Updated

 

 

 

You may have seen the pictures of the updates we’ve been making to our home on Facebook or Instagram. Now, it seemed to me that if I could update my home, I could update SlowItDownCKD’s social media. So I did. The website at www.gail-raegarwood.com is totally SlowItDownCKD now, as are the Instagram, LinkedIn, Twitter, and Pinterest accounts. Of course, the blog was next. I liked my updates, but realized some of the new organizations on the blogroll (the list to the right of the blog) may be unknown to you.

No problem. I’ll just introduce them to you. Allow me to make the introductions…

We’ll go alphabetically down the roll here. The American Association of Kidney Patients, The American Kidney Fund, and The American Society of Nephrology are not new. Just in case you need a reminder of what each is, I’ve linked their titles to the organization. Just click on one of them to go to their websites, as you usually do for any title on the blogroll.

This brings us to The International Federation of Kidney Foundations. This is directly from the young (established 1999) organization’s website:
The International Federation of Kidney Foundations leads the way in the prevention and treatment of kidney disease, through its Membership on all continents around the world. The Federation was formed to foster international collaboration and the exchange of ideas that will improve the health, well-being and quality of life of individuals with kidney disease. We hope to achieve this by advocating for improved health care delivery as well as adopting and disseminating standards of best practice of treatment and care. We facilitate education programs for member organisations, promote research, communicate with other organisations and exchange ideas, particularly those concerning fund raising….
The IFKF helps facilitate the establishment of more kidney foundations and to help existing foundations become more dynamic and effective. Worldwide, most individuals with chronic kidney disease or hypertension are not diagnosed until long after the illness has developed. Moreover, when they are diagnosed they are too often treated sub-optimally or not at all. In many parts of the world, once end stage kidney failure occurs, patients do not have access to dialysis or kidney transplantation.
IFKF members join together with ISN members and kidney patient associations, to celebrate World Kidney Day annually in March, to influence general physicians, primary healthcare providers, health officials and policymakers and to educate high risk patients and individuals.

I’ve been interested in the global effects of Chronic Kidney Disease since I started preparing for Landmark’s 2017 Conference for Global Transformation at which I presented this past May. Writing two articles for their journal opened my eyes- yet again – to the fact that this is not just a local problem, but a worldwide problem. That’s why I included Kidney Diseases Death Rate By Country, On a World Map in the blogroll. I mapped out the statistics I found here on a trifold map to exhibit at the conference. Seeing the numbers spread all over the world was startling, to say the least.

Here is their 2015 global CKD information:
In 2015, the Asian nations of India and China fared the worst when it came to the number of deaths due to this degenerative health condition per thousand people. According to the World Health Organization (WHO) data (I’m interrupting. Would you like a link to WHO on the blogroll?), India had the highest number of kidney diseases deaths. The data put the figure at an astounding 257.9 per 1,000 people. China had the second highest number of deaths due to kidney diseases. Here, the number stood at 187.4 per 1,000 people. Though not as bad as the two Asian nations, the United States was also grappling with the problem of kidney diseases deaths in 2015. The nation had 59.8 deaths (per 1,000 people) due to kidney diseases, while Indonesia, which occupied the fourth place, had an estimated 43 deaths (per 1,000 people) due to kidney diseases. Nations such as Egypt, Germany, Mexico, Philippines, Brazil, Thailand and Japan reported deaths between 20 and 40 (per 1,000 people) due to kidney-related diseases. But, on the positive side, there were many nations in the world where a negligible number of people died due to kidney diseases. It is a noteworthy fact that countries such as Maldives, Vanuatu, Iceland, Grenada, Comoros, Belize, and many others, reported a zero figure in 2015.

But then I wanted to cover more localized information about CKD, so I included The National Chronic Kidney Disease, Fact Sheet, 2017. This is basically facts with pictograms that make the information about the United States’ CKD information more visual and easier to grasp. The information is more distressing each year the site is updated.

Fast Stats

• 30 million people or 15% of US adults are estimated to have CKD.*

• 48% of those with severely reduced kidney function but not on dialysis are not aware of having CKD.

• Most (96%) people with kidney damage or mildly reduced kidney function are not aware of having CKD.

After several sites that are not new, the last new site, other than direct links to SlowItDownCKD’s kidney books, is The Kidney & Urology Foundation of America. Why did I include that? Take a look at their website. You’ll find this there:
The Kidney & Urology Foundation focuses on care and support of the patient, the concerns of those at risk, education for the community and medical professionals, methods of prevention, and improved treatment options.
What Sets Us Apart?
The Kidney & Urology Foundation of America is comprised of a dedicated Executive Board, medical advisors, educated staff and volunteers who provide individualized support to patients and their families. Adult nephrologists and transplant physicians comprise our Medical Advisory Board, Board – certified urologists serve on the Urology Board, and pediatric nephrologists and urologists represent the Council on Pediatric Nephrology and Urology.
We are a phone call or e-mail click away from getting you the help you need to cope with a new diagnosis, a resource for valuable information on kidney or urologic diseases, a window into current research treatment options or a link to a physician should you need one.

Are there any organizations I’ve left out that you feel should be included? Just add a comment and I’ll be glad to take a look at them. I am convinced that the only way we’re going to get any kind of handle on Chronic Kidney Disease as patients is by keeping each other updated.

Until next week,
Keep living your life!

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Starting the New Year with a Miracle

fireworksHappy New Year and welcome to 2017.  We did our usual stay in, watch movies, and toast with non-alcoholic champagne (I know that’s contradictory.) at midnight.  With our New York daughter here, it was even more meaningful.

A new year brings to mind new beginnings… and that leads me to Part 3 of the miracle series, as promised. I am so, so serious about this and hope you decide to take on for yourself causing a miracle in CKD by sharing information.

I was thinking about social media the other day. Where are the public service announcements about Chronic Kidney Disease?  I am still – nine years after my diagnose – knocking on seemingly closed doors to encourage Public Service Announcements everywhere. While the public doesn’t seem as involved with network television or radio as they were when I was younger, we now have Twitter, Facebook, Instagram, LinkedIn, and Tumblr to name just a few ways we can share.

I use a both a Facebook page and a Twitter account to post one fact about or information pertinent to those with CKD daily. Join me at newslowitdownckdfbcoverSlowItDownCKD on Facebook and @SlowItDownCKD on Twitter. I also monitored Libre’s Tweet Chat with Gail Rae 1/10/12. I knew nothing about Twitter at the time, but it was a way to share the information I had. You may not want to do this, but feel free to ‘steal’ the information posted and share it with others.

There are also Podcasts, Internet Radio Shows, YouTubes, etc. to share what the public needs to know about CKD. A YouTube can be viewed by one person who posts it on Facebook and go viral. Don’t bother looking at mine. They’re pretty painful. I’ll look into this again at a later date.

On the other hand, these are some of the social media venues that interviewed me: The Edge

Podcast 5/9/16, Online with Andrea 3/23/15 & 3/07/12, What Is It? How Did I Get It? 2/17/12, and Improve Your Kidney Health with Dr. Rich Snyder, DO 11/21/11. I never knew these venues existed before I started working towards the miracle I wanted to cause.

Lo and behold, my sharing brought others who wanted to know about CKD, so I was profiled by Nutrition Action Healthletter, Center for Science in the Public Interest 9/16, New York State United Teachers ‘It’s What We Do’  8/9/16, and Wall Street Journal ‘Health Matters’  1/13/14. Remember that Clairol commercial in last week’s blog?

Let’s say you agree that sharing can cause a miracle in Chronic Kidney Disease and want to join in living a life causing this miracle. The first thing you’d want to do is learn about CKD. The American Kidney Fund and the National Kidney Foundation both have a wealth of information written AKF logofor the lay person, not the medical community. By the way, the National Kidney Foundation also has information about NKF-logo_Hori_OBCKD globally. Maybe you’d rather join in World Kidney Day gatherings and distribute materials. Then keep an eye on World Kidney Day’s Twitter account for locations around the world.

As you can see, I’ve been creating this miracle is by writing for these organizations and more kidney specific ones, as well as guest blogging for various groups. You may not choose to do that… but you can speak at your religious group meetings, your sports league, your weekly card game, or whatever other group you’re comfortable with.

A miracle doesn’t have to be profound. You can help create this one. All you need is a little education about CKD and the willingness to introduce the subject where you haven’t before.friends

I live my life expecting miracles and I find they happen.  This miracle that I’m causing – and is happening – has been (and is) created by sharing, sharing, sharing. The more than 200 million people who have Chronic Kidney Disease need this information, to say nothing of those who have yet to be diagnosed.

kidneys5There aren’t that many organs to go around for those who didn’t know they had CKD and progressed to End Stage Renal Disease.  We know that transplantation is a treatment, not a cure, and one that doesn’t always last forever. We also know that kidneys from living donors usually last longer than those from cadaver donors. Share that, too.

We have our no cost, no pain, no tools needed miracle right on our lips… or at our fingertips. Start sharing, keep sharing, urge others to share, and help to prevent or slow down the progression in the decline of kidneys worldwide. Sharing is causing a miracle in CKD. Both deaths and hospitalizations for this disease have declined since 2008. If that isn’t a miracle, I don’t know what is. I keep saying I live my life expecting miracles; this is one of them.hearing

I was a private person before this disease. Now, in addition to the Facebook page and twitter accounts, I make use of an Instagram account (SlowItDownCKD) where I post an eye catching picture daily with the hash tag #SlowItDownCKD. This brings people to my weekly blog about CKD – as does my Instagram account as Gail Rae-Garwood – and the four books I wrote about it: one explaining it and the others the blogs in print – rather than electronic form for those who don’t have a computer or are not computer savvy. Time consuming? Oh yes, but if I expect to live a life of miracles, I need to contribute that time to share what I can about the disease and urge others to do the same.IMG_2979

I am urging you to realize you are the others I am asking to help cause a miracle in Chronic Kidney Disease. As the Rabbinic sage Hillel the Elder said, “If I am not for myself, who will be for me? If I am only for myself, what am I? If not now, when?” Now. You. Me. Others. CKD.

