to remain healthy but too much in the bloodstream becomes toxic. The kidneys remove these toxins and change them into urine that enters the bladder via the ureter.”kidney location

Well, healthy kidneys do, but just how effective are your compromised kidneys at doing this job? I went to DaVita at http://www.davita.com/kidney-disease/diet-and-nutrition/lifestyle/top-15-healthy-foods-for-people-with-kidney-disease/e/5347, but in addition to the usual warnings about potassium levels, I found this:

“1/2 cup serving fresh sweet cherries = 0 mg sodium, 160 mg potassium, 15 mg phosphorus

Cherries have been shown to reduce inflammation when eaten daily. They are also packed with antioxidants and phytochemicals that protect the heart.”

Does that mean they’re good for CKD patients?

From my reading, I’ve also garnered the information that cherries can help with iron deficiencies, lower blood pressure, improve sleep, help with gout, and lower the risk of heart disease.

Or can they? Remember that too much potassium can actually cause an irregular heartbeat or possibly stop your heart.

Oh Cindy, I’m sure I’ve only added to your confusion.  Watch your potassium levels.  Look them up on your last blood test.  Why not give your nephrologist a call, too, just to be sure.  Do you have a renal nutritionist? He or she would know far better than I since this question of whether to eat the cherries or not is so individualized.

Then we have stages.  I am stage 3, which I used to think was early stage (hence the book’s title) but now realize is moderate damage.  I don’t know what stage Cindy is, but I do know the dietary rules change when you reach end stage and I’m going to guess they’re even different for those on different kinds of dialysis and those who are transplants.stages chart

So Cindy’s question is sort of asking me which sexual position is best for her.  I’m purposely being provocative here so that you’ll see just how individualized the renal diet is. What’s best for you depends on your needs.  Call the nutritionist!

Knowing End Stage Renal Disease is not my area of expertise, I took a peek at National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC), A service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)National Institutes of Health (NIH), at http://kidney.niddk.nih.gov/KUDiseases/pubs/eatright/index.aspx#potassium anyway to see what dialysis patients can eat.  Apparently, potassium could be a problem here, too. This is what I found:

“Potassium is a mineral found in many foods, especially milk, fruits, and vegetables. It affects how steadily your heart beats. Healthy kidneys keep the right amount of potassium in the blood to keep the heart beating at a steady pace. Potassium levels can rise between dialysis sessions and affect your heartbeat. Eating too much potassium can be very dangerous to your heart. It may even cause death.”

Okay, cherries can be a problem.  Then I started wondering if it mattered what type of cherries they were. I found at least 18 different kinds, but none of the websites discussed potassium.

I learned more about cherries and potassium than I thought I wanted to.  I’m sure you did, too, but I offer you the same advice I offered Cindy: check with your renal nutritionist or nephrologist – always.  I am not a doctor, but rather someone who researches CKD on a layman’s level.  Cindy, thanks for asking.

Holy cow!  July 4th weekend is sneaking up on us!  I’m looking forward to as much water walking as we can get in since two, not one, but two neighbors have offered us the use of their backyard pools – one actually a lap pool – and we have discovered our neighborhood pool which charges only $20 per person a season.  We may not have the ocean out here, but we’ve got lots of pools.  Here’s hoping you enjoy your holiday weekend.

Kidney Book CoverWhoops!  Almost forgot to include that SlowItDown will now be sharing the book’s Facebook page, twitter account, website (http.gail-rae.com), email address (myckdexperience@gmail.com) and telephone number (602-509-4965).  I was getting run down trying to run the two separately in addition to my personal one!

Until next week,

Keep living your life!

Not ON the Water, IN It

It’s hot, 112 degrees already and summer has just started. Much as I’d love to, I can’t stay in the house writing all day, every day. I also need to exercise on a daily basis… as do you if you have Chronic Kidney Disease.

What’s that? Why do you have to exercise if you have CKD, you ask? Let’s go back to What Is It And How Did I Get It? Early Stage Chronic Kidney Disease, page 100, for the answer to that one. (Digital book owners, don’t forget to use the search document function instead of the page number.)Book Cover

“I knew exercise was important to control my weight. It would also improve my blood pressure and lower my cholesterol and triglyceride levels. The greater your triglycerides, the greater the risk of increasing your creatinine. There were other benefits, too, although you didn’t have to have CKD to enjoy them: better sleep, and improved muscle function and strength. But, as with everything else you do that might impinge upon your health, check with your doctor before you start exercising.

I researched, researched and researched again. Each explanation of what exercise does for the body was more complicated than the last one I read. Keeping it simple, basically, there’s a compound released by voluntary muscle contraction. It tells the body to repair itself and grow stronger. The idea is to start exercising slowly and then intensity your activity.”

