Water, Water Everywhere

11194487_10206480685479477_4614482644786730988_oYesterday was Mother’s Day here in the U.S.  Here’s what I posted on that day:

When I grew up, mothers were all married women. Not anymore! Happy Mother’s Day to the moms who are moms in a lesbian relationship, the dads who are moms in a gay relationship, the single dads who are both mother and father, the moms in straight relationships, the older siblings bringing up their brothers and sisters, the single moms and those who have lost their child. You’re all still mothers and I relish enjoying this day with you.

I hope yours was a very happy one, even if your children are far away like my Nima who is in New York. Nima

This mother (two biological daughters, two step-daughters, two significant others) has been writing about sea sickness remedies, both medical and natural, for the past two weeks.  That got me to thinking about another kind of water and why we need it.

I’ve mentioned that I see a nutritional counselor to help me prevent my pre-diabetes from becoming diabetes. We all know I need 64 oz. of fluid intake a day as a Chronic Kidney Disease patient, but it’s not all water.  There’s my beloved 16 ounces – or two cups – of coffee a day plus any solid that turns to a liquid when melted (think ices) and the liquid in fruits such as watermelon.  By the way, did you know that our bodies are 50-75% water depending upon our health and age?diabetes equipment

Debbie, my nutritional counselor, kept hitting the need to hydrate.  Until she realized I already take this into account daily, she asked me to keep count of the number of eight ounce glass of water I drank each day.  That’s how important she felt it was.  We know that; we’re CKD patients.

But, have you ever wondered why it’s so important that we keep hydrated?  That’s one of those questions that was answered when I was first diagnosed, but – being who I am – I don’t remember the answer.  And that got me to wondering if you did.

The most obvious answer is that we need water so that our metabolism can function at its best. This is important so we have energy and build new cell materials. Let’s explore this a bit more.

The Oxford Dictionary defines catabolism (love that name) as

the breakdown of complex molecules in living organisms to form simpler ones, together with the release of energy; destructive metabolism.

In this case, ‘destructive’ is a positive.  No destruction of complex molecules = no release of energy.  Heaven knows we already have enough problems with energy as CKDers.

I used the Medical-Dictionary at http://medical-dictionary.thefreedictionary.com/anabolism for an explanation of anabolism.

The phase of metabolism in which simple substances are synthesized into the complex materials of living tissue.

So catabolism is the function of metabolism which breaks down complex molecules for energy and anabolism is the function that builds up cell material.metabolism

Oh, almost forgot – metabolism simply means change. How can I remember a college etymology lesson from fifty years ago, but not remember what my nephrologist told me seven years ago????

All right, but why the need to hydrate? While a commercial site, Nestle Waters at http://www.nestle-waters.com/healthy-hydration/water-fonctions-in-human-body (I did wonder about that ‘o’ in fonctions.) lists the five reasons we need water.  Notice number five and remember that toxins need to be eliminated, too.  That’s the job of the kidneys… and they need water to do it.water to cells

  1. Cell life
  2. Chemical and metabolic reactions
  3. Transport of nutrients
  4. Body temperature regulation
  5. Elimination of waste

As I researched, I hit medical sites, sports sites, pregnancy sites, elder care sites, and even pediatric sites.  All included hydration in their how-to-stay-healthy advice.

As CKDers, we know that an excess of sodium, phosphorous, potassium, and protein is not good for us.  Guess what flushes out the excess.  That’s right.  Your kidneys filter it from your blood, it’s converted to urine, and leaves your system.  Of course, you don’t want to overtax your already compromised nephrons by going over your daily limits of each of the above.

We’ll pause for a moment here while you go get a drink of water.

409px-Glass-of-waterRefreshed?  Okay.

Did you know there are different types of water? Many thanks to Consumer Reports for the following chart.

Artesian

Water obtained from a well that taps a confined aquifer, an underground layer of rock or sand that contains water. Example: Fiji Natural Artesian Water.

Distilled

Water that has been boiled and then recondensed from the steam that the boiling produces. Distillation kills microbes and removes minerals, giving water a flat taste. Example: Glacéau Smartwater.

Mineral

Groundwater that naturally contains at least 250 parts per million of dissolved solids. All minerals and other trace elements must be present in the water when it emerges at the source. Example: Calistoga.

P.W.S.

Public water source, also known as municipal water supply, or tap water. Fun fact: Aquafina, one of the top 10 selling domestic brands, used to say “P.W.S.” on its label—but changed that in 2007 under pressure from Corporate Accountability International to make clear that the water came from a public supply and not some pristine mountain spring called P.W.S.

