question Joan
Joan,
Thanks for taking the time and explaining things so well for us on the
list. I have a question that I can’t seem to get any answer from my endo.
As a dx I have listed renal failure. I have microalbumunuria, but BUN and
creatin are in normal levels. I am anemic and the Dr. says this is due to
my kidney failure that a hormone is not being given to my bone marrow. I
understand this, but for the dx and the anemia I would think I would have
to have more irregular labs. Does this sound normal?
Gail
May 5th, 2005 at 1:46 pm
Gail,
I know the Q is to Joan, but as you and I have been discussing on another
list about the low iron, I did not know the kidney failure dx. That bone
marrow thing is why I take the 8,800u EPO injections bi-weekly. That is
also why I think a nephrologist would do you sooooo much better than your
endo is. He may specialize in DM, but the neph KNOWS the kidneys. My endo is
not taking *care* of me either - neph is doing most of it now.
Jan
May 5th, 2005 at 6:49 pm
I have been listening to you Jan. I have been checking out some neph’s. The
one in the clinic with my Endo is not well recommend by word of mouth. I
have heard of one in St. Louis that is highly recommended by my friend that
had a kidney transplant six years ago. It is a far way to go and I am
trying to find out about some closer. I really am looking into it.
Gail
May 6th, 2005 at 6:02 am
<< As a dx I have listed renal failure. I have microalbumunuria, but BUN and
creatin are in normal levels. I am anemic and the Dr. says this is due to
my kidney failure that a hormone is not being given to my bone marrow. I
understand this, but for the dx and the anemia I would think I would have
to have more irregular labs. Does this sound normal?
>>
Hi Gail! How’s it going?
Renal failure is a big scarey that our doctors LOVE to use. Essentially once
we start spilling protein, even at the microscopic level, we have started
renal failure. That doesn’t mean our kidneys are going to stop right now…
the lab numbers can be fine, just over the years, or given infections that
compromise us, they gragually start to change.
just means we need to be nicer to them. Make sure we take in adequate fluids
daily - leave the sodas alone, easy on the high protein / meat diets -
adequate carbohydrates - which is not a nice word for us. Protein sparing is
the name of the diet, and one which you should discuss with your
nutritionist. Leaning toward a more vegetarian diet is also a good thing,
tofu (I know, some are saying yecch!, but you can get VERY inventive with
tofu, cheap, low in cholesterol, good source of vegetable protein which
doesn’t affect the kidneys that meat will. And vegetarian diets are truly
fun…it’s not all rabbit food and crunch….Vegetarian Times - is a great
magazine with some outrageous recipes. even online - vegetariantimes.com
Two books to invest in - Gail - I hope you have a magnifier to help you read,
I know with your eyes it ain’t easy.( I saw some assistive devices that can
be used like an overhead projector that hooks up to the TV so it blows
everything up…Soon as I find the site, I’ll let you know.)
The Merck Manual of Diagnosis and Therapy, and Taber’s cyclopedic medical
dictionary. Both are very helpful in keeping us on track and your
understanding medicalese. Can get them at Amazon.com.
Then there’s the cdc.gov - go to the niddk - national institute of diabetes,
digestive and kidney diseases for additional info. as well.
So, don’t get scared. making changes now is the most important. Getting on
medications that will help spare those kidneys - ACE inhibitors - vasotec,
Diovan, etc.
learn all you can so that you aren’t so frightened.
And everyone! absolutely NO NSAIDS ! motrin, ibuprofen, advil, nuprin,
anaprox, celebrex, vioxx, clinoril….all of it will cause renal failure and
congestive heart failure.
I went to a medical lecture by Dr. Gary Buller, who is a professor in the
school of medicine at Yale Medical School. His specialty is Nephrology and
he is studying the effects of NSAIDS on renal function and its effects on
diabetics and hypertensives. They all affect prostaglandins which are a very
important hormone that controls fluids running in and out of the kidneys.
Mess with them and you turn them off.
Those of us with arthritis - use tylenol or aspirin - use discretion - these
have their complications if used too much too. Take a look at vitamin
therapy, homeopathic techniques, and nutrition…they all play a part in pain
control….Hope this helps Gail. Homework, again! Joan :)))
May 6th, 2005 at 2:10 pm
<< Gail,
I know the Q is to Joan, but as you and I have been discussing on another
list about the low iron, I did not know the kidney failure dx. That bone
marrow thing is why I take the 8,800u EPO injections bi-weekly. That is
also why I think a nephrologist would do you sooooo much better than your
endo is. He may specialize in DM, but the neph KNOWS the kidneys. My endo is
not taking *care* of me either - neph is doing most of it now.
