Long-term Type 1s: Kidney Health

I’m 45 with Type 1 since I was eleven. I’ve been complication-free thus far, but just received lab results showing a low creatinine clearance (67). I just started taking Altace (2.5 mg. day). Anyone else out there trying to ward off kidney complications as a long-term Type 1? I’m wondering if a restricted protein diet might help? Also wondering if I should insist on seeing a nephrologist at this point. My endo specializes in kids and my primary care physician is swamped.

 

I’m feeling like I’m not getting much information on this other than a phoned in script. At least get an initial consult with a nephrologist. If you only need the one visit, at least you’ll know all the basis are covered. And have a relationship with a nephro for the future if needed. A while after I was diagnosed, and had been exercising regularly but with increasing vigor, I decided to have a checkup & treadmill stress test with a cardiologist, just to be on the safe side about my increasingly vigorous exercise program. I didn’t have any symptoms or problems, but given my (middle-)age and diabetes it seemed sensible.

 

It seems sensible to get your kidney situation checked out sooner rather than later! I use him because there’s a shortage of board-certified endocrinologists in my Chicago suburb. I saw a much better one (for long-term adult type 1s which makes it a rather narrow aperture of opinion) on the North side, but it was an absurd commute, so I use the pediatric specialist. I am his only patient not on a pump.

Uncovering the Atkins diet secret

The controversial and popular Atkins diet works for reasons that Dr Atkins may not have fully understood, the BBC 2 programme Horizon has discovered. Through a series of scientific experiments the programme shows that although the diet allows people all the fat and protein they want, they actually eat as few calories as people on low fat diets. And the reason for this, according to recent research is because the quantity of protein the regime encourages, acts like an appetite suppressant.

 

The meat, fish and eggs in the Atkins diet control hunger and stop people eating their usual quantity of calories. The theory behind Dr Atkins’ diet is that by cutting down on starchy foods like potatoes, bread and pasta and eating mainly protein and fats like meat, eggs and cheese you can eat as much as you want and still lose weight. Dr Atkins even said there was no need to worry about calories. The idea that people could gorge on as many calories as they desire and still lose the pounds brought Dr Atkins much criticism and even prompted some scientists to call his diet “scientific heresy”.

 

Horizon teamed up with the University of Kansas and commissioned a scientific investigation to test Dr Atkins’ most controversial theory. This states that on his diet you actually burn more calories than usual – allowing you to lose more weight. Dr Atkins had two ideas about where the extra calories were going. Firstly, he believed you burn more calories when your body uses fats and proteins as fuel.

News from the pregnant weight watcher

It’s been a while. For those who don’t remember, I used to lurk and sometimes post here, until February when I found out I am pregnant and was told “so long” by Weight Watchers. Well, I am happy to report that my anxieties about gaining weight have proven unfounded. I am on week 18 (that’s beginning the fifth month, for those of you who haven’t been through the pregnancy lingo craziness), and have gained only 10 pounds, without watching what I ate, except for healthy VS bad choices (oh, and I do have my Big Mac now and then, as if it was a Flex Points treat).

 

The first 9 pounds were gained during the first trimester, and I was freaking a bit: what? I don’t even show and I gained 9 pounds? The last one was gained in month 4, again without “dieting” or anything like that. I am exercising more than I ever did, albeit very carefully: prenatal yoga, prenatal aqua-jogging. I never knew exercising could be so fun! I just hope the new habit sticks AFTER the birth. Well, I am happy to report that my anxieties about gaining weight have proven unfounded. I am on week 18 (that’s beginning the fifth month, for those of you who haven’t been through the pregnancy lingo craziness), and have gained only 10 pounds, without watching what I ate, except for healthy VS bad choices (oh, and I do have my Big Mac now and then, as if it was a Flex Points treat). The first 9 pounds were gained during the first trimester, and I was freaking a bit: what? I don’t even show and I gained 9 pounds? The last one was gained in month 4, again without “dieting” or anything like that.

Coffee anxiety

This is going to sound simplistic, but tell your mind that you WILL have a good day and things ARE going to get better. Try and catch negative thoughts and counter-act them with positive statements, thoughts and emotions. And, keep busy….go for a walk/run outside in the sunshine. Visit a museum or go see a movie. Act postitive – stand straight, get focused, smile. It’s also know as acting “as if” and it has been scientifically proven to make you actually feel better. I did this very thing this morning before going to an job interview. I started the usually negative tapes – “I’m never going to find a part-time job I like.”

