Dear diary, it’s been too long! So much has happened since my last entry back in October and it’s a bit complicated to explain. Maintaining a healthy body can be a difficult balancing act. After a complete physical, including an artery scan and blood vessel flexibility test, my doctor found anomalies that pointed to elevated blood pressure – some thickening in the neck arteries and small blood vessels that tested “abnormal”. (Interestingly, I have since read a Science Daily article that explained that vegans and strict vegetarians are at risk for hardened arteries if they don’t get enough of the vitamins and nutrients that can prevent it, namely B12 and Omega 3′s.) My cholesterol levels weren’t an issue, but my vegetarian diet, which didn’t include eggs or milk, clearly needed improvement. I was very low in vitamins B12 and D. At that point, I was feeling pretty lousy from the lack of B12 – nervous, unfocused, plagued with painful and annoying sores on my tongue, constantly sick with colds and a wicked throat ailment that delayed one of my doctor visits. Before this, I was hardly ever sick. I was glad there was a reason and a solution for my ill health, and the vitamin D deficiency actually gave me hope. I had just read about a study linking low vitamin D to high blood pressure. I told my doctor cheerfully and he was full of genuine sympathy. “Maybe we’ll get lucky,” he said.

Because I’m fairly young and my blood pressure hovers in the pre-hypertension to stage 1 range, he was inclined to put me on medication to bring it down right away, but I didn’t want that. I convinced him to let me monitor myself morning and night and follow a regular exercise routine – a 2 mile walk a day at least 5 days a week. He knew the walking would be good for my heart, but he wasn’t sure it would help my blood pressure that much. Again, I had read about another study that showed that exercise can lower blood pressure in the short term as well as the long term. Plus exercise is a great stress reliever. Although I accept that my high blood pressure is at least partly hereditary, I know stress has something to do with it. After 2 weeks of walking, the doctor could see that my blood pressure numbers were dropping. He knew how determined I was, so he agreed to give me a few months to see what exercise, relaxation, and vitamin D could do.

So that’s what I’ve been up to – doctoring (and slowly paying off the doctor bill), taking my vitamins, exercising like crazy, working hard, and attempting to de-stress. There have been setbacks. The B12 didn’t kick in until I took a potent liquid version. And I lost a little too much body fat from walking, which left me exhausted and threw my hormones out of whack. I’m back in the swing now, eating sockeye salmon, drinking milk, eating eggs, and everything under the sun reputed to lower blood pressure – oranges, orange juice, blueberries, strawberries, walnuts, dark chocolate, green tea.

I have days when my blood pressure gets me down, when I don’t want to test myself. The beeping sound when the test begins makes me nervous and I hate it when the cuff squeezes my arm, sometimes so tight that it leaves a red mark. Even if I have 8 out of 10 good blood pressure readings, the perfectionist in me seizes on the higher ones (even when they aren’t that high at all).  I wonder what I did wrong.

Sometimes this whole health regimen overwhelms me. I’ve started practicing a relaxing breathing technique described by Dr. Andrew Weil. It seems to be helping, but I know I have more to do. In the last few months, I’ve read about so many activities that are said to lower blood pressure that I feel I need to make a list and create a schedule for myself to fit everything in – tai chi, yoga, meditation, singing, music therapy, tap dancing (I made this last one up myself; if I could dance in front of the TV watching Fred Astaire and Ginger Rogers, I’m convinced I’d tap the high blood pressure away.)

It’s nearly April 15. Last night I couldn’t help thinking about my taxes as the blood pressure cuff squeezed tighter and tighter. Needless to say, the reading was a little high. Maybe that “to do” list isn’t such a crazy idea after all.

