Living with Diabetes and Kidney Disease

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1

A little over two years ago my doctor informed me during a routine exam. That my blood work had indicated a problem with my kidneys. I had lost 60 percent function. this really grabbed my attention. Since he had never mentioned it before. This meant a big change in diet and sugar control.

I had to get in very tight control. Changed insulin from 70/30 to Lantus and Novolog, tighten up the diet,see an Neprologist. Okay one of life’s little challenges. “It’s not uncommon for diabetics to have some kidney problems, especially for some one like you. Who’s been a diabetic as long as you have.” He said. " You can live a long time with less function and not have any noticeable change."

That was before my knee went and the full replacement that followed a year later. The surgery went well, the hospital and rehab didn’t. For the two month that followed neither were able to control my blood sugar or hypertension. I didn’t regain control til I was back home. As it turn out it was to late, more damage done.

By May of 2008 my kidneys started to fail. June back in hospital for kidney failure. Dialysis started on the 16th June, 2008.
It’s been eights months. The first two month were by far the worst, the changes the body goes through are not pleasant. This is in part due to the amount of toxins in the body and adjusting to the cleansing of the blood done by the machines. Shortness of breath, loss of balance, weakness and feeling sick are common.

Over time I began to adjust to the treatments and the change in diet. Renal diet is very different for the 1800 cal. diabetes diet, I was on. It more like the Atkins diet on steroids, Very high in protein and more protein, adding a diabetic diet to it is even worse. Most of the exchange food is no longer allowed. Control of Phosphorous and Calcium is critical. Since a build up on either can lead to complications or death. While adjusting to this lifestyle change I became acutely aware that my blood sugar was spiraling out of control and my hypertension was climbing back up. I needed a change.

First I changed the shift at the dialysis center, to the early shift. this allowed me to go in fasting. It also allowed me align my meals and insulin does to a more even schedule. asked for a change in blood pressure medication. talked to dozens of nutritionist on what is the best food plan. Increased my exercise routine and began losing weight. I still fight with the diet there are no set guidelines or at least any I’ve found. But I have over a few month reduced the amount of insulin I take at meals and have far better control. My A1C is not perfect but the last month it was 5.2 it’s getting better.

All it takes is a positive attitude and a little perseverance.

2

Hi There:

Sorry about your kidney function decrease. It never ceases to amaze me how some of the institute professionals(who are supposed to help a Person) make mistake after mistake with the Patient suffering the consequences. I’d love to know what dream they were dreaming when they were supposed to be learning techniques of how to care for a Person properly. Most People have at least one horror story under their belt, including me and you. But then on the other hand we usually have a “miracle” story to tell also.

Thank goodness you had the courage to take a different shift at the center so that you could rearrange your schedule. Why did you need a knee replacement? Thank you for pointing out kidney function decrease and dialysis treatment symptoms/process. I actually haven’t heard or read much about it. I’m sure dialysis sux. My Hubby’s Aunt had to go through that and I know that she was totally exhausted for 2 days later. I was under the impression that a Person with kidney function decrease wasn’t supposed to eat very much protein. I think your A1c is Excellent, btw. You’re certainly right about the positive attitude and perserverance. I’m Glad that you possess both. :o)

3

Hi. sorry I didn’t respond earlier but Thursday was a dialysis day and I was feeling pretty washed out.

To answer your questions. I had the knee replaced due to Osteoarthritis. cartilage and bone damage was to the point I would either have it replaced or be confined to a wheel chair. This was necessary in order to continue working. My problems with Kidney disease started to accelerator after I was released from rehab. The leg swelling I experienced after surgery was considered post operative and not connected to kidney function. It wasn’t till much later I learned kidney disease cause swelling in the legs. A failure on my part not to get more information about my condition when I received my first diagnosis.

About the diet. The major issues in the renal diet are Protein, Potassium, Phosphorus and Sodium. Low Protein levels lead to poor health. Albumin level are checked to see protein in blood this is an indicator of both kidney and liver function. Protein is important for production of red blood cells. Kidney patients are often anemic. Low levels indicate malnutrition, muscle weakness and wasting.

Potassium - too much can lead to heart problems or heart stoppage. The kidneys regulate the amount of potassium in the body with out them the levels formulate. The use of binders help control this build up and pass the potassium out as solid waste. In accordance all food high in potassium are not allowed. This is a long list.

Phosphorus- can cause cardiovascular disease, brittle bones, and itching skin. Milk and dairy products, nuts, dried beans, chocolate, and dark sodas are not allowed.

Sodium - causes water retention and shortness of breath.

All are regulated naturally through the kidneys. When kidneys fail This no longer occurs. Dialysis removes excess amount of these as well accumulated fluids. You eat more protein and reduce every thing else, to maintain a balance. Blood test are done monthly test include Albumin and Creatinine levels. A1C, average
weight to liquid gain/loss.

Dialysis is figured upon a dry weight. Since the body no longer removes excess fluid it remains in the body as weight. Removal of fluids lowers weight. By controlling the amount of liquid intake weight can be estimated. Since renal patients are only allowed 40 ounces of liquid a day combined with food makes a daily weight gain. Once determined the dry weight is the target goal of dialysis. My dry weight is 102 Kilos. or 224 pounds.My average weight gain is 2 kilos or 4 pounds a day. A challenge session is used to determine if there is a change in dry weight. I had a challenge day yesterday, unfortunately I had a weight gain of 1/2 a kilo. Since I am on the transplant list I can gain weight. So it’s tighten up the diet and exercise and lose the 1/2 kilo or more

Finding balance with the diet and my diabetes is a challenge. But at the center I go to I see a lot of people who have resigned to their condition. I can’t do that. being alive is one thing having a life is another. I’m making moves to go back to college while waiting for a transplant. Having a positive attitude is every thing.