Peter Tan – The Digital Awakening
Living One Day At A Time
The serum creatinine for March 18 is 279 u/mol as compared to 288 u/mol in August 2, 2010. This is not a significant drop but I am not complaining. It has come down from a peak of 299 u/mol in June 2, 2008. As long as it maintains at current levels, I am a happy camper.
Wuan accompanied me to the University Malaya Medical Centre (UMMC) yesterday. It was for my scheduled check-up at the Spinal Rehabilitation Clinic. I had been anxious from the time we went there three weeks ago to have my blood drawn for renal profile, blood glucose test and lipid profile.
I had half-expected the serum creatinine to be higher than previous results. I have been going through a spell of lethargy that I thought could be due to be caused by my kidneys. It was a great relief when I saw that the serum creatinine was 288 umol/L. No doubt, it was very high due to kidney disease, it has stayed below 300 umol/L. That was all I had been hoping for.
Serum potassium was marginally higher at 5.4 mmol/L. Normal values should be between 3.6 to 5.2 mmol/L. I need to be aware of potassium-rich food that I have to cut down on. Serum urea had come down although still above the desired range, while sodium was hovering at previous levels. Fasting blood glucose looked good. Likewise, lipid profile. Saying that I am happy with the results is an understatement. I am ecstatic!
My kidneys are failing. That is an irrefutable fact. Their condition will only worsen with time. There is no way to determine whether the deterioration will be gradual or sudden. All I can do is to continue to be aware with the dos and don’ts of chronic renal failure and hope that their decline will be arrested.
When I was back in Penang recently, I did not have time to go for my scheduled check-up due this month. Since Wuan is on leave today, we spent almost the whole day at Pandan Indah. In the morning, I got my blood tested and had an ultrasound of my abdomen. In the afternoon, we saw Dr. Lim, the Physician and Nephrologist at Hospital Pantai Indah.
My serum creatinine had risen to 271umol/L from 258umol/U when it was tested in February. Although the calibration of the testing equipment of different laboratories varies, the serum creatinine count still shows an increase. My protein intake has to be further reduced in order not to strain the kidneys further. The three portions of meat that I was allowed is further reduced to two now.
Protein is needed to build, maintain and replace the tissues in the body. Protein provides the body with essential amino acids for such purposes. My low-protein diet, if not properly managed will result in protein depletion. This will cause a host of health problems from anaemia to osteoporosis. Symptoms for both are manifested in my blood tests and rippled finger nails called koilonychia.
Ketosteril was prescribed to supplement my low-protein diet with essential amino acids and Sangobion for my anaemia. Those are expensive drugs. One month’s supply of Ketosteril and Sangobion costs nearly RM600. That is not inclusive of Detrusitol that I am taking to relax my spasmodic bladder which is the cause of my renal failure in the first place. One month’s supply of Detrusitol costs RM170.
To cut down on the expenses for Ketosteril, Dr. Lim has suggested a “drug holiday” where I go without Ketosteril for Saturdays and Sundays. To maintain my protein intake, I have to increase it from 29gms of protein on weekdays to 36gms of protein on weekends. 36gms of protein will allow me three portions of matchbox-sized meat.
This progression is not something that I did not expect. Because of my spinal cord injury, I knew full well that renal failure will be one of the problems that I will have to come face to face with. Nevertheless, the thought that my kidneys may totally fail one day in the future is extremely unsettling. When that day comes, dialysis will be the only solution. That will be an expensive therapy and one that will restrict many aspects of my life. I pray that that day will never come.