Miracles Redux

Welcome to the last blog of 2016. I find it hard to believe another year has passed, although I do acknowledge that I’m a bit slower and more new-years-eve-celebrations-live-streamcontent to stay in my office to write rather than run around town. It’s a bit harder to maintain my body, although my mind is doing fine… as long as I don’t have to remember too much at once, that is. Well, my knees may have something to say, but I try to keep them happy with daily exercise and the braces.knee brace

I sincerely hope you enjoyed a joyous Christmas if you celebrate. And that you continue to enjoy Chanukah and Kwanzaa (which starts today) if you celebrate. We’ll be leaving for the Trans-Siberian Orchestra concert as soon as I finish the blog… a gift from us to us and one of the kids for Christmas. On Wednesday, we’ll have our Annual Chanukah Gathering. Our New York daughter will be with us since her Chanukah gift is a plane ticket. Being a two religion family, we celebrate both Chanukah and Christmas.

Before I get to more about creating a miracle, I am proud to announce that Healthline, a trusted health information site,  has named SlowItDownCKD one of The Best Kidney healthlineDisease Blogs of 2016. Talk about being surprised… and honored. Sort of a nice Christmas present, don’t you think? I suppose I can consider the publication of my novel, Portal in Time, my Chanukah present. I didn’t do too shabbily this year.

You know, it’s never too late to give either the novel or one of my Chronic Kidney Disease books as a present. Don’t forget you deserve presents, too.

Okay, on to more about miracles – or Part 2 – as I promised last week.

Unhealthy%20KidneyIf CKD were common knowledge, if those in high risk categories were aware of it, we might have a chance of preventing the disease in those who don’t have it yet and/or slowing down the progression of the decline in kidney function of those who have been already diagnosed.

Exactly how can we do that? On the most basic level, there’s the spoken word. It’s not just the medical community that can talk about the disease. I can as a patient. You can, too, because you know me and I’ve told you about the disease (and/or you suffer from CKD yourself).  This is most effective in areas of the world that do not have access to – or money for – doctors and treatment.  This is where we can prevent more and more of the disease by preventing more and more hypertension and diabetes.

If I tell you what I know about curtailing sodium intake in high blood pressure and you tell me what you know about smoking as it contributes to hypertension, we’ve just shared two important aspects in the prevention of high blood pressure. If I tell you what I know about sugar in diabetes Healthy%20Kidneyand you tell me what you know about carbohydrates and diabetes, we’ve just shared two important aspects in the prevention of diabetes. Then my husband starts sharing what he knows… and your third cousin once removed shares with her East Indian neighbor what her nephrologist told her… and your boss’s secretary shares what his boyfriend learned at his CKD awareness meeting, you’ve got a lot more people aware of what needs to be done about CKD. Sometimes causing a miracle is played out by sharing with people. Think of the miracle this kind of communication on a daily basis can cause.

The people you speak to will share with those they know, those they know will share with others they know until many, many hairmore people become aware of CKD – just as that long ago Clairol hair coloring ad demonstrated how telling someone who tells someone can go on ad infinitum. Simplistic? Yes, but it works…and that’s part of living the life of causing a miracle in CKD.

Then there’s the printed word. If people are aware of CKD books and newspapers, business and educational publications can alert their populations that the disease exists and is lethal, but may be prevented and/or slowed down. Most businesses have wellness components. What perfect vehicles to transform the world’s awareness of CKD.IMG_2979

For example: my four Chronic Kidney Disease books are sold in 106 countries. I have 107,000 readers. This in itself is a miracle, not just for me but for everyone who is in some way connected to the disease. It is not uncommon for one community member to buy the book, then share it with everyone else in their social circle. If there’s a library, the books can be ordered and then shared for free.

These are some of the pieces I’ve written: American Kidney Fund   “Slowing Down CKD –  It Can Be Done”  7/14/16, Dear Annie 10/14, KidneySteps  9/11/13  &  7/4/12, National Kidney Foundation 6/6/13, It Is What It Is 3/9/12, Kevinmd.com 1/1/12, Working with Chronic Illness 1/11/10, KidneyTimes 1/11/10. Bragging? No, just demonstrating it can be done… but I had to cause it to happen by knocking on doors.