Until next week,

Keep living your life!

Inked

tattooThere’s a woman I know, younger than I by three and a half decades, who is inked… and I mean inked. She has sleeves on both arms and (almost) a body suit.  Don’t know what I’m talking about? Take a look at http://www.inkedmag.com/tattoo-lingo/. Unfortunately she’s lost a job or two when narrow minded employers saw her arms, but that’s not what I’m writing about today.

Oh, all right. Here are the definitions of the jargon above: inked = tattooed; sleeve= fully tattooed on the arm; body suit= tattoos on the majority of the body.

I was thinking about her the other day and that got me to thinking about tattoos and whether or not they’re safe for us since we have Chronic Kidney Disease. Let’s take a look at the tattooing process itself to see if there’s anything there to worry about.

I turned to The Mayo Clinic at http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/tattoos-and-piercings/art-20045067 for this information.

“A tattoo is a permanent mark or design made on your skin with pigments inserted through pricks into the skin’s top layer. Typically, the tattoo tattoo machineartist uses a hand-held machine that acts much like a sewing machine, with one or more needles piercing the skin repeatedly. With every puncture, the needles insert tiny ink droplets.

The process — which is done without anesthetics — causes a small amount of bleeding and slight to potentially significant pain.”

Personally, I’m too much of a scaredy cat to give tattooing a try now that I know about the possibility of pain. There’s enough of that in my life already… like the endometrial biopsy a few months ago. Ugh! But maybe you’re not…

Well, why might you want a tattoo in the first place? Maybe it’s an artistic requirement for your soul.  Maybe it’s to remind yourself of some life lesson like my New York daughter, Nima’s. Or maybe it’s a medical tattoo to wear rather than a medical alert bracelet.

What is itHmmm, I’d think again. As CKD patients, our blood is already not that pure. Remember, as I explained in What Is It and How Did I Get It? Early Stage Chronic Kidney Disease,

“The kidneys remove these toxins (e.g. from the blood) and change them into urine ….”

Our kidneys are not functioning at the top of their game. With my current GFR of 51, my kidneys are only functioning at a teeny bit more than half capacity while still trying to filter the blood as kidneys with a GFR of 100% would. Oh, right, GFR. In The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 1 that’s explained according to the NKDED:

“The National Kidney Disease Education Program at The U.S. Department of Health and Human Services provides the following information.DIGITAL_BOOK_THUMBNAIL

  1. A blood test checks your GFR, which tells how well your kidneys are filtering. GFR stands for glomerular filtration rate. …”

Here’s what I found on Health Impact News at http://healthimpactnews.com/2015/think-before-you-ink-the-little-known-risks-of-tattoos/ that makes me so leery of tattoos.

“In 2011, a study in The British Journal of Dermatology revealed that nanoparticles are indeed found in tattoo inks, with black pigments containing the smallest particles (white pigments had the largest particles and colored pigments were in between).

Nanoparticles are ultramicroscopic in size, making them able to readily penetrate your skin and travel to underlying blood vessels and your bloodstream. Evidence suggests that some nanoparticles may induce toxic effects in your brain and cause nerve damage, and some may also be carcinogenic.”Healthy%20Kidney

Whenever I speak to someone who has a tattoo, they tell me the ink only goes as far as the dermis (the second layer of skin) and nowhere near the blood.  I often wondered about that since the dermis is rife with blood vessels. I guess I just learned that the tattoo owners were misinformed. And why we as CKD patients should not be allowing even the possibility of more toxins entering our blood streams for our already overworked kidneys to eliminate.

Are tattos pretty? I think so.  Are they spiritual? Sometimes they are. Are they worth the risk? It’s your decision, but I can’t agree that they are. I found even more evidence to the contrary on WebMd at http://www.webmd.com/skin-problems-and-treatments/laser-tattoo-removal?page=2

“There are minimal side effects to laser tattoo removal. However, you should consider these factors in your decision:

tattoo removalThe tattoo removal site is at risk for infection. You may also risk lack of complete pigment removal, and there is a slight chance that the treatment can leave you with a permanent scar….”

I’d also read on various sites that simply being tattooed may leave you open for infection if the autoclave (instrument steaming machine) or needles are not clean enough. I don’t know of any sites to rate the cleanliness of tattoo parlors, but I do know infection opportunities are far more common for us as CKD patients…and they are more dangerous for us.

This paragraph from The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 2 should clarify the why of avoiding infection possibilities.

Digital Cover Part 2 redone - Copy“Think about it: your liver and your kidneys are the two most important blood filters you have. We already know we need to maintain as steady a blood pressure in the kidneys as we can to do no more damage to them.  The liver does this by releasing angiotensin which constricts your blood vessels. Don’t forget the liver helps maintain your blood sugars.  If it can’t do that due to infection, kidney function can be further reduced. The liver also filters toxins and drugs from the blood.”

I wondered if I’d find enough information for a blog about CKD patients and tattoos. On the contrary, I find I could go on and on.

Tuesday is the beginning of National Kidney Month. While I won’t be leading my team in the kidney walk this year (Damn neuropathy!), I’ve got another surprise up my sleeve to celebrate. I may be able to announce that next week.2015-04-18 22.09.45

Don’t forget about the National Kidney Fund of Arizona’s annual conference on March 11th and 12th. I’ll be there on the 11th. You can register at www.SWNC.org.

Until next week,

Keep living your life!

Still Getting Birthday Gifts… like OAB

happy birthdayBear has just spoiled me and spoiled me for this birthday. It was not a special birthday, just a birthday. His reasoning, “I’m celebrating being with you for another year.” Which, of course, made me think. My first thought? I realized how much I liked being adored by the man I love.

My second?  Time changes things.  Your weight changes.  Your hair color changes.  Even your height changes. There are those that say aging is a problem. I say if you’re aging, you’re alive so it’s not a problem, but rather something to which you need to adapt.

Part of the birthday celebration was an overnight at The Desert Rose Bed and Breakfast in Cottonwood. The place was unique. They house animals they’ve rescued: llamas, cats, chickens. I thought the llamas were the most picture worthy, but then I’d never seen the kind of fluffed out rooster they had. Up the hill was a goat farm. For a city woman like me, this was heaven.

Except – there was this – there were no hand rails on the steep path from the house to the animals. Nor were there steps. The runoff from a recent hose cleaning of some apparatus near the house caused the loose gravel covered road to be slick. So we took teeny little ‘old person’ steps while the owner, a young woman possibly in her thirties, practically scampered. We got to see the animals, but we had to adapt how we got to them due to our age related capabilities.llama

The private bath was another eye opener for me. Bear opted for the room with the spa. It was so relaxing and could have even been romantic except that there were no grab rails. We slipped, we fell, we worried if Bear broke his foot.  But it was supposed to be romantic!

Oh well. There was also the kind of shower I’d only seen in magazines.  You know the kind that could easily fit six people (uh, not my style) with two separate shower heads – one on each end of the shower. This was a new toy for me, until the floor got wet. Again, no grab rails. There was no safety mat on the shower floor, either. So we tried to hold on to the walls. Hah! They were tile that was just as slippery.

You get the point?  This was a beautiful, romantic, upscale bathroom… and wasted on us because there were no safety features to accommodate our gifts from aging. Of course, not everyone would have felt this way, but we each have neuropathy which can make balancing difficult.

shoqweIn addition to grab bars in our at home bathrooms, we have no area rugs anywhere in the house. This is to cut down on the possibility of tripping. When our primary care doctor suggested ways to prevent injuring ourselves, we listened. Bear’s time flat on his back after his foot surgery convinced us we never wanted to go through that again. For me, with my ‘age related’ macular degeneration, we also use ultra-bright LED bulbs throughout the house.

Okay, so where am I going with this? I’m circling in on the kidneys via urination. Remember the kidneys produce urine which is stored in the bladder.  I wanted to know what was usual for people ‘our age’ and why. After all, I’d made the bathrooms as safe as possible understanding that one or the other of us was going to get up during the night to urinate.

I turned to The Cleveland Clinic at http://health.clevelandclinic.org/2015/12/stop-full-bladder-killing-sleep/ for some help.

“If you’re urinating more than eight times in 24 hours, that’s too much. A lot depends on your age. And if you’re between age 65-70 and going more than twice a night, you should make an appointment with your doctor. Also, see a doctor if you are getting up more than once a night if you are between age 60-65, and more than three times each night if you are age 70 or older. While your bladder’s capacity does not necessarily decrease with age, the prevalence of overactive bladder increases with age.”

Apparently, an overactive bladder may also lead to increased falls. Not fair! We’re already dealing with the neuropathy to avoid this. Oh, right. “…if you’re aging, you’re alive so it’s not a problem, but rather something to which you need to adapt.”detrusor

I wonder if aging is a factor because the detrusor (bladder muscle) ages right along with the rest of you.  A long time ago, I explained that my Chronic Kidney Disease was caused by nothing more than growing older. I hate to admit it, but it does make sense. All of you ages when you age, not just certain parts.

