It’s the Heat AND the Humidity

Hawaii is so beautiful… and Maui so healing. There was just one thing, though. I somehow managed to forget how humid it is. As you may or may not remember, after we’d come back from the Caribbean and from San Antonio last year, I vowed never to go to a humid climate during the summer again. Well, Maui was Bear’s 71st birthday present so maybe that’s why I so conveniently forgot my vow.

Here’s why I shouldn’t have. This is updated from SlowItDownCKD 2016.

ResearchGate at https://www.researchgate.net/publication/263084331_Climate change and Chronic Kidney Disease published a study from the Asian Journal of Pharmaceutical and Clinical Research from February of 2014 (That’s over three years ago, friends.) which included the following in the conclusion:

“Our data suggest that burden of renal diseases may increase as period of hot weather becomes more frequent. This is further aggravated if age advanced and people with chronic diseases like diabetes and hypertension.”

That makes sense, but how will this happen exactly? I included this June, 2010, article in The Book of Blogs: Moderate Chronic Kidney Disease, Part 1. Apparently, heat (and humidity) has been an acknowledged threat to our kidneys for longer than we’d thought.

“.…Dr. HL Trivedi of the Institute of Kidney Diseases and Research Centre (IKDRC) said, ‘…. Rapid water loss causes the kidney’s functioning to slow down, resulting in temporary or permanent kidney failure.’ Extreme heat causes rapid water loss, resulting in acute electrolyte imbalance. The kidney, unable to cope with the water loss, fails to flush out the requisite amount of Creatinine and other toxins from the body. Coupled with a lack of consistent water intake, this brings about permanent or temporary kidney failure, explain experts.”

The article can be viewed directly at http://www.dnaindia.com/health/report_heat-induced-kidney-ailments-see-40pct-rise_1390589 and is from “Daily News & Analysis.”

By the time this book’s twin, The Book of Blogs: Moderate Chronic Kidney Disease, Part 2, was ready for publication, the (then) spokesman for The National Kidney Foundation – Dr. Leslie Spry – had this to say about heat and humidity:

“Heat illness occurs when body temperature exceeds a person’s ability to dissipate that heat and is commonly diagnosed when the body temperature approaches 104 degrees Fahrenheit and when humidity is greater than 70 percent. Once the humidity is that high, sweating becomes less effective at dispersing body heat, and the core body temperature begins to rise.”

The entire article is at http://www.huffingtonpost.com/leslie-spry-md-facp/heat-illness_b_1727995.html.

Oh, so humidity affects sweating and body heat rises. Humidity greater than 70%. That covers almost the entire time we were in the Caribbean and Texas (and now Hawaii). Well, what’s the connection between heat illness and CKD then?

The CDC offers the following advice to avoid heat illness:

“People with a chronic medical condition are less likely to sense and respond to changes in temperature. Also, they may be taking medications that can worsen the impact of extreme heat. People in this category need the following information.
• Drink more water than usual and don’t wait until you’re thirsty to drink.
• Check on a friend or neighbor, and have someone do the same for you.
• Check the local news for health and safety updates regularly.
• Don’t use the stove or oven to cook——it will make you and your house hotter.
• Wear loose, lightweight, light-colored clothing.
• Take cool showers or baths to cool down….”

Uh-oh, we’re already in trouble. Look at the first suggestion: our fluid intake is restricted to 64 oz. (Mine is, check with your nephrologist for yours.) I know I carefully space out my fluids – which include anything that can melt to a liquid – to cover my entire day. I can’t drink more water than usual and, sometimes – on those rare occasions when I’ve been careless – have to wait until I’m thirsty to drink.

Diabetes is the foremost cause of CKD. I was curious how heat affected blood sugar so I popped over to Information about Diabetes at http://www.informationaboutdiabetes.com/lifestyle/lifestyle/how-heat-and-humidity-may-affect-blood-sugar and found this:

1. If our body is low on fluids, the kidneys receive less blood flow and work less effectively. This might cause blood glucose concentrations to rise.
2. If someone’s blood sugar is already running high in the heat, not only will they lose water through sweat but they might urinate more frequently too, depleting their body’s fluids even more.

There’s more at the website if this interests you.

According to the U.S. Department of Veterans’ Affairs at https://www.visn9.va.gov/VISN9/news/vhw/summer07/humidity.asp,
“Hot weather can lead to dehydration, heat exhaustion and heat stroke, but the dangers increase when you add humidity to the mix. When the temperature rises above 70F and the humidity registers more than 70 percent, you need to be on the alert.

Who’s most at risk?
People with high blood pressure, heart disease, lung disease or kidney disease (I made that bolded.) are most vulnerable to the effects of humid conditions, as are those over age 50. Other risk factors that can affect your body’s ability to cool itself include being obese; having poor circulation; following a salt-restricted diet; drinking alcohol; having inefficient sweat glands; and taking diuretics, sedatives, tranquilizers or heart or blood pressure medication.”

So, pretty much, the way to deal with heat and humidity having an effect on your (and my) CKD is to avoid it. That doesn’t mean you have to move, you know. Staying in air conditioning as long as you can so your body is not overheated and can better handle this kind of weather will help. Wearing a hat and cool clothes will also help. I certainly relearned the value of wearing cotton this past week. It’s a fabric that breathes. I’ll bet that this is how those CKD patients who live in humid areas deal with it. Feedback, anyone? Robin? Mark?

