Increase Dairy?

[George Jung]

So the dietitian in the center is making her rounds.....when she stops at me she says my phosphorus is low, asked about binders (I don't take very many) and told me I should increase my dairy!  How common is something like this?  I already consume some dairy products (bowls of cereal and such) and now I am supposed to have more?  What's your take on this?

[Chicken Little]

I am allowed to have dairy.   My phosphorus is fine and it helps me increase my protein. 

[Amanda From OZ]

You probably have been dialysing well and still have some kidney function?.................. but don't worry why!! just enjoy the extra milkshakes and icecream. 

[thegrammalady]

see what your doctor wants you to do. my dairy is restricted but not because of phosphors. dietitians don't know it all.

[MiSSis]

I'm jealous, George!  I'm on a dairy restricted diet because of high calcium levels.  Even after 4 parathyroid surgeries, we still can't keep my PTH levels under control.  I haven't been able to have milk for several years now and struggle a lot with cheese since it's in just about everything if you eat out.  Just this week I found out about a non-dairy substitute called Coffee Rich which my dietitian said I can start using like milk on cereal.  If they were telling me to increase my dairy, I'd be having a glass of milk with some Oreo cookies RIGHT NOW!!!   What do you use for binders?  I use Renagel since they do not contain any calcium but I know some patients use TUMS and get some added calcium that way.

[goofynina]

Just dont enjoy it too much George cuz remember, the Neph giveth and the Neph taketh away (and quick too)

[George Jung]

Well, I don't exactly know who my doctor is to ask them about it, the only people I see are those in the center.  Whoever it is that makes rounds once a week has looked at my labs in the past when I was concerned about consuming too much dairy and what might happen to my bones, and she said not to change anything (at the time).  I never go to see this dietitian, she comes around once a month to hand out lab results and makes her comments while doing so.  The thing of it is that like I said, I already consume dairy....to be truthful about it, I go through a gallon of milk every third or fourth day, I also keep a half gallon of ice cream in the freezer along with some Klondike Bars or something that I will eat one about everyother day.  My binders are Phoslo 667 mg which I take only when at home and only when I think of it, once....maybe twice a day (one each time).  The dietitian was going to have me reduce taking them but........I hardly take any so that is not an option.  I still have my original prescription from when I first started taking them 5 months ago!  She did say not to enjoy too much dairy but I have already been living in dairy heaven with my bowls of cereal, ice cream,cheese, and chocolate milk.  Maybe now I will make that stop at Starbucks that I pass up everytime I drive by one, or maybe I will go for an extra cheese calzone tonight

[glitter]

wow- your very lucky to be able to have so much- I hope that you can have it for a long time to come.....I budget my husbands by the ounce.

[susie q]

I dream about dairy.. and fluids especially... omg... if only..
Enjoy it while you can... so jealous.. 

[kianhu]

Well, I don't exactly know who my doctor is to ask them about it, the only people I see are those in the center.  Whoever it is that makes rounds once a week has looked at my labs in the past when I was concerned about consuming too much dairy and what might happen to my bones, and she said not to change anything (at the time).  I never go to see this dietitian, she comes around once a month to hand out lab results and makes her comments while doing so.  The thing of it is that like I said, I already consume dairy....to be truthful about it, I go through a gallon of milk every third or fourth day, I also keep a half gallon of ice cream in the freezer along with some Klondike Bars or something that I will eat one about everyother day.  My binders are Phoslo 667 mg which I take only when at home and only when I think of it, once....maybe twice a day (one each time).  The dietitian was going to have me reduce taking them but........I hardly take any so that is not an option.  I still have my original prescription from when I first started taking them 5 months ago!  She did say not to enjoy too much dairy but I have already been living in dairy heaven with my bowls of cereal, ice cream,cheese, and chocolate milk.  Maybe now I will make that stop at Starbucks that I pass up everytime I drive by one, or maybe I will go for an extra cheese calzone tonight

Have you had a parathyroidectomy? 

