Running, but Getting Nowhere

First things first, as usual: Happy Kwanzaa to those who celebrate this week long holiday. For those of you unaware of this particular holiday, Dictionary.com tells us it is

“a harvest festival celebrated from Dec. 26th until Jan. 1st in some African-American communities.”

AudreI was introduced to it by the wondrous Audre Lorde, my neighbor, best friend, and the poet laureate of NYS back on Staten Island in the ‘80s. While I miss her terribly since her death, what’s she’s taught me is part of who I am today.  Thank you, Audre.

Let’s run up to the end of 2015 and restless leg syndrome. (Well, that was an awkward transition, wasn’t it?) I have a new reader who is confounded by it, but can’t get a doctor’s appointment soon enough for some immediate answers at this time of year so let’s see what we can find out for him.

According to The National Institute of Neurological Disorders and Stroke (Don’t let that title scare you; this is just where I went for information) at http://www.ninds.nih.gov/disorders/restless_legs/detail_restless_legs.htm

Restless legs syndrome (RLS) is a neurological disorder characterized by throbbing, pulling, creeping, or other unpleasant sensations in the legs and an uncontrollable, and sometimes overwhelming, urge to move them.”

While that makes sense, it doesn’t explain why a Chronic Kidney Disease patient might develop RLS. I went to Medscape.com at http://www.medscape.org/viewarticle/707972_4 for some sort of explanation.

“A disturbance of dopaminergic transmission has been postulated to underlie the development of idiopathic RLS, but the increased incidence in CKD might reflect hyperphosphatemia or iron deficiency.”

Whoa, Nellie (as my father used to say)! Let’s slow this down a bit.  I can see that “hyper” means over, and “phosphate” has to do with phosphorous, but how do you put it all together? MedicineNet.com did that for me.

dairy“An elevated level of phosphate in the blood. Higher-than-normal levels can be caused by ingestion of phosphate-rich foods, such as dairy products, or by kidney failure.”

Notice that kidney failure is not the only cause. So does that mean my new reader is eating too much high phosphorous food?  I don’t know. Dwayne, are you?

Being a newbie to all this, he may need a list of high phosphorous foods. Luckily, there is one in The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 1.DIGITAL_BOOK_THUMBNAIL

HIGH PHOSPHORUS FOOD TO LIMIT OR AVOID

Beverages

ale                                                     beer

chocolate drinks                            cocoa

drinks made with milk                 dark colas

canned iced teas

 

Dairy Products

cheese cottage cheese                  custard

ice cream                                        milk

pudding                                          cream

soups                                               yogurt

 

Protein

carp                                                  crayfish

beef liver                                         chicken liver

fish roe                                            organ meats

oysters                                             sardines

 

Vegetables

dried beans and peas                   baked beans

black beans                                    chick peas

garbanzo beans                             kidney beans

lentils                                              lima northern beans

pork ’ n beans                                split peas

soy beans

 

Other foods

bran cereals                                   brewer’s yeast

caramels                                         nuts

seeds                                               wheat germ

whole grain products

Does this help any, Dwayne? Let us know.

Next question: What’s so bad about having high phosphorous levels in the blood when you have CKD?

Back What Is It and How Did I Get It? Early Stage Chronic Kidney Disease for the answer to that one.

What is it“This is the second most plentiful mineral in the body and works closely with the first, calcium. Together, they produce strong bones and teeth. 85% of the phosphorous and calcium in our bodies is stored in the bones and teeth.  The rest circulates in the blood except for about 5% that is in cells and tissues. Again, phosphorous is important for the kidneys since it filters out waste via them. Phosphorous balances and metabolizes other vitamins and minerals including vitamin D which is so important to CKD patients. As usual, it performs other functions, such as getting oxygen to tissues and changing protein, fat and carbohydrate into energy.

Be aware that kidney disease can cause excessive phosphorus. And what does that mean for Early Stage CKD patients? Not much if the phosphorous levels are kept low. Later, at Stages 4 and 5, bone problems including pain and breakage may be endured since excess phosphorous means the body tries to maintain balance by using the calcium that should be going to the bones. There are other consequences, but this is the one most easily understood.”

The other possible cause of RLS in CKD (alphabet soup, isn’t it?) is iron deficiency. I wrote about that a bit in The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 2.

“The National Kidney and Urologic Diseases Information Clearinghouse at http://kidney.niddk.nih.gov/kudiseases/pubs/anemia/anemia_508.pdf explains.

‘Healthy kidneys produce a hormone called erythropoietin, or EPO, which stimulates the bone marrow to produce the proper number of red blood cells needed to carry oxygen to vital organs.  Diseased kidneys, however, often don’t make enough EPO. As a result, the bone marrow makes fewer red blood cells.’

You can’t correct it by simply taking EPO injections.  It’s just not that simple.  To quote what I wrote in What Is It and How Did I Get It? Early Stage Chronic Kidney

‘…EPO can worsen your HBP – which can both cause and be caused by CKD.  Most nephrologists agree it’s better to take the EPO injections and increase your HBP medication to control your hypertension.’

Digital Cover Part 2 redone - CopyThat was thought to be true when I researched for the book over three  [now almost four] years ago, but since then the medical science community has discovered that synthetic EPO may be harmful to your body in that it may cause the body to produce antibodies for EOP.  Then your liver becomes involved, too, since it produces a small amount of EPO.”

