Metabolic Syndrome doesn’t Sit Well with Me

I have been dismayed by this spare tire around my middle for a while.  I looked around and noticed some of my female friends have it, too.  For some reason, I didn’t look at my men friends’ middles.tire

Was it a post-menopausal thing? No, not with these young women friends having it, too.  So I asked and more than one told me she had Diabetes.

Whatever could that have to do with my spare tire, I wondered.  I may be pre-diabetic, but I don’t have diabetes.  No, I think it’s something else.  So I researched and found I’d been in denial about having (self-diagnosed) Metabolic Syndrome. Certainly I’ll speak with my primary care physician, but meanwhile I decided to tell you about it.

Did you know that one out of every three United States citizens and Canadian citizens suffer from Metabolic Syndrome?  While the title sounds exotic, it’s not. Okay, with those kinds of numbers, this isn’t a case of Metabolic Syndrome being the disease – or syndrome – of the day.  You know, when all of a sudden, everyone you know thinks (s)he has whatever it is… like me.

Okay, so what is it? This is what the Mayo Clinic at http://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/basics/definition/con-20027243 had to say about it:

“Metabolic syndrome is a cluster of conditions — increased blood pressure, a high blood sugar level, excess body fat around the waist and abnormal cholesterol levels — that occur together, increasing your risk of heart disease, stroke and diabetes.”

Busted!  On my August blood draw report, my blood sugar level was high at 6.2 via the A1C.  That’s what it’s been for a year. Normal is between 4.8 and 5.6. A reading of 5.7 – 6.4 indicates increased risk for diabetes.  Just in case you don’t remember, the Hemoglobin A1C measures how well your body handles blood sugar over a three month period. This is important for Chronic Kidney Disease patients because, as defined in What Is It and How Did I Get It? Early Stage Chronic Kidney Disease (page 132 for those with the book), hemoglobin:

“Transports oxygen in the blood via red blood cells and give the red blood cells their color.”Book Cover

Awk!  I almost, but not quite, hesitated to check just how abnormal my cholesterol level was and for how long. I snuck at a quite peek at my book (page 130) before I did that just to be sure I knew what I was checking. The definition of cholesterol was:

“While the basis for both sex hormones and bile, can cause blockages if it accumulated in the lining of a blood vessel.”

So cholesterol is a good thing unless there’s a buildup.  Wait a minute; I need a refresher about bile.

MedlinePlus at http://www.nlm.nih.gov/medlineplus/ency/article/002237.htm cleared this up for me:

“Bile is a fluid that is made and released by the liver and stored in the gallbladder.

Bile helps with digestion. It breaks down fats into fatty acids, which can be taken into the body by the digestive tract.”

My latest cholesterol reading (with medication to keep it low) for Total Cholesterol were in range (100 – 199) at 165, as were my HDL Cholesterol reading at 49 (greater than 39 is acceptable), my VLDL Cholesterol reading at 23 (5-40 is considered normal), and my LDL Cholesterol reading (anywhere from 0 – 99 is normal).

Let’s backtrack just a bit.  HDL is High Density Lipoprotein, the cholesterol that keeps your arteries clear or – as it’s commonly called – the good cholesterol.  VDL is Low Density Lipoprotein or the ‘bad’ kind that can clog your arteries. VLDL is Very Low Density Lipoprotein and one of the bad guys, too. It contains more triglycerides than protein and is big on clogging those arteries.

Hmmm, this is part of Metabolic Syndrome, but I didn’t have it.  Did I ever have a cholesterol problem?  I looked back over the past year and noticed my Total Cholesterol had been out of whack by a point or two once or twice.

blood pressure 300dpi jpgWhat about increased blood pressure?  Well, I do have Chronic Kidney Disease and usually ran about 130/80.  The 130 was the systolic part of the reading; it measured the pressure when the heart is beating.  The lower part of the reading, or diastolic (the 80 in my case) was when the heart was at rest between beats. A normal blood pressure for a person my age (67) with CKD according to the new Eighth Joint National Committee is 150/90. Uh-oh, that’s under control, too.

Having both your cholesterol and your blood pressure under control were good things, and in this case, they pointed out the folly of self-diagnose.  Mea culpa!

By the way, this was important for CKD patients because we’re already at risk for heart disease simply by being CKD patients.  Why add to that risk with hypertension (high blood pressure) and/or hyperlipidemia (high cholesterol)?

Okay, so I didn’t have Metabolic Syndrome despite the spare tire I carried. But maybe you do.  Let’s see what you can do about it.

According to MedicineNet at http://www.medicinenet.com/metabolic_syndrome/page4.htm#what_is_the_treatment_for_metabolic_syndrome, the treatment is – you guessed it – diet, exercise, and no smoking.  Medication is used if the syndrome is severe enough, but life style changes are the first line of treatment.

Tonight, my brother and sister-in-law arrive from Florida.  By the time I blog next week, we will have spent time in Prescott, Sedona, and Jerome.  For those of you who don’t know these cities in Arizona, each has its own, distinct personality.  We will also have had an early birthday party for my brother so they can meet my family here, all the step-daughters and almost son-in-laws.  Ladies and gentlemen: this is the best medicine for whatever bothers me.firworks

I am so excited I almost forgot to tell you about the book.  I want to make sure none of you students is renting it for a semester.  Even if you don’t use Amazon’s Kindle Match Book Program, buying the book is LESS EXPENSIVE than renting it, especially the digital copy.  I’m sorry if you’ve been duped into renting.  Periodically I write reminders in the blog about this.

Until next week,

Keep living your life!

A Meta Is Going to Come? Shouldn’t That Be A Change is Going to Come?