I also share my information via this blog. A doctor in a remote village in India prints and translates it to share with whichever patient has the bus fare to make it to the clinic. That patient brings the translation back to his family, friends, neighbors, and whoever else he thinks may be interested. blood drawThis nephrologist’s view is the same as mine: We both need to live a life causing a miracle in Chronic Kidney Disease Awareness by sharing information. People who may not have known Chronic Kidney Disease exists now know via this sharing. Others who have undergone the simple blood and urine tests to diagnose the illness can share that the tests are not painful, other than the initial pinch of the needle for the blood draw. You would be surprised how many people, even in the high risk groups, don’t take the tests because they fear there will be pain involved. No sharing, no awareness. No awareness, no diagnose. No diagnose, no slowing down the disease.

Here are some of the blog and book mentions that have helped in my sharing of the information: Federal Register 9/25/13, The Neuropathy Doctor’s News 9/23/13, The NephCure Foundation 8/21/11, World’s Leading Expert.com 9/11/12, Glendale Community College Gaucho Gazette 8/22/11. These came about without my intervention. So what you share gets shared by others….

I’ve got some more thoughts, but we’ll have to leave them for Part 3 in the New Year. This blog is getting too long and my family is waiting for me.  Happy New Year to each and every one of you. Please be safe if you’re going out to celebrate.

Until next week and the New Year,

Keep living your life!



To Wash or Not To Wash

Peggy Rickard belongs to the same Landmark Worldwide Center (an international personal and professional growth, training and development landmarkqrcompany) as I do here in Arizona.  I didn’t know her, but she wanted to perform a service project for one of her Landmark courses and she wanted it to deal with the kidneys. The manager of the center – the ever affable Philip Rand – knew I did “something with kidneys,” so he asked if I would call her.  When I did, it turned out that she has a medical advocacy business, but that had nothing to do with her project.

We had a wonderful conversation.  Here was someone in one of my other communities who spoke my kidney language. Peggy had already contacted The National Kidney Foundation of Arizona and learned from Dr. James Ivie, the Director of Patient Services, that what was really needed was to have the information leaflets about kidney disease and donation translated into Spanish since Hispanics are at a higher risk for kidney disease.

Kidney ArizonaMaybe I can pick out a few words of Spanish here and there, but she needed more. I couldn’t translate the leaflets into Spanish for her and didn’t know anyone who could.  That night, I went to the center for the completion session of The Wisdom Unlimited course in which I had been participating. In a greet-those-you-don’t-know moment, I spoke with Nathaniel (Nat) Garcia II – since he was the person directly in front of me – only to discover he is a missionary… and fluent in Spanish…and more than willing to do the translations.  Problem solved.

That got me to thinking about language. While taking a shower the next morning, the bottle of shampoo I was using caught my eye. It had the words ‘sulfate free’ in large letters on the label.  Hmmm, sulfate looks a lot like sulphur.  Are they related?

After checking a bunch of dictionaries, I decided to use the definition of The Medical Dictionary at http://medical-dictionary.thefreedictionary.com/sulfate since it seemed the simplest to understand.

“a salt of sulfuric acid”

Uh-oh, sulfuric means made of sulfur. Although the spelling may be different, sulfuric acid is highly corrosive. It’s also a mineral… and is used in both waste water treatment and fertilizer creation. Why would shampoo have this as an ingredient in the first place?shampoo

I figured the best person to provide an answer would be a hair stylist so I read Melissa Jongman’s article on http://hubpages.com/style/Sulfates-Are-they-damaging-your-hair-Why-to-opt-for-a-sulfate-free-shampoo

“Sulfates are detergents used to make the shampoo lather. They’re inexpensive to use in shampoos, which explains why more than 90% of shampoos contain them. The most common sulfates used in these shampoos are:

  • Sodium Lauryl Sulphate (SLS)
  • Sodium Laureth Sulphate (SLES)
  • Ammonia Laureth Sulphate (ALS)
  • TEA Lauryeth Sulfate (TEA)
  • Sodium Myreth Sulphate (SMS)”

This was not looking good.  Sulphur is something we, as Chronic Kidney Disease patients, need to avoid. As I explained in What Is It and How Did I Get It? Early Stage Chronic Kidney Disease, sulphur can further damage your already damaged kidneys.

Book CoverSo what can we do?  Not washing our hair is obviously not the answer. I googled shampoos without sulfates and came up with a list of 43 at http://sulfatefreeshampoos.org/sulfate-free-shampoo-list/#list. While the latest edit of this list was during this new year, I am not familiar with the editors nor the products. However, you can safely bet that I’ll try them.

Let’s go back to why sulfates are not good for CKD patients for a minute. I stumbled across a CKD education site called quizlet.com. Perusing this site, I found the statement that

“Very late CKD is due to reduced excretion of sulfates and phosphates.”

