Brendan Shea's Blog, page 20

Protein is too high!!!

Excerpt from my new book on living with kidney disease

So, I was doing some volunteer work in town, and I was painting benches for about 4 hours in the sun. Normally I would be okay with that, but this time out I got super weak, and didn’t feel great. 

Later that day I had a routine kidney-related blood test at the hospital, and in between I went and got a burger, fries and a very large drink that I refilled. So I drank about 64 ounces of soda right after doing the work, but when I got to the hospital, they also wanted urine, and I could barely provide an adequate sample. Not to be gross, but I was so dehydrated that it was a problem. 

Later, when I got my test back, my protein level was about 500 and some when it should have been less than a hundred. Now, when I’m considering activities, I don’t want to feel as though I’m useless, but I do tend to monitor how long I work, what kind of weather I work in, and make sure to be hydrated constantly.

More recently, I had to be out in the heat to help repair a household item, and I knew the heat was bad, but felt guilty about not helping out the people working on the item as I am only in my mid-fifties. I did not have that much physical work to do on this project, but I was out in the heat for hours. 

I guess it is my fault, but I got really weak, and my kidneys started to sting. I told the others working that I had to go back in the house and they were understanding.

My one friend on the crew asked later how I was doing and I explained about the heat, but then I looked the issue up online and the internet confirmed and clarified my suspicions:

 Heat stress, which invokes increases in core body temperature, particularly when coupled with dehydration (i.e., a hypertonic, hypovolemic state), amplifies processes that may result in kidney-related pathology, the most notable of which is acute kidney injury (AKI), which is generally defined as an acute reduction in kidney function (AKI)

So if you suffer from CKD, or if you are concerned about injuring your kidneys, please be sure to avoid heat stress, or get your kidney function tested. Before I was aware I had CKD, hospital tests for things like Creatinine, GFR and protein meant little to me; now they are touchpoints for my survival.

ꭥ

“No one ever hates his own body, but feeds it and takes care of it just like Christ does for the church because we are parts of his body.”

— Ephesians 5:29, 30

A Small Excursion

Journal on today’s jaunt

Today I had to de-sap my vehicle. It had been parked in an unfortunate locale, and was laden with muck. Heading to the Shell, I triple-washed the windows, but then felt I’d got a freebie. Needing wiper fluid, the counter man, on selling it to me, asked if I wanted a car wash. I said no, but on filling my car with windshield cleaner, I realized I was headed to Los Gatos, and I didn’t fancy rolling up with grunge on the body, so I circled back and bought my ticket.

The line was long to clean my “bus”, so I put on Felix Francis’, “Crisis” on my Libby app and listened with my hearing aids while running the AC significantly. On rolling through the brushes, my antenna carefully removed and stowed, I wondered if the car would get clean. I’d only used the cheapest cycle, and it had been pretty sticky with grime.

Heading to a book sale, I had to use the facilities, so I got a key at a gas station and took care of business. Wanting to pay for the privilege, I spied my beloved Lenny & Larry’s Snickerdoodle, and it was pricey, but I grabbed one for later. Continuing to Los Gatos, I saw the annual Art & Wine festival in full swing, with a cover band, booths and food trucks. I figured I might get lunch there.

Version 1.0.0

Finding a good parking space a few blocks away from the action, I noted happily, that my jalopy was quite clean. I walked mostly in shade to the events. This was good, as my CKD and being under the sun do not mix very well if prolonged. Struggling to find the sale, my phone told me to turn left at Villa Ave, which if there, was 100% unmarked. Following my nose and tracking with Google Maps, I located a small plaza behind the festival, where a tent stood, with a few ladies overseeing the klatch, and where maybe thirty boxes of books were being perused by various and sundry.

Happy to have landed there without further ado, the sun bearing down pretty well by then, I located a tome on Biblical places, with photos and descriptions. I MIGHT have gotten it were it a less hefty volume, but I live in a small home, and have little shelf space. I kept looking, determined to find something worth buying, and happened on a handsome little hardcover Shakespeare from maybe the 1940s. Then I spotted a Grisham, and later, A.A. Milne’s When We Were Very Young. I am not so young, but it looked like fun, and might have good resale value later if I relinquished it at the bookstore.