Purified

Water from any source that has been treated to remove chemicals and pathogens according to standards set by the U.S. Pharmacopoeia. Must contain no more than 10 parts per million of dissolved solids. Distillation, deionization, and reverse osmosis are all purification methods. Examples: Aquafina, Dasani. (Note from me: recently, Dasani has started added minerals to their water.)

Sparklingbottled water

Water that contains carbon dioxide at an amount equal to what it contained when it emerged from its source. Carbon dioxide lost during the treatment process may be added back. (Carbonated waters such as soda water and seltzer are considered soft drinks, not bottled waters.) Example: Perrier.

Spring

Water derived from an underground formation from which water flows naturally to the Earth’s surface. Spring water must be collected at the spring or through a borehole tapping the underground formation (aquifer) feeding the spring. Examples: Arrowhead Mountain Spring Water (Nestlé), Evian. (Hmmm, Nestle also has minerals added now.)

I stick to either spring water or osmosis filtered water.  Be wary of any water with minerals added. You don’t really need more of those.

Digital Cover Part 1

 

Book Cover

It’s contest time.  Post a picture of you reading any of my three books in the most unusual place you can think of and win a copy of Part 2The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 1.  You can post your pictures at https://www.facebook.com/WhatHowearlyCKD which is SlowItDownCKD’s Facebook page.  Make sure the title and your face are clearly visible. Keep it clean and keep them coming!  The contest ends on May 31.  Thank you to inspired reader, Geo De Angelo, for sparking the idea in my mind. I’m eager to see how creative you can get.

Until next week,

Keep living your life!

Higher and Higher

Today we start off with an announcement:  What Is It And How Did I Get It? Early Stage Chronic Kidney Disease’s profits have offset the cost of 2011’s donations of itself! That is not bragging about earnings, but rather an indication of just how many books were donated that year.Book Cover

And just why is that important to anyone but Gail, you ask.  Remembering my passion is to get the information about CKD out to the public, you’ll be able to see the connection after reading this:

“That guideline {e.g. providing a common language for communication among providers, patients and their families, investigators, and policy-makers and a framework for developing a public health approach to affect care and improve outcomes of CKD} led to a paradigm change in the approach to CKD, shifting from an uncommon disease often culminating in kidney failure and treatment by nephrologists to a common condition leading to death from cardiovascular disease. As a result, CKD is now accepted as a worldwide public health problem and the global guideline was developed to address this issue.”

This quote is from Andrew S. Levey, MD, co-chair of the NKF KDOQI workgroup that developed the 2002 CKD Guideline and Dr. Gerald J. and Dorothy R. Professor of Medicine at Tufts Medical Center in Boston.

NKF-logo_Hori_OBYou can probably figure out that NKF is the National Kidney Foundation, but you might need a little help with KDOQI.  That’s the acronym for their Kidney Disease Outcomes Quality Initiative.

2002 was a long time ago, but this statement was issued on December 27th, 2012, which was the night before the release of Kidney Disease: Improving Global Outcomes (KDIGO).

By the way, many thanks to the National Kidney Foundation for each time they’ve asked me to write for them, suggested my name for articles about kidney disease awareness advocates, or offered me suggestions.

I’ve freely quoted from their page: http://www.kidney.org/news/newsroom/nr/Updated-CKD-Guideline-Enable-Physicians-Predict-More-Accurately.cfm, and yet, there’s even more information there.  Take a look for yourself.

So, CKD is now a common disease. And many people suffering from it die of cardiovascular disease. And hypertension can lead to that… and CKD.  Seems pretty circular.

Back to basics.  Hypertension or high blood pressure is defined on page 132 of What Is It And How Did I Get It? Early Stage Chronic Kidney Disease:

“A possible cause of CKD, 140/90 mm Hg is currently considered hypertension, a risk factor for heart disease and stroke, too.”

blood pressure 300dpi jpg

Now, about that 140/90…. According to the National Institutes of Health‘s National Heart, Lung, and Blood Institute at http://www.nhlbi.nih.gov/health/health-topics/topics/hbp/printall-index.html, as of January, 2014,

“If you have diabetes or chronic kidney disease, a blood pressure of 130/80 mmHg or higher is considered HBP.”

