Thursday, 22 May 2014

Diabetes & Dialysis (糖尿病&透析)

This Blog is my life experience of being a diabetic, how I manage my dialysis as well as kidney transplant with the intention to benefit others who are facing diabetic issues and renal failure.

Diabetes & Dialysis
My life in three stages: pre-diabetic day, pre dialysis days and renal failure days.

Pre Dialysis Days
I have to admit that I didn’t exercise as much as I should be.
When I first visited my doctor in January 2008, I was told that I have diabetes.
The doctor also warned me the consequences of diabetes – renal failure and thus requires weekly dialysis. I took it lightly
Anticipated the renal failure, I had my fistula created in February 2013.
Renal Failure Days
Finally, that day came.  That day was May 2013 – the day I had my first HD

In August 2013, I had refreshment for my fistula.  According to the vain surgeon, refreshment is only required subsequent to the fistula creation after a few years

My Meals
Egg white – On average, I took two egg white daily to maintain sufficient Albumin
Beef – I will consume beef to get my dosage of Hemoglobin for my lunch during my dialysis days which fall on Tuesday, Thursday and Saturday.

Potassium
Due to renal failure, excess potassium is not able to be excreted from our bodies.  Vegetables such as Yam & Potato and fruits such as banana and kiwi fruits, with high potassium must be avoided.
What I didn’t know was that both Ginger Root (Grounded) and Coriander contain high potassium.
I was using many grounded ginger root and coriander to marinate my beef as I am avoiding salt. During a routine blood test in September 2013, my potassium level shot up to 6.2 mmol/L which was way above the ideal range of between 3.3 to 5.0 mmol/L.  My potassium is always within 4.5mmol/L
I did a search in wikipedia.org and found the potassium contains of:
  • Ginger Root (Grounded) – 1320mg per 100g
  • Yam - 816mg per 100g
  • Coriander also known as Chinese Parsley – 521mg per 100g
  • Potato – 421 mg per 100g
My potassium has returned to normal after avoiding grounded ginger root and coriander.
Personal experience:
  • I avoid raw vegetables as they contain higher potassium.  Packed mix vegetables is my alternative (they tend to contain lesser potassium base on my research)
  • No banana, kiwi fruits and mangoes as all contain high potassium.  I consume apples every day.  All berries such as strawberry and blue berry are suitable for consumption.
Fluids
Due to renal failure, most fluids will tend to be retained in the body.  I have lost 5 kg of water since I stated my dialysis.
In between my dialysis days, most of the time, my water retention is between 2-3 kg.  The highest retention was 4kg
One should limit the ALL fluids intake to 1kg per day.  My personal experience to minimize retention:

  • Change to a smaller drinking mug
  • If you have to take coffee or tea, only consume 50% as against pre-dialysis days
  • Totally avoiding soup
  • Reduce salt consumption – Salty dishes will increase your fluids consumption resulting higher water retention.  Always ask for less salt and oil when ordering foods
  • Fast foods tend to contain high amount of salt.
  • Avoid or minimize canned foods as they tend to contain lots of salt
  • Do not consume soft drinks as one will tend to finish the whole can of soft drinks.  If you really miss it so much, half a can is the maximum.
  • Exercise for three times a week, during non-dialysis days