Tiredness could be due to underlying illness such as kidney failure

[okarol]

Sunday, Aug. 31, 2008 , 12:00 a.m.
Tiredness could be due to underlying illness such as kidney failure

DEAR DR. DONOHUE: I read your article on iron-deficiency anemia. I have been treated for it for two years and have not had any improvement in how I feel.

I am seeing a specialist, who gives me a shot of Aranesp about once a month, when my hemoglobin result is low. At first, he prescribed iron pills, but they caused extreme itching. They were discontinued. The Aranesp is rather expensive. I feel no difference after getting a shot of it. I am tired and sleep quite a bit. I have been a night owl all my life. I am in bed by 2:30 a.m. and sleep until 10:30 a.m., which gives me eight hours of sleep. After breakfast, while reading the paper, I fall asleep until 2 or 2:30 in the afternoon. Sometimes I am so tired that I lie on the bed and sleep until 3 or 4 in the afternoon. I am a diabetic and take 10 different medicines. I would appreciate your giving me any advice that would lead to a cure for my anemia. — G.C.

A: Not only do you take 10 medicines, you have five doctors. I believe there is a communication gap amongst you and your medical team. You should talk to your primary care doctor, who is the captain of your medical team. He or she can explain why you’re being treated with the medicines you’re taking, and the primary care physician can take a careful look for the cause of your great fatigue.

I don’t think you have iron-deficiency anemia. Aranesp is a medicine that stimulates the bone marrow to produce more red blood cells. A red blood cell deficiency is the definition of anemia. An iron lack is only one cause of it. Aranesp is used for anemias often brought on by kidney failure or by chemotherapy treatment for cancer. Both can slow the production of red blood cells by the bone marrow. This drug and similar marrow-stimulating medicines are not given to the point where the red cell deficiency is completely corrected; they’re given to restore the red cell count to a level where symptoms are minimal and blood transfusions are not needed. Used too often, they can cause clots in blood vessels and can lead to serious heart problems.

Your tiredness could be due to an underlying illness like kidney failure. A discussion of your problem with your primary care doctor should clear any misunderstanding.

http://timesfreepress.com/news/2008/aug/31/tiredness-could-be-due-underlying-illness-such-kid/

[boxman55]

Ah Duh! ... Boxman

[kitkatz]

If I had known the fatigue I had for years before emergency dialysis was sign of kidney failure I would have gone to the doctor.

[RightSide]

Yep.  I spent two years in psychotherapy to try to figure out why I was fatigued and feeling "bleh" all the time.  I've been peeing foamy urine for a whole year, but I had not known about its significance so I ignored it.  Till too late.