It Isn’t  Ain’t; It’s AIN.  

I’ll explain that in a minute, but first – on this Labor Day weekend – I want to thank all the readers who have liked individual blogs. These likes let me know I’m writing about topics that interest you.

Let’s turn to AIN now.  You know it’s not just a word, but an acronym. That’s a word formed by the initials of a term, like ASAP for as soon as possible. By the way, ‘nym’ means name, while ‘acr’ means height, summit, tip, top.  ‘O’ connects the two roots. So, we have the tip of the words or the first letters forming an acronym which becomes a recognized word. Thank you to my college course in Greek and Latin roots. I knew that would come on handy someday and it has again and again.

Well, what does AIN mean? It is the acronym for Allergic Interstitial Nephritis, which is a mouthful itself. ‘Allergic’ we get. That’s a common enough word. ‘Interstitial’, though? I remember the prefix (group of related words before the root word that changes its meaning) ‘inter’ means between, but between what? Merriam-Webster Dictionary at https://bit.ly/3h3cF0H, here we come.

asituated within but not restricted to or characteristic of a particular organ or tissue —used especially of fibrous tissue

 baffecting the interstitial tissues of an organ or part

I wonder if we’ll need both definitions. I think we need to be reminded of what nephritis is before we can tell. Again, I remember from that college course so very long ago (Funny what sticks in your mind, isn’t it?) that ‘itis’ means inflammation. We know from all the writings about Chronic Kidney Disease that ‘neph’ means kidneys. Putting these together, we have inflammation of the kidneys. Let’s take a look at my favorite dictionary again, just to be certain.

Yep, there we have it at www.merriam-webster/dictionary/nephritis:

“acute or chronic inflammation of the kidney caused by infection, degenerative process, or vascular disease”

How do you define the whole term? According the excerpt from Nancy A. Finnigan and Khalid Bashir’s book Statpearls on NCBI’s bookshelf at https://bit.ly/31ZTeS2,

“Allergic interstitial nephritis (AIN) is the most common form of acute interstitial nephritis. It is most often caused by exposure to a drug. AIN is often associated with an acute decline in renal function and may be associated with permanent renal insufficiency.”

Acute? Oh, yes. That’s means sudden. It’s the opposite of chronic, which means long term. Looks like we only needed the second dictionary definition of interstitial after all.

So, this kind of nephritis is usually caused by drugs? Which drugs? I went to UpToDate at https://bit.ly/3i4exHS for the answer:

“The most common drug causes of AIN now include …:

  • Nonsteroidalanti-inflammatoryagents (NSAIDs), including selective cyclooxygenase (COX)-2 inhibitors
  • Penicillinsand cephalosporins
  • Rifampin
  • Antimicrobial sulfonamides, including trimethoprim-sulfamethoxazole
  • Ciprofloxacin and,perhaps toa lesser degree, other quinolones
  • Diuretics, including loop diuretics such as furosemide and bumetanide, and thiazide-type diuretics
  • Cimetidine (only rare cases have been described with other H-2 blockers such as ranitidine) [24,25]
  • Allopurinol
  • Proton pump inhibitors (PPIs) such as omeprazole and lansoprazole [26-29]
  • Indinavir
  • 5-aminosalicylates (eg, mesalamine)”

There are some very common drugs on this list. As Chronic Kidney Disease patients, we are warned away from NSAIDS. I’ve been warned about Ciprofloxacin, too, and PPIs, but diuretics? Most of the other drugs we’d have to ask our doctors about when and if they’re prescribed. Then again, I ask my family doctor to check the effect of the drug on the kidneys when she prescribes a drug. She happily does so.

You should note that many of these drugs do not require a prescription. In that case, speak with your pharmacist about its possible effect on your kidneys before buying any over the counter drug. Another possibility is using Drugs.com or a similar website for possible effects on your kidneys before using any drugs.