Not only that, but blood pressure can change depending upon the arm that is being used to measure it, the time of day, whether you’ve just smoked (Just don’t!), had a cup of coffee or eaten just prior to the test, even if you’ve just woken up.  We all know what worry or stress can do to your blood pressure.  It seems even your race can make a difference.

_68045928_picture1A little less than a year ago, a team at London University College developed a wrist sensor to measure blood pressure as the blood leaves the heart itself. They discovered that blood pressure does not drop as much as thought during the night and that it might be possible to predict heart disease by using this monitoring.

I was particularly interested since I have a wrist monitor that my PCP (primary care physician) prefers I not use, thinking the measurement of the blood passing through the arm arteries more accurate.  I’d originally thought this was a wrist monitor but it doesn’t measure the blood flowing through the wrist.  This was a surprise to me and one I’d like to follow closely.  If you’d like to, also, take a look at http://www.bbc.com/news/health-22812477

The Centers for Disease Control and Prevention provides a chart that makes clear why Blacks (or African Americans as they are referred to in the chart) are at 3.5 times the risk of CKD.  Look at the numbers, ladies and gents.  Hbp {high blood pressure} is the second leading cause of CKD. As usual, there’s so much more information about high blood pressure on their page: http://www.cdc.gov/bloodpressure/facts.htm.

Race of Ethnic Group Men (%) Women (%)
African Americans 43.0 45.7
Mexican Americans 27.8 28.9
Whites 33.9 31.3
All 34.1 32.7

 

 
 
   
   

It’s common knowledge that exercise can lower blood pressure, but how many readers know that it can also make your blood pressure medication more effective? On 4/23 of last year, The American Heart Association issued this statement:

“Alternative therapies such as aerobic exercise, resistance or strength training and isometric hand grip exercises could help people reduce blood pressure. Biofeedback and device-guided slow breathing reduced blood pressure a small amount. Due to their modest effects, alternative therapies can be used with — not as a replacement for — standard treatment.”

Rae%208x10%205792%20Sepia%20TinType[1]Oh, so that’s why I didn’t give away the isometric hand grips when we gave up 1880s competitive shooting.  Good for the trigger finger, just as good for the blood vessels – with proper medication.

Wait a minute.  Both the United Kingdom and the United States have populations with almost a third of the people suffering high blood pressure. Think about this.  What could this mean?

I don’t know if it’s because I’m getting older or not, but life seems to be moving so fast these days.  First there was Passover, then Easter, now Mother’s Day coming up with Father’s Day soon to follow and all those lovely birthdays and anniversaries in between.  How much stress is this?  How much stress is getting ready for your vacation?

No, I’m not saying these occasions should be ignored to lower our blood pressure.  I am saying we are the ones in control of how we treat these occasions.  Are they going to be occasions of stress?  Or gatherings with joint efforts and a relaxed delight in seeing the people involved? {And now you know why our wedding invitation – which I wrote – refers to me as “the Former Wannabe Hippie.”}

Happy Mother’s Day to all those who are mothers, wish they were, have mothers, or ever even remotely considered motherhood – male moms included.Mother's Day 2012  And what better gift for the mom in a family that has a CKD sufferer than…

Until next week,

Keep living your life!

Another Holiday

Holidays abound! Or maybe it just feels that way. No sooner did my Russian Jewish almost son-in-law and I co-host our Seder then it was time to get ourselves together for Easter. Sometimes it’s a lot of work to have such an integrated family.

passover This time, no one stepped up to bat and I soon found out why. Another almost son-in-law had minor surgery, but was still in pain and not ready for people. A third adult child had weekend guests and had to work Sunday evening. But one couple wanted an Easter celebration.

So I quickly figured out that I could go to the weekly Sustainable Blues dance lesson that my youngest, Abby Wegerski, taught every week AND make dinner for these adult children if I planned carefully. That’s when I realized I wasn’t weighing and measuring or looking at my renal diet Bible before cooking. All the ingredients I needed were renal friendly and readily available in our house.blues

What a relief! It took almost seven years for this information and this way of being to become part of me. The point here is that the renal diet has become a way of life, one I don’t often think about too much anymore. I can easily remember a time I needed to pull out the diet list to see what I could eat, then another list to see if the protein, potassium, phosphorous, or sodium (3 Ps and and S, as I call them in What Is It And How Did I Get It? Early Stage Chronic Kidney Disease) levels were too high and finally the KidneyDiet app to make sure I hadn’t gone over my limits for each of these and a calorie count.