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DIARY OF A KIDNEY LOVER

It’s good to be back here writing again after these last three weeks on the DASH diet. They weren’t necessarily bad weeks, but I was definitely up and down – excited, elated, frustrated, blue. To recap from my blog of a few weeks ago, my blood pressure is sometimes on the high side, so I’m on a quest to protect my kidneys and lower my blood pressure naturally.  I’ve been watching my sodium for quite some time, but that alone doesn’t seem to do much for me.  The DASH diet (that stands for “Dietary Approaches to Stop Hypertension”) sounded like an intriguing solution. It’s based on a comprehensive scientific study and is proven to lower blood pressure within 14 days.  The DASH way of eating calls for a combination of whole foods – not vitamin supplements – that provide the right combination of potassium, magnesium, calcium and fiber to lower blood pressure.  For me, that meant 6 servings of grains a day (which I never got up to), 4 of veg, 4 of fruit, 2 of low-fat dairy, 1 of fats/oils and 1/4 of nuts, seeds and beans. The diet is basically a better, healthier version of my already vegetarian diet; and for those who eat meat, that’s definitely allowed. You don’t necessarily need to restrict sodium with this diet, but it works better if you do, so I kept the sodium to a minimum like I normally do.

Week 1 started out fine. I enjoyed shopping for organic kale and chard and things I hadn’t consumed in years like low fat milk and graham crackers. I quickly discovered that (1) the cereal I bought just didn’t agree with me – way too much fiber when combined with the other things I was eating – and (2) this diet calls for more food than I normally eat.  The latter was partly ok, since I’m often too busy to eat a midday snack and end up starving by dinner time.  I dialed down the quantities a bit; even then, there was no room for non-essential food. When I strayed a bit on the weekends (I usually eat out at least twice or have a sweet with coffee), I found I missed my fruits and vegetables. The variety of colors, shapes, textures, never mind the flavors – appealed to the artist in me. This was clearly my honeymoon period. I was so enamored with my asparagus, squash and carrot tacos that I took a picture of them for you.

Gorgeous Grilled Goodness

I was walking around my neighborhood every evening, feeling good about life. At the end of the first week, I took my blood pressure at the pharmacy (not as reliable as a trip to the doctor, of course) and my reading had gone down about 10 points from the week before.  The bottom number was still a little high, but not as high as the previous week. I felt great.

By week 2, I had the food nailed down. I snacked happily on Asian pear, peaches, carrots, but my workload increased and the days turned ridiculously hot. There wasn’t enough time to exercise and the few times I went out at the end of the day (in 100 plus temps) it got dark much faster than before. I didn’t think slacking off on the exercise would make that much of a difference, but it did. My next trip to the pharmacy about 2.5 weeks in, was completely disappointing. Granted, the circumstances weren’t ideal. I’m always nervous when I take my blood pressure. Two really nice seniors had set up a table right next to the machine (I have no idea what they were advocating) and I had to crawl into the seat to take my reading. I was having trouble figuring out where to put my arm in the machine while the helpful man by my side, straight out of American Gothic, was predicting a wonderfully low reading for me.  No such luck. I was about 20 points higher than the previous week.  My pulse was over 100. I was either unbelievably nervous or in serious trouble. I took another reading and got my usual high normal numbers. My pulse had slowed only slightly. I was really mad. It didn’t help having an elderly gentleman, however nice, telling me I “really need to take care of that.”

So I moped, I railed, I took a day away from work so I could think. I became nervous that my pulse was too high, that maybe I had a hyperactive thyroid, which runs in my family. In the middle of the night, I felt my pulse and it was always the same – a seemingly fast bump, bump, bump. I considered changing my Facebook status to “Michelle is a stressball.” I could see that I had approached this endeavor all wrong. I had not been disciplined enough about exercise. A friend I had not talked to in a long time said, “I think your body needs yoga.” So, I planned to do yoga the following night.  What the heck. I used to love yoga. (Then why did I stop?) The next day, I took more time for myself. I unearthed my camera and took photos in my mother’s garden. I found a cactus that made me very happy, and here it is.

Will a cactus help lower my blood pressure?

That night, yoga felt great, but I had trouble with the deep breathing. That was telling.  Stressballs don’t do much deep breathing.  It’s an important thing to relearn.

