Friday, December 28, 2012

Heart-Healthy Diet for Dialysis Patients

http://www.davita.com/kidney-disease/diet-and-nutrition/diet-basics/heart-healthy-diet-for-dialysis-patients/e/8070#

Heart-Healthy Diet for Dialysis Patients

Provided by DaVita® Dietitians

It is a challenge to follow a heart-healthy and kidney dietwhen you're on dialysis, because many heart-healthy foods are high in potassium and phosphorus. For example, nuts, seeds and avocados are good sources of healthy fats, but are not recommended for people with chronic kidney disease (CKD). Your dietitian can help you make choices that are right for your diet prescription. DaVita dietitians created a grocery list full of heart- and kidney-friendly items. To start, you'll need to know which fats are good for you and which you should avoid.

Fats for heart health: What to choose and what to avoid

Keep your heart healthy by choosing good fats such as monounsaturated fats, polyunsaturated fats and omega-3 fatty acids. Choose foods low in saturated fats and trans-fatty acids.

Choose monounsaturated fats: These are good fats that help lower bad cholesterol in our bodies. Good sources are canola oil, olive oil and peanut oil.

Choose polyunsaturated fats: These also help lower bad cholesterol and are similar to monounsaturated fats because they are plant-based and liquid at room temperature. Good sources include safflower, sunflower and soybean oils.

Choose omega-3 fatty: These fatty acids have been shown to lower the risk of heart disease. Good sources are fish such as salmon, tuna, herring, rainbow trout and mackerel.

Limit saturated fats: These generally come from animal products and are solid or waxy at room temperature. Limit chicken skin, high-fat cuts of meat, fried and fast food, cheese, butter, whole milk, ice cream and coconut oil, and palm and palm kernel oils found in processed and baked foods.

Avoid trans-fats: This unhealthy "hidden" saturated fat is found in many processed foods such as stick margarine, vegetable shortening, whipped toppings and commercially-baked cookies, cakes and crackers. Look for trans-fat listed on the nutrition label of all packaged foods.

Heart-healthy grocery list for dialysis patients

Stock a heart- and kidney-friendly kitchen with these recommended items from DaVita dietitians.

Dairy and dairy alternatives

1% or non-fat cottage cheese1% or non-fat milk (limit dairy to 1/2 cup per day)

1% or non-fat milk (limit dairy to 1/2 cup per day)

Italian ice and sorbet

Light or non-fat sour cream

Low-fat or non-fat cream cheese

Low-fat soymilk (unenriched)

Local or regional milk alternatives may be available (check with your dietitian)

Non-fat, non-dairy creamer (avoid those with phosphate additives)

Rice milk, unfortified

 

Fruits and vegetables

Tip: Refer to the "Potassium and Chronic Kidney Disease"article for list of potassium-appropriate fruits and vegetables. Also, prepare without butter, lard, bacon fat, margarine or fatback.

Apples

Apricots (limit 2)

Broccoli

Carrots

Green beans

Strawberries (limit 5)

Meats and eggs

Chicken without the skin: baked, grilled or broiled, not fried

Fresh and saltwater seafood (avoid the bones which may be in sardines and canned salmon)

Lean cuts of beef/veal (tenderloin, eye/top/bottom round)

Lean ground beef, chicken or turkey (choose at least 90% lean)

Lean pork (pork tenderloin, loin roast, sirloin/loin chops)

Turkey without the skin, turkey breast and tenders

Wild game (venison, dove, quail, pheasant, rabbit, squirrel, goat and frog)

Whole eggs, egg whites, Eggsland's Best Eggs® and egg substitutes such as Egg Beaters®

Starches

Cream of Wheat or Rice®, Malt-o-Meal® and grits (not instant)

Corn Flakes®, Corn or Rice Chex® and Rice Krispies®

Flour tortillas

Oatmeal (contains phosphorus, so check with your dietitian)

Pasta, noodles, macaroni, rice, couscous and potatoes (leeched or double-boiled)

White bread, bagels, English muffins, hamburger or hot dog buns, dinner rolls, hard rolls and pita bread

Approved fats

Cholesterol-lowering margarines such as Benecol® or Take Control®

Oils (corn, safflower, soybean, sunflower, canola, olive and peanut)

Reduced or fat-free mayonnaise, salad dressing and sour cream, and gravy made from skimmed broth

Tub, squeeze, or spray margarine (no stick margarine or butter)

