Sunday, March 6, 2011

Kidney talk: My kidney-healthy diet and how I cheat

From the website of Brusters, an ice cream chain you've probly never heard of. Sister Ellen introduced me. We drove out to the one in Trevose, PA. Real good.

This is a technical article I'm printing for my own use. I also hope to share it w/ other kidney patients.

After I get my new kidney on April 1 I'll be able to eat everything except grapefruit which contains an enzyme that interferes w/ the immunosuppressants I'll be on.

Unconscionable that my nephrologist never mentioned the need for a special diet to slow the progression of my kidney disease. He did say, tho, that kidney disease like mine, which was caused by taking the drug lithium for 16.5 years for manic depression (bipolar disorder) progresses far slower than other renal failures.

Symptoms? I have none. Of course I take a shitload of pills that keep me healthy. In the beginning of my kidney disease, I suffered from terrible skin itching (the toxins were spreading all over my body) and I was pretty tired.

My doctor is really great with meds. After a few months, these symptoms resolved themselves.

Did you know that the kidneys not only filter out wastes in the form of urine but they also have many other functions?

According to Wiki:

They are an essential part of the urinary system and also serve homeostatic functions such as the regulation of electrolytes, maintenance of acid-base balance, and regulation of blood pressure.

They serve the body as a natural filter of the blood, and remove wastes which are diverted to the urinary bladder. In producing urine, the kidneys excrete wastes such as urea and ammonium; the kidneys also are responsible for the reabsorption of water, glucose, and amino acids.

The kidneys also produce hormones including calcitriol, renin, and erythropoietin.

In essence:

- regulation of electrolytes

- maintenance of acid-base balance (my sodium bicarbonate pills handle this)

- regulate blood pressure (Norvasc, Toprol and Hytrin)

- reabsorb water, glucose and amino acids (hence my low protein diet) - my kidney doctor said people w/ end-stage renal failure don't even feel thirsty. B/c of the glucose situation I developed diabetes but control it w/diet, sex and rock n roll.

- production of hormones including calcitriol, renin, and erythropoietin. (I take Calcitriol which is a form of vitamin D. It's used to prevent low levels of calcium in patients w/ kidney diz or patients whose parathyroid glands (in neck) don't work properly.

My nephrologist calibrates the above drugs very carefully. At one point my calcium levels were too high and he had me get blood tests so he could adjust my Calcitriol.

Was trying to think how I knew about a special kidney diet. Perhaps it was b/c of Lillian Burnley. I got to know her real well when I volunteered at the Upper Moreland Public Library when she was director. She was on kidney dialysis and told me about the strict diet one must adhere to while on dialysis. (Read my memorial to her here.)

Off I went to Mary Ann Moylen, registered dietician at the Willow Grove Giant Supermarket. She made up a food plan for me.

It was difficult to follow in the beginning b/c there were so many restrictions. But human beings are endlessly resilient and I soon got used to it and accepted it.

Popcorn became my fave snack. I sprinkle it w/ nutritional yeast gotten at the health food store. Absolutely addicting. When I'm working on deadline for, I eat lots of popcorn and the kernels fall into the indentations on my keyboard.


LOW SODIUM - that meant I couldn't put salt on my watermelon and had to learn to cook w/ herbs and not salt. Began using bay leaves, whole cinnamon, fresh poultry seasoning (thyme rosemary sage).

LOW PHOSPHORUS - The operative word here is "limited" but mostly I just cut things out entirely. Dairy products are out. This meant no cheese. Can you imagine living w/o cheese? A grilled cheese and tomato sandwich. Forget it. Cheese over spaghetti. Forget it. A slice of cheese w/ an apple? You get the picture. Oh, I did have an occasional ice cream.

It gets worse.

Legumes are high in phosphorus. No more peanuts or beans/peas such as lentils, peas, pinto or kidney beans.

Whole grains are high in phosphorus. I stopped eating oatmeal, brown rice, and whole wheat for a while. Finally, tho, I couldn't keep away from my homemade breads which use whole grain flour (wheat and rye) so I gave in. But on the days when I ate my bread I tried to stay clear of other verboten foods.

LOW POTASSIUM - No tomatoes, potatoes, sweet potatoes, mangos, oranges, pumpkin, avacados, peanuts, and other nuts. It's the tomatoes that hurt the most. We have a garden that produces ripe red cherry tomatoes. I permitted myself a few.

LOW PROTEIN - I gave up all meat and limit myself to chicken and fish. I have an egg for breakfast but even that is not officially sanctioned by Ms Moylen. The yolk is too high in phosphorus. She handed me a box of EggBeaters.

I took em home and could not bring myself to make eggs with all those artifical ingredients. "Fuckit," I said, "and took to my eggs with gusto."

FAT - no restrictions for the kidney diet. Mary Ann stressed the importance of fat in the diet. Okay to eat mayo which is made of eggs and oil and seasoning. Make mine real Hellmann's.





I'd already given up caffeine in preparation for going off my last psychiatric med, Klonopin. That was a toughie, but I don't miss it one iota.

Had pretty much given up drinking when I went on psych meds. That wasn't hard at all. Occasionally at birthday parties I'd drink half a glass of beer, which I love, or wine, which I also love. I'll continue these parsimonious ways after my new kidney is sewn in.

When I visit Helene's house I always check her stash of licorice. And usually take three nubs, very chewy and delicious.

My last taste of chocolate was at Kremp's Florists. I was starving and they'd just cut up one of their chocolate truffles. I took a tiny piece - and sucked on it all the way home. Super!

When I shop at Giant, I always look for their cheese samples. That's how I get my 'cheese fix' in.

The only beverage I drink is water and cow's blood.

Here's my list of things I want to eat after the operation, or in heaven, whichever comes first:

- spaghetti and meatballs with tomato sauce and lots of fresh parm cheese on top

- macaroni and cheese

- buttered sweet potato

- buttered mashed potatoes with sour cream and chives on top (yes!)

- a Big Mac (just fucking kidding)

- Manhattan Bagel has a bagel and cream cheese w/ turkey bacon and avocado (yes!)

- home-made yogurt as a quick lunch w/ fruit

- Jell-O pudding mix - Cook n Serve - chocolate and vanilla made w/ real milk, not that awful rice milk or almond milk I tried

- V-8

- Olives

that'll do for a start.

1 comment:

  1. Still looking for time to read Dr. S's articles. Sorry I haven't but want to. All this about the diet is interesting. My brother had to follow a careful diet but his kidneys were pretty far gone due to his out of control diabetes-Type I that he had for years.

    I am sure I would cheat sometimes as I am already known to do so in different ways. The trick is to weigh pleasures carefully, know the risks and balance them with the benefits to the quality of life we aspire to. But I know you, of all people, know, because you wring every drop of "interesting" out of shreds of even the commonplace. I mean that in a totally non-pejorative sense, too, Ruth!