I continued to do things for myself.  I took the time to read a great article in the April Vogue (Yes, I am obviously way behind on my reading). It was about young Dutch model Kim Noorda’s struggle with food and weight.  On the borderline of an eating disorder, she had become adept at eating “a little less.” She spent so much time worrying about what she ate that she didn’t have time for anything else. The author, Sally Singer, encouraged her to enter a program to help her see that she could be more than a model who worried about every bite she ate.  She encouraged her to be “a little more.” I really liked that advice.  As much as I wanted balance in my life, I could see that I wasn’t getting there.  I was too focused on health and blood pressure and stress and it was stressing me out. In the past, balance meant the right amount of creativity vs. work.  But yoga has made me realize that I need time for breathing, too, and stillness and relaxation, meditation.  That has to be the way forward for me.

My doctor’s appointment is just about a week away. I’m going to keep on exercising, practicing yoga, eating good food, worrying less, spending time writing, drawing, taking photos. This time around, I’ll be sure to stop and smell the cactus and BREATHE.

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DIARY OF A KIDNEY LOVER

Just a quick entry to say I’ve checked off one exciting thing from my life’s to-do list.  I finally visited one of those traveling anatomy exhibits showcasing real bodies and organs at the LA County Fair last weekend. I couldn’t believe my luck when I saw the poster at the entrance gates to the fair.  I had no idea something like that would be there.  Two of my friends made sickly noises – no way they were going – but Mom and I beamed as we bought our special tickets to “Our Body: The Universe Within”. We waited in a long line to get in, analyzing the reactions of people leaving the exhibit.  Young cool boys smiled. Older people and children looked pensive or bewildered.

It was pretty crowded inside and I must say, I was disappointed at the 20-somethings giggling and pointing at the bodies. What did they think they were going to see? But when I told my friend, the grade school teacher, she said, “Oh, don’t feel so bad.  They’re just laughing because they’re uncomfortable. They haven’t faced their mortality before.” And of course, she was right. Even with the somber lighting, there was a strange carnival atmosphere – life and death side by side, as they must be. There was music and cheering from the Selena Gomez concert outside, but I managed to focus after a while. I perused the muscles of the legs, the spinal column, the brain, the surprisingly large lungs and what looked like a coral reef of dried-out blood vessels surrounding them.  I found the kidneys mid-way through the show. It’s strange seeing lifeless organs that are meant to be filled with blood and activity.  They were miraculous nonetheless, and much smaller than I thought – even smaller than my tiny fist.

By that time, Mom was feeling queasy and it was time to go.  It was a fascinating show and I do recommend it, despite the jeering kids. (You can learn more about the exhibit here.) There were plenty of people interested in the science of it all, reverent as they stared at a lung shriveled by smoking or a liver damaged by alcohol abuse.  Perhaps some contemplated a lifestyle change…starting tomorrow.  Until then, they had things to check off their personal to-do lists. Chocolate-covered bacon and fried Snickers maybe. It was a day at the fair, after all.

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DIARY OF A KIDNEY LOVER

OK.  Time for a change.  After a very tasty Chinese dinner last week, I had one of the worst heart-burn episodes I have ever had (and I don’t even get heartburn).  I felt like I was going to die.  Thinking about it, I’m sure that yoga move my Mom told me to try didn’t help any.  There is a time and a place for yoga and this wasn’t it.

But here I am, alive and eager to turn over a new leaf, literally!  I am a vegetarian, so I wouldn’t say that I am really unhealthy, but I do need more balance in my diet, less stress, less sodium, less restaurant meals, more exercise – the usual healthy stuff.  And I should confess that I have had a few moderately high blood pressure readings at the doctor’s office.  I attributed these to “white-coat” hypertension – blood pressure that’s only high when you’re in the doctor’s office.  You can read more about that here. http://www.winnipegfreepress.com/life/ignoring-white-coat-pressure-dangerous-102324989.html.  Although I really like medicine and enjoy talking to doctors if we’re talking about kidneys, I don’t like talking to doctors if I’m the patient.  The possibility of pain, illness, the reminder of the high cost of my health insurance, not to mention the cost of the visit – no wonder my blood pressure is a little high! The whole doctoring experience makes me nervous.  But I shouldn’t dismiss my previous readings, given what I know about high blood pressure and kidney disease.  Kidney filtration is driven by our blood pressure and higher BP “slams” the kidneys, forcing them to work much harder. It can cause permanent scarring and damage.

