I Hate Dialysis Message Board

Dialysis Discussion => Dialysis: Pre-Dialysis => Topic started by: MooseMom on January 03, 2012, 01:01:34 PM

Title: I'm struggling a bit
Post by: MooseMom on January 03, 2012, 01:01:34 PM
For a while now, I've been noticeably more fatigued.  My egfr has been at around 15 - 16 for about a year, but it just feels like recently I've felt more tired.  All of my blood values are just a hint below "normal range", and have been for a long time, so I can't say that I'm anemic, certainly not to the point that I need Procrit or something.  All of my other values are pretty much as they have been for a while, but these days I can barely pull myself out of bed.  I sleep pretty well, so I don't think it is poor quality of sleep.

I'm sure I am just like the rest of you pre-D people in experiencing this fatigue.  I will do housework for an hour or so, but then I have to sit down and rest (that's when I jump onto IHD).  If I've been really active...like, if I have taken my usual long walk...I might fall asleep in my chair for an hour or so.

Is there anything that y'all do to give yourselves a boost of energy?  Or do you just sorta go with the flow and rest when you need to?  I've never had to marshall my energy, so this is all rather depressing, but there you go. ::)  Any suggestions?  Thanks!
Title: Re: I'm struggling a bit
Post by: justme15 on January 03, 2012, 01:42:32 PM
welcome to my world!! except I think my world is a little worse. i'm still working, and on my way home today I fell asleep at the stoplight!!
I don't have a good answer, but what works best for me is to stay busy/active. once I sit down, it takes and act of God to pull me up from the sofa. I find that once I finally do get up, and stay up, doing various things, cleaning, etc, I'm able to do it without needing a break. With my job, once I'm out the door and working, i'm usually ok. but once I get home and relax, i'm done for the evening.
so I guess I don't have any real advice except you just have to push yourself.  I never really feel energized, unfortunately :-(.
Title: Re: I'm struggling a bit
Post by: MaryD on January 03, 2012, 02:12:55 PM
I was always tired, Tired, TIRED before I started PD.  But unlike justme I "went with the flow".  I am retired, so it was easy to schedule a short snooze in the afternoon.  It was energising to a certain extent. 

I could only work in short bursts.  When I got home from shopping I was too pooped to put away anything other than the chilled/frozen stuff - time to sit down for a bit.  30 minutes in the garden - best to sit down and attempt today's sudoku.  Load the dishwasher and wipe the benches - time for a row or two of knitting.

Since starting PD I am far more alert.  Now when I get home from shopping, not only does it get put away, but it's followed by 15 minutes in the garden.

I always felt that my pre-D tiredness was a slightly confused, thinking through the fog, lack of energy sort of tiredness.  It was definitely different to a low Hg tiredness, which always felt more like utter exhaustion
Title: Re: I'm struggling a bit
Post by: monrein on January 03, 2012, 02:21:09 PM
Hi MM...I've been off busy with holiday stuff for the past two weeks or more but wanted to hop in and say that there really was nothing I could do to jump start myself...just rest and do things in short bursts.  I used to garden sitting on the ground and all cooking prep was done sitting as well.  Even cooking at the stove sometimes I'd sit on a tall stool. 
Thinking of you and wishing that I actually had some "magic" to dispense.   :cuddle;
Title: Re: I'm struggling a bit
Post by: MooseMom on January 03, 2012, 02:42:54 PM
Hi MM...I've been off busy with holiday stuff for the past two weeks or more but wanted to hop in and say that there really was nothing I could do to jump start myself...just rest and do things in short bursts.  I used to garden sitting on the ground and all cooking prep was done sitting as well.  Even cooking at the stove sometimes I'd sit on a tall stool. 
Thinking of you and wishing that I actually had some "magic" to dispense.   :cuddle;

What, you didn't get any extra magic for Christmas that you can send my way? :P

Yeah, I do the gardening sitting on the ground, and yeah, I have a tall stool upon which I sit to do my chopping and stirring. 

I can't really complain.  I don't work outside of the home (ie, I'm "just a housewife" :rofl;), so I have the luxury of being able to do things in my own time.  In a way, I am grateful for having a very good reason to take things slowly and to stay in bed for longer if I need to.  I was just wondering if anyone had any tricks up their sleeve.

I am assuming that once I start D, I'll have more energy like some of you have experienced, but I'm not ready to make that leap just yet.  MaryD, yeah, I feel foggy.
Title: Re: I'm struggling a bit
Post by: Rerun on January 03, 2012, 03:13:07 PM
How often do you get your labs done?
Title: Re: I'm struggling a bit
Post by: Deanne on January 03, 2012, 03:25:06 PM
I'm always tired, too. I haven't found any answers, other than to do things in short bursts and nap a lot on weekends (I work full-time). I've mostly given up "optional" things, like hobbies, painting (haven't finished painting my closet doors & trim), cooking. I make myself go walking with friends on weekends, about three miles each day, because I know I'll only feel worse if I don't do it. It's all short burst though. Get up, shower, dress, have breakfast, sit on the floor to throw a ball for the dog. Vacuum, then lay down and watch TV and nap. Get groceries, then back to the couch. I tried going to the mall a couple of times recently, just to get out for a while, but it was exhausting and not much fun. I'm not sure how I'll handle yard/garden work when spring comes around. I'm a single homeowner. I was thinking about hiring someone to help with it, but I might try to force myself through it because I think the exercise and activity is still good for me.
Title: Re: I'm struggling a bit
Post by: MooseMom on January 03, 2012, 10:29:42 PM
How often do you get your labs done?

