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To thine own self be true


About four weeks ago I had an appointment with my nephrologist. Love her. She's been a great advocate for me as my PKD progresses, going out of her way to do things like prescribe Tolvaptan / Jynarque (I'm her first patient on the medication) and doggedly pursue a radiologist to get a total kidney volume (TKV) calculated from a recent CT scan.

One of the things we discussed briefly was my report of fatigue. She suggested a TSH (thyroid) test to which I shared that I had recently been tested and my levels were within the acceptable range.

Somehow that's where the conversation stopped and we continued onto another topic.

A couple of weeks later as my fatigue continued, I reached out to her and asked if we could add iron and Vitamin D tests to my next lab appointment (I go in every four weeks to monitor liver function while I'm on Tolvaptan). Yay! She said yes.

Fast forward to today. I got my labs done - and got the results back.

My interpretation of the results is that I'm borderline anemic and low on Vitamin D.

Hallelujah!

Granted I still need to wait for my doctor's review of the results and (hopefully) instructions on how to fix my levels. But the important thing here is that had I not pushed for the tests, my fatigue could continue and my frustration with my health, my energy, my body would continue.

And when you have a chronic disease like PKD, you really don't need anything adding to overall frustration levels.

Also interesting was that I'm not 100% sure that my nephrologist saw these tests as part of my PKD treatment as she suggested that if fatigue continued to be an issue I should see my primary care provider.

Which brings us to another key point. Just because your doctor treats chronic kidney disease, they may not be well-versed in some of the subtleties of PKD. My own research had shown that anemia and low Vitamin D levels could cause fatigue when you're cyst bound. It's possible that that's not the case with other varieties of kidney disease.

So remember. As great an advocate as my nephrologist is, nothing compares to self-advocacy.

Knowledge is power. Be courageous and use it to your advantage.

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And so it begins

At my last appointment, the nephrologist actually offered to give me a referral for transplant. And then a week later I got THIS in the mail from my insurance company. Crap! It's getting real now. If something like that doesn't take the wind out of your sails, I don't know what will. Granted I had let my doctor know a couple of months ago that I wanted to be screened and ready to go as soon as my eGFR hit 20. Did I think it would be this year? No. My estimates were three years from now. Yet the combination of the four point eGFR drop + the transplant referral leads me to believe that my DOCTOR believes I should hit 20 within the year. I don't think I'm going to be able to last until the artificial kidney comes out. :-(

Words to live by

I never knew - couldn't even fathom - how tough it is to live with a chronic disease. Sure I've been hypothyroid for YEARS but it never really felt serious. I take a little pill once a day. There are no side effects. I get my energy back. Good and good. Polycystic Kidney Disease is nothing like that. There is no cure - save transplant. But even then you take anti-rejection drugs for life. If you forget your meds, you risk transplant rejection. How's that for adding a little anxiety to your anxiety? There is a single drug that SLOWS DOWN the disease's progression, but that promise of dialysis and/or transplant is always right over the horizon. The side effects of that drug are constant thirst and the knowledge of every public rest room within a hundred miles. And while you wait for the disease to progress, you get to experience soul draining fatigue, anxiety, physical discomfort as your kidneys expand to fill your abdominal cavity, the look of a pregnant belly (...

What a night!

Tues Apr 2 2019 - Oh dear God! What a night! That plant? Yeah. Could have been me. Not taking my second dose until 530pm? Never going to happen again. Wow. Just wow. I woke up every 90 minutes. I went to the bathroom every 90 minutes. I GUZZLED water every 90 minutes. I felt like I was traversing a desert and hadn't had a drink in days. I drank three liters (about 3/4 of a gallon) of water DURING THE NIGHT! Who does that?!? So here are my learnings from my first day & night on Tolvaptan: Don't take the meds late - make sure I get that first dose in at 6am and that second dose in at 2pm, Start building up that bladder durability during the day. Act like it's strength training. Feel the urge and delay going as long as is feasible (accidents are not an option). Hopefully this will allow me to sleep longer than 90 minutes. If I'm going to drink that much water, I'm prepping it before going to bed and having it bed side. Last night I was running up...

Teach us to fish

I've recently started trying to educate myself on current research and insights around PKD and all the diseases that seem to show up along with it.  While it's exciting to learn that we're on the verge of significant innovation in how CKD and PKD are diagnosed and treated, I find myself a bit disappointed. Instead of shouting the news from the roof tops... instead of spreading the excitement, the medical community hides the punchline. They share their findings in dry journal articles, steeped in language that is hard to understand. I realize the audience for the articles is not Joe or Jane Public. I realize that they're scholarly discussions of research methodology, statistics, inference and conclusion. I also realize that this is potentially a single data point that may, or may not, contradict current beliefs. Regardless, wouldn't it be nice if these studies included a simply worded summary of the work? Something easily consumable by the general pu...

Round 2 deja vu

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