I’ll be making my doctor’s appointment very soon (still need to work up to that, but it’s on the task list for Monday) and in the meantime, I’ll be making changes to my diet. The DASH diet (“Dietary Approaches to Stop Hypertension”) – a healthier way of eating that’s safe for nearly everyone – has caught my eye lately. I’ve seen news articles all over the web and even in the research project pages on the UKRO site.  Check out this USA Today article for more info http://www.usatoday.com/yourlife/food/diet-nutrition/2010-09-03-dash-heart_N.htm and this research project abstract if you’re feeling a bit more ambitious http://ukrocharity.org/research/john-mckay-fellowship-grant/yang-full-project-summary/. The first few paragraphs describing the connection between low blood pressure and an optimal diet of more potassium vs. sodium are particularly interesting to me.

I can’t wait to dig into the DASH book on my desk.  Once I’ve read the book (it’s quite short!), I’ll get out to the pharmacy for a few free blood pressure checks, and on to the farmer’s market for some leafy greens and other veggies, fruits, nuts.  Now that the weather’s fine, there’s nothing stopping me from adding daily walks to my kidney lover regimen. Then, it’s on to the doctor’s office.  I’ll let you know how it all goes.

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DIARY OF A KIDNEY LOVER

This was meant to be a quick entry to share the trends – some alarming, some inspiring – I’ve been noticing lately.  Somehow it grew.  First of all, kidney disease is a worldwide problem.  It’s getting a lot of press these days, particularly in Australia, where the number of people admitted to the hospital for dialysis treatments has jumped by more than 70% in the last decade.  This may be because they have a tendency to dialyze patients very early – a practice they appear to be re-evaluating given the high cost and questionable health benefits.  But it is also an indicator that the Australian population, like ours, is getting older and more importantly, getting fatter.  You can check out the whole article here. http://www.abc.net.au/news/stories/2010/08/18/2986720.htm?section=justin

And fat naturally brings me to food.  I’ve just read a really interesting post explaining why fructose in drinks and foods is so bad for us.  I want to talk more to Dr. Yu about this, because it’s fairly technical, but it appears that fructose could greatly increase the risk of high blood pressure, diabetes and kidney disease.  At the same time I was reading this, I saw a Tweet touting the miracles of chocolate.  An American Heart Association journal stated that moderate chocolate consumption is linked to lower risks of heart failure in older and middle-aged women.  Of course, the article stressed that the benefits must be weighed against the negatives – excess calories and fat.  Right!  So when my Mom offered me some chocolates yesterday, needless to say, I passed.

Now on to the inspiring.  You probably heard that Grizz Chapman from 30 Rock had a kidney transplant recently – fantastic news!  Transplant stories just make me feel good and I have heard so many lately.  On Twitter, I came upon The Match Story, an upcoming book about one of only 2 face transplants ever.  The Match Story website has a fascinating video about a Boston Med episode based on the story (see it at http://thematchstory.com/) and the Match Story Facebook page is lovingly hosted by the wife of the man whose face was used in this amazing transplant.  Now I really want to explore the facts and history of kidney transplants with one of the USC experts I met recently and I will be reporting what I discover, either here or in our Q & A blogs.  Stay tuned!

