It was a devastating experience, this flash floods. I was due for a dialysis treatment on that fateful day and all I could do was call the clinic, cancel my schedule, and get listed for another session. I’m lucky enough that I wasn’t toxic and overloaded with fluid because if that were the case, I wouldn’t be able to make it that Monday. I would have gone to a hospital for an emergency dialysis if I haven’t been controlling my fluid intake.

Ah well, nevertheless, the past incidence serves a reminder for patients like me to be prepared for the unexpected. Someone like me who’s been on dialysis for quite a long time now has already grasped the importance of a regular treatment cycle. Whether I like it or not, I must admit that these treatment schedules are so important to me now, it’s been a part of my everyday existence.

Being prepared for the worse scenarios like typhoons, calamities and disaster is not being a pessimist or an alarmist. For us patients who relies on our dialysis treatments for life, being prepared is just being realistic.

(Note: By the way, I’ve decided to abuse another picture for this post. In fact, I am thinking of doing my own images for the rest of my upcoming posts… what do you think guys? Is it a good idea?)

I took some stock photos and manipulated it to my liking, and well, you guessed right, just for the hell of it. I hope you like it guys!

It’s nice to be back into blogging again.

What about you? Are you also suffering from Hypertension? You know you might be, and worse, you’re not even aware of it. This is a common enough scenario, especially for the population’s poorer class who’s financial capability to seek medical attention is virtually non-existent. Nobody could really blame these people the tendency to take for granted the sensibility of early detection through screening. But if you’ll ask me, however, this should not be an excuse.

Why is high blood pressure dangerous?

The higher the blood pressure, the harder the heart has to work to keep on pumping against increasing resistance. If, in the course of time, the heart muscles tires, it could eventually lead to heart failure. Because of the enormous burden it puts on the arteries, high blood pressure adds to their wear and tear, especially in the target organs, the brain, coronary and kidney vessels. Stroke and Myocardial Infarction (heart attack) are frequent and dangerous consequences of untreated hypertension.

Recognizing high blood pressure

High blood pressure is a Silent Killer simply because it doesn’t show typical symptoms that might serve as early warning signals. In fact, in certain cases, many people feel well and energetic despite their high blood pressure. There is only one way of finding out whether or not you have hypertension and that is to have your blood pressure checked. Measurements must be repeated at least once a year. If an elevated pressure is detected in time, early treatment can help prevent the possible fatal consequences.

Prevention of complications from high blood pressure

Bringing the pressure down relieves the strain on the heart and arteries; this lessen and often eliminates the dangerous consequences of elevated pressure. With proper treatment, high blood pressure can be normalized, or at least brought down to a tolerable level. The treatment does not call for any heroic measures; regular checking of the blood pressure, a few generally painless changes in one’s eating and living habits, and taking the prescribed medication everyday. If detected and treated in time, hypertension should not stop you in leading a normal and productive life. All that is required is determination and close doctor-patient cooperation.

Protect yourself against high blood pressure

A genetic predisposition is a frequent cause of hypertension. It “runs in the family”. Caution is advised if you have a family history of high blood pressure. Your way of living could have an important bearing on whether or when you will develop hypertension. If you are overweight, has a high sodium intake on your diet, under psychological stress, agitated and hyperactive, you’re more likely a candidate, or can exacerbate an existing tendency. Losing weight, cutting down on salt in the diet, and avoiding stress are useful precaution to help you keep your pressure down.

Protect your health why you still can and when you still can. As always, being well-informed is being well-prepared.

As to the validity of this knowledge, I am not completely sure. Maybe if someone who’s been infected with the virus dips in the sauce, let’s say, of the fish ball; eats some of it, dips it again, then followed by you dipping into the fray, maybe there could be a chance for you getting infected. Not to mention the fact that it seems quite disgusting enough and appetizing at the same time.

– image courtesy of www.nmh.org

Although there’s one thing I am certainly aware of being at risk to Hepatitis. Being a dialysis patient, this virus just looms around the corner, waiting for an opportune time to get into your system. Patients that are financially incapable of sustaining EPO injections to treat Kidney Failure-related Anemia, turns to occasional blood transfusions as an alternative method, which in turn, puts them at a higher risk of being infected with the Hepatitis Virus.

“Hepatitis has been a long-standing problem in hemodialysis facilities. Essentially, hepatitis is an inflammation of the liver caused by a virus. Hepatitis viruses are bloodborne pathogens and are major biological hazards for everyone in the dialysis facility.  Hepatitis viruses, unlike HIV, can survive for long periods of time outside the human body.”

