On our own initiative, Karen and I obtained a referral and made an appointment last week to see a nutritionist. I have not been ordered to begin a restrictive, "pro kidney" diet yet, but we figure I will at some point so I might as well get in the habit.
Besides, in order to have the permanent catheter needed for Peritoneal Dialysis inserted into my abdomen, I've been told by my nephrologist that I probably need to lose about 30 pounds of belly fat. (All my pants seem to agree.) Karen has lovingly decided to go on the diet with me, so I won't begrudge my lettuce while she's downing cheeseburgers.
We have tried to make better and wiser food choices to coddle my damaged kidneys, but Karen has found that the diet information she's researched on the Internet seems to be wildly contradictory from site to site. We decided to go to one professional source that we can actually look at and talk to, and abide by what the nutritionist says.
So we met with an effervescent wisp of a woman named Maryjean who asked me to come with a list of everything I'd eaten in the previous 24 hours, read it, then shook her head a lot. Obviously we'll need to eat less and exercise more if we intend to lose weight, but there's so much less to eat, too.
We received a list of foods that are naturally high in potassium, which is Kryptonite for kidneys, and generally should be avoided. That list includes:
Tomatoes
Tomato juice
Tomato paste
Spinach
Potatoes
Carrots (raw)
Baked beans
Squash
Potato Chips
Mushrooms (raw)
Artichokes
Lima beans
Broccoli
Melons (all kinds, including water!)
Peaches
Orange juice
Bananas
Raisins
Avocados
Brussel sprouts
Radishes
Peanut butter
Nuts
Scallops
Sardines
Cocoa
Hot chocolate
Dates
What's left, you ask? We asked, too. Maryjean smiled sweetly and talked about creative food alternatives, most of which sounded to me like eating wallpaper paste.
I don't think I'd mind so much having medical issues if I could at least eat what I wanted. The two best things I do in life are eat and sleep, and one of them is about to be severely compromised. I've said it before and I'll say it again: I foresee a steady diet of chicken – baked – and rice in my future.
Tuesday, October 13, 2009
Monday, October 12, 2009
Pill Popping
Back home after a jolly and fulfilling Homecoming weekend at my alma mater, Hope College, I'm putting away my rectangular lime-green traveling pill case until it's time to go wandering off somewhere again.
Karen gave me the plastic pillbox last Christmas as one of my stocking stuffer gifts. I laughed, but I also understood immediately the thoughtfulness behind her present. She knows I have to gulp a bunch of medications and supplements every day in my current condition, and being the extremely organized person she is (she's a FranklinCovey trainer, you know), she wanted to help me do so as efficiently as possible.
I can take them without water now. So adept have I become at swallowing pills that, except for the front-loaded morning dosage that can be as many as 11 pills at once, at the appointed times throughout the day I just pop 'em in my mouth like breath mints and let them slide down my throat. This is not a skill I wanted to become proficient in, but if practice makes perfect I should be nearly immaculate.
I've talked about my medications before but never in much detail, so I thought I'd like to introduce them to you.
Every day I take:
25 mg of carvedilol, a non-selective beta blocker to control my high blood pressure (thought to be the primary cause of my kidney distress), twice a day;
10 mg of prevastatin, to reduce my total and LDL cholesterol;
800 mg of renagel, used to reduce levels of phosphorus in people with kidney disease, at every meal;
100 mg of allopurinol, intended to decrease the levels of uric acid in my body and prevent a recurrence of searingly painful gout, twice a day;
160 mg of Exforge, also prescribed for treatment of high blood pressure;
25 mcg of Vitamin D, a supplement to replace the vitamin that healthy kidneys naturally produce to maintain proper phosphorus and calcium levels in the body;
one-half of a Centrum Silver multivitamin, as my kidney specialist was concerned about the potential effects of taking some vitamins at their full potency (it's bad enough that it's a Centrum "Silver," but then only half a pill? Boy, does that make you feel old!);
100 mg of Vitamin B-1, which I added on my own. I read somewhere that it could help in the treatment of kidney disease, and my doctors, while skeptical, admitted that it couldn't hurt.
In addition, every other day I also take:
0.6 mg of colchicine, also prescribed to prevent my gout from flaring up again, and
1 mcg of zemplar, (and I'm taking this off the Web site), "a synthetically manufactured...active form of Vitamin D indicated for the prevention and treatment of secondary hyperparathyroidism in chronic kidney disease."