Now for some great, unrelated news: One of our daughters gave Bear the best birthday present. She and her husband FaceTimed us in Maui on Bear’s birthday to tell us we’re going to be grandparents. This is a first for them… and for us. To make this even better – as if that were possible – little one is expected on our anniversary. I love the ebb and flow of the universe, don’t you?

Until next week,
Keep living your life!

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Recreating Creatinine

I throw a lot of terms around as if we all understood them. Sorry for that. One reader made it clear he needed more information about creatinine. In another part of my life, I belong to a community that calls reviewing or further explanation of a certain topic recreating… and today I’m going to recreate creatinine.

Let’s start in the beginning. This is what I wrote in the beginning of my CKD awareness advocacy in What Is It and How Did I Get It? Early Stage Chronic Kidney Disease :

“Creatinine is a waste product of muscle activity. What actually happens is that our bodies use protein to build muscles and repair themselves. This used protein becomes an amino acid which enters the blood and ends up in the liver where it is once again changed.  This time it’s changed into urea which goes through the kidneys into the urine.

The harder the muscles work, the more creatinine that is produced and carried by the blood to the kidneys where it also enters the urine.  This in itself is not toxic, but measuring the urea and creatinine shows the level of the clearance of the harmful toxins the body does produce.  These harmful toxins do build up if not voided until a certain level is reached which can make us ill. Working kidneys filter this creatinine from your blood.  When the blood levels of creatinine rise, you know your kidneys are slowing down.  During my research, I discovered that a non-CKD patient’s blood is cleaned about 35 times a day. A CKD patient’s blood is cleaned progressively fewer times a day depending upon the stage of the patient’s disease.”

Got it. Well, I did have to read it a couple of times to get it straight in my mind. Now what? Let’s see what more information I can find about what this means to a CKD patient. The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 1 contains the following explanation from DaVita,

“Because there are often no symptoms of kidney disease, laboratory tests are critical. When you get a screening, a trained technician will draw blood that will be tested for creatinine, a waste product. If kidney function is abnormal, creatinine levels will increase in the blood, due to decreased excretion of creatinine in the urine. Your glomerular filtration rate (GFR) will then be calculated, which factors in age, gender, creatinine and ethnicity. The GFR indicates the person’s stage of Chronic Kidney Disease which provides an evaluation of kidney function.”

I thought you might want to know more about this test, so I turned to The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 2 since I remembered including The National Kidney Disease Education Program at The U.S. Department of Health and Human Services’ information (including some reminders about definitions) concerning the process of being tested for CKD.

  1. “A blood test checks your GFR, which tells how well your kidneys are filtering.…

2. A urine test checks for albumin. Albumin is a protein that can pass into the urine when the kidneys are damaged.

If necessary, meaning if your kidney function is compromised, your PCP will make certain you get to a nephrologist promptly.  This specialist will conduct more intensive tests that include:

Blood:

BUN – BUN stands for blood urea nitrogen.

Creatinine The creatinine blood test measures the level of creatinine in the blood. This test is done to see how well your kidneys work.

Urine:

Creatinine clearance – The creatinine clearance test helps provide information about how well the kidneys are working. The test compares the creatinine level in urine with the creatinine level in blood.”

Aha! So there are two different creatinine readings: blood or serum and urine. By the way, MedicineNet at http://www.medicinenet.com/script/main/art.asp?articlekey=5470 defines serum as “The clear liquid that can be separated from clotted blood. Serum differs from plasma, the liquid portion of normal unclotted blood containing the red and white cells and platelets. It is the clot that makes the difference between serum and plasma.”

This is starting to get pretty complex. It seems that yet another test for CKD can be conducted with a urine sample. This is from SlowItDown 2015.

“In recent years, researchers have found that a single urine sample can provide the needed information. In the newer technique, the amount of albumin in the urine sample is compared with the amount of creatinine, a waste product of normal muscle breakdown. The measurement is called a urine albumin-to-creatinine ratio (UACR). A urine sample containing more than 30 milligrams of albumin for each gram of creatinine (30 mg/g) is a warning that there may be a problem. If the laboratory test exceeds 30 mg/g, another UACR test should be done 1 to 2 weeks later. If the second test also shows high levels of protein, the person has persistent proteinuria, a sign of declining kidney function, and should have additional tests to evaluate kidney function.

Thank you to the National Kidney and Urologic Diseases Information Clearinghouse, A service of the NIH, at http://kidney.niddk.nih.gov/kudiseases/pubs/proteinuria/#tests for that information.”

Is there more to know about creatinine? Uh-oh, this savory little tidbit was reprinted in SlowItDownCKD 2016 from an earlier book.

“.…Dr. HL Trivedi of the Institute of Kidney Diseases and Research Centre (IKDRC) said, ‘…. Rapid water loss causes the kidney’s functioning to slow down, resulting in temporary or permanent kidney failure.’

Extreme heat causes rapid water loss, resulting in acute electrolyte imbalance. The kidney, unable to cope with the water loss, fails to flush out the requisite amount of Creatinine and other toxins from the body. Coupled with a lack of consistent water intake, this brings about permanent or temporary kidney failure, explain experts.”

This seems to be calling for a Part 2. What do you think? There’s still BUN and albumin to deal with. Let me know what else you’d like to see included in that blog.

Have I mentioned that I’ll be presenting a display about CKD Awareness at Landmark’s Conference for Global Transformation? Or that both an article and an update about CKD Awareness will be included in their journal?

Until next week,

Keep living your life!