Snacks and desserts

Balance® high-protein bars and Quaker Q-smart® snack bars

Italian ice, sorbet, Popsicles® and frozen fruit bars

Low-fat cookies and cakes such as angel food cake

Low-fat microwave or air-popped corn

Rice or popcorn cakes

Unsalted pretzels and crackers

Beverages

Clear sodas (Sprite® and 7-Up®), orange soda and ginger ale

Crystal Light® (avoid products with added calcium or phosphorus)

Cranberry, grape or apple juice, or homemade lemonade (avoid those with calcium, potassium or phosphate additives)

Regular or decaf coffee or tea


UPDATE. 12/28/2012

Went Crestwood Hospital for a one hour FISTULOGRAM, Tuesday, December 11, 2012.
While doc was ballooning my fistula, he punctured artery.
My hand hurt really bad. Had emergency surgery.
My potassium rose to 6.3.
Was given 1 quart of blood.
The next morning a catheter was inserted.
Had my first dialysis that afternoon.
I was so weak.
Was given 2 quarts of blood.
Released from hospital Thursday night.
Had my first in center dialysis 6am Friday (FMC NANC), December 14, 2012.
Mon, Wed, Fri, 6am is my schedule.
Saw David (CRNP @ Dr Smelser) one time last week.
Braided my hair all night, Wed, Dec 19th.
My arms are so sore, especially in shoulders.
Met the nurse, dietician, social worker, finance person, building supervisor, etc. this week.
Real weak after dialysis.
Vomited after dialysis, Sunday, December 23, 2012.
Have not returned to work since Tues, Dec 11th.
Very hard to sit-up.
I drove my truck for the fist time since Dec 11th, Christmas Day.
My legs were so weak and I barely was moving.
Drove my truck again yesterday by myself to Dr. Phillips office.
It was a long walk from garage to his office, but I made it.
Don't believe I eat enough protein. May have to get powder.

Spoke to Susan on yesterday.
Hopefully I can start home dialysis on January 7th.
She will get back with me if that date is ok.

All for now. :-).

Sent from my iPad
Janice M. Isbell (ABD)

Friday, December 7, 2012

UPDATE 12-07-12

OK.  Much to share. 
First, I got a call Wednesday from the Home Hemo Nurse stating that she can give me dialysis at her center until she can train me to do it at home.  Good in that I will start the journey to feeling better.  Second I had to go to vascula surgeon to ensure the fistula I got in 2009 is usable.  Well now I have to go to Crestwood Hospital next Tuesday at noon for a fistulagram.  Am pretty tired today.  Hopefully I will feel much better soon.  I am so cold in this office, with the heater on.  Hopefully I will no tbe sensitive to cold once dialysis starts.  Looking forward to meeting with the dietician to get some help on a menu for myself. 
 
I applied for and got a leave of absence from school.  I have spent so much money for the past three courses and accomplished NOTHING.  I am unable to focus or study.  Just aweful is how I feel.  Time and money gone.  But I will not cry over spilled milk.  Will use this leave of absence to get myself feeling better.

Wednesday, December 5, 2012

NXSTAGE DIALYZER (12-5-12)

I met with the home hemo nurse on Monday.
It was an anxious time for me waiting for her to arrive at my house.
But the nurse was nice and offered many explanations.
Susan works for Fresenius Medical Care.
She explain that the hemo dialysis I would do at home is with the NxStage System One.
I showed her the space in my bedroom that I will use to house the System One and the PureFlow dialysate preparation system.
The bedroom space is juston the other side of the wall from the washing machine and dryer.
I can make a hole into the wall to put the drain tube in the drain for the water and connect the water tube to the water line.
No major plumbing required.  THANK YOU JESUS!
I posed the option of having my husband, mom, son, and daughter in law trained as my partner.
Susan will check and determine if we must come tothe center or I can be trained at home.
She said I would meet with the doctor, nurse, dietician, and social worker once a month.
She noted I would not have to pay for the equipment.  That was a major stress taken off me.
I guess I have delayed so long in fear of bankrupting my family.
I am so glad their is help, financially and support from the staff.
Hopefully I wil be able to come off some of my medications.
The literature summarizes the benefits of daily, more frequent dialysis:
  • Less stress on the heart
  • Better blood pressure control with fewer medications
  • Much quicker recovery time after treatment
  • Improved appetitie and the ability to drink more
  • Fewer depressive symptoms
  • Better mental and physical health
  • More energy and viatality
  • Felling of being in control of treatment and life
  • Lower risk of death
  • Ability to travel
 Most patients dialyze 5 days per week taking off Wednesday and a week end day.
I am looking forward to trying this method.
I must first contact the vascular surgeon and determine if my fiscula is working correctly.
 
