Stress Is as Stress Does

I have been so stressed lately. It’s the usual: Covid-19, the elections, etc. But then there are the personal reasons: my upcoming surgery, Bear’s cataract surgery and being his caretaker, the third under-the-slab water leak in our house, and my brother’s ill health come to mind right away. I do take time to quietly read, play Word Crush, or watch a movie, but the stress is still there… and my blood glucose numbers are going up. “Is there a correlation?” I wondered. 

You may remember (I certainly do) that Healthline included this blog in the Best Kidney Disease Blogs for 2016 & 2017. They like my work; I like theirs, so I went to their website to see what I could find about stress and diabetes. I have diabetes type 2, by the way. That’s the type in which you produce insulin, but your body doesn’t use it well. 

Okay, now let’s see what Healthline at https://bit.ly/2TIHwWZ has to say: 

“… But there’s a problem. The body can’t differentiate between danger and stress. Both trigger fight-or-flight. 

So today’s most common ‘danger’ isn’t wild animals. It’s the letter from the IRS. There’s no quick resolution — no violent fight, no urgent need to run for miles. Instead, we sit in our sedentary homes and workplaces, our bodies surging with sugar, with no way to burn it off. 

That’s how stress messes with diabetes. Acute stress floods us with unwanted (and un-medicated) sugar. Chronic stress is like a leaking faucet, constantly dripping extra sugar into our systems. The impact on blood sugar caused by stress is so significant that some researchers feel it serves as a trigger for diabetes in people already predisposed to developing it.” 

Wait a minute here. “Acute stress floods us with unwanted (and un-medicated) sugar.” How does it do that? The answer I liked best is from Lark at https://bit.ly/3ebZU4b. Yes, Lark is a company that produces electronic aids for various stages of diabetes, but it also offers short, easy to understand explanations of what’s happening to your diabetes during different situations. 

“Cortisol signals your brain and body that it is time to prepare to take action. You may be able feel this as your heart pounds and muscles tense. At the same time, what you may not feel is that cortisol signals a hormone called glucagon to trigger the liver to release glucose (sugar) into your bloodstream. The result: higher blood sugar. 

Cortisol’s role in preparing your body for action goes beyond mobilizing glucose stores. Cortisol also works to make sure that the energy that you might spend (whether fighting a bear or running to stop your toddler from toddling into the street) gets replenished. That means you may feel hungry even when you do not truly need the food – and that can lead to weight gain. Again, the result is an increase in blood sugar.” 

Quick reminder: 

“Think of cortisol as nature’s built-in alarm system. It’s your body’s main stress hormone. It works with certain parts of your brain to control your mood, motivation, and fear. 

Your adrenal glands — triangle-shaped organs at the top of your kidneys — make cortisol. 

It’s best known for helping fuel your body’s ‘fight-or-flight’ instinct in a crisis, but cortisol plays an important role in a number of things your body does. For example, it: 

• Manages how your body uses carbohydrates, fats, and proteins 
• Keeps inflammation down 
• Regulates your blood pressure 
• Increases your blood sugar (glucose) 
• Controls your sleep/wake cycle 
• Boosts energy so you can handle stress and restores balance afterward” 

Thank you to WebMD at https://wb.md/35RaDgr for the above information. 

Let’s get back to how we end up with excess sugar in our blood due to both acute (sudden) and/or chronic (long term) stress. Diabetes Education Online, part of the Diabetes Teaching Center at the University of California, San Francisco, offers the following explanation. You can find out more by going to their website at https://bit.ly/3oNXgqi.    

“During stressful situations, epinephrine (adrenaline), glucagon, growth hormone and cortisol play a role in blood sugar levels. Stressful situations include infections, serious illness or significant emotion stress. 

When stressed, the body prepares itself by ensuring that enough sugar or energy is readily available. Insulin levels fall, glucagon and epinephrine (adrenaline) levels rise and more glucose is released from the liver. At the same time, growth hormone and cortisol levels rise, which causes body tissues (muscle and fat) to be less sensitive to insulin. As a result, more glucose is available in the blood stream.” 

Now I’m stressed about being stressed… and that’s after trying to keep my stress levels down so I don’t make my Chronic Kidney Disease worse… now I find it’s also making my diabetes worse. What, in heaven’s name, will happen if I continue to be this stressed? 