Women and Water (Men, too)

Welcome to March: National Kidney Month and Women’s History Month. I’m going to fudge a bit on the ‘History’ part of that as I did last month with Black History Month. I don’t often have guest bloggers, but this month will feature two women as guest bloggers in honor of Women’s History Month. The first is Jessica Walter, who sent me the following email last month:

Hi There,

I am a freelance health and food writer, I have teamed up with a small senior lifestyle advice site, I worked with them to develop a complete guide on how to eat better and be healthier from a dietary point of view. This includes detailed information on why being hydrated is so important. … you can check out the article here:

https://www.senioradvisor.com/ blog/2017/02/7-tips-on- developing-better-eating- habits-in-your-senior-years/.

I liked what Jessica had to say and how easily it could be adapted not only for senior Chronic Kidney Disease patients, but all Chronic Kidney Disease patients.

In addition, she sent me this short article about hydration and CKD. It’s easy to read and has some information we constantly need to be reminded of.

Staying Hydrated When You Have Chronic Kidney Disease

We all know that drinking water is important for our health, and monitoring fluid intake is critical for those with chronic kidney disease. Too much water can be problematic, but so can too little. Dehydration can be serious for those with chronic kidney disease. If you are suffering from vomiting, diarrhea, fever, or diabetes, or if you urinate frequently, you may become dehydrated because you are losing more fluid than you are taking in. For those without chronic kidney disease, the solution is to increase the intake of water until the body is sufficiently hydrated.

Since dehydration can decrease blood flow to the kidneys, and as fluid intake must be controlled in patients with chronic kidney disease, it’s important to closely monitor their fluid intake and loss in these circumstances.

Recognizing The Signs

The first step is to recognize the physical signs of dehydration. You may have a dry mouth or dry eyes, heart palpitations, muscle cramps, lightheadedness or fainting, nausea, or vomiting. You may notice a decrease in your urine output. Weight loss of more than a  pound or two over a few days can also be an indicator of dehydration. If you are taking ACE inhibitors and ARBs, such as lisinopril, enalapril, valsartan, or losartan, or water pills or diuretics, these medications can harm your kidneys if you become dehydrated. It is doubly important to be aware of signs of dehydration if you are on any of these medications.

Steps to Take

To rehydrate your body, start by increasing your intake of water and ensure that you are eating plenty of fruits and vegetables. (Me here: remember to stay within your renal diet guidelines for fruits, vegetables, and fluids.)If you cannot keep water down, or if increased consumption doesn’t alleviate the signs of dehydration, contact your health care provider  immediately.

They may also recommend a different fluid than plain water since electrolytes and minerals can also be reduced if you are dehydrated, but you may still need to watch your intake of potassium, phosphorus, protein, and sodium. Your doctor may recommend an oral rehydration solution that will restore your body to a proper level of hydration. If you have a fluid restriction because you are on dialysis, you should consult your healthcare provider if you have issues with or questions about hydration. Taking in or retaining too much fluid when you have these restrictions can lead to serious complications, including headaches, swelling, high blood pressure and even stroke. Carefully monitoring your fluid intake and watching for signs of dehydration will help you to avoid the consequences of dehydration.

I’ve blogged many times over the last six years about hydration. I’m enjoying reading this important material from another’s point of view. I’m sorry Jessica’s grandmother had to suffer this, but I’m also glad Jessica chose to share her writing about it with us.

 

This June, 2010, article included in The Book of Blogs: Moderate Chronic Kidney Disease, Part 1 furthers explains:

“.…Dr. HL Trivedi of the Institute of Kidney Diseases and Research Centre (IKDRC) said, ‘…. Rapid water loss causes the kidney’s functioning to slow down, resulting in temporary or permanent kidney failure.’

Extreme heat causes rapid water loss, resulting in acute electrolyte imbalance. The kidney, unable to cope with the water loss, fails to flush out the requisite amount of Creatinine and other toxins from the body. Coupled with a lack of consistent water intake, this brings about permanent or temporary kidney failure, explain experts.”

The article can be viewed directly at http://www.dnaindia.com/health/report_heat-induced-kidney-ailments-see-40pct-rise_1390589 and is from “Daily News & Analysis.”

The CDC also offers advice to avoid heat illness:

“People with a chronic medical condition are less likely to sense and respond to changes in temperature. Also, they may be taking medications that can worsen the impact of extreme heat. People in this category need the following information.

  • Drink more water than usual and don’t wait until you’re thirsty to drink.
  • Check on a friend or neighbor, and have someone do the same for you.
  • Check the local news for health and safety updates regularly.
  • Don’t use the stove or oven to cook——it will make you and your house hotter.
  • Wear loose, lightweight, light-colored clothing.
  • Take cool showers or baths to cool down.
  • Seek medical care immediately if you or someone you know experiences symptoms of heat-related illness(http://www.cdc.gov/extremeheat/warning

It’s clear we need to keep an eye on our hydration. While we’re doing that, keep the other eye out for SlowItDownCKD 2016 purposely available on World Kidney Day on Amazon.

Until next week,

Keep living your life!

Not Quite the Bionic Woman

knee braceI have a knee brace.  The little sucker goes from mid-calf to mid-thigh… and it’s going to have a twin for the other knee.  I’m sort of disappointed because I thought it was going to be solely for when I exercise daily.  Only that’s not true; it’s going to be for eight hours a day. How did I so misunderstand what the doctor was saying?

