It’s the Salt of the Earth

passoverPassover begins tonight at sundown. A Guten Pesach for all those who celebrate.  We’re hosting the first seder here tonight.  Only  three of our eleven guests are Jewish, although there is a hint of Jewish blood in a few others.  All are welcome… including Elijah.

Yesterday, I attended a Palm Sunday Brunch hosted by an acting colleague. Unfortunately for me, none of the food she carefully made from scratch was on the renal diet (I can’t eat many of the traditional Passover foods either), so I did my taste-each-food-to-be-polite thing. I had such minimal amounts of each that I wasn’t doing damage to my kidneys, but I also discovered new tastes.

I realized none of this food tasted salty to me, as food not on the renal diet usually does. When asked, she told me she doesn’t use salt but spices instead. This stuff was delicious! If I weren’t on the renal diet, I would have asked her for the recipes for each dish she’d made.

Nancy’s not using salt in her cooking got me to thinking if we needed salt at all. Actually, I knew we did, but I didn’t know why. I poked around and found the following on an NPR blog:

“If you don’t keep up your sodium level in your body, you will die,” explains Paul Breslin, a researcher at the Monell Center, a research institute in downtown Philadelphia devoted to the senses of taste and smell. (Breslin also teaches at Rutgers University.) “

That’s extraordinarily blunt, but there’s quite a bit more about this at http://www.npr.org/blogs/thesalt/2012/12/20/167619010/the-paradox-and-mystery-of-our-taste-for-salt. What I got from this is the same question I usually have: why?Whatever Happened to Common Sense?

I remembered that salt regulates your hydration but decided to check this anyway. According to The Royal Academy of Chemistry at http://www.rsc.org/get-involved/hot-topics/Salt/do-we-need-salt.asp,

It is the sodium (ions) present in salt that the body requires in order to perform a variety of essential functions. Salt helps maintain the fluid in our blood cells and is used to transmit information in our nerves and muscles. It is also used in the uptake of certain nutrients from our small intestines. The body cannot make salt and so we are reliant on food to ensure that we get the required intake.

An EurekAlert at http://www.eurekalert.org/pub_releases/2013-08/mu-anr082013.php made me realize another important function of sodium, the element our bodies cannot produce:

Researchers at McGill University have found that sodium – the main chemical component in table salt – is a unique “on/off” switch for a major neurotransmitter  receptor in the brain. This receptor, known as the kainate receptor, is fundamental for normal brain function and is implicated in numerous diseases, such as epilepsy neuropathic pain.

Normal brain function!brain

Just in case you didn’t take chemistry in high school or college – which I admit was too intimidating for me – salt is 40% sodium and 60% chloride. It’s the 40% sodium that causes a problem if you have too much of it. This is a quandary. You need salt to live and function well, but too much can kill you via raising your blood pressure.

There is an ongoing controversy of how much salt we need on a daily basis. This is what is on Colorado State’s website at http://www.ext.colostate.edu/pubs/foodnut/09354.html:

The Dietary Guidelines for Americans recommended reducing sodium intake to no more than 2,300 milligrams per day. However, those with hypertension, over the age of 51, or who are African American, should consume no more than 1,500 milligrams of sodium per day. This recommendation includes over half of all Americans.

But have they taken into account the fact that we sweat during the summer or when we work out and lose a great deal of sodium that way? Does that mean we need more sodium during these times? And how do you judge how much sodium is too much anyway? Or do we use the Goldilocks Theory of ‘just right’ here.

All right, then. The next logical question would be how much is usually too much. Hello Medical News Today at http://www.medicalnewstoday.com/articles/146677.php. That’s where I found this handy, dandy, how much chart.

food labelHow to read food labels and identify high and low salt foods

You should check the labels of foods to find out which ones are high and low in salt

content. If the label has more than 1.5g of salt (or 0.6g of sodium) per 100g it is a

high salt content food.

If it has 0.3g of salt (0.1g of sodium) per 100g then it is a low salt content food. Anything in

between is a medium salt content food.

  • High salt content food = 1.5g of salt (or 0.6g of sodium) per 100g
  • Medium salt content food = between the High and Low figures
  • Low salt content food = 0.3g of salt (0.1g of sodium) per 100g

The amount you eat of a particular food decides how much salt you will get from it.

As renal patients, we need to pay special attention to the amount of sodium we ingest. I’m on the Northern Arizona Council of Renal Dietitians’ diet which permits 2,000 mg. of sodium a day. That’s really limited since a teaspoon of salt has about 2,300 mg. of sodium. Of course, now that I’m over 51 (okay, way over), I’m down to 1,500 mg. of sodium daily.

How do I keep within my guidelines, you ask? It’s become easy, but don’t forget I’ve had seven years to perfect it. We do have filled salt shakers available in the kitchen, but they’re invisible to me. I use spices in cooking instead. My best friend there is Mrs. Dash’s, although there are many other spices on the renal diet. I just like her (its?) blends. I check labels copiously when I do the marketing and Bear does too. If there’s hidden sodium in foods, there’s not much I can do about it. However, checking labels and ignoring the salt shaker will help keep my kidneys safe from too much sodium. (Pssst: I also ignore whatever food you can buy at gas stations.)salt shakers

As DaVita tells us (http://www.davita.com/kidney-disease/diet-and-nutrition/diet-basics/sodium-and-chronic-kidney-disease/e/5310)

Particularly damaging is sodium’s link to high blood pressure. High blood pressure can cause more damage to unhealthy kidneys. This damage further reduces kidney function, resulting in even more fluid and waste build up in the body.