This wonderful revelation doesn’t mean that I don’t hit my own ‘refresh’ button periodically to make sure I really am correctly eye judging the amounts of each food I use in cooking and eating or that I don’t need to occasionally check to see if I’m right about the amount of whatever is in it.

I still carry all three of these – Northern Arizona Council on Renal Nutrition Diet, AAKP Nutrition Counter, and KidneyDiet app – as my talismen. There’s a certain security in knowing I have them if I need them. I also find that sometimes I just don’t remember exactly what I read in each, so it’s a comfort to have them at hand.Book Cover In Chapter 8: The Renal Diet of What Is It And How Did I Get It? Early Stage Chronic Kidney Disease, I offer an example of the intricate and annoyingly painstaking little notebook I devised to keep track of my CKD nutrition. Ladies and Gentlemen: I am pleased (for CKD sufferers) to announce this is now obsolete!!!

One of the very first apps I purchased was KidneyDiet. It is not the same as my little notebook, but works equally well. The only thing it doesn’t do is tell you if you’ve reached your daily limit in each category of food (milk, meat or meat substitutes, grains, fruits, vegetables, and fats).

android_welcomeYou’re an intelligent person. You can figure out just by looking at a display of your entries if you’ve had your one four ounce serving of milk, five ounces of meat or meat substitutes, however many servings of grain (depends upon your sex, weight, and whether or not you want to lose weight), your three servings each of fruits and vegetables and your fill of fat intake. You’re the one entering your limits (as prescribed by your dietician), and they show up red if you’ve gone over them. Calories and cholesterol are also included, as is fluid intake. The nicest part is that if there’s a food you like which isn’t on the pre-existing list that comes with the app, you can add it. Do that once and you have the information for that food every time you enter it.

No, I do not own stock in the KidneyDiet app, although that might not be such a bad idea. I am thrilled that life keeps getting easier for us as CKD patients. I know I’ve written about the app before, but each time I use it, I’m grateful for how it’s made my life easier.

Wait a minute! I just realized the next holiday on the calendar is Mother’s Day. This should be interesting because I’m not cooking for that. If Bear does, no problem. He knows my dietary restrictions almost as well as I do. But if it’s one of the kids, especially one of the newer additions to the family…. Maybe it’s time to be more stringent when they ask me what I can eat, or better yet, tell them in advance.

When we went to Florida and stayed with my brother, Paul, and sister-in-law, Judy Peck (she of the magnificent cooking), Judy asked me what I could eat. So I sent her the renal diet I follow. It was overwhelming to her, just as it is to new CKD patients. As usual, she successfully simplified the matter. By asking me what I could eat instead of adhering to the list, she saved herself from having to pick and choose from a double sided page of dietary restrictions and I (of course) only told her the foods Bear and I liked. The moral of the story: everyone was happy once this was briefly discussed. photo (2)

The theme of today’s blog is that life is becoming easier for CKD patients but we’ve got to keep talking, keep exchanging ideas, keep each other updated about new information. CKD is part of me now, but it sure isn’t all of me.

About keeping each other informed: The Free Health Screening by Path to Wellness is on Saturday, 4/26 from 8:30 to 1:30 at The Golden Gate Community Center 1625 N. 30th Ave. in Phoenix, Az. While it is free you need to call for an appointment – the number if you speak English is 602 840 1644. For Spanish speakers, the number is 602 845 7905. You must be over 18 and have a family member with diabetes, heart or kidney disease, or have diabetes or high blood pressure yourself.

Have you looked at Dr. Mario Trucillo’s American Recall Center (www. recallcenter.com)? That was the site discussed in last week’s blog. I’d be interested to hear what you think of it.

I challenged myself to create a business card for SlowItDown doing all the formatting and graphics myself.  This is the final product:SlowItDown business card

Feedback?

 

Until next week,

Keep living your life!

Eat And Be Well

Here’s hoping all you mothers – and fathers being both mother and father to your children – had a wonderful Mother’s Day. There are just too many such fathers to mention individually here.

I don’t know where the idea originated that you had to give birth to your children to be their mother, but I see examples every day of non-birth mothers being terrific mothers.  That one’s for you, sweet Sharon.