More importantly, what the heck is this for?  I double checked this with the rheumotologist: it’s to postpone knee surgery as long as possible. As I understand it, there’s even a possibility of avoiding the surgery all together. I like that option. It’s also meant to minimize the pain. I like that, too.

The culprit here is osteoarthritis, which has worsened with age.  Lucky me. All those years of dance, judo, Tai Chi, Aikido, and stage movement blueshave done a job on my knees. That doesn’t mean I stop dancing or exercising, though. It also doesn’t mean I start taking more medications, either. Hey! I have Chronic Kidney Disease.

Let’s do our usual back tracking here. First question: What is osteoarthrosis of the knee? The American Academy of Orthopaedic Surgeons has a wonderfully clear explanation with an accompanying diagram:

“Osteoarthritis is the most common form of arthritis in the knee. It is a degenerative, ‘wear-and-tear’ type of arthritis that occurs most often in people 50 years of age and older, but may occur in younger people, too. In osteoarthritis, the cartilage in the knee joint gradually wears away. As the cartilage wears away, it becomes frayed and rough, and the protective space between the bones decreases. This can result in bone rubbing on anatomy of the kneebone, and produce painful bone spurs. Osteoarthritis develops slowly and the pain it causes worsens over time.”

You can read more about osteo and other types of knee arthritis on their site at http://orthoinfo.aaos.org/topic.cfm?topic=a00212.

Well, that explains why the knees clicking isn’t a source of amusement anymore and why getting on my knees to play with sweet Ms. Bella is now agony.

As for medications, sure NSAIDS will help… except I can’t take them. Here’s a reminder why not from What Is It and How Did I Get It? FullSizeRender (2)Early Stage Chronic Kidney Disease:

 “NSAID: Non-steroidal anti-inflammatory drugs such as ibuprofen, aspirin, Aleve or naproxen usually used for arthritis or pain management, can worsen kidney disease, sometimes irreversibly.”

I’ll pass on those. I do take Limbrel, though. That’s not a NSAID and does help with the pain of arthritis. In The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 1, I defined Limbrel:

“a food medication {By prescription only} to deal with the pain preventatively.“

So now we understand why the knee braces (and the Limbrel). They – the braces – supposedly fit under your clothes. Uh, no, not if you’re a woman IMG_2982who wants to wear anything remotely stylish or not live in longish skirts. I could not get my capris or slacks on over the brace. Living in Arizona, longish skirts may work in the winter time, but they are too damned hot for the summer… which lasts from early May to late October.

So, how do these babies work you ask. I went over to the manufacturer’s website for the answer to that one.

“The Unloader One applies a gentle force design to reduce the pressure on the affected part of the knee, resulting in reduction in pain and thus allowing the patient to use the knee normally and more frequently.

Untreated, the cartilage will gradually wear down. The increased pressure on the underlying bone is the cause of the pain experienced by most osteoarthritis (OA) sufferers. The wear and tear on the cartilage will gradually cause the knee to become painful and feel stiff when moving.”

You can read more about knees on their website, but remember this is the site of a product for sale:  http://www.ossur.com/oa-solutions/unloader-uploaderbraces-and-osteoarthritis/knee-pain/unloader-braces-and-oa-knee-pain

I wanted to know a bit more about how the knee works. The National Institute of Health at http://www.niams.nih.gov/Health_Info/Knee_Problems/default.asp explained in detail.

Bones and Cartilage

The knee joint is the junction of three bones: the femur (thigh bone or upper leg bone), the tibia (shin bone or larger bone of the lower leg), and the patella (kneecap). …The ends of the three bones in the knee joint are covered with articular cartilage, a tough, elastic material that helps absorb shock and allows the knee joint to move smoothly. Separating the bones of the knee are pads of connective tissue called menisci (men-NISS-sky). …The two menisci in each knee act as shock absorbers, cushioning the lower part of the leg from the weight of the rest of the body as well as enhancing stability.

Muscles

There are two groups of muscles at the knee. The four quadriceps muscles on the front of the thigh work to straighten the knee from a bent position. The hamstring muscles, which run along the back of the thigh from the hip to just below the knee, help to bend the knee.

Tendons and Ligaments

The quadriceps tendon connects the quadriceps muscle to the patella and provides the power to straighten the knee. The following four ligaments connect the femur and tibia and give the joint strength and stability:

  • The medial collateral ligament, which runs along the inside of the knee joint, provides stability to the inner (medial) part of the knee.LateralKneeDia_cropped1
  • The lateral collateral ligament, which runs along the outside of the knee joint, provides stability to the outer (lateral) part of the knee.
  • The anterior cruciate ligament, in the center of the knee, limits rotation and the forward movement of the tibia.
  • The posterior cruciate ligament, also in the center of the knee, limits backward movement of the tibia.

The knee capsule is a protective, fiber-like structure that wraps around the knee joint. Inside the capsule, the joint is lined with a thin, soft tissue called synovium.”

CKD brings a new way of thinking about every part of your body… even your knees. Think about it.
FullSizeRender (3)

IMG_2980

Until next week,

Keep living your life!

The American Kidney Fund Blog

AKF logoI was honored that The American Kidney Fund (www.kidneyfund.org) asked me to write a blog for them. This is that blog. Once it was published last Thursday, I started thinking. If you share the blog and ask those you shared with to share it, too, and they asked their friends to share it, too… image how many people would become aware of Chronic Kidney Disease. Will you do that?

