Last Week, The Country… This Week, The World

Last week, I wrote about a U.S. clinical trial program, AllofUs Research Program. This week we’re going global. Huh? What’s that, you ask. It’s KidneyX.

I can just feel you rolling your eyes. (Ask my children if you don’t think I can do that.)  Hold on a minute and I’ll let KidneyX explain what they are from their website at http://www.kidneyx.org.

“The Kidney Innovation Accelerator (KidneyX) is a public-private partnership to accelerate innovation in the prevention, diagnosis, and treatment of kidney diseases. KidneyX seeks to improve the lives of the 850 million people worldwide currently affected by kidney diseases by accelerating the development of drugs, devices, biologics and other therapies across the spectrum of kidney care including:

Prevention

Diagnostics

Treatment”

I know, I know. Now you want to know why you should be getting excited about this program you don’t know much about. Let’s put it this way. There hasn’t been all that much change in the treatment of kidney disease since it was recognized. When was that? This question was answered in SlowItDownCKD 2015:

“…nephrologist Veeraish Chauhan from his ‘A Brief History of the Field of Nephrology’ in which he emphasizes how young the field of modern nephrology is.

‘Dr. Smith was an American physician and physiologist who was almost singlehandedly responsible for our current understanding of how the kidneys work. He dominated the field of twentieth century Nephrology so much that it is called the “Smithian Era of Renal Physiology“ .He wrote the veritable modern Bible of Nephrology titled, The Kidney: Structure and Function in Health and Disease. This was only in 1951.”

1951?????? It looks like I’m older than the history of kidney disease treatment is. Of course, there were earlier attempts by other people (Let’s not forget Dr. Bright who discovered kidney disease in the early 1800s.) But treatment?

Hmmm, how did Dr. Smith treat kidney disease I wondered as I started writing about KidneyX.

Clinics in Mother and Child Health was helpful here. I turned to their “A Short History of Nephrology Up to the 20th Century” at https://www.omicsonline.org/open-access/a-short-historic-view-of-nephrology-upto-the-20th-century-2090-7214-1000195.php? and found this information:

“His NYU time has been called the Smithian Era of renal physiology for his monumental research clarifying glomerular filtration, tubular absorption, and secretion of solutes in renal physiology …. His work established the concept that the kidney worked according to principles of physiology both as a filter and also as a secretory organ. Twenty-first century clinical nephrology stems from his work and teaching on the awareness of normal and abnormal functioning of the kidney.”

I see, so first the physiology and function of the kidney had to be understood before the disease could be treated.

 

I thought I remembered sodium intake as part of the plan to treat CKD way before the Smithian Era. I was wrong. This is also from SlowItDownCKD 2015:

“With all our outcry about following a low sodium diet, it was a bit shocking to realize that when this was first suggested as a way to avoid edema in 1949, it was practically dismissed. It wasn’t until the 1970s that the importance of a low sodium diet in Chronic Kidney Disease was acknowledged.”

Aha! So one of our dietary restrictions wasn’t accepted until the 1970s. I was already teaching high school English by then. Things did seem to be moving slowly when it came to Chronic Kidney Disease treatment.

Let’s see if I can find something more recent. This, from the National Kidney Fund at https://www.kidney.org/professionals/guidelines/guidelines_commentaries sounds promising, but notice that this has only been around since 1997. That’s only 21 years ago. It has been updated several times, but there doesn’t seem to be that much difference… or maybe I just didn’t understand the differences.

“The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI)™ has provided evidence-based clinical practice guidelines for all stages of chronic kidney disease (CKD) and related complications since 1997…. KDOQI also convenes a small work group of U.S. based experts to review relevant international guidelines and write commentary to help the U.S. audience better understand applicability in their local clinical environment.

Clinical Practice Guidelines are documents that present evidence-based recommendations to aid clinicians in the treatment of particular diseases or groups of patients. They are not intended to be mandates but tools to help physicians, patients, and caregivers make treatment decisions that are right for the individual. With all guidelines, clinicians should be aware that circumstances may appear that require straying from the published recommendations.”

