It’s a new year and a great time to make sure your health is in order. The following checklist can be taken to your doctor to review your overall well-being. In addition, Dr. Mary Meyer, who has been practicing in the areas of critical care, transplant and nephrology over the past 18 years, also suggests six items that you should pay extra attention to when talking with your doctor.

Good health checklist

Physical health review

• Checkup
• Blood and urine lab work
• Medicine and supplement review
• Flu shot and other vaccines updated
• Exercise review
• Nutrition review
• Dialysis modality review if you’re on dialysis
• Emotional health review
• Check in with your feelings
• See a counselor if necessary
• Stay active by working or volunteering
• Keep moving and doing things that interest you

While all the items on the checklist are important, Dr. Meyer especially recommends the following six topics be addressed with your doctor.

Flu and pneumonia shots check

Flu shots are the best way for everyone to prevent getting the flu, but if you have kidney disease you are encouraged even more to get the vaccine. The U.S. Centers for Disease Control and Protection suggest that people who have kidney disease and/or diabetes and need regular medical care have a flu shot.

While Pneumovax® shots (a vaccine effective against the 23 most common strains of a bacterium that causes pneumonia) are usually given before flu season in October or November; the beginning of the year is a good time to make sure you are up to date on both shots. If you still haven’t gotten your flu or pneumonia shots, ask your doctor. Flu season can last until May, so you’ll want to be protected.

Transplant check

If you’ve had a kidney transplant recently, you should make sure that your doctor pays special attention to the status of your new kidney. When going in for follow-up checkups, bring your surgery handbook, if you have one, and the list of medicines you are taking.

You should also tell your doctor how your home monitoring has been going. This monitoring should include regular, self-administered checks on weight, temperature and blood pressure. If you notice a dramatic weight gain, you could be retaining fluids. Temperature change can indicate infection. If there is a noticeable change in blood pressure, you should visit your doctor.

Diabetes check

If you have diabetes, the American Diabetes Association suggests that you visit your doctor two to four times a year, and if you are on insulin, these visits should occur at least four times so by the time you walk in for your New Year checkup, it should have been only a few months since your last doctor’s visit.

Dr. Meyer advises that you see an endocrinologist (a doctor who is more specialized in treating diabetes) if you aren’t working with your primary care doctor or nephrologist to manage your diabetes.

Dr. Meyer offers a few guidelines about what to look for and discuss with your doctor. Along with checking your glucose (blood sugar) level, blood pressure and weight, your doctor should take blood to check cholesterol, blood fat and glycated hemoglobin (hemoglobin A1c). The hemoglobin A1c test will give a measure of your blood glucose level over the past two to three months, probably since your last doctor visit. A urine sample should also be taken to look for protein. Protein in the urine (proteinuria) occurs when the kidneys are damaged. For people with diabetes, this is a sign of diabetic nephropathy—meaning kidney function has declined. This, in time, could lead to kidney failure. In addition to treating diabetes, your endocrinologist will also take steps to help prolong your kidney function and possibly even prevent kidney failure.

Medicine check

The New Year is also the perfect time to go over your medicines with your doctor. You should review what you are taking, how you are feeling and how your body is responding to the medicines based on your lab results. You can help your doctor determine if you’re taking the right medicines, or if there are medicines you no longer need to take. “It’s the perfect time to streamline the drugs you are taking,” Dr. Meyer says.

Activity level check

Even if you are on dialysis, Dr. Meyer recommends you stay active. “A lot of people say that you shouldn’t work if you are on dialysis. I think that’s the wrong advice. The more you get out into the community the better,” says Dr. Meyer. In addition to the social benefits of working, the financial benefits of an income and health insurance can also provide peace of mind.

Exercise can also provide a health benefit. Most people on dialysis can do some form of physical activity. A study published in the Archives of Physical Medicine and Rehabilitation showed that people who exercise while on dialysis may have more effective treatments because exercise can reduce urea (a toxin that accumulates between dialysis sessions) by 20%.  Physical activity can help you feel better, stronger and more in control of your health no matter when you do it. Talk to your doctor about what kind of physical activity will be good for you. Even a little bit of exercise can be a big help.

Depression check

For a person with kidney disease, the everyday dealings with physical health issues can be all consuming. “Everybody is so busy dealing with the physical issues that they forget about the emotional strain,” says Dr. Meyer. But Dr. Meyer believes that it’s a good idea to take the time to check in with your feelings and emotions.

