You’re Bringing What?

I have stayed overnight in the hospital three times in my life: once for a concussion, of which I don’t remember anything (No surprise there.), and twice for the birth of each of my daughters, of which I only remember the actual births. I’m facing a six to thirteen day stay towards the end of the month… and I just don’t know what to bring or why. While it’s not a kidney related stay, as Chronic Kidney Disease patients we all know CKD patients may need to stay in the hospital, too, for transplants,  kidney cancer, or other reasons.

I got a call from the surgeon’s office today. They were able to explain what to bring on the day of surgery: nothing. It seems there are no lockers to hold valuables while you’re in surgery. While I took a breath to contemplate life without my phone and/or iPad, it was explained that I would probably be sleeping until the next day, anyway. I didn’t know that. Hmmm, maybe I’ll just bring a book – a real book – for that first day… just in case I wake up. I can bring a paperback so I won’t care if it’s ‘mislaid.’ Or can I?

All right, enough guessing. Let’s do some researching here. This is from MedicineNet at https://www.medicinenet.com/hospital_10_tips_packing_for_a_hospital_stay/views.htm:

  1. Documents and paperwork. Ideally, you should bring all the necessary paperwork in one folder, preferably the kind with a tie or snap closure to guarantee that important documents will not be lost. Don’t forget insurance cards, a list of all the medications you are currently taking, and a list of telephone numbers of family and friends. If you have a written power of attorney or living will, always bring those along with you too.
  2. A small amount of money for newspapers, vending machines, and such. Bringing credit cards or large amounts of cash is not recommended, since theft can occur in hospitals. It is also a good idea to leave all jewelry at home, it is one less thing to worry about losing or being stolen.
  3. Clothing. You may want to bring comfortable pajamas or lounging clothes, if you’ll be able to wear your own clothing. Bring a supply of loose-fitting underwear and comfortable socks …. A cardigan-style sweater or bed jacket can help ward off the chills. Make sure you have slippers to walk around in the hospital and one pair of regular shoes (in case you’re allowed to walk outside, and you’ll need them for the trip home anyway).
  4. Eyeglasses, if you require them.
  5. Writing paper and pen, for making notes or recording questions you want to ask your doctor
  6. A prepaid phone card for calls from your room telephone.
  7. Toiletries. You can bring your toothbrushtoothpaste, lotion, deodorant, soap, shampoo, a comb or hair brush, and other toiletries from home, but avoid perfumes and any highly scented products. Lip balm is also a good addition to your toiletries kit.
  8. Something to occupy your time – Bring books or magazines to help pass the time….
  9. Photos or small personal items. Many people enjoy having a couple of small framed photos or mementos from home to personalize their hospital space.
  10. Finally, check the hospital’s policy about electronic items before you pack your laptop, portable DVD player, MP-3 or CD player, or cell phone. In particular, cell phone use is forbidden in many hospitals since it may interfere with electronic patient monitoring equipment. Don’t forget that high-end electronic items can also be targets for theft – if you are allowed to bring them, make sure that a relative or friend takes them home or that they can be safely stored when you’re sleeping or not in your room.

Now, wait a minute. I get it that MedicineNet may be referring to the day after surgery. But, in my case, that means I prepare a bag and give it to my daughter to bring the next day. The staff at the surgeon’s office did tell me the hospital will provide a toothbrush and toothpaste, but will they allow me to bring the BiPap that I use for sleep apnea or the mouth piece I sleep with to prevent my jaw from locking? Let’s look again.

U.S. News has some of the same items on their list at https://health.usnews.com/health-news/patient-advice/slideshows/11-items-to-pack-in-your-hospital-bag?onepage :

To recap, here are 11 items to pack in your hospital bag.

  • Loose, warm and comfortable clothing.
  • Your own pillow.
  • Your own toiletries.
  • Flip-flops.
  • Earplugs and earphones.
  • Comfort flicks.
  • Escapist books.
  • Laundry lists: of your medications, doctors and family and friends.
  • Pen and paper.
  • Scents.
  • Drugstore supplies.”

They also make a really good point about bringing you own medications and toiletries so you’re not being charged for them by the hospital. I would avoid the scents just because so many people are scent sensitive these days.

 

I was still a bit confused, so I went to my hospital’s website. I learned that not only are cell phones permitted, but Wi-Fi is offered for free. Great. What more can I find out about what to pack, I wondered. My biggest desire was for Shiloh, my comfort dog, to be with me but I knew that wasn’t going to happen.