What is itBirthday giveaway for What Is It and How Did I Get It? Early Stage Chronic Kidney Disease! All you have to do to win is be one of the first three people to enter the contest and follow SlowItDownCKD on Twitter. Here’s link to enter for a chance to win: https://giveaway.amazon.com/p/542abbec7a52e10a#ln-fo

I hope you’re keeping an eye on P2P’s Chronic Illness Buy and Sell’s contest. I’ll be gifting a copy of one of my Chronic Kidney Disease Books to three different winners.  Each winner will receive a different book. This one started February 1st and runs until St. Valentine’s Day.  Here’s the address: http://www.facebook.com/groups/P2PBuy.Sell. You do need to be a member of the group, tag yourself in a comment below the announcement of the contest, and be involved with kidney disease as a patient or caretaker.

My accountant (Yep, working on those this week.) thinks I’m nuts to be part of so many giveaways and contests, but my mission… no, my passion… is to get information about Chronic Kidney Disease out to as many people as I can, in as many ways as I can, for as long as I can.

IMG_1398

To that end, Phoenix area readers, please let me know if you are interested in joining Team SlowItDownCKD for this year’s kidney walk at Chase Stadium on Sunday, April 17.

Until next week,

Keep living your life!

DON’T K.E.E.P. It a Secret

National Kidney MonthHello, Week Two of National Kidney Month.  Surely, you’ve gotten yourself checked for Chronic Kidney Disease by now.  After all, more than 20% of us here in the U.S. have it. That’s 10 million people. Mind boggling, isn’t it. Here’s the kicker: that’s as of 2010 – five years ago now – according to The National Kidney and Urologic Disease and Information Clearinghouse at http://kidney.niddk.nih.gov/kudiseases/pubs/kustats/#3

But, wait, it gets worse. If you, like me, are over 50, your risk has increased.  Over 70 {Awk!  That’s only two years away for me.}, it increases even more.  What hurts for me is that so many people don’t know they have Chronic Kidney Disease. I’ve read statistics placing this at anywhere from 20 to 90%.  Rather than go on again about if-I-had-been-diagnosed-at-stage-1-rather-than-stage-3-I-would-have-had-more-time-to-slow-down-the-progression-of-my-ckd, let’s just say it’s easy to have yourself tested.

I’ve written about just needing a simple blood test and a simple urine test.  You can even have this done via the usual blood tests you already take if you usually take blood tests.  I have my pcp’s and nephrologist’s blood draw orders combined if they fall within two weeks of each other – with my doctors’  blessings. It’s not cheating, folks; it’s one less needle in your arm as I see it.

Well, what about if you don’t have blood tests regularly?  You could ask your PCP to write you orders for this. Most won’t do so without a visit, though.  Let’s say you don’t have the money, or can’t get an appointment early enough.  What then?K.E.E.P.

That’s where K.E.E.P. comes in. The acronym stands for Kidney Early Evaluation Program and is offered by the National Kidney Fund.  According to their website, this is what is offered.

  • Risk Survey

  • Body Mass Index (BMI): Height and Weight Measurements

  • Blood pressure check

  • ACR urine test for albumin (a type of protein) – For individuals at risk only!

  • Free educational materials

  • Opportunity to speak with a health care professional

Notice, no blood test.  Think of K.E.E.P. as a place to begin your kidney education. That risk survey and the urine test for “at risk” individuals are important parts of the program.  Over 50 – go to a K.E.E.P. event. Over 70 – definitely go to one.  These are not the only “at risk” definers, though. Add in the following.

  • Anyone with high blood pressure, diabetes

  • Anyone with a family history of kidney failure

  • African-Americans, Hispanics, Asians, Pacific Islanders and American Indians

  • Individuals who are obese (body mass index of 30 or above)

Now you can see why your BMI is measured and your blood pressure read.   Thank you to the National Kidney Fund at https://www.kidney.org/keephealthy for the above information.  If you’re interested – and I’m sure hoping you are – you can find the locations and dates of these on the upper right hand corner of the same page.  You’ll have to enter your geographical information, but that’s it.

That’s another option, but budgets are being cut all over the place.  So let’s say there’s no K.E.E.P. event near you. What now? How about the Path to Wellness program? What’s that, you say. It’s a partnership between the renal and heart communities for the following purpose according to the website of the Cardio Renal Society of America at http://www.cardiorenalsociety.org/ {The website does seem to be aimed toward medical professionals.}

Public Health Education and Early Detection

Path to Wellness is an integrative community-based screening program addressing the interconnections between kidney disease, heart disease, and diabetes. It encourages utilization of community-based or primary care services and empowering a diverse demographic of at-risk patients to make significant, positive changes in their personal well-being and quality of life.

In Arizona, the Arizona Living Well Institute is also involved in this project.  Dr. J. Ivie, the Director of Patient Services at the National Kidney Foundation of Arizona provides a more patient oriented description of the event.

Path to Wellness has already touched close to 400 Arizonans at risk of diabetes, heart disease and kidney disease by providing education, screening, self-management skills and connection to a medical home.  We are scheduling the first screening event of 2015 on Saturday, March 28th at the Salvation Army KROC Corps Community Center near South Mountain in Phoenix.

By the way, they are calling for volunteers to help out at this program, so please contact Dr. James Ivie via any of these methods if this interests you. I was recently made aware that high school students need to perform community service as a graduation requirement and was wondering if this is applicable if the students are over a certain age.  Again, a question for Dr. Ivie.

Phone:         602.845.7905

Fax:              602.845.7955cardiovascular

Address:      360 E. Coronado Rd. #180

                      Phoenix, AZ 85004

Email:          www.azkidney.org

Digital Cover Part 1I like to perform community service, too.  In this case, that service is for my kidney community.  Hmmm,  World Kidney Day is March 12. The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 2 is now available in both print and digital versions on Amazon.com.  The logical connection between the two for me is that World Kidney Book will be the day this book is free.  Remember I offered The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 1 free on February 2nd because it was my birthday? {Doesn’t every author offer their books free on their birthday?} This works the same way.  You just order the book.Part 2

Here’s how my mind works: I have dissolved in laughter because I just realized I was wondering if What Is It and How Did I Get It? Early Stage Chronic Kidney Disease is feeling left out because there’s never been a freebie day for that book.  I get it!  It’s a book {but it’s my baby.}Book Cover

Whoa!  I’ve been getting calls that the blog address no longer works.  After a little gentle questioning, it came out that the callers were using the old address: https://gailrae.wordpress.com.  If you use that address, you’ll receive the following message:

“gailrae.wordpress.com is no longer available.  The authors have deleted this site.”  No I didn’t! I just changed the name to gailraegarwood.wordpress.com.  I’ll consider this a reminder to myself to leave well enough alone.

I followed a forum user’s advice to simply change the name, not realizing all the old blogs will be deleted.  I thought the site was being deleted and you would be redirected to the new address for all the blogs.  Silly me.  I am extremely thankful The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 1 and  The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 2 were published before this mini catastrophe,  but am still not happy with it.  Oh well. Might as well choose it since I have to do the work anyway.

Hang on while I recreate the blog.   Well, actually, if you’re reading this, it’s already recreated.  Yay!

Until next week,

Keep living your life!

Good bye to National Kidney Month

I thought it over and decided to print the letter The National Kidney Foundation asked me to write for the syndicated Dear Annie column (Does anyone click on links anymore?). This is what was published on March 10, three days before World Kidney Day.

Annie’s Mailbox® by Kathy Mitchell and Marcy Sugar

Dear Annie:

I switched doctors six years ago — and my world fell apart. My new doctor insisted on all kinds of new tests, and I’m glad she did. Simple blood and urine tests let me know that there was a good possibility my kidneys weren’t functioning well.

I didn’t know that there are rarely any symptoms until the kidneys are failing. I didn’t know that one in three American adults is at risk for kidney disease. I didn’t know that high blood pressure and diabetes are two of the leading causes of this disease. But I learned quickly that early detection and proper treatment can slow its progress.

I learned so much in the following months: why I need to watch my weight, why regular exercise helps and why I need to make sure my high blood pressure is under control. I’ve been able to maintain the same degree of kidney function since being diagnosed, but not without lots of information and changes in my lifestyle.

March is National Kidney Month. March 13th is World Kidney Day. Won’t you help me join the National Kidney Foundation in urging Americans to learn about the risk factors and simple blood and urine tests for kidney disease? There are many free kidney health screenings around the country. The National Kidney Foundation at kidney.org provides information about these screenings and about staying healthy.

Thank you,

Gail Rae-Garwood

Glendale, Ariz.

the National Kidney Foundation, Inc.

And Annie’s response:

Dear Gail Rae-Garwood:

Thank you so much for sharing your story. We hope our readers will take your advice and check for screenings in their area or discuss their kidney health with their personal physicians. We are sure your letter will help many. Bless you.

We all know I’m well beyond getting a kick out of seeing my name in print (sort of), so why the letter? And why the great desire – let’s make that passion – to spread Chronic Kidney Disease Awareness?

Let me offer you some more statistics from The National Kidney Foundation at http://www.kidney.org/news/newsroom/factsheets/FastFacts.cfm :

1 in 9 United States citizens have CKD.

Most of them don’t know they have it.

Blacks are three times more likely to undergo kidney failure.Book Cover

Hispanics are 1.5 times more likely.

Fewer than 17,000 have kidney transplants annually.

118,000 are on the waiting list for a kidney.

13 people die while awaiting a kidney transplant daily.

If your kidneys fail, only dialysis or transplant can keep you alive.

415,000 are on dialysis.

About 180,000 more are living transplantees.

Medical payments increase from $15,000 to $70,000 annually from stage 4 to stage 5 CKD.

Medicare pays $30 billion (yes, billion) annually on treatment for kidney failure.

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(Photo by Nima Beckie.  Subject: Greater New York Kidney Walk participant tying his orange scarf on a lamp post midway across the Brooklyn Bridge.)