[George Jung]

Have you had a parathyroidectomy? 

NO.  I am not real keen on removing parts of my body and it's systems.  Simply because my phosphorus is a little low is no reason to even think of such a thing.  I will have an extra glass of chocolate milk thank you very much.

[kianhu]

LOL, I was just wondering why your Calcium is so low.  It is usually after a parathyroidectomy.  Make sure you are not on a high dosage of Vitamin D (Zemplar, Hectorol).

[George Jung]

Thankfully I am not on a high dose of anything.  The only meds I am on are the phoslo and an occasional Ambien CR, nothing else at all.  I am grateful for these days as I know my future will likely be full of meds (during and after transplant, whenever that time comes).

[jbeany]

A gallon of milk every three or four days ------- oh, I am soooo jealous!  Seriously, if they want you to increase your dairy, go for it.  Enjoy the freedom for as long as it lasts.  Have some cheese for those of us in the high-phos club!

[George Jung]

I really don't understand it....how is this possible?  I am rather constant with my consumption so it makes me wonder what has changed.  Undoubtedly I will take advantage in honor of those in the high-phos club and eat more cheese.  I didn't get my calzone today but I can almost smell it it is so close in my future.    (I sure could have used some smilies toasting with tall glasses of frothy chocolate milk for this one)

[George Jung]

Today I was told to stop taking any binders.  I am curious what has changed for me to be using less meds.  Any thoughts?

[goofynina]

Today I was told to stop taking any binders.  I am curious what has changed for me to be using less meds.  Any thoughts?

Sheeit, i wouldnt be questioning it, i would just enjoy it   but then again, they'd probably never tell me something like this so i guess i just need to shaddup 

[MiSSis]

Hey, if you find out what's causing this phenomenon can you please let the rest of us in on your secret?  I'd love to be a member of that group!

[kianhu]

They usually tell you to stop binders when your phos is way too low.  Some patient take calcium supplements in between meals to keep calcium up but not with meals.  Hope this helps. 

[George Jung]

They usually tell you to stop binders when your phos is way too low. Some patient take calcium supplements in between meals to keep calcium up but not with meals. Hope this helps.

I know that much.  The question at hand is why is the phosphorus low?  What has changed to be relying on less medication?

[kianhu]

Very rarely do I see a patient with a low phosphorus.  It usually means the patient is eating poorly.  I have also seen it after a parathyroidectomy and you said before that you have not had that surgery.  How is your albumin and calcium levels? 

[George Jung]

What do you mean by "eating poorly"?  Not eating enough?  If so, defiantly not the case here, my appetite has been very very good.  I don't feel as if I would be described as a poor eater in any sense of the word actually.  I am mindful of my consumption and try to maintain a balance diet (basically I eat whatever I want to be truthful, in moderation of course). 

Albumin : 4.1   
Corrected Calcium : 9.0   
Phosphorus : 3.5 
enPCR : 0.81 
eKdrt/V : 1.83   
Potassium : 3.7

[kianhu]

Your labs are fine.  Normal phosphorus is 3.5-5.5.    All those labs look perfect to me.  Model patient.   

[George Jung]

Thanks.  I am told that quite often these days.  "Your an A+ patient", "You score a 4.0 on your labs".  Nobody can tell me any reason for changes however and I am very curious.  I want to share my secret with all of the good people here at IHD.

Phosphorus History:

Dec. = 5
Jan. = 7 (was told to increase binders.  I was not taking very many)
Feb. = 5.5 (although I increased binders I still did not take them regularly)
Mar. = 3.5
Apr. = 3.5

Phoslo 667 mg Gelcap
Quantity 200
Date Filled 12/01/06
I still have 20+ pills remaining

Does that put some perspective to my binder consumption?

I appreciate the input BTW

[charee]

Hey George After 6 weeks of dialysis I'm off my blood pressure meds and Caltrate, I can eat what I like , they put it down to the fact that I do 6 to 8 hours 4 times a week, not sure that would be the reason in your case unless you increased your hours on the  machine ?