I started my dialysis treatment on September 2003 and has been through it for almost seven years now. I have experienced so many things all that time, have seen fellow patients come and go , but still I’m at it up until now. A friend once asked me if I ever get tired of dialysis? Of course I do. But for someone who’s been through a lot and fought all the way, succumbing to weariness is never an option.

If you’re wondering if I ever experienced depression, well the answer is yes, I did. I was diagnosed with Chronic Kidney Failure at 26 and for someone who’s merely starting to make something of his life, the reality of my predicament is just too much to handle. I guess anybody, under the same circumstances, would feel the impact and would think about what tomorrow might bring. In fact, almost any patient (not just with kidney failure) would go through some form of depression or another. Maybe it’s simply human nature to ask the “Why’s” whenever we’re faced with life-changing events.

I did go through a state of depression while I was still at the early stages of my treatment. I still go through it now from time to time. The only difference I made is that I never let it show, not if I can help it. Depression, for me, is a mind set. The more you think about it, the more you would feel it’s effect on your life. I’m not saying that I’m numbing myself from all the pain and the weariness. All I’m implying is that when depression sets in, it’s still your choice whether to fight that feeling or simply succumb to it and allow it to conquer you instead.

I’m still here, fighting as best I can and looking forward to win an uphill battle someday. Need I say more that I chose the former? That I never allowed depression to take the most out of life, eve through the most wearying times of my treatment? They say that I’m an optimist and I tend to look on the brighter side of life. That I am. Why wouldn’t I? I’m already living on the side of life where darkness just looms beyond the horizon. Believe me, I wouldn’t deprive myself the pleasure of looking on the bright side.

I hope you would too.

- images courtesy of RLHyde and ktylerconk

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I had my monthly laboratory test for the month of June taken last week and only just now did I find the time to post it here. The past week had been quite busy for me, redesigning Dialysis Postings and my other blogs - Private Corner and Itlog de Arina, and my grandfather being rushed to the hospital due to uncontrolled Diabetes. But that’s all behind now and I’m here once again updating DP, posting my recent lab results, and trying to spew bits and pieces of information that I hope would be quite useful to my dear readers.

Enough with the chatter. My hemoglobin is down to 8.2 gm/dL. Anemia is on the rampage again and there are numerous factors that might be causing it. It might be that I’m not having sufficient doses of EPO injections, or my body’s not responding well to my current EPO therapy. Either way, I should resolve the issue immediately or risk the possibility of my hemoglobin’s further decline and the need for blood transfusion.

My creatinine level’s a bit high at 14 mg/dL. I might be the culprit on this one because I’ve been consuming more protein than I’m allowed recently, especially red meats. The solution – stricter protein intake, less or no red meat, and back to eating fish more often. The others – Phosphorus, Calcium, Potassium, Sodium, etc. – are fairly under acceptable levels.

I also had my Hepatitis Profile taken together with my monthly laboratory. Both the test for the virus – HBsAg and HCV – turned non-reactive, meaning I don’t have Hepatitis. The only sad outcome is that the test for my antibody against the virus – Anti-HBs – also turned out non-reactive, meaning my body’s still not producing enough antibody to have me protected.

To sum it up, I’m still doing fairly well with my lab results and treatment. Although there are certain adjustments I have to make and try to implement them as soon as I am able. But it’s all good and I’m still in business with the my battle against kidney failure.

image credit – positivenation.co.uk

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Based on randomized, controlled data, omega-3 fatty acids in fish oil are now routinely used to prevent the progression of IgA nephropathy, the world’s most common glomerulopathy

Image courtesy of Club Marine

I was surfing the net and happen to pass by this article about Omega 3 fatty acids. Being a kidney patient, I am always careful on what I eat, and try to follow my prescribed diet as best as I can. Having fish in them is a good choice, if not a must. It doesn’t only gives you the protein your body needs, but fortifies your heart and brain health as well. Another advantage for dialysis patients of substituting fish for beef or pork is that you could get a much bigger portion without as much by-product or waste.

It’s true that red meat offers a higher quality of protein than fish do. But for people who have malfunctioning kidneys, acquiring protein from a source that generates less waste after being broken down by the body could mean a lot. It doesn’t just helps you keep your Creatinine level checked, but it also lowers your Triglyceride level and reduces your risk from Heart Disease.

I, for one likes fish. Since time immemorial, fish courses was already a staple in our family table. The only difference, now that I’m suffering kidney failure and under dialysis treatment, is the way I prepare or eat them. Before that, fish in any form of preparation would do. May it be fried, dried, soured, sautéed or raw like sushi, I’ll eat it no matter what. But now is a different matter because of the factors to consider. My advice for my fellow patients is that it’s best that you’ll be the one to prepare the dish. That way, you could stick with your diet restrictions without sacrificing the taste of your food.But if you can’t cook, try to explain how would you want your fish done to the person who would do the cooking.

Among the fishes that are rich in Omega 3 fatty acids are Mackerel, lake Trout, Herring, Blue fin Tuna, Salmon, Albacore Tuna, and Sardines, to mention a few.

A word of advice for my fellow dialysis patients – always try to consult with your renal dietitian or nephrologist regarding your diet for the simple reason that every patient has unique dietary and nutritional needs. What’s good for others might be bad for you.

But all in all, fish is good for you. Let’s make fish a part of our diet and pave a way for a healthier life.