I went right to The National Kidney Foundation at https://bit.ly/2HQVsvs for an answer I could trust. 

“The combined impacts of increased blood pressure, faster heart rate, and higher fats and sugar in your blood can contribute to a number of health problems, including high blood pressure, diabetes, and heart disease (also known as cardiovascular disease). 

Stress and uncontrolled reactions to stress can also lead to kidney damage. As the blood filtering units of your body, your kidneys are prone to problems with blood circulation and blood vessels. High blood pressure and high blood sugar can place an additional strain or burden on your kidneys. People with high blood pressure and diabetes are at a higher risk for kidney disease. People with kidney disease are at higher risk for heart and blood vessel disease. If you already have heart and blood vessel disease and kidney disease, then the body’s reactions to stress can become more and more dangerous.” 

Oh, my! I think I’d better quietly read, play Word Crush, or watch a movie right now.  

Before I leave, I did want to let you know a $10 million Kidney Prize competition has been launched. If you’re seriously interested, go to https://akp.kidneyx.org. According to their website, KidneyX is 

“The Kidney Innovation Accelerator (KidneyX), a public-private partnership between the U.S. Department of Health and Human Services (HHS) and the American Society of Nephrology (ASN), is accelerating innovation in the prevention, diagnosis, and treatment of kidney diseases.” 

Until next week, 

Keep living your life! 

Stop Stressing!

I am retired.  I get up when I want. I go to bed when I want. I stay in when I want. I go out when I want. I have no deadlines except those I impose on myself. But people I love do have stress in their lives: jobs, relationships, mental health…and I am stressed by their stress.

What, in heaven’s name, is this stress doing to my kidneys since I have Chronic Kidney Disease?  It is further reducing my already compromised immune system is what it’s doing.  Let me tell you why I don’t need that and neither do you.

Flashback to Alaska about a month ago. Bear was in the throes of cellulitis. It was about 60 degrees and raining lightly. We needed to return the knee scooter to the rental company before we left the state, which meant I stood outside in the rain for over 40 minutes waiting for them to show up.  They didn’t. I straightened that out and we ended up racing to the airport to be there two hours before our flight, as required. Then Bear felt ill, so we sat in the ice cold military waiting room for over 12 hours until our flight.  There was no sleep that night.  Are you starting to get the picture?

The result was a plain, old ordinary upper respiratory infection that took my already compromised immune system three weeks to heal from.

Let’s do the usual backtracking here and take a look at how Chronic Kidney Disease compromises your immune system in the first place. According to WebMD’s explanation of what stress can do to anyone, CKD or not, at http://www.webmd.com/balance/stress-management/effects-of-stress-on-your-body,

Stress that continues without relief can lead to a condition called distress — a negative stress reaction. Distress can lead to physical symptoms including headaches, upset stomach, elevated blood pressure, chest pain, and problems sleeping. Research suggests that stress also can bring on or worsen certain symptoms or diseases.

Make no mistake. Stress can be a killer for those with CKD.  Did ‘elevated blood pressure’ from the explanation above jump out at you?  A large number of us were already taking blood pressure lowering medication before we developed CKD.  Another large number who were not had blood pressure lowering medication prescribed for them by their nephrologists.  Why?

Let’s go back to basics here. In the glossary of What Is It and How Did I Get It? Early Stage Chronic Kidney Disease, I defined hypertension (high blood pressure) as

A possible cause of CKD,… , a risk factor for heart disease and stroke, too.

Just below that definition is the one for hypertensive nephrosclerosis:

Kidney damage caused by HBP (high blood pressure).

As a reminder, nephron refers to the kidneys and sclerosis to hardening of the – in this case – organ.

Dirty words! So my already high blood pressure MAY have been part of the cause of my CKD which compromised my immune system and then stress further compromised it.  Oh my.

Wait a minute. Let me grab this thought. Got it! How does the immune system work anyway? The National Institutes of Health was helpful here.

