Miracles Redux

Welcome to the last blog of 2016. I find it hard to believe another year has passed, although I do acknowledge that I’m a bit slower and more new-years-eve-celebrations-live-streamcontent to stay in my office to write rather than run around town. It’s a bit harder to maintain my body, although my mind is doing fine… as long as I don’t have to remember too much at once, that is. Well, my knees may have something to say, but I try to keep them happy with daily exercise and the braces.knee brace

I sincerely hope you enjoyed a joyous Christmas if you celebrate. And that you continue to enjoy Chanukah and Kwanzaa (which starts today) if you celebrate. We’ll be leaving for the Trans-Siberian Orchestra concert as soon as I finish the blog… a gift from us to us and one of the kids for Christmas. On Wednesday, we’ll have our Annual Chanukah Gathering. Our New York daughter will be with us since her Chanukah gift is a plane ticket. Being a two religion family, we celebrate both Chanukah and Christmas.

Before I get to more about creating a miracle, I am proud to announce that Healthline, a trusted health information site,  has named SlowItDownCKD one of The Best Kidney healthlineDisease Blogs of 2016. Talk about being surprised… and honored. Sort of a nice Christmas present, don’t you think? I suppose I can consider the publication of my novel, Portal in Time, my Chanukah present. I didn’t do too shabbily this year.

You know, it’s never too late to give either the novel or one of my Chronic Kidney Disease books as a present. Don’t forget you deserve presents, too.

Okay, on to more about miracles – or Part 2 – as I promised last week.

Unhealthy%20KidneyIf CKD were common knowledge, if those in high risk categories were aware of it, we might have a chance of preventing the disease in those who don’t have it yet and/or slowing down the progression of the decline in kidney function of those who have been already diagnosed.

Exactly how can we do that? On the most basic level, there’s the spoken word. It’s not just the medical community that can talk about the disease. I can as a patient. You can, too, because you know me and I’ve told you about the disease (and/or you suffer from CKD yourself).  This is most effective in areas of the world that do not have access to – or money for – doctors and treatment.  This is where we can prevent more and more of the disease by preventing more and more hypertension and diabetes.

If I tell you what I know about curtailing sodium intake in high blood pressure and you tell me what you know about smoking as it contributes to hypertension, we’ve just shared two important aspects in the prevention of high blood pressure. If I tell you what I know about sugar in diabetes Healthy%20Kidneyand you tell me what you know about carbohydrates and diabetes, we’ve just shared two important aspects in the prevention of diabetes. Then my husband starts sharing what he knows… and your third cousin once removed shares with her East Indian neighbor what her nephrologist told her… and your boss’s secretary shares what his boyfriend learned at his CKD awareness meeting, you’ve got a lot more people aware of what needs to be done about CKD. Sometimes causing a miracle is played out by sharing with people. Think of the miracle this kind of communication on a daily basis can cause.

The people you speak to will share with those they know, those they know will share with others they know until many, many hairmore people become aware of CKD – just as that long ago Clairol hair coloring ad demonstrated how telling someone who tells someone can go on ad infinitum. Simplistic? Yes, but it works…and that’s part of living the life of causing a miracle in CKD.

Then there’s the printed word. If people are aware of CKD books and newspapers, business and educational publications can alert their populations that the disease exists and is lethal, but may be prevented and/or slowed down. Most businesses have wellness components. What perfect vehicles to transform the world’s awareness of CKD.IMG_2979

For example: my four Chronic Kidney Disease books are sold in 106 countries. I have 107,000 readers. This in itself is a miracle, not just for me but for everyone who is in some way connected to the disease. It is not uncommon for one community member to buy the book, then share it with everyone else in their social circle. If there’s a library, the books can be ordered and then shared for free.

These are some of the pieces I’ve written: American Kidney Fund   “Slowing Down CKD –  It Can Be Done”  7/14/16, Dear Annie 10/14, KidneySteps  9/11/13  &  7/4/12, National Kidney Foundation 6/6/13, It Is What It Is 3/9/12, Kevinmd.com 1/1/12, Working with Chronic Illness 1/11/10, KidneyTimes 1/11/10. Bragging? No, just demonstrating it can be done… but I had to cause it to happen by knocking on doors.

I also share my information via this blog. A doctor in a remote village in India prints and translates it to share with whichever patient has the bus fare to make it to the clinic. That patient brings the translation back to his family, friends, neighbors, and whoever else he thinks may be interested. blood drawThis nephrologist’s view is the same as mine: We both need to live a life causing a miracle in Chronic Kidney Disease Awareness by sharing information. People who may not have known Chronic Kidney Disease exists now know via this sharing. Others who have undergone the simple blood and urine tests to diagnose the illness can share that the tests are not painful, other than the initial pinch of the needle for the blood draw. You would be surprised how many people, even in the high risk groups, don’t take the tests because they fear there will be pain involved. No sharing, no awareness. No awareness, no diagnose. No diagnose, no slowing down the disease.