My step-daughter Kelly and her fiancé Sean made a Mother’s Day bar b q and invited her sister Lara, along with Lara’s love, my daughter Abby, and Bear and me.  That’s my kind of Mother’s Day.  The only thing that could have made it better is if my NY daughter, Nima, had been there.download

As usual, Sean asked me first how I needed my chicken seasoned and if the piece he had chosen for me was small enough. That kind of thoughtfulness is a given with this gracious man.  Alex brought the sweetest watermelon… something else I could eat.  Someone brought potato salad which I admit I had a teaspoon of “just to taste,” and someone else brought potato chips.  I had no trouble eating my limited permitted share of those.  Kelly even made a cup of coffee just for me.

I see today’s blog is going to be about food.  Keeping that in mind, I found this general guideline to healthy eating at: http://healthfinder.gov/HealthTopics/Category/health-conditions-and-diseases/diabetes/eat-healthy

The Basics

Your body needs the right vitamins, minerals, and other nutrients to stay healthy. A healthy diet means that you are eating:

  • Vegetables, fruits, whole grains, and fat-free or low-fat milk products
  • Seafood, poultry, lean meats, eggs, beans, peas, seeds, and nuts

Limit foods high in:

  • Cholesterol, sodium (salt), and added sugars
  • Tans fats – Trans fats may be in foods like cakes, cookies, stick margarines, and fried foods.
  • Saturated  fats – These fats come from animal products like cheese, fatty meats, whole milk, and butter.
  • Refined grains – Food products with refined grains include white bread, noodles, white rice, and flour tortillas

 

What I found interesting here is that what the general population is urged to eat is not that much different than what we early stage Chronic Kidney Disease sufferers are told to eat.  We do have to limit the fruits and vegetables to three different sized portions of each.  The portion depends on the particular fruit or vegetable. We also need to cap our limited types of seafood, poultry, lean meats, and eggs to five ounces per day.  As for seeds and nuts, those are no-no’s for us.

Look at the foods the government feels we should avoid.  Look familiar?  Take a look at the renal diet your nutritionist gave you and you’ll find them on that as foods to limit (or avoid), too.glycemic-index

You probably noticed the above information was taken from a website dealing with diabetes.  That’s because diabetes is one of the leading causes of Chronic Kidney Disease and vice-versa. That’s another reason to watch your intake of foods with a high glycemic index – the indicator of how quickly your blood sugar rises after eating the food – which includes not only what we usually consider sweets, but ice cream, too.

P1050446-1024x677You know we need to stay as healthy as possible, including keeping our weight down. One way to do that is NOT skipping breakfast.  Why?  This is how study researcher Dr. Tony Goldstone, M.D., Ph.D. of Imperial College London in the UK explains it:

“Through both the participants’ MRI results and observations of how much they ate at lunch, we found ample evidence that fasting made people hungrier, and increased the appeal of high-calorie foods and the amount people ate.”

You can read more about the study that led him to come to this conclusion at: http://www.medicalnewstoday.com/articles/251709.php

You need to understand that skipping breakfast (literally breaking the fast you incur while you sleep) is a form of fasting.  If you take medication that requires food along with it, you’re also delaying the effects of the medication since you’re not taking it until later in the day.

Here’s an interesting finding on a study publicized in The Journal of Renal Nutrition in 2009:

“Long-term fish consumption was independently associated with improved kidney function among elderly individuals, a finding that extends the current knowledge regarding the benefits of fish intake on human health.”

But we knew that, didn’t we?  Take a look at: http://www.jrnjournal.org/article/S1051-2276(12)00181-1/abstract for more, slightly technical, information on this study.

By the way, are you taking Omega 3 (fish oil) supplements?  There’s a theory it helps retard the progress of CKD. I’ll been taking it all five years since my diagnosis and I’m still at stage 3A.

While that’s something I would suggest – and please remember:  I’m not a doctor.  You need to run my suggestions by your nephrologist before you even think of acting on them! – something I will  caution you  about is grapefruit or grapefruit juice.  Let’s go back to Healthfinder.gov at: http://www.healthfinder.gov/News/Article.aspx?id=670988&source=govdelivery#.ULPppKAFqXI.twitter for the information about this: is

“Even small amounts of grapefruit or grapefruit juice have the potential to cause sudden death, acute kidney failure, respiratory failure, gastrointestinal bleeding and other serious side effects when paired with these medications. Included are certain cholesterol-lowering medications, blood pressure drugs, cancer treatments and antibiotics such as erythromycin, the researchers said.”

