3/12/20

462) World Kidney Day

March 12, 2020
Thursday

My motivation for posting on my blogs is encouraged by my brother-in-law who is visiting and maintains several journals simultaneously!  I think the current COVID-19 crisis is important to document on blogs such as mine, for people who have compromised immune systems from taking cyclosporine, myfortic, and other immune system suppressants.  And,
since today is World Kidney Day we should all 1) wash our hands carefully for 30 seconds; 2) drink up a fresh, cold glass of H2O, toasting the fact that we have another day on the planet!  And, 3) Keep your hands away from your face unless you wash them again right beforehand. 

Today's Message is quoted from an online article in Renal & Urology News World kidney day 2020: Kidney health for everyone everywhere.  "In 2020, the World Kidney Day campaign highlights the importance of preventive interventions – be it primary, i.e., to prevent de no CKD, or secondary or tertiary, i.e., prevention of worsening early CKD or progression of more advanced CKD to end-stage kidney disease, respectively. Primary prevention should focus on the modification of CKD risk factors and addressing structural abnormalities of the kidney and urinary tracts, and exposure to environmental risk factors and nephrotoxins. 

In persons with preexisting kidney disease, secondary prevention, including blood pressure optimization, glycemic control and avoiding high-protein high-sodium diet should be the main goal of education and clinical interventions. In patients with moderate to advanced CKD, management of comorbidities such as uremia and cardiovascular disease along with low-protein diet are among the recommended preventative interventions to avoid or delay dialysis or kidney transplantation.

"[Tertiary prevention indicates managing disease after it is well established in order to control disease progression and the emergence of more severe complications, which is often by means of targeted measures such as pharmacotherapy, rehabilitation, and screening for and management of complications.]

"Whereas national policies and strategies for non-communicable diseases may exist in a country, specific policies directed toward education and awareness about CKD screening, prevention, and treatment are often lacking. There is an urgent need to increase awareness for preventive measures throughout populations, professionals and policy makers."


3/11/20

461) Missing an Anniversary in a World of Worry

March 11, 2020
Wednesday

Shayna texted a little while ago: "happy belated birthday to Mordecai! 💕"  I realized we had missed it again (It's March 9th).  And it is no wonder, with all the other world news that is crowding everything out.  We with immunosuppressed systems (and our friends with immune-deficient systems) fit that category of folks who better watch carefully or we might just lose the benefits our modern world with state-of-the-art medicine has accustomed us to. 

I, for one, worried excessively about going to the university to be part of hosting a webinar for social workers in China because of the warnings coming out about my particular group's mortality rate given the new COVID-19 epidemic.  Watch out if you are:
  1. Adults over 70
  2. Serious long-term health issues (Transplant, Liver disease, Heart issues, HHT, etc)
  3. Compromised immune systems
  4. Shortness of breathe
  5. Avoid crowds
For us the CDC recommends just staying home.  For the most part I am happy to stay home.  I will only worry about others coming into my home and infecting me! And, of course as soon as the CDS recommend that us old folks "stay home", the Trump Administration overrules the CDC recommendations.

The upshot from Jack's Brain

Since my liver issues have been crowding out my old favorite kidney issues (last year especially) and with little real detailed information and trust (like I used to easily have with Dr. Richard Lewis) I have been thinking more about how one leaves this life and the usually comforting consciousness we have about our daily experiences here on the planet.

When I imagine the narrative of departing this reality~life~plane~world~existence I conjure up scenes of softness with those I love by my side as I slip away peacefully.  Of course, thinking about succumbing to the Coronavirus is much more appalling. The sick patient is covered with plastic so as to not infect any hospital staff or relatives.  There are tubes up both nostrils, a resuscitator in the mouth and no ability or opportunity for last goodbyes with family aside from the blurry view through three layers of latex.

The dying patient is alone, choking, and unable to communicate.  Sounds horrible to me. 
Hopefully I will be one of the old farts who dodges the virus and is able to have the kind of slipping away that is planned for and mercifully accepted, like slipping out of the party when one has had enough.