At the Heart of the Matter

Happy New Year! Here’s wishing you all a very healthy one. I, on the other hand, found myself in the cardiologist’s office the very first week of 2019. That was odd for me.

It all started when I asked my very thorough primary care physician what – if anything – it meant that my blood pressure reading was ten points higher in one arm than the other. By the way, she’s the one that suggested I take my blood pressure on a daily basis. Her nurse always used the left arm to take the reading, so I did too. Then I got curious about what the reading on the other arm would be and how much difference there would be between arms. I expected a point or two, not ten.

Although my readings had always been a bit high, they weren’t high enough to warrant extra attention… until I mentioned the ten point difference to my PCP. BAM! I had an appointment with the cardiologist.

This information in last year’s April 23’s blog will explain why:

“We know that hypertension is the number two cause of CKD. Moderating our blood pressure will (hopefully) slow down the progression of the decline of our kidney function. Kidney & Urology Foundation of America, Inc. at http://www.kidneyurology.org/Library/Kidney_Health/High_Blood_Pressure_and_Kidney_Disease.php explains this succinctly:

‘High blood pressure makes your heart work harder and, over time, can damage blood vessels throughout your body. If the blood vessels in your kidneys are damaged, they may stop removing wastes and extra fluid from your body. The extra fluid in your blood vessels may then raise blood pressure even more. It’s a dangerous cycle.’

And heart rate? The conclusion of a study published in the Journal of Nephrology reads:

‘Heart rate is an independent age-dependent effect modifier for progression to kidney failure in CKD patients.’

You can read the entire study at https://www.researchgate.net/publication/232714804_Heart_rate

So we know that blood pressure and heart rate are important for Chronic Kidney Disease patients. Just in case you’ve forgotten, heart rate is a synonym for pulse which is the number of times your heart beats a minute.

MedicineNet at https://www.medicinenet.com/script/main/art.asp?articlekey=154135 offers more about what the difference between readings from both arms MAY mean:

“People whose systolic blood pressure — the upper number in their reading — is different in their left and right arms may be suffering from a vascular disease that could increase their risk of death, British researchers report.

The arteries under the collarbone supply blood to the arms, legs and brain. Blockage can lead to stroke and other problems, the researchers noted, and measuring blood pressure in both arms should be routine.

‘This is an important [finding] for the general public and for primary care doctors,’ said Dr. William O’Neill, a professor of cardiology and executive dean of clinical affairs at the University of Miami Miller School Of Medicine.

‘Traditionally, most people just check blood pressure in one arm, but if there is a difference, then one of the arteries has disease in it,’ he said.

The arteries that run under the collarbone can get blocked, especially in smokers and diabetics, he noted. ‘If one artery is more blocked than the other, then there is a difference in blood pressure in the arms,’ O’Neill explained.

‘Doctors should, for adults — especially adult smokers and diabetics — at some point check the blood pressure in both arms,’ he said. ‘If there is a difference it should be looked into further.’

The report appears in the Jan. 30 online edition of The Lancet. ”

Notice I capitalized may. That’s because, in my case, there apparently was no blockage. My cardiologist had a different view of things. He felt there wasn’t a problem unless the difference in readings between your two arms is more than 20 points and that your blood pressure would have to be much higher than my slightly elevated blood pressure before this could be considered a problem.

He made note of my diabetes and congratulated me for taking such good care of myself, especially since I’m a caretaker. I must have looked puzzled because he went on to explain that caretakers sometimes have a sort of martyr complex and are convinced they cannot take the time away from the person they’re caring for to care for themselves. And, yes, he did use the oxygen masks in an airplane analogy to point out how important it is for caretakers to care for themselves first.

Now that I’ve wandered on to the subject of caretakers, seemingly continuing the thread from last week’s blog, here’s a health screening from Path to Wellness that may interest you if you live in Arizona. I urge you to take part yourself and bring anyone you think may be affected or has someone in their lives that may have CKD.

What: The National Kidney Foundation of Arizona will host a FREE health screening, aiming to identify chronic diseases in their early stages in those at highest risk.

When: Saturday, January 26, 2019, 8:30am- 12:00pm (appointments highly recommended**)

Where: Betty Fairfax High School (8225 S. 59th Ave., Laveen, AZ 85339)

Individuals who are 18 years or older and have a family member with diabetes, high blood pressure or chronic kidney disease, OR have high blood pressure or diabetes themselves are urged to attend this important event. Early detection means the possibility of preventing further, life-risking damage to the kidneys.

**Appointments may be scheduled by calling the National Kidney Foundation of Arizona at (602) 840-1644 (English) or (602) 845-7905 / (602)845-7912 (Spanish).

OR

Visit https://azkidney.org/pathtowellness and register online!

This medical screening includes immediate onsite results and medical education and is provided at absolutely no cost. The event is staffed with medical professionals, with the ability to screen 200 attendees.

About Path to Wellness: The Path to Wellness program is the product of a community collaboration between the National Kidney Foundation of Arizona and Cardio Renal Society of America. This January screening is provided in partnership with Adelante Healthcare and the Phoenix Metropolitan Alumnae Chapter, Delta Sigma Theta Sorority, Inc. Sorority, Inc., and generously funded by the BHHS Legacy Foundation. Path to Wellness screenings are unique in that they try to target areas of cities where the high demographics of under-insured or at-risk individuals may have an opportunity to detect chronic health problems early on, in a cost-free environment. The screenings also offer the unique advantage of both on-site results, and post-screening education on chronic disease management.