Victorian clockYou may notice the blog is late today.  Blame the flu.  Scratch that.  I’ll take responsibility.  While I was debating whether or not it was time to take the flu shot all Chronic Kidney Disease patients are urged to take each year, the flu found me.  No kidding about this compromised immune system business.  I considered this a light case, but was just ordered back to bed… after over a week of laying low.

Keep in mind that this year’s flu’s vaccine only covers three or four of the many strains around, so you may end up with the flu even after having the shot.  My family doctor’s advice?  Once you’re well again have the inoculation and protect yourself from as many strains as you can.flu shot

Dr. Jamal Attalla is my new nephrologist and also a Landmark Graduate.  That’s where I met him way before I even knew he is a nephrologist.  I like that he is non-alarmist, non-paternalistic and easy going.  When I told him that 50 as an eGFR reading was my panic point, he very gently reminded me that readings will vary within a range depending on the day, your hydration, etc. – all variable factors.  I knew that.

Then he reminded me that after 35, we lose about 1% of our kidney function yearly.  I was under the impression it was ½% annually and thought that started at a much later age.  Finally, we talked about my reading of 48%. But I understood better now how that happened and am confident I can raise it again before I see him a year from now.

Enough about me, let’s get to that metabolic syndrome.  Oh, wait, that’s about me too.

Kibow has sent me quite a bit of information about using their probiotics as a method of treating chronic kidney disease.  I need to warn you that this is not an endorsement of their product.  I don’t know enough about it yet.

Along with their press release, they sent me a booklet entitled Kibow’s Educational Guide to Probiotics and Kidney Health written by Natarajan Ranganathan, Ph.D. and Henry D’Silva, M.D.  In the booklet, they discuss metabolic syndrome.  This part of that discussion lists five conditions in metabolic syndrome.  Only three are necessary to diagnose the syndrome:

“1. Abdominal obesity

2. high blood pressure

3. high blood sugarapple shaped

4. low levels of ‘good’ HDL cholesterol

5. high triglycerides”

I’d first heard about metabolic syndrome two years ago when I met an Aussie nurse at a friend’s house.  She assumed I knew all about it.  When I told her I didn’t and asked her to explain, she promised a coffee date to do just that.  We never had the date since she was called home quite suddenly and I forgot about the syndrome.

Then Kibow sent me their material.  Except for the high triglycerides and low levels of ‘good’ HDL cholesterol, I have all these conditions.  Granted, the abdominal obesity is self-diagnosed but you’d have to be blind (and I’m not yet) to miss it.

So what’s the big deal about metabolic syndrome?  By the way, meta does mean change.  According to The National Institutes on their Institute of Heart, Lungs, and Blood page at http://www.nhlbi.nih.gov/health/-topics/ms/:

“The term ‘metabolic’ refers to the biochemical processes involved in the body’s normal functioning. Risk factors are traits, conditions, or habits that increase your chance of developing a disease.”

The National Institutes is a fount of information on all topics that deal with your health.

heart attackAgain, the same question: what’s the big deal about metabolic syndrome?  Usually it’s stated backwards for Chronic Kidney Disease patients.  The MayoClinic at http://www.mayoclinic.com/health/metabolic%20syndrome/DS00522  tells us:

“Metabolic syndrome is a cluster of conditions — increased blood pressure, a high blood sugar level, excess body fat around the waist and abnormal cholesterol levels — that occur together, increasing your risk of heart disease, stroke and diabetes.”

Sometimes, Chronic Kidney Disease is mentioned as one of the diseases this syndrome puts you at risk for.  We, however, already have that, so why should we try to either avoid the syndrome completely or ameliorate it if we do have it?

Before I was diagnosed with Chronic Kidney Disease, I joyfully proclaimed Dr. Andrew Weil as my health guru and actually had pretty good health following his suggestions.  This is what he has to say,

“Doctors may also prescribe medications to lower blood pressure, control cholesterol or help you lose weight. Insulin sensitizers like Glucophage (Metformin) may be prescribed to help your body use insulin more effectively. It lowers blood sugar, which also seems to help lower cholesterol and triglycerides as well as decreasing appetite. The side effects of Metformin (often temporary) include nausea, stomach pain, bloating and diarrhea. A more serious side effect, lactic acidosis, can affect those with kidney or liver disease, severe heart failure or a history of alcohol abuse and is potentially, though rarely, fatal. Aspirin therapy is often given to help reduce risk of heart attack and stroke.”

Notice the mention of kidney damage and that of aspirin therapy.  We just can’t take the chance.

Take a look at his article yourself for even more information: http://www.drweil.com/drw/u/ART03193/Metabolic-Syndrome.html.Dr. Andrew WEil

Sometimes you just have to use your common sense.  We ARE already at risk of heart disease, diabetes, and high blood pressure as CKD sufferers.  Why would we take a chance of doubling our risk of developing these medical problems?  Don’t forget that while diabetes and high blood pressure can cause CKD, the reverse is true, too.

Kindle has offered me the opportunity to correct two spelling errors in the book.  What I want to know – since they are simple words – is how did spell check (and me for that matter) miss these in the first place? I find it amazing that not one single medical term was misspelled, but these two common words were.Book Cover

Keep an eye out for a new print/digital program they’ll be announcing.  It’s theirs so I’m not at liberty to discuss it until they announce it.  That is a bit of a tease, isn’t it?

Exercise is an essential part of slowing down the progression of your CKD, so kudos to Abby Wegerski (that’s my baby!) and her instruction partner, Tyler Robbins, on the One Year Plus dance celebration for Sustainable Blues this past weekend!

Until next week,

Keep living your life!blues