Tuesday, July 24, 2012

Protein and I

According to Health Alicious Ness, these are the ten foods with the highest level of protein:

  1. Cheese
  2. Mature (Large) Beans
  3. Lean Veal and Beef 
  4. Roasted Pumpkin, Squash, and Watermelon Seeds 
  5. Lean Meats (Chicken, Lamb, Pork, Turkey)
  6. Fish (Tuna, Anchovies, Salmon)
  7. Fish Eggs (Roe and Caviar) 
  8. Yeast Extract Spread (aka: Marmite) 
  9. Lobster and Crab 
  10. Lentils, Pulses, and Peanuts   
If you read most websites, they will indicate that protein is the most important factor that should be considered in your diet.  If you are not yet on dialysis, protein intake is limited.  Now that you're in dialysis, protein intake is required, since dialysis takes away protein from your body.

As of now, as I am not allowed meat due to high phosphorus levels (yeah, sucks, right?) I take as much eggs as possible. Poached, not fried.  I take them as snacks. I sometimes eat two at a time.  I have low blood pressure nowadays, so I am not worried about the cholesterol of the egg yolks as of now.

DaVita has a list of kidney-friendly protein foods you can eat, that is, if you don't have restrictions like I do. 

If you cannot have these, or if you are vegetarian, there are lots of vegetables and fruits that has protein.  Again, watch out for your restrictions, i.e. potassium/uric acid when choosing the right kind of veggies/fruits.  Livestrong cited some examples:

Fruits --  apricots, prunes, cherries,  banana (potassium!), papaya, kiwi, avocado, coconut,  dates, watermelon, peaches and tomatoes.

Veggies -- spinach, asparagus, broccoli, cauliflower, potato, celery, kale, celery and carrots.

Legumes --In general, legumes are the best source of non-animal based protein. Examples are soybeans, lentils, black beans, chickpeas, green pea, quinoa, alfalfa, clover, carob, Brazil nuts, almonds and peanuts.

Again, ask your doctor or nutritionist on the amounts of protein you can take every day.  This will be based on your blood levels.

Have a stress-free day!

A Hemodialysis Patient's Diet

Out of all the "problems" hemodialysis patients have, dieting is the most challenging.  There are a lot of food that we cannot eat.  This is one of the three things that a hemo patient should remember:

1. Eat the right KIND and AMOUNT of food.
2. Take the right medicine as PRESCRIBED by the doctor.
3. Do not miss out on hemo sessions.

There are diet considerations you have to remember when you are a hemo patient.  You have to eat foods that are:
  • adequate in protein
  • adequate in calories
  • low in potassium
  • low in sodium
  • low in phosphorus
  • controlled fluid intake
Protein -- necessary for muscle build-up.  Protein is lost during dialysis, so it is necessary to eat the RIGHT kind of protein.  Since meat has high phosphorus content, I cannot eat meat (I have high phosphorus).  I am only allowed poultry and fish.

Potassium -- high potassium can cause heart failure; thus fruits (including juices), and vegetables should be taken in moderation.  I am a little guilty on this, because I am EXTREMELY addicted to green mangoes, and most sour foods.  I will try to consolidate a list of low potassium fruits and veggies in my next post.

Phosphorus -- now, this one I am VERY mad about, because its side effects are nasty.  Phosphorus takes away the calcium from your body, so it is necessary to take calcium supplements.  High phosphorus levels cause eye irritation, ITCHINESS, and joint pain.  Patients are now prescribed with phosphate binders that we have to take with every meal.  It prevents phosphate to enter the bloodstream.  If you have high phosphorus levels, these should be avoided:
  • All sorts of seafood and sardines, anchovies, dried shrimp paste (bagoong)
  • Dairy products e.g. milk, cheese, yogurt
  • Bean products e.g. all forms of nuts, seeds, monggo
  • Malted drinkse.g. Nesvita, Milo
  • Oats, cereals
  • Chocolate (guilty!)
  • Organ meats e.g. liver, intestine
  • Bone-based food e.g. chicken feet and pork bone
  • Softdrinks
Sodium/Salt -- absorbs fluid thus adding to your gain, making you thirsty, can cause high blood pressure.  Hmmmm..... I always have low blood pressure! Do I need salt, then? Ahahahahaha.