The immune system protects the body from possibly harmful substances by recognizing and responding to antigens. Antigens are substances (usually proteins) on the surface of cells, viruses, fungi, or bacteria. Nonliving substances such as toxins, chemicals, drugs, and foreign particles (such as a splinter) can also be antigens. The immune system recognizes and destroys substances that contain antigens (Me here: the body does already contain antigens of its own.) ….The immune system includes certain types of white blood cells. It also includes chemicals and proteins in the blood, such as antibodies, complement proteins, and interferon. Some of these directly attack foreign substances in the body, and others work together to help the immune system cells.

There’s a great deal more of such information at http://www.nlm.nih.gov/medlineplus/ency/article/000821.htm

Keep in mind that our kidneys filter our blood.  If our kidneys are damaged, our blood filtration is not at 100%, including those ever important white blood cells. Ever notice how high your white blood count is when you have an illness?  This is why. You might also look for your leukocyte esterase level on your blood test results since those indicate the presence of white blood cells.

This is so complicated, but then, isn’t everything?  Whatever happened to black and white answers, she whined winningly.

So we have already poorly filtered blood and further reduced blood flow (That’s what hypertension is.) caused by stress. Wonderful, just wonderful. Ugh! Obviously, this is something to be avoided, if possible.  But how?

As CKD patients, we can stop stressing ourselves about the following, those things that common – but misguided – knowledge tells us is our disease worsening when they actually may be anxiety produced:

• Extra Urination Anxiety can actually cause more frequent urination. When you experience anxiety, the part of your brain that controls the withholding urination actually slows down, because anxiety requires resources to be sent to other parts of your brain. This can lead to concerns over your renal health, although generally nothing is wrong.
• Lower Back Pain Lower back pain is also very common with anxiety. Lower back pain comes from severe stress and tension, and yet it’s associated with some conditions that affect the kidneys as well which can have many people worried about their kidney health.
• Life Experiences Anyone that suffers from anxiety and has had a friend or family member diagnosed with a terrible kidney condition is at risk for developing anxiety over the idea of poor kidneys. Anxiety can turn life experiences into very real concerns, and so kidney health concerns are one of the issues that can come up when you see it in others.
• Urine Color Urine color is another issue that can cause anxiety. Many people check their urine color for diseases habitually, and every once in a while the color of a person’s urine may be very different than what they expect. This can create concerns that the urine color changes are due to kidney problems.

Many thanks to Calm Clinic at http://www.calmclinic.com/anxiety/kidney-problems for these reassuring words.

Here’s hoping you can find more ways to reduce any existing stress in your life.  Look hard, we all have stress of some kind of another.

Until next week,

Keep living your life!

‘Twas The Night Before The Night Before Christmas

’Twas the night before the night before Christmas and all through the house…. The night before the night before Christmas?  Where did the time go? Hmmmm, there are no children here to constantly remind us Christmas is coming.  We rarely watch television (although we often watch movies), so we didn’t see the ads that could have reminded us.  Oh, I did know it was coming… just not so quickly.

And that’s often the case when we deal with a chronic illness.  We know that doctor’s appointment is coming up and we’re eager to see the results of our blood tests.  After all, we’ve worked so hard on diet, exercise, sleep, and lack of stress (that’s funny: stressing for lack of stress).  We just didn’t know it was coming so quickly. Did we have enough time to lower our blood pressure?  Was it enough time to lose some weight?  Did we monitor our eating enough in this amount of time that our cholesterol numbers are down?  Time, time, time.  It all comes down to time.

I have a modest proposal (apologies there, Mr. Swift).  What if we ignore time and just always – okay, almost always – watch the diet, exercise, sleep enough, and avoid stress.  Oh right, that’s what we’re supposed to be doing: lifestyle changes.

According to an article published in the European Journal of Social Psychology way back in September of 2009, it takes an average of 66 days to form a new habit. The article was written by Phillippa Lally and her colleagues from the Cancer Research UK Health Behaviour Research Centre based at UCL Epidemiology and Public Health, and was based on their research.  You can find more at: http://www.ucl.ac.uk/news/news-articles/0908/09080401

Since it’s habits that form your life style, I had trouble accepting that number so I kept researching.  Ugh, I kept coming up with the same number although one analysis of this same article did mention that it can take as few as 18 or as many as 254 days to form a habit depending upon the individual.  I’ll take the 18 days option, please.

