Blessed Assurance: Success Despite the Odds

by Jacquie Lewis-Kemp, Author & Health Coach for Living life with diabetes and organ transplants, rather than limiting life because of them.

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Blessed Assurance: Success Despite the Odds

CALENDAR OF EVENTS
04/14/12 Writer’s Expo, The Upper Room, Detroit, MI
04/21/12 Signing Books, God’s World 2-4 PM                 Seven Mile and Schafer in Detroit, MI
04/28/12 Walking with Jackie’s Crew to cure MS              at Covington School, Bloomfield Hills, MI
05/01/12 Advocating diabetes and kidney education programs at the American Diabetes Association and National Kidney Foundation’s        Diabetes & Kidney Day in Lansing, MI
05/12/12 Signing books at Antioch Baptist Church  in Pontiac, MI
8/4-8/12 Signing books at the Bass Mollett booth at the   National Funeral Directors & Morticians Association convention in Las Vegas, NV
09/29/12 University of Michigan Transplant Center’s    Vita Redita Gala & Charity Auction  at THE BIG HOUSE! in Ann Arbor, MI
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Perhaps one of the most difficult aspects of chronic kidney disease is the diet.  After you get past figuring out how you will schedule dialysis and what you need to do in order to have energy and strength, you find that diet plays a large role in making that happen.

Salt Restriction

It is common knowledge that too much salt isn’t good for you. However for dialysis patients high, sodium foods impact a dialysis patient immediately. Already plagued with water retention, something as simple as a slice of pizza or a bag of potato chips can cause dialysis patients severe ankle swelling or swelling in the abdomen causing shortness of breath.
Excess sodium also causes blood pressure to rise and cause headaches, mental dullness and a loss of energy. At its worse, hypertension (high blood pressure) can incite cardiac complications.

Phosphorus Restrictions

Who ever thought that potatoes would be something restricted on a diet? But they are a very special case when it comes to kidney disease. The kidneys filter waste from the blood and it is expelled through the urine. When your kidneys don’t function properly, one of the chemicals that don’t get filtered is phosphorus. Doctors prescribe phosphorus binders which make it so that phosphorus can be cleared in the stool rather than urine. However, the best option is to limit consumption of high phosphorus foods like nuts, organ meats, chocolate, cola drinks and beer.

Potassium Restrictions

An orange on the restricted list? For the same reason that phosphorus builds up in the blood stream for dialysis patients, potassium also builds up in the blood stream. Excess potassium can cause problems such as weakness, muscle cramps, tiredness, irregular heartbeat and, worst of all, heart attack. Potassium is found mostly in fruits, vegetables and dairy products. Certain fruits and vegetables are very high in potassium while others are lower. However, eating a large amount of a low-potassium food can cause potassium to add up to dangerous levels. Be aware that most foods contain some potassium — meat, poultry, bread, pasta — so it can add up. Butter, margarine and oils are the only foods that are potassium free.
Refer to the charts below from DaVita Dialysis, as simple reminders of which foods should be restricted and some suggested alternatives.

High potassium

High phosphorus

Double jeopardy —High potassium and high phosphorus

Fruits

Meat

Milk

Vegetables

Poultry

Dairy products

Fish and seafood

Nuts and seeds

Wild game

Chocolate

Eggs

Whole grain products

Dried beans and peas

Check the list below to see if you are eating any of the double jeopardy foods on the left. Using some of the alternatives listed on the right will help improve your chances of keeping potassium and phosphorus under control.

Double Jeopardy Foods (High Potassium & High Phosphorus)

Alternatives

Cheese

Vegan rella cheese, low-fat cottage cheese, sprinkle of parmesan cheese (use very small amounts of extra sharp cheeses for the maximum flavor)

Chocolate

Desserts made with lemon or apple, white cake, rice-crispy treats

Cream Soup

Broth-based soups made with pureed vegetables or make soups with Mocha Mix® nondairy creamer or Rich’s Coffee Rich®

Dried beans and peas

Green beans, wax beans

Ice Cream

Mocha Mix® frozen dessert, sorbet, sherbet, popsicles

Milk

Mocha Mix® nondairy creamer, Coffeemate®, Rich’s Coffee Rich®, Rice Dream® original, unenriched rice beverage

Nuts

Low-salt snack foods including pretzels,tortilla chips, popcorn, crackers, Sun Chips®

Peanut butter

Low-fat cream cheese, jam or fruit spread

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African Americans are disproportionately affected by diabetes and hypertension which make up more than 2/3 of all cases of kidney failure. Understand these risks and take charge of your lifestyle to prevent kidney disease.

Further, share what you’ve learned with family, friends, your neighborhood and your congegation.

 

 

 

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Chronic diseases or conditions like diabetes, multiple sclerosis, hypoglycemia, asthma, kidney disease, hypertension, heart disease and transplant living all require a regimen that requires strict adherence. Not following these regimens or staying within the guidelines can cause serious problems, long term complications or even sudden death. Almost all of these conditions require a special diet or dietary restrictions.  Some of them can be controlled with diet alone. Others also require medicines and test procedures.