Here are some of the blog and book mentions that have helped in my sharing of the information: Federal Register 9/25/13, The Neuropathy Doctor’s News 9/23/13, The NephCure Foundation 8/21/11, World’s Leading Expert.com 9/11/12, Glendale Community College Gaucho Gazette 8/22/11. These came about without my intervention. So what you share gets shared by others….

I’ve got some more thoughts, but we’ll have to leave them for Part 3 in the New Year. This blog is getting too long and my family is waiting for me.  Happy New Year to each and every one of you. Please be safe if you’re going out to celebrate.

Until next week and the New Year,

Keep living your life!

 

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It’s a Miracle!

It’s that time of year again… the time to believe in miracles. There’s the miracle of Mary’s virgin birth at Christmas. And there’s the miracle of the Christmas TreeChanukah oil burning for eight nights instead of the one it was meant to. That got me to thinking about miracles and so, we have a different kind of several part blog beginning today. Consider it my gift to you this holiday season.

Miracles happen every day, too. We just need to take action to make them happen… and that’s what I’d like to see us do with Chronic Kidney Disease by sharing the available information.  This particular miracle is helping to alleviate the fear of needing dialysis and/or transplantation. This particular miracle is helping patients help themselves and each other. This particular miracle is helping doctors appreciate involved patients.

Yet, causing this miracle by sharing information is overlooked again and again. Chronic Kidney Disease, or CKD, is easily diagnosed by simple blood tests and urine tests (as we know), but who’s going to take them if they have no idea the disease exists, is widespread, and may be lethal? By Menorahsharing information, those at high risk will be tested. Those already in the throes of CKD can be monitored and treated when necessary. While CKD is not curable, we know it is possible to slow down the progression of the decline in your kidney function.

According to the National Institutes of Health at http://www.ncbi.nlm.gov/pmc/articles/PMC4112688,

“2014: Worldwide, an estimated 200 million people have chronic kidney disease (CKD).”

Before I was diagnosed, I had never heard of this disease… and apparently I’d had it for quite some time.  Why weren’t people sharing information about this?  Couldn’t that have prevented my developing it? At the time of my diagnose nine years ago, I meant doctors.  I don’t anymore. Nor do I leave causing a miracle by sharing to others.

This is my life. I have had Chronic Kidney Disease for nine years. As a college instructor who taught Research Writing at the time of my diagnose, I researched, researched, and researched again, but the only person I was sharing my research with was the nephrologist who treated me and FullSizeRender (2)monitored my condition. I may have expected a miracle there, but I didn’t get one. Why?

I got to thinking about that and realized he already knew what I told him. That’s when it struck me that if I expected a miracle with CKD, I would have to start sharing this information with the people who need it: the ones who didn’t know, the ones who had just been diagnosed and were terrified, and the families of those with CKD who didn’t know they also might be at risk. I went so far as to bring CKD education to the Native American Communities in Arizona since Native Americans are at high risk. I had the information and had experts willing to come to the communities to share that information.

We all know this is a costly, lethal disease if not caught early and treated… and that it’s not just the elderly who are at risk. One out of ten people worldwide has CKD, yet an overwhelming number of them are unaware they have it. We know CKD can be treated, just not the way those who don’t have it might expect. A diet with restrictions on protein, potassium, phosphorous and sodium may be one aspect of that treatment. Exercise, adequate sleep, and avoiding stress are some of the other aspects. Some patients – like me – may have to take medication for their high blood pressure since that also affects kidney function. Imagine preventing a death with lifestyle changes. Now imagine EXPECTING the miracle of preventing that death by sharing this information. Powerful, isn’t it?

We know the basic method of diagnosing CKD is via routine blood and urine tests. Yet, many people do not undergo these tests during doctor or clinic visits, so don’t know they have Chronic Kidney Disease, much less start treating it.urine container

This is where the miracle I expected in my life began for me. I started speaking with every doctor of any kind that I knew or that my doctors knew and asked them to share the information. They were already experiencing time constraints, but suggested I write a fact sheet and leave it in their waiting rooms since they agreed there’s no reason to wait until a person is in kidney failure and needs dialysis or a transplant to continue living before diagnosing and dealing with the illness.

My passion about producing this miracle multiplied threefold from that point on. So much so that I went one better and wrote a book with the facts. I was convinced we would be able to cause a miracle by sharing information about this disease. My goal was clear: have everyone routinely tested.

Dr. Robert  Provenzano, a leading nephrologist in the United States,  succinctly summed up the problem worldwide.

“Chronic Kidney Disease is an epidemic in the world…. As other countries become Westernized, we find the incidence of Chronic Kidney Disease and end-stage renal failure increases. We see this in India, and in China. We see this everywhere. …”

We repeatedly see diabetes and hypertension cited as the two major causes of CKD. Does your neighbor know this? How about the fellow at the gas bp cuffstation? Ask them what Chronic Kidney Disease is. More often than not, you’ll receive a blank look – one we can’t afford if you keep the statistic at the beginning of this paper in mind. We can cause a miracle to change this.

Sharing can be the cause of that miracle… but that’s not something we can leave to the other guy. We each ARE the other guy. More on this next week.