A study by Yale University found that depression is generally accepted to be the most common psychological disorder associated with dialysis. The feelings of sadness and hopelessness associated with depression can take away from one’s quality of life. Depression is an illness that should be treated by a professional in the same way you would treat diabetes or high blood pressure. Dr. Meyer’s advice is to listen to your feelings, and if necessary see a counselor. If you are on dialysis, talk to the social worker in your clinic. The social worker can help determine if you have clinical depression and can assist you with getting more treatment if needed. In addition, social workers are trained to teach stress reduction techniques that can help alleviate emotional strain. Your mental well-being is just as important as your physical health.

Make this year the best it can be by taking care of your physical and emotional needs. Use this checklist and follow Dr. Meyer’s advice to help you have a Happy, Healthy New Year.

- Reprinted with permission by DaVita Inc.

- Source from www.DaVita.com

By Margaret, DaVita dietitian in El Paso, Texas

We’re all familiar with the busy schedule of the holiday season. We rush through shopping, decorating and holiday parties. On top of all that, there is an extra challenge: continuing healthy, safe eating habits during the holidays.

Is there a key to being successful in following a kidney-friendly diet during this hectic time?  Here are a few ideas:

Ask for help

Friends and family can be our biggest help in following dietary guidelines. Don’t be shy about letting them know what types of foods you can and cannot eat. You can even offer to bring a dish or appetizer you know you’ll be able to eat to a party.

Try to plan ahead

If you know a shopping trip will last beyond mealtime, take a portable meal with you. If you’re attending a party in the evening, eat smaller meals earlier so you can have a little extra at the party. If possible, ask ahead of time which foods will be served at the party. That way, you can have a picture in mind of which foods you can eat.

Set new goals each day

It is easy to get caught up in the season and think: “Oh well, there’s no way I cay stay on my diet this month.” Thinking this way can lead to a whole month of eating foods that may harm your health. Instead, take one day at a time. If you eat too much on one occasion, remember to ‘get back on track’ the next day. Before you know it, you’ll have come through the holiday season with a pretty good and safe eating record.

Try this Party Snack Mix recipe when you go to your next holiday party—or take it along as a snack for a shopping trip.

Party Snack Mix

Recipe taken from Living Well on Dialysis, National Kidney Foundation.

- Reprinted with permission by DaVita Inc.

- Source from www.DaVita.com

After Halloween (and all the diet pitfalls that holiday brings), it seems there’s an array of foods tempting us to overindulge. Thanksgiving, Hanukkah, Kwanzaa, Christmas and New Year’s Day all seem to revolve around traditions that include food. Because diet is so critical for people with kidney disease who are on dialysis, DaVita® dietitians have come up with a list of 11 holiday eating tips especially for renal patients. There are also some suggestions on food choices that would make up tasty and healthy holiday meals.

11 Tips for Holiday Eating

1. When in doubt, always ask your dietitian about healthy meal choices, especially for your individual eating plan.
2. Limit salty foods. Salt makes you thirsty. If you eat too much salt, you may drink too much fluid and possibly make your next dialysis treatment difficult.
3. Make your stuffing from scratch and reduce or eliminate the high sodium ingredients such as salt and broth.
4. Use nondairy topping or whipped cream instead of ice cream on desserts.
5. Remember to take your phosphate binders. Binders should always be taken with food, because the main action occurs as food is being digested.
6. Select low potassium desserts such as cake and/or fruit pies, instead of pecan pie, pumpkin pie, fruitcake or chocolate desserts.
7. Remember that Jello® and other gelatins count as fluid.
8. Remember that gravy counts as fluid.
9. Roast meats to the correct internal temperature. Poultry must reach 185º F.
10. Never eat raw eggs. Use pasteurized eggs in recipes that call for uncooked eggs (such as eggnog or cream pie), or buy commercially-prepared egg products that have been pasteurized.
11. Leach potatoes (to lower the potassium content). To leach: Peel the potatoes and cut into small pieces. Soak in large amount of water (for 1 cup of potatoes, use 10 cups of water) for at least four hours. Drain the water and rinse. Cook in a large pot of water until tender. Drain the potatoes and prepare.

You can put together a delicious holiday meal for the entire family and still select foods that are acceptable for a kidney-friendly diet. Remember to prepare foods with herbs and spices in place of high sodium seasonings. Reduce or replace high potassium and high phosphorus ingredients. You can find recipes for some of the items listed below, as well as many others, in the recipe section of DaVita.com.

