Feeling Better After Dialysis Is As Easy As Can Be!

Know The Numbers!

There are two numbers that you should know: Your KT/V and URR (Urea Reduction Ratio). KT/V and URR measure how much of the waste product, called urea, is removed from your blood. Not getting enough dialysis time and having too much urea left in your blood after dialysis will leave you feeling sick.

Knowing your KT/V and URR numbers can assure you that waste in the blood is being removed sufficiently.

Know Your Numbers!

• Goal: KT/V greater than 1.2
• URR greater than 65%

These goals are the minimum numbers for adequate dialysis. To find out your exact number, just ask the nurse, dietitian, or doctor at your dialysis center.

Know How To Reach Your Goal!

• Always go to all your scheduled dialysis treatment.
• Stay for the full treatment.
• Follow your diet.
• Avoid excessive fluid weight gains between treatments.
• Check your KT/V and URR number every month.

Adequate Dialysis Will Help You:

• Eat better and feel less nausea.
• Have fewer hospital stays.
• Feel less tired and live longer.

Signs & Symptoms of Inadequate Dialysis:

• Itchy skin.
• Poor appetite.
• Fatigue.
• Shortness of breath.
• High blood chemistries.

Dialysis removes waste products and extra fluid from your blood. Inadequate dialysis leads to a build up of waste and fluid in your blood.

Although you may feel okay without adequate dialysis, overtime you will become weak and tired.

Attending and staying for all your dialysis treatments is very important. People with less waste products in their blood feel better, are healthier and, live longer.

by Jody Gardener-Jones

Phosphorous Tips

Nutrition Facts may not list phosphorous. Check the ingredients.

Milk, nuts and dark colas are high in phosphorus.

Kidney disease can cause an unhealthy buildup of phosphorus.

Dialysis alone can’t remover all the extra phosphorus from your body.

More than 7 out of 10 dialysis patients have high phosphorus.

Dialysis helps remove extra phosphorus from your body.

If not treated, high phosphorus can be a serious condition.

Phosphorus buildup can cause bone disease and heart disease.

With high phosphorus levels, you may not feel any symptoms.

Phosphorus is a mineral found in many foods.

by Jody Gardener-Jones

Medication Tips

Ask friends how they remember to take their medication.

Refill your prescriptions before you run out of your medication.

Ask friends or family to help you remember yor medication.

Put a note on the refrigerator to remember your binder medication.

Talk to your health care provider about the mediations you take.

If you travel, remember to take your medications with you.

Which binder medication is right for you? Ask your health care provider.

Take all of your medications as directed.

by Jody Gardener-Jones

Diet/Food Tips

In your diet, replace wheat bread with white bread.

When shopping choose foods low in phosphorus.

Use information on Nutrition Facts labels to choose healthy foods.

Instead of ice cream for dessert try sherbet.

Work with your dietitian to choose kidney-friendly foods.

Ask your dietitian about proper portions size.

Talk with your dietitian before changing your diet.

Make a list of questions to ask your dietitian.

When you need answers, ask your dietitian questions.

Ask your dietitian questions while at dialysis.

Ask other dialysis patients if they have any food ideas.

Do you know which foods to limit? Ask your dietitian.

Prepare your meal and your binder medication together.

by Jody Gardener-Jones

General Tips For Dialysis Patients

It’s important to come to all of your dialysis appointments.

Stay the entire time at your dialysis appointments.

A strong support system helps you stay on track.

You have chronic kidney disease, but it’s not who you are.

Talking about kidney disease may help you cope.

Use your dialysis time wisely. Plan your meals or read.

Talk to others dialysis patients about joining a support group (I say social group).

Stay on track with your dialysis when you travel.

You are the most important player when it comes to your health.

Stay on track with diet, dialysis, and medication.

Dialysis is important. So are proper diet and medication.

Dialysis does the job of healthy kidneys.

Set realistic goals to help keep you on track.

Track your progress with your scheduled lab results.