For now, Merry Christmas, Happy Chanukah, Happy Kwanzaa (somehow implicit in this holiday is the miracle of bringing people together), and every other holiday I’ve inadvertently missed or don’t know about.

portal_in_time_cover_for_kindleI just got word that Portal in Time – my first novel – is available on Amazon.com. Consider that as a holiday gift for those friends not interested in CKD. Of course, I just happen to have four CKD books on Amazon.com for those who might be interested in CKD. Be part of a miracle.IMG_2979

Until next week,

Keep living your life!

Blood and Thunder, Without the Thunder

I’ve been thinking a lot about blood lately and realize it’s time for a refresher about blood and CKD. It’s been doctor-visits-week for me and each one of them wanted to talk about blood test numbers… because I have Chronic Kidney Disease and my numbers are the worst they’ve been in seven years.Blood Oxygen Cycle Picture 400dpi jpg

This made me realize how very little I remember when it comes to how CKD affects your blood.  Soooo, I’m going right back to the very beginning. According to National Institute of Diabetes and Digestive and Kidney Diseases at http://www.niddk.nih.gov/health-information/health-communication-programs/nkdep/a-z/kidney-disease-mean-for-me/Pages/default.aspx, this is how:

“CKD means that your kidneys are damaged and can’t filter blood like they should. This damage can cause wastes to build up in your body. It can also cause other problems that can harm your health.”

By the way, this is a reader friendly page with visuals that the organization freely shares. You’ve seen them in my books and blogs. There is no medicalese here, nor is there any paternalism.  I like their style.

The National Kidney Foundation at https://www.kidney.org/kidneydisease/aboutckd explains in more detail.

“If kidney disease gets worse, wastes can build to high levels in your blood and make you feel sick. You may develop complications like high blood pressure, anemia (low blood count), weak bones, poor nutritional health and nerve damage. Also, kidney disease increases your risk of having heart and blood vessel disease. These problems may happen slowly over a long period of time.”

Maybe seven years is that ‘long period of time’, not that I have heart or blood vessel disease that I know of. But I do have high blood pressure which may have contributed to the development of the CKD. Circular, isn’t it? High blood pressure may cause CKD, but CKD may also cause high blood pressure.  Or is it possible that the two together can cause ever spiraling high blood pressure and worsening CKD?

Book CoverI’m going to go back to What Is It and How Did I Get It? Early Stage Chronic Kidney Disease here for some basic definitions that may be helpful in understanding today’s blog.

Albumin:   Water soluble protein in the blood.

Chronic Kidney Disease:  Damage to the kidneys for more than three months, which cannot be reversed but may be slowed.

Hypertension: A possible cause of CKD, 140/90 mm Hg is currently considered hypertension, a risk factor for heart disease and stroke, too. (New guidelines say these numbers are for CKD patients.)

Nephrons: The part of the kidney that actually purifies and filters the blood.

Let’s take a detour to see how sodium can affect high blood pressure which can affect so many other conditions.  This is a quote from Healthline.com at http://www.healthline.com/health/fast-food-effects-on-body which appeared The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 2.

“Too much sodium helps to retain water, so it can cause general bloating and puffiness. Sodium can contribute to high blood pressure {Which, as we know, is the second leading cause of CKD} or enlarged heart muscle. If you have congestive heart failure, cirrhosis, or KIDNEY DISEASE {My bolding and capitalization in this paragraph.}, too much salt can contribute to a dangerous build-up of fluid. Excess sodium may also increase risk for kidney stones, KIDNEY DISEASE, and stomach cancer.

High cholesterol and high blood pressure are among the top risk factors for heart disease and stroke.”Part 2

Oh my! Sodium, high blood pressure, enlarged heart muscle, stroke, heart disease, dangerous fluid build-up. They all can be inter-related. And that’s the problem with CKD:  your blood is not being filtered as it should be. There’s waste buildup in your blood now.

It’s that same not well filtered blood that flows through your body possibly causing hearing problems, as was discussed in a previous blog.  It’s that same not well filtered blood that flows through your body possibly causing your high blood pressure. It’s that same not well filtered blood that flows through your body possibly causing “swelling in your anklesvomitingweakness, poor sleep, and shortness of breath.” (Thank you WebMD at http://www.webmd.com/a-to-z-guides/understanding-kidney-disease-basic-information for that last quote.)

I’m sorry to say this all makes sense.  All these conditions are inter-related and they may be caused by CKD, or high blood pressure which causes CKD, or both.

blood pressure 300dpi jpg

I see something I’ve ignored here. I have high blood pressure and I have CKD… and a lot of microalbumin in my urine.  This is new, and it’s a bit scary. Oh, all right, a lot scary.  I write about it so I have to research it and therefore, allay my fear by learning about it.

What did I learn about microalbumin, you ask? The MayoClinic at http://www.mayoclinic.org/tests-procedures/microalbumin/basics/definition/prc-20012767 says it in the simplest manner.

“A urine microalbumin test is a test to detect very small levels of a blood protein (albumin) in your urine. A microalbumin test is used to detect early signs of kidney damage in people who have a risk of kidney disease.Unhealthy%20Kidney

Healthy kidneys filter waste from your blood and keep the healthy components, such as proteins like albumin. Kidney damage can cause proteins to leak through your kidneys and leave your body in your urine. Albumin (al-BYOO-min) is one of the first proteins to leak when kidneys become damaged.”