ALL FOR NOW!
 
 
 

Friday, November 30, 2012

The buttonhole technique, or constant-site cannulation

Found the following on DaVita.com
Dear Annie,

Can you explain the buttonhole technique?

Connie

Dear Connie,

The
buttonhole technique, or constant-site cannulation, is a way for care partners or patients to cannulate an arteriovenous (AV) fistula by inserting a dialysis needle into the same spot for each dialysis treatment, with little or no pain. A fistula is cannulated in exactly the same location for 6-8 treatments until a tract (think of an earring hole) is developed. Once this tract is established, a blunt needle is used for cannulation thereby decreasing the need for sharp needles. When cannulating buttonholes, great care must be taken to protect against infections, as micro-organisms can be easily carried through the tract into the patient's bloodstream.

Annie

Monday, November 26, 2012

Symptoms of Parathyroid Disease (Hyperparathyroidism)

DEFINITELY DID NOT KNOW THIS INFORMATION ABOUT PARATHYROID DISEASE.
 
I have parathyroid disease.  Have been taking Zemplar to control it.  It's amazing how many of the sysmptoms I have.
This article said I can have a 20 minutes surgery to remove the tumor on my thyroid, but Nephrologist said why go through another surgery.
I am really considering this surgery.  If I forget to take the meds, all hell breaks out.  I am dizzy, light-headed, exhausted, etc.
If I can stop taking this med with a small surgery, why not?  Believe the risk is that the parathyroid is very close to the vocal cords.
HHHMMM, lots to consider!!!!!
 
 
 
Symptoms of Parathyroid Disease (Hyperparathyroidism)
bullet Loss of energy. Don't feel like doing much. Tired all the time. Chronic fatigue.
bullet Just don't feel well; don't quite feel normal. Hard to explain but just feel kind of bad.
bullet Feel old. Don't have the interest in things that you used to.
bullet Can't concentrate, or can't keep your concentration like in the past.
bullet Depression.
bullet Osteoporosis and Osteopenia.
bullet Bones hurt; typically it's bones in the legs and arms but can be most bones.
bullet Don't sleep like you used to. Wake up in middle of night. Trouble getting to sleep.
bullet Tired during the day and frequently feel like you want a nap (but naps don't help).
bullet Spouse claims you are more irritable and harder to get along with (cranky, bitchy).
bullet Forget simple things that you used to remember very easily (worsening memory).
bullet Gastric acid reflux; heartburn; GERD.
bullet Decrease in sex drive.
bullet Thinning hair (predominately in middle aged females on the front part of the scalp).
bullet Kidney Stones (and eventually kidney failure).
bullet High Blood Pressure (sometimes mild, sometimes quite severe; up and down a lot).
bullet Recurrent Headaches (usually patients under the age of 40).
bullet Heart Palpitations (arrhythmias). Typically atrial arrhythmias.
bullet Atrial Fibrillation (rapid heart rate, often requiring blood thinners and pacemakers).
bullet High liver function tests (liver blood tests).
Most people with hyperparathyroidism will have 5 - 6 of these symptoms. Some will have lots of them. A few people will say they don't have any... but after an operation they will often say otherwise. 95% of people with hyperparathyroidism will have 4 or more of these symptoms. In general, the longer you have hyperparathyroidism, the more symptoms you will develop.

FEELING MUCH BETTER, BUT (you know there is always a but!)

