In 2004, I was diagnosed with Stage 3 Chronic Kidney Disease with a serum creatinine of 188 umol/L. At this stage, the kidneys are moderately impaired with decreased function to filter out waste products from the bloodstream. The urologist put me on 1mg Detrusitol twice daily and advised me to continue perform clean intermittent catheterisation (CIC) every four hourly which I have been doing since 1991. That is to reduce the occurence of urine reflux back to the kidneys and damaging them further.
By the following year, my serum creatinine climbed to 262 umol/L and bumped the diagnosis to Stage 4 Chronic Kidney Disease (CKD). I have been living with Stage 4 CKD for the past seven years. At Stage 4, there is advanced kidney damage. It is likely that I will need dialysis or kidney transplant in the future. There are five stages of chronic kidney disease altogether. Stage 5 CKD is known as end stage renal disease (ESRD). This is the final stage of kidney disease where the kidneys have lost almost all their function and dialysis or kidney transplant is needed to live.
I have not thought much about how serious my kidney failure was until recently when I read up more on this disease. At Stage 4, my kidneys are teetering on the brink. Dr. Liong, the urologist at Lam Wah Ee Hospital in Penang, had warned me that life will be difficult not only for me but the family as well should I need to undergo dialysis. It will be a drain on finance and time. Each dialysis treatment costs about RM200.00, requires four hours and has to be performed three times per week. That was the reason he kept reminding to mantain my remaining kidney function as much as possible by catheterising religiously, cut down on protein intake and avoid red meat.
My low-potein diet is basically two matchbox-sized portions of meat per day. I am also to cut down on the intake sodium, phosphorous and purine. High phosphorous level in the bloodstream causes itching. I cut down on the consumption of carbonated drinks, dairy products, peas, beans, nut and chocolates. Purine is metabolised into uric acid. My kidneys are unable to keep the uric acid level optimal. This could lead to gout. To prevent this condition, I avoid spinach, cabbage, cauliflower, organ meats, sardines and mackerels.
Stage 4 CKD is associated with a host of symptoms that I have been experiencing for the last few years. I get exhausted easily because of anemia which is common in people with kidney disease. This condition is exacerbated by the fact that I also have alpha thalassemia trait that causes anemia and small red blood cells. The other apparent symptom is short attention span. This could be the reason why I have been unable to finish the books I have been reading and the lack of updates in this blog lately. I just could not keep my mind focused on one single task long enough to see it to completion.
Chronic kidney disease increases the risk of cardiovascular disease. This is already manifested by my undesirable cholesterol levels that necessitated the long term use of Lipitor to bring my cholesterol under control. The good news is that the electrocardiogram done in November last year did not show any problem with the heart. The other good news is that after a two-month therapy of Lipitor, my cholesterol levels showed marked improvements. At the same time, I did not suffer the potentially kidney-damaging side effects associated with the medicine.
Considering that the sword of Damocles is hanging over my head where my kidneys are concerned, I am quite laid-back about it now as compared to when it was first diagnosed, not that there is much I can do to reverse the condition. I can only slow down the progression of the disease by going for regular check-ups and following the advice of doctors and dieticians.
Of course there were the occasional anxieties, especially just before getting the blood test results or after indulging on more meat that I should. Otherwise, my daily routine is least disrupted. I am determined not to let it affect Wuan’s and my quality of life. It has not so far. My greatest hope is that the kidneys’ current condition will to hold for a long time to come. From the looks of the latest medical reports, there is a good reason for me to be cautiously optimistic. That aside, there is a nagging sense that I will be blindsided by a health condition I least expected, as if a Stage 4 CKD is not bad enough. Hopefully, that is just an overactive imagination working overtime.
Tags: Detrusitol 2mg tablet, Detrusitol SR 4mg, dialysis, end stage renal failure, kidney failure, kidney transplant, Lam Wah Ee Hospital, Lipitor, low-protein diet, renal diet, Tolterodine 2mg, Tolterodine SR 4mg, Tolterodine Tartrate
Detrusitol SR 4mg prolonged release capsule.
After one year on a twice daily dosage of Detrusitol 2mg tablets, the University Malaya Medical Centre pharmacy has switched me back to the Detrusitol SR 4mg extended release capsules again. For unexplained reasons, the pharmacy stopped dispensing the SR 4mg.
Detrusitol in the prolonged release capsule form is more convenient as I need to take it only once daily. Unlike the previous SR capsules which were packed seven capsules to a blister strip, the current ones come loose in 30s to a small plastic container. The new capsules appear smaller in size too.
I have been taking Detrusitol either in 2mg tablets or 4mg prolonged release capsules since 2004 when I was diagnosed with chronic renal failure. This is to relax my overactive bladder and the frequent urge to urinate, and in turn, reduces the risk of a reflux of urine from the bladder back to the kidneys, which if left unchecked will cause further damage to them.
Tags: Detrusitol 2mg tablet, Detrusitol SR 4mg, extended release capsules, neurogenic bladder, overactive bladder, prolonged release capsules, Tolterodine 2mg, Tolterodine SR 4mg, Tolterodine Tartrate
The lump in the scrotum has been bothering me again of late. Prior to the discovery of the lump, I stopped driving for a while because my legs were spasmodic. When the spasms struck, my legs would get in the way of the hand controls and steering wheel. The spasms went away about one week after I finished the antibiotics.
Its size has not reduced much after the two-week course of antibiotics. The spasms have returned. I believe there is a relation between the spasms and the lump. I was at the UMMC Rehabilitation Medicine Clinic for my scheduled three-month check-up yesterday. The doctor examined the lump and advised me to get a biopsy done. I am going back to SJMC soon to have the lump checked again by the urologist.
When I went to collect my supply of medication, the pharmacist changed my dosage of Detrusitol from the 2mg twice a day to one 4mg once daily prolonged-release capsule. I told him that I have had problems with the 4mg capsule as it caused problems with urination. He told me that was the only dosage the pharmacy has now and if I prefer the 2mg tablet I have to get it elsewhere. I decided to give the 4mg capsules a try again.
I cannot understand why the pharmacy prefers to dispense the 4mg capsules instead of the 2mg tablets. A one-month supply of Detrusitol SR 4mg capsules costs RM249 while the Detrusitol 2mg tablets costs only RM170 when I last bought them myself. Anyway, the instruction was that I should take one capsule at night. Based on my previous experience with Detrusitol SR, I decided to take the capsule in the morning instead. I had my first dose this morning and will be monitoring my bladder’s reaction in the coming days.