Time to get back to KidneyX before I run out of room in today’s blog. Here’s more that will explain their purpose:

“Principles

  • Patient-Centered Ensure all product development is patient-centered
  • Urgent Create a sense of urgency to meet the needs of people with kidney diseases
  • Achievable Ground in scientifically-driven technology development
  • Catalytic Reduce regulatory and financial risks to catalyze investment in kidney space
  • Collaborative Foster multidisciplinary collaboration including innovators throughout science and technology, the business community, patients, care partners, and other stakeholders
  • Additive Address barriers to innovation public/private sectors do not otherwise
  • Sustainable Invest in a diverse portfolio to balance risk and sustain KidneyX”

This may explain why think tanks for kidney patients, all types of kidney patients, are beginning to become more prevalent.

Let’s go back to the website for more information. This is how they plan to succeed:

“Building off the success of similar public-private accelerators, KidneyX will engage a community of researchers, innovators, and investors to bring breakthrough therapies to patients by:

Development

Driving patient access to disruptive technologies via competitive, non-dilutive funding to innovators.

Coordination

Providing a clearer and less expensive path to bringing products to patients and their families.

Urgency

Creating a sense of urgency by spotlighting the immediate needs of patients and their families.”

One word jumped out at me: urgency. I am being treated for my CKD the same way CKD patients have been treated for decades…and decades. It’s time for a change.

One thing that doesn’t change is that we celebrate Memorial Day in the U.S. every year. And every year, I honor those who have died to protect my freedom and thank my lucky stars that Bear is not one of them. There is no way to describe the gratitude those of us who haven’t served in the military – like me – owe to those who have and lost their lives in doing so.

Until next week,

Keep living your life!

Psoriatic Arthritis on Memorial Day

Memorial DayToday is Memorial Day. I find myself having a hard time saying ‘happy’ and ‘Memorial Day’ together.

For those of you outside of the U.S., this is a holiday started as Decoration Day by freed slaves after our Civil War to commemorate the lives of those who died earning their freedom. Slowly, individual states made this day for decorating graves a holiday and then it became a national one.

I am married to a veteran. There is nothing happy about this holiday, although there is respect and gratitude… at least in my house.

I have respect and gratitude for our living soldiers, too. That brings us to the subject of today’s blog: psoriatic arthritis and Chronic Kidney Disease. A close friend of the family – an Airman – wanted this information for his father. I was happy to oblige him, even more than I usually am to answer readers’ questions since he is military and he asked on Memorial Day.

As usual, we need to go back to the basics here. In this case, that means going back to the blog about psoriasis in The Book of Blogs: ModerateDigital Cover Part 2 redone - Copy Stage Chronic Kidney Disease, Part 2.   That’s where I first wrote the following information about psoriasis:

“…according to Psoriasis.com at http://www.psoriasis.com/what-is-psoriasis.aspx

‘psoriasis is a chronic (long-lasting) disease of the immune system. While the exact cause of psoriasis is unknown, scientists believe the immune system mistakenly activates a reaction in the skin cells, which speeds up the growth cycle of skin cells.’

There are seven types of psoriasis.  The one you are probably familiar with – if you are familiar with any – is plaque psoriasis. WebMD at http://www.webmd.com/skin-problems-and-treatments/psoriasis/psoriasis-types?page=1  tells us:

psorasis‘About eight in 10 people with psoriasis have this type. It is also sometimes known as psoriasis vulgaris. Plaque psoriasis causes raised, inflamed, red skin covered by silvery white scales. These may also itch or burn. Plaque psoriasis can appear anywhere on your body….’

Here’s the most important information in that particular blog for us as CKD patients:

“…doctors now know they need to screen psoriasis patients for CKD, although it seems to be only those patients with over 3% of their bodies affected by psoriasis who have doubled their risk of CKD. With 60% of the population at risk for CKD, it could be that percentage may change once these routine CKD screenings for psoriasis are in place, especially since psoriasis is also so common among every ethnic group.  This, of course, also includes those populations we know are at high risk for CKD.”

But my young Airman friend asked about psoriatic arthritis and Chronic Kidney Disease, so we need to take a look at what arthritis is.

According to The U.S. National Library of Medicine at http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024677/:

arthritis

“Arthritis is a general term for conditions that affect the joints and surrounding tissues. Joints are places in the body where bones come together, such as the knees, wrists, fingers, toes, and hips. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.”