I’ve mentioned water walking as an exercise and gotten quite a few questions about it. I have to admit I’d never heard of it before I moved to Arizona and met Bear. His house is in a senior citizen community that has a community center with a water walking pool.

It was exciting to be doing something I’d never done before and questioned him unmercifully, although he kept telling me you get in a pool that has lanes and walk. I could not visualize it, so I went online to see what it looked like. Then I couldn’t imagine what it would feel like, especially for someone who always wants to be near water rather than in it.

The pool was enormous to my water walking pool virgin eyes. There were shady parts and sunny parts. Uh-oh, I was going to have to get a hat with a bigger brim to protect my neck and shoulders from the sun, too. Oh, and water soluble sunscreen.sun hat

I couldn’t make sense of the arrows on the pool floor and the curvy shoulder high dividing walls between lanes until I was actually in the pool. I started out in waist high water following the arrows and keeping in the lanes they pointed to on different sides of the dividers until I found myself in chin high water when we completed our first circuit.

water walkingNow it all made sense. It was just like traffic lanes and directional markings on the road when you drive! Of course, waist and chin high are relative. I’m 5’5’, so Bear’s 5’10” meant the water was not as high on him.

There’s another benefit to water walking if you have arthritis. You’ve read my complaints about arthritis here and even in the Wall Street Journal column by Laura Landro about CKD Awareness activists (I still prefer being called an advocate). If you missed it, you can read that article in the January 20th, 2014 blog.

I went to the site of The Arthritis Foundation at http://www.arthritistoday.org/what-you-can-do/staying-active/activity-types/water-walking.php and read the following:

“Like all water exercises, water walking is easy on the joints. ‘The water’s buoyancy supports the body’s weight, which reduces stress on the joints and minimizes pain,’ says Jones [an aquatic coordinator]. ‘And it’s still a great workout. Water provides 12 times the resistance of air, so as you walk, you’re really strengthening and building muscle.’ You do not bear weight while swimming and walking, however, so you’ll still need to add some bone-building workouts to your routine.”

My almost constantly complaining knees were quiet in the water walking pool. My slightly painful hip didn’t seem to hurt. And, best of all, my elbows weren’t aching. I’m sold. What makes it even better is that water walking strengthens your muscles.

The bottom of the pool is purposely rough to prevent slips. After one circuit without water shoes, I knew I’d have to get some. While they were not severely damaged, I did notice annoying little scraps and cuts on the soles of my feet, especially my toes.water walking shoes

That probably means I was walking on my toes, something the Mayo Clinic at http://www.mayoclinic.org/healthy-living/fitness/multimedia/aquatic-exercise/sls-20076730 suggests you NOT do.

“In water that’s about waist-high, walk across the pool swinging your arms like you do when walking on land. Avoid walking on your tiptoes, and keep your back straight. Tighten your abdominal muscles to avoid leaning too far forward or to the side.”

I’ll also have to work on tightening my abdominals since I walked into the wall or the dividers a few times. I knew I wasn’t drunk (I don’t drink), so now I know why this happened.

A non-medical site, Ask.com, had some information about how you can water walk in any water. After all, not everyone has access to a water walking pool.

• Walk forward and backward with short steps, long steps, average steps, or step kicks.

• Move in a pattern of a circle or square. Be sure to go in both directions to balance the demands on your body.

There are more suggestions about technique at their site: http://spas.about.com/od/exercise/a/waterwalking.htm

SlowItDown business card

The big news here these days is that SlowItDown and What Is It And How Did I Get It? Early Stage Chronic Kidney Disease are combining their Facebook and Twitter accounts. When you want to catch up with SlowItDown, just go to What Is It And How Did I Get It? Early Stage Chronic Kidney Disease’s Facebook and Twitter accounts. There will still be a daily tidbit about our disease on both. It occurred to me that I was doing double duty (Say that three times fast!) since both deal with the same issue.

Until next week,
Keep living your life!

Their Father’s Food  

GmM8B2ylPUP0lIuKR9OqrzOqFEOtJtRaf2Rpt6ncsBkHere’s hoping you all enjoyed your Father’s Day yesterday.  Although we were missing Nima who lives in New York and Kelly and Sean who both had to work, it was a very good day for us.  Lara’s love played the guitar for a sing-a-long and Darin showed us the newspaper article which quoted him.  Abby had to leave early for the Blues dance lesson she teaches, but we’d had a good, long afternoon together by that time.  Long enough that Lara finally got to really just talk with her dad.