Be certain to make that appointment with your new nephrologist, Dwayne.  After reading today’s blog, write a list of questions for the doctor and have someone with you during your appointment to be sure you ask all your questions and understand the answers. Keep us posted.

Mini-contest. I have one lonely copy of The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 1 hanging around my office all by itself, just looking for a new home.  Be the first to comment on today’s blog and you’ll have yourself a new book.

Wow! Only three days left in 2015.

Until next year,

Keep living your life!

Maybe Just a Little One

IMAG0269 (1)I love my dog, and because she’s recently had three surgeries for cancer, I’ve had some sleepless nights.  It looks like she’s going to be all right, but I’m tired.  So I thought about taking naps. Well, I really thought about napping after Nima sent me a chart of the value of different length naps and asked me if that information were true.

As Chronic Kidney Disease patients, most of us have sleep problems.  For a while, I experienced interrupted sleep.  That seems to have magically disappeared.  Not so, the sleep apnea which will be my constant companion for life…and why I wear the mandibular advancement device every night. Then there’s insomnia and let’s not forget restless leg syndrome.

I know, I’m rushing again.  I think I’ll start to slow down by explaining the difference between insomnia and interrupted sleep.

{As I wrote last week} According to Wikipedia – which is open to the general public for editing – this is the definition

Segmented sleep, also known as divided sleepbimodal sleep patternbifurcated sleep, or interrupted sleep, is a polyphasic or biphasic sleep pattern where two or more periods of sleep are punctuated by periods of wakefulness.

Insomnia, on the other hand, according to the Mayo Clinic at http://www.mayoclinic.org/diseases-conditions/insomnia/basics/definition/con-20024293 is

… a persistent disorder that can make it hard to fall asleep, hard to stay asleep or both, despite the opportunity for adequate sleep. With insomnia, you usually awaken feeling unrefreshed, which takes a toll on your ability to function during the day. Insomnia can sap not only your energy level and mood but also your health {which is already compromised by Chronic Kidney Disease}, work performance and quality of life

I’ve never discussed restless leg syndrome so we’ll need a definition of this, too.  MedicineNet at http://www.medicinenet.com/script/main/art.asp?articlekey=16440 tells us this is

An uncomfortable (creeping, crawling, tingling, pulling, twitching, tearing, aching, throbbing, prickling, or grabbing) sensation in the calves that occurs while sitting or while lying down. The result is an uncontrollable urge to relieve the uncomfortable sensation by moving the legs. Restless leg syndrome is a common cause of painful legs. The leg pain typically eases with motion of the legs and becomes more noticeable at rest, worsens during the early evening or later at night, and may cause insomnia.

Whoa, there’s a lot keeping us up at night!

Well, what about napping?  I found this wonderfully explanatory chart on the web. What I truly liked about it is all the attributions at the bottom.  I didn’t know much of this and found it too enticing not to share the entire chart with you.  The source is Positive Med at http://positivemed.com/2012/09/17/napping/napping

As to the best way to nap, HPRC {Human Performance Resource Center, a Department of Defense initiative under the Force Health and Protection Readiness Program} at http://hprc-online.org/mind-tactics/sleep-optimization-1/sleep-optimization-strategies/nap-to-be-at-your-best-mentally  has the simplest, most direct answer:

The bottom line? Your brain requires sleep to function optimally. If you do not get the recommended seven to eight hours of sleep each night, then napping will reduce your sleep debt. Nap when you can and as long as you can to get the seven to eight hours of sleep you need every 24 hours.

No fuss, no bother, just do it.  This common sense approach to napping has me reconsidering.  If my body needs it, tells me so, and makes it difficult to function without sleep, why not nap?

Something else that’s been keeping me awake is converting The Book of Blogs: Moderate Stage Chronic Kidney Disease from digital to print. I don’t mind this at all.  My brain is bursting with ideas about this and I’m eager to get to the editing.  I’m laughing at myself for ever thinking this was going to be a piece of cake.  It’s a print book, for goodness’ sake!  That means all the click throughs and web addresses need to go.  Yet, the sources of whatever I use that someone else wrote must remain clear.41DsvandphL._BO2,204,203,200_PIsitb-stThe Book of Blogs

Thank you, thank you, thank you to all the readers who have dropped me notes that they’re already enjoying the digital copy of the book.  I hope you were all able to make use of the two day discount price of $ .99 to celebrate the publication of my second Chronic Kidney Disease Book.

While Amazon is terrific at coming up with ways to keep the book affordable, I won’t be able to do another low price or free day until April according to the contract I signed. Keep in mind that you can lend it for free for 14 days if you are a member of Kindle Unlimited.

Once I finish editing The Book of Blogs: Moderate Stage Chronic Kidney Disease for print – Book Coverand you know I’ll be sure to let you know when the print version is available – be on the lookout for a box set of this second book and my first about our disease What Is It and How Did I Get It? Early Stage Chronic Kidney Disease.

And this is where I start asking you for reviews.  I realize it’s early days {to borrow a phrase from Downton Abby} yet, but I would appreciate a review on Amazon when you finish the book. Amazon.com will be my only distributor for this book.

Until next week,

Keep living your life!