It Hurts, But Just a Little

Are you watching out for your health? It’s been pretty busy over here with Bear’s retirement, the impending death of a loved one, Nima’s visit to say goodbye to Cheryl, and life in general.  That might explain why I just plain forgot about watching out for mine – specifically, the pain in my shoulder. Bear is officially retired, Nima’s gone home, there’s nothing more to do for Cheryl and it’s life as usual so the pain is back.  It hurts, but just a little.  NSAIDS are out of the question, or are they?
I forgot to mention my computer is fried (Do you think I use it too much?), so I pulled out my trusty laptop to write this blog… and found some interesting – if older – articles I’d saved. The first one to hit my eye (figuratively, literally would have prompted a whole new discussion of pain killers!) was about the NSAID controversy. NSAID means Non-Steroidal Anti-Inflammatory Drug. Steroids have an adverse effect on the kidneys in that they strain the kidneys during filtration.

One of these articles discusses weighing the risk against the benefits of taking NSAIDS. I also have osteoarthritis, but prefer to take Limbrel – a food medication (by prescription only) to deal with the pain preventatively.  I am afraid of damaging my kidneys further and am not willing to take NSAIDS. I went off the Limbrel for a while since it’s so expensive, but noticed the pain in my elbows right away. That’s when I decided the cost of the Limbrel was worth it if it meant no NSAIDS. That was my personal version of weighing the risks against the benefits. You can read this article at http://www.reuters.com/article/2011/09/13/us-kidney-disease-idUSTRE78C6D820110913.

Reading MedScape’s coverage of the same study made me realize that 96% of the mild CKD patients in the study were unaware of their diagnose. This article at http://www.medscape.com/viewarticle/749705?src=nl_topic also mentions that at the 2011 date of publication  far more patients were aware of their diagnose than during the actual study which took place between 1999 and 2004.  I think it’s this careful communication between nephrologist and patient that allows us, as the patients, to make informed decisions for ourselves.

I would like to see more of this, though.  I’m still waiting for my own nephrologist to call me back about the steroidal drugs I was given during my cataract surgery although I clearly explained to the ophthalmologist that I have CKD and wanted nothing that would harm the kidneys.  I’m beginning to wonder if doctors other than nephrologists know what drugs are harmful to the kidneys. But, then again, I’m also wondering why my specialist can’t either return a phone call or ask his MA to do so. Am I nervous about this? You bet. I am actually looking forward to seeing my primary care doctor (that’s right: primary care) for my quarterly blood test since she also orders a GFR reading.

Keeping the drug theme going, you may have noticed comments from Colleen Cheuvront about a drug treatment for late stage CKD with type 2 diabetes. While the drug is in phase 3 trials, I have found quite a bit of information on it and some of that not quite as positive as Colleen would have us believe.  By the way, Colleen, thank you for bringing Bardoxolone Methyl to my attention.  I will be watching the results of the trials very closely.  I am trying so hard to avoid dialysis and this just might be helpful. I don’t have diabetes of any type, but am hoping if this drug is successful, it may lead to the discovery of a drug for CKD that is effective even if you don’t have diabetes. (Hello, Pollyanna, haven’t seen you in a while.)

According to the US National Library of Medicine (www.ncbi.nim.nih.gov.pubmed/22859857), Bardoxolone Methyl does accomplish what the manufacturer says it does: ”  increases estimated GFR,  and decreases BUN, serum phosphorus and uric acid concentrations in patients with moderate to severe CKD. ”  However, it also raises albuminuria – not good for CKD patients. No mention of diabetes was noted here.

As for side effects, The New England Journal Of Medicine mentions not only the muscle spasms, but the more common gastro-intestional adverse reactions. (www.nejm.org/doi/full/10.1056/NEJMoa1105351#t=articleResults).  Right now, the internet is awash with information about this new drug.  I am neither pro nor con, so I’d recommend you research it.  This could be very exciting!

I just realized the book is on sale not only in Europe as well as the United States, but also in India where the blog has 1,300,000 readers.  The word about CKD is getting out there.  I feel so gratified.  Be sure to tell those who need it where they can get the book or read the blog.  Remember that if they cannot afford the book and want to read it they need only send me the name and address of their nephrologist.  Then I’ll visit my pretty little local post office (well, it’s really the setting of the building that’s so pretty) and mail a copy out to the doctor. For those of you not feeling the effects of the economy, look for the book in print and/or digital at Amazon.com or BarnesandNoble.com.  You know, you can always leave a message for me at 623-266-2609 to order a book or ask questions.  I’m laughing now because I realize I haven’t been this available since I was a single working mom with little kids.

 


Until next week,

Keep living your life!

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