It was all good, except the food.  Bear doesn’t have Chronic Kidney Disease and usually follows the renal diet with me anyway.  Yesterday was the exception.  Since we finally figured out that I’m not Bear’s mother and he’s not my father, this was the last Mother’s Day (He always makes me a bar b q with food I can eat.) or Father’s Day we would host. I gave him a pad and pen and said, “Write down your menu.”

Bear was raised in the Midwest and eats a lot of food that’s still strange to this ex New York Jew.  Let’s start with the honey baked ham.  Okay, he spent his childhood summers on his grandparents’ farm; I get that. I grew up not eating ham because it’s not kosher and we were practicing Jews.  But why isn’t it on the renal diet?ham

Thank you Wedliny Domowe at http://www.meatsandsausages.com/hams-other-meats/hams for this information. Ham is a processed meat.  It can be cured in a number of ways, but most include the use of salt, and nitrites, which themselves are either sodium or potassium. The dry method of curing uses salt, while the wet method uses brine. And what is brine but a solution of sodium in water? And then there’s smoking. {Ack! Smoke contains formaldehyde and alcohol.}

We know as CKDers that we need to limit our sodium intake. As I wrote in What Is It And How Did I Get It? Early Stage Chronic Kidney Disease, pages 73-4,

“Basically, sodium balances fluid levels outside your cells.  You need it because it is responsible for watering your cells.  This watering is the prompt for potassium to Book Coverdump waste [cell process by-products] from your cells….If you have damaged kidneys and cannot excrete most of the sodium you ingest, you’re up against higher blood pressure which may worsen your CKD which may further cut down on your elimination of sodium and so on and so forth in an ever spiraling cycle. In addition, for CKD patients, too much sodium causes fluid retention, thereby causing swelling, further resulting in weight gain, leading to shortness of breath.”

And let’s not forget that high blood pressure is the second leading cause of Chronic Kidney Disease.

Well, what about the potassium in the nitrite used in preserving the ham.  Why do CKDers have to limit the amount of potassium they ingest? By the way, too much sodium can increase your need for potassium.

But isn’t potassium good for you?  After all, it does help the heart, muscles, and our beloved kidneys function normally as well as dumping wastes from our cells. Here’s the kicker, an excess of potassium can cause irregular heartbeat and even heart attack.

We are not your everyday people whose kidneys can filter any excess potassium from our bodies.  We have compromised kidney function which could mean a buildup in potassium.  No wonder CKD may lead to cardiovascular problems!potassium

I’m almost afraid to look at the rest of Bear’s Father’s Day menu.  He also requested cold cuts of roast beef.  Uh-oh, that’s another cured meat.  Cold cuts also tend to be fattier cuts and have nitrates, which are different than the nitrites discussed above.

According to Dictionary.com at http://dictionary.reference.com/browse/nitrate, a nitrate is “a salt or ester [That’s an organic compound.] of nitric acid.”  Wait a minute!  Nitric acid is a corrosive liquid, as most of us learned way back in high school.

And, as Dr. Veeraish Chauhan (one of the nephrologists in Florida that received a donation of the book this past March when I was there) wrote in his April 6, 2013 {our wedding day!} blog, “… red meat could be a big source of uric acid, which has been shown to be associated with worsening of CKD.”

Red meat contains cholesterol.  Fattier cuts contain more cholesterol. This substance can clog the arteries, leading to heart problems.  We already have a higher risk of heart problems simply because we have CKD.  Why raise the risk???

And then we have the sweet potato casserole.  Sweet potatoes?  I don’t remember the last time I had one of those. Talk about potassium overload!  We already discussed the CKDers’ problems with that.sweet potato casserole

Well, what about the green bean casserole?  I didn’t have to eat the crispy, fried onions on top of it. But it’s in creamed mushroom soup.  Oh, right.  Creamed soup is high in phosphorous. The National Kidney Foundation at http://www.kidney.org/atoz/content/phosphorus.cfm tells us, although phosphorus is necessary to work with calcium for healthy bones:

“High phosphorus levels can cause damage to your body. Extra phosphorus causes body changes that pull calcium out of your bones, making them weak. High phosphorus and calcium levels also lead to dangerous calcium deposits in blood vessels, lungs, eyes, and heart. Phosphorus and calcium control is very important for your overall health.”

The orange mimosas seemed to delight everyone but Abby.  I didn’t even try one.  I.just.don’t.drink.  Too much alcoholism in my family history.  Anyway, while the orange juice in this drink didn’t seem to be a problem, the champagne was actually good for us, according to the National Institutes of Health.

Their MedlinePlus at http://www.nlm.nih.gov/medlineplus/news/fullstory_145838.html posted new findings about the benefits of wine.  Champagne is a wine.  Surprise!  If you have CKD, wine in moderation may help protect you from that health disease you’ve at risk of.carrot cake

I am not even going to analyze the carrot cake from Cheesecake Factory.  That is so bad for you on so many levels!  I am so glad I researched these foods AFTER the celebratory meal so I wasn’t tempted to spout this information to those enjoying the food.

