I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: UkrainianTracksuit on April 06, 2014, 08:58:37 PM
-
Hello,
My father is in his late seventies and he recently had a complete medical check up. He's had hypertension since his 50's but other than that, he thought he was extremely healthy. He's very active and exercises, very fit and still works. At the medical appointment to discuss his results, the doctor raised a big red flag about my father's kidney function. It was a routine blood analysis and his eGFR was 38 %. Personally, I don't know my parents medical records so I don't know if he had any signs of falling kidney function before. I know that he's never seen a nephrologist or 'pays attention' to his kidneys. (You guys know what I mean.) It's obviously bothering him because he'd never mention it if it wasn't.
I understand that in his late seventies that there will be reduced kidney function and I guess for his age he is doing well. However, when I heard 38 %, all I heard was "Stage 3! Stage 3! Stage 3!" in bright flashing lights. I don't know if this was a rapid loss or if it has been hovering in slow decline. The doctor hasn't sent him to see a nephrologist; is that because of age or should my father push to see one? The only advice given was to reduce salt, find sources of hidden salt in food (honestly, he makes his own pickles and pickled cabbage loaded with salt: don't think that will change :( Besides, my mother does the food shopping for my grandfather so she is hardcore with food labels) and monitor blood pressure at home. A change in blood pressure meds was mentioned but hasn't happened yet. My grandfather on my mom's side began HD in his late seventies also due to age and hypertension of 40 + years.
As the first question stated, should he ask to see a nephrologist? Should he push to have more routine testing done to keep track of his function? Or, since it is his age, accept that it isn't a big deal and be happy he's not in deeper decline? I know that each patient is a case by case basis but when I hit Stage 3, I started experiencing potassium problems, severe anemia and was put on EPO. I'm still wondering if with such function, would kidney-friendly diet issues come into the conversation? For example, would it be a good idea to lay off the drinking? (Whiskey and vodka are his two preferred choices; some studies say moderation helps the kidneys, other say lay off.) I know that all of these questions would be addressed by a renal team. I'm simply looking for opinions on what should be done next.
Truly, at his age with his function, I feel he will not end up on dialysis. This isn't a "is dialysis in the future" question but there is obvious kidney disease going on. Should we be happy with 38 % at this age? And then again, I don't know the future and why things happen; is dialysis coming? Who knows...
Thanks for any input. (By the way, I would have attempted to 'Search' but I'm kind of flustered which terms I should have used! ;D )
-
I'm so stupid! It just dawned on me before walking out the door that this belongs under the Pre-Dialysis section. Sorry, moderators, for creating work for you. :waving;
-
Your father is in his late seventies. I'm sure you would like to have him around forever but you know. Have you ever had a conversation with him about end of life issues? How does he see his life? Some people would want to see a nephrologist, keep an eye on kidney function, reduce salt, etc. others would rather go out "happy" with lots of rich food and booze. Most do a medium path. If he cuts back on salt but still has his salty treats occasionally, if he takes his blood pressure meds, it could be he'll be fine for a number of years.
I have no idea if he should stop drinking or not. Again, is it going to make him miserable so he hates life?
If you can do it, the honest talk is the best path. Talk about dialysis, heart attacks, strokes. What does he want you to do for him? When does he want you to say no more treatment? Ask if his paperwork is in order, whatever he needs in his country for a will, power of attorney, etc. This is a tough conversation but you can do it. Don't forget to have one with your mom too.
-
Sorry for not answering your questions sooner, jeannea. Lots of social responsibilities when someone gets newly engaged.
My mother is 14 years younger than my dad so I naively figured she would do everything. You are right that I needed to have “the talk” with BOTH my parents. I guess because they’re so young looking and active I forget they are senior citizens. Anyways, it was done and I was pleased to know most things had already been dealt with. Then, I had a discussion about kidney issues with my father. He’s a bit more informed about HD than the average person because he picks up/drops off my grandfather for his sessions. He’s also the “go to guy” when there are issues. He said dialysis wouldn’t be the end of his world but there comes a time to let go too. He’d know when the time comes.
Finally, he’s going to see a nephrologist. As he said, they sent my grandfather for dialysis around the same age and now, he’s doing wonderfully. Late 80s and a good quality of life. Since my father still wants to go to work everyday (I guess it’s easy to work when you’re the boss), play ice hockey, travel and gamble, he believes a lot of life is still left to live. Only at the point when he is “useless” he would refuse care. I told him he still has function left before even considering end stage so preserve what he can. I have a sneaking suspicion he’ll be speaking to the renal dietitian soon. Wish someone was there to translate that masterpiece of a discussion… ::) I told him to let me know the results of his next tests. Not only eGFR, but creatinine and potassium and phosphorus, etc. etc...
I just think it’s ironic that in my whole life with chronic illness and kidney issues, he never paid attention. He didn’t concern himself with it. And yet, here he is, with it staring him in the face. I should tell him “Pull up your socks and deal with it!” like he told me… but kidney disease is no fun! It's better to support when you understand.
-
Good for you for talking about it! It sounds like he knows how he wants to handle things.