Other sodium-related complications include the following:

  1. Edema: noticeable swelling in your legs, hands and face
  2. Heart failure: excess fluid in the bloodstream can overwork your heart making it enlarged and weak
  3. Shortness of breath: fluid can build up in the lungs, making it difficult to breatheUntil next week,

So lay off the salt, my friends.

recall centerBefore I leave you this week, I wanted to let you know that Dr. Mario Trucillo contacted me about his new company.  He is a Ph.D. with the American Recall Center (www. recallcenter.com) “a brand new medical information site aimed at bringing consumers the most up-to-date FDA information in easy to understand, plain language terms,” according to his e-mail.  I have been looking at the site and am pleased to announce I understood everything I read there… not often the case for me.  Why not take a look for yourself?  There are not that many plain language medical websites available. The more I look at this one, the more I like it.

Until next week,

Keep living your life!

Timidly Exploring Dialysis

We are a Landmark Education family; that is Nima, Abby, and I are all Landmark Education graduates.  Abby has taken many of their enlightening courses and was candidated as an Introduction Leader.

In other words, she demonstrated her willingness to bring Landmark Education to others and now knew enough about the program to be able to do so.  This is a big deal in the Landmark world and it was celebrated Friday night.

Of course Bear and I went to the celebration to support her.  We even got dressed up a little (this IS Arizona – people go to weddings wearing jeans.).  Since I recently retired – yes, again – from teaching, I went right to my teaching clothes to find something appropriate to wear tonight. landmarkqr

While I’ve only gained a few pounds (no, really), my body has finally decided to show my age.  Out went the tightly fitted dressy tee shirts that accentuated the belly.  Out went the fancy blouses with no room for the droopy bust. Out went the casual dress pants with their tight waistlines. Out went the maxi skirts that now reached the floor since I’ve shrunk.

And it struck me.  I looked something like the peritoneal dialysis patient Walter A. Hunt mentions in his book Kidney Disease: A Guide for Living: “ Peritoneal dialysis also causes weight gain and an increased waistline, which are mostly caused by fluid retention.  It may be difficult to find clothes that fit properly, because your abdomen may become quite large.”

I was reading the book on the recommendation of Mark Rosen from Facebook’s KIDNEY DISEASE AND DIET IDEAS AND HELP 1. Any book he recommends is worth a gander.  I had been looking for a newer book than mine that deals only with early stage chronic kidney disease. (There aren’t any as far as I could research.) What I didn’t realize is that Mr. Hunt wrote about dialysis and transplant in his book.

I began to wonder what else I don’t know about either of these medical procedures and ended up where I always do: MedlinePlus, a service of U.S. National Library of Medicine and National Institutes of Health  at: http://www.nlm.nih.gov/medlineplus/dialysis.html.  This is what I found there:

“When your kidneys are healthy, they clean your blood. They also make hormones that keep your bones strong and your blood healthy. When your kidneys fail, you need treatment to replace the work your kidneys used to do. Unless you have a kidney transplant, you will need a treatment called dialysis.thCAQ0P7T3

There are two main types of dialysis: hemodialysis and peritoneal dialysis. Both types filter your blood to rid your body of harmful wastes, extra salt and water. Hemodialysis  does that with a machine. Peritoneal dialysis uses the lining of your abdomen, called the peritoneal membrane, to filter your blood. Each type has both risks and benefits. They also require that you follow a special diet. Your doctor can help you decide the best type of dialysis for you.”

This may be old news to those of you who are already dealing with renal dialysis and it was to me, too, but what about those people who are still in early stage or who love someone in early stage?  They don’t need to be bewildered when (if) this becomes necessary for them down the road, the way they were when they were first diagnosed with Chronic Kidney Disease.

As much as I deplore the thought of dialysis – I can’t stand anyone fiddling with me, not even for a manicure or a massage – this may become a necessity somewhere down the line for me –  or you.  We all know I intend to be one of the 80% of CKD patients who never progress beyond stage 3… but what if I’m not?  What if you’re not?

I don’t know much about either kind of dialysis, but am learning by forcing myself to research and finish reading Mr. Hunt’s book.  This is something I have studiously avoided in the last five years but I think it’s time to grow up.  I may never need this information, but it doesn’t hurt to have it.

I’ll tell you this, though.  Even though it’s Passover right now and Easter was Sunday, I made the commitment NOT to experiment with foods that are not on my renal diet.  And, since I know these are family heavy holidays, I took time off periodically to sit down and read a book for more than ten minutes at a time so I was at least rested.

While I was the one who invited nine people for Easter dinner (less than a week before our wedding, no less), Bear popped right in and took the stress off me.  He did the meal planning and the shopping.  I just asked each of our guests to make their specialties: Kelly made her creamy mashed potatoes, Lara her grandmother’s recipe cheesecake, Abby the crescent rolls, Sean’s mom Mary Ann the string bean casserole.  Alex brought wine and on and on. easter-dinner

It was pretty clear I needed something I could eat, so Bear brought me turkey, salad, bananas and strawberries.  I didn’t even miss tasting the ham, sweet potatoes, macaroni and cheese or some of the home made food.

I have a confession: I always get the adult children (the youngest is 28 for heaven’s sake!) Peeps and since the adults were disappointed they didn’t get any last year, I got them some this year, too. I know, I know, it’s all sugar and food coloring.

Sometimes, I get glutted by just being with my family.  Maybe that’s why while I might ‘taste’ the foods forbidden to me, I don’t seem to want to eat bunches of them.  Whoa, were the Beatles right when they sang, “All you need is love?”

A nice spring holiday present for me: the book continues to do well in the foreign market.  Let’s see what we can do about moving here at home too.

passoverI hope your Easter and Passover were (and still is in the case of Passover) happy, healthy, and rejuvenating.

Until next week,

Keep living your life!