All right, let’s try something else.  How about getting enough sleep.  How much sleep is enough sleep anyway?  According to Dr. Timothy Morgenthaler on the Mayo Clinic site (http://www.mayoclinic.com/health/how-many-hours-of-sleep-are-enough/AN01487), seven to eight hours is what an adult needs, but then he lists mitigating circumstances under which you might need more:

• Pregnancy.      Changes in a woman’s body during early pregnancy can increase the need for      sleep.
• Aging.      Older adults need about the same amount of sleep as younger adults. As you      get older, however, your sleeping patterns might change. Older adults tend      to sleep more lightly and for shorter time spans than do younger adults.      This might create a need for spending more time in bed to get enough      sleep, or a tendency toward daytime napping.
• Previous      sleep deprivation. If you’re sleep deprived, the amount of sleep you      need increases.
• Sleep      quality. If your sleep is frequently interrupted or cut short, you’re      not getting quality sleep. The quality of your sleep is just as important      as the quantity.

Those first two weeks after Bear’s surgery when I was his caretaker, I rarely enjoyed more than two hours of sleep at a time and there seemed to be no difference between day and night.  I’m not saying this would be true for everyone, but we paid for it dearly.  I ended up in the emergency room needing a breathing treatment to relieve the bronchial symptoms that were making it so difficult to breathe and I just may have brought home a virus for Bear who soon started running a high fever. We were both run down from lack of sleep.  Of course, Bear was already in recuperative mode, but we proved to me how very important sleep is.

When I was first diagnosed with Chronic Kidney Disease almost six years ago, the value of exercise was brought home again and again by my nephrologist.  Until I researched for What Is It And How Did I Get It? Early Stage Chronic Kidney Disease, I wasn’t clear about why this was important.  This is what I discovered:

I knew exercise was important to control my weight.  It would also improve my blood pressure and lower my cholesterol and triglyceride levels. The greater your triglycerides, the greater the risk of increasing your creatinine.  There were other benefits, too, although you didn’t have to have CKD to enjoy them: better sleep, and improved muscle function and strength. But, as with everything else you do that might impinge upon your health, check with your doctor before you start exercising.

I researched, researched and researched again.  Each explanation of what exercise does for the body was more complicated than the last one I read.  Keeping it simple, basically, there’s a compound released by voluntary muscle contraction.  It tells the body to repair itself and grow stronger. The idea is to start exercising slowly and then intensity your activity.

Okay, so we know during that 66 days to form a habit, seven to eight hours a night of sleep is one of the habits we should be forming and half an hour of exercise daily is another.  Might as well throw in following the renal diet and avoiding stress as two other habits to get into.  However, considering how long this blog is already, those are topics for another blog.  Who knows?  Maybe even next week’s blog.

Amazon is offering the book in many different countries as well as ours.  It’s also offering the Kindle MatchBook in each of these countries.  Remember?  That’s the program that allows you to buy the digital edition at a 70% discount if you’ve EVER bought a print copy of the book from them.  Why mention it yet again?  It just occurred to me that you can gift the newly diagnosed, their friends and/or family in many different countries! And for those who asked, yes, the book is available on B&N.com, but their digital reader is The Nook, not the Kindle, so there’s no MatchBook discount program on this site.

May you have a Merry Christmas and a Happy Kwanzaa if those are the holidays you celebrate.  Oh my!  Just one more 2013 blog. I think I’ll go back to the earliest ones from this year to see how varied they are.  I’ll bet there’s more than one about the health benefits of coffee.

By the way, there has been some controversy about the authorship of the poem from which I played upon for the title of this blog, but I’m more than willing to accept Clement Moore as the author of “ ‘Twas The Night Before Christmas.”

Until next year,

Keep living your life!

Whatever Happened To Integrity?

I have been thinking a lot about integrity – or the lack thereof – in today’s society.  I run into it constantly.

Bear spent part of his morning grumbling about it in his shop.  His machinery is well kept and maintained.  However, one of the machines is out of calibration for no apparent reason.  I didn’t understand it all, but it seems to be related to the shoddy way it was made.

I ran into a professional situation that reeks of lack of integrity.  We all know there are procedures to be followed in any job. In this situation, the people involved not only acted as if those procedures didn’t exist, they also caused great discomfort to others who were not part of the situation.

Then there are the people who are always telling you what they are going to do for you… and don’t.  Why bother?  If you’re not going to do it, why say you are?