Slowing Down CKD—It Can Be Done

When a new family doctor told me nine years ago that I had a problem with my kidneys—maybe chronic kidney disease (CKD)–my first reaction was to demand, “What is it and how did I get it?”

No doctor had ever mentioned CKD before.

I was diagnosed at stage 3; there are only 5 stages. I had to start working to slow it down immediately. I wanted to know how medication, diet,stages of CKD exercise and other lifestyle changes could help. I didn’t want to be told what to do without an explanation as to why… and when I couldn’t get an explanation that was acceptable to me, I started researching.

I read just about every book I could find concerning this problem. Surprisingly, very few books dealt with the early or moderate stages of the disease.  Yet these are the stages when we are most shocked, confused, and maybe even depressed—and the stages at which we have a workable chance of doing something to slow down the progression in the decline of our kidney function.

I’ve learned that 31 million people—14 percent of the population—have CKD, but most don’t know they have it. Many, like me, never experienced any noticeable symptoms. Many, like me, may have had high blood pressure (hypertension) for years before it was diagnosed. Yet, high blood pressure and diabetes are the two leading causes of CKD.

I saw a renal dietician who explained to me how hard protein is on the kidneys… as is phosphorous… and potassium… and, of course, sodium. Out bananawent my daily banana—too high in potassium. Out went restaurant burgers—larger than my daily allowance of protein. Chinese food? Pizza? Too high in sodium. I embraced an entirely new way of eating because it was one of the keys to keeping my kidneys functioning in stage 3.

Another critical piece of slowing down CKD is medication. I was already taking meds to lower my blood pressure when I was first diagnosed with CKD. Two more prescriptions have been added to this in the last nine years: a diuretic that lowers my body’s absorption of salt to help prevent fluid from building up in my body (edema), and a drug that widens the blood vessels by relaxing them.

For a very short time, I was also taking a drug to control my pre-diabetes, but my doctor and I achieved the same effects by changing my diet even more. (Bye-bye, sugars and most carbs.) The funny thing is now my favorite food is salad with extra virgin olive oil and balsamic vinegar. I never thought that would happen: I was a chocoholic!

Exercise, something I loved until my arthritis got in the way, was also important. I used to dance vigorously several nights a week; now it’s once a week with weights, walking, and a stationary bike on the other days. I think I took sleep for granted before CKD, too, and I now make it a point to blues dancersget a good night’s sleep each day. A sleep apnea device improved my sleep—and my kidney function rose another two points.

I realized I needed to rest, too. Instead of giving a lecture, running to an audition, and coming home to meet a deadline, I slowly started easing off until I didn’t feel like I was running on empty all the time. I ended up happily retiring from both acting and teaching at a local college, giving me more time to work on my CKD awareness advocacy.

I was sure others could benefit from all the research I had done and all I had learned, so I wrote my first book, What Is It and How Did I Get It? Early Stage Chronic Kidney Disease, in 2011. I began a blog after a nephrologist in India told me he wanted his newly diagnosed patients to read my book, but most of them couldn’t afford the bus fare to the clinic, much less a book. I published each chapter as a blog post. The nephrologist translated my posts, printed them and distributed them to his patients—who took the printed copies back to their villages. I now have readers in 106 different countries who ask me questions I hadn’t even thought of. I research for them and respond with a blog post, reminding them to speak with their nephrologists and/or renal nutritionists before taking any action… and that I’m not a doctor.

What is itEach time I research, I’m newly amazed at how much there is to learn about CKD…and how many tools can help slow it down. Diet is the obvious one. But if you smoke or drink, stop, or at least cut down. If you don’t exercise, start. Adequate, good quality sleep is another tool. Don’t underestimate rest either; you’re not being lazy when you rest, you’re preserving whatever kidney function you have left. I am not particularly a pill person, but if there’s a medication prescribed that will slow down the gradual decline of my kidney function, I’m all for it.

My experience proves that you can slow down CKD. I was diagnosed at stage 3 and I am still there, nine years later. It takes knowledge, commitment and discipline—but it can be done, and it’s worth the effort. I’m sneaking up on 70 now and know this is where I want to spend my energy for the rest of my life: chronic kidney disease awareness advocacy. I think it’s just that important.

IMG_1398SlowItDownCKD 2015 Book Cover (76x113)

 

SlowItDownCKD is the umbrella under which Gail Rae-Garwood writes her CKD books and blog, offers talks, participates in book signings, is interviewed on podcasts and radio shows, and writes guest blogs. Her website is www.gail-raegarwood.com.

Until next week,

Keep living your life!

Deep in the Heart of Texas

Last week I wrote that I’d tell you about our Texas trip this week and that’s just what I’ll do… sort of. We were in San Antonio for the Air Force Basic Training Graduation of a close family friend. I hadn’t wanted to go. The rest of the family was driving 14 hours straight. I thought they were insane.

It turned out I was right about that, but I am glad I went anyway.  The next day, our friend proposed to his girlfriend – who just happened to be our daughter – at The Riverwalk’s Secret Waterfall, Airmen escort and all. THAT was worth the ride. And we got to know his family better, understand them more, and value their company.  As they say in the ad, secret“Priceless.”

There was only one fly in the ointment. While the temperature was manageable for us since we live in Arizona, the humidity was not for the same reason. For my other than U.S. readers (and there are quite a few of them since I have 107,000 readers in 106 countries), Arizona’s usual humidity is low, very low. We do have a three minute rainy season in August (Okay, maybe it’s a teensy bit more than three minutes.) when it rises, but that’s not the norm.