I was thinking of combining the SlowItDown and book FB pages, twitter accounts, and website.  Any thoughts of your own about this?

Until next week,

Keep living your life!

Kidney Book Cover

Baby, It’s Hot Outside

I just caught up to the fact that it’s June.  No, it wasn’t the calendar that told me, but the temperature.  We live in Arizona and its hot, dry heat or not.  That means cooling off any way you can. IMG_0584

This weekend, we finally took the three hour round trip drive to visit my friend and her family.  Her five year old daughter proudly showed off the family’s new addition since I’d been there last – a wonderful, cooling swimming pool.  I was tempted, but the 105% temperature kept me inside with the air conditioning.

That’s when I was offered some filtered water.  Did I want ice? I was asked.  I immediately shook my head.  “CKD, no ice, please.”

My friend cocked her head.  Her father had had a kidney transplant so she was well aware of the renal diet.  True, her father was treated in Korea, so there might have been some differences in treatment, but ice?

She asked me why and I immediately knew what I was going to blog about today.

For years, I’ve misunderstood something my nephrologist said.  I heard, “Don’t use ice.”  What he really said was something like, “If you use ice, you need to count the cubes in your fluid intake.”

I’ve spent time since Saturday researching the ice question and found nothing about avoiding ice.  I did find one warning about cold beverages from DaVita at http://www.davita.com/kidney-disease/overview/living-with-ckd/seven-summertime-precautions-for-people-with-kidney-disease/e/4894 : “Be careful of very cold beverages, which can cause stomach cramps.”

The lesson I learned from this misunderstanding of what I thought I heard is to recheck what you think you know every once in a while.  After all, I thought I had the diet down pat.

Hah!  I forgot that I was terrified when I was first diagnosed and thinking I was going to die imminently. I adhered strictly to what I heard and, apparently, adhered just as strictly to what I thought I’d heard.

sun-graphic1Wait a minute… maybe I need not have avoided the heat, either.  I researched that, too.  Just as with ice, I found a general warning about the elderly, but nothing specific to CKD.

““With the elderly, the heat accumulates in their bodies over hours to days. If you have a long heat spell, the elderly person accumulates heat through each of those days because they can’t really eliminate or dissipate the heat,” explains Dr. Crocker. “Sometimes it’s because of a medication, sometimes it’s a lack of mobility, or in some cases the older you get, the less active your sweat glands are, so it becomes harder and harder for you to eliminate heat.”

This is from The Austin Diagnostic Clinic at http://www.adclinic.com/2012/08/hot-summer-days-challenging-dangerous/#.U5X-ZKROUY0.

By the way, National Public Radio (NPR) has a fascinating blog about the term ‘elderly’ at http://www.npr.org/2013/03/12/174124992/an-age-old-problem-who-is-elderly.  While 65 was the accepted age for elderly here in the USA for quite some time, this is now under debate.  I, however, still envision an elderly person as frail and delicate… something I’m not.

But, again, there was nothing specific to CKDers in the quote above.  In thinking about it, I began to wonder if the risk of dehydration from the summer heat is the problem for us.

According to The National Kidney Fund at http://www.kidney.org/atoz/content/kidneysnottowork.cfm

“Kidneys can become damaged if they are not getting good blood flow. This can happen if you become dehydrated or seriously ill.”

Aha!  This was starting to make sense.  WebMD at http://www.webmd.com/fitness-exercise/tc/dehydration-topic-overview explains this for us.

“Usually your body can reabsorb fluid from your blood and other body tissues. But by the time you become severely dehydrated, you no longer have enough fluid in your body to get blood to your organs, and you may go into shock, which is a life-threatening condition.”ice water

Okay, so we know we need to drink fluids, especially in hot water. Our kidneys are already having a hard time cleaning our blood effectively and we are reabsorbing ineffectively cleaned blood prior to this point of dehydration.

But how do we know if we’re becoming dehydrated? What are the symptoms? I turned to my standby, the Mayo Clinic at http://www.mayoclinic.org/diseases-conditions/dehydration/basics/symptoms/CON-20030056 for the symptoms of mild dehydration:

  • Dry, sticky mouth
  • Sleepiness or tiredness — children are likely to be less active than usual
  • Thirst
  • Decreased urine output
  • No wet diapers for three hours for infants
  • Few or no tears when crying
  • Dry skin
  • Headache
  • Constipation
  • Dizziness or lightheadedness

And then I laughed.  I experience one or more of those symptoms at one time or another.  The clinic does make the extremely helpful point that the color of your urine is a good indicator of dehydration. If it’s clear or light in color, you’re fine.  If it’s dark, start drinking!  Interestingly enough, having CKD is already a risk factor for dehydration so let’s not make it worse for ourselves.

