2023-02-25 - 9:27 a.m.

When people look healthy I swear doctors order routine tests but don't always pay attention to carefully reading the results.

I just saw a new Dr. who is in one healthcare system, where I apparentely also had work done in the past.

Way back in 2011. At that time I was taking Lithium for bipolar.
(It was not that long after the stressful trauma experiences and I was likely then having stress at work that induced anxiety- and anxiety brings on symptoms)

I stopped taking the Lithium when I noticed pain in my left side and was rather sure it was in my kidneys.

But I stopped when I told my Dr. this and I had been doing well and she thought a good idea to see how I continued to do without it.

What I do not recall is any discussion of the results of blood testing. The Dr. does test for lithium levels- as lithium is known to cause damage to the kidneys and has to be monitored. I suppose small amts are seen as OK?

Well I don't know if the general blood work was ALSO reviewed carefully.

Cause this system now has a new MY CHART which is great where one can see all medical records ( from their health care system)

There is only blood work from 2011 and the blood work from this past week's appointment. My current blood work looks good! Iorn is up! *Yeah diet of eating meat much more often as well as taking iron supplements works.

All else looks really good but for a slightly elevated cholestoral (surprise! ) So I need to exercise ( already knew that and started!) And also watch diet (Which I have not done of late. I eat eggs and higher cholestoral foods too often without concern).

That will be easy to correct.

But I was reading about what this is- EGFR cause the # back in 2011 was less than 60 and now it is 105 BIG VARIANCE So wanted to know what the heck that was about.

WOW It was this:

https://my.clevelandclinic.org/health/diagnostics/21593-estimated-glomerular-filtration-rate-egfr

No wonder I was feeling pain in my kidneys. YEAH They were impaired due to Lithium. And I was taking a very LOW DOSE of lithium as well. Serious stuff. The thing is, my doctor and most psychiatrists order an actual measure of lithium to be sure it is not showing up in too high concentrations. There was a separate lithium test and that looked good! I wonder how many also look at that biomarker pf EGFR. I note the level that showed of that EGFR was such that if it remained at that for three months it would be considered moderate kidney impariment. Not good! So good thing I stopped that medication when I felt the kidney pain. But the thing is I was feeling pain as there was already some impariment in my kidney functioning! The concerning thing is it was my feeling the pain that made make that decision, not any doctor reading the blood tests and seeing the red flag.That is what is suprising.

Now Lithium DOES work really well when needed. It works well for my mental health for sure when I was feeling paranoid but thankfully for me I h

I think that is the sad part. Some folks have to choose between risk of kidney impairement , failure and need of dialysis later in life BY CHOICE in order to treat their metal illness as honestly for some that is the less painful long term choice. I mean a quality life for years with that challenge

OR not being stable.

That is when they find nothing else that stablaizes them.

THANKFULLY for me SLEEP , DIET and yeah even feeling well when have lapsed on exercise.... but also Exercise- Keep me stable.

I think writing as well obviously.
The problem is that while journaling may work as well for my Mental Health is does nothing for my PHYSICAL body .

I need to run more and write less in the mornings.

Maybe it is the one last act of defiance as I know I have to cut our fats and pay attention to cholesteral
BUT....

that Tiramisu cake in the refrigerated bakery section was there... half off..

DARN I even forgot to serve it last night when my neighbor and friend Dr. Fauci came over and we enjoyed a visit. I had just put pot pies in the oven and one teen/young adult was down for the count so I did get to share a meal with him. He brought the remains of old boxed wine. A chardonney which after some months in fridge was actually surprisingly still palatable. It was old... he was not sure how old. Thought it might end up as cooking wine. It surprisingly tasted ok so we enjoyed finishing it off along with the pot pies. I have not shared a glass of wine with a friend in a long time, and it was really nice to sit in my kitchen and do so.

