Cleaning Out

Today I gimg_3613et to finish the final edits for my novel Portal in Time and submit it to my publisher. That means the next step is cleaning out my files and my computer. Writers accumulate an awful lot of unnecessary material when researching for a book.

That simple thought got me to thinking about another kind of cleaning out, the body kind. By the way, it seems the words cleanse and detox – short for detoxification – are being used interchangeably. Whichever term we use, are they safe for us as Chronic Kidney Disease patients?

But first – there’s always a first, isn’t there? – a warning: if you’re thinking of doing one for weight loss, don’t. According to Medicine.Net at http://www.medicinenet.com/cleansing_and_detox_diets/article.htm,

“There is no scientific evidence that “detox” (short for detoxification) or “cleanse” diets result in rapid weight loss or have any health benefits, says Heather Mangieri, RDN, LDN, a spokeswoman for the Academy of Nutrition and Dietetics and founder of NutritionCheckUp in Pittsburgh.

Indeed, the opposite may be true: One study published in 2011 in the journal Obesity found that beginning a weight-loss diet with a fast or cleanse could be counterproductive.”IMG_2980

Now wait just a minute, if they provide no ‘rapid weight loss or have any health benefits,’ why do people go to the trouble of doing them? I wrote about this just a bit in relation to brain fog in SlowItDownCKD 2015.

“…with CKD I’d talk over detoxing and/or taking supplements to support cell power with my nephrologist before actually following that advice.  Some nephrologists are dead (Yikes! Wrong word choice) set against detoxifying while others have a more eclectic approach to gentle detoxifying.”

Ah, so there MAY be some benefits in relation to brain fog. What’s brain fog again? The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 2 (I have got to get around to shortening that title.) can help us out here.

“According to integrative medicine expert Dr. Isaac Eliaz, when experiencing brain fog

FullSizeRender (3)‘…people feel as if there is a thick fog dampening their mind. While the medical and mental health establishments don’t generally recognize brain fog as a condition, it’s a surprisingly common affliction that affects people of all ages. Symptoms include pervasive absentmindedness, muddled thought processes, poor memory recall, difficulty processing information, disorientation, fatigue, and others.’

You can read more at http://www.rodalenews.com/brain-fog.”

Well, what exactly is a detox?  The Free Dictionary’s medical dictionary at http://medical-dictionary.thefreedictionary.com/detoxification offers this as one of its definitions:

“A short-term health regimen involving procedures thought to remove toxins from the body, such as drinking large amounts of liquid, eating a restricted diet or fasting, taking nutritional supplements, and undergoing enemas.”

Now we get to the meat of the matter. Why do Chronic Kidney Disease patients need to be so careful about cleanses? I looked at the ingredient list of several different cleanses on Amazon.com.  (Click on the ingredient lists to make them larger so you can read them more carefully.) The first product was Super Colon Cleanse. One of the first ingredients was Psyllium Husk Powder 1 g. Uh-oh. Not good for us. As Metamucil Advisor – the manufacturer of fiber products -at http://www.metamuciladvisor.com/avoid-psyllium-and-metamucil-in-kidney-disease/ explains,

“Psyllium husk is a natural fiber that comes from the plant called Plantago Ovata. Plantago Ovata produces thousands of seeds that are coated with cleansea gel like substance that is extracted to create psyllium husk. The psyllium husk is a natural soluble fiber laxative that can be consumed to add bulk to the feces. Consuming psyllium powder will draw water to the stool making it easier to have a bowl movement. Psyllium husk is recommended to not be taken by individuals who have kidney disease because it is high in magnesium that individuals with chronic kidney disease must avoid. It is highly recommended to consult your physician before starting any product of psyllium husk to make sure it is safe with any health conditions you might have.”

dr-tobiasWell, that’s only one cleanse.  Let’s take a look at another. Dr. Tobias Colon: 14 Day Quick Cleanse is composed of herbs, no psyllium. But there’s a problem there, too.  As Chronic Kidney Disease patients we are cautioned against taking herbs, not so much because they will cause damage, but because we don’t know how much of each is safe for our kidneys.

I thought I remembered writing about this in What Is It and How Did I Get It? Early Stage Chronic Kidney Disease  – another really long title – and decided to find that information. Here it is:FullSizeRender (2)

“While none of this is established, the following might be toxic to the kidneys -wormwood, periwinkle, sassafras (I remember drinking sassafras tea as a child.  Did that have any effect on my kidneys?) and horse chestnut just to name a few. Then there are the herbal supplements that might be harmful to CKD patients: alfalfa, aloe, bayberry, capsicum, dandelion, ginger, ginseng, licorice, rhubarb and senna.  There are others, but they seemed too esoteric to include….”

They say three is the magic number, so let’s take another look. This time as something label ‘detox.’  Baetea 14 Day Teatox is the one I chose. I think I liked the play on words: detox, teatox, a tea to detox. Lots of herbs, but then I looked at the last ingredient – Garcinia Cambogia. That rang a caution bell in my mind so I went right to a site about the side effects of this product at http://garciniacambogiatopic.com/side-effects-garcinia-cambogia/.

“Our kidneys and liver remove toxins, waste and other substances from our body.  They are the main organs designed to clean the body of detox-teaimpurities.   People who already have diseases of the kidneys or liver should not take Garcinia Cambogia because their bodies might not be able to utilize and remove the supplement effectively.”

*sigh* It looks like we’ll just have to detox the old fashioned way, with increased fiber, as much water as your nephrologist permits, and exercise. You might consider going meat and sugarless, too. Of course, it wouldn’t hurt to cut down on carbs, either. It looks like we, as Chronic Kidney Disease patients, are moving closer and closer to clean eating.