And star fruit (carambola)!! Avoid it at ALL costs, because the cost could be your life.  It is toxic to people with Chronic Kidney Disease.  It’s a tropical fruit so chances are you’re not going to run into it too often.  I am so glad I wasn’t adventurous enough to try it in Nigeria all those years ago.  My daughter, Nima, did try it when our Nigerian friends (Remi Okunoye and her children Moriyika, Oliaton, and Benga) were living with us back on Staten Island, but she immediately spit it out.  She was a young child, not used to the taste, and it was too strong for her. Now that she’s at risk for CKD since I have it, I’m glad she did that.is (1)

I took the following quote from an article beguilingly entitled It’s not just what you eat, but when you eat it: “When a species’ typical daily rhythm is thrown off, changes in metabolism also happen. For example, in people, night shift workers have an increased prevalence of obesity and metabolic syndrome, and patients with sleep disorders have a higher risk for developing obesity. Also, less sleep means more weight gain in healthy men and women.”  This is discussed more technically at: http://www.eurekalert.org/pub_releases/2012-11/uops-inj110612.php

Enjoy what you do feel safe eating – and there is quite a bit of that type of food available, you know.

Until next week,

Keep living your life.

Be Inspired

Wow!  Both Mother’s Day and Mother’s Day have slipped by.  I hope all of you had a wonderful time with your mother, father, chosen mother, chosen father, surrogate mother, surrogate father and/or whoever fills the role for you. I hope you had laughter, tears, hugs and kisses – or, at least, a really firm handshake for those who are not demonstrative.

Please be aware that if one of your biological parents has CKD, you are at higher risk for the disease. AND if you are the biological parent, so are your children.

That made me so angry when it was explained to me. Of course, I had no clue why I was angry – but it is said that anger is the flip side of sadness. I have children.

Hmmm, have you considered giving a copy of What Is It And How Did I Get It? Early Stage Chronic Kidney Disease to either your parent or your child as a late Mother’s or Father’s Day gift?  What about as a graduation gift to the aspiring medical student? Now that’s inspiration.

Wait!  I have to repeat this: Dr. Jamal Atalla is such a gentleman that he said nothing when I misspelled his name in last week’s blog.  My apologies and thank you for your kindness in not mentioning it, Jamal. I was actually meeting with Tamara Jensen from AKDHC when I realized I’d misspelled his name and stopped mid-sentence to make a mental note to mention this in the blog.

Many people choose to share a meal out to celebrate holidays.  Bear’s daughters, Lara and Kelly, and Kellly’s significant other – Sean – took us to Cracker Barrel for breakfast to celebrate.  [I noticed the bracelet part of medical alert bracelets being sold as interchangeable watch bands  at the cashier’s counter. Apparently, they are the same things.  A little too fancy for my taste, but worth checking out.] My daughters, Nima and Abby, were in New York having lunch out  with their father.

And, yes, I was able to find something on the menu that fit the renal diet I follow.  Naturally, I did get those “Are you sure?” questions from the friendly waiter when I asked there be no butter, syrup, sweetened fruit, or powdered sugar on top of my made-from-scratch French toast and just black coffee and water with lemon but no ice.  I’m used to my diet now and thoroughly enjoyed it as much as the others enjoyed their bacon, sausage, and whatever else they had. Have I inspired you to eat out safely for your CKD?

Some readers were surprised to discover that I’d seen my nutritionist not once, but twice. My nephrology center, AKDHC, includes a yearly consultation with a nutritionist.  Now that I’m older and on Medicare, I decided to see what they cover.  Surprise!  Three visits, the first year and two every year thereafter.  This is from their website. 

 

Medical Nutrition Therapy

How often is it covered?

Medicare covers medical nutrition therapy services prescribed by a doctor for people with diabetes or kidney disease. This benefit includes:

  • An initial assessment of nutrition and lifestyle assessment
  • Nutrition counseling
  • Information regarding managing lifestyle factors that affect diet
  • Follow-up visits to monitor progress managing diet

Medicare covers 3 hours of one-on-one counseling services the first year, and 2 hours each year after that. If your condition, treatment, or diagnosis changes, you may be able to get more hours of treatment with a doctor’s referral. A doctor must prescribe these services and renew their referral yearly if you need treatment into another calendar year. These services can be given by a registered dietitian or Medicare-approved nutrition professional.

This is the address at which you can find the rest of this article and others that may be of interest to you.  http://www.medicare.gov/navigation/manage-your-health/preventive-services/medical-nutrition-therapy.aspx?AspxAutoDetectCookieSupport=1  Hopefully, this has inspired you to call your nephrologist for a visit with the practice’s nutritionist.