It's quite an assortment. I don't know how AIDS patients feel, but I can empathize. If you didn't think or feel that you were sick, pouring a pile of pills into your hand every day certainly will serve as a reminder. When I travel for more than a few days, it takes me almost a half-hour to sort all my medications and supplements, recall the proper dosages and stick them in their appropriate Monday-through-Sunday slot in my neon green pill case.
I guess it's that shade of electric green so I won't lose the case.
Not that I wouldn't like to.
Karen gave me the plastic pillbox last Christmas as one of my stocking stuffer gifts. I laughed, but I also understood immediately the thoughtfulness behind her present. She knows I have to gulp a bunch of medications and supplements every day in my current condition, and being the extremely organized person she is (she's a FranklinCovey trainer, you know), she wanted to help me do so as efficiently as possible.
I can take them without water now. So adept have I become at swallowing pills that, except for the front-loaded morning dosage that can be as many as 11 pills at once, at the appointed times throughout the day I just pop 'em in my mouth like breath mints and let them slide down my throat. This is not a skill I wanted to become proficient in, but if practice makes perfect I should be nearly immaculate.
I've talked about my medications before but never in much detail, so I thought I'd like to introduce them to you.
Every day I take:
25 mg of carvedilol, a non-selective beta blocker to control my high blood pressure (thought to be the primary cause of my kidney distress), twice a day;
10 mg of prevastatin, to reduce my total and LDL cholesterol;
100 mg of allopurinol, intended to decrease the levels of uric acid in my body and prevent a recurrence of searingly painful gout, twice a day;
160 mg of Exforge, also prescribed for treatment of high blood pressure;
25 mcg of Vitamin D, a supplement to replace the vitamin that healthy kidneys naturally produce to maintain proper phosphorus and calcium levels in the body;
one-half of a Centrum Silver multivitamin, as my kidney specialist was concerned about the potential effects of taking some vitamins at their full potency (it's bad enough that it's a Centrum "Silver," but then only half a pill? Boy, does that make you feel old!);
100 mg of Vitamin B-1, which I added on my own. I read somewhere that it could help in the treatment of kidney disease, and my doctors, while skeptical, admitted that it couldn't hurt.
In addition, every other day I also take:
0.6 mg of colchicine, also prescribed to prevent my gout from flaring up again, and
1 mcg of zemplar, (and I'm taking this off the Web site), "a synthetically manufactured...active form of Vitamin D indicated for the prevention and treatment of secondary hyperparathyroidism in chronic kidney disease."
It's quite an assortment. I don't know how AIDS patients feel, but I can empathize. If you didn't think or feel that you were sick, pouring a pile of pills into your hand every day certainly will serve as a reminder. When I travel for more than a few days, it takes me almost a half-hour to sort all my medications and supplements, recall the proper dosages and stick them in their appropriate Monday-through-Sunday slot in my neon green pill case.
I guess it's that shade of electric green so I won't lose the case.
Not that I wouldn't like to.
Thursday, October 8, 2009
A Place Called Hope
I'm on the road again today (does it seem to you I've been traveling a lot since I started writing this blog? It does to me!). I'm traveling with Karen to Holland, Mich., on the shores of Lake Michigan to attend Homecoming at my alma mater, Hope College.
This weekend has taken on a different significance for me since I was asked to serve as a member of the college's Alumni Association Board of Directors a year ago. I feel much more connected to the campus goings-on and my fellow alums as a whole, though I will spend an entire day trapped in a conference room for meetings. But I am that guy who really enjoys going back to the old school, catching up with friends of a bygone time, reliving old memories while creating new ones.
I think it's kind of cool to have gone to a college named Hope. I remember getting razzed a lot about it as a teenager when I chose to attend there – "Hey, 'hope' you get accepted! 'Hope' you graduate!" – and while the lure of a large university was powerful, I knew then that I made the right choice. I still know it today.
One of the main reasons I went to Hope, I must admit, was to be closer to my parents, who where quite elderly at the time. But there's something about a small school that's more embracing, more caring. More sincere. When my favorite English professor, Jack Ridl, retired a few years ago, he sent me a handwritten note to thank me for the role I played as one of his students and congratulate me on my success as a journalist. How many people who've been out of a university for 35 years receive a letter like that?
Maybe it's symbolic, too. Like that lady says in the Cancer Treatment Centers of America commercial, "Hope is everything." And as time and my kidneys pass away, hope is a commodity that cannot come in great enough supply.
This weekend has taken on a different significance for me since I was asked to serve as a member of the college's Alumni Association Board of Directors a year ago. I feel much more connected to the campus goings-on and my fellow alums as a whole, though I will spend an entire day trapped in a conference room for meetings. But I am that guy who really enjoys going back to the old school, catching up with friends of a bygone time, reliving old memories while creating new ones.