I just noticed he has been home alot latetly (see the car) and last we chatted his adult chidren ( son and DIL) were moving in with him along with two dogs and a cat so I sent a text inviting him to stop by if he liked. He just rennovated his house- did a beautiful rennovation. He was so happy to have it done and wanted to start enjoying it and of course then some kids came back home (which frankly is fine with him but the adjustment a little challenging of course. It is just temporary as he helps them out for about a year is the plan). He got rid of the cat and dog perfumed carpet of 20 plus years! (These townhouses all originally had carpeting everywhere. I hate that as it is awful for allergies.) He now has lovely hardwood floors throughout the main level and basement. He discovered the builders used the cheapest possible building materials and there was no insulation in the basement back wall! NO WONDER our houses are so much colder in the basments! (Same constuction)
So he shored up that wall and had decent insulation put in. It was literally cheap grade plywood - unbelieveable.

Speaking of cheap materials. I was really happy with my new roof but when I had the pest control guy come and give an inspection he looked at my roof and asked "hmm.. why did they use plywood?" I looked up and said "I don't know? Did they?" Whatever... I am happy with my roof and hope not consqeuential ( and hope he is wrong though would not be surprised if he is not wrong that the grade wood under the roof should have bene better. I mean I did get the whole roof replaced at far less than most quotes in this area so if they did that with cheaper material underneath that could be a factor. I did what I could afford.). The pest control guy actually was really patient, and slow and thorough. He even went up to the attic and looked at all entry points possible of my house for any potential pest issues. He laughed at my story of the scammer BS artist of pest control dude who some years ago told me I had squirrels in my attic ( when I did not). He in fact KNEW the guy! HE was like "WAs it THis place in Hamilton?"
YES A pest control sales rep/ estimator from the tiny town of Hamilton VA where there is one pest contol company is a Bullshit artist LIAR. The quote that dude gave me was outlandish and he was full of it.

I thought that kinda funny but also sad that the guy is KNOWN by the others in the county for his BS

But ALSO GOOD that enough consumers apparently have called others and let it be know that office is not trustworthy!

*WHY Called it out here! Paramount Pest control Hamilton VA for VA peeps.

I mean that was YEARS Ago and they guy who came even knew which one it was that were liars!(I Had not offered that info just that some dude was full of shit in the past).

OOPS forgot to offer the Tirmisu last night. I should have to get rid of some more of it! (HA and my skinny friend could handle it. He was a marathon runner for years and I swear he NEEDS some meat on his bones. His "dinner" was a hot pretzle and beer. I couldn't NOT feed him once it was clear the kid upstairs was down for the count still and even the smell of pot pie was not waking them.)

So Today's Main thing to be documenting so don't forget.

*AVOID LITIHIUM and if need some help in furture for mental wellness TRY SOMETHING ELSE.
That pain in side was indeed kidney pain and the EGFR level was WAY LOW-- like dangerously low

and I know I was not diligent in getting blood work to test lithium levels when I was supposed to. EEK

I mean I recall I got it done once- but I was on SUCH A low level of Lithium I mean like the lowest possible dose ( I swear microdosing works on me. Just like a freaking half glass of wine gets me buzzed its like microdose of ANY Med works.. I always use LESS than prescribed and feel benefits. EXCEPT Antibiotics which take as prescibed. MY doctors know this and say start with half and see what happens and often leave it at that- the prescription says one thing with the Dr. knowing I am taking less... ) I think I just thought it not likely any concern UNTIL I FELT THE PAIN IN KIDNEY And was bummed.

So this is what that blood test showed. Possible my Pychiatrist SAW that and just agreed when I said having pain that it was a good idea to stop the Lithium but did not MENTION TO ME the concerning test. ( BUT I think she would have told me? ) Possible the Lithium level test ( a different test!) was the only one SHE ordered and the other full CBC which measured GRF was ordered by general MD and case of the tests not looked at together? CAse of lack of intergration and lack of communicaiton betwwein primary and specailaist?

That happens all the too often where there are multiple doctors but they are all looking at certain pieces of the puzzle- that of their expertise but they don't put it all together to look at the BIG PICTURE

Stage 3 (eGFR between 30 and 59) means you have decreased kidney function and may experience symptoms.