At first, I laughed it off; I already know I have CKD. Until I saw the results for this test, but I’ve requested what we used to call a do-over when we were kids and my doctor saw the value in that.

Ready for some good news?

Both The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 1 and The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 2 have indexes now. I promised them before Christmas and Kwanzaa and I delivered. Sort of, that is.  Amazon came through right away; B&N.com will take another five weeks or so.Digital Cover Part 1

Happy, happy holidays to all of you.  I’ll see you once more before 2016. Talk about time flying!

Until next week,

Keep living your life!

The Flu Flew By

‘Tis the season to be jolly… and get the flu.  You’ll be in crowds at your holiday parties, even in stores when you get your shopping done. Everyone’s got to eat, even Scrooge, so you will be in the markets – and crowds – whether you want to be or not.

Uh-oh, so what do you do about the flu? According to Dec. 3, 2012’s MedPage, the flu has arrived early this year.  Bah! Humbug! Just in time for the holiday season.

“The flu season is officially under way about a month earlier than usual, the CDC announced on a call marking the beginning of National Influenza Vaccination Week. {For your information, that was Dec. 2-8 this year} ‘This is the earliest regular flu season we’ve had in nearly a decade, since the 2003-2004 flu season,’ CDC director Thomas Frieden, MD, MPH, said on a conference call with reporters.”Shoppers1

Who even knew there was a National Influenza Vaccination Week? You can read a bunch of statistics about this early flu season at: http://www.medpagetoday.com/InfectiousDisease/URItheFlu/36225?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&xid=NL_DHE_2012-12-04&eun=g596983d0r&userid=596983

Reminder: as a chronic kidney disease patient, you already have a compromised immune system.  Help yourself to avoid the flu by getting that vaccine.  In some cases (you’ll have to ask health care worker if you are part of this group), you may be able to take the nasal vaccine.  This is especially helpful if you have a great dislike for injections, but if you can’t because you have ckd, just look away during the shot.  That has been proven to make it easier to handle the fear, as I wrote about in an earlier blog.

By the way, Medicare covers the cost of the flu shot.

So, again I ask what do you do about the flu? According to Healthfinder.gov, you can protect yourself from the flu by doing the following:

Getting the flu vaccine is the most important step in protecting yourself from the flu. Here are some other things you can do to keep from getting and spreading the flu:

  • Stay away from people who are sick.
  • If you are sick, stay home for at least 24 hours after your fever is gone.
  • Wash your hands often with soap and warm water.
  • Try not to touch your nose, mouth, or eyes.
  • Cover your mouth and nose with a tissue when you cough or sneeze

The entire article about the flu may be found at: http://healthfinder.gov/prevention/ViewTopicFull.aspx?topicID=18

Most of this sounds fairly obvious. But then Bear told me about someone at work who simply sneezes and coughs into the air around him. That got me to thinking.  Do you find yourself shying away from certain people who do the same?  Maybe you should.

Since the cataract surgery and the sealing off of my tear ducts, I am always touching my eyes to wipe away the extra moisture. Until I read this article, I’d always thought of myself as someone who doesn’t keep touching my face.  But that’s not true, is it?

And how many people in this economy really do take off from work for 24 hours after their fevers break?  Who can afford to do that? We have people struggling to hang on to minimum wage positions while a string of other people are ready and waiting for these same jobs.

It’s worth thinking about this yourself.  Remember when we were taught to cough or sneeze into the inside of our elbows?  Looks like that’s not as effective as stopping the particulate spray immediately at its source – your nostrils.  Makes sense to me.

We live in Arizona.  It’s so dry we try NOT to wash our hands since that dries out the skin.  I’m not saying we’re a dirty demographic, simply that we try to wash our hands only when necessary. That is not often, but it needs to be during flu season.

fluBut have hope!  According to Rob Stein on NPR’s Health News, “One big difference between this year and the 2003-2004 season is that so far the vaccine appears to be a very good match for the strains of flu that are circulating most widely. That’s important because one of the reasons officials are concerned is that one of the strains is similar to the 2003-2004 strain that caused so much illness and so many deaths.”

I think that’s good news.  It sounds like good news.  Is it good news? Why DID the 2003-2004 strain cause so much illness and so many deaths?  Somehow, that’s not as reassuring as I’d like it to be.

The original article is at: http://www.npr.org/blogs/health/2012/12/07/166745954/unusually-early-flu-season-intensifies?ft=1&f=103537970

I wondered how to tell the difference between a cold and the flu.  Since being diagnosed with ckd, I make it a point to take the flu vaccine annually, yet there have been times when I just didn’t feel that well. I found my answer in the following: http://abcnews.go.com/health/t/blogEntry?id=17885194

“ ‘With influenza you might also feel very poorly, with aches and pains in your muscles and joints,’ said Dr. William Schaffner, chair of preventive medicine at Vanderbilt University Medical Center in Nashville, Tenn. ‘There’s often a cough, too, which is much more prolonged and pronounced.’ ”

That does answer my question.  No muscular aches or pains, so what I experienced was just a cold.