I am feeling much better since going through the flu, pruritis (itching due to end stage kidney failure), forgetting to get my EPO shot, etc.
I have gone 1 month without the EPO shot and yes I am more tired than ever.  :-&lt sigh But overall I feel fine.
I have not been as focused as I should on losing 15 pounds.  :( sad  But I will kick things into gear.  Realize I have to force myself.
This weekend I forced myself to put up curtains in my bedroom.  I was pain-staking but I DID IT!  =)) rolling on the floor
That one act is great to me because I have been lying around the house because I am too tired to do anything. 
I visited a friend (along my family) for Thanksgiving.  I stayed until 8 p.m.
This is a great feat because at the end of the day, I was sleepy but not exhausted.  :D big grin
About a month ago I would have been so exhausted that my legs hurt so bad.  Can't describe the feeling.
Would like to walk.  I love walking.  But the bursors in my hip hurt to bad. Plus, my calf muscles cramp.
Must hit the gym but I have procrastinated and not gotten up from my desk except to use the bathroom, get water/lunch/snack forom vending room, and rarely I vist coworkers to see how they are doing.  Otherwise I am at my desk tooooo tired to move. 
Must do better.  Was told I would feel better after starting dialysis.  But actually I am not looking forward to dialysis.
Have asked for a kidney donation on Facebook from anyone with O blood type.  Still praying.  Family members are getting checked.
 
I HAVE LEARNED MORE ABOUT THIS ITCHING AND SENSATIONS I HAVE BEEN FEELING.  ?@_@? studying
The following webistes provided more information.

What Causes Pruritis in Renal Failure?  http://www.ehow.com/how-does_5731185_causes-pruritis-renal-failure_.html

Top 7 Tips to Relieve Itching Skin In Kidney Disease Fast  http://www.kidneycoach.com/367/kidneys-itching-top-7-tips-to-relieve-itching-skin-in-kidney-disease-fast/

Kidney Disease Itching   http://www.wellsphere.com/wellpage/kidney-disease-itching

Renal itch.   http://www.ncbi.nlm.nih.gov/pubmed/10733630

There are many more sites with information about this itching sensation.  I was pretty unbreable last week.  It interrupted my sleep.
I hypothesize I ate too many biscuits (too much phospherus)?????
I was eating a biscuit and OJ in the mornings on the way to work.
Sometimes (a lot) I forget to eat a TUMS (phospherus blocker) with meals.  Defintely working on this.  Must ge tthis diet thing down.  :-&lt sigh
 
Well all for now.  10:47 a.m.
 
Janice
Keep on Keeping On!
 
 
 
 
 

Friday, November 16, 2012

When to start dialysis %u2014 Home Dialysis Central

I was visiting Home Dialysis Central, and found some information I thought you might be interested in. You can read it here: http://homedialysis.org/article/life_at_home/when_to_start_dialysis


Sent from my iPad

Wednesday, November 14, 2012

Today is a hard day. 10/17/12

Lots of spasms in my spinal cord.
I am in day 5 of the FLU!
So weak. Muscles aches really bad.
I threw up at work yesterday after being there 2 hours.
Had to go home.
Feet are burning. As usual, ears are ringing.

Friday, October 12, 2012

Cool this morning

Right knee hurting.
Up TIL 1230 with mom at ER. All OK.
THROAT IS KILLING ME.
Sinuses draining in throat.
Season of high pollen.
Up late again. On way to work.

JMI

Wednesday, October 3, 2012

ANGER BE GONE!

ANGER BE GONE!
1.  Face in Pillow.
2.  Scream it Out.  SCREAM! U MUST LET GO!
3.  Cold water on Face.  Dry Face.
4.  Write your plan for the day.
5.  EXECUTE!
6.  Repeat daily until you only need STEPS 4 & 5.
ANGER BE GONE! 

@jmitutor (c) 2012

Tuesday, October 2, 2012

CHEAP BLUE CROSS BLUE SHIELD

This post is against CHEAP BLUE CROSS BLUE SHIELD. OK, here's the problem. I've had chronic kidney disease since 1989 due to Systemic Lupus Erythematosus! A few years ago I started taking Epo shots for my kidneys because the kidney function is low (now @ 12%). At first if my hemoglobin (Hgb) was under 11, I received a shot. I have always paid ~$30 per shot every two weeks. I'm anemic. Then CHEAP BCBS would only pay their portion if my Hgb was below 10. THEN CHEAP BCBS changed their rules to say they'll only pay their portion if my Hgb is below 9. I go to the doctor today and was told that CHEAP BCBS may be lowering the number again. In the mean time I'm dragging to get out of the bed in the morning, striving thru the day, and running to the bed at night. SUCKS! I put money in a flexible spending account to cover the extra medical costs (co pays etc).
  • I always put monies in a flexible spending account. This year I put $5000. It was spent by August. Now stupid Congress has lowered the max amount to $2500. If that's not enuf, was refused by UAB to put me on their kidney transplant list because I had colon cancer surgery in 2009. Said to call again in 2015. So last week I went to UAB to get on their transplant list. They are meeting Wednesday. So pray Saints, have a lot on my mind. But I am even more saddened for those who do not have insurance to complain about.
  • Then UAB frankly tells you it's a LONG process unless you get a live donor OR apply to many Kidney transplant lists with shorter waiting times. The pharmacist said the meds can run up to ~$1200 / month, and that's WITH insurance. So you know I have to start stockpiling me some cash.