Hmmm, no mention of psoriatic arthritis. That’s all right. I’m sure the American College of Rheumatology can help us out here. There’s more information on their site at http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Psoriatic-Arthritis.

“Psoriatic arthritis is a type of inflammation that occurs in about 15 percent of patients who have a skin rash called psoriasis. This particular arthritis can affect any joint in the body, and symptoms vary from person to person. Research has shown that persistent inflammation from psoriatic arthritis can lead to joint damage. Fortunately, available treatments for are effective for most people. Psoriatic arthritis usually appears in people between the ages of 30 to 50, but can begin as early as childhood. Men and women are equally at risk. Children with psoriatic arthritis are also at risk to develop uveitis (inflammation of the middle layer of the eye). Approximately 15 percent of people with psoriasis develop psoriatic arthritis. At times, the arthritis can appear before the skin disorder.”

Ah, we know Chronic Kidney Disease is an inflammatory disease. Now we know that arthritis is, too. Being a purist over here, I wanted to check on psoriasis to see if falls into this category, too. Oh my! According to a Position Statement from the American Academy of Dermatologists and AAD Association at https://www.aad.org/Forms/Policies/Uploads/PS/PS-Maintenance%20Therapy%20for%20Psoriasis%20Patients.pdf:

“Psoriasis is a chronic inflammatory, multi-system disease associated with considerable morbidity and co-morbid conditions.”

SlowItDownCKD 2015 Book Cover (76x113)

Arthritis is an inflammatory disease; psoriasis is an inflammatory disease; and Chronic Kidney Disease is an inflammatory disease. The common factor here is obvious – inflammatory disease. So what, if anything, can my young Airman friend suggest to his father (other than the most important: See your doctor.)?

What is itCertainly not to take NSAIDS. I defined  – and cautioned against – NSAIDS in the glossary of What Is It and How Did I Get It? Early Stage Chronic Kidney Disease. There’s been no new research to debunk this warning since then.

“NSAID: Non-steroidal anti-inflammatory drugs such as ibuprofen, aspirin, Aleve or naproxen usually used for arthritis or pain management, can worsen kidney disease, sometimes irreversibly.”

Well, what can the man do for these three inflammatory diseases? Let’s take a look at Dr. Rich Snyder’s guest blog in The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 1. In discussing probiotics and alkaline water, he threw in this little gem.

Alkaline/anti-inflammatory based diet: Some say, “Eat for your blood type.” But, what is the DASH diet for hypertension? It is not just a low salt  It is also full of anti-oxidants and anti-inflammatory.”

Food as medicine for an inflammatory body condition? DASH diet? Whoa! I just realized that this is the way I’ve come to eat myself in the last nine years.  What is the DASH diet? “DASH stands for Dietary Approaches to Stop Hypertension….”

Take a look at the Mayo Clinic’s information about this at http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456. There’s far too much to explore here, but I do urge you to remember you have CKD, so although it is an inflammatory disease, you need to be mindful of your renal diet should you decide to adopt the DASH diet.food is medicine

Until next week,

Keep living your life!

A Cautionary Tale 

Memorial DayToday is Memorial Day here in the U.S. It’s a celebration of our fallen warriors, the ones who fought for us so we wouldn’t have to fight for ourselves… and it began as a celebration of freed slaves honoring those who fought for their freedom way back in 1865. As Time.com at http://time.com/3894406/who-invented-memorial-day/ phrases it:

On May 1, 1865, freed slaves gathered in Charleston, South Carolina to commemorate the death of Union soldiers and the end of the American Civil War. Three years later, General John Logan issued a special order that May 30, 1868 be observed as Decoration Day, the first Memorial Day.

I married a retired military man. Memorial Day has had more meaning for me in the last eight years than ever before in my life.  It’s been a revelation, as our wedding invitation stated:

The Retired Lieutenant Colonel

Paul Arthur Garwood

and

The Former Wannabe Hippie4wedding

Gail Rae

Invite you to our wedding reception

Thank you again to all those who gave their lives so I wouldn’t have to.

Being a bit dramatic here, I also sort of saved my own life last week by saving my kidneys from further damage.  I know, I know. There’s no comparison, but it sure is a good way to get into today’s topic.