Don’t let yourself become run down with the festivities this year, take the time to relax, maybe even put your feet up and read What Is It And How Did I Get It? Early Stage Chronic Kidney Disease. It’s available in digital – which is less expensive than the book – and print at Amazon.com and B&N.com.

You’ll be in good company.  I’ve gotten notice that personal trainers, doctors, medical assistants, phlebotomists, physicians’ assistants, chiropractors, naturopaths and gym owners have been reading it to understand how better to deal with their clients (or patients, as the case may be) who have CKD.  What a nice holiday present for me.

Here’s my wish that you had a Happy Chanukah and/or are happily preparing for Christmas and Kwanzaa.

Until next week,2012-12-12 19.41.37-1

Keep living your life!

Back To The Salt Minds

Here we are right smack in the middle of Chanukah with Christmas and Kwaanza coming up. We’ve read all the health articles about how to plan our party eating

including the Menorahmenorah lighting and latkes one at our house later this week – and we all know to avoid sodium since it causes so much havoc with blood pressure which causes further problems, right?  Maybe not.

Be prepared to have your minds blown (ahem, I am a child of the 60s):

Scant Evidence That Salt Raises BP, Review Finds

Published: December 04, 2012

The evidence for health benefits associated with salt reduction is controversial and the “concealment of scientific uncertainty” is a mistake, researchers suggested.

salt

Because this is such a treatment shattering controversy, I decided to let the experts speak for themselves. Do go to the following link and listen to them yourselves. (Notice the doctors insist that sodium restriction needs to depend upon the individual patient, not that it should be universally discarded.)

You can read the rest of the article and hear the doctors at: http://www.medpagetoday.com/Cardiology/Hypertension/36248?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&xid=NL_DHE_2012-12-05&eun=g596983d0r&userid=596983&email=myckdexperience@gmail.com&mu_id=5721543

So, what does this mean for us as Chronic Kidney Disease patients?  Well… let’s go back to CKD basics for a moment.  We are restricted as far as the three ps (protein, potassium, phosphorous) and sodium, not to mention fluid intake and – for some of us – caloric intake.  {That’s odd, these restrictions don’t seem that complicated anymore, but when I type them, they look a bit daunting.}

Okay, so sodium.  Too much sodium can lead to hypertension (or can it?), which may lead to CKD. You already have CKD.  You are still at risk for edema, which is swelling caused by fluid retention in the tissues of the body.  Since this is already a potential problem for CKD patients, why exacerbate it?

This is what I wrote about sodium in What Is It And How Did I Get It? Early Stage Chronic Kidney Disease:

“What makes it worse is that there is no internal mechanism that tells us if we need more or less salt.  CKD sufferers are in a spot because the kidneys are the only route by which to eliminate excess salt.

Basically, sodium balances fluid levels outside your cells.  You need it because it is responsible for watering your cells.  This watering is the prompt for potassium to dump waste [cell process by-products] from your cells. Sodium does deal with other functions of the body, but this is a pretty important one.

If you have damaged kidneys and cannot excrete most of the sodium you ingest, you’re up again higher blood pressure {is that still true?} which may worsen your CKD which may further cut down on your elimination of sodium and so on and so forth in an ever spiraling cycle.  In addition, for CKD patients, too much sodium causes fluid retention, thereby causing swelling, further resulting in weight gain, leading to shortness of breath. That’s why your nephrologist asks if you’ve experiences shortness of breath.”

It gets worse.  Too much sodium can increase your need for potassium. While potassium is a necessity since it “dumps waste from your cells, but also helps the kidneys, heart and muscles to function normally.  Too much potassium can cause irregular heart beat and even heart attack.  This can be the most immediate danger of not limiting your potassium.” (also from my book)                                                                bbq-chips-beer-230

That is a simple, direct and universally accepted explanation of the horrors of sodium for CKD patients.  But is it still true for you?  With these newly uncovered controversies, who knows?  Speak with your nephrologist, but use common sense, too. I would not recommend running for the salt shaker under any circumstances, but is it safe to eat the fresh made potato chips you ordered at the local brewery (not that I drank any beer. Oh – I mean, not that you drank any beer.) when you tasted a bit of salt on them?

We are not an overly social couple, yet we have our Chanukah party, a friend’s huge pot luck, Bear’s work holiday social (Let’s hear it for Rockler’s!  They know how to do it right.), Christmas eve at Sean and Kelly’s (wow, another family tradition torch passed to the next generation) and now I’m playing around with the idea of a quiet champagne and caviar – neither of which I can eat – new year’s eve if that’s something the Arizona grown children and the assorted fiancés and boyfriends or best friends would be interested in.  That’s a lot of food intake planning.

I thought about taking it party by party and that has worked well for me.  Prior to that, I had a forbidden list I carried around in my head.  That was a total bust.  I would become frustrated at all the foods I couldn’t eat even though they were beautifully and enticingly displayed in front of me and just go whole hog.  Then I had to deal with the guilt, to say nothing of the bodily discomfort, that I felt after.