I found my fourth book, Kahlil Gibran’s The Prophet, also a tiny hardcover, but it was so nice, and I figured someone might need it more than I did. I am already a Christian, and am not that into most non-fiction so I left it there for someone else. Going up to the “counter”, a few boxes of books on a trestle table, I eventually got the attention of the four ladies there. They encouraged me to get a fourth book, as it would be included in the price, but I thanked them kindly, saying I had what I needed and paid in full.

One of them smiled at me… four for a dollar…

I’ll stand pat

An excerpt from my new book on kidney disease…

So, I figured I could sue my doctor but then I reconsidered. I am a Christian. Does that give me a degree in morality? Not necessarily, but Christians aren’t to sue other Christians. I figure we can’t love people while suing them for the shirt off their backs. If they are Christians or not, and Christians are called to love, I guess I could sue someone and still care about them, but it seems contradictory, and so far, I’m thankful to say, I’m very opposed to a lawsuit.

Not only that, but if I think about the thousands of times I poured salt and butter on my food, the gluttony I struggle with, and the unhealthy eating habits that I have, if I had listened to reason then, when my wife warned me about my dietary mischief, I probably would have maintained a higher GFR1 throughout.

Glomerular filtration rate (GFR) is a measurement of how well your kidneys are functioning. It is the rate at which blood passes through the glomeruli, the tiny filters in your kidneys that remove waste and extra water from your blood. ︎

My main breaker what?

From my 2023 book, Solar 102

One of the dirges of the solar world, or any contracting world, is having to tell people when something they want can’t be had… at least not without spending an inordinate amount of money.

To hack NBT (Net Billing Tariff or NEM3, PG&E’s newest and draconian tariff), one still has to have a workable project, but there are still the same old hindrances, as noted in the last chapter. A customer can have all the usable, south/west facing roof in the world, but if their electrical is not adequate, then savings is possibly out of reach.

As noted before, the pathway of the electrical is key. That pathway is either overhead, to a masthead socket on the roof, which many aesthetically minded people find deplorable, but it could save them thousands… or the electric wiring to the main breaker and meter is underground, usually from the street.

No customer really wants to hear that the project will cost tens of thousands more, so many solar companies just sell the project beforehand. I can’t tell you how many people have come to my company for service, who had nightmare issues with their installer… , ‘the roof type was a no-go’, ‘they didn’t tell me I needed a main panel upgrade’, ‘we didn’t realize the electric meter was too near the gas’. 

People lose tons of time and money to solar companies and other contractors who are dishonest, ignorant or just sloppy. And who picks up the tab besides the customers? Contractors who care. They’re the ones who pick up the pieces, and they’re the ones who might be resented for telling the truth.

So it comes down to one thing: Do you want a tasty lie or a bitter truth? If you’re preparing to buy a solar system, you might get a lower price from some companies, but the headaches that can ensue are often fiscally & operationally painful.

Please click here for a link to my short and concise book, Solar 102: How to Beat PG&E’s Net Billing Tariff, that explains a bit more.

The In-Between Time

A Short Story

Brendan Shea

Mercury Press

No part of this book may be reproduced, recorded or transmitted in any form by any means, without the express written permission of the author, with the exception of a few brief sentences for review purposes.

Text copyright © 2024 by Brendan Shea 

Mercury Press, an imprint of Positive Pres

From a collection of short stories I’m writing:

The In-Between Time

The air had a hint of coolness but it was heating up at only 9am. The crows ‘ghalked’ and the birds ‘yipped’ and the others ‘cheaped’. There was a subtle breeze. No, it stopped.

The woodpecker ‘ohd-ohd-ohd-ohd’d’.

She sat on her haunches like a sentry for her master to return. Children and adults hummed their speech in the distance. The last sound was a soft but insistent droning, over silence, punctuated by the ‘yip’ of some bird, and the buzz of some insect or other. It turned out the droning was a generator on a distant glampsite.

I sat in my folding camp chair, with my book and umbrella, wondering quietly what the day would bring. 

She ambled over and sat beside me. The ‘sunny girl’ now wanted a bit of shade. My wife huffed, “OK”, in the distance; she’d return with good news: “We can move to a shady campsite” (and be shady folks )

A rant on expectations

From my new book on Kidney Disease…

So in the beginning, I was asked a simple question. It was as though I was at the drive-up window at Jack in the Box, and I got to decide if I wanted French fries or onion rings.

I had been diagnosed as having Stage 3B Kidney Disease, and I was scheduled to meet via phone with the Nephrologist or kidney doctor.