Let’s move from using renal nutrition therapy to stave off End Stage Renal Disease to alternatives should you reach stage 5.  What if you’re among the 20% of CKDers who aren’t able to stabilize at stage 3 and need to go on to dialysis?

This article from the University of Washington caught my eye a couple of months ago. Frankly, I had trouble believing this was even possible. It just sounded too much like science fiction. After pondering and pondering, I’m now convinced it is more science than fiction. I’d be interested to hear your opinion.

Wearable artificial kidney to be tested for safety and effectiveness in collaboration with FDA

By Leila Gray and Linda Sellers

UW Health Sciences/UW Medicine and Northwest Kidney Centers

A wearable artificial kidney, designed as a new treatment for kidney failure, will be tested in Seattle. The trial will be done in collaboration with the Food and Drug Administration under a new Innovations Pathway announced Monday.

The battery-powered wearable artificial kidney in its current form weighs about 10 pounds and is worn in a belt around the waist. Dr. Victor Gura, an associate clinical professor at the David Geffen School of Medicine, University of California, Los Angeles, invented the device. His goal is to free end-stage kidney disease patients from being tethered for several hours for three or more days a week to a dialysis machine. The hope is to improve the quality of life of these patients.

Researchers will be testing a wearable device that takes over the blood-cleaning functions of the kidneys…. The Wearable Artificial Kidney is being developed by Blood Purification Technologies Inc. based in Beverly Hills, Calif..

“Quality of life issues will likely be embedded in the trial design,” Himmelfarb said. “We’ll probably be asking patients, ‘Can you move with ease? How do you feel? How does the device or the treatment affect your daily life? Can you go to work with it on or go out with your family and friends?’ We will be looking at key health outcomes as well as health economics.”

“At present, if you want to attend your cousin’s wedding in New York City, you need to check to be sure time slots are available at a center for you to get your dialysis done. You can’t just walk in,” he said. “If you live in a rural area, you probably drive a long distance every week for your dialysis sessions. A safe, effective, wearable artificial kidney would give end-stage kidney disease patients much more freedom in their lives.”

You can find the entire article at: http://www.washington.edu/news/articles/wearable-artificial-kidney-to-be-tested-for-safety-and-effectiveness-in-collaboration-with-fda

So we’ve gone from renal nutritional therapy to external artificial kidneys in just one blog.  I am so inspired to realize just how much is available to us.

Nathaniel Smalley, former East Coast Swing venue owner and now professional photographer, has initiated a Facebook page for nature and wildlife photography (https://www.facebook.com/#!/groups/NaturePhotographyWildlifePhotography/permalink/321242084623998/?notif_t=like). The professionals there (I’m one of the non-professionals) called this photograph inspiring, so look at it and realize Chronic Kidney Disease is not necessarily a death sentence. 

Until next week,

Keep living your life!

Validation That It Is The Most Important Meal Of The Day

I hope all the mothers out there had as good a Mother’s Day as I did. I was lucky enough to have two of our daughters here for an impromptu luncheon.  While Nima was in New York and Abby assisting at a Landmark Advanced Course, Lara and Kelly each managed to have the day off and be here. Flowers abounded as did love and lots of good feelings. Everyone enjoyed the meal, renal diet cooking or not (hey!  I was the cook).

I’m laughing out loud right now (remember LOL?).  No sooner did I include the book’s Amazon reviews in the last blog than I started getting requests for the Barnes and Noble reviews.  Amazing how people seem to root for one bookstore or the other, almost as if they were football teams.  So, to be fair, here they are:

 Well written and very informative! This book includes tons of definitions

Well written and very informative! This book includes tons of definitions and images and would be helpful for anyone looking to learn more about kidney disease. Gail’s perspective is real (even funny at points) and I think anyone dealing with CKD will definitely be able to relate with her stories. This book is beneficial for anyone going through CKD, caregivers, and medical professionals.

Highly Recommended! Very useful

This book is wonderful because it explains all you need to know for early stages of ckd and not in medical terms, but in terms that everyone can understand. The author was so passionate about getting the information to others who are going through what she went through as this information was not available to her. Her altruistic motive for this book is also what makes it wonderful. I would definitely buy a copy if I were you.

Must Read For Any CKD, or possible CKD patient, family member, friend

This book gives great insight and an in-depth look into CKD. What to expect, what to look for, not just as a patient but for those that are in the patient’s life as well. Diet, exercise, nutrition, supplements, etc. is all touched on in this book. If you are a newly diagnosed CKD patient, already a CKD patient, or a family/friend of a CKD patient…you will want this book to give you a better piece of mind of what you’re dealing with and how to make your life a little easier at the same time.

