Type 2 diabetes/dialysis

hey everyone,
my daughter has a question that she is hoping you can answer… she has a type2 diabetic mother-in-law who also has renal failure. she goes three times a week to dialysis. they put her on an anti-biotic drip at the end of each dialysis and she should be eating yogurt to prevent yeast infections, etc. BUT, because she has renal failure she can’t have anything with potassium in it. her question is, are there any yogurts out there that don’t have potassium in them, or is there something else with no potassium or a lot of salt that does the same thing. the anti- biotic drip is because she just recently lost two of her toes. my daughter said to thank-you in advance.
debb…

Hi Deb,
I am in renal failure also, but am not on dialysis just yet. There is basically no food that does not have at least some potassium in it. The yogurt isn’t really a tremendous source of potassium. I eat Weight Watchers, but your daughter should just go to the store and pick up the different labels and get whichever one appeals to her that has a lowest amount in it. The things she needs to watch our for and avoid are things like potatoes, breads, bananas, strawberries, oranges, orange juice, melons pineapple, mangoes a lot of the cereals and the list goes on. She may be fortunate enough to find a dietician who can help her with this. Be careful there. There are a number of books , but once again, be careful. You really have to read to find how seriously they take your commitment. To a kidney patient, commitment is everything. For me my nephorogist has been my best guide. He can tell you how much he wants you to cut out. And frequent blood tests are imperative. When I am doing well, my blood gets tested for my potassium level every two weeks. When I am not doing so well, it is tested each week. I forgot to add spinach to that list above. And I should add that carb counting and keeping her blood sugar as low as possible .will help her kidneys function their best. I send her my best wishes. The diet may sound daunting, but it is definitely doable. I would also add that ground flax seed is a very good thing to add. My doctor asked me to give it about 6 months and see if we can get an improvement by adding the ground flax seed. I don’t know how it helps, but after a couple of months (2 1/2 ) I am seeing a little improvement. I am presently using 6 tablespoons per day. As long as anything at all is better, I will keep it up. Good luck.

Deb, my heart goes out to you. It is very difficult to get someone to change their eating habits especially when it is a drastic change. But the breads and potatoes and cereals and fruits that I mentioned are the foods highest in potassium. There are a lot of other foods that need to be watched, but the important thing to remember is that if anyone is careless in what they give her to eat, she will be back in intensive care right away. It is extremely difficult to lower the potassium level once it is in there. And i must warn that a high potassium level can stop the heartbeat and the brain functioning. Then all other organ systems will follow suit. So it isn’t that she would be really sick, it will be very difficult to keep her alive. I don’t mean to be the bearer of bad news, It is just that it is one of the miost important things that she must absolutely do.
I mix three tablespoons of the ground flax seed in my yogurt for breakfast. It doesn’t taste great, but I really like feeling better. To do that, I would even eat cardboard. just joking. Then for lunch I have a protein drink and mix another 3 tablespoons of ground flax in there. Then in the afternoon if I am too hungry before dinner, I have a big tablespoon of peanut butter. I just lick it off the spoon and it is especially nice if you want a cup of tea or a cup of coffee. You have to be very careful about any fruits you eat. The peanut butter will give her a little fat which she can use and not too much protein which she will have to watch also. Patty also won’t be able to eat much in the way of meats. But there will be plenty of really good vegetables she can eat and lots of ways to make them. The pastas will be like the breads. She will need to cut them out. I hope the dietician coming will be really dedicated to helping Patty with a true renal diet. She can do very well if she follows a true renal diet with her diabetic diet. I forgot to mention the delicious sweet peppers, the reds, greens and yellows. Those will have to be limited also. But blueberries are about the safest of the fruits when she wants fruit. They aren’t quite as high in potassium, but have loads of antioxidants. I also bake with the ground flax seed and make pancakes and muffins and waffles. Of course i use the sugar free syrup, but it tastes good to me and to our kids. And she can even have whipped cream on her waffles or pancakes on top of the sugar free syrup.
I am not looking forward to starting dialysis, so I spend a lot of time be very grateful for all the things I can do and can have now. When i start it, I will do it right here in my own home. I am positive I can take care of that and it will be much easier to adapt into my life here at home. Just let me know if I can help in any way.