Be active. Ask questions to help you understand your treatment.

by Jody Gardener-Jones

Dialysis, Dialysis, Dialysis...

by KMJ

Advice From The Kidney Doctor

In this article of Be Healthy, Be Happy, I’d like to discuss an issue that comes up every day in the dialysis center: fluid restriction. There is no doubt that fluid intake is the most important determinant of weight gain between one session of hemodialysis and the next, particularly in patients with minimal urine output. However, we must be careful not to neglect the importance of dietary sodium intake as well. Patients drink for one of two reasons: thirst, and because they ‘feel like a drink’ – for example, social drinking. It is very difficult for a conscious patient to ignore thirst, and severe thirst will drive a patient to find fluid wherever they can. When patients do this, it is not because they are ‘mad’, ‘totally non-compliant’ or ‘too stupid to understand the importance of fluid restriction’ – it is because it is nearly impossible to ignore such a strong physiological stimulus. The over-riding stimulus to thirst is sodium concentration. Thus, we should concentrate on advising and helping dialysis patients to limit their salt intake, which will help limit thirst. Advising dialysis patients to restrict fluid intake when they have not had advice on how to limit their salt intake is inhumane, and is a waste of time. What other factors may impact thirst and fluid gains? A certain amount of sodium is delivered to each patient during each dialysis session. This may be prescribed by your nephrologist to help keep your blood pressure from dropping. If you’re caught in a vicious cycle of increasing fluid gains and increasing symptoms during rapid fluid removal on dialysis, talk to your nephrologist about your ‘sodium profile’ and how this can be changed to promote less thirst. There’s also some evidence that ACE inhibitors, a certain class of blood pressure medication, can reduce thirst and weight gain in dialysis patients with habitually high inter-dialytic weight gain and fluid overload.

In summary, a low sodium diet with advice to drink only when thirsty has been shown in clinical trials to significantly limit weight gains. The hard part then becomes the practical difficulty of persuading patients to limit dietary sodium intake. The high sodium content of many processed foods means that simply avoiding salt at the table and in cooking will not be enough to achieve these effects. However, any reduction in salt intake is likely to have a beneficial effect in the right direction. Talk to your dietician about the possible sources of sodium in your diet, and ways to lower it. And then maybe you won’t raise as many eyebrows when you get on the scale!

Dr. Christopher Caputo
Queens Nassau Nephrology Services

Finally... Photos From The 2010 Long Island Kidney Walk

Hi everyone... yes, finally I have posted some photos of this year's Kidney Walk... I arranged the photos into a slideshow video but there was some technical difficulties with Google and Blogger with getting videos uploaded to the Blog... things have been fixed, at least for now... if there seems to be any future problems with the slideshow, I will repost the photos individually... I hope you enjoy the images... as you will see, it was a really fun day for everyone...

I am also providing a link to where I have the same photos from the slideshow stored online at my picasa web album... this is because the quality of the photos in the slideshow seem a bit diminished... I guess this comes from the video processing done by Google... the quality of the pre-processed photos are better and you can see them at a larger size... Here is the link below:

http://picasaweb.google.com/106897143679492476030/LongIslandKidneyWalk2010#

by KMJ & Jody Gardener-Jones

And We Walked...

Yes we did walk... many of us, walking as one...

Yesterday's NKF Long Island Kidney Walk at Hofstra University in Hempstead, Long Island was fantastic. All the weather forecasts spoke of rain for the day and there was none... we even got peeks of sunshine on a cloudy but great day. The 'Be Healthy Happy' team was in the place- 65 walkers strong and representing to the fullest... For sure, all the teams present were looking good... No doubt, it was a wonderful experience for everyone...

I would like to thank the team members very much for their paricipation and support, as well as all those who sponsored and supported the team... the 'Be Healthy, Be Happy' team would be nothing without you guys... and may we do it even better next year...

Stay tuned for upcoming posts with many photos and videos of the day's events...

by KMJ and Jody Gardener-Jones

People Feel Best...