The National Center for Chronic Disease Prevention and Health Promotion at http://www.cdc.gov/diabetes/pubs/factsheets/kidney.htm offers more information:

More than 20 million people have CKD.

44% of new cases are caused by diabetes.

28% of new cases are caused by high blood pressure.warning

Between 1999 & 2010, more females than males developed CKD.

CKD occurrence increases in those over 50 years of age.

One of every three with diabetes develops CKD.

One of every five with high blood pressure develops CKD.

Men with CKD are twice as likely as women with CKD to develop kidney failure.

 

And now the National Institutes of Health at http://report.nih.gov/NIHfactsheets/ViewFactSheet :NIH

Cardiovascular disease is the main cause of death in dialysis patients.

Medicare is spending 6% of its payouts on kidney care.

Kidney disease runs in families.

warning

Of course, now you’re thoroughly grossed out and maybe scared out of your mind about ckd. Good! That’s exactly what I was aiming for.

I don’t see the point in you, your best buddy, your child, anyone who touches your life being diagnosed at stage 3 as I was. I wasted all of stage 1 and stage 2 when I could have been spending that time working to SLOW the decline of my kidneys so I could be one of the 80% of CKD patients who never needs dialysis or a transplant (and, no, I don’t mean because I already died).

And why did I was that much time instead of prolonging my life? I was never tested. That’s it. Simple, direct, and to the point. The fear here should be in having CKD and not knowing it instead of fearing you have it. If it turns out you don’t have CKD, I am extremely happy for you and maybe a bit envious. But if you do, let’s start working on prolonging your life NOW. You realize I’m not talking about a year or two, but decades here.

I want to see grandchildren, but my children aren’t ready for that yet. No problem. I am perfectly content to wait the five or ten years until they’re ready. By working hard at slowing the decline of my kidney function, I have the time to wait.baby-shots-5

The tests themselves are simple. Do you urinate? (You’d better be responding in the positive here or you’ve already got a bigger problem than CKD.) Then you can just urinate into a vial instead of the toilet. No special training needed. Ever have your blood drawn? Did you die from it? (I know, I know, but it’s a rhetorical question.) Okay, so have your blood drawn again and ask to be tested for Chronic Kidney Disease. It is not a separate blood test, but can be included in one you may be having anyway.

So it’s good bye to National Kidney Month, but not to taking care of yourself… say by having the blood and urine tests for CKD. Be a pal. If you can’t do it for yourself, do it for me. Don’t deprive the world of the pleasure of your company because you didn’t take the test.

Until next week,

Keep living your life!

 

 

It’s Still National Kidney Month

And I still have pre diabetes.  It sounds like something someone made up and maybe it is, but my A1C test result is still high and getting higher despite the changes I’ve made in my eating habits.  When better than National Kidney Month to explain why this could be a problem for those of us with Chronic Kidney Disease?kidney

We’ll need a little background here (as usual).  First, what is A1C test?  According to The Mayo Clinic at http://www.mayoclinic.org/tests-procedures/a1c-test/basics/definition/PRC-20012585,

“The A1C test result reflects your average blood sugar level for the past two to three months. Specifically, the A1C test measures what percentage of your hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar (glycated). The higher your A1C level, the poorer your blood sugar control and the higher your risk of diabetes complications.”

I’m sure you noticed how often I rely on The Mayo Clinic for definitions.  I find their simple explanations make it easier for me (and my readers) to understand the material.  I also like that they explain in their explanations. These phrases surrounded by dashes or in parentheses further clarify whatever the new term may be.

Okay, so we can see why this needs to be tested.  Now, what does it have to do with diabetes and what is diabetes anyway? This time I looked for a medical dictionary and found one at our old friend The Free Dictionary.  It’s at http://medical-dictionary.thefreedictionary.com/Diabetes+Mellitus. The mellitus is there because that’s how members of the medical field usually refer to diabetes – as diabetes mellitus. This is what I found there,

“Diabetes mellitus is a condition in which the pancreas no longer produces enough insulin or cells stop responding to the insulin that is produced, so that glucose in the blood cannot be absorbed into the cells of the body. Symptoms include frequent urination, lethargy, excessive thirst, and hunger. The treatment includes changes in diet, oral medications, and in some cases, daily injections of insulin.”

Book CoverIn What Is It And How Did I Get It? Early Stage Chronic Kidney Disease I define glucose as the main sugar found in the blood.  I go on to explain that in diabetes, the body doesn’t adequately control natural and ingested sugar.  The Free Dictionary definition shows us how the body loses control of insulin production and what it means for the glucose levels… which is what the A1C test measures.

So… PRE diabetes? What’s that?  Funny you should ask. The English teacher in me can tell you that pre is a prefix (group of letters added at the beginning of a word that changes its meaning) meaning before.  Pre diabetes literally means before diabetes which makes no sense to me because that would mean everyone without diabetes was pre diabetic.  It helped me understand when I was told pre diabetes was formerly called borderline diabetes (a much better term for it in my way of thinking).

This time I went to WebMD for a simple explanation.  In addition to learning that pre diabetes means your glucose, while not diabetic, is higher than normal, I found this interesting statement:

“When glucose builds up in the blood, it can damage the tiny blood vessels in the kidneys, heart, eyes, and nervous system.”  KIDNEYS!

You can read more about this at http://www.webmd.com/diabetes/guide/what-is-prediabetes-or-borderline-diabetes.

Well, then what’s a normal level you ask? According to my primary care physician, 4.8-6.0 is normal BUT this range needs to be adjusted for Chronic Kidney Disease patients.  I (what else?) looked this up at Lab Tests Online http://labtestsonline.org/understanding/analytes/a1c/tab/test and found more of a range:

  • A nondiabetic person will have an A1C result less than 5.7%.
  • Diabetes: A1C level is 6.5% or higher.glucose
  • Increased risk of developing diabetes in the future: A1c of 5.7% to 6.4%

My result was 6 in the emergency room last November.  During my regularly scheduled CKD yearly lab last September, it was 5.9 with a big H (for high) next to it.  The August before that it had been 6.1.  Back in January of last year, it was 6.  I seem to be staying in a very close range for over a year, but it’s still pre diabetes.

All right then, what’s normal for a CKD patient?  I don’t know.  Life Options says just keep it under 6.5 (http://lifeoptions.org/kidneyinfo/labvalues.php). The rest of the internet seems to think the A1C results need to be adjusted only if you have both diabetes and CKD.  Looks like my nephrologist and I will have to have another talk about this.

You would think the danger of an elevated A1C  would be diabetes, but I’m wondering if the damage to those tiny blood vessels may be worse.

diabetes_symptomsHave I raised questions in your mind?  Is your A1C normal?  How do you tell if different sources hold different values as normal?  Time to ask your doctor.  And time to remind you again, that I am NOT a doctor, just a CKD patient with loads of questions and a willingness to research some answers for us all. Something to consider.

Other things to consider: have you had your kidneys tested?  It’s a simple blood test and a simple urine test.  Sure you don’t have the time, but no one does.  Then again, it’s sure worth it to avoid the need for dialysis (now THAT takes time) and a transplant down the road.

You know that 59% of our country’s population is at risk for CKD, but did you know that 13 million U.S. citizens have undiagnosed CKD?  That’s scary.  Take the test.

Here’s a link to the letter I wrote for Dear Annie – a nationally syndicated column – for National Kidney Month: http://m.spokesman.com/stories/2014/mar/10/annies-mailbox-learn-risk-factors-of-kidney/ It appeared on March 10, 2014 just prior to March 13 World Kidney Day.Nima braceket

Above is a picture of Nima. She’s pointing to the bracelet I gave her that she’s wearing so that I would be with her on last year’s Greater New York Kidney Walk while I was actually ill back home in Arizona.

Until next week (and the last day of National Kidney Month),

Keep living your life!

World Kidney Day

World Kidney DayThursday, March 13th, is World Kidney Day.  It’s always the second Thursday in March. But what is it?  And who started it?  And why? As you can see, I have questions, lots of questions and always.

Between my step-daughter’s helping me update the look of the blog, fulfilling TheNephrologist.com’s suggestion that I add an About Me link (Let me know what you think about the About Me), and all the day to day tasks of life, this question has been nagging at me. Sure I could live a happy life without answering it, but why? (See what I mean about always having a question?)

I discovered this is a fairly new designation. It was only eight years ago that it was initiated.

According to http://worldkidneyday.org, “World Kidney Day aims to raise awareness of the importance of our kidneys to our overall health and to reduce the frequency and impact of kidney disease and its associated health problems worldwide.”

Sound familiar?  That’s where I’m heading with SlowItDown, What Is It And How Did I Get It? Early Stage Chronic Kidney Disease, and this blog. We may be running along different tracks, but we’re headed in the same direction.kidney-book-cover

The 54 year old International Society of Nephrology (ISN) – a non-profit group spreading over 126 countries – is one part of the equation for their success.  Add to that the 15 year old International Society of Nephrology (ISN) – another non-profit located in 41 countries – along with a steering committee, The World Kidney Day Team and you have the makings of this particular concept.

While 157 countries celebrated last year, I suspect this year even more countries will be involved.  Why, you ask? (Oh, good, someone else asking questions.)  This year’s theme is Chronic Kidney Disease and Aging. We all age… in every country… in every part of the world… whether we’ve been diagnosed with CKD or not.

While there are numerous objectives for this year’s World Kidney Day, the one that lays closest to my heart is this one: “Educate all medical professionals about their key role in detecting and reducing the risk of CKD, particularly in high risk populations.”

