A litte fine tuning

Saturday target: 6.3 kilos; actual loss 6.7 kilos, .4 kilos below established dry weight

Cramps: None … Woo hoo!

Blood pressure: Controlled… only got light-headed for a minute or two at weigh out.

Jane, my awesome primary nurse (get that $5 ready for me, Jane <grin>), did some fine tuning on my treatment yesterday and I made it through without cramps or crashing blood pressure. We did a profile to take most of the fluid off early in treatment, adjusted my sodium level up a bit, lowered the temperature a smidge, and when my BP seemed to start to drop (before I got my first physical warning sign bright lights) we lowered my head.

My target was still high, 6.3 kilos, but remember I left heavy Thursday by over 1.5 kilos. When treatment was over, I was .4 kilos under my established dry weight (which I think is still at least a kilo high).

I’m going to ask to see a dietitian at Mayo’s if I’m not already scheduled to do so. I want to ask the best way to diet while on dialysis and if there are aids to doing so. Even if my BMI (body mass index) would be good enough to qualify for a transplant, I know I need to lose weight to reduce the stress on my heart, joints, etc. But it’s become slow going for several reasons including the underlying diabetes, my age, metabolism, thyroid problems and lack of exercise.

I am beginning to believe a South Beach-type of diet wouldn’t be half bad for me. That’s a radical change since I’ve always felt that the best way to diet was balanced nutrition. But with renal complications, I’m not so sure.

Dialysis patients need to eat more protein not just to promote healing, my best friend nurse and her MD husband tell me, but to help pull fluid from my tissues. Since my kidneys are so injured, they don’t know how to process things like they used to. One thing they can no longer do is pull fluid from the tissues. Dialysis cannot help there because the only place from which the artificial kidney can extract fluid is the blood. In other words, if fluid passes into my tissues, it will not be extracted by dialysis.

But eating more protein can help do that because of it’s molecular structure. I’m not sure I could adequately explain the process but I certainly do understand the analogy: Protein acts as a magnet pulling the fluid from tissues into the bloodstream where dialysis can grab onto it and flush it from the body.

In other words, if I eat a steak my liver takes the protein in the steak and converts it into albumin and sends it into the bloodstream. The albumin acts as a magnet for the fluid trapped in my tissues. The question is, how big a steak should I eat?

Is 5 ounces cooked weight enough (about the size of a deck of cards, my diabetes educator would say) or should I eat 8 or 12 ounces? Should I eat a normal portion of protein and add a protein supplement?

Let’s not tackle the cholesterol issue right now, maybe later. But if you’re worried, I do take medication to lower my cholesterol.

I know it would be best for me to exercise and I have dusted off my treadmill and used it more often of late, but not as often or as long as I should. I’ve got to work on that to increase my matabolism, lose weight, increase my stamina, etc. I’ve noticed it can help calm my restless leg syndrome, too. So, I guess I should make it a goal, simple and easy to start and then add to it. Here goes: My goal is to walk 10 minutes a day on those non-dialysis days for one month starting today.

I may have to develop a little check list or chart to tack up top the posts to keep you apprised of my progress and to hold myself accountable to me and you. Probably not a bad idea.

I didn’t get the car washed yesterday, but I did get the Mayo form filled out. Today’s preparation check off list includes:

• Get laptop to take on trip
• Do another grocery run for Mom. Six double rolls of toilet tissue does not make her feel secure at home alone. I’m not kidding. Toilet paper, bread and trash bags are very important to Mom’s sense of security. That and “something sweet” to have on hand.
• Pack the hand knits I’ve made for my cousin Jean and her 21/2 grandkids who are my surrogate grandkids
• Pack my clothes
• Pack my meds (at this stage in my life, that could take a whole carryon itself) and toiletries
• Get my knitting bags in order. I’ll knit between appointments, on dialysis and in the hotel room at night so I’ll take several small projects (socks and caps mostly) that qualify as idiot knitting.
• Get all my electronics organized — nanoPod, cellphone, digital camera
• Check my packing list to make sure I’ve not forgotten anything
• Pack the car

I work until 3 p.m. today, so I think my late afternoon and evening will be full.

Another thing I’d like to do with this blog is give renal and renal diabetic patients a little help finding ways to eat healthy without being boring so I’ll be featuring recipes here or guiding you to other places on the Web where you can find good recipes.

Here’s the first, one my own recipe and one a low sodium soy sauce recipe.

No salt lemongrass vinagrette

1/2 cup rice wine vinegar

1/3 cup canola oil

3 Tbsp lemongrass paste

2 Tbsp cilantro paste

3 packets sweetner (I use Equal)

3 Tbsp lemon juice

2 Tbsp dijon mustard

Place ingredients in a lidded jar and shake well. Has a nice bright, lemon taste. I find the pastes in the produce section of my grocery. You can add a bit of hot with red pepper flakes or chili paste and you add garlic, too. You might try a little ginger for a more Oriental taste, too.

If you like Oriental food, you’ve probably mourned its loss in your diet. Here’s an idea: Cook your own vegetables and protein sources (a simple sauceless beef stirfry for example) and add that Oriental oomph with this very low sodium soy sauce recipe. You’ll find it HERE.

Note: The nutritional information also gives you potassium and phosphorous levels. Such a deal!