Yes, party by party is better for me. But that’s not all.  I am analytic, so I peruse the offerings and then – slowly – mentally check off what I can ingest, all the while socializing. That works for me. So does the old dieter’s motto: do-not-stay-seated-at-the-table-with-that-wonderfully-aromatic-food-in-front-of-you.  Feeling well armed to go to your holdiay parties with sodium intake well in hand?  Go party!

Until next week,

keep living your life!                       1129852_Christmas_Buffet_Smoked_salmon_Ham_Mini_quiches___Sausage_rolls_Pizza_Mincemeat_Lattice__nibbles_etc

Po…Pot…Potassium? What’s that?

Here’s hoping you had a wonderful Christmas – if that’s what you celebrate – and/or Chanukah, Kwaaza or a holiday I don’t know about yet.  Everyone’s financial situation was so tight this year that I was told repeatedly, “I have never spent so little on gifts as I did this year,” or “I can’t afford any gifts. I’ll have to come up with some other ideas.”  And this year was the year that these same people gave the most thoughtul, creative and inspired gifts. From the letter telling me how my step-daughter felt about me to the afternoon spent with my daughter and all the thoughtful, really thoughtful gifts inbetween, if this is how a no-money gifting season goes, I wish we’d treat every year this way – whether or not there was money available.  Tissue alert: With my four daughters – step and biological – and my fiance, “I don’t need no stinkin’ gifts.” (Thank you, “Treasure of Sierra Madres” for the almost quote.)

Okay, you can put the tissues away again.  We did visit and go out to restaurants a bit.  This time I heard another question several times: “What’s with you and potassium?”  Just as I was framing an original post on this very subject, The National Kidney Foundation posted their potassium fact sheet.  Nothing like learning from the masters!

On Potassium and Your CKD Diet

What is potassium and why is it important to you?

Potassium is a mineral found in many of the foods you eat. It plays a role in keeping your heartbeat regular and your muscles working right. It is the job of healthy kidneys to keep the right amount of potassium in your body. However, when your kidneys are not healthy, you often need to limit certain foods that can increase the potassium in your blood to a dangerous level. You may feel some weakness, numbness and tingling if your potassium is at a high level. If your potassium becomes too high, it can cause an irregular heartbeat or a heart attack.

What is a safe level of potassium in my blood?

Ask your doctor or dietitian about your monthly blood potassium level and enter it here:

If it is 3.5-5.0………………………You are in the SAFE zone
If it is 5.1-6.0………………………You are in the CAUTION zone
If it is higher than 6.0……………..You are in the DANGER zone

How can I keep my potassium level from getting too high?

  • You should limit foods that are high in potassium. Your renal dietitian will help you plan your diet so you are getting the right amount of potassium.
  • Eat a variety of foods but in moderation.
  • If you want to include some high potassium vegetable in your diet, leach them before using. Leaching is a process by which some potassium can be pulled out of the vegetable. Instructions for leaching selected high potassium vegetables can be found at the end of this fact sheet. Check with your dietitian on the amount of leached high potassium vegetables that can be safely included in your diet.
  • Do not drink or use the liquid from canned fruits and vegetables, or the juices from cooked meat.
  • Remember that almost all foods have some potassium. The size of the serving is very important. A large amount of a low potassium food can turn into a high- potassium food.
  • If you are on dialysis, be sure to get all the treatment or exchanges prescribed to you.

What foods are high in potassium (greater than 200 milligrams per portion)?

The following table lists foods that are high in potassium. The portion size is ½ cup unless otherwise stated. Please be sure to check portion sizes. While all the foods on this list are high in potassium, some are higher than others.

High-Potassium Foods
Fruits Vegetables Other Foods
Apricot, raw (2 medium)
dried (5 halves)
Acorn Squash Bran/Bran products
Avocado (¼ whole) Artichoke Chocolate (1.5-2 ounces)
Banana (½ whole) Bamboo Shoots Granola
Cantaloupe Baked Beans Milk, all types (1 cup)
Dates (5 whole) Butternut Squash Molasses (1 Tablespoon)
Dried fruits Refried Beans Nutritional Supplements:
Use only under the
direction of your doctor
or dietitian.
Figs, dried Beets, fresh then boiled
Grapefruit Juice Black Beans
Honeydew Broccoli, cooked Nuts and Seeds (1 ounce)
Kiwi (1 medium) Brussels Sprouts Peanut Butter (2 tbs.)
Mango (1 medium) Chinese Cabbage Salt Substitutes/Lite Salt
Nectarine (1 medium) Carrots, raw Salt Free Broth
Orange (1 medium) Dried Beans and Peas Yogurt
Orange Juice Greens, except Kale Snuff/Chewing Tobacco
Papaya (½ whole) Hubbard Squash  
Pomegranate (1 whole) Kohlrabi  
Pomegranate Juice Lentils  
Prunes Legumes  
Prune Juice Mushrooms, canned  
Raisins Parsnips  
  Potatoes, white and sweet  
  Pumpkin  
  Rutabagas  
  Spinach, cooked  
  Tomatoes/Tomato products  
  Vegetable Juices  

What foods are low in potassium?