I answered my cell phone and my Nephrologist gave his preamble, indicating some key points about the road I was now on, and asked me if I wanted to get a transplant: New kidney, or if I wanted dialysis.

Now I would think that most anyone would prefer a transplant. There might be a few who did not believe in transplants. Jehovah’s Witnesses might not, because they don’t even get blood transfusions last I checked, as they feel their blood would be tainted. But then, they wouldn’t get dialysis either; I feel badly for them. But I would guess there are some others who would opt for dialysis for whatever reason.

But think of it, you could be wired up to a machine overnight, or several times per day at home, or a few days per week at a remote location. This is dialysis. Life expectancy is said to be 10-15 years from what I have read.

Or you could opt for a kidney transplant. The life expectancy might not increase that much, but if the transplant took, and there were no complications (which I understand can occur), you are home free, and do not have to be tethered to a device to cleanse your system for many hours each week for the rest of your life.

Seems like a gimme, no? Transplant.

So I said I’d like a transplant.

Now the doctor did mention transplant would take some time, and that I MIGHT need to be on dialysis for a little time if my GFR fell too low while I was waiting for some angel to drop a kidney in my lap, but the choice between dialysis and transplant was presented as a simple choice, “Fries? Or Onion Rings?”, here dialysis or transplant.

The same doctor said he felt I’d have no trouble getting a transplant in time, but a year or two later, when my GFR had (probably expectedly) gone from 33 to 23, the doctor was not nearly as optimistic. He said I was doing well under the circumstances, but the circumstances were not good. But nothing unexpected or adverse had occurred. I had the same condition that was taking the expected course. So why the change in outlook?

My nurse had told me depressing things in our subsequent consult, but again, the staff of the hospital seemed inconsistent in their messaging. Was the staff thinking I was going to off myself because they told me the outlook was grim?

I had no intention of doing so, but the inconsistent messaging is hopefully not so poor with other patients. I appreciate my doctor and nurse, and commend them for their sympathy, but I am in this fight to win, and whether I win or lose, I need to know where I stand, but recently my doctor seemed grim about the whole thing. Maybe he sees a lot of death and needs to be encouraged.

So if someone presents dialysis versus transplant, know that the choice may not be up to you, but you can assert your preference and try to map things out and follow through as best as possible.

I work in sales support, and in sales, expectation is key. I was selling a product that took 3-6 months processing before the company was able to permit operation of the system/product. If salespeople glossed over that to make the sale, and it took on the long end of that timeline, which happened at times, the customer would be livid. 

I always gave the customer the worst case scenario, and was firm and direct about it. That way, if things took as long as possible, they might not be happy, but their expectations were clear and things went relatively well.

Nobody’s perfect. I just wish the medical profession would be straight with people. Maybe their ability to assess the risk of self-harm or disaster potential was mistakenly applied in my situation… so they were maybe true to their hippocratic oath to protect me, by being less than straightforward… 

Hunan Juan

(Hunan Yuan)

Today, my family took me out to lunch to my favorite Chinese restaurant in California, Hunan Yuan of Redwood Road, Oakland. Szechuan Palace is my other favorite, but I’m not sure if it’s still there. In Park Slope, Brooklyn, in the late 1980s, they served the best sesame chicken on the planet.

I hadn’t been to Hunan’ (I like to call it Hunan Juan, the world’s best Chinese/Mexican restaurant, but they only serve Chinese food) in years, but we had one of the same servers from years ago. The people at Hunan Yuan are very kind and professional.

The food was splendid: I ordered pork fried rice, and my family ordered sesame chicken and an eggplant dish. The fried rice was great, but not heavy on flavor but we didn’t order white or brown rice, and the fried rice was a great foil for the tasty sesame chicken and the succulent eggplant.

Afterwards, we headed down the hill to Piedmont and enjoyed Fentons, a storied creamery about ten minutes’ drive from our lunch destination. The ladies had sundaes, and I went with the apple pie a la mode (vanilla). The crust of the pie was heavenly; it almost tasted like a fresh buttery croissant.

I chose the pie in deference to my CKD, but did not eat much of the bottom crust. The top was delicious and the apples were fantastic.

Later, I got to hug my family before I headed to the freeway to go home. There was a terrible traffic jam on the way, but I got home unscathed, and grateful.