What are the symptoms, if any, of AIN? Well, much like Chronic Kidney Disease, there are often no symptoms until it is quite advanced. Then you would notice the acute drop in kidney function. A blood test and urine test will help with the diagnosis, although the urine test will only show the presence of white blood cells. That indicates an infection. Sometimes a kidney biopsy is required to diagnose AIN.

And now the biggie: what do you do if you develop AIN? You stop the medication. It’s common sense. Your doctor will probably suggest that once it’s been determined you have allergic interstitial nephritis. Remember though, there are other causes of AIN such as infections and/or autoimmunity.

Topic switch: While I’ve been laboring over this blog, I’ve also been thinking about the fact that today is Labor Day in the United States. Coming from a union family, I thought I’d tell you a little bit about Labor Day that you may not know.

This, and more information about Labor Day, may be found at https://bit.ly/3jPeaRR

“In the late 1800s, the state of labor was grim as U.S. workers toiled under bleak conditions: 12 or more hour workdays; hazardous work environments; meager pay. Children, some as young as 5, were often fixtures at plants and factories.

The dismal livelihoods fueled the formation of the country’s first labor unions, which began to organize strikes and protests and pushed employers for better hours and pay. Many of the rallies turned violent.

On Sept. 5, 1882 — a Tuesday — 10,000 workers took unpaid time off to march in a parade from City Hall to Union Square in New York City as a tribute to American workers. Organized by New York’s Central Labor Union, It [sic]was the country’s first unofficial Labor Day parade. Three years later, some city ordinances marked the first government recognition, and legislation soon followed in a number of states.”

As many of you already know, my grandfather was an organizer for the Brass Workers Union. Many a time he’d disappear. He was jailed for his activities, but that didn’t stop him.

As you labor to avoid AIN and keep your kidneys functioning properly, enjoy the holiday weekend.

Until next week,

Keep living your life!

The Flu: Part 3, The Last

martin-luther-king-jrToday is such a momentous day.  It is not only Martin Luther King, Jr.  Day, but the second inauguration of President Obama.  2013-01-21T024432Z_1452960950_GM1E91L0TCM01_RTRMADP_3_USA-INAUGURATIONAs I sit at my computer, I ruminate how far we’ve come in a relatively short amount of time.  I remember becoming aware of the Civil Rights Movement and crying when I watched fire hoses being turned on the crowds.  I remember how I wondered as a little girl why my friend’s skin was darker… and assumed she’d just been in the sun longer than I had.  And I remember the prejudice both of us experienced as we traveled in the rural south only forty years ago.  She is Black, but I am a Jew.

And now I wonder how to slide into a blog about chronic kidney disease.  There is no sedge way here. That’s all right, though, because we’re not exactly dealing with ckd today, but the flu instead.  I do promise that this will be the last blog about the flu (this year, that is).

I have just spent four uncomfortable days zapped of energy and not enjoying the movies I watched or books I read while enduring the flu. I was truly surprised at the OTC (over the counter) medications my nephrologist recommended to me.  Tylenol Cold?  A steady regime for four days?  This for a CKD patient who has taken six Tylenol in the last five years?  But that’s what the man said.

Dylsem Cough Suppression was another OTC he recommended.  Then there was the Benedryl that came with a caution not to take it until I was going to sleep. It would knock me out. Oh, and the Mucinex.  The one recommendation I got a kick from was hot tea with lemon and honey (I actually asked him if he knew my mother, but I think he didn’t hear me.) laced with whiskey. This for someone who doesn’t drink?

Now that I’m feeling better – even if I don’t sound better – I’m nervous about all this medication.  I carefully read each and every label.  Not a single one mentioned anything about possible kidney damage.

I think I’ve become accustomed to not taking OTC medication and I think that’s done me well. As I finished each bottle – especially the Tylenol Cold – I noticed I felt more alert, more aware of my body, and less… less what?  Tamped down?  Cocooned?  I don’t know the word, but I certainly feel more here.