Since this is a blog about chronic kidney disease, you’re probably asking yourself, “Okay, so what does this have to do with me?” You, or someone you know and love, just might be out of integrity with themselves about taking care of their ckd and keeping that GFR on the rise.   

For example, both my nephrologist and my primary care doctor have been telling me for months that my A1c is too high. That’s the blood test that lets you know how your body is handling glucose over a three month period.  I politely nodded and said I’d work on it.

But I didn’t.  I was out of integrity with myself and, if I didn’t get right with myself, I was in for trouble in the form of diabetes. We all know how the combination of ckd and diabetes heightens your chances for some kind of cardiovascular event.

This time, I immediately transformed by ceasing to eat any sweets and cutting down my daily carbohydrate intake to between four and six units a day.  Think of a unit as a slice of bread or 1/3 cup of spaghetti.

Easy enough for her, you say?  Not so!  What I haven’t told you yet is that Bear has an incredible sweet tooth.  While he offered not to bring sweets into the house, I didn’t think that was fair.  He lives here too, and he doesn’t have chronic kidney disease.

The transforming part is that I don’t crave his sweets, even if he’s eating them right in front of me. I don’t think I’ve ever been like this before.

My downfall is usually the carbohydrates (I am the grand-daughter of a miller, you know!).  I have not gone over my limit once since I decided to become in integrity with myself. I’ve thought about it and decided it’s just not worth it. By the way, I got a little reward for this transformation: my weight dropped immediately and continues to drop.

Maybe it’s exercise for you.  Are you telling yourself that you’ll exercise tomorrow?  To borrow a line from Arthur Miller’s Waiting for Lefty  (which I was in a long, long time ago), “Tomorrow never comes for you.”  Is there some guilt in not doing what you need to for your health?  We don’t just need exercise because we’re human, we especially need exercise because we have chronic kidney disease.

Ah, maybe you’re one of those people who tell yourself you’ll get a good night’s sleep tomorrow night, or after you finish that good book, or another project.  Doesn’t work that way, folks.  You can’t make up for sleep you missed and we, as those who have ckd, need that sleep.

Or stress?  How about stress? I just gave my notice at a job I took because I loved it.  Thank goodness, I didn’t need the money, but I wasn’t ready to retire from this field yet.  The last month or so has been so stressful that even I noticed the black rings under my eyes and my inability to remember things clearly enough.

I had to make this right with myself.  Once I ascertained that another person could slip right into my place and made arrangements to give her the material she needed, I resigned.  Yes, I loved that job but my health is more important.  My supervisor is a person of integrity and completely understood the reasons for my resignation.

It may seem that I am making myself out to be a paragon of integrity, but all I’m really doing is providing you with examples from my life of how you can be in integrity with yourself in dealing with your chronic kidney disease.

On the book front, I remember writing that I had almost recouped the initial outlay to print the book but I forgot something.  This something came to my attention as I prepared my taxes.  I have donated over $1000 worth of books last year alone to doctors’ offices, clinics, nephrology associations, and kidney organizations.

Bear and I are marrying on April 6^th of this year. Yay us! I’m going to ask each of you for a wedding present.  Buy a book and give it to someone you know can use the information in it or donate it to an organization that needs it. Digital copies are available on both Amazon.com and B&N.com.  Print copies are available on Amazon.com or via an email to me at myckdexperience.com.

What a day!  It’s almost 11 p.m. and the blog is still not finished.

Until next week,

Keep living your life!

 

The Coffee Blog

Last week’s blog discussed different kinds of drinks.  I mentioned that coffee is my favorite.  Since I’m still recovering from the second cataract surgery and we all know how good it feels to be self-indulgent when you’re recovering, this week’s blog is all about coffee.  I won’t be repeating what I included in last week’s blog, but there is quite a bit of medical information about coffee available.  Let me just pour myself a cup and I’ll tell you….

We’re smiling because we’ve just had COFFEE.

Really? Drinking Coffee Lowers Colon Cancer Risk

Over the years, most studies of the subject have been either small or plagued by methodological flaws. But recently a team of researchers at the National Cancer Institute followed half a million Americans over 15 years. The researchers looked in detail at their diets, habits and health, and found that people who drank four or more cups of coffee a day — regular or decaf — had a 15 percent lower risk of colon cancer compared with coffee abstainers. While the researchers could not prove cause and effect, they did find that the link was dose-responsive: Greater coffee consumption was correlated with a lower colon cancer risk. The effect held even after they adjusted their findings for factors like exercise, family history of cancer, body weight, and alcohol and cigarette use.