Fish be with you all!

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In a few hours I’ll be off to my dialysis treatment. I’m already planning in advance how I would conduct my travel from our house in Manila, to the clinic in Quezon City. It’s only about 30 minutes away from our home, that’s if you have your own car, which I don’t. I take public transports (Jeepneys) and it takes 3 transfers before getting to the clinic. It’s tedious for patients like me, but there’s no getting around it, and besides, it’s a lot cheaper than taking a cab.

~ Image courtesy of www.a2gov.org

But it’s not the travel that bothers me. It’s the heat. You can’t hide from it whenever your outside, and even when you’re in the shade, you still can palpably feel the heat. It’s summer here in the Philippines, and to make matters worse, we’re currently under the El Niño Phenomenon. I have posted before on this blog the effects of summer and heat on dialysis patients. Today I reiterate it once again that excessive heat and humidity has a significant impact on dialysis patients.

We find it hard to tolerate the heat simply because we have a higher body temperature than normal people.

Mean oral temperature in hemodialysis patients was higher than in healthy individuals [98.7 degrees F (37 degrees C) vs. 98.4 degrees F (36.8 degrees C); p < 0.001], as was the mean average axillary temperature [97.7 degrees F (36.5 degrees C) vs. 97.5 degrees F (36.3 degrees C); p = 0.02] and mean left axillary temperature [97.9 degrees F (36.6 degrees C) vs. 97.6 degrees F (36.4 degrees C); p < 0.001].

~ Pub Med

And, if bad comes to worse, when our tolerance for heat comes to an end, the first thing that comes to mind is to beat the heat – that is, to drink water to quench our thirst and alleviate the heat we’re experiencing. It’s all good and well, drinking lots of water to rehydrate oneself and avoid the dangers and perils of dehydration or heat stroke. But for us with malfunctioning kidneys, drinking too much water tells a different story and would be quite dangerous at some point.

But don’t despair my fellow patients. There are lots of ways we could tolerate excessive heat and avoid the dangers that comes with it. Here are some that helps me survive the day, and I hope would be helpful to you too.

• Stay in the shade and stay away from direct sunlight, especially from 10 am – 3 pm, where it’s the hottest part of the day. If you’re not working and don’t have anything important to do outdoors, it would be best to just stay in the house.
• If you really have to go outside on the hottest part of the day, bring adequate protection from the sun, like an umbrella or sun shade. Also, don’t forget your towels or an extra piece of clothing, as you might need it.
• If you’re quite thirsty and finding it hard to regulate your fluid intake, go ahead – drink some water. But remember, sip and don’t gulp. But if your fluid intake is really ‘that’ restricted, try sucking on an ice cube, or some sour fruit like lime or calamansi, or brush your teeth to freshen up your mouth. It somewhat relieves your thirst.

These are some tips that worked for me and I hope would be helpful to you too, although every person is unique and has different needs. Summer time is somewhat of a punishment for us patients, but there’s no getting around it. So what can we do?

If you can’t beat ‘em… try to enjoy ‘em! A wonderful summer to you all!

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The previous onslaught of Tropical Storm Ondoy last Saturday, September 26 left people here in Metro Manila stunned and grieving. Floods devastated the city and left traffic almost non-existent, if not leaving them at a stand still, on streets. Here in our immediate area, where the deepest flooded area reached waist high, we weathered out the storm inside the house.

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?)

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Hypertension or High Blood Pressure, as it is more commonly known, is one of the silent killers that plagues the general population. It owes its lethal efficiency to the fact that it goes on undetected for months, and even for years, up until a point where significant damage has already been done. Such as it was in my case, where I neglected and took it for granted, in spite of being aware of its past devastation on our family’s medical history. But that’s all in the past, and as I have always told myself, regret is one of the most futile and unproductive of all human emotions. So there’s really nosense in trying to undo what’s already been done.

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.

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The Pinoy’s common conception of getting infected with Hepatitis is eating street foods that are unsanitary. On occasions, you would sometimes overhear somebody jokingly pointing out that you’d get the Hepatitis Virus with the food you just bought from the street, free of charge. “Libreng Hepa”, (free hepatitis),  some smart ass would say.

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.

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This was the news 5 days ago describing the current status of the A(H1N1) Influenza Virus rampage, a.k.a. Swine Flu, here in the Philippines:

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.

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Did you recently encountered the question “Why do you blog?”. I do, and I always find the time to read through posts just to know why bloggers do what they do. You might be amazed at what you’d discover. From the bland, to the usual, to the eccentrically mundane reasons, bloggers have various opinions for setting up their blog. As for me, after more than 2 months of writing in this blog, I finally decided to write a post about why I blog and why I chose dialysis and kidney failure as my topic.

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.

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Dialysis patients are required to take monthly laboratory tests. This is to ensure proper monitoring of our body’s blood and chemistry levels. These tests are also used by doctors as reference on how patient’s respond to dialysis, if they are eating right, their responsiveness to EPO shots via their hemoglobin levels, and so on. I have been through this routine tests all my dialysis years and still going through with it. My lab test schedule for the month of May would be performed on my next dialysis session, this coming Thursday to be specific. My past blood test, since I started my treatment, were fairly okay. There are certain blood levels that dialysis patients and doctors use as reference and it’s quite different from the ones normal people use.

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.

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