– source RenalWEB

It’s mandatory for dialysis patients to take the required Hepatitis Vaccine and have their Hepatitis Profile checked from time to time. I’ve been vaccinated last year, taking 2 vials of Engerix B, (Note: I think a single vial is the normal dose given for this vaccine), for 3 consecutive months, then taking the booster dose on the following month. For further details about this, it’s advisable to seek your Nephrologist or medical staff in your dialysis clinic. They’re the ones who could elaborate more on the subject.

I just took my Hepatitis Profile recently. It’s 3 or 4 types of laboratory tests that would ascertain if your body has already developed an antibody or defense against the virus and/or if you’re laready infected with it. Fortunately, my antibody turned up positive reaction and the test for the virus itself turned up negative.

I guess I got away practically unscathed and without having to worry about jaundice or my liver deteriorating for a while.

The battle goes on, though.

MANILA – Thirty-three new cases of influenza A (H1N1) were confirmed by the Department of Health (DOH) on Thursday bringing the country’s total number of victims of the virus to 344, as the World Health Organization (WHO) predicts the virus will be active for three more months.

Of the new H1N1 patients, 24 are male and 9 are female, and 31 are Filipino nationals, Health Undersecretary Mario Villaverde said in a press briefing in Malacañang.

The new patients’ ages range from one year to 52 years old, Villaverde said.

He also said that out of the total number of cases so far, 242 patients have fully recovered from the illness, 142 of whom recovered only recently.

Despite the large number of patients who have recovered from the illness, the DOH again reminded the public to observe proper hygiene to prevent the spread of the disease.

– courtesy of ABS-CBN News

To date, 36 new infections has been added to the total count of the confirmed cases, from which 79% have fully recovered.

– image courtesy of GMA News

(Update 06/25: Sorry for the link error on GMA News. I already resolved the matter and fixed the link.)

The mere fact that there is a contagious disease on rampage outside the comfort of your house is enough to make us dialysis patients concern of our health. I previously voiced out my concerns regarding the “Swine Flu” virus, and I also stated my basis for these concerns.

I have been practicing caution from this Flu Virus in my household way before it got here in the Philippines and started infecting people. I make it a habit to clean my hands before and after meals; I always carry a hand sanitizer with me; and I avoid physical contact from sick family members, relatives, and friends.

The Philippine Kidney Dialysis Foundation or PKDF, the clinic where I go for my dialysis treatments, has recently put up information posters regarding the A(H1N1) Virus. It includes a brief but concise description of what the virus is, symptoms to watch out for, as well as various preventive steps a patient could take.

Some of these steps are:

• Always wash your hands before and after meals.
• Use alcohol-based hand sanitizers.
• Avoid being in contact with people that are sick with colds or flu.
• Avoid being in heavily populated areas like school campuses, malls, and markets as much as possible.
• Get enough hours of sleep and always eat healthy foods that would help boost your immune system.

Another precaution our clinic is taking is that it makes sure every person entering the clinic doesn’t have a fever. A nurse is stationed at the entrance and checks your body temperature. If you checked in with a fever, you are denied entrance to the clinic’s premises and advised to have yourself checked further by a doctor or in a hospital.

This might sound a bit strict, but as a patient that’s more likely to get infected than others, I am in complete sympathy with this precutionary measure. I’m sure my fellow patients share the same view.

Why do I blog?

I blog simply because I like doing so. I am not much of a talker, and I can easily express myself through writing. I tend to grab every opportunity to write about something, and blogging, as most people could attest to, is one excellent way of doing so. Thus, here I am, blogging my heart out.

Why blog about Dialysis and Kidney Failure?

If you have been to this blog before, you’ll know that the reason behind this is fairly obvious — I am suffering from Kidney Failure and had been under Dialysis treatment for six years now. On my earlier days of writing on Dialysis Postings, my primary aim was to simply have an online journal. A kind of personal diary where I could write about my experiences with life in kidney failure and dialysis. But seeing how powerful a blog could become, I was encouraged to rearrange my purpose.

I am still blogging about my experiences in living with dialysis. But I also blog with the hope of creating awareness on the issue of kidney failure. This is a significant issue that most people wouldn’t even notice. I really can’t blame them, for I myself was completely ignorant about it before. Until I got diagnosed with the disease. It is true that it’s quite hard to detect kidney failure early enough to avoid it’s devastating effects, because it doesn’t show any symptoms on its early stages. But I do believe that having adequate information about it would forewarn people on its gravity, and would encourage them to have the initiative to take action before it’s too late.

If you are at risk of getting kidney failure, it ’s wise to have yourself screened for kidney disease. Let my past attitude of nonchalance be a lesson to you so that you won’t find yourself in regret of not having to take any action before.

Remember, forewarned is forearmed.