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DIARY OF A KIDNEY LOVER

This is the diary entry I didn’t want to write because I have to tell you that my Uncle Bob passed away a few weeks ago.  I have been thinking about this a lot, trying to figure out how to start this blog, how to include all the things I want to say.  I even tried writing some of this in a handmade journal in a Starbuck’s, without edits or stalling, just words and scribbles and arrows.  It helped a little, but in the end, it was time to go and the entry was not complete.  And when I left, I thought I saw my uncle sitting at a table outside.  The mind sometimes sees what it wants to see.  On the walk home, I saw three very real and very tiny lizards cross my path, felt the sun on my back and thought how beautiful the planet is.  And I thought about all the days that had led up to that one.  My uncle, a long-time diabetic and more recent kidney disease patient, had been admitted to the hospital following a stroke and heart attack – pretty typical ailments for someone afflicted with kidney disease.  Seven weeks of up and down days followed.  This, too, was probably pretty typical.  Everyone thought he was finally getting better until a series of infections took over his body.

On that walk, I didn’t want to think too much about the physical part of his illness.  I figured there would be time for that later.  I decided simply to remember my uncle.  I dug deep and realized that he and my aunt had taught me two of my most important lessons.  They made a good team, you see; she was everyone’s favorite nursery school teacher and he was a policeman with the city of LA.  Uncle Bob could be fun and he could be stern, obviously a good disciplinarian, which brings me back to my lessons.  First, don’t be a tattletale.  People don’t like tattletales and ultimately, they stop listening to your stories.  Second, don’t throw a metal toy gun at anyone’s head.  Yes, my cousin Matt made me so mad that I threw a little gun at him.  Thankfully, he was a moving target and the gun must have just grazed him, but it made him bleed.  I still remember the faces of my aunt and uncle, near tears with concern for their son.  They were gentle with me though, determined to get through.  And they taught me in the kindest way possible – through the visible love they demonstrated that day – that violence is never the answer.

I think I will end it here.  August 10 was my Uncle Bob’s birthday.  He would have been 64 today.  What an example he has been in my life!

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DIARY OF A KIDNEY LOVER

At a party some Sundays ago, a man I’d just met said to me, “You must love kidneys.”  No, I wasn’t slurping them up with fava beans and a nice Chianti.  (I’m a vegetarian, for the record.)  He was referring to my work – the hours I divide between UKRO and DaVita Dialysis.  “You give a lot of time to those lucky organs,” he said.  I admit that sometimes I am “all kidney all the time.”  However, I know I can do more.  And this is how I know.  I like to read the obituaries.  When I come across one eulogizing a lifelong advocate of this or a tireless activist for that, I am particularly inspired.  Here was a person who cared enough to fight for something.  I want to be that kind of person.  I think of some of the dedicated people I have known, past and present – the nurses whose compassion means everything to their patients, the researchers who light up describing the complexity of the kidney.  Dedicated people are not necessarily content.  They keep pushing themselves.  They keep asking themselves how they can do better.

So how can I do better?  How can I do more?

First, I will embrace who I am.  My name is Michelle and I am a kidney lover.  I worked as a DaVita marketing manager for just over 8 years and I continue to work for them as a graphic design consultant.  In my time there, I have guided traveling patients to dialysis centers, have organized and attended trade shows for nephrologists and patients and have worked on ads that I hope attracted a few good nurses and doctors.  For the last 6 months, I have been working with UKRO, learning more about kidney disease than ever before.  That may be because the disease is suddenly personal.  My uncle, who is diabetic, started dialysis barely a year ago.  And I know way too many diabetics who are at increased risk for kidney disease.

Second, I will raise awareness about this devastating and, in many cases, preventable disease.  I will blog about kidney disease, sharing personal stories and the latest news about research, causes, prevention, treatment, diet, whatever I see and hear.

Third, I will make a donation to UKRO.  It takes a lot of money and time to make a medical breakthrough, but it does happen.  Every dollar helps.  Small grants help researchers take their work to the next level so they can get even bigger government grants.  With more dollars come more researchers, more ideas, more approaches to a cure.

I am taking a little break from writing this blog, going to our website, clicking on the Donate Now button.

There!  It’s done.  That was easy.  I hope that you’ll join me.

Now I am ready to make it official.  I am updating my Facebook status today:  Yes, I am a kidney lover!

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