I think it's kind of cool to have gone to a college named Hope. I remember getting razzed a lot about it as a teenager when I chose to attend there – "Hey, 'hope' you get accepted! 'Hope' you graduate!" – and while the lure of a large university was powerful, I knew then that I made the right choice. I still know it today.
One of the main reasons I went to Hope, I must admit, was to be closer to my parents, who where quite elderly at the time. But there's something about a small school that's more embracing, more caring. More sincere. When my favorite English professor, Jack Ridl, retired a few years ago, he sent me a handwritten note to thank me for the role I played as one of his students and congratulate me on my success as a journalist. How many people who've been out of a university for 35 years receive a letter like that?
Maybe it's symbolic, too. Like that lady says in the Cancer Treatment Centers of America commercial, "Hope is everything." And as time and my kidneys pass away, hope is a commodity that cannot come in great enough supply.
Wednesday, October 7, 2009
Poison or Hanging?
At my kidney specialist's suggestion, I recently visited a local office of Da Vita, the nation's largest chain of dialysis clinics, to attend an educational session on kidney failure. I had gone through this "Kidney 101" tutorial once previously in Detroit but Karen had not, and I thought it a good idea for us to experience the process together.
We were greeted by a very knowledgeable and attractive registered nurse named Dawn who led us to a private conference room and played one of those hokey "Your Kidneys and You" movies like you might have endured in sixth-grade health class. At one point, Dawn even strapped on a heavy rubber body apron, almost like a fat suit, to demonstrate the relationship between the kidneys and a form of blood cleansing called Peritoneal Dialysis, or PD.
Dawn and me, at Da Vita
Dawn was very nice and patiently answered all the questions Karen posed. I tried to be my usual nonchalant and amusing self, but let me be honest with you: The specter of what is inevitably going to happen to my body gives me the shivers and makes me more than a bit queasy.
Because to manually replace the function my kidneys perform in cleaning my blood, I either have to have an operation to graft one of my veins to an artery, creating what's called a fistula, so my blood can be pumped out of my body, filtered through a machine and returned – that's called Hemodialysis – or have a tube inserted in my stomach into the lining of my abdominal cavity, where a special solution will flow though to cleanse my blood. That's PD.
Both processes have their advantages and disadvantages, but from where I sit now, they sound like the difference between being asked, "Would you prefer poison, or should we just hang you?" We have decided to go with PD, which is administered in the home and I eventually can do by myself. (Hemodialysis demands actually traveling to a center like Da Vita three times a week, spending eight hours at a shot.) It seems like the lesser of two evils.
I know either method will be for my own good, and will be necessary in order for me to keep living. But they both sound horrific and ominous. The operation was a success, but we lost the patient; I think he passed out.
We were greeted by a very knowledgeable and attractive registered nurse named Dawn who led us to a private conference room and played one of those hokey "Your Kidneys and You" movies like you might have endured in sixth-grade health class. At one point, Dawn even strapped on a heavy rubber body apron, almost like a fat suit, to demonstrate the relationship between the kidneys and a form of blood cleansing called Peritoneal Dialysis, or PD.
Dawn and me, at Da Vita
Dawn was very nice and patiently answered all the questions Karen posed. I tried to be my usual nonchalant and amusing self, but let me be honest with you: The specter of what is inevitably going to happen to my body gives me the shivers and makes me more than a bit queasy.
Because to manually replace the function my kidneys perform in cleaning my blood, I either have to have an operation to graft one of my veins to an artery, creating what's called a fistula, so my blood can be pumped out of my body, filtered through a machine and returned – that's called Hemodialysis – or have a tube inserted in my stomach into the lining of my abdominal cavity, where a special solution will flow though to cleanse my blood. That's PD.
Both processes have their advantages and disadvantages, but from where I sit now, they sound like the difference between being asked, "Would you prefer poison, or should we just hang you?" We have decided to go with PD, which is administered in the home and I eventually can do by myself. (Hemodialysis demands actually traveling to a center like Da Vita three times a week, spending eight hours at a shot.) It seems like the lesser of two evils.
I know either method will be for my own good, and will be necessary in order for me to keep living. But they both sound horrific and ominous. The operation was a success, but we lost the patient; I think he passed out.
Tuesday, October 6, 2009
Sick
Karen stayed home sick from work yesterday. It's not the swine flu, but it might as well be; I called it the "whine flu," which I thought was just hilarious. She didn't seem to share my sense of humor.