The address for this article is: http://well.blogs.nytimes.com/2012/07/02/really-drinking-coffee-lowers-colon-cancer-risk/?partner=rss&emc=rss

And to answer your question about what colon cancer has to do with chronic kidney disease, you have to remember you are medically compromised already. Cancer is a disease caused by inflammation, just as chronic kidney disease  is.  By the way, it’s said that alkaline foods are a better way of eating should  cancer rear its ugly head in your life.

But that’s not all  drinking coffee can do for you:

Coffee Drinking Linked to Lower Death Risk

Older adults who drank coffee—caffeinated or decaffeinated—had a lower risk of death overall than others who did not, according a study by researchers from the National Cancer Institute and AARP. Coffee drinkers were less likely to die from heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections.

You can find this information at http://blog.rwjf.org/publichealth/2012/05/17/public-health-news-roundup-may-17-2/

I am an older (thank you for that ‘er’) adult. I absolutely love coffee. I also have chronic kidney disease which may lead me down the primrose path to diabetes.  Perhaps I can prevent that?  Too bad I’m restricted to two cups a day.

This one can get a bit technical so I’ve copied the most easily understood part of it:

Coffee consumption inversely associated with risk of most common form of skin cancer

PHILADELPHIA — Increasing the number of cups of caffeinated coffee you drink could lower your risk of developing the most common form of skin cancer, basal cell carcinoma, according to a study published in Cancer Research, a journal of the American Association for Cancer Research.

“Our data indicate that the more caffeinated coffee you consume, the lower your risk of developing basal cell carcinoma,” said Jiali Han, Ph.D., associate professor at Brigham and Women’s Hospital, Harvard Medical School in Boston and Harvard School of Public Health.

You can find the whole article at http://www.eurekalert.org/pub_releases/2012-07/aafc-cci062612.php

So coffee – formerly universally maligned by the medical community – now can help prevent colon and skin cancer and prolong your life.  I’m liking this very much, but we’re not done, folks.  I’m grinding (love being punny) the sources out right now.

 I am in heaven!  Look what I found at http://www.everydayhealth.com/diet-nutrition/0310/9-healthy-reasons-to-drink-coffee.aspx?xid=tw_weightloss_20120123_coffee (You’ll probably understand my over the top joy if you remember I’ve had both a root canal and a crown replacement so the dentist could reach the cavity underneath the crown  this summer.  Both were so expensive that, even with insurance, I’ll be paying them off well into the new year.)

9 Healthy Reasons to Indulge Your Coffee Cravings

 Coffee gets a bad rap, but study after study shows your java habit is actually good for you. From a lower stroke risk to fewer cavities, here are the best reasons to enjoy a cup or two.

“Coffee is incredibly rich in antioxidants, which are responsible for many of its health benefits,” says Joy Bauer, RD, nutrition and health expert for Everyday Health and The Today Show. Its caffeine content may also play a protective role in some health conditions, but many of coffee’s health perks hold up whether you go for decaf or regular.

According to this article, coffee can help avoid diabetes, skin cancer, stress, cavities, Parkinson’s disease, breast cancer, heart disease, and head and neck cancers.

Parkinson’s disease runs in the family, too.  That’s another reason I’m so happy to have found this article.

One of the most romantic acts my sweet Bear performs is bringing me a cup of coffee to wake me up each day.  Sharing that time as we drink our coffee in bed cements the connection between us.  Could be I’m mixing up coffee and love, but there does seem to be some kind of interaction there.

My neighbor Amy – one of the busiest people I know – makes time to come over for a cup of coffee whenever she can.  She gets an hour’s break from her three kids and household duties or gets to de-stress from her work day and I get the pleasure of her company and hearing what’s going on in her life.

There’s more to coffee than caffeine.

An aside: talk about over problem solving – I just happened to notice that I can link websites from wordpress, too.  I seem to be doing a lot of that over stuff as I get older!

Until next week,

Keep living your life!