 

Monday, July 30, 2012

WELL I MUST BE BETTER...

07-25-2012

The rash on my arms and hands are gone.

Wonder if they were due to stress.  I thought it was the dishwashing liquid, but still using the same.

Had a great manipulation at the chiropractor today.

Back feeling much better.

The 2012 Bean Family Reunion was GREAT!

The family came in and helped without anyone asking - THANK U JESUS!!!!!

GOD SHOULD UP AND SHOWED OUT.

 

07-26-2012

Receive my letter from Vanderbilt rejecting my request to be on the list for a kidney transplant.

Must wait 5 years from date of my colon cancer surgery.

Therefore will consider my request after December 2014.

SAD - SAD - SAD - BUT MOVING RIGHT ALONG!

Had to get an Epo shot today.  Count was 9.5.  It was 9.7 the last time.

Received 4,000 units instead of the 2,000 I received the last time. :-*

 

 07-30-2012

 

I AM 56 YEARS OLD - TODAY!!!



 

 

Monday, July 9, 2012

THIS WEEKEND WAS A SLUGGISH ONE!

I went to church with my son and his family on Saturday.  My mom also attended.  It was indeed a blessed time.  All went out to eat, but I was so tired and weak I did not believe I would make it to the truck.  BUT GOD, saw fit to help me.  I was in bed for the rest of the day and on Sunday.  Just could not move. My chest was killing me.  Will I broke down and ordered some Prilosec from CVS paharmacy.  Maybe it IS GERD.  Will check.  Wasn't the last time.  Now I have a pain in my back just below my left sholder blade.  U know I am tired when I pass up opportunities to tutor.  Will tutor today at noon at the Post Library.  Give me strength Lord.  Getting excited and happy about family reunion.

 

 


 

Friday, July 6, 2012

FEELING MUCH BETTER TODAY 07-06-2012

Did not experience a stomach ache today.  Still itred as heck but moving right along, albeit slowly.  Watch the Wimbledom men's tennis match today.  Great to focus on something else.  Did take a look at my homework.  Did a little update to my package.  LOTS to do before the reunion, still no word on the mortgage.  The underswriters do not believe in GOOD CUSTOMER SERVICE.  But thank you God for the hope of buying a new home.  Lots of land to relax on.  Just what I need. 

TODAY IS A BAD DAY - must write to get relief. JULY 2, 2012

I AM SO WEAK AND LIGHT-HEADED!  I am very tired and had stomach problems this morning. This seems to be a daily routine.  Maybe it is time for me to start dialysis.  But I am questioning why I am anemic.  The last  time it was colon cancer.  Don't want to start dialysis and find that the true cause of my anemia is not my kidneys.  This is a big decision and I am not going to make it casually.  But I know I also must recognize that if it is my kidneys I will become too sick and will have dialysis imposed on me instead of me "choosing" to dialyze

Have some anxiety about a few things: 

(A) buying a new home and today is the closing day and my mortgage company has not finished putting all the financial papers into place, disappointed but know God will make it happen,

(B) planning a family reunion on the property.  Need time to clear and clean the land. 

(C) mom lives with us now, really trying to get her to be more independent and get out of the house so she wont be depressed while we're at work.

(D) can't "think" to complete a simple assignment in the PHD program - God give me relief,

(E) must complete writing up awards on the job,

(F) son and family moving in our house until theirs is complete.  Not sure if mom welcomes them.  That bothers me and maybe I should question her to ensure that I am not interpreting her actions and attitude.  Also would like them to move with us to the new home and mom definitely is against their moving in with us. but I know Rodney (my nephew) wants to be in the house alone, not share with my son and his family.  this bothers me that my mom and nephew are being unreasonable about a house I struggled to pay off, and the one I am trying to get. and

(G) what am I going to do with the school (JMIA)? 

