The Last Hurrah

That's what my Dad said as he characterized his last "family" vacation. He went with Marcia. I wonder why he didn't invite me along. Jeez. Or is that speaking I'll of the dead? Something I may be soon. 5 years tops IF I opt-in to dialysis. Hemodialysis is the best method for ridding the body of creatinine, which is a byproduct of metabolism and is a waste product. It is measured in milligrams per decilitre (mg/dl). The normal range for men is .6 - 1.3 or 1.4 depending on who you ask. At 5.0, dialysis is required or you will soon die. Or get a transplant but that seems highly unlikely due to several disqualifiers. One is my weight and the other is the state of my Liver. 

I'm just writing this to leave a paper trail of the final period of my life. It helps me come to grips with the gravity of it all and to stay upbeat and positive. 

It's a miracle, well, actually many miracles, that I'm even still alive to pen this memoir or Journal, whatever you wanna call it. 

I know I'm waiting with baited breath on the results of the blood draw I had done today. As I stated elsewhere, probably on Facebook, I'm most interested in the BUN (Blood-Urea-Nitrogen) to Creatinine Ratio.  Here's a snapshot to help understand what we're looking at:

Mhistorical creatinine levels have peaked at 12.0 mg/dl in July of 2017 while recovering from the ingestion of ~550 200mg Ibuprofen Gel Tabs. Dialysis was in order of course and by August and a month or so of 4 hours' hemodialysis every other day my Creatinine was below 5 and pry closer to 3 so permanent Dialysis wasn't necessary. There were two other serious suicide by NSAID attempts as well I'm afraid, in 2013 and 2021 and involved 300 Advil and 300 generic Ibuprofen caplets. No dialysis was necessary during the latest try in 2021 likely due to the administration of a charcoal cocktail, which I recall drinking through a straw at Broadlawns hospital. Then I was transferred to the Veterans Medical Center's ICU unit and intubated for the third time. I had dialysis briefly after the first one too. My Creatinine was 1.38 last November (2022), which is high normal but I didn't see a BUN - Creatinine Ratio on any VA lab results I reviewed all the way back to August, 2017, after being transferred by ambulance 🚑 from Hospital Sisters Hospital System's St. John's Catholic Hospital in Springfield, Illinois. 

As is glaringly apparent, I've clearly injured the shit out of my poor beans. And my Liver. My BP isn't too high usually 140/90 at the highest. Occasionally higher but not very often. I was on Amlodipine for hypertension but I quit taking it for a couple of reasons. It may have been causing or contributing to the peripheral aedema I now have and my BP is WNL without it. Currently, the swelling in my feet, ankles and lower legs is mild but it was severe. Grade 4 pitting aedema is a very bad thing to have. I've cut way back on sugars as they are a preservative for the kidneys, drying them out so to say. I also watch my sodium intake. I'll likely need to eventually be on a strict kidney diet and a liquid restriction as my condition deteriorates. 

Being morbidly obese (BMI 41.0!) surely complicates matters and I'm working on shedding a lot of that. One good sign is the pain in my left upper quadrant just below the rib cage has attenuated somewhat. It migrated to the center more then returned to the LUQ. It used to be way more prevalent now I barely notice it. Quitting cigarettes likely helped as there are over 4,000 chemical toxins in them. I drink way more water now and so that may have helped. I figure less pain the better the situation is inside. I abstain from alcohol almost completely so that isn't an aggravating factor. My liver showed some inflammation and scarring on a November 2022 Ultrasonic Scan with a loss of volume indicating fatty infiltration. Some scarring was also noted. No follow up treatment was scheduled or mentioned in the record just the admonishment to shed 10% of my 300 pounds. So the liver could have a chance to regenerate or at least not worsen. Extensive scarring is called chirrosis and is irreversible and lethal. A liver transplant is not in the cards for me due to obesity and CKD. 

Oh, regarding that CKD, I read a little bit ago on one website that symptoms I'm having such as foamy urine, caused by proteins the kidneys couldn't reclaim cuz they're damaged, can be Stage 1 or 2. Heretofore, I thought that proteinuria as it's called, was only a manifestation of End Stage Renal Failure. So be careful jumping to hasty conclusions and remembering I'm no doctor nor did I stay at a Holiday Inn Express last night. Lol.

Recent reduction in urine output is worrisome as is the likelihood of having the condition called Proteinuria. The stream is pretty weak as well which is another bad sign. A sudden urge to go in concert with low output is a certain indicator that the kidneys are not working as well as they should. 

So, in closing, I'll repeat myself by saying I'm exceedingly interested in the results of the blood testing I had earlier today. Farxiga is available to help slow the progression of CKD I believe so perhaps that'll help.