I get a full work up every other month (or every three months if I can't get an appt on time), but I get a basic metabolic panel done every month.  I have to get a sample drawn for the Gift of Hope histocompatibility thingy, and to avoid the $40 draw fee, my neph has provided me with a standing order for a BMP, and the lab will do the GOH draw for free.  So, I get monthly checks of things like potassium and calcium.
Title: Re: I'm struggling a bit
Post by: MooseMom on January 03, 2012, 10:43:29 PM
I'm not sure how I'll handle yard/garden work when spring comes around. I'm a single homeowner. I was thinking about hiring someone to help with it, but I might try to force myself through it because I think the exercise and activity is still good for me.

In anticipation of a downturn in my energy levels, I have replaced the front lawn with mulch, paving and perennials that require little care.  I knew I didn't want the hassle of keeping up a lawn.  So now, all I really have to do is put down mulch each spring, hand weed and do fall chores like cutting back the paeonies, etc.  My back garden is north facing and is quite wooded; grass is very difficult to grow in such shade, so I don't bother with it.  Over the years, I've allowed the leaves to fall where they may, and it has created more of a "forest floor" type environment than a cultivated yard.

We have a local charity that tries to provide housing and employment opportunities for developmentally disabled adults, and recently they started a program where they will come to your home and do light gardening.  I thought we could help each other, but after they came and assessed my needs, they declined.  I was really shocked.  All I wanted was for them to maybe do some raking in the autumn (we have a LOT of trees!), so I am not really sure why they turned me down.  Anyway, that might be something you could think about.  But I do get your point about wanting to stay physically active.  That's why I refuse to own a snowblower.  I do all of the snow shovelling around here!   Oh, and those leafblowers!  IF I CAN USE A RAKE, YOU CAN, TOO, SO SHUT THAT BLOODY THING OFF! ::)
Title: Re: I'm struggling a bit
Post by: JustDee on January 03, 2012, 11:44:24 PM
I am so glad I'm not the only one that has to "rest" after doing the laundry and dishes.  Those of you that are still doing gardening get my bewildered admiration.  I work full time (sort of) and when I'm home I am almost useless.  Hubby does all the cooking and what little cleaning gets done in very very extremely short bursts.  We are trying to buy a new home, our current home is 1700 square feet on 8 acres, to downsize to something more manageable.  I know that when I get on PD it's gonna take a lot of room for the supplies but we really don't need this big house with 3 bedrooms just for the two of us and our two dogs.  Plus the land is ALL hilly, almost no level ground, so because of my years of gout I don't walk at home much..I really think walking more would help my energy level.  If I knew for sure that dialysis would make me feel better I might ask the Doc to get me started in that direction.  I'm at "13%" with a creatine level of 3.2 so dialysis is probably just around the corner anyway.  I think the Foggy feeling is even worse then the fatigue...I feel like I'm lost my mind...and I miss it!!!!
Title: Re: I'm struggling a bit
Post by: Jean on January 04, 2012, 12:52:10 AM
Well, MM, my numbers are somewhat better than yours, but then again, I am 72 now. My idea of housework goes like this, work for 10 minutes, sit for 15 minutes. If I keep at it I can accomplish a lot in one day, however, I never did get out in the yard much this summer, and boy does it look bad. A year or so ago, I would have dropped dead rather than have my yard or my porch look the way they do. Now, I just walk on by. I am enrolled in a clinical trial for a drug like Procrit and I have been so hoping for some help in the energy direction, but so far, no good, at least in the way I feel. I will find out what my numbers are tomorrow.
Title: Re: I'm struggling a bit
Post by: kristina on January 04, 2012, 01:37:01 AM

Are you eating enough?

I went through such a phase when I was being too careful about my daily portions
and I think I depleted myself a bit of nutrients...
I now eat a little more and I feel much more energy...

Good luck from Kristina.
Title: Re: I'm struggling a bit
Post by: Mr. B 123 on January 04, 2012, 01:48:31 PM
M M,

I have the same lack of energy, about 3-4 in the afternoon if I sit down for more than 5 minutes I will fall asleep.  Usually my wife and boys just let me nap for a while.  Then about 10:00 p.m. I can't stay awake thru the TV news and fall asleep again and then wake up at 1:00 a.m. and will be awake until about 4:00.  I have had crazy sleep patterns for about a year.  My eGFR is at about 25.  I just nap when I need to, problem solved. 