 

“I’m tired of playing the job seeking game.” “I’m going to run out of money soon and be poor and struggling again.” and so on. I told myself that I was going to reframe all those statements, which I did. Many times I reframe not so much with actual verbage, but emotional thought. One thing I told myself was something along the lines of “I am going to meet a wonderful woman who is going to help me find a job that I like and where I can connect with others.” Yeah, overcoming negative stereotypes is a constant battle. But I have witnessed people who have changed others’ opinions about them (and perhaps their particular race or enthnicity) around. Don’t make it become a self-fulfilling prophesy. Only you give yourself value. I know that is not an easy concept to translate into reality, but it can happen.

 

If they think you are dumb, do things that make you look smart. If they think you are incompetent, do things that prove the opposite. Go out of your way to be proactive and friendly. Don’t accept their value judgements about you. I had to do this during my 25years of working in corporate America. Being an attractive white female had its disadvantages (believe it or not) in that no one ever took me seriously. It was a constant battle to stop people from discounting my ideas and contributions. But eventually I learned to step up to the plate and make them listen. I think it’s Dr. Phil that says that you teach others how to treat you.

Do thin people get depressed

I’m down because of the holidays. I’m eating everything in sight.I think to myself “gee if I was only thin I wouldn’t be feeling this bad.” There’s hardly a single facet to us that doesn’t seem like, if it were different, it would cause the depression to lift. If only I were thinner. If only I could put on a little weight. If only I were smarter. If only I were dumber. If only I had a job. If only I could quit. Yeah, and I’ve had experiences with being so fatigued by Prozac I couldn’t work out. Before Prozac I was a big runner but I stopped ’cause Prozac gave me the whirlies.

 

Going off Prozac (for other reasons) was hard but I recently got to lace on the Nikes again. But believe me, I’d go back to Vitamin P if it still worked! Yea, i find exercising to be very helpful when ya get depressed..sometimes i’d do 500 crunches pushups..then lift some weights go out and jog..it makes me feel better. But yea..the effects arent permanent..if u stop exercisin u feel like shit..dats why i used to work out 24/7..but now i only do workout an hour a day..got too lazy..hehe…so i make it up by drinkin alkihol and goin online and sleeping.

Benzos and Paxil

My doctor put me 20 mg Paxil for persistent anxiety which worsened a growing insomnia problem. When I couldn’t sleep (I had early morning awakenings after 4 hours of sleep), he put me on 1 to 2 mg of Ativan (Lorazipam) as a sleeping pill. What he has not made clear is whether or not the insomnia will end after I’m on the Paxil for at least 4 to 6 weeks. I’m at the end of week three. The insomnia is, in fact, a major cause of anxiety in my life. At the same time, I am concerned about becoming dependent on the Ativan/benzo.

 

At present, I need a narcotic (Ativan) to go to sleep and then I have to drink coffee in the AM to get over the groggy feeling and stay awake during the morning. This doesn’t seem particularly healthy, though I’m usually fine by afternoon. I’m exercising again and actually feel pretty good…having dropped about 10 pounds. But this sleep & dependence thing still has me worried. I’m on my second go ’round with Paxil (30 mg daily this time vs. 40 mg daily a couple of years back – took Effexor in between). Anyhow, I also found that Paxil affects my sleep, but if I take all my dose in the AM, it seems to help immensely.

 

You should get your Dr.’s ok before doing this, but mine said no problem. Even doing this still doesn’t still fully cure my insomnia. I take 100 mg of serzone at bedtime and a .5 mg Xanax pill in the middle of the night. Before taking Paxil in the morning, however, I was taking more nightly drugs than now. One last comment, which is probably apparent from the above, the insomnia did not get better over time. My side effects with Paxil, however, are not necessarily typical so your insomnia could very well go away by itself.

Exercise may increase the concentration

Some scientists believe that exercise may increase the concentrations in the bloodstream (and therefore the brain) of the neurotransmitters serotonin and norepinephrine, as do certain antidepressant drugs. Indeed, in a recent study of clinically depressed 50- to 77-year-olds at Duke University Medical Center, researchers found that performing regular exercise compared favorably in reducing depression over a 16-week period both with taking the antidepressant Zoloft (a commonly prescribed serotonin reuptake inhibitor), and with the combination of taking the drug and exercising.

 

Six months after the Duke study ended, the researchers completed a second round of interviews with the subjects to find out how they were faring. Remarkably, the scientists found that the subjects who were in the exercise-only group were far less likely to relapse into a major depression than either the group who had been on medication, or those who had combined medication with exercise. The researchers speculated that people who attributed their improved mental health to their own personal efforts may have felt more empowered — and thus were less likely to relapse into depression than people who may have attributed their improvement to taking a pill. Now Duke is undertaking a new study to further examine the issue.

 

For instance, how much of the exercise-only group’s benefit had to do with the “social support” of getting together with other people to exercise? The new study will include subjects who exercise at home, as well as others who exercise in group settings.