Saturday 20 December 2014

Blood Test Report & Creatinine {Update#8} (验血报告&肌氨酸酐)

Blood Test Report & Creatinine {Update#8} (验血报告&肌氨酸)
How many of you are aware what a Creatinine is and why a test is being carried out.  How it being measured and what is are the complications if one has a high creatinine.  When my Nephrologist told me I have a Creatinine, it never registered to me that I was moving to end stage renal failure.
So what is Creatinine?
Creatinine is a waste product made by the muscles. Creatinine passes into the bloodstream filters through the kidneys and eliminates in urine.  Healthy kidneys filter creatinine and other waste products from your blood. If one’s kidneys are not functioning properly, an increased level of creatinine may accumulate in the blood.
How to test Creatinine?
A blood sample is being drawn from one’s vain and the result can indicate whether one’s kidneys are functioning properly.  The acceptable creatinine result range is 54-101 UMOL/L which can be varied from hospital to hospital and between male and female.  The said range is being used by the hospital I am visiting.
Doctors measure the blood creatinine level as a test of kidney function. The kidneys' ability to handle creatinine is called the creatinine clearance rate, which helps to estimate the glomerular filtration rate (GFR) – the rate of blood flow through the kidneys.  A low GFR indicates possible kidney disease and warrant further investigations by the doctors to identify why the renal functions have decreased.
Doctor may check the level of creatinine in one’s urine – patient is asked to collect 24 hours’ worth of urine in a container.  Such test will provide more accuracy in determining the level of kidney failures.
What are the symptoms of too much Creatinine?
While some may not have any symptoms at all while others may find out they have high creatinine in a routine blood test.  Some possible symptoms include:
·        Feeling tired
·        Dehydration
·        Confusion
·        Loss of appetite – Especially during end stage of renal failure
Other abnormal blood test levels on sodium, potassium, chloride and bicarbonate may indicate a kidney problem.  I have a posting on renal failure due to high blood pressure.
In my previous post, “HbA1c vs Blood Glucose”, I have mentioned that I will include my test result on HbA1c in this posting.  Being a diabetic, HbA1c is one of the most important factors how well I have been controlling my blood sugar via diet and exercises.  After talking to many people, I found that majority are not aware of what is HbA1c.  Prior to my transplant, I didn’t monitor my blood glucose pre and post meal.
A laboratory test was carried out in mid-December to verify the appropriateness of the dosage and the result is within the expectation of Nephrologist.  Most important – Creatinine is stable (肌氨酸酐是稳定).
Nephrologist (肾脏病学) has decided to reduce the evening dosage of my Mycophenolate Mofetil (Cellcept®) from 500mg to 250mg.
Here are the results:
Date
HbA1c
mmol/L
Peak (UG/L)
Creatinine
Cyclosporine Taking
Dec 2014
5.1
621
87
125 mg - OM
110 mg – ON
(No actions are required)
Aug 2014
5.6
896
109
125 mg - OM
110 mg – ON
(No actions are required)
Jul 2014
Not
Available
1381
107
125 mg - OM
110 mg – ON
(reduction in OM & ON)
With my HbA1c is within excellent range, my way of exercising and diet control have proven to be correct.  I don’t jog but walk.  Though I avoid some foods, I control my portion of all other foods.
Since my transplant, I did not do anything unusual in the manner of taking my drugs as compare to my earlier post “Post-Transplant Medications” (我没有做什么异常以服我的药方):
1.     I always take my drugs on time (我总是准时服我的)
2.     I take my drugs with HL milk for better absorption and for my daily calcium intake (我使HL牛奶服药达更好的吸收和完部分每日钙的需)
Do take note that renal doctor DID NOT adjust the dosage on the basis of test results alone.  There are other indicators that he will review before making the final and crucial decision. (注意à 肾脏医生没有根据单独测试结果调整剂量。他在做出最后和关键的决定前将回顾的其他显示)
Underlying message of my Post to you & your family’s health:
High Risk Groups:
1.  Persons who have kidney disease and high blood pressure may lead to kidney failure.  Persons with high blood pressure have to monitor their diets closely.
2.  Persons who are taking medications which are affecting the renal function.
It is highly recommended to have a creatinine test.  Remedies can be taken to avoid further complications
Diabetic:
For this group, doctor may recommend to have a creatinine test at least once a year.
Post-Transplant Group:
Creatinine is one of the most important and basic blood test for all post-transplant patients.  How frequent will depend on the conditions of individual patient as well as the hospital.  A typical outpatient schedule is recommended as follow:
·         First 2 weeks – Twice weekly
·         Up to first 3 months – Once a week
·         4th to 6th month – Every two weeks
·         7th to 9th month –Every three weeks
·         10th to 12th month – Every four weeks
·         After first 1 year – Every 2 – 3 months
Other Relevant Posts for your Reading (您能其他相关的博):

