Monday, February 10, 2014

Chickens. Roost. You Do The Math

This isn't gonna be easy - parts of my life I have deliberately kept from public consumption, but it's pretty clear now that was more or less a waste of time. So, here goes.

I might be out of the hospital, but it's not because I'm appreciably better. I was admitted because I had congestive heart failure. What that means is that my body was retaining water to the point of ridiculousness. My stomach is extended to the point of distension. When I eat something, I am immediately short of breath because there is just no room in my body cavity for the bottom of my lungs against the diaphragm to expand. Also, I generally find myself in the bathroom within a half hour of eating, regardless. Making room.

So what put me in this state? I'm on diuretics, right? Well, yes I am, but they don't always work as advertised. I've also got by definition kidney disease because of my diabetes, so just increasing the dosage is not necessarily an option. Unless I'm wanting kidney dialysis real bad.

Plus, I've got a leaky valve in my heart. This has been going on for a long time. My previous cardiologist held the opinion that getting it fixed would be riskier than just letting it be. He felt is wasn't serious.

This is in total contrast to the local cardiologist. I've seen him in the past - the other one is from Wichita and I sometimes have to go there to see him. He does come out here to the medical center I frequent once a month. But the local one wanted to see me in short intervals and his lab fees were significantly higher than any one else I'd seen. Since my insurance paid based on their idea of the cost, that meant more coming out of my pocket. I just felt at the time he was breaking me, so I went back to the doctor from Wichita.

The problem with this leaky valve over time is that it allowed backpressure in the system - every time my heart pumps, it pressures up both sides of the system. This is forcing water from my blood into my tissues. My weakened kidneys can't handle it. I actually gained over forty pounds from my first hospital stay to my latest. I can assure you that is not because I was gorging myself at the local buffets.

It didn't help that my company switched insurance companies at the first of the year and I never received a card with the necessary info. So, I had a ton of doctors' appointments that I wasn't about to go to until I got this straightened out. By the time I did, I could barely drag myself to my pickup to drive to Dodge. I did have the foresight to bring my overnight bag, laptop and some other stuff. I figured I wasn't coming home, and I did not.

Back to my water retention - apparently my sodium intake was too high.

Now I'm here to tell you I thought I was doing a good job of avoiding sodium. I do not eat potato chips or other salty snacks. I didn't even have a salt shaker in the house until one of my classmates came to visit for several days, and I knew she's want some salt. My sister even breaks out the salt shaker to season the foods I prepare.

But I wasn't avoiding enough of the "bad" foods. Lunchmeat, bread, canned soups, cheese, sausage, bacon, tomato sauce, salad dressing - man the list goes on and on. It doesn't bother most of the populace, but me it does. A couple of the major offenders I was eating was dill pickles and the instant cup of ramen noodles. I'd eat some Cherub tomatoes and have several dill pickles for my evening snack, and when I was trucking, I'd have pickles packed to go with my deli sandwiches. Which, as it turns out, is actually a tad lower in sodium than regular commercial lunchmeat. Still high, though.

I have switched to fruit (fresh, dried and canned (sugar free)) as a snack, but too little too late. I'd bet my sodium levels are lower than most, but still too high for my weakened kidneys.

Apparently I've been drinking too many fluids, too. I generally went through about a gallon of tea, plus any juices or milk. Rarely any sodas. Which apparently overwhelmed my system.

So what does all this mean for my future?

I'm still weak as hell - and I'm still anemic, for that matter. My red blood cell count is still in the nines when it should be in the twelves and higher. Apparently the kidneys signal the bone marrow to produce, so yeah. Borked kidneys.

So that leaves me in far too poor shape for a heart surgeon to want to screw with. I'm simply not worth the risk to them. Plus, getting that valve repaired is no guarantee that my system won't immediately build up the backpressure again.

So I am on a liquid restriction and a diet. I have to exercise, period. No choice.