So peeps the lesson here is be really ACTIVE in your own health care. If I have learned one thing from having kids with chronic illness it is this:

You do not get proper care unless you actually take it upon yourself to educate yourself and advocate for yourself.

TRUTH
Those with chronic illness have to FIGHT to receive the treatment and care they really need. If you don't do it and are passive, doctors more often than not dismiss symptoms.

So I was happy with the Nurse Practictioner I saw. She was very through. But she did get just couple things wrong in her notes.

I told her of the exposure to chemicals. My friend is a teacher ( math but he is geeky so of course when telling him of this dumb thing I did I knew he would be interested in finding out what gas I created, as my 18 yr old was. I mean we had a funny conversation about CHEMISTRY of what can create... joked and laughed alot as we did so...
hard to describe how and why it was funny but it was
ANd I can NOT LAUGH without having serious trouble breathing

Laughter induces asthma and a horrid cough. I read of it and it is called exposure asthma- damage in lungs essentially which hopefully will heal in time.

Now I liked the Nurse practicioner but she got one thing wrong in the notes..

Q. Productive Cough?

A. DENIEd

mmmm... no not really... I said that there is not much of one, and only a little mucus coughed up only when I lay down to go to sleep at night and upon waking. Then I have VERY LITTLE thick yellow mucus and it is coming from DEEP in my lungs it seems. Not upper respiratory

Not real trouble during the day.

But that nuance did not hit the notes.

She heard a NO as visibly she did not witness such. My oxygen was 100% when measured by the thing on finger tip
and breathing sounded clear to her with no wheezing when she listened to my lungs

ALL GOOD

But still I am refraining from singing for a couple of weeks. I am RUNNING and SWIMMING
but I felt irritation on my vocal chord and feel like chior will be taxing. Give it a rest and then next week go back to chior.

I noticed when sitting at church for Ash Wed services, which I was a Deacon at- helping out on Wed night, and then sat in the pew for the service rather than singing

That when in the PEW and not in an active participatory role it is such a deeper expreience of prayer for me in a way. I mean I get more emotionally touched to be honest and the songs and Pastor's message just HITS differerent when I don't also have to wear the hat of being responsible to DO SOMETHING. When singing I am activeling in thinking mode and it takes such focus to pay attention to the service, to the cues of when to come in- to have the music ready and sight read.

Its so different from active listening.
This is why I avoided joining chior for a year. I put it off. I did not want to join as felt NEEDED that time for deeper prayer. I needed the healing for that first year of finding a church that was so cathartically moving as it is a place I felt I belonged.

I mean it is a church where the mission really is that ALL ARE WELCOME TO GOD'S TABLE

and they mean all.

It is moving that they walk the walk and don't just talk the talk. But it is also hard and heartbreaking at times and deeply important that my church actually addresses the hard realities of the world and does the WORK of dialogue around all the tough issues. And not just a cursorily nod, not a comment here or there. but EVERY Sunday. With EVERY service.
Meaningfully interperting scripture thoughtfully and not in an isolated bubble ignoring the responsibiltuy of trying to be the change in the world.
At a recent sermon the pastor challenged us all-

Would you welcome Tyree here
and the officers who killed him.

I mean she asks the tough questions.
The mission the church set forth is RECONCILIATION

Transformative reconciliation

My church had a speaker come who was a former klansman and I was not yet a member- as this was a good half dozen years ago I think. The church wants to have him back-
but here is one man's journey he is sharing

https://people.com/human-interest/former-kkk-leader-turned-his-life-around-and-now-works-to-help-others-do-same/

Its a church that is active in community and hopes to make a difference and reclaim Christianity as actually following Christ. Christ in humility of loving the poor and socially calling out harm done and disrupting the status quo to seek support and bring all to the table- not just those with money and power.

So it speaks to me as a real church. Not disconnected.

I am happy to have work to do with this church in my own community.

So now- for breakfast. Coffee and tiramusi, a run and then some prep work for a church event tomorrow before I head to work this weekend.

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