A1C! A1C! (Sounds like a Cheer to Me!)

For those of you who don’t know us personally, we do a lot of eating out during celebrations.  (Is Labor Day an eating out kind of holiday?) August is full of birthday celebrations.happy birthday

We started off by celebrating Sean’s August 20th birthday early since he and Kelly were going to be in Michigan with his family on his actual birthday.  I somehow magically found Salute Ristorante Italiano (http://www.saluteaz.com/) in Phoenix which actually had a delicious meal that required no substitutions whatsoever for me… and they didn’t know that I was coming or that I had renal disease.  Hurray for them!  It was Sean’s celebration, but I felt I was the one who’d gotten a present.

Bear’s birthday was the 23rd.  On the spur of the moment, we decided to go to Buca de Beppo’s (www.bucadibeppo.com) for a late lunch/ early dinner since I had a Landmark Worldwide class that night and we wanted to do something to celebrate.  This meal didn’t turn out so well for me.

While Bear ordered a delicious meal, I could taste the salt in the cheese ravioli with meat sauce.  The meatballs weren’t salty, but they were still red meat.  Let’s see:  cheese, red meat, and salt.  Good thing Bear also ordered a salad. Then I completely blew it by having half a chocolate chip cannoli in chocolate sauce while the wait staff sang Happy Birthday to Bear.  Amazing how fast the body lets you know you’re not doing right by it.ravioli

The next day, I’d promised to take Bear to his favorite restaurant for his favorite meal before we went to hear Greg Warren perform at Stand Up Scottsdale (http://standupscottdale.com).  While Greg Warren (www.gregwarrencomedy.com) was an excellent choice, Flo’s (www.madebyflo.com) was a renal diet disaster.  This is in no way a bad review for Flo’s, but rather a bad review for deviating from the renal diet.

Once or twice a year, I indulge myself with their scrumptious house fried rice… even though it’s fried.  But not the day after a meal that did me no good!  To make it worse, they must have changed their recipe for the Vietnamese Spring Roll. It was deeply fried with a very mushy interior. By the time, Bear’s complimentary dessert of chocolate covered wonton surrounding a slice of orange arrived, I was very happy to eat just the orange.

Ah, but we’re not done.  Grown children Abby, Lara, and Lara’s sweetheart joined us for ‘The Mortal Instruments: City of Bones’ (Eh.  Maybe I wasn’t in the mood.) and dinner at Claim Jumpers (www.claimjumper.com/) afterward.  This is a place where Bear usually shares a really tasty renal diet meal with me… but not on his birthday: ribs, mashed potatoes, roasted veggies with sour dough cheese bread and then a taste of the chocolate cake a la mode.  All I have to say is, “What the dickens is wrong with me?!?!?!?!?”

sad faceMy poor beleaguered body could not keep up with so many foods I usually do not eat and I felt physically ill.  To make matters worse, my A1C will be a mess this time around.

Oh, right, A1C.  That’s the topic of today’s blog.  Let’s start the way we usually do with a definition. I picked up Amgen’s Understanding Your Lab Values: A guide for patients with chronic kidney disease. While this is a drug company (and I don’t recommend any drugs; that’s up to your doctor), their informational guides are usually clear and straight to the point.  They define A1C as, “a test that measures your average blood glucose levels over 2 to 3 months.”  Mine is evaluated via my usual quarterly blood draw.

You’ve probably figured out that this has to do with diabetes or pre-diabetes. According to DaVita at http://www.davita.com/kidney-disease/causes/diabetes/the-a1c-test-and-patients-with-chronic-kidney-disease/e/7802, people with Chronic Kidney Disease should keep their A1C readings between 4.0 and 5.9%.  Mine has been rising steadily for the last several years and is presently at 6.1, which is considered pre-diabetic.

Okay, so your glucose levels can be tested for a two to three month average and over a certain percentage is considered pre-diabetic.  What is so important about blood glucose anyway?A1C

Our old friend MedicineNet at http://www.medterms.com/script/main/art.asp?articlekey=32858 tells us blood glucose is:

“The main sugar that the body makes from the food in the diet. Glucose is carried through the bloodstream to provide energy to all cells in the body. Cells cannot use glucose without the help of insulin.

Glucose is a simple sugar (a monosaccharide). The body produces it from protein, fat and, in largest part, carbohydrate. Ingested glucose is absorbed directly into the blood from the intestine and results in a rapid increase in blood glucose. Glucose is also known as dextrose.”

Got it!  We need blood glucose for energy.  And the cells need insulin to provide this energy from glucose. Well, how is this a problem?  Wait a minute – insulin – diabetes.  Oh, my!

I’m getting close to diabetes.  All right, then let’s look at diabetes.  What’s that? Well, we can figure out it’s the body’s inability to handle a surplus of glucose in the body, but what harm is it specifically to you (and me) as a Chronic Kidney Disease patient?

According to Diabetes.co.uk at http://www.diabetes.co.uk/how-does-diabetes-affect-the-body.html, “The kidneys are another organ that is at particular risk of damage as a result of diabetes and the risk is again increased by poorly controlled diabetes, high blood pressure and cholesterol. “

I am not liking this. I’m already being treated for hypertension [high blood pressure] and hyperlipidemia [high cholesterol].  I don’t think I can afford to add diabetes to the list.  And that’s why next week’s blog will be about diabetes.

talkingstickresortThank you for all the support you’ve shown for SlowItDown, the project to bring free CKD education by trained educators to any community that needs it. It was our pleasure to be part of The Fourth Annual Men and Women’s Gathering at Talking Stick Resort this past Thursday.  This was hosted by The Salt River Pima – Maricopa Indian Community and open to all tribes.  Non-tribal members were welcome as well.

Several medical professionals, including nephrologists, have offered to help make this an interactive blog.  Please send your questions in comment form and we will answer them as quickly as possible. I’m enjoying the change of direction for the blog.

And to think this all started when I wrote What Is It And How Did I Get It? Early Stage Chronic Kidney Disease because I needed answers.

Until next week,

Keep living your life!

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