I wrote about dreaming about my bladder last week.  Well, I decided I needed to take that dream a bit more seriously. Off I went to my local pharmacy for an over the counter (OTC) urinary tract infection (UTI) kit.

I chose the Azo Brand because it is

the same urinary tract infection test used in many doctor’s offices, to determine if the bacteria that cause a UTI are present. {The description continues.} Then call your doctor with the results. The most reliable, over-the-counter UTI home test available, AZO Test Strips offer two UTI tests in one – including both Leukocyte (white blood cells) and Nitrite tests – which makes them more reliable than nitrite-only tests. (Doctors look for Leukocytes as well as Nitrites in diagnosing UTIs.)

test-strips-right_3Leukocytes are higher when you are fighting an infection. Unfortunately, that’s any infection. So what about nitrites?

When the urinary tract is infected by harmful bacteria then it leads to the development of nitrites as a byproduct. The kidneys are responsible for filtering the blood and for the elimination of unwanted waste materials from the body. However, they are incapable of filtering out the nitrites. The nitrites can however travel from the kidneys into the bladder and get stored there. They are then passed out along with the urine. Therefore the presence of nitrites in urine is generally an indication of the presence of a urinary tract infection.

Thank you for that information, Diseases List at http://diseaseslist.org/nitrites-in-urine/  Notice our kidneys are NOT at fault for once.

So far, so good.  I mean bad.  You take the test by urinating on a dipstick.  First you urinate for a second or two, then hold the dipstick under the urine stream, and then sort of mop up the excess urine.  Pay attention when you do this or it can get messy.

There were three test strips with accompanying color charts in the box.  I took all three. (Did I ever tell you about a family member who took the same OTC pregnancy test a dozen times just to be sure?  This doubt must run in the family.) You guessed it. All three were not just positive for UTI, but highly positive.

As you know, doctors don’t prescribe medication over the phone so I tried to make an appointment with my primary care doctor.  She is much sought after and had no openings that week, much less that day. She is part of a practice so I took an appointment with another doctor in the practice, one I had seen a time or two before under the same circumstances.

He had my chart in front of him.  I was wearing a medical alert bracelet. I told him three times I had Chronic Kidney Disease. In addition to ordering ciprofloxacin 250 mg. – which is safe for certain stages of CKD for certain periods of time at certain dosages – he ordered phenazopyridine 200 mg. for the pain. He kept talking about not being alarmed when it changed the color of my urine.

I didn’t feel like he’d heard a word I said.  I wasn’t too worried, because I always check with the pharmacist before taking any new medication.  She was alarmed, told me not to buy this medication, and that she would be contacting this doctor to tell him prescribing phenazopyridine for anyone with CKD was inappropriate.  This is the second time this has happened since I was diagnosed with CKD.

The National Institutes of Health warn that you tell your doctor if you’ve had kidney problems should he/she prescribe this drug.  I did… a NIHminimum of three times. This is what Drugs.com at http://www.drugs.com/mtm/phenazopyridine.html had to say about this pain reliever.

What is the most important information I should know about phenazopyridine?

You should not use phenazopyridine if you have kidney disease.

Okay, beating a dead horse here (I’m just so damned annoyed!), so let’s see if we can figure out why CKD patients should not be using this drug. Uh-oh, MedicineNet at http://www.medicinenet.com/phenazopyridine-oral/article.htm tells us

Although the exact mechanism of action is unknown, phenazopyridine is thought to provide relief of symptoms of UTIs by acting as a local anesthetic on the lining of the urinary tract.

All right, let’s try this another way then.  Why shouldn’t CKD patients take this drug? After looking at Wikipedia – even taking into account that anyone can edit these entries – I’m wondering why anyone would take it at all. It’s a form of Azo dye.

Less frequently it can cause a pigment change in the skin or eyes, to a noticeable yellowish color. This is due to a depressed excretion via the kidneys causing a buildup of the drug in the skin, and normally indicates a need to discontinue usage.

kidney functionWhat! Exits via the kidneys? Excretion can be depressed?  Nope, not for me, not for you either. Take a look at http://en.wikipedia.org/wiki/Phenazopyridine

Here’s the caution: sure we trust our doctors and those doctors they trust, but check with your pharmacist, too.

