 Re: Rise in Creatinine
I concur what was said about the possible need for a biopsy. The
nephrologist will not ask for one just to get it, he will only have it
done if there is something that needs to be determined. If you have
PCD, it will show up in an ultrasound. Much less intrusive, and
certainly safer.
As to the use or non use of low protein diets, what was said is true.
The current protocol calls for not using low protien diets. It has been
shown that the only real thing that happens when a patient uses this
diet is that when they start dialysis, the patient is sicker, usually
suffering from malnutrition. Any benefit from a slight reduction in
BUN, such as a small amount less of nausea, are far outweighed by the
detrimental loss of protein in the muscles. This can be followed by
measuring Serum Albumen levels, a simple blood test. Albumen levels
below 3.5 are considered indications of malnutrition. Don't get me
wrong, until you start dialysis, a slight decrease in protein intake
would not be bad, just don't go too far. Once on dialysis, you will
have to increase protein intake, as some protein is dialyzed out during
treatments, and there is a statistical association with lower Albumen(>
3.5) and premature death in dialysis patients.
I understand the desire to remain off of dialysis, but the simple truth
is that the best way to approach this is to either find a living donor
for a transplant, or when it becomes difficult to tolerate the way you
feel, to begin dialysis. It does take a while to get used to it, and it
is not anything to look forward to, but the situation could be much much
worse. Trying to avoid it all costs will only lead to bigger problems,
such as ending up hospitalized for months to recover from the
malnutrition. Just remember to keep talking, learning and being
proactive. This will make you feel at least partly in control, and
maybe will help to speed up the adjustment.
Also, please don't consider the professionals "enemies". They are not
out to get you, nor are they trying to take anything away from you. You
will have to learn to live a new lifestyle, and how you do will pretty
much be up to you. The diet is tough, but much less so than it used to
be. I recommend that you follow strickly what you are told to do in the
beginning. After you have been stabalized, and your blood work shows
you are in good control, then approach the dietician about liberalizing
your diet a bit. This entails adding back in occasional small portions
of the foods that you like alot but have given up. Work with the
dietician because she or he can monitor you a little closer. As your
blood work continues to be OK, push for a little more. You will
eventually find a level in your diet that you can tolerate, and maybe
even enjoy, while still being safe. As you might suspect, you generally
have to eat a much more healthy diet on dialysis anyway, but it doesn't
have to so restrictive that you just don't want to eat anymore. Also
remember that different patients will have different diets, as we are
all a little bit different
One more suggestion. If you know for a fact that you are not going to
get transplanted, I would suggest you get a referal to a vascular
surgeon well enough in advance of your projected dialysis dtsrt time so
as to have a permanent access in place and developed before you need it.
The development can take 3-6 months if it is a Fistula, less if it is a
graft. You would do this to avoid using a catheter in the jugular vein.
Catheters are good for emergencies, or when no other access can be
found, but they have much higher rates of failure, they generally give
poorer quality treatments, as well as infection(sepsis) rates. Sepsis
is very serious, even fatal. Use one only if you have to, and for only
as long as you have to.
Now to satisfy the trolls, I am not a doctor. I have 19 years of
experience on dialysis, and I have experienced Peritoneal dialysis,
Hemodialysis and 2 Transplants. While I have not experienced every
possible problem seen in dialysis patients, I have seen most of them up
close and personal. I am a keen observer. I have an Engineering
Degree, and this is the way my brain works. I have also studied the
history of dialysis in length, and keep up with the current thoughts in
the field on a constant basis. I don't claim to know everything, and if
I say something that is not true, I will own up to it when it is pointed
out. This is one way to increase your knowledge, as you will hear
things from time to time that are not true, and the only way you'll know
is if somebody who knows it to be false corrects you.
Please keep up the posts. I know I am a bit wordy, but I would be glad
to help you to learn as much as you feel you need.
Dave
|
Last Thread
Next Thread
06-27-06 01:28 PM