So how do we prevent dehydration?  What can we do if we can see if starting?

Obviously, drinking more fluids will help. I’m limited to 64 ounces in a day, but I get creative in summer. Sometimes, I will have that half cup of ice cream.  Watermelon magically (hah!) appears on the table.  Now that I realize I don’t have to avoid ice, they too will become part of both the anti-dehydration campaign and the anti-dehydration campaign in our house.watermelon

I’m not sure if this is common knowledge, but dehydration can also cause kidney stones.  If you don’t have the fluid in your body to prevent crystallization, crystallization is more apt to happen.  Kidney stones are,

“Stones caused in the urinary tract and kidney when crystals adhere to each other.  Most of those in the kidneys are made of calcium.”

(Love this author’s style).  That’s from What Is It And How Did I Get It? Early Stage Chronic Kidney Disease, p. 133.

Talking about the book, it’s clear that digital outsells print and that in foreign markets, England outsells other countries.  I wonder if it’s the languages.  I’d thought about translations, but how would I be able to edit the texts if I don’t know the languages myself?  I’ve tried online translation, but the results are never quite what I originally wrote in English.

May you stay cool and hydrated.

Until next week,

Keep living your life!Book Cover

Your Thyroid and Chronic Kidney Disease Have Something Going On.

Today’s blog was written at the request of a reader.  The deal is I write a blog about hyperthyroid and its connection to Chronic Kidney Disease and she goes directly to her nephrologist to ask him the same questions she asked me.

While I’m a good researcher, I am not a doctor and that’s who should be asked your CKD questions.  Come to think of it, any time you receive any well-meant advice about this disease, check with your nephrologist first… even if you admire the brain of the person giving the advice.THYROID_72

Let’s do our usual go-back-to-basics-first.  The thyroid, according to WebMD at http://www.webmd.com/women/guide/understanding-thyroid-problems-basics , “… secretes several hormones, collectively called thyroid hormones. The main hormone is thyroxine, also called T4. Thyroid hormones act throughout the body, influencing metabolism, growth and development, and body temperature. During infancy and childhood, adequate thyroid hormone is crucial for brain development.”

There doesn’t seem to be anything alarming there, so let’s go to the T4.  I turned to What Is It And How Did I Get It? Early Stage Chronic Kidney Disease for information about this and found it on page 23 (Usual reminder: digital book owners, use a word search rather than a page).

“What this test is really for is to see if the T3 test comes back abnormal.  If it does, the lab needs to run another thyroid test.  That test, the T4, is a further thyroid test which looks for specific causes of the abnormality.”

Ah, so we need to be tested via a blood draw to see if there is an abnormality in our thyroid function.  Without getting technical, the abnormalities could be hypothyroid or hyperthyroid.  As a former English teacher, I know hypo is a prefix (group of letters added to the beginning of a word that changes its meaning) that means under, while hyper means over.

blood_test_vials_QAMy reader’s question was about hyperthyroid, but for the safe of completeness, I’ll include the symptoms of hypothyroid. These are the main symptoms – although there are many more – as found on http://thyroid.org.nz/Thyroid_Problems.php

  1. Cold hands and feet
  2. Chronic fatigue
  3. Lethargy and fatigue
  4. Emotional instability
  5. Depression

Hyperthyroid is not as common as hypothyroid and presents different symptoms:

  1. Sweating
  2. Anxiety and Excitability
  3. Thirst
  4. Racing heart
  5. Hunger
  6. Muscle weakness
  7. Shortness of breath
  8. High blood pressure
  9. Insomnia
  10. Weight loss

Numbers 7 & 8 caught my eye immediately since they seem to have something to do with CKD.

The diagnose I was specifically asked about is hyperthyroid, renal.  We already know renal means kidney, so this deals with how the overactive thyroid affects the kidneys.  Remember that hormones travel through the blood and that the thyroid produces a hormone.  Too much of that hormone produces the above symptoms.thyroid

As I understand it (and, again, I am not a doctor) – as mentioned –  the thyroid produces a hormone which is released into the blood, while the kidneys filter the blood.  If you have CKD, your kidneys are not functioning as well as they should.  If you have hyperthyroid, you are producing extra thyroid hormone that your compromised kidneys cannot purge from your blood as well as they should.

This quote from Wellness Resources at http://www.wellnessresources.com/health/articles/thyroid_and_kidney_problems_overlap/#ref1  encapsulates the interplay between the kidneys and the thyroid:

“A considerable body of science now links thyroid problems and kidney problems  in a “chicken and egg” manner.”