Hey, where are the weirdest places to read my CKD books entries?  We got some really weird ones, but we want to see yours.  The contest runs until the end of the month.  That’s plenty of time to snap a picture and post it. Not on FB?  Include it as a comment on the blog or email it.  You can even post it on Twitter.Digital Cover Part 2 redone - Copy

Book Cover

Until next week,

Keep living your life!DIGITAL_BOOK_THUMBNAIL

From The Military To Potatoes

Memorial Day

Today is Memorial Day, a day to be especially grateful to those who lost their lives making sure the rest of us were safe.  I wondered if some of our fallen warriors had chronic kidney disease although the scientific history of our disease is so recent. I’ve spent the last several days researching CKD and the military in an attempt to answer my own question, yet haven’t quite succeeded.

All I know is that some of our present protectors have CKD.  This is how I discovered that:

The National Institutes of Health offered a particular Funding Opportunity Application [FOA] on December 1st, 2011, with the first submission being accepted on January 14, 2012.

“The goal of this FOA is to encourage Research Project Grant (R01) applications on prevention and treatment of obesity, diabetes, and chronic kidney disease in military personnel (active duty and retired) and their families. “

Notice “active duty” in that sentence. Both The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) participate in this study.  Unfortunately, my attempts to follow up on the study consistently brought me back to the FOA. You can read the FOA at http://grants.nih.gov/grants/guide/pa-files/pa-11-260.htmlNIH

The Department of Defense’s Instruction for Medical Standards for Appointment, Enlistment, or Induction in the Military Services “…Establishes medical standards, which, if not met, are grounds for rejection for military service. Other standards may be prescribed for a mobilization for a national emergency….”

As of September 13, 2011, according to Change 1 of this Instruction, the following was included:

“Current or history of acute (580) nephritis or chronic (582) chronic kidney disease of any type. “

Until this date, chronic kidney disease was not mentioned.  You can read this for yourself on page 27 of the document at http://www.dtic.mil/whs/directives/corres/pdf/613003p.pdf.  I cannot explain the seeming contradiction between the FOA and the Directive.

NimaAlthough, when my daughter Nima Rosensfit– researcher par excellence – asked me if I had a particular request for Mother’s Day, I asked her for research on the early history of CKD.  She found there wasn’t very much until fairly recently.  The fact that the first set of clinical practice guidelines (K/DOQI comprised Chronic Kidney Disease: Evaluation, Classification and Stratification) wasn’t published until February, 2002, may account for the lack of information from the military.These may be found at http://www.kidney.org/professionals/kdoqi/pdf/prot.pdf

While my information is inconclusive (at best), I sincerely hope that our warriors – whether on active duty or retired – have the same kind of care for their CKD as those of us who are civilians do.  Thank you again… and again…and again to our protectors, including my Bear. 2013-05-10 14.53.10-6

Yesterday, we were invited to several events.  One of these was a birthday brunch for my step-daughter, Lara Garwood.  Her sweetheart made certain there was food I could eat.  When my eyes lit up at the sight of baby potatoes (I’m Russian by heritage.), he commented, “I leached the potatoes, sort of.”

Book CoverLet’s go back to basics here for a moment. On page 134 (Do a word search instead of relying on the page number if you own a digital copy of the book.) of What Is It And How Did I Get It? Early Stage Chronic Kidney Disease, I define potassium as,

“One of the electrolytes, important because it counteracts sodium’s effect on blood pressure.”

Dictionary.com tells us that electrolytes are:

“…any of certain inorganic compounds, mainly sodium, potassium, magnesium, calcium, chloride, and bicarbonate, that dissociate in biological fluids into ions capable of conducting electrical currents and constituting a major force in controlling fluid balance within the body.”

Potassium is necessary for the nerves and muscles. The heart is a muscle. But our compromised kidneys cannot eliminate enough potassium from the blood before it travels back to the heart. This may lead to heart attack… or kidney failure. It’s a chicken and the egg kind of thing.

These are the acceptable values of potassium in your blood. As you can see, there is a difference in the values for adults and children of various ages. Thank you everydayhealth.com at http://www.everydayhealth.com/health-center/potassium-k-in-blood-results.aspx for the chart.