Hang in there!
Title: Re: I'm struggling a bit
Post by: lmunchkin on January 04, 2012, 06:02:05 PM
J. seems to be more energetic during the summer months than winter.  He does seem to sleep alot during the colder months.  Not that thay is what you are talking about, but it could be a contributor! Heck, Im not all that energetic during winter either, Lol.

lmunchkin
 :kickstart;
Title: Re: I'm struggling a bit
Post by: willowtreewren on January 04, 2012, 06:29:51 PM
MM, before Carl started dialysis he would come home from work, sit down, and zzzzzzzzz.

It didn't matter what he tried to do to stay awake. I would go ahead and fix dinner and wake him up to eat. Then after dinner he would read, which was code for holding a book in his hands with his chin resting on his chest. Around 8:00 PM he would rouse himself long enough to look at e-mail or whatever for about an hour and then head to bed.

He wasn't "feeling bad" but he certainly wasn't much company!  :bow;

 :cuddle;

Aleta
Title: Re: I'm struggling a bit
Post by: MooseMom on January 04, 2012, 10:26:26 PM
I know this is going to sound odd even though I've mentioned it once before, but out of all of the meds I've taken over the past 7 years, the only one to give me any gyp is the renvela.  When I started this thread yesterday, I was feeling decidedly worse than usual, and then I remembered that I had taken my binders at lunch instead of at dinner as I usually do.  At the moment, I am to take 2 binders with either lunch or dinner.  Yesterday, I judged that what I was going to have for lunch would be more phosphoric than what I was going to have for dinner, so I took them at lunch, and boy, did that make me feel awful.  When I have them at dinner, I suppose I sleep through the ill effects.  I just don't understand why binders, of all things, would make me feel so rotten.

@Kristina, yes, I do think I eat enough, although I have found that I tend to eat less at meal times but need a snack around 4 or 5 in the afternoon.  We rarely eat dinner much before 7:30, and if I get hungry, well, actually I will feel nauseous before I feel hungry, so I'll eat a little something and will feel better.

@lmunchkin, yes, the colder weather does make me want to hibernate, although up here we have not really had much cold weather late, which is odd.  I love the dark, dreary days because it makes me want to stay all cuddly in bed longer, and I will often indulge that whim.

@Mr B123, I have a crazy sleep schedule, too, but I do so more for psychological reasons, I think.  I will read until maybe 2AM, and then I will sleep quite well but not awaken for good until maybe 10AM.  I know that makes me sound like a lazy toad, but I get my eight hours, and there's no one around to really care when those 8 hours being and end.  I have made the miserable discovery that if I sleep really late, it gives me fewer daylight hours that I am alone in this house before my husband comes home from work.  Fewer hours in which to stew and worry about my crap kidneys... :'(

@ Jean, that's interesting about the clinical trial.  I'd love to know more about that.  Did you find out your numbers?  Don't you just love getting lab results? :sarcasm;  God, I really hate that.  I get into such a tiswas about 2 days before my neph appt.  I hope things are at least not any worse for you.
Title: Re: I'm struggling a bit
Post by: Hemodoc on January 04, 2012, 11:25:21 PM
My worst days are when I have too much phosphorus or sodium. Fortunately, I have not had to take any binders so I can't comment on that aspect but it doesn't sound like a lot of fun. I find that the longer I go on dialysis and CKD, the more I have to pay attention to my diet. One thing I found is the hidden phosphorus in so many of our processed foods that don't agree with me at all anymore.

I have gone to a very generic, home cooked diet and avoid most of the processed foods that I used to tolerate just a couple of years ago. Reevaluating your diet for some of these elements might be useful.

Many medicines also have a side effect of fatigue and there are common causes of fatigue such as sleep apnea, hypothyroidism and other ailments that you should discuss with your doctor. Sleep apnea is a higher risk in dialysis patients and ESRD patients.

Unfortunately, fatigue is a constant companion of CKD and ESRD which will improve with good dialysis that raises your GFR back to 30 with nocturnal home hemodialysis. Even though your numbers are less than what current levels recommended for starting dialysis, it may simply be that after fighting this battle for so many years, you are actually approaching the time when renal replacement therapy will become a reality. In many ways, the few weeks prior to starting dialysis were the worst as far as how I felt and did improve when I started dialysis. However, even today, fatigue is a constant companion. Uremia takes a lot out of our bodies especially for those that have enjoyed truly active lifestyles in the past.

Exercise is important as you have noted, but I do believe it is worth discussing with your doctor to check for ordinary causes as well most of which are noted by simply looking at your symptoms, physical exam and some fairly simple blood tests. Just because we have renal disease, we should remember that there are other correctable causes of fatigue that a doctor should always consider as well. Wouldn't hurt to run this symptom past your medical team to get their input.

Be good and keep learning and reading. You are way ahead of the game already.

God bless,

Peter
Title: Re: I'm struggling a bit
Post by: MooseMom on January 05, 2012, 12:50:09 AM
Thanks for that, Hemodoc.