Is it that the medications did their job?  Probably.  Is it that I got more sleep and rest than I have in quite a while?  Probably that, too.  But maybe, just maybe, my body doesn’t like more medications.  Sounds a bit hocus-pocus, but this is the same body that has slowly raised its GFR with careful guidance from me.

Would I take the flu shot again even though I got the flu after taking it this season?  Absolutely.  It was my misfortune to take the immunization for the wrong strain of flu this year. flu shot That’s never happened before, but then again, there haven’t usually been this many different strains of flu before in the same season.

Another reason is that this inoculation against  influenza also prevents heart attack and stroke.

“If you’re tempted to skip your flu shot, consider this: Getting vaccinated cuts risk for a heart attack or stroke by up to 50 percent, according to two studies presented at the Canadian Cardiovascular Congress.”  This is the lead sentence in Lisa Collier Cool’s Nov. 26, 2012 Yahoo Health article. You can read the whole article (and I urge you to.  There’s information here that was news to me.) at: http://health.yahoo.net/experts/dayinhealth/shot-prevents-heart-attacks

According to a Reuters’ Jan. 18, 2013 article, the number of flu cases is beginning to taper off but this has been a difficult year. We already know that.  Both Boston and New York State have declared Medical Health Emergencies. Look around you.  Are there people missing from your office?  Your school?  I noticed fewer people in the markets, too.

This same article talks about a dearth of Tamiflu.  Weren’t we told just last week that there was a shortage of the vaccine, too?  Do you see where I’m going with this? If you haven’t gotten your inoculation, get it.  If you have, but can’t find Tamiflu (not that everyone is prescribed Tamiflu), ask your doctor. No reason to panic.  Honestly, I sometimes wonder just how objective our news is.  Oh, the article.  It’s at: http://news.yahoo.com/flu-u-still-widespread-starting-ease-cdc-says-191406674–finance.htmlflu

A MedPage Today article offered some startling information on January 19th of this year: “A resounding 85% of 2,000-plus MedPage Today readers voted “yes” to our survey question asking if media attention promoted a “pseudo epidemic” as patients mistake cold symptoms for flu.” Did I do that?  Did you?  As someone who rarely becomes ill for more than a day at a time, did I simply not recognize a bad cold for what it is?

I couldn’t secure an appointment with my pcp (primary care physician) until this coming Wednesday – fully a week after I started to feel symptoms.  Will it be too late for her to tell the difference?  It’s an interesting article, although I’m not necessarily endorsing it.  Read it for yourself at: http://www.medpagetoday.com/InfectiousDisease/Vaccines/36924?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&xid=NL_DHE_2013-01-21&eun=g596983d0r&userid=596983&email=myckdexperience@gmail.com&mu_id=5721543

As I read a New York Times article about the severe flu season (http://www.nytimes.com/2013/01/19/health/flu-season-worse-than-average-officials-say.html?smid=tw-nytimeshealth&seid=auto&_r=1&) from last Saturday, it occurred to me that when the media refers to the elderly, they mean people over 65.  That means me!  I had not been paying attention to any health warnings for the elderly because they didn’t apply to me.  Hah!  Reality smacks me in the face again.

I could go on and on, but you’ve probably read a great deal yourself about the flu.the flu ends with you

As far as the book, I believe I have come close to paying off the initial cost of publication.  When you buy a book (Amazon.com, B&N.com, or DogEarPublishing.com), my profit goes right back into the book.  That’s what has allowed me to donate books to those who could not afford the book, were just diagnosed, and/or were somehow related to CKD patients.

As soon as I earn enough to pay off turning the book into an e-book , paying for the books I ordered to donate, and then translating it into Spanish (my next project), I intend to order more books to donate.

India, Malaysia, Pakistan, Turkey, Tunisia, the United Arab Emirates, Egypt, Saudi Arabia, Singapore, South Africa, The UK, Canada, Australia, Italy, Ireland, Germany, New Zealand, The Philippines, and Mexico, as well as the USA,  thank you.  Buy a book for yourself and help someone else who needs it.

Until next week,

Keep living your life.Book signing