I thought VeryWellHealth at https://www.verywellhealth.com/what-to-pack-for-the-hospital-3157006 was more realistic about what to pack and I especially appreciated the warnings about electronics:

“You won’t have a lot of space to store things, so try to fit everything you need into a standard roll-on bag. Be sure that is well labeled and is lockable as an extra layer of security.

Among the things you should include on your packing checklist:

  • Personal medications, preferably in their original container so that the nurse can find them for you if you are unable to reach them
  • A list of your current medications to add to your hospital chart, including names, dosages, and dosing schedule
  • Comfortable pajamas (loose-fitting is best)
  • A light robe for modesty, especially in a shared room
  • Slippers with rubber soles (to prevent slipping)
  • Plenty of socks and underwear
  • Toothbrush, toothpaste, and deodorant
  • Hairbrush or comb
  • Soap, skin care products, and hair care products if you prefer your own (ideally travel size)
  • Special needs products like tampons, sanitary pads, or denture cream
  • Glasses (which may be easier than contacts if you think you’ll be dozing a lot)
  • Outfit to wear home (something loose is best, also make sure it won’t rub on your incision)
  • A cell phone charger for your cell phone
  • Your laptop charger if you intend to bring one
  • Earplugs if you are ​a light sleeper
  • An eyemask if you are used to black-out curtains
  • Entertainment such as books, a portable DVD player, puzzles, or magazines
  • Earbuds or earphones for your P3 or DVD player
  • Non-perishable snacks, especially if you have dietary concerns (such as diabetes or chronic medications that need to be taken with high-fat foods)”

One quick call to the hospital to see if they have any additions to make to these lists and I’m ready to pack. How about you?

Until next week,

Keep living your life!

Sex?

I know, I know. When you see that question on an application, you want to answer ‘yes,’ but you’re only given the choice of male or female. Well, at least that’s my experience. Okay, got that out of the way.

Way back in 2011, the following was included in my first Chronic Kidney Disease book, What Is It and How Did I Get It? Early Stage Chronic Kidney Disease. This was way before the website, Facebook page, the blog, the Instagram, Pinterest, Twitter, and LinkedIn accounts. Way before the articles, radio shows, and interviews, book signings, and talks about CKD. Come to think of it, this was way before SlowItDownCKD was born.

I haven’t found too much about sex that’s different from the problems of non-CKD patients although with this disease there may be a lower sex drive accompanied by a loss of libido and an inability to ejaculate. Usually, these problems start with an inability to keep an erection as long as usual. The resulting impotency has a valid physical, psychological or psycho-physical cause.

Some of the physical causes of impotence, more recently referred to as Erectile Dysfunction [E.D.] for a CKD patient could be poor blood supply since there are narrowed blood vessels all over the body. Or maybe it’s leaky blood vessels. Of course, it could be a hormonal disturbance since the testicles may be producing less testosterone and the kidneys are in charge of hormones….

While E.D. can be caused by renal disease, it can also be caused by diabetes and hypertension. All three are of importance to CKD patients. Sometimes, E.D. is caused by the medications for hypertension, depression and anxiety. But, E.D. can also be caused by other diseases, injuries, surgeries, prostate cancer or a host of other conditions and bodily malfunctions. Psychologically, the problem may be caused by stress, low self-esteem, even guilt to name just a few of the possible causes….

Women with CKD may also suffer from sexual problems, but the causes can be complicated. As with men, renal disease, diabetes and hypertension may contribute to the problem. But so can poor body image, low self-esteem, depression, stress and sexual abuse. Any chronic disease can make a man or a woman feel less sexual….

Common sense tells us that sex or intimacy is not high on your list of priorities when you’ve just been recently diagnosed….

Sometimes people with chronic diseases can be so busy being the patient that they forget their partners have needs, too. And sometimes, remembering to stay close, really close as in hugging and snuggling, can be helpful….

Well, what’s changed since I was writing What Is It and How Did I Get It? Early Stage Chronic Kidney Disease? in 2010?

The National Kidney Foundation at https://www.kidney.org/atoz/content/sexuality now includes the following on their website:

It’s important to remember that people with kidney failure can have healthy marriages and meaningful relationships. They can fall in love, care for families, and be sexual. Staying intimate with those you love is important. It’s something everyone needs.