The following table list foods which are low in potassium. A portion is ½ cup unless otherwise noted. Eating more than 1 portion can make a lower potassium food into a higher potassium food.

Low-Potassium Foods
Fruits Vegetables Other Foods
Apple (1 medium) Alfalfa sprouts Rice
Apple Juice Asparagus (6 spears) Noodles
Applesauce Beans, green or wax Pasta
Apricots, canned in juice Cabbage, green and red
Carrots, cooked
Bread and bread products: (Not Whole Grains)
Blackberries Cauliflower Cake: angel, yellow
Blueberries Celery (1 stalk) Coffee: limit to 8 ounces
Cherries Corn, fresh (½ ear)   frozen (½ cup) Pies without chocolate or high potassium fruit
Cranberries Cucumber Cookies without nuts or chocolate
Fruit Cocktail Eggplant Tea: limit to 16 ounces
Grapes Kale  
Grape Juice Lettuce  
Grapefruit (½ whole) Mixed Vegetables  
Mandarin Oranges Mushrooms, fresh  
Peaches, fresh (1 small) canned (½ cup) Okra  
Pears, fresh (1 small) canned (½ cup) Onions  
Pineapple Parsley  
Pineapple Juice Peas, green  
Plums (1 whole) Peppers  
Raspberries Radish  
Strawberries Rhubarb  
Tangerine (1 whole) Water Chestnuts, canned  
Watermelon (limit to 1 cup) Watercress
  Yellow Squash  
  Zucchini Squash  
     

How do I get some of the potassium out of my favorite high-potassium vegetables ?

The process of leaching will help pull potassium out of some high-potassium vegetables. It is important to remember that leaching will not pull all of the potassium out of the vegetable. You must still limit the amount of leached high-potassium vegetables you eat. Ask your dietitian about the amount of leached vegetables that you can safely have in your diet.

How to leach vegetables.

For Potatoes, Sweet Potatoes, Carrots, Beets, and Rutabagas:

  1. Peel and place the vegetable in cold water so they won’t darken.
  2. Slice vegetable 1/8 inch thick.
  3. Rinse in warm water for a few seconds.
  4. Soak for a minimum of two hours in warm water. Use ten times the amount of water to the amount of vegetables. If soaking longer, change the water every four hours.
  5. Rinse under warm water again for a few seconds.
  6. Cook vegetable with five times the amount of water to the amount of vegetable.

For Squash, Mushrooms, Cauliflower, and Frozen Greens:

  1. Allow frozen vegetable to thaw to room temperature and drain.
  2. Rinse fresh or frozen vegetables in warm water for a few seconds.
  3. Soak for a minimum of two hours in warm water. Use ten times the amount of water to the amount of vegetables. If soaking longer, change the water every four hours.
  4. Rinse under warm water again for a few seconds.
  5. Cook the usual way, but with five times the amount of water to the amount of vegetable.

References:
Bowes & Church Food Values of Portions Commonly Used, 17th Ed., Pennington, JA, Lippincott, 1998.
Diet Guide for Patients with Kidney Disease, Renal Interest Group-Kansas City Dietetic Association, 1990.

 
The National Kidney Foundation would like to thank the
        Council on Renal Nutrition for the development of this fact sheet.

[Me: This is a bit different from my renal diet.  There are foods on here that my diet doesn’t allow, but you’ll see when you look at your diet that most foods we need to concern ourselves with are mentioned on this list.]

On the book front, don’t forget the Twitter Chat on Jan. 9 from 8-9 EST.  Locals, come on down to Bookman’s in Mesa on Jan. 14 from 1-3 for a book signing.  Oh, KevinMD.com will be running an excerpt from the book within the next week and a half or so.  I’ll send out a bulletin when I find out the exact date.  My new year is already looking pretty bright.  That’s what I wish for you: a happy, healthy new year with lots of whatever you desire in it.

Until next week (which will actually be next year),

Keep living your life!

 
 

How Sweet It Is… Or Is It?

Thanksgiving is over and I thought I’d learn from that not so successful experience (as far as energy and proper eating only – it was a delicious experience having my step-daughter to ourselves), but I’m not so sure I have.  Hence, excerpts from two helpful articles.  When I scan the internet for articles to present on the blog, I usually end up finding some that help me with my own difficult areas.  Odd how the universe takes care of you, isn’t it?  I raised my children to believe that things happen for a reason whether we know the reason or not, and am so gratified to hear them remind me of that time after time.  You’ll understand as you read today’s blog.

Fructose Raises Risk for Kidney Disease, Hypertension

By David Liu, Ph.D.

 Saturday, Nov 19, 2011 (foodconsumer.org) — Eating too much fructose may cause a series of diseases including fatty liver, insulin resistance or diabetes, dyslipidemia, hypertension and kidney disease, according to a report in the Nov 2011 issue of International Journal of Nephrology. In the report, Marek Kretowicz of Nicolaus Copernicus University in Torun Porland and colleagues reviewed 62 studies and concluded that studies suggest that excessive fructose intake may be one of the causes for the current epidemic of obesity, diabetes and cardiorenal disease. Fructose is a monosaccharide present in sucrose (beet sugar, cane sugar etc), high fructose corn syrup (hfcs), honey and fruits.
 