Just a few of the things on my mind.  Cannot sleep.  have been struggling in the length and quality of the sleep I have had for the past couple of years.  I do know the family drama is getting to me, but I pray daily to the Lord to remove any negative thoughts.  I love my husband, son, daughter in law and grand-kids and would do anything for them but will not let others hurt them.  I have been very generous to my extended family and only ask for appreciation and respect for my decisions. 
My toe nails are filled with fungus.  Must brain storm solutions and choose the best.  Need to lose a minimum of 40 pounds.  So, I guess I just need to develop a list and do ONE THING AT A TIME until I get my health back to a point of me functioning well.

Friday, June 8, 2012

EXTREME EXHAUSTION

 

Visited oncologist.  Learn I have a kidney stone. Also have cardiac effusion. Meeting with cardiologist on Monday.  Too much controls my strength. MOST OF IT MY FAULT!  Missed Zemplar Dose, Missed Vivelle Dot Dose, Not drinking enough water, Not getting enough rest, etc.

 

But now I am wondering where did the excess fluid around my heart come from?  Maybe that's why I am so tired.  I wonder if the Lupus is the cause and is attacking the lining of the heart sack.  Wonder if the fact that I fell at home and smashed my face on the floor is the trauma that caused the buildup of excess fluid.  Wonder if the manipulation at the chiropractor caused this buildup of excess fluid in the heart sack.

 

ALL OF THE ABOVE CAN BE FALSE.  I just need to wait until Monday when I see the doctor.  YEAH THAT'S RIGHT!

No Excuse - A Philosophy for SUCCESS!
Mrs. Janice Mitchell Isbell, A.B.D.
http//:www.janiceisbell.com

Tuesday, May 15, 2012

EXHAUSTED!

I have been spent, tired, don't want to get out of the bed.

My body is so tired.  But hesitant about dialysis.

Know will feel better  with dialysis.

 

The meds are hurting my stomach even when I eat something before taking.

My left hip is bothering more than ever.

My spine hurt in the midsection of my back.  NOW WHAT IS THAT?!

INFO LEARNED:  Kidney Disease & Vitamin D Deficiency  http://www.livestrong.com/article/255681-kidney-disease-vitamin-d-deficiency/

 

Vitamin D deficiency is a common problem among those with chronic kidney disease. Vitamin D is a mineral that is found in plant and animal sources, dietary supplements, as well as synthesized from exposure of your skin to sunlight. Low levels of vitamin D can cause weak bones, muscle spasms, fractures and may even increase your risk of death if you have chronic kidney disease. Fortunately, this condition can be treated with a vitamin D supplement prescribed by your doctor.


I am now taking 1 vitamin D tablet once each week (1.25 MG / 50,000 UNIT).  Prescribed by rheumatologist.  Received prescription in the mail.
 
I have experience SEVERE LEGS & FEET CRAMPS.  Dink lots of water to relieve.  Helps sometimes.
 
Going to nephrologist this afternoon for more blood tests.

Friday, May 11, 2012

FOUND A NEW WEBSITE WITH LOTS OF INFO. http://www.fistulafirst.org/Home.aspx

The Fistula First Breakthrough Initiative is dedicated to improving care for people with chronic kidney disease by increasing AV fistula placement and use in suitable hemodialysis patients.

National AV Fistula Rate Reaches 60.4% in February 2012

 

 

 

I have been having pain in my arm that has the fistula.  I was reading one of the forums @ davita.com and learned of some of the probable reasons for the pain and a site with more information.

 

The LPN said "More than likely, from my experience, the most logical to me, the pain could be caused by stenosis (narrowing of the vessel). The narrowing could be literally anywhere on the side of the AVF. I've had my patients tell me their shoulder hurts, nowhere near the access, and i've sent to them for a fistulagram and there's been a blockage or stenosis in the vessels closer to the shoulder and chest. Believe it or not this can cause pain not only in your shoulder on access side but in or around the access as well. The easiest way to detect stenosis can actually be done by you. Ask your unit for a cheap stethoscope so you can listen to your access at home and before you go to treatment. If there's stenosis in your access, you will hear a high pitched sound. Normal sound will be like a washing machine. You can listen to it here for both fistula and graft. just scroll to the bottom for the audio clip links.

http://www.fistulafirst.org/Healthca...eConcept9.aspx

another reason could be, "steal syndrome" or "blood robbing" which is where blood is being "stolen" from the rest of the arm because of "collaterals" that are forming. Collaterals are extra vessels forming from the access which in turn steals blood from the access which in turn, blood does not distribute throughout the arm like it should. Think of your fistula as a main road/highway, all the little side streets, turn off and exits would be the collaterals that were formed from that major highway/road "

 

I WAS SO GLAD TO LEARN THA TTHE PAIN WAS REAL & NOT IN MY HEAD!

