The End of the Nephrologist’s Report

You’re right.  This was a long report.  It actually is only two pages, but in blogging, it needed to be chopped into sections or I would have lost most of you a long time ago.  I’m surprised at how much I get out of reading it each time I work with this report.  I thought I had it practically memorized by now, but I keep noticing new information.  Well, not new, I’ve read it before – but information I’m first paying attention to.  So let’s finish up this report.

The IMAGINING STUDIES section was followed by the nephrologist’s IMPRESSIONS, which started out with “Chronic Kidney Disease Stage 2, estimated glomerular filtration rate of 60-5 mL/min, likely secondary to presumed hypertensive nephrosclerosis.”  That means kidney damage due to HBP. (Even though the high blood pressure had been treated for the last 20 years?  I did ask and was told simply, “Yes.”).

Ironically, the next item in IMPRESSIONS was “Hypertension, well controlled on current medications.”  (I asked the same question  again and was told “yes” again.) Then there was mention of the cysts. Surprisingly, I also had iron deficiency without anemia.  I somehow never connected my fatigue with kidney disease, but I was learning. My history of dyslipidemia [high tryglycerides or cholesterol or both] and my nephrolithiasis [kidney stone] were mentioned, too.

Finally, the nephrologist’s RECOMMENDATIONS. These included starting ferrous sulfate [iron] 325 mg. p.o. [by mouth] at noon.  Why noon? It seems you’re meant to take this with a meal to minimize the chance of stomach upset. I suppose that made sense, but I was alternately teaching and acting at night, so noon was not a meal time for me.

The vitamin C I had been taking was eliminated since it has high oxalate [combines with calcium to form kidney stones] consistency which could cause further nephrolithiasis.

I had read of Omega 3 therapy being helpful in retarding the development of CKD and discussed this with my doctor. In this section of the nephrologist’s report, he agreed that I could safely take 1200 mg. one tablet p.o./b.i.d. [twice a day].

Here’s a tricky one: I was to continue drinking at least 64 ounces of fluid  [eight cups] a day but not more.  Yes, I did start keeping track.  I knew a cup of coffee was eight ounces, and I had two a day.  That left me with 48 ounces which I kept to water unless I had four ounces of soy milk with my morning cereal. But then I discovered that some things I’d always thought were solids are really liquids.  I’ll be writing about this in more depth in a later blog since it requires an extensive explanation.

The report, of course, ended with a one – two punch: I would need to exercise for at least 30 minutes a day and possibly decrease food portions, so I could lose weight (all right already!  I got it!) for better blood pressure and renal function. Below that were my provider’s name and other information identifying the electronic file.

Although I had carefully looked up every term I didn’t know and had sat with this report for days while I did, I felt like I’d been run over by a truck – a big one.  That’s when I decided (yet again) I had to research everything I could about this disease.  I read, I Googled, I sat in the library right next to the reference librarian, and I made a pest of myself at my doctor’s office via phone calls and unscheduled visits – not the way to endear yourself to someone you need on your side.

In an unusual way, this paid off.  I discovered I couldn’t find what I wanted in one book, and it took too long to extract one bit of information from this source and another from that.  I didn’t see the purpose of every newly diagnosed CKD patient hoeing the same row.  I decided to take my doctor’s challenge: I would write that book I needed about early CKD.  That book is now in final edits and will be available in early 2011 (if I have my way).  Gee, shameless, blatent self promotion feels so good.

On that happy note,

Keep loving your life.

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2 CommentsLeave a comment

  1. book long overdue; article in this month’s Atlantic re: dialysis very interesting

    • You’re right. I’ve got my fingers in too many pies. I will NEVER teach, take a course, write a book and shoot a film at the same time again. I mean it. Really. I’m serious this time.

      I’m pushing for end of the year publication, but I think these things always take longer than you think.

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