Many people think that sexuality refers only to sexual intercourse. But sexuality includes many things, like touching, hugging, or kissing. It includes how you feel about yourself, how well you communicate, and how willing you are to be close to someone else.

There are many things that can affect your sexuality if you have kidney disease or kidney failure — hormones, nerves, energy levels, even medicine. But there are also things you and your healthcare team can do to deal with these changes. Don’t be afraid to ask questions or get help from a healthcare professional.

DaVita at https://www.davita.com/kidney-disease/overview/living-with-ckd/sexuality-and-chronic-kidney-disease/e/4895 also offers advice:

Once again, it’s important to remember, you are not alone.

There are no limits with regard to sexual activities you may engage in as a patient with renal disease, as long as activity does not place pressure or tension on the access site, causing damage. (Me: This is for advanced CKD.)

If you are sexually active, practicing safe sex and/or using birth control are needed, even if you think you may be physically unable to have children.

Activities such as touching, hugging and kissing provide feelings of warmth and closeness even if intercourse is not involved. Professional sex therapists can recommend alternative methods as well.

Keeping an open mind and having a positive attitude about yourself and your sexuality may lower the chances of having sexual problems.

There are both medical and emotional causes for sexual dysfunction. The reason for your dysfunction can be determined through a thorough physical exam in addition to an assessment of your emotional welfare and coping skills.

Relaxation techniques, physical exercise, writing in a journal and talking to your social worker or a therapist can help you to feel better about your body image and/or sexual dysfunction.

Resuming previous activities, such as dining out or traveling, as a couple or single adult, can be helpful.

Provide tokens of affection or simple acts of kindness to show you care.

Communicate with your partner or others about how you feel.

According to the Kidney Foundation of Canada at file:///C:/Users/Owner/AppData/Local/Packages/Microsoft.MicrosoftEdge_8wekyb3d8bbwe/TempState/Downloads/Sexuality%20and%20CKD.pdf, these may be the causes of sexual problems in CKD.

Fatigue is a major factor. Any chronic illness is tiring, and chronic kidney disease, which is often accompanied by anemia and a demanding treatment, practically guarantees fatigue.

Depression is another common issue. Almost everyone experiences periods of depression, and one of the symptoms of depression is loss of interest in sexual intimacy.

Medications can also affect one’s ability or desire to have intercourse. Since there may be other medications which are just as effective without the side effect of loss of sexual function or desire, talk to your doctor about your pills.

Feelings about body image Having a peritoneal catheter, or a fistula or graft, may cause some people to avoid physical contact for fear of feeling less attractive or worrying about what people think when they look at them. (Me: Again, this is for late stage CKD.)

Some diseases, such as vascular disease and diabetes, can lead to decreased blood flow in the genital area, decreased sexual desire, vaginal dryness and impotence.

It looks like the information about CKD and sexuality hasn’t changed that much, but it does seem to be more available these days.

Until next week,
Keep living your life!

Good Enough 

Yesterday, I carefully applied my eye liner, examined myself in the magnifying mirror, nodded to myself and murmured, “Good enough.” I’ve been saying that an awful lot lately and finally realized – once a valued, constant reader asked about the connection between worsening vision and Chronic Kidney Disease – that it may be due to my CKD.

This, after I’ve spent years attributing “Good enough” to the slowest developing ever case of macular degeneration,  the age related need for reading glasses, and my impatience with makeup. Of course, then I remembered that I couldn’t read a darned thing without the reading glasses and, that without ample light, even they didn’t do the trick.eye liner

Back to the drawing board, ladies and gentlemen. Here’s what DaVita at http://www.davita.com/kidney-disease/overview/symptoms-and-diagnosis/eyes-and-chronic-kidney-disease/e/4732 has to say about CKD and vision.

Diabetes and high blood pressure aren’t only the leading causes of chronic kidney disease (CKD). They’re also the leading causes of eye disease and loss of vision. If your renal disease is a result of either condition your vision may be at risk.

Some of the most common eye problems that occur in CKD patients are retinopathy, cataracts and glaucoma.”

Here are some quickie reminders before we continue. The American Diabetes Association at http://www.diabetes.org/diabetes-basics/  tells us, “Diabetes is a group of diseases characterized by high blood glucose levels that result from defects in the body’s ability to produce and/or use insulin.”

Book CoverI turned to What Is It and How Did I Get It? Early Stage Chronic Kidney for a reminder about high blood pressure: “A possible cause of CKD, 140/90mm Hg is currently considered hypertension, a risk factor for heart disease and stroke, too.”

