Damned If You Do and Damned If You Don’t.

It is absolutely amazing how many things can go wrong with the human body.  Some, such as cancer, are drastic while others, like a general feeling of being unwell or fatigue (sound familiar, Chronic Kidney Disease sufferers?), are not. For example, Bear has developed the Helicobacter pylori infection. This, according to MedlinePlus (part of the U.S. National Library of Medicine) at https://www.nlm.nih.gov/medlineplus/helicobacterpyloriinfections.html  is

H. Pylori a type of bacteria that causes infection in the stomach. It is found in about two-thirds of the world’s population. It may be spread by unclean food and water, but researchers aren’t sure. It causes Peptic ulcers and can also cause stomach cancer.”

That made me nervous.  I immediately (and unfairly) blamed the food we’d eaten during our almost recent cruise to the Caribbean – specifically, during our ports of call in Haiti and Jamaica – and debated phoning my brothers and sisters-in-law right away… oh, and getting myself checked. After all, it was either a simple blood or breath test. Our primary care doctor preferred the blood test.

That decision was sort of a mistake. Our usual – and very good – phlebotomist was out that day having taken a sleep test (Good for her!) in a faraway part of the valley the night before and couldn’t make it in, so a daily temp did the drawer. Oh! That was almost a week ago and I still have a three inch black and blue mark on the puncture site.  I want my regular phlebotomist.

I know, I know, get back on topic.  I didn’t make those calls because my test came back negative… so it wasn’t the food at the ports of call.  Well, then what caused Bear’s infection? WebMD at http://www.webmd.com/digestive-disorders/h-pylori-helicobacter-pylori tells us,

“Many people get H. pylori during childhood, but adults can get it, too. The germs live in the body for years before symptoms start, but most people who have it will never get ulcers.”

That made sense. As a child, Bear spent his summers on his grandfather’s farm and participated in whatever chores a child his age could perform. This is not to say the food or water on the farm were unclean, but

“…H. pylori bacteria may be passed from person to person through direct contact with saliva, vomit or fecal matter…. Or “Living with someone who has an H. pylori infection.”

Thank you for that information Mayo Clinic at http://www.mayoclinic.org/diseases-conditions/h-pylori/basics/risk-factors/con-20030903.

Considering the existence of this type of infection wasn’t discovered until 1982 and Bear was a child way before then, he may have contacted it in the manner described above.

Of course now you’re wondering what the heck we were going to do about it, no matter how my poor hubby developed it since it could have drasticantibiotics consequences if we didn’t. (Long sentence there.) MedicineNet.com at http://www.medicinenet.com/helicobacter_pylori/page8.htm explains:

H. pylori is difficult to eradicate from the stomach because it is capable of developing resistance to commonly used antibiotics. Therefore, two or more antibiotics usually are given together with a PPI and/or bismuth containing compounds to eradicate the bacterium. (Bismuth and PPIs have anti-H. pylori effects.)”

Is it effective? We don’t know yet, since Bear is in the middle of the regiment.  However, I’ve read that sometimes the infection can re-occur even if this treatment is successful and that the blood test is not a good choice to re-test after the medication has been finished. One step at a time, folks, one step at a time.

While I’m concerned about Bear, I also wanted to know how this might affect someone with Chronic Kidney Disease who developed it. It seems that it doesn’t until you reach End Stage Chronic Kidney Disease. Since I don’t know much about dialysis or any of the other end stage blood cleansing methods I can only give you information about the little I understood.

pepticOne is this conclusion from a PubMed.gov study at http://www.ncbi.nlm.nih.gov/pubmed/24907021.

“The H. pylori infection rate is lower in PUD patients with CKD and ESRD than in those without CKD.”

Ugh! Alphabet soup PUD is Peptic Ulcer Disease; CKD is Chronic Kidney Disease; and ESRD is End Stage Renal Disease.

But then I found a more negative study on Medscape at http://www.medscape.com/viewarticle/843877.

“This is currently the largest nation-based study in which the risk of ESRD in H. pylori-infected patients was examined. H. pylori infection was associated with a subsequent risk of ESRD. H. pylori-infected patients with concomitant chronic kidney disease (CKD) or cardiovascular disease (CVD) risk factors were at higher risk of ESRD than were those who had a single CKD or CVD risk factor.”

I also found it interesting that the stomach medication Omeprazole, which has just been linked to CKD, is prescribed along with antibiotics to treat H. Pylori. Now there’s a Catch 22. You can take it as prescribed for your infection, the medication may damage your kidneys, or you can not take it and have the infection damage your kidneys anyway.

Ouch!  Enough of this gloom and doom.  Tomorrow is my birthday and that means gifts for you.  I am giving away one copy of each of my kidney disease books: What Is It and How Did I Get It? Early Stage Chronic Kidney Disease; The Book of Blogs, Moderate Stage Chronic Kidney Disease, Part 1; and The Book of Blogs, Moderate Stage Chronic Kidney Disease, Part 2.IMG_1398

What is it

 

What do you have to do to receive your gift? Simply be one of the first three people to like my Facebook page: SlowItDownCKD and leave a comment about Chronic Kidney Disease. The first person to do so will receive a copy of What Is It and How Did I Get It? Early Stage Chronic Kidney Disease, the second will receive a copy of The Book of Blogs, Moderate Stage Chronic Kidney Disease, Part 1, and the third of the three will receive a copy of The Book of Blogs, Moderate Stage Chronic Kidney Disease, Part 2. Don’t forget to leave the comment. Enjoy my birthday, everyone.