Until next week,

Keep living your life!

Say That Again

I have been uttering that phrase for years, maybe even a decade. Each time I went for a hearing test, I was told I was getting there, but I didn’t need hearing aids yet. This year it changed. I’ll bet it’s because I have CKD.

This is from SlowItDownCKD  2011:

“Research shows that hearing loss is common in people with moderate Chronic Kidney Disease. As published in the American Journal of Kidney Diseases and highlighted on the National Kidney Foundation web site, a team of Australian researchers found that older adults with moderate Chronic Kidney Disease (CKD) have a higher prevalence of hearing loss than those of the same age without CKD.”

How moderate CKD and hearing are connected is another matter, one that apparently isn’t as well documented. Here’s what I found on Timpanogos Hearing and Balance’s website at https://utahhearingaids.com/hearing-loss-likely-individuals-chronic-kidney-disease/ and the other sites I searched. This comes from the same Universtiy of Sydney study I cited in my 2011 blog.  A study that was completed in 2010… eight years ago.

“The link between hearing loss and CKD can be explained by structural and functional similarities between tissues in the inner ear and in the kidney. Additionally, toxins that accumulate in kidney failure can damage nerves, including those in the inner ear. Another reason for this connection is that kidney disease and hearing loss share common risk factors, including diabetes, high blood pressure and advanced age.”

Wait a minute. I wrote about this in SlowItDownCKD 2014, too:

“Suddenly it became clear. If toxins are – well – toxic to our bodies, that includes our ears. My old friend The Online Etymology Dictionary tells us the word toxic is derived directly from late Latin toxicus, which means ‘poisoned.’

Now I got it. Moderate CKD could be poisoning our bodies with a buildup of toxins. Our ears and the nerves in them are part of our body. Damaged nerves may cause hearing loss. I’d just never thought of it that way before. Sometimes all it takes is that one last piece of the puzzle to fall in place.

Hmmm. High blood pressure is the second most common leading cause of CKD and it can also lead to hearing loss. Let’s take a look at that.

According to WebMD

‘Certain illnesses, such as heart disease, high blood pressure, and diabetes, put ears at risk by interfering with the ears’ blood supply.’

I went right to What Is It and How Did I Get It? Early Stage Chronic Kidney Disease to figure out how since it includes a diagram from The National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health that demonstrates how high blood pressure is caused… and if you read on, you’ll read about the problems high blood pressure causes….and this sentence:

‘Humans have 10 pints of blood that are pumped by the heart through the arteries to all the other parts of the bodies.’

That would include the ears. Moderate CKD might mean that blood is tainted by the toxins our compromised kidneys could not rid us of.”

I was frustrated at not finding any more recent research, but sometimes you just have to take what you can get… like now.

I thought of an online hearing test I’d heard (Ouch! Poor word choice there.) about and decided to give it a try since it asked questions rather than having you listen to sounds as you would in an audiologist’s office. Here are my results from the  Better Hearing Institute at http://www.betterhearing.org/check-your-hearing

“SUMMARY

 Your hearing loss would be described as: Mild Hearing Loss. A hearing test may be necessary to monitor your hearing loss.

DETAIL REPORT

 Your Check Score: You scored 21 out of a possible 60 points. The remainder of this report will tell you what your score means.

Your Check Norm: Your score of 21 is at the 19 percentile of people with hearing loss in the United States, where low percentages mean lower hearing losses and high percentages mean more serious hearing losses compared to other people with hearing loss….

Subjective Hearing Loss Description: Based on the responses of more than 10,000 people with hearing loss and their family members, they would describe your hearing loss as: Mild Hearing Loss.

What Your Hearing Loss Means for Your Quality of Life: Research has shown that the higher your predicted hearing loss, the more likely the following quality-of-life factors may be negatively affected:

  • irritability, negativism and anger
  • fatigue, tension, stress and depression
  • avoidance or withdrawal from social situations
  • social rejection and loneliness
  • reduced alertness and increased risk of personal safety
  • impaired memory and ability to learn new tasks
  • reduced job performance and earning power
  • diminished psychological and overall health

What should you do next? Based on your score, we recommend the following: A hearing test may be necessary to monitor your hearing loss. Now hearing loss is situational, and the next step you take is dependent on your need to hear in various listening situations. Some people can live with mild hearing losses. Others, such as teachers and therapists whose auditory skills are very important for their everyday work, require corrective technology — such as hearing aids — even when their hearing loss is at mild levels. It becomes important for them to do something about their hearing loss so they can function adequately in their work environment….

References:

To review the study this report is based on visit:
http://www.betterhearing.org/hearingpedia/bhi-archives/eguides/validity-and-reliability-bhi-quick-hearing-check

To review research on hearing loss and quality of life visit:
www.betterhearing.org/hearingpedia/counseling-articles-tips/impact-treated-hearing-loss-quality-life as well as the following publication conducted by the National Council on the Aging (NCOA):
Hearing Aids and Quality of Life

My audiologist will be introducing me to hearing aids in the new year. I thought I had considered all the ramifications of CKD. And, frankly, I thought I understood what was happening to my kidneys. It looks like I did understand the loss of some kidney function… just not how that would affect the rest of my body.

I don’t know whether to break out the duct tape or the crazy glue to keep this aging body in one piece. Are you laughing? Good, because I wanted to have this Chanukah blog leave you in a good mood. I know, I’ll break out the dreidles in your honor. Happy Chanukah!

Until next week,

Keep living your life!