Jan >>
Gail - Jan is right - the best person to go to is a nephrologist - should be
board certified and hopefully affiliated with a large university teaching
hospital….get access to anyone with research grants. Check him out
thoroughly - make a question list and stick to it. If he takes the time to
explain things to you in ENGLISH, then he/she is your man! You work together
as a team, not the doctor doing to or for you….Joan
May 6th, 2005 at 7:12 pm
Joan,
Thanks, I have watched my protein intake for years. Was on several ace
inhibitors and could not take any, I have an asmatic cough and they made it
much worse. I am on cozaar and cardura for B/P. Just started them a year
ago. I have been on a diuretic for over 25 yrs. I had low B/P till just
over a year ago and then up all of the sudden. I have had two UTI in the
last six months which is very unusual, never had one before.
Seems as though we are pulled every which way. See one specialist and they
want us to watch this another specialist something else. It is a mad house.
I have used the overhead magnifier, but could not use it. It made me dizzy
going back and forth. They let me try it for some time, but said some
people can never adjust to them.
Gail
May 7th, 2005 at 3:05 am
<< And everyone! absolutely NO NSAIDS ! motrin, ibuprofen, advil, nuprin,
anaprox, celebrex, vioxx, clinoril….all of it will cause renal failure and
congestive heart failure.
>>
Do you mean we should never use any of these? Even if our kidneys are OK
right now? My doctor prescribes anaprox for me for menstral cramps, they are
severe. I dont use them alot but there are some times Im in extreme pain.
Any other suggestions of medicine to relieve the pain? Thanks Chrissy
May 7th, 2005 at 9:06 am
joan,
hi good morning! no nsaids?never knew that. thanks for all the very helpful
info and the book titles.i finnally got my results from the dr (not the
copy) i think i will still ask for the copy.he said
they were ok.i had read very high range b4 and now he said they are just
above the normal numbers (in the 100’s) does that mean now i dont have the
macro(something another?) anymore.
i should have thought to ask him right? sometimes tho i think i get more
info here.i thought it
could not reverse,but be stiffled.he kept me on ace-inhib.i take
vestril.thank you guys for all
the GREAT info and support.
sharon
<< As a dx I have listed renal failure. I have microalbumunuria, but BUN
and
creatin are in normal levels. I am anemic and the Dr. says this is due to
my kidney failure that a hormone is not being given to my bone marrow. I
understand this, but for the dx and the anemia I would think I would have
to have more irregular labs. Does this sound normal?
>>
Hi Gail! How’s it going?
Renal failure is a big scarey that our doctors LOVE to use. Essentially
once
we start spilling protein, even at the microscopic level, we have started
renal failure. That doesn’t mean our kidneys are going to stop right
now…
the lab numbers can be fine, just over the years, or given infections that
compromise us, they gragually start to change.
just means we need to be nicer to them. Make sure we take in adequate
fluids
daily - leave the sodas alone, easy on the high protein / meat diets -
adequate carbohydrates - which is not a nice word for us. Protein sparing
is
the name of the diet, and one which you should discuss with your
nutritionist. Leaning toward a more vegetarian diet is also a good thing,
tofu (I know, some are saying yecch!, but you can get VERY inventive with
tofu, cheap, low in cholesterol, good source of vegetable protein which
doesn’t affect the kidneys that meat will. And vegetarian diets are truly
fun…it’s not all rabbit food and crunch….Vegetarian Times - is a great
magazine with some outrageous recipes. even online - vegetariantimes.com
Two books to invest in - Gail - I hope you have a magnifier to help you
read,
I know with your eyes it ain’t easy.( I saw some assistive devices that can
be used like an overhead projector that hooks up to the TV so it blows
everything up…Soon as I find the site, I’ll let you know.)
The Merck Manual of Diagnosis and Therapy, and Taber’s cyclopedic medical
dictionary. Both are very helpful in keeping us on track and your
understanding medicalese. Can get them at Amazon.com.
Then there’s the cdc.gov - go to the niddk - national institute of
diabetes,
digestive and kidney diseases for additional info. as well.
So, don’t get scared. making changes now is the most important. Getting
on
medications that will help spare those kidneys - ACE inhibitors - vasotec,
Diovan, etc.
learn all you can so that you aren’t so frightened.
And everyone! absolutely NO NSAIDS ! motrin, ibuprofen, advil, nuprin,
anaprox, celebrex, vioxx, clinoril….all of it will cause renal failure
and
congestive heart failure.
I went to a medical lecture by Dr. Gary Buller, who is a professor in the
school of medicine at Yale Medical School. His specialty is Nephrology and
he is studying the effects of NSAIDS on renal function and its effects on
diabetics and hypertensives. They all affect prostaglandins which are a
very
important hormone that controls fluids running in and out of the kidneys.
Mess with them and you turn them off.