Try any of the following for your holiday entrée:

• Roasted Turkey
• Tenderloin with Mustard Sauce
• Roast Pork with Apples
• Roast Beef
• Cornish Hen
• Fish
• Roast Chicken
• Braised Beef Brisket
• Roast Lamb
• Leg of Lamb

Your choice of side dishes can include:

• Leached Mashed Potatoes
• Noodles
• Leached Sweet Potatoes
• Rice, Rice Pilaf, Spanish Rice
• White Breads
• Low Salt Stuffing (use white bread), Baked Stuffing, Fresh Herb Cranberry Stuffing

Garden vegetables and fruits you can choose from:

• Carrots, Glazed Carrots
• Green Beans, Gourmet Green Beans, Savory Green Beans
• Corn
• Cauliflower
• Cabbage
• Peppers
• Lettuce
• Zucchini, Zippy Zucchini
• Summer Squash
• Pineapple
• Cranberries
• Apples
• Peaches

Mouthwatering desserts that make good choices:

• Apple Pie
• Cherry Pie
• Peach Cobbler
• Angel Food Cake
• Pound Cake
• Snickerdoodles
• Carrot Cake
• Hot Fruit Compote

Wondering what to do with that leftover turkey? Try these suggestions for a high protein lunch or dinner:

• Sliced Turkey Sandwiches
• Baked Turkey Loaf
• Turkey and Vegetable Stir-fry
• Homemade Turkey Pot Pie
• Turkey Salad
• Turkey Wrap
• Turkey and Rice Casserole
• Turkey and Dumplings

Summary

Hopefully these suggestions will help you create enjoyable holiday dinners this season that also will let you stay on course with your dialysis diet. You can find more ideas and recipes for people with chronic kidney disease, diabetes or those on dialysis at DaVita.com/Recipes. As a final word, remember, moderation is the key.

- Reprinted with permission by DaVita Inc.

- Source from www.DaVita.com

Diabetes can be a debilitating disease if it gets worse, but you can enhance the quality of your life by keeping to the right diabetic diet. In order to find out what the best meal options should be you will definitely have to talk to a certified nutritionist. This week, Magic Kitchen reviewed some online resources that provide healthy meal options and recipes for people with diabetes:

1-      The Reader’s Digest Diabetes Super Foods Article: Offers unique information on what each super food does for your body and how it helps. Also provides tips and information on eating the right kind of food for diabetes.

2-      Diabetic Lifestyle: Magic Kitchen thought this website has a lot of information about how to cope with diabetes and how to eat healthy with this disease. Recipes are also available by food item and meal course.

3-      Fast Diabetes Recipes: HelpGuide offers a variety of advice on diabetes management but Magic Kitchen believes that the easy to make, quick diabetes recipes are definitely the most attractive part of the website.

Written by Karen Dunker, RD

Did you know that the average Thanksgiving or Christmas dinner has over 2,000 calories? That number of calories is usually what you would consume over an entire day. The holidays are sometimes challenging if you are watching your waistline and following the kidney diet. But eating right during the holidays is possible. Listed below are five healthy holiday eating tips for people with chronic kidney disease (CKD). These tips may help you avoid unwanted weight gain without depriving yourself of kidney-friendly foods.

1. Don’t skip meals before a holiday dinner

You may be looking forward to a holiday feast with all the trimmings. But it is not a good idea to arrive at a dinner party hungry. People tend to eat more when they are extremely hungry. Before you decide to skip a meal, remember to eat a light but wholesome breakfast and lunch to avoid overeating at dinnertime. Eating well-balanced meals throughout the day may also stop you from making decisions that go against your kidney diet.

2. Make the right choices at the dinner table

Holiday dinners should not be looked at as an “all-you-can-eat” occasion. Look over the buffet ahead of time and make the best choices based on your favorite foods and your kidney diet prescription. Ask your renal dietitian about what you can eat and what to pass on when you go to a holiday gathering.

3. Portion control

Holiday dinners should not be looked at as a free-for-all when it comes to eating. Watch the portion size of side dishes, especially when there are many possibilities to choose from. You can sample many different foods if you take just a spoonful of each. Moderation is the key. Eating your food slowly and savoring each bite can also help control your portions and make you feel more satisfied.

4. Trim the fat

Make a conscious choice to limit high fat items, including fried foods, creamy dishes and casseroles, which can be high in potassium and sodium. Take off the skin from turkey and other poultry foods. If you decide to eat roast beef, be sure to trim off any excess fat. When it comes to eating dessert, choose a treat that is kidney-friendly, such as fruit pie, cobbler, angel food cake, pound cake or lemon meringue.

