Monday, 26 May 2014

Blood Test Report & Creatinine (验血报告&肌酸酐)

Doctor ordered a blood test regarding my Urine Chemistry (尿化) and Kidney Profile (肾脏功能) on Saturday and result was available within two hours.

Results for Creatinine (肌酸), Potassium () and Urea (尿) went beyond the acceptable range.

In an earlier post, I have mentioned that Cyclosporine may affect the reading of Creatinine and Potassium.  Though my Creatinine has been fluctuating but it never went beyond the acceptable range.

Doctor decided to reduce the evening dosage of Cyclosporine by 25mg.  He will order a C2 test on Cyclosporine next week.

A high level of Urea indicates that the kidney may not be working properly or being dehydrated (low body water content). As I am passing urine with good volume and tend to urine more often after midnight, Doctor decided to monitor the situation closely and not taking any further actions.  (高级尿素表明肾脏可能不适当地运作或被脱水 (低身体水含量) 好尿量并且经常趋向尿在午夜,医生决定严密地监测和不采取任何另外行动)

Sunday, 25 May 2014

Ureteral Stent (输尿管)

It is known as JJ tube or double J tube as well. (叫作JJ管或DJ)
Main purpose is to prevent or treat obstruction of the urine flow from the new kidney. (主要目的将防止或对待尿流程的阻碍从新的肾)
The tube can be removed one month after the surgery.  Taking too long to remove it may cause infection. (管可在手术后的一个月拔。太时间去拔出会导致传)

The tube can be removed in a matter of a few minutes by pulling on the thread.  (管可在几分钟被拔拉扯螺)

Friday, 23 May 2014

Foods to Avoid for LIFE (手术后一辈子不能吃的东西)

1.     All types of ginseng (所有参类 - 人参, 高丽参, 花旗参等)
2.     Bird nest ()
3.     Hashima (雪蛤膏)
4.     Ganoderma lucidum (灵芝)
5.     Royal jelly (蜂王浆)
6.      Deer-horn (鹿茸)
7.     Individual packed Chinese medicine which the ingredients is not known (个体包装了成份不被认识的中)

8.     All types of pomelo / grapefruit  ()

Thursday, 22 May 2014

Post-Transplant Diets (移植之后饮食)

-    Drink as much water as you like
-    Input and output should be around 3 liters
Protein Intake:
-    To promote wound healing and prevent muscle lost
-    Good source of protein include bread, rice, milk, cheese, meat, fish & poultry
-    Chose brown over white rice
-    Chose low fat over full cream milk and cheese
-    I believe eating too much red meat & poultry will give undue pressure to the only kidney I have
-    FISH is my choice over meat & poultry.  I prefer salmon () and mackerel () as both comes with excellent source of omega-3 oils and lean protein
Potassium Level:
-    I experienced excessive potassium in my blood in the initial few blood test
-    I have to avoid fruits such as mango and avocado and vegetables such as potato and broccoli with high potassium level
Garlic ()
-    A very powerful antibiotic to help protect the heart and reduce high cholesterol and blood pressure levels (非常强有力的抗生素帮助保护心脏和减少高胆固醇和血压水)
-    I consume raw garlic most of my meal (吃蒜是我的膳食的一部)
Weight Gain
-    -    Prednesolone will tend to improve one’s appetite
-    Avoid foods high in carbohydrates, fats & sugar.  They will cause high glucose level and may cause diabetes
-    Regular exercise to control your weight. I start with brisk walking after the surgery.

Matters to Note (应注义事项):
1.  Do not carry or lift any heavy objects (不要举任何重的东西)
2. Avoid raw foods such as Sushi as the body is lack of immunization (因为身体是缺乏免疫,避免未加工的食物例如寿)

3. As a matter of belief, I don’t consume seafood with shell so to enhance the wound healing process (个人意 - 我不吃壳的海鲜以提高手恢复过)

Post-Transplant Medications (移植之后疗程)

Rejection Prophylaxis
1.        Neoral (Cyclosporine)
2.        Cellcept.
- Both Neoral & Cellcept must be taken every 12 hours and taken on time
- Cyclosporine may cause potassium retention & increased blood pressure.
3.        Methylprednisolone
- For the treatment of Immunosuppression
- To be taken AFTER foods
- For the treatment of GERD
Insulin Aspart
- For the treatment of Type 2 Diabetes

Two methods to monitor (监测) the "Concentration” (浓度) of Cyclosporine & Cellcept:
(A)     C0 (谷值) also known as the lowest concentration – To draw blood within one hour to half an hour before the next dosage
(B)     C2 (峰值) also known as the highest concentration – To draw blood, two hours exactly, after taking (服用) taking the dosage
It is important to monitor the concentration:
(A)     Insufficient dosage will cause rejection from the new kidney
(B)        Taking too much of Cyclosporine may lead to higher creatinine

Matters to Note (应注义事项):
1.        High dosage of Cellcept & Methylprednisolone will reduce the immunization (免疫).  Doctor should reduce dosage from as early as third week to forth week, the latest, subsequent to the surgery.
2.        Reading of White Blood Cell is a good indicator whether one is infected or not.
3.        Taking both Cyclosporine & Cellcept with fresh milk will tend to give better absorption within the system

4.        Wear face mask for at least two months whenever going out.  Avoid going to crowded places for at least one year due to low or no immunization (每当出去, 戴着面罩至少两个月. 由于低或没有免, 去拥挤的地方至少一年)

Pre-Transplant Preparations (移植前必须准备事项)

Background (背景): I'm a diabetic for many years and was on dialysis prior to the operation (在手术之前, 我是一个糖尿病患者并且是在透析).