I have always approached diet and exercise as something to be scoffed at and never even attempted. Not me, not interested. It's been a way of life since day one, as far as I can remember. I'm sure there are self image problems associated with this self destructive attitude. On top of all that, I am King of All Procrastinators. Why do today what I can put off until tomorrow? And I'm pretty much an anti-social hermit most of the time.

And, my close friends know this. My Cuzzin' Tom stopped in to see me Friday before he helped me get released on Saturday, and he had an intervention in mind. An intervention just like you'd give to an alky or druggy or whatever. He informed me that he wasn't going to stand for more of the same from me - he was there to help and support me, but he'd kick my ass if I didn't reform. He told me that I was a very great person who everyone loves, and he did NOT want to have to explain all of that to someone while he was standing next to my casket. He and my buddy Road Pig hold the opinion that my house burned down so I would learn just how much the community values me.

He's been working on losing some weight and exercising, and he knows the little tricks one uses to motivate. Instead of looking at something as a chore, look at it as something that improves my health. Take every chance to do something on foot every day - haul out my garbage (something I've been too weak to do, and I generally put it in my pickup and drive to the dumpster which is about a hundred yards away), just walk around the area, whatever, as long as I get out and do something. If I'm snowed in or have some sort of weather, just do some stuff inside - as long as I do something.

Needless to say, he got my attention. It was pretty emotional for both of us. Thing is, he is absolutely correct, end of story, no other argument accepted.

I like tomato sauce? Get a ton of roma tomatoes and make it myself. Tomato soup - the same only buy a chicken and boil it, pull the chicken out, remove the skin, debone that for various meals, and cook down the broth - no sodium in that. Chicken broth for the tomato soup. Which is what I did Saturday and Sunday. I made my own tomato soup - actually more of a vegetable soup with mass quantities of tomato. I had chopped up bell peppers, onion, garlic, celery, carrots and such and got it to cooking, and was busy dicing tomatoes and the thought that the chunks would have to be sieved out and what a waste - when I saw my blender staring at me. Problem solved. I used about a cup and a half of my highly reduced chicken broth and have even more saved back, and I've got several meals worth of my own tomato soup. It's kinda spicy, but that's what I was doing with the canned stuff. It's different, but it's fresh, not sugared and salted up. I also found I could use it for flavor in the ramen noodle cups - I'd shake out the freeze dried veggies and then rinse out all the salty dried broth flavor, add the freeze dried veggies back, add some frozen mixed veggies from the freezer, and pour in the tomato soup. Turned out pretty good.

I've also got a big container of chicken salad now - and I used fat free Miracle Whip - which is relatively low in sodium compared to the other stuff. I made chicken breakfast tacos for breakfast - I started out thinking I had the ingredients for two tacos, and it turned into enough for four. In the past, I would have went ahead and made all the tacos I could and ate 'em all - waste not want not, right? Today, I have the makings for another breakfast in the fridge. I used the salad I had already made up for topping as well - perhaps diced carrots aren't necessarily a breakfast item, but they were today on my tacos. I used a griddle coated with butter flavored cooking spray, chopped red and green bell peppers, a small amount of diced onion, some canned sliced jalapenos, two eggs and a ton of spices. I did go ahead and use a small amount of cheese and hot sauce.

And, even though it's really too soon to tell, this all does seem to be working. I lost 3.4 pounds over yesterday morning's weight. My cardiologist told me to be happy with a pound/week - but this is for sure water weight. I kinda had a clue, based on how many potty trips were needed yesterday. The diuretics worked well yesterday. The real test is if that continues - I had days before where the diuretics kicked arse, but maybe only once a week, which was not enough. Plus, several months ago, I had seemingly reached a stalemate losing weight - but that was when I was forty pounds lighter. It seems that once I get so much water off, that's it. Until, I suspect, I knock off some real weight.