It was once related to me that- "People feel best when they are united and moving together for a good cause". Surely, today's Kidney Walk which will take place later this morning is a good cause- more so, a great cause. I trust that everyone will be there united and moving together... and yes- FEELING THEIR BEST. May we be blessed with a fun-filled, successful event.

by KMJ

Understanding The Dialysis Patient

So you have to have dialysis. How did this happen?  Why did it happen to me?  Iʼm sure that these are
some of the questions you have asked yourself. As a society we tend to overindulge. Because of this overindulgence, it has affected our health. We are overweight with hypertension and diabetes.
Hypertension is a disease that is called the silent killer. Unless you get regular medical checkups
you may not know you are hypertensive until it is too late. Hypertension affects every bodily system
and the kidneys are no exception. You find yourself in the hospital having to get a catheter because
your kidneys have stopped working. Dialysis???  What is dialysis you are asking yourself? Dialysis
is something you will need for the rest of your life. It is the only thing that is going to keep you alive
other than having a kidney transplant.  And who knows when that will happen. The kidneys work as
our bodyʼs cleaner. They help to get rid of the toxins and wastes in our system. They help get rid of
fluid. They also help regulate:
   • erythropoietin, or EPO, which stimulates the bone marrow to make red blood cells
   • renin, which regulates blood pressure
   • calcitriol, the active form of vitamin D, which helps maintain calcium for bones
      and for normal chemical balance in the body

Compliance???  What does that mean???  It means to follow the rules. When it comes to dialysis,
compliance is very important. You have to monitor what you eat and drink. Some people think that
it doesnʼt matter what they eat or drink, I will go to dialysis and it will clean me out. Yes dialysis will take care of it, but it canʼt take off all the excess fluid because you will cramp, your blood pressure
will drop. Your body is a wonderful machine but it canʼt be abused. As the saying goes, your body is
your temple.  And you should treat it as such. You eat and drink too much and it will eventually affect
your heart. What do the kidneys have to do with my heart???  All the extra fluid and toxins have no
where to go so it affects all your other organs and something has to give. I have seen too many
patients that are not compliant and they wind up in the hospital with Congestive Heart Failure and
other ailments. Every time they come back to dialysis you can see that they are not the same, like
the life has been taken out of them.  And if they go to the hospital too many times because of
non-compliance their life will be cut very short.

People think that when they are on dialysis that their life if over. It is not!!! It is just another chapter
in your life. You can still do things you have always done but maybe in a different way. Or maybe
you have to try different things to keep your life a fulfilled one. Life is not over, just ask your
family. Iʼm sure they want you around for a long time and you can be if you just take care of
yourself. You can teach your family, especially children, that they should do things now to take
care of themselves so they donʼt wind up having to have dialysis.  And children learn by example.
So if you start eating healthy and acting healthy this will help them in the long run. We have to
stop the cycle of abuse to our body and teaching your children will help. Hopefully, they wonʼt
have to go through what you have gone through.

by Catherine Heed, LPN

The Lighter Side Of Dialysis

 * * * * *

by KMJ

Busy, Busy, Busy...

Hi everyone...

I would like to apologize to my visitors for the infrequent posts during the past couple of weeks. I have been very busy preparing myself and the 'Be Healthy, Be Happy' team for the upcoming NKF Long Island Kidney Walk taking place Sunaday, May 23, 2010 at Hofstra University in Hempstead, NY. I will do my best to do better with new posts during this last week of preparations and will surely be back on track with the blog after the Kidney Walk is over.

I want to thank everyone who visit my blog and I hope that the experience is educational and entertaining. I welcome your comments and critiques as they help me provide a better blog for my readers. I also encourage those who visit the blog and like what they see, to sign up as a follwer of the blog. This helps me to attract more attention and sponsors in the future, which in turn enables me to be able to pursue other avenues of enlightening others about and helping others with kidney disease.

