I’m Tired.

baby-shots-5I’m tired.  I’m almost always tired.  That is my most prevalent complaint lately.  And why?  Because I have Chronic Kidney Disease, Stage 3A. I thought I remembered this particular symptom doesn’t appear until dialysis starts – at stage 5 – so I decided to re-research my research… and surprised myself with the results.

Just in case you don’t remember, I retired from teaching at the community college last February (right after my 66th birthday) and from acting a month later. Two careers down and a year older, I’m still tired. True, I do blog every week and work on SlowItDown.  However, it’s still two careers down.

I was becoming concerned.  According to Donna D. Ignatavicius, MS RN, and M. Linda Workman, Ph.D, authors of Medical-Surgical Nursing: Critical Thinking for Collaborative Care, I shouldn’t be.  They explain that patients with early symptoms of chronic renal failure may complain of a general feeling of illness and that lack of energy and fatigue are often reported without any identifiable cause.

By the way, the book is available on Amazon, but I cannot recommend it yet since I just ordered it.  More on that after I read it. Okay, so maybe my CKD hadn’t advanced and maybe I hadn’t developed diabetes. Maybe it was just the stage of CKD I was in.

I wanted to check with my old standby, The Mayo Clinic.  Their website told me: “Signs and symptoms of kidney disease may include:Location of Kidneys

  • Nausea
  • Vomiting
  • Loss of appetite
  • Fatigue and weakness
  • Sleep problems
  • Changes in urine output
  • Decreased mental sharpness
  • Muscle twitches and cramps
  • Hiccups
  • Swelling of feet and ankles
  • Persistent itching
  • Chest pain, if fluid builds up around the lining of the heart
  • Shortness of breath, if fluid builds up in the lungs
  • High blood pressure (hypertension) that’s difficult to control”

You can read more about these symptoms at: http://www.mayoclinic.org/diseases-conditions/kidney-disease/basics/symptoms/con-20026778

Wait a minute!  Where in heaven’s name was loss of appetite when you needed it!  Here I am with CKD, aging, exercising, following the renal diet, and not losing weight. I realize that sounds pretty shallow.  Let me explain.  My weight has always been a problem.  I’m not saying I WANT another symptom of CKD, but since I have CKD anyway, I would have preferred that symptom.

hiccupsI also had never questioned why I have hiccups so often.  Bear thought it was that I ate too fast, so I slowed down. (Hey, almost 45 years of running up to the fourth floor cafeteria, waiting in line, and then bolting down your food so you can get to the restroom and drop off your reports in the office three flights back down before teaching your next class doesn’t dissipate that quickly.  Long term habits….)

And why is fatigue a symptom of CKD in the first place?  I found the following at: http://www.kidneyabc.com/ckd-treatment/991.html (Which looks like it might just be a Chinese herbal site; it wasn’t quite clear.): “Fatigue in CKD (Chronic Kidney Disease) is most often caused by anemia in which the count of red blood cells are lower than normal. As red blood cells distribute oxygen to body tissues and cells, a shortage of oxygen can cause fatigue. Anemia begins in early stage of CKD, and tends to get worse as renal function decreases and less erythropoietin (EPO) is produced by kidneys.”

new blog shotThis is something that I explained in What Is It And How Did I Get It? Early Stage Chronic Kidney Disease. I’ve been diagnosed with non-anemic low iron levels. Well, it’s nice to know I’m not anemic, but the low levels of iron produce the same fatigue. Why?

The National Kidney and Urologic Diseases. Information Clearinghouse at http://kidney.niddk.nih.gov/kudiseases/pubs/anemia/anemia_508.pdf explains: “Healthy kidneys produce a hormone called erythropoietin, or EPO, which stimulates the bone marrow to produce the proper number of red blood cells needed to carry oxygen to vital organs.  Diseased kidney, however, often don’t make enough EPO. As a result, the bone marrow makes fewer red blood cells.”

You can’t correct it by simply taking EPO injections.  It’s just not that simple.  To quote what I wrote in my book, “…EPO can worsen your HBP – which can both cause and be caused by CKD.  Most nephrologists agree it’s better to take the EPO injections and increase your HBP medication to control your hypertension. “

That was thought to be true when I researched for the book over three years ago, but since then the medical science community has discovered that synthetic EPO may be harmful to your body in that it may cause the body to produce antibodies for EOP.  Then your liver becomes involved, too, since it produces a small amount of EPO.flu

So, what can you do for this fatigue?  I went to the same Chinese herbal site because their recommendations were simply so logical.

“Regular exercises have many benefits for stage 3 CKD patients:

Boost your energy.

Improve your immune system.