The researchers cited studies as suggesting that not all fructose sources are the same.  Not all sources of fructose cause diabetes, kidney disease and cardiovascular disease. The researchers said natural sources of fructose such as fruits are rich in beneficial nutrients like antioxidants, vitamin C or ascorbic acid, polyphenols, potassium, and fiber that may counter the adverse effect of fructose. Previous studies found fructose intake was not correlated with increased risk of high blood pressure or hypertension in a population in which much of the fructose intake came from fruits.  However, the association was found significant when the fructose from fruits was excluded. According to the report, fructose can cause fatty liver and glycogen accumulation, insulin resistance and islet dysfunction, obesity, hypertension and vascular disease, and kidney disease.  {Me:  Get the message?  Fruit, not candy or cakes.  Now where have I heard that before?}
 
You can find the article at: http://www.foodconsumer.org/newsite/Nutrition/Food/fructose_kidney_disease_diabetes_hypertension_1119110936.html
 
The following is an excerpt, but it just might be worth your while to read the entire article at: http://www.kevinmd.com/blog/2011/11/living-chronic-illness-holiday-season.html?utm_medium=twitter&utm_source=twitterfeed  I know a great deal of my problem with celebrations is that, not only do others not understand that I don’t have the energy I used to (say, isn’t that true of a great many people who are not ill, simply aging?), but half the time I don’t, so the day of the dinner, party, etc. comes and I’m too tired from the preparations to enjoy it.  I’ve got to grow up and stop this ridiculous cycle.  Thank you, Toni.
 

Living with chronic illness during the holiday season

….Bottom line, suffering from a chronic condition can be an ongoing crisis—for you and for those you’re close to. That crisis can come to a head during the holidays when people’s expectations of one another are high and when stress levels for everyone are likely to be off the charts for any number of reasons—health, financial, relationship issues. ….when the holidays arrive, you’re suddenly thrust into the middle of a lively and chaotic social scene where you’re expected to participate in a range of activities, often for days in a row. A bit of advance warning to loved-ones can go a long way toward minimizing stress levels over unrealistic expectations….If you’re one of the many people with chronic health problems who don’t look sick, the initiative is with you to make your condition visible. Here are some suggestions for helping loved-ones understand what your life is like and for giving them a heads-up on what to expect from you during the holidays.

Share information with them from the Internet or from books

Often the best way to educate loved-ones about chronic pain and illness is to use a neutral source because it takes the emotional impact out of the communication….. Print out select pages or forward a few links to family and close friends. Alternatively, if you have a book about your condition {like mine!}, photocopy the pages that cover what you’d like them to know about you. In your accompanying note, keep it “light”—you could joke that “there won’t be a test.” But also make it clear that this favor you’re asking is important to you.

Write a letter

….Without complaining, express how difficult it’s been for you to adjust to this unexpected change in your life and how you wish you could be as active as you once were during the holidays….I would end by telling them what to expect from you during the holidays—that you may have to skip some events, that you may have to excuse yourself right after eating to go lie down, that you may have to come late and leave early. In my experience, spelling out my limitations ahead of time is helpful not just to others, but to me, because I find it much easier to exercise the self-discipline it takes to excuse myself from a room full of people if I know that at least some of them are already expecting it….

Find that ONE ally and enlist his or her help

….It’s so helpful for me to be “prompted” by my ally because, when I start to overdo things, adrenaline kicks in which fools me into thinking I’m doing fine. But using adrenaline to get by just sets me up for a bad crash later on. Your ally may be a close friend or family member who’s just waiting for you to enlist his or her help. Think long and hard before you decide there’s no such person in your life.

In the end, you may have to recognize that some loved-ones may never accept your limitations

….Just as you can’t force people to love you, you can’t force people to accept you. But getting angry at them just exacerbates your own symptoms. That’s why it’s important to protect yourself from allowing their lack of understanding to continually upset you. Think of it as protecting yourself from another chronic condition: chronic anger….

Thank you to both contributing authors for helping me understand my life at this time of the year.

Shifting gears here, all.  Libre (see the blog roll) has asked me to host a tweet chat on January 9th from 8-9 p.m. EST. I’ll throw out some topics and you tweet your feelings or thoughts about them.  This is a first for me, so thank you Mandy from Libre for making certain my other foot followed me into the 21st century.  But wait!  That’s not all! (Do I sound like 3 a.m. tv commercials?), there have been book signings in the east valley and the west valley – locals will understand I mean the Valley of the Sun or Phoenix and the surrounding areads, everyone needs to make plane reservations – but not in the south valley.  That will soon be remedied: I’ll be signing at Bookmans, 1056 S. Country Club Dr., Mesa on January 14th from 1-3.

Have a wonderful holiday, whether you celebrate Christmas, Chanukah (tonight is the first candle lighting), Kwaaza or another I haven’t discovered yet.  How incredible it is that it’s already this time of year.

Until next week,

Keep living your life!