I do not eat a lot of processed foods at all, but when I do, I am an avid label reader and am very mindful of inorganic phosphates.  I like to think that I am successfully adhering to my diet, but I will examine it more closely.  I have been following a pre-renal diet for 7 years now, but perhaps I have become lazy and less vigilant, so yours is a good suggestion. 

I have had my thyroid checked, and it's OK.  I have thought about sleep apnea, but I have no evidence that that is a problem for me.  Do you have any idea why exactly sleep apnea is so common in renal patients?  What's the connection?  I've always thought that was odd.

I do understand that fatigue is a "constant companion" of this disease, and some days are better than others.  Today was better than yesterday simply because I made sure to take my binders in the evening.  I find that my mood in an important factor in this equation; if I am less stressed, I have more energy.  If I have something to look forward to, again, I feel more energetic.  If I have a dreaded neph appt where I will hear yet another set of lab results, well, I don't feel so great.

And you are absolutely right to remind me that CKD can't be the cause of every single ailment or symptom I may experience. 

Do you really think my numbers are "less than what current levels recommend for starting dialysis"?  My neph's nurse told me that they don't really start thinking about initation dialysis in asymptomatic patients until egfr reaches 10 or so.  I get a very thorough checkup every other month, my fistula is ready to go and no one has yet started mentioning dialysis.  I am thinking that my neph may be of the mindset that early initiation isn't the best thing for me, thank goodness, but I do realize that when to start dialysis is the "billion dollar question" as posted on RFN!

Thanks so much for your encouragement.  It is very much appreciated.
Title: Re: I'm struggling a bit
Post by: Hemodoc on January 05, 2012, 01:36:50 PM
Not sure the exact connection of sleep apnea and CKD. Most patients it relates to obesity.

As far as starting dialysis, a paper last year showed early starts had worse outcomes. In the last couple of decades, the dialysis patient has started earlier and earlier. The prior starting point for many was 14-15, but with the study from last year, they are now looking more at 9-10 but that is dependent on clinical symptoms as well. I think that you will find when you do start, that you will feel much better early on with the added clearances of your residual GFR and dialysis combined. Preserving your remaining GFR once you start should be a big part of your survival routine first by avoiding any nephrotoxic meds, and secondly by getting good, slow and gentle dialysis.

Rapid ultrafiltration rates in some studies induced acute renal failure in the remaining kidney function and most folks are anephric, or unable to pee shortly after starting dialysis. There is an obvious aging decline that is going to occur, but much in my opinion is from the aggressive dialysis techniques. That is one reason that PD preserves renal function better than Hemodialysis. I know of one researcher looking into the daily dialysis to see if GFR is preserved by daily dialysis. That would be a huge plus to show since residual GFR correlates to survival.
Title: Re: I'm struggling a bit
Post by: lmunchkin on January 05, 2012, 03:57:17 PM
Excuse the intrusion to your post MM, but Hemodoc, is that also the reason they want people who are eligible for a transplant to try PD first, because it is much more gentle on what ever renal function they have? Hemo is more intrusive because it is systemic?

lmunchkin
 :kickstart;
Title: Re: I'm struggling a bit
Post by: Hemodoc on January 05, 2012, 08:24:23 PM
Excuse the intrusion to your post MM, but Hemodoc, is that also the reason they want people who are eligible for a transplant to try PD first, because it is much more gentle on what ever renal function they have? Hemo is more intrusive because it is systemic?

lmunchkin
 :kickstart;

There are different reasons to consider PD first which is advocated by some groups as the best first line RRT. They note that some studies show that there may be a survival benefit coupled with saving the dialysis access for a later date. For some, that has been a good option because it allows more independent living as well as slower loss of residual renal function.

However, I don't believe that I have seen any studies looking at PD compared to Home hemodialysis especially the nocturnal daily option and how survival and complications compare. In general, NHHD has mortality benefits equivalent to cadaveric transplant according to a study by Pauly et al in 2009.

For someone that has a donor lined up and needs a bridge to transplant, some have done very well using the PD option on  temporary basis. If your wait for transplant is going to be a long time, I believe that survival in most instances is probably better going the home hemo route with daily dialysis.
Title: Re: I'm struggling a bit
Post by: lmunchkin on January 07, 2012, 05:26:21 PM
Thanks Hemodoc.  This makes sense!

lmunch
Title: Re: I'm struggling a bit
Post by: malaka on January 09, 2012, 01:40:01 PM
This might well be my last post here in this particular "pre-dialysis" forum as I got the word from my nephrologist today that pending the results of today's blood work, I may be starting dialysis this week.  Hemodialysis at a center, pending this week's evaluation for PD. 

While I may still do home dialysis, the more I looked into PD, the better I liked the idea of being machine free (at least part time) so I wasn't trapped at home or in a center.  Sure, I could move about on home dialysis, but the thought of lugging the equipment around wasn't too appealing. 

Then I spoke with an acquaintance who was on PD and somehow regained sufficient kidney function to be free of all dialysis.  Apparently, there is some truth to the idea that PD retains kidney function fairly well. 