Alleviate edema.

Lower high blood pressure.

Aerobic exercises such as walking, jogging, dancing, swimming, etc. are preferred. And remember to avoid strenuous exercises.”

How can you argue with that?  I couldn’t, especially since dancing is included!

happy birthdayThank you all for your birthday wishes.  I like to respond to each of you individually and hope I haven’t missed anyone.  Let me know if I have. It was a lovely day with the kids, and neighbors helping me celebrate, as well as my long distance friends emailing, snail mailing, Facebook inboxing, and texting.  I truly feel cherished by those in my communities.

I also believe I’ve gotten across to the French division of Amazon by writing in English and letting them translate it instead of giving in to my own misguided insistence upon using my fractured French.  Take a look for yourself by going to Amazon’s website, scrolling down to the bottom of the page where the different countries of operation are listed, hitting France, and inputting the title of the book – in English.

I’m tired… time to take a rest.

Until next week,

Keep living your life!

It’s a Weighty Question

There’s a new addition to our family.  Oh, no, no!  Of course, with all our daughters, it’s natural to think it’s a grand child, but it’s actually a “grand” cat.  Let’s see now, we’re up to two grand dogs and three grand cats, plus our own Bella dog.  Little miss Annabelle is just twelve weeks old and cute as a button.  Thinking about cats led me to wonder if you knew that cats can also have CKD. And if you knew that some of the same treatments are used for feline CKD as for human CKD. That’s why you’ve got to be careful when you do your own research that what you’re reading deals with human, not feline, CKD.    

My daughter, Abby, brought Annabelle to the bar-b-q my fiance – Bear – threw to celebrate my 65th birthday yesterday (The bar-b-q was yesterday; my birthday was February 2 – Ground Hog’s Day – just in case you were wondering.) so everyone could meet the little cutie.

Being human, we overate, which got me to wondering about how hard it’s become for me to lose weight, much less maintain a healthy weight.  I remembered a blog I’d read on NPR way back in November and decided to share it with you.  I can’t be the ONLY one concerned with my weight, can I?

Hormones And Metabolism Conspire Against Dieters

by

There are some fresh insights from Australia that help explain why it’s so difficult for dieters to keep off the weight they lose.

Willpower will only take you so far, in case you haven’t run that experiment yourself. Turns out our bodies have a fuel gauge, not entirely unlike the gas gauge on our cars, that tell us when it’s time to tank up on food.

The gauge relies on hormones that signal to the brain when and how much to eat. But as Dr. Louis Aronne, who directs the comprehensive weight control program at Weill Cornell Medical College in New York, explains, the human fuel gauge can sometimes be way off the mark — especially for dieters.

A study just published in the New England Journal of Medicinedocuments a pretty extreme diet regimen that limited 50 overweight and obese Australian volunteers to about 550 calories a day for 10 weeks.

Most of them, though not all, actually stuck with the diet, and, not surprisingly, lost a lot of weight. While dieting they shed an average of nearly 30 pounds, or 14 percent of their body weight. At a year, they’d still kept a lot of the weight off, but, on average, their loss was down to 8 percent 15 months after the start of the study.

What happened to their hormones? The researchers measured a whole bunch of them, including insulin, leptin (an appetite suppressant) and ghrelin (a hunger stimulator) and found that more than year after the weight loss, the hormones were telling the people to keep eating — a lot.

As Aronne puts it, their internal gas gauges went down 65 percent instead of the 10 percent or so that would have been more in line with the weight lost. In essence, “they think they’re going to run out of gas  very, very soon.”

So it’s not just a lack of willpower that’s tripping people up. Their hormones are sending a strong, confounding signal to chow down.

What’s more, the study found that the metabolic  rate of the dieters remained low a year after the low-calorie diet  ended, making it even harder to burn off those calories.

While this might be a plausible explanation, I don’t find it all that comforting.  Yes, I do understand better why I’m having such a hard time with the weight, but I also know this means more exercise to burn off some of those calories my body is holding on to.  Guess I’d better learn to love exercise all over again, only exercise that accommodates arthritis this time.

You can find the blog at: http://www.npr.org/blogs/health/2011/11/03/141769832/hormones-and-metabolism-conspire-against-dieters?sc=fb&cc=fp

On another note, the lovely Aaron Milton of the FB page P2P for sufferers of any chronic illness posted an “Add to cart” button for the book there.  I’d like to do that to the blog and the book’s FB page, as well as my person website (www.gail-rae.com) but Aaron’s forgotten how he did it.  Anyone know how to do this?

Until next week,

Keep living your life!

Published in: on February 6, 2012 at 12:20 pm  Leave a Comment  
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