Her blog is also a great resource to use daily too. I wish I had known about this book when my mom was going through CKD before her transplant, it would have helped us better understand everything that was happening, was going to happen, and terminology that the doctors used. A must read!

This is an incredibly well-researched, well-written book written by a woman who herself developed kidney disease. Her book provides clear and comprehensive information for all about the care patients need to have, and responds to the fears and concerns of all involved with coping with kidney disease. It is an honest, very personal accounting of her experience, and I found it to be written clearly, providing tons of pertinent information about every facet of how to cope with this illness.

I think Ms. Rae wrote this book for the ordinary person who learns that they will be living with kidney disease from the moment of diagnosis, on. But after reading, I believe that it is also a book that every family member, every friend of someone who has developed kidney disease ought to read as well, in order to better understand what their loved ones are going through. I also believe that this book will benefit every professional in the medical community who deals with patients coping with Kidney Disease. It has helped me better understand my friend and her struggles with this disease, and will help everyone who is involved with a patient on any level to be better able to understand their concerns, anxieties, needs and limitations. For these reasons I think it is a great guide for the medical community as well as for the patient/family/friends, as it can help all understand the kind of information patients need to have in order to take good care of themselves. Don’t pass this book up!

 Highly Recommend For Recent CKD Diagnosis

IF you have recently been diagnosed with Chronic Kidney Disease this book should be your next purchase. Gail Rae shares her personal experiences with the disease, lists of foods which have become part of her diet, how to decipher your medical records, questions to ask your doctors, and what she has learned about living with CKD.

Naturally, reviews are  not the purpose of this blog. Let’s talk about breakfast, instead.  You know Mom always used to say (well, my mom didn’t but the ads on Saturday morning cartoons did), “Breakfast is the most important meal of the day.”  And you know diabetes is one of the two (the other is high blood pressure) most common causes of Chronic Kidney Disease.  Here’s some information that ties breakfast and Type 2 diabetes together. Since this may be new information to some of you, I’ve left in all the hyperlinks for a change.

Really? To Lower Your Risk of Diabetes, Eat Breakfast

By ANAHAD O’CONNOR April 30, 2012

THE FACTS

The benefits of eating a solid breakfast are hard to dispute.

People who skip that all-important first meal of the day, studies show, suffer setbacks in mood, memory and energy levels. They are also more likely to gain weight, in part because of excess eating later in the day. Research on the habits of people taking part in the National Weight Control Registry, a long-running study of successful dieters, for example, shows that about 80 percent eat breakfast daily.

But emerging research suggests another advantage to consistently eating breakfast: a reduced risk of Type 2 diabetes.

In a study published in the current issue of The American Journal of Clinical Nutrition, researchers followed 29,000 men for 16 years, tracking their diets, exercise, disease rates and other markers of health. About 2,000 of the men developed Type 2 diabetes over the course of the study.

Those who regularly skipped breakfast had a 21 percent higher risk of developing diabetes than those who did not. The heightened risk remained even after the researchers accounted for body mass index and the quality of the subjects’ breakfasts.

Other studies have also found a link between skipping breakfast and greater risk of Type 2 diabetes. While it is not clear why the relationship exists, some scientists suspect that a morning meal helps stabilize blood sugar through the day.

Some studies show that consuming a larger proportion of your calories later in the day, especially carbohydrates, has a detrimental impact on blood sugar and insulin levels.

THE BOTTOM LINE

Regularly skipping breakfast may raise the risk of Type 2 diabetes.

If you’d like to see the original, it’s at: http://well.blogs.nytimes.com/2012/04/30/really-to-lower-your-risk-of-diabetes-eat-breakfast/?partner=rss&emc=rss

Did I eat breakfast or didn’t I?  Hmmm, excuse me, I’ve got to go take Anahad’s sound advice.

Until next week,

Keep living your life!

p.s.  Unfortunately,  I STILL haven’t heard from the medical alert bracelet people yet about why they didn’t warn me the bracelet may fall apart if submerged repeatedly (it hasn’t yet) until the bracelet  arrived in the mail so I’ve got to rescind my recommendation for http://www.medicalidfashions.com.  They may have other medical alert bracelets that do not require you remove them before you shower, bathe, or swim but I would not be willing to order another one only to have it arrived with the same warning.