However, the American Heart Association has changed this a bit as of Dec. 2013. “The American Heart Association maintains its recommendation of initiating treatment — starting with lifestyle changes and then medication if necessary — at 140/90 until age 80, then at 150/90.” Yet, The Journal of the American Medical Association maintains that people over 60 should not be considered hypertensive until they register 150/90.

While that’s not new information to me, I did wonder how hypertension could affect your sight. The American Academy of Ophthalmology at http://www.aao.org/eye-health/ask-eye-md-q/how-does-high-blood-pressure-affect-vision came to the rescue here.

“If the blood pressure is very high it can be called malignant hypertension and cause swelling of the macula and acute loss of vision. Otherwise hypertension can cause progressive constriction of the arterioles in the eye and other findings. Usually high blood pressure alone will not affect vision much, however hypertension is a known risk factor in the onset and/or progression of other eye disease such as glaucomadiabetic retinopathy, and macular degeneration as well as blocked veins and arteries in the retina or nerve of the eye that can severely affect vision.”

My first response to this information was, “What’s an arteriole? A small artery?”  Time to find out. I turned to my old friend MedicineNet at http://www.medicinenet.com/script/main/art.asp?articlekey=2335 for the definition.arteriole in eye

“A small branch of an artery that leads to a capillary. The oxygenated hemoglobin (oxyhemoglobin) makes the blood in arterioles (and arteries) look bright red.”

That makes sense.  Do you remember what glaucoma and/or macular degeneration are?

Back to another trusted source for one of the definitions: The Mayo Clinic at http://www.mayoclinic.org/diseases-conditions/glaucoma/basics/definition/con-20024042.

“Glaucoma is a group of eye conditions that damage the optic nerve, which is vital to good vision. This damage is often caused by an abnormally high pressure in your eye.”

I sort of, maybe, remembered writing about macular generation in The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 2.Digital Cover Part 2 redone - Copy Sure enough, I found it.

“An eye disease that progressively destroys the macula, the central portion of the retina, impairing central vision. Macular degeneration rarely causes total blindness because only the center of vision is affected.” (according to MedicineNet at http://www.medicinenet.com/script/main/art.asp?articlekey=10027). Oh, MedicineNet again.  That’s a good source for easily understood medical definitions if you’re looking for one.

Let’s say you don’t have diabetes or hypertension.  Does CKD affect your vision then?  Interestingly enough, most sites I pulled up talked more about CKD being caught during an eye exam than CKD causing vision problems… except in diabetic End Stage Renal Disease.  This is when you need to have your eyes carefully checked and often.

PubMed, part of the US National Library of Medicine, National Institutes of Health, at http://www.ncbi.nlm.nih.gov/pubmed/21784818 puts a bit of a different spin on the vision/CKD exploration. “Retinal abnormalities are common in inherited and acquired renal disease.”

journal_logoWow! This is from an older study – 2011 – conducted by the well-respected Clinical Journal of the American Society of Nephrology.  I don’t know if my CKD is inherited or acquired, but it is renal disease and I do have vision problems… and so does my valued, constant reader.

By the way, blurred vision may be an indication that you are suffering from uremia. This reminder brought to you by the Renal Network’s Kidney Patient News at http://www.kidneypatientnews.org/ckd/index.php.

Of course, I can almost hear some of you asking what uremia is.  The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 1 was DIGITAL_BOOK_THUMBNAILof help here: it’s “the buildup of waste in the blood due to kidney failure.”

I really enjoy learning from the research I do to answer your questions, so thank you for another opportunity to do that. Just keep in mind that I’m not a doctor and you need to ask these questions of your nephrologist who will answer them or refer you to another specialist if need be.

Another birthday approaches – which I consider another opportunity to give you gifts.  Keep your eye on P2P’s Chronic Illness Awareness Buy and Sell’s page on Facebook and SlowItDownCKD on Facebook, Twitter, and Instagram in addition to this blog for Book Give- Away announcements.happy birthday

Last but not least, The  17th Annual Southwest Nephrology Conference and 4th Annual Convention of Cardio Renal Society of America will be held right here in Arizona at the We-Ko-Pa Resort & Conference Center in Scottsdale. The dates are March 11-12. I’ll be attending part of the time. Why not meet me? Register at www.swnc.org or by calling 1 (877) 587-1357.