Potassium (K)
Adults: 3.5-5.2 milliequivalents per liter (mEq/L) or 3.5-5.2millimoles per liter (mmol/L)
Children: 3.4-4.7 mEq/L or 3.4-4.7 mmol/L
Infants: 4.1-5.3 mEq/L or 4.1-5.3 mmol/L
Newborns: 3.7-5.9 mEq/L or 3.7-5.9 mmol/L

 

depression-cause-heart-attack-1I went to Kidneys.com at http://www.yourkidneys.com/kidney-education/Diet-and-nutrition/Potassium-and-early-stage-kidney-disease/3191 to see what, if any, the symptoms of high potassium levels are.

  • Nausea
  • Weakness
  • Numbness or tingling
  • Slow pulse
  • Irregular heartbeat
  • Heart failure

Now, keep in mind that at early stages of CKD you may not have high levels of potassium.  The idea is to keep your levels low so that you do not do damage to yourself since your kidneys are not doing such a great of eliminating it.

But here’s the kicker: raising potassium levels could lower your blood pressure. Remember high blood pressure is the second leading cause of CKD.  Just like riding a bicycle, it’s all a matter of balance.

Since being diagnosed, I’ve leached the potassium out of potatoes by cutting them into pieces, soaking them in water for four hours, changing the water, and letting them soak again or soaking them in the refrigerator overnight.  That’s a lot of time involvement, time I knew my almost son-in-law did not have in his schedule.potatoes

So I researched for a less time consuming method that I could mention to him.  I wanted to eat what he prepared, but only if it didn’t cause my CKD to progress. I was surprised to discover that the only effective way to leach potatoes and other vegetables is to double boil them.  Thank you to Kidneycoach.com at http://www.kidneycoach.com/356/potassium-leaching-study-shows-not-all-leaching-methods-work/  for this new, researched, effective method.

However, I find that new research disparaging. Sure, the potassium is out, but boiled potatoes?  And other vegetables since all contain some level of potassium?  How is that appetizing?  Then again, I like being alive, I like not being on dialysis, so I will just cope.

Talking about coping, electronic sales of the book are doing so nicely.  Feel free to share them with friends and tell others where you got them.  The name of the game is get the information about slowing down the gradual decline of your kidney function out to the public.  After all, that’s how SlowItDown was named.SlowItDown business card

Until next week,

Keep living your life!

Lest We Forget

Today is Memorial Day.  Until I became engaged to a retired army colonel, I never truly understood what that meant.  He’s told me.  Even with keeping the worst of it to himself, from Bear’s memories I understand… and the sacrifices of these men and women were horrific.  It is not  ‘happy’ Memorial Day; it is a somber day to remember what our countrymen and countrywomen have given for us.

A friend from my theater life, James David Porter( Arizona Curriculum Theater),  posted this on Facebook today:

“Memorial Day began as “Decoration Day” in the 1860s, to honor the 625,000 soldiers who died in the Civil War. The first Decoration Day event was organized by freed African-American slaves in 1865 in Charleston, S.C., where a parade of 10,000, led by 3,000 black schoolchildren, took place to honor the dead around a racetrack that had been used as a burial ground.”

Once you’re over being surprised that Memorial (instituted as Decoration) Day  was orginally organized by freed slaves, pay attention to the part that  mentions it was “to honor the dead.”  Organ donations are not the only way our dead offer us life. Oh, and thank  you to Larry Jacobson, a former colleague a million years ago, for locating the picture above.

I’ve  got an exercise video for you to demonstrate that exercise CAN be fun.  We went to Nathaniel Smalley’s (he and his wife, Elizabeth had two swing dance clubs here until recently)  Feather Focus’s photography exhibit Friday night where Bill Morse was dj for some East Coast Swing Dancing.  I wasn’t about to pass up the chance to do some exercise I actually liked!  My partner is MacGyver Mann who teaches at Gmann’s in Mesa (Arizona) on Thursday nights.  I never met him before so you can appreciate what a good lead he is. It’s night, it’s outdoors and it’s dark.   But it is fun and got my heart rate up!  Can you catch the smile on my face? http://www.youtube.com/watch?v=OHPReqcTMIU&feature=channel&list=UL. Thank you, Bear, for getting any video at all for us with your wonderful, magical phone.