Last week, the humidity in San Antonio, Texas, was between 68% and 72%. Even the air conditioning in the hotel bowed before it.  Our Airman had Air Force logoscheduled the entire weekend for us: The Airman’s run on an open field, late lunch at a restaurant with no available indoor seating, graduation on the parade field, an afternoon on The Riverwalk. There’s more, but you get the idea.  All of it outdoors, all of it in 68% to 72% humidity, all of it uncomfortable as can be.

And, it turns out, all of it not great for a Chronic Kidney Disease patient. Why? Well, that’s the topic of today’s blog. ResearchGate at https://www.researchgate.net/publication/263084331_Climate_change_and_Chronic_Kidney_Disease published a study from the Asian Journal of Pharmaceutical and Clinical Research from February of 2014 (That’s over two years ago, friends.) which included the following in the conclusion:

“Our data suggest that burden of renal diseases may increase as period of hot weather becomes more frequent. This is further aggravated if age advanced and people with chronic diseases like diabetes and hypertension.”DIGITAL_BOOK_THUMBNAIL

That makes sense, but how will this happen exactly? I included this June, 2010, article in The Book of Blogs: Moderate Chronic Kidney Disease, Part 1. Apparently, heat (and humidity) has been an acknowledged threat to our kidneys for longer than we’d thought.

“.…Dr. HL Trivedi of the Institute of Kidney Diseases and Research Centre (IKDRC) said, ‘…. Rapid water loss causes the kidney’s functioning to slow down, resulting in temporary or permanent kidney failure.’

Extreme heat causes rapid water loss, resulting in acute electrolyte imbalance. The kidney, unable to cope with the water loss, fails to flush out the requisite amount of Creatinine and other toxins from the body. Coupled with a lack of consistent water intake, this brings about permanent or temporary kidney failure, explain experts.”

The article can be viewed directly at http://www.dnaindia.com/health/report_heat-induced-kidney-ailments-see-40pct-rise_1390589 and is from “Daily News & Analysis.”

By the time this book’s twin, The Book of Blogs: Moderate Chronic Kidney Disease, Part 2, was ready for publication, the (then) NKF-logo_Hori_OBspokesman for The National Kidney Foundation – Dr. Leslie Spry – had this to say about heat and humidity:

“Heat illness occurs when body temperature exceeds a person’s ability to dissipate that heat and is commonly diagnosed when the body temperature approaches 104 degrees Fahrenheit and when humidity is greater than 70 percent. Once the humidity is that high, sweating becomes Digital Cover Part 2 redone - Copyless effective at dispersing body heat, and the core body temperature begins to rise.”

The entire article is at http://www.huffingtonpost.com/leslie-spry-md-facp/heat-illness_b_1727995.html

Oh, so humidity affects sweating and body heat rises.  Humidity greater than 70%. That covers almost the entire time we were in Texas. Well, what’s the connection between heat illness and CKD then?

The CDC offers the following advice to avoid heat illness:

“People with a chronic medical condition are less likely to sense and respond to changes in temperature. Also, they may be taking medications that can worsen the impact of extreme heat. People in this category need the following information.

  • Drink more water than usual and don’t wait until you’re thirsty to drink.
  • Check on a friend or neighbor, and have someone do the same for you.
  • Check the local news for health and safety updates regularly.
  • Don’t use the stove or oven to cook——it will make you and your house hotter.
  • Wear loose, lightweight, light-colored clothing.
  • Take cool showers or baths to cool down.
  • Seek medical care immediately if you or someone you know experiences symptoms of heat-related illness(http://www.cdc.gov/extremeheat/warning.html).”

bottled waterUh-oh, we’re already in trouble. Look at the first suggestion: our fluid intake is restricted to 64 oz. (Mine is, check with your nephrologist for yours.) I know I carefully space out my fluids – which include anything that can melt to a liquid – to cover my entire day. I can’t drink more water than usual and, sometimes – on those rare occasions when I’ve been careless – have to wait until I’m thirsty to drink.

Diabetes is the foremost cause of CKD. I was curious how heat affected blood sugar so I popped over to Information about Diabetes at http://www.informationaboutdiabetes.com/lifestyle/lifestyle/how-heat-and-humidity-may-affect-blood-sugar and found this:

  1. If our body is low on fluids, the kidneys receive less blood flow and work less effectively. This might cause blood glucose concentrations to rise.
  2. If someone’s blood sugar is already running high in the heat, not only will they lose water through sweat but they might urinate more frequently too, depleting their body’s fluids even more.

There’s more at the website if this interests you.

So, pretty much, the way to deal with heat and humidity having an effect on your (and my) CKD is to avoid it. That doesn’t mean you have to move, you know.  Stay in air conditioning as long as you can so your body is not overheated and can better handle this kind of weather. Wearing a hat and cool clothes will also help. I certainly learned the value of wearing cotton this past week. It’s a fabric that breathes.

What is itUntil next week,SlowItDownCKD 2015 Book Cover (76x113)

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!

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

Let The Sun Shine…

Here we are in lovely, warm, sunny Florida.  But you just left lovely, warm, sunny Arizona, you may say and you’d be right.  We’re here to see family and friends, one of whom is over 65 and has dropped over 60 pounds via exercise and diet.  Jo is my inspiration!

I’ve wanted Bear to meet my brothers for a bunch of years now. This is an opportunity for him to meet one of them, Paul Peck, and his gracious wife, Judy.  Come to think of it, I haven’t seen them since Abby’s college graduation.