Hi Deb,
Everything has some amount of potassium in it. The thing about meat is the protein content. The kidneys have a very hard time with very much protein. The doctor will want Patty to limit the amount of protein she takes in. She can’t have protein at each meal, like eggs for breakfast and a sandwich for lunch and some meat for dinner. She will have to trade off and select when she wants her protein or else limit it to about 2 ounces per meal. I use ground almonds and flax seed for pancakes. The ground almonds or any ground nuts makes a kind of flour that can be used for any baking or pancakes. And there are sugar free syrups and sugar free honey that both taste good also. Potassium and protein will be the biggest things she will have to watch besides the number of carbs. I don’t want to discourage you. There is still a great deal we can eat. It just takes some time to understand what all the different foods have in them. It will get easier as time goes by. There are food counter books and i am sure you can find some things at the library as well. The best thing though will be buy a book that tells you the contents of all the different foods. The dietician may be able to tell you which one she would prefer that you use.

Hmm… shortly after my dx I was looking for foods that were high in potassium, and the source of my main list seems to have disappeared. Right now I can’t seem to find lists of low potassium foods, but I can find assorted lists of high potassium foods (which would be Patty’s “avoid these foods” list)…

http://www.hoptechno.com/bookfoodsourceK.htm
http://lpi.oregonstate.edu/infocenter/minerals/potassium/
http://www.health.gov/Dietaryguidelines/dga2005/document/html/AppendixB.htm

I have downloaded the USDA SR20 database, so I may be able to do a search from there… the issue I find with that database is that the serving sizes are so completely off as to be ridiculous…

I’ve just generated a .pdf based on the information in USDA NAL SR20; the Excel file may be based on USDA NAL SR17 (an older version) but is in alphabetical order of foods (it should be easily sorted for low-potassium in Excel). Hope this helps.
8583-PotassiuminCommonFoods.pdf (5.45 MB)
8584-potassiumsources.xls (1.61 MB)

I certainly understand where you’re coming from… you do what you can do, and then you need to have the strength to let go… and just be there for Steph, Brian, and the kids.

Hi Debb,
I realize this is so very hard for you and your daughter and her husband and kids. I don’t remember exactly what age you said Patty is, but she may really not want to live. This may be her way of making sure she doesn’t have to go on for much longer without her husband. My Dad passed away 28 years ago. Mom held on and did all that she could do. But she missd my Dad awfully bad. She had all of us and a lot of grandkids and great grandchildren. But when she suspected she had cancer, she never told any of us or went to the doctor until it was too late. By the time we found out the metastasis was too far When we did learn about the cancer and understood Mom’s wishes, we went with Hospice and just let her go. It was extremely hard for all of us, but Mom was tired and just wanted to be with Dad. By that time there was no treatment that would have worked, so we just loved her enough to let her go. This may be what Steph and Brian may have to do. Sometimes, people who are ill may also just be too scared to make big changes in their lives. For some, change may be really terrifying.
Whatever we can help you with and Steph and Brian and the kids, i know all of us will be more than willing to pitch in and do. There may be nothing that Patty accepts and then maybe later on she will. Whichever way it goes, just write on here and tell us anything you need and just keep us updated. Maybe the best thing we can do is listen to your worries. That is fine too. We are all here for each other, no matter what it is. Just know that we are with you.

My heart goes out to you, Steph, and her family. It certainly does sound as if Patti wanted to find some way to be free of these physical limitations and with her beloved husband.

While it may sound corny to say it, I know that people do seek out and find their soulmates in the afterlife, or wait for them if they have passed on first. (Like the “rainbow bridge” story, but for people rather than pets.)

Hi Debb,
I am so sorry for all the pain and grief and my heart and prayers are with you and Steph and Brian. For some people all the struggling with illness is just too much. And i really believe Patty is with her husband now. My Mom had to go on living for another 20 years after my Dad passed away and when she got cancer she just couldn’t fight it. She wanted to let it go and we loved her enough to let her make her own decision. It is very hard to not try to change things for our loved ones. I know all of you did everything that you possibly could and are relieved Patty is no longer suffering.
Thank you for letting us know what happened. Please keep coming back on and let us know how you all are doing. I am sending you a big hug.