So yes, Cynthia, the CKD could have caused the hyperthyroid, renal, and vice versa.  However, hypothyroid does seem to be more common than hyperthyroid.

If there are topics you’d like me to research for you, Dear Readers (after Stephen King’s writing), please ask.  You can leave a comment here or inbox me on Facebook via the blog’s page.  I offer you the same deal.  I’ll research for you providing you ask your nephrologist the same question you’re asking me.

It’s clear to me that digital books are not the future of anything, but are what’s more desired right now.  Digital copies of What Is It And How Did I Get It? Early Chronic Kidney Disease consistently outsell the print copy.  That’s fine with me.  While you can pass around a print copy, you can also share the digital copy.  Just keep sharing the Chronic Kidney Disease information.

Another way to share is to send SlowItDown the list of communities in your area that could use CKD education.  It’s free. It’s taught by trained educators. And it’s brought to you.  Could your church use the education as a public service?  What about your local library?  Police station?  Senior citizen center?  Let’s get those phones ringing, folks.  602 509-4965. Don’t feel like talking to me?  Then email: ckded@cox.net.

I am absolutely thrilled that health treatment companies are starting to ask me what it’s like to be a CKD patient, even though I am an early stage patient.  Their interest means the medical profession is looking for new, possibly more effective, ways to slow down the progress of our incurable disease.The Table

On a personal note, we got out for a date day this past Friday.  I once considered a movie and dinner sort of humdrum as a date.  Now that we are still dealing with medical issues, it is wonderful!  Life is definitely a matter of how you look at yours… and mine gets better every day.

We also got out to a party for a bit this weekend.  I’m always amazed that the one person at a social function whose mother has CKD, or whose brother is a nephrologist, or whose roommate works in a doctor’s office, or who is worried about high blood pressure sits right next to me and starts talking.

On another front entirely, sometimes, as (slightly) older people with medical issues, we need help.  So we organized a text group message list.  It includes all our daughters out here in Arizona and two of their significant others.  A third significant other and the woman I consider my niece just asked to be added to the list.

I’d thought it was a burden, but these younger, (thankfully) healthy people WANT to help us out when we need it.  Maybe this would be a good idea for you.SlowItDown business card

Until next week,

Keep living your life!

From The Military To Potatoes

Memorial Day

Today is Memorial Day, a day to be especially grateful to those who lost their lives making sure the rest of us were safe.  I wondered if some of our fallen warriors had chronic kidney disease although the scientific history of our disease is so recent. I’ve spent the last several days researching CKD and the military in an attempt to answer my own question, yet haven’t quite succeeded.

All I know is that some of our present protectors have CKD.  This is how I discovered that:

The National Institutes of Health offered a particular Funding Opportunity Application [FOA] on December 1st, 2011, with the first submission being accepted on January 14, 2012.

“The goal of this FOA is to encourage Research Project Grant (R01) applications on prevention and treatment of obesity, diabetes, and chronic kidney disease in military personnel (active duty and retired) and their families. “

Notice “active duty” in that sentence. Both The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) participate in this study.  Unfortunately, my attempts to follow up on the study consistently brought me back to the FOA. You can read the FOA at http://grants.nih.gov/grants/guide/pa-files/pa-11-260.htmlNIH

The Department of Defense’s Instruction for Medical Standards for Appointment, Enlistment, or Induction in the Military Services “…Establishes medical standards, which, if not met, are grounds for rejection for military service. Other standards may be prescribed for a mobilization for a national emergency….”

As of September 13, 2011, according to Change 1 of this Instruction, the following was included:

“Current or history of acute (580) nephritis or chronic (582) chronic kidney disease of any type. “

Until this date, chronic kidney disease was not mentioned.  You can read this for yourself on page 27 of the document at http://www.dtic.mil/whs/directives/corres/pdf/613003p.pdf.  I cannot explain the seeming contradiction between the FOA and the Directive.

NimaAlthough, when my daughter Nima Rosensfit– researcher par excellence – asked me if I had a particular request for Mother’s Day, I asked her for research on the early history of CKD.  She found there wasn’t very much until fairly recently.  The fact that the first set of clinical practice guidelines (K/DOQI comprised Chronic Kidney Disease: Evaluation, Classification and Stratification) wasn’t published until February, 2002, may account for the lack of information from the military.These may be found at http://www.kidney.org/professionals/kdoqi/pdf/prot.pdf

While my information is inconclusive (at best), I sincerely hope that our warriors – whether on active duty or retired – have the same kind of care for their CKD as those of us who are civilians do.  Thank you again… and again…and again to our protectors, including my Bear. 2013-05-10 14.53.10-6

Yesterday, we were invited to several events.  One of these was a birthday brunch for my step-daughter, Lara Garwood.  Her sweetheart made certain there was food I could eat.  When my eyes lit up at the sight of baby potatoes (I’m Russian by heritage.), he commented, “I leached the potatoes, sort of.”