I suspect I'll be looking into a lot of things online - like sodium free broth, low sodium soups and so on. Most of what I've seen on Amazon per soups are that the really low level stuff is all vegan organic. Blechhhh. I'm not ordering a case of that stuff until I try a single can from somewhere. And if you look at the labels on, oh, say Campbell's Heart Healthy stuff? Loaded, absolutely loaded with salt. In fact, a lot of that stuff has added sodium to make up for the lack of taste from less fats. That might be heart healthy for some, but not for moi.

The dietician I spoke with told me it was more important to get a handle on portion control that worry about counting calories just yet. Main course meat? Size of a computer mouse. Can't use Montreal Steak Seasoning anymore. Baked potato? One of the smaller taters - certainly not one of the huge baked taters the restaurants serve.

I'm sure I'm going to end up mixing my own salad dressings as well - vinegar and oil and spices I'm sure. I'll be shopping a lot more in the fresh produce sections. Online recipes for ideas, etc.

One thing that really irked me about my convo with the dietician - sure, lots of sodium filled foods are right out - like tons of bacon. But then she advised me to eat sandwiches with meats from the deli, which are lower in sodium than your average Oscar Meyer stuff. Hello? Bread and deli meats are still loaded with sodium - how can that be acceptable? It is, though. Beats me.

So my life is gonna be full of challenges of all sizes, each and every day. I guess one good thing - I was sure counting on lap band surgery to help me out - if I can't hold it, I can't screw it up, right? But if I can control my diet and lose weight in order to make myself healthy enough to be a candidate for surgery, why bother with it? I wouldn't need to go through that if I can diet successfully enough to lose that much weight. I put that in the plus column of future goals.

I dunno. I'm not sure I'm strong enough - but like Cuzzin' Tom says, little steps that I can successfully complete and put in the win column. It's taken a pretty big step just to get to this point - I just hope I can maintain and improve. Two days does not make a recovery.

And let me reiterate that this situation is my fault. Maybe I've got bad genes. Maybe I was raised wrong. Does. Not. Matter. I knew enough that what I was doing to myself was bad for my health, and I did it anyway. Nobody held a gun to my head, nor programmed my mind, or sent out mind control rays, or whatever. It's all on me, myself, and I.

I can take heart in that I am blessed with some very good friends. My buddy Road Pig has tried his own variety of intervention over the years, and I've ignored his advice. My buddy the Young Doctor spoke rather frankly to me several months ago on the subject. And Cuzzin' Tom. And particularly my sister. How can I ever be worthy of these people? Clearly they must be deranged to love me as they do. Boy, do I have the wool pulled over their eyes.

Well, maybe not so much. Maybe it's time I cut myself some slack and learned how to take care of myself not only for my sake, but for theirs as well, and the community as a whole.


threecollie said...

If you can maintain your commitment to making your own foods the way you are, I'll bet you will feel so much better it will amaze you. Whenever we run out of home prepared stuff here, such as when we run out of beef and have to eat store bought sausage or sandwich meat or anything, we all feel terrible. You might ask you diet person if you can use Mrs. Dash seasonings. 0 sodium and very flavorful. I could send you some of the Italian seasoning i put together too, if you would like some. Just send me your addy. It is just oregano, thyme, marjoram and basil, but mixed in the right proportions it is great on meat, eggs, in salad dressing, soup, etc. Let me know if you'd like some. And hang in there. Sounds like you are heading in a great direction.

Jeffro said...

Interesting. Thyme and marjoram I do not have - but when I do Italian I use parsley flakes, basil leaves, oregano, and garlic and onion powder if I don't already have the real thing in the food. Sometimes I also use caraway seeds. I saw them on a Pizza Hut pizza once and thought "why not?"

Then for my Tex Mex taste I use chili powder, basil leaves, cumin, crushed red pepper and cilantro.

I'd think thyme and marjoram would be good on say, a roast. With garlic, of course.

Jeffro said...