Until next week,

Keep living your life!

To Wash or Not To Wash

Peggy Rickard belongs to the same Landmark Worldwide Center (an international personal and professional growth, training and development landmarkqrcompany) as I do here in Arizona.  I didn’t know her, but she wanted to perform a service project for one of her Landmark courses and she wanted it to deal with the kidneys. The manager of the center – the ever affable Philip Rand – knew I did “something with kidneys,” so he asked if I would call her.  When I did, it turned out that she has a medical advocacy business, but that had nothing to do with her project.

We had a wonderful conversation.  Here was someone in one of my other communities who spoke my kidney language. Peggy had already contacted The National Kidney Foundation of Arizona and learned from Dr. James Ivie, the Director of Patient Services, that what was really needed was to have the information leaflets about kidney disease and donation translated into Spanish since Hispanics are at a higher risk for kidney disease.

Kidney ArizonaMaybe I can pick out a few words of Spanish here and there, but she needed more. I couldn’t translate the leaflets into Spanish for her and didn’t know anyone who could.  That night, I went to the center for the completion session of The Wisdom Unlimited course in which I had been participating. In a greet-those-you-don’t-know moment, I spoke with Nathaniel (Nat) Garcia II – since he was the person directly in front of me – only to discover he is a missionary… and fluent in Spanish…and more than willing to do the translations.  Problem solved.

That got me to thinking about language. While taking a shower the next morning, the bottle of shampoo I was using caught my eye. It had the words ‘sulfate free’ in large letters on the label.  Hmmm, sulfate looks a lot like sulphur.  Are they related?

After checking a bunch of dictionaries, I decided to use the definition of The Medical Dictionary at http://medical-dictionary.thefreedictionary.com/sulfate since it seemed the simplest to understand.

“a salt of sulfuric acid”

Uh-oh, sulfuric means made of sulfur. Although the spelling may be different, sulfuric acid is highly corrosive. It’s also a mineral… and is used in both waste water treatment and fertilizer creation. Why would shampoo have this as an ingredient in the first place?shampoo

I figured the best person to provide an answer would be a hair stylist so I read Melissa Jongman’s article on http://hubpages.com/style/Sulfates-Are-they-damaging-your-hair-Why-to-opt-for-a-sulfate-free-shampoo

“Sulfates are detergents used to make the shampoo lather. They’re inexpensive to use in shampoos, which explains why more than 90% of shampoos contain them. The most common sulfates used in these shampoos are:

  • Sodium Lauryl Sulphate (SLS)
  • Sodium Laureth Sulphate (SLES)
  • Ammonia Laureth Sulphate (ALS)
  • TEA Lauryeth Sulfate (TEA)
  • Sodium Myreth Sulphate (SMS)”

This was not looking good.  Sulphur is something we, as Chronic Kidney Disease patients, need to avoid. As I explained in What Is It and How Did I Get It? Early Stage Chronic Kidney Disease, sulphur can further damage your already damaged kidneys.

Book CoverSo what can we do?  Not washing our hair is obviously not the answer. I googled shampoos without sulfates and came up with a list of 43 at http://sulfatefreeshampoos.org/sulfate-free-shampoo-list/#list. While the latest edit of this list was during this new year, I am not familiar with the editors nor the products. However, you can safely bet that I’ll try them.

Let’s go back to why sulfates are not good for CKD patients for a minute. I stumbled across a CKD education site called quizlet.com. Perusing this site, I found the statement that

“Very late CKD is due to reduced excretion of sulfates and phosphates.”

Of course! That makes perfect sense: as our kidney function declines, we are not excreting as much of these substances as we did before we were lucky enough (ouch!) to develop CKD and they build up.  That’s CKD 101.

A nervous me decided to see what other beauty or health products used sulfates. I discovered it’s used in body wash (Wait! Isn’t sulfate a skin irritant?), toothpaste, and nail polish. That tripped a thought. Didn’t I blog about that?

I used the search function on the blog only to find that that blog dealt with other chemicals in nail polish.  (Gritting teeth and crying out in anguish) Is nothing safe anymore? All right, pick a chemical… any chemical.

Looking at the ingredients in both hair products and nail polish, I chose phthalates. The Centers for Disease Control and Prevention (CDC) at http://www.cdc.gov/biomonitoring/Phthalates_FactSheet.html helped us out with this one:chemistry

“Phthalates are a group of chemicals used to make plastics more flexible and harder to break. … They are used in hundreds of products, such as vinyl flooring, adhesives, detergents, lubricating oils, automotive plastics, plastic clothes (raincoats), and personal-care products (soaps, shampoos, hair sprays, and nail polishes)….

