Wednesday, 25 May 2016

Politics, CKD Humour and New Challenges

A couple of weeks ago my fellow residents ejected me from the local parish council (civil parish, not church), bringing down the curtain on a short and relatively undistinguished career in local politics. Nobody is mourning the passing of my (lack of) political ambitions, least of all me. I voluntarily chose to vacate my seat on the district council last year despite a good chance of retaining it and this year I eschewed the opportunity to move to a safe parish seat despite the high risk of not being re-elected  (a process dubbed the "chicken run" before the 2014 Croydon local elections when senior Conservatives shifted themselves out of risky wards). But at least now I get to tell people I have retired from politics to spend more time with my remaining kidneys.

I did enjoy most of my time in local politics, it opened up new perspectives, developed new skills, and I learned a lot about how politics actually works from the inside; the good, the bad and the ugly. Politics can be a dirty business, but that's not solely down to the minority of politicians who are warped by the (often limited) power they receive, but also by sections of the electorate only too willing to be diverted by trivia or indifference. Now it's time to focus on some new challenges.

Monday, 23 May 2016

A Moment of Truth

So the moment of truth came when I stepped on to the hospital scales and weighed in at 115.2kg, a 9kg loss since my previous appointment in January. My consultant was pleased and despite the flu and gout that plagued the months in between my kidney function was stable, with eGFR up 1 point at 28. So for now I’m holding my own and the more weight I lose the better some of the readings will get, although nobody is pretending there will be a fairy tale ending to CKD.
I explained about the gout attacks and it was agreed I could ditch Furosemide given it was probably doing more harm than good, and in her own words she doesn’t want me getting down to 100kg only to have worn out joints. I still need to take the higher dose of sodium bicarbonate, and if I feel like I’m retaining water I need to start taking the water tablets again. Fortunately to the best of my knowledge I’ve never suffered water retention, either that or I have and just haven’t realised it.
I got a prescription for Colchicine (a.k.a. magic tablets) which pretty much took care of the current attack in three days. I’m now waiting to be fully clear so I can start on a low daily dose of Allopurinol, although I’ll also need to take a couple magic tablets every day for two weeks to mitigate against a new attack when I start. At the moment the swelling is gone from both feet and I’m taking decent walks, but there is still a little residual pain in a couple of joints I want to clear (also my in-laws are going to bring me back some more magic tablets from Northern Cyprus in a couple of weeks so I won’t risk running out at a crucial point).
In the afternoon I saw my GP for my annual check, most of the blood readings (kidney function aside) weren’t noteworthy but did warn that I’d flagged for pre-diabetes and needed to look at my diet and weight. I explained about the weight loss programme to get down to 100kg so I make the transplant list when the time comes, he seemed tiny bit surprised we were looking at that outcome already, but didn’t challenge it when I said it was inevitable at some point. I just need to carry on with what I’m doing, there is no other treatment needed.
So now the challenge is to fight complacency on the diet front, I have slipped a little lately, not massive binges, but a little less disciplined than a couple of months ago. Getting rid of the gout and the better weather should enable more exercise, I’m thinking of treating myself to a fit bit for my birthday which will hopefully act as challenge to my activity levels.

Sunday, 15 May 2016

Diet Update Week 15 – Mixed Blessings

It's been awhile since I posted an update, this blog has temporarily been relegated to the furthest back of back burners (it has always been a low priority).
The good news is that I hit my target of 117kg about a month ago, my reading on Wednesday, on a brand new set of scales put me at 114.9kg. My next visit to the consultant is this coming Tuesday morning so it will be interesting to see what the hospital scales say (I also have a session with my GP in the afternoon). 115kg seems a bit too good to be true. Although I'm pretty much sticking to my diet, I've started allowing myself a little more leeway such as treating myself to chocolate a couple of times a week post-Easter fast. I've also tended to drink less alcohol lately as I'm worried it could be aggravating recent gout attacks, although I've been a moderate drinker for years so it's probably negligible in terms of calories removed from my diet.   
The bad news is that my general heath has been pretty rubbish for about two months now. Over Easter I had bout of flu, and I'm not talking about "man-flu", on Easter Sunday I crawled in to bed at about 5pm with a full on fever. This is despite the annual flu jab late last year. I never get flu, but this year it hit me like a locomotive. It took weeks to fully get over it, even after the worst had passed I went through several weeks of feeling run down, tired and lethargic. The mucus cough wouldn't shift, I couldn't sleep properly, I experienced ear infections and temporary deafness.
The next problem has been a chronic attack of gout that has lasted for over three weeks now, albeit with fluctuating levels of intensity. First in my right foot and currently in my right foot. I haven't allowed it to stop me, but it has been terrible for mobility, I've had to reduce my morning walks partly to manage pain and partly because I was taking too long to get to the office. I made a decision last week to temporarily suspend my water tablet (and consequently the sodium bicarbonate it's intended to counteract), I'm fairly certain this didn't cause the attack, but it's probably prolonging it as raised uric acid levels are a common side effect. It hasn't helped that I've exhausted the stash of colchicine I brought back from Turkey last summer, I'm not a big advocate of 'self-medication' but I stick to the usage limits and it's very handy when a Turkish pharmacy will sell you 50 tablets for £2 without a prescription (an NHS prescription 12 tablets for £8.40, but getting a convenient appointment is the difficult part).
I can spot the signs that gout is impending but I've never been able to work out the trigger, if indeed there is any one specific trigger. This time I noticed that the initial flare up came after eating a meal containing chorizo sausage, and there was a noticeable spike in pain the two weeks later when I ate chorizo again. However, I've eaten chorizo many times without getting gout, there are probably other commonalities I've missed, and there have been other spikes in this current attack where chorizo is nowhere to be seen. It’s all a bit mystifying, I’ll have plenty of things to talk about with the docs next week.