If you’re ever in the Oakland Hills, check out Hunan Yuan, and if you want death by ice cream, Fentons is the bomb.

Who’s the culprit?!

From my new book…

So what caused my CKD? Was it hereditary? Did my lifestyle bring it about? Was it sin? Maybe just something God is using to shape my life?10

Was I wrong to think I did something to deserve CKD or to assume God allowed it to bring me favor through adversity? That is perhaps the subject of a different story, but while God is good, there are consequences to our actions. King David was a man after God’s own heart, and yet some of David’s children were very messed up, and it was a result of David’s sin.11

In 2nd Samuel 13-2412, the Bible illustrates this. I am not a Mormon, but the Church of Jesus Christ of Latter Day Saints has a very effective if brief treatise on this subject.13

For whatever reason, early on in my psychiatric treatment, I was prescribed the drug lithium14. After a couple of years on this drug, my only apparent problem was that I became a very heavy drinker; but my liquids of choice were non-alcoholic. The worst impact I knew of was that I carried, and still generally hold onto today, around twenty pounds of water weight.

On being diagnosed with CKD,  I asked what caused my kidneys to become scarred. It was found that the lithium was to blame. 

In retrospect, I am very grateful to a young psych nurse by the name of Joan. She seemed to think the lithium was not best, for what reason I don’t know, and put me on several large pink pills. 

I took five of them daily for years. The medication is commonly known as  Depakote, and as far as I know, after twenty-five or so years on that drug, it has never harmed me a bit. It can cause liver damage, but Kaiser has monitored it very carefully, and I was taken off of it a couple of years ago as my bipolar symptoms eased, and as I needed to lose a few pounds as well.

Today, I only take one psych med, and my psychiatrist says it is really only to allow my brain to slow down at night and allow sleep. She indicates that psych meds are otherwise medically unnecessary for me today; this is a great encouragement to me, following thirty years of pharmacological dependence on psych pills.I can honestly say that my mental illness has had several long-term ramifications, and the CKD is way up there on the list. Being deemed fit to not take psych meds other than to sleep was a big win to me.

10 For we know that God works all things together for the good, for those that love Him, for those that are called according to His purpose -Romans 8:28

11 From Britannica.com

12 From Bible Gateway

13 From The Church of Jesus Christ of Latter Day Saints

14 Certain lithium compounds, also known as lithium salts, are used as psychiatric medications, primarily for bipolar disorder and for major depressive disorder. Serum levels of lithium above 2.0 mEq/L can cause severe toxicity and additional symptoms, including kidney disease

GFR Blues

From my new book…

So, I downloaded my bloodwork from the hospital website and noticed my Glomerular Filtration Rate (or GFR) numbers from the past five years. The GFR was a normative 60 in the mid to late 2018, but in 2020, it was 53, and in 2021, it was 42, but my doctor never said anything.

My heart jumped negatively. Then, in 2022, it was in the low thirties. That is when my doctor emailed me, ‘flapping his wings’ and crying out, “Warning! Danger!!”. So why did he not tell me at 53 GFR? 60 was the baseline norm (at least for my demographic), so 53 should have meant a test to see if the drop was an anomaly. I asked my kidney doctor and my CKD nurse about this, and they both said it would not have made a difference if I’d known sooner.

But I think it would have because my GFR has been 24 for a year and a half and has not gone down. Why? I asked my medical staff. Diet and medication, they said. So why not start those at 53 or 42 GFR? Why wait until critical mass is reached?

So I don’t know that I’ll try to bring a lawsuit, but I do want to advocate for healthcare providers to notify patients sooner that they may be in danger.

Do the doctors think patients are so feeble that they can’t take the news? Would a doctor not tell a patient they had cancer until the tumor had metastasized? If someone knew their GFR was substantially dipping, they could at least take steps to minimize damage and prepare for the worst.

It could have been me or you…

Since we lost writer Dorothy Miles, today’s Google Doodle subject…

I have to be grateful. She was a sixtyish writer who succumbed to suicide.

I am a straight, male, fiftyish writer who has struggled with psychiatric illness.

She did great things in her life, and her life was important, but my mental malady is largely healed, thirty plus years in, and I am very thankful.

Please feel free to read about Dorothy Miles here.

And here.

Here is a song about it by Kirk Franklin*

God bless you.

(*the song is about homelessness but is the correct sentiment)