Guard Your Kidney Health!

If you are a diabetic, you’ve likely been cautioned by your physician about the consequences of allowing your blood sugar to run high. You may have shrugged off the horror stories about how unchecked high blood sugar can damage your eyes, your heart, and circulation to your extremities. You probably have thought, “I’m young (or relatively so), and it’s not going to be as bad as all that.”

I thought that too.                                                                                                                               

Apart from being overweight since childhood, I had always been in good health. One of my doctors had described me as having “the heart of an 18-year old.” I walked long distances, I could sprint 15 or 20 yards without too much trouble and I could lift heavy objects such as furniture and lumber with relative ease. I felt good about my health.                                                

Then one day in early 1989 I went in to see my new doctor after a change in insurance companies for a routine physical. His nurse checked my blood pressure, listened to my heart and lungs, and took a blood sample. Then I waited in the examination room for the doctor to come in. 

After 10 or 15 minutes, he came in. He was short and muscular, with silvery, salt-and-pepper hair in a wiry crew cut, and a close-cropped beard. He looked every inch the ex-Navy man that I later found out he was.

He consulted his clipboard and went down the list of test results: heart, good. Blood pressure, fine. Lungs, clear. Then he looked at me and said, “Alan, you are a diabetic.”                                      

The breath went out of me. I was speechless, feeling as though he had slammed me over the head with a 2 x 4. I was 30 years old and felt as if my life was over.                                                       

He prescribed Glucotrol1 to help regulate my blood sugar and gave me some literature that explained what types of foods affected blood glucose. He warned me that if the oral medication didn’t do the trick, I might have to begin insulin injections.                                                             

I drove home in a funk, feeling as though I had discovered a severe moral failing in myself.
As is so often the case, I started out being careful about what foods I ate, faithfully taking my meds. I was later switched from Glucotrol to a then-new medication called Glucophage, known today as metformin

Over time, however, as is the case with so many diabetics, I gradually drifted away from a proper diet, and within a few years the diabetic diet that I had been so careful to follow was only a memory.                                                                                                                                                       

In early 1998, I developed what I thought was a chest cold. I took the usual over-the-counter medications for it, but nothing really seemed to help. I fought the symptoms for a couple of weeks before waking at dawn one morning feeling like my chest was full of jelly. My wife drove me to the ER, where they diagnosed my pneumonia and started me on a strong antibiotic. 

However, they found something else: My blood glucose was well over 300.                                       

This time I didn’t get by with just an oral medication. I was put on a long-acting form of insulin called Lantus3, and had to learn to use diabetic syringes, drawing the prescribed dosage from a glass vial and injecting it into my abdomen. Things stabilized for a while, and then over a period of years I went through cycles when I gradually became lax about testing my sugar and taking my insulin, and then something would occur to prompt me to get back in the swing of things; Lather, rinse, repeat.                                                                                                                                 

My life took a radical change in direction in December 2002, when I was involved in a head-on car wreck on the Interstate.                                                                                                                                 

I was heading home early from work because of an impending snowstorm when a vehicle went out of control on the other side of the highway and crossed the median, striking my car head-on. 

I came to only to discover that I was hanging out of the drivers’ window of my car almost to my waist, and the engine was on fire beneath the crumpled hood.                                                                  

I later found out that I had broken both ankles and most of the bones on the left side of my body. I spent a total of seven months in four different hospitals.                                                                            

It was a long, slow road of rehabilitation, but I gradually regained much of my independence, although to this day I still use a wheelchair much of the time.                                                        

Things began to take an even more ominous turn around 2005, when I once again had a checkup with a new doctor. As was the case so many times before, my heart and lungs checked out fine; my blood sugar was, as usual, somewhat high, but not as high as in some previous cases. However, she cautioned me, blood tests showed indications that I might be developing issues with my liver and kidneys.

I was in denial over this, and after pondering it for a couple of days, managed to shut the door on it. Soon it was totally forgotten.                                                                                                         

Shortly thereafter, my life changed yet again. I went through a divorce, remarried, and in December 2007, moved from Arkansas to South Dakota. Living on the Rosebud Indian Reservation seemed to agree with me. I had thought that life in Northwest Arkansas was laid back compared to the Oklahoma City metro where I had grown up, but after a few months in South Dakota, I found myself more relaxed than I had been in years.                                      

Unfortunately, that relaxation, as it had all too many times before, extended to the monitoring and treatment of my diabetes. I felt good, and I took that to mean that everything was fine.

I couldn’t have been more wrong.                                                                                                                 

In the early summer of 2008, I started feeling ill. I was lethargic, had difficulty getting up from the bed and walking to the bathroom (not an easy task for me at the best of times, due to the injuries from the car wreck). By mid-July I felt as though I was as bloated as an engorged tick. 

One day as I was coming out of the bathroom, struggling to make it down the hall to where my wheelchair was parked, I fell flat on my face. I discovered that, no matter how I tried, I didn’t have the strength to get up.                                                                                                                    

My nine-year-old stepdaughter happened to be the only family member that was nearby. She went downstairs and alerted my sister-in-law and her husband, who came running and tried to help me up, to no avail.                                                                                                                       

They called my wife at work. She rushed home and called the local ambulance service. They soon arrived and got me up off the floor. At my wife’s insistence, I agreed to let them transport me to the emergency room. I don’t really remember much after that—it’s a confused jumble of memories.                                                                                                                                          

I wound up spending six weeks in the hospital. They installed a hemodialysis catheter in my upper chest and the first week that I was hospitalized they removed approximately 50 liters of waste liquid from my body. The bloated feeling that I had been experiencing was due to having suffered acute renal failure4. One of the doctors estimated that if my treatment had been delayed another three days I would have died.

Since that time, I have undergone hemodialysis treatment three days a week at a local dialysis clinic. I consider myself quite lucky that there is a clinic only 10 miles from my rural South Dakota home. Some of the other patients at my facility travel 75 miles or more for their treatments.                                                                                                                                                  

I now have a mature arteriovenous (AV) fistula5 in my right forearm, which is an access point created by surgically connecting an artery and vein together, usually in the arm. Over a period of time, this creates a “toughened” blood vessel that will stand up to repeated punctures with the large (typically 14 gauge) needles used in hemodialysis.                                                                                    

Every Tuesday, Thursday and Saturday, I get up at five in the morning and make the trip to the dialysis clinic, where I spend four hours watching TV or surfing the Internet while my blood circulates through a machine that removes waste matter and excess liquid. It’s inconvenient, but it’s certainly better than being six feet under.                                                                                       

Take my advice – for your own sake and that of your family, maintain your blood glucose properly and avoid the complications it can cause.

1 &ldqu
;Glucotrol,” Revised 11-21-2011.  
2 “Metformin,” Medline Plus. Revised 08-15-2012.                      
3 “Your Day by Day Guide to Living With Lantus,” Revised July 2012.
4 “Acute renal failure,” WebMD. Revised May 10, 2011.
5 “Arteriovenous fistula,” Encyclopedia of Surgery. 2012.

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