Fluid -- as dialysis patients cannot urinate anymore, or do but less, it is necessary to control your fluid intake.  This includes water, tea, coffee, milk, juice, soup, juicy fruits, gravy, condiments, porridge, oatmeal, ice cube, ice cream, gelatine.  High fluid intake can cause your body to swell or bloat.  It can cause shortness of breath and high blood pressure.

Please note, however, that I am a hemodialysis patient, not a nurse, doctor, or nutritionist.  What is indicated here are diet don'ts in general for hemo patients.  It will take blood tests to figure out your levels and what should be really avoided.  Your doctor can refer you to a nutritionist for a diet plan.

I have problems with diet lately, because I am gaining weight I have lost when I got the chicken pox.  I am now eating a lot of rice!  Every dialysis session I check my gain and it's 4 kilos or sometimes more!  The ideal gain should be less than 2 kilos.  This gain causes me to have difficulty during sessions like low blood pressure.  I really should stop eating rice! Wah!!!

I still have high phosphorus, potassium, and uric acid levels.  I am trying very hard to stay away from foods that have rich amounts of these, but sometimes, they cannot be avoided, i.e. no other food to eat, or you're in a party.

I do allow myself to cheat, but not too much.  For example, when we have "nilagang baka," I only eat the vegetables and some soup.  At least I still can taste the beef in it.  The same with "sinigang na baboy."

I now miss eating peanut butter and nuts!  I drool when there is shrimp on the table.  I sigh when I see beef steak.  Yes, these are some of the hardships a hemo patient goes, but still, I am thankful that I am alive.

Friday, July 13, 2012


As my new kidney got rejected, I have to undergo dialysis, which according to Wikipedia is a process for removing waste and excess water from the blood, and is used primarily to provide an artificial replacement for lost kidney function in people with renal failure.

I was advised to do it 3x a week for the rest of my life or until I undergo another transplant. I am doing it for a year now.

The process is simple enough. The machine is primed. Tubes and a dialyser is placed on it. A nurse injects you with 2 big needles connected to tubes which will then be connected to the machine. One tube removes dirty blood from your body, gets circulated and cleaned by the dialyser; and it goes back as cleaner blood to the other tube. The process takes 4 hours.

Does it hurt? Aside from the needle pricks, the process itself should not hurt. If it does, you have to tell your nurse.

Don't you get bored? Luckily, the dialysis center I am in has free wifi access so I can go online anytime. We are also provided with cable tv.

What other problems will you encounter? There's having low or high blood pressure; itchiness; painful cramps; feeling too cold or too hot.

How can you avoid these? Eat a hearty meal before dialysis, meals should be accdg to prescribed diet by your doctor/nutritionist (mainly no meat, no dairy, no legumes); control fluid intake; bring candies so you can raise your sugar level in case you need to; and take your medicines regularly.

How will you feel after dialysis? As you have been sitting for more than 4 hours, you'll feel a need to stretch. Standing should be done slowly because you might feel dizzy and fall. After a few hours, you'll feel hungry and better.

Can you live a normal life with hemodialysis? Sure! A lot of patients still work. Some of them have been on hemodialysis for more than 10 years now.

How do you choose the right dialysis center? I go for friendly and efficient staff first, then cleanliness and facilities. Of course, you also have to think of its affordability. Most centers offer Philhealth packages. Some accept PCSO guarantees.

These are some of the aspects that describe hemodialysis in the Philippines. I'll tackle the hemodialysis patient's diet tomorrow.

Thanks for reading! :)