How Phthalates Affect People’s Health

Human health effects from exposure to low levels of phthalates are unknown. Some types of phthalates have affected the reproductive system of laboratory animals. More research is needed to assess the human health effects of exposure to phthalates.”

Maybe the human health effects are unknown and maybe this passes quickly via the urine, but if you have Chronic Kidney Disease, you are not filtering your blood as well as other people.  Why take a chance of making it worse?

Now that I’ve probably made you fearful of using any beauty product on the market, be aware that there are many products without phthalate. Breast Cancer Action (Yes, there seems to be a connection between breast cancer and phthalates.) at http://www.bcaction.org/our-take-on-breast-cancer/environment/safe-cosmetics/phthalate-free-cosmetics/  offers a list of companies which produce phthalate free beauty aids.

DIGITAL_BOOK_THUMBNAILDigital Cover Part 2 redone - Copy

Let’s talk about service and gratitude for just a minute.  While I’ve always believed in service, it’s only since I’ve been diagnosed with Chronic Kidney Disease (way back in in 2008) that I’ve become aware of how very thankful I am for the little things in life – like spreading CKD Awareness by writing this blog, posting some CKD tidbit on Twitter daily, starting an Instagram account for SlowItDownCKD, and offering my books.  Thank YOU for being the readers.

Until next week,

Keep living your life!

But What Does That Mean?

11164740_10206320086664607_5860553690846776933_oI have to start off with gratitude to Team SlowItDownCKD for their willing participation in yesterday’s National Kidney Foundation of Arizona Kidney Walk. Abby Wegerski, Lara Garwood (and their ‘others’), Keith Harris, Patti DuBois, and Amy Vlasity with her children – Olivia, Willie, and Adam – all showed up bright and early.  I was so busy passing out book cards, speaking to others, and enjoying the dancing my team did that I neglected to notice which radio and TV stations were there.  Let me know if you can help out here.

Funny anecdote: when I presented Dr. Ivie of NKF of Az. with a copy of The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 1, he looked at it quizzically and said something to the effect that it looked thicker than the other one I’d given him.  He was actually referring to What Is It and How Did I Get It? Early Stage Chronic Kidney Disease.  Thank you, Dr. Ivie, for proving to me that I got the cover just right for everyone to know this is a series.Book Cover

I’m glad to report there are loads of questions about last week’s blog.  These are questions I was going to answer when I got the results, hopefully for next week’s blog.  However, I’ll happily yield to public demand.

To refresh your memory, the test in question is NutrEval (FMV Amino Acids) with Nutrient & Toxic Elements. Below is a scan of the orders.  Lots of different elements being tested here.  I could think of several ways to explain them, but turned to the CPT codes as what seemed to be the easiest way of doing so.

Notice there are CPT codes to the right of the profile components.  CPT means ‘Current Procedural Terminology” according to The American Medical Association (AMA) at http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page

I attempted to use the AMA code manager at https://ocm.ama-assn.org/OCM/CPTRelativeValueSearch.do?submitbutton=accept  where you can enter any CPT code. No go, it turned out the site required registration and payment. I also wonder if this is not a billing site.

Back to figuring this out.  Next I did a simple Google search. I did come up with a few sites, but they all seemed to be for billing purposes. Well, maybe I shouldn’t be using those codes.  Maybe they were codes used solely for billing.

Oh! Mental head slap!  That’s exactly why CPT coding was developed and what it’s used for. (Do you think I can get away with saying I’m still tired from yesterday’s walk as my excuse for not catching that immediately?)

IMG_0070Think!  What else could I do? I could do a simple search for the name of the test, couldn’t I?  I decided to find out. I looked for the most esoteric name I could find and settled upon 8-OHdG.  Anyone ever hear of it?  Me, neither. But Farley’s Free Medical Dictionary has.  This is at http://medical-dictionary.thefreedictionary.com/8-OHdG 8-OHdG 8-hydroxy-2’-deoxyguanosine.

A modified DNA nucleoside product generated by reactive oxygen species (ROS), which is elevated in colorectal carcinoma, but not in adenomas. 8-OHdG is also elevated in ulcerative colitis (UC) and increases with disease duration and dysplasia. MUTYH, the human mutY homologue, is responsible for excising misincorporated adenine and for suppressing mutations caused by ROS. Nuclear expression of MUTYH is attenuated in UC.