I'm not looking forward to having a tube sticking out of my belly, but I think 4+ exchanges per day at 1/2 hour each is better than having needles sticking into me 3 hours per day.
And, at age 59, my career as a male underwear model was over long ago so the tube/scar thing doesn't bother me.

On the brighter side, I got a Kindle so I can read with one hand while sitting at the hemodialysis center.  I hope it works!
Title: Re: I'm struggling a bit
Post by: MooseMom on January 09, 2012, 01:47:25 PM
Oh gosh, malaka, you sound so calm and composed!  I'd be sobbing in a corner somewhere dark and disturbing.

It's so hard to know which modality is best until you're actually using it.  Such a hard decision.  If PD sounds best to you, then I hope your evaluation will show that it will indeed be suitable for you.  I, too, have heard that it is good for retaining residual renal funtion, so that's definitely a plus.  I'm sure you've read the posts from all of the people here who love it.

Do tell us more when you find out, OK?  I'm very eager to follow your story.

How has this news hit you?  Do you feel pretty well prepared, or are you really freaking out?  Do you feel like the time has come for you to start?  What do YOU think?
Title: Re: I'm struggling a bit
Post by: JustDee on January 09, 2012, 11:39:37 PM
I'd do think I'll be in the corner with MM Crying and pulling my hair when the DAY comes.  Knowing that Dialysis is "somewhere" in my future is a far cry from "come in tomorrow and we'll set ya up".  I too am going to give PD a try......again, sometime in the distant future....so I'm eager to hear all the details of your experiences Malaka.  Be strong, be brave.....you are going where no one has wanted to go before.   :bow;
Title: Re: I'm struggling a bit
Post by: malaka on January 10, 2012, 08:10:34 AM
Just got the word.  Friday afternoon is appointment number one.  Would have been tomorrow, but I'm getting my PD evaluation tomorrow. 

I have to look at it this way.  When diagnosed with membraneous nephritis, I knew there were three outcomes:  get better. stay the same, or go on dialysis.  No way to tell then which I'd be.  So I drew the short straw.  Nobody could do anything about it, including my nephrologists.   

So I have to look at it this way.  I'm on a transplant list.  I've treatment options without dialysis.  I can either start dialysis or die.  Duh....  So, I am evaluating the dialysis options.  If PD isn't appropriate, then I'll investigate home dialysis.  I'm trying to avoid in center hemodialysis so I can maintain some semblance of a normal life.  What else can I do????
 
Sure, I know that as of Friday, my current life is over.  I don't see dialysis as some adventure or anything desirable, but realize that my choices are limited.  So I am accepting of this turn of events. 
Title: Re: I'm struggling a bit
Post by: Joe on January 10, 2012, 09:10:36 AM
Malaka, that's about the best we can do. Realize this is the page of our lives we are on and live it. Good luck!
Title: Re: I'm struggling a bit
Post by: MooseMom on January 10, 2012, 09:30:12 AM
I don't see dialysis as some adventure or anything desirable, but realize that my choices are limited.   

As long as you don't call it a "journey"... :P

I know your choices are limited, and I know you just have to suck it up and get on with it, but still...

Well, don't let dialysis disable you.  I think that is what frightens me the most, that I'll just be plopped down into a chair, hooked up to a machine and gradually become more and more of a shrunken husk, unable to do anything other than return in 2 days and do it all over again.  There is just not enough emphasis on physical rehabilitation of dialysis patients in this country, and if you are going to dialyze to live instead of live to dialyze, then you just have to do it yourself, and that doesn't seem right.  So, once you are able to take your dialysis home, either PD or home hemo, then I guess that will make it easier to accept this turn of events.  It's one thing to just placidly accept your doom, but it is quite another to take things into your own hands as much as possible, give yourself the best chance to live a good life on dialysis, and THEN accept it.

I'd be interested to know what you are thinking and feeling as Friday draws near.  You could be very instructive to the rest of us who are right behind you.  I have no idea how I am going to cope, so if you could be generous enough to describe how life seems to you between now and Friday, I'd really be grateful.  That said, I don't want to intrude..

I'll be thinking a lot about you over the rest of the week, and I am eager to know what you decide about PD.  I hope Friday goes well.
Title: Re: I'm struggling a bit
Post by: malaka on January 10, 2012, 11:01:48 AM
Tube and liquids or needles and a machine.  Or maybe I'll graduate to tube and a machine.  What I'm looking for now is the least intrusive dialysis method.  And having spent a lot of time on line, here and elsewhere, it seems to me that PD (whether manual or automated) is the least intrusive dialysis method.  So I'm hoping I qualify.  With two old abdominal surgeries and diabetes, I'm not so sure.  But I'm not ruling it out. 

Like you, I have little desire to be strapped to a chair with needles stuck into me to live.  I don't want to live for dialysis.  One nagging thought, however, is that as of Friday I'll be joining the 20% mortality per year group.  That isn't exactly comforting, you know. 