Then there’s my New York cousin, Nina Peck and her partner, Sandra, who just happened (ha ha) to move five minutes away from my brother.  That’s another one I haven’t seen in a bunch of years.

Of course, I get to bring the book to Florida, too.  Some of the medical departments of the colleges there are following me on Twitter, but I don’t think any clinics or private sector doctors are.  Good, another way for me to spread the word. The Table

Oh, right, hot weather and CKD. The rules for CKD patients in potentially hot weather are the same anywhere in the world.

According to Dr. Leslie Spry, a National Kidney Foundation spokesperson, “Heat illness occurs when body temperature exceeds a person’s ability to dissipate that heat and is commonly diagnosed when the body temperature approaches 104 degrees Fahrenheit and when humidity is greater than 70 percent. Once the humidity is that high, sweating becomes less effective at dispersing body heat, and the core body temperature begins to rise.” The entire article is at: http://www.huffingtonpost.com/leslie-spry-md-facp/heat-illness_b_1727995.html

We don’t worry about humidity in Arizona, but this is Florida.  No disrespect meant, but I clearly remembering telling my mother, Belle Peckolick, that Florida felt like taking a shower and not drying off.  She was living there at the time and just laughed.  She’d been a New Yorker, so the humidity was a higher dose of what she was used to.

Now’s the time to wear the hat you (meaning I) bought for just that purpose, but forgot was in the trunk of the car.  Otherwise, melanoma just might be a possible drawback of a day in the sun.  Melanoma.com tells us,

“Melanoma is the most serious type of skin cancer. It begins in skin cells called melanocytes. Though melanoma is predominantly found on the skin, it can even occur in the eye (uveal melanoma).

Melanocytes are the cells that make melanin, which gives skin its color. Melanin also protects the deeper layers of the skin from the sun’s harmful ultraviolet (UV) rays.

melanomaWhen people spend time in the sunlight, the melanocytes make more melanin and cause the skin to tan. This also happens when skin is exposed to other forms of ultraviolet light (such as in a tanning booth). If the skin receives too much ultraviolet light, the melanocytes may begin to grow abnormally and become cancerous.”

You are not only heating up your body by being out in hot weather, but exposing yourself to the sun’s ultraviolet light. Use that hat to shade some of your body.

DaVita reminds us to use sunscreen with at least 15 spf.  Don’t forget if you’re swimming – which this aqua-phobe won’t be although I’m looking forward to walking on the beach – you need to slather more on after each dip. You can read more of their hot weather tips, some for dialysis patients, at http://www.davita.com/kidney-disease/overview/living-with-ckd/seven-summertime-precautions-for-people-with-kidney-disease/e/4894

You know you need to drink water during hot weather, but is there a difference among waters?  Yes, there is.  As a CKD patient, your fluid intake is probably restricted (mine is 64 oz. which includes coffee, tea, juice, ice cream, sherbet, and Jell-O.  You get the picture: anything liquid or liquid in a frozen or jelled form.)

Mary Ellen Herndon, a renal nutritionist warns us, “Many drinks labeled as water are loaded with sugar and empty calories. Even though these drinks have ‘water’ in their name, drinking them regularly may cause weight gain and may increase your risk of obesity.”  For the rest of the article, go to http://www.kevinmd.com/blog/2012/08/6-tips-choosing-water-drink.html?utm_medium=twitter&utm_source=twitterfeed

According to WebMD at http://www.webmd.com/a-to-z-guides/chronic-kidney-disease-home-treatment, we also need to be careful about exercising during the hot weather.  I don’t mean stop, simply make certain you are not becoming dehydrated.  Stay away from energy drinks!  As an older adult, I’ve become aware that I can dehydrate more easily when I exercise – especially since my kidneys are not working at top capacity.

Don’t be intimidated by the sun.  We can benefit from the sun if we’re cautious about it. Fifteen minutes or so a day of sunshine can elevate your vitamin D naturally.  Wearing a shirt to cover some of your body can help you protect yourself from the ultraviolet rays while you’re indulging in some free vitamin D production.

Be sure to protect your eyes, too.  This is a direct quote from the DaVita site mentioned above: “Sunglasses protect your eyes in the same way that sunscreen protects your skin from harmful sun damage. Your sunglasses should block at least 99% of UVB rays and 50% of UVA rays. Wraparound sunglasses and other styles that completely cover the eyes are best.” This information is good for anyone, chronic kidney disease sufferer or not.wraparound sunglasses

Excuse me while I see if I can interest any of my friends or family into visiting Epcot with  me.

Until next week,

Keep living your life!

Hot as Hades

My fiance has gotten into the habit of looking up the weather forecast on his super-duper telephone before we go to sleep. This is Arizona, ladies and gentlemen.  We have a low of 103 degrees with a high of 110 this week, unlike July 2 when we hit 118. 

The Irish Kidney Association posted this DaVita article on a really hot day. I was glad to learn something new from it (spraying your mouth with lemon water to keep yourself from drying out) and wondered if you might, too. 

If you do decide to get your daily 15 minutes of vitamin D via direct sun light, remmber to do it in the early morning, before the heat hits – especially if you live in a climate like mine.

Seven Summertime Precautions for People with Kidney Disease

There are certain precautions that everyone should take during the sunny and warm summer months. If you have chronic kidney disease (CKD), you’ll need to take a few additional steps to protect your health in the summertime or when visiting warmer climates.