I thank you all for your support and I hope to see many of you at the upcoming Kidney Walk.

by Jody Gardener-Jones

Fluid Control For Those On Hemodialysis

The goal of fluid restriction is to help you feel comfortable before, during and after your dialysis sessions. Even though dialysis gets rid of excess fluid and waste in the body, it is not as effective as healthy kidneys. Why? Healthy kidneys work all the time—24 hours a day, 7 days a week. Most people on hemodialysis get treatments three times a week for about three or more hours at a time. This means, in the days between your dialysis treatments, your body holds on to excess fluid and waste your kidneys cannot remove.

Going over your recommended fluid allowance can lead to too much fluid building up in your body between treatments. This build up causes swelling and increases your blood pressure, which makes your heart work harder. Too much fluid can build up in the lungs, making it difficult for you to breathe.

Hemodialysis removes fluid as the blood is filtered through the dialysis machine. However, there is a limit on how much fluid can be safely removed during a dialysis session. If you exceed your fluid allowance, more fluid must be removed. Your body may not be used to having so much fluid removed at once. Some people experience muscle cramping during dialysis when they gain too much fluid weight. Taking out a lot of fluid can also cause a drop in blood pressure, which can leave you feeling nauseated, dizzy and weak after the treatment. Sometimes, an extra dialysis session may be required to remove all the extra fluid.

by Jody Gardener-Jones (from davita.com)

Dialysis Diet

Wastes in the blood come from food and liquids that are consumed. People on dialysis must adhere to a dialysis diet to cut down on the amount of waste in their blood. Following a dialysis diet may also bolster kidney function and delay total kidney failure.

A dialysis diet is one that is low in sodium, phosphorous and protein. A dialysis diet stresses the importance of consuming high-quality protein and limiting fluids. Some dialysis diets may also call for limited potassium and calcium. Every person is different, and therefore, a dietician will work with each patient to come up with a dialysis diet that is tailored to his or her needs.

by Jody Gardener-Jones

The 3rd Annual Long Island Kidney Walk

The 3rd Annual Long Island Kidney Walk will be held on May 23, 2010 at Hofstra University, in Hempstead, NY.

Join us, the 'Be Healthy, Be Happy' team. Together, we are going to make a difference in the kidney care community.

Can't wait to see you out there!

by Jody Gardener-Jones

Sometimes, Laughter Is The Best Medicine...

A man suffered a serious heart attack and had open heart bypass surgery. He awakened from the surgery to find himself in the care of nuns at a Catholic Hospital. As he was recovering, a nun asked him questions regarding how he was going to pay for services. He was asked if he had health insurance.
     He replied, in a raspy voice, "No health insurance."
The nun asked if he had money in the bank.
     He replied, "No money in the bank."
The nun asked, "Do you have a relative who could help you?"
     He said, "I only have a spinster sister, who is a nun."
The nun got a little perturbed and announced loudly. "Nuns are not spinsters! Nuns are married to God."
     The patient replies, "Then send the bill to my brother-in-law."

*****

A man walks into a psychiatrist's office wearing only underwear made of Saran Wrap. The psychiatrist says, "Well, I can clearly see you're nuts."

*****

While acquainting myself with a new elderly patient, I asked, "How long have you been bedridden?"
After a look of complete confusion she answered, "Why, not for about twenty years--  when my husband was alive."

*****

John and David were both patients in a mental hospital. One day while they were walking past the hospital swimming pool, John suddenly dove into the deep end. He sunk to the bottom and stayed there. David promptly jumped in to save him. He swam to the bottom of the pool and pulled John out.

The Medical Director came to know of David's heroic act. He immediately ordered that David be discharged from the mental hospital as he considered him to be okay. The doctor told David,
     "David, we have good news and bad news for you. The good news is that we are going to discharge you because you have regained your senses. Since you were able to jump in and save another patient you must be mentally stable. The bad news is that the patient whom you saved, Mr. John, hung himself in the bathroom, and died."