Book CoverLet’s go back to basics here for a moment. On page 134 (Do a word search instead of relying on the page number if you own a digital copy of the book.) of What Is It And How Did I Get It? Early Stage Chronic Kidney Disease, I define potassium as,

“One of the electrolytes, important because it counteracts sodium’s effect on blood pressure.”

Dictionary.com tells us that electrolytes are:

“…any of certain inorganic compounds, mainly sodium, potassium, magnesium, calcium, chloride, and bicarbonate, that dissociate in biological fluids into ions capable of conducting electrical currents and constituting a major force in controlling fluid balance within the body.”

Potassium is necessary for the nerves and muscles. The heart is a muscle. But our compromised kidneys cannot eliminate enough potassium from the blood before it travels back to the heart. This may lead to heart attack… or kidney failure. It’s a chicken and the egg kind of thing.

These are the acceptable values of potassium in your blood. As you can see, there is a difference in the values for adults and children of various ages. Thank you everydayhealth.com at http://www.everydayhealth.com/health-center/potassium-k-in-blood-results.aspx for the chart.

Potassium (K)
Adults: 3.5-5.2 milliequivalents per liter (mEq/L) or 3.5-5.2millimoles per liter (mmol/L)
Children: 3.4-4.7 mEq/L or 3.4-4.7 mmol/L
Infants: 4.1-5.3 mEq/L or 4.1-5.3 mmol/L
Newborns: 3.7-5.9 mEq/L or 3.7-5.9 mmol/L

 

depression-cause-heart-attack-1I went to Kidneys.com at http://www.yourkidneys.com/kidney-education/Diet-and-nutrition/Potassium-and-early-stage-kidney-disease/3191 to see what, if any, the symptoms of high potassium levels are.

  • Nausea
  • Weakness
  • Numbness or tingling
  • Slow pulse
  • Irregular heartbeat
  • Heart failure

Now, keep in mind that at early stages of CKD you may not have high levels of potassium.  The idea is to keep your levels low so that you do not do damage to yourself since your kidneys are not doing such a great of eliminating it.

But here’s the kicker: raising potassium levels could lower your blood pressure. Remember high blood pressure is the second leading cause of CKD.  Just like riding a bicycle, it’s all a matter of balance.

Since being diagnosed, I’ve leached the potassium out of potatoes by cutting them into pieces, soaking them in water for four hours, changing the water, and letting them soak again or soaking them in the refrigerator overnight.  That’s a lot of time involvement, time I knew my almost son-in-law did not have in his schedule.potatoes

So I researched for a less time consuming method that I could mention to him.  I wanted to eat what he prepared, but only if it didn’t cause my CKD to progress. I was surprised to discover that the only effective way to leach potatoes and other vegetables is to double boil them.  Thank you to Kidneycoach.com at http://www.kidneycoach.com/356/potassium-leaching-study-shows-not-all-leaching-methods-work/  for this new, researched, effective method.

However, I find that new research disparaging. Sure, the potassium is out, but boiled potatoes?  And other vegetables since all contain some level of potassium?  How is that appetizing?  Then again, I like being alive, I like not being on dialysis, so I will just cope.

Talking about coping, electronic sales of the book are doing so nicely.  Feel free to share them with friends and tell others where you got them.  The name of the game is get the information about slowing down the gradual decline of your kidney function out to the public.  After all, that’s how SlowItDown was named.SlowItDown business card

Until next week,

Keep living your life!

A Foggy Day… in Your Brain

Coffee Beans_0I don’t know about you, but I thoroughly enjoy my 16 ounces of coffee a day.  I savor it and draw those two cups out as long as I can.  I relish the taste and adore the aroma.  And, I thought they would cut through what I’ve discovered is called ‘brain fog.’

To be honest, I’d never heard the term before.  Maybe I live too sheltered a life… or maybe I just didn’t realize it had anything to do with me.  After all, I don’t do drugs or drink.  I do get eight hours of sleep a night, follow the renal diet, and exercise just about every day.  So what does brain fog have to do with me or any other renal patient?

You probably know this blog is posted on as many Chronic Kidney Disease Facebook pages as I could find.  These are not for medical advice, but for sharing ideas and information – always with the warning that none of us are doctors.  That’s the same warning I mention in the blog.Book Cover

I receive daily notices of who posted what where.  I noticed a question about brain fog and was surprised at the responses.  The question asked who else suffered this cloudiness of thought and what stage they were in.