Who likes t o complain - I DO NOT!

 

But the surgeon did acknowledge that the vein was narrowing.  I had a fistualogram on Monday, May 7th.  Was still sick on Tuesday, so nausious.  But much better now.  I am a little sore from the surgeon ballooning my fistual but am glad that things will get better.

 

THANK U LORD!

Thursday, May 10, 2012

Vitamin D and CKD EasyLink Access #: 460 By Nadiya Lakhani, RD, LD http://www.kidneytimes.com/article_print.php?id=20091006131150



 


Vitamin D and CKD 
EasyLink Access #: 460

By Nadiya Lakhani, RD, LD
 
It's seems that everyone is talking about vitamin D and for a good reason. Long winter months indoors and use of heavy sunscreen are some of the reasons that keep our bodies from absorbing the UV rays necessary to make healthy amounts of vitamin D leading to vitamin D deficiency. But for people with chronic kidney disease, it's not just an issue of vitamin D deficiency but a deficiency in active vitamin D as well.
 
Where Does Vitamin D come from and what does it do?
Vitamin D is naturally found in food and is made in the body with the help of sunlight. In addition to sun, foods (fish, egg yolks, and milk) and dietary supplements are other sources of vitamin D. However to work in the body, vitamin D must be activated by the kidneys. It first goes through the liver and then the final stage of activation is completed by the kidneys. Next, this active vitamin D hormone works as a messenger telling the kidneys, bones, and intestines to balance calcium and phosphorus in the blood. Keeping calcium and phosphorus at the right balance is important to keep bones healthy and strong and to keep nerves and muscles working properly. When there is not enough active Vitamin D, the calcium in the body is not absorbed appropriately and bones get weak and brittle.
 
What is Parathyroid Hormone (PTH)?
PTH is another messenger needed for calcium and phosphorus balance. PTH is released by the parathyroid glands when 1) active vitamin D levels are too low or 2) when calcium levels are too low or 3) when phosphorus levels are too high. These glands continue releasing PTH until these levels are normal. PTH works by telling the kidneys to filter out extra phosphorus and to activate vitamin D. PTH also works on the bones to add calcium into the blood.
 
What Happens in Chronic Kidney Disease (CKD)?
As kidney function declines, the kidneys don't respond to PTH and they are less able to balance calcium and phosphorus or activate vitamin D. Low calcium, high phosphorus, and low active vitamin D levels trigger the parathyroid gland to work "overtime" and continue releasing PTH in the blood.
 
As the parathyroid gland continues to work overtime, this leads to too much PTH or a condition known as Secondary Hyperparathyroidism (SHPT). SHPT can be harmful to the body and if not treated early can lead to bone pain, nerve problems, itching, weak or brittle bones, calcium build up, and resistance to therapy. SHPT begins early in chronic kidney disease – well before dialysis is needed. So ask your physician about checking your PTH levels. Research shows that calcium and phosphorus levels are normal in CKD but this is only at the expense of PTH. PTH levels should be checked every three months and more frequently as kidney disease progresses.
 
How Should SHPT Be Managed?
During the early stages of CKD, the nephrologist may check Vitamin D levels, known as "25-hydroxy" as well as PTH levels and prescribe a vitamin D supplement, such as ergocalciferol or cholecalciferol. This is not active vitamin D. The body still needs to convert it to its active form in order to work properly. The nephrologist may then prescribe active vitamin D, such as Zemplar (Paricalcitol), Hectorol (doxercalciferol) or a branded generic known as Rocaltrol (calcitriol). These medications work to control the buildup of PTH. These are different from ergocalciferol or cholecalciferol (or from over the counter supplements you get at GNC) because they are not active and do not correct active vitamin D deficiency. Zemplar, Hectorol, and Rocaltrol all activate the vitamin D receptor but all have different side effects or impact on minerals such as calcium and phosphorus. Talk to your doctor about which one is best for you. 
 
In addition to following your treatment regime, it's also important to follow your diet and know your numbers. You play the most important role in managing your SHPT and preventing bone disease. If you are not yet on dialysis, ask your doctor about medical nutrition therapy or RD counseling. A Registered Dietitian (RD) can talk to you about ways to slow down the progression of kidney disease and manage your SHPT. 
 
