I've been too busy with work, family life
and other projects to do any blogging recently. I had my Nephrologist
appointment in early June and my stats were largely unchanged, the consultant
believes they look a little better when I lose weight and a little worse when I
gain it.
At 115kg I was slightly heavier than the
previous appointment, which was no surprise. My recent weight seems to have
settled around the 115kg mark, which is one or two kilos above where it has
been for most of the past two years. It's a little disappointing in that I did
get down to around 112kg 18 months ago, so I know it's possible to get there.
My potassium levels were largely unchanged
despite some efforts I made to reduce potential intake; suggesting it's one of
those things that’s hard to shift the dial on. She did suggest increasing my
sodium bicarbonate from 0.5g in the evening to 1g (I already take 1g in the
morning), which cleared up the reason I take it in the first place. Sodium
bicarbonate apparently helps flush potassium out of the kidneys, it also counteracts
acidosis, where the kidneys fail to excrete acids (excess uric acid is the
cause of dreaded gout). The flip side is that sodium bicarbonate is linked to
higher blood pressure, resulting in a balancing act.
As it happens she never passed on these
instructions to my GP, so my script is yet to change. My potassium levels are
the probable culprit for the leg and calf cramps I suffer daily, particularly
when in bed. I've trained myself to recognise warning signs and possible
triggers such as the natural urge to stretch too quickly when waking in a
morning, and to react fast when cramps do occur e.g. jumping out of bed and
immediately stretching the relevant limb results in a short sharp pain, whereas
letting it recede naturally takes longer and leaves residual soreness that can
last all day.
The week following week the Nephrologist I
had my annual medical at the GP surgery. My cholesterol levels have got worse,
but this is more down to my 'good' HDL cholesterol being low relative to my
'bad' LDL cholesterol, rather than the LDL shooting up. Of more concern my
HbA1c level had increased, putting me back in 'prediabetic' range again. Two
years ago I was in this range, then I lost some weight and dropped out of it,
now my weight has gone up a bit I'm back in it again (I'm still 10kg lighter
than first time round). To shine a bit of perspective on this prediabetic
reading, my HbA1c has gone from 5.9% to 6.0% which, that 0.1% putting me back
in range. I got out of it before, I'll do it again.
These prediabetes readings also explain what
happened with my referral to the 'Healthier You' diabetes prevention programme.
This NHS programme is intended to intervene early with high risk patients, the
premise being that prevention is better (and definitely much cheaper) than
cure. My GP referred me late last year on the basis of my medical history
including my weight management issues, my chronic kidney disease and my
previous prediabetes reading, but because my then most recent HbA1c test just
dropped me out of range I was rejected! Time permitting I'll write a more
comprehensive post on this subject, but it’s a good demonstration of arbitrary
rules being applied to clinical decision making, in this case a 0.1% variance
in HbA1c led to an eight month delay in getting me on a programme that offers
significant benefits to my health and the cost of my future treatment!
No comments:
Post a Comment