1. Go outside and get moving

Sunny summer days are ideal for going outside and exercising. If you have kidney disease, be sure to check with your doctor  before starting a summertime exercise routine. Your physician can help you create an exercise plan that will support your health. Even if you feel tired at times, easy exercises may help you feel better. Walking and yoga are two activities that put only minimal stress on the body. To reap the benefits of having sunlight activate vitamin D in your skin, so spend 10-15 minutes in the sun before applying sunscreen.

2. Keep good fluid balance

Check with your dietitian or healthcare team for guidance about your fluid
intake and whether it should be adjusted on days that you spend more
time outdoors. Be careful of very cold beverages, which can cause stomach cramps. It’s best to avoid drinking caffeine or alcohol  or ingesting large amounts of sugar, as these can actually cause your body to lose more fluid. Try to stay cool by wearing a hat or a wet bandana around your neck to help control your thirst.[Gail’s note: When I was teaching high school in NYC, the kids had to take their Regents exams in hot and humidity. We all used the bandana trick.  Some of the students soaked their bandanas and kept them in the freezer overnight.  Now that was VERY effecitve.] You might want to
carry a small spray bottle filled with lemon water or mouthwash to spray
your mouth when you are feeling dry.

3. Save your skin from sun exposure

Everyone should wear sunscreen and apply it liberally. Unprotected sun exposure can cause skin damage. Use a sunscreen with an SPF of at least 15. Remember to reapply your sunscreen every two hours and also right after swimming or exercising. A water-resistant sunscreen will be less likely to come off if you swim or perspire. You can also protect your skin by covering up with a shirt, wearing a hat or sitting in the shade. You may want to soak up some sun before applying sunscreen to activate some of the vitamin D in your skin. Ten to 15 minutes is all it takes.

4. Wear sunglasses

Sunglasses protect your eyes in the same way that sunscreen protects your skin from harmful sun damage. Your sunglasses should block at least 99% of UVB rays and 50% of UVA rays. Wraparound sunglasses and other styles that completely cover the eyes are best.

5. Protect your access if you go swimming

If you are on dialysis and have a vascular access — whether it’s an AV fistula, a graft or a catheter — remember to cover it with a protective dressing when you swim. Ask your nurse which holds up best in water. For those with a central venous catheter (CVC), they should not submerge themselves and the CVC in the water at all. For people on peritoneal dialysis (PD), your healthcare team will show you how to properly clamp your PD catheter shut. The PD catheter should be immobilized to avoid trauma to or tension on the catheter while swimming. The dressing should be changed as soon as
you’re done with swimming. When going for a swim, do so in the ocean or a
chlorinated pool. Avoid bodies of water that aren’t chlorinated, such as ponds, lakes and rivers, which have a greater chance of hosting bacteria that can infect your access.

6. Eat healthy summer foods

Research shows that fruits and vegetables are important for good health, yet most people don’t eat enough. Summer is the perfect time to fill your plate with kidney-friendly foods that are low in phosphorus and potassium.
Remember to practice portion control as all fruits and vegetables contain some potassium. Here is a list of fruits and vegetables that can add color and flavor to your kidney diet:

Fruits Vegetables
Blackberries Carrots
Blueberries Cauliflower
Cherries Cucumber
Grapes Eggplant
Peaches Green beans
Plums Lettuce
Raspberries Onion
Strawberries Peppers (sweet and bell)
Watermelon (1 cup per day) Potatoes (leached)
  Snow peas
  Summer squash
  Radishes

Use these summertime ingredients to make delicious meals found at DaVita.com/Recipes. Try the following:

Fruit recipes Vegetable recipes
Ambrosia Chicken Lettuce Wraps
Blueberry-Peach Crisp Cucumber-Carrot Salad
Creamy Fruit Salad Eggplant Casserole
Quick Fruit Sorbet Grilled Summer Squash
Red, White and Blue Pie Picnic Potato Salad
Watermelon Summer Cooler Savory Green Beans

7. Plan your vacation to include dialysis

When you’re on dialysis you can still enjoy a summer vacation. To
accommodate treatments while you’re away, pre-planning is the key to a
successful trip. If you do in-center hemodialysis or home hemodialysis (HHD), ask your nurse or social worker how you can schedule treatments at a dialysis center close to where you’ll be staying. Home hemodialysis patients dialyzing with the NxStage System One can take their portable equipment with them and continue HHD while they’re on vacation if they prefer.

People on peritoneal dialysis can also take their equipment with them. Be sure to pack enough supplies to do your PD exchanges when you’re away. You can also work with your supplier to have dialysate delivered to your destination. Start planning at least three months before your trip, and ask fellow patients for any tips on the DaVita Discussion Forums.

Summary

By taking a common-sense approach to summer, you can enjoy long, warm
days while you support your kidney health. Taking a few summertime
precautions — protecting your skin, staying hydrated, controlling liquid
intake and planning a summer getaway — means you can have fun and
remain healthy.

If you can’t click through on the recipes, here’s the link to the original article:    

http://www.davita.com/kidney-disease/overview/living-with-ckd/seven-summertime-precautions-for-people-with-kidney-disease/e/4894

While we aren’t up to dialysis yet, I wanted you to see that there are ways to enjoy the summer even when we get there.     

Say, it’s only 10 a.m.  Maybe you can still get your 15 minutes of sunlight n before it gets too hot.

Until Tuesday,

Keep living your life.

           

Published in: on July 15, 2011 at 10:26 am  Comments (2)