Of course! That makes perfect sense: as our kidney function declines, we are not excreting as much of these substances as we did before we were lucky enough (ouch!) to develop CKD and they build up.  That’s CKD 101.

A nervous me decided to see what other beauty or health products used sulfates. I discovered it’s used in body wash (Wait! Isn’t sulfate a skin irritant?), toothpaste, and nail polish. That tripped a thought. Didn’t I blog about that?

I used the search function on the blog only to find that that blog dealt with other chemicals in nail polish.  (Gritting teeth and crying out in anguish) Is nothing safe anymore? All right, pick a chemical… any chemical.

Looking at the ingredients in both hair products and nail polish, I chose phthalates. The Centers for Disease Control and Prevention (CDC) at http://www.cdc.gov/biomonitoring/Phthalates_FactSheet.html helped us out with this one:chemistry

“Phthalates are a group of chemicals used to make plastics more flexible and harder to break. … They are used in hundreds of products, such as vinyl flooring, adhesives, detergents, lubricating oils, automotive plastics, plastic clothes (raincoats), and personal-care products (soaps, shampoos, hair sprays, and nail polishes)….

How Phthalates Affect People’s Health

Human health effects from exposure to low levels of phthalates are unknown. Some types of phthalates have affected the reproductive system of laboratory animals. More research is needed to assess the human health effects of exposure to phthalates.”

Maybe the human health effects are unknown and maybe this passes quickly via the urine, but if you have Chronic Kidney Disease, you are not filtering your blood as well as other people.  Why take a chance of making it worse?

Now that I’ve probably made you fearful of using any beauty product on the market, be aware that there are many products without phthalate. Breast Cancer Action (Yes, there seems to be a connection between breast cancer and phthalates.) at http://www.bcaction.org/our-take-on-breast-cancer/environment/safe-cosmetics/phthalate-free-cosmetics/  offers a list of companies which produce phthalate free beauty aids.

DIGITAL_BOOK_THUMBNAILDigital Cover Part 2 redone - Copy

Let’s talk about service and gratitude for just a minute.  While I’ve always believed in service, it’s only since I’ve been diagnosed with Chronic Kidney Disease (way back in in 2008) that I’ve become aware of how very thankful I am for the little things in life – like spreading CKD Awareness by writing this blog, posting some CKD tidbit on Twitter daily, starting an Instagram account for SlowItDownCKD, and offering my books.  Thank YOU for being the readers.

Until next week,

Keep living your life!

Electronically Speaking

Happy New Year to each and every one of you.  It gives me great pleasure to start the first blog of 2016 with good news: Suzanne Kelly has won a DIGITAL_BOOK_THUMBNAILcopy of The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 1 by being the first reader to comment on the last blog of 2015. Suzanne, please email me at SlowItDownCKD@gmail.com with either your address or that of the friends you thought would benefit from having this book… and thank you for the opportunity to start off the New Year with good news.

I’ve been looking at quite a few CKD pages on Facebook and was, once again, reminded how quickly things change. Only one of the three pages I listed in 2011’s What Is It and How Did I Get It? Early Stage Chronic Kidney Disease is still in existence.  That’s The Transplant Community Outreach with 5,897 members which is “… an online support group of individuals and families who are recipients, are waiting for a transplant, are donor family members, caregivers, or those who have a connection with organ What is itdonation and transplantation.” I like that they’ve asked me to post this blog weekly, although it is about moderate stage chronic kidney disease.

I offered another list of such pages in The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 2 which was published only last year.

  • Kidney Disease and Diet Ideas and Help 1
  • Show Your Scars Tour
  • Kidney Disease Is Not a Joke
  • The Transplant Community Outreach {I write Kidney Matters for them at their request.}
  • Renal Patient Support Group
  • Chronic Kidney Disease
  • P2P {Peer To Peer}
  • But You Don’t Look Sick
  • TCO Women’s Health
  • Kidney Disease Shout BoardDigital Cover Part 2 redone - Copy

To the best of my knowledge, Show Your Scars Tour, Chronic Kidney Disease, and TCO Women’s Health are no longer with us. But, there are loads of additional pages for us, including some secret groups that I don’t think I’m at liberty to write about. Comment if you’d like to know more about secret groups and I will gladly contact the administrator of the appropriate one for you. Some of the other pages I read are:

  • Kidney Advocates which is a brand new page administrated by the ever striving advocate, James Myers. This man has invited me to post the blog on every page he’s involved with.  If it’s possible, he may be more serious about advocacy than I am.
  • Kidney Disease Ideas and Diet 1 (not to be confused with Kidney Disease and Diet Ideas and Help 1) whose former administrator has become an online friend since we share so many of the same issues in our personal lives. The purpose of this page is simple: “…Sometimes in Unhealthy%20Kidneylife we need a little hand up. Battling kidney disease and getting new dietary instruction can be hard. Every stage is different. We are here to help.”
  • Stage 3 ‘n 4 CKD Kidneybeaners Gathering Place, a smaller, highly active group moderated by my favorite weisenheimer, Robin Rose, who – as a lay person – has an incredible understanding of medicalese. As she writes, “Stage 3 ‘n 4 CKD is a unique place to live – predialysis medicine isn’t that available… so we gather together to share, to support, to learn, to research, and to thrive together… speak your story, your experience, your feelings, your research… let’s commit to staying healthy together!”
  • Women’s Renal Failure Support Group which is fast becoming a favorite since I can be a bit of a prude, but this is women only (as they have to keep reminding men who try to post on the page).

These are some I’m active on are (in alphabetical order):

British Kidney Patient AssociationGFR

Chronic Kidney Disease Support Group

Dialysis & Kidney Disease

GM Kidney Information Network

I Hate Dialysis

kidneys5Kidney disease isn’t for sissies

Kidney Disease, Dialysis, and Transplant


People on dialysis

Renal Patient Support Group

There’s even a page for the buying and selling of Chronic Disease paraphernalia which is called, appropriately enough, P2P’s Chronic Illness Awareness Buy & Sell and administered by Sandie Jones who is also the administrator of Peer to Peer (P2P). That’s no surprise, but it is innovative.

And last, but not least, we have (ahem) SlowItDownCKD where I post Chronic Kidney Disease related medical tidbits that I’ve found by perusing different medical sites, Twitter, Instagram, Pinterest, newspapers, medical journals, even medical texts. I am limited as to what I post since I’ve made it a firm policy to post only what I understand. Whoops, there go the CKD diet cookbooks right out the window.kidney-book-cover

These posts also appear on Twitter as @SlowItDownCKD. I have found some really CKD informative people or organizations to follow there. My all-time favorite is @kidney_boy, nephrologist Joel Topf, who answers my questions and includes me in as much nephrology work as he can considering I’m a layman. Lay woman?

Same for @nephondemand (Dr. Tejas Desai) who also answers whatever I ask. I also follow nurses, doctors, teaching institutions, renal dieticians, anyone who is some way connected to CKD.

I am surprised every time a doctor, nurse, teaching institution, or renal dietician follows me. I make it very clear that I am NOT a doctor, just a layman (Oh, here we go again: lay woman?) who has Chronic Kidney Disease and wants to make certain everyone, everywhere in the whole wide world, is aware of its existence so they’ll get tested.

happy birthdayAh ha! You are hereby notified that I intend to give presents on my birthday, which is February 2. No, it’s not my 70th yet; that’s next year.  I just like to give presents.  Keep an eye on the Facebook page P2P’s Chronic Illness Awareness Buy & Sell for details as they’re released.

Here’s hoping 2016 is, indeed, Sweet 16 for you. There’s nothing wrong with making each new year the best year you’ve had yet.  Gratitude and service are the way to go in my book (Yep, I’m punning.)fireworks

Until next week,

Keep living your life!

Auld Lang … Ah Choo!

Happy middle of Kwanzaa.  I hope your Hanukkah, Christmas, or whatever else you may celebrate that I don’t know about was merry, too. Ours was…maybe even too merry.  Even with cutting out overt sugar and dairy and sticking to the renal diet, I felt like I was getting sick.  Too much running around?  The stress of this happy season?  Who knows, but there it was.Kwanzaa

One of my daughters heard it in my voice and asked me why I just didn’t take Airborne and nip whatever this was in the bud.  I knew I couldn’t, but I’d forgotten why.  Hello, today’s blog. This is not a blog to vilify this product, but one to inform you why we – as Chronic Kidney Disease patients – cannot take any product of this ilk.

Let’s start at the beginning.  According to their website at http://www.airbornehealth.com/how-it-works, this is the short list of what’s in Airborne.

Vitamins and Minerals

  • Vitamin C: Antioxidants that go to work on the cellular level to quench free radicals and support cellular health.  Vitamin C also supports the function of immune cells throughout your body.
  • Vitamin E:Naturally-occurring antioxidant nutrients that inactivate harmful free radicals
  • Vitamin A:Phyto-nutrients that work as antioxidants, on the cellular level, to promote immunity and protect DNA
  • Zinc: An essential nutrient that works as a trigger for over 200 different enzymes and supports the number and function of several different immune cells.
  • Selenium, Manganese, Magnesium: All minerals that support immunity

airborneOkay, so what is the problem here? I needed more information since their website called this the “short list,” so I marched into my pharmacy, took a look at the ingredients, and physically backed up.