Until next week,

Keep living your life!

Another Cause of CKD?

180116_10150140748275850_2010917_nI’ve mentioned before that I’d been an actor for decades before I retired from this maybe four years ago.  As happens when you’re lucky, I’ve remained friendly with some of the wonderful people I met through the plays and/or movies I’ve been in.  One such friend – James David Porter, a talented scriptwriter, director, actor, founder of Arizona Curriculum Theater, and an extremely intelligent person – is cognizant of both my Chronic Kidney Disease and my awareness advocacy for the disease.act

You probably already know about the warnings re heartburn and kidney disease … so is he. As soon as the news hit general sites, he posted it to my personal Facebook page.  I’d already picked up the information about this from the medical sites I belong to, but he didn’t know that. I love it when my friends look out for me.

And I, in turn, want to look out for you. That’s why I’ll be writing about the problem today. Let’s go way back to the beginning for this one.

I had had something: heartburn, upset stomach, acid reflux??? a few months ago. Not having experienced digestive problems before I didn’t know what it was. Heck, I didn’t even know if it was a digestive problem, but I knew I couldn’t take the nausea and sensitive stomach too much longer without investigating.  After weeks of this not going away on its own, I made an appointment with my trusted primary care doctor.

While I was waiting for the appointment, I took a look at Medical Surgical Nursing: Critical Thinking for Collaborative Care, 4th Ed. although I bookcan only understand some of it and we know how dangerous a little knowledge can be. According to what I read, it didn’t seem that I had an ulcer. Hmmm, maybe gastritis?

Something seemed off with what I was reading, sort of out of sync, so I checked copyright date. Uh huh, the book is 14 years old… and outdated. Time for a newer edition.  Case in point and message sent: check the copyright dates of any medical texts you have.  They get outdated fast these days.

Okay, let’s see what the doctor had to say. She addressed my ‘abdominal pain in the pit of my stomach’ and the nausea, diagnosing it as ‘epigastric pain’ and nausea. Well, how is that different from stomach pain?

The stomach is defined by WebMD at http://www.webmd.com/digestive-disorders/picture-of-the-stomach in this way:

“The stomach is a muscular organ located on the left side of the upper abdomen. The stomach receives food from the esophagus. As food reaches the end of the esophagus, it enters the stomach through a muscular valve called the lower esophageal sphincter.

The stomach secretes acid and enzymes that digest food. Ridges of muscle tissue called rugae line the stomach. The stomach muscles contract periodically, churning food to enhance digestion. The pyloric sphincter is a muscular valve that opens to allow food to pass from the stomach to the small intestine.”

stomach_72I always get the stomach and the abdomen mixed up, so I looked that up too. Healthline at http://www.healthline.com/human-body-maps/abdomen#seoBlock was helpful here.

“The abdomen is the area below the chest and above the pelvis. It is comprised of muscles, vertebrae, ribs, blood vessels, nerves, and several vital organs, including the liver, small intestine, large intestine, and kidneys.”

Oh, so the stomach is part of the abdomen.

We still need one more definition here: Epigastric. According to The Free Dictionary at http://www.thefreedictionary.com/epigastric, that means, “The upper middle region of the abdomen.” Ah, another part of the abdomen.

The good doctor prescribed 40 mg. of Omeprazole each morning before breakfast. Omeprazole’s generic name is Prilosec. I saw nothing in the pharmacy handout for this medication that related specifically to CKD.

However, the risk doesn’t seem to be to me since I already have CKD but to those who use these drugs who do not yet have CKD. I do wonder if it could cause Acute Kidney Injury or acute interstitial nephritis (both short term as opposed to chronic) in those who both already suffer from CKD and use these drugs since it’s not made clear in the articles.

There are many versions of this announcement but I’ll be using the one from HealthDay at http://consumer.healthday.com/gastrointestinal-information-15/heartburn-gerd-and-indigestion-news-369/ppis-and-kidney-disease-706877.html since it is the least medicalese one I’ve located.

gastro“MONDAY, Jan. 11, 2016 (HealthDay News) — A type of heartburn medication called proton pump inhibitors may be linked to long-term kidney damage, a new study suggests.

Prilosec, Nexium and Prevacid belong to this class of drugs, which treat heartburn and acid reflux by lowering the amount of acid produced by the stomach.

People who use proton pump inhibitors (PPIs) have a 20 percent to 50 percent higher risk of chronic kidney disease compared with nonusers, said lead author Dr. Morgan Grams, an assistant professor of epidemiology at Johns Hopkins University in Baltimore.

The study was published Jan. 11 in JAMA Internal Medicine.

The study doesn’t establish a direct cause-and-effect relationship between the drugs and chronic kidney disease. However, Grams said, ‘We found there was an increasing risk associated with an increasing dose. That suggests that perhaps this observed effect is real.’”

This information is brand, spanking new. I would suggest speaking to your doctor if you are taking one of these medications. I would not suggest doing anything – such as stopping without medical advice – in a panic.  I’m a nut about my health and even I spoke this over with my PCP, who I might mention, is a highly collaborative doctor, one who listens to what I have to say and talks it over with me. Now that’s the way to have a doctor.

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Book news!  The twins will have a little brother this year. Translation: There will be another Book of Blogs, although I think it’s time for a less unwieldy title. Maybe something like SlowItDownCKD: 2015. Also, my birthday is February 2, so Facebook’s P2P’s Chronic Illness Buy & Sell and I are cooking up a little online birthday party. You’re all invited.What is it

Until next week,

Keep living your life!