If only my nurse practitioner had been trained, she could have warned me immediately that I needed to make lifestyle changes so the decline of my kidney function could have been slowed down earlier. How much more of my kidney function would I still have if I’d known earlier?  It’s too late for me. That was six years ago and this shouldn’t still be happening… but it is.weeping

I received a phone call last week that just about broke my heart.  Someone very dear to me sobbed, “He’s dying.” When I calmed her down, she explained a parent was sent to a nephrologist who told him he has end stage renal disease and needed dialysis or transplantation immediately.

I pried a little trying to get her to admit he’d been diagnosed before end stage, but she simply didn’t know what I was talking about.  There had been no diagnose of chronic kidney disease up to this point. There was diabetes, apparently out of control diabetes, but no one impressed upon this man that diabetes is the foremost cause of CKD.

What a waste of the precious time he could have had to do more than stop smoking, which he did (to his credit), the moment he was told it would help with the diabetes.  Would he be where he is now if his medical practitioners knew more about what he could have done to detect the disease, especially since this man is high risk due to his age and diabetes?  I fervently believe so.

While this is a terribly dramatic scenario, it happened and I’m willing to bet it’s happening more than we know.  I, for one, am more than happy we now have World Kidney Day.

Their site offers materials and ideas for celebrations as well as a page to post your own activity.  Take a look at the map of global celebrations and prepare to be awed at how wide spread World Kidney Day celebrations are.

Before you leave their page, take a detour to Kidney FAQ (Frequently Asked Questions) on the toolbar at the top of the page.  You can learn everything you need to know from what the kidneys do to what the symptoms (or lack thereof) of CKD are, from how to treat CKD to what to ask your doctor, and a toolbox full of helpful education about your kidneys to preventative measures.

BearandmeI have a close friend who is involved in the local senior center where she lives.  She says she doesn’t know anyone else but me who has this disease.  Since 1 out of every 10 people does and being over 60 places you in a high risk group, I wonder how many of her friends don’t know they have CKD or don’t even know they need to be tested.  I’d rather be mistaken here, but I’m afraid I’m not.

For those of you who have forgotten (easily read explanations of what results of the different items on your tests mean are in What Is It And How Did I Get It? Early Stage Chronic Kidney Disease), all it takes is a blood test and a urine test.  I have routine blood tests every three months to monitor a medication I’m taking.  It was in this test, a test I took anyway, that my family physician uncovered Chronic Kidney Disease as a problem.

On the home front, I’ve been thinking about how much time and energy it takes to stay up and running.  I have allergies, but I am NOT removing my sweet Bella from our home.  Since the antibodies in the immunology injections do not affect the kidneys in any way, I’ve opted to go that route.IMAG0269 (1)

The plantar fasciitis is still a pain (Get it? Are you groaning?), so I asked the podiatrist to help me fight it without medication. I’m looking forward to enjoying dancing again without having to pay for it afterwards.  More ice, more exercise, more rest.  I can find a way to do that.

Until next week (when it will still be National Kidney Month),

Keep living your life!

Coffee, The Elixir of The Gods (Or Did I Just Make That Up?)

With all that’s going on in my life and in the world, I awoke today thinking, “Coffee, today’s blog is going to be about coffee!”  First thing I did was make the coffee (my turn today) and then pop back into bed with Bear and check Facebook.

And there it was, right in front of me.  And now, here it is, right in front of you. Mark Rosen shared MedicalPk’s coffee post (http://www.medicopk.com/health-benefits/some-surprising-health-benefits-of-coffee/).  Mark originated The Kidney Disease Ideas and Help Page I follow on Facebook and MedicalPk is a medical blog for students.Some-surprising-health-benefits-of-COFFEE  Look at all the benefits of coffee mentioned in this chart!  I made that a very large reproduction so you could read it. I wasn’t so sure this could all be true since I remembered the old adage, “If it sounds too good to be true, it probably is.” *Notice, the article also mentions the negatives of coffee so look at the website.

Of course, as Chronic Kidney Disease patients, we can’t run wild in our pursuit of the perfect cup of coffee and how often we can have it. It’s 16 ounces (two cups) maximum for me so I want to have the best taste I can. Coffee Masters’ Jamaican Me Crazy is my favorite.  We discovered it while choosing our wedding cake at Bakery-Wee in Glendale and immediately ordered a ten pound bag.  I sort of, maybe, kind of knew that our wedding guests were not going to drink that much coffee.  Hence, almost two months later, there it is – waiting for me – on the kitchen counter next to the coffee machine everyday.

CoffeeCupPopCatalinStockBut it’s become one of those once-in-a-while-heaven-descends treats for me. I haven’t quite figured out how it can have the “richest, sweetest essence of the darkest tropical island rum” without containing alcohol, despite what it says on the package. That’s a topic for another blog.

Going a step further in my coffee research, I found an article at http://www.medicalnewstoday.com/articles/257888.php that explains the benefits of Greek coffee and how that works.  The part that intrigued me was this:

“The endothelium is a layer of cells that lines the blood vessels, which is impacted by lifestyle habits and aging. The researchers focused on coffee because earlier research has proven that moderate coffee intake may decrease the risk of coronary heart disease, they [sic]} wondered whether it could have a positive impact on other areas of endothelial health.”

According to the article based on the findings which were published in Vascular Journal earlier this year, it did. If you look at the chart, you’ll see heart disease mentioned as one the ailments coffee may help prevent there, too.

Another article, this one from Digestive Disease Week, offered more good news about coffee:

“Coffee consumption helped protect against the autoimmune liver disease known as primary sclerosing cholangitis (PSC), a disorder of the bile ducts that causes inflammation and obstruction and that can lead to transplantation or death.”

This one is discussed on MedpageToday at: http://www.medpagetoday.com/MeetingCoverage/DDW/39292.  On the chart, liver cirrhosis is mentioned as another ailment coffee may help prevent.liver

There’s a wonderful slide show of both the merits and drawbacks of coffee consumption at: http://www.medscape.com/features/slideshow/coffee?src=ptalk#12.  I urge you to see this for yourself. On this slideshow, not only are the benefits mentioned in the chart about Parkinson’s disease, gout, cancer, diabetes, and heart disease also noted, but there are also slides about improving glucose metabolism, promoting weight loss in the overweight (obviously, you need to drink more than the two cups a day I do), lessening of the risk of developing depression, slowing the progress of Hepatitis C, benefitting dry eye syndrome, and preventing MRSA infections (those are the antibiotic resistant ones).Coffee Beans_0

Coffee does initially raise blood pressure, but it also has the potential to lower it long term… one of life’s little dichotomies. Among the other drawbacks of my favorite beverage are the obvious ones: it can contribute to anxiety, insomnia and tremors (so that’s why my mother and her father had these.  Or was it the Parkinson’s disease that seems to run in the family?) Coffee can exacerbate withdrawal symptoms and there is the potential for it increasing the risk of glaucoma.

The article I liked the best during my research is at: http://bodyodd.nbcnews.com/_news/2012/11/20/15309215-coffee-helps-you-see-the-bright-side.  It offers a detailed explanation of how dopamine is elevated by drinking coffee.  In layman’s terms, that means coffee can make you feel good.  As a non-drinker, non-smoker, I can personally attest to the fact that my two cups of coffee per day make me feel great… and not simply in terms of energy.YGCnpYEUFRtlrF00_f9frLXF_JWiNWNHS9AVZmM1PxI

Talking about coffee, yesterday the Transplant Community Outreach from Facebook invited me to a lunch gathering of people from different parts of Arizona and California. I write KIDNEY MATTERS for the group so they knew I wasn’t a transplant.  I marveled as they ate pretty much whatever they wanted.  The conversations centered on their various transplants and other diseases, but it was so definitely not a pity party.  These people realized they were on their second or third chances and were enjoying life tremendously.  Thank you for inviting me, Janet Peralta.

Kidney educators are waiting to start their kidney education classes on the local Native American reservations.  I am still waiting to get them on the reservations.  If you can think of any access at all, please let me know.  There is nothing like saving a life… even indirectly.

The book has been introduced to British Columbia via Patti Telford and Colorado’s Evans Community Army Hospital via Deanna Leclair.  Thank you both for being the cause of these new avenues for getting the information where it’s needed.  And thank you LandmarkEducation for giving me the opportunity to get this information to places I hadn’t even realized it was needed.

Until next week,The Table

Keep living your life!

1885… To The Present

1885 is my favorite year.  Don’t ask me why because I don’t know.  Maybe it’s a reincarnation thing, maybe it’s a time travel thing, maybe it’s not.  All I know is that it draws me like honey draws flies.

These are my wedding shoes.  If they ever arrive, I’ll dye them red to match the sash on my Victorian wedding dress and Bear’s Victorian western vest. (Yep, he has the 1885 fever, too, except he prefers the Western area 1885.)safe_image

Back to the shoes.  They are contemporary yet are in the style of ladies’ 1885 dress shoes – called dancing pumps back then.  Here’s a little no longer secret:  I found them online, then researched and discovered they were the shoes I was looking for.  Sort of like my dress search.

So what does this have to do with Chronic Kidney Disease you ask?  I wondered that myself as I patiently waited for the yard people to show up and clear out the once beautiful bushes and trees we lost to January’s frost.  I always seem to gather ideas for the blog when I’m doing something else.

I know what dresses, shoes, and Western vests looked like in 1885, but not what the face of Chronic Kidney Disease looked like at that time. So I did what I do best: researched. This was one of the few times I didn’t succeed. I tried every combination of search parameters I could think of.  I finally decided to put a time cap on the research. Nothing, nada.

Book CoverThen I did one of those mentally smack your forehead thingies (I tried it in reality once and it hurt!) Of course I was only finding information about transplants and dialysis at that time.  Chronic Kidney Disease wasn’t as yet recognized as a disease.