David replied, "Doctor he didn't hang himself, I hung him there to dry."


by KMJ

Awareness

Awareness Is The Key To Good Health

• Ask Questions.
• Watch Your Treatments.
• Alert Staff of Problems.
• React Quickly and Calmly if any problem accrues.
• Educate Yourself.

Ways You Can Be Aware

• Medications - Know what kinds of medicine you take and know about your dialysis prescription.
• Access -  Protect your arm (or where your access is).
• Diet - Know what foods are good and safe for you to have. Know how much fluid is safe for you to have.
• Advocacy - Speak up for yourself! Or ask your social worker to help you.

by Jody Gardener-Jones

The Role Of The Nephrology Social Worker In A Dialysis Center

Social work is a profession that helps individuals, families, and groups change behaviors,
emotions, attitudes, relationships, and social conditions to restore and enhance their capacity

to meet their personal and social needs and improve their quality of life.

A licensed master’s social worker (LMSW) is part of the interdisciplinary team provided to

each person who receives treatment at a dialysis center. Social workers in a dialysis setting

will help those receiving treatment identify and use their strengths to cope with the adjustment

to the dialysis regimen and fluid/dietary restrictions.

Your nephrology social worker can:

  · Provide education on the CKD/ESRD illness and treatment options
     including transplant.

  · Assess quality of life by continuing to monitor for depression and assist
     the individual in adapting their life to ESRD through supportive counseling.

  · Will assess and coach the individual toward maximized physical,
     emotional, and social balance. They encourage the individual to continue to
     seek and attain what they desire in life.

  · To encourage and guide the patient to deal with outside stressors or
     barriers that may interfere with the person’s adherence to treatment.

  · Will offer support to family/caregiver.

  · Provide assistance with concrete services such as insurance,
     transportation, and travel.

Anyone dealing with a major life changing situation, such as chronic illness, will undergo a
period of adjustment. Using the support provided by your nephrology social worker could
ease the stress and anxiety experienced by the challenges of the ESRD illness.

Get to know and use the services of your nephrology social worker, it just could make a
difference in your quality of life.

by Mary Rzeszut, LMSW

Words Of Inspiration

When one door of happiness closes, another opens, but often we look so long at the closed door that we do not see the one that has been opened for us.   -Helen Keller

by Jody Gardener-Jones

Did You Know...

When a person's kidneys no longer function properly or not at all, they have chronic kidney disease (CKD). When the kidneys fail, a person needs dialysis or a kidney transplant to survive.

Diabetes is the number one cause of kidney disease, responsible for about 40% of all kidney failure cases. High blood pressure is the second leading cause, responsible for about 25% of these cases.

The number of people diagnosed with kidney disease has doubled each decade for the last two decades.

Some 26 million Americans (1 in 9 adults) have chronic kidney disease and most do not know it.

Over 367,000 people depend on dialysis for their survival.

83,000 people in this country are on the waiting list for a kidney transplant.

1 person dies every 2 hours waiting for a kidney transplant.

More than 70,000 Americans die each year because of  CKD.

Early detection can help prevent the progression of kidney disease to kidney failure.

Currently, there is no cure for chronic kidney disease.

** Sources: The National Kidney Foundation and The American Society Of Nephrology
** The numbers presented here, though current, are close approximations only, due to the fact that
     they are constantly changing.


by KMJ

Chronic Kidney Disease: Two Short Videos

Here, I am presenting two short videos that excellently give brief explanations of chronic kidney disease. One is from videomd.com and the other is from livestrong.com- two very good sites that offer videos that cover a whole range of health issues.

by Jody Gardener-Jones

The National Kidney Foundation Dinner For This Year's Long Island Kidney Walk

Hi everyone... this is Jody and I would like to take this time to inform everyone that on May 23rd, 2010 (which is a Sunday), the National Kidney Foundation will hold it's 3rd Annual Long Island Kidney Walk at Hofstra University in Hempstead, Long Island in New York. I formed my own team- 'Be Healthy, Be Happy' for the occasion and I and my team members will be out there in full force along with all the other teams and their members as well as many others. We walk with the goal of raising awareness about chronic kidney disease (CKD) and to raise funds so that the National Kidney Foundation can continue doing all the great necessary things that it does for those with CKD and to educate others so that they will hopefully never get the disease.