Until next week,

Keep living your life!IMG_2982

Clearing My Head

Today’s the day to bring up those isolated thoughts roaming through my mind.

But first: happy birthday to Lara, she of the bunnies {the one I introduced on this blog – Temperance – now has a buddy, Seely} and one of the five lovely daughters in this blended family.  It’s quite a coincidence how their ages step: each one is just about a year older (or younger, depending upon how you look at it) than the others.  May you have many more healthy, happy, fun birthdays Lara.

Questions have been raised about pertussis (whooping cough) which I hope to have answered for you a.s.a.p.  Parts of Texas and Seattle, Wa., already have epidemics so I’m in contact with the CDC experts awaiting an explanation as to why CKDers need to be extra careful about this disease – if, indeed, we do. Thank you to Laura for bringing up the question.

Some of you have been asking for a way to check on the interactions of any medications you may be taking. After a bit of researching, I’ve found just such a function at: http://healthtools.aarp.org/health-encyclopedia?cmp=NLC-HealthEng-CTRL-82510-LONG-ENCYC.  Look on the upper right side of the page.  I don’t think this one is terribly medical in its explanation since it is AARP (American Association  of Retired People) rather than a physician’s site.  Let me know how you like it if you decide to give it a shot.

I pulled up this article from last Halloween (hmmm, is the date relevant?) as an example of why I have so many doubts about drugs, drug companies and just what each drug can do despite the fact that we sometimes need the drug.

Controversial Cholesterol Pill Vytorin Shows Promise For Kidney Patients

 by

 October 31, 2011
 
[This is me: the first part of the article refers to a television advertisement demonstrating that your high cholesterol may be caused by genetics, bad habits or a combination of both.]

Remember Grandpa Frank?

Way back in 2008, the ad above ran in heavy rotation on TV during the heyday of Vytorin, a cholesterol-lowering pill that claimed to fight both genetics and bad habits.

Soon after the ad had appeared, oh, say thousands of times across the country, the Food and Drug Administration asked the company to revise the ads with Grandpa Frank and other relatives because the ads didn’t reveal a study showing Vytorin wasn’t any more effective than simvastatin, a generic cholesterol medicine that is one of Vytorin’s components.

Later that year there was more bad news for Vytorin — and fear among patients — when a study suggested Vytorin raises the risk of cancer slightly. Sales fell from a peak of $5 billion a year to $2 billion last year.

None of this caused the FDA to change its view of the safety of Vytorin. The agency even issued a statement in 2009 essentially exonerating Vytorin of the cancer risk.

Now, Merck, the maker of Vytorin, is looking to regain some of the lost sales of the drug by touting its use in people with chronic kidney disease.

A new FDA analysis shows Vytorin lowered the relative risk of heart attacks and strokes by 22 percent among CKD patients in the relatively early stages of disease — before they need dialysis. For those with more severe, later-stage disease, the drop was 6 percent.

The FDA analysis also failed to find any increase in cancer or cancer deaths in the 20,000-plus patient study.

Merck is seeking FDA approval for use of Vytorin in CKD patients of which there are 26 million in the U.S. alone, according to the National Kidney Foundation.

A committee of independent advisers to the FDA will go over the data for and against Vytorin at a meeting Wednesday.

You can read the article at: http://www.npr.org/blogs/health/2011/10/31/141880804/controversial-cholesterol-pill-vytorin-shows-promise-for-kidney-patients?ft=1&f=1027

I’ve got questions:

1. Why is Vytorin, rather than its generic form –  simvastatin – being touted?  Didn’t the article state that this component of Vytorin was just as effective?

2. What happened to the study suggesting that Vytorin raises the risk of cancer slightly?

3. Since I found this on the official FDA site for Vytorin at Drugs.com, why isn’t it mentioned in the article? (http://www.drugs.com/pro/vytorin.html) ” In patients with chronic kidney disease and estimated glomerular filtration rate <60 mL/min/1.73 m2, the dose of Vytorin is 10/20 mg/day in the evening. In such patients, higher doses should be used with caution and close monitoring.”
 
4. Where is there mention of further studies discussed in the FDA’s report: “With all the controversy surrounding ezetimibe in the past 18 months, the cardiology community anticipates the results of IMPROVE-IT, the large clinical-outcomes study chaired by Dr. Eugene Braunwald of the TIMI Study Group and cochaired by Dr. Robert Califf  (Duke Clinical Research Institute, Durham, NC). The study will compare simvastatin 40 mg plus ezetimibe 10 mg with simvastatin 40 mg alone in 18 000 patients with a recent acute coronary syndrome. Those results will be available in 2012.
 
I do not mean to attack this particular drug from this particular company, but am using this article as an example of just how unsure I am about what we are being told about the drugs we use and how contradictory the information about these drugs can be.
 
On a happier note, did I tell you that I decided to go to my graduation?  I have earned a high school diploma, Bachelor of Arts, and Masters degree – not to mention the numerous certificate programs I’ve completed – (okay, okay, I know I could be  the poster child for life long learning).  This time, it was an Academic Certificate in Creative Writing from Rio Salado Community College and I realized this might be my last opportunity to attend one of my own graduations, as opposed to being part of or attending others’ graduations. I must say this was such an exhilarating, inspiring experience!  I urge you not to ignore your own milestones.  Take every chance you can get to celebrate yourself. This is my younger daughter, Abby, and me right after the ceremony.   
 
Until next week,
Keep living your life!