We have a choice here: wait for the nutrition counselor prescribing the test to explain this in detail IF the value is unacceptable upon testing or define each unknown separately.  I’m willing to wait until the test results are in.  Do tell me if you’re not and we’ll explore these terms together.

Maybe we’ll have more luck with another term.  Which one, though?  Ummmm, okay, let’s take a look at Pyruvic Acid. The same dictionary tell us this is

CH3COCOOH, an intermediate in carbohydrate, lipid, and protein metabolism.

Now we could look up CH3COCOOH but what good would it do?  We have what we need. We know carbohydrates, lipids (fats), and protein have to be metabolized in order to be of any use to us.  This acid helps to do that.  We can understand how a lack of or surplus of this could affect us. I’d pay special attention to this component since it’s the metabolism of these components that give us energy… or in my case, seemingly not enough energy.

Let’s try another one.  How about Behenic Acid this time?  I found this definition at Dictionary.com (http://dictionary.reference.com/browse/behenic+acid?s=ts).

a crystalline, saturated fatty acid, C 22 H 44 O 2, obtained from plant sources, used chiefly in the manufacture of cosmetics, waxes, and plasticizers.

Frankly, the definition left me scratching my head and wondering why I would be tested for that.  Wait! I’ve got it, but it’s supposition. Maybe too coxemeticsmuch of that seeping into my system would cause a problem.  Clogging?  If so, clogging what?

Drugs.com at http://www.drugs.com/dict/behenic-acid.html told me it’s

A constituent of most fats and fish oils; large amounts are found in jamba, mustard seed, rapeseed oils, and cerebrosides.

And that it has a synonym:  N-docosanoic acid. This is getting frustrating.  It’s at times like these that I wish I did have all the answers, but – as I keep saying – I’m not a doctor.

Okay, one more shot – this time at the synonym. Oh boy, the information about this is written in deep chemistry terms.  That’s a foreign language to me.  I will have the same questions for my nutrition counselor when the test results are in as you probably have reading this blog.

Hey, maybe I could work with a word I know – like manganese. Oh, sorry, that means

manganesea mineral that is found in several foods including nuts, legumes, seeds, tea, whole grains, and leafy green vegetables. It is considered an essential nutrient, because the body requires it to function properly.

Thank you to WebMD at http://www.webmd.com/vitamins-supplements/ingredientmono-182-manganese.aspx?activeingredientid=182&activeingredientname=manganese for information we could all finally understand.  It doesn’t help to have loads of information about a component if the information doesn’t make sense to you.  I’m the one who’s meant to simplify explanations and I couldn’t understand enough to explain to you.

On a happy note, I am more than willing to share both my results and the explanations the nutritional counselor offers me when they arrive.  You know that saying about sometimes it just doesn’t pay to even get out of bed….Part 2Digital Cover Part 1

 

Until next week,

Keep living your life!

Paint on My Nails

I am happy to say that we have had quite a few celebrations lately.  Abby successfully changed careers from insurance to municipal funding.  Lara was promoted to the first female Krav Maga head instructor in Phoenix. Nima started her New York tour company (Spellbound… give her a call.). firworksOne of my son-in-laws changed careers, too, and is now the CEO of an established firm.  Oh, and The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 1 was published.

Having four grown daughters now and in the throes of Macular Degeneration which is now at the point of I-can’t-see-my-nails-clearly-enough-to-do-them-myself (Why, oh why, couldn’t it be I-can’t-see-the-dishes-clearly-enough-to-do-them-myself instead?), I caved.  I don’t really like anyone fussing with any part of my body, but I wanted to look really nifty for each of these celebrations.  So I went for a manicure/pedicure again…and again…and again… and then I got to thinking.

Indeed, there is a relationship between Chronic Kidney Disease and nail polish, but it isn’t exactly what I expected.  I scurried right over to DaVita at http://www.davita.com/kidney-disease/overview/symptoms-and-diagnosis/hair,-nails-and-chronic-kidney-disease/e/  and found the following.