About the Author
Nadiya Lakhani, works for Dallas Nephrology Associates as the Pre-Transplant dietitian along with seeing patients with CKD in office practice. Nadiya's background includes working as a Renal Dietitian for Fresenius Medical Care and as Clinical Dietition for various hospitals. She is also active within the renal community and serves as the Regional Representative for the National Kidney Foundation, Council for Renal Nutrition and American Dietetic Association, Renal Practice Group.
 
Last Updated October 2009
 


The information on KidneyTimes.com is provided for general information purposes only.
Always consult with your healthcare team before making any changes to your healthcare or nutrition regime.

KidneyTimes.com is a program of Renal Suppot Network.

For more information about RSN go to RSNhope.org.


Sent from my iPad

Tuesday, April 24, 2012

5 Diet Guidelines for Stage 5 CKD Non-Dialysis Patients

http://www.davita.com/education/article.cfm?educationMainFolder=diet-and-nutrition&category=lifestyle&articleTitle=5-diet-guidelines-for-stage-5-ckd-non-dialysis-patients&articleID=8121#

 

Disclaimer: This article is for informational purposes only and is not intended to be a substitute for medical advice or diagnosis from a physician.

 

A stage 5 chronic kidney disease (CKD) or end stage renal disease (ESRD) diagnosis means that your kidneys are working at less than 15 percent and can no longer clean your blood adequately. To prevent dangerous amounts of toxin buildup in your body, you'll need dialysis or a kidney transplant. These toxins include protein waste products, potassium, phosphorus, sodium and fluid. When waste accumulates in the bloodstream a condition called uremia occurs, causing symptoms such as:

  • poor appetite
  • nausea
  • vomiting
  • decreased taste and smell
  • a bad taste in the mouth
  • fatigue
  • difficulty sleeping
  • itching
  • restless legs

The diet for stage 5 CKD takes into consideration lab results, nutritional status, and plans for transplant, dialysis or no treatment. For most people in stage 5, eating becomes a challenge because of uremia. Preventing malnutrition is a top priority because people who are undernourished are at higher risk for hospitalization and even death before starting dialysis or undergoing surgery for a kidney transplant.

The following five diet guidelines can help you manage your nutrition and diet in stage 5 CKD prior to dialysis or transplant..............................................

 

GREAT INFO.  PLEASE GO TO WEBSITE AND READ THE TIPS!

INFO ABOUT ZEMPLAR

Articles
Paricalcitol Capsules
Brand names for this medication

Zemplar

What is this medicine?

PARICALCITOL (par i KAL si trole) is a man made form of vitamin D. It is used in patients with chronic renal failure. It helps your body keep the right amount of calcium and phosphorus for healthy bones and teeth.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of the following conditions:
• liver disease
• too much calcium, phosphorus, or vitamin D in your blood
• an unusual or allergic reaction to paricalcitol, vitamin D, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. You can take it with or without food. If it upsets your stomach, take it with food. Take your medicine at regular intervals. Do not take your medicine more often than directed.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.


What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following medications:
• vitamin D

This medicine may also interact with the following medications:
• certain antibiotics like clarithromycin, telithromycin
• certain medicines for seizures like phenobarbital
• digoxin
• diuretics
• grapefruit juice
• medicines for cholesterol like cholestyramine, colestipol
• medicines for fungal infections like ketoconazole and itraconazole
• medicines for HIV called protease inhibitors
• nefazodone
• mineral oil
• orlistat
• some antacids and vitamins

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. You will need to have important lab work done while you are taking this medicine.

You will need to be on a special diet while you are taking this medicine. Do not take any non-prescription medicines that have vitamin D, phosphorus, or magnesium including antacids, unless directed by your doctor. Take calcium only as directed. The extra supplements can cause side effects.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• bone, muscle pain
• breathing problems
• chest pain, irregular heartbeat
• fever, infection
• hallucinations
• increased need to urinate
• increased thirst
• numb, tingling pain
• unexpected weight loss
• unusual blood pressure
• unusually weak or tired

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
• constipation, diarrhea
• dry mouth
• headache
• loss of appetite
• metallic taste
• nausea, vomiting
• stomach upset
• trouble sleeping

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.



© 2010 Gold Standard. All rights reserved.
This site does not provide medical or any other health care advice, diagnosis or treatment. See more information and other important terms and notices.