RE: Doctor's Appointment...

[Guest guest]

Hi

everyone, I have been thinking a bit about attitude the last few days. I saw my new neph on Thursday for the

first time. His offices were clean,

his staff cheerful and amazingly enough he was running

early!!!!!!!!!!!!!!!!!!!!! He read

through the records I brought from the UK chuckling to himself as he went occasionally

asking a question. My UK neph said

that if I did not go on the steroids I would be on dialysis with in a decade, Oz

neph (a fish oil man) thinks that there is only about a 15% chance that my

condition will ever get any worse than it is, and that steroids are certainly

not appropriate at this stage. His

is also wanting to monitor glucose as there is a family diabetes history where

as the UK guy didn’t think it was relevant. He also said that there was no medical reason to drink loads

of water if not thirsty and that kidneys need a little salt. I feel much lighter, healthier and

happier. He said to consult him

again if pregnancy was likely so he can change the meds, but also said that

pregnancy and kidney disease don’t match and so I would require close

monitoring but that there is no reason to not go ahead and do it. But isn’t it strange how the way you

see yourself can change in an instant?

[Guest guest]

Thanks for sharing that . Always interesting to hear about the different approaches different nephrologists may have - and in different continents too.

About salt:

Your new neph's comment about the kidneys needing a little salt is exactly what I've been told also. The pre-dialysis renal diet I'm on now is low sodium, but it does not go to the extreme of eliminating absolutely everything with sodium. In fact, bread (normal everyday bread) is a major component of it, as are pastries, etc. The dietecian also said not to bother with unsalted butter or margarine if I don't like the taste of it (and I don't!), because the small amount of sodium in it isn't enough to worry about (as long as I stick to the daily recommended amounts of fats like margarine). I'm also allowed a bit of cheese. The basic idea is to avoid too much sodium by not using table salt at all, and not using any processed foods that are high in sodium (like potato chips, canned tomatoes, processed cheeses, processed meats, etc.), and it's not so much for the kidneys themselves, but more as an aid in keeping blood pressure as normal as possible, and edema down. They really worry a lot more about keeping within the recommended range of meat (or alternatives) protein, and the phosphorus (to prevent bone problems).

Pierre

RE: Doctor's Appointment...

Hi everyone, I have been thinking a bit about attitude the last few days. I saw my new neph on Thursday for the first time. His offices were clean, his staff cheerful and amazingly enough he was running early!!!!!!!!!!!!!!!!!!!!! He read through the records I brought from the UK chuckling to himself as he went occasionally asking a question. My UK neph said that if I did not go on the steroids I would be on dialysis with in a decade, Oz neph (a fish oil man) thinks that there is only about a 15% chance that my condition will ever get any worse than it is, and that steroids are certainly not appropriate at this stage. His is also wanting to monitor glucose as there is a family diabetes history where as the UK guy didn’t think it was relevant. He also said that there was no medical reason to drink loads of water if not thirsty and that kidneys need a little salt. I feel much lighter, healthier and happier. He said to consult him again if pregnancy was likely so he can change the meds, but also said that pregnancy and kidney disease don’t match and so I would require close monitoring but that there is no reason to not go ahead and do it. But isn’t it strange how the way you see yourself can change in an instant?

[Guest guest]

> Wrong. There are methods of determining kidney function without a

24 hour

> urine collection, using only blood work and a spot urine sample.

Most years

> I haven't done more than one 24 hour, some not at all. What you

can't

> determine without a 24 hour collection is proteinuria over a 24

hour period.

> Pierre

>

said: Your kidneys have plenty of " spare " ability, so it is

possible to lose

function and not have a significant change in your serum creatinine.

This

is why the creatinine clearance is more useful and a better direct

measure

of kidney function. In order to measure creatinine clearance, you

simultaneously measure the fluid output of the kidneys over a fixed

period

of time (hence the 24 hour collection) and then measure the

creatinine

concentration in that urine sample as well as the blood.

Is there a direct contradiction between these 2 posts? I'm a little

bit confused.

Marty

> Doctor's Appointment...

>

>

> > Well, I really hate going to the doctor in the fall. They are so

> > busy with tons of sick people that they can't really stop and

talk to

> > you or listen to you even. Had to get my yearly womanly checkup,

> > which is just too fun anyway. All that went okay, except a place

on

> > my left breast he wants me to keep a watch on.

> >

> > I tried to ask him about my hand and elbow pain this summer, which

> > has gotten progressively worse. He just told me to put

Aspercreme on

> > it. Thanks doc, I'm only 28 and having arthritis-type pains that

> > even hurt when I drive, and you're not even a bit worried.

> >

> > Then I showed him a hard spot beneath one ear, right behind the

jaw

> > bone. He felt it and said it felt like an enlarge lymph node,

told

> > me just to watch it for any changes. Not worried about that

either,

> > huh doc?

> >

> > He told me to come back in March (one year since I had my last 24-

> > hour urine and bloodwork) and he would do bloodwork ONLY for the

> > kidneys. Said I didn't need a 24-urine every year if my

creatinine

> > and BUN stayed the way they have been (1.4 and 19). I thought you

> > couldn't figure your kidney function percentage without the urine

> > test. Is this right or wrong? He said he would add a bloodtest

for

> > rheumatoid arthritis in March too.

> >

> > I just felt rushed aside and not listened to. I really hate that

> > feeling.

> >

> > Teri

> >

> >

> >

> >