Nitrogen waste products build up in people with CKD, which can lead to damaged fingernails and toenails. Show your doctor if you have any abnormal change in your nails such as:

  • Yellow or opaque coloring
  • Brittle nails
  • Pitted nails (can easily break off or fall off)painted nails
  • Linear depressions across the fingernail (called Beau’s lines)
  • Ridge-shaped nails
  • Raised ridges, thin and concave shaped (called koilonychia)
  • White streaks, spots on the nails (called leukonychia)

It’s clear you can’t see these damage indicators if you can’t see your nails.  All right then, maybe I could have my nails done for the occasions, then take off the polish or the gel tips after.  Would that work for me, I wondered?

The concern over the chemicals found in nail polishes—and gel manicures—are {sic} not new, but the link to cancer, however, is. In a recent article published in the  Journal of the American Academy of Dermatology, Chris Adigun, M.D., an assistant professor of dermatology at NYU School of Medicine, emphasized the dangers of frequent use of gel manicures.  ”The essential UV light required during the application of the gel is a risk factor for skin cancer,” wrote Dr. Adigun.  “[And] in general, any manicure left in place for an extended period of time is not a good idea Journal of American Dermatologybecause you are a not seeing what is going on underneath the nail polish,” he says.

Frequent gel manicures can lead to nail thinning, brittleness, peeling, and cracking. Or worse, gel polish can hide nail discolorations that can signal various lung, heart, kidney {my italics} and liver diseases, as well as diabetes and anemia.

VidaVibrante.com at http://www.vidavibrante.com/2013/08/19/gel-manicures-when-too-much-of-a-good-thing-is-bad-for-your-health/  is not a site for CKD patients specifically, nor is it a medical site.  Yet, that’s where I found the above medical cautions. This is not looking good.

I was surprised to find that WebMD at http://www.webmd.com/beauty/nails/20120411/is-your-nail-polish-toxic had this information.

In recent years, some nail product makers have removed these chemicals {This refers to dibutyl phthalate, toluene, and formaldehyde.} from their products, then labeled them as non-toxic.

“What we found out is that in many of the cases the label was inaccurate,” Lang tells WebMD. “And that’s really what our message is. We don’t know if our samples are representative of the industry.”

Some products that did not carry a toxic-free label actually had none of the chemicals in them, the researchers also found.

Encarta Dictionary tells us toluene istoulene

a colorless liquid aromatic hydrocarbon resembling benzene, but less flammable. Use: solvent, high-octane fuel, organic synthesis.

And we put that on our nails?  Willingly?  I think that’s the end of thinking about gel tips for me, but does it mean I have to give up this new practice of having my nails done entirely?  Even for special occasions?  Oh, okay, lots of special occasions.

Ummm, so what – if any – brands are safe? I jumped over to EcoWatch at http://ecowatch.com/2014/02/19/7-nontoxic-nail-polish-brands/ for some brands. Zoya, Piggypaint, Suncoat, Honeybee Gardens, RGB, Sheswai, and LVX are the brands they named.

I don’t know very much about cosmetics – including nail polish – but I’m certainly willing to give these brands a try. Allow me to join the rank of those who misquote the Bard’s line from Macbeth: Vanity {It’s really “frailty.”}, thy name is woman.Kidney Arizona

But I’m not misquoting this. The Phoenix Kidney Walk is April 19th and we have a team!  SlowItDown is the umbrella group (not really sure that’s the right word) for all the books and the blog.  Remember asking me to come out from behind the typewriter?  This is it!  Use the walk as an excuse to introduce yourself to me or, better yet, join the team.  Just in case you don’t remember how:

Go to Kidneywalk.kintera.org. You’ll see “Register Here” in blue on the top left. Click it. Then you’ll need to sign an agreement, click join a team, choose SlowItDown from the dropdown. Hit continue and it will ask you to create a sign on with the usual basic questions asked.

If you’d prefer not to walk, but do want to donate, please do that in Team SlowItDown’s name.  Thanks, all.

Big news!  Every third order for The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 1 will be FREE from now until the end of the month.  We already had an order-it-free day on my birthday and now Amazon has come up with this deal.  Yay, Amazon.  I urge you to The_Book_of_Blogs-_M_Cover_for_Kindletake advantage of this. To make certain there’s a free book in the deal for you, ask two friends to order the book at the same time.

Keep an eye out for Part 2, also.  I’m working really hard to have that out by the end of this shortened month. Funny story about why there’s a Part 1 and a Part 2.  No matter how I edited, cut, shortened the original version of the book, it came out to over 600 pages.  I could barely hold it!

Until next week,

Keep living your life!