I already knew that Vitamin C could promote kidney stones and that I was prone to those, having already had one.  Wait a minute. 1633% of the daily value?  We all know I’m not a doctor, but that sounds like asking for a kidney stone to me.

This is not to say you need to completely avoid Vitamin C.  You need it; just not in such high doses.  The per cent I quoted above is for one dose, but the instructions for Airborne direct you take this up to three times a day.  In other words, triple that percentage.

Backtrack time.  This is why you need this particular vitamin.

Vitamin C, also known as ascorbic acid, is necessary for the growth, development and repair of all body tissues. It’s involved in many body functions, including formation of collagen, absorption of iron, the immune system, wound healing, and the maintenance of cartilage, bones, and teeth.

Vitamin C is one of many antioxidants that can protect against damage caused by harmful molecules called free radicals, as well as toxic chemicals and pollutants like cigarette smoke. Free radicals can build up and contribute to the development of health conditions such as cancer, heart disease, and arthritis.

Thank you to WebMD at http://www.webmd.com/diet/features/the-benefits-of-vitamin-c?page=3 for that information.

Potassium caught my eye right away, too. That’s something I need to limit as a CKD patient, so why would I want to add extra?  Maybe if I had a deficiency I would, but this is not usually the case with us. I relied on What Is It and How Did I Get It? Early Stage Chronic Kidney Disease to remind myself just what this is and why it’s important.

One of the electrolytes, important because

it counteracts sodium’s effect on blood pressure.Book Cover

This is not looking so good, is it?

Uh-oh, it has 10% of your daily value for sodium… for one serving.  Multiply that by three and you get a whopping 30% or 690 mg. of salt/day.  Hmmm, I’m only permitted 1500 mg. daily.  This accounts for getting close to 50% of my daily sodium allotment.

On mykidney.com {A kidney blog which seems to be defunct now.} at http://mykidney.com/06032008-1, Krissi – the writer of the blog – has the following to say about Airborne’s Vitamin E content.

If taken as recommended, “Airborne” will provide 300% of the safe daily dose. And like Vitamin A, Vitamin E is also a fat-soluble vitamin and can quickly build up into toxic levels.

However, the ‘safe daily dose’ for a CKD or ESRD patient is only 8-10mg per day. Just one dose of Airborne actually provides not 300%, but 900% of the safe daily dose for kidney patients.Airborne pix

Back to me here. Notice the herbal ingredients listed at the bottom of the label. What amounts of each are in one dosage?  How about in three? And just what do they do to your kidneys? Did you notice that the FDA was in no way involved with this product? And why no clinical studies?

Well, now I know why I can’t take Airborne or any other product like it and so do you.

Whoa!  Did you know about this?

Airborne Health, a Bonita Springs, Fla.-based herbal supplements firm, has agreed to pay $23.3 million to settle a class-action lawsuit brought against the company for falsely claiming its vitamins prevented colds.

Now, let’s be fair here.  This was back in 2008.  You can read the entire New York Times article at http://www.nytimes.com/inc_com/inc1204579617407.html  Checking into any changes to their formula since then, I could only find changes in their advertising from ‘miracle cold cure’ to ‘immunity booster,’ but not for us.  We can’t handle all the extra bursts of all that good stuff.

new-years-eve-celebrations-live-streamOh my!  This is the last blog for 2014.  May your new year bring everything you want for yourself… including the best health you can achieve.  I always say go for 150%. I wonder if that’s to ensure you reach 100%.

This is also the last blog to be included in the new book The Book of Blogs: Moderate Stage Chronic Kidney Disease.  Don’t look for it yet since it still needs to be edited, but soon.  That’s my New Year’s present to myself.  There’s also another radio interview coming up in March, but we’ve got plenty of time to talk about that.

Until next week,

No, until next year,

Keep living your life!

Bedtime is Best

This is what early stage CKD looks like

Ladies and Gentlemen, welcome to the first post of 2012.  Here’s hoping you have the very best year you’ve had to date.

Dr. Kevin Pho started my new year right by posting an except from the book at  http://www.kevinmd.com/blog/2012/01/chronic-kidney-disease-patient-perspective.html which is the address for his KevinMD.com blog.  I am constantly overwhelmed by the kindess of the medical professionals in helping me with my quest to get the book into the hands of every newly diagnosed CKD patient.