At least I'm starting slowly as my GFR is still 13.  Its the darn nephrotic syndrome and difficulty with fluid that makes my nephrologist want to start me on dialysis.  Hemodialysis in the center to start so I can get my meds rebalanced under (hopefully) watchful eyes.  He expects only 2 hours per session to start as I retain some kidney function.  So I'm expecting the main purpose of this dialysis is to draw off fluid.  I've gained 10 pounds in about 3 weeks without any change in diet or activity level.  Maybe dialysis will draw that down in about the same length of time.  Talk about your crash diets!  Fortunately, my fistula was put in last summer and is fuly "mature". 
Title: Re: I'm struggling a bit
Post by: MooseMom on January 10, 2012, 11:57:18 AM
Oh geez, yeah...that 20% mortality per year stat.  Stuff of nightmares.  Now, goodness knows I'm not Little Miss Sunshine, but even I know that such statistics don't come anywhere near telling the whole story.  There is also that "five years survival rate" on D stat that is misleading.  Now, my mother survived 5 years, but then she was 77 when she started D, and whenever I would accompany her to dialysis, it didn't escape my notice that most of the patients were elderly and had a whole host of other problems.  And most of them weren't healthy enough to qualify for a transplant.  So, there are lies, damn lies and statistics.

If you can do dialysis at home, you can avoid a lot of the things that cause illness and hospitalization in the first place.  A hospital is a dangerous place for a dialysis patient...all of those sick people!   :rofl;
Title: Re: I'm struggling a bit
Post by: amanda100wilson on January 10, 2012, 01:21:54 PM
I should have died about  18 years ago, given that I have had CKD for getting on for 23!  Stats don't tell everything, and although I know a goo number of people personally both on dialysis and with a transplant, I know of only one or two who have died (none from the latter).  Ignore stats. Or you will make your life miserable worrying about it.
Title: Re: I'm struggling a bit
Post by: malaka on January 11, 2012, 02:36:24 PM
I flunked this test.  The nephrologist I saw was very honest.  PD = 700 to 1000 calories of dextrose (sugar) per day which isn't good for a diabetic patient, puts pressure on old surgical scars with an elevated risk of herniation, and most concerning to him (pay attention MM) was my nephrotic syndrome. 

Those with nephrotic syndrome have low blood albumin (protein) which causes the liver to kick out more cholesterol and triglycerides.  I'm one of them.  I failed Lipitor therapy (some enzyme called CPK rose too high) and the doc told me that PD causes additional loss of albumin which increases further cholesterol and triglycerides levels.  Those, as most of us know, are bad for hearts and brain circulation (i.e. stroke risk).  So, for those reasons, he told me that I wasn't a good candidate for PD as first line therapy. 

Therefore, he recommended hemodialysis with training for home hemodialysis on the NxStep machine.  While he said I could still try PD, the cardiovascular risk in my case made it less desireable than hemodialysis.

Oh well, at least I know.   
Title: Re: I'm struggling a bit
Post by: MooseMom on January 11, 2012, 03:57:43 PM
Malaka, I'm afraid I wasn't clear on another post of mine.  I've reread it, and I had posted that "nephrotic syndrome is an umbrella term for any renal disease."  That's incorrect, of course.  However, to be clearer, "nephrotic syndrome" IS an umbrella term for a certain kind of renal disese, mainly those where the glomeruli are damaged, the result being loss of protein, hyperlipidemia, generalized swelling and low albumin levels.  I have fsgs, which is evidenced by nephrotic syndrome (just to make things more confusing).  I have all of the above symptoms save edema, although I am beginning to suspect that I DO have generalized swelling but it is just not obvious to anyone but me.  So, apologies for not being clearer!

I had incredibly high levels of blood lipids before starting treatment 7 years ago, but fortunately, the aggressive treatment (I take three different meds for high chol/triglycerides) prescribed has worked and has not caused me any problems.  What do you take for this problem if you "failed" the lipitor therapy?  I was started on Crestor but had an allergic reaction, so I'm taking pravachol which is older but generally safer.  Did lipitor adversely affect your liver?  Is your cholesterol pretty much under control now?

Funnily enough, my neph intially suggested PD to me (despite the nephrotic syndrome, which seems contradictory to what your neph told you), but for my own reasons, I've decided on home hemo.  But I understand why PD is appealing, and I'm disappointed on your behalf.  Still, I'd hate to see any therapy just cause you more problems.  I'm glad that he is amenable to home hemo, though!  I am hoping you will post more about how Friday goes and how you will begin your NxStage training.

Are you terribly disappointed, or are you OK with this?
Title: Re: I'm struggling a bit
Post by: malaka on January 12, 2012, 04:50:26 PM
I take Welchol (which also reduces blood sugar levels for reasons unknown to science) and Tricor which is an anti-triglyceride med.  Damn horse pills, but.......