Ready for some kidney news? First, do you remember my disappointment with the medical jewelry company that sent the alert bracelet with a note saying that it should not be immersed in water, as in bathing or swimming?  I don’t know about you, but I have this habit of showering every day and that includes immersing myself in water.  I also have arthritis which means taking jewelry off and then putting it back on is a nightmare – even with the arthritis helper made specifically for this purpose.  My mother loved that little device; I’m just not co-ordinated enough with my left hand to use it on a bracelet worn on my right hand since I’m right handed. We can now bypass the whole problem.  Read on:

Tattoos Replace Bracelets for Medical Alerts

By Chris  Kaiser, Cardiology Editor, MedPage Today

Published: May 25, 2012

 
 

PHILADELPHIA   —  As more people with diabetes replace their medical alert bracelets with tattooed warnings, there might be a need for a standard design and body location, a researcher here said.

“The tattoo has to be easily recognizable to first responders,” Saleh Aldasouqi, MD, from the Sparrow Diabetes Center of Michigan State University in East Lansing, said during a press conference.

“It may be that we need guidelines for medical alert tattoos for both patients and tattoo artists,” Aldasouqi said. “Should tattoos be prescriptive? I don’t know. We’re at the beginning of this dialogue and I think it’s an important one.”

Medical alert tattoos for diabetes are a relatively new phenomenon and Aldasouqi admitted he has no hard data on the number of people who choose ink over metal to alert first responders in case of an emergency.

He initially became aware of medical tattoos about 3 years ago when a patient showed up with one. His search of the literature, however, produced only two case reports. But a search on the Internet revealed ample evidence that the practice is alive and well.

“You can find groups of people discussing their medical tattoos,” he said.

Rick Lopez, who works at Hard Ink Tattoo in Philadelphia, told MedPage Today that he recently inked a diabetes alert on a young man.

“He brought the bracelet into the shop and I just copied it onto his wrist,” Lopez said.

He said he has tattooed a lot of “cancer ribbons” on customers, generally family members of those with cancer who want to show support, but also on cancer survivors as well. And he has inked the autism puzzle ribbon. But only one medical alert.

Aldasouqi and colleagues reported a case presentation here of a 32-year-old women with type 1 diabetes who decided to shed the alert jewelry for a permanent ink reminder on her wrist.

She said she was frustrated with the numerous broken necklaces and bracelets throughout her life, and the ensuing costs of them.

Last year in the American Family Physician journal, Aldasouqi published another case report of a man who tattooed his diabetic condition onto his wrist.

As the practice of medical tattoos grows, he wants to ensure it’s headed in the right direction. Paramedics have to be educated about these tattoos so they recognize them during an emergency. There perhaps should be some standardization in design and location, such as the wrist, so it’s easier to identify the tattoo as an alert, he said.

He cited a case where a man had the letters “DNR” inked on his chest. During an emergency, first responders thought the tattoo might be a directive for “do not resuscitate.” As it turned out, the man had lost a bet in his youth, which resulted in those letters emblazoned on his chest.

Aldasouqi has recently teamed up with a colleague from the University of Helsinki to produce peer-reviewed studies on the phenomenon and to begin a registry of patients with medical tattoos.

You can read the article in its orginal form at: http://www.medpagetoday.com/MeetingCoverage/AACE/32916.

One of my step-daughers, Kelly Garwood, is gloriously tatooed (or is called inked?).  Here’s hoping she never needs to add a medical tatoo to the collection of art on her body.

Before I sign off, a little reminder that while I’m donating books as fast as I can at urgicare centers, and PCPs’, nephrologists’ and urologists’ offices, there are still plenty left for you to order a personalized one for the discount price of $8.00.  I finally figured out the price had to be less than that of the digital copy of the book or where’s the discount?

Also, myckdexperience.com is no longer a viable address, so if you’d rather order digital or print (not discounted or personalized), go through Amazon or B & N.

The nephrologist I mentioned who wanted to sell our books together is becoming disillusioned since neither online selling site is willing to do this.  I wonder if we should offer the two book set via our blogs.  What’s your opinion here?

Until next week,

Keep living your life!