I’ve posted about taking cholesterol medication at night and am doing so myself.  Then I ran across this article from MedicineNet.com and will explore whether or not to also take hypertension medication at night.  It all makes sense to me, but I would suggest you talk it over with your nephrologist before you make any changes in your medication taking regiment.


Blood Pressure Drugs at Bedtime May Cut Heart Risk

                View the High Blood Pressure (Hypertension) Slideshow Pictures

Latest High Blood Pressure News

Study Suggests Benefits to Taking Blood Pressure Drugs Before Going to Sleep

By Kathleen Doheny WebMD Health News

Reviewed by Laura J. Martin, MD

Oct. 27, 2011 — Taking at least one blood pressure medicine at bedtime cuts the risk of heart problems, according to new research.

The study also shows that participants taking at least one blood pressure pill at bedtime had lower blood pressure while asleep.

Earlier studies have suggested that bedtime dosing of at least one blood pressure medication may help control blood pressure. But the new study is believed to be the first to look at whether the timing makes a difference in terms of heart attacks, strokes, and death.

Ramon C. Hermida, PhD, director of the bioengineering and chronobiology labs at the University of Vigo in Spain, studied 661 people with both high blood pressure and chronic kidney disease.

“Taking blood-pressure-lowering medication at bedtime, compared to [taking] all medication upon awakening, not only improved blood pressure control, but significantly reduced the risk of cardiovascular events,” Hermida says in a news release.

The research appears in the Journal of the American Society of Nephrology.

Timing of Blood Pressure Medicines

Hermida’s team asked half of the men and women to take all their blood pressure medicine when they got up in the morning. On average, each person took two medicines. Many took more than three.

The researchers asked the other half to take at least one of their blood pressure medicines at bedtime.

They measured blood pressure by using 48-hour ambulatory monitoring at the start of the study — not just a single daytime measurement used in most earlier studies. They also measured blood pressure three months after any treatment changes or, at the least, every year.

The researchers followed the men and women for about five and a half years. They looked to see which heart problems developed. They tracked death from any cause and from heart disease or stroke.They also tracked heart attack, angina, heart failure, and other problems.

More than half of those with chronic kidney disease also have high blood pressure, according to the National Kidney Foundation. High blood pressure increases the risk of the kidney disease worsening. Overall, one in three U.S. adults has high blood pressure, according to the researchers.

Bedtime Dosing of Blood Pressure Medicine

Those who took at least one blood pressure medicine at bedtime had lower nighttime blood pressure while asleep. They were also more likely to have overall good control of their blood pressure.

The bedtime group was one-third as likely to have heart and blood vessel problems such as heart attack, stroke, or heart failure, the researchers found.

Improved overnight blood pressure with bedtime dosing had a real benefit. Each 5-point drop in sleep-time blood pressure was linked with a 14% reduction in risk for heart attack, stroke, or heart failure.

“Cardiovascular event rates in patients with hypertension can be reduced by more than 50% with a zero-cost strategy of administering blood pressure-lowering medications at bedtime rather than in the morning,” Hermida says in a news release.

Why Blood Pressure Drugs Work Best at Bedtime

Hermida tells WebMD that some of the body’s blood pressure control systems are most active while we sleep. So medicines designed to control those systems work better when taken close to the time when the systems are activated most fully.

The study results ”make absolute sense to me,” says Robert Graham, MD, MPH, an internist and director of residency research at Lenox Hill Hospital. Graham, an assistant professor of medicine at New York University, reviewed the study findings for WebMD.

”Certain medications have the greatest effect on the body while we sleep,” he says. Indeed, bedtime dosing of blood pressure medications recently has been a hot topic among experts.

Graham has been prescribing blood pressure medicines to be taken at bedtime for years, he says, as it seems to help with the top side effects of blood pressure medicine: fatigue and drowsiness.

“If you do have high blood pressure, and have a hard time getting it [down to your] goal, maybe you should talk with your doctor about changing the time [you take the medicine],” he says.

SOURCES: Journal of the American Society of Nephrology, published online Oct. 24, 2011.Ramon Hermida, PhD, director, bioengineering and chronobiology labs, University of Vigo, Pontevedra, Spain.Robert Graham, MD, MPH, director of residency research, Lenox Hill Hospital; assistant professor of medicine, New York University. ©2011 WebMD, LLC. All Rights Reserved.

You can find the original article at: http://www.medicinenet.com/script/main/art.asp?articlekey=151006#

Many, many hopes for a happy new year.  Join us for the upcoming TwitterChat on Jan. 9 from 8-9 EST at #LibreChat.  If you’re local, schedule in the book signing at Bookman’s in Mesa on Saturday, Jan. 14 from 1-3.  I really enjoy meeting my readers and their friends and family.  One person seems even more interesting than the other!