5. Use kidney-friendly substitutions for your meals

Are you cooking a dish for a party and want to make sure it doesn’t pack on the pounds? If you cook, use healthy recipe substitutions for your kidney diet dishes. Listed are some ingredients a recipe may call for and the kidney-friendly substitute to use instead.

Summary

Watching your kidney diet does not have to drag down your holidays. Ask your dietitian about other holiday eating and dining tips. You can look on DaVita.com/Recipes for holiday dishes that are kidney-friendly, too. Following these five tips may help you enjoy a successful holiday season and remind you that you are in charge of your health.

- Reprinted with permission by DaVita Inc.

- Source from www.DaVita.com

People with chronic kidney disease (CKD) often have trouble falling asleep and staying asleep. Your physical and mental health can contribute to your sleep problems. Common causes for disrupted sleep patterns in kidney disease patients include: restless leg syndrome, sleep apnea, inadequate dialysis clearance, emotions, changes in sleep patterns, and caffeine.

Restless leg syndrome

Some renal patients wake up in the middle of the night because of an uncomfortable sensation they feel in their legs. Their legs feel itchy or tingly, or may jerk or move on their own, waking them up. People may even experience leg cramps while they are awake, usually during a hemodialysis session. This is called restless leg syndrome. It often occurs when the legs are at rest, such as when a person is sitting or lying in bed.

Mild cases of restless leg syndrome occur periodically, while moderate to severe cases can occur regularly. The sensation varies from patient to patient. It can be irritating, itchy or painful. Some patients find that moving their legs makes the uncomfortable sensations lessen or go away entirely. Because restless leg syndrome occurs when you are trying to relax or fall asleep, it can leave you feeling tired from lack of rest.

Doctors have pinpointed several factors that can contribute to restless leg syndrome. They are:

• Iron deficiency or anemia
• Caffeine, alcohol, tobacco
• Diabetes
• Certain anti-nausea, anti-seizure and allergy medications

Tell your doctor if you experience feelings in your legs or limbs that prevent you from falling asleep. Your doctor may want to adjust your treatment to ease the symptoms of restless leg syndrome and help you get a better night’s sleep.

Sleep apnea

Sleep apnea is a sleep disorder. It is a condition that causes your breathing to be interrupted or stopped during sleep. Breathing can stop for more than 10 seconds while you are in a deep sleep. These non-breathing intervals are called apneas. They are usually followed by sudden attempts by your body to breathe. One of the symptoms of apnea is snoring. Patients with sleep apnea often snore heavily. The snores continue until breathing is interrupted or stops, which signals an apnea. The person will then snort or gasp to take in air and the snoring continues until the next apnea. Many patients do not remember the apneas they experienced during the night. However, because their sleep is interrupted, they will often feel tired and drowsy during the day.

A slight or complete obstruction to the airways can cause sleep apnea. This blockage can be in your mouth, nose or throat. A doctor can determine if you have sleep apnea by conducting a physical exam and a sleep study. If you are diagnosed with apnea, your doctor can discuss treatment options with you.

Inadequate dialysis clearance

A build up of waste in the blood can cause you to feel ill and uncomfortable. This could make sleeping difficult. If you are on peritoneal dialysis, your doctor will occasionally test your dialysate to make sure it is pulling enough waste and toxins from your body.

Patients on peritoneal dialysis and hemodialysis will also have their Kt/V rate tested. The Kt/V rate tells your doctor how well your dialysis treatment is working. Hemodialysis patients should have a target Kt/V of at least 1.2. Peritoneal dialysis patients should have a Kt/V of at least 2.1. In order to meet the target Kt/V, you should not skip dialysis sessions. Missed dialysis sessions can mean a build up of waste and fluid, leading to other complications besides sleepless nights.

Emotions

Worry, anxiety and sadness can keep you up at night. Also, if you find yourself able to fall asleep, but then awaken in the early morning hours unable to return to sleep, this is a sign of clinical depression. Talk with your doctors and social worker. They are there to help. If your sadness, anxiety or depression lasts more than two weeks, tell your doctor immediately.

Changes in your sleep pattern

Sometimes patients who have chronic kidney disease are more tired than usual. They tend to fall asleep earlier than their normal bedtime or nap during the day. This could affect your ability to fall asleep or stay asleep at night.