According to Dr. G. Eknoyan of Baylor College’s Department of Medicine’s Renal Section:

“Nephrology is a young discipline.  Several events contributed to its emergence during the years following World War Two. First was the increasing interest in studies of kidney function and physiology that started as part of the war effort during World War Two and was fostered during the post-war boom by the newly established National Institutes of Health {sound familiar, anyone?} and the flourishing pharmaceutical industry.  Second was the introduction in the mid-1900s of new technologies directly relevant to the care of individuals with kidney disease, specifically dialysis and kidney biopsy.”

You can read the entire article at: http://www.touchbriefings.com/pdf/3342/eknoyan.pdf, although Dr. Eknoyan attributes his information to S.J. Peitzman’s book Dropsy, Dialysis, Transplant, A short history of failing kidneys published by Johns Hopkins University Press in Baltimore in 2007.

It seems sort of silly now, but my heart goes out to all those who needlessly died of the as yet unnamed (and undiscovered) Chronic Kidney Disease in 1885.  Bringing in Bear’s love of all things Western, the ludicrous part of me wonders if it was all that buffalo meat that exacerbated the disease.

I was astonished to discover that The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI ™) was not put into place until 1997 and then updated only five years later in 2002.  No wonder I had so much trouble even attempting to discover the face of Chronic Kidney Disease in 1885.  I was over a century too early.

stages chartThis is where you’ll find all their guidelines: http://www.kidney.org/professionals/KDOQI/guidelines_commentaries.cfm

There is so much information on this site about CKD in conjunction with diabetes, hypertension, diet, age, treatment, and dyslipidemia (high cholesterol) – to mention just a few of the categories – that it would make sense to urge you to explore the site yourself instead of attempting to explain it.

I was surprised that their chart does not differentiate between stages 3A and 3B as The Renal Association does. I was just a bit perturbed at one of The Renal Association’s statements, although I recognized its validity: “Most patients with Stage 3 CKD are older, and only a minority go [sic] on to get more serious kidney disease.” The older part didn’t thrill me, but the” only a minority” part sure did. This information is at: http://www.renal.org/whatwedo/InformationResources/CKDeGUIDE/CKDstages.aspx

According to Wikipedia at http://en.wikipedia.org/wiki/Chronic_kidney_disease, “British guidelines distinguish between stage 3A (GFR 45–59) and stage 3B (GFR 30–44) for purposes of screening and referral.” Yet, my nephrologist, who is not British and practices right here in Arizona, is the one who explained to me that I am Stage 3A.

I’m convinced that the renal diet plays a very large part in keeping dialysis at bay. I’m also delighted at how easy it’s become to stay within the guidelines of the diet.  Last night, for no earthly reason except we wanted to, we went to see ‘Buddy’ at The Arizona Broadway Theater, which is a dinner theater. I made exactly two substitutions to the printed menu, skipped dessert and was perfectly within my guidelines as to portion size, vegetable and protein restrictions, and carbohydrate restrictions, too.

OLYMPUS DIGITAL CAMERA

I seem to forget to talk about the book in my latest blogs.  I neglected to mention that I introduced the representatives of the Gila River Indian Community to the book at last week’s Southwest Nephrology Conference, as well as having the opportunity to give a copy to the representatives of The Northern Arizona Council of Renal Dietitians.  They’re the ones who developed the renal diet I follow as a patient of AKDHC {Arizona Kidney Disease and Hypertension Center}.  As a matter of fact, Crystal Barraza, the nutritionist associated with AKDHC, contributed to the book.

While this month is National Kidney Month, World Kidney Day is this Thursday, March 14th.  Why not consider donating a kidney?

Until next week,

Keep living your life!

Goofy (And I Don’t Mean Disney’s).

World –  not National – Kidney Day is March 14th – not March 13th – this year.The Table

There is no World Kidney Month; it’s National Kidney Month.

Mea Culpa.  Forgive me.

It Is Not All In Your Mind; It’s In Your Organs, Too.

It’s National Kidney Month and National Kidney Day on March 13th is coming up fast, so – naturally – the Southwest Nephrology Conference was this past weekend.  It was the usual   Az. Kid Walk pleasure to see Dr. James Ivie, Director of Patient Services at The National Kidney Foundation of Arizona.  The man is wonderfully generous and will be distributing business cards for the book and blog at the Arizona Kidney Walk on April 7th at Chase Field as he allowed Dr. Jamal Atalla from Arizona Kidney Disease and Hypertension Center (AKDHC) to do at the last KEEP (Kidney Early Evaluation Program) event here.

I am up to my elbows in wedding preparations and had to push to make the time to attend the conference and, other than the non-renal diet food (geared to nephrology related practitioners, not patients), I was glad I did.

So much of the material was right up my alley, even though I’m what’s called ‘Allied Health’ rather than medical practitioner. True, I couldn’t quite understand the very technical medical issues, but what I did understand is worth sharing here.

There’s so much to share that I wasn’t sure what to concentrate on this week… until I spoke with Nima. We went from discussing my great-niece’s first birthday party to Nima’s god-mother’s youngest granddaughter’s Bat Mitzvah to lithium. That part of that family has a number of male members who have taken lithium for extended periods for bipolar disorder years ago.

According to Wikipedia, “Trace amounts of lithium are present in all organisms. The element serves no apparent vital biological function, since animals and plants survive in good health without it. Nonvital functions have not been ruled out. The lithium ion Li+ administered as any of several lithium salts has proved to be useful as a mood-stabilizing drug in the treatment of bipolar disorder, due to neurological effects of the ion in the human body.” The operant word in this definition is SALTS.  You can read more about lithium at:   http://en.wikipedia.org/wiki/Lithium.

There were two Plenary Sessions.  It was at the second one, “Psychiatric issues in kidney patients” presented by Dr. Christian Cornelius from Phoenix’s own Banner Good Samaritan Medical Center (where two of Cheryl’s grandchildren were born and also where she was diagnosed with the colorectal cancer that ended her life) that I suddenly sprang into attention again.

Hey, it had been a long morning and lunch was coming up soon.  I hadn’t been able to eat the mid-morning snack of cookies, soda, or coffee. I was tired from getting up at 5:30 to get to the conference down in Chandler in time. Tired and hungry – not the greatest combination.

cookiesWhat was this man saying?  Something about lithium doubling the risk for Chronic Kidney Disease?  And I was off… how many psychiatric patients knew that fact?  How many of their caretakers knew that just in case the patient was not responsible at the time of treatment?  What about children?  Did their parents know?  Was a screening for CKD performed BEFORE lithium was prescribed?

26 million Americans have kidney disease that is not yet diagnosed.  What if one of these psychiatric patients belongs to that group?  What if they all do?  Currently, kidney disease is the ninth leading cause of death in the United States.  Ninth!!!  Are these undiagnosed psychiatric patients moving it to the eighth?  And what about the 73 million at risk for kidney disease due to high blood pressure, diabetes, or family history?  Are they being given lithium without screening?  (You can read more facts about kidney disease at: http://www.kidney.org/news/newsroom/factsheets/FastFacts.cfm.)

I decided to dig deeper, as I often do.  Again and again on different sites about side effects of different psychiatric drugs, I found warnings that patients need to have a complete medical exam before starting the drug and then periodical exams to check whether or not the patient has developed some damage from taking the drug.  Here’s my question: do these exams include kidney screening?lithum

First I looked at my Twitter feed and found this at: http://www.winnipegfreepress.com/local/screening-for-kidney-disease-on-first-nations-193767521.html

“The $1.6-million federally funded project — First Nations Community Based Screening to Improve Kidney Health and Dialysis — will launch in March.

The project, co-led by Manitoba First Nations’ Diabetes Integration Project and Manitoba Health’s Manitoba Renal Program, provides early detection and treatment to several First Nations communities.

Detection of the disease in people as young as eight can take less than 15 minutes.”

The article deals with a KEEP type program for some Canadian First Nations and is included here to demonstrate the growing awareness of the need to screen for kidney disease, not to infer that First Nations have psychiatric disorders.

Other than that article, there is nothing about screening for kidney disease.  If medical practitioners aren’t aware of the prevalence of CKD – and, obviously, I am not referring to the entire medical professions – how can psychiatric practitioners be expected to know to do this?

I am not a psychiatric patient, not even for minor psychiatric issues, so I don’t know what the screening process is first hand.  However, I do know people who have confided in me (no names for privacy’s sake) that they are taking drugs for some psychiatric condition.  Big mouth here always asks what effect that drug might have on their kidneys… or liver for that matter since such drugs may hit the liver negatively.

That is not enough.  We need a lot more big mouths to ask the right question about drugs: How will this affect my kidneys?

I’m asking for one, no two, wedding presents from each and every one of you.

  1. Have yourself tested for kidney disease
  2.  Before you take any drug for any reason, ask how it will affect your kidneys.

Wow!  You have it in your power to make me a happy bride.  Please do it for your sake and mine.  wedding dress

Until next week,

Keep living your life!

I Showed You Mine, Now Show Me Yours

Bear and I are going to be married on April 6th. It will be a simple ceremony in our back yard under the magnificent palo verde tree (which I hope recovers from the recent freeze to be magnificent again very, very soon). We each have two daughters and one has a fiancé.  Add Bear’s best friend and you have our wedding party. Reverend Doctor Mitzi Lynton of Creative Living Fellowship will be officiating.  Simple, sweet, and to the point.

I don’t see how that will change anything for us since we’ve been together – and loving it – for years.  Well, there will be a thin white gold band under my engagement ring. Oh, and I’ll add Garwood as a hyphenate to Gail Rae. Wait, Bear will wear a wedding band, as yet unchosen, too.  But that’s it.  Or is it?