Those of us with arthritis - use tylenol or aspirin - use discretion -
these
have their complications if used too much too. Take a look at vitamin
therapy, homeopathic techniques, and nutrition…they all play a part in
pain
control….Hope this helps Gail. Homework, again! Joan :)))
May 7th, 2005 at 5:13 pm
Joan,
Thanks, I have watched my protein intake for years. Was on several ace
inhibitors and could not take any, I have an asmatic cough and they made it
much worse. I am on cozaar and cardura for B/P. Just started them a year
ago. I have been on a diuretic for over 25 yrs. I had low B/P till just
over a year ago and then up all of the sudden. I have had two UTI in the
last six months which is very unusual, never had one before.
Seems as though we are pulled every which way. See one specialist and they
want us to watch this another specialist something else. It is a mad house.
I have used the overhead magnifier, but could not use it. It made me dizzy
going back and forth. They let me try it for some time, but said some
people can never adjust to them.
Gail
May 10th, 2005 at 11:49 pm
Hi Gail: I know the problem with the cough. There are different ACE
inhibitors. there are those that are angiotensin I or angiotensin 2
inhibitors. These meds work on different sites in the kidneys. My
cardiologist switched me to Diovan, which worked and I didn’t have any side
effects, which for me and my
May 11th, 2005 at 7:57 am
Hi Gail: I know the problem with the cough. There are different ACE
inhibitors. there are those that are angiotensin I or angiotensin 2
inhibitors. These meds work on different sites in the kidneys. My
cardiologist switched me to Diovan, which worked and I didn’t have any side
effects, which for me and my allergies, was wonderful. There are times when
we all start feeling like pill factories.
If you are having recurrent UTIs you should have your endo or nephro order an
ultrasound of kidneys and bladder. You could be cooking some stones which
can cause the UTI.
For those of us lucky to have a significant other, sex is fun but the after
is important too. Always get to the potty (can tell the grandma in me,
right?) and empty the bladder. Women who are sexually active and diabetic
have a tendency to develop more infections.(even if they aren’t diabetic).
Bacteria like to migrate up the urethra and have fun too!
Other thing you might try are cranberry capsules …healthfood store again.
Don’t need the juice - it will crank up the glucose. Cranberry caps have
dried cranberry skin in it….it’s the source of the tannins that work so
well when we do have UTIs so get the benefit of neutralizing urine and
bacteria and no elevated sugars to boot. Joan:)
May 11th, 2005 at 12:09 pm
I have been using Vasotec for almost 10 years, with great success. (no
change in kidney function since starting using Vasotec). Do you know of
the differences between Vasotec and Diovan?
David
May 12th, 2005 at 12:12 am
Hi Chrissy:
ever hear of Evening Primrose oil?? Has wonderful properties that work great
for PMS. #1 500 mg capsule daily, religiously, along with your B vitamins -
Brewer’s yeast tablets - about 10 per day and see how you feel by you
May 12th, 2005 at 8:20 am
Hit the stupid touchpad again. The combination of vitamins that are heart
protective - from Dr. Joe Prendergast - endocrinologist that started a
wonderful website for patient self-management …my favorite
www.diabeteswell.com
L-arginine (amino acid) 1000mg 2x/day - works GREAT for those wonderful leg
cramps! Try it and see what I mean!!!
Vitamin C 1000 mg 2 x/day
Vitamin E 400 IU 2 x/day
Folic Acid 4 - 8 mg per day
Aspirin 81 mg. (low dose) 2 x/day
I had some major problems earlier last year with ischemia (chest pain) and
thought I was working on a heart attack, and had been subscribing to the
E-news from Dr. Joe, when he mentioned the above. Figured I had nothing to
lose. All the tests - thallium stress test, echocardiogram, etc. came back
grossly normal. This combo Worked wonders!!
Now - Aspirin is just as good a prostaglandin (the hormone that causes those
wonderful period cramps - makes us cross our eyes some days!) suppressor as
any of the NSAIDS only thing it doesn’t do is hurt the kidneys they way the
NSAIDS will.
Dr. Buller - the lecture I went to…was very emphatic. The only reason why
we think aspirin isn’t as good is advertizing. MDs and NPs and PAs too, get
hustled by the pharmaceutical companies to prescribe their products- not that
they are any better, just work differently. Have the same risks as aspirin,
but more profound problems with fluid retention…which leads to more
hypertension, which leads to more diuretics which leads to more pills.
Simple is a good thing.
The Evening Primrose oil capsules have been recommended by Naturopaths,
homeopaths, herbalists, etc for a long time. When I see patients in the
office, we discuss alternatives rather than writing a prescription….working
on maintaining health, rather than curing a problem makes more sense to take
care of the whole person and not just the disease…..
And remember, if it’s one a day or one twice a day, three will NOT be better.
The cdc now has another site for alternative medicine…check it out…and
giveit a try
….Joan :))))
May 12th, 2005 at 4:28 pm
Hi Sharon:
no, microalbuminuria ( spilling small protein particles)…tells us that
those kidneys are starting to work uphill instead of down. Learn nutrition, y
May 13th, 2005 at 12:35 am
touchpad again!
anyway, it’s important to understand about nutrition and what we put into our
bodies. Supersizing is not the answer.