That means I stayed home from work, too. Wait, that's not exactly accurate. I always stay at home; I just stayed away from work.
I love having my mate around the house all day, even in her sniffly condition, but from my perspective she could not have picked a worse time to fall ill. I have at least five big stories due over the next 10 days, and having someone else in your space when you were anticipating being alone can be disconcerting. The fact you know that someone else is hurting and you want to be there for them can divert your attention even more. I didn't even have time to write my blog to you yesterday.
I got frustrated and a bit peevish. Then I reminded myself that nobody chooses the time or the way they wish to get sick. I certainly didn't. And these blasted kidneys do qualify me as sick, I also have to remind myself, even though now most of the time I feel just dandy.
The time will come, I fear, when Karen will be doing the Nightingale thing for me on a far longer basis than I am in helping her to tend to a simple cold. And work, I've found as I've matured, always seems to have a magical way of getting done if one perseveres. It shouldn't get in the way of showing a little compassion and a comforting spirit when the one you love is sick.
I need to keep that in mind, and pray that she will, too. You know what they say about payback.
Sunday, October 4, 2009
Friday, October 2, 2009
The Man From Glad
On the road again today, driving back home to Champaign from Detroit. Can't wait to see my wife's smile and sparkling blue eyes again. You know, when we were dating, I would always play the Elton John song "Blue Eyes" at some point while traveling to see her, sing along with gusto and get all geeked up to be with her. (I'm not sure she knows that.)
These long road trips are wearying but necessary, since most of my major clients are still located in Motown and many of the stories I write demand I be here for research and interviews. When I think about it, though, I'm glad I have the ability to make these treks.
When I go on dialysis (which will be sooner than later, so I'm told), the journeys will be more challenging – I'll have to lug along a suitcase-sized blood cleaning machine along with several large bags of filtering solution – but I'll still make them. I refuse to let my condition define my lifestyle.
Besides, I remember a couple of years when I couldn't seem to land a job if my life depended on it and was living in Detroit too broke to afford a car. You want to talk about desperation, I was the definition. Detroit, for all its wonders, must have the worst public transportation system of any major city. I've always believed it was by design: We make the cars, and by thunder, everybody here is going to buy at least one.
So even something as unremarkable as having a late-model American automobile to drive on these multi-state commutes makes me glad, and thankful. I'm also glad to have:
The most remarkable wife any man could hope for – funny, smart, beautiful, organized and a more knowledgeable sports fan than I could ever hope to be;
In-laws who are genuinely good and nice people, and who have accepted me into their lives;
Emma and Madison, the twins, who keep me active, engaged, and constantly fascinated;
A friend like Larry Kaplan, who has reserved a room for me at his condo in West Bloomfield, Mich., providing me a place to stay and work whenever I'm in Detroit;
More assignments than I could have dared to wish for in this troubled economy, and most important,
My health, now and for whatever form it may take in the future. Because, like the old folks say, when you've got your health, you've got everything.
How can one man be so blessed?
These long road trips are wearying but necessary, since most of my major clients are still located in Motown and many of the stories I write demand I be here for research and interviews. When I think about it, though, I'm glad I have the ability to make these treks.
When I go on dialysis (which will be sooner than later, so I'm told), the journeys will be more challenging – I'll have to lug along a suitcase-sized blood cleaning machine along with several large bags of filtering solution – but I'll still make them. I refuse to let my condition define my lifestyle.
Besides, I remember a couple of years when I couldn't seem to land a job if my life depended on it and was living in Detroit too broke to afford a car. You want to talk about desperation, I was the definition. Detroit, for all its wonders, must have the worst public transportation system of any major city. I've always believed it was by design: We make the cars, and by thunder, everybody here is going to buy at least one.
So even something as unremarkable as having a late-model American automobile to drive on these multi-state commutes makes me glad, and thankful. I'm also glad to have:
The most remarkable wife any man could hope for – funny, smart, beautiful, organized and a more knowledgeable sports fan than I could ever hope to be;
In-laws who are genuinely good and nice people, and who have accepted me into their lives;
Emma and Madison, the twins, who keep me active, engaged, and constantly fascinated;
A friend like Larry Kaplan, who has reserved a room for me at his condo in West Bloomfield, Mich., providing me a place to stay and work whenever I'm in Detroit;
More assignments than I could have dared to wish for in this troubled economy, and most important,
My health, now and for whatever form it may take in the future. Because, like the old folks say, when you've got your health, you've got everything.
How can one man be so blessed?
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