Until next week,

Keep living your life!

Notices for the New Year

Happy New Year, One and All.  May this be your best year yet.

I  have two pre-blog notices for you today:
What a way to start the year! KevinMD will post an excerpt from the book sometime around 7 p.m. today on: http://www.kevinmd.com/blog/2012/01/chronic-kidney-disease-patient-perspective.html
The correct info for the Jan. 9 Twitter chat from 8-9 EST is: #LibreChat.  Hey, I’m still learning. 
Meanwhile, again, the very best new year to you and yours.

Po…Pot…Potassium? What’s that?

Here’s hoping you had a wonderful Christmas – if that’s what you celebrate – and/or Chanukah, Kwaaza or a holiday I don’t know about yet.  Everyone’s financial situation was so tight this year that I was told repeatedly, “I have never spent so little on gifts as I did this year,” or “I can’t afford any gifts. I’ll have to come up with some other ideas.”  And this year was the year that these same people gave the most thoughtul, creative and inspired gifts. From the letter telling me how my step-daughter felt about me to the afternoon spent with my daughter and all the thoughtful, really thoughtful gifts inbetween, if this is how a no-money gifting season goes, I wish we’d treat every year this way – whether or not there was money available.  Tissue alert: With my four daughters – step and biological – and my fiance, “I don’t need no stinkin’ gifts.” (Thank you, “Treasure of Sierra Madres” for the almost quote.)

Okay, you can put the tissues away again.  We did visit and go out to restaurants a bit.  This time I heard another question several times: “What’s with you and potassium?”  Just as I was framing an original post on this very subject, The National Kidney Foundation posted their potassium fact sheet.  Nothing like learning from the masters!

On Potassium and Your CKD Diet

What is potassium and why is it important to you?

Potassium is a mineral found in many of the foods you eat. It plays a role in keeping your heartbeat regular and your muscles working right. It is the job of healthy kidneys to keep the right amount of potassium in your body. However, when your kidneys are not healthy, you often need to limit certain foods that can increase the potassium in your blood to a dangerous level. You may feel some weakness, numbness and tingling if your potassium is at a high level. If your potassium becomes too high, it can cause an irregular heartbeat or a heart attack.

What is a safe level of potassium in my blood?

Ask your doctor or dietitian about your monthly blood potassium level and enter it here:

If it is 3.5-5.0………………………You are in the SAFE zone
If it is 5.1-6.0………………………You are in the CAUTION zone
If it is higher than 6.0……………..You are in the DANGER zone

How can I keep my potassium level from getting too high?

  • You should limit foods that are high in potassium. Your renal dietitian will help you plan your diet so you are getting the right amount of potassium.
  • Eat a variety of foods but in moderation.
  • If you want to include some high potassium vegetable in your diet, leach them before using. Leaching is a process by which some potassium can be pulled out of the vegetable. Instructions for leaching selected high potassium vegetables can be found at the end of this fact sheet. Check with your dietitian on the amount of leached high potassium vegetables that can be safely included in your diet.
  • Do not drink or use the liquid from canned fruits and vegetables, or the juices from cooked meat.
  • Remember that almost all foods have some potassium. The size of the serving is very important. A large amount of a low potassium food can turn into a high- potassium food.
  • If you are on dialysis, be sure to get all the treatment or exchanges prescribed to you.

What foods are high in potassium (greater than 200 milligrams per portion)?

The following table lists foods that are high in potassium. The portion size is ½ cup unless otherwise stated. Please be sure to check portion sizes. While all the foods on this list are high in potassium, some are higher than others.

High-Potassium Foods
Fruits Vegetables Other Foods
Apricot, raw (2 medium)
dried (5 halves)
Acorn Squash Bran/Bran products
Avocado (¼ whole) Artichoke Chocolate (1.5-2 ounces)
Banana (½ whole) Bamboo Shoots Granola
Cantaloupe Baked Beans Milk, all types (1 cup)
Dates (5 whole) Butternut Squash Molasses (1 Tablespoon)
Dried fruits Refried Beans Nutritional Supplements:
Use only under the
direction of your doctor
or dietitian.
Figs, dried Beets, fresh then boiled
Grapefruit Juice Black Beans
Honeydew Broccoli, cooked Nuts and Seeds (1 ounce)
Kiwi (1 medium) Brussels Sprouts Peanut Butter (2 tbs.)
Mango (1 medium) Chinese Cabbage Salt Substitutes/Lite Salt
Nectarine (1 medium) Carrots, raw Salt Free Broth
Orange (1 medium) Dried Beans and Peas Yogurt
Orange Juice Greens, except Kale Snuff/Chewing Tobacco
Papaya (½ whole) Hubbard Squash  
Pomegranate (1 whole) Kohlrabi  
Pomegranate Juice Lentils  
Prunes Legumes  
Prune Juice Mushrooms, canned  
Raisins Parsnips  
  Potatoes, white and sweet  
  Spinach, cooked  
  Tomatoes/Tomato products  
  Vegetable Juices  

What foods are low in potassium?