Vegetarian is a good thing…limit meats…think about what goes into our
feed animals…massive amounts of antibiotics, and growth hormones…not
conducive to healthy eating.
Start learning more…less scarey that way….Joan :)))
May 15th, 2005 at 6:24 am
Urinary Tract Infection
Gail
May 15th, 2005 at 5:37 pm
<< I have been using Vasotec for almost 10 years, with great success. (no
change in kidney function since starting using Vasotec). Do you know of
the differences between Vasotec and Diovan?
David >>
Hi David:
Giving you guys all my references: The Nurse Practitioner’s Drug Handbook -
current is 3rd Edition about $40.00.-amazon.com or e_books.com
Vasotec - enalapril maleate - ACE inhibitor
works on preventing angiotensin 1 to angiotensin 2, which is a potent
vasoconstrictor ( makes blood vessels tighten up - increases blood pressure)
If you reduce the angiotensin 2 levels you decrease peripheral arterial
resistance essentially helping blood pressure to come down. Decreases
aldosterone secretion, and lowers sodium and water retention.
Diovan - valsartan - ACE inhibitor - angiotensin 2 antagonist
works a different way to get to angiontensin 2 - blocks the bnding of
angiotensin 2 to receptor sites in the smooth muscles of the blood vessels
and the adrenal gland, which inhibits the pressor effects of the
renin-angiotensin system.
sort of keeping things balanced, but precariously from a different angle.
Have to be careful when using with diuretics (water pills), can make blood
pressure go toooo low.
now, back to homework….nite all …Joan :)))))
May 15th, 2005 at 9:49 pm
Thanks Joan. All this stuff is very interesting but it does not address
the reason I use Vasotec; to prevent Kidney deterioration, not so much lower
blood pressure. Since Vasotec works in my case, leave well enough alone,
is my view. But, what about the Generics? My MD says it should make no
difference, but if I can afford it, don’t rock the boat. Vasotec is $1.50
or so for 20 mg. The Generic is $1.00. Fifty cents/day is about
$175/year. So, go with the flow, don’t take any chances; too
fundamental a concern to take the risk, in my view.
David
May 18th, 2005 at 9:27 pm
joan,
thanks .
touchpad again!
anyway, it’s important to understand about nutrition and what we put into our
bodies. Supersizing is not the answer.
Vegetarian is a good thing…limit meats…think about what goes into our
feed animals…massive amounts of antibiotics, and growth hormones…not
conducive to healthy eating.
Start learning more…less scarey that way….Joan :)))
May 20th, 2005 at 8:05 am
<< ever hear of Evening Primrose oil?? Has wonderful properties that work
great
for PMS. #1 500 mg capsule >>
yes I have but have never tried it. Thanks!
May 23rd, 2005 at 4:26 am
<< But, what about the Generics? My MD says it should make no
difference, but if I can afford it, don’t rock the boat. Vasotec is $1.50
or so for 20 mg. The Generic is $1.00. Fifty cents/day is about
$175/year. So, go with the flow, don’t take any chances; too
fundamental a concern to take the risk, in my view.
David >>
David: I’ve sent a link to an article on medscape.com.
y
May 23rd, 2005 at 12:33 pm
<< But, what about the Generics? My MD says it should make no
difference, but if I can afford it, don’t rock the boat. Vasotec is $1.50
or so for 20 mg. The Generic is $1.00. Fifty cents/day is about
$175/year. So, go with the flow, don’t take any chances; too
fundamental a concern to take the risk, in my view.
David >>
you can also use medline, or the drugs link to look up whatever meds you are
curious about…Joan:))
May 23rd, 2005 at 8:41 pm
<< But, what about the Generics? My MD says it should make no
difference, but if I can afford it, don’t rock the boat. Vasotec is $1.50
or so for 20 mg. The Generic is $1.00. Fifty cents/day is about
$175/year. So, go with the flow, don’t take any chances; too
fundamental a concern to take the risk, in my view.
May 24th, 2005 at 4:49 am
Thought all of you might like some further enlightenment….NPs also work
quite well in diabetes management…Joan:)))
May 24th, 2005 at 12:56 pm
<< But, what about the Generics? My MD says it should make no
difference, but if I can afford it, don’t rock the boat. Vasotec is $1.50
or so for 20 mg. The Generic is $1.00. Fifty cents/day is about
$175/year. So, go with the flow, don’t take any chances; too
fundamental a concern to take the risk, in my view.
May 25th, 2005 at 1:16 am
Thanks for the reference; however, even if I had an MD degree, I doubt that
I would understand this article. After reading it, I almost with I hadn’t!
David