Although naps can be refreshing, naps that are too long can interfere with your ability to fall asleep and stay asleep at night. If you are tired and feel that a nap can help you, limit your nap time. Naps that last longer than an hour can disrupt your sleep cycle.

Caffeine

Caffeine is a stimulant; it jump starts your body, making you feel more alert and less tired. Many people drink caffeinated coffee, tea or sodas in the morning to wake up, especially if they have not had restful sleep the night before. This lack of sleep can lead to tiredness later in the day. Some people reach for a late afternoon caffeine “pick me up.” Unfortunately, too much caffeine late in the day can affect your ability to fall asleep later that night. In the morning, the caffeine cycle starts again.

If you’re having trouble sleeping, try reducing the amount of caffeine in your diet.  Keep an accurate food diary to show your renal dietitian. She can help you identify drinks and certain foods that contain caffeine.

For those on cycler-assisted peritoneal dialysis

Patients who depend on Continuous Cycler-Assisted Peritoneal Dialysis or Nocturnal Intermittent Peritoneal Dialysis may find the cycler noises wake them up. Sometimes the sensation of the exchanges can awaken them from sleep.

Many patients grow accustomed to the sounds and sensations of the cycler over time. But if you are losing sleep because of this type of treatment, talk to your doctor about alternatives.

- Reprinted with permission by DaVita Inc.

- Source from www.DaVita.com

I wanted to write a blog about a certain exercise routine that has inspired me lately. MagicKitchen.com is excited about health – and exercise is certainly a part of that!

The exercises I follow are all on www.BodyRock.tv. This is a blog/community led by Zuzanna and Freddy. Freddy films Zuzanna doing workouts for their followers, Body Rockers, to perform as well. They post new workouts a few times a week and there are seemingly endless archives of past workouts to try at any time.

The workouts they provide are “high intensity interval training” (HIIT) workouts. They involve a series of different timed exercises with high and low intensity intervals. The workouts are normally between 10 and 20 minutes long but they will rock your body! You are supposed to push your very hardest for those few minutes and your metabolism will stay elevated for the whole day. Trust me, those 12 minutes will make you work and sweat like you wouldn’t believe.

Zuzanna and Freddy to try post about all aspects about health. They post about self-image,  relationships, and they post all the time about eating healthy. One way of getting their followers to follow a good diet is by creating Diet Challenges. They’ve had challenges to drink enough water, cut out sweets, to eat more tomatoes, and more. These exercise gurus know that eating well is just as important as exercising hard and frequently.

The core of Zuzanna and Freddy’s diet plan is to eat 5 small meals per day and include a serving of lean protein (chicken, fish, low-fat dairy, lean beef, wild game, etc) and veggies in each one. They only approve of eating carbs other than veggies and legumes after working out. Fruits are encouraged in moderation for their vitamin and antioxidant benefits. And of course, drink plenty of water. You may drink green tea with meals and have one black coffee before working out.

Here’s an example of a typical day on their diet and exercise program:

7AM

MagicKitchen Vegetable Omelet http://www.magickitchen.com/menu/breakfast/omelet.html

1 C Strawberries

10AM

½ C Lowfat cottage cheese

2 C Green salad with romaine, carrots, celery, and mushrooms

1 T Oil and balsamic vinegar dressing

12:30PM

12 Minute “What You Want Workout” http://www.bodyrock.tv/2011/08/11/what-you-want-workout/

1  Protein shake

1PM

MK Penne with Meatballs & Marinara http://www.magickitchen.com/menu/Pasta/penne-with-meatballs.html

6 oz Raw carrots and tomatoes

4PM

1 Grilled chicken breast with pesto sauce

MK Beets with Feta http://www.magickitchen.com/menu/side_dishes/Beets_with_Feta.html

MK Spinach Italiano http://www.magickitchen.com/menu/side_dishes/spinach-italiano.html

7PM

2 Stalks Celery

2 T Garlic hummus

MK Bone-in Pork Shank in Bordelaise Sauce http://www.magickitchen.com/menu/main_courses/pork-shank.html

The community on BodyRock.tv is extremely supportive and involved. They post recipe ideas, inspirational stories, and videos of workouts. It is a very well-rounded blog and community. I would definitely suggest that anyone looking to improve their physical fitness and composition should check it out. One video and you’ll be hooked by Zuzanna’s appearance and attitude. Body Rockers everywhere are feeling the improvements to their lives. Don’t you want to give it a try?

Mindy, MagicKitchen.com Blogger