Tomorrow, Friday, at 2:30 the "big adventure" begins.  I won't call it a journey, don't worry. :2thumbsup;
Title: Re: I'm struggling a bit
Post by: MooseMom on January 12, 2012, 06:01:19 PM
OK, 2:30...I'm going to note that in my calendar.  I really hope everything goes well.  I'm sure everyone will take good care of you, but I know that it will be a landmark day, nonetheless.  I will be most anxious to hear how it all went, so please post when you feel like it.   :cuddle;
Title: Re: I'm struggling a bit
Post by: KraigG on January 13, 2012, 03:04:50 AM
I've known for about 3-4 years I was going to go on dialysis. My transplanted kidney took that long to take its final breath.

The last 2 years sleep has been elusive. Even if I go to bed at a normal time, I wake up around 3 am, stay awake for 3-4 hours, then back to bed. Now, I can't get to bed until 5 or 6 am. It's 5 am now, and I'm still wide awake. Tired during the day, obviously, but not enough to fall asleep at a traffic light.

I think there's caffeine in the stuff they put in the machine :)
Title: Re: I'm struggling a bit
Post by: malaka on January 16, 2012, 09:50:50 AM
Boring, but I survived. I'll post more when I have a tolerable keyboard.
Title: Re: I'm struggling a bit
Post by: rsudock on January 17, 2012, 11:35:02 AM
Moosey I am so sorry I missed this post my dear friend...I am sorry you are feeling fatigued...I hate that feeling. I still feel like that post transplant...it is so annoying...I am honestly thinking maybe UPPERS are the answer???

Hang tough the best you can....

xo,
R
Title: Re: I'm struggling a bit
Post by: MooseMom on January 17, 2012, 01:50:30 PM
malaka, I'm glad you survived! :P  I have been wondering how you were doing, but I didn't want to nag you and figured you'd check in with us when you were ready.  If "boring" is the worst of it, then I'm glad for you!

rsudock, it was just me whining again. ::)  But I'm not happy that you are not feeling better.  Having a new kidney is supposed to make you feel better!  Didn't they teach you that in transplant school? :P  Is there a particular reason you're not feeling good?  Is there a specific problem?  I hope something can be done for you.  You've been through so much, and you deserve to feel good again!
Title: Re: I'm struggling a bit
Post by: malaka on January 18, 2012, 06:06:56 AM
Session #1 was 11 pound weight loss in three hours!  Session #2 was a failure -- too much clotting.  So I went to surgery yesterday for a lroto-rooter job on the fistula.  Returning for session today.  We'll see.  While boring, dialysis isn't as bad as I thought it would be.
Title: Re: I'm struggling a bit
Post by: rsudock on January 18, 2012, 10:25:50 AM
I just think the last month dealing with CMV and then some sorta of flu has taken me awhile to get back to my normal level of tiredness ya know? I am just now this week starting to feel decent again...thank heavens!  I just got to use to being 10 years out with transplant, feeling like a normal person that I forgot how it feels during the first year of transplant...oh their I go now whining!!!

 :cuddle;  Moosey and Rsudock!

xo,
R
Title: Re: I'm struggling a bit
Post by: MooseMom on January 18, 2012, 04:22:25 PM
Actually, R, your "whining" is instructive because it serves to remind us that while transplantation is a miracle for those lucky enough to benefit from it, that doesn't mean it is easy.  People need to know that.  So, thank you for the reminder! :cuddle;
Title: Re: I'm struggling a bit
Post by: malaka on January 20, 2012, 07:47:27 AM
Session 2 (a successful one unlike the first session 2) was easier.  I'm settling into the routine.

The most troubling part, and it may be center-specific, is looking around at all the other patients.  It reminds me of a scene of a combat hospital with missing limbs, masks on some,
some moaning and groaning.  Lots of people in wheelchairs, using walkers, etc.  One can only wonder whether the aging process is accelerated by CKD and/or dialysis.  It certainly makes transplantation lok more desireable than before.   The thought of permanent anti-rejection meds and dietary restrictions seems only to be a minor inconvenience compared to what these patients struggle with every minute of every day.

The staff is upbeat and attentive. 

I've applied for Medicare and SSD.   Maybe I'll be able to work some day, but now my life is centering around dialysis appointments.  I chose MWF afternoons to minimize inconvenience, but that's still a good part of the work week.  Working for myself, I can take all the unpaid time off I want, but the payroll, rent, etc., doesn't change.  Not practical to keep the shop open only part time, and I don't want to be paying for my own job. 

The strangest part is that the dialysis machines sound like high end dishwashers ... a quiet liquid swooshing noise which doesn't prevent me from nodding off.  Taking a nap, however, is a little troubling to the staff who appear to be concerned whether I'm dead or alive!
Title: Re: I'm struggling a bit
Post by: MooseMom on January 20, 2012, 10:38:00 AM
Several years ago, I had to go to my clinic for an appointment with the renal dietician.  I saw a lot of what you say...patients wheeled in and out on guerneys because they were incoherent, lost of patients in wheelchairs who were either elderly or amputees or both.  It was all I could do to keep from freaking out as I was talking to the dietician.  I couldn't wait to get out of there.

I've seen the same things in the various clinics my mother attended, both in her home city and in other places as she travelled to visit family.