I’m starting to wonder what my chronic kidney disease – newly diagnosed as stage 3A or the beginning part of stage 3 – means to our life together. Bear is already wonderful about sharing meals with me when we go out and being sure to order only what I can eat.  He even picks up my exercise habit every so often and accepts that I get tired for no reason (hah!) sometimes. But I suspect there’s more.

According to The Journal of the American Society of Nephrology (JASN), a new study reveals your lifetime risk of developing kidney failure:

Approximately 1 in 40 men and 1 in 60 women of middle age will develop kidney failure if they live into their 90s.

People with reduced kidney function face an even higher risk.

Kidney failure is on the rise and currently afflicts 2 million people worldwide.

You can read the EurekAlert! notice about this article for yourself at: http://www.eurekalert.org/pub_releases/2012-08/ason-wyl081012.php

I’m a person with reduced kidney function.  So I face a higher than 1 in 60 women risk for kidney failure.  Not on your life!!!  Or maybe I should say my life.

I’m perfectly capable of keeping that heightened risk at bay and I intend to.  I have so much to look forward to. Obviously, we won’t be starting a family(That would be one for Ripley’s Believe It Or Not).  But there are daughters, lots of daughters, and they may choose to someday. 

Abby is starting her new job today.  I wouldn’t have missed that for the world.  How many better and better positions is she going to find in her career?  Kelly and Sean will have their own wedding next year and I’ll be there.  I want to see more of Nima… New York isn’t that far away. And Lara, how will she choose to have her life develop?

So, you ask, “How will you do that, Gail?”  I’ll educate myself about chronic kidney disease even more, that’s how. 

These are the groups I follow on twitter that have information to help me (and you):

Am Soc Nephrology‏@ASNKidney  –  ASN: Leading the Fight Against Kidney Disease.

American Kidney Fund‏@KidneyFund  –  The American Kidney Fund fights kidney disease through direct financial support to patients in need, health education and prevention efforts.

DaVita@DaVita  –  Giving life to dialysis patients. Creating #kidneyaware communities. Cultivating leadership with #DaVitaU. Living our core value of fun.

Joel Topf‏@kidney_boy  – Salt whisperer, nephrologist, runner, blogger and editor of @kidometer. Interests: teaching, medicine, electrolytes, CKD, and all things Apple#FOAMed advocate

Kidney Foundation‏@ChattanoogaKF  –  To provide help and information to those affected by kidney disease.

Kidney Foundation@kidneycanada  –  The Kidney Foundation of Canada is the national volunteer organization committed to reducing the burden of kidney disease.

Kidney Research UK‏@Kidney_Research  –  Right now, over 3 million lives in the UK are affected by chronic kidney disease. Please support Kidney Research UK.

KidneyDiet®‏@KidneyDietApp  –  An App to help you watch the 3Ps. Phosphorus. Potassium. Protein. CKD, ESRD, dialysis – whatever your situation, now make better diet choices w/ KidneyDiet®.

KidneyMI‏@KidneyMI  –  The mission of the National Kidney Foundation of Michigan is to prevent kidney disease and improve the quality of life for those living with it.

Libre, LLC‏@LibreClothing  –  A clothing company for chemotherapy, dialysis, & other infusion patients; making everyone’s day a little more Libre!

Mostly Medical Links‏@MostlyMedLinks  –  Interesting medical news and links via @JoshuaSchwimmer, a nephrologist.

NKF of Hawaii‏@KidneyHI  –  National Kidney Foundation of Hawaii

NKF Upstate NY‏@NKF_UPNY   –  The National Kidney Foundation Serving Upstate and Western New York

NurseGroups  – The social career resource for nurses. Tweeting daily nursing and health news. #TeamNurses

NYTimes Health‏@nytimeshealth  –  Health news from the Science desk of The New York Times

Renal Info‏@renalinfo  –  Baxter is a diversified company that develops & manufactures products that save and sustain the lives of people with kidney disease and other medical conditions

RenalFellowNetwork‏@RenalFellowNtwk  –  A website written for renal fellows, by renal fellows.

RenalSupportNetwork‏@RSNhope  –  Renal Support Network is a nonprofit, patient-focused, patient-run organization that provides non-medical services to those affected by chronic kidney disease.

RNCentral.com‏ @RNCentral  –  Nursing education, news, and healthy living tips

NKF_Advocacy‏@NKF_Advocacy  –  Join the National Kidney Foundation’s advocacy movement for people affected by chronic kidney disease, organ and tissue transplant and donation!

RWJF PublicHealth‏@RWJF_PubHealth  –  RWJF’s public health program area. We want to make staying healthy less costly and improve quality of life for all Americans. http://www.NewPublicHealth.org

The Kidney Group‏@thekidneygroup  –  Consistently voted Top Nephrology Practice in So Florida, we bring you kidney and related health news with commentary by our board certified nephrologists.

World Kidney Day‏@worldkidneyday  –  World Kidney Day’s objective is to raise awareness globally of the importance of Kidney Health and to increase screening for chronic kidney disease

You’re probably thinking, “Oh, so many different National Kidney Foundation addresses,” but each one has different, interesting, and (most importantly) helpful information pretty much on a daily basis.  Did I miss any?  Which do you follow that I haven’t listed here?

I’m making this journey and I’m going to enjoy it.  More information about ways to prolong it will certainly help.  I showed you mine.  Now show me yours.

Until next week,

Keep living your life!

National Kidney Month And Doctors Who Get It

Yesterday, day four of National Kidney Month, my buddy Karla and I met at the Herberger – our state theater – to see a play I knew nothing about.  For me, it was just an excuse to get together and see a friend of hers onstage.  The play, “Dead Man’s Cell Phone,” turned out to be about what happens to a trafficker in human organs and the people he’s connected to after he dies. Naturally, I want to play the role of his mother in some other production of this play. It’s an odd-ball role, right up my alley.

But what really struck me was that I unwittingly chose to attend a play about kidneys during National Kidney Month.  At the talk with the actors after the play, I mentioned that.  Not one person in the theater (and it was half full of people who stayed for the talk) knew this is National Kidney Month.

That’s why I’ll be posting something about the kidneys on Twitter every day this month.

I’ll also be guesting on a radio show for this purpose tomorrow night, Tuesday March 6th from 7:30pm – 9:30pm EST. The URL for this is:
http://www.blogtalkradio.com/onlinewithandrea/2012/03/07/early-stage-chronic-kidney-disease

And I’ll be at The Kidney Foundation’s 21st Annual Chattanooga Renal Symposium on March 29th, 2012.  The event will be held at the Historic Sheraton Read House. If you’re anywhere nearby,  I’ll be in the vendors’ area with 200  nephrologists milling around.  Come say hello.

This month a specific nephrologist and I will be exploring selling our books as a set, one book written by the doctor and one written by the patient.

I’m doing my bit for National Kidney Month.  What can you do?

World Kidney Day is Thursday, March 8.  I expect there to be all kinds of symposiums, conferences and information booths available to you that day.  Why not bring a friend who doesn’t know much about Chronic Kidney Disease and the need to be tested for it to one of these?

We patients are not the only ones trying to be aware.  This New York Times article can give us some insight into what some of our doctors are doing to stay aware.

Teaching Doctors to Be Mindful

By PAULINE W. CHEN, M.D.
Doctors from across the world gather at the Chapin Mill Retreat Center in Batavia, N.Y. to bring intention, attention and reflection to clinical practice.Brett Carlsen for The New York TimesDoctors from across the world gather at the Chapin Mill Retreat Center in Batavia, N.Y., to bring intention, attention and reflection to clinical practice.
It was 6:40 in the morning and nearly all of the doctors attending the medical conference had assembled for the first session of the day. But there were no tables and chairs in sight, no lectern, no run-throughs of PowerPoint presentations. All I could make out in the early morning darkness were the unmoving forms of my colleagues, cross-legged on cushions and raised platforms, eyes closed and hands resting with palms upward in their laps.

They were learning to meditate as part of a mindful communication training conference, held last week at the Chapin Mill Retreat Center in western New York, and sponsored by the University of Rochester Medical Center.

There has been a growing awareness among doctors that being mindful, or fully present and attentive to the moment, not only improves the way they engage with patients but also mitigates the stresses of clinical practice.

Mounting paperwork demands and other time and productivity pressures can lead to physician burnout, which affects as many as one in three doctors, recent studies have shown. The loss of enthusiasm and engagement that results can lead to increased errors, decreased empathy and compassion toward patients and poor professionalism. Other problems include physician substance abuse, abandonment of clinical practice and even suicide.

Despite the pervasiveness of burnout, few interventions have been shown to be effective. But two years ago, University of Rochester researchers studied the effects of a yearlong course for practicing primary care physicians in mindful communication. Their findings, published in The Journal of the American Medical Association, showed that doctors who took part in the course became more present, attentive and focused on the moment and less emotionally exhausted over time. Moreover, the doctors’ ability to empathize with patients and understand how patients’ family and work life or social situation could influence their illness increased and persisted even after the course had ended.

“Mindful communication is one way for practitioners to feel more ‘in the game’ and to find meaning in their practice,” said Dr. Michael S. Krasner, an associate professor of clinical medicine at Rochester and one of the study authors. He, along with his co-author Dr. Ronald Epstein, a professor of family medicine, psychiatry and oncology at Rochester, developed the course in mindfulness.

But it takes training, and that training can be particularly challenging for physicians who are used to denying their personal responses to difficult situations. In addition to learning to meditate, doctors participate in group discussions and writing and listening exercises on topics like medical errors, managing conflict, setting boundaries and self-care. Small group discussions are meant to increase awareness of how one’s emotions or physical sensations influence behaviors and decisions.