·      Type 2 Diabetes - 10 Myths & Facts [10个神话&事实关于第二类型糖尿病]

·      Neighborhoods That Encourage Walking Reduce Obesity and Diabetes {鼓励更多步行的邻里有助于减少肥胖病和糖尿病}

·      Diabetes Nutritional Gains from Healthy Whole Grains (糖尿病营养-从整个五谷获取健康)

·      Foods NOT Suitable for Diabetic {Update#1} (食物不适于糖尿病患者)



I am not a Medical Doctor. All my blog postings are my personal experience that I've went thru and what I've read up from internet. If you've any symptoms of diabetes OR want to better manage your health, I strongly urge you to have regular medical-ups to avoid future complications. In addition, control your diet portions and have regular exercise.  (我不是一位医生。所有我的博克投稿是我有经历的我的个人经验,并且我从互联网读了。如果您有糖尿病的任何症状或要更好处理您的健康,我强烈敦促您有规则健康检以避免未来复杂化另外,控制您的饮食部分并且有定期运动.)


Sunday 30 November 2014

Difference between Glycosylated Hemoglobin (HbA1c) and Blood Glucose (葡基化的血红蛋白 (HbA1c) 和血糖之间的区别)

Difference between Glycosylated Hemoglobin (HbA1c) and Blood Glucose (葡基化的血红蛋白 (HbA1c) 和血糖之间的区)
In my previous posts, I have not included my test result on HbA1c which is one of the most important test results for a diabetic.
HbA1c refers to Glycosylated Hemoglobin.  By measuring Glycosylated Hemoglobin (HbA1c), clinicians are able to get an overall picture of what our average blood sugar levels have been over a period of weeks/months.  Measuring HbA1c is important for people with diabetes as the higher the HbA1c, the greater the risk of developing diabetes-related complications.
HbA1c vs Blood Glucose Level
From my discussion with many people, most, if not all, cannot distinguish the difference between HbA1c and Blood Glucose Level.  They have the impression both tests are identical.  Here is the difference:
·         HbA1c – measures the average blood glucose in the blood over the past 6 to 8 weeks
·         Blood Glucose Level – A measure of the concentration of glucose in one’s blood at a single point in time, i.e., at that point of time only when blood is taken from a finger [My personal experience – By monitoring my pre and post meal glucose level, I can determine how good I am controlling and adjusting the portion of foods.]
HbA1c Target
·         Excellent – less than 6%
·         Satisfactory – 6% to 8%
·         Poor – more than 8%
Blood Glucose Target
·         Pre-meal glucose (mmol/l) – 4.0 – 7.0
·         2-hour post meal glucose (mmol/l) – < 10.0
Both sets of Target are provided by one of the largest local hospitals.
I will include my HbA1c result in my next “Blood Test & Creatinine Report” update.
Underlying message of my Post to you & your family’s health:
High Risk Groups & Pre-Diabetic:
Family history – My father is a diabetic.  As such, I am considered as a high risk group.   In other words, diabetes is within family history, PLEASE have regular check-ups and watch your diets to avoid complicatins
Race – Certain races such as Chinese, Hispanics are considered high risk group
Pre-Diabetic – Very likely to develop diabetics.
For these groups, regular doctor check-ups are highly recommended.  Most important of all, do follow up on your doctor’s advice and recommendations.  By taking extra efforts at the beginning, it will pro-long reaching end stage kidney failure.
Diabetic:
One of my major mistakes was that I did not conduct pre and post meals glucose testing when I was diagnosed with diabetes.  As a result, I was not aware the right size of my meal portion.  I was depended on my Doctor to control my diabetes which eventually where dialysis is required.  Do not let this happen to you.
Being diabetic who is insulin dependent, pre meal glucose testing can determine or adjust the amount of insulin to be given to oneself taking into consideration of one’s pre meal glucose level as well as the type of food to be taken.  Post meal testing result will provide whether one is right in the judgment of insulin level injected.
Pre and post meal glucose level testing will go a long way before reaching end stage kidney failure (stage 5 in medical terms) OR one may not reach there with proper diet and exercise.
[My personal experience – I am doing home blood glucose monitoring to ensure good control of my diabetes.]
Post-Transplant Group:
Besides Cyclosporine, Prograf® is another prescribed medicine to help prevent organ rejection in people who have had a kidney, liver, or heart transplant.  One of the drawbacks of Prograf® is it may lead to diabetic.
Having spoken and discussed with patients in this group, they have been advised to do post meal glucose testing to ensure glucose is under control and do not have any harmful consequences to the organ.
Other Relevant Posts for your Reading:

·     Type 2 Diabetes - 10 Myths & Facts [10个神话&事实关于第二类型糖尿病]

·     Neighborhoods That Encourage Walking Reduce Obesity and Diabetes {鼓励更多步行的邻里有助于减少肥胖病和糖尿病}

·     Diabetes Nutritional Gains from Healthy Whole Grains (糖尿病营养-从整个五谷获取健康)

I am not a Medical Doctor. All my blog postings are my personal experience that I've went thru and what I've read up from internet. If you've any symptoms of diabetes OR want to better manage your health, I strongly urge you to have regular medical-ups to avoid future complications. In addition, control your diet portions and have regular exercise.  (我不是一位医生。所有我的博克投稿是我有经历的我的个人经验,并且我从互联网读了。如果您有糖尿病的任何症状或要更好处理您的健康,我强烈敦促您有规则健康检以避免未来复杂化另外,控制您的饮食部分并且有定期运动.)

Saturday 15 November 2014

Peanut Butter – A brand with lesser Sugar {花生酱 – 这个品牌用较少的糖}

Peanut Butter – A brand with lesser Sugar {花生酱 这个品牌用较}
I like to apply peanut butter to my wholemeal bread for breakfast.  My favorite brand is Peter Pan for its low sugar content.
During my quarterly review with the Senior Consultant from the Department of Endocrinology, he mentioned that peanut butter from Marks & Spenser is a better option for me. I have tried M&S and it’s packed with nuts, and bursting with taste with much better texture.
For the sake of comparison, I have included Nutella as one of the components.  Here are the contents comparisons between the three items:
A Comparison P.Pan (Creamy) Marks & Spencer (Crunchy) Nutella
Serving Size (g) 100 100 100
Calories 656 n/m n/m
Energy n/m 538kcal 628kcal
Total Fat 53.1 50.8 31.6
- Saturated Fat 9.4 11.2 n/m
Sodium (mg) 0.4 0.2 n/m
Carbohydrate 18.8 14.8 57.3
Dietry Fiber 6.3 6.6 n/m
Sugars 9.4 4.9 n/m
Protein 25.0 24.4 6.0

Here are some interesting facts that I observed:
1.        Both P.Pan and M&S have listed peanuts as the first ingredient
2.        Nutella listed Sugar as the first item of the ingredient listing BUT why didn’t it has the Sugar content listed – isn’t that interesting?
3.        If you like peanut butter for breakfast, please chose the brand wisely for a better health
Further information on Nutella is available at “Wikipedia”:
1.        Nutella manufactured by the Italian company Ferrero.  Under Italian law, it cannot be labelled as a chocolate cream, as it does not meet minimum cocoa solids concentration criteria. Ferrero consumes 25% of the global supply of hazelnuts
2.        Nutella contains 70% saturated fat and processed sugar by weight. A two-tablespoon (37 gram) serving of Nutella contains 200 calories including 99 calories from 11 grams of fat (3.5g of which are saturated) and 80 calories from 21 grams of sugar. In addition, the spread contains 15 mg of sodium and 2g of protein per serving.  [My View – The tastier the food, more harmful to one’s health.  Now you know why they didn’t mention the sugar contents in its label.]
3.        In the United States, Ferrero was sued in a class action for false advertising that led some to believe that Nutella carries nutritional and health benefits, being touted as 'part of a nutritious breakfast'. They agreed to pay $3 million (up to $4 per jar for up to five jars in returns by customers) in an April 2012 settlement. The settlement also required Ferrero to make changes to Nutella's labelling and marketing, including television commercials and their website

Other Relevant Posts for your Reading (您能其他相关的博):

·     Blood Test Report & Creatinine (验血报告&肌氨酸酐)

·     Difference between Glycosylated Hemoglobin (HbA1c) and Blood Glucose (葡基化的血红蛋白 (HbA1c) 和血糖之间的别)

Disclaimer: I am not a Medical Doctor. All my blog postings are based on my personal experience that I've went thru and what I've read up from the internet. If you've any symptoms of diabetes OR want to better manage your health, I strongly urge you to have regular medical-ups to avoid future complications. In addition, control your diet portions and have regular exercise. 

(我不是一位医生。所有我的博克投稿是我的个人经验,并且我从互联网读了。如果您有糖尿病的任何症状或要更好处理您的健康,我强烈敦促您有规则健康检以避免未来复杂化另外,控制您的饮食部分并且有定期运动.)