Once I understood what brain fog was, I imagined the responses would all mention end stage.  They didn’t.  I saw all stages from 2 through 5 mentioned.  I was grabbed by the fact that no one in stage 1 had responded and that’s when brain fog became the topic of today’s blog.

According to integrative medicine expert Dr. Isaac Eliaz, when experiencing brain fog:

“…people feel as if there is a thick fog dampening their mind. While the medical and mental health establishments don’t generally recognize brain fog as a condition, it’s a surprisingly common affliction that affects people of all ages. Symptoms include pervasive absentmindedness, muddled thought processes, poor memory recall, difficulty processing information, disorientation, fatigue, and others.”

You can read more at http://www.rodalenews.com/brain-fog.brain

Sound familiar?  Maybe that explains why you couldn’t find the tea bags in their usual spot even though they were there.  Or why you didn’t speak with the person you meant to about a certain subject (Yep, me and SlowItDown with a potential community), but just chatted instead.

While this is interesting, what does it have to do with renal disease?  I know there are readers who only want to read about subjects that affect us as sufferers of this disease.  I know because I get a good laugh when they ask what a particular blog has to do with renal disease.  It’s obvious they haven’t read the blog since the blog is ONLY about renal disease, but just commented instead.  But, more importantly, that’s why I write the blog.

So I did what I love to do: researched the topic. Here’s what I found:

www.naturopathconnect.com offered me my first insight into how our kidneys and brain fog are connected.

“Make sure your liver and kidneys are not overloaded or congested. When your liver and kidneys are not functioning well, they are less able to clear your system of the multitude of toxins that float around in your bloodstream. When your body is overloaded with toxins, your brain suffers as well….Dehydration may be a key factor in less-than-optimal kidney function, so water is essential to keep the kidneys in tip-top shape.”

Got it – toxins.  Uh, what toxins?  And how do they affect the brain, I wondered.  Back to researching.blood

Dr. Martin Morrell of healthtap.com offered an explanation. However, this is not an endorsement of him or the site.  I am not a fan of asking online doctors unfamiliar with your particular medical history for advice.

“… if your blood urea increases, which is supposed to be cleared by your kidneys, this ‘poison’ will affect the ability of the brain to work properly.”

Oh, blood urea. Well that explains it. But how can I explain blood urea?  I’ll allow the experts to do that.

http://www.patient.co.uk/health/routine-kidney-function-blood-test has the simplest explanation.

“Urea is a waste product formed from the breakdown of proteins. Urea is usually passed out in the urine. A high blood level of urea (‘uraemia’) indicates that the kidneys may not be working properly, or that you are dehydrated (have a low body water content).”

In the U.S., we call this test B.U.N. or Blood Urea Nitrogen Blood Test.  So as I understand it, if your protein intake is high, more urea is produced.  But since your kidneys are already compromised by CKD,  the toxins remaining in your body are not eliminated as well and are still in the blood that flows through your brain.  That’s logical.

blood_test_vials_QAThe more urea remaining in your system, the more sluggish your brain.  It does sound like a perfectly formed ‘if-then’ equation from probability theory. The only difference here is that this is not a theory, but, rather, what we may encounter as CKD patients.

What to do?  What to do?  Obviously, keeping our protein intake low will help.  My renal diet limits me to five ounces of protein a day. I rarely ingest more protein than that. Well, bully for me!  So how else can I alleviate my sometimes brain fog?

I was all over the web on this one and found that besides what I was already doing for my CKD, I could also avoid heavy metal (and I always thought that was a kind of music) exposure, use a blue light, get myself some natural sun light, check my medication side effects and lots more.  This is the stuff of several blogs.

It’s real.  Brain fog could be affecting you, especially if you have CKD.  And from what I’ve read, once you’ve gotten your CKD slowed down as much as possible, the other ‘fixes’ are easy.

Okay, so coffee’s not going to help here but I’ll drink it anyway.SlowItDown business card

I just got the report from my publishers.  Thanks to all of you who brought the book as Christmas, Chanukah, or Kwanzaa presents.  That was a good month for sales which allows me to donate even more books.

SlowItDown is slowly progressing. Interesting choice of words there. We have new educators in New York and Washington, D.C. and – frankly – need your help in finding the communities that need us.

Sweet 16Between birthday parties (Happy Sweet 16, Olivia Vlasity!) and graduations (Congratulates on that and acceptance to U. of A. College of Medicine, Jordan Mudery), and the chance to spend time doing nothing graduationwith Bear, this was almost the perfect weekend for me.  Here’s to many of those for you!

Until next week,

Keep living your life!

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