I had an aunt who had kidney failure and dialzyed for 7 years until she died just short of her 90th birthday.  I suspect that as we live a longer time, things like kidney failure are just more common.
Title: Re: I'm struggling a bit
Post by: Mr. B 123 on January 20, 2012, 11:59:46 AM
Malaka,

Thanks for sharing your experiences.  Hope all goes well from now on.  Sounds like we have a lot in commom, 59 years old, got a fistula last summer, run your own business and just trying to survive.  I will watch for future posts from you as I think I am not far behind you in my kidney condition.  I see the kidney doc on Monday and hope the report is positive and I will be good for another 3 months until the next blood tests.  I also see you got a Kindle, how do you like it? I got a Nook, pretty neat machine.  Take care!
Title: Re: I'm struggling a bit
Post by: malaka on January 21, 2012, 09:00:27 AM
It seems to get easier each time.  The dialysis machine doens't sound alarms as often.  Maybe my fistula is growing?  THe kindle is good, except I have not figured out how to open email attachments yet.  So I'm missing all the jokes!
Title: Re: I'm struggling a bit
Post by: malaka on February 02, 2012, 01:32:39 PM
If its not one thing, its another!  Dialysis is going easier (no alarms in the past few sessions) BUT..... nephrologist stopped by and said "we are going to increase your time on the machine from 2.5 hours to 3 hours.  Depending on your urea levels, you may need even more time."  Why this matters, (other than dialysis is B O R I N G) is that I'll be moved to earlier treatment start times, which makes my attempt to continue working even harder. 

I'm not thrilled with needing more time, either, as it makes me question how well dialysis is working.  You don't get quite the information about blood chemistry in a clinic that you can get in a doc's examining room.
Title: Re: I'm struggling a bit
Post by: MooseMom on February 02, 2012, 02:38:11 PM
If its not one thing, its another!  Dialysis is going easier (no alarms in the past few sessions) BUT..... nephrologist stopped by and said "we are going to increase your time on the machine from 2.5 hours to 3 hours.  Depending on your urea levels, you may need even more time."  Why this matters, (other than dialysis is B O R I N G) is that I'll be moved to earlier treatment start times, which makes my attempt to continue working even harder. 

I'm not thrilled with needing more time, either, as it makes me question how well dialysis is working.  You don't get quite the information about blood chemistry in a clinic that you can get in a doc's examining room.

This is a really big problem, this problem of how much time you need to dialyze.  On the one hand, having to sit in that damn chair for longer than absolutely necessary can't be fun at all, and it absolutely does interfere with getting to work.  If it is true that you don't live to dialyze but, rather, you dialyze to live, then much more effort should be made in making dialysis fit into the world of employment.  The whole original idea behind dialysis was to "rehabilitate" renal patients and return them to happy and productive lives.  That's why in the beginning, people would dialyze at home on their own time.  But now that dialysis has become big business, there is not so much effort put into fitting treatment into your life.

On the other hand, the longer you are able to dialyze, the better your health will be.  I am not sure it's true to say that dialysis isn't working, rather, your dosage needs to be changed in the same way that a pill might not work as well at a lower dosage than at a higher dosage.  More time SHOULD meet better outcomes, but it does come at a price, ie, time on the machine.

I would think that you could get the same info about blood chemistry if you ask for it.  I've read lots of posts from IHD members who insist on getting full lab results as opposed to those silly "report cards" with smiley or frowny faces on them.

Keep us posted, OK?
Title: Re: I'm struggling a bit
Post by: malaka on February 04, 2012, 09:22:52 AM
I foound out yesterday that they only draw blood for labs once per month so that's why I haven't gotten new information.  I will next week.  Apparently, once you start the Big D, the insurers only pay for monthly labs since you're not being treated for possible cure, just maintaince.   Hmm....... ???
Title: Re: I'm struggling a bit
Post by: mamagemini on February 20, 2012, 07:43:19 PM
I wanted to chime in here...I too am exhausted every day. Especially around 3 to 4. I use to take an hour nap and now it is up to 2 hours. But then at night I am up late, such a vicious cycle. Nausea too has set in, that whole nauseousness but hungry feeling is weird. Brain fuzziness is another thing I deal with too. A friend who had a transplant and dealt with different dialysis told me to try B12 every other day. It works on good days. Green tea is another thing I use for the mornings because I work full time and a part time job. When I get to the part time job I am done. Don't know how long it will be before I let that one go.
Those definitely are not cures but they get me through the work day.  :)
Title: Re: I'm struggling a bit
Post by: MooseMom on February 20, 2012, 10:09:40 PM
Mamagemini, thanks for sharing those ideas.  What do you do for the nausea?  Does the green tea help?  The B12?
Title: Re: I'm struggling a bit
Post by: mamagemini on February 24, 2012, 08:53:06 PM
Sometimes yes. I love my Green Tea and l drink it in the mornings. The B12 does help with energy too and mood.
The nausea I deal with unless it gets bad. I am calling in to the doctor to see if he can prescribe some anti nausea meds. I was taking Reglan but it expired. It worked really well!