This can seem overwhelming for someone first diagnosed with a chronic illness, and it can continue if the patient doesn’t develop a regimen to accommodate the medicine schedule, the dietary restrictions and timing, and exercise requirements. The restrictions that a chronic condition requires can feel overwhelmingly restrictive, but consider the alternative. If a diabetic doesn’t develop a regimen to consistently take medication, follow a low glycemic diet with the prescribed carbohydrate restrictions and exercise as suggested, then blood sugars can dip too low and cause a severe hypoglycemic reaction resulting in loss of consciousness or even death. Other chronic conditions can result in similar serious conditions as well as sudden death.  This is why a regimen to prevent these severe reactions is important.

How do you manage diabetes? How do you eat an elephant? One bite at a time!

In other words, you break down what needs to happen and put it up against your usual daily schedule.

  1. 1. List the things that must be done for proper management of your condition. In the case of diabetes, you would list your dietary requirements and restrictions, your medicine doses and times, your test and exercise requirements/suggestions.

  2. 2. List your normal daily activities and job travel and/or timing requirements. For instance if you work 8am until 5pm, and you travel 10%  of the time, typically Tuesday through Friday.

  3. 3. Now blend the lists by figuring out what the breakfast requirements translate into as far as a meal; what you will eat for lunch (whether purchased at a restaurant or packed in a  brown bag lunch) and how you will complete dinner requirements. When you will test and if you will gets some midday exercise walking outside or to lunch.

  4. 4. You should also write down when you will test during these hours and at home.

  5. 5. Finally look over the list of requirements and make sure that you determine what supplies you need to make this regimen work. For instance, if carrying blood testing supplies and the machine is not convenient, then you might want to consider keeping an  extra set at work in a locker or in your desk. If that means keeping medicine at work as well, make sure to consider the storage requirements of the medication. For instance, insulin doesn’t need to be refrigerated; however it shouldn’t be kept in direct sunlight either.

  6. 6. Schedule time for exercise so that it is not an afterthought that is not done regularly.

The key is to make sure that what your condition requires, you make available and convenient so that it is easy to be compliant to your doctor’s orders.

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I didn’t expect it–the smell. The extreme smell of disinfectant and bleach, the quiet coming and going of staff and patients. The dialysis center. I hadn’t been inside a dialysis center for nearly 11 years, when I was on peritoneal dialysis or PD as those of us in the “Kidney World” call it.  I agreed to participate in a study for the National Kidney Foundation as a peer mentor talking with dialysis patients.  I am a certified peer mentor, however this study required additional training and all through the training I was excited to participate.  The study’s hypothesis is something I believe in and feel strongly will be successful. Even though I am a peer mentor, much of my work promoting organ donation has been at speaking engagements, church functions and during book signings.  So I really hadn’t been back to a dialysis center until today.

I was glad that the social worker and National Kidney Foundation representative met with me in the conference room first. I needed a minute to collect myself. It is not that I was afraid or changed my mind about volunteering; I just didn’t anticipate the reaction of a negative déjà vu.

After our discussion about how the day would go, I gowned up to meet my patients.  I remember that when I was on dialysis, I was afraid of what would happen next . . . after dialysis.  And if I didn’t do anything today, I wanted the people that I met to know that there can be a successful life after dialysis. With that mantra, my nervousness about the bleach that I smelled turned into eagerness to meet new friends.

My afternoon was spent meeting very interesting people. Sometimes when we get caught up with disease, illness and chronic conditions, we forget about the interesting and complex lives that we live. I shared and they shared. I think we had a good day. I’ll be back in a couple weeks and look forward to building the relationships I created today. Although I’m the mentor presumably offering information and ways to make it successfully through dialysis, I feel like I’m the one who benefited from today’s activities.

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Kidney Transplant

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Kidney Transplant

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Kidney Transplant

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On our parents' balcony before Jacquie's wedding

I can hardly believe that it has been 11 years.  Eleven years since my little brother donated his left kidney to me so that I might live.  In eleven years you would think that I would be pretty used to saying that, but it still brings the same tears to my eyes just writing it.

You know Jeff has never known a big sister without diabetes–taking a shot is what she did everyday, a couple times a day.  But slowing down because of illness is not what he was used to either and I think that is why he stepped up to become the big brother (despite our ages) and save my life.

I had lunch with my husband, mother and brother Jeff to tell them that the doctor recommended that I begin dialysis.  Because I was running my dad’s business at the time, Jeff asked, “What will you do?” I told him I wasn’t sure, perhaps I’d have to find a job.  Jeff piped up with a proclamation that no one expected nor could we proove would be possible.  Jeff said that he would give me a kidney.

We knew that we were the same blood type, but tissue type is another hurdle.  Nevertheless, my hero, my little brother was willing to undergo serious, complicated surgery to save his sister’s life.  And his wife supported his decision.

While all this is serious stuff–we had a ball making light of the process.   From doctors testing us to qualify us for transplant “from the rooter to the tooter”, to Jeff’s journey in the hospital from his room across the hall, to my room with foly catheter in tow and having to remind the newbie nurse that neither he nor the lead in the catheter were as long as the distance between them, so she should slow down.

I will forever be grateful to my little brother.

God bless and keep you Jeff. Much love,

Jac

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