In one exercise, for example, doctors are asked to write about a mistake in their professional or personal life. Examples of such errors have included missing a diagnosis, prescribing the wrong medication, making assumptions about a patient that led to inadequate care or failing to be present for their own families because of an inability to balance work and family life. The doctors must then discuss the issue with two peers, describing not only the event but also any associated physical and emotional sensations. One of the other doctors has the task of practicing appreciative inquiry, or listening without making judgments or jumping to conclusions. And the other serves as an observer, offering suggestions at the end of the session for how the listener might improve his or her skills.

Many of the participants at last week’s conference, capped by the organizers at 40 and coming from the United States and Canada and from as far away as New Zealand, described the four-day experience as “transformative.” “I can honestly say that these have been some of the most important days of my life,” said Dr. Elissa Rubin, a pediatrician and lactation consultant who traveled to the conference from Mineola, N.Y., on Long Island.

But the real challenge for these participants — and the growing number of advocates of such training — is not acquiring mindfulness. It is finding the time and support necessary to sustain their skills and teach others.

Once back in their work environments, many say it is easy to fall back into old patterns. Dr. Krasner and Dr. Epstein have had to close down some of their programs directed at interns and residents because of financial issues. And a frequent topic of conversation among several of last week’s participants who hoped to teach at their own institutions were how to best introduce these ideas to colleagues who might be skeptical or administrators who might be hesitant to set aside valuable clinical time for training courses or pay for a program that does not generate revenue.

Nonetheless, Dr. Krasner and Dr. Epstein remain optimistic, in large part because they believe that mindful communication is not just another optional skill or fringe fad in health care. “Mindfulness,” Dr. Epstein said, “and the self-awareness it cultivates, is a fundamental ingredient of excellent care.”

Their patients would agree. In clinic, a patient who has suffered for years from chronic pain told me why he remained Dr. Epstein’s patient. “He’s the best doctor I’ve ever had because he can get to what I am trying to say quicker than any other doctor.

“I’m not sure how he does it, but he just really gets it.”

You can view the original article at: http://well.blogs.nytimes.com/2011/10/27/teaching-doctors-to-be-mindful/?smid=tw-nytimeshealth&seid=auto

Until next week,

Keep living your life!

World Kidney Day Is Only Six Years Old

Each Monday, I find it progressively more difficult to choose a topic.  I am amazed at how much information is being disseminated about kidney disease and its treatment and/or underlying causes these days.  Since March 8 is the sixth World Kidney Day, I thought we would go back to the basics to start today’s blog.  Thank you, again and again and again to The National Kidney Foundation for all the information they make available to us.  This is their World Kidney Day posting:

Top 10 Reasons to Love Your Kidneys

Sometimes the more you know, the more you love.  The National Kidney Foundation urges Americans to get to know two humble, hardworking organs: the kidneys.  To help raise awareness and appreciation for all the vital functions the kidneys perform, the National Kidney Foundation offers 10 reasons for Americans to love their kidneys and take steps now to preserve kidney health:

1. Filter 200 liters of blood a day, removing two liters of toxins, wastes and water

2. Regulate the body’s water balance

3. Regulate blood pressure by controlling fluid levels and making the hormone that causes blood vessels to constrict

4. Support healthy bones and tissues by producing the active form of vitamin D

5. Produce the hormone that stimulates bone marrow to manufacture red blood cells

6. Keep blood minerals in balance

7. Keep electrolytes in balance

8. Regulate blood acid levels

9. Remove drugs from the blood

10. Retrieve essential nutrients so that the body can reabsorb them

In my book, I discuss how important it is to tell every doctor you see about your Chronic Kidney Disease.  Notice #9. “Remove drugs from the blood.”  You may need to take a lower dosage of whatever drug was prescribed or, perhaps, take it less often.  If your kidneys are not fully functioning, the drugs are not effectively being removed from your blood.  It would be similar to willfully taking a drug overdose if you do not make your doctors aware of your CKD when they prescribe for you.  Make sure your pharmacist knows about your CKD, too.  You cannot rely on your doctors – specialists or not – to remember every warning on every label.  That’s where your pharmacist comes in.  He or she has that same information.  You are ultimately the one in charge of your health.  It makes perfect sense to draw upon all your resources.

I also discuss in my book the problem in my local hospital’s emergency room when I had a bladder infection.  Just in case you don’t remember, my primary care doctor wasn’t available, so her M.A. told me to go to an Urgent Care facility rather than wait since I have CKD.  When I arrived and told the receptionist I have CKD, she immediately sent me to the hospital emergency room in case I needed blood or other tests for which the Urgent Care wasn’t equipped.  After a battery of tests in the emergency room, sulphur drugs were prescribed, although I’d took them repeatedly about having CKD.  Sulphur drugs can harm the kidneys even more.

This got me to thinking about if I were brought into the e.r. under true emergencies conditions – as in unconscious.  How would they know I had CKD before they located someone who could tell them about my medical background?  Or access my records elsewhere? I knew the answer was a medical alert bracelet, but spent quite a bit of time ignoring the issue.  Then I got sick again – a simple flu – but the bracelet idea popped back into my mind full blown, so I started searching for one.

I wanted something that looked like jewelry, but not too much like jewelry because I have simple tastes.  So, I did what I do best: researched.  This is what I came up with:

I chose the black plate and had “Chronic Kidney Disease” inscribed on two lines on the back.  Now, the bracelet itself:

It’s jewelry like, something I’m comfortable wearing and it does the job of making me feel secure should I ever have a true emergency.  I’ll be adding  http://www.medicalidfashions.com/ to the blog roll later on.  They are one of several sites with the type of medical alert i.d. bracelet I’ve been discussing.  Feel free to click through now or wait for the address to be added to the blog roll.  You know, don’t you, that I have nothing to do with any of the companies I mention to you except that I want to share what I’ve found.

Ah, talking about sharing!  I found this review of the book on Amazon and walked on air for the rest of the day!

5.0 out of 5 stars The Best Info on Kidney Disease around!, February 20, 2012
This review is from: What Is It And How Did I Get It? Early Stage Chronic Kidney Disease (Kindle Edition)

This is an incredibly well-researched, well-written book written by a woman who herself developed kidney disease. Her book provides clear and comprehensive information for all about the care patients need to have, and responds to the fears and concerns of all involved with coping with kidney disease. It is an honest, very personal accounting of her experience, and I found it to be written clearly, providing tons of pertinent information about every facet of how to cope with this illness. I think Ms. Rae wrote this book for the ordinary person who learns that they will be living with kidney disease from the moment of diagnosis, on. But after reading, I believe that it is also a book that every family member, every friend of someone who has developed kidney disease ought to read as well, in order to better understand what their loved ones are going through. I also believe that this book will benefit every professional in the medical community who deals with patients coping with Kidney Disease. It has helped me, and will help everyone involved with the patient on any level to be better able to understand their patient’s concerns, anxieties, needs and limitations. For these reasons I think it is a great guide for the medical community as well as for the patient/family/friends, as it can help professionals understand the kind of information their patients need to have in order to take good care of themselves. Don’t pass this book up!

Got to go check out a symposium that sent me an invitation to exhibit.  This is a new one for me.

Until next week,

Keep living your life!

Dear Abby Speaks

Thursday is World Kidney Day, while March in National Kidney Month.  There’s a reason there’s such attention being paid to our kidneys.  Yesterday, my neighbor texted me in the middle of her work day to let me know our local newspaper, The Arizona Republic, carried a Dear Abby column about kidney disease.  With thanks to Amy Vlasity and Dear Abby, that column is today’s blog.

Take care of kidneys before it’s too late

by Dear Abby – Mar. 7, 2011 12:00 AM

Dear Abby: Like many other young adults, I was too busy establishing a career during my 20s and early 30s to care much about diet and exercise.

I felt healthy, so I saw no need to change my lifestyle. My doctor had told me my blood pressurewas elevated during a number of my yearly physical exams, but I didn’t ask any questions and took no action.

Then one morning, I walked into my doctor’s office complaining of a severe headache and nausea. I was sent to the hospital with a dangerously high blood pressurereading.  After just a few tests, I was told I had chronic kidney disease.

Even though it can be silent and cause no symptoms, high blood pressure should not be ignored. It is a leading cause of kidney disease, and because I didn’t pay attention, my kidneys began to shut down.

Abby, please tell your readers who are at risk for chronic kidney disease (and that’s anyone with high blood pressure, diabetes or a family history of CKD) to check how their kidneys are functioning. I found out – too late – how important it is.

– Aziza M., New York City

Dear Aziza: Of course I will pass on your warning. According to the National Kidney Foundation, more than 26 million adults and thousands of American children have chronic kidney disease – and most of them don’t know they have it. In addition, millions of people who have diabetes, hypertension and other diseases are unaware that they too are at risk for developing it.

Thursday is World Kidney Day. The National Kidney Foundation is offering free screenings during the month of March through the Kidney Early Evaluation Program in cities and towns around the country.

With more than 50 local offices nationwide, the NKF provides early-detection screenings and other vital patient and community services. To find a screening near you, visit www.kidney.org.

I went to the website and found what looked like a comprehensive list of screening areas throughout the country, but didn’t see my home state.  That’s when I noticed the area directly above the list where you can enter your zip code, hit submit and a drop down list of local centers will appear.

Today’s blog will stay short and sweet so you get the message: urge everyone you know to get themselves checked.  There are no symptoms until you have lost MOST of your kidney function.  Don’t wait, please.

Until Friday,

Keep living your life.