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!