The following table list foods which are low in potassium. A portion is ½ cup unless otherwise noted. Eating more than 1 portion can make a lower potassium food into a higher potassium food.

Low-Potassium Foods
Fruits Vegetables Other Foods
Apple (1 medium) Alfalfa sprouts Rice
Apple Juice Asparagus (6 spears) Noodles
Applesauce Beans, green or wax Pasta
Apricots, canned in juice Cabbage, green and red
Carrots, cooked
Bread and bread products: (Not Whole Grains)
Blackberries Cauliflower Cake: angel, yellow
Blueberries Celery (1 stalk) Coffee: limit to 8 ounces
Cherries Corn, fresh (½ ear)   frozen (½ cup) Pies without chocolate or high potassium fruit
Cranberries Cucumber Cookies without nuts or chocolate
Fruit Cocktail Eggplant Tea: limit to 16 ounces
Grapes Kale  
Grape Juice Lettuce  
Grapefruit (½ whole) Mixed Vegetables  
Mandarin Oranges Mushrooms, fresh  
Peaches, fresh (1 small) canned (½ cup) Okra  
Pears, fresh (1 small) canned (½ cup) Onions  
Pineapple Parsley  
Pineapple Juice Peas, green  
Plums (1 whole) Peppers  
Raspberries Radish  
Strawberries Rhubarb  
Tangerine (1 whole) Water Chestnuts, canned  
Watermelon (limit to 1 cup) Watercress
  Yellow Squash  
  Zucchini Squash  

How do I get some of the potassium out of my favorite high-potassium vegetables ?

The process of leaching will help pull potassium out of some high-potassium vegetables. It is important to remember that leaching will not pull all of the potassium out of the vegetable. You must still limit the amount of leached high-potassium vegetables you eat. Ask your dietitian about the amount of leached vegetables that you can safely have in your diet.

How to leach vegetables.

For Potatoes, Sweet Potatoes, Carrots, Beets, and Rutabagas:

  1. Peel and place the vegetable in cold water so they won’t darken.
  2. Slice vegetable 1/8 inch thick.
  3. Rinse in warm water for a few seconds.
  4. Soak for a minimum of two hours in warm water. Use ten times the amount of water to the amount of vegetables. If soaking longer, change the water every four hours.
  5. Rinse under warm water again for a few seconds.
  6. Cook vegetable with five times the amount of water to the amount of vegetable.

For Squash, Mushrooms, Cauliflower, and Frozen Greens:

  1. Allow frozen vegetable to thaw to room temperature and drain.
  2. Rinse fresh or frozen vegetables in warm water for a few seconds.
  3. Soak for a minimum of two hours in warm water. Use ten times the amount of water to the amount of vegetables. If soaking longer, change the water every four hours.
  4. Rinse under warm water again for a few seconds.
  5. Cook the usual way, but with five times the amount of water to the amount of vegetable.

Bowes & Church Food Values of Portions Commonly Used, 17th Ed., Pennington, JA, Lippincott, 1998.
Diet Guide for Patients with Kidney Disease, Renal Interest Group-Kansas City Dietetic Association, 1990.

The National Kidney Foundation would like to thank the
        Council on Renal Nutrition for the development of this fact sheet.

[Me: This is a bit different from my renal diet.  There are foods on here that my diet doesn’t allow, but you’ll see when you look at your diet that most foods we need to concern ourselves with are mentioned on this list.]

On the book front, don’t forget the Twitter Chat on Jan. 9 from 8-9 EST.  Locals, come on down to Bookman’s in Mesa on Jan. 14 from 1-3 for a book signing.  Oh, KevinMD.com will be running an excerpt from the book within the next week and a half or so.  I’ll send out a bulletin when I find out the exact date.  My new year is already looking pretty bright.  That’s what I wish for you: a happy, healthy new year with lots of whatever you desire in it.

Until next week (which will actually be next year),

Keep living your life!