Oh, and if you ever want my phone or home address - I have them posted on my About page on Facebook. That's public enough!

Bob D said...

You have great friends and family Jeffro, please keep heading in the right direction. I'll keep you in my prayers.

Bob D.

Earl said...

Well, seems you will have to make a journey back to the old days, when you had to work to work. Looking at the stuff the doctors want, the changes in life you need, it is all good stuff.

I am with threecollie homegrown and homemade will fit your life better, more processing has stuff you don't have time to identify.

About the exercise, start slow, do record your progress - remember you are healing and exercising so don't over do anything.

CGHill said...

The trouble with weight-loss schemes is that there are always plateaus along the way, and they're always discouraging.

I've dropped 68 lb from Peak Weight, and it wasn't a nice, steady decline: it was ten, then nothing for a while, then ten, and so on.

Chas S. Clifton said...

All good plans. Make it yourself, yes, avoid the processed stuff. And good luck to you!

Anonymous said...

...and we are all witnesses of your plans and promises. That was clever, to make yourself accountable, if only to a virtual audience. I would be ashamed to go down on my promises, too (that's why I don't, as a rule).

I always cook from scratch, so can't see how that might constitute a big step for you - but then, I have been doing it for 35 yrs, and now it's second nature. So, Jeff, in 35yrs you will not notice, too!

Will try to think up some no-salt recipes for you - why don't you ask Erica ("Fillyjonk "); she has been on no-sodium diet due to high blood pressure for some time now, she might have already developed a good regimen and rotating menu.

Jeffro said...

if only to a virtual audience

I wrote that for everyone - my feeds are posted on Twitter and Facebook, so there are a lot of people close to me that have seen this and other posts. I meant what I said - that I have only me to blame.

HEATHER said...

Hey Jeffro, I sent you a facebook friend request. I have a great recipe for making your own ranch dressing mix, and taco seasoning mix. They don't have the sodium that are in the little envelopes you buy in the stores. I will be praying for you. When my mama passed it wasn't her cancer, it was kidney failure caused by her diabetes, so take care of yourself!!

Moms Musings said...

It sounds like you have the commitment to stick to your new regimen. Congrats.

Anonymous said...

What's this fixation with whom to blame? Important thing is to work on fixing the problem(s).
You are fortunate that you have this young doctor who is not indifferent, you have friends and relatives who care, and you have a clear plan. I like it that you sound determined and energetic.

Wishing you the best,


Jeffro said...

Sorry, Tatyana- I mistook your meaning. For all this optimism and all I'm really kinda prickly overall....

Anonymous said...

I re-read my comment 3 times and still can't see what could be taken as offense.
Noticed a typo, though: I intended to write "that's why I don't promise". Just in case: supposed to be a joke.

Feel better, Jeff.

Jess said...

As I've aged, one of the most sobering things I faced was how little it takes to keep me alive and not gaining weight.

It's not bad genes; it's good genes designed to survive when meals could be difficult to catch. Unfortunately, our body is too willing to store everything and the result is not always the best.

Hang in there. The toughest part is the toughest part.

drjim said...

You CAN do it, Jeff!

I'm down 15 pounds, well on my way to the 30 my Doc wants me to lose by July.

And all I did was take my wife's advice on how to eat, and stick to it.

I'm a diabetic heart patient too, so I know what you're going through.

Just keep at it one day at a time. Some days you won't see or feel any progress, but the next day you will.

Hang in have a lot of friends out here rooting for you, and praying for you.

Dad Bones said...

That you've educated yourself on your condition and what you have to do to remedy it counts for a lot, Jeffro.

Oh for those bygone days when the open highway was yours and you could eat anything you wanted to. You've got some great memories.

An old barroom brawler who had to face the fact that he was losing and getting hurt much more than he was winning told me that we all have to slow down sometime.

You've had quite a life and still have a million good stories to tell that we all want to hear.