I believe the following factors will contribute to the successful surgery as well as a faster healing process (我相信以下因素将造成手术的成功以及一个更加快速的恢复过).
My diet during dialysis period (我的饮食在透析期):
  1. Two to four egg white daily (每日两到四个蛋)
  2. Consume beef for lunch during dialysis day (在透析日,午餐食用牛)
Two weeks before surgery (在手前的两个星):
1.          Six egg white daily (每日六个蛋)
2.          Consume beef and fish daily (吃牛)
At all times ():
  1. No smoking ()
  2. No drinking ( 禁酒)
  3. Exercise for 3-4 times weekly (每周锻炼3-4)

To assess one's health conditions and to pass the hospital's Review Committee, following medical check-ups are necessary (医疗检):
  1. Echocardiography (回波绘图仪 - 用超频率音响检查心)
  2. Treadmill Stress Test (踏车压力测)
  3. CT Scan Iliac Arteries and Veins (CT扫描髂动脉和静)
  4. CT Coronary Angiogram & Calcium Score (CT冠状管造影术&钙比)
  5. Gastroscopy (胃镜检)
  6. Tissue Typing & Antibody Identification (组织键入&抗体证)

Matters to Note (应注义事项):
After the surgery, one should not undertake another major surgery.  Prior to the surgery, one should:
1.  Have a dental checkup and fix all necessary teeth filings

2.  Any concerns from the CT Scan, they should be resolved prior to the surgery

Diabetes & Dialysis (糖尿病&透析)

This Blog is my life experience of being a diabetic, how I manage my dialysis as well as kidney transplant with the intention to benefit others who are facing diabetic issues and renal failure.

Diabetes & Dialysis
My life in three stages: pre-diabetic day, pre dialysis days and renal failure days.

Pre Dialysis Days
I have to admit that I didn’t exercise as much as I should be.
When I first visited my doctor in January 2008, I was told that I have diabetes.
The doctor also warned me the consequences of diabetes – renal failure and thus requires weekly dialysis. I took it lightly
Anticipated the renal failure, I had my fistula created in February 2013.
Renal Failure Days
Finally, that day came.  That day was May 2013 – the day I had my first HD

In August 2013, I had refreshment for my fistula.  According to the vain surgeon, refreshment is only required subsequent to the fistula creation after a few years

My Meals
Egg white – On average, I took two egg white daily to maintain sufficient Albumin
Beef – I will consume beef to get my dosage of Hemoglobin for my lunch during my dialysis days which fall on Tuesday, Thursday and Saturday.

Due to renal failure, excess potassium is not able to be excreted from our bodies.  Vegetables such as Yam & Potato and fruits such as banana and kiwi fruits, with high potassium must be avoided.
What I didn’t know was that both Ginger Root (Grounded) and Coriander contain high potassium.
I was using many grounded ginger root and coriander to marinate my beef as I am avoiding salt. During a routine blood test in September 2013, my potassium level shot up to 6.2 mmol/L which was way above the ideal range of between 3.3 to 5.0 mmol/L.  My potassium is always within 4.5mmol/L
I did a search in and found the potassium contains of:
  • Ginger Root (Grounded) – 1320mg per 100g
  • Yam - 816mg per 100g
  • Coriander also known as Chinese Parsley – 521mg per 100g
  • Potato – 421 mg per 100g
My potassium has returned to normal after avoiding grounded ginger root and coriander.
Personal experience:
  • I avoid raw vegetables as they contain higher potassium.  Packed mix vegetables is my alternative (they tend to contain lesser potassium base on my research)
  • No banana, kiwi fruits and mangoes as all contain high potassium.  I consume apples every day.  All berries such as strawberry and blue berry are suitable for consumption.
Due to renal failure, most fluids will tend to be retained in the body.  I have lost 5 kg of water since I stated my dialysis.
In between my dialysis days, most of the time, my water retention is between 2-3 kg.  The highest retention was 4kg
One should limit the ALL fluids intake to 1kg per day.  My personal experience to minimize retention:

  • Change to a smaller drinking mug
  • If you have to take coffee or tea, only consume 50% as against pre-dialysis days
  • Totally avoiding soup
  • Reduce salt consumption – Salty dishes will increase your fluids consumption resulting higher water retention.  Always ask for less salt and oil when ordering foods
  • Fast foods tend to contain high amount of salt.
  • Avoid or minimize canned foods as they tend to contain lots of salt
  • Do not consume soft drinks as one will tend to finish the whole can of soft drinks.  If you really miss it so much, half a can is the maximum.
  • Exercise for three times a week, during non-dialysis days