Last year, I walked at the Kidney Walk for the first time and I really had a wonderful experience. I met many new people and I also found out that yes, I can walk 5K (3.1 miles). For those of you who live in the New York City metro area as well those who live elsewhere but plan on being in the neighborhood that weekend, I invite you to come on out and walk with us. Your participation and support is surely needed and will be greatly appreciated. Besides, you will have a good time.

Last night, the National Kidney Foundation held it's kick-off dinner for this year's Long Island Kidney Walk. My good friend Catherine Heed (who is also one of my nurses at Winthrop University Hospital Dialysis Center) and I attended the event together. I must say that we really, really had a great time. We saw a few people that we knew and met many more new people. We even got the chance to meet, chat with, and take pictures with Grizz Chapman, one of the stars of the Emmy winning NBC television show '30 Rock'. He also is a dialysis patient and was there to kindly lend his support for the cause. The whole event was really nice- the food, the atmosphere, and several people gave some enlightening presentations. Even I spoke before the attendees... and you know I had to promote the 'Be Healthy, Be Happy' blog. Below are a few pictures that Catherine and I took at the event.

A fellow patient from my Dialysis Center and his lovely family

My good friend and nurse Catherine Heed (seated) and I  with some friends

Lindsay Gilman fron the National Kidney Foundation and I

One of the speakers at the Event

The actor Grizzwald "Grizz" Chapman from the NBC show '30 Rock'  speaking

Grizz and I in front of the lens

Grizz and some of our younger attendees

This is me giving my short presentation

I apologize for these last two photos being out of  focus, but my speech was on point

by Jody Gardener-Jones

Welcome

Please know that you are not alone………..

My name is Jody Gardener-Jones and I have chronic kidney disease (CKD). I was diagnosed in August, 2007 at the age of 27 and since then I have been undergoing dialysis treatment. Denial, anger and depression are just a few emotional issues I had to face when I was first diagnosed. Once I had learned to deal with my illness by acknowledging and accepting that I have an illness and also knowing that it is not a death sentence, with proper treatment and diet, I was able to begin to have a productive life, and not forgetting my faith, supporting team of doctors, dialysis medical staff and my family and friends, my emotions have changed to happiness, satisfaction, hope, joy, as well as countless other positive emotions.

As you learn to live and cope with kidney disease, remember- you do not have to go through the difficult times alone. Be willing to seek the support of your friends, family, healthcare team, and patient organizations, such as a support group. Be open to the idea that difficult emotions are a normal part of life and cannot be avoided. These emotions can provide an opportunity to learn new ways of coping and help you grow as a person.

With this blog, I want to provide a forum for discussions, advice, education, words of inspiration, healthy and delicious recipes, and lots of humor and fun. I will be featuring articles and stories from doctors and other medical staff, patients and their family/friends and anyone else interested in contributing. I want to emphasize to everyone that in no way is CKD a death sentence and that in spite of their condition, they can and must maintain a full and fun-filled healthy lifestyle.

It is my hope that all visitors to this blog will be educated, entertained, and inspired by what they read, see, and hear. I invite you all to become members and to contribute by way of your articles/essays, poems/prose, words of advice/inspiration, humor, and questions. You can even contribute photos, videos, and artwork. I only ask that all contributions be, in some way, in the spirit of this blog- which is health and happiness. You may contribute what you may, by sending your material to me at behealthyhappy@gmail.com . I ask, that along with your material, that you send me your name as you would like it to appear and any professional titles that you may hold so that I can properly credit you along with your submissions. I also welcome any questions that you may have.

by Jody Gardener-Jones