Let me state this as an example:

• A normal person’s hemoglobin range: 12 – 14 grams per deciliter (g/dL)
• A dialysis patient’s hemoglobin range: 10 – 12 grams per deciliter (g/dL)

To elaborate this further, I have prepared a list of the common laboratory tests that I take along with their acceptable ranges. The blood levels below are provided for your reference and are to be used as guidelines. Levels may vary upon individual differences or depending on the dialysis unit;s laboratory procedures. It is always advisable to talk to your doctor, nurse, and dietitian about your blood levels.

• Blood Urea Nitrogen (BUN) : 60 – 110 mg/dL
• Creatinine : 8.0 – 20.0 mg/dL
• Potassium (K) : 3.5 – 5.0 mEq/L
• Calcium (Ca) : 8.5 – 10.5 mg/dL
• Blood Sugar (fasting) : 60 – 100 mg/dL
• Blood Sugar : less than 140 mg/dL
• Alkaline Phosphatase : 25 – 100 units/L
• Phosphorus (P) : 2.3 – 4.7 mg/dL
• Sodium (Na) : 135 – 145 mEq/L
• Albumin : 3.8 – 5.5 gm/dL
• Total Protein : 6.0 – 8.0 gm/dL
• Hematocrit (HCT) : 33% – 36%
• Hemoglobin (Hgb) : 10 – 12 gm/dL

Basically, through this monthly lab exams, a dialysis patient, doctor, nurse, and dialysis unit’s medical staff can monitor the patient’s progress while undergoing treatment. For me that has been going through with it for quite a long time now, and for other’s as well, it may sound routinely boring. But I hope this article may serve as reminder on how vital this monthly blood tests are to a dialysis patient.

Anemia is common in people with kidney disease. Healthy kidneys produce a hormone called erythropoietin, or EPO, which stimulates the bone marrow to produce the proper number of red blood cells needed to carry oxygen to vital organs. Diseased kidneys, however, often don’t make enough EPO. As a result, the bone marrow makes fewer red blood cells. Other common causes of anemia include blood loss from hemodialysis and low levels of iron and folic acid. These nutrients from food help young red blood cells make hemoglobin, their main oxygen-carrying protein.

– Source:  NIDDK/NKUDIC

Before I was even diagnosed with kidney failure, I already noticed a slight pallor in my complexion. But ignorant and unaware as I was before, I merely put it down as lacking of exposure to sunlight. I thought that a bit of time under the sun or outdoors would soon resolve this and restore my complexion into a much healthier pallor. I should have known better. Today, six years into my treatment, I am happy to say that I am much well-informed.

Anemia in kidney failure and dialysis patients has two treatment options (It has two, in our clinic, at any rate. First, the more recommended, is by injecting a genetically engineered form of Erythtropoetin or EPO. It is usually administered via injection under the skin and this procedure is much more recommended because the hormone is better absorbed by the body when given through the subcutaneous region. Other patients who can’t tolerate needles has the alternative to take it via intravenous (IV) line, while hooked on a dialysis machine. The intravenous method, however, requires a larger, more expensive dose and may not be as effective.

The second treatment option that my fellow patients in our clinic follow to treat anemia is blood transfusion. Although this is not fully recommended, on the simple fact that there are certain dangers and uncertainties that comes with blood transfusion, it is a lot more cheaper than taking injection twice or thrice weekly. I really can’t blame them, in any case. I guess the little money that a patient could save through this option outweighs the dangers.

In my case I am taking EPO shots twice a week. I was taking 5000 units of Recormon (Erythropoetin or Epoetin Beta) during my earlier days of treatment. Last year I was shifted to Renogen (Epoetin Alfa). Both drugs treat kidney failure-related anemia. The shift was due to economical reasons, since Renogen is a lot more cheaper than Recormon and my body seems to respond much better to the former that the latter.

Though I must advice my fellow patients that they consult with their physicians first before taking EPO injections. This explains why:

The U.S. Food and Drug Administration (FDA) recommends that patients treated with EPO therapy should achieve a target hemoglobin between 10 and 12 grams per deciliter (g/dL). Recent studies have shown that raising the hemoglobin above 12 g/dL in people who have kidney disease increases the risk of heart attack, heart failure, and stroke. People who take EPO shots should have regular tests to monitor their hemoglobin. If it climbs above 12 g/dL, their doctor should prescribe a lower dose of EPO. The FDA recommends that patients whose hemoglobin does not rise to the target level with normal doses of EPO ask their doctor to check for other causes of anemia.

– Source: NIDDK/NKUDIC

So it is imperative that you work closely with your doctor or the medical staff in your dialysis clinic while treating anemia so that they could monitor your progress and perform necessary adjustments whenever the need for it arises.

I know it might be harrowing to think about the complications that comes along with kidney failure and dialysis. But being a dialysis patient myself, I am aware that I don’t have much choice on the matter. I have learned through experience that it’s much better to accept, learn about your illness, and find out ways to relieve yourself of the already difficult life of a dialysis patient. Besides, it always pays to have an optimistic frame of mind.

The kidneys play a key role in keeping a person’s blood pressure in a healthy range, and blood pressure, in turn, can affect the health of the kidneys. High blood pressure, also called hypertension, can damage the kidneys and lead to chronic kidney disease (CKD).

– Source NIDDK/NKUDIC

This might seem both alarming and outrageous, but it’s true, and it’s a fact. And I just don’t say it from research or reading journals about it, but I’m saying it from experience. Had I known myself to be inflicted with hypertension, I would have done steps to prevent it from helping destroy my kidneys. My doctor said that besides CGN or Chronic Glomerulonephritis, hypertension became one of the contributing factors that lead to kidney failure. But I was young then, and thought myself impervious to such diseases and conditions. Well, I was wrong, and paid dearly for it.

I am still suffering from hypertension up to this day simply because it’s closely associated with kidney failure. Although I am a lot wiser now than before and medications help me maintain my blood pressure at acceptable levels, I still make it a point to implement ways to keep my hypertension at bay.

• I avoid salty and sodium-rich foods as often as I can. Salt makes you more thirsty and if you drink too much water, you might experience fluid overload that will increase your blood pressure.

• I try to stay cool and avoid staying under the sun too much for the same reason that this would make you want to drink more.

• Avoid fatty and deep fried foods, as well as those that are high in cholesterol. Not only will it trigger your blood pressure to rise significantly but will also put you at risk with stroke and heart attack.

• Consult with your doctor on a regular basis and always take your medications for hypertension. Skipping them would desensitize your body to the drug and would cause dangerous spikes in your blood pressure.

It’s hard enough coping with kidney failure and dialysis alone, and even harder to manage different complications that comes along with it. But with sensible management, eager determination, and abundant amount of faith, things could go as normal as it can be for patients like me.

Be wise. Well-informed is well-prepared.

Your individual meal plan will be based on your age, your weight, foods you like, your dialysis treatment and other medical conditions such as diabetes, heart disease, and high blood pressure. It will be tailored to your needs but may not meet the specific needs of other patients. Most people with kidney disease must modify their intake of certain nutrients such as protein, potassium, sodium, phosphorus, and fluid. Following the meal pattern suggested by your renal dietitian will help you feel your best.

The following are some things a dialysis patient needs to know about:

• Protein is used to build and repair tissue. Several of the foods you eat contains protein. The best sources are meat, poultry (chicken, turkey, etc.), seafood, dairy products, and eggs. The best source, also called High Quality Protein, comes from red meat like beef, though it produces more excess waste in the body than other sources. Your renal dietitian might limit you from taking these.

• Potassium regulates nerve and muscle function. Since your heart is made mostly of muscle, this mineral plays a vital role in the regulation of heartbeat. Excess potassium in the body is removed by the kidneys. For people with malfunctioning kidneys, dialysis performs this job. But if you accumulate too much potassium in between treatments, it might cause heartbeat irregularities. Worse, your heart might suddenly stop if potassium is left uncontrolled. Almost all foods contain some potassium. Some foods that are very high include bananas, avocados, oranges, tomatoes, winter squash, dried fruits, milk and nuts. How often these foods can be eaten, and/or their portion size may need to be limited.

• Calcium and Phosphorus work together in the body. They are balanced to keep your bones strong and healthy. There’s an imbalance of these minerals in kidney failure but it can be restored with medications and a moderate level of phosphorus in your diet. Since calcium and phosphorus are found in many of the same foods, it is difficult to get enough calcium without getting too much phosphorus. Almost all foods have some phosphorus, but the highest levels are found in dairy products (milk, yogurt, cheese), eggs, meats, dried beans and nuts. You may be asked to take a calcium supplement and a phosphorus “binder”. It is advisable to ask your doctor about it.

• Sodium helps regulate the fluid balance in your body. High-sodium foods may upset this balance in kidney disease. Some foods that have the highest amounts of sodium are cured, processed, and smoked meats and cheeses (ham, bacon, sausage, cold cuts, cheese and snack foods like potato chips, pretzels, corn chips, salted nuts and pickles). Some foods that do not taste salty have a lot of sodium. Examples are soups, ketchup, mustard, relishes, some seasonings, steak sauces, meat tenderizers, canned or packaged foods and restaurant foods, When you prepare foods from scratch, you can control the amount of sodium used, like salt, for instance. Also, avoid using salt substitutes because they’re most likely to be high in potassium, and it’s more harmful to you than sodium.

These are meant to serve as a guide and a patient is still advised to consult with his/her doctor and renal dietitian for individual meal plans. Eating